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Traditional Chinese medicine is science, ma-an! National Geographic promotes quackery

There’s a whole genre of quack apologia for traditional Chinese medicine that I like to call “traditional Chinese medicine is science, ma-an!” Basically, it tries to convince you that the prescientific, mystical, vitalistic mass of nonsense that is traditional Chinese medicine is “ancient knowledge” that was far ahead of its time and that its wisdom will be rediscovered to become the future of medicine. It’s utter nonsense, of course. Unfortunately, in its January issue, National Geographic fell for this myth—hard.

Traditional Chinese is science, ma-an! No, really, TCM is science! Really and truly it is! It’s real medicine!

That’s a frequent refrain from proponents of TCM. Indeed, it’s a propaganda line that I see so frequently that, seeing the latest example of it that I’m going to discuss here, I decided to name it the “traditional Chinese medicine is science, ma-an” gambit, or maybe just the “TCM is science” gambit. Never mind that it’s not at all true. If there’s one thing TCM is not, it’s science.

As I’ve described many times before, TCM is based in ancient mysticism and vitalism. It is based on an Asian version of the dreaded ancient European concept of the four humors, except that TCM calls them the “five elements.” Just as ancient European medicine dating back at least to Hippocrates blamed disease on imbalances in the “four humors” and sought to restore that balance, TCM saw disease as an imbalance of the “five elements” (which must be better than four humors because, you know, it’s five and it’s not European). Unfortunately, thanks to Chairman Mao Zedong in the 1940s and 1950s, the entire history of TCM has been retconned and camouflaged as being science-based. It worked spectacularly, and, beginning in the 1970s, TCM has been increasingly accepted in mainstream medicine, its lack of scientific basis notwithstanding. Acupuncture and various other TCM modalities are offered in all too many academic medical centers, such as the Cleveland Clinic, which opened its own Chinese herbal medicine clinic, and UCSF, which spent $37 million to build an “integrative medicine” center that includes TCM. Meanwhile, high profile general science journals like Nature and Science think nothing of publishing advertising sections dedicated to promoting the message that TCM is science and that science-based medicine is looking to its “ancient wisdom” for medical breakthroughs. Meanwhile the World Health Organization is revamping its codes for classifying diseases to encompass TCM, while the Chinese government passes laws to promote TCM by requiring it in state hospitals and lowering the bar for its approval. Basically, TCM has become big business in China, and the Chinese government protects it against criticism. Mao’s campaign to “integrate” TCM into “Western medicine” continues apace, unfortunately, as his successors carry on his work with the help of credulous “Western” physicians.

That history is why in the January issue of National Geographic features an article by Peter Gwin entitled How ancient remedies are changing modern medicine. Its subtitle? Long overlooked by Western science, traditional Chinese treatments are yielding cutting-edge cures.

Traditional Chinese medicine is science, ma-an!

I can practically write this article myself, having seen its like so many times before. All you do is to interview a couple of pharmacologists investigating herbs of TCM origin, picking ones who think they’re on to something or might actually be on to something, don’t bother interviewing skeptics, and write a narrative about how traditional Chinese medicine is science now. I can even predict some of the examples that will be used, and I did. For instance, Gwin buys into the narrative about artemisinin, the treatment for malaria whose discoverer won the Nobel Prize:

In 1972, the year Cheng finished his Ph.D. in pharmacology at Brown University, a chemist in the People’s Republic of China named Tu Youyou announced the discovery of an antimalarial substance based on a Chinese medicinal herb mentioned in a fourth-century formula.

During the Vietnam War, Tu had been tapped to work on a secret military project to help the Vietcong combat malaria. The disease accounted for roughly half their casualties. Western health researchers were also trying to solve this problem, screening more than 200,000 compounds. But Tu wondered if an answer might lie in classical Chinese medical texts. She tested several plants related to fever and found a remedy based on a yellow-flowering herb called wormwood (Artemisia annua). The drug derived from her research, called artemisinin, has been credited with saving millions of lives and earned her the 2015 Nobel Prize for medicine.

Of course, I’ve discussed artemisinin before when Tu was awarded the Nobel Prize, as have Scott Gavura and Steve Novella. All of us noted that there was nothing special about TCM with respect to artemisinin. Nor did the awarding of the Nobel Prize to Tu in any way “validate” TCM, as its advocates claimed. After all, all Tu did was to look for compounds used in TCM for fever and ended up testing 2,000 compounds. This is nothing more than pharmacognosy, a branch of the science of pharmacology that is focused on natural products and a lot of grunt work evaluating so many compounds for activity against malaria. She then chemically modified artemisinin to dihydroartemisinin, resulting in a compound that was stable and had a ten-fold higher activity against malaria, which led to the development of other derivatives of artemisinin. Nothing about the story of artemisinin “validates” TCM. By sheer chance alone, one might expect that any traditional medicine system using herbal medicine will yield the occasional artemisinin. Herbs, after all, can contain medically useful compounds. Interestingly, some traditionalists were even sad that they were forced to admit that Tu YouYou did basically use the same methods of the dreaded “Western” medicine to turn artemisinin into a useful anti-malarial medicine.

Gwin also quotes a Yale pharmacologist named Yung-Chi Cheng, who makes an analogy to aspirin as a reason not to dismiss ancient medicine. Indeed, aspirin does predate TCM, if you mean the use of salicylate-rich plants, such as willow, in traditional medicine. References to the use of such plants appear in clay tablets from ancient Sumer and as well as the Ebers Papyrus from ancient Egypt, which referred to its use as a pain reliever, while Hippocrates used willow leaf tea to ease the pain of childbirth. The use of salicylates as pain relievers and anti-inflammatory drugs has been described ever since, up until 1897, when Bayer added an acetyl group to salicylic acid to produce aspirin. If you’re interested in learning more, here’s a cool timeline of the history of aspirin that shows that the use of plants rich in the salicylates for medicinal purposes goes back at least to 3,000 BC. However, I’d counter that aspirin is unique or very close to it. Are there other medicines so widely used whose precursors have been used continuously for thousands of years? Again, aspirin is a great drug, but it’s also very rare as an example of ancient medicine that remains so utterly useful today. No one’s saying that we shouldn’t study ancient medicines to see if they have any usefulness, but if there’s one thing I’ve noticed about boosters of TCM, it’s that they seem to view TCM as a cornucopia of undiscovered medicines that will cure cancer, heart disease, and every disease known to humans.

That’s because traditional Chinese medicine is science, ma-an!

Balance, as long as it’s false

Gwin also engages in a heapin’ helpin’ of false balance. But first, he leaves out some key facts. For instance, he mentions that ” traditional medicine remains a vibrant part of the state health care system” and that “most Chinese hospitals have a ward devoted to ancient cures.” That’s true, but that’s only part of the story. The Chinese government has been promoting TCM to one degree or other ever since Mao Zedong and, more recently, Chinese law mandates that every state medical facility offer TCM. Of course, in reality, Mao didn’t use TCM, and during the 1920s and before educated and elite Chinese viewed it as the quackery it was. Indeed, TCM 110 years ago was brutal, with acupuncture then using large lancet-like needles rather than the thin filiform needles used now, which weren’t introduced until the 1930s.

So let’s look at the false balance. First, Gwin lays down a common trope used by TCM supporters and believers:

From a research perspective, it very well may be a golden age. Scientists from leading universities in the United States and Europe, including UCLA, Duke, and Oxford, as well as many in Asia, are looking at the scientific underpinnings of some traditional treatments for diseases such as cancer, diabetes, and Parkinson’s.

Traditional Chinese medicine is science, ma-an! Funny, but scientists are also looking at the “underpinnings” of quackery that’s part of TCM like acupuncture, tongue diagnosis, and the like.

Next, he adds an appeal to popularity:

But the practice of melding the modern with the traditional is also spreading among health care consumers. When they don’t find relief from Western medicine, Americans increasingly are turning to traditional treatments, notably acupuncture, which is now covered by some health insurance plans, and cupping, a muscle therapy that involves suction and is endorsed by many professional athletes. The internet has fostered the growth in herbal remedies, which are often cheaper than doctor-prescribed pharmaceuticals. A patient can read about a traditional remedy online, order the herbs on Amazon, and watch YouTube videos on how to prepare them at home. The result is a growing alternative health sector, which in 2017 saw U.S. herbal supplement sales top eight billion dollars, a 68 percent increase since 2008.

Take that, skeptics! Traditional Chinese medicine is science, ma-an! And it’s popular, too! Checkmate, skeptics!

Speaking of skeptics, here’s how Gwin describes us:

You’ll also find doctors who denounce traditional Chinese medicine as pseudoscience and quackery, pointing to some of its most outlandish claims, like the ancient practice of prescribing firecrackers to chase away demons, or mysterious concepts still embraced, such as a nebulous life force called qi (a term translated literally as “the steam that rises from the rice”). Others rail against its use of animal parts and warn against the potential dangers of its herbal formulas.

Unfortunately, notably, Gwin appears not to have actually interviewed a single real skeptic for his article, or, if he did interview anyone, no quotes made it past the final edits. Now here comes the false balance:

“Rarely do you find anyone who looks at it objectively,” says medical historian Paul Unschuld. A leading authority on the history of Chinese medicine—and often an unsparing critic of the way it’s interpreted—he has collected and translated hundreds of ancient medical texts and is working with a Chinese-German startup to study them for ideas about treating a variety of illnesses, including epilepsy. “People generally see only what they want to see,” he says, “and fail to fully examine its merits and its faults.”

Traditional Chinese medicine is science, ma-an! That’s right, skeptics and believers are the same. They only see what they want to see, and skeptics ignore all the benefits of belief in the mystical magical qi, the torture of bears to harvest their bile, the killing of rhinos and tigers for their parts to make into useless medicines! I can’t help but note that Unschuld, as expert as he might be in Chinese history, seems to buy into the false dichotomy that doctors can be “mechanics” or “intellectuals.” Guess which category “Western medicine” practitioners fall into compared to TCM practitioners. On second thought, not exactly:

The intellectual healer follows a different course. He wants to know why biomedicine has arrived at its current notions of the origin and nature of disease, and at therapeutic interventions derived from them. He wants to know what the essential difference is between different health care traditions, and he wishes to have arguments (and be able to voice these arguments) as to why he prefers one approach over another. The intellectual healer may realize that one type of health care is good for a certain portion of his clientele, while the mental set-up of another portion of his clientele requires a different therapeutic approach.

In other words, it’s the “integrative medicine” practitioner, who’s willing to draw from “both worlds,” who’s the true “intellectual healer,” not the “Western doctor” or the TCM practitioner. No wonder Gwin interviewed Unschuld!

Here’s some more false balance. Gwin references a story he did about rhinocerous poaching. Rhino poaching is a huge problem. Poachers kill them for their horns because rhino horn is used in TCM to treat a wide variety of ailments. Gwin noted that such extracts, which are mostly keratin, produce little or no physiologic effect but could work through the placebo effect. (That’s a whole other can of worms, namely the misunderstanding of placebo effects.) He then reports that he got letters from readers “angrily denouncing Chinese medicine as ‘ignorant,’ ‘cruel,’ and akin to ‘witchcraft,'” which it, in fact, is. Now here’s a doozy of a bit of false balance:

Such criticisms aren’t without merit. Rhino horn sales in Asia are a primary factor pushing rhino populations toward extinction. In addition to bears, many other animals—including several threatened species such as tigers, leopards, and elephants—are poached in the wild or farmed for their parts.

But modern medicine has its own controversial practices. The effectiveness of many popular antidepressant drugs remains hotly debated, with some studies showing they are barely more effective than placebos. Yet these drugs are extensively marketed and widely prescribed by physicians, generating billions of dollars in revenue. (This isn’t to say depression drugs don’t work. If a patient’s symptoms are relieved, then one can argue they work. But the chemicals in the pills themselves may not always be the source of the relief, just like the chemicals in rhino horn aren’t necessarily the source of relief for patients who take it.) When considered alongside other notable examples—the overprescription of opioids, doctor-endorsed fad diets, and questionable surgeries—Western indignation over traditional Chinese medicine can seem more hypocritical than Hippocratic.

Traditional Chinese medicine is science, ma-an, and science-based medicine boosters are a bit of hypocrites! TCM is the cause of the wanton killing of endangered species for their parts, which are mixed into various potions, as well as the torture of Asian bears to harvest their bile, but damn if “Western medicine” doesn’t have its own “questionable” practices!

There’s only one response to this, and it comes to us courtesy of Godzilla:

William Cole gets a Godzilla facepalm

So. Much. False. Balance.

So. Much. Misunderstanding. Of. Placebo. Effects.

Alternatively, in response I like to quote Ben Goldacre:

Yes, science-based medicine has some questionable practices. However, many of these problematic practices are due not to its science but rather due to an inadequately rigorous application of science. The answer, therefore, is more rigorous science, not to embrace magic. Again, just because “conventional medicine” has problems does not mean that magic works! It does not mean that a system of medicine based on mysticism, vitalism, and prescientific beliefs is superior—or even equivalent. It does not mean that we should take prescientific mysticism, much of which is actually well demonstrated in a beautiful and elaborate infographic of TCM concepts and practices included in the article, complete with balancing the “four proporties” and the “five flavors” in herbal remedies. Yet Gwin credulously regurgitates that false dichotomy. Epic fail!

Let’s put it this way. In the article, there is a photo of a TCM practitioner setting a patient’s back on fire. (The patient is completely covered in a blanket.) Its caption reads:

In a fire treatment session in Chengdu, an alcohol-soaked cloth is draped over a patient and set alight to warm the skin and open the pores; an herb-infused oil is then applied. The therapy aims to treat joint pain and other ailments, but research has yet to prove such claims.

I hope there’s a burn unit in Chengdu. Also, wouldn’t a large heating pad achieve the same end with far less chance of causing significant burns? The TCM practitioner could even control the temperature! I am, however, amused by the part about how “research has yet to prove such claims.” Ya think?

Traditional Chinese medicine is science, ma-an! Really, ma-an!

There are a couple of other examples, besides that of artemisininm, that Gwin appears impressed by. The first is a combination of multiple TCM herbs based on an 1,800-year-old recipe for a mixture of skullcap, licorice, peony, and Chinese date, described as a treatment for “diarrhea, abdominal pain, and scorching heat in the anus.” It’s designated PHY906 and was touted as good for alleviating the symptoms due to chemotherapy side effects. PHY906 is a powder containing a spray-dried aqueous extract derived from the Huang Qin Tang formula. It consists of four principal herbs (Figure 1): Glycyrrhiza uralensis Fisch, Paeonia lactiflora Pall, Scutellaria baicalensis Georgi, and Ziziphus jujuba Mill.

Me being me, naturally I couldn’t resist searching PubMed for PHY906. When I did, I found that the earliest publication dates back to 2003, which means that this compound has been in development for at least 15 years. Yet, one thing I didn’t find was a decent-sized randomized phase III clinical trial of the compound. A recent summary of the evidence for PHY906 reveals a compound that might be useful to combine with the chemotherapy agent irinotecan for some cancers and could potentially alleviate some GI symptoms of chemotherapy-induced toxicity, but nothing special. You wouldn’t know that from the writeup by Gwin, which makes PHY906 sound like an incredibly promising new agent based on ancient wisdom. In reality as I see it perusing the evidence, PHY906 looks like a somewhat promising agent that could be useful when added to conventional chemotherapy. Time will tell, although you’ll be forgiven if, reading Gwin’s article, you’re left with the impression that PHY906 will cure all cancers, as Gwin goes to the fields in China where the herbs are harvested and marvels at them.

Finally, perhaps the most offensive part of Gwin’s article is how it seems to go out of its way to justify the use of bear bile in TCM. The harvesting of bear bile is truly a barbaric practice. Bears are confined in tiny cages, with catheters implanted in their gallbladders to harvest the bile. That doesn’t stop Gwin from lionizing Paul Iaizzo, head of the University of Minnesota’s Visible Heart Lab, who’s been studying bear bile as a means of keeping hearts viable longer for transplant. Apparently, Iaizzo has produced evidence that certain chemicals from bear bile can prolong the viability of hearts harvested for transplant.

Particularly egregious is this passage:

I ask him whether the Chinese practice of drinking bear bile could really bestow any health benefits. “It could,” Iaizzo says, noting the chemicals would enter the bloodstream and move through the heart and other organs. He doesn’t condone farming bears for their bile, emphasizing that the chemicals can be synthesized, but the science is the science. And though the ancient Chinese didn’t understand how bear bile helped humans, they observed that it did.

Did they, though? I would question that assertion. Identifying effects on survival and symptoms due to cardiovascular disease requires rigorous clinical methodology and randomized clinical trials. It is doubtful that anecdotal observations from hundreds or thousands of years ago would identify a clinically meaningful benefit. Yes, the chemicals from bear bile can be synthesized, but the whole passage struck me as at least partially justifying the use of bear bile as medicine. You think I’m being too harsh? I don’t think so. Look at this passage concluding the article:

As I hold the pig heart, I can feel its rhythm slowing. It finally stops. The pig died hours ago, and now its heart has stopped too. Its color seems to dim—like a mahi-mahi that loses its lightning yellow glow as it dies in the hands of a fisherman. I wonder if whatever is now gone is what the ancient Chinese meant by qi.

I think of the moment in the hospital when I was holding my father’s hand and felt his pulse finally stop. I’m suddenly aware of my own heart, flexing and lurching inside my rib cage, and wonder about its other mysteries.

Dammit. Traditional Chinese medicine is science, ma-an! Except that it isn’t. I groaned as I read the conclusion of this article. I’m sorry that Gwin’s father died, but qi doesn’t exist. The five elements don’t exist, not in the way TCM claims they do. Acupuncture doesn’t work. A few TCM herbal remedies might work, but that doesn’t justify TCM. Again, I find it particularly telling the Gwin didn’t bother to interview a single skeptic. It’s almost as though he’s a believer in TCM himself.

No matter how much advocates try to claim that TCM is science, ma-an, it’s not. Unfortunately National Geographic has jumped on the TCM propaganda bandwagon to promote its prescientific, pseudoscientific, and mystical nonsense.

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]

90 replies on “Traditional Chinese medicine is science, ma-an! National Geographic promotes quackery”

In a fire treatment session in Chengdu, an alcohol-soaked cloth is draped over a patient and set alight to warm the skin and open the pores; an herb-infused oil is then applied. The therapy aims to treat joint pain and other ailments, but research has yet to prove such claims.

If my back is burned, the pain will probably take my mind of joint pains. But to me it sounds like whacking your finger with a large hammer, to get rid of the pain of a paper-cut.

(I just saw that issue of Nat Geo on the grocery store magazine rack and decided it was time to read this post.)

Per Orac, the obvious thing to do is test whether heat applied to a large area of the back has any beneficial effect.

It’s especially helpful that the claimed heat healing modality also uses oil applied to the skin, because that should overcome the problem we see with testing acupuncture, of getting a meaningful control for a procedure that inherently produces a specific sensory impression (sticking someone with needles vs. poking them with prods vs. what exactly?). So:

Test group: Heat + herbal oil. Control 1: Cooling + herbal oil. Control 2: Herbal oil only, room temperature.

Or if you prefer: Test group: Heat + herbal oil. Control 1: Heat + any conventional cooking oil e.g. olive or coconut. Control 2: Heat only.

There’s at minimum a huge anecdotal following for the use of conventional electric heating pads to alleviate muscular (and possibly joint) pain, and real doctors often suggest using heating pads or hot water bottles for pain. To the extent that this situation continues, it’s not too unreasonable to infer that a substantial number of patients find that heat does relieve pain (or they’re good placebo-reactors, keeping in mind the actual usefulness of placebos in dealing with subjective symptoms).

Thus “if this works,” there’s potential for developing whole-back heating pads that are “safe and effective if used as directed,” and/or finding the active chemicals in the herbal oil, that can be synthesized for proper medicine. If it doesn’t work, we can add it to the “discards” list in the proverbial medical waste bin of history.

What I do when I run into an enthusiast for Asian, European, or other traditional medicine, is to hear them out and then eagerly suggest that whatever-it-is be tested per the standards of science. The point being to encourage an interest in scientific method and then teach enough of it to the person, that they can start thinking skeptically: for example the bits about seeking to falsify your preferred hypothesis.

To which I add “if you get negative results, that basically means that nature is a heck of a lot more interesting than you thought it was…” What’s “interesting” is that the natural universe may and often does turn out to be a lot more awesome than our invented magical explanations make it out to be. This, folks can discover for themselves, as they go down the trail toward more empirical and rational approaches.

And there’s always the possibility that some of these traditional modalities might turn out to be beneficial in one way or another. Great!, another success for pharmacognosy etc.! And, in the mannerly spirit of reciprocity, when we find a traditional modality that has value, we can and should give pats on the back to its advocates, and more invitations to them to go down the science trail.

Yes anti-depressants do not work for everyone, but if you have severe clinical depression they can literally be a life saver. I certainly wouldn’t be typing this without them. I know this isn’t the main thrust of the article, but the way people denigrate anti-depressants makes me so angry, because it puts off people who really need them from trying them, and that can be fatal.

And this is used as a counter argument to eating pangolins. Like, really? He gets the anti-depressant stuff at least half wrong and then thinks that balances out species extinction?

Excellent point (I know a couple of people with depression, taking SSRIs: yes, life-saving medicine).

The denigration of antidepressants often occurs by alt-med advocates claiming that their herbals or whatever are better. When we in the science-based world critique alt-med, we shouldn’t let that stand as an implicit assumption. Instead, we should go out of our way to say that despite some equivocal findings, the plain fact remains that antidepressants work well enough for a large enough number of people, that they’re always worth trying.

What I think is up with this: Given a quantity of different antidepressant meds, e.g. Lithium, Prozac, and the other SSRIs that are similar to Prozac. Assume that each medication has a population normal curve of effectiveness: very effective for some people, less effective for most, and not effective for some. Each of those normal curves’ mean average results, by itself might not be too terribly far from the control group means, so one could conclude for each med, in and of itself, that it’s “not much more effective than placebo.”

BUT, and this is the important part: If you put all those curves together, what you end up with is that the antidepressants, as a whole category, do show significant benefits for a very significantly higher percentage of the population, compared to placebo.

The reasonable inference is that if a particular medication doesn’t work for someone, chances are that if they try a number of them under doctor’s care, they will eventually find the one that works well for them. And in fact, this is what we actually see occurs.

That’s the more-complete explanation of what’s going on with that, and there’s probably a good way of expressing it much more concisely.

Everyone who has depression should be encouraged and supported to try as many different meds as possible until they find the one that works best for them. Knowing in advance that this may take a few months between all the various meds, can provide a basis for viewing it not as a dreary task, but as an interesting personal experiment.

Alas, it took twenty years to figure out that SSRIs do not work too well for me, my lifesaver was bupropion.
But, better late than never.

Sure, every treatment modality might be used also in cases where it is not absolutely necessary or where there’s another option. Psychiatrists themselves do admit that finding the right drug for a given patient is often a bit of alchemy and that in a sense, psychiatry is the least science-based specialty. But just because our knowledge of what’s going on in the brain is imperfect and so is psychiatry, it doesn’t mean that doing nothing would be always better
There’s a lot of the “it’s just in your head” trope, too. Well, sure it’s in my head. Still, the depression is a major PITA.

I remember reading a book of a Dutch musician, who suffered from depression. It took a long time before they found the right anti-depressant, that worked for him. It was an interesting read.

I remember as a child walking barefoot in the sandy playground and occasionally ocean beaches. Sometimes the most amazing idea popped into my head. After reading today’s RI, I realize I was experiencing (through that alt-med process of “grounding”) and primitive version of solid state semiconductor physics, possibly even communicating digitally with gaia herself. Sure, scientific greats like Bose and Shockley were actually already creating semiconductors, but I was experiencing them in a TCM kind of fashion.

So we can’t criticize the Chinese (and credulous Western TCM followers) for animal cruelty and driving species toward extinction, because some We$tern medicines may not work well enough to justify large-scale use?

My five elemental humors must be too sluggish at this time of day to get my brain wrapped around this analogy.

Need more coffee.

One of my favorites.

“I’m sorry, ‘herbal medicine’, “Oh, herbal medicine’s been around for thousands of years!” Indeed it has, and then we tested it all, and the stuff that worked became ‘medicine’. And the rest of it is just a nice bowl of soup and some potpourri, so knock yourselves out.” – Dara Ó Briain

I love Dara so much, I purchased a region free bluRay/DVD player just so I could have his DVDs, and his rant on the above is one of my favorites – that and Barry, who thinks the sky is a carpet painted by God.

Indeed it has, and then we tested it all, and the stuff that worked became ‘medicine’.

Well, to a point. The most useful was forbidden to be ‘tested’ though it showed remarkable efficacy.

Ancient Chinese secret — Hemp. CBD with a little bit of THC (entourage effect). It’ll pretty much fix what ails ya. NO STUDIES TO SHOW?? No studies to show that it does not. Checkmate, pharma shills.

Ohh, there is the marijuana-derived CBD, Epidiolex that the FDA approved. Funny that. Now that it is recognized as safe and has efficacy, it is, after all, classified as a true ‘drug’. That very classification limits access to it. Fuckin’ bastards.

Where the heck do you live that CBD is less accessible? Where I live the stuff is everywhere (at the pet food store, for crying out loud) and there are weed stores everywhere the law allows them, which sell not just variations on weed but also CBD oils.

Seriously, the issues with studying weed had nothing to do with pharma or medicine and everything to do with America’s obnoxious Puritan roots that scream that anything that might maybe feel nice is to be forbidden. See, Prohibition. Or sex, or rock and roll, or you know, lots of things.

As Mark Twain said “Nothing so needs reforming as other people’s habits. Fanatics will never learn that, though it be written in letters of gold across the sky. It is the prohibition that makes anything precious.”


To be fair, it has been ammended:

This notice has been updated to reflect recent action by the U.S.
Congress regarding cannabidiol (CBD) derived from industrial hemp. On
December 12, 2018, the U.S. House of Representatives gave final passage to the
Agricultural Improvement Act of 2018 i which is expected to be signed into law.
This bill contains a provision legalizing industrial hemp, beyond the existing pilot
programs passed by Congress in 2014. As a result of this Congressional action,
CBD derived from industrial hemp, with a THC concentration of not more than
.3%, can be legally produced, sold, and possessed in the State of Alabama.
However, as stated in the bill, the new federal law will not prevent states from
adopting laws to restrict or regulate the production of industrial hemp.
Furthermore, prescription drugs and other consumables containing CBD will
continue to be regulated by the U.S. Food and Drug Administration.

But they already shut down the CBD shops and arrested many people.

Alabama being a puritanical state isn’t the fault of the pharmaceutical industry. Until 2013, you couldn’t homebrew beer in that state. You think they’re going to be lax on cannabinoids??

Ya know? I’ve been thinking. The FDA now calls their approved CBD a true ‘drug’ so that it can never be added to food and what not. I wonder; Would not Orin Hatch’s DSHEA supplement act apply here??? I mean, I think that CBD was in food before nineteen hundred and ninety four —

I love you, Alis B. Toklas:

Unschuld has said that Western medicine can’t achieve miracles and cannot solve many everyday health problems which many people know Chinese and other traditional medicines can – regardless of scientific evidence.

The guy is a big intellectual buffoon.

I had a coworker say pretty much the same thing to me while we were standing outside the research institute that developed bone marrow transplants. “What about bone marrow transplants?” I said, gesturing at the buildings (where we had worked at a prior lab). “Well, I mean, but quality of life stuff…”

He doesn’t work here anymore.

When reading between the lines in Orac’s post, it’s clear that TCM is ancient and mystical.

Ironically, yesterday I had the opportunity to browse through several antiquated National Geographic Magazines and came to the conclusion that more effort, and page space, was put into advertisements. Love the theme music for National Geographic television though.

Q. How is the National Geographic empire like the Star Wars movies.

A. Both have memorable, and mood altering music.

Is music therapy an aspect of TCM?

Advocates of TCM frequently shill studies of herbs by SBM but as Orac describes, very often research doesn’t go very far: for years- even at RI, believers discuss various mushrooms being studied for anti-cancer effects ( Cordyceps, Turkey Tail, Shiitake etc)** but when I looked into it, there was no there there ( and I wasn’t in Oakland at the time),

Unfortunately, Natl Geo is starting sound like PRN. Lots of promises but when you look closely….that’s about all.

I sometimes wonder if there is a more nefarious motive behind support for TCM and other woo as medicine ( especially if paid by the state) because SBM is high tech and expensive perhaps if some patients could be maintained by cheaper products and treatments. Isn’t that how Mao started ?

** I have a Naturopathy book from the 1990s!

Why is it that the Asian countries always come up with the most sadistic ways to torture animals??

Sounds a bit racist or at least ignorant to me. I would say American factory farming definitely amounts to “torture” in a lot of cases, especially for pigs.

Unfortunately animal cruelty is routine in the farming industry, it just goes on behind closed doors and most people don’t look for what they don’t want to see. Veal production, goose liver pate and hens growing so fast their legs break are not an advert for an enlightened West.

Unfortunately animal cruelty is routine in the farming industry

Let’s not forget Rubashkin, Agriprocessors (one of the few admirable PETA routines; I think Shmueli’s Failed Messiah has been archived in toto), and of course, Jared Kushner’s role in the conclusion.

Wow! Very well written article. Thank you so much, this article proves the dangers of social media and the internet when any uneducated person can write an article trying to de-value a form of medicine he clearly knows nothing about. Please, name me a form of medicine that has lasted over 4000 years despite not working…?

5 element theory is fairly systematic in its approach to assessment – much more so than I assume any faith model x)

Well, the four humors lasted 3000+ years, (up to the Enlightenment), so I’d say in the grand scheme of human history they’re the same.

History is full of people doing pointless things for no reason – it’s called superstition generally, but also voting in Russia etc. People believe all sorts of nonsense and live by it, it doesn’t make it right. Eg Religion, organised or not can be very harmful to your life chances while holding hope for a better next life for which there is no evidence.

Apart from the fact that TCM has not been practiced in its present form for as long as science based medicine, how did TCM practitioners evaluate their results? Apart from new diagnostic tools, proper analysis has been facilitated by technological advances in communication and travel, that not only enable people to communicate findings/theories but also analyse results among large groups of people, obviously, these tools were not around 4,000 years ago.

Your question assumes said form of medicine emerged fully formed from well I don’t know from where.

Modern medicine took centuries to advance to the model it is today, one that works. It took the development of science to advance our knowledge of anatomy, physiology, microbiology, and pharmacology (among other sciences) to the point where we could develop treatments that worked, and understand how and why they worked.

Faith healing isn’t medicine. It’s prayer. It’s theology and nothing else. That’s why it doesn’t work.

TCM is not scientifically based. It’s an amalgam of practices that never worked and is little different from its European counterparts from the Middle Ages, that has been given a modern (yes modern) window dressing. It’s not medicine, it’s quackery.

Ditto for ayurveda.

Name any continuous civilization that has existed for 4,000 years or more. China would be the one and only. And as it happens, Chinese bureaucracy over the millennia has been excellent at keeping written records of all kinds of things.

Thus they have managed to preserve ancient medical practices along with much else, and then add new ones per Chairman Mao, often claiming that what’s new is old again, as we have seen.

That, however, plus current and emerging Chinese excellence in certain areas of science and technology (three cheers for their space program!) does not translate into effective medicine. No correlation, as in, being an expert at X does not make one an expert at Y or Z.

There will come a time, probably soon, when Chinese medical science starts making world-class breakthroughs. Then we might see the emergence of new Chinese medical “traditions” that are solidly grounded in science, and we can give full credit where credit is due, just as we will have done by then for China landing astronauts on the Moon.

But again, expertise in X does not equate to expertise in Y or Z, and so for the moment, the situation continues with various “old traditional” practices that, to put it mildly, aren’t supported by science. I don’t expect that situation to last for long, before the “new tradition” of science-based medicine gets huge.

I think the only medical science from China that is really science-based is probably the thing that really made headlines and was frowned upon.

China is not a continuous civilisation going on for 4000 years.

The 4000 years old script is not the same. It’s been developing for 4000 years, as any other script – and there were quite some local variations, it was unified under the first guy who actually proclaimed himself the emperor, the Ch’in Shi Huang-ti of the terracotta army fame. The culture is not 4000 years old, nor is it uniform. If nothing else, there was always quite a strong idea that the North and South are culturally distinct. Hey, the Southerners would call themselves the T’ang long after the actual T’ang dynasty fell – it lasted quite a bit longer in the South while other things were going on up North. Sheesh, there’s a period that’s actually called Warring states. And another, called Sixteen Kingdoms. However, there has been the idea of the emperor as the supreme ruler over all the kings and chiefs and whoever, only that some of the barbarians are not civilised enough to get it and obviously, if one wants to rule a state effectively, there is some trend for centralisation and unification so there has always been this idea that China is one country, one culture, one anything. But it never worked that way. And these days, it’s happily used for the same political reasons as, well, anywhere, anytime.
I could provide more detailed essay back in the day when my knowledge of Chinese history actually existed – I’m afraid I’m a bit lazy to look up references (and I admit that I’m sorta old and I never really got to adapt to the pinyin transcription which I find nearly indecipherable, I just use Wade-Giles which is slowly disappearing so it would be quite a bit of pain to actually look something up).

I like to compare it to the hypothetical idea that the European Union would want to claim to be a direct descendant of ancient Rome. I could name tens of reference points that could be used to spin it this way. But, well…

“…to warm the skin and open the pores…””

As my dermatologist likes to say, “they are not little doors”. The cosmetics industry makes billions”opening” and “closing” pores–amongst other nonsense.

“…as a treatment for “diarrhea, abdominal pain, and SCORCHING HEAT IN THE ANUS.”

Wow! Even hemorrhoids aren’t that bad! (Though, being a fiber lover, I have limited experience.) But the credulousness of Nat Geo does really fry my ass.

I guess that when i was in Chengdu having a gallstone attack the doctor stopping my pain and nausea with chi gung from five feet away was my gullibility
Dr Cohen

BTW the two countries with the largest populations on the planet are India (where acupuncture was invented) and China.

Source for the Indian inventing acupuncture?
According to some Indian nationalists, lots of things are invented in India, including rockets and cosmetic surgery.

You wonder why the average Chinese and Indian lifespan has increased by twenty odd years since the 1960s if these countries are supposed to be hotbeds of ancient effective healing practices.

And Liechtenstein, where it wasn’t invented, has one of the smallest populations of any country on the planet. The point of this datum is obvious, of course.

And what has having the largest population on the planets to do with medical science?

Ha! This is my go-to question when people claim that SBM/EBM is no good and we should all use [woo of the week]. I ask “does [woo of the week] offer birth control that is at least as effective as an IUD?”

The silence is deafening.

Science is a system of inquiry. TCM inquires in a different way than the scientific method. TCM never was science. It is a practice. And science has shown that there are many effective TCM treatments. Let’s remember that science uses a system where clinicians who actually practice medicine, have questions that are offered to scientists so that science can investigate them. TCM remains an excellent source for such questions. While TCM is not science it is not worth discounting. Science has demonstrated that point many times.

” And science has shown that there are many effective TCM treatments.”

Name 2. With good clinical trial data.

Hmmm. I wonder where a link to this post was shared. We seem to have an influx of new commenters who are TCM apologists.

What I find particularly interesting about the obsession with traditional Chinese medicine is that the majority of it isn’t actually traditional. A huge amount of so-called “traditional Chinese medicine” was actually invented as part of the “barefoot doctors” program created by Chairman Mao.

The barefoot doctors were minimally training in basic hygiene and paramedical/emergency medical basics. They also dispensed all sorts of remedies, under the pretense of being part of a great, historic tradition of Chinese medicine, both to make it palatable to the population (who weren’t familiar with modern medicine), and to support Mao’s attempts to promote Chinese nationalism and cultural superiority.

Yup. Much of what is now called “TCM” either didn’t exist or was VERY different as recently as around 100 years ago. For instance, acupuncture used much larger needles and was much more akin to the dreaded European or “Western” practice of bloodletting than what it is now. Indeed, the really thin filiform needles now used for acupuncture were a relatively recent innovation, having been introduced in the 1930s. Basically the Chinese medical profession, under Mao’s orders, retconned the entire history of TCM to turn a large number of folk medicine traditions into a seemingly coherent single form of medicine. What does remain from ancient Chinese medicine contains a lot of quackery, too: tongue diagnosis, pulse diagnosis, acupuncture. In reality the only part of TCM that might have any value is a small subset of its herbal medicine.

What an idiot you are! Being called traditional doesn’t mean it can’t be changed or improved. The traditional is in the belief that human body as a whole, thus to balance the imbalance. Your ancestor never own a damn phone doesn’t mean you idiot can’t use one.

A friend of the family, near my parents’ age, had been a medical missionary in China, before being “asked to leave” at some point. His family had actually been doing it for a couple of generations and he was fluent in both Cantonese and Mandarin and literate in both as well. Circa the early 70’s, he was at some function when someone asked him his opinion of the “Barefoot Doctor’s Manual” (the new English translation) and he was quite irate about the “damn fool’s” leaving out most of the good material for first aid and decent nursing practice that was in the original.

I suspect that if anyone wants to read about Chinese medicine they should have a look at Science and Civilisation in China the massive work started and led by Joseph Needham.

It is a rather big work, Wiki says that ” To date there have been seven volumes in twenty-seven books. ” The crew has been working on it since 1954 so I think we can say they have made a good start.

I am pretty sure it has a medicine book though my local university does not have it. IIRC it has one volume on metallurgy.

The author of this article hates it when people get excited over nothing , probably because science told him artificially induced euphoria is harmless, now he has trouble empathizing with others.

why shouldn’t we be excited?

Our reductionist model has been employed by research institutions for centuries and we still can not pinpoint the mechanism behind what causes or relieves pain – no wonder it has trouble justifying TCM. No matter what we tell Asia about the placebo effect they will continue to use acupuncture and for good reason. Find someone who knows what they are doing and see why for yourself – the world is big and full of wonder!

OK, if TCM is so fantastic and scientific medicine is worthless, then what is the super effective method of birth control provided by TCM, and why is it not used everywhere in the world?

“Our reductionist model has been employed by research institutions for centuries and we still can not pinpoint the mechanism behind what causes or relieves pain”

Well someone has never heard of nociceptors, C-fibres, or prostaglandins. Or Google, apparently, because I just checked and you can find information about all of them by looking up what causes or relieves pain.

If TCM is so all-fired wonderful, how come China has suffered devastating epidemics for thousands of years right down to this century?

Biology, chemistry and such are science, but not medicine, be TCM or modern medicine. You are just a science idiot, asshole!

Why is everything a competition? In China allopathic medicine and TCM work side by side. The only tool that is used in explanation is denigration. My mother is 97, has never taken meds for anything besides UTI and has utilized TCM and herbals for many complaints and has been successfully treated because she was open minded enough to try differing modalities of health care. Though she was hospitalized with a broken bone and loved that TCM helped that break to be less painful. TCM is not anti science in Asia or in Europe, but shares a goal of health and healing for people and their diseases and difficulties.

Yeah. My father on the other hand, was similarly a big booster for TCM for the past thirty years, utilized TCM and herbals for many complaints until four years ago he suffered a massive stroke due to untreated hypertension. He’s now in a nursing home where he will receive nothing but science-based medicine if I have anything to say about it. As Science Mom said, anecdotes != data.

Before you can “explain” why a flying carpet “works” to get you from Boston to London works, you need to know whether it works. “I bought a carpet in Boston in 2004, and now I’m in London” doesn’t mean there’s any connection between those facts, and if it turns out that you moved to Atlanta in 2008, and bought an Atlanta-Edinburgh airline ticket last year and rented a car in Edinburgh, that leaves no reason to take the flying carpet claim seriously.

It also sounds like your mother isn’t sufficiently open-minded to try any of the standard pharmaceutical treatments for pain, even when hospitalized with a broken bone. What’s the basis for rejecting “western” medicine, including aspirin, which has been in use in its current form longer than acupuncture? (If that doesn’t count as “taking meds,” I’d double-check what other meds she “hasn’t taken” that were part of her health care and pain relief.)

It’s not “denigration” to say “if this is so wonderful, prove it. Let’s figure out which bits of it are having the useful effects and at what doses, which are harmful, and which are a waste of money.” Don’t slaughter endangered species because someone, somewhere in China, uses both artemisinin and rhino horn.

There’s a lot wrong with your post. I’m hoping you maintain being open-minded and hear us out. First, and most obvious, your experience is pure anecdote. Science cannot rely on anecdotes for multitudes of reasons such as no controls (did TCM even play a role healing or was it allopathic medicine; was it really herbs and TCM that healed your mom or was it simply the passage of time; did behavior changes and positive outlook heal more than herbs and TCM) and human memory is very faulty.

Sure TCM also tries to heal people too but we’ve had systematic review after systematic review that shows consistently that there’s no reason to use these. Most, if not all studies are poor quality, but those that are better are usually too small or show mixed results AT ABSOLUTE BEST or show negative results (i.e. neutral or even harm). It’s a red flag that most TCM in the market contain a warning that it hasn’t been evaluated by the FDA. If TCM wants to be on the same level as allopathic medicine, then it should be subject to the same regulations as drugs and NOT as supplements. That the practioners try selling their products as supplements is a warning that they don’t wish to stand up to FDA’s scrutiny, and they don’t pay the price, consumers do, for exploiting the laxer regulations supplements receive.

And there’s TCM’s history. As in the comments above, TCM fell out of favor with the educated Chinese elite for being superstitious medicine, but Mao decided to revive it purely for monetary and nationalistic reasons, as he himself didn’t even use TCM. As a result, what you’re buying in is a result of historical nationalistic propaganda and duping the population through false hope rather than being “open minded”. This propaganda lives on as people continue being misled into thinking this medicine is helpful or even “traditional”.

TCM is thoroughly an unrecommended product. A healthy part of open-mindedness would be to accept the claims, but also test them. Allopathy medicine has maintained an open mind by subjecting them to tests, showing they don’t ignore TCM. But those tests show bad results, so it’s okay to discard them. Just as how bashing your head against the wall isn’t a cure for anything, TCM shouldn’t be accepted.

Our reductionist model has been employed by research institutions for centuries and we still can not pinpoint the mechanism behind what causes or relieves pain – no wonder it has trouble justifying TCM.

A couple of centuries at the very most. OTOH, TCM has had 4000 years (citation as above) to work on this problem and has come up with…what’s Chinese for bupkis?

Well, having spent the last week and a half recovering from oral surgery, I’ll gladly thank that reductionist model for the development of benzocaine and ibuprofen!


China’s President has decreed TCM to be the equal of “Western” medicine.

No decree is deemed necessary for science. No traditional Chinese science to proudly rank alongside Western science.

TCS didn’t land a Chinese craft on the far side of the moon. Just plain science.

TCM can sometimes be scientised as in the case of artemisinin. Artemisinin is not TCM. Artemisinin is not Western or Chinese. Artemisinin is a scientifically specified drug. It’s chemistry is known.

Acupuncture not so much. Science doesn’t specify it.

China’s President can decree TCM to be the equal of Western medicine but that doesn’t make TCM equal to science based medicine. Only science can turn TCM into science based medicine.

Like the rest of the physical world the only way to properly understand how human bodies and medicines work is to do the science. No competition. Medicine. One medicine. One science.

I am fairly certain that China’s president, after declaring TCM the equal of “western” medicine, will avail himself of “western” medicine for whatever ails him from headaches and muscle pain to surgery.

“Our reductionist model has been employed by research institutions for centuries and we still can not pinpoint the mechanism behind what causes or relieves pain”

Isn’t it entertaining when woo-justifiers don’t have the foggiest idea what they’re talking about?

It’d make a lot more sense to say that despite a great deal of understanding of the mechanisms of pain and the existence of numerous proven therapeutic options to counter it, coming up with effective, safe and non-habituating pain control for many patients (particularly those with chronic pain) remains a challenge.

I’ll take evidence-based modern pain control over TCM potions any day. EBM pain remedies work a helluva lot better than rhino horn* or other TCM foolishness, and aren’t responsible for driving plant and animal species to extinction.

*yes, rhino horn is touted to relieve pain along with a laundry list of other problems and diseases.

I have had two strokes. that I can stand and talk and WRITE is due to the amazing work of the actual Doctors and Nurses at Froedtert Medical Center in Wauwatosa, WI. I’m sure they have something similar in “Ancient Chinese Medicine”, but I’d rather be alive

the scientific underpinnings of some traditional treatments for diseases such as cancer, diabetes, and Parkinson’s

You have to wonder, if there is a traditional treatment for Parkinson’s Disease, why are we naming it after some dude from 1817?

National Geographic is now a 21st Century Fox asset so part of their mission statement is to ingratiate themselves with wherever the markets are. Expect a lot more China-directed lordosis.

There’s a trap that western people fall into with TCM and equivalents in that because of their background they assume that ingredients practices etc were chosen/developed because of a proven healing efficacy. A friend of mine has been reading a book on ‘witchcraft’ and amusing me with select quotations, but I think there are interesting parallels with TCM. The worldview was completely different and so the system for choosing herbs etc, although having it’s own rather elegant internal logic was, in terms of a modern western mindset, completely bananas. Likewise in TCM, the reasons for choosing these herbs would have had more to do with what we consider astrology than any known healing properties, because without proper studies you cannot properly evaluate results, as any ‘evidence’ that accumulates is effectively no more than a collection of anecdotes which, as we all know, does not equal data.

The worldview was completely different and so the system for choosing herbs etc, although having it’s own rather elegant internal logic was, in terms of a modern western mindset, completely bananas.

I rather suspect that the impression of an elegant internal logic in TCM is a late ret-con, trying to bring together umpteen different strands of superstition and fit them into a Procrustean structure of coherence. But I am willing to be convinced otherwise, given that there are actual scholars of the TCM traditions who sometimes comment here.

Again, aspirin is a great drug

Meh. My new cardiologist took me off of it because, he said, it’s pointless unless one has already had an MI. Oh, and I have enough of a lenghtened prothrombin time that I can’t get an LP; MRA and MRV instead. (A different specialist seen for a different reason had reason to take a gander at them and quipped, “Well, you still have temporal lobes.” I’m not fully convinced.)

It does f-all for me in terms of pain relief. Ibuprofen works way better. (For acute pain, yeah, opioids work a treat. I’ve taken them to make immediate post-surgery pain go away.)

Interesting video by an English chemist about TCM.

Nice explanation for why all the excitement about discovering potential disease treating chemicals in TCM products does not equal an effective current treatment.

I have problems with his visit to the store but it is a good example of how even well meaning advice from non qualified people can be dangerous.

I can’t say how much it pains me to see how so-called traditional Chinese medicine is burgeoning outside of China. It’s personal. My wonderful, brilliant daughter, having earned her degree in psychology from a highly respected university, is now getting a degree in “Oriental Medicine” as an acupuncturist. Of course, she is free to determine her own path, she knows how I feel about acupuncture, and I will support her and not grapple with her any more. She’s my daughter and that comes first.
I just hope she doesn’t do this only to become disillusioned when it’s too late to start over.

It would be very enlightening to see Yung-Chi Cheng’s conflict of interest statements and his list of supporters. From the article it sounds like he is tight with the PRC. Is he getting funding to promote TCM?

It seems a little like old-fashioned Cold War skullduggery where the US and the USSR would send scientists to their opposing country as ambassadors of cultural exchange and scientific fellowship but it was all a big propaganda effort with a little spying thrown in on the side.

Jesus Christ, squeezing the web space of an arthritic thumb is not fucking ‘acupressure’. “LI 4,” my ass.

In related news, doing the same thing on top of your head while rocking the painful hand back and forth is not a method for contacting the Pleiadeans.

If Chinese medicine is all useless, they wouldn’t exist to this date. And if Western medicine is all good and no harm, people wouldn’t look for alternative cures and medicines ! You would not believe me until one day you experience the failure of western medicine and the benefits of a Chinese herbalist yourself.

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