“I firmly believe that if the whole materia medica could be sunk to the bottom of the sea, it would be all the better for mankind and all the worse for the fishes.”
— Oliver Wendell Holmes, M. D., Professor of Medicine , Harvard
“With all his conscience and one eye askew, So false he partly takes himself for true.”
— Rudyard Kipling
The best therapy for a disease is one that treats its cause. The best treating clinician is the one who really winnows the situation down to its Occam’s Razor basis, and fixes that.
As I get to what I am coming to for today’s column, making this mastery-of-the-obvious point seems impelling. It’s not meant as snark, but snarkily I might add that its thrust is so alien to what many biotechnology companies are doing these days that, now that I have asserted it, I think Frank Archambeau should keep a tsunami watch on the Pacific. Sometimes making a clear statement of how things should be upsets natural order. To Alan Harris…be warned: the Thames may rise and flood London town! To all the fine Irregulars checking in from many corners of the planet, here’s hoping that asserting treating the cause of disease is best does not cause the earth to open up in city-swallowing flame-spewing fissures. To our readers in Switzerland, do sound alarms if there’s a avalanche on Mont Blanc.
If you come into a hospital with anemia, a doctor can give you oxygen to make what blood cells you’ve got be more effective, and could even put you on a beta-blocker to reduce cardiac oxygen demands. But you would agree, I hope, that the best therapy for the anemia is addressing the cause: If the patient’s hemoglobin is really low because he just passed two quarts of blood from a bleeding stomach ulcer, you need to go in and fix that ulcer and you probably need to give back some blood. This is not rocket science. If the blood loss has been gradual and is from a deficiency in iron, folic acid or vitamin B12, a sprinkle of those vitamins will cause the bone marrow to get moving and really crank out new red blood cells in a hurry. In the latter case, the patient may not need a transfusion…and that’s a good thing, as it protects him from hepatitis XYZ: ...
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