INTERVIEW HEINZ SPRANGER

By Heinrich Hunger

Oct. 2001

Professor Heinz Spranger is a German Nosologist and Semiotist, and a Practitioner in Periodontology and Oral Medicine. He is the Vice-President of the German Employers Association of Medical and Non-Medical Health Practitioners, the Head of the Academy of Systems Sciences, a former founder and Dean of the Faculty of Oral Medicine at the University Witten/Herdecke, and the former head of the Department of Periodontology and Oral Medicine, at the Johann Wolfgang Goethe University Frankfurt/Main. He is also a member of the Group for the Reappraisal of the HIV/AIDS Hypothesis, and a member of South Africa's Presidential AIDS panel. Prof. Spranger was awarded the German Ribbon of the Order of the Distinguished Service Cross (Verdienstkreuz am Bande des Verdienstordens der Bundesrepublik Deutschland) in April, 2001 for his humanitarian scientific efforts.

Interviewer: "Professor, can you tell us a bit about yourself?"

Prof.: "I worked in the field of Periodontology and Periodontics between the years 1968 and 1988. First as a clinician at a clinic in Berlin, afterwards as the head of the department of Periodontology in Frankfurt/Main, and later at the University of Witten.

It was my work to create and categorize a German medical nomenclature. This was done with international coordination, so that it is more comparable with other nomenclatures. If the nomenclature is the same in all countries communications becomes easier.

As associate of Professor Leiber, pediatric nosologist and semiotist in Frankfurt/Main, I achieved the reputation of a medical semiotist specialized in oral medicine."

Interviewer: "What does a medical nosologist and semiotist study?"

Prof: "Nosology and semiotology are Systems Sciences. Nosology is the science of the designation and the classification of diseases. Semiotology deals with the description of clusters of already named symptoms.

In our field the theoretician needs a good basic training in biology and medicine. He must be able to compare, and when needed, arrange independent investigations. Therefore my department in Frankfurt also had its own research lab, and we co-operated with other universities and other countries too."

Interviewer: "Professor, as we know, you got through four fields of a university career: Teaching, scientific work, practice of Oral Medicine and administrational work. Where and when did you become interested in AIDS"

Prof: "During my teaching of Periodontology and Oral Medicine, when explaining the microbial aspects of the oro-pharyngeal flora, I followed my concept of the mucous tissues barriers.

This concept is that resistance against disease is provided by four barrier layers of protection, that must remain intact. These are jointly known as the 'inner human surface'. 1. The superficial microbial bio-film as a contamination barrier against extraneous influences of a passenger microbial flora. 2. The density and thickness of the epithelium as a barrier against the inflow of toxins. 3. The phagocyte activity of lining cells in the papillary connecting tissue. And 4. The immune capacity of lymphocytes in the reticular connecting tissue.

Life-style-habits that damage these barriers, or the use of toxic agents for treatment, contaminating the inner human surface, are unacceptable for the maintenance of human health. All of our periodontal and oro-pharyngeal treatment concepts fundamentally involve the correction of the function and density of those barriers.

This concept had another consequence: We learned to work on opportunistic diseases by strengthen the resistance with all kinds of biological medicine.

So, when I started to investigate the so-called AIDS-indicator diseases within my field of Oral Medicine, I had to divide the "syndrome" into the basic symptoms of several well-known diseases.

I could assume that, treating the symptoms of these diseases with respect to the human ecology on one side and to the living system on the other side step by step, we had success. We did not need to explain this syndrome as a result of contamination by a "new" type of virus, and to fight against it by using agents, which are toxic for the resistance barriers and are reducing the immunologic activities too."

Interviewer: "What was the impact of AIDS on your practical work?"

Prof.: "My clinical work depended on both the personal contacts with my patients, and on my role as head of a clinical department. So I had to care for my own HIV-positive patients, as well as for the other HIV-positive patients attending the clinic. We took care of the environment, the lifestyle, and the opportunistic diseases of our patients by information, active prevention and professional treatment with success.

In the same 12 years, the time when I was chairman of the German commission for the approval of dental and medical equipment, the German Dental Association set up a commission for the assurance of hygienic care in dental practices. The technical members of this commission gave directions for the treatment of HIV-positive patients; fearing a virus they recommended that dentists, periodontists and their hygienists dress up 'in latex' for fear of an HIV infection.

My administrative work became very difficult because of these theories when some dentists in the midst of the 1980's refused the examination and the treatment of HIV-positive persons. Therefore our clinic had to act as a diagnostic and treatment centre for those people too. We took care of our patients with so-called AIDS-indicator diseases and opportunistic infections as usual. We took care, of course, to ensure the aseptic, antiseptic and hygienic treatment of our patients. But the hygiene was as normally against all possible microbial factors and other contaminations."

Interviewer: "Do you accept HIV to be the cause of AIDS?"

Prof.: "This is no question; it only could be an answer to an clinically uninteresting question. I have the same problem as all medical practitioners: We are formed by our personal education and experience: During my former scientific work I had to use the electron microscope. I had the need to visualise. But until today no one has ever published a picture of purified HIV.

In the past I also had to use biochemical detectors. All HIV-tests I know, screening, searching-tests and confirming-tests cannot eliminate the influence of other causal agents. It is not possible to use these tests alone. In our periodontal practice we use ELISA and Western Blot to detect signs of rheumatic arthritis in some cases of periodontitis, just to alert us, but we had to use other investigations and tests too.

When teaching biology and oral medicine I had to teach my students to make plausible deductions. In my own laboratory during the time as head of a Department of Periodontology my students could learn how unspecific these tests could be.

So why should I trust those tests to be acceptable for the detection or screening of HIV?

This is the reason why I never been able to believe HIV to be the only cause of the AIDS-syndromes.

Interviewer: "What do you think about the future understanding of AIDS in your field of Oral Medicine?"

Prof.: "In the midst of the 1980's - in our field of medicine too - a lot of research has been published that over-simplified the clinical picture of AIDS.

During the last 40 years we have learned to involve more and more systemic aspects, and to focus on signs that could be separated and resolved out of the large number of symptoms of a syndrome.

The most important are the socio-economic factors of a disease, the possible role of hygiene and nutrition. Secondly are life-style habits, and as third factors like anamnestic risks and other iatrogenic factors.

The handicaps of human ecological factors have to be eliminated first. Lack of personal and ecological hygiene, malnutrition, and malabsorption are the most important health risks, as we learned from the past, the times of wars and other crises in Europe.

Actually history showed us that most diseases are multi-causal in origin. Mono-causality is an over-simplification.

This is a fact from medical history that is very important for the parts of the world that still suffer from poverty today. Poverty and poor informations about healthy life-style together implicate the extraordinary use of several life-style habits.

When a lot of special and individual health risks are added to these problems, diseases arise that we call 'poverty-diseases'. The first duty of human ecology and medicine should be the elimination of these factors. Only then is medicine able to treat the diseases step by step. This may be the nosologic and semiotologic correct way to solve the problem of AIDS."

Interviewer: "Thank you, professor, for your opinions."