There is a phrase about severely worm-infested furniture, that it is only in one piece because the woodworms hold hands.
The same might be said for modern medicine. ‘Medical Science’ only holds together because doctors worldwide have agreed not to challenge its overall hegemony Even those few doctors who go it alone and challenge medical practice do so, only in narrow areas, such as nutrition, statins, or psychiatric drugs,. These ‘rebellions’ are contained or quelled, by bringing the doctor before their regulatory body, as in the case of Dr Sarah Myhill or ignored as with Dr Michael Moseley. So, like the Roman Empire, Western Medicine can continue to rule long after it has been beneficial for the citizens.
There are two major areas where Western Medicine has been life-changing – trauma surgery and infection. Most of the major improvements in life expectancy have come from public health, such as improving sanitation and providing fresh water.
The Romans also had good public health, building aqueducts, sewers and draining swamps to interrupt the lifecycle of the mosquito and thus prevent malaria or bad/mal air disease. Galen, father of modern medicine, was doctor surgeon to the Gladiators of the Coliseum, with only one gladiator dying outside the ring during his three-year tenure of this prestigious post. By comparison, his predecessor lost eighty Gladiators.
Galen provided medicine with a systematic framework, still in use today. Whilst most medical ideas were developed during the 19th and early twentieth century I recently retook various medical exams, only to be reassured that almost nothing has changed in the last forty years. There can be few fields of human endeavour, apart from the moon landings, that have so successfully sidestepped progress.
For example, CT Scanners, MRI Scanners, Ultrasound Scans, operating microscopes and keyhole surgery were around in the eighties. Drugs have become more sophisticated, and one or two new ideas have emerged but with the invasion of money and the Pharmaceutical industrusty, big business has secured the status quo.
Yet very few areas of Medical Science withstand rational scrutiny. And with medical micro specialisation balanced against the self-interest of General Practice, medicine lacks any vestige of internal consistency. For example, big pharma depends on randomised controlled trials to gain FDA licences for its products. But nothing about disease is random. Disease does not happen out of the blue. Disease is rare in truly happy, healthy people. Instead it associates with poverty, other medical conditions, stress and poor lifestyles.
Treating high blood pressure with medication alone is irrational. It requires frequent blood pressure checks because the disease process that means the body needs a high pressure blood pump has not been altered or even discovered. Hence year on year, the blood pressure rises. Yet high blood pressure is rare in undeveloped countries. Thus although lowering blood pressure seems to be a good idea, no one knows why blood pressure rises in the first place.
The above paradox is the case for all chronic diseases. They get worse with time, because the underlying mechanism is unknown or ignored. And were the patient to be cured, there would be no business. As far as the Health Industry is concerned, the healthy person has no life time value, and hence is a poor investment.