pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

More Medical Proverbs – Do They Work?

December 1, 2018

We’ve already talked about medical proverbs such as “cold hands, warm heart,” “feed a cold, starve a fever,” “drink eight glasses of water a day,” “cigarettes will stunt your growth” and that “apple a day”… thing.

But there are some we left out because the list was getting a bit long for one sitting. I’m going to take another shot at listing a few more, some from the “dawn” of medicine and others which are beginning to hit up against the way doctors are practicing medicine these days!
Hippocrates’ aphorisms still true and applicable today

Medical Proverbs
Any truth to them?

Next to accountants, doctors are probably the most “concrete” people there are. Let things get a little catawampus or out of kilter and we want to design a study to see why and how to “fix it.”

Give us an aphorism… and we want to test it.

Whoever Is Desirous of Pursuing His Medical Studies Must Pay a Good Deal of Attention to the Different Seasons of the Year

Clear back almost 500 years before Christ, good old Hippocrates noted the correlation between patients health and the seasons of the year for his “medical students.” He was talking about the climate in general.

As medical proverbs go, the reason this one has stuck is because each succeeding generation of doc’s has seen its usefulness… and we still do today. Europe noted seasonal variations in even the “plague” and “consumption.” There are seasonal variations in Malaria cases… and, pediatricians have noted such variable incidences of “croup.”

Infectious diseases such as Lyme disease and influenza have such strong seasonal trends they are recognized easily by the public; but, what about non-infectious diseases.

Yes, studies show the incidence of heart disease is linked to both cold and hot weather. Pollution, strongly related to climate, is a major factor in such common problems as heart disease and asthma.

Hippocrates would not be surprised in the least that this aphorism is proven ; and he didn’t just stop at seasons. He wrote a whole manuscript of aphorisms including: “Without exercise, a good diet alone is not sufficient and eventually medical treatment will be needed,” “Walking is man’s best medicine” and “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.”

The Sick Should Be the Doctor’s Books

This saying by Paracelsus (1493-1541) is the most endangered of being totally forgotten of any I’ve mentioned so far; and, I dare say, comes as a complete and total surprise to perhaps most doctors trained in the last 15–30 years!

Yea, I know they all like to blame it on the Obama administration’s complete decimation of medical practice through all the draconian demands and limitations of medical record paperwork and data entry; but, when was the last time YOU got a “GOOD” physical exam? You’re even lucky these days IF THE DOC EVEN LOOKS UP FROM THE COMPUTER AND LOOKS AT YOU!

For the most part an increasing number of docs have given up. They treat data, lab and x-ray as though they think it will tell them everything they need to know in order to fill in the blanks on the forms to submit to the government or insurance for payment.

There it was, way back in the 1500’s, the physician’s of the time knew they didn’t understand everything; BUT, they did know that a physician should look to the patient and develop the skill which would tell them what the patient needed.

This proverb implies that acquiring the knowledge to become a physician should be patient-oriented. Wouldn’t it be great if this still was the current focus of today’s medical study curriculum, with increasing emphasis on a patient-centered learning process, supplemented by lectures and texts.

Sometimes the Remedy Is Worse Than the Disease

This saying is attributed to Sir Francis Bacon back in the 15-hundreds—in actuality before the beginnings of what we now call scientific medicine.

Back then, the prevailing thought was that the body was composed of various “ethers” or “humors” which were out of balance in disease. Back then the very blood in the body served an unknown purpose.

Back then, “blood-letting” was thought to be a “cure” for many illnesses. Think about it. How did the person who tried it first come up with it? And, what happened that it ever got repeated… and over and over?

This is clearly a procedure which was worse than any so-called “disease” it was called upon to treat.

And lest you sit too smugly, little changed to dispel the aphorism even to the beginning of the 20th century.

William Osler, known as the father of modern medicine, said: “The person who takes medicine must recover twice, once from the disease and once from the medicine” making the proverb sometimes

Eat to Live, Not Live to Eat

Socrates (469-399 BC) wrote this down 1549 years ago! Remember, back then (well I guess you wouldn’t would you) the majority of morbid obesity was only seen in the “fat aristocrats” whose lives were one big opulent orgy—and they weren’t to well thought of.

But Socrates noted the curse of gluttony obvious enough to write about it back then; and others over the 15-hundred intervening years have added their hearty: “Amens.”

Today, in the 21st century, we will forever be known as the era of the global epidemic of obesity. The era when the number of earth inhabitants who were overweight surpassed the number who were malnourished! (literally)

There are those with their head in the sand who’d like to think obesity is all genetic and not consider empty nutrition, gluttony, sedentary lifestyle, a food industry full of avarice and laziness as part of the problem at all. After all, that avoids any real work and we can merely wait for gene splicing, fecal implants and pharmaceuticals to catch up.

There is no question that, looking at it universally and globally, there are a lot of factors and not just one cause for everyone; BUT, EVERY SOLUTION INCLUDES EXERCISE, AVOIDING CRAP FOOD AND PUSHING AWAY FROM THE TABLE!! (sorry!)

When the genetics are better understood and so-called “technology” catches up, all that will do is even the genetic playing field and make it easier to maintain weight for those with the “bad genes” making this medical proverb

Health Checks Add Minutes to Your Consultation Without Adding Any to the Patient’s Life

This is a quote from an Australian practitioner which, fortunately, has NOT become a proverb; but, seems to have caught on with a huge number of US practitioners in this age of Obama mandated data-entry and regulations.

Many doctors have solved the draconian paperwork-database problem by hiring a secretary to be in the room with them and take down all the minutiae which now has to be data-entered into databases… well that makes it awkward to undress and even disclose the truth, so they don’t want to or won’t.

On the whole, this statement is almost the stupidest cop-out I’ve ever heard! And, as Dumbledore said: “frankly, it disgusts me”… more than a little.

“Adds NOTHING to the patient’s life??” Tell that to the 12-year-old who I found an abdominal mass on routine exam which led to him having it removed BEFORE it became UN-removable! Tell that to the 6-year-old girl who we caught meningococcal meningitis when it still looked like a “cold” all because we actually DID A GOOD EXAM like we were taught in medical school!!!

You can tell even thinking about this upsets me because of the cavalier attitude I see in many physicians these days. It is true that, for the most part, significant illness is not common in children.

Perhaps only one in a hundred “stomach aches” turns out to actually be a tumor, perhaps only one in 70 “colds” turns out to actually be meningitis; but what if that is YOUR “one?” You can bet the code they are billing you with, charges the full charge for “complete history and physical”; do you really want to be cheated out of a good physical?

A doctor can be too lazy to have them undress and get away with it most of the time – that’s the problem. They might rationalize “If it was that bad they should have gone to the ER in the first place,” after all. “Chances are they’ll be back if it gets worse.” “If it get’s worse chances are they’ll see someone else who’ll do a thorough exam.”

Basically the never-ceasing disclaimers about “hanging up and going to the ER” you hear EVERY single time you call the doctor are telling you loudly that YOU are totally responsible for obtaining care for yourself and your children 24/7—including the four weekdays a week the receptionist actually answers the office phone!

Although they probably should be put on the endangered species list, there still are good doctors left and you shouldn’t have to settle for a rushed or partial exam or care.