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…The Real History of Medicine.

Title for this installment: Experiences in Empiricism – Past and Present.

Introduction: “The beautiful rests on the foundations of the necessary,” Ralph Waldo Emerson. Thanks for being part of the early TGM experience as we continue to lay the necessary foundation for what we think is beautiful, good medicine. Empirically minded doctors throughout history have had the mindset that evidence from experience – if the evidence has born the test of time – is just as valuable as evidence supported by rigorous scientific research. The practitioners who are more rationalist-minded tend to believe – rationalize – that we shouldn’t offer any therapy unless: A) it’s undergone the gamut of scientific studies to ‘prove’ that it’s safe and effective; and B) unless we’ve fully defined the therapy’s mechanism of action. This is neither practical nor realistic for the advancement of good medicine.

Empiricism at Work Historically: The Homeopaths Introduced Nitroglycerin to Medicine.
Nitroglycerin is a perfect case in point for our discussion today, because back in the 1800s, before the FDA even existed, it was introduced into medicine empirically, not based on controlled scientific studies. And we need to credit and thank the Homeopaths – the chief empiricists of that time – for the fact that the good medicine has been grandfathered into our modern-day ‘standard of care.’

If the Homeopaths Introduced Nitroglycerin into Medicine Today:
The current ‘FDA-Approval-Based’ health care model (the approval of drugs, ‘space alien molecules’) largely controls our health care and it fosters and epitomizes the rationalist mindset. It’s possible that if nitroglycerin were discovered today that we’d never get the medication through the FDA approval process and included in our therapeutic armamentarium.

EDTA Chelation: Contemporary Example of Empirically-Based Therapy.
The NIH Trial to Assess Chelation Therapy (TACT) for the treatment of cardiovascular did not come about as a result of a pharmaceutical company wanting to get approval for a promising cardiovascular drug, since Abbot lab’s patent on EDTA expired a long time ago. Instead, the NIH trial was initiated largely as a result of public pressure on the NIH – pressure by innovative, contemporary, empirically-minded doctors and their satisfied patients – to get approval for a non-patentable, and thus non-prevailing therapy that empirically really works (based on the historical experiences of doctors and their patients).

Modern-Day Medical Mavericks and Chelation Therapy:
Even to get to the point of now having the NIH trial, a lot of good doctors, empirically-minded practitioners – history’s recent medical heretics – have fought really hard to be able to offer EDTA chelation to their patients.

Insights From Informal Polling of Contemporary Empiricists at ACAM Meetings:
If the vast majority of doctors offering intravenous EDTA chelation to their cardiovascular disease patients (with chest pain and claudication) indicate during a ’straw pole’ that they see – experience – dramatic improvements in their patients, does this really mean anything? To the empirically minded doctor, probably: yes. To the rationalist minded doctor: probably not. The different frames of reference and perceptions regarding the value of empirical evidence illustrate the tension between the empiricists and the rationalists throughout medical history.

Echoes From the Wilds of Good Medicine: Thank you Steve from Arizona for feedback and insights.

Good Medicine Word of the Week: Empiricism – the frame of thought, the mindset for medicine, that experience-based evidence throughout medical history – not necessarily just controlled clinical trials – are really important and valid aspects of good, evidence-based medicine.

Next week’s show: The 3rd installment of History of Healing–History of Killing, with more necessary insights to lay the foundation for TGM.

Good medicine is a beautiful thing. Thanks for being part of it with us!

Send TGM #5 to a friend: click here.

 

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The Real History of Medicine

Title for this installment: Empiricism versus Rationalism: The tension continues on the medical front lines, and will never end.

To continue to lay the foundation for That’s Good Medicine, lets talk about:

Why we baby boomers should know and understand medical history: The disadvantage of men not knowing the past is that they do not know the present. History is a hill or high point of vantage, from which alone men see…the age in which they are living. [G. K. Chesterton (1874 - 1936)]. We need to know the past to understand what’s really good medicine! The history of allopathic medicine (conventional, orthodox medicine) has been largely one of suppression both in its therapeutic approaches and politics. And some very important historical milestones are simply left out from most medical history timelines.

Empiricism’ versus ‘Rationalism’: critical foundational concepts for our listeners:

Empiricists – past and present – recognize that medicine is largely based on experience, not rigorous science. Most of our current therapies and therapeutic approaches are not based on scientific studies, nor do we know exactly how a lot of what we do even works, but we use it anyway. The empiricist says, “That’s okay, as long as it works, and it’s safe.”

Rationalist-minded practitioners on the other hand ‘rationalize’ that under all (or most) circumstances – even independent of experience – we should and must define the rationale for every therapeutic approach before we can offer it to our patients. This is neither practical nor possible.

The ongoing tension between empirically-minded practitioners and the rationalists is epitomized historically by the homeopaths versus the druggists, the druggers -  the conventional doctors of the day who have the AMA/rationalist mentality.

Bottom line: 1) Our system of health care, and all systems of health care, have evolved primarily from doctors’ experiences with their patients – real life experimentation figuratively speaking – not from scientific research studies on humans or other animals; 2) TGM listeners’ high point of vantage should allow them to see that the empiricist versus rationalist concept is really a spectrum (not black or white), with each healthcare practitioner poised, in his thinking, at some point between the two poles; 3) The history of medicine is characterized by a perpetual tension between the two ways of thinking, providing a yin-yang balance; 4) Key for the advancement of good medicine is for doctors to find the right spot on the spectrum between empiricism and rationalism, because too much of either is not good medicine.

Echoes from the Wilds of Good Medicine (listener feedback). Lisa from Louisiana wrote:

“I have listened to your first few episodes and I am very excited that you are doing this for us who are out there looking for ways to take our health into our own hands by searching for information. I must comment on one thing though: Your target audience. I understand that the majority of your listeners may be baby boomers but don’t forget about those of us out there who do not fit into that category. I, for instance, am 37 yrs old and have lived with Ulcerative Colitis [UC] for 13 years. Keep up the good work. I’m looking forward to you next show.”

Thanks Lisa. Please always know that we Baby Boomers (from the love generation) welcome you and all other X-Geners to TGM!

Integrative Medicine Approaches for Ulcerative Colitis: At Kevin’s insistence, in response to Lisa’s feedback, we mention a few integrative medicine approaches for UC, which we’ll cover in depth on future shows, and the new discovery that UC is caused from an immune deficiency – more specifically and importantly, it occurs from autoimmunity. It’s an auto-immune condition due to dysbiosis in the gut when white blood cells capture antigens of foreign microbes and activate the immune defenses. This emphasizes the critical importance of gastrointestinal health and the potential for probiotics for health and healing!

Good Medicine Word of the Week: Rationalism: the belief that under all or most circumstances we must use scientific studies to fully define the rationale for every therapeutic approach, before we can offer it to our patients. This is not rational for the advancement of good medicine!

Next week’s show: 2nd installment of History of Healing-History of Killing. Nitroglycerine is a really good medicine. Is our current use of it based on scientific studies? Which empiricists of the 1800s are responsible for our current use nitroglycerine? The homeopaths! We’ll also discuss: why contemporary doctors are positioning themselves more and more toward the pole of empiricism; the concept of health promotion versus disease control; and why the new model of health care that we’re currently dominated by – the FDA Approval-Based Health Care’ Model – is not good medicine.

Send TGM #4 to a friend: click here.