Why isn’t CAM mainstream?

[Skeptic Guy]

IMO, modern medicine began the day it accepted the scientific method to determine the efficacy of its treatments, procedures, and medicines. Medicine had always had 'medicines' it considered effective, but had no system to prove it until science came along.

And I always dislike calling it 'Orthodox medicine'. There's only medicine. It either works (medicine) or doesn't work (homeopathy, etc).

 

[blutoski]

Well, they got noticed by parliament and the House of Lords in the UK (or whatever acronym our country was at that point):

When I read through this, the only thing that's clear is that a politician forced a committee of medical professionals to include homeopathic submissions despite their expert judgement. ie: homeopathy seems to have benefitted from a beguiled a politician, who overruled the professionals and rammed it down their throats.

This is how healthfraud thrives in many countries today. Homeopathy and chiropractic are specifically protected in the US and Canada by special political exclusions from the requirement to demonstrate efficacy.

 

[RationalVetMed]

When I read through this, the only thing that's clear is that a politician forced a committee of medical professionals to include homeopathic submissions despite their expert judgement. ie: homeopathy seems to have benefitted from a beguiled a politician, who overruled the professionals and rammed it down their throats.

This is how healthfraud thrives in many countries today. Homeopathy and chiropractic are specifically protected in the US and Canada by special political exclusions from the requirement to demonstrate efficacy.

The original source was pro-homeopathic but it is a claim that I have heard and read with great frequency and which has the ring of truth (whatever that means) although I will have to check the parliamentary records (don't even know if they're on-line).

The point that is being made when this sort of thing is repeated is that even though cholera patients treated homeopathically had a far better recovery rate than those treated conventionally (the reasons being, we now realise, that a/ current medical treatments were so noxious they actually made patients worse and b/ Patients in homeopathic hospitals were from a better social class and given a better plane of nutrition - no references, just something I read somewhere, all contributions welcome). But, despite this difference the conventional medics of the day tried to have the statistics suppressed; what reason could they have had to have wanted to exclude the homeopathic figures other than to protect their own turf and prevent people seeking the homeopathic option?

Do you have a reference to anything confirming that homeopathy and chiro don't have to prove efficacy?

Yuri

 

[Skeptic Ginger]

What is the reason, historically, that orthodox medicine has risen to predominance?

It works.

 

[Skeptic Ginger]

...
Do you have a reference to anything confirming that homeopathy and chiro don't have to prove efficacy?

Yuri

QuackWatch has concise summaries if you have failed to read the thousands of threads on these failed alternatives.

 

[Skeptic Ginger]

This brings up an important point. If any of you have access to getting into these Obama Health Care Forums, we need a voice to speak out against bad medicine.

 

[Rolfe]

QuackWatch has concise summaries if you have failed to read the thousands of threads on these failed alternatives.

I don't think Yuri Nalyssus, VetFFVoo, is really in much doubt about all that. I think his point was perhaps subtly different.

Rolfe.

 

[RationalVetMed]

QuackWatch has concise summaries if you have failed to read the thousands of threads on these failed alternatives.

Ouch!

What I was asking for was evidence that, in law, these modalities are not obliged to prove efficacy yet are allowed to practice under state patronage. Thanks for the reminder about quackwatch though.

Yuri

 

[RationalVetMed]

I think I’m starting to see a pattern emerging:

It worked better than the alternatives.

beat me to it! Doh!TAM

It worked better than the alternatives.

Fixed it for you.

Because it works.

It works.

Sigh, I really, really wish I’d put the phrase, “By the way, I know it works better, that's not my point” in the opening post!

Yuri

 

[Rolfe]

It really is an interesting question. Until the mid-20th century there wasn't an awful lot of stuff that actually "worked" at a self-evident level. Certainly not as far as therapeutics were concerned, though I'll grant you gaseous anaesthetics and antiseptic surgery and vaccination.

I still think prior probability had quite a lot to do with it. You could try asking Abigail Woods. She's a vet, and the only expert I know in the history of veterinary medicine. She might have some useful insights.

Rolfe.

 

[Dr. Trintignant]

Was giving lemons to sailors with scurvy or injecting exctract of cow pus into people to prevent small pox any more rational than dosing with very dilute camphor to treat cholera

Yes, it was more rational. Citrus was found to cure scurvy in one of the very earliest clinical trials. It was not a very good trial by modern standards (not blinded; missing a control group), but for such an obvious and otherwise irreversible disease as scurvy, those aspects were not such a big deal. Likewise, injection of cow pus was a result of a scientific test--a verification of a hypothesis based on the observation that milkmaids rarely got smallpox. Again, the test was crude by modern standards, but both the conclusions and the way they were arrived at were basically correct.

- Dr. Trintignant

 

[T.A.M.]

I think I’m starting to see a pattern emerging:





Sigh, I really, really wish I’d put the phrase, “By the way, I know it works better, that's not my point” in the opening post!

Yuri

Yuri;

I know you know it works. My comment (that it works) is not to you, but to answer the reason why it came to be the dominant form of health care, as opposed to the "alternative" medicines.

TAM

 

[Rolfe]

But I think Yuri's point was that the effect seems to have been evident before there were any self-evident therapeutic techniques available to "mainstream" medicine.

Rolfe.

 

[balrog666]

I guess I missed it - what the hell is CAM? And why would any rational person give a Flying Fickle of Fate about it?

 

[Rolfe]

There's a reason why you decided to post in this thread when you have no idea what it is about and care less?

Rolfe.

 

[Ysidro]

One big question you seem to be missing is "how and when are you defining the start of modern medicine?" I'd say that's a doctoral thesis in and of itself!

 

[Skeptic Ginger]

Ouch!

What I was asking for was evidence that, in law, these modalities are not obliged to prove efficacy yet are allowed to practice under state patronage. Thanks for the reminder about quackwatch though.

Yuri

I was sort of wondering why you were seeming to be asking for evidence woo was woo. Sorry for the misunderstanding. I think the thread title is confusing, "why isn't CAM mainstream?"

It's political and appalling at the same time. I am beginning to mount a campaign about this very thing. In fact, I suggest skeptics of bad medicine make an effort to get in on these town meetings Obama plans to hold regarding health care reform. I am going to see about getting in on WA State's meeting. Apparently the Gov is in charge of who attends.

In this state, the woo believers have been actively lobbying our state legislature and they have gotten bad laws passed. We need skeptics and scientists more passionate about countering this bad trend. It has been going on under the radar.

As for the infomercials and that mess, I think either a pro-business, and/or pro-free speech is clouding the judgment of regulators. We need to lobby federal legislators for stronger consumer protection laws.

And in England they apparently have a few members of the royal family who are convinced homeopathy works. That needs addressing, for sure.

(Sorry for repeating myself there about the Obama health care reform meetings.)

 

[Skeptic Ginger]

One big question you seem to be missing is "how and when are you defining the start of modern medicine?" I'd say that's a doctoral thesis in and of itself!

While lots of people think of Hippocrates as an early pioneer in medicine, modern medicine actually began closer to 150 years ago. Prior to that, there was a lot of scientific exploration of the anatomy of the human body, and some successful though crude surgery was developed like amputations. But there was very little in the way of systematic testing of remedies and cures.

Many people are unaware but Florence Nightingale was a pioneer in evidence based medicine in the 1850s.

She developed the "polar-area diagram" to dramatize the needless deaths caused by unsanitary conditions and the need for reform. With her analysis, Florence Nightingale revolutionized the idea that social phenomena could be objectively measured and subjected to mathematical analysis. She was an innovator in the collection, tabulation, interpretation, and graphical display of descriptive statistics.

John Snow is credited as being the first successful epidemiologist. He mapped cholera cases and found they were clustered around one particular town water pump.

Then there was the case of the nurse midwives who discovered hand washing.

Microorganisms were first directly observed by Anton van Leeuwenhoek, who is considered the father of microbiology. Ignaz Semmelweis was a Hungarian obstetrician working at Vienna's Allgemeines Krankenhaus in 1847, when he noticed the dramatically high incidence of death from puerperal fever among women who delivered at the hospital with the help of the doctors and medical students. Births attended by the midwives were relatively safe. Investigating further, Semmelweis made the connection between puerperal fever and examinations of delivering women by doctors, and further realized that these physicians had usually come directly from autopsies. Asserting that puerperal fever was a contagious disease and that matter from autopsies were implicated in its development, Semmelweis made doctors wash their hands with water and lime before examining pregnant women, thereby reducing mortality from childbirth to less than 2% at his hospital. Nevertheless, he and his theories were viciously attacked by most of the Viennese medical establishment.

That Wiki entry needs editing. They left out the fact handwashing was practiced by the midwives before Semmelweis realized it mattered, and only mentioned the doctors attending births directly after performing autopsies.



To my surprise, that same Wiki entry notes

The Atharvaveda, a sacred text of Hinduism, is the first ancient text dealing with medicine. It identifies the causes of disease as living causative agents such as the yatudhānya, the kimīdi, the kṛimi and the durṇama. The atharvāns seek to kill them with a variety of drugs in order to counter the disease (see XIX.34.9). One of the earliest western references to this latter theory appears in On Agriculture by Marcus Terentius Varro (published in 36 BC), wherein there is a warning about locating a homestead in the proximity of swamps:
“ ...and because there are bred certain minute creatures which cannot be seen by the eyes, which float in the air and enter the body through the mouth and nose and there cause serious diseases.[2]

I'm going to have to investigate that. It sounds very interesting.

 

[RationalVetMed]

Yuri;

I know you know it works. My comment (that it works) is not to you, but to answer the reason why it came to be the dominant form of health care, as opposed to the "alternative" medicines.

TAM

 

[RationalVetMed]

I guess I missed it - what the hell is CAM? And why would any rational person give a Flying Fickle of Fate about it?

CAM in this context stands for Complementary and Alternative Medicine, an eclectic group of therapeutic and diagnostic modalities which claim to provide health benefits outside those offered by conventional, science based medicine. As a rule they have little real science to support their claims but proponents tend to point to the general high level of satisfaction amongst users as evidence that it is useful.

People should care about it for several reasons. Some (not many) of the techniques are directly harmful but the biggest concern is that these, essentially ineffective practices are used in place of real medicine and the patient suffers as a result of delayed diagnosis.

Welcome to science, maths and medicine!

Yuri