# In Singapore, the TCM Practitioners Board shows why quacks shouldn’t self-regulate

In Singapore, a traditional Chinese medicine practitioner treated a diabetic for “yang deficiency” by applying a heatlamp to his foot. The diabetic suffered a burn that didn’t heal and lost his foot. The TCM Practitioners Board did almost nothing, showing that quacks can’t self-regulate.

I’ve probably mentioned this before, but I’ll mention it again. I have a bunch of Google Alerts set up for various key words and phrases. I mention this not because it’s in any way unique or even particularly unusual blogger to do this, but rather to explain how I’m ending up today writing about a case of traditional Chinese medicine gone wrong in, of all places, Singapore. Of course, I do deconstruct the claims of TCM and TCM practitioners on a semi-regular basis, and Singapore is in Asia, meaning that it is not unusual to find TCM practitioners getting into trouble there, given the popularity of TCM in many areas in Asia even outside of China. (Heck, the World Health Organization has shown a disturbing credulity towards TCM.) It’s also not surprising that Singapore would have a TCM Practitioners Board. (At least I didn’t find it so.) It’s also not surprising that such a board set up to regulate quacks is tolerant of quackery, given that its members are quacks who believe in the same quackery. In other words, quacks shouldn’t self-regulate. This is how I came across the story of Lee Miing Chong, a TCM practitioner in Singapore and the damage he did to one patient that led to sanctioning by the TCM Practitioners Board. Google done it. Google led me to it.

Specifically, Google led me to a letter to the editor of the The Straits Times, What is TCM diagnosis based on? by Dr. Ong Siew Chey. It’s a response to a chain of letters about a diabetic patient who lost part of his leg thanks to the quackery that is TCM. Yes, it’s just one story. Yes, it’s in a nation far, far away from here. However, it’s a case that, I can almost guarantee, no one in the US medical blogosphere is discussing that gives insight into how TCM is practiced—and not just in the Western nations into which it has insinuated itself, thanks to an active effort of WHO and the Chinese government. So let’s go to the original news story that provoked Dr. Ong’s response, TCM practitioner suspended after treatments caused patient to lose part of leg:

A traditional Chinese medicine (TCM) practitioner has been suspended for three years and fined \$5,000 after his treatments caused a diabetic patient to subsequently lose part of his left leg to amputation.

Mr Lee Miing Chong treated the 59-year-old patient on two occasions in 2015 for poor sensation in both feet, the TCM Practitioners Board said in a statement on Wednesday (March 13).

On Jan 3 that year, Mr Lee used heat lamp therapy on the soles of the patient. However, after the treatment, blisters developed and burst when the man walked. The patient returned to the clinic immediately.

Despite Mr Lee cleaning his wounds, applying medication and bandaging his feet, the patient ran a high fever that lasted until the next day.

Anyone who’s done primary care or, as I have during my training, vascular surgery (in other words, anyone who’s had to deal with diabetic feet, not exclusive of those two specialties) knows that it’s a terrible idea to apply a heating lamp to a diabetic foot, particularly the foot of someone who is already complaining of decreased sensation in that foot. Diabetes, as many of you know, causes damage to the microvasculature of the foot as well to the nerves. It’s a frequently deadly combination. The reason is that compromised blood flow to the foot means that in diabetics minimal injuries, injuries that you or I might not even notice and that for you or me would heal without incident, don’t heal as fast or might not heal at all. They can fester and become infected, to the point that the infection threatens the limb. These infections can be very difficult to treat because compromised blood flow means that antibiotics don’t penetrate as well and don’t heal as well after the debridement of dead tissue. Speaking of dead tissue, compromised blood flow can even lead directly to tissue death by itself. Now, add to that decreased sensation, and the danger is even worse. The diabetic can’t tell when he’s suffered an injury and therefore doesn’t care for it, leading to its getting infected and not being discovered until it’s much further along. That’s why meticulous foot care is absolutely essential for diabetics, especially ones already complaining of decreased sensation indicative of nerve damage (neuropathy).

You can see why applying a heating lamp to the foot of a diabetic like this is a horrible idea. What happened to the patient was completely foreseeable to anyone with a basic understanding of diabetes and its effect on feet. If Lee had applied a heating lamp to my soles, for instance, I’d be able to tell him when it got too hot and pull my foot away before it blistered. Even if I did get blisters, they’d almost certainly heal without incident, because I’m not diabetic, and I don’t have diabetic vasculopathy or neuropathy. Mr. Lee’s patient needed immediate treatment by someone who knows diabetic feet, preferably a vascular surgeon.

When the patient went to see Mr Lee the next day, he was given acupuncture and electric pulse treatment. But as his condition worsened, he had to be admitted to hospital on the same day for severe burn wounds on his feet.

As he had diabetes, the burns did not heal. Four months later, his left leg was amputated below the knee.

What a surprise! The acupuncture didn’t help a serious burn on the soles of a diabetic feet! Who’d have thought it? So what recourse did this patient, now missing the lower part of his leg unnecessarily, have? It’s not good. He complained to the TCM Practitioners Board. Did the Board do anything? Not really. Not much:

After an inquiry, the investigation committee concluded that while using the heat lamp was appropriate and generally accepted in treating the man’s condition of general weakness and chills, Mr Lee did not inform his patient about the risks or other available treatment options.

It also found that Mr Lee failed to take adequate precautions and care when providing the heat treatment. Instead, he placed the heat lamp too close – a palm’s length – to the soles of the patient’s feet and for an extended period of time.

He did this despite the patient telling him that both his feet had poor sensation and asking him to be careful.

A heat lamp is an “appropriate and generally accepted” TCM treatment for general weakness and chills? Well, as I’ve discussed many times before, TCM is basically a vitalistic system based on prescientific beliefs not unlike those of humoral theory. Where in humoral theory there are the four humors that need to be balanced, in TCM there are five elements, and various diagnoses balancing fire (heat) with cold. There are also treatments involving actual fire, such as the one I described before during which an alcohol-soaked cloth is draped over a patient and set alight to warm the skin and “open the pores,” after which an herb-infused oil is applied. I asked at the time whether a heating pad would have made more sense, but putting a heating pad on a diabetic foot would be just as bad as a heating lamp.

In any case, notice how the TCM Practitioners Board doesn’t question what Lee did. It only blames him for being sloppy about doing it. Hilariously (at least it would be hilarious if not so infuriating and harmful to patients), the board then continued:

In addition, the investigation committee noted that Mr Lee failed to provide an appropriate and generally accepted method of TCM treatment after the patient’s soles suffered burns.

Why hilarious? Apparently there is no accepted TCM treatment of burns, at least not according to the Singapore TCM Practitioners Board:

He gave his patient acupuncture and electric impulse treatment when he should have advised the man to seek immediate medical attention, given the seriousness of his injuries.

This led to a delay in the patient seeking appropriate medical treatment.

So what was the punishment? Nothing more than a \$5,000 fine, a three year suspension, and a censure, even though apparently Lee Miing Chong fell back on the ever popular quack tactic of blaming the patient.

Now here’s where Dr. Ong Siew Chew comes in with a letter to the editor, Clarifications on TCM treatment:

Initially, Mr Lee used heat lamp therapy on the soles of the patient’s feet for the man’s condition of general weakness and chills.

This part of the treatment was considered “appropriate” by the TCM Practitioners Board even though numbness of the feet in a diabetic patient is usually caused by neuropathy or ischemia, and neither situation should be treated with the application of heat.

Precisely. Applying heat to the soles of the feet to treat “weakness and chills” is not just quackery, it’s dangerous quackery. It cost this man his foot. Dr. Ong Siew Chey, I note, is pretty well-known in Singapore as a retired Professor of Surgery at the University of Singapore. I like the way he thinks, too, based on this interview with him published by the Singapore Medical Association from 2010:

Surgeons of my generation were the last of the general surgeons who had to do everything from head to toe. Of course, the Chinese have a saying…The English equivalent is “Jack of all trades but master of none.” For sub-specialisation, the Chinese have another saying… meaning that if you look at a leopard through a tube, all you see is one spot. General practice and sub- specialisation both have their good and bad points. There seems to be no perfect solution to our dilemma.

The main problem arises when patients have multi-organ conditions. When you have some six consultants coming in for one single case, disorganisation, conflict and confusion may be unavoidable. You need somebody with broad knowledge and experience in charge, someone who knows what is going on.

Yep. And I say this as someone who started as a general surgeon and then subspecialized. In any case, This is the core issue, which is why I sarcastically said that apparently TCM has no accepted treatment for burns. This eminent retired surgeon in Singapore zeroed in on this issue, too:

The board said that Mr Lee failed to provide “an appropriate method of TCM treatment for the patient’s burns”, and that he should have advised the patient to “seek immediate medical attention”.

The TCM Practitioners Board should clarify what the “appropriate method of TCM treatment” here refers to.

It should also indicate whether “immediate medical attention” means Western medical treatment.

And if so, at what stage of the treatment does the board favour a switch to Western treatment?

All excellent questions.

Two weeks later, having received no response, Dr. Ong Siew Chey noted that there had been no response to his letter from the TCM Practitioners Board and reiterated his questions. So the Executive Secretary of the TCM Practitioners Board, Quah Ai Mui, finally responded:

The patient had first consulted Mr Lee for his condition – general weakness and chills.

The diagnosis based on TCM syndrome differentiation was deficiency in “yang” energy.

Treatment with a heat lamp is appropriate and is one of the generally accepted methods of TCM treatment for this condition.

However, Mr Lee failed to take adequate precaution and care when he was administering the heat lamp treatment to avoid inflicting burns or injury to the patient’s feet.

When the patient developed blisters on his feet due to thermal burn, Mr Lee should have referred the patient for Western medical treatment.

When the patient subsequently developed a high fever which persisted, Mr Lee should have referred the patient to the hospital for further treatment without delay.

I can only conclude two things from this. First, “yang energy deficiency” is utter nonsense, a fake diagnosis based on superstitious prescientific vitalism. Second, apparently TCM is only good for treating fake diagnoses like “yang energy deficiency,” because, according to the TCM Board, once the patient developed a real medical problem (significant burns on the soles of his feet and sepsis), TCM should be abandoned.

Dr. Ong Siew Chey would not be deterred. (I’m really starting to like this guy.) In another letter, What is TCM diagnosis based on?, he responded:

According to the board, the diabetic patient’s initial complaints were “weakness and chills”.

Whether the symptoms were systemic or confined to only the feet is not clear.

If the symptoms were systemic, the cause could be anaemia or infection.

If only the legs and feet were affected, the cause could be lack of blood supply to the lower extremities or diabetic neuropathy.

There could have been other causes that required scientific investigation.

Why did the board call it a “deficiency of yang energy” and agree that heat lamp application to the feet was “appropriate” treatment?

What is the patho-physiological basis of “yang energy”?

Singapore is now a First World country and is able to provide scientific, evidence-based medical treatment to its people. Why is there still a need for treatment based on 2,500-year-old concepts?

I couldn’t have said it better myself (although I could have taken longer to say it).

Fans of TCM were not pleased, however. For instance, Amos Wu Pom Hin wrote that “one mistake by a TCM practitioner does not justify throwing the baby out with the bathwater” and then went on:

To leap from this complaint of the uncertain utility of TCM to the conviction that it must then be useless is, according to physicist Carlo Rovelli, the failure to grasp the utility of uncertainty, bringing about the “origin of much silliness in our society”. Is science-based medicine the iron-clad practice that it is made out to be? Albert Einstein was humble enough to proffer that “if we knew what it was we were doing, it would not be called research”.

While experts revel in their scientifically proven practices, people should acknowledge that they do not know everything.

Thus, to denigrate TCM just because it had its roots in primitive and herbal cures is to commit the fallacy of argumentum ad ignorantiam, or arguing from ignorance, that something is false simply because it has not been proven true.

This comment merits the Godzilla facepalm:

The “utility of uncertainty”? Um, sir, there’s no uncertainty here. TCM does not have a basis in science. It’s prescientific quackery. Also, seriously, this guy needs to learn his logical fallacies. Or maybe not, given that he himself just demonstrated a logical fallacy of his own while projecting it onto TCM critics. I mean, seriously. How does one go from appealing to ignorance, saying that just because we don’t know for sure it’s not true doesn’t mean it’s not true (“people should acknowledge that they do not know everything”) to accusing TCM critics of basically the same sort of thinking? The cognitive dissonance must be astonishing. At least he admitted that TCM had its roots in “primitive and herbal cures,” although he does conveniently ignore a lot of the religion and prescientific vitalism that are also the basis of TCM.

Finally, Tan Jun You invokes the “your science can’t explain my TCM” fallacy, even as he commits the argumentum ad populum (appeal to popularity) logical fallacy:

Traditional Chinese medicine (TCM), in a very quick and general view, is based on the black box theory, in which one sees the signs that manifest on a patient’s “exterior body” through the “inner body’s” complex system with many possibilities.

It also takes into account a holistic view of the environment and the body, as well as the subjective feelings of the patient’s own body condition.

It requires a huge paradigm shift in perspective as TCM methodology cannot be explained in scientific terms, as concluded by many scholars and researchers worldwide.

To quote from the website of the National Centre for Complementary and Integrative Health, the US Federal Government’s lead agency for scientific research on complementary and alternative medicine: “TCM can be difficult for researchers to study because its treatments are often complex and are based on ideas very different from those of modern Western medicine.”

How convenient. If science doesn’t support your quackery, say that it requires a “paradigm shift” because your quackery can’t be explained “in scientific terms.” To be honest, I wouldnt’ care that much that TCM is “based on ideas very different from those of modern Western medicine” if those ideas could be tested scientifically. Of course, many of them can, and nearly all of them failed. The only useful remedies to come out of TCM are few and far between and virtually all herbal remedies that don’t need the mystical vitalistic edifice of TCM to explain their utility and could be discovered by pharmacognosy, the branch of pharmacology that studies the medicinal properties of natural products.

Perusing this story and the subsequent exchange of letters to the editor, I can’t help but be depressed. The arguments for pseudoscience are the same all over the world. It also shows us that boards regulating quack specialties are also the same all over the world, which is why quacks can’t be trusted to self-regulate.

## By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

## 47 replies on “In Singapore, the TCM Practitioners Board shows why quacks shouldn’t self-regulate”

Dangerous Baconsays:

Bottom line: has this patient had an upsurge in yang energy since losing his lower leg? If so, the TCM did its job.

I hate you. I should have thought of that joke and included it in my post…

Eric Lundsays:

Dr. Ong is definitely on the right track in asking about the physiological basis of “yang energy”, but I would go deeper and ask, what is “yang energy” in the first place? Presumably it’s the opposite of “yin energy”, but beyond that, I haven’t a clue.

And that’s reason #1742 why TCM is not medicine. How can you even design a clinical trial, let alone one that won’t be laughed out of an IRB, if you can’t consistently describe the condition you are attempting to treat?

F68.10says:

You just have to publish a bogus paper where you claim that inter-rater reliability is high enough to start considering yang energy as an objective concept.

Well, what are yin and yang? With a bit of self education courtesy of Google it seems there are a variety of definitions, almost all of which are not quantifiable in any scientific sense. However in one popular definition yin is matter and yang is energy. Both are measurable so we’re making progress.

Of course we want our yin and yang to be balanced, and since E=mc^2 that would seem to be straight-forward. But then how can they possibly ever be out of balance? The only situation I am aware of is when there is spacetime curvature, such as in cosmology where common concepts such as conservation of energy don’t apply. Presumably disease causes spacetime curvature.

I can think of a couple of simple ways to measure this. One is to draw a square on the patient’s body. The trick is in how you do the drawing. You need a small wheel and a protractor. The wheel is used to measure distance. Travel in a straight line for a specific distance. Turn exactly 90 degrees and do it again, then twice more.

If the end point exactly matches the start point there is no curvature and your matter (yin) and energy (yang) are in balance. Congratulations, you’re in perfect health! However if they don’t match you are sick. The distance between start and end points relative to the square’s dimensions is the amount of imbalance. Whether the curvature is convex or concave discriminates between yin and yang imbalance. Perhaps the direction and distance between start and end points indicates the disease and treatment options.

Science!!

Denice Waltersays:

Spacetime curvature! Who would’ve thought?

If you peruse Wikipedia, the yin yang article discusses all of the many ways this idea has been applied. I came across this in taiji class: any pair of opposites can be designated: up/down, left/right, north/south. hot/ cold.. whatever you like. I am especially of yang as masculine/ yin as feminine thus yang-ness led to suppression of female gods supplanted by the sun god. At last we have an explanation for the rise of the patriarchy out of earlier matriarchal wholeness. Or something.

Eric Lundsays:

That is an excellent starting point for an alt-med grift. Because while on a plane a square will consist of four right angles separated by sides of equal length, attempting to do this on a curved surface, such as a normal human body, will not always work. For example, if you start at the top of the thumb and draw sides of the right length, you will close the curve with only three sides, not four. This is related to the joke about walking X distance south, then X distance east, shooting a polar bear, and finally walking X distance north to return to your starting point–there is a place on earth (the North Pole) where this is possible.

IOW, it can be rigged so that your yin and yang are never in balance.

Never mind that what Einstein showed is that matter and energy are equivalent. You can view a particle as always having its “rest mass” and treating its motion relativistically, or having a somewhat higher mass and moving according to classical mechanics. As long as you are in a place where gravity is negligible (which for this purpose is almost everywhere in the universe–you have to get pretty close to a black hole or neutron star for gravity to become important enough), you get the same answer either way.

Denice Waltersays:

And woo / TCM can often get “pretty close to a black hole” level of density

Christopher Hickiesays:

I have recently discovered to forms of energy called ping and pong. They are thermodynamic enantiomers of each other and orthogonal to ying and yang. They have existed since the Big Bang but interact primarily with dark matter. However, if you buy my proprietary quantum molecular meta material concentrator you can harvest their previously heretofore undiscovered health benefits. Email me at [email protected].

“rest mass”

That’s very old school, as in decades behind the times. The only mass is rest mass. Objects do not gain mass when they move (relative to something).

“attempting to do this on a curved surface, such as a normal human body, will not always work”

But it can be fun to try.

“TCM can often get “pretty close to a black hole” level of density”

If we can just push it a little bit higher it’ll form an event horizon and never again trouble our universe.

“dark matter”

That would be yin, so baryons must be yang. There is more of one than the other so our universe must be ill. That would explain the existence of quackery.

BillyJoesays:

“Einstein showed is that matter and energy are equivalent”

Einstein’s equation was all about mass. In fact his actual equation was m=E/c^2. Mass is, in fact, not equivalent to energy, otherwise the equation would be M=E. Mass is also not “frozen energy”, or a “form of energy”, or “able to be converted into energy”. Mass is a property of energy.

“rest mass”

There is only rest mass. Mass in physics IS rest mass. Mass does not increase with motion. Energy increases with motion but not mass. Which is consistent with the fact that mass and energy are not equivalent.

In fact his actual equation was m=E/c^2.

Which is why photons are massive. Dear G-d, this gets tiresome fast every time.

F68.10says:

Depends what you mean by massive, Narad. To me they are massless, but their energy does indeed curve spacetime itself, in much the same way as mass would. That’s why you could create a black hole purely with photons. A so called Kugelblitz.

https://en.m.wikipedia.org/wiki/Kugelblitz_(astrophysics)

F68.10says:

May Christ be recrucified! Did someone really have the nerve to publish this yington yangton “speculation”?

Or is it an inside joke of the scientific community to make cranks look even worse than they really are?

Depends what you mean by massive, Narad.

My point was that the momentum term was omitted: $E^2 = (m_0 c^2)^2 + (pc)^2$.

Jenora Feuersays:

@Eric Lund:
There are actually multiple locations where the ‘polar bear’ thing can be done. The most obvious one is if your starting point is the north pole, as you mentioned. But the other is if your starting point is X(1+1/2pi) north of the south pole, at which point your ‘X distance east’ is a complete circle around the south pole, and the ‘X distance south’ and ‘X distance north’ follow the same path in opposite directions.

Granted, there aren’t any bears, or indeed any land animals, native to Antarctica.

Smut Clydesays:

if your starting point is X(1+1/2pi) north of the south pole, at which point your ‘X distance east’ is a complete circle around the south pole, and the ‘X distance south’ and ‘X distance north’ follow the same path in opposite directions.

I remember that Mathematical Games column! Gardner also pointed out all the other solutions, where you start out slightly closer to the South Pole so that the “X distance East” becomes twice around the pole, or thrice, or whatever.

TonyLurkersays:

“one mistake by a TCM practitioner does not justify throwing the baby out with the bathwater”

To quote former Libertarian candidate Harry Browne, “But they don’t understand, it’s Rosemary’s Baby!”

While he was talking about something else, I like the quote, and it’s particularly applicable here, because the very core of TCM is what is nonsense (The baby), and it’s some side things (a few drops of “the bathwater”) that have shown modest value.

Mimisays:

Or….just throw out the baby and the bathwater because the baby has no brain and can’t live anyway (but the TCM “doctors” want to keep it on life support indefinitely because they have “another way of understanding.)

F68.10says:

That criticism could well apply to conventional doctors too…

dougsays:

The problem is that what they think is a baby bath is actually a chamber pot.

Jazzletsays:

Thanks for that ORD, Biggest Bro used to sing that to me when he bathed me when I was just a nipper, made me smile to hear it again 🙂

Old Rockin' Davesays:

There are a lot of versions available, but John and Tony are the best.

sirhctonsays:

When the patient developed blisters on his feet due to thermal burn, Mr Lee should have referred the patient for Western medical treatment. . . . When the patient subsequently developed a high fever which persisted, Mr Lee should have referred the patient to the hospital for further treatment without delay.

When I read this, I remembered something related to reading instruction for grammar school pupils. I, along with my contemporaries, were taught via one of the phonics methods. Ten or fifteen years later a variety of “sight recognition” methods held sway. The noticeable thing was that the majority of the remedial classes for those having problems were phonics based. It struck me, as with the above quote, that there seemed to be a considerable disconnection in thinking or procedure.

Now, add to that decreased sensation, and the danger is even worse.

One might wonder what the TCM treatment for Hansen’s disease is.

sirhctonsays:

Probably isolation from the general population in some sort of isolation. They could even congregate all sufferers there into their own community. Yeah, that sounds right and it is actually similar to TWM (Traditional Western Medicine).

F68.10says:

I’ve read they used acupuncture on the diseased portions of the skin.

I’ve also read that China/India pioneered the use of chaulmoogra oil in the treatment of leprosy. Which did ultimately end up being picked up by western medicine.

Seems that leprosy wasn’t the best example to discredit TCM.

sirhctonsays:

Damn it! I insist you cater to my bad typing and proofreading skills by making comments editable. If you are not going to send me my share of the Big Pharma shill payments, it’s the least you could do with your huge share.

Dangerous Baconsays:

“I’ve also read that China/India pioneered the use of chaulmoogra oil in the treatment of leprosy. Which did ultimately end up being picked up by western medicine.”

“Seems that leprosy wasn’t the best example to discredit TCM.”

Actually, chaulmoogra oil wasn’t widely viewed as having effectiveness against leprosy until an injectable form was devised by EWM (Evil Western Medicine). And even then there were often horrific side effects and many doubts about its value.

ideal treatment for leprosy. Side effects still created problems, treatment was extended, and
there was disagreement about how effective it really was. Although there were numerous reports
in the literature about the drug’s efficacy and many physicians swore by it, others were skeptical
about the therapeutic claims made for the drug. Then Director of the National Institute (later
Institutes) of Health George McCoy, who had once headed the Leprosy Investigation Station in
Hawaii and supported the use of Chaulmoogra, had by 1942 come to doubt its therapeutic value.
He published an attack on the drug in that year, noting that many experienced students of the
disease expressed serious doubts about the value of the oil in treating leprosy, especially when
discussing the subject in private. He quoted (anonymously) the views of four experts in leprosy
whom he had consulted, all of them critical about the effectiveness of the drug.”

https://lhncbc.nlm.nih.gov/system/files/pub2003048.pdf

Hopefully, TCMers aren’t still using this stuff to treat the disease.

F68.10says:

So you dispute that chaulmoogra oil constituted a scientific contribution to western medicine?

Is it time for “Zoo Animals on Wheels”?

Dangerous Baconsays:

Chaulmoogra oil may or may not have had some utility in treating leprosy, but it’s not what you’d want to hang your TCM hat on.

Berton Roueche (best known for his articles on medical detection/epidemiology in the New Yorker) had a 1953 story about a leprosy case from the annals of the N.Y. City Health Department, in which the victim of leprosy was subjected to chaulmoogra oil injections as his disease (lepromatous variant) slowly progressed. The first real signs of disease reversal came when he was finally switched to a sulfone drug. (I’d link to the article but it’s behind a paywall). I remember the public health doctor he interviewed, who was doubtful about the early cases in which they used chaulmoogra oil actually showing tangible benefits from the drug.

F68.10says:

I do not care about TCM at all. I’m just claiming that my question was a question about the history of scientific progress (which I do not like being rewritten). You’ve answered essentially by a “maybe” and then went on to rightfully promote sulfones (which is not what the question was about).

Whether or not chaulmoogra oil may or may not have had utility in treating leprosy is not the same issue as to whether or not it constituted scientific progress. The former may be indefinitely in dispute. The latter should in principle have a rather clear cut answer depending on what the litterature at the time claimed.

Mimisays:

OMG–why are you so snotty? No one is rewriting anything, but simply trying to expand in order to answer your previous complaint. This oil apparently did little and that was recognized as soon as something better came along. How hard is that?

F68.10says:

Not hard at all. But that’s beside the point I was initially making. DB was making a strawman of my statement, moving the discussion to a different topic.

Bashing TCM is fun. Bashing doctors for not caring enough about what is true or not is even more fun for someone with my background.

Snotty? That’s definitely an improvement from assertions that I’m a terrorist. Thanks Mimi for pointing out that it seems I’m on the path to redemption or salvation.

JustaTechsays:

I’ll second that article. I know it’s in one of the two “Medical Detectives” volumes which might be available at the library. All of his articles are really well written and accessible.

(I found a paperback of Medical Detectives at a giant book sale when I was 12 or 13, and put me on the path to where I am now, including to hanging out with all of you.)

MaineJensays:

Reminds me of the homebirth midwives (CPM “credential”), who have their own regulatory board as well. When someone sits on her hands and lets a baby die on her watch, the other midwives give her a slap on the wrist and a group hug, and then she goes on practicing like nothing ever happened. It’s a great system! /sarc

Reminds me of the homebirth midwives (CPM “credential”)

Oh, L-rd, I’m reminded of when I wasted precious hours of my life at MDC. Does this still involve a baby pool in the living room?

Dangerous Baconsays:

If an appearance in the medical literature of the time qualifies as “scientific progress”, we should also include Benjamin Rush’s “non-injurious torture” methods of treating the mentally ill.

Especially good was his idea of having the staff of the mental asylum dress up as ghosts and goblins to frighten patients back into sanity. It’s “traditional”, so maybe we should bring it back.*

In addition to producing excellent medical detection stories, Berton Roueche also wrote about environmental matters (a book called “What’s Left”, about threatened natural wonders in the U.S.).

*Big Pharma would never allow it though. 🙁

F68.10says:

“If an appearance in the medical literature of the time qualifies as “scientific progress”, we should also include Benjamin Rush’s “non-injurious torture” methods of treating the mentally ill.”

Yeah. I know. Reality hurts. It’s not because it’s torture that it isn’t scientific progress.

No contradiction here. Let’s move on.

“It’s “traditional”, so maybe we should bring it back.”

I hope you’re not putting these words in my mouth.

FKsays:

This story could equally likely have happened in Hong Kong – I guess that’s why you illustrated it with a picture of a such in Hong Kong, not in Singapore.

Nice pedantry there. No, I picked the photo because it’s a photo of a giant inflatable duck in an Asian city. Nothing more.