MAGAZINE EDITION

2006

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REVIEW: BAD MEDICINE

Dadid Wooton

320 pp Oxford University Press
ISBN-10: 0192803557

By Chris Johnstone
Contact the editor by e-mail at christopher.johnstone@ntlworld.com

This is an interesting book, but it is hard to see what it is for. David Wooton does not do hatchet job on medicine, as in the recurrent trend, but complains about how slow we are to learn from our discoveries.

He convincingly argues that medicine only started doing any real good after 1865 when Lister demonstrated the advantages of antiseptic surgery in a Scottish hospital. Up until then he argues that most people suffered doctors and often more harm was done than good.

The humoral theory of illness held sway for over 2000 years and still we describe people as sanguine and melancholic. Wootton argues that this and miasma theory held back scientific medicine for centuries and consigned thousands upon thousands to early deaths.

The art of bloodletting was the mainstay of medical practice and if your patient got iller after blood letting you had not let enough. Many patients died weak awful deaths as their physicians drained them of their vital fluid, Byron among them.

Harvey’s demonstration that blood flowed around the body did little to help except stop the arguments about which bits of the body should be bled to heal whichever illness. If the blood flowed it did not matter where the blood was removed from (although the erudite arguments of medical men continued for hundreds of years). Many people did not believe Harvey at the time and I learnt that the word autopsy comes from this time. Harvey showed others how to prove to themselves that blood flowed, he said they did not have to simply believe him, they could see it with their own eyes, autopsy.

I attended a lecture in Glasgow recently and was shown blood letting equipment that every country GP would have carried and used up until the end of the 19th century. Old ideas die very slowly, especially where there is nothing else to replace them.

Scurvy was shown to be cured by drinking fruit juices, but the naval doctors dismissed the idea and it was not accepted for over 70 years. Thousands of sailors died unnecessary deaths due this short-sightedness.

However it is easy to see how ideas are not taken on board. Senior doctors will have spent their lives believing and teaching their own theories of illness and it can be hard to let go, to accept one has been wrong for years and that you could have saved lives, but failed to do so.

Wootton goes on to discuss how slowly Lister’s ideas were taken on board and the carnage that continued in lying in hospitals well after Semmelweis showed how to prevent puerperal fever. Semmelweis died insane, possibly driven mad by the fact that he was aware of the amount of women’s deaths he was responsible for before he adopted his aseptic techniques. He must also have been demented by the fact that his ideas were slow to catch on and women were dying needlessly across Europe.

The power of placebo and the positive power of belief in one’s physician is touched upon. It is one reason why some people got better and all doctors were not regularly lynched up until 1865 and beyond. I discovered my new hero, John Haygarth, the discoverer of the placebo effect. A man after my own heart and should be the father of general practice.

I thoroughly enjoyed this book. It gave a different slant to some of the greatest discoveries of modern medicine. It is a powerful warning against how slowly we adapt to new ideas and how tightly we cling to our beliefs, even when demonstrably wrong.

Bad Medicine is published by Oxford University Press and is available from Amazon for £9.74

Other hoolet online articles by Chris Johnstone can be found at:
hoolet edition 51 - Enough And No More
hoolet edition 50 - Now We Are 50
hoolet edition 49 - The Policy Palsy
hoolet edition 48 - The Last Waltz
hoolet edition 47 - The Old New Contract
hoolet edition 46 - Teaching to the Converted
hoolet edition 45 - Turkeys Voting For Christmas
hoolet edition 44 - That's a nasty QOF
hoolet edition 43 - Calm Down, Calm Down, It's only the NHS
hoolet edition 42 - Perpetually Fooled Initiative
hoolet edition 41 - Crisis? What Crisis?
hoolet edition 40 - Doing What You Are Told
hoolet edition 39 - A History of hoolets
hoolet edition 38 - Where did it all go wrong?
hoolet edition 37 - Commodificationalising the NHS
hoolet edition 36 - The Cost of Everything and the Value of Nothing
hoolet edition 35 - Much Too Much, Much Too Soon
hoolet edition 34 - What Shall It Profit a Government?
hoolet edition 33 - A Long Career in Applied Cynicism
hoolet edition 32 - My Greatest Pleasure
hoolet edition 31 - Goodbye to the NHS
hoolet edition 30 - The National Health Service is Sorry
hoolet edition 29 - MMR More Media Rubbish
hoolet edition 28 - A Life of Pleasure
hoolet edition 27 - Barricade medicine

Other hoolet reviews by Chris Johnstone:
Bad Medicine
Armed Madhouse
The Bullet Trick
The Medical Detective
Plundering the Public Sector

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.