Chinese Doctor/ Gary Chang

There’s Only One Kind of Medicine

I’ve spent the last three years in Asia, mostly in China and Thailand. During that time, I’ve met Westerners, many working for NGOs and charities, who defend cultural medicinal practices.

One friend of mine, who worked with Karen hill tribes, argued that their use of raw eggs for treating burns was a perfectly acceptable and reasonable practice. Why? Because their medicine men have been doing it for generations. It’s traditional. Treating burns with egg appears to be a common folk remedy – even in the West – but its dangerousness should be apparent to anyone who knows anything about bacteria and open wounds.

I’ve met American students taking five-year courses in traditional Chinese medicine at universities in Beijing, learning about acupuncture and meridians, which are imaginary lines of energy running through the human body. In Thailand, there’s a thriving economy of workshops and courses for foreigners to study Reiki (palm healing), astrology, Ayurveda, “soul plan” and aura reading, urine therapy (drinking your own urine), and deviating douche (cooling your genitals to remove toxins.)

English-speaking publications in major Asian cities run cutesy articles like “how to stay cool during the summer using traditional Chinese medicine.” (In case you’re wondering, traditional Chinese medicine suggests drinking hot tea to stay cool in the summer.)

These are personal anecdotes, but they reflect the Western world’s growing fascination with traditional and alternative medicines.

Indeed, even when not actively supporting alternative medicine, Westerners will still typically pay a deferential respect to it.

Brendan Borrell, in recent piece for Aeon Magazine, described traditional African practices such as “false tooth extraction,” in which infants and children have their teeth painfully dislodged using needles or sharpened objects (such as a bicycle spoke.) There’s a lot of good stuff in the article, particularly his call for science to “be the great leveller” when it comes to medicine. But despite concluding that false tooth extraction should be eliminated, he also spends a significant portion of the article seemingly defending (or excusing) traditional medicine:

Across many cultures, magical thinking and medicine have been closely intertwined, and it is not surprising that this is the case in present-day Africa. Here, the causes of one child’s death are often as murky as the reasons for the survival of another, and so the human mind seeks to fill in the gap. Indeed, we know that belief alone can be as powerful as the most sophisticated drugs. Many clinical trials have shown that patients taking a placebo do better than those taking nothing at all. Perhaps a dubious (even dangerous) treatment such as tooth extraction provides some relief — for the mother, if not for the child. ‘The removal of false teeth may seem brutal,’ the anthropologist Mogensen writes, ‘but it is also something that makes the mother keep an eye open as to the development of her child.’ It is one way for a mother to be clear of conscience, should her child die in her arms.

There was also an article on Medium from Brian Orme titled “Why Alternative Medicine Is Alternative” – an editor’s pick, no less – in which the author declares:

Going from a traditional doctor to a homeopathic one is like going from a TED talk to a David Copperfield performance. Both can be fun and helpful but the experiences, well, they’re just made up of different kinds of magic.

All medicines are just different kinds of magic? Really?

I had high hopes when I saw the title of Orme’s article. I thought he might actually describe why alternative medicine is alternative. Instead I got empty musings about how “after all, medicine is more of an art than a science.”

Why is there this tendency to defend and excuse (if not outright praise) traditional and alternative medicine? A bizarre cultural relativism underlies the way Westerners frequently talk about these forms of medicine. Who are we to say that a culture’s beliefs are wrong? Who are we to say the way they practice medicine is inferior?

I understand the desire to respect and be sensitive to cultures, but cultural practices don’t change reality.

One would hope this isn’t necessary to point out, but it probably is: the human body is a part of physical reality. The way it responds to chemical substances, the way pathogens affect it, and the way physical trauma harms it are not subject to personal or cultural beliefs. No more than any other chemical or physical reaction is subject to belief or opinion. Nor is an African body or a European body different because of the culture they exist in. They may be different because of genetic reasons or because of environmental effects, but these have nothing to do with religious, cultural, or traditional beliefs.

None of this is to defend what we inaccurately label “Western medicine.” Western doctors make mistakes, they can be stubborn or ignorant, Western studies have methodological errors, and pharmaceutical companies may push harmful drugs for short-term profits. It is, in fact, these very apparent shortcomings of medicine in the Western world that likely drive people to embrace alternative medicine.

But the debate is not between “Western medicine” and traditional medicine, it’s between methodological, evidence-based medicine and everything else. As the title says, there is only one kind of medicine.

You’re either running tests on whether your treatment works or you’re not. You’re either attempting to eliminate the practitioners’ biases, as well as the patients’, or you’re not. You’re either using a large enough sample size to eliminate anecdotes and false positives, or you’re not.

This is all about eliminating human error. It’s all about excluding other factors that could influence the outcome, so that we can attempt to clearly track cause and effect. Evidence isn’t a Western bias anymore than calculus is a Western bias.

The problem with traditional and alternative medicines is not that they don’t work. Maybe some of their remedies are effective. The problem is that the majority of practitioners of traditional medicine don’t subject their techniques to an evidence-based methodology. In fact, many scorn the very idea of double-blind studies and large sample sizes.

Borrell describes this well:

Maurice Iwu, the esteemed Nigerian ethnopharmacologist and author of the Handbook of African Medicinal Plants (1993), has railed against Europeans who try to modernise African medicine by preserving its rational elements and dispensing with the magical ones. ‘The use of herbs in combination with the power of the human spirit, assistance from the gods, and other unseen forces constitutes a fundamental aspect of African ethnomedicine,’ he has written. Iwu and other proponents of traditional and alternative medicine often frame it as a cultural issue, suggesting that science, which they associate exclusively with the West, cannot possibly cast judgment outside that realm.

They insist that their medicine works not because of science, but because of principles such as vitalism or the five elements.

These underlying assumptions are patently false. There is, for example, no such thing as vitalism’s “vital spark.” Perhaps an idea like vitalism can be used as an interesting mental model or analogy for how the human body works, but it’s not an actual explanation of anything.

Similarly, the meridians of traditional Chinese medicine can’t be used to explain why acupuncture works because a meridian isn’t real. Does that mean acupuncture is complete bunk? Probably. But if acupuncture is effective, we’ll only know by using an evidence-based methodology. And there will have to be a true, identifiable, physical cause.

Claiming that your medicine works because of mysterious energy levels, qì, good and evil spirits, the five elements, yin and yang, power crystals, or because water has a memory is the equivalent of saying “a wizard did it.” That’s not an explanation that intelligent, rational human beings should be accepting. In fact, it’s an explanation that it is near criminally irresponsible to accept, especially when human lives are at stake.

I want to be clear: I am not arguing in favor of some sort of Western imperialism. I don’t think Western countries should be forcing their ideas on anyone. What I want is for rational, educated people to stop defending insane medicinal practices out of some kind of cultural respect. I want anthropologists to stop being so intent on preserving the “fascinating and quaint” practices of poor tribal people. This isn’t about culture. It’s about human health and well-being. It’s about life.

Imagine a population of Inuit people in Alaska. For generations, they have been building poor shelters without insulation. Every winter, nearly a third of their number, mostly children, is wiped out from the freezing temperatures and related illnesses. Would any reasonable, ethical person look at these people and think, This is their traditional housing. They’ve been using these houses for generations. They believe their houses work, who am I to say otherwise? After all, building houses is more of an art than a science.

No. The decent, humanistic response can only be: I have to try to help these people build houses with better insulation. It could save thousands of lives.

Why is it different with medicine? Yes, human bodies are more complex than houses, but that doesn’t make them subject to cultural bias. There are ways that work for building insulated houses and there are ways that don’t work, and just the same, there are ways that work for healing bodies and ways that don’t work.

Real dentistry saves lives. Real vaccinations save lives. Real antibiotics save lives. Defending untested traditional medicines puts people at risk. In 2008, the World Health Organization approximated that in some Asian and African countries “80% of the population depend on traditional medicine for primary health care.”

Countless children die all over the world because of unclean water, fever, infections, and the lack of real, proven-to-work medicine.

Human beings should help each other, they should take care of each other, not let each other die out of some grotesque form of cultural deference. This is not a matter of respecting culture, it’s a matter of respecting human life.

Writer. Designer.

Writer. Designer.