MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Monthly Archives: January 2018

This systematic review aimed to identify and explore published studies on the health, wellbeing and economic impact of retreat experiences. Three electronic databases were searched for residential retreat studies published in English. Studies were included, if they involved an intervention program in a residential setting of one or more nights, and included before-and-after data related to the health of participants.

A total of 23 studies including 8 randomised controlled trials, 6 non-randomised controlled trials and 9 longitudinal cohort studies met the inclusion criteria. These studies included a total of 2592 participants from diverse geographical and demographic populations and a great heterogeneity of outcome measures, with 7 studies examining objective outcomes such as blood pressure or biological makers of disease, and 16 studies examining subjective outcomes that mostly involved self-reported questionnaires on psychological and spiritual measures.

All studies reported post-retreat health benefits ranging from immediately after to five-years post-retreat. Study populations varied widely and most studies had small sample sizes, poorly described methodology and little follow-up data, and no studies reported on health economic outcomes or adverse effects, making it difficult to make definite conclusions about specific conditions, safety or return on investment.

The authors concluded that health retreat experiences appear to have health benefits that include benefits for people with chronic diseases such as multiple sclerosis, various cancers, HIV/AIDS, heart conditions and mental health. Future research with larger numbers of subjects and longer follow-up periods are needed to investigate the health impact of different retreat experiences and the clinical populations most likely to benefit. Further studies are also needed to determine the economic benefits of retreat experiences for individuals, as well as for businesses, health insurers and policy makers.

In the article, the authors also state that the findings from the reviewed studies suggest there are many positive health benefits from retreat experiences that includes improvements in both subjective and objective measures… The results from the most rigorous studies that used randomized controlled designs were consistent with less rigorous studies and suggest that retreat experiences can produce benefits that include positive changes in metabolic and neurological pathways, loss of weight, blood pressure and abdominal girth, reduction in health symptoms and improvements in quality of life and subjective wellbeing.

As it happens, we have discussed one of their ‘most rigorous’ RCTs on this blog. Here is what I wrote about it when it was first published:

The ‘study‘ in question allegedly examined the effects of a comprehensive residential mind–body program on well-being. The authors describe it as “a quasi-randomized trial comparing the effects of participation in a 6-day Ayurvedic system of medicine-based comprehensive residential program with a 6-day residential vacation at the same retreat location.” They included 69 healthy women and men who received the Ayurvedic intervention addressing physical and emotional well-being through group meditation and yoga, massage, diet, adaptogenic herbs, lectures, and journaling. Key components of the program include physical cleansing through ingestion of herbs, fiber, and oils that support the body’s natural detoxification pathways and facilitate healthy elimination; two Ayurvedic meals daily (breakfast and lunch) that provide a light plant-based diet; daily Ayurvedic oil massage treatments; and heating treatments through the use of sauna and/or steam. The program includes lectures on Ayurvedic principles and lifestyle as well as lectures on meditation and yoga philosophy. The study group also participated in twice-daily group meditation and daily yoga and practiced breathing exercises (pranayama) as well as emotional expression through a process of journaling and emotional support. During the program, participants received a 1-hour integrative medical consultation with a physician and follow-up with an Ayurvedic health educator.

The control group simply had a vacation without any of the above therapies in the same resort. They were asked to do what they would normally do on a resort vacation with the additional following restrictions: they were asked not to engage in more exercise than they would in their normal lifestyle and to refrain from using La Costa Resort spa services. They were also asked not to drink ginger tea or take Gingko biloba during the 2 days before and during the study week.

Recruitment was via email announcements on the University of California San Diego faculty and staff and Chopra Center for Wellbeing list-servers. Study flyers stated that the week-long Self-Directed Biological Transformation Initiative (SBTI) study would be conducted at the Chopra Center for Wellbeing, located at the La Costa Resort in Carlsbad, California, in order to learn more about the psychosocial and physiologic effects of the 6-day Perfect Health (PH) Program compared with a 6-day stay at the La Costa Resort. The study participants were not blinded, and site investigators and study personnel knew to which group participants were assigned.

Participants in the Ayurvedic program showed significant and sustained increases in ratings of spirituality and gratitude compared with the vacation group, which showed no change. The Ayurvedic participants also showed increased ratings for self-compassion as well as less anxiety at the 1-month follow-up.

The authors arrived at the following conclusion: Findings suggest that a short-term intensive program providing holistic instruction and experience in mind–body healing practices can lead to significant and sustained increases in perceived well-being and that relaxation alone is not enough to improve certain aspects of well-being.

This ‘study’ had ethical approval from the University of California San Diego and was supported by the Fred Foundation, the MCJ Amelior Foundation, the National Philanthropic Trust, the Walton Family Foundation, and the Chopra Foundation. The paper’s first author is director of research at the Chopra Foundation… Just for the record, let me formulate a short conclusion that actually fits the data from this ‘study’: Lots of TLC, attention and empathy does make some people feel better… 

END OF QUOTE FROM MY OWN POST

The subject of health retreats could be relevant and important. Educating people and teaching them the essentials about healthy life-styles is potentially a good thing. It could well turn out that health retreats benefit many individuals, while saving money for society.

Yet, do we need all sorts of quackery for achieving this aim?

No, we don’t!

A rational programme would need to teach and motivate people about diet, weight control, smoking cessation, regular sleep, relaxation, exercise, etc. It could prevent disease and save funds. This approach has existed in Europe long before the US ‘New Agers’ with their flimflam jumped on this bandwagon. Health education is a good idea, but it does not require the use of alternative therapies or luxury retreats.

As it turns out, the new systematic review is a disappointment. It fails to stress that no firm conclusions can be drawn from flimsy data and degenerates into little more than an embarrassing advertisement for Deepak Chopra’s and similar entrepreneurs’ money-making retreats. It totally ignores the sizable body of Non-English literature on the subject, and is focussed on promoting fashionable retreats and wellness centres in the US and Australia.

To be fair to the authors, they almost admit as much when they state: “Competing interests: MC is a board member of the Global Wellness Summit and has previously been a paid presenter at the Gwinganna Health Retreat. RMIT University has received donations from Danubius Hotel Group, Lapinha, Sunswept Resorts, Sheenjoy and The Golden Door for ongoing retreat research.”

I rest my case.

How often have we heard this? YOU ARE WRONG! MY TREATMENT DOES WORK!!! ONLY THE OTHER DAY, I HAD A PATIENT WHO WAS CURED BY IT.

Take for instance this tweet I got yesterday:

F SThomas‏ @spenthomf

You go too far @EdzardErnst. In fact I was consulted about a child who hadn’t grown after an accident. She responded well to homoeopathy and grew. How much are you being paid for your attempts to deny people’s health choices?

The tweet refers to my last post where I exposed homeopathic child abuse. Having thought about Thomas’ tweet, I must say that I find it too to be abusive – even abusive on 4 different levels.

  1. First, the tweet is obviously a personal attack suggesting that I am bribed into doing what I do. I have stated it many times, and I do so again: I receive no payment from anyone for my work. How then do I survive? I have a pension and savings (not that this is anyone’s business).
  2. Second, it is abusive because it claims that children who suffer from a pathological growth retardation can benefit from homeopathy. There is no evidence for that at all, and making false claims of this nature is unethical and, in this case, even abusive.
  3. Third, if Thomas really did make the observation she suggests in her tweet and is convinced that her homeopathic treatment was the cause of the child’s improvement, she has an ethical duty to do something more about it than just shooting off a flippant tweet. She could, for instance, run a clinical trial to find out whether her observation was correct. I admit this might be beyond her means. So alternatively, she could write up the case in full detail and publish it for all of us to scrutinise her findings. This is the very minimum a responsible clinician ought to do when she comes across a novel and potentially important result. Anything else is my view unethical and hinders progress.

I do, of course, sympathise with lay people who fail to fully understand the concept of causality. But surely, healthcare professionals who pride themselves of taking charge of patients ought to have some comprehension of it. They should know that clinical improvements after a treatment is not necessarily the same as clinical improvement because of the treatment. Is it really too much to ask of them to know the criteria for causality? There is plenty of easy-reading on the subject; even Wikipedia has a good article on it:

In 1965, the English statistician Sir Austin Bradford Hill proposed a set of nine criteria to provide epidemiologic evidence of a causal relationship between a presumed cause and an observed effect. (For example, he demonstrated the connection between cigarette smoking and lung cancer.) The list of the criteria is as follows:

  1. Strength (effect size): A small association does not mean that there is not a causal effect, though the larger the association, the more likely that it is causal.
  2. Consistency (reproducibility): Consistent findings observed by different persons in different places with different samples strengthens the likelihood of an effect.
  3. Specificity: Causation is likely if there is a very specific population at a specific site and disease with no other likely explanation. The more specific an association between a factor and an effect is, the bigger the probability of a causal relationship.
  4. Temporality: The effect has to occur after the cause (and if there is an expected delay between the cause and expected effect, then the effect must occur after that delay).
  5. Biological gradient: Greater exposure should generally lead to greater incidence of the effect. However, in some cases, the mere presence of the factor can trigger the effect. In other cases, an inverse proportion is observed: greater exposure leads to lower incidence.
  6. Plausibility: A plausible mechanism between cause and effect is helpful (but Hill noted that knowledge of the mechanism is limited by current knowledge).
  7. Coherence: Coherence between epidemiological and laboratory findings increases the likelihood of an effect. However, Hill noted that “… lack of such [laboratory] evidence cannot nullify the epidemiological effect on associations”.
  8. Experiment: “Occasionally it is possible to appeal to experimental evidence”.
  9. Analogy: The effect of similar factors may be considered.

And this brings me to my 4th and last level of abuse in relation to the above tweet and most other claims of this nature: being ill-informed and stupid while insisting to make a nonsensical point is, in my view, offensive – so much so that it can reach the level of abuse.

Brace yourself: the wonders of homeopathy seem to be without limits. You can even increase the height of your children with homeopathy!

This website explains in some detail:

SBL Rite-Hite Tablets growth promoter homeopathic medicine is indicated for children who do not grow or develop satisfactorily, suffer feeble digestion & imperfect assimilation, anemia, lack of concentration, poor memory. A clinically proven homeopathy research product from SBL that aids proper physical development of growing children to gain proper body size in terms of height and girth

SBL’s Rite-Hite is a homeopathic medicine for height increase in children. It is a clinically established proven formulation which contains well balanced homeopathic medicines. Rite-Hite helps to achieve the optimal balance of factors like genetics, hormonal balance, nutritional status and general health and thereby promotes optimal growth…

Other Height (Growth) promoter Homeopathy medicines similar to WL14 drops
Buy Bhargava Tallo-Vit Tablets, Homeopathic Grow tall medicine
Lords Hite Up Tablets for Height Growth. Homeopathy medicine
Haslab Physi Hite Tablets– homeopathy medicine for height increase
SBL Rite Hite Tablets. Homeopathy Medicine for Height increase
Blooume16 GRO T Drops. Homeopathy grow tall medicine-Buy online
Wheezal WL14 Grow Tall drops – Homeopathy height increase medicine

Action of individual Ingredients in Rite-Hite:
Baryta carbonica: For children who are mentally and physically backward, do not grow and develop swollen abdomen, loss of memory.
Silicea: For imperfect assimilation and consequent defective nutrition. Children who are slow walking.
Natrum Muriaticum: Great emaciation; losing flesh while eating well. Anaemia

Calcarea Phosphorica: For anemic children who are peevish with feeble digestion, it is excellent for tardy dentition troubles and promote growth of healthy bones. It also covers abdominal flatulence in children, mild inflammation of tonsils, colic or soreness around navel, diarrhea with undigested food in stools.

END OF QUOTES

In my view this is plain and obvious child abuse (I don’t need to go into showing that none of the claims are plausible/evidence-based because it is painfully obvious). Some of the clinical scenarios are indicative of a severely sick child, for instance:

  • mentally and physically backward, do not grow and develop swollen abdomen, loss of memory;
  • anaemic children who are peevish with feeble digestion;
  • losing flesh while eating well, anaemia.

To not take such children to a doctor or hospital and instead lose valuable time with homeopathy is criminal neglect and unethical abuse. No question about that!

I can only hope that no parent will ever fall for it.

UK farmers are being taught how to treat their livestock with homeopathy “by kind permission of His Royal Highness, The Prince Of Wales”. This website explains:

The Homeopathy at Wellie Level (HAWL) Course has been developed specifically for those who tend livestock by the School of Agricultural Homeopathy, and is taught by homeopathic vets and qualified homeopaths – all with farm experience.  This is the ONLY course in the UK to provide qualified teaching aimed at empowering farmers and smallholders to use homeopathy for their animals with both confidence and understanding. We have been operational since 2001 and over the years have gathered literally hundreds of positive feedback comments and course testimonials…

HAWL is funded largely by donations, relies heavily on the generosity of supporters and volunteers, and makes no profit. We subsidise our courses, and our post-course support groups, in order to make them affordable to all; many of our farmers and smallholders run their farms single-handedly or with family members. Our aim is to educate, inform and support those who seek to reduce the burden of antibiotics, chemical wormers, and other drugs in the food chain and on the environment…

END OF QUOTE

Today, Oliver Kamm, a Times business columnist and leader writer, sates in THE TIMES that part of the blame for the persistence of fake medicine lies with, of all people, the heir to the throne. In a new book titled More Harm than Good?, Professor Edzard Ernst says that, as the most prominent advocate of homeopathy, the Prince of Wales is engaged in “foolish and immoral” support for unproven remedies for serious illness. You can say that again.

Yes, let’s say that again: foolish and immoral!

In our book, Kevin Smith and I develop the argument that the practice of and education in alternative medicine systematically violates medical ethics. We are sure that our argument holds water. It is not possible, we think, to practice or teach fake medicine within the rules and standards of medical ethics. This means that most of alternative medicine is unethical.

We have not drawn such conclusions lightly and feel that our ethical perspective on alternative medicine deserves serious consideration. It would be good, if the Prince of Wales gave it some thought.

Our new book entitled MORE HARM THAN GOOD? THE MORAL MAZE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE is out. At the moment merely as an e-book, but in a few days the paperback will be available too. Yesterday, Kevin Smith and I were invited to a press briefing at the London SCIENCE MEDIA CENTRE.

On this occasion, Kevin and I explained to the journalists what our book is about. Essentially, it is an analysis of the many ethical issues in alternative medicine. We picked out just a few points which we thought might be of interest. I briefly discussed the fact that much of the research in this area is misleading to the point of being unethical. Kevin explained that this also applies to education and discussed the ethics of commerce.

In the latter context, Kevin briefly mentioned Prince Charles because he had come out with a range of ‘Dutchy Originals Herbal Tinctures’. I never mentioned Charles with a single word, and neither did the subsequent discussion focus on him.

Altogether, we all thought that the press briefing went well. We had good questions, and the journalists showed keen interest in our ethical perspective on alternative medicine.

This morning, I am surprised to see that THE TELEGRAPH, THE DAILY MAIL and apparently also the EXPRESS (I haven’t seen it yet) all carry articles about my alleged war with Prince Charles. The TELEGRAPH’s headline is: Professor reignites war with Prince Charles over homeopathy support. 

While it is, of course, entirely fine that the press reports about this particular aspect, I find it nevertheless disappointing that the essential messages of our book were lost. Nobody can be truly surprised about this, I think.

The real surprise lies elsewhere.

The newspapers cite Clarence House coming to the defence of Prince Charles. A spokesperson is quoted stating “Unfortunately the book misunderstands and misrepresents this position which The Prince has reached after years of talking to experts in many different areas of medicine.”

Yes, that is surprising!

Our book only became available hours before this comment was made. Someone in Clarence House must be a very fast reader.

On their website, the British Homeopathic Association (BHA) have launched their annual winter appeal. Its theme this year is ‘building a better future for homeopathy’. The appeal is aimed at the following specific goals:

  • Continuously fighting to retain NHS services in the UK by supporting local patients & groups and providing swift media responses employing experts in areas such as media, politics, law and reputation management for ultimate effectiveness. Currently undertaking a legal challenge to NHS England
  • Establishing charitable homeopathic clinics throughout the UK, with clinics currently in Norwich, York, Bath, Edinburgh and looking at developing other clinics in Liverpool, Wales, Oxford and London in 2018.
  • Making further investment to enhance our digital presence and promotion of key messages.
  • Continuoustly improving our website to make it the place for information on homeopathy from finding practitioners to finding the latest Health & Homeopathy online.
  • Investing in research and education to keep homeopathy strong in the long term, increasing the number of healthcare professionals using homeopathy in their everyday practice.
  • Taking homeopathy to the people and growing our community of supporters with public events, local events and national promotion.

I have to say, I find this almost touching in its naivety. I imagine another lobby group, say the cigarette industry, launching a winter appeal: BUILDING A BETTER FUTURE FOR CIGARETTES.

Do I hear you object?

Cigarettes are unhealthy and not a medical treatment!!!

Quite so! Homeopathy is also unhealthy and not a medical treatment, I would argue. Sure, highly dilute homeopathics do not kill you, but homeopathy easily can. We have seen this on this blog many times. Homeopathy kills when it is advocated and consequently used as an alternative therapy for a life-threatening disease; there is no question about it. And there also is no question about the fact that this happens with depressing regularity. If you doubt it, just read some of my previous posts on the subject.

In any case, an appeal by a medical association should not be for its own benefit (homeopathy); it should be for patients (patients tempted to try homeopathy), I would suggest. So, lets design the goals of an appeal for patients along the lines of the above appeal – except our appeal has to actually be in the best interest of vulnerable patients.

Here we go:

  • Continually fighting to stop homeopathy on the NHS. As homeopathy does not generate more good than harm (no ineffective therapy can ever do that), we have a moral, legal and ethical duty to use our scarce resources such that they create the maximum benefit; and this means we cannot use them for homeopathy.
  • Establishing charitable organisations that educate the public about science and evidence. Too many consumers are still falling victim to the pseudo-science of charlatans who mislead people for their own profit.
  • Making further investments to combating the plethora of unethical misinformation by self-interested quacks and organisations many of which even have charitable status.
  • Continually improving websites that truthfully inform the public, politicians, journalists and others about medicine, science and healthcare.
  • Investing in research and education to keep science and evidence-based medicine strong, for the benefit of vulnerable patients and in the interest of progress.
  • Taking the science agenda to the people and growing the community of science-literate supporters on a local, national and international level.

As I had to follow the lines of the BHA, these goals are regrettably not perfect – but I am sure they are a whole lot better than the BHA original!

‘Doctor’ Colleen Huber (DCH) is the US naturopath who is currently suing Britt Hermes. For me, this is enough reason to do a bit of reading and find out who DCH is and what motivates her. Here is what I found out (I added some * to the quotes [all in italics] and comments below).

DCH has an impressive presence on the Internet. One website, for instance, tells us that DCH is a Naturopathic Medical Doctor* in Tempe, Arizona. Her clinic, Nature Works Best Cancer Clinic, has had the most successful results of any clinic in the world reporting its results over the last 9 years **.

Dr. Huber authored the largest and longest study*** in medical history on sugar intake in cancer patients, which was reported in media around the world in 2014. Her other writing includes her book, Choose Your Foods Like Your Life Depends On Them ****, and she has been featured in the books America’s Best Cancer Doctors and Defeat Cancer. Dr. Huber’s academic writing has appeared in The Lancet *****, the International Journal of Cancer Research ***** and Molecular Mechanisms *****,  and other medical journals ******. Her research interests are in the use of therapeutic approaches targeting metabolic aspects of cancer…

*I am puzzled by this title. Is it an official one? I only found this, and it omits the ‘medical’: Currently, 20 states, five Canadian provinces, the District of Columbia, and the U.S. territories of Puerto Rico and the U.S. Virgin Islands have passed laws regulating naturopathic doctors. Learn more about licensure from the Association of Accredited Naturopathic Medical Colleges. It seems that Arizona is the only state where the ‘medical’ is allowed. However, don’t take this to mean that DCH went to medical school.

** ‘most successful results of any clinic in the world’? Really? Where are the comparative statistics?

*** the study had all of 317 patients and was published in an obscure, non-Medline listed journal.

**** currently ranked  #1,297,877 in Books on Amazon.

***** no such entries found on Medline.

****** sorry, but my Medline search for ‘huber colleen’ located only 2 citations, both on arthritis research conducted in an US Pfizer lab and therefore probably not from ‘our’ DCH.

Another website on or by DCH informs us that her outfit Nature Works Best is a natural cancer clinic located in Tempe, Arizona, that focuses on natural, holistic, and alternative cancer treatments. Our treatments have proved to be an effective alternative to traditional chemotherapy and radiation, which we do not use in our treatments. Rather, we have developed a natural method of treating cancers based on intravenous vitamin therapy which may include Vitamin-C, Baking Soda, and other tumor fighting agents as well as a simple food plan. *

Our team of naturopathic medical doctors have administered an estimated 31,000 IV nutrient treatments, used for all stages and types of tumors. As of July 2014, 80% of patients who completed our treatments alone went into remission, 85% of patients who completed our treatments and followed our food plan went into remission. **

* Give me a break! Vitamin-C and Baking Soda are claimed to have proved to be an effective alternative to traditional chemotherapy and radiation ? I would like to see the data before I believe this!

** Again, I would like to see the data before I believe this!

Finally, a further website proudly repeats that her academic writing has appeared in The Lancet and Cancer Strategies Journal, and other medical journals. It even presents an abstract of her published work; here it is:

Recent recommendations for the more widespread prescription of statin drugs in the U.S. have generated controversy.  Cholesterol is commonly thought to be the enemy of good health.  On the other hand, previous research has established the necessity of cholesterol in production of Vitamin D and steroid hormones, among other purposes, some of which have been shown to have anti-cancer effect.  We compare total serum cholesterol (TC) in cancer survivors vs cancer fatalities, and we assess the value of deliberately lowering TC among cancer patients.  We also examined diet in the survivors as well as those who then died of cancer.

In this original previously unpublished research, we conducted a double-blind retrospective case series, in which we looked back at data from all 255 cancer patients who came to and were treated by our clinic with either current dietary information, and/or a recent serum TC level, measured by an unaffiliated laboratory or an unaffiliated clinic over the previous seven years, comparing TC in the surviving cancer patients versus those cancer patients who died during that time.

Surviving cancer patients had 24.0 points higher mean total cholesterol than the mean for deceased cancer patients.  A number of dietary differences between cancer survivors and those who then died of cancer were also found to be notable.

Caution is advised before attempting to lower cholesterol in cancer patients with close to normal TC levels.  Those cancer patients with higher TC were more likely to survive their cancer.

I don’t know about you, but I am not impressed. Surviving cancer patients had 24.0 points higher mean total cholesterol than the mean for deceased cancer patients. Has DCH thought of the possibility that moribund patients quite simply eat less? In which case, the observed difference would be a meaningless epiphenomenon.

At this point, I stopped my reading; I now knew more than I needed to know about DCH (if you want to read more, I recommend this or this post).

As I mentioned at the beginning of this post, DCH is currently suing Britt Hermes for libel. Apart from being exceedingly stressful, such an action can also be hugely expensive.

Britt is therefore hoping to do some crowd-funding to assist her financially.

I wish my post has motivated you to donate generously.

A cognitive bias known as the Dunning-Kruger Effect has, I think, considerable relevance in alternative medicine. The effect means that, the less you know, the less able you are to recognize how little you know, and the less likely you are to recognize your limitations. Consequently, your confidence in yourself is inflated and you believe you are more competent than your opponent. Expressed differently:

  • Incompetence prevents the recognition of incompetence.
  • Too stupid to doubt.

Even though the phenomenon of illusory superiority is today attributed to David Dunning and Justin Kruger, many others before them have alluded to the phenomenon:

Image result for dunning kruger effect

The relevance of the Dunning Kruger Effect to alternative medicine seems obvious, I think. Here we are confronted with all sorts of practitioners who believe they know it all, can treat any condition, alleviate the ‘root cause’ of all ills, etc., etc. Many of my previous posts on this blog have dealt with aspects of this problem. And with unfailing regularity, the discussions brought some individuals badly affected by the Dunning-Kruger Effect to the fore. Typically, they go on and on and on… consumed by their inflated confidence and trapped by their incompetence to realise their incompetence. And typically, they find an audience who is gullible enough to applaud them.

They often remind me of a cartoon I once saw:

The little graph below explains it all quite neatly:

Image result for dunning kruger effect

The novice lacks knowledge but, as he acquires a modicum of (pseudo-)knowledge, he gets a boost of confidence. An experienced person has enough knowledge to know that he knows very little; therefore his confidence is relatively low. When experience and knowledge combine to become wisdom, confidence grows and we might be talking to a real expert. Oddly, in terms of confidence, the novice can score higher than even the wisest expert.

To some extent, this simple graph even explains the popularity of many forms of quackery: they are being promoted by people who know very little but are bursting with confidence. And it is this high level of confidence that tends to impress the gullible public who then eagerly adopt the quackery.

Where the graph is somewhat misleading, I think, is where it might give the impression that there is an automatic and necessary transition from novice to expert (from left to right on the X-axis). In many individuals, this development does occur but, sadly, in many others it does not. The evangelical believers in alternative medicine, I fear, usually belong to the latter, sad category.

If I am correct, the Dunning Kruger Effect can therefore partly explain 1) the inflated confidence of proponents of alternative medicine, as well as 2) the current popularity of quackery.

Recently, I was asked about the ‘Dorn Method’. In alternative medicine, it sometimes seems that everyone who manages to write his family name correctly has inaugurated his very own therapy. It is therefore a tall order to aim at blogging about them all. But that’s been my goal all along, and after more than 1 000 posts, I am still far from achieving it.

So, what is the Dorn Method?

A website dedicated to it provides some first-hand information. Here are a few extracts (numbers in brackets were inserted by me and refer to my comments below):

START OF QUOTE

Developed by Dieter Dorn in the 1970’s in the South of Germany, it is now fast becoming the widest used therapy for Back Pain and many Spinal Disorders in Germany (1).

The Dorn Method ist presented under different names like Dornmethod, Dorntherapy, Dorn Spinal Therapy, Dorn-Breuss Method, Dorn-XXname-method and (should) have as ‘core’ the same basic principles.

There are many supporters of the Dorn Method (2) but also Critics (see: Dorn controversy) and because it is a free (3) Method and therefore not bound to clear defined rules and regulations, this issue will not change so quickly.

The Method is featured in numerous books and medical expositions (4), taught to medical students in some universities (5), covered by most private medical insurances (6) and more and more recognized in general (7).

However because it is fairly new and not developed by a Medical Professional it is often still considered an alternative Healing Method and it is meant to stay FREE of becoming a registered trademark, following the wish of the Founder Dieter Dorn (†2011) who did NOT execute his sole right to register this Method as the founder, this Method must become socalled Folk Medicine.

As of now only licensed Therapists, Non Medical Practitioners (in Germany called Heilpraktiker (Healing Practitioners with Government recognition) (8), Physical Therapists or Medical Doctors are authorized to practice with government license, but luckily the Dorn Method is mainly a True Self Help Method therefore all other Dorn Method Practitioners can legally help others by sharing it in this way (9).

What conditions can be treated with the Dorn Method? Every disease, even up to the psychological domain can be treated (positively influenced) unless an illness had already led to irreversible damages at organs (10). The main areas of application are: Muscle-Skeletal Disorders (incl. Back Pain, Sciatica, Scoliosis, Joint-Pain, Muscular Tensions, Migraines etc.)

END OF QUOTE

My brief comments:

  1. This is a gross exaggeration.
  2. Clearly another exaggeration.
  3. Not ‘free’ in the sense of costing nothing, surely!
  4. Yet another exaggeration.
  5. I very much doubt that.
  6. I also have difficulties believing this statement.
  7. I see no evidence for this.
  8. We have repeatedly discussed the Heilpraktiker on this blog, see for instance here, here and here.
  9. Sorry, but I fail to understand the meaning of this statement.
  10. I am always sceptical of claims of this nature.

By now, we all are keen to know what evidence there might be to suggest that the Dorn Method works. The website of the Dorn Method claims that there are 4 different strands of evidence:

START OF QUOTE

1. A new form of manual therapy and self help method which is basically unknown in conventional medicine until now, with absolutely revolutionary new knowledge. It concerns for example the manual adjustment of a difference in length of legs as a consequence of a combination of subluxation of the hip-joint (subluxation=partly luxated=misaligned) and a subluxation of the joints of sacrum (Ilio-sacral joint) and possible knee and ankle joints. The longer leg is considered the ‘problem’-leg and Not the shorter leg as believed in classical medicine and chiropractic.

2. The osteopathic knowledge that there is a connection of each vertebra and its appropriate  spinal segment to certain inner organs. That means that when there are damages at these structures, disturbances of organic functions are the consequence, which again are the base for the arising of diseases.

3. The knowledge of the Chinese medicine, especially of acupuncture and meridian science that the organic functions are stirred and leveled, also among each other, via the vegetative nervous system

4. The natural-scientific  knowledge of anatomy, physiology, physics, chemistry and other domains.

END OF QUOTE

One does not need to be a master in critical thinking to realise that these 4 strands amount to precisely NOTHING in terms of evidence for the Dorn Method. I therefore conducted several searches and have to report that, to the best of my knowledge, there is not a jot of evidence to suggest that the Dorm Method is more than hocus-pocus.

In case you wonder what actually happens when a patient – unaware of this lack of evidence – consults a clinician using the Dorn Method, the above website provides us with some interesting details:

START OF QUOTE

First the patients leg length is controlled and if necessary corrected in a laying position. The hip joint is brought to a (more or less) 90 degree position and the leg is then brought back to its straight position while guiding the bones back into its original place with gentle pressure.

picture link to dorn therapy pictures

This can be done by the patient and it is absolutely safe, easy and painless!

The treatment of Knees and Ankles should then follow with the same principals: Gentle pressure towards the Joint while moving it from a bended to a more straight position.

After the legs the pelvis is checked for misalignment and also corrected if necessary in standing position.

Followed by the lumbar vertebrae and lower thoracic columns, also while standing upright.

Then the upper thoracic vertebrae are checked, corrected if necessary, and finally the cervical vertebrae, usually in a sitting position.

The treatment often is continued by the controlling and correction of other joints like the shoulders, elbow, hands and others like the jaw or collarbone.

END OF QUOTE

Even if we disregard the poor English used throughout the text, we cannot possibly escape the conclusion that the Dorn Method is pure nonsense. So, why do some practitioners practice it?

The answer to this question is, of course, simple: There is money in it!

“Average fees for Dorn Therapy sessions range from about 40€ to 100€ or more…  Average fees for Dorn Method Seminars range from about 180€ to 400€ in most developed countries for a two day basic or review or advanced training.”

SAY NO MORE!

 

 

 

This announcement caught my eye:

START OF 1st QUOTE

Dr Patrick Vickers of the Northern Baja Gerson Centre, Mexico will deliver a two hour riveting lecture of ‘The American Experience of Dr Max Gerson, M.D.’

The lecture will present the indisputable science supporting the Gerson Therapy and its ability to reverse advanced disease.

Dr Vickers will explain the history and the politics of both medical and governmental authorities and their relentless attempts to surpress this information, keeping it from the world.

‘Dr Max Gerson, Censored for Curing Cancer’

“I see in Dr Max Gerson, one of the most eminent geniuses in medical history” Nobel Prize Laureate, Dr Albert Schweitzer.

END OF 1st QUOTE

Who is this man, Dr Patrik Vickers, I asked myself. And soon I found a CV in his own words:

START OF 2nd QUOTE

Dr. Patrick Vickers is the Director and Founder of the Northern Baja Gerson Clinic. His mission is to provide patients with the highest quality and standard of care available in the world today for the treatment of advanced (and non-advanced) degenerative disease. His dedication and commitment to the development of advanced protocols has led to the realization of exponentially greater results in healing disease. Dr. Vickers, along with his highly trained staff, provides patients with the education, support, and resources to achieve optimal health.

Dr. Patrick was born and raised outside of Milwaukee, Wisconsin. At the age of 11 years old, after witnessing a miraculous recovery from a chiropractic adjustment, Dr. Patrick’s passion for natural medicine was born.

Giving up careers in professional golf and entertainment, Dr. Patrick obtained his undergraduate degrees from the University of Wisconsin-Madison and Life University before going on to receive his doctorate in Chiropractic from New York Chiropractic College in 1997.

While a student at New York Chiropractic College(NYCC), Dr. Patrick befriended Charlotte Gerson, the last living daughter of Dr. Max Gerson, M.D. who Nobel Peace Prize Winner, Dr. Albert Schweitzer called, ” One of the most eminent geniuses in medical history. “

Dr. Gerson, murdered in 1959, remains the most censured doctor in the history of medicine as he was reversing virtually every degenerative disease known to man, including TERMINAL cancer…

END OF 2nd QUOTE

I have to admit, I find all this quite upsetting!

Not because the ticket for the lecture costs just over £27.

Not because exploitation of vulnerable patients by quacks always annoys me.

Not even because the announcement is probably unlawful, according to the UK ‘cancer act’.

I find it upsetting because there is simply no good evidence that the Gerson therapy does anything to cancer patients other than making them die earlier, poorer and more miserable (the fact that Prince Charles is a fan makes it only worse). And I do not believe that the lecture will present indisputable evidence to the contrary – lectures almost never do. Evidence has to be presented in peer-reviewed publications, independently confirmed and scrutinised. And, as far as I can see, Vickers has not authored a single peer-reviewed article [however, he thrives on anecdotal stories via youtube (worth watching, if you want to hear pure BS)].

But mostly I find it upsetting because it is almost inevitable that some desperate cancer patients will believe ‘Dr’ Vickers. And if they do, they will have to pay a very high price.

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