Complementary and alternative medicine Medicine Quackery

“Traditional” nonsense

One aspect of “complementary and alternative medicine” (CAM) is the resurgence of practice of what has frequently been called “traditional Chinese medicine” (TCM). I’ve pointed out before that TCM is a prescientific system of medicine based largely on superstition and vitalism. Indeed, where ancient Greek and European medical systems believed that disease is due to imbalances in the four humors, TCM postulates disease to be due to imbalances in the five elements: Water, wood, fire, earth, and metal. These elements are thought to be related by cycles known as the Shen or Nourishing Cycle and the Ko or Regulating cycle. None of it makes any more or less sense than the humoral theory of medicine. It’s all ideas that were developed before germ theory, scientific medicine, or other basic aspects of medical science that we all take for granted. One can understand why Europeans from hundreds of years ago and the ancient Chinese developed these ideas about disease. They didn’t have the basis in the knowledge of how the body works and of microbes that can attack the body that would have allowed them to have come up with a better system because the necessary knowledge wasn’t discovered until the 18th and 19th centuries.

One can’t so easily understand or forgive modern day physicians who practice such nonsense.

Fortunately, I don’t have to today, because instead I’ll be dealing with one Dr. Mark Wiley, who bills himself as a “doctor of both Oriental and Alternative medicine, best selling author, martial art master and international seminar instructor.” In other words, he’s not a real doctor. Wikipedia lists him as having a Ph. D. in Alternative Medicine from the Indian Institute of Alternative Medicine, in association with the Open International University for Complementary Medicine and the World Health Organizations; an O.M.D. in Oriental Medicine from the Philippine-Chinese Association of Tui-Na, Acupuncture and Oriental Medicine; a
Bachelor of Science in Applied Sociology from Drexel University; and an Associate of Applied Science (Small Business Management) from Camden County College. He’s apparently parlayed this woo-ducation into a thriving alt-med business called the Wiley Method, which all appears to be based on “balance,” whatever that means. So I guess it makes sense that he’s also promoting TCM nonesense like asking if “blood stagnation” is making you ill:

We all know that blood circulates in our bodies. But what you may not know is that aside from being a vital nutrient substance blood can also be a cause of pain in the body. One of the ways blood causes pain is when it becomes “stagnant.” That is, locations where blood becomes “static” (e.g., sluggish) in the organs and tissues.

He then lists these factoids as if they were some sort of evidence that blood stagnation is real:

  • 25.1 million Americans live with heart disease
  • 32% of Americans suffer hypertension
  • 12% of females over age 20 are deficient in iron
  • 16% of adults have high-cholesterol
  • 1 in 6 Americans contract arthritis
  • 26 million Americans, between ages 20-64, suffer back pain

OK, I suppose that if you stretch the metaphor of “blood stagnation,” you can (sort of) say that heart disease is due to stagnation of the blood, but that “stagnation” has a physical cause: blockage of coronary arteries leading to clots that cut off the blood flow to the cardiac muscle. As for hypertension and iron deficiency anemia, it’s hard to see how this can be “blood stagnation.” Ditto arthritis and back pain. High cholesterol increases the risk of heart disease; but in and of itself it does little or nothing to blood flow. Maybe “Dr.” Wiley will explain. Unfortunately, there’s no “maybe” about it:

Blood is formed by the essence of the food and beverages we consume. This essence is extracted by the energetic function of the spleen and stomach, which also produce qi or life force.

Once formed, blood circulates not only in the veins but throughout the body by way of the meridian complex. It is jointly controlled by the heart (which dominates blood and vessels and circulates it), the liver (which promotes the free-flow of qi, stores blood and regulates blood volume in circulation), and by the spleen (which controls the blood and prevents hemorrhaging).

Dr. Wiley flunks basic physiology. While it’s true that one can view blood as being “formed from the essence of the food and beverages” we consume, that is true only in the most trivial way. All of the building blocks of proteins, nucleic acids, fats, an polysaccharides that make up who we are are derived from simpler molecules, which in turn trivially have to come from somewhere. That somewhere is our food. As for the rest, it’s just vitalistic nonsense. Indeed, Dr. Wiley then states that blood stagnation can be caused by deficiency of stagnation of qi (that mystical, magical life “energy” that TCM postulates as the life force). It’s also supposedly caused by an excess of heat or cold in the blood itself. Convenient, eh? It can be cold; it can be hot; it can be a deficiency of magic. It all produces the same sorts of symptoms, which can be virtually any symptoms at all or any disease at all. Don’t believe me? Check out how Wiley describes the various manifestations of blood stagnation. A couple of examples follow:

Blood stagnation in the heart may cause palpitations, what has been described as “a suffocating sensation” in the chest, cardiac pain and a purplish-color to the lips and nails. It may also cause mania.

Huh? Where did the mania come from? In any case, if you have cardiac pain and purplish lips and nails, you are in serious trouble. Get thee to an emergency room STAT! Waiting around for someone like Dr. Wiley to help you will result in your winding up totally purple and pain-free, if you know what I mean and certainly with no further excess of heat. If you don’t know what I mean, I mean room temperature.

I’ll give Wiley credit for one example, though:

Blood stagnation in the limbs and body surface may cause gangrene, a local purplish or bluish skin color, localized swelling or pain.

Well, duh. If you cut off the blood supplie to a limb, it’ll become gangrenous. It’s one of the first things they taught me in surgery residency and before that in medical school.

And here’s my favorite:

Blood stagnation in the liver may cause hypochondriac pain.

I’m sorry, but I couldn’t help but chuckle. One could just as easily say that “blood stagnation” anywhere can cause hypochondriac pain, because hypochondriacs are what TCM practitioners love. (I know, I know, he almost certainly meant this, but I much prefer my interpretation.)

The sad thing is that TCM is a major part of quackademic medicine. It’s infiltrating our medical schools, which should be bastions of science-based medicine. It’s being studied as though it were anything other than prescientific, vitalistic, faith-based practice, of which acupuncture is a major part. True, there might be some utility to some of the herbs used in TCM, but even that’s been pretty disappointing. Be that as it may, it’s not surprising that our old “friend” Dr. Brian Berman is heavily into TCM. So, apparently, is Memorial Sloan-Kettering Cancer Center and M.D. Anderson Cancer Center. It’s invading and metastasizing everywhere. That may not sound so bad, but once you know what TCM is, if you’re a science-based kind of person like I am, you’ll soon be just as disturbed and–dare I say?–as militant as I am.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

82 replies on ““Traditional” nonsense”

I recently came up against TCM when I came across the Placenta Network. It is mindboggling to see the claims these people make for products they haven’t even tested (badly or otherwise).

Basically, they say “try this, I hope some of the ingredients made it through the preparation process.”

I used to be fairly tolerant of “traditional medicines”, but – along with the problem that some of the loonier remedies are endangering some beautiful animals – this sort of idiocy has tilted me over into the “don’t say traditional medecine, say superstition” camp.

Oh gawd, that reads like a letter to the Telegraph. Sorry. I stand by it all though.

Once formed, blood circulates not only in the veins but throughout the body by way of the meridian complex.

Wait, I thought that the meridian was what life energy (ki/qi/chi) flowed through. Is he saying that blood and life energy can be changed into each other? That blood is a form of life energy?

the liver (which promotes the free-flow of qi, stores blood and regulates blood volume in circulation),

Isn’t it the spleen that stores blood? And according to Wikipedia “The liver synthesizes angiotensinogen, a hormone that is responsible for raising the blood pressure when activated by renin”, but I don’t think that’s what he meant by “regulates blood volume in circulation”.

and by the spleen (which controls the blood and prevents hemorrhaging)

The reserve of blood the spleen holds can help you survive if you undergo hemorrhaging, but I thought what prevented hemorrhaging was blood clotting.

“I’m sorry, but I couldn’t help but chuckle. One could just as easily say that “blood stagnation” anywhere can cause hypochondriac pain, because hypochondriacs are what TCM practitioners love.”

He probably meant hypochondriac pain as pain in the hypochondriac region. Although I agree that your interpretation is perfect for TCM.

Blood stagnation
Isn’t this called “clotting”?
I was told once that “blood goes round and round”, and that it’s not good if this isn’t happening.

My knowledge of A&P literally extends no further than Anatomy and Physiology for Dummies (I do have a proper textbook, I just started with that one to get my head around the terminology), and even I could do better than that. Perhaps the universities could consider it as an addition to their curriculum?

It is frightening that he is giving out actual medical advice.

Many years ago I worked as a volunteer interpreter and translator working with foreign patients at Sloan-Kettering. I do have some background in the biological sciences and found that in serving as the liaison between physicians, nurses, therapists and patients, my knowledge of physiology, biochemistry and human anatomy was very useful indeed. I do not recall any non science based practices being in vogue at the time, BTW this in the early 1980s.

Since I do not have access to the actual study cited below, I’d be curious to hear from someone who has actually read it, as to how the results compare to the placebo effect? I’d also be curious as to whether or not the investigators mention any plausible mechanisms for such an effect and last but not least how many times have such studies been replicated by independent investigators?!

A recent study [PubMed Abstract] conducted by Memorial Sloan-Kettering investigators and published in the April 2010 issue of the Journal of Clinical Oncology sought to determine if acupuncture could reduce pain and dysfunction in individuals with cancer of the head or neck who had received a surgical dissection of lymph nodes in their neck. The study evaluated 58 patients who were suffering from chronic pain or dysfunction as a result of neck dissection. For four weeks, study participants were randomly assigned into one of two groups: those receiving weekly acupuncture sessions and those receiving standard care, which included physical therapy, as well as pain and antiinflammatory medication.

The study found that individuals in the group receiving acupuncture experienced significant reductions in pain and dysfunction when compared with individuals receiving standard care. Individuals in the acupuncture group also reported significant improvement in xerostomia, a condition in which patients receiving adjuvant radiation therapy experience extreme dry mouth.

Those are rather extraordinary claims…

Well, there are some hopeful signs… There have been a lot of TCM practitioners setting up shop around here in the last few years, but now they all seem to be closing down again. I guess quackery is one of the first things people cut out of their budgets when times get tough.

One thing that’s really funny about all this is how TCM gets a pass because it’s perceived as all exotic and stuff — there’s a substantial population of Nude Agers out there who are utterly credulous about anything Oriental. The same wide-eyed gullibility applies to traditional medicine from India, also.

I wonder how far a woomeister might get if they decided to resurrect “traditional European medicine” and started flapping their gums about the humors, and applying leeches for everything? My guess is not very far — Europe is too familiar to have the same cultural cachet, so you don’t hear many New Agers applying the “wisdom of the ancient Romans” to things, or, God forbid, “the wisdom of the Middle Ages”. Besides,leeches are pretty yucky.

It’s interesting in this context that homeopathy, the One Woo to Rule Them All, somehow gets a pass, despite its decidedly European origins.

@Matthew Cline

Wait, I thought that the meridian was what life energy (ki/qi/chi) flowed through. Is he saying that blood and life energy can be changed into each other? That blood is a form of life energy?

Is he saying that meridians exist?

New Agers tend to like witches and folk anything, so one could probably make oodles of cash on traditional European medicine, as long as it’s non-academic traditional European medicine. Humoral pathology, being the creature of the European* intellectual elite, is clearly a hegemonialistic plot to separate us from money that rightly belongs to woomeisters – a sort of Big Pharma avant la lettre.

* For some definition of “Europe” that includes, among other places, Alexandria and the Aegean coast of Asia Minor.

Andreas @9 — Well, then, let’s go into business! I’ll order up a shingle to hang out, and you start working on the website. Where can we get some leeches?

It would almost be worth it just to see what would happen if you tried to get yourself included in “integrative” medicine. Perhaps if “TWM” practitioners dressed in 18th Century garb started showing up in hospitals armed with barber’s tools, leeches, and various potions designed to cure the humors, it would help expose the utter foolishness of quackademic medicine.


Is he saying that meridians exist?

I was trying to say that, even if you accept the existence of life energy, saying that blood flows through the life-energy-circulatory-system doesn’t make any sense.

I knew a woman that was stuck in the hospital for weeks once strep spread throughout her entire body- she was barely alive and couldn’t walk and finally- one of her friends (An M.D.) took her from the hospital straight to a Chinease Medicine doctor and within a week she was walking again and well. Just because scientific studies haven’t been funded, doesn’t mean it doesn’t work.

Classygirl@12 — I’m so glad your acquaintance got better!

But your anecdote gives no reason whatsoever to believe that the TCM had anything to do with her recovery.

I live in Taiwan and that crap is everywhere, even “provided” in supposedly proper clinics and hospitals.

The Taiwanese “understand” when I or other educated westerners refuse to have anything to do with it. What galls me are idiot westerners here who call me “closed minded” for not taking part, for refusing it until it’s proven by rigorous testing.

And then the idiots claim “it is”. 9_9


Just because scientific studies haven’t been funded, doesn’t mean it doesn’t work.

But it DOES mean that nobody knows that it works. And that the people who claim it does are therefore not telling the truth.

And in many cases there is no need for specifically targeted studies to know that it doesn’t work. It is quite certain that (outside of the philosophical realm) there are no such things as meridians or life energy, since if they existed we’d have found them already. Ergo anything which relies on such for its effect we know to be incorrect even without more specific evidence.

Oh Lord!

I can’t believe that I actually “understand” the nonsense he wrote and can expand upon it! If you delve into the miasma of TCM, you shall discover that it’s *even* worse than you thought! First of all, there isn’t just *qi* ( trans. “energy”?), there are two other imaginary “substances”: one higher- *shen* ( trans. “spirit”?) and one lower- *jieng* ( trans.”essence”? figure it out!); “theoreticians” of TCM / T’ai Chi (e.g. Dr Yang Jwing Ming, “The Root of Chineses Chi Gung”, YMAA, 1994) “explain” all of the arcane interconnections between said imaginary substances and how they may be controlled/ transformed into each other via breathing, meditation, exercise, diet, massage, and herbals and how this relates to ( imaginary) meridians/ acupuncture points, imaginary organs/ real organs with imaginary functions, the *five* elements *AND* immortality! Woo hoo!

It is the epitome of material ripe for Tooth Fairy Science! I hope Dr Berman doesn’t get his hands on Dr Yang’s work: bad science for decades!

From what I can fathom, they are talking about physical and psychological sensations that are already understood. They teach methods to make you feel ( and sometimes actually *be*) physically stronger and to manage emotions. The feelings you experience from exercise might be expanded metaphorically into imagined intimations of immortality. And yes, virility is a key element in the quest.

Like US/ UK woo-meisters, they apply this imaginary explanatory system to curing all what ails ye. Thus the laundry list of ailments is trotted out. A western woo might say all is due to oxidation stress or inflammation, while those inspired by the mysteries of the East will call stagnation. Again, we learn little here except about the dearth of the believer’s knowledge and his ( or her) troubled realtionship with reality.

I guess it’s nice to feel that you have control of your body and that longevity ( or even immortality) is yours for the taking if you *do the right things*. But it doesn’t make it true!

@ palindrom : while I don’t know much about *ancient European traditional medicine*, but I’m sure that someone is selling herbs/ books in this manner ( Michael Tierra?). They certainly sell ancient European magical charms and amulets and I’ve gotten gifts- Celtic and Brythonic- to prove it!

One reason for the popularity of traditional Chinese medicine. I suspect that most Americans, believers or not, have an image something like the shop in the movie “Gremlins” – dark, filled with hundreds of tiny wooden drawers and jars full of unidentifiable stuff, with a wise old Chinese man with a long grey beard, granny glasses, a long black robe and a black silk skullcap. Everyone is instantly familiar with that kind of image. As I used to tell my patients, “That old man is DEAD. Your Chinese herbs come from a big factory with smokestacks and a rail siding, run by an Asian yuppie too busy riding around in his Porsche and texting his broker to ever visit the factory floor.” Now I know there are plenty of things potentially wrong with this description, so please don’t flame me over it, but I was not aiming for strict accuracy; I was painting a broad picture to get them thinking, and it worked as often as not.

Classygirl — my grandpa was stuck in the hospital for weeks with a staph infection. When they let him out, he didn’t get TCM and guess what? He was mostly back to his own self within a week as well. So she had weeks of standard antibiotic care followed by a single TCM treatment, and you think the TCM is what cured her?

(Mind you, that’s even assuming your story is accurate.)

Anarchic Teapot

along with the problem that some of the loonier remedies are endangering some beautiful animals

This needs to be hammered home, especially with New Agers, “Greens” and the “Back to Nature” crowd. By using TCM they are endorsing poaching of endangered species and the horrific cruelty of extracting bear bile from caged bears. We need to shove this in their face.

I’m sad to say that the cancer treatment center at which I work has now expanded its CAM offerings to include acupuncture, the faux TCM tent pole. I’m stationed in an already space-challenged Radiation Oncology unit, and now, two days a week, we must surrender one of our exam rooms to an acupuncturist (increasing patient wait times, and therefore not only wasting the time and resources of the patients who seek “pain treatment” from the acupunturist, but also the time of patients waiting to see an actual doctor for actual treatment of their actual disease).

palindrome @10

Perhaps if “TWM” practitioners dressed in 18th Century garb started showing up in hospitals armed with barber’s tools, leeches, and various potions designed to cure the humors, it would help expose the utter foolishness of quackademic medicine.

This might be hard to pull off in a hospital setting, but I think it could be snuck into Med Schools, especially the ones that are integrating woo into their programs.

I had a cold this past weekend (very rare for me, I haven’t been sick in years). I watched motocross, AMA, and WSBK for the first couple of days, and I didn’t get better. Then, on Monday, I watched DVRed US open, and the cold went away! Just because the scientific studies of the effect of Roger Federer on the common cold haven’t been run, doesn’t mean it doesn’t work.

Nice post Orac.

I’m sad to say it, but I think that martial arts have become a gateway into woo. A draw of martial arts these days is the idea of the peaceful warrior, who heals as well as he can kill. People in the arts frequently strain to see how the ideas they are practicing can go either way. Chinese medicine is an inlet because it takes the idea of the death-touch and turns it into acupuncture: a person who wants to believe in the pressure-point fighting that a martial arts instructor is selling is also a tempted to believe that those same pressure points are a means of manipulating vitality to positive ends. By getting deeply into martial arts, many people precondition themselves to accepting woo. I’ve met many a person who smoked the Qi bong in my time at fighting schools.

The inability of martial arts to show that they have a basis in reality is a part of the reason I’m no longer practicing them. It is kind of fun, but the more advanced you become, the more likely it is that you’ve put yourself in a position where it’s easy to lose touch with reality. How many masters that teach “death touch” have ever actually gone out and proven it works? Would you want to associate with that person if they had?

You’ve really chosen a winner this time, Orac. Unsupported claims, dismal A&P, and these unrelated stats to “prove” blood stagnates, somehow, in people who still have a pulse (and no crushed limbs or bacteria induced clotting and gangrene).

25.1 million Americans live with heart disease
32% of Americans suffer hypertension
12% of females over age 20 are deficient in iron
16% of adults have high-cholesterol
1 in 6 Americans contract arthritis
26 million Americans, between ages 20-64, suffer back pain

1 & 2 – Aging population, exercise, big macs, sodium? We don’t need to postulate unseen causes here.

3 – I’m thinking menstrual cycle.

4 – See 1 & 2.

5 – So what?

6 – 26 million Americans have back pain? Is that all? I’d have thought just shoveling snow in winter would’ve caused more back pain than that.

These “masters” of TCM need to up their game. Their knowledge of A&P is too vague and consistently wrong to pass an intro course and their grasp of what evidence is needed to support a claim is plainly lacking. I suspect they talk about magical meridians because they can’t name and place real anatomical structures and don’t remember if the foramen magnum is in the head or the butt.

In fact, next time I meet one, I’m going to ask them some such question. Pin the biceps brachis on the human.

3 – I’m thinking menstrual cycle.

I’m thinking poor diet/eating disorders – what’s the frequency of the latter in women over 20? I wouldn’t be surprised if it’s a similar percentage.

It’s easy to keep up with the iron loss from your period if you’re eating decently, but when you’re bombarded with the ‘thin uber alles’ message, that doesn’t always happen.

My brothers friend is a majorly brain washed wooster. We happened to be hanging out one night (he was visiting from out of town) and I noticed he was eating a raw squash like it was an apple. He was complaining about an upset stomach and pulled a bottle of pills out of a bag he had brought with him and took a couple, he then curled up on the ground and started squeezing his legs up to his chest. I ask him if he was okay and he told me he was just trying to get his blood flowing again because it gets stagnant sometimes and causes him to have an upset stomach, and that this technique breaks up the stagnation. He went into the bathroom, so I took the opportunity to check out the bottle of pills now sitting on a counter. I took a few quick pictures of the bottle front and back with my I-phone so I could check it out more thoroughly when I got home. It turns out it was Traumeel, a homeopathic medicine.

Neither the pills nor the curling up squeezing blood flow technique seemed to work and not surprisingly he went to bed early due to a stomach ache.

Roadstergal wrote:

I’m thinking poor diet/eating disorders – what’s the frequency of the latter in women over 20? I wouldn’t be surprised if it’s a similar percentage.

Dunno how serious to take it, but some years ago there was some newspaper articles about how the rise in veg(etari)anism was causing an uptick in iron deficiency among younger Swedish women (the older ones mostly keeping eating meat).

@26: A homeopathic remedy against stagnant blood? Dare one ask what the active “ingredient” was?

Everyone seems to have this idea that the operation of medicine is cultural. It’s not. The culture of medicine is in its appearance, the irrelevant things like the “white coat”. There is nothing that would prevent doctors from doing science-based medicine in what appears to be the setting of their society’s traditional healing center.

Also, remember that quacks use newspeak to convince patients that their nonsense is science. So if it came down to it (chelila vechas), real doctors could use newspeak to convince a patient that their science-based operations are a new form of the patient’s favorite nonsense.

I wonder how far a woomeister might get if they decided to resurrect “traditional European medicine” and started flapping their gums about the humors, and applying leeches for everything?

Well, homeopathy is a traditional European “medicine”. (I think. Maybe it’s a traditional US medicine.) Also what about the current fad for lay midwives and home birth. I’ve often heard people hark back to the good old days when midwives delivered babies at home and even references to the medieval midwives who were killed as witches as martyrs of the movement. So I’m not sure that you’re right: maybe ancient Europe has become sufficiently exotic.

Incidentally, we do use a medication derived from leeches occasionally. It’s called hirudin and is of use for certain clotting disorders. So maybe we should bill conventional medicine as traditional European medicine. Think anyone’d go for it?

12% of females over age 20 are deficient in iron

The usual cause of iron deficiency is blood loss, with or without poor dietary iron repletion. How the FSM is making blood thinner (i.e. easier to lose) going to help that? Even allowing for the moment the ridiculous claim that Wiley has anything to offer in the way of anti-coagulants.

@20 Dianne: Homeopathy was, as Orac has often reminded us, invented by Samuel Hahnemann, a German, so certainly European. Being invented around ~1800 it’s perhaps a tad young to be labelled “traditional” – it’s more pseudoscientific than prescientific – but woosters rarely shy way from ancient wisdom from last week, so shouldn’t mind.

Re witchburning, it’s a chiefly early modern phenomenon. Not that the average aficionado of the good old days is likely to make much difference between the seventeenth century and the seventh.

What got me about this are his degrees in applied sociology and business. Sounds like core curriculum for woosters: sociology to learn how to manipulate people and business to learn how to take their money.

Being invented around ~1800 it’s perhaps a tad young to be labelled “traditional”

Wahnsinn. Everything ante-ego (before one’s own life) is old enough to be labelled traditional. And what’s a century or 10 more or less anyway? Certainly woomeisters are into home birth and homeopathy, European or not.

Dianne 34 — “Certainly woomeisters are into home birth … ”

In the past, at least, there were non-wooish reasons for home birth. Back in the Bad Old Days — say, the early 1970s and earlier — women were subjected to all kinds of totally unnecessary interventions in hospital settings, some of them humiliating and dehumanizing. People who wanted something less intrusive and controlling were out of luck.

But in our area at least, this has changed — the local tertiary-care center has a birthing center and the option of having Certified Nurse Midwives in attendance, who respect people’s preferences but call in the cavalry as soon as they’re needed. These CNMs are highly trained and deliver excellent care. They’re certainly not to be confused with the local hippie lady, who can be downright dangerous.

Our local hospital is an academic medical center, where everyone is on salary and there’s no direct economic competition for patients. The OB docs actually set up the CNM service decades ago, and the level of trust and cooperation between the OBs and the CNMs is apparently really exemplary.

Smoke and Mirrors come to mind, nonetheless after having 7 different cancers and being misdiagnosed by the head of oncology I took it upon myself to do research on all types of treatments. After about 2000 hours of study most of which was discarded my take on TCM is as follows:

1. Many modern medicines are derived from herbal supplements.

2. If the TCM products are researched you will find that many of the molecules extracted by hot water decoction or ethyl alcohol are cited in PubMed as having some efficacy.

3. Having a life threatening disease and finding high toxicity in chemotherapy products one may opt for adjunct therapies using TCM provided those products are non toxic.

4. Since chemotherapy causes the immune system to collapse and our well meaning physicians do next to nothing to re-establish the immune system it behooves us as patients to not inquire into natural anecdotal remedies. Such as the polysaccharides derived from mushrooms, baicalein derived from skull cap root, turmeric extracts and the like.

5. I cannot say if they work, what I can say anecdotally is that my oncologist has stated that Lymphoma with Richter’s transformation ( my correct diagnosis) has never been cured, that no indication of these diseases can be found in my body, that my immune system blood work shows that the NK cells have been boosted by 28% and 32% after taking various TCM herbals and German probiotics.

6. I agree completely with such terms as, “damp heat”, “blood stagnation” etc is rather goofy, nonetheless allopathic medicine has great limitations and terrible side effects, e.g.: Prosac may cause young people to commit suicide, thalidomide caused horrible side effects in the new born, other allopathic drugs are being advertised on the tube and the disclaimers as to their side effects are massive. Look at all the ambulance chasing attorneys who are advertising for victims of allopathic meds side effects to sue the drug companies which have made such drugs AND those drugs were being approved by the FDA.

One must in my view be careful with any concoction one takes from TCM, Herbals, Probiotics and Allopathic meds. What I do know is that all knowledge is limited, it can be added to and taken away from, it is up to each person to be his/ her own advocate and treat the body holistically, which means to use all types of medical knowledge and practice to cure if possible the disfunction of ones body.


With TCM, woo-meisters and quackademics have a nearly endless supply of Eastern mysticism and pseudo-science with which to entice marks. I have a long comment in moderation that explores some of the more ridiculous, intertwined nonsense purveyed by Chi Gung-sters.

@ Roadstergal ( #21) if you like RF on DVD, you should see men’s tennis *live*; it’s very… uh, *health-enhancing*, plus European dudes sometimes buy you drinks

Palindrom — and go back another century, and you get maternity wards where the total lack of infection control meant sometimes an entire ward would succumb to infection. Then again, a doctor-assisted home birth would have been preferred in those days, assuming one had a good doctor. (As much as midwives deplore interventions such as forceps, Queen Victoria lauded her physician’s use of them in delivering one of her children during a particularly difficult labor. Which was, of course, conducted at home. Actually, in those days, royal births were conducted at home *with an audience*, since it was future pretenders to the throne that were being born and so witnesses were important.)


It’s easy to keep up with the iron loss from your period if you’re eating decently, but when you’re bombarded with the ‘thin uber alles’ message, that doesn’t always happen.

Depends on the woman and the definition of “iron deficient”. Most women won’t become anemic enough to cause concern after their period. However, they frequently become anemic enough to be deferred as a blood donor. So it depends on what they mean by “iron deficient”.

In somewhat related news — could this be a good sign?

Boiron SA (BOI), a French maker of homeopathic remedies, fell the most since at least 1989 in Paris trading after reporting a slump in first-half earnings.

Boiron declined 6.80 euros, or 25 percent, to 20.10 euros. The stock’s loss was the biggest since at least Nov. 17, 1989, according to data compiled by Bloomberg.

First-half operating profit plunged 93 percent to 686,000 euros from 9.2 million euros a year earlier, the company said in a statement late yesterday. Sales in the second quarter declined 3.3 percent.

“The uncertainties tied to the economic environment lead us to being prudent as to the outlook for the year,” Boiron said in the statement.

@Calli Arcade #37:

I don’t recall Queen Victoria having a forceps birth. But ether was used in the birth of her last child (or last two children — reports differ) and she thought this innovation was wonderful. Perhaps you’re thinking of her eldest grandchild, Wilhelm II of Germany. He was a breech birth and was pulled out by his left arm. (I don’t remember if forceps were used.) On the other hand, Victoria’s cousin Charlotte and Charlotte’s unborn son died because forceps weren’t used. It was because of their deaths that Victoria came to the throne.

Oh, and Victoria didn’t like an audience — she made the ministers wait in the next room.

re: comment 3:
“He probably meant hypochondriac pain as pain in the hypochondriac region.”

Hypochondriac region = wallet

Your continual use of the words “vitalism” and “vitalistic” as if they were the worst possible epithets you could level at someone trying to understand health and healing is not only unsettling, but overlooks so much interesting contemporary thinking as to be tantamount to your own version of being “traditional”. What is “science-based medicine”? Is it really so easy to define? For that matter, is “science” that easy to define? Your rabid positivism could stand a little more exposure to philosophy, medical or otherwise…

N.B. I might start with the skeptic Paul Feyerabend. He has some interesting things to say about “science”, and some even more fascinating personal reflections on alternative medicine…

Necromancer, define “vitalism” and post the scientific literature that shows it exists and can be measured. We really don’t care what you think of science, only the evidence you have to support your statements.

And who is “N.B”? The comments are from anarchic teapot, Matthew Cline, FacelessMan, herr doktor bimler, SAS, Fred Magyar, Dunc, palindrom, Mojo, Andreas Johansson, Classygirl, P Smith, Beamup, Denice Walter, Old Rockin’ Dave, Calli Arcale, Militant Agnostic, Bethany, Roadstergal, viggen, Composer99, Scott Cunningham, scott, Collin, Dianne, Sports Medicine Parker CO, Dianne, Roger Worldie, Liz Ditz, Queen Khentkawes, and RS. I don’t see any that even start with an “N.”

@ Chris

N.B. stands for Nota bene, I guess. Our new friend is well-read.
(nothing wrong with it, as long as it’s not just shiny paint on weak arguments)

As for defending vitalism, yeah, as you said. Someone trying to understand health and healing by using concepts which are nothing else but magical thinking is the one overlooking a few bits of scientific data.
I got the feeling the Necromancer is about to engage us in post-modernism (“overlooks so much interesting contemporary thinking”). Again.

I could be wrong, of course. That would not be the first time, nor the last. Please carry on, Necromancer.

Heliantus, there is one thing I hate in this world are people who use abbreviations thinking everyone knows them, and that their particular special mix of the alphabet is unique. I comes from using Power Spectral Density (PSD) graphs and PSDs, which for some odd reason was also the same as some idiotic bean counter form.

So is The Necromancy a more well read relative of Blackheart?

Because he has already got on my bad side of not defining acronyms before using them. Always a black mark when I reviewed lab reports (the other was the idiotic use of a “gravity constant”… convert weight into mass by dividing by gravity and call it either a slug or a slinch… and for Thor’s sake don’t do what a British company did thirty years ago and create a “kilogram-force”, when Newtons are perfectly acceptable).

Oops, I meant “The Necromancer.” Lo siento. Or should I just abbreviate that to “L.S.”?

Here are a few excerpts from a short article on Paul Feyerabend: (

Feyerabend described science as being essentially anarchistic, being obsessed with its own mythology, and making claims to truth well beyond its actual capacity. He was especially indignant about the condescending attitudes of many scientists towards alternative traditions. For example, he thought that negative opinions about astrology and the effectivity of rain dances were not justified by scientific research, and dismissed the predominantly negative attitudes of scientists towards such phenomena as elitist… He envisioned a ‘free society’ in which ‘all traditions have equal rights and equal access to the centres of power’. For example, parents should be able to determine the ideological context of their children’s education, instead of having limited options because of scientific standards. According to Feyerabend, science should also be completely subjected to democratic control: not only should the subjects that are investigated by scientists be determined by popular election, scientific assumptions and conclusions should also be supervised by committees of lay people.

Why should I pay any attention to bullshit like this?

What a bunch of bulls*%t. The Atlanteans perfected Systematic Harmonitative Intragrated Transcendental therapy. It is ancient, traditional, cosmic, and futuristical. Its mysteries have never ever been proven wrong, so it blows all other medicine away.
I had a stubbed toe for a week so finally took some of it and the next day my toe was better.

“Why should I pay any attention to bullshit like this?”

Well, you wouldn’t want people to think you are condescending, would you? And, you definitely wouldn’t want people to think you have “negative opinions” (about the bullshit), would you?

I have a lot of time for Paul Feyerabend and remember his writing making a lot more sense than is presented in that summary. He disagreed with Karl Popper on how science progressed but the key point is that his arguments were expressed precisely enough that they could argue, rather than descending to “not even wrong” levels of vagueness.

IIRC his claim was that the hypothesis-generating aspect of science — the initiation of research projects — was anarchic, in that there was no “correct” definable methodology for determining new ideas to be put to the empirical test.

@Matthew Cline

I was trying to say that, even if you accept the existence of life energy, saying that blood flows through the life-energy-circulatory-system doesn’t make any sense.

Ah, but see the comments of this TCM apologist, who ‘translates’ “the spleen is the root of post-heaven essence” as meaning “digestive functions are responsible for getting nutrients into the body after birth”, and then, when it is pointed out that the spleen is not part of the digestive system, says that “spleen” actually means “pancreas”.

@The Necromancer

Vitalism is not the “worst possible epithet” Orac could think of. It’s the correct word for a medical philosophy which posits a “life force”.

Your continual use of the words “vitalism” and “vitalistic” as if they were the worst possible epithets you could level at someone trying to understand health and healing

The problem with “vitalist” theories (if I understand the term correctly) is that they don’t explain anything; they’re simply a restatement of the original problem (why is this person not healthy?) in less transparent and thus more impressive language. The person is not healthy because the healthiness is not healthifying properly around the body.

One might as well explain fire in terms of phlogiston.

Paul Feyerabend […] has some […] even more fascinating personal reflections on alternative medicine…

Feyerabend strikes me as refreshingly pragmatic. For most of his life, when he was in intractable pain due to a spinal injury, he used whatever treatments worked for him. Towards the end of his life when he had brain cancer, he used chemotherapy on the theory that this gave him the best chance of finishing more papers.

The problem with vitalistic theories is that they are wrong. Demonstrably wrong. Thanks to modern biochemistry and physics we understand in quite fine details where the “life force” come from, how it is transformed and distributed. It comes from hydrogen fusion in the sun, plants capture photons energy in chemical bonds of hydrocarbons, we can move thanks to energy released from ATP hydrolysis etc. etc. Postulating some kind of metaphysical “life force” different from well-known biochemical reactions is ridiculously superfluous. It’s as ridiculous as claiming that cars move thanks to motion spirits that dwell in the oil fields and are transferred via gasoline and willpower of the driver into cars and make the cars go. And adding half teaspoon of powdered cheetah bones to brakes fluid will repair windshield wipers of your car and make it go faster by making motion spirits happy.

No, no, no, everybody– the meridian system is *well* established science. See, the medidians (or “longitudes”) go around the earth from pole to pole, and the parallels (or “latitudes”) go around the earth parallel to the equator. And that’s how Modern Science allowed European explorers to invade other peoples’ cultures and basically make their lives miserable.

But never mind about that.

The point is, it’s all actual, real, genuine science!

Although how it relates to internal medicine, I cannot begin to imagine.

The Necromancer comes onto this thread full of fail.

Although you’d think he or she would at least give the ‘nym its due respect and try to pull this off on at least a year-old thread or something.

A serious question –

I do NOT believe that acupuncture has any effects beyond placebo, but it does have a very powerful placebo effect.

In a cancer clinic, it might work better for nausea or chronic pain than well-tested alternatives.

Is it ethical to include it because WE know it’s purely placebo, but “sell” it as legitimate in that setting?


Would you be prepared to give cancer patients a treatment that has no actual effect, but can have a powerful nocebo effect?

A good friend of mine has chronic pain, and was persuaded to try acupuncture (narcotics, acetominophen, and NSAIDs can do only so much). She was in much worse pain after the acupuncture session.

Vicki, that’s the same sort of anecdotal approach used to sell the woo – one case is not data.

Studies of acupuncture (with sham needle controls, an impressive comparison set-up) do show a very definite effect – acupuncture does not outperform placebo, but both groups do produce effects, sometimes on conditions that don’t always respond to evidence-based approaches.

I actually don’t know whether I think using that effect is ethical or not – short-term, it seems, why not help as much as we’re able?; long-term, I do think it’ll come back and bite us (it might give support to the idea of including woo in health-coverage packages).


Is it ethical to include it because WE know it’s purely placebo, but “sell” it as legitimate in that setting?

There is a word for that: fraud.

Having different kinds of expertise than most commenters here, I took a look at Dr. Mark Wiley as a martial arts instructor (videos can be found at his web site Integrated Escrima) and saw what I judge to be effective technique and good presentation of body mechanics, completely free of woo. It seems a shame that he has also engaged in this alt-med nonsense. Oh, perhaps to earn a better living, or meet some cultural concept of success?

@ BobGo:

I’ve found that amongst alt med purveyors, it’s common to sell more than one form of woo. They may offer several methods of re-charging that old life force: look over woo-ful websites and you’ll see what I mean. They sometimes mix medical/ psychological woo as well ( Mercola). Mark H calls it “crank magnetism” ( suscribing to more than one form of pseudo-science) but it’s also business expansion. One can’t live by Chakra balancing alone.


Well, there are some hopeful signs… There have been a lot of TCM practitioners setting up shop around here in the last few years, but now they all seem to be closing down again. I guess quackery is one of the first things people cut out of their budgets when times get tough.

Perhaps they forgot the first rule of alt-med: Dead marks don’t pay!

@ Denice Walter:

Yes, I’m aware of “crank magnetism”, the attraction to multiple forms of woo/denialism. I was making the contrasting observation that, of his two areas of “expertise”, one is actually quite in touch with physical reality. The Filipino martial art escrima may carry some Asian cultural baggage, but it is a highly tuned competive, physical sport. Being a professional escrima coach is no more selling woo than being a football coach or flamenco dancing teacher is selling woo. Escrima may not be your favorite sport — probably not your cultural heritage. Not mine either. But it does seem to be part of Mark Wiley’s cultural heritage. It would be overly simplistic to equate martial arts, or a sport popular in another part of the world, with woo.

So, apparently, is Memorial Sloan-Kettering Cancer Center and M.D. Anderson Cancer Center. It’s invading and metastasizing everywhere.

Perhaps it’s because… surprise! it actually works? I’d trust those two institutes; they wouldn’t put their reputations on the line by endorsing pseudoscience and sham medicine.

Here is the PubMed link to the study referred to by Fred Magyar above. Funny how not one of you woo-busters had anything to say about the positive evidence for “woo medicine”, eh?

Regardless, go through it. I’m sure you smart bunch will find fallacies in the study design; never mind that it was published in a peer-reviewed journal of repute.

And here’s a newsletter from the Sloan Kettering archives which refers to the above study, as well as another study showing positive evidence (link below):

Now let’s hear something more intelligent and compelling than the tired old counter-argument, “placebo effect!”

@ BobGo”

Martial arts as a form of *exercise* – may have physical and/or psychological benefits which can be shown by *data*- thus are not woo. However, the problem lies when other more arcane benefits are extolled- like longevity and ( ahem) immortality.

Martial artists ( like yoga instructors) are not immune from tacking on woo to increase profits as our woo purists are known to supplement their income by purveying more than one variety of pseudo-science.

OK, this is perhaps a dead thread (on vitalism, no less), but I will pick it up again by responding to the skeptical cries of “so what is vitalism, anyway?” with the following quote:

“To do this is, above all, to grasp what human will and human reason can do, and what they cannot. How can this be known? Not by a specific inquiry or discovery, but by an awareness, not necessarily explicit or conscious, of certain general characteristics of human life and experience. And the most important and most pervasive of these is the crucial line that divides the ‘surface’ from the ‘depths’ – on the one hand the world of perceptible, describable, analyzable data, both physical and psychological, both ‘external’ and ‘inner’, both public and private, with which some of the sciences can deal, although they have in some regions – those outside physics – made so little progress; and, on the other hand, the order which, as it were, ‘contains’ and determines the structure of experience, the framework in which it – that is, we and all that we experience – must be conceived as being set, that which enters into our habits of thought, action, feeling, our emotions, hopes, wishes, our ways of talking, believing, reacting, being. We – sentient creatures – are in part living in a world the constituents of which we can discover, classify and act upon by rational, scientific, deliberately planned methods; but in part […] we are immersed and submerged in a medium that, precisely to the degree to which we inevitably take it for granted as part of ourselves, we do not and cannot observe it from the outside; cannot identify, measure and seek to manipulate; cannot even be wholly aware of, inasmuch as it enters too intimately into all our experience, is itself too closely interwoven with all that we are and do to be lifted out of the flow (it is the flow) and observed with scientific detachment, as an object. It – the medium in which we are – determines our most permanent categories, our standards of truth and falsehood, of reality and appearance, of the good and the bad, of the central and peripheral, of the subjective and the objective, of the beautiful and the ugly, of movement and rest, of past, present and future, of one and many; hence neither these, nor any other explicitly conceived categories or concepts can be applied to it – for it is itself but a vague name for the totality that includes these categories, these concepts, the ultimate framework, the basic presuppositions wherewith we function.”

From Isaiah Berlin, The Hedgehog and the Fox: An Essay on Tolstoy’s View of History (Chicago: Elephant, 1993 [1953]), 67-8.

That makes it much clearer, doesn’t it?

That makes it much clearer, doesn’t it?

I think I lost all my Vitalism trying to slog through that mess.

I see why he calls himself “The Necromancer.” He is ignoring over a century of science, especially the bits about basic chemical reactions, photosynthesis, biochemistry, the discovery of DNA and RNA, and on and on. I believe he is quite lost and confused.

Thanks for clearing that up, Necromancer, because, of course, when I’m looking to evaulate medical claims my first resource is an obscurantist essay about Tolstoy…

In case there’s any question, this is the 21st century now and we’ve learned a lot that wasn’t known in the 19th that was Tolstoy’s era. (Though it should be noted that Wohler had synthesised urea by the time Tolstoy was writing, a major blow to the vitalist theory.) Looking to Tolstoy’s views on medicine would be akin to looking to his views on commercial aircraft safety.

— Steve

I loved that Berlin essay as an undergraduate, but it has nothing whatsoever to do with vitalism. It’s about different kinds of thinkers, based on a quote from Archilocus, “the fox knows many things, but the hedgehog knows one big thing”. Berlin didn’t mean it to be taken seriously, even if it wasn’t misinterpreted.

Dr Zen @70

Wow – an unblinded study with no placebo arm shows a significant effect in completely subjective measures. Colour me unimpressed. They make claims about “non subjective measures” like range of motion, but Richard Saunders and Brian Brushwood have demonstrated increased range of motion from wearing the Placebo Band.

All this demonstrates is a failure of the peer review process. Your arguments from authority are as lame is this study. The “peer reviewed study” that you find so impressive is so lame it is probably not worth Orac’s time to deconstruct it.

@ Militant Agnostic

Your opinions noted.

Relief from pain and other distressing symptoms is always subjective regardless of scales we may devise to quantify the phenomenon.

Did you even read through the entire abstract? There was a reason they opted not to use a placebo control arm:

The decision to use a pragmatic control reflected the following factors. A specific active treatment control seemed unwarranted because the efficacy of standard treatment in this setting is not well established. Because acupuncture already had been shown to be superior to placebo in the treatment of neck and shoulder pain of other etiologies,24,27,29 the need for a placebo control was unclear and posed added logistical burdens to patients, which may have adversely affected a patient’s willingness to participate.

I thought the findings in the second study were interesting and unexpected, since placebo effect should typically wear off faster compared with a conventional treatment, correct?

Sounds like the “placebo effect” in this instance is outperforming the “science-based medicine”.

By 2 weeks post-treatment, the venlafaxine group experienced significant increases in hot flashes, whereas hot flashes in the acupuncture group remained at low levels. The venlafaxine group experienced 18 incidences of adverse effects (eg, nausea, dry mouth, dizziness, anxiety), whereas the acupuncture group experienced no negative adverse effects.

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