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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!

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