Hacking the inflammatory reflex.

Abstract

Medical breakthroughs create surprises. But medicine abhors surprise, so breakthroughs often begin life being viewed as alternative treatments or being scorned as quack ideas. Consider, for example, Ignaz Semmelweis, who in 1847 discovered that handwashing improved survival of women with peripartum infection, especially when gloveless medical students doing autopsies washed their hands before delivering babies. Despite rigorous statistical proof, Ignaz's breakthrough ideas infuriated his colleagues, who committed him to an asylum, where he died at age 47 years at the hands of his prison guards. Decades later, Louis Pasteur provided the scientific mechanism explaining Ignaz's findings and picked up the cause of advocating for physician handwashing. He too faced the wrath and scorn of physicians who derided and ridiculed the germ theory as quackery. Clearly medical breakthroughs are often more evolutionary than revolutionary. 1 Lipton P Inference to the best explanation. Routledge, London2004 Google Scholar , 2 Obenchain TG Genius belabored: childbed fever and the tragic life of Ignaz Semmelweis. University of Alabama Press, Tuscaloosa2016 Google Scholar Non-invasive vagus nerve stimulation for rheumatoid arthritis: a proof-of-concept studyUse of the device was well tolerated, and patients had clinically meaningful reductions in DAS28-CRP. This was an uncontrolled, open-label study, and the results must be interpreted in this context. Further evaluation in larger, controlled studies is needed to confirm whether this non-invasive approach might offer an alternative treatment for rheumatoid arthritis. Full-Text PDF