A lot of traditional Chinese medicine is actually based on science. That is: a practitioner had many patients with the same ailment, and would give some of them one medication, and others another medication (herbs usually, o mixes of herbs). They'd then keep notes of what worked and what didn't. Rinse and repeat for a few centuries.
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.
I feel TCM's empirical roots probably did stumble on some real remedies (many people I know, including myself, have definitely benefited from certain aspects of TCM, especially acupuncture), but there's a problem.
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).
Eh, the replication crisis shows that the "methodological discipline" of RCTs is really not all that strong. But they're still better than nothing. I think you've set up a false dichotomy.
If the effect size for a given treatment was small, I would expect it to be outcompeted by other treatments with larger effect sizes. Practitioners who are disciplined in their thinking will make better discoveries, can treat patients more effectively, and will have more business, thereby training more apprentices in their methods. Over hundreds of years, it's easy to see how this process finds treatments with relatively large effect sizes.
This isn't true at all. It's even stated in the article that TCM was popularized in the 50s. Prior to the 50s it was no different to medicine practiced anywhere else in the world before science figured out whats worked. Modern science extracted the specific elements from herbs and such that are effective and figured out dosages to apply. TCM is very much hit and miss. You're also not allowed to give it to children. Because they have no real idea of the dosage given.
No, just like with Ayurveda there is plenty of actual stuff they stumbled on through trial and error.
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 not insignificant though. There are hundreds of medically validated remedies and that’s scratching the surface of hundreds of thousands of potential plants.
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.