The stupid truly burns brightly in this one. Dana Ullman, known to readers of Respectful Insolence, Science-based Medicine, and this blog as Hahnemann's cognitively impaired bulldog, has started blogging at the Huffington Post. It's certainly an appropriate venue for his brand of cult medicine belief, but that doesn't make it any less painful. His inaugural piece, entitled The Wisdom of Symptoms: Respecting the Body's Intelligence betrays a stunning level of ignorance of basic human biology.
I have good and bad news about the human body: it is neither wise nor foolish, good nor evil, nor is it simple in any way. It is a complex system where few simplistic explanations suffice. It would be nice to believe in "feed a cold, starve a fever" and other simplistic pablum, but things are rarely so simple. This is why there is a science to medicine---our instincts and hunches often betray us, and only by studying the body systematically can we form valid conclusions.
Or, if you're lazy or deceitful, you can just make shit up.
Which brings us to Dana Ullman who has come up with the shattering
observation that, "just because a drug is effective in getting rid
of a symptom does not necessarily mean that this treatment is truly
curative (or even helpful)."
Really? I never would have
guessed that---which is why I read the literature, which is pretty
damned clear that sweeping generalizations such as this are
meaningless. Take the symptom of chest pain---if you don't know the
likely causes of a case of chest pain, you won't know how to work it up
or treat it properly. Giving someone nitroglycerin may make a patient
feel better, but may indicate a cardiac etiology or an esophageal
etiology. If you simply treat the pain with nitroglycerin without
treating the underlying cause you may cause someone to die. That would
be a bad thing. His "revelation" simply reveals how ignorant he is
about current concepts of human medicine.
His ignorance, rather
than giving him pause, leads to more senseless expostulations. He goes
on to write about the "wisdom" of the body, whatever the hell that
Our human body has survived these thousands of years because of its
incredible adaptive capabilities, and one of the ways that it adapts is
through the creation of symptoms. Whether it be through fever and
inflammation, cough and expectoration, nausea and vomiting, fainting
and comatose states, and even the variety of emotional and mental
states, each symptom represents the best efforts of the bodymind to
fight infection and/or adapt to physical and psychological stresses.
What an ignorant load of horse shit. First of all, "the human body"
has not "survived these thousands of years". As a distinct species we
are a couple of million years old, more or less. We have survived
because we have survived. If we hadn't survived, we wouldn't be having
this discussion. Human beings have been generally able to reproduce at
a faster rate than we die. Our bodies work very much like other
mammals (and other vertebrates for that matter). While vomiting may be
"beneficial" when it is caused by a toxic ingestion, it is not so
beneficial when it is caused by increased intracranial pressure.
Although symptoms may be the best effort of the organism to defend
itself at that time, it is not usually effective to simply let the body
try to heal itself. Most often, some treatment must be provided to help
nurture, nourish, and augment the body's own wisdom. The challenge to
physicians, healers, and patients is to determine when to help aid this
inner wisdom of the body and when to intervene to make certain that the
body does not harm itself.
One can view the human body in one of two fundamental ways: as a
typical biological organism that is subject to the usual laws of
physics, chemistry, and biology, and therefore understandable through
systematic investigation; or as some sort of mystical thing infused
with an elan vital,
subject to the whims of the supernatural and fundamentally mysterious.
It's pretty easy to verify which is a better model of reality, and
which is a fundamentally arbitrary fantasy.
What Ullman is
leading to is a fetishization of symptoms. He elevates the subjective
experience of illness to a magical force for good. I have bad news for
you, Dana: symptoms are a biological phenomenon which are neither
inherently good or bad.
Nesse and Williams show how our symptoms and seemingly normal body functions work as important defenses:
- Fever is an important, even vital, defense against infection.
- Tears help wash and cleanse the eyes.
- The respiratory system is bathed in antibody and enzyme-rich
secretions that are propelled up and down the throat and bronchial tree
so that invaders are killed.
- The ears secrete an antibacterial wax which helps to fight infection.
- The frequent washing of the mouth with saliva kills
some pathogens and dislodges others so that the stomach's acid and
enzymes can destroy them.
Without having to tell the bodymind what to do, our innate survival
instinct has developed sophisticated responses to both old and new
infections and stresses.
no, no! I'm wondering if this guy is even educable. Fever is not some
magical defense against infection. Fever is (usually) caused by the
release of certain cytokines as a reaction to many different stimuli,
especially infection. There is no evidence that suppression of fever
prevents healing. The "discovery" that tears help cleanse the eyes his
hardly groundbreaking. None of these support his assertions about our
"innate survival instinct". Now, if Ullman had actually bothered to
learn some immunology, he'd be blown away by the beautiful truth. Our
bodies have evolved very sophisticated defenses against malignancy and
infectious disease. The truth is much more complicated and interesting
than Ullman's oversimplification.
This type of teleologic
thinking is child-like. Confounding a reaction with a purposeful,
beneficial response is idiotic. For example, hypertension can cause
compensatory thickening of the heart muscle, analogous to a biceps that
grows with weight-lifting. Unlike a biceps muscle, this thickening is
not beneficial. While it temporarily keeps the cardiac output up, it
leads to accelerated heart damage, and eventually heart failure.
established his fundamental misunderstanding of biology, Ullman tops it
off with praise for his pet medical cult, homeopathy.
The implications of recognizing that symptoms are efforts of the body
to defend itself are significant. Because some conventional drugs work
by suppressing symptoms, these drugs tend to provide helpful
temporarily relief but tend to lead other new and more serious problems
by inhibiting the body's defense and immune processes. Such drugs
should be avoided except in dire situations or in extreme pain or
discomfort when safer treatments are not working fast or adequately
other words, based on his own fantasy about how the body works, doctors
have it all wrong, but thankfully, he has all the real answers without
having to perform all that pesky science.
Because symptoms are adaptations of the body in its efforts to defend
and heal itself, it makes sense to use treatments that mimic this
wisdom of the body. Ultimately, homeopathic medicine is a well-known
therapeutic modality that honors this wisdom of the body. Homeopathy is
a type of "medical biomimicry" that uses various plant, mineral, and
animal substances based upon their ability to cause in overdose the
similar symptoms that the sick person is experiencing.
This only "makes sense" if you buy into the false assumptions about human biology.
is no way to state this forcefully enough: Dana Ullman is an ignorant
twit who leads a fringe medical cult which promulgates dangerous