Tuesday, November 21, 2023

The Requirement of Scientific Literacy

Environmental & Science Education, STEM, Health, Medicine, Nature of Science, History of Science, Culture, Science & Society

Ed Hessler

Scientists find traditional Chinese medicine is based on a complex network of proteins – 3,000 years before modern science.” -- South China Morning Post *

This reporting for the OSS Weekly November10, 2023, by Jonathan Jerry dives into a recent report on traditional Chinese medicine (TCM) in Science Advances. "It’s one of those impenetrable bits of data wrangling that can easily be dismissed as nonsense by the TCM skeptic or blindly embraced as confirmatory by the TCM believer."  So it needs some analysis. 

The sole focus is on herbalism and doesn't mention the variety of other TCM interventions. This is a mapping study based on purported associations, not on any herbal used "in a clinical trial or even in the laboratory".  Computers do the work of going through the massive lists pf data: symptoms, genes and their corresponding proteins, herbs.

Jerry's description of how the thinking goes which because you can read it doesn't need more comments by me. I reduce (he explains) this to a few words. In large data sets finding associations is all but inevitable but one-to-one correspondences are difficult; they are nearly impossible, because so many variables are involved and the herbs are complex mistures of "unknown amounts of various chemicals," with no plant-to-plant consistency. 
There is a good discussion about these, including sample sizes which reveals just how thin the conclusion reached by the authors is. We can add into the mix that when "practitioners using scientifically effective herbs could not (have) known the scientific reasons when they first started using them thousands of years ago". Jerry provides an analysis of the methods used in this investigation which do not include standard biomedical practices.

I was interested to learn that TCM " is not particularly old. It is a modern reinvention spearheaded by Chairman Mao Zedong in the middle of the 20th century." This history is important, a situation in which the Chairman must have thought "I must do something to provide some form of medical care." Interestingly, TCM does not have a "concept of disease; the focus is on symptoms."

While "proponents of TCM are quick to point to the Nobel-Prize-winning malaria treatment artemisinin as a TCM success story," it "represents a triumph of modern scientific refinement, but artemisinin represents a triumph of modern scientific refinement. It was a pharmaceutical company, Novartis, which mixed an artemisinin derivative, artemether, and lumefantrine into a beneficial medication for malaria. Pills are good not because the pharmaceutical industry benefits from them, but because they deliver a consistent dose of a well-studied molecule as opposed to the chemical chaos of whole herbs."

Now don't knock plants or am I. Jerry reminds us that "Effective drugs are developed from plants all the time. It's just that plants are the beginning of the process, not the end."

Jerry closes with a summary of the three take-home messages which are embedded above and thoroughly discussed in his reporting.

- Researchers behind a new study claim to have revealed the scientific foundation of traditional Chinese medicine (TCM) 

- Using large data sets, they looked for connections between symptoms, proteins, and herbs used in TCM and found some associations that were likelier than would be expected by chance 

- This theoretical exercise needs to be balanced against the implausibility of TCM: its herbs are variable mixtures of chemicals and its practices are incongruous and were repackaged by Mao Zedong in the middle of the 20th century to provide some kind of healthcare in the countryside even though he did not personally believe in their validity 

* Epigraph from Jonathan Jerry.
A great story on how science is equipped to understand.

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