|Year : 2016 | Volume
| Issue : 1 | Page : 4-6
Iatrogeny of Alzheimer's disease: A view point
Manu Kothari, Lopa Mehta
Ex. Professor and Head, Department of Anatomy, Seth GS Medical College and King Edward Memorial (KEM) Hospital, Mumbai, Maharashtra, India
|Date of Web Publication||17-Feb-2016|
Department of Anatomy, Seth GS Medical College and King Edward Memorial (KEM) Hospital, Parel, Mumbai - 400 012, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kothari M, Mehta L. Iatrogeny of Alzheimer's disease: A view point. J Craniovert Jun Spine 2016;7:4-6
Modern Medicine (MM) is held responsible for creating the iatrogenic epidemic of Alzheimer's disease. All cholesterol-lowering therapeutic agents and dietary deprivation of fat bring about myelin and neuronal damage. Regular intake of aspirin produces microbleedings in the brain. An insult is added to these injuries by vilifying Lady Nicotine that is known to lower the incidence of Parkinsonism More Details and Alzheimer's disease.
Diseases of Medical Progress (DOMP) is a well-known entity and has been recorded as far back as 1956.  Much water has flown down the Ganges and the overall scene is not very heartening. Dr. Sandeep Jauhar's latest invective is but a glimpse of the state of iatrogenic MM.  We propose that MM is busy spawning the Alzheimer's epidemic in countries rich and poor.
Cholesterol, portrayed as the devil to be exorcised among lipids, comprises the cyclopentanoperhydrophenanthrene nucleus and is vital to the body economy interalia, hormonally, cellularly, and neurally. Sex hormones and steroids are but a variant of cholesterol. The per second cytopoiesis of four million necessitates cholesterol as the cell-cover. The Gray's Anatomy avers that in the constituents of myelin, "The major lipid species are cholesterol (the most common single molecule), phospholipids, and glycolipids."  The cholesterol-lowering therapeutic agents are celebrated dementors and their demyelinating role is waiting to be exposed through some human trials or animal tribulations.
It suffices to say that the gains of the cholesterol-lowering therapeutic agents are hypothetical; the ravages, thereof, are self-evident. The lipid hypothesis inflicts a double whammy by denying the delights of dietary fat and offering the potential poisons in the form of cholesterol-lowering medications. The 1995 (34 th ) edition of the yearly "Current Medical Diagnosis and Treatment" launches its chapter on "Lipid Disorders" by a mea culpa: "A major problem for clinicians is that current therapies for high blood cholesterol do not reduce total mortality, in part because their use has been associated with an unexplained increase in deaths from noncardiovascular causes."  The text is further candid: "As with most primary prevention interventions, however, large numbers of healthy patients (sic) need to be treated to prevent a single event; for cholesterol lowering, it may be necessary to treatment (sic) more than 600 patients for several years to prevent a single coronary death or five or six nonfatal coronary events."  In the subsequent editions of the book, both the above stand deleted sans any scientific reasons.
MM completes its assault on the sanity of the body by its too hackneyed a jihad against what was once depicted by Herbert Spencer as "divine tobacco," whose positive contributions to health have been glossed over. Now comes the news that tobacco lowers the incidence of both Parkinson's and Alzheimer's diseases. ,,,,,
Winston Churchill, who, so to say, drank like a fish and smoked like a chimney, on his 80 th birthday, was photographed by a young journalist who expressed the hope that he be able to photograph the great man the next year as well. "Why not, young man," quipped Churchill, "I see nothing wrong with you!" Having said that, he went to bat till a ripe age of 94 years. Mark Twain's health, creativity, humor, and longevity, lay, in his own words, to two strict rules on smoking: To never ever smoke when asleep, and smoke only one cigar at a given time.
Iatrogeny of different kinds are public knowledge. DOMP was conceived vis-à-vis MM's antibioticism. Raeburn, writing in "The Lancet" on immunodeficiency in children, warned: "In years to come, the story of antibiotics may rank as Nature's most malicious trick" on mankind.  The current viral epidemics have been ascribed to the monkey slaughter that medical experimenters have indulged into. The Polio Vaccine alone had entailed a "sacrifice" of a million monkeys (Deborah Blum).  The peaceful simian viruses are busy turning to the human apes for a lodgment and humanity is reaping the whirlwind. Cancer chemotherapy itself is known to be a cause for second cancer. , Aspirin has been found to cause microbleeds in the brain, only to aggravate the neural damage detailed above. ,,,, The current epidemic of the fashion and the fad of being Worried Well (WW) - Worried Well - Is a fitting climax to what Alex Comfort, the gerontologist and the sex guru depicted long ago as The Anxiety Makers (Panther, London, 1967). Comfort held anxiety-making as a "curious preoccupation of the medical profession." 
Globally, medical Check-up Clinics are alchemically transmutating the well who walk into the clinic into the Worried Well that walk out from there, loaded with investigative prophecies of doom, killjoy proscriptions, and needless, harmful, lifelong preventive prescriptions. Checkup clinics are booming business and booming iatrogeny as well. Through his book titled Mirage of Health - Utopias, Progress and Biological Change (1959), René Dubos  and the term "healthism" size up MM's, media's and mankind's obsessive compulsive, almost neurotic tilting at the windmills of preventive checkupism. In the passing, it may be mentioned that "iatrogeny" could etymologically connote doctorpoiesis as well. "The New England Journal of Medicine" long ago suggested replacing "iatrogeny" by "iatrality" and "iatrogenic" by "iatral".
The Alzheimerogenic iatrality (pardon the neologism) resides in dietary deprivation of the delights of fat, cholesterol-lowering drug-induced myelin and neuronal damage,  the microbleedings in the brain from aspirin and statin  obsession, and last but not the least, in the abjuring of the better side of Lady Nicotine. All the foregoing factors act individually or in consort to promote a faster rate of the apoptosis of cerebral neurons with effects that are too evident to merit elaboration.
MM needs, in all humility, to roll back on its lipid and tobacco hypotheses. Mencken, the celebrated US journalist and social critic, bemoaned the killjoy asceticism of MM vis-à-vis the daily delights of life. Dubos, the founder member at Rockefeller Institute, wrote: "In the words of a wise physician, it is part of doctor's function to make it possible for his patients to go on doing the pleasant things that are bad for them - Smoking too much, eating too much, drinking too much - Without killing themselves any sooner than is necessary."  Mencken declared that "The true physician does not preach repentance; he offers absolution." By the way, Mencken's words are epigraphic to the 2000 edition of The Concise Oxford Textbook of Medicine.
We may end with a doggerel:
Beer and Bacon,
Taken in a mood of cheer
Is superior to the ideal diet
Taken in a mood of fear.
MM's ostensible jihad to save humankind from the perils of a killer disease No. 1, 2, 3,…, n is laudable as a public rhetoric but, so far has had a very poor outcome. It has been Oceanic Output, zero Outcome (OO0O) - Oceanic Output, zero Outcome. Despite all kinds of statistical scares doled out by MM, human population has been mounting up and up, to threaten to burst the Earth at its seams. So you must conclude that the killerness lies more in the minds of MM, than in reality. In which case, let humanity savor the joys of eating, smoking, drinking, and the bedroom to spread some shivers of joy that are likely to be the best antidote to Alzheimer's and the like.
| References|| |
Moser RH. Diseases of medical progress. N Engl J Med 1956;255:606-14.
Jauhar S. Doctored: The Disillusionment of an American Physician. New York: Farrar, Straus and Giroux; 2014.
Kettenmann H. Nervous system. In: Standring S, editor. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41 st
ed. Elsevier; 2016. p. 42-67.
Browner WS. Lipid disorders. In: Tierney LM Jr, McPhee SJ, Papadakis MA, editors. Current Medical Diagnosis and Medical Treatment. 34 th
ed. USA: Lange Medical Book; 1995. p. 1041-52.
de Lau LM, Breteler MM. Epidemiology of Parkinson's disease. Lancet Neurol 2006;5:525-35.
Ritz B, Ascherio A, Checkoway H, Marder KS, Nelson LM, Rocca WA, et al
. Pooled analysis of tobacco use and risk of Parkinson Disease. Arch Neurol 2007;64:990-7.
Hershey LA, Perlmutter JS. Smoking and Parkinson disease: Where there is smoke there may not be fire. Neurology 2014;83:1392-3.
Kenborg L, Lassen CF, Ritz B, Andersen KK, Christensen J, Schernhammer ES, et al
. Lifestyle, family history and risk of idiopathic Parkinson disease: A large Danish case-control study. Am J Epidemiol 2015;181:808-16.
Baron JA. Beneficial effects of nicotine and cigarette smoking: The real, the possible and the spurious. Br Med Bull 1996;52:58-73.
Fratiglioni L, Wang HX. Smoking and Parkinson's and Alzheimer's disease: Review of the epidemiological studies. Behav Brain Res 2000;113:117-20.
Raeburn JA. Antibiotics and immunodeficiency. Lancet 1972;2:954-5.
Deborah B. The Monkey Wars. Oxford: Oxford University Press; 1995.
Freter CE, Longo DL. Late consequences of cancer and its treatment. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison's Principles of Internal Medicine. 18 th
ed. Vol. 1. New Delhi: McGraw-Hill Medical; 2012. p. 838-43.
American Cancer Society. How does Chemotherapy Affect the Risk of Second Cancers? Available from: http://www.cancer.org/cancer/cancercauses/othercarcinogens/medicaltreatments/secondcancerscausedbycancertreatment/second-cancers-caused-by-cancer-treatment-chemotherapy. [Last accessed on 2015 Dec 12].
Kakar P, Charidimou A, Werring DJ. Cerebral microbleeds: A new dilemma in stroke medicine. JRSM Cardiovasc Dis 2012;1:2048004012474754.
Cordonnier C, van der Flier WM. Brain microbleeds and Alzheimer's disease: Innocent observation or key player? Brain 2011;134:335-44.
Wong KS, Chan YL, Liu JY, Gao S, Lam WW. Asymptomatic Microbleeds as a risk factor for aspirin-associated intracerebral hemorrahages. Neurology 2003;60:511-3.
Vernooji MW, Hagg MD, van der Lugt A, Hofman A, Krestin GP, Stricker BH, et al
. Use of antithrombotic drugs and the presence of cerebral mirobleeds: The Rotterdam Scan Study. Arch Neurol 2009;66:714-20.
Gorelick PB. Cerebral microbleeds: Evidence of heightened risk associated with aspirin use. Arch Neurol 2009;66:691-3.
Comfort A. The Anxiety Makers. London: Panther Books; 1968.
Dubos R. Mirage of Health - Utopias, Progress, and Biological Change. New York: Harper & Brothers; 1959. p. 170-219.
Buck RW. Letter: Iatral, not iatrogenic. N Engl J Med 1976;294:1298.
Klopfleisch S, Merkler D, Schmitz M, Klöppner S, Schedensack M, Jeserich G, et al
. Negative impact of statins on oligodendrocytes and myelin formation in vitro
and in vivo
. J Neurosci 2008;28:13609-14.
Romero JR, Preis SR, Beiser A, DeCarli C, Viswanathan A, Martinez-Ramirez S, et al
. Risk factors, stroke prevention treatments, and prevalance of cerebral microbleeds in the Framingham Heart Study. Stroke 2014;45:1492-4.
Mencken HL. Concise Oxford Textbook of Medicine. Oxford, USA: Oxford University Press; 2000. p. 20.