Science-based medicine throughout time

[SidDithers]

An interesting thought experiment - how well could a surgeon from 2013 fare if a time machine dropped them 300 years into the past. Long blog entry but a good read.

http://www.sciencebasedmedicine.org/science-based-medicine-throughout-time/

First, imagine that you’re dropped into a foreign city with only the clothes you wear. No wallet, no hand bag, no money, no cell phone, no identification. Pretty scary, huh? But still, most of us would get out of the situation fairly easily. We would find the embassy of our country of origin, or if it were in another city, contact the local police and ask to use their phone. A few days later we would be home.

That’s not the scary scenario I rehearse. Imagine that you’re dropped into the city you live in with only the clothes you wear. No wallet, no hand bag, no money, no cell phone, no identification. And it’s 500 years ago. (Or for you colonial types, 300 years ago in one of your country’s first cities.)

It’s a fun thought experiment, with Martin pointing out that you would speak the language with what to the natives living at that time would seem a very strange and nearly incomprehensible accent. Think of how hard it is to understand the English spoken in Shakespeare’s plays, which is full of idioms, turns of phrase, and vocabulary peculiar to the time, and then just think about the number of words that we use that would be incomprehensible to, say, an American living in the Midwest, which at the time for where I live would have been ruled by the French as part of New France but mostly populated by indigenous tribes. So for purposes of the thought experiment, I’ll pick New York or Boston. I could also make like The Doctor and claim imagine that the TARDIS (or something else) had given me the ability to speak the native language and appear to be dressed like everyone else. Or I could imagine that I didn’t understand the language and had to learn it. Over time, it wouldn’t really matter. Here’s the part of Martin’s thought experiment that caught my eye:

Some might think that a well educated modern Westerner would soon become one of the sages of the age thanks to their superior technological and scientific knowledge. For one thing, it wouldn’t be hard for most of us to become the best doctor in the world of AD 1509 if knowledge was all it took. But I have a feeling that such knowledge would not be easily applied in a society that is completely unprepared for it, and not easily implemented in an environment where none of today’s infrastructure exists. And say that you’re actually a doctor or an engineer – how much could you achieve without access to any materials or tools invented in the past 500 years? I mean, I know the principles of nuclear fusion, aviation, antibiotics, vaccination and basic biochemistry, but don’t ask me to put them into practice starting from scratch!

Well, I am a physician and surgeon, and I don’t know if I could elevate myself to a sage of the age with my knowledge. The reason is that so much of what I do and have done in medicine relies on the technology and science of the time—this time, as in the decades between 1984 (when I entered medical school) and now. Let’s start with something very, very basic. I’m a surgeon. I try to cure or treat diseases by operating. Operating on a patient, however, is very difficult without reliable anesthesia, and inhalational anesthesia using ethyl ether wasn’t discovered and widely applied until the 1840s. Before that, there were various herbal anesthetics and hypnotics, natural drugs like opium extracts and later morphine, and even alcohol. While these may have sufficed for minor operations (barely), they were not at all sufficient for doing anything major, such as entering a major body cavity like the abdomen or chest.

Sid

[geek tragedy]

1. Other than adding decades to life expectancy, what has science done for human health?

I say we bring back leeches as a general treatment for ailments.

[SidDithers]

2. Heheh...

Yeah, but apart from better sanitation and medicine and education and irrigation and public health and roads and a freshwater system and baths and public order... what have the Romans done for us?

/Python



Sid

[geek tragedy]

3. People's Judean Front for the win. nt

[zappaman]

4. It's the Peoples Front of Judea!

Splitter!

[idwiyo]

5. In “complementary and alternative medicine,” ...the ideas remain the same, and only the names change

Finally, it occurs to me that the way medicine was practiced 300 years ago here in the colonies bears a lot of resemblance to many “alternative” therapies. Medicines back then were virtually all derived from herbs or animal products, often the herbs or animal products themselves, unpurified. Germ theory was at least 150 years in the future, and disease was thought to be due to things that very much resemble alt-med’s concepts of disturbances in the flow of qi. While I might be very much a fish out of water in 1710 as far as trying to practice medicine and surgery, I suspect many “alternative” medicine practitioners would not be, and that’s the difference. SBM changes substantively as science advances. In “complementary and alternative medicine,” (CAM), the ideas remain the same, and only the names change