bogus claims
Pre-hypertension, or stage 1 hypertension as it is also called, is usually defined as a systolic pressure reading between 120 mmHg and 139 mmHg, or a diastolic reading between 80 mmHg and 89 mmHg. It remains a significant public health challenge and appropriate intervention is required to stop its progression to hypertension and cardiovascular diseases.
This double-blind, randomized, two parallel arms, placebo-controlled study tested the effects of individualized homeopathic medicines (IH) against placebo in intervening with the progression of pre-hypertension to hypertension.
Ninety-two patients with pre-hypertension were randomized to receive either IH (n = 46) or identical-looking placebo (n = 46). Both IH or placebo were applied in the mutual context of lifestyle modification (LSM) advice including dietary approaches to stop hypertension (DASH) and brisk exercises.
The primary endpoints were systolic and diastolic blood pressures (SBP and DBP); secondary endpoints were Measure Yourself Medical Outcome Profile version 2.0 (MYMOP-2) scores. All endpoints were measured at baseline, and every month, up to 3 months.
After 3 months of intervention, the number of patients having progression from pre-hypertension to hypertension between groups was similar without any significant differences in between the groups. Reduction in BP and MYMOP-2 scores were also not significantly different. Lycopodium clavatum, Thuja occidentalis and Natrum muriaticum were the most frequently prescribed medicines. No serious adverse events were reported from either group.
The authors concluded that there was a small, but non-significant direction of effect favoring homeopathy, which ultimately rendered the trial as inconclusive.
We have come across this terminology before; homeopaths seem to like it. It prevents them from calling a negative trial by its proper name: A NEGATIVE TRIAL. In their view
- a positive trial is a study where homeopathy yields better results than placebo,
- a negative trial is a study where placebo yields better results than homeopathy,
- an inconclusive trial is a study where homeopathy yields results that are not significantly different from placebo.
Is this silly?
Yes, it is completely bonkers!
Is it dishonest?
Yes, in my view, it is.
Why is it done nonetheless?
Perhaps a glance at the affiliations of the authors provides an answer:
- 1Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India. Electronic address: [email protected].
- 2Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
- 3Principal and Administrator D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
- 4Dept. of Practice of Medicine, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
- 5Dept. of Practice of Medicine, Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Howrah, Govt. of West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
- 6Dept. of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Block GE, Sector III, Salt Lake, Kolkata 700106, West Bengal, India; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
- 7Dept. of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, Govt. of Uttar Pradesh, affiliated to Dr. Bhimrao Ramji Ambedkar University, Agra, Govt. of Uttar Pradesh), India.
- 8Dept. of Repertory, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
Despite these multiple conflicts of interest, the article carries this note:
“Declaration of Competing Interest: None declared.”
During the last few days, we were entertained by one of the more fanatical specimen of the lunatic fringe. From the outset, ‘ASTRO’ was out to provoke, insult, and foremost state utter nonsense. Within just a few hours ‘ASTRO’ posted dozens of comments, one more hilarious than the next.
As always, I let it pass for a while because this sort of thing usually is very amusing and mildly instructive. Then, when my fun was over, I told him or her that my conversation with him or her was finished, thereafter I sent ‘ASTRO’ my usual hint to indicate that my patience was wearing thin (an overdose of nonsense, fun, and hilarity might be toxic) and now I have blocked ‘ASTRO’.
This little incident is a mere triviality, of course. Yet, it is also a most welcome reminder to demonstrate what is needed to get blocked by me. Here are a few selected ‘bon mots’ posted by ‘ASTRO’ which all contributed to his or her dismissal from this blog:
- Lenny is an intellectual terrorist
- you manipulate data
- you are nobody in the scientific world
- I’m very sorry for your lack of education
- I don’t hate you for lying, I pity you
- With all sincerity, and seeing that you don’t have a single scientific publication, I recommend that mounts a business for atheists resentful and sell cheap products with the face of Carl Sagan or James Randi in a coffe cup or pins, I assure you that the media will make of your business, earn some money and you’ll be able to publish a book trash like Ben Goldacre, with his “Bad science” or the Steven Novella. Poor quality is a typical sign of skeptical pseudoscientists.
- your “letter to the editor” is based on manipulating data and making false accusations, everything
- you only have an opinion based on your belief and denial that may well be a projection of your lack of knowledge
- I’m disappointed that you have very superficial knowledge, no wonder Mathie will ignore you
- Your comments again reflect that you haven’t the slightest idea
- your lack of reading comprehension is evident
- You are very ignorant
- your aggressiveness and lack of empathy tell a lot about your profile of atheist resentful of life
- these” verdicts ” that Ernst quotes in his pamphlets are at best a fraud
- in reality you, Grams and the team of the anti-homeopathy propaganda network have no idea what you’re talking about
- Ernst,” friend, ” you’re still pretty aggressive, maybe you need some joy in your life. Now I understand why the pseudoscientific skeptical atheist community is so childish and so toxic
- anyone who questions Edzar’s sacred dogmas is a troll
- Thank you for confirming that you are a sectarian
- your obsessive behavior borders on harassment
- Magazines like Skepter are very popular with immature gentlemen who believe they are the world or with teenagers who are just out of college who believe that science is done with whims
- don’t be like Lenny and try to grow up
- real science is in the objective pursuit and not in harassment campaigns orchestrated by a few clowns who believe James Randi is unquestionable
- every time I read your entries I feel sorry that your level of logic is so low and lousy
- Your naivety and superficial knowledge in philosophy of science (and that of most of those who follow you) is very pitiful
- you are the example of a pseudo-sceptic, a rude and cowardly skeptic who can’t tolerate criticism
- your friends are a sect, possibly a group based on coertion
- it doesn’t look like “Lenny” has a single scientific article published, not to mention your colleagues in the “About” section that the few who look like scientists are mediocre in their fields, the rest are small-time activists. No wonder, so much envy, so much anger, so much hatred, that’s what leaves fanatical atheism. They’re talibans of science, not scientists
- you with your age presume a lot and I only see you being interviewed by mainstream media that talk nonsense against homeopathy
- You had to control that aggressiveness, you feel more nervous and angry, maybe you’re a relative of the troll Lenny
- The obsessive behavior of Aust trying to refute Frass already looks like that of a stalker, similar of the journalist Christian Kreil who invented a whole string of nonsense in a German public media trying to link Frass to a questionable company, the media does not even mention Frass’s refutation to Kreil
One thing we cannot accuse ‘ASTRO’ of is that he or she was not industrious. You might ask why I did not stop his aggressive stupidity earlier after it had stopped being funny. Perhaps I should have – but, to be honest, these trolls do amuse me a great deal. More importantly, they might teach us important lessons:
- The fun one can have with fanatics is usually short-lasted.
- Some weirdos are very well misinformed, i.e. they read a lot and misunderstand even more.
- The minds of heavily deluded people are beyond productive discussions.
- Any hope to educate them will be disappointed.
- If we allow them to, they swiftly make themselves ridiculous.
- Their pseudo-arguments are strikingly similar.
- Their aggressiveness can be considerable.
And finally, the little ‘ASTRO’ interlude tells you something else:
It really does need a lot to get banned from my blog.
By guest blogger Ken McLeod
RICHARD MICHAEL NILSSON is the owner of Colloidal Minerals Australia Pty Ltd, ACN 003 484 955, of Wyongah New South Wales (NSW), Australia. On August 13 he was convicted in the Wyong Court, after pleading guilty to offences including intimidation with intent to cause fear of physical or mental harm.
Nilsson is a prolific antivaxxer, deluging unlucky politicians, journalists, health officials, etc with emails containing misinformation about vaccines and warning of the dire consequences to come to anyone involved in vaccination programs. He has been known to harass and threaten. Usually recipients have better things to do than engage with a crank, but he has been known to go too far.
As the Sydney Daily Telegraph reported on 14 August 2021: “Anti-vaccine activist Richard Nilsson pleads guilty to sending death threats.”
“A Central Coast anti-vaccine campaigner who sent death threats to The Sunday Telegraph journalist Jane Hansen has pleaded guilty to the charge of using intimidation to unlawfully influence a person.
“Richard Nilsson, 66, from Wyongah, sent an email to Ms Hansen’s work email address on the evening of February 27.
“The subject of the email was “WHEN IS A MURDER WARRANTED? YOURS, YES?”
The contents of the email read: ‘I am proposing that your murder might well be a celebration of not life but death! And what a celebrated and glorious one at that!
‘I know ten thousand that would do it, but of course it only needs one and you will never know until it is too late!
‘I expect you might meet your maker, maybe in the near future … the sooner the better, yes?’
“Ms Hansen has reported widely on vaccination since 2013 when The Sunday Telegraph launched the No Jab No Play campaign, and more recently has reported on the vaccine rollout for Covid-19.
“On February 27, the evening the email was sent, Sky News re-ran a documentary made by Ms Hansen called Big Shots, which looked at anti-vaccine activity in relation to the pandemic and the vaccine rollout.
“Mr Nilsson followed up his email with another with the subject line: “WHEN IS SLUT NOT A SLUT AND IS A SELECTIVE SLUT STILL A SLUT?” before launching into a barrage of abuse.
“Mr Nilsson, who runs a business selling colloidal silver, faced Wyong Court on August 11 and pleaded guilty to a charge of use intimidation/violence to unlawfully influence a person.
“He received an 18-month Community Corrections Order to be of good behaviour.
“Ms Hansen said threats to journalists who write on the subject of vaccination were not unusual but Mr Nilsson’s emails were unsettling in their violence.
‘All journalists get abused on occasion, especially on the currently highly emotive topic of vaccination, and mostly it is best ignored but this email was next level and no one should have to put up with such vile abuse,’ she said.
“Mr Nilsson is well known by politicians, who have also received numerous emails from him suggesting all manner of conspiracies, including that Covid vaccination is a mass depopulation exercise.”
Nilsson appeared before His Honour Ian Guy in case number 2021/00159728, R V Richard Michael Nilsson. He was convicted of stalking or intimidation with intent to cause fear of physical or mental harm, an offence under section 13 of the Crimes (Domestic and Personal Violence) Act 2007 (NSW). This attracts a maximum penalty of 5 years imprisonment and/or $5,500. He could also have been convicted of using a carriage service to menace, harass or cause offence, an offence under section 474.17 of the Criminal Code Act 1995 (Commonwealth of Australia). That carries a maximum penalty of 3 years imprisonment.
He was sentenced to a Community Corrections Order requiring him to be of good behaviour.
A rational person would have thought themselves lucky that they had avoided years of a high-fibre low-calorie diet of porridge and baked beans, but we are not dealing with a rational person here.
Hardly was the ink dry on the Court file, than on the 15th, two days after he was found guilty, Nilsson pounded his foam-flecked keyboard and sent another rant in an email to 130 people and organisations, including politicians, Skeptics groups, a Radiation Oncologist, government departments, doctors, political parties, people in the horse-racing industry, scientists, journalists, lobby groups including climate and conservation organisations, mental health groups, the National Security Hotline, and a coal mining company.
It reads: “Subject: FW: The Hidden Victims of the Covid Vaccine and why I included you all in this email…
“When will it be that enough lives have been ruined and enough have been murdered? And when will the maiming and the killing end?
“My hope is that some of you here own up and confess (I know who among you are in this group and I suspect in time you will all pay a heavy price for your crimes and transgressions), while others it is incumbent upon you to inform all those you purport to represent that the maiming and killing that has transpired and of course is inevitably and scheduled to transpire will continue until such time we say: f_ ck you!
“I know, and some of you know too, who the traitors are. Scott Morrison is just one and Greg Hunt is another and of course Jane Halton, Brendan Murphy and Paul Kelly are other worthless humans and are included and we know they are just tools – plasticised and fake as they are.
“I have an incomplete list of those who need to answer for their crimes and it does not include all I have included in this email.
“Add a Mr Skerrit. His evilness is seen in his face and in his utterings and communications and his connection with Jane Halton and the WHO and the so-called, Australian Health (sickness proliferation) Dep’t and Event 201 should not be lost on anyone with brain cells that still operate and are able to coordinate.
“Wake the f_ _k up!”
All emphases and redactions above are as in Nilsson’s email. Scott Morrison is the Prime Minister, Greg Hunt the Commonwealth Minister for Health, Brendan Murphy is a former Chief Medical Officer (CMO) of Australia and now Secretary of the Department of Health. Paul Kelly is the current Chief Medical Officer, the “Mr Skerrit” he refers to is Adjunct Professor John Skerritt, Deputy Secretary, Health Products Regulation Group, Therapeutics Goods Administration. “Jane Halton” is a former Secretary of the Commonwealth Dept of Health, now Council Member of the Australian Strategic Policy Institute.
The “Event 201” that Nilsson refers to was a tabletop exercise conducted in October 2019 by the Johns Hopkins Center for Health Security (CHS), the World Economic Forum and the Bill and Melinda Gates Foundation in New York City. According to the CHS, “®he exercise illustrated areas where public/private partnerships will be necessary during the response to a severe pandemic in order to diminish large-scale economic and societal consequences”.
Event 201 simulated the effects of a fictional coronavirus originating in bats but passing to humans via pigs. Claims that Event 201 was a rehearsal for the COVID-19 pandemic have been debunked by fact-checking outlets such as USA Today and FullFact, but facts have never matter to antivax conspiracy theorists and other assorted cranks. All emergency response authorities and health bureaucracies conduct exercises to identify threats and to develop and improve response plans. There was nothing unusual in “Event 201” except in the fevered imaginations of nutters and fruitloops.
Does Nilsson, with no qualifications whatsoever, really think that he knows more about emergency response and immunology than those distinguished experts, and all the scientists researching Covid19 and vaccines? How does 20 minutes reading email conspiracy theories trump PhDs, professorships and Nobel Prizes? How conceited does someone have to be to imagine that? Where is the boundary between conceit and dementia? So does accusing honourable people of ‘crimes and transgressions,’ ‘maiming and killing,’ being ‘traitors,’ are evil tools, ‘who need to answer for their crimes’ constitute the good behaviour that the Court imposed? And coming within hours of the Court hearing?
Watch this space.
In their 2019 systematic review of spinal manipulative therapy (SMT) for chronic back pain, Rubinstein et al included 7 studies comparing the effect of SMT with sham SMT.
They defined SMT as any hands-on treatment of the spine, including both mobilization and manipulation. Mobilizations use low-grade velocity, small or large amplitude passive movement techniques within the patient’s range of motion and control. Manipulation uses a high-velocity impulse or thrust applied to a synovial joint over a short amplitude near or at the end of the passive or physiological range of motion. Even though there is overlap, it seems fair to say that mobilization is the domain of osteopaths, while manipulation is that of chiropractors.
The researchers found:
- low-quality evidence suggesting that SMT does not result in a statistically better effect than sham SMT at one month,
- very low-quality evidence suggesting that SMT does not result in a statistically better effect than sham SMT at six and 12 months.
- low-quality evidence suggesting that, in terms of function, SMT results in a moderate to strong statistically significant and clinically better effect than sham SMT at one month. Exclusion of an extreme outlier accounted for a large percentage of the statistical heterogeneity for this outcome at this time interval (SMD −0.27, 95% confidence interval −0.52 to −0.02; participants=698; studies=7; I2=39%), resulting in a small, clinically better effect in favor of SMT.
- very low-quality evidence suggesting that, in terms of function, SMT does not result in a statistically significant better effect than sham SMT at six and 12 months.
This means that SMT has effects that are very similar to placebo (the uncertain effects on function could be interpreted as the result of residual de-blinding due to a lack of an optimal placebo or sham intervention). In turn, this means that the effects patients experience are largely or completely due to a placebo response and that SMT has no or only a negligibly small specific effect on back pain. Considering the facts that SMT is by no means risk-free and that less risky treatments exist, the inescapable conclusion is that SMT cannot be recommended as a treatment of chronic back pain.
Guest post by Norbert Aust and Viktor Weisshäupl
Imagine you recently published an excellent and rigorous trial providing solid evidence that a certain therapy is able to help patients suffering from some inevitably fatal condition. You proved that your therapy is able to significantly prolong the patients’ lifetime, much longer than with the current state-of-the-art therapeutic approach. But the patients not only live considerably longer, but they also do so with a much better quality of life (QoL) and subjective well-being. In short: this therapy marks some progress that would otherwise take years or decades of scientific effort.
And then someone comes forward and points out your data apparently were manipulated. Essential parameters of this trial were modified sometime after data collection was completed, with the patients’ outcome and first analyses available. Thus the results were biased in a certain direction and the critics show that the results as published in your study show characteristics that such manipulations would evoke. After all, this holds an implication of scientific misconduct that could, if verified, ruin your academic reputation more or less completely.
What would you do?
Ignore the preposterous concerns because you know your methods and performance were rigorous and solid? After all, anytime some real academic criticism arises you are ready to prove your findings are well-founded results of accepted scientific methods. Or would you publish data or documents that your critics were too ignorant to find or to understand, and thus to stop such rumours once and for all? Maybe you could even clarify some of the issues raised by those critics, maybe add some follow-up information or data to ensure no more misunderstandings occur. Or would you try to find some clues for a libel lawsuit?
Well, we thought some of the above would happen after we contacted the authors of the recent study on adjunct homeopathy in non-small cell lung cancer. On that date, we forwarded our detailed analysis to the lead author and all the co-authors.
Of course, we even considered the possibility, not very likely though, that we would receive some explanation for the numerous exclusion criteria while other serious conditions that coincide with advanced age did not preclude enrollment. Or an updated CONSORT diagram accounting for the patients excluded. Or some explanation just why the numerous amendments to the protocol were necessary but not important enough to mention them in the published paper.
But nothing of this happened as yet (July 2021). Instead on June 14 and 16, 2021, not two weeks after our messages to the authors, the registration data at ClinicalTrials were updated once again and a new version of the protocol was uploaded [3]. And this update looks pretty much like it is meant to cover up and blur the former data that we based our analysis on. Of course, these data and the former version of the protocol are available still – just one layer further down, and you have to scroll to the bottom of the page to find the small link “history of changes”. Maybe not many visitors will do that.
In contrast to the versions before, now the uploaded data are in line with the study as published, namely, they include a full list of the exclusion criteria and the reduced observation time for QoL, which was the primary outcome. Note: throughout the trial until the end of data assessment those parameters were set with pregnancy as the only exclusion criterion and two years follow up time, only to be amended in the protocol uploaded two months after data collection was complete and analysis presumably was well underway.
In addition, there is a new version of the study protocol, this one dated Feb. 6, 2014. Of course, this protocol is fairly new, in spite of the date it carries. Why would the older version allegedly from January 2011 be uploaded to the register in September 2019, if this more actual version already had existed and was available?
Contrary to the prior version all the clues are removed that would indicate that this document was finished at a much later point in time than given in its date: References to some future software versions that were released years after the protocol was allegedly compiled are dropped. And this strange literature reference “25” that corresponds to the reference list in the final study as published but is pointless in the protocol without any reference list, is removed too. And of course, again contrary to the prior version, the exclusion criteria are identical with the final study as is the shortened follow-up time for QoL.
New to the protocol is a section “Bringing in the patient’s voice”, where the authors disclose how they want to “systematically research the ethical, legal, socio-political, and science theoretical dimensions of homeopathy as in the case of lung cancer (non-small-cell lung carcinoma) exemplified” in some “integral social scientific study”, where some “focus groups” of 4 to 10 participants together with their relatives, friends and caregivers included should be used to study “interactions between individuals, collectively shared and uncontested assumptions, and the emergence of collective meaning”.
But from all of this more or less meaningless but very sciency sounding socio-speak, not a single word found its way into the study. Nothing. So it is pointless to try to figure out what the content of this part of the investigation is all about.
Why then was this chapter added? This “integral social scientific study” was to start after the “third or fourth homeopathic treatment” (But why should patients not be included in this “research” from the very first beginning?). Is it perhaps to give some rationale why the follow-up time for QoL was to end after the third homeopathic treatment?
So what we see, when we look up the study at ClinicalTrials now, is a perfectly matching set of data and a protocol that corresponds to the study as published and looks as if it was published at a time where the trial was underway and the patients were still blinded. If you do not look very closely everything now appears to be perfect.
And here we would like to forward some critique to the register: The purpose of the study register is to prevent not only publication bias but misleading manipulation from happening as well. They do quite a good job in preserving former versions of data and documents and keeping them available to the public. Many national study registers do not offer this service. But you must be of a suspicious mind and of some persistence to actively search and find and check the history of modifications. Thus, a cover-up like the one we are witnessing here might well prove successful. We, therefore, propose to improve the presentation of the registration: If vital amendments occurred that may affect the outcomes – such as protocol changes, extensions of exclusion criteria, modifications of follow-up time – this should be indicated upfront in the study’s record instead of some small hint to “history of changes” at the very bottom of the page.
In conclusion, there appears to be no proof that the results of the study were produced using rigorous scientific methods. And the issues we raised in our report to the authors remain unresolved.
Weleda, the firm founded by Rudolf Steiner and Ita Wegman originally for producing and selling their anthroposophic remedies, celebrates its 100th anniversary. It is a truly auspicious occasion for which I feel compelled to offer a birthday present.
I hope they like it!
On the Weleda UK website, we find an article entitled ‘ An introduction to Homeopathy‘ which contains the following statements:
- Homeopathy works by stimulating the body’s own natural healing capacity. The remedy triggers the body’s own healing forces and so a remedy is prescribed on a very individual basis.
- If you do experience complex, persistent or worrying symptoms then please seek the advice of a doctor who specialises in homeopathy.
- Today there are four homeopathic hospitals offering treatment under the National Health Service – in London, Glasgow, Liverpool and Bristol.
- It’s still the only alternative medicine incorporated into the NHS.
- Homeopathy can be used to treat the same wide range of illness as conventional medicine, and may even prove successful when all other forms of treatment have failed.
- Over-the-counter homeopathic medicines are made using natural plant, mineral and, occasionally, animal substances
- … active elements are in infinitesimally small quantities.
As I understand a bit about the subject – not as much as my friend Dana Ullman, of course, but evidently more than the Weleda team – I thought I might offer them, as a birthday present, a free correction of these 7 passages. Here we go:
- Homeopathy is claimed to work by stimulating the body’s own natural healing capacity. In fact, it does not work. Yet, believers argue that the remedy triggers the body’s own healing forces and so a remedy is prescribed on a very individual basis.
- If you do experience complex, persistent or worrying symptoms then please seek the advice of a doctor who specializes in something other than homeopathy.
- Today there are no homeopathic hospitals offering treatment under the National Health Service – the ones in London, Glasgow, Liverpool, and Bristol all closed or changed their names.
- It’s no longer incorporated into the NHS.
- Homeopathy cannot be used to treat the same wide range of illnesses as conventional medicine and is not successful when all other forms of treatment have failed.
- Over-the-counter homeopathic medicines are made using any imaginable substance and even non-material stuff like vacuum or X-rays.
- … active elements are absent.
HAPPY BIRTHDAY, WELEDA!
So-called alternative medicine (SCAM) for cancer is the title of my new book. I was informed that it has been published but, in reality, the hard copy might still take a few days until it is available (there were major problems at the proof-reading stage which caused a considerable delay). To give you a flavor of the book, allow me to show you my introduction; here it is:
In February 2013, my wife and I were in good spirits. I had recently retired from my post at Exeter University, and we were heading off to celebrate Danielle’s round birthday with her family in Brittany. There was just one thing that bothered us: Danielle had recurring abdominal pains. She had seen our GP in England several times about it. The last time, she had received a prescription for some antibiotics. I knew they would not help; her symptoms were not due to an infection.
After our arrival in France, things got worse, and Danielle consulted a gynaecologist at the out-patient clinic of the local hospital. More tests were ordered; an ultrasound showed an abnormality; a subsequent MRI revealed a tumour of the uterus. The gynaecologist advised to operate as soon as possible, and Danielle agreed.
The operation went well, but the gynaecologist, Dr Matthieu Jacquot, was concerned and said he had to be more radical than he had anticipated. The diagnosis was still uncertain until the results from the histology lab were in. A few days later, when we saw Dr Jacquot again, our hopes that all was fine were thoroughly dashed. He explained that Danielle had cancer of the endometrium and laid out the treatment plan which an entire team of oncologists had designed after an in-depth review of her case: a second, much more extensive operation, followed by six sessions of chemotherapy, followed by months of daily radiotherapy, followed by two sessions of brachytherapy.
Dr Jacquot could not have been more empathetic. He explained in detail what consequences all this would have. Danielle’s life would be dominated for the next year by a long series of treatments that were unpleasant to say the least. We were both shocked and close to tears.
Before arriving at a decision, we talked to friends and experts in this area. Opinions differed marginally. Two days later, we had made up her mind: we would stay in Brittany for the entire year and get Danielle treated exactly as Dr Jacquot suggested.
The second operation was much tougher than the first, but Danielle recovered well. Ten days later, she was back in our home and looked after by a nurse who came daily to change the bandages and give injections. On her third visit, the nurse broached the subject of chemotherapy which was scheduled to start soon. She explained how unpleasant it would be and what horrendous side effects Danielle was facing. Then she said: ‘You know, you don’t need to go through all this. They only pump you full with poison. There is a much better approach. Just follow the anti-cancer diet of Dr Schwartz.[1] It is natural and has no side effects. It would surely cure your cancer.’ When Danielle told me about this conversation, I informed the nurse that from now on I would myself take charge of the post-operative care of my wife and that her services were no longer required.
Today, Danielle is cancer-free. Had she listened to the nurse, she would almost certainly no longer be with us. But the lure of a ‘natural’ cancer cure with no side effects is almost irresistible. Faced with a serious diagnosis like cancer, most patients would consider any therapy that promises help without harm. Inevitably, they encounter a myriad of so-called alternative medicines (SCAMs), and many patients give SCAM a try.
In addition to Dr Schwartz’s cancer diet, there are hundreds of SCAMs that specifically target vulnerable cancer patients like Danielle. How can patients not be confused, and who might give them responsible advice? Conventional doctors rarely do. A recent summary of 29 relevant papers concluded that physicians will discuss complementary therapies only when a patient him/herself raises this issue within a consultation.[2] But cancer patients are often too embarrassed to ask about SCAM. Those who are courageous enough usually get short shrift. Many conventional doctors are not just critical about SCAM, but also know very little about the subject.[3]
Patients deserve evidence-based information, instead they often get unhelpful blanket statements from their GPs such as:
- ‘there is no evidence’;
- ‘that’s all rubbish, best to stay well clear of it’;
- ‘if you want to try it, go ahead, it cannot do much harm’.
All of these are untrue. Frustrated by such erroneous platitudes, patients might go on the Internet for help where they are bombarded with uncritical promotion. We investigated the information on SCAM for cancer provided by popular websites and found that they offer information of extremely variable quality. Many endorse unproven therapies and some are outright dangerous.[4] Sadly, the advice patients might glean from newspapers[5] or health-food stores[6] tends to be equally misleading and potentially harmful.
Subsequently, some patients might visit a library and read one of the many books on the subject. If anything, they are even worse. We have repeatedly analysed the contents of consumer guides on SCAM and always concluded that following their recommendations would shorten the life of the reader.[7] To give you a flavour, here are a few titles currently on sale:
- Cancer Medicine from Nature
- Outsmart Your Cancer: Alternative Non-Toxic Treatments That Work
- Cancer Medicine from Nature
- Perfect Guide on How to Cure Breast Cancer Through Curative Approved Alkaline Diets & Herbs
- How to Starve Cancer
- Healing the Prostate: The Best Holistic Methods to Treat the Prostate and Other Common Male-Related Conditions
- Outsmart Cancer: Defeat Cancer With Vitamin B17, Healthy Nutrition and Alternative Medicine
Cancer patients would, of course, all like to ‘outsmart cancer’; they are desperate and vulnerable. In this state of mind, they easily fall victim to anyone who sells false hope at inflated prices. The consequences can be tragic.
In 2016, the actress English Leah Bracknell, for example, raised ~£50 000 to treat her lung cancer in the German ‘Hallwang Private Oncology Clinic’. The SCAMs used there included homeopathy, micronutrients, natural supplements, whole-body hyperthermia, and ozone therapy, none of which cures cancer. If cancer patients fall for bogus treatments, they not just lose their money but also their lives. Leah Bracknell died of her cancer in 2019.[8]
Three basic facts are indisputably clear:
- a high percentage of cancer patients use SCAM,
- misinformation about SCAM is rife,
- misinformation endangers the lives of cancer patients.
It follows that there is an obvious and urgent need for an evidence-based text naming the SCAMs that are potentially harmful and discussing those that might be helpful.
My book is aimed at doing just that.
[1] Dr Laurent Schwartz cancérologue iconoclaste — Guérir du Cancer (guerir-du-cancer.fr)
[2] Stub T, Quandt SA, Arcury TA, et al. Perception of risk and communication among conventional and complementary health care providers involving cancer patients’ use of complementary therapies: a literature review. BMC Complement Altern Med. 2016;16(1):353. Published 2016 Sep 8. doi:10.1186/s12906-016-1326-3
[3] Ziodeen KA, Misra SM. Complementary and integrative medicine attitudes and perceived knowledge in a large pediatric residency program. Complement Ther Med. 2018;37:133-135. doi:10.1016/j.ctim.2018.02.004
[4] Schmidt K, Ernst E. Assessing websites on complementary and alternative medicine for cancer. Ann Oncol. 2004;15(5):733-742. doi:10.1093/annonc/mdh174
[5] Milazzo S, Ernst E. Newspaper coverage of complementary and alternative therapies for cancer–UK 2002-2004. Support Care Cancer. 2006;14(9):885-889. doi:10.1007/s00520-006-0068-z
[6] Mills E, Ernst E, Singh R, Ross C, Wilson K. Health food store recommendations: implications for breast cancer patients. Breast Cancer Res. 2003;5(6):R170-R174. doi:10.1186/bcr636
[7] https://edzardernst.com/2013/09/drowning-in-a-sea-of-misinformation-part-8-books-on-alternative-medicine/
[8] https://edzardernst.com/2019/10/leah-blacknell-1964-2019-another-victim-of-cancer-quackery/
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The publication of this book is perhaps the right occasion to publicly thank two regular and one occasional contributor to this blog. I am grateful to
- Prof. Michael Baum, emeritus professor, for writing the foreword,
- Dr. Julian Money-Kyrle, retired consultant oncologist, for his constructive comments on chapter 1.4,
- Richard Rasker for his corrections and advice on the entire text.
Thank you all.
It has been reported that an Australian naturopath would refuse entry to her business to anyone who has received a COVID-19 vaccine in the past two weeks. In her original Facebook post, Ms. Holland said that vaccinated people would have to wait a minimum of two weeks after vaccination before attending her clinic due to “the shedding of spike proteins” caused by “these experimental treatments”.
Christine Pope, who is on the Australian Traditional Medicine Society (ATMS) board of directors, said she believed the views shared by the Warrnambool naturopath were part of the alternative medicine sector’s “fringe” and didn’t represent the industry. “We’re always very careful to tell our practitioners about posting appropriately and within their scope of practice,” Ms. Pope said. “These sort of comments to me look like they’re outside their scope of practice. We do a lot of training about making sure that you’re posting appropriately within your scope of practice and about things about which you are qualified in. As an association supporting natural medicine practitioners, it’s not really our job to promote or comment on the vaccination program – we’re not public health experts … and this is really outside my scope of practice. But from a public health perspective (vaccination) is the best option we’ve got.”
Sharon Holland, who runs a clinic in Warrnambool, cited on Facebook a number of discredited medical professionals who have become figureheads of the anti-vax and COVID conspiracy movements, including Judy Mikovits, Robert Malone, Peter McCullogh, and J Bart Classen. “Often de-bunked and fact-checked (by whom) can mean silenced,” Ms. Holland wrote. “We still have free speech available to some extent. This is a very emotive and divisive subject so my post was bound to ‘ruffle feathers’.”
The ATMS says its accredited practitioners need to “stay within their scope of practice” and avoid posting about vaccines they haven’t studied. Ms. Pope urged people to lodge a complaint about bogus health claims through the ATMS website or the healthcare complaint commissioner in the appropriate state.
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This course of events begs several questions. In my view, the most important are:
- Is Sharon Holland an exception, or are many/most naturopaths of her opinion?
- Instructing practitioners about “posting appropriately and within their scope of practice” sounds fine but might miss the point entirely. What really matters are the messages ATMS members orally convey to their patients. Is there any evidence on this issue?
- Surely, the anti-vax sentiments of naturopaths must originate from their education. Is there any evidence as to what they are taught about the subject?
- Is the ATMS going to take action against Ms. Holland and other members who endanger the public with their anti-vax stance?
I was alerted the these Chiropractic Paediatric Courses. After studying the material, I was truly stunned. Now that I have recovered, I feel I should share it with you:
Chiropaeds Australia is an approved and accredited provider of the Diplomate of Australian College of Chiropractic Paediatrics program.
Diplomate of Australian College of Chiropractic Paediatrics Offered for the first time in 2013, the Diplomate program is a two-year chiropractic paediatric course. This course is ideal for the family chiropractor wanting to improve his or her knowledge in chiropractic paediatrics. The emphasis is on conditions and management issues which are commonly seen by the family chiropractor.
The course is structured around 20 four-week modules over two years. Each module consists of required reading, exercises and at the end of each four-week module there is a six-hour seminar. Each six-hour seminar will reinforce the reading and develop the practical and management skills needed to feel confident in providing optimal chiropractic care for children…
Registration post 31 December – $AUD 6050 (includes GST) This covers the cost of all materials and seminars but does not include any books or texts you may decide to purchase.
To provide you with an impression of the content of the modules, I have chosen three of them. Here they are:
Module 7
Neurological assessment of the infant
1. Neurological examination of the infant (Infanib)
2. Motor issues: diagnosis and chiropractic management
a. Gross motor developmental delay
b. Hyper/ hypotonia
c. Cerebral palsy
It is only by knowing how to assess the infant’s neurological system that you can start to fully appreciate and understand the immense impact of the subluxation. The information covered in this module allows you to demonstrate to your parents the impact the subluxation has on their infant’s nervous system. As a result your subluxation diagnosis, treatment and management with infants will be enhanced. We look at muscle function issues which occur in this age group with particular emphasis on gross motor developmental delay and hyper/hypotonia.
Module 8
Neurological assessment of the pre-schooler and the school aged child
1. Gross motor function
2. Fine motor function
3. Cerebellar function
4. Assessment of higher cognitive functions
5. Visual processing
6. Auditory processing
7. Language development
Syndrome management
1. Auditory processing syndromes
2. Visual processing syndromes
Chiropractic has a major role to play in treating and managing children with learning difficulties. Crucial to optimal outcomes is an ability to fully assess and determine the particular issues and neurological problems your patient experiences. This module is very practical: you will learn how to accurately test cortical and cerebellar function in preschool and school aged children to a very advanced level. Being able to perform extensive testing of learning ability in children will assist you to accurately find and monitor their learning difficulties. The interplay of higher cortical function, cerebellar function and the subluxation is explored and the impact of your consultation assessment routine on the subluxation is addressed. Management of learning difficulties is emphasised.
Module 11
The child’s ear, nose and throat
1. Acute otitis media
2. Chronic otitis media
3. Serous otitis media
4. Nose and throat issues with children
5. Tonsillitis, epiglottitis, coup and neck abscesses
Chiropractors have a key role to play in the treatment and management of otitis media along with other conditions associated with recurrent viral infection as well as decreased or imbalanced immune system function. We cover the diagnosis of each condition along with chiropractic treatment and management, including the interaction of the subluxation and the immune system. Nutritional management is also covered. Key management issues are explored and literature based knowledge is provided to allow you to educate you patient’s parents. This fosters improved compliance with your care and permits you to expand the boundaries of your chiropractic care of children.
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I wonder whether some chiropractor feels like defending this outright charlatanry.
I know of no evidence to assume that chiropractors can provide effective care for children. I see, however, many reasons to fear that they may cause considerable harm. I also see no reason to take a profession seriously that tolerates or even supports such extreme quackery.
I have expressed these concerns often enough, e.g.:
- The effectiveness of chiropractic spinal manipulations/mobilisation for children is unproven. TIME TO STOP TREATING KIDS!
- Chiropractic for kids: a ‘complete disregard for the evidence and scientific facts’
- Chiropractic for kids: a pack of offensive lies
- Chiropractic spinal care for children is dangerous, unwarranted and must cease immediately
- Don’t let a chiropractor near your kids!
- Chiro for kids? No!
In my view, it is high time to stop this dangerous nonsense.
Subluxation is … a displacement of two or more bones whose articular surfaces have lost, wholly or in part, their natural connection. (D. D. Palmer, 1910)
The definition of ‘subluxation’ as used by chiropractors differs from that in conventional medicine where it describes a partial dislocation of the bony surfaces of a joint readily visible via an X-ray. Crucially, a subluxation, as understood in conventional medicine, is not the cause of disease. Spinal subluxations, according to medical terminology, are possible only if anatomical structures are seriously disrupted.
Subluxation, as chiropractors understand the term, has been central to chiropractic from its very beginning. Despite its central role in chiropractic, its definition is far from clear and has changed significantly over time.
DD Palmer (the guy who invented chiropractic) was extremely vague about most of his ideas. Yet, he remained steadfast about his claims that 95% of all diseases were due to subluxations of the spine, that subluxations hindered the flow of the ‘innate intelligence’ which controlled the vital functions of the body. Innate intelligence or ‘inate’, he believed, operated through the nerves, and subluxated vertebra caused pinched nerves, which in turn blocked the flow of the innate and thus led to abnormal function of our organs. For Palmer and his followers, subluxation is the sole or at least the main cause of all diseases (or dis-eases, as Palmer preferred).
Almost exactly 4 years ago, I published this post:
Is chiropractic subluxation a notion of the past? SADLY NOT!
In it, I provided evidence that – contrary to what we are often told – chiropractors remain fond of the subluxation nonsense they leant in school. This can be shown by the frequency by which chiropractors advertise on Twitter the concept of chiropractic subluxation.
Today, I had another look. The question I asked myself was: has the promotion of the obsolete subluxation concept by chiropractors subsided?
The findings did not surprise me.
Even a quick glance reveals that there is still a plethora of advertising going on that uses the subluxation myth. Many chiros use imaginative artwork to get their misleading message across. Below is a small selection.
Yes, I know, this little display is not very scientific. In fact, it is a mere impression and does not intend to be anything else. So, let’s look at some more scientific data on this subject. Here are the last 2 paragraphs from the chapter on subluxation in my recent book on chiropractic:
A 2018 survey determined how many chiropractic institutions worldwide still use the term in their curricula.[1] Forty-six chiropractic programmes (18 from US and 28 non-US) participated. The term subluxation was found in all but two US course catalogues. Remarkably, between 2011 and 2017, the use of subluxation in US courses even increased. Similarly, a survey of 7455 US students of chiropractic showed that 61% of them agreed or strongly agreed that the emphasis of chiropractic intervention is to eliminate vertebral subluxations/vertebral subluxation complexes.[2]
Even though chiropractic subluxation is at the heart of chiropractic, its definition remains nebulous and its very existence seems doubtful. But doubt is not what chiropractors want. Without subluxation, spinal manipulation seems questionable – and this will be the theme of the next chapter.
[1] https://chiromt.biomedcentral.com/articles/10.1186/s12998-018-0191-1
[2] https://www.ncbi.nlm.nih.gov/pubmed/25646145
In a nutshell: chiros cannot give up the concept of subluxation because, if they did, they would be physios except with a much narrower focus.
