A proctologist asked his nurse for an instrument while he was examining his patient. To his surprise, she handed him a beer.
He responded, “I said butt-light, NOT Bud light!”
This is part of the problem.
You have a theory of disease which includes a mechanism and suggests a way of curing it. Your theory may be humors, it may be chakras, it may be gods, it may be germs/hormones/chemistry/etc.
You apply your theory, make your mental models, and figure out the treatments which ought to work. But the system is "noisy: lots of people may get better, even if left untreated, and some people with get worse or even die no matter what anyone can do. Patients and those who treat them are susceptible to placebo effects.
Meanwhile, it can be hard to tell who pulls through because of a treatment and who pulls through despite it.
One thing modern medicine is very good at is keeping someone alive in an ICU when they should be dead, day after day. Sometimes that alone is enough to get someone “over the hump” to a point where their physiology can bring them back to the living.
This is not to denigrate the work of surgeons, oncologists, etc, etc, etc (not to mention nurses and other paramedicals) who have tools and can do things that were unthinkable 150 years ago, and are pretty amazing even just looking back 30 years or so.
Not necessarily. Aristotle maintained that women had fewer teeth than men, without ever thinking to check.
At least after the rediscovery of the classical physicians, the line would probably be that the cure (and the theory behind it) came from the wisdom of the ancients and would be beyond question. If it failed it was because the doctor didn’t do it right, the patient didn’t approach it in the right spirit, or the right materials were not available. I.e., user error.
It’s the same philosophy that keeps people praying, which has never been shown to provide predictable, reliable benefits. The priest has an excuse whether the prayer comes true or not. If it comes true, God did it. If it didn’t come true, you didn’t pray hard enough. Or to the right gods.
Also, superstitious sports fans.
Dude, I have an aunt who assumed women have one more rib than men do because of Adam and Eve. Now. In 2017.
Same nurse used to keep their pen behind their ear. Reached up for it and found a rectal thermometer there instead: “Dammit. Some asshole’s got my pen!”
How would that work?
Adams rib was physically taken, not genetically erased.
From what I read - the problem was not so much the lack of explanation, as the doctors refused to believe the evidence… not for logical reasons, but because like global warming deniers, it didn’t fit with their world view. They were doctors, the cream of Austrian society, educated out the wazoo - not filthy like some common working class ditch digger. So telling them they needed to wash their hands intensely with strong chemicals was insulting to their view of themselves. Statistics were irrelevant. Of course, Semmelweis was none to tactful about it, earning a lot of hate and eventually being driven crazy.
That’s what is often said, but I read that the real reasons why they didn’t listen to him were in fact perfectly legitimate :
-He was an absolute nobody. Assuming they even heard about his results, they had no particular reasons to pay much attention to his work when they presumably already had on their desks works produced by famous and recognized doctors and scientists.
-Most who looked at it assumed he just had made up his results. Once again, he was a nobody working in some obscure hospital and they had no reasons to trust him. Plenty of people nowadays state that they have found a cure for cancer. How many established scientists actually look at claims instead of just dismissing them out of hand?
-Finally, he didn’t offer any explanation for what he observed. Basically, he was stating : “so, there are those magical disease vapors that somehow stick on people, stay there despite regular washing that remove all trace of anything , so presumably they’re invisible too, and they then jump on unsuspecting patients who also become ill”. So, it wasn’t because they were poor scientists that they ignored the results, but at the contrary because the idea appeared unscientific to them, and reeking of baseless “humorism” or such from past eras.
So, they reacted like a modern scientist would when hearing about some unexplained magical result, unverified, supposedly obtained by some unknown person without credentials. They ignored it.
It’s a lot easier to check how many teeth someone has than how many ribs someone has tough.
Whoops, ignore this post
There’s another element to this, which no one has directly noted yet.
Modern Egotism and false derision. One of the things that a well trained historian learns, is that the stories we tell ourselves about the past, are often shaped, not as much by what is actually known about the past, as by current day socio-political machinations.
Ever see the old SNL Steve martin skit, where Steve played a classic medieval doctor? That was an excellent portrayal of the way that post-Science historians have wildly exaggerated what ancient medicine was actually like. The exercise in self-worship by the modern people looking back, is the same indulgence that leads to a lot of myths about past leaders’ “infamous foolishness” which didn’t really happen.
by the way, I read somewhere, and no I don’t have a link, that “bleeding” does actually work, and is still applied today, for certain specific situations.
Without being overly egocentric, can I make a modern-day comparison?
I have a handful of diagnosed issues, and perhaps one or two undiagnosed. None of the docs talk to each other…ever…and if I bring up to one specialist what another has said, I get blinked at. As I get worse, I hear “Well, we could try another medicine,” or “Let’s change the dose of X medicine,” or more likely, no response at all. I did have one doc, a couple years ago, who was probably the least “qualified,” try to integrate some of my health issues and responses…but alas, he got let go for not toeing the corporate line.
What I am trying to say is, outside a purely research environment, I haven’t seen much evidence for empiricism in modern practical medicine outside the strictly conventional (local infection + antibiotics = cure kinda thing). The rest is hazy grabbing at straws.
Seeing how amazing human recuperative powers can be (even in the face of bleeding/purging regimens) and how stubborn practitioners have historically been, it’s not surprising how long it took many of them to discard worthless treatments. The process has of course been speeded up greatly in recent decades (it’s bizarre to hear alties use the term “conventional medicine” when it’s overwhelmingly alt med that clings to long-disproven nonsense, while “conventional medicine” is far more open to adopting newer, more effective options and discarding what doesn’t work well.
I think it largely boils down to extraordinary claims requiring extraordinary evidence. If you think you’ve got what it takes to overturn the existing health paradigm(s), you’d better bring your “A” game.
Nitpick: I’d put the turning point for when the odds of recovery started really favoring the patient around the 1890s. For instance, by that time surgical sterile technique was commonly practiced and anesthesia was widely used* (for a look at how grim things were just a few decades earlier, read David Oshinsky’s Bellevue).
*Fun fact: Hahnemann (father of homeopathy) is credited with rejecting the harsh, ineffective remedies of his time for much gentler but still ineffective remedies. Hahnemann is less well known for rejecting anesthesia (he believed that pain was necessary for healing, even if patients had to be held down by attendants in order to undergo surgery).
No, but somebody published an opinion paper in The Lancet about 20 years ago proposing that all medical students be required to take an acting course so that they could convincingly pretend that they were concerned for their patients’ well-being. No joke.
Yeah, it is hard to place a hard line in the sand for this. The period of scientific medicine starting back then had a remarkable series of successes. Probably the period from antiseptic surgery to the discovery of antibiotics - say 50 years- was the biggest shift in medicine ever seen. Patient expectations for the vast majority of fatal conditions changed from certain death to cure. Since then we have made significant progress, but in some ways on the second order problems. On a world scale our lack of success with malaria remains a significant blot on this record.
Well we can blame the Greens for Malaria with their half baked DDT ban. My parents, born in the 50’s, did not get malaria, my sister and I, born in the 1980’s did. Of course malaria today is a lot more treatable with medication, the prognosis had gone from, “fucked” to “should be ok, after three weeks of feeling lousy”.
Even thousands of years ago, doctors had effective remedies that did make people better. They knew how to treat injuries, they had some effective herbal remedies, they could perform basic surgery with tools made form germ resistant alloys and, if all else failed, they had marijuana and opium.
Now, all of those things have certainly advanced further now, but people still get worse after medical treatment and still die with the best possible care.
Prima facie, using mercury to treat syphilis or blood-letting to treat a fever is no more ridiculous than poisoning people with chemotherapy and hoping they don’t die.
Except that cancer chemotherapy, for all it’s drawbacks, has more evidence of efficacy than the use of mercury as medicine.
Also, blood letting is still the treatment of choice for hemachromatosis, although these days we use a needle and a blood collection bag rather than a barber with a sharp knife and a bowl to catch the blood.