Tuesday, September 8, 2009

Blind Men and an Elephant: are Drug Preventive Strategies Missing the Elephant?

You probably know the blind men and an elephant fable. If not this is a Jain version of it:

ตาบอดคลำช้าง -- Illustrated Proverb: Blind men...

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Six blind men were asked to determine what an elephant looked like by feeling different parts of the elephant's body. The blind man who felt its leg says the elephant is like a pillar; the one who feels the tail says the elephant is like a rope; the one who feels the trunk says the elephant is like a tree branch; the one who feels the ear says the elephant is like a hand fan; the one who feels the belly says the elephant is like a wall; and the one who feels the tusk says the elephant is like a solid pipe.

Wikipedia

Each of these six men are correct. Yet, their conclusions are useless to say the least.

The question I would like to raise: are preventive treatments using drugs, such as aspirin, statins, warfarin, and ACE inhibitors missing the elephant?

These blind men are one tool of perception: vision. Scientists use different tools to perceive reality. These tools evolve. Nowadays, we have electron microscopes and PCR. Before using these tools scientists were blind to existing facts. This fable shows that being  100% correct does not assure understanding reality. The outcome of randomized controlled trials can be 100% correct and still derail us from reality.

If you have read some of my previous posts, you probably know where I am going with this. This is another criticism to using reductionist science in preventive science.

Researchers such as Weston A. Price and Daphne Miller noticed the dramatic preventive effect of particular diets. Price went further in connecting the quality of the soil to the quality of fruit, vegetables, milk, and meat. To understand reality we must always consider the possibility of the presence of a striking reality that our perception is not to seeing. This strategy should prevent overplaying findings, as overplaying the effect of saturated fat on heart disease.

Miller, D., 2008. The Jungle Effect: A Doctor Discovers the Healthiest Diets from Around the World--Why They Work and How to Bring Them Home, William Morrow.

Price, W.A., 2008. Nutrition and Physical Degeneration 8th ed., Price Pottenger Nutrition.

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