Kumar said:
Can you tell me in percentage that how many people can be cured/treated by (1) If no medicine is given (2) By placebo effect if pills or any other mean is given (3) By current medical care. Pls consider all usual negligences.
Your guess may be almost as good as mine.
However, define "cured". I'd say that the word means you actively did something to make the patient better. I'd also say it implies that the patient is back to normal afterwards.
So, by these definitions, nobody is "cured" if no medicine is given. Estimates of around 70% across the board for people just getting better on their own though. Same with placebo effect. It cures nobody, but again about 70% of people will get better anyway. On average. (Of course, close on 100% of people will get better from a common cold, while 0% of people will get better from a multiple myeloma, for example.)
Medical care. Well, permanent cures of stuff that wouldn't have resolved on its own are mostly to be found in surgery subjects. Consider appendicitis. Pretty much fatal if left alone, very high success rate with surgery, and after surgery patient no longer has the disease, it will not recur, and no ongoing care is needed. That's a clear-cut "cure". In contrast, medical care often speeds up recoveries that might well have happened anyway. (I don't think I'd have died from pneumonia in 1988 if I'd been left alone, but I was still darn grateful for the hospital bed and the erythromycin. Did these "cure" me? Depends on your definition.) Or it manages conditions that would otherwise be fatal, without necessarily achieving a "cure". Consider diabetes. It can't be cured as such, but diabetics can live close to a normal life and a normal life-span thanks to medical control. So talking about percentage of patients "cured" isn't a good way of assessing the benefits of medicine.
You see the difficulty of generalised statistics? Common cold, no treatment, 100% recovery. Appendicitis, no treatment, 0% recovery, 100% fatal; surgical treatment, >99% cure (I think). Diabetes, no treatment, 0% recovery, very high percentage fatal (even milder type II will get you in the end); medical treatment, 0% cure, but >90% recovery in the sense of clinically well on permanent treatment. Giving across the board figures is meaningless.
Placebos and useless things like homoeopathy are fine if you've got something that is going to get better anyway. Carry on. But when you're talking about real illness of the treatable variety, they're dangerous, pernicious rubbish.
Kumar said:
[Unquote here: Rolfe, I was willing to know some informations from you because you have indicated previously. How the clinical lab. tests were done before 1875. Were those by taking blood samples as you take now & those were on ionic basis or on salt basis? Is it possible that those time doctors have found substances in salt forms by analysing the dead body's parts because living body's tests may be possible then. I mean can you tell me something about physiology & clinical lab tests of that time. Thanks)
I only have three old veterinary papers from way back then, two on horse sweat analysis (the subject of my own PhD) and one on horse urine analysis. They are dated 1888 to 1890. Analytical methods were extremely crude, and they didn't have much available. They did have litmus paper, I can see that, but in general the Materials and Methods are not well described. My impression is that Smith, the author of the urine paper, is ashing the urine and then redissolving it in different solvents to do his analysis. But in fact it doesn't matter whether he was analysing dry (salt) material or dissolved (ionic) material, it's the same substance being measured.
He describes quite a lot of constituents - total solids, urea, hippuric acid, benzoic acid, total nitrogen, ammonia, phosphoric acid, sulphuric acid and other sulphur compounds, chlorine, calcium oxide, magnesium oxide, potassium oxide and sodium oxide. There's an interesting misunderstanding there, because in fact the sodium, potassium and chloride are actually present as dissociated ions and that was what he was picking up, not chlorine gas, or oxides - or if these were what he measured, they aren't the forms the elements take in the original fluid. In contrast the calcium (and I think the bulk of the magnesium) is present as insoluble suspended salts, principally calcium carbonate. Smith did realise this, in fact he stated "the amount of salts in suspension is in some cases remarkable, the most common being the carbonates of lime and magnesia", which is bang on the money, but he chose to express his results in a different form in the tables.
There are limitations due to lack of understanding of the actual compounds one might expect to encounter. Smith handles the urea/ammonia aspect very well, but clearly knows nothing at all about the other major nitrogenous compound which is present in pretty large quantities, creatinine. Other things he describes, like benzoic acid, well, I wouldn't even bother looking. I suspect he may have been measuring something else. Also, there's no record of his having looked down a microscope at the samples, which is surprising - if he had, he'd have seen crystals of calcium carbonate in abundance.
It's really interesting, but entirely from a historical perspective. On one hand I'm impressed by the painstaking work with such limited equipment, and by how far he got in some of the areas (especially spotting the insoluble, suspended calcium carbonate, and the discussion of the urea content). On the other hand, I'm judging it in the light of what I know from being able to do my own measurements using modern equipment, and where we differ, I'm confident that my figures are right and his mistaken. This is how it is with very old science. We may admire the accomplishments, but we don't rely on the results any more!
I don't know when the first analyses of blood were done. I don't have a historical reference for this, though I'm becoming interested enough to look for one, if anyone has written such a work. (I'm finding Google impossible, because of the word "history" appearing in most medical links anyway, referring to case history.) If they were doing that stuff with urine and sweat back then, I'd be surprised if nobody had tried the same game with blood serum. However, it's a lot more complex in composition than urine or sweat, and it would have been more difficult to get meaningful results. Also, I don't believe they were at the stage of being able to make many clinical conclusions from their results. I'd think it was more at the stage of finding out what's there at all - the problem is that clinicaly significant changes in many constituents would be too small for the available methods to detect
Blood glucose measurement might be the best documented - MRC_Hans may know when the earliest measurements were done.
Kumar, you've stimulated my interest in this, and I think I'll try to find out more about it. But I repeat, this is historical interest. I'd like to know when various methods were developed, and when they were precise enough to be able to pick up clinically significant alterations in subtle things like sodium and potassium, as opposed to the things with huge alterations such as glucose and urea. I'd like to know what the methods were, and how they compare to what we do now. But I don't believe I have anything to learn from the results of these times. The chemists working then were pioneers, and much to be respected, but we can do so much better now and see where they were impressively right and where they were stunningly wrong.
Dr. Schüssler was one of these early pioneers, as far as I can understand it. He tried to do some basic analyses of body constituents. Bizarrely, he looked at whole ashed bodies rather than individually at different body fluids or organs, so he would inevitably have got a broad mean with no concept of the differences between different fluid compartments or tissues. And his results would have been about as accurate as Fred Smith's urine figures, which is to say only approximate at best.
Now why should we take any account of such findings in modern medicine? The answer is we don't. It's not relevant. I'm not sure of the history of it, but as far as I can gather rather than stay in the mainstream, just adding to discoveries and revising them when better data became available, he founded a cult where he claimed to use the results of these early analyses to formulate a system of treatment. The existence of this cult, which seems to be perpetuated, as always with bogus treatment cults, by people ascribing coincidental recoveries to the treatment (and your accounts of your own experience do nothing to persuade us otherwise), appears to have "frozen" the discipline as it was in the late 19th century, while real science has left it far behind.
Kumar, I know you think this tissue salts thing is marvellous and could benefit many people if the mechanism of action were elucidated, but it just ain't so. It might have been a rational idea in its time, but it was based on false premises - partly due to the limitations of the analytical methods giving imprecise results, missing things that are there and finding things that aren't (silica), and partly due to the incorporation of enough homoeopathy to ensure that the remedies have very very little in them at all. I'm grateful to you for stimulating my interest in the history of my subject, but I can assure you that we're not missing anything the great doctor discovered in 1870.
You're imagining all this. If you want to think of it as faith healing then that might be the best way to look at it. You keep looking for a scientific explanation, but there isn't one. Because any science there was, is long out of date. The rational explanation, and the one I favour, is that everything is explained by wishful thinking and coincidental recovery. You certainly can't demonstrate anything different, as there are no controlled or repeatable studies in your favour. But if there is any effect there, magic has got to be the cause, 'cos it sure ain't scientific.
Rolfe.