The New York Times is strange: it’s one of the few papers left that has a weekly science section (and a good one), but over on the opinion pages you can read endless paeans to religion and the beneficial effects of faith, as well as criticisms of atheism and science itself.
Two days ago, the Times ran a particularly invidious critique of modern science: “The enigma of Chinese medicine.” The author is Stephen T. Asma, a professor of philosophy at Columbia College here in Chicago. His Wikipedia page says he’s a Buddhist, and he’s written a number of books about that religion/philosophy and other issues. Asam’s piece was brought to my attention by a friend who added, “The NY Times will publish anything by a philosopher who sneers at science.”
As far as I can construe Asma’s piece—and it seems a bit muddled—it appears to be a subtle denigration of Western science-based medicine and a call for us to try other forms of healing, including acupuncture, feng shui, and even turtle blood. Now many modern medicines have come from folk remedies—quinine, for instance, came from observing that native Peruvians used the bark of the cinchona tree, which contains that alkaloid, to cure malaria. But this doesn’t mean that every type of “folk healing” is efficacious, or should be pursued by sufferers. And any folk remedy adopted as a general treatment should be vetted via blind testing with placebos. For that’s the only way to determine whether it works.
But Asma’s piece doesn’t really say that stuff. Instead, it contains a number of questionable statements. I’ll try to be brief, but will probably fail.
The piece begins when Asma describes catching a cold in Beijing. His Chinese wife recommended that he drink a concoction of turtle blood and grain alcohol (they slit the turtle’s throat in front of him). He said he felt better that day and the cold subsided, but so what? Can turtle blood really kill viruses? Or was it a placebo effect: one that cost the life of an innocent turtle? Or, most likely, the cold was waning naturally.
That got Asma thinking that this kind of alternative medicine deserves serious consideration—and also about the supposed problems with science-based “Western” medicine:
Many Westerners will scoff at the very idea that turtle blood could have medicinal effects. But at least some of those same people will quaff a tree-bark tincture or put on an eggplant compress recommended by Dr. Oz to treat skin cancer. We are all living in the vast gray area between leech-bleeding and antibiotics. Alternative medicine has exploded in recent years, reawakening a philosophical problem that epistemologists call the “demarcation problem.”
I’m dubious about those eggplant compresses, but we know from scientific study that cinchona bark does work against malaria. I see no reason not to test promising folk remedies with scientific methods before we gain confidence in them. But what about that demarcation problem?
Asma criticizes the criteria used to demarcate science from pseudoscience, like Popper’s “falsifiability” criterion (one, by the way, that I think is quite good). Asma implies, in fact, that astrology can actually be validated via science, ignoring the fact that astrology has been shown to be useless in predicting personality traits:
The contemporary philosopher of science Larry Laudan claims that philosophers have failed to give credible criteria for demarcating science from pseudoscience. Even falsifiability, the benchmark for positivist science, rules out many of the legitimate theoretical claims of cutting-edge physics, and rules in many wacky claims, like astrology — if the proponents are clever about which observations corroborate their predictions. Moreover, historians of science since Thomas Kuhn have pointed out that legitimate science rarely abandons a theory the moment falsifying observations come in, preferring instead (sometimes for decades) to chalk up counter evidence to experimental error. The Austrian philosopher Paul Feyerabend even gave up altogether on a so-called scientific method, arguing that science is not a special technique for producing truth but a flawed species of regular human reasoning (loaded with error, bias and rhetorical persuasion). And finally, increased rationality doesn’t always decrease credulity.
Not so fast! The “claims of cutting-edge physics”, like string theory, are not accepted as valid hypotheses precisely because they have not been shown to be falsifiable. That is, nobody’s figured out a way to test string theory using real-word observations. That’s why, while it’s intriguing and the subject of a lot of study, it’s still controversial. As for his notion that astrology passes Popper’s tests, Asma admits that this works only if you tweak or distort the data. So how does that invalidate Popper?
Finally, yes, scientists are loath to abandon theories that have passed many tests, but eventually, when theories become so weak or are subsumed by more general ones, or when findings prove to be false, they’re abandoned. Look how quickly the faster-than-light neutrino finding was ditched when it was investigated and found to be due to loose wiring. Darwin dispelled the idea of creationism among thinking people within a decade after publishing The Origin.
The demarcation problem exists only if you adopt remedies that haven’t been tested, or have been shown not to work, like laetrile as a cancer cure. All Asma is doing in the excerpt above is dissing science: emphasizing flaws, bias, error, and rhetoric, but failing to mention both its self-correcting nature and the fact that it’s given us results.
In the end, science is validated by those results, and Asma’s implications that the scientific method is flawed, or that scientists cling desperately to false theories, are simply ways for him to denigrate an approach that has produced enormous progress. If scientific methods weren’t applied to medicines, we’d still be back in the era of turtle blood, spells, and shamans. Which would Asma prefer if he could rely on only one? Increasing rationality may not always decrease credulity, but it’s the only way we know to better understand the universe. Or does Asma have another way to decrease credulity?
Asma then goes on to tout acupuncture and feng shui, saying that they can have beneficial effects. And perhaps they can, but are those effects placebo effects? As far as I know, and I may be wrong, scientific tests of acupuncture, using “placebos” in which needles are placed in spots theoretically not be connected to maladies, have shown it to be at best a placebo. And so, I suspect, is feng shui. Asma notes that he bought his apartment in China partly on the basis of a realtor’s assurance that the place had “positive qi energy,” and that he feels better when his desk faces the doorway rather than away from it. But of course when his desk faces the doorway he can see a creek!
To his credit, Asma admits that the benefits of feng shui may be placebo effects. I’ve long thought that doctors should study placebos more, because if you can get beneficial effects without the side effects of more dangerous medicines, that’s worth knowing. Studies of placebo effects—including sham surgery on knees!—have shown that they can work (as in the case of antidepressants) with nearly the efficacy of “real” drugs. (That doesn’t hold, by the way, for antibiotics!) But the effects of placebos must be studied using the methods of modern science. There’s no “demarcation problem” here: psychology can affect well-being and perhaps healing, but we won’t know that without the proper blind tests.
Sadly, Asma then goes off the rails, implying that Darwin’s theory of evolution wasn’t solid science because it “didn’t correspond to the experimental method of the falsifiability model.” Bollocks! Has Asma even read Darwin carefully? In The Origin and other books, Darwin is constantly testing his theories against alternatives, and the alternatives (e.g., creationism) against evolution. The chapters on biogeography and embryology, for example, show how observed facts are consistent with “descent and modification,” and not with creationism. There are innumerable observations that could falsify evolution, too, and Darwin mentions those (one would be a consistent failure of artificial selection to change wild plants and animals).
Since Darwin, evolutionary biology has generated many verified predictions, like the discovery of feathered dinosaurs as the ancestors of birds. Asma implies that evolution is “less observable” than other scientific phenomena, and although evolution is widely accepted, it’s not accepted through observation. But Darwin did, of course, do experiments, like placing plant seeds in seawater to see if they could survive ocean journeys to colonize islands (they could). And read about his cute experiments with earthworms.
Observation and experiment are not the only way to establish scientific truth. We haven’t seen the Higgs boson or the electron, either, but they’ve led to enough verified predictions that we can regard their existence as scientific truths. We can’t do experiments on stars, but we have a damn good idea how stars evolve, and that comes from observation, reason, and extrapolation.
But neither solid observation nor experimentation validate the supposed “energy” behind qi. If that exists, let its advocates make predictions that we can test. Put blindfolded people in various positions, and see if the “energy-propitious” locations give those subjects more well being.
I can’t resist quoting the following paragraph, in which Asma, while drawing a distinction between evolution and qi, equates evolution with natural selection. That’s not only wrong, but Asma’s characterization is incomplete even as a description of natural selection. Don’t they have scientists to vet this kind of stuff?
Darwinism only posits three major ingredients for evolution; offspring vary from their parents and siblings, offspring resemble their parents more than non-kin, and more offspring are born than can survive in their environment. Each of these facts is easily observable and when you put them together you get adaptive evolution of populations. No additional metaphysical force, like qi, is being posited.
Those are the ingredients for selection only if you add that those organisms that can survive carry heritable variations facilitating that survival (actually, the key trait is not survival but reproduction). And, not to defend qi, but one can still test whether metaphysical forces can have effects. ESP, intercessory prayer, and the like, have all been falsified, though they’re supposedly based on metaphysical forces. Contrary to the claims of faitheists and believers, one can test the supernatural.
Actually, I’m not sure whether Asma even knows what point he’s trying to make, except “let a hundred remedies blossom”. Well, in the sense that we should study things that might be efficacious, even if they’re folk remedies or metaphysical contentions, I agree with him. But he could have said that in a couple of paragraphs instead of in a long essay that comes off as being anti-science.
His confusion is instantiated in the final paragraph:
It seems entirely reasonable to believe in the effectiveness of T.C.M. and still have grave doubts about qi. In other words, it is possible for people to practice a kind of “accidental medicine” — in the sense that symptoms might be alleviated even when their causes are misdiagnosed (it happens all the time in Western medicine, too). Acupuncture, turtle blood, and many similar therapies are not superstitious, but may be morsels of practical folk wisdom. The causal theory that’s concocted to explain the practical successes of treatment is not terribly important or interesting to the poor schlub who’s thrown out his back or taken ill.
Ultimately, one can be skeptical of both qi and a sacrosanct scientific method, but still be a devotee of fallible pragmatic truth. In the end, most of us are gamblers about health treatments. We play as many options as we can; a little acupuncture, a little ibuprofen, a little turtle’s blood. Throw enough cards (or remedies), and eventually some odds will go your way. Is that superstition or wisdom?
The first sentence of the second paragraph is deeply confused. A “sacrosanct scientific method” is in fact the only way to be sure that any remedy works, even as a placebo. It’s the only way to find out the “fallible pragmatic truth”, which I interpret as a pompous synonym for “scientific truth.” By playing off qi against the “sacrosanct scientific method”—I’m sure the word “sacrosanct” is pejorative here—Asma implies that folk/spiritual medicine is, in principle, distinct from science.
It’s not. What is in opposition is the efficacy of remedies tested scientifically versus claims for other remedies that haven’t been tested using that “sacrosanct scientific method”.
As for me, I’m no gambler. When I have a cold, I don’t drink turtle’s blood or resort to acupuncture, but just rest and stay hydrated. (Pain relievers don’t help.) I don’t even take zinc lozenges, reported to shorten the duration of colds, as the results of those studies are mixed.
It’s not wise to gamble with your health, and Asma’s advice to “play as many options as you can” may in fact be dangerous. Should we undergo psychic surgery, or seek phony cancer cures in Mexico? After all, we should “play as any options as we can.”
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Dr. Coyne, if it’s any consolation, the New York Times series in which that essayette is published, THE STONE, or something like that, is the crazy aunt in the attic of the New York Times.
Go back to some of its prior essays, and you will know what I mean.
Also, read the readers’ comments to that article, and you’ll see that they are scathing.
Consolation would be if they paid me to write a counter-article, something that I’ve recently been unsuccessful in trying to do.
Why should it be consolation that this kind of stuff gets published in the country’s best newspaper. Who’s running that railroad?
They should pay you for a counter article. A lot of poor, unaware schmucks are going to read this in the New York Times and think turtle blood cures are as equally good or better than taking some Advil and drinking lots of fluids!
Well, it should be a philosopher, I guess, in keeping with the theme. I’d do it, but don’t have a PhD. Not hard to do. The philosophical aspects of this are…quite lacking (be nice, be nice!).
Perhaps the omniscient Maureen Dowd should hold forth on this topic, also.
Ben Goldacre has been fighting this kind of crap for years on his Bad Science
blogweb site. I don’t know if he has ever been given the honor of trashing NYT woo at the NYT, but perhaps I haven’t been paying close enough attention.Errr, “the beancounters”? Pretty much like everywhere else.
That’s priceless! Indeed–when is that awful series going to end? I’m afraid they’ll never run out of philosophy…
Over on Science Based Medicine the team of medical bloggers there have long regarded Dr Oz as having gone over to the Dark Side for promoting rubbish remedies alongside conventional medicine.
“…if you can get beneficial effects without the side effects of more dangerous medicines, that’s worth knowing. Studies of placebo effects—including sham surgery on knees!—have shown that they can work (as in the case of antidepressants) with nearly the efficacy of “real” drugs.”
The “effect” in the placebo effect is its effect on the clinical study as a confounder. It is not a true therapeutic effect. Placebos do not have true, lasting efficacy.
If we are to accept the placebo effect as a true medical therapeutic effect, we have just accepted the quackery of the witch doctor or the dances of the shaman as legitimate medicine.
IANA doctor, but IMO…
For broken bodies, no. For hypochondrial problems, it’s a very appropriate cure. And pretty much every culture has those. Nor should we belittle these sorts of health issues. People get stressed, and that stress manifests in lots of ways that impact people’s actual health.* Providing relief from the feelings of stress or temporary relief from the symptoms is (IMO) a useful thing to do, and there is absolutely no reason why we should be using strong drugs or surgery or other major interventions to do that. Placebos are perfectly good for that.
*Robert Sapolsky’s work with baboons springs to mind. In a troupe, food and resources are shared pretty egalitarian – everyone has the same “lifestyle.” But the stressed out apes live literally years less than the less stressed apes. Well, we humans are also a collection of more- and less- stressed out apes.
You mean that things that don’t cure are fine for use when no cure is needed. Right?
Placebos are ethically problematic because they require the Dr. to deceive the patient.
It’s worth noting that one of the positives of a classic double blind study is that the doctor isn’t lying; he doesn’t know any more than the patient whether the treatment is real or not.
Sounds like my doctor all the time. Hey, maybe we’re both part of a study!! 😉
Oh no. My fondness for turtles is similar to your fondness for felines.
I have a pair of Reeves turtles in my home that have been with me (and been a ‘couple ‘) longer than my marriages.
I wonder what the professor would say about people who kill rhinos for their horns as medicine?
Yes I was upset at reading that too. I had a tortoise for over 40 years. I have no patience for these stupid remedies that always seem to require horrible treatment and suffering of innocent animals!
One might even argue that it is borderline religious in nature. This silly idea that pain and suffering leads to better health or “purity” and is thus justified.
It pisses me off.
Maybe his cold would have subsided even faster if he’d painted a pentagonal star on the floor and sacrificed a few chickens. What a jackass.
All the suffering of animal testing without the benefits – he should be proud.
I’m amazed that academically trained and rational people can still be so susceptible to magical thinking. I have a friend from China who swears that tiger bone powder cured a childhood fever.
I’ve met some myself. They know the look I start to give when they start going on about some weird folky treatment they received from some lunatic at his house.
I believe that whiskey contains some genuine anti-virals (hot whiskey has long been offered to people with cold and flu, in Ireland at least). I also believe that most whiskey tastes better without turtle blood (scotch being a possible exception).
I think the curative powers of whiskey have been proven beyond doubt.
Cognac works rather well, too. My mother’s remedy for a cold or a sore throat has always been a mug of warm milk with some honey and a generous amount of cognac, or even just cognac by itself. Even if one doesn’t feel better right away, one surely feels happier. In Mexico I have encountered a similar approach to fighting the common cold: I was once advised to drink mezcal/tequila with a lime, and repeat the operation until I felt better and/or happier. This is a kind of folk wisdom I actually feel respect for.
The warm milk plus honey and whisky is known as a posset in the UK and it’s traditionally taken it for a cold. It doesn’t cure the cold it’s true, but one does forget about it (if there’s enough whisky).
Right. In “a concoction of turtle blood and grain alcohol,” one of the two ingredients has an established ability to make one “fe[el] better that day.”
It’s Turtle Bloody Marys all the way down!
Causal or casual? “Please, doc, you got to give me something. Anything!” He said, “Ooo eee, ooo ahh ahh, ting tang, walla walla bing bang….”
I’ve got to say, to a layman, Asma’s thinking seems rather rigorless for a Professional Philosopher (should that get a “TM”?). The story of his acceptance of turtle blood, as related, seems a classic instance of superstition.
Yes. It should get a “™”.
Love the Witchdoctor reference. 😀
Does he not know that Traditional Chinese “medicine” is driving thousands of animal and plant species to extinction? My blood boils whenever someone endorses such a destructive method of “healing”.
What an ignorant idiot.
Indeed. The appalling disregard for the preservation of those plant and animal species alone should be enough to turn anyone off traditional East Asian quackery (I believe the problem is not restricted to China alone, pretty bad in South East Asia as well – poor pangolins!).
On a lighter note, I have fond memories of a trip within Mexico with some friends, one of them a strong believer in traditional Chinese “medicine”. A few of us got a bad case of Montezuma’s revenge, including him. He alone insisted on treating it with some traditional remedy bought in China for just that purpose. No need to guess who spent a good portion of the trip looking at bathroom walls.
I agree! It seems that these things inevitably involve not only the death or the extinction of animals (both terrible) but also the torture which is sometimes prolonged.
Also, I love pangolins. They are one of my favourite animals & I’d love to see one in person!
Oh yes, the torture. Bear bile harvesting anyone?
Haha, but hey all that is natural is good right? Even Moctezuma’s revenge.
And thanks to people like Asma it is becoming extremely popular in America as well.
As one who has fought in the trenches of modern medicine for more than 25 years I can attest to the persistent nature of Woo. Much like the ‘god of the gaps’ arguments used by Christians, Woo proponents seem immune to the erosion of their arguments through scientific methods. It’s magic after all- no need to comply with scientific plausibility. It must be a limit of science, not any flaw in their reasoning, so the argument goes.
Science is hard and we still don’t have a comprehensive philosophical account detailing how it works. Therefore turtle blood for all. I mean who wouldn’t kill a small animal to stop the relatively short and mild discomfort of a cold.
So disgusting that he finds this just a novelty hook for his story — I hope the participants in this barbarity, including Asma himself( “play the good guest and don’t judge the culture”) also believe in karma and have to imagine being reborn as sacrificial turtles. Or finned sharks. or etc.etc.
I had exactly the same reaction when I read the article. Can’t the guy just have a cold for a few days? Did he have to slaughter a turtle?
So what? There is an enormous difference between having criteria (for ‘good science’) that occasionally lead to false positives and negatives, and choosing to have no criteria.
Imperfect human investigative methodologies are a fact of life. You have to be willfully obtuse or incredibly stupid to look at this imperfection and decide it means one should have no methodology at all.
They may be. That is why they should be tested.
If you are selectively ignoring past studies that say your preferred cure doesn’t work, it’s superstition.
Now, let’s make some allowance for reasonable ignorance here. Not every layman will be up on the latest turtle-blood-cure results, if they even exist. One might reasonably think this is in the “yet to be tested” category. But there have been many studies of more standard woo, such as astrology, and they don’t work. When such past studies exist, it is foolish and biased to ignore them.
Philosophy: A route of many roads leading from nowhere to nothing. – Ambrose Bierce
Thanks for the analysis, Dr. Coyne.
May I add that rampant antiscientific behavior of science publications and of researchers themselves has crushed my “faith” in what has purported to be modern medical science (see Ben Goldacre’s TED talk at https://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe.html, for an intro). After years of working my way toward proper skepticism, and urging my friends to do the same, it’s deflating, to say the least, to learn that even the scientific establishment can’t be trusted to produce scientific results. We should be treating the “miracle of modern medicine” with the skepticism we apply to any other miracle, and demand access to all the data before subjecting our bodies to supposedly therapeutic chemicals and procedures.
I think you conflate science and industry. The two are not the same.
Perhaps you’re right. How do you see that affecting the import of my comment?
It matters that you direct your fire at the correct target.
gbjames, help me out a little more, if you don’t mind. I don’t want to sling accusations wantonly, and if I really have missed the target, I’d like to learn to see it. I attack “rampant antiscientific behavior of science publications and of researchers themselves,” “what has purported to be modern medical science,” and “the scientific establishment,” in which I include the scientists who suppress results that aren’t pleasing, the media they use to publicize the cherry-picked results, and the peers who fail to speak up about the suppression. Is this not “the industry”?
If by “the industry” you mean the corporations that fund the research, I haven’t attacked them here because that’s a separate issue, less related to the conflation of science and pseudoscience discussed in Dr. Coyne’s blog. Incidentally, I don’t find their unscrupulous ways as disturbing as the scientists’ because the corporations don’t claim to operate according to the rigorous ethical standards that are inherent to science. I never expected corporations to behave responsibly. My disappointment in the scientific establishment is because I had counted on it to counteract the pressure of moneyed interests.
When scientists themselves participate in disclosing only the studies that support desired claims, the science they’re practicing is falsely presented, and thus false. I’m not attacking science itself; I love science, and wish that it were in more common use. It’s the failure to measure up to science, by entities that claim to be practicing science and that are vested with that authority, that worries me.
It seems to me that I’m calling attention to the difference between science and industry, not conflating them.
Do you still think I’m off base?
Thanks.
Follow the money. In today’s medical industry there are just a few types of players. You’ve got your pharmaceutical giants. You’ve got your medical equipment manufacturers. You’ve got your hospitals. And you’ve got your health care insurance companies (here in the US). The motivation for, as an example, failing to make public the negative results for efficacy tests for new drugs, is the direct result of the economics of big corporate profit generating strategies.
Blaming “the scientists”, when the real powers behind your complaints are more likely to be business school gradates and corporate lobbyists, is to my mind misdirected fire.
So, yes, I think you are still off-base.
Thanks. I understand better where you’re coming from. I never doubted that money was behind the deceit. I still think scientists, by virtue of being scientists, have a special responsibility; without such a construct, we slide toward anarchy.
I appreciate your taking the time to explain.
Sure. The enterprise of science needs a critical eye like anything else. I am often appalled at doctors and the industries behind medicine. That is not a critique of science, per se. The existence of problems in medicine, of which there are many, does not imply that medicine as practiced, warts and all, is not better than witch doctoring.
The first thought I had reading this was, even if the remedy did work, why did they have to kill the turtle? Did they really need so much blood that taking a sample wasn’t enough, or was impractical? Mind you, I’m not sure what is worse. I saw a program years ago which showed some restaurants slice open a snake along its body length, squeeze some of its blood into a glass of wine, then throw the snake back into it cage to heal and have the process repeated (This was for culinary effect, not medicinal).
Personally I think the whole drinking blood of ___ goes back to the origin of vampirism. ie. If an animal or person loses too much blood they die, therefore blood is the source of life, and if you can add more blood to your body you will live longer or be healthier.
As to being used medicinally, are there any unique components (preferably active) of blood that actually survive being digested? (Sugars, salt, and water would, but you don’t need to drink blood to get those in your diet.)
Of course the healing components of turtle blood don’t survive digestion. That’s how you can tell the shaman who knows his stuff from the mere pretenders, because the legit shaman will inject the blood, or at least have you snort it.
“…or at least have you snort it.”
Hahaha! This brings to mind an hilarious picture.
Anyone doing that to a snake should be fed to a python (even if it does regurgitate him afterwards, like the dog in the last thread).
“I don’t even take zinc lozenges, reported to shorten the duration of colds, as the results of those studies are mixed.”
Taking zinc lozenges can be a very bad idea, especially in large quantities. Zinc inhibits copper absorption. Zinc lozenges (or the over use of dental creams with zinc) can result in copper deficiency. Copper deficiency can result in significant neurologic problems, including skin numbness, peripheral neuropathies, and walking problems (ataxia). Those who have had surgeries that reduce intestinal absorption especially should be concerned about the intake of zinc and the potential for reduced absorption of copper (which can occur even without ingesting extra zinc).
Major work in this area is by N. Kumar of the Mayo Clinic. A primary review paper on “Copper deficiency myelopathy” is by Stephan R. Jaiser and Gavin P. Winston (2010) in the Journal of Neurology 257: 869-881.
I am often embarrassed by the misguided ramblings of some of my colleagues in philosophy. Please don’t think that we’re all the same in this regard. There are a few good ones still out there.
Yes. For a philosopher, he doesn’t seem to be very good at thinking.
I was going to make exactly that point. I do have a tendency to scoff at philosophers in general and I have to remind myself that Dennett and Harris are philosophers to make me shut up. I imagine doctors get equally annoyed at the exploits of quacks.
Loads of tosh surround the subject of “the placebo effect”. Loads! Placebos really work? They certainly go down a whole lot better with patients than sitting on a waiting list for treatment. Any safe “treatment” received now, inert or otherwise, works better than a promised treatment some time – psychologically, at least.
If sham surgery is as good as drugs which have clearly demonstrated superiority over sugar pills that suggests that the sham surgery was not inert but effective.
Asma is a science-sceptic philosopher. Basically a person with an animus against a discipline which has achieved far more than his chosen discipline in a much shorter time. Such as he choose their philosophers carefully to show that scientific knowledge is not privileged because scientists are human beings, and — drum roll — fallible! Practical achievements of science count for nothing because all scientists are mere human beings – no better and no worse.
Popper contended that Darwin’s theory was not fasifiable, but he was egregiously wrong on that score.
Turtle blood could be truly miraculous. The way to find out is to conduct scientific tests. Not philosophical tests. Traditional Chinese Medicine in so far as it passes scientific testing automatically becomes standard medicine – not alternative medicine. It’s alternative until scientifically tested. If if fails it remains alternative.
Acupuncture is well tested and remains alternative. It fails the scientific test. I see it as psychotherapy by another name. Like all alternative therapies. Human sympathy has its place. Science has its’.
Incidentally, if the equations of quantum mechanics or general relativity are ever experimentally shown to fail, then string theory is experimentally shown to fail, since the theory is predicated on the experimental success of those equations. String theory is falsifiable.
Asma’s advice to “play as many options as you can” may in fact be dangerous.
As Steven Jobs found out.
Indeed, that is a good example. Also, it really can’t be good for all the animals probably involved.
First, everyone should go to this excellent website: http://www.quackwatch.org/ moderated by Dr. Stephen Barrett. If you want the low down on alternative medicines, and why most are “quackery”, this is your one stop shopping site. Then, check out the NIH site for Complementary and Alternative Medicine: http://nccam.nih.gov/. Careful reading will show that most (not all) herbal remedies don’t work, or they show no evidence of working, or in fact, are dangerous, especially when combined with other medicines. As Jerry noted, most of what was in that NY TImes opinion was “woo”, poor science, and wishful thinking. Americans and others spend billions of dollars on 21st centuray snake oil. Sometimes with extraordinarily adverse consequences. Rhinos will probably be eliminated from the wild in the near future just because people in China erroneously think it helps with their sex drive. Finally, perhaps Asma should wonder why lifespans increased so dramatically recently – it wasn’t due to chiropracty, or acupuncture, or herbals. I’d bet western medicine, antibiotics, and sanitation had something to do with this.
Awesome – I’ve added both of these sites to my Evernote!
Sign up for the quack watch newsletter. It’s great.
Professor Asma might enjoy Brian Dunning’s piece about the Barefoot Doctor’s Manual and ‘Traditional’ Chinese medicine in the West
http://skeptoid.com/episodes/4259
If Asma sincerely believes that oral ingestion of fresh turtle blood has significant curative properties for the common cold, he should immediately commence a proper double-blind study. If true, there’s a Nobel in it for him, probably the most significant one in the history of the prize.
That neither he nor any other snake-oil…erm, turtle-blood salesman has ever so much as written a grant proposal is all you need to know about how sincerely he believes his own lies.
Also…I should think that drinking raw turtle blood would carry a non-trivial risk of salmonella infection. And, unless the rest of the turtle is being used for food, I’d have significant ethical problems with the practice as well.
Lastly, if there actually are curative properties of turtle blood, it’s highly likely that treatments could be developed that don’t require killing turtles that are even more effective than drinking their blood. Again, if turtles are already a farmed staple food source for those who currently follow this practice, that’s not quite so much of a concern, but it’d be hugely significant if the effect were real (which it obviously isn’t).
That a philosopher so spectacularly fails to recognize such blindingly obvious concerns as these just reconfirms my already-low opinion of the field.
Cheers,
b&
The blood would also suffer from the same problem “herbal medicine” does – lack of standardized ingredients. This is one reason to oppose the permenent status of “traditional” or whatnot. Chemists can figure out what is in it that works, if anything, and reproduce it with known amounts of both it and, more crucially, impurities.
» Ben Goren:
That a philosopher so spectacularly fails to recognize such blindingly obvious concerns as these just reconfirms my already-low opinion of the field.
And I suppose your opinion of that field is based on roughly a-thousand-fold experience?
Exceptionalism is irrelevant. Lematre was a Catholic priest; his work on the expanding universe and the Big Bang does nothing whatsoever to validate Catholicism.
When philosophy works, it is either accidental or a result of using the scientific method. Philosophy as a field has no method of determining the merits of its fruit; Plato’s philosophical work remains as valid today as ever — never mind that, scientifically, it’s been demonstrated to be “not even worng.”
Cheers,
b&
This is not topical — the post it goes with is long gone. Familiar faces here, though, especially what’s-his-name in the center:
http://pictoraltheology.blogspot.com
Much to comment on and little time, so no refs and likely many mistakes:
That is one legitimate idea, but it has no data behind and I am not aware of a proposal how to test it.
The “sophisticated” response is that we are supposed to need an independent way to know that falsifiability works. Which means a philosopher can claim we never learned how to make hammers, since a smith needed to know that a hammer worked before he used it to make new hammers!
Particle physicist Matt Strassler is right now addressing what we know of string theory over at his blog “Of Particular Significance”. He points out that “vanilla string theory” (with particles, as we know we have at low energies and easily can have at Planck energies) is testable, but at Planck energies. That is, falsifiability is not a theoretical problem but a practical problem.
Last I heard they succeeeded in double blind testing! IIRC someone developed a sheated acupuncture needle where no one could know or feel the needle position – within the skin or still in the sheat.
And no, it have no effect whatsoever.
There is both practical problems and ethical problems. The former revolve around that there seems to be no observed “placebo” effect except the confound, as Gingerbraker notes. IIRC early studies have them, later have not, I think the metaanalysis comes down to that there isn’t any certified “placebo” in placebo.
I like Theobald’s model of how evolution is *more* observable, since combinatorics of large phylogenies makes their constrained topology have much likelihood than other observations.
I take a very dim view of supposed ‘direct’ observation. As Jerry points out it sight is evolved, fairly certain but often fooled. It reminds me too much of the scientifically problematic idea of ‘common sense’.
And again, there is no testable definition of ‘direct’. Hypothesis testing makes all sorts of constraints equal (to observation). Relativity makes all observations happen in the past light cone some distance away and relative to the observer. Cosmology makes all observations imprecise (finite resources). Quantum mechanics makes semiclassical causality (general relativity) emergent.
There may be practical difficulties with appending constraints on each other, which is presumably why physicists still handwave a consensus but fuzzy “direct observation” terminology around. But there seems to be no theoretical problem here.
“Do you know what they call alternative medicine that has been proved to work? Medicine.”
Tim Minchin
http://goo.gl/uFn7z
All this guy needs to do, is look through the NCAMM site, and see that after ~$1.2 billion being spent, there’s pretty much nothing to show for it; other than it doesn’t work or, still not sure.
I’m guessing he was also applauding Steve Jobs’ avoidance of that Western-style resolution for his pancreatic cancer.
” falsifiability is not a theoretical problem but a practical problem.”
For direct testing of string theory’s own postulates, e.g. extra dimensions, that is true. But string theory also has to be consistent with *observable* predictions of relativity and QM. Thus falsifiability is built in to string theory, since it is conceivable that we might observe the equations of relativity or QM to fail. String theory does not predict a possible failure of those equations at currently testable energies.
Sorry, this should have gone below comment 23.
It’s well-confirmed that if you take antibiotics for a cold, you’ll usually get better in a few days. It’s also well-confirmed that if you don’t take antibiotics for a cold, you’ll usually get better in a few days.
And while thinking about the placebo effect, don’t forget about the nocebo effect!
If you take antibiotics for a cold, you are a fool. Colds are caused by viruses. Antibiotics have no effect.
Which pretty much makes Frank’s point.
How about acupuncture? Is that quackery?
I’d say it’s fair to call it fowl….
b&
Yes
Here’s the blurb for Asma’s book “Why I Am a Buddhist: No Nonsense Buddhim With Red Meat and Whiskey” on Amazon.
“There have been a lot of books that have made the case for Buddhism. What makes this book fresh and exciting is Asma’s iconoclasm, irreverence, and hardheaded approach to the subject. He is distressed that much of what passes for Buddhism is really little more than “New Age mush.” He loudly asserts that it is time to “take the California out of Buddhism.” He presents a spiritual practice that does not require a belief in creeds or dogma. It is a practice that is psychologically sound, intellectually credible, and esthetically appealing. It is a practice that does not require a diet of brown rice, burning incense, and putting both your mind and your culture in deep storage.”
Doesn’t sound like the author of the NYT piece, does it? An actual Buddhist practicioner in a review titled “A Shockingly Awful Book” resonds:
“As a Zen student of several years, it is obvious to me that Asma’s knowledge of Buddhism comes entirely out of other books, not from personal experience within any Buddhist tradition. He talks about Zen quite a bit, for example, but his ideas about Zen are grounded in the long-ago days of Jack Kerouac and the Dharma Bums. And judging by his photo, Asma wasn’t yet born during the Beat Zen era. Asma reveals no connection with, or even a dim awareness of, contemporary American Zen, which is a far cry from the “Bohemian” Zen of his romantic fantasies.
Asma’s tone is glib, shallow, and self-centered. He belongs under a bell jar in an exhibit titled “What’s Wrong With Western Buddhism.”
In other words, Asma is a fraud. But he has a PhD in Philosophy. And the likely reason Jerry will not be allowed to rebut him and others like him is that Jerry’s PhD is in Biology.
A hard headed approach to Buddhism just seems funny because of its incongruity.
Simon Singh has written a relevant book: Trick or Treatment, Alternative Medicine on Trial. It got him a libel suit in the UK.
Yes, that book is fabulous (co-authored with Edvard Ernst). I use it in a seminar I teach called “What’s the Alternative to Alternative Medicine?” Although I thought the suit was because of his stance against the British Chiropractic people?
In any case, an even more recent and similar book, also terrific, is Paul Offitt’s Do You Believe in Magic? I’m using that one as well.
I thought the BCA felt chiropractors had been libeled and brought suit, which is apparently very hard to fight in the UK. As I recall Simon has devoted much of his life in recent years to fighting the lawsuit and campaigning for libel reform.
Asthma can be often misdiagnosed. I was diagnosed with asthma as a child. It turned out to be an allergy. I’m fine today as long as I stay away from pussycats.
🙁
How about prevention? Is it a part of alternative medicine in your view?
What? Alternative medicine is not based on the scientific method and therefore has no scientific evidence that it works. That’s why it’s called, “alternative”. Preventative medicine is stuff you do to prevent illness and it’s based on the scientific method, has scientific evidence that it works and therefore is not called “alternative”.
I suppose you could have alternative preventative medicine, which would be a practice, not based on the scientific method that has no evidence that it works to prevent illness.
Daily megadoses of Vitamin C springs to mind….
b&
Or “maintenance chiropractic” treatment.
“Alternative medicine” is neither of those things, in my view. Not if you want to get well…
Before you diss acupuncture you need to visit the Shanghai NeuroBehavior unit where they have done very sound and serious scientific research, accepted by Western physicians and scientists who have visited there. They have established that electro-accupuncture works for about 60% of those who are tested for its appropriate use. They have also established that response to electro-accupuncture can be predicted by testing on the web between the thumb and the first finger. As a health care professional I know that no treatment, no medication works equally well with everyone. It is no surprise then that this is true of electro-acupuncture. As for the placebo effect — we now know that the so-called “placebo effect” is also in action with opiates & other pain medications.
Joseph Needham has a book called ‘Celestial Lancets’ which seems neither overly credulous nor overly dismissive of at least some aspects of Chinese medicine. I have been given acupuncture in Japan and have found it effective.
An excerpt From Steve Novella (of the Science-Based Medicine movement) and David Colquhoun, available here: http://www.sciencebasedmedicine.org/acupuncture-doesnt-work/
on the state of acupuncture research:
Since it has proved impossible to find consistent evidence after more than 3000 trials, it is time to give up. It seems very unlikely that the money that it would cost to do another 3000 trials would be well-spent.
A small excess of positive results after thousands of trials is most consistent with an inactive intervention. The small excess is predicted by poor study design and publication bias. Furthermore, Simmons et al.33 demonstrated that exploitation of “undisclosed flexibility in data collection and analysis” can produce statistically positive results even from a completely nonexistent effect. They say this is “… not driven by a willingness to deceive but by the self-serving interpretation of ambiguity, which enables us to convince ourselves that whichever decisions produced the most publishable outcome must have also been the most appropriate.”
With acupuncture, in particular, there is documented profound bias among proponents.4 Existing studies are also contaminated by variables other than acupuncture, such as the frequent inclusion of “electroacupuncture” which is essentially transdermal electrical nerve stimulation masquerading as acupuncture.
The best controlled studies show a clear pattern, with acupuncture the outcome does not depend on needle location or even needle insertion. Since these variables are those that define acupuncture, the only sensible conclusion is that acupuncture does not work.
Everything else is the expected noise of clinical trials, and this noise seems particularly high with acupuncture research. The most parsimonious conclusion is that with acupuncture there is no signal, only noise.
To be fair, there are potential real benefits to be had from going to an acupuncturist. The problem is, they have nothing to do with needles — and, indeed, they’re the same benefits to be had from going to an homeopath.
Specifically, what does the victim^Wpatient good is having a sympathetic authority figure take them and their ills in a calm, relaxed environment.
That’s the one thing that the quacks have over the doctors: bedside manner. That’s not the fault of the doctors themselves; they’re too overworked to have sufficient time to devote to each patient. Ideal would be for doctors to see no more than a half-dozen patients per day, max. That way, each patient can get an entire hour uninterrupted with the doctor — plenty of time to address everything the patient is concerned about and for the doctor to address things the patient should be concerned about but isn’t.
Of course, we’d need a hell of a lot more doctors — and this at a time when the insurance companies are doing everything they can to cut expenses. Not an healthy recipe. Simply eliminating the entire insurance and medical billing industries and shifting all those expenses to hire more doctors would do an awful lot of good, though….
Cheers,
b&
Same reason chaplains are sometimes effective (quite effective, if they’re any good at it).
I don’t know about the US, but in NZ we have ‘industrial chaplains’ who seem to be religion-neutral. I’m sure they could produce a prayer on demand, probably to suit any required demonination, but mostly I think they rely on the placebo effect. And on being able to carry on a conversation on most topics of general interest. I’d far sooner trust one of those – or a homeopath – than a acupuncturist. I have a phobia about sharp pointy objects.
I came across this on the internet:
Acupuncture anesthesia for open heart surgery in contemporary China.
Zhou J, Chi H, Cheng TO, Chen TY, Wu YY, Zhou WX, Shen WD, Yuan L.
Source
Department of Cardiothoracic Surgery, Shu Guang Hospital affiliated with the Shanghai Traditional Medicine University, Shanghai, China.
Abstract
BACKGROUND:
Although the use of acupuncture anesthesia for open heart surgery, which was introduced in China four decades ago, has declined in recent years, there is a renewed interest in it in contemporary China due to the escalating medical costs associated with open heart surgery. This study was aimed to determine whether a combined acupuncture-medicine anesthesia (CAMA) strategy reduces early postoperative morbidity and medical costs in patients undergoing open heart operation under cardiopulmonary bypass.
METHODS:
From July 2006 to October 2010, CAMA was applied in 100 patients undergoing open heart surgery in comparison with another 100 patients under the conventional general anesthesia (GA). For all the CAMA patients, an abdominal breathing training program was practiced for the 3 consecutive days prior to operation. About 15 to 20 min prior to surgical incision, acupuncture needles were inserted into the bilateral points ZhongFu, LieQue, and XiMen. During operation, patients were kept on spontaneous breathing. Endotracheal intubation was not employed but only prepared as a standby. The narcotic drugs, fentanyl and midazolam, were intravenously injected but in very low doses as compared to GA. Open heart procedures were performed routinely in both groups.
RESULTS:
Compared with the GA patients, the CAMA patients had a less usage of narcotic drugs (p<0.001), less postoperative pulmonary infection (p<0.05), shorter stay in intensive care unit (p<0.05), and a lower medical cost (P<0.05).
CONCLUSIONS:
A combined acupuncture-medicine anesthesia strategy reduces the postoperative morbidity and medical costs in patients undergoing open heart surgery under cardiopulmonary bypass.
I’m a great believer in alternative medicine myself, and the more alternative the better. Years ago, in my misspent youth – this story is absolutely true – I was working on a large arable farm in Bedfordshire and lodging at the local pub. I used to help behind the bar in the evenings, and grew friendly with some of the locals, among whom was Eric, who was hunch-backed and half-gipsy and had the repuation of being a poacher. One evening Eric was there, looking very ill with his voice reduced to a croak – he was looking so ill that I told him he’d better go home and go to bed. Eventually he left. The next evening he was back, bright and cheerful, and nothing at all wrong with his voice. I said something about his being at death’s door the previous evening and asked him how he had recovered so quickly. ‘Cup of warm hedgehog fat,’ he replied. ‘Get that down you, and you come out clean as a whistle.’
🙂 I wondered where all the hedgehogs had gone – assume you now have a market stall selling it!
One correlation I have noticed: When philosophers quote Thomas Kuhn, they are usually peddling woo.
I saw an item in the Sunday Times a week or two ago I think one of its magazines, that told of a woman with some form of cancer who declined chemotherapy & made a recovery ‘by’ eating a healthy diet. Now I suppose that much chemotherapy is like using a battering ram to crush a nut, but I am sure that there are always cases where there is a spontaneous loss of a tumour etc might have occurred anyway. What some people do is extrapolate from one case, to say ‘this must be a proper cure’ when it probably is not.
In many cases adjuvant chemotherapy is given wholesale to patients because some small subset respond to it while for most it has no effect. For example, in a ten year study of Tamoxafin timing and adjuvant chemotherapy [1] in a type of breast cancer, only 5% of the patients saw any benefit from the adjuvant chemotherapy. The problem is that we can’t (or couldn’t, I think we can now with genomic tests) tell in advance who would benefit and who wouldn’t, so we had to give it to everyone to ensure that those who will benefit get it.
If the woman you speak of were in the situation of the people in this study then 95% of the time she would be just as well off without the chemo. If she happened to be one of the 5% of the cases who respond to the adjuvant chemo, however, it would make a large difference in her survival time. So sure, she survived, just as you’ll probably survive a round of Russian Roulette. That doesn’t make it smart, and saying you survived your round of Russian Roulette because you were drinking tea at the time, or whatever, is even less so.
1. Albain, K. S. et al. Adjuvant chemotherapy and timing of tamoxifen in postmenopausal patients with endocrine-responsive, node-positive breast cancer: a phase 3, open-label, randomised controlled trial. The Lancet 374, 2055–2063 (2009).
” . . . a concoction of turtle blood and grain alcohol . . . .”
Is this the result of several hundred years of trial-and-error testing of blood from various mammals? How about panda blood? And then a comparison of Giant versus Red panda blood?
“Studies of placebo effects—including sham surgery on knees!—have shown that they can work . . . .”
Wish I had known that forty years ago. Does it work with torn knee cartilage? Every part of the knee? Interstitial fluid accummulation? (I once accepted an unsolicited offer to “lay hands on” and offer up pray for my knee. Who was I to decline the touch of a nice pair of female hands to my patella? The worst that could happen was that it wouldn’t work, and it didn’t. What if any placebo effect was quite temporary. Perhaps I didn’t have suffcient faith.)
“The causal theory that’s concocted to explain the practical successes of treatment is not terribly important or interesting to the poor schlub who’s thrown out his back or taken ill.”
The causal theory is
important. If you can figure out what is is in the turtle blood that has an effect, you could get it from other sources when turtles become extinct, or search for it from more humane sources to begin with, or synthesize it. Why on earth would it be better not to know what’s really going on with our bodies and medicine?
“Contrary to the claims of faitheists and believers, one can test the supernatural.”
I’d say we can test the claims people make that they call supernatural. If a “supernatural” claim is demonstrated to be real, in what sense does it remain supernatural?
(Sastra?)
‘I’d say we can test the claims people make that they call supernatural. If a “supernatural” claim is demonstrated to be real, in what sense does it remain supernatural?’ – #38
Exactly.
(Lack of) Standarization of ingredients and impurities is one of the reasons why I will never want to take a herbal remedy. Plants make stuff for their own purposes. This is also true for animal parts, like blood.
Herbal remedies used for culinary purposes are often a good idea, though. For example, chamomile tea is a delightful drink and a pretty decent relaxant at the end of a stressful winter day. And eating plenty of fresh veggies, especially cabbage and celery, with every meal will do more for your digestive system than any over-the-counter pill.
And let’s not forget that coffee and tea are, technically, herbal stimulants!
Cheers,
b&
“And eating plenty of . . . celery . . . . .”
Once upon a time I recklessly and cavalierly ingested more than a few stalks of celery (sans the counteracting piemento cheese normally slathered in the stalk’s “groove”), and as a consequence can expertly testify to its facilitative alacrity and expeditiously expulsive and cleansing qualities. (I remember feeling a little out of kilter; no doubt an electrolyte/fluid imbalance/insufficiency.)
I gather that Einstein chose the “c” in his “E = mc^2” because “c” is the first letter in the Latin “celeritas,” “speed.” Hence the most apt name “celery” which, forsooth, truly doth impose on one a certain celerity, focus of mind, and amplified sphincter tonus.
Who needs fancy colonoscopy cleansing concoctions when the green grocer can grease the gastronomical skids?
(Dr. McCoy from “Star Trek: The Voyage Home:”
“My God, man! Don’t you see that this patient is suffering from post-prand(r?)ial lower abdominal distention?!?”)
Except:
/@
“Plants make stuff for their own purposes.”
Yeah, many plants fill their leaves with toxins that make them distasteful, if not poisonous, because the plants want to use the leaves to gather solar energy, not to feed mooching herbivores.
There is so much so catastrophically wrong with what Asma writes about the philosophy of science that it’s very hard indeed to believe he is a professor of anything, much less philosophy. For brevity’s sake, I’ll just concentrate on the second paragraph Jerry quotes from Asma’s piece.
Firstly, falsificationism has nothing to do with positivism; lumping Popper in with positivism shows complete ignorance of the difference between a search for a criterion of meaning (positivism) and a criterion of demarcation between science and non-science (falsification). Popper’s explicit goal was to refute positivism.
Second, as Jerry has pointed out, some of the more fanciful ideas e.g. in string theory are indeed no more than speculation (as of now). Speculation is fine, but if you do nothing else, you’re not doing science. How that is even controversial, I cannot imagine. And as to astrology, even if there had been at some point an interesting theory that made testable predictions, those predictions have been falsified. So, at the very best, astrology used to be a science. But actually, falsificationism not only demands that a theory make testable predictions, it also demands that a theory be capable of solving an actual problem. As David Deutsch says (in The Beginning of Infinity):
And astrology is just such a case: Why all people born at the same time should share character traits, for example, is left completely unexplained—and those explanations that are given are internally inconsistent. Without an explanatory theory, however, you’re usually looking at usually cherry-picked instances of some phenomenon; only an explanatory theory can bind the instances together by positing a causal connection.
Apart from the fact that this is entirely rational (cf. the faster-than-light neutrino story, which played out in strictly Popperian terms), this again shows complete ignorance of Popper’s criterion. Trivially, it was not proposed as a description of what every scientist on earth actually does. That line of attack never had the least bit of plausibility. Falsifiability as a criterion proposes methodological rules, i.e. it is a normative concept. And almost as trivially, every observation is fallible; it should be painfully obvious (to a professional, at least) that not every observation is taken at face value and that any theory that observation contradicts is immediately abandoned. Here’s Popper on that very point (from The Logic of Scientific Discovery, § 22):
The operative word here is “accepted”, since Popper is talking about a logical property. No finite number of observations, even we accept all of them as fact, can ensure the truth of any conclusion (this would be—invalid—inductive reasoning). However, if we accept an observation as fact that contradicts a theory, then we have no choice but to regard that theory as false (this would be deductive reasoning).
Following that, Asma’s dig at how Feyerabend supposedly first pointed out that “science is not a special technique for producing truth” is just as idiotic, as Popper has always taken great pains to point out that science is the search for truth, but that “the genuine rationalist does not think that he or anyone else is in possession of the truth” (All Life is Problem-Solving). Also:
And finally, there is this: “We like to think that a rigorous application of logic will eliminate kooky ideas.” Um, no, we don’t think that—at least we don’t if we have a passing acquaintance with logic:
TL;DR: Have a look at this condensed account of falsifiability by Popper himself. After reading that, you will know a hell of a lot more about Popper’s ideas than Stephen Asma does.