MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

bogus claims

On this blog, we have seen more than enough evidence of how some proponents of alternative medicine can react when they feel cornered by critics. They often direct vitriol in their direction. Ad hominem attacks are far from being rarities. A more forceful option is to sue them for libel. In my own case, Prince Charles went one decisive step further and made sure that my entire department was closed down. In China, they have recently and dramatically gone even further.

This article in Nature tells the full story:

A Chinese doctor who was arrested after he criticized a best-selling traditional Chinese remedy has been released, after more than three months in detention. Tan Qindong had been held at the Liangcheng county detention centre since January, when police said a post Tan had made on social media damaged the reputation of the traditional medicine and the company that makes it.

On 17 April, a provincial court found the police evidence for the case insufficient. Tan, a former anaesthesiologist who has founded several biomedical companies, was released on bail on that day. Tan, who lives in Guangzhou in southern China, is now awaiting trial. Lawyers familiar with Chinese criminal law told Nature that police have a year to collect more evidence or the case will be dismissed. They say the trial is unlikely to go ahead…

The episode highlights the sensitivities over traditional Chinese medicines (TCMs) in China. Although most of these therapies have not been tested for efficacy in randomized clinical trials — and serious side effects have been reported in some1TCM has support from the highest levels of government. Criticism of remedies is often blocked on the Internet in China. Some lawyers and physicians worry that Tan’s arrest will make people even more hesitant to criticize traditional therapies…

Tan’s post about a medicine called Hongmao liquor was published on the Chinese social-media app Meipian on 19 December…Three days later, the liquor’s maker, Hongmao Pharmaceuticals in Liangcheng county of Inner Mongolia autonomous region, told local police that Tan had defamed the company. Liangcheng police hired an accountant who estimated that the damage to the company’s reputation was 1.4 million Chinese yuan (US$220,000), according to official state media, the Beijing Youth Daily. In January, Liangcheng police travelled to Guangzhou to arrest Tan and escort him back to Liangcheng, according to a police statement.

Sales of Hongmao liquor reached 1.63 billion yuan in 2016, making it the second best-selling TCM in China that year. It was approved to be sold by licensed TCM shops and physicians in 1992 and approved for sale over the counter in 2003. Hongmao Pharmaceuticals says that the liquor can treat dozens of different disorders, including problems with the spleen, stomach and kidney, as well as backaches…

Hongmao Pharmaceuticals did not respond to Nature’s request for an interview. However, Wang Shengwang, general manager of the production center of Hongmao Liquor, and Han Jun, assistant to the general manager, gave an interview to The Paper on 16 April. The pair said the company did not need not publicize clinical trial data because Hongmao liquor is a “protected TCM composition”. Wang denied allegations in Chinese media that the company pressured the police to pursue Tan or that it dispatched staff to accompany the police…

Xia is worried that the case could further silence public criticism of TCMs, environmental degredation, and other fields where comment from experts is crucial. The Tan arrest “could cause fear among scientists” and dissuade them from posting scientific comments, he says.

END OF QUOTE

On this blog, we have repeatedly discussed concerns over the validity of TCM data/material that comes out of China (see for instance here, here and here). This chilling case, I am afraid, is not prone to increase our confidence.

Reflexology is an alternative therapy that is subjectively pleasant and objectively popular; it has been the subject on this blog before (see also here and here). Reflexologists assume that certain zones on the sole of our feet correspond to certain organs, and that their manual treatment can influence the function of these organs. Thus reflexology is advocated for all sorts of conditions, including infant colic.

The aim of this new study was to explore the effect of reflexology on infantile colic.

A total of 64 babies with colic were included in this study. Following a paediatrician’s diagnosis, two groups (study and control) were created. Socio-demographic data (including mother’s age, educational status, and smoking habits of parents) and medical history of the baby (including gender, birth weight, mode of delivery, time of the onset breastfeeding after birth, and nutrition style) were collected. The Infant Colic Scale (ICS) was used to estimate the colic severity in the infants. Reflexology was applied to the study group by the researcher and their mother 2 days a week for 3 weeks. The babies in the control group did not receive reflexology. Assessments were performed before and after the intervention in both groups.

The results show that the two groups were similar regarding socio-demographic background and medical history. While there was no difference between the groups in ICS scores before application of reflexology, the mean ICS score of the study group was significantly lower than that of control group at the end of the intervention.

The authors concluded that reflexology application for babies suffering from infantile colic may be a promising method to alleviate colic severity.

The authors seem to attribute the outcome to specific effects of reflexology.

However, they are mistaken!

Why?

Because their study does not control for the non-specific effects of the intervention.

Reflexology has not been shown to work for anything (“the best clinical evidence does not demonstrate convincingly reflexology to be an effective treatment for any medical condition“), and there is plenty of evidence to show that holding the baby, massaging it, cuddling it, rocking it or doing just about anything with it will have an effect, e. g.:

This trial of massage treatment for infantile colic showed statistically significant or clinically relevant effect in comparison with the rocking group.

The majority of the included trials appeared to indicate that the parents of infants receiving manipulative therapies reported fewer hours crying per day than parents whose infants did not…

…kangaroo care for infants with colic is a promising intervention…

I think, in a way, this is rather good news; we do not need to believe in the hocus-pocus of reflexology in order to help our crying infants.

“In at least one article on chiropractic, Ernst has been shown to be fabricating data. I would not be surprised if he did the same thing with homeopathy. Ernst is a serial scientific liar.”

I saw this remarkable and charming Tweet yesterday. Its author is ‘Dr’ Avery Jenkins. Initially I was unaware of having had contact with him before; but when I checked my emails, I found this correspondence from August 2010:

Dr. Ernst:

Would you be so kind as to provide the full text of your article? Also, when would you be available for an interview for an upcoming feature article?

Thank you.

Avery L. Jenkins, D.C.

I put his title in inverted commas, because it turns out he is a chiropractor and not a medical doctor (but let’s not be petty!).

‘Dr’ Avery Jenkins runs a ‘Center for Alternative Medicine’ in the US: The Center has several features which set it apart from most other alternative medicine facilities, including the Center’s unique Dispensary.  Stocked with over 300 herbs and supplements, the Dispensary’s wide range of natural remedies enables Dr. Jenkins to be the only doctor in Connecticut who provides custom herbal formulations for his patients. In our drug testing facility, we can provide on-site testing for drugs of abuse with immediate result reporting. Same-day appointments are available. Dr. Jenkins is also one of the few doctors in the state who has already undergone the federally-mandated training which will be necessary for all Department of Transportation Medical Examiners by 2014. Medical examinations for your Commercial Drivers License will take only 25 minutes, and Dr. Jenkins will provide you with all necessary paperwork.

The good ‘doctor’ also publishes a blog, and there I found a post from 2016 entirely dedicated to me. Here is an excerpt:

.. bias and hidden agendas come up in the research on alternative medicine and chiropractic in particular. Mostly this occurs in the form of journal articles using research that has been hand-crafted to make chiropractic spinal manipulation appear dangerous — when, in fact, you have a higher risk of serious injury while driving to your chiropractor’s office than you do of any treatment you receive while you’re there.

A case in point is the article, “Adverse effects of spinal manipulation: a systematic review,” authored by Edzard Ernst, and published in the Journal of the Royal Society of Medicine in 2007. Ernst concludes that, based on his review, “in the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation.”

This conclusion throws up several red flags, beginning with the fact that it flies in the face of most of the already-published, extensive research which shows that chiropractic care is one of the safest interventions, and in fact, is  safer than medical alternatives.

For example, an examination of injuries resulting from neck adjustments over a 10-year period found that they rarely, if ever, cause strokes, and lumbar adjustments by chiropractors have been deemed by one of the largest studies ever performed to be safer and more effective than medical treatment.

So the sudden appearance of this study claiming that chiropractic care should be stopped altogether seems a bit odd.

As it turns out, the data is odd as well.

In 2012, a researcher at Macquarie University in Australia, set out to replicate Ernst’s study. What he found was shocking.

This subsequent study stated that “a review of the original case reports and case series papers described by Ernst found numerous errors or inconsistencies,” including changing the sex and age of patients, misrepresenting patients’ response to adverse events, and claiming that interventions were performed by chiropractors, when no chiropractor was even involved in the case.

“In 11 cases of the 21…that Ernst reported as [spinal manipulative therapy] administered by chiropractors, it is unlikely that the person was a qualified chiropractor,” the review found.

What is interesting here is that Edzard Ernst is no rookie in academic publishing. In fact, he is a retired professor and founder of two medical journals. What are the odds that a man with this level of experience could overlook so many errors in his own data?

The likelihood of Ernst accidentally allowing so many errors into his article is extremely small. It is far more likely that Ernst selected, prepared, and presented the data to make it fit a predetermined conclusion.

So, Ernst’s article is either extremely poor science, or witheringly inept fraud. I’ll let the reader draw their own conclusion.

Interestingly enough, being called out on his antics has not stopped Ernst from disseminating equally ridiculous research in an unprofessional manner. Just a few days ago, Ernst frantically called attention to another alleged chiropractic mishap, this one resulting in a massive brain injury.

Not only has he not learned his lesson yet, Ernst tried the same old sleight of hand again. The brain injury, as it turns out, didn’t happen until a week after the “chiropractic” adjustment, making it highly unlikely, if not impossible, for the adjustment to have caused the injury in the first place. Secondly, the adjustment wasn’t even performed by a chiropractor. As the original paper points out, “cervical manipulation is still widely practiced in massage parlors and barbers in the Middle East.”  The original article makes no claim that the neck adjustment (which couldn’t have caused the problem in the first place) was actually performed by a chiropractor.

It is truly a shame that fiction published by people like Ernst has had the effect of preventing many people from getting the care they need. I can only hope that someday the biomedical research community can shed its childish biases so that we all might be better served by their findings.

END OF QUOTE

Here I will not deal with the criticism a Australian chiropractor published in a chiro-journal 5 years after my 2007 article (which incidentally was not primarily about chiropractic but about spinal manipulation). Suffice to say that my article did NOT contain ‘fabricated’ data. A full re-analysis would be far too tedious, for my taste (especially as criticism of it has been discussed in all of 7 ‘letters to the editor’ soon after its publication)

I will, however, address ‘Dr’ Avery Jenkins’ second allegation related to my recent (‘frantic’) blog-post. I will do this by simply copying the abstract of the paper in question:

Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic* manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery territory infarctions and large cortical-sparing left middle cerebral artery infarction. This suggests the presence of functionally patent and interconnecting leptomeningeal anastomoses between cerebral arteries, which may provide sufficient blood flow to salvage penumbral regions when a supplying artery is occluded. Conclusion: Chiropractic* cervical manipulation can result in catastrophic vascular lesions preventable if these practices are limited to highly specialized personnel under very specific situations.

*my emphasis


With this, I rest my case.

The only question to be answered now is this: TO SUE OR NOT TO SUE?

What do you think?

Osteopathy is an odd alternative therapy. In many parts of the world it is popular; the profession differs dramatically from country to country; and there is not a single condition for which we could say that osteopathy out-performs other options. No wonder then that osteopaths would be more than happy to find a new area where they could practice their skills.

Perhaps surgical care is such an area?

The aim of this systematic review was to present an overview of published research articles within the subject field of osteopathic manipulative treatment (OMT) in surgical care. The authors evaluated peer-reviewed research articles published in osteopathic journals during the period 1990 to 2017. In total, 10 articles were identified.

Previous research has been conducted within the areas of abdominal, thoracic, gynecological, and/or orthopedic surgery. The studies included outcomes such as pain, analgesia consumption, length of hospital stay, and range of motion. Heterogeneity was identified in usage of osteopathic techniques, treatment duration, and occurrence, as well as in the osteopath’s experience.

The authors concluded that despite the small number of research articles within this field, both positive effects as well as the absence of such effects were identified. Overall, there was a heterogeneity concerning surgical contexts, diagnoses, signs and symptoms, as well as surgical phases in current interprofessional osteopathic publications. In this era of multimodal surgical care, the authors concluded, there is an urgent need to evaluate OMT in this context of care and with a proper research approach.

This is an odd conclusion, if there ever was one!

The facts are fairly straight forward:

  • Osteopaths would like to expand into the area of surgical care [mainly, I suspect, because it would be good for business]
  • There is no plausible reason why OMT should be beneficial in this setting.
  • Osteopaths are not well-trained for looking after surgical patients.
  • Physiotherapists, however, are and therefore there is no need for osteopaths on surgical wards.
  • The evidence is extremely scarce.
  • The available trials are of poor quality.
  • Their results are contradictory.
  • Therefore there is no reliable evidence to show that OMT is effective.

The correct conclusion of this review should thus be as follows:

THE AVAILABLE EVIDENCE FAILS TO SHOW EFFECTIVENESS OF OMT. THEREFORE THIS APPROACH CANNOT BE RECOMMENDED.

End of story.

I hear this argument so regularly that it might be worth analysing it (yet again) a bit closer.

It is used with the deepest of convictions by proponents of all sorts of quackery who point out that science does not know or explain everything – and certainly not their (very special) therapy. Science is just not sophisticated enough, they say; in fact, a few years ago, it could not even explain how Aspirin works. And just like Aspirin, their very special therapy – let’s call it energy healing (EH) for the sake of this post – does definitely and evidently work. There even is ample proof:

  • Patients get better after using EH, and surely patients don’t lie.
  • Patients pay for EH, and who would pay for something that does not work?
  • EH has survived hundreds of years, and ineffective therapies don’t.
  • EH practitioners have tons of experience and therefore know best.
  • They are respected by very important people and organisations.
  • EH is even reimbursed by some insurance companies.

You have all heard the argument, I’m sure.

How to respond?

The ‘proofs’ listed above are simply fallacies; as such they do not need more detailed discussions, I hope.

But how can we refute the notion that science is not yet sufficiently advanced to explain EH?

The simplest approach might be to explain that science has already tested EH and found it to be ineffective. There really is nothing more to say. And the often-quoted example of Aspirin does clearly not wash. True, a few decades ago, we did not know how it worked. But we always knew that it worked because we conducted clinical trials, and they generated positive results. These findings we the main reasons why scientists wanted to find out how it works, and eventually they did (and even got a Nobel Prize for it). Had the clinical trials not shown effectiveness, nobody would have been interested in alleged mechanisms of action.

With EH, things are different. Rigorous clinical trials of EH have been conducted, and the totality of this evidence fails to show that EH works. Therefore, chasing after a mechanism of action would be silly and wasteful. It’s true, science cannot explain EH, but this is not because it is not yet sophisticated enough; it is because there is nothing to explain. EH has been disproven, and waffling about ‘science is not yet able to explain it’ is either a deliberate lie or a serious delusion.

So far so good. But what if EH had not been submitted to clinical trials?

In such cases, the above line of argument would not work very well.

For instance, as far as I know, there is not a single rigorous clinical trial of crystal healing (CH). Does that mean that perhaps CH-proponents are correct when claiming that it does evidently work and science simply cannot yet understand how?

No, I don’t think so.

Like most of the untested alternative therapies, CH is not based on plausible assumptions. In fact, the implausibility of the underlying assumptions is the reason why such treatments have not and probably never will be submitted to rigorous clinical trials. Why should anyone waste his time and our money running expensive tests on something that is so extremely unlikely? Arguably doing so would even be unethical.

With highly implausible therapies we need no trials, and we do not need to fear that science is not yet sufficiently advance to explain them. In fact, science is sufficiently advanced to be certain that there can be no explanation that is in line with the known laws of nature.

Sadly, some truly deluded fans of CH might still not be satisfied and respond to our reasoning that we need a ‘paradigm shift’. They might say that science cannot explain CH because it is stuck in the straightjacket of an obsolete paradigm which does not cater for phenomena like CH.

Yet this last and desperate attempt of the fanatics is not a logical refuge. Paradigm shifts are not required because some quack thinks so, they are needed only if data have been emerging that cannot possibly be explained within the current paradigm. But this is never the case in alternative medicine. We can explain all the experience of advocates, positive results of researchers and ‘miracle’ cures of patients that are being reported. We know that the experiences are real, but are sure that their explanations of the experience are false. They are not due to the treatment per se but to other phenomena such as placebo effects, natural history, regression towards the mean, spontaneous recovery, etc.

So, whichever way we turn things, and whichever way enthusiasts of alternative therapies twist them, their argument that ‘SCIENCE IS NOT YET ABLE TO EXPLAIN’ is simply wrong.

The UK ‘COLLEGE OF MEDICINE’ has recently (and very quietly) renamed itself; it now is THE COLLEGE OF MEDICINE AND INTEGRATED HEALTH (COMIH). This takes it closer to its original intentions of being the successor of the PRINCE OF WALES FOUNDATION FOR INTEGRATED MEDICINE (PWFIM), the organisation that had to be shut down amidst charges of fraud and money-laundering. Originally, the name of COMIH was to be COLLEGE OF INTEGRATED HEALTH (as opposed to disintegrated health?, I asked myself at the time).

Under the leadership of Dr Michael Dixon, OBE (who also led the PWFIM into its demise), the COMIH pursues all sots of activities. One of them seems to be publishing ‘cutting-edge’ articles.

A recent and superb example is on the fascinating subject of ‘holistic dentistry‘:

START OF QUOTE

Professor Sonia Williams … explores how integrated oral health needs to consider the whole body, not just the dentition…

Complementary and alternative approaches can also be considered as complementary to ‘mainstream’ care, with varying levels of evidence cited for their benefit.

Dental hypnosis (British Society of Medical and Dental Hypnosis) can help support patients including those with dental phobia or help to reduce pain experience during treatment.

Acupuncture in dentistry (British Society of Dental Acupuncture) can, for instance, assist with pain relief and allay the tendency to vomit during dental care.  There is also a British Homeopathic Dental Association.

For the UK Faculty of General Dental Practitioners, holistic dentistry refers to strengthening the link between general and oral health.

For some others, the term also represents an ‘alternative’ form of dentistry, which may concern itself with the avoidance and elimination of ‘toxic’ filling materials, perceived potential harm from fluoride and root canal treatments and with treating dental malocclusion to put patients back in ‘balance’.

In the USA, there is a Holistic Dental Association, while in the UK, there is the British Society for Mercury-free Dentistry. Unfortunately the evidence base for many of these procedures is weak.

Nevertheless, pressure to avoid mercury in dental restorative materials is becoming mainstream.

In summary, integrated health and care in dentistry can mean different things to different people. The weight of evidence supports the contention that the mouth is an integral part of the body and that attention to the one without taking account of the other can have adverse consequences.

END OF QUOTE

Do I get this right? ‘Holistic dentistry’ in the UK means the recognition that my mouth belongs to my body, and the adoption of a few dubious treatments with w ‘weak’ evidence base?

Well, isn’t this just great? I had no idea that my mouth belongs to my body. And clearly the non-holistic dentists in the UK are oblivious to this fact as well. I am sooooooo glad we got this cleared up.

Thanks COMIH!!!

And what about the alternative treatments used by holistic dentists?

The British Society of Medical and Dental Hypnosis (Scotland) inform us on their website that a trained medical and dental hypnotherapists can help you to deal with a large variety of challenges that you face in your everyday life e.g.

Asthma Migraines
Anxiety & Stress Smoking Cessation
Dental Problems Insomnia
Weight Problems Psychosexual Disorders
Depression Pain Management
Irritable Bowel  And many other conditions

I hasten to add that, for most of these conditions, the evidence fails to support the claims.

The British Society of Dental Acupuncture claim on their website that the typical conditions that may be helped by acupuncture are:

  • TMJ (jaw joint) problems
  • Facial pain
  • Muscle spasm in the head and neck
  • Stress headaches & Migraine
  • Rhinitis & sinusitis
  • Gagging
  • Dry mouth problems
  • Post-operative pain
  • Dental anxiety

I hasten to add that, for most of these conditions, the evidence fails to support the claims.

The British Homeopathic Dental Association claim on their website that studies have shown improved bone healing around implants with Symphytum and reduced discomfort and improved healing time with ulcers and beneficial in oral lichen planus.

I hasten to add that none of these claims are not supported by sound evidence.

The COMIH article is entitled “The mouth reflects whole body health – but what does integrated care mean for dentists?’ So, what does it mean? Judging from this article, it means an amalgam (pun intended) of platitudes, bogus claims and outright nonsense.

Pity that they did not change their name to College of Medicine and Integrated Care – I could have abbreviated it as COMIC!

Daniel P Wirth used to be THE star amongst researchers and proponents of paranormal healing. About 15 years ago, there was nobody who had published more studies of it than Wirth. The extraordinary phenomenon was not just the number of studies, but also the fact that these trials all reported positive findings.

At the time, this puzzled me a lot. I had conducted two trials of paranormal healing myself; and, in both, cases the results had turned out to be negative (see here and here). Thus I made several attempts to contact Wirth or his co-authors hoping to better understand the phenomenon. Yet I never received a reply and became increasingly suspicious of their research.

In 2004, it was announced that Wirth together with one of his co-workers had been arrested and later imprisoned for fraud. Several of his 20 papers published in various journals were subsequently withdrawn. I remember writing to several journal editors myself urging them to follow suit so that, in future, the literature would not be polluted with dubious studies. Eventually, we all forgot about the whole story.

Recently, I took a renewed interest in paranormal healing. To my surprise, I found that several of Wirth’s papers are still listed on Medline:

1 Does prayer influence the success of in vitro fertilization-embryo transfer? Report of a masked, randomized trial.

Cha KY, Wirth DP.

J Reprod Med. 2001 Sep;46(9):781-7. Erratum in: J Reprod Med. 2004 Oct;49(10):100A. Lobo, RA [removed].

PMID: 11584476

2 Multisite electromyographic analysis of therapeutic touch and qigong therapy.

Wirth DP, Cram JR, Chang RJ.

J Altern Complement Med. 1997 Summer;3(2):109-18.

PMID: 9395700

3 Multisite surface electromyography and complementary healing intervention: a comparative analysis.

Wirth DP, Cram JR.

J Altern Complement Med. 1997 Winter;3(4):355-64.

PMID: 9449057

4 Wound healing and complementary therapies: a review.

Wirth DP, Richardson JT, Eidelman WS.

J Altern Complement Med. 1996 Winter;2(4):493-502. Review.

PMID: 9395679

5 The significance of belief and expectancy within the spiritual healing encounter.

Wirth DP.

Soc Sci Med. 1995 Jul;41(2):249-60.

PMID: 7667686

6 Complementary healing intervention and dermal wound reepithelialization: an overview.

Wirth DP.

Int J Psychosom. 1995;42(1-4):48-53.

PMID: 8582812

7 The psychophysiology of nontraditional prayer.

Wirth DP, Cram JR.

Int J Psychosom. 1994;41(1-4):68-75.

PMID: 7843870

8 Complementary healing therapies.

Wirth DP, Barrett MJ.

Int J Psychosom. 1994;41(1-4):61-7.

PMID: 7843869

Multi-site electromyographic analysis of non-contact therapeutic touch.

Wirth DP, Cram JR.

Int J Psychosom. 1993;40(1-4):47-55.

PMID: 8070986

____________________________________________________________________________

Of these 9 papers, only the first one in the list carries a note indicating that the paper has been removed. In other words, 8 of Wirth’s articles are still available as though they are fine and proper.

The situation is even worse on ‘Research Gate’. Here we find all of the following articles with no indication of any suspicion of fraud:

———-

Article: Does Prayer Influence the Success of in Vitro Fertilization-Embryo Transfer? Report of a Masked, Randomized Trial

KY Cha · Daniel P. Wirth · RA Lobo

Abstract: To assess the potential effect of intercessory prayer (IP) on pregnancy rates in women being treated with in vitro fertilization-embryo transfer (IVF-ET). Prospective, double-blind, randomized clinical trial in which patients and providers were not informed about the intervention. Statisticians and investigators were masked until all the data had been collected and clinical outcomes were known. The setting was an IVF-ET program at Cha Hospital, Seoul, Korea. IP was carried out by prayer…

Article · Oct 2001 · The Journal of reproductive medicine

———-

Article: Exploring Further Menstruation and Spiritual Healing

Daniel P. Wirth

Article · Apr 1997 · Alternative and Complementary Therapies

———-

Article: Multisite Surface Electromyography and Complementary Healing Intervention: A Comparative Analysis

Daniel P. Wirth · Jeffrey R. Cram

Abstract: A comparative analysis was conducted on a series of three experimental studies that examined the effect of various local and nonlocal (distant) complementary healing methods on multisite surface electromyographic (sEMG) and autonomic measures. The series concentrated sEMG electrode placement on specific neuromuscular paraspinal centers (cervical [C4], thoracic [T6], and lumbar [L3]), along with the frontalis region, due to the fact that these sites corresponded to the location of individual…

Article · Feb 1997 · The Journal of Alternative and Complementary Medicine

———-

Article: Multisite Electromyographic Analysis of Therapeutic Touch and Qigong Therapy

Daniel P. Wirth · Jeffrey R. Cram · Richard J. Chang

Abstract: The influence of complementary healing treatment on paraspinal electromagnetic activity at specific neuromuscular sites was examined in an exploratory pilot study that used a multisite surface electromyographic (sEMG) assessment procedure. The study was a replication and extension of previous research that indicated that complementary healing had a significant effect in normalizing the activity of the “end organ” for the central nervous system (CNS). Multisite sEMG electrodes were placed on…

Article · Feb 1997 · The Journal of Alternative and Complementary Medicine

———-

Article: Non-contact Therapeutic Touch intervention and full thickness cutaneous wounds: A replication

Daniel P Wirth · Joseph T. Richardson · Robert D. Martinez · William S. Eidelman · Maria E.L. Lopez

Abstract: The study described here utilized a randomized double-blind methodological protocol in order to examine the effect of non-contact therapeutic touch (NCTT) on the healing rate of full-thickness human dermal wounds. This study is the fifth experiment in a series of extensions based on the original research design, and is an exact methodological replication of the second study in the series. Thirty-two healthy subjects were randomly divided into treatment and control groups and biopsies were…

Article · Oct 1996 · Complementary Therapies in Medicine

———-

Article: Wound Healing and Complementary Therapies: A Review

Daniel P. Wirth · Joseph T. Richardson · William S. Eidelman

Abstract: A series of five innovative experiments conducted by Wirth et al. which examined the effect of various complementary healing interventions on the reepithelialization rate of full thickness human dermal wounds was assessed as to specific methodological and related factors. The treatment interventions utilized in the series included experimental derivatives of the Therapeutic Touch (TT), Reiki, LeShan, and Intercessory Prayer techniques. The results of the series indicated statistical…

Article · Feb 1996 · The Journal of Alternative and Complementary Medicine

———-

Article: Haematological indicators of complementary healing intervention

Daniel P. Wirth · Richard J. Chang · William S. Eidelman · Joanne B. Paxton

Abstract: The effect of Therapeutic Touch, Reiki, LeShan, and Qigong Therapy in combination on haematological measures was examined in an exploratory pilot study utilizing a randomized, double-blind, within-subject, crossover design. Fourteen subjects were randomly assigned to treatment and control conditions for two one-hour evaluation sessions separated by a 24-hour period. Six blood samples were taken from each subject — three during the treatment condition and three during the control condition —…

Article · Jan 1996 · Complementary Therapies in Medicine

———-

Article: The significance of belief and expectancy within the spiritual healing encounter

Daniel P. Wirth

Abstract: Historically, traditional cultures recognized the importance of belief and expectancy within the healing encounter and created complex rituals and ceremonies designed to elicit or foster the expectancy and participation of both the healer and patient, as well as the community as a whole. This holistic approach to health care was a fundamental component in the spiritual healing rituals of virtually all traditional native cultures. The focus of the current study was to assess the impact of…

Article · Aug 1995 · Social Science & Medicine

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Article: Non-contact Therapeutic Touch and wound re-epithelialization: An extension of previous research

Daniel P. Wirth · Margaret J Barrett · William S. Eidelman

Abstract: The results demonstrated a non-significant effect for the treatment versus control groups. Several factors may have contributed to the non-significance, including: the ineffectiveness of the healers, the inhibitive or dampening effect of plastic, the use of self-regulatory techniques, the dependent variable examined, the type of dressing utilized, the influence of distance, and the healers’ belief as to the effect of distance. Future studies would benefit by examining the methodological…

Article · Oct 1994 · Complementary Therapies in Medicine

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Article: The effect of complementary healing therapy on postoperative pain after surgical removal of impacted third molar teeth

Daniel P. Wirth · David R. Brenlan · Richard J. Levine · Christine M. Rodriguez

Abstract: This study utilized a randomized, double-blind, within subject, crossover design to examine the effect of Reiki and LeShan healing in combination on iatrogenic pain experienced after unilateral operative extraction of the lower third molar. Two separate operations were performed on 21 patients with bilateral, asymptomatic, impacted lower third molar teeth. The patients were randomly assigned to the treatment or control condition prior to the first operation. For the second operation,…

Article · Jul 1993 · Complementary Therapies in Medicine

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Article: Full thickness dermal wounds treated with non-contact Therapeutic Touch: a replication and extension

Daniel P. Wirth · Joseph T. Richardson · William S. Eidelman · Alice C. O’Malley

Abstract: The effect of non-contact Therapeutic Touch (NCTT) therapy on the healing rate of full thickness human dermal wounds was examined in a double-blind, placebo controlled study. Punch biopsies were performed on the lateral deltoid in 24 healthy subjects who were randomly assigned to treatment and control groups. Active and control treatments were comprised of daily sessions of 5 min of exposure to a hidden NCTT practitioner or control exposure. Placebo effects and the possible influences of…

Article · Jul 1993 · Complementary Therapies in Medicine

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Article: The Effect of Alternative Healing Therapy on the Regeneration Rate of Salamander Forelimbs

DANIEL P. WIRTH · CATHY A. JOHNSON · JOSEPH S. HORVATH

Article · Jan 1992

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Article: Complementary Healing Therapy For Patients With Type I Diabetes Mellitus

DANIEL P. WIRTH · BARBARA J. MITCHELL

Abstract: The effect of Noncontact Therapeutic Touch (NCTT) therapy and Intercessory Prayer (IP) on patient determined insulin dosage was exam- ined in an exploratory pilot study which utilized a randomized, double-blind, within subject, crossover design. Sixteen type I diabetes mellitus patients were examined and treated daily by NCTT and IP healers for a duration of two weeks. Each patient underwent two separate sessions-one in the treat- ment condition and one in the control condition-with the…

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What is even worse, Wirth’s papers continue to get cited. In other words, Wirth’s research lives on regardless of the fact that it is highly dubious.

In my view, it is long over-due for all journal-editors to fully and completely delete Wirth’s dubious papers. This is particularly true since several experts have alerted them to the problem. Furthermore, I submit that failing to take action  amounts to unethical behaviour which is quite simply unacceptable.

It’s still ‘HOMEOPATHIC AWARENESS WEEK’. What better time for introducing you to one of the most bewildering aspect of this bizarre therapy?

Homeopathy is not just being promoted as a treatment for humans and animals, it is also advocated for plants. There are plenty of websites about this that give concrete advice such as this one: “Try the key symptom of a remedy that you would normally give to a person, on plants. For example, in cases of freezing where the leaves turn to a light or silvery colour, use Aconite 200 CH. When the leaves are more of a reddish colour use Belladonna 200 CH. Just like with a feverish child. If the child is pale then you know it is an Aconite fever. If is extremely red on the other hand, like a hot tomato, then the remedy is Belladonna. And you see this on the leaves too. You simply convert it one to one.”

Given this school of thought within homeopathy (not even Hahnemann would have dreamt this up), it seems only logical to use plants also for attempts to prove that highly diluted homeopathic remedies are more than pure placebos.

Weird?

Not to homeopaths!

Not even to some academic researchers within the realm of homeopathy.

The authors of this systematic review evaluated publications on plant-based test systems. A literature search was conducted in online databases and specific journals, including publications from 2008 to 2017 dealing with plant-based test systems in homeopathic basic research. To be included, they had to contain statistical analysis and fulfil quality criteria according to a pre-defined manuscript information score (MIS). Publications scoring at least 5 points (maximum 10 points) were assumed to be adequate. They were analysed for the use of adequate controls, outcome and reproducibility.

Seventy-four publications on plant-based test systems were found. Thirty-nine publications were either abstracts or proceedings of conferences and were excluded. From the remaining 35 publications, 26 reached a score of 5 or higher in the MIS. Adequate controls were used in 13 of these publications. All of them described specific effects of homeopathic preparations. The publication quality still varied: a substantial number of publications (23%) did not adequately document the methods used. Four reported on replication trials. One replication trial found effects of homeopathic preparations comparable to the original study. Three replication trials failed to confirm the original study but identified possible external influencing factors. Five publications described novel plant-based test systems. Eight trials used systematic negative control experiments to document test system stability.

The authors concluded that, regarding research design, future trials should implement adequate controls to identify specific effects of homeopathic preparations and include systematic negative control experiments. Further external and internal replication trials, and control of influencing factors, are needed to verify results. Standardised test systems should be developed.

Really, just one (!) replication trial found effects of homeopathic preparations comparable to the original study? And yet the authors do not arrive at the only possible conclusion that is based on the actual data presented?

THE AVAILABLE EVIDENCE FAILS TO SHOW THAT PLANT-BASED TEST SYSTEMS PROVIDE SOUND EVIDENCE TO SUGGEST THAT THEY ARE USEFUL OR THAT HIGHLY DILUTED HOMEOPATHICS ARE DIFFERENT FROM PLACEBOS.

But there are other things which seem odd here. The very first two sentences of the abstract of the above article read as follows: Plant-based test systems have been described as a useful tool for investigating possible effects of homeopathic preparations. The last reviews of this research field were published in 2009/2011.

This is odd because there is a very similar review dated 2015 (what is more, it is by some of the authors who also did the new review); it concluded: Plant models appear to be a useful approach for investigating basic research questions relating to homeopathic preparations, but more independent replication trials are needed in order to verify the results found in single experiments. Adequate controls and SNC experiments should be implemented on a routine basis to exclude false-positive results.

Why do the authors mislead us so badly?

Ahh, I see! They are affiliated to the following institutions:

  • Centre for Complementary Medicine, Faculty of Medicine, Institute for Infection Prevention and Hospital Epidemiology, University of Freiburg, Germany
  • Institute of Integrative Medicine, University of Witten/Herdecke, Witten, Germany
  • Institute of Complementary Medicine, University of Bern, Switzerland.
  • Hiscia Institute, Arlesheim, Switzerland
  • Crystal Lab, Landgoed Roepaen, Ottersum, Netherlands.

Could they have an interest in perpetuating the notion of homeopathy (for plants)?

Could it be that these researchers are less than objective?

So what?

No reason to make a fuss, because no harm done!

Not entirely true: some might choke laughing about the idea of treating plants with highly diluted, shaken water.

Today, enthusiasts of homeopathy celebrate the start of the HOMEOPATHY AWARENESS WEEK. Let’s join them by re-addressing one of their favourite themes: their personal experience with homeopathy.

Most homeopathy-fans argue that the negative scientific evidence must be wrong because they have had positive experiences. Whenever I give a lecture, for instance, there will be at least one person in the audience who presents such an experience (and I too could contribute a few such stories from my own past). Such ‘case reports’ can, of course, be interesting, illuminating or leading to further research, but they can never be conclusive.

This concept is often profoundly confusing for patients and consumers. They tend to feel that I am doubting their words, but nothing could be further from the truth. Their experience is certainly true – what might be false is their interpretation of it. I think, I better explain this in more detail using a concrete, published example.

After the publication of our 2003 RCT of homeopathic Arnica which showed that two different potencies have effects that do not differ from those of placebo, I received lots of angry responses from people who told me that they had the opposite experience or observed positive outcomes on their pets. In my subsequent publication in the journal ‘Homeopathy‘ entitled ‘The benefits of Arnica: 16 case reports‘, I have tried my best to explain their experiences in the light of our finding that highly diluted homeopathic Arnica is a placebo:

Sixteen case reports of the apparent benefits of Arnica … raise several relevant points. Firstly, topical Arnica preparations are often wrongly equated with homeopathic Arnica, the subject of our trial. The former are herbal preparations (ie not homeopathically diluted), which have undisputed pharmacological activity. Taken orally they would even be toxic. Thus all Arnica for oral administration must be highly diluted and has therefore no pharmacological effects. The case reports show that many lay people seem to be unclear about the difference between herbal and homeopathic Arnica.

Secondly, if animals seem to respond to homeopathic Arnica, as claimed in several of the case reports, this is not necessarily a proof of its effectiveness. Animals are not immune to placebo effects. Think of Pavlov’s experiments and the fact that conditioning is clearly an element in the placebo response.

Thirdly, the natural history of the condition can mimic clinical improvement caused by therapy. Many of the 16 cases summarized can be explained through a placebo response or the natural history of disease or the combination of both phenomena…

Many of the letters I received were outspoken to say the least. The authors stated that they were ‘appalled’, ‘saddened and angry’ by our research. Others implied that I was paid by the pharmaceutical industry to abolish homeopathy in the UK. One person felt that ‘it is highly irresponsible to dismiss a natural healing remedy with no evidence at all’. I believe the case reports … convey an important message about the power of belief, anecdotes, placebos and expectation.

END OF QUOTE

The thing about case reports and personal experiences is quite simply this: they may seem almost overwhelmingly convincing, but they can NEVER serve as a proof that the treatment in question was effective. The reason for this fact could not be more simple. Any therapeutic response is due to a complex combination of factors: placebo effects, natural history of the condition, regression to the mean, etc.

See it this way: you wake up one morning with an enormous hangover. You try to identify the cause of it. Was it the beer you had in the pub? The wine you drank before you went out? Or the whiskey you consumed before you went to bed? Perhaps you think it was the Cognac you enjoyed at a friend’s house? Only one thing is for sure: it was not the glass of shaken water you drank during the night.

 

Prof Ke’s Asante Academy (Ke claims that asante is French and means good health – wrong, of course, but that’s the least of his errors) offers many amazing things, and I do encourage you to have a look at his website. Prof Ke is clearly not plagued by false modesty; he informs us that “I am proud to say that we have gained a reputation as one of the leading Chinese Medicine clinics and teaching institutes in the UK and Europe. One CEO from a leading Acupuncture register commented that we were the best in the country. One doctor gave up his medical job in a European country to come study Chinese medicine at Middlesex University (our partner) – he said simply it was because of Asante. Our patients, from royalty and celebrities to hard working people all over the world, have praised us highly for successfully treating their wide-ranging conditions, including infertility, skin problems, pain and many others. We are also very pleased to have pioneered Acupuncture service in the NHS and for over a decade we have seen tens of thousands of NHS patients in hospitals.”

He provides treatments for any condition you can imagine, courses in various forms of TCM, a range of videos (they are particularly informative), as well as interesting explanations and treatment plans for dozens of conditions. From the latter, I have chosen just two diseases and quote some extracts to give you a vivid impression of the Ke’s genius:

CANCER

There are some ways in which Chinese medicine can help cancer cases where Western medicine cannot. Various herbal prescriptions have been shown to help in bolstering the immune system and some herbs can actually attack the abnormal cells and viruses which are responsible for certain types of cancer.

Chinese Medicine treatment aims first to increase the body’s own defence mechanisms, then to kill the cancer cells. Effective though radiotherapy and chemotherapy may be, they tend to have a drastic effect on the body generally and patients often feel very tired and weak, suffer from stress, anxiety, fear, insomnia and loss of appetite. Chinese Medicine practitioners regard strengthening the patient psychologically and physically to be of primary importance.

Chinese Medicine herbal remedies can help reduce or eliminate the side-effects from radiotherapy or chemotherapy. Astragalus will help raise the blood cell count, the sickness caused by chemotherapy can be relieved with fresh ginger and orange peel, and acupuncture can also help. To attack the cancer itself, depending on type and location, different herbs will be used.

A Chinese Medicine practitiioner will decide whether the illness is the result of qi energy deficiency, blood deficiency or yin or yang deficiencyGinseng,astragalusChinese angelicacooked rehmannia rootwolfberry rootChinese yam and many tonic herbs may be used. But it is vital to remember that no one tonic is good for everybody. All treatments are dependent upon the individual. Some anti-cancer herbs used are very strong and sometimes make people sick, but this is because one poison is being used against another. How they work, and how clinically effective they are, is still being researched. No claims can be made for them based on modern scientific evaluation.

Acupuncture and meditation are also very important parts of the Chinese Medicine traditional approach to the treatment of cancer. These alleviate pain and induce a sense of calmness, instill confidence and build up the spirit of the body, so that patients do not need to take so many painkillers. In China, they have many meditation programmes which are used to treat cancer.

MENINGITIS

Chinese Medicine herbal treatment for meningitis has been very successful in China. In the recent past there were many epidemics, particularly in the north, and the hospitals routinely used Chinese herbs as treatment, with a high degree of success. One famous remedy in Chinese Medicine is called White Tiger Decoction, the main ingredients of which are gypsum and rice. These are simple things but they reduce the high fever and clear the infection from the brain. Modern medicine and Chinese Medicine used together is the most effective treatment.

END OF QUOTES

Ghosh, I am so glad that finally someone explained these things to me, and so logically and simply too. I used to have doubts about the value of TCM for these conditions, but now I am convinced … so much so that I go on Medline to find the scientific work of Prof Ke. But what, what, what? That is not possible; such a famous professor and no publications?

I conclude that my search skills are inadequate and throw myself into studying the plethora of courses Ke offers for the benefit of mankind:

Since 2000, Asanté Academy has officially collaborated with Middlesex University in running and teaching the BSc and MSc in Traditional Chinese Medicine.

  • BSc Degrees in Acupuncture and Traditional Chinese Medicine
  • MSc Degree in Chinese Medicine
  • Professional Practice in Herbal Medicine, Chinese Herbal Medicine and Acupuncture

But perhaps this is a bit too arduous; maybe so-called diploma courses suit me better? Personally, I am tempted by the ‘24-day Certificate Course in TCM Acupuncture‘ – it’s a bargain, just £ 2,880!

PS

Prof Ke, if you read these lines, would you please tell us where and when you got your professorship? Your otherwise ostentatious website seems to fail to disclose this detail.

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