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Tuesday, May 17, 2022

Snatching Victory From Defeat

There it was, as I always suspected, in the hallowed pages of a prestigious medical journal: “67 percent of initial disease diagnoses are wrong.” Predictably, the article blamed not the diagnosticians, but the uncanny ability of the body not only to disguise legitimate symptoms but also to present new and misleading ones.

There in the same issue was a lively discussion of intestinal flora, pointing out that of the 600 or more species of bacteria living in your gut, individual microbes numbered more than 10 times all the cells in your body, and performed countless useful functions not foreseen by evolution. The part that really drew my attention, though, was that the relative proportion of the different species varied according to the host’s state of health.

In one of those flashes of inspiration you get between sleeping and waking, I realized that bacteria meant fermentation, and that meant gas. What if every disease knocked off a different species of bug, changing the makeup of total gas produced? Here, then, might be the opportunity to diagnose disease by gas analysis, eliminating the errorprone human element.

Fired by the enthusiasm peculiar to youth, my colleagues and I set out to transform the medical world. We collected intestinal gas samples by the usual method from patients having well-identified diseases, and drew them (the gases) through a gas chromatograph, which separated out each component according to the speed at which it traversed the instrument’s capillary, followed by a mass spectrograph that identified each component by its molecular weight as it issued from the capillary. Presto! It worked like a dream; every distinct disease we tested produced its own unique blend of gases in terms of composition and proportion of the total.

But then the bottom fell out of our world; small procedural changes involving the patient, such as a change of nurses between the initial and confirmation sampling, could alter the diagnosis, sometimes radically. We had run up against the same problem that made seasoned physicians look silly.

Cheated of our anticipated Nobel, after fruitless attempts to stabilize collection procedures, we turned in desperation, though without much logic, to analyzing lung rather than gut gases, and here we struck pay dirt, though not in the field of disease diagnosis.

It seems we all expel exotic gases in our breath, some causing everyone in our vicinity to flee for cover, but others attracting members of the opposite sex like bees to nectar. Predominant among these attractants is oxytocin, a small peptide that in the brain acts as a neurotransmitter but in the body as a hormone. Unusually, the breakdown products only of the brain variety are expelled in the breath, which is perhaps why we are so fond of kissing. However, oxytocin is in no sense an aphrodisiac, but instead creates a feeling of trust in the inhaler, so if you want to improve your love life, you have to be a fast talker.

Clearly, we are onto something that, made up in atomizer form and discreetly sprayed at the right moment, might well revolutionize the relationship between the sexes and could possibly resolve the Middle East problem. Check this column for future developments.

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