The History of ConMedChapter 2, The History of ConMed: No other industrial complex could have produced so many products and commodities that have so persistently failed - and still survive.by Steven Scrutton10 August 2011 
Chapter 1, Creation and Failure of the NHS Chapter 2 - Synopsis This chapter looks at the origins of ConMed within the new medieval universities of the 12th and 13th centuries, and how throughout its rise to pre-eminence it has sought to sideline and undermine traditional medicine. It shows that ConMed has never worked, that it has always been an expensive, ineffective and inherently dangerous form of medicine. It has ultimately achieved its dominant position within the NHS not by the successful treatment of illness, but initially by its roots in the 'higher', ‘educated’ aristocratic social classes, and so from the privileged social and educational background of its practitioners. Later in could rely on its superior professional organisation, and contacts with the political elite, and from the 20th century onwards, its highly successful publicity and propaganda campaigns about the safety and efficacy of it drugs. It is sustained now by the enormous profitability of Big Pharma companies. It traces how ConMed rose to a position of pre-eminence in the 20th century through its partnerships, first with medical insurance schemes, and then the publicly funded NHS. It shows how NHS-ConMed consolidated its social and commercial power through its regular and effective publicity about 'wonder drug' or 'magic bullets' and claims for 'medical breakthroughs' - none of which have ever materialised. It also explains how NHS-ConMed's pre-eminence within the NHS has been achieved only at the loss of a considerable amount of traditional knowledge and expertise in treating illness. Most people today assume, almost without giving the matter a second thought, that as NHS-ConMed is so dominant within health care it must have been proven to be the best, and most effective system of medicine. This is particularly so when the NHS regularly reinforces the view that ConMed is based on 'science', and that there is 'no scientific evidence' that other therapies work. The assumption is that the NHS devotes its resources to ConMed because of its proven ability to deal with illness and disease successfully, safely, and even cost-effectively. The truth is different. The history of ConMed shows that it has never been a successful medical treatment, and that its dominance within the NHS is the result of other, non-medical factors. Indeed, the history of ConMed has been one of human mayhem, an ongoing story of disaster following disaster, with the sick patient the almost inevitable victim. Yet never before has a single form of medical practice been so dominant. In the past there were always several competing strands of medical thought and therapy, functioning side-by-side, often vying with each as to their validity and effectiveness. This competition was healthy. It meant that the development of medical knowledge and thought was multi-directional and pluralistic. It also meant that the patient had some means of comparison and choice as to what medical treatment he or she preferred to receive, as well as applying some constraint on the costs of medical treatment. Medicine. An overview from Ancient TimesThe Origins of ConMedNHS-ConMed has become a publicly-funded healthcare monopoly. Moreover, it has maintained its monopoly status in recent decades when other public monopolies (coal, rail, steel - even some public care services) have been dismantled as a result of the alleged inefficiency inherent in monopolies. Indeed, the health industry is perhaps the most accepted, least questioned monopoly that has ever existed in the UK. The foundations of this monopoly began in early medieval times, when the academic study of medicine was formally organised within the new, highly prestigious universities of Oxford and Cambridge. The physicians produced came from the highest social classes. Their social status, and prestigious education gave them tremendous influence and power within society, at least within the higher social and political circles. The new medics quickly and arrogantly assumed that they knew more about health and medicine than 'traditional' practitioners - often the local 'wise women' of villages who practised herb-based medicine modestly and unassumingly within their communities. The new physicians looked down on such women. They assumed that their knowledge and practical skills were inferior, because they were inferior, and could not match, and must not be seen to match, the new breed of physician, who was, in every way, superior to these uneducated, and (often) illiterate women. This arrogance is described in Barbara Grigg's book, "Green Pharmacy" , an excellent historical record of medicine from a herbal perspective. When describing Tudor times and attitudes, she says this: The sheer length of his training must have convinced the 16th century physician that all available medical knowledge was now at his fingertips. To men like these - a well-bred and exclusively educated elite - it was unthinkable that anyone less well-trained than themselves should dare to describe himself as a doctor. It was even more unthinkable that the homegrown simples used by amateurs and by vast numbers of illiterate quacks might possibly be more effective than the grand compounds ..... which they prescribed for their wealthy patients. Within this arrogant, closed circle of academic medical practitioners began the rise of 'scientific' medicine, or ConMed, as it is called here. Their sense of superiority, their ongoing efforts to discount and ridicule the value of traditional medicine, and the growing belief that 'science' had (or at least would have) all the answers to disease and ill-health has continued to this day, and are attitudes that dominate NHS-ConMed, the way they view their drugs, and the way they consider traditional therapies: ...how could it be otherwise if any old woman with a glimmering of knowledge or skill should be allowed to take on diseases by which distinguished scholars and gentlemen, with years of training behind them, were defeated?" (Griggs, p64) The Persecution of Traditional MedicineCertainly, by Tudor times herbalists felt under threat, and from 1512 onwards, ConMed's 'elitism' began to be enshrined within legislation and law of the country. There was some attempts to protect traditional medicine, for instance, Henry VIII passed an Act of Parliament to protect herbalists, and in this document can be found evidence of the same kind of tactics ConMed still uses against traditional therapies today. So ConMed began to use their social and political influence to seek priority and dominance over traditional therapists, who they considered to be no more than 'charlatans'. Throughout the following centuries, and particularly in the 20th century, they attempted to undermine and restrict both the practice of traditional medicine, and to develop their own legal dominance. Yet the new physicians, even with increased legal validation, still had difficulty asserting their authority. Traditional therapies were highly valued by the ordinary people. They were well established, especially in rural areas. They were readily available. And most important, they were inexpensive. So whilst laws might be enacted conferring rights and exclusivities on ConMed practitioners, and seeking to restrict traditional therapists, they were always difficult to enforce. ConMed practitioners regularly dismissed traditional practitioners as 'quacks', but they appeared to have an ability the 'elitist' physicians did not possess. Their simple, non-academic learning was based on generations of experience and observation, and it taught them how to treat sick people successfully. This success helped the 'quacks' and 'charlatans' to maintain their popularity. Most people continued to use traditional healers when they were sick. The persecution of witches between the 15th and 18th centuries is not usually associated with the practice of medicine. It was essentially the religious persecution and slaughter of women (in the main); modern estimates suggest variously that the Catholic and Protestant churches killed between 1 million and 9 million people during this time in Europe and America.(Ehrenricich & English 1973). In 1484 Pope Innocent VIII pronounced a Papal Bull against the new crime of witchcraft, denouncing witches as an organised conspiracy of the Devil against the peace and order of the Holy Christian Empire. In 1486 two Dominican monks published the book 'Malleus Maleficarum' - the hammer of witches! This became the text-book for witch-hunters during the next few centuries, outlining how witches could be identified, cruelly tortured, condemned and hideously executed.& We seem to have some form of 'collective amnesia' about these awful events, which continued until just two centuries ago. Perhaps this is not surprising. It was one of the darkest,vilest and most evil atrocities in human history. But whilst the persecution of witches was essentially religious and political there were very strong health elements too. The Malleus Maleficarum called for the destruction of "the ancient and secret knowledge of poisons": Christian authorities admitted that the good witches' help to the country people was of ancient tradition and good effect, but this was the cause for burning them. The white witches power to cure sickness proved that she had a pact with the Devil. The priest could not cure; they had only punitive dogmas, abstract words, empty gestures typical of rootless ritual. If the good witch could cure, clearly she possessed superior knowledge and power - a possibility the church could not allow. Instead, it officially sourced her power in evil: "The white and the black witch were both guilty alike in compounding with the devil" (Sjoo & Mor, page 305). So these simple, inoffensive, but wise women, whose knowledge was based on the simple knowledge and customs of the past, were condemned to death in vast numbers. Their 'unexplained' power was suspicious, rooted in evil, and condemned as 'demonic'. As Sjoo & Mor state, "it was not the witches 'wickedness' but her effectiveness that the church wanted to destroy.. Who was it that persecuted her? The priestly classes. Who were the priests? The son's of upper class families, and as such, often the elder brothers of those who entered medicine - ConMed practitioners. Are traditional practitioners still persecuted? They are sometimes described as 'witches', or using 'witchcraft'. Professor Michael Baum, professor emeritus of surgery at University College London, certainly does so. In a Daily Mail article, "Homeopathy is worse than witchcraft - and the NHS must stop paying for it", Professor Baum is quoted as saying: This scares me. Homeopathy is to medicine what astrology is to astronomy: it's witchcraft - totally barmy, totally refuted, and yet it's available on the NHS. For while homeopathic medicine is not toxic, its use as an alternative to conventional medicine can, in fact, cause serious harm. http://www.dailymail.co.uk/health/article-451908/Homeopathy-worse-witchcraft--NHS-stop-paying-it.html Homeopaths may not be tortured or burnt today. But the desire of many health academics like Professor Baum, a well-known sKeptic, and many governments throughout the world, no doubt all encouraged by the Big Pharma companies, is to restrict and ban its practice, as it is with most other traditional therapies, and as it is to control the purchase and use of vitamins and minerals. Undermining the ancient skills and knowledge of traditional therapiesThis division, between 'the successful but simple' and 'the complex but unsuccessful' medical therapies, has also continued to the present day. The arrogance of ConMed has sustained itself - despite its inability to treat disease successfully or safely, and despite its other major disadvantage, that it is the most expensive medical system of all. So it is important to emphasise that prior to the advent of ConMed, traditional medicine was not 'backward' or 'primitive', as is so often implied. ConMed would have us believe that health practitioners prior to the modern era were lacking in knowledge about health and the treatment of disease, and that traditional medical practitioners were largely ignorant and ineffective. The term 'Old Wives Tales' is often used to dismiss their practices - without recognising who these 'old wives' were, and the time-honoured source of their knowledge about the treatment of illness. Everything that came before 'science' was neither primitive nor ineffective. In the grave of Neanderthal man, in a cave in Iraq, grains of flower pollens were found thickly scattered in the soil surrounding his bones. The family and friends of the dead man, it became clear, had surrounded his body with clusters of flowers and branches of his summer-time funeral. Analysed some 60,000 years after the death of this unknown caveman, the pollens were identified as coming from eight different genera of flowering plants ... even of which are still used for medicine in dozens of different ways by the local people (Griggs 1981) Throughout ancient and medieval times, medicine was based securely on empiricism. Societies had learnt from generations of past experience about the medicinal qualities of plants and herbs that grew abundantly around them. So although traditional practitioners may not have had the (dubious) benefit of a university education, or knowledge of the 'scientific method', and despite their inability to conduct 'randomised, double-blind' trials, humankind was neither dull or backward, even as far back as Neanderthal times! Indeed, by Medieval times, there was a vast body of knowledge, and considerable understanding and skill in dealing with sickness and disease. In an albeit over-glamourised past, medical treatment was usually provided by 'wise women' using the extensive knowledge of the use of local plants and herbs gained through countless generations. Treatment was probably rough and ready, perhaps even a bit hit-and-miss, but it was doubtless far more effective than we now give credit. The treatments used were usually simple, readily available locally, and inexpensive. And each treatment was securely based on the apparently forgotten 'science' of empiricism. In other words, they knew, from experience, that their remedies worked. Then, as now, people were quite able to deduce that they were sick, and that after taking some form of medical treatment they got better! But then, as now, NHS-ConMed dismiss these personal experiences as anecdotal, and 'unscientific'. So ancient and medieval therapists probably disseminated their medicine considerably more safely, probably more effectively, and certainly less expensively, than NHS-ConMed does today! The Herbal Materia MedicaAnyone who wishes to examine the extensive knowledge of traditional therapists need only look at the herbal Materia Medica. Perhaps the most renowned collector of herbal knowledge was Nicholas Culpeper (1616-1654), who set out to chronicle the vast amount of accumulated knowledge. Culpeper's most famous book, called "The English Physician", was subtitled 'a Complete Method or Practice of Physic, whereby a Man may preserve his Body in Health, or cure himself when sick, with such things one-ly as grow in England, they being most fit for English Bodies'. The book demonstrates the vast amount of knowledge available on the medicinal value of plants at this time. Yet it was his first book, a translation of the 'London Pharmacopoeia' from Latin to English, that produced the most controversy. Its publication made this vast body of knowledge accessible to a greatly increased number of people. This certainly annoyed the new university trained 'academic' physicians. Prior to Culpeper, Latin had been used to keep written medical knowledge the exclusive preserve of the privileged, educated few, and writing in the vernacular served to undermine this exclusivity. ConMed has always preferred to avoid valuable medical knowledge getting into the hands of other, less educated, less sophisticated people - people outside their select group. Their opposition to this translation demonstrated that even at this early stage they had become an organised professional group, and moreover that it was an organisation that preferred restrictive trade practices, intent on maintaining their medical knowledge exclusively to themselves. Today, NHS-ConMed no longer uses Latin but instead has developed a highly technical, highly medicalised language to describe sickness and disease, and the medical procedures and techniques it employs. Most professions will use language as a technique of obfuscation to convince people outside the profession that the subject is too difficult, too complicated for them. ConMed want people outside their exclusive group to believe that health is too complicated for them to meddle with, and that they must leave it to the experts! This represents a fundamental difference between NHS-ConMed and traditional therapies. Traditional therapists tend to tell their patients that they are in more control of their health than any doctor or therapist. NHS-ConMed believes that health can only be maintained, or regained, through trained medical intervention - involving medical testing, operations, and perhaps more importantly, by drug treatment. The introduction of minerals, and 'heroic' medicineGiven this wealth of traditional herbal information, it is astonishing that ConMed felt able to turn its back on this heritage. The new physicians increasingly moved away from traditional plant-based treatments. ConMed had continued to use plant-based medicines in their practice prior to the 17th century, but from this time they began to develop drugs from a variety of mineral and chemical compounds. Many of these compounds were active poisons, such as arsenic, antimony, mercury and vitriol, but ...he was able to do this, he claimed, because the chemical techniques by which these mineral medicines were prepared rendered them virtually harmless... (Griggs 1981) Thereafter, even where ConMed continued to use plants and herbs, they sought to 'isolate' the 'active' ingredient, and if possible, to produce it artificially (see, for example, Aspirin). ConMed claimed, then as now, that their new chemistry enabled them to produce medicines that could liberate the hidden therapeutic potential of substances, which could be refined in such a way as to rid them of their 'undesirable' side-effects. And of course, NHS-ConMed is still trying to persuade us that they can do this, four centuries and more later - and with an equal lack of success! The real reason for turning their back on traditional medicine was their pursuit of knowledge and understanding - the development of science. But another reason was to produce 'medicines' that were exclusive the few people who could make them, who could use their monopoly to ensure that their drugs were profitable. By the late 18th century, Griggs describes the impact that the 'scientific method' was having on both the focus, and the quality of medical thought. There was, she said " ... an undue attachment to theory, and a corresponding decline in the value placed on observation, clinical experience, and the careful evaluation of drugs". Abandoning the natural healing energy of the bodyIncreasingly ConMed turned its back on the bountiful supply of common, widely available, local herbs that could more cheaply, more effectively, and more safely deal with illness, and moved their focus to the apparent 'power' of highly toxic substances and poisons. At the same time, it was abandoning something much more important. ConMed was discounting not only the bounteous healing power of nature, but also the ability of the human body to regulate and heal itself through its own inner energy, and within its own resources. Instead, ConMed thought that it could 'defeat' disease by the power of their intellect, and with their new medications. They would be able to force the body into compliance. Strangely, it was this macho approach to the body (ConMed has always been dominated by men, unlike traditional medicine) that began to make it a more 'exciting' medicine to some people. The power of the new drugs seemed to be full of promise and mystery. Not just minerals were used, but new exotic plants from exotic parts of the world. Many 19th century novels contain vivid, often lurid descriptions of ConMed treatment at this time. Whilst we may tend either to laugh or cringe at the medicine practiced this was not the way it was seen by many people, particularly those from the wealthier more privileged classes. The medical mind of the country ... has clearly tended to extravagance in remedies and trust in remedies, as in everything else ... how could such a people be content with any but 'heroic' practice? What wonder that ... the American eagle screams with delight to see three drachms of calomel given at a single mouthful. (Griggs quoting Oliver Wendell Holmes, 1809-1894) 19th century ConMed practise has been described as "bleed, blister and purge":
Griggs (p159) described the impact that Calomel had: Less still was known of its long-term side-effects, but its most immediate and visible ones were a matter of record. These were, indeed, horrific: following salivation, extensive areas of the facial flesh and bone sometimes became blackened and mortified, then sloughed away, eye, cheek and all. Sometimes whole portions of the jaw rotted and fell out; occasionally the diseased jawbones fused together as if in lockjaw, dooming the victim to a silent death from starvation unless the condition was corrected by painful surgery. Similar arguments could be made about modern drugs. Little of substance has changed in the way that NHS-ConMed views the human body, human illness, or the way it practices medicine. It continues to look for 'heroic', 'wonder' cures. It continues to convince people that whilst previous drugs and treatments were ineffective or dangerous, their current drugs and treatments are more effective and safe. We are told they are based firmly on 'science', but they remain as far from treating illness successfully as they have ever been. Essentially, ConMed remains unchanged - an expensive, dangerous, and ineffective form of medicine. The reputation of ConMed in the 19th centuryThere is no doubt that as the 19th and early 20th centuries progressed, science enabled us to understand the make-up and structure of the body, and the pathology of disease, and was able to do so in ever-increasing depth. This has been a triumph. Yet whilst this new scientific knowledge and understanding grew with remarkable speed, it had little impact on ConMed's ability to treat sickness and disease successfully. It continued to use methods that people feared, and avoided whenever possible. Treatments continued to be unsuccessful. The drugs they used were extremely toxic, often more lethal to the patient than the illnesses they purported to treat. Indeed, Griggs (p172), speaking about the USA describes the attitude of most people towards ConMed: If the medical profession was beginning to have its doubts about Heroic Medicine, huge numbers of the American public were no longer in any doubt at all: they had rejected it and opted enthusiastically for botanic medicine. (Samuel Hahnemann - a disenchanted doctor) Even doctors trained in the 'orthodox' manner were turning against the powerful drugging (mainly with Antimony and Calomel), bleeding and blistering procedures of the time. Perhaps the most notable of these, who early in his career recognised that ConMed was causing more harm than good, was Samuel Hahnemann (1755-1843), a brilliant German doctor and experimental chemist. He devoted his life to developing a system of medicine that was safe, and did no harm - and in doing so gave birth to homeopathy. Although a 'new' therapy, homeopathy was based on the ancient medical premise that 'like cures like'. So in developing its remedies, homeopathy was able to draw on the traditions and knowledge of common herbs, but also the new minerals. The difference was that Hahnemann also developed a system of dilution or potentisation that recognised that that they could be dangerous. By doing so he produced remedies that worked alongside the energy of the body, and in doing so made homeopathy safe, effective, and also inexpensive. As might be imagined, the orthodox medical profession of early 19th century Saxony found Hahnemann the most odious of medical heretics for a number of reasons. He was an eloquent critic of the bleeding and purging medicine they relied on; he attacked their most cherished theories; and he was a dangerous rival, attracting numbers of patients away from the Regulars. These alone would have drawn down on him the united fire of the profession, whilst his most un-heroic doses of medicine guaranteed the deadly enmity of the apothecaries... (Griggs p178). The rapid rise of homeopathy during the 19th century, alongside the continuing strength of herbal medicine, at least in rural areas, is evidence that ConMed did not have a 'monopoly' position within medicine. There were three main reasons for this:
We will now consider each these factors in order to see how ConMed was first held back, but eventually managed to overcome these apparently overwhelming barriers to acceptance. Expensive MedicineConMed has always been expensive medicine. Its costs have always been high. This arises from the long and expensive training their physicians require (not least because they deal with dangerous substances and drugs), the large financial rewards they have always expected, the investment in exotic plants and dangerous minerals and the chemistry required to make them at least marginally safer for people to consume. This meant that ConMed was outside the financial reach of all but the wealthier and aspiring classes in society prior to the days of medical insurance. Most people could not afford ConMed; so even if they had wanted to, they did not use it. "The cost of medical care had risen to a level at which basic medical care (such as it was) was beyond the means of much of the population. (Doyal p167) By the end of the 19th century it was realised that the state would have to become involved in paying for medical care if the ordinary people were to benefit from the new promises being made by ConMed. Dangerous MedicineWhilst some people were attracted to the demonstrably dramatic effects of the new 'heroic' drugs, readings of 19th century novels demonstrate that this medicine was instrumental in killing people. Yet strangely, the lethal effects of ConMed have never proven to be an insurmountable problem. If a patient dies, the explanation given is that death was caused by the original illness, and not the treatment of the illness! It is an explanation difficult to challenge, particularly as ConMed became a master of denial and obfuscation over the centuries. It is only in recent decades that the concept of iatrogenic (doctor-induced) has disease began to be more widely understood. (see Chapter 5) So ConMed continued to be a medicine that most people mistrusted, although at the same time there was a growing fascination with their new drugs, and the claims made for them. As the 20th century began, mistrust and fascination existed side-by-side. ConMed was certainly beginning to raise some interesting questions:
After all, science seemed to be inventing so many wonderful things - the train, the aeroplane, the motorcar, the telephone, the electric light. Anything seemed possible and within the reach of science. Surely medical science would be able to produce similar advances in the treatment of disease. In the search for an answer, ConMed seemed to feel that almost anything seemed worth trying. It continued to develop 'heroic' medicines of all kinds. And advances did seem to be emerging, especially in the field of surgery - notably in anaesthesia and infection control. But ConMed was certainly far from becoming 'popular' medicine, with a track record of successful treatment. Ineffective Medicine - the epidemics of the 19th centuryDespite the problems associated with the cost and dangers of ConMed, perhaps its most significant failure was its sheer inability to treat disease successfully - even though, as we will see, its propaganda always seemed able to overcome this problem. ConMed had failed to meet the challenges of the Black Death in the 14th century, and a succession of later medieval plagues. Subsequently it failed to meet the challenge of Syphilis and many other diseases. Yet it is in the 19th century that its greatest failures can be witnessed. The industrialisation and urbanisation in the UK during the late 18th and early 19th centuries was a massive upheaval for millions of people. Employment on the land was drastically reduced, first by the enclosure movement, and then by the mechanisation of agricultural production. People were uprooted from their rural villages (and so from their traditional health care resources) and left in order to find work in the new industries in the burgeoning towns. The development of these new urban conglomerations was piecemeal and unplanned. The quality of housing, water supply and sanitation was poor, and as the new towns became more crowded, living conditions became increasingly unhygienic. Traditional therapies did not follow people into the urban areas, and so health provision was at best rudimentary, at worst, non-existent. Many of the epidemic diseases of the 19th century are now known to have resulted from this process of industrialisation and urbanisation, and the poor conditions in which so many people lived. Allied to poverty and inadequate diet, people became increasingly susceptible to a variety of 'killer' diseases such as Cholera, Typhoid, and Tuberculosis (TB). In the 1830s / 1840s there were several waves of contagious disease that killed thousands of people. The first, from 1831 to 1833, included two influenza epidemics and the first appearance of cholera. The second took place from 1836 to 1842, and included major epidemics of influenza, typhus, typhoid, and cholera. Between 1846 and 1848, a series of epidemics struck simultaneously. A virulent form of typhus appeared which by 1847 had accounted for over 30,000 deaths. At the same time there was a severe influenza epidemic that killed almost 13,000 people. There was also widespread dysentery. Cholera returned in 1848, affecting many of the areas hardest hit by the typhus epidemic, leaving an estimated 50,000 people dead. Contemporary statistics show how bad the situation became. The Registrar General reported in 1841 that while mean life expectancy in Surrey was just 45, it was only 37 in London and 26 in Liverpool. Mortality figures for over-crowded districts like Shoreditch, Whitechapel and Bermondsey were typically half again or twice as high as those for middle-class areas of London. In the 1830s almost half the funerals in London were for children under ten years old. Many people died from infections and diseases that we would rarely die from today, such as measles and scarlet fever. Yet throughout the 19th century, ConMed doctors were entirely helpless - they had nothing to treat these diseases. Some sense of this failure can be seen in Bruce Haley's book, "The Healthy Body and Victorian Culture": A glance at the contents of a typical volume of the Lancet (1849) tells the melancholy story: "On the Advantage of Copious Bleeding in Inflammatory Diseases"; "Report of a Case of Cholera Treated by Transfusion"; "Treatment of Cholera by Small and Repeated Doses of Calomel"; "On the Employment of Embrocations and Injections of Strong Liquid Ammonia in the Collapse Stage of Cholera." One title begins promisingly, "On the Production of Cholera by Insufficient Drainage", but continues, "with Remarks on the Hypothesis of an Altered Electrical State of the Atmosphere." Such treatment was, of course, quite useless. A more recent account of the hopelessness of ConMed in the 19th Century can be found in Wikipedia (by Jimmy Wales, its founder): A survey of medical publications from the late 18th century through the early 20th century shows that doctors who followed the most widely accepted practice of medical establishment techniques in the 19th century (and to a lesser extent in the 18th and early 20th century) commonly dosed most every patient with a mercury compound called calomel, which resulted in serious immediate and long term harm. This was as a "cathartic" to "purge" the "poisons" out of the patient. Antimony was another widely used harmful drug. There does not appear to have been much testing of the effectiveness and safety, and handwaving assertions were given that such administration of what are now considered poisons of no benefit had "cured" numerous ailments. A similar universal practice was the removal of blood from the patient, again apparently to "remove poisons". The result was that Cholera, Influenza, Scarlet Fever, Smallpox, Typhoid, Typhus and TB swept through the country, with ConMed proving entirely unable to cope. In each of these epidemics the same three conclusions can be applied:
Comparative medical researchThere have been few studies comparing the effectiveness of different medical therapies. The NHS-ConMed monopoly is now very powerful. If it had more confidence in its effectiveness, and if it was genuinely looking for the best medical treatment for its patients, there would have been many more. It would, for instance, be quite easy to select a large sample of people with a diagnosed illness, divide them into matching groups, and treat one with NHS-ConMed and another with homeopathy in order to compare outcomes. But NHS-ConMed does not welcome, or perhaps it does not dare to accept such a comparison with traditional medicine. Yet there are several 19th century comparative studies - and some of these are quite striking. Homeopathy almost invariable came out equal, and often best in such comparison - often by a considerable margin. So let us look at some of the comparisons between ConMed and Homeopathy. Typhus Fever 1813. The 1813 Typhus epidemic followed in the wake of Napoleon's march through Germany to attack Russia - followed by a calamitous retreat. When the epidemic hit Leipzig Hahnemann treated 180 people, and only lost two (less than 1%). Allopathy mortality rates were over 30%. Cholera Epidemic 1831. Dr Quin reported that deaths in 10 homeopathic hospitals were about 9%. Deaths under homeopathic treatment in Russia were under 10% (Admiral Mordoinov). Deaths in homeopathic care in Bavaria (Dr Roth reported) were about 7%. Allopathic treatment showed death rates of between 40% and 80%. Cholera Epidemic - Austria 1831. There was a 33% death rate using homeopathy, and a 66% death rate using Allopathy. These figures were reported by Dr Wild, an allopathic physician, in the Dublin Quarterly Journal and "on account of this extraordinary result, the law interdicting the practice of homeopathy in Austria was repealed" Cholera Epidemic 1854 - London. An historically important epidemic as this was the first time a disease outbreak was traced to a particular source - a public water pump. 10,738 people died. The pump was closed and the epidemic ceased. The House of Commons requested a report regarding the various methods of treating the illness. When the report was issued no homeopathic figures were included. The House of Lords requested an explanation and it was admitted that the homeopathic figures were to be included in the report it would 'skew the results' so they were suppressed! Upon examination the buried report revealed that under allopathic care the mortality rate was 59.2% while under homeopathic care mortality was only 9%. The reluctance of ConMed to research outcomes of treatment and compare itself with homeopathy has a history. Michael Emmans Dean's "The Trials of Homeopathy" looks at the research into homeopathy during its earliest years, outlining every piece of research undertaken from 1821 onwards. Much 19th century research indicated that homeopathy was successful, and usually significantly more successful than both ConMed treatment and placebo. Whilst pointing out and acknowledging the unsatisfactory nature of some of this evidence, the conclusions cannot be seen as anything other than significant. Yet Dean outlines the opposition many of these trials received from ConMed practitioners: Allopathic attempts to prevent trials taking place, or to suppress results when these emerged, are the strongest evidence of the reluctance to allow the results of homeopathic treatment to influence the development of medical science. (Dean p134) Dean concludes that ConMed 'sceptics' had rejected homeopathy by 1842, and looking at the evidence they had at hand he states that: a systematic review of prospective trials of homeopathy that took place before 1842 shows not only that the individual trial evidence used by the most notable critics was wholly invalid, but also that virtually no fair trials of homeopathy had taken place by that time. So much for the impartiality of 'scientific' medicine in 1842! Dean goes on to examine the comparative trials of homeopathy between 1844 and 1886. As he says, most of those favourable to homeopathy seem to have disappeared from the historical record, and not unnaturally, he asks "Why?" His conclusion is as follows: Authentic trials of homeopathy took place - against allopathic opposition - because of interest shown by governments and hospital administrations. Homeopathy was compared with allopathy in treatment of serious conditions such as cholera and pneumonia, and some good quality fair trials provide confirmation of evidence that had been dismissed when obtained retrospectively. Contemporaneous attempts to suppress or discount the homeopathic results show that they constituted a serious embarrassment to orthodoxy, which reacted by trying to outlaw homeopathy. However, such evidence was not accepted by ConMed 'science'. Instead of looking at homeopathy to see what it might offer, vested financial and medical interests decided to oppose it, quite regardless of the evidence. So the 'persecution' of homeopathy began within 20 years of its first appearance! As Galileo had discovered many years earlier, when science faces the opposition of a powerful and influential vested interest (the Church), science (real science, objective science) loses! From that time to the present, homeopathy has been under attack from the 'science' of ConMed - real science, objective science loses out yet again! ...homeopathy had been outlawed by Imperial decree in Austria from 1819 onwards, a ban that was lifted only after Fleishmann's mortality rates ... in Vienna in the cholera epidemic of 1836 was half that of the allopaths. (Dean p135) ConMed sought to ban homeopathy in the UK in the 1858 Medical Act, but failed (Dean p136). But this did not prevent the British Medical Association (BMA) imposing its own internal rules - forbidding any member to practice homeopathy, or to consult professionally with homeopaths. Similar restrictive practices were being introduced at the same time in the USA, and elsewhere. So this was not a 'scientific' debate about the effectiveness of opposing medical therapies. It was the defence of vested interests. ConMed, the dominant medical system, was determined to defend its medical and social status at any cost. And so it has continued. Modern scientific evidence that supports the effectiveness of homeopathy is not recognised, leave alone accepted by ConMed. Paolo Bellavite and Andrea Signorini, in "the Emerging Science of Homeopathy", outlines some of the good quality science that has been undertaken in recent years, and comes to three conclusions: a) Homeopathic treatment has proven effective in many controlled clinical trials, whereas other studies have yielded negative results, indicating that, from the experimental point of view, homeopathy can be treated like any other form of therapy. In particular, the fields of application and the limits of the homeopathic approach can be indicated. And so the struggle goes on between NHS-ConMed, a medical system with immense influence and power but little medical success, and traditional medicine (of all types) which all have excellent track records in improving health, but little social or political influence. Science is not the issue here. The NHS-ConMed establishment is not open to science that does not support its preconceptions, and its vested interests. The dominance of ConMed has everything to do with power, and little to do with science! The earth is flat, and the cosmos revolves around the earth - if that is what you want to believe - and if that is what the dominant power wants us to believe - and no amount of science will change that prejudice until it is absolutely forced to do so. An apple a day keeps the doctor away!So for reasons of expense, ineffectiveness and danger most people in the 19th, and early 20th century continued to avoid ConMed doctors and their drugs. My mother, born early in the 20th century, often told me about how people viewed doctors when she was a child. They were to be avoided, to be called only in extremis. Her family was not wealthy, but neither were they poor. She would certainly have agreed this statement: ...doctoring at this time had an appallingly bad reputation: if you could save a friend from falling into the clutches of the medical profession by passing on some tried and trusted family receipt for his disorder, you would be rendering him a service indeed. Griggs (p109) She would often use the 'apple a day' phrase, although by the time I was able to discuss such things with her the NHS had been established for many years and by then she had largely accepted NHS-ConMed's propaganda. She was part of the generation that had learnt to accept its treatments through the course of her life, and in that sense she was typical of her generation, happy to dismiss the drugs that ConMed had used during the 19th century, without ever questioning whether the 'new' drugs were any better in terms of either safety or effectiveness. The Rise of ConMedSo how did ConMed become the dominant factor in the nation's health care provision? Quite simply, several situations and events conspired to ensure that the triple burden of expense, effectiveness and safety were resolved; or at least, they seemed to have been resolved. How this was done now requires examination. Medicine and the social class divideHowever ineffective or dangerous ConMed was thought to be, there was a kind of perverse glamour about the new medicine, especially amongst the more formally educated and wealthier sections of the community. There was always a possibility that some of their medical claims just might transform our health. And the more 'respectable' the scientific study of medicine became, the more science was seen to be explaining the workings of the human body, the more it seemed to describe what was happening in sickness and disease, the more it seemed that ConMed may have the answers to human health. Moreover, the medicine of the intellectual, the rich and the influential, became increasingly attractive to the new middle classes, and the aspiring working class. Even the costs and dangers of ConMed were attractive to some. ConMed attained 'snob' value, a social credibility not matched by its performance. Aspiring people began to use ConMed in order to demonstrate they could afford do so. It became, for some, a form of conspicuous spending, a demonstration of social status. As Griggs (p83) comments in relation to the increased use and popularity of the drug Antimony: It is a curious and depressing truth, demonstrated again and again in medical history, that the desire of the average physician to administer powerful and active drugs is only equalled by the desire of the average patient to have powerful and active drugs administered to him. In comparison, traditional therapies seemed to be rather commonplace and 'old-fashioned'. Most prescriptions were based on common herbs that could be grown in the garden, or which grew wild and abundantly in the countryside. They were not exotic, they were mundane. They rarely hit the headlines, and were never subject to exciting claims about their effectiveness, and were never proclaimed to be 'medical breakthroughs'. Nor were the people who practiced traditional medicine wealthy, of high social status, or equally important, they were not well organised as a profession. Although in the treatment of illness any comparison with ConMed indicated that traditional methods were more effective, traditional practitioners did not attract wealthy clients. Nor did traditional practitioners tend to be ambitious. Herbalists, homeopaths, and practitioners of other traditional therapies have never been an organised profession. Griggs p 246, speaking about the profession of herbalism said: One of the most acute problems, at all times, was poverty. There are no glittering prizes in the profession of herbal medicine, and the men and women it attracts - then as now - are seldom ambitious, politically motivated, or wealthy So whilst ConMed could point to little success in the treatment of illness, they were at least a professionally and politically well-organised group. There were good incomes to be made for doctors treating the wealthier classes, and also, increasingly large profits for the emerging drug companies. Moreover, ConMed had began to relinquish some of its more absurd and dangerous treatments - for instance, by the mid-19th century blood letting was gradually dropped, and the use of Calomel was abandoned. NHS-ConMed has become of chamelion of the medical world in its ability to change its methods and treatments. It is now one of its enduring features - the ability to proclaim a drug or procedures as a breakthrough, only to drop it several years later. It has become adept at taking up, and then discarding medical practices and drugs once they are found to be ineffective. Whilst the herbalism of Culpepper would not be much different to the herbalism of today, and the homeopathy of Hahnneman not much different to the homeopathy practiced today, the ConMed of yesterday is not the ConMed of today - mainly because the ConMed of yesterday has been discarded, proven to be either unsafe and ineffective. Likewise it is entirely predictable that the ConMed of today will be discarded by the ConMed of tomorrow. This is often called 'medical progress'. It is actually the process of covering up medical failure! And at the turn of the 20th century several new treatments had appeared - the development of anaesthesia and pain management, new x-ray technology, new anti-septic techniques, the discovery of blood groups, and developments in bio-chemistry that made possible new forms of drug treatment - all appeared to augur well for the future. It probably did feel as though a new age of 'scientific' medicine was emerging - the abandonment of the 'old' and 'dangerous', and the emergence of the 'new' and 'safe'. It seemed to be an exciting and glamorous time. But it was only the excitement of watching a ship being wrecked on the rocks of experience! The 20th century has witnessed thousands of new drugs being brought into the health market, but each has been removed as soon as it was realised they were ineffective or dangerous. The history of ConMed is strewn with abandoned 'miracle' drugs, each one written off as 'old' technology, and replaced with a new one, based on the latest thinking, the latest 'science' - and this is all done in the name of 'progress'. Throughout these disasters the publicity of ConMed has been brilliant. The merits of the new drugs have been heralded from the mountain-tops, whilst the old discredited drugs have been quietly dropped, often without a whimper, to the oblivion of the dustbin. Rarely has the crucial question ever been asked:
Yet as the people's link with traditional medicine faded, particularly in urban areas, the new promises of ConMed heralded a new age. Those who had previously not wanted it, and those who could not afford it, began to aspire to it. It was the medicine of the upper, educated classes, the medicine of their 'superiors' - so it must be better. And if the claims for the new drugs were correct, they wanted to have access to them. So increasing numbers of people were ready to move to ConMed, and would certainly do so - if they were able to afford it. And this problem was soon to be resolved. Health Insurance - making ConMed affordableThe late 19th and early 20th century saw the extension of the franchise, and the rise of socialism. The working classes were now part of the electorate, a new source of political power that could not be ignored. If working class votes were important, so too were their demands. Ideas about the equality of man had gathered strength. Political campaigns about poverty, poor housing, and access to education were all well-established. So strong arguments arose for seeking equality in accessing the best health treatment for everyone. The question of how poorer people were to gain access to health care became an important political issue. In the first decade of the 20th century, a series of government initiatives sought to improve the health of the working class. The infant mortality rate was as high as 163 per 1000 in 1899 (Doyal p163), and this was at a time when the country was desperate for both industrial workers, and soldiers for its colonial wars. The Liberal government was the first to make a major contribution to the development of a medical health service. Free school meals were introduced, and medical inspections for all were introduced. And already by this time, because of its superior professional and political organisation, ConMed was able to control and exploit of the process: Doctors, district nurses, health visitors were all asserting their superior knowledge and authority, establishing moral sanctions on grounds of health and the national interest, and denigrating traditional methods of child care ...The authority of state-over-individual, of professional over amateur, of science over tradition, of male over female, of ruling class over working class, were all involved in the redefining of motherhood in this period, and in ensuring that the mothers of the race would be carefully guided... Davin (quoted in Doyle p 165) Then, in 1911, the Liberal Government passed the National Insurance Act. This provided a basic income during sickness, and a national scheme of primary medical care. The new scheme covered all workers earning below £160 per year (the threshold for paying income tax). It required a weekly contribution of 4d from men, 3d from women, to which the employer contributed 3d and the Treasury a further 2d. For the first time, some working people now had access to ConMed. The task of controlling sickness benefits and medical care was placed in the hands of local 'insurance committees'. Within the limitations of the Act, many more people could now afford to be treated by the medicine of the rich and powerful. ConMed's superior social, financial and political organisation now began to yield quite exceptional fruit. It used its influence and power throughout the social and political world, taking full advantage of the medical benefits opened up by the 1911 Act, and as Griggs (p245) states, within 2 years of it coming into force, only one area, Worcester, was still allowing its members to patronise local herbalists (and presumably other traditional practitioners). They (the Herbalists) wrote anxiously to the Prime Minister, Mr Asquith to protest: "...the recent decision will deprive thousands of His Majesty's subjects from being treated by the system of medicine they desire ... and give a monopoly to one system of Medicine, which never seems to have been intended by recent medical legislation" It made no difference. And by the time opposition to this growing monopoly was organised, the First World War had started, and the war took priority. ConMed had made its first major move towards a more widespread popular acceptance. The medicine ConMed offered was still as dangerous as ever - but at least it was now affordable to an increasing number of people, regardless of social class. So began ConMed's rise to its present monopoly position with our national health system. One of the three obstacles it had faced - expense - was being removed by medical insurance, and would be removed entirely with the establishment of the NHS in 1948. Everyone then would have access to NHS-ConMed - and all without charge. Public Health Reform - ConMed assumes mantle of effectivenessOne of the most important scientific contributions to overcoming the appalling late 18th, early 19th century health legacy in the industrial towns was the realisation that many killer diseases were the result of poverty, malnutrition, poor sanitation and water supply, and damp and inadequate housing. The science that proved the link between disease and living conditions was a major contribution, and led directly to the massive Victorian programme of public health reform. The public health measures in towns and cities during the second half of the 19th century produced the most dramatic improvements in national health. The process began with the Public Health Bill of 1848, which empowered a central authority to establish local boards with a duty to see that new homes had proper drainage, and that local water supplies were dependable. The boards were also authorized to regulate the disposal of wastes and to supervise the construction of burial grounds. The Victorian public health reforms that followed produced clean water supplies, efficient sanitation, and improved housing, and these measures undoubtedly accounted for the decline of the killer diseases, and health improvements. However, the credit for this massive achievement was effectively hi-jacked by ConMed. ConMed began to produce statistics that seemed to show it was their drugs that had relieved us from the scourge of epidemics. Science, they claimed, had discovered how to fight disease successfully. It was their pills and vaccinations, their treatments and procedures, that was winning the battle over disease. It was not true, but it was widely believed - and still is! So despite its ineffectiveness, despite its lack of safety, ConMed was able to develop a facade of medical competence. With each subsequent improvement in housing and nutrition, increased affluence, and the corresponding improvements in health and greater longevity, ConMed has continued to claim credit for them - improvements in national health for which it has had little, if any responsibility. New miracle drugs and proceduresSo with the costs of ConMed being met through insurance and taxation, and their new claim to medical competence, two of its major problems were overcome. But in addition, ConMed began to persuade us that they were beginning to win the wider battle against ill-health. They were now introducing more effective surgical procedures, and more 'effective' drugs to the market place. During the first half of the 20th century, several new drugs and procedures seemed to suggest that ConMed might be successful in the battle against disease. These treatments, it was claimed, were arising from science - an improved understanding of the human body, and greater knowledge about its pathology. After all, society had by this time entered 'the age of science' that was producing such exciting developments. Electrical power, telephone communication, the train, the motor car, and many other marvels were transforming society. Medical science would soon make discoveries of equal merit that would overcome disease. The optimism was contagious. People were prepared to wait patiently for new medical breakthroughs, and certainly ConMed lost no opportunity to herald its new wares. The assumption arose that the elimination of disease was now at hand, or at least, just around the corner. The demand for, and the development of health insurance, and eventually the NHS, were in part the result of these increased hopes and expectations. If ConMed could deliver the new utopia it was important to ensure that the benefit of the new treatments were available to all. And soon, ConMed seemed to be doing just this:
The optimism created by these developments led to the belief that NHS-ConMed possessed the key to better health. Yet it is now possible to look at these apparent 'breakthroughs' and see that this early optimism was entirely misplaced. These and other treatments have failed, and with the benefit of hindsight, and this new analysis, we need to begin to understand why this has been so. Remember that ConMed abandoned the ancient secrets of treating illness and disease many centuries before this time. It was, and still is, engaged in a 'fight' with the body, a 'battle' against disease. It did not understand, and it still does not understand, that medical treatment has to work alongside the natural energies of the body, not in opposition to them. (See chapter 4) So although NHS-ConMed may have appeared, and still appears to many, to have won a few short-term battles, the war itself was being lost – even at that time. It still is! NHS-ConMed - still failing to deliver healthhe promise of NHS-ConMed in the late 19th, early 20th century has never materialised. It has failed to live up to any of the expectations it created. Each new ;wonder drug', new each 'magic bullet' has fallen from the pedestal on which they were placed. The optimism was not just about these early drugs, but about NHS-ConMed’s ability, given time, to produce many more. But these too have failed to materialise. The suspicion that ConMed was not delivering its promises has been around for some time. Griggs (p257) quotes an English Pharmacologist, Dr EW Adams, in 1936 in the British Medical Journal: ...considering the spate of new drugs which has in ever-increasing volume poured forth from the laboratories of the world, the number proved to be of real and permanent value has not been nearly so large as might reasonably have been hoped. The huge NHS-ConMed edifice has been built on sandy foundations. Promises have been made but never fulfilled. Expectations have been repeatedly raised and then dashed. We have been dazzled by NHS-ConMed for over a century - but we have not been made better. Yet despite its ongoing failure NHS-ConMed has been enormously successful in maintaining optimism - the popular expectation that 'good health' and 'miracle cures' are 'just around the corner' lives on. The monopoly partnership seems to be as strong as ever:
Indeed, there is no shortage of promises for the future, each one more intricate (and more expensive) than the last. Yet nothing NHS-ConMed has offered seems able to prevent people from becoming ill in ever increasing numbers, with an increasing complexity of disease. What NHS-ConMed can see, what it knows about health, what it understands about disease, is a poor substitute for an ability to make us better when disease strikes. The NHS-ConMed monopoly has demonstrated an amazing ability to sustain itself, despite the evidence. No other industrial complex could have produced so many products and commodities that have so persistently failed - and still survive. The reality is that NHS-ConMed has never had, and continues to have, no medical treatment that can be described as 'successful' in treating disease.
***************************************************************************** *****************************************************************************
|
Word of the Day
Word of the Day
provided by The Free Dictionary
|