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Chinese Medicine - Has anyone used it? Opinions on effectiveness?

67 posts in this topic

37 minutes ago, TrueMetis said:

Only if it varies for no reason at all. You just said that medicine is becoming more personalized. That medicine uses empiricism, so why is TCM different? How is recognizing differences in metabolism and adjusting treatment accordingly not empirical?

There were no effective control groups, and the results, if any, weren't really systematically analyzed. There were some core books and instructions on it, but for a long, long, long time, it was an apprenticed skill passed on from master to student. So there's bound to be a large set of variations. It just doesn't map well to the western scientific concept. 

 

The western scientific empiricism just doesn't play well with the history and culture behind TCM. I am happy to say that TCM is not scientific. It really isn't. Not yet, at least. Maybe in another 50 or 100 years it will be - but not right now. I just know that in some cases, it is nevertheless effective. The problem is that in the same bin of "not scientific" are things like homeopathy and all those "natural cures" junk. So it's good to be skeptical and untrusting. I'd rather people err on that than be too gullible and end up with ineffective, or worse, harmful, remedies. 

 

The fact is though that in China and Taiwan and other Asian countries, these non-scientific methods of treatment are still being used. Sometimes in place of, but often time in conjunction with, western medicine. It is not scientific, but it's how people live. 

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2 hours ago, Ser Scot A Ellison said:

Wait... are you saying it's not possible to test herbal remidies? 

You can make allowances for "random effects" in statistics, up to a point. But you still need to figure out active ingredients and determine more explicit rationale for individualized treatment. 

53 minutes ago, TerraPrime said:

Another layer of challenge is that TCM is highly personalized. 

Two people showing up with highly similar symptoms, like a persistent night coughing, might be given two different types of herbal mixture, by the same doctor. The main ingredients might be the same but the supplementary ones can differ according to the individual patient. This is a little ironic because the advances in genomics is heralding the era of personalized medicine, and yet, the ancient Chinese had recognized the individual differences in metabolism and the need to adjust treatment accordingly. 

Same thing with acupuncture. The same description of hip pain may get you 12 needles in one person or 16 in another. 

Then there's the variation from doctor to doctor. 

TCM just wasn't born out of the desire to standardize all practices to one set of criteria, and so it defies empiricism. 

I think there's more likely to be value in things like TCM established over long history of practice than what might pass for "TCM" in North America (to say nothing of nonsense like homeopathy). I'm not sure this research is being done sufficiently now. 

Some individualization is also likely to be somewhat arbitrary, but differences in metabolism are getting more important, particularly with all the "pro-drugs" around. 

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17 minutes ago, TerraPrime said:

There were no effective control groups, and the results, if any, weren't really systematically analyzed. There were some core books and instructions on it, but for a long, long, long time, it was an apprenticed skill passed on from master to student. So there's bound to be a large set of variations. It just doesn't map well to the western scientific concept. 

 

The western scientific empiricism just doesn't play well with the history and culture behind TCM. I am happy to say that TCM is not scientific. It really isn't. Not yet, at least. Maybe in another 50 or 100 years it will be - but not right now. I just know that in some cases, it is nevertheless effective. The problem is that in the same bin of "not scientific" are things like homeopathy and all those "natural cures" junk. So it's good to be skeptical and untrusting. I'd rather people err on that than be too gullible and end up with ineffective, or worse, harmful, remedies. 

 

The fact is though that in China and Taiwan and other Asian countries, these non-scientific methods of treatment are still being used. Sometimes in place of, but often time in conjunction with, western medicine. It is not scientific, but it's how people live. 

So it's less "TCM defies empiricism" and more "TCM has a whole bunch of baggage and it's taking a while to test it".

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58 minutes ago, TrueMetis said:

So it's less "TCM defies empiricism" and more "TCM has a whole bunch of baggage and it's taking a while to test it".

He never said TCM defied empiricism; he said that anecdotes about how people were helped by X is not a substitute for efficacy studies. 

That said, there's not been a lot of good news about success stories as far as testing TCM goes. 

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9 minutes ago, Kalbear said:

He never said TCM defied empiricism; he said that anecdotes about how people were helped by X is not a substitute for efficacy studies. 

That said, there's not been a lot of good news about success stories as far as testing TCM goes. 

What?

2 hours ago, TerraPrime said:

TCM just wasn't born out of the desire to standardize all practices to one set of criteria, and so it defies empiricism. 

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2 minutes ago, TrueMetis said:

What?

I was talking more to what Aemon said, not what Terra said. 

That all said, modern medicine also doesn't standardize all practices to everyone and has a lot of fairly custom things it does from time to time, so the comparison isn't entirely fair in that way either. Cancer is a good example, where there are an absurd amount of different types and treatment plans depending on the location, type, stage, candidate, progression, etc. Another study recently indicated that there are different types of depression based on certain types of brain, and (more interestingly) certain medicines work better with certain brain types. 

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2 minutes ago, Kalbear said:

I was talking more to what Aemon said, not what Terra said.

Quoting error? Cause I don't know why you quoted me then.

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Just now, TrueMetis said:

Quoting error? Cause I don't know why you quoted me then.

You had responded last; I thought you were talking about what Aemon said. I hadn't realized you were talking to what Terra said. 

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On 4/12/2017 at 6:07 PM, Raja said:

Furthermore, even the abx example is for some lyme disease study that I can't even access because of the ridiculous NEJM access issue ( a whole other discussion, btw). The author is disagreeing based solely on that study, which makes zero sense to me. The efficacy of antibiotics is not the issue facing medicine right now, rather antiobotic stewardship is what health care professionals should be more vigilant about. 
 

Lyme disease is the worst example that I can think of off the top of my head to illustrate the efficacy of abx. It's a money-making business at this point - all of the different so-called tests and treatments available for it. I attended a seminar recently showing meta study results and the early results of the clinic focussing on it in the area of the UK with the highest prevalence. Bottom line is clinicians should only really treat the condition when acute. If it's 'chronic lyme' there is no evidence that abx are of any use and the symptoms need to be managed in other ways.

Anyway, plenty of people wouldn't be here if they hadn't received abx for serious infections. As Raja says it is the management of prescribing policy which is the much bigger problem. The drugs work. It is how they are used that is the issue. Maybe campaign for the farming industry to stop shoving abx into cattle in the US instead?

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On ‎4‎/‎19‎/‎2017 at 2:14 PM, TrueMetis said:

What doesn't have chemical properties? Sugar has chemical properties, have all the studies that show a placebo effect using sugar pills just shown the sugar does everything?

Sugar's short and long-term effects are pretty well known. What I mean here is why start from the assumption that any effects from herbs are placebo when most pharmaceuticals are attempts to synthesize active ingredients originally found in plants? You're just starting from: "Obviously a plant can't cause a physiological response to the person ingesting it and it must be a placebo effect". Like the placebo effect Socrates got from drinking hemlock tea?

The main animus against naturally occurring herbs is that they are unpatentable and thus not worth the millions of dollars needed to test them properly. Where's the business sense in proving that St. John's Wort is more effective than Prozac if literally any company can harvest and package it?

And to be sure, a lot of traditional remedies probably are bunk and operate on the placebo effect. But starting from an assumption that all herbs are worthless just betrays a cultural or corporatist bias. 

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19 minutes ago, Weeping Sore said:

Sugar's short and long-term effects are pretty well known. What I mean here is why start from the assumption that any effects from herbs are placebo when most pharmaceuticals are attempts to synthesize active ingredients originally found in plants? You're just starting from: "Obviously a plant can't cause a physiological response to the person ingesting it and it must be a placebo effect". Like the placebo effect Socrates got from drinking hemlock tea?

The main animus against naturally occurring herbs is that they are unpatentable and thus not worth the millions of dollars needed to test them properly. Where's the business sense in proving that St. John's Wort is more effective than Prozac if literally any company can harvest and package it?

And to be sure, a lot of traditional remedies probably are bunk and operate on the placebo effect. But starting from an assumption that all herbs are worthless just betrays a cultural or corporatist bias. 

WS,

That's why I was surprised by Aemon's suggestion that herbal remedies are untestable.  It certainly puts drug companies in the "cat bird seat".

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Posted (edited)

55 minutes ago, Weeping Sore said:

Sugar's short and long-term effects are pretty well known. What I mean here is why start from the assumption that any effects from herbs are placebo when most pharmaceuticals are attempts to synthesize active ingredients originally found in plants? You're just starting from: "Obviously a plant can't cause a physiological response to the person ingesting it and it must be a placebo effect". Like the placebo effect Socrates got from drinking hemlock tea?

The main animus against naturally occurring herbs is that they are unpatentable and thus not worth the millions of dollars needed to test them properly. Where's the business sense in proving that St. John's Wort is more effective than Prozac if literally any company can harvest and package it?

And to be sure, a lot of traditional remedies probably are bunk and operate on the placebo effect. But starting from an assumption that all herbs are worthless just betrays a cultural or corporatist bias. 

You start with that assumption it doesn't work because you start with no actual evidence it works. All you've got, as Aemon said, is anecdotal evidence from non-standard herbs. (Which btw Scot is not at all saying herbal remedies are untestable, it's saying they haven't been tested) Assuming then that they have some effect is completely without merit. Like assuming global cooling because it was kinda cold one day during summer. To break out a cliche, the plural of anecdote is not data. And the actual assumption here is: "There's no mechanism given for how this works, the only thing we have to suggest it's even a thing are anecdotes, and most plants don't have medicinal properties so we're not going to assume this one does." Which is a good thing, less people end up fatally poisoned that way. Bad enough people take things like colloidal silver with all the studies showing it's not effective and dangerous, I can only imagine the number of people who would die if we assumed shit like that was effective based on anecdotes before we had a chance to study it.

Edited by TrueMetis

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1 hour ago, TrueMetis said:

You start with that assumption it doesn't work because you start with no actual evidence it works. All you've got, as Aemon said, is anecdotal evidence from non-standard herbs. (Which btw Scot is not at all saying herbal remedies are untestable, it's saying they haven't been tested) Assuming then that they have some effect is completely without merit. Like assuming global cooling because it was kinda cold one day during summer. To break out a cliche, the plural of anecdote is not data. And the actual assumption here is: "There's no mechanism given for how this works, the only thing we have to suggest it's even a thing are anecdotes, and most plants don't have medicinal properties so we're not going to assume this one does." Which is a good thing, less people end up fatally poisoned that way. Bad enough people take things like colloidal silver with all the studies showing it's not effective and dangerous, I can only imagine the number of people who would die if we assumed shit like that was effective based on anecdotes before we had a chance to study it.

TM,

He said because the herbs themselves are non-uniform, there will be varying levels of "active ingredients" from herbal remedy to herbal remedy (heck from plant to plant), you're not going to be able to perform normal "clinical trials" of such remedies.

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44 minutes ago, Ser Scot A Ellison said:

TM,

He said because the herbs themselves are non-uniform, there will be varying levels of "active ingredients" from herbal remedy to herbal remedy (heck from plant to plant), you're not going to be able to perform normal "clinical trials" of such remedies.

So standardize. This is hardly the first time we've tested herbal remedies mate, plenty of modern medicine used to be herbal medicines. Ever take an aspirin? This isn't anything new.

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8 minutes ago, TrueMetis said:

So standardize. This is hardly the first time we've tested herbal remedies mate, plenty of modern medicine used to be herbal medicines. Ever take an aspirin? This isn't anything new.

If the point is that the plants themselves cannot deliver uniform levels of the active ingredients I believe Aemon's point is that the diverse levels of active ingredients make's herbal remedies difficult to test emperically.  Yes, aspirin comes from willow bark... but it is now standardized and uniform.

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3 hours ago, Weeping Sore said:

Sugar's short and long-term effects are pretty well known. What I mean here is why start from the assumption that any effects from herbs are placebo when most pharmaceuticals are attempts to synthesize active ingredients originally found in plants? You're just starting from: "Obviously a plant can't cause a physiological response to the person ingesting it and it must be a placebo effect". Like the placebo effect Socrates got from drinking hemlock tea?

The main animus against naturally occurring herbs is that they are unpatentable and thus not worth the millions of dollars needed to test them properly. Where's the business sense in proving that St. John's Wort is more effective than Prozac if literally any company can harvest and package it?

And to be sure, a lot of traditional remedies probably are bunk and operate on the placebo effect. But starting from an assumption that all herbs are worthless just betrays a cultural or corporatist bias. 

An herb or plant being unpatentable is no roadblocks to those who wish to profit from it. Tobacco,  marijuana, cocaine,  heroin and morphine... These are derived from plants and all generate money for those that deal in them. 

 

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I've been getting dry needling (piston method, not leaving them in), which is based on acupuncture, as part of physio on my hip for about five or six weeks now. I was pretty skeptical when he first brought it up, and he could tell. He said they weren't trying to realign my qi or anything like that, but using the needles can help release the tension in the muscles knotted deep down that are hard to reach with just massage. He said there are studies looking at the practice, so being a librarian, I looked for the studies. Most have to do with back and neck injuries, but there was evidence of relief experienced. So, I said to hell with it and went for it.

All I can really say is it has been working for me. I went from barely being able to put any pressure on that muscle with six bad knots getting almost barf inducing needling (doesn't hurt, just felt suuuuper gross the first few times) down to one still bad spot and two that were just a twinge. Even after the second weekly round of that, I no longer limped, and I could roll over at night without feeling like my leg was being ripped off. So, so far so good. Will it last? Dunno. Gotta work on my three times smashed knee next (no needles, just strengthening exercises), which is what likely caused the wonky hip in the first place. Gah.

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12 hours ago, Ser Scot A Ellison said:

TM,

He said because the herbs themselves are non-uniform, there will be varying levels of "active ingredients" from herbal remedy to herbal remedy (heck from plant to plant), you're not going to be able to perform normal "clinical trials" of such remedies.

There has been and continues to be research. But it is not easy and the quality of the studies so far has not been so high. 

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16 hours ago, TrueMetis said:

So standardize. This is hardly the first time we've tested herbal remedies mate, plenty of modern medicine used to be herbal medicines. Ever take an aspirin? This isn't anything new.

But when we take asprin it's a synthetic version not a herbal remedy. Same as, we don't use tree bark to treat malaria, we use synthetic chloroquine. 

 

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3 hours ago, Isis said:

But when we take asprin it's a synthetic version not a herbal remedy. Same as, we don't use tree bark to treat malaria, we use synthetic chloroquine. 

 

Right it's synthetic now, after we tested the old herbal remedy version, identified and purified the active ingredient, and started using just that instead of the whole thing. No reason we can't do the same thing with TCM to identify what actually works.

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