Monday, May 21 , 2018, 7:04 pm | Fair 65º

 
 
 
 

Victor Dominocielo: The Modern Practice of Medieval Medicine

“Medieval medicine” is what doctors and other healers practiced for most of our recorded history (even before the Medieval Period, 476 AD through 1517 AD). Medical practice was based on the defunct Theory of the Four Humors (balancing body fluids), ridiculous notions of anatomy and physiology, very occasional, haphazard and isolated scientific discoveries and results falsely associated with confirmation bias and the placebo effect. The great hallmark of medieval medicine was that doctors did not follow scientific research and experimentation (because there was none) and allowed the healer’s individual, biased observations and the patient’s placebo effect to dictate practice.

Modern medicine had to wait for the Germ Theory of Disease (germs carry disease not evil spirits or magical forces), precise knowledge of anatomy and physiology, treatment based on scientific experimentation and techniques coordinated with statistically successful outcomes (from about 1870 onward). The great hallmark of modern medicine is that it follows years of scientific research and experimentation to remove doctor and patient biases and requires improvement above and beyond the patient generated placebo effect.

Medieval medicine is placebo-based folk medicine from our not too distant past. Divorced from even basic biological knowledge and absent any research methodology, healers practiced according to their personal observations. Unfortunately, almost any procedure was perceived to have “worked” because of the placebo effect and our natural survivability for most diseases.

In this setting of false associations and confirmation bias, bloodletting, prayer, poisonous purgatives and emetics, “eye of newt and toe of frog, wool of bat and tongue of dog …” (Shakespeare), moxibustion, water, sugar, oil, alcohol based “snake oil” concoctions, etc., all appeared to work. Everything “worked” because the placebo effect and doctor/patient bias was always present.

As these folk medicines trickled down through history, trial and error usually did away with those that were overtly harmful. But even therapies that weren’t overtly harmful didn’t do any good either, since all they ever were was the patient generating their own placebo improvement. In other words, the theatrics engaged in by these “healers” had no healing effect but since the patient usually improved on their own, the healer and the patient thought that their system “worked.”

For example, aromatherapy has a certain theatrical procedure, just as does iridology, reflexology and the pretty, fluid movements of reiki energy attunement. The various theatrics of the different alternative systems do nothing. “A placebo is a zero,” as Dr. Steve Novella, from Sciencebasedmedicine.org often states, but since the patient almost always improves, patient and “healer” fool themselves and confirm their own biases that their particular brand of theatrical “medicine” is working.

There are three situations where medieval medicine is still practiced in our world. As we might expect, underdeveloped countries with few educational opportunities still practice superstition-based law and medicine. Every year there are still a few stories of “witches” being burned at the stake in some small village.

And then there’s this: “As BBC explains, the tradition of cooking (human) albinos into potions is not a new one in Tanzania, and the parents of albino children are forced to fear that, at any minute, a band of men may kidnap their children to sell to wealthy sectors of society for use in witchcraft.”

These backward, pre-scientific, superstitions in isolated places around the globe do not undermine Modern Medicine. However, the second, more troubling situation in which “Medieval Medicine” is practiced is the growing infusion of placebo based folk medicines into science-based medicine (SBM).  More and more (previously) reputable medical centers, M.D.s in private practice and medical insurance companies are becoming associated with these pre-scientific systems of medicine which are labeled complementary, integrative or alternative (CIA).

It’s hard to imagine that intelligent, well-educated people can use ineffective, pre-scientific medical systems like homeopathy that are proven not to work or fool themselves into believing that invisible forces like reiki are real and will magically heal. But just how outlandish and goofy can alternative medicine get? Would you believe … doll tapping? That’s right: If you have a headache, you tap your surrogate doll in the head. Shoulder pain  Tap the doll in the shoulder. It’s very hard to believe that anyone thinks this nonsense could possibly have any effect, but here it is: “Voodoo acupuncture doll tapping” (also known as Tong Ren Acupuncture). The M.D.s at science-based medicine do not recommend watching this video while eating or drinking since the resultant hysterical laughter presents a very real choking hazard.

The patients in this video look like well-educated, affluent and caring individuals. But they’re also poster children for the Dark Ages. If you’ve ever wondered what it was like to believe in witchcraft, magical forces and hobgoblins, these people are good modern-day examples. This video even has Craig Benson, the former governor of New Hampshire, as an advocate of Tong Ren. By all that’s rational, what’s next in the “Annals of Alternative Medicine” — hand puppets?

The reason for this improper mixing of science and superstition in modern medical practice is the desire on the part of M.D.s to please the patient (placebo) when they have no statistically significant SBM therapy to actually heal the patient. For example, back pain, knee pain, end of life situations, etc., all push scientifically minded M.D.s toward an attitude of, “Since I can’t do anything real for the patient, I’ll refer them to the “snake oil,” voodoo, doll tapping people. What’s the harm?”

Even though CIA medicine is a poor second to science-based medicine in this context, it is not the worst practice that M.D.s do to undermine their own profession. The board-certified M.D. who does not just endorse or refer patients to snake oil salesmen but actually practices it themselves is the worst use of medieval medicine in our modern world. Some doctors still ignore years of scientific research and confuse their own biases, personal experience and the patient’s placebo effect with good medical practice. M.D.s who set themselves up as lyme disease specialists and anti-vaccine M.D.s fall into this medieval medicine category. There is information about lyme treatment here and vaccines here.       .

But the practice of medieval medicine in our modern society can get even worse. Dr. Ben Johnson, M.D., sells Harmonized H2O (Osmosisskincare.com), which he claims “vibrates” and sends “frequency messages” to harmonize internal imbalances in our bodies and enhance our tanning hormone. It’s magic water that will protect you from UV rays, in other words, drinkable sunscreen. There is no known mechanism in physics, chemistry or biology that could explain these ridiculous claims but that doesn’t stop Dr. Ben. Magic water at $30 bucks a bottle. Sounds legit!

Then there is Dr. Oz, an outstanding cardiothoracic surgeon, who gets a bit carried away with his beliefs in pre-scientific “energy medicine,” herbalism and the very profitable supplement industry. Besides being hauled before a Senate sub-committee because of his use of misleading and deceptive advertising, Dr. Oz lets his wife and her girlfriends “play” in his operating room.

“Occasionally, Oz even invites Reiki masters into his operating room, allowing them to tend to patients undergoing precarious surgeries like heart transplants. Drawing on viable unseen energies, Reiki masters like Pamela Miles and Julie Motz have melded their expertise with Oz’s mastery as a heart surgeon” (click here).Talk about corrupting the practice of science-based medicine! What kind of medicine are we practicing when we need a sign over the hospital entrance which says, “Please keep the Reikian Energy Healers out of the Operating Room”?

In the entire history of science, we have never gone deliberately backwards in our explanation of the natural world. We don’t expect geologists to come up with pre-scientific, alternative explanations for volcanoes such as, “The gods must be angry; we’d better sacrifice a virgin.” Unfortunately modern medicine can now claim that dubious distinction. Dr. Mark Crislip, M.D., sums up the problem very succinctly: “It is an oddity of medicine. I would wager that astronomy journals do not publish editorials touting astrology as a solution for difficult problems.  Similarly, psychology journals do not look to psi and chemistry journals do not advocate the methods of alchemy. In medicine, the editors (of medical journals) have no problem with suggesting nonsense …” (click here).

When M.D.s refer patients to placebo based folk medicine, they are fostering the practice of medieval medicine, ignoring decades of scientific research and are providing recommendations and interventions based on their own biased clinical observations, biased patient reports and the patient generated placebo effect. Modern medicine has to grow up, keep moving forward scientifically and leave the pre-scientific superstitions and practices of medieval medicine behind. Let’s keep the “medieval” out of modern medicine.

— Victor Dominocielo, M.A., a California-credentialed teacher for 37 years, is the human biology and health teacher at a local middle school. He earned his master of arts degree in education from UCSB. The opinions expressed are his own.

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