Zhong Yixue and modern medicine

[MagusYanam]

We were having some discussion of this topic earlier in the Christianity subforum (which I don't think was particularly appropriate), but I would like to continue this discussion here.

At the moment, I am writing from an Internet Cafe in Guilin, Guangxi Province, China. I am here attending a two-week-long seminar in Traditional Chinese Medicine, or Zhong Yixue or just TCM. While I've been here I have seen and heard some things that have made me look twice at practises I thought at one time to be rather sketchy in their medicinal merit.

I've seen, however, what acupuncture, moxibustion, Chinese herbology and tuina (therapeutic massage) can do for a patient and what sort of maladies have been helped by traditional practises. I'm not quite convinced as yet that TCM is a 'science', so to speak, but it is certainly a methodology with certain scientific qualities. For example, it is based in observation of patients under many different sets of conditions. Many if not most TCM practices are replicable under different conditions and applicable to many patients.

I tend to view TCM as a bit like classical E&M. Early in its study (that is, before quantum electrodynamics were developed), no one really knew what magnetism and electricity 'were' per se, but the effects were clearly noticeable, capable of being studied, and capable of being systematised. Likewise, I still don't know what qi is per se (other than how it is described by Chinese traditional texts), but I can feel what it does after practising qigong, for example. Study and systemisations of TCM do exist (otherwise I wouldn't be here).

Thoughts on this topic? I might not get back to this thread for about a week, but I invite discussion until that time.

[Curious]

The newest and most effective malaria treatment is using Artemesin based drugs which are derived from a 2000 year old Chinese herbal tea. I have personally used accupressure to alleviate totally the pain in a patient who had been treated extensively with powerful painkillers to no avail. People fail to realise that although we may have greater knowledge about a great many things today, we are not necessarily any smarter than humans of a few thousand years ago. They weren't all superstitious idiots who ran for the nearset witch-doctor at the first sign of illness. Native Americans had very effective treatments for TB, cuts, broken bones and infection, as did other peoples. As for witch-doctors, even modern doctors recognise the psychological and physical benefits of placebo.

[Corvus]

Interesting question, but I'm not entirely sure it really belongs in the philosophy forum, even if some TCM function based on the existence of some sort of life energy. Oh well, it can stay here till someone complains.

The newest and most effective malaria treatment is using Artemesin based drugs which are derived from a 2000 year old Chinese herbal tea. I have personally used accupressure to alleviate totally the pain in a patient who had been treated extensively with powerful painkillers to no avail. People fail to realise that although we may have greater knowledge about a great many things today, we are not necessarily any smarter than humans of a few thousand years ago. They weren't all superstitious idiots who ran for the nearset witch-doctor at the first sign of illness. Native Americans had very effective treatments for TB, cuts, broken bones and infection, as did other peoples.

By the same token, let's not exaggerate the wisdom of the ancients and the orient. I am sure some TCMs work, but let's be sceptical about all of them until we understand which really do. Many holistic and alternative methods really only exist to make one's pocket lighter. Though this certainly doesn't apply to one of the cheapest of traditional Chinese medicines; one's own urine.

[ST88]

I agree that there is some therapeutic value in Traditional medicines in all cultures. Certain plant extracts and other naturally occuring products have been proven to contain actual medicinal substances. Accupressure alleviates pain in the same way that massage does. And accupuncture helps with certain "nerve pain" syndromes by -- as I understand it -- tricking the brain into thinking that pain isn't where it is, and is much smaller than it normally would be. And, like Curious says, there is the placebo effect. I'm sure that Traditional medicine qualifies as a science if only for the trial and error aspect of it. After thousands of years, the laws of economics should have weeded out the treatments that didn't work. But I would say that the goal of the doctor is not the same as the end-result. Because those treatments that have survived aren't the ones that have "worked" the best, per se (although that may be true), they are the ones that have satisfied the most people to the largest degree. A satisfied customer is the best PR anyone could hope for. So those treatments that made the patient feel better were the ones that got passed down to apprentices.

I think it's also important to note,that the vast majority of illnesses that a given person has in h/h lifetime are minor, untreatable, and must run their course. Minor viral infections, for example, do not require any medicinal interventions, but also mimic the early actions of serious conditions. However, the Traditional medicine doctor may prescribe some root or another for the minor condition. After three weeks, the patient is cured. The patient believes that the root saved him from the serious condition. Perhaps the doctor does also. No harm, no foul, except for the money exchanging hands and the side effects of the treatment -- and, of course, the value of believing that the serious condition could be alleviated by the root.

[Bro Dave]

I am amazed by how we "Westerners" who feel we are techologically superior, and therefore totally superior, will simply dismiss Eastern medicinal practices, which have been effective for thousands of years! Yes, many are couched in very non-scientific practices. That does not eliminate them as legitimate. The more we come off our high horses, and actually investigate them, them more we are finding reasons for their effectiveness. But even here, we should tred lightly. The Western medical practicioner are reluctant to use anything the do not fully understand. The Chinese do not have that choice. There are millions of people who need help NOW, regardless of whether anyone understand HOW it works.

Bro Dave

[Dilettante]

I'm sorry if I sound like a hard-nosed skeptic, but I suspect Chinese or other traditional national medicines have little to offer. I think it's safe to say that our knowledge of the human body has advanced quite a bit since those ancient techniques were first developed. There may be one or two techniques that upon scientific analysis prove moderately effective, but for the most part I would bet it is just the placebo effect at work. Has anyone measured "qi" ? If those folk remedies can pass strict tests, like ordinary drugs do, I'd be happy to change my mind, but until then I remain skeptical. As for urine therapy, its virtues were sung by Pliny the Elder and other European ancients. However, the ancients were wrong about many things, so I wouldn't even touch urine, unless it's presented to me in homeopathic dilutions (that is, no molecules left in distilled water).

[Curious]

I'm sorry if I sound like a hard-nosed skeptic, but I suspect Chinese or other traditional national medicines have little to offer.

There is absolutely nothing wrong with being sceptical, especially concerning the underlying principles. It is worth noting though that many therapies were discovered by accident and the "science" was then invented to explain these effects. Accupuncture, for example, was discovered quite by accident when soldiers who were injured in battle were found to have been cured of long standing conditions. After several soldiers were found with the same injury all who claimed some benefit from the injury, then it got people to thinking. The same can be said when people who ate certain foods never got certain conditions or who were cured when they ate the foods. Sailors were given fresh fruit to combat scurvy but this does not mean they knew why it stopped them developing it. The wild claims of some people concerning the principles involved, I believe, is the main reason why the west has been so slow to exploit Eastern medicine with the exception of a few hippie types.

[Dilettante]

Curious wrote:

It is worth noting though that many therapies were discovered by accident and the "science" was then invented to explain these effects. Accupuncture, for example, was discovered quite by accident when soldiers who were injured in battle were found to have been cured of long standing conditions. After several soldiers were found with the same injury all who claimed some benefit from the injury, then it got people to thinking. The same can be said when people who ate certain foods never got certain conditions or who were cured when they ate the foods.

It's true that discoveries are sometimes made by chance (or apparently by chance), and that some traditional therapies may have accidentally found a "fulcrum" even if their practitioners don't exactly know how it works. But nowadays there are all sorts of rigorous tests which should be able to establish which of those folk therapies work (if any) and which don't. Rather than talking about "alternative therapies", we should be speaking of therapies that work and therapies that don't work, and herbal remedies (such as echinnacea) do rather poorly when subjected to the same rigorous tests as conventional drugs. There seems to be an almost religious, dogmatic belief in the superiority of "natural" remedies. This, IMO, is pure German romanticism. Plants are made up of chemical compounds too, and they can kill you! The hemlock Socrates drank was just as "natural" as a soy milk. I don't see how needles stuck into traditional acupuncture points on imaginary "meridians" which do not correspond to anything anatomically speaking, and which supposedly carry a substance or energy called "qi" can help anyone except as a case of the placebo effect. I read somewhere that acupuncture got its start in the US as a result of Nixon's Chinese trip. It could also be that the "exotic" factor was at play. It's all very well to say those remedies have been effective for years, but I would like to get my hands on some thorough statistical studies, if any are available.
The most common reasons people give for believing in "alternative" therapies are the following:

- They (or someone else they know) tried it and say "it works".
- A doctor says "it works".
- Ancient tradition, practice or folklore "shows it works".
- A scientific study "shows it works".

The problem is that none of the above are good reasons to believe in the efficacy of any therapy, alternative or otherwise. Anecdotal evidence is not reliable, doctors are not necessarily scientists (most are not, and medicine is not a science anyway), tradition and folklore are not reliable, and a single scientific study is not sufficient to establish a causal relation.

Besides, spontaneous remission of many illnesses is possible, human physiology is extraordinarily complex, and medical treatments are not easy to test. Since there are no good reasons to think those therapies work, we should proportion our belief to the evidence and remain skeptical.

[Curious]

[The most common reasons people give for believing in "alternative" therapies are the following:

- They (or someone else they know) tried it and say "it works".
- A doctor says "it works".
- Ancient tradition, practice or folklore "shows it works".
- A scientific study "shows it works".

Well in the case of the anti-malarial artemesin based drugs derived from a 2000 year old chinese tea, it is the peroxide bridge portion of the molecule that has been found to destroy the malarial parasite, this has a cure rate of 95%. This is better than any other known drug for malaria.

[Dilettante]

...And that would be the fulcrum (the peroxide bridge) which, as I said, is sometimes accidentally found, even if the ancient Chinese didn't know precisely how or why it worked. Unfortunately, most of the time there is no fulcrum to be found.