Be cautious of Chinese medicine shop herbal remedies. I have been told by doctor friends, one of whom is a full professor of orthopedics and oncology at National Taiwan University hospital, that a lot of shops in Taiwan spike the remedies with steroids to boost the perceived effectiveness of the herbal remedies. He also told me about a patient that had had an herbal pack remedy applied to the knee in such a way that gangrene set in. The way that my friends so matter of factly talk talked to me about adulterated herbal remedies this was truly unsettling. In light of all the recent problems with food product quality in Taiwan, I’d never touch herbal remedies unless the doc or shop could somehow prove to me me they were not steroid spiked.
I had experience with that back when I had my skin allergies. I tried Chinese medicine from a co-worker and got the instant reaction I knew all too well from steroids. Told my co-worker about it and didn’t take it again. Fifteen years ago now I guess.
In case you missed it:
That’s why we won’t suggest patients to go to Chinese medicine “shop” randomly, since the quality of the herbs are not well regulated in some Chinese medicine shop. We always tell our patients to go to licensed TCM doctors like us, usually we will also provide herbs to patients. The herbs in our hospital are sampled and analyzed for toxin or drugs. I believe it’ll be much safer.
In every business, there must be someone who’s not honest with what they do. They just want to make money, they don’t even respect what they do. The government should make more effort in regulating the quality of herbal medicine. My suggestion: come to TSGH if you want to try TCM.
Anti-depressants? Well probably better than placebos but ineffective in the majority of cases or work once but not the second time.
Anti-depressants? Well probably better than placebos but ineffective in the majority of cases or work once but not the second time.[/quote]
and therein lies the art of designing clinical trials. It is amazing what some drug companies get away with, and that drug licensing boards (eg, the FDA) let them.
Taipei tests find some Chinese herbs high in toxic levels:
taipeitimes.com/News/taiwan/ … 2003606567
Too bad they don’t add dbol to the herbal remedies.
[quote=“Xeno”]Taipei tests find some Chinese herbs high in toxic levels:
taipeitimes.com/News/taiwan/ … 2003606567[/quote]
Thanks for sharing this news link. The issue of toxin in Chinese herbs has long been discussed for decades. As you may know, 90% of Chinese herbs in Taiwan came from mainland China. It is a pity that not every businessman is honest. To make the best of their own profit, they’re willing to sacrifice the health of others. However, don’t lose faith.
Fortunately, after all these years using Chinese medicine, in both powder and decoction, we rarely heard that patients are poisoned by herbal medicine, despite the shocking news like this one. The reasons are as follows:
- We don’t eat the whole herbs, we boiled the water with herbs in it and drink only the liquid, throw away the dregs.
- We won’t use one single herbs for a long period of time. We will adjust the formula to best fit the dynamic individual condition. This can avoid poison, if there is something bad in certain kinds of herbs.
- Most of the commonly used herbs are safe, if you go to licensed TCM doctors.
If we’re going to talk about poisoning, we must emphasize on the dosage and the time of exposure. Most of the poisoned cases I’ve ever heard about TCM came from misuse, including overdose (the ancient classics already warn us but someone insist to use as he wishes) and long period of misuse (more than 3-5 years). If you’re able to analyze the benefit and harm of TCM objectively, you will use it more wisely.
As you may know, most of the modern medicine drugs has a longer list of side effects, people still use it. Most chemotherapy drugs do damages to the connective tissue, patient still need it. If the dosage and the timing of using the medicine is well controlled, the benefit is bigger than harm, vice versa.
Go to licensed TCM doctors or come to TSGH if you want safer TCM services.
I would like to share a concept here. The most precious thing in TCM is not herbs. It’s the TCM theory that matters. Although this theory has been well developed thousands of years ago, written in 黃帝內經, the essence of theory seems to be correct. I hope I can find some time to introduce them to you guys. Thanks for your reading this.
But the theory is so obviously incorrect. Earlier in this thread:
Everyone knows that wind, cold, summer heat, humidity, dryness and fire do not cause disease. The ancients were wrong. If one wanted to be unkind about it the ancients would have failed high school statistics and science. Correlation is NOT causation. For example, just because a certain (say, fungal) infection often appears in humid environments doesn’t mean that humidity causes it. A scientifically trained doctor would correctly identify the cause of the disease as a fungus and prescribe a clinically tested medicine that works. Like Betadine. I’m guessing the ancients didn’t know about iodine either. How could they? They didn’t know about the elements. Or germs.
Still, over time they may have developed methods which worked under certain circumstances even if the cause were not scientifically known.
But the theory is so obviously incorrect. Earlier in this thread:
Everyone knows that wind, cold, summer heat, humidity, dryness and fire do not cause disease. The ancients were wrong. If one wanted to be unkind about it the ancients would have failed high school statistics and science. Correlation is NOT causation. For example, just because a certain (say, fungal) infection often appears in humid environments doesn’t mean that humidity causes it. A scientifically trained doctor would correctly identify the cause of the disease as a fungus and prescribe a clinically tested medicine that works. Like Betadine. I’m guessing the ancients didn’t know about iodine either. How could they? They didn’t know about the elements. Or germs.[/quote]
I had exactly the same judgement with you on TCM theories when I was a freshmen, I feel confused because none of these theories are compatible with the knowledge I had. As I read more and learn more about this medicine, I learn a lot about the philosophical view of ancient Chinese, which in sum is Taoism, then I realize all these words make sense.
You questioned wind, cold, summer heat, humidity, dryness and fire doesn’t “cause” disease. Let me give you a brief example: If you go to dessert, you feel hot, mouth ulcer, dry eye, dry skin. We say it’s caused by dryness. And treat this with some herbal medicine which can moisture the body. This is just a brief example, the TCM mechanism is not described here because you’ll need more background knowledge to understand it. Of course the ancestor don’t know the “modern medicine view of pathophysiology,” they developed their own view of TCM pathophysiology. Of course they don’t know about bacteria or Betadine because they don’t have microscope and other technology as we do. Therefore, all that they can do is to describe the result of microorganism and developed their own manner to treat. And this theories has been used for thousands of years. Before modern medicine enter China and Taiwan, TCM has been taking good care of Chinese people for thousands of years.
We’re all trained with modern western scientific method since we’re young. Imagine you don’t learn modern math, science when you’re kids. You learn the Four Books :《論語》、《孟子》、《大學》、《中庸》and the Five Classics:《詩經》、《尚書》、《禮記》、《周易》、《春秋》。You’ll know TCM better than me. If you insist in judging TCM in a modern way and don’t want to spend time to understand the ancient time and space background and the whole picture of this medicine, you’ll definitely think they’re wrong. They’re not wrong, they just speak a language you do not yet understand. Thanks for your reply, gotta go to work!
How on earth would you know? What data are you using to make this claim? Life expectancy for Chinese people was 43.47 in 1960, according to the World Bank, and less than 40 before 1949. I wouldn’t call that ‘good care’. The dramatic improvements in the health of the Chinese people occurred after the introduction of modern medicine, sanitation, and personal hygiene.
That is simply cultural relativism. All cultures have their own truths. If you believe in relativism then there is no need for evidence, or facts. So you can say, “TCM has been taking good care of Chinese people for thousands of years” because you don’t care about life expectancy, or any other method of “judging TCM in a modern way”. And you wouldn’t care about this kind of study either:
[quote=“Journal of Internal Medicine”]Abstract.
Even though widely used in today’s clinical practice, acupuncture has remained a controversial subject. Many reviews are currently available but most lack a critical stance and some are overtly promotional. The aim of this overview is to provide a balanced, critical analysis of the existing evidence. Some of the original concepts of traditional acupuncture are not supported by good scientific evidence. Several plausible theories attempt to explain how acupuncture works but none are proved beyond doubt. The clinical effectiveness of acupuncture continues to attract controversy. Many controlled clinical trials and numerous systematic reviews of these studies have been published. Considerable problems are encountered when interpreting these data. Heterogeneity is a significant drawback of both clinical trials and systematic reviews. Some of the controversies may be resolved through the use of the new ‘placebo needles’ which enable researchers to adequately control for placebo effects of acupuncture. The majority of studies using such devices fails to show effects beyond a placebo response. Acupuncture has been associated with serious adverse events but most large-scale studies suggest that these are probably rare. Nonserious adverse effects occur in 7–11% of all patients. In conclusion, acupuncture remains steeped in controversy. Some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response.[/quote]
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2005.01584.x/abstract;jsessionid=0A49E8E57CFC956AABF22FA115B9660C.f02t03
But I think most people with an education would care.
How on earth would you know?[/quote]
If I have understood joey0825’s arguments correctly, then he doesn’t claim to know. Here are some previous replies:
I think this gets to the point of his argument. My response would have been: in the absence of large-scale controlled trials, it’s very difficult to rule out that the patient hasn’t simply recovered on their own.
“Since event Y followed event X, event Y must have been caused by event X.” is a logical fallacy.
If TCM has no empirical evidence to support it (as you say), then we really have no way to know that it is effective.
I want to point out that I have no bias against TCM – if good-quality evidence comes to light that shows it’s effective, then I will gladly support it.
But in the absence of emprical evidence, then claims of effectiveness are just claims and anecdotes, and nothing more.
I might add, that some medicines commonly taken in the West also only have weak evidence to support their efficacy (cough medicines are a good example). We are right to be skeptical of whether they really work.
But pointing out the existence of examples such as these doesn’t justify further bad science. As scientists, we shouldn’t just be looking for evidence that supports our convictions, we also need to look for evidence that disproves our convictions.
I just like to point out to those who seems to think TCM is mambo-jumbo voodooish crap that there are plenty of scientific studies on TCM, and there are peer reviewed academic papers on a lot of these stuff using scientific methods.
Get on an academic internet connection and see for yourselves:
JTCM
sciencedirect.com/science/journal/02546272
Chinese Medicine Journal
cmjournal.org/content
as you can see from this article, ingredients of TCM are analyzed using genetics:
cmjournal.org/content/9/1/26
there are more, but these have a high impact factor (don’t personally agree with the use of impact factors, but at least it means they are not some crap that people threw together).
So claiming that there’s no science behind TCM is a little confusing to me. When the first vaccine was developed for polio, not every aspects of how the process works was known to Dr. Salk, he just knew it works. It doesn’t make it any less effective.
While I agree TCM has a lot of room to go to becoming more quantitative in their approach, some of the accusations seem baseless.
How on earth would you know? What data are you using to make this claim? Life expectancy for Chinese people was 43.47 in 1960, according to the World Bank, and less than 40 before 1949. I wouldn’t call that ‘good care’. The dramatic improvements in the health of the Chinese people occurred after the introduction of modern medicine, sanitation, and personal hygiene.
That is simply cultural relativism. All cultures have their own truths. If you believe in relativism then there is no need for evidence, or facts. So you can say, “TCM has been taking good care of Chinese people for thousands of years” because you don’t care about life expectancy, or any other method of “judging TCM in a modern way”. And you wouldn’t care about this kind of study either: [/quote]
When I said “taking good care of”, I didn’t mean “prolong the life expectancy”. Of course modern medicine, sanitation, and personal hygiene is the main reason for life expectancy prolonged. What I really want to say is that even when our ancestors live without modern technology and modern medicine, they still use their knowledge and wisdom to make their best to solve the problem of life. They develop a theory and modify it by practicing it. It works for most of the cases. (according to medical books, clinical practice and some clinical study.) However, it also failed in some area, we must admit. I never claim TCM is almighty, neither is modern medicine. BTW, TCM is not equal to acupuncture. We use herbal medicine in Taiwan more than in western countries.
I’m sorry for my poor English that I can’t fully express my thought sometimes, which might lead to some misunderstand. I apologize. I’ve been posting on this website for a couple of months and I found that we’re not on the same page all the time. Our educational background might be different, not to mention our vision in health care. People tend to believe what they see and disagree with what is invisible to them. Although I’ve been trying to make TCM theory easier to understand for you guys, it seems to be useless because you need the whole picture, not just a couple of quick glances I’ve been trying to offer.
I don’t want to argue with you guys about the effectiveness of Chinese medicine. I’ve said it all in the previous posts, including the problem of study design. TCM is not perfect, neither is modern medicine. Although the essence theory of TCM is awesome, lots of records in ancient medical books are meaningless. You’ll need some TCM training to differentiate. It’s not easy to learn TCM. It needs to be modernized, validated. I’m not here to persuade you guys, I know you wouldn’t change what you believe easily.[color=#0000FF] I’m just here to remind you there is another choice[/color] (maybe that’s why it’s also called CAM, complementary and alternative medicine). We will keep working hard on benefiting our patients. I hope one day I can go abroad to practice TCM so that more and more people around the world would know TCM better and benefit from TCM. Of course I’ll have to master English first! Thanks for all your replies, which makes me think about the things need to be done to promote TCM. Thanks again, I love you all.
[quote=“joey0825”]
I’m sorry for my poor English that I can’t fully express my thought sometimes, which might lead to some misunderstand. I apologize.
…
Of course I’ll have to master English first![/quote]
Just want to say that, despite our lack of agreement, I think your English is pretty good, so no need to apologise!
我相信你的英語比我的中文流利得多!
[quote=“hansioux”]I just like to point out to those who seems to think TCM is mambo-jumbo voodooish crap that there are plenty of scientific studies on TCM, and there are peer reviewed academic papers on a lot of these stuff using scientific methods.
Get on an academic internet connection and see for yourselves:
JTCM
sciencedirect.com/science/journal/02546272
Chinese Medicine Journal
cmjournal.org/content
as you can see from this article, ingredients of TCM are analyzed using genetics:
cmjournal.org/content/9/1/26
there are more, but these have a high impact factor (don’t personally agree with the use of impact factors, but at least it means they are not some crap that people threw together).
So claiming that there’s no science behind TCM is a little confusing to me. When the first vaccine was developed for polio, not every aspects of how the process works was known to Dr. Salk, he just knew it works. It doesn’t make it any less effective.
While I agree TCM has a lot of room to go to becoming more quantitative in their approach, some of the accusations seem baseless.[/quote]
The burden of proof lies with those making claims, not those questioning claims. Skeptics like me have the right to ask where is the evidence for the ancient wisdom? Where are the studies? Right now there is a rush to subject herbal medicines to clinical trials precisely because the ancients, in their supposed wisdom, never tested anything properly. They didn’t know about germs. Didn’t even know about them. They didn’t know the placebo effect. The ‘central underlying principle’ of TCM is qi yet you won’t find that existing anywhere in this universe, not even with a Large Hadron Collider.
Yes, some TCM treatments work. All cultures have some kind of traditional medicine and of course some of it is effective. But the question is, how much is effective? More exactly, how much of it works better than a placebo? I just quoted a review on acupuncture stating that The majority of studies using such devices [placebo needles] fails to show effects beyond a placebo response. Your local acupuncturist in China won’t tell you that though because, “recent studies reported that most clinicians and nurses [of TCM] had not heard of or did not understand the meaning of evidence-based medicine”.
The journal Nature published a good editorial in 2007:
Editorial
Nature 448, 105-106 (12 July 2007)
[quote]Hard to swallow
Abstract
Is it possible to gauge the true potential of traditional Chinese medicine?
Researchers, practitioners and drug companies around the world are engaged in a complex, tentative dance over the best way to tap into the unknown potential of traditional Chinese medicine. The scientific community and the drug industry both tend to be sniffy about ‘traditional’ cures; yet there is a strong sense that millennia of practice in China — much of it barely documented — is likely to have yielded at least some treatments that work.
Pharmaceutical companies are understandably eager to enter a Chinese domestic market that was estimated by the Boston Consulting Group to be worth US$13 billion last year, and growing fast. But they are tantalized by one opportunity above all: the prospect that the nation’s traditional medicine might contain a number of potentially profitable compounds hidden somewhere in its arcane array of potions and herbal mixtures.
The task of finding these elusive gems has been approached in a typically reductionist manner, with researchers seeking single compounds that might have a role in treating specific diseases. Sometimes this has been successful: artemisinin, for example, which is currently the most effective treatment for malaria, was fished out of a herbal treatment for fevers. But such success stories have been few and far between.
So if traditional Chinese medicine is so great, why hasn’t the qualitative study of its outcomes opened the door to a flood of cures? The most obvious answer is that it actually has little to offer: it is largely just pseudoscience, with no rational mechanism of action for most of its therapies. Advocates respond by claiming that researchers are missing aspects of the art, notably the interactions between different ingredients in traditional therapies.
Nevertheless, the drug industry is not exactly awash with promising new medicines at the moment. Perhaps as a result, the global regulatory process has become increasingly receptive to traditional approaches. In 2004, for example, the US Food and Drug Administration issued new guidelines on botanical drugs that made it much easier to get extracts into clinical trials if there was some history of prior use, and that obviated the need to characterize all compounds in an extract.
Some researchers in China and elsewhere, meanwhile, are advocating systems biology — the study of the interactions between proteins, genes, metabolites and components of cells or organisms — as a way to assess the usefulness of traditional medicines (see page 126). Constructive approaches to divining the potential usefulness of traditional therapies are to be welcomed. But it seems problematic to apply a brand new technique, largely untested in the clinic, to test the veracity of traditional Chinese medicine, when the field is so fraught with pseudoscience. In the meantime, claims made on behalf of an uncharted body of knowledge should be treated with the customary scepticism that is the bedrock of both science and medicine.
[/quote]
So one of the world’s premiere scientific journals considers TCM mambo-jumbo voodooish crap. There has been no ‘flood of cures’. What else would one expect from a knowledge system that is pre-scientific?
[quote=“antarcticbeech”]
The burden of proof lies with those making claims, not those questioning claims. Skeptics like me have the right to ask where is the evidence for the ancient wisdom? Where are the studies? Right now there is a rush to subject herbal medicines to clinical trials precisely because the ancients, in their supposed wisdom, never tested anything properly. They didn’t know about germs. Didn’t even know about them. They didn’t know the placebo effect. The ‘central underlying principle’ of TCM is qi yet you won’t find that existing anywhere in this universe, not even with a Large Hadron Collider.
Yes, some TCM treatments work. All cultures have some kind of traditional medicine and of course some of it is effective. But the question is, how much is effective? More exactly, how much of it works better than a placebo? I just quoted a review on acupuncture stating that The majority of studies using such devices [placebo needles] fails to show effects beyond a placebo response. Your local acupuncturist in China won’t tell you that though because, “recent studies reported that most clinicians and nurses [of TCM] had not heard of or did not understand the meaning of evidence-based medicine”.
So one of the world’s premiere scientific journals considers TCM mambo-jumbo voodooish crap. There has been no ‘flood of cures’. What else would one expect from a knowledge system that is pre-scientific?[/quote]
Thanks for your reply, I totally understand your point. However, you are still standing on the same ground to judge TCM. [color=#0000FF]You’re like trying to measure the temperature with a ruler.[/color] It won’t work, unless you’re willing to throw away the ruler and trying to use thermometer, or just feel the temperature with your own hand if you don’t have thermometer. Just don’t use ruler, please. If you really want to get to know TCM, you need to approach TCM in the right way. If you’re just want to tell me that TCM is crap, I’m sorry that won’t work because I see TCM masters treat lots of diseases with herbs and the effect is better than modern medicine. And it’s reproducible by following TCM theory. Lots of modern medicine doctors came to him for help when their patients or family are sick and they have no better treatment to do.
I respect your point of view, although I know you might not see the whole picture of health care. You want solid evidence, we all want evidence. In fact, dolphin can swim with sonar, people didn’t know that until we invent sonar detector. But Dolphin still swim on their own way. They don’t care if we know sonar or not. All signal needs the right detector to catch the signal, or you’ll think it’s just nonsense. The phenomenon is right there, you can choose to ignore it because you need more solid evidence, or you can choose to respect it because it does work in most of cases. You can keep waiting for the evidence that satisfy you, we’ll just keep practicing TCM to benefit our patients, family and friends. Again, TCM is not almighty, thankfully, I learned both TCM and modern medicine.
[color=#008040]I’m sorry, this is too time consuming for me. I’m a little bit tired of saying the same thing again and again. I’m not expecting you to change, but I need to leave this thread and focus on more important things. I’m grateful for all your reply. [/color]I think it’s time for me to stop this kind of 雞同鴨講。
Merry Christmas and Happy New Year!
[quote=“joey0825”]
I’m sorry, this is too time consuming for me. I’m a little bit tired of saying the same thing again and again. I’m not expecting you to change, but I need to leave this thread and focus on more important things. I’m grateful for all your reply. [/color][/b]I think it’s time for me to stop this kind of 雞同鴨講。
Merry Christmas and Happy New Year![/quote]
Hi Joey
I just wanted to say, it’s been interesting for me to discuss this with you. And it was generous of you to spend your time in this thread.
I also wanted to say, if there are truths to be known about TCM, then it ought to be possible to determine those truths empirically, through controlled experiment and repeated observation. After all, that is the basis of the scientific method. If the theories and concepts behind TCM are falsifiable and have explanatory power, that is to say they have the power to explain empirical evidence in a repeatable way, then in principle there is no good reason to suggest that we couldn’t use the scientific method to investigate the effectiveness of TCM. Perhaps it is even possible to make new discoveries.
But without controlled experimentation, without falsifiability, and without repeatability, it’s difficult to see how the scientific world would accept claims for the efficacy of TCM.
From my impression, you seem like someone who is passionate about their field. This comes across as really inspiring. You also come across as someone that cares about helping your patients. It seems you must be a busy person, but if you have any spare time at all, I would encourage you to contribute your time, knowledge and experience toward generating a scientific understanding of TCM.
Wishing you a happy Christmas, and a great New Year!