Is that a cart or a barrow that horse is pushing?

Large amounts of money are spent each year in Australia on “complementary” and “alternative” medicine. These words describe medicines which have not been proven to work, because medicines that have been properly tested and shown to be safe and efficacious are real medicines and not alternatives. One of the perennial claims of the alternative medicine industry is that there is no money to do testing (sales of snake oil in Australia each year are about the same as the value of Australia’s wine exports, and the wine industry can afford research). Another claim is that it is pointless to test anything which cannot be patented because nobody can make money selling anything which has no patent, a view which must be worrying to the companies which make, as an example, the generic paracetamol tablets I see in supermarkets.

Relief is now at hand for the impoverished alternative industry, because the Victorian government has announced a grant of $500,000 to help set up Australia’s first research centre for complementary and alternative medicines. (The press release used the word “complimentary”, so it is little wonder that there is no money for research if they give it away for free.). In announcing the grant, the Minister for Innovation, Mr John Brumby, said that “the new centre would assist research into the toxicity, quality and efficacy of treatments such as Chinese medicine, Indian Ayurvedua, Arabic Unani, homeopathy and osteopathy”. He went on to say that the “effectiveness, safety and quality of most of these therapies is (sic) yet to be understood”.

At this point it would seem reasonable to ask why these things are being sold at all if there are all these unknown qualities. I mentioned paracetamol before. If this drug were to be invented today by a real pharmaceutical company, it is very doubtful whether it would ever get to market. The dosage at which it becomes dangerous is so close to the therapeutic dose that it probably would only be available on prescription, and then only if it could be shown to have advantages over existing dangerous pain killers like narcotics. The difference between real medicine and “alternative” medicine is that the pharmaceutical company would in fact do a whole lot of research and testing before even thinking about selling the chemical. In altworld, it is sufficient to just say that there is something which might cure something and therefore it should be sold. It is even better if some traditional use can be demonstrated, as if longevity is all that is necessary to prove efficacy. (It is usually about here in the conversation that skeptics mention astrology, but I will defy tradition and not do so.) An exotic name for the “medical” tradition is also helpful.

I have spent a lot of time looking at alternative medicines, but I have to be honest and admit that I had never come across the term “Arabic Unani” until I read it in the Minister’s press release. As this satisfies the “exotic name” criterion, I decided to investigate further. The first thing I found is that it is actually Greek, because the word “unani” means “Greek” in Arabic, and it is derived from the works of Hippocrates and Galen. For those who aren’t fully familiar with who’s who in medical research, Hippocrates lived in Greece between 460 and 390BC, and Galen lived in Rome between 129 and 199AD. Unani is based on the concept of humours, and its practitioners work on balancing the humours using such techniques as prodding reflex points (in the hands, feet and ears), prescribing herbs and sometimes pricking reflex points so that they bleed.

Unani is a perfect example of the difference between real and pretend medicine. Real medicine can also trace its roots back to Hippocrates and Galen, but it recognises that a lot has been learnt in the past two thousand years. Enormous amounts of time, effort and money have been spent to get to the point where we know that there is more to life than an interaction of blood, phlegm, choler and melancholy, even when these are enhanced by the life force which can be measured in the pulse. To spend even one cent on an attempt to validate what can only be described as ancient superstition can only be a waste of money.

Mr Brumby goes on to show that his government’s interest in alternative medicine may simply be pragmatic. He points out the possible economic benefits to his state of having an industry which can be a customer for herbal agricultural products. It is interesting to note that he talks about “increasing … market participation” rather than joining a market. It seems that the results of the research have already been decided.

It is ironic that the announcement of the grant should come in the same week as a coroner’s court in Melbourne was hearing a story about how the parents of a child with epilepsy stopped giving the child anti-convulsive medicine on the advice of a naturopath and an iridologist. Sometimes research into alternative medicine costs $500,000. Sometimes it costs a child’s life.

This article by Peter Bowditch appeared in the January/February 2004 edition of Australasian Science