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Oriental Medicine: a Tall Tale of Outdated Lore

Editor’s Note: Dr. Gorski was on a rare vacation last week, recharging his batteries. As a result, there is no new material by him this week. Fortunately, Ben Kavoussi was ready with another in his series of posts on traditional Chinese medicine. Dr. Gorski will return next week; that is, if he doesn’t return even sooner because he can’t stand to be away from SBM for two whole weeks.

The established laws of nature do not support Oriental Medicine’s claim of Yin and Yang and Five-Phases Theory. Oriental Medicine’s main theory was constructed when our civilization had limited methods to understand our surroundings, and as such, it is only an ancient illusion.1

— Yong-Sang Yoo, MD, PhD, Chairman of the Committee for Medical Unification, Korean Medical Association, 2010

Yong-Sang Yoo is one of the strong and growing voices in Korea that is calling for an end to the national insurance coverage for Oriental Medicine.

Similarly, Professor Zhang Gongyao of the Central South China University petitioned the central government of China in 2006 to abolish support for Oriental Medicine because it has “no clear understanding of the human body, of the functions of medicines and their links to disease. It is more like a boat without a compass: it may reach the shore finally but it’s all up to luck.”2 Zhang Gongyao and fellow critics have consequently blasted China’s traditional medicine as an often ineffective, even dangerous derivative of witchcraft that relies on untested concoctions and obscure ingredients to trick patients, and employs a host of excuses if the treatments do not work.3

Bloodletting is used in Oriental Medicine to relieve excess “heat,” meaning fever, sore throat, joint pain, muscle sprain, as well as inflammation. It is often practiced in unsanitary conditions.

A Product of Archaic Thinking

The arguments of Yong-Sang Yoo and Zhang Gongyao are reminiscent of those of William R. Morse, Dean of Medical School at West China Union University, who wrote in 1934 that China’s traditional medicine was a “weird medley of philosophy, religion, superstition, magic, alchemy, astrology, feng shui, divination, sorcery, demonology and quackery.” Morse added that Chinese diagnostic methods “border on the ridiculous and possibly cross the line into absurdity.” Harvey J. Howard — a Dean at the Peking Union Medical College — also wrote in 1934 that “the great majority of these Chinese medicines reminds one of the list of remedies suggested by the third witch in Shakespeare’s Hamlet.”4

Despite its antiquated underpinnings, Oriental Medicine has survived in East Asia due to an unfortunate interplay of socioeconomic and political forces. For instance, after being outlawed during the Japanese occupation (1910-1945), the profession was resurrected in South Korea and was able to join the National Medical Insurance program in 1987. This revival is due to the Korean government’s laissez-faire policy, combined with the unified efforts and the activism of the advocates.5 In China, Oriental Medicine has a protected status that — at least in theory — guarantees it equal footing with scientific medicine.

But since the 1970s, Oriental Medicine has almost experienced some popularity in the West, although for different reasons. Once considered archaic and obsolete, Oriental Medicine has greatly benefited from the postmodern attitudes towards science and knowledge. This is because postmodernists consider the “truth” as being relative to one’s viewpoint or stance. They do not see science as a superior process of acquiring knowledge, but as a “belief system,” a “language game,” which does not give more access to truth than other conceptual constructs.6

This attitude towards science has even achieved the status of academic orthodoxy in Liberal Arts and Humanities in the last decades.7 Many proponents of “alternative” medicine use this academic attitude to reject science as a method of determining the truth about health and treatments.8 Anti-science advocates believe that these notions offer a viewpoint that is “placed in stark contrast to the naive materialism that informs some scientific points of view.”9

The proponents of unscientific medicines, however, do not realize that prior to the scientific revolution, medicine was some kind of “mass professional delusion,” as David Wootton has pointed out. Prescientific remedies, in general, did more harm than good. Wootton argues that patients sought help from physicians, not because of the efficacy of the ancient remedies, but out of desperation; because doing something was perceived as better than doing nothing.10

They also tend to forget that, as Paul Unschuld has argued, a sharp contrast between “Western” (meaning scientific) medicine and Oriental Medicine is entirely fictitious. The concepts and practices of scientific medicine have their roots not only in traditional European medicine but also in Chinese medicine, writes Unschuld. This is because modern medicine has emerged from a set of conceptual roots that once existed in Europe and continue to exist today in the Far-East. Unschuld therefore argues that by looking at Eastern medicine, modern medicine is actually looking at its own past.11

Prevalent Along the Silk Road

The conceptual similarities mentioned by Unschuld are not coincidental. Historical evidence clearly indicates that the medicine of medieval China and Europe were once intimately linked through the contribution of Middle-Easterners. Due to the importance of this rich cross-pollination along the Silk Road, the historian Paul Buell also disputes the validity of “any claims of isolation between east and west, west and east, with the individual worlds turned in on themselves.” Rather, he recognizes an ongoing “medical and other globalization of the cultures of Eurasia in the 13th and 14th centuries.”12

Indeed, the spice trade by Middle-Easterners along the Silk Road brought many herbal, animal and mineral products to Europe from the Far-East. These products were used for seasoning food, dying fabrics, making perfumes, love potions and tonics, and also for treating diseases. Often spice traders would create a sense of mystery by withholding the origins of their wares, and would ensure high prices by spinning fantastic tales about how they obtained them.13 This trade was so vital to Europeans that when it was curtailed by wars in the Near East and the conquest of Constantinople by Ottoman Turks in 1453, they decided to explore a maritime route to the spice sources westwards. In 1492, Christopher Columbus set out sail to find this route.14

As a result of the commerce between Europe and the Far-East during the Middle-Ages, it would be accurate to state that although the medieval medicine of Europe owes its origin to Greeks and Romans, a significant portion of it actually came from concepts that were commonly shared along the Silk Road. These concepts are commonly known as humorism or humoralism. It is a belief that the body is made up of several fluids (humors), and an excess or deficiency of any of them directly influences health and disposition. Diseases were not seen as forces or entities separate from the body, but as states of humoral imbalances.15

In humorism, each body fluid (humor) was associated with an organ, a quality, a temperament, etc. (Table 1). The prevalent belief was that if humors became imbalanced (dyscrasia) or unhealthy (cacochymia) illness resulted. Deficiencies and excesses or humors were diagnosed by examining the pulse, body discharges and complexion. Bloodletting, purging, enemas, nutrition, and herbal remedies were routinely used as ways to bring the humors back into balance.16

Blood was thought to be made in the liver and distributed throughout the body in the veins. Air and “vital spirits” went from lungs to the heart, where they were distributed to the tissue via arteries. The fact that a cut artery squirted blood rather than air was explained by unseen links between arteries and veins that opened upon injury. The belief was that the tissues consumed all blood delivered to them, and the liver had to make new blood continuously.17


The four humors in Greco-Arabic medicine. The Chinese have a five humor system, with different but comparable relationships. Source: Jackson WA, 2001

It is important to realize that humorism was a first step towards scientific thinking and materialism. Prior to that, disease was believed to be caused by malignant supernatural forces, such as angry divinities, demons, spirits, or by witchcraft and malediction. It was the punishment for impiety and sin, or for the failure to observe religious rites and precepts. Paul Unschuld also views the advent of humorism as a shift from the “ontological” (single-factorial) view to a “functional-individualistic” (multi-factorial) view of disease.

A late medieval publication, the Fasciculus Medicinae (first printed in 1491) illustrates the most important figures of the humoral theory in medieval times.18. If you look at the books on the top shelf in this woodcut from the Fasciculus, next to Aristotle, Hippocrates, and Galen, stand Avicenna, Haly Abbas, Rhazes, Mesue, and Averroes. Pliny the Elder’s Historia Naturalis, and the books of Isaac Judaeus and Avenzoar are either open on the stand or on the table.

In this first printed medical text to contain illustrations, the author outlines the breadth of medical lore in 15th century Italy. This woodcut represents a scholar at the University of Padua surrounded by medical classics. Image Source: Title page from Johannes de Ketham’s Fasciculus Medicinae. Venice: J. and G. de Gregoriis, de Forlivio (Venice, 1495). Library of Congress, US.

The birthplace of the majority of these authors traces the Silk Road. Avicenna was a Central Asian, born near Bukhara in present-day Uzbekistan. Haly Abbas was from Ahvaz, in contemporary Iran. Rhazes was born in Ray, and Mesue in Gundeshapur — both in Iran. Isaac Judaeus Israeli was born in Egypt, and Averroes and Avenzoar were from Andalusia, in present-day Spain. The period of this remarkable Judeo-Islamic contribution to European medicine is from 8th to 12th century.

The most important figure during this period was Avicenna (ابن سينا, Ibn Sīnā, 980–1037), the author of the Canon of Medicine (القانون في الطب, Al-Qanun fi al-Tibb). Originally written in Arabic, the Canon was a summary of all the medical knowledge of its time. The complete compendium, or portions of it, were eventually translated into Persian, Latin, Chinese, Hebrew, German, French, and English.19

The illustrated opening page of the second book of the Canon of Medicine. Undated; probably from Iran at the beginning of 15th century. Source: The National Library of Medicine, US.

The earliest and most enduring translation of the Canon into Latin is attributed to Gerard of Cremona (c.1114–1187), who completed it in Toledo, Spain.20 Soon afterward, the influence of the Canon was permeating the writings of 13th century physicians in Europe.21 In the 14th century, medical universities made extensive use of it for teaching.22 It remained a standard reference for every medical practitioner throughout the rest of the Middle Ages.23 An improved translation was published in Venice in 1527 and was reprinted several times. In total, some sixty partial or complete editions of the Canon were published in Europe between 1500 and 1674.

A Latin copy of the Canon of Medicine, dated 1484, at the P.I. Nixon Medical Historical Library. Image source: The University of Texas Health Science Center at San Antonio, TX, US.

Zhu Ming of Beijing University of Chinese Medicine, and Felix Klein-Franke of the Hebrew University of Jerusalem have argued that on reading the Canon, they were struck by the similarity of some of Avicenna’s writings to Chinese medical theories. Among them, is Avicenna’s theory of humors, his pathology, his remarks about how to distinguish the primary disease from the secondary, and his pulse diagnosis (sphygmology). Avicenna distinguishes 19 types of pulse, each with a quality that indicate a specific functional disorder. According to Klein-Franke and Ming, Avicenna’s sphygmology does not have much in common with Galen’s; instead, it significantly resembles Chinese pulse theory.24

In addition, the Canon makes several references to medicines of Chinese origin. Klein-Franke and Ming name 17 plants on which Avicenna wrote “imported from China” or “the Chinese type is preferable,” etc. It is therefore indisputable that Avicenna had access to, and made great use of, the medical lore of China.

Other scholars have looked at the ways in which Greco-Arabic medicine has influenced Chinese medicine. The Canon was translated into Chinese during the Yuan dynasty (1271–1368), and published along with other Persian and Arabic texts in the hui hui yao fang (回回藥方), with much of the text in Arabic.25

A late 15th century version of hui hui yao fang exhibited in the Chinese Hui Cultural Relics Museum. Image source: SINA Corporation, China.

The hui hui yao fang was probably the official formulary of the Mongolian administration during the Yuan dynasty. Paul Buell sees this document as a “smoking gun” of cultural influences, most of which are now untraceable, because nearly all the other relevant works have been lost. This is why the impact of Chinese medicine on Greco-Arabic medicine, and vice-versa, is widely unknown.

Avicenna is not the only medieval figure whose work shows the exchange of medical ideas and manuscripts between Middle-Easterners and the Chinese. The bibliographer Ibn al-Nadim (ابن النديم, dec. 995 or 998) writes that while a Chinese scholar was visiting Rhazes (رازی, Rāzī) in Baghdad, he translated the so-called “Sixteen Books of Galen,” i.e. the Arabic summary of the most influential books written by Galen. The fate of this translation remains unknown.26

Cultural exchanges along the Silk Road are the reason why Y. C. Kong and D. S. Chen of the Chinese University of Hong Kong write that there is an “inherent affinity between Islamic and Chinese medicines.”27 Paul Buell adds that the medical syncretism that came out of this exchange became in the Middle Ages the base of most European and Middle-Eastern practices, with influences felt as far afield as India and Africa. As seen earlier, this syncretism is apparent in the illustrations of the Fasciculus Medicinae.

Discarded After the Renaissance

Beginning in the 16th century, humorism became increasingly criticized by Renaissance scholars. Andreas Vesalius (1514–1564) was the first to publish a treatise that challenged the anatomy of Galen and Avicenna (the same year that Copernicus published, 1543 — a remarkable year). Others followed suit, including William Harvey (1578–1657), who refuted many humoral assumptions about blood in his treatise on cardiovascular circulation. Harvey measured the amount of blood pumped by the heart in one hour, and showed that it exceeds the weight of the entire body. He also showed that the valves in the heart and the veins allowed the blood to flow in one-way only, and that veins carried blood towards the heart, not towards the limbs.

In the 17th century, humorism was already synonymous with obscurantism and ignorance. The French playwright Molière (1622–1673) made great use of humoral language in writing comedies:

Now, when the vapors of which I speak pass from the left side, where the liver is located, to the right side where the heart is, it happens that the lung… having communication with the brain… by means of the vena cava… meets on its way the vapors which fill the ventricles of the scapula… and because the aforementioned vapors have a certain malignity… which is caused by the acridity of the humors engendered in the concavity of the diaphragm…28

Now compare this laughable anatomy and physiology with a paragraph on “Internal Diseases” in a prevalent textbook of acupuncture and Oriental Medicine, published in 1999.

Wind stirred up by upsurge of liver yang sends qi and blood upwards , which together with the accumulated phlegm Fire disturb the mind , leading to sudden loss of consciousness…29

The inventions and discoveries of the 18th century allowed medicine to undergo a paradigm shift. Disease became subject to new rules of classification and medical knowledge took on an unprecedented precision. Physicians began to describe phenomena that for centuries had remained below the threshold of the visible and expressible.30

Medieval notions such as Humoral pathology, vitalism and spontaneous generation were entirely discredited in the 19th century, when Louis Pasteur, Robert Koch, and others bacteriologists were able to establish indisputable links between germs and disease trough observation and experimentation. The discovery of the cellular basis of disease, and the role of microorganisms in pathogenesis made modern and scientific medicine possible.

Interestingly, as Paul Unschuld points out, when in 19th century Ferdinand von Hebra identified the mite as causing scabies, or when Agostino Bassi identified a fungus as causing silkworm disease, their ideas were initially rejected, not because they were new and revolutionary, but because they were based on a single-factorial view of disease, which then was considered to be old and outdated!

The 20th century witnessed the advent of the molecular basis of disease which addresses the chemistry of disease and recovery processes. Science has identified specific molecules that are involved in disease susceptibility, progression and prognosis, and has allowed the development diagnostic and therapeutic methods based on biochemistry. This has led to an exponential success in disease prevention and treatment, increasing the life expectancy and the quality of life of modern humans.

However, the postmodern fallacy that the science behind these spectacular achievements is merely a “language game” and a “belief system” has allowed the return of mass professional delusions under the label of Chinese, Oriental or Asian Medicine. As an unfortunate byproduct, dangerous and outdated therapies have been legitimized, and quacks and charlatans can overtly defraud those who cannot distinguish scientific medicine from lore and fantasy.

Modern purveyors of obscurantism and ignorance have also created alternative training programs, have funded biased research and publications, have accused the scientific community of corruption and conspiracy, and have spurred legislative efforts to subvert evidence-based medicine and peer-reviewed science.31

This is why responsible physicians, scientists, and public health officials in the West should follow the momentum created by Yong Sang Yoo and Zhang Gongyao in Asia, and call for an end to the licensing of Oriental Medicine practitioners. The modalities and the rationale used by these practitioners are almost identical to the ones we abandoned centuries ago. As George Ulett, MD, PhD, wrote in 2003, it is a “travesty that in this time of scientific evidence-based medicine,” treatments based on archaic thinking are given to unsuspecting patients.32

With many thanks to Daniel Bederian-Gardner, Ui-Won Hwang, Paul Ingraham, Hyunwoo Kim, Chul Koo and Robert Slack for their valuable comments or contributions. The opinions expressed here are those of the author.

References

  1. Yoo YS. Traditional Oriental Medicine and Integrative Medicine. Hanyang Medical Reviews 2010, Vol. 30, No. 2. Return to text
  2. Zhou SF. The Future of Traditional Chinese Medicine. Aust J Acupunct Chin Med 2009;4(1):23–24. Return to text
  3. Magnier M. Scalpel vs. Herb in China. Los Angeles Times. January 08, 2007. Return to text
  4. Morse WR. Clio Medica—Chinese Medicine. Paul B. Hoeber, Inc. 1934. Return to text
  5. Lee HJ, Jun W; Hong SP. Alternative Modernity: The Revival of Korean Oriental Medicine in Modern South Korea. American Acupuncturist; Winter2008, Vol. 46, p18. Return to text
  6. Lyotard JF. The Postmodern Condition: A Report On Knowledge. University of Minnesota Press. 1984. Return to text
  7. Boghossian P. Fear of Knowledge: Against Relativism and Constructivism. Oxford University Press. 2006. Return to text
  8. Stenger VJ. “Postmodern” Attacks on Science and Reality. Quackwatch. Posted 30 May 98. [Accessed 15 April 2012] Return to text
  9. Morris W. Medical Epistemology: A Bias of Culture?. Acupuncture Today. March, 2011, Vol. 12, Issue 03 Return to text
  10. Wootton D. Bad Medicine: Doctors Doing Harm since Hippocrates. Oxford University Press, USA; 1st edition. 2006. Return to text
  11. Unschuld PU. Traditional Chinese medicine: Some historical and epistemological reflections. Social Science & Medicine, 1987, vol. 24, issue 12, pages 1023-1029. Return to text
  12. Buell PD. Medical Globalization in the Mongol Era’, in T.S. Ishdorj (ed.), Mongol Sudlalyn Ogulluud, Essays on Mongol Studies, Ulaanbaatar: ‘Bembi San’ Khevleliyn Gazar (Mongolian Academy of Sciences, International Congress of Mongolists), 138–47. 2007. Return to text
  13. Dalby A. Dangerous Tastes: The Story of Spices. University of California Press; 1st edition. 2002. Return to text
  14. Turn J. Spice: The History of a Temptation. Alfred A. Knopf. New York. 2004 Return to text
  15. Siraisi NG. Medieval and Early Renaissance Medicine: An Introduction to Knowledge and Practice. Chicago: University of Chicago Press, 1990. Return to text
  16. Jackson WA. A Short Guide to Humoral Medicine. TRENDS in Pharmacological Sciences. Vol.22 No.9 September 2001 Return to text
  17. Unglaub Silverthorn D. Human Physiology: An Integrated Approach. Benjamin Cummings; 4 edition. 2006. Return to text
  18. de Ketham, J. The Fasciculus Medicinae of Johannes de Ketham, Alemanus : facsimile of the first (Venetian) edition of 1491. With English translation by Luke Demaitre ; commentary by Karl Sudhoff ; trans. and adapted by Charles Singer. (Birmingham, Ala.: The Classics of Medicine Library, 1988). Return to text
  19. Elgood C. A Medical History of Persia and the Eastern Caliphate. Cambridge. Cambridge University Press, 1951. Return to text
  20. Savage-Smith E. Europe and Islam. In: Western Medicine: An Illustrated History. London I (ed). Oxford University Press: New York. 1997. Return to text
  21. Siraisi NG. The Canon in the Medieval Universities. In: Avicenna in Renaissance Italy: The Canon and Medical Teaching in Italian Universities after 1500. Princeton University Press: Princeton. 1987; 44-46. Return to text
  22. Khan KJ. The Canon: Essential Artillery of the Medieval Medical Student. University of Toronto Medical Journal, Volume 89, Number 1, December 2011. Return to text
  23. McVaugh MR. Europe and Islam. In: Medicine in the Latin Middle Ages. In: Western Medicine: An Illustrated History. London I. (ed). Oxford University Press: New York. 1997; 58-59. Return to text
  24. Klein-Franke F, Ming Z. Avicenna’s Links with Chinese Medicine. A Chapter of the History of Sino-Arabic Relation During the Middle Ages. Asian Medicine. December 1998. Return to text
  25. Alpher JV, Aris A. Oriental Medicine: An Illustrated Guide to the Asian Arts of Healing. Serindia. United Kingdom, 1st Edition 1995. Return to text
  26. Klein-Franke F, Ming Z, Qi D. The passage of Chinese medicine to the west. Am J Chin Med. 2001;29(3-4):559-65. Return to text
  27. Kong YC, Chen DS. Elucidation of Islamic drugs in Hui Hui Yao Fang: a linguistic and pharmaceutical approach. J Ethnopharmacol. 1996 Nov;54(2-3):85-102. Return to text
  28. Poquelin JP (dit Molière). Le Médecin Malgré Lui. Editions Larousse (FR). 2007. Return to text
  29. Xinnong C (Editor). Chinese Acupuncture and Moxibustion. Foreign Languages Press; Revised edition. 1999. Return to text
  30. Foucault M.The Birth of the Clinic: An Archaeology of Medical Perception. Vintage. 1994. Return to text
  31. Auwaerter PG, Bakken JS, Dattwyler RJ, Dumler JS, Halperin JJ, McSweegan E, Nadelman RB, O’Connell S, Shapiro ED, Sood SK, Steere AC, Weinstein A, Wormser GP. Antiscience and ethical concerns associated with advocacy of Lyme disease. Lancet Infect Dis. 2011 Sep;11(9):713-9. Return to text
  32. Ulett GA. Acupuncture: archaic or biologic? Am J Public Health. 2003;93:1037. author reply 1037-8. Return to text

Posted in: Acupuncture, Health Fraud, History

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26 thoughts on “Oriental Medicine: a Tall Tale of Outdated Lore

  1. nybgrus says:

    Excellent piece, Ben. I find myself having to explain to people why acupuncture and TCM are pretty much entirely BS. In some cases this is because they genuinely want to believe it or have experienced it themselves and feel the power of anecdote. But in most cases it is actually because they hear from numerous sources, some reasonably credible, that this stuff “works” in China and that it is used extensively there with success. Couple that with the argument from antiquity and it becomes difficult to untangle for them and it often takes me a while to explain why it doesn’t actually work. The hardest part is to assert that in fact it doesn’t even work in China because to many people this is “common knowledge” and my claim that it isn’t so is the extraordinary claim which requires extraordinary evidence… which of course takes a while to discuss and most people don’t have the time or desire to do so.

  2. Janet Camp says:

    Most of this was covered in one or another of my cultural anthropology classes, but you provide some fascinating detail that may make it easier to help “deprogram” some of my more ardent belief-oriented acquaintances. Sadly, someone who comments here at times reports that some colleges today harbor some very post-modernist anthropology professors who confuse cultural relativity with their post-modernist notions about science.

    Any suggestions as to how we, as readers who are not doctors or practicing scientists, can support the effort to end the licensing of CM followers? I just returned from a road trip that covered seven or eight states and hardly a town seems to exist that doesn’t have at least one alt-med practitioner–usually a chiro or acupuncturinst. Many places are veritable hives of alt-med/post-modernism, and sadly these are often university communities.

    Our task is large.

  3. cervantes says:

    Okay, but I think it’s at best an exaggeration to say that postmodernism has “achieved the status of academic orthodoxy in Liberal Arts and Humanities in the last decades.” Boghossian is intent on attacking it so he builds up the enemy. I would say the reality is that this was a fad in the 1980s that was fading by the mid-90s. Alan Sokal’s Social Text hoax actually had a substantial impact. Postmodernism became a joke, not orthodoxy. For a good time, go here. Sample:

    “1. Predialectic discourse and the subcultural paradigm of consensus

    If one examines the subcultural paradigm of consensus, one is faced with a choice: either accept Debordist situation or conclude that reality is fundamentally impossible, but only if dialectic postsemioticist theory is invalid; if that is not the case, we can assume that sexual identity, paradoxically, has intrinsic meaning. It could be said that the subject is interpolated into a subcultural paradigm of consensus that includes consciousness as a paradox. Long[1] holds that the works of Pynchon are an example of mythopoetical nationalism. ”

    There are a few people still around who managed to become tenured non-entities during this period, but as I say, it’s had its day.

  4. Ken Hamer says:

    “It is more like a boat without a compass: it may reach the shore finally but it’s all up to luck.”

    I don’t think TCM actually “reaches the shore” so much as runs aground.

  5. tyro says:

    I didn’t believe that BS about livers & wind. Surely this must be an exaggeration. I did a quick google search and I’m shocked to say I found lots of confirmation. In fact it was even worse than you wrote. How Stuff Works even has a page which “informs” us:

    “Liver Wind Moving Internally: Since the liver is in charge of the smooth flow of qi, any abnormal body movements are typically related to liver imbalances due to wind. This internal wind is considered an excess pattern, but it can arise from a variety of causes, such as blood deficiency, excess heat, or liver yin deficiency. ”

    http://tlc.howstuffworks.com/family/traditional-chinese-medicine-internal-organ-syndromes4.htm

    I sent a complaint note to howstuffworks.com for promoting such obvious nonsense. It’s one thing to point to bad studies purporting to show a benefit to accupuncture, it’s quite another to talk about excess internal wind from the liver resulting in excess heat or liver yin deficiency.

    I also found a TCM Student guide at http://www.tcmstudent.com/journal/Liver%20Wind.html which says:

    “Internal Wind signs are characterized by movements hence the tremor of limbs and convulsions. It also prevents the Liver from moistening the sinews, causing rigidity. The main signs are high fever with thirst, red face and eyes, ringing in the ears, convulsions, hypertonicity, upward staring eyes, rigidity of neck and back and clenched jaw. Other signs are short inhibited voidings of urine, constipation. In severe cases, when entering the pericardium, the extreme Heat and Wind can cloud the Mind causing clouded spirit, delirious speech and coma.

    The tongue will be deep-red, stiff and with a thick, yellow coating. The Pulse will be wiry, rapid and full.

    The method will be clearing. The treatment will be clear Heat, disperse the Liver and subdue Wind.

    Useful herbs for this type of pattern are: Ling Yang Jiao (Cornus Antelopis), Niu Xi (Acyranthes) and Gou Teng (Uncaria).

    Formulas: Ling Jiao Gou Teng Tang (Antelope Horn and Uncaria Decoction) or An Gong Niu Huang Wan (Peaceful Palace Bovine Bezoar pill).”

    So in the case of a disorder which, according to them, can lead to a coma, they’re suggesting antelope horn and Peaceful Palace Bovine Bezoar pill. Insanity.

  6. Ben Kavoussi says:

    @ nybgrus

    Thank you. Indeed, the stuff does not even work in China, and apparently the government has been gradually marginalizing ancient remedies. However, China is a populated nation with low wages in certain layers of the population, and herbal and other traditional healers still cater to the poor–even if their stuff does not really work.

  7. nybgrus says:

    @janet:

    I am that sad someone who comments here. And I went to an undergrad which, perhaps overly, prides itself on its science curriculum. And has 5 Nobel laureates who are active tenured professors. With buildings named after them. That I studied in.

    But the SocSci department and the BioSci department were basically completely separate in every way imagineable and did not inform each other.

    @Ben:

    Your work on this topic is truly great and wonderfully useful. In the instances where someone actually becomes interested in the evidence I can reference your primary sources (I don’t often reference your actual article since people are more interested in small bits of primary evidence in my experience, but I do also reference your whole works as well). Thanks for putting in the time and effort.

  8. Ben Kavoussi says:

    @ Janet Camp,

    Thanks for your comments. Alt-med practitioner and traditional healers are everywhere in the US, and there are many reasons for this: first we still do not have an affordable and universal healthcare system like European countries, and people seek alternative medicine because in many ways it is cheaper. In Chinatowns across the US you can find patent formula teapills for a couple of dollars. I personally used them when I lived in New York City many years ago and did not have any money to go to the doctor. In downtown Los Angeles you find many “botanicas” that sell medicinal herbs and religious items to the Hispanic population. In other neighborhoods you have chiropractors and acupuncturists. They are usually cheaper than an urgent care clinic.

    Also, apparently only 10-30% of all health problems are brought to professional attention (Mc Daniel at al., “Family-Oriental Primary Care”, Spinger, 1990). The rest of the care is provided by family members or through self-care. Here again people use herbs, supplements and Alt-med because they are cheaper and readily available.

    And then, there is the world of faith healing and spirituality for those who believe in them.

    Are we going to close all of these “parallel” healthcare facilities in the name of science and progress? Not until we have a universal and affordable healthcare system to offer in return. They are there for socioeconomic reasons, even if most of the stuff they sell and do is absolutely worthless.

  9. Ben Kavoussi says:

    @ cervantes,

    Thank you for the clarifications concerning postmodernism. I am not familiar with the work of Guy Debord, but will read about it. And iIf postmodernist attitudes towards science and technology are fading, bravo, this is just great news!

  10. Ben Kavoussi says:

    @ Ken Hamer

    I agree with you. I suspect that Zhang Gongyao of China has formulated his criticism it this way for political reasons. My Korean counterparts told me during our last meeting that in articles that overtly and radically criticize traditional notions meet a lot of resistance and are not easily published. There is therefore a certain self-censorship among Korea skeptics. Perhaps Zhang Gongyao is facing the same dilemma in China…

  11. Ben Kavoussi says:

    @ tyro,

    Thank you for your comments. This is only half the insanity. The other half is the use of animal products to “clear Heat, disperse the Liver and subdue Wind.”

    The products traditionally used for “Wind Moving Internally” involve rhino horn (xijiao), antelope horn (lingyangjiao), and bear bile (xiong dan). This garbage justifies the horrific capture and murder of bears and rhinos in the name natural and traditional medicine:

    http://www.sciencebasedmedicine.org/index.php/asian-bear-bile-remedies-barbarism-or-medicine

    The enormous insanity of TCM is beyond belief!

  12. Eugenie Mielczarek says:

    Ben,
    Thanks for your excellent post .
    NIH’s NCCAM has funded $78 million for acupuncture research awards , http://www.centerforinquiry.net/docs/opp/culling-non-science.pdf, and millions for introduction of acupuncture into medical school curriculum and support of oriental colleges of medicine. Sadly no one in Congress seems to be concerned about this latter use of funds diluting our health care system.

  13. Jan Willem Nienhuys says:

    Am important reason for the upsurge of TCM is the fact that Mao Zedong stimulated its use because he hoped that way all kinds of quacks could serve to create the impression that medical care was impoving.Mao Zedong himself shunned TCM, he only wanted the best of Western medicine. Maybe I read in another article of Kavoussi that actually ‘modern’ TCM was cobbled together in that time. TCM is a succesful export article, and a week ago I saw an article about a Chinese institution for quality control that wants to improve the name of TCM.

    A friend of mine spends every year a few weeks in a Chinese hospital in a specialist team. Sometimes I ask him about the status of acupuncture nowadays in China. The hospitals run small acupuncture clinics, somewhat in the manner Western hospitals often have a chapel or a meditation center, and also partly to attract customers (whenever someone presents to the acupuncture clinic with a serious problem, he is referred to the real hospital…).

    This aspect, the fact that modern TCM bascially is just Maoist propaganda spread by people who even don’t believe in themselves, could stand more elucidation.

  14. Ben Kavoussi says:

    @ Jan Willem Nienhuys,

    Thank you for your comments. Concerning Mao Zedong and TCM during revolutionary China, a reader sent me this excellent article/podcast that I highly recommend:

    http://skeptoid.com/episodes/4259

    It is called “Mao’s Barefoot Doctors: The Secret History of Chinese Medicine” by Brian Dunning.

    Concerning acupuncture in Chinese hospitals I was told the same thing: they are small, marginal and rundown clinics for some customers. They are not a real ancillary service.

  15. Ben Kavoussi says:

    @ Eugenie Mielczarek

    yes, indeed NCCAM has financed since its inception, hundreds of meaningless research with implausible rationals. My argument is that if we know that this research is predominant bogus, them perhaps we should look at it differently: Is the bogus research financed by NCCAM a case of Fraud, Waste & Abuse? Can it be riposted to the HHS Office of Inspector General at http://oma.od.nih.gov/pi/DPIAllegationsHotline.html ?

    Perhaps.

  16. Ben Kavoussi says:

    @ Eugenie Mielczarek

    Correction: “reported” to the HHS Office of Inspector General.

  17. Quill says:

    I think this is an excellent, scholarly and accessible article. The quote from Molière made my day.

    I also think it’s important to understand the interconnections of human thought and not simply think in terms of one culture or era being distinct from another. Everything has a cause and one of the causes of modern science was the Renaissance’s profound dissatisfaction with the lack of efficacy of traditional medicines. I think it would help everyone out if we remind people that today’s science didn’t just pop up as a conspiracy to suppress ancient wisdom but is in fact a natural evolution of that wisdom.

    And humor is important. Twain wrote that “against the assault of laughter, nothing can stand.” Molière had it right and perhaps it’s time to write more plays and make more videos about the “Wacky World of Chiroquackery” or find a new Aristophanes who will not take TCM seriously and say to the OMD “You have all the characteristics of an alternative medicine peddler: a horrible voice, bad education and vulgar methods.” Or find another Swift or Orwell or -someone- that can expose things like TCM for what they are: the faded customs of long transcended methods that should be studied as history not as contemporary practice.

    To paraphrase Shakespeare, let us come to bury TCM, not to praise it or regard it as serious. The best that men could do need not live after them; the past should be more oft interred with their bones.

  18. Ben Kavoussi says:

    @ Quill

    Thank you for your comments and your kind words. You are right, Molière had it right. In Molière’s plays, humoral medicine never cures anyone and those who practice it are put on stage just to display their own vanity and ignorance. As he wrote in The Imaginary Invalid, “All the excellency of their art consists in pompous gibberish, in a specious babbling, which gives you words instead of reasons, and promises instead of results.”

    Fortunately, Molière is still taught in high schools in French speaking countries and kids get to laugh about the medieval doctors. I assume that later in life, when they hear gibberish like wind and phlegm-fire “disturb the mind , leading to sudden loss of consciousness,” they get a chuckle out of it because they think of
    Molière and the ignorant and unscrupulous physicians of his time.

    Unfortunately we in the US suffer from collective amnesia, and do not remember the medicine that was practiced here during Washington’s time. Here, people find bloodletting and lancing with fine needles very exotic, and allow the license ignorant voodoo doctors to provide outdated nonsense in lieu of real medicine. I remain amazed.

  19. I completely agree with this article, but can we stop using “postmodernism” as a straw-man for scientific illiteracy? For one, postmodernism is not even a unified set of theories, but a bunch of often contradictory, often antagonistic ideas that shouldn’t be put together (as they too often are in the US). I can think of several postmoderns who wouldn’t think of science and/or medicine as a language game. Georges Canguilhem, who was himself a medical doctor, Foucault’s mentor, an influence on Derrida and a large number of French philosophers after 1950, was also a virulent opponent of CAMs.

  20. Ben Kavoussi says:

    @ François Luong,

    Thank you for your comments. I am actually a former student of the late Yvette Conry, who co-authored “Medecine, science et technique: Recueil d’etudes redigees a l’occasion du centenaire de la mort de Claude Bernard” with Georges Canguilhem.

    During my 4 years at the université Nancy 2, France, I never heard Conry talk about Canguilhem as a postmodernist. I would even argue that the association of Foucault with postmodernism is entirely erroneous. As you mention, Canguilhem was indeed an opponent of CAM.

    Jacques Derrida is a different story. Derrida – who I admire tremendously – did not have any formal training in biomedical sciences, and his Rhetoric of Drugs (1990) is not a book medicine but a book on the archeology of ideas, philosophy and linguistics. What Derrida might have said about medicine is certainly out of his domain of expertise.

  21. Ben,

    I apologize for my assumption you made blanket assessment of postmodernism. It’s obviously not true and you are much more familiar with it.

    I tend to associate Canguilhem with postmodernism because of the tremendous influence he had on the majority of the philosophers and thinkers who are associated with this nebula. I don’t know if Derrida wrote anything about medicine (my interests tend to veer more toward the poetic and mathematics). I was just name dropping him (and Foucault) to describe Canguilhem (because Canguilhem is under-read in the US). I also tend to cringe whenever I see a French philosopher dally with natural sciences, while not having much familiarity with them (e.g. Deleuze & Guattari, Virilio)(Anglo-American analytical philosophers annoy me for the same reasons).

    At any rate, I think, rather than accuse French Theory (which I will use instead of postmodernism) for the success of CAMs, I would have a look at the privatization of public education and free-market economics for causation. Privatization of public education, starting with Reagan in the 1970s (in California), leading to fewer funds for scientific education, leading to a scientifically illiterate population.

    Which leads us to free-market economics, in which all discourses, without regulations, are presented equally. So CAMs are given as much opportunity as medicine in the market of ideas. Considering now our previous point (a scientifically illiterate population), CAMs will always seem more appealing to the (irrational) customer because it will always provide you with a compelling narrative (“Oh, you’ve got cancer. It’s okay, though, it’s just your energy that is out of whack. I can fix that with some calendula”).

    To finish, I have a hunch that CAMs have a lot less success in countries that have made a lot of investment in scientific education at an early level and where the medical and paramedical industries are heavily regulated. The same could probably be applied to the antivaccination movement.

    François

    PS: I was born in Nancy and started university in Strasbourg.

  22. And I forget, the postcolonial scholar would probably characterize TC and Ayurvedic medicines (all of which are actually Western constructs) as essentialist and Orientalist (Edward Said’s epithet).

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