Leeches and the legitimizing of folk-medicine

https://press.asimov.com/articles/leeches-and-the-legitimizing-of-folk-medicine

by mailyk • 11 months ago

30 48 11 months ago

press.asimov.com

I remember reading a memoir of a manual therapist who described his work with Ida Rolf. Rolf discovered a specific approach to massage, "rolfing". It appeared very effective, she had a number of apprentices and followers and she was interested in clinical testing and such. Turned out that it would be very expensive. With all her money she could maybe afford a couple small-scale trials. She decided money could be better spent elsewhere.

AlecSchueler• 11 months ago

Rolf isn't a form of massage, it's more like simple exercises that are just things designed to help bring awareness to your posture, where you hold your weight etc.

dang• 11 months ago

I think you might be confusing Rolfing with Feldenkrais. They're both great!

karamanolev2• 11 months ago

I have an interesting story with non-scientific medicine. Normally, I'm a very science-oriented person—"read the paper or it didn't happen." I will even avoid reading a news article about the paper; I'll just go and read the paper itself. The way I treat my illnesses and injuries is the same. That being said, I suffer a lot from sore throats—I will get some flu, get better in 3–4 days, and then my throat will hurt for weeks. In a particularly bad bout, I tried waiting for 2 weeks with no improvement. I almost couldn't swallow. I went to the doctor and was prescribed antibiotics. That resolved it in about 24 hours, and I completed the full course. Three weeks later, the same thing happened. I waited 2 weeks to see if it would resolve on its own, and when it didn’t—antibiotics again. Of course, the problem came back only weeks later.

So I thought—I'm going to try homeopathy. What's the worst that can happen? I'm in pain anyway. I decided to try a scientific approach (not very, given N=1), so again I waited 2 weeks to see if it was going to resolve itself. It didn’t. I went to a homeopathic doctor and got a bottle with some "magic." It took 3–4 days for the symptoms to improve, but they didn’t come back for months. When they did, I jumped straight to the homeopathic medicine, and it helped in the same way it did the first time around. I haven’t used antibiotics for my throat since.

I have no explanation for this. There have been hundreds or thousands of studies on homeopathy, and my reading is that the consensus is that it's "quack medicine." Yet it clearly worked for me, and it worked better than antibiotics for that particular issue. What gives?

lukan5• 11 months ago

No one ever said homeophaty has no effect. But there is no evidence it works beyond being a placebo.. which is what I suspect happened also in your case, whether your consciouss mind believes in homeopathy or not. You gave it a chance, so some parts of your mind decided it will magically work, so it did.

Oh and unlike homeopathy, leeches have a real effect besides placebo.

agos3• 11 months ago

placebo is not that effective

griffzhowl5• 11 months ago

That wouldn't explain the difference in effect between the antibiotics and the homeopathy

boxed• 11 months ago

It could be that you didn't get real homeopathic medicine. There's been quite a few cases of babies dying after being given "homeopathic" medicine. Because real homeopathic medicine is indeed quack science, literally diluting a substance to the degree of one molecule per a sphere of water the size of the entire solar system, but homeopathic producers are grossly immoral and stupid/bad and unregulated, so can contain high, in some cases deadly, doses of various substances.

TLDR:

Homeopathic medicine is, in theory, 100% safe, since it's literally nothing.

Homeopathic medicine is, in theory, 100% ineffective, since it's literally nothing.

Homeopathic medicine is, in practice, rolling the dice with unregulated producers that have been known to ship poisons.

graemep• 11 months ago

I think this is the most probable explanation.

Homeopathic medicine is based on the same principles as sympathetic magic. You might as well ask someone to cast a spell.

https://pietersz.co.uk/2013/07/homeopathy-magic

There have been similar problems with dilution of herbal medicines, but of course herbs do often have medicinal properties.

arkey7• 11 months ago

Interesting, you're describing exactly what I went through a few years ago.

In my case, however, I turned to pure ginger infusions, following the advice of a herbalist. Haven't gone through it again so far, plus it also works great for colds and flu.

merksoftworks• 11 months ago

So, gingerol is anti inflammatory. Fun fact, so is allicin, which is produced by garlic. You get a lot of medicine that looks quite a bit like quack medicine - for instance people making garlic extract: https://www.allicin-c.com/?AFFID=549212

But then you end up with peer reviewed studies which indicate some anti-viral properties of garlic: https://pmc.ncbi.nlm.nih.gov/articles/PMC7434784/

ajuc• 11 months ago

I have asthma, a few times I got an attack when I left my drugs at different home. Usually in such situation I have to go to a nightly doctor office (it always happens in the middle of the night on weekends).

But several times this happened I've been at my home and I have some old empty inhalers with 0 doses left and like 5 years past expiry date. I'm talking the disk inhaler, with discreet capsules of the drug that get used on every application - so if there were any traces of the drug substance - it would have been very small amounts that stuck to the inhaler walls or whatever.

I still used it and it stopped the asthma attack just as well as the real thing.

Placebo is one hell of a drug.

Similarly - even just preparing to go to the doctor in the middle of the night lessens the asthma attack for me. Just before I go to the doctor waiting in the queue the symptoms are often very minor.

hackingonempty• 11 months ago

I have no explanation for this.

One possibility that RCTs are designed to eliminate is "regression to the mean." If the natural course of disease is to wax and wane and you intervene whenever the disease is waxing it can seem like your intervention is effective even when it has no specific effect.

In addition, placebos produce a small effect even when you know you are taking a placebo.

unnamed76ri• 11 months ago

I’ve been on meds that wreck my immune system and so I get sick a lot. Every time I start feeling the smallest tickle of an upper respiratory virus I start doing the following: 1. Gargle with salt water 3x a day 2. Use saline nasal rinses 2x a day

I still get sick a lot, but haven’t needed antibiotics in all the years I’ve kept to this routine.

wazoox• 11 months ago

For your nasal rinses I hope you're using a "rhino horn" and not an expensive solution sold in pharmacies. Since I discovered it I rinse my nose much more often and more abundantly, and it's great (and waaaay cheaper than alternatives).

griffzhowl5• 11 months ago

There is a null hypothesis which isn't ruled out: it would take two weeks plus 3-4 days for your sore throat to resolve itself, but you were waiting only two weeks each time, taking your timings at face value.

Still, that doesn't explain why the symptoms return sooner after antibiotics than with homeopathy. The body is complicated and there are many variables.

Do you drink alcohol? I'm wondering whether you consciously or subconsciously adjust how much you drink more during or after an antibiotics course than the homeopathy, or whether there's some similar confounding variable. Strong alcohol of course has some anti-bacterial properties (as well as some well-known side-effects which aren't so beneficial), but I don't really know what I'm talking about, just a thought that occurred

lolc• 11 months ago

With letting the infection persist there might also be an added effect of having trained the immune system. If this is a case where it takes long to build antibodies. This may result in a longer period without an infection due to the improved immunity.

karamanolev2• 11 months ago

I don't drink, smoke, take drugs. My main vice is drinking a ton (about a liter a day) of Coke Zero.

reedf1• 11 months ago

To me the obvious "cure" for your sore-throat in this story was doing nothing. This has surprising efficacy. Antibiotics are serious drugs. They are inordinately useful, but they also have side-effects. Antibiotics can wheel your body completely out of equilibrium - your sore throat could have been due to yeast or been some kind of fungal thing which the antibiotics inturn made worse (or caused some kind of fungal -> bacterial cycle). In this case homeopathy gave you some utility; it gave you psychological permission to do nothing while feeling like you were doing something.

GuB-42• 11 months ago

My guess is placebo, done "right" homeopathy is maybe the purest form of placebo, as extreme dilution make sure that there is nothing active in there. In your case, antibiotics may have been placebo too.

For me, the most probable explanation is that your body just healed by itself and taking nothing would have had the same result. It is not uncommon for symptoms to appear, repeat a few times, and disappear completely. It happened to me countless times, like, for example a cough persisting after a cold episode, coming and going for a few weeks after I realize it is completely gone, some minor injury occasionally manifesting itself before finally disappearing completely.

Your symptoms are a bit more serious, enough for you to justify doing something, but it is probably the same idea. That your interventions worked may be a coincidence, in addition to some placebo effect which is known to be somewhat effective for pain.

jfjfitttjtmt• 11 months ago

Maybe in next century we discover that "horse medicine" is very good against viral infections!

__alexs6• 11 months ago

I think we should really just stop asking if "the old ways" actually work or not as it seems entirely irrelevant to the people that seek them out most of the time. They are acts of pure ritual.

arkey7• 11 months ago

Well that's a bit too much of a generalisation maybe?

Yes, there are old ways that have been proven wrong, which were based on ignorance at the time, but there are also old ways which are totally legit and are little known or accepted nowadays based on today's ignorance.

__alexs6• 11 months ago

Take turmeric for example. It contains curcumin, a chemical that has quite good evidence for anti-inflammatory properties. However curcumin is not present in turmeric in clinically relevant quantities. People taking turmeric medicinally are not actually interested in the curcumin, if they were they would be taking a concentrated extract. They are interested in the ritual and cultural associations of turmeric.

In most cases when we do find evidence for something clinically relevant in traditional medicine we either discover that the effect is something other than it is traditionally associated with and/or that you need to take it at extreme doses for it to do anything at all.

darth_avocado• 11 months ago

Some old ways do work and it is worth asking whether they work. Aspirin was infamously drawn from Willow bark as a treatment. Artemisinin which treats chloroquine resistant malaria was derived from wormwood after looking for inspiration in ancient Chinese medicine. There are probably more examples out there where ancient medicine has informed modern medicine.

__alexs6• 11 months ago

I am not arguing that plants do not contain interesting chemicals. I am arguing that they are typically used in a ways that are ineffective and the users don't care because they fulfilled their main priority, taking part in a ritual.

h3lp• 11 months ago

Folk medicine that succeeded in rigorous clinical trials is called 'medicine'?

Leeches and the legitimizing of folk-medicine

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