[net.med] prevention <---> treatment

tjs@cbdkc1.UUCP ( Tom Stanions) (07/17/85)

A while ago someone said on the net that it was a waste of time for doctors to
spend time on prevention.  I think that many people feel this way, health is
cheap until we have lost it.  I found the poem that follows in a book and
thought that it might interest the net-folks:






                     THE FENCE OR THE AMBULANCE

        'Twas a dangerous cliff, as they freely confessed,
                Though to walk near its crest was so pleasant:
        But over its terrible edge there had slipped
                A duke and many a peasant;
        So the people said something would have to be done,
                But their projects did not at all tally:
        Some said, "Put a fence round the edge of the cliff";
                Some, "An ambulance down in the valley."

        But the cry for the ambulance carried the day,
                For it spread to the neighboring city;
        A fence may be useful or not, it is true,
                But each heart became brimful of pity
        For those who had slipped o'er the dangerous cliff,
                And the dwellers in highway and alley
        Gave pounds or gave pence, not to put up a fence,
                But an ambulance down in the valley.

        "For the cliff is all right if you're careful," they said;
                "And if folks even slip or are dropping,
        It isn't the slipping that hurts them so much
                As the shock down below - when their stopping."
        So day after day when these mishaps occurred,
                Quick forth would the rescuers sally
        To pick up the victims who fell off the cliff
                With their ambulance down in the valley.

        Then an old man remarked:  "It's a marvel to me
                That people give far more attention
        To repairing results than to stopping the cause
                When they'd much better aim at prevention.
        Let us stop at its source all this mischief," cried he,
                "Come, neighbors and friends, let us rally;
        If the cliff we will fence, we might almost dispense
                With the ambulance down in the valley."

        "Oh, he's a fanatic," the others rejoined;
                "Dispense with the ambulance, never!
        He'd dispense with all charities, too, if he could:
                No, no! We'll support them forever.
        Aren't we picking up folks just as fast as they fall?
                And shall this man dictate to us? Shall he?
        Why should people of sense stop to put up a fence
                while their ambulance works in the valley?"

        Thus this story has beautifully told
                How our people with best of intentions,
        Have wasted their years and lavished their tears
                On treatment with naught for prevention.

        But a sensible few, who are practical, too,
                Will not bear with such nonsense much longer;
        They believe that prevention is better than cure,
                And their party will soon be the stronger.
        Encourage them, then, with your purse, voice, and pen,
                And (while other philanthropist dally)
        They will scorn all pretense, and put up a stout fence
                On the cliff that hangs over the valley.


                                        Joseph Malines





{allegra|ihnp4}!cbdkc1!tjs

geb@cadre.ARPA (Gordon E. Banks) (07/24/85)

Two things: 

1) You clearly misunderstood my posting when I said it was largely
a waste of time for doctors to push prevention.  The reasons were
clearly spelled out...studies have shown that beyond the realm
of infections diseases (immunizations, sanitation, etc.) there is
little doctors can do.  A lot of people won't listen to doctors, 
the government, etc. when it comes to changing personal habits of 
diet, excercize, smoking, drinking, and drugs.  (By diet, I don't
mean the quack diets and "nutrition" some of you have been talking
about, I mean weight control, cholesterol control, etc.)  Most 
doctors I know counsel patients with each visit to stop smoking,
moderate their booze and food, but usually to no avail.  There is
enough in the media about these things (with Doctors on TV if you
will) so that anyone but those with their heads in the sand know
all about it already.  So what do we do about those who didn't
listen and got sick, those who listened but got sick anyway
(yes, even vitamin nuts get sick), and those who get old and get
sick (no yogurt won't make you live to 130 and die in your sleep).
Some one has to be able to diagnose and treat them, and herbalism
isn't the answer (at least for the population who know better).
Thus we have doctors, good ones and bad ones.

2)  Re the sugar debate.  The posters who said the only disease
sugar is implicated in scientifically is dental caries are right.
Most physicians would agree that overindulgence in sweets is probably
not a healthful practice, but the evidence is largely lacking unless
you have diabetes, obesity, or some other disease exacerbated by
sugar or calories.  However, the "raw honey" information posted
was sheer superstition.  Raw honey has been reported to cause
botulism in infants, but otherwise no significant health differences
have been discovered between this bee-sugar and cane or beet
sugar.  Many parents have believed the quack theory that a taste
for sweets is acquired and not innate, despite evidence to the contrary
in humans and animals, only to find that their child, upon tasting
his first candy, is wildly enthusiastic about it.  It seems that
a taste for sweets has some evolutionary advantage after all (oh,
excuse me all you creationists out there).  

tjs@cbdkc1.UUCP ( Tom Stanions) (07/26/85)

In article <467@cadre.ARPA> geb@cadre.ARPA (Gordon E. Banks) writes:
>1) You clearly misunderstood my posting when I said it was largely
>a waste of time for doctors to push prevention.

I think not.

>                                                         there is
>little doctors can do.  A lot of people won't listen to doctors, 
>the government, etc. when it comes to changing personal habits of 
>diet, excercize, smoking, drinking, and drugs.

They can stop condoning bad habits by saying that there is no problem just
because they haven't been able to prove to their satisfaction any exist.
This is important when many intelligent people think problems exist.  People do
listen to doctors when you say what they want to hear.

>(yes, even vitamin nuts get sick), and those who get old and get

True, and people who are into wellness and "right living" also get sick.  Many
sicknesses are natural and neccessary for health.  Colds clear the body of
catarrh and other build ups, some sicknesses are the body removing problems.
The worst thing to do in many cases (and the first thing that doctors often do)
is to suppress the symptoms.

>Some one has to be able to diagnose and treat them, and herbalism
>isn't the answer (at least for the population who know better).

Your (supposedly) scientific approach fails to mention that herbal and other
natural methods work for almost all problems including those to small or to
large for the current medical community.  Does the fact that they work pale in
importance to your opinion.  Does that mean that if I go for the treatment that
works better with less destruction I don't know better?  The people who go for
natural methods are the ones who have spent time to learn what is best, the
only thing they know less of is "doctor-hype".

>                    However, the "raw honey" information posted
>was sheer superstition.  

Again, how do you know that this is superstition?  I thought that going for the
facts without the medical blinders on was good practice.  Natural honey is
unrefined, and even though it's use should be kept to a minimum, it's unrefined
state will better prevent the problems caused by refined sugar (ref. earlier
articles).


{allegra|ihnp4}!cbdkc1!tjs

fsks@unc.UUCP (Frank Silbermann) (07/26/85)

In article <cadre.467> geb@cadre.ARPA (Gordon E. Banks) writes:
>
>2)  Re the sugar debate.  The posters who said the only disease
>sugar is implicated in scientifically is dental caries are right.
>Most physicians would agree that overindulgence in sweets is probably
>not a healthful practice, but the evidence is largely lacking unless
>you have diabetes, obesity, or some other disease exacerbated by
>sugar or calories.

And how many people DON'T have a problem with obesity?  After age 30,
it's the _uncommon_ person whose weight is right where it should be.
Conclusion:  Sugar is not likely to be harmful for you unless you are
an ordinary American :-(.

>However, the "raw honey" information posted was sheer superstition.
>Raw honey has been reported to cause botulism in infants, but otherwise
>no significant health differences have been discovered between this
>bee-sugar and cane or beet sugar.

The "quack" book I read said that honey soothes inflamed mucous membranes.
If this is just an old wives tail, then why does my doctor recommend honey
and lemon juice in a glass of tea to soother sore throats?  Why didn't he
just recommend sugar in the tea, instead of honey, assuming there is no
difference?  After all, sugar is cheaper, and more convenient to handle.

I've read that Roman soldiers used honey as a balm for binding wounds.
If honey really has no such antiseptic effect, then why doesn't it spoil
when stored at room temperature?

>Many parents have believed the quack theory that a taste for sweets
>is acquired and not innate, despite evidence to the contrary
>in humans and animals, only to find that their child, upon tasting
>his first candy, is wildly enthusiastic about it.  It seems that
>a taste for sweets has some evolutionary advantage after all (oh,
>excuse me all you creationists out there).  

No one says that a taste for sweets is acquired.  It's the taste for
NON-SWEET foods that must be acquired.  But you eat a lot of sugar,
you won't aquire this taste.  Heathy food like vegetables and grains
will taste bad in comparision (as an analogy, it's unlikely that
you'll discover a love for good books unless you can first break
yourself of the TV habit).

	Frank Silbermann

oliver@unc.UUCP (Bill Oliver) (07/27/85)

In article <unc.34> fsks@unc.UUCP (Frank Silbermann) writes:
>


>
>I've read that Roman soldiers used honey as a balm for binding wounds.
>If honey really has no such antiseptic effect, then why doesn't it spoil
>when stored at room temperature?

Honey doen't spoil because the high osmotic pressure of the, 
dare I say it - sugar - in the product.  The same effect is 
found in molasses and other processed high osmotic pressure 
sugar products (especially many so-called "freezer-treats").
This is the basis for sugar-curing meats, as well. Basically,
any organism that tries to live in the sugar solution gets all
of its water sucked through the cell wall and it stops growing.


This is also why, when any of these things do spoil, they
tend first to spoil by the growth of organisms, usually fungi, on the
surface.  Mix water with the honey and you get a great medium.


Bill Oliver

hutch@shark.UUCP (Stephen Hutchison) (07/30/85)

In article <34@unc.UUCP> fsks@unc.UUCP (Frank Silbermann) writes:
>In article <cadre.467> geb@cadre.ARPA (Gordon E. Banks) writes:
>>However, the "raw honey" information posted was sheer superstition.
>>Raw honey has been reported to cause botulism in infants, but otherwise
>>no significant health differences have been discovered between this
>>bee-sugar and cane or beet sugar.
>
>The "quack" book I read said that honey soothes inflamed mucous membranes.
>If this is just an old wives tail, then why does my doctor recommend honey
>and lemon juice in a glass of tea to soother sore throats?  Why didn't he
>just recommend sugar in the tea, instead of honey, assuming there is no
>difference?  After all, sugar is cheaper, and more convenient to handle.

Actually, MY doctor recommends that NO strong acids, like citric acid in
lemon juice, be used when a sore throat is present, since the acidity
can further inflame the raw tissues.  He DID recommend hot, weak tea with
sugar, or dilute fruit juices.  He said that the sugar had a soothing
effect, and that a saline solution gargle or chicken soup (fresh, not
the boullion cube variety) would also help.

>I've read that Roman soldiers used honey as a balm for binding wounds.
>If honey really has no such antiseptic effect, then why doesn't it spoil
>when stored at room temperature?

Honey doesn't spoil at room temperature because bee spit has a weak
antibiotic effect.  However, if you leave it uncovered, which the bees
do not, it will mold if it stays out long enough.  Not a lot of things
WILL grow on a pure sucrose base, though, at least, it wasn't too good
as a culture medium back in bio class in school.  Proteins were lots better.

Hutch

hutch@shark.UUCP (Stephen Hutchison) (07/30/85)

In article <1486@shark.UUCP> hutch@shark.UUCP (Stephen Hutchison) writes:
>In article <34@unc.UUCP> fsks@unc.UUCP (Frank Silbermann) writes:
>>In article <cadre.467> geb@cadre.ARPA (Gordon E. Banks) writes:
>>>However, the "raw honey" information posted was sheer superstition.
>>>Raw honey has been reported to cause botulism in infants, but otherwise
>>>no significant health differences have been discovered between this
>>>bee-sugar and cane or beet sugar.
>>I've read that Roman soldiers used honey as a balm for binding wounds.
>>If honey really has no such antiseptic effect, then why doesn't it spoil
>>when stored at room temperature?
>
>Honey doesn't spoil at room temperature because bee spit has a weak
>antibiotic effect.  However, if you leave it uncovered, which the bees
>do not, it will mold if it stays out long enough.  Not a lot of things
>WILL grow on a pure sucrose base, though, at least, it wasn't too good
>as a culture medium back in bio class in school.  Proteins were lots better.
>
>Hutch

AHA!   Mere moments after I finish this reply, I am embarrassed to see
the discussion of the real reason: osmotic pressure.  Right, duh, now
I remember.  Bacteria can't grow because they keep being forced into
spore state by the nasty dehydrating environment.  Oh well

sean@cadre.ARPA (Sean McLinden) (07/31/85)

In article <1066@cbdkc1.UUCP> tjs@dkc1.UUCP ( Tom Stanions) writes:
>... Many
>sicknesses are natural and neccessary for health.  Colds clear the body of
>catarrh and other build ups, some sicknesses are the body removing problems.
>The worst thing to do in many cases (and the first thing that doctors
>often do) is to suppress the symptoms.

What?? Colds don't "clear the body of catarrh" (a Hippocratean term for
mucosal inflammation), the "catarrh" is the body's response to invasion
by an unfriendly organism (the virus causing the cold). And while I agree
that too vigorous a concern for alleviation of symptoms can, in fact,
be damaging, the truth of the matter is that in many cases the RESPONSE
of the body to the disease is more damaging than the disease, itself.

Perhaps you would also have us believe that flys come from horse manure.