Dr. Henry Heimlich Widely Criticized

Robert S. Baratz, MD, PhD, DDS

Henry Heimlich, M.D. is best known for popularizing a method to treat choking in 1974. Shortly thereafter he was dismissed as chief of surgery at the Cincinnati Jewish Hospital and never worked again as a surgeon. Virtually all of his work has been called into question. Now in his mid 80s, Heimlich has also promoted his “maneuver” for treating drowning and asthma. Medical authorities have regularly criticized this use. For example, recent reviews by the American Heart Association and the American Red Cross point out the dangers of adopting his recommendations.

For years Heimlich and his associates have promoted abdominal thrusts—the so-called Heimlich maneuver—as a first measure in the treatment of near-drowning. His advocacy appears to be based on observations of eight cases. Heimlich and his spokespeople  have regularly stated that "thousands of lives" have been saved by use of abdominal thrusting. However, they have produced no objectively collected, widely accepted data to support the claim. During the past year, the National Council Against Health Fraud has asked Heimlich several times for details on his allegedly successful cases, but he has produced nothing.

Periodically the American Heart Association (AHA) reviews its guidelines and recommendations for resuscitation. The process of these reviews is long, extensive, worldwide, and scientific. The AHA committees that are charged with assessing each type of resuscitation e.g. sudden cardiac arrest, traumatic cardiac arrest, lightning strikes, drowning, choking, etc., and  are required to review and analyze critically all relevant literature, and grade the quality of data available for assessment of effectiveness. Years of careful consideration go into the guidelines, since their implementation will literally affect the lives of most people.

Previous guidelines have not promoted abdominal thrusts for drowning, but had allowed them if it was suspected that a foreign body was aspirated as part of the drowning. Moreover, abdominal thrusts were not encouraged or promoted as first treatment for drowning in the CPR guidelines. Now the AHA actively discourages abdominal thrusting for drowning/near-drowning resuscitation. I quote the AHA which now states, based on thorough review:

"Attempts to remove water from the breathing passages by any means other than suction (e.g. abdominal thrusts or the Heimlich maneuver) are unnecessary and potentially dangerous. The routine use of abdominal thrusts or the Heimlich maneuver for drowning victims is not recommended."

"There is no evidence that water acts as an obstructive foreign body. Maneuvers to relieve FBAO [Foreign Body Airway Obstructions]  are not recommended for drowning victims because such maneuvers are not necessary and they can cause injury, vomiting and aspiration and delay CPR."

The AHA Guidelines are based on a series of referenced articles and critical review of all evidence available. The physiology of choking is simple, and can be deadly. A solid foreign object blocks the trachea. It acts as a ball-valve, letting the victim exhale but not inhale. The lungs gradually lose air and diminish in size, raising the diaphragm. Air exchange stops. Without removal of the object, death can occur. Abdominal thrusts in some people can squeeze the lungs a bit and produce pressure to expel the object, but scientific studies with actual measurements show that chest thrusts are more effective, as one would expect. An already raised diaphragm cannot be raised much further to expel air from the lungs. Squeezing the lungs directly will expel air with more force. Thus chest thrusts are superior—and safer. It is time for him to stop promoting his speculations.

Heimlich has also advocated abdominal thrusting for treating asthma attacks. Most asthma attacks are spasmodic, in whole or in part, and use of the thrusting is illogical and medically unsound. No data exist to support abdominal thrusting for asthma. The immediate use of medications and other proven emergency measures in the hands of trained medical personnel is required for treating asthma attacks.  Delay in treatment of asthma can be rapidly fatal.

Malariotherapy Mischief

Heimlich also claims that malaria parasite injections are effective against cancer, Lyme disease, and HIV/AIDS. For more than a decade, he has carried out clandestine human experiments with "malariotherapy" in Third World countries. The U.S. Centers for Disease Control and Prevention and other governmental bodies have disclaimed this bizarre and scientifically unsupportable method. Nevertheless, his Heimlich Institute Foundation, which has funded and sponsored such work, continues to solicit and accept funding for "malariotherapy" research for HIV infections.

In 2004, Heimlich engaged Victoria Wells Wulsin, M.D. to review his work on malariotherapy and write a business plan for promoting it. Wulsin concluded that "the preponderance of evidence indicates that neither malaria nor Immunotherapy will cure HIV/AIDS" and that the Heimlich Institute had been too secretive about its work. Despite claims by Heimlich that that no active work on malariotherapy was being done, Wulsin’s report shows that it was. When it became clear that the report would be made public by others, she released it but added an executive summary in which she claimed that her involvement with the Heimlich Institute was "strictly limited" to a research review. However, the original report indicates that she had access to experimental data, knew that something was radically wrong, and was aware of ethical violations that she should have reported to appropriate governmental authorities. The report also indicates that an "American sponsor" was collaborating with Heimlich, but Wulsin has refused to reveal the sponsor's name. Wulsin is is now running for a seat in the U.S. House of Representatives.

Association with Dr. Edward Patrick

In October 2008, a federal court judge dismissed a libel suit brought by Edward Patrick, M.D. against the Cleveland Scene newspaper and Thomas Francis, a writer whose cover story, "Playing Doctor," had accused Patrick of lying about his professional experience. Patrick is board-certified in emergency medicine, based on a one-year residency program followed by credit for practice. However, critics believe he did not complete residency training. The newspaper article also questioned the veracity of data from Patrick that were used to establish the Heimlich maneuver. as a method for treating choking. The judge concluded that Patrick misrepresented the extent of his medical training and failed to present credible information to rebut other accusations made in the article. Patrick is appealing the dismissal.

For Further Information

This article was revised on October 23, 2008.

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