Monday, October 26, 2009

Alternative Medicine: Groucho Marx, Jin Bu Huan, and Coffee Enemas

After Ling Wang died, one of her friends said, "It was always lovely to be with her. She played the guitar and loved to play games. She was the kind of girl who was so sweet and so happy. Everybody who knows her is devastated." The death of the 25-year-old graduate student from Newcastle University was a tragedy indeed. The coroner determined the cause of death: liver failure due to jin bu huan, a Chinese herbal remedy that Ms. Wang had taken for an upset stomach and a rash.

In his book Anatomy of an Illness, Saturday Review Editor-in-Chief Norman Cousins described the sickness that put him in the hospital: “I was suffering from a serious collagen illness – a disease of the connective tissue…Collagen is the fibrous substance that binds the cells together. In a sense then, I was coming unstuck. I had considerable difficulty in moving my limbs and even in turning over in bed. Nodules appeared on my body, gravel-like substances under the skin…I asked Dr. Hitzig about my chances for full recovery. He leveled with me, admitting that one of the specialists told him I had one chance in five hundred.” Facing this poor prognosis from the practitioners of conventional medicine, Mr. Cousins devised his own treatment: laughter induced by a steady diet of Marx Brothers films and washed down with massive doses of Vitamin C. This unlikely combination cured him completely.

As these two cases illustrate, alternative medicine has an inconsistent record of success (as does conventional medicine). This topic has been in the news recently due to the last week’s publication of Knockout: Interviews with Doctors Who Are Curing Cancer by ‘70’s icon Suzanne Somers. In Knockout, Ms. Somers urges cancer patients to eschew chemotherapy in favor of, among other things, coffee enemas.

The book inspired a certain amount of commentary, much of it from outraged doctors predicting fatal consequences for patients who take Ms. Somers advice. However, a piece by the American Cancer Society’s Dr. Otis Brawley counsels a more thoughtful approach for coming to terms with alternative medicine (http://www.cnn.com/2009/HEALTH/10/23/commentary.brawley.cancer.treatment/index.html):

“I am not critical of the concept of alternative and complementary medicine. When used wisely, it can be useful. Indeed, open-mindedness to other ideas is how we advance conventional medicine. Today, conventional medicine has the extract of a tree bark called aspirin or the root of a plant called vincristine because of observations from those who practiced non-conventional medicine.

“My problem is with some and not all of the advocates of alternative and complementary medicine. My problem is with those who reject the scientific method. Some actually do not reject the scientific method. They seem not to even realize that there is such a thing to reject.

“Some well-meaning advocates for complementary and alternative therapies are against any rigorous evaluation of these therapies.”

In short, Dr. Brawley says that a rational person is an open-minded person. She is willing to believe anything, provided you prove it. Controlled, statistically significant study of new treatments is the surest way to more Norman Cousins and fewer Ling Wangs. The Logic Critic gives Dr. Brawley…

Impeccable Reason. 4 Blades - Flawless.

1 Comments:

Blogger Peter Everett said...

There is no alternative medicine; there is good medicine, some of which is proven and some of which is not, and there is bad medicine, some of which is proven, and some of which is not.

The large pharmaceutical companies and the FDA would like to marginalize anything that was not produced under patent and vetted by an FDA-approved, double-blind, placebo-controlled, randomized trial as "alternative", meaning quackery.

The anti-corporate, wooly-headed, new age "healers," would like to marginalize anything that is the product of the pharmaco-industrial complex as an unnatural poison.

There is lots of incredibly good medicine that has never been subject to randomized, controlled trials, and never will be. Insulin for type-1 diabetes comes to mind.

One of the great problems facing medicine today is that there are many so-called alternative medicines that are good and many that are not, but we don't know which is which, and the current economic framework for drug development prevents us from sorting them out.

Red wine, fish oil, turmeric, high-dose vitamins, these are all under active investigation. Each has demonstrated significant potential for health benefits. There should be nothing "alternative" about them.

The ultimate alternative medicine is water. It turns out that drinking 3 liters of water per day can dramatically slow the progression of polycystic kidney disease, which affects about 500,000 Americans and is a leading cause of end-stage renal disease, dialysis and transplant. It is incredibly costly. The FDA would require a clinical trial costing more than $100,000,000 before it would allow someone selling water to say that it is safe and effective at slowing PKD. The pharmaceutical companies that are spending that money on expensive drugs intended to reproduce the hormonal effects of drinking 3 liters of water with a pill are going to insist that anyone selling water that competes with their expensive drug should go to jail. They will insist that insurers pay for their drug, but not pay for water.

Nobody has a monopoly on good medicine or good science. Large randomized controlled trials are a good way, but not the only way, and sometimes not an ethical way, to learn what works and what doesn't.

November 1, 2009 8:14 PM  

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