The clinician caring for infants and children does not wish to interfere unnecessarily with their diets and thereby jeopardize their nutrition and their development of good eating habits. Yet serious illness may be completely relieved by eliminating an offending ingestant, so the physician does not wish to overlook this therapeutic measure. If he turns to recent medical reports for help, he is confused and bewildered by the varying definitions and by the lack of critical judgment applied to the cases reported. When a patient improves after removing a food from his diet, is it the result of the quantity, quality or pharmacologic properties of the food or because of the psychologic associations with the food? If a purified fraction of the food, administered—withheld—readministered under controlled conditions appropriately produces symptoms, is this an example of intolerance or allergy?
The need is urgent for extensive investigations of the basic mechanisms and for sound clinical studies in the fields of food intolerance and, particularly, of food allergy. Continuation of noncritical attitudes towards food allergy can only further debase this subject and may well lead to neglect of its true value, to the detriment of the patients. "If the gravity of decisions in medical research are greater than in other research, so much greater is the need to plan the investigations for the avoidance of bias and for the elimination of subjective judgments about alternative explanations of the results."
At the present time, one must conclude that the physician should respect the importance of promoting good eating habits and that, while he should readily suspect foods as a cause of symptoms, he will accept this situation only after carefully designed studies of the patient demonstrate it. Otherwise: "Cava medicum, nocere atque sanare potest!" (Beware of the physician: he can harm as well as heal!)
Clinical Studies on the Predisposing Factors of Infective Endocarditis in Infants and Children