osler, polypharmacy, herbal formulas

[Guest guest]

Vis a vis Todd's post about the MDs' perspective on herbal formulas, I

was struck to see several aphorisms from William Osler, who I generally

respect, that may have been the basis for this biomedical perspective-

or at least indicate it in its infancy- particularly see 211 and 215

 

*How Not To Treat Him*

 

209

 

One of the first duties of the physician is to educate the masses not to

take medicine.

 

210

 

Man has an inborn craving for medicine. Heroic dosing for several

generations has given his tissues a thirst for drugs. The desire to take

medicine is one feature which distinguishes man, the animal, from his

fellow creatures.

 

211

 

If many drugs are used for a disease, all are insufficient.

 

215

 

The battle against polypharmacy, or the use of a large number of drugs

(of the action of which we know little, yet we put them into bodies of

the action of which we know less), has not been fought to a finish.

 

http://www.vh.org/adult/provider/history/osler/3.html#e

 

 

--

 

 

Version: 7.0.300 / Virus Database: 265.6.10 - Release 1/10/2005

[Guest guest]

Interestingly, Bob Damone recently made independent mention to me of

Osler's issue with polypharmacy and the profound impact his writings

had on 20th century medical practice. Apparently, this suspicion of

polypharmacy, unbeknownst to me, is one of the most deeply ingrained

and strongly indoctrinated features of modern medicine. Objections

have been raised that MDs do indeed practice polypharmacy, often of the

worst kind. However in most cases I deal with, there is a very low

limit to how many drugs would ever be prescribed by a physician for any

given complaint. Massive abuse of polypharmacy in WM is usually not

the work of a single physician, but the tendency of specialists to

prescribe for each isolated condition without regard to any other.

Keeping in mind that Osler wrote at a time when it was much more

difficult to assess drug safety and interactions, WM still remains

quite wary of prescribing more than three medicinals for any discrete

condition. The idea of using 15-25 medicinals for a given chief

complaint such as diabetes or hypertension is beyond their

comprehension and will likely never be acceptable in American research

circles. However, I suppose there is the possibility of the Chinese

(and Asia in general) becoming the leading force in the next generation

of science. If Asian research somehow becomes the gold standard

worldwide, then good TCM research may still emerge from those regions

in years to come and carry with it the authority that it now lacks (and

deservedly so in many cases).

 

As a side note, it is certainly interesting that two other schools of

medical practice that were prominent in Osler's day also frequently

railed against allopathic practices, amongst them polypharmacy.

Leading American homeopaths and Eclectics were of one mind on the issue

of the single remedy. And there is no doubt that Osler's critique was

strongly influenced by prior, concurrent and much more numerous

arguments of the exactly same nature made in the journals of these

schools throughout the 19th century. But just like only a democrat

could reform welfare, only an MD could make the same argument that had

fallen on deaf ears when made from outside for decades before. But the

fact remains that many in all branches of professional western medicine

(homeopathy, herbology and allopathy) favor the single remedy. While I

believe there are ways that computer modeling could demonstrate the

potential efficacy and safety of polypharmaceutical approaches to

healthcare based upon TCM principles, I do not think there is the will.

Plus I do believe the current era of drug development is just about at

an end. Many recent blockbusters have resulted in serious problems.

The paradigm has been exhausted and is about to shift, but that shift

is already moving in a very distinct direction that involves genomics,

stem cells and miniaturized technology, not the use of crude natural

materials.

 

While such advances may allow regular regeneration or replacement of

aging body parts, they will not prevent all manner of suffering. Even

one in perfect health is still subject to the occasional flu, stress

related digestive and other disorders, the impact of bad habits like

smoking and drinking. While much of the damage done from such insults

may be easily repairable in the near future, people will still suffer

from symptoms that need to be relieved in some way from time to time.

And many will still prefer the least iatrogenic approaches. Sure, you

could control that pain with prednisone and just deal with the side

effects until your next scheduled regeneration treatment of you could

use chinese herbs and other natural supplements and enjoy not just long

life, but quality of life. While WM may solve the problems of cancer

and heart disease relatively soon, I doubt anything better than TCM for

daily suffering will be on the horizon near as quickly. However, our

continuing role will depend on adapting our delivery systems. There is

no future for raw herbs, except for a narrow, isolated segment of the

population and it is essential that we develop viable alternatives that

truly as cost effective as raw herbs. Currently, as far as I am aware,

only Blue Poppy makes a line of formulas that actually provides

decoction level dosage in capsule form for about $75 per month. If

there are others that can deliver the equivalent of 60-70 grams per day

at this price, please let me know as we are upgrading our pharmacy.

 

On Jan 12, 2005, at 1:00 PM, Brian B. Carter, MS, LAc wrote:

 

>

>

> Vis a vis Todd's post about the MDs' perspective on herbal formulas, I

> was struck to see several aphorisms from William Osler, who I generally

> respect, that may have been the basis for this biomedical perspective-

> or at least indicate it in its infancy- particularly see 211 and 215

>

> *How Not To Treat Him*

>

> 209

>

> One of the first duties of the physician is to educate the masses not

> to

> take medicine.

>

> 210

>

> Man has an inborn craving for medicine. Heroic dosing for several

> generations has given his tissues a thirst for drugs. The desire to

> take

> medicine is one feature which distinguishes man, the animal, from his

> fellow creatures.

>

> 211

>

> If many drugs are used for a disease, all are insufficient.

>

> 215

>

> The battle against polypharmacy, or the use of a large number of drugs

> (of the action of which we know little, yet we put them into bodies of

> the action of which we know less), has not been fought to a finish.

>

> http://www.vh.org/adult/provider/history/osler/3.html#e

>

>

 

Chinese Herbs

 

 

 

 

 

 

[Guest guest]

 

It takes a lot of money to keep the pharmacuetical wheels turning, something

that is declining. No amount of advertising will change this. I would like

to also point out that many patients will take many more than 3 medicines

concurrently.

Later

Mike W. Bowser, L Ac

 

> <

>

>

>Re: osler, polypharmacy, herbal formulas

>Fri, 21 Jan 2005 08:48:06 -0800

>

>Interestingly, Bob Damone recently made independent mention to me of

>Osler's issue with polypharmacy and the profound impact his writings

>had on 20th century medical practice. Apparently, this suspicion of

>polypharmacy, unbeknownst to me, is one of the most deeply ingrained

>and strongly indoctrinated features of modern medicine. Objections

>have been raised that MDs do indeed practice polypharmacy, often of the

>worst kind. However in most cases I deal with, there is a very low

>limit to how many drugs would ever be prescribed by a physician for any

>given complaint. Massive abuse of polypharmacy in WM is usually not

>the work of a single physician, but the tendency of specialists to

>prescribe for each isolated condition without regard to any other.

>Keeping in mind that Osler wrote at a time when it was much more

>difficult to assess drug safety and interactions, WM still remains

>quite wary of prescribing more than three medicinals for any discrete

>condition. The idea of using 15-25 medicinals for a given chief

>complaint such as diabetes or hypertension is beyond their

>comprehension and will likely never be acceptable in American research

>circles. However, I suppose there is the possibility of the Chinese

>(and Asia in general) becoming the leading force in the next generation

>of science. If Asian research somehow becomes the gold standard

>worldwide, then good TCM research may still emerge from those regions

>in years to come and carry with it the authority that it now lacks (and

>deservedly so in many cases).

>

>As a side note, it is certainly interesting that two other schools of

>medical practice that were prominent in Osler's day also frequently

>railed against allopathic practices, amongst them polypharmacy.

>Leading American homeopaths and Eclectics were of one mind on the issue

>of the single remedy. And there is no doubt that Osler's critique was

>strongly influenced by prior, concurrent and much more numerous

>arguments of the exactly same nature made in the journals of these

>schools throughout the 19th century. But just like only a democrat

>could reform welfare, only an MD could make the same argument that had

>fallen on deaf ears when made from outside for decades before. But the

>fact remains that many in all branches of professional western medicine

>(homeopathy, herbology and allopathy) favor the single remedy. While I

>believe there are ways that computer modeling could demonstrate the

>potential efficacy and safety of polypharmaceutical approaches to

>healthcare based upon TCM principles, I do not think there is the will.

> Plus I do believe the current era of drug development is just about at

>an end. Many recent blockbusters have resulted in serious problems.

>The paradigm has been exhausted and is about to shift, but that shift

>is already moving in a very distinct direction that involves genomics,

>stem cells and miniaturized technology, not the use of crude natural

>materials.

>

>While such advances may allow regular regeneration or replacement of

>aging body parts, they will not prevent all manner of suffering. Even

>one in perfect health is still subject to the occasional flu, stress

>related digestive and other disorders, the impact of bad habits like

>smoking and drinking. While much of the damage done from such insults

>may be easily repairable in the near future, people will still suffer

>from symptoms that need to be relieved in some way from time to time.

>And many will still prefer the least iatrogenic approaches. Sure, you

>could control that pain with prednisone and just deal with the side

>effects until your next scheduled regeneration treatment of you could

>use chinese herbs and other natural supplements and enjoy not just long

>life, but quality of life. While WM may solve the problems of cancer

>and heart disease relatively soon, I doubt anything better than TCM for

>daily suffering will be on the horizon near as quickly. However, our

>continuing role will depend on adapting our delivery systems. There is

>no future for raw herbs, except for a narrow, isolated segment of the

>population and it is essential that we develop viable alternatives that

>truly as cost effective as raw herbs. Currently, as far as I am aware,

>only Blue Poppy makes a line of formulas that actually provides

>decoction level dosage in capsule form for about $75 per month. If

>there are others that can deliver the equivalent of 60-70 grams per day

>at this price, please let me know as we are upgrading our pharmacy.

>

>On Jan 12, 2005, at 1:00 PM, Brian B. Carter, MS, LAc wrote:

>

> >

> >

> > Vis a vis Todd's post about the MDs' perspective on herbal formulas, I

> > was struck to see several aphorisms from William Osler, who I generally

> > respect, that may have been the basis for this biomedical perspective-

> > or at least indicate it in its infancy- particularly see 211 and 215

> >

> > *How Not To Treat Him*

> >

> > 209

> >

> > One of the first duties of the physician is to educate the masses not

> > to

> > take medicine.

> >

> > 210

> >

> > Man has an inborn craving for medicine. Heroic dosing for several

> > generations has given his tissues a thirst for drugs. The desire to

> > take

> > medicine is one feature which distinguishes man, the animal, from his

> > fellow creatures.

> >

> > 211

> >

> > If many drugs are used for a disease, all are insufficient.

> >

> > 215

> >

> > The battle against polypharmacy, or the use of a large number of drugs

> > (of the action of which we know little, yet we put them into bodies of

> > the action of which we know less), has not been fought to a finish.

> >

> > http://www.vh.org/adult/provider/history/osler/3.html#e

> >

> >

>

>Chinese Herbs

>

>

>

>

>

>

>

[Guest guest]

 

What is most ironic to me is this discouragement of polypharmacy,

when it is the reality of clinical practice of biomedicine, whether the

result of several physicians or one. It is interesting that the single

remedy was the bias of William Osler and the ideal practice of

biomedicine, but also eclectic herbal medicine and homeopathy. It

would seem that one of the walls that holds us back is this cultural

bias in the West against combination medicine.

 

 

On Jan 21, 2005, at 8:48 AM, wrote:

 

> Interestingly, Bob Damone recently made independent mention to me of

> Osler's issue with polypharmacy and the profound impact his writings

> had on 20th century medical practice.  Apparently, this suspicion of

> polypharmacy, unbeknownst to me, is one of the most deeply ingrained

> and strongly indoctrinated features of modern medicine.  Objections

> have been raised that MDs do indeed practice polypharmacy, often of

> the

> worst kind.  However in most cases I deal with, there is a very low

> limit to how many drugs would ever be prescribed by a physician for

> any

> given complaint.  Massive abuse of polypharmacy in WM is usually not

> the work of a single physician, but  the tendency of specialists to

> prescribe for each isolated condition without regard to any other. 

>