Alternative Medicine and Real medicine

40 thoughts on “Alternative Medicine and Real medicine”

1. There were no specious arguments, nor incorrect or strawman arguments or statements. Is the post self-serving? To some degree. I HAVE multiple chemical sensitivity. So I’ve lived it. I AM living it. I have a documented destroyed brain as a result. There’s little wonder that I get defensive about it as I myself have had to respond to disbelief, accusations of neurosis and pysychogenesis with zero evidence, yet when I present solid evidence, it’s ignored. I’ve had so many strawman arguments thrown at me about MCS and its sufferers instead of having my personal experience addressed.
   I’ll answer just a few: I’m no technophobe and I certainly wasn’t a chemophobe until this happened. And I had no idea where my symptoms were coming from until about two years after they started. And the first product that showed me that it was a chemical of some sort was a product that I loved. Still, the charge of “hysterical chemophobe” has been thrown at me for so many years, when I KNOW, from personal experience, as well as the experiences of millions of others, that it’s very real. Biology doesn’t lie: there are genetic predispositions to it. Genes = organic origin. There is a working theory with subsequently found biological markers. Biological markers = organic disease. Yet we still have people out there who deny the existence of the disease, simply because they latched onto a position of denial far too early.
   Emotion? Yeah, I’ve got plenty of that. Wouldn’t you? I know there is a genetic component and I’m watching the clock ticking as my children are getting older. I don’t expect much will happen with me, but I want my kids to be free from the hell this has made with my life. I can still communicate well, but the damage to my brain has made me useless as an employee. Useless as an employee made me useless as a husband. I’ve been thrown out on the street, and this man who has years of working in technical fields and the sciences, and I can’t even figure out how to put a life together.
   So yeah, there’s a lot of emotion. It would be bad enough if it was simply a case of the dispassion progress of science. I could accept that. But it’s far beyond that: it’s the denialism and the overt efforts to prevent this disease from being understood. I certainly cannot point that finger at you. But my previous post exposed very real problems with the western medicine versus alternative medicine argument. Your lack of engagement is not proof of faulty reasoning.

2. I once had an acquaintance with an odd, asymptomatic blood condition that caused her to be tested positive for HIV. Apparently, she also tested positive on home pregnancy tests (she already had adult children at the time). You can imagine the stress that caused until the doctors figured her out.
   In addition to false positives, there is a question of unnecessary treatments. Tumors particularly can be risky to treat. I read a piece long ago concerning the risk factors of colonoscopy and other early detection movements and positing that many small tumors that now send people into costly and risky treatments may have remained small and asymptomatic for their entire lives. The author questioned whether improving survivability numbers were due to actually saving patients that would have died or merely due to the massive increase in diagnosis of patients that would have survived anyway.
   I’ll have to look that paper up. Regardless, it’s sufficiently off-topic to save it for another day. Thank you again for the lively discussion.

3. We agree. I am not pleased at all with some of the same things you point out. We agree more than disagree. As for efficacy there are some uncertainties.
   Your comments on neuro and psych are what I am concerned about too. The efficacy of antidepressants and the new atypical antipsychotics are a problem. Atypicals are incredibly expensive and too widely used. The use of psych drugs in pediatric psych is a problem along with medicalizing behavior and pushing pills.
   As for prevention, annual physicals are low yield as asserted by one of the big annual physical providers–the Mayo Clinic that still does a lot of annual physicals even though they say they are not that important. Annual pap smears never made any sense to me and finally the intervals were changed and reduced significantly in older women with previous negatives.
   I never thought annual physicals were good for anything other than churn and exchanges of money for tests. Other preventive screenings and alleged good and bad test results resulted in a lot of churn too. There is a downside to a lot of testing and screening. I guess I am inclined to advise people not to be to anxious and not to ask for a lot of testing. People worry and fret sometimes about abnormals that are not as ominous as presented. False positives in mass screenings are a factor too. For example the recent CDC recommendation for mass screening for HIV was a bad idea, since the at risk population in the US is known, and false positives are unavoidable and quite troublesome.

4. John, It seems we’ve reached the reply limit on this one so I have to start over down here. I’ll understand if you don’t notice it.
   I was not referencing medicines that don’t work but rather the “7% of approved drugs [that] are purported to have no known primary target, and up to 18% [that] lack a well-defined mechanism of action.”
   http://www.ncbi.nlm.nih.gov/pubmed/22711801
   The point of that article is that mechanisms are being discovered for why these drugs work, but my point was that their usefulness was discovered before their mechanism. Admittedly I see the “it is not known by what mechanism” addendum primarily on drugs designed to treat problems in the murky area of psychiatry.
   The peripheral and central nervous systems are far from being fully understood. Maybe gating explains acupuncture and maybe it doesn’t, but that’s irrelevant to it’s classification as junk science. Wild theories and myths about why it works do not take away from it’s usefulness. I feel it is more beneficial to the general public to tackle the question of when it is useful and what the side effects are then to dismiss it entirely because of it’s fanciful back-story.
   As for chiropractic, the modern claim “A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.” is a far cry from B. J. Palmer’s claim that there was no such thing as contagious disease. The judgment of chiropractors based on 100-year-old claims is why some have chosen to abandon the title in favor of osteopath, or physical therapist. The basic idea that a joint can become misaligned in such a way as to interfere with nerve function doesn’t seem that out there to me, but I’m not up to debating anatomy at your level. I’m merely pointing out that the majority of chiropractors today reject the old school spiritualism and also their definition of subluxation differs from the medical community’s in scale only.
   MDs have been allowed to change the definition of medicine in response to new information over the decades without being denigrated for their discipline’s past mistakes. Why not afford acupuncturists and chiropractors the same courtesy?
   As an example of my larger point from the medical world, Phlebotomy went from curing innumerable diseases, to curing none, to now being used by specialist to treat a very narrow and specific set of conditions. I am not arguing for the belief that alternative therapies can cure all conditions, but that they may be useful in treating a few specific conditions. It would be a shame if that truth went undiscovered because the learning process was halted during the stage of believing they cure nothing.
   As for the strain caused by hypochondriacs, I’ll cede to your superior knowledge about the system in which you’ve worked for decades. However, I’m still unwilling to believe that the majority of people who seek alternative pain management don’t feel pain that is very real to them. Even if it is purely psychological then the alternative providers do a service by taking some of the load off of the overworked medical system. Still, pending further research I’ll leave that one as opinion.
   I will say that the majority of the strain caused by the “worried well” is a bed the profit-based medical community made themselves. I’m by no means a socialist, but I was under the impression that the concept of well-child visits, and regular check-ups came from the MD community. Of course I do recognize the difference between doctors who care for patients and administrators who care for the business. But then, without the one, how could we have the other? I’m not offering solutions there, just observations. You’ve already expressed your opinions on the preventative health movement, and I agree with you. Perhaps we could discuss the health risks of early detection practices someday?

5. I know that acupuncture and chiropractic work, but the underlying theories are baloney. Charlatans are people who would foist a false theory on people even if they have something that works to some degree for some reason.
   We agree that the science has to be able to give us some evidence or underlying plausibility for a technique or we should admit as much.
   As for misconduct and pushing drugs with marginal or no efficacy–true.
   However particularly a problem in the soft science areas of medicine, so please make that distinction.
   I put a blood pressure drug on the market that doesn’t work? Not possible, but put a drug on the market that will make people feel better? Or less depressed–the soft endpoint encourages data dredging and tunnel vision or confirmation bias.
   Medical and surgical treatments for well established conditions survive if they are effective, and die for lack of a second when the efficacy doesn’t measure up.
   You have no idea how much medicine is plagued by hypochondriacs and the worried well–most family practice and primary care is routine maintenance care with a significant burden of the worried well and a bunch of minor illnesses that are self limited but cause people to be concerned.
   Even in emergency medicine only 20 percent of the visits involves serious and urgent conditions. So you think about it, we spend 7,000 per head on medical care but a significant portion of that in America is on worried people and routine or minor acute care. For Each individual the majority of the cost of their medical care may be in the last 6 months of their lives, but for the population the worried well and minor ambulatory care with a lot of excess tech, lab and xrays, sucks up a lot of effort and money.
   And, just looking out over the population from my perspective of 42 years of practice, like any common good or resource (you know the tragedy of the commons) 20% percent of the population use 80% of the resources, some appropriately, some definitely inappropriately.
   The inappropriate use of medical resources and the level of dissatisfaction that I speak of is particularly in the segment of the population, severely underestimated because it is self reporting–personality disorders. Personality disorders are not only disruptive, they are not crazy, so they operate in regular society, and some gravitate to having a lot of medical needs. They are needy. They wear their families, their friends and their care givers out. Psychiatrists don’t like to take care of them because they are incurable–they are happy being dysfunctional–they think they’re fine, but they are best described as adolescent arrest.
   Various kinds of personality disorder exist, but they have a high rate of emotional disorders which increases tremendously their use of medical resrouces.
   Public outcrys and complaints about inadequacy of medical care are frequently carried forward by personality disorders. They are more common than you might suppose, very disruptive and depleting. Sometimes personality disorders operate at the highest levels of society, and they vary in terms of their adaptability and and success.
   Think about the jerks you have met at work and the ones in family and acquaintances. Read about the personality disorders. I try to educate the residents on personality disorders because they are very disturbing to the medical care process–manipulative, deceptive, demanding, incurable.
   The real world of medical care requires wisdom and some knack for what’s achievable after one determines what the patient has and what can be done.

6. Bringing up the ancient roots of some forms of alternative medicine is no more relevant than bringing up the 4 humors in reference to mainstream western medicine. My objection is that you say acupuncture and chiropractic don’t work, and then say anything that does work doesn’t count because it fits your definition of mainstream. That is by definition tautology.
   If a chiropractor or acupuncturist has dropped the unproven and practices only the proven beneficial treatments for the appropriate conditions then they are not a charlatan regardless of what the founders of their discipline were wrong about. Hippocrates didn’t exactly have a perfect track record either. Sir William Osler supported the use of bloodletting long after its efficacy was cast into doubt by research. Medical history is a different conversation altogether. If your complaint is only directed towards the few who still maintain ancient beliefs in the face of modern knowledge, then my only argument is that you didn’t make that clear in your original post.
   You ask “Does that mean the vital energy/force/electricity stuff makes sense?” I am merely suggesting that that thought process works both ways. The parts of the underlying mythology that don’t work do not disprove the parts that do. Whether or not we can definitively say why a treatment works is irrelevant to the question of does it work. Many medicines today are sold world wide without the pharmaceutical company that invented them being able to explain how they work.
   All I’m saying is that alternative medicines have an important place in the ongoing development of medicine. Choosing to call functional chiropractic physical therapy doesn’t change the fact that it was developed by chiropractors based on real anatomy and real results. The fact that we don’t know why acupuncture helps some people with chronic pain isn’t a reason to stop using it, especially considering the risks of long-term drug-based pain management. If the results are real, patients don’t usually care why it works. To denigrate those individuals for choosing to do what works for them for whatever reason doesn’t make them inclined to listen to you when you talk about actual research. Dismissing their ailments as hypochondria guarantees they won’t listen to you.
   I’m not saying hypochondriacs and malingerers don’t exist, but I think you overstate their role in this debate. Time is the most important healing agent in acute back injury, but chronic back pain is a different animal. I think it’s a bit too coincidental to suggest that people who find relief after visiting a chiropractor simply chose to pursue one right around the time their back was going to get better on its own.
   I do, as you suggest, enjoy the conflict. I hope you don’t take that to mean I don’t admire your intellect and value your opinion. If I didn’t I wouldn’t bother writing to you. It may not surprise you that I don’t have a lot of friends in the real world with which to have this sort of challenging exchange.

7. No, when I say that proven methods are mainstream medicine, its not tautological, it’s definitional.
   Good medicine is applying proven techniques. I am not against african/chinese/ukrainian/slobovian medicine or even some french medicine if it works.
   herbal medicine describes how pharmacy got started. when a herbal graduates to proven efficacy, its mainstream to me.
   Naturopathy has no proven treatments that I am aware of but a proven treatment get’s a vote as long as it’s used for the proven benefit.
   Same with the soft on the edges stuff, like chiropractic. Manipulation has benefits, stretching, pressure, massage, can’t deny it. Does that mean the vital energy/force/electricity stuff makes sense? I would object.
   That doesn’t mean it’s only placebo, means it has some obvious benefits from the know benefits of physical therapy.
   moxbution-no, homeopathy-no, incantations-no, aroma therapy-no, the electric and physical force field stuff-no. some I don’t know about-??

8. “sometimes Mr. GH, you really just enjoy the conflict. ”
   True. I comment here as much to practice debate skills as any other reason. I love to learn new things, but I make my teachers work for it. Besides, if I agreed with everything you write, I’d have no reason to read anything you say.
   My issue here is apparently one of semantics. You pretty much believe the same things I do, but you use words I wouldn’t. I get the impression that you are dismissing entire industries without acknowledging the many well-documented benefits they have over traditional medicine. If acupuncture or chiropractic are effective at managing chronic pain without the side effects of pills then that should be acknowledged without the use of contentious language.
   Again you’re using tautological reasoning. By writing your own definition for “mainstream” to include any effective treatment regardless of acceptance by the MD community you’ve rendered your argument unassailable but ultimately meaningless. Of course it’s true that effective treatments are good and ineffective ones are bad, but I’m sure you know that isn’t what most readers would get from the phrase “mainstream medicine is good and alternative medicine is bad”. So why use phrasing to that effect if you’re not also interested in the conflict?

9. I will clarify or expand on my comments.
   The Magic seekers are the ones who are searching for effects. That includes the many who claim a benefit that I say is placebo. I never said that there was a benefit beyond placebo effect in the “Alternative” treatments, otherwise they would be allopathic.
   Now I won’t argue that there are economic and other motivations that make people ignore evidence that something works, but there are also are economic and other motivations that cause people to make something a legitimate treatment when it isn’t.
   If the blinded randomized studies show a decent effect–game over, the treatment is not Alternative–it is mainstream.
   Now there may be alternative treatments or potions or herbals that are inconsistent in quality and effect, that’s another problem.
   I do not accept acupuncture as a treatment for anything other than pain, and the mechanism is not clear, where placebo effect kicks in is not clear.
   For example I don’t agree that acupuncture treats addictions.
   The number one reason that people seek out alternative treatments? Yes indeed it is that they are looking for something allopathic medicine has failed to provide.
   Charlatans have been taking advantage of that for a long time. Combination of factors, many “sick” patients are not so much sick as mental cases. I won’t go into to detail, takes too long, but when I see a person with a bag of medicines and an obsessive need to tell me about all kinds of symptoms, but is still not diagnosed, I know it’s gonna be a long session and that I might be their hero for a while but soon I will be another one of the bad and uncaring allopathic physicians who doesn’t know nothing.
   Now I will say that on certain things I often restore faith of angry frustrated patients because I am very experienced and I pay attention. However, that doesn’t really explain the allopathic/alternative tension. That’s a lot more complicated–and very much case specific in the real world as it relates to patients.
   However there are devoted social anarchists working their agendas and anti science people who use the things mentioned to fashion an anti traditional medicine antagonism that I will not excuse. They are not arguing from good evidence about some therapies that are accepted as proven, but haven’t been adopted in mainstream medicine, they are arguing junk medicine. I offer opinions based on more than prejudices or biases. I know that much of alternative medicine is nothing but working the placebo effect and if the evidence is otherwise, then it is no longer alternative medicine but should be included as effective.
   I agree with you that scientific evidence is the determinative factor. However, lets take just one example–most everyone agrees that chiropractors have a following because of back pain. Controlled studies show that time is the most important factor in mechanical back pain. So what do we do with that? Hypnosis is effective for medical conditions but it is probably do to the power of suggestion.
   In the case of real diseases and not the musculo skeletal and psychogenic, alternative treatments are bound to be either efficacious or not–so it’s never in those areas where “alternative” medicine develops as a factor–it happens in the soft and uncertain areas where method of delivery and attitude of the patient combine to create the placebo effect.
   If you will accept my rejection of alternative treatments when I assert their effect is placebo, then we can agree that when alternative medicine is effective then it’s mainstream as far as I am concerned.
   I read about pressure therapy for tension headaches, and for my purposes, it works, sometimes, to break the tension headache cycle. That, to me is mainstream even if a lot of doctors don’t believe in it. That’s why I would argue that your point is maybe a little over the top and your critique of my criticism of alternative therapies is a little harsh.
   I am only arguing in favor of what works, not what looks good or garners support. I think you are inclined to be the same way, and sometimes Mr. GH, you really just enjoy the conflict.
   I would also say that there is no one more difficult to treat or satisfy than the worried well.

10. John, a number of times you have admitted that some of these therapies you classify as “alternative” work for specific conditions in specific cases. You even talk about reasons why they may work beyond placebo effect. Why then do you denigrate anyone who may use these therapies as “magic seekers”? You seem to include even those uses of acupuncture and chiropractic that you admit work.
    The number one reason people seek out alternative medicine is that allopathic medicine has failed them. The only power struggle is between unionized medicine and their non-union competition. Individuals seeking relief from their condition couldn’t care less about doctors’ collective ego.
    Many of your objections to alternative therapies seem rooted in prejudices based on ancient claims. I doubt you could find an acupuncturist today that claims he can cure cancer or a chiropractor that claims he can cure a viral infection. Even if you did, it wouldn’t prove that all practitioners are quacks any more than the fact that some MDs make ridiculous claims proves all MDs are quacks.
    I support reasonable regulation and the need for scientific analysis of any potential treatment, but sweeping statements implying that any practitioner that isn’t approved by the AMA is a witch doctor are no more scientific than saying all modern doctors are pill pushing quacks. It seems to me that the scientific thing to do is to leave prejudice out of the equation and judge the treatments on their effectiveness for specific conditions regardless of the source.

11. It seems that a lot of people have forgotten that most “real medicine” started out as “alternative medicine” I’m sure most people here know the history of aspirin. Hippocrates’ practice of grinding up willow bark to treat pain and fever would today be considered “alternative medicine”. A lot of pharmacology can be traced back to medicine men and their magic plants.
    Hippocrates didn’t know what acetylsalicylic acid was any more than ancient acupuncturists knew what neurological blocking effects were. Medicine always has been and always will be a learning process of trial and error. Experimentation and often failure will always be necessary to the process. Scammers and quacks will always exist on both sides. Dismissing alternative treatments out of hand is no more scientific than accepting them without question. The same is true of modern western medicine. Regardless of scientific rigor, the reason many alternative therapies persist in the US today is that, placebo effect or not, many people get more relief from them than they do from AMA approved doctors.
    If acupuncture, or some other therapy, seems to work in some cases, then the scientific thing to do is to study it to isolate what makes it work so that we can exploit that property to the fullest while throwing away only those parts of the practice that do not work. The same way we isolate the active ingredients in magic herbs to make effective medicine.

12. A web site is about opinion. Make your case. Support your opinions with what you think are good arguments and good evidence.
    There are so many incorrect or self serving or strawman argument statements in this big soup of stuff.
    Try not to be to hysterical, and maybe you will see that junkscience.com is unflinchining in its efforts to expose hysterical and unfounded claims.
    And the assertions made are too often full of emotion and not based on the realities.
    There are millions of sufferers indeed, and, too often they are counted as, unfortunately, counted in the millions of neurotics looking for magic.
    I will not detail all the specious arguments presented above about things that we criticize. The junkscience is there and must be identified and exposed.

13. “Surgeons do what works.”
    Not always. There has been, and continues to be, plenty of experimentation with surgery with less than desired results. And for all the insistence that alternative practitioners prove the efficacy of everything they do with randomized controlled double-blind studies, I’d love to see you do that with various surgical interventions.
    While I remember, the psychiatrist who posted that there isn’t a single use of herbs or supplements that has been proven to work is patently untrue. I don’t know where he’s getting his information from; Quackwatch perhaps, but there are many supplements that not only are known to work, but they are studied and used by mainstream medical experts. For crying out loud, his own field has N-acetyl cysteine that has been irrefutably proven to help with OCD and bipolar depression along with other issues. St John’s Wort has also been proven to work when the proper extraction is used.
    This article in particular, and the “junk science” and “skeptics” in general, have problems. They use bad logic and they hold alternative medicine to a phony standard. And they give modern medicine a pass.
    For all the accusations used against alternative medicine (and many are quite valid), the fact that some of the procedures are not KNOWN to work is not an argument for standard medicine. Years ago, the British Medical Journal embarked on a study of western medical interventions to determine the efficacy. They apparently stopped at 2400 procedures and ditched the study because the findings were ugly: 52% of the procedures had unknown efficacy, no efficacy, or they were harmful.
    One of the problems that I have with sites like this is that, just like the world of alternative medicine, there is too little neutrality. Sure, the Chinese may not have known WHY acupuncture works, but the fact is, it does. As an aside, Stephen Barrett at Quackwatch was asked how acupuncture could have possibly been proven to work on dogs. His response was to suggest that dogs were influenced by the placebo effect.
    Another example of the validity of at least some of Chinese medicine is Fecal Microbiota Transplantation. Finally western medicine has a very effective treatment for Clostridium difficile infection and probably many other gastrointestinal problems. The Chinese have been doing that since the 4th century.
    There’s a huge problem with a lot of the accusations from these quarters: one of them is the denial of very real medical conditions. We’ve been through it many times before. Patients have suffered with conditions such as allergies, asthma, multiple sclerosis, rheumatoid arthritis, and many more very real medical conditions, only to be told that it is all in their heads. It continues today with conditions like multiple chemical sensitivity. We’re told either that it doesn’t exist (that’s very wrong) or that regular doctors don’t have an answer yet and alternative practitioners should not be used because there are a lot of scammers. So people are left suffering. Denialism doesn’t help anyone, either the people with the diseases or the “skeptics” who tarnish their reputations by denying the existence of a disease just because it isn’t well understood. They make it all the worse by ignoring clear scientific supporting evidences and rest on proven sham studies like the Staudenmeyer study. Known genetic involvement is here. A theory confirmed with biological markers is here. And so are perhaps millions of sufferers.
    There are many things we still don’t know about the human body, particular on the molecular level. We didn’t even know nitric oxide existed as a neurotransmitter until the 1990s, yet because many people staked their reputations on the non-existence of MCS, they couldn’t bring themselves to admit they were premature and that this molecule plays a central role in that disease process. That process is now known to be shared with conditions such as Alzheimer’s and Huntington’s Diseases as well as autism.
    I don’t care where the knowledge comes from. I just want to know the truth. And from what I’ve been reading for the past 20 years, just as it is in politics: neither side has a monopoly on reality.

14. No disagreement. You might recall, James Reston, the columnist for the NYT was the sentinel case for Chinese Medicine works and I would point out that for some very suggestible people pain can be treated and people can undergo painful procedures under the influence of hypnosis.
    In fact your son’s experience is similar to others–acupuncture does distract from or mitigate pain.
    One explanation neurologists give is gating theory, one neuro signal mitigating another.
    However, there is no scientific basis for qi or meridians that are the theory of acupuncture.
    Your son would no doubt say that it works and that’s all he wants. My point is that he uses acupuncture for a specific effect and doesn’t worry about the other supposed benefits. Surgeons do what works. That’s why they are so formidable in the medical field.

15. Your article is very interesting. However my friends son is a leading surgeon that has one numerous awards for using acupuncture to block pain instead of pain killers in third world countries where they can’t afford the anesthesia.

16. The Herman commentary is unfortunately a tale of the woe that comes from people searching for magic. Also it is funny how health food promoters take on a patina of authority that makes people get into these alternative medicine and alternative therapy choices that sometimes have unintended consequences. Jumping into magic is a crap shoot.
    Homeopathy and and chiropractic have an impact because there are a lot of people looking–sometimes very smart people just like the idea of rejecting traditional (here read allopathic) practices. Kind of a power thing.

17. As a practicing psychiatrist/neurologist of over forty years experience, I absolutely reject alternative medicine because there is a demonstrable placebo effect which often either temporarily masks the patient’s symptoms, interacts with existing therapies or worsens symptomatology by delaying needed care.
    Nothing with the “herbal supplements” has proven out to be of true therapeutic value to FDA standards when actual controlled, randomized and double-blind studies (ones that meet FDA approval standards) have borne out anything but a potentially modest placebo effect. If we all remember back less than 20 years ago, a good many of those patients with depression and anxiety were turning to St John’s Wort, Kava kava, etc. What we found out later on is that these drugs either potentiated (e.g. enhanced/synergized the activity) or inhibited the activity of existing FDA approved products to the point where patient management became difficult. Similarly, many patients never told us they were using herbal products because they were “natural” and therefore not “drugs” to the patient. In particular, in my neurology practice, I saw many patients taking herbal products that interfered with warfarin (Coumadin) therapy and over the period of ten years, five of my patients had seriously debilitating strokes that could have been likely avoided. At the M&M weekly meetings, it was discovered that these patients were taking herbals but had told only their primary care physicians, but did not let me know. Another problem we face in patient management.
    As with most “natural” or “herbal” supplements, it was not until very recently that we had any manufacturing standards applied to them. Prior to that, the strength and intensity of any pharmacological action of any molecular entity that could have been present in the plants used in making those products was subject to extremely wide variation in strength and potency, rendering them useless to those of us in the health care professions who were taught about dose-response curves, blood level monitoring, etc.

18. My goodness, to point out that Darwin proposed a theory without knowledge of cellular structure and function is an ad hominem cheap shot–I think not. Scientists of Darwin’s time had no knowledge of cellular organelles or structure and thought that the cell was just a soup with a membrane envelope. As for Darwin’s knowledge of genetics and inheritance, he had none because there was none, Mendel came after Darwin. DNA came much later. Electron microscopy came to be when i was in medical school in the 60s–histology and biochemistry are creatures of the 20th century.
    Misapplication of the ad hominem pejorative would apply if I said that Aristotle was wrong when he proposed there were 4 elements? I am an Aristotelian devotee, and i think his methods and particularly his meditations on politics and morals such were seminal, much better than Plato, but I know he worked with limited knowledge of some things, just like Darwin. I would say the 4 elements doesn’t work, and Darwin’s theory doesn’t. That’s all.
    I think Aristotle was a genius with what he had, but his theories on what made up the physical world were just plain wrong. Darwin’s theory about how functional complexity and variety in living things came to be takes one obvious commonality, living things are carbon based, can reproduce and seem in some phyla to be related, but then he takes a leap to mutation with selection that can’t be explained. We don’t know how, and there must be some organizing factor that moved things that we have not discovered.
    People who demand credentials and evidence and are proud to be skeptics don’t consider the disadvantages that impeded Darwin’s attempts to formulate a theory based on his observations? He was a phylologist who made observations, but had no tools to know the cell or DNA or inheritance.
    He developed a theory out of his observations of changes possible with breeding and his observations of intra species adaptations. However there is no substitute for knowledge in science, and present day 4 th
    graders know more biology than Darwin did or any of his
    contemporaries–that’s not an attack on Darwin but it does reflect on those who are religiously devoted to his theory that was formulated without even rudimentary knowledge of living things.
    Dawkins said that Darwin’s theory makes for contented atheists and
    Roy Spencer, astrophysicist and our ally in the climate battle pointed
    out to me that he sees a lot of religiosity in Darwinian devotees.

19. Ad homs on Darwin don’t help you any.

20. One more thing to clarify– I am not a creationist–i don’t think some big boy with a beard made the universe in 6 days and then rested.
    i prefer to just look at the Darwin theory and ask the pertinent questions. what are the physical and mathematical probabilities and are they consistent with the theory.
    My answer is no–and i do not have the answer, anymore than i really practice molecular biology when I see people and treat them–I believe in the Dirty Harry rule–a man’s got to know his limitations. I have no clue why my horses are perfect horses and my dogs are perfect dogs and my wife is a perfect woman. Do you? Does Darwin really? A man who didn’t know genetics or cellular structure and function?

21. Not even close to an answer, Gamecock. I know my genetics and statistical probabilities. I don’t know the answer, but Darwin ain’t.
    A big list of arguments doesn’t get past me–but if you show me a good argument for mutation with selection that works within the physical limits of chemistry and the physical limites of the history of the universe–I’ll consider.
    Most evolutionists just pound on a tautology–it works because it works.
    The Physical limits of mutation and selection are well known and when one piles the random shuffling of genetic material for one functional enzyme with the complexity required of a functional protein, that only introduces the enormous problems of the Darwinian theory.
    There is a limit.
    And there are bars to jump over that Darwin’s theory can’t jump.
    Consider this—the simple problem of random mutation producing the simple protein called beta lactamase, taht functions as an enzyme that is made by bacteria that interferes with antibiotics of the lactam family. It has 150 amino acids with a proper left right configuration and a specific sequence. Gotta have the proper composition, not just the right number and kind of amino acids.
    The largest number of opportunities that any material event had to occur in the observable universe since the big bang are measured as interactions at 10 to the 43rd, and the limited number of particles at 10 to the 80, and the limited time since the big bang at 10 to the 16th seconds.
    These three relevant factors produce a product of a cap on the possibilities of random genetic events that could have produced a proper sequence of 150 amino acids to be 10 to the 139th power since the beginning of time.. (One adds powers to multiply- add 80, 43 and 16=139)
    To emphasize how inadequate that is, for a simple cell, using 250 different and unique proteins for structure and function, and assuming the size of cellular proteins would average 150 amino acids (on the low side for humans), the chance for all of the proteins developing, by random shuffling, of genetic material is 10 to the 41,000th power (10 to 164 x 250).
    The random resource consumption of time events to make a 150 amino acid protein by genetic codon mutation is 1 times 10 to the 164 power. Therefore there is not enough time or opportunity to randomly shuffle DNA to produce one random protein sequence like the 150 amino acid Beta Lactamase, and there are more and also much more complicated proteins (structural, carrier, and enzymes) needed for the various living organisms that come out together to make a functional biochemical environment. One cell is quite a factory and very complex. There are millions of cells in our body.
    How can one propose living organisms by random mutation with selection?
    There are those that propose a genetic “direction” or purposeful mutation and even the concept of the “selfish” gene (Dawkins’ idea) that moves things in the evolutionary direction. My answer would be that such selfish genes would demonstrate intelligence or design, which is not possible for chemicals or molecules. There is no current theory that explains direction and the creation of functionality out of chaotic random mutations, even those that follow the particle or chemical laws.
    To impose or suggest a purpose or direction is to dress up intelligent design as a mysterious cellular phenomenon to explain away the Darwin fallacies. The designer is in the cell or the chemical or the molecule or the proteins or the DNA? Really?
    Well, in fact intelligent design is a mystery, so label it what you like. The selfish gene is the atheist’s intelligent designer. Dawkins didn’t put it that way, I did, but he led me there.
    How can one propose living organisms by random mutation with selection? It’s like walking into a Las Vegas casino and never making a wrong call. The physics and chemistry don’t allow such luck.

22. The answers are here:
    http://www.talkorigins.org/indexcc/list.html

23. http://www.talkorigins.org/indexcc/CI/CI101.html

24. Hey gamecock. so evolutionary theory doesn’t explain hard science like gravity. So what. The point is that evolutionary theory doesn’t attempt to explain graity, but it doesn’t explain what it pretends to explain, functional complexity and variety in living things so you are left with just shouting.
    I don’t have an explanation for functional complexity and variety and you can look all you want for an explanation from evolutionary theory from Darwin, who didn’t know his ass from molecular or genetic or cellular biology theory. My goodness, the man new some breeding of pigeons and he observed intra species modifications and then he projected to inter species and intra phyla changes produced by mutation with selection.
    Give me a damn break–he was a very limited intellect and phylologist with a big beard. Not credentials for the evolutionary movement that persists today as a religion of the athiests and secularists.
    How is it that I am constantly dealing with the religious nuts that support Darwin? The religion is anything but mystery or design–but it’s still pretty devoid of any evidence to support evolution as a comprehensive and definitive explanation. That’s why I say BS. Show me your intermediates, show me how it works the way you say its does.
    I know my genetics and my mutations and i don’t see the solid evidence–in fact i see a flimsy film of arguments.

25. “he may well have psoriatic arthritis”
    I don’t know exactly what he has, other than he said “psoriasis.” The way his skin used to look, psoriasis sounded accurate. He did say that the medicine is very expensive, like $8,000 a year. He suggested the government won’t approve it for treating psoriasis for no other reason than they don’t want to be on the hook for the cost for all the Medicare/Medicaid patients who might benefit from it. It could cost them billions.
    Heck of a basis for drug approvals.
    Government involvement can only make things progressively worse. With the power to approve/disapprove on any basis they want, it stifles development. And treatment. People are dying because of it.

26. There is a low of physics that says: “for every action, there is an opposite and equal reaction” (the shotgun recoil that knocks the girl on her butt). But the same law is true of medicine. Some reactions are harmless, others may kill you.

27. “evolution doesn’t explain the molecular/chemical processes”
    Nor does it explain gravity. So what?

28. That’s herbology, again, arguably not alternative because probiotics have been rigorously proven effective at helping stomach trouble especially after antibiotic use. I believe melatonin has also been proven effective in studies.

29. There are “real medicines” that are worthless and some are even harmful, the very thing “alternative medicine” is accused of. Watch the TV ads, first comes the “real medicine” miracle cure ad, then comes the lawyer’s ads advising victims, (of the same miracle med) to signup with their office to sue.
    My wife’s grandfather was prescribed a new “miracle” prescription and at the next visit to his Doctor the Dr. asked: “Joe, how’s that new medicine working for you?” Joe replied: “Don’t rightly know, don’t know how I’d a felt iffin I hadn’t a took it.”

30. John’s a doctor. His conclusion states what many doctors believe, that if it’s proven, it’s not alternative. Several groups debate over whether chiropractors or accupuncturists are truly alternative medicine because of the proven benefits (when they stay within the purview of their fields), and some pharacists will react with horror to herbology being labeled as alternative, again because it is in a very real sense, pharmacy.
    The problem is when the practitioners of these fields leave science behindd and start claiming the unproven. For example, “made by a schoolteacher” Airbone or homeopaths. , much less the out and out magical cures.

31. I would add a couple of things.
    Koch’s postulates are usually considered in the context of infectious disease, but the principles are adaptable to other things. For example Bradford Hill’s rules on toxicology are just a modification of the Koch’s postulates for harm caused by agents.
    As for the obvious exceptions to the agent caused harms and illnesses, we have to distinguish diseases based on what we know of the mechanisms. I would say we know some things about some things and what we don’t know is a big subject.
    How’s that for equivocation?
    However, i would always and forever remind those who are not in the biological sciences, including medicine, that we are not physicists or chemists and molecular biology creates a lot of uncertainty and questions. Take a look at a picture book of cellular level structures by an electron microscope. And that just structure–complexity that is asounding. There is a whole lot of mystery in living things.
    That’s why evolutionary theory is so silly–random mutations achieving functional complexity that allows selection by survival or advantage–boy there’s a theory that has a outcome bias.
    Although evolution theory does eliminate the need for that mystery that keeps causing people heartburn, and, it certainly makes atheists feel better, I don’t care whether the mystery is god or magic mouthwash–evolution doesn’t explain the molecular/chemical processes that produce the complexity that is right outside my window, from dogs and horses to plants with flowers.
    Evolutionary theory is about as proven as the tooth fairy.
    So, to return to the point–I can’t tell you all the whys and hows of many medical conditions, the best i can do sometimes is say what some of the indicia and effects are and treatments that are known to mitigate those effects. If i could get down into the ribosomes and endoplasmic reticulum of the cells of living things–maybe i could tell you more–if i knew what i was looking at. Molecular biology is like driving in a fog. More unknown than known. Hard sciences are more amenable to scientific experimentation–living things are more complex and there are layers of events we don’t understand or we don’t even know we don’t understand. How was the Rumsfeld aphorism–there are the known unknowns, and the unknown unknowns.

32. I generally agree with you. My brief is with the damage caused by boards/panels/governments, who in their zeal to make sure everything is perfect, do real harm. The barriers they have erected to the introduction of new medicines . . . REAL medicines . . . is obscene.
    How about Freddie Couples et al flying to Europe to get treatment for their backs? American doctors are not allowed to perform the same procedures. It should be between them and their doctors. Get the government out of health care. It’s none of their business.

33. Communicable diseases have fallen solidly into the domain of mainstream medicine, subject to the scientific method, largely as a result of Koch’s Postulates. Not even the Chinese try to treat an infection without antibiotics anymore. Unfortunately other causes of diseases are more cryptic, and the equivalent of Koch’s Postulates have not yet been developed for allergies, hypertension, metabolic diseases, etc.

34. Gamecock,I read your reply and would like to add some thoughts of my own.With regard to so-called alternative medicine, I have read that someone said that there is no such thing .He said either the medicine works, or it does not work! As someone who has a degree in science and my dental degree,and having a younger brother who is a medical doctor, I personally hold no truck with these unscientific, unverifiable,unrepeatable nostrums. More to the point about your brother, he may well have psoriatic arthritis, an autoimmune disease, (ask me how I know) so certain drugs ,especially certain kinds of immunosuppressives may affect and treat both. I personally would stick with so called conventional medicine.

35. My critical observation about alternative medicine (I’m mainly speaking of unregulated supplements) is their faddish nature. If something was truly as effective as many claim, it would become popular and stay popular. Among the has-beens of miracle supplements I can think of off the top of my head are Vitamin E, Lecithin, Echinacea, St. John’s Wort, Garlic, Ginseng, etc. I think there may be a kernel of truth in their purported benefits, but you’d probably have to take many times the recommended amounts to get the effect. At which point you might be at some toxicity level and certainly a lot poorer. Better off looking into modern medicine’s remedies.
    Having said that, I’ll still swear my probiotic helps my digestive process and my melatonin helps me sleep.

36. It is sad how many otherwise intelligent people fall for naturopathy and holistic medicine. Big example: Steve Jobs so sad to lose him

37. “If blinded studies show an effect that is reproducible, that’s real medicine, no longer alternative medicine.”
    So ginseng has no affect on endurance unless it has been certified to have an effect.
    My brother has been cured of severe psoriasis by alternative medicine. He takes a medicine for arthritis that, off label, cures psoriasis. His doctors told him straight to his face that, had he not also had arthritis, they could not have prescribed the drug for his psoriasis.
    There are many off-label uses for drugs. The medical-government industrial complex, imbued with the precautionary principle, are appalled. But front line providers are helping people anyway.

38. Whether it is regular medicine or “alternative medicine” once you remove placebo effect and spontaneous recovery, it greatly reduces the actual cures.

39. It would be nice if “climate science” could learn objective research as well as the NIH.

40. I agree entirely that “alternative medicine” is a branch of junk science (i.e. not science at all). However, this has nothing to do with whether or not governments should support medical science or other parts of the medical-health system. NIH is generally rather strict about what is science and what is not and they tend to be strictly empirical so their science is not junk.

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