2) Relationship to HOD Test.(4) This is a card sort test similar in principle to the MMPI but containing entirely different questions. Perceptual symptoms including hallucinations and illusions are specifically covered. The HOD test can be described as a perceptual test. Patients sorted 145 cards into true and false piles and these were recorded and scores obtained. We standardized this test on thousands of subjects and have reported the results widely.
We found that there was a better relationship between the presence of high scores in the test and the presence of kp in the urine than there was between kp and clinical diagnosis. Schizophrenics had much higher scores than did any other group of psychiatric patients, with the exception of patients with delirium tremens and normal subjects undergoing the LSD experience. In one study in New York, the investigating team found that the admission HOD test results were more closely correlated to the final discharge diagnosis than they were to the admitting diagnosis, even though none of the clinicians were able to see the results of the HOD test.
3) As an indicator for treatment. By 1960 we had completed four double blind controlled prospective studies on schizophrenic patients comparing niacin, niacinamide and placebo.(5) Based upon these studies and upon open clinical studies going back to 1951, I had concluded that schizophrenic patients responded better to any treatment when they were given adequate doses of vitamin B3. Forty years later this is still my conclusion, as it is of every physician who uses the same treatment. The only physicians who disagree are those who have never used the treatment and who have even refused to examine earlier studies. There is no patent on vitamin B3, and without a patent there is no financial incentive for any company to promote this treatment.
Since schizophrenic patients, most of whom had the factor in their urine, responded better when treated with vitamin B3, I concluded that any psychiatric disease, no matter what they were diagnosed clinically, might also do better with this vitamin. This was confirmed by a large series of open clinical studies. I will not term these studies anecdotal, which has become the politically correct term for denigrating any studies that are not double blind, since all clinical studies depend upon the history or herstory of patients and how they respond, i.e. upon anecdotes. The only difference is that in double blind studies the anecdotes are collected by physicians or others who are blinded by not knowing what treatment is being given. At least this is the theory of this type of procedure. In fact, the vast majority of these studies are so imperfectly blinded that few clinician or nurses have much difficulty deciding whether the patient was on placebo or something more active.
Worshippers of the double blind remind me of the emperor whose nakedness was seen only by a child not yet blinded by tradition. This report by Kraus is an excellent example of the type of anecdotal history which has contributed so much to medicine.
The presence of the mauve factor in urine became a valuable indicator to use vitamin B3. Later, when Dr. C. C. Pfeiffer showed that kp bound pyridoxine and zinc and described the syndrome pyrolleuria, this became another important indicator that vitamin B6 and zinc must be used. It is especially valuable for children, who are very difficult to diagnose because they vary so much one from the other.