5 ms·

Leeches and the legitimizing of folk-medicine

30 points by mailyk 1y ago

Mikhail_Edoshin 1y ago
I remember reading a memoir of a manual therapist who described his work with Ida Rolf. Rolf discovered a specific approach to massage, "rolfing". It appeared very effective, she had a number of apprentices and followers and she was interested in clinical testing and such. Turned out that it would be very expensive. With all her money she could maybe afford a couple small-scale trials. She decided money could be better spent elsewhere.
- AlecSchueler 1y ago
  Rolf isn't a form of massage, it's more like simple exercises that are just things designed to help bring awareness to your posture, where you hold your weight etc.
  - dang 1y ago
    I think you might be confusing Rolfing with Feldenkrais. They're both great!
troupo 1y ago
[flagged]
- lolc 1y ago
  You're being very unfair to the article paraphrasing it this way. If you'd read it with a bit more of an open mind, you'd have understood why leeches work for some treatments.
  - troupo 1y ago
    This is the first third of the article: --- start quote --- "Men would rather pop Viagra forever than let a leech near their body,” Dr. Andrei Dokukin says. Dokukin, an alcoholic in recovery, received leech therapy himself to treat his liver cirrhosis. Dokukin tried hirudotherapy at the behest of his mother back in Russia, where it remains common practice. Five years later, he claims that his liver has fully compensated Leeches have been used across centuries and cultures to treat a litany of conditions <list of different disparate conditions>. The problem, however, is that we don’t know just how well they work. Despite leeches’ having gained FDA approval as a medical instrument in 2004, a frustrating lack of clinical evidence persists. Still, it would be a mistake to write off leech therapy as an ancient tradition of little worth. Many highly beneficial modern treatments, from bacteriophage therapy to cancer drugs, began their journey as “folk remedies.” --- end quote --- I stopped reading after this lengthy intro. I think my paraphrasing is rather on point. I've now skimmed the rest. There's a very tiny section in "why leech works" that only describes hirudin as anticoagulant. And then the conclusion: "Good remedies back in action" when actual "action" is that at vest it's a coagulant. Oh look. The conclusion: --- start quote --- It may be some time before we can come up with robust evidence for the efficacy and safety of leech therapy. But that is not the crux of this story. People all over the world continue to use this treatment even in the absence of clinical evidence. It is mostly patients in the West who lose out. --- end quote --- Right. I have a set of healing crystals to sell to you
    - lolc 1y ago
      Yes those quotes do not reflect well on the article. You still missed the part where leeches are used to help with tissue transplants. Regarding your jab at the end: In my view it's fraud to sell healing crystals if you don‘t think they are. Otherwise it's just mistaken.
      - troupo 1y ago
        > Yes those quotes do not reflect well on the article. And that's 90% of the article > You still missed the part where leeches are used to help with tissue transplants. Quote from my post: "There's a very tiny section in "why leech works" that only describes hirudin as anticoagulant." That's it, that is the only thing that works in leaches. And in the same section about tissue transplants they literally talk about risk of infection, for example. And yet the entire aticle is literally "we have no evidence if they work for all the other use cases, but who cares, the west is missing out in this good remedy". > In my view it's fraud to sell healing crystals if you don‘t think they are. It's fraud to sell non-working medicine even if you think it's working.
karamanolev 1y ago
I have an interesting story with non-scientific medicine. Normally, I'm a very science-oriented person—"read the paper or it didn't happen." I will even avoid reading a news article about the paper; I'll just go and read the paper itself. The way I treat my illnesses and injuries is the same. That being said, I suffer a lot from sore throats—I will get some flu, get better in 3–4 days, and then my throat will hurt for weeks. In a particularly bad bout, I tried waiting for 2 weeks with no improvement. I almost couldn't swallow. I went to the doctor and was prescribed antibiotics. That resolved it in about 24 hours, and I completed the full course. Three weeks later, the same thing happened. I waited 2 weeks to see if it would resolve on its own, and when it didn’t—antibiotics again. Of course, the problem came back only weeks later. So I thought—I'm going to try homeopathy. What's the worst that can happen? I'm in pain anyway. I decided to try a scientific approach (not very, given N=1), so again I waited 2 weeks to see if it was going to resolve itself. It didn’t. I went to a homeopathic doctor and got a bottle with some "magic." It took 3–4 days for the symptoms to improve, but they didn’t come back for months. When they did, I jumped straight to the homeopathic medicine, and it helped in the same way it did the first time around. I haven’t used antibiotics for my throat since. I have no explanation for this. There have been hundreds or thousands of studies on homeopathy, and my reading is that the consensus is that it's "quack medicine." Yet it clearly worked for me, and it worked better than antibiotics for that particular issue. What gives?
- hackingonempty 1y ago
  > I have no explanation for this. One possibility that RCTs are designed to eliminate is "regression to the mean." If the natural course of disease is to wax and wane and you intervene whenever the disease is waxing it can seem like your intervention is effective even when it has no specific effect. In addition, placebos produce a small effect even when you know you are taking a placebo.
- unnamed76ri 1y ago
  I’ve been on meds that wreck my immune system and so I get sick a lot. Every time I start feeling the smallest tickle of an upper respiratory virus I start doing the following: 1. Gargle with salt water 3x a day 2. Use saline nasal rinses 2x a day I still get sick a lot, but haven’t needed antibiotics in all the years I’ve kept to this routine.
jfjfitttjtmt 1y ago
Maybe in next century we discover that "horse medicine" is very good against viral infections!
__alexs 1y ago
I think we should really just stop asking if "the old ways" actually work or not as it seems entirely irrelevant to the people that seek them out most of the time. They are acts of pure ritual.
- darth_avocado 1y ago
  Some old ways do work and it is worth asking whether they work. Aspirin was infamously drawn from Willow bark as a treatment. Artemisinin which treats chloroquine resistant malaria was derived from wormwood after looking for inspiration in ancient Chinese medicine. There are probably more examples out there where ancient medicine has informed modern medicine.
  - __alexs 1y ago
    I am not arguing that plants do not contain interesting chemicals. I am arguing that they are typically used in a ways that are ineffective and the users don't care because they fulfilled their main priority, taking part in a ritual.
    - 4gotunameagain 1y ago
      The ritual is the entire evolutionary societal mechanism that allowed us to use plants as medicine, or safely prepare toxic foodstuff. This is the very nature of evolution; not all rituals will make sense. The ones that do, prevail.
      - __alexs 1y ago
        Science is itself a form of ritual for sure. I didn't say we shouldn't have rituals and I support your right to chew on a tree if that's what you want to do.
- h3lp 1y ago
  Folk medicine that succeeded in rigorous clinical trials is called 'medicine'?

30 points by mailyk 1y ago

I remember reading a memoir of a manual therapist who described his work with Ida Rolf. Rolf discovered a specific approach to massage, "rolfing". It appeared very effective, she had a number of apprentices and followers and she was interested in clinical testing and such. Turned out that it would be very expensive. With all her money she could maybe afford a couple small-scale trials. She decided money could be better spent elsewhere.

AlecSchueler 1y ago
Rolf isn't a form of massage, it's more like simple exercises that are just things designed to help bring awareness to your posture, where you hold your weight etc.
- dang 1y ago
  I think you might be confusing Rolfing with Feldenkrais. They're both great!

troupo 1y ago

[flagged]

lolc 1y ago
You're being very unfair to the article paraphrasing it this way. If you'd read it with a bit more of an open mind, you'd have understood why leeches work for some treatments.
- troupo 1y ago
  This is the first third of the article: --- start quote --- "Men would rather pop Viagra forever than let a leech near their body,” Dr. Andrei Dokukin says. Dokukin, an alcoholic in recovery, received leech therapy himself to treat his liver cirrhosis. Dokukin tried hirudotherapy at the behest of his mother back in Russia, where it remains common practice. Five years later, he claims that his liver has fully compensated Leeches have been used across centuries and cultures to treat a litany of conditions <list of different disparate conditions>. The problem, however, is that we don’t know just how well they work. Despite leeches’ having gained FDA approval as a medical instrument in 2004, a frustrating lack of clinical evidence persists. Still, it would be a mistake to write off leech therapy as an ancient tradition of little worth. Many highly beneficial modern treatments, from bacteriophage therapy to cancer drugs, began their journey as “folk remedies.” --- end quote --- I stopped reading after this lengthy intro. I think my paraphrasing is rather on point. I've now skimmed the rest. There's a very tiny section in "why leech works" that only describes hirudin as anticoagulant. And then the conclusion: "Good remedies back in action" when actual "action" is that at vest it's a coagulant. Oh look. The conclusion: --- start quote --- It may be some time before we can come up with robust evidence for the efficacy and safety of leech therapy. But that is not the crux of this story. People all over the world continue to use this treatment even in the absence of clinical evidence. It is mostly patients in the West who lose out. --- end quote --- Right. I have a set of healing crystals to sell to you
  - lolc 1y ago
    Yes those quotes do not reflect well on the article. You still missed the part where leeches are used to help with tissue transplants. Regarding your jab at the end: In my view it's fraud to sell healing crystals if you don‘t think they are. Otherwise it's just mistaken.
    - troupo 1y ago
      > Yes those quotes do not reflect well on the article. And that's 90% of the article > You still missed the part where leeches are used to help with tissue transplants. Quote from my post: "There's a very tiny section in "why leech works" that only describes hirudin as anticoagulant." That's it, that is the only thing that works in leaches. And in the same section about tissue transplants they literally talk about risk of infection, for example. And yet the entire aticle is literally "we have no evidence if they work for all the other use cases, but who cares, the west is missing out in this good remedy". > In my view it's fraud to sell healing crystals if you don‘t think they are. It's fraud to sell non-working medicine even if you think it's working.

karamanolev 1y ago

I have an interesting story with non-scientific medicine. Normally, I'm a very science-oriented person—"read the paper or it didn't happen." I will even avoid reading a news article about the paper; I'll just go and read the paper itself. The way I treat my illnesses and injuries is the same. That being said, I suffer a lot from sore throats—I will get some flu, get better in 3–4 days, and then my throat will hurt for weeks. In a particularly bad bout, I tried waiting for 2 weeks with no improvement. I almost couldn't swallow. I went to the doctor and was prescribed antibiotics. That resolved it in about 24 hours, and I completed the full course. Three weeks later, the same thing happened. I waited 2 weeks to see if it would resolve on its own, and when it didn’t—antibiotics again. Of course, the problem came back only weeks later. So I thought—I'm going to try homeopathy. What's the worst that can happen? I'm in pain anyway. I decided to try a scientific approach (not very, given N=1), so again I waited 2 weeks to see if it was going to resolve itself. It didn’t. I went to a homeopathic doctor and got a bottle with some "magic." It took 3–4 days for the symptoms to improve, but they didn’t come back for months. When they did, I jumped straight to the homeopathic medicine, and it helped in the same way it did the first time around. I haven’t used antibiotics for my throat since. I have no explanation for this. There have been hundreds or thousands of studies on homeopathy, and my reading is that the consensus is that it's "quack medicine." Yet it clearly worked for me, and it worked better than antibiotics for that particular issue. What gives?

hackingonempty 1y ago
> I have no explanation for this. One possibility that RCTs are designed to eliminate is "regression to the mean." If the natural course of disease is to wax and wane and you intervene whenever the disease is waxing it can seem like your intervention is effective even when it has no specific effect. In addition, placebos produce a small effect even when you know you are taking a placebo.
unnamed76ri 1y ago
I’ve been on meds that wreck my immune system and so I get sick a lot. Every time I start feeling the smallest tickle of an upper respiratory virus I start doing the following: 1. Gargle with salt water 3x a day 2. Use saline nasal rinses 2x a day I still get sick a lot, but haven’t needed antibiotics in all the years I’ve kept to this routine.

jfjfitttjtmt 1y ago

Maybe in next century we discover that "horse medicine" is very good against viral infections!

__alexs 1y ago

I think we should really just stop asking if "the old ways" actually work or not as it seems entirely irrelevant to the people that seek them out most of the time. They are acts of pure ritual.

darth_avocado 1y ago
Some old ways do work and it is worth asking whether they work. Aspirin was infamously drawn from Willow bark as a treatment. Artemisinin which treats chloroquine resistant malaria was derived from wormwood after looking for inspiration in ancient Chinese medicine. There are probably more examples out there where ancient medicine has informed modern medicine.
- __alexs 1y ago
  I am not arguing that plants do not contain interesting chemicals. I am arguing that they are typically used in a ways that are ineffective and the users don't care because they fulfilled their main priority, taking part in a ritual.
  - 4gotunameagain 1y ago
    The ritual is the entire evolutionary societal mechanism that allowed us to use plants as medicine, or safely prepare toxic foodstuff. This is the very nature of evolution; not all rituals will make sense. The ones that do, prevail.
    - __alexs 1y ago
      Science is itself a form of ritual for sure. I didn't say we shouldn't have rituals and I support your right to chew on a tree if that's what you want to do.
h3lp 1y ago
Folk medicine that succeeded in rigorous clinical trials is called 'medicine'?