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The Lancet

The series of publications stemming from the PACE trial continues to roll on with the inevitability of a juggernaut or tumbrel. The venue for this series of reactionary proclamations has been The Lancet and specialty journals of that group. People might ask how such a prestigious publication could not just allow such expressions of prejudice and poorly-supported claims to not just make it into print, but also to get cover photographs and approving editorials.

It might help to check the dates at which The Lancet published articles attacking TB patients as evolutionary mistakes.

(One can almost hear this moss-backed living fossil say "harrumph". Note that this author was in a government position in British healthcare. You will not read anything there about pasteurization of milk, which the British government did not feel necessary, it having been invented in France and practiced in America. The problem was not mycobacterium tuberculosis, it was those damn patients. If you check the bibliography, you will find some sources later prominent in Nationalsozialistische Rassenhygiene.)

A brief look at medical history will help clarify matters.

The Lancet was founded in 1823, a time when lancets were closely identified with the medical profession because bleeding patients was a very common practice for treating nearly every condition, even if some advanced doctors no longer considered it a sovereign remedy. This was before the introduction of the stethoscope into British medicine, so that could not be used as a symbol of the profession.

(The stethoscope had been invented in France in 1816, but this counted against it in British eyes, if they were even aware of it. Golding Bird introduced a new British stethoscope in 1840, which marks him as something of a radical innovator.)

They couldn't use a white coat as a symbol either. Prior to the germ theory of disease doctors didn't wear white coats -- paintings reveal dark coats and trousers, which would not show disturbing stains -- and might not even wash their hands between autopsies and obstetric examinations. (See Ignatz Semmelweis and puerperal fever.)

The one effective prescription available for actually changing the course of any infectious disease at the time was quinine for (mostly-preventive) treatment of malaria, often served mixed with gin. Unfortunately for the reputation of The Lancet, this practice did not become common among British doctors and bartenders until about 1850. (The antimalarial properties of quinine were actually discovered by accident, since it was originally used purely to deal with the symptoms of fever, shaking and pain.)

This was also before the introduction of anesthesia, antibiotics, antiseptics, aseptic surgery, aspirin, epidemiology, medical measurement of temperature, blood pressure, etc. Doctors were educated in the sense that they could tell you that the Greek phthisis (φθίσις) was also called consumption, (though even a fellow of the Royal College of Physicians did tell a dying John Keats his illness was all in his head -- after Keats spit arterial blood, and recognized what it meant, because was he trained as a doctor and had tended a brother dying of TB.) What they could seldom do is change the course of that disease for the better. The best educated could tell you that Hippocrates said the disease was almost always fatal, and warned doctors not to visit victims in order to protect their reputations.

In these present papers the Lancet continues a long tradition of looking backwards while advancing aft-end first into the future.


A treat to encounter your writing. Final sentence sums it up. I'll be reading more here. thanks.
Thanks, I needed some scathing humour tonight! "Aft-end first" -- snork! -- I'll be laughing about that in my sleep!

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