Yesterday, the CDC held a Twitter party for National Infant Immunization Week, which is, conveniently enough, this week. Our old “friend” Ginger Taylor tried to call in her squadron of flying antivaccine monkeys to fling poo at what should have been a celebration of the success of vaccines; so I sent up the Bat Signal, the better to attract some voices of reason to the sliming of the #CDCvax hashtag used for the Twitter party to counter the antivaccine quacks. P.Z. Myers picked up the call too, and the rest is history. I almost felt sorry for Ginger and her fellow antivaccine loons, as they found their own tactics turned against them.
As amusing as that was, unfortunately, during the festivities I was made aware of this article Michigan doctor reveals plan to stop autism. I thought I knew all the Michigan antivaccine docs, but apparently I didn’t. The story is about someone named Dr. Marvin Anderson, who lives up north and runs a clinic called Abba’s Place. (Those of you familiar with Michigan will know what that means.) Specifically he lives in the Grand Traverse Bay area near Traverse City in a small town called Cedar, and there, he “treats” autistic children. In fact, he apparently has a book out called Autism Prevention, Care and Management. I could tell from the title that the book would be chock full of antivaccine quackery, and, as far as I can tell from reading the description of it that it is, as the article makes clear:
His treatment for ASD and ADHD is primarily directed to the digestive tract, including the liver. Animal studies have shown an intriguing connection between inflammation in the intestinal tract and inflammation in the brain. Autism also can involve impairments in the body’s detoxification pathways. Dr. Anderson’s program includes identifying contaminants that are present in his patients and creating a detoxification plan for their safe and efficient removal. Inflammation elsewhere in the body, including the brain, is also addressed. An important part of this plan involves care of the liver using the principles of liver cleansing advanced by Dr. Sandra Cabot in her best-selling book, The Liver Cleansing Diet.
Oh goody. I’ve encountered Sandra Cabot’s quackery before, but for some reason I never got around to blogging about her. Perhaps the reason is that she advocates a bunch of treatments to “detoxify” the liver and get rid of stones, such as liver flushes and gallbladder flushes, as well as colon cleanses to “detoxify,” which is just as much quackery. There’s nothing there that’s particularly original or amusing from a quack point of view, although there is an incredible amount of mercenary activity going on, with lots of supplements and weight loss products on sale. Most of Cabot’s quackery appears to be centered on the GI tract, particularly the liver, and that seems to be what much of what Anderson’s about, too.
Perusing Anderson’s website, I saw that almost all of the conditions treated by Anderson are the same sorts of conditions, both real and imagined, that quacks love to “treat,” particularly with “detoxification”: toxicity, poisoning, environmental disease, environmental toxicity, environmental sensitivity, environmental poisoning (aren’t poisoning and toxicity close enough to the same thing that they could be lumped under the same category?), multiple chemical sensitivity, chemical sensitivity, intestinal bacterial overgrowth, gluten sensitivity (of course!), food allergies, autism alternative treatment, autism complementary treatment, autism natural treatment, autism alternative therapy, autism remedy, and…hey, wait a minute! Either this guy is the worst Google search optimization guy ever, using obvious variants on the same thing to try to increase his page ranking, or he’s just plain dumb. Take your pick. Or maybe not. His new patient intake form is custom-made to encourage parents to confuse correlation with causation. For instance, there’s a passage that says:
Please make notation of any other event, action, etc. that you think may have some bearing/relationship to your child’s condition. Again, be as detailed as possible and do not hesitate to mention anything, no matter how small or insignificant, that you believe is related to your child’s problem(s).
Later in the form, there’s a detailed chart for the child’s vaccination history, with “reactions” listed after each one, including “irritable,” “seizure,” “bowel” (as in any bowel complaints), and the all-purpose “other,” which is no doubt used for parents who think their child became autistic after vaccination. I’ll give him some mild credit; the form is really detailed. The problem is that it’s so detailed that it’s virtually guaranteed to find something. Also, there’s a reason why pediatricians try to maintain a neutral tone when asking parents about what happened, in particular not asking leading questions so as not to implant a correlation into the parents’ minds that probably has nothing to do with the child’s complaint. Anderson’s form is packed with leading questions.
Not surprisingly, Dr. Anderson is also clearly highly antivaccine. To get an idea of what I mean, just look at the three laws he wants the state of Michigan to pass to “end the autism epidemic.” I’ll start with the third one first, because it’s as mundane as prohibiting deposition of hazardous waste in fertilizer fillers on farmland. It’s not entirely clear what he means here, because there is no evidence that autism is associated with living on a farm that uses a lot of fertilizer. None of this stops Anderson from wildly speculating about the “nationwide use of cadmium, lead, arsenic, dioxins, radionuclides and other hazardous waste in fertilizer,” none of which have been shown to be correlated with autism. But, then, hey? Why let science get in the way of a good story? Certainly Anderson doesn’t.
But what about vaccines? Well, the first law he wants on the books is this:
Require that all newborn infants receive an autism prevention screening test prior to receiving any vaccinations. The “one size fits all” approach to vaccinations is no longer working. According to Dr. Gregory Poland et al. in Vaccinomics and Personalized Vaccinology, included in the 2012 Jordan Report, Accelerated development of vaccines, “…significant individual variation exists in risk of adverse events and in immune response to a given vaccine. Our laboratory has termed the study of individual genetic, epigenetic, and other host-factor contributions to variations in immune responses to vaccines as ‘vaccinomics’.” The number of recommended vaccinations has been steadily increasing, along with adverse reaction reports. The current vaccination recommendations from the CDC and the American Academy of Pediatrics fail to take sufficient account of individual differences, both inherited and acquired, that determine the infant’s ability to tolerate a standard vaccination load. The escalating rate of autism and the frequent observation that autism develops in some children shortly after having received an immunization strongly suggests that the current approach to vaccinations is both outdated and dangerous.
It is rather amusing how Anderson misappropriates a speculative article by Dr. Poland about “personalized vaccinology,” in which the authors describe potential advances in the development of vaccines utilizing next generation sequencing and various predictive tests designed to determine how well individuals will mount an immune response to a vaccine and which individuals are more likely to have adverse reactions, and use it to argue that one of those adverse reactions is autism. It isn’t, and Dr. Poland doesn’t say that it is. Indeed, Dr. Poland’s article is in no way evidence supporting the discredited vaccine-autism hypothesis. The overwhelming scientific consensus, based on numerous epidemiological studies and scientific papers is that vaccines are not associated with autism. Contrary to what Anderson writes, the escalating rate of autism and the observation that autism develops in some children after vaccination do not suggest that the current approach to vaccinations is outdated and dangerous. It indicates that Anderson doesn’t know what he is talking about and is, in fact, an antivaccine loon.
If that’s not enough to indicate that, the second law that Dr. Anderson proposes is even more hilarious:
Restrict the prescription of vaccinations to a physician who is board certified as a Vaccination Specialist. The majority of our immune system resides in our intestinal tract, including our liver. The medical profession has largely failed to recognize the important role of the liver as the body’s major filter in processing the ever-increasing onslaught of chemicals, including drugs, to which it is exposed. Liver overload and functional liver failure are now common. Strong evidence of this exists in the Environmental Working Group’s finding in Body Burden: The pollution in newborns of 287 toxic compounds in the umbilical cord blood of newborns. These infants were receiving contaminants that the mother’s liver had failed to remove. The most effective approach to this problem would be to create a new specialty in medicine, along the lines of Dr. Poland’s vaccinomics, that would train doctors to better understand newborn immunology, including the vital role of the liver. These doctors would be thus uniquely qualified to write the vaccination prescription. To accomplish this, Anderson proposes that the medical schools in Michigan should, without delay, add this new specialty to their curriculum per state law. Assessment of this physician’s performance would be based on the autism rate in the patients that he/she evaluates and the immunizations that are recommended.
I’m sorry, but I just about burst out laughing when I read this. Talk about the legal adage of “assuming facts not in evidence”! This entire paragraph is based on classic autism quackery tropes, particularly the “toxins” gambit, in which vaccine ingredients are portrayed as so horrifically toxic that they instantly turn the child autistic. Anderson here assumes that that vaccines cause autism by introducing a whole bunch of “toxins” into the body that overwhelm the baby’s “detoxification” capabilities. Again, there’s just one little problem. The report Anderson cites doesn’t support the concept that vaccines cause autism. All it demonstrates is that various chemicals can be detected in umbilical cord blood at concentrations of in the parts per billion to parts per trillion range. It’s a rather ridiculous report, actually, because such concentrations are so low that, for most of the chemicals discussed, there’s no evidence that such low concentrations of these chemicals are dangerous. To give you a bit of comparison, that report found lead in umbilical vein blood ranging from 0.07 to 2.3 ppb. That’s parts per billion, people. Lead concentration in soil ranges from 50 to 400 ppm (that’s parts per million). The blood concentration of lead that’s considered actionable by the CDC is 10 μg/dL. That’s 0.1 ppm (or 100,000 ppb), or roughly 43,000 times higher than the highest lead concentration reported.
In away, it would actually be hilarious if Michigan were to enact the three laws proposed by Anderson, and, trust me, Michigan’s got just the clueless legislature to do it, too. Well, perhaps “hilarious” is the wrong word. Actually, there’s no “perhaps” about it. Still, it would be poetic justice to see Anderson’s reaction when his “vaccinologists” had the same prevalence of autism in their patients as any other pediatricians. Because vaccines don’t cause autism, and nothing that Anderson proposes could reasonably be expected to prevent autism, that would be the result. I can just see it now: Bogus “vaccinologists” would be reduced to trying to game their numbers or admitting that nothing they do prevents autism. Anderson would be reduced to explaining why his amazing law had zero effect on autism prevalence in the state.
54 replies on “A Michigan doctor reveals plan to stop autism…hilarity ensues”
Alas I’m not familiar with Michigan. I wouldn’t even be able to point it at a map, if I didn’t look it up before. Abba just makes me think of a Swedish group, but I’m sure you don’t have that in mind.
Like, my child saw a black cat crossing his path, my neighbour looks like a witch, my neighbour scolded at my child?
Exactly. Or she was vaccinated two weeks before…
When people get scared by “toxins” that appear in “Parts/billion” I like to point out that of all the anatomically modern human beings who have ever lived, from Cro-Magnon on, ~1 ppb have walked on the moon.
I had a discussion with a speech therapist about Autism. Now I am wondering if is there a link between the three-in-one vaccinations and the increasing number of children diagnosed with Autism??
For further hilarity we should have Dr. Anderson debate Dr. Jay Gordon, who has his own book on “preventing autism” that is equally hilarious and completely unsupported by any science.
I think you’re off somewhere on your lead concentrations. 10 μg/dL is 0.1 ppt, not ppm. The relation to ppb is correct so it doesn’t change the (obvious) conclusion.
Restrict the prescription of vaccinations to a physician who is board certified as a Vaccination Specialist.
Does such a board certification actually exist? I was not previously aware of the need for any such specialization. I am acquainted with the concept of doctors who specialize in travel medicine, whom you would see if you were traveling to a country that required yellow fever immunizations (that was the reason I saw one: I was preparing for a trip to Brazil). But apart from vaccinations that one would only need for visiting certain countries, most vaccinations would take place in the context of a more general practice (pediatrics or internal medicine).
So if I’m right that there is currently no such board certification, the effect of this law would be to make vaccinations unavailable in the state of Michigan. There is at least one major international airport in Michigan (DTW), so that would be very bad for worldwide health.
Is 1ppm=1,000,000ppb, or is 1ppm=1,000ppb?
I know in the US 1 billion=1,000 million while in other countries 1 billion=1,000,000 million. I’m unfamiliar with what the standard for ppm and ppb is in the medical research you cite and would like some clarification. Thanks.
OT- but after all, we are talking loons, *n’est-ce pas*?
Dear, old Mikey ( Natural News) applauds Dr Oz and follows in his footsteps by investigating ‘charlatans’ who hawk superfoods, superments and other woo.
I didn’t just make that up: I’m creative not a fiction writer.
SUPPLEMENTS…. ( sigh!)
Renate — it’s the state that looks like a giant mitten. It used to be a fairly sane place to live.
You can always tell a Michigander. Ask him where he’s from and he will hold up his right hand and point to the appropriate place.
I’m quite serious about this, I left Detroit in 1979 and haven’t been back for longer than ten days at a time, but it’s still my first reaction.
…the effect of this law would be to make vaccinations unavailable in the state of Michigan.
He’s taking a page from the anti-abortion playbook; many states have learned that the way to eliminate abortions is to require abortion clinic doctors to have admitting privileges at local hospitals. The only abortion clinic in Mississippi, for example, is served by a doctor who flies down there from Chicago every month.
So, since he has not been able to get admitting privileges locally…..
If the right ( eastern) side is a mitten, what do you call the other side?
-btw- this is not an example of projective testing *a la* Rorshach
It is so darn frustrating when MDs or DOs participate in this anti-vaccine and other woo-nonsense. What a waist of a medical education and residency.
See…while you guys were having all the “fun” tweeting at Ginger, I was busy posting about this quack doctor.
The bot notified her groupies in her daily “Media Review” and was bragging about her posts and her pimping for all the new books written by her and her colleagues:
“Of course the most important part of this story is the fact that A DOCTOR is saying these things. (And by an interesting coincidence that FDA just announced that they’re cracking down on people using detoxification as a treatment for autism.)
I posted comments. NOW that we have Karen’s book, Louis’, Wayne’s and mine—hitting the shelves at once….joining others already there. I posted links to the books.”
“Karen’s book” refers to this woman whose child was compensated for a vaccine injury related to a DPT shot, and who showed up on Age of Autism a few days ago to provide details of the claim and the award from the United States Court of Federal Claims. The *journalists* at AoA have had their hooks into her, since 2011.
Is 1ppm=1,000,000ppb, or is 1ppm=1,000ppb?
The latter. This style of reporting concentrations follows American usage.
u13010175: “Now I am wondering if is there a link between the three-in-one vaccinations and the increasing number of children diagnosed with Autism??”
With what evidence? The DTP vaccine has been used for sixty years, and the MMR vaccine was introduced in the USA in 1971. Do you have verifiable documentation dated before 1990 that the rates of autism in the USA increased due to the use of either “three-in-vaccine”?
Oh, and the original polio vaccine introduced in 1955 had three strains of polio virus. Can you document an increase of autism starting close to sixty years ago?
Though before you start digging for that data, try reading the papers in this list: Vaccine Safety: Examine the Evidence.
about those books:
Did you ever notice how many of them ( including AJW’s and Stagliano’s) are published by Skyhorse?
– its head honcho, Tony Lyons, is an anti-vax autism parent ( his ex has a book about their daughter/ for easy reference, the former has an Icelandic patronymic name) and he has one himself with another like-minded parent. Also he gave Null his own ‘publishing company’ ( imprint).
Notice that not all of these tomes are ‘non-fiction’ – both Stagliano and Conte have written fictional detective stories
oh, wait scratch that “not all” etc.
Perhaps this speech pathologist should stick to speech pathology instead of opining about a subject s/he clearly isn’t qualified to opine about.
I keep seeing statements about “The majority of our immune system resides in our intestinal tract.” I tried to look that up but end up on woo sites.
Is that really accurate or is it misleading?
Thanks for answering.
@Denice — #17:
Anti-vaxxerism and medical quackery isn’t the only thing being trafficked by Skyhorse. It is also the publisher of a UFO/9-11/JFK conspiracy book by actor Richard Belzer (John Munch from “Law & Order: SVU”), and recently put out material by a fringe anti-Semitic periodical called the “American Free Press” run by Holocaust-denier Willis Carto.
“Dear, old Mikey ( Natural News) applauds Dr Oz and follows in his footsteps by investigating ‘charlatans’ who hawk superfoods, superments and other woo.
I didn’t just make that up: I’m creative not a fiction writer.”
For an even more off-the-scale reading on your irony meter, check out this scornful NN story about Portland dumping 38 million gallons of water from its drinking supply because a teenager peed in the reservoir:
While making fun of Portland officials for going nuts over an incredibly tiny percentage of urine in the water*, NN doesn’t see any contradiction in its frequently going batshit crazy over incredibly tiny amounts of “toxins” in supplements, vaccines etc.
*of course, since NN has hosted a blog proclaiming the wonders of drinking your own urine, it might be peeved (sorry) that Portland isn’t busing people up to the reservoir en masse to urinate in it.
Just a brief note on billions.
The use of ‘billion’ to mean 10^12 is pretty much universally deprecated – the occasional old fart still pretends confusion but they’re still counting their money in shillings too…
If by the western part of the stae, you mean the part that is not attached to the mitten, we call that the U. P., for Upper Peninsula and people who come from that part of the state are referred to as Yoopers.
JCL @ #23:
Thanks, I thought that was the case, so I was a little confused by nescio’s question.
I’ve read a lot of books over the years, and since many of them were on scientific or historical subjects, a large proportion (I don’t want to say half, but easily a third) have been British—back to the days when the title marched up the spine instead of down. The oldest ones had to put a disclaimer in the front that “billion” meant 10^9, in the American sense, but lately (like the last 45 years) that doesn’t seem to have been considered necessary.
“Liver overload and functional liver failure are now common.”
Is “liver overload” a real thing? And Isn’t liver failure kind of dramatic and deadly? I’d think someone would have noticed if liver failure had become “common”
“u13010175: “Now I am wondering if is there a link between the three-in-one vaccinations and the increasing number of children diagnosed with Autism??”
I’ve plotted on a line graph, the use of disposable diapers, the use of the MMR vaccine and the “increasing number of children diagnosed with autism”, and I came to the conclusion that disposable diapers cause autism. (Thanks dingo199) 🙂
Here’s another example of a nurse (who should have known better), who plotted on a line graph, the use of ultrasound technology and the prevalence of autism. She concluded that ultrasounds during pregnancy cause autism;
“The Ultrasound-Autism Connection”
No, it’s alive and well.
At first, I thought u13010175 in comment #3 was joking. Asking a speech pathologist for advice about vaccines and autism is like asking your greengrocer for advice about car repair. Sure, there’s a 1 in a million chance they know more than you about it, but wouldn’t you rather ask a mechanic to fix your brakes? I’m glad you’re here, though, because Orac is a doctor and many of us are scientists or parents of kids with autism (or both, in my case) who know quite a bit about autism or vaccines.
I noticed over at ERV that there’s a bunch of posters that are “u” followed by a string of numbers (although they also use X. Lastname) that are posting rather similar comments that also happen to be off-topic and agenda-y (not vaccines though). I would suspect that u13010175 might be among that crew.
@bill smith: I wouldn’t venture to quantify the human immune system – do we do it by cells? by strength of response? strength of regulation? – but the gut/GI tract definitely has a lot going on in terms of your immune system. The importance of this took a while longer to be recognized in comparison to the basics like antibodies and cell-mediated immunity, and it’s a pretty complicated system, which is probably why it’s fun to co-opt for woo. What’s really neat about gut immunity is that the vast majority of the responses are suppressive. Your gut is constantly exposed to loads of bacteria, viruses, and food antigens, so of course your immune system puts a lot of its effort into not responding to those things (they’re not [usually] hurting you, after all). How the gut decides what to and what not to respond to is a really interesting question, especially as we start to figure out diseases like IBD, Crohn’s, and Coeliac’s (sp?), where it’s obviously making the wrong decision some of the time.
I hope that sort of tangentially answers your question.
@ Bill Smith
There are “serious” academic references for this statement. See for instance:
I cannot confirm that it is true, but in any case, the intestinal lymphoid tissue is primordial.
I took a look, and their brilliance is underwhelming.
It actually looks like a bunch of sock puppets. Something that Orac frowns upon.
10 ug/dL = 10 ug/100 g = 0.1 ug/g = 0.1 ppm
0.1 ppm = 100 ppb = 100,000 ppt
As far as most of our immune system being in our intestines it is true and not true. There is a lot of immune activity in our gut because it is the only continuous tube with access to the outside world. Plus there is a lot of commensal bacteria that needs to be kept under control, not to mention all the antigen testing from food that occurs there. It is not some separate things though. There is a lot of immune activity because it is necessary not because that is the only place that the immune system can fight off infections.
On the subject of the immune system in the gut: I used to isolate several types of cells/tissues from intestines (not human) to measure immunization responses. The ones I’m remembering off the top of my head are Peyer’s patches (little round, flat blobs on the outside of the intestine) and Intra-Epithelial Lymphocytes, which reside inside the intestinal tissue itself. There was another type of immune cell in the guts, but I’m not remember it.
So you do have a lot of mature immune cells in your gut. (The cells in bone marrow and the thymus aren’t really mature, but I’m pretty sure the ones in the spleen and lymph nodes are.)
I hope that’s helpful.
a bunch of posters that are “u” followed by a string of numbers (although they also use X. Lastname) that are posting rather similar comments that also happen to be off-topic and agenda-y (not vaccines though). I would suspect that u13010175 might be among that crew.
Also happening at the Aetiology blog… with names of the form MHM$$$$$$. All the spammers claim to come from Pretoria, as if the sockpuppet set the “Location” field and left it.
And Life Lines.
Also happening at the Aetiology blog…
And Life Lines.
Looking at the sheer waste-of-space vacuity of the comments in question, I wonder if someone is testing new customised-spam software.
I suspect all these vociferous ‘critics’ of vaccination are actually engaging in a slight variation of the euphemistic ‘practice building’ which Chiropractors work so hard. If you could somehow screw a moment of genuine honesty from one of them you’d find they didn’t really give two craps about autistic children. Moreover It would be instructive to see Dr. Anderson react to a case of fulminate Smallpox were one suddenly presented to him – assuming he’d recognize the symptoms in the first place. I do not doubt for a moment he would be the first reaching for a bifurcate needle and screaming at his nearest public health officer for enough vaccine to immunize his whole family – AND himself!
Does that test he wants to mandate before vaccination even exist, or is that another case of “come up with a superficially plausible requirement that is as impossible as if the doctor had to slay a dragon by strangling it with a unicorn hair during a total solar eclipse.”
Why is it that these quack detoxification specialists never have affiliations with insurance companies, or Medicare, or Medicaid?
I’d love to see the panel of tests he orders from a “specialty laboratory” to determine liver toxicities.
@ Bill Smith
Sorry for the wrong link.
I would say yes. There is, as yet, no test to confirm who is at risk for autism.
@Narad 28 Well I guess I stand corrected – though I was thinking more of the ‘English’ vs ‘Amercian English’ distinction rather than other languages
Denise @ 9: Superments: Splendid meme! Definition: ‘Superments are supplements that make super-duper health claims.’ I propose we adopt the term with that definition.
Shay @ 12: Highly plausible hypothesis you have there, that the anti-vaxxers are following the anti-abortionists’ playbook.
Denise @ 18 and Sebastian @ 21 re. ‘Skyhorse.’ Hmm… that would be a winged unicorn, wouldn’t it? ‘Horsie in the sky, with diamonds’ (sorry, I couldn’t resist).
The fact that the publisher is in bed with an avowed nazi (eww) as well as 9/11 conspiracy-theorists is very interesting, and we should make much use of it by way of linking the quack books to the nazi & 9/11 truther stuff. For example, just a quick comment in relevant forums to say, e.g. ‘also published by Skyhorse, (list a couple of titles)… go look them up.’ Let people do their own Amazon searches and come to their own conclusions.
@Lurker — #46: If you look on the homepage of Skyhorse now, you will see conspiracy books by Jesse Ventura (“They Killed Our President: 63 Facts That Prove A Conspiracy To Kill JFK”) and Roger Stone (“The Man Who Killed Kennedy: The Case Against LBJ”), as well as Belzer’s JFK tome. The Willis Carto material also mainly deals with the Kennedy assassination. Kennedy seems to be a theme with Skyhorse apart from anti-vaxxerism.
@Lurker, I think the skyhorse is Pegasus.
Shay-Turn your right hand, palm up. This quack lives near the top of your little finger. Turn your left hand, palm up and perpendicullar to the right; I attended university on the thumb, sticking out into Lake Superior. Currently still covered in ice and snow.
Actually, my autistic child likes the wilderness of the UP, and being on a farm is restful for her. Any improvement may be due to reducing excess stimulation.
Ruth — I grew up in that little spot where the scaphoid butts up against the trapezoid and the trapezium.
(Do Italians have as much fun telling people where they’re from as Michiganders do, one wonders).
I saw this on the MSNBC site. Remind you of anyone?
>>Let me just repeat the point from earlier in the week: it’s clear at this point that no amount of evidence, no number of investigations, no hours of hearings, no volumes of comprehensive reports will ever be enough for those who want the Benghazi conspiracy theories to have merit. It’s no longer about substantiation; it’s more of a feeling. It’s as if Stephen Colbert’ persona were real and a large group of people proudly declared, “It doesn’t matter if the evidence says we’re wrong because our guts say we’re right.”
It’s no way to win an argument, but for Benghazi conspiracy theorists, they’ve already won the argument by convincing themselves that their version of reality is superior to everyone else’s.<<
This will get attention from the Flying Monkey Squad
Spoiler alert – it’s more genetic and les teh evil vaccines, but still we don’t know it all.
I think it has been discovered by some of those members.
I’ve never seen any Italian pointing out at their lower legs, they somehow expect that everyone would know where, say, Lecce is, and if they don’t, shame on them, undereducated foreigners. I do recalll that in English, I’ve seen references to the lower parts of the boot, though.