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History of Medicine
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Body health dependent on the
balance of 4 humours:
 Blood, phlegm, bile, and black bile
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Sweating, vomiting, urinating,
bleeding, oozing pus were ways to
restore balance
Treatment linked to this theory
 Blood letting – cutting, cupping, leeches
 Induce vomiting - Ipecac, calomel
 Blistering – mustard pack to induce
infection
History of Medicine
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News Flash 1799! George
Washington has a sore throat!
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Blistered throat
Leeches behind ears and on throat
Enema
Emetic
More blood letting = 5 pints!
History of Medicine

News Flash 1881! President
Garfield Shot!
 Drs probed wound with fingers
 “Healthy pus” discharged – Whew!
We thought he might die…
 Died of infection – strep bacteria
were introduced by probing of
doctors
History of Medicine
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Rise of Thomsonians in early 1800s
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Less violent treatment
Thought that disease was a result of cold
Herbs used to purge the body
Warm baths
Return medicine to laypeople
Others
 Homeopaths: Let nature do it…diet,
exercise, hygiene
 Hydrotherapy: Diet, bathing
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These beat throwing up and enemas!
History of Medicine

Why were these therapies supported?
 No cures!
 Some benefits – diet, exercise,
cleanliness
 Accidental successes – Many diseases
are self limiting – “post hoc ergo propter
hoc”
 Popular press
 Placebo effect
 Reason was used instead of
experimentation
History of Medicine
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New Advances…Europe 1800s
 Microscope, stethoscope,
thermometers
 Study of Bacteriology
 Study of parasites
 Epidemiology: Correlation of disease
and treatments - found bleeding to
be ineffective – Whew!
History of Medicine
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James Lind - 1747
 In a controlled experiment, gave
oranges/lemons to British sailors and
they didn’t develop scurvy
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Joseph Lister – 1850s and 1860s
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Aseptic surgery
Antiseptic carbolic acid
4% mortality rate
Paradigm shift:
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Development of microscope
Humours to microorganisms
Claude Bernard:
“Why think?
Exhaustively experiment,
then think.”
History of Medicine
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Advances in U.S.
 Johns Hopkins dies and leaves 3.5
million to open a university/hospital
Quaker trustees of estate decided on
the German model
 Research and experimentation
began with much success
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Immunizations – Typhoid, cholera,
rabies
Research Culminated In…
First Cure 1891: Diphtheria
“El garrotillo”
Francisco de Goya
1746 - 1828
History of Medicine
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Sometime in the early 1900s…
“a random patient, with a random
disease, consulting a doctor
chosen at random had, for the first
time in the history of mankind, a
better than fifty-fifty chance of
profiting from the encounter”
- Lawence Henderson, Harvard, 1964
Science Makes a Difference!
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Average Life Expectancy
Current Tx in Autism Field
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Rapid prompting
Sensory integration
 Facilitated communication
 EDTA Chelation
 Xango juice
 Mega-Vitamins
 GFCF diet
 Auditory integration
 Relationship development intervention
 Psychomotor patterning
 Sciopathy
 Behavior Analysis*
Current Tx in Autism Field
Why are there so many?
 No cure for autism
 Accidental successes
 Kids may improve for unknown reasons
 Kids may improve due to concurrent Tx
 Press and internet blogs
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“(Child’s name) reasoning and behavior have changed for the
better since drinking this juice. “
 Placebo effect?
 Lack of appropriate experimentation –
sound familiar? Reason vs experiments
Current Tx in Autism Field
Why are they used? (cont’d)
 Proponents tell us that Tx is
supported by “Research”
 But sometimes studies don’t have
objective measurement
 Some studies don’t establish
causality
Current Tx in Autism Field
Should I Try This One?
 Is there scientific support?
 Make evidence-based decisions
 Are the studies that support it
correctly done?
 Weigh risks/costs vs benefits
 Short term vs long term
 What about cost of not trying
alternatives
Beware of “Research Shows”
 HRT (Hormone replacement therapy during
menopause)
 1985: 122,000 nurses studied by Harvard
Medical School
 HRT is effective at managing menopausal
symptoms
 Also, concluded that nurses taking HRT during
menopause had 1/3 as many heart attacks
 This result formed the basis of therapeutic wisdom
for the next 17 years
Beware of “Research Shows”
 1998: Heart-Estrogen Replacement (HERS)
Clinical Trial– post-menopausal women
 Concluded that estrogen increased frequency of
heart attacks in those women who had existing
heart disease.
 2002: Women’s Health Initiative (WHI)
Clinical Trial – post-menopausal women
 Concluded that HRT was a potential health risk for
all post-menopausal women including heart
disease, stroke, breast cancer. But may offer
protection from osteoporosis and maybe
colorectal cancer.
 2011 – Effects of HRT less clear – short term
use maybe OK
Observational Study - Nurses
Collection of Subjects:
Some take Drug and
some do not
Prescriber Effect: Drug
may be prescribed to
healthier (or sicker) patients
Compliance Effect:
Those who follow Dr
orders are generally
healthier!
BIAS!!
Assignment
for Analysis
Drug
Healthy User Bias: Those
who take the drug do many
things right! (diet, exercise)
No Drug
Observational Studies
“They can distinguish associations
between events…But they cannot
inherently determine causation…”
-Gary Taubes, New York Times, Science Journalist
Controlled Experiment – HERS/WHI
Subjects
Random
Assignment
Drug
No Systematic Bias
Placebo