"Studies" vs. Common Sense. The American College of Chest Physicians ("ACCP") recently announced that studies show that cough syrup doesn't work and may even harm patients by delaying them in seeking medical attention for serious conditions.

Americans buy about $2.9 billion worth of over-the-counter cold medicine and another $400 million of prescription cold medication, a university study found in 2003. About $270 million goes for cough syrup, which generally sells for a few dollars a bottle.

We are to believe that Americans are so astonishingly stupid that they spend $270 million a year on something that doesn't work, with many of them coming back year after year to buy something that doesn't work? I don't think so.
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Nor does Dr. Marc K. Siegel, an associate professor of medicine at the NYU School of Medicine, think so. In an op-ed piece in the New York Post today, he says:

OK, I've always understood that cough syrup contains low doses of chemicals that have never been proven to work. And I certainly understand that I must look for the underlying cause of a problem, not simply slap on a treatment. But what's the ACCP's [answer] to a question like this: "Doc, I have a bad cough. It's always gotten better with Robitussin. What am I supposed to do now?"

Well, ACCP, what do you have to say? Suffer through it? You would have me tell my patients to suffer through it? You can't be serious.

My answer: "If it helps you, then continue to take it."

Am I treating a cough, or just providing a placebo? If the latter, what's wrong with that?

Medicine is in large measure about how people feel. If someone feels better for taking cough syrup, it works.
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Indeed, clinical medicine consists in seeing by actual practice in the field what works and what does not work. It doesn't rely upon academic studies. The pretense of academics is that a lot of what we think we know is false. The assumption of democracy is that when you put together the actual experience and wisdom of the many, you are likely to come up with better public policy than if you heeded only the few. Plainly that doesn't always work, as for instance in regard to legislation as to religiously influenced views of morality. But as to what works and what doesn't work, I'd rather listen to the many than the few.
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I know that cough drops have worked for me. When I was attending real-estate school, I'd often get a tickle in the throat because of the air conditions in the closed classroom. A Hall's cherry-flavored cough drop handled the problem nicely. And tasted good too. Am I imagining that? Well, let's see. Without the cough drop, I coughed. With the cough drop, I didn't. Hmm. That's a toughy.
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Maybe something else would have worked equally well.

Research published in the journal Pediatrics in 2004 suggested dextromethorphan, often listed on labels as DM, or diphenhydramine, an antihistamine, did not offer any more relief to children suffering from cough than sugar water.

But sugar water doesn't come in handy little lozenges you can carry in pocket or purse, does it?
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There are times when people need to greet each day's "scientific" news — this week: coffee is bad for you; next week: coffee is good for you — with a healthy dose of skepticism. Listen to your body and you may hear greater wisdom, truer to you, than anything you'll hear on TV or read in the papers.
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(The current U.S. military death toll in Iraq, according to the website "Iraq Coalition Casualties", is 2,236.)
- posted by L. Craig Schoonmaker @ 5:17 PM