Protecting Tao
May 26, 2009 at 12:58 pm | In Chinese Medicine, History Lesson, Social Medicine | Leave a Comment“Tao is precious and not to be passed on, unless the student is sincere and compassionate towards human suffering”
Huang Di Nei Jing Su Wen, chapter 4, Truth from the Golden Chamber
Top killers in U.S.
January 14, 2009 at 9:57 pm | In BioMedicine, Modern Research, Science, Social Medicine | 3 CommentsTags: Iatrogenic Disease

Tope three killers in the u.s. as reported in JAMA: 1 700000 2. 553000 3. 250000
(* Note: I made two errors when making my beautiful piechart – I cited 250,000 as the number of iatrogenic deaths, when the actual number is 280,000. I also mistakenly switched two sources for the deaths, ADRs and total injuries. Source below.)
Over a million patients are injured in U.S. hospitals each year, and approximately 280,000 die annually as a result of these injuries. Therefore, the iatrogenic death rate dwarfs the annual automobile accident mortality rate of 45,000 and accounts for more deaths than all other accidents combined.
Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, Laffel G, Sweitzer BJ, SheaBF, Hallisey R, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA. 1995 Jul 5;274(1):29-34.
When these numbers came out in 1995, Reuters didn’t pick them up. Why? These are shocking numbers.
It’s not the only piece of research that paints this shocking picture either: Gary Null paints a picture far more gruesome – total deaths due to conventional medical interventions and problems picked up in hospitals (such as infections) is 783,936 per year. Then, depending on the numbers for the other two top killers, Heart Disease and Cancer, Conventional medicine takes either the top or second spot.
Let’s look at another pie graph:

Top three killers in the u.s. as reported by G Null
The modern healthcare system is not supposed to do this. This is out of bounds. What now?
References:
Lazarou J, Pomeranz BH, Corey PN, Incidence of Adverse Drug Reactions in Hospitalized Patients, Journal of the American Medical Association (JAMA), Vol. 279. April 15, 1998, pp. 1200-05.
Bates, DW., Drugs and Adverse Drug Reactions: How Worried Should We Be? JAMA, Vol. 279. April 15, 1998, pp. 1216-17.
Leape L, Error in medicine, JAMA 1994;272:1851-7.
Schuster M, McGlynn E, Brook R. How good is the quality of health care in the United States? Milbank Q. 1998;76:517-563.
Starfield B. Evaluating the State Children’s Health Insurance Program: critical considerations. Annu Rev Public Health.
Phillips D, Christenfeld N, Glynn L. Increase in US medication-error deaths between 1983 and 1993. Lancet. 1998;351:643-644.
Leape L. Unnecessary surgery. Annu Rev Public Health. 1992;13:363-383.
Weingart SN, Wilson RM, Gibberd RW, Harrison B. Epidemiology and medical error. BMJ. 2000;320:774-777.
Guyer B, Hoyert D, Martin J, Ventura S, MacDorman M, Strobino D. Annual summary of vital statistics 1998. Pediatrics. 1999;104:1229-1246.
HarHolland E, Degruy F. Drug-Induced Disorders – November 1, 1997 – American Family Physicianrold LR, Field TS,
Gurwitz JH. Knowledge, patterns of care, and outcomes of care for generalists and specialists. J Gen Intern Med. 1999;14:499-511.
World Health Report 2000. Available at: http://www.who.int/whr/2000/en/report.htm. 2000;21:569-585.
Pediatrics in 15th century China
December 26, 2008 at 1:40 am | In Chinese Medicine, History Lesson, Social Medicine | Leave a CommentTags: Malnutrition, Pediatrics
From the opthalmology text Yin-Hai Jing-Wei (Essential Subtleties on the Silver Sea), circa 1500:
The condition “malnutrition harm in children” develops mostly in well-to-do families because such parents spoil [their offspring]. A child is like the sprout of a plant that hardly endures the impact of wind, sun, cold, and dew. Similarly, how could a child, whose five viscera and six bowels are still immature, and whose qi and blood are [still] weak, endure rich, greasy, and fried food, as well as all kinds of flesh food? There are cases where [children] beginning with one year of age [are allowed to] follow their own taste, and eat candies and other sweets, and meat of geese, ducks, chicken, pigs, cows, and goats. Or, just having finished their meals, children are allowed to suck again; or, just satiated with milk, the children are fed again with other food. This condition results from parental over-affection, and that is why it occurs in well-to-do families.
I have copied this section out simply because it is instructive to see that people have always had bad habits, and that, perhaps, we are not as original as we like to think – that even in our orgiastic development of technology we may only be following primal impulses, rather than doing something different, or new.
The following is a basic presentation of the above disorder:
- distention of the belly.
- loose stool or diarrhea.
- pain in the abdomen (colic).
- fever that begins in the afternoon and does not abate until the middle of the night.
- irritability, restlessness and crying or screaming.
- red, inflamed eyes (such as pink-eye), sensitivity to light.
- in severe cases, the child will have protruding eyeballs and a membrane can grow, covering the pupil.
Again, any disorder exists on a spectrum of mild to severe, and usually exists in conjunction with other patterns as well as a person’s individual internal terrain.
WHO endorses Traditional Medicines
November 11, 2008 at 7:52 pm | In Chinese Medicine, Modern Health-Care, Social Medicine | Leave a CommentTags: Chinese Medicine, collaboration, WHO
from: http://www.newvision.co.ug/D/9/34/658616
World health body endorses traditional medicine
Sunday, 9th November, 2008HEALTH representatives from more than 70 countries gathered in Beijing on Friday to swap ideas on how to make traditional medicine, ranging from acupuncture to leech treatment, more widely available.
The two-day World Health Organisation (WHO) event, built around seminars on regulatory standards and folk medicine in cultures from South Africa to Japan, is expected to end with member countries agreeing to expand traditional medicine in their health care systems.
WHO officials at the event said blending traditional and Western medicine could make each more effective. “Integration of traditional medicine into national health systems will not only bring benefits to patients, but will also ensure safety and proper use,” assistant WHO director-general Carissa Etienne told reporters at a briefing.
Speakers also called for research on traditional medicines, which WHO director-general Margaret Chan called “a valuable source of leads for therapeutic advances and the discovery of new classes of drugs”.
Herbal and other treatments have sometimes been found effective in studies. Artemisinin, a plant ingredient used in southern China for centuries to fight malaria, became regarded as the best treatment for the disease after research proved its ability to clear parasites quickly.
(…continue reading at this link)
We can be very insulated in the “developed world”. I guess that’s why they call it the “developing world”.
Doctors Wanted
October 14, 2008 at 3:50 pm | In Modern Health-Care, Social Medicine | Leave a CommentTags: Choice, perception
According to Eisenberg et al, [1] total visits to alternative healthcare practitioners exceeded total visits to primary care physicians in the US back in the 1990s.
If we can leave our notions of healthcare aside and look at the available evidence, it would likely become apparent that there already exists a “shadow system” of healthcare – effective, safe, and able to provide some of the very medicine we need.
More and more professionals are calling for interprofessional collaboration, including “emerging” healthcare systems like Chinese Medicine. [2] In the 21st century it won’t be possible to maintain the rigid hierarchical structure as it exists today.
1. Trends in Alternative Medicine Use in the United States, 1990-1997
David M. Eisenberg, MD; Roger B. Davis, ScD; Susan L. Ettner, PhD; Scott Appel, MS; Sonja Wilkey; Maria Van Rompay; Ronald C. Kessler, PhD
JAMA. 1998;280:1569-1575.
2. The Case for Interprofessional Collaboration
Geoffrey Meads; John Ashcroft; Hugh Barr; Rosalind Scott; Andrea Wild
Blackwell Publishing. 2005
Robot for Rent
October 13, 2008 at 1:28 am | In Social Medicine | Leave a CommentTags: Social Medicine, Technology
from: http://www.iht.com/articles/ap/2008/10/07/business/AS-TEC-Japan-Robot-Suit.php
It’s unusual that a powerful technologist rebuffs the military, so it’s always nice to hear of it happening:
Robotics technology is common in manufacturing sectors, but product liability concerns restrict its widespread use in everyday life. Sankai said the HAL technology is devoted to social welfare purposes only, adding he has refused requests from military officials to share it.
It is interesting to me because the military will easily get their hands on something they want, or develop it on their own, so Sankai’s gesture is really “nothing more” than a powerful symbol that can remind us of where our priorities are, or ought to be.
As a final note:
[P]roduct liability concerns restrict [HAL technology's] widespread use in everyday life.
“We are going to be very cautious, but we wanted to take the initiative to help people,” Daiwa director Takashi Hama said.
Because, once again, military + robotics = terminator. And most of us know what ended up happening with that.
Scientific Authority
October 7, 2008 at 9:08 am | In BioMedicine, Social Medicine | Leave a CommentTags: authority, Science, Skepticism
Scientific authority, like any type of authority, is easily abused, and often unwittingly abused.
M. Scott Peck takes a stab at illuminating the subject in the paragraphs below.
The Danger of Cloaking Moral Judgment in Scientific Authority
This is a major pitfall. It is a pitfall because we ascribe to science much more authority than it deserves. We do so for two reasons. One is that very few of us understand the limitations of science. The other is that we are too dependent upon authority in general.
When our children were infants we were blessed by the very best of pediatricians, a kind and dedicated man of great erudition. When we visited him a month after the birth of our oldest child, he instructed to start feeding her solid foods almost immediately, because such supplementation was needed for babies being breast fed. A year later, when we visited him a month after the birth of our second daughter, he directed us to delay feeding this one solid food as long as possible so as to not deprive her of the extraordinary nutrition in breast milk. The state of “science” had changed! When I was in medical school we were taught that the essential treatment for diverticulitis was a low-roughage diet. Now medical students are taught that the essential treatment is a high-roughage diet.
Such experiences have taught me that what is paraded as scientific fact is simply the current opinion of some scientists. We are accustomed to regard science as Truth with a capital T. What scientific knowledge is, in fact, is the best available approximation of truth in the judgment of the majority of scientists who work in the particular specialty involved. Truth is not something we possess; it is a goal toward which we, hopefully, strive.
[...]
The problem is aggravated by the fact that the public is actually eager to be guided by the pronouncements of scientists. [...] We are content, even anxious, to let our authorities do our thinking for us. There is a profound tendency to make of our scientists “philosopher kings,” whom we allow to guide us through intellectual labyrinths, when they are often just as lost as the rest of us.
M.S. Peck, MD, 1985, pp 257-258.
As I mentioned in yesterday’s post regarding skepticism, it is very important to turn both science and skepticism in on themselves and each other. If this is not done, neither deserves their own title.
Skeptical to the End
October 2, 2008 at 12:46 pm | In BioMedicine, Chinese Medicine, Social Medicine | Leave a CommentTags: Acupuncture, BioMedicine, Skepticism
I found an interesting post and comment thread at scienceblog.com (http://tinyurl.com/3zgatd). It seems that a study involving drugs and acupuncture for hot flashes due to cancer therapy found that acupuncture was as effective at relieving hot flashes as the commonly-used drugs, had other beneficial effects such as increased libido and energy, had no side-effects, and produced a longer-lasting effect than the drugs, and is more cost-effective.
The data from this study are clear. What is interesting are the varied “skeptical” responses, which ranged from denouncing acupuncture as religious and superstitious, to saying it was all a placebo effect. Without needing to dispute any of these charges, I feel a need to ask a question: How can it be that a placebo is so superior to a tested drug? (1)
Skepticism is not the automatic gain-saying of certain classes of claims. It is the ability to retain critical thought, in particular of one’s own self. Simply calling one’s attitude “skeptical” does not make it so. Many other behaviours masquerade as skepticism: cynicism, egoism, narcissism – it’s tricky. For this reason the power of skepticism must be turned in on itself a good portion of the time. The word comes from the Greek skeptomai, which means to look about, or to consider; to not be rigid or fixed in one’s point of view.
Paraphrased from Wikipedia:
A Philosophical Skeptic makes certain propositions about (a) an inquiry, (b) a method of obtaining knowledge through systematic doubt and continual testing, (c) the arbitrariness, relativity, or subjectivity of moral values, (d) the limitations of knowledge, (e) a method of intellectual caution and suspended judgment.
Also from Wikipedia:
The “Skeptikoi” were a school of philosophers of whom it was said that they “asserted nothing but only opined.” In this sense, philosophical skepticism, or Pyrrhonism, is the philosophical position that one should avoid the postulation of final truths. Turned on itself, skepticism would question that skepticism is a valid perspective at all.
1. Alleviation of Hot Flashes With Increase in Venlafaxine Dose
Prasad R. Padala, Srinivas B. Rapuri, and Kalpana P. Padala
Prim Care Companion J Clin Psychiatry. 2007; 9(1): 70–71.
PMCID: PMC1894834
Heart Patients should be Screened for Depression
September 29, 2008 at 7:56 pm | In Modern Health-Care, Social Medicine | Leave a CommentTags: authority, heart disease, jargon
“Heart Patients should be Screened for Depression”. This is last week’s recommendation of the American Heart Association.
Does that mean a heart patient gets pushed through a screen-door? Cheesecloth? It sounds so technical. It just seems to me that a trained professional is very likely to simply see it, if they know the person and have the person’s confidence. But that can’t really happen at 5 to 7 minutes per appointment. I wouldn’t tell that person I felt down in the dumps either.
There are ideas that depression is difficult to see. I disagree. It is difficult to see for white-coated professionals who carry an air of superiority and give their patients a paltry sum of time. I has been my experience that those white-coated professionals who maintain their balanced concern for their charges do pick up on a patient’s state of mind – and the more time they spend, the more likely they are to pick it up soon.
It is also interesting to note that it is not already widely known, as a type of red-flag, that people with heart disease could be expected to have some trouble being light-hearted.
It seems to me that this is one more symptom of the distant medical doctor and alienated patient relationship.
Tainted Milk from China
September 29, 2008 at 3:08 pm | In Social Medicine | Leave a CommentTags: China, Environment, Tainted Milk
Man, China really has to get a grip. First they try to annihilate CM and now they’ve got runaway industrialisation creating every environmental problem you can think of. And capitalism unleashed on this scale leads to quite a bit of white-collar crime as the business cut-throat style of kung fu becomes more and more prevalent…
However, something predictable happened as I was researching this post. The further I went in, the bigger and more complex the picture became. This is not an issue of one country being incompetent or reckless. There is a web of effects ranging from the newly developing Chinese middle-class, China’s movement to capitalism (authoritarian capitalism/social capitalism), what China is contracted to do and under what restrictions, how political machination plays a part in the successes and failures reported here in the west, how 1st world nations have become desensitised to their own often very negative effects on the rest of the world, and so on. It is unfortunately not so clear cut as “China really produces a lot of dangerous garbage – what a weird country”. It is easy for us to think of ourselves as particularly advanced, but that is our own rosy thinking. For example, it was not quite 30 years ago that the u.s. itself was battling a lead pollution health crisis – the same one that China is battling now. We tend to forget our own errors and instead imagine that China is unusual or reckless, when in many cases China is simply repeating the west’s mistakes as it follows the west’s examples.
Some things to keep in mind:
1. Economic Size
There is a very important seaport in South America called Valparaiso. Did you know that days where every single outbound vessel is heading for China are frequent?? Scary. Those ships are not loaded with products, but rather with raw materials that China then makes products with to temporarily stem the first world’s appetite for TVs, washing machines, plastics, what-have-you.
I bring this up because China is a huge economic force. Over 1 billion people strong. When an internet company promises 98% uptime, that translates to almost seven and a half days down per year.
2.
Chinese business is obviously responsive to the customer or contractor – and when the bosses want cheap products, pay cheap wages and generally act cheap, well, they will get cheap products, made cheaply, out of cheap materials. Why don’t we hear about the demand that has led to the supply?
3.
China is in the midst of developing a fully industrialised economy at lightning speed. In practical terms this means that they are, wrongly, cutting lots of corners – for example, they are they world’s largest producer and consumer of coal. Read about illegal coal mines here.
4.
Is it possible that there are heavy political forces at work creating, in essence, a trade embargo?
5.
It is easy to look at another country and see it’s scars and failures. We should look at ourselves as harshly and with as much fear:
Listeria
The most recent reports indicate that two-thirds of food samples in Toronto hospitals showed contamination! I mean come on!
Global Warming
The first world used so much coal during industrialisation that it threw the planet’s climate off. While some people still debate the reality of it, satellite imagery of the ice caps is shocking, and others say that the final word has been in since at least 2005. The “first world” set up a situation (and set an example!) that is potentially devastating for us as a species, and has proven devastating for others already. But it is such a broadly defined threat that we find it difficult to grasp. But, as always, we did it to ourselves. It is accepted that there are two major sources for the global warming problem: 1. the burning of fossil fuels (coal in particular), and 2. deforestation. Not to put too fine a point on it, but we know what the source of both those sources is: overconsumption.
Some forecasters are predicting a worldwide food shortage as a result of global warming – and the coal that China (and others) are adding into the mix doesn’t help. You see, half of the world’s grain production comes from three countries (the u.s., India and China). China’s wheat production is twice that of the u.s.’, and China’s rice production is far more than that. If these forecasters are right, there is a great risk of a permanent drought along the yellow river in the next 20-30 years due to the loss of glacier mass in the Himalayas. Both the Yang-Tze (in China) and Gangetic (in India) river basins will be affected in this manner.
6.
The Assembly Line and Globalisation
This is, simply put, a dangerous combination. Stuff gets everywhere with identical errors very fast.
And finally, what is perhaps my most scathing point:
7. The powerful are under attack??
It is the 1st world nations (who have a stranglehold on government and finances) who have the permits and documentation necessary to legally carry out dumping, mining, deforestation, pollution (kyoto anyone?), “development” and so on.
Gou Qi Zi / Wolfberries
September 29, 2008 at 2:50 pm | In Chinese Medicine, Social Medicine | Leave a CommentTags: Herbal Medicine
Gou Qi Zi are a very commonly used herb in CM, so it is surprising to see the obsessively focussed coverage in the health media of this new wonderfood.
Most Nutrient Dense Food on Earth
I doubt it. “You say that to all the herbs!” Come on, it’s good, but it’s not that good.
Hospital Food
September 25, 2008 at 1:35 am | In Modern Health-Care, Social Medicine | Leave a CommentTags: BioMedicine, Dietetics, Hospital
“A good doctor first makes a diagnosis, and having found out the cause of the disease, tries to cure it first by food. If food fails, only then will drugs be prescribed.”
- Sun Si-Miao (581-682 C.E.)
It has always amazed me how such an important part of convalescence – the food that we eat – is so … well … slummed through … in modern hospitals.
The excuse of funding can be brought up; that hospitals are bare-bones emergency services and not some 5-star hotel…but the fact of the matter is that properly-fed patients heal much faster and recover their status as outpatients quicker.
Knowing that the mean cost of one day in the hospital is about $1,200, it seems that the addition of what amounts to a mid-range restaurant that will serve a meal for 15 to 20 dollars is trivial, if it could help take off days of hospital care.
The obvious question is, of course, how do we know that food would create this effect? Well we have two negative pieces of evidence that we can use to illuminate the positive:
1. It was an understanding of medical science about 40-50 years ago that food has “no effect on the creation or remission of disease”. We are in a greatly different position now, where any food one could care to mention is being researched for its health effects.
2. Many foods have been clearly incriminated in the creation of certain diseases: fatty food and obesity and heart disease; excess sugar and diabetes; fried food and certain cancers; the list continues. We can only assume that not all foods have such strong negative effects – that many foods have equally strong positive effects.
Can you imagine that, one day, the answer to the question, “why were you in the hospital?!??” would be, “Oh, I go there for the food!”
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