__________AidsMyth.com
Medical Ignorance &
The Democracy
of Intellect
12th June 2000
By Professor
Dr. Manu Kothari
Department of Anatomy,
Seth G.S. Medical College, Mumbai, India.
Member of the SA AIDS Panel
AidsMyth Dissident
News & Jethu Mundul in India
Stylistic Edit by Fintan Dunne
In 1996, the KEM Hospital, in Mumbai(Bombay) the institution
where I work, celebrated its 50th year. And the Dean asked me to suggest to
him a rather unusual, offbeat topic for a conference to be held. So I said,
Sir, why don't you hold a first ever conference on Medical ignorance. And
he started laughing. He didn't take up the issue for the simple reason, he
said, that if this conference is held, money flowing in from pharmaceutical
firms will cease! So I said, O.K. sir. I give you a guarantee that I will
organise the conference, but not talk at it. But somehow it never came to
pass.
Now, the recent AIDS Panel meeting that took place in Pretoria at the
behest of the President Mbeki, was to decide
whether the orthodox group is right that HIV causes AIDS, and AIDS is a fatal
disease that must be treated with emergency measures - or whether there is
not much substance in the entire hypothesis, as a very small group on the
other side thinks. And I think it was very bold of the President, to intellectualize
the issue and bring us together.
Peter Duesberg is the pioneer dissident, one
might say, who doesn't believe that an HIV virus causes AIDS, and who doesn't
believe that AIDS should be treated in the current manner. Peter points out
that the orthodox group seems to be poorly read, yet the dissident group which
is very well read, is not listened to for whatever reason.
MEDICAL IGNORANCE
All this spurs me to discuss the failure, or otherwise, of medicine in such
leading areas as cancer, heart attack, hypertension, stroke, diabetes, arthritis,
peptic ulcers. First let's go back to a very important book which from the
Rockefeller Foundation in 1977 called 'Doing
better and feeling worse, Health in the United States'.
Now, who is "Doing Better"?
Until the '60s, the United States used to spend about 8 billion dollars a
year on health. Now it is spending 1.25 billion dollars a day. Moral of the
story : doctors, hospitals and manufacturers are having a gala time!
And who is "Feeling worse"?
Obviously the patient! And the 1977 conclusion that patients are feeling worse,
remains unchanged as of May 2000 A.D.
The question is "Why so"?
In the first chapter written by Lewis Thomas,
a Yaler, philosopher, physician, and who was lately the Director of Sloan
Kettering Institute, he says, "..When it comes to these
major issues like cancer, heart attack, hypertension, stroke, diabetes, arthritis
and peptic ulcer.. Medicine knows next to nothing"! And in the same
book, there is another medical physician Wildarsky,
who says that in 9 problems out of 10, medicine can do precious little. In
fact, there is a global survey that 9 prescriptions and procedures; 9 investigations
or whatever out of 10, are not only unnecessary but unwarranted!
Why have we come to this?
We have come to this because, I think, beginning 1930, technology started
taking over thinking. Betrand Russel, circa 1930,
said that Modern Education teaches how to do, but not how to think. The common
man wants Medicine - like Justice, to be not only done, but be seen to be
done. And so, he demands therapy not only be done, but be seen to be done.
Assertive action has become a priority issue in medicine, however wrong it
may be.
Now with regard to AIDS, let me point out a few epistemological principles
which come to the fore. Epistemology is the science of knowledge. It is a
science which takes any piece of information and weighs its worthwhileness,
its possibility, its impossibility or its uselessness. Consider that about
300 years ago, an apple fell on the bald pate of Newton and gravitation was
born. Since then we have been studying gravitation left, right and centre!
We know everything about it to the 10th decimal point. But one thing remains
certain, we can't alter gravity. As Robert Arturu
says,"The apple must fall down"!
Therefore, no matter how much we know everything about cancer cells, that
in no way will allow us to alter the cancer cell. In fact, Lyall
Watson on the European side and Lewis Thomas
on the American side, both have generalised that the biggest discovery of
the 20th century is the discovery of Human Ignorance!
Back in 1977, one of my American students, sent me the 'Encyclopedia
of Scientific Ignorance'. This was followed up by Pergaman
Oxford in 1979 with the 'Encyclopedia of Medical
Ignorance.' These two encyclopedias more than underscore what Lyall
Watson and Lewis Thomas said. Let us go back in the hoary past to Shankaracharya.
He said in 9th century, that if "Gyaan"(knowledge)
is "Aananth"(happiness), so is "Agyaan"(ignorance).
And much later Blaise Pascal said that knowledge
is the inner surface of the sphere, whose outer surface is painted with ignorance.
So sometimes when somebody tells me that I am well read, I tell him that I
know that I am very very ignorant, because the more you know, the more exponentially
you become ignorant.
And that explains to you why some of the greatest people who are very learned,
are almost painfully humble. You almost get irritated that this man knows
so much and yet he pretends to be humble. But in the depths of his heart you
see, he knows that he doesn't know!
THE DEMOCRACY OF INTELLECT
I am a teacher, and so I've got to teach my students. And I often ponder what
is my role here? Then I realise that I am a member of "the
democracy of intellect". This is a phrase used by Jacob
Bronowski in one of his small books titled 'Democracy
and Intellect'. There is neither dissidence nor proponence. There is
only a democracy of intellect. And what is my task? The task of any teacher
is to take the student to the outer limits of knowledge and to the beginning
of his ignorance, thereby establishing an epistemological equality which must
be at the heart of any democracy.
So thinking along these lines, in our own department where I have been teaching
for the last forty years, we have very cardinal principles. That on the first
day, the student must learn to have a healthy disrespect for the three T's....
teacher, what is taught and the textbook. And towards that end we encourage
them to take an oath which was supposed to be a ritual in early Europe, especially
in particular universities. You take an oath, that here I have come not
to worship what is known, but to question! Question, question and question!
Therefore, the issue of HIV/AIDS also demands questioning.
TOO LATE FOR CANCER
Now to help our questioning on HIV/AIDS, or rather, to have a moral right
on this issue, let us take other fields where things seem pretty clear.
In 1946 Augustus Bier wrote, that all you know
about cancer can be written down on a visiting card! And still today it remains
unchanged. Around 1983, James Watson of the double
helix fame, characterised cancer research as intellectually bankrupt, financially
ex-invigorating and therapeutically useless. And he said cancer establishments
are a lot of shit. That is the term he used.
Sir Meg McFarlen, the Nobel Laureate, summed up the entire Nobel scene, and
he said that after a thousand years of work, the outcome is precisely nil.
And today what has happened is: the cancer cell no longer is taken as a structural
entity. The cancer cell is taken as one more form of normal cells. Now the
question is: what is cancer cell and what is normal cell? Albert
Szent-Gyorgii, the Nobel Laureate for the discovery of vitamin C and
actin myocine, while chairing a session in America at the 69th Ciba Symposium
on Sub-molecular biology and cancer, on the last page, he is asked, "Can
you define what is a cancer cell?" And he says, typically of a
humble person,"My dear sir, how can I tell you what's
a cancer cell when I don't know what's a normal cell?" Yet in the cancer
establishment, the bogey of the cancer cell as a vicious, savage cell is being
sustained.
Another unholy humbug which they are sustaining, is that chemotherapy and
radiotherapy are useful because they tend to kill the more fast multiplying
cells as compared to normal cells. This went on until cytokinetics arrived.
And cytokinetics arrived to destroy two illusions. Cytokinetics showed that
- if at all, cancer cells multiply painfully slowly, with the result that
when you give radio therapy and chemotherapy, before you kill a single cancer
cell, you will destroy a million normal cells. That is the trade off, okay?
And the other illusion which it destroyed was that of early diagnosis, yet
we still drumbeat early diagnosis. From 1802 through the 19th and 20th century,
some of the most leading thinkers have shown that early diagnosis is not possible.
This was said intuitively. Then came cytokinetics. And cytokinetics has shown
that before a tumour assumes one milligram of weight, which no scan ever can
detect, it's a billion cells strong! And to arrive at that it will take a
few years. Which means that by the time a cancer is diagnosed, a symptomatic
silent cancer - diagnosed and detected by the most sensitive scan, it has
been in the patient's body from 5-20 years.
CANCER IS UNRESEARCHABLE
And therefore, when I think about this bogey of early cancer, I say, quoting,
almost paraphrasing Churchill :"Never
in the history of science has so much untruth been told, by so few, to so
many, for so long". We wrote the 10th chapter of our smaller book,
because Ivan Illich realised that the larger
volume 'Nature of Cancer', at 1000 pages, meant
few would read it. So he said. Manu, bring it to one tenth, and we brought
it! The 10th chapter was titled : 'Cancer is unresearchable'.
When I sent it to England, my publisher said, Manu, you are in the habit of
joking, but this is carrying a joke too far! So I said, what you do is circulate
this chapter among top cancer specialists in England, and if they ask me to
modify it - I'll do it. If they ask me to drop it, I'll drop it. On purely
intellectual grounds they could do neither. That chapter has stayed in the
series of additions and translations and we have shown that cancer is unresearchable.
1979, 14th March was the 100th birth anniversary of my beloved Einstein,
And therefore, (Dr.)Lopa and I decided to pay
a tribute to him. Why pay a tribute to him? Let it be known to the whole world
that in the words of J.B.S. Harding, Einstein
has been the greatest Jew after Jesus Christ! So Lopa and I wrote an article,
On Time, Uncertainty, Relativity and Normality in Medicine.
It was published in Chicago. The title was "Trans science
Aspects of Disease and Death". Maintaining that from the common cold
to cancer, basically science can do nothing about its cause, about its course,
or about its cure.
So some friend told me, I'm a Luddite. I don't know what are technological
advances. There is MRI. There is CT Scan and therefore, he says, just see.
So therefore the next chapter was, "Trans technique
Aspects of Diseases and Death." Believe me, up till today, about
cause, course and cure of common cold, cancer, coronary, heart attack, hypertension,
stroke, diabetes, HIV and AIDS, medicine knows next to nothing. And medicine
must accept that it knows next to nothing. Okay?
About diabetes. We seem to know that there is diabetes and we treat with anti-diabetic
drugs. But I think we are kidding! Diabetes is a multi faceted problem. Protein
metabolism is disturbed, fat metabolism is disturbed, sugar metabolism is
disturbed, arterial health is disturbed. At the moment we have only one parameter,
glucose level. So we give a drug to bring the glucose to the doctor's desired
level - not necessarily to the patient's comfort. And you call it curing diabetes,
treating diabetes! You're kidding.
I think, some years ago, there was a Conference held only to define Diabetes
mellitus. And at the end of 3 days, they gave up, saying that it can't be
defined. Medicine has not defined hypertension, medicine has not defined heart
attack, medicine has not defined cancer, medicine can't define arthritis,
and medicine can't define HIV and AIDS! It Can't! When you are so grossly
deficient, how can you research?
BYPASSING THE BYPASS
At the moment I am writing the ABC of cardiology. A for artery, B for blood,
C for codium or heart. And what is my revelation? I thought that cardiologists
must be knowledgeable people, but there is profound ignorance! There is not
a single genuine anti-cardiac drug, not a single one.
And I must wax eloquent on angiography, angioplasty and bypass. It was in
1993 that Renu Varmani, trained here, but now a big person in America, majestically
declared "We no longer trust coronary angiogram in the
USA. We go for intracoronary ultra sonogram". So I said, "Madam,
should I put an obituary in the Times of India tomorrow, that coronary angiography
is dead?" She said "You must pay, you must do
that." But then she said "When you do angioplasty,
the coronary arteries are invariably torn". So I said, "Shall
I announce tomorrow that coronary tear is part of coronary care?" She
said "Yes". And what is the bottom line today?
That angioplasty does not lengthen life and creates many complications.
And if you put a stent inside? Stent induced stenosis of the arteries is today
described as the most common iatrogenic, malignant disorder. Okay! I have
just received a download from American College of Cardiology and American
Heart Association, which says angiography is unreliable! Therefore you do
intracoronary ultra sonogram which is unreliable, therefore you do thalium
optic study which is unreliable, therefore you do coronary angioscopy! All
four together are unreliable. Now the fact that they are unreliable, I translated
into the fact that if you do angioplasty and bypass, nobody's life is lengthened.
No one!
Let's go to bypass. Let's take Harrison's Textbook of
Medicine Large volumes, Volume One and Two.. Nearly two and a half
thousand pages, which I have followed from 10th to 14th edition, 1983 to 1998!
Fifteen years and Five editions! And you go to the section, coronary bypass...
and what does it say? We don't know how bypass works! But the following are
the three theories.
1) Placebo is effective 64%! This 64% I got from another book, but
no wonder N.Y.Times once described coronary bypass as the costliest Aspirin!
Okay, you spend a lot of money, and you are convinced that the right thing
has been done.
2) Sensory neurectomy. Because the pericardium is cut, nerves are cut,
the heart is botched up as ever. But because the fellow doesn't feel the pain,
he does get alarmed any longer.
3) And perhaps the worst is in cold print."Bypass
probably works by infarcting the ischaemic segment", translated into
ordinary language, it means, bypass - by killing the complaining segment.
So the segment is killed. It's nerves are killed and the fellow is pain free
immediately on the operating table. But moral of the story... bypass is a
surgery which is very very unscientific, to say the least.
And I have a book, History of Coronary Revascularization,
by Richard Preston, one of the Brooklyn cardiologists.
And he has stated from 1890 till today (and this is a book around 1978), he
asked his cardiologist friend, why they were selling an operation which had
very poor rationale. And the reply was the consideration of the economy. This
is a marketplace, my client wants to buy, so I want to sell!
HEART OF THE MATTER
Moral of the story, what do we do in cancerology or cardiology? We cannot
attack the primary problem, precisely because there is no problem! It's a
part of growing. Okay? Everybody gets it. So you can't treat everybody, but
what do we do? Whenever there is a symptom, when cancer causes lump, in case
the lump is bothering the contours and the beauty of the person, remove it!
If it is blocking a tube, remove it.
Moral of the story, Tata(Mother) hospital has to ease, provided there is dis-ease!
Presence of cancer means nothing, okay? In fact, may I read out to you from
Boyd's Pathology, that cancer is one of the classical
examples where the person may be totally at peace with himself. There is a
lump, but he has no disease. He has got cancer, but he has no dis-ease
In a similar fashion, you may take my coronary angiogram and find it awfully
diseased, but I have no symptoms. Because I have no symptoms, I am not dis-eased.
There is no need for an "easer" called physician. And therefore,
there is no need for the physician to violate what is called Heal's
Law. He says that it is impossible to make an asymptomatic person feel
better, therefore it is very much possible to make an asymptomatic patient
feel worse.
You go to Hinduja (hospital). You go well dressed, and pay a large amount.
You walk in as a person, you walk out as a patient! Because what do they do?
They investigate, and as Rousseau says, implant
into your brain a worm of suspicion which starts crawling. From that day you
start thinking that all is not hunky-dory with you. This particular preempting
a disease, is not benefiting anybody in any field.
THE BOTTOM LINE
Therefore, my bottom line about cancer, my bottom line about coronary, my
bottom line about diabetes and hypertension is, if they are silent, do nothing!
And as and when you treat, treat the symptom, warning the individual that
this will worsen his condition. One symptom will disappear, others will arrive!
Just to give you an example, Lawrence Clinical Pharmacology
is now in its 8th celebrated edition. You go under the section of cardiac
failure. You go to the summarizing box at the end of chapter, and there is
a very profound statement "Relief of symptoms does not
improve prognosis and vice versa".
You go to the 1956 Transactions of the N.Y. Academy
of Medical Sciences, vol 6. There is a fifty page article by Hardin
Jones of National Cancer Institute of Bethesda,
Maryland. He surveyed global cancer of all types and compared the untreated
and the treated, to conclude that the untreated outlives the treated,
both in terms of quality and in terms of quantity. Secondly he said, "Cancer
does not cure". Third he said"There is a physiological
mechanism which finishes off an individual".
Which brings me to Bertrand Russel's 1918 article
on Causation. He said, Causalism has died in
all advanced sciences, but in some sciences it survived. Because like the
King of England, and the king of Egypt, it's supposed to do no harm. Okay?
END OF PART 1
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BIOGRAPHICAL
DETAILS
Name: Kothari Manu Liladhar
Date of Birth: Nov 19, 1935.
Nationality: Indian
Present Position: Professor Department of Anatomy,
Seth G.S. Medical College, Parel, Mumbai 400 012, India.
Qualifications: M.B.B.S.,
University of Bombay,1959. M.S. (General Surgery),
University of Bombay, 1963. M.Sc. (Human Anatomy),
University of Bombay, 1965.
Appointment in Anatomy Dept.,
Seth G.S.Medical College, Bombay from 1964 to date as Asstt.Prof., Professor
and Head of Department of Anatomy.
Publications:
Eight
Books including:
The Nature of Cancer (Vol.One),Bombay,1973. Cancer:Myths and Realities of
Cause and Cure,London,1979. The Other Face of Cancer, Goa, 1994. Human Genetics,
Bombay,1986. Essentials of Human Embryology, Bombay,1983. Death: A new perspective
on the phenomena of disease and dying,London, 1986. Living and Dying,Goa,
1996. Violence in Modern Medicine:In, Violence and Science,1988.
Numerous Articles including Ten on Anatomy, mainly in the Journal of Postgraduate
Medecine, Mumbai. Twenty three on Biology from 1968 to 1985. Eighteen on Surgery
from 1960 to 1974. Thirteen on Medical Philosophy from 1975 to 1993. Seven
General articles in the National Journal of Homeopathy from 1994 to 1996.
Papers presented at Conferences, Orations, Guest Lectures and Key Note addresses.
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