The ones that don't work may have just been experiments that were set up wrong, such as using the wrong plant, harvesting the wrong part of the plant, or otherwise ignoring parts of the herbalist lore that the experimenter thought weren't important. These are all things that happen.

And some herbalism is just bunk, sure. But a failure to reject the null hypothesis isn't "final". It just means that experiment didn't work.

Not everything is easy to test. Not all herbalism, home remedies, etc. are described well; not all practitioners actually understand how it works even if it does work. (And sometimes experimenters test the purported mechanism, rather than the claimed effect, which is just silly.) All of these things can interfere with the transition from folklore to formal methods.

Yes as long as we never prescribe a remedy because we believe it works but because we know it works, anything else is fine.

We can even find drugs in dreams, for all we care, as long as we test them later.

Now can you explain me why homeopathy and acupuncture still exist ? They just dont hurt, but they cure nothing.

I would have more confidence in Big Pharma if it wasn't an industry driven by profits, but for public good.

Look at ketamine vs esketamine, for example: "Why isn’t ketamine an approved depression treatment, then? It comes down to profits. Ketamine’s patent expired in 2002, meaning that further studies into the drug would not bring any financial returns to the companies funding them." [1]

I think it would make sense that there are also natural remedies that may be available, and cheap for consumers, but simply aren't considered because they would not be profitable. It's not worth it for them to look into these natural remedies if they can't put a patent on them and make money. Big Pharma, being primarily for profit, would even have an incentive to discredit these natural remedies, as it could harm their business.

[1] https://qz.com/1889308/why-isnt-ketamine-approved-as-an-anti...

This is what I came here to say, very much agree. I frequently have the experience of going to examine.com or Cochrane Collaboration for info on more natural remedies and see that we just don’t have enough science on them to know.

Feels like the kind of market failure that could be solved by foundations, government funding, or legislated incentives to pharma

Yes I agree, the ones that work are packaged, labeled and sold at a high profit as Pharmaceuticals.

Typically, the ones that work are quickly synthesized and a method that can be patented is developed. Then the plant is scheduled and kept illegal so that you have to pay the pharma for something that grows naturally.

I'm always surprised by the vitriol directed at Biotech on HN. Isolating and enhancing the effect of a natural substance along with ensuring dosage typically requires quite a large amount of engineering effort. Why shouldn't that be patented? I think we can all agree that swallowing a tablet of aspirin is better than extracting your own from a willow tree.

There's lots of things to not like about big pharma. How much money has big pharama spent on lobbying congress to keep certain plants scheduled so they can maintain their stockholders? The stories on big pharma and their role in the opioid crisis, stories on big pharma pricing structures that are not the same depending on who/where you are even though there's no difference in the pill. The agressive nature of pill pushing (even non-opiods) on doctors. The aggressive nature of advertising to desperate patients to pressure their doctors to prescribe medication that won't actually help but may worsen situations.

I think the vitriol is because they profit scandalously from their efforts.