MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

alternative therapist

We have repeatedly discussed on this blog the fact that many alternative practitioners are advising their patients against vaccinations, e. g.:

There is little doubt that this phenomenon contributes to low immunisation rates. This, in turn, is a contributing factor to outbreaks of measles and other infectious diseases. The website of the European Centre for Disease Prevention and Control has recently published data on measles outbreaks in Europe:

Bulgaria: There is an increase by three cases since 21 July 2017. Since the beginning of 2017 and as of 16 July, Bulgaria reported 166 cases. During the same time period in 2016 Bulgaria reported one case.

France: On 27 July 2017 media quoting the French Minister of Health reported the death of a 16-year-old unvaccinated girl. She had fallen sick in Nice and died on 27 June 2017 in Marseille.

Germany: There is an increase by four cases since the last report on 21 July 2017. Since the beginning of 2017 and as of 26 July, Germany reported 801 cases. During the same time period in 2016 Germany reported 187 cases.

Italy: There is an increase by 170 cases since 21 July 2017. Since the beginning of 2017 and as of 25 July, Italy reported 3 842 cases, including three deaths. Among the cases, 271 are healthcare workers. The median age is 27 years, 89% of the cases were not vaccinated and 6% received only one dose of vaccine.

Romania: There is an increase by 229 cases, including one additional death, since 21 July 2017. Since 1 January 2016 and as of 21 July 2017, Romania reported 8 246 cases, including 32 deaths. Cases are either laboratory-confirmed or have an epidemiological link to a laboratory-confirmed case. Infants and young children are the most affected groups. Timis, in the western part of the country closest to the border with Serbia, is the most affected district with 1 215 cases. Vaccination activities are ongoing in order to cover communities with suboptimal vaccination coverage.

Spain: There is an increase by seven cases since 14 July 2017. Since the beginning of 2017 and as of 25 July, Spain reported 145  measles cases.

United Kingdom: Public Health Wales reported two additional cases related to the outbreak in Newport and Torfaen, bringing the total to ten cases related to this outbreak. In England and Wales there is an increase by 76 cases since 21 July 2017. Since the beginning of 2017 and as of 23 July 2017, England and Wales reported 922 cases. In the same time period in 2016, they reported 946 cases.

In addition to the updates listed above ECDC produces a monthly measles and rubella monitoring report with surveillance data provided by the member states through TESSy. The last report was published on 11 July 2017 with data up to 31 May 2017.

Measles outbreaks continue to occur in EU/EEA countries. There is a risk of spread and sustained transmission in areas with susceptible populations. The national vaccination coverage remains less than 95% for the second dose of MMR in the majority of EU/EEA countries. The progress towards elimination of measles in the WHO European Region is assessed by the European Regional Verification Commission for Measles and Rubella Elimination (RVC). Member States of the WHO European Region are making steady progress towards the elimination of measles. At the fifth meeting of the RVC for Measles and Rubella in October 2016, of 53 countries in the WHO European Region, 24 (15 of which are in the EU/EEA) were declared to have reached the elimination goal for measles, and 13 countries (nine in the EU/EEA) were deemed to have interrupted endemic transmission for between 12 and 36 months, meaning they are on their way to achieving the elimination goal. However, six EU/EEA countries were judged to still have endemic transmission: Belgium, France, Germany, Italy, Poland and Romania. More information on strain sequences would allow further insight into the epidemiological investigation.

All EU/EEA countries report measles cases on a monthly basis to ECDC and these data are published every month. Since 10 March 2017, ECDC has been reporting measles outbreaks in Europe on a weekly basis and monitoring worldwide outbreaks on a monthly basis through epidemic intelligence activities. ECDC published a rapid risk assessment on 6 March.

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Personally, I believe that it is high time to stop the rhetoric and actions of the anti-vaccination movements. This includes educating alternative practitioners and their patients. If necessary, we need regulation that prohibits their dangerous and unethical activities.

‘Alternative truth’ is a term that I used first in 2013 . Since then I had to employ it with increasing frequency. Disturbingly, since then similar terms, such as ‘alternative facts’, ‘alternative science’ etc., have become ‘en vogue’. In an NEJM-editorial on the subject, Alta Caro from the University of Wisconsin Law School, Madison, US recently concluded: Reasonable people may disagree about how to interpret data, but they do not ignore scientific method by giving credence to flawed, fraudulent, or misrepresented studies … Whether in the debates regarding climate change, evolutionary theory, or human reproduction, alternative facts are just fiction, and alternative science is just bad policy.

I am tempted to add AND ALTERNATIVE TRUTHS ARE JUST LIES!!!

On this blog, we are confronted with so many lies that it would be only normal, if we gradually got used to them.

  • I think we must resist this temptation.
  • I think we should expose those who tell untruths again and again.
  • I think it is our moral and ethical duty.
  • I think the truth is far too precious to allow it to be eroded by anyone.

Because I feel strongly about this issue, I would like to use this post to give two of my former colleagues the opportunity to correct the untruths they have published about me and my actions.

The 1st is Prof Harald Walach;

as I pointed out in a previous post, he stated the following untruth (his remarks were in German, and this is my translation):

“My friend and colleague George Lewith from Southampton gave a keynote lecture on his review of chiropractic interventions for infant colic. This was prompted by the claim, made by Singh and Ernst a few years ago, that chiropractic was dangerous, that no data existed showing its effectiveness, and that it had dangerous side-effects, particularly for children. The chiropractors had sued the science journalist Singh for libel and won the case. George Lewith had provided the expert report for the court and has now extended his analysis on children.

To put it briefly: the intervention is even very effective; the effect-size is about one standard deviation. The children cry less long and more rarely. And the search of the literature for dangerous side-effects resulted in no – literally: not one – case of side-effects, not to mention dangerous ones. The fuzz had started back then because an unqualified person had walked over the back of a thin woman and had thus broken her neck. The press had subsequently hyped the whole thing to a “deadly side-effect of a chiropractic intervention”. 

The 2nd is Dr Peter Fisher;

as I pointed out in another post, he too published an untruth about me:

In this article which he published as Dr. Peter Fisher, Homeopath to Her Majesty, the Queen, he wrote: “There is a serious threat to the future of the Royal London Homoeopathic Hospital (RLHH), and we need your help…Lurking behind all this is an orchestrated campaign, including the ’13 doctors letter’, the front page lead in The Times of 23 May 2006, Ernst’s leak of the Smallwood report (also front page lead in The Times, August 2005), and the deeply flawed, but much publicised Lancet meta-analysis of Shang et al…”

And why bring this up again?

For the reasons mentioned above.

And for giving Walach and Fisher the opportunity to correct their errors. If they don’t, their untruths will be henceforth called lies.

To a significant extend, this blog has always exposed untruths in the realm of alternative medicine – not just one or two, but hundreds. Obviously, some of them are more clear-cut than others. If, for instance, someone claims that acupuncture has been proven to be effective for a given condition, this many seem like a lie or untruth to you, like a misinterpretation of the evidence to someone else, or like the truth to a third person.

But there are some statements which are demonstrably false. These are often the most irritating lies, frequently forwarded by people who should know better and who nevertheless insist on not being truthful. Below I have listed a few, randomly-chosen examples upon which I have previously commented. For clarity, I have copied the quotes in question, linked them to my original posts, named the authors in brackets, and added a brief comment by myself in bold print.

I was at Exeter when Ernst took over what was already a successful Chair in CAM. (anonymous reviewer of my book at Amazon)

Anyone can check this fairly easily, for instance, in my memoir ‘A SCIENTIST IN WONDERLAND’, there was no pre-existing chair at Exeter.

Ernst’s leak of the Smallwood report (also front page lead in The Times, August 2005), (Dr Peter Fisher, homeopath of the Queen)

This was painfully investigated during a 13 (!) months inquiry which found that I did not leak this report. Again you find the full details in my memoir.

…homeopathic care is recommended for people who have been exposed (or think they have been exposed) to toxic substances… (Dana Ullman US homeopath)

As far as this statement implies that homeopathy is effective for treating intoxications, this is not only a lie but a very dangerous nonsense.

Homeopathy has a long history of being used successfully in veterinary practice for both domestic and farm animals. (UK Faculty of Homeopathy)

If this is to suggest that homeopathy is of proven effectiveness in treating diseases of animals, this is a lie.

Homeoprophylaxis, the homeopathic vaccine alternative, prevents disease through nosodes. (Lisa is the mastermind behind All Natural Ideas)

Homeoprophylaxis has never been proven to prevent any disease; this lie could kill millions.

There are essentially two categories of critics. The first category consists of individuals who are totally ignorant of homeopathy and just repeating propaganda they’ve been exposed to. The second category is people who know that homeopathy works, but have a vested financial interest in destroying it. (Alan Schmukler, US homeopathy)

This lie is quite funny in its transparent defamation of the truth, I think.

Homeopathy works like a vaccine. (Dr Batra, Indian homeopath)

Homeopathy does not even remotely work like a vaccine; in fact, it works like a placebo, if at all.

…UK invests 0% of its research budget on CAM… (Dr Michael Dixon, GP and advisor to Prince Charles)

There has always been a sizable budget for CAM-research in the UK.

Even cancer viruses have, on record, been put into vaccinations. There is no actual vaccine for cancer. The only reason to put cancer viruses in the mix is to create more cases of cancer. In this day and age, one of the most dangerous things you can do for your health is to get vaccinated… (US homeopath)

In this short quote, there are more lies than I care to comment on. The paranoia of the anti-vaccination brigade is astounding and endangers many lives.

A lie is a statement used intentionally for the purpose of deception. In alternative medicine, we encounter so many lies that one would need to continually publish volume after volume to expose just the most harmful untruths. The danger of these lies is that some people might believe them. This could seriously harm their health. Another danger is that we might get used to them, trivialise them, or – like Trump and co – start thinking of them as ‘alternative facts’.

I will continue to do my best to prevent any of this from happening.

 

Quackademia is an apt term for the teaching or promotion of quackery in universities. Sadly, this is a serious problem, and we have therefore discussed it already several times (see here, here and here). If you have read my memoir, you know that I had my fair share of quackademia ‘hands-on’, so to speak. This article from Australia has more on the subject:

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Friends of Science in Medicine have complained that alternative practitioners who speak at events were then using the names and logos of universities on their promotional material. Edith Cowan University recently cancelled a workshop promoting pranic crystal healing — which claims to use crystals to energise and heal the body — after complaints from FSM that it had no scientific basis. The university also cancelled Brisbane-based nutrition author Christine Cronau, who was due to promote her low-carbohydrate, high-fat diet on June 25. In response to a website petition calling on the university to cancel Cronau’s seminar, ECU said it rejected the booking because “it does not align with our evidence-based approach to dietetics teaching and research”.

The talk has been moved to Murdoch University, which, despite being lobbied to cancel the booking, said in a statement this week that it would go ahead. Murdoch said it promoted critical thinking and learning through discussion, debate and exposure to alternatives points of view. “One way to achieve this is to welcome other voices on campus in the form of guest speakers or visiting lecturers,” the statement said. “The university takes a common sense approach to the debate of controversial issues and we encourage respectful and insightful debate of thought- provoking topics.”

FSM president John Dwyer said universities should review the content of external health seminars before they hired out their venues. “We don’t have an issue with free speech, but some of the material is just not scientific,” Professor Dwyer said. “Often universities don’t know about the nature of the pseudo-scientific events they are hosting.”

Cronau said she was disappointed ECU had cancelled her talk but her faith in common sense had been restored by Murdoch University. “My approach has actually become a lot less controversial, so I don’t know why it has generated such comments,” she said.

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I find this story interesting. It reveals several things:

  • Quacks love to infiltrate universities; this gives them a veneer of respectability, they think.
  • This discloses their schizophrenic attitude to the ‘scientific establishment’ in an exemplary fashion: they often are fiercely against science but, at the same time, they are only too happy to jump at opportunities of decorating themselves with scientific feathers.
  • Universities are run like businesses these days. They tend to take the money where they can get it. Issues like scientific credibility rarely figure high on the agenda.
  • When challenged, universities claim they are favouring free speech, open-mindedness and respectful debate.
  • This usually is but a lame excuse.

I remember protesting while at Exeter against a weekend course of pure quackery which the organisers were advertising under the logo of my university. My protest fell on deaf ears, and my peers pretended to favour free speech, open-mindedness and respectful debate. After I had retired, the University of Exeter even allowed quacks to infiltrate and made this surprising announcement: Our complementary therapists will be offering 15-20 minute taster sessions in our complementary therapies yurt. The therapy taster sessions on offer will include: shaitsu bodywork, reflexology, indian head Massage, seated back massage and much more. To take advantage of these free taster sessions just pop along to the yurt on the day of the festival.

But the Australian events also offer a glimmer of hope in this usually bleak situation. Sometimes our protests do have an effect! I therefore urge everyone to not give up. Quackademia is a pest, and for the sake of future generations, we must not allow it to infest our universities.

Since more than 20 years, I have been writing about the risks of alternative therapies. One of my first papers on this issue was published in 1995 and focussed on acupuncture. Here is its abstract:

The use of acupuncture is widespread. The procedure is often claimed to be totally, or at least reasonably, safe. The published evidence regarding its potential risks is reviewed. The repeated and/or inappropriate use of an acupuncture needle carries the risk of infections. Amongst others, AIDS and hepatitis have been transmitted. Acupuncture needles may also traumatise tissues and organs. Pneumothorax is the most frequent complication caused in this way. Finally, needles may break and fragments can be dislodged into distant organs. A serious and more general concern related to the safety of acupuncture is the competence of the therapist, whether or not medically qualified. The “philosophy” of acupuncture is not in line with orthodox diagnostic skills; therefore acupuncturists can be dangerously unconcerned with diagnostic categories. Thus indirect risks might add significantly to the direct risks of acupuncture. It is concluded that the true risk of acupuncture cannot be estimated. Whatever its extent, it could and probably should be lowered by enforcing educational and clinical standards.

My reason for banging on about the potential harms (direct and indirect risks) of alternative medicine is fairly obvious: I want to alert healthcare professionals and consumers to the fact that these treatments may not be as harmless as they are usually advertised to be. Yet, I have often be called an alarmist fear-monger. In my view, nothing could be further from the truth.

Thinking about fear-mongering, I began to ask myself whether those who regularly accuse me are the ones guilty of the deed. Are alternative practitioners fear-mongers? Surely not all of them, but some clearly are. Here are a few of the strategies they use for their fear-mongering.

NON-EXISTING DIAGNOSES

Perhaps the most obvious way to instil fear into people is to tell them that they are affected by a disease or condition they do not have. Many alternative practitioners do exactly that!

  • A chiropractor might tell you that you have a subluxation in your spine.
  • A naturopath would inform you that your body is full of toxins.
  • An acupuncturist will tell you that your life energy is blocked.
  • A homeopath might warn you that your vital force is too low.

These diagnoses have one thing in common: they do not exist. They are figments of the therapist’s imagination. And they have another thing in common: the abnormalities need to be corrected, and – surprise, surprise – the very therapy that the practitioner specialises in happens to be just the ticket for that purpose.

  • The chiropractor will tell you that a simple spinal adjustment will solve the problem.
  • The naturopath will inform you that a bit of detox will eliminate the toxins.
  • The acupuncturist will tell you that his needles will de-block your chi.
  • The homeopath will persuade you that he can find the exact remedy to revive your vital force.

And there we have the third thing these diagnoses have in common: they are all treatable, will all result in a nice bill, and will all improve the cash-flow of the therapist.

MEDICALIZING TRIVIALITIES

But often, it is not even necessary for an alternative therapist to completely invent a diagnosis. Patients usually consult an alternative practitioner with some sort of symptom – frequently with what one might call a medical triviality that does not need any treatment at all but can be dealt with differently, for instance, by issuing some life-style advice or just simple re-assurance that nothing major is amiss. But for the fear-monger, this is not enough. He feels the need to administer his therapy, and for that purpose he needs to medicalize trivialities :

  • A low mood thus becomes a clinical depression.
  • A sore back is turned into a nasty lumbago.
  • A tummy upset morphs into a dangerous gastritis.
  • Abdominal unrest is diagnosed to be a leaky gut syndrome.
  • A food aversion turns into a food intolerance, etc., etc.

The common denominator is again the fact that fear is instilled into the patient. And again, a useless therapy is administered, if at all possible in the form of a lengthy series of treatments. This, of course, generates significant benefit – not therapeutic, but financial!

DEMONIZING CONVENTIONAL MEDICINE

But there is always the risk that the patient is wiser than expected. She might be so scared learning of her condition that she decides to see her doctor. That would mean a loss of income which has to be avoided! The trick to achieve this is usually not difficult: conventional healthcare professionals must be demonized.

  • They are not treating the root cause of the problem.
  • They are in the pocket of BIG PHARMA.
  • They prescribe medicines with terrible side-effects.
  • They have no idea about holism.
  • They never have enough time to listen, etc., etc.

I know, some of these criticisms are not entirely incorrect (for instance, many conventional medicines do have serious side-effects but, as I try to point out ad nauseam, we need to consider their risk/benefit balance). But that is hardly the point here; the point is to scare the patient off conventional medicine. Only a person who is convinced that the ‘medical mafia’ is out to get her, will prove to be a loyal customer of all things alternative.

DISEASE PREVENTION

And a loyal customer is someone who comes not just once or twice but regularly, ideally from cradle to grave. The way to achieve this ultimate stimulus of the practitioners cash flow is to convince the patient that she needs regular treatments, even when she feels perfectly alright. The magic word here is PREVENTION! The masters here are the chiropractors, I guess; they promote what they call ‘maintenance care’, i.e. the regular treatment of healthy individuals to keep their spines subluxation-free. It goes without saying that maintenance care is a money-making scam.

The strategy requires two little lies, but that’s forgivable considering the good cause, boosting the income of the practitioner:

  1. Conventional doctors don’t do prevention.
  2. The alternative treatment is an effective preventative.

The first statement can be shown to be an obvious lie. All we know about effective disease prevention today comes from conventional medicine and science; nothing originates from the realm of alternative medicine. Remarkably, the most efficacious preventative measure of all times, immunisation, is frequently defamed and neglected by alternative practitioners.

The second statement is a necessary lie; how else would a patient agree to pay regularly for the practitioner’s services? I am not aware of any alternative therapy that can effectively prevent any disease.

CONCLUSIONS

  • Some alternative practitioners regularly instil fear into consumers.
  • Several strategies are being used for this purpose.
  • They have the aim of maximising the therapists’ income.
  • Fear-mongering is unethical and despicable.
  • Pointing out that a certain therapy might fail to generate more good than harm is not fear-mongering.

In 2006, the World Health Organization and UNICEF created the ‘Global Immunization Vision and Strategy’, a 10-year strategy with 4 main goals:

  1. to immunize more people against more diseases,
  2. to introduce a range of newly available vaccines and technologies,
  3. to integrate other critical health interventions with immunization,
  4. to manage vaccination programmes within the context of global interdependence.

More than a decade later, we have to realise that this vision has been frustrated, not least by fans of alternative medicine (FAMs). They are almost by definition more negative about the value and achievements of conventional medicine and science. This shows in all sorts of ways; the clearest this phenomenon is documented must be the FAMs’ attitude towards immunisations. Few rational thinkers would doubt that vaccinations are amongst the most important achievement in the history of medicine.

Vaccination is a miracle of modern medicine. In the past 50 years, it’s saved more lives worldwide than any other medical product or procedure.”

Yet FAMs are not impressed by such statements and often refuse to have their kids vaccinated according to the recommended schedule. This trend has significantly contributed to vaccination rates that, in some parts of the world, are now dropping so low that our ‘herd immunity’ is jeopardised.

One such place is Germany, and the German government is now making a controversial move against parents who choose to refrain from vaccinating their children. Germany is presently passing a law that will force kindergartens to inform the authorities, if parents don’t provide evidence that they have gotten advice from their doctor on vaccinations for their children.

The NHMRC report on homeopathy is the most thorough, independent and reliable investigation into the value of homeopathy ever. As its conclusions are devastatingly negative about the value of homeopathy, it is hardly surprising that homeopaths tried everything and anything to undermine it. This new article gives what I believe to be a fair account of the allegations and their validity:

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Since the NHMRC declared homeopathy to be ineffective in treating any health condition, a number of disputes have been made by major organisations in favour of homeopathy. Australia’s two peak industry organisations, Complementary Medicines Australia (CMA) and the AHA, both argue in their letters to the NHRMC that the position was prejudiced based on a draft position statement leaked in 2012 stating it is unethical for health practitioners to treat patients using homeopathy, for the reason that homeopathy (as a medicine or procedure) has been shown not to be efficacious [19,20]. Furthermore, both the CMA and AHA highlight serious concerns regarding the prelude to and instigation of the work of the NHMRC’s HWC as well as the conduct of the review itself to finalise their conclusion on the use of homeopathy. Several grave issues were raised in both letters with five common key flaws cited: (1) no explanation was provided as to why level 1 evidence including randomised control trials were excluded from the review; (2) the database search used was not broad enough to capture complementary medicine and homeopathic specific content, and excluded non-human and non-English studies; (3) no homeopathic expert was appointed in the NHMRC Review Panel; (4) prior to publication, the concerns raised over the methodology and selective use of data by research contractor(s) engaged for the HWC review were abandoned for unknown reasons; and (5) no justification was provided as to why only systematic reviews were used [19,20]. Other serious accusations made by the AHA in their response letter to the NHMRC involved the blatant bias of the NHMRC evident by: the leakage of their draft position statement in April 2011 and early release of the HWC Draft Review regarding homeopathy to the media; no discussion of prophylactic homeopathy i.e. preventative healthcare; and no reference to the cost-effectiveness, safety, and quality of homeopathic medicines [19].

Despite the NHMRC findings being strongly disputed, they are further supported by positions taken by a number of large and respected organisations. For example, in 2009, the World Health Organization (WHO) advised against the use of homeopathic medicines for various serious diseases following significant concerns being raised by major health authorities, pharmaceutical industries, and consumers regarding its safety and quality [21]. They reported the clinical effects were compatible with placebo effects [21]. Similarly, in Australia, the Australian Medical Association (AMA) further supports the NHMRC findings by stating in their position statement released in 2012 that there is limited efficacy evidence regarding most complementary medicines, thereby posing a risk to patient health [22]. More recently, in May 2015, the Royal College of General Practitioners (RACGPs) strongly advocated in their position statement against general practitioners prescribing homeopathic medicines, and pharmacists against supporting or recommending it, given the lack of evidence regarding its efficacy [23]. This is particularly pertinent to conventional vaccines given the recent case between the Australian Competition and Consumer Commission (ACCC) vs. Homeopathy Plus! Australia Pty Ltd. The Federal Court found Homeopathy Plus! Australia Pty Ltd guilty of contravening the Australian Consumer Law by engaging in misleading and deceptive conduct through claiming that homeopathic remedies were a proven, safe, and effective alternative to the conventional vaccine against whooping cough [24].

The positions of the NHMRC, WHO, AMA, and the RACGPs regarding homeopathy is further supported by Cochrane reviews, which provide high-quality evidence with minimal bias [25]. Of the twelve homeopathy Cochrane reviews available in the database, only seven address homeopathic remedies directly and were related to the following conditions: irritable bowel syndrome [26], attention deficit/hyperactivity disorder or hyperkinetic disorder [27], chronic asthma [28], dementia [29], induction of labour [30], cancer [31], and influenza [32]. Given most of these reviews were authored by homeopaths, bias against homeopathy is unlikely [26-32]. The overarching conclusions from these reviews fail to reveal compelling evidence regarding the efficacy of homeopathic remedies [26-32]. For example, Mathie, Frye and Fisher show that there is “no significant difference between the effects of homeopathic Oscillococcinum® and placebo in prevention of influenza-like illness: risk ratio (RR) = 0.48, 95% confidence interval (CI) 0.17-1.34, p-value = 0.16 [31]. The key reasons given for this failure to provide compelling evidence relate to low quality or unclear data, and lack of replicability, suggesting homeopathic remedies are unlikely to have clinical effects beyond placebo [26-32].

Sadly, the ACCC vs. Homeopathy Plus! Australia Pty Ltd is not the only case that has made headlines in Australia in recent years. An article in the Journal of Law and Medicine coincided with the NHMRC report regarding the number of deaths attributable to favouring homeopathy over conventional medical treatment in recent years [33]. One such case was that of Jessica Ainscough, who passed away earlier this year after losing her battle with a rare form of cancer “epithelioid sarcoma“ after rejecting conventional treatment in favour of alternative therapies [34]. Although doctors recognise Ms. Ainscough’s right to choose her own cancer treatments and understand why she refused the disfiguring surgery to save her life, they fear her message may influence others to reject conventional treatments that could ultimately save their lives [35]. Another near death case was that of an eight-month-old boy whose mother was charged with “reckless grievous bodily harm and failure to provide for a child causing danger to death” after ceasing conventional medical and dermatological treatment for her son’s eczema as advised by her naturopath (an umbrella term that includes homeopathy) [36]. The all-liquid treatment plan left the boy severely malnourished and consequently, he now suffers from developmental issues [37]. This case is rather similar to that of R vs. Sam in 2009, where the parents of a nine-month-old girl were convicted of manslaughter by criminal negligence after favouring homeopathic treatment over conventional medical treatment for their daughter’s eczema. The girl died from septicaemia after her eczema became infected [36,37].

[references are provided in the original document]

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The NHMRC report stated that

Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness. People who are considering whether to use homeopathy should first get advice from a registered health practitioner. Those who use homeopathy should tell their health practitioner and should keep taking any prescribed treatments.

Few other reports have previously expressed our concerns about homeopathy so clearly – little wonder then that the world of homeopathy was (and still is) up in arms.

The last time something similar happened was during the Third Reich when homeopathy had been evaluated thoroughly by leading scientists and the conclusions turned out to be just as devastatingly negative. At the time, German homeopaths allegedly made the report disappear, and all we have today about this comprehensive research programme is a very detailed eye witness report of a homeopath who had been intimately involved in the research.

Today, it is thankfully no longer possible to make major research documents disappear. So, homeopaths have to think of other strategies to defend their trade. In the case of the NHMRC report, they act like all cults tend to do and resort to misleading statements and slanderous allegations. This, I feel, is unsurprising and will inevitably turn out to be unsuccessful.

The Rubicon Group (TRG) is a collaboration of chiropractic educational institutions, emerging educational efforts and interested parties. The seven institutional members include Barcelona College of Chiropractic (Barcelona, Spain); the Chiropraktik Akademie (Dresden, Germany); Life Chiropractic College West (San Francisco, California, USA); Life University (Atlanta, Georgia, USA); McTimoney College of Chiropractic (Abingdon, Oxfordshire, UK); New Zealand College of Chiropractic (Auckland, New Zealand); and Sherman College of Chiropractic (Spartanburg, South Carolina, USA).

TRG has issued the following statement:

Definition and Position Statement on the Chiropractic Subluxation

The term ‘subluxation’ has been used by the chiropractic profession for over a century.1, 2 It is an important element of chiropractic practice, embedded in legislation and regulation, and its clinical implications have been, and continue to be, scientifically explored.2, 3
The term subluxation, as used by chiropractors, is a researchable concept that is important to health and health care delivery.1, 2, 4 The need to properly define this entity has been widely recognized as a high priority within the profession, as evidenced by the number of groups and organizations who have offered definitions of subluxation.1, 2, 5-10

Many of the past definitions do not provide a testable definition of chiropractic subluxation.11 

Some do not reflect the current research that supports a neurologically-centered model of subluxation. 2 The Rubicon Group (TRG) has utilized the current available scientific evidence to define the chiropractic subluxation. Contemporary neurophysiological language and concepts, based on current scientific publications on the topic, have been used. As this definition is subject to ongoing scientific exploration that is likely to lead to new findings and understandings, modifications may be anticipated. However, this definition reflects what is currently known, and it is congruent with current neurophysiological scientific understanding.

“We currently define a chiropractic subluxation as a self-perpetuating, central segmental motor control problem that involves a joint, such as a vertebral motion segment, that is not moving appropriately, resulting in ongoing maladaptive neural plastic changes that interfere with the central nervous system’s ability to self-regulate, self-organize, adapt, repair and heal.”

(The Rubicon Group, May 2017.)

There are three key elements, namely:

A chiropractic subluxation often relates to the spine and its connecting structures. 1 Chiropractic subluxation assessment generally involves evaluating the pathophysiological consequences of the central segmental motor control problem; 4, 12 these may include pain, asymmetry, biomechanical or postural changes (such as changes in relative range of intervertebral motion), changes in tissue temperature, texture and/or tone, and other findings that can be identified using special tests. 12 Once identified, subluxations are corrected using a variety of techniques including high velocity low amplitude chiropractic adjustments, instrument assisted adjustments, and lower force manual techniques and approaches.13

A growing body of scientific evidence has demonstrated that spinal function impacts central neural function in multiple ways,3, 4, 14-19 and that improving spinal function has an impact on clinical outcomes.20-24 Scientists have known for several decades that neurons continuously adapt in structure and function in response to our ever-changing environment.25-27 This ability to adapt is known as ‘neural plasticity’,27 and it is now well understood that the central nervous system can reorganize in response to altered input.28-35 Examples of increased sensory input that can lead to neural plastic changes include repetitive muscular activity 29, 36-41, such as typing or playing the piano, or repeated tactile sensory input such as occurs with blind Braille readers.42 Similar central nervous system change or reorganization may take place due to a decrease in behavior or activity.+ 32, 43-49 Thus the concept, that alterations in paraspinal muscle function due to abnormal spinal movement patterns are capable of changing central neural function, is totally congruent with current neuroscience understanding, as well as current scientific findings.3, 4, 14-19
[references can be found in the original]

MY COMMENT:

Subluxation is not so much a ‘self-perpetuating motor control problem’ as a self-perpetuating money-maker for chiropractors, it seems to me. The history of the use of this term shows that chiropractors have changed its meaning each time they were unable to deny its nonsensicality. To throw subluxation over board is not an option because chiropractic is at its hear a subluxation cult.

Yet, we have repeatedly been told that chiropractors have all but given up the concept of ‘subluxation’. This is clearly not the case. The above statement of TRG speaks for itself, and so does a recent study showing that “the majority of [North American chiropractic] students would like to see an emphasis on correction of vertebral subluxation”. It is the correction of the non-existent subluxation that stimulates the cash flow of chiropractors, a fact known even to the novices of the cult.

The new definition, it seems to me, is little more than self-serving nonsense. Wikipedia – I know, it’s not always the most reliable source, but in this case it is miles better that TRG – has this to say about subluxation: “In chiropractic, vertebral subluxation is a supposed misalignment of the spinal column leading to a set of signs and symptoms sometimes termed vertebral subluxation complex. It has no biomedical basis and is categorized as pseudoscientific by leading authorities. Traditionally, the “specific focus of chiropractic practice” is the chiropractic subluxation and historical chiropractic practice assumes that a vertebral subluxation or spinal joint dysfunction interferes with the body’s function and its innate intelligence, as promulgated by D. D. Palmer, the inventor of chiropractic.”

Wikipedia furthermore mentions that “in 2015, 8 internationally accredited chiropractic colleges: AECC, WIOC, IFEC-Paris, IFEC-Toulouse, USD-Odense, UZ-Zurich, UJ-Johannesburg and Durban University of Technology made an open statement which included: “The teaching of the vertebral subluxation complex as a vitalistic construct that claims that it is the cause of disease is unsupported by evidence. Its inclusion in a modern chiropractic curriculum in anything other than an historic context is therefore inappropriate and unnecessary”.”

Subluxation currently divides the chiropractic profession as we have seen here, for instance. But it is certainly not a concept that most chiropractors have been wise enough to declare obsolete.

The website of ‘HOMEOPATHY 360’ has just published a new post offering a handy instruction for killing patients suffering from acute appendicitis. If you do not believe me – I don’t blame you, I too found it hard to believe – read this short excerpt advocating homeopathy for this life-threatening condition (for readers without a medical background: if acute appendicitis is not treated promptly, the inflamed appendix might burst, spilling faecal material into the abdominal cavity, resulting in a life-threatening peritonitis):

The post is entitled “A Cure of Acute Appendicitis Using Frequent Homeopathic Doses in Solution

Here is the abstract:

“Placing centesimal potencies in solution and prescribing them frequently for acute conditions is not widely practiced. It can be superior to dry doses in many cases, where a persistent mild medicinal action is preferred to a strong aggravation. By prescribing dissolved doses of Arnica Montana 1m, a case of acute appendicitis was cured quickly. This suggests that centesimal potencies given frequently in solution may be more efficacious, prompt and gentle than treatment with dry doses.”

Fascinating, isn’t it?

Here are more details demonstrating that the author has done his homework:

“When treating a patient with acute medical condi­tion, in certain cases we fail to cure. Even though our case taking, evaluation, analysis, remedy and potency selection seem correct. What is the cause? In the Organon 5th edition (1833) Dr. Hahnemann introduced olfaction and dissolved centesimal remedies as a new method of administering doses. Around the year 1840 Hahnemann began to introduce LM potencies into his practice. From 1840 to 1843 he used both centesimal and LM potencies side by side in medicinal solutions. By these methods he hoped to avoid unwanted aggravations and provide rapid cure.

In some acute cases the aggravation can be discouragingly pro­longed and often cannot be discerned from the patient’s own disease. Many times we change the original prescrip­tion which could very well have been the simillimum. In acute diseases, a dry dose will many times produce an un­necessary aggravation because of the patient’s increased susceptibility. I have much experience now with what I call a “watery dose.” To prepare it, one or two globules of size 10 are diluted in 15ml. of distilled water in which 5 drops of alcohol added with 20 to 30 succussions. From this solution 10 drops are added to another 15 ml of water, and from this solution 5 to 10 drops dose repeated according to the severity of the disease. In such diluted solutions the correct number of drops must be precise. Every time be­fore taking the dose the solution is succussed 5 to 10 times. The same solution can be used for several days or weeks. Hahnemann recommended using carefully measured and dosed solutions with sensitive patients. Many times I have used this method with great success. It is not necessary to take 4 oz. to 8 oz. of water, Just fifteen ml. of distilled water is sufficient. This technique of dosing is also known as a split dose because it uses one or two pills in a solution that is then split over several days or weeks.

The results using this type of dosing can be very dif­ferent from dry doses. There is continuous amelioration of the complaints without aggravation. This comes closer to the ideal of strengthening the weakened vital force than is seen when we simply produce a similar stronger artificial disease in the patient.”

The author also provides a detailed case history of a patient who survived this treatment (of course, without mentioning that acute appendicitis can, in rare cases, have a spontaneous recovery).

MY ADVICE:

I would not recommend Arnica or any other homeopathic remedy for routine use in acute appendicitis (or any other condition) – unless, of course, you want to kill a maximum number of your patients suffering from this medical/surgical emergency.

I am sure you always wanted to know what animal chiropractic is all about!

This website explains it quite well:

START OF QUOTES

…Animal chiropractic (veterinary spinal manipulative therapy) focuses on the preservation and health/wellness of the neuro-musculo-skeletal system. Chiropractic is the science that is centered around the relationship between the spine and the nervous system. The spine is your body’s foundation and the nervous system, including your brain, spinal cord and nerves, controls your entire body. They must work together harmoniously to improve one’s general health and their ability heal. If the systems are not functioning to their highest potential you may experience changes in digestion, heart and lung function, reproduction and most evidently musculature. When adjacent joints are in an abnormal position, called a subluxation, the nervous system and all that it controls will be negatively impacted. If these subluxations are not corrected, they can result in prolonged inappropriate stimulation of nerves. This could result in reduced function internally, musculo-skeletal dysfunction and pain.

Spinal manipulation is the art of restoring full and pain free range of motion to joints and can greatly benefit an animal after they have experienced subluxations. The veterinarian will use their hands to palpate joints both statically and in motion. By doing this, they can determine where the animal is experiencing decreased motion or misaligned joints. Once identified, an adjustment can be performed. An adjustment or spinal manipulation is a gentle, specific, quick and low force thrust that will be applied at an angle specific to the different areas of motion in the spine and extremities. Only a certified animal chiropractor will understand the complexity involved in adjustments and can best assess if an animal can benefit from chiropractic care.

Many animals can benefit from this alternative therapy. If you notice that your animal has a particularly sensitive spot somewhere on their body, is walking or trotting differently and or not performing to the same ability they have previously, they may be a candidate for a chiropractic assessment. However, an animal does not need to be sick or injured to benefit from chiropractic care. Animals in good health or ones used for sporting activities are also prime candidates for chiropractic care. By maintaining your pet’s proper spinal alignment and mobility they will attain optimal function of muscles, nerves and tissues that support the joints. When the body can move freely your pet will experience improved mobility, stance and flexibility, which can evolve into improved agility, endurance and overall performance. Finally, many people have never considered that chiropractic care can also benefit their animal by boosting their immune response. It can aid in providing a healthier metabolism and a vibrant nervous system which all facilitate your animal’s natural ability to heal themselves from within. Chiropractic care can enhance the quality of your pet’s life ensuring many active and healthy years to come.

…during veterinary school I began the process of researching how to become an animal chiropractor or veterinary spinal manipulative therapist. As I researched further, I noticed that this specialized profession has grown. It became apparent that one should be certified by either the College of Animal Chiropractors or American Veterinary Chiropractic Association to practice on animals…  It was surprising to find out that there are only four programs in the USA and Canada that are approved by both organizations. The courses consisted of over 200 hours of intensive study and hands on learning followed by certification testing…

END OF QUOTE

Yes, I did shorten the quote a bit but, rest assured, I did not cut out a single word about the efficacy of animal chiropractic. Even if I had wanted to, I couldn’t: there is no mention of it in the article.

I wonder why!

Looking into Medline, I found several reports related to the subject:

  • One study suggested an association between chiropractic findings in the lumbar vertebrae and urinary incontinence and retention in dogs.
  • A case report highlighted the potential benefits of combining traditional medical management with chiropractic treatment and physical therapy techniques for management of severe acute-onset torticollis in a giraffe.
  • A review explained that there is limited evidence supporting the effectiveness of spinal mobilization and manipulation in animals.
  • An observational study suggested that chiropractic manipulations elicit slight but significant changes in thoracolumbar and pelvic kinematics.
  • A comparative study measured the spinal mechanical nociceptive thresholds in 38 horses, and showed that they increased by 27, 12 and 8% in the chiropractic, massage and phenylbutazone groups, respectively.

… and that was basically it. Not a single study to suggest that chiropractic is effective for specific conditions of animals.

Frustrated, I went on the site of the ‘College of Animal Chiropractic’; surely there I would find the evidence I was looking for. They offer lots of platitudes and this largely nonsensical statement:

“When a joint become restricted in its range of motion(hypomobile or ‘locked-up’), through trauma, repetitive injury, degenerative changes, or structural stresses, the surrounding tissues are affected. This, in turn, further affects the joints ability to move freely and sensitive structures are activated causing the area to be sensitive or painful. Nerves are the communication links between all tissues in the body to the brain and spinal cord; when joint dysfunction is present, messages to other areas are also affected, which can lead to pain, weakness, reduced function, and compensatory changes. Animal chiropractic focuses on the restoration of movement and the promotion of heath by restoring normal joint mechanics and soft-tissue function, thus, normalizing neurological patterns that facilitate healing . The main tool an animal chiropractor uses to restore joint motion is called an “adjustment”, or veterinary spinal manipulation. This gentle, specialized, manual skill, involves the application of a quick, low-force maneuver that is directed to a specific area of a joint at a specific angle. A certified animal chiropractor understands these joint angles intimately and can best asses if an animal can benefit from chiropractic care, and, is the only professional who is qualified to adjust your pet.”

But no evidence!

By now I was desperate. My last hope was the ‘American Veterinary Chiropractic Association’. All I found there, however, was this: the “American Veterinary Chiropractic Association (AVCA) is a professional membership group promoting animal chiropractic to professionals and the public, and acting as the certifying agency for doctors who have undergone post-graduate animal chiropractic training.”

Not a jot of evidence!

The assumption that animal chiropractic is effective seems to rely on the evidence from human studies…

… and we all know how solid that body of evidence is!

My conclusion from all this: chiropractors treating animals and those treating humans have one important characteristic in common.

THEY HAPPILY PROMOTE BOGUS TREATMENTS.

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