Medicine got off to a bad start. The body is so astounding complex, no one could begin to comprehend how things worked, why one got sick, and why one recovered. This was fertile ground for a mythology. However, more and more has become known (though far more remains to be discovered), but somehow, many myths remain mainstream.

In the 14^th century, smearing goat dung into a wound to elicit the foul humors (i.e. causing a massive infection) was standard practice in spite of the glaring evidence that it led to more amputations the cures. By the early 19^th century, this was tossed out and replaced by a new set of causes; sudden changes of temperature, etc.

The late 19^th brought a lot of useful change: the germ theory of disease, and how to treat it with inoculations, anesthesia, sterility, better waste disposal. This continued into the 20^th century. At some point in the earlier 20^th century, medicine began doing more good than harm. One could say its Golden Age was dawning. In the 21^st century, we have far more tools, far more drugs, far more ways to keep people alive. Medicine now proudly boasts that it is “evidence based.” This is a strange thing to boast about, as it clearly points out that this did not used to be the case. But is it indeed evidence based?

Medical Mythology Lives On

Unfortunately, the answer is somewhere between “not really” and “not entirely.” Plenty of mythology lives on. And here we are not talking about external influences like politics and profit motive. (Though these two cause alarming amounts of suffering.) We are instead talking about cases where large segments of the medical profession regularly recommend Treatment “A” despite evidence that Treatment “A” doesn’t work, or that Treatment “B” is better.

This is discussed in detail in a broad ranging “exposé” found here. The interested reader will have already clicked the link and won’t be reading this. For those that remain, here is a summary.

• Stents. Stents prop up the inside of arteries and are routinely installed in patients who have blocked arteries. But, for that segment who have stable heart disease, i.e. the artery is partially blocked, but the blood is flowing adequately, stents are of no use. They prevented no heart attacks and failed to increase longevity. But “why not?” you might think. Be safe. Stents aren’t so safe. One in 50 will suffer serious complications or even die. So here we have a somewhat risky procedure being applied to a group wherein it is known that there is no benefit.
• Antibiotics for ‘Chronic’ Lyme disease. There is no benefit here, and this is well known.
• Special sponges for preventing infection in colon cancer. Apparently these actually cause more infections than they prevent.
• Blood pressure lowering medications for diabetics produce serious side effects while preventing no heart attacks.

The list goes on and on. There is more in the Atlantic article.

The article is not without praise: “For all the truly wondrous developments of modern medicine—imaging technologies that enable precision surgery, routine organ transplants, care that transforms premature infants into perfectly healthy kids, and remarkable chemotherapy treatments, to name a few—it is distressingly ordinary for patients to get treatments that research has shown are ineffective or even dangerous.”

However, it is obvious that the drug industry will push and push to get their drugs used as widely and frequently as possible. In the US at least, congress just made this a lot easier: FDA standards are to be lowered significantly. This will no doubt go on until the next thalidomide debacle.

What Can One Do?

Challenge every drug. Make sure benefit is there, overall benefit. Google it. Better still, see if it is listed in www.theNNT.com, a fascinating website wherein actual claims for various drugs and procedures are analyzed. NNT means Number Needed to Treat. An NNT of 300 for heart attack prevention would mean 300 must take a drug in order for one to avoid a heart attack (statins). Here is what the NNT has for beta-blockers, a widely prescribed blood pressure-lowering med.

Now go back and read the Atlantic article. It covers a lot more ground. It’s long but well worth it.