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'[EE]:: 13 observed things that do not make scienti'
2007\02\08@073612 by Russell McMahon

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New Scientist March 2005
Well worth a read. Interesting in their own right and sharing a common
lesson,
13 observed phenomena that appear to be real and that appear to
contradict relevant scientific "received truth".

       http://space.newscientist.com/article.ns?id=mg18524911.600

Includes placebo effect (specific interesting cases), dark matter /
energy, changing physical "constants", incoming cosmic rays which
(impossibly") exceed the GZK energy limit,  tetraneutrons,
unidentifiable force affecting Pioneer spacecraft trajectories, the
Kuiper cliff - but, where is planet X, cold fusion is back AND
respectable to the point of being DOD fundable, ... .

Apart from their interest for their own sakes many of these are of
interest for the light they throw on what we know, what we find we
don't know, how we decide what we think we know and similar. Applying
the lessons from these disciplines to other areas of 'science' where
dogma rules supreme and thinking is essentially forbidden could be
valuable. "*KNOWING* that we know" in any area, when, of course, we
don't, has been shown time and again to be a sure way of not growing
in knowledge. It still seems to happen though :-).


       Russell


2007\02\08@111713 by Stephen R Phillips

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--- Russell McMahon <spam_OUTapptechTakeThisOuTspamparadise.net.nz> wrote:

> New Scientist March 2005
> Well worth a read. Interesting in their own right and sharing a
> common
> lesson,
> 13 observed phenomena that appear to be real and that appear to
> contradict relevant scientific "received truth".
>
I've only had troubles with science when it ceased to be used as a tool
and became a religion. ;)

Stephen R. Phillips was here
Please be advised what was said may be absolutely wrong, and hereby this disclaimer follows.  I reserve the right to be wrong and admit it in front of the entire world.



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2007\02\09@080750 by Gerhard Fiedler

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Russell McMahon wrote:

> Includes placebo effect (specific interesting cases),

If we (collectively) spent only 10% of the efforts spent on (sellable)
drugs on the placebo effect (and other "cheap" methods), I think the
financial crises in the various health systems wouldn't exist.

It's unbelievable how much effort gets spent on /avoiding/ placebo effects,
compared to /creating/ them. This is putting the Hippocratic oath upside
down...

I bet the side effects and dependency problems of saline solution are
easier to deal with than the ones of morphine... let alone the legal
problems.

Goes right on to homeopathy:

> No homeopathic remedy has ever been shown to work in a large randomised
> placebo-controlled clinical trial.

"Placebo-controlled" is the keyword here: in this logic, if something works
similarly to a placebo, it's considered "not working". But it's known that
placebos work (even though we don't know exactly how). Am I the only one
seeing a logical fallacy here?

Add to that the very basic, principal problem in applying the scientific
method to human health issues, and we see right were science became some
sort of belief system (rather than a tool with limitations).

Gerhard

2007\02\09@082150 by Paul Anderson

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On 2/9/07, Gerhard Fiedler <.....listsKILLspamspam@spam@connectionbrazil.com> wrote:
>
>
> "Placebo-controlled" is the keyword here: in this logic, if something works
> similarly to a placebo, it's considered "not working". But it's known that
> placebos work (even though we don't know exactly how). Am I the only one
> seeing a logical fallacy here?
>
There is a key problem.  Placebos are unpredictable, real medicine is
far more predictable in it's behaviour.  With a placebo, you can't sit
down with the patient and tell them what to expect.  Whether it works
or not is pure chance.

> Add to that the very basic, principal problem in applying the scientific
> method to human health issues, and we see right were science became some
> sort of belief system (rather than a tool with limitations).
>
I really don't understand your meaning.  What is the problem of
applying the scientific method to biology?


--
Paul Anderson
VE3HOP
wackyvorlonspamKILLspamgmail.com
http://www.oldschoolhacker.com
"May the electromotive force be with you."

2007\02\09@090338 by Tony Smith

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> > Add to that the very basic, principal problem in applying the
> > scientific method to human health issues, and we see right were
> > science became some sort of belief system (rather than a
> tool with limitations).
> >
> I really don't understand your meaning.  What is the problem
> of applying the scientific method to biology?


True, just because we don't know doesn't make it unknowable.  

I'll happily believe something until someone points out that it's wrong (and
has a good case).  I guess I'm supposed to go on believing...

It's a bit like the continental drift theory that came up a while back.
Nutter comes up with theory, gets ignored, eventually gets his case across,
everyone say 'fair enough', books get re-written, and now we wait for the
next nutter.  I'm not sure it counts as belief if you change your mind.

Tony

2007\02\09@094423 by Timothy J. Weber

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Paul Anderson wrote:
> On 2/9/07, Gerhard Fiedler <.....listsKILLspamspam.....connectionbrazil.com> wrote:
>> Add to that the very basic, principal problem in applying the scientific
>> method to human health issues, and we see right were science became some
>> sort of belief system (rather than a tool with limitations).
>>
> I really don't understand your meaning.  What is the problem of
> applying the scientific method to biology?

I don't know what Gerhard meant, but to me, the problem is that science
seeks general laws, while human health depends on individual circumstances.

Or: A scientific approach to medicine relies on statistics - what
treatment produces a beneficial effect in a substantial percentage of a
population while producing harmful effects in a small percentage of a
population.  But a single person represents a very complex system, and
it's generally difficult to predict what the effects of a given
treatment will be on that complex system.  You can predict what the
*average* effect will be, or what the effect *usually* will be, but not
what the *specific* effect will be this time.

Medical science has already plucked a lot of low-hanging fruit, and so
we're all grateful for pain-killers, first aid, sterile surgical
techniques, antibiotics, vaccines, etc.

But a lot of the problems we're left with are complex systems problems,
which don't respond well to the scientific tendency to analyze and
factor out.  E.g., John Doe keeps getting sick, and lots of drugs have
been tried to no avail, or they've made it worse, or perhaps caused it,
and either nobody can name the problem or they call it "Doe's Syndrome"
but don't know what can be done about it.

I know at least four people who fall into that category, with either
life-threatening or significantly debilitating conditions.

Now, you could say that just shows there are areas science hasn't yet
figured out; it doesn't mean it's broken.

But I think some of these complex-individual-systems problems won't ever
be solved by science, because they're simply not amenable to
large-scale, long-term studies.  I.e., you'll never know what
specifically was wrong with John Doe, and unless there is a sufficiently
large population with identical symptoms, you may never even recognize a
pattern.  The anomalies just fall through the cracks.

"The plural of anecdote is not data" is an essential scientific
aphorism.  So what do you do if all you have is one anecdote?  How do
you perform a controlled study on one subject?
--
Timothy J. Weber
http://timothyweber.org

2007\02\09@095605 by D. Jay Newman

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> "Placebo-controlled" is the keyword here: in this logic, if something works
> similarly to a placebo, it's considered "not working". But it's known that
> placebos work (even though we don't know exactly how). Am I the only one
> seeing a logical fallacy here?

Placebos work on some people some time. And if something works only as good
as a placebo, then give people the placebo rather than the drug.

> Add to that the very basic, principal problem in applying the scientific
> method to human health issues, and we see right were science became some
> sort of belief system (rather than a tool with limitations).

What are the problems with applying the scientific method to human
health issue?

The scientific method is and extremely simple and powerful tool. Yes, you
have to make more difficult hypothesis when you are talking about complex
systems, but the scientific method is still the best we have. Perhaps there
are better ways out there, but I don't know of any.

> Gerhard
--
D. Jay Newman           ! Author of: _Linux Robotics: Building Smarter Robots_
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2007\02\09@111405 by Paul Hutchinson

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> -----Original Message-----
> From: piclist-bouncesspamspam_OUTmit.edu On Behalf Of Gerhard Fiedler
> Sent: Friday, February 09, 2007 8:07 AM
>
<snip>
> placebo effects,

I found this recent placebo article very informative:
http://www.theness.com/neurologicablog/default.asp?Display=33

Paul

<snip>

2007\02\09@151638 by peter green

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> If we (collectively) spent only 10% of the efforts spent on (sellable)
> drugs on the placebo effect (and other "cheap" methods), I think the
> financial crises in the various health systems wouldn't exist.
>
> It's unbelievable how much effort gets spent on /avoiding/
> placebo effects,
> compared to /creating/ them. This is putting the Hippocratic oath upside
> down...
placebos create a tricky moral situation.

essentially we have discovered that patients get better to some degree if we lie to them in a certain way (that is essentially what a placebo is), that puts principles of honesty directly against principles of helping the patient.





2007\02\09@154713 by William Chops Westfield

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On Feb 9, 2007, at 6:39 AM, D. Jay Newman wrote:
>
> What are the problems with applying the scientific method to human
> health issue?
>
The basic problem seems to be in the assumption that test subjects
are nearly identical, when it becomes increasingly clear that there's
tremendous variations between individuals when it comes to things like
the body's reaction to diseases and/or drugs...

BillW

2007\02\09@161647 by Russell McMahon

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> placebos create a tricky moral situation.

> essentially we have discovered that patients get better to some
> degree if we lie to them in a certain way (that is essentially what
> a placebo is), that puts principles of honesty directly against
> principles of helping the patient.

It's even harder than that.
A placebo is apparently NOT a lie - rather it's something which has  a
variable  effect that doesn't work the same way as "conventional"
drugs do. Traditionally the placebo was seen as working on the mind by
a different channel than drugs, which also work on the mind. However,
the article I referred to not only showed that placebo administered on
the last day of a morphine pain relief course instead of morphine
worked just as well *BUT* that when a morphine inhibitor was included
which would have stopped Morphine working, then the placebo also then
failed to work. If that test was done double blind, or even well
controlled single blind, then it suggests that summat's happening.

As a spoiler, and to show how careful you have to be with such things,
double blind or not: My wife's notes that when she was given morphine
for pain, it took several days after the end of the course for the
effects to disappear. This is not what she experiences with other
'pain killers' such as panadol/acetaminophen whose effects are falling
off badly at 4 hours and utterly gone at 8 hours.




           Russell


2007\02\09@162816 by D. Jay Newman

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> On Feb 9, 2007, at 6:39 AM, D. Jay Newman wrote:
> >
> > What are the problems with applying the scientific method to human
> > health issue?
> >
> The basic problem seems to be in the assumption that test subjects
> are nearly identical, when it becomes increasingly clear that there's
> tremendous variations between individuals when it comes to things like
> the body's reaction to diseases and/or drugs...
>
> BillW

This is why I stated that the hypothesis is more difficult in such
studies. In many cases statistical studies must be made of large
groups of subjects. By doing this it is possible to test a hypothesis
to a given degree of precision.

Medical studies are generally *not* easy.
--
D. Jay Newman           ! Author of: _Linux Robotics: Building Smarter Robots_
                       !
@spam@jayKILLspamspamsprucegrove.com     ! "Those who would give up essential liberty to
                       ! purchase a little temporary safety deserve neither
http://enerd.ws/robots  ! liberty nor safety." -- Benjamin Franklin

2007\02\09@173335 by Timothy Weber

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D. Jay Newman wrote:
> This is why I stated that the hypothesis is more difficult in such
> studies. In many cases statistical studies must be made of large
> groups of subjects. By doing this it is possible to test a hypothesis
> to a given degree of precision.
>
> Medical studies are generally *not* easy.

What if the number of potential test subjects in the world is smaller
than the number required for statistical significance?

What if it's one?

I think an increasing fraction of the medical problems we'd like to
solve are looking like that.
--
Timothy J. Weber
http://timothyweber.org

2007\02\09@175137 by D. Jay Newman

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> D. Jay Newman wrote:
> > This is why I stated that the hypothesis is more difficult in such
> > studies. In many cases statistical studies must be made of large
> > groups of subjects. By doing this it is possible to test a hypothesis
> > to a given degree of precision.
> >
> > Medical studies are generally *not* easy.
>
> What if the number of potential test subjects in the world is smaller
> than the number required for statistical significance?
>
> What if it's one?
>
> I think an increasing fraction of the medical problems we'd like to
> solve are looking like that.

Trust me, I know this.

Unfortunately then we are down to modeling and our models aren't good
enough yet.

The scientific method is a tool. It cannot be used in all cases because
of the above difficulties. Once we get a better model of how biology
works, then we can use the scientific method to deal with one-offs.
--
D. Jay Newman           ! Author of: _Linux Robotics: Building Smarter Robots_
                       !
KILLspamjayKILLspamspamsprucegrove.com     ! "Those who would give up essential liberty to
                       ! purchase a little temporary safety deserve neither
http://enerd.ws/robots  ! liberty nor safety." -- Benjamin Franklin

2007\02\09@180809 by Tony Smith

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> > What are the problems with applying the scientific method to human
> > health issue?
> >
> The basic problem seems to be in the assumption that test
> subjects are nearly identical, when it becomes increasingly
> clear that there's tremendous variations between individuals
> when it comes to things like the body's reaction to diseases
> and/or drugs...
>
> BillW


That's ok.  Just increase your test base (ie more people) and assume it
averages out.  The more the merrier (bar the outliers, they may be unhappy).

Tony

2007\02\09@184824 by Russell McMahon

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>> > What are the problems with applying the scientific method to
>> > human
>> > health issue?

>> The basic problem seems to be in the assumption that test
>> subjects are nearly identical, ...

> That's ok.  Just increase your test base (ie more people) and assume
> it
> averages out.  The more the merrier (bar the outliers, they may be
> unhappy).

That's the exact issue which prior posters are commenting on.
"Statistical significance"is generally taken as starting around 2
standard deviations or about 2% in each tail (although you can draw
some good conclusions at lower confidence levels than that (and the
latest sweep all before it Global Warming report is based on a 10%
level !!!!) .

With a sample of 1 million people and 2% in one "tail" (and assuming
that the 2% in the other tail are uproariously happy at how well THEIR
system responds to a given drug, that eating excess carbs make them
thinner and that smoking decreases their cancer risk, then that's
10,000 very unhappy people that the results are unrepresentative for.
In the whole of the US that's about 3 million very unhappy people. And
in the world that's about 200 million very unhappy people.

As you fix the "easy" problems and turn to the hard ones you meet the
unrepresentative people, and if that happens to include 'you and
yours' you are not going to be at all happy with a statistical
treatment.

My wife recently contracted giardia* (probably from a suspect water
supply while camping at new year).
((* Giardia is an amoeba that is transmitted via water supplies and
unsanitary conditions and that gives you a far better than average
case of upset stomach and worse).

After several weeks she was finally diagnosed as having giardia and
given a stiff course of Metranidazol antibiotic. Bad call !!!!!!!!!!!
Her immune system was apparently exceptionally effective and doing a
good job of attacking the giardia. The metrnidazol killed the
remaining giardia and her immune system, robbed of its enemy and with
its systems running on full blast,  went on a rampage and attacked ALL
her major muscles. It's now been weeks since that happened and the
excruciating pain is slowly subsiding but still very hard to face. In
time, we are told, it will fade away a the body finally works out that
it is not its own enemy. Some people are not so "lucky" and end up
with this condition for life. Fortunately, this sort of reaction
appears to be well out in the tail of standard responses - but the std
"take two aspirin and call me in the morning" approach doesn't help at
all in such extreme circumstances. In this case, nothing much else
helps either, but at least it seems like it will come right by itself.


       Russell




2007\02\09@201447 by Tony Smith

picon face
{Quote hidden}

And the alternative?  Everyone unhappy?

As you initially pointed out, some bits of biology don't really make sense.
Until they do, we're stuck with rounding up as many guinea pigs as possible
to see what happens.

I've had diseases for which there isn't a cure (hepatitis-A) besides 'go
home for a month' and other conditions (epilepsy & migraines) where 'this
may or may not work'.  

I have found a migraine drug that 'sorta works'; it take the edge off the
migraine but has side effects in my case.  One was described as 'nasal
irritation', which I guess really means 'you'll bleed like a stuck pig in
your sleep'.  In that case, I'll wear the side effects.  If anyone out there
gets migraines as well, you'll know waking up covering in blood is pretty
trivial in comparison.

Amusingly, one drug had listed 'may cause headaches & nausea'.

Tony

2007\02\09@201843 by Timothy J. Weber

face picon face
D. Jay Newman wrote:
>> I think an increasing fraction of the medical problems we'd like to
>> solve are looking like that.
>
> Trust me, I know this.
>
> Unfortunately then we are down to modeling and our models aren't good
> enough yet.
>
> The scientific method is a tool. It cannot be used in all cases because
> of the above difficulties. Once we get a better model of how biology
> works, then we can use the scientific method to deal with one-offs.

Agreed.  I'm not saying it's a bad tool, just that it's not helpful with
these problems right now, and we don't have a good alternative.
Probably modeling *is* the best alternative, but it's hard too.

I always think of Dr. McCoy in Star Trek IV, visiting a 20th-century
hospital: "This is the dark ages!  They're CUTTING PEOPLE OPEN in there,
Jim!" (or so).  Someday we will know more.
--
Timothy J. Weber
http://timothyweber.org

2007\02\09@204941 by David VanHorn

picon face
>
>
> Amusingly, one drug had listed 'may cause headaches & nausea'.


Ambien, a sleep aid, says "May cause drowsiness".

I HOPE SO!!

:-P

2007\02\09@211457 by Paul Anderson

face picon face
On 2/9/07, Russell McMahon <RemoveMEapptechTakeThisOuTspamparadise.net.nz> wrote:
>
>
> As you fix the "easy" problems and turn to the hard ones you meet the
> unrepresentative people, and if that happens to include 'you and
> yours' you are not going to be at all happy with a statistical
> treatment.
>
It's only statistical because we still have a poor understanding of
the biology involved.  This is rapidly improving, and has been over
the long term.  We're a long way ahead of the days of Galen, who
thought that women had two wombs, one for male children and the other
for female.  The scientific method is key in determining how the body
works, and as our understanding progresses healing the body becomes
more and more analagous to repairing any other machine.

>
> Her immune system was apparently exceptionally effective and doing a
> good job of attacking the giardia.
>
I honestly have to question this statement, though.  If her immune
system was being exceptionally effective, then why was she still
suffering from it?  I can't help but expect that if this is the case,
a visit to the doctor wouldn't have been necessary.

> The metrnidazol killed the
> remaining giardia and her immune system, robbed of its enemy and with
> its systems running on full blast,  went on a rampage and attacked ALL
> her major muscles.
>
I admit my knowledge of the biology is limited.  I have heard similar
notions mentioned before, including the idea that an antibiotic
*kills* the immune system.  I must confess that I have never
understood how this is supposed to work.  While the analogy on the
surface seems sensible, what little I've read on the subject would
seem to indicate that it doesn't bear scrutiny.  I would very much
appreciate comment from anyone on the list who has more insight.



--
Paul Anderson
VE3HOP
spamBeGonewackyvorlonspamBeGonespamgmail.com
http://www.oldschoolhacker.com
"May the electromotive force be with you."

2007\02\09@222236 by D. Jay Newman

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> > Amusingly, one drug had listed 'may cause headaches & nausea'.
>
> Ambien, a sleep aid, says "May cause drowsiness".
>
> I HOPE SO!!

Ambien can be nasty. If you don't get 8 hours of sleep it can cause some
pretty nasty side effects.

In my experience, all drugs have the following side effects: nausea,
constipation, diarhea, headaches, and the exact opposite of what the effect
is supposed to be.

Of course, a common drug, clonazepam (a relative a Vallium) has two possible
side effects that would be annoying in combination: impotance and increased
sexual desire. :)
--
D. Jay Newman           ! Author of: _Linux Robotics: Building Smarter Robots_
                       !
TakeThisOuTjayEraseMEspamspam_OUTsprucegrove.com     ! "Those who would give up essential liberty to
                       ! purchase a little temporary safety deserve neither
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2007\02\09@222434 by Russell McMahon

face
flavicon
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>> Her immune system was apparently exceptionally effective and doing
>> a
>> good job of attacking the giardia.

> I honestly have to question this statement, though.

We paid $250 for that opinion :-).
That's $NZ but in spending power about the same as $US250 in the US.
Hopefully we got what we paid for :-).
Our doctor basically said take painkillers and it will probably get
better.
The specialist said "This is what has happened" (as above) take
painkillers and it will probably get better.
However, he did also go through the various blood test results and
explain how they helped j\him arrive at his conclusion and also
explained why he thought that in this case it would probably get
better and not instead trn into something like fibromyalgia.
Fibromyalgia is essentially just long term persistent pain that has no
other medical label that suits. Having it tends to lead to you being
viewed as a faker and a nut case by some people. Alas, this doesn't
make the all too real pain go away.

> If her immune
> system was being exceptionally effective, then why was she still
> suffering from it?

Giardia is not a trivial bug to combat. It gives you diaorhea par
excellence, significant discimfort and pain and, left to its own
devices, you can have it for literally months. Most people do NOT
manage to shake it off themselves or combat it effectively without
antibiotic. It takes an above average response to it to get rid of it
promptly by oneself and here "prompt" is apparently measured in weeks
to a month rather than days. So ...

> I can't help but expect that if this is the case,
> a visit to the doctor wouldn't have been necessary.

Your prerspective is understandable but certainly doesn't have to be
correct, even though it may be. In her case she may have succeeded in
fighting it off. In her case, if I am to believe the man who we paid
$250 to,  she was doing better than most. Alas, it seems she still is.
He said that the muscle sheath on the major muscles is similar enough
genetically to giardia, and I do not know how true this is, that the
body on occasion 'mistakes' the two when things change suddenly. His
explanation fits the available informatuon well enough. It may be
totally wrong.

{Quote hidden}

That may happen, but it is not a "similar notion" to what is being
proped here but something entirely different.

> I  must confess that I have never
> understood how this is supposed to work.  While the analogy on the
> surface seems sensible, what little I've read on the subject would
> seem to indicate that it doesn't bear scrutiny.

As you have two totally different examples I'm not sure which yiu are
referring to. The antibiotic kills the bug version makes total sense
to me - even if ut has no basis in fact :-).

>I would very much
> appreciate comment from anyone on the list who has more insight.

Consider the above a layman's proxy reply for the specialist we saw.



       Russell

2007\02\09@225912 by Jake Anderson

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>  
>> The metrnidazol killed the
>> remaining giardia and her immune system, robbed of its enemy and with
>> its systems running on full blast,  went on a rampage and attacked ALL
>> her major muscles.
>>
>>    
> I admit my knowledge of the biology is limited.  I have heard similar
> notions mentioned before, including the idea that an antibiotic
> *kills* the immune system.  I must confess that I have never
> understood how this is supposed to work.  While the analogy on the
> surface seems sensible, what little I've read on the subject would
> seem to indicate that it doesn't bear scrutiny.  I would very much
> appreciate comment from anyone on the list who has more insight.
>
>
>
>  

I think you missed a comma here.
The antibotic killed the bug and then without that bug her immune system
went on to attack the body.
The antibiotic did *not* "kill" the immune system.


@Russell, Hope your wife feels better soon. If she is having problems
with the painkillers (or doesn't like using them long term on principle)
think about hypnosis. My "Better half" got RSI in her right arm and it
flares up from time to time. Once the pain has started and she realises
"oh hey this actually hurts i should probably stop doing it" We use
hypnosis to remove the sensation of pain. Taking care that they know its
damaged and if she does anything else to injure it then that will still
hurt. We find her recovery to be much quicker without the pain. I think
its because when a muscle hurts the body tries to protect it by tensing
it up, limiting blood flow and the like (doesn't help when you cant
sleep either).

2007\02\10@081355 by Gerhard Fiedler

picon face
Paul Anderson wrote:

>> "Placebo-controlled" is the keyword here: in this logic, if something
>> works similarly to a placebo, it's considered "not working". But it's
>> known that placebos work (even though we don't know exactly how). Am I
>> the only one seeing a logical fallacy here?
>>
> There is a key problem.  Placebos are unpredictable, real medicine is far
> more predictable in it's behaviour.  

Since we don't know yet much about the placebo effect, how can you say that
it is unpredictable? Could it not be that we just don't understand it well
enough to make it more predictable? At some point possibly more so than the
confirmedly quite unpredictable drugs?

If you ever have read the list of possible (undesired) side effects of most
medications, you wouldn't say that there is a lot "predictable". Give a
drug to thousand "subjects" and try to predict the outcome -- not the
general direction, but a /prediction/ in the sense we expect it in science.
I doubt there would be a high correlation between predictions and reality.


> I really don't understand your meaning.  What is the problem of
> applying the scientific method to biology?

I'm not talking about biology (I never even used this term), I'm talking
about medicine, about health of humans. I'm also not saying that there
aren't a large number of good and powerful applications of scientific
medicine. I'm just trying to point out that there are some limitations to
it that stem from the scientific principle.

Some have already been mentioned. But there's more. Health, for me, is
about me feeling healthy. It is not about the population of my
area/country/the world being to 83% free of certain symptoms. I'm
reasonably certain that I share this with most.

Scientific medicine is pretty much exclusively about statistics. But I
don't really care if a certain treatment only works in 1% of the cases and
therefore is dismissed by scientific medicine as not relevant because its
effectiveness can't be differentiated from statistical noise -- if it works
for me. Who's to say that it doesn't work in 1% and that I'm not part of
those 1%? Definitely not statistical medicine. What I expect of a health
professional is that he knows his statistics, but that she also can get a
notion of the individuality (at which point she isn't a scientist anymore
and starts to become a healer).

Then there's the "falsify by experiment" aspect of science. When was the
last time we did large scale controlled experiments with humans regarding
health? I'm not talking about studies, I'm talking about experiments.
Controlling all relevant conditions we know of, just like we do it with
electronics, physics, etc. The answer is: we don't do that. So where's the
science when the method is not being applied? We only apply it to
/biology/: to subsets of the human, to tissues, to cells and so on. We
don't apply it to the whole. Accordingly, we have a lot of scientific
knowledge about the parts, but very little about the whole. But it's that
whole that wants to be healthy. Healthy tissues definitely help with that,
but it doesn't stop there. (And one man's healthy tissue may be another
man's problem area...)

There's another thing that hasn't been mentioned so far. Health != biology.
There's much more to health than biology (and science in general) claim to
cover. Health is also about /feeling/ healthy. Part of that is a certain
absence of known diseases and ailments, and scientific medicine can help a
lot with that. But this is not all. It's well-known (probably even
"scientifically" confirmed by studies) that happier people are more healthy
on average (everything else being equal), but when was the last time a
health professional you consulted focussed on this? Are there scientific
methods to become happier? If it has an influence, it should be part of the
equation -- and it can't be. Nobody claimed yet that science is about
happiness.

How do you measure "health"? If we want to talk scientifically about
health, we have first to define what it is, and then how to measure it.
After more than a century (two?) of "scientific medicine", this hasn't been
done. There's a reason for this: it is impossible, because it is not part
of the scientific domain. Which is my point.

There's still more. We are, in medicine, to observe ourselves. That's by
definition subjective. That's different from science, where we assume that
we can observe objectively. Statistical medicine tries to work around this
with double-blind studies, by "objectivizing" diseases into symptom
clusters, but nothing can work around the fact that one human observes
another human and that many ailments are highly subjective. As far as
tissues etc. go, this can be made objective, to some degree, but not as far
as "humanness" goes -- anything "human" has to be taken out for it to get a
semblance of objectivity. I for one don't want to reduce my health to
everything non-human.

(I won't get into the distortions that the huge amounts of money create
that get burned on "health issues" that have a potential to make more
money. Health is not about making money -- but the "health system" is,
mostly. And so is most of scientific medicine. Methods that don't show a
potential to make money generally don't get pursued very eagerly by the
industry. Placebos is such a case, to get back to the initial argument.
This is understandable, but shows that healthy humans is not a primary goal
of scientific medicine. It's actually something that they very much try to
avoid. A generally healthy humanity would put a whole industry -- one of
the biggest -- out of business; unless, of course, they can make money out
of it, somehow. So far they only have figured how to make money from people
who feel sick. Guess what their goal is? When you want to understand how
things work, follow the money, they say -- that's not different here.)


The argument that it's just more time that is needed doesn't address any of
the principle shortcomings of scientific/statistic medicine. Of course,
more time for scientific/statistical medicine will bring more advances in
the areas it covers -- but there's little chance it will bring advances in
the areas it doesn't cover /by principle/. There is nothing in the
scientific method that says that it will find an answer to /every/
question; that's not even part of science itself (as long as you don't make
a religion out of it). For me, there are a number of good arguments why
health of individual humans is only partially addressed by science. And by
definition, there's no scientific proof that this is wrong :)

Gerhard

2007\02\10@081917 by Gerhard Fiedler

picon face
peter green wrote:

> placebos create a tricky moral situation.
>
> essentially we have discovered that patients get better to some degree
> if we lie to them in a certain way (that is essentially what a placebo
> is),

Not necessarily. Often (usually, always?) people know that they are
participating in a study where a certain percentage gets placebos. They are
not being lied to.

> that puts principles of honesty directly against principles of
> helping the patient.

If the patient is being helped...?

In a broader sense, every experiment with humans, involving placebos or
not, creates a tricky moral situation. Most people would rather run the
risk to take a placebo than a new untested drug with unknown effects, where
nobody knows whether it helps the problem, or whether the side effects will
be far worse than the positive effects. Yet that is done also, regularly.

Gerhard

2007\02\10@100604 by peter green

flavicon
face

> Not necessarily. Often (usually, always?) people know that they are
> participating in a study where a certain percentage gets
> placebos. They are
> not being lied to.
right, thats ok the people know they are part of a study and have agreed that they may or may not be getting a placebo.

but what about when you go beyond the study? how do you propose to use placebos in the normal medical world without lieing to patients?


2007\02\10@114950 by Timothy J. Weber

face picon face
Gerhard Fiedler wrote:
> Some have already been mentioned. But there's more. Health, for me, is
> about me feeling healthy. It is not about the population of my
> area/country/the world being to 83% free of certain symptoms. I'm
> reasonably certain that I share this with most.

Well put.

> But this is not all. It's well-known (probably even
> "scientifically" confirmed by studies) that happier people are more healthy
> on average (everything else being equal), but when was the last time a
> health professional you consulted focussed on this? Are there scientific
> methods to become happier?

I think there may be... but they are usually called 'religions.'  Or,
perhaps, 'philosophies.'  And so we draw Venn diagram circles around
them and consider them separately.

(e.g., by noting that we may be passing out of the "EE" tag!)
--
Timothy J. Weber
http://timothyweber.org

2007\02\10@144400 by Gerhard Fiedler

picon face
peter green wrote:

> but what about when you go beyond the study? how do you propose to use
> placebos in the normal medical world without lieing to patients?

The placebo effect means basically that scientist have observed that
certain effects thought to be caused only by a certain drug can be caused
by "nothing more" than the person believing (or thinking, or whatever -- in
any case not by the drug). And this possibly without many of the side
effects of the actual drug (say, a diarrhea because the drug upsets the
stomach before it gets into the blood and does its thing).  

Studying this effect and learning to be able to cause it directly without
the placebo workaround, say by "only" believing, sounds to me like a very
worthy proposition. Obviously this is different for a drug company... The
patients would avoid the side effects, the drug company would stop making
money. That's where the two groups have different goals.

I don't see where lying comes in here, or where there is a tricky moral
situation.

Conversely, one could see a tricky moral situation (that we have come to
accept) in suggesting a medication where the possible side effects may be
so strong that they can be worse, and in some cases much worse, than the
original problem.

Gerhard

2007\02\10@151233 by peter green

flavicon
face

> I don't see where lying comes in here, or where there is a tricky moral
> situation.
how do you convince someone that something works when you and they both know full well its a sugar tablet with no direct affect?



2007\02\10@152106 by RJW

flavicon
face
geee this email was at first listed as coming from you and i was like WTF?

On Sat, 10 Feb 2007 12:11:40 -0800, peter green <RemoveMEplugwashspamTakeThisOuTp10link.net>  
wrote:

{Quote hidden}

--
Excuse me if I've forgotten to offend someone.

2007\02\10@212733 by Gerhard Fiedler

picon face
peter green wrote:

>> I don't see where lying comes in here, or where there is a tricky moral
>> situation.
> how do you convince someone that something works when you and they both
> know full well its a sugar tablet with no direct affect?

I'm not sure you really read my message. I never talked about a sugar
tablet. I never talked about something that does not have an effect. Does
"studying this effect and learning to be able to cause it directly without
the placebo workaround" ring a bell?

Who says that the placebo effect is not a "direct effect"? What is a
"direct effect", what is not a "direct effect"? And what is so good about a
"direct effect", and what is so bad about its contrary (whatever that is --
an "indirect effect", maybe)? Maybe taking a drug is a quite indirect
effect, as opposed to directly influence your own body, you all by
yourself?

You also seemed to have switched from a "tricky moral situation" to a
completely different problem. The questions around this are difficult
enough without jumping all over the place. We probably get somewhere more
efficiently if we stick to one question until it's finished, then move on
to the next...

(Besides, you convince them the same way you convince someone to take a
drug that may make him sick for a few days: it seems like the best option
at the time to the patient. Nobody is forced to take any medication, or
undergo any type of treatment.)

Gerhard

2007\02\11@032248 by Russell McMahon

face
flavicon
face
>> I don't see where lying comes in here, or where there is a tricky
>> moral
>> situation.

> how do you convince someone that something works when you and they
> both know full well its a sugar tablet with no direct affect?


"Direct effect" is an interesting concept here.

Valium is said to score close to placebo in well controlled trials.



           Russell

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