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Tuesday, June 18, 2013

Allopathic Medicine

Allopathic medicine is an expression commonly used by homeopaths and proponents of other forms of alternative medicine to refer to mainstream medical use of pharmacologically active agents or physical interventions to treat or suppress symptoms orpathophysiologic processes of diseases or conditions.

The ability to conduct blinded clinical trials comparing a diet and exercise interventions to pharmacological interventions is not possible. The paradigm of allopathic single cause disease research culminates in clinical trials that compare the effects of real or fake pharmaceutical products. The diet and exercise method of treating illness does not fit this model. Nonetheless, we have several extraordinary claims of diet and exercise being used to cure disease. What prevents us from scientifically designing experiments to compare behavioral changes in diet and exercise to pharmaceutical interventions?

Of course, the first thing to note is that there is no money in getting people to become and remain healthy. It would be like asking the oil industry to try and get us all to drive electric cars. That doesn't mean that there is no money in health. We know there is profit in sickness. That is where going down the wrong path, single cause witch hunts, can be best for sickness profiteers. There is a bias not only exhibited by pharmaceutical executives but among scientists as well. If you are going to have a career in biochemistry or medicine, wouldn't it be easier to spend it looking for single causes? Gene hunters and medicinal chemists alike need to live in a world where their efforts will one day be packaged into a pill and sold to the sick. What kind of a scientist then would want to learn more about health and how we can eat, drink and exercise our way in and out of it? 

The study of health, what constitutes a healthy person, has led us to set standards for blood pressure, cholesterol levels, blood cell counts, and so on.  Doctors from the dawn of time have claimed to have a superior knowledge on how to quantitate an individuals health. They put their patients through a battery of tests based on their complaints. The degree of their disease state is summed up which leads to the treatment plan. Currently that most often means pills will be prescribed. Using the scientific wisdom of the pharmaceutical industry, the doctors prescribe the dosage. If the patient gets sicker the dosage is changed. If they get better they stay the course. If they die they must have come too late. 

If doctors can make these kinds of assumptions, why can they not assess the efficacy of a change in ones diet and exercise? 

It comes back to the Drunk Under the Streetlight effect. Doctors and medical science have found the easiest place to look for answers. The complexity of the body and what happens when we eat fruits and vegetables versus Twinkies is too hard to follow. Instead we offer monoclonal antibodies and follow a small set of biomarkers. Much easier. Unfortunately, the answers they are coming up with are not making the population any healthier. Conversely, the fast food and lazy lifestyles are definitely having an adverse effect. Since food and drink is put into the body, just as pills are, why can we not quantitate their effects like we do drugs that have only a miniscule effect at best?

I once worked for a company that claimed their pill reduced tumor size by 57%. That is pretty specific. Why have we never seen a pill get rejected but the methods of evaluation get moved up the ladder? When this particular drug product, an antibody against denatured collagen IV, crashed and burned, so did the methodology of evaluating tumor reduction. It was as if they had created a special tool that only works on their widget. Yet cancer is not the property of any biotech/pharma company. Why so many different protocols? We somehow have come to the conclusion that the drug industry, in conjunction with the FDA, employs a scientific method. A method, by the way, that cannot evaluate diet and exercise change.

The people who advocate diet and exercise as medicine do not get the same respect because they are somehow different. They don't have a single cause/cure disease narrative. They simply claim that a disease state is most often entered into by poor behavioral choices and exited by making better choices. 
Much like a religion, the pharmaceutical industry and the FDA have decided on an easy to follow narratives when designing answers. Feynman on religion:

"God was invented to explain mystery. God is always invented to explain those things that you do not understand. Now, when you finally discover how something works, you get some laws which you're taking away from God; you don't need him anymore. But you need him for the other mysteries. So therefore you leave him to create the universe because we haven't figured that out yet; you need him for understanding those things which you don't believe the laws will explain, such as consciousness, or why you only live to a certain length of time -- life and death -- stuff like that. God is always associated with those things that you do not understand. Therefore I don't think that the laws can be considered to be like God because they have been figured out. "

We haven't figured out the complexities of the human body and how diet, exercise and pills truly alter the path of our health. So we have the pharmaceutical industry that is based on taking the hard sciences of math, physics and chemistry into the soft scientific world of medicine. The foundation of the entire industry, one disease, one molecule, one metabolic pathway and one API, active pharmaceutical ingredient, is the doorway into which we enter the Cargo Cult Airport.

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