Tuesday, October 02, 2007

Most of my life has been devoted to medicine. My hobby has been the history of medicine. It’s a profession I have loved, but experience and the study of history have made me aware that physicians have made some pretty stupid mistakes and even in this modern era continue to blunder.
When visiting the Presidential homes and Civil War sites, I am always most interested in what happened medically. It’s frightening to know what happened in the Civil War. There were over 600,000 deaths in that conflict. 400,000 of the deaths were due to disease or complications from wounds. The mortality rate for amputation of a major extremity was 80%. The doctors had no concept of the germ theory of disease and spread infection by the use of unsterile instruments and simply not washing their hands between patients.
Pictured above is George Washington on his deathbed. He developed a sore throat and fever and died within a couple of days, He was surrounded by his doctors who were bleeding him and doing other useless and harmful things to make his exodus miserable. The doctors were acting out of ignorance. Doctors in Washington’s day could do very little other than hold your hand. Washington is said to have died of quinsy. This is a medical term no longer used but represented a peritonsillar abscess. This is a collection of pus around the tonsil, which today would be treated with antibiotics and possible drainage. Doctors now believe that Washington most likely had epiglottitis. This is a serious infection of the epiglottis which produces marked swelling and obstruction of the upper airway. It’s caused by the bacteria Haemophilis. It is treated with antiobiotics but there is now a vaccine which prevents this dreaded infection.
The most stupid blunder in the medical care of presidents was with James Garfield. Garfield, our twentieth president, was assassinated by Charles Gaileau. He was shot, with the bullet lodging adjacent to an upper lumbar vertebra. Doctors, with their unsterile hands, repeatedly probed the wound in search of the bullet. Alexander Graham Bell even tried to localize the bullet electronically. It took Garfield about a couple of month to die from sepsis because of the mismanagement by his physicians. He would probably have lived if he had simply been left alone. The bullet did not need to be removed. At his trial, Gaileau pleaded insanity. He readily admitted that he shot President Garfield but his doctors were the ones who killed him. Gaileau was right, but hung anyway.
Unfortunately doctors continue to blunder. That’s the reason they call it the Practice of Medicine.
Medical errors are a big cause of death. Also, conflicting medical information can be just as harmful as hands on treatment. On one hand the public is told that alcohol will prevent heart attacks and the next thing they hear is that alcohol is a cause of breast cancer. What is the public to do with conflicting and confusing medical information? Are we sure we want universal health coverage?
Today we learned that most of the cold remedies for children are unsafe and may be taken off the market. Doctors are simply recommending saline drops, humidifiers and chicken soup for the most common of medical illnesses. Next, they will be going back to blood letting.
As for me. I’m staying on the porch and hopefully learning something from medical history. I’m keeping the TV off and not listening to all the drug advertisements. The TV ads told be how great Vioxx was, then I learned it could kill me. Who am I to believe these days?


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