How would you feel if I told you that the Science Museum says that homeopathy and acupuncture, as medical treatments, are no more effective than drumming or divination? Satisfied? I hope so.
In my previous post touching on the Science Museum’s exhibits I attempted to make a general point about what themes and approaches can and should be included within a science museum (by which I mean a museum that has object collections, as opposed to a science centre, which generally does not). Naturally, because this was sparked by comments responding to criticism of the Science Museum’s Living Traditions display, the debate has continued to focus on this particular exhibit and the manner in which complimentary and alternative medicine (CAM) should be dealt with in particular. Additional posts have since appeared e.g by @noodlemaz here, Stephen Curry here and David Waldock here, that have added further images and descriptions of the display. I had begun to be won over to the view that it was perhaps somewhat hastily or thoughtlessly put together and, especially after reading Stephen’s thoughtful account, I did not think that I would have more to add, although for my own satisfaction I went to see The Science and Art of Medicine yesterday.
I am glad that I bothered, because what I found was something more sophisticated and satisfying than I had come to expect. Stephen raised many interesting questions that could have been further explored, but let’s remember that a museum display simply cannot cover everything and that most visitors tend to wander through, focus on a few objects, read very little text, and pass on. I think that, given these limits, the Museum chose an appropriate set of themes to consider and raised some particularly interesting points.
Firstly, readers need to be aware of how the gallery as a whole is introduced. On entering there is, on the right, a small display on ‘Henry Wellcome and his Collection’. This makes the important point that was entirely missing from the first posts and comments on this topic: the Science Museum has care of these important collections and a duty to make use of them in displays. Their nature invites historic and anthropological treatment. On the left is a plan of the room and an introduction to the three sections, ‘Before Modern Medicine’, ‘Modern Medicine’ and ‘Living Medical Traditions’. Each has an introductory text panel and a case with three emblematic objects. For the first there is a bust of Hippocrates, lead crosses and a 17th-century mortar and pestle; for the second, a stethoscope, a microscope and models of sanitary ware representing efforts in public health; for the third we have a Chinese acupuncture model, a Shangro rattle and a clay Shirodhara pot used (I think) for oil in the Ayurveda tradition. I think these cases make it pretty clear to visitors what’s what, and where the science, and successful treatment and prevention, lies.
What else might they have done? It would have been plainly wrong if they had included things like cupping, bleeding and purging within their historic displays (as they do) and not shown that they continue to be practiced. If they had focused purely on the role of CAM in Britain then they would have ignored the global approach that appears elsewhere in the gallery. Focusing purely on the scientific evidence would not have made good use of the object collections, would have made the display much less rich and contextual than the rest of the gallery, and would have made understanding the choices of anyone represented within the display more difficult.
Some specific points:
1) Is the Science Museum promoting CAM? No. It describes some of the other medical approaches that exist, mainly (except in the recordings on the interactive screen and one of the “personal stories”) in other countries. It is clear that the whole exhibit is based on the premise that these traditions are not effective. Does anyone really believe that the Science Museum is saying that faith healing, divination, community meetings, song or dance are effective means of countering disease? These are placed alongside homeopathy and acupuncture, so, in the context, their effectiveness is made pretty clear. In fact, much more clear for most casual visitors than if evidence was cited in the text. Likewise, all of these are placed outside the narrative of the development of biomedicine, antiseptic surgery, public health etc.
2) Does the exhibit include advertising? No. I would be extremely surprised if there were anyone who was prompted to contact any of the individuals represented within the display, and I would be amazed if anyone who looked around them thought for a minute that the museum was promoting these approaches any more than they were promoting the pre-19th-century approaches they display elsewhere. Certain practitioners and their places of work are named in the recordings, in order to be clear about sources and and the fact that, while most of the exhibit focuses on other countries, varieties of these practices are carried out in this country (this very city) too. I cannot imagine that anyone has ever whipped out pen and paper to make a note of these names and they are not distributed in written form by the Museum. One label within the section on various African traditions points out an email address on a piece of packaging. Anyone who seriously suggests that they are doing this in order to advertise the company is being disingenuous. This 2005, foil-wrapped packet of herbs stands alongside similar products collected by Henry Wellcome between 1880 and 1920 to show that what some people think of as ‘traditional’ and ‘natural’ has been subject to enormous change over time and distance.
This is a key point within this exhibit. They have chosen to challenge simplistic notions of what these traditions are. Skeptics should be pleased – they clearly show that, although there are old roots, claims made by practitioners to represent ancient traditions are far from clear cut. The Museum does this throughout the display by showing how cross-fertilised they are, how mixed with modern medicine, how intercut with modern advertising and marketing. Did anyone think that the Museum was also advertising Clipper teas – which appear twice – or Geri Halliwell’s yoga video? I think these were well chosen to show how aspects of these traditions have become widely accepted, but shorn of what serious practitioners would consider essential elements of the practice as a whole. The displays clearly show that all sorts of spiritual beliefs and other, slightly off-putting, practices like purging go alongside yoga, acupuncture and herbal medicine.
3) Is the display uneducational? No. It has lots to teach, although it has annoyed people that the lessons of this particular display are not scientific facts (though they are actual facts, in that real people said and did these things, and they pertain to how scientific medicine is perceived in various societies). I was particularly impressed by the decision to show examples of these traditions being mixed: homeopathy and Ayurvedic medicine in India (the former, as it says, a ‘scientific’ import by 19th-century western missionaries); conventional medicine and faith healing in Nepal (where, “when the hospital opened doctors expected biomedicine to become the Sherpa’s first choice of healthcare. Instead the people of Kunde were reluctant to abandon their traditional medical beliefs – a situation that continues today”, one reason for which includes a belief that dying in hospital rather than can hinder the soul’s progress); African herbal medicine and conventional medicine in Uganda (where, despite the patient being a trained health inspector at the local hospital, he chooses a traditional healer, in part because of the respect that these individuals have within their community, providing social care that, presumably, the government does not); Traditional Chinese Medicine (TCM) and conventional medicine in China (where one individual and his treatments integrate both approaches); and acupuncture and conventional medicine in the UK (here, as has been noted, the display refers to the on-going debate about “the place of acupuncture within the NHS”).
All of this aided my education and understanding,.I have had to reshape any ideas I might have had about distinct and unchanging traditions, and I have learnt a lot about what people in other parts of the world understand as medicine, and the importance of regulation in shaping this. Elsewhere in the gallery I recommend the section on National Health Services, where the lack of hospital and medical services in rural areas of Africa, India and China are made clear. Next to this is a section on Third World Medicine, which relates successes in public health and, for example, in eradicating smallpox, but also demonstrates why there has been suspicion of and deep concern about some Western interventions, examples including DDT/malaria, unregulated sales of Western drugs and promotion of infant formula. Comments about the regulation of medical practitioners and drugs in Britain from the 18th century onwards are also very pertinent as elements that make the Western experience very different from that of the much of the rest of the world.
4) Does the display duck controversy or try to avoid offending people? No, if you mean proponents of CAM (how big a constituency is this really likely to be for the Science Museum? How big a constituency is it at all? This post by the Tribal Scientist suggests that those at risk from CAM in the west is relatively small and, if unlikely to be reached by campaigns like 10:23, unlikely to be reached by the Science Museum either). I repeat: the clear premise is that these practices are not effective as treatments. I think the Museum is right to assume that their visitors consider the triumph of modern, evidence-based medicine to be just that and, in case not, the displays are shaped to help people come to that conclusion. So they are, as a science museum, being controversial by including CAM and helping visitors explore some of the reasons why these (changing) traditions continue to exist. Losing Simon Singh as a trustee and getting this kind of rap from fans of science is, surely, much more difficult for the Museum than offending users of homeopathy, yet they have stood by this display for the last five years, and continue to do so.
All of the above shows that, while my first post tried (in vain) to stick to the comments about what science museums are for, I do disagree with the approach taken in the posts by Alex, Marianne and David as I do not think they fairly represent the context of the display or the tone and content of gallery as a whole. For instance, for Alex to write, as he did in his original post, of the case study on homeopathy “That’s right, they categorically state that homeopathy helped her” looks to me like propaganda (even if it is propaganda for a good cause). The framing of the “personal stories”, the use of the word “believes” and big quotation marks must have made it clear to Alex that it was the patient who said this and not the Museum. In the end, though, I suppose it comes down to the individual’s view as to whether the Museum should only be in the business of telling visitors about the current scientific consensus or doing this (often in events, interactives and online rather than or as well as in object displays) and encouraging broader and more discursive approaches.
And, incidentally, I was pleased to see at least four astrology-related items within the Museum’s Cosmos & Culture astronomy display ;-)