The concept that certain individuals suffer a specific illness caused by multiple food and chemical sensitivities is the basis of a medical practice known as “clinical ecology.” This concept evolved from the earlier theory of allergic toxemia caused by multiple food sensitivities, described above. In the early 1950s Randolph broadened the idea of allergic toxemia to include sensitivity to environmental chemicals, in addition to foods, as causative agents of this disease, which he called “environmental illness.” Later, hypersensitivity to microorganisms, especially Candida albicans, was added to the list of causes.
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The term “environmental illness” was used for many years, along with other names such as environmentally induced disease, chemical hypersensitivity syndrome, multiple chemical sensitivities, cerebral allergy, chemically induced immune dysregulation, twentieth century disease, total allergy syndrome, ecologic illness, and food and chemical sensitivities. In recent years, “multiple chemical sensitivities” has been the preferred term.

Cullen introduced the term “multiple chemical sensitivities” to apply to a subgroup of such patients who have attributed their illness to their workplace, using the following definition:
An acquired disorder characterized by recurrent symptoms, referable to
multiple organ systems, occurring in response to demonstrable exposure to
many chemically unrelated compounds at doses far below those established
in the general population to cause harmful effects. No single widely
accepted test of physiologic function can be shown to correlate with
symptoms.

In February 2006, a workshop organized by the International Programme on Chemical Safety of the World health Organization recommended a new name, “idiopathic environmental intolerances,” because the term multiple chemical sensitivities “makes an unsupported judgment on causation” (i.e., environmental chemicals), does not refer to “a clinically defined disease,” and is not based on “accepted theories of underlying mechanisms nor validated clinical criteria for diagnosis.” Furthermore, the “relationship between exposures and symptoms is unproven.” 53 For these reasons, the term “idiopathic environmental intolerances” (IEI) is to be used here.
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IEI is described by clinical ecologists as a condition of multiple symptoms involving numerous areas and systems of the body without accompanying abnormal physical findings or laboratory test results. Many complaints are nonspecific. Additionally, certain defined illnesses such as rheumatoid arthritis, multiple sclerosis, and inflammatory bowel disease, as well as defined psychiatric disorders, have been attributed to multiple food and chemical sensitivities. The methods used for diagnosing and treating multiple food and chemical sensitivities encompass many of the unproved and inappropriate procedures described in more detail later in this chapter. The clinical findings and theories of IEI and the phenomenon of the clinical ecology movement have been critically scrutinized in recent years.
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