curiosity, the ineluctable correlate of scepticism
During a recent gathering with neighbours I found it hard to keep my cool when someone told me recent evidence had come out supporting reflexology’s credentials as a healing technique. Expressing just a touch of scepticism, ho ho, I got the irritated response that ‘science doesn’t know everything’. I’ve already treated that ‘criticism’ in my introductory ‘fountains of good stuff’ podcast, transcribed here, but I feel the need to go further in dealing with this odd line of attack, because it annoys the shit out of me.
‘Science doesn’t know everything’ is one of those semantically not-quite-right phrases that reminds me of the half-opaque lines of Ringo Starr (examples are ‘tomorrow never knows’ and ‘it’s been a hard day’s night’) that tickled Lennon and McCartney into basing songs around them. Science isn’t a sentient being as far as I’m aware – and if it is I hope it’s not a supernatural one – so there’s no chance of it ever ‘knowing’ anything.
I’ve already had a rough go at defining what science actually is in the aforementioned ‘fountains’ intro, but any definition should, IMHO, be light and provisional rather than hard and fast. Certainly it’s about reliable knowledge, and the means of arriving at it, but it’s also, as many have said, about a way of thinking, a way of life. A way of life characterised by, and fueled by, curiosity and wonder. And what better words can there be, in our language?
Science is about questions rather than answers, and so the questions that come to mind when I’m told that ‘they’ve found’ that reflexology really works are questions like – ‘Really?’ How does it work? So there really are connections between zones on the soles of the feet and the pancreas, the gall bladder, the eye, the lungs, etc etc, as the theory suggests? Are they direct connections, or do they work through the peripheral nervous system? What, precisely, is the cellular pathway? Are the signals communicated electrically or chemically? What, if any, are the messenger molecules? If they’re not felt, through the nervous system, via the brain, but are more directly connected, so that only a third person (i.e. a trained reflexologist) can detect the connection, why would such a system have evolved? What possible evolutionary benefit would such a bizarrely non-neurological system provide? Curiouser and curiouser.
I did ask my neighbour if she could provide more details about the actual study or studies supporting reflexology, and she promised to do so, but that hasn’t happened. Well, fine, it was all very informal and semi-drunken. I’ve googled myself for recent studies supporting reflexology, but I’ve come up empty. If anybody out there has evidence – obviously non-anecdotal – to contribute to this vital debate about the future of medical knowledge, I’d be very interested to hear about it.
The fact is, though, that our knowledge of the human body and how it functions, and goes wrong, is burgeoning. And the more we know, the more we have to learn. That’s to say understanding just keeps generating more questions, so that, paradoxically, we now know more and at the same time less than we’ve ever known before, and so it will continue. That’s the fuel of science – the not knowing, the wonder. There are today thousands of labs, studying intracellular molecules, nanoparticles, subatomic forces, retroviruses, glial cells, genes, etc etc, all of them fueled by this hunger to know. And all these researchers are well aware of, and delighted by, the fact that knowing will just lead to more questions, more research, more puzzlement and wonder. It truly seems to be a self-sustaining system. I find it invigorating and exhilarating. I also find it rather amazing that all this research, particularly in medicine, has accounted for the fact that we, in the west, have increased our life expectancy by 2.5 years in every decade, in extraordinarily linear fashion, since the mid-nineteenth century. That’s to say, since the regularisation of medical training and the universal acceptance of the germ theory of disease, among other things.
Which brings me back to reflexology and other forms of so-called complementary medicine. The ‘science doesn’t know everything’ remark, whatever can be made of it, seems to be arguing that Herr Science, that burly, self-absorbed, Germanic (i.e. barely comprehensible) autocrat, should stop being so smug and should listen to the wise practitioners of tried-and-true folk medicine, coz they might learn summat, en it?
Au contraire, I say.
To me, all the smugness is on the side of reflexologists, iridologists and homeopaths, and their supporters. Not to mention evasiveness, defensiveness, and, worst of all, lack of curiosity. All that can generally be gotten out of these people are ‘It works!’, ‘It worked for me!’ ‘You should try it!’ ‘How can you condemn it without even trying it?’ and of course ‘science doesn’t know everything!’ – and when you try to pin these people down about the mechanisms involved in such treatments – that’s to say, the field in which curiosity comes to play - just sit back and watch the obfuscations and contradictions pile up.
To focus more closely on reflexology again, I’ve presented the same ‘foot map’ as I did in my last post on the subject. Note, for example, that there’s a tiny zone on each foot, just below the middle toes that corresponds to the eyes. Unfortunately the map doesn’t tell us whether the zone on the left foot corresponds to the left eye, the right eye, or both, but hey, details details. What I’m curious about, for now, is – where did this map come from, and how does it compare to other reflexology maps? Presumably, if reflexology is true, then each reflexology map would be the same – just as modern maps of the human brain would be more or less identical in every one of the thousands of neurophysiology research labs worldwide. The zones won’t be shifting around according to different practitioners, right?
However, it should also be pointed out that, if every reflexologist is working from the same map, it doesn’t follow that reflexology is true, any more than the fact that a thousand priests are preaching from the same bible proves that the bible is true. They could all be working from copies of an original map which was the imaginative invention of a single ancient, or not-so-ancient, healer (or quack, or well-meaning but deluded Believer).
This zonal map comes from a Thai tourism site which presumably intends it be some harmless R & R for jaded westerners and a boost to the local economy. Good luck to them, I say, but the actual map – if you can ignore all the colours and shapes, which tend to obscure rather than illuminate the ‘zones’, is roughly similar to the one at the top of the post. It’s more detailed, and more ambitiously labelled, including zones associated with the gonads, and ‘insomnia points’ on both feet. However, there are some glaring and one might say pretty vital contradictions. In this coloured map we find a zone for the heart on only one foot (I don’t know if it’s the left or the right, because I don’t know if we’re supposed to be looking at the feet from above or below), just above centre and to one side. On the other map there are two zones for the heart, one on each foot, just above the instep. If we look at these zones on the coloured map, they refer to – the parathyroid glands! A pretty serious discrepancy, I would’ve thought. Possibly even fatal.
And of course there are other discrepancies and vagueries. The more carefully you look, the more you find. So how do we resolve these problems? Do we look at more maps and try to come up with ‘consensus zones’? Do we research all the maps to uncover the most authentic? And by what criteria?
Well, here’s another map:
Again this one is in general agreement with most zones on the other maps. It plumps for the ‘thyroid area’ instead of the more specific ‘parathyroid glands’ and the completely different ‘heart’ on the other two maps, and it adds the ‘buttocks’ at the heel, of which there’s no mention in the others, but overall there’s a sense that these might come from the same source.
So is this an ancient Ayurvedic or Chinese source? Well, the Thai tourism brochure mentioned above actually quotes from a Chinese source, but it clearly refers to simple massage, not anything so complex and extraordinary as reflexology (a term apparently invented by one Eunice Ingham in the 1930s, renaming it from zone therapy, a term and a ‘theory’ devised by one William Fitzgerald in around 1913). The only ancient source who actually comes close to hinting at anything like modern reflexology is the Roman medical writer Aulus Cornelius Celsus, whose writings are thought to be derived from the Greek Hippocrates. In his De Medicina, he writes this:
Much more often, however, some other part is to be rubbed than that which is the seat of the pain; and especially when we want to withdraw material from the head or trunk, and therefore rub the arms and legs.
It ain’t much, and no ancient ‘zonal maps’ are extant, and I very much doubt if any ever existed. References to any complex and precise ancient teaching about zones in the hands, feet or anywhere else connecting with organs or glands in the body are totally unsubstantiated. It’s likely that the various more or less related modern zonal maps are loose reproductions from the imaginative writings of Fitzgerald, Ingham and other early twentieth century enthusiasts.
So, my curiosity and scepticism have brought me to a dead end, really. There’s clearly little interest, either from supporters or detractors, in spending money on rigorous trials to evaluate a practice that seems incapable of even providing a mechanism or pathway for its working. It would be hard to work out what to test, and supporters of the practice could easily explain away null findings by arguing that the wrong maps were used or that the zones were rubbed clockwise rather than anti-clockwise, or without sufficient skill, or conviction even. And when all else fails, and the lack of any scientific evidence becomes impossible to ignore, these unsceptical and incurious believers can always just shrug and say, ‘well, science doesn’t know everything…’