There is one particular group of patients, those suffering from peripheral ischaemia (starvation of blood to extremities such as legs) who would surely be ideal as pilot groups for the study of the efficacy of chelation.

According to a report in The Lancet (Vol 339 April 11, 1992) between 500 to 1,000 people per million of the population in western Europe suffer each year from critical ischaemia and as many as a quarter of these are faced with major amputations.

The medical joke about having your leg off becomes a grim reality for 6,000 to 10,000 people each year, and although bypass surgery can be effected on femoral (leg arteries) it is a longer and more difficult operation than amputation (up to 8 hours of a surgeon's time rather than a mere half hour for amputation). Furthermore, says The Lancet, the former technique 'commits the surgeon to long-term responsibilities' whereas with amputation 'the surgeon can quickly dissolve responsibility to the limb fitter and rehabilitation specialist.'

It is not difficult to envisage which option is likely to be more often recommended to the patient when busy National Health surgeons are involved, bearing in mind that balloon angioplasty (the other alternative) may be effective but is unlikely to last.

Surely if these people knew about the option of chelating they would opt for it every time over surgery, even if the treatment carried a risk, which it doesn't unless kidney function is seriously impaired.

In fact, there have been research projects preferred to chelating physicians in America: first they must concede that one leg be removed by surgery and then they may treat the other by chelation. In one such case, where the surgeon inadvertently cut off the better of a patient's two legs (the other was subsequently saved by chelation) the patient is suing the surgeon.

This circumstance is apparently ideal for comparing two treatments and their efficacy for trial purposes, but leads to a fundamental question of ethics. Is the pursual of scientific proof interfering with the way patients are sometimes regarded and treated?

Case history patients who had had bypass surgery and angioplasty before chelation therapy sometimes complained of this: that they had been made to feel more like guinea pigs than patients and furthermore that they had not always been acquainted with the risks of any surgical procedure they were about to undergo, nor what the consequences might be. Some had actually been frightened into taking decisions regarding surgery on an 'or else' basis (this factor is more generally in evidence with private patients).

One patient showed me a letter from his cardiac physician after he refused to take beta blockers as recommended. 'I will not be held responsible for what happens to you,' the letter said tersely. To be fair: consultants are probably exasperated into such responses by some of their patients who expect to be 'got better' by drugs or surgery while they still carry on as before, eating the wrong things, drinking, smoking, etc.

Nonetheless, patient consideration does seem to have gone out of the more commercial end of the cardiovascular branch of medicine, especially in America. Chelating physicians as a bunch seem to take far more joy in their medicine than the average specialist, probably because they are confronted with very sick people who get better and stay better.

'Our first duty is to support and comfort the patient.' Dr Wayne Perry of the Arterial Disease Clinic in London says. 'Our aim must always be to empower patients, not disempower them,' says Dr Fritz Schellander of the Liongate Chelation Clinic in Tunbridge Wells. 'The doctor's first aim is not to harm,' says Dr Van Der Schaar of the Leende Chelation Clinic near Eindhoven in the Netherlands.

EDTA Chelation Therapy, Oxygen/Ozone Therapy, therapies for help in stress management, advice on diet and lifestyle changes are all empowering measures. The patient feels better, the patient gets better. Mood improves, fear abates, optimism returns. Life is worth living again. In fact, it becomes infinitely more precious because it has had to be fought for.

There is a saying, 'the secret of good health is to have a serious disease and cure it.' Arterial disease may not be completely curable, but it is controllable and doctors who work in chelation and other clinics for the circulation seem to have re-acquainted themselves with the original medical values of 'will this treatment serve the patient? not 'will this treatment suit the patient?'

Surgery, regrettably, because of its life-draining effect on body reserves, both physical and psychological, to say nothing of financial (either on account of surgery of on account of recuperation afterwards), does not empower the patient. One, two or three bypasses and you can have no more - you run out of spare parts and you run out of physical reserves to take the strain of the operation. Arteries which are cleaned out as in angioplasty can be damaged by the procedure - and it is damaged arteries that cause atherosclerosis in the first place. Plaque has been seen to gather around the heart where the surgeon's sutures position the bypass. Options close in on such patients.

Time and time again chelation clinicians find people at their doors who have been given up by orthodox medicine which can 'do no more' for them.

There is an awful suspicion that in advising the surgical option sooner and sooner, doctors are consciously or unconsciously choosing a group of patients who will best serve their statistics and last longer with them. This is especially true of private medicine in America (and probably elsewhere) where one critic of the cardiac surgery business has observed that the skill seems to be in getting the patient at the exact moment when surgical intervention will produce the most revenue and the least comeback when it fails - in that intervening decade between disablement and death.

This may sound like a terrible indictment of a profession composed largely of caring, responsible people. But why is it that each and every chelating physician has had to fly in the face of the establishment in order to pursue a treatment which does not harm and usually improves patients? Most of orthodox medicine will not even listen or learn about what they have to offer. All of the chelating physicians have been ostracized reviled, excluded and sometimes persecuted. Since there is no danger to health in what they are doing (EDTA has been licensed as a safe medicine, albeit not for the purposes of treating circulatory diseases), then the reason has to be commercial. (They cannot - or should not - say it is because double blind trials have not been done on EDTA and circulatory disease, because double blind trials were not done before bypass and angioplasty were used to treat circulatory disease.)

Let us look at what might happen to the cardiovascular business were chelation therapy to be admitted to its ranks.