By Arthur F. Coca, MD
Summary: The Journal of Immunology was launched in 1916 and has been a leading publication in its field ever since. If you look up information about the journal’s founder, Dr. Arthur Coca, you will discover some impressive things. After receiving his MD at the University of Pennsylvania and working at the Cancer Institute of Heidelberg, Germany, Dr. Coca joined Cornell University Medical College as an instructor in pathology and bacteriology before becoming a professor of medicine at Columbia’s medical school and, finally, serving as honorary president of the American Association of Immunologists until his death in 1959. What you won’t find in a typical biography of Dr. Coca is mention of the Coca Pulse Test, a simple self-health tool the physician developed to detect “nonreaginic” food allergies, that is, food allergies that are not rooted in an antigen-antibody reaction. Because modern medicine refuses to acknowledge the existence of nonreaginic food allergies, it must ignore the greatest finding of one of its most renowned immunologists. Fortunately, in the following article, you can hear all about such food allergies—as well as how to use the pulse test to determine them—straight from Dr. Coca’s mouth. Moreover, you will discover the same surprise he did in treating his patients: If pulse-accelerating foods are removed from the diet, the body often moves naturally to its normal weight, requiring no caloric or other restriction other than avoiding the allergenic foods. Careful study of the information presented here may well save you, a loved one, or a client, if you are a health practitioner, from years of misdiagnosis and misery. From the Journal of Applied Nutrition, 1954. Lee Foundation for Nutritional Research reprint 100.
[The following is a transcription of the original Archives document. To view or download the original document, click here.]
Overweight and Underweight as Manifestations of Idioblaptic Allergy
The symptom complex categorically known as idioblapsis, a part of allergic disorders, is described. Particular attention with its relationship to over- and underweight is given, with case histories.
General Considerations
Since 1935 a special medical diagnostic art—with special, rigorously tested rules of interpretation—has been developed upon the proposition that the pulse rate is often specifically affected (usually accelerated) by [certain] foods and other substances, which in such a circumstance can frequently be identified as the specific exciting causes of a number of life-spoiling and life-threatening conditions (migraine, eczema, epilepsy, multiple sclerosis, circulatory hypertension, diabetes, and others).
This special method is practiced essentially by exposing an individual to various foods, inhaled substances (especially tobacco smoke), etc., by observing which of these cause acceleration of the pulse rate, and by advising the individual to avoid them. If under such avoidance any abnormal condition disappears, then that condition is provisionally classified as a local manifestation of a hereditary disease entity that has been named idioblapsis, or idioblaptic allergy. (More than 90 percent of the white population has been found to be affected by this disease1). This classification is confirmed if the condition promptly returns upon reexposure of the individual to the pulse-accelerating materials. This confirming experiment is frequently omitted in practice.
It may not be superfluous to describe briefly the routine practice of the pulse-dietary technique that has been found useful in most cases and to list a few helpful rules of interpretation.
When the patient telephones for his first appointment, he is given the following instructions:
1. He must stop smoking entirely until the cigarette test, which will be made later.
2. He counts his pulse for 1 minute:
- Just before each meal
- Three times after each meal, at half-hour intervals
- Just before retiring
- Just after waking, before rising, in the morning.
All pulse counts are to be made sitting except the important one upon waking, which is made recumbent, before sitting up.
3. He records all the items [ingested] at each meal.
4. He continues these pulse-dietary records for three to five days for the usual three meals.
5. He then makes single-food tests for one or two whole days as follows. Beginning early in the morning, after the “before rising” count, and continuing for 12 to 14 hours according to circumstances, he eats a small portion of a different single food every hour; for example, slice of bread, glass of milk, orange, 2 tablespoonfuls of sugar in water, a few dried prunes (or a peach), egg, potato, coffee, meat, apple, banana, etc. He counts the pulse just before each eating and again one half-hour later.
6. He brings the whole record with him for his first appointment, which usually lasts 2 or 3 hours and which is not spent in examinations (those having been made by other competent physical diagnosticians) but in explanations of the pulse-dietary method.
A physician who is experienced in the interpretation of the pulse-dietary record can usually determine from the examination of the records at the time of the appointment whether the solution of the case will be relatively easy or difficult. A few easy cases have been entirely solved at this single appointment, the resulting instructions having brought complete and lasting freedom from all the allergic symptoms.
The following tentative rules of technique and interpretation of the pulse-dietary record may be helpful to those who are beginners in the art. One must not, however, forget the occasional exceptions to these rules.
Rule 1. If the pulse count taken standing is much greater than that taken sitting, this is a positive indication of present “allergic tension” (Sanchez-Cuenca).
Rule 2. If the daily maximal pulse rate is constant (within one or two beats) for three days in succession, this indicates that all food-allergens have been avoided on those days.
Rule 3. If the ingestion of a frequently eaten food causes no acceleration of the pulse, then that food can be tentatively considered nonallergenic for the individual. (Exceptions: (a) latent sensitivity to a “minor” food allergen (b) shock tissue “exhausted” by a recent major reaction.)
Rule 4. If exposure to “house dust” causes irregularity of the pulse, this regularly excludes the [individual’s] commonly eaten foods as allergens, since house dust is, at least usually, a “minor” allergen, hence it does not affect persons who are protected by stronger reactions.
Rule 5. The pulse reaction to an inhalant allergen is more likely to be of shorter duration than that to a major food allergen.
Rule 6. Pulse rates that are only 6 points above the estimated normal daily maximum should not be ascribed to foods but to an inhalant.
Rule 7. If the minimum pulse rate does not regularly occur before rising after the night’s rest but at some other time in the day, then this usually indicates sensitivity to the house dust in bed mattresses or pillows.
The record of one relatively easy case (Tables 1 and 2) illustrates the problem of interpretation. In this case the single-food testing could be omitted.
Case History of Mrs. E.E.
Mrs. E.E., age 32, gave an allergic history of urticaria (twice after having eaten shrimp), canker sores, abnormal tiredness, and headaches with vertigo. Her chief complaint was an unsightly and annoying eruption about the mouth and chin, which was more pronounced at the time of the menstrual period and was completely absent during her pregnancy. There were papular elevations set in flat areas of congestion, which varied in color from pale pink to rather “angry” red.
Over a period of 12 days, the patient noted, with more or less regularity, the routine pulse rates and the items of her usual diet. Part of this record is presented in Tables 1 and 2. The record is remarkable for the extent of information it contains both as to the allergenic and the nonallergenic foods for this patient. No less than nineteen foods can be seen in Table 1 to be probably nonallergenic (confirmed in Table 2), while six can be identified as most probably allergenic.
Table 1. Pulse Record of Mrs. E.E. on an Unrestricted Diet
| May 11 | May 12 | May 13 | May 15 | May 17 | May 19 | May 20 | |
| Pulse | Pulse | Pulse | Pulse | Pulse | Pulse | Pulse | |
| Before Rising |
61 | 57 | 64 | 56 | — | 70 | 66 |
| Breakfast | 68 | 70 | 70 | 69 | 75 | 74 | 68 |
| +30 min | 75 | 74 | 73 | 78 | 71 | 74 | 76 |
| +60 min | 80 | 78 | 76 | 75 | 71 | 77 | 73 |
| +90 min | 76 | 71 | 81 | 73 | 62 | 72 | 68 |
| Diet | orange, coffee, wheat cereal |
pineapple, bacon, egg, bread, coffee, crabapple jelly |
apricot, bread, wheat cereal, crabapple jelly, coffee |
apple-sauce, cinnamon toast, coffee, sugar |
wheat cereal, coffee, (fudge) |
egg, grapefruit, wheat cereal, apple butter, coffee |
egg, coffee, coffee cake |
| Lunch | – | 75 | 69 | 68 | 80 | 68 | 74 |
| +30 min | – | 89 | 65 | – | – | 76 | – |
| +60 min | – | 75 | 74 | 78 | – | 78 | – |
| +90 min | 69 | 71 | 82 | – | – | 74 | – |
| Diet | beef, macaroni, tomato, lettuce, cucumber, vinegar, pepper, potato, coffee, butter |
chicken, noodle, tuna fish, milk, bread, lettuce, mayo, olive, chocolate, pickle |
tomato, potato, carrot, pea, cake, cream, wine |
clam chowder, liver- wurst |
tomato, cheese, rye bread, tea, cheese-cake |
chicken, rice, cream cheese, apple butter, tea |
beef, potato, tea, tomato, marsh- mallow, chocolate pudding |
| Dinner | 65 | 70 | 60 | 65 | 64 | 76 | 66 |
| +30 min | 69 | 73 | 64 | 66 | 68 | 78 | 68 |
| +60 min | 68 | 74 | 68 | 84 | 68 | 75 | 66 |
| +90 min | 63 | 69 | 62 | 65 | 64 | 72 | – |
| Diet | tuna fish, olive, tomato, celery, mayo, apple juice, potato |
lamb, potato, barley, pineapple, walnut cake |
lamb, barley, macaroni, spinach, celery, milk, coffee |
beef, potato, milk, spinach, peach, cake, cinnamon, coffee, sugar |
ham, potato, carrot, apple, peach, cream, cake, coffee |
mackerel, tea, potato, tomato, ice cream |
beef, potato, corn, coffee, chocolate pudding, marsh- mallow |
Table 2. Pulse Record of Mrs. E.E. on Selected Diet
| May 29 | May 30 | May 31 | June 1 | June 2 | |
| Pulse | Pulse | Pulse | Pulse | Pulse | |
| Before Rising |
– | 60 | 58 | 58 | 60 |
| Breakfast | – | 66 | 68 | 67 | 68 |
| +30 min | – | 67 | 60 | 69 | 68 |
| +60 min | – | 70 | 62 | 70 | – |
| +90 min | – | 66 | 61 | 68 | – |
| Diet | – | pep cereal, coffee, bread |
pep cereal, coffee, sugar, bread |
pep cereal, coffee, cake |
wheat cereal, coffee |
| Lunch | 62 | 64 | 66 | 64 | – |
| +30 min | 65 | 66 | 66 | 66 | – |
| +60 min | 68 | 69 | 68 | 68 | – |
| +90 min | 66 | 68 | 70 | 64 | – |
| Diet | apple, lettuce, mayo |
beef, potato, carrot, onion, corn, coffee, apple pie |
lettuce, bread, mayo, sardines, apple juice, rice |
carrot, beet, lettuce, mayo, apple juice |
– |
| Dinner | 66 | 64 | 66 | 64 | 66 |
| +30 min | 62 | 62 | 68 | 68 | 68 |
| +60 min | 64 | 64 | 68 | 66 | 68 |
| +90 min | 60 | 60 | 66 | 64 | 64 |
| Diet | beef, potato, corn, coffee, apple pie |
lamb, tomato, potato, coffee, apple |
tomato, lamb, potato, coffee, beets |
ham, potato, carrot, apple, mayo, coffee |
beef, carrot, pepper, lettuce, potato, applesauce, coffee, mayo |
| Upon Retiring |
60 | 58 | 60 | 60 | 62 |
[Tables] reprinted by permission from Familial Nonreaginic Food Allergy, 3rd Edition, by A.F. Coca, Charles C. Thomas, publisher, Springfield, Illinois, U.S.A.
Taking 56 provisionally as the lowest [pulse] count and adding 12 beats as a possible normal range produced 68 as the estimated normal maximal count. It was then noticed that after dinner on May 11, 13, 17, and 20, the count did not exceed 68 or 69, which suggested that no allergenic foods were eaten at those meals. The patient was thus instructed to limit her diet to the items contained in those four meals, which she did on the five days from May 29 to June 2.
It is seen that on the three days on which the record was complete [May 30–June 1] the maximal rate was the same, 70, indicating that no allergenic food was eaten on those days. The highest count on the other two days was 68, also indicating an allergen-free diet. The normal low count turned out to be not 56 but 58.
It is seen also that in a number of instances, the abnormally high counts could he attributed to individual foods in the respective menus that are not included in the list of nonallergenic foods: orange (breakfast, May 11), pineapple (breakfast, May 12), apricot (breakfast, May 13), cinnamon (breakfast, May 15), grapefruit (breakfast, May 19), chicken (lunch, May 17, May 19).
It is noteworthy that this patient (like another, who has confirmed the observation in several tests) can eat peach (dinner, May 17) but not the closely related apricot. The patient continued to avoid five of the six items just mentioned, occasionally eating chicken, which has not affected her skin. Her eruption gradually disappeared, and it has not recurred in the succeeding two years.
Scratch tests were carried out with concentrated glycerinated extracts (Lederle) of orange, pineapple, cinnamon, chicken, and the glycerine-control solution. All of these tests gave negative results. This patient did not consult a dermatologist, hence a dermatologic diagnosis cannot be offered.
The record would seem to indicate that the pulse in the individual was not effected by digestion, ordinary physical activity, or psychological influences. The 5-day record is that of a wholly nonallergenic normal pulse that reaches its exact maximum (70) at least once every day. There is not even a need for the usual statistical consideration of observational error. One sees also that the variations of the counts within the normal range of this patient’s pulse rate (58–70) are of no medical diagnostic significance.
Overweight
The public is being taught through the several media of communication in the United States that overweight is due to overeating, and this impression is confirmed in the common advice by physicians to cardiovascular cases to “lose weight.” That advice implies that overweight is subject to the willpower control of the patient, and it is generally supplemented with specific instructions to reduce the caloric intake.
Yet experience with the use of the pulse-dietary survey and the avoidance of all pulse-accelerating foods with patients who happened to be “overweight” indicate that this condition is a manifestation of idioblaptic allergy. In short, persons with various “chief complaints” (indigestion, migraine, eczema, hypertension, etc.) who have identified and avoided all their pulse-accelerating food allergens, and so have been entirely relieved of their chief symptoms, have reported with some astonishment that they have lost their excessive weight in spite of an unrestricted caloric intake.
Some medical authorities limit their nutritional attention to what may be called “obesity,” that is, the extreme cases of overweight, paying no attention to the lesser degrees that are sometimes referred to as “pleasing plumpness.” Among the listed “causes” of obesity are mentioned “endocrinopathy,” involving especially the thyroid and pituitary glands, and the “endocrine imbalance” of women in the child-bearing period. However, there is no surmise as to the cause of these “causes,” and the usual “treatment” of the overweight consists of the restriction of caloric intake, which cannot be thought to correct the reputed endocrine abnormality but serves merely as asymptomatic corrective—which, by the way, is the principle of most of the therapy of the chronic illnesses.
A few brief case histories will illustrate the principle of the food-allergic (idioblaptic) etiology of overweight.
Case 1. Mrs. G.J., age 33, had experienced urticaria and occasional canker sores and was annoyed by an estimated overweight of 10–15 lb. Her chief complaint was a dry, scaling, peeling fissured dermatitis of the hands. There was occasional itching. Her normal pulse range was estimated as 62–74. Her food allergens and, respectively, observed pulse maxima were: sugarcane (92), corn (84), pea bean (82), peanut (82).
These four foods were regularly avoided after March 11, 1946, and the dermatitis soon disappeared. On September 24, 1946, her hands were still quite healed, and they have remained free [of dermatitis] since then with one exception. On that occasion she tested cane sugar once, and the dermatitis began to appear on the following day. She eats corn, pea, and bean very seldom, and no dermatitis follows these single tests, although the pulse is markedly accelerated by corn and mildly so by pea and bean. She has lost 12 lb of her excessive weight. Cutaneous tests with the four pulse-accelerating foods gave negative results.
Case 2. Miss A.C.M., age 50, height about 5 ft 3 in., complained of migraine (left-sided with vomiting, marked abnormal tiredness, neuralgia, constipation, chronic rhinitis, and occasional vertigo). The pulse-accelerating foods were found to be cow’s milk, cereals, cane sugar, citrus fruits, beef, lamb, fish, and yeast. After avoidance of these foods and the substitution of goat’s milk and beet sugar, her pulse range was 64–80, and all of the aforementioned symptoms ceased. There had been a moderate overweight at 139 lb. In the first week of avoidance, there was a loss of 4.5 lb of weight, which was interpreted as a loss of water associated with allergic edema. In the next 3 weeks, there was a gradual weight fall to 129 1/2 lb, where it remained stationary. Her diet, which she ate with no restriction of quantity, comprised goat’s milk, beet sugar, egg, pork, potato, yam, banana, tomato, pea, bean, carrot, spinach, date, prune, apple, and lettuce. It is pertinent to emphasize that this patient always ate to her appetite’s content, never concerning herself about her caloric intake, particularly with respect to carbohydrates and fat.
Case 3. Mrs. M.D.B., age 74, height 5 ft 3 in., complained of “bilious attacks” with fainting spells, abnormal tiredness, constipation, migratory neuralgia, and heartburn. Her obesity was considered by her to be a natural accompaniment of her age. After avoidance of her pulse-accelerating foods (milk and other dairy products, citrus fruits, carrot, beet, spinach, asparagus, and onion), all of the aforementioned symptoms ceased and her weight dropped—rapidly at first, then gradually—from 185 to 152 lb, where it has remained stationary through the years since 1941. Carbohydrates and fats have been unrestricted.
Case 4. Dr. C., age 75, height 5 ft 7.5 in., had controlled his numerous allergic symptoms (migraine, vertigo, hypertension, etc.) by limited sympathectomy followed by avoidance of pulse-accelerating foods and inhalants. At that time (1950), he was somewhat concerned over a moderate obesity (168 lb). Suspicion was directed toward strawberry, which only occasionally seemed to cause gastric discomfort—the pulse being affected by unidentified inhalants and so not an entirely dependable criterion. Strawberry was finally eliminated from the diet, since when the weight soon fell to 154 lb, where it has remained through the succeeding years. Carbohydrates and fats have been quite unrestricted.
Case 5. Mrs. L.A., age “over 50,” height 5 ft 10 in. The outstanding complaints were her overweight (235 lb) and a marked abnormal fatigue and weakness. There was also a circulatory hypertension of 190/110. The food sensitivities were few and negligible with respect to this inquiry. She does not eat walnuts and pecans “because they do not agree,” and she avoids beets, spinach, and cherries, which “make her stiff and sore.” An exhaustive pulse-dietary testing over a period of years has revealed no other pulse-accelerating food sensitivities. Consequently, there have been no other dietary restrictions.
However, there are a number of inhalant sensitivities, and some of these excitants are difficult or even impossible to avoid entirely. Among these are: some pollens that are prevalent throughout several months of the summer; house dust, which seems to have been a major excitant and which has been largely curbed with Dust-Seal; and coal gas, which it has not been possible to avoid completely. Contact with the pollens has been lessened through the use of air filters and closing doors and windows of the house during the day.
After such measures were instituted, the blood pressure fell to 180/85, then 160/95, and the weight has lessened by 25 lb to 210 lb, which is still definitely “overweight.” Also, the patient’s fatigue and weakness have been greatly relieved. There has been no medication in this case. The normal pulse range that now frequently prevails is unusually low, 40–51. Previous to the institution of the measures of inhalant avoidance, the pulse was commonly between 60 and 70, occasionally [as high as] 78.
Underweight
Case 6. Mr. A.R., chemist, age 28. In August 1939 he said that over the previous six months he had suffered almost constant severe headaches, nervousness, chest pain, extra systoles, vertigo, heartburn, occasional abdominal pain, and neuralgia of legs and arms. In that interval he had lost 25 lb of weight. Only two food substances accelerated his pulse—milk and yeast. Upon avoidance of these, all of his symptoms ceased, some of them recurring briefly immediately after the unwitting consumption of milk in an omelet, which [he had] taken [to be] pure egg. Within about two months, his weight had increased by 25 lb to an estimated normal height-weight ratio. Unfortunately, this man’s record has been misfiled, and the exact weights and measurements are not accessible.
Case 7. Mr. A.L.K., age 54, height 5 ft 10 in., came for consultation on October 7, 1946, suffering from a dry, scaly, slightly inflamed eruption affecting the ears, arms, body, and legs. He was obviously undernourished, weighing 140 lb, which is about 30 lb under the estimated normal weight for a man of his age and height (see Thomas D. Wood in Cyclopedia of Medicine, vol. 3, p. 525). His blood pressure at his first visit was 180/108. Two weeks later, it was 176/100. His company physician found it [to be] 160/90 at that time.
His pulse-accelerating foods [were found to be] eggs, fowl, fish, pork, beef, lamb, coffee, corn, potato, onion, and asparagus. Since elimination of all of these foods from his diet, he has depended for protein on milk, cheese, pea, bean, peanuts, and other nuts. Improvement of the dermatitis was noticeable on October 20, with marked improvement 5 days later and complete healing thereafter. By October 25 the company physician found his blood pressure to be 156/86 and, 11 days later, 128/78.
On February 17, 1947, the patient reported recurrence of the dry, scaly eruption on the left hand, legs, and body. The blood pressure had risen to 160/84. He stated that he had been indulging for some time in wine without making the customary pulse test, and he agreed to discontinue it. This he did, and on March 9 he reported that the eruption had again disappeared and that his company physician had found his systolic pressure to he 130. Since that time there has been no recurrence.
Notwithstanding the sharp restriction of his diet, he gained 12 lb weight in the first three weeks of “specific food avoidance,” and since then he gained an additional 13 lb, arriving at a stationary 165 lb, which is near the estimated normal.
Case 8. Miss R.E.A., age over 40, height 6 ft, had suffered anginal pain (no electrocardiographic examination), fatigue, tachycardia, arrhythmias, anorexia, and vomiting without nausea. She had lost 46 lb of weight from an original underweight of 126 lb to [weigh] about 80 lb. She regained 40 lb of the lost weight in the next 5 years, due, she believes, to the “accidental” avoidance of inhalant allergens—“exposure to certain perfumes causes marked, prolonged anorexia for two days.”
She then began to apply the pulse criterion in the identification of specific excitants, though depending usually on symptomatic consequences in final judgment. Upon avoidance of pecan and walnut, ginger, chocolate, commercial candies, salad dressings, ice cream and jellies, etc., and also “house-dust” (by Dust-Sealing), pollens, and perfumes, her weight gradually increased by an additional 20 lb to 140 lb at the present time. Her general health and well-being are greatly improved.
Comment
The foregoing case histories, which have been selected from a somewhat larger number of similar ones, suggest that both overweight and underweight may be manifestations of the recently recognized category of allergic disease named idioblapsis. It may be reasonably surmised that the overweight in the described cases represented not only the abnormal deposit of fat due to some allergic derangement of the organs (endocrine?) that control that function, but also a diffuse deposit of allergic edematous fluid.
Underweight, on the other hand, would seem to be caused by some allergic interference with the normal utilization of the food consumed or by allergic anorexia.
Knowledge concerning the exact manner in which these opposite effects are produced would seem, for the present, of less practical importance than the observation that both may be corrected through avoidance of food allergens identified by their constant pulse-accelerating action.
By Arthur F. Coca, MD, FACA (Honorary), Oradell, NJ. Reprinted from Journal of Applied Nutrition, Vol. 7, 1954, by the Lee Foundation for Nutritional Research.
References
1. Coca, A.F. Familial Nonreaginic Food-Allergy, 3rd Edition; Charles C. Thomas, publisher, Springfield, Illinois, U.S.A.
2. Sanchez-Cuenca, B. Problems Actuals de Alergologia Clinica; Editorial Saturnia Calleja, S.A., Madrid, 1954.
3. Storck, Hans. International Archives of Allergy etc., vol. 3, Supplementum, 1952.
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