By Gerald N. Grob
Utilizing old and modern information and case reports, the authors additionally learn tonsillectomy, melanoma, center ailment, nervousness, and melancholy, and establish ameliorations among rhetoric and fact and the weaknesses in prognosis and therapy.
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Extra resources for Diagnosis, Therapy, and Evidence: Conundrums in Modern American Medicine
Although criticisms of the procedure were common by the 1930s, its decline did not begin until well after 1945 and involved debates over the nature of evidence, the signiﬁcance of clinical experience in the validation of a particular therapy, and the role of competing medical specialties. The decline in the number of tonsillectomies in the last quarter of the twentieth century, however, proved transient. By the 1990s a new justiﬁcation for T&A had begun to emerge, and the procedure began to be used as a therapy for obstructive sleep apnea disorder.
The DSM-III replaced etiologically based diagnoses with 30 Diagnosis, Therapy, and Evidence symptom-based diagnoses as its central classiﬁcatory principle. Symptombased measures were especially valuable because they could easily produce high reliability—unlike the situation in the previous manuals, different psychiatrists examining the same patient would derive the same diagnosis. Such reliability was seen as a way to silence the critics who claimed that psychiatry was not even able to measure the entities it claimed to study and treat.
Nor did such traditional justiﬁcations for T&A—recurrent throat infections—disappear. T&A is an example of how a therapy is introduced and persists despite the absence of persuasive evidence of efﬁcacy. Explanations of the etiology of the two most important causes of mortality in contemporary America, namely, coronary heart disease (CHD) and cancer, present equally problematic cases. As late as 1960 most knowledgeable individuals believed that CHD was a chronic degenerative disease related to aging and one that could not be inﬂuenced by speciﬁc preventive measures.
Diagnosis, Therapy, and Evidence: Conundrums in Modern American Medicine by Gerald N. Grob