tag:blogger.com,1999:blog-5811749743523633503.post4257901059391088284..comments2024-03-20T11:36:53.907+00:00Comments on Restoring Mayberry: Medicines and placebosBrian Kallerhttp://www.blogger.com/profile/11082602126850605083noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-5811749743523633503.post-5585318650632267062012-04-10T18:01:15.519+01:002012-04-10T18:01:15.519+01:00A couple of comments. First, it's simply not ...A couple of comments. First, it's simply not true that most effective herbal medicines have been turned into pharma drugs. Most herbal medicines have multiple active ingredients, and many of those simply can't be turned into single-compound patentable pills with the same efficacy (much less safety). And the vast majority of non-Western plants have never been subjected to that type of study at all.<br /><br />Second, the fact that people didn't know why things worked in the past doesn't prove that they were always delusional when they thought things did work. Those plants that you will admit to be effective because they have been turned into pharma drugs (e.g., aspirin, opioids) had their activities explained in terms of humors too. While the scientific method may (I say may) have been developed only in medieval Islamic society, "trial and error" is not something people were too mindless to do until recently; it is how people have always learned about their environment. How did the ancestors of today's Native Americans learn which plants could be used as food? By experimentation, no PhD needed.<br /><br />And finally, many people fall victim to the claim that in the past, everyone died by 40 for the lack of modern allopathy. (The most imbecilic formulation I've seen claimed that the Romans died of old age at 20!) The main reason life expectancy was always so low, and still is so low in undeveloped countries, is that infant and young child mortality is horrific. Adults in the 30-40 range also ran a risk of dying from infectious disease, childbirth, or violence that we'd consider appalling today. But if you avoided those fates, you could indeed live to old age; quite a number of Romans made it to 70, 80, or even 100, and they were well familiar with the phenomenon of senile dementia. While allopathy has helped reduce the toll of infectious disease, with antibiotics and vaccinations, the biggest factor is public health measures such as clean water, clean food, and less crowded and polluted living space. No MD is required for the provision of those goods.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5811749743523633503.post-23054818956321951072012-04-10T13:23:46.860+01:002012-04-10T13:23:46.860+01:00Brian,
I suppose I would draw the line at the tra...Brian,<br /><br />I suppose I would draw the line at the traditional, "do no harm". That still leaves plenty of space for argument and discussion, however. Harm to the bank account is certainly a form of harm. And maybe leading people into superstition or misunderstanding of the world is a significant harm as well.<br /><br />As for the science, there's a good rundown on some of the efforts to tease out what exactly is the <a href="http://www.skepdic.com/placebo.html" rel="nofollow">placebo effect</a> at skepdic. Sometimes the placebo effect just shows that people would've gotten better on their own (more or less regardless of whether the treatment was drugs or sugar pills) and sometimes the placebo seems to have actual physiological effects. In any case, I still think the whole mess of effects is integral to any effort to heal people, and healers have been sensitive to that fact for as far back as we can see.Andy Brownhttps://www.blogger.com/profile/03820201752437230985noreply@blogger.comtag:blogger.com,1999:blog-5811749743523633503.post-1941794936190570212012-04-10T07:21:34.530+01:002012-04-10T07:21:34.530+01:00Andy,
A fair point, although on the spectrum bet...Andy, <br /><br />A fair point, although on the spectrum between the examples you give, where would you draw the line? <br /><br />I wonder, based on what you've said, if one could measure the effectiveness of treatments when people had more faith in the treatment.Brian Kallerhttps://www.blogger.com/profile/11082602126850605083noreply@blogger.comtag:blogger.com,1999:blog-5811749743523633503.post-91052917270683958952012-04-09T22:01:27.005+01:002012-04-09T22:01:27.005+01:00I don’t have any more sympathy than you for charla...I don’t have any more sympathy than you for charlatans who dissuade people from effective healing. I just wanted to make an observation and maybe take the opportunity to sort out my own thinking on the topic. <br /><br />There is a “mechanical” effect that physically operates on a physical problem (e.g. a chemical that causes veins to dilate, a bacteria the produces toxins in the tissues). There’s also the “psychological” effect that can affect the body physically (e.g. the placebo affect, psychosomatic ailments, toxic stress, the power of positive thinking, etc.). For thousands of years people have used both – coupling actual mechanical effects with all the “theater” of healing and quackery to strengthen, focus and direct the psychological effects. In my opinion a school of healing worthy of the name makes use of both of these. In truth, for its day to day success modern medicine relies both on mechanics and on the psychological effects (e.g. placebo effect) that comes from people’s faith in science and medicine. (This is probably one reason why doctors so long insisted on all the trappings of authority – and the more recent disdain for human psychology is one reason why despite their impressive arsenal of treatments, modern doctors so often fail at actual healing.) I think herbalism, massage, chiropractics, etc. also manage both aspects, the mechanical and the psychological. There are others, like homeopathy, crystals, faith healing, that (in my opinion) can only avail of the second – and that makes them much, much weaker in general and completely inappropriate for healing things beyond the body’s psychosomatic abilities.<br /><br />I guess what I’m saying is that a crystal healer who cures someone’s tension headaches is doing good work, (indeed better than the M.D. with his pain pills) while a crystal healer who says they can replace chemotherapy is a dangerous quack who needs to be shut down. On the other hand, I think that a doctor who considers it enough to prescribe Lipitor for the suicidal American diet, isn’t much of a healer either.Andy Brownhttps://www.blogger.com/profile/03820201752437230985noreply@blogger.comtag:blogger.com,1999:blog-5811749743523633503.post-2294910608622287362012-04-09T09:53:26.057+01:002012-04-09T09:53:26.057+01:00Andy,
Thanks for the thoughtful response. I agree...Andy, <br />Thanks for the thoughtful response. I agree that placebos can have a powerful effect, and I suspect this is why alternative medicines, prayer, magic rituals and faith healers seem to work, at least for a while. I think it’s important to make two ethical distinctions, though. Firstly: prayer and sugar pills cost you nothing, while faith healers and homeopaths are profitable enterprises. <br />Secondly: It’s one thing to pray for the sick because it’s the kind thing to do -- I’m told people do get better faster when they know people are praying for them, and it certainly won’t make the situation worse. That’s not the same, though, as faith healers or alternative therapies, however, in which people are told the intervention is literally eliminating the pathogen. The latter basically assures someone they don’t need to see a doctor anymore – which could cost them their lives. <br />Does that make sense? Feel free to write back. <br /><br />Anonymous, <br />See, for example, “The History of Infant, Child and Adult Mortality in London, 1550-1850” in The London Journal, November 2007.Brian Kallerhttps://www.blogger.com/profile/11082602126850605083noreply@blogger.comtag:blogger.com,1999:blog-5811749743523633503.post-50237583298525047322012-04-09T02:40:39.822+01:002012-04-09T02:40:39.822+01:00Where and when did *most* children did not survive...Where and when did *most* children did not survive into adulthood?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5811749743523633503.post-6034699697044170412012-04-09T00:10:29.416+01:002012-04-09T00:10:29.416+01:00That's a big topic you've bitten off today...That's a big topic you've bitten off today, and I can think of a few responses I'd like to make. I'll limit myself to a traditional anthropological observation though. People resort to magic when they've reached the limit of what (they believe) they can do in the "real world". Azande potters knew all about working the clay and managing the temperature and so on, but still, sometimes the pot cracks in the heating. And to deal with that there is only magic or prayer. In your descriptions of healing and quackery, I see that dynamic. There are things we (believe we) can do or (we believe) modern medicine can do about our health and maladies. But maybe scientific medicine can't help us or we've lost our belief in it. Since "doing nothing (!)" isn't an option, we will inevitably do something that we're convinced will have an effect. And oddly enough, the human body seems to respond pretty positively to such a stratagem (e.g. the "placebo effect"), so the cycle gets reinforced.<br /><br />In that part of the spectrum of human malady that responds to the placebo affect (and it is wider than most people realize), that's fine - and there I think is where much alternative medicine succeeds. Of course, scientific medicine has some pretty good mechanical cures that people are foolish to reject, and there are also serious mechanical problems that can crop up in the body that no amount or belief in quackery will cure.<br /><br />To circle back to my Azande potters, I think my point (and I'm mostly through my third black and tan here, so be charitable) is that the trick is to keep track of the clay and the temperature before you resort to magic -- BUT, oddly enough the human body responds to magic in a way that the clay really doesn't. And for that reason I see the magic of alternative medicine as playing a more constructive role than most garden variety magic.Andy Brownhttps://www.blogger.com/profile/03820201752437230985noreply@blogger.com