> The authors behind the paper drawing connections between symptoms, proteins, and Chinese herbs are hopeful that their model will show which herbs used in TCM seem particularly promising. They claim that chemicals in some herbs are known to interact with the same proteins involved in a particular symptom, but that this herb-symptom association has so far been ignored by TCM practitioners. They give several examples, such as Aristolochia fangchi known colloquially as Fang Ji which, based on their computer work, could help with abdomen distention. Patients beware: that plant was used in the 1990s instead of the listed herb as part of a slimming regimen in Belgium, where it caused “an outbreak of terminal renal failure.” That is something that abstract maps of chemical interactions may not tell you, but we should not forget what we already know from experience.
My SO had to publish similar kinds of papers when she was in Vietnam - she also had to spend $4-6k in "gifts" for the members of her thesis defense committee (despite her earning a stipend of around $100/mo) and publish politically oriented papers otherwise some technicality would come up to prevent her from getting permission for further research in Japan on an ASEAN grant, and this was at Vietnam's equivalent of JHU.
There is a similar trend in India with Aryuveda/Unani.
The strategic and commercialized research that matters always aligns tends to align with modern medicine.
That said, folk medicine does have credence in a lot of Asia (even in China today) due to issues around access and trust. There is a need for mid-level practitioners, and working on mainstreaming and retraining folk medicine practitioners as MLPs could help from a primary care perspective, and is a strategy both China and India are starting to leverage.
It's such a big problem in Western academia that the political class in several countries are able to deny "experts", and their understandings.
People in general have seen so many missteps within Western academia, both allowing some really poor science to be published, and wrongly denying (and ridiculing) what turned out to be solid (thankfully some of these things are discovered when actual scientific method is employed and hypothesis are tested), that they are willing to accept politicians who deny science.
In Western and especially American academia, there are private sector grants and commercialization avenues for research. Outside of top tier programs (think Peking tier programs in China or AIIMS tier programs in India), that's nonexistent in most Asian countries, so your department's funding is at the whim of government bureaucrats who tend to be recruited via civil service exams and promoted based on political loyalty, not based on domain experience.
Furthermore, Folk Medicine programs are heavily sponsored in a number of Asian countries as a misguided attempt at building an MLP pipeline plus as a cash grab by local or provincial governments who often treat these kinds of programs as businesses.
This is sad, and misinformed.
Multiple countries fund their academic research through the state. Adding the misinformation about being "promoted based on political loyalty" is a strong sign of your bias.
Funding can only come through one of three routes:
1. State - which is where people are supposed to be working for the betterment of their country, but is vulnerable to the bias of the politics of the day.
2. Private - which is where people are motivated by a profit, but is vulnerable to the bias of the politics of the company.
3. Voluntary/Charity - which is where people are motivated by whatever wakes them up in the morning, but is vulnerable to the donors.
ALL funding models are vulnerable to the bias of whoever is in control of the funding.
I'm saying that having a mixture of both provides checks and balances to moderate the influence of both.
> Adding the misinformation about being "promoted based on political loyalty" is a strong sign of your bias
I'm talking about countries like China and India, where folk medicines have been politicized, lateral movement into the bureaucracy is non-existent, and criticism against TCM and Aryuveda is being slowly suffocated.
That's a bit surprising, after seeing so many people I know in academia who are basically being used as private sector R&D on the cheap (see all the formal methods work being funded by cryptocurrency outfits...), I would have assumed that most large corporations even outside of "innovation" sectors would take advantage of this.
But maybe this effect in places like the US are just downstream of the wild wage arbitrage you get by doing this.
Generally, those institutions managed by the central government of both countries are better managed than those under local and provincial governments.
R&D output, calibre of student base, and access to research equipment is also reflected by that trend. And any private sector funding goes to those programs.
And it's hard to describe the mismanagement that happens in lower tier programs in countries like China and India compared to the US - corruption remains a massive issue in both countries.
I mean, you could change some trivial details and end up with a valid description of JHU. How much is tuition in Vietnam? There're your "gifts". And so on. What language was "replication crisis" initially coined in? (No, for real, I don't know.)
Public medical school tuition is around $3-6k per year in a country where most households aren't earning above $300/mo, financial aid is nonexistent, and "student loans" for the middle class means going to some tattooed chain smoker jeweler who pounds Ruou San Dinh like water and demands double digit interest rates.
> you could change some trivial details and end up with a valid description of JHU
You don't have JHU students (or any Western medical students) moonlighting as unlicensed doctors under their professors working license and giving them a $200-500/mo cut. This is fairly common at UMP Hanoi and HCMC, let alone lower tier programs. You also don't need to pay a $1-3k bribe in speed money to get your working license in the US.
---------
There's a reason my SO immigrated abroad like a lot of her peers - if you don't have the right connections or enough money (black or white), you will not succeed in Vietnam.
Thao Dien, Landmark 81, Sunrise City, and D1 is not representative of middle class Vietnam - neighborhoods like D10 and Phu Nhuan is.
It might actually be worse. There's a strong religious/nationalist element to some Ayurvedic promoters in India which vociferously rejects any kind of scientific rigor - the attitude amounts to "if Western science says Ayurveda is wrong, Western science must be wrong". TCM doesn't seem to attract the same degree of dogmatism.
India's AYUSH Ministry (founded 2014) is itself based on China's NATCM and the formalization of TCM in the 60s-70s.
And just like in China, BAMS/BUMS is used as a stopgap MLP in rural and underserved communities the same way TCM is in China.
Both are holdovers from the anti-colonial movement of the 50-70s that continue to be cynically used as stopgaps for failures at expanding MLP in both countries, because no real doctor wants to work in a rural primary clinic earning $200-400/mo when they can demand 6-7x that working as a doctor in an urban area with superior amenities.
That said, I've started seeing much stronger criticism of AYUSH in India than the equivalent for TCM - AYUSH doctors are increasingly shown as "negative" or "antagonist" characters or quacks in most state subsidized TV shows in India, even in BJP ruled states (eg. Gram Chikitsalay (2025) and BJP ruled Madhya Pradesh and Chhattisgarh; Laakhon Mein Ek (2019) and BJP ruled Maharashtra; Panchayat (2025) and BJP ruled Madhya Pradesh and Uttar Pradesh) but recent CDramas like 你好，我的大夫 (2023) and 老中医 (2018) humanize and treat TCM as if it's not a quack field.
We then realized that our relationship was too stressful (many factors there), not working, it was making me completely miserable to a point my body was just noping out of life.
Imagine then: should I have taking antibiotics, Panadol, long consultations with specialist ? Or a bit of BS fake juice ? The problem was not solvable by medicine and the government would have had to pay for it - in fact it did since I took all those medications that did nothing much. So not even for the placebo effect, sometimes you're sick because of life (stress is really a sickness inducer) and no amount of pharmaceuticals will truly help you.
It'll be easy enough for them to manage from a perception standpoint. They'll just declare that modern medicine has recognized and assimilated the concepts of traditional Chinese medicine, that "modern" medicine as taught and practiced in the west now reflects traditional Chinese concepts, and that western medicine and traditional Chinese medicine have evolved convergently to the same point because western medicine copied Chinese medicine. It'll be accepted by people who know better as a polite lie.
The original appeal of traditional Chinese medicine to the Chinese government was that it made it possible for them to provide a form of officially recognized health care to the entire population long before they were able to train enough doctors. From the government's point of view, there's no reason for it to outlive that necessity. If they want a flood of chauvinistic pro-TCM propaganda to proclaim Chinese superiority -- maybe they do, maybe they don't -- they can do that while at the same time having schools of TCM teach basically the same thing as western medical schools.
They didn't always understand why this worked, and often attributed it to a lot of ideas that do sound like pseudo-science. But their experimentation was quite methodic.
This isn't ubiquitous. We're talking about thousands of practitioners, in dozens of cultures over millennia. I'm sure some simply sold Chinese snake oil.
From what I've seen of traditional Chinese medicine, it's about 98% nonsense and 2% home remedy like chicken soup for a cold.
In Ayurveda- Turmeric has medically validated anti inflammatory effects, exactly what it has been traditionally used for. Triphala for GI health, Boswell is for joint paint and arthritis, Neem as an antimicrobial, Arjuna for hypertension, Ashwagandha for anxiety etc.
There are a lot of these trial and error medications that do work. The ratio is definitely not 98:2, more along the lines of 70:30.
It's a kind of proto-clinical research, and without the methodological discipline of Randomized Control Trials (RCT), it's easy to draw the wrong conclusions from observations. Some observations with small effect sizes might be accepted as truth.
It's not that it doesn't work all the time, but that the conclusions are noisy.
(that said, RCT is not perfect either because the body is a complex variegated thing with feedback loops that we can't fully map, and many interventions have tail risks. But as far as principled approaches for getting at the truth go, RCT offers just one more guardrail against confirmation bias).
But TCM would have none of these, so no, it's not "due to bias".
I'm mainly referring on the nutritional and health benefits that the in-laws perceived if they were bought as souvenir a few thousands dollars worth of 1 kg ginseng as opposed to the equivalent of 1 kg ginger worth a few dollars [1],[2].
[1] Ginseng:
https://en.wikipedia.org/wiki/Ginseng
[2] Ginger:
During the Vietnamese resistance war, Vietnamese moving down the Ho Chi Minh rail were contracting malaria in the jungle. The Chinese were asked for aid, and Tu Youyou was tasked with assembling a team to help.
One thing Tu Youyou did was consult "traditional Chinese medicine" with how to aid victims of malaria. Most of what she found did not work, but wormwood did produce results. Tu Youyou again consulted traditional Chinese medicinal texts and they said wormwood should be used with cold water. The team extracted artemisinin from the wormwood in cold water, and a new (and old) way of fighting malaria was born.
If you take an idea with a pseudoscientific origin, and you test it in a sound scientific way, you're doing science, not pseudoscience.
TCM is interesting: There are countless different TCM preparations that do nearly nothing are can be actively harmful to the kidneys or liver, but every once in a while there is a a novel compound discovered in some plant somewhere that does something.
I can’t tell how much of this is because TCM has some treatments that actually work, or if it’s a case of a broken clock being right twice a day. I suspect it’s more of the latter.
Around me I see practices like "gratitude", "meditation" and "breathing exercises" get bandied around like they're some new profound thing as if we hadn't known about for thousands of years that have appeared in various guises universally throughout different civilisations.
Just because the metaphors and models of explanations could be flawed doesn't mean the effects should be thrown out
Edit: I have a good friend, a scientist no less, who suffered from severe eczema and was completely let down by western medicine who was put through decades of progressively stronger and stronger steroids. Nothing worked. Eventually the doctors gave up and shrugged their shoulders and was advised to give "alternative medicine" a go. Desperate my friend visited a traditional Chinese doctor who was prepared to guide them through a rigorous exclusion diet while also preparing mystery herb soup and suddenly a lifetime of eczema subsided and became very manageable.
The older I get the more determined I find myself trying to glean the accrued wisdom of people who came before us...
Most people don’t care where, when, or why a concept was invented as long as it works.
Quibbling over who discovered it first or trying to drag the conversation back to who discovered it first is like the person who tries to claim credit for being into a band before they were popular: Nobody cares, they just want to enjoy it.
> The older I get the more determined I find myself trying to glean the accrued wisdom of people who came before us...
Going back to the actual article: There is a big illusion of accrued wisdom of the ancients in TCM that isn’t backed up by the research. There are occasional hits where a TCM preparation intersects with a truly active compound, but it should be raising red flags when TCM practitioners claim to have cures for everything and different TCM practitioners will come up with different answers for the same patient. When the first one doesn’t work they’ll have another answer the next visit, and the next visit, and so on.
The human body is not just human DNA organs working together, but also an ecosystem with myriad bacteria, and we are still in infancy when it comes to understanding the bacteria.
TCM seeks a black box metaphorical approach, which sounds like quackery but I do think it is capable of addressing _some_ blindspots in modern medicine, eg why some medication would work on a yin body but not a yang body... the difference is in the bacterial ecosystem.
That said, I see TCM (and other traditional approaches) as a last resort when modern medicine fails, and I certainly agree the approach is incapable of resisting shamanic beliefs.
You have no problem accepting eg a treatment can only work on a man, but not on a woman. But modern medicine have no concept of a yin body type and a yang body type, which may or may not be male and female.
The whole idea of TCM is balance, and it varies with the individual, unlike modern medicine, where there is a right and wrong answer to everything. Bacteria bad, antibiotic good. Fever bad, paracetamol good.
Take fecal transplants for example. I dont think it is well understood how it works or it will be a pill by now, and is a last resort when all else fails. And it doesnt involve killing all the bacteria, but restoring balance to the bacterial ecosystem.
In people's zeal to point out TCM's problems (due to its pre-modern scientific roots), I feel like they're also throwing away its potential. Skepticism shouldn't be about wholesale dismissal (which is just intellectual laziness masked as rightenousness) but about improving outcomes.
You can also take some homeopathic remedies and do a couple of chiropractic adjustments meanwhile. I've also heard that some Christian Science practitioners work wonders if you give them all your Earthly belongings.
The ability to say: "It's likely a viral disease. Wait and see if it worsens" - is a pretty powerful point _in_ _favor_ of modern medicine.
Yet the inverse is not true: the prevailing attitude on HN here is not "western medicine is here to stay as staple but other practitions can add value on top", but to dismiss other practitions wholesale based on their inability to conform to intellectual standards, regardless of measurable outcomes. This is "my god is the only god" all over again.
A chiropractor was able to heal my back problems where months of going to a physiotherapist failed to do so. Aren't we supposed to stay humble and curious for new avenues of scientific exploration, rather than dismissing everything we don't understand?
That said, I fully agree homeopathy and chiropractherapy are full of bullshit and potentially dangerous. TCM, as practiced in a certified scholarly environment in Asia, expects the practitioner to have a considerable basic knowledge in modern medicine too, and is humble enough to acknowledge TCM cannot solve everything. A good TCM practitioner will refer you to a GP when they know modern medicine is more effective.
There are symptoms and idiopathic conditions I've had that multiple specialists at top-tier hospitals were unable to diagnose, but mostly because they were too-narrowminded in their approach (blood tests, etc.) to see the big picture.
The current medical paradigm has blind spots, and we should be humble enough to acknowledge that alternative perspectives, even if they're not as rigorous as we'd like, can give us chances to improve patient outcomes. Wholesale dismissal to the point of labeling TCM as "govt propaganda" is forsaking improved patient outcomes for the purpose of winning an argument based on intellectual purity.
There's a reason for that.
The prevailing attitude on HN is not to combine strengths, but to dismiss TCM wholesale based on intellectual purity and geopolitical alignment. This is not only willful dismissal of the potentential to improve patient outcomes, but also shuts down curiocity and starting points for new actual scientific discovery.
Whenever I see stuff about TCM being "vindicated" it's usually stuff like this, along the lines "we found a scientific basis for symptom X being alleviated by chemical C which is found in plant P and traditional medicine indeed suggests using P to treat X". And this article seems to basically be saying the same. Big whoop. It's no surprise that people over time figured out that certain plants might help with certain symptoms, and that later with better science we isolated the specific chemicals in those plants that drive such effects.
Saying this vindicates TCM is like saying chicken soup is vindicated as a cure for what ails you because it turns out that if you're sick it's good to get plenty of fluids and some protein from chicken and vitamins from vegetables.
What matters is not just whether something works, but how it works relative to alternatives, and what its cost/benefit ratio is. If you were living 1000 years ago maybe it made sense to chew willow bark or whatever, but now there's not really a reason to do that instead of just taking aspirin. If you want to eat extra garlic or whatever because it gives you a placebo effect, there's no harm in that, but if you're spending hundreds of dollars on bogus garlic supplements then maybe you're wasting your money.
There are a lot of folk remedies that are harmless in themselves, but their main harm comes when they induce people to reject real solutions.
Forget blind test, you can get 13 different perscriptions from 10 TCM doctors. I am not joking. During the pandemic, top-notch TCM scholars call Covid-19 warm-disease, another group categorize it as cold-disease. Some others name it wet-disease, they all came up with totally different "treatments", which basically boils down to dead bodies of insects and herbs.
But why do billions of ppl believe in TCM anyway? Because scientific medicine is hard, and does not cover 100% symptoms. AFAIK There isn't a effective cure against viruses like antibiotics. This market is dominated by pain-killers and "alt" medicines. And yes sometimes ppl refuse or forget to take vaccines.
E: A 100b (possibly multiple) industry doesn't hurt either, which is... shockingly large. I was going to joke people spend more on dumber things to feel good, but that's... a solid chunk of change.
How else can we foster trust that medicines are reliable?
Modern medicine was born by consolidating and empirically scrutinizing thousands of years of all sorts of medicine.
There is no such things as chinese physics, ayurvedic chemistry, traditional biolgy.
tkcranny•8h ago
—Tim Minchin
jxjnskkzxxhx•7h ago
atombender•7h ago
[1] https://youtu.be/KtYkyB35zkk?si=QfGJepREYJIlg3hd
rcxdude•6h ago
zaptheimpaler•6h ago
But it takes discernment to know which unproven thing might work and won't hurt though. TCM sounds more dangerous than not because the herbs you can get will be unregulated and possibly contaminated.
arp242•5h ago
I'm not familiar with the history of meditation or mindfulness, but I've seen people claim some pretty ridiculous things about yoga, perhaps the most ludicrous was someone claiming that some positions will prevent certain cancers due to "massaging your organs". Yoga absolutely has benefits but that's just nonsense.
rtpg•6h ago
Meanwhile if someone told me "yeah eating a bunch of ginger when you have a cold is good to you because ginger has a bunch of stuff that's good for your body then" I don't have a particularly hard time believing it. Sure! Why not!
The article's critique about symptom management rather than disease management is legit though. And the precision for actual research is good. But at the end of the day if my body needs some stuff for symptom management and some TCM strategy involves me giving myself like 20x the dose of it... well it's something, isn't it? Though you could argue about it "deserving" credit or not.
Nobody whines about the unscientificness of giving yourself a bunch of salt through chicken noodle soup after a hangover.
sorcerer-mar•6h ago
> well it's something, isn't it?
It's probably not!
If you want to say such remedies produce a placebo effect and that's sufficient for such purposes, IMO that's a valid approach.
rtpg•6h ago
In the abstract I'm open to some specific traditional medicine thing working for "some" reason, but I understand that that makes me (as they say in the industry) a mark.
sorcerer-mar•5h ago
It is absolutely possible to stumble upon things, as is often the origin of hypotheses that develop into drugs, but 99.999% of these will still end up being false.
It's way more likely you found a thing that convinces you it does something desirable in the body than that you actually found something that does something desirable in the body.
arp242•5h ago
Sure, but that doesn't come with an entire theory about Chi energy lines, and no one claims this is "medicine" either (other than perhaps jokingly).
That's really the key thing. If you want to get a massage, or aromatherapy, or Reiki or whatever just because you like it, then that's fine. I'm happy for you! Massages even have proven benefits. Some may have benefits that are not yet proven. If you start claiming it will cure your cancer however...
This is also why I don't buy "detox" drinks that some restaurants have, even though some of them seem quite nice. The "detox" is just bollocks. I once even saw "detox" coriander leaves in the store. I like coriander. Maybe it's even good for you (I don't know). But "detox" coriander? Just, ugh...
A_D_E_P_T•6h ago
Artemisinin (qinghaosu) from artemisia annua. This won the 2015 Nobel Prize, and is now the cornerstone of global malaria therapy.
Arsenic trioxide, the purified form of the TCM mineral pishuang, now a very common treatment for acute promyelocytic leukemia. Often curative in a single dose: https://www.sciencedirect.com/science/article/pii/S221304891...
Camptothecin from camptotheca acuminata, precursor of topotecan and irinotecan for solid tumours.
Ephedrine from ephedra sinica -- template for modern bronchodilators and decongestants.
Many others. Omacetaxine, minnelide, and more.
Very often, the first thing a medicinal chemist seeking new drug templates does is look to herbs that are used by indigenous populations or in "traditional" medicine systems. There's an entire journal dedicated to this:
> https://www.sciencedirect.com/journal/journal-of-ethnopharma...
roncesvalles•6h ago
Naturopathic medicinal cultures aren't totally bullshit. They're just "unscientific" i.e. they haven't gone through the rigors of the scientific method to establish their efficacy, or often their etiologies and mechanisms of action are completely made-up.
A_D_E_P_T•5h ago
Yeah, lovastatin comes from red yeast rice, which is also TCM. The other statins are downstream of it.
> Naturopathic medicinal cultures aren't totally bullshit. They're just "unscientific" i.e. they haven't gone through the rigors of the scientific method to establish their efficacy, or often their etiologies and mechanisms of action are completely made-up.
I agree 100%. But natural products are -- and always have been -- the great repository of drug templates. All modern pharmacopoeias owe a real debt to TCM in particular.
Instead of complaining like the guy who wrote the article in OP, it's best to try and take what's good and discard what's bad, without preconceptions or prejudice.
spauka•6h ago
See P5-6 in section "The implausibility problem" - which points out that in order for the treatment to be effective it had to be refined into a form that is not rapidly eliminated from the body.
A_D_E_P_T•5h ago
privatelypublic•5h ago
When you have thousands of years of people writing down their folk cures, sooner or later somebody will be right.
SuperNinKenDo•6h ago