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Complementary and alternative medicine History Medicine

Back to the Golden Age before modern medicine?

So many adherents to “alternative” medicine detest modern medicine, which they see as not being “natural.” In contrast, herbalism, homeopathy, acupuncture, various forms of “energy healing,” are touted as being highly in tune with nature. They’re right about one thing. Throughout the vast majority of human history, humans have relied on unscientific treatments for illness that were indeed much more “in tune” with nature (mainly because they didn’t have the knowledge to do much else). Indeed, it’s only been in the last 100 to 150 years that science advanced to the point where real advancements could occur in medicine. So what was human history like in that “Golden Age” before nasty, reductionistic, unfeeling modern medicine rose?

Something like this:

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

35 replies on “Back to the Golden Age before modern medicine?”

I’ve loved stuff like this ever since someone gave me a copy of Otto Bettmann’s “The Good Old Days–They Were Terrible!” when I was in middle school.

It is quite sad really that Jenny McDeath and the other idiots cannot go back to the good old days and leave us to step lively into the future unhindered by morons.

My father was in his late eighties, mostly doing well on heart meds:someone rebuked me for “allowing” this as she sang the praises of natural herbs and minerals.I responded that if it weren’t for the “evil of Big Pharma”,he’d probably have died of a bleeding ulcer at age 70;while I could hardly envision myself brewing up a concoction of hawthorn and foxglove,I certainly wouldn’t trust giving it to him.The drugs enabled him to be relatively active and independent-visiting people,going on short trips,using an exercise bike,caring for himself- almost until the very end of his life.In the “Golden Age” before modern medicine,people like my father,my grandmother,my aunts(before you say “heredity”-2 are my mother’s relatives)wouldn’t have lived to advanced ages: the very old were mostly myth, not reality.If I were Woo,I could probably write a treatise about the high concentration of very elderly people who have lived in my immediate vicinity-but I’m not Mike Adams and this isn’t the “Valley of Longevity” in Ecuador-it’s *New Jersey*- impure, unnatural,mall-loving,Big Pharma-dependent New Jersey.(And if you look at census data, there’s nothing unusual about my neighbohood)

The sad thing is, just like the rainforests, the millenia of human folklore remedies have not yet been fully explored for nuggets of usefulness–at least in part because of the hostility of many of the “natural remedy” crowd to the scientific method.

It’s too bad our first response to a particular remedy isn’t “Is it natural?” but “Does it work?”

It kind of reminds me of the debate in agriculture right now: Organic is always better! “Conventional” is always better! Go define better and then put it to the test. A lot.

Tamara

Great video. People are very selective in their memory. For instance, those arguing for “back to nature” medicine aren’t going to turn down modern medicine in an emergency. You know, pain killers, MRIs, surgery, etc… A few years ago I was hit by a truck while on my bike and suffered an acetabular fracture. I consider it a miracle that they could use an MRI to diagnose it, give me painkillers to take away the intense pain, cut me open and put 5 bolts in my pelvis and rehabilitate me to that I had a full recovery (and still ride bicycles). The kicker is that it was all routine to these professionals, not cutting edge. In the “good old days” I would have been dead or at least crippled for life with chronic pain.

I’ll take the good old science based medicine any day!

And of course the woo-meisters splutter back, “B-but… sure, we live longer now, but are we having better quality of life?”

@Owen, #1

And the mighty ORAC has responded–twice! Now Dana Ullman has attacked, complete with his picture and moniker “Huff Post Blogger”. He makes a big deal out of Orac’s anonymity and, predictably, calls him a shill for BigPharma (no evidence of course).

When we were expecting, and I was hanging out in places with a lot of expectant mothers, nothing annoyed me more than the “I don’t like X, I prefer to use the natural route.”

I would point out that back in the “good old days” when things were done “naturally,” that infant mortality rates were more than 1 in 10, and MOTHER mortality rates were as high as 1 in 100. Nowadays, it is almost unheard of for a mother to die in childbirth, and such events are considered tragic. While it has always been bad, it used to be fairly common (as common as autistic kids now – remember, that is an out of control epidemic!)

Even things like “not inducing labor at or near your due date” can have drawbacks. Given the nature of early ultrasound, it is actually pretty easy to get a very good estimate of the due date, which means we have a very good idea of when the pregnancy is full term. Many OBs like to induce soon after full term because they know that the only thing that is really happening after that time is that the baby is growing, making delivery more difficult, without any beneficial development.

Perhaps if the doctors had done that with my sister, instead of allowing her to deliver “naturally,” my nephew, who arrived stillborn 2 weeks late, would still be alive.

Mother Nature is a cruel, uncaring bitch.

I’ll take modern science based medicine thank you very much. Hell, I’ll even take the post modern gee-whiz regenerative medicine that is showing great promise right now.

@Pablo

When women began to deliver in hospitals more often the death rate for both mother and child was higher than home deliveries. “Child-bed fever” (aka unwashed hands) was a big killer. I read that mothers were sometimes told to prepare for their deaths and given last rights as they were going into labor.

The tables have turned now. I know someone who lost a child in a home delivery (planned) that in all likelihood would have been fine in a hospital. Sad. That is not to say that modern child birth is perfect. Some institutions seem a little trigger-happy with interventions. Maybe that is borne of lawsuit fears.

My great uncle had his penultimate stroke in the wood shop of the veteran’s hospital; he always liked working with his hands. He was a veteran of the Great War, and died in 1989 at the age of 91.

If his lifespan isn’t argument enough in favour of modern medicine, let’s talk about how, in the Great War, his horse rode over a mine (or perhaps an unexploded shell) and the resulting blast severely injured both of his legs; I believe he was eighteen at the time. Had he relied on “natural medicine” he’d likely have died from gangrene as a result; had he undergone the usual treatment of the time he likely would have been a double amputee to prevent said gangrene. Instead, the medic treated him with the then-latest product of Big Pharma, called “sulfa powder”. Uncle Bill never wore short pants again, and would never qualify for the Track team, but he kept the use of both legs for the next seventy-odd years.

I’ll have what he had, thank you very much.

— Steve

@Pablo

I’m so sorry for the loss of your nephew. It’s hard for people to understand the reality of losing a baby unless they know someone who has suffered through such a loss. Bereaved mothers are the saddest people on earth, and that pain never goes away, especially when there’s guilt involved.

Both of my grandmothers (now deceased) lost babies at or near delivery. I’m sure they would be pleased to know that I had the option of a cesarean birth to deliver my butterball of a baby. If I had been born two generations earlier, my child and I would be just another sad statistic instead of the thriving, healthy people we are.

I’m so sorry for the loss of your nephew. It’s hard for people to understand the reality of losing a baby unless they know someone who has suffered through such a loss. Bereaved mothers are the saddest people on earth, and that pain never goes away, especially when there’s guilt involved.

Miscarriages are hard enough (1/6 of pregnancies spontaneously miscarry, and 85% of them are basically because it was never going to work out), but full-term losses are especially terrible. This was my sister’s first, and was the first grandchild in the family, and so the excitement level was through the roof. So after carrying and anticipating for 9 mos + 2 weeks, suddenly the world collapses. She goes through all of labor and delivery to deliver a fully formed baby. Perfect in every way, except he is dead.

I can’t imagine having to go through it.

It still hurts, of course, but the pain is lessoned now, 30 years later, by her 3 wonderful (adult) kids and by the full set of 17 grandkids (with one of them mine) and 2 (with 2 on the way) great-grandkids.

@Han

Thank you for your insight, so few people know what it is like to lose a child firsthand (thank all things holy). I would never wish that on my worst enemy.

I lost my firstborn son in 2002 to a defect that now can be surgically repaired. In just the last eight years modern science has made it so no other mother will have to watch her (oherwise healthy) son slowly die of this defect.

@Pablo

You are great! And I second your opinion of “mother nature”!

I’ve had alties pull the “Golden Age” back to pre-agricultural times, where it is (or they think it is) harder to check up on. Back then, people knew how to call upon the Spirit of the Earth to aid them in healing and recovery.

Need I say, they all just loved the movie Avatar.

I’ve noticed people have this same issue with morality. ‘Sure thing mom. You didn’t marry dad just cuz he knocked you up. Whatever. That’s just an issue with my generation.’

“Need I say, they all just loved the movie Avatar. ”

I still can’t believe I wasted my last night in New York watching that piece of crap.

@Tamara: You’d be wrong about not testing folk cures; after all, aspirin is a derivative from a particular willow whose bark would be boiled as a remedy for many things (though the salicylic acid, the actual ingredient in the willow, is far more unpleasant to consume than aspirin). The Chincona bark is another folk cure used by modern medicine – well, except that it’s easier to synthesize the active ingredient than to extract from bark. The Belladonna plant provides atropine, the Coca plant provides cocaine (used as an anesthetic in hospitals), the Poppy provides a variety of opiates. Cabbage, capsicum, parsley, and a few other plants provide Vitamin C (bye-bye scurvy). Folk cures are quite easy to test and have been tested; most are nonsense while many of the known useful ones are exploited – some are not exploited because there are far more effective treatments. So, if you can find more isolated tribes and find out about their folk cures and test them, you may find a few new drugs; however it is a myth that “most” folk cures have not been exploited because the pharmaceutical industry really loves folk cures that work. There is also no reasonable basis for claiming that “most cures” in the ____ (insert forest/marsh/ocean/whatever) “have not been discovered yet.”

@Pablo # 11
One of the difficulties in comparing perinatal outcomes between eras is the contribution of other scientific developments- eg sanitation.
Here is a link to a CDC review of a 1980s review of perinatal and maternal mortality in the “Faith Assembly” in Indiana, which makes a fair attempt at controlling for such confounders.
http://www.cdc.gov/mmwR/preview/mmwrhtml/00000345.htm
Those ascribing to the Faith Assembly beliefs of eschewing all modern medicine (while living in a developed setting) had a 2.5 x increase in perinatal death, and 92 x increase in maternal death, compared with Indiana as a whole. The figures are alarming as they stand, but may indeed be even worse, as those women in the Faith Assembly communities were predominantly well educated, white and between 20-34- “low risk” in obstetric parlance; while the control group of were not so selected.
When I am asked what obstetric practices have contributed to the safety of pregnancy and birth, I refer my inquirer to this paper.
My apologies for my clumsy link- am a middle-aged clinician, not a researcher!

Heck, just reading the “Bills of Mortality” for the 1600s makes me all verklumpt with nostalgia for the Golden age of plague, smallpox and short life spans. Back in the day, before you PharmaShills and know-it-alls messed things up, 30% of the kids didn’t have to worry about their careers because they were dead by 10. (not dead asleep by 10PM, but dead and buried before their 10th birthday).

Because of my interests is medieval history, I recently purchased the book, “Leechcraft”, which contains the original Old English text of three Anglo-Saxon herbal/healing manuscripts. They provide a fascinating glimpse into the culture of the time, and also give you an appreciation of how far things have come.

I bought it through Amazon and from the recommendations autogenerated by Amazon that I’ve deleted since then, it appears as if people have purchased the book as if they were expecting to find real, effective medical advice…yikes.

The Good Old Days were not good.
I suppose our woo-miesters from Huff-Puff will come out with some contention that of course it’s Their development of Alt-med-quackery which caused Lifespans to triple, infant mortality to dwindle and formerly lethal diseases to be little more than potentially messy nuisances.

Anne – interesting. Basically, what it showed is that is the maternity complications on “natural” deliveries in the 1980s were essentially the same as what was going on at the the turn of the century.

I suppose our woo-miesters from Huff-Puff will come out with some contention that of course it’s Their development of Alt-med-quackery which caused Lifespans to triple, infant mortality to dwindle and formerly lethal diseases to be little more than potentially messy nuisances.

No, they chalk it up to “sanitation and nutrition” combined with “the diseases were going away on their own.”

@14:
your family history of medicine is a little fuzzy.
sulfonamides were NOT available in WWI. twenty years too soon.
While sulfa had some real successes with strep throat,
some staph infections, and some pneumonia – starting in
the late 1930’s – the WWII movie scenario of pouring sulfa powder
over every wound was mostly wishful thinking.
Still, it was a helluva drug, with real pharmacological usefulness.
Still is… hell, most MRSA strains are still susceptible.

Sigh. I have no doubt that the altmed crowd are aware of these criticisms and have elaborate answers for them. The posters here sound very much like people who find one of the (many) contradictions in the bible and thisnk that this will be news to a well-indoctrinated christian.

Remember, when debating a fanatic, to address yourself to the third party, and to not get caught up in attempting to convince the fanatic – it’s pointless. This also means that there’s never any point debating a fanatic on turf where there are not third parties to address yourself to. It’s a wste of breath.

According to that link:

“The correct quote is “an estimated 44,000 to 98,000 among them die each year as a result of medical errors.”

Now does this mean “they would have lived, if not for the medical error”, or does it mean “the doc should have been able to save them, but he/she screwed up”?

From the POV of medical responsibility and ethics, they are similar. Ethically, the issue is the cause and type of screw up. But from the POV of the question of whether modern med is a good idea, they are vastly different.

julian writes of Avatar:

I still can’t believe I wasted my last night in New York watching that piece of crap.

Aw, lighten up, Jules. Yeah, the story rates about a Bambi for complexity (the evil men are destroying the forest!), but for pure movie spectacle, at the moment it’s hard to beat. And before the movie there was the trailer for Alice in Wonderland in 3D with Johnny Depp. (Wonder what mind-altering substances will be found among the crowds turning out for that film?)

In general, though, I do agree with you that I often regret doing things when visiting another city that I could just as well do at home. (The only movie I can recall taking the time to see in NYC is Diva, which of course never got anywhere near my home town, and is still one of my all-time favorites.)

Tsu Dho Nimh @ #22: “Verklumpt”? Maybe if you’re Eddie Murphy (see Nutty Professor II, “The Klumps”). For the rest of us, it’s verklempt (Yiddish) or verklemmt (German).

Pedantic mode over. I now return to my regularly scheduled personality.

i would just like to say a big thanks to all the docotrs and reaserchers out there. i had a neihbor who needed a heart value repalcement at 32 do to a birth defect. without it she would have died. now she can live to a ripe old age like the rest of us. what more do u need say more people get to live in confort and are having way more fun then people have ever had so keep up the good work

i find it sad that people don’t understand how good we have it really. So agian thanks for making my life and others better in big ways and small

I second marge’s comment. The things that modern medicine can do is absolutely amazing.

One of my favorite examples of how great modern medicine is comes in the imaging. Think about this for a second – we have the ability to look inside a body and see what is going on, without having to cut it open! Do you realize how big of a step that is in terms of diagnosis and treatment?

With all the kerfluffle with Suzanne Sommers and her dissing of modern medicine treatments of breast cancer, keep in mind that without modern science and the ability to do imaging, most cancers aren’t going to be detected until they are so big that they have caused major damage. While many breast cancers are found as lumps, many are not.

You have a broken bone? Easily observed, and pretty easily treated (although annoyingly). Now, try doing that without having a radiograph. How does the doctor know if your bone is broken? Jiggle it and see if you scream? Yeah, that sounds fun. More importantly, when the radiograph shows that it ISN’T broken, we don’t need to cast it, although we would have in the past.

There are so many great imaging techniques that are brought to us by modern science. Without science, how are you going to know what’s happening? Dissection?

Well, there is always biopsy, but then again, that is based on science (pathology), too.

Yeah, the good old days. You have got to be kidding me! In college I once had to write a term paper on a topic relating to “science and technology in the early modern world”, and since I was mad at the prof I chose midwifery. One of my friends nearly threw up just reading my sanitized description of the procedures for removing a stillbirth. Horrific. (Got an A, because she didn’t want to admit she didn’t read the paper!)

So they can take those good old days and shove them!

Both of my grandmothers died while my parents were children.

How often does that happen any more?

‘good old days’ indeed. If you mean any time before the mid 1950s, then I’d have been dead at age 8. Thanks to penecillin and oxygen tents, I’m still around (mumble) years after the fact. (I give some more details, more about the science than my medical history, at Life saving science.)

Isaac Asimov told the story of some people who were talking about the ‘good old days’, in this case late Victorian England. Talking about the servants they’d have, and their lives of ease. He observed, in those days we’d have been the servants.

Two things I feel sure of when people talk about the ‘good old days’ a) they’re envisioning themselves as part of the exceedingly small wealthy class and b) they have no clue what living at that time was actually like (even for the wealthy).

My hope is that tomorrow will be better than today, my kids will have a better world than I grew up in, and my grandkids’ world will be even better than that. We have some work to do to make this happen.

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