Impartial Observer   /     np episode 005 Medicine – What’s Old Is New

I recently had a colonoscopy, and it started me thinking about medical procedures. But first, my colonoscopy. If you’ve never had one, you’re missing a positively dehumanizing experience. This is a procedure where you are laying on your side in a fetal position with your butt exposed. After the administering of anesthesia, you are out of the picture. This is the part that worries some patients. There was a story in the news not too long ago where a man had his phone recording and later heard the surgical team mocking him during the procedure. I didn’t have that problem; at least I hope not. I think I did make a mistake by asking my doctor if he knew what he was doing. I was joking, but I don’t think he realized that. This procedure requires that air is pumped into your colon so the implements of torture can be introduced. If the surgeon knows how much air should be used, there’s no problem. If not, you will sound like a Harley Davidson every time you take a step. That’s exactly what I sounded like as I walked through a very crowded hospital lobby. Now let’s see some older procedures that are getting a second look.

LOBOTOMY

In the first procedures, small holes were drilled into the skull and ethanol was injected into part of the brain to functionally sever the frontal lobes. This is the area of the brain that affects personality,  motivation,  and attention. In the 1940s these became routine office procedures in which the doctor pushed an icepick through the top of the eye socket and severed the frontal lobe. Roughly 40,000 Americans were “treated” with this procedure, with a significant amount of associated death and morbidity.   This type operation is having some success with seizures and epilepsy.   With improvements in localization provided by high-resolution imaging (e.g. MRI scans) and brain wave studies, teams of neurosurgeons and neurologists are now able to target and remove small regions of the brain to significantly improve seizure control while causing minimal secondary damage. Promising results have led to a rise in the lobotomy-like procedure. MLA: “Azathioprine – Wikipedia, the free encyclopedia.”

ELECTROSHOCK THERAPY

In the popular novel and movie, One Flew Over the Cuckoo’s Nest, Big Nurse (Nurse Ratched), used electroshock as a tool to terrorize and control the patients in her ward. It was shown to be very effective in improving mental illness, especially severe depression. At its height in the 1940s and 50s, it was estimated that approximately one-third of patients hospitalized with affective disorders (e.g., bipolar, depression, anxiety) had undergone the treatment. Unfortunately, it was also associated with significant memory disturbances and confusion, and prior to the use of anesthetics was known to cause bodily harm, including bone fractures and dislocations.   The negative public perception, combined with the rise of antidepressant use from the 1950s onwards, led to a significant decrease in the use of ECT.  Over the past 20 or so years, however, ECT has had a resurgence due to its effectiveness in patients with severe depression that do not respond to medication alone. It is estimated that roughly 100,000 Americans receive ECT per year in the United States, and it is considered to be the gold standard treatment for severe depression.

LEECHES AND BLOODLETTING         MLA: “Azathioprine – Wikipedia, the free encyclopedia.”

   For thousands of years, bloodletting was a practice of ancient medicine to balance the humours. It is thought to have been among the most common medical practices from the antiquity period through the late 1800s. The first documented uses were in ancient Egypt around 1000 BCE. In Hippocrates’ Greece, when dietary changes, exercise, sweating, and vomiting proved unhelpful, the body was frequently “re-balanced” through bleeding. Various methods of bloodletting were used over time, usually involving small knives to score the skin or nick a vein. The use of leeches, too, has increased in the past couple of decades after it was discovered that the leeches’ saliva secretions contain several medicinal enzymes. In microsurgery and tissue reimplantation, leeches can help relieve blood congestion and allow for proper circulation.  

THALIDOMIDE Web source: http://www.sciencemag.org/content/290/5494/1063.summary Web source: http://www.schaeffersresearch.com/content/news/2015/03/03/analyst-update-mylan-i.

..      Developed in Germany in the 1950s, thalidomide was considered a cure-all. It was marketed as a treatment for respiratory infections, insomnia, cough, colds, headaches, nausea, and — most significantly — morning sickness. The application was denied by the U.S. Food and Drug Administration .Doctors prescribed thalidomide to thousands of pregnant women for morning sickness until they realized children were being born with serious birth defects. It was estimated that between 10,000 and 20,000 children were born with missing and severely malformed limbs, and roughly 50% of them died. In 1991, researchers found that the drug had a significant impact on the regulation of the immune system. Seven years later, the FDA approved the drug for the treatment of leprosy, and since that time it and multiple derivatives have been used effectively on blood cancers and other immune system disorders.

MAGGOTS Web source: http://www.schaeffersresearch.com/content/news/2015/03/03/analyst-update-mylan-i… Web source: http://www.wallstreet-online.de/diskussion/500-beitraege/562542-1-500/lamp-63162…

Maggots have been used for thousands of years to treat wounds. In the 1930s, studies found that maggots contain antimicrobial properties. Despite the growing body of evidence, however, the discovery of penicillin and other antibiotics led to far lower maggot usage for infectious wounds.  In 2004, the FDA approved the prescription of maggots for the treatment of non-healing wounds, including diabetic ulcers, venous stasis ulcers, and other non-healing traumatic or surgical wounds. FECAL TRANSPLANT Web source: http://blog.nutritioncare.org/act-3-cultural-sensitivity-with-a-geriatric-patien… Taking stool from one healthy person and implanting it in the digestive system of an unhealthy person certainly sounds like one of the least pleasant treatments. Despite the “ick” factor, recent studies have shown fecal transplant to be exceedingly successful in controlling some bacterial infections in the gut that do not respond to available antibiotics.  Fecal transplants have been used to treat other ailments as early as the fourth century. Chinese medical reports from the period discuss its application in the treatment of food poisoning and severe diarrhea. At that time, and for at least the next 1,200 years, a solution of stool and water was simply drunk by the patient. 

ARSENIC Web source: http://argonm11.imascientist.org.uk/2011/03/who-discovered-the-cure-for-tubercul… Web source: http://www.marfan.org/about-us/news/2014/11/18/losartan-shown-be-effective-treat…

As is the case with many modern chemotherapies, arsenic is well known for both its ability to fight disease and cause serious side effects and death. Arsenic has been used in several medicinal tonics as well, most famously Fowler’s solution, which was used to treat high blood pressure, gastric ulcers, asthma, eczema, tuberculosis, and both skin and breast cancers. While these tonics were somewhat helpful, they had significant side effects and fell out of use in the mid-1900s.  In the early 1900s, a physician, Dr. Paul Ehrlich found that atoxyl, a derivative of arsenic, was highly effective in the treatment of trypanosomiasis, a common and often fatal chronic infection of the time. Based on this, he searched for a similar derivative of arsenic to treat syphilis, and in so doing created the concept (and name) of chemotherapy. He created Salvarsan, which was the first effective treatment of syphilis; it quickly became the most prescribed drug in the world.     Looking at these treatments I suppose my colonoscopy wasn’t that bad.

The post np episode 005 Medicine – What’s Old Is New appeared first on NONSENSE POTPOURRI.