The public usually wants to know two things regarding any medical treatment. Is it effective and what are the dangers associated with it. There is however other aspects that scientists use to put the public’s mind even further at ease. If they also tell the public that the mechanism of action is known and that everything regarding this treatment is backed-up by a considerable body of scientific literature, then surely people will even feel more confident to use a specific treatment. The public will not go and read the scientific evidence, simply because they do not have access to the literature and even if they had, they will in all likelihood not be able to understand the contents. It is written in a scientific language and thus the public trust trained people at Universities to explain this contents to them in plain language. Consequently, if scientists explain how traditional Chinese medicine (TCM) works in plain language and add that there is a massive body of scientific literature backing this up – why should the public doubt what they say?
In part 1 of misleading the public, I wrote about how the National Institute of Complementary Medicine (NICM) go about presenting research findings and how they remain quiet when they should speak up. Their main research finding was that individually tailoring TCM herbs for irritable bowel syndrome is inferior to a standardised herb extract, which proves that the TCM theory and practice is based on a pre-scientific belief system. Not only do they ignore their own research findings and mislead the public into believing that TCM is effective but they also take it one step further. Now they explain how the theory behind TCM works in a very convincing way! In a second radio interview, dealing with complementary medicine in general, they continue to mislead the public with the main objective to create public trust in the TCM theory and practice. Here is the unedited excerpt from the transcript.
“Norman Swan: And Alan Bensoussan of the University of Western Sydney, has found that in Australia, Traditional Chinese Medicine is more than a $90-million industry, for non-trivial interventions like acupuncture and herbal mixtures. But the problem for the sceptical consumer is the apparent lack of discipline amongst alternative practitioners. They seem to pick and choose between philosophies and theories to suit themselves rather than relying on hard data. There doesn’t often appear to be one body of proven knowledge which you can be sure they have.
Alan Bensoussan: Let me give you an example in the purest of sciences, in physics. We look at light, and we describe light as being wave motion, particularly when we describe diffraction-refraction effects and so forth, and explain how a rainbow appears. But we also simultaneously choose another theory for explaining light, the photon theory, the quantum theory of light, when we want to talk about the momentum and particles being knocked out of place. So we choose, even in the purest of sciences, different theoretical tools to explain our observations.
Now naturopathy may do that in a very eclectic fashion, and I think naturopaths are probably the most eclectic of the complementary therapists. But I need to acknowledge that even in Chinese Medicine, there are different theoretical schools and those schools are not whimsical. They’re schools that describe for example the sort of thinking and tools one should use in treating and managing infectious diseases. And then there’s another school that one should use, another body of theory that one uses in managing chronic internal illness. So there are theoretical tools that are constructed for the understanding of particular clinical portraits.
Norman Swan: Give me a practical example of where almost this dualism, in terms of thinking about somebody and their problem, can work.
Alan Bensoussan: OK. Take two patients that have both got low back pain and they come in to see their GP. They’re both chronic low back pain patients. The first patient has pain that appears first thing in the morning, has a lot of stiffness, but once they’re up and moving around for an hour or so, have a hot shower, they improve. The second patient, also with low back pain says their pain is fine first thing in the morning, they have no problem when they get up, but as the day goes on their pain registers more significantly and they have to actually sit down, lie down and rest, and they’re fine the next morning when they get up.
Now a GP would examine these two patients and send them off for various tests and determine whether there’s any pathology involved at all, whether there’s any arthritis or rheumatism or malalignment of the vertebra, whatever. If there’s no particular pathology in these two patients, the question has to be asked what can the GP actually do? How can the GP actually using medical science, differentiate between these two patients if there’s no obvious pathology. And I don’t think this is too contrived a situation, there are many inexplicable low back patients.
If those two patients went to a Chinese Medicine practitioner, there’s one theoretical tool that that Chinese Medicine practitioner can use which will help actually distinguish those two patients. And this might sound a little bit simplistic because the theory does, but if we just go along with this for a minute: the concept of circulation of energy is paramount in Chinese Medicine. The Chinese physicians have always said there’s more than just blood circulating in the body, there’s also energy, human energy of some sort circulating in the body. We don’t know how to measure that yet.
If we accept that as a theoretical tool though, we accept this concept of circulation of energy, the patient who has pain upon rising first thing in the morning when they’ve been rested all night through the coldest part of the day, they get up, they’re stiff, they’re sore, they move around for a while and when their energy starts circulating they add warmth as well, their energy starts circulating, their blood starts moving, the pain dissipates. So that first patient had a problem that was related to obstruction, stagnation of energy, a blockage of energy, an accumulation.
The second patient you’ve probably already understood, is quite the opposite, because they’re fine when they get up in the morning, it’s as the day goes on when their energy becomes depleted, their area of greatest vulnerability is exposed, which is their low back. So in fact for that second patient, they’re suffering a weakness or a deficiency of energy in the low back.
Now the concept of energy there is only a little tool, but what it’s done for the Chinese Medicine practitioner is it’s actually allowed a separation of those two patients, a conceptual separation. The first patient has too much energy in the low back, an accumulation, a stagnation, and that needs dispersing. The second patient has a deficiency of energy in the lower back and that actually needs strengthening, you actually need to bring energy, in in a sense, to the low back. So the treatments are actually at opposite ends of a spectrum.
The first patient would receive acupunctural herbs that disperse the accumulation of energy, the second patient would receive acupunctural herbs that strengthen and tonify the low back. It’s a tool like this concept of circulation of energy, that actually allows the Chinese Medicine practitioner to distinguish these patients, and allows the Chinese Medicine practitioner to treat the patients in a way that the patient themselves may understand better, and ultimately hopefully, be more effective.The alternative with Western medicine would have been simply to prescribe both of those patients analgesics or anti-inflammatories of some sort.”
End of transcript
There is a lot that can be said about this radio interview, but the most important aspect is the explanation of the theory that governs TCM. If scientists know how TCM works (mechanism of action) surely that will put peoples’ mind at ease about using TCM. So comparing it to quantum physics, which most people know something about (e.g Large Hadron Collider and the Higgs boson), makes sense and is quite convincing. For most of us quantum physics is something we only know about, without us even going to try and understand it – it is just way above our heads. By placing the theory governing TCM on equal footing with research into quantum physics, surely the public will think that TCM is very well studied and thus safe and effective? And this is the NICM’s intention.
The question is; can you put these two theories on equal footing? Let’s look at the example of light. We can observe light, we can use light (torch, laser etc), we can predict how light will behave under specific conditions, we can scientifically define light – all of this due to hundreds of years of scientific research. By using the scientific method and by running one experiment after the other, many of which failed at first, we gained valuable knowledge of light and quantum physics in general, that we can now use in our everyday lives. Thus it is based on thorough scientific research. Do we know everything there is to know about light? Probably not – but future research will reveal the deeper quantum secrets which will hopefully lead to even more practical uses of light.
The theory behind TCM and the reason that different practitioners will prescribe different herbs for the same patient is based on a complete lack of scientific research or evidence. We cannot observe the energy that flow through these so-called meridians, thus we cannot measure it. And if we cannot measure it we cannot influence it or use it or predict what it will do under specific conditions. The main theory behind TCM, that energy flow through meridians, has been discussed endlessly and it has been relegated to pseudoscience – but not at the NICM. They are simply comparing apples with pears with the main objective to create public trust in the theory governing TCM.
Although this radio interview might at first sound really convincing this is nothing more than intentionally misleading the public. These people at the NICM are trained scientists and they know exactly what is going on. They are also fully aware of the very long list of risks associated with the use of herbs and yet they continue to work very hard at creating and strengthening the publics’ trust in TCM. The reasons for this can be found here. My next blog post will deal with the so-called “body of scientific evidence” for TCM and the simple question; where are all those excellent results?