Category Archives: Medicine

Medical Therapy Effectiveness

The chart below is not based on research — but instead, is my intuitive, personal estimates for dialogue purposes.  Nonetheless, I feel that exposing my basic intuitions graphically can makes dialogue easier.  Below the chart I will give a brief explanations for each of my evaluations.

Preliminary Notes:

Placebo Benefit:  Even if a treatment is ineffective, placebo is the know positive effect due to expectation of both the patient and the practitioner.  I have chosen 30% as the basic baseline of this effect placebo — a common choice.  But placebo effect is complex and it is not my purpose to discuss it here — thus, this too could be a large mistake on this chart.

Ignored Harm:  Sham and unnecessary treatment result in harms which I do not  count the following into the “harm” category above.  They are important to consider, of course, but for simplicity, I have left them out of my intuitive calculus.

a) financial harm
b) false-hope harm
c) postponing or avoiding correct treatment with a false treatment

Treatment Summaries:

  • Homeopathy:  It offers hours of personal psychological insights that may give it that potential of 5% over placebo baseline of 30%.  But most homeopathy (OTC) has no psychological treatment.
  • Acupuncture:   I am not sure where research is at present, but it may help for a few conditions.
  • Manipulation Therapy:  helps relieve pain for several conditions.
  • Energy Healers:  Ineffective – only placebo effect
  • Herbal Therapy:   Herbs are drugs, some benefit and some harm.  Most are taken in too little quantity  and for wrong purpose to keep actually.  Some are given badly and cause harm.
  • Faith Healing:    Ineffective — only placebo effect
  • Primary Care Medicine:   Harm is cause by wrong prescriptions, inappropriate prescribing, side effects of meds, and the cure being worse than the treatment — to name a few.
  • General Surgery:  Harm is done when surgery done unnecessarily, anesthesia deaths, inapproriate surgeries, surgical mistakes.

Conclusion:

Here are the important points I am trying to illustrate by this graph are:

  • Alternative folks tend to look at harm
  • Orthodox folks so distain alternative medicine, they don’t want anyone to even mention benefit — even if placebo.
  • Orthodox folks lump all alternative medicines into the same category. (this is an orthodoxy hallmark)
  • There is often a trade of risk of harm for benefit (we all choose differently)

If you’ll notice, my points in this post parallel points concerning conversation between religious folks and non-religious folks as seen in my previous post on the harm & benefit of religions.  The deadlock dialogue between camps is similar too.

Question to readers:  Tell me your own intuition of the numbers or what sort of graph you’d draw.  Give me your arguments.  I am ready to change.

Other related posts:

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Confessions of a Homeopath

I am a former Homeopath (Homeopathic medical practitioner – wiki). Below are the posts I have written about Homeopathy itself and about my experiences with Homeopathy.

Much of this blog is about religion, but the same parts of our mind that create our religions, creates our politics, our allegiances, our superstitions and even our pseudo-sciences (and “sciences”).

If you have particular questions let me know in the comments below and perhaps I will try to address them in a future post.

My related posts:

 

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Treat the patient, not the numbers

In Oriental Medicine and in Homeopathy, we would not run any laboratory tests before treating a patient.  Information was solely gathered by physical observation and the interview process.  So detailed and careful were those exams that they put Allopathic Medicine (“Modern Medicine”) to shame.  So, by the time I studied Allopathic Medicine in PA school (22 years ago), I was ready to learn that observing the patient in front of you is often more important than a measurement or lab test.

Below are a few classic examples:

High Blood Pressure

At my first job out of PA school in an ER, providers will still treating high blood pressure reflexively.  If a patient’s blood pressure was high, they popped a few pills into the patient to bring it down to “normal” quickly.  I had learned that such a practice was dangerous but it took me three months to get the ER staff to change their old habits.  If someone has had high blood pressure for a long time, they probably need that pressure to keep both their heart and brain perfused with blood.  We now know that lowering chronic hypertension abruptly can lead to ischemic disasters.

Low Oxygen Levels

Pulse Oximetry is a gentle finger clamp that uses a laser to measure how much oxygen is in your blood.  When these first came out, if someone had low oxygen levels, they reflexively supplemented their oxygen with an oxygen mask.   But ironically, if a pt has acute exacerbation of  Chronic Obstruction Pulmonary Disease (COPD) high levels of uncontrolled oxygen can result in respiratory failure!  For unlike healthy patients whose respiratory reflex is triggered by high CO2 levels, in these patients it is low O2 levels that trigger the response which you can blunt by supplying uncontrolled oxygen – thus ironically killing someone using oxygen.  This problem was later solved with special delivery systems.

High Temperature

The old school ideology was that body temperature needs to be brought down to normal range.  In Japan and China, a person with a fever is made to sweat more — their high temperature is raise further.  The body produces a fever to kill bacteria.  It is true that only some organism are killed or slowed down by high body temperatures and that the response is non-specific, but you should usually give fever a chance to work.  But in the ERs where I first worked, nurses would not give blankets to patients with fevers even if they had the chills in fear of raising their temperature.  And they would always give Tylenol or Motrin for any temperature over 100 deg C.  It took me 1 year to get that practice changed.  I had to print out article after research article and finally present them to the medical group.

Well, those are only a few examples to a principle which I will quote in an up-coming post.

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Related Posts:

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Health & Medicine

Last updated: Oct 2013

This is an index for posts on medicine and health.  I have practiced and studied medicine for decades– both “alternative” and “orthodox” (loaded terms, I know).  Jumping between various contradictory medical practices and philosophy has taught me much.  The comparative nature of my experiences have greatly influence my opinions about philosophy, religion and people in general. 

Sub-Indexes:

Alternative Medicine: General

On “Orthodox” Medicine

Nutrition:

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Schizophrenia Saves Us

Vodpod videos no longer available.

Humans have odd diseases that you’d expect to be weeded out of the genome over millions of years, but we have found that there is a mathematical advantage to genes which, in full (rare) version causes bad diseases but in mild (common) versions offers benefits to our organism. I first read about this principle in a 1996 book: Why We Get Sick: The New Science of Darwinian Medicine by Nesse and Williams.

This video is of Professor Robert Sapolsky, neuroscientist at Sanford, lecturing on how soft versions bad psychological traits have fed human religions.  If we understand what religion offers, we can better understand why we are “afflicted” by it ! Here are some of my notes to tease you to listen to this great lecture !

Sapolsky notes that religion has become a amalgam of many functions:
Religion –> Ritualism (obsessive-compulsive) + Magic (schizo) + Morals

Disease

Full

Partial
Sickle Cell Dz
terrible suffering
no malaria
Tay-Sachs Dz
early death
no tuberculosis
Cystic Fibrosis
early death
no cholera
Schizophrenia
devastating
Shaman Witch Doctors
OCD
crippling
Ritualist to share anxiety

Robert M. Sapolsky Books

  • Monkeyluv (2005)
  • Why Zebra’s Don’t Get Ulcers (2004)
  • A Primate’s Memoir (2002)
  • The Trouble with Testosterone (1998)
  • Stress, the Aging Brain, and the Mechanisms of Neuron Death (1992)

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Seeing Jesus: The Benefits of Pareidolia

jesus-in-toastPareidolia is the ability to see familiar things in otherwise spurious noise.  In this toasted cheese sandwich, some see Jesus’ face.  Though such hallucinatory visions may seem silly, perhaps they point to a beneficial way our minds work.  On my site I often try to point out that besides seeing the silliness in superstition or religion, we should also try to see why the mind behaves like this and in seeing such, we may notice that, even being skeptics or religion-free, our mind does the same thing often.

Like Treats Like

I contend here that we have a pareidolia function in the mind — one which can both be useful and deception. Being a former Oriental Medicine practitioner (herbs and acupuncture) I know another example of the mind using the brain’s pareidolia module.  There is an accepted principle in some branches of Oriental Medicine where if a plant looks like some part of human anatomy, it should have some remedial effect on pathology in that part of human bodies.
lotus_rootFor example, Lotus Root has channels running through it so when it is cut it looks like similar to how a cross-section of lungs would look. Lotus Root is used to treat phlegm in colds.  This notion of using things with similar form to the human body to treat ailments of that part of the body is, of course, silly.  But, as I will explain later, it still may be useful.

In the West, this principle is known as the Law of Correspondences.  This Law is based on the assumption that the divine order is redundant with hints of the implicit order.2

Homeopathy

Homeopathy1 uses this principle in a more abstract form of “like cures like” (I am an ex-homeopath too).   Let’s look at two homeopathic examples of this law of correspondence working as “like cures like”.  Sulfur is one of homeopathy’s many “remedies” (medicines). The homeopathic logic goes that if sulfur causes skin rashes, it can also be expected to cure skin rashes.  Bee’s venom is also a homeopathic medicine.  Since a person stung by a bee is induced to hyperactivity, swelling, redness, and pain,  then people with sore red, inflamed throats who can’t sit still may be treated with bees venom (Aspis mellifica).

We may wonder why this sort of silly logic does not get weeded from human consciousness by evolutionary principles and that is because Pareidolia is useful !

Pareidolia is Desirable

Pareidolia helps us to see patterns in the otherwise chaotic night sky.  Ancients looked at the chaotic sky and saw the shapes of humans and animals from their myths and then used those shapes to help them in navigation and calendar building.  Pareidolia is a memory device — it is easier to remember things familiar to us than mere random patterns.  I am thankful for pareidolia.

Another, less virtuous, reason for the persistence of pareidolia is that if you try 1000 herbs that share something with lungs, one of them might work. Then, with selection bias, you forget the other 999 failures and, BANG! , you have another “confirmed” superstition.   But at least it is now easier to remember the use of that herb.

We humans are funny. And as you can see my past intellectual wanderings in previous posts, I myself have fallen for pareidolia several times in my confused life. Silly me.

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1. Here is a good sight describing Similia Similibus Curentur (Like cures Like) and likewise exploring the pros and cons of homeopathy.

2.  Here is a 1920 Theosophy publication explaining The Law of Correspondences.

See a neuroscience article on this phenomena here.

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