May 27th, 2009 by ValerieTinleyNP in Primary Care Wednesdays
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A report just released on HealthReform.gov, the website for the Obama Administration’s healthcare reform effort, is entitled Roadblocks To Healthcare: Why The Current Health Care System Does Not Work For Women, and cites that more than half of American women (52%) delay or avoid care because of cost, compared to 39% of men.
A video synopsis of the report, hosted by Kathleen Sebelius, the Secretary of Health and Human Services, states that women are being left behind when it comes to healthcare and that there are over 21 million uninsured women in the U.S. Young women have much more difficulty finding affordable health insurance than do men and often pay higher premiums – sometimes one and a half times – those of a young man. These facts all add up to women not getting the care they need to stay healthy.
As a primary care provider (PCP) focusing on women’s health, the findings of the report don’t surprise me, not even a little. From my anecdotal studies of the number of women that I have seen over the years, the majority of women struggle to receive the care they need because they cannot afford it. What typically will happen is that these women delay, often for years, any type of check-up or preventive care because of costs. Instead, they wait until they are sick or are having issues, and then they are forced to find the money and the time to seek medical care.
I also have found another factor beyond price that is creating a barrier to healthcare for women, and the word is “convenience.” Many women cannot, or often will not, take the time to seek routine medical care when most doctor’s offices are open, which is nine to five. Frequently these women are working, albeit on jobs that offer them little or no healthcare coverage, and are loathe to take time off of work for a non-emergency medical issues. Women also have the lion’s share of childcare responsibility, and are more likely to put their children’s schedules and family needs well before theirs.
Primary care can be the first place to look for a solution in bringing affordable, convenient care to women so that there are no roadblocks to access. We strive to do just this at our practice. Our Well Women Clinics were spearheaded after much deliberation about cost and convenience. We started last year and have found them to be a great success. For these clinics, we designated specific days during the month for routine well women check-ups. Hours for these check-ups are early morning through lunch one day and mid-afternoon through evening on another days. We offer the clinics two days each month on different days of the week, ideally making times available for each patient’s schedule, whether she is a current patient with us or a new one.
Although the biggest hurdle for women to getting the care may be cost, as the Obama Administration’s report cites, let us not forget the role that convenience in getting this care plays. Healthcare and wellness does not have a nine-to-five schedule. Likewise, most women’s roles beyond possibly those in a regular “office” job are not on such a regimented schedule; their roles as caretakers and mothers have round-the-clock demands. We need to work with women determine and then remove all of the roadblocks to accessing of care, starting first and foremost with cost, moving to convenience and then considering others that may exist.
Until next week, I remain yours in primary care,
Valerie Tinley, MSN, RNFA, FNP-BC
May 26th, 2009 by KevinMD in Better Health Network
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The following is a reader take by Paul Ravetz.
Does the “Art of Medicine” really exist, or perhaps more importantly, can it do so in the computer age?
Computers are both the boon and the bane of medicine. Electronic medical records (EMRs) are excellent for retrieval of information about labs, medications, and past medical history of our patients. These records are much easier to access than our old paper charts. However, I feel that the Achilles Heel of these advances lies in the fact that physicians are so busy inputting information into their computers that they do not spend enough time communicating with the patient.
Communication with your patient is the epitome of the Art of Medicine. It is vital that physician and patient understand each other. This includes not only what the patient says but what they mean. This takes time, a commodity which is in short supply in the age of EMR. One should always remember a basic caveat about computers, which is, “garbage in, garbage out.” If wrong information is fed into the computer, it doesn’t matter what algorithm that you use because you will be following a false trail.
Computerization of medicine will lead to great advances if it is implemented properly. However, the way things are presently being done cheats the patient out of the most important part of the doctor patient relationship – time to communicate. I always remember the precept advanced by Sir William Osler, the father of modern medicine, “Listen carefully doctor, the patient is giving you the diagnosis.”
The combination of the computer age along with the time to listen to the patient and to accurately define their problem will indeed lead to a new age in medical care, but to ignore one or the other is not to fulfill our obligation to our patients.
Paul Ravetz is a family physician.
*This blog post was originally published at KevinMD.com*
May 26th, 2009 by Medgadget in Better Health Network
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“.. imagine it is the tool with which you are about to remove a man’s limb. This is a dark, sombre instrument, with serious purpose.”
We don’t often unbox things here at Medgadget. For whatever reason, Phillips and GE keep forgetting to mail us their latest CT scanners for review. And Intuitive Surgical, where’s our da Vinci? We need something to make our morning lattes. That being said, recently we got our hands on a wonderfully preserved, rare 1800s surgical kit, made by the famous pre-civil war surgical equipment manufacturer Henry Schively out of Philadelphia, PA. We thought we’d use this opportunity to reminisce on surgery of the past, you know, before ether was given a try, and when surgeons could operate in formal attire. To help us on our voyage through the kit, Medgadget has enlisted our friend Dr. Laurie Slater, whose website Phisick showcases a formidable collection of medical and surgical antiques. Being more knowledgeable on such matters than us, he has kindly offered to act as our guide. From the confines of this post / interview, we’ll explore the surgical kit, touch on surgery in the 1800s, and get you thinking about the days when you’d probably dress like these gentlemen.
So let’s get started. Hinge opening… Now.
Dr. Slater, thank you for kindly serving as our guide through this kit.
You are very welcome. I’m delighted to be able to get a first hand look at this lovely surgical set, so thanks for asking me.
Before we dig into our kit, tell us a bit about why you started collecting medical antiques? What prompted you to start Phisick and where did the word ‘Phisick’ come from?
What I first thought would be a passing interest was not. I come from an era of medicine where much of the equipment tends to be plastic and throw-away. The first time I set eyes on some of the older surgical instruments, I was bowled over by the incredible workmanship and the painstaking effort which someone had lavished on them. I remember thinking that whoever had constructed them a) knew what they were doing and b) was in no hurry. They were of the highest quality, made from the finest materials, with a mastery of design and engineering which, I fancied, would have challenged the legendary skill of the elfin silversmiths of Lothlorien. They had function, obviously, but also form.
Take for example the capital saw (the large one) in your set. The handle is made from dark black smooth ebony which is a durable hardwood, polished and oiled over many hours to a smooth waterproof finish. The curve of the handle is simple, but with a design reminiscent of something from the animal kingdom. Well weighted in the hand; the inner curve fitting the surgeons grip and the upper ‘fin’ and lower ‘fish tail’ anchoring the palm to the handle. This, along with the crosshatching will prevent any slippage when the teeth of the the cold polished steel meet with bone.
Stop for a moment and have another look, but this time imagine that this instrument is about to saw through your own leg without anaesthetic. Or look at it from the surgeon’s point of view and imagine it is the tool with which you are about to remove a man’s limb. This is a dark, sombre instrument, with serious purpose.
An appreciation of these instruments and the men who designed and constructed them has helped me see medicine and history in a different light, and an altogether more vibrant context.
About “Phisick”… The word was commonplace in the 1500s and synonymous with our current day “medicine.” Spelling back then was fairly relaxed and no-one much worried about interchanging a “y” for an “i”. You could ‘take phisick’ by swallowing a pill, or doctors could ‘practise phisick’ by trying to cure their patients. So this was the name I chose for a website which celebrates the beautiful, breathtaking, sometimes life-giving tools invented by the pioneers of medicine and surgery.
We’re fortunate to know a bit of history behind this set. It belonged to a Dr. Geo L. Shearer (an ancient relative of one of your editors), who practiced medicine in Dillsburg, Pennsylvania from 1825 to 1878. Were such personal surgical kits normal possession of doctors in that era?
Knowing who the owner really brings this piece to life. I found a great account of Dr. George L Shearer and which included his role in the history of Dillsburg. The census in 2000 listed the population of Dillsburg at 2063, but when he first started there this figure was closer to 600. He was clearly a pillar of his local society – Chief Burgess of the borough, School Director, member of the Town Council and active in securing the Borough Charter, the State Road from Dillsburg to York, and the railroad. But for the people living there he would have been first and foremost their doctor. The author of this account of Dillsburg describes his “passing from time into eternity” in 1878 and he is also mentioned in his son’s obituary as “The beloved physician” so he was clearly held in both warm and high esteem.
The surgical set you have here in style and configuration is no later than 1840 and predates the civil war by over 20 years which raises the possibility that as the owner, he might have had some prior surgical training. However, the amount of use it would have had at the hands of a local doctor in a small town would have been pretty limited and it seems more likely that if this set had seen much use that it would have done so during the years of the Civil War. During the Gettysburg Campaign, Dillsburg was twice invaded by Confederate cavalry at which time Dr Shearer would have been 61. If he had performed surgery at this time he would have done so in one of two roles, either as a militia surgeon, or a contracted private surgeon. At the start of the war the army forces on either side had their own army surgeons, those of the Union forces numbered 113, of which 24 joined the Confederates. Such were the terrible casualties in an engagement managed by pre-war strategies designed to suit professional soldiers, but acted out by massive numbers of poorly trained civilian recruits, that by the end of the war over 15,000 surgeons had been required to serve in the army forces of either side. Bollet, a civil war historian writes about this:
“During the first year of the war, and especially during the Peninsula Campaign in 1862, army surgeons performed all operations. Soon the overwhelming numbers of battle wounded forced the army to contract civilian surgeons to perform operations in the field alongside their army counterparts. Their ability ranged from poor to excellent.”
In fact, because of controversy over the staggering number of casualties, strict rules were put in place to ensure that only experienced surgeons could operate and one figure suggests that only one in fifteen doctors performed amputation surgery. If Dr Shearer had had such a role he might have used this set to treat both wounded local conscripts from his home town (the number varied in the account I have read but was circa 30 of which 8 died) or soldiers with war wounds (who would have numbered considerably more). In fact, neither George L. Shearer nor his son, James M. Shearer are listed in the A.M.A. Deceased Physicians database. This in itself is not uncommon. Nor is he listed as a surgeon or asst. surgeon in the Roster of Regimental Surgeons for the Union Army, (but he would not have been of course unless he had actively joined the Union Army). Interestingly his son James M. Shearer is listed in the Roster as an assistant surgeon from Dillsburgh, Pa., who served until Aug. 1863. with the Pennsylvania 12th Reserves Infantry, (41st. Volunteers.) Nor is George L mentioned in the Medical and Surgical History of the War of Rebellion. So without any corroborative evidence that he was a surgeon in the Civil war it is not possible to say that this is a civil war surgical set, but the story as it has unfolded so far raises some fascinating possibilities.
In general, how would surgery be done in the 1800s? Would doctors ever operate on house calls? Any sort of anesthetics?
Dr Shearer practiced medicine in Dillsburg and to the six hundred residents of this backwater town in Pennsylvania he would also have been their physician, surgeon, gynaecologist, obstetrician and paediatrician. This heavy set contains instruments used for major surgery such as amputation or craniotomy. In practice, in a town of Dillsburg’s size, outside of war, either of these operations would have been very rare and I doubt it would have seen a great deal of use in this context. It certainly would not have been carried with him on any regular basis. Most likely he would have had another medical bag or physicians leather pocket case in which the more common instruments in daily use were contained and which he would have taken on his house calls. The sort of surgery he might have undertaken would have been suturing of wounds, the drainage of an abscess or possibly the treatment of a superficial flesh would from a bullet (likewise not a common injury in peacetime). He might have used the smaller knives, forceps and needles in the set for this. Local anaesthetic was not invented until the 1880s and none of these procedures wound would have merited ether or chloroform and so would have been done without anaesthetic.
With regards to surgery, the turning point in the 1800s was circa 1846, with the introduction of anaesthesia. Prior to this time the use of an orderly to hold the patient down and alcohol or opium was a poor substitute, and meant that only absolutely major surgery could be undertaken. By far the most common operation was amputation, but also craniotomy (drilling holes in heads – which I will talk about later) and also the removal of bladder stones. The imperative in any case where the patient was conscious would have been to perform surgery as quickly as possible and the earlier surgeons prided themselves in the speed at which they could operate, some claiming to be able to remove a leg in under one minute!
After the introduction of anaesthesia there was a rising tide of surgical procedures. Most of them however would have been done in the civilian hospitals. In Massachusetts Hospital there were a mere 39 operations carried out in the 10 years prior to 1846 and 189 operations (60% of them were amputations) in the 10 years post. It was not until the turn of the century however with the introduction of antisepsis and asepsis that the volume increased significantly by which time in Massachusetts they were averaging 2,427 operations each year.
During the civil war it was estimated that as many as 60,000 amputations were performed on both sides. Because of horrific casualties of war and their appalling prognosis, the surgeons of the time were given pretty bad press and held in poor esteem by the public. Rumours abounded that amputations were performed needlessly, even though this was almost certainly not the case. Surgeons were also accused of performing amputation without anaesthetic. With the notable exception in 1862 of 254 casualties at the battle of Luka, this was not true either, but the reason such accusations exist have explanation. Most of the amputations were performed outside because sunlight afforded by far the best illumination and so many procedures were done in public view of “passers by.” The anaesthetic would be applied by placing a cloth over the nose and face which had been soaked in either ether, or chloroform or a mixture of the two. As soon as the patient passed out the cloth was removed and this would have afforded only a relatively light anaesthetic. (And probably just as well because had it been held in place longer, fewer patients may have woken up). However, the light anaesthetic meant that the patients would tend to thrash around during the procedure even whilst unconscious. It seems likely that the observation of such movements in a public forum would lead to the assumption of an untrained eye, that the patient was still awake.
Given that these kits were used many, many times, how common were infections as a result of surgical procedures in the 1800s?
Many of the surgical procedures done in the civil war were complicated by infection as they were done without the knowledge of the role that bacteria played or the benefits of antisepsis and asepsis. Hospitals of the time were characterised by the stench of the ubiquitous pus and infection. The overcrowded and unhygienic conditions made the situation worse. Thick creamy pus from staphylococcal infection was referred to as “laudable pus” because it tended to be local in nature. The more serious infection from streptococcal infection produced a clear watery or bloodstained discharge and was called malignant because it caused septicaemia and death, hospital gangrene and osteomyelitis. The latter was a chronic infection in bone which was a complication of the almost inevitable infections which followed broken bones exposed to the air. The presence of osteomyelitis was a common indication for amputation.
This particular kit was made by Henry Schively. Since we’re a medical technology blog, would you mind briefly telling us about the medical instruments manufactured in that era?
In the late 18th century most American surgeons were buying their instruments abroad, or from agents who had imported them from England. Henry Schively (1761 – 1811) is described in Edmonson’s book on American surgical instruments as ‘the Premier Philadelphia surgical instrument maker of the era of heroic surgery’ which was the period from 1774 to 1840. He along with a number of other local artisans (there were 50 master smiths registered in the thriving city of Philadelphia, 10 of whom were listed as “instrument makers”) contributed to Philadelphia becoming the centre of the American instrument trade. Supporting this development was the fact that Philadelphia and the surrounding regions had also become the leading American medical centre of the time, boasting the very first public anatomy lectures and dissections, as well as the first medical school, the university of Pennsylvania. The first surgical chair of this medical school was held by Philip Physick, the “father” of American surgery. Relatively few of these early master craftsmen managed to sustain successful businesses but Henry Schively and John Rohr were among the better known. Schively was famous for inventing the Bowie knife, although it was his focus on making surgical instruments which marked him out and he was approached by many surgeons, Physick amongst them to construct and refine instruments which they had invented. Schively and the family business later carried on by his son beyond 1850 was acknowledged in its time as one of the finest surgical instrument makers in America.
Here’s an overview of the kit showing all of the tools inside. Do you think this was a common, general surgical kit, or do you think it might have been for more specialized procedures?
The set contains the basic surgical tools which would have been needed to perform emergency surgery by way of amputation and this is not an uncommon configuration. The essential tools for this would usually comprise of a Liston knife or knives which had long straight razor sharp blades polished steel blades for cutting through the muscle. A capital saw (the large one) was for sawing through weight bearing bones. The forceps and smaller knives would have been used for trimming the muscle and skin in such a way as to produce flap. The needles were used to sew the flap of skin and muscle in place over the bone stump. There would also have been a tourniquet for applying pressure around the limb to temporarily cutt off the blood supply.
In addition to these surgical tools the set also contains two hand trephines and other instruments used for trepanation. These would often come separately in their own case and so this set represents a “compendium” if you like. Other examples of sets which combined instruments for different purposes were carried on board ships. These were grand compendia with comprehensive collections of tools to manage all eventualities, including general surgical, orthopaedic, urological, ophthalmological and dental instruments.
This is the trepanning set within the kit. Would you mind briefly describing why a doctor would perform trepanning and how he would do the procedure?
Trepanation is the procedure of drilling a hole in the skull. The two main reasons for doing this would be to drain a collection of blood which had accumulated between the skull and the surface of the brain, or to elevate a depressed bone fracture. The former, often referred to as a subdural haematoma would raise the pressure within the skull and cause brain damage, and in a depressed fracture it was the bone of the skull pushing on the brain (like a collapsed ping-pong ball) which would damage the brain or causes it to swell. When done correctly for the right indications trepanation is a relatively simple procedure which is life saving. This set contains two drills with different sized crowns (“drill bits”), either of which can be attached with a screw to the horizontal crosshatched ebony handle. This forms a drill which is used in a similar way to a cork screw. A flap of scalp would first have been raised to clear the area of the skull to be tapped. In order to anchor the circular drill and prevent slippage a central spike is moved forward and fixed in place to start the drilling (see here). The drill is turned through the cranium until a disk of bone can be removed. This may have been pried out with a lever like ‘elevator’ and the edges of bone trimmed with a sharp knife or ‘lenticular’ and filed down with a ‘raspatory’. The instrument on the top right hand side of the case would probably have been used as a combination of an elevator and raspatory. Sometimes one hole would be enough to drain a collection of blood. Other times a larger plate of skull would need to be removed and this was done by drilling three or more holes and passing a small abrasive wire (a Gigli saw) between two holes at a time to saw through the intersection.
Tell us, if you could, about the the lancet and what they’d be used for? Why was a scalpel or normal knife not sufficient to let blood?
Patients were frequently bled by their physicians in the 19th century and this was considered a panacea for numerous complaints ranging from headaches to gout. It was almost certainly ineffective in 99.9% of them. One such phlebotomy instrument used was the “spring lancet”. The name is largely self explanatory. The device is primed by pulling the black lever which also moves the blade upwards and holds it in position under tension. The lower edge of the instrument is held over the area to be bled and it is fired by pressing the arm on the side which released the blade at speed into the flesh. The ensuing blood was usually collected in cups applied to the skin (see here). I doubt that this spring lancet came with the set originally but would have been a later addition. It is the sort of instrument Dr Shearer might well have carried on his person or in his medical bag. Physicians also used small knives and thumb lancets to do the bleeding but because the spring lancet was able to pass the blade through the skin more quickly, they were less painful. Later automatic devices called scarificators worked on similar principles but primed multiple blades at a time (see here).
The above vertebrae was found in the kit. Any idea why a surgeon might keep that around!?
This is a human cervical vertebra (from the neck). The central body has been drilled and so it almost certainly once belonged to an anatomical model skeleton. The reason it has found its way into this set is not obvious. The container in which it sits, along with the spring lancet is where the tourniquet for this set would have gone.
What do you think this little brush might have been used for?
This is a brush which would have been used to brush away the small pieces of skull bone which accumulated around the drill bit during trepanation. It is probably made from bone although it could be ivory. Although most of the pieces in the set are made from ebony it is possible that this was original as a number of items in the set do combine the two.
What about these saws? How do you think they might have been used? Amputations?
The top saw is called a Hey saw after William Hey an English surgeon (1736-1819). It is used to perform craniotomies, but instead of using a trepan, Hey removed a plate of bone by sawing linear intersecting lines through the skull. The middle saw we have talked about is called a capital saw and this is the large saw which would have been used in leg amputations to saw through the femur or tibia. The bottom one is called a metacarpal saw and would have been used to cut smaller bones in the forearm or hand or finger bones.
Anything else in the kit or about the kit that you’d like to comment on?
Just to reiterate that this is a superb very early surgical set made by one of the most famous American instrument makers and I am delighted to have had the opportunity to look at it and explore the history with you. American and civil war surgical instruments are not my specific area of expertise and so this exercise has been very educational and enjoyable one for me.
Thank you so much for helping us out! If our readers what to learn more about medical antiques, do you have any recommendations for books, or other resources (besides Phisick of course) that they might want to check out?
There are a number of good books on antique medical and surgical instruments which include:
Antique Medical Instruments by Elisabeth Bennion
American Surgical Instruments by James Edmonson
Medicine: Perspectives in History and Art by Robert Greenspan
For those with a more specific interest in Civil War surgical instruments I would recommend a trip to Michael Echols’ web site which reflects his wealth of knowledge on this subject. I particularly want to thank Michael for the help he graciously offered in researching this set.
I would also recommend reading Bollet’s illuminating article “The truth about Civil War surgery“.
Lastly your readers may be interested in browsing the links page at Phisick.com where they can find a number of sites related to medical antiques and the history of medicine.
*This blog post was originally published at Medgadget*
May 26th, 2009 by admin in Better Health Network, Quackery Exposed
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By Dr. John Snyder of the Science Based Medicine Blog
I recently saw a 14 year old girl in my office with a 2 day history of severe abdominal cramps, bloody diarrhea, and fever. Her mother had similar symptoms as did several other members of her household and some family friends. After considerable discomfort, everyone recovered within a few days. The child’s stool culture grew a bacterium called Campylobacter.
Campylobacter is a nasty little pathogen which causes illness like that seen in my patient, but can also cause more severe disease. It is found commonly in both wild and domestic animals. But where did all these friends and family members get their campylobacter infections? Why, from their friendly farmer, of course!
My patient’s family and friends had taken a weekend pilgrimage to a family-run farm in Buck’s County, Pennsylvania. They saw farm animals and a working farm. And they all drank raw milk. Why raw milk? Because, as they were told and led to believe, raw milk is better. Better tasting and better for you.
In 1862, the french chemist Louis Pasteur discovered that heating wine to just below its boiling point could prevent spoilage. Now this process (known as pasteurization) is used to reduce the number of dangerous infectious organisms in many products, prolonging shelf life and preventing serious illness and death. But a growing trend toward more natural foods and eating habits has led to an interest in unpasteurized foods such as milk and cheese. In addition to superior taste, many claim that raw milk products provide health benefits not found in the adulterated versions. Claims made about the “good bacteria” (like Lactobacillus) conquering the “bad” bacteria (like Campylobacter, Salmonella, and E. coli) in raw milk are pure fantasy. Some even claim that the drinking of mass-produced, pasteurized milk has resulted in an increase in allergies, heart disease, cancer, and a variety of other diseases. Again, this lacks any scientific credibility.
With this growing interest in unpasteurized dairy products has come an increase in the rate of food-born infections. The federal government developed the Grade ‘A’ Pasteurized Milk Ordinance in 1924, providing a set of guidelines for the safe processing and handling of milk products. Although all 50 states have voluntarily adopted these guidelines, the FDA has no oversight jurisdiction. It is up to individual states to determine their own safety protocols and enforcement strategies. While selling raw milk is currently illegal in 26 states, those with a will have found a way to skirt the law to get their fix of the real deal.
My patient was a victim of a recent outbreak in Pennsylvania, but similar outbreaks of infectious disease due to unpasteurized milk products are a recurring headache for public health officials. Between 1973 and 1993 there was an average of 2.3 milk born disease outbreaks per year. That number increased to 5.2 per year between 1993 and 2006. Whatever the numbers are, there is no question that the increasing consumption of raw milk is a genuine threat to public health.
The health claims made for raw milk, and against its pasteurized cousin, are being heavily pushed by a small but passionate contingent one might refer to as “food guardians.” These are people who espouse a return to the good old agrarian days of wholesome, farm-raised foods, free from man-made chemicals and mass-market processing. Some of these ideals are highly respectable and healthful responses to the ways in which society has dealt with the need to push products to a mass market at profit. For example, the use of pesticides, animal hormones and antibiotics, and farm run-off can have deleterious environmental and human health consequences. However, many of the health claims that are made about products like raw milk are not supported by scientific evidence, and lack scientific plausibility. Despite this lack of evidence, however, the allure of raw milk products is clearly on the rise.
Beyond the obvious public health consequences of this trend lies the problem of an increasing public credulousness when it comes to pseudoscientific claims. This is similar to the trend we are seeing regarding concerns about the dangers of vaccines and excessive fears concerning certain potential environmental hazards.
Unscientific and outright fraudulent claims about the health benefits (as well as the hidden dangers) of a variety of foods is on the rise. And bogus or unsupported nutrition claims are big business. From the immune boosting and weight loss powers of the acai berry, to the cancer protective effects of vitamins, nutrition pseudoscience is all the rage. While raw milk will never have quite the celebrity cache of these “super foods”, it is promoted with the same lofty yet empty claims, and provides the added bonus of infectious diarrhea.
On a recent visit to a local high-end wine shop, I came face-to-face with the ease with which people fall prey to the marketing of food pseudoscience. A woman was examining a bottle of wine when the store keeper approached to offer help. She told her a little about the wine and then said, “And all of their wines are biodynamic.” To this, the shopper exclaimed “Oh wow, that’s great.” She bought the wine, likely without having a clue what the term “biodynamic” even means. Biodynamic farming is a mixture of Gaia-like principles (the earth is a living organism) and organic practices, with a smattering of mysticism, alchemy, and astrology. In essence, a smorgasbord of pseudoscientific farming practices perfect for the current culture of armchair environmentalism and the new found heal-thy-self mantra of the well-to-do. While the motivating factors and socioeconomic status may differ between those drinking biodynamic wine and those drinking raw milk, both are relying on false beliefs and unsupported claims in making their choices to consume these products.
As a lover of cheese, I appreciate that there are those whose refined palates favor the delicacy of unpasteurized, aged cheeses so prevalent in other countries. But to stretch this taste preference to include health benefits unsupported by science and even common sense is not just misguided, it can be dangerous. Dangerous because it increases the risk of infectious disease, but also because it perpetuates a credulous perspective that adds to the ongoing erosion of our appreciation and acceptance of science.
*This blog post was originally published at Science-Based Medicine*
