Errors in Medicine, Bloodletting, Vioxx, Lobotomies, Thalidomide, Oxycontin by Jeffrey Dach MD

Errors in Medicine, Bloodletting, Vioxx, Lobotomies, Thalidomide, Oxycontin by Jeffrey Dach MD Historical examples of medical establishment being catastrophically wrong: Bloodletting (standard practice for centuries) Lobotomies (Nobel Prize awarded, performed on 50,000+ patients) Thalidomide (caused birth defects in 10,000+ children) Vioxx (killed 60,000+ people, withdrew after 5 years) Opioid crisis ("not addictive" according to manufacturer, 500,000+ deaths) DES (Di-Ethyl Stilbestrol) given to pregnant mothers, banned in 1971 for causing Cervical cancer in their daughters. Mercury Containing Medications and Foods Gastric Ulcers Caused by Stress ignoring H.Pylori. Medical Endorsement of Smoking Weight Loss Drug Fen-Fen Organoflouride pesticides (Lindane, DD) banned in Israel in 1978 for causing breast cancer. Sabine Live Virus Polio \/a<<ine: Removed from the US market in 2000 because it caused paralysis. Header Image: Hysterosalpingogram showing Diethylstilbestrol (DES) Cervix with T-shaped appearance of uterine corpus with well-demarcated annular constriction of proximal horns. The lower segment appears wide. Courtesy of National Cancer Institute and Wikimedia commons Public Domain. Bloodletting (standard practice for centuries) Parapia, Liakat Ali (2008). "History of bloodletting by phlebotomy". British Journal of Haematology, 143(4), 490–495. doi:10.1111/j.1365-2141.2008.07361.x. PMID:18783398. URL: https://doi.org/10.1111/j.1365-2141.2008.07361.x Summary: This paper reviews the ancient origins and long-standing use of bloodletting. It was eventually abandoned becauseit caused more harm than benefit through excessive blood loss and lack of therapeutic value. Warner, John Harley (1980). "Therapeutic explanation and the Edinburgh bloodletting controversy: Two perspectives on the medical meaning of science in the mid-nineteenth century". Medical History, 24(3), 241–258. URL: https://doi.org/10.1017/s0025727300040308 Summary: The article analyzes the 19th-century debate in Edinburgh that led to the decline of bloodletting, using statistical evidence to demonstrate its ineffectiveness for conditions like fevers, marking a shift toward evidence-based medicine that exposed the practice's flaws. Lobotomies (Nobel Prize awarded, performed on 50,000+ patients) Berrios, German E. (1997). "The Origins of Psychosurgery: Shaw, Burckhardt and Moniz". History of Psychiatry, 8(1), 61–81. URL: https://doi.org/10.1177/0957154X9700802905 Summary: This work traces the early development of psychosurgery, including Moniz's leucotomy that earned the Nobel, but highlights ethical and efficacy issues, showing how organic brain interventions for mental illness often led to severe, irreversible damage. Kotowicz, Zbigniew (2005). "Gottlieb Burckhardt and Egas Moniz – Two Beginnings of Psychosurgery". Gesnerus, 62(1/2), 77–101. URL: https://doi.org/10.1163/22977953-0620102004 Summary: Comparing early psychosurgical experiments, the paper discusses Moniz's procedure and its widespread adoption despite complications like epilepsy and personality changes, underscoring the medical community's overenthusiasm and later recognition of its barbaric nature. Thalidomide (caused birth defects in 10,000+ children) Vargesson, Neil (2015). "Thalidomide-induced teratogenesis: history and mechanisms". Birth Defects Research Part C: Embryo Today: Reviews, 105(2), 140–156. URL: https://doi.org/10.1002/bdrc.21096 Summary: Reviewing the drug's development and marketing as safe for pregnancy, the paper explains mechanisms behind deformities like phocomelia, emphasizing inadequate testing that failed to detect teratogenic effects, leading to widespread fetal harm. Miller, Marilyn T. (1991). "Thalidomide Embryopathy: A Model for the Study of Congenital Incomitant Horizontal Strabismus". Transactions of the American Ophthalmological Society, 81, 623–674. URL: https://pubmed.ncbi.nlm.nih.gov/1808819/ Summary: Using thalidomide embryopathy as a case study, the article details ocular and other birth defects caused by the drug, highlighting the medical oversight in not conducting pregnancy-specific trials, which resulted in preventable congenital anomalies. Vioxx (killed 60,000+ people, withdrew after 5 years) Jüni, Peter; Nartey, Lisa; Reichenbach, Stephan; Sterchi, Rebekka; Dieppe, Paul A.; Egger, Matthias (2004). "Risk of cardiovascular events and rofecoxib: cumulative meta-analysis". The Lancet, 364(9450), 2021–2029. URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)17514-4/fulltext Summary: This meta-analysis aggregates data showing Vioxx's elevated cardiovascular risks, arguing that evidence warranted earlier withdrawal, exposing data suppression and regulatory failures that contributed to thousands of heart-related deaths. Bresalier, Robert S.; Sandler, Robert S.; Quan, Hui; Bolognese, James A.; Oxenius, Bettina; Horgan, Kevin; et al. (2005). "Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial". The New England Journal of Medicine, 352(11), 1092–1102. URL: https://www.nejm.org/doi/full/10.1056/NEJMoa050493 Summary: Reporting from the APPROVe trial, the paper reveals doubled risks of heart attacks and strokes with long-term Vioxx use, leading to its withdrawal and illustrating how initial approvals overlooked cardiovascular harms in favor of other benefits. Opioid crisis ("not addictive" according to manufacturer, 500,000+ deaths) Van Zee, Art (2009). "The promotion and marketing of oxycontin: commercial triumph, public health tragedy". American Journal of Public Health, 99(2), 221–227. doi:10.2105/AJPH.2007.131714. URL: https://doi.org/10.2105/AJPH.2007.131714 Summary: The paper critiques Purdue Pharma's aggressive marketing of OxyContin as low-addiction risk, which fueled overprescribing and the epidemic, detailing how misleading claims and sales tactics led to widespread addiction and overdoses. Kolodny, Andrew; Courtwright, David T.; Hwang, Catherine S.; Kreiner, Peter; Eadie, John L.; Clark, Thomas W.; et al. (2015). "The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction". Annual Review of Public Health, 36, 559–574. doi:10.1146/annurev-publhealth-031914-122957. URL: https://doi.org/10.1146/annurev-publhealth-031914-122957 Summary: Framing the crisis as driven by overprescribing based on underestimated addiction risks, the article advocates for public health reforms, highlighting medical and pharmaceutical errors that transitioned patients to heroin and fentanyl. Low-fat guidelines (created obesity and diabetes epidemic) Tobias, Deirdre K.; Chen, Mu; Manson, JoAnn E.; Ludwig, David S.; Willett, Walter; Hu, Frank B. (2015). "Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis". The Lancet Diabetes & Endocrinology, 3(12), 968–979. URL: https://doi.org/10.1016/S2213-8587(15)00367-8 Summary: This meta-analysis shows low-fat diets are not superior for long-term weight loss compared to other diets, challenging guidelines that promoted them and suggesting they may have contributed to obesity by not addressing overall calorie and carbohydrate intake. Schwingshackl, Lukas; Hoffmann, Georg (2013). "Comparison of effects of long-term low-fat vs high-fat diets on blood lipid levels in overweight or obese patients: a systematic review and meta-analysis". Journal of the Academy of Nutrition and Dietetics, 113(12), 1640–1661. URL: https://doi.org/10.1016/j.jand.2013.07.010 Summary: Comparing lipid effects, the review finds low-fat diets reduce cholesterol but high-fat diets improve other markers, concluding no clear superiority and questioning the blanket promotion of low-fat guidelines amid rising obesity and diabetes rates. Misconception that peptic ulcers are caused by stress (Helicobacter pylori discovery) Palmer, E. D. (1954). "Investigation of the gastric mucosa spirochetes of the human". Gastroenterology, 27(2), 218–220. URL: https://pubmed.ncbi.nlm.nih.gov/13183283/ Summary: This influential paper dismissed the presence of bacteria in the stomach, claiming no spirochetes were found in biopsies, reinforcing the erroneous belief that peptic ulcers were psychosomatic or stress-induced, delaying recognition of bacterial causes for decades. Marshall, B. J., & Warren, J. R. (1984). "Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration". The Lancet, 323(8390), 1311–1315. URL: https://doi.org/10.1016/S0140-6736(84)91816-6 Summary: This groundbreaking study identified Helicobacter pylori in gastric biopsies, challenging the long-held medical error that ulcers were primarily caused by stress or acid, showing instead a bacterial etiology that revolutionized treatment and prevention. Topical bioidentical hormone replacement using natural human hormones risks for menopause (WHI study, 2002 and 2004) misinterpreted as causing breast cancer and blood clots. Catastrophic decline in HRT use and prescribing by doctors due to misinterpretation of findings. Cancer preventive properties of estrogen and carcinogenic properties of synthetic Progestins ignored. Rossouw, J. E., Anderson, G. L., Prentice, R. L., LaCroix, A. Z., Kooperberg, C., Stefanick, M. L., et al. (2002). "Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial". JAMA, 288(3), 321–333. doi:10.1001/jama.288.3.321. URL: https://doi.org/10.1001/jama.288.3.321 Summary: This large trial reported increased risks of breast cancer, heart disease, and stroke with combined HRT, leading to a drastic decline in its use and highlighting the medical oversight in promoting it broadly without age-stratified risk assessment. Manson, J. E., Chlebowski, R. T., Stefanick, M. L., Aragaki, A. K., Rossouw, J. E., Prentice, R. L., et al. (2013). "Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials". JAMA, 310(13), 1353–1368. URL: https://doi.org/10.1001/jama.2013.278040 Summary: Long-term follow-up of the WHI trials clarified that risks were overstated for younger women, showing benefits in some groups and exposing the initial overreaction as a medical error that deprived millions of appropriate therapy. Diethylstilbestrol (DES) for preventing miscarriages Dieckmann, W. J., Davis, M. E., Rynkiewicz, L. M., & Pottinger, R. E. (1953). "Does the administration of diethylstilbestrol during pregnancy have therapeutic value?". American Journal of Obstetrics and Gynecology, 66(5), 1062–1081. URL: https://doi.org/10.1016/S0002-9378(16)38619-0 Summary: This randomized trial found DES ineffective for preventing miscarriages, yet its continued prescription ignored these results, leading to widespread harm and highlighting a failure to heed evidence against its use. Herbst, A. L., Ulfelder, H., & Poskanzer, D. C. (1971). "Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women". New England Journal of Medicine, 284(15), 878–881. URL: https://doi.org/10.1056/NEJM197104222841604 Summary: This study linked prenatal DES exposure to rare vaginal cancers in daughters, exposing the catastrophic error of prescribing it despite lack of efficacy, resulting in bans and recognition of transgenerational risks. Fenfluramine-phentermine (Fen-Phen) for weight loss Connolly, H. M., Crary, J. L., McGoon, M. D., Hensrud, D. D., Edwards, B. S., Edwards, W. D., & Schaff, H. V. (1997). "Valvular heart disease associated with fenfluramine-phentermine". New England Journal of Medicine, 337(9), 581–588. doi:10.1056/NEJM199708283370901. PMID:9271479. URL: https://doi.org/10.1056/NEJM199708283370901 Summary: Reporting unusual valvular heart disease in 24 women using Fen-Phen, this paper revealed the off-label combination's severe cardiac risks, prompting market withdrawal and exposing inadequate oversight of unapproved uses. Abenhaim, L., Moride, Y., Brenot, F., Rich, S., Benichou, J., Kurz, X., et al. (1996). "Appetite-suppressant drugs and the risk of primary pulmonary hypertension". New England Journal of Medicine, 335(9), 609–616. URL: https://doi.org/10.1056/NEJM199608293350901 Summary: This international study linked fenfluramine derivatives to increased pulmonary hypertension risk, contributing to evidence of Fen-Phen's dangers and the medical error in promoting it without long-term safety data. Medical endorsement of cigarette smoking Gardner, M. N., & Brandt, A. M. (2006). "“The doctors' choice is America's choice”: the physician in US cigarette advertisements, 1930–1953". American Journal of Public Health, 96(2), 222–232. URL: https://doi.org/10.2105/AJPH.2005.066654 Summary: Analyzing tobacco ads featuring doctors, this paper details how the medical establishment endorsed smoking despite early evidence of harms, perpetuating a public health catastrophe through misleading promotions. Proctor, R. N. (2012). "The history of the discovery of the cigarette–lung cancer link: evidentiary traditions, corporate denial, global toll". Tobacco Control, 21(2), 87–91. URL: https://doi.org/10.1136/tobaccocontrol-2011-050338 Summary: Reviewing the delayed recognition of smoking's cancer link, this article highlights medical and corporate denial despite 1950s evidence, illustrating how endorsements prolonged widespread harm. Use of mercury compounds like calomel in medicine Warkany, J., & Hubbard, D. M. (1948). "Mercury in the urine of children with acrodynia". The Lancet, 251(6510), 829–830. URL: https://doi.org/10.1016/S0140-6736(48)92026-1 Summary: Identifying mercury from calomel teething powders as the cause of acrodynia (pink disease), this paper exposed the poisoning risks of routine mercury use in pediatrics, leading to its decline. Clarkson, T. W. (2002). "The three modern faces of mercury". Environmental Health Perspectives, 110(Suppl 1), 11–23. URL: https://doi.org/10.1289/ehp.02110s111 Summary: Reviewing historical medicinal mercury use including calomel, this article details toxicity cases and the error in assuming low absorption, contributing to recognition of widespread poisoning. Ignorance of handwashing in preventing puerperal fever (Semmelweis's findings rejected) Semmelweis, Ignaz (1861). "Die Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers". Pest, Wien und Leipzig: C.A. Hartleben's Verlag-Expedition. (Translated as: The Etiology, Concept, and Prophylaxis of Childbed Fever, 1983, University of Wisconsin Press). URL: https://www.google.com/books/edition/The_Etiology_Concept_and_Prophylaxis_of/Hr5pAAAAMAAJ Summary: Semmelweis's seminal work demonstrated through data that handwashing with chlorinated lime reduced puerperal fever mortality from 18% to under 2%, but it was ignored by the medical establishment due to resistance to the idea of cadaveric particles causing infection, leading to unnecessary deaths. Nuland, Sherwin B. (1979). "The enigma of Semmelweis—an interpretation". Journal of the History of Medicine and Allied Sciences, 34(3), 255–272. doi:10.1093/jhmas/XXXIV.3.255. PMID:383747. URL: https://doi.org/10.1093/jhmas/XXXIV.3.255 Summary: This paper explores why Semmelweis's evidence-based handwashing protocol was rejected, attributing it to professional jealousy, poor communication, and doctrinal resistance, resulting in prolonged high maternal mortality rates until germ theory was accepted. Heroin marketed as non-addictive cough suppressant (introduced by Bayer) Dreser, Heinrich (1898). "Pharmakologisches über einige Morphinderivate". Pflügers Archiv für die Gesamte Physiologie des Menschen und der Tiere, 72(9-10), 485–521. doi:10.1007/BF01663134. URL: https://doi.org/10.1007/BF01663134 Summary: Dreser, working for Bayer, introduced heroin as a safer, non-addictive alternative to morphine for cough and pain, based on animal and human tests, leading to its widespread marketing and use despite emerging addiction evidence. Manges, Morris (1898). "A new narcotic: diacetylmorphine or heroin". New York Medical Journal, 68, 826–828. URL: https://books.google.com/books?id5d0-AQAAMAAJ&pgPA826 Summary: This early clinical report praised heroin's efficacy for respiratory conditions without addiction risk, contributing to its promotion as a miracle drug, which later proved catastrophic as addiction rates soared. Overenthusiastic medical use of cocaine (promoted as safe anesthetic and tonic) Koller, Carl (1884). "Über die Verwendung des Cocain zur Anästhesirung am Auge". Wiener Medizinische Wochenschrift, 34(43), 1276–1278, 1309–1311. (Translated as: On the use of cocaine for producing anesthesia on the eye, Lancet, 1884;124:990-992). URL: https://doi.org/10.1016/S0140-6736(02)47617-3 Summary: Koller's landmark paper introduced cocaine as a local anesthetic for eye surgery, sparking widespread medical adoption, but overlooking addiction and toxicity risks that led to overuse and harm. Freud, Sigmund (1884). "Über Coca". Centralblatt für die gesammte Therapie, 2, 289–314. URL: https://archive.org/details/bercoca00freugoog Summary: Freud enthusiastically promoted cocaine for various ailments including depression and morphine addiction, based on personal use, but his advocacy contributed to unchecked medical and recreational abuse before dangers were recognized. Radium-based treatments and tonics (caused poisoning and cancers) Martland, Harrison S. (1931). "Occupational poisoning in manufacture of luminous watch dials". Journal of the American Medical Association, 92(6), 466–473. doi:10.1001/jama.1929.02700320016005. URL: https://doi.org/10.1001/jama.1929.02700320016005 Summary: This study detailed radium poisoning in dial painters, showing bone necrosis and cancers from ingesting radium, exposing the medical error in promoting radium as safe for therapeutic use. Wick, R. R., & Gössner, W. (2002). "Peteosthor—a medical disaster due to Radium-224". Radiation Protection Dosimetry, 98(4), 393–401. doi:10.1093/oxfordjournals.rpd.a005891. PMID:12074467. URL: https://doi.org/10.1093/oxfordjournals.rpd.a005891 Summary: Reviewing the use of Radium-224 injections for ankylosing spondylitis and tuberculosis, the paper highlights increased bone sarcomas and liver cancers, demonstrating the catastrophic oversight in radiation therapy. X-ray shoe-fitting fluoroscopes (caused radiation burns and cancers)Williams, C. R. (1949). "Radiation exposures from the use of shoe-fitting fluoroscopes". New England Journal of Medicine, 241(9), 333–335. URL: https://doi.org/10.1056/NEJM194909012410903 Summary: This report measured high radiation doses from fluoroscopes, warning of risks to children's foot development and clerks' health, leading to recognition of unnecessary exposure in retail settings. Hemplemann, L. H. (1949). "Potential dangers in the uncontrolled use of shoe-fitting fluoroscopes". New England Journal of Medicine, 241(9), 335–336. URL: https://doi.org/10.1056/NEJM194909012410904 Summary: Highlighting acute burns, chronic skin damage, and growth interference from stray radiation, this paper urged regulation, exposing the medical and public health error in allowing unshielded devices. Promotion of infant formula over breastfeeding (led to malnutrition and deaths in developing countries) Jelliffe, D. B., & Jelliffe, E. F. P. (1978). "The volume and composition of human milk in poorly nourished communities. A review". The American Journal of Clinical Nutrition, 31(3), 492–515. doi:10.1093/ajcn/31.3.492. PMID:415603. URL: https://doi.org/10.1093/ajcn/31.3.492 Summary: This review showed that aggressive formula marketing displaced breastfeeding, causing higher infant mortality from diarrhea and malnutrition due to contaminated water and over-dilution in poor settings. Piwoz, Ellen G., & Huffman, Sandra L. (2015). "The impact of marketing of breast-milk substitutes on WHO-recommended breastfeeding practices". Food and Nutrition Bulletin, 36(4), 373–386.URL: https://doi.org/10.1177/0379572115602174 Summary: Analyzing global data, the paper links formula promotion to reduced breastfeeding initiation and duration, exacerbating health disparities and highlighting the error in endorsing substitutes without safeguards. 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Category Archives: Errors

Errors in Medicine, Bloodletting, Vioxx, Lobotomies, Thalidomide, Oxycontin by Jeffrey Dach MD

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