More than any other time in history, mankind faces a crossroads. One path leads to despair and utter hopelessness. The other, to total extinction. Let us pray we have the wisdom to choose correctly.
~ Woody Allen
No good deed goes unpunished.
The website whatstheharm.net is a depressing recitation of the harm that humans do to themselves and others from participating in various forms of nonsense in the attempt to do good. It my backfire, and instead pain and death result.
I would bet that most practitioners of medical woo are true believers. They do not intend to harm people, and believe they are doing good for their patients. Certainly the consumers of alternative therapies intend to have good benefits from their use of sCAM modalities. Most want to get better, and do not intend to hurt themselves or others.
Unfortunately, actions always have unintended consequences. Sometimes the harm is directly to the patient. Sometimes the harm in indirect, with collateral damage to people or the environment. My hospital system has an extensive recycling program to handle the huge amounts of waste generated by the need to insure that all manner of materials are sterile. Patients in isolation consume large amounts of paper and plastic to keep infection confined. My hospitals actively look for ways to decrease their environmental impact and carbon footprint and still deliver high quality medical care. Legacy Health System, where I work, is an award winning leader recycling medical waste, which is a lot more difficult to dispose of than the pop cans and paper bags in your house. Hopefully the trash in your house is not covered with pus, blood and other potentially hazardous medical waste. We try to be good global citizens.
I wonder if some branches of the alternative medical industrial complex are so environmentally conscious.
Natural products are at the greatest risk for being adversely affected by a demand for their use. If millions of people want a natural product that has limited supply, soon that product will be exhausted and the product extinct. Adverse effects from alternative therapies can come in many forms, and the alternative practice with the greatest adverse impact on the environment is probably traditional Chinese medicine (TCM). A billion or more people wanting a traditional herbal or animal product is going to have a detrimental effect on the herb or animal being consumed. There are numerous examples of the adverse effects on the environment from traditional Chinese medicine.
For years the Rhinoceros was hunted not for food or sport, but for the horn. There is a form of magical thinking that derives function from the structure of a natural product like a rhino horn. It looks like a penis. I guess. I must not have been paying close attention during in my urology rotation. Because it looks like a penis, it must have efficacy on impotence. So the rhino horn was ground up to treat impotence. For centuries it was the Enzyte of the world. But Rhino horn is more than an aphrodisiac. Although the rhino horn is no more than a fingernail with extra calcium and phosphorus, the horn has been used in Chinese medicine to treat damn near anything.
I will note here that trying to determine what a given Chinese preparation is ‘really’ used for is an exercise in frustration and, as best as I can determine, there as many uses for each TCM preparation as there are acupuncture points: an infinite number only limited by the imagination of the practitioner.
“It (rhino horn) should not be taken by pregnant women; it will kill the fetus. As an antidote to poisons (in Europe it was said to fall to pieces if poison were poured into it). To cure devil possession and keep away all evil spirits and miasmas. For gelsemium [jasmine] and snake poisoning. To remove hallucinations and bewitching nightmares. Continuous administration lightens the body and makes one very robust. For typhoid, headache, and feverish colds. For carbuncles and boils full of pus. For intermittent fevers with delirium. To expel fear and anxiety, to calm the liver and clear the vision. It is a sedative to the viscera, a tonic, antipyretic. It dissolves phlegm. It is an antidote to the evil miasma of hill streams. For infantile convulsions and dysentery. Ashed and taken with water to treat violent vomiting, food poisoning, and overdosage of poisonous drugs. For arthritis, melancholia, loss of the voice. Ground up into a paste with water it is given for hematemesis [throat hemorrhage], epistaxis [nosebleeds], rectal bleeding, heavy smallpox, etc. (1)”
I like that ‘etc.’ at the end. I thought Bayer aspirin was the wonder drug that works wonders, but aspirin will not calm the evil miasma of hill streams, mores the pity. With all the alleged benefits of consuming rhino horn, all with no biologic plausibility whosoever, it is no wonder that despite the advent of Viagra and its cousins, the rhino is still being hunted for its horn. A century ago, there were one million black rhinos in Africa; now there are 2,500 and the population is falling (2). A horn fetches $500 in a country where the average farmers makes $1.50 a day (2a). On the international market a horns gets more than $10,000 for a kilogram. No wonder the Rhino is hunted to near extinction. The fact that they have no medicinal benefit does not prevent the harvesting of the rhino. All species eventually become extinct, but to become extinct because of medical woo is particularly depressing.
Rhinos are not the the only animal disappearing due to relentless harvesting of animal parts for worthless therapies.
Tigers
In 1900 there were 100,000 tigers in India, now there are less than 5,000. China now has under 100 tigers, as they are killed and chopped up into their constituent parts for many worthless medical therapies, including, but not limited to
” a tiger’s penis soaked in alcohol is said to increase virility; its nose suspended over the marriage bed is believed to increase the chance of having a boy and its whiskers are said to cure toothache (4).”
TCM loves the tiger bones, something that the tiger cannot live without, as a treatment for arthritis, often as a tiger bone wine. 14% of the US has some form of arthritis, and if the numbers are true for China, there are 172 million potential customers for tiger bones. There are also many people outside of China who use the therapy as well. That’s a lot of tiger bones, and given declining tiger populations, it is no wonder tiger bones go for 400 dollars a kilogram, each tiger having 4.5 kilograms of bone.
“The usual dosage for Tiger bone taken orally to treat rheumatic pain is three to six grams daily. At this rate, a daily user of Tiger bone would consume one to two kilos of bone per year. Extrapolated further, the world’s remaining Tigers would provide, at most, a year’s supply of medicine to 125 800 daily users – the equivalent of far less than even 1% of China’s human population (13).”
That would be about 1/3 a tiger per year per person.
It is not a minor problem: “More than 150,000 over-the-counter traditional Chinese medicines containing – or purporting to contain – tiger bone and parts from other critically endangered species are sold in the United States (4).” Support TCM, you are indirectly supporting the extinction of rhinos and tiger and more.
As Tigers are harvested to extinction, traditional Chinese medicine has substituted other big cats like leopards, whose days are now probably numbered.
Bears
“In traditional clinical practice, bear bile was used in fever fighting, detoxification, inflammation, swelling and pain reduction. It was also used in the cure of carbuncle of heat type, pyocutaneous diseases, hemorrhoid, overabundance of liver-fire, convulsion caused by the overabundance of heat, epilepsy, tic, and redness of eyes due to liver heat etc (15).”
Again that pesky etc. Pick a disease, real or imagined, and bear bile may be a therapy. The one problem not treated with bear bile that I could find is impotence, the only TCM animal product not used for some sort of sexual dysfunction. The producers and consumers of TCM products seem to have a lot of sexual dysfunction. Cause or effect?
Rather than hunt bears, farmers keep bears in cages with a catheter in their gall bladder where they can drain the bile like sap from a maple tree. It is not a good life for the bear and often fatal. The Chinese have hundreds of farms with thousands of bears, as do other SE Asian countries.
There is an active ingredient in bear bile, ursodeoxycholic acid, that dissolves gall stones. It can be, and is, synthesized for human use. Oddly enough, the natural product is considered superior to synthesized molecule, and so the bile drainage continues and the bear population in China continues to dwindle to supply bear for the farms.
I never thought I would be agree with PETA on anything, but torturing bears for bile that does nothing or has a synthetic equivalent hardly seems like an ethical treatment of an animal. The Humane Society description of bear bile harvesting does not appear particularly pleasant for the bear, which has its bile ‘milked’ without the benefit of anesthesia (14).
” An un-sterile latex or stainless steel catheter was inserted through the external fistula directly into the gall bladders of each bear to drain the fluid daily either by gravity into a tray or by suction with an un-sterile syringe. This extraction method was called the “Free-dripping Fistula Technique”. The fluid was then dried and manufactured as “Bear Bile Powder” (Bear bile extraction) . The bears were suffering extreme pain due to daily bile extractions. Many of them often die from illnesses (such as cholecystitis, cholelithiasis, polyp formation, obstruction of the cystic duct, strictures and partial herniation of the gall bladder wall, liver cancer) and chronic infections caused by the presence of foreign bodies and their open wounds (15).”
Besides bear farms, bears are illegally hunted for their gallbladders all over the world.
The usual dose of bear bile is 0.25–2.5 g is taken as a pill or powder (15), and given that the average bear in a farm makes 20 to 40 ml a day of milked bile, it takes a lot of bears to provide the required bile. Prices vary, but bear bile can go for $1000 dollars for 250 cc. In beer talk, that would be about half a pint.
“In 1970 one kilo of bear gall bladder cost around US $200, but by 1990 the price had risen to between US $3,000 and US $5,000 per kilo. Recent market price with legal certification has risen to between US $30,000 and US $50,000 per kilo (our experience in legal market of Hong Kong) (15).”
There is considerable financial incentive to hunt bears to extinction to provide worthless medications.
Sharks
The Chinese are not the only culture who uses nonsense to help drive animals into extinction. 100 million sharks are killed every year. Some are killed as a by product of fishing, some for food, some for sharks fin soup, and some for medication. Somewhere along the line it was mistakenly thought that sharks do not get cancer. They do get cancer, and they get cancer of cartilage, albeit not very frequently. William Lane, PhD has been the primary marketing force behind the idea that shark cartilage can prevent and treat cancer, publishing books on the topic and selling shark products. Again, there was no good reason to suggest that shark cartilage had anti-tumor effects, although some data in the lab suggests that it inhibits the formation of new blood vessels, needed to support tumor growth. The clinical trials for any efficacy of shark cartilage in the treatment of cancer have been negative, but the end result was has been to help push 126 shark species towards extinction.
A Google search reveals many organic/natural/ online pharmacies sell shark cartilage. I suppose extinction is natural and organic, and supporting and profiting from the extinction of animal species is also natural and organic. Who cares is Jaws is going extinct? Not the purveyors of shark cartilage.
Saiga antelope
These animals have been hunted for their horns, which are used to treat stroke, colds and high blood pressure, and, since rhino horn is both expensive and rare, a cheaper alternative to rhino horn. Because of the protection of the rhino combined with their tiny numbers, the practitioners of traditional Chinese medicine have had to find another species to decimate for useless medical therapy. As a result their numbers of Saiga have gone from 1 million to under 30,000 and falling.
Turtles and Tortoises (7)
Half of the 90 turtle species in Southeast Asia are endangered, due to demand in China for turtle meat and traditional medicines. “The World Conservation Fund has documented the rapid decline in just the last few years of the Chinese three-striped box turtle, whose fat, used in soup and jelly, is believed to cure cancer; only a few colonies of the once-abundant turtle now survive in the wild (9).”
Sea horses (8)
There approximately 90 health and medicine products containing sea horse are sold in China and elsewhere. As is often the case, the sea-horses are being used for, among other things, an aphrodisiac. . To meet this demand some 20,000,000 sea horses are harvested each year. All die for no valid reason, and seahorse stocks are plummeting.
Other animals consumed by traditional Chinese medicine include the slow loris, whose fur is believed to accelerate healing of wounds. Extracts from the eyeballs of the loris are turned into a love potion. The civet cat is used for its anal scent gland to induce abortions well as to treat arthritis, stimulating blood flow, and increasing libido. Again with the impotence.
As mentioned above, it is not just the Chinese that use animal parts for medicinal purposes, but the effects are the best documented due to the large population and the economic clout that allows the trade in medical animal parts to flourish. India, Brazil, and Sudan are a few of the countries with documented use of local plants and animals for medicinal purposes (16), however they have not (yet) had a documented adverse effect on the local ecosystems.
Data suggests in Brazil:
“Of the total of species recorded, 24 (71%) are not under extinction risk. On the other hand, Myrmecophaga tridactyla (Linnaeus 1758), Coendou cf. prehensilis (Linnaeus 1758), Dusicyon sp., Mazama cf. Americana (Erxleben 1777), Rhea americana (Linnaeus 1758), and Crypturellus noctivagus zabele (Spix) 1825, which are officially considered as threatened species by the Brazilian Institute of Environment and Renewable Natural Resources (1989), were found among the set of faunistic resources prescribed as medicines at the time of this research.”
There is good money in the trade of animals, even to the point where the director of the Berlin zoo was selling ‘extra’ tigers to the Chinese for medical use (10).
Plants have it worse than animals, feeding the voracious appetite for traditional Chinese medicine. Over 400 plants are at risk for extinction from medical use as 5 billion people use plants as the basis for their medical care, although not all of them from traditional Chinese medicine. Examples include, but are not limited to
Magnolia
Half of the world’s species of magnolias are under threat of extinction, which is used in traditional Chinese medicine to treat cancers and slow down the onset of heart disease (12). There are two diseases with similar pathophysiology: cancer and heart disease. I can see why they have the same treatment.
Manchurian Ginseng (13)
A popular treatment for memory function as well as cancer, COPD, diabetes, fatigue, increasing libido (where it that etc. when I need it?), Ginseng has all but been eradicated in China and Korea. As a result it is harvested in the US and sent to China. Wild ginseng is though to have better medicinal properties than farm raised, so the harvest of wild ginseng continues in the US, threatening that species with extinction in the US as well.
Dendrobium candidum
An orchid that is believed to cure hoarseness, is so rare that it now costs 12,000 times more than wheat.
Licorice
Licorice root is an Asian plant species commonly used for pain relief and to treat coughs, skin infections, food and drug poisoning. Licorice is almost wiped out in China – “largely at the hands of Chinese soldiers making some pocket money by digging up the plant while on duty in the country’s northern border region, which is called by some the “licorice zone”(6). Due to excessive harvesting and habitat destruction, licorice root is now grown in less than half its previous area; reduced from 50,000 square miles to about 19,000 square miles.”
These are just the tip of the iceberg as “of the 1,581 species of animals used as a medical resource, 1,306 are terrestrial animals and 275 are marine animals… 11,146 are of plant origin (5).
One of the complaints about natural herbal medications is that there is uncertainty as to what the concentration of active products, if any, are. It is argued that a superior way to treat disease is to isolate the active ingredient and then synthesize it. Herbalist of all stripe reply that one needs the complex formulation of the natural product for efficacy. No natural/herbal product I am aware of is superior to the synthesized pure product and none of the synthesized products lead to animal or plant extinction.
We are, perhaps, at the beginning of a mass extinction of animal and plant species for a variety of reasons. That we are wiping out ginseng and tigers and bears for the myth that they can cure or treat disease, that these plants and animals are dying out because of belief in magic, is evil.
Some Chinese practitioners object to interference and criticism of their practice, feeling it is racist for the West to put limits on Eastern practices that we do not understand.
“In addition, we would like to point out that recent campaigns against the use of some of our medical resources, for example tiger bones, bear bile and rhino horns, have led to a negative stereotyping of our practice…As part of a scheme in recent history to cast the then Chinese herbalists as ‘the other’, their use of animal material medica has been exploited in the past to devalue the yao they use, and in the process, devalue and delegitimize their medical practice (5).”
It is racist to be against unproven, implausible magic that is leading to the extinction of hundreds of animal and plant species. Special pleading to allow the pointless extinction and torture of animals for worthless medical therapies.
There is also a movement to make traditional Chinese medicine sustainable, by using alternative worthless products instead of endangered medically worthless products. There are arguments that the bear bile farms are helping prevent the bears from being hunted to extinction, a sort sort of greening TCM induced extinction. Traditional Chinese Medicines is the Hummer of the altmed world, trying to sustain the a destructive practice despite its causing more harm than good to the world. It could be an unexpected byproduct of the adoption of science based medicine that rhinos and tigers and bears would be saved from TCM induced extinction. Perhaps the rational use of science derived evidence will make the TCM therapies will go the way of acupuncture….. bad example. One would hope that if science would demonstrate that the therapies are worthless or that there are synthetic alternatives, that the march of the tiger and rhino towards oblivion would be halted.
Homeopathy
Water is an increasingly precious resource in the world, and will become even more so as the glacier melt that provides water to large numbers of people disappear with the glaciers. I have read that future wars in the mideast may be over water not oil.
It takes a lot of water to make a homeopathic concoction.
I love this quote, from the Australian Councils Against Health Care Fraud
“Homeopathic vaccines – (A) little bottle of water contains what the label describes as a homeopathic vaccine against meningococcal disease. As if that lie is not enough, the label also contains a claim which puts the product in breach of consumer protection and fair trading laws. It says that this preparation is “200C”, but if that is the case then the manufacture of this single bottle would have involved 800 manufacturing steps (excluding packaging) and would have produced 495 litres of waste water. (To produce a single year’s worth of “vaccine” doses would require 73% of the water needed to produce all of the Coca Cola consumed in Australia in a year.)”
Evidently they drink a lot of Coke down under. To make one 200C vial of meningococcal vaccine would take as much water as a 50 minute shower with a low flow shower head. That is a lot of wasted water (17). Multiply that by the hundreds of different homeopathic concoctions and you have an enormous amount of water being wasted for no purpose.
It is a moral-ethical question as to where your responsibility ends. We recycle in part because there is a sense that we are responsible for our garbage even after we have thrown it away. A similar sense of responsibility is lacking for our carbon footprint, but growing. I am old enough to remember more politically active times, when one did not eat California grapes or Nestles chocolate because to do so was to support a companies that were ‘evil’. In part I have accepted nothing, not even a piece of pizza, from a drug company in over 25 years because half of drug costs go to support advertising. My patients subsidize the cost of my ‘free’ pizza and I think it is not ethical for my patients to pay more for medications so I can get a free pen or other trash to add to the landfill. Everyone will draw the line as to where their responsibility ends at a different place.
The bumper sticker reads “Think globally, act locally”. Want to help rhinos and tigers and bears? Don’t support the practices that are driving them to extinction. Support your local traditional Chinese practitioner and you may be inadvertently supporting the extinction of numerous animal and plant species as well as doing nothing to promote your own health.
The harm of medical woo can extend beyond the damage we do to ourselves and others. It can lead to extinction. As Clint said, “Its a hell of thing to kill a species.”
Just don’t bring up the plane flight to the SBM conference.
—–
Thanks to my colleagues, esp Dr. Atwood, who covered spot my two weeks ago when I was ill.
(1)http://209.85.173.132/search?q=cache:U648KL9qCKcJ:www.biaza.org.uk/public/images/campaigns/rhinoDocs/chinese.pdf+rhino+horn+aphrodisiac&hl=en&ct=clnk&cd=12&gl=us
(2) http://entertainment.timesonline.co.uk/tol/arts_and_entertainment/article378490.ece
2a) http://www.american.edu/TED/rhinoblk.htm
(3) <sarcasm></sarcasm >
(4) http://news.bbc.co.uk/1/hi/special_report/1998/chinese_new_year/50218.stm
(5) http://www.environment.gov.au/biodiversity/trade-use/publications/symposium/tiger.html#materia
(6) http://www.independent.co.uk/news/science/the-bear-bile-cure-539187.html
(7) http://www.itmonline.org/arts/turtles.htm
(8) http://www.taipeitimes.com/News/feat/archives/2003/06/24/2003056592
(9) http://advocacy.britannica.com/blog/advocacy/2008/11/708/
(10) http://www.telegraph.co.uk/earth/earthnews/3336945/Berlin-Zoo-director-accused-of-selling-animals-for-Chinese-medicine.html
(11) http://bigcatrescue.blogspot.com/2007/02/clouded-leopard-parts-used-in-chinese.html
(12) http://chinesemedicinenews.com/2008/01/19/medical-plants-face-extinction-magnolia-included
(13) www.traffic.org/species-reports/traffic_species_mammals14.pdf
(14) http://www.hsus.org/wildlife/issues_facing_wildlife/wildlife_trade/the_unbearable_trade_in_bear_parts_and_bile/
(15) http://www.ethnobiomed.com/content/5/1/2
(16) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0001-37652005000100004&lng=en&nrm=iso&tlng=en
(17) It has been suggested by others that, given the vast quantities of water needed to make homeopathic concoctions, perhaps they are not really making the preparations with the dilutions like they say they are. In Portland water bills are public knowledge and every year the local paper publishes the top 10 water users. We do not have a homeopathic factory in the city, but might I suggest that if you have one in your city, get the water bill and see how much water they use and compare it to the homeopathic concoction production.