“One of the first duties of the physician is to educate the masses not to take medicines.”– Sir William Osler
In the 21st century, I could only echo that great sentiment as a truism, despite the tall talk of the “so-called” evidence-based medicine. Napoleon Bonaparte went one step further, but one could argue that he was not a physician. Napoleon was at the receiving end of such a medical practice in Persia where he died. “Medicine is a collection of uncertain prescriptions the results of which, taken collectively, are more fatal than useful to mankind.” Napoleon, though, was more accurate scientifically today. The latest science says that uncertainty is the only certainty in the world. This is truer of medical science, if there is one. A proverb is a short sentence based on long experience. If that were so, this one from Voltaire takes the cake: “The art of medicine consists in amusing the patient while nature cures the disease.”
I have often written that our evidence base has been built on loose sand.
Of course, no one seems to take it seriously. They would have, if it had any financial interest behind it. The present Randomised Controlled Trials and linear relations help generate billions of dollars in chemical therapeutics even if that results in thousands dying of our efforts directly or indirectly.
Recently, I had a message from one of my students, who is a leading dermatologist in India doing innovative research. “I always wondered when I used to listen to you during my student days and respected your views all along. In dermatology evidence is found only in 28 per cent of published studies. All molecular biology companies come with an offer to give authorship if we buy their equipment for our laboratory! Doesn't that mean that most molecular biology studies are prototype and try to find out how what is known fits into their study?”
The foundations of our evidence in modern medicine like the statistical risk calculations, (especially the relative risk reductions in place of absolute risk reductions that are sold to gullible doctors in most of the “scientific” articles without mentioning the NNT figures) and, the RCTs, which have no true science base, are very shaky, indeed. We need to have a new science of man, which is sadly missing in this whole bargain. Physics changed in 1925 and there is no more physics, but we still use the same old physics laws for our statistics. Matter is not made up of matter. Matter and energy are interchangeable. (journalofcosmology.com/QuantumConsciousness106.html) Human molecules communicate with one another which can now be documented through the photon lights emitted from each DNA.
What is the science base of our reductionism, organ based specialisation and our reliance on Mendelian inheritance? Instead of trying to rehash the existing evidence base, it is better to think of a new evidence base for health and illness. Health is a state where each human body cell is in sync with other cells. Illness is when this communication breaks down. ( >en.wikipedia.org/wiki/Biophoton )
We need a new non-linear, holistic, dynamic, scientific base for future medical research. Nature has provided a robust repair mechanism inside the human system which has been weakened by our modern lifestyle. Even though both Claude Bernard and Louis Pasteur did note that the “terrain is more important than the seed” we have gone the whole hog on the seed, risk factors, and what have you. Modern medicine has forgotten the essence of illness care which is basically strengthening the terrain.
Our ancient wisdom
Indian Ayurveda and many other complementary systems stress just that fact to strengthen one's immune system. Ayurveda has many immune boosting modalities in its armamentarium.
Many simple methods which have stood the test of time are being forgotten now, thanks to the brainwashing of the masses through mass media advertisements about the wrong approaches to keep one healthy. The leading one among them is goading people to have a regular “health” check-up. Nothing could be more dangerous than that to apparently healthy people. When one is healthy one should NEVER ever go for a check up!
The common man will have the doubt as to how he/she could know about health. One is healthy when one has a) enthusiasm to work and b) enthusiasm for being compassionate. One of the ancient exercises could be the most potent modern medicine, a daily walk if one is not a physical labourer. Universal love is another life-giving elixir.
(The writer is former professor of cardiology, Middlesex Hospital Medical School, University of London and former Vice-Chancellor, Manipal University. Email: hegdebm@gmail.com)
