The only significant health care advances we've made are better nutrition and hygiene.

Take two and call the doctor in the morning... and get charged $50 for the walk-in visit.

We got a speech from the obstretrician about four years ago that went something like:

'In the fifties, we told pregnant women to do , and that was terrible. Then in the sixties, we told them , which was nearly as wrong; in the 70s, it was , which was madness; in the 80s and 90s it was , which wasn't really right either.

Now, *here's* what you need to do:'

This last bit was given with a perfectly straight face, and I was only just able to keep from bursting into laughter.

Check this one out:
http://www.guardian.co.uk/medicine/story/0,,1781002,00.html

Anyone who claims that we know the first thing about how the brain works is full of it.

The only significant health care advances we've made are better nutrition and hygiene.

That is nonsense that I'll bet you don't really believe, and that I'll go double or nothing that you don't act upon.

What did you just lose?

I would add vaccinations to that list. Some diseases like cholera and typhus are eliminated by proper hygiene, but many others aren't.

I know what you mean when you say "significant", but I think to say so overlooks a whole host of advances that don't necessarily cross the threshhold of world changing. Dentistry comes to mind. And from my personal experience, I suffered a terrible leg injury that would have left me lame in any other day and age, and thanks to the miracle of surgery, I can walk normally.

John Adams received innoculations.

Anti-biotics.

Blood transfusions.

Effective anesthesia.

Insulin.

Cataract surgery.

Kidney transplants.

And so on. Sure, there is a lot that gets forgotten, and the simple things still work best. But, not all that is new is suspect (or insignificant).

You youngun's don't remember the scourge of polio. Pneumonia and yellow fever were almost always fatal, not to mention tetanus and other infections.

Nutrition and hygiene are crucial as the first line of defense, but other life savings inventions have made our lives immeasurably better.

That's just counterfactual.

But Orrin's basic point is surely valid, even if he forgot antibiotics. Since hygiene, antibiotics and antiseptics it is very hard to know what general advances are due to medicine and what to prosperity. The rest is all very disease specific and not without ambiguity. Erp, did you realize you (and Jim) are still celebrating major advances that are more than half a century old while the medical establishment is feeding us with daily reports of great new advances that keep us beholden to their authority? I'm sorry to be brutal, but at times I have to wonder whether modern medicine (not individual doctors)isn't 90% focussed on extending death more than saving lives.

I didn't forget antibiotics. They just aren't that significant.

They are if you're wounded. Emergency and trauma care have improved significantly even in the last 25 years, thanks to warfare, crime and the automobile. Compare survival rates for seriously wounded soldiers from the Vietnam era to today.

There are too few for it to be significant.

Speaking of nutrition and hygiene, lack of them is apparently what caused the Aztecs to be killed off from hemorrhagic fever, while the better nourished and cleaner Spaniards were saved:

http://www.discover.com/issues/feb-06/features/megadeath-in-mexico/?page=1

OJ -

Your comment about soldiers and survival rates is perhaps (technically) accurate, but just for soldiers. Don't be obtuse. I suspect what Joe really meant was that the lessons learned in military trauma care have greatly increased the survival rates for all trauma care. As an example, the new materials (based on crustacean shells, I believe) used to provide and promote coagulation for battlefield injuries, are coming into wide use in hospitals.

Peter, I take your point. I did have to think for a few minutes to make my list, and even as I did, I recognized none of it was "new". Some dramatic developments are, such as re-attaching severed limbs, cellular and genetic approaches to fighting cancer, micro-surgery, in-vitro fertilization, surgery in utero, etc. You are probably correct about fending off death, although I don't think that a brutal observation.

However, a clean source of water and lots of anti-bacterial soap would change life in Africa and much of Asia more than any of these developments. That it still hasn't happened 40 or 50 years after the obvious is a pretty brutal statement in itself.

Jim: thanks, but no. I'm pretty sure all the ones who come home who would otherwise not have are significant. Come to think of it, so are the ones who don't.

jim:

Such drastic trauma cases aren't significant.

Of course, I realized that the cures I mentioned were 50+ years old, but then nutrition and hygiene are even older.

It depends on your goals whether you think medicine should prolong life (or delay death, if you prefer) or just let nature take its course and allow us to die off when nutrition and hygiene aren't up to the job of fighting off infections or regenerating failing organs.

Here in geezerland, lots of us, men especially, are alive and kicking because of by-pass surgery, diabetics are kept alive with improved methods of monitoring insulin, kidney dialysis and organ transplants are prolonging life as well. Knee and hip replacements are common so we can still get around without assistance and not bother our kids with the tedium of worrying about us.

My 91 year old mother died a couple of weeks ago from vascular dementia aka hardening of the arteries. Not a pretty sight I can tell you. She was perfectly healthy except that her arteries failed to supply blood to her organs and her body quietly closed down until she stopped breathing. For the last couple of months, she was medicated so that she was comfortable and totally out of her mind.

I thank God that she didn't last too long in the state of, as the death certificate said, end stage dementia.

Nope. Hips and stuff may improve quality of life for a few folks, but the rest just doesn't have a significant effect.

Here's another - the treatment of stomach ulcers has totally changed since 1983, when Australian doctors announced that bacteria actually caused them. After the laughing stopped, and people looked at their work, it was confirmed.

In that vein, the new medicines for acid relief are also a positive development for many people. And some of them are even OTC.

Now remember, just because this stuff gets ad time on TV doesn't mean it is not significant.

Nice if you get tummy aches, but not significant.