Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

For example, the trial called just three witnesses, who were all doctors sympathetic to Dr Rush’s approach to medicine. Also, the case was argued by seven lawyers, which suggests that powers of persuasion were more influential than evidence. Rush, with his wealth and reputation, had the best lawyers in town arguing his case, so Cobbett was always fighting an uphill battle. On top of all this, the jury was probably also swayed by the fact that Cobbett was not a doctor, whereas Rush was one of the fathers of American medicine, so it would have seemed natural to back Rush’s claim.

Not surprisingly, Rush won the case. Cobbett was ordered to pay $5,000 to Rush in compensation, which was the largest award ever paid out in Pennsylvania. So, at exactly the same time that George Washington was dying after a series of bloodletting procedures, a court was deciding that it was a perfectly satisfactory medical treatment.

We cannot, however, rely on an eighteenth-century court to decide whether or not the medical benefits of bloodletting outweigh any damaging side-effects. After all, the judgement was probably heavily biased by all the factors already mentioned. It is also worth remembering that Cobbett was a foreigner, whereas Rush was a national hero, so a judgement against Rush was almost unthinkable.

In order to decide the true value of bloodletting, the medical profession would require a more rigorous procedure, something even less biased than the fairest court imaginable. In fact, while Rush and Cobbett were debating medical matters in a court of law, they were unaware that exactly the right sort of procedure for establishing the truth about medical matters had already been discovered on the other side of the Atlantic and was being used to great effect. Initially it was used to test a radically new treatment for a disease that afflicted only sailors, but it would soon be used to evaluate blood letting, and in time this approach would be brought to bear on a whole range of medical interventions, including alternative therapies.

Scurvy, limeys and the blood test

In June 1744 a hero of the British navy named Commander George Anson returned home having completed a circumnavigation of the world that had taken almost four years. Along the way, Anson had fought and captured the Spanish galleon Covadonga, including its 1,313,843 pieces of eight and 35,682 ounces of virgin silver, the most valuable prize in England’s decade of fighting against Spain. When Anson and his men paraded through London, his booty accompanied him in thirty-two wagons filled with bullion. Anson had, however, paid a high price for these spoils of war. His crew had been repeatedly struck by a disease known as scurvy, which had killed more than two out of three of his sailors. To put this into context, while only four men had been killed during Anson’s naval battles, over 1,000 had succumbed to scurvy.

Scurvy had been a constant curse ever since ships had set sail on voyages lasting for more than just a few weeks. The first recorded case of naval scurvy was in 1497 as Vasco da Gama rounded the Cape of Good Hope, and thereafter the incidences increased as emboldened captains sailed further across the globe. The English surgeon William Clowes, who had served in Queen Elizabeth’s fleet, gave a detailed description of the horrendous symptoms that would eventually kill two million sailors:

Their gums were rotten even to the very roots of their very teeth, and their cheeks hard and swollen, the teeth were loose neere ready to fall out…their breath a filthy savour. The legs were feeble and so weak, that they were full of aches and paines, with many blewish and reddish staines or spots, some broad and some small like flea-biting.

All this makes sense from a modern point of view, because we know that scurvy is the result of vitamin C deficiency. The human body uses vitamin C to produce collagen, which glues together the body’s muscles, blood vessels and other structures, and so helps to repair cuts and bruises. Hence, a lack of vitamin C results in bleeding and the decay of cartilage, ligaments, tendons, bone, skin, gums and teeth. In short, a scurvy patient disintegrates gradually and dies painfully.

The term ‘vitamin’ describes an organic nutrient that is vital for survival, but which the body cannot produce itself; so it has to be supplied through food. We typically obtain our vitamin C from fruit, something that was sadly lacking from the average sailor’s diet. Instead, sailors ate biscuits, salted meat, dried fish, all of which were devoid of vitamin C and likely to be riddled with weevils. In fact, infestation was generally considered to be a good sign, because the weevils would abandon the meat only when it became dangerously rotten and truly inedible.