My favorite paragraph lands near the end, after a great debunking of the paper:
> The authors behind the paper drawing connections between symptoms, proteins, and Chinese herbs are hopeful that their model will show which herbs used in TCM seem particularly promising. They claim that chemicals in some herbs are known to interact with the same proteins involved in a particular symptom, but that this herb-symptom association has so far been ignored by TCM practitioners. They give several examples, such as Aristolochia fangchi known colloquially as Fang Ji which, based on their computer work, could help with abdomen distention. Patients beware: that plant was used in the 1990s instead of the listed herb as part of a slimming regimen in Belgium, where it caused “an outbreak of terminal renal failure.” That is something that abstract maps of chemical interactions may not tell you, but we should not forget what we already know from experience.
In 2015, the Nobel Prize in Medicine was won by Tu Youyou.
During the Vietnamese resistance war, Vietnamese moving down the Ho Chi Minh rail were contracting malaria in the jungle. The Chinese were asked for aid, and Tu Youyou was tasked with assembling a team to help.
One thing Tu Youyou did was consult "traditional Chinese medicine" with how to aid victims of malaria. Most of what she found did not work, but wormwood did produce results. Tu Youyou again consulted traditional Chinese medicinal texts and they said wormwood should be used with cold water. The team extracted artemisinin from the wormwood in cold water, and a new (and old) way of fighting malaria was born.
> Most of what she found did not work, but wormwood did produce results.
TCM is interesting: There are countless different TCM preparations that do nearly nothing are can be actively harmful to the kidneys or liver, but every once in a while there is a a novel compound discovered in some plant somewhere that does something.
I can’t tell how much of this is because TCM has some treatments that actually work, or if it’s a case of a broken clock being right twice a day. I suspect it’s more of the latter.
Just because we have made innovations in the method of research and discovery doesn't mean that we should throw away everything that we had before.
Around me I see practices like "gratitude", "meditation" and "breathing exercises" get bandied around like they're some new profound thing as if we hadn't known about for thousands of years that have appeared in various guises universally throughout different civilisations.
Just because the metaphors and models of explanations could be flawed doesn't mean the effects should be thrown out
Edit:
I have a good friend, a scientist no less, who suffered from severe eczema and was completely let down by western medicine who was put through decades of progressively stronger and stronger steroids. Nothing worked. Eventually the doctors gave up and shrugged their shoulders and was advised to give "alternative medicine" a go. Desperate my friend visited a traditional Chinese doctor who was prepared to guide them through a rigorous exclusion diet while also preparing mystery herb soup and suddenly a lifetime of eczema subsided and became very manageable.
The older I get the more determined I find myself trying to glean the accrued wisdom of people who came before us...
"Around me I see practices like "gratitude", "meditation" and "breathing exercises" get bandied around like they're some new profound thing as if we hadn't known about for thousands of years that have appeared in various guises universally throughout different civilisations."
These have been VASTLY improved and optimized compared to their traditional counterparts. Evidence-based trials with brain scans, and other methods.
For example, achieving strong vagus nerve stimulation on demand to activate the parasympathetic nervous system could take years(or they might never get there) to learn for traditional Buddhist meditation practitioners, and nowadays we get there in a few sessions of EMDR therapy.
> Around me I see practices like "gratitude", "meditation" and "breathing exercises" get bandied around like they're some new profound thing as if we hadn't known about for thousands of years that have appeared in various guises universally throughout different civilisations.
Most people don’t care where, when, or why a concept was invented as long as it works.
Quibbling over who discovered it first or trying to drag the conversation back to who discovered it first is like the person who tries to claim credit for being into a band before they were popular: Nobody cares, they just want to enjoy it.
> The older I get the more determined I find myself trying to glean the accrued wisdom of people who came before us...
Going back to the actual article: There is a big illusion of accrued wisdom of the ancients in TCM that isn’t backed up by the research. There are occasional hits where a TCM preparation intersects with a truly active compound, but it should be raising red flags when TCM practitioners claim to have cures for everything and different TCM practitioners will come up with different answers for the same patient. When the first one doesn’t work they’ll have another answer the next visit, and the next visit, and so on.
The criticism is that they claimed to have the solution the first time, instead of only claiming that they will try something functionally random.
A methodical process and a random or intuitive process only look like the same trial and error on the outside, and only to the (probably willfully) ignorant.
The trappings and ceremony of a theory and methodology are not actually a theory or methodology.
It doesn't do anyone any good to allow any confusion of the two.
A lot of scientists dabbled into pseudoscience but that doesn't invalidate their scientific accomplishment, and their scientific achievement doesn't validate their pseudoscientific pursuit
I am sure there are some truths in some thousand years of research, ala "Don't throw the baby out with the bathwater", but that doesn't validate the system or study as a whole.
I am biased as an ethnic Chinese, but I feel modern medicine is afraid that it's approach, the sum of parts empiricism may be incomplete, in that we dont understand all the parts yet.
The human body is not just human DNA organs working together, but also an ecosystem with myriad bacteria, and we are still in infancy when it comes to understanding the bacteria.
TCM seeks a black box metaphorical approach, which sounds like quackery but I do think it is capable of addressing _some_ blindspots in modern medicine, eg why some medication would work on a yin body but not a yang body... the difference is in the bacterial ecosystem.
That said, I see TCM (and other traditional approaches) as a last resort when modern medicine fails, and I certainly agree the approach is incapable of resisting shamanic beliefs.
Why not apply scientific method to Traditional Chinese Medicine and use double blinded placebo controlled trials to test its validity? In the end also modern medicine is using exactly this method and can treat substances using the black box method.
The fundamental problem is TCM acknowledges individual differences that cannot be measured or even dont exist in the eyes of modern medicine, eg identical twins with different diets will have different responses to the same treatment, so going double blind will mean the results will be inconsistent.
This is why sample size is important tho. With a large enough sample size, you can ignore differences in individuals bc the trend of the control will be smaller than the experiment (or not)
You have no problem accepting eg a treatment can only work on a man, but not on a woman. But modern medicine have no concept of a yin body type and a yang body type, which may or may not be male and female.
The whole idea of TCM is balance, and it varies with the individual, unlike modern medicine, where there is a right and wrong answer to everything. Bacteria bad, antibiotic good. Fever bad, paracetamol good.
Take fecal transplants for example. I dont think it is well understood how it works or it will be a pill by now, and is a last resort when all else fails. And it doesnt involve killing all the bacteria, but restoring balance to the bacterial ecosystem.
Is this yin, yang somehow measurable? If not then there is a fundamental problem.
Also Western medicine is very well aware of side effects, it's actually one of the fundamental concepts. For example it knows that taking Paracetamol is good against pain, but increases risk to the liver, especially when taken with alcohol. It's also very well aware of causes of fever and doesn't recommend lowering it for the sake of it, only from certain dangerous level. It also knows that taking antibiotics affects gut bacteria, so it's often recommended to take also probiotics. It knows that some medicine could affect women differently, especially when they are pregnant or are breast feeding. The list goes on, it's never black and white.
I am also Chinese and this is exactly how I feel. The experience of going to a doctor with minor ailments, only to be sent away with the attitude of "take some paracetamol and come back when symptoms worsen" is maddening. In the mean time TCM practitioners have answers that often work for these kinds of things.
In people's zeal to point out TCM's problems (due to its pre-modern scientific roots), I feel like they're also throwing away its potential. Skepticism shouldn't be about wholesale dismissal (which is just intellectual laziness masked as rightenousness) but about improving outcomes.
> In the mean time TCM practitioners have answers that often work for these kinds of things.
You can also take some homeopathic remedies and do a couple of chiropractic adjustments meanwhile. I've also heard that some Christian Science practitioners work wonders if you give them all your Earthly belongings.
The ability to say: "It's likely a viral disease. Wait and see if it worsens" - is a pretty powerful point _in_ _favor_ of modern medicine.
The unspoken part is the human mind is a big part in health, and treatments that does nothing medically but fools the human mind can work wonders too.
There is a lot we do not understand yet, just as blood letting was conventional medicine a few hundred years ago, and it isnt even entirely wrong since we still use leeches and some treatment, I think we have much to gain if we are not hasty in dismissing alternative approaches.
That said, I fully agree homeopathy and chiropractherapy are full of bullshit and potentially dangerous. TCM, as practiced in a certified scholarly environment in Asia, expects the practitioner to have a considerable basic knowledge in modern medicine too, and is humble enough to acknowledge TCM cannot solve everything. A good TCM practitioner will refer you to a GP when they know modern medicine is more effective.
And just who here is rejecting the viral model? Saying "other practitions have stuff worth exploring" is not at all the same as "the regular western medicine model should be abandoned". Why do you feel threathened? This makes no sense to me.
Yet the inverse is not true: the prevailing attitude on HN here is not "western medicine is here to stay as staple but other practitions can add value on top", but to dismiss other practitions wholesale based on their inability to conform to intellectual standards, regardless of measurable outcomes. This is "my god is the only god" all over again.
A chiropractor was able to heal my back problems where months of going to a physiotherapist failed to do so. Aren't we supposed to stay humble and curious for new avenues of scientific exploration, rather than dismissing everything we don't understand?
There are symptoms and idiopathic conditions I've had that multiple specialists at top-tier hospitals were unable to diagnose, but mostly because they were too-narrowminded in their approach (blood tests, etc.) to see the big picture.
All forms of medicine, new or ancient, should undergo validation and integrated into "mainstream" medicine.
If wormwood worked but only when using cold water, study that extract, isolate the compound to promote reproducibility of benefits and minimize side-effects from unnecessary compounds, and attempt mass production at cheap prices for public benefit without destroying the environment.
How else can we foster trust that medicines are reliable?
Modern medicine was born by consolidating and empirically scrutinizing thousands of years of all sorts of medicine.
Lumping all aspects of TCM into one thesis to be proved or disproved seems ill-advised. Would you think of treating western medicine, and all the ground it covers as a single monolithic field to prove/disprove?
Anyone is free to use the well tested scientific methods to show if a claim is true or not (medicine or otherwise). There is no need to prefix it western-, modern-, traditional-, chinese, ayurvedic- etc. If it works it is just medicine.
There is no such things as chinese physics, ayurvedic chemistry, traditional biolgy.
The Chinese and Korean golden herbs ginseng is way overrated. Just consume ginger instead of the 100x more expensive ginseng for all the recipes that people been come up over the centuries and the nutritional benefits probably the same if not better. It is essentially an overpriced souvenirs for your in-laws, that's it.
Care to provide details of the stimulant effect that you were experiencing?
I'm mainly referring on the nutritional and health benefits that the in-laws perceived if they were bought as souvenir a few thousands dollars worth of 1 kg ginseng as opposed to the equivalent of 1 kg ginger worth a few dollars [1],[2].
I recommend Examine.com for supplement literature reviews which are far more in-depth than Wikipedia.
"Research indicates that American ginseng may improve short-term working memory and reaction time, particularly at lower doses, and some positive results were noted in older adults and people with schizophrenia. However, the overall effectiveness on cognition remains uncertain because no significant improvements were found in verbal memory or attention."
My prediction: within 50-100 years, traditional Chinese medicine will be like osteopathy in the United States: impossible to distinguish from mainstream modern medicine, even though it bears a name reflecting its origins in pseudoscience.
It'll be easy enough for them to manage from a perception standpoint. They'll just declare that modern medicine has recognized and assimilated the concepts of traditional Chinese medicine, that "modern" medicine as taught and practiced in the west now reflects traditional Chinese concepts, and that western medicine and traditional Chinese medicine have evolved convergently to the same point because western medicine copied Chinese medicine. It'll be accepted by people who know better as a polite lie.
The original appeal of traditional Chinese medicine to the Chinese government was that it made it possible for them to provide a form of officially recognized health care to the entire population long before they were able to train enough doctors. From the government's point of view, there's no reason for it to outlive that necessity. If they want a flood of chauvinistic pro-TCM propaganda to proclaim Chinese superiority -- maybe they do, maybe they don't -- they can do that while at the same time having schools of TCM teach basically the same thing as western medical schools.
Chinese civilization has had a population of hundreds of thousands of people going back many hundreds of years. It's not the least bit surprising that they've figured out useful stuff about medicine. Even if you believe that the TCM theories are wrong, and it was all trial and error, the default position should be that it's possible to identify useful treatments through trial and error. It's Western chauvinism to believe that useful treatments can only be discovered via Western methods.
Acupuncture is like herbal supplements. There are studies you can point to if you want to defend it, which is handy for people who make money on it.
I know a guy who worked for a veterinary clinic for years and used to bellyache about how the owner was a hippy dippy quack who was promoting alternative treatments like acupuncture and herbalism, and it was fine if people were morons and chose that stuff for themselves, but to use it on animals, yadda yadda yadda.
Then he bought the clinic from her. Less than a year later, he was certified in veterinary acupuncture and was making sure that new vets he hired were down with alternative medicine. "There are studies...." Yeah, you knew about those studies before, when you were calling it an unethical scam. We all know what new information changed your mind, and it wasn't in veterinary journals, it was in the finances of the clinic you just bought. Lost a lot of respect for that guy overnight.
The whole point is that science is the difference. Vaccines work. The business of selling vaccines might be sleazy because of the way they go about it, but the product itself isn't a scam.
“Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientific knowledge, and it has been characterized as quackery.”
(Now you either accuse Wikipedia of Western chauvinism or dismiss Wikipedia altogether.)
Notice that Wikipedia talks about acupuncture vs "sham acupuncture".
That's intellectually dishonest IMO. They should just compare acupuncture against placebo pills.
The problem with making that comparison is that if you do, acupuncture beats placebo! So the western scientists who need acupuncture to lose had to come up with a new "placebo". Hence "sham acupuncture".
The problem with "sham acupuncture" is that it is designed to mimic the physical sensation of acupuncture. But if you read the text I linked, it explains that acupuncture works primarily via the nervous system! So "sham acupuncture" is basically the real thing. Total intellectual dishonesty.
Go on Amazon and search for "acupuncture mat". You'll find lots of plastic mats that don't penetrate the skin, but replicate the sensation of penetrative acupuncture, with many many 5-star reviews. I often fall asleep on an acupuncture mat. The sensation in my back muscles is unmistakeable after 15 minutes.
Saying "acupuncture doesn't do anything", for me at least, is like saying "alcohol doesn't do anything". It's just absurd, and I don't need an RCT to classify it as absurd. (I've recommended acupuncture to others; some have an immediate strong response like me, others find it useless. Maybe it's variation in how the nervous system works.)
Anyways, if you read the textbook I recommended, it says many of the same things as Wikipedia. The needle location doesn't matter a ton. The stuff about meridians has no scientific basis. That's why they call it a "Western Medical Acupuncture" text. But acupuncture is still a useful treatment and has proven so in many RCTs.
I believe that dkarl’s point was that what is now called “osteopathy” in the US is functionally the same as modern medicine, since that is what actually works. But they keep the name for its brand recognition. (But even if this is true, there is still every reason to avoid it, since if its practitioners were any good, one would assume they would rather be regular medical practitioners.)
Well marketted placebo has it's place, ancient wisdom/mysticism more useful make believe than plethora of of modern health supplments backed by mediocre "research". It's easier placebo narrative to believe in.
E: A 100b (possibly multiple) industry doesn't hurt either, which is... shockingly large. I was going to joke people spend more on dumber things to feel good, but that's... a solid chunk of change.
Given the prodigious amount of pro-TCM papers coming out of China, I am concerned about a 51%-type attack on our peer review process that will take decades if not centuries to undo.
The simple truth is that if not all players are playing by the same rules, we can’t treat the output of the game as a monolithic corpus of factual knowledge. That needed to happen a long time ago, so maybe it’s for the best to be forced to come up with a different strategy.
There isn't much strategy behind pro-TCM papers other than "publish and perish" due to the hyper-competitive and metrics driven nature of Chinese academia. Most of these papers will be published in lower tier journals and used as a line-item within their CV in order to meet departmental KPIs or get promotions or funding, and some nameless bureaucrat won't care because metrics have been hit and his ass has been covered.
My SO had to publish similar kinds of papers when she was in Vietnam - she also had to spend $4-6k in "gifts" for the members of her thesis defense committee (despite her earning a stipend of around $100/mo) and publish politically oriented papers otherwise some technicality would come up to prevent her from getting permission for further research in Japan on an ASEAN grant, and this was at Vietnam's equivalent of JHU.
There is a similar trend in India with Aryuveda/Unani.
The strategic and commercialized research that matters always aligns tends to align with modern medicine.
That said, folk medicine does have credence in a lot of Asia (even in China today) due to issues around access and trust. There is a need for mid-level practitioners, and working on mainstreaming and retraining folk medicine practitioners as MLPs could help from a primary care perspective, and is a strategy both China and India are starting to leverage.
> There is a similar trend in India with Aryuveda/Unani.
It might actually be worse. There's a strong religious/nationalist element to some Ayurvedic promoters in India which vociferously rejects any kind of scientific rigor - the attitude amounts to "if Western science says Ayurveda is wrong, Western science must be wrong". TCM doesn't seem to attract the same degree of dogmatism.
It isn't all that different. The religious aspect of Aryuveda/Unani isn't that significant (no one is quoting sutras or the Koran in AYUSH "research"), and Aryuveda/Unani programs (BAMS/BUMS) aren't much different from their TCM equivalents in their "research" (they're aping systemic and evidence based methods the same way TCM "researchers" are) as well as curriculum.
India's AYUSH Ministry (founded 2014) is itself based on China's NATCM and the formalization of TCM in the 60s-70s.
And just like in China, BAMS/BUMS is used as a stopgap MLP in rural and underserved communities the same way TCM is in China.
Both are holdovers from the anti-colonial movement of the 50-70s that continue to be cynically used as stopgaps for failures at expanding MLP in both countries, because no real doctor wants to work in a rural primary clinic earning $200-400/mo when they can demand 6-7x that working as a doctor in an urban area with superior amenities.
That said, I've started seeing much stronger criticism of AYUSH in India than the equivalent for TCM - AYUSH doctors are increasingly shown as "negative" or "antagonist" characters or quacks in most state subsidized TV shows in India, even in BJP ruled states (eg. Gram Chikitsalay (2025) and BJP ruled Madhya Pradesh and Chhattisgarh; Laakhon Mein Ek (2019) and BJP ruled Maharashtra; Panchayat (2025) and BJP ruled Madhya Pradesh and Uttar Pradesh) but recent CDramas like 你好，我的大夫 (2023) and 老中医 (2018) humanize and treat TCM as if it's not a quack field.
I read this response and immediately thought - it's not an exclusive problem of the Chinese academia, Western academia is struggling HARD with the problem.
It's such a big problem in Western academia that the political class in several countries are able to deny "experts", and their understandings.
People in general have seen so many missteps within Western academia, both allowing some really poor science to be published, and wrongly denying (and ridiculing) what turned out to be solid (thankfully some of these things are discovered when actual scientific method is employed and hypothesis are tested), that they are willing to accept politicians who deny science.
The problem exists in Western academia as well, but not to the same magnitude as in much of Asia.
In Western and especially American academia, there are private sector grants and commercialization avenues for research. Outside of top tier programs (think Peking tier programs in China or AIIMS tier programs in India), that's nonexistent in most Asian countries, so your department's funding is at the whim of government bureaucrats who tend to be recruited via civil service exams and promoted based on political loyalty, not based on domain experience.
Furthermore, Folk Medicine programs are heavily sponsored in a number of Asian countries as a misguided attempt at building an MLP pipeline plus as a cash grab by local or provincial governments who often treat these kinds of programs as businesses.
> Outside of top tier programs (think Peking tier programs in China or AIIMS tier programs in India), that's nonexistent in most Asian countries, so your department's funding is at the whim of government bureaucrats
That's a bit surprising, after seeing so many people I know in academia who are basically being used as private sector R&D on the cheap (see all the formal methods work being funded by cryptocurrency outfits...), I would have assumed that most large corporations even outside of "innovation" sectors would take advantage of this.
But maybe this effect in places like the US are just downstream of the wild wage arbitrage you get by doing this.
Because the gap between tier 1 programs and those that aren't is massive in countries like China and India.
Generally, those institutions managed by the central government of both countries are better managed than those under local and provincial governments.
R&D output, calibre of student base, and access to research equipment is also reflected by that trend. And any private sector funding goes to those programs.
And it's hard to describe the mismanagement that happens in lower tier programs in countries like China and India compared to the US - corruption remains a massive issue in both countries.
> In Western and especially American academia, there are private sector grants and commercialization avenues for research. Outside of top tier programs, that's nonexistent in most Asian countries, so your department's funding is at the whim of government bureaucrats who tend to be recruited via civil service exams and promoted based on political loyalty, not based on domain experience.
This is sad, and misinformed.
Multiple countries fund their academic research through the state. Adding the misinformation about being "promoted based on political loyalty" is a strong sign of your bias.
Funding can only come through one of three routes:
1. State - which is where people are supposed to be working for the betterment of their country, but is vulnerable to the bias of the politics of the day.
2. Private - which is where people are motivated by a profit, but is vulnerable to the bias of the politics of the company.
3. Voluntary/Charity - which is where people are motivated by whatever wakes them up in the morning, but is vulnerable to the donors.
ALL funding models are vulnerable to the bias of whoever is in control of the funding.
I'm not saying state funding is bad or private funding is good.
I'm saying that having a mixture of both provides checks and balances to moderate the influence of both.
> Adding the misinformation about being "promoted based on political loyalty" is a strong sign of your bias
I'm talking about countries like China and India, where folk medicines have been politicized, lateral movement into the bureaucracy is non-existent, and criticism against TCM and Aryuveda is being slowly suffocated.
I mean, you could change some trivial details and end up with a valid description of JHU. How much is tuition in Vietnam? There're your "gifts". And so on. What language was "replication crisis" initially coined in? (No, for real, I don't know.)
Public medical school tuition is around $3-6k per year in a country where most households aren't earning above $300/mo, financial aid is nonexistent, and "student loans" for the middle class means going to some tattooed chain smoker jeweler who pounds Ruou San Dinh like water and demands double digit interest rates.
> you could change some trivial details and end up with a valid description of JHU
You don't have JHU students (or any Western medical students) moonlighting as unlicensed doctors under their professors working license and giving them a $200-500/mo cut. This is fairly common at UMP Hanoi and HCMC, let alone lower tier programs. You also don't need to pay a $1-3k bribe in speed money to get your working license in the US.
---------
There's a reason my SO immigrated abroad like a lot of her peers - if you don't have the right connections or enough money (black or white), you will not succeed in Vietnam.
Thao Dien, Landmark 81, Sunrise City, and D1 is not representative of middle class Vietnam - neighborhoods like D10 and Phu Nhuan is.
American medical school tuition is $40k-$70k a year, median monthly household income is about $6.5k. Meanwhile, median household income in Vietnam is actually closer to $650 a month; the population of households earning the lowest amount is quite high, but ~75% of Vietnamese households earn more than $400 a month.
But then, most US households aren't sending their kids to medical school in the US; the income of your average medical student's family is significantly higher than the median here. I'll assume the same is true in Vietnam. Though, if not, and doctors are instead coming from a much more representative sample of the population, good on them; it's better than we've managed.
The differences are colorful but seem to represent a front-loading of obstacles that the US medical education system spreads out on the back end. And there's no higher-earning market to try to get to from here in order to make the math work.
FWIW, the point here is not to lionize Vietnam's system, but to point out how embarrassing that there are any comparisons to be drawn at all between how their schools and one as "prestigious" as JHU operate. And, per the original post I replied to, there are.
Western medicine has a similar history. Treatments did more harm than good prior to the scientific method being used. The poor who couldn't afford to see a doctor were actually better off than the rich who were subjected to all manner of bizarre "remedies".
Western medicine was just as bizarre and ineffectual as TCM in the past. The poor who couldn't afford to see a doctor were actually better off than those who had money.
TCM is not a single branch of "alt" theory, but a clusterfuck of inconsistent, contradictionary schools of thoughts which was umbrella-ed by state funded insitutions after 1949.
Forget blind test, you can get 13 different perscriptions from 10 TCM doctors. I am not joking. During the pandemic, top-notch TCM scholars call Covid-19 warm-disease, another group categorize it as cold-disease. Some others name it wet-disease, they all came up with totally different "treatments", which basically boils down to dead bodies of insects and herbs.
But why do billions of ppl believe in TCM anyway? Because scientific medicine is hard, and does not cover 100% symptoms. AFAIK There isn't a effective cure against viruses like antibiotics. This market is dominated by pain-killers and "alt" medicines. And yes sometimes ppl refuse or forget to take vaccines.
Camptothecin from camptotheca acuminata, precursor of topotecan and irinotecan for solid tumours.
Ephedrine from ephedra sinica -- template for modern bronchodilators and decongestants.
Many others. Omacetaxine, minnelide, and more.
Very often, the first thing a medicinal chemist seeking new drug templates does is look to herbs that are used by indigenous populations or in "traditional" medicine systems. There's an entire journal dedicated to this:
Ironically, you've picked an example (Artemisinin) which is discussed at some length in the linked article - as an example where TCM success is overstated and not backed up by real-world results!
See P5-6 in section "The implausibility problem" - which points out that in order for the treatment to be effective it had to be refined into a form that is not rapidly eliminated from the body.
That's an extremely silly objection when (a) artemisinin is effective as a standalone drug if you administer it frequently enough, (b) the discovery of artemisinin and its derivatives in malaria treatment was quite literally inspired by TCM, and (c) most natural products are modified prior to use in pharmaceutical industry, and artemisinin is particularly lightly modified. (Just given a simple ester in artesunate's case.)
Why should we take TCM any more seriously than traditional western? Do we still boil bark for a headache? Of course not, especially when it comes with so many tannins you get a stomach ache instead?
When you have thousands of years of people writing down their folk cures, sooner or later somebody will be right.
>Why should we take TCM any more seriously than traditional western?
Wasn't the entire idea behind evidence-based medicine to start putting traditional western treatments to the test and check if they actually work? I think we do take traditional western methods quite seriously, and we should do the same with TCM.
With regard to your bark example, right here in the thread someone points out: "E.g. willow bark was used to treat pain for thousands of years, which led to the discovery of aspirin."
It's still not a vindication of TCM specifically. All traditional medicine cultures have contributed something to modern medicine. E.g. willow bark was used to treat pain for thousands of years, which led to the discovery of aspirin. I believe even cholesterol-reducing statins come from traditional medicinal herb.
Naturopathic medicinal cultures aren't totally bullshit. They're just "unscientific" i.e. they haven't gone through the rigors of the scientific method to establish their efficacy, or often their etiologies and mechanisms of action are completely made-up.
> I believe even cholesterol-reducing statins come from traditional medicinal herb.
Yeah, lovastatin comes from red yeast rice, which is also TCM. The other statins are downstream of it.
> Naturopathic medicinal cultures aren't totally bullshit. They're just "unscientific" i.e. they haven't gone through the rigors of the scientific method to establish their efficacy, or often their etiologies and mechanisms of action are completely made-up.
I agree 100%. But natural products are -- and always have been -- the great repository of drug templates. All modern pharmacopoeias owe a real debt to TCM in particular.
Instead of complaining like the guy who wrote the article in OP, it's best to try and take what's good and discard what's bad, without preconceptions or prejudice.
I'm not particularly bought into the traditional chinese medicine stuff but isn't the line more drawn at how "normal" medicine is about synthesizing specific doses of chemicals to give those?
Meanwhile if someone told me "yeah eating a bunch of ginger when you have a cold is good to you because ginger has a bunch of stuff that's good for your body then" I don't have a particularly hard time believing it. Sure! Why not!
The article's critique about symptom management rather than disease management is legit though. And the precision for actual research is good. But at the end of the day if my body needs some stuff for symptom management and some TCM strategy involves me giving myself like 20x the dose of it... well it's something, isn't it? Though you could argue about it "deserving" credit or not.
Nobody whines about the unscientificness of giving yourself a bunch of salt through chicken noodle soup after a hangover.
No... Normal medicine is whatever we know works. It is unfathomably hard to figure out whether something works, ergo it is very specific knowledge (specific isolated compounds in specific amounts).
> well it's something, isn't it?
It's probably not!
If you want to say such remedies produce a placebo effect and that's sufficient for such purposes, IMO that's a valid approach.
Fair enough, I can agree with the idea that you draw the line at "knowledge, gotten in the 'correct' way" as the categorization strategy.
In the abstract I'm open to some specific traditional medicine thing working for "some" reason, but I understand that that makes me (as they say in the industry) a mark.
No no, my point is that it's unbelievably hard to know things. The reason we do unfathomably expensive clinical trials is because that's what's required to isolate signal from noise in a biological system. The reason they fail so frequently is because we're wrong most of the time we try it.
It is absolutely possible to stumble upon things, as is often the origin of hypotheses that develop into drugs, but 99.999% of these will still end up being false.
It's way more likely you found a thing that convinces you it does something desirable in the body than that you actually found something that does something desirable in the body.
> Nobody whines about the unscientificness of giving yourself a bunch of salt through chicken noodle soup after a hangover.
Sure, but that doesn't come with an entire theory about Chi energy lines, and no one claims this is "medicine" either (other than perhaps jokingly).
That's really the key thing. If you want to get a massage, or aromatherapy, or Reiki or whatever just because you like it, then that's fine. I'm happy for you! Massages even have proven benefits. Some may have benefits that are not yet proven. If you start claiming it will cure your cancer however...
This is also why I don't buy "detox" drinks that some restaurants have, even though some of them seem quite nice. The "detox" is just bollocks. I once even saw "detox" coriander leaves in the store. I like coriander. Maybe it's even good for you (I don't know). But "detox" coriander? Just, ugh...
On the other hand, this does lead to a situation where people simultaneously scoff at a school of thought while telling you that all the useful stuff from said school has already been integrated into whatever orthodoxy they represent. Must be nice to be able to claim credit for something while deriding the people who actually discovered it. Not that I'm a huge "stan" for TCM or anything. I'm very much not.
However, the case of meditation/mindfulness shows that it can take a very long time between a treatment being invented and it being proven to work. It was called pseudoscience until it was statistically proven to work. Unproven is not disproven.
But it takes discernment to know which unproven thing might work and won't hurt though. TCM sounds more dangerous than not because the herbs you can get will be unregulated and possibly contaminated.
Something can simultaneously be a pseudo-science and still work. Do some aspects of TCM have benefits? Sure, probably – it's a huge field. But that's more coincidental than anything else, and their mechanisms of action are unrelated to TCM's pseudo-scientific theories. If you go to a forest and start eating random stuff then some will also have some benefit.
I'm not familiar with the history of meditation or mindfulness, but I've seen people claim some pretty ridiculous things about yoga, perhaps the most ludicrous was someone claiming that some positions will prevent certain cancers due to "massaging your organs". Yoga absolutely has benefits but that's just nonsense.
I'm not sure if it was completely original there. It's a relatively common retort now, though I do think that Storm was the first time I recall hearing it.
Western medicine has a similar history. Treatments did more harm than good prior to the scientific method being used. The poor who couldn't afford to see a doctor were actually better off than the rich who were subjected to all manner of bizarre "remedies".
In China, they are capable of having a balanced understanding of which pradigm is suitable for which problems. For small, vague or chronic things like "stress" or "chronic stomach discomfort", they go to a TCM practitioner whereas western medicine doctors can't diagnose and treat that properly. This is combining the best of both worlds.
The prevailing attitude on HN is not to combine strengths, but to dismiss TCM wholesale based on intellectual purity and geopolitical alignment. This is not only willful dismissal of the potentential to improve patient outcomes, but also shuts down curiocity and starting points for new actual scientific discovery.
I suspect this (and political popularity) is why Swiss health insurance covers non-traditional medicine. Must be cheaper for some people to get acupuncture or herbal medicines, even at a markup, as a first-line treatment. And the placebo effect is real, so it's not like it's ineffective for some cases, just not necessarily better than placebo.
Exactly, like for instance I've been sick for 4 weeks until last week, like terribly, fever, throat pain, red eye lids, tiredness. Completely dead, just sleeping whole weekends. At some point I broke up with my gf (bit related, bit unrelated to the fact I was dead lol) and... the next day I'm running around, completely fine, dating and flirting like nothing was wrong.
We then realized that our relationship was too stressful (many factors there), not working, it was making me completely miserable to a point my body was just noping out of life.
Imagine then: should I have taking antibiotics, Panadol, long consultations with specialist ? Or a bit of BS fake juice ? The problem was not solvable by medicine and the government would have had to pay for it - in fact it did since I took all those medications that did nothing much. So not even for the placebo effect, sometimes you're sick because of life (stress is really a sickness inducer) and no amount of pharmaceuticals will truly help you.
Whenever I see stuff about TCM being "vindicated" it's usually stuff like this, along the lines "we found a scientific basis for symptom X being alleviated by chemical C which is found in plant P and traditional medicine indeed suggests using P to treat X". And this article seems to basically be saying the same. Big whoop. It's no surprise that people over time figured out that certain plants might help with certain symptoms, and that later with better science we isolated the specific chemicals in those plants that drive such effects.
Saying this vindicates TCM is like saying chicken soup is vindicated as a cure for what ails you because it turns out that if you're sick it's good to get plenty of fluids and some protein from chicken and vitamins from vegetables.
What matters is not just whether something works, but how it works relative to alternatives, and what its cost/benefit ratio is. If you were living 1000 years ago maybe it made sense to chew willow bark or whatever, but now there's not really a reason to do that instead of just taking aspirin. If you want to eat extra garlic or whatever because it gives you a placebo effect, there's no harm in that, but if you're spending hundreds of dollars on bogus garlic supplements then maybe you're wasting your money.
There are a lot of folk remedies that are harmless in themselves, but their main harm comes when they induce people to reject real solutions.
What an absurd general claim anyway. Triumphantly declaring anything about the wide beliefs of many peoples over thousands of years feels a lot like tilting at windmills. Whoever wrote this paper should not be allowed near the press.
I feel many commentators here are overly dismissive of TCM to the point of intellectual laziness and even geopolitically-motivated paranoia. Yes, there are plenty of things in TCM to be skeptical about, but skepticism shouldn't be about dismissal but about improving tangible outcomes. Regular/western medicine (however you want to call it in contrast to TCM) can treat many big things but I'm sure many of you have had experience with small, vague, chronic things (like "stomach discomfort problems") that doctors have had absolutely no idea how to deal with, and they just send you away with a "take paracetamol for a few weeks and come back when you're nearly dying lol" attitude. In the mean time TCM can treat many of those cases even if you don't believe in their theories.
The current medical paradigm has blind spots, and we should be humble enough to acknowledge that alternative perspectives, even if they're not as rigorous as we'd like, can give us chances to improve patient outcomes. Wholesale dismissal to the point of labeling TCM as "govt propaganda" is forsaking improved patient outcomes for the purpose of winning an argument based on intellectual purity.
It is several orders of magnitude cheaper to produce bullshit than it is to produce truth and/or invalidate bullshit.
The truth value/prediction value for the knowledge system as a whole produced by the invalidation of bullshit is orders of magnitude less valuable than the creation of truth.
Note: the production of bullshit can be VERY economically/socially valuable for the specific producer of bullshit, but emphatically not valuable for the entire knowledge system.
Tolerance of bullshit in a field decreases the likelihood of robust invalidation by others due to the above.
It is a plague on intellectual pursuits, and why we are well aware of several famous “bullshit artists” in the western medical tradition: they are famous because bullshitting is rare, unacceptable, and career destroying.
If that is not true of a knowledge system, you have a culture, not a science.
Culture is great by the way! Awesome! Important! Culture is not meant to be predictive!
Not science though.
Great way to tell if you have a science on your hands or a culture: are extremely large quantities of money dependent upon accuracy of predictions?
If so, you’ve likely got a science! If not, well, might be a culture.
Science is a rather vague term. What you mean is the scientific culture popular in usa, europe etc. Which has definite biases in its vindication process.
The science as we know it is pretty well defined. Involving generating precise hypothesis, doing double blind experiments, evaluating results and making predictions, submitting to peer review for result reproduction.
But TCM would have none of these, so no, it's not "due to bias".
There are always cultural biases. There are always choices of interpretation. Our science does not spring forth fully formed from the observation of phenomena after all
You really don't understand the very definition of science.
It's a means of predicting the success of a hypothesis. It is not a collection of beliefs.
There are plenty of successful hypotheses that science has "proven", which are now accepted by the "scientific community", but the word has an actual definition.
A lot of traditional Chinese medicine is actually based on science. That is: a practitioner had many patients with the same ailment, and would give some of them one medication, and others another medication (herbs usually, o mixes of herbs). They'd then keep notes of what worked and what didn't. Rinse and repeat for a few centuries.
They didn't always understand why this worked, and often attributed it to a lot of ideas that do sound like pseudo-science. But their experimentation was quite methodic.
This isn't ubiquitous. We're talking about thousands of practitioners, in dozens of cultures over millennia. I'm sure some simply sold Chinese snake oil.
I feel TCM's empirical roots probably did stumble on some real remedies (many people I know, including myself, have definitely benefited from certain aspects of TCM, especially acupuncture), but there's a problem.
It's a kind of proto-clinical research, and without the methodological discipline of Randomized Control Trials (RCT), it's easy to draw the wrong conclusions from observations. Some observations with small effect sizes might be accepted as truth.
It's not that it doesn't work all the time, but that the conclusions are noisy.
(that said, RCT is not perfect either because the body is a complex variegated thing with feedback loops that we can't fully map, and many interventions have tail risks. But as far as principled approaches for getting at the truth go, RCT offers just one more guardrail against confirmation bias).
Eh, the replication crisis shows that the "methodological discipline" of RCTs is really not all that strong. But they're still better than nothing. I think you've set up a false dichotomy.
If the effect size for a given treatment was small, I would expect it to be outcompeted by other treatments with larger effect sizes. Practitioners who are disciplined in their thinking will make better discoveries, can treat patients more effectively, and will have more business, thereby training more apprentices in their methods. Over hundreds of years, it's easy to see how this process finds treatments with relatively large effect sizes.
This isn't true at all. It's even stated in the article that TCM was popularized in the 50s. Prior to the 50s it was no different to medicine practiced anywhere else in the world before science figured out whats worked. Modern science extracted the specific elements from herbs and such that are effective and figured out dosages to apply. TCM is very much hit and miss. You're also not allowed to give it to children. Because they have no real idea of the dosage given.
No, just like with Ayurveda there is plenty of actual stuff they stumbled on through trial and error.
In Ayurveda- Turmeric has medically validated anti inflammatory effects, exactly what it has been traditionally used for. Triphala for GI health, Boswell is for joint paint and arthritis, Neem as an antimicrobial, Arjuna for hypertension, Ashwagandha for anxiety etc.
There are a lot of these trial and error medications that do work. The ratio is definitely not 98:2, more along the lines of 70:30.
It’s not insignificant though. There are hundreds of medically validated remedies and that’s scratching the surface of hundreds of thousands of potential plants.
That's not what was being said. They are saying that when your body does something different, in this case producing fever, it is (often) because of a change in the level of some number of proteins. You get new copies of proteins through gene transcription, and these changes (both increase and decrease) can be detected through changes in the levels of the transfer RNA corresponding to those proteins. Look up differential transcription analysis for more information.
My favorite paragraph lands near the end, after a great debunking of the paper:
> The authors behind the paper drawing connections between symptoms, proteins, and Chinese herbs are hopeful that their model will show which herbs used in TCM seem particularly promising. They claim that chemicals in some herbs are known to interact with the same proteins involved in a particular symptom, but that this herb-symptom association has so far been ignored by TCM practitioners. They give several examples, such as Aristolochia fangchi known colloquially as Fang Ji which, based on their computer work, could help with abdomen distention. Patients beware: that plant was used in the 1990s instead of the listed herb as part of a slimming regimen in Belgium, where it caused “an outbreak of terminal renal failure.” That is something that abstract maps of chemical interactions may not tell you, but we should not forget what we already know from experience.
In 2015, the Nobel Prize in Medicine was won by Tu Youyou.
During the Vietnamese resistance war, Vietnamese moving down the Ho Chi Minh rail were contracting malaria in the jungle. The Chinese were asked for aid, and Tu Youyou was tasked with assembling a team to help.
One thing Tu Youyou did was consult "traditional Chinese medicine" with how to aid victims of malaria. Most of what she found did not work, but wormwood did produce results. Tu Youyou again consulted traditional Chinese medicinal texts and they said wormwood should be used with cold water. The team extracted artemisinin from the wormwood in cold water, and a new (and old) way of fighting malaria was born.
> Most of what she found did not work, but wormwood did produce results.
TCM is interesting: There are countless different TCM preparations that do nearly nothing are can be actively harmful to the kidneys or liver, but every once in a while there is a a novel compound discovered in some plant somewhere that does something.
I can’t tell how much of this is because TCM has some treatments that actually work, or if it’s a case of a broken clock being right twice a day. I suspect it’s more of the latter.
Just because we have made innovations in the method of research and discovery doesn't mean that we should throw away everything that we had before.
Around me I see practices like "gratitude", "meditation" and "breathing exercises" get bandied around like they're some new profound thing as if we hadn't known about for thousands of years that have appeared in various guises universally throughout different civilisations.
Just because the metaphors and models of explanations could be flawed doesn't mean the effects should be thrown out
Edit: I have a good friend, a scientist no less, who suffered from severe eczema and was completely let down by western medicine who was put through decades of progressively stronger and stronger steroids. Nothing worked. Eventually the doctors gave up and shrugged their shoulders and was advised to give "alternative medicine" a go. Desperate my friend visited a traditional Chinese doctor who was prepared to guide them through a rigorous exclusion diet while also preparing mystery herb soup and suddenly a lifetime of eczema subsided and became very manageable.
The older I get the more determined I find myself trying to glean the accrued wisdom of people who came before us...
"Around me I see practices like "gratitude", "meditation" and "breathing exercises" get bandied around like they're some new profound thing as if we hadn't known about for thousands of years that have appeared in various guises universally throughout different civilisations."
These have been VASTLY improved and optimized compared to their traditional counterparts. Evidence-based trials with brain scans, and other methods.
For example, achieving strong vagus nerve stimulation on demand to activate the parasympathetic nervous system could take years(or they might never get there) to learn for traditional Buddhist meditation practitioners, and nowadays we get there in a few sessions of EMDR therapy.
> Around me I see practices like "gratitude", "meditation" and "breathing exercises" get bandied around like they're some new profound thing as if we hadn't known about for thousands of years that have appeared in various guises universally throughout different civilisations.
Most people don’t care where, when, or why a concept was invented as long as it works.
Quibbling over who discovered it first or trying to drag the conversation back to who discovered it first is like the person who tries to claim credit for being into a band before they were popular: Nobody cares, they just want to enjoy it.
> The older I get the more determined I find myself trying to glean the accrued wisdom of people who came before us...
Going back to the actual article: There is a big illusion of accrued wisdom of the ancients in TCM that isn’t backed up by the research. There are occasional hits where a TCM preparation intersects with a truly active compound, but it should be raising red flags when TCM practitioners claim to have cures for everything and different TCM practitioners will come up with different answers for the same patient. When the first one doesn’t work they’ll have another answer the next visit, and the next visit, and so on.
An odd criticism. Would it be better if, when the treatment didn't work, they just prescribed the same thing?
I mean, most of TCM is pure bunkum, but blaming them for continuing to try to fix the problem is odd.
The criticism is that they claimed to have the solution the first time, instead of only claiming that they will try something functionally random.
A methodical process and a random or intuitive process only look like the same trial and error on the outside, and only to the (probably willfully) ignorant.
The trappings and ceremony of a theory and methodology are not actually a theory or methodology.
It doesn't do anyone any good to allow any confusion of the two.
A lot of scientists dabbled into pseudoscience but that doesn't invalidate their scientific accomplishment, and their scientific achievement doesn't validate their pseudoscientific pursuit
> doesn't validate their pseudoscientific pursuit
If you take an idea with a pseudoscientific origin, and you test it in a sound scientific way, you're doing science, not pseudoscience.
I am sure there are some truths in some thousand years of research, ala "Don't throw the baby out with the bathwater", but that doesn't validate the system or study as a whole.
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I am biased as an ethnic Chinese, but I feel modern medicine is afraid that it's approach, the sum of parts empiricism may be incomplete, in that we dont understand all the parts yet.
The human body is not just human DNA organs working together, but also an ecosystem with myriad bacteria, and we are still in infancy when it comes to understanding the bacteria.
TCM seeks a black box metaphorical approach, which sounds like quackery but I do think it is capable of addressing _some_ blindspots in modern medicine, eg why some medication would work on a yin body but not a yang body... the difference is in the bacterial ecosystem.
That said, I see TCM (and other traditional approaches) as a last resort when modern medicine fails, and I certainly agree the approach is incapable of resisting shamanic beliefs.
Why not apply scientific method to Traditional Chinese Medicine and use double blinded placebo controlled trials to test its validity? In the end also modern medicine is using exactly this method and can treat substances using the black box method.
This is already being done and in many cases the RCTs show that the TCM treatments are effective.
There's a whole article about exactly this and it can be accessed by clicking the title of this page. And guess what it's saying.
Do you know what "RCT" stands for?
They are doing that — in China, in Chinese papers. Not everything has been researched yet, but there's quite a lot of active research going on.
The fundamental problem is TCM acknowledges individual differences that cannot be measured or even dont exist in the eyes of modern medicine, eg identical twins with different diets will have different responses to the same treatment, so going double blind will mean the results will be inconsistent.
Ah, the old "if you try to test for results, the results won't show up" problem.
Ghosts and ESP suffer from the same issue.
This is why sample size is important tho. With a large enough sample size, you can ignore differences in individuals bc the trend of the control will be smaller than the experiment (or not)
That's the fundamental problem right there.
You have no problem accepting eg a treatment can only work on a man, but not on a woman. But modern medicine have no concept of a yin body type and a yang body type, which may or may not be male and female.
The whole idea of TCM is balance, and it varies with the individual, unlike modern medicine, where there is a right and wrong answer to everything. Bacteria bad, antibiotic good. Fever bad, paracetamol good.
Take fecal transplants for example. I dont think it is well understood how it works or it will be a pill by now, and is a last resort when all else fails. And it doesnt involve killing all the bacteria, but restoring balance to the bacterial ecosystem.
you could design a study to do any of this. it isn't done because a proof of failure kills sales more than a lack of proof.
Is this yin, yang somehow measurable? If not then there is a fundamental problem.
Also Western medicine is very well aware of side effects, it's actually one of the fundamental concepts. For example it knows that taking Paracetamol is good against pain, but increases risk to the liver, especially when taken with alcohol. It's also very well aware of causes of fever and doesn't recommend lowering it for the sake of it, only from certain dangerous level. It also knows that taking antibiotics affects gut bacteria, so it's often recommended to take also probiotics. It knows that some medicine could affect women differently, especially when they are pregnant or are breast feeding. The list goes on, it's never black and white.
I am also Chinese and this is exactly how I feel. The experience of going to a doctor with minor ailments, only to be sent away with the attitude of "take some paracetamol and come back when symptoms worsen" is maddening. In the mean time TCM practitioners have answers that often work for these kinds of things.
In people's zeal to point out TCM's problems (due to its pre-modern scientific roots), I feel like they're also throwing away its potential. Skepticism shouldn't be about wholesale dismissal (which is just intellectual laziness masked as rightenousness) but about improving outcomes.
> In the mean time TCM practitioners have answers that often work for these kinds of things.
You can also take some homeopathic remedies and do a couple of chiropractic adjustments meanwhile. I've also heard that some Christian Science practitioners work wonders if you give them all your Earthly belongings.
The ability to say: "It's likely a viral disease. Wait and see if it worsens" - is a pretty powerful point _in_ _favor_ of modern medicine.
The unspoken part is the human mind is a big part in health, and treatments that does nothing medically but fools the human mind can work wonders too. There is a lot we do not understand yet, just as blood letting was conventional medicine a few hundred years ago, and it isnt even entirely wrong since we still use leeches and some treatment, I think we have much to gain if we are not hasty in dismissing alternative approaches.
That said, I fully agree homeopathy and chiropractherapy are full of bullshit and potentially dangerous. TCM, as practiced in a certified scholarly environment in Asia, expects the practitioner to have a considerable basic knowledge in modern medicine too, and is humble enough to acknowledge TCM cannot solve everything. A good TCM practitioner will refer you to a GP when they know modern medicine is more effective.
And just who here is rejecting the viral model? Saying "other practitions have stuff worth exploring" is not at all the same as "the regular western medicine model should be abandoned". Why do you feel threathened? This makes no sense to me.
Yet the inverse is not true: the prevailing attitude on HN here is not "western medicine is here to stay as staple but other practitions can add value on top", but to dismiss other practitions wholesale based on their inability to conform to intellectual standards, regardless of measurable outcomes. This is "my god is the only god" all over again.
A chiropractor was able to heal my back problems where months of going to a physiotherapist failed to do so. Aren't we supposed to stay humble and curious for new avenues of scientific exploration, rather than dismissing everything we don't understand?
Chiropractic was invented in the the US, in the 1800s, by a spiritualist. It's not TCM, it's TAM (Traditional American Medicine) :-P
Yes, chiropractic has gotten an overly negative internet image.
It truly is mostly quackery (varying by the practitioner, and how much kool-aid they've drunk), but there are problems that it can fix.
I had pain going up and down steps for over a year; one THUNK! adjustment by a chiro, and that pain was gone forever (or at least the last 30 years).
That being said: chiros can't fix most of the things its most ardent supporters claim... who are quacks, and very vocal, unfortunately.
This is also how I feel as well.
There are symptoms and idiopathic conditions I've had that multiple specialists at top-tier hospitals were unable to diagnose, but mostly because they were too-narrowminded in their approach (blood tests, etc.) to see the big picture.
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All forms of medicine, new or ancient, should undergo validation and integrated into "mainstream" medicine. If wormwood worked but only when using cold water, study that extract, isolate the compound to promote reproducibility of benefits and minimize side-effects from unnecessary compounds, and attempt mass production at cheap prices for public benefit without destroying the environment.
How else can we foster trust that medicines are reliable?
Modern medicine was born by consolidating and empirically scrutinizing thousands of years of all sorts of medicine.
Lumping all aspects of TCM into one thesis to be proved or disproved seems ill-advised. Would you think of treating western medicine, and all the ground it covers as a single monolithic field to prove/disprove?
Anyone is free to use the well tested scientific methods to show if a claim is true or not (medicine or otherwise). There is no need to prefix it western-, modern-, traditional-, chinese, ayurvedic- etc. If it works it is just medicine.
There is no such things as chinese physics, ayurvedic chemistry, traditional biolgy.
The placebo effect is a helluva drug.
Most illnesses take care of themselves in about a week or so.
The Chinese and Korean golden herbs ginseng is way overrated. Just consume ginger instead of the 100x more expensive ginseng for all the recipes that people been come up over the centuries and the nutritional benefits probably the same if not better. It is essentially an overpriced souvenirs for your in-laws, that's it.
I've taken pretty low grade ginseng and gotten a pretty noticeable stimulant effect from it. That's certainly never happened with ginger.
Care to provide details of the stimulant effect that you were experiencing?
I'm mainly referring on the nutritional and health benefits that the in-laws perceived if they were bought as souvenir a few thousands dollars worth of 1 kg ginseng as opposed to the equivalent of 1 kg ginger worth a few dollars [1],[2].
[1] Ginseng:
https://en.wikipedia.org/wiki/Ginseng
[2] Ginger:
https://en.mmwikipedia.org/wiki/Ginger
I recommend Examine.com for supplement literature reviews which are far more in-depth than Wikipedia.
"Research indicates that American ginseng may improve short-term working memory and reaction time, particularly at lower doses, and some positive results were noted in older adults and people with schizophrenia. However, the overall effectiveness on cognition remains uncertain because no significant improvements were found in verbal memory or attention."
https://examine.com/supplements/american-ginseng-panax-quinq...
China is in a bind; for propaganda reasons, they can’t back down from their support of “traditional Chinese *”, just like the USSR with Lysenkoism.
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My prediction: within 50-100 years, traditional Chinese medicine will be like osteopathy in the United States: impossible to distinguish from mainstream modern medicine, even though it bears a name reflecting its origins in pseudoscience.
It'll be easy enough for them to manage from a perception standpoint. They'll just declare that modern medicine has recognized and assimilated the concepts of traditional Chinese medicine, that "modern" medicine as taught and practiced in the west now reflects traditional Chinese concepts, and that western medicine and traditional Chinese medicine have evolved convergently to the same point because western medicine copied Chinese medicine. It'll be accepted by people who know better as a polite lie.
The original appeal of traditional Chinese medicine to the Chinese government was that it made it possible for them to provide a form of officially recognized health care to the entire population long before they were able to train enough doctors. From the government's point of view, there's no reason for it to outlive that necessity. If they want a flood of chauvinistic pro-TCM propaganda to proclaim Chinese superiority -- maybe they do, maybe they don't -- they can do that while at the same time having schools of TCM teach basically the same thing as western medical schools.
>They'll just declare that modern medicine has recognized and assimilated the concepts of traditional Chinese medicine
That's actually happening though. See this text for example: https://www.amazon.com/Introduction-Western-Medical-Acupunct...
Chinese civilization has had a population of hundreds of thousands of people going back many hundreds of years. It's not the least bit surprising that they've figured out useful stuff about medicine. Even if you believe that the TCM theories are wrong, and it was all trial and error, the default position should be that it's possible to identify useful treatments through trial and error. It's Western chauvinism to believe that useful treatments can only be discovered via Western methods.
Acupuncture is like herbal supplements. There are studies you can point to if you want to defend it, which is handy for people who make money on it.
I know a guy who worked for a veterinary clinic for years and used to bellyache about how the owner was a hippy dippy quack who was promoting alternative treatments like acupuncture and herbalism, and it was fine if people were morons and chose that stuff for themselves, but to use it on animals, yadda yadda yadda.
Then he bought the clinic from her. Less than a year later, he was certified in veterinary acupuncture and was making sure that new vets he hired were down with alternative medicine. "There are studies...." Yeah, you knew about those studies before, when you were calling it an unethical scam. We all know what new information changed your mind, and it wasn't in veterinary journals, it was in the finances of the clinic you just bought. Lost a lot of respect for that guy overnight.
Well yeah, and the anti-vax people will point out that big pharma is making money off of the vaccines. That's not a counterargument.
The whole point is that science is the difference. Vaccines work. The business of selling vaccines might be sleazy because of the way they go about it, but the product itself isn't a scam.
It's like claiming that used cars were a scam only because used car dealers are... well you name them.
"There are studies you can point to if you want to defend it, which is handy for people who make money on it." -- Anti-vaxxer
> That's actually happening though.
No, it is not.
From <https://en.wikipedia.org/wiki/Acupuncture>:
“Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientific knowledge, and it has been characterized as quackery.”
(Now you either accuse Wikipedia of Western chauvinism or dismiss Wikipedia altogether.)
Notice that Wikipedia talks about acupuncture vs "sham acupuncture".
That's intellectually dishonest IMO. They should just compare acupuncture against placebo pills.
The problem with making that comparison is that if you do, acupuncture beats placebo! So the western scientists who need acupuncture to lose had to come up with a new "placebo". Hence "sham acupuncture".
The problem with "sham acupuncture" is that it is designed to mimic the physical sensation of acupuncture. But if you read the text I linked, it explains that acupuncture works primarily via the nervous system! So "sham acupuncture" is basically the real thing. Total intellectual dishonesty.
Go on Amazon and search for "acupuncture mat". You'll find lots of plastic mats that don't penetrate the skin, but replicate the sensation of penetrative acupuncture, with many many 5-star reviews. I often fall asleep on an acupuncture mat. The sensation in my back muscles is unmistakeable after 15 minutes.
Saying "acupuncture doesn't do anything", for me at least, is like saying "alcohol doesn't do anything". It's just absurd, and I don't need an RCT to classify it as absurd. (I've recommended acupuncture to others; some have an immediate strong response like me, others find it useless. Maybe it's variation in how the nervous system works.)
Anyways, if you read the textbook I recommended, it says many of the same things as Wikipedia. The needle location doesn't matter a ton. The stuff about meridians has no scientific basis. That's why they call it a "Western Medical Acupuncture" text. But acupuncture is still a useful treatment and has proven so in many RCTs.
I will never, ever, ever see an “osteopath”. Or a chiropractor.
It’s a red flag for critical thinking capabilities.
I believe that dkarl’s point was that what is now called “osteopathy” in the US is functionally the same as modern medicine, since that is what actually works. But they keep the name for its brand recognition. (But even if this is true, there is still every reason to avoid it, since if its practitioners were any good, one would assume they would rather be regular medical practitioners.)
Well marketted placebo has it's place, ancient wisdom/mysticism more useful make believe than plethora of of modern health supplments backed by mediocre "research". It's easier placebo narrative to believe in.
E: A 100b (possibly multiple) industry doesn't hurt either, which is... shockingly large. I was going to joke people spend more on dumber things to feel good, but that's... a solid chunk of change.
Given the prodigious amount of pro-TCM papers coming out of China, I am concerned about a 51%-type attack on our peer review process that will take decades if not centuries to undo.
The simple truth is that if not all players are playing by the same rules, we can’t treat the output of the game as a monolithic corpus of factual knowledge. That needed to happen a long time ago, so maybe it’s for the best to be forced to come up with a different strategy.
There isn't much strategy behind pro-TCM papers other than "publish and perish" due to the hyper-competitive and metrics driven nature of Chinese academia. Most of these papers will be published in lower tier journals and used as a line-item within their CV in order to meet departmental KPIs or get promotions or funding, and some nameless bureaucrat won't care because metrics have been hit and his ass has been covered.
My SO had to publish similar kinds of papers when she was in Vietnam - she also had to spend $4-6k in "gifts" for the members of her thesis defense committee (despite her earning a stipend of around $100/mo) and publish politically oriented papers otherwise some technicality would come up to prevent her from getting permission for further research in Japan on an ASEAN grant, and this was at Vietnam's equivalent of JHU.
There is a similar trend in India with Aryuveda/Unani.
The strategic and commercialized research that matters always aligns tends to align with modern medicine.
That said, folk medicine does have credence in a lot of Asia (even in China today) due to issues around access and trust. There is a need for mid-level practitioners, and working on mainstreaming and retraining folk medicine practitioners as MLPs could help from a primary care perspective, and is a strategy both China and India are starting to leverage.
> There is a similar trend in India with Aryuveda/Unani.
It might actually be worse. There's a strong religious/nationalist element to some Ayurvedic promoters in India which vociferously rejects any kind of scientific rigor - the attitude amounts to "if Western science says Ayurveda is wrong, Western science must be wrong". TCM doesn't seem to attract the same degree of dogmatism.
It isn't all that different. The religious aspect of Aryuveda/Unani isn't that significant (no one is quoting sutras or the Koran in AYUSH "research"), and Aryuveda/Unani programs (BAMS/BUMS) aren't much different from their TCM equivalents in their "research" (they're aping systemic and evidence based methods the same way TCM "researchers" are) as well as curriculum.
India's AYUSH Ministry (founded 2014) is itself based on China's NATCM and the formalization of TCM in the 60s-70s.
And just like in China, BAMS/BUMS is used as a stopgap MLP in rural and underserved communities the same way TCM is in China.
Both are holdovers from the anti-colonial movement of the 50-70s that continue to be cynically used as stopgaps for failures at expanding MLP in both countries, because no real doctor wants to work in a rural primary clinic earning $200-400/mo when they can demand 6-7x that working as a doctor in an urban area with superior amenities.
That said, I've started seeing much stronger criticism of AYUSH in India than the equivalent for TCM - AYUSH doctors are increasingly shown as "negative" or "antagonist" characters or quacks in most state subsidized TV shows in India, even in BJP ruled states (eg. Gram Chikitsalay (2025) and BJP ruled Madhya Pradesh and Chhattisgarh; Laakhon Mein Ek (2019) and BJP ruled Maharashtra; Panchayat (2025) and BJP ruled Madhya Pradesh and Uttar Pradesh) but recent CDramas like 你好，我的大夫 (2023) and 老中医 (2018) humanize and treat TCM as if it's not a quack field.
I read this response and immediately thought - it's not an exclusive problem of the Chinese academia, Western academia is struggling HARD with the problem.
It's such a big problem in Western academia that the political class in several countries are able to deny "experts", and their understandings.
People in general have seen so many missteps within Western academia, both allowing some really poor science to be published, and wrongly denying (and ridiculing) what turned out to be solid (thankfully some of these things are discovered when actual scientific method is employed and hypothesis are tested), that they are willing to accept politicians who deny science.
The problem exists in Western academia as well, but not to the same magnitude as in much of Asia.
In Western and especially American academia, there are private sector grants and commercialization avenues for research. Outside of top tier programs (think Peking tier programs in China or AIIMS tier programs in India), that's nonexistent in most Asian countries, so your department's funding is at the whim of government bureaucrats who tend to be recruited via civil service exams and promoted based on political loyalty, not based on domain experience.
Furthermore, Folk Medicine programs are heavily sponsored in a number of Asian countries as a misguided attempt at building an MLP pipeline plus as a cash grab by local or provincial governments who often treat these kinds of programs as businesses.
> Outside of top tier programs (think Peking tier programs in China or AIIMS tier programs in India), that's nonexistent in most Asian countries, so your department's funding is at the whim of government bureaucrats
That's a bit surprising, after seeing so many people I know in academia who are basically being used as private sector R&D on the cheap (see all the formal methods work being funded by cryptocurrency outfits...), I would have assumed that most large corporations even outside of "innovation" sectors would take advantage of this.
But maybe this effect in places like the US are just downstream of the wild wage arbitrage you get by doing this.
Because the gap between tier 1 programs and those that aren't is massive in countries like China and India.
Generally, those institutions managed by the central government of both countries are better managed than those under local and provincial governments.
R&D output, calibre of student base, and access to research equipment is also reflected by that trend. And any private sector funding goes to those programs.
And it's hard to describe the mismanagement that happens in lower tier programs in countries like China and India compared to the US - corruption remains a massive issue in both countries.
> In Western and especially American academia, there are private sector grants and commercialization avenues for research. Outside of top tier programs, that's nonexistent in most Asian countries, so your department's funding is at the whim of government bureaucrats who tend to be recruited via civil service exams and promoted based on political loyalty, not based on domain experience.
This is sad, and misinformed.
Multiple countries fund their academic research through the state. Adding the misinformation about being "promoted based on political loyalty" is a strong sign of your bias.
Funding can only come through one of three routes:
1. State - which is where people are supposed to be working for the betterment of their country, but is vulnerable to the bias of the politics of the day.
2. Private - which is where people are motivated by a profit, but is vulnerable to the bias of the politics of the company.
3. Voluntary/Charity - which is where people are motivated by whatever wakes them up in the morning, but is vulnerable to the donors.
ALL funding models are vulnerable to the bias of whoever is in control of the funding.
> Adding the misinformation about being "promoted based on political loyalty" is a strong sign of your bias.
So, you are claiming that promotions based on political loyalty does not happen in Asian countries? I'd say that shows a pretty strong bias.
I'm not saying state funding is bad or private funding is good.
I'm saying that having a mixture of both provides checks and balances to moderate the influence of both.
> Adding the misinformation about being "promoted based on political loyalty" is a strong sign of your bias
I'm talking about countries like China and India, where folk medicines have been politicized, lateral movement into the bureaucracy is non-existent, and criticism against TCM and Aryuveda is being slowly suffocated.
>and this was at Vietnam's equivalent of JHU.
I mean, you could change some trivial details and end up with a valid description of JHU. How much is tuition in Vietnam? There're your "gifts". And so on. What language was "replication crisis" initially coined in? (No, for real, I don't know.)
> How much is tuition in Vietnam
Public medical school tuition is around $3-6k per year in a country where most households aren't earning above $300/mo, financial aid is nonexistent, and "student loans" for the middle class means going to some tattooed chain smoker jeweler who pounds Ruou San Dinh like water and demands double digit interest rates.
> you could change some trivial details and end up with a valid description of JHU
You don't have JHU students (or any Western medical students) moonlighting as unlicensed doctors under their professors working license and giving them a $200-500/mo cut. This is fairly common at UMP Hanoi and HCMC, let alone lower tier programs. You also don't need to pay a $1-3k bribe in speed money to get your working license in the US.
---------
There's a reason my SO immigrated abroad like a lot of her peers - if you don't have the right connections or enough money (black or white), you will not succeed in Vietnam.
Thao Dien, Landmark 81, Sunrise City, and D1 is not representative of middle class Vietnam - neighborhoods like D10 and Phu Nhuan is.
American medical school tuition is $40k-$70k a year, median monthly household income is about $6.5k. Meanwhile, median household income in Vietnam is actually closer to $650 a month; the population of households earning the lowest amount is quite high, but ~75% of Vietnamese households earn more than $400 a month.
But then, most US households aren't sending their kids to medical school in the US; the income of your average medical student's family is significantly higher than the median here. I'll assume the same is true in Vietnam. Though, if not, and doctors are instead coming from a much more representative sample of the population, good on them; it's better than we've managed.
The differences are colorful but seem to represent a front-loading of obstacles that the US medical education system spreads out on the back end. And there's no higher-earning market to try to get to from here in order to make the math work.
FWIW, the point here is not to lionize Vietnam's system, but to point out how embarrassing that there are any comparisons to be drawn at all between how their schools and one as "prestigious" as JHU operate. And, per the original post I replied to, there are.
Shot: https://www.google.com/search?q=jhu%20retracted%20study
Chaser: https://www.thebaltimorebanner.com/education/higher-educatio...
Western medicine has a similar history. Treatments did more harm than good prior to the scientific method being used. The poor who couldn't afford to see a doctor were actually better off than the rich who were subjected to all manner of bizarre "remedies".
Root of curiosity: https://news.ycombinator.com/item?id=44466838
Western medicine was just as bizarre and ineffectual as TCM in the past. The poor who couldn't afford to see a doctor were actually better off than those who had money.
TCM is not a single branch of "alt" theory, but a clusterfuck of inconsistent, contradictionary schools of thoughts which was umbrella-ed by state funded insitutions after 1949.
Forget blind test, you can get 13 different perscriptions from 10 TCM doctors. I am not joking. During the pandemic, top-notch TCM scholars call Covid-19 warm-disease, another group categorize it as cold-disease. Some others name it wet-disease, they all came up with totally different "treatments", which basically boils down to dead bodies of insects and herbs.
But why do billions of ppl believe in TCM anyway? Because scientific medicine is hard, and does not cover 100% symptoms. AFAIK There isn't a effective cure against viruses like antibiotics. This market is dominated by pain-killers and "alt" medicines. And yes sometimes ppl refuse or forget to take vaccines.
Did someone poke you with one too many accupunture needles?
You know what they call alternative medicine that's been proved to work? - Medicine.
—Tim Minchin
TCM has a lot of wins along just those lines. For instance:
Artemisinin (qinghaosu) from artemisia annua. This won the 2015 Nobel Prize, and is now the cornerstone of global malaria therapy.
Arsenic trioxide, the purified form of the TCM mineral pishuang, now a very common treatment for acute promyelocytic leukemia. Often curative in a single dose: https://www.sciencedirect.com/science/article/pii/S221304891...
Camptothecin from camptotheca acuminata, precursor of topotecan and irinotecan for solid tumours.
Ephedrine from ephedra sinica -- template for modern bronchodilators and decongestants.
Many others. Omacetaxine, minnelide, and more.
Very often, the first thing a medicinal chemist seeking new drug templates does is look to herbs that are used by indigenous populations or in "traditional" medicine systems. There's an entire journal dedicated to this:
> https://www.sciencedirect.com/journal/journal-of-ethnopharma...
Ironically, you've picked an example (Artemisinin) which is discussed at some length in the linked article - as an example where TCM success is overstated and not backed up by real-world results!
See P5-6 in section "The implausibility problem" - which points out that in order for the treatment to be effective it had to be refined into a form that is not rapidly eliminated from the body.
That's an extremely silly objection when (a) artemisinin is effective as a standalone drug if you administer it frequently enough, (b) the discovery of artemisinin and its derivatives in malaria treatment was quite literally inspired by TCM, and (c) most natural products are modified prior to use in pharmaceutical industry, and artemisinin is particularly lightly modified. (Just given a simple ester in artesunate's case.)
Why should we take TCM any more seriously than traditional western? Do we still boil bark for a headache? Of course not, especially when it comes with so many tannins you get a stomach ache instead?
When you have thousands of years of people writing down their folk cures, sooner or later somebody will be right.
>Why should we take TCM any more seriously than traditional western?
Wasn't the entire idea behind evidence-based medicine to start putting traditional western treatments to the test and check if they actually work? I think we do take traditional western methods quite seriously, and we should do the same with TCM.
With regard to your bark example, right here in the thread someone points out: "E.g. willow bark was used to treat pain for thousands of years, which led to the discovery of aspirin."
It's still not a vindication of TCM specifically. All traditional medicine cultures have contributed something to modern medicine. E.g. willow bark was used to treat pain for thousands of years, which led to the discovery of aspirin. I believe even cholesterol-reducing statins come from traditional medicinal herb.
Naturopathic medicinal cultures aren't totally bullshit. They're just "unscientific" i.e. they haven't gone through the rigors of the scientific method to establish their efficacy, or often their etiologies and mechanisms of action are completely made-up.
> I believe even cholesterol-reducing statins come from traditional medicinal herb.
Yeah, lovastatin comes from red yeast rice, which is also TCM. The other statins are downstream of it.
> Naturopathic medicinal cultures aren't totally bullshit. They're just "unscientific" i.e. they haven't gone through the rigors of the scientific method to establish their efficacy, or often their etiologies and mechanisms of action are completely made-up.
I agree 100%. But natural products are -- and always have been -- the great repository of drug templates. All modern pharmacopoeias owe a real debt to TCM in particular.
Instead of complaining like the guy who wrote the article in OP, it's best to try and take what's good and discard what's bad, without preconceptions or prejudice.
I'm not particularly bought into the traditional chinese medicine stuff but isn't the line more drawn at how "normal" medicine is about synthesizing specific doses of chemicals to give those?
Meanwhile if someone told me "yeah eating a bunch of ginger when you have a cold is good to you because ginger has a bunch of stuff that's good for your body then" I don't have a particularly hard time believing it. Sure! Why not!
The article's critique about symptom management rather than disease management is legit though. And the precision for actual research is good. But at the end of the day if my body needs some stuff for symptom management and some TCM strategy involves me giving myself like 20x the dose of it... well it's something, isn't it? Though you could argue about it "deserving" credit or not.
Nobody whines about the unscientificness of giving yourself a bunch of salt through chicken noodle soup after a hangover.
No... Normal medicine is whatever we know works. It is unfathomably hard to figure out whether something works, ergo it is very specific knowledge (specific isolated compounds in specific amounts).
> well it's something, isn't it?
It's probably not!
If you want to say such remedies produce a placebo effect and that's sufficient for such purposes, IMO that's a valid approach.
Fair enough, I can agree with the idea that you draw the line at "knowledge, gotten in the 'correct' way" as the categorization strategy.
In the abstract I'm open to some specific traditional medicine thing working for "some" reason, but I understand that that makes me (as they say in the industry) a mark.
No no, my point is that it's unbelievably hard to know things. The reason we do unfathomably expensive clinical trials is because that's what's required to isolate signal from noise in a biological system. The reason they fail so frequently is because we're wrong most of the time we try it.
It is absolutely possible to stumble upon things, as is often the origin of hypotheses that develop into drugs, but 99.999% of these will still end up being false.
It's way more likely you found a thing that convinces you it does something desirable in the body than that you actually found something that does something desirable in the body.
> Nobody whines about the unscientificness of giving yourself a bunch of salt through chicken noodle soup after a hangover.
Sure, but that doesn't come with an entire theory about Chi energy lines, and no one claims this is "medicine" either (other than perhaps jokingly).
That's really the key thing. If you want to get a massage, or aromatherapy, or Reiki or whatever just because you like it, then that's fine. I'm happy for you! Massages even have proven benefits. Some may have benefits that are not yet proven. If you start claiming it will cure your cancer however...
This is also why I don't buy "detox" drinks that some restaurants have, even though some of them seem quite nice. The "detox" is just bollocks. I once even saw "detox" coriander leaves in the store. I like coriander. Maybe it's even good for you (I don't know). But "detox" coriander? Just, ugh...
On the other hand, this does lead to a situation where people simultaneously scoff at a school of thought while telling you that all the useful stuff from said school has already been integrated into whatever orthodoxy they represent. Must be nice to be able to claim credit for something while deriding the people who actually discovered it. Not that I'm a huge "stan" for TCM or anything. I'm very much not.
However, the case of meditation/mindfulness shows that it can take a very long time between a treatment being invented and it being proven to work. It was called pseudoscience until it was statistically proven to work. Unproven is not disproven.
But it takes discernment to know which unproven thing might work and won't hurt though. TCM sounds more dangerous than not because the herbs you can get will be unregulated and possibly contaminated.
Something can simultaneously be a pseudo-science and still work. Do some aspects of TCM have benefits? Sure, probably – it's a huge field. But that's more coincidental than anything else, and their mechanisms of action are unrelated to TCM's pseudo-scientific theories. If you go to a forest and start eating random stuff then some will also have some benefit.
I'm not familiar with the history of meditation or mindfulness, but I've seen people claim some pretty ridiculous things about yoga, perhaps the most ludicrous was someone claiming that some positions will prevent certain cancers due to "massaging your organs". Yoga absolutely has benefits but that's just nonsense.
Dara O'Brien.
Are you trying saying the quote is misattributed? Because it's from Tim Minchin's comedy act/poem "Storm" [1].
[1] https://youtu.be/KtYkyB35zkk?si=QfGJepREYJIlg3hd
I'm not sure if it was completely original there. It's a relatively common retort now, though I do think that Storm was the first time I recall hearing it.
Western medicine has a similar history. Treatments did more harm than good prior to the scientific method being used. The poor who couldn't afford to see a doctor were actually better off than the rich who were subjected to all manner of bizarre "remedies".
Science can't make you immortal so people will keep turning to mumbo jumbo.
In China if you get in a car accident or just catch a bad case of the flu, you'll be taken to a hospital that practices...western medicine.
There's a reason for that.
In China, they are capable of having a balanced understanding of which pradigm is suitable for which problems. For small, vague or chronic things like "stress" or "chronic stomach discomfort", they go to a TCM practitioner whereas western medicine doctors can't diagnose and treat that properly. This is combining the best of both worlds.
The prevailing attitude on HN is not to combine strengths, but to dismiss TCM wholesale based on intellectual purity and geopolitical alignment. This is not only willful dismissal of the potentential to improve patient outcomes, but also shuts down curiocity and starting points for new actual scientific discovery.
Exactly. Western medicine is not particularly good at treating chronic conditions.
The Chinese government supports TCM because it's cheaper than healtchare.
I suspect this (and political popularity) is why Swiss health insurance covers non-traditional medicine. Must be cheaper for some people to get acupuncture or herbal medicines, even at a markup, as a first-line treatment. And the placebo effect is real, so it's not like it's ineffective for some cases, just not necessarily better than placebo.
Exactly, like for instance I've been sick for 4 weeks until last week, like terribly, fever, throat pain, red eye lids, tiredness. Completely dead, just sleeping whole weekends. At some point I broke up with my gf (bit related, bit unrelated to the fact I was dead lol) and... the next day I'm running around, completely fine, dating and flirting like nothing was wrong.
We then realized that our relationship was too stressful (many factors there), not working, it was making me completely miserable to a point my body was just noping out of life.
Imagine then: should I have taking antibiotics, Panadol, long consultations with specialist ? Or a bit of BS fake juice ? The problem was not solvable by medicine and the government would have had to pay for it - in fact it did since I took all those medications that did nothing much. So not even for the placebo effect, sometimes you're sick because of life (stress is really a sickness inducer) and no amount of pharmaceuticals will truly help you.
This is news? :-)
Whenever I see stuff about TCM being "vindicated" it's usually stuff like this, along the lines "we found a scientific basis for symptom X being alleviated by chemical C which is found in plant P and traditional medicine indeed suggests using P to treat X". And this article seems to basically be saying the same. Big whoop. It's no surprise that people over time figured out that certain plants might help with certain symptoms, and that later with better science we isolated the specific chemicals in those plants that drive such effects.
Saying this vindicates TCM is like saying chicken soup is vindicated as a cure for what ails you because it turns out that if you're sick it's good to get plenty of fluids and some protein from chicken and vitamins from vegetables.
What matters is not just whether something works, but how it works relative to alternatives, and what its cost/benefit ratio is. If you were living 1000 years ago maybe it made sense to chew willow bark or whatever, but now there's not really a reason to do that instead of just taking aspirin. If you want to eat extra garlic or whatever because it gives you a placebo effect, there's no harm in that, but if you're spending hundreds of dollars on bogus garlic supplements then maybe you're wasting your money.
There are a lot of folk remedies that are harmless in themselves, but their main harm comes when they induce people to reject real solutions.
What an absurd general claim anyway. Triumphantly declaring anything about the wide beliefs of many peoples over thousands of years feels a lot like tilting at windmills. Whoever wrote this paper should not be allowed near the press.
I feel many commentators here are overly dismissive of TCM to the point of intellectual laziness and even geopolitically-motivated paranoia. Yes, there are plenty of things in TCM to be skeptical about, but skepticism shouldn't be about dismissal but about improving tangible outcomes. Regular/western medicine (however you want to call it in contrast to TCM) can treat many big things but I'm sure many of you have had experience with small, vague, chronic things (like "stomach discomfort problems") that doctors have had absolutely no idea how to deal with, and they just send you away with a "take paracetamol for a few weeks and come back when you're nearly dying lol" attitude. In the mean time TCM can treat many of those cases even if you don't believe in their theories.
The current medical paradigm has blind spots, and we should be humble enough to acknowledge that alternative perspectives, even if they're not as rigorous as we'd like, can give us chances to improve patient outcomes. Wholesale dismissal to the point of labeling TCM as "govt propaganda" is forsaking improved patient outcomes for the purpose of winning an argument based on intellectual purity.
It is several orders of magnitude cheaper to produce bullshit than it is to produce truth and/or invalidate bullshit.
The truth value/prediction value for the knowledge system as a whole produced by the invalidation of bullshit is orders of magnitude less valuable than the creation of truth.
Note: the production of bullshit can be VERY economically/socially valuable for the specific producer of bullshit, but emphatically not valuable for the entire knowledge system.
Tolerance of bullshit in a field decreases the likelihood of robust invalidation by others due to the above.
It is a plague on intellectual pursuits, and why we are well aware of several famous “bullshit artists” in the western medical tradition: they are famous because bullshitting is rare, unacceptable, and career destroying.
If that is not true of a knowledge system, you have a culture, not a science.
Culture is great by the way! Awesome! Important! Culture is not meant to be predictive!
Not science though.
Great way to tell if you have a science on your hands or a culture: are extremely large quantities of money dependent upon accuracy of predictions?
If so, you’ve likely got a science! If not, well, might be a culture.
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Science is a rather vague term. What you mean is the scientific culture popular in usa, europe etc. Which has definite biases in its vindication process.
The science as we know it is pretty well defined. Involving generating precise hypothesis, doing double blind experiments, evaluating results and making predictions, submitting to peer review for result reproduction.
But TCM would have none of these, so no, it's not "due to bias".
There are always cultural biases. There are always choices of interpretation. Our science does not spring forth fully formed from the observation of phenomena after all
You really don't understand the very definition of science.
It's a means of predicting the success of a hypothesis. It is not a collection of beliefs.
There are plenty of successful hypotheses that science has "proven", which are now accepted by the "scientific community", but the word has an actual definition.
A lot of traditional Chinese medicine is actually based on science. That is: a practitioner had many patients with the same ailment, and would give some of them one medication, and others another medication (herbs usually, o mixes of herbs). They'd then keep notes of what worked and what didn't. Rinse and repeat for a few centuries.
They didn't always understand why this worked, and often attributed it to a lot of ideas that do sound like pseudo-science. But their experimentation was quite methodic.
This isn't ubiquitous. We're talking about thousands of practitioners, in dozens of cultures over millennia. I'm sure some simply sold Chinese snake oil.
I feel TCM's empirical roots probably did stumble on some real remedies (many people I know, including myself, have definitely benefited from certain aspects of TCM, especially acupuncture), but there's a problem.
It's a kind of proto-clinical research, and without the methodological discipline of Randomized Control Trials (RCT), it's easy to draw the wrong conclusions from observations. Some observations with small effect sizes might be accepted as truth.
It's not that it doesn't work all the time, but that the conclusions are noisy.
(that said, RCT is not perfect either because the body is a complex variegated thing with feedback loops that we can't fully map, and many interventions have tail risks. But as far as principled approaches for getting at the truth go, RCT offers just one more guardrail against confirmation bias).
Eh, the replication crisis shows that the "methodological discipline" of RCTs is really not all that strong. But they're still better than nothing. I think you've set up a false dichotomy.
If the effect size for a given treatment was small, I would expect it to be outcompeted by other treatments with larger effect sizes. Practitioners who are disciplined in their thinking will make better discoveries, can treat patients more effectively, and will have more business, thereby training more apprentices in their methods. Over hundreds of years, it's easy to see how this process finds treatments with relatively large effect sizes.
This isn't true at all. It's even stated in the article that TCM was popularized in the 50s. Prior to the 50s it was no different to medicine practiced anywhere else in the world before science figured out whats worked. Modern science extracted the specific elements from herbs and such that are effective and figured out dosages to apply. TCM is very much hit and miss. You're also not allowed to give it to children. Because they have no real idea of the dosage given.
Where do rhino horns and tiger parts factor into that science?
From what I've seen of traditional Chinese medicine, it's about 98% nonsense and 2% home remedy like chicken soup for a cold.
No, just like with Ayurveda there is plenty of actual stuff they stumbled on through trial and error.
In Ayurveda- Turmeric has medically validated anti inflammatory effects, exactly what it has been traditionally used for. Triphala for GI health, Boswell is for joint paint and arthritis, Neem as an antimicrobial, Arjuna for hypertension, Ashwagandha for anxiety etc.
There are a lot of these trial and error medications that do work. The ratio is definitely not 98:2, more along the lines of 70:30.
Sure, if you experiment throughout several thousand years, you are eventually bound to find something useful
It’s not insignificant though. There are hundreds of medically validated remedies and that’s scratching the surface of hundreds of thousands of potential plants.
Genes cause fever ? I stopped there.
That's not what was being said. They are saying that when your body does something different, in this case producing fever, it is (often) because of a change in the level of some number of proteins. You get new copies of proteins through gene transcription, and these changes (both increase and decrease) can be detected through changes in the levels of the transfer RNA corresponding to those proteins. Look up differential transcription analysis for more information.
Traditions form Chinese medicine have been vindicated. This is a situation where more analysis really is more.