Traditional Chinese Medicine is Quackery

There are people who think Traditional Chinese Medicine is superior to evidence based Western medicine.  These people think that TCM successfully treated people for a variety of ailments for thousands of years, so they turn to such treatments, rather than science based medicine.  Why do they think this?  What is TCM?   The introduction to this paper describes it this way:

Traditional Chinese medicine (TCM) has a history of thousands of years. It is formed by summarizing the precious experience of understanding life, maintaining health, and fighting diseases accumulated in daily life, production and medical practice. It not only has systematic theories, but also has abundant preventative and therapeutic methods for disease.

 

Steven Novella explains why TCM is not a valid form of medicine:

It may be trivially true that TCM has a long history, but it is hard to ignore that the placement of this statement at the beginning of a scientific article implies an argument from antiquity – that TCM should be taken seriously because of this long history. I would argue that this is actually a reason to be suspicious of TCM, for it derives from a pre-scientific largely superstition-based culture, similar in this way to the pre-scientific Western culture that produced the humoral (Galenic) theory of biology.

The next line is an admission that TCM is largely based on anecdotal information, described as the “precious experience” of life. This is a point that is often overlooked or not understood by proponents but central to the scientific/skeptical position – what is the value and predictive power of “precious experience” in developing a system of medicine?

I maintain that there are many good reasons to conclude that any system which derives from everyday experience is likely to be seriously flawed and almost entirely cut off from reality. Obvious short term effects, the lowest hanging fruit of observation, are likely to be reliable. Uncontrolled observation is a reasonable way to discover which plants, for example, are deadly poisons. This is likely to produce some false positives but few false negatives, which is fine for survival.

Other obvious effects, like nausea, diarrhea, and psychedelic effects are also easy to discover. Similarly it was probably obvious that people need to eat, breathe, and drink in order to stay healthy and alive. But records of pre-scientific thinking about health and disease shows that little else was.

Pre-scientific doctors thought, for example, that pus was a good thing, a sign that a wound was healing.  They also did not realize that removing blood from the body was harmful, because they did not understand the vital physiological effects of blood and had fanciful superstitious notions about its role in the body.

So there are severe practical limits to what uncontrolled life experiences could figure out about health and disease. Every culture figured out some basic things, like local plants that had some uses, how to treat some forms of trauma, and to midwife childbirth, but could not figure out the complexities of biology, physiology, anatomy,  biochemistry, genetics, infection and disease pathophysiology and epidemiology.

Understanding health and disease took a more sophisticated method of observing nature – science.

How, then, could a pre-scientific culture without any knowledge of modern biology and without the methods of science develop a valid and effective system of medicine? The answer is – they couldn’t. In addition, there is now a large body of psychological research showing the many ways in which people systematically deceive themselves when it comes to finding correlations and making assumptions about cause and effect.

There is nothing about the Chinese culture or the Chinese people that should make them exempt from these documented psychological effects, or that would make their culture unique among the world’s cultures in stumbling upon notions about health and illness that were actually correct. It is extreme cultural hubris to think otherwise. When the institution of medicine in the West incorporated scientific methods as the standard of determining which treatments were safe and effective, and in understanding disease, over time almost everything that constituted “traditional Western medicine” was overturned. The “precious experience” of centuries of Western medicine resulted in largely worthless or harmful treatments, from blood-letting to toxic mineral-based treatments.

I’m not a scientists. I’m not a doctor.  I don’t know the first thing about treating illnesses or ailments.  I *do* know that our brains trick us in a variety of ways. Whether by cognitive shortcuts or biases, our minds fool us in many ways.  When practitioners of TCM claim that their methods work because people tell them they work, all they’re saying is that “our methods work bc we are told they work”.  That’s not a reliable method of determining the reliability of a given treatment.  That’s where science comes in, and specifically, the scientific method:

The scientific method is a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge.  To be termed scientific, a method of inquiry must be based on empirical and measurable evidence subject to specific principles of reasoning.  The Oxford English Dictionary defines the scientific method as “a method or procedure that has characterized natural science since the 17th century, consisting in systematic observation, measurement, and experiment, and the formulation, testing, and modification of hypotheses.”

The chief characteristic which distinguishes the scientific method from other methods of acquiring knowledge is that scientists seek to let reality speak for itself, supporting a theory when a theory’s predictions are confirmed and challenging a theory when its predictions prove false.  Although procedures vary from one field of inquiry to another, identifiable features distinguish scientific inquiry from other methods of obtaining knowledge. Scientific researchers propose hypotheses as explanations of phenomena and design experimental studies to test these hypotheses via predictions which can be derived from them. These steps must be repeatable to guard against mistake or confusion in any particular experimenter. Theories that encompass wider domains of inquiry may bind many independently derived hypotheses together in a coherent, supportive structure. Theories, in turn, may help form new hypotheses or place groups of hypotheses into context.

Scientific inquiry is intended to be as objective as possible in order to minimize bias. Another basic expectation is the documentation, archiving and sharing of all data collected or produced and of the methodologies used so they may be available for careful scrutiny and attempts by other scientists to reproduce and verify them. This practice, known as full disclosure, also means that statistical measures of their reliabilitymay be made.

Testability, r
epeatability, weeding out bias-these are proven methods for enabling us to understand reality.   This is not present in TCM (or any form of alternative “medicine”). Dugald Christie wrote the book Thirty Years in Moukden. 1883-1913. Being the Experiences and Recollections of Dugald Christie, C. M.G., which is available online for free.  Harriet Hall illuminates several examples of TCM found in the book:

Acupuncture

Chinese doctors own that they know nothing at all of surgery. They cannot tie an artery, amputate a finger or perform the simplest operation. The only mode of treatment in vogue which might be called surgical is acupuncture, practised for all kinds of ailments. The needles are of nine forms, and are frequently used red-hot, and occasionally left in the body for days. Having no practical knowledge of anatomy, the practitioners often pass needles into large blood vessels and important organs, and immediate death has sometimes resulted. A little child was carried to the dispensary presenting a pitiable spectacle. The doctor had told the parents that there was an excess of fire in its body, to let out which he must use cold needles, so he had pierced the abdomen deeply in several places. The poor little sufferer died shortly afterwards. For cholera the needling is in the arms. For some children’s diseases, especially convulsions, the needles are inserted under the nails. For eye diseases they are often driven into the back between the shoulders to a depth of several inches. Patients have come to us with large surfaces on their backs sloughing by reason of excessive treatment of this kind with instruments none too clean.

[…]

Mercury for bullet wounds

He describes removing a piece of bone from a severe gunshot wound, upon which a quantity of pure mercury poured out. The patient said, “That is the melted bullet!” Chinese doctors make no attempt to extract bullets, and they put mercury into the wound saying it will “melt the lead.” The patient is easily deceived.

[…]

Superstitions

Lucky days are chosen for taking medicines. A hair is twined around a limb above a sore to keep the poison from going to the heart. A patient attributed his illness to punishment for having offended the Tiger-god by eating tiger’s flesh. A Chinese doctor brought his daughter to the Western doctor, asking him to operate to “remove the evil thing that is preying on her life.” He believed a tortoise was growing in her abdomen and drinking her blood three times a day. He thought he could feel the tortoise’s head moving; he was actually feeling the pulsations of her aorta. The child didn’t have an abdominal problem; she had advanced tuberculosis of the lungs.

[…]

Doctor-shopping

Patients have little confidence in their doctors. If the medicine doesn’t cure them in a few days, they set it aside and consult another doctor without telling the first. It is common to use the medicines of several doctors at once.

Note: This is important to know, because people commonly assume that an herbal treatment that has been used for centuries must be safe and effective because if it wasn’t the herbalists would have known by now and would have stopped using it. Patients switched doctors when the treatment wasn’t working, without telling the first doctor. So he would assume his treatment had cured the patient and he got no feedback about treatment failures and side effects. These ancient herbalists had no systematic way of evaluating treatment successes vs. failures or of discovering adverse effects.

Hall concludes with:

The book offers a glimpse into history showing how truly ineffective and barbaric TCM really was. This information could go a long way to correct the misconceptions of those who have succumbed to the “ancient wisdom” fallacy. If they read it and paid attention. Which they won’t.

Plants often contain chemical compounds that act on the human body, and TCM accidentally came across some herbal remedies that actually work, but scientific testing is required to figure out which ones those are. And regulation of sources is required to prevent contaminants and ensure purification and standardization. TCM may have made a few serendipitous herbal discoveries, but as a system of medical care it has no validity. It is a historical curiosity and an anachronism.

 

 

 

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Traditional Chinese Medicine is Quackery
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