Alexey Vodovozov: ‘It is silly to expect a positive curative effect from chak-chak’
Medical myths around us: supplements, bloodletting, homoeopathy, physical therapy, antibiotics...
“They’d better breathe the steam of potato than rush to a pharmacy and buy antibiotics,” says scientific journalist, therapist Alexey Vodovozov. Realnoe Vremya is publishing the second part of the talk Myths, Fallacies and Mistakes in Medicine Vodovozov delivered in the Tatarstan National Library within Milmax Science scientific lecture. He spoke about horrors of folk medicine, the tradition of bloodletting, standing on a bed of nails, a search of “your” doctor, the placebo effect, homoeopathy, supplements, physical therapy and much more.
“A lot of things came to current medicine from folk medicine”
What are the most ineffective natural remedies?
Folk medicine in itself is an oddity. We have medicine as some sphere of knowledge. And absolutely everything that worked stayed there. Now we can go to the riverbank of Lower Kaban and find white willow. We can make an infusion from its bark and then drink it to reduce a high temperature. Will it be folk medicine? Yes, on the one hand. On the other hand, we can go to a pharmacy and buy aspirin. It will be the same thing but a cleaner, dosed medicine without impurities. Once this was traditional medicine. Then we figured out that it had salicylates, and their form isn’t very suitable for a person. We modified them chemically a bit, set up industrial production and now we certainly know the dose of the active substance in a pill, we know side and positive effects. And we use clean aspirin perfectly understanding this.
The same happens in other fields. A lot of things came to current medicine from folk medicine, for instance, atropine. It might seem to be an antidote to poison. It is belladonna, a poisonous plant. But understanding its action, we took it from folk medicine and apply for the good of patients. Suitable sources that are tested by time and knowledge, settle in the arsenal of normal medicine. And remedies that don’t work remain in folk medicine.
And some things from folk medicine are rites. Yes, I understand that ritual things calm down children’s parents first of all. And this is why I would not severely criticise folk medicine. They’d better breathe the steam of potato than rush to a pharmacy and buy antibiotics. At the same time, we should keep in mind that one shouldn’t overdo potato steam — we can have our upper airway burnt, people manage to have even their trachea burnt. Ground mustard was allegedly a very efficient remedy as early as in my childhood. Mustard used to be put in woollen socks, the socks were put on a child at night. Do you imagine how red and sweaty legs can be? In fact, it is a chemical burn. There used to be completely brutal natural remedies for worms — a peeled glove of garlic put on the other side of the digestive tract and other awful things.
Usual medicine doesn’t care what exactly one’s throat is gargled with. The process itself matters. But what we added are shades of folk medicine
But it has something positive too. For instance, is a gargle folk or conventional medicine? It is usual medicine, a normal approach. And usual medicine doesn’t care what exactly one’s throat is gargled with. The process itself matters. But what we added are shades of folk medicine. Camomile, calendula, eucalyptus can be used. And these nuances of folk medicine don’t halt conventional medicine and comply with scientific knowledge. Also, if it seems to a person that he fulfils himself as a doctor for his family members. But he doesn’t go to a pharmacy to get serious medicine. So some things in folk medicine are useful: they settled and have still been used. But of course, with moderation, without invasive intervention, without poisonous substances and other strange substances. But don’t do strange experiments on yourself and especially on children.
“Some people quite sensibly do bloodletting”
What do you think about bloodletting?
It is a thing that put down roots during the golden century of Islam, approximately on the cusp of millennia. Bloodletting was considered almost a panacea. It was supposed a person had to be removed blood no matter what had happened to a person, what diseases he or she had had. From a perspective of modern medicine, there is a kernel of truth. But it isn’t big. Indeed, bloodletting stimulates blood making organs. But not really. The positive effect, to put it mildly, is very exaggerated.
It is said sometimes that even during a hypertensive emergency a person starts to feel better if the excess “curdled” blood is removed. Of course, not exactly. Blood curdles only because it is outside. As soon as we remove blood from a person, it curdles, moreover, quickly enough. It is the norm. So the procedure of bloodletting has mainly a historical, traditional context. In most cases, it won’t do as much harm as it could. But in some conditions — sepsis, pneumonia, infectious hepatitis, immunodeficiencies — it simply cannot be used.
So the procedure of bloodletting has mainly a historical, traditional context. In most cases, it won’t do as much harm as it could
Some people quite sensibly use it. Even religious clerics who I have talked with do this. They perfectly understand that any medical procedure has indications and contraindications. Not all people can undergo it. But like everywhere, there are fanatics who are ready to do absolutely any procedures (and it doesn’t matter if it is detox for worms, bloodletting or potato steam) in any situation, which isn’t allowed of course.
“It is a big problem to find your doctor”
It has become trendy to stand on a bed of nails in the last years. Through fear, pain, people allegedly enter a state when some curative processes take place inside. How does this help from a scientific point of view? Can anybody do it?
It is a good illustration of that a human organism is an amazingly strong system. It is hard to tilt the balance. Intermittent fasting can be practised, one can walk on a bed of nails or hot coals, abuse the organism in all the possible ways, and it will tolerate it all. The compensatory capabilities of our organism are simply incredible, especially at a young and middle age. This is possible if a person is busy and at least harms himself moderately, not completely, and understands that we don’t have a panacea in general.
We don’t have any methods that would work for the whole range of health issues: as effective as in cancer, immunodeficiency, infection, ENT pathologies. There is no such thing. Unfortunately, it hasn’t been possible to find and provide, measure the life power throughout the existence of science. And one likely shouldn’t count on it.
But mental issues can be sometimes a matter. Some pain syndrome turns into a mental rather than physical problem with time. And during remission, without acute manifestations, people find options of how to cope with this chronic pain, transform their system. And this becomes one of the options. Some people are hypochondriacs who consider they have all the diseases. They can do this, it will be a distractive therapy. But one should understand that the range of application is very narrow here. If you have a real problem, we won’t solve it but we can even make it worse. To start with, it is necessary to make sure we don’t have anything serious. If not, do pilates, even capoeira, Thai Chi, whatever. Most importantly, enjoy it.
A human organism is an amazingly strong system. It is hard to tilt the balance. Intermittent fasting can be practised, one can walk on a bed of nails or hot coals, abuse the organism in all the possible ways, and it will tolerate it all
But in any case, it is necessary to find your doctor. It is a problem, it isn’t easy. Many have their own car repairers, computer specialists, manicure, eyebrow and other masters we trust. So a doctor should be on the list. This doctor doesn’t necessarily have to be a great professional in all the spheres. The doctor can be a guide: I mean you saw a specialist, then saw the doctor you trust, and if he said it is alright, you keep talking with the first one. Our health is in our hands. And it should be treated very carefully. I meet smart colleagues not only in private but also in public clinics who prescribe reasonable treatment that mainly consists of a couple of medications and a correction to lifestyle. If the list of prescriptions comprises 15-20 medications, you are likely in a wrong place.
Also, there are problems of diagnostics. In medicine, diagnostics and treatment are divided. And this is correct: it is simply impossible to teach a doctor everything, this is why there are specialists. There are as many doctors who make a diagnosis as opinions, something in the middle and considered has often to be chosen.
“The placebo effect is still studied”
There is a question about the placebo effect. Is there research on its efficacy? For instance, some claim that a child is given homeopathy and he stops crying...
Some say that they give something to animals and they really feel better. As you know, it is very hard to make this case unbiased. But when it comes to this, it turns out that a child understands a parent’s mood too. If a parent is worried, if his mum is nervous, the baby starts crying too. If his mum gave him something and thinks it works, she calmed down, she felt better, and the baby scanned this emotional state. He started to feel better because his mum started to feel better.
Little kids often cry for a reason we don’t really understand. They start to cry and then suddenly stop. We remember those cases when they stopped crying after some medication much better than the episode when they stopped crying for no reason. We are really prone to look for causality when there is none. To say how placebo really works, clinical trials are conducted. For instance, a child is given this medication, and the parents then are asked about the child’s state. And they objectively evaluate the child’s state. It turns out that these two estimates dramatically differ. The parents, for example, think it became better, while the objective picture didn’t change. But the parents thought that if they did something, did something good for the child, he certainly started to feel better. The placebo effect is still studied...
Today homeopathy is of historical interest. But in general it is an absolutely ineffective means
“As soon as some occurrence appeared, it immediately tried to be used for treatment”
What do you think about homeopathy and supplements?
These are called parapharmaceuticals, and pharmacies earn the biggest revenue from them. I consider supplements as what they are — as food supplements. It is food. They are regulated by Russia’s consumer rights protection watchdog, not the health watchdog. That’s it. It is like expecting positive effects from carrot, chak-chak or something like this. It is not a drug, and it is deliberately written down on the packaging.
The situation with homeopathy is toughest. Scientific medicine very actively renounced this field around the world and transfers it to a private business. In the history of homeopathy, there hasn’t been anyway found any evidence of efficacy or at least possible mechanism of its work yet. Today homeopathy is of historical interest. But in general it is an absolutely ineffective means. Medicine has a lot of drugs with doubtful or unproven efficacy.
What about physical therapy? In Russia, physical therapy is using different magnets and so on. Does this really work?
What is called physical therapy abroad is our physical exercise. This practice arrived in the same Germany and here simultaneously. For some reason, we refused this in the 90s. I don’t really understand why because there was a lot of good groundwork. After the Great Patriotic War, rehabilitation was up to physical therapists. It was mainly exercises designed to recover a person, not equipment.
As for equipment... As soon as some occurrence appeared, it immediately tried to be used for treatment. Electricity appeared, people started to be treated with electricity. Radiation was discovered, a boom instantaneously began. And cosmetics with radium appeared, and water was charged with radioactive elements, people tried to treat with radiation too. Today something new appears, which people immediately up and try to use in treatment. But when scientific background comes to the fore, it turns out it doesn’t work.
As soon as some occurrence appeared, it immediately tried to be used for treatment. Electricity appeared, people started to be treated with electricity. Radiation was discovered, a boom instantaneously began. And cosmetics with radium appeared, and water was charged with radioactive elements
“If the baby has a chance of being born healthy, why not do it?”
What is your opinion about ambiguous issues of transhumanism or genetic modification? Without serious intervention into human body’s functions, we won’t be able to seize galaxies and go to Mars.
Scientists at times are unaware of crossing the border with little public support. But there are deterrents such as ethics, legislation. But I am on the other side: I understand we cannot move forward without it. We need such people who will show that it is possible. If we are going to conquer other worlds or understand ours more or less well, we will really have to solve this problem.
Children who weren’t supposed to be born in general are born today thanks to achievements in medicine. Why cannot we do so that they are born healthy from the beginning? There is pre-implantation genetic screening even now, but only for in vitro fertilisation. We already can diagnose embryos and put only the one without some defective genes into the womb. People start to say for some reason that it is eugenics. But this isn’t completely true. I understand that we meddle in the process. But if the baby has a chance of being born healthy, why not do it?
This is how it happens — progress goes ahead, and ethics catch up with it later
Perhaps, not scientists will have to solve this problem because they are ready for this, they can do it, and it is a norm for them. This is how it happens — progress goes ahead, and ethics catch up with it later. It is never the other way round. Ethical issues also have to resolved. AI specialists just theoretically say that some time later they will be able to create real artificial intelligence, the one that will become an individual. Ethics immediately come closer and start asking: “Ah, interesting, and if you turn it on, you will have a moment of creation, you will create a new creature, it will be an individual. And you cannot turn it off, it will be a murder.”
Children, senior students in Kazan asked me an interesting question during one of my trips. I was talking about medicine of the future and organs-on-chip. It is, in fact, cells that are placed on a big number of biosensors. We can make a model of a lung, kidney, liver, collect all this at an information centre. So I was asked: “Does this device feel pain?” And I got to think. Because we can do harm, we will feel mediators of pain, those molecules that carry them. Then this will get to the analysis centre in the bloodstream. In fact, a signal of pain will go to a model of the brain. This device turns out to experience pain. It won’t communicate it. But everything related to pain already exists there inside. Is this ethical? A lot of questions arise here too. In any case, we boil down to ethics. I hope society will mature. I doubt that we can keep going in the same direction without genetic intervention at the previous pace.
Such old ladies are often shown my programmes on YouTube on TV and said: “Here, please, watch, it is a programme. A doctor is talking, everything is explained.” It works sometimes
What can we do with mums, grannies who spread fakes?
It is really hard. They have a different system of values when it comes to information sources. The same television, for example, it is still a reliable source for them.
Such old ladies are often shown my programmes on YouTube on TV and said: “Here, please, watch, it is a programme. A doctor is talking, everything is explained.” It works sometimes. My book is sometimes put nearby — they still think that whoever isn’t printed. There are plenty of my colleagues’ books, a lot of books on any field. One can guess what a person is interested in and show him correct records on TV from YouTube because they don’t accept the Internet, they don’t consider it as a source of information. This is why show such programmes on television and put correct books at hand. Some very old people start to actively be interested and switch to the good side. But all this should be done gradually — it is an attempt on the outlook. If you try to pull the person out right away, he won’t let do this. And if this is done slowly, step by step...