MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

In part one and part two of this series of posts, we have discussed altogether six ‘tricks of the trade’:

TREAT A NON-EXISTING CONDITION

MAINTENANCE TREATMENT

IT MUST GET WORSE BEFORE IT GETS BETTER

THINK HOLISTICALLY

IT’S DUE TO THE POISONS YOUR DOCTOR GAVE YOU

A CURE TAKES A LONG TIME

Now it is time to disclose three more.

DETOX

Alternative therapies are hugely diverse, but they nevertheless have a few characteristics in common. One is that many of their practitioners try to persuade their patients that they are being poisoned. This sounds odd, however, it is true.

Most alternative therapists tell their patients sooner or later that they need to ‘detox’ and, as it happens, their type of treatment is ideally suited to achieve this aim. Detox is short for detoxification which, in real medicine, is the term used for weaning addicts off their drugs. In alternative medicine, it is used as a marketing slogan.

Yes, detox, as used in alternative medicine, is nothing but a marketing slogan. I have several reasons for this statement:

  • The poisons in question are never accurately defined. Instead, we hear only vague terminologies such as metabolic waste products or environmental toxins. The reason for that lack of precision is simple: once the poison is named, we could be able to measure it and test the efficacy of the treatment in  question in eliminating it from the body. But this is the last thing these ‘detoxers’ want because we would soon establish how bogus their claims are.
  • None of the alternative therapies claimed to detox our body take any toxin from us; all they do take from us is our cash.
  • Our body has powerful organs and mechanisms to detoxify (skin, lungs, kidneys, liver). These take care of all the toxins we undoubtedly are exposed to. If any of these organs fail, we do not need homeopathic globoli or detoxifying diets, or electric foot baths or any other charlatanry; in this case, we are more likely to need an A&E department’s intensive care.

My advice is, as soon as you hear the word ‘detox’ from a quack, ask for your money back and go home.

THE TEST OF TIME

Another thing that many alternative therapies have in common is their age. They have almost all been around for hundreds, if not thousands of years. To the enthusiasts of alternative medicine, this means that these interventions have ‘stood the test of time’; they argue that acupuncture, for instance, would not be around any more, if it were not effective. They tell their patients, write in books and argue in debates that the age of their therapy is like a badge of approval from millions of people before us, a badge that surely weighs more that modern scientific studies (which tend to cast doubt on the effectiveness of the treatments in question).

This line of thinking has always puzzled me. We are talking of TECHNOLOGIES, health technologies, in fact. Would we argue that a hot air balloon is an older technology that an aeroplane and therefore better suited for transporting people from A to B? The fact that acupuncture was developed thousands of years ago might just mean that it was invented by relatively ignorant people who understood too little about the human body to create a truly effective intervention. And the fact that blood-letting was used for centuries (and thus killed millions), might teach us a lesson about the true value of ‘the test of time’ in medicine.

My advice is to offer leeches, blood-letting and mercury cures to those who try to persuade you that the test of time has meaningful therapeutic implications.

TREATING THE ROOT CAUSE OF THE DISEASE

Alternative practitioners often claim that, in conventional medicine, doctors only treat the symptoms of their patients, whereas they treat the root causes of the illness. I have often wondered where this assumption and the fierce conviction with which it is so often expressed come from. I have to conclude that the explanations are quite simple.

  • This notion is the mantra that is being taught over and over again during the practitioners’ training. It even constitutes a central message of most ‘textbooks’ for the aspiring alternative practitioner.
  • More importantly in the context of this post, the notion is a clever sales-trick. It sounds profound and logical to many consumers who lean towards alternative medicine. Crucially, it kills two flies with one stroke: it denigrates conventional healthcare and, at the same time, elevates alternative medicine.

The idea that alternative practitioners treat the root causes is  based on the practitioners’ understanding of aetiology. If a traditional acupuncturist, for instance, is convinced that all disease is the expression of an imbalance of life-forces, and that needling acupuncture points will re-balance these forces thus restoring health, he must automatically assume that he is treating the root causes of any condition. If a chiropractor believes that all diseases  are due to ‘subluxations’ of the spine, it must seem logical to him that spinal ‘adjustment’ is synonymous with treating the root cause of whatever complaint his patient is suffering from.

These are concepts that are deeply engrained into the minds of alternative practitioners. And they have one embarrassing feature in common: they are false! Some practitioners surely must know that; yet I have so far not met one who therefore would have stopped using it. The reason must be that, as a trick of the trade to increase his cash flow, it is invaluable.

My advice is to use your abilities for critical thinking, explain to the practitioner who tells you that he is going to treat the root causes of your condition that he is a quack, and look for a proper physician.

 

12 Responses to The tricks of the quackery trade (part 3)

  • Please define ‘proper physician’.

    Sorry to be pedantic, but remarkably, some registered medical practitioners, in good standing with the GMC and with licences to practice issued by the GMC, practice homeopathy.

    A three line whip on Edzard’s injunction that patients should “use your abilities for critical thinking”.
    Unless you are content with magic medicine.
    As a magician, I confess – ‘magic’ has no basis in reality.
    Patients: by all means enjoy the experience, the witchcraft, the wizardy if you will, but do not fool yourself – or allow yourself to be fooled. Please.

    • point taken – I should have not written ‘proper’ but ‘responsible’.

    • Richard: this is your first recent post that doesn’t mention your excellent book Real Secrets of Alternative Medicine: An Exposé. So let me give it a plug here. BTW, the Amazon UK site claims not to have any books by ‘Richard Rawlins’ unless you search on the full title as well!

  • Will we have “boosting the immune system” (always a really stupid idea!) in part 4?

    • True. For my friends with auto-immune conditions or severe allergies, “boosting” their immune systems could be lethal.

  • EE: If a chiropractor believes that all diseases are due to ‘subluxations’ of the spine, it must seem logical to him that spinal ‘adjustment’ is synonymous with treating the root cause of whatever complaint his patient is suffering from….Some practitioners surely must know that; yet I have so far not met one who therefore would have stopped using it.

    I have never used it. It’s a silly concept.

  • Detox: I nearly laughed out loud during an introductory yoga class with my foster-child when the instructor said “these twisted positions detoxify you”.
    As Edzard suggests:
    – detoxify you of what
    – how do they know

    In that case it was probably right for me to not criticise (make a scene) because I was trying to support and bond with the foster child, but in general a brief dose of polite scepticism would be good. Perhaps “I don’t think that’s true. What do you think is being removed and how do you know?”

    Socially, we depend on most of what people saying being true – life is too hard if you reject everything – and those who spread bullshit take advantage of this. Noticeably true with blatantly false claims made during referendum and election campaigns – if you repeat them enough most people start to accept them, or at least their framework.

  • This is worded very poorly…

    “Our body has powerful organs and mechanisms to detoxify (skin, lungs, kidneys, liver). These take care of all the toxins we undoubtedly are exposed to.”

    Example:

    Foetal exposures to organophosphorus insecticides have also been linked to developmental effects, including reduced birth length and weight and reduced head circumference [26–28]. These effects have been shown not only to be linked with organophosphorus exposure and the variability of the paroxonase 1 (PON1) gene, which has several nucleotide polymorphisms. These various forms of the PON1 gene signal the body to make the PON1 enzyme that in essence detoxifies the organophosphorus insecticide. The PON1 enzyme differs among people both in terms of concentration and activity [29]. Although exposure to these chemicals can be intermittent, a low level chronic exposure from dietary residues likely exists. In CDC’s National Exposure Report, the population levels presented likely represent this dietary exposure as the large sample size probably minimizes the contribution of ‘spikes’ in exposure from intermittent dermal, inhalation or non-dietary ingestion routes of exposure. As a part of the Food Quality Protection Act of 1996 [30], the US Environmental Protection Agency (EPA) was tasked with re-evaluating all permissible food tolerances and to consider both aggregate and cumulative exposures from chemicals with the same mode of action. Because the organophosphorus insecticides share a common mode of action as cholinesterase inhibitors, they were among the first class of pesticides whose tolerances were re-evaluated. As a result of this re-evaluation, food tolerances of the most commonly applied organophosphorus insecticide, chlorpyrifos, were reduced by a factor of three. In addition, all US residential applications of the organophosphorus insecticides chlorpyrifos and diazinon were legislatively banned at the end of 2001 and 2002, respectively. Thus, we were able to use the NHANES measurements as a tool to evaluate the efficacy of these regulatory actions in reducing exposures to organophosphorus insecticides.

    http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2007.00185.x/full

    • @Mr Dale

      Your point is correct. There are indeed some poisons that remain in the body and are not removed by the skin, lungs, liver or kidneys. Mercury, lead and DDT spring to mind as further examples, as well as the organophosphorus molecules in your link. Cigarette smoke contains toxins which do their damage before any detoxification mechanism kicks in to remove them. Edzard might have better written: “These take care of almost all the toxins we undoubtedly are exposed to”. But then he’d have had to make his post longer by delving into fine details.

      Now, please show me the evidence that altmed claims for ‘detoxification’ are in any way supported by evidence. Or that altmed detoxification removes organophosphorus, lead, mercury or DDT. The important point in the original post is that camists use ‘detox’ as a marketing slogan. That ‘detox’ is bandied round as something magic that can be achieved by sticking needles into bodies, swallowing ‘remedies’ that contain no active ingredient, scraping the skin with a blunt instrument and virtually the whole panoply of unproven nonsense that comprise Big Snakeoil. And all without specifying exactly which toxins are removed. The example you provide is typical of the difference between medical research and woo-woo claims: it details the precise mechanism by which a chemically related group of toxins are removed from (some) bodies.

      • Frank: Now, please show me the evidence that altmed claims for ‘detoxification’ are in any way supported by evidence.

        Why should I? I didn’t make the claim.

        • But Dale your a chiropractor so doesn’t that mean that you subscribe to all that rubbish because All chiro’s are the same!

          • CC: But Dale your a chiropractor so doesn’t that mean that you subscribe to all that rubbish because All chiro’s are the same!

            It appears that Frank is caught up in his own mind game. It happens.

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