__________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 spending1.25 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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