This post has little to do with forensic psychiatry but is fascinating. Apart from “eat shit” being a term of abuse it has become a reality in the world of medicine, the latest New Yorker magazine has an article about faecal transplants.
This apparently simple procedure has been life-saving, in particular for people with Clostridium difficile infections due to use of prophylactic roared spectrum antibiotics, the article states that this afflicts more than 500,000 people each year, killing 15,000, almost all hospital patients who received antibiotics. A cottage industry has grown up with friends and neighbours providing the raw material. I was astonished to read that in our digestive tracts there are about as many as 100 trillion bacteria, fungi, viruses, and other tiny creatures and that 40% of faeces is composed of microbes. The first known account of faecal transplantation dates to a fourth century Chinese handbook but for years the only proponent has been Thomas Borody, a gastroenterologist in Sydney who has performed more than 5000 faecal transplants for a variety of conditions including people with autoimmune disorders including Crohn’s disease and multiple sclerosis. It is known that patients with Crohn’s disease have a gut microbiome that is less diverse than average and is lacking in key species of bacteria. A nonprofit organisation has set up an anonymous faecal transplant business with donors such as Vlaidimir Pootin and Dumpledore. The FDA has decided that faeces are a drug! This has the potential to shit on the whole process (excuse me, I couldn’t help it). The implication is that only major pharmaceutical companies with massive amounts of money will be able to fund the FDA requirements. One company is trying to produce an enema derived from faeces and has spent millions of dollars and is very opposed to the work of the nonprofit organisation.