Wednesday, November 7, 2007

Punch and Judy or The Sad Comedy of Medicine under Queen Victoria (Books - The Ghost Map by Steven Johnson)

Steven Johnson's The Ghost Map, on the London cholera outbreak of 1854 is non-fiction that reads like a novel. It's not all descriptions of Dickensian filth, he sets the scene for us by giving us some insight on Victorian medicine:
Reading through the newspapers and medical journals of the day, what stands out is not just the breadth of remedies proposed, but the breadth of people involved in the discussion: surgeons, nurse, patent medicine quacks, public health authorities, armchair chemists, all writing the Times and the Globe (or buying classified advertising there) with news of the dependable cure they had concocted.

Some doctors treated cholera with laudanum - essentially, heroin -another with linseed oil:
Sir, Induced by the very favourable results of the use of castor oil in cholera, as reported by Dr. Johnson, I have just put his practice to the test of experience, and I regret to say with signal failure...

Sir, Let me entreat your metropolitan readers not to be lead by the letter of your correspondent into the belief that smoke is in any way a preventative of cholera...

Punch responded to the tennis match with an editorial:
It really is nauseating to witness the quantity of doctor's stuff that is allowed to run down the columns of the newspapers. It will be neccessary at last to proceed against the public press as a public nuisance if we have much more of the "foul and offensive matter" circulating under our noses every day at our breakfast tables to an extent highly dangerous to the health, the patience, and the nerves of the reading community. If the doctors who write to the papers would agree in their prescriptions for cholera, the public might feel grateful for the trouble taken, but when one medical man's "infallible medicine" is another man's "deadly poison," and the specific of to-day is denounced as the fatal drug of to-morrow, we are puzzled and alarmed at the risk we run in following doctors' contradictory directions.

This is not unlike what one can see today during a one-hour episode of ER - easily half-a-dozen commercials for prescription drugs. Drug companies trying to ride on the credibility coattails of fictional doctors. A real ethical violation of the consumer. There are active turf wars between several of the leading treatments for autism that echo the above feuds. But curing some illnesses will always exceed our best knowledge, no matter how much we know, and although medicine is served by science it is itself a practice, some say an art, that must negotiate between the limits of what we know and the desire of the sick to feel better.

The sad irony is that the treatment of choice for cholera today, Johnson tells us, is water.

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