Angry Doctor

Wednesday, October 31, 2007

Always the last place you look

This letter is so classic, angry doc has to feature it even though it is from the Chinese newspaper.

You can get a passable version of the story by running the text through Babel Fish, but in brief, the writer related how she had sought medical advice (from both western and traditional Chinese physicians) for a total of 11 times for her symptoms of vertigo and vomting, but could not find a cure or relief. On the advice of a specialist, she underwent an MRI; while no pathology was identified, her symptoms continued.

Eventually she saw a TCM physician, who made the diagnosis of vestibular neuronitis and prescribed her with a five-day course of medicine, after which her symptoms disappeared and she was gradually restored to health.

The cure, as it turned out, was at the last place she looked.

Isn't it always?

Taken at face value the story is one of how one physician managed to cure a patient of her (until then) intractable illness while 11 others could not - from the way she told the story, this was probably what the writer wanted to convey - and certainly this could have been the case.

But those who know more about vertigo and the natural history of vestibular neuronitis may have a different take on the story. They will know why an MRI was done, and the significance of a 'negative finding' on the MRI. They will also know that the condition may run a course of several weeks, but be ultimately self-remitting.

The cure, eventually, will come from the last place you looked, or the last doctor you saw.

Still, angry doc would like to know what medicine the writer was given.

Labels:

119 Comments:

  • Was the TCM physician the first to diagnose vestibular neuronitis?

    By Blogger Lim Leng Hiong, At November 02, 2007 1:07 pm  

  • I would find it interesting as to how the traditional Chinese medicine practitioner reconciles the diagnosis of vestibular neuronitis with the philosophy and teachings of his discipline.

    In western or evidence-based medicine, this condition is associated with viral infection or ischaemia (insufficiency of blood supply). How would yin, or yang, or the interaction of the five elements explain vestibular nerve and/or labyrinth disturbance? Hmmm....

    Any TCM practitioner out here who can put in his/her input?

    By Blogger John, At November 02, 2007 2:07 pm  

  • leng hiong,

    The letter didn't say, but I doubt it even if that was the way the writer did remember it. Vestibular neuronitis is a rather loosely used term that can cover over a multitude of faults...

    Of course, it really doesn't matter whether it was a TCM or western doctor who last saw her before she was cured, you realise.

    By Blogger angry doc, At November 02, 2007 5:29 pm  

  • Hmm, the TCM practitioner that she consulted appears to be double-trained in conventional medicine as well, since he suspected an infection cause.

    I don't think germ theory is an integral aspect of TCM, which is why the Ministry of Health had to bring in TCM practitioners to comply with compulsory patient isolation procedures during the SARS crisis back in '03.

    By Blogger Lim Leng Hiong, At November 02, 2007 9:10 pm  

  • TCM physicians do study a bit about microbiology and western medical science.

    Exactly how much I am not sure but they do study it.

    In this day and age they cannot ignore those facts. The purpose and intent of teaching those things is so that they do not miss medical emergencies where the patient could be treated if he/she was sent to the hospitals ASAP rather than given acupuncture or herbs and lose precious time in the treatment chain.

    TCM practitioners can be censured for malpractice if they tried to treat medical emergencies and did not refer the patient to the hospital A&E.

    TCM practitioners are not that bad lah. Some may be, but most truly do try their best for the patients.

    As it is most patients do not go to the TCM physician as the first option for a serious problem. They usually see them for chronic mild conditions that are not well managed by western medicine. In other words they are trying everything cos nothing seems to work so why not keep trying?

    By Blogger Dr Oz bloke, At November 03, 2007 8:40 am  

  • To Dr Oz Bloke, I am glad and relieved that they are trained to spot emergencies. I just wonder how they resolve the different approaches to a symptom of evidence-based medicine (it is not so western now, with so many scientists in Asia too)and of traditional Chinese medicine.

    They seem quite conflicting. One talks of biochemistry, physiology, anatomy and histopathology. The other seems so philosophical and amorphous.

    By Blogger John, At November 03, 2007 10:10 am  

  • According to the Singapore TCM College site, their 5-year full-time course teaches 100 hours each of Human Physiology, Human Anatomy, and Western Internal Medicine.

    They also teach 60 hours each of Pharmacology and Pathology, and 40 hours each of Microbiology and Biochemistry, plus 20 hours of 'Medical Biology'.

    This is out of a total course of 2240 hours.

    I'm not too sure whether Anatomy and Physiology mean the same things in that course as in med school, but if they do then the TCM course is devoting aout 23% of their course-work on 'western' science and medicine.

    Much of it, however, is still on the ancient classics.

    http://www.singaporetcm.com/eclg/syllabus.html

    If indeed the basic sciences they teach are the same as the ones I learnt in med school, I wonder how the students can reconcile the sciences and the practice too.

    By Blogger angry doc, At November 03, 2007 12:59 pm  

  • I remember a survey from many years back that found that most people seek TCM treatment for musculoskeletal complaints, and western medicine for coughs and cold.

    By Blogger angry doc, At November 03, 2007 1:03 pm  

  • People believe what they want to believe. As simple as that.

    By Blogger John, At November 03, 2007 1:59 pm  

  • You're quite right angrydoc,

    the TCM physicians do know quite a bit about anatomy, physiology and microbiology.

    They study it in the Chinese language. The anatomy, pathology, physiology etc etc

    How do they reconcile?

    Well that's the thing. I suspect that many people out there have little understanding of TCM principles. They think it is mostly a con job, all "nonsense" etc.

    I have said here that it is a philosophical way of explaining what is correct.

    Eg the link between the liver and spleen is explained in terms of Wood and Earth elements associations, but in western medical science we know there are linkages between the two organ systems.

    SO basically, if you end up at similar conclusions but explain it differently (one via science, the other via ancient philosophy) what does that mean? Almost same conclusions!

    TCM is not very much wrong in many of the "physiology" explained with philosophy when you correlate their findings and conclusions with western medical science. Just that their system and way of thinking and explaining is philosophical.

    It is quite amazing that thousands of years ago, the chinese already knew of the associations of heart and kidney diseases (although they explained it with FIRE and WATER element linkages).

    So reconciling between TCM and western medical science is not really that difficult because TCM is not really that different in their assessment of pathology via organ system from that of western medicine.

    I know some of you have strongly disagreed with me when I said that it would be good to study TCM before making damning seemingly ignorant conclusions about TCM. I guess it is up to the individual what they want to believe. People like to believe what they want to believe.

    It cuts both ways.

    Why just believe?

    Go find out for yourself.

    By Blogger Dr Oz bloke, At November 05, 2007 9:22 am  

  • "I remember a survey from many years back that found that most people seek TCM treatment for musculoskeletal complaints, and western medicine for coughs and cold."

    Hi angrydoc,

    It makes sense.

    MSK complaints are treated with 3 main modalities in western medicine.

    1) Analgesia

    2) Physiotherapy

    3) Surgery

    1 and 2 take a long time and are slow. As far as 1 is concerned, not much by way of actually treating the cause. But just symptomatic relief. Can have gastritis side effects too.

    3 is too invasive for most people's liking.

    So trying TCM is not a bad option. It's slow anyway. And the principles sound much better than just symptom relief.

    As for colds and flu, TCM is too slow. Western medicine is fast relief. And the disease course for colds and flu is short. So if you use a slow treatment modality principle like TCM, no point cos by the time the treatment works, you have fully recovered on your own!

    For the matter many Singaporeans have bad bad misconceptions about the use of antibiotics (but that's another story I have written on my blog ages ago).

    These days I don't bother so much already.

    Angrydoc, your comment gives some indication that people are not dumb. While they believe what they want to believe, they are also mostly not so dumb to believe extreme beliefs like cow dung for antisepsis.

    By Blogger Dr Oz bloke, At November 05, 2007 9:31 am  

  • 'Cow dung' thinking does not apply only to cow dung, but describes an inability or unwillingness to look at beliefs familiar to us in our culture critically.

    To me, the fact that the TCM college includes 'western' science in its curriculum is an admission that there is a more scientific and valid way of looking at the human body and its functions.

    To make that admission but to continue to teach and promote a system of healthcare based on pre-scientific 'philospophy' is cow dung thinking.

    By Blogger angry doc, At November 05, 2007 10:38 am  

  • "To make that admission but to continue to teach and promote a system of healthcare based on pre-scientific 'philospophy' is cow dung thinking."

    I think that's very strong.

    My view is that as far as TCM is concerned, there are certain associations they use for treating certain conditions that are being studied using western medical science to see if there is evidence. For example inserting needles into the skin for pain relief. Sounds absurd. But the evidence has shown why it works.

    Think of it as another way to stimulate lateral thinking and give some avenue to new research to test new hypotheses etc.

    I am sure the interest in researching chinese medicine in the USA is not blind faith but rather curiosity and investigation. Sometimes these ideas throw up interesting results.

    Ask Barry Marshall about what was said to him when he said PUD was due to an infection?

    It is one thing to be steeply grounded in reality and science. It is another thing to totally close doors on possibilities.

    Please note that I'm not trying to promote TCM. Hardly. But what I think is that we should not throw everything out the window just yet.

    Why are you guys so fierce and have such strong extreme seemingly hatred? Jia lat man!

    By Blogger Dr Oz bloke, At November 05, 2007 10:58 am  

  • "For example inserting needles into the skin for pain relief. Sounds absurd. But the evidence has shown why it works."

    Inserting needles into skin to relief pain is not absurd.

    Thinking and teaching that inserting needles into skin relieves pain because it unblocks invisible energy flowing in invisible channels in your body when the evidence is contrary is absurd.

    By Blogger angry doc, At November 05, 2007 11:14 am  

  • Dr Oz bloke said...I know some of you have strongly disagreed with me when I said that it would be good to study TCM before making damning seemingly ignorant conclusions about TCM.

    There is sufficient body of literature out there for a layman, never mind a doctor, to make an informed opinion.

    To suggest that one has to study TCM is not only arrogant but quite stupid.

    I suppose you can't have a valid opinion on the existence of garden gnomes and "it would be good" if you first went to Fairy School for a few years and graduated with Fairytology? Preferably "Summa Cum Laude"?

    I guess it is up to the individual what they want to believe. People like to believe what they want to believe.

    And you are describing yourself most aptly.

    Also, I would have preferred to more accurately state SOME people ... and not generalise.

    Logical, reasoned thinking people aka sceptics, would be happy to believe in the flow of qi and the existence of meridien lines etc provided there were evidence to support this. The studies done so far indicate otherwise.

    That you keep repeating and calling for people to be open minded when the evidence already indicates otherwise clearly shows who is the closed minded one.

    By Blogger JB, At November 05, 2007 11:50 am  

  • Does a few aspects of the medications prescribed by TCM work? Undoubtedly. What I have issues with are as angry doc pointed out, the thought processes which lead to their uses are wrong.

    I find it hard to reconcile the two. On one hand, there is the scientific method. There are tests for antigens, substances; there are cells we can see using microscopes; anatomy to memorise; rigorous trials to document the effects and side-effects of drugs etc.

    I am not sure whether yin/yang and the five elements can explain adult kidney polycystic disease, for example. Or the multistep process of carcinogenesis.

    The approach of a symptom from the scientific model of observation, documentation and experimentation; and using philosophical concepts are different.

    Just to add, I am not being "chaunivistically" anti-TCM, I am a Chinese too. Those meds that work, have probably been observed to work over centuries. It is the logic behind the use that I have an issue with

    By Blogger John, At November 05, 2007 12:06 pm  

  • To jb,
    Calm down and read my posts carefully. Also,try to keep more degoratory comments out of here and keep this discussion civil, thanks.

    By Blogger John, At November 05, 2007 12:09 pm  

  • John said...To jb,
    Calm down and read my posts carefully. Also,try to keep more degoratory comments out of here and keep this discussion civil, thanks.


    Hi John, I am calm.

    I wasn't aware I was responding to your post. Are you DrOzBloke?

    Am I not entitled to call a spade a spade?

    The suggestion that one has to study TCM before his opinion becomes valid is ludicrous and stupid and I said so.

    If you wish to skirt daintily around what's blindingly obvious, that's your prerogative but don't presume to tell others how to respond.

    I am sure if anyone made blatant, rude and unnecessary comments the Blogmeister will know what to do.

    Thanks.

    By Blogger JB, At November 05, 2007 12:44 pm  

  • Dear jb,

    Yes I am stupid.

    Does that answer your questions?

    Just ignore me. I'm just an idiot writing nonsense. Why do you get so worked up by idiots like me?

    And ok for the record, you do not need to study TCM to know it is nonsense. You know it is nonsense. The evidence is out there. You are intelligent, discerning and smart. Kudos to you.

    Me I'm just dumb. Sorry about that.

    Angrydoc, please tell jb that I'm dumb too. Thanks. :)

    By Blogger Dr Oz bloke, At November 05, 2007 1:16 pm  

  • "Inserting needles into skin to relief pain is not absurd.

    Thinking and teaching that inserting needles into skin relieves pain because it unblocks invisible energy flowing in invisible channels in your body when the evidence is contrary is absurd."

    Actually why is it not absurd? Try telling it to a child.

    "Your leg hurts? Let daddy poke you with these sharp needles and let the needles stay in there for half an hour and it will help relieve your pain"

    See what the child says. Frankly the idea seemed absurd to me. Poke me with a needle? Ouch! That's gonna hurt. And what? It's supposed to relieve my pain not add to it? Are you nuts? That's what I thought last time!

    Yes I agree with you angrydoc that the explanation via TCM is absurd. But hey the acupuncture worked!

    My point is this. TCM philosophies are absurd. The liver is not a piece of wood, but TCM says it is related to wood and spring?

    Yes they are absurd. But the end outcome may be the same.

    Needle in skin = relieves pain. Explained via science or TCM philosophy still doesn't deviate from the fact it relieves pain. But of course scientific explanation is the way to go when it proves and disproves the philosophy. But TCM philosophy may give us some leads to plan new treatment strategies and then prove them with science later on.

    Angrydoc, I hope you get what I'm trying to say? I'm certainly not promoting people to think of everything in TCM philosophy.

    But what do I know. I am stupid anyway.

    By Blogger Dr Oz bloke, At November 05, 2007 1:22 pm  

  • The period is the 1970s

    Dr ozbloke : Professor jb, I just saw the news about Nixon's visit to China and how the chinese performed surgery using acupuncture as the anaesthesia. I'd like to conduct trials to see the results of acupuncture as an analgesia

    Professor jb : A trial on acupuncture?

    Dr ozbloke : Yes Prof! The chinese explain it as clearing blockages in the meridians where this thing called Qi flows. I know nuts about what Qi and all that is. But I have reason to believe there may be some scientific explanation to explain why inserting needles into skin would relieve pain.

    Professor jb : Dr ozbloke, can I ask you a question?

    Dr ozbloke : sure!

    Professor jb : if I insert a needle into your body would that be painful?

    Dr ozbloke : Yes.

    Professor jb : and what you are saying is that you have reason to believe that inserting needles into people would actually REDUCE their pain? Do you know how absurd that sounds?

    Dr ozbloke : But Prof I think it might have something to do with the gate theory of pain or even release of biochemicals in the brain that may have an analgesic effect.

    Professor jb : but the chinese have already explained that it works because of this hocus pocus meridian and Qi theory. How absurd is that?

    Dr ozbloke : Yes I agree that is absurd, and I'm not trying to study that or prove that. I think there is some scientific explanation for the pain relief via release of endorphins in the brain.

    Professor jb : Don't be stupid dr ozbloke. You'll never get funding for this fantastical absurd fairy tale idea of yours.

    Dr ozbloke :........

    By Blogger Dr Oz bloke, At November 05, 2007 1:34 pm  

  • "Actually why is it not absurd?"

    That's a very good question.

    It is not absurd because it is not beyond the realm of everyday possibility that doing something physical to your body will result in a physical response.

    Afterall, when we itch we scratch, when we are numb we massage, and when we hurt we rub.

    It becomes absurd when you postulate a theory to explain this finding, and when you continue to stick to and promote this theory when the evidence is contrary.

    It becomes absurd when you use the same unproven theory to claim that inserting needles into the skin can cure other diseases when there is no data to demonstrate that.

    "Acupuncture" doesn't work. Inserting needles into the skin works for some symptoms. I think it is important to make that distinction.

    By Blogger angry doc, At November 05, 2007 2:16 pm  

  • As an unwritten policy I only delete spam and spam disguised as comments. Having said that, I did once delete a rude comment to protect the person who made that comment. So I am no saint.

    I assume when readers leave comments they are prepared to take responsibility for them, and that they know when to take a comment seriously, and when to ignore one.

    By Blogger angry doc, At November 05, 2007 2:18 pm  

  • Dr Oz bloke said...Dear jb,

    Yes I am stupid.

    Just ignore me. I'm just an idiot writing nonsense. Why do you get so worked up by idiots like me?


    I am not at all "worked up" by what you write. I am merely stating an opinion which is contrary to yours. Isn't this what the *Comments* section is for? If anyone is "worked up", it sure isn't moi.

    Also, I did NOT call you stupid. I called your suggestion stupid. BIG difference. I know of lawyers, engineers and even doctors who believe in The Secret - Law of Attraction - and other woo woo nonsense. Some doctors and engineers have been known to become suicide bombers hoping to be fast-tracked into paradise where virgins await. Intelligent people can and do believe in stupid things.

    I regret that you can't understand this. Your mistake *MY* fault.

    By Blogger JB, At November 05, 2007 2:28 pm  

  • Hi angrydoc,

    I appreciate your reply on the one about absurdity.

    I agree that if there is evidence to show that something works because of a better scientific reason, then we should stop using some inferior philosophical means of explaining it.

    However it all begins with the first steps.

    1) Observation that inserting needles relieve pain

    2) A scientist who believed there is reason to explain how it works scientifically and that it is not a hoax

    3) Testing the scientific hypotheses

    the problem I see is that some people stop at step 1 and call it a hoax because the explanation at that stage was really totally absurd sounding. Hence it had to be wrong and nonsense.

    It took brave men to say hey let's try to test out a few hypotheses on this "totally nonsensical, absurd treatment".

    Otherwise we would be here also laughing about how silly people could be thinking inserting needles into painful area reduces pain and doesn't increase pain?

    Who were these brave men? And how were they treated when they started their experiments? I'm sure with lots of derision.

    By Blogger Dr Oz bloke, At November 05, 2007 2:31 pm  

  • Hi jb,

    You may not write it. But from the tone of your posts I can gather you don't respect me too much and don't think too much of me at all.

    Well maybe I read too much into things and only I feel that your posts are not only contradictory to mine but also rather derogatory on my opinions.

    But I admit to you and do tell you now that I do think I am stupid.

    Anyway have a good day. :)

    By Blogger Dr Oz bloke, At November 05, 2007 2:34 pm  

  • People stopping at step 1 just because the theory sounds absurd is a problem, but if you look at the literature you will find that his has not stopped people from conducting studies on a whole host of alternative medicine treatment.

    The flip-side of the problem is people refusing to stop at step 1 when the evidence shows no efficacy (as with homeopathy), and people who refuse to abandon a theory when it has been shown to be inadequate (as with the miasma theory and acupuncture).

    It may take a brave man to push an unconventional theory, but it takes a braver man to admit that his theory is wrong when the evidence are contrary.

    By Blogger angry doc, At November 05, 2007 2:40 pm  

  • Hi angrydoc,

    I was listening to the radio recently and there was an ENT surgeon talking about immunotherapy.

    The radio host commented that it is something like homeopathy. And the ENT surgeon agreed that on some levels it is similar.

    Thought it was an interesting statement for the ENT surgeon to make.

    I agree with you that it is hard for people to admit defeat. However it is also true that good scientists don't know when to quit. Thomas edison anyone?

    Magical glass bulbs that will replace the oil lamps?

    I'm not a scientist. I am just a doctor. I'm also not smart. In fact I think I am stupid. I leave these things for the people to sort out.

    For me, my job is to treat patients well, help them discern the medical information out there and advise them ethically and rationally without any bias as far as I can.

    By Blogger Dr Oz bloke, At November 05, 2007 2:53 pm  

  • "The radio host commented that it is something like homeopathy. And the ENT surgeon agreed that on some levels it is similar.

    Thought it was an interesting statement for the ENT surgeon to make."

    Except that homeopathy is nothing like immunotherapy. Still, I am quite surprised that the radio host knew about homeopathy - didn't think it was a well-known thing in Singapore.

    Good scientists know when to quit.

    The science and idea behind a light bulb were sound - Edison did not postulate trapping invisible energy inside a glass bulb that would shine.

    He also did not persist in using the same material that burnt out quickly each time, but experimented with different materials until he found the right one.

    That is clearly not the kind of attitude displayed by some proponents of alternative medicine.

    By Blogger angry doc, At November 05, 2007 3:03 pm  

  • I think the big issue here is with the word "some" versus "all".

    The way some people write it, it is like ALL alternative medicine practitioners are bad and cheats.

    And some people read some people writing about some aspects of alternative medicine positively as ALL alternative medicine....

    By Blogger Dr Oz bloke, At November 05, 2007 3:14 pm  

  • To Dr Oz bloke - For me, my job is to treat patients well, help them discern the medical information out there and advise them ethically and rationally without any bias as far as I can.

    I recall in a previous post you were arguing for acupuncture for its placebo effect even when its lack of efficacy has been established. And then as now you keep saying how objective you are on this issue.

    Suurre. :-)

    PZ

    By Blogger PZ, At November 05, 2007 3:16 pm  

  • Hi jb, sorry, I thought that your comment was referring to me as the phrase that Oz bloke and I used was very similar.

    Well, you are correct in saying that it is your prerogative to express whatever opinion you hold. That is the purpose of this forum after all. As for the manner it is expressed, I leave it to you.....

    To pz,
    I think that there is no contradiction between being objective and placebo effects in medicine.

    Knowing a particular form of treatment only gives placebo effects is being objective.

    Unless I have misunderstood you....

    By Blogger John, At November 05, 2007 3:37 pm  

  • Dr Oz bloke said...You may not write it. But from the tone of your posts I can gather you don't respect me too much and don't think too much of me at all.

    I don't presume to know people whom I have not met nor make judgments about people I do not know.

    I have merely rebutted the points that I felt required a response. That you would read so much into it is a reflection of your own thinking for which I cannot claim any credit.

    It's nothing personal. Honest, doc.

    Besides, this tack you are adopting appears suspiciously like "Appeal to pity" which is some sort of fallacy isn't it? ;-)

    By Blogger JB, At November 05, 2007 3:38 pm  

  • To John -

    "I think that there is no contradiction between being objective and placebo effects in medicine.

    Knowing a particular form of treatment only gives placebo effects is being objective.

    Unless I have misunderstood you.."


    Hi John,

    Yes, you have misunderstood me. You can read and better understand if you read the whole exchange here.

    PZ

    By Blogger PZ, At November 05, 2007 4:02 pm  

  • Yeah fallacy. Jb you are right man!

    Oh and PZ welcome too. :)

    Just wondering, am I really that wrong and bad in my comments?

    So bad ar?

    Angrydoc?

    Sorry just having a bad problem with self confidence lately. Sigh.

    By Blogger Dr Oz bloke, At November 05, 2007 4:02 pm  

  • Dr ozbloke is an idiot! Ridiculous joker! Everyone just ignore him.

    Can't believe such a moron got through medical school and is out there treating patients!

    By Anonymous Anonymous, At November 05, 2007 4:05 pm  

  • i do notice the recent features in Mind&Body where the TCM Expert copies wholesale from western medical sources regarding the featured medical question , then subsequently starts with the usual liver is on fire and kidney is too windy explanation. It's absurd!

    Point is that TCM physicians should stop validating their TCM theories with western medical scientific knowledge.

    By Anonymous Anonymous, At November 05, 2007 9:09 pm  

  • oz bloke, since you want my opinion, I'll give my two cents...

    From past comments you can see that you have people who support your integrative approach to TCM and modern medicine, and you have people who criticise your approach, so if it's a matter of self-confidence, it's not all one-sided.

    As for the reason why some people disagree with you, I think it's because they find your comments inconsistent. On the one hand you acknowledge that we need to be evidence-based, but on the other hand you seem unwilling to accept that so far, despite all the studies, there is no evidence that the philosophy and theories behind TCM correspond to observed phenomena. You continue to say that there is value in TCM phiosophy - to my mind it is precisely this reverence for the philosophy behind TCM that is holding its practitioners back from embracing the scientific method fully.

    (Deep down inside, you want TCM to be proven right, right?)

    In terms of delivery, sometimes you use arguments which are fallacious, including the 'science has been wrong before' argument to plead for an 'open mind' (that's another one there) towards alternative medicine. These arguments ignore the fact that science prides itself on the fact that it is open to being wrong in the face of new evidence, whereas alternative medicine isn't, and that there is a lot of evidence out there that put the claims of alternative medicine into question.

    The other thing that irks people is your suggestion that people need to study TCM to be able to criticise it intelligently; this again ignores the fact that so far any evidence of efficacy from TCM has been shown to be independent from its theories of qi and five elements, but can be explained with physiology or biochemistry.

    Finally, when you fail to convince people with your argument, you fall back to a 'victim' role and suggest that the reason why people disagree with you is not because your arguments are fallacious or unconvincing, but that it's because they *choose* not to agree with you - this insults the intellectual integrity of those who debate with you.

    Behind all that is the fact that you are a doctor, which I think accounts for both the support and the criticism you receive. Laymen who like the idea of integration between TCM and western medicine like the fact that a western doctor validates their thinking, while skeptics and scientists who consider TCM a pseudoscience think that it is wrong for a doctor and man of science to lend credibility to pseudoscience.

    Personally, I always welcome your comments even if we don't agree with each other. You are one of the first readers of this blog and your participation helped shaped the direction the blog subsequently took.

    Sometimes your comments annoy me, as no doubt some of my posts annoy you - this is bound to happen since we are both passionate about the subject. Nevertheless I am glad we have open discussions on an open forum, and I continue to learn things from them.

    By Blogger angry doc, At November 05, 2007 9:15 pm  

  • Thanks angrydoc,

    I guess I'm in the business to please these days. So I do appreciate your comments.

    Will take note what not to say again and what to say again :) But yeah looks like cannot please everyone here.

    Deep down I don't wish for TCM to be proven right. Frankly I don't really care too much on a serious level. I mean I don't even like being a doctor and wish I could totally leave medicine.

    But at the moment the medical landscape is such that I should believe in TCM a bit otherwise I'd lose business while at the same time I shouldn't be too far into it otherwise I get ostracized by mainstream doctors.

    So got to straddle the middle ground. I'm also confused lah.

    By Blogger Dr Oz bloke, At November 05, 2007 9:24 pm  

  • Ah! Isn't money the driving force for the seers in the seer-sucker theory while hope drives the suckers?

    By Blogger I must be stupid, At November 06, 2007 7:54 am  

  • To i must be stupid,

    What isn't in this world? It is either money or power.

    Doctors need to feed their families, send their kids to colleges, prepare for retirement, and see other doctors too.

    What, you think all doctors are born congenitally, fabulously rich?

    By Blogger John, At November 06, 2007 9:02 pm  

  • Hi john,

    Going by your logic, robbers and thieves have plenty of justification to loot and plunder (To feed their families).

    Besides, I thought this thread was about the intellectual honesty involved in western and chinese medicine.

    My point on the seer-sucker theory wasn't meant to be an attack on doctors in general. What i was trying to say was that whenever there is demand for anything no matter how ridiculous it is, be it astrology, homeopathy, fortune telling etc., there will be people supplying that kind of stuff.

    No offense meant seriously! :)

    By Blogger I must be stupid, At November 06, 2007 9:34 pm  

  • To I must be stupid,

    I guess with your post following so closely behind dr oz bloke's, the inference would be that doctors and TCM physicians are the 'seers' driven by money and their patients are 'suckers'. Don't worry, no harm done at all!

    When I explained that all people need money for their families, I really didn't expect that someone would think that I implied that robbers are morally justified!

    Oh boy...;)

    To the anonymous poster who expressed the surprise on how TCM practitioners can start off with scientific explanations and concepts and suddenly veer off into the 5 elements and yin/yang, I share your amazement totally.

    By Blogger John, At November 06, 2007 9:52 pm  

  • "When I explained that all people need money for their families, I really didn't expect that someone would think that I implied that robbers are morally justified!"

    Heh heh! I tot you meant that doctors/chinese physicians are justified to push unproven drugs/treament to patients in the name of feeding of families, which in my opinion could very well cost those poor patients their lives and is downright unethical.

    By Blogger I must be stupid, At November 06, 2007 10:06 pm  

  • Unethical practices and people dying from their treatment.

    This is not something that doesn't happen. It happens. But we have disciplinary committees and laws to deter this.

    But does it still happen? Yes unfortunately it does.

    TCM physicians also have a TCM board who will censure TCM physicians who practice unethically or are negligent. TCM physicians pay a malpractice insurance just like western doctors do (but much cheaper cos few sue TCM physicians).

    So the measures are all in place to try to prevent these things from happening. It isn't like the TCM physicians just run amok and let everyone do whatever they liked with no responsibilities. I used to think of TCM physicians like geomancers, fortune tellers "boh zeng hu". But I realise I was wrong in the past.

    However what I do know is that many laymen do not ever think of suing the TCM physician for some strange reason. Have encountered many malpractice cases at A&E but patients do not blame the TCM doctor. Weird.

    By Blogger Dr Oz bloke, At November 07, 2007 9:39 am  

  • Hi Dr ozbloke,

    Perhpas the TCM board does self-regulate its members. But how can you sue a TCM physician if we don't even know if their treaments even work in the first place? Isn't this rather like the geomancer case angrydr brought up previously?

    By Blogger I must be stupid, At November 07, 2007 9:47 am  

  • Hi i must be stupid,

    I think it's about using Bolam's principle.

    As in whether what the TCM physician did, is it what most other competent TCM physicians would have done in the same situation.

    This would lead to a bigger debate I'm sure as to whether majority TCM physicians doing something that isn't proven to work constitutes a scam in the first place.

    In my mind, I'm thinking more along the lines of "do no harm". At least if the majority of TCM physicians are not causing harm or killing patients and you encounter a TCM physician who did cause harm and/or killed a patient there is some case for argument.

    For the matter what is it that people here feel? Do the majority of TCM physicians out there cause patients harm?

    Anyway I brought this up because imustbestupid and john were discussing about patients losing their lives after TCM physicians' unethical practices to feed their families.

    By Blogger Dr Oz bloke, At November 07, 2007 10:11 am  

  • There are now TCM centres set up in general hospitals like Changi, and even in the Institute of Mental Health.

    What happens when things go wrong? A doctor or a TCM practitioner does not need to do anything to cause harm. Some conditions would be catastrophic if nothing is done. Something as innocuous as unilateral lower limb pain could be the harbinger of the very dangerous necrotising fasciitis. Could that be passed off as 'feng shi'(wind and wet, or 'arthritis').

    If it really is necrotizing fasciitis, then what?

    But as Dr Oz Bloke pointed out, Singaporeans somehow do not hold TCM practitioners to the same standard as doctors.

    By Blogger John, At November 07, 2007 10:44 am  

  • " A doctor or a TCM practitioner does not need to do anything to cause harm. Some conditions would be catastrophic if nothing is done. Something as innocuous as unilateral lower limb pain could be the harbinger of the very dangerous necrotising fasciitis."

    John, you are spot on.
    Are TCM physicians skilled enough to pick out most, if not all life threatening conditions?
    What is worrying is the way TCM is being promoted. With TCM centres set up in hospitals, letters in ST forum claiming that TCM cures cancer better than conventional medicine without a follow up rebuttal. To the layman out there, it seems as though that TCM is becoming accpeted as part of "real" medicine, if there's such a thing.

    Perhaps it would be good if the public is educated on the limits on what TCM can do.

    By Blogger I must be stupid, At November 07, 2007 11:12 am  

  • Hi guys,

    From what I understand, TCM physicians are taught regarding medical emergencies and when they should send the patient to the A&E.

    Whether or not they can diagnose necrotizing fascitiis I dunno. But I think most competently trained TCM physicians would send the patient to the A&E. Having said that, NF is something even if you went to the western doctors straight away, the prognosis can be extremely poor anyway.

    Give some credit to the TCM physicians. They are not as "dangerous" as the tone of many posts here make it out to be.

    Also give more credit to the patients. Usually they don't present themselves to the TCM physician if they are really very very sick.

    The current promotion of TCM seems to be for chronic ailments that have poor results when treated with western medicine and when all else fails.

    I don't think most people out there would believe in TCM as the ideal treatment for acute medical emergencies. Not even the TCM physicians themselves. In the TCM course they do teach the TCM physician when to refer to the hospital (ie western doctors).

    I don't think it's so bad. But I might be wrong.

    By Blogger Dr Oz bloke, At November 07, 2007 11:52 am  

  • To Dr Oz Bloke,
    Kinda sad for the TCM physicians eh?

    Cannot treat
    1) medical emergencies
    2) surgical emergencies
    3) conditions that can be treated by scientific methods

    Usually only the very best people or methods are used when all else fails. For TCM..........oh dear.

    But as 'I must be stupid' pointed out, if there is a buyer, there would be seller.

    By Blogger John, At November 07, 2007 12:01 pm  

  • Well.....I used to get very angry seeing all those patients with fractures healed with malunion cos they went to the Chinese Sinseh. Also couldn't understand those patients who come to me for lipid blood tests and ask me for advice but would say they are taking chinese medicine and refuse to take western medicine.

    TCM physicians have their limits. Some patients still go to them.

    Just a side note. TCM physicians are quite poorly paid frankly. Their remuneration is no where near that of western doctors.

    Yes they still have a following, but you can see TCM physicians going into Aesthetic TCM practices etc as well.

    By Blogger Dr Oz bloke, At November 07, 2007 12:10 pm  

  • Wow, it's like a chatroom in here...

    My 'problem' with TCM practitioners are at two levels.

    Intellectually, it is with the fact that TCM is a pseudoscience, and promotion of pseudosciene engenders an atmosphere where other pseudoscience can also flourish.

    I still cannot understand how TCM practitioners can operate on the basis that 'our theory and practice are only good for such cases; anything more serious/urgent must resort to a totally different paradigm'.

    In practice, I see bad outcomes due directly to TCM intervention, and indirectly through patients delaying seeking western medicine treatment because they are on TCM. Having said that, this has more to do with individual practitioners than with TCM itself, since even with western medicine you can have doctors holding on to cases they shouldn't; and both western doctors and TCM practitioners have been known to miss fractures or misuse steroids and antibiotics.

    I share oz bloke's amazement at how patients who suffer bad outcome at the hands of TCM practitioners never file a suit against them. However, with 'mainstream' hospitals now housing TCM practices on the premises, expectations will change and I think it will be a matter of time before it happens. Then we can truly see how much responsibility these institutions are willing to take for a non-scientific modality of treatment operating under their roof.

    By Blogger angry doc, At November 07, 2007 5:03 pm  

  • "Usually only the very best people or methods are used when all else fails. For TCM..........oh dear."

    john, see today's post. :)

    By Blogger angry doc, At November 07, 2007 5:04 pm  

  • "What is worrying is the way TCM is being promoted. With TCM centres set up in hospitals, letters in ST forum claiming that TCM cures cancer better than conventional medicine without a follow up rebuttal. To the layman out there, it seems as though that TCM is becoming accpeted as part of "real" medicine, if there's such a thing."

    I think that is a real problem.

    If a letter promoting chelation for heart disease prevention or spreading vaccine fear appears on the ST Forum, there are people who will see it as their 'territory' to rebut the letter. With TCM, there is no one. With institutions now housing TCM outlets, it will probably be harder for people in the public sector who are against promotion of pseudoscience to speak out against it publicly without making their employers look bad.

    By Blogger angry doc, At November 07, 2007 5:34 pm  

  • "With institutions now housing TCM outlets, it will probably be harder for people in the public sector who are against promotion of pseudoscience to speak out against it publicly without making their employers look bad."

    How about the SMA? Are they going to just still there and allow pseudoscience to be associated with the hospitals? At the rate things are going, we might even have a hospital for homeopathy just like in the UK.

    By Blogger I must be stupid, At November 07, 2007 5:44 pm  

  • I'm sure oz bloke will be delighted to tell you more about the SMA... :)

    By Blogger angry doc, At November 07, 2007 5:46 pm  

  • Hi angrydoc,

    I used to say to patients who liked to compare TCM with western medicine that if TCM wants to compete on equal ground then they should have primary and tertiary level centres.

    At the moment if you have a problem that the TCM doctor cannot fix...where do you go? To the western doctor or A&E. How convenient. A tad unfair isn't it?

    I used to say if you see a TCM physician and he cannot fix you, then you go to the TCM hospital to see the TCM specialist or surgeon to fix you. That way you can compare apples with pears at least and not oranges.

    But I realised this is a trend we cannot go against.

    I was listening to the radio just now and there was this professor from several top universities including Oxford and works in WHO talking about the global trends in natural health. And he commented that TCM was the most globally accepted and practiced alternative medicine. He described how there was a chinese TCM physician who speaks chinese and german treating Austrian ski resort customers with TCM. He described it as conservative Austrians getting TCM treatment.

    It looks like these things are more likely to grow than to disappear.

    As it is some medical insurance plans in Europe would cover alternative TCM treatments if they are performed by western medical doctors. This is a wave of change perhaps MOH realised they cannot stop.

    So what do you do?

    By Blogger Dr Oz bloke, At November 07, 2007 7:51 pm  

  • The Germans seem to have fondness for alternative medicine.

    Unproven therapy is definitely gaining ground, under the guise of 'natural' and 'holistic' treatment and 'health freedom'.

    What do I do?

    I fight my battle where I can: on this blog, where I work, and when I teach.

    And I am not alone.

    We may not win in the end, but it's a cause worth fighting for.

    By Blogger angry doc, At November 07, 2007 8:00 pm  

  • Yeah the germans indeed are very active in the alternative medicine circles.

    Europe is generally a lot more liberal than the US.

    You do realise you have to fight WHO as well.

    By Blogger Dr Oz bloke, At November 07, 2007 8:29 pm  

  • Who?

    By Blogger angry doc, At November 07, 2007 9:20 pm  

  • I think ozbloke means World Health Organization

    By Anonymous Anonymous, At November 08, 2007 8:55 am  

  • there's an article in Mind Your Body dated 7 Nov Page 16 1st question that is a simple case of how TCM and western medicine gets intertwined.It's the kind of practical situation laymen faces. Apart from the theoretical debate whether there is "proof/no proof of tcm working", can anyone shed somelight how to make sense of this article? It'd be enlightening given the vast opinions here.Could it be:
    1) don't believe a word of this article-"not proven tcm philosopy in this"
    2) believe if it does no harm-"no harm believing"
    3) believe because it's in mainstream paper-surely no hocus pocus in *gasp* ST supplement!
    4) others.
    reading it, i find point 1-3 applies..-LH

    By Anonymous Anonymous, At November 08, 2007 12:36 pm  

  • Well angrydoc, looks like you and your friends certainly have a fight on your hands.

    And from the looks of it....you guys are losing ground everyday.....

    Too bad..

    By Anonymous Anonymous, At November 08, 2007 12:43 pm  

  • To Anon 12:43,

    Well angrydoc, looks like you and your friends certainly have a fight on your hands.

    And from the looks of it....you guys are losing ground everyday.....

    Too bad..


    To me, this issue of increasing popularity in unproven therapy is more about the effectiveness of communicating technical knowledge to non-experts who need it to make healthcare decisions.

    It's not about winning any fight.

    It's about emphasizing one point - the most effective, most reliable and best understood tools should be used first to solve a problem.

    In addition, prefering untested (or inherent unprovable tools) to solve problems entails taking unnecessary risks when more reliable alternatives are already present.

    If people really understand this concept, then I doubt they will see alternative medicine in such glowing terms.

    By Blogger Lim Leng Hiong, At November 08, 2007 2:48 pm  

  • I do know of people who have had good results with alternative therapy.

    I myself experienced good results as well.

    It may not work for everyone, but it doesn't mean it will work for no one either.

    KH

    By Anonymous Anonymous, At November 08, 2007 3:31 pm  

  • Unlike leng hiong, I do see this as a fight because I work in a setting where I can see that the price of believing in unproven therapy is paid in the very human cost of health and lives, as well as resources which could have gone towards bettering human health and lives.

    However, that's just language - the term 'fight' describes the fact that I see this as a struggle, and not because there is anything physically violent in what we do.

    Like leng hiong, I believe the method is in promoting public understanding of science. We need to make people understand that the scientific method is the best tool we have at describing the world around us, and that applying science to alternative medicine is the best way to separate the useful from the wishful.

    By Blogger angry doc, At November 08, 2007 5:44 pm  

  • I do know of people who have had good results with alternative therapy.

    I myself experienced good results as well.

    It may not work for everyone, but it doesn't mean it will work for no one either.


    Yes KH, you've brought up an important point. Any form of treatment will appear to work for some people.

    But is the treatment really effective?

    Will it work in many patients, or only a few people will benefit?

    To investigate this, a few success stories is not enough.

    Modern medicine has methods, such as carefully controlled clinic trials, to find out if a type of treatment is actually effective.

    Alternative medicine is not evaluated by these methods, or worse, demonstrated to have no effect at all.

    Of course, as a patient, it's not necessary for you to care whether a treatment results in a real effect or not, as long as you feel better.

    But for doctors, they have to be more certain.

    If alternative medicine is prescribed for something that conventional medicine can already solve, that is taking an unnecessary risk.

    By Blogger Lim Leng Hiong, At November 08, 2007 5:45 pm  

  • Communicating science to people.

    Headline news today about how prevalent drug-resistant bugs are in our community.

    Perhaps another study someone should do is to ask the people on the street what their ideas are regarding taking antibiotics for colds and flu.

    Where's that communication? And we're talking evidence based medicine (or rather no-medicine) here!

    There are all kinds of problems. Both in alternative as well as mainstream medicine.

    Excessive use of antibiotics (prescription only) by people given by their doctors is causing HARM.

    I say western doctors solve their own problems first before talking about alternative medicine practitioners.

    By Anonymous Anonymous, At November 09, 2007 8:31 am  

  • leng hiong, my friend and I saw the western doctors for out problems and didn't get good results. It is a long term problem. With alternative medicine there is much more better improvement.

    KH

    By Anonymous Anonymous, At November 09, 2007 9:21 am  

  • Hi anon 8:31 AM,

    While the indiscriminant use of anibiotics is indeed a problem in mainstream medicine, it is irrelavant to the criticism of alternative medicine. Two wrongs do not make a right.

    By Blogger I must be stupid, At November 09, 2007 9:24 am  

  • I must be stupid,
    I didn't say two wrongs make a right. But I find it strange that angrydoc and gang want to fight against alternative medicine when there are far more dangerous issues within their own western medicine to fight for. Example this communication thing. Why don't the MOH or HPB spend more time educating patients about proper use of antibiotics?

    My GP often tells me that he knows about this problem but most patients want antibiotics and if he doesn't give it to them, they don't like it and he loses business. He also complained that MOH and HPB do nothing to support good doctors like him. On the other hand another clinic where the GP gives out antibiotics for every cold and flu that clinic's business is overflowing!

    So much so my GP says he has started pandering to the crowd to survive.

    Two wrongs don't make a right. But if the majority are doing wrong, while the minority does right....the wrong becomes the "right" to some people.

    By Anonymous Anonymous, At November 09, 2007 9:51 am  

  • Yeah, i get your point. The problem of alternative medicine and the indiscriminant antibiotic use are 2 different types of problems.

    Doctors will readily admit that antibiotics are not indicated for the common flu, while proponents of alternative medicine will give all sort of rubbish explanation as to why you should use alternative medicine. One is a regulation problem while the other is more of a problem with intellectual honesty.

    By Blogger I must be stupid, At November 09, 2007 10:13 am  

  • Are you sure doctors will readily admit that? Try going to a GP for flu and see if you get thrown antibiotics!

    By Anonymous Anonymous, At November 09, 2007 10:27 am  

  • There are all kinds of problems. Both in alternative as well as mainstream medicine.

    Excessive use of antibiotics (prescription only) by people given by their doctors is causing HARM.

    I say western doctors solve their own problems first before talking about alternative medicine practitioners.


    You've brought up a good example. I remember writing about the problem of bacterial resistance to beta-lactam antibiotics during my undergrad.

    Of course at that time, new classes of antibiotics were already under development. The solution is on the way.

    This is a real problem. But it arises partly because of the success of beta-lactam antibiotics in treating infectious diseases.

    In the past 40+ years, together with other healthcare improvements, antibiotics helped to reduce worldwide child mortality from 198 per 1000 in 1960 to 81 per 1000 in 2002 (UNICEF data). In Singapore the reduction is even more dramatic - ten-fold reduction from 40 to only 4 per 1000 in 2002.

    But did you notice something else? The problem of antibiotic resistance is discovered by conventional medicine. The mechanism of this problem, the potential risks, the possible solutions...and so on, are investigated with scientific principles.

    It is not relevant to support your enthusiasm for alternative medicine by pointing out problems in conventional medicine.

    Perhaps you can show us an example of how alternative medicine detects its own problems, and the methods used to solve them.

    By Blogger Lim Leng Hiong, At November 09, 2007 11:35 am  

  • leng hiong, you beat me to saying what I wanted to say, but I've composed a post with a comic so I will post it anyway...

    By Blogger angry doc, At November 09, 2007 12:06 pm  

  • chanced upon this...hmm.-LH

    http://tcm.health-info.org/WHO-treatment-list.htm

    By Anonymous Anonymous, At November 09, 2007 2:14 pm  

  • Hi LH,

    I know what angrydoc would say. Those research papers are not peer reviewed credible ones. So not counted?

    In any case, the way the medical fraternity works is that unless the research makes its way into a big journal like Lancet, NEJM etc it is always going to be viewed with suspicion.

    Much less chinese research papers!

    But it was interesting that the site grouped the conditions and evidence under different levels of credibility.

    By Blogger Dr Oz bloke, At November 09, 2007 2:57 pm  

  • chanced upon this...hmm.-LH

    http://tcm.health-info.org/WHO-treatment-list.htm


    The Quackometer returned a result of 10 canards for this website.

    http://quackometer.net/?url=http://tcm.health-info.org/

    By Blogger Lim Leng Hiong, At November 09, 2007 4:37 pm  

  • Actually, angry doc would say that the summary on the site suggested a number of mechanism by which inserting needles into people's skin may produce certain effect, but did not claim that acupuncture works because the theories behind acupuncture are correct.

    Publication bias is an issue with alternative medicine journal and journals in languages other than English, but then it is hard to say whether the side reporting less effect is biased against, or whether the side reporting more effect is biased for, or is the reality somewhere in between.

    http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=11691776

    Overall, the quality of clinical trial for acupuncture is acknowledged to be poor even by complementary and alternative medicine journals/practitioners:

    http://www.liebertonline.com/doi/abs/10.1089/1075553041323911?journalCode=acm

    and

    http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2796.2005.01584.x

    Having said that, each paper needs to be evaluated on its own merit, based on its methodology and power - being published by a small journal is no sure sign that a study is useless, and being published by a big-name paper doesn't mean the study is flawless either.

    By Blogger angry doc, At November 09, 2007 5:00 pm  

  • To Dr Bloke-"But it was interesting that the site grouped the conditions and evidence under different levels of credibility.", I thought it was interesting as some earlier comments was all about a TOTAL lack of studies on tcm-which seems unlikely-maybe we hasn't chance upon it?, that's why I posted it for comments. noticed I only say "hmmm"-precisely for discussion-no jumping to conclusions-LH

    By Anonymous Anonymous, At November 09, 2007 5:15 pm  

  • lim leng hiong, I've tested the quackometer. All it probably does is search for keywords like TCM, acupuncture, herbs, qi, meridians and stuff like that.

    I entered the website of several MLM companies and they registered zero canards.

    In summary the quackometer is quack. It is hardly and objective and reliable way to assess the content of a website based on solid scientific research evidence.

    I'm surprised that lim leng hiong resorts to using the quackometer to criticize that website LH brought up.

    By Anonymous Anonymous, At November 09, 2007 5:20 pm  

  • To Leng Hiong

    got your point on the suggested credibility issue, am NOT suggesting that the site link is a 'testimony' of any sorts-but on this tcm thread, I don't know if it's because there is no good acupuncture clinical trial information because there isn't or because cannot find. so that explains the "hmm". That's an interesting quackometer site btw! am not inclined to intepret the results as it is (or not), because realised authentic links are really difficult to gauge at times!
    To angry doc, fortunately you did not reply exactly as predicted by Dr Bloke. "suggested a number of mechanism by which inserting needles into people's skin may produce certain effect, but did not claim that acupuncture works because the theories behind acupuncture are correct." you mean the theory can be wrong, but the results can be right?

    sidetrack a bit-guess how many (if any) cannards your blog got :P -LH

    By Anonymous Anonymous, At November 09, 2007 5:34 pm  

  • lim leng hiong, I've tested the quackometer. All it probably does is search for keywords like TCM, acupuncture, herbs, qi, meridians and stuff like that.

    I entered the website of several MLM companies and they registered zero canards.

    In summary the quackometer is quack. It is hardly and objective and reliable way to assess the content of a website based on solid scientific research evidence.

    I'm surprised that lim leng hiong resorts to using the quackometer to criticize that website LH brought up.


    Just curious to see what the quackometer would say. Of course I know some questionable health product websites that score 0 canards.

    You say the first thing you tried the quackometer on is MLM companies. Are these MLM companies involved in healthcare?

    By Blogger Lim Leng Hiong, At November 09, 2007 5:37 pm  

  • Hi LH,

    Yes you brought up an interesting point about research and evidence.

    During the course of my study with regard to controversial topics like homocysteine, hyperinsulinism, Lp(a) etc I also came across several studies in renowned journals like NEJM, Lancet and Circulation that challenged the value of lowering LDL in preventing CHD.

    To be frank, if you search hard enough you will find research results that challenge what many doctors would say is "right".

    Of course the challenge is to analyse and critique the studies. But every study will have their problems and weaknesses.

    Even in meta-analyses, the studies that they choose to include or exclude from the meta-analysis can be due to huge bias.

    Sometimes it takes a while for new research evidence to get through to the mainstream medical thinking.

    By Blogger Dr Oz bloke, At November 09, 2007 5:42 pm  

  • To Annon 5.20 pm
    "I'm surprised that lim leng hiong resorts to using the quackometer to criticize that website LH brought up."

    Don't think Leng Hiong meant that way (hope I'm not wrong!), rather I'd take it as he meant to caution on 'not believing all that we see on website'-maybe in particular this one. Pl refer my reply to his post above. -LH

    By Anonymous Anonymous, At November 09, 2007 5:47 pm  

  • I get one canard! :)

    "you mean the theory can be wrong, but the results can be right?"

    Not exactly. It's rather the case that the observed phenomenon is real, but the theory behind does not adequately describe how or why it works.

    Take the case of acupuncture again. Acupuncture postulates that the reason why someone has pain is because of of qi or blood stasis, and that needling helps unblock this and relieves the pain, and describes a number of meridiens and acupoints accordingly.

    Actual studies show that there is no objectively demonstrable qi or meridiens, and that the pain relief occurs even when the needles are not inserted into acupoints along meridiens, and that there may be other biochemicals released during needling which may account for the effect observed.

    Do you see the difference?

    By Blogger angry doc, At November 09, 2007 5:47 pm  

  • got your point on the suggested credibility issue, am NOT suggesting that the site link is a 'testimony' of any sorts-but on this tcm thread, I don't know if it's because there is no good acupuncture clinical trial information because there isn't or because cannot find.

    Yes, I understand. Thanks for your effort in finding it, since it's a resource that points to the original studies. I'm not sure how many of those papers are on PubMed though.

    sidetrack a bit-guess how many (if any) cannards your blog got :P -LH

    Zero so far, but I'm planning to write some articles about quantum physics, so things may soon change. BWAHAHAHAHAR! :P

    By Blogger Lim Leng Hiong, At November 09, 2007 5:51 pm  

  • dr oz bloke: "TCM practitioners are not that bad lah. Some may be, but most truly do try their best for the patients."

    鲁迅:“中医不过是一种有意或无意的骗子”。

    By Blogger blacktag, At November 10, 2007 8:23 am  

  • Angry doc said...Actual studies show that there is no objectively demonstrable qi or meridiens, and that the pain relief occurs even when the needles are not inserted into acupoints along meridiens,...

    Please don't confuse me with facts! My mind is made up!

    Objectively,
    Jim Burke

    By Blogger JB, At November 10, 2007 10:58 am  

  • "It's rather the case that the observed phenomenon is real, but the theory behind does not adequately describe how or why it works.Do you see the difference?"

    You are saying that it'd be foolish to believe something that is contrary to scientific evidences/what cannot-or yet to be tested robustly by science? Fact or theory first? I mean if the case in point i.e acupuncture-*works* to relieve pain-but the theory behind is yet to be 'endorsed' scientifically- is the grouse then changes from whether some aspects from tcm works to whether can be *proven* to work?

    Dr Bloke was candid to say-
    'To be frank, if you search hard enough you will find research results that challenge what many doctors would say is "right".

    Even in meta-analyses, the studies that they choose to include or exclude from the meta-analysis can be due to huge bias.

    Sometimes it takes a while for new research evidence to get through to the mainstream medical thinking.'

    In this discussion over tcm (I don't refer it to alternative medicine as an interchangable term since alt.med can include other stuff)- is this all about "proving" a theory acceptable by science? Will all that tcm has to offer be suddenly 'legitimised and accepted' if there's good concrete scientific studies to back it up?

    I do not know how to gauge tcm intellectually,I depend on dr's advice when sick.But I am dismayed when the dr shuts the mind to contemplate other options when conventional medicine may not work/work as well and another possible path is present unless 'proof' is there and stance towards it is "Guilty unless proven innocent."

    Do you see the difference? -LH

    By Anonymous Anonymous, At November 11, 2007 1:11 pm  

  • Hi LH,

    It's not like we are picking on TCM and refusing to acknowledge that there are studies to verify the efficacy of those treatments. But there are different kinds of evidence: good and bad. This link here, http://skepticalpd.com/blog/how-to-rate-evidence/, explains how to rate the different kinds of evidence.

    We do have very good reasons to be skeptical about TCM, since it claims to be able to treat more or less anything under the sun. Claims like it can treat AIDS, http://www.tcmpage.com/hpaids.html ,are so extraordinary that it is reasonable to demand extraordinary evidence. A couple of poorly designed trials are not going to sway our opinion.

    For example, if i were to do a study by posing this question to a group mentally ill patients : Have you ever seen a flying pig?

    I could very well get a high percentage of positive answers. Now if i were to wave the results of this study in front of skeptics of flying pigs? I'm sure they will not be convinced by me. To convince them that there are flying pigs, I would probably need to sample a group of sane people, produce video documentation or even capture a flying pig to show these people.

    Dr ozbloke said "'To be frank, if you search hard enough you will find research results that challenge what many doctors would say is "right"."

    This is precisely why we need to scrutinize the methodology of those research studies and see if they are reproducible. This is the only way to safeguard against research fraud.

    By Blogger I must be stupid, At November 11, 2007 2:14 pm  

  • No, you still don't get it, LH.

    "You are saying that it'd be foolish to believe something that is contrary to scientific evidences/what cannot-or yet to be tested robustly by science?"

    Not necessarily foolish, but certainly unscientific. If you choose to believe in things without requiring evidence, or even when the evidence is contrary, then there is no reason why you shouldn't believe in anything and everything.

    "Fact or theory first?"

    Observed facts first, but then any theory proposed must match observed facts.

    "I mean if the case in point i.e acupuncture-*works* to relieve pain-but the theory behind is yet to be 'endorsed' scientifically- is the grouse then changes from whether some aspects from tcm works to whether can be *proven* to work?"

    That 'acupuncutre' *works* only shows that inserting needles into skin relieve certain symptoms, and not that the theory of acupuncture is correct (especially in the face of evidence contrary). You may not see the difference, but I think it's an important one.

    I won't stop my patients from seeking acupuncture treatment (even if I could, which I couldn't), but I make the distinction between the treatment having an effect and the theory behind it being correct.

    "In this discussion over tcm (I don't refer it to alternative medicine as an interchangable term since alt.med can include other stuff)- is this all about "proving" a theory acceptable by science?"

    Not all about, but it comes in too. If you think there is another way of proving a theory other than by the scientific method, you are free to propose it on this blog and explain why you think it is an adequate or superior way of looking at our world in an objective, falsifiable and reproducible manner.

    More importantly, in the case of acupuncture, the observed phenomenon already do not support the theory behind acupuncture.

    "Will all that tcm has to offer be suddenly 'legitimised and accepted' if there's good concrete scientific studies to back it up?"

    If there is good concrete scientific studies to back up a mode of treatment, then it will likely be 'legitimised and accepted' if it is more cost-effective or superior to currrent modes of therapy.

    However, as I emphasised many times before, proof that a mode of therapy works is not proof that the theory behind that mode of therapy is correct.

    If, however, qi and meridiens can be demonstrated in an objective and measurable manner, it will make it possible to prove the theories behind TCM.

    "But I am dismayed when the dr shuts the mind to contemplate other options when conventional medicine may not work/work as well and another possible path is present unless 'proof' is there and stance towards it is "Guilty unless proven innocent.""

    The stance is not "guilty until proven innocent", but "not proven until proven". Doctors do not shut their minds to other options, but continue to require evidence for them just as they require evidence for treatment they offer themselves. Why should they have lower standards of proof for 'other options'? Why should you?

    I will be dismayed if doctors recommend other options without requiring some proof of efficacy.

    By Blogger angry doc, At November 11, 2007 2:15 pm  

  • Hi imbs, yes I understand what you mean, thanks for sharing the link. But I don't intend to 'just anyhow pull out a clinical trial and claim that it proves certain things'neither do I think that way-which I see you are trying to explain with your flying pig analogy.
    "It's not like we are picking on TCM and refusing to acknowledge that there are studies to verify the efficacy of those treatments. "
    My, that's good to hear!
    -LH

    By Anonymous Anonymous, At November 12, 2007 10:40 pm  

  • " No, you still don't get it, LH."

    I see that you have taken the efforts to try and explain and I do appreciate that for a meaningful discussion. There's a few points in there I wanted to clarify which I think by your response didn't interpret it the way I wanted it to be. I know you are making a distinction between acupuncture having an observed effect of relieving pain but without sound scientific theory behind makes it "wolly" and dubious-is that right? if still no, then I also don't need to clarify part 2 (where *you* still don't get it too)-LH

    By Anonymous Anonymous, At November 12, 2007 10:48 pm  

  • "I know you are making a distinction between acupuncture having an observed effect of relieving pain but without sound scientific theory behind makes it "wolly" and dubious-is that right?"

    Yes and no. The observed effects are not really 'woolly' since it is demonstrable; the 'explanation' is not just woolly, but more likely 'wrong' as demonstrated by the findings.

    "if still no, then I also don't need to clarify part 2 (where *you* still don't get it too)"

    This part I don't get. What is part 2?

    By Blogger angry doc, At November 12, 2007 11:33 pm  

  • Looks like I still only get it 50% right with your "Yes and No " reply.

    "Why should they have lower standards of proof for 'other options'? Why should you?

    I will be dismayed if doctors recommend other options without requiring some proof of efficacy."


    I mean to say, if most people find accupuncture (as a case in point) works and you don't-because the theory don't support, is it being a bit hung-up over 'theory'. Not to say that I'll believe everything and anything that cannot be proven by science, but I think somethings really can't be explained by science yet. I am not saying tcm is all accurate etc,but some principles and advice in MYB for eg. seems to make sense-like the article I referred previously(altho' you may "pooh pooh" it and say there is no scientific reason that thyroid problem is related to "weak qi" etc)I thought it's quite exasperating when you ask doctors what they think of tcm as offering some alternative relief and we get the *disapproving look*- I mean most are usually looking for other hopes when they ask that.-LH

    By Anonymous Anonymous, At November 13, 2007 5:29 pm  

  • "Not to say that I'll believe everything and anything that cannot be proven by science, but I think somethings really can't be explained by science yet."

    If something cannot be explained by science, how do you know it is true? If you accept any explanation which seems to make sense, then why would invisible qi be more acceptable to you than an invisible demon?

    "I mean most are usually looking for other hopes when they ask that."

    I think maybe that's where our difference is: I don't think a doctor's job is to offer hope; I think a doctor's job is to give his advice and opinion based on his knowledge, which should be evidence-based.

    By Blogger angry doc, At November 13, 2007 5:54 pm  

  • "If something cannot be explained by science, how do you know it is true?"

    that qn comes about because you equate truth as something 'justifiable by science'(only).It can become a general qn,but back to topic,
    I just said that I think not *everything* can be explained by science" and I suspect (suspect only) that's why people are trying tcm in those areas where there are observed phenomenon (to quote your phase) because they see it works.and yes, knowing that you have said that "the explaination is more likely wrong"...

    "If you accept any explanation which seems to make sense, then why would invisible qi be more acceptable to you than an invisible demon? "

    Gd qn-except that if I had accept any explanation which seems to make sense, then we'd not be discussing this! see, the key word here is "make sense" -of the maze of info in making healthcare decision as a non-tech person and hearing different opinions.

    "I think maybe that's where our difference is: I don't think a doctor's job is to offer hope;"

    it seems a bit queer hearing that you don't think a doc's job is to offer hope. you may realise the contrary someday.maybe it's part of the doc's expected role-a bit like if you are a nurse you are expected to be gentle and caring (but nurses (they are only humans..)do have a temper!).

    so don't worry, you are not hope-less yet.

    *pause* am hopeful

    -LH

    By Anonymous Anonymous, At November 13, 2007 10:46 pm  

  • "the key word here is "make sense" -of the maze of info in making healthcare decision as a non-tech person and hearing different opinions."

    But why does invisible qi make more sense to you than invisible demons?

    "it seems a bit queer hearing that you don't think a doc's job is to offer hope."

    A doctor's job is to offer advice and options based on knowledge. To profess an ability to heal that one does not possess is to be a quack.

    By Blogger angry doc, At November 13, 2007 11:11 pm  

  • "A doctor's job is to offer advice and options based on knowledge. To profess an ability to heal that one does not possess is to be a quack."

    That accusation can be made of many oncologists as well.

    By Anonymous Anonymous, At November 14, 2007 10:09 am  

  • But why does invisible qi make more sense to you than invisible demons?
    ------------
    ..Overheard

    "Objection.This is a (mis)leading paraphased question as invisibility and demons are outside the topic. It subtlely implied that making sense out of tcm is comparable to that-which is not apple to apple"


    sesame magistrate :"Objection sustained. The question thus need not be answered."

    "To profess an ability to heal that one does not possess is to be a quack."

    sesame magistrate : "People may turn to aspects of tcm when they are looking for alternative/complementary relief methods. For a healer who is willing to explore other safe options (offers hope)does not mean 'recommend other options without requiring some proof of efficacy.' since a mode of therapy works, but noted there are disagreements on the 'theory'and what aspects of tcm works.
    Those who are unsure if you are seeing a quack/qualifies as a quack can reference to www.quackometer.net (at own risk).

    Don't be too upset or happy at the results although it could be derived scientifically.

    Time to visit Goldlilocks. I heard she went to seek treatment for knee pain.

    --------
    -LH

    By Anonymous Anonymous, At November 15, 2007 9:39 am  

  • "I mean to say, if most people find accupuncture (as a case in point) works and you don't-because the theory don't support, is it being a bit hung-up over 'theory' ... but I think somethings really can't be explained by science yet."

    So you shouldn't have any problem undergoing caning therapy and be caned by an old man from Malayasia to cure your ailment?

    By Anonymous Anonymous, At November 15, 2007 10:00 am  

  • "I mean to say, if most people find accupuncture (as a case in point) works and you don't-because the theory don't support, is it being a bit hung-up over 'theory' ... but I think somethings really can't be explained by science yet."

    This is exactly cow-dung thinking.

    By this reasoning, by all means visit your favourite shaman, voodoo doctor or snake oil salesman for the latest miracle cures.

    By Anonymous Anonymous, At November 15, 2007 10:15 am  

  • LH,

    On the second part we are in disagreement only over definitions: I consider advice to seek acupuncture for symptoms which it has been proven to work for as offering an option, not offering hope.

    On the first part you are merely evading the question. You need to explain why you consider one form of explanation which invokes an invisible entity as making more sense than another. We *are* comparing apples to apples.

    By Blogger angry doc, At November 15, 2007 12:00 pm  

  • "On the first part you are merely evading the question. You need to explain why you consider one form of explanation which invokes an invisible entity as making more sense than another. We *are* comparing apples to apples."

    Hi Angry doc,

    actually TCM has a bit of spiritual component in its history. However this has been suppressed recently by the TCM board at least locally.

    So there might be some weight in comparing the TCM theories of Qi and Yin/Yang to spiritual philosophies eg spirits/ghosts etc.

    After reading many many arguments from both sides it appears that angrydoc's camps arguments are basically about treatment related to health and how they MUST be proven via scientific research methods before they can be used and recommended for the various conditions they are alleged to be able to treat.

    However, the nature of TCM does include some element of spirituality, spirit controlling the body etc. In a way that almost means a religion of some sorts with a strong faith element.

    Now if TCM was merely a religion and did not engage in healing activities to the extent of becoming part of the nation's health care system, I doubt angry doc and supporters would bother with it.

    However from a religious and spiritual point of view there have been many accounts of healing done by religious figures eg Jesus Christ.

    One wonders how that would fit in?

    Sorry to bring in the religious element but I wasn't the one who started it. Angrydoc's comment about ghosts and spirits being invisible like Qi just got me thinking.

    Can science prove the Christianity faith? Or the Buddhist faith? Or Islamic faith? Or Taoist faith? Or Hindu faith? etc etc?

    Interestingly historically in the old days, science was held back many times due to the religious powers being more influential in society. Scientists who had new (now we know correct) theories of the universe were thrown in jail for being blasphemous.

    Today, science and religion have drawn a line and they have well marked out territories.

    This debate will never end. As long as people continue to do get positive results with a form of "unproven" treatment, that treatment will be continued to be explored by people who are seeking help.

    By Blogger Dr Oz bloke, At November 16, 2007 8:44 am  

  • Yes. Essentially we are talking about things which are "the substance of things hoped for, of evidence not seen".

    "angrydoc's camps arguments are basically about treatment related to health and how they MUST be proven via scientific research methods before they can be used and recommended for the various conditions they are alleged to be able to treat."

    Again, yes. The *efficacy* of a method must be proven, preferably over a control group (with or without placebo and blinding).

    However, this must be done with the understanding that any efficacy observed does not automatically mean that the theory behind the method is correct. The Goldilocks story I posted is to illustrate the fact that unless there is an independently verifiable mechanism of action which can be observed, any theory which invokes invisible forces can be used to 'explain' observed phenomenon, even when they have no basis in reality, and no one will be able to dispute it.

    "However from a religious and spiritual point of view there have been many accounts of healing done by religious figures eg Jesus Christ.

    One wonders how that would fit in?"

    My simple observation of that, the religious beliefs behind notwithstanding, is that judging from the number of patients you and I have to see, oz bloke, there simply aren't enough of these healers around!

    "As long as people continue to do get positive results with a form of "unproven" treatment, that treatment will be continued to be explored by people who are seeking help."

    Say rather that as long as people continue to *think* they get positive results with a form of unproven treatment, they will continue to seek it.

    By Blogger angry doc, At November 16, 2007 12:38 pm  

  • "On the second part we are in disagreement only over definitions"

    yes, i agree-although many patients do equate being offered an option by their dr as a form of hope-ok. I think you have understand the point already.Because there are cases where pts do not even get this offer of option-not because there wasn't any probably, but because the dr isn't willing to consider any (probably they regard 'em as outside scientifically proven & tested scope).I hope you understand I'm not talking abt shamans,voo doo etc).This is from my encounters with people who shared their experiences, and I do not claim for all.

    On this thread, I'm trying to understand why, if some aspects of tcm has shown results, why there is still so much backlash and somewhat vehemant objections from med professionals. After all, there is asymmetry of knowledge here.

    simple eg: a) Broke leg>op> after op>can walk w/o pain = no issue.

    b) Broke leg>op>after op>can walk>got aches>leg weak etc..=dr recommends physio, gives painkillers..

    To stress that this is a very simplified situation. There can be many variables to affect outcomes. But people is likely to turn to tcm for relief if the dr can't further improves the situation to (b)And we hear drs saying people are ignorant, turning to 'unproven mtds'that undo their work...

    so what extent has such feedback actually help the patient. if according to tcm philosopy-eating/avoiding certain food to faciliate healing post op. works, then why not? (I don;t refer to nutritional science here).

    If the conclusion is clear to all that acupuncture (as an eg)isn't working-it's all a farce-then fine (with me at least). I'd think I have gained a new knowledge to learn how to make better health related decisions.

    -LH

    By Anonymous Anonymous, At November 16, 2007 3:48 pm  

  • "You need to explain why you consider one form of explanation which invokes an invisible entity as making more sense than another."

    I am not evading. If I can answer,I would, but I can't because I really think it's not apples to apples.It's something like asking why would believing in God makes more sense than believing in ghosts?(since both are invisible)

    The Goldilocks story I posted is to illustrate the fact that unless there is an independently verifiable mechanism of action which can be observed, any theory which invokes invisible forces can be used to 'explain' observed phenomenon, even when they have no basis in reality, and no one will be able to dispute it.

    ok i understand-this one is clearer-you are asking why would I believe/make sense to me that the observed phemomemon (the acupuncture relieves pain)is due to "qi" and not 'demon'-since both are invisible? if this understanding is correct, then back to above- I still don't think it's apples to apples because making sense of 'qi' and 'demon' are 2 different things. As to *why*- sorry I don't know how to explain. it's not that I don't want to.

    -LH

    By Anonymous Anonymous, At November 16, 2007 4:00 pm  

  • LH,

    Thanks for continuing to read and comment.

    I think for the 'second' part we are more or less in agreement.

    "On this thread, I'm trying to understand why, if some aspects of tcm has shown results, why there is still so much backlash and somewhat vehemant objections from med professionals."

    Because just because *some* aspects of TCM have shown results does not mean that *all* of TCM work, and it is important for people to make that distinction. As an analogy, imagine if doctors claimed that just because antibiotics works for some diseases/infections, *all* of western medicine works.

    "making sense of 'qi' and 'demon' are 2 different things. As to *why*- sorry I don't know how to explain."

    If you can't explain why qi and demon are different, then you also cannot dispute someone who claims that they are the same, can you? :)

    We all come to this blog, these discussions, with our own sets of experiences and prejudices. One of the things I hope we can do here to to present and look at evidence, and consider them critically even when they are contrary to our own cherished beliefs, or beliefs which we have never questioned.

    By Blogger angry doc, At November 16, 2007 4:11 pm  

  • Hi Doc,

    However from a religious and spiritual point of view there have been many accounts of healing done by religious figures eg Jesus Christ.

    One wonders how that would fit in?
    - Dr Oz Bloke

    Religion, to my knowledge, doesn't purport to be a system or modality of cure for illness.

    The cures claimed and referenced in religious magic-books usually done by messianic religious figures point to miracles and divine intervention of sky fairies and not meant to imply first-line medical therapy.

    The answer is, religion wouldn't fit in medically, otherwise, Christians would go to their priests or Jews their rabbis when sick.

    Can science prove the Christianity faith? Or the Buddhist faith? Or Islamic faith? Or Taoist faith? Or Hindu faith? etc etc

    If existence of invisible sky fairies can be proven the word FAITH need not be invoked. And the wicked sky fairy need not threaten you with torture in hell for all eternity if you do not believe in her.

    As Sam Harris puts it so succinctly - "Faith is nothing more than the license that religious people give one another to believe in their God when reasons fail.

    PZ

    By Blogger PZ, At November 16, 2007 4:17 pm  

  • Hi LH,

    "making sense of 'qi' and 'demon' are 2 different things. As to *why*- sorry I don't know how to explain."

    You can’t make sense of demons because most of us no longer hold the primitive beliefs of say the Amazonian tribes of the Caboclos, Manioc, Kayapo and the Witoto, who believe demons are the cause of illness.

    Whether you think such beliefs silly and ludicrous, undoubtedly it makes sense to these primitive people. If it did not then of course they too would reject this belief.

    "Qi" makes sense to you just as much as invisible demons do the Caboclos. The thing is, "making sense" of a belief does not make it true.

    The fact is both are faith-based belief systems and identical.

    Invisible demons or invisible qi may "make sense" to the people who believe them but that doesn't make it true or appear less ludicrous and silly to those who see through the lens of evidence-based belief.

    PZ

    By Blogger PZ, At November 16, 2007 9:18 pm  

  • Hi PZ,

    i nearly missed seeing yr comment since this has already gone into archives. Just a response which assuming you'll come back and check-

    Qi" makes sense to you just as much as invisible demons do the Caboclos. The thing is, "making sense" of a belief does not make it true.

    Just to clarify that this phrase 'make sense' in the context of the previous posts has nothing to do with 'belief'. I think this notion comes in because of the way a qn about comparing 'qi' and 'demons'.

    It's may not be appropriate to reduce all of tcm philosophy to just "invisible qi" and goes into a philosophical discussion on beliefs, faith, demons etc.

    From what you said, then "not making sense (of a belief) doesn't make it false either".

    I surmise your point is about *evidence-based* both in theory and outcome aspects. It's also baffling hearing that more practitioners have obtained further qualitications in acupucture as in the news recently.

    -LH

    By Anonymous Anonymous, At November 18, 2007 11:44 am  

  • From what you said, then "not making sense (of a belief) doesn't make it false either" -LH

    Certainly, I agree.

    Making or not making sense is irrelevant to the truth or falsity of beliefs.

    I think this notion comes in because of the way a qn about comparing 'qi' and 'demons'.

    Your belief in invisible qi (blocked) is no different to the Coboclos' belief of invisible demons being the underlying cause of ailments and illness. You BOTH share a faith-based belief system and as Angrydoc had pointed out earlier *IS* comparing "apples to apples" - something you keep refuting and are still refuting.

    Can you explain how your faith-based belief system is different to that of the Coboclos?

    PZ

    By Blogger PZ, At November 18, 2007 12:40 pm  

  • "It's also baffling hearing that more practitioners have obtained further qualitications in acupucture as in the news recently."

    As oz bloke wrote on a comment in another post, MOH's guidelines are that acupuncture provided by western doctors are to be "in accordance with current clinical evidence". For conditions where evidence is lacking or where acupuncture is provided as a part of a clinical trial, full disclosure and proper informed consent are to be made.

    This shows that hype aside, the MOH acknowledges the difference between sticking needles into people relieving some condtions, and *acupucture* *working*. Of course, how much of that translates to the patients through the practitioners and media is another matter altogether.

    By Blogger angry doc, At November 18, 2007 1:24 pm  

  • Your belief in invisible qi (blocked) is no different to the Coboclos' belief of invisible demons being the underlying cause of ailments and illness. You BOTH share a faith-based belief system.

    Hi PZ,
    "Belief" as in I've seen cases where acupuncture (as a case in point)works. I question & evaluate it too.

    so it's not belief as in faith based/religious based where you believe banging a wall repeatedly will turn it into a door type.(well, not exactly a good eg. offhand but hope you get it).

    thus *really* not apples to apples. :)


    'Of course, how much of that translates to the patients through the practitioners and media is another matter altogether.'

    Hi Angry Doc,that's true and it's indeed a bit of a problem. While you have explained that some of tcm has its roots in unscientific theory and methods, science has yet be able to refut some of "tcm's results" yet.

    -LH

    By Anonymous Anonymous, At November 19, 2007 10:52 pm  

  • "Belief" as in I've seen cases where acupuncture (as a case in point)works. I question & evaluate it too.

    so it's not belief as in faith based/religious based where you believe banging a wall repeatedly will turn it into a door type.(well, not exactly a good eg. offhand but hope you get it).

    thus *really* not apples to apples. :)
    ________________

    LH are you stupid or just being stubborn and argumentative?

    When you are not going around in circles you go off-tangent. No one is disputing that needling the skin produces certain effects. Where is your evidence of invisible qi??? If you can't produce the evidence than you might as well claim that invisible demons are the cause. Get it????

    Studies already show that there is no demonstrable qi and that the pain relief occurs even when the needles are inserted into non-acupuncture points.

    Belief without evidence *IS* not only faith based but also cowdung thinking however you may wish to deny it.

    Belief AGAINST contrary evidence is going a step further - plain idiotic. Whoever wrote that "Ignorance can cured but stupidity is forever" must have you and your cow-dung thinking ilk in mind.

    "so it's not belief as in faith based/religious based..."

    Of course it is! Believing in imaginary gods, invisible demons or invisible qi without evidence *IS* faith based. Yes you can be stubborn and deny it all you want but you can't change this fact.

    I don't know why rational and intelligent people like Angrydoc and others even bother to respond to a stubborn and argumentative moron like you.

    By Anonymous Anonymous, At November 20, 2007 12:35 pm  

  • Annon 12.35pm

    this is rude! what it is to be civil? unfortunately you do not know how to.-LH

    By Anonymous Anonymous, At November 25, 2007 9:35 pm  

  • This can't really have effect, I think like this.
    do not forget check | check 2 | also 5 you may 7 | this 6 | do not forget site also 1 | also 2

    By Anonymous Anonymous, At December 31, 2012 4:52 am  

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