Friday, March 14, 2008

The Osler Corner - On polypharmacy

Osler was one of the greatest physicians of all time. Here are some of his thoughts on polypharmacy from around a century ago.
For generations the people of the United States have indulged in an orgy of drugging. Between polypharmacy in the profession and quack medicines, the American Body has become saturated ad nauseum.
Sir William Osler (1849-1919), British Medical Journal (1910) 1470-2
The young physician starts life with twenty drugs for each disease, and the old physician ends life with one drug for twenty diseases.
Sir William Osler (1849-1919)
The battle against polypharmacy, or the use of a large number of drugs (the action of which we know little, yet put into bodies of which we know less), has not been fought to a finish.
Sir William Osler (1849-1919), in Aequanimitas p255
In 2008 polypharmacy may occur because treatment guidelines are imposed on doctors for multiple specific diseases. Even when guidelines are science-free or commercially biased, the legal and practical risks of disobeying them may override logic. Clinical trials (and guidelines) rarely take account of polypharmacy, and generally exclude patients taking other medicines.

Click here for collated posts from the Osler Corner

Earlier|Later|Main Page

1 comment:

Anonymous said...


You may or may not be interested in the EDICT Project ("Eliminating Disparities in Clinical Trials"), which is a primary work project for me right now.

Here is the web address:


--Daniel Goldberg