From: lady@uhunix.uhcc.Hawaii.Edu (Lee Lady)
Subject: Re: On pre-scientific traditions of medicine (was: Use of term
Followup-To: sci.med
Summary: The absence of research is not proof of anything.  
Organization: University of Hawaii (Mathematics Dept)
Distribution: sci
Date: Fri, 21 Aug 1992 10:40:14 GMT

In article <1992Aug20.020904.22932@spdcc.com> dyer@spdcc.com (Steve Dyer) writes:
>In article <1992Aug20.005948.4969@news.Hawaii.Edu> lady@uhunix.uhcc.Hawaii.Edu (Lee Lady) writes:
>>I started taking zinc lozenges last winter to suppress cold symptoms on
>>the basis of articles posted on the net and the recommendation of a
>>couple of personal friends.  Maybe in five or ten years there will be a
>>scientific study proving their effectiveness, but in the meantime
>>you'll be having colds and I won't.  They work fantastically well.
>
>Well, there have been some studies pointing to a beneficial effect
>though I frankly don't know what the current consensus is, but anyway,
>this is an example of an inexpensive and harmless therapy being taken
>for an inconsequential (but inconvenient and annoying) illness.  Big deal.

I don't consider colds inconsequential.  I'm barely functional when I
have a bad cold.  And as far as "big deal":  It sounds to me like the new
FDA regulations or the proposed legislation now in Congress might make my
zinc lozenges illegal.  That would really piss me off.  

Besides which, Gordon said that it was crazy to put things in your body
that don't have official approval.  I wanted to make the point that as
far as I'm concerned his assertion, taken in the generality in which he
made it, is totally crazy.  

>Listen, Gordon doesn't get colds anyway, because he takes 500mg/day of
>vitamin C.  :-\  The point is that that level of supplementation is
>somewhat analogous to your using zinc lozenges: it can't hurt, and it's
>cheap.

That is precisely the point I've wanted to make in all my postings about
nutritional supplements.  

I agree that if there's serious question about the safety of a product
then it should not be easily available.  (I disagree with Herman about
this.)  I agree that if there's serious danger that use of the product or
therapy will prevent people from obtaining available effective treatment
for a serious condition, then we should be very cautious.  

Those are questions of safety.  But when if comes to *effectiveness* let
me decide my own level of risk and waste my own money if I want to.  

>>Getting rolfed didn't offer me all the benefits I'd hoped for but I have
>>no regrets about having given it a try.  Besides, everybody I knew
>>started telling me that I looked a whole lot better and my posture had
>>improved.  
>
>So?  I don't understand what you are attempting to address here.
>I don't think traditional medicine has much against Rolfing if it's
>considered a kind of massage therapy (modulo the bruises.)  If it
>were said to cure dandruff, that would be a different matter.

Rolfing is an alternative therapy which has not been approved by medical
authority and whose effectiveness has not been shown by published controlled
double-blind studies.  As I understand it, you and Gordon claim such
therapies should not be allowed.  Certainly Gordon has said that using
any such therapy is crazy.  

>And this is MY complaint with many of the anti-medicine whiners: they think
>they're back in their adolescence talking back to Daddy.  I mean, c'mon,
>we're all supposed to be grown-ups here.  No one is "disallowing" you
>from making up your own mind on your own values.  

>...on the facts which are available.  If someone advocates colon irrigation
>or (as is seen in rec.food.veg today) a fasting/herbal laxative treatment
>for "impacted feces" and the ills of the world which go with that, someone
>schooled in traditional medicine (and hopefully a lot of other individuals)
>certainly OUGHT to withhold their approval. 

Aren't these two citations from you a little inconsistent?  I take it
that "withholding approval" means that I legally couldn't obtain these
therapies (not that I'd want to!)  For practical purposes, that pretty
effectively seems to disallow me from making my own decision on the issue.  

>But you're actually demanding something different: respect from the
>scientific community about therapies which don't necessarily deserve
>such respect, and that will be granted on a case-by-case basis, based
>on the facts which are available.  

Excuse me, you seem to have me confused with someone else.  What I want
is a hands-off policy on the part of the FDA on things whose safety does
not seem questionable, especially nutritional supplements which have been
widely used and have a much better safety record than many prescription
drugs.  

Secondly, I would like to have real knowledge available from the
scientific establishment on alternative approaches, so that when
somebody tells me, for instance, that taking 5000 units per day of
vitamin E will double my sexual potency I can find out from a qualified
authority whether a) this would be dangerous; b) nobody knows whether
it is safe or not; c) the rationale for this just doesn't make any
sense; d) there is some informal evidence supporting this claim but
nobody has done a careful study; e) people did some careful studies and
there was no evidence of the claimed effect.

Thirdly, I would like recognition from the scientific community that in
the empirical world proof is not a binary quality, that there are
degrees of certainty.  And that when a therapy has strong informal
evidence in its favor -- whether anecdotal or statistical but based on
imperfect studies -- that therapy is deserving of serious scientific
investigation.

I would be quite satisfied to see research conclusively proving that
therapies such as homeopathy and chiropracty don't work.  I would be
delighted to have solid scientific research to base my own personal
decisions on.  I would love to know that I could get real information
about alternative therapies from my doctor.  

What I don't like is the attitude that the absence of acceptable
research is proof that a particular approach has no merit.

--

Imagination is more important than knowledge.  -- Einstein 

lady@uhunix.uhcc.hawaii.edu         lady@uhunix.bitnet
Newsgroups: sci.med