Correspondence

Correspondence

Dr. Sampson “Postmodern Medicine ” Is a Clear and accurate analysis of the effects of postmodernism on medicine. My field is history of medicine and I want to underline that although the deleterious influence of postmodernism on medical science is, for the moment at least, contained in history of medicine, it has been devastating.

Whereas physicians and other health practitioners usually have a scientific background, quite often historians (including medical historians) have no idea of what science and the scientific method are, and what the purpose of an experiment is. For this reason, they more easily become prey of the antiscientific arguments of postmodernism. Most journals, granting agencies, and academic departments are controlled by a history-of-medicine establishment dedicated (more or less consciously) to the tenets of postmodernism. Therefore, it is very difficult to publish papers, to obtain grants, or to achieve academic recognition unless one conforms to the inanities of the postmodern worldview. As a result, in history of medicine, absurdities abound.

The assertion that Pharaoh Ramses II could not have had tuberculosis because, at the time, the bacillus had not yet been discovered is a case in point. Similar statements intended to enlighten us-old relics of past erroneous misconceptions-are not difficult to find. If you were under the impression, for example, that there has been progress in medicine, stand corrected The historian’s [of medicine] task becomes complicated; the idea of progress can seem more a fantasy than reality “Progress” begins to look too simple a story needing to be examined with skepticism.2

In case you thought that, in the struggle against infectious diseases, the laboratory was a tool to discover their etiology, be advised that you were mistaken. The lab was simply an instrument to attribute responsibility (in this case to microorganisms) In addition, if you believed in the objectivity of scientific knowledge, you were again mistaken and must, again, be corrected The 3 major points that the history of medicine can teach [are]: 1) scientific knowledge is not “objective” but is a function of historical time and place 4 

This teaches us that in Peru, for example, the structure of insulin could be different from that here and that, in this country, perhaps depending on the outcome of the forthcoming elections, the islets of Langerhans could henceforth be found in the liver. 

It is sad that these vacuities have seeped into our academic centers. If the teachers so teach, what are we to expect from the students? 

PLINIO PRIORESCHI, MD, PhD http://www.history-medicine.com 

1. Sampson W. Postmodern medicine. Sci Rev Alt Med. 2000;4(1):18-20 

2. Neve M. Conclusion. In: Conrad LI, et al. The Western Medical Tradition: 800 BC to AD 1800. Cambridge, UK: Cam-bridge University Press; 1995:477-478. 

3. Cunningham A. Transforming plague: the laboratory and the identity of infectious disease. In: Cunningham A, Williams P (eds.). The Laboratory Revolution in Medicine. Cambridge, UK: Cambridge University Press; 1992:209-244. 

4. Lerner BH. From Laennec to lobotomy: teaching medical history at academic medical centers. Am J Med Sci. 2000;309(5):279-284. 

THERAPEUTIC TOUCH 

In Vol. 2, No.l, containing the report by Long, Bernhardt, and Evans on Therapeutic Touch (TT), I commented editorially that the paper confirmed findings of Rosa et al. Rosa and Samer, in a series of communications, pointed out that the Long paper does not confirm Rosa, and if anything, Long et al. claimed to contradict it. 

To review in brief, Rosa et al. found that TT practitioners could not identify the “Human Energy Field” that they claim to modify through TT. Long et al. found that under different experimental circumstances, while mimicking the TT procedure, naive subjects can identify a sensation. They went on to show that the sensation has qualities consistent with radiant body heat. Long claimed to control for some cues not specifically controlled for in the Rosa study, and showed that there are other ways in which TT practitioners can err by misinterpreting sensory cues. 

Ms. Rosa and Mr. Sarner are correct that the Long study does not confirm Rosa study findings. But the editors do not agree that Long necessarily disproves the Rosa paper’s conclusions. 

Our original editorial comment did stress that the Long paper did not rule out other mechanisms such as self-delusion, which the Rosa paper apparently suggested. The Long study still supports the general notion that TT is baseless. The Editor’s comment should have stated that work so far suggests that TT practitioners and subjects can err in various ways under differing circumstances. I appreciate Rosa and Sarner bringing this to our and readers’ attention.  Wallace Sampson, MD Editor 

From The National Council for Reliable Health Information 

FDA to Consumers: 

“Good Luck with Dietary Supplements” 

According to a story by Reuters dated January 6, 2000, the FDA stated that it wanted to increase its watchdog role in keeping herbs, vitamins, and other nutritional supplements safe for the public by becoming more involved in the monitoring of supplements and by establishing new manufacturing guidelines. To do the job, the agency needed more funding from Congress so it could expand tracking of serious adverse effects and promote research of supplements and their effects as part of a 10-year plan for implementing the 1994 law regulating supplements. However, a February 14, 2000, story in the San Francisco Chronicle said that the Food and Drug Administration (FDA) had announced that it would no longer even attempt to track the adverse effects of dietary supplements. Shortly after, NCRHI learned that the Chronicle story was in error and that the FDA plans to continue tracking adverse reactions to dietary supplements through its Special Nutritionals Adverse Event Monitoring System, which is part of the MedWatch medication monitoring program. Since its inception in 1993, the program logged 2612 adverse reactions including 184 deaths-38 from ephedra products. Such reports are only the tip of the iceberg. Since the dietary supplement industry is generally hostile to oversight in the first place, it is not surprising that the most dubious of its constituents are uncooperative in the tracking of adverse effects. One company admitted to receiving over 3500 consumer complaints about its ephedra-based diet regimen, none of which were passed on to the FDA. It would take serious undercover detective work to discover the in-house problems of scofflaw companies. The Chronicle story was meant to notify the public that the FDA lacks the resources it needs to adequately police the supplement industry. The agency apparently does not want to create a sense of security among consumers that the FDA is doing its consumer protection job. 

It is clearly up to the media to expose the outrageous situation congress created with the 1994 dietary supplements law by covering the tragedies that befall consumers as they experiment with dietary supplements. Health professionals must do their part by uncovering adverse events and reporting them in the medical literature as case reports, letters to editors, studies of emergency room visits, and so on. 

Response to Mass Psychogenic Illness 

An editorial in the January 13, 2000, issue of the New England Journal of Medicine discusses the response to mass psychogenic illness. The same issue contains a report of mass psychogenic illness at a high school in McMinnville, Tennessee. The editorial’s author, Simon Wessely, MD, of Guy’s, King’s, and St. Thomas’s School of Medicine in London, states that “invisible viruses, chemicals, and toxins,” have replaced the spirits and demons of days past that once triggered such outbreaks of hysteria. What’s crucial today is the response to these outbreaks once they have been identified as psychogenic. It’s important to remember that the symptoms are very real physical symptoms, causing real pain and suffering, and to say such illnesses are “all in the mind” belittle what people are experiencing.