110 Years Ago

Cross post from Medscape.

Today I saw in a chart the diagnosis qi deficiency and blood stagnation as a reason for acupuncture. Don't get me started. It was so very dispiriting to see ancient nonsense in an EMR as if it were actually meaningful. I knew that it was really a problem with too much phlegm and the patient needed to be bled with leeches, but would they listen to me? No.

At least qi and blood stagnation don't have ICD codes, even if acupuncture does.

Reality-based medicine, for all its flaws, has done so much to improve the human condition, but due to limitations people still turn to nonsense.

I like to read history and it is always striking as an ID doctor how people used to die from preventable infections. In Team of Rivals: The Political Genius of Abraham Lincoln people died left and right from infections, many of which I see at best once a decade or less. Safe water, flush toilets, vaccination, nutrition, and an understanding of disease epidemiology has made so many infections a rare curiosity.

Nothing brings it home like numbers. Today I came across the US mortality statistics from 1905.

46,788 deaths from epidemic diseases: 10,771 from typhoid (33/100,000), 10,729 from diphtheria, 17901 from malaria, 1180 from smallpox, 3,213 from measles, 3778 from scarlet fever, 6629 from influenza, and 1468 from erysipelas. Erysipelas! Group A streptococcal cellulitis killed almost 1500 people. Amazing.

62,162 from TB in all its forms (194/100,000), 1234 from syphilis, 10,551 from meningitis. 1214 from tetanus.

3374 people died of appendicitis.

And on and on and on, death after death from diseases that are rarely fatal today.

Heart disease was (relatively) nothing having killed 38,510.

And that was in a population of 46,765,351.

I have seen one case of typhoid and a case of malaria or TB about once a year. I have never seen a case of measles. no diphtheria, and maybe one case of Scarlett fever.

And evidently 1905 had a record number of football deaths with 19 resulting in reforms that led to the forward pass.

We had to wait until 1910 for the Flexner report to get medicine on a path a bit better than the forward pass.

All those improvements in human health and the marked decrease in infectious diseases have been made possible by the the relentless research and efforts of all the natural and ancient healing modalities like, well, hmm.

None of them. The human condition has not been improved by any SCAM. Makes it all the more sadder to see it in the medical record.

Points of Interest 10/27/2015
SfSBM @ NECSS 2016

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