The recent controversy regarding Patanjali’s Coronil drug that was first touted as a treatment for the COVID 19 virus and later approved by the AYUSH Ministry as an “immunity booster” compelled me to try and analyse the presence of alternative medicine, pseudoscience and its growing popularity especially in context of the Pandemic that has led to a growing anti-science rhetoric around the world.
To me, the manner in which alternative medical techniques have been able to work around the systems of medical research and even root themselves into societies to the point wherein they are no longer subject to the same scrutiny is questionable. The manner in which this cognitive bias is created around these systems of medication to dispel all criticism, avoid clinical trials and peer review is indicative of the need for a complex discussion on them.
Regardless it is important to firstly define alternative medicine after which we can classify them and start to deconstruct their cases
Definition:
Alternative medicine is a term which itself is part of a larger web of different terms that essentially attempt to qualify a non-mainstream system of medication, one which usually ditches the empirical nature of current health science and opts for a more unorthodox methodology.
The National Cancer Institute classifies alternative medicine as:
“Treatments that are used instead of standard treatments. Standard treatments are based on the results of scientific research and are currently accepted and widely used. Less research has been done for most types of alternative medicine. Alternative medicine may include special diets, megadose vitamins, herbal preparations, special teas, and magnet therapy. For example, a special diet may be used instead of anticancer drugs as a treatment for cancer.”
Furthermore, it is important to classify alternative medicine as either a complementary system or substitute for mainstream medication.
In the case of a complementary system, alternative medicine is used alongside the normal course of treatment. In such a sense alternative medicine does not compete with conventional medication, therefore it does not have the same burden of proof. The use of multivitamins, diets, body and mind exercises is usually observed in most cases as the risk is minimised. Medical professionals also believe that this is a good method to institute a healthier lifestyle in the daily routines of their patients.
It is the substitute method of alternative medication that catches more flak. This method is employed especially by segments within homeopathy, naturopathy, Ayurveda, Chinese traditional medication etc. In this, alternative medication presents itself as a direct competitor to conventional medication. Therefore, it undertakes the same burden of proof and carries a higher risk upon the failure of alternative medicine to cure the ailment.
Justifications and Rationale:
The reasoning behind alternative medicine differs from one system to another, with its proponents using scientific terms, faith systems, the appeal to nature and traditional cultural appeal to qualify their medication as valid. Many of these reasons are rooted in a cultural syncretism that these medical systems follow, attempting to associate culture and tradition with their medicine.
This is an attempt at appealing to a patriotic geo-political mindset of individuals, especially in the aftermath of colonial cultural suppression. This is especially seen in the Western vs Eastern argument that attempts to classify modern medicine as a western construct and its alternatives as a traditional substitute or complement to them. This mentality will be discussed further within this article.
Regardless, it here that we must further classify the substitute alternative medicine based on the source of its validity and origin. Three major forms of alternative medication are therefore found:
Faith Based:
Faith based healing is usually the least scientific as it hinges on the religious and spiritual faith of individuals. This sort of healing is most prominent within Abrahamic religious communities especially the more evangelical sects within them. In Christianity for example the idea of faith healing is encountered within the Bible with Jesus bringing upon the downtrodden healing through his faith and divinity. This idea has been replicated by the leaders of the various cults within the fate today, some of the more prominent examples being the Mormon Church (the Church of Latter-Day Saints) and the newer wave of televangelists in the US.
In India the mantle has been taken by self-styled godmen that usually exploit superstitious beliefs for their own benefit. Exorcisms, herbal cures and “genuine miracles” are common place in most of India with those suffering from mental illness being the prime candidate for their cures.
Traditions and Rituals:
Traditional medicine (Ayurveda, Yunani, Traditional Chinese, Sidhha) are medical systems that receive their credibility from their longevity and cultural connection to the land. Though of great use as a compliment to conventional medicine, especially in an integrated format, these systems typically find legitimacy and support within their nations of origins as a substitute of conventional “western” medicine. However, in a highly globalised market these products and medical systems have found markets outside of their homelands. Ayurveda has made great inroads into the west and experts have speculated that this growth will only increase.
One of the great selling points of such systems are their perceived ancient heritage that allows them to attract customers, especially those dissatisfied with the manner in which conventional medical systems and medical experts have treated their ailments in the past. Traditional Chinese medicine has gained traction under governmental attempts at methodological standardisation which they hope will give the system more legitimacy in the medical community.
This was analysed by the National Bureau of Asian Research while looking at China’s vision for a ‘New World Order’. The report said:
“The construction of a Chinese paradigm rooted in Chinese tradition does not aim at defining abstract theories that explain patterns of international behaviour. Instead, this aims at providing a discursive framework that helps the party-state justify its ambitions while defusing external threat perceptions.”
This narrative of a cultural battle against western constructs props up again and again as we try to analyse the reasoning behind these traditional medical systems. In the case of Ayurveda for example there are allegations of attempts at defaming Ayurveda and by extension India.
This article for example alleges that:
“There is a deep-rooted conspiracy to destroy and demolish Ayurvedic stream of medicine. It is being hatched in Western capitals where global pharma giants are threatened by the superiority of the simple but effective and humane Ayurveda.”
This mentality will be probed further down the line.
“Scientific”:
This is that part of alternative medicine that has a tendency to claim affinity towards science and compliance with the scientific method. These systems sometime tread the line between science and pseudoscience employing perceived questionable methodology to gain legitimacy to the same level as conventional medication.
Homoeopathy and naturopathy are prime examples of alternative medicine systems which fall under this category. Homeopathy is extremely polarising in its standings in the medical community with certain experts terming it as blatant pseudoscience and others considering it the future of medication.
In this category we see the contrarian, anti-mainstream, anti-big pharma rhetoric take full shape. Those who are doubtful of the efficacy of mainstream conventional medication believe that homeopathy and naturopathy are better alternatives that are ostracised by the mainstream pharma industry for profit motivations.
Dissecting the Phenomenon:
As stated earlier all three of these medical systems find support from prevailing narratives that stem from faith, tradition and anti-mainstream science. These narratives form the bedrock of alternative medical systems. Thus, the three underlying elements (that is, religion, anti-western sentiment and anti-science rhetoric) must be probed.
A Matter of Faith:
Religion during the Dark Ages was a human belief system that encompassed almost all of human life. Sensuality, diet, clothing, music and even medicine was regulated by the theocratic institutions that prevailed at the time. Since then, however, as institutions became increasingly secularised elements such as medicine and science strayed away from religious ideological dogma of the times.
As a reaction faith healing became more common amongst the superstitious religiously fundamentalist sections of society who clung to these beliefs adamantly as a knee-jerk response to isolation and rejection by the mainstream. This was seen especially in the United States of America with the establishment of the Mormon Church and the Evangelical movement which continues to sell faith-based cures to the ill and the needy.
This instance has only been exacerbated in places like India that have emerged after significant foreign rule. The Muslim conquests in the Middle Ages and subsequent colonisation by European powers led to a Hindu-centric phase of cultural and historical revivalism. In the midst of this, medicine and science became significant battlegrounds. Even today we see a growing wave of mythological worship of older ideals in India. This rhetoric which believes in the superiority of ancient Indian culture in every aspect continues to feed the ever-consuming machinery of religious dogma. The worst affected are the poor who are susceptible to the machinations of self-styled godmen who wish to exploit religious faith by selling mythic cures.
A Cultural War:
As mentioned earlier, a common element in the growth of traditional medicine such as Ayurveda and Traditional Chinese systems, was the narrative of west versus east. This is a phenomenon that is seen in multiple different aspects in nations that have emerged from Euro-centric colonial exploitation.
In the case of India for example we see that Ayurveda is touted as India’s answer to ‘western medicine’. There is a growing sentiment of nationalistic pride in Ayurveda and proponents wish to push it to a position wherein it can challenge and replace conventional medical systems.
This self-styled Ayurvedic Guru’s response to question regarding empirical testing of treatments highlights the scientific exceptionalism that ‘experts’ and proponents attribute to Ayurvedic medicine:
“Amma gave a beautiful reply that traditional therapies were combinations of many ingredients often mixed with oil. She continued that such therapies came from the inner vision of ancient sages and felt that it is very difficult to study such complex systems and that may be why those in Ayurveda may be less inclined to scientifically investigate how these medicines work.”
China’s perception of its traditional medical is no better. The cases for both will be considered and deconstructed further down the article.
Science and Pseudoscience:
This category claims to come from a genuine sense of scientific empiricism. However, over the history of medical systems such as Homeopathy, the efficacy of their research has been questioned multiple times. Even today, the mainstream scientific community seems to disdain systems such as homeopathy and naturopathy, terming them as pseudoscientific scams. The history of these two systems provides us with an insight into the mentality behind its support, which has grown in multiple different markets over the past few decades.
Homeopathy came about when its German creator Samuel Hahnemann rejected the conventional medicine of the early 1800s, believing that the treatments at the time were dangerous and irrational. Homeopathy came into being as an alternative that was characterised by low-doses in an attempt to be safe and non-toxic. However, even by those standards the practice was criticised by the medical minds of the time. In those times the idea behind homeopathy was safety and non-toxicity. However, the current rhetoric behind homeopathy comes from its 20th century revival. After a brief association with the Nazi Regime the true revival of homeopathy came in the late 1970s with the New Age Movement, an eclectic spiritual movement in the West that gave calls to a return to nature and natural products. Homeopathy became the go-to for members of this movement as a safe “all-natural” alternative to conventional medication. Since then it has persisted in pockets of the globe with one of its largest consumers being India,
Naturopathy too began as a 19th century alternative to conventional medication. The call to natural remedies used to “vitalise” the body became popularised during this period with a particular disdain for invasive surgeries. Naturopathy finds its basis in the Natural Cure movement and Thomas Allinson. Popularised in the US by Benedict Lust the movement grew and then shrunk in the same manner as Homeopathy. Similarly, it saw a revival in the 20th century with its association with the holistic health concept. Today it is immensely popular in pockets of the United States as well as other nations including India, though under other names or with slight Indic modifications.
Deconstructing the Case:
Faith Healing:
Faith healing finds its basis in the faith of conventional religious beliefs or spiritual practices. However, it becomes clear that at best faith healing is a compliment towards conventional healing, serving as a soother of emotional and mental strife in the midst of ravaging ailments.
Faith healing often points to cases of seemingly “miraculous” recoveries made by patients after being treated by faith healers. However, here the maxim of “post hoc ergo proctor hoc” comes into play. The post hoc fallacy is then coupled by the genuine medical phenomenon of the placebo effect. The placebo effect entails the belief of healing leading to brief periods of symptomatic alleviation.
This is furthermore, backed up by the Lourdes effect, simply stating that while towns such as Lourdes claim phenomenon such as spirits, miracles and divine intervention, these events have a clear ability of never appearing unambiguously and consistently. In a sardonic form, this is a perfect example of the manner in which, extreme amounts of empirical exceptions have to be made for the case of faith healing.
At best the case can be made that a touch of religious and faith-based support in trying times helps patients cope better with their ailments. This was witnessed in the CAM (Complimentary Alternative Medicine) usage of faith healing in cancer patients.
Traditional Medicine:
In this we will be considering the case of Ayurveda and TCM (Traditional Chinese Medicine). We see that in the case of TCM the first problem that we encounter is the basis of diagnosing the ailment. In TCM, it is believed that the underlying cause of ailments is instability in a persons Qi (life force). The case for this Qi is shaky and its existence is unverified. As far as medical research has shown, from an empirical point of view
This Quora thread shows us a bunch of different arguments for the existence of Qi and its Indian counterpart, Prana.
The first argument comes from a veteran of Qigong who states:
“Here in the west there is certainly not much in the way of scientific evidence, but that is mostly down to the fact that the wrong type of instruments are being used, in order to measure the wrong type of energetic activity.
Here in the west, it is mostly assumed that Qi is a form of electromagnetic or even electrical energy. However, the focus of scientific research on the phenomenon of Qi in China has been on conceptualising Qi as a type of radiation, as well as having an electromagnetic quality.”
Firstly, we see the “here in the west” line being used multiple times, clearly showing the phenomenon of an east vs west mentality in the analysis of traditional medical systems. Regardless it is laughably easy to dismantle this case as energies classified as radiation and electromagnetic can be easily empirically calculated and their presence verified. The lack of this in the case of Qi and Prana shows the issue of this argument.
Another argument made is:
“Qi/prana is the same as spiritual energy, astral energy, and similar terms. All these concepts are beyond the physical. As such, science in the sense of current physics theory, cannot explain qi.”
This showcases the empirical exceptionalism required to justify this extremely basic element of TCM. The argument that science in its current sense simply cannot explain Qi is an argument from ignorance, inherently saying that since conclusively a proposition cannot be disproven it is automatically proven.
Another element we encounter is the belief that while conventional medication is exclusively pathological (interested in the disease) and does not consider the patient, TCM has a better chance at holistic healing.
This argument stems from the holistic care narrative, which is quickly dismantled by the idea of allopathic aftercare, dietary and lifestyle changes prescribed by doctors and conventional medicines attention on mental and emotional healing through actual psychoanalytical processes.
As for Ayurveda, the prevalence of proponents who are belligerent in their support of the practice, especially in India, makes it hard to look at basic elements of the medical system to deconstruct it. However, it is possible to see multiple common logical errors in the manner with which Ayurvedic medicine tackles ailments.
At the start we see that there is an antiquated look at medicine, with an emphasis on elemental properties (earth, fire, air etc.) over actual diagnosis. The existence of bodily humours (doshes) to explain all ailments is also doubtful at best with no pathological empirical evidence for the same. Coupled with a chronic issue of standardised testing and reliability markers, Ayurveda has a long way to go before becoming a legitimate substitute for conventional medicine.
Ayurvedic treatment has an emphasis on natural ingredients, a fact that is harped upon by proponents of the practice. This appeal to nature however is an illogical ideal, often finding its inception at the premise that natural is safe, or natural is better. This concept itself has been heavily criticised and is considered a logical fallacy. The argument that “natural is good” therefore stands no ground. Ayurveda as a substitute for allopathy would thereby deny the multiple benefits of bio-technologically manufactured drugs in lieu of a fallacious argument. Moreover, there have been concerns regarding the existence of heavy metals in Ayurvedic drugs especially given the toxic characteristics of them (thus also refuting the argument made by ‘Amma’ regarding the safe, nontoxic nature of Ayurveda).
More concerning however in both of these cases is how nationalistic pride, cultural revisionism and nostalgic naivety is being used to push an agenda for the mistaken legitimisation of both Ayurveda and TCM in the international medical community. There have been concentrated attempts by both China and India to push for an increase in acceptance of their medical systems as scientifically proven. The WHO has been pressurised on both accounts for the same and research against this proposition has been actively denounced, not on an empirical level, rather a nationalistic one.
Homeopathy and Naturopathy:
Homeopathy is a difficult case to crack, essentially due to the overwhelming amount of both positive and negative research on the topic. Thus again, like Ayurveda, we must look at the efficacy of the fundamental practices of homeopathy.
Homeopathy’s two major elements are the principle of “like causes like” and the process of potentisation. The principle of “like causes like” is explained by the School of Homeopathy as:
“One way is to assume that the body knows what it is doing and that symptoms are its way of taking action to overcome illness. This healing response is automatic in living organisms; we call it the ‘vital response’. The similar medicine acts as a stimulus to the natural vital response, giving it the encouragement it needs to complete its healing work.”
Succinctly put, it is the belief that ingredients that cause the symptoms of disease have the ability to cure said disease. This principle itself was criticised heavily in the 2010 Fourth Report titled “Evidence Check 2” by the UK Science and Technology committee. The report stated:
“It is not reasonable to lump "symptoms" into categories independent of physiological causation. For example, there are many different kinds of stimulants—caffeine, nicotine, amphetamines—but the metabolic pathways they use to cause stimulation differ. The principle of like-cures-like overlooks this complication, by holding that any kind of stimulant could, at low enough doses, counteract insomnia. But insomnia is caused by different things, such as pain, hormonal changes, psychological disorders or jet lag as well as the use of stimulants. Treating the symptoms and ignoring the causes is simply not good medical practice.”
Potentisation is the process of severely diluting the active ingredients in water. This is also an actively criticised part of the homeopathic process. All conventional thinking points out that the process of dilution lessens the effect of active ingredients yet homeopathy argues that potentisation unlocks the abilities of these ingredients and increases their effectiveness. The 2010 Fourth report had this to say about potentisation:
“When we asked Professor David Harper, Chief Scientist at the DH, about the scientific plausibility of homeopathy, he agreed with our assessment that there was "a lack of scientific plausibility in how homeopathic remedies might work”
The notion that water could hold imprints of solutions previously dissolved in it is so far removed from current scientific understanding that, as Professor David Colquhoun, Professor of Pharmacology at UCL, put it: "If homeopathy worked the whole of chemistry and physics would have to be overturned".”
The Australian National Health and Medical Research Council conducted a study, on the question of standardisation and legitimisation of homeopathy in the nation. The study concluded that there was no evidence of the positive effects of homeopathy. The study’s concluding paragraph put it as:
“Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective.”
In 2011 the Swiss Health Technology Assessment report cleared the way for homeopathic pharmacies in Switzerland and gave homeopathy the seal of approval stating:
“There is sufficient evidence for the preclinical effectiveness and the clinical efficacy of homeopathy and for its safety and economy compared with conventional treatment.”
However, by 2012 criticisms of the report began to pour in. One of the most well circulated at the time comes from the Swiss Medical Weekly. The critique raised questions on the efficacy of the report, the content inside it and a possibility of conflict of interest stating:
“The present paper has established that the authors of this report adopted a very unusual strategy in what should have been an impartial evidence appraisal. It appears that their goal was not to provide an independent assessment but to choose criteria that would lead to their chosen conclusion that homeopathy is effective. To this end, they chose to adopt a highly questionable criterion of “real-world” effectiveness, ignore negative findings concerning homeopathy in favour of implausible reinterpretation of results, and attack RCTs.”
As stated earlier, the deluge of positive and negative research regarding homeopathy means that more research is required however, at the same time, the lack of conclusive evidence either for or against the proposition must not lead to an empirical lethargy in terms of the risk factor of homeopathy becoming a substitute for conventional medicine.
Naturopathy doesn’t fair much better, with its emphasis on vitality and lack of empirical results. Furthermore, in recent times the emergence of a whistle-blower faction insider the naturopathy circles of the US has chipped away at its credibility.
The face of this whistle-blower movement is former naturopath Britt Marie Hermes who had this to say after coming out against naturopathy:
“Naturopathy is not what I was led to believe. The profession functions as a system of indoctrination based on discredited ideas about health and medicine, full of pseudoscientific rhetoric and loaded with ineffective and dangerous practices. Naturopaths must be highly scrutinized because they have an ongoing history of deceit and exploitation—veiled in good intention.”
Furthermore, in her article titled “The shocking confessions of a naturopathic doctor” she says:
“Naturopathic “medicine” appears to have an ethical framework unlike anything in the medical community. I could not have learned this more abruptly than having that naturopathic “elder” discourage me from reporting a federal crime. Months later, I fully realized the danger of naturopathic self-regulation when the state’s naturopathic board disciplined my former boss with a mere slap on the wrist.”
Therefore, naturopathy is probably guilty of disguising questionable medical opinions as empirical fact. The lack of ethical considerations in the practice, mixed with the denial of empirical lack of evidence leads to an increasingly unfavourable perception of the system.
Conclusion:
Finally, at the end of this rather long article I must reiterate my points. Due to the rather comprehensive nature of this write up I shall be enumerating my arguments in bullet points.
· Alternative Medicine is of two types, complementary and substitutive.
· The substitutive alternative medicine can further be divided into three categories, faith based, traditional and pseudoscientific.
· Faith based medicine and healing has a bogus methodology as a substitute and is riddled with logical fallacies. Complimentary benefits aside, it must not be allowed to be presented as an alternative to conventional medical procedures.
· Traditional medicine, though useful in a complementary capacity is plagued by nationalistic sentiment that is pushing for the creation of a false narrative, backed up by fundamentalist sentiment.
· Questionable and divisive medical systems such as homeopathy require better research and caution during processes of legitimisation.
· Pseudoscientific forms of medicine like naturopathy require further analysis, however in their present form, they appear to not qualify as substitutes for conventional medication.
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