How A Bone Disease Grew To Fit The Prescription

SPIEGEL: Osteopenia, it turns out, is a slight thinning of the bones, which occurs naturally as women get older and typically doesn't result in disabling bone breaks. In fact, it's a condition that only recently started to be thought of as a problem that required treatment. And to understand its full evolution from non-problem to problem, you need to go back to the beginning, to 1992 and a place very far away from Katie Benghauser's suburban Richmond home.

Dr. ANNA TOSTESON (Professor of Medicine, Dartmouth College): The meeting took place in Rome, Italy, in a hotel near the top of the Spanish Steps.

SPIEGEL: This is Anna Tosteson, professor of medicine at Dartmouth College. In 1992, Tosteson was one of a small group of experts on osteoporosis, invited to Rome for a meeting organized by the World Health Organization. One focus of which was a definition for osteoporosis. You see, for a long time, doctors were only able to diagnose osteoporosis after a woman got a fracture. But bone scanning machines had made it possible to figure out if bones were weak before fractures occurred. The question before the experts then was this: Since after the age of 30, all bones lose density, how much bone loss was normal? And how much put women at risk and so should be categorized as a disease? Anna Tosteson says the experts in the room went back and forth, looking at research and trying to decide where on a graph of diminishing bone loss to draw the line.

Dr. TOSTESON: Ultimately, it was just a matter of, well, it has to be drawn somewhere. And as I recall, it was very hot in the meeting room.

(Soundbite of laughter)

Dr. TOSTESON: And people were kind of in shirtsleeves, and it was time to kind of move on, if you will. And I can't quite frankly remember who it was who stood up and drew the picture and said, well, let's just do this.



OUTSTANDING!!

http://www.npr.org/templates/transcript/transcript.php?storyId=121609815

Cocaine

As a medical researcher, Freud was an early user and proponent of cocaine as a stimulant as well as analgesic. He wrote several articles on the antidepressant qualities of the drug and he was influenced by his friend and confidant Wilhelm Fliess, who recommended cocaine for the treatment of the "nasal reflex neurosis". Fliess operated on Freud and a number of Freud's patients' noses whom he believed to be suffering from the disorder, including Emma Eckstein, whose surgery proved disastrous.[34]

Freud felt that cocaine would work as a panacea for many disorders and wrote a well-received paper, "On Coca", explaining its virtues. He prescribed it to his friend Ernst von Fleischl-Marxow to help him overcome a morphine addiction he had acquired while treating a disease of the nervous system.[35] Freud also recommended it to many of his close family and friends. He narrowly missed out on obtaining scientific priority for discovering cocaine's anesthetic properties (of which Freud was aware but on which he had not written extensively), after Karl Koller, a colleague of Freud's in Vienna, presented a report to a medical society in 1884 outlining the ways cocaine could be used for delicate eye surgery. Freud was bruised by this, especially because this would turn out to be one of the few safe uses of cocaine, as reports of addiction and overdose began to filter in from many places in the world. Freud's medical reputation became somewhat tarnished because of this early ambition. Furthermore, Freud's friend Fleischl-Marxow developed an acute case of "cocaine psychosis" as a result of Freud's prescriptions and died a few years later. Freud felt great regret over these events, which later biographers have dubbed "The Cocaine Incident".[citation needed] However, he managed to move on, and some speculate that he even continued to use cocaine after this event. Jürgen von Scheidt posits that most of Freud's psychoanalytical theory was a byproduct of his cocaine use.[36]


In _The Origins of Psycho-Analysis: Letters to Wilhelm Fliess, 1887-1902_
(by Sigmund Freud, edited and authorized by a large number of people,
published by Imago Publishing Company, London, 1954), p4-6, I find
this information: Fliess trained as a nose-and-mouth specialist.
He discovered a syndrome, which he dubbed the nasal reflex neurosis,
typified by many and varied symptoms, all over the body; what they had in
common was that they could all be brought "temporarily to an end by
anaesthetizing with cocaine the responsible area in the nose". He
subsequently observed that "neuroses with a sexual aetiology" often
assumed the form of nasal reflex neurosis, and was led to assume a
"special connection" between the nose and the genitalia, particularly
the female genitalia, it seems. In this regard he remarks on the
phenomenon of the "vicarious nosebleed in place of menstruation"...
All of this was apparently detailed in an 1897 opus.

http://dev.null.org/psychoceramics/archives/1996.04/msg00014.html

it would appear this has been going on for quite some time...