For those of you who don’t know who Dara O’Briain is, he’s an Irish comic who appears a great deal on UK television. He’s a very funny and very likeable and very clever man. However, he has taken to including his heavily simplified version of ‘What is medicine?’ into his stage act and I am sure he is very influential in a derisive pub logic sort of way. And it is because celebrity-status provides a powerful platform in support of whatever opinion the celebrity in question wishes to put forward that we have to counter these arguments point by point. So here is why he is wrong.
His simplified version goes pretty much like this: “Medicine is better than herbs because it is just the stuff in herbs and plants that works that is extracted and purified.” Let us analyse this sentence so that we understand exactly why it is wrong.(note 1)
1. First of all, and this is probably the biggest error. Medicine is not ‘the stuff in plants that works’. The stuff in plants that works is natural. Medicines are man made. The inventors of this man made molecule may very well start with a natural molecule – but you can’t patent nature. So the molecule is tweaked in some way, not to make it more effective, but so as to be able to own it by patenting it. Once it is owned in this way it can be sold for big bucks. So the question is: does this matter? And of course it does. Life has evolved for billions of years alongside other life. The environment around us is what we have evolved to be adapted to, which is another way of saying to be healthy in. We have not evolved to get benefit from artificially tweaked molecules. Bio-chemical receptors in the body are so highly specific that even mirror image molecules cannot replace each other. So, on this level, medicines are not ‘the stuff in plants that works’ and so cannot be superior to herbs.(note 2)
2. ‘the stuff in plants that works’ is supposed to conjure up an image of a single molecule in a herb that is effective in some way surrounded by many different molecules that are just packaging. The molecule that ‘works’ is referred to as the active ingredient. So, this is a perception – not a description – of the facts. It is a theory. The theory can be described in this way: that because a herb works it contains an active ingredient. But why do we prefer this way of looking at the problem to other perceptions that might be equally or even more valid: for example, that the herb contains multiple molecules in interesting patterns and it is this community of molecules that is effective?
Scientists by and large are uncomfortable with complex narratives such as this one because their methodology is reductionist. Reductionism is a very powerful tool but it cannot deal with complex facts – and there is very powerful evidence that it is the complex relationship of molecules within a plant that makes it effective for healing and not the fact that it contains a single active ingredient.
3. Which brings me to the issue of ‘purification’. The idea of purification contains an ambiguity. On the one hand it means the isolation of a molecule so that it exists by itself without any other molecules being present. But it also means ‘to be made perfect’ in a moral sense. So when we hear the word purified we process both meanings at the same time so that we see the isolated molecule as being ‘good’. We also think of it as being ‘clean’ – unsullied by all that horrible dirty nature stuff.
But is it? Is an isolated molecule better than the natural molecule existing within its natural setting surrounded by other molecules in interesting arrangements? We know that cannabis is a powerful healing agent and that one of its effects can be to reduce nausea and pain. THC is ‘the active ingredient’ and one artificially created isomer of THC is called Drobinol. This is sold under the name Marinol.
Now, here’s the thing: there has never been a documented human fatality from overdosing on natural THC or cannabis in its natural form, but Marinol and other derivatives can be primary causes of death.(note 3)
Another example that is closer to home is the purified extract of the tobacco leaf otherwise known as nicotine. Purified nicotine is an extremely powerful poison and it does not take very much liquid nicotine dropped on to the skin to kill a person. But as we know tobacco leaves take a lot longer to kill a person – and it may not even be the nicotine that does the killing. (note 4)
So, if you think that a ‘purified’ extract that has been tweaked and can cause death is superior to a natural untweaked molecule existing within a context of other molecules that does not cause death then I have to question your sanity.
Over to You Mr O’Briain.
(c) Jonathan Chamberlain 2013
1. Exact quote: “Oh, herbal medicine’s been around for thousands of years!” Indeed it has, and then we tested it all, and the stuff that worked became ‘medicine’. And the rest of it is just a nice bowl of soup and some potpourri, so knock yourselves out.” http://www.goodreads.com/quotes/557094-i-m-sorry-herbal-medicine-oh-herbal-medicine-s-been-around-for
4. “Historically, nicotine has not been regarded as a carcinogen and the IARC has not evaluated nicotine in its standalone form or assigned it to an official carcinogen group. While no epidemiological evidence supports that nicotine alone acts as a carcinogen in the formation of human cancer, research over the last decade has identified nicotine’s carcinogenic potential in animal models and cell culture”