Nityananda's Diagnosis: Assorted Anomalies

In chapter 32 of 'Someone Has Poisoned Me,' Nityananda Das has summarized his medical 'evidence' under the heading "Health Biography Analysis". There he tries to link all of Srila Prabhupada's symptoms to arsenic poisoning. We will show that most of this chapter is total misinformation, and is not supported by any available scientific literature.

Text in italics is taken from Nityananda Das' book

A symptom of chronic arsenic poisoning is damage to the optic nerve, resulting in decreased vision and eventual loss of vision. Damage to the central nervous system resulted in loss of hearing as well

Reference to arsenic poisoning causing blindness is simply not found in the available literature, which includes most of the scientific publications listed by Nityananda Das as references. However, diabetic retinopathy is the most frequent cause of new blindness in adults aged 20-74. Damage is caused by constriction of small blood vessels in the retina, which impairs vision.

In Srila Prabhupada's last month we saw paralysis and extreme pain in one leg, a sign of nerve and muscle damage due to arsenic - SHPM.

In chapter 7 we will explain the well-documented fact that the neuropathies attributable to arsenicosis are seen to be a polyneuropathy (symmetrical nerve damage to both legs and/or both arms), which develops in the extremities and gradually moves inwards towards the trunk. There is a large body of literature confirming clinical polyneuropathy as a symptom of arsenicosis, exemplified in the study of J Oh Shin:

In all cases, arsenic neuropathy was clinically characterised by a subacutely developing, symmetrical sensory-motor polyneuropathy.

And also Ellenhorn in his handbook on toxicology and human poisoning:

A symmetrical sensory neuropathy with paresthesias and loss of vibratory or position sense also develops after chronic exposure.

We could literally fill pages with research papers describing again and again that arsenic poisoning repeatedly produces a bi-symmetrical neuropathy, which gradually causes loss of feeling and movement in the legs, starting from the extremities. This is frequently associated with pins and needles sensations.

Therefore the assertion that Srila Prabhupada's paralysis and pain in one leg is a sign of nerve and muscle damage due to arsenic is either a gross ignorance of the copious clinical evidence on this point or is a deliberate attempt to mislead the innocent reader.

Furthermore, there is specific clinical evidence that a myopathy (disease of muscle tissue) of one thigh muscle is often seen in advanced diabetes, as reported in Harrison's Principles of Internal Medicine (a book quoted by Nityananda as reference):

The only notable myopathy of diabetes mellitus is ischemic infarction of thigh muscles. This condition occurs in patients with poorly controlled diabetes and presents with acute onset of pain, tenderness, and edema of one thigh with a palpable mass. The muscles most often affected include the vastus lateralis, thigh adductors, and biceps femoris.
Harrison's Principles of Internal Medicine

Thus the symptom of extreme pain and immobility in one thigh matches perfectly with the diagnosis of untreated diabetes, while it has no relationship at all to the signs of arsenic intoxication given in the literature.

Some nights Srila Prabhupada was restless and could not sleep, while other times He would sleep most of the night and day. This is peculiar to arsenic poisoning - SHPM

This insomnia/somnolence is again another general symptom. The fact that Nityananda claims that this tendency to occasionally sleep more and at other times be kept awake by pains related to chronic illness is a symptom 'peculiar' to arsenic poisoning is certainly amazing. Not only is this an extremely non-specific symptom, but also in all the literature studies there was not one mention made of arsenicosis causing excessive sleep or inability to sleep in the victims. Therefore it is another completely baseless speculation according to available scientific and medical evidence.

One of the most dramatic and clear indications of chronic arsenic poisoning is Srila Prabhupada's photophobia, or sensitivity of eyes to light. This symptom manifests as a result of arsenic damage to the optic nerve - SHPM.

Again this so-called 'symptom' of arsenicosis is conspicuous by its absence from the available literature. Why Nityananda Das would make up a symptom and then claim it to be 'one of the most dramatic and clear indications of chronic arsenic
poisoning' is not known. However, one thing is certain, it shows a distinct lack of scientific method and impartial search for truth.

One of the main failings of Nityananda's book is the distinct lack of verifiable references. Despite his strong claims, he fails to quote evidence from the scientific literature to substantiate them.

For example, after claiming that photophobia is a clear indication of chronic arsenicosis, Nityananda Das directs the reader to Appendix 22 for "a more detailed justification of arsenical photophobia".

In appendix 22 however, we find that the only reference to photophobia is single line from Forshfvud's book on the death of Napoleon, in which he claims that "compiled from works of standard authorities on toxicology" a symptom of chronic
arsenic poisoning is "sensitivity of the eyes to sunlight or bright artificial light." However, Mr Forshfvud doesn't say where he found this information.

In all of the standard works of toxicology that we studied, there was absolutely no mention of photophobia being a symptom of arsenicosis. A search of the Medline database, which contains every medical paper published worldwide since 1966, did not bring up a single hit for 'arsenic and photophobia'. Compare this to 55 for 'arsenic and neuropathy' and 92 for 'arsenic and hyperkeratosis'. This means that not one paper establishing a link between arsenic and photophobia has ever been published in the history of medicine.

Despite Nityananda's attempt to bring Prabhupada into the conspiracy by portraying him with dark glasses, and his protestations of photophobia being a 'dramatic and clear indication' of arsenic poisoning, the bare fact of the matter is that it is simply not accepted as a known symptom in the scientific/medical world.

Many signs of neurologic damage usually seen in long-term chronic poisoning cases are not documented in Srila Prabhupada's case, probably in part because He departed before they fully developed - SHPM.

To say that someone died of a disease before they could exhibit the symptoms of the disease is a meaningless statement. Death is the ultimate symptom of a serious disease. If someone dies from a disease then there will certainly be other accompanying
symptoms. To say otherwise would be akin to saying that someone died of AIDS before they could exhibit the symptoms of immune system breakdown etc.

Notwithstanding this unsound reasoning, if neuropathy were a late occurring symptom of arsenicosis then we may give some credence to Nityananda diagnosis. However this is not the case as confirmed by Bansal et al:

"It is usually sub-acute prolonged poisoning which affects the peripheral nervous system along with characteristic skin changes such as hyperkeratosis ... Arsenic neuropathy usually appears within one to two weeks following ingestion."

and also by Ellenhorn:

"A symmetrical sensory neuropathy with paresthesias (pins and needles) and loss of vibratory or position sense also develops after chronic exposure."

Chronic (gradually occurring) exposure is exactly what Nityananda Das is propounding. The fact that there was no evidence of polyneuropathy or complaints of pins and needles by Prabhupada is therefore strong evidence that he wasn't suffering from arsenicosis, and to say he passed away before these symptoms could be perceived is neither logically nor medically sound.

That persistent itching of the back being due to irritation and damage to the skin's nerve endings is an arsenic symptom is another total speculation, nowhere to be found in the literature. Returning to actual facts, the American Diabetes Association lists dry, itchy skin as one of the most prominent symptoms of type 2 diabetes mellitus.

As previously mentioned, Srila Prabhupada was undergoing total system collapse of his physical body, which was ravaged by age, untreated diabetes and kidney disease. He frequently remarked that his preference was for massage and chanting of the Holy Name as the best medicine rather than complicated remedies whose effects were uncertain. This was his policy as early as 1967, and it continued right up to the end of his pastimes. The supposition that Prabhupada's desire for massage was due to arsenic is simply another unsubstantiated fantasy.

Constipation is a common occurrence and one may wonder why it is significant in Srila Prabhupada's case study. When constipation is found ALTERNATING regularly with diarrhoea, and in conjunction with all of the other symptoms of arsenic poisoning, it then becomes recognized as an "arsenic" symptom - SHPM

Of interest also is a discussion with Dr. Gopal in mid-October 1977 wherein Srila Prabhupada described a "vomiting tendency", where He regularly felt like vomiting but did not. This is another feature of arsenic poisoning, and is documented in the case history on Napoleon - SHPM.

As we have documented elsewhere, there is actually more literature which debunks the idea of Napoleon's poisoning than that which supports it. We can also look at the transcript of the conversation from the BBT archives to see what was really said:

Dr. Gopal: Vomiting?
Prabhupada: There was some tendency.
Dr. Gopal: There was some tendency, but you never had.
Prabhupada: Had little.
Dr. Gopal: Do you feel any difficulty during urination?
Prabhupada: Not at all...

Prabhupada: Best thing hari-nama.
Tamala Krishna: Best thing.
Prabhupada: Let me hear Hare Krishna and peacefully pass away.

Compare this with the October 20 entry in TKG's diary:

Srila Prabhupada could not sleep during the night. In the morning, we tried to feed him, but he vomited. When Dr. Gopal
came to examine him, he asked, "Can you take anything besides misri jala?" "Yes," Prabhupada answered. "Harinama. Best
thing is harinama. Let me hear harinama and peacefully pass away."

To say that this is evidence that Prabhupada "regularly felt like vomiting but did not" is a misrepresentation. Prabhupada confirmed that he did actually vomit when he had the feeling to, just that it was 'a little'. It should also be noted that this was one particular incident referring to a particular day's symptoms.

If we understand that Prabhupada's condition was a result of his diabetes, the gastrointestinal upsets are certainly no cause for concern. The American Diabetes Association reports that of those people suffering from diabetes mellitus type 2, "Many also feel edgy, tired, and sick to their stomach." Thus feelings of nausea are common to those suffering from diabetes, what to speak of someone in Prabhupada's condition who was experiencing total systemic collapse with little methodical medical treatment.

Arsenic caused Srila Prabhupada's heart to palpitate, quicken its beat, and become irregular in its beat, all noted in the health biography - SHPM

The two major types of arsenic poisoning are acute (appearance of symptoms within hours of a large oral dose) and chronic (gradual onset of symptoms over several weeks following repeated small doses or environmental exposure). It is important to note that the clinical signs of the two types of arsenic intoxication are quite different. We carried out extensive research into more than 50 medical publications, including most of the 24 medical references cited in SHPM. With few exceptions, the references to arsenic-induced cardiac irregularities, especially ventricular dysrhythmia, relate to acute rather than chronic poisoning. Goldfrank's Toxocologic Emergencies gives the typical account of acute intoxication:

Acute toxicity typically begins with gastrointestinal symptoms of nausea, vomiting, abdominal pain and diarrhea ...
Cardiovascular instability often accompanies or quickly follows these symptoms ...Patients with severe poisoning may also develop acute encephalopathy with delirium, seizures, coma, dysrhythmias, fever ...acute renal failure, and death.

The symptoms of chronic poisoning are also commonly agreed on as being; a progressive symmetrical polyneuropathy (gradual loss of feeling, pins and needles in both legs beginning with the feet), dermatological features (scaly rash, dappling
of trunk, thickening of palms and soles), Mees lines (white lines of arsenic deposited in fingernails), nausea and general weakness.

Therefore, the overwhelming experience of experts is that while cardiac effects are often seen in cases of acute intoxication, in chronic poisoning cardiovascular symptoms are far less noticeable, and are extremely unlikely to be seen in the absence of the other more prominent neurological and dermatological symptoms of arsenic intoxication.

Nityananda Das' hypothesis is that Srila Prabhupada was given small doses of arsenic over a long period, thus producing symptoms of chronic, rather than acute poisoning. It is therefore inconsistent with the literature to attribute Prabhupada's cardiac disturbances to chronic arsenicism, in the absence of the other symptoms such as symmetrical polyneuropathy, dermatological changes and nail bed irregularities.

While the literature doesn't support a diagnosis of chronic arsenical cardiac complications without dermatological or neurological signs, there is abundant literature linking diabetes with cardiovascular disease, especially heart attack and stroke.

Coronary artery disease is the most common cause of death in adults with diabetes mellitus. Diabetes mellitus is an independent risk factor for coronary artery disease, and the incidence of coronary artery disease is related to the duration of diabetes.

As discussed in the previous paper, it was common knowledge within ISKCON since 1969 that Prabhupada was a diabetic. He confirmed this fact himself and Dr McIrvine who treated Prabhupada at Watford Peace Memorial Hospital in 1977 also gave the same diagnosis. Diabetes and heart disease are closely related in the literature.

Coronary heart disease (CHD) is the leading cause of diabetes-related death; adults with diabetes are two to four times more likely to die from CHD as their non-diabetic counterparts.

Coronary artery disease and stroke are quite common. Silent myocardial infarction occurs with increased frequency in diabetes and should be suspected whenever symptoms of left ventricular failure appear suddenly. Diabetes may also be
associated with the clinical picture of cardiomyopathy, in which heart failure occurs in the face of apparently normal coronary arteries and in the absence of other identifiable causes of heart disease.

That Srila Prabhupada lived an extremely pure life, never smoked or took alcohol, nor had any other identifiable causes of heart disease is yet another indication that his diabetes was the cause of his repeated heart attacks and stroke.

Prabhupada confirmed the fact that such diabetic heart attacks are generally severe and life threatening, citing his own experience.

He had said that when the heart attack had come, it had been meant for his death; therefore he had called out loudly, "Hare Krishna!" thinking that the moment of death had come.
May, 1967 (Prabhupada Lilamrita).

To say that Srila Prabhupada's heart problems of 1977 were due to arsenic fails to acknowledge the fact that he had displayed these clinical signs for at least ten years prior to this. In fact, details of his symptoms recorded independently in 1967 and 1977 display a remarkable similarity in describing his condition.

During the last week of May, Srila Prabhupada began to feel exhausted. He spoke of heart palpitations. Hoping that the symptoms would clear up in a day or two, Kirtanananda requested Prabhupada to rest and see no visitors. But Prabhupada's
condition became worse.

May, 1967 (Prabhupada Lilamrita).

Working on Srimad-Bhagavatam, he was completely transcendental to his physical condition, despite the accompanying heart palpitations and despite his faint voice and general weakness. Even to sit was difficult, and yet once he began working, nothing could stop him.
July, 1977 (Prabhupada Lilamrita).

Therefore, to say that chronic arsenicosis was the cause of Srila Prabhupada's heart palpitations and other cardiovascular problems of 1977 is to disregard both the available medical literature and the clear historical facts of identical symptoms recorded since 1965. Rather, the cardiac traumas experienced by Srila Prabhupada from 1965 through to 1977 are clearly attributable to diabetes mellitus, which had gone untreated for many years, if not decades.

There were 21 symptoms listed in Chapter 19 which are unique only to arsenic poisoning and are not found in kidney disease - SHPM.

Let's examine each of these 21 'symptoms' separately to see how many really are "unique" only to arsenic poisoning.

1. Photophobia
2. Hoarse, weak or slurred voice
3. Mucous and cough
4. Restlessness, irritability, tossing and turning
5. Hyperkeratosis
6. Drooling
7. Hypothermia
8. Conjunctivitis
9. Loss of vision
10. Heavy with sleep
11. Behavioural changes
12. Mental disturbance
13. Constipation
14. Hearing loss
15. Indigestion
16. Fainting, dizziness
17. Sudden weakness or collapse of legs
18. Painful or malfunctioning liver or spleen
19. Lack of muscular co-ordination
20. Paralysis and pains in legs
21. Loosening and loss of teeth

We could spend days presenting scientific papers which all agree on the specific symptoms attributable to arsenicosis. All the
experts agree they are:

1. Symmetrical peripheral neuropathy (nervous system damage).
2. Arsenical skin lesions, hyperkeratosis (thickening of skin) of palms and soles.
3. Mees' lines (transverse bands of white and dark across the nails).
4. Raindrop hypo-pigmentation of trunk.

Other more generic clinical signs include anorexia, gastrointestinal disturbances, fever, headache, pallor, weakness, and catarrhal inflammations of nose, throat and eyes, hoarseness, tracheobronchitis, loss of appetite, nausea, vomiting and diarrhoea.

In the list of 21 symptoms given above, the one and only specific arsenic symptom listed is hyperkeratosis. Unfortunately for Nityananda's theory, Srila Prabhupada didn't show this symptom even in the slightest. Numerous disciples intimately massaged Prabhupada's hands and feet in his last days, and all attest that the skin was smooth and soft.

As far as the other 20 symptoms go, many of them are totally ambiguous. To say that drooling, constipation, indigestion and fainting are all symptoms unique to arsenic poisoning is really drawing a long bow. Prabhupada was suffering from total systemic collapse due to untreated diabetes and kidney failure, and these symptoms are consistent with this fact. Anyone can see that they cannot be used as proof of arsenic poisoning.

In conclusion, the presentation of medical symptoms as given by Nityananda Das shows serious, irreconcilable flaws in his diagnosis, and exposes grave doubts about his medical credibility. He wilfully neglects to speak according to established scientific evidence, and fails to show that there is any specific medical evidence whatsoever to suggest that Srila Prabhupada was administered poison.


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