I’ve been reading this great book called “Mark Twain and Medicine.” Twain had a great time poking fun at the terrible state of medical practice in the 19th century. The world would have been better off without doctors until the early 1900s. There are still problems but nothing like the slaughter carried out by physicians in the 19th century.

Mark Twain referred to the doctors as assassins and said they were more effective killers in war than the soldiers. He suggested replacing the troops with doctors for greater efficiency in killing. Looking at the statistics, Mark Twain was correct. Of the 618,000 soldiers who died in the Civil War, two thirds died of disease and treatment by the doctors. The doctors had no idea of the germ theory of disease and performed operations with unwashed hands and contaminated instruments. Dysentery and other medical conditions were caused by filth and were treated by blood letting and purging. Calomel was a standard treatment for almost everything. This was a powerful cathartic that further complicated the dehydrated state of the patients and the calomel contained mercury that was poisonous. Ipecac, used to induce vomiting, was also a standard treatment.

As many as 400,000 of the Civil War causalities could have been prevented if the doctors had known what they were doing or simply left the patient alone. For example, the mortality for yellow fever was about 30% if untreated and 60% if the doctor applied his deadly skills and went to work with his poisons.

Twain also hated the practice of Christian Science. This practice was set up to always be a winner. If the patient had enough faith then their disease (which was self limited to begin with) would be cured. If the patient died then it was because the patient didn’t have enough faith. It wasn’t the fault of Christian Science.

Twain also attack patent medicines that were very prevalent in his time. Most of these medicines were primarily alcohol with a little flavoring. They were totally ineffective except for making the person who concocted the solution rich.

Fortunately, much of this witchcraft and unrestrained charlatanism no longer exist; however, much harm to the patient still occurs in medical practice. We still need a Mark Twain to show us the error of our ways with good humor. This would be more effective than the current practice of litigation that only makes the lawyers rich and still allows medical mistakes, fraud and poor practice. The lawyers have now joined the ranks of the assassins.