Last week, I wrote about how Senator Tom Harkin is up to his old shenanigans again, trying at ever turn to do for the actual practice of quackery what he did for the research of quackery by creating the National Center for Complementary and Alternative Medicine (NCCAM) and what he still does to promote quackery by berating NCCAM for in essence being too scientific in not having validated enough of his cherished woo. In essence, Harkin has slipped a provision into the Senate version of the 600+ page health care reform bill that is currently taking shape in Congress that included funding for "community wellness programs," which, if science-based, would be a good thing, but which, when sponsored by a quackery supporter like Tom Harkin, is usually woo-speak for including all manner of unscientific "alternative" medical modalities and dubious dietary advice, usually with supplements. As I've characterized it before, you can look at it as a "bait and switch," in which CAM advocates appropriate sensible, science-based modalities like diet and exercise as being "alternative" (the bait) and then use that to argue that the woo they associate with such modalities (up to even pure woo like reiki or homeopathy) is effective (the switch).
Another provision that laid bare Harkin's true plans, however, was the one he also slipped into the bill that includes "alternative" medicine practitioners as part of the bill's definition of the "health care workforce." That's part of the Trojan Horse aspect of what Harkin's trying to do. In the belly of a sturdy-looking offering lurks a whole lot of pseudoscience. It doesn't take too much consideration to realize that the reason for this provision is almost certainly to lay the groundwork for requiring the government to pay for "alternative" medicine services, and, as the government goes, so too goes the private health insurance industry, at least when it comes to what health care services will be funded. As you might imagine, I was not too happy about this. Indeed, I was a bit snarky. Probably no more snarky than usual on this topic, but entertainingly snarky enough.
Apparently I hurt someone's feelings, or at least riled him up.
Here's one kind of science I despise, the smug up-its-own-ass kind that thinks all you have to do is go around being a smart-arse and everyone will realise what idiots they've been and come and sit at your feet with rapt attention...
Um, well, no, not exactly. I mix the smart-arse stuff with a lot of scientific evidence. On one day, I may be a smart-arse, so to speak, and on another day I'm analyzing the latest cancer research. I like to think that variety is what keeps this blog traffic up there as consistently number three or four among ScienceBloggers, behind P.Z. and Ed (and the occasional interloper). I have a distinct viewpoint, a science- and evidence-based approach to medicine, and a niche that I filled four years ago. The main topics generally include alternative medicine, science-based medicine, anti-vaccine lunacy (which, shockingly, I haven't written much about in a while; I may have to remedy that), skepticism and critical thinking, with a coterie of less frequent topics, such as evolution versus creationism. I've built up my blog and my "brand" over four years. I certainly didn't get to where I am now by simply being a smart-ass and hoping to get people to sit at my feet with rapt attention. Indeed, although I like the traffic as much as anyone, I'd probably still be doing this if I had even 1/10 of the traffic, which is what I did have at about the one year mark after starting this blog.
But let's see what our friend's real complaint is:
I have to say here that I'm not a person who's impressed by reiki or homeopathy but I'm pretty sure most of us consider chiropractors to be a useful therapy. And some would even go so far as to include the above-mentioned and add acupuncturists as well. After all, it's what works for you, right? That's why I can't stand the tone of this guy's article and am pushing this article out. If the Catholic church had its way, we'd still be curing our ills by holding prayer sessions and subsisting on bread and water to toughen us up... Similarly, if this guy has his way, we'll just stick with Big Pharma using us as guinea pigs for newer drugs with ever more "interesting" side effects...
There we go. Now, we're talking! Get it all out. Liken science-based medicine to a religion and "alternative" medicine to Galileo! I knew he wanted to, and he's finally made his belief plain. Note first how he tries to show us how seemingly reasonable he is by disavowing the more ridiculously implausible bits of alt-med, such as homeopathy and reiki. It's the old "because I don't believe total nonsense believe me when I support this other, less egregiously nonsensical nonsense" ploy. He's also pulling the old "mean," "hateful," and "arrogant" doggerel, with a dash of the "science is just another religion" thrown in for good measure. Of course, one could point out that at the time of Galileo, pretty much all that could be done for serious illness was to pray. Oh, and bleeding, leeches, and purges with toxic heavy metals or the placement of nasty poultices to draw out the evil humors. That was the medicine of the time. It was science that overcame that. It took hundreds of years, but we actually have effective medicines and treatments for many illnesses and vaccines to prevent other illnesses. And, yes, a huge part of scientific medicine is effective pharmaceutical drugs, but it's far more than just drugs. Our unhappy friend falls into the common trap that alt-med mavens fall into, namely that "science-based medicine = pharmaceuticals."
Our friend also loves him some straw men:
But something I'm even more afraid of than someone like Sn Harkin, though, is the kind of person who sneers and thinks just calling something "woo" means that's it, the end of the matter, everyone has to agree with me now, thank you all very much you poor misguided shills you.
Uh, no. If you read my blog, you'll find copious examples where I explain exactly why I consider something to be pseudoscience or, as I like to call it, "woo." Provide me with evidence to show my characterization to be wrong, and I'll reconsider. Whining about my characterizing it as "woo" as though I'm trying to shut off debate is just silly. Our friend also doesn't understand the scientific method:
What I'm saying is - where does your "respectful insolence" stop? My grandma prescribed camomile tea for certain ailments, other herbs for others. Her knowledge was not learned in a University, it was passed down from one generation to the next - generations that had little better to do than exist, work, and observe the effects of certain herbs on certain illnesses and pass that knowledge on to their offspring. It's how all our advances were made at one stage. It's how pharmacology came to exist.
Is that "woo?"
Ah, yes, the appeal to ancient wisdom, also known as the appeal to antiquity. My grandma does it; so it must be as good as science! All those ancient people did it; so it must be comparable to modern science. Here's the problem. As I've explained time and time again, anecdotal evidence can be very deceiving, and the plural of "anecdotes" is not "data." Those ancient healers also thought for hundreds of years that bleeding was a great treatment for what ails you. They did it by working, observing the effects of bleeding on various ills, and then passing that knowledge on. True, if an effect is really marked, such as a poison that kills, anecdotal evidence can be fine. Give a couple of people a poisonous herb and see that they immediately got really sick, and that's pretty good evidence that it's toxic. However, most illnesses and most treatments aren't that black and white. The placebo effect, regression to the mean, and the self-limited nature of many illnesses can easily make it appear that a useless remedy (homeopathy, anyone?) or even a potentially harmful remedy (purging with antimony or arsenic, anyone?) actually does some good. That's why it became increasingly appreciated that the scientific method, with proper controls and blinding, is necessary to determine what really works better than a placebo. As I've tried to school a certain anti-vaccine pediatrician time and time again, humans are easily fooled. They easily confuse correlation with causation. It takes a certain humility to realize how easily we can be fooled and why the scientific method is so necessary. Many alt-med mavens either don't understand that or, like the aforementioned pediatrician, refuse to accept it.
But the grand finale really cracked me up:
What about we say that "proper" pharmaceutical companies are the only thing that doesn't constitute "woo." Oh dear, they actually have a worse record than the animals and my granny. Because my granny never prescribed anything to me that caused severe side effects or death. And yet, every year, we hear about another drug from big pharma that has caused a spate of deaths or injuries or disablements...
Your granny also never prescribed anything to you that would cure a serious illness, either. It's all a matter of risk versus benefits. The reason we tolerate worse side effects for cancer treatment is because, well, many cancers will kill you if left untreated. I don't hear granny saying that her soup will cure cancer. I do hear a lot of quacks claiming that their brand of pseudoscience or mystical rearrangement of the flow of your qi will cure cancer.
I love this last part, a total tu quoque logical fallacy:
Are surgeons the only medical people that aren't "pitching woo?" In my experience and reading, their success rates are not all that crash hot either. They kill more people by direct action than all the faith healers kill by "wooing" someone into ignoring symptoms. Oh yeah - and they come from a long line of bloodletters, "animal magnetists," and people who thought leeches and maggots would cure blood problems and infections. Oh wait, they're bringing those back in mainstream medicine, aren't they?
Oooh, I'm so insulted. Of course, I've been critical of my profession when it is too slow to stop doing procedures that don't work; but let's get one thing straight. There are some problems that only surgery can fix and some diseases that only surgery can cure. Once again, it's a matter of risk versus benefit. But nice try. Our friend apparently thinks it's not so bad for quacks to "woo" someone into eschewing effective therapy because scientific medicine, in his mind, is so much worse. As for maggots and leeches, if science can show them to be useful for medical purposes, I have no objection.
Finally, our friend reiterates his science as a religion meme. He even pulls out the F-word:
And yes I in general agree with scientific rationalism, agree that science has most of the answers. What I don't agree with is the schoolboy name-calling, the slightly pious and fervent tone of moral rectitude. That's not rational.
That's how fundamentalists protect their desmesnes and their beliefs. And there's few things as dangerous as a fundamentalist, especially a Scientific Fundamentalist.
A "scientific fundamentalist." What on earth is that? Science is not religion. Unlike religion, it is inherently self-correcting in that it ultimately throws out ideas that the evidence doesn't support. True, it may take a lot longer than we would like. It may be a lot messier than we like, and this messiness gives supporters of woo endless ammunition to paint science as being wrong all the time, leading them to ask how science can dismiss pseudoscience when it changes its precepts seemingly so often.
As for "schoolboy name-calling," if our friend is so upset by my labeling acupuncture and aspects of chiropractic "woo" and promoters of such modalities, "woo-meisters," he really does have a thin skin.
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The shorter rebuttal
This was his argument:
- Straw Man
- Oracâs rude, rude I tell you.
- Straw Man
- Appeal to ancient wisdom
- Science is sometimes wrong
- Straw Man / general name calling.
What a waste of a blog post.
Dude, with all due respect, you blog about what you want to blog about, and I'll blog about what I want to blog about. Besides, it's a holiday, and, as with most holidays, traffic is way down. The perfect time for a quickie fun post that took very little time to write. After all, if I wrote this on, say, a Wednesday (usually my maximum traffic day), I'd drive too much traffic over to our "friend's" site.
Orac, I think he meant Zencookbook's post was a waste, not yours...
Chill - I meant his post was a waste, not yours.
Skeptico: if it wasn't for straw men, some of these people would be entirely alone in the world.
I rarely comment but thank you Orac for doing posts like these.
Off topic:
Interesting choice of word in this sentence, "... (I may have to remedy that), skepticism and critical thinking, with a coterie of less frequent topics, such as evolution versus creationism."
I've seen coterie used to describe a group of people with some common interest, (often used disparagingly), but never for a group of related topics. Did you mean to extend the definition, or were you really looking for another word?
That whole "Scientific Fundamentalist" thing...where does this freakish mistrust of science paired with a belief that scientific evidence can be equated with dogma come from? Why do these guys make this same stupid accusation time and time again that a given person "believes in" science like it's a religion? Belief isn't the question, but here we are a-freakin'-gain with someone who's framing the question in thinly-veiled religionism. *sigh* I wish I were more bored by this kind of thing than irritated.
Because belief is all that they understand.
"Investigators are focusing on at least five doctors who prescribed drugs to Michael Jackson as they try to unravel the circumstances surrounding the pop starâs death, according to law enforcement sources."
It wasn't alternative medicine that murdered Michael Jackson.
self-limited nature of many illnesses
Interesting choice of words.
That's why it became increasingly appreciated that the scientific method, with proper controls and blinding, is necessary to determine what really works better than a placebo.
That and a little bit of Rockefeller.
it is inherently self-correcting in that it ultimately throws out ideas that the evidence doesn't support.
Science may, but people do not. Lest we forget, people actually apply the scientific method and people are subject to conflict.
This blog posting is not about Michael Jackson. What makes you think it is? A lack of reading comprehension?
It certainly wasn't science-based medicine.
When people abuse medications in ways that the label says not to, well, guess what?
It's not the medication's fault.
Which is why peer review and replication is a necessary part of science: To balance out those conflicts. If a competitor with different interests gets the same results, you can be more confident. If lots of people from all sorts of backgrounds get the same result, you can be even more confident. And, of course, proper blinding also prevents the experimenter from tampering with the results: He doesn't know which patient results to tweak until it's too late.
Of course, the alternative medicine method of finding the truth is, "I know because I'm not a fallible mortal, I'm a god with infallible perceptions of how the treatment works on individuals, despite all the confounding alternative explanations for the results." The typical altie practitioner wants to tear down all those protections because all that hard work and self-questioning gets in the way of haphazardly experimenting on the public for fun and/or profit.
Murdered?
How has that been determined? This is a possibility, but there is still a lot to learn about what happened. Maybe we will find out that he was taking a natural medicine that was responsible for his death.
Many proponents of scientific medicine has been very critical of the treatments that have been reported. I have only written 2 posts on the problems with his treatment. When Michael Jackson Is The Patient - A Call That Everyone Will Criticize and more recently in Michael Jackson and Diprivan (Propofol) I expect to write more.
I am just one person writing about this case of unconventional medicine.
Actually, this is alternative medicine. This is medicine that is not accepted by conventional medicine. What else was Michael Jackson receiving, but alternative medicine?
Whether your alternative medicine is murder in this case has yet to be determined.
That guy must have shares in a scarecrow factory.
In spite of his dismissal of homeopathy and reiki, the arguments he uses against your critique(s) of "straight" chiropractic can be applied unaltered against your critiques of homeopathy or reiki (or any other pseudoscience).
Off topic: There's a measles outbreak in Brooklyn. The majority of cases are in people who are...get ready for a big surprise...unvaccinated! Yes, I know you're all gasping in shock but once again vaccination saves lives. Or at least prevents misery. I don't know that any of the victims has died yet.
Own Up To Irrelevance,
This post has nothing to do with what you wrote. Nothing.
This is about science. If there are posts that are in any way related to what you wrote, that would be the time to attempt to make your irrelevant case.
Well, it's in his interest to attack you. The blog is set up to sell a woo cookbook. By attacking you, he increases his own sales with the woo crowd.
Your post does have a major inaccuracy, though: He *is* claiming his granny's cooking can cure cancer. See http://www.zencookbook.com/
It wasn't alternative medicine that murdered Michael Jackson.
That's hysterically funny, really!!
I've always found it interesting that nobody uses "alternative medicine" to get high. 100C LSD would pretty much level a city, wouldn't it? Or how about an acupuncture needle to unlock a serotonin dump? And why can't a reflexologist give a patient a nice reflexological happeh ending?
I think that's also a numbers issue. There are about 20 million surgeries in the US a year. I'm not sure how many faith healings are done, but they aren't tracked as well, obviously. Surgeries are inherently risky medical procedures. Faith healing can be risky, but not in a way that can be dramatically told in an anecdote.
The best way to ask the question is whether surgeries are routinely done which do not improve survival. For example, does gallbladder surgery improve survival? I read somewhere it might not.
Again, this is why doctors need to get behind single-payer health care. The biggest impetus for woo along the lines of what Mister Zen Cookbook's pitching is the skyrocketing costs of health care in the US. Let's say you're a sixty-year-old fellow with trashed knees: What sounds better to you, a $35,000 knee replacement or taking $50 worth of glucosamine every month? You'd have to live to 120 before the pills approached the cost of the surgery. Similarly, pushing the whole "eat this and you'll never ever get (insert name of favored disease here)" schtick is considered to be far cheaper, and less fraught with side effects, than taking actual medicines for said complaints.
Orac, give it to em with both barrels.
Damn the Woo-torpedoes full speed ahead !
Are not these 'plethora' of straw men a potential inexhaustable energy source?
Or might their burning generate both excessive methane and intolerable noise?
Hmmm, well being called a Scientific Fundamentalist is maybe not such a bad thing. According to dictionary.com, fundamentalism is defined as "strict adherence to any set of basic ideas or principles." As long as those principles are the scientific method, I would say that's quite a compliment!
Or would you prefer to be called a Scientific Methodist?
"zencookbook". Zen cookery? As in, "If you want to cook a lamb, begin at the serving"? Zen kookery, I say.
Yes, how about them maggots?
I seem to remember a press release a few months back, which claimed that a comparison found that longterm healing was no better than from some other wound treatment. The difference was that short term the wounds looked cleaned up.
With the usual caveats (I misunderstood, I misremembered, the wounds weren't for the typical maggot treatment, the comparison was statistically unsound), what if that is the case?
Maggots will work at the wounds out of immediate self interest, so perhaps there will be less cases of maltreatments using them. But then we have the icky (and itchy?) factor, and perhaps the economics, speaking against them. Perhaps they will end up as useful but not used?
That's a lie. Vaccines are totally ineffective. What really happened is that Big Pharma kidsnapped the children of some brave anti-vaxers and injected them with a genetically-engineered measles clone!
"zencookbook"? Zen cookery? As in, "If you want to cook a lamb, begin at the serving"? Zen kookery, I say.
Yes, how about them maggots?
I seem to remember a press release a few months back, which claimed that a comparison found that longterm healing was no better than from some other wound treatment. The difference was that short term the wounds looked cleaned up.
With the usual caveats (I misunderstood, I misremembered, the wounds weren't for the typical maggot treatment, the comparison was statistically unsound), what if that is the case?
Maggots will work at the wounds out of self interest, so perhaps there will be less cases of maltreatments. But then we have the icky (and itchy?) factor, and perhaps the economics, speaking against them. Perhaps they will end up as useful but not used?
I realize this is off-topic, but I love Phoenix Woman's argument here. "Health care costs are skyrocketing, so we need a single-payer system so that people will invariably choose the more expensive treatment." WHAAAA??? That has to be the most inept defense of single-payer I've ever seen.
Also, as Orac and so many, many others constantly point out, "alternative" medicine is usually fantastically expensive, as one would expect from a scam. Refer again to the Homeopathic A&E vid for a succinct reminder- "a bottle of basically just water in one hand, and a huge invoice in the other." And FYI: national health insurance abroad is notoriously woo-friendly. The UK and France (and many others) even cover...homeopathy.
Yeesh.
D'oh! Sorry about the double posting, my browser crashed on posting and I only briefly scanned the last comment when I got back.
I also wanted to say this:
James, I know you are just joking. But for the record - science is a method, not a specific idea or principle. If it wasn't working, we would have to use something else.
Those definitions are describing theology, and would be teleological, confusing cause and effect, if applied on anything real. I'm not sure I would see them as flattering when used on science and scientists as much as perversely trying to conceal the facts of how science works.
Funny how scientists say alternative medicine does not work. But then they have no problem stealing and using homeopathy strategies.
"Homeopathy is a form of alternative medicine... that treats patients with heavily diluted preparations which are thought to cause effects similar to the symptoms presented."
"Doctors .....believe they can build up a child's tolerance for a food that prompts an allergic reaction by exposing the child to tiny amounts of that food."
Hmmmm. "Heavily diluted solutions to cause disease effects." "Tiny amounts of food to cause tiny allergic effects."
Looks similar to me.
Uh, Torby @ 32? You can't seriously be making the argument that homeopathy is equal to building tolerance for food allergies... can you?
In case you are, a review is in order. If the two really were equivalent, doctors would dilute peanut butter (for arguments sake) to the point where there is not a single molecule of peanut butter left.
The patient would take a few drops of this water, but nothing would happen, good or bad. The method doctors are actually using to alleviate food allergies requires that the patient be exposed to the food in question. Don't mistake "tiny" amount for "not even there."
@32: Yes, they look similar ... if you ignore the fact that one method's explanation has science backing it, and the other has magical thinking backing it.
And if you ignore that homeopathy often dilutes to the point where there is not one molecule of the substance left, vs the anti-allergy method which MUST have enough to have an effect, while balancing it to not be enough to provoke a (strong, anyway) allergic reaction.
And if you ignore that in one case, the effects the substance causes are considered beneficial, while in the other they're considered harmful.
And, you know, just if you generally ignore any form of reality at all.
@ Dianne: Brooklyn! I wonder why? Let me guess,could it have been in one of the more hipster-friendly enclaves, like say, I don't know...Williamsburg,Park Slope?(BTW,I *like* hipsters and Brooklyn- I have some ancestry and lots of relatives there)
The recent recall of Zicam provided Orac an opportunity, again, to write entertainingly of his extreme antipathy toward homeopathy. I have never used a homeopathic product but it's worth noting that:
1. Three clinical studies at Dartmouth and the Cleveland Clinic documented Zicamâs efficacy in 2000. But the FDA has received about 130 complaints alleging loss of smell after using one of these two Zicam products. There were, however, no cases of anosmiaâloss of the sense of smellâin the clinical studies. Matrixx points out that sinusitis and rhinitis, which often accompany the colds and allergies for which Zicam is used, are themselves causes of the loss of smell.
2. Homeopathic remedies have been widely used in Europe for well over 150 years, clinical studies have been published in major medical journals, and the remedies have a long history of safety.
On the other hand conventional FDA-approved medicine does not have such a good record of safety:
1. An average of 195,000 people in the USA died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a new study of 37 million patient records that was released today by HealthGrades, the healthcare quality company:
http://www.medicalnewstoday.com/articles/11856.php
2. In the period from 1969 to 2002, 75 drugs were recalled by the FDA because of safety concerns.
3. In 2008 the FDA received 526,000 adverse event reports related to drugs and biologic products. During that same year the FDA received only 1,080 adverse event reports related to dietary supplements.
Why do medical bloggers express so little outrage over these statistics?
John -- I might point out that "remedies" that don't DO anything are inherently safe to use. Homeopathy (most of it anyways) has that advantage, at least.
"My grandma prescribed camomile tea for certain ailments, other herbs for others. Her knowledge was not learned in a University, it was passed down from one generation to the next -..."
and Orac replies:
"Those ancient healers also thought for hundreds of years that bleeding was a great treatment for what ails you."
What a poor, misleading response. Bleeding was invented by patriarchal physicians who based their invented, non-intuitive treatment on the "science" of the time, the Four Humors representing the Four Elements in the human body, which they felt needed to be in balance to avoid disease etc.
These "ancient healers" were hardly the same people as the "ancient healers" referred to by your critic who at least collected empirical data and attempted to evaluate it and pass it on in a reasonable way.
I can't figure out if you are being disingenuous or just ignorant, because your example seems to actually support your critic's point of view about the "scientific" medical establishment.
Funny I don't happen to recall any Sumerian tablets or Egyptian hieroglyphs that are double blind published studies on the effectiveness of bleeding...but that's just me, however I have a masters in Microbiology and a minor in history.
pathgirl
And if those studies really were well-performed, of sufficient size, and properly controlled, then Matrixx will have no problem meeting the FDA's demand that Matrixx establish safety and efficacy for Zicam. Remember, the FDA's complaint about Zicam was not that it is dangerous--it is that Matrixx has been misusing the "homeopathic" label as a loophole to avoid submitting the documentation of safety and efficacy that is required for an pharmacological preparation intended to treat an illness.
This really falls into the "Well, DUHHHH!" category. By this argument, doing nothing is always better than a real treatment, because real treatments invariable have real risks. People occasionally die of complications after having a broken limb set. Does that mean that we should not set broken limbs? Or maybe treat them with acupuncture or reiki?
The fallacies are obvious to anybody with even a rudimentary grasp of basic reasoning:
a) Counting total adverse event numbers rather than incidence. Did it ever occur to you that it might matter how many people are using these respective treatments?
b) Counting the risks of the treatment, without counting the risk of the illness. Let's suppose that an illness has a 99% chance of killing you, and a treatment has a 90% chance of saving your life, and a 1% chance of killing you. Would you really rather have the disease or the treatment?
And why on earth is it a bad thing that the FDA has recalled drugs because of safety concerns? Virtually every industry occasionally has product recalls for safety reasons. People are fallible and not every risk can be anticipated. I'd worry more about an industry that does not have safety recalls. Does that mean that the people running the industry are infallible gods, who never accidentally place people at risk? Or just that they aren't smart enough to know when their products were hurting people? Why did the FDA have to force ephedra of the market, when it was the source of more serious adverse event reports than all other "nutritional supplements" combined? Why wasn't the nutritional supplement industry able to figure out that ephedra was a hazard, the way that Merck figured out that Vioxx was a hazard, and took it off the market on their own accord?
Isabella completely misses the point about bleeding:
Bleeding was trendy because some guy came up with some idea he thought was clever: Balancing the four humors. The idea was simple, elegant, and WRONG. The idea lasted for generations because no one bothered to test it, and instead relied on anecdotes and tradition to carry on the idea. That's exactly the same way alternative medicine works, and exactly the same criticisms apply. We're very, very glad allopathy is dead, and someday hope to shove its alternative medicine cousins into the same grave.
You should try learning a thing or two about how science works, Isabella. Just because real scientific medicine now occupies the popular slot once occupied by the dangerous quackery of allopathy doesn't mean that they are even remotely the same.
@Isabel
What makes you think those two are different ancient healers? And no, they did not use science at all to validate the humour theory at the time, so pointing out "the science at that time" is fallacious. So I don't know what you are talking about when you tell us about them gathering empirical data.
To put it another way, saying scientific medicine is grounded in allopathy is like saying NASA is based on geocentrism.
Henry @30 is not, I think, comparing like with like. Try separating the two issues:
On the one hand, compare the cost of effective treatment against inneffective. Nomatter the sums involved, effective treatment is always better. At least real homeopathy (as opposed to alt drugs pretending homeopathy to dodge safety checks) has no side effects. It's still worth nothing.
The second issue compares effective treatment against no treatment at all. Only in messed up, sick societies is this even seen as an option. And the secondary costs of lost work, destruction of families, etc, far outweighs the cost of treatment to all but the most venally heartless.
What is needed is a means by which no-one has to make that choice.
Bronze Dog @ 43 - I am definitely stealing that one.
Isabel's comment about the "Science at that time" illustrates the misunderstanding many people have about science - they see it as nothing more than received knowledge like religion. They ignore that it is self correcting.
There are fewer recalls in the supplement industry because there is no monitoring. Were cars safer in the 1950s than they are now because there were no safety related recalls back then?
Oh please calm down people. I put scientific in quotes didn't I? But it was based on Aristotle's theories, accepted by learned men of the time, and certainly was a cure promoted by Greek physicians who were part of the medical establishment of the day. It was also arbitrary and fantastical and was not at all based on the accumulation of knowledge obtained through trial and error over many generations.
As a treatment it bears no relation at all to the folk medicine referred to, which was in fact often viewed as in opposition to patriarchal medical establishment, at times with disastrous results for the practitioners of folk medicine.
But that is an aside: the important distinction is as others have been pointing out, that bleeding is akin to hocus pocus snake-oil treatment, but indigenous knowledge of medicinal plants, obtained through accumulation of trial-and-error results over many generations, is an imperfect method which does however have some relation to modern science.
You still don't understand. Those anecdotal "trial and error results" were obtained in the same way the anecdotes for allopathic bleeding were obtained. There's still no significant difference from our point of view.
It also doesn't help that you refer to a singular "medical establishment" as if the one built on top of allopathy's grave was the exact same thing.
@Torby Renson:
1) When treating a food allergy with tiny doses of the food in question, this is done with a series of doses, with each does more concentrated than the last. That is, each dose is less diluted than the previous dose. Doesn't sound much like homeopathy to me.
2) About "stealing" the idea from homeopathy, I don't know the history of the treatment, but there are two plausible ways that it developed, neither having anything to do with homeopathy:
2a) The idea was "lets build up a tolerance to the allergen", with that inspired by building up tolerance to certain poisons, something which predates homeopathy by many, many years.
2b) The fact that there's multiple types of antibodies produced by the immune system, with the types involved in allergies not triggered by tiny amounts of the allergen, while a second type of antibodies is triggered by tiny amounts. (This is the actual mechanism behind the treatment)
I ended up a little inspired.
trrll, I was trying to raise this question: Why is it that homeopathy drives some doctors into a frenzy of scorn and criticism? When one homeopathic product (Zicam) is recalled, it gets headline coverage and many posts at ScienceBlogs. Acetaminophen-containing pain relievers are the number one cause of liver failure in the US; Until recently this fact was ignored by the FDA, the news media, and the doctors at ScienceBlogs.
to Militant Agnostic: The whole purpose of the FDA's mandatory Adverse Event Reporting system was to increase monitoring of the supplement industry. Many in the supplement industry cooperated willingly because they knew the numbers would be low, especially when compared to pharmaceuticals. Billions of bottles of dietary supplements are sold annually and the industry has an excellent track record of safety.
John
Zicam is NOT a homeopathic product. This is the point. If it were a homeopathic product it would by definition contain no zinc. No Zinc - no loss of smell.
That's a labelling issue or it's fraud or it's quality control. It's not a massive conspiracy by big pharma. Stop conflating different issues.
That acetaminphen/paracetamol is one of the leading causes of adverse drug reaction in every first world nation is not news to anybody who has trained in any evidence-based health field. This is not something that is ignored by the FDA or any other regulatory body. It might be ignored by the media but that's not a regulatory problem. That's just the media at work. Moving a pharmaceutical product from being prescription-only to over-the -counter is a very serious decision. Should we put aspirin on prescription-only because it has side-effects? What about alcohol or ibuprofen?
Drug regulation and clinical practice in general require a tradeoff between benefits and harms. That's why you can buy paracetamol over the counter in many places. It's relatively safe and effective. When you start talking about supplements then we have a problem because they are completely ineffective given the current evidence. That is why harms must be taken much more seriously. Any harm detected outweighs the negligible or non-detectible benefits.
I realise that you will now ignore this idea of ratios between benefit and harm.
"You still don't understand. Those anecdotal "trial and error results" were obtained in the same way the anecdotes for allopathic bleeding were obtained. There's still no significant difference from our point of view."
First, would you mind clarifying who "our" refers to? Thanks
And no, empirical knowledge (however faulty) of the effects of various plants and whole-cloth invention based on false (and totally unrelated to human health) beliefs are not the same thing. I don't know how anyone can say they are equally unrelated to modern science.
I would imagine they have an excellent track record for safety because most of them do nothing. And they're typically exempt from having to provide any evidence of efficacy.
As for Zicam and Acetaminophen... Well, what do you expect? Real medicines are expected to have drawbacks because they have actual effects, and when a new drawback is discovered, we have to redo a risk-benefit analysis, and possibly recall the product if the risk outweighs the benefits. That is a very mundane fact.
With Zicam, well, we're experiencing the equivalent of finding out that a bunch of allopaths used a particularly dangerous species of leeches to do their bleeding. We know bleeding based on the four humors theory is dangerous and completely ineffective. What do you expect when allopathy's slightly less evil twin, homeopathy, is found to be marketing a drug with a significant risk (unlike the typical diluted nothing in most homeopathic remedies) and still no demonstrable benefit.
Would you get outraged if you found out allopaths were employing more dangerous species of leeches and that they were popular? I'd sure be blogging about it.
Skeptics. Scientists. People like that.
The problem with the typical naturopath/herbalist is that their "empirical knowledge" isn't at all empirical. They collect anecdotes, allow their biases to fit their preconceived notions of how it works. That's just like the allopaths who figured they had an idea about balancing humors, bled people who they thought were "too sanguine" or something, and only paid attention to the people who got good results while minimizing those who didn't.
The so-called "empirical knowledge" collected by woos today and their herbalist ancestors is no different than the "empirical knowledge" gathered by bleeding allopaths over generations. When woo can consistently pass the same sort of tests modern pharmaceuticals have to, they'll cease being "alternative".
Until they can do that, it's all just creatively interpreting anecdotes to justify ideas made up whole cloth.
The plural of anecdote is not data.
You don't sound like a skeptic to me.
we don't know how herbalists decided chamomile had particular uses, but we do know the humors idea was invented out of thin air.
@Antipodian:
Actually, technically it is homeopathic. The master list of substances that are used in homeopathic preparations lists the minimum dilution of zinc as 1:10, and Zicam used 1:100. So, technically, it fits within the current law.
@John:
Because homeopathy violates everything we currently know about chemistry and physics. Physics has been wrong before (Newtonian gravity vs Relativity, classical mechanics vs quantum mechanics), but to accept that the current models are wrong will take a lot more than the poor and inconsistent clinical trials that have been done so far, and scientists simply aren't going to accept the clinical experience of homeopaths and the anecdotal testimony of those taking homeopathic treatment as evidence that the current models of physics are wrong.
And note that there are ways to do a proper double-blind clinical trial with completely individualized homeopathic treatments, like the homeopath giving the treatment to a third party who then randomly either passes it straight along to the patient or replaces it with a placebo sugar pill or vial of water.
@Isabel:
How does the theory of four humors have anything to do with science?
Treatment with herbs and treatment via blood-letting was passed down and refined because of clinical experience, which has been shown to not be that great at getting things right. Since herbal treatments started with clinical experience it's possible for it to get things right (like willow bark for pain), but the clinical experience over the centuries of those herbal treatments being used aren't a guarantee of them being any good, since if centuries of accumulated clinical experience did guarantee such, then clinical experience would also have made the practitioners of blood-letting realize that it didn't work.
1) Why should being non-intuitive matter?
2) Why should the physicians being patriarchal have any bearing on the discussion of the four humors theory? It would matter for treatments that have a different effects on men and women, or for the treatment of things that affect primarily or only women, but so far as I'm aware this doesn't apply to the practice of blood-letting. Being patriarchal might have been a reason that male physicians of the time didn't use herbal treatments, since it was something that women were doing, but I don't see how that has a bearing on the development and use of blood-letting, unless your argument is that they would never have developed blood-letting if they had used herbal treatments, because if they'd used herbal treatments they would have never had any need to try to develop any further medical procedures.
Matthew
1:10 is just a typical solution. I find it hard to believe that fits the definition of homeopathic. Wouldn't this result in too many real medications fitting into the definition of homeopathic?
Do have have a link that describes your point more fully perhaps?
"I don't know how anyone can say they are equally unrelated to modern science.
How does the theory of four humors have anything to do with science?"
Matthew, Um it is not related at all? wasn't that my point???But that experiementing with plants was a respectable precursor to modern science (clueing scientists in to some great medicinal plants, as you point out the example of willow bark)
"treatment via blood-letting was passed down and refined because of clinical experience, "
oh really? JUST LIKE experimenting with the plants available in the environment? You make up a ludicrous story about balancing four humors and it's the EXACT SAME THING? You actually can fine-tune that concept? Really? How? Yes I know by coincidental recovery etc - but that is not the same spirit as true exploration - they had a lot of vested interest in supporting Aristotle's theories.
"but the clinical experience over the centuries of those herbal treatments being used aren't a guarantee of them being any good, "
agreed
"then clinical experience would also have made the practitioners of blood-letting realize that it didn't work."
I'm not sure those physicians were looking for results. That was a totally different situation - that was my original point.
"Being patriarchal might have been a reason that male physicians of the time didn't use herbal treatments, since it was something that women were doing, but I don't see how that has a bearing on the development and use of blood-letting,"
and women could not do, not being certified physicians...you might be on to something!
My point was bringing up the humors thing was a disingenuous way to cast aspersions on early herbalists.
@ Torby Renson, according to your distorted comparison immunizations are homeopathic;think before you post.
I liked the part where he was in favor of scientific rationalism 'in general.'
When and how, I wonder, does he determine the exceptions?
antipodean, I support completely the notion of a ratio of benefits to harm. What I can't understand is someone trained in evidence-based medicine claiming that supplements are worthless. There are studies coming out every week proving otherwise. Are the recent studies listed below definitive--the last word on their subjects? Definitely not. Will a supplement ever cure cancer? Probably not. But the evidence continues to accumulate that supplements can be very useful in promoting health.
1. Queen's University Belfast academics have helped develop an antioxidant supplement which may slow down sight loss in elderly people:
http://www.sciencedaily.com/releases/2009/06/090619082129.htm
2. A combination of antioxidant supplements and resistance training may protect against bone loss in postmenopausal women, suggests a new study from Canada:
http://www.nutraingredients-usa.com/Research/Antioxidants-plus-exercise…
ALSO-----A NEW REVIEW OF RESVERATROL
Resveratrol is at the forefront of anti-aging research due to its powerful ability to activate sirtuins in the nucleus of the cell, key gene signals involved with cell survival. Interestingly, higher doses of resveratrol also help kill cancer cells. The excitement is permeating the scientific world, as can be seen in the comments from
authors of a recent review on resveratrol.
âThe breadth of benefits is remarkable â cancer prevention, protection of the heart and brain from damage, reducing age-related diseases such as inflammation, reversing diabetes and obesity, and many more,â said
Lindsay Brown, associate professor in the School of Biomedical Sciences at The University of Queensland and corresponding author for the study:
http://www.wellnessresources.com/studies/entry/resveratrol_health_benef…
@antipodean:
Sorry, I can't remember exactly where I read that. I think that it was on one of sciencebasedmedicine.org, Neurologica or BadScience.net, since those are the other science-type blogs that I read.
@Isabel:
Since it was based on nothing but clinical experience I don't see how much it could be considered a precursor of modern science. Blood-letting, being something that went from theory to practice, is less similar to modern science than ancient herbalism, but that doesn't make ancient herbalism a precursor to modern science, unless you want to consider all systems based on empirical experience to be precursors to modern science.
Sorry, I should have been more precise. They thought that their clinical experience was letting them validate and refine the practice of blood-letting, because clinical experience can be misleading like that.
I could see why they'd have a vested interest in not discrediting the medical modalities they were currently using, but why would they have a vested interest in supporting Aristotle's theories? Also, if clinical experience had repeatedly shown that blood-letting wasn't working, and this was repeatedly covered up, I'd think there'd be some surviving evidence of it happening.
Why wouldn't they be looking for results? Wouldn't that please their patrons?
Also, blood-letting wasn't the only harmful treatment they had. They also had things like medicines containing mercury and arsenic. Were those modalities also somehow toeing the line of Aristotelian thought? Or was there some other reason for them to not care about the negative results those treatments actually caused? And if the preparations of mercury and arsenic weren't an application of pure theory to practice, then their use must have been based on some form of empirical experience.
"1) Why should being non-intuitive matter?"
I meant non-sensical, or not based on any previous knowledge or experience.
Isabel, you're still missing out on the fundamental point: Allopathic bleeders and early herbalists both relied on "clinical experience" AKA "uncontrolled anecdotes subject to experimenter bias" to determine what "worked." They both had strong incentives to believe they were right. The herbalists just got luckier: Science found that some herbs had useful effects, whereas bleeding did not. Of course, many herbs were and are useless, and others are harmful. Relying on anecdotes prevented the herbalists from figuring that out and doing any refinement. It was the scientific method, not interpreting uncontrolled anecdotes to fit tradition-based biases, that did the hard work.
If uncontrolled anecdotes were any good, bleeding and the underlying four humors nonsense would have never lasted so long. Useless herbs are still sold today under the same anecdote-worshiping haphazard "trial and error" rationale that allopaths used.
Oh, and you may not realize that there are plenty of Eastern herbalists who have a vested interest in interpreting anecdotes in terms of "Yin" and "Yang". There's also Ayurveda, which does diet and herbalism in terms of Air, Fire, and Water, IIRC. Just ask the recent troll Happeh about the former.
Because it is stupid? And not just a little bit stupid, but mind-numbingly stupid, so stupid that it is hard to imagine how any person with even rudimentary knowledge of physics, mathematics, or biology could take it seriously?
It seems to have gotten about the same news coverage as, for example, when the FDA recommended that childhood cold medications be taken off the shelves. The hazards of acetaminophen are old news, well documented in the literature and on the label, and have been for years, so they are not news. Over a decade ago, I remember forcibly restraining somebody from taking Tylenol when they developed a headache after a night of heavy drinking. Old news does not get heavy press coverage. A re-evaluation of risk-benefit for combination opiate-acetaminophen preparations (long overdue, in my opinion), on the other hand, is news. In both cases, what was "newsy" was the FDA taking action. The additional coverage that Zicam got mostly centered about how the "homeopathic" designation allowed the manufacturer to evade the requirement for providing evidence of benefit and safety to the FDA--an exclusion that is reasonable for more typical ultradilute homeopathic preparations that contain no active ingredients, but not for Zicam
@antipodean:
Aha! Here, on sciencebasedmedicine.org, quoting the response Skeptico received from the makers of Zicam:
You could look up online the zinc gluconate entry in the pharmacopoeia, but it takes $29.00 (US) to get one day's worth of access.
@Isabel,
Where is the evidence that ancient herbalists properly studied (or studied at all) their products? Have you heard of the doctrine of signatures? herbs were selected for their resemblance to afflicted body parts. For example, aristolochia was given to women after child birth because the shape of the flower is reminiscent of the birth canal, it is of no therapeutic value. Because it is a slow-acting poison, nobody connected it to to the women's deaths.
Do you know that over 100 herbs were used to treat malaria in ancient China, and only one was (sometimes) effective? http://www.ncbi.nlm.nih.gov/pubmed/16722826?ordinalpos=21&itool=EntrezS… That is not a very good record for the old "experimentalists" you think existed.
Your notion that bloodletting is different because it was based on a flawed philosophy is irrelevant. The doctrine of signatures is a flawed philosophy, too. The "benefits" of bloodletting were established in practice just as the "benefits" of all those ineffective antimalarial herbs were.
Of the thousands of herbs and their many suggested uses, only a few have reliable, clinical support. Those herbs with provisional support often fail when subjected to larger, higher-quality studies (black cohosh, echinacea and saw palmetto come to mind). Whatever you think passed for research in ancient times was unreliable, regardless of the theory.
I thought that bloodletting is actually useful in some conditions - eg hemochromatosis (where there's too much iron in the blood, the body starts storing it in organs, causing damage, drawing blood stops the organ storage, ending the damage). Furthermore, in Survival of the Sickest Dr Moalem speculates, based on various evidence, that the mutation that causees primary hemochromatosis was selected for by the plague (see Black Death), so blood-letting might have been particularly more likely to be useful in Europe in the 15th-18th centuries as the population with hemochromatosis would have been larger, as they and their descendents were the ones who survived the various outbreaks of plague.
There are other conditions where blood-letting could appear to be beneficial, eg if a patient was agitated then the weakness from extensive bloodletting would lead of course to them being less agitated, which could look like a temporary cure. This can happen with herbs too, eg opium from poppies waas used to "promote sleep" under the name laudanum.
So ancient "doctors" could plausibly have observed in their clinics occasional anecdotal evidence of patients improving after blood-letting, just as doctors prescribing herbs could occasionally see patients improving after the herbs.
So bloodletting could have gone from practice to theory.
The trouble with this trial-and-error approach for both blood-letting and herbalism is that without a proper study it's very easy to deceive yourself that a treatment is beneficial based on some vivid anecdotes. It's also far harder to identify the conditions for which a treatment is useful from the ones for which it's a waste of time or actively harmful.
Not insolent enough considering how poor his response was. Grandma's camomile tea? The guy is a blathering idiot.
Sit at your feet indeed. He has obviously never tried to herd cats.
"The hazards of acetaminophen are old news, well documented in the literature and on the label, and have been for years, so they are not news."
Not *all* the hazards are on the label. Evidence has been accumulating for many years about the increased risks of developing asthma and allergies, yet most people are not aware of this. Why is that?
Actually, I wasn't joking in that way. I don't see how it is at all contradictory to refer to the scientific method as a set of principles. If I referred to it as a set of facts or a set of theories, I think that would be the misunderstanding you are referring to. But I think it makes sense to refer to it as a set of principles for sifting out reality. I don't think I misspoke in any way.
Exactly. Take herbal medicine, which Isabel has been trying to defend in this thread. Now, I do think that for any given herbal remedy, if I assume that it is ineffective, I will be right at least 95% of the time, possibly more. But herbal remedies in theory can work, even though most of them don't and even the ones that do there is a better alternative (e.g. willow bark is an effective analgesic, but I'll just take some aspirin, please, thank you). The fact that they could in theory work makes me much less annoyed by them.
Homeopathy can't work, or at least anything diluted over about 6X or so can't really work. It's one thing for you to try to sell me an herbal preparation that may or may not have a pharmacological effect; it's quite another to have you try to sell me expensive water. The latter is quite worthy of the "frenzy of scorn and criticism" is inspires.
Exactly. There are a lot of "alternative" cures that could work, even if the rationale advanced for them doesn't make sense. There is no inherent reason why acupuncture can't work. There are no meridians that carry chi, to be sure, but the nervous system and pain reception are complicated enough that it is plausible that a stimulus at one location on the body could interfere with pain perception at another. It may or may not be true, but it does not fly in the face of everything that we know about physiology and physics. But homeopathy is just crazy.
John: " What I can't understand is someone trained in evidence-based medicine claiming that supplements are worthless. There are studies coming out every week proving otherwise."
John starts with a straw man (it is not claimed here or by evidence-based medicine advocates in general that all supplements are worthless, just that the vast majority have not been shown to provide the health benefits claimed for them). Also, touting two preliminary studies showing that something "may" have health benefits, plus yet another "miracle" compound that supposedly cures everything but for which hard evidence is lacking, hardly helps your case.
Seeing as how red wine and tomatoes are supposed to provide such fantastic health benefits, it's amazing that Italians don't live forever.
Once in awhile it'd be nice to see advocates of woo respond to criticism with something other than:
1) You're a meanie!
2) Your science is a religion too!
3) Modern medicine kills billions!
4) Big Pharma Baaaad!
5) Unimaginative personal insults
"Have you heard of the doctrine of signatures?" yes I am familiar with it. It has no basis in science. But indigenous medicine sometimes does. We don't know for sure until we test the results. But we wouldn't bother testing something derived from the D. of S.
So I wouldn't use the doctrine of signatures as a reason to dismiss herbal medicine. And when someone refers to their grandmothers wisdom I associate that with much useful knowledge that we have inherited, not superstition for sure like the D. of S.
Too subtle a distinction for this crowd I can see. But an important one.
"Your notion that bloodletting is different because it was based on a flawed philosophy is irrelevant. The doctrine of signatures is a flawed philosophy, too."
And both promoted by patriarchal male Physicians....
"Whatever you think passed for research in ancient times was unreliable, regardless of the theory. "
Oh dear. I AGREE WITH YOU. Okay? I ALREADY greed in fact. That's completely irrelevant to the (too subtle for this crowd) point I was making.
Why do you all love to repeat the same thing over and over? That all "ancient healers" were alike in how they came up with treatments - that is not true, and there are definitely distinctions that can and should be made.
AARRGGHH!!! Sorry, but I really, really, hate this gross mischaracterization. Neither Newtonian gravity nor classical mechanics are "wrong." They are completely correct approximations of the more general theories, applicable in certain regimes. That's a VERY long way from being "wrong."
Epicycles were wrong. The ether was wrong. Newtonian gravity and classical mechanics are simply incomplete - there's a HUGE difference. And an important one, too, since incomplete approximations are still hugely useful in the regime where they apply.
#75 Seeing as how red wine and tomatoes are supposed to provide such fantastic health benefits, it's amazing that Italians don't live forever.
Thatâs because the fantastic benefits of the Italian diet are completely undone by certain negative impacts of the Italian lifestyle; Catholic guilt, vendetta and riding a scooter without a helmet, being the top three.
Evidence has been accumulating for many years about the increased risks of developing asthma and allergies, yet most people are not aware of this. Why is that?
For starters, because correlation does not equal causation?
That all "ancient healers" were alike in how they came up with treatments - that is not true, and there are definitely distinctions that can and should be made.
Why? Piffle is piffle, regardless of source.
But, Isabel, with your continuous use of "patriarchal" I really think there's something underneath your current arguments. Care to share?
As normally understood, right and wrong are binary concepts. You can no more be a little bit wrong than a little bit pregnant. An approximation may be accurate enough for practical purposes, but if it is not exact, then it is still wrong. Newtonian mechanics says that infinite velocities are possible, and that is as wrong as epicycles.
However, I think that what you are getting at is a valid point, because thinking about right and wrong as absolutes can be very misleading. In science, we generally presume that everything we know is likely wrong. But one cannot then conclude that we know nothing, and that one answer is as good as another, or that it is reasonable to suppose, for example, that gravity might any day be replaced by a theory of "intelligent falling", or that physics and thermodynamics will be revised so radically as to make homeopathy plausible. One scientific theory replaces another when its predictions are more accurate over a wider range of conditions than the previous theory. So while we never know whether our theories are perfectly right, there is a progression toward greater and greater ability to predict what happens in nature. When Newton's theory was supplanted by Einstein's, it did not change our expectation that man cannot fly by flapping his arms.
Isaac Asimov wrote cogently about this two decades ago, in an essay entitled "The Relativity of Wrong", in which he argued that right and wrong should be fuzzy concepts rather than absolute, such that it would be reasonable to say that, while it is wrong to say that the earth is flat, and also wrong to say that it is a sphere, the flat earth is more wrong than the sphere.
I'm not sure I agree with that being "normally understood." Most people I know are comfortable with right and wrong being degrees. I would certainly expect it in a community reasonably knowledgeable about science, as this one is.
But that's still beside the point, since the statement I was objecting to is equally incorrect even if you use binary right/wrong. After all, GR is quite certainly wrong in the binary sense, as is QM.
What that does mean is that in a scientific context, binary right/wrong is not "misleading" - it's completely and utterly useless, because EVERYTHING is then "wrong." So that definition can (and indeed must) be discarded with extreme prejudice.
So while I more or less agree with your general sentiment, I'd have to say that you don't take it anywhere near far enough. Binary right/wrong is straight-up WRONG. (Irony intended, and that sentence shouldn't be taken literally in either sense of wrong.)
Posted by: Isabel | July 6, 2009 10:48 AM
I see you elided the fact that ancient herbalists had a poor record of success, regardless of philosophy. This cannot be simpler- tell us what herbs have been proven to be effective on the basis of adequate tests.
Isabel "Why do you all love to repeat the same thing over and over? That all "ancient healers" were alike in how they came up with treatments - that is not true, and there are definitely distinctions that can and should be made." Great- introduce us to the reliable literature that supports your claims (please, no wikipedia).
Posted by: Isabel | July 6, 2009 10:48 AM
I see you elided the fact that ancient herbalists had a poor record of success, regardless of philosophy. This cannot be simpler- tell us what herbs have been proven to be effective on the basis of adequate tests.
Isabel "Why do you all love to repeat the same thing over and over? That all "ancient healers" were alike in how they came up with treatments - that is not true, and there are definitely distinctions that can and should be made."
Great- introduce us to the reliable literature that supports your claims (please, no wikipedia).
Sorry if this is a duplicate
Isabel: "And both promoted by patriarchal male Physicians...."
Aw c'mon Isabel. Who's your daddy? :)
"This cannot be simpler- tell us what herbs have been proven to be effective on the basis of adequate tests. "
why must you change the subject? Because clearly that is what you really want to talk about. You won't get any argument about the need to scientifically test the effects of herbs from me. But I am sure you will keep trying:) btw a 5% success rate is not bad considering the number of choices available!
Do the readers of this blog really not see a distinction between 1) humans or other animals experimenting with the effects of plants in the environment and through trial and error, however biased and imperfect, using and passing on knowledge about plants and 2) Humans in a powerful class in a complex society decreeing in advance which plants will be useful for specific conditions because of how the shape of their leaves resembles a particular body part or based on other elaborate theories of armchair philosophers?
These are exactly the same to you, and you would not favor one or the other as a source of plant choices for scientific testing?
Why are scientists using indigenous people in rain forests right now for exactly that purpose then?
Maybe this blindness could explain the 'poor' success rate mentioned. I wonder if the success rate is as low when testing medicinal plants from an indigenous culture that did not go through a long period of pre-scientific civilization. For example when comparing the results when testing plants identified by Amazon shamans to plants recommended by the Doctrine of Signatures. I'd place my bets on the former.
"Isabel: "And both promoted by patriarchal male Physicians....""
I was just highlighting how the two sources lumped together by Orac were completely different in structure, even opposing each other to a large degree, and were totally different in ways very relevant to the discussion.
"btw a 5% success rate is not bad considering the number of choices available!"
5% being about what you expect by applying the standard 5% false positive rate to your statistics.
I can understand being hard and fast about only using medicines that have been scientifically proven to work. The problem is that a substance I use - royal jelly - has kept me healthy since I began taking it. If I was to rely solely on medical or scientific testing then I would have denied myself a highly efficient preventitative.
If proof is the criterion, I haven't had the flu in twenty years and have had three colds in the last nine years. What is your success rate, taking alleopathic medicines?
Reminder: the plural of anecdote is anecdotes, not data.
And wtf is "alleopathic" anyway?
I can understand being hard and fast about only using medicines that have been scientifically proven to work. The problem is that a substance I use - royal jelly - has kept me healthy since I began taking it. If I was to rely solely on medical or scientific testing then I would have denied myself a highly efficient preventitative.
If proof is the criterion, I haven't had the flu in twenty years and have had three colds in the last nine years. What is your success rate, taking alleopathic medicines?
berlo_wills, try reading the error message.
"If proof is the criterion, I haven't had the flu in twenty years and have had three colds in the last nine years. What is your success rate, taking alleopathic medicines?"
Ciggies and alcohol do the same for me. No flu, no colds for years. And none of my children has cavities!
Anecdotes do not equal data.
@berko wills
You should read "Don't Get Duped" by Larry Forness (MD). He says that when a patient asks him if she should use royal jelly he replies "sure, if you want to grow three times your normal size and lay millions of eggs."
Isabel, I take it you realize that even your "non-patriarchal" herbalists have produced very little of value. As for ethnobotany today- can you point to any traditional uses that have been verified? ... I didn't think so. Outside the pale of scientific medicine, indigenous people do not do reliable research.
"alleopathic" medicine is a type of catch-all that fails to account for the fact that each individual's metabolism and physiology is unique; a 'quick and dirty fix' if you like.
This is why antibiotics 'work' but make the immune system weaker on each usage, whereas a suitable herbal remedy aids the body's natural ability to repair itself. It's also why you can't do a laboratory test on subjects and get a uniform or measurable result.
Not to puncture your balloon or anything
(you smoke cigarettes and never get chest ailments/colds. I find that VERY hard to believe)
Oh, you mean dead disciplines like homeopathy's sister discipline allopathy.
What precisely do you mean by "weaker"? I've met countless alties who seem to think the immune system consists of one dial. Humans are not simple machines, and you can't just "boost the immune system" to get darker toast.
Virtually all pharmaceuticals work on that basis, last I checked.
Curiously, I've run into countless woos who, in between the lines, end up claiming that the human body has no self-healing abilities because coincidental recovery from self-limiting diseases or regression to the mean are utterly impossible as alternate explanations for described anecdotal improvements.
You don't need a uniform result, only one better than chance and natural recovery. Of course, if you can't get a measurable result, how do you know it works at all? All too often, woos demand that I believe they are gods, immune to the cognitive biases and flawed perceptions of us lowly mortals living outside the ivory tower, and thus they can see causality happen with their third eye.
Amusing to hear that coming from someone who doesn't even know what we believe or the rationale behind it. You're so insulated from the world that you actually believe science doesn't already practice individualization of therapies. Why do you think our doctors keep detailed records and your practitioners usually don't?
Because it doesn't fit into your pigeon-holed, limited view of the human body as a simple toaster that he can have a tolerance for smoking. It's still going to be bad for him, probabilistically speaking as time goes on, but it's well within the realm of statistics that he could be one of the lucky ones who lives well despite the dangerous, dangerous habit.
You say one thing, but believe another. I do believe that is known among our sort as "hypocrisy," berko.
@berko_wills #95:
This sounds odd. Do you have any evidence of that?
Again, do tell; any evidence?
The fact that I am unique doesn't make me dissimilar in every possible respect from every other member of the human species.
Again, how does a herbalist measure my metabolism and physiology so as to determine precisely what remedy is suitable? I'd wager quite a lot that conventional medical diagnostic techniques can establish my uniqueness with far greater precision than a herbalist can manage.
Robin #97: the family doctor for one - "I'll give you one prescription for antibiotics then see how you go" because 'One of the foremost concerns in modern medicine is antibiotic resistance. Simply put, if an antibiotic is used long enough, bacteria will emerge that cannot be killed by that antibiotic. This is known as antibiotic resistance. Infections exist today that are caused by bacteria resistant to some antibiotics. The existence of antibiotic-resistant bacteria creates the danger of life-threatening infections that don't respond to antibiotics.
There are several reasons for the development of antibiotic-resistant bacteria. One of the most important is antibiotic overuse.
There are a number of sites that mention the effect of herbal remedies in building up resistance. I would personally be happy to be a guinea pig: give someone of similar build an anti-flu vaccine, I'll just take royal jelly. Expose us both to influenza and see what happens. That'll sort out this 'anecdote' business and 'doctors/scientists would have done individual tests'. Bring it on.
And I don't see herbalists. I buy mine over the counter in Chinatown. If it works, who cares whether the boffins in the lab can prove it. I'm living proof!
You understand immunity just about as well as you understand how to spell and know what "allopathy" means (in reality anything that is no homeopathy, so even "herbalism" is allopathy).
By the way, how do you know what are in the herbs you buy? How do you know they are not adulterated with real pharmaceuticals. From Chinese Herbal Medicines:
You end your screed with "I'm living proof!" --- You obviously did not understand why you were answered twice with words to these effect: The plural of anecdote is anecdotes, not data!
Fine Chris, I'm not getting hung up definitionally. I'm not even averse to the use of 'conventional medicines' as pharmaceuticals are now known (having taken over from herbs that have been effective for thousands of years) - my quarrel is with sites like this that would seek to shut down the availability and use of herbal treatments on the grounds that they're not 'scientifically proven'. For me, natural remedies work far better, and at less cost, than their chemical equivalent and I'd hate to see pedants deny me something that does so much good.
I'm sure if I was able to run the trial to bypass those run by reliable medical scientists (who couldn't possibly have any barrows to push in the way of pharmaceutical subsidies or the fact that a guy whose keeping himself healthy on stuff he grows in his backyard is going to have little to no use for doctors or expensive medicines) you'd find some way to deny the validity of the results.
I am seriously thinking of going to the media and making just such a challenge: on doctors and scientists terms; let's test how good the stuff is. No fudged data or BS reports to hide behind. No longer anecdotal since I've agreed to the stringent controls of the test. No offence, but I'd dearly love to prove you all wrong.
What evidence do you have that Orac wants to shut down the availability of herbal treatments?
All I see is an attempt at education. Something you seem to be slow at.
Okay, so you say "No longer anecdotal since I've agreed to the stringent controls of the test. No offence, but I'd dearly love to prove you all wrong."
How many people will be in your study? What particular herbs will you be studying? What will be the effect? How will you test the effects? Will it involve blood draws or urine samples? How many people will be in the control group? How will you control for other substances ingested by both groups? How will you control the active ingredient in each herbal packet (herbal meds tend to vary in their makeup, sometimes it depends on where the plant was cultivated, how much rain there was, or if the seller was adulterating the mix). Who will monitor the health and test the subjects?
You were planning a real study,right? Because with just one person (yourself) is just an anecdote, not data.
Also, have you done a review of previous studies on PubMed? Do you know about the other Scienceblogs blogger who specializes in researching herbs? Have you been to his blog (and guess what, I'm not going to tell you... because if you are such an expert at herbal medicines you should know about him already!).
@berko_wills #98:
I asked you to provide evidence in support of your claim that:
and you changed the subject to misuse of antibiotics leading to antibiotic resistance. That is, as USAan lawyers say, non-responsive. I repeat; do you have any evidence in support of your claim above?
Again, some cites (not sites) in support of your claim that "a suitable herbal remedy aids the body's natural ability to repair itself" - in ways different to conventional medicine - would be interesting.
Finally, your claim that "each individual's metabolism and physiology is unique" was part of your criticism that conventional medicine is a "quick and dirty fix" taking no account of those differences whereas herbalists did take such account. I wondered how herbalists measured those differences better than conventional healers. Your answer is that you don't see herbalists; you buy herbal remedies over the counter - and presumably take them as indicated on the box. Can you see that there might be the glimmerings of a contradiction between those two positions?
Robin, I didn't change anything. You just misunderstood me. My contention is, to be very clear, that every usage of antibiotics weakens the immune system. They have their place, to be sure, but that is chiefly to overcome some malady which you already have. The trick is to prevent getting sick in the first place: whether by exercise, fresh veges, or natural medicine.
To reiterate: I am NOT talking about abuse of prescription drugs.
My further contention is that, once you have found a natural substance that works at bolstering your immune system and preventing illness, repeated dosage will not cause any weakening of the body's defence against disease or illness. I welcome any evidence you can show me to the contrary.
Chris, point taken. I'm all anecdote, or I'm a superhuman alti with a very effective placebo. Either way, I'm as fit as a fiddle while all those around me are dropping like flies. Must be something in that.
Further: no, there's no problem with buying natural products off the shelf. I don't stop to ask the grocer about the jar of pickled beetroot if the ingredients are all known. Phidomalodextrin is a different matter.
Bronze Dog:
My argument is the complete opposite, actually, that the human body is different. One person's peanut butter sandwich is another's anaphylactic shock. Test substances by trying them on your skin, if it reddens, you're allergic. But pharmaceuticals aren't designed this way: they are made to cure symptoms rather than systems. This is why they are a 'quick fix'. When you are already diagnosed with something nasty, it's too late to grind some root in with some ginger and hope that will cure you. Do that beforehand as a preventative.
It's not hypocritical to state that a medicine can ward off illness while a cigarette cannot. Cigarettes kill more people than traffic accidents and heart disease combined. I imagine the number of people felled by bee pollen is considerably smaller! And, again anecdotal, the phlegmy spluttery behaviour of smokers around me suggests they are far more prone to respiratory ailments, not less.
@berko_wills #103&104:
My bad, Robin, I see the problem now. This is much better:
Okay.
And when asked for evidence to support that contention, you replied with something that has nothing at all to do with the immune system. In other words, you either completely misunderstood the question, or deliberately evaded it.
Please provide some actual EVIDENCE that said "natural medicine" actually helps with anything.
Since you're the one making the ludicrous assertion that there's some fundamental difference between a molecule produced in a plant and a chemically identical molecule produced in a lab, the burden of proof is on YOU.
Good grief. You just don't have the faintest clue about logic or science, do you? There is absolutely NO reason to suppose that there "must be something in that" when coincidence is an entirely plausible alternative explanation!
@berko_wills #106:
I'm sorry, but this:
@berko_wills #106:
I'm sorry, but this:
without more does not support the hypothesis of antibiotic damage to the immune system.
For example, those who suffer more infections are more likely to have antibiotics prescribed. Those who suffer more severe infections are likely to have more infections in general; and are more likely to take antibiotics.
In any event, this is simply a further assertion that evidence exists. Where is that evidence?
The page goes on to suggest that:
Any research evidence of the effectiveness of Vitamins A or C as antibiotics?
...and the man recommends the use of colloidal silver!
@berko_wills:
It gets worse:
http://drlwilson.com/Articles/Vaccines.htm
He complains about vaccination as weakening the immune system "by introducing poisons into the body"; while recommending internal use of a toxic, carcinogenic heavy metal (silver) which has no biological function in the human body and with no demonstrated health benefits from such use.
You should try listening to yourself: You said you found it extremely hard to believe that a person could smoke and not have trouble with colds or breathing-related troubles. That demonstrates an absolutist mindset, when it's quite possible that, through either probability or some resistance factor, a guy could be just fine despite being a smoker. It is unlikely, but not unexpected to happen.
Oh, and wonderful straw men, there. Science keeps track of allergies, and is heavily into prevention. What do you think medical records are all about. The problem is that "alternative" "medicine" has not demonstrated any usefulness as a preventative. Also, scientific medicine DOES address systems as well as symptoms. Quacks only parrot that propaganda because they like to make up imaginary, supernatural causes like miasmas and blocked chi. Homeopathy, in particular, is based entirely on symptoms: Whereas doctors know that sometimes a disease manifests without all the symptoms, homeopathy was invented on the idea that you treat a person ill with some symptoms with something that causes those same symptoms.
My mother would be dead right now if doctors were like you said. Because she got a doctor who looked into the cause, he found an internal infection that didn't produce a fever (a particular symptom) as would be expected. Thanks to the anti-biotic treatment, she's still alive.
It's also amazing that you think we're the ones who believe in "quick fixes." That's typically the province of quacks.
And we all know that with great, great confidence because of statistical analysis performed under the scientific method. There are still outliers who live well thanks to dumb luck or built-in resistances. It's not absolute that smoking will cause problems. Very few things in life are absolute. A person who only looked at the lucky/resistant smokers for testimonials really could fool himself into believing smoking is harmless or even beneficial.
The problem is that you don't understand what the point of bringing the original joke was about: Anecdotes are pretty worthless for determining cause and effect because they're inherently cherrypicking data. They can raise a question to do a more detailed analysis of, but that's it.
Quoting a "Dr" Wilson:
berko_willis, you need to do a bit more research and be careful of who you get information from.
It is common knowledge that Vitamin A can be toxic, and even deadly after a certain dosage. And recent research shows that these herbs are not as effective.
Also, it is a fallacy to state that herbs are safer than real medications. Many herbs have very real and very serious side effects, which is also known by those who do study herbs seriously. I have actually taken a class in the use of herbs in medicine, which was just around the time comfrey was found to have toxic effects. The instructor was sure to instruct the class that many supposedly "safe" herbs should be used with caution (a big example: garlic does have antimicrobial properties, but eating too much can cause serious problems with blood pressure).
And to repeat again: the plural of anecdote is anecdotes, not data.
The reason that is important is that the DNA makeup of each person varies slightly. This causes a variation in response to various substances. This is why some people like me cannot tolerate cilantro, or why some other people cannot drink milk, and why around 10% of the whole population cannot tolerate opioid narcotics, and why a good chunk of people of Asian descent cannot drink alcohol with turning red, and on and on and on.
In short: If something affects you in a certain way, it will not necessarily be true for everyone else.
Again, this is common knowledge among those who have taken basic high school or beginning college biology. So I would suggest that before you go off on your "study" that you find your nearest community college and sign up for some basic science classes, starting with biology.
Where'd he go?
Do the readers of this blog really not see a distinction between 1) humans or other animals experimenting with the effects of plants in the environment and through trial and error, however biased and imperfect, using and passing on knowledge about plants and 2) Humans in a powerful class in a complex society decreeing in advance which plants will be useful for specific conditions because of how the shape of their leaves resembles a particular body part or based on other elaborate theories of armchair philosophers?
I think I see what Isabel's getting at here. I think she's saying that bloodletting and the doctrine of signatures were used for centuries regardless of whether they worked or not, because "the establishment" of the time decreed that these were the Best Available Treatments.
I think she's saying that chamomile tea and willow bark and the like were used for centuries because experience suggested they *did* work, despite being ignored by "the establishment."
If that's what she's saying, then no, arbitrary decrees on the one hand and anecdotal evidence on the other hand are *not* the same thing.
The problem is, I think this is an over-simplified and somewhat misleading comparison. It does not seem to me, from my studies of history, that "established" medicine ever actually had that sort of authority, that people would follow its recommendations without considering whether or not they seemed to work. People in the Middle Ages were not fools, and could certainly observe the results of treatment and draw their own conclusions. The literature of the time contains enough dissidence, argument, and evaluation of competing ideas to demonstrate that the pronouncements of "authority" were by no means accepted uncritically.
So in fact, I think that bleeding and other "establishment-supported" techniques were, in practice, observed and evaluated on the basis of whether or not they seemed to work, in exactly the same way as herbal medicines were.
The second factor in this discussion is that, without keeping and analyzing records, it's impossible to tell whether an herbal remedy actually works, or whether it just *seems* to work because you are selectively remembering only the times when it succeeded and forgetting the times when it failed. This is what's meant by "anecdotes are not data" -- the human memory is not reliable, so you have to run some sort of check to make sure you really are getting the results you think you are.
http://www.netsci.org/Science/Special/feature11.html
pre-scientific humans also discovered cannabis, coffee and tea, alcohol, tobacco, coca leaf, as well as safe ways to preserve foods, spices, and many other useful things, even developed balanced diets all w/o the scientific method.
OF COURSE I agree trial and error is not perfect, many useless things get through because of coincidental effects or selective memory, and that the scientific method greatly speeds up progress.
Chrissl,
I see what you are saying, but my point was also (and perhaps more importantly) that the indigenous people would have taken a wider look to begin with, and based their choices of plants to experiment with on previous success with other plants, not restricting their choices for heart medicine on plants with heart shaped leaves etc.
With the possibility of many these species going extinct