Srila Prabhupada's medical care

Concerns about the quality of care Srila Prabhupada received in his final manifest days have been long held by some devotees. As early as 1995, PADA began publicly calling attention to conversations like the one in Vrindabin on November 8, l977, in which Srila Prabhupada says that he has been poisoned. Only recently have greater numbers of devotees begun to seriously question what occurred during Srila Prabhupada's final days. Many feel that allegations of poisoning are strongly indicated, and that serious investigation is required to determine if poisoning actually occurred, whether intentional or accidental.

An ever increasing number of disciples are also adamant that the time has come for a complete and public reporting of the details of Srila Prabhupada's health, medical program, and personal care. In response to the allegations of poisoning, a number of devotees have come forward to share their past experiences and remembrances from late 1977.

Information is being sought on exactly what prescriptions and medicines Srila Prabhupada was taking, who was directing his program of care at various times, what program of diet was being followed, etc.

Also reports state that Srila Prabhupada had called his Sister Pishima to Mayapur to cook for him, because he was concerned that he was being given poison. Although Srila Prabhupada ordered that his sister Pishima should cook for him, yet, it seems that in the last days only the leaders, such as Tamal Krishna and senior Sannyasis in Vrindavana, were in charge of the water, medicine and cooking?

Citrakara dasa, an MD in Alternative Medicine, an Ayurveda Physician and disciple of Srila Prabhupada, reported on his extensive discussions with Abhirama dasa about the quality of care Srila Prabhupada received. Citrakara dasa expressed serious concerns about the handling of Srila Prabhupada's diagnosis of diabetes.

In his report of November 12, 1997, Mahabuddhi dasa quotes segments of a tape conversation in Bengali, where Srila Prabhupada complains that he has been given very sweet hot milk. Like Citrakara dasa, Mahabuddhi dasa also questions why a known diabetic was being given sugar.

INTRODUCTION: HEALTH BIOGRAPHY

CHAPTER 17: 1977 HEALTH BIOGRAPHY

On his taped memories of Srila Prabhupada, Tamal Krishna Goswami recalls that Srila Prabhupada developed a "cold" in New Vrindaban during Hie visit there June 22 to July 2, 1976. Tamal states that this cold came to visit New York on July 9. However, Srila Prabhupada first became ill on May 4, 1976 in Hawaii, the day after Tamal arrived there to discuss with Srila Prabhupada the futility of his directive to go to China. By the time Srila Prabhupada was leaving New York on July 20 for Europe and India, Satsvarupa's biography describes:

"Srila Prabhupada's health was worsening, as often happened when he traveled extensively. Particularly in New York his health began to suffer... Senior devotees entreated him to rest awhile before going to England and India. He had spent a very pleasant day at the ISKCON farm in Pennsylvania, and the devotees suggested he go there for two or three months to rest, recover his health, and write."

Satsvarupa recounts that there were daily pleas for Srila Prabhupada to stay, including on the last day in New York, "...even as he left his room and got on the elevator, a few men followed, still suggesting he not go... Srila Prabhupada had remained jolly so far, despite his physical weakness, and despite his disciples' pleading..." Srila Prabhupada then said, "I want the benediction to go on fighting for Krishna, just like Arjuna." (Sat:6.208)

Tamal states on a tape recording that Srila Prabhupada "never fully recovered" from His New York illness. (Tamal Krishna Goswami was GBC of New York temple at the time.) Hari Sauri's diary better describes the New York illness than did Satsvarupa's biography. Srila Prabhupada became very ill within hours of leaving New York, remaining ill for the next month in Europe. After recovering from the July-August illness, there were no more serious health problems until January 1977. But by the time Tamal went to Mayapur in February 1977, Srila Prabhupada was even more weak than when he had last seen Him in New York.

From Satsvarupa Goswami's biography we read of vague health problems prior to 1977, such as swelling of the hands and feet, that were aggravated by old age and the rigors of constant travelling and preaching engagements. Satsvarupa notes that Srila Prabhupada was supposedly mildly diabetic, although there is no available officially rendered diagnosis to this effect. Perhaps this notion comes from the 1967 visit to Bellevue Hospital at the time of Srila Prabhupada's heart attack. He had no significant heart troubles since the attacks of 1965 and 1967. He had the usual colds and occasional bronchitis, and briefly became very ill in Vrindaban in 1974. Srila Prabhupada was very regulated and deliberate in His eating habits to maintain optimum digestion and health. He received massages daily and took regular morning walks for His good health.

In TKG's Diary, Srila Prabhupada's health and medical condition is not clearly defined, except with vague and contradictory so-called diagnoses, such as "internal fever", which makes no sense whatsoever. At the end of Tamal's book, we are left confused as to what illness had befallen Srila Prabhupada. To illustrate the point, see Chapter 42: Parade of Doctors, Treatments, and Mis-Diagnoses. On November 5, 1997, Abhiram Prabhu published a letter on the internet giving a summary of his knowledge and experience as Srila Prabhupada's nurse, but it also is very limited. The diagnosis therein of dropsy is also completely inadequate. Dropsy is a kidney disease, which we will see only partially explains Srila Prabhupada's medical condition.( See Chapters, 18, 32)

Srila Prabhupada's 1977 medical history is poorly documented and recorded, and though He was seen by a "parade" of allopathic and Ayurvedic physicians, many of their names and most of their treatments are unknown. Satsvarupa's biography is cursory, giving only the briefest health information. In Satsvarupa's and Tamal's accounts, we read of periodic downturns in health and of general symptoms like swelling and no appetite, of various unspecified pills, tonics and of dark sunglasses. Thus the whole matter seems a little mysterious and more than a little frustrating.

Specifically, what was Srila Prabhupada suffering from? Kidney problems? What was the specific disease or ailment, and what was its cause? To study Srila Prabhupada's physical symptoms and thus be able to diagnose His illness, this author has compiled information from all available sources into one synthesized health biography, contained in the following chapters.

We will see that Srila Prabhupada certainly had kidney problems, but also that He clearly had all the signs of chronic arsenic poisoning. The coming chapters will illustrate the difference between kidney disease and arsenic poisoning, and demonstrate that both conditions were present in Srila Prabhupada's body, judging from the symptoms chronicled in a composite and lengthy health history from May 1976 to November 1977.

A review of the health history of Srila Prabhupada in 1977, presented in Chapters 20 through 31, lends the impression of a band-aid approach to health care coupled with a resolute avoidance of any qualified medical attention or evaluation. There was no coherent or intelligent approach to dealing with Srila Prabhupada's health problems. Understandably, Srila Prabhupada would be cautious in dealing with hospitals and doctors, as the Western medical profession can just as easily ruin one's health as well as restore it. Nevertheless, sufficient funds and contacts were available to procure a wide choice of qualified and cooperative doctors without being subjected to injections and operations. Instead, the horrors and defects of modern medicine were repeatedly described to Srila Prabhupada in what almost seems to be a determined attempt to steer Srila Prabhupada AWAY from any proper medical attention. Why? Was there something to conceal that only modern Western medical techniques could discover? Tamal was especially emphatic is discouraging the use of doctors and medicines, a fact that can be seen clearly in the Conversations Books but not in TKG 's Diary.

It is ironic that 22 years after Srila Prabhupada was repeatedly discouraged by Tamal Krishna from availing Himself of proper medical attention that Tamal himself, through modern medicine, was diagnosed with advanced prostate cancer. On January 26, 1999, Tamal employed the best doctors and surgical procedures in a modern Western hospital in the hope of becoming cured, (it seems he was) Why did Tamal not take the advice he gave to Srila Prabhupada, and go to Vrindaban to chant and die out of distrust in Western medicine and doctors? Why the apparent double standard?

At the best, it appears that Srila Prabhupada's caretakers stood by helplessly, perhaps even somewhat uselessly, while Srila Prabhupada withered away due to misunderstood health problems and a series of contradictory mis-diagnoses. It might seem farfetched that the avoidance of modern medicine was deliberate and necessary to prevent detection of the real cause of Srila Prabhupada's declining health, namely poisoning. Yet, that is what this book is about; and such a conclusion may not be so crazy after all. Indeed, very unfortunately, it appears to be all too true.

From the accounts available, Srila Prabhupada was already in a veakened condition on February 26, when the first and very serious attack of 1977 illness occurred. Thereafter, the grave worsening of Srila Prabhupada's health was marked by a series of abrupt, repeated, and sudden downturns, in May, July, September and October, illustrated in a later graph. Each downturn brought increased weakness and inability to eat or digest food.

We can understand that Srila Prabhupada most probably had weak kidneys, but, as we shall see in the health biography, there were physical symptoms not consistent with kidney disease, diabetes or poor digestion, the 3 ailments offered to explain Srila Prabhupada's poor health in His last year.

Abhiram Prabhu, who served Srila Prabhupada as his nurse from July 25 through October 16, 1977, notes that Prabhupada was actively involved in his own health care. He has said that much to the chagrin of those closely involved, Srila Prabhupada's approach was to accept the help of anyone who came forward with sincere goodwill, apparently accepting that such a person was sent by Krishna for that purpose. Hari Sauri also offers his analysis on this subject in Appendix 21. Nevertheless, it remains clear Srila Prabhupada was serious about restoring His health. This is evidenced by His calling for certain doctors from His past and how He remembered or invented medicines and treatments to use in the pursuit of improved health. He was, though, more inclined towards natural and Ayurvedic procedures and cures.

Throughout 1977, Srila Prabhupada primarily entrusted His health care to His servants, depending on their best judgment and arrangements. Although He would sometimes initiate some action regarding His health, generally Srila Prabhupada abided by the recommendations and decisions of Tamal Krishna, and, to a lesser extent, His other servants and the GBC members. This was especially true later in 1977. The GBC meetings and decisions regarding Srila Prabhupada's health were compliant with Tamal's emphasis on avoidance of doctors and real medical attention.

The summary is that Tamal alone directed to a great degree the course of Srila Prabhupada's health care in 1977. Tamal filtered the news, the letters, the guests. Tamal ruled the situation with a strong hand and he was firmly situated as Srila Prabhupada's guardian, advisor, and personal secretary. Tamal was more or less in control, at least from an external perspective. He had great latitude in charting and steering the course of Srila Prabhupada's health care, travel plans and interaction with the outside world of devotees, guests and doctors.

Aside from the written sources available, further information about Srila Prabhupada's physical symptoms was obtained from the recollections of individual devotees, such as Dristadyumna, Udayananda, Bhagwat, Sura, Pradyumna, and others. Most information was accumulated from the Conversations Books, based on actual tape recordings of Srila Prabhupada. These recorded room conversations provided many details and "the rest of the story " in many incidents poorly or not chronicled by Tamal or Satsvarupa.

Each remedy that was undertaken to restore Srila Prabhupada's health, however, produced no lasting results. Adridharana, in a recorded interview (which was stolen and ended up with the GBC), recalled feeling a mood of frustration with these various and ineffective health care attempts. Some, including Adridharana, had hoped a qualified doctor would be found who would be able to treat Srila Prabhupada consistently until cured. There had already been a parade of various practitioners, (see Chapter 42) some good, some bad, all who came and went, and the treatments and medicines also came and went. Adridharana located and brought the last kaviraja to treat Srila Prabhupada at the end of October 1977. Despite the stellar qualifications of the last kaviraja, his treatments were ineffective, either because he was too late or he had mis-diagnosed the ailment. It was both.

Why was each new treatment soon discontinued, one after another? Why were there adverse reactions almost EVERY time Srila Prabhupada began a new treatment? The result was the repeated rejection of doctors, medicines and treatments, one after another. Bhavananda and Tamal were "relieved" that Srila Prabhupada decided to die peacefully, without further botheration with "the struggle to live." Could something unknown to us have caused those adverse reactions, besides the various medicines themselves? Or is it an odd coincidence? (see Chapter 40)

Gradually Srila Prabhupada's health deteriorated and He finally decided to finish his pastimes in this world on November 14, 1977. We now know there was a poisoning of Srila Prabhupada, (see Chapter 33) which, of course, occurred only by the sanction of the Supreme Lord. Srila Prabhupada may or may not have been aware of it earlier than November, (see Appendix 18 ) We know Srila Prabhupada knew that He was being poisoned because He said exactly that a few days before His disappearance.

The final pastimes of Srila Prabhupada have very much of the flavor of Jesus Christ's crucifixion, where the pure devotee willingly accepts the Lord's arrangement without protest. Srila Prabhupada may have known that He was being poisoned throughout 1977, and the absence of His protest or an earlier acknowledgement to this effect can be understood as His surrender to Krishna's plan, while, out of His boundless mercy, still accepting service from those who were His poisoners.

As stated before, the symptoms of Srila Prabhupada's illness in 1977 are recorded in bits and pieces in various publications. The information from all sources was combined into one comprehensive, synthesized health biography by this author in Chapters 20 through 31. This synoptic chronicling provides a sound basis for evaluation and diagnosis of Srila Prabhupada's illness by symptom analysis.

We understand that Srila Prabhupada had weak or problematic kidneys long before His serious 1977 illness. Did Srila Prabhupada have the symptoms of kidney disease in 1977? Yes. But were there additional symptoms which are not found in kidney disease? Yes, again. Kidney disease symptoms are described in Chapter 18, and upon examination, we can ascertain quite positively that there was more going on with Srila Prabhupada than simply kidney disease. Although the symptoms indicate that Srila Prabhupada had kidney problems, there are many symptoms which must be attributed to some other cause, and this book establishes that other cause to be chronic arsenic poisoning.

The same process used to ascertain the correct diagnosis of Srila Prabhupada's illness by examination of physical symptoms is applied to diabetes in Appendix 7. Diabetes symptoms do NOT match the symptoms that Srila Prabhupada displayed, as there are several diabetes symptoms which Srila Prabhupada positively did not display, such as obesity and excessive hunger. There is definitely some other cause besides diabetes which is producing the kind of symptoms that Srila Prabhupada had. This book shows that cause to be chronic arsenic poisoning.

A complete and summary analysis of symptoms will be made after the health history, in Chapter 32. First, however, we will study the symptoms of kidney disease and arsenic poisoning. In this way, when the reader progresses to the health history in Chapters 20-31, he will know what to recognize as attributable to kidney disease, arsenic poisoning, or both.

ARSENIC POISONING SYMPTOMS

CHAPTER 19: WHY ARSENIC?

Srila Prabhupada displayed the symptoms of poisoning, as He Himself stated twice. But which poison? There are many poisons which are effective in causing death. The factors which led this author to examine arsenic poisoning as the best match to Srila Prabhupada's symptoms, as studied in His 1977 health history, are as follows:

1. The opinion of an Ayurvedic doctor, Dr. Mehta, detailed below

2. Arsenic is an age-old method of choice for poisoning in politics and intrigue, during the Middle Ages and in India (see Appendix 14 )

3. Arsenic is readily available in India

4. The speech reversals (see Chapter 37-38) reveal arsenic poisoning

5. It was found that Srila Prabhupada's symptoms were incredibly similar to those of Napoleon

6. Arsenic poisoning is very difficult to recognize, and looks like kidney disease and a normal "old-age" deterioration of physical health

Dr. Mehta, an Ayurvedic physician who lives in Houston, was shown several photographs of Srila Prabhupada during His last days, and he also observed the video documentary of Srila Prabhupada's last months entitled: "The Final Lesson." Dr. Mehta has been a practicing Ayurvedic physician since 1948. His summary comments are:

"The expression and symptoms of the face, the eyes and the manner of speaking indicate to me that Srila Prabhupada was poisoned, most probably by arsenic or mercury. He Himself said that He was poisoned, confirmed by dullness of the face and how the natural color of the body is gone. This is very hard for the average person to understand; only the experienced eye can tell."

Srila Prabhupada, as we shall see, clearly displayed the symptoms of arsenic poisoning, and not simply the symptoms of kidney failure alone. The symptoms of kidney failure were definitely present and are repeatedly observed. There are, however, many other very prominently displayed symptoms which are synonymous with arsenical intoxication, and these symptoms are not found in any condition of kidney disease or diabetes. Let it be stated here again that arsenical intoxication produces kidney malfunction and failure. Thus it is so easy to mistake arsenic poisoning for kidney disease, as many, perhaps about half, of the symptoms are identical or similar.

In consulting with Dr. Stopford of the Duke University Department of Toxicology, it was also confirmed that many of Srila Prabhupada's symptoms cannot be explained by kidney or diabetic diseases, but most surely can be attributed to arsenic poisoning. Symptom analysis is a very critical element of the research into Srila Prabhupada's cause of "death."

GENERAL INFORMATION:

Chronic and acute poisoning differ in that chronic means exposure over a prolonged period of time in smaller amounts and acute is more all at once. Subacute poisoning is in between the two. Because Srila Prabhupada's health declined over ten months, chronic poisoning is compatible with His health history, whereas acute poisoning might apply to the final days and subacute poisoning applies to marked and drastic downturns in His health.

Arsenic is found in nature in low levels, and has been a common environmental contaminant in the twentieth century. In its various chemical forms, it can be highly poisonous and has actually been used for thousands of years for killing others, in political intrigue, revenge, murder, war, and the elimination of perceived enemies. Medicinally, arsenic compounds have been useful in the West at least since the time of Hippocrates in the 5th century BC. In modern times, arsenic has been used to treat skin diseases, anemia, syphilis, and other ailments.

Arsenic is a natural element having both metal and non-metal physical and chemical properties. In its chemical behavior, it resembles nitrogen, phosphorus, antimony and bismuth. In nature it exists as an element, and also in stable compounds, trivalent (-3 or +3) and pentavalent (+5). It binds covalently with most non-metals (notably oxygen and sulfur) and with metals such as cadmium and lead. In biochemical behavior, it resembles phosphorus, competing with phosphorus analogs for chemical binding sites. Toxicity of the various arsenic compounds in mammals extends over a wide range, determined, in part, by unique biochemical actions of each compound, but also by absorbability and efficiency of biotransformation and disposition.

Arsines (gaseous) are most poisonous, followed closely by arsenites and arsenates (inorganic trivalent compounds). Inorganic pentavalent compounds are somewhat less toxic than arsenites, while the organic (methylated) pentavalent compounds incur the least hazard of the arsenicals, with widespread use in pesticides. Inorganic arsenite as arsenic trioxide is the most prevalent natural form and is also the most toxic form of arsenic besides arsine gas. Arsenic metal is thought to be nonpoisonous due to its insolubility in water or bodily fluids. In animals and plants arsenic combines with hydrogen or carbon to make organic compounds.

Pentavalent arsenicals are relatively water soluble and absorbable across mucous membranes, while trivalent arsenicals, having some water solubility but greater lipid (fat) solubility, are more readily absorbed across the skin. The arsenite salts are more soluble in water and are better absorbed than the oxide. Experimental evidence has shown a high degree of gastrointestinal absorption of both trivalent and pentavalent forms of arsenic, most compounds exceeding a 90% absorptive rate. The greatest absorption occurs predominantly in the small intestine and colon.

Goldfrank's text states: "Tasteless and odorless, arsenic is well-absorbed via the gastrointestinal, respiratory, and parenteral routes." Ingestion has been the usual basis of poisoning and gut absorption efficiency depends on: the physical form of the compound, its solubility characteristics, the gastric Ph, gastrointestinal motility, and gut microbial transformations.

Once absorbed, many arsenicals accumulate in and cause extensive toxic injury to cells of the kidney, liver, spleen, lungs, heart, nervous system, blood vessels, gastrointestinal tract, and other tissues. Much smaller amounts accumulate in muscle and neural tissue, but cause great toxic injury there as well. If a victim survives arsenic poisoning after the first few days, the liver and kidneys show degenerative changes.

Two biochemical mechanisms of toxicity are recognized with arsenic:

1. reversible combinations with thiol groups contained in tissue proteins and enzymes

2. substitution of arsenic ions for phosphate in many reactions, including those critical to oxidative phosphorylation.

Arsenic is thought to cause toxicity by combining with sulfhydryl (-SH) enzymes and interfering with cellular metabolism.

Most arsenic compounds are tasteless and odorless. Arsenic trioxide (As2O3) used to be a common cause of accidental poisoning because it is readily available, is practically tasteless, and has the appearance of sugar as a white crystalline powder. Arsenic trioxide, also known as arsenious oxide, white arsenic or simply as arsenic, is extremely toxic as one of the deadliest known poisons, with 60 to 200 milligrams being fatal. This amounts to about 1/300 of an ounce or the weight of one quarter of a 3 by 3 inch post-it note. Arsenic also has been used and is stored around the world for military purposes as a poison gas. Arsenic is extracted from nature by smelting arsenopyrite, found widely around the world.

Children, embryos, the chronically-ill, and the elderly are more sensitive to arsenical intoxication. The type of compound, dosage, health condition and duration of exposure are critical factors. Arsenic compounds are commonly found commercially in treated lumber, wood preservatives, pesticides, herbicides, fungicides, dyes, and paints, and is often present in tainted tobacco and some old folk remedies. Tryparsamide, carbasone and arsphenamine are a few arsenic compounds used in medicine to treat ailments such as intestinal parasites, syphilis, psoriasis and dysentery.

In arsenic poisoning, urinalysis may reveal proteinuria, hematuria, and pyuria. Urinary arsenic excretion varies inversely with the postexposure time period, but low-level excretion may continue for months after exposure. In cases of suspected arsenic toxicity in which the urinary arsenic measurements fall below accepted toxic levels, analysis of hair and nails may permit a diagnosis. Because of the high sulfhydryl content of keratin, high concentrations of arsenic are deposited in hair and nails. Chronic ingestion of small amounts of arsenic, as is suspected in the case of Srila Prabhupada 's poisoning, result in highest concentrations in hair, nails, and skin, tissues which are rich in cysteine-containing proteins. Chronic accumulation also occurs in the lungs.

Deposition in the proximal portions of hair can be detected within 30 hours of ingestion, and arsenic stays fixed at this site for years (in Napoleon's case, 150 years). Hair grows at a rate of 0.4 mm per day (half inch a month) while nail grows 0.1 mm per day. Total replacement of a fingernail takes 3-4 months while toenails require 6-9 months of growth. Because of its chemical similarity to phosphorus, arsenic is deposited in bone and teeth and is retained there for long periods.

Humans eliminate and detoxify inorganic arsenic by a metabolic process of methylation, yielding cacodylic acid (dimethylarsinic acid) as the chief urinary excretion product. Biomethylation can quickly become saturated, however, the result being the deposition of increasing amounts of arsenic in soft tissues. Otherwise arsenic can be eliminated by many routes (feces, urine, sweat, milk, hair, skin, lungs), although most is excreted in urine. The half-life for urinary excretion is 3 to 5 days, during which time great damage is done to the internal tissues and organs. Another half of the remaining amount is eliminated within another week, the next half-life in another month, etc. Thus after 6 weeks there still remains about 10 to 15 % of the original amount in the urine. Thus repeated doses will begin to accumulate in the body quickly despite the process of elimination. As arsenic takes its toll, the body loses its ability to eliminate it, compounding the toxic accumulation and the rate of internal destruction of tissues and organs.

In single or acute arsenic poisonings, the arsenic is deposited throughout the body in most organs and tissues. If there is chronic poisoning of repeated doses over a long period of time, the efficiency of elimination by the body dramatically decreases and arsenic accumulates much more permanently in the internal organs and tissues. The blood, liver, brain, heart and kidneys are top priority in the body's cleansing, while arsenic is pushed out the urine and into the hair, nails and skin as much as possible. Chronic poisoning gradually takes a serious irreversible toll of damage to the blood manufacturing capability, the kidneys and liver, the brain and heart, the central nervous system progressing from the periphery inwards, and the muscular system, among other areas of acute damage.

Some of the symptoms of arsenic poisoning can be seen with other illnesses, making it very difficult for a doctor to detect it, and it is easily mis-diagnosed as more commonly understood ailments and diseases, such as kidney disease, (see Appendix 13) Chronic (low level) arsenic poisoning from repeated absorption of toxic amounts generally has an insidious (subtle or stealthy) onset of clinical effects and is very difficult for a doctor to recognize.

Arsenic poisoning can be detected by studying the patient's symptoms, or by the testing of tissue samples, hair, fingernails, teeth, or urine. The onset of gastrointestinal symptoms may be so gradual that the possibility of arsenic poisoning would be easily overlooked. Over all, arsenic intoxication has not been extensively studied due to its rarity, and its effects are not fully known.

In observing Srila Prabhupada's stubborn reluctance to take any food or drink for many months, and in light of the fact that Srila Prabhupada Himself stated He was being poisoned, it is interesting to quote Goldfrank's text with this advice:

"For all cases, if homicidal intent is suspected, patients should be advised against accepting food or drink from anyone. Visitors should be closely monitored and outside nutritional products should be forbidden."

Nityananda das: Srila Prabhupada may have had His major exposure to arsenic earlier in 1977 with hair readings far above the elevated reading of His October hair. Very little additional arsenic may have been required later in 1977 to maintain a Srila Prabhupada's declining health after initial heavy doses of poison early in 1977. Once poisoned with adequate amounts of arsenic, Srila Prabhupada's body would have naturally worsened in health due to the latent effects as the year wore on.

please also see:
SRILA PRABHUPADA'S HEALTH BIOGRAPHY ANALYSIS