THE SCIENTIFIC METHOD
Science has been a latecomer in the world's history. Up until the 20th century, there was no precise testing of any treatment. If the patient didn't die and did recover, there was acceptance that whatever treatment was given must have worked. Most of what was done for the patient was ineffective but harmless. At times, it was downright dangerous. For instance, our founding father, George Washington, was bled in 1799 when he had pneumonia, undoubtedly hastening his death. Benjamin Rush, the great Philadelphia physician of the 1770s, likewise, treated almost every ailment with purging, i.e. laxatives, helping none and probably hurting many. In the 1800s, things hadn't really changed very much. And why? One main reason was that there were so few really effective treatments for any medical condition. Even as late as the 1950s, the effective medications could almost be counted on one hand: the heart medicine digitalis, aspirin, sulfa and another new antibiotic called penicillin, a few toxic diuretics, some hormones, Maalox for indigestion, lots of laxatives and an herb called belladonna (in Spanish it means beautiful lady - the girls put the liquid in their eyes to dilate their pupils and attract men to their large luscious eyes). Belladonna in gastroenterology was used as an antispasmodic to relax the intestinal tract. Even though there was little to offer (we didn't really know it at the time) patients still came to see physicians. And, despite our ineffective treatments, patients did get better.
So what is the Scientific Method on which all modern medicine and, indeed, much of science and technology are based? Simply put, it means that a treatment or a hypothesis is subjected to rigorous testing to see if the treatment works or if the hypothesis is true. For instance, a scientist hypothesizes that a drug will be effective in treating a certain disease. The fact that the scientist wants to believe it does not make it so. Objective testing must be done. Where possible, the double blind test is performed. Neither the patient nor the researcher knows who gets the active drug and who gets the placebo sugar pill. This eliminates biased reporting on the part of both individuals. The results are measured and then the code is opened to see if the treatment did anything good. When there is a significant difference as measured by a complex statistical formula, then we can say the treatment works. Sometimes, it doesn't work or it actually makes the patient worse. Still, it is the best system we have. All scientists, not just doctors, use this technique in one form or another. The federal Food and Drug Administration (FDA) uses these scientific guidelines to approve new treatments. So whenever someone or some published article mentions a great treatment for some disorder, we need to scrutinize the data. Testimonials by individuals don't really mean much. They can sound great but, from a scientific viewpoint, they are almost meaningless. In fact, they may actually be damaging as there may be a serious underlying problem such as cancer, which is not discovered early.
The FDA gets a lot of bad press. However, they do an enormous amount of good. To the extent possible, they assure us that the food we eat is safe. They brought us the new food labels that provide a great deal of valuable information for the consumer on calories, fat, sodium and other nutrients. They regulate medical devices such as heart valves and kidney dialysis systems. We would never buy a heart valve from Radio Shack and ask a physician to insert it just because a friend said it was great. Likewise, the FDA regulates the pharmaceutical drug industry. These manufacturers, at times, become frustrated with the FDA's regulatory and bureaucratic burden. But believe me, the public benefits by being assured that the prescription medicines they take and the medical devices used on them have undergone rigorous scientific testing, the Scientific Method. Who would want it any other way? So, remember the Scientific Method in the rest of this essay.
Frank W. Jackson MD
© 1998 fwj
updated 8/2006
fwj@comcast.net
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