A new illness has steadily risen its head in conjunction with the rise
of modern medicine, it is called iatrogenesis - doctor induced illness.

A BRIEF HISTORY OF MEDICINE IN THE 19TH + 20TH CENTURY

19th century America had several competing medical approaches.  No single
school of thought was dominant.  It was so easy to become a doctor that
there was a glut on the market, leaving most poor.

The 19th and early 20th century saw the "regulars" fight for monopoly.  The
"regulars" were allopaths, who treated the middle classes.  Their
middle-class constituency gave them an advantage over the rest.

At the beginning of the 19th century, the "regulars" used their influence to
have laws passed in state legislatures. The "regulars" argued, "the public
must be protected from quacks.  Only the regulars should be authorized!",
even though the public wanted choice in health care practitioners.

By the middle of the century the laws had been repealed by the rising tide
of populism - grassroots, feminist, anti-slavery.  This was called The
Popular Health Movement.

An important contributor to the movement was a poor farmer, Samuel Thompson.
Thompson observed that members of his family were suffering at the hands of
"gentlemen doctors" and felt that healing should soothe, not injure.  He
remembered herbal cures he learned as a boy from an old woman.  In 1822, he
recorded the knowledge in a book.  Thompson felt that, "by learning to heal
ourselves, we can break our chains of dependence on experts."

By 1839, 100,000 copies of his New Guide to Health had been sold.  At its
peak, Thomsonianism embraced nearly a quarter of all Americans.  It was
democratic in giving people power and knowledge to heal themselves.  It was
political in pushing women's and working class issues.

But in 1838 Alva Curtis split from the annual Thomsonian convention and
established the Independent Thomsonian Botanical Society with the view of
monopolizing the techniques by a new elite.  The popular movement petered
out.

In 1847 a group of doctors followed the British example and formed
themselves into the American Medical Association.

"Any occupation wanting professional status creates a systematic body of
theory.  It claims the exclusive authority of its practitioners and adopts a
code of ethics.  It tries to build solidarity amongst its practitioners
around formal values, norms, and symbols.  And it cloaks itself with the
medallions of professions to supports its claims.  If there is no body of
theory, it is created for the purpose of being able to say there is."
    Eliot Friedson quoted in 'Rockefeller Medicine Man'

But at the beginning of the 20th century "regulars" faced competition from
all sides.  Apart from the numerous alternative healers, there was an excess
of "regulars" themselves.  They were being churned out by the many
proprietary schools, the only entry requirement often being ability to pay.

In 1901, the American Medical Association (AMA) responded, "the growth of
the profession must be stemmed if individual members are to find the
practice of medicine a lucrative profession."  Journal of the American
Medical Association, 1901

So the AMA adopted The Ideological Solution.  At the time, the public was
replacing religion with science as the legitimate source of truth.  The ADA
would cloak itself in science and award itself special status in its pursuit
of "truth".  In 1893, John Hopkins University put labs in its medical
school, and staffed them with men committed to scientific research.  But
labs were expensive.  If they were made a requirement for medical schools,
most would go bust, neatly reducing the number of doctors produced.

Medical research was funded by corporate capitalists, including John D.
Rockefeller (1839-1937) and Andrew Carnegie (1835-1919).  Having accumulated

colossal fortunes they set up philanthropies to distribute their surplus
cash.

The new capitalists brought a new industrial ideology.  It fitted into their
mechanistic world-view.  The engineers they employed rationalized the
production process by dividing tasks into mental and manual labour along
scientific lines.  They thought a similar approach to medicine would be just
as effective.

The AMA had "science" as an excuse to monopolize medicine.  But it needed a
hit-man to waste the opposition.  In 1907, the AMA found it's hit-man and
commissioned Abraham Flexner, head of the Rockefeller Institute for Medical
Research to survey all medical schools.

The Flexner Report concluded:
1. fewer doctors can be produced by making education inaccessible
2. to support #1, medical training should be longer and harder
3. Negroes should only practice on Negroes. 5 out of 7 Negro medical schools
should be closed
4. there was no demand for women doctors.  All of the 3 women's medical
schools should be closed (in 1973, only 17% of medical students were women)
5. with Negroes and women out of the system, Flexner turned to ridding poor
people from medical practice.  To do this, they closed schools without the
"proper" labs and increased medical training time, making fees more
expensive and driving out the poor
(in 1973, only 12% of medical students came from the poorer half of the
population)

The Flexner Report put medical power in the hands of a small clique of
white, middle class men.

By emphasizing laboratory medicine, it turned health-care into an expensive
commodity.  An expansive commodity that had a dynamic of its own.  The
voracious appetite of the process required even more research and
investment.  Between 1962 and 1975, the proportion of the U.S. gross
national product going on health-care rose from 4.5% to 8.4% [I understand
that its about 14% today].  In 1975, $95 Trillion was spent. In spite of
this boom in the health sector, male life expectancy recently began to fall.

Amongst its critics, Ivan Illich coined the term "iatrogenesis" - illness
caused by the medical profession itself.  He saw 3 finds of iatrogenesis:
1. clinical iatrogenesis is organic doctor-made illness
2. social iatrogenesis refers to the medical-industrial complexes role in
maintaining a sickening society
3, cultural iatrogenesis saps people's will to suffer their reality (ex.
overprescription of antidepressants)

Illich concludes that the medical establishment does more harm than good and
should be abolished.

Rob B.