placebo effects: to the group

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on 9/15/00 11:05 AM, alonmarcus at alonmarcus wrote:

 

 

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----- Original Message -- It is not just belief. If you'd like a textual reference for herbal pharmacology, try " Principles and Practice of Phytotherapy " by Simon Mills and Kerry Bone (Churchill-Livingstone). On page 23: " There is a fundamental difference between administering a pure chemical and the same chemical in a plant matrix. It is this issue of the advantage of chemical complexity which is both rejected by orthodoxy as having no basis in fact and avoided by most researchers as introducing too many variables of comfortable research. " Just because it is difficult to design studies for the complex pharmacology of plant medicines or polypharmacy prescriptions doesn't mean that there are not precedents for their use, or one cannot make a case for it.

 

>>>>>Zev this paragraph is just what I am talking about. The fact that the Medical Industry- has taker over medicine in the last 50yr does not mean that herbs do not have pharmacological mechanisms and that these are their primary mode of action. It is possible to study an herb or formula and document the biological affects and mechanisms including identifying active and inert ingredients. An herb is not nessaseraly safer than a drug of similar pharmacological femely. For example, Digxin is safer than the herbal verity in equivalent therapeutic dose and Sudafed has less side-effects than Ma Huang (on equivalent effective dose).

What is great about herbal therapies is the traditional diagnostic ways that allow us to see the body from a different perspective. The clinical usefulness of herbs with relatively lower active ingredients dosage with limited side-effects. It is the synergistic ways herbal formulas have been prepared that result in these affects. The same thing is beginning to be done with drug combinations and design in western medicine. It is statement that herbs function differently than drugs that you can not back up. Naked-sense observation does not take into account things like placebo, spontaneous recovery, natural course, etc. The lack of prognostic discussion of disease process in TCM is the best evidence of this problem. There are millions of pages of discussion of diagnosis (which usually means plugging in system of correspondence, which can apply to any situation) and treatment principals but little discussion on actual outcome. A naked-sense of observation which is applied through one set of filters (e.g. TCM) can miss a whole different set of problems (which is one of the problems of modern medicine today). I object to this type of approach as providing statement of truths (as western science does every day). Unless one examines the evidence from many perspectives and documents ones conclusion in my mind it is still just a belief system.

Alon

 

I have seen a disturbing trend in our profession, and I feel I must speak my heart and mind.

 

We are somehow buying the dogma that:

1) biomedicine is scientific and Chinese medicine is not.

2) Chinese medicine is a belief system and biomedicine is not

3) Chinese medicine is only valid if proven by studies designed according to biomedical standards

4) Chinese medicine must be explained by biomedical concepts in order to be valid.

5) Modern clinical trials and studies are objective, without any influence from the minds or thinking of patients or practitioners, or, for that matter, those who finance and initiate these studies.

6) The influence of consciousness on healing can be reduced to 'placebo effect' or 'psychosomatic'. . basically a convenient way of discounting this vital aspect of the medical encounter.

 

We are at a beginning stage of a new profession in the West, based on an ages-old tradition in the East. Cultural and language barriers are still great hurdles to overcome. Few are trained in the Chinese language, or the cultural influences that inform the fundamental concepts of the medicine. Few understand the basic concepts adequately.

 

For example, the phenomenon of qi. Because it is apparently not explainable by biomedicine, it is ignored in all attempts to understand how Chinese medicine works. Studies and clinical trials cannot discount this fundamental principle, or any others.

 

All medicinals used in Chinese medicine have an essential qi, and enter channels. This is a fundamental concept of Chinese medicine. Just because it cannot be adequately explained by biomedicine does not mean it is just a belief, or doesn't exist. Leaving out the phenomenon of qi makes it impossible to discuss the use of plant medicinals in a complete fashion.

 

There is a dimension of Chinese medicine that is not reducable to laboratory science, and I don't have a problem with this. Chinese medicine has its own criteria and parameters, and is based on a logical system that works. Pharmacological data is fine, interesting, and often confirms what what already accepted knowledge, sometimes not. It should be used as adjunct information on the medicines, not the basis on which it is practiced.

 

We should appreciate the differences, as well as the common ground, and move on with our attempts to learn this tradition.