Sep 02 2013

TCM for Flu

A recent new report exposes Chinese health officials for recommending worthless and unscientific remedies for the flu. Chinese doctors have been leveling the criticisms, pointing out that the recommended Traditional Chinese Medicine (TCM) treatments are not supported by evidence.

TCM has had a rocky road in China. By the first half of the 20th century it was on the wane, at least in the cities, where “western” scientific medicine was taking hold. It’s possible that if this trend had continued, then TCM would have gone the way of humoral medicine and blood letting in the West – replaced by modern medicine.

Mao Zedong had a huge role to play in history taking a different course. He was trying to modernize China under communist rule.  Part of his plan was to merge TCM with modern scientific medicine, thereby keeping the cultural roots of China, but meeting his agenda of modernizing.

The real boost to TCM, however, came from the barefoot doctor program. This program, which was actually a good idea, was designed to meet the medical needs of the hundreds of millions of citizens who did not live in the cities. They could not train enough doctors to meet this need, so they trained hundreds of thousands of farmers to be doctors and paramedics. They were given 6-9 months of training, then sent back to their villages and farms to provide needed medical care.

The barefoot doctors, however, were largely underequipped and did not have access to needed medicines. So they were also given the Barefoot Doctor manual – which had a large section on what to do when you do not have modern medicine available, including how to identify and use local herbs. The result of this manual was to make TCM seem more legitimate in the eyes of Westerner, when in fact the TCM methods included in the manual were a last resort substitute when real medicine was not available.

China, it seems, is still struggling to reconcile its cultural past (in the form of TCM) and modern science. Doctors trained in modern medicine have to exist alongside TCM practitioners essentially practicing ancient superstition. This conflict is coming to a head over the treatment of flu. According to this article:

Gansu’s health commission, for instance, encouraged residents to go outdoors, preferably into wooded areas, for fresh air and sunshine. Listening to music was also deemed an effective way to keep the H7N9 virus at bay.

Massaging the side of one’s nose was also said to help, as was exposing parts of one’s legs and stomach to incense once a day.

Health authorities in the eastern province of Jiangsu suggested a long list of herbal drinks, including the popular ban lan gen, a type of root that is often taken to fight the flu and was prescribed during the Sars outbreak a decade ago.

There is no evidence, and essentially no plausibility, that any of these methods are effective.  Herbs might be helpful, they are essentially unpurified drugs, but it is unlikely that ban lan gen has specific efficacy against the flu, and there is no published evidence to support such a claim.

Scientifically trained doctors in China correctly point out:

“The traditional Chinese medicine industry is trying to cash in,” he wrote.

Professor David Hui Shu-cheong, who teaches respiratory medicine at the Chinese University of Hong Kong, said there was no scientific evidence to show that ban lan gen is effective at preventing influenza.

TCM proponents demonstrate that they are operating under a different and unscientific paradigm with the following statements:

David Fong Wang-fun, a retired professor of Chinese medicine at Hong Kong’s Baptist University, said Chinese medical theories have long shown that ban lan gen functions as a health supplement, but it is not for emergency treatment.

Notice how Wang-fun does not appeal to evidence, but to “Chinese medical theories.” Essentially, he is using tradition and pre-scientific superstitions as his justification, not evidence. If you think I am being harsh when referring to TCM as pre-scientific superstition, just read through the Wikipedia page on TCM (which is consistent with direct sources). Here’s a taste:

Five Phases, sometimes also translated as the “Five Elements” theory, presumes that all phenomena of the universe and nature can be broken down into five elemental qualities – represented by wood, fire, earth, metal, and water. In this way, lines of correspondence can be drawn:

Proponents of old superstitions as a viable “alternative” to modern medicine have been developing their rhetoric to justify advocating for treatments that are not backed by evidence. One such proponent is quoted in the article:

“The biggest headache regarding traditional Chinese medicine is that its effectiveness often cannot be explained,” said Dr Dong Xieliang, president of the Xian Xietong Hospital in Shaanxi . “The curing process can be so sophisticated it may not be simply explained scientifically, physically or chemically.”

According to proponents of TCM, and CAM generally, the problem is that their treatments cannot be explained or shown to be effective with standard scientific evidence, and the supposed mechanisms are not in line with modern science. The problem, in their world view, is with the limitations of modern science.

Meanwhile the real problem is that they are not even asking the right questions – do the treatments even work? They assume efficacy, rather than proving it first. Science begins by asking the most basic questions, and uses careful systematic observation to answer that question. If I may quote myself:

“What do you think science is? There’s nothing magical about science. It is simply a systematic way for carefully and thoroughly observing nature and using consistent logic to evaluate results. Which part of that exactly do you disagree with? Do you disagree with being thorough? Using careful observation? Being systematic? Or using consistent logic?”

I wonder what part of that Dr Dong Xieliang wants to jettison (perhaps all) in order to come up with the answers he wants.

Conclusion

The current conflict of TCM and the flu is one small part of a larger collision of world views. What we are seeing with the alternative medicine movement (in all its forms) is a conflict between a scientific rational world view and a magical mystical world view.

The gurus and snake oil salesman like the mystical world view. It’s more profitable, and they are not held to any pesky standards.

They desperate try to hide the fact that by rejecting science they are essentially saying that they want the freedom to ignore inconvenient evidence, use bad or contradictory logic, and make sloppy observations in order to support their claims.

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3 responses so far

3 Responses to “TCM for Flu”

  1. Astrosmurfon 02 Sep 2013 at 10:01 am

    During a recent visit to Beijing I walked through one of the largest bookstores in the City. The huge top floor contained books that seemed to be university text books. There were large sections on everything you would expect: math, computer programming, electronics, medicine, law et cetera. The amount of books on traditional Chinese medicine were enormous, probably about the same amount as the “western” medicine books or slightly more. So it seems that the support for TCM in Chinese academia is quite big. It would be interesting know how much the TCM and the “western” medicine blend together in the education of physicians in China.

  2. locutusbrgon 02 Sep 2013 at 12:09 pm

    Disappointing and sad. One of the great ripostes to traditional Chinese medicine advocates in the west is demonstrating how industrialized China has moved steadily away from TCM. I hate seeing this destructive erosion of the scientific evaluation and evolution of treatment. As opposed to wishful thinking, confirmation bias, and unregulated profiteering.

  3. ChrisHon 02 Sep 2013 at 10:04 pm

    When I get a mild flu or cold, I do enjoy some hot and sour soup from the neighborhood Chinese restaurant.

    Though on a really bizarre related note (especially since I kept reading the title as “TamiFlu for Flu”), I just discovered a very interesting. I am reading The Drunken Botanist. On page 183 is about a small Chinese evergreen tree related to the Magnolia. The pharmaceutical industry buys about 90% of the world’s supply of this tree’s fruit, star anise, to make TamiFlu.

    I just thought it was a pretty cool factoid. Now back to the deck to continue reading the book in the fading sunlight.

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