Saturday, December 03, 2005

Infinite Diseases and Money Making Opportunities

Notes from Dr R.W. mentions an article in StudentBMJ promoting Ayurvedic Medicine.

EoR is amazed and confused by the article, written by a "house officer in medicine", which makes him wonder why the author ever bothered studying conventional medicine.

First comes the claim to seniority (which, EoR notes, the great majority of SCAMs all make:

It has been practised for over 5000 years and is the oldest known system of medicine.

So is trepanning, which EoR prefers because at least he can see the practitioner doing something, and there's an obvious way for the demons - sorry, toxins - to escape at the end. And it creates that Holy Grail of the True Believers: an open mind.

Ayurvedic apparently postulates a "unique constitution" for every patient. This must at least make medicine interesting since, instead of the endless queues of cold and flu sufferers, every patient will have a different disease. But

Ayurveda describes three broad categories of constitutional type, called doshas: vata, pitta, and kapha. Each person is a unique mixture of these, but most have one dominant dosha. The doshas are described in terms of opposing qualities. For example, hot-cold, static-mobile, heavy-light.

By EoR's calculations, that's only eight different conditions, not exactly a plethora of 'unique' constitutions.

After listing a number of (perceived) problems with conventional medicine (short consultations, specialist referrals, the inability to "treat the majority of patients who come to general practitioners") the author states that Ayurveda is the way to go:

The fundamental difference is that in Ayurvedic practice the analysis of symptoms is quality based. Rather than rely solely on the empirical scientific method, or objectivity, practitioners are encouraged to develop more subjective, intuitive faculties as a tool for diagnosis.

Leaving aside the assumption that GPs never make 'quality based' analyses, this seems to mean that instead of assessing the evidence, Ayurvedic practitioners make a best guess. Very comforting. Ayurveda is also a nice little money-spinner. Where most people will only go to a GP when they are ill, or for an annual checkup,

Ayurveda describes six generic stages of disease. According to this system orthodox medicine identifies disease only at a late stage. Ayurveda can identify illness earlier, when it is only a minor imbalance, and so can correct it before serious disease develops.

This is the old 'maintenance' that all SCAMs demand. Spend your money just in case. Subtle changes are being effected. Honest. Would anyone lie about this? But what if, after spending all that money, you still get sick? Never mind,

In Ayurveda, the patient is more responsible for his or her own health and therefore has an active role in his or her treatment rather than simply receiving it.

Brilliant stuff! I treated you perfectly well, but it's your own fault you got sick! Now here's some more medicine.

The author concludes:

What more can we learn?

EoR ventures to suggest critical and logical thinking, objective evaluation of unproven claims, and how to evaluate evidence vis a vis anecdote just for starters.

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