WEIGHT THE RISK AGAINST THE BENEFITS. There are risks so serious, especially in the treatment of late cases by intensive methods, that the patient should not be asked to take them. There are benefits so doubtful and methods so double=edged that a hair- line judgment can very properly be drawn between the decision to do or not to do.
THERAPEUTIC PARADOX. The intense action, particularly of the arsphenamines, produces not only therapeutic shock but a rapidity of healing which has disadvantages sometimes far exceeding any possible advantage. It is a very proper question, involving many still unsolved problems in the defense mechanism, as to whether routinized and perhaps over-energetic treatment is necessary or desirable. The radical or complete curability of syphilis in man remains to be proved.
Again, at the meeting of the French-speaking dermatologists and syphilographers at Brussels, July 24 to 28, 1926, when Chairman Flandin was asked “Does one cure syphilis?” he stated he was of the opinion that, Excepting in the initial stage, preserological chancre, our present-day therapeutic methods do not enable us to remove treponemata from the organisms, where they continue capable of producing late cutaneous and visceral lesions and whence they can be transmitted to the offspring. This shows that we do not succeed in curing syphilis.
RESULTS OF ORTHODOX TREATMENT OF ACUTE CONTAGIOUS DISEASE.
The contention of the dominant school that there has been advance in control of diphtheria is definitely contradicted by the fact that the mortality rate is greater since the introduction of antitoxin in 1895 than it was in the years previous to its use. This was definitely proven by statistics of the Metropolitan Asylums Board of London, as given by that great man, W.R. Hadwen, M.D., J.P., in March, 1920, as follows:.
The Metropolitan Asylums, Board statistics show that the death rate for persons inoculated for diphtheria has been reduced from 29 percent to 8 per cent: BUT it is not told that in the very same Metropolitan Asylums Board reports it is shown that amongst the un-antitoxined cases the death rate has been reduced during the same period from 13 per cent to less than 2 per cent; that is, that whilst the average mortality per cent during the whole period of the patients treated with antitoxin, was 14 per cent, the average mortality amongst those who were not antitoxined was only 6 per cent, and the latter includes all the moribund cases, complications and second-week cases, which makes the comparison the more remarkable.
In 1939 we find the following quotation from Advances in the Prevention and Treatment of Contagious Diseases of Childhood, by Platou, Erling S. and Dwan, Paul F. Minnesota Medicine, 22.71, February, 1939:.
“Statistical analysis of mortality rates in the State of Minnesota shows a general decline in the deaths from the more common diseases of childhood since 1915.” However, the deaths from diphtheria, scarlet fever, measles and pertussis in the pre- school age have remained practically unchanged during this period.
THE NEWEST CHEMO-THERAPY.
The New York State Journal of Medicine for May 1, 1937, has an highly illuminating article by Charles Solomon, M.D., from which I quote:.
The history of mans efforts to cure his ills by using drugs is rather an appalling thing. It is filled with successive triumphs of bland incredulity over sound judgment. Time after time both laymen and physicians have been stampeded, fro some mysterious reason, into believing that an individual drug or drug preparation, or a specific class of drugs, had all the characteristics of a panacea.
The much-publicized sulphanilamide group of drugs has been heralded as one of the greatest advances in scientific medicine. Yet in the brief period of its existence, two to three years, after it had been used in the treatment of various infections, a professor in one of the most prominent medical teaching institutions of our country made the following statement:.
Sulphanilamide is the most overrated and one of the most poorly proven fads of pseudo-medical science.
It is worthless in urinary tract infections and contra-indicated in pneumonia.
DR. Oscar W. Bethes, New Orleans, Louisiana, in an article entitled, Very Recent Developments in the Therapy of The Pneumonias, printed in International Medical Digest for the month of May, 1939, Vol. 34, No. 5, pages 302-303, speaks plainly of the failure of sulphanilamide. I give you his exact words:.
Sulfanilamide has been employed for several years, long enough, it would seem, for its therapeutic status to have been fairly well established. Yet this goal has not been reached. ”
Our experience leads us to believe that sulfanilamide is not highly effective in the treatment of pneumococcic lobar pneumonia” (quotation from Mode of Action, Clinical Use and Toxic Manifestations of Sulfanilamide, by P.H. Long, E.A. Bliss and W.H. Feinstone). “The use of sulfanilamide in the treatment of pneumonia has not been sufficiently encouraging to warrant recommendation of this product to replace specific antiserum. While sulfanilamide has value, the results are not striking”. (Quotation from Current Comment: Sulfanilamide Pyridine, J.A.M.A., 111: 2122, December 3, 1938.
CONTROL OF HEALING ARTS.
Unfortunately, since the earliest days in the history of medicine there has been an attempt by groups of physicians or schools of practice to control the healing arts. This is amply proven by medical history. The great Hippocrates was discredited by the dogmatists and the empirics of the ancient world until the rise of the methodics. Then for thirteen centuries Europe was completely dominated by the Galenists. Everything that conflicted with the philosophy of Galen was rejected, but with the rise of Paracelsus a new era of medicine followed.
Paracelsus was replaced by the sects of the Chemists, who in turn were forced to yield to the Vitalists. It would seem that the many centuries of medical study should have brought about a unity of medical thought. Yet today physicians still disagree in respect to disease as old as the human race.
Judge Daly, of New York, in rendering his opinion in Corsi vs. Marciszek, 4 Ed. Smith, 1-5, made the assertion that it is impossible for the law to recognize any class of practitioners, or the followers of any particular system of method of treatment, as exclusively entitled to be regarded as doctor… and that in adverting to the conflicting views and differences of opinion that exist and have ever existed in the practice of the healing art, it is not to call in question the value of learned, skillful and experienced physicians, but merely to show the error of attempting, in the present state of medical science, to recognize as law any one system of practice.
When Dr. Benjamin Rush helped to frame the Constitution of the United States, he insisted that there be incorporated in it a clauses for medical as well as religious freedom, holding that the one as well as the other was necessary to the safeguarding of liberty. He was not successful, and since that day the battle for medical freedom has been waged with increasing hostility.
The late Professor William James of Harvard College, in his address delivered before the Committee of Public Health, Boston, Mass., regarding the exemption of mental healers from the operation of a drastic law pending before the Massachusetts Legislature, said:.
Were medicine at present a finished science, with all practitioners in a agreement about methods of treatment, such a bill as this, to make it penal to treat a patient without having passed an examination, would be unobjectionable.
Clarence Darrow, in an address given October 26, 1921, throws considerable light on the methods of medical legislation. He says, in part:.
To tell you or to tell me that we must have such a physician as the State Legislature provides, is to take away one of the most fundamental rights.
The history of homoeopathy is an example of the attempt of the regular school of medicine to thwart medical progress. Hahnemann, though one of the greatest living physicians of his day, a scholar, a teacher, and writer of note, was denied the right of practice in his own native country.
Every graduate of the regular school of medicine, who has become converted to the practice of homoeopathy, has been a victim of criticism and persecution by the dominant school. In the past few years homoeopathic hospitals have been denied the right of standardization unless the name homoeopathy was eliminated. One Past President of the American Institute of Homoeopathy, who was also a member of the A.M.A., gave an address in favor of homoeopathy at a National Clinic Day program. He was warned that should he repeat such an address he would forfeit his membership in the A.M.A.
There seems to be an impenetrable wall of egotism, prejudice and intolerance, precluding the penetration of the ranks of the dominant school of medicine, and it becomes necessary to educate the lay mind. It is often through education of the public that great truths are forced upon prejudiced teaching institutions, which history shows have been the last to accept valuable discoveries.
Seattle.
Chairman, Bureau of Surgery