Medical roundup

RSI

"Repetitive strain injury": an iatrogenic epidemic of simulated injury.

This brilliant analysis is by Dr David Bell and examines the rapid rise in new cases which earned the condition the derisory term "kangaroo paw". He analyses the concept of occupational neurosis and notes, as a psychiatrist, that many people seen by him for this condition had personality disorders.

Doctors contributed to this epidemic with an uncritical acceptance summarized in the article as "abnormal diagnosis behaviour which leads to abnormal illness behaviour in the patient and is invariably compounded by abnormal treatment behaviour".

The author examines historical precedents and concludes "The medical opinions which supported 'RSI' did not merely lack objective scientific backing; they contradicted established medical knowledge and common sense and were accompanied by a failure to conduct an adequate examination".

This article is well worth reading by all doctors and skeptics.

Source: The Med. J. of Australia Sep 4, 1989 Vol.151.

Rheumatic Non-Disease

Dr B.S. Rose continues this theme in an article entitled "Rheumatic non-disease: The phantom epidemic." The author claims that "the importance of non-disease has hitherto been greatly underestimated" and he is probably right. He defines Type 1 disease to be the attribution of disease on a speculative basis eg. 'non-herbicide poisoning'.

Type 2 non-disease is defined as the sensational labelling of common dysfunctions in a particular social context eg. chronic fatigue syndrome, formerly ME or myalgic encephalomyelitis (RSI of the brain?) Type 2 non-disease would obviously include RSI.

Source: Patient Management Dec 1989/Jan 1990

Alternative Medicine

"I believe it is time for a serious evaluation of alternative medicine" writes a columnist, RETRACTOR, as he outlines a classic case where herbal treatment failed to help an ill patient because, as the herbalist put it "We left it too late". This herbalist has all the outcomes covered. If the patient recovered, take all the credit but if he doesn't, it was too late!

RETRACTOR makes a plea that doctors inform their patients about the scientific aspects of alternative treatments instead of acquiescing. I suspect that there is not enough time during the average consultation and many people are immune to scientific critique ("normals" according to McGlone).

Source: New Zealand Doctor June S

Homeopathic Treatments For Pets

We get a clue as to its attraction for Vets when "people are paying hundreds of dollars a visit to have their pets treated... We've just scratched the surface" (presumably of their owner's wallets).

Animals probably recover even better from minor ailments than humans so they are on to a good thing with homeopathic treatment which is, after all, an expensive way of administering a placebo. A constipated python (boa constrictus?) which had eaten 8 or 9 mice was given nux vomica. It worked in 24 hours but the article does not go into details about just what was deposited on the owner's carpet afterwards.

Source: Christchurch Press June 13 1990

Ozone

Ozone has been in the news lately. It is given by injection and its New Zealand proponent, Dr Rickard, is described as a naturopath, osteopath and clinical psychologist (not necessarily in order of scientific validity). As usual with a quack remedy ozone is touted as "the answer to cancer, and could cure every other virus, including the common cold."

This treatment fails to account for the fact that under normal circumstances our haemoglobin (oxygen-carrying pigment) is saturated with oxygen and adding ozone (which immediately breaks down into oxygen) will not significantly alter the amount of oxygen available to the tissues. Enhancing tissue oxygen supplies would be expected to enhance the growth of cancerous tumours, not reduce them!

In France doctors are injecting patients with ozone at $NZ60—120 a shot and claim that it "combats fatigue, purifies the body of toxins, fights memory loss, and stimulates the circulation."

Here again is the vague, subjective language of people demonstrating a fundamental ignorance of basic science which I feel is probably excusable in a country where homeopathy is part of mainstream medicine! A cosmetic surgeon has been giving these injections to about 20 patients a day for 6 years. Using the figures supplied that's an income of $NZ1200-2400 per day which I feel is the main attraction for the doctors. Readers who would like to try the treatment but who dislike injections will be relieved to know that it can be given "anally through a tube."

Gazing into my crystal ball, I predict that this treatment will arrive here in New Zealand a few minutes either side of 4.15pm on the 13th May 1991.

Source: Christchurch Press May 11 1990, NZ General Practice March 27 1990.

Rationalism versus irrationalism in the care of the sick: science versus the absurd

This article outlines how rationalism and irrationalism have coexisted throughout the history of medical practice. For example, even after Harvey had proved his theory about the circulation of the blood, anatomists continued to search in vain for the (non-existent) pores postulated by Galen to link the two ventricles of the heart. Harvey lost his job and his livelihood, surely a graphic example of the wrath of the "normals" descending on the head of an "alien" (see NZ Skeptic No 16, Matt McGlone).

The author outlines how the enormous advances made by modern medicine have fostered a public belief that a cure or treatment exists for every ailment. As many as 50% of complaints which present to GPs do not have a diagnosis. It is the doctors who cannot live with uncertainty who fall into the trap of adopting specious treatments.

This is an excellent review and well worth reading.

Source: The Med. J.of Australia Dec 4/18, 1989 Vol.151.