Mojo
Mostly harmless
Do you think that businesses should be allowed to make claims for their products without evidence to support those claims?
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MS & Chinese Herbal Medicine
- Thread starter eclipsemullet
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- multiple sclerosis
Do you think that businesses should be allowed to make claims for their products without evidence to support those claims?
Absolutely. I guess that you'd equally consider the claim that Chinese herbs may harm MS sufferers to be similarly plausible. After all many of the pharmacologically active ingredients in Chinese medicine have been shown to stimulate the immune system. There's therefore a plausible mechanism whereby these might antagonize an auto immune disease like MS.
You appear to be assuming that research has not yet been done into any of the remedies on offer. Googling reveals a number of warnings including the following with regard to MS
Gingko. Although the risks for gingko appear to be low, there is an increased risk for bleeding at high doses. Ginkgo can also interact with high doses of vitamin E, anti-clotting medications, aspirin, and NSAIDs. Large doses have also been known to cause convulsion. Randomized trials have failed to show any benefit.
Bee Venom. For years, anecdotal reports have claimed that bee stings relieve some MS symptoms, although a study on mice indicated that it may worsen MS. Bee venom contains many chemicals, some of which can cause severe and sometimes deadly allergic reactions in some people.
You'll see from this that "experience" is not always a reliable guide. 18th Century experience told western doctors that blood letting was a panacea. When George Washington died of a cold, the medical intervention of letting a total of 5-7 pints of blood is almost certainly what finished him off. Evidence trumps experience every time, and when all you have to go on is "experience" then you're gambling. In this case with very high stakes.
Not to mention that people should be especially cautious in taking a cocktail of further drugs when they're already on powerful medication that may interact.
You'll also consider the pro's and cons of having your pharmacologically active preparations being unregulated, untested and of unknown dosage and purity. The cons are obvious. What are the pro's again? That you can't be certain that it won't work. Was that it?
But the main point is not that anyone here is saying that TCM can't or will never be shown to be beneficial to MS sufferers. It's that it hasn't been. Therefore to market it as if it has been is fraudulent.
We have laws regarding what you can say about treatments for serious disease, and what evidence you need before you say it. Even in the plausible but unlikely scenario that this "doctor" is absolutely 100% correct about his preparations being beneficial for MS sufferers, he still doesn't have sufficient evidence that this is the case. He would be correct by luck rather than the required level of judgement.
If I buy a trinket for pennies at a jumble sale and engage in an elaborate ruse to trick you into parting you with hundreds of dollars for it, somehow deluding you into thinking it's worth thousands then that's a con. It's still a con in the unlikely event that the trinket I bought turns out to be worth millions. I had no good reason for knowing this.
TCM is largely a product of Mao's cultural revolution. Notwithstanding the claims to be rooted in 6,000 years of culture it was the communists who invented the barefoot doctor. In China those who can afford it, use the same evidence based medicine as we do in the west. Those who can't afford real medicine are fobbed off with a cheaper and largely ineffective alternative. Not a big deal for most conditions which are self limiting anyway but a real bummer if there's something seriously wrong with you. It's not as if China was ever going to run out of peasants, why should the megalomaniacal elite spend a whole chunk of their economy on imported medical care when they can con their peasants into accepting less? If it turns out that hidden amongst this random noise of herbal remedies is something that can be isolated, purified, tested and used as a real medicine, even then, those who sold it before this testing were still conmen. Maybe some of the individual practitioners are as much dupes as they are duplicitous. Examples of seized Chinese herbs containing crumbled up prescription only pharmaceuticals suggest at least some cases where the duplicity is certain. However even true believers, are not exempt from the law. They are not exempt from their ethical obligations.
Selling a concoction as being known to help MS is a con if your only reason for claiming this is that MS makes you feel floppy and people with vaguely similar symptoms have been fobbed off with this same concoction for hundreds of years with no systematic follow-up on the effects. We place the bar a little higher than that with medicine and with good reason. Those making a living from this have a moral obligation to their customers to do the same.
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Not plausible, merely possible.
Consider a Chinese program in the 1970s to screen recommended anti-malarial herbs for efficacy [FONT="]http://www.ncbi.nlm.nih.gov/pubmed/16722826?ordinalpos=21&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/FONT][FONT="] [/FONT]
They screened more than 100 herbs and only found one that was active.
Also consider herbs recommended to treat arthritis http://www.ebm-first.com/herbal-medicine.html Scroll down to: "Complementary and Alternative Medicines for the treatment of rheumatoid arthritis," osteoarthritis and fibromyalgia. Note that, of 76 recommendations only 4 had some evidence of efficacy.
The bottom line is that traditional uses, even old ones, are not likely to pan out.
Beerina
Sarcastic Conqueror of Notions
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I would be happy to automatically disbelieve, or have a "healthy skepticism". I think "plausible but unconfirmed" gives it far, far too much credence. "Plausible but highly unlikely" is more accurate.
Why? If this or that herb, touted for "6000 years" as curing something actually cured it, it would long since be a well-established remedy.
If this herb cured MS, it would have worked 50 years ago, and the guy's doctor would have noted it and tried it on other people, whom it also would have worked on, and it would be an established cure.
That has not happened. Therefore, though the idea of a mysterious herb or herb combo that could cure MS is plausible, this particular herb is not.
Hence this is a case of fraud, and the people should be told not to lie about it, and, if they continue, be tossed in jail for lying.
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Andrew Wiggin
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Ya'all are reading things into what I wrote that I didn't say. I just don't consider automatically disbelieving to be any more sceptical than automatically believing. I consider it plausible that an herbal formula can have a medical effect, and I admit that I don't know. It's worth keeping an open mind, and evaluating on a case by case basis. Without the OP being willing to do a lot more footwork than he or she did, and track down the specific herbs and claims, there's nothing knowable here at all, other than the fact that a claim was made in the window of a chinese shop. That's not enough for me to call that claim true or false.
I'm not an advocate of traditional chinese medicine; I'm an advocate for not automatically disbelieving or giving in to group consensus. What I see here is groupthink in action. The OP came in looking for confirmation of a position he or she had already decided to believe and already started to take action against, and got that confirmation. I consider an assessment of closer to 'maybe, but I don't know' to be more accurate.
Nowhere in what I wrote did I say that I thought chinese herbs were an ideal or effective treatment for MS. Given the choice between two remedies, one that research shows to be effective, and one where there is no data, I'd choose the one that's shown to be effective. I wouldn't advocate consuming random herbs until they were known to be at least harmless, and for the sake of argument before someone brings it up, I do acknowledge the opportunity cost of choosing one treatment over another.
I also know that very little research has been done, leaving this firmly in the 'don't know if it works or not' category. I'm honest enough with myself to admit that I don't know, and I mistrust the pronouncements of those who claim absolute knowledge of the unstudied.
Just off the top of my head, a few medications that started as traditional folk remedies;
Statins for cholesterol control. The prototype drug was found in a fermented japanese rice used as a traditional remedy.
Digoxin; the prototype was digitoxin, from the foxglove plant, used to calm a racing heart, and chewed and smoked by the american indians as a calming remedy.
Opiate painkillers; even the synthetic ones are based on the structure of morphine from the opium poppy. Many are still extracted from the plant, as it is cheaper than synthesizing them. Poppy tea was used an an intoxicant and painkiller from ancient times.
Dronabinal; medical grade THC extracted from marijuana and dosed as a gelcap. This was a folk remedy of a modern folk culture; it's used to increase the appetite of chemotherapy patients so they don't lose weight, and was studied due to the hippie claims of 'the munchies'.
Aspirin and NSAID antiinflamatories; the prototype drug was found in willow bark, used as a painkiller and fever reducer in traditional medicine worldwide. Aspirin is actually an interesting case; it's not a very good painkiller, and has a lot of toxic side effects. I've read that it wouldn't make it through approval by today's standards but is grandfathered in under the concept of 'generally recognized as safe'. In fact it's more commonly used as a platelet aggregation inhibitor these days.
All these are medications we're familiar with. Some of them are ones that were known from ancient times to the point where there was really no research done; they were just known to work. Others were found in modern times by looking at what other cultures believed and used. In the statin example, that entire class of medications would never have been found if the folks responsible for finding it had just said 'Oh, that's just traditional oriental medicine. Nothing to that stuff but chi, meridians, and woo like that'. Sometimes it's worth at least listening and keeping an open mind.
I'm not an advocate of traditional chinese medicine; I'm an advocate for not automatically disbelieving or giving in to group consensus. What I see here is groupthink in action. The OP came in looking for confirmation of a position he or she had already decided to believe and already started to take action against, and got that confirmation. I consider an assessment of closer to 'maybe, but I don't know' to be more accurate.
Nowhere in what I wrote did I say that I thought chinese herbs were an ideal or effective treatment for MS. Given the choice between two remedies, one that research shows to be effective, and one where there is no data, I'd choose the one that's shown to be effective. I wouldn't advocate consuming random herbs until they were known to be at least harmless, and for the sake of argument before someone brings it up, I do acknowledge the opportunity cost of choosing one treatment over another.
I also know that very little research has been done, leaving this firmly in the 'don't know if it works or not' category. I'm honest enough with myself to admit that I don't know, and I mistrust the pronouncements of those who claim absolute knowledge of the unstudied.
Just off the top of my head, a few medications that started as traditional folk remedies;
Statins for cholesterol control. The prototype drug was found in a fermented japanese rice used as a traditional remedy.
Digoxin; the prototype was digitoxin, from the foxglove plant, used to calm a racing heart, and chewed and smoked by the american indians as a calming remedy.
Opiate painkillers; even the synthetic ones are based on the structure of morphine from the opium poppy. Many are still extracted from the plant, as it is cheaper than synthesizing them. Poppy tea was used an an intoxicant and painkiller from ancient times.
Dronabinal; medical grade THC extracted from marijuana and dosed as a gelcap. This was a folk remedy of a modern folk culture; it's used to increase the appetite of chemotherapy patients so they don't lose weight, and was studied due to the hippie claims of 'the munchies'.
Aspirin and NSAID antiinflamatories; the prototype drug was found in willow bark, used as a painkiller and fever reducer in traditional medicine worldwide. Aspirin is actually an interesting case; it's not a very good painkiller, and has a lot of toxic side effects. I've read that it wouldn't make it through approval by today's standards but is grandfathered in under the concept of 'generally recognized as safe'. In fact it's more commonly used as a platelet aggregation inhibitor these days.
All these are medications we're familiar with. Some of them are ones that were known from ancient times to the point where there was really no research done; they were just known to work. Others were found in modern times by looking at what other cultures believed and used. In the statin example, that entire class of medications would never have been found if the folks responsible for finding it had just said 'Oh, that's just traditional oriental medicine. Nothing to that stuff but chi, meridians, and woo like that'. Sometimes it's worth at least listening and keeping an open mind.
Andrew Wiggin
Master Poster
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I'd say that such things are well established remedies within the culture that uses them. Without studying such things with actual, unbiased methods, we don't know if they work or not, but as long as there are plenty of people willing to stand up and claim that they can't possibly work, and point fingers at the silly natives who believe such foolery, we'll never know. We've only been using methods that show if things actually work for a tiny tiny fraction of human history, and there are an awful lot of plants and folk remedies. We haven't even scratched the surface of what's out there to be known.
It isn't that anything is assumed not to work. After all, the vast majority of our pharmaceuticals are from natural sources. It's that it isn't any more likely to work for a given condition than any other unselected substance. If you want to propose that it is plausible for a specific TCM herb to work for MS you have to be willing to say that it is equally plausible that the weed I dig out of my lawn will work on MS. That's all. Traditional use has been clearly demonstrated, over and over again, to be a method which is unable to identify substances which are effective for specific conditions, nor substances which are ineffective for specific conditions.
Also, you may want to reconsider you sources with respect to the claim that aspirin wouldn't make it through the approval process today. This is obviously false, as aspirin isn't even subject to black box warnings.
Linda
Also, you may want to reconsider you sources with respect to the claim that aspirin wouldn't make it through the approval process today. This is obviously false, as aspirin isn't even subject to black box warnings.
Linda
Our investigations show that the yield for unselected substances is on the order of one in a thousand. We may not know if one works or not, but we have a very good idea as to the odds before testing.
Linda
RationalVetMed
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Mojo
Mostly harmless
The thread is about a business making claims that its treatments can treat a variety of conditions, in particular MS. Do you think they should be allowed to make these claims for a product that is "firmly in the 'don't know if it works or not' category"?
Wolfman
Chief Solipsistic, Autosycophant
Wanted to comment here. First, I'm by no means a proponent of TCM (quite the opposite, I'm an active advocate for greater testing of TCM claims). However, TCM is not "largely a product of Mao's Cultural Revolution". Yes, the "barefoot doctor" is...but then, today the "barefoot doctor" has almost entirely disappeared, whereas TCM has not.
TCM has a very long history, and was very actively and widely practiced long before Mao. It is true that Mao, and the Communists, promoted the use of TCM, at least in part due to the lack of money to provide regular medical care to its citizens. However, the idea that it was 'only for the poor' is ridiculous; Mao himself used TCM quite regularly (a practice continued, by all reports, by the majority of modern Chinese leaders). Today, China's wealthy routinely use TCM, as well as regular medicine.
China has entire universities dedicated solely to the study of TCM; and every Chinese hospital that you visit will have two drug dispensaries, one for 'western medicine', one for TCM medicine.
The idea that "Those who can't afford real medicine are fobbed off with a cheaper and largely ineffective alternative" is complete nonsense. I am close friends with a great many Chinese doctors who believe equally in the efficacy of both kinds of medicine, and who will give their patients a choice as to what kind they want to use (I'm routinely asked, when I go to see a doctor, which I'd prefer). These doctors are people who sincerely want to see their patients recover, and who give this choice specifically because they believe both methods will work just as well.
"why should the megalomaniacal elite spend a whole chunk of their economy on imported medical care when they can con their peasants into accepting less" <-- This statement is a load of unmitigated horse crap, and reeks of ignorance. The Chinese gov't has spent huge amounts of money improving medical care in China. The idea that they're ignoring the poor, and just letting them die off by offering treatments that they know don't work...well, I don't know how to respond adequately without breaking forum rules about personal attacks, so I'll just let you imagine the depths of my disdain.
Here are the FACTS.
TCM is considered by a great many Chinese -- including qualified doctors, and government leaders -- to be a legitimate, effective form of treatment for patients. And that is the reason it has been and continues to be promoted as a cheap alternative to other medical treatments. The very fact that Chinese doctors and Chinese government leaders use TCM routinely puts the lie to your claim.
As with most things in China, the real answer is much more complex than your simplistic (and entirely wrong) claims. In China, people are taught to accept 'truth' on authority, not on evidence. This is not just a Communist thing, it is true of most of China's history. Authority figures have been telling them for centuries that TCM works; therefore, they believe it.
Worse, the debate about testing and quantifying TCM is every bit as emotional and controversial a topic in China as the abortion debate is in N. America. Some Chinese doctors have called for much more thorough and comprehensive testing of TCM...and have often been attacked (physically and/or verbally) for doing so, some of them losing their jobs.
You see, TCM is tied irrevocably with "traditional Chinese culture". It is one of China's ties to its past, demonstrating their ability and superiority over hundreds/thousands of years. To say it doesn't really work, or that it needs to be "proven", really means to say that the entire nation of China, all its leaders, and all its citizens, have been wrong for all this time. And that, predictably, incites very defensive reactions.
This is apparent in the emotional nature of the debate within China. Whenever someone criticizes or questions TCM, they are rebuked with strong emotional and patriotic claims: they are accused of being anti-Chinese, unpatriotic, etc. This attitude makes it extremely difficult to bring about any real change, or examination, for TCM practices within China. And the debate is all the more difficult because so many of China's leaders -- contrary to the claims of the OP -- believe very sincerely in the efficacy of TCM.
I'm sure that, somewhere in the vast mix of drugs and treatments used in TCM, some of them actually are effective, and do work. The problem is, there is no objective method by which one can determine which work, and which do not. Testing them is still a cultural taboo...to question TCM means to question the teaching of many generations of respected Chinese doctors and leaders. I've known people who have died in China, simply because they sought TCM treatments for serious medical conditions, rather than proper medical care. Of particular relevance is the fact that the majority of these people that I knew came from educated, affluent families -- not peasants.
Its going to take a long, long time to get around this. Not because of some evil government conspiracy to kill off the poor people, or a callous disregard for peasants who can't afford 'real' medicine; but because it is culturally entrenched as an integral part of the Chinese identity. Even Chinese doctors who don't believe in TCM must tread very carefully in their medical practice; publicly saying that they don't believe in it could mean punishment, or even loss of their jobs. And they must offer TCM alternatives to their patients, even if they don't believe they're useful, or face being accused of being 'bad doctors'. At best, they can recommend that "I think this [western medicine] will be more effective than this [TCM treatment]."
Or is it the other way round?
Are you cirticising people for presuming that the medicines don't work, when nobody has said any such thing?
Are you proposing that the truth of the matter is that we don't know whether they work or not when we all agree that in many cases this is quite true. I for one agreed that it's plausible but unknown whether it's benficial or not. In fact I add it's plausibel or unknown whether it's beneficial or harmful. So why labour that point.
In fact the only places where we disagree are
1) That you're chastising the OP for not doing additional reasearch to find out exactly what treatment is being proposed as a treatment when in fact the OP has asked and reciveed an evasive answer and in any case the intrinsic problem with herbalism is that even the practioner has no way of knowing the dosage of the active ingredients or what adulterants may be present
2) That you claim there isn't research to suggest that TCM doesn't cure MS when in fact there is research available on at least some of the ingredients and treatments commonly used which shows that it does no good with a very real potential for harm.
3) We also appear to disagree on the value of cultural experience.
However there is certainly one thing that I'm reading into what you didn't say. You didn't say that if it's unknown whether something is beneficial or harmful for a condition then it's wrong to sell it as a treatment for that condition
What do you think I'm reading into that?
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Wolfman
Chief Solipsistic, Autosycophant
Ocelot -- I pretty much agree with the rest of your arguments here...it is the characterization of the actual practice of TCM (and the reasons for it) in China that I take issue with.
jakesteele
Fait Accompli
A lot of it depends on how the adverts are worded. There's an old saying in the marketing world, "It's all in how you write the ad." In other words, if you make an absolute claim such as 'We can cure..." then it is definitive and final. If you say things like, "an ancient herbal remedy that was believed to help alleviate and sometimes cure..." then you have a whole different scenario.
Please post the exact wording so we can take a look. It may be the reason the law is powerless.
Also, on a side note, I have been into herbal medicine for years and have found a number of herbs to be very effectual for certain ailments, most of which haven't been put through trials. The results of a trial, which has very few people in it, are secondary if the herb actually works with people who have first hand, a posteriori knowledge, especially over extended periods of time. And please, don't start with the confirmation bias thing. You can only stretch it so far until the bubble bursts.
Thanks for coming to this thread a month later to point out my error. I really appreciate it.
Under UK law what matters is not the precise formulation of weasel words but rather, how the average customer would be expected to understand the presentation as a whole.
The consumer protection from unfair trading regulations 2008
So if you're a trader and advertise a product as "an ancient herbal remedy that was believed to help alleviate and sometimes cure..." then only if your average customer is a collector of things that were once thought to be effective medicine are you home free. However if your average customer is afflicted with a disease and has bought your product on basis that reading your advertising has lead them into thinking it's an effective remedy for their condition then we move onto the next stage which is you having to prove that it is an effective remedy even if the factual information you provided didn't explicitly say that.
Loophole closed.
I'm glad you've found relief from your ailments but I'm not quite so ready to give all the credit to alternative medicine.
I recognise the possibility that the herbs that you've used are responsible for the positive effects that you've experienced. It may well be that they are effective for your conditions in a manner as yet untested by science. That's one possibility. (I should note that even this this doesn't resolve the issue of the drugs being unregulated, untested for safety or efficacy, with variable dosage and adulterants or the danger of delayed medical treatment)
However there are other factors that may be in play in addition to the possibility that the drugs work. Either enhancing the perceived effect or working to create an illusion ther of effect where none in fact exists.
You've dismissed confirmation bias due to extended experience. There is however a recognised way of removing confimation bias and that's not it. Confirmation bias works just fine over extended experience. Double blind testing does the trick. Nothing else is quite up to snuff. Even if you you had an a priori insitance that herbal medicine had a positive effect you should at least acknowledge that confirmation bias can work to increase your perception of that effect.
However confirmation bias isn't the only other factor in play. (and whatever you say either it is in play or you're not human)
There's also self selecting sample, small sample size, post hoc ergo propter hoc, regression to the mean, the placebo effect, mistaken diagnoses and the fraudulent adulteration of herbal remedies with genuine pharmceuticals. Just to name a few.
These are all other possibilties which working in various combinations may easily be used as alternative explanations for any perceived or real benefit you've experienced.
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Yeah, the bulk of the perceived improvements seem to come from underestimates of expected improvement if nothing were done. Once we started using control groups, the surprising discovery wasn't that people got better after taking herbals, it was just how much people got better when taking nothing. It turns out we do a poor job of predicting what will happen.
Linda
But TCM today is distinguished by historians from "Chinese Traditional Medicine" which is the genuine thing practiced before Mao.
Fallacy of popularity. And Mao had a real doctor.
That does not make it effective. False appeal to authority.
Popularity still does not make it effective. Bloodletting used to be popular.
[Followed by more appeals to popularity and authority]
There certainly is, it is called controlled testing. False special pleading.
That does not matter. Without testing it is unethical to promote it in the UK (China, too).
What is "western medicine?" I only know of "medicine" which is evidence/science-based, and stuff which is not.