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2 April 2012, 11.02am EST

Does traditional Chinese medicine have a place in the health system?

Most of traditional healing practices are based on intuitive principles of diseases involving the imbalance of elemental qualities. For the ancient Greeks and Romans, whose systems of traditional healing were accepted in Europe until the scientific revolution, these elements were the four bodily fluids…

Frdgzv2p-1333327588 — Despite recent attempts to retain traditional healing practices in China, modern medicine is supplanting traditional medicine there. Jean-François Chénier

Most of traditional healing practices are based on intuitive principles of diseases involving the imbalance of elemental qualities.

For the ancient Greeks and Romans, whose systems of traditional healing were accepted in Europe until the scientific revolution, these elements were the four bodily fluids or humours. Each corresponded to the four fundamental elements of the world – earth, water, air and fire.

In traditional Chinese medicine, the elements are wood, fire, earth, metal and water; for the ancient Unani medicine in India, the four humors (akhlaat) are air, earth, fire and water; for Indian Ayurveda medicine, health is the balance of three elemental energies in the universe: air, water and fire.

None of the ideas have any scientific basis.

With the advent of modern medicine, traditional European practices were relegated to a handful of surviving herbal remedies. Similarly in China, despite recent attempts to retain traditional healing practices, modern medicine is supplanting traditional medicine.

Paradoxically, in Australia and other developed countries there’s increased interest in complementary and alternative medicines, reverting to irrational approaches to health practice, despite people from such countries benefiting most from medicine’s advances.

The resurgence of interest in traditional Chinese healing in Australia, along with other alternative medicines, is due to rising discontent with conventional medicine; a preference for natural (or gentler) alternatives to pharmaceutical drugs or surgery; desire for greater control over personal health care and the relatively low success rate of conventional medicine in treating conditions, such as chronic pain, for some individuals.

This has led to the recent contentious decision to permit traditional Chinese medicine practitioners to be registered with the new national Chinese Medicine Board of Australia from July this year. The board will be a new member of the Australian Health Practitioner Regulation Agency.

I have argued against the move, along with my colleague Associate Professor Hubertus Jersmann, in articles published today in MJA Insight and the Sydney Morning Herald.

The decision follows Victoria’s move (in 2000) to register traditional Chinese medicine practitioners, which has had a positive impact on tightening standards and dealing with complaints.

Among traditional Chinese medicine practitioners to be registered are those who provide Chinese medical diagnosis, dispense Chinese herbs and perform acupuncture. All three components of this practice have serious flaws, being based on non-existent energies (Yin and Yang), non-existent bodily structures (meridiens) and on principles of disease diagnosis based on the imbalance of five non-existent elements. It is therefore doubtful whether such practitioners are able to make correct and safe diagnoses.

Proponents of traditional medical practices often point out that extracts from animals and plants have been the source of effective remedies in modern medicine. And while pharmacology and medicinal chemistry have enabled this revolution since mid-1800s, only a handful of the extracts used in traditional healing have been proven to contain active principles beneficial for fighting disease. These include about 120 chemical substances out of the thousands of herbal remedies used in traditional medicines.

Artemisia annua or qing hao su became incorporated into medicine after it’s anti-malarial activity was proven through research. Scamperdale

Take, for instance, qing hao su, a herb used in China for treating fever for over 2,000 years. About 40 years ago, scientific research found that it had specific anti-malarial activity and its active compound, artemesin, was isolated.

In fact, it’s fortunate that most herbal remedies have little acute toxicity. This is due to empirical experience, which over time has selected out those proven to be overtly toxic. But the more subtle, chronic toxicity of herbal remedies remains a serious concern.

Only 6% of plants species have been screened chemically and pharmacologically to identify their active principles. This process, started by modern medicine just over 150 years ago, is continuing with investigations of potential benefits of new therapies often based on a long history of empirical evidence.

This is why research on active chemical principles in herbal remedies showing some potential beneficial effect is fully supported by the Friends of Science in Medicine (FSM), of which I am a founding member.

FSM represents a growing number of medical researchers, clinicians and members of the public concerned by the “current trend which sees government-funded tertiary institutions offering courses in the health care sciences that are not underpinned by sound scientific evidence". We are worried that this gives unwarranted credibility given to their practitioners and practices, including traditional Chinese medicine.

Even though it falls within traditional Chinese medicine, acupuncture requires separate consideration because, despite being based on a flawed theory of non-existent “meridiens”, it has shown promising effectiveness in some ailments.

Acupuncture is based on the idea of “meridiens”. aloucha

But it’s important to remember that despite its popularity, acupuncture has only proven beneficial in alleviating some symptoms of pain and nausea. And the mechanisms by which it appears to work are similar to the physiological processes in the nervous system underlying the placebo effects on pain. Ultimately, research on acupuncture has enabled it to become incorporated in medicine in the few conditions for which it has proven to be effective.

My view, shared by many, is that there’s only one medicine and adjectives such as traditional and “Western” are irrelevant. Rather, medicine is about efficacy and safety, proven through scientific research.

Living in a modern society requires that in matters of health, we unapologetically only accept practices that have undergone the scrutiny of science. And once that criteria is fulfilled, we can accept it as effective medical treatment and teach it in our universities.

Sadly, this is not the case for most traditional Chinese medical practices and practitioners.

Articles also by This Author

11 May 2012 Budget good news: no taxpayer dollars for a ‘bunch of hooey’

14 March 2012 Mind over matter? The ethics of using the placebo effect

31 January 2012 Pointing the bone at chiropractic quackery – lessons from the UK

29 March 2011 A neuroscientist’s view: spare children the manipulations of chiropractic quackery

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83 Comments sorted by

Jon Wardle

NHMRC Research Scholar, School of Population Health at University of Queensland

So you acknowledge registration has had a positive impact on standards and complaints, yet you still argue against registration? Sounds more like professional politics than good public health.

about 1 year ago report
1. Marcello Costa
  
  Professor of Neurophysiology, Department of Physiology at Flinders University
  
  In reply to Jon Wardle
  
  Jon,
  always ready to see the small issues but not the elephant in the room.
  Our opposition remains because the small advantages of registration are outweighed by the disadvantages as pointed also in the article today in the MJA InSight. Once registered these health operators acquire a totally unwarranted credibility par with proper doctors of Medicine. There is no professional politics in pointing to this gross and gigantic discrepancy.
  
  about 1 year ago report
2. Jon Wardle
  
  NHMRC Research Scholar, School of Population Health at University of Queensland
  
  In reply to Marcello Costa
  
  Marcello, I think it is you missing the forest for the trees. Despite your personal views high utilisation would suggest that for most Australians the issue of legitimacy is moot. The public already see these practitioners as legitimate, and in a common law nation like Australia they already enjoy the freedom of practice that you express concern about. What you are suggesting only allows them to enjoy this legitimacy without any accountability. Hardly a good outcome for patients.
  
  about 1 year ago report
3. Joel Mayes
  
  Bicycle Mechanic
  
  In reply to Jon Wardle
  
  A reduction in complaints does not equate to efficacy in treatments which should be the main measure used to determine a treatments suitability.
  
  But given you have published a text book which suggests homoeopathy for the treatment of Asthma[1], dermatitis[2], oestrogen withdrawal in breast cancer patients[3], opportunistic infections in HIV+ patients[4] (what the f*ck!), URTIs in infants[5], type 2 diabites[6] (again what the f*ck!) and referenced this study
  
  http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2967177-2/abstract#aff4
  
  as with a statement that is shows 'an overall trend towards an effect for homoeopathy'[7] which is the opposite of the studies findings I don't expect you to accept that.
  
  [1] Clinical Naturopathy page 143
  [2] Clinical Naturopathy page 486
  [3] Clinical Naturopathy page 414
  [4] Clinical Naturopathy page 728
  [5] Clinical Naturopathy page 120
  [6] Clinical Naturopathy page 312
  [6] Clinical Naturopathy page 558
  
  about 1 year ago report
4. Jon Wardle
  
  NHMRC Research Scholar, School of Population Health at University of Queensland
  
  In reply to Joel Mayes
  
  Three quick points: 1) COAG's AHMAC criteria for regulation of health professions quite clearly state that regulation is based on potential patient risk, not 'suitability', efficacy or 'recognition' of a profession. Registration is not a 'prize' or 'privilege' 2) Your other points seem ad hominem and aren't really relevant here, but the study you link was not actually referenced at all - go back and check 3) Of the 4000 references in the book, yes, some were of homoeopathy if studies existed, though it was suggested they be used only in an adjuvant capacity. Never was there any suggestion of not using conventional medications
  
  about 1 year ago report
5. Joel Mayes
  
  Bicycle Mechanic
  
  In reply to Jon Wardle
  
  Regarding the trial You are correct and I apologise the study from your book is this one.
  
  http://www.ncbi.nlm.nih.gov/pubmed/9310601
  
  The conclusion still states that there is no evidence for homoeopathy being efficacious any single clinical condition. which is at odds with the way homoeopathy is discussed in your book.
  
  Jon writes
  "3) Of the 4000 references in the book, yes, some were of homoeopathy if studies existed, though it was suggested they be used only in an adjuvant capacity…
  Read more
  
  Regarding the trial You are correct and I apologise the study from your book is this one.
  
  http://www.ncbi.nlm.nih.gov/pubmed/9310601
  
  The conclusion still states that there is no evidence for homoeopathy being efficacious any single clinical condition. which is at odds with the way homoeopathy is discussed in your book.
  
  Jon writes
  "3) Of the 4000 references in the book, yes, some were of homoeopathy if studies existed, though it was suggested they be used only in an adjuvant capacity. Never was there any suggestion of not using conventional medications"
  
  Lets read page 120 then
  ---==---
  Homoeopathic treatment has been shown to be more cost-effective then conventional drug therapy in recurrent respiratory infections. Individualised treatment may also be more efficacious at preventing URTI in the paediatric population.
  ---==---
  
  While you do not discourage the use of conventional medicine in your practice, and I do applaud and respect you for that, I feel that statements like the above may encourages others to take a different path.
  
  One your first point, I believe that patient risk is highly related to the efficacy of the treatment offered and should be a consideration when deciding how regulate a health profession.
  
  about 1 year ago report
6. Marcello Costa
  
  Professor of Neurophysiology, Department of Physiology at Flinders University
  
  In reply to Jon Wardle
  
  Now we begin to understand the absurdity of the defense of registering practitioners of alternative therapies.
  It appears that it is acknowledged by the regulatory bodies that registration has a prime aim at ‘regulation is based on potential patient risk, not 'suitability', efficacy or 'recognition' of a profession’.
  
  In other words it is accepted that first of all these ‘professions’ represent a danger for public health. The public may sympathize with the attempts to minimize harm that comes…
  Read more
  
  Now we begin to understand the absurdity of the defense of registering practitioners of alternative therapies.
  It appears that it is acknowledged by the regulatory bodies that registration has a prime aim at ‘regulation is based on potential patient risk, not 'suitability', efficacy or 'recognition' of a profession’.
  
  In other words it is accepted that first of all these ‘professions’ represent a danger for public health. The public may sympathize with the attempts to minimize harm that comes from permitting unproven medical practices.
  
  Joel Mayes correctly points out ‘patient risk is highly related to the efficacy of the treatment offered and should be a consideration when deciding how regulate a health profession’. However the regulatory bodies do not appear motivated by the dangers that inappropriate therapies may detract patients from seeking proper medical advice. The Regulators clearly are more concerned with the more direct risks of these harmful procedures. Indeed they are right to be concerned. The very logic of choosing a herbal remedy for a TCM treatment is flawed at its conception falsely based on personalized diagnosis and personalized mixture (concoction I would say) of herbal and animal extracts.
  
  As Wallace Sampson, professor emeritus of clinical medicine at Stanford University and editor of The Scientific Review of Complementary Medicine is quoted to say in an article on Science (Science 299, 188-190. 2003) “Those empirical observations on herbs are unreliable, fanciful, false, [and] irrelevant,” he says, adding that any promising leads would arise purely by chance
  
  This explains why, as Jon reminds us, in his paradoxical defense of registration, the suitability or efficacy of the TCM procedures is not even considered important by the regulatory bodies.
  
  To confirm this suspicion would be sufficient to open online the document of the Chinese Medicine Board of Australia page, under the Continuing professional development registration standard where one reads ‘for the purposes of this registration standard, practice is not restricted to the provision of direct clinical care. It also includes working in a direct nonclinical relationship with clients; working in management, administration, education, research, advisory, regulatory or policy development roles…’
  
  In other words not even formally learned skills in the practice of TCM are required to be registered! Experience in TCM bureaucracy is sufficient.
  
  In fact the idea of competence that makes so hard for medical doctors to obtain a degree and registration, is simply missing for alternative medicine ‘professions’. Is of great concern to read the very low level of competency expected in order to obtain registration from the TCM board. There is little hope to validate any of the procedures of TCM currently in use. Even for a new student in Australia that wishes to embark in a tertiary course in TCM the ATAR level of entry is close to 50.
  
  Furthermore under the Grandparenting and General Registration Eligibility Registration Standard Practitioner one learns that ‘before 1 July 2015 may be qualified for general registration in the profession if the individual: has practised the profession at any time between 1 July 2002 and 30 June 2012 for a consecutive period of 5 years or any periods together which amount to 5 years.’
  
  In other words having practiced under the ancient name of TCM is sufficient to obtain registration and with it the professional credibility to treat patients!
  
  This is what I, and others, strongly oppose the move to register traditional Chinese medical practitioners as is manifestly contrary to good public health and the interest of patients.
  
  about 1 year ago report
7. Tim Scanlon
  
  Author and Scientist
  
  In reply to Jon Wardle
  
  That is not a sound nor logical argument at all.
  
  A lot of people like Michael Bay movies, doesn't make them any good. Roughly 30% of Aussies smoke, doesn't make it healthy.
  
  The reality is that until something has been tested and found to be safe AND effective, then it has no place in society.
  
  about 1 year ago report
8. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Jon Wardle
  
  It is a logical fallacy to assume that anything that is popular must be for the common good and should be encouraged. As well as Tim's example of cigarette smoking, I would add gambling, drink-driving and dangerous speeding. A civil society has the responsibility to protect its citizens against some of their poor choices when it leads to an impact on the rest of society - whether financial or in health outcomes.
  
  about 1 year ago report
9. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Jon Wardle
  
  Why would you use homoeopathy as an adjuvant in asthma therapy when there is no good evidence it does anything in asthma?
  http://summaries.cochrane.org/CD000353/homeopathy-for-chronic-asthma
  Why would you use homoeopathy as an adjuvant for opportunistic infections when there is no good evidence it does anything?
  (no evidence of any sort found)
  
  about 1 year ago report
10. jerry sprom
  
  logged in via email @gmail.com
  
  In reply to Marcello Costa
  
  Professor Costa,
  You say "My view, shared by many, is that there’s only one medicine and adjectives such as traditional and “Western” are irrelevant. Rather, medicine is about efficacy and safety, proven through scientific research"
  
  Perhaps you could comment on this statement?
  "To support this, the Government’s 2009-10 Budget provided funds under the Medicare Benefits Schedule — a quality framework for reviewing services listed on the Medicare Benefits Schedule (MBS). The MBS contains 5,703…
  Read more
  
  Professor Costa,
  You say "My view, shared by many, is that there’s only one medicine and adjectives such as traditional and “Western” are irrelevant. Rather, medicine is about efficacy and safety, proven through scientific research"
  
  Perhaps you could comment on this statement?
  "To support this, the Government’s 2009-10 Budget provided funds under the Medicare Benefits Schedule — a quality framework for reviewing services listed on the Medicare Benefits Schedule (MBS). The MBS contains 5,703 items, the majority of which have never been comprehensively assessed for their safety, effectiveness and/or cost-effectiveness."
  
  http://ihea2011.abstractsubmit.org/presentations/123/
  
  And I am sure you are aware of the recent commentary published in the BMJ by Ray Moynihan critical of FSM. I think Prof Kerryn Phelps has it right when she says that FSM have created a situation that is combative and divisive and is not helpful to rational discussion about the integration of CAM with conventional medicine.
  
  about 1 year ago report
11. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to jerry sprom
  
  The unpublished abstract that you reference doesn't actually say what you think it says.
  
  The MBS covers everything from consultations to diagnostic procedures to drug and non-drug therapies, but maybe the abstracts authors were thinking of acupuncture (an MBS listed item) when they wrote the abstract.
  
  MBS coverage:
  http://www.health.gov.au/internet/mbsonline/publishing.nsf/Content/a-z
  note acupuncture, which could do with some reassessment.
  
  In this particular situation (an on going…
  Read more
  
  The unpublished abstract that you reference doesn't actually say what you think it says.
  
  The MBS covers everything from consultations to diagnostic procedures to drug and non-drug therapies, but maybe the abstracts authors were thinking of acupuncture (an MBS listed item) when they wrote the abstract.
  
  MBS coverage:
  http://www.health.gov.au/internet/mbsonline/publishing.nsf/Content/a-z
  note acupuncture, which could do with some reassessment.
  
  In this particular situation (an on going review of items in the MBS), drug A may have a strong evidence base for efficacy, but has not been recently reviewed as to whether its is as effective or cost effective as drug B, or whether drug B is equally effective, but has a better safety profile (same goes for comparing modern CT scans with MRI for cost effectiveness).
  
  It's not just therapies, but diagnostics as well, eg is "Electron Microscopy of biopsy material" cost effective in diagnosis?
  http://www9.health.gov.au/mbs/search.cfm?q=72852&sopt=I
  
  What is not clear from the abstract is NOT that most items on the MBS have no strong evidence BUT that they have not been assessed under the NEW MSAC process. These items have had assessment before, indeed pharmaceuticals are rigorously assessed via the Pharmaceutical Benefits Advisory Committee.
  
  More on the myth that modern medicine is not evidence based
  http://theness.com/neurologicablog/index.php/how-much-modern-medicine-is-evidence-based/
  http://www.veterinarywatch.com/CTiM.htm
  
  about 1 year ago report
12. Marcello Costa
  
  Professor of Neurophysiology, Department of Physiology at Flinders University
  
  In reply to jerry sprom
  
  Jerry,
  the principle of testing procedures in Medicine is well accepted and no one will disagree with this principle. The process to do so is the realm of all the established regulatory bodies for Medicine. They may differ from country to country but there is full agreement with the principles behind the processes.
  
  These are fundamentally that it is possible to assess the scientific validity of explanations of any medical procedure and to test experimentally the evidence for efficacy and…
  Read more
  
  Jerry,
  the principle of testing procedures in Medicine is well accepted and no one will disagree with this principle. The process to do so is the realm of all the established regulatory bodies for Medicine. They may differ from country to country but there is full agreement with the principles behind the processes.
  
  These are fundamentally that it is possible to assess the scientific validity of explanations of any medical procedure and to test experimentally the evidence for efficacy and toxicity. Not so for alternative medicines, including traditional Chinese medicine. Paraphrasing a personal comment by a TCM practitioner that ‘Chinese Medicine does not treat a particular disease but works on the body as a whole. When we try to conduct a double blind study in order to prove the validity of this ancient art we completely go against the whole theory and concepts of Chinese Medicine’.
  I rest my case on this issue.
  
  What about the idea of ‘integrative medicine’? The idea of having hand in hand a proper medical practitioner and practitioners of alternative medicines is as bad as having an analytical chemist working in the same lab as an alchemist. Is not divisive. It is simply a silly idea. The few surviving alchemists should be seen with some personal sympathy but not in activities that impact on the life of the public. History relegated them to pre-scientific chemistry. Similarly ‘alternative’ medical practices also are relegated to pre-scientific medicine.
  
  Unfortunately the term ‘integrative’ has been hijacked by the proponents of this totally irrational approach to health. An appropriate ‘integration’ of health services with GPs working hand in hand with allied sciences such as physiotherapists, psychotherapists, nutritionists, podiatrists, nurses etc is totally consistent with modern scientific Medicine. None of these allied sciences proposes outrageous explanations or purport to cure in mysterious ways diseases or ‘whole’ persons. Modern Medicine is truly integrative, and regards the unity of science, including human biology is its strength.
  The battle Prof Phelps fight in Australia to have GPs working together with say homeopaths, is hopelessly flawed. Intellectually combative? Yes indeed.
  
  about 1 year ago report
13. Justin Case
  
  Gardener
  
  In reply to Tim Scanlon
  
  Your argument is even more fallacious and lacking in logic Tim. Unless of course your so-called logic is simply that everyone else must simply do whatever you happen to say, because like hey you know everything about about everything and everyone else are just ignorant fools who understand nothing, particularly their own experience.
  
  Are we living in Scientism based fascist state now?
  
  So the central committee for the advancement of global scientism will now be providing prescriptive rules…
  Read more
  
  Your argument is even more fallacious and lacking in logic Tim. Unless of course your so-called logic is simply that everyone else must simply do whatever you happen to say, because like hey you know everything about about everything and everyone else are just ignorant fools who understand nothing, particularly their own experience.
  
  Are we living in Scientism based fascist state now?
  
  So the central committee for the advancement of global scientism will now be providing prescriptive rules for every element of your life and you better damn well follow their instructions.... no matter what.
  You know humans never would've existed or survived for millenia if it wasn't for the grand central scientific committee of the important and authoritative humans (self-appointed) of the FSM coming to our rescue, just a few weeks ago.
  
  Can you provide any theory comprehensively supported by evidence from basic principles that life can exist in this universe?
  Or maybe we all really don't exist because you and your simplistic science can come up with no rational reason as why life ever came to be. Therefore it should not exist.
  So anything is only true if it comes out of the mouth of an FSM sycophant, just ignore reality. Everything in the universe exists purely on the basis of the supposed logic supposedly taking place inside the fatty tissues inside a skull.
  
  Since when was society proven to be scientifically safe and effective anyway?
  
  about 1 year ago report
14. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Ian Musgrave
  
  Where are the studies of homeopathy that compare it AGAINST conventional therapy, rather than as an "adjunct"? Don't its practitioners have enough faith in its effectiveness to test it, or is there a lack of volunteers?
  
  about 1 year ago report
15. Bayani Bacalla Mills
  
  logged in via Facebook
  
  In reply to Justin Case
  
  Not a logical argument? How so?
  
  Tim exposed the flaw in Jon's argument as the logical fallacy of "The Appeal to Popularity"; you've not attempted to explain how Tim's argument was not logical, merely accused him of telling people do to what he says - something which he hasn't done at all.
  
  Tim reasonably pointed out that we should be testing claims about a treatment before accepting them as being true.
  
  It should also be addressed that people are inherently poor at understanding personal experience…
  Read more
  
  Not a logical argument? How so?
  
  Tim exposed the flaw in Jon's argument as the logical fallacy of "The Appeal to Popularity"; you've not attempted to explain how Tim's argument was not logical, merely accused him of telling people do to what he says - something which he hasn't done at all.
  
  Tim reasonably pointed out that we should be testing claims about a treatment before accepting them as being true.
  
  It should also be addressed that people are inherently poor at understanding personal experience, particularly the underlying causes of a perceived benefit.
  
  Humans are pattern-seeking creatures; we look for patternicity in both meaningful and meaningless data, often coming to conclusions about agency when there is none.
  
  It takes skills developed over time to understand the cognitive biases that play on our thoughts, and to recognize the ways in which we can be misled in to believing things that ain't so.
  
  And, as a side note, yes, there are a two key theories supported by much evidence on how life can arise from basic chemical comounds, not just in the universe, but here on Earth.
  
  I am going to hazard at a guess that you're not one to actually keep up to date on the latest science news in astronomy, evolutionary biology, or physics - and that's ok, not everyone is terribly interested - but to reduce the methods used in scientific inquiry to the simplistic levels you've proposed is ignorant, and likely willful ignorance.
  
  Something isn't true because someone says so; we know something is true because we've taken the time to be considerate of the evidence, careful with our inquiry, and conservative about what the evidence bares.
  
  about 1 year ago report
16. Marcus
  
  logged in via Twitter
  
  In reply to Sue Ieraci
  
  and that's where people start shouting nanny state
  
  about 1 year ago report
17. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Marcus
  
  ...and others would call it a civil society.
  
  about 1 year ago report
18. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Jon Wardle
  
  Jon - I am fascinated to see that the Naturopathy text that you have co-edited is organised in body systems and diagnoses in accordance with the medical model, and uses many medical references. Does naturopathy have its own model of anatomy, physiology, pathology and pharmacology, or does it follow the standard clinical sciences?
  
  about 1 year ago report
19. Kelly O'neill
  
  logged in via Facebook
  
  In reply to Jon Wardle
  
  Wrong. You confuse two forms of legitimacy
  
  about 1 year ago report
20. Kelly O'neill
  
  logged in via Facebook
  
  In reply to Jon Wardle
  
  Wrong again. COAG is a political forum, not a medical one.
  
  about 1 year ago report
Peter Ormonde

Peter Ormonde is a Friend of The Conversation.

Farmer

Excellent piece.

I would not be in any great rush to consign a few thousand years of herbal medicine to the wastebin of history... some of this stuff works. But the mystical explanations are mere superstition. The important thing is to evaluate and examine these claims scientifically rather than blindly accepting the nonsense explanations on offer.

I am a regular consumer of acupuncture. It works - at least for me. I have also seen it work on greyhounds and horses. I have seen serious operations…
Read more

Excellent piece.

I would not be in any great rush to consign a few thousand years of herbal medicine to the wastebin of history... some of this stuff works. But the mystical explanations are mere superstition. The important thing is to evaluate and examine these claims scientifically rather than blindly accepting the nonsense explanations on offer.

I am a regular consumer of acupuncture. It works - at least for me. I have also seen it work on greyhounds and horses. I have seen serious operations including a hysterectomy performed using needles as the only pain relief. I have no idea why or how it works.

But meridians? Undetectable hypothesised links that flow outside the body with some sort of undetermined energy? Not on your life.

We do the art - the demonstrable value -of Chinese medicines and the Ayurveda a great disservice by burying it in mythological explanations and feudal fairy tales.

I have a long term interest in Aboriginal medicines and uses of Australian plants in particular. These characters were professional observers and tended to be extremely pragmatic in their approach to such matters. They had to be. 40,000 years of empirical observation is well worth a look I reckon - like using honey and ash for treating burns. Too important - too rare and valuable - just to throw away.

But the explanations? The purported theories? Not worth a pinch.

about 1 year ago report
1. Marcello Costa
  
  Professor of Neurophysiology, Department of Physiology at Flinders University
  
  In reply to Peter Ormonde
  
  Dear Peter,
  pleased to hear that acupunture works for you. I assume is for some pain? As I reported, it may ameliorate some symptoms of pain, but of course not the causes.
  The reports of entire very serious operations performed solely under acupunture analgesia when investigated appear to have been actually with parallel medications.
  Demonstrable values should be precisely that, demonstrable. If so most welcome. As agreed research is necessary and welcome but must come before using potentially dangerous practices or replacing those already validated.
  
  about 1 year ago report
2. Stiofán Mac Suibhne
  
  Contrarian / Epistemologist
  
  In reply to Marcello Costa
  
  There is an inter-disciplinary 'medical' form of acupuncture that does not draw on traditional knowledge for its explanations. There is evidence from trials and basic research to support acupuncture in wider range of conditions than pain. There are active research groups looking at underlying mechanism, particularly strong in Skandinavia. The British Medical Acupuncture Society is a useful source of information and they also produce a peer reviewed journal, Acupuncture in Medicine published by the…
  Read more
  
  There is an inter-disciplinary 'medical' form of acupuncture that does not draw on traditional knowledge for its explanations. There is evidence from trials and basic research to support acupuncture in wider range of conditions than pain. There are active research groups looking at underlying mechanism, particularly strong in Skandinavia. The British Medical Acupuncture Society is a useful source of information and they also produce a peer reviewed journal, Acupuncture in Medicine published by the BMJ group.
  
  http://www.medical-acupuncture.co.uk/
  
  http://aim.bmj.com/
  
  There are courses in western / medical acupuncture in NZ & the UK in univeristies but in Australia the discipline has not been incorporated into the tertiary sector. So called 'dry-needling' training from jobbing physiotherapists has come to be the dominant non traditional based needling practice. Most courses are just 2 or 3 days and the approach is very much technical rather than theoretical. In Australia acupuncture / dry needling are in regulatory fog.
  
  AHPRA are currently developing an endorsement for acupuncture for registered healthcare practitioners following a working party report.
  
  about 1 year ago report
3. Marcus
  
  logged in via Twitter
  
  In reply to Marcello Costa
  
  most of western medicine is not concerned with treating the 'causes'. many of the causes are lifestyle related. and most alternative medicines seek to treat these, the same cannot be said for many practitioners of western medicine, but that is slowly changing.
  
  about 1 year ago report
4. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Marcus
  
  That is simply not true, preventative medicine is a major part of so called "western" medicine. Everything from clean water supplies, to vaccination campaigns, to "life-be-in-it" to those "eat more vegetables" adds on TV are a direct part of "western" medicine.
  
  "Lifestyle" causes are vastly over rated in disease causation. For example, high bllod pressure is often thought by many lay people to be a lifestyle disease, yet it is highly resistant to lifestyle interventions (I spent mthe eraly part of my career styding the role of stress in high blood pressure, and my coleagues worked on high salt). Exercise and good diet with fresh fruit and vegetables (not multivitamines) will reduce you chances of deveopling high blood pressure, and can reduce the need for drugs whif you develop it, Insulin dependednt diabetes is
  
  about 1 year ago report
5. Marcus
  
  logged in via Twitter
  
  In reply to Ian Musgrave
  
  True, I was referring more to GPs than policy makers, most would prefer to dispense drugs that treat symptoms rather than work with patients to help change their lifestyle and treat causes.
  
  about 1 year ago report
6. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Ian Musgrave
  
  (stupid buttons) that should read ...and can reduce the need for drugs whif you develop it, but high blood pressure is not just people being fat and lazy,
  
  Doctors do advise on diet and exercise (and you can't have missed the decades of exercise and healthy eating adds on TV and news papers, Heart Foundation fun runs, and the changes to school canteens all designed to encourage better lifestyles. These weren't bought about by naturopaths.
  
  What doctors won't do is advise taking useless vitamin and mineral supplements.
  
  about 1 year ago report
7. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Marcus
  
  GP's (as noted in the second part of my post due to stupid buttons) play an important role as well, and your characterisation of them is incorrect.
  
  If you go to a GP with high blood pressure, most will give you guidance on diet and life style. If you go to a GP with a kid in the middle of an acute asthma attack, they are going to work on stabilizing the asthma, not giving out pointless vitamin and mineral supplements.
  
  about 1 year ago report
8. Marcus
  
  logged in via Twitter
  
  In reply to Ian Musgrave
  
  I guess some people just get better GPs than others.
  
  about 1 year ago report
9. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Marcus
  
  I support Ian's view - the myth that medicine only "treats the symptoms" while alternative therapists "treat the whole person" is simply not true. In many ways, quite the opposite.
  
  Who is at the forefront of public health campaigns about smoking, exercise, healthy eating, junk food advertising, eating a balanced diet, SIDS prevention, and so many others? The medical profession - including the AMA. And none of these campaings are about drugs - they are all about lifestyle. I have not seen similar campaigns launched by acupuncturists, CTM therapists or homeopaths. In fact, homeopathy is directed ONLY at treating symptoms (albeit with an inert substance).
  
  I would be very surprised to find any GP who approaches an obese patient with high blood pressure or diabetes who does not promote weight loss as a first strategy. The real benefit of our medical system is that it has approaches for lifestyle and prevention AS WELL as acute crises.
  
  about 1 year ago report
10. Joel Mayes
  
  Bicycle Mechanic
  
  In reply to Marcus
  
  I saw a GP 5 times last year, and only once was I been given a prescription drug, Panadeine Forte for pain management with a kidney stone.
  
  I even had a notifiable disease (Campylobacteriosis) and the GP's assessment of my physical condition (mid 30s, very fit & otherwise in excellent health) prompted a treatment regime of advising me on how to stay hydrated despite (amazing, earth shattering, hourly) diarrhoea, to avoid diary and meat for the duration, and advice on how to minimise the chances of infecting my partner.
  
  This is n=1 ancedata of course but it is my experience that most GPs do not prescribe unneeded drugs or treatments, and I imagine that there would be penalties if they did (perhaps Ian or Sue know more about this?)
  
  about 1 year ago report
11. Marcus
  
  logged in via Twitter
  
  In reply to Joel Mayes
  
  And you know what? A naturopath would have given very similar advice.
  
  about 1 year ago report
12. Grendelus Malleolus
  
  Senior Nerd
  
  In reply to Marcus
  
  They might however also add advice to take a herbal anti-parasitic formula at the time of a waxing moon along with a probiotic, a homeopathic complex spray and garlic and oregano.
  
  http://www.naturopath.co.nz/Articles/Digestive+Problems/Campylobacter+is+a+Common+Cause+of+Food+Poisoning.html
  
  about 1 year ago report
13. Marcus
  
  logged in via Twitter
  
  In reply to Grendelus Malleolus
  
  Garlic does have proven anti-bacterial properties.
  
  about 1 year ago report
14. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Marcus
  
  Marcus - garlic doesn have some antiseptic properties in some situations, but anything oral is fairly useless in treating an illness with vomiting and diarrhoea - it won;t be absorbed.
  
  More to Grendel's point - how often will you see a naturopath or homeopath and not be presecribed some sort of "remedy"? It is much more likely that your GP will tell you to treat your cold with salt-water gargles and lots of fluids rather than sell you some sort of "remedy".
  
  about 1 year ago report
15. Joel Mayes
  
  Bicycle Mechanic
  
  In reply to Marcus
  
  The difference being that GP's advice comes from a strong evidence base where as the Naturopath would have been guessing.
  
  Sure they may have guessed correctly this time, but maybe next time I get given black salve and lose half my face, or I'm told to removal *all* salt from my diet and drink an additional 6 litres of water a day and end up dead.
  
  about 1 year ago report
16. Grendelus Malleolus
  
  Senior Nerd
  
  In reply to Marcus
  
  So if the alone garlic works does this mean that buying the herbal anti-parasitic formula (at the time of a waxing moon) along with a probiotic, a homeopathic complex spray and oregano) are then a 'bogus bonus' sale for the health food store?
  
  In any case it is insufficient to state that "Garlic does have proven anti-bacterial properties". That may be correct as a general statement but when discussing a specific pathogen you need to determine whether or not Allicin (the principle antimicrobial…
  Read more
  
  So if the alone garlic works does this mean that buying the herbal anti-parasitic formula (at the time of a waxing moon) along with a probiotic, a homeopathic complex spray and oregano) are then a 'bogus bonus' sale for the health food store?
  
  In any case it is insufficient to state that "Garlic does have proven anti-bacterial properties". That may be correct as a general statement but when discussing a specific pathogen you need to determine whether or not Allicin (the principle antimicrobial component of garlic) is active in killing campylobacter and then determining whether this effect still occurs in the gut.It ma be that is does, and if so, Hooray! Science will have confirmed that garlic includes an ingredient that can be used to treat Joel's Campylobacteriosis.
  
  Should he just rush out and buy a head of garlic and munch those cloves down? Well maybe, but maybe not. Garlic, being a crop, is responsive to the soil and the soil nutrients. These can influence the Allicin content, as can the varietal of garlic that Joel may be able to buy locally. This problem can of course be worked around by processing garlic into a powder with a standardised Allicin content, and thus you have just created a pharmaceutical substance from a natural botanical source using science that confirmed the effectiveness in the first place.
  
  But did Joel need it?
  
  Under the section on that page that discusses treatment you can see the following advice:
  
  "Most cases of campylobacter will recover without treatment over time. If infected, I can recommend a visit to a health food shop or your naturopath who may prescribe nutritional or herbal medicines and may even recommend fluid and electrolyte replacement if necessary, depending upon the severity of the infection. In addition, patients should drink plenty of water while the diarrhoea persists. I am personally not a big fan at all of antibiotics, and I have seen most all cases of campylobacter cured very promptly with natural medicines."
  
  In the case Joel described above, his GP did NOT prescribe antibiotics, DID recommend the fluid intake and diet cautions and didn't try to sell him anything that in all likelihood would not hasten the end of the infection. The naturopath site even acknowledges that "Most cases of campylobacter will recover without treatment over time" so why do they go on to recommend a bunch of stuff unlikely to have any benefit?
  
  about 1 year ago report
17. Grendelus Malleolus
  
  Senior Nerd
  
  In reply to Sue Ieraci
  
  My apologies Sue - I spent too long in composing my response and totally missed your succinct and pithy reply. Makes mine largely superfluous I suspect.
  
  about 1 year ago report
18. Joel Mayes
  
  Bicycle Mechanic
  
  In reply to Grendelus Malleolus
  
  Antibiotic treatment of Campylobacter is considered marginal in someone of otherwise good health
  
  http://cid.oxfordjournals.org/content/44/5/696.full
  
  So that Naturopath's comment about antibiotics is a bit of a strawman, and the rest of there treatment a fine application of regression to the mean.
  
  about 1 year ago report
19. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Grendelus Malleolus
  
  No worries. The more the merrier!
  
  about 1 year ago report
20. Peter Reefman
  
  Project Manager
  
  In reply to Peter Ormonde
  
  For a long time I've been a sceptic of eastern medical / health practices, but I'm currently reading Bruce Lipton's book "The Biologyy of Belief" (# ISBN 13: 9781401923129 ISBN 10: 1401923127) and am finding my scepticism challenged. I don't have the medical / scientific background to determine the accuracy of Bruce Lipton's position, and I understand that at the end of the book he refers to options for dealing with things like self-belief limitiations that are possibly not helpful, but the way he ties cell biology to multi-cellular organisation, including in us humans, makes for a compelling re-think of some of these eastern practices, EVEN if their history is muddled with some whacky notions and purported foundations.
  
  about 1 year ago report
21. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Peter Reefman
  
  Peter - one of the key things to find out is whether "the way he ties cell biology to multi-cellular organisation," is actually based on the real science, rather than just good use of jargon.
  
  about 1 year ago report
Tim Scanlon

Author and Scientist

It is always a problem when untested treatments are allowed to be dispensed. Some herbal diet supplements are actually mild poisons, as the article points out, some of the herbal remedies are actually toxic. Until such time as they have been tested for safety AND effectiveness there is little point in having them on the market.

about 1 year ago report
1. Christopher Yates
  
  WHO Science Tech
  
  In reply to Tim Scanlon
  
  If Chinese medicine worked, we would use it to cure disease. There would be no debate, and we would not call it Chinese medicine. We would call it medicine.
  
  9 months ago report
Sue Ieraci

Public hospital clinician

It seems to me that there is a similar ethical principal that goes with teaching unproven therapies in universities. On the one hand, regulation of the therapists is an important part of protecting the public (which is the role of the regulator). On the other hand, the mantle of "regulated profession" adds a certain amount of credence to the therapist in the public eye. The same dilemma exists to some extent with chiropractic - there is an obligation to work in the public good and promote public health, and yet some chiros are publicly anti-vaccination. IF a profession is regulated, shouldn't the promotion of anti-scientific advice be sanctioned?

about 1 year ago report
David Colquhoun

Professor of Pharmacology, UCL

You put it perfectly

"being based on non-existent energies (Yin and Yang), non-existent bodily structures (meridiens) and on principles of disease diagnosis based on the imbalance of five non-existent elements. "

It baffles me that several vice-chancellors bring their own institutions into disrepute by offering degrees with non-existent value in Chinese medicine.

about 1 year ago report
1. Marcus
  
  logged in via Twitter
  
  In reply to David Colquhoun
  
  Calling them "non-existent energies" is perhaps taking them a bit literally. The same thing happens when you take any ancient document literally, (the bible, any other religious texts) they become nonsense. The idea of balance and harmony is not really nonsense and pretty much sums up the concept of 'good health'. I think you need to approach these things from a different angle and remember to keep an open mind.
  
  about 1 year ago report
2. Grendelus Malleolus
  
  Senior Nerd
  
  In reply to Marcus
  
  Marcus - that approach would be perfectly acceptable if what we were discussion was merely the ancient texts, however the context is contemporary practitioners who, if speaking in terms of 'balance" should be able to describe what they are balancing and the scientifically plausible method of action by which their treatment has its effect.
  
  about 1 year ago report
3. Christopher Yates
  
  WHO Science Tech
  
  In reply to Marcus
  
  If Chinese medicine worked, we would use it to cure disease. There would be no debate, and we would not call it Chinese medicine. We would call it medicine!
  
  9 months ago report
Marcus

logged in via Twitter

"Only 6% of plants species have been screened chemically and pharmacologically to identify their active principles."

Doesn't that tell you that we still have a lot to learn, and that maybe we shouldn't stop using the other 94% right away? 150 years of western scientific testing is not much compared to 2,000 years of practical testing. Is it?

about 1 year ago report
1. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Marcus
  
  2,000 years of "practical" testing can get things very, very wrong. Many popular therapies used for millennia are worthless
  https://theconversation.edu.au/what-cam-courses-at-universities-should-look-like-5339.
  
  about 1 year ago report
2. Marcus
  
  logged in via Twitter
  
  In reply to Ian Musgrave
  
  so can 150 years of "modern" medicine - would you like a list?
  
  about 1 year ago report
3. Peter Ormonde
  
  Peter Ormonde is a Friend of The Conversation.
  
  Farmer
  
  In reply to Marcus
  
  As I mentioned above I've had a long-term interest in uses of native plants and Aboriginal medicines.
  
  There was actually a systematic effort to identify and analyse the active constituents of many of them immediately after WW2 via the embryonic CSIRO when we were on the hunt for options to escape the tyranny of a very Imperial pharmaceutical industry.
  
  From the dim recesses of my memory the lead author was called Lazak or Lasak. The book produced is rather hard to find and I have been unable to track it down on the interweb. Well worth a look in the dusty corners of the campus library. Do we still have libraries?
  
  Menzies shut the project down at the behest of the British Government.
  
  about 1 year ago report
4. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Marcus
  
  I can give you my own even bigger list. The important point being that modern medicine can and does re-test and reject ineffective therapies (calomel anyone?).
  
  CAM uses things without any serious testing. The fact something has been used for thousands of years is irrelevant (crocodile dung as a contraceptive for example)
  
  about 1 year ago report
5. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Peter Ormonde
  
  A lot of potentialy fantastic CSIRO projects got shut down in that era (CSIRO helped develop the first computer with a hard wired square root function, it was felt that cloud seeding was more important than computers, so the computer work was abandoned).
  
  There is a lot of ongoing work on developing drugs from Australian native plants, using Aboriginal medicinal plants.
  http://www.chem.mq.edu.au/~jjamie/ethnopharm.htm
  https://repository.uwa.edu.au/R/-?func=dbin-jump-full&object_id=30150&local_base=GEN01-INS01
  http://www.eolss.net/Sample-Chapters/C03/E6-79-73.pdf
  
  about 1 year ago report
6. Marcus
  
  logged in via Twitter
  
  In reply to Peter Ormonde
  
  unfortunately money does not grow on trees. or shrubs.
  
  about 1 year ago report
7. Peter Ormonde
  
  Peter Ormonde is a Friend of The Conversation.
  
  Farmer
  
  In reply to Ian Musgrave
  
  Not all TCM medications are "ancient wisdom" for that matter.
  
  It was only in the early part of the 20th century that starfish were "recognised" as having a purportedly therapeutic value in the not-so TCM. There are now few of these left on the reefs around the Philippines as a result.
  
  about 1 year ago report
8. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Marcus
  
  "...so can 150 years of "modern" medicine - would you like a list?"
  
  A valid list would include ALL effective therapies and ALL failed therapies. If youa re able to assemble such a list, Marcus, it would be very interesting to see the ratio of lives saved to lives lost - even for something like antibiotics, for example. My guess would be that antibiotics' benefits vastly outweigh the risks.
  
  about 1 year ago report
9. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Peter Ormonde
  
  "Ancient wisdom" is simple wisdom for ancient times, relevant to the technology that was available. Hippocrates is recognised as one of hte great thinkers of medicine, and yet almost allof his models have been replaced as we learned more about how the body works by direct observation, experimentation and imaging.
  
  My guess is that the ancient sages would think we were crazy to follow their theories in this day and age, when we have so much more evidence about how the body works. They all worked to improve on the theories of those who came before them. Why do we think they would advise us to remain statis, or regress, rather than striving for better knowledge.
  
  about 1 year ago report
10. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Sue Ieraci
  
  Oops - I meant "simply" wisdom for acient times - not "simple"
  
  about 1 year ago report
11. Peter Ormonde
  
  Peter Ormonde is a Friend of The Conversation.
  
  Farmer
  
  In reply to Marcus
  
  Tell that to the Afghans with their pretty poppy paddocks - or those in Tasmania for that matter... let alone the acres of cannabis grown in wardrobes around the place... quinine, valerian, St John's Wort, garlic, feverfew a few thousand others as well. Money can and does grow on trees - even in mushrooms.
  
  I remember having a meeting with a group of bright young Indian lads running a pharmaceutical operation in Mumbai making HIV antivirals under licence. I suggested in passing that the folk medicines of India's tribal groups must be of some interest since they had been surviving in the forests for many millenia. They reacted with absolute fury. "These people have no place in the future of modern India - they are pre-agricultural!" The last word was spat out like the ultimate insult.
  
  Silly huh?
  
  about 1 year ago report
12. Marcus
  
  logged in via Twitter
  
  In reply to Peter Ormonde
  
  Lobotomies, cigarettes, mercury, radium, heroin, LSD, ECT,?
  
  about 1 year ago report
13. Marcus
  
  logged in via Twitter
  
  In reply to Sue Ieraci
  
  I am aware that many ancient remedies have been replaced, As have many modern remedies. I just think we should be more open-minded and willing to learn from TCM rather than just dismissing all of it as outdated hippy nonsense. And yes we should be striving for better knowledge, and this should include acknowledging that our current knowledge is not the be all and end all of everything.
  
  about 1 year ago report
14. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Marcus
  
  Cigarettes weren't a therapy. Tobacco smoking was part of some medical rites in some native American tribes though, and counts more as "traditional" medicine (and it was "western" medicine that found out that smoking was cancer causing).
  Mercury is a quite reasonable antibacterial and was used since the 16th century for syphilis. It has a narrow therapeutic margin due to it's toxicity, but until we developed modern antibiotics in the last 150 years, it was the best we had.
  Radium was the first…
  Read more
  
  Cigarettes weren't a therapy. Tobacco smoking was part of some medical rites in some native American tribes though, and counts more as "traditional" medicine (and it was "western" medicine that found out that smoking was cancer causing).
  Mercury is a quite reasonable antibacterial and was used since the 16th century for syphilis. It has a narrow therapeutic margin due to it's toxicity, but until we developed modern antibiotics in the last 150 years, it was the best we had.
  Radium was the first effective anticancer therapy (there were lots of weird and wonderful quack uses for it, spas used to boast that they had more radium in their waters than other spas, but that's "alternative" medicine). Radium therapy has been superceded by more effective ways of delivering radiation to tumors (remember radium use was back in the 1900's-1940's).
  Heroin is a very effective pain control drug, currently denied us because of the moral panic in the US.
  LSD was never a mainstream therapy, it was briefly used as an *experimental* drug in some forms of psychiatry in the 70's, but never made the grade.
  
  about 1 year ago report
15. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Marcus
  
  A very good article on the history of radium in medicine,incidentally showing it was the alternative therapists, not the medical profession, that abused radium.
  http://www.rsc.org/images/Dronsfield_tcm18-200827.pdf
  
  about 1 year ago report
16. Marcus
  
  logged in via Twitter
  
  In reply to Ian Musgrave
  
  Cigarettes were once ‘physician’ tested, approved http://www.hemonctoday.com/article.aspx?rid=37712
  
  Mercury still being used well into the 20th century - FDA Merbromin "untested" http://www.fda.gov/RegulatoryInformation/Legislation/FederalFoodDrugandCosmeticActFDCAct/SignificantAmendmentstotheFDCAct/FDAMA/ucm100219.htm
  
  Radium still being used well into the 20th century http://baltimorechronicle.com/rupnose.html
  
  It is often not until many years later that we find out about the dangers of many so called medicines. It's pretty easy to label everything that failed as *experimental* or "alternative" when in fact that may not have been the case at the time.
  
  about 1 year ago report
17. Marcus
  
  logged in via Twitter
  
  In reply to Ian Musgrave
  
  therapists/doctors/businessmen/quacks the lines can become pretty blurry pretty quickly
  
  about 1 year ago report
18. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Marcus
  
  Merbromin (here in Australia it was Mercurochrome, as kids we often had red knees from Mercurochrome on cuts, now our kids knees are brown from iodine compounds) is not mercury (it's a mercury compound, but that makes it a very different kettle of fish). Systemic administration of mercury, vs topical application of stabilised mercuric compounds are and do very different things.
  
  Mercurochrome has vastly less toxicity issues than mercury because of its topical application, and it is hardly a "failed…
  Read more
  
  Merbromin (here in Australia it was Mercurochrome, as kids we often had red knees from Mercurochrome on cuts, now our kids knees are brown from iodine compounds) is not mercury (it's a mercury compound, but that makes it a very different kettle of fish). Systemic administration of mercury, vs topical application of stabilised mercuric compounds are and do very different things.
  
  Mercurochrome has vastly less toxicity issues than mercury because of its topical application, and it is hardly a "failed" therapy in the sense that you mean (it was a very effective disinfectant, and drinking it was a *really* bad idea, just like drinking our modern iodine containing antiseptics would be).
  
  Since when was the 1940's not part of the 20th century? For some indications radium was still used into the 1980's, but it's heyday was in the early part of the 20th century, before synthesis of more effective radionuclides and the rise of chemotherapy.
  
  Again, it was hardly a failed therapy, it revolutionised the treatment of cancer, treating cancers that X-rays could not touch. It has been superceeded because of *better* radionuclides and cancer chemotherapy.
  
  But the important point is that these things worked, unlike 2000 year old formulas that have no evidence that they work. They were superceeded by better compounds and processes, but they still worked and radium revolutionised the treatment of cancer, 2000 years of rhino horn use has not revolutionised the treatment of convulsions (in fact there is no evidence it does anything to at all)
  
  And ads saying 9 out of 10 doctors smoke rancid dromedaries are still not therapy, it doesn't even come near the "9 out of 10 dentists brush their teeth with dead echindnas" type of advertising, where the product has some relation to health effects.
  
  about 1 year ago report
19. Peter Ormonde
  
  Peter Ormonde is a Friend of The Conversation.
  
  Farmer
  
  In reply to Ian Musgrave
  
  Eeek. I'd managed to forget mercurochrome ... I think I was 11 when I realised that not everyone had permanently red knees and elbows. My mum used to swab in on with a mop. But I'm not sure today's kids even have knees.
  
  A really interesting discussion.
  
  about 1 year ago report
20. Ian Musgrave
  
  Senior lecturer in Pharmacology at University of Adelaide
  
  In reply to Peter Ormonde
  
  Mine do (and elbows and have done some spectacular face plants). When one finally prise them off the computer games and shoves them outside they can become quite active.
  
  about 1 year ago report
21. Joel Mayes
  
  Bicycle Mechanic
  
  In reply to Ian Musgrave
  
  Ian writes
  "Merbromin (here in Australia it was Mercurochrome, as kids we often had red knees from Mercurochrome on cuts, now our kids knees are brown from iodine compounds) is not mercury (it's a mercury compound, but that makes it a very different kettle of fish)"
  
  I often wonder if the people who don't understand this live in fear of their glass of water floating upwards then exploding. After all it's mostly Hydrogen an extremely flammable gas.
  
  about 1 year ago report
22. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Marcus
  
  But modern medicine updates its own database and methods according to current knowledge and evidence, whereas TCM static. Why would it be a good thing to ignore new evidence about how the body works?
  
  about 1 year ago report
23. Peter Ormonde
  
  Peter Ormonde is a Friend of The Conversation.
  
  Farmer
  
  In reply to Ian Musgrave
  
  Thanks Ian,
  
  Good to see some of us are grabbing onto this stuff before it's lost for keeps.
  
  The third paper above is particularly interesting.
  
  Looks like someone has resuscitated the book I referred to somewhere here ...
  It's Lassak EV and McCarthy T., "Australian Medicinal Plants", New Holland Publishers 2006
  
  Well worth a look.
  
  Incidentally those with a naturally suspicious turn of mind might recall that one Tony Abbott went and got himself lost out on the edges of the Simpson…
  Read more
  
  Thanks Ian,
  
  Good to see some of us are grabbing onto this stuff before it's lost for keeps.
  
  The third paper above is particularly interesting.
  
  Looks like someone has resuscitated the book I referred to somewhere here ...
  It's Lassak EV and McCarthy T., "Australian Medicinal Plants", New Holland Publishers 2006
  
  Well worth a look.
  
  Incidentally those with a naturally suspicious turn of mind might recall that one Tony Abbott went and got himself lost out on the edges of the Simpson a few months back. The entire nation of course went into lock down with a bad attack of the Harold Holts.
  
  Now it transpires that Tony was off looking for Pitchuri (Duboisia hopwoodii)... a widely traded and greatly treasured Aboriginal plant. It contains up to 25% dry weight of nicotine and nor nicotine. It was treated in wood ash and chewed or held in the mouth like a quid of Quat. Also contains atropine and a few interesting alkaloids from memory.
  
  Under the influence of Pitchuri, desert dwellers could walk for days without food or water. Like Peruvian marching powder. The strongest Pitchuri came from up around Birdsville and was reportedly the main reason people stayed living there long after it became extremely difficult. Birdville putchuri was traded all over the country in little pouches woven so tight that they were waterproof.
  
  Now I wonder why Tony was off getting himself lost looking for that. All those late night sittings? The bike riding? Talking to Barnaby Joyce? Now there's a task that would take some endurance.
  
  For those interested here's a nice little summary: http://www.entheology.org/edoto/anmviewer.asp?a=47.
  
  Oh yes it's got enough of a whack to double as a poison for emus and the like. Handy stuff apparently.
  
  about 1 year ago report
Gabriel Chan

logged in via Facebook

The article below purports to summarise the emergence of popularity of "Traditional" orientalism-biased health in the West. Interesting read - if true, blows the CAM movement right out of the water!

http://skeptoid.com/episodes/4259

about 1 year ago report
Phillip Ebrall

Professor of Chiropractic at Central Queensland University

Colquhoun's comment "several vice-chancellors bring their own institutions into disrepute by offering degrees with non-existent value in Chinese medicine" reveals either a regrettable 19th Century British Imperialism or a stunning lack of awareness of the number of Vice Chancellors of universities in China who teach and deliver Chinese Medicine at the highest levels of known evidence.

Costa's comments suggest neurophysiologists should restrain their comments to the area of knowledge with which they are expert, ie neurophysiology, and leave comment on other disciplines to clinicians and those trained in such disciplines.

about 1 year ago report
1. David Colquhoun
  
  Professor of Pharmacology, UCL
  
  In reply to Phillip Ebrall
  
  I'd expect Ebrall to defend alternative medicine because that is where his income comes from. I have no such conflicting interest in the argument.
  
  But It is really going a bit far to describe a scientific disagreement as "19th Century British Imperialism". It just shows that your are clutching at straws. In the absence of good evidence, just be abusive.
  
  As you must surely be aware, medicine is highly politicised in China. Although advocates like to present acupuncture as thousands of years…
  Read more
  
  I'd expect Ebrall to defend alternative medicine because that is where his income comes from. I have no such conflicting interest in the argument.
  
  But It is really going a bit far to describe a scientific disagreement as "19th Century British Imperialism". It just shows that your are clutching at straws. In the absence of good evidence, just be abusive.
  
  As you must surely be aware, medicine is highly politicised in China. Although advocates like to present acupuncture as thousands of years old, it was in fact virtually extinct in China in the first half of the 20th century. It was revived by Mao Tse Tung as a way to revive Chines nationalism, and to give the appearance of providing healthcare for the masses without spending too much money. Western acupuncture is in fact a political construct. I have no doubt that Chinese vice-chancellors are still obliged to toe the political line. In the west, vice-chancellors have nos such excuse. They just haven't bothered to read the evidence.
  
  about 1 year ago report
2. Kelly O'neill
  
  logged in via Facebook
  
  In reply to Phillip Ebrall
  
  Incredible. QUT and now you with the funny CAM hats on, What is it about qld? And logic? China??? Health??? Serious? LOL
  
  about 1 year ago report
3. Marcello Costa
  
  Professor of Neurophysiology, Department of Physiology at Flinders University
  
  In reply to David Colquhoun
  
  thank you David for the clarification of the first issue raised by Ebrall.
  
  About his second issue addressed to me (he addresses me and you by surname as in old fashion schools), I am puzzled.
  
  He suggests that I should restrain my comments to my area of expertise. I agree with this principle wholeheartedly. My humble experience as teacher in Anatomy, Physiology, Pharmacology etc for medical and science students, should entitle me to some experience in evaluating what we teach medical and…
  Read more
  
  thank you David for the clarification of the first issue raised by Ebrall.
  
  About his second issue addressed to me (he addresses me and you by surname as in old fashion schools), I am puzzled.
  
  He suggests that I should restrain my comments to my area of expertise. I agree with this principle wholeheartedly. My humble experience as teacher in Anatomy, Physiology, Pharmacology etc for medical and science students, should entitle me to some experience in evaluating what we teach medical and science students and evaluating its scientific foundations or otherwise.
  My more than four decades experience in research, funded by peer review and the general knowledge expected as a Neuroscientist, might just perhaps enable me to comment on the evidence for existence or otherwise of meridiens, on the efficacy and mechanism behind acupunture, on even on the lack of evidence for the ‘subluxations’, still taught as a valid concept in Chiropractic courses in some Australian Universities.
  
  What kind of experts do you think Ebrall is suggesting should be commenting and evaluating these obscure concepts?
  
  about 1 year ago report
Mark Crossland

Acupuncturist and Shiatsu Therapist

I'm not so sure that I would agree that "acupuncture has only proven beneficial in alleviating some symptoms of pain and nausea". The World Health Organisation undertook a review and analysis of reports on controlled clinical trials on Acupuncture and reported (among other things) that Acupuncture has been proved - through controlled clinical trials - to be effective in treating some 28 conditions, including allergic rhinitis, hypertension, stroke, induction of labour, depression and correction of malposition of fetus. It also concluded that therapeutic effect had been shown on a further 63 conditions, but further proof was needed. This referred to conditions such as bronchial asthma, cholecystitis and female infertility. In an article I read in the Courier Mail (15/01/2012), the FSM described Acupuncture (along with other modalities) as being "unproven". Now you are saying that it is "partly proven".... I am confused!

about 1 year ago report
1. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Mark Crossland
  
  Mr Crossland - can you link to the trials of effectiveness of acupuncture that you mention?
  
  about 1 year ago report
2. Mark Crossland
  
  Acupuncturist and Shiatsu Therapist
  
  In reply to Sue Ieraci
  
  I have a pdf of the 87 page report, which I am happy to email through...
  
  I also had a quick look on the WHO website, and I believe that this is the report that I have (although I am not 100% sure)...
  
  http://apps.who.int/bookorders/anglais/detart1.jsp?codlan=1&codcol=93&codcch=196
  
  about 1 year ago report
3. Sue Ieraci
  
  Public hospital clinician
  
  In reply to Mark Crossland
  
  Mark - your link takes me to an out-of-print book, but I did find these papers:
  
  http://www.annals.org/content/138/11/898.short
  Annals of Internal Medicine : A Review of the Evidence for the Effectiveness, Safety, and Cost of Acupuncture, Massage Therapy, and Spinal Manipulation for Back Pain
  " Initial studies have found massage to be effective for persistent back pain. Spinal manipulation has small clinical benefits that are equivalent to those of other commonly used therapies. The effectiveness of acupuncture remains unclear. All of these treatments seem to be relatively safe. Preliminary evidence suggests that massage, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy."
  and
  Cochrane - acupuncture for insomnia: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005472.pub2/abstract
  "Currently there is a lack of high quality clinical evidence supporting the treatment of people with insomnia using acupuncture."
  
  about 1 year ago report

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