Chairman Mao: The real inventor of "traditional Chinese medicine"

Most, if not virtually all, of what is now referred to as "traditional Chinese medicine" is quackery. I realize that it's considered "intolerant" and not politically correct to say that in these days of "integrative medicine" departments infiltrating academic medical centers like so much kudzu enveloping a telephone pole, but I don't care. I'm supposed to be impressed that the M.D. Anderson and Memorial-Sloan Kettering Cancer Centers, among others, have lost their collective mind and now "integrate" prescientific nonsense along with their state-of-the-art cancer therapy? I don't think so. I can be puzzled by it. I can be dismayed by it. I can even be enraged by the infiltration of woo into prestigious medical centers. I am not, however, impressed by it, at least not in the sense that I'm about to jump on the bandwagon and embrace pseudoscience, too. I will admit, however, to being impressed—but not in a good way—with the ability of clinical leaders at such institutions who really should know better to embrace pure pseudoscience, including acupuncture, tongue diagnosis, the balancing of hot, cold, damp, and the other things that TCM claims to balance, and the vitalism that is at the heart of TCM in the form of qi, the undetectably imaginary life "energy" whose flow is supposedly redirected to healing effect by acupuncture.

Particularly galling about the ascendency of TCM in the US is the myth that is swallowed whole by its advocates. That myth is the very history of TCM, whose true origins are unknown by all but a very few. Contrary to popular belief (particularly about acupuncture), those beliefs do not go back thousands of years into antiquity, when the ancient healing wisdom of the Chinese was supposedly first discovered. In actuality, very few people are aware that the single person most responsible for the current popularity of TCM was not some ancient Chinese healer but rather Chairman Mao Zedong. That's why an article published by Alan Levinovitz in Slate.com entitled Chairman Mao Invented Traditional Chinese Medicine is so important.

Before I get to the good stuff, I do have to point out one thing that irritated the hell out of me about the article. Never let it be said that there is anyone more dismissive of naturopathy. My favorite description of naturopathy is that it is a veritable cornucopia of quackery, selected in a manner not unlike that of the proverbial menu in a Chinese restaurant: One quackery from column A, two from column B. Naturopathy mixes homeopathy, TCM, herbalism, diet woo, and just about every other form of quackery you can think of, mixing it into one homogenous pseudoscientific slurry of quacky badness. I was also the one who noticed that Senator Barbara Mikulski (D-MD), a woo-friendly legislator almost on par with the Dark Lord of Legislative Quackery and Creator of the National Center for Complementary and Alternative Medicine (NCCAM) himself, Senator Tom Harkin (D-IA), had gotten a resolution through the Senate declaring the week of October 7-13 as Naturopathic Medicine Week. I declared it Quackery Week, and a few bloggers agreed. Oh, well, it wasn't one of my more successful ideas.

Be that as it may, Levinovitz uses Naturopathic Medicine Week to introduce his article, and it's a mistake:

Mikulski and the rest of the Senate may be surprised to learn that they were repeating 60-year-old justifications of Chinese medicine put forward by Chairman Mao. Unlike Mikulski, however, Mao was under no illusion that Chinese medicine—a key component of naturopathic education—actually worked. In The Private Life of Chairman Mao, Li Zhisui, one of Mao’s personal physicians, recounts a conversation they had on the subject. Trained as an M.D. in Western medicine, Li admitted to being baffled by ancient Chinese medical books, especially their theories relating to the five elements. It turns out his employer also found them implausible.

“Even though I believe we should promote Chinese medicine,” Mao told him, “I personally do not believe in it. I don’t take Chinese medicine.”

TCM is not naturopathy. It is part of naturopathy, but it is not naturopathy, any more than homeopathy is, even though, as I have pointed out, you can't have naturopathy without homeopathy. The introduction is a stretch that gives the mistaken impression that naturopathy is mostly TCM. It's not. For instance, take a look at this statement by a naturopath named Erika Horowitz:

Detoxification is a big part of naturopathic theory and practice. Helping the body eliminate toxins safely and effectively can play an important role in improving health and preventing disease. One of the most useful detoxification therapies I use in my practice is the use of UNDA numbers, which are unique combinations of liquid homeopathic formulas founded on the theories of Chinese medicine, homeopathy, and anthroposophy.

This brief paragraph to me sums up the essence of naturopathy, which is to mix and match quackeries from a variety of sources like an insane game of Mad Libs for quacks. One coud as well insert Ayurvedic medicine, Native American medicine, shamanism, iridology, reflexology (popular among naturopaths), detox foot baths, biotherapeutic drainage, and, of course, chelation therapy.

My little fit of pique over an aspect of the article thus disposed with, I'll say that the rest of the article is quite good, and it is quite true that much of the reason for the popularity of TCM in China and its spread to the US and beyond was because of Chairman Mao's promotion. The reason, as has been explained on one of my favorite bloggers, Kimball Atwood, and others, is because there simply weren't enough doctors in China trained in scientific medicine, as admitted by Mao (quoted by Levinovitz):

Our nation’s health work teams are large. They have to concern themselves with over 500 million people [including the] young, old, and ill. … At present, doctors of Western medicine are few, and thus the broad masses of the people, and in particular the peasants, rely on Chinese medicine to treat illness. Therefore, we must strive for the complete unification of Chinese medicine. (Translations from Kim Taylor’s Chinese Medicine in Early Communist China, 1945-1963: A Medicine of Revolution.)

Who knew? (Well, I did.) I also knew, as Levinovitz relates, that this was the very first "integrative" medicine, "integrating quackery with science-based medicine more than four decades before the term "integrative medicine" caught on in the US. A particularly pertinent quote sums this idea up:

“This One Medicine,” exulted the president of the Chinese Medical Association in 1952, “will possess a basis in modern natural sciences, will have absorbed the ancient and the new, the Chinese and the foreign, all medical achievements—and will be China’s New Medicine!”

Indeed, what's interesting about Levinovitz's article is his description of how the exportation of TCM to the world was quite deliberate, as part of a strategy to popularize it among the Chinese. There was a problem, however. As Levinovitz noted, there was no such thing as "traditional Chinese medicine." Rather, there were traditional Chinese medicines. For many centuries, healing practices in China had been highly variable, and attempts at institutionalizing medical education were mostly unsuccessful and "most practitioners drew at will on a mixture of demonology, astrology, yin-yang five phases theory, classic texts, folk wisdom, and personal experience." While it's irresistible (to me, at least) to make an analogy to how naturopaths draw from a wide variety of quackeries, TCM is not naturopathy. Mao realized that TCM would be unappealing to foreigners, as even many Chinese, particularly those with an education, realized that TCM was mostly quackery. For instance, in 1923, Lu Xun realized that "Chinese doctors are no more than a type of swindler, either intentional or unintentional, and I sympathize with deceived sick people and their families." Such sentiments were common among the upper classes and the educated. Indeed, as we have seen, Mao himself didn't use TCM practitioners. He wanted scientific "Western" medicine.

Mao's strategy to deal with these criticisms was quite deliberate—and clever. It consisted of two strategies, both designed to mythologize TCM as being a scientifically sound and harmonious "whole medical system" and to provide "evidence" in the form of testimonials that it worked, as Levinovitz relates:

His solution was a two-pronged approach. First, inconsistent texts and idiosyncratic practices had to be standardized. Textbooks were written that portrayed Chinese medicine as a theoretical and practical whole, and they were taught in newly founded academies of so-called “traditional Chinese medicine,” a term that first appeared in English, not Chinese. Needless to say, the academies were anything but traditional, striving valiantly to “scientify” the teachings of classics that often contradicted one another and themselves. Terms such as “holism” (zhengtiguan) and “preventative care” (yufangxing) were used to provide the new system with appealing foundational principles, principles that are now standard fare in arguments about the benefits of alternative medicine.

The second part of the strategy was the dissemination of spectacular anecdotes to "prove" the efficacy of TCM. The most famous of these was the case of James Reston, a New York Times editor who underwent an emergency appendectomy while visiting China in 1971. Even though the surgeons there used a fairly standard anesthesia technique, described by my good bud anesthesiologist Dr. Kimball Atwood as sounding like a "standard regional technique, most likely an epidural," acupuncture was used to treat cramping on second evening after the surgery, which I interpreted as being the evening of postoperative day one. The story is familiar to any surgeon; about a day and a half after surgery Reston had some cramping, likely due to postoperative ileus that kept the gas from moving through his bowels the way it normally does. It passed after an hour or so. Around that time, the staff at the hospital used acupuncture to treat his discomfort, and the logical fallacy known as post hoc ergo propter hoc fallacy (and a bunch of credulous Westerners, eager to believe that some magical mystical "Eastern" wisdom" could do what "Western medicine" could not, did the rest. Most likely what happened is that Reston finally farted, letting the built up gas move through and relieving the cramps and bloating. About a day or two after an uncomplicated appendectomy is about right for that.

Over time, reports of "acupuncture anesthesia" trickled out of China to a welcoming, credulous "Western" press. When examined closely by doctors who know about anesthesia (such as an anesthesiologist), these stories universally have big holes in them. Just a few examples were catalogued by an anesthesiologist, again my good bud Kimball Atwood. In fact, you can view Levinovitz's article as the CliffsNotes version of the campaign by Mao to convince the West that acupuncture (and, by extension, TCM) worked as well or better than any "Western medicine." Read Kimball Atwood's epic “Acupuncture Anesthesia”: A Proclamation from Chairman Mao (Part I, Part II, Part III, Part IV, and Part V) for the detailed version. Of particular interest to students of "integrative medicine" is Part III, in which Dr. Atwood has an entire section entitled "From ‘Co-operation’ to ‘Integration,'" in which he lists the five main party slogans about TCM:

  • 1945-50 ‘The Co-operation of Chinese and Western Medicines’
  • 1950-8 ‘The Unification of Chinese and Western Medicines’
  • 1950-53 ‘Chinese Medicine studies Western Medicine’
  • 1954-8 ‘Western Medicine studies Chinese Medicine’
  • 1958- ‘The Integration of Chinese and Western Medicines’

Mao's idea was nothing less than the complete unification of TCM and "Western" medicine, as quoted by Kimball Atwood further from The Private Life of Chairman Mao:

Mao laughed. ‘The theory of yin and yang and the five elements really is very difficult,’ he said. ‘The theory is used by doctors of Chinese medicine to explain the physiological and pathological conditions of the human body. What I believe is that Chinese and Western medicine should be integrated. Well-trained doctors of Western medicine should learn Chinese medicine; senior doctors of Chinese medicine should learn anatomy, physiology, bacteriology, pathology, and so on. They should learn how to use modern science to explain the principles of Chinese medicine. They should translate some classical Chinese medicine books into modern language, with proper annotations and explanations. Then a new medical science, based on the integration of Chinese and Western medicine, can emerge. That would be a great contribution to the world.’

It's certainly a "contribution," but it's certainly not "great." Unfortunately, it is a contribution that keeps on giving. "Integrative medicine" today echoes the very same arguments pioneered by Chairman Mao, the Chinese medical establishment 60 years ago, and one of the greatest mass propaganda machines that ever existed. Of all the TCM modalities, acupuncture benefited the most from Chinese propaganda. Most people are unaware of TCM tongue diagnosis (which is basically reflexology, with organs mapped to areas of the tongue rather than to areas of the soles of the feet or palms of the hand) or its ideas of balancing five elements. Almost everyone, however, knows what acupuncture is, and many of them believe that there might be something to it, the more so given that so many academic medical centers are embracing quackery like acupuncture wholesale.

Moreover, acupuncture is probably not nearly as ancient as its advocates portray it. Common portrayals of acupuncture paint it as being 3,000 years old, as implausible as that is. Why implausible? For one thing, the technology to make such incredibly thin needles didn't exist 3,000 years ago. For another thing, as Harriet Hall points out, the earliest Chinese medical texts from the 3rd century BC don't mention acupuncture, and the earliest reference to "needling" is from 90 BC referring to bloodletting and lancing abscesses. Indeed, even by the 13th century the earliest accounts of Chinese medicine reaching the West didn't mention acupuncture, and the first account of acupuncture by a Westerner in the 1600s described large golden needles inserted into the skull and left in place for 30 respirations. It has also been argued that acupuncture evolved from bloodletting based on astrology.

While it is true that there was such a thing as Chinese folk medicine that's existed for hundreds of years, the phenomenon of TCM as we know it today was invented—or perhaps I should say "re-invented"— nearly out of whole cloth by Chairman Mao, whose powerful propaganda machine used a combination of "harmonizing" inconveniently unharmonious sources and manufacturing a dog and pony show of testimonials and demonstrations of "acupuncture anesthesia" to sell it first to the Chinese people and then to the rest of the world. The entire undergirding of TCM is little more than vitalism, magical thinking, and five elements instead of four. It is very depressing to think there are more than a few Very Serious Academic Doctors out there who have bought into this myth and have even widened Mao's vision of "integration" beyond "integrating" SBM with TCM to include virtually every form of magical quackery in existence.

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The mysticism around all things labeled "Chinese" was strong in the late 60's and early 70's. Consider the TV series Kung Fu, (you gotta admit, seeing Kwai Chang carry that cauldron of boiling water out into the snow was cool) as well as Bruce Lee's films. And then, of course, there is that "ancient Chinese secret" Calgon commercial (http://www.youtube.com/watch?v=mzixL7Ef-bI). This makes me wonder how much of all these baby boomers falling for CAM isn't due to marketing messages of all-things-Chinese in the US combined with Mao's invention of TCM (which quacksters can cite for almost anyt snake oil they push).

By Chris Hickie (not verified) on 25 Oct 2013 #permalink

Or has it something to do with the idea of old wisdom coming from the east, popularised by many rockstars?
All those people, leaving church and following eastern guru's instead?

It seems to me that Chinese medicine circa 1700 really wasn't so different from Western medicine circa 1700. In particular, the "five elements" theory reminds me of the "four humors" theory from the pre-scientific era of Western medicine.

I can see why Mao felt the need to make what we now call TCM widely available within China: the empirical knowledge of folk medicine is better than nothing, and China didn't have the resources to deploy modern medicine nationwide. But I hadn't been aware of his role in systemizing it. And his insistence on Western medicine for himself doesn't help his "man of the people" image.

By Eric Lund (not verified) on 25 Oct 2013 #permalink

Gosh. As if Mao had not already been responsible for enough misery and death. Granted, he had a pretty huge population base to work with, but he did manage to rack up an extremely impressive body count.

By palindrom (not verified) on 25 Oct 2013 #permalink

"Most, if not virtually all, of what is now referred to as “traditional Chinese medicine” is quackery."

An ever-increasing number of traditional Chinese herbal formulas have demonstrated efficacy in placebo-controlled clinical trials. There's no point in arguing further over what sorts of question may be asked about acupuncture - that's an unresolvable philosophical disagreement - but when a consumed medicine shows efficacy in a placebo-controlled clinical trial of the form preferred in America, insisting that its continued use must nonetheless be Quackery must generate increasing amounts of cognitive dissonance. A popular variety of scientism says that our beliefs should be based solely on the results of formal scientific studies, but also that traditional multicompound medicines must be believed to be worthless. When hundreds of positive clinical trials have been published on herbal medicines, these two dogmas are placed on an inescapable collision course.

A popular variety of scientism says that our beliefs should be based solely on the results of formal scientific studies, but also that traditional multicompound medicines must be believed to be worthless.

Science say s no such thing about traditional multi compound medicines. There is a branch of pharmacology that studies them and other natural products: Pharmacognosy.

Also, perhaps you could supply a couple of those placebo-controlled randomized trials for herbs. As I recall, St. John's wort didn't do so well when tested that way, for example.

"St John's Wort didn't do so well...."

And yet alt media perseverates in calling it the ' cure for depression'. Similarly, Echinacea for colds etc.

By Denice Walter (not verified) on 25 Oct 2013 #permalink

Ironically, people who advocate for TCM seem to reject a genuine 'holism' because they argue against the common ground of humanity, preferring instead to establish and celebrate cultural differences as if this entailed that people in different areas live in alternative universes and are entirely different kinds of beings. Look at this quote from the article:

In the words of anthropologist Judith Farquhar: “The standards of argument by which we judge our own most rigorous explanations cannot be applied to Chinese medicine.”

As the author rightly notes, this turns the Chinese people into irrational proponents of the absurd. And yet it's a sentiment I hear again and again. "Don't judge by your own standards because not everyone is like you."

Look, it doesn't matter if folks want to wax lyrical over the insights and wisdom unique to China: it's basically racist. They're not being culturally sensitive: they're being horribly divisive.

As I've said before, I think this celebration of tribal distinctions and rejection of universal humanism is based on a deep confusion over the difference between claims-of-fact and preferences-aesthetics-and-lifestyles. All the talk about "unifying" Western and Eastern medicine -- or of appreciating what they each bring to the table -- would actually make sense if they weren't talking about medicine, but about art. Let's not condemn Chinese dance, let's film it and integrate it into a program along with ballet and Irish step-dancing! Let many flowers bloom!

But countries and people don't get to do their own kind of science -- with their own kind of results which express their own kind of culture. This has nothing to do with narrow-mindedly condemning lifestyles which are "different than our own" (of which I am often accused.) It has to do with recognizing what we have in common.

And that includes the basics of biology, chemistry, physics, and anatomy. The folks who seem to think the rejection of traditional Chinese medicine is fueled by racism need to rethink the implications of denying that.

Medline has articles from everywhere including China - including articles on herbs. So when someone talks to me of the herbal secrets of the Orient, it seems silly.

@Jane: The reason for relying on rigorous scientific trials is because that is the only reliable method we know of for determining what works and what doesn't.

It seems statistically likely to me that some of these Chinese herbal treatments will be found to actually work, at which point science-based medical practitioners will be happy to include them in their repertoire. But many others will be found to not work, and as Orac mentions, many of the studies which claim to show an effect have study design issues. In other cases, the herb may turn out to have unacceptable side effects--more than one drug has fallen out of use for exactly this reason. For instance, cocaine has a legitimate medical use as a local anesthetic, but it is almost never used for that purpose because it is so highly addictive, and other equally good local anesthetics are available which do not have this side effect.

By Eric Lund (not verified) on 25 Oct 2013 #permalink

@Eric - over the past decade, the amount of "published" medical research coming out of China has exploded - unfortunately, we are now finding that a lot of that research is either bogus or incredibly overstated.....

But if you go using the treatments of chairman Mao,
You ain't going to cure anyone anyhow

By Chris HIckie (not verified) on 25 Oct 2013 #permalink

Chris @12 -- Not only that, but such treatements might not leave you feeling (shoo-bee-doo) all right.

By palindrom (not verified) on 25 Oct 2013 #permalink

" There’s no point in arguing further over what sorts of question may be asked about acupuncture – that’s an unresolvable philosophical disagreement 'genuine' acupuncture has been proven to perform no better than sham acupuncture controls"

FTFY

In other cases, the herb may turn out to have unacceptable side effects–more than one drug has fallen out of use for exactly

With regard to traditional Chinese medicien, there's aristolochia (aka birthwort). Traditionally presecribed to treat arthritis and ease childbirth, it contains high levels of aristolochic acid, a potent carcinogen. Consumption of herbal remedies incorporating birthwort has been causally associated with increased risk of both cancer and endemic nephropathy.

When hundreds of positive clinical trials have been published on herbal medicines, these two dogmas are placed on an inescapable collision course.

Jane, time again for my standard cut-to-the chase question:

What in your opinion is the single most compelling positive clinical trial demonstrating that the efficacy of a traditional herbal medicine is due to the interaction of multiple active compounds working synergistically, rather than the presence of a single or a few active molecules that retain activity when isolated?

When hundreds of positive clinical trials have been published on herbal medicines

[citation(s) needed] I don't think any of those words mean what you think they mean.

This reminds me, I haven't had take-out in a while...

By AnObservingParty (not verified) on 25 Oct 2013 #permalink

what sorts of question may be asked about acupuncture – that’s an unresolvable philosophical disagreement

The what?
Acupuncture works or it doesn't work. It is either a scam or it isn't. This is not high-level metaphysical debate, and the cloud of obfuscation here does not inspire much credence in your other claims.

By herr doktor bimler (not verified) on 25 Oct 2013 #permalink

@Jane

Not to be too demanding or anything, but even if there was an herbal that was even better than a placebo, shouldn't it really be better than other medical options before we decide it's worth using?

@ Chris Hickie:
@ palindrom:

Ha ha ha.

By Denice Walter (not verified) on 25 Oct 2013 #permalink

The reference to "traditional multicompound medicines" and their supposed synergism (because God/Gaia put them all in there not for the plants, but for our benefit) goes along with the altie belief in "adaptogens", which is the much more science-y way of saying "good for what ails you".

Really, this blog must be an unbearable irritant for those annoyed by "scientism". Your science can't measure our woo!!!

"But if you go using the treatments of chairman Mao,
You ain’t going to cure anyone anyhow"

Nice.

By Dangerous Bacon (not verified) on 25 Oct 2013 #permalink

Science say s no such thing about traditional multi compound medicines.
But people who are scientism-ists do.
I've had almost exactly that conversation. My attitude towards herbs is that they may have powerful compounds in them, may work for what they are used for, but they are also might also cause harm and may be adulterated. That seems realistic to me.
Yet I've encountered people who seem to believe categorically that herbs must be ineffective. They think their prejudices are a shortcut to knowledge. It's like claiming to be a "good American" by hanging a flag on your house.
Plants are amazing little chemical factories. Especially small plants that have to survive by their wits - ingenious chemicals are the "instincts" and brains of plants.
An interesting subtlety to herbal medicines:
I was looking into recent research on non-IgE mediated food allergies, and an article titled "Non-IgE Mediated Food Allergy – Update of Recent Progress in Mucosal
Immunity" http://www.ncbi.nlm.nih.gov/pubmed/22680623
says

Herbal medicines have also been shown to reveal good clinical responses. However, studies have shown that many of the compounds contained in herbal remedies have no direct effects on humans, since these compounds cannot be absorbed in the gut [126]. However, biological compounds can be generated from the metabolism of these compounds by the microbiota in the gut. Therefore, the efficacy of herbal medicines can be dependent on composition of the gut microbiota [127]. For example, glycyrrhizin, a key component of Chinese herbal medicines, is processed by gut microbes into 18ß-glycyrrhetic acid, that exert anti-inflammatory, anti-viral, and antifungal actions [127]. On the other hand, certain herbal medicines can affect the composition of the gut microbiota similar to the dietary components; Ginkgo leaf extract have been shown to inhibit growth of pathogenic bacteria but not commensal microbes with anti-inflammatory properties such as bifidobacterium in
vitro [128].

Lots of ginkgo research on Medline, mostly animal studies.

Luara, I'm very, very skeptical of these claims, specifically references 127 and 128. I can't seem to acquire the original review article, could you post the citation for these references so I could give them a read?

"Plants are amazing little chemical factories. Especially small plants that have to survive by their wits – ingenious chemicals are the “instincts” and brains of plants."

My question remains: why should the evolutionary ingenuity of plants be assumed to translate into benefits for humans? Lots of these compounds seem to be for the express purpose of repelling bugs, grazing animals and humans.

"Plants were intended to benefit mankind" is a religious and homo sapiencentric viewpoint, but not a very logical one.

By Dangerous Bacon (not verified) on 25 Oct 2013 #permalink

@Sastra #8,
I trained in biomedical sciences, worked in clinical biochemistry for seven years and then studied social anthropology at SOAS in London, in the late 80s, when post modernism was just getting a grip. You can probably imagine the conversations about ethnocentricity, "other ways of knowing" etc. I enjoyed.

When someone tried to paint modern science as just another way of knowing, I would usually point out that if you want to design a jet aircraft or an antibiotic, you are probably better off using the scientific method, not some tribe's folk wisdom about how to acquire the power of flight or how to banish the demons that cause infectious disease, regardless of where they happen to live. If that failed to convince them that cultural relativity isn't always a good thing, I would bring up female genital mutilation, which almost always worked.

By Krebiozen (not verified) on 25 Oct 2013 #permalink

Luara,

Yet I’ve encountered people who seem to believe categorically that herbs must be ineffective.

Are you sure? They are clearly wrong, as willow bark and foxglove demonstrate very clearly. If they believe categorically that we aren't going to find any as yet unknown safe and effective drugs in the herbs that herbalists currently use, I tend to agree with them.

Look at NCCAM who have spent billions of dollars searching for effective CAM treatments including herbal remedies. I have to assume they would have looked at the most promising treatments first, yet they have found nothing that is safer or more effective than conventional treatments so far. Not a sausage. The vast majority of herbal treatments in use in America and Europe clearly do very little indeed, if anything.

We may still find some Chinese herbs that contain interesting and useful compounds, and it wouldn't surprise me if there is was a plant in a rain forest somewhere that is about to become extinct that contains a cure for something. That's pharmacognosy, as Orac pointed out.

Therefore, the efficacy of herbal medicines can be dependent on composition of the gut microbiota.

That's true of a number of conventional drugs as well. I don't see your point.

By Krebiozen (not verified) on 25 Oct 2013 #permalink

A good and useful post - but the chest-thumping about defying "political correctness" served no purpose other than to induce flashbacks of Bill O'Reilly and his ilk.

Next time, can we just have a long detailed description of post-ileus farting instead, please?

By Pierce R. Butler (not verified) on 25 Oct 2013 #permalink

An ever-increasing number of traditional Chinese herbal formulas have demonstrated efficacy in placebo-controlled clinical trials.

Yet, traditional use does not significantly improve results in the screening of active compound banks in pharmaceutical chemistry compared to random selection of compounds.

I wonder why that is.

“Plants were intended to benefit mankind” is a religious and homo sapiencentric viewpoint, but not a very logical one.

It's also a very dangerous way of thinking.

Some of the most potent poisons known are entirely organic and natural.

Sorry if this has been addressed earlier. I'm using cumbersome methods to access the blog.

The training of "doctors" in China is bifurcated. They can train in TCM through that system of universities, or they can do a diluted form of training in more Western-oriented medicine at primarily the undergraduate level. My knowledge of this may be limited, though.

At the US university where I recently worked, we had a "doctor" who had the equivalent of an undergraduate degree--what most of us would probably consider a nursing degree--working in a lab job because she could not possibly pass boards to work as a physician here. In China, she said she would be considered a doctor.

In addition, we had a PhD biology student who had done a degree in a prestigious school of Chinese medicine. Her background was so sporadic that she required remedial coursework, as did the "doctor" who had been credentialed in China as a practicing travelling/village physician.

Make of that what you will, I guess. Neither of these people could have passed nursing exams, much less any other exams, to practice anything resembling direct patient care in the US.

I realize that this is an aside, in addition to being merely a personal anecdote: but I for one can vouch for the efficacy of Echinacea. I'm horribly allergic to it, it seems. The last two times I've taken it I have developed Anaphylaxis. The first time this happened when some well-meaning soul handed me a capsule of it alongside some paracetemol when I had a cold. The second time, I had a glorified milkshake (plus a "shot" of what was supposed to be B+C complex) from a well known Australian franchise & whilst driving home, noticed my tongue & lips swelling up.
Fortunately I now keep some vials of Adrenaline at home :/

I'm told (by physicians) that this is apparently not uncommon, especially given how many people take Echinacea nowadays. Apparently some of the Worried Well take it daily as a "prophylactic" along with their Olive Leaf Extract. I suppose if you have that much money to waste...

I don't mean to pour scorn on all herbs. I, for one, enjoy a nice cup of Mint tea some evenings. I just don't expect it to equal the effect of something like esomeprazole!

In fact, by some quirk of Consumer Law in Australia (and I believe we're not alone in this) the herbal tea I buy as a beverage for a few dollars from the supermarket is held to a far tougher level of scrutiny than any of the expensive herbal panaceas taking up ever more shelf-space in our pharmacies. Idk about anyone else, but this really annoys me. It should certainly annoy people who feel they rely on them:

http://doubtfulnews.com/2013/10/what-you-want-might-not-be-in-there-but…

By AntipodeanChic (not verified) on 25 Oct 2013 #permalink

Luara, I’m very, very skeptical of these claims, specifically references 127 and 128. I can’t seem to acquire the original review article, could you post the citation for these references so I could give them a read?

It's here (PDF), grasshopper.

For example, glycyrrhizin, a key component of Chinese herbal medicines, is processed by gut microbes into 18ß-glycyrrhetic acid, that exert anti-inflammatory, anti-viral, and antifungal actions [127].

The question here, to my mind, is why the presence of liquorice in Chinese herbal medicines is particularly noteworthy in and of itself. It's not as though its use as a folk remedy is distinctively Chinese.

@Sara: you get the same thing with some Indian qualifications. I once had the "joy" of working on a project with a woman who had Indian medical qualifications (I forget from where, which is amazing because she told everyone about them so often) but she could not pass board certification in Australia so she couldn't practice medicine. But we had to address her as "doctor" and damn did she think she was better than everyone else (she was also a Brahmin which didn't help).

By Christine (the… (not verified) on 25 Oct 2013 #permalink

@AntipodeanChic, Echinacea makes me nauseous. Trying to convince the woo-believers I know that it WON'T make me feel better is damn near impossible.

By Christine (the… (not verified) on 25 Oct 2013 #permalink

As someone who's worked in natural products chemistry, I just wanted to point out that one reason why "multicompound herb synergy" is logically plausible is that there are usually many structurally related compounds in a single organism (often secondary metabolites). Since they're structurally similar, they're likely to be active at the same receptor family - a mixture of agonists, partial agonists and antagonists, which could theoretically act together to mitigate the side effects or slow the metabolism of the most potent compounds, and therefore there's a possibility that the whole plant would work better overall than the isolated compounds. Of course, you could drastically improve the crapshoot by separating out all the compounds and recombining them in the optimal proportions for human use (and weeding out all the other crap in the process, or tweaking structures to improve their action) - Western pharmacology is slowly moving from the one-active, "magic bullet" approach to this kind of multicomponent therapeutic.

My question remains: why should the evolutionary ingenuity of plants be assumed to translate into benefits for humans?
I didn't say that it necessarily does. But it often has. The benefits of eating plenty of fruits and vegetables - and particular fruits like kinds of berries - are well known. A lot of recreational drugs come from plants also,
This site is extremely polarized in its discussions - if you take issue with anything, you're assumed to be expressing some "altie" prejudice.
I find the same thing in discussions with alt-med believers - that I'm assumed to be prejudiced in a skeptical way.
But actually I'm just mentioning the things that I take issue with, in what people say. I found the contention that the popularity of acupuncture etc. originated in Chinese Communist propaganda, amusing enough that I propagated it elsewhere.
I brought up the passage about herbs because it suggests a subtlety about testing herbal medicine - that the efficacy might depend on the diet of the person who's using them. The Chinese herbal remedies were likely first used on people who were eating the traditional plant-based lowfat Chinese diet, not the standard American diet - which would change their gut flora and thus perhaps the efficacy of herbal remedies. Most pharmaceuticals probably go into the bloodstream in their original form, not altered chemically by the gut flora. Probably, the pharmaceutical company would first test drugs in vitro, because that's less expensive. Human cells would be directly exposed to the drug. Only later would the drug be tested on living creatures with gut flora. A drug which must be chemically altered by gut flora to be useful, probably wouldn't pass the drug co.'s screening.
Traditional remedies were tested by individual people first (or possibly fed to their dogs first).
So while efficacy of pharmaceutical drugs may also depend on the gut flora, likely this is more often true of herbal remedies.
I for one can vouch for the efficacy of Echinacea. I’m horribly allergic to it, it seems.
I developed a ginkgo allergy, after taking a ginkgo supplement daily for a few months. I read that ginkgo has allergens in it. This is one advantage of pharmaceutical drugs - they isolate the active ingredient and hopefully the active ingredient isn't an allergen. Although allergens are usually reintroduced in the excipients.
There is lots of research on herbs on Medline that looks promising. Type in "ginkgo" for example and a lot comes up. I really doubt the claim that the herbal remedies on the shelves aren't doing anything. I think a lot of them are bioactive in humans - just that, as I said, they may not be as good as the pharmaceutical drugs, may also be doing harm, and also may be adulterated. Shavings from lumberyard floors are sometimes sold at hgh price as pau d'arco tea.

@M: If you've worked with natural products chemistry, then you should also know that proving that synergy requires a boatload of hard, complicated work. For example:

http://blogs.plos.org/takeasdirected/2011/07/15/the-whole-herb-and-noth…

Or, as a good buddy of mine who was a natural products pharmacologist before becoming a science communicator puts it:

Today’s herbalists and purveyors of alternative medicines will frequently argue that 1) whole herbs possess a synergy that is missing when one isolates and uses pure constituents, or that 2) the mixture is safer than pure compounds because one compound can reduce the side effects of another without compromising its therapeutic efficacy. In the former case, synergy has actually be described in the scientific literature but the cases are extremely rare. These few cases are scientifically fascinating and worthy of discussion in future SBM posts. The safety attributed to herbal mixtures is more likely due to the fact that any active constituent lacks the abundance or oral bioavailability to have any effect, pharmacological or toxicological. I have yet to see any convincing peer-reviewed publication that convincingly demonstrates efficacy and reduced side effects in the same herbal mixture.

In fact, as I learned more about herbal medicines as used today, I became increasingly disappointed that so few of them were actually backed up by clinical trials.

http://www.sciencebasedmedicine.org/a-natural-product-of-his-environmen…

The bottom line is that known examples of actual synergy are rare, and the claims of "synergy" promoted by herbalists and TCM practitioners are, for the most part, not supported by science.

Luara,
I'm not intending to pick on you, but you seem to have the same fence-sitting attitude to some CAM as I had some years ago. In the end it was the evidence that finally made me fall off the fence into the skeptic camp. I feel obliged to challenge you with similar evidence.

The benefits of eating plenty of fruits and vegetables – and particular fruits like kinds of berries – are well known.

The benefits of berries are well known to whom? There have been a lot of claims about various antioxidants and other chemicals contained in various berries, but I'm not aware of any clinical trials that show any actual clinical benefits from consuming them.

I recently referred here to the EPIC cancer study, that has studied diet and lifestyle in over half a million people since 1999 but has found no evidence that fruit (or vegetable, in most cases) consumption has any effect at all on breast cancer, gastric cancer or prostate cancer. This is surprising in the light of the CAM litany that fruit, particularly brightly colored fruits, and vegetables prevent or even cure cancer.

By the way, a quick search of PubMed for goji berries reveals some worrying data about allergies and even autoimmune hepatitis, but very little data about any benefits, despite their recent enormous popularity.

The Chinese herbal remedies were likely first used on people who were eating the traditional plant-based lowfat Chinese diet, not the standard American diet – which would change their gut flora and thus perhaps the efficacy of herbal remedies.

You have great faith in the observational abilities of Chinese doctors over thousands of years that I do not share. Look at Aristolochia, which is recommended in TCM for various conditions, but which we now know causes renal failure, cancer and death; it has killed countless thousands of people. How can I possibly believe that TCM has accurately assessed the subtle effects of herbs in combination, when it failed spectacularly to notice these devastating effects of Aristolochia? There are other TCM herbs that have less devastating but nasty side effects that have also apparently not been noticed despite millennia of observations.

There is lots of research on herbs on Medline that looks promising. Type in “ginkgo” for example and a lot comes up.

Please don't make the mistake of thinking that because "a lot comes up" on Medline it means that ginkgo has any useful effects, a lot of the stuff that comes up is negative evidence. Even Cochrane concluded (PMID: 19160216) that:

The evidence that Ginkgo biloba has predictable and clinically significant benefit for people with dementia or cognitive impairment is inconsistent and unreliable.

It doesn't work to prevent Alzheimer's either (PMID: 22959217), or as a cognitive enhancer (PMID: 23001963). A standardized extract, EGb 761, may be effective in age-related dementia (PMID: 23808613) but according to the Lancet (PMID: 22959218) this may not be clinically significant. I strongly suspect that the benefits of ginkgo are down to placebo effects. By the way, did you know that there is no traditional use for ginkgo to treat dementia, or cognitive decline, or to improve memory or concentration? There are a number of uses for ginkgo in TCM, but these are not amongst them.

I really doubt the claim that the herbal remedies on the shelves aren’t doing anything. I think a lot of them are bioactive in human

You may think that, but what evidence do you have? I don't know of any herbal remedies that have been shown to have clinically significant effects, except in some cases as standardized extracts e.g. horse chestnut (venous insufficiency), turmeric (cancer prevention) and cinnamon (lowering blood sugar), which in my opinion crosses the divide between herbalism and medicine. Even then in most cases the evidence is suggestive rather than definitive.

In the case of turmeric, for example, poor absorption means that it would be impossible to attain the blood concentrations that have been shown to have possible benefits through eating the spice; you need the extract, curcumin. That doesn't stop people from claiming that curry prevents cancer (it does, of course, but for other reasons, it also cures warts, baldness and erectile dysfunction*).

I think the useful substances in the vast majority of herbs have already been discovered, and the rest amounts to little more than "a nice bowl of soup and some potpourri".

* Sorry, but I need that money from the Curry Promotion Council.

By Krebiozen (not verified) on 26 Oct 2013 #permalink

Orac,

The bottom line is that known examples of actual synergy are rare, and the claims of “synergy” promoted by herbalists and TCM practitioners are, for the most part, not supported by science.

As Dangerous Bacon alluded at #21, claims of synergy are based, explicitly or not, on the idea that plants were put on the Earth by some deity for human benefit. This comes directly from Judeo-Christian scripture, which for all its useful advice is not known for its scientific rigor, so it isn't surprising that real cases are rare as they are due to happenstance rather than divine will.

By Krebiozen (not verified) on 26 Oct 2013 #permalink

About those oft-reported benefits of berries, goji, gingko (for cognition), turmeric, cinnamon et al-

despite the LACK of any solid SB evidence for therapeutic effects, woo-meisters continue to hawk supplements, which either blend them *synergistically* with a host of other spuriously supported magical ingredients or present in isolation, at their websites.

-btw-I am also a card-carrying member of the Curry Promotion Council and have just learned that I'm going to a place where curry abounds later tonight- and I don't mean Mumbai. Perks of the trade.

By Denice Walter (not verified) on 26 Oct 2013 #permalink

The Chinese herbal remedies were likely first used on people who were eating the traditional plant-based lowfat Chinese diet, not the standard American diet – which would change their gut flora and thus perhaps the efficacy of herbal remedies.

This, however, is plain speculation on your part; neither your source nor its source makes such a suggestion. Kim et al., after noting the lack of population-level differences, do cite this inter alia, but there it's found that the experimental high-fat, high-beef diet increased β-glucuronidase; if β-glucosidase goes along for (something I didn't scour it for, because I have to get out the door) the ride, the net effect would be the opposite of what you suggest as far as glycyrrhizin is concerned.

I can think of lots of benefits to using berries, cinnamon and turmeric -- not all in the same dish, mind you -- but none of them are medical.

Denice, stop torturing me. I live 23 miles from the nearest Indian restaurant. Come to think of it, I live 23 miles from the nearest restaurant. Period.

Krebiozen #41 wrote:

As Dangerous Bacon alluded at #21, claims of synergy are based, explicitly or not, on the idea that plants were put on the Earth by some deity for human benefit. This comes directly from Judeo-Christian scripture ...

Only from the Bible? Oh, come now,

The Earth is Our Mother.

Sastra,

Only from the Bible? Oh, come now,

You're right, I hadn't realized the extent to which these notions predate Christianity, The Great Chain of Being in Greek philosophy, for example. It still based on mankind being at the top and all Earth's plants and creatures designed for our benefit, which doesn't seem quite right to me, as a domesticated primate.

By Krebiozen (not verified) on 26 Oct 2013 #permalink

Shay,
I don't recall if you are in the US, and I'm not sure that Indian food in the US is the same as Indian food in the UK. In the UK what is sold in nearly every Indian restaurant is actually Bangladeshi food (most chefs are from one village) with quite a number of adaptations for the UK market.

The legend about chicken tikka masala, for example, is that it was invented when a British customer ordered chicken tikka (grilled marinated chicken) and rice, and then asked where the sauce was. The chef knocked up a mixture of curry sauce, tomato and cream and a new dish was born.

Anyway, if you are interested in cooking Indian food at home, and you are fond of the food that is produced by British Indian restaurants, and I'm pretty sure by Indian restaurants worldwide, I highly recommend a couple of cookbooks: 'The Curry Secret - Indian Restaurant Cookery at Home' and its sequel 'The New Curry Secret' there are Kindle versions of both.

The technique is rather strange, as almost all dishes are made with a single stock curry sauce, but with additional spices and other bits and pieces for each variation. I finally got around to trying it out a few weeks ago, and it worked beautifully. I like the more authentic curries I normally make, but every now and then I fancy a takeaway, and now I can make them myself.

By Krebiozen (not verified) on 26 Oct 2013 #permalink

Krebs, I have learned many valuable things from you, but the references above are by far the most important! I try and cook Indian food from scratch, using a well-stained version of Madhur Jaffery's BBC cookbook. It's good, but nothing like the meals I used to get in the UK.

My favourite place in student days was on Spital Hill in Sheffield. The local Pakistani taxi drivers used to eat there-a sure sign of authenticity. It was cheap and delicious. On one memorable evening, a fierce gust of wind blew the outside toilet down.

By sheepmilker (not verified) on 26 Oct 2013 #permalink

Kreb: I am in the US.

Fortunately the data center for a major service corporation is located in the county seat (that 23 miles I mentioned). We have a fairly robust Indian population here and half a dozen Indan restaurants, which is pretty remarkable for a town of 100K that's a good two hour drive from Chicago. I can't vouch for their authenticity, but whenever I eat in one, it's full of Indians. Is that a good sign?

I can only cook Indian at home when the spousal unit is at a trapping convention, alas. He can't abide the smell of either turmeric or (sigh) garlic.

He can’t abide the smell of either turmeric

There's one I've never heard of before...

or (sigh) garlic.

... but the devil asafoetida is your friend. Mebbe.

@shay

OMG, I could no more live with a person who couldn't abide garlic than I could live with a ...well, a HOMEOPATH!

Does turmeric have a distinct odor? I cook a fair amount of Indian food and haven't noticed--maybe because I'm still overcome by the garlic by the time I get to the turmeric. :-)

@shay

OMG, I could no more live with a person who couldn't abide garlic than I could live with a ...well, a HOMEOPATH!

Does turmeric have a distinct odor? I cook a fair amount of Indian food and haven't noticed--maybe because I'm still overcome by the garlic by the time I get to the turmeric. :-)

The Chinese herbal remedies were likely first used on people who were eating the traditional plant-based lowfat Chinese diet, not the standard American diet – which would change their gut flora and thus perhaps the efficacy of herbal remedies.

I can't see how this sub-hypothesis helps. let us postulate that these remedies might work for people who have the right gut biota, on account of eating the "traditional Chinese diet" (to the extent that there is such a thing, China encompassing an entire range of cultures and diets), to explain why they do not work in trials with American consumers. So what? The result is the same... they don't work for American consumers, and health shops who market them to American consumers are low-life frauds.

By herr doktor bimler (not verified) on 26 Oct 2013 #permalink

I'm a big fan of Indian food. I find that washing it down with drinks made from water, hops, yeast and malted barley is a particularly satisfying experience.

By DrBollocks (not verified) on 26 Oct 2013 #permalink

sheepmilker,
I'm glad to be of service, particularly in the realm of curry. I can't guarantee that the recipes in these books will generate food similar to that eaten by Pakistani taxi drivers in Sheffield. I have eaten Indian food in Glasgow, Aberdeen, Manchester, Cambridge, London and Cornwall, and they do replicate that very well.

I have also eaten Indian food in India, none of which was remotely similar to British Indian restaurant food.

The best was from a lovely little family-run hotel a friend had recommended in New Delhi; lots of small dry highly spiced dishes, eaten in a beautiful garden with monkeys and brightly colored birds in the trees. Sadly we had to move out after one night when we realized that what we had assumed were weekly rates were daily rates (we were students on a very limited budget).

Among the worst was the dhal and rice we ordered at a cheap cafe near Jodhpur railway station - real authentic Indian food, right? Wrong. The rice was that instant white rice you can buy in supermarkets, and the dhal was basically mildly spiced gruel. Barely edible. Another was the pizza I ordered for fun at a hotel in Jaisalmer, a beautiful fortress town in the Rajastan desert. I was served a chapati covered in bright fluorescent-red tomato ketchup, with paneer grated over it. I suppose that served me right for pining for western food after a few weeks of rice and dhal.

By Krebiozen (not verified) on 27 Oct 2013 #permalink

Shay,

I can’t vouch for their authenticity, but whenever I eat in one, it’s full of Indians. Is that a good sign?

It's a good sign that you are eating food that is familiar to those particular Indians. Do you know where they are from? Are you sure they are Indians, not Pakistanis, Bangladeshis, Nepalis or Sri Lankans? There are as many different South Asian cuisines as there are Chinese.

You mostly get bread and samosas in the north where wheat grows, and they use lots of tomato, yoghurt and paneer in their cooking.

In the south they use more rice, where they grow it, and also tamarind and coconut. You will find tandoori dishes in the north and sambars in the south.

There are exceptions to these rules of thumb everywhere.

By Krebiozen (not verified) on 27 Oct 2013 #permalink

Dorothy -- it was one of those thos whirllwind military courtships. I didnt realize he couldn't eat garlic and he didn't realize I was a Democrat until after the knot was tied.

Isn't it a little late ( early?) for a food discussion? It's not 3 am GMT.

At any rate, since I probably set off the curry bomb...

Since the age of 14 or so, I attended schools/ universities in cities where there were restauants from this region as well as ( in some) street and snack food places for emigres. I have also had an Indian female friend and been given cook books as gifts - including the Madhur Jaffrey BBC one, Julie Sahni's and Ismail Merchant's( !). I still have the second but am- alas- not a great chef but can do a few things well.

I have worked in places where I can get good regional cuisine and now scout around for good examples -also my cohorts have a fondness for it- one since childhood. I frequently have meetings ( for our project ) at a Pakistani buffet that is rather incredible for its humble storefront atmosphere- they produce their own 'Lahore Qulfi'on a stick and sweets. Last night, I wound up on a street where there is a multitude of curry houses amidst other diverse cuisine ( Nepalese, Moroccan, Korean) and had chicken tikka.

Around here, within a mile or so, I have a serious, well-appointed North Indian restaurant, a biryani/ dosai house, a few Chineseplaces, two Japanese, Italian places, Korean, Egyptian etc.
So I don't need to cook. EVER.

I think in one book, Madhur Jaffrey narrates her adventures in the UK and US and also does a bit about Indian English in a food context: who can ever forget "selices" of bread and chicken "cutlass"? I know I can't.

By Denice Walter (not verified) on 27 Oct 2013 #permalink

A great refresher in the not so ancient art of TCM. As and aside for anyone interested in the life of Maou, I highly recommend Mao: The Unknown Story by Jung Chang and Robert Halliday. It's a riveting account of his life and the forces that shaped the PRC in its early years. My eldest sister's mother-in-law was from an aristocratic Shanghai family and they left China in the late 20s to escape the Communists who slaughtered half their family. I always used to think her hatred of all things communist and very dramatic stories might have been exaggerated . . . until I read this book. A fascinating look into the paranoia and megalomania that drove Stalin, Mao and Kim Il Sung.

By Pareidolius (not verified) on 27 Oct 2013 #permalink

It definitely has a slight odor, at least to me. I'm something of a supertaster/supersmeller. (Seriously, my friend uses me as a sniffer dog whenever we meet for tea.

By Politicalguineapig (not verified) on 27 Oct 2013 #permalink

Denice,
It's always 3 am somewhere.

I think in one book, Madhur Jaffrey narrates her adventures in the UK and US and also does a bit about Indian English in a food context: who can ever forget “selices” of bread and chicken “cutlass”? I know I can’t.

I have an old, stained and battered (yum, book tempura) copy of Madhur Jaffrey's 'Eastern Vegetarian Cookery', which has some great background information on cooking all over East and South Asia. To be honest I'm not that impressed with some of the recipes; I have had disappointing results even when followed to the letter.

Some of the restaurants and cafes I ate in in northern India had some wonderful odd bits of English, including the ones you mention, on the menus. Things like 'jamtost', which I thought was something exotic I had never heard of, but it turned out to be toast with jam.

The 'cutlass' (with an infinite variety of spellings) is ubiquitous, of various kinds, usually vegetarian involving chick peas (often gram flour), always highly spiced and frequently delicious.

By Krebiozen (not verified) on 27 Oct 2013 #permalink

PGP,
Turmeric? Back when I had a sense of smell I found it had a slight smell, not particularly pleasant, and a definite taste, if I used too much to color rice for example (cheap substitute for saffron). It's definitely a spice that adds color rather than taste or aroma to a dish, which is almost as important, of course.

By Krebiozen (not verified) on 27 Oct 2013 #permalink

About spice smells:

Turmeric smells relatively mild - bitter/ pungent? HOWEVER I wonder if people are mixing it up with cumin ( or curry masala mixes containing it) which does have a more distinctive scent - and is perhaps too *exotic* for the un-initiated.
-btw- both can really stain clothing- I once destroyed an expensive blue-grey cardigan which I tried to restore ( an Indian woman suggested lemon) No dice. Even efforts to dye it -didn't work.

Back to 'interesting English'/ foods div:
at East Asian cafes, where they sell bubble tea, faux European pastry, sponge cake etc I have come across something IIRC called coffee tea ( w/ milk).

I guess if you can't make up your mind- have both.

By Denice Walter (not verified) on 27 Oct 2013 #permalink

Chris #1 - ironically enough, one traditional Chinese medicine that seems to actually have some minor health benefits is....snake oil (from sea-snakes - it's a very good source of Omega-3 fatty acids).

Denice #63 - i found the iced coffee & tea combination to be pretty tasty.

By Lancelot Link (not verified) on 27 Oct 2013 #permalink

Turmeric smells relatively mild – bitter/ pungent?

(Sticks nose in bag of turmeric)

When it's fresh, I'd call it peppery and a bit floral in nearly equal measure to the mustiness that is all that remains after it's been around for a while. W—pedia suggests that it's "mustardy," but I haven't replaced the stale Colman's that was tossed when I moved, so I can't compare.

Shame on scienceblogs spreading lies about Chinese culture! At least Chinese people know how to live healthy for thousand of years. Look at the healthy old Qigong masters in China! They more about health than you scienceblogs (or better pharmablogs) guys who talk BS. We have used massages based on acupuncture points for thousands of years instead of taking toxic painkillers.

It is really a shame that lies are spread in the name of science here.

By Michael Yao (not verified) on 28 Oct 2013 #permalink

The idea of synergy makes lots of sense. It is common sense that eating an orange is better than just taking a tablet of vitamin C. If you don't believe in this whole herb thing, why don't you just try to survive with vitamin pills and supplements instead of fruits?

We occasionally get fresh turmeric root here, but I haven't found any benefit to it over dried. As far as I'm concerned it's a coloring, and makes no useful contribution to flavor that I can discern.

Denice,

I guess if you can’t make up your mind- have both.

That's how mocha was invented.

By Krebiozen (not verified) on 29 Oct 2013 #permalink

@Michael Yao:

[citation needed]

Michael Yao,

Shame on scienceblogs spreading lies about Chinese culture!

What lies?

At least Chinese people know how to live healthy for thousand of years.

What evidence do you have for this? In China during the Shang Dynasty (from "The Cambridge History of Ancient China" edited by Michael Loewe and Edward Shaughnessy):

The life expectancy in 1500 BC was so short, even for the royalty who lived far better than others, that kings would not be able to take the throne as sons because they were too young. The king's younger brother would take over for him once he died, and after that then the oldest son would take the throne after his father was succeeded first by his brother.

Things weren't any better by the Ming Dynasty, 3,000 years later, when average life expectancy was 30 (from 'China's Geography: Globalization and the Dynamics of Political, Economic, and Social Change by Gregory Veeck, et. al., 2001). So when was this golden age when traditional Chinese medicine kept people healthy, or did they just stay healthy until they died at a young age?

Look at the healthy old Qigong masters in China!

They are con artists! Look at this video of a Qigong master knocking over all his students with laughably fake Qi. Yet when he is faced with a mixed martial arts fighter he doesn't stand a chance.

They more about health than you scienceblogs (or better pharmablogs) guys who talk BS. We have used massages based on acupuncture points for thousands of years instead of taking toxic painkillers.

Maybe, but we now know that acupressure and acupuncture are no more effective than a placebo.

It is really a shame that lies are spread in the name of science here.

If you have some evidence to support your claims, please share it. Otherwise, I suggest you withdraw your unfounded accusations.

By Krebiozen (not verified) on 29 Oct 2013 #permalink

Steven,

The idea of synergy makes lots of sense. It is common sense that eating an orange is better than just taking a tablet of vitamin C. If you don’t believe in this whole herb thing, why don’t you just try to survive with vitamin pills and supplements instead of fruits?

I don't think "synergy" means what you think it means, and you are confusing nutrition with medicine. A vitamin C tablet will take care of your vitamin C requirements just as well as an orange will, but obviously an orange has other nutritional value. Fruits aren't herbal medicine, and have little to do with "this whole herb thing", and nothing to do with the concept of synergy under discussion.

By Krebiozen (not verified) on 29 Oct 2013 #permalink

Krebiozen: "We occasionally get fresh turmeric root here, but I haven’t found any benefit to it over dried."

I grow saffron crocus, which are presently blooming and I need to gather the threads every day since the flowers last only a day or so. After I gather them I put them on a paper towel and zap them in the microwave oven for thirty seconds, where they shrink by half.

I decided a few days ago to try cooking rice with fresh saffron, and there was very little flavor. It seems they have to be dehydrated to release both their color and flavor/odor.

Chris,

I decided a few days ago to try cooking rice with fresh saffron, and there was very little flavor. It seems they have to be dehydrated to release both their color and flavor/odor.

That probably breaks down the cellular structure enough to release cell contents. Some recipes I have seen suggest steeping the saffron in hot milk before adding to rice. Perhaps the fat content in the milk extracts more flavor and color? That may be worth a try.

You might want to be careful - you know that saffron is a precursor of ecstasy and other drugs. Is crocus cultivation legal any more? (I'm joking, but only half)

I don't know if I have related here my experience in Morocco, where i was excited about the huge variety of spices available, and how cheap they were. I excitedly bought a box of sachets of saffron, but when I got home and opened it I found they were paper wraps containing a few grains of yellow food coloring. I had a similar experience in Egypt with "silk" which turned out to be rayon.

By Krebiozen (not verified) on 29 Oct 2013 #permalink

Another thing about fresh root turmeric is that you have to peel and slice it, which will stain your fingers yellow for a few days, unless you wear gloves of course. It really isn't worth it, in my opinion. Fresh galangal is another matter entirely.

By Krebiozen (not verified) on 29 Oct 2013 #permalink

The best evidence for Chinese medicine is healthy Chinese people! That is what I call evidence based medicine. Western people poison themselves with chemical cocktails while Chinese people stay healthy with Qigong and herbs.

By Michael Yao (not verified) on 30 Oct 2013 #permalink

Michael Yao,

How then do you explain healthy people who do not take Chinese medicine? Do you have studies that show that the outcomes are better for Chinese medicine than for other methods of treatment? If so, would you share?

By Mephistopheles… (not verified) on 30 Oct 2013 #permalink

I've not tried chemical cocktails - I generally stick to Scotch, bourbon, wine, or beer. But if they're tasty I'd consider them.

By Mephistopheles… (not verified) on 30 Oct 2013 #permalink

Of course, if you let people without any clue about acupuncture points run some tests, then what you get is a placebo. But this proves your inability to do acupuncture/acupressure.

By Michael Yao (not verified) on 30 Oct 2013 #permalink

Michael Yao,

The best evidence for Chinese medicine is healthy Chinese people! That is what I call evidence based medicine.

So provide some evidence that Chinese people are in general healthier than Western people with similar lifestyles but who use conventional medicine.

Western people poison themselves with chemical cocktails while Chinese people stay healthy with Qigong and herbs.

So why is the life expectancy in China lower than in the US, France and the UK?

By Krebiozen (not verified) on 30 Oct 2013 #permalink

Of course, if you let people without any clue about acupuncture points run some tests, then what you get is a placebo. But this proves your inability to do acupuncture/acupressure.

Studies directly comparing 'genuine' acupuncture to sham acupuncture controls (insertion at the wrong meridian points, use of retractable needles, twirling toothpicks against the skin, etc.) demonstrate that even when you let people who are knowledgable about acupuncture points administer treatment you're still only getting a placebo effect.

Michael Yao,

Of course, if you let people without any clue about acupuncture points run some tests, then what you get is a placebo. But this proves your inability to do acupuncture/acupressure.

Which studies on acupuncture are you referring to? This meta-analysis published this month found:

When comparing acupuncture to sham controls, there was little evidence that the effects of acupuncture on pain were modified by any of the acupuncture characteristics evaluated, including style of acupuncture, the number or placement of needles, the number, frequency or duration of sessions, patient-practitioner interactions and the experience of the acupuncturist.

My emphasis.

By Krebiozen (not verified) on 30 Oct 2013 #permalink

@Michael Yao:

[citation still needed]

Chris,
In all fairness, I don't think that melamine and diethylene glycol are part of traditional Chinese medicine nor are they added for their medical benefit.

I'm sure that Michael Yao has some better evidence for how well Chinese medicine works than "There are more than a billion Chinese people and some of them are healthy." Even now he is no doubt writing up the data to prove it indisputably!

By Mephistopheles… (not verified) on 30 Oct 2013 #permalink

"...Chinese people stay healthy with Qigong and herbs..."

Not to mention sewer oil.

http://www.theatlantic.com/china/archive/2013/10/chinas-frightening-unp…

I find Michael Yao's defense of TCM interesting. When I was in grad school, both ABC and FOB Chinese (American-born Chinese/Fresh Off the Boat Chinese, and that's how they referred to themselves) were politely contemptuous of it. TCM in their opinion was for people who were too poor to afford "real" medicine.

True, M O'B. But I have a strong dislike of all encompassing claims like those used by Mr. Yao. China is a very complicated place, and blanket claims can go both ways. I just posted about some of the issues with corruption that occurs there, but I could have also posted about all of the real medical research that happens. China does have real hospitals, and some very dedicated medical researchers who do stay away from TCM.

The real quacks are you pharma guys teaching "alternative history" here. It is common sense to listen to the healthiest people for health advice, and these are the Qigong masters who live longer than 100 years.

By Michael Yao (not verified) on 30 Oct 2013 #permalink

There are goatherds in the Balkans who live to be 100 years old. They may be healthy, but what qualifies them to give advice?

And why would any rational person listen to them, anyway?

Michael Yao #89 wrote:

It is common sense to listen to the healthiest people for health advice, and these are the Qigong masters who live longer than 100 years.

Assuming that Qigoong masters do indeed live longer than 100 years (which I'm skeptical of -- what, all of them?), you should know that there have got to be a lot of confounding factors in this. Not just medicine but diet, genetics, environment, lifestyle, etc. Things which made a difference and things which didn't, things which can be controlled and things which can't.

I saw a commercial for yoghurt which showed very elderly people in Russia eating it. I'd want more evidence for a direct connection. So would you.

the Qigong masters who live longer than 100 years.

My imaginary Caucasus-mountain villagers living to 140 on a diet of yoghurt can out-live your imaginary Qigong masters!

By herr doktor bimler (not verified) on 30 Oct 2013 #permalink

Back in the days, the place where contented villagers lived to contented super-centenarian old age -- thanks to a natural diet and freedom from the stresses of Western life-style -- seemed to move around the world, in the manner of Fiddlers' Green. Sometimes it would be a remote village in the Caucasus, and sometimes the Vilcabamba valley in Ecuador, and sometimes the Hunza Valley in Pakistan... the common features being (a) remoteness, and (b) absence of reliable record-keeping.

The Caucasus / yogurt / longevity fiction appears in Evans' "Spoor of Spooks" (1954), IIRC.

I must thank Narad for introducing me to this.

By herr doktor bimler (not verified) on 30 Oct 2013 #permalink

HDB,

and sometimes the Hunza Valley in Pakistan

A while ago I came across a book called Hunza: Lost Kingdom of the Himalayas (large PDF) written by a male nurse who spent 20 months living with the Hunza in the 1950s. He was faced with malaria, tuberculosis, trachoma, malnutrition and more. Also serious respiratory problems and irritated eyes because the Hunza traditionally have fires inside their huts with the smoke exiting through a hole in the roof, as many of our ancestors did a thousand years ago.

Here are some highlights from Chapter 4, 'The Healthy Hunzas Come to the Doctor', just to give a flavor of how healthy these remarkable people actually are. Warning - some graphic descriptions that may upset the weak-stomached:

Very gently his uncle and I pulled the dirty little cotton shirt off over his head, loosened the drawstring that held up his pants and took them off. All that was left of that little boy weighed less than forty pounds. The two separate bones of his forearm showed clearly, with a groove between. His abdomen was a deep hollow, notched up between his ribs. All over his emaciated brown arms and legs were the sores that were draining his life away—ugly, black crusts over raw, suppurating flesh. Both elbows were completely covered; three-inch scabs spotted his legs like macabre spangles. Blood and yellow pus oozed from the sores around his shoulders, where we had hurt him taking off his shirt. His eyes were running tears of pain, but somehow he gathered strength to smile at me. [...]

Forty-five minutes spent on one little boy, and thirty-odd other patients to treat before noon! Fortunately, most of them had malaria, dysentery, worms, trachoma, and other things easily diagnosed and quickly treated. [...]

Hunza cannot produce enough food to last the year, so a partial famine develops every spring. No one starves to death, but everyone goes hungry. Barley is the first crop to mature in the spring. The barley harvest breaks the famine in Hunza, so it is an occasion for real rejoicing. Most of the Hunzas would eat barley-flour chapatis from now until wheat harvest early in October. Only the Mir and a few well-to-do families had sufficient wheat to last the year. [...]

On my fourth morning in Hunza we faced sixty-two patients, the most I ever had in one day. They came chiefly from Baltit and Altit, but some were from Hasanabad, five miles west, and one family had walked all the way from Ghumessar, twelve miles east. Beg and Hayat worked right at my side. Both of them were fastidious about touching oozing sores, but cleansing of ringworm and impetigo sores was the only time-consuming job they could do for me. One boy would be soaking the gooey mess off the face of an impetiginous baby with potassium permanganate, while the other translated for me with the next patient. Beg was much more distressed than Hayat, both by revulsion at the sores and by horror at the pain he was causing. Twice I heard him mutter, "I'm sick myself!" but he went on.[...]

Of course, a real doctor could have done much more than I did. However, these people had been without any medical attention for three years. Most of their ailments were common things fully developed before they bothered to come to me, which made diagnosis easy. In my two trips I was to treat 5,684 patients. No patient ever died or grew worse because of my treatment. Some died in spite of treatment, and some because they needed treatment far beyond my abilities. Most of the people who came to me were helped or cured by the simple things I was able to do for them. Five or six would probably have died if treatment had not been available.

There are myths, and there's reality...

By Krebiozen (not verified) on 30 Oct 2013 #permalink

Methuselah lived 900 years;
Methuselah lived 900 years
But who calls that livin'
When no gal will give in
To a man who's lived 900 years?

It is common sense to listen to the healthiest people for health advice, and these are the Qigong masters who live longer than 100 years.

The Guinness Book of World Records had a preamble to their section on Longevity to the effect that claims of extreme old age were the ones most frequently exaggerated or fraudulent, mostly on the basis of national pride or for commercial reasons. This is why their requirements for longevity claims are extremely stringent.

Make of that what you will.

When no gal will give in
To a man who’s lived 900 years?

Maybe one with a great great great great great great great great great great great great great great great great great great great great great great great great great great great great great great great grandfather fixation?

One wonders how strongly lifespan correlates to poor math education.

By Gray Falcon (not verified) on 30 Oct 2013 #permalink

It certainly seems to correlate with "perceived virtue" and "exotic location, far from the ravages of Western medicine and soft living" and "being as one with Nature".
How well is Shangri-La surviving the Chinese occupation?

By herr doktor bimler (not verified) on 30 Oct 2013 #permalink

Why don't you just learn more about health from Chinese health experts who are healthy when they are old? Health is an important part of Chinese culture for thousands of years. It is ironic that you attack the healthiest people because Western medicine is all about making money from sick people and you hate to see how we live healthy without drugs. Of course, in your parallel universe, we live very healthy beyond 80 years because of placebos. I want to see Western people at their old age who are as healthy as we are.

Western people get sick from a fatty diet, Chinese people live healthy with a balanced diet, so you have the arrogance to teach that we are wrong? You have to understand that our diet comes from the philosophy of yin yang balance, as part of TCM, and this existed before Mao for thousands of years. Learning Chinese history from you is like learning biology from creationists.

By Michael Yao (not verified) on 30 Oct 2013 #permalink

#100 "Western Medicine" vs. "Chinese Medicine" is a false dichotomy.

"Western people get sick from a fatty diet" is a false generalization.

"Chinese people live healthy with a balanced diet." All Chinese people? What about Chinese people living in the West? What about Chinese people who practice what you erroneously call "Western medicine"? Are you saying Chinese people who practice scientific medicine are somehow not Chinese?

Nevertheless, I am prepared to entirely believe and agree with everything you have said, provided you prove it, and supply references to proof, in the form of a well-designed, double-blinded study in a top-tier journal that has been peer-reviewed.

In fact, we are all quite easily convinced that way, by and large.

Shay - the title of the song you quoted is very apropos to Micheal Yao's unsupported assertions about Chinese longevity.

One could also follow the example of an American Bluesman who lived to 97 by eating a Bic Mac, small fries and a Diet Sprite every day.

By Militant Agnostic (not verified) on 30 Oct 2013 #permalink

“Chinese people live healthy with a balanced diet.”

Because there is one single diet across all of China, from Yunnan to Heilongjiang to Xinjiang. I call shenanigans.

By herr doktor bimler (not verified) on 31 Oct 2013 #permalink

@Michael Yao - I am, frankly, disappointed. I'd really hoped you'd come through with some sort of valid evidence and argument.

Around the world you find people who live to be 100 or older. Everywhere I've been, you'll find articles in the newspaper about them. If they're still rational, the reporters always feel compelled to ask one question: "To what do you owe the secret of your longevity."

And you know what? They all say different things. The things that one person says directly contradict what another says. What do we learn from that?

By Mephistopheles… (not verified) on 31 Oct 2013 #permalink

By the way, if you've got evidence that health outcomes from traditional Chinese medicine are demonstrably better than other treatments, please share. Something more than vague hand waving and generalizations not based in fact, please.

By Mephistopheles… (not verified) on 31 Oct 2013 #permalink

Sometimes I think of Indian guru's, who look very old, while still somewhere in their 60s.

I believe that George Burns (who lived to be 100) credited his longevity to cigars.

And you know what? They all say different things. The things that one person says directly contradict what another says. What do we learn from that?

That nobody really knows why, and that long life is most likely a combination of genetics and good luck?

By Edith Prickly (not verified) on 31 Oct 2013 #permalink

Sadly, many of my relatives have a combination of genetics and bad luck that give them both a long life and crippling dementia. I'm beginning to panic whenever I see my mother forget something.

By Gray Falcon (not verified) on 31 Oct 2013 #permalink

You know, I vaguely recall an interview with a man who was at one point in time the oldest man in the U.S. who credited his longevity to his lifelong love of bacon, which he apparently ate every day.

Now that's a diet routine I can get behind ;)

By Indigo_Fire (not verified) on 31 Oct 2013 #permalink

Certainly the promise of bacon provides motivation to live another day.

Anecdotal evidence ( after studying psychology of aging):

amongst the extreme elderly in my own family,I noticed a few commonalities:
no one was overweight
each was very independent in thought and activity
every one really liked cheese.

Here's the problem:
one liked fresh cheeses ( like ricotta), one liked Swiss and similar types, another liked all types..etc

Not one was a vegan or ate a particularly "healthy diet". Yes, cigarettes, cigars, coffee, tea and alcohol were involved.

By Denice Walter (not verified) on 31 Oct 2013 #permalink

Micheal Yao, you forget that in times of famine Chinese people eat everything. And truth be told we have no idea how big a role industrial pollution has had on health in NA, but the Chinese people are about to find that out. Regardless of eating a balanced diet people will be overcome by toxins - the body can only handle so much and I think it's safe to say that people in China are slowly being choked to death by air pollution.

Curious,

Actually, if Michael Yao is correct about the overall health of the Chinese population and you, TBruce, Shay, and Chris are correct about pollution as well as toxic substances adulterating food and toiletries in China, this those herbs are pretty amazing stuff. If you can stay amazingly healthy despite being poisoned by your air, water, food, cooking oil, and toothpaste (just to list a few things) through Chinese medicine, then that would certainly be worth a paper and, perhaps, a Nobel prize!

By Mephistopheles… (not verified) on 31 Oct 2013 #permalink

Chinese people live healthy with a balanced diet, so you have the arrogance to teach that we are wrong? You have to understand that our diet comes from the philosophy of yin yang balance, as part of TCM, and this existed before Mao for thousands of years

I was curious enough to ask the Google how Chinese life expectancy compares against expectancies in those bad-diet Western countries, and whether it deteriorated while China adopted Western ways.

By herr doktor bimler (not verified) on 31 Oct 2013 #permalink

link fail, does not open in a new windows.

Alain

If Chinese people relied on quackery for thousands of years, then we would have died out a long time ago, and you won't see many of us around. Take up some classes in Qigong or TaiChi, with a Kung Fu grandmaster, and acupuncture will make sense to you. The Kung Fu masters are the healthiest people in the world because of the underlying philosophy of TCM.

If you are seriously against TCM, then you should go to a Chinese park and tell them and all practitioners of Qigong/TaiChi who live a healthy life in their old age how superstituous they are. Let us see who is laughing at who :)

By Steve Yang (not verified) on 01 Nov 2013 #permalink

@Steve Yang -

If Chinese people relied on quackery for thousands of years, then we would have died out a long time ago, and you won’t see many of us around.

You are arguing from antiquity. I could just as easily say that whatever medicine - if any - that any ancient peoples who weren't wiped out must be safe and effective. What that really shows is that it is perfectly possible to live and reproduce with care that is, in effect, no care at all.

Take up some classes in Qigong or TaiChi, with a Kung Fu grandmaster, and acupuncture will make sense to you.

It's not a question of whether it makes sense or not. It's a question of whether it can be demonstrated to work safely and reliably. With possible exceptions for certain forms of back pain, the studies do not show that it works. If you have data that shows that it does, please share.

The Kung Fu masters are the healthiest people in the world because of the underlying philosophy of TCM.

If that is true, then I'm sure you know of a rigorously controlled study in a peer reviewed publication that demonstrates this, and that you'd be willing to share that information with us. Extra points if it shows which parts of the underlying philosophy of TCM provide the most benefit.

If you are seriously against TCM, then you should go to a Chinese park and tell them and all practitioners of Qigong/TaiChi who live a healthy life in their old age how superstituous they are.

This assumes that all people who practice Qigong or Tai Chi do it because they believe in an unproven system of medicine rather than are doing it for the exercise or because they just enjoy it. Note: you are the only person to use the term "superstitious" in this thread; others would say misinformed.

Let us see who is laughing at who

Logically, wouldn't you have to hear who is laughing at whom? But I digress. I personally don't laugh at people who use or prescribe treatments that are either known to be ineffective or not proven to be effective, including treatments that may be hazardous.

By Mephistopheles… (not verified) on 01 Nov 2013 #permalink

Take up some classes in Qigong or TaiChi, with a Kung Fu grandmaster, and acupuncture will make sense to you

Take some classes in yoga from a Thai kick-boxing grandmaster, and homeopathy will make sense to you.
Take some classes in Feldenkrais Body-work from a Graeco-Roman Wrestling champion, and Ayurveda will make sense to you.

I am just disappointed that Steve / Michael Yang / Yao didn't weave more Shaolin Monks into his cool story.

By herr doktor bimler (not verified) on 01 Nov 2013 #permalink

#120 Steve Yang

"If Chinese people relied on quackery for thousands of years, then we would have died out a long time ago..."

Why? Europeans relied on quackery for thousands of years and they're still around.

Telling us that the reason Chinese people live so long is Qi Gong or TCM, when life expectancy on China is lower than the US, the UK and France makes no sense at all.

By Krebiozen (not verified) on 01 Nov 2013 #permalink

Telling us that Qigong and TCM and Tai Chi and acupuncture are all the same thing (all taught by "Kung Fu grandmasters"!) makes no sense at all either. Or that there is a single Chinese diet. "Michael Yao" / "Steve Yang" is as much Chinese as I am

By herr doktor bimler (not verified) on 02 Nov 2013 #permalink