MD, PhD, FMedSci, FSB, FRCP, FRCPEd

I recently got this comment which might seem reasonable to some readers:

“What is most humorous about the author and this website is how he knocks the hell out of alternative medicine and therapies yet never provides readers with any alternatives, despite claiming to be an expert. For example: it’s like needing new tyres for your car and the salesman keeps on telling you that, I’m sorry this tyre, that tyre, and that tyre is not suitable for your car either. So you ask We’ll what tyre do you recommend then and he says… No comment. Anyone can pick holes in anything that’s easy, but to offer alternatives and provide useful workable information, to complete the equation that’s what is really needed. So all the author is doing is adding negativity and problems to this world without providing any real solutions.”

Reasonable?

Not really!

Why not?

There are several reasons, for instance:

  1. Legitimate criticism is not the same as “knocking the hell” out of something.
  2. Responsible physicians do not offer ‘real solutions’ via the Internet without knowing the full details of the patient they are talking to. In my view, this would not be ethical.

“Yeah, pull the other one!” I hear my opponents mumble. “There must be general solutions to the problems you are discussing on this blog that do not need any knowledge about specific patients!”

Perhaps, let’s see.

Let me go through 5 recent posts and let me try – in deviation from my usual stance – to offer some solutions that are reasonable, ethical and responsible.

  • here I knocked the hell out of Bowen technique advertised for “a wide range of acute and chronic conditions, including back pain, sciatica, neck, shoulder and knee problems, arthritis, asthma, migraine, sports injuries and stress”. My solution: if you suffer from any of these problems, see a good physician, get a proper diagnosis and an evidence-based treatment that fits your special needs.
  • here I knocked the hell out of alternative therapies for chronic pain. My solution: if you suffer from any of these problems, see a good physician, get a proper diagnosis and an evidence-based treatment that fits your special needs.
  • Here I knocked the hell out of homeopathy which allegedly is employed “all over the world [by] doctors, nurses, midwives, vets  and other healthcare professional  who integrate  CAM therapies into their daily  practice because they see effectiveness.” My solution: if you suffer from any of these problems, see a good physician, get a proper diagnosis and an evidence-based treatment that fits your special needs.
  • Here I knocked the hell out of ‘Brain Dust’, an “adaptogenic elixir to maintain healthy systems for superior states of clarity, memory, creativity, alertness and a capacity to handle stress”. My solution: if you suffer from any of these problems, see a good physician, get a proper diagnosis and an evidence-based treatment that fits your special needs.
  • Here I knocked the hell out of homeopathy for allergic rhinitis. My solution: if you suffer allergic rhinitis, see a specialist, get a proper diagnosis and an evidence-based treatment that fits your special needs.

Sorry, am I boring you?

Yes, that’s why I don’t usually offer ‘real solutions’.

I rest my case.

104 Responses to After “knocking the hell out of alternative medicine”, let me offer you some real solutions

  • It can’t be reiterated too often: “What do you call alternative medicine that works? Medicine!” However, with apparently more units dealing with terminal care of patients offering various forms of snakeoil; and with large hospitals in the USA shamelessly taking the dollar from the National Center for Complementary and Integrative Health to provide ‘training facilities’ and clinics offering snakeoil, the boundary between medicine and pseudo-medicine is become ever more blurred.

    Rubbing and grooming each other are instinctive and common mammalian behaviours, particularly among primates. They often make people feel better for a while and there’s no reason whatsoever to discourage similar activities with sick people. But as soon as this sort of thing becomes extended into specific therapeutic claims, supportive evidence is required.

  • Very very very easy answer! Yes, how about evidence based treatments – they are very very few in reality. Not even Paracetamol is something to give patients (except Children with fever). Another problem is when method like acupuncture gives better results than evidence-based pharmacological medical treatment for migraine for example. (Shown in the so called German “modellvorhaben”). Then we shall use the beta-blockers for example and not the more effective acupuncture. No, you really make the real World patient questions too easy for you!
    Christer Carlsson
    MD PhD

    • “you really make the real World patient questions too easy for you”
      did I?
      you must have read it differently from what I really meant. My solution: if you suffer from any of these problems, see a good physician, get a proper diagnosis and an evidence-based treatment that fits your special needs.
      THIS MEANS THAT IT IS NOT EASY; IN FACT, IT IS TOO COMPLICATED TO GIVE A MORE MEANINGFUL AND PRECISE ANSWER.

    • Very very very easy answer! Yes, how about evidence based treatments – they are very very few in reality. Not even Paracetamol is something to give patients (except Children with fever). Another problem is when method like acupuncture gives better results than evidence-based pharmacological medical treatment for migraine for example. (Shown in the so called German “modellvorhaben”). Then we shall use the beta-blockers for example and not the more effective acupuncture. No, you really make the real World patient questions too easy for you!
      Christer Carlsson
      MD PhD

      [citations needed]

      • It is certainly no surprise that Christer Carlsson, the president of the Swedish Acupuncture Society is securely confident in his income bringing vocation.
        It will hopefully be interesting to see his presentation of evidence for the superiority of a Mao era reinvention of archaic magic over an extremely effective group of well proven and efficient drugs.

        Here’s an interestingly naive elaboration on the “modellvorhaben”:
        https://www.ncbi.nlm.nih.gov/pubmed/19369191
        I do not have time now to delve deeper into this now but it seems to display what I call “the grand fallacy of acupuncture research” that because sham and verum are equally (in)effective, that must mean they are both efficacious 😀

        • Cummings summarises the German series of acupuncture trials – ART, ARC and GERAC. The latter found acupuncture and sham to be equally as effective as prophylactic medication in migraine and superior to standard care in low back pain. Acupuncture involved deep needling and stimulation (“de qi”) at acupuncture points. Sham involved shallow needling without stimulation at non-APs.

          As Cummings states the hypothesis of specific acupuncture points being necessary for acupuncture efficacy is not supported by the German trials.

          He also suggests that the form of sham which was employed was unlikely to be an inert placebo. The implication is that needling of any kind in any place is therapeutic.

          It is now known that blunt sham needles pricking the surface of the skin work as just as well as deep needling – when administered under the pretense of being acupuncture.

          What is required are RCTs in which acupuncture is compared with sham acupuncture not administered under the pretence of being acupuncture. Then we will be able to see clearly that acupuncture benefits consist purely and entirely of placebo effects. Of that, I am 100% convinced.

          Until this experiment is done nobody will ever persuade me that pricks made at random points on the body can cure every health problem that flesh is heir to; not even that clinically significant benefits for patients suffering serious pain can be sustained for any meaningful (cost effective) period of time.

          (Kaptchuck’s claims to have shown that honest placebos work do not hold up. Fake “honest”, to coin a phrase.)

    • ‘Evidence Based Medicine’ does what it says on the tin.
      It identifies treatments (‘medicine’) based on plausible evidence.
      No one ever pretends the evidence is perfect – but medicine bases its treatment on evidence.

      Yes, there is an alternative to alternative medicine (CAM or camistry) – it’s called, just to reiterate again (!), ‘medicine’.
      OK?

  • Unfortunately, Prof. Ernst should go on knocking as well as giving genuine answers to what are often hard and painful issues, since he has the insights, credibility, and the time to do so, which most of us don’t have because ‘life’ has steered us in other directions. There is just a new scandal, and I use the word advisedly, in the Netherlands.

    A judge has judged that a Dutch 12 year old boy called David who has a brain tumour has the right to refuse chemotherapy because “he knows full well what he is doing”.

    As such, I have no problems with this. Not everyone is the same, and he has the right (as permitted by law in the Netherlands) to decide whether or not he wants this treatment.

    However, it seems that he wants “alternative healers” (who are in effect illegally practicing medicine) to treat him. I would submit that if this is what he wants, he is by definition mentally incapable of making an informed or well-balanced decision. Choosing treatment that has not been shown to work, or even been shown not to work, makes no sense at all and should be refused.

    I hope not, but if I ever find myself in such a situation, I may very well decide to refuse treatment as well, and opt for euthanasia instead. That is my decision, and I would certainly want it to be accepted. However, I would submit that – contrary to what the judge said – if I were to decide to get treatment by alternologists it would prove beyond the reasonable doubt that I am mentally incapable of making responsible decisions, I should be declared non compos mentis and treated whether I want it or not.

    This issue is definitely stirring up emotions in the Nederlands, and Belgium as well. It was in the television news on the NOS (Netherlands) and the De Redactie (Belgium), and here is a written link:
    http://www.volkskrant.nl/wetenschap/david-12-heeft-een-hersentumor-maar-weigert-chemo~a4494116/

  • Yes , once you become a bubble burster, a debunker and a purveyor of reality, there is often not much on the other side to re-ignite the enthusiasm , only mundane reality.

  • Oh dear. Where to start?
    I doubt that any car dealer i’ ve ever met would fail to set you right with respect to the correct tyres for your car. He might even be glad to sell you some. What were you doing driving around with such an ill- matched set anyway?
    And would you then take advice from a spiv about using alternative tyres made from sausages? ( sorry about my recurring use of the ‘sausage’ motif but it is one of the best words in the English language).

  • Sarahnz
    How shall I put this in a way that you will understand?
    When you cultists make an outrageous, untrue claim, and then say ‘It’s true! Go on, look it up!’, what you do not or can not understand is that many of us, if we didn’t know the facts already, do just that.
    Your absurd and oft- repeated lie about proper medicine being the World’s greatest killer is a case in point.Do you know anything about the chancers who are greatly responsible for this murderous insanity? ‘Doctor’ Null, ‘Doctor’ Mercola, ‘Doctor’ Axe?Do you really think the rest of us don’t?
    If we’re to talk about being offended, then I have to say that I’m offended by your astonishingly low opinion of others’ intelligence.But then it was ever thus with cult followers.

    • Yes, they have a license to kill, and they do. Over and over. I’ll take food as my medicine. I’m 62, haven’t seen an MD since mid 1990’s, take no meds, vaccinations and skip all those “must have” medical procedures, etc. mammogram, colon scope, x-rays, MRI’s and cat scans. The road to health is a path FAR away from modern medicine and I refuse to be another patient for life to pad the pocket of others.

      • CONGRATULATIONS!!!
        please report again as soon as you fall ill [I hope it’s not soon]
        someone said: ALL THOSE HEALTH FREAKS WILL FEEL REAL STUPID ONE DAY LYING IN HOSPITAL DYING OF NOTHING.

      • Yes, they have a license to kill, and they do. Over and over.

        If that is so, how do you explain that these people are so bad at killing that we are living longer than ever before in history?
        Surely, these licenced killers must have been taught how to kill with some degree of success, right?

  • What exactly constitutes evidence based-treatment medicine. Would someone tell all the readers exactly what percentage of modern medicine has been proven to work and therefore evidence based. Everyone is getting carried away assuming that the number is quite high when in fact the percentage is quite low. Yes most of contemporary medicine is unproven. So all this talk about evidence based treatment total hogwash. Who’s game enough to quote a number. Or would too many people be shocked into disbelief to find out that there beloved arguments aren’t based on anything substantial.

    • “Patient outcome surveys confirms benefits of homeopathic treatment.”
      IT’S NOT A TERM THAT ANYONE I KNOW USES [you might mean ‘evidence-based medicine’ the definition of which you can easily look up]
      “what percentage of modern medicine has been proven to work ”
      % changes all the time [the point is that EBM is an ongoing project]
      “the percentage is quite low”
      but it’s increasing, while for homeopathy etc., it is decreasing.
      ” all this talk about evidence based treatment total hogwash”
      ONLY TO SOMEONE LIKE YOU WHO CLEARLY DOES NOT UNDERSTAND IT.

    • Sarahnz
      The number is in the link I gave earlier. Only 10% of all treatments – conventional or alternative – is conisdered to have sufficient evidence behind it.

      • Olavius said:

        The number is in the link I gave earlier. Only 10% of all treatments – conventional or alternative – is conisdered to have sufficient evidence behind it.

        It doesn’t, of course, but that’s not what Prof Ernst asked you:

        how many % of alternative therapies are of unknown efficacy?

      • Even if 10% was correct, that still beats alternative medicine any day 😉

  • Most of what you term as evidence based medicine lacks the evidence.
    http://clinicalevidence.bmj.com/x/set/static/cms/efficacy-categorisations.html

    Most of the patients going to a homeopath has already tried the “evidence” based treatment, but are still suffering. So they pay for the treatment out of their own pocket even though the “evidence” based treatment is for free. If nobody were helped we would soon be running out of patients. Patient outcome surveys confirms benefits of homeopathic treatment.

    He who cures is right.

    • “Patient outcome surveys confirms benefits of homeopathic treatment.”
      IT’S HARD TO FORMULATE A SENTENCE THAT IS MORE WRONG THAN THIS ONE!

      • But “He who cures is right.” must come close.

        • I am fascinated!
          where does that link support what you claim about observational studies?

          • Patient outcome surveys, i.e. study that tracked the outcome of patients receiving homeopathic treatment.
            The largest study at Bristol Homeopathic Hospital followed over 6,500 consecutive patients with over 23,000 attendances in a six-year period. 70% of follow-up patients reported improved health; 50% reported major improvement.

          • yes, that’s the most famous one.
            these patients also benefitted from:
            1) conventional treatments,
            2) the placebo effect,
            3) the natural history of the condition,
            4) regression to the mean,
            5) the extra attention and TLC,
            and many other effects.
            SO WHY DO YOU THINK THE OUTCOME YOU MENTION HAD ANYTHING TO DO WITH THE HOMEOPATHIC REMEDIES?

          • @Olavius

            It was a customer satisfaction survey that did not measure treatment outcomes. It did not show that customers’ perceived improvement was due to any sugar pills they might have taken.

          • only if your point is that studies without control groups cannot test efficacy

          • Olavius, you should really make yourself acquainted with the concept of prior probability and what a p-value really measures. Hint: It does NOT measure whether homeopathy has worked in a trial or not. As for Robert Hahn, he is an excellent clinician and not a statistician. He therefore too misses the fine points of prior probability. He also does not grasp how Prof. Ernst approach really works. He accused him of achieving his results by artificial data when in reality this was only an extrapolation, very much like the calculation of the Michaelis-Menten constant. Another hint. Probabilities can be extremely tricky to understand. Example: If you have a rare blood type and a blood stain is found on the site of a crime consisting of two blood types, namely your rare one and a very common one, this speaks – given no other evidence – in favour of you, as odd as it may sound.

          • Olavius,

            your collection demonstrates why observational studies have their weaknesses. As an example I will dissect the URTI study. The results are in brief that patients visiting GPs with homeopathy consume less antibiotics, while having the same disease progress combined with a risk of developing secondary infections. This risk is not significant, though, but I have no doubt that it will be significant in a group using no antibiotics.

            The conclusions of these results is pretty clear:
            (a) in an acute setting, antibiotics and antiinflammatory drugs are of very limited effect – that is known and biologically feasible
            (b) antibiotics and antiinflammatory drugs may act as a prevention of secondary infections – that is also known and biologically feasible
            (c) use of homepathics does not alter the course of the disease, but might lead to something nastier like a secondary infection due to reduction of *real* drugs caused by a placebo effect – that is also known and biologically feasible.

            So, what we see here is actually a nice placebo effect. The probably most important sentence in the abstract is: “A non-statistically significant excess was estimated through modelling for associated infections in the GP-Ho group and needs to be further studied.”

            This study works in no way to your favours.

          • Olavius, the large scale studies don’t prove your point. Let us examine the URTI study.

            The result is in short:

            (a) GP plus homeopathy have the same course of diesease as the others
            (b) GP plus homeopathy lead to less use of antibiotics.
            (c) GP plus homeopathics have very likely a higher risk of secondary infections. Though not significant, I bet it would reach significance if use of antibiotics is entirely excluded.

            The conclusion of the study is that homeopathy is inferior to state-of-the art treatment. Why ? The course of the disease is the same, the likely preventive effect of antibiotics wanes. The data are entirely compatible with a placebo effect.

    • @Olavius

      According to your link it’s 11% of treatments that are ‘beneficial’ according to the evidence (I know that’s close to 10% but why round down and not quote the real figure?). Then there’s 24% for which evidence suggests the treatments are ‘likely to be beneficial’. So that’s 35% of treatments supported by positive evidence. The real catch is the 50% of treatments of ‘unknown effectiveness’ the link states that this category includes all the CAM data, as well as unproven ‘orthodox’ treatments.

      So the real conclusion to be drawn from your link is that at least 35% of treatments used in real medicine have a positive evidence base, and the proportion would be higher if modalities recognized to fall under the heading of CAM were removed from consideration. (“What do you call CAM with positive evidence for efficacy?” “Medicine.”)

      • 11% is not very convincing is it. Especially when you consider all the hundreds of billions of government research, fund raising, donation dollars etc. spent over the decades to arrive at that number. Smells fishy doesn’t it?

    • And the Aztecs sacrificed people to keep the Sun rising. And it did.

      You say “He who cures is right”

      Fancy withdrawing your fatuous assertion?

      • Simon Baker-‘It must be true because I saw it’ essentially. Or the feller I know here who said rather scornfully -we’ve all met them- ‘I’ve been smoking for forty yeasts and it’s never done me any harm’.

        • Smoking yeasts?! Gosh, worked with the pathogenic ones for 40 years and never thought of that!

          • Frank Odds- as they had somebody say on ‘ Brass Eye’, it’s not a fact, but it is true.

  • Olavius should note that comments, on this website, that direct attention to EBM will be scrutinised to focus on something that the commenter wrote that distracts the reply comments from addressing the substance of the comment.

    Here are three comments to address:
    50% of EBM has ‘unknown’ efficacy, and, as Dr. Ernst stated above, the percentage with known efficacy is low.

    Virtually all medicines used in EBM have a range potential side effects.

    Medical doctors should be required to fully disclose the potential side effects and level of efficacy of the medicines that they prescribe for their patients. Not to do so is failing to obtain fully informed consent and, in my opinion, unethical practice.

    • correct!
      but this also goes for alternative practitioners, doesn’t it?

      • Yes, of course.

        • so, how many % of alternative therapies are of unknown efficacy?

          • So homeopathic treatment for acute middle ear infection is alright then?

            Since you recommend EBM the finger points at you. What would you suggest for a patient with moderate depression? EBM? How many patients need to take statins for one patient to benefit? How come researchers have a hard time to reproduce clinical trials?

            And I disagree with the premise that only RCT’s can prove efficiency. You also have to consider patient outcome surveys, statisitics and other empircal evidence.

            Truth of the matter is that if you remove all treatments from the NHS without sufficient evidence behind it you would end up with a pretty short list. Would you be prepared to do this?

          • “So homeopathic treatment for acute middle ear infection is alright then?”
            WAHT MAKES YOU THINK THAT?
            “What would you suggest for a patient with moderate depression?”
            I DID TRY TO EXPRESS THAT RESPONSIBLE DOCTORS DON’T GIVE SUCH ADVICE VIA THE INTERNET; WE NEED TO SEE THE PATIENT, TAKE A HISTORY, DO AN EXAM, DISCUSS TREATMENT OPTIONS. IN SOME CASES CBT IN OTHERS HYPERICUM MIGHT BE AN OPTION.
            “How many patients need to take statins for one patient to benefit?”
            LOOK UP NNT YOURSELF
            “How come researchers have a hard time to reproduce clinical trials?”
            DO THEY?
            “And I disagree with the premise that only RCT’s can prove efficiency. You also have to consider patient outcome surveys, statisitics and other empircal evidence”
            I DISAGREE WITH YOUR DISAGREEMENT. PLEASE TELL US WHAT YOUR SCIENCE BACKGROUND IS TO DISAGREE.
            “Truth of the matter is that if you remove all treatments from the NHS without sufficient evidence behind it you would end up with a pretty short list. Would you be prepared to do this?
            THE LIST WOULD BE NOT AS SHORT AS YOU THINK, AND EBM IS AN ONGOING, FAIRLY YOUNG PROCESS – GIVE IT A BIT OF TIME!

          • cannot reply below.
            Otis media
            https://www.ncbi.nlm.nih.gov/pubmed/11224838
            https://www.ncbi.nlm.nih.gov/pubmed/22226309

            But please tell me what does my background has to do with what opinion I have. If I were a car mechanic or a politician I would still think that more than just RCT’s needs to be taken into considerration. For instance
            https://www.hri-research.org/resources/homeopathy-the-debate/essentialevidence/observational-studies/

            And by the way I would love to see your list on the 11% treatments considered by BMJ to carry sufficient evidence. This number is going down – it was 17%, then 13% and now 11% (sorry not 10% as stated earlier).

          • so, one of your refs is a pilot study and the other one is a ‘preliminary’ trial.
            say no more.
            from what you say, you have no background in reading trials or understanding research methodology – nothing wrong with that, of course. but why don’t you learn. and if you don’t want to learn, why not be quiet about such matters?
            it’s not MY LIST!!
            and let me tell you: you completely misunderstand these % figures – please do catch up and learn the basics.

          • It not within my scope to comment on the efficacy of ‘alternative therapies’.

            According to my knowledge of homeopathy, there are no scientific studies that prove efficacy of homeopathy for a particular medical condition. If I am wrong, please would a commenter provide the link to the study that proves efficacy of homeopathy for a particular medical condition. Thank you.

          • Accring to your knwledge of homeopathy … which is probably non-existant. YOu owe us a whole bunch of answer and before these are not answered nobody will answer you.

          • Oh yes I understand the chart. It says 11% of all treatments are considered based on the current evidence to be beneneficial. 89% is not. Would you recommend the treatments in the 89% group to be removed from the NHS?

            Off course a random of 100 patients could receive treatments from the 11% group, but as far as I am aware no large studies has ever been made to confirm this.

            And the evidence is not getting stronger – it is getting weaker – the beneficial group has shrunken over the years from 17% to 13% to 11%.

          • oh, no you don’t!

          • Why is it you do not answer the question? Would you recommend NHS removed all treatments which doesn’t belong to the 11% (or 11%+24%) group.?

          • because you do not understand and interpret these % figures correctly

          • No, Olavius, it really doesn’t.

          • Oh no, you don’t understand the chart. 35% of the therapies are ‘beneficial’ or ‘likely to be beneficial’ The 50% of ‘unknown effectiveness’ include modalities that nobody in their right mind could possibly consider rational approaches to treatment. So the 35% is an underestimate. Your rationale that “89% is not. Would you recommend the treatments in the 89% group to be removed from the NHS?” is a pejorative misconstruction of the evidence in your link.

    • Oh, OK, here’s Greg. I expect he can answer a couple of questions.

      Please provide a single concrete example where any of the sceptical side has demonstrated a lack of understanding of homeopathy.

      You still have not commented on the fact that the CDF seems to have been mismanaged because it applied the standards of SCAM to actual medicine.

  • Boy, they ‘ ve all come out this time.
    Tacoma’s point rivals those of Sarahnz for demonstrable silliness.
    As has happened before, I think I’ll just sit back and observe a while. No use talking to a wall.

    • Maybe the science that you worship isn’t that solid after all. But you would never admit it though would you, even if it was right in front of you. Beliefs engrained as deeply as yours requires a life time to undo.

      • Sarrahnz- you’re being silly again. Your scorn for science is frankly risible, indeed when taken to the Trump extent downright frightening. And unlike you, I don’t follow an evidence- free cult, therefore Idon’t ‘worship’ anything, let alone science. I think the word is more suited to your homeopathy religion.

        • No idea why you guys keep referencing homoeopathy with my comments, I’ve never commented on or discussed the subject. So how about you keep it on point instead of going off track.

          • Sarahnz- what then do you propose as an alternative to modern medicine, if not homeopathy? Prayer? Distant healing? Therapeutic touch? Vast amounts of Vitamin C? Magic?

  • Quote from this blogentry
    http://edzardernst.com/2016/12/when-sceptics-or-skeptics-criticise-homeopathy-they-are-often-wrong/

    “Several well-conducted clinical studies of homeopathy with positive results have been published. It is therefore not true to claim that there is no good trial evidence at all to support homeopathy. The much better point sceptics should make is that the totality of the reliable evidence fails to show that highly dilute homeopathic remedies are more effective than placebos.”

    Could be interesting to learn what these studies you consider to be ok are.

    • Olavius, you should make yourself acquainted with the concept of prior probability and what a p-value really says. A p-value of less than 0.05 in an RCT does NOT say a treatment works.

  • I dont pretend to be an expert on clinical research. But Robert Hahn is.
    https://www.ncbi.nlm.nih.gov/pubmed/24200828

    In 1997 Klaus Linde and co-workers identified 89 clinical trials that showed an overall odds ratio of 2.45 in favor of homeopathy over placebo. There was a trend toward smaller benefit from studies of the highest quality, but the 10 trials with the highest Jadad score still showed homeopathy had a statistically significant effect.

    To conclude that homeopathy lacks clinical effect, more than 90% of the available clinical trials had to be disregarded. Alternatively, flawed statistical methods had to be applied.

    Future meta-analyses should focus on the use of homeopathy in specific diseases or groups of diseases instead of pooling data from all clinical trials.

    • I am afraid, you are wrong yet again.
      read up about Hahn in previous posts.
      read Linde’s second analysis of the same data-set.

  • Edzard wrote:
    ‘My solution: if you suffer from any of these problems, see a good physician, get a proper diagnosis and an evidence-based treatment that fits your special needs.’

    Sounds so simple. The problem Edzard is that everyone who uses CAM has already done that! There are limits to how many times someone can keep going round in circles with Drs , Specialists and EBM treatments.
    I wished all EBM treatments worked as well in reality as they do on this blog.
    That is why CAM exists.
    If it was all as easy as you make out then there would never have been any demand for CAM.

    • “Sounds so simple”
      ONLY SOMEONE VERY NAIVE MIGHT THINK THAT – IT IS EVERYTHING BUT SIMPLE!
      ” I wished all EBM treatments worked as well in reality as they do on this blog.”
      YOU HAVEN’T EVEN NOTICED THAT THIS BLOG IS NOT ABOUT ‘EBM-TREATMENTS’!

    • Perfectly said…

      • Sarahnz- as Edzard already said, a basic understanding of the concept of logical fallacies
        would seem to be useful here.8

  • Remind me why CAM still exists in the UK Edzard.’ Real medicine’ ie EBM in the UK is usually delivered through the NHS. This system often fails patients. So they go to CAM. Is this being naive?

    • naïve + a classical fallacy
      I recommend reading up about ‘logical fallacies’

    • “So they go to CAM. Is this being naive?”

      Somewhat. Some people indeed turn to CAM from dissatisfaction with real medicine, but there are plenty of folk who have been brought up with faith in CAM, or turn automatically to ‘healthy’ alternatives to deal with trivial problems because they believe ‘natural’ is better per se than man-made, or that CAM therapies are ‘gentle’, or they hold ‘spiritual’ views that favour CAM over what they perceive as materialistic. This isn’t a comprehensive list; I’m sure there are other reasons as well.

    • This system often fails patients. So they go to CAM. Is this being naive?

      It is the equivalent of switching from a pension plan to a lottery ticket.

  • There you go again about logical fallacies Dr. Ernst. Add that to your list: when you are out of arguments resort to ad hominem and complain about your opponents logical fallacies.

    Theevenbetterthanthegoodthinkingsocietysociety wrote:

    The problem Edzard is that everyone who uses CAM has already done that! There are limits to how many times someone can keep going round in circles with Drs , Specialists and EBM treatments.
    I wished all EBM treatments worked as well in reality as they do on this blog.
    That is why CAM exists.
    If it was all as easy as you make out then there would never have been any demand for CAM.

    Dr Ernst, perhaps you will write a blog to answer this question?
    Are there limits to how many times someone can keep going round in circles with Drs , Specialists and EBM treatments?

    • Read up on logical fallacies, Greg. You’ll find out what ad hominem actually means and you may grasp some of the myriad errors in your arguments. Although I doubt it because you’ve managed to give the concepts an amusingly wide berth thus far.

  • I was once a CAM practitioner. Always complementary and not alternative. Frank obviously hasn’t got a clue about CAM patients. People brought up with CAM still go to the Dr to check things out. Patients demand CAM and they are prepared to pay for it. NHS just can’t deal with the totality of everyone’s health needs. Is that a logical fallacy?
    It does seem that anyone who disagrees with Edzard or others on here just gets’ logical fallacies’ replied every time. I would suggest that they should read up on this as well.

    • CAM enthusiasts like yourself are so full of fallacies that I would need to point them out in almost every one of their many comments. I do this perhaps far too rarely, you are right.

    • “NHS just can’t deal with the totality of everyone’s health needs.” I think we’re entering murky waters if we equate the NHS with orthodox medicine. After all, the NHS still pays for some CAM therapies; and it affords the salaries of hospital chaplains, whose work is far from evidence based.

      Besides, the issues discussed on this blog are not specific to the UK. I’d modify your statement to read thus: “orthodox medicine just can’t deal with the totality of everyone’s subjective vision of their health needs, nor does it have answers for every objectively diagnosed medical problem”.

      “People brought up with CAM still go to the Dr to check things out.” Indeed, some do — think of the British royal family as a shining example of those who behave that way — but there’s no shortage of individuals who imagine they have no illnesses they can’t cure with CAM: think of many comments on this blog from Iqbal as a good example.

    • If advocates stopped using logical fallacies in their ‘arguments’, we wouldn’t have to point them out. Just a thought.

      But you didn’t provide any argument, logical or otherwise, just a series of unconnected premises. There is potentially an implied conclusion, but if I have guessed correctly what that was, then yes, your argument is fallacious.

  • Great to have a ‘logical fallacies’ routine to fall back on as a justification for anything said.
    Of course anyone pointing out any reliance on ‘logical fallacies’ as an answer to everything might get the ‘belligerent twit’ routine.
    This blog should be read by everyone.

    • no it’s great to have logic, because fallacies are the domain of belligerent twits

      • When you think about it Edzard all your writings, reports, books, presentations, that you have put out over the years are only backed up by and based on 11% of proven data. With a number so low does that qualify your statements as expert or mere opinions?

    • “This blog should be read by everyone.”

      I agree absolutely.

  • Dr Ernst, is a medical doctor that did some homeopathy training with his ‘boss’:Dr. med. Walter Zimmerman: Chief physician from 1958 to 1989 Due to his charismatic personality, Dr. Zimmermann contributed significantly to the success of the clinic. He succeeded in wiping out all debts with the help of generous donations and to finance the lecture theater. (Google).

    Dr Ernst stated that before the advent of modern medicine, there was not much medicine, human beings died at 31 etc. This evidences Dr Ernst’s lack of knowledge of the history of medicine: Greece, Rome, China, India, Egypt…all had traditional systems of medicine that people used for thousands of years.

    Dr Ernst has no idea of how Hahnemann compiled the Homeopathic Materia Medica: Dr Ernst relies on fable to concoct the notion that Hahnemann relied on his ‘provings’ when the fact is that Hahnemann was a master chemist and knew the plants and drugs of the apothecary inside out. Hahnemann’s Materia Medica cites pages of authorities from which Hahnemann obtained information about medicines.

    Dr Ernst keeps repeating his mantra that there is no evidence that homeopathy has an effect better than placebo, when this is an untrue statement.

    Dr Ernst ignores questions that he can’t/won’t answer and then mumbles on about fallacies but rarely does he do an actual analysis of the pointed out fallacy.

    Given that Dr Ernst has ignored so many questions that commenters have raised and then gone away after his fallacy rebuttal, maybe, he will answer this one:

    ‘Theevenbetterthanthegoodthinkingsocietysociety wrote:

    The problem Edzard is that everyone who uses CAM has already done that! There are limits to how many times someone can keep going round in circles with Drs , Specialists and EBM treatments.
    I wished all EBM treatments worked as well in reality as they do on this blog.
    That is why CAM exists.
    If it was all as easy as you make out then there would never have been any demand for CAM.

    Dr Ernst, perhaps you will write a blog to answer this question?
    Are there limits to how many times someone can keep going round in circles with Drs , Specialists and EBM treatments?’

    Logic and fact: an interesting discussion but, for now, can Dr Ernst focus on fact?

    Thank you

    • Dr Ernst stated that before the advent of modern medicine, there was not much medicine, human beings died at 31 etc. This evidences Dr Ernst’s lack of knowledge of the history of medicine: Greece, Rome, China, India, Egypt…all had traditional systems of medicine that people used for thousands of years.

      What was the average lifespan in those thousands of years? What was the life expectancy at birth?

      Hahnemann’s Materia Medica cites pages of authorities from which Hahnemann obtained information about medicines.

      How does that validate his law of similars and his law of infinitesimals?

      Dr Ernst keeps repeating his mantra that there is no evidence that homeopathy has an effect better than placebo, when this is an untrue statement.

      What is the evidence for this claim?

      Dr Ernst ignores questions that he can’t/won’t answer and then mumbles on about fallacies but rarely does he do an actual analysis of the pointed out fallacy.

      He often has. How often does he need to repeat the same things before alternologist lunkheads get it through their thick and/or uncooperative skulls?

      If it was all as easy as you make out then there would never have been any demand for CAM.

      If that is the case, why does religion still exist? Why does astrology still exist? Why are so many people still “touching wood”?

      Dr Ernst, perhaps you will write a blog to answer this question?

      Which of these questions? All of them? Please provide evidence that he has not answered it/them on this blog.

      Logic and fact: an interesting discussion but, for now, can Dr Ernst focus on fact?

      Why?

  • see a good physician, get a proper diagnosis and an evidence-based treatment that fits your special needs.

    Indeed. We should never forget that good physicians offer a holistic and highly individualised approach, which is something that cannot and should not be generalised, except perhaps for the words of Dr. McCoy in the Omega glory:

    I can do more for you if you just eat right and exercise regularly.

    That was in 1968. I can’t help but wonder how many of the alternologists we see on this blog were even born at the time, and it wasn’t new even then. It also wasn’t about “curing” or “healing”, but about prevention, something alternologists don’t seem to be very interested in.

    • The Neijing (roughly 2000 years old) bangs on about lifestyle and diet being the crucial factors in health. I’m not sure why you’d say ‘alternologists’ aren’t interested in prevention – it’s a fundamental principle of Chinese medicine at least. Sadly, many people arrive at our doors as a ‘last resort’ though, so the horse has bolted.

      • What was the Neijing an alternative for? Or was it just a deeply flawed medical text, representing what was then considered medicine?
        Prevention is a fundamental principle of medicine. Just because patients often don’t want to hear about it, doesn’t mean it isn’t.
        Alternologists have interesting ways of demonstrating their interest in prevention. The lack of enthusiasm for bed nets for the prevention of malaria springs to mind.

        • @Bart

          ‘Prevention is a fundamental principle of medicine. Just because patients often don’t want to hear about it, doesn’t mean it isn’t.’

          Maybe that’s true in principle, but in my experience, conventional doctors often jump straight to medication, and are either unable (due to time constraints?) or unwilling to discuss prevention. This is a great pity.

          ‘Alternologists have interesting ways of demonstrating their interest in prevention. The lack of enthusiasm for bed nets for the prevention of malaria springs to mind.’

          I’m not sure exactly what you’re referring to, but you demonstrate an extraordinary capacity for the sweeping generalisation.

          P.S. Sorry to see ‘houseofquack’ has been suspended – I’m sure it was a good read.

          • ” you demonstrate an extraordinary capacity for the sweeping generalisation”
            I AM SO GLAD WE HAVE FOUND SOMEONE WHO IS ENTIRELY FREE OF THIS VICE:
            “conventional doctors often jump straight to medication, and are either unable (due to time constraints?) or unwilling to discuss prevention”

          • Sorry to see ‘houseofquack’ has been suspended

            It was suspended for technical reasons: it and a few others were the victim of an exploit that caused major problems for my provider. I don’t like that, but I have learned to accept facts in my old age.

  • Logical observations of today,
    I cannot find someone able to get tyres that fit my car –> lets try to fit any old tyres, that are a waste of money and could damage my car or be dangerous to use
    I have exhausted all medicine that has proven efficacy and is available to me –> Lets try something that has been proven ineffective because it is available to me
    I do not know how the universe was created –> An invisible pink unicorn created it. Some fella told me so

  • @Edzard

    ‘” you demonstrate an extraordinary capacity for the sweeping generalisation”
    I AM SO GLAD WE HAVE FOUND SOMEONE WHO IS ENTIRELY FREE OF THIS VICE:
    “conventional doctors often jump straight to medication, and are either unable (due to time constraints?) or unwilling to discuss prevention”’

    You omitted the important prefix ‘in my experience’. I have found this to be the case from my personal encounters, and the reports of many of my patients, which add up to many hundreds of examples of this tendency. However I should have made it clear that of course there are also many doctors who take prevention very seriously. Bart seems to be picking out a specific case and drawing extremely broad conclusions about CAM practitioners from it.

    • I think that WITH the prefix it is even worse!

    • Bart seems to be picking out a specific case and drawing extremely broad conclusions about CAM practitioners from it.

      Has it occurred to you that Bart was merely giving an easily verifiable example?

      • I’m not even sure how you’re defining what an ‘alternologist’ is, let alone how you’re relating bed nets to their lack of interest in prevention. So I’m afraid I don’t find this to be easily verifiable.

        • I’m not even sure how you’re defining what an ‘alternologist’ is,

          You seemed to understand it pretty well less than an hour ago.
          I define an alternologist as someone who practices and/or promotes and/or claims to believe in practices that have not been shown to be effective.
          I also define a quack as someone who practices and/or promotes and/or claims to believe in practices that have been shown not to be effective.

          let alone how you’re relating bed nets to their lack of interest in prevention

          Well, you could argue that my example is a non-starter because bed-nets *have* been shown to be effective and are therefore not of any interest to alternologists and quacks, which would be consistent with their aversion to evidence. Maybe I am too optimistic in thinking that alternologists and quacks care at all about the wellbeing of their gullible victims.
          In any case, this should get you started: https://www.newscientist.com/article/mg19125613.100-homeopaths-under-fire-over-tropical-treatments/

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