Atwood's medical resistance question in "letters" in Jan/Feb issue S.I.

[Ladewig]

On page 61 of the latest issue of Skeptical Inquirer, Kimball Atwood responds to a reader's letter defending alternative medicine by (among other things) asking the writer "to name a single example, since the era of scientific medicine began in the second half of the twentieth century, of a correct claim that faced dogmatic, closed-minded rejection by the 'medical mainstream' for any significant amount of time."

My knowledge of medical history is rather limited, but searching the web gave seemed to produce the example of the Heimlich Manuever. Although, it was introduced in 1974, the manuever was not endorsed by the U.S. Surgeon General until 1985. The endorsement was an emphatic one, saying that the Heimlich should not be considered the best approach to saving choking victims, it should be considered the only approach to saving choking victims.

Is this case an example of the medical mainstream (granted, a broadly defined group) rejecting a useful technique for a significant amount of time?


_____________________

p.s. The Heimlich Manuever is now considered the best approach to saving drowning victims as well. The manuever should be instituted before CPR is administered.

[RichardR]

I saw that letter too - a pretty good rebuttal, I thought.

It depends what you mean by a "significant amount of time". I wouldn't have thought that 11 years was significant, considering how long it can take for any new therapy to be developed and tested. In addition, I don't think you could claim that this delay was due to "dogmatic, closed-minded rejection by the 'medical mainstream'" – just a delay in giving full approval.

I would be interested, though, if anyone has any other examples.

[An Infinite Ocean]

The Heimlich Manuever can actually be dangerous, and should never be the first method employed to stop someone choking. Especially if you don't know what you're doing.

[Dr. Imago]

Originally posted by An Infinite Ocean
The Heimlich Manuever can actually be dangerous, and should never be the first method employed to stop someone choking. Especially if you don't know what you're doing.

I agree.

One of the original objections, something that can still be problematic, is the breaking-off of the xiphoid process at the inferior border of the sternum by improperly placed hands and subsequent puncturing of the liver. Likewise, some choking victims early on in the episode can actually clear the object themselves if given a few seconds left alone to try to cough it out, and too-quick intervention coupled with bad technique can do more harm than good. Of course, if the person is not able to clear the object it is better to attempt the Heimlich (preferably done correctly) rather than do nothing.

Best bet: get properly trained before attempting it. It is (techincally) a "medical procedure" and should not be administered if you don't know what you're doing. Every American Heart Association (AHA) Basic Life Support (BLS) course teaches the proper techinque, by the way, along with how to correctly do CPR.

-TT