To me this sounds like you’re saying that you’d rather the public be lab rats than the actual lab rats… Because doing science to find good stuff and selling it is more expensive than selling stuff and not doing science.
No, I’m saying that not all logical evidence counts as scientific evidence.
I know or have good reason to believe lots of things without subjecting
them to double blind trials.
Only a tiny fraction of all the questions we could ask will ever be tested
with rigorous experiments, because experiments are expensive. If drug
companies didn’t already have good reason to think something would work,
there would be no lab rats. Even government wouldn’t be willing to fund
research without a reasonably high prior probability of sucess. Widely used
herbs are one source of “good reason” that already exists, especially for
herbs that have been in use a long time.
That’s entirely an argument from antiquity/argument from popularity. I don’t accept it as a valid reason to believe that a given herb is safe and effective.
Drug compounds are highly testable. We should test them rigorously and throw out stuff that doesn’t work.
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Historical data certainly is evidence of an herb’s safety, if not its effectiveness. There’s a reason chamomile tea is popular and urushiol toilet wipes are not, and you don’t need a laboratory to discover why.
Of course things should be tested, but there’s no reason everything needs to be distilled down to its most obviously active ingredients. You don’t put your food in a centrifuge and separate the nutrients out into pill form, discarding anything that doesn’t have a clinically proven benefit. There ought to be a good reason (besides profit) to go to the expense of doing that to an herb that already works well enough in its natural state. For serious medicine the main reason is standardized contents and dosage, but for stuff just to settle your stomach or soothe a mild sunburn, there’s not much advantage to pharmaceutical preparations versus things straight from the garden.
“A herb” and “an herb” both sound wrong to me.
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For the most part I agree with you. Although it still never fails to piss me off when I see stuff like “Echinacea super immune boost coldfigher” pills or “Airborne Vitamin C Never get the flu again screw vaccines” water fizzifier on the shelves. These things are constantly being advertized as if they’re effective for specific conditions even though the science shows all they’re really good for is making your urine more expensive.
I mean, if we have a therapeutic herb that’s safe and effective in it’s natural state, then sure it’s okay. But the way the DSHEA is written, practically anything plant based can be advertized as effective against any malady without requiring any research, and without having to be accountable for what amounts to medical fraud. And all too often people end up forgoing science based medical care for hogwash like homeopathy and herbal medicine for things that really should be treated by the doctor.
(small aside, like most Americans, my pronunciation of “herb” sounds like “urb” or “erb”, so “an herb” sounds natural to me, but “a herb” also sounds natural when someone with an RP accent says it with a hard “H”)
There’s also cases like Ephedra, where there’s these claims about magical healing TCM extracts of Ephedra, and it turns out it makes people’s hearts explode, so the FDA had to step in and just ban it from the market. The thing is: Most noticeably effective herbal supplements are so wildly inconsistent in their concentration, potency and internal synergism that the FDA had to ban them anyway. The DEA swept in and picked up most of the rest, and all the market’s got now are the sparklers and pop-its of the herbal medicine world to work with.
Those highly effective herbs have been investigated already, and made into drugs with consistent, regulated, high purity compounds and carefully standardized and metered dosing. I think this is a good thing. I don’t think it’s a good idea to simply let people kill themselves with “Miracle Chinese Potion of Ancient Wisdom”, when we’ve already figured out it’s active ingredients are just Ephedrine and Pseudoephedrine and we already have a much safer and better regulated way to dose that stuff out.
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Of course we should test rigorously and reject what doesn’t work. I am not
arguing for woo or for any traditional herbal medicine system based on woo.
But to say that tradition and popularity are no evidence at all is
disingenuous or willfully obtuse. How many (believed to be) medicinal herbs
are there worldwide? A few thousand, maybe, most never scientifically
tested? Yet a 5 minute search turns up dozens of manufactured drugs
originally derived from plants. That seems implausible by chance alone.
Actually, anyone know of any good review articles on drug trials based on
compounds identified by or derived from plants, and how they stack up to
other drug candidates on how often they are
safe/unsafe/effective/ineffective they are?
I don’t think we disagree, but I’m a bit of a stickler about epistemology.
You keep saying that tradition, and a long history of use are indicative of at least some value to a treatment, but that simply isn’t true.
Homeopathy disproves the notion. People have been using it for hundreds of years now even though all the proposed mechanisms it would work by have been disproven, and every study with half decent methodology shows it’s a placebo. But if so many people have used it for so long, there must be something to it, right? Wrong. Not a single penny more should be spent on homeopathic medicine ever. Whether it’s for study or just buying the stupid crap.
What I’m saying is that it’s simply not reasonable to expect results without developing knowledge in a valid way about these plants. The plural of anecdote isn’t data.
So while I agree plants have all kinds of potential for treatment, I refuse to accept appeals to traditional use as sufficient evidence for efficacy and safety, I refuse to accept popularity as a valid reason to think any specific treatment is worth my time and money, and I categorically am disgusted by the naturalistic fallacy because our entire modern world exists with all of our advanced technologies because natural simply doesn’t mean better.
If you’re a stickler for epistemology then it should be obvious that I am
talking about Bayesian evidence. Even though most herbal remedies are
placebos, some aren’t, at a rate higher than chance. Therefore, if
something has been used as a remedy for a long time and (unlike homeopathy,
an obvious strawman) there is no strong prior reason showing that efficacy
is impossible or very unusually unlikely, then yes, that is evidence.
I’m not claiming proof or statistical significance. Only you mentioned
homeopathy and the naturalistic fallacy. You say, correctly, that the
plural of anecdote is not (scientific) data. But where do you think good
hypotheses come from? Almost all the logical evidence in research goes into
figuring out the right question to ask. Controlled experiment is the
hardest and most important step, but anecdotes show you what to experiment
with.
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I agree with your points, and you expressed what I’ve been trying to say all along here:
We can have all the hypotheses we want, but just having an interesting hypothesis isn’t grounds to treat humans, and with nearly all these herbal remedies and supplements, a hypothesis is all they have to go on. And occasionally a study so slanted it’d make the tobacco industry blush.
I keep a small pot of aloe plants in my kitchen. Yes, we have a bottle of aloe in the bathroom too, but I can’t count the number of times I’ve been grateful I didn’t need to go anywhere to put fresh aloe on a scrape/cut immediately. It works better than the “99% pure aloe” you can buy in a store, too.
If marketing and quality control are your main complaints, the solution is rather simple. Like with most things, eliminate commerce. If people choose to use it, they need to make it themselves. When people undertake the benefits and risks on a personal basis, it’s no one elses problem.
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