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Whiter medicine? Translating itself and Translating in Symmetry with Complementary and Alternative Holistic Traditions
- Rey C. Tiquia (9 September 2006)
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The nuciform sac-the darker side of the moon.
- BM Hegde (9 September 2006)
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Rey C. Tiquia, Independent Scholar/Practitioner Traditional Chinese Medicine 243 Waterdale Rd. Ivanhoe 3079 Victoria Australia
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Professor Mike Saks in chapter eight "East meets west : the emergence of an holistic tradition" of the book "Medicine A History of Healing Ancient Traditions to Modern Practices" (Marlowe & Co. 1997 ) of which the late Roy Porter was the consultant editor is of the view that the future of medicine is to move straight ahead towards holism. However, he warned that there is an inherent tension between holism and scientific biomedicine which is still not fully resolved that attempts to combine the influences of the family, community and the national dimensions of life with a narrow scientific notion of medicine in an integrated biopsychosocial model, leaving biomedicine as the overriding element in the equation. This mirrors the experience of of many alternative practitioners when they are included within ortho- dox heath-care teams. They too, have frequently been subordinated within a framework of medical dominance, raising doubts about whe- ther their approaches are really being employed in a balanced and integrated manner .[p215] Furthermore, holistic reform of biomedicine is further complicated according to Prof. Saks by "continuing argument that randomised controlled trials should be used as the "gold standard" for assessing the value of alternative medicine in the West as they are in biomedicine" including traditional Chinese medicine ... a sentiment echoed recently by Professor Jin Ling Tang from the Hongkong Cohrane Branch [Tang JL. Research Priorities in traditional Chinese medicine. BMJ. 2006;333:391-394] We can say then that a holistic future for biomedicine lies in translating itself and translating in symmetry with other complementary and alternative holistic tradions. Competing interests: None declared |
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BM Hegde, Retired Vice Chancellor Mangalore 575004, India
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Dear Editor, I agree that we should take pride in what modern medicine has achieved but, there is also the other side of the coin that we seem to be missing! 80% of the world population has no touch with modern medicine, thanks to the prohibitive cost. The hi-tech stuff is available only to the rich. This reminds me of the time, exactly a Century ago, when George Bernard Shaw beautifully showed the tricks of the medical profession through his characters in his play Doctor’s Dilemma: “Sir Colenso Ridgeon thinks he has discovered a cure for tuberculosis through opsonins. Ridgeon has a limited number of vacancies at his medical Lourdes. He must decide between offering treatment to a decent, impoverished elderly fellow physician or to an artistically gifted young scoundrel. The matter is complicated by middle-aged bachelor Ridgeon’s attraction to the talented cad’s “arrestingly good-looking wife.” “All professions,remarks one of the play’s doctors, are conspiracies against the laity. And Shaw, in addition to debunking medical omniscience and conventional morality, introduces an amusing set of conspirators here. Harrumphing Sir Patrick Cullen has been around long enough to be dubious of the variously self-interested medical pontifications of his colleagues. Gentleman’s physician Sir Ralph Bloomfield Bonington is dangerously cavalier in his attacks on disease, juggling vaccines willy-nilly. And Sir Cutler Walpole thinks the cure for everything from TB to toothache is the removal of the patient’s nuciform sac.” My efforts to locate the nuciform sac in the human anatomy texts have failed so far! Shaw assembled a motley medical army which is almost identical to the usual crowd that one meets today after one hundred years! Through this satire Shaw was able to stop the cruelty of total colectomies for chronic fatigue syndrome. The medical profession and their journals could not stop Sir Arbuthnot Lane from his surgical heroics! Thomas Lewis, the then Chief of Sloan Kettering in his beautiful book, The Lives of a Cell, has a good advice for all of us. “Instead of always emphasizing what we actually know in science, it would be enormously fruitful to focus alternatively on what we do not know. For it is here that the wonders lie. To know is the domain that is safe, where risk taking is no longer necessary. To dwell in it forever is not only to never advance, it is also to promote a deceptive and false view of ourselves as knowing more than we do-of being more powerful than we really are.” Now let us take an impartial audit. 59% of improvement in the health scene in the west has come from higher standards of living, better nutrition, control of simple communicable diseases through better sanitation and education while only 3.4% could be attributed to hi-tech medicine. The war on cancer is anything but won and the future does not look good. Our present modalities of treatment of cancer remind us of the way our ancestors used to brand every disease with red hot iron! Even there treatment strategies depend more on who you see and what facilities they have. The only disease mankind has been able to eradicate, small pox, was achieved through very low tech vaccination system that prevailed in India from “times out of mind”. Our war against chronic diseases is anything but started to yield any benefit to the patients. "Doctor-thinks- you have a disease" treatments and disease inventions through routine screening are our biggest rice bowls! The big till movers, the cardiac interventions, is another big story. "Nortin Hadler of North Carolina at Chapel Hill is urging the U.S. medical Establishment to rethink its most basic precepts of cardiovascular care. Bypass surgery in particular, he says, should have been relegated to the archives 15 years ago. People often believe that having these procedures fixes the problem, as if a plumber came in and fixed the plumbing with a new piece of pipe, explains Dr. L. David Hillis, of the University of Texas Southwestern Medical School. But it fundamentally doesn't fix the problem. With doctors doing about 400,000 bypass surgeries and 1 million angioplasties a year in the US alone -- part of a heart-surgery industry worth an estimated $100 billion a year -- the question of whether these operations are overused has enormous medical and economic implications, says Dr. David Waters, chief of cardiology at the University of California at San Francisco.” "There is quite a lot of good evidence for symptom relief, says Dr. Robert Henderson, a cardiologist at Nottingham City Hospital. Critics such as Hadler, on the other hand, emphasize the risks. Not only is there a 1% to 2% chance of dying during a bypass operation, there is a high risk of complications and a 40% chance of cognitive deficits. Recent studies even raise questions about whether surgery causes the symptom relief. In June 2005, Harvard Medical School associate professor Roger J. Laham reported on follow-up results of a randomized trial looking at laser surgery to improve blood flow. Patients who got the surgery had significantly less pain and improved heart function. But so did patients who had a sham operation -- the equivalent of a placebo. After 30 months the placebo effect was still there. Scans and other tests showed physiological gains in blood flow among only those who thought they had been operated on. A similar large placebo effect might explain most of the benefits that we've seen so far with balloon angioplasty and bypass surgery," Laham says. Similar comparisons can help pinpoint dubious treatments in the past like the classic case of tonsillectomy. "More recently, Dr. James N. Weinstein, chair of orthopedic surgery at Dartmouth found that people with back pain are up to 20 times as likely to have back surgery in some parts of the country as in others. Yet it's not clear that they do better as a result. At many hospitals, cardiac units have become major profit centers. Out of 100 patients who get a drug-coated stent vs. a bare-metal stent, maybe 10 will avoid a repeat procedure," says Dr. Eric J. Topol, chief of cardiology at the Cleveland Clinic Foundation. But how many will wind up with a heart attack or death? We just don't have that nailed down yet.” David Eddy’s computer model ARCHIMEDES has scientifically debunked most of our heroic treatment models as useless and might even be dangerous. This is reflected in IOM audit of US medicine. To have an impartial audit, Fiona Godlee should invite researchers to write about our failures as well. We will thus have built a great Centenary memorial to Sir George Bernard Shaw, through the leader in the field, BMJ. “Knowledge advances not by repeating known facts, but by refuting false dogmas” wrote Karl Popper. Let us learn from history as otherwise we will be cursed to relive history, as warned by Cicero. Remember Galen in 127 AD proclaimed that the blood gets pumped through the liver. For nearly 1500 years everyone believed that only to be refuted by William Harvey in 1628 AD! Yours ever, Bmhegde Competing interests: None declared |
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