Modern medicine’s scientific base is still shaky. Yet, it is prevalent today, thanks to pharmaceutical and medical devices lobbies who earn millions. If the profession can overcome the enormous pressure of the powerful pharmaceuticals lobby, mankind could hope to get modern medicine to do most good, to most people, most of the time

“We understand and agree that performance audits are a good thing, but this goes beyond what is needed or prudent right at this moment.”— Pam Carter

“Learn from history; if you do not, you will relive history”, wrote Cicero, the great Roman thinker. Knowledge can only advance if we are able to audit our outcomes to see where we have faulted and whither should we be headed. The so called ‘modern’ medicine, which is hailed as the best in the world, has had its share of ups and downs, but is firmly in the driving seat today thanks to its claptrap and the trillion dollar pharmaceutical and the medical devices industries backing it to the hilt, for their own benefit, and least bothered about human welfare. Medical research is also directly and indirectly controlled by these greedy people. Disease mongering is rampant these days, with the market forces working in the medical arena, as we have taken the noble profession of doctoring to the market place in a corporate economy. Audit does clearly show us that the two abovementioned patrons are our biggest detractors today, thanks to their greed and proclivity for big profits, irrespective of consequences.

Auditing the then modern medicine in 1823, a young doctor and Member of the House of Commons, Thomas Wakeley, with his indignation and reforming zeal, wrote, “Doctors in London are a bunch of incompetent, nepotistic, and corrupt lot.” He said that they had become an abscess on the patient’s body, so to speak. He started a science journal in that year to educate London doctors. He called it The Lancet used to puncture the abscess that he was referring to. Nearly 187 years later, in 2010, The Lancet commissioned a leading medical historian, Hillary Butler, to audit and find out the impact of The Lancet on the medical profession. She wrote that the incompetent, nepotistic, and corrupt body that it was in 1823 has transformed itself in 2010 into a Corporate Monstrosity which would cut all Wakeleys at the knee! So it has been a sad saga for mankind of being pushed from the frying pan to the fire!

Bad Medicine is an educative book written in 2006 by one of Britain’s great historians, David Wootton, who teaches history at the York University. This wonderful book could help doctors to understand their calling in a better light. Wootton has had an advantage that he has been able to look from the outside which gave a different perspective of the problem. As an outsider he might not understand the finer nuances of medicine which basically deals with the enigma called the human body. Wootton divides the scene for the first 2500 years from Hippocrates era as the first half and the second half from then on till today. Let me sum up his finding for the first half as follows:

•  Simply put, from the 5^th century till the end of the 19^th century, doctors found out that patients were prepared to pay for their treatment, which was both “ineffective and usually deleterious.” The poor who could not pay for their sickness were lucky that they escaped torture, so to speak

•  During this period, surgery, most of it was abdominal surgery, was almost universally fatal. Rest of the modalities like blood letting, emetics and purging only weakened patients and many a time killed them. Only 20% to 30% of the patients survived which was attributed to the placebo effect! Bone setting did some good though.

•  Progress did not take place despite the fact that biology did improve during the period. Blood circulation and progress in anatomy were significant but they did not translate into therapy in any area.

•   A Kansas City doctor, Arthur Hertzler, wrote in 1938, “I can scarcely think of a single disease that doctors cured during these early years except with an exception of malaria and the itch.” Doctors knew how to relieve suffering, set fractured bones, sew up cuts, and open boils. Joseph Mathews, the president of the American Medical Association, wrote in 1905 that the only drugs that doctors needed were emetics and laxatives.

•  Homeopathy was introduced by Samuel Hahnemann, in 1810, which was quickly condemned by the American Medical Association as placebo. Interestingly there is sufficient and more proof in this period to show that the so called Hippocratic medicine was also just a placebo treatment where patients rarely recovered. Extensive studies on placebo effect were done during that period.
 

Homeopathy, chiropractic, praanic healing, radio aesthesia, and many other useful methods of treatment were successfully killed by the wealthy Rockefeller and Carnegie foundations who produced the now infamous Abraham Flexner report of 1910 in America.
 

Flexner was a retired high school headmaster at the Carnegie Foundation who wrote the report, on the state of medical education in the USA! The American government was made to ban all other medical systems based on this report! Homeopathy survived in Europe, especially in Britain, where the Royalty patronizes it even today! Dr JN McCormack, the then American Medical Association’ most powerful member in 1903, during one of his unguarded moments, admitted that they killed homeopathy. He said: "We must admit that we have never fought the homeopath on matters of principle. We fought them because they came to our territory and got our business.” Is not the cat out of the bag? The 1953 Abraham Fitzgerald report on cancer treatment fraud in modern medicine, which came to light lately, should expose shady dealings.    

Even to this day institutions teach medicine and award degrees in London, Bologna, Montpellier, US or Paris. Wotton clearly indicates that during the period under review mentioned above (i.e. 5^th to 19^th centuries), Hippocratic medicine was bad medicine which did more harm than good. Even Thomas Sydenham, known as the ‘English Hippocrates’, otherwise a wise man, was in agreement with the Hippocratic tradition.

The 20^th and 21^st centuries saw a lot of progress in biology and other sciences. Some of these developments have had profound influence on medical practice. Understanding of the human body has gone too far. Pharmaco-therapeutics has moved forward by leaps and bounds, with drugs coming out of the thousands of greedy pharma houses like a magician pulling out rabbits from his hat. Advances in anesthesia and surgery have reached their peak with doctors being able to operate on any organ. Microsurgery, robotic surgery, laser surgery and many more practices seem to have perfected the surgical technique. Preoperative and postoperative mortalities have fallen drastically.

Wootton thinks, which I’m in total disagreement with, that the most important advance in the modern era was the ‘Germ Theory’ along with the discovery of antibiotics. He goes overboard praising the last two in his book, not realising what it has brought in their wake to mankind—the curse of nosocomial infections with super bugs that can not be killed by any antibiotic. Super bugs cause real jitters to the medical world and our expensive intensive care units (ICUs) are slowly converting themselves into conduits to go to meet our maker in heaven. However, ICUs are a great rage today as 90% of the corporate hospitals’ profits are derived from dying patients in ICUs.

Wootton also thinks that the unraveling of the human genome has been another milestone development. He is wrong there as well. The new human meta-genome comprising of just about 25,000 human genes and trillions of germ genes upsets the calculations of our pundits who have been working overtime on genetic mapping and development of exogenous stem cells. This also brings the curtain down on Wootton’s euphoria on the germ theory as germs are now shown to be our friends in need and part of us. The latest treatment for fatal gastrointestinal infections is to introduce faeces, called faecal transplant, from a healthy donor through a Ryle’s tube into the gut which brings about recovery in hours to a usually fatal outcome.

The audit could be summed up based on three studies.

Writing about the disease era, Mary Tinnetti from Yale (Am. J. Med 2004; 116: 179) has this to say: “The time has come to abandon disease as the focus of medical care. The changed spectrum of health, the complex interplay of biological and nonbiological factors, the aging population, and the interindividual variability in health priorities render medical care that is centered on the diagnosis and treatment of individual diseases at best out of date and at worst harmful. A primary focus on disease may inadvertently lead to undertreatment, overtreatment, or mistreatment.” 

Barbara Starfield from Johns Hopkins, in her comment in the Journal of the American Medical Association (2000; 284: 483), feels that present day doctors, drugs and surgeries together lead the list of causes of human death and disability!
 

Gary Null and his colleagues from The Institute of Nutrition, using the US government statistics, arrived at the conclusion, in 2008, that the medical fraternity of modern medicine leads cancer and heart attack deaths with the first rank in that order of preference, as the causes of mortality and morbidity.
 

All is not well with us.

Modern medicine’s scientific base is still shaky. Physics changed science nearly 90 years ago but medicine is yet to catch up. Quantum physics has shown that the human body is immaterial-mental and spiritual. Diseases are just an altered energy pattern and the remedy, naturally, should be rearranging the altered energy pattern. If the profession can overcome the enormous pressure of the powerful pharmaceuticals lobby, mankind could hope to get modern medicine to do most good, to most people, most of the time. Interestingly, modern medicine has been kind to the poor as they were not touched by it. The poor were spared of the sorrows of iatrogenesis and nosocomial deaths. Of course, the poor pay for their poverty with their lives. Even placebo effect seems to be the sole cause of human relief as per the latest study, done using the latest technologies, in Oxford, Cambridge, Hamburg and Munich universities. (Sc. Transl. Med. March 2011 and Genetics 2008; 179: 727)
 

Interestingly, life expectancy and good health have very little to do with drugs, surgeries and what have you. Life expectancy was based on Hippocratic medicine to the tune of 2% to 18% only. Rest of it, between 82% and 98%, came from economic prosperity, better nutrition, employment, sanitation, better work environment, better living, education, and tranquility of mind. Modern medicine was probably about 3.4% useful to mankind. The developing countries could learn a vital lesson from the audit to concentrate on the factors that bring down mortality and improve health.

In conclusion, I would like to agree with the title of David Wootton’s book in full, which reads: Bad Medicine—Doctors Doing Harm since Hippocrates. If only we could do what Maimonides advised us that we will do much better: “The physician should not treat the disease but the patient who is suffering from it.”
 

 “A bitter reality of truth can be wisely told in a sweet tale of lullaby.”  — Toba Beta, 
 

To read more articles from Dr Hegde, please click here.
 

(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS. He is also Editor-in-Chief of the Journal of the Science of Healing Outcomes, Chairman of the State Health Society's Expert Committee, Govt of Bihar, Patna. He is former Vice Chancellor of Manipal University at Mangalore and former professor for Cardiology of the Middlesex Hospital Medical School, University of London.)