Trüeb Ralph Michel, Dutra Hudson, Dias Maria Fernanda Reis Gavazzoni
Center for Dermatology and Hair Diseases Professor Trüeb, Zurich-Wallisellen, Switzerland.
Department of Dermatology, Alvaro Alvim School Hospital, Campos dos Goytacazes, Brazil.
Int J Trichology. 2019 Jan-Feb;11(1):1-7. doi: 10.4103/ijt.ijt_79_18.
Medical trichology is the branch of dermatology that deals with the scientific study of the hair and scalp in health and disease. As any discipline, the practice of medical trichology is not immune to malpractice, either deliberately or carelessly. In his publication "Autistic Undisciplined Thinking in Medicine and How to Overcome It," Swiss psychiatrist Eugen Bleuler describes yet another form of malpractice in medicine reflecting autistic-undisciplined thinking. Autism is not limited to psychopathology, but inherent to the thinking of man throughout history in his drive for knowledge, with thousands of theories lacking any basis in reality. Bleuler recognized the drive character of autistic thinking and how it leads to conclusions that are unshakable because they are determined by, and fulfill, emotional needs, rather than rational argumentation. Even with correct questions, the complexity and incalculability of some problems are often so great that it cannot do justice to realistic thinking and the boundaries between inadequately substantiated hypothesis and autistic sham explanation disappear. Statistics, careful research design, and the attempt to impose stringent methods on our thinking are to be commended. The habituation of the public to useless medicine, to misconceptions, is not hygiene, but negligent endangerment. It has created an industry that largely lives on the autistic thinking of patients and doctors and because it is prosperous, makes propaganda among lay people as well as among doctors that necessarily leads to abuses. This article aims at exposing the most prevalent among abuses in trichological practice due to autistic-undisciplined thinking, specifically: iron supplementation, antiandrogenic treatment, and individualized cell-based therapy in female androgenetic alopecia, treatment of folliculitis decalvans with retinoids, and the value of nutritional therapies.
医学毛发学是皮肤病学的一个分支，专门对健康和患病状态下的头发及头皮进行科学研究。与任何学科一样，医学毛发学的实践也难免会出现故意或疏忽导致的医疗失误。瑞士精神病学家尤金·布鲁勒在其著作《医学中的孤独症式无纪律思维及其克服方法》中描述了医学中另一种反映孤独症式无纪律思维的医疗失误形式。孤独症并不局限于精神病理学，而是贯穿人类历史求知过程中思维的固有特征，有成千上万毫无现实依据的理论。布鲁勒认识到孤独症思维的驱动性特点，以及它如何导致因由情感需求决定并满足情感需求而非理性论证得出的不可动摇的结论。即使问题正确，某些问题的复杂性和不可预测性往往极大，以至于无法公正对待现实思维，未经充分证实的假设与孤独症式虚假解释之间的界限也不复存在。统计学、精心的研究设计以及试图在我们的思维中强加严格方法是值得称赞的。公众对无用药物和错误观念的习以为常并非卫生问题，而是疏忽造成的危害。这催生了一个很大程度上依赖患者和医生的孤独症思维而生存的产业，而且由于它繁荣兴旺，便在普通人和医生中进行宣传，必然导致滥用。本文旨在揭露毛发学实践中因孤独症式无纪律思维导致的最普遍的滥用行为，具体包括：补铁、抗雄激素治疗以及女性雄激素性脱发的个体化细胞疗法、用维甲酸治疗脱发性毛囊炎以及营养疗法的价值。
