Hi Everybody! Welcome to fictional medicine!

Medical school is hard. Not crazy hard, but it’s a lot of work. There’s the four years of undergrad including the basic science requirements, the admission process, med school itself, and the post-graduate training. It’s vigorous for a number of reasons, some more and less useful.  One of the useful bits is the firm grounding in the basic sciences. Since our bodies are a sack of chemistry, physics, biology, and biochemistry, it makes sense to understand these topics before getting into the fun stuff.

Anatomy and physiology cover the normal workings of the human body.  Pathology and pathophysiology cover what goes wrong with these processes.  Human biology is very well—if incompletely—understood.  And while it is complex, there is nothing spooky or supernatural about it; it’s just biology (and chemistry, physics, etc.).

And while there is nothing supernatural about human medicine, it’s not in any way mundane.   It’s beautiful, fascinating, at times even mysterious.

Imagine a medical student who didn’t buy this whole science thing.  Imagine he’s in the anatomy lab, his lab partners meticulously hunting for the thoracic duct and the azygous vein (“which azygous vein, the right or the left?”).  He looks at the mess of meat on the slab and thinks, “all that is well and good, but where’s the qi? I can’t find my merridians!”

This is the folly of so-called “other medicines” like Traditional Chinese Medicine or Ayurvedic medicine.  They are based on millennia of pre-scientific folk lore, often mixed with excellent observations about the natural course of diseases.  But they don’t hold a cupping candle to medicine based on how the body actually works.  If you know anything about biology, reading something like this piece from the Huffington Post seem silly, absurd.  But people take it very seriously.

Aside from being logically inconsistent, the piece, called “Less Bloat, More Gloat: Using Chinese Medicine to Fight Winter Fat” should have been listed under “fiction”.  The logical inconsistency comes in the first paragraph.  After the title’s “fighting winter fat”, the author, talking about weight gain in the winter, says:

You’re most likely experiencing water weight. Those skinny jeans fit a little skinnier, your fingers and ankles feel swollen, your eyes look like the aftermath of a party girl who got a little too tipsy last night, you feel bloated and you just know everyone will be talking about your newly risen muffin top at the party.

So is it fat, or is it “water weight”?  The author, Grace Suc Coscia, has a bunch of initials after her name, none of which convince me that she would know the difference.  From her bio:

Grace combines ancient wisdom with cutting-edge science to empower clients to stay lean and sexy for life. For the past 12 years she has maintained a busy practice in Venice, California. Grace integrates a science-based combination of Eastern medicine, Chinese herbology, acupuncture, and genetic, adrenal, and food sensitivity testing to help clients attain efficacious results that transcend the limited Western medicine perspective.

There is nothing here that makes sense.  Here’s the thing: we’re not talking about “cultural hegemony” or “traditional knowledge”; we’re talking about biology.  Biology doesn’t care what you believe about the human body.  The way it works is the way it works, and no appeal to ancient folk lore can change this.  Let’s take a look at Coscia’s “science-based combination”.

Traditional Chinese medicine and herbology focuses on a cycle of five elements to which nature rotates. Since you’re part of nature, you also experience these changes. From this Eastern perspective, winter becomes the water season. That’s one reason why water weight becomes such a drag during the frigid months.

Where do you even start with this kind of idiocy?  Let’s get one thing straight: there is no “cycle of elements”.  There are about 118 known “elements”, fewer that naturally exist.  These elements are palpable, measurable, and make up everything around us.  They don’t metaphorically comprise everything that is; they are all matter (barring a few possible exceptions such as dark matter).  This is not some sort of metaphor or analogy.  This is how it is. There is no “Eastern perspective”, no “water season” that causes “water weight” in winter months.

She does mention that salt intake affects water balance.  But that’s about the only thing that makes sense.  Among the gems:

And don’t forget winter is water season. Drink eight to 10 glasses of purified water throughout your day, but minimize liquids during meals since too many liquids can dilute your stomach acid and inhibit protein digestion.

Wait—are we getting too much water or too little?  I lost track.  And don’t get me started on “adrenal support”.

I love fiction.  I’m currently reading Moby Dick to my daughter, a surprisingly funny novel given the seriousness of its themes.  But few things are as serious as human health, and making up stories about it is neither entertaining nor instructive.  It’s dangerous.

I’ll leave you with this little sample of fictional medicine.

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  1. I wonder if she is also one of the woo-ists who believe that many people are suffering from a mild iodine deficiency; she recommends sea salt rather than (presumably iodized) table salt.

  2. orange

     /  January 9, 2012

    You don’t get it…TCM. It is not healthy for you to use your words as arrows. Prevention in the Chinese character is a picture of an arrow with a box around it. TCM has its own anatomy, physiology, pathology, differentiations, treatment principles and treatment modalities that takes 3-5 years to study and now 2 years pre university (Although regulation is not everywhere so it is kind of hit and miss). Chemistry, biology, biochem, etc have little to no ability to be anything but reductionist but they are so beautiful and provide such an amazing understanding into our world! It is amazingly hard to switch your mind from studying chemistry for 4 years to understand a different and seemingly weird ‘science’. Peripheral nervous stimulation to modulate the autonomic nervous, endocrine and immune systems is the contemporary medical way to explain acupuncture. This gives us more palatable understanding but doesn’t provide true insight.

  3. JustaTech

     /  January 10, 2012

    Winter is “water weight” season? That’s odd, in my experience, my limbs actually shrink slightly in cold weather (not enough to notice in clothing, but my rings and watch are much looser). Clearly, since this is my personal experince, I am right and this author (Grace) is wrong.

    Orange, I don’t understand what you are saying. You say “Chemistry, biology, biochem, etc have little to no ability to be anything but reductionist but they are so beautiful and provide such an amazing understanding into our world!” So, we are not part of our world, and that’s why science is wrong? Last time I checked humans are part of the world, follow the same natural laws, so why would medicine not be based on the scientific understanding that exaplins the rest of the world? Also, something tells me that your understanding of the immune systems leaves a lot to be desired.

  4. I think comments to that post are being screened with the same open-mindedness that Darth Vader reserves for people who lack faith. My comment has been trashed. You can judge how horribly dangerous and inflammatory it was, as Lazarus saved me a copy (lovely plugin, very useful):

    “Oh good grief. To lose weight, try eating less and eating better: fresh fruit and veg; cut down on salt and sugar. Exercise. Get regular sleep (exercise helps). Don’t nibble on snacks: eat fruit instead of candy.

    If you’re bloated after a meal, it’s because you pigged out. Stop doing it, you know where your next meal is coming from, we don’t like in caves any more.

    TCM is just an unscientific folk tradition that’s driving beautiful and irreplaceable wild animals extinct to make their ludicrous “cures”: http://www.china-guide.com/health/reference.html (tiger bone, rhino horn…)”

  5. orange

     /  January 14, 2012

    @ Justa Tech Winter is water weight season is not something I learned in school. There is a 5 element theory that explains how you should seasonally adjust your lifestyle, aids in dx and what illnesses you will have a tendency to in that season.

    5 elements – 5 seasons – 5 tastes – 5 organs – and many more

    water – winter – salty – Kidney

    Kidney is representative of a group of functions, physiologies and pathologies and not equivalent to modern medical understandings.

    The Kidney functions are divided into Kidney yin, yang, Qi, essence and Blood.

    Kidney is a main organ in fluid physiology so I think this is what the article meant.

    It doesn’t matter that winter does something different to your body in terms of swelling or water retention than other people. It just shows the 5 element theory is working different in you and we would just find out how. And…..this is going to blow your mind…if it turns out that a theory is looking like it is wrong we don’t throw it out, we just keep it and use it when it will work.

    But it is hard for me to explain the essence of TCM, writing is not my thing. The Haung Di Nei Jing,
    and Foundations of CM by Macioca are good. I also like the Tao of Pooh. It is a culture shock to read. It is more of a culture shock the longer you have thought in modern western science terms.

    Science is not wrong. Science provides modern western medicine with a view on health, it is not the only valid view. Science provides reductionist theory. TCM provides emergent theory. Even the incorporation of mind, body and spirit is different from a western, tcm and ayurvedic philosophy.

    What I don’t like is rejecting a medical system without even giving it the time of day and saying that medical system must live up to your medical system standards. Why not vice versa?

    I don’t know anything about the immune system, other than what we learned in anatomy and physiology, I have forgotten most of that. I have a feeling there are things you don’t understand either but I am curious what made you say that. I don’t have a desire at this time to learn more about the western medical immune system, why do you think I should? I don’t appreciate how you made that statement and would prefer to be in a debate with an intention to learn rather than a disrespectful verbal war.

  6. @orange:
    You realize, of course, that what you say sounds like idiotic gibberish to any intelligent person, right?

  7. Western medical immune system? Do people in east asia have different sorts than europeans?

  8. orange

     /  January 15, 2012

    In TCM every system and the system interactions are understood differently. Immune system is similar to Wei Qi in TCM. In other east asian traditional medical systems they probably have a different understanding as well.

    @ anarchic teapot, I and every TCM professional I know does not use or condone the use of tiger bone, etc. I also don’t support unregulated TCM formulas that are packaged as herbal sleep aids with ativan slipped into them.

    @ monkeypox, this same logic was used by the europeans when they decided residential schools and elimination of sun dances, etc was the best thing for first nations people.

    Again, I would have loved to continue this conversation but I don’t accept this disrespectful treatment.

    The creation of a more peaceful and happier society has to begin from the level of the individual, and from there it can expand to one’s family, one’s neighbourhood, to one’s community and so on.
    Dalai Lama

    Thank you very much for your responses.

    With love, orange.

    • orange:
      “I and every TCM professional I know does not use or condone the use of tiger bone”
      Then I must ask why why is it still being used, as is rhino horn.

  9. Acknowledging that science is better than fiction in medicine is not cultural hegemony.

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