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The Journal of Orthomolecular Medicine Vol. 10, No.l, 1995


Predictive Medicine: The Story of Odds and Ends

E. Cheraskin, M.D. D.M.D.

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Some years ago in a stimulating, and at times irritating, book entitled "Apes, Men and Morons," anthropologist Earnest A. Hooten made the comment that it is a very short-visioned medical science which works backward from the autopsy table, rather than forward from the cradle.1 He sees no bright future for scientific achievement in the healing arts by limiting its responsibility to repair work and curative procedures.

For practical purposes and as an immediate working hypothesis, predictive medicine may be defined as the clinical discipline designed to anticipate disease in man.2 The intent, by such an approach, is to foretell illness before it erupts in its classical form. Thus, predictive medicine allows for primary prevention (prevention of occurrence). This philosophy immediately sets predictive medicine apart from conventional medicine where the cardinal theme, by act if not by word, is the identification of existing disease with subsequent treatment and, at best, secondary prevention (prevention of recurrence).

The concept of risk is an ancient one. Consultation with the Delphic oracle or pre-diction of the health of inhabitants of a city from a survey of the city's topography as described by Hippocrates are both early forms of risk assessment. The 18th and 19th centuries provided many instances of increasingly sophisticated studies identifying risk analysis. For example, in 1775, Sir Percival Pott described the association between chimney sweeping and scrotal cancer. These observations, however, were fortuitous, not the result of deliberate epidemiologic studies to identify risk analysis.

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