Re:College of Medicine, Quackery, a vocabulary of denigration ?
These recent exchanges will remind some readers of the Mad Hatter's
tea party (1) , when statements, sometimes abusive, were thrown back and
fore, to little effect except for the bemusement of observers. The
participants had such fixed but different views of the world about them,
without appreciating the nature and extent of those differences, that
they might have been speaking in different languages, for all the sense
that they made to each other.
Other readers will be reminded of events a century and more ago, and
wonder what we can learn from them, for the benefit of our patients, which
should always be our prime concern.
At the beginning of the last century, Bleuler and Kraepelin, well
respected physicians and psychiatrists, were working on the delineation
and diagnosis of the major psychoses. They heard what their distressed
and distracted patients said, and categorised their behaviour and
responses in an attempt to enable psychiatric diagnoses to be made as
were the diagnoses of physical diseases, on symptoms and physical signs.
They were seeking objectivity,partly in an attempt to be seen as more
scientific, by colleagues.
They heard what their patients said , but they did not listen to them.
They dismissed their patient's ramblings or outbursts as signs of disease,
without any meaning nor relevance, except in so far as they were an aid in
categorising them. They regarded their psychotic patients as being
inaccessible to reason and dialogue.
Half a century later, it was realised that many of the 'deluded' and
'psychotic' statements that generations of psychiatrists had heard as
meaningless, were often full of meaning and significance, and described
the traumas that may have precipitated and accompanied the illness. It was
necessary to listen, as well as to hear, and to be aware of the very
different nature of reality, seen from the side of the patient, or the
'other'. Many of the labels attached to behaviour and speech which
psychiatrists were used to attaching to patients, could be considered a
"vocabulary of denigration ". (2)
A quack is defined in the Oxford English Dictionary as someone who
will " puff or palm off with fraudulent and boastful pretensions..
administer quack medicines.. seek to remedy by empirical or ignorant
treatment. "
Perhaps those writers who have made accusations of quackery are
neglecting their professional duty by not asking the General Medical
Council to investigate those whom they identify ?
If they have used the word without understanding it, they have been
mischievous, to say the least.
Or is there some other explanation ?
Do contemporary critics of complementary medicine have their own
'vocabulary of denigration', enabling them to dismiss the experience and
practice of colleagues which conflicts with their own sense of reality,
and which discomforts them so much that they forgo the option of enquiring
more of what they do not understand ?
Their discomfort can be easily understood, even condoned . Worldly success
and recognition may encourage a type of self esteem which is analogous to
an inflating balloon. With his every puff it grows bigger, obscuring the
owner's view of the world. With every puff it becomes more fragile and
vulnerable to the smallest pin prick.
We must strive for a more adult debate, learning from the military,
the importance of proportionality in our responses, when challenged. And
be sensible, like Professor Colquhoun, apologising when we cross
reasonable boundaries in debate.
Professor Ernst recognises " ..outright quackery which has the
potential to kill patients ."
Perhaps a matter for the GMC ?
And yet, " adverse drug reactions have reached epidemic proportions
and are increasing at twice the rate of prescriptions. The European
Commission estimated in 2008 that adverse reactions kill 197,000 EU
citizens annually, at a cost of 79 billion euros ." (3)
No contest there, on NNK ( Number Needed to Kill ).
1 Alice's Adventures in Wonderland (1865) Lewis Carroll
2 The Divided Self (1960) RD Laing
3 The Lancet Vol 377 June 4, 2011. p1915
Competing interests:
Contented Gp, occasional unpaid homeopath, no connection with The College of Medicine.
Rapid Response:
Re:College of Medicine, Quackery, a vocabulary of denigration ?
These recent exchanges will remind some readers of the Mad Hatter's
tea party (1) , when statements, sometimes abusive, were thrown back and
fore, to little effect except for the bemusement of observers. The
participants had such fixed but different views of the world about them,
without appreciating the nature and extent of those differences, that
they might have been speaking in different languages, for all the sense
that they made to each other.
Other readers will be reminded of events a century and more ago, and
wonder what we can learn from them, for the benefit of our patients, which
should always be our prime concern.
At the beginning of the last century, Bleuler and Kraepelin, well
respected physicians and psychiatrists, were working on the delineation
and diagnosis of the major psychoses. They heard what their distressed
and distracted patients said, and categorised their behaviour and
responses in an attempt to enable psychiatric diagnoses to be made as
were the diagnoses of physical diseases, on symptoms and physical signs.
They were seeking objectivity,partly in an attempt to be seen as more
scientific, by colleagues.
They heard what their patients said , but they did not listen to them.
They dismissed their patient's ramblings or outbursts as signs of disease,
without any meaning nor relevance, except in so far as they were an aid in
categorising them. They regarded their psychotic patients as being
inaccessible to reason and dialogue.
Half a century later, it was realised that many of the 'deluded' and
'psychotic' statements that generations of psychiatrists had heard as
meaningless, were often full of meaning and significance, and described
the traumas that may have precipitated and accompanied the illness. It was
necessary to listen, as well as to hear, and to be aware of the very
different nature of reality, seen from the side of the patient, or the
'other'. Many of the labels attached to behaviour and speech which
psychiatrists were used to attaching to patients, could be considered a
"vocabulary of denigration ". (2)
A quack is defined in the Oxford English Dictionary as someone who
will " puff or palm off with fraudulent and boastful pretensions..
administer quack medicines.. seek to remedy by empirical or ignorant
treatment. "
Perhaps those writers who have made accusations of quackery are
neglecting their professional duty by not asking the General Medical
Council to investigate those whom they identify ?
If they have used the word without understanding it, they have been
mischievous, to say the least.
Or is there some other explanation ?
Do contemporary critics of complementary medicine have their own
'vocabulary of denigration', enabling them to dismiss the experience and
practice of colleagues which conflicts with their own sense of reality,
and which discomforts them so much that they forgo the option of enquiring
more of what they do not understand ?
Their discomfort can be easily understood, even condoned . Worldly success
and recognition may encourage a type of self esteem which is analogous to
an inflating balloon. With his every puff it grows bigger, obscuring the
owner's view of the world. With every puff it becomes more fragile and
vulnerable to the smallest pin prick.
We must strive for a more adult debate, learning from the military,
the importance of proportionality in our responses, when challenged. And
be sensible, like Professor Colquhoun, apologising when we cross
reasonable boundaries in debate.
Professor Ernst recognises " ..outright quackery which has the
potential to kill patients ."
Perhaps a matter for the GMC ?
And yet, " adverse drug reactions have reached epidemic proportions
and are increasing at twice the rate of prescriptions. The European
Commission estimated in 2008 that adverse reactions kill 197,000 EU
citizens annually, at a cost of 79 billion euros ." (3)
No contest there, on NNK ( Number Needed to Kill ).
1 Alice's Adventures in Wonderland (1865) Lewis Carroll
2 The Divided Self (1960) RD Laing
3 The Lancet Vol 377 June 4, 2011. p1915
Competing interests: Contented Gp, occasional unpaid homeopath, no connection with The College of Medicine.