By Gerald N. Grob
Utilizing historic and modern information and case reports, the authors additionally learn tonsillectomy, melanoma, middle ailment, nervousness, and melancholy, and determine modifications among rhetoric and truth and the weaknesses in prognosis and remedy.
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Additional info for Diagnosis, Therapy, and Evidence: Conundrums in Modern American Medicine
The belief in the concept of speciﬁc diseases, oddly enough, is of relatively recent vintage. Until the late nineteenth century physicians conceived of disease in individual rather than general terms. Health was a consequence of a symbiotic relationship or balance between nature, society, and the individual. Disease represented an imbalance; its symptoms were ﬂuid and constantly changing as the body attempted to restore a balance. 29 Early efforts to develop some sort of nosological or disease classiﬁcation system ﬂoundered, largely because such systems were based on descriptions of symptoms.
13 Even before RCTs came into existence, surgery for peptic ulcer was beginning to come under scrutiny because of its risks and subsequent complications. Indeed, the absence of a consensus on the value of surgery was demonstrated by the existence of sharp differences in the frequency of hospital referrals to surgery. ” Medical facilities often had very different therapeutic styles. The Mayo Clinic in Minnesota—an institution created by brothers trained as surgeons—referred 45 to 65 percent of its patients with gastric ulcer to surgery in the ten-year period beginning in 1935; surgical treatment for duodenal ulcer declined from 26 percent in 1920 to 12 percent in 1944.
Despite the great uncertainties that underlie psychiatric diagnoses, they are widely considered to reﬂect empirical ﬁ ndings and psychiatric knowledge. The chapters on anxiety, depression, and PTSD illustrate the key role of a variety of professional and non-professional interest groups in shaping the classiﬁcation of disease. The conﬁguration of these groups at any particular time shapes the extent to which symptoms will be deﬁ ned as natural or as pathological. While the framework of debates regarding these conditions is usually phrased in scientiﬁc rhetoric, at bottom the debates reﬂect ongoing controversies about the nature and causes of human suffering.