8 ms·

'Western' medicine though as opposed to what? Nostalgic prescientific systems such as Chinese, ayurvedic, etc don't do anything at all. So yes, scientific medi

'Western' medicine though as opposed to what? Nostalgic prescientific systems such as Chinese, ayurvedic, etc don't do anything at all. So yes, scientific medicine definitely has huge lacunae. Given the relative slowness of progress in understanding complex systems science has had in general, they'll be there for a long to come. But it's not as if there's some other candidate 'system' that has a better understanding.

coldtea 7y ago
>'Western' medicine though as opposed to what? Nostalgic prescientific systems such as Chinese, ayurvedic, etc don't do anything at all. That's not really true. Their explanations can be hocus pocus, but their mechanics/drugs/techniques can be as effective as western versions, simply come around by tradition/trial and error/Lindy effect and so on for millennia.
- rscho 7y ago
  As effective as western versions, and often even identical but in a far less controlled form. Also often just as toxic.
  - coldtea 7y ago
    >and often even identical but in a far less controlled form I dunno, I'd trust something used for centuries (given it doesn't kill its users) over something hastily discovered, sorta understood, and rushed to market (after being extracted and distilled in the most potent chemical form) for profit... At least traditional remedies/drugs don't have the "let's rush this to make a buck" nor the profit motive involved (well, people selling them today want to make a profit, but I'm talking about actual traditional drugs, used for millennia, and which anybody could e.g. just grow/distill/whatever in their country, so there was no exclusivity thing)...
    - simiones 7y ago
      The problem is that many "traditional" remedies/drugs such as those found in Ayurvedic and traditional Chinese medicine have the "this must work based on a priori magical/philosophical knowledge, so no amount of evidence that it kills patients / does nothing at all will convince us to stop" problem. There very likely are traditional remedies that absolutely do work, but those lie more in folk remedies (especially use of native plants in teas), which tend to be slow trial-and-error over generations, rather than formal systems based on magical principles.
- jcims 7y ago
  You touched on something there that has been a pet peeve of mine for ages. People dismissing treatments like accupunture wholesale because there’s no scientific evidence for Qi. So what? It’s the effect we’re interested in, not the explanation.
  - crispinb 7y ago
    "People" might do that, but science certainly doesn't. Theoretical plausibility guides research, which is reasonable (there's no point in amassing prior knowledge if you don't use it). But empirical evidence is the determiner. And empirical studies of acupuncture have been a mixed bag - mostly it seems not to work, and where it does, sham treatments do just as well. Homeopathy is worse, but acupuncture is up there as a 'treatment' with a very poor empirical base. [an aside: I worked for a while in an fmri lab alongside a guy who did acupuncture reasearch. He was the most ideological researcher I've every come across in any field - flatly refusing to accept the validity of any data (even when collected by himself) that didn't support acupuncture's use. As someone now living in Australia's hippy zone, I find this a very recognisable & alarming trait of the 'alternative' health field.]
  - bedobi 7y ago
    If acupuncture had an easily and consistently replicable effect it would have been incorporated into medicine, even if we didn't understand how or why it worked. (just like paracetamol and any number of other widely used drugs and treatments we don't really know how or why they work)
- crispinb 7y ago
  > their mechanics/drugs/techniques can be as effective as western versions This may be true of some indigenous medicines, discovered by trial-and-error and careful observation over multiple generations. These are disappearing fast, and remain largely unsystematised. But treatments from the major medievalist 'systems' are different - their very strong derivation from fictional rubrics has resulted in their use being insulated from disconfirming observation (as was medieval 'Western' medicine). I'm not a specialist, but results I've seen from contemporary studies of Indian and Chinese treatments seem to show they don't work. And then there's the more impressionistic evidence from history. The populations of premodern India & China were horrifically unhealthy from all accounts I've read. Their medical systems did nothing for them.
- gus_massa 7y ago
  Don't worry. (Almost?) All the traditional drugs that are effective have been stolen by Big Pharma and are now produced in mass and distributed in a more pure form (or perhaps with some chemical tweak to make it more safe, reduce the side effects, make it cheaper or easier to produce, or as part of an evil trick to get the patent). So the effective ancient drugs are now part of medicine. Only the leftover are still classified as "traditional" medicine, so don't expect to find too much useful things there.
alkonaut 7y ago
As opposed to something holistic but still scientific. By “holistic” I mean that western medicine divides specializations too much and anything that doesn’t fit one box just falls outside everyone’s field. Generalist doctors aren’t very holistic either - they tend to just treat very common things or refer to a specialist. Example: if you have abdominal pains, you will be referred to a gastrointestinal specialist. After some tests and maybe a gastroscopy they will diagnose or rule out the common things: ulcers, celiac disease etc. This is what modern western medicine excels at. They find and cure the likely things quickly. They can often rule out the dangerous things like cancer. But now imagine for a second that the abdominal pain actually was a manifestation of a back disc issue. Few gastrointestinal specialists would find that and say “I think your back is the real problem and the gut pain is just a secondary symptom”. And you have already been referred as far “down” in the specialist chain as you can. This is when people start fumbling after alternatives. Note that there is nothing “non western” about having a more more holistic (less narrowly specialized) perspective on medicine, it’s just something that is hard so doesn’t get much attention. Perhaps the traditional specializations should be restructured? We are now seeing some headway such as the connection between gut bacteria and mental health for example.
- crispinb 7y ago
  Sure - agree with all of this. That's more to do with institutions than 'western medicine' as a science. Most science disciplines are similarly imperfectly implemented when they hit the real worlds of politics, inertia, profit, tribalism, etc.
- kirrent 7y ago
  > But now imagine for a second that the abdominal pain actually was a manifestation of a back disc issue. Few gastrointestinal specialists would find that and say “I think your back is the real problem and the gut pain is just a secondary symptom”. What are you talking about? Referred pain is well known and any doctor and especially any specialist will have studied and be familiar with common and likely referred pain pathways in the same way that they're familiar with other common interactions between systems. If you're struck with left arm pain while seeing an orthapedic surgeon, they'll make sure that you're not having a heart attack rather than trying to rule out orthapedic causes first. In your example, assuming an uncommon referred pain that your gastroenterologist is not familiar with, what more do you want from them than ruling out a gastrological cause? It's incredibly useful information that you and your primary care physician will be able to use to help track down the real cause. And if, after consulting multiple specialists, your primary care physician has no more ideas for pursuing the root cause of the issue, they'll help manage your chronic condition in consultation with a pain specialist and psychologist if required. Bottom line, doctors think more holistically thank you realise. To the extent that isn't sufficient, the medical system as a whole should be treating the patient as a whole. If that's not happening because of a variety of perverse incentives that's the fault of how we structure and pay for our healthcare systems and not the fault of western medicine.
kolinko 7y ago
As opposed to holistic. Western medicine is excellent when you can diagnose a specific single issue and fix it. For issues that don't have a single-specific cause, the western medicine won't help much - it can cover specific symptoms, and tell you to do more sport, fix your diet and go to a therapist. Example - all kinds of chronic pain (IBS etc), chronic tiredness, etc. Doctors will order all kinds of tests, and if there is no clear single issue, they won't help you. Eastern/holistic medicine may not be perfect, but if science-backed options are exhausted, it's all there is. Also, with all my respect and sympathy towards strict science, it has it's limitations - especially when it comes to complicated systems. That's why nobody argues for using science-based methods of running startups :) Finally, fun fact, if we use current medical criteria, parachutes were never proven to work. No double-blind placebo-controlled human trials. :)
- crispinb 7y ago
  it has it's limitations - especially when it comes to complicated systems. I agree - the science of complexity is in its infancy (as I mentioned in the parent). But your conclusion doesn't remotely follow. That there are conditions scientific medicine isn't yet much help with (truly!) does not connote that non-scientific systems must therefore do better. Eastern/holistic medicine may not be perfect, but if science-backed options are exhausted, it's all there is. But the treatments promoted by the major medival 'Eastern' systems don't work. You don't need a new understanding of complexity to demonstrate this - you give sick people the treatments, and see if they get better. They don't. So 'all there is' in this case is nothing. Hardly surprising from a prior plausibility angle: the 'whole' their so-called 'holistic' rubrics work with (chakras, qi, etc) are old metaphysical fictions.

coldtea 7y ago

>'Western' medicine though as opposed to what? Nostalgic prescientific systems such as Chinese, ayurvedic, etc don't do anything at all. That's not really true. Their explanations can be hocus pocus, but their mechanics/drugs/techniques can be as effective as western versions, simply come around by tradition/trial and error/Lindy effect and so on for millennia.

rscho 7y ago
As effective as western versions, and often even identical but in a far less controlled form. Also often just as toxic.
- coldtea 7y ago
  >and often even identical but in a far less controlled form I dunno, I'd trust something used for centuries (given it doesn't kill its users) over something hastily discovered, sorta understood, and rushed to market (after being extracted and distilled in the most potent chemical form) for profit... At least traditional remedies/drugs don't have the "let's rush this to make a buck" nor the profit motive involved (well, people selling them today want to make a profit, but I'm talking about actual traditional drugs, used for millennia, and which anybody could e.g. just grow/distill/whatever in their country, so there was no exclusivity thing)...
  - simiones 7y ago
    The problem is that many "traditional" remedies/drugs such as those found in Ayurvedic and traditional Chinese medicine have the "this must work based on a priori magical/philosophical knowledge, so no amount of evidence that it kills patients / does nothing at all will convince us to stop" problem. There very likely are traditional remedies that absolutely do work, but those lie more in folk remedies (especially use of native plants in teas), which tend to be slow trial-and-error over generations, rather than formal systems based on magical principles.
jcims 7y ago
You touched on something there that has been a pet peeve of mine for ages. People dismissing treatments like accupunture wholesale because there’s no scientific evidence for Qi. So what? It’s the effect we’re interested in, not the explanation.
- crispinb 7y ago
  "People" might do that, but science certainly doesn't. Theoretical plausibility guides research, which is reasonable (there's no point in amassing prior knowledge if you don't use it). But empirical evidence is the determiner. And empirical studies of acupuncture have been a mixed bag - mostly it seems not to work, and where it does, sham treatments do just as well. Homeopathy is worse, but acupuncture is up there as a 'treatment' with a very poor empirical base. [an aside: I worked for a while in an fmri lab alongside a guy who did acupuncture reasearch. He was the most ideological researcher I've every come across in any field - flatly refusing to accept the validity of any data (even when collected by himself) that didn't support acupuncture's use. As someone now living in Australia's hippy zone, I find this a very recognisable & alarming trait of the 'alternative' health field.]
- bedobi 7y ago
  If acupuncture had an easily and consistently replicable effect it would have been incorporated into medicine, even if we didn't understand how or why it worked. (just like paracetamol and any number of other widely used drugs and treatments we don't really know how or why they work)
crispinb 7y ago
> their mechanics/drugs/techniques can be as effective as western versions This may be true of some indigenous medicines, discovered by trial-and-error and careful observation over multiple generations. These are disappearing fast, and remain largely unsystematised. But treatments from the major medievalist 'systems' are different - their very strong derivation from fictional rubrics has resulted in their use being insulated from disconfirming observation (as was medieval 'Western' medicine). I'm not a specialist, but results I've seen from contemporary studies of Indian and Chinese treatments seem to show they don't work. And then there's the more impressionistic evidence from history. The populations of premodern India & China were horrifically unhealthy from all accounts I've read. Their medical systems did nothing for them.
gus_massa 7y ago
Don't worry. (Almost?) All the traditional drugs that are effective have been stolen by Big Pharma and are now produced in mass and distributed in a more pure form (or perhaps with some chemical tweak to make it more safe, reduce the side effects, make it cheaper or easier to produce, or as part of an evil trick to get the patent). So the effective ancient drugs are now part of medicine. Only the leftover are still classified as "traditional" medicine, so don't expect to find too much useful things there.

alkonaut 7y ago

As opposed to something holistic but still scientific. By “holistic” I mean that western medicine divides specializations too much and anything that doesn’t fit one box just falls outside everyone’s field. Generalist doctors aren’t very holistic either - they tend to just treat very common things or refer to a specialist. Example: if you have abdominal pains, you will be referred to a gastrointestinal specialist. After some tests and maybe a gastroscopy they will diagnose or rule out the common things: ulcers, celiac disease etc. This is what modern western medicine excels at. They find and cure the likely things quickly. They can often rule out the dangerous things like cancer. But now imagine for a second that the abdominal pain actually was a manifestation of a back disc issue. Few gastrointestinal specialists would find that and say “I think your back is the real problem and the gut pain is just a secondary symptom”. And you have already been referred as far “down” in the specialist chain as you can. This is when people start fumbling after alternatives. Note that there is nothing “non western” about having a more more holistic (less narrowly specialized) perspective on medicine, it’s just something that is hard so doesn’t get much attention. Perhaps the traditional specializations should be restructured? We are now seeing some headway such as the connection between gut bacteria and mental health for example.

crispinb 7y ago
Sure - agree with all of this. That's more to do with institutions than 'western medicine' as a science. Most science disciplines are similarly imperfectly implemented when they hit the real worlds of politics, inertia, profit, tribalism, etc.
kirrent 7y ago
> But now imagine for a second that the abdominal pain actually was a manifestation of a back disc issue. Few gastrointestinal specialists would find that and say “I think your back is the real problem and the gut pain is just a secondary symptom”. What are you talking about? Referred pain is well known and any doctor and especially any specialist will have studied and be familiar with common and likely referred pain pathways in the same way that they're familiar with other common interactions between systems. If you're struck with left arm pain while seeing an orthapedic surgeon, they'll make sure that you're not having a heart attack rather than trying to rule out orthapedic causes first. In your example, assuming an uncommon referred pain that your gastroenterologist is not familiar with, what more do you want from them than ruling out a gastrological cause? It's incredibly useful information that you and your primary care physician will be able to use to help track down the real cause. And if, after consulting multiple specialists, your primary care physician has no more ideas for pursuing the root cause of the issue, they'll help manage your chronic condition in consultation with a pain specialist and psychologist if required. Bottom line, doctors think more holistically thank you realise. To the extent that isn't sufficient, the medical system as a whole should be treating the patient as a whole. If that's not happening because of a variety of perverse incentives that's the fault of how we structure and pay for our healthcare systems and not the fault of western medicine.

kolinko 7y ago

As opposed to holistic. Western medicine is excellent when you can diagnose a specific single issue and fix it. For issues that don't have a single-specific cause, the western medicine won't help much - it can cover specific symptoms, and tell you to do more sport, fix your diet and go to a therapist. Example - all kinds of chronic pain (IBS etc), chronic tiredness, etc. Doctors will order all kinds of tests, and if there is no clear single issue, they won't help you. Eastern/holistic medicine may not be perfect, but if science-backed options are exhausted, it's all there is. Also, with all my respect and sympathy towards strict science, it has it's limitations - especially when it comes to complicated systems. That's why nobody argues for using science-based methods of running startups :) Finally, fun fact, if we use current medical criteria, parachutes were never proven to work. No double-blind placebo-controlled human trials. :)

crispinb 7y ago
it has it's limitations - especially when it comes to complicated systems. I agree - the science of complexity is in its infancy (as I mentioned in the parent). But your conclusion doesn't remotely follow. That there are conditions scientific medicine isn't yet much help with (truly!) does not connote that non-scientific systems must therefore do better. Eastern/holistic medicine may not be perfect, but if science-backed options are exhausted, it's all there is. But the treatments promoted by the major medival 'Eastern' systems don't work. You don't need a new understanding of complexity to demonstrate this - you give sick people the treatments, and see if they get better. They don't. So 'all there is' in this case is nothing. Hardly surprising from a prior plausibility angle: the 'whole' their so-called 'holistic' rubrics work with (chakras, qi, etc) are old metaphysical fictions.