I Sense a Disturbance

I Sense a Disturbance

“If you can't dazzle them with brilliance, baffle them with bullshit.” ― W.C. Fields

My involvement in science-based medicine has made me a much more critical reader of the medical literature, both for real medicine and pseudo-medicine. At one time I would have skimmed or read an article and taken it at face value. Reading critically was not an automatic approach to the literature. Now my default mode of reading papers is through the lens of all I have learned in the last decade. And I must say, there is a tremendous amount of awful studies published. And all those studies are an equally tremendous waste of time and money.

 

Some are not content to do new worthless, poorly designed, pseudo-medical trials. Some need to reformulate the metaphor under which the magic of pseudo-medicine is understood. So we get "A Disturbance Rejection Framework for the Study of Traditional Chinese Medicine."

In disturbance rejection, an engineering concept, a great metaphor, is found to show how the TCM is practiced...It is through such analogies Wuxing is systematically used to explain human physiology and pathology

Just what the world needs, the practice of medicine based on metaphor. TCM is a complex fiction, with no diagnostic or therapeutic intervention that is based in reality. Chi and ying and yang and meridians are, to use a Shakespearian analogy,

...a tale Told by an idiot, full of sound and fury, Signifying nothing.

The authors, being electrical engineers and pre-meds, know nothing about their topic, as demonstrated when then they state

There is little doubt in the effectiveness of some of the TCM practices even in the West, as the wide acceptance of acupuncture, for example, attests. It is also widely recognized, however, that due to the historical and cultural differences, the tenants of TCM are often considered rather abstract and vague and are prone to misinterpretations, in the context of Western science.

There is no doubt.  TCM doesn't work. Is it my imagination, or are engineers more likely than any other professional to pull a Dunning-Kruger? They continue

Precisely such interrelationships are front and central in the conceptions of the TCM and have been largely beyond the grasp of quantitative studies of the Western science.

There is no such thing as Western science, the ongoing slightly creepy/racist idea that one culture has a different reality than another.

The uselessness of TCM for understanding disease is evidenced in their laughable description of liver cancer:

Pathogenic factors of liver cancer are complex, in view of the TCM, and they are associated with stagnation of qi from sustained low mood and the lack of adequate flow; the dysfunction of the Zang and Fu organs resulting in inadequate cleansing of the turbidity; and the inadequate flow of qi and blood, leading to accumulation syndrome, that is, fiery and poisonous. Therefore, the TCM concludes the liver cancer is a disease of amassing in the abdomen, of tympanites, and of jaundice, and so forth.

As the liver encounters the pathogenic qi, it rises up and attacks. Both the healthy and the pathogenic qi are exuberant at this stage and their struggle is violent and sustained. As the pathogenesis develops, the pathogenic qi takes hold and the healthy qi degrades, leading to the dysfunction of the liver and the symptoms of difficulty of dispersing, qi stagnation, phlegm obstruction, improper qi accumulation, lack of blood movement, and the gathering syndrome. As the pathogenic qi becomes increasingly stronger, the disease heightens, so does the loss of the healthy qi, until it is mostly gone, along with any resistance to the disease, which finally reaches the terminal stage.

I love that phrase: "As the liver encounters the pathogenic qi, it rises up and attacks." I almost did a spit take on the computer. It says something about the medical knowledge  of the authors and the quality of the journal that such a phase could pass muster.

This is one of the reasons life expectancy of the Chinese was so short before they started using reality based medicine. How, as an example, the oncogenic effects of chronic hepatitis B and the prevention of liver cancer with the vaccine enter into the TCM understanding is not mentioned; lost, I suppose in the violent and sustained struggle, laying waster to any rational thought. I have asked before: is there any disease for which any pseudo-medicine, including TCM, has made a positive difference? Nope.

To judge from the content, they are the Jon Snow of medical understanding.

But what then is Disturbance Rejection you ask? As best I can tell, when a system is perturbed out of equilibrium, it actively, rather than passively, seeks to counter the pertubation.

How does this relate to TCM? Got me. I read and re-read the paper and it is to my mind gibberish, perhaps a TCM Sokal, or a TCM time-cube.

They sum up their approach with liver cancer as an example as follows:

The above process of pathogenesis can be understood in the framework of disturbance rejection: the liver system is affected by disturbances and loses balance; the disturbance is compensated by the use of healthy qi which has limited supply. When such imbalance is not restored quickly, due to the severity of the disturbance and the weakened state of the body, the liver system runs out of energy and the disturbance rejection ability. At this point, only the external intervention, based on the understanding of the cybernetic model of Wuxing, can help the system recover its balance.

So your organs are out of balance, you give herbs, the ballance is restored. That's your Active Disturbance Rejection. A whole lot of words trying to add modern concepts to an the complex fantasy that is TCM.

The authors seem to think TCM is not used or understood because there is a difference in language and they have found a

language of a holistic science for the West, that is, inherently congenial to the Eastern thinking in Yin-Yang and Wuxing.

TCM is rejected because it is based on nonsense and worthless in practice. With liver cancer as an example it is laugh out loud funny. But trying to pretty it up with the concepts of cybernetics is putting lipstick on a pig.

Points of Interest 7/8/2014
Points of Interest 7/7/2014