Over 40 years, medicine has changed, but not as much as it should have. The technology revolution has yet to happen, clinical medicine is hanging on. There have however been some rather curious changes, that is in diagnosis – and without any good reason, certainly not backed up by diagnostic or pathological insights. For example:
Alzheimers
Was: A diagnosis of exclusion, when no other cause was dementia found eg Pick’s disease or Jacobs Creutzfeld
Now: Any form of loss of mental function in the over 50’s – no investigation needed
Migraine
Was: A tightly defined condition, which included headache, aura (warning), visual symptoms including flashes, distorted visual fields, dislike of bright light, physiological symptoms often gastrointestinal, family history, lasting twenty or longer hours.
Now: Any severe headache
Meniere’s Disease
Was: Three symptoms, all of which had to be present – progressive deafness, episodic dizziness and tinnitus (noise in the ears)
Now: Severe dizziness and or tinnitus
Autism
Was: a specific condition in children who were developing normally until the age of 2 – 3yrs at which age the children deteriorated, losing speech, physical abilities and social skills.
Now: Almost any learning delay or mental impairment
Chronic Fatigue / ME / Fibromyalgia:
Was: Initially described in the 1980s and was called ‘Yuppy Flu’ and used to describe symptoms after a bad viral infection. Symptoms of fatigue, muscle pains, mental fog. Most importantly, it was a syndrome of exclusion, this meant that some doctors inferred this was a psychological syndrome however it meant that other similar diagnoses were postively excluded
Now: This diagnosis is applied to anyone complaining of the above symptoms whether or not they have any other recognised condition
There are several reasons a ‘Diagnostic Net’ might be widened
1 – Enabling Big Pharma to selling expensive medications more widely
eg Migraine – migraine medications, developed in the 90s, such Zomig or other triptan – cost up to £30 a tablet.
2 – Proper diagnosis expensive eg Meniere’s requires sophisticated investigation It is cheaper to make a vague diagnosis and prescribe a non-specific medication
3 – Political considerations eg Autism. The original diagnosis, of a child who deteriorated mentally at 2 – 3 yrs of age. This is the peak vaccination age, and allows the suggestion that vaccination may damage children to gain a foothold. If however Autism includes all cases of delayed learning and mental impairment then vaccine damage only accounts for a small proportion of cases. Additionally, Autism has attracted a lot of funding thanks to the activism of parents of autistic children.
4 – Pragmatism – eg Alzheimers, only a small proportion of cases with significant mental deterioration recover. Easier to put all cases in a single basket, rather than look for individual differences and find the small proportion who might be treatable, for example, severe depression, subdural hematoma, alcoholism, vitamin B or other deficiency. Even in those cases, prolonged medical treatment may not help
Maybe I too cynical but there seem to be common themes as to why these diagnoses have widened their scope. These reasons are largely to do with the ever increasing influence of Big Pharma on the behaviours and prescribing habits of doctors.
The diagnosis of Autism may have changed because a condition that can be associated with vaccination is politically and pharmaceutically unacceptable.
Alzheimers – not yet a Big Pharma honey pot, but when it is the wider the net, the greater the profit. The same is true of Menieres, so do the minimum
Migraine = £30 a pop Migraine relief Headache = 5p aspirin
Over the last 40 years Big Pharma has taken over medicine. The consequences are legion, instead of tackling western lifestyles, doctors are too busy prescribing complicated expensive drug treatments. Despite every treatment, life expectancy is only just holding its own against the tsunami of modern disease. The food industry whilst wrecking our food supply, hides under the cloak of Medicine which persistly refuses to acknowledge the role of diet and exercise in the gross epidemics of modern diseases.
Imperial College, the most important medical school and research centre in the UK, is almost completely paid for by Big Pharma. Evidence, for any condition is led by the ‘Double blind controlled trial’ which is the primary weapon of Big Pharma that ensures their dominance in the market place.
Diagnosis is critical to the Art & Science of Medicine – without a diagnosis it is impossible to practice medicine – because without a diagnosis and without rational treatment and the determination to find a cure, doctors become applied pharmacologist, following NHS / NICE protocols as dictated to them by Big Pharma
If Western Medicine is to be of use and to build on the massive advances it made in the Twentieth Century, it needs to precisely define its terms and make sure that we are talking about the same thing, and that also makes sure that we can continue to use the wisdom of earlier generations because we are using the same language.