No Data? It’s Hocus-Pocus

Medicine in the 19th and 18th centuries was full of questionable therapies and useless drugs. Many treatment methods were bizarre or terrifying. And this is exactly how future generations will see today’s healthcare—for reasons we know about.

We are privileged to live today: Medicine is human, hospitals are modern, and healthcare professionals have access to state-of-the-art devices and technologies. We take a visit to the doctor or an injection given by a nurse for granted, but in fact, it’s a luxury.

It wasn’t that long ago things looked very different.

Medicine was often helpless, and diagnosis and treatment were random. In the early 19th century, there was no health insurance. In the US, surgical procedures ranged from $300 to $3000 (in today’s purchasing value)—pretty expensive considering the low survival rate of patients due to lack of antiseptic techniques and anesthesia.

In the book “The Mystery of the Exploding Teeth: And Other Curiosities from the History of Medicine,” medical historian Thomas Morris reveals doctors’ behind-the-scenes work 150–200 years ago. You will find them funny, but back then, patients had no reason to laugh.

Fortunately for us, the innovators of previous generations—who often pursued their ideas against popular beliefs—turned medicine into a science. Or rather semi-science since many health-related decisions and actions are still biased instead of data-driven.

Many stories from the past reveal the future and make us realize why data will bring the next renaissance to medicine. Here are just a few of them.

Health illiteracy: Didn’t you know that swallowing knives can be deadly?

The first International Classification of Diseases (ICD) was published in 1893, listing 161 medical disorders. Its current edition lists 69,000 diagnosis codes—impressive progress in just 150 years.

However, before disease systematization, patients were diagnosed and treated at random. There were almost no medical guidelines. Doctors did not know human anatomy, so they followed their own experience, often based on misconceptions or good luck.

It often had disastrous consequences for patients.

In 1861, dentist W. H. Atkinson (Pennsylvania, USA) described a disturbing phenomenon he called “exploding teeth.” First, the patient experienced severe pain, then a loud sound resembling a shot. Ultimately, the tooth broke into pieces, and the pain disappeared.

A similar case is described in the 1874 book “Pathology and Therapeutics of Dentistry.” This time, the tooth explosion was so intense that it left the patient temporarily deaf. Many blamed the chemicals used in fillings and even the electric charge accumulating in the teeth.

Another example shows an extreme lack of health literacy. At the turn of the 19th century, the American sailor John Cummings, during a boozy party, decided to imitate a French juggler eating knives. Cummings did not know that the sword-swallower was pretending, so he literally swallowed his friends’ clasp knives. The story ended with a tragic death, although only after the 35th knife.

Trail-And-Error medicine: Bloodletting may help unless the patient dies

Today, when we take a pill from a pharmacy, we can be sure it has undergone a clinical trial procedure confirming its effectiveness and safety, or at least it meets quality standards. But in the past, drugs and medical procedures were created based on trial and error and actually tested on patients.

A treatment was often more dangerous than the diseases it was intended to cure.

As was the bloodletting procedure practiced until the end of the 19th century. It was believed that many diseases could be cured simply by removing “bad blood.” There was no rational evidence for this, but the tradition.

In the early 18th century, Lord Anthony Gray, Earl of Kent, suddenly fell while playing bowls. He wasn’t breathing and had no pulse—enough evidence to conclude that he was dead. But doctor Charles Goodall didn’t want to give up that easily. To revive the dead man, he tried some original methods: bloodletting, putting snuff into the nostrils, serving metallic wine to induce vomiting, shaving the head and applying an anti-inflammatory balm, burning with a hot frying pan, and applying sheep entrails to the stomach. Finally, Goodall gave up, and Lord Gray was lucky to be already dead.

Every surgery was torture. Before ether was used for anesthesia for the first time in 1846, getting patients drunk was the only way to reduce pain. No, it didn’t really help. Due to a lack of knowledge, antiseptic techniques, or antibiotics, surgeries often ended deadly. Therefore, they were performed only when necessary.

Some miracles led to drawing false conclusions, such as the case of Thomas Tripple. One day, the shaft of a horse cart pierced his chest and pinned him to a stable wall. Instead of dying, Tripple went home and took a rest. All it took for Tripple to live happily for another 11 years was bloodletting. At the time, few people knew that an exception doesn’t prove the rule.

Scientific evidence: Believe it or not

Looking through 19th-century chronicles and articles, historians have difficulty distinguishing what is a deliberate lie, manipulation for publicity, and what is simply the result of gross ignorance. Some doctors believed in miracles because they had no reason to doubt them.

In 1746, the London physician Richard Jackson wrote the article “A Physical Dissertation on Drowning,” describing the story of a Swedish gardener who fell into a frozen river and returned after 16 hours underwater to tell everyone what had happened. At the same time, William Harvey, another physician, wrote a serious report on a 152-year-old man named Thomas Parr. Parr was such a great trickster that he was even invited to the court of King Charles I.

Until the development of the modern pharmaceutical industry, people were treated mainly with herbs. Many of them are life-saving and have been used until today. But some, such as a 1799 painkiller made from foul-smelling morphine and a mixture of raven vomit, probably didn’t work.

Relief: Data debunks myths

A lot has changed since then. However, we can be sure that in 100–200 years, current methods will also seem old-school. Doctors guided by their experience instead of sophisticated AI-based decision support systems will be received with surprise by future generations.

Just as the new discoveries of the 20th century allowed us to eliminate the terrifying medical practices, today, digitalization, access to data, and artificial intelligence offer the opportunity for unprecedented advances in medicine.

Data are like witnesses to health: There are many of them, however, while each has valuable knowledge about a small part of the human body, none has an understanding of the whole. For the big picture of health to emerge, their knowledge must be combined. For the first time in human history, we can do it by applying interoperable technologies and strengthening our willingness to share data.

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