On 04/05/2006, at 12:02 PM, Ian Cheong wrote:
At 3:37 am +0930 4/5/06, Oliver Frank wrote:
[...]I wonder whether this claim about swapping sides arose
because somebody who was seen as authoritative once said so, and
that that statement has been repeated ever since without
examination, challenge or attribution? I suspect that this has
happened more than once in medicine. For example, Sir Humphrey
Seenalot states that the major cause of haemorrhoids is
constipation. Sir Humphrey does not produce any evidence or
research - he is an eminent haemorrhoidologist who has treated a
lot of people with haemorrhoids and he just says so. He even has
said so in his textbook of haemorrhoids, which is the standard
work in the area. For the next fifty years, everybody else quotes
this as a fact.
Sadly, that's the way of the world and human thought....
Most anatomy textbooks have loads of anatomical inaccuracies,
because most anatomy textbook writers write textbooks by reading
other people's textbooks and not from observation of real human
anatomy.
Lots of things in Murtagh's book I disagree with, but he's a
professor.
That's actually a bit unfair. I visited him when he was writing the
first edition - we passed by his study which was packed to the
ceilings with photocopies of the sources he used to compile the tome.
He wasn't a professor in those days.
Many medical conditions are poorly understood and managed
historically.
I saw a patient with probable polymyalgia rheumatica yesterday.
Merck Manual says "prevalence, etiology, and pathogenesis unknown".
Hey but we sound great when we know what it is!
One day, IT will enable us to analyse the collective wisdom of
front line clinicians and real patients to generate real data and
better science.
I wonder whether there are any GPs on the neurology working group of
Ken Harvey's since most presentations of headache are to GP surgeries?
Alex
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