{"id":2734,"date":"2015-09-08T14:17:29","date_gmt":"2015-09-08T14:17:29","guid":{"rendered":"http:\/\/healthicine.org\/wordpress\/?p=2734"},"modified":"2015-10-28T14:08:38","modified_gmt":"2015-10-28T14:08:38","slug":"understanding-medical-cures","status":"publish","type":"post","link":"http:\/\/healthicine.org\/wordpress\/understanding-medical-cures\/","title":{"rendered":"Understanding Medical Cures"},"content":{"rendered":"<p>Jan and John are finishing up their rounds, and heading to the hospital cafeteria for lunch. John re-opens yesterday&#8217;s conversation about the word &#8216;cure&#8217;.<\/p>\n<p>&#8220;Well, did you learn anything about the medical definition of cure in your research last night?&#8221;<\/p>\n<p>Jan is frustrated, &#8220;I learned that medical dictionaries don&#8217;t take the word &#8216;cure&#8217; seriously.&#8221;<!--more--><\/p>\n<p>&#8220;Really? For example?&#8221;, John picks up a \u00a0tray and orders a Reuben sandwich.<\/p>\n<p>&#8220;First I went \u00a0to Stedman&#8217;s Medical Dictionary. It gives several definitions. The first one is &#8216;<em>to heal, to make well<\/em>&#8216;. But healing is, as we&#8217;ve already discussed, independent of curing the illness &#8211; healing happens before, during, and after the illness. And &#8216;to make well&#8217; is just simplistic. We could go on another dictionary search to find the meaning of &#8216;well&#8217; &#8211; I think it&#8217;s less well defined than &#8216;cure&#8217;.&#8221;<\/p>\n<p>&#8220;I see that. To make well, might range from an apology, meant to make the patient feel better, to a painkiller that makes them feel better, to a cure.&#8221; John challenges. &#8220;But doesn&#8217;t &#8216;well&#8217; in medicine mean without disease?&#8221;<\/p>\n<p>Jan responds, &#8220;It&#8217;s OK\u00a0in simple cases, but many cases are not simple. What if someone has more than one illness.&#8221;<\/p>\n<p>&#8220;Yes, an elderly person might suffer from obesity, hypertension, arthritis and diabetes.&#8221;<\/p>\n<p>&#8220;Then, the Stedman&#8217;s definition says you can&#8217;t just cure one illness, because they are still sick? &#8221;<\/p>\n<p>&#8220;Now you&#8217;re getting technical and pedantic,&#8221; John comments dryly.<\/p>\n<p>&#8220;If we are to define cure, we need a definition that holds up to such simple challenges,&#8221;\u00a0Jan went on, &#8220;<em>the second definition is &#8216;a restoration of health<\/em>&#8216;. Does health disappear when someone gets sick? I don&#8217;t think so.&#8221;<\/p>\n<p>&#8220;Health is always present, as long as we are alive. \u00a0Maybe they mean that &#8216;some health is lost&#8217; when we get sick, and we recover it when we get better.&#8221; \u00a0John offered.<\/p>\n<p>&#8220;But restoration of health happens before, during and after the disease is diagnosed. often happens after the disease is stopped. They&#8217;re still mixing and confusing\u00a0healing and\u00a0curing.&#8221; Jan objected.<\/p>\n<p>She continued, &#8220;Their third definition is &#8216;<em>a special method or course of treatment<\/em>&#8216;. That seems OK at first, but many, perhaps most treatments simply do not cure &#8211; most treatments are for symptoms, not cures. In fact, a &#8216;course of treatment&#8217;, might be given to someone who is not even sick, not in need of a cure. \u00a0I can get a\u00a0hair treatment &#8211; so I look better. But there is no intent to cure my ugliness.&#8221;<\/p>\n<p>&#8220;You&#8217;re not ugly,&#8221; John laughed, &#8220;but it&#8217;s an interesting comparison. \u00a0So, Stedman&#8217;s Medical Dictionary defines cures that are\u00a0used when you are not sick, when you are sick, and even after your sickness is gone. Is that so bad?&#8221;<\/p>\n<p>&#8220;It&#8217;s worse, they don&#8217;t even use the word disease, or illness. \u00a0Can you cure someone if they don&#8217;t have an illness?&#8221; Jan showed John the text:<\/p>\n<p><a href=\"http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/08\/StedmansCureContinuum.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-2742 size-large\" src=\"http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/08\/StedmansCureContinuum-1024x647.jpg\" alt=\"StedmansCureContinuum\" width=\"640\" height=\"404\" srcset=\"http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/08\/StedmansCureContinuum-1024x647.jpg 1024w, http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/08\/StedmansCureContinuum-300x190.jpg 300w, http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/08\/StedmansCureContinuum.jpg 1366w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>Jan continued, her voice getting louder, &#8220;How can we cure people, how can we search for cures, if cure is not properly defined? \u00a0Can there be a science of medicine, if we can&#8217;t even find a good definition for &#8216;cure&#8217;?&#8221;.<\/p>\n<p>John responded quietly, &#8220;Did you check anywhere else?&#8221;<\/p>\n<p>&#8220;Yes. Mosbey&#8217;s Medical Dictionary is different, but\u00a0no\u00a0better. \u00a0They first defined cure as &#8216;<em>restoration to health of a person afflicted with a disease or disorder<\/em>&#8216;&#8221;.<\/p>\n<p>&#8220;At least it mentions disease,&#8221; John comments.<\/p>\n<p>&#8220;Yes, but it&#8217;s the same &#8216;<em>restoration to health<\/em>&#8216;, implying that once you have a disease or a disorder, you are no longer &#8216;healthy&#8217;. \u00a0But health doesn&#8217;t disappear because you have an illness. It is there, actively fighting the disease. \u00a0If you lose your health &#8211; you are dead.&#8221;<\/p>\n<p>&#8220;Well, many diseases are the result of a drop in health, and a restoration of health is the only real cure. Scurvy is caused by an unhealthy diet, and cured by a healthy diet.&#8221;<\/p>\n<p>&#8220;Yes,&#8221; Jan agreed. \u00a0&#8220;It almost seems they have recognized that restoring health can cure a disease &#8211; but I don&#8217;t think it was meant that way. If so, they might have said something like &#8216;<em>an improvement in health that eliminates disease<\/em>&#8216;.&#8221;<\/p>\n<p>Jan continued, &#8220;It doesn&#8217;t actually speak about stopping\u00a0the disease. What if health is restored, but the disease is still present. \u00a0Is that a cure?&#8221;<\/p>\n<p>&#8220;Is it possible to &#8216;<em>restore health<\/em>&#8216; without curing the disease?&#8221;<\/p>\n<p>&#8220;Of course. The unhealthiness might be disconnected from the disease &#8211; once the disease takes hold. \u00a0If you get cholera from drinking unhealthy water, and you stop drinking unhealthy water &#8211; it doesn&#8217;t cure you.&#8221;<\/p>\n<p>&#8220;And what is a &#8216;<em>disorder<\/em>&#8216;?&#8221; Jan continued, &#8220;A broken leg is a disorder &#8211; but we don&#8217;t cure it. The definition is simply useless as a scientific tool.&#8221;<\/p>\n<p>&#8220;Yes, I see that. We don&#8217;t cure disorders, only diseases. Do they give another definition?&#8221;, asks John.<\/p>\n<p>&#8220;&#8216;<em>The favorable outcome of a treatment of a disease or disorder<\/em>&#8216;. It&#8217;s simplistic nonsense. A person has arthritis, and they take some medicine that makes them\u00a0feels better, it&#8217;s a favorable outcome. \u00a0So the medicine\u00a0&#8216;cured&#8217; them, according to Mosbey&#8217;s. But they still have the disease, and it&#8217;s probably getting worse.&#8221; \u00a0Jan is visibly frustrated. She stops talking and looks at John, hoping for an answer.<\/p>\n<p><a href=\"http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/09\/MosbeysCureContinuum.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-2752 size-large\" src=\"http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/09\/MosbeysCureContinuum-1024x546.jpg\" alt=\"MosbeysCureContinuum\" width=\"640\" height=\"341\" srcset=\"http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/09\/MosbeysCureContinuum-1024x546.jpg 1024w, http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/09\/MosbeysCureContinuum-300x160.jpg 300w, http:\/\/healthicine.org\/wordpress\/wp-content\/uploads\/2015\/09\/MosbeysCureContinuum.jpg 1366w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<p>&#8220;Hmm..&#8221;, John thinking aloud, &#8220;Interesting that Stedmans does not require a disease to find a cure, and Mosbey&#8217;s does not require\u00a0stopping the disease to produce a cure.\u00a0It&#8217;s like the old joke,\u00a0<em>&#8216;the operation\u00a0was a success, but the patient died anyway<\/em>.'&#8221;, John smiled.<\/p>\n<p>&#8220;It&#8217;s more than that. \u00a0A favorable outcome as defined by the doctor? or by the patient? \u00a0A patient who is so sick they want the right to die, would consider a treatment leading to death as a favorable outcome. \u00a0Does that make death a cure?&#8221; Jan asked, rhetorically adding\u00a0&#8220;A favorable outcome is not always a cure, although a cure is\u00a0almost\u00a0always a favorable outcome.&#8221;<\/p>\n<p>&#8220;Almost always? \u00a0Wouldn&#8217;t it be always?&#8221;, John asked.<\/p>\n<p>&#8220;Well, there are cases where medicine attempts to &#8216;cure&#8217; a disease that others don&#8217;t consider a disease. \u00a0There have been searches for medical cures for left-handedness, and homosexuality. In those cases, a cure might not be a favorable outcome for the patient nor for the society.&#8221;<\/p>\n<p>&#8220;A cure that cures a non-disease. Interesting. You&#8217;ve been thinking about this a lot. It seems Mosbey&#8217;s has got stuck\u00a0on a challenging question: does a cure cure the disease, or the patient?&#8221;, John looks up at the clock. \u00a0&#8220;Well, time to get back to work. \u00a0Maybe if you check some of the authoritative medical reference books, you can find a better definition of cure?&#8221; \u00a0He gets up and starts to clear the table.<\/p>\n<p>&#8220;So.. both the medical dictionaries actually say that &#8216;cure&#8217; is to stop a disease?&#8221;<\/p>\n<p>&#8220;Not only that, one doesn&#8217;t use the word &#8216;disease&#8217;, and the neither requires actually &#8216;stopping&#8217; the disease. I wonder what MERCK says&#8221;, Jan replies. &#8220;I&#8217;ll check tonight. \u00a0Tomorrow&#8217;s lunch, then.&#8221;<\/p>\n<p>&#8220;Tomorrow is my weekend.&#8221; John replies with a smile, &#8220;You&#8217;ve got Tuesday and Wednesday to do your\u00a0research. See you Thursday.&#8221;<\/p>\n<p>=========================================<\/p>\n<p>Standard dictionaries don&#8217;t provide a clear definition of cure. \u00a0And medical dictionaries don&#8217;t do any better. \u00a0Will Jan and John find the true meaning of cure? \u00a0Stay tuned&#8230;<\/p>\n<p>to your health, tracy<\/p>\n<p>This post is the second in a series about the word &#8216;cure&#8217;. You can see the first post here: &#8220;<a href=\"http:\/\/healthicine.org\/wordpress\/means-cure\/\" target=\"_blank\">What means Cure?<\/a>&#8221;<\/p>\n<p>Tracy is the author of two books about healthicine:<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/ws-na.amazon-adsystem.com\/widgets\/q?ServiceVersion=20070822&amp;OneJS=1&amp;Operation=GetAdHtml&amp;MarketPlace=US&amp;source=ac&amp;ref=tf_til&amp;ad_type=product_link&amp;tracking_id=persona01-20&amp;marketplace=amazon&amp;region=US&amp;placement=1495484254&amp;asins=1495484254&amp;linkId=CVS6MEY4D7AUFHU6&amp;show_border=false&amp;link_opens_in_new_window=true\" width=\"300\" height=\"150\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" data-blogger-escaped-scrolling=\"no\"><\/iframe> <iframe loading=\"lazy\" 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for lunch. John re-opens yesterday&#8217;s conversation about the word &#8216;cure&#8217;. &#8220;Well, did you learn anything about the medical definition of cure in your research last night?&#8221; &hellip; <a href=\"http:\/\/healthicine.org\/wordpress\/understanding-medical-cures\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2734","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/posts\/2734","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/comments?post=2734"}],"version-history":[{"count":14,"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/posts\/2734\/revisions"}],"predecessor-version":[{"id":2833,"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/posts\/2734\/revisions\/2833"}],"wp:attachment":[{"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/media?parent=2734"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/categories?post=2734"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/healthicine.org\/wordpress\/wp-json\/wp\/v2\/tags?post=2734"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}