Jun 01 2012
There is no shortage of technology in my household: computers, smart phones and tablets of one kind or another. The nice thing about being a blogger and an app developer is I can justify it all. Well, mostly. The “It’s probably tax deductible” gambit can only be used so many times. It is remarkable how much of my life is filtered through the digital lens. I think if google glasses ever become a reality, my kids and I will be the first up to be permanently wired into the world. To my way of thinking, the Daemon haunted world looks like hog heaven.
There is an app for just about anything, many of which feed into my OCD. I keep track of my daily walk and I have walked over 1500 miles since July 1, 2011. When I developed my middle aged bloat I had the option of medications to control the metabolic results or lose some damn weight. Losing weight is simple in concept, hard in execution. Take in fewer calories than you expend and the weight will slowly, ever so maple bar free slowly, come off. It took 9 months to drop the 45 pounds needed, and I must say I feel just as old and creaky as I did before, but my labs are better. The opposite of the placebo effect: I am subjectively the same but am objectively better. I’ll take it. One of the cool features of the app I used, and still use, for calorie management is that it will take a picture of the bar code of food and give you the nutritional information for entry in the program. Amazing.
A fellow bugdoc sent me a link to story about Chinese Tongue diagnosis. The journal article has been accepted for publication as Automated Tongue Feature Extraction for ZHENG Classification in Traditional Chinese Medicine
It is as fine a piece of tooth fairy science and tooth fairy engineering as I have ever encountered.What is ZHENG? The paper starts with the usual blather: ancient, blah blah, holistic blah blah enhances body resistance yada yada. The standard logical fallacy filled introduction to justify the study nonsense. Been there, done that. Is ZHENG based on any known anatomy, physiology, biochemistry or validated in prior well done clinical trials. Of course not. At least no that I can find on the Pubmeds or the Interwebs.
They proceed with
For thousands of years, Chinese medical practitioners have diagnosed the health status of a patients’ internal organs by inspecting the tongue, especially the patterns on the tongue’s surface. The tongue mirrors the viscera. The changes of tongue can objectively manifest the states of a disease, which can help differentiate syndromes, establish treatment methods, prescribe herbs and determine prognosis of disease.
Nope. Wrong. Another nonsensical mapping system. While a few diseases can manifest on the tongue (my personal favorite being disseminated histoplasmosis) the tongue does not mirror the viscera any more that the ear, the head, the hand, the foot or the iris. As I have mentioned before, damn is the body crowded when all these mapping systems are applied to one person. They then describe ZHENG:
It is a characteristic profile of all clinical manifestations that can be identified by a TCM practitioner. ZHENG is an outcome after analyzing all symptoms and signs (tongue appearance and pulse feeling included). All diagnostic and therapeutic methods in TCM are based on the differentiation of ZHENG, and this concept is as ancient as TCM in China ZHENG is not simply an assemblage of disease symptoms but rather can be viewed as the TCM theoretical abstraction of the symptom profiles of individual patients. As noted in the abstract, ZHENG is also used as a guideline in TCM disease classification. For example, patients suffering from the same disease may be grouped into different ZHENGs, whereas different diseases may be grouped as the same ZHENG. The Cold ZHENG (Cold syndrome) and the Hot ZHENG (Cot syndrome)are the two key statuses of ZHENG. Other ZHENGs include Shen-Yang-Xu ZHENG (Kidney-Yang deficiency syndrome), Shen-Xu ZHENG (Kidney deficiency syndrome), and Xue-Yu ZHENG (Blood Stasis syndrome).
I have read and re-read the paragraph and searched the web and the Pubmeds to better understand the concept of “patients suffering from the same disease may be grouped into different ZHENGs, whereas different diseases may be grouped as the same ZHENG.” Reminds be of trying to understand the classification of Streptococci, only less helpful. ZHENG seems to lack the useful clinical ability to classify and discriminate, but I am not certain. My summary of ZHENG: it is anything they want it to be.
‘When I use ZHENG,’ Humpty Dumpty said, in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.’
‘The question is,’ said Alice, ‘whether you can make ZHENG mean so many different things.’
‘The question is,’ said Humpty Dumpty, ‘which is to be master — that’s all.’
As T. Jefferson noted in a different context,
Ridicule is the only weapon which can be used against unintelligible propositions. Ideas must be distinct before reason can act upon them…
I am not so sanguine that reason can act upon ZHENG.
Still, they came up with a way to use computerized pattern recognition and applied it to the tongue to identify the ZHENG state, and then compared it to patients with ‘known’ Hot ZHENG, Cold ZHENG, Gastris and H. pylori in the mother of all multiple comparisons and came up with…. well, I really don’t know. Nothing really. If you judge from Why Most Published Research Findings Are False, the authors hit 5 of 6 reasons why any positive result is probably bunk.
Mostly they concluded that, after what looks to be a huge amount of coding and clinical effort, they have a computer program that can analyze a part of a tongue and it somewhat correlates with the patients ZHENG status. The effort was more to calibrate the system than to validate it as a diagnostic tool, but still generating useless results none the less. All sound and fury, signifying nothing. It saddens me that so much time, effort and money was expended on nothing of value. It is like getting a degree in homeopathy or naturopathy.
If you think if we have problems with the money spent by NCCAM, this study was funded in part by The National Science Foundation of China, who has a subsection for Chinese medicine. Can you imagine the politics and cultural background of funding in China for their traditional forms of SCAM? We have it so easy.
The depressing aspect of the paper is the authors intention to continue to apply what appears to be sophisticated and complex computer programming to fiction, and then bring out a smart phone app. Take a picture of your tongue, it will let you know if your ZHENG is hot or cold, and then you can seek appropriate care.
“As we continue to work on the software we hope to improve its ability. Eventually everyone will be able to use this tool at home using webcams or smartphone applications. That will allow them to monitor their zheng and get an early warning about possible ailments,” Duan said.
This will not be the only app available covering some form of SCAM. Looking at the iTunes store and the Android store all the standard SCAMs are well represented with multiple apps, fewer in the iTunes store than the Android marketplace. There are few apps on Blackberry and Windows phone, but then virtually no ones uses Windows phones. You can diagnose and treat yourself (of course they all have the appropriate disclaimer) and others with apps that assist in homeopathy, naturopathy, chiropractic and herbology.
The Android marketplace has a lot more ‘fun’ apps, probably as it is easier to develop and deploy on the Android app store.
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Few SCAMs are not represented by at least one app; applied kinesiology and craniosacral therapy the main exceptions I could find, although they were found as subset of chiropractic apps. Entering “the amazing meeting” into iTunes did lead to Bible apps. LOL.
There is a smart phone app for almost anything. Skeptic related apps are in very short supply. There are Logical Fallacy apps, but they only pop if you search especially for them and evidently not used by ZHENG researchers. Except, it seems, Science Based Medicine. There is no shortage of medical woo and nonsense in the app stores, but little in the way of medical science and skepticism. For SBM, there is no app for that.
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