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the translator, Mr. Aime Ricci:
Medicine of Hope, part 7 Rheumatic diseases are diseases that are watching us throughout our existence, from the age of six weeks old, such as youthful rheumatoid arthritis, until the degenerative osteoarthritis of the aged. Statistics report that more than 5% of the Canadian population suffers from arthritis in the broad meaning of the word: 25,000 children are not yet 13 years old, 300,000 adults are not yet 45 years old. Approximately 30 million Americans suffer from it. (Statistics from the 1980s.) Let us explain briefly that the generic word "rheumatism" includes all the problems of the bones, muscles, tendons, ligaments, while the word arthritis is limited only to joints. Medicine differentiates about a hundred different forms of arthritic diseases, which it classifies into eight groups: synovitis or inflammation of the membrane surrounding the joints (of which rheumatoid arthritis is the most widespread), articular arthritis, arthritis with crystals (gout), articular infections (with gonococci or staphylococci), cartilage degeneration (osteoarthritis), muscular inflammation (rare), localized conditions (such as stiff necks and lumbago) or generalized. The complexity of the causes of arthritis does not cease to raise a flood of assumptions. Each one gives his own explanation: infectious, hormonal, auto-immunology, psychological (stress), hereditary, traumatic, and climatic. However, according to the experts, the rheumatologists, diet does not have anything to do with it except that it must be balanced. I do not agree at all. Alimentation is the main gate of this group of diseases like other diseases. It is nevertheless curious to note that arthritis attacks occur at the time of food abuses, when pork is eaten, when alcohol is taken, wine, spicy dishes, in a word, when the liver is overloaded. Despite all that, the experts insist in telling us that diet does not count and that we can eat anything we want. Chronic patients suffering from arthritis that I have treated with ICT all presented problems of biliary dyskinesia, a tendency to chronic constipation and signs of hepatism. These peoples had poor nutrition. Arthritis is seldom an isolated disease. There are almost always other pathological states associated or subjacent that too many doctors neglect, even famous rheumatologists, who should enlighten us during a diagnosis. They (the patients) usually have an etiologic link (causal) with this articular manifestation. [IPTQ Webhost Update 7/11/03: A biliary dyskinesia patient has suggested that Dr. Paquette's ideas about this condition are incorrect or out of date. She provided these links for more recent information: 1, 2, and 3. It appears that Dr. Paquette was using this term to refer to a wider range of problems, which IPT might be able to address.] We blame on heredity a number of causes to all our ills. Wouldn't this be rather the environment in which we live, the wild rhythm of our life, the opulence, and the bad nutrition habits we acquire as of birth that we develop and transmit from family to family? The malnourished obese baby we stuff like an hippopotamus to the point that food is coming out of his ears, sees himself ingrained with nutrition habits he is not about to lose, and already preparing himself quite a sad medical balance sheet. He becomes bulimic (compulsive eater) and later is ridden with complexes. All the methods have been tried to overcome this terrible disease that is arthritis, and that in the various spheres of medicine: acupuncture, chiropractic, osteopathy, homeopathy. They have had, for the most part, only disappointing results. The swollen, hot, red, and painful sick joint is only the symptom of the disease and not the disease itself. A rational treatment should not be limited only to look at and to treat the diseased joint. It is necessary to look beyond the symptoms. It is necessary to use the wide angle rather than the telephoto lens. It is necessary to treat the entire organism beginning with a good detoxification. ICT also has tackled the job, and here are some of the results obtained, treating the patient, rather than the disease.
This case deserves, in fact, to be mentioned. I will always remember this morning of September 1977 when I saw this man presenting himself for the first time to my office in a lamentable state of rheumatoid arthritis. He had a staggering gait, walking as he said, "on ball bearings", the feet swollen by inflammation and pain, his legs barely carrying him. His head was at "five to noon" (slanted), unable to straighten his spine because of the pain. When he advanced his hand, he could not squeeze mine, and asked me not to squeeze his. He could neither close nor open his hands completely. The elbows had neither complete extension nor inflection. The shoulders and the head formed one single unit with the thorax, turning with it, limited in their movements. It was the same for the knees and ankles. In spite of all this, the patient displayed a sad but sympathetic smile. Declared invalid by conventional medicine for the last seven years, he had commuted from his home to Toronto, a 500 mile (800 km) trip where Dr. AF, rheumatologist, took care of him with a lot of sympathy and friendship. He punctured the joints that were too painful and hospitalized him for weeks. In seven years, he had spent more time in the hospital than in his home, and had even been immobilized in a wheelchair for ten months. He had been receiving cortisone for the last three years, and had been treated with gold salts for two years without noticeable improvement. He had also been receiving physiotherapy for the last five years. His wife dealt with managing the restaurant and their 27 employees, while he could not even hold a pencil between his fingers to do the bookkeeping. To get out of bed in the morning, he initially had to sit on the edge of the bed, and sometimes, after half an hour, he succeeded in taking a few steps, because he did not lack courage and did not want to become ankylosed (stiffened). For the night, they had made some metal splints to prevent his fingers from curling up, splints that he left me... in "ex voto" (as a votive offering)! On his arrival, he could not drive his own car, nor was he able to hold the steering wheel, turn the ignition key, step on the accelerator or the brakes, and get in or out of the car alone. He could not even hold a comb in his fingers to comb his hair, raise the arm to do so, or shave. I saw many sad cases of arthritis during my career, and I suffered myself enough from it for ten years to talk about it from experience, but I had never seen such a case. ICT has been really marvelous for him. After three weeks of treatment, I invited him to go moose hunting and he followed me in the trails, stepping over the obstacles... and he could shoot his rifle! His fingers, his neck, his shoulders, his legs allowed him to do it. He was resplendent with happiness. He was a very courageous patient, willful to get well again and followed rigorously the diet and the lifestyle I had imposed on him. I spoke to him on the telephone May 8, 1994. He has never been hospitalized again for arthritis since his ICT treatment in 1977. A taxi driver for the last 5 years, he just took his retirement on May 1, 1994. He authorized me with pleasure to divulge his name: "Gerry Roy", Cochrane, Ontario.
Accidentally crushed under a car in a garage. Lumbar pains and sciatica for the last 16 years worsened 5 years ago. Has undergone three operations on the spine in the lumbar area and followed treatments of physiotherapy without notable improvement of his condition. Total incapacitation during long months. Back home, after only two ICT treatments, his doctor considers the patient fit to return to work.
Strong fellow and good sportsman he stopped working for the last eleven months due to arthritis. He has been hospitalized for this condition six different times and treated by a team of rheumatologists. Has received massive doses of cortisone and gold salts with slight improvement. During the first examination, significant pains mainly to the knees, hands, elbows, shoulders and the spine. In the morning, getting up, the patient must follow the walls and lean against them to be able to walk. Less than 24 hours after the first ICT treatment, he jogs and declares feeling "like a young man". One month later, he maintained his improvement that he estimates at 75%, resumed his normal activities, and has even spent the previous day playing golf on wet ground.
Farmer, age 42, male Diagnosis: rheumatoid arthritis. Articular pains for the last 5 years, concerning especially the lower limbs, shoulders, cervical and dorso-lumbar spine. Suffering every day for the last 2 years. Can only sleep with sedatives. After several consultations with the local doctors and some orthopedists, he is told that nothing more can be done. Another recommends to him to sell his land, to ask for a pension of invalidity, to buy a small house in the village, not to work any more and do a little of exercise to prevent him from becoming ankylosed. The patient receives two treatments of ICT with incredible relief. A year later, he acknowledges "not to have been in as good a shape in six years, to have worked like he never did on his farm, even in the cold and humidity, and having taken no medicine since his two treatments". He even took the luxury to enjoy winter sports.
Ecology preservation agent, age 42, male Diagnosis: rheumatoid arthritis for the last 12 years. All the joints except those of the spine are involved. Three rheumatologists acknowledge to him that they "cannot do much for him any more". One week after the first ICT treatment, 50 % improvement of his general condition, and 90% at the shoulders, knees, ankles and the toes. Thereafter, although he must be exposed for a prolonged time in the cold for his surveillance work in snowmobile his condition keeps improving in an incredible fashion. In spite of this spectacular change, the symptoms recur after a few years, after having abandoned his life regimen. He is conscious of that.
Tour guide, age 49, male Diagnosis: poly-arthritis. Articular pains since age 29, each day, in the fingers, wrists, shoulders, ankles, the cervical-dorsal-spinal area. Following one ICT treatment, no crisis for 3 years. Having given up on the recommended diet, he retained the obtained improvements in spite of some rare arthritis attacks.
Taxi driver, age 68, male Diagnosis: polyarthritis since age12. For one year, the aches and pains have been much more acute on the fingers, hands, shoulders, knees, cervical and dorsal vertebrae. Cannot raise his arms. Can get up in the morning only by letting himself roll out of bed onto the floor. Following the ICT treatment, the aches and pains disappeared completely and the patient feels a surprising general improvement.
For the last 20 months, 3 separate hospitalizations, physiotherapy and 29 gold salts injections. Quits working 9 months ago because of illness. After the ICT treatment can return to work in the following days. Has not stopped working for 11 years.
(Victoire Munn) Housewife, age 65 Diagnosis: rheumatoid polyarthritis for the last 30 years.
Reference: See respiratory diseases, case # 15. Two days after her first ICT treatment, she climbs the highest mountain of Haiti without pain in the hip.
Housewife, age 40 Diagnosis: Polyarthritis for the last 10 years. Since her only two ICT treatments 9 years ago, the patient never suffered any arthritis attacks nor took any medications. Remarkable and unforeseeable fact, the patient who had suffered from bilateral deafness for 30 years recovered an almost normal auditive acuteness the day following her second treatment. She canceled the purchase of a hearing aid.
Beginning of the problems 7 years ago, diagnosis confirmed 3 months ago by tomography. Excruciating pain for the last few months, especially in prolonged standing position or toward the end of the day. The orthopedists suggest one of three surgical solutions: osteotomy (resection of a piece of bone), arthrodesis (final blocking of joint) or total prosthesis (replacement of the joint). Following the ICT treatment received 16 years ago, the patient was able to function until November 1990, when he received a total prosthesis of the hip. That was already a strong improvement, which postponed the evolution of the disease.
The pain gradually reached both hands, both elbows, neck, hips, left shoulder, both ankles and both feet. Cannot close the hands and can only walk with much difficulty. After the first treatment of November 1977, she notices a sharp improvement, which she confirms on national television on December 30, 1977, on the CBC program called: "The story of a doctor in Ferme-Neuve".
Luxation (dislocation) of the hip at the time of an accident in 1971. Can only walk 300 or 400 meters (1000 to 1300 feet) but with lots of pain. Awakened very often at night by the pain, sometimes only while simply turning over in his bed. Lying down in bed, he must raise his left leg with the help of the right foot to get up. Must constantly change position when sitting. Cannot stand up for long periods of time without pain. The orthopedist wants to permanently immobilize his joint (arthrodesis). Following ICT treatments in 1977, he functions well without surgery for 12 years until a second accident in 1989: he had the same hip crushed under the wheel of a truck. He must undergo a hip prosthesis (hip replacement). There had been, up to that time, a 60% improvement. It did not prevent him from walking or working. He had resumed his trucking job.
All the joints are involved. Cannot stand up, cannot fold her arms nor close her hands. On her arrival at the clinic, we carry her in our arms to her room, on the second floor. The day after the first treatment, she goes down the stairs without holding the banister, bends over, touches the floor with her fingers and raises her arms very high in the air to our great amazement. She can fold her arms and close her hands extremely well.
Very deformed patient who arrives at the clinic of Haiti in a wheelchair. She cannot even stand upright. Pains at the cervical and lumbar spine, shoulders, elbows, wrists, hips, knees, ankles, and feet. Cannot raise her arms nor walk around alone. Treated with cortisone for 7 years, which triggered angina. She must stop cortisone treatment. Acupuncture during a year and a half and gold salts for the last four years. Takes NSAID (Non Steroidal Anti Inflammatory Drugs). Twenty-four hours after her first treatment, she succeeds in moving her fingers and begins to stand up. After 48 hours, she gets up alone and is most happy to have been able to do alone her "toilette intime" (personal hygiene), for the first time in 12 years. A few days later, another feat for her: She can cut her meat alone. She evaluates her improvements at 80% for the knees, 70% for the neck, 40% for the shoulders, 50% for the right wrist and 100% for the other joints. After one month, she does not feel any more pain and does not take any more medications. Two months later, I meet her in her neighborhood. She is smiling and walking towards me.
Housewife, age 63 Diagnosis: rheumatoid arthritis for the last 20 years.
This is quite a sad case of rheumatoid arthritis. All the joints are affected: cervical-dorsal spine, shoulders, elbows, knees, feet and ankles. The hands have been deformed for 15 years and the wrists for three years. Hospitalized for 3 years at the same hospital (and hospitalized before in 5 different hospitals), she was treated with cortisone and gold salts. Secondary circulatory and digestive troubles (very serious). Patient arrived at the clinic in a wheelchair. Can not stand up, nor walk, nor extend her arms, close or open her hands. She has not been able to cross her legs for fifteen years. She is very happy after a few days to walk alone down the big staircase of the clinic and later to cross her legs. She can close and open her hands.
This is another order of diseases in which the ICT could, in the few cases where I had the occasion to use it, bring improvements where conventional medicine had failed. As it is very rare that such cases would come to me, I do not have yet experience of a sufficient number of cases to draw up valid statistics in the cases of multiple sclerosis, nor of hemiplegia (paralysis of half of the body). However, of the only three cases of multiple sclerosis that I have had the occasion to treat, the first one deserves our attention (case # 1), because the improvement of 45% in 2 or 3 weeks in question was declared and confirmed under oath, in front of the president of the College and a judge of the Superior Court, June 7, 1978. The second case that I will present to you is even more exciting (case # 2). There will be also a question of a few cases of slipped (herniated) discs (cases # 3, 4, 5, 7 & 8). Here are the facts. But first, let me tell you that before undertaking the treatment, I had well informed the patients that I did not promise anything to them. "If we never try this treatment," I said to them, "we will never know if it can do you any good: It is up to you to decide freely. I have the impression that it will be successful, if not, it would not even be worth trying it". And it worked.
(Dec. 1977) Housewife, age 43 Diagnosis: multiple sclerosis. This is a 43-year-old patient whose diagnosis of multiple sclerosis was confirmed in 1974 at the Lake Shore hospital of Pointe-Claire, but whose first manifestations go back to 1967. It is known that this disease starts as a spontaneously curable attack, but usually recurs. The age of the subject is usually between 20 to 35 years and one frequently finds in the antecedents, vertigo, pins and needles of the extremities, transitory amaurosis (loss of sight total or partial). The diagnosis is usually based on a neurological syndrome: pyramidal and cerebellar signs (nervous attack in cranial cavity). What ever it was, the patient was recognized as suffering of multiple sclerosis, diagnosis confirmed by telephone call at the archives of Lake Shore Hospital. After study of her case regarding ICT, I have confirmed to the patient that there was no specific recognized treatment to treat this condition and I explained to her that she was perfectly free to refuse or to accept the treatment I was suggesting to the best of my knowledge. Because in the light of the experience I had acquired in the last year and half, she did not run any risk except to see her general condition improving. I even said to her that if we succeed, it would be a world first, nobody to date having tried ICT on this disease as Dr. Perez had informed me. In the present case, the problems had appeared without notice as double vision, from one day to the next, ten years earlier. That had lasted approximately two months, and after seven years of remission, reappearance of double vision in 1974, accompanied by insensitivity to the left forearm, numbness in four fingers and in the left half of the face. A few months later, slow and progressive insensitivity to the left lower limb, from the knee to the foot, so that the patient "drags her leg", does not control her movements any more and that the foot frequently turns in varus (inside). About three years ago, the patient could walk several kilometers but at the time of the examination, she could walk only 100 meters, feels tired and without endurance. She stays up a few hours in the morning, but spends the remainder of the day in bed, not even getting up in the evening. Two months ago, she tried to go shopping with her mother to make some purchases and had to turn back after a few minutes. The patient accepts a first treatment on December 9, 1977. In the following days, we notice better blood circulation. The patient can spend the days standing. She walks with more ease, and that in a remarkable fashion, even smoothly. On Christmas Eve, the patient goes alone to do her shopping, driving her car herself, spends there two hours and returns on her own. She does not have to go to bed when she gets back. January 5, 1978, at the time of her fourth and last ICT treatment, she informs me that she spent the holidays without fatigue, in spite of a lot of visitors at the house, the excess work and the late evenings, sometimes up to 4 o’clock in the morning. Her general condition and her resistance are greatly improved. She intends to go cross-country skiing, something she has not been able to do in the last 2 years. I have not seen this patient since June 1978, and it is a pity. If ever ICT was recognized and allowed in Quebec, I have the impression that many cases could in turn benefit from it. If we never test this therapy in the diseases known as irreversible, who will be able to appreciate it justly?
This is about a very strong man, a bar employee, weighing 110.5 kg (243 lb.), who had never been sick, who, suddenly on May 11, 1976, felt a numbness in the left hand, the arm and the face, and mainly some pain in the left eye. While trying to get up, he feels the numbness reach the left lower limb and collapses on the floor. Transported urgently to the Queen Mary hospital, he is diagnosed very early with a left hemiplegia consecutive to a cerebral hemorrhage. After four weeks, he is transferred to Royal Victoria and to Catherine Booths for seven more weeks of physiotherapy where he re-learns to walk. Thereafter, eleven months of physiotherapy and treatment at a chiropractor, twice a week, hardly improves his condition. When he shows up in my office on October 15, 1977, he tells me that they do not want to treat him any more in physiotherapy, because they told him: "We are only treating those who can be improved. Go home, nothing else can be done for you". For a man like him, hyperactive, and at the prime of his life, this answer is demoralizing him. He is not interested in doing his exercises. During his first consultation, he walks with difficulty, for a maximum of 15 to 20 minutes and very slowly dragging his leg. The left upper limb is completely inert, inactive. His left hand is so spastic that if he succeeds with great effort in closing his hand, it is necessary for him to unfold each finger one by one, with the other hand, to slacken them. The day after his first treatment, he comes for his control examination which I also call "24 hour profile". I will never forget the following fact: I am in consultation in my cabinet when I hear someone enter the waiting room. Usually, the patients sit down and wait for their turn. But that morning, the newly arrived person does not stop walking, and so heavily (110.5 kg-243 lb.) that the whole floor "shakes". Disturbed in my consultation and unnerved, I get up and open the office door with the intention to ask him to be so kind as to sit down and to wait... . "Doctor, he says shaking my hand, with tears in his eyes, you do not know how good it is to be able to walk, to feel my foot touching the floor. I walk for the pleasure of walking". I was so moved, that I slipped back in another room, so that no one could see me crying... . Only one case like this one, and it boosts-up your morale for months! Before the end of the five treatments, which he received at that time, this patient walked for four to five hours without fatigue. Moreover, without help from his right hand, he was raising his left arm completely in the air, though in jerky moves and when he made a fist, his fingers relaxed by themselves without help.Perhaps there is nothing extraordinary for you who are reading this, but for a desperate hemiplegic, paralyzed for two years, who is "listening to his body", the least improvement of his condition means a lot. I have recorded this patient with a video tape recorder, before his departure. He has retained the ground gained and his condition has improved some more. He has resumed work after two years. PS: Before beginning the treatment, I had said to this patient: "If in 24 hours, there is no improvement, we stop the treatments". There was a significant improvement, which was retained for two years without resumption of the problems. I have never had other news from him.
Mechanic, age 36, male Diagnosis: two slipped discs and cephalgias. Consulting for recent arthritis at the left knee and also for cephalgias for 8 years. As secondary diagnosis, two slipped discs at L4-L5 and L5-S1 (at the 4th. and 5th. lumbar vertebrae as well as at the first sacral) for the last 8 years, accompanied by lumbo-sciatica (lumbar pain radiating along the sciatic nerve). He cannot stand up for more than a half-hour, suffers constantly, even in the morning after a night’s rest. He had to sell his garage because of his disability. Treated by orthopedists and chiropractors with little success. Two days after his single and only ICT treatment, his condition improved so much that he started working again as a truck-driver on the maintenance of winter roads. He was not feeling any more pains to the left lower limb nor to the lumbar spinal column. Nine years later, he is still working.
Farmer, age 59, male Diagnosis: slipped disc and circulatory problems. Consults for angina, paroxysmal tachycardia (acceleration by excess of cardiac pulsation), circulatory and digestive troubles. Other diagnosis: slipped disc and bilateral lumbo-sciatica, especially on the right, for which he has been followed by an orthopedist each month for 3 years. Incapacity to lean forward for 18 months, he can only bend forward to bring his hands to 16 inches (40 cm) off the floor. Orthopedic consultations every 2 weeks for the last 18 months. He is wearing an orthopedic corset (brace) for the last year. The day after his first ICT treatment, the lumbar pain and the sciatica are completely gone. The patient can bend his spinal column freely and he can lay both hands flat on the floor. He still could do it after 9 years; the pains had disappeared. This case was brought to the attention of the College along with case # 5, circulatory diseases.
After only one ICT treatment, in addition to the improvement of his circulatory and digestive troubles, the lumbar pains and the sciatica decreased by 80% to disappear completely after two months. After six years, the sciatica has never returned.
accident).
The patient arrives at the clinic in a wheelchair, left arm and leg completely inert. Less than two hours after the first treatment, the patient is very happy, lying in bed, to be able to raise his left arm approximately 3 to 4 inches (7,5 to 10 cm) and to be able to fold it on his chest. He also succeeds in moving his left leg with abduction (distance) and adduction (bringing together of a limb to the body) movements by raising it about 6 inches (15 cm) above the bed. Forty-eight hours after the first treatment, the patient, lying down, can raise the leg to 46 degrees and the arm at 35 degrees.
My own case: Jean-Claude Paquette (March 1976). Doctor-Surgeon, age 48 Diagnosis: slipped disc, left sciatica. On November 3, 1975, while transporting at arm’s length a cumbersome part of machinery weighing about 55 to 66 lb. (25 to 30 kg), I almost dropped it while walking in the snow. I gave it a quick jerk upward to get a better grip. It is at this time that I suddenly felt a very sharp pain in the lumbar area and that I fell to the ground. Transported urgently to the Hôtel-Dieu hospital in Saint-Jérome, the orthopedist diagnoses a slipped disc with left lumbo-sciatica. On February 6, 1976, on recommendation of the orthopedist, I consult a famous neurosurgeon, who confirms the diagnosis and suggests surgery "without which, he said, I will not get better". I know too well the after-effects of this operation and I do not want to remain "mortgaged", having in mind the cases of more than thirty patients operated who will have to watch themselves for the rest of their lives. I prefer to wait as long as possible and try to find another way. The pain does not leave me for nearly five months, day and night, irradiating from the left buttock to the big toe. I do not stop practicing medicine during that time. The days when I can, I walk supporting myself on a chair or using crutches. In the car, it is necessary for me to get out about every fifteen minutes to stretch my leg. On March 20, 1976, going through Mexico City on my way to Acapulco, Dr. Perez notices my suffering. "Claude, you seem to be in pain, what is wrong?" "It is a slipped disc." "Are you sure of the diagnosis." "I saw the best neurosurgeon of French Canada." "What would you say to be all right tomorrow morning?" I start laughing. "Let us see, Donato, you know well that it is surgical." "Very well, if you are not yet tired enough of suffering!" He leaves me to go and see his patients. I have a very bad time in Acapulco. Back in Mexico City on March 30th., I went back to see Donato and told him: "Listen, Donato, I have no faith in your medical treatment for a condition relating to surgery, but I really do not have any choice. I am suffering too much." The following day, March 31, I receive my first and only treatment for this condition. Less than twenty-four hours later and I declare it under oath, the pain has 100% disappeared and I have never again suffered from it. That was 18 years ago. (Declaration 1994).
(Oct. 1986) Civil engineer, age 38, male Diagnosis: slipped disc, lumbo-sciatica. Problems going back two years and treated medically with only temporary relief. Constant return of pain. The day after the ICT treatment, the pain has 100% disappeared. On April 17, 1994, 8 years later, the pain has never returned.
Sudden left facial paralysis in July 1977. Hospitalized 3 months at the Victoria hospital. Left Hemiplegia in July 1979. Cyanosis of left upper limb. The day after the first ICT treatment in Haiti, the left arm is still slightly cold and circulation is clearly improved at the left forearm. Sitting, he can extend the left leg horizontally and succeeds in raising his arm almost to shoulder height. The following day, or the third day, he can walk without a cane, which he has not been able to do for two years. He succeeds in raising the left arm to shoulder level. Lying in bed, he raises his left leg to 65 degres. On the fifth day, he realizes that he can flex the fingers of the left hand. The sixth day, he gets in and out of my jeep alone. All smiles, he can hold a candy between the fingers of his left hand. During the evening, he raises his left arm to eye level and the cyanosis has 80% disappeared. These observations are signed on the file by the patient and are countersigned by four patients, witnesses who share his joy. |
