Medicine's Glass House
( Originally Published 1957 )
For well over half a century, organized medicine has waged an unceasing campaign to put across the idea that the medical doctor is infallible. By means of a steady stream of newspaper and magazine articles, books and motion pictures, radio and television presentations, the legend of the omnipotent "Man in White" has been firmly implanted in the public mind. And by similar tactics, non-medical methods of healing have been cleverly belittled and ridiculed.
On the whole, this campaign has succeeded very well. When a patient dies, the relatives generally accept the medical doctor's regretful "I have done everything possible" without question. And when a medical doctor makes a mistake it is very difficult to prove it; the evidence is buried and few medical doctors are willing to speak of the errors of their colleagues.
A large segment of the public senses that the medical doctor is not half so infallible as he would have his patients believe, and dissatisfaction with medical results is frequently so great that criticisms of medical practice find their way into media of public information.
For example, one national magazine published an article describing the disillusioning experience of a man whose symptoms were diagnosed by ten different medical doctors as having been caused by ten different diseases. Only one of the ten M.D.'s, of course, could have been right but there is the possibility that all ten were wrong.
All through the history of medicine some of the most distinguished practitioners have been frank to admit the shortcomings of their profession. Hippocrates, the "Father of Healing," debunked the idea that medical doctors could work miracles by proclaiming, "If anyone believes medical art capable of per-forming more than nature allows, he is either mad or ignorant." This is in close accord with the chiropractic thesis that the chiropractor can merely adjust, while only nature cures.
Similarly, Dr. Oliver Wendell Holmes remarked somewhat sardonically that "Nature cures, but the doctor pockets the fee." He had scant respect for the efficacy of drugs and considered many of them more harmful than beneficial, saying: "If the whole materia medics, as now used, could be sunk to the bottom of the sea, it would be all the better for mankind—and all the worse for the fishes."
A great many medical men are opposed to the medical dependence upon drugs which has grown so prevalent in recent decades. The great medical pioneer, Sir William Osier, warned : "We put drugs, of which we know little, into bodies of which we know less, to cure disease of which we know nothing at all."
Dr. Harvey D. Cushing stated flatly that "a great part of what is called scientific medicine is a fetish."
Dr. James K. Hall observed, "Medicine has just about conquered all diseases only when we are talking to non-medical people," and added, "The most doleful and helpless mortal is the sick physician who has to subject himself to his fellow of like ignorance." And the famed anthropologist of Harvard University, Dr. Ernest A. Hooten, spoke of medical doctors as "high priests" who "patch up people but do not improve them."
"If we were honest, how many patients would we have?" asked Dr. William Howard Hay in commenting on medical guesswork. "Quacks" was his label for medical doctors who pretend to know exactly what they are doing when in fact they are in total ignorance of what to do.
In the light of observations like these, it is difficult to understand how medical propaganda such as What Price Your Life? can blandly dub chiropractic as "completely unscientific" and "fraud." There is an aphorism about the pot not calling the kettle black, and it seems to apply admirably to organized medicine's statements concerning chiropractic. Chiropractors do not denounce medical doctors as frauds, and they do not pretend to be infallible, even though, in many ailments, they achieve much higher percentages of cures than do the M.D.'s.
The chiropractor is not only concerned with diagnosing disease as a specific ailment. He searches for a detectable structural abnormality and corrects it. Thus wrong diagnosis to him is never a pitfall. The medical doctor, on the other hand, must make a correct diagnosis if he is to treat the patient effectively. When diagnosis is incorrect, medical treatment at best does no good and at worst does much harm, if only in delaying application of the right treatment. As a result, any evidence of widespread error in medical diagnosis is highly disturbing, to say the least.
There is, unfortunately, a great deal of such evidence. One of the most important modern studies along these lines was made some years ago by Dr. Richard Cabot of Harvard Medical School. Dr. Cabot performed autopsies on the cadavers of patients who had died at Massachusetts General Hospital and found that more than 50 per cent of the diagnoses had been incorrect and that the patients had been treated for diseases they didn't have while there had been no treatment for the diseases they did have.
Dr. Cabot found 28 different fatal ailments in the cadavers he autopsied. In none of these ailments had diagnosis been 100 per cent accurate. It was highest for diabetes mellitus (95 per cent) and lowest for acute nephritis (16 per cent). In 13 of the ailments the percentage of correct diagnosis was 50 or less; these included chronic interstitial nephritis, thoracic aneurism, hepatic cirrhosis, acute endocarditis, peptic ulcer, suppurative nephritis, renal tuberculosis, bronchopneumonia, vertebral tuberculosis, chronic myo-carditis, hepatic abscess, aortic pericarditis, and acute nephritis.
These findings emphasized what every medical doctor knows only too well, that correct diagnosis in some ailments is a simple matter while in others it is virtually impossible.
Many diseases are mistaken for others or are not detected at all. For instance, while serving as Surgeon General of the U.S. Public Health Service, Dr. Thomas Parran made the startling statement that laboratory tests for syphilis were so inaccurate in this country that half of the cases of the disease were missed entirely while many persons who did not have syphilis were treated for it.
Incorrect diagnosis is undoubtedly responsible for millions of unnecessary surgical operations each year. "I am amazed at the discrepancy between the number of abdominal scars I see daily and the few cases of genuine acute appendicitis," Dr. M. G. Peterman told a recent meeting of the A.M.A. Dr. Norman F. Miller reported not long ago that 246 hysterectomies performed during a four-month period in 10 mid-western hospitals at least one-third had been unnecessary; he bluntly titled his report, which appeared in American Journal of Obstetrics, "Hysterectomy—Therapeutic Necessity or Surgical Racket?" Just as bluntly, the urologist Dr. Arbor D. Munger told an A.M.A. group that "In the surgical treatment of diseases of the kidney the fetish for nephrectomy (kidney excision or removal) comes near to being the surgical original sin." There are so many unnecessary operations on women that ethical M.D.'s refer to them as "rape of the pelvis." Operations performed solely for the purpose of making money and which are totally unnecessary are tagged "chronic remunerative."
Reporting in Woman's Home Companion, the well-known medical writer Albert Deutsch charged flatly: "Medical men have long known the shocking fact that nine million surgical operations performed annually in America are unnecessary. Among doctors it is an open secret that in many an operating room the cloak of surgery covers mayhem and even man-slaughter."
Sheer money hunger and not faulty diagnosis is responsible for innumerable unnecessary operations. According to Dr. Paul R. Hawley, director of the American College of Surgeons, this results in over-charging by numerous surgeons, fee splitting between surgeons and general practitioners, and even "ghost surgery"- a practice in which the patient believes that a prominent surgeon operated on him while actually the operation was performed by an assistant working for the big name.
It is possible for any hospital, by examining tissue after it has been removed, to determine whether an operation was necessary. Again according to Dr. Hawley, in some hospitals up to 70 per cent of the tissue removed in appendectomies was perfectly healthy. And in the report American Medicine: Expert Testimony out of Court appears the opinion that at least 50 per cent of the surgery performed in this country is the work of physicians who lack the "special qualifications" essential to first rate service.
The whole field of drug therapy is in a state of chaos, for many M.D.'s are completely bewildered concerning the merits or demerits of a wide variety of drugs. "Most drugs," wrote Sir William Osier, "have no curative effects whatever on the diseases for which they are administered." The famous Baruch Report—a study of so called "unorthodox" methods of healing financed by the wealthy statesman-philanthropiststated unequivocally: "Medicine based exclusively on empirical use of pills and potions is becoming obsolete ..."
There is a mountain of medical evidence that many drugs—in particular the new "wonder drugs" that are often rushed into widespread usage before their possible hazards are thoroughly investigated-have done a great deal of harm.
The world-famous pathologist, William Boyd, M.D., in his introduction of the recent 7th Edition (1961) of "A Textbook of Pathology, an Introduction to Medicine" makes a most revealing statement on this problem:
"Use of the library makes us aware of the fact that the picture of disease is changing before our very eyes. Old diseases are passing away as the result of the assaults of modern therapy, but new ones are continually taking their place. The inn that shelters for the night is not the journey's end. Many of these new diseases are iatrogenic (iatros, a physician) in nature; that is to say, they are the result of the well-meant but injudicious use of therapeutic agents. In these days when tranquilizers take the place of baby-sitters, blood transfusions are given thoughtlessly, indiscriminately and often needlessly, exposure to diagnostic or therapeutic ionizing radiation has be-come so universal, antibiotics are regarded as the cure-all for the most minor infections, and steroid therapy is the refuge of the destitute, it is small wonder that the old maladies are replaced by new man-made ones, and that allergies to a multitude of antigens have become so commonplace that they are said to exceed pathogenic microorganisms in number. I must apologize for the too frequent use of the words `what is powerful for good can be potent for evil,' but this is true of so many situations created by medical therapy that I have been unable to resist the temptation. If we continually interfere with nature, we must pay the penalty. The idea is of pro-found importance to the medical student who is to become the future doctor with the safety and welfare of his patient at heart."
Further, Robert H. Moser, B.S., M.D., associate professor of internal medicine, Graduate School, Baylor University, Houston, Texas, has just published a volume titled "Diseases of Medical Progress," which provides a startling survey of diseases and syndromes unintentionally induced as a result of widely accepted medical therapeutic procedures.
The survey lists dozens of diseases and fatal side effects and other hazards as a result of indiscriminate prescription of dangerous drugs in the following categories : antibiotic induced diseases, hormone induced diseases, collagen and collagen-like diseases, pulmonary diseases, renal diseases, cardiac diseases, metabolic diseases, dermatologic diseases, hematologic diseases, neurologic diseases, hepatic diseases and a number of other iatrogenic (physician-induced) diseases.
The Foreword of this book is startling in its frankness:
"It is no secret that certain drugs, surgical procedures, and other forms of therapy can, even when properly employed, create unfavorable, often harassing, and sometimes fatal side effects. Unhappily, it is also true that drugs are frequently administered or other procedures performed, apparently without due regard for their disquieting and sometimes dangerous potentialities. One need but mention, for example, the wide-spread use of antibiotics for trivial upper respiratory infections and comparable minor ailments—a practice that seems to continue in spite - of the exhortations of many qualified authorities that these agents are, as a rule, ineffective in such cases."
And along the same lines The New England Journal of Medicine warned in its January 12, 1950, issue that although folic acid brings about remission in pernicious anemia, paralysis may be induced; that benadryl, employed against anaphylactic symptoms, may cause urticaria; that aminopyrine has caused many deaths and that the toxicity of this drug was not proven until it had been in medical usage for 15 years.
Penicillin is a proven killer and has probably taken far more lives than the official records indicate. The sulfa drugs have killed many thousands. In the treatment of pneumonia, sulfa was found to have killed one of every 160 patients treated with it. A U. S. Public Health survey revealed that the use of sulfa in treating burns, wounds, and ulcers often resulted in symptoms of sulfa poisoning such as severe skin eruptions.
Another "miracle drug," streptomycin, has been found to be nowhere nearly so efficacious as it was first believed to be. In tuberculosis, for example, it fails to benefit the majority of patients and may cause permanent vertigo, while the mere fact of its use often induces in the patient a false sense of security which may prove disastrous.
Still another "miracle drug," chloromycetin, was recently found to induce aplastic anemia which is frequently fatal. ACTH or cortisone has produced extremely grave complications in arthritic patients, one study of 4,376 patients treated with ACTH revealed that 734 had to be taken off the drug because of harmful side effects ranging from water-logged tissues to perforated ulcers. Thirty-five of the patients died of causes the investigators believed "to be directly attributable to the side effects of ACTH."
Hormones have been supposed to be wonder workers, too. But, according to the prominent health columnist Dr. T. R. Van Dellen, the female sex hormones "are not curative (in disorders of the female glandular system)" and prolong the climacteric or change of life adjustment. In both sexes, hormone treatments may stimulate the growth of cancer cells.
There is a great deal of evidence that "shots" and vaccines are nowhere near so effective as their boosters claim. One medical school of thought holds that the decline of many once prevalent diseases is actually due to improvements in general health through better diet and modern sanitation.
We have had some very dismal experiences following mass inoculations, particularly in the armed services, which indicate that the serums can sometimes cause more illness than they prevent. As a glaring illustration, during less than seven months of 1942, 28,585 cases of yellow jaundice broke out in U. S. soldiers following inoculations against yellow fever. It is a proven fact that smallpox vaccine has taken many lives. Following a 1947 "smallpox scare" in the New York area, six million persons were vaccinated. Shortly afterward, numerous deaths were re-ported from after-effects of the vaccine such as inflammation of the brain and spinal cord. In his May 14 broadcast, Walter Winchell declared that ". . an unofficial survey indicated that more people died from vaccination than smallpox itself in the past months."
The subject of vaccines and inoculations is amedical hot potato. No less a medical power than the president of the Ohio Medical Society, Dr. J. F. Baldwin, came out with the assertion that "the hand that rocks the vaccine factory is the hand that rocks the medical profession." He was promptly deposed from his high post, which might indicate to some that what he said was absolutely accurate.
The drug industry is a billion dollar business, and unquestionably it wields tremendous power in the medical world. According to Dr. Charles Solomon in his paper Chaos in Drug Therapy—A Vicious Circle, big business competition and high pressure salesman-ship by the drug manufacturers are responsible for a very sorry situation. "When ... (the M.D.'s) credulity is played upon by subtle advertising psychology, and when the drug industry is so organized that ruthless profit competition occurs," he writes, "the results are disastrous not only to medical therapy but to pharmacy, to nursing, and to the teaching of pharmacology and related subjects."
There is no doubt that a vast number of medical doctors are either cynical about the alleged merits of a vast variety of drugs or follow the drug manufacturers' propaganda without question. They get on the bandwagon for every new "miracle drug" and pre-scribe it indiscriminately, knowing that their patients will consider them behind the times if they don't.
Furthermore, there is a growing tendency for M.D.'s to prescribe proprietary medicines (drug preparations with trade names) instead of working out prescriptions to fit individual cases. Because of the plentitude of proprietary medicines, it is a fact that many M.D.'s are extremely rusty in their materia medica. When your medical doctor writes a prescription "it is all too often written incorrectly," according to Dr. Solomon. This inaccuracy is a standing joke among druggists.
Also because of the tremendous variety of proprietary medicines that are available, many medical students neglect the study of materia medica. As internes, they are often "altogether incapable of writing a satisfactory prescription for a patient," an article in International Medical Digest charged some years ago. "The shelves of some hospital pharmacies remind one of the exhibits of proprietary medicines in a chain-drug-soda-fountainlunch-room" wrote Dean Ernest E. Irons of Rush Medical College in American Journal of Pharmacy. Most trademarked drugs, according to Dr. Irons, cost far more than the standard drugs, although they do no more than meet the standards of the United States Pharmacopoeia. Thus a multitude of patients pays unnecessarily high prices for medications simply because their medical doctors are too ill educated, too lazy, or too busy to prepare individual prescriptions.
Nowhere is this professional flabbiness more evident than in the widespread prescribing of sedatives and narcotics which relieve pain and mask symptoms without effecting any benefit. According to Dr. Harry Gold, there is no depressant drug "in common use in which as a result of prolonged use there fails to arise a state of irritability and emotional unrest," while discontinuance of these drugs may result in symptoms ranging from irritability to convulsions.
Closely akin to the mumbo-jumbo of the witch doctor is the widespread administration of placebos or "little pink pills" which contain no drugs and whose sole benefit is psychological. Obviously the M.D. who passes out placebos along with some words of encouragement doesn't know what else to do. But, according to Dr. Wallace Y. Yater, chairman of the A.M.A. section on experimental medicine and therapeutics, placebos have no particular "psychological value" while the patient "should know what he is getting ..."
Thus it is painfully apparent that incompetence and chaos exist in many areas of medical practice. The facts justify the statement of Waldemar Kaempffert, noted science writer of The New York Times; to the effect that medicine is "the most pretentious of all the sciences, and the least scientific . . ." They justify the cynical remarks that have been attributed to many medical doctors, such as the comment of a New York heart specialist that his work consisted mainly of "correcting the mistakes made by other doctors," or the remark of another prominent M.D. that the one action that would do most to improve medical services would be to "chloroform half the medical profession."
So the infallible "Man in White" does not appear to be so infallible after all. Under the circumstances, it is not surprising that medicine is losing patients to chiropractors by the millions. If the medical doctor spent more time in improving the quality of his own services and less time in belittling and even libeling a successful competitor, say chiropractors, everybody would be benefited.
As Medical Economics observed : "Do you (the M.D.) think the average American is too ignorant to know what's good for him? If not, why not let him decide whether he wants to go to a chiropractor? . Isn't that the American way?"