Seems like we're still grinding up rhino horns and tiger penis and hoping for the best outcome, just that we do it with extensive testing now so we get a statistically acceptable outcome viable for marketing.
For example, we can observe how the brain functions in some instances, but why it works like does will elude us perhaps forever. Highly complex systems like the inner biomechanical workings of our brains are essentially a black box.
Like software incompatibility: every program is the story of "how", written explicitly, and translated into instructions. The only way to fit them together is to implement "why". If we could write both stories together, we could factor out incompatibility.
We don't test medicine for marketing, we test them for results. If homeopathy and Chinese medicine would teach us one thing it's that testing only for marketing would be the greatest waste of time and money ever.
Often we have some idea how they work and what the internal end result appears to be, but the pathways that the drug seems to work on aren't fully understood. So we know the drug does something to that pathway, but it is to some extent a black box for us. But the fact that the drug operates on the pathway also opens new avenues for the scientists to gain a better understand of that pathway.
Modern medicine is optimized for end results. If a drug appears to work, the "how" is of secondary importance. We can always figure that out later. Sometimes we find stuff in nature, for example, like chemicals produced by fungi or bacteria, and we discover that they have medicinal properties. They nevertheless get productized as drugs, even when we don't fully understand them or the pathways they target.
except thousands of common herbal remedies are replaced by patent medicine with legal controls, because $MONEY
Except they are not being replaced? Just like in the good old days™ you can still get out and collect the herbs you're looking for. It's just that nowadays we know that component X of a herbal remedy actually does the job so you just buy that in tablet form (or whatever) instead eating of the whole thing.
on the small chance that you are not being sarcastic.. Our city here has >300,000 residents.. and most cities nearby are paved. Where do the herbs come from ?
If there is a flower in the Amazon with "heal all" properties, but it's only found in the Amazon, do you fault the company that creates a pill form and sells it in France?
Big Pharma has it's problems, but it's done wonders for the availability of medicines for the vast majority of people on Earth.
Herbs aren't magic you know, you've come across many if you've walked through any trail. Although I wouldn't blindly go picking anything and everything you see, some are toxic!
This isn't a problem with big pharma, but rather, an issue with your understanding of how little we know about medicine. We occasionally still find new body parts, and we've been dissecting bodies for centuries.
We don't cure some diseases because we don't know the reasons they happen, but find out some medicines that seem to help. Others, we don't cure simply because we don't know how to prevent them.
And this sort of thing isn't limited to medicine: We weren't sure the astronauts would survive. We did what we could to me reasonably sure, but... we weren't. This isn't new, nor is it contained to medicine. We've done a lot of things without understanding the underlying mechanisms.
Maybe pop an aspirin!
Freudian slip of the week !!
ex-computational pharmacology here .. EX- !
The idea that doctors (or even the medical community) are standing on the top of a Mountain of Truth is a harmful fantasy.
The difference is that empirical studies have demonstrated the effect of "willow bark tea" and the lack of an effect of "ground up rhino horn".
When you read of new work on friction in 2023 does it reduce your confidence in the field of physics?
It is true that we are still just scratching at the surface of biology, but incrementally we (humanity) are making progress every day. It's not engineering.
When insulin was discovered in 1921-2, it was only known that a pancreatic extract that has gone through some specific chemical processes could lower blood sugar.
International units of insulin were initially defined not by the quantity of material, but rather by their effect.
An international unit was defined to be the amount of extract that once given to a 24-hour fasted 1 kg rabbit, would lower its blood glucose level to 45 mg/L.
Only in the 1950s, it was discovered that insulin was a specific protein, and the definition was updated accordingly.
We could use rhino horns well before the chemical is isolated and a synthesized.
History of aspirin: https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.14520
mechanism of action isn’t even on the list.
“it works, it won’t kill you faster than the thing it treats, we have no idea why” is totally legit. welcome to biology, the dance of control with non-engineered systems.
There is nothing of any interest in aspirin for commercial pharmaceutical organizations - any money spent in research is not recoverable. They will of course focus their efforts on researching new drugs, as their shareholders would expect.
Like everyone else has said, it’s normally easier to find out « if » something works before the « why » and only one of those questions needs a « yes » to stop someone suffering.