A MEDICAL FALLACY

Dominion, Volume 12, Issue 228, 20 June 1919, Page 8

A MEDICAL FALLACY

DIAGNOSIS OF DISEASE

THE,NEW WARFARE (From the London Correspondent of the Melbourne "Age.") London, April 1. The experience which the science of medicine gained during the war has lefiiilted in many important discoveries, uid in new methods of treatment, which will assist tho medical profession in its continuous war against disease. It has rlso stimulated the revolt against certain medical traditions,'which conservative members of the profession regarded as hallowed by time and progressive doctors had come to regard as antiquated. One of the most interesting phases of the revolt which is now taking place in medicine is that which concerns the diagnosis of disease. In the past the medical profession classified disease into separate categories, and gave each category a name. The general public, which knows nothing about the science of medicine, seized hold of these names, and as a general thing derived comfort from them. A man who felt ill and consulted a doctor was comforted when he was told that he was suffering from dyspepsia, because he knew that dyspepsia is not fatal. Lumbago, gout, rheumatic fever, measles, mumps, and colds are all regarded by the public as comforting complaints, because they t.re not fatal, or at least not much more fatal than old age. On the other hand, Bright's disease, tuberculosis, cancer and typhoid are dangerous, because people die irom them. By means of names for diseases the publio was able to prescribe for itself in some degree. The average man, when he was told the name of th'e disease from which ho was suffering, knew whether it was infectious or non-infectious, curable or incurable. The doctor who could not give a name to the disease of the patient who consulted him was regarded by the patient as a. fool. If he gave a wrong name, the patient was unable to correct, him, but if he admitted that he was in doubt as to the cause <,f the patient's condition, and hesiUted to gjve the illness a specific name, the patient went elsewhere .for treatment, for he felt that he was in danger until he knew, the .name of his complaint. In explanation.of the birth of this fallacious form of 'diagnosis, the medical correspondent of "The Times'.' states:— "Great thinkers, Bright and Addison and others, seeking for explanations of disease in post-mortem rooms, had shown that in those who died in a particular way. particular changes were found after death; and they connected these changes with tho symptoms noted in the living, and so built up a science of pathology. But this science, depending on tho facts of death to explain the facts of life, was bound to be more or less of a- transitory character. The facts of life may be cast into relief by the facts of death; they cannot thus be elucidated.' It was well, perhaps, for the doctor to be ablei by means of one or other of a group of tests, to declare that this organ or that organ was definitely diseased. As a general rule, however, all ho was saying was that for some reason unexplained tne organ had broken down in its work, and had becomo the seat of 'fibrous change,' just as the feet become the seat of 'fibrous change' whon corns grow on them. Tho mischief was that this kind of medical thought led to the vision of trees and not of forests. The 'fibrous change' was apt to become, in that conception, the whole disease, and not, as it certainly is, one of the results of tho disease. Doctors thought in organs, hearts, and livers, and. lungs, when they should have been thinking in great bodily changes due to assaults upon the whole organism."

But tho experience gained.during the war lias shed mudi light on medical! problems. As a result of the medical examination of the millions of men who formed the vast national armies, ,*nd the hundreds of thousands who wore rejected ns unfit for military service, the doctors citme across many men who had all the symptoms of specific diseases such as heart disease, kidney disease, and liver disease, but hod not tho 'fibrous changes* which had hitherto boon regarded as tho causes of these symptoms. And os-a result of further experience it was found that men who possessed the symptoms of some disease which was classed by the profession as incurable made complote recovery. a

"It wik necessary to look for a new explanation, and to adopt a new conception,'" writes the medical correspondeivj; of the "Times." "Happily there was not, in some instances, fnr to look. Dysontcry, trench; fever,' scarlet fever, diphtheria and other diseases were seen to be followed by heart troubles and other organ trouble's with great regularity. Tin's was no new observation, but it came with overwhelming force! Tho conception clarified that these diseases of organs were due to the invasion of the body by germs, and that long, loni< before tho 'iibrous change' occurred the body was engaged in a grim fight for life, with resulting impairment of function.

"Here was the new medicine—the conception of disease as n long process, possibly a life-long process, with, as the end, phenomena of the process, the 'fibrous changes.' The great truth—treat infections, not symptoms of infection—emerged. Better still, prevent the infections altogether. It became evident that many of the so-called appearances of disease— the 'fibrous changes'—arc really but signs of the struggle nature is making daj- and night against tho disease. To treat these is like cutting away the props of an unsteady house, with the idea that the props are the cause of the unsteadiness. The new medicine does not shake its head over heart murmurs; it attentats to fiud the infection which is causing the trouble, and to eradicate it. The infection may be in the teoth, or throat, or alimentary tract. Tho pioneer researches of Sir Arbuthnot I.ane have alroadv pointed the way in this direction. But there are., still weary miles to be traversed before the nation as a whole awakes to tho possibilities presented. If 'we can prevent or stay infection, we can. probably prevent all tho effects of infection —that is to say, the bulk of disease:"