By Gerald N. Grob
Utilizing ancient and modern info and case experiences, the authors additionally learn tonsillectomy, melanoma, middle illness, nervousness, and melancholy, and establish variations among rhetoric and truth and the weaknesses in prognosis and remedy.
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Additional resources for Diagnosis, Therapy, and Evidence: Conundrums in Modern American Medicine
37 Consider, for example, how the understanding of blood disorders was shaped by changing technologies, physician identities, and social and political assumptions about patients and diseases. 38 Other diagnoses of relatively recent vintage manifested a similar pattern. It has long been known that excessive consumption of alcohol can have serious consequences for health. Before the 1970s, however, there was little or no awareness of the concept that infants born to women who drink also can have severe health problems and disabilities.
The creation of the ICD (which in the twentieth century has undergone no less than ten revisions) did not resolve the problem of developing clear and unambiguous diagnostic categories. Indeed, Kerr L. White has noted that there are thousands of “labels” describing the health problems that beset humanity. ”34 20 Diagnosis, Therapy, and Evidence Because the United States has a divided system of government, the collection of vital statistics followed a somewhat different path. As early as 1639 the Massachusetts General Court mandated that a record be kept of all births, marriages, and deaths.
While the framework of debates regarding these conditions is usually phrased in scientiﬁc rhetoric, at bottom the debates reﬂect ongoing controversies about the nature and causes of human suffering. Conclusion To delineate the respective roles of rhetoric and reality is not to denigrate either medicine or the health care system. It is rather to point to factors that both shape and distort the nature and practice of medicine. Etiological theories that have little or no basis in fact, diagnoses that lack reliability or validity, and therapies whose efﬁcacy is at best problematic and at worst dangerous 32 Diagnosis, Therapy, and Evidence are all too common.