Amidst the current controversy of chiropractic spinal manipulation for new-born babies, the previous director of Chiropractor’s Association of Australia NSW, Alex Fielding, published an interesting article. In it, he declared:
- I do not condone the chiropractic treatment of children for non-musculoskeletal conditions it is simply not our place. There is little to no evidence for it and it should not be done. If a chiro is report them to AHPRA.
- There is no evidence for “subluxation” it simply has not been shown to exist by any credible source.
- Chiropractic does not equal spinal manipulative therapy (SMT) or adjustment. We are trained to assess and treat musculoskeletal conditions, use exercise rehab, various forms of manual therapy including SMT, give sound evidence based advice and refer to better suited health professionals in the appropriate circumstance. To say there is no evidence for chiropractic is an ill informed politically charged statement, if you mean SMT, say SMT.
Here I only want to comment on his last point. I think it is important, not least because we hear it ad nauseam. As soon as there emerges new evidence to show that SMT does little for back or neck pain or is ineffective for non-spinal conditions, chiropractors insist that they do so much more than just SMT, and therefore any such findings do not ever lend themselves to a verdict about chiropractic care.
In my view, this argument is a bit like ‘wanting the cake and eat it’ (chiros want to be different from physios by adhering to SMT, but they don’t want to be judged by the uselessness of SMT). It begs the following questions:
- What other modalities do chiros use?
- For which conditions do they use them?
- What is the evidence for or against them?
- In what percentage of patients do chiros use SMT?
The last question may be the most important one. I am not aware of data from ‘down under’ but, in the UK, the percentage is close to 100%. This is why I often call SMT the ‘hallmark therapy of chiropractors’. No other profession employ it more frequently. It is the treatment that defines the chiropractic profession.
If the evidence for SMT is flimsy or negative or non-existent, it seems not unreasonable to voice doubts about the profession that uses it most. The fact that chiropractors also administer other modalities – most of which, by the way, have a shaky evidence-base too – is simply a smoke-screen used to mislead us.
An example might make this a bit clearer. Imagine a surgeon who takes out the tonsils of every patient he sees, regardless of any tonsillitis or other tonsil-related condition (historically, this fad once existed; tonsillectomy was even used to treat depression). This surgeon also does all sorts of other things: he prescribes pain-killers, gives antibiotics, orders bed-rest, gives life-style advice etc. etc. Yet he is a charlatan because his hallmark intervention is not effective and even puts patients at unnecessary risks.
I know, the analogy is not perfect, but it makes the point: chiropractors refuse to be judged by the uselessness of SMT. Yet it is what defines them and they continue using SMT pretty much regardless of the evidence. Fielding pleads: To say there is no evidence for chiropractic is an ill informed politically charged statement, if you mean SMT, say SMT. I’d say there is no good evidence for SMT nor for chiropractic care that includes SMT.
My advice for chiropractors therefore is: abandon SMT and become physiotherapists. This will make you a bit better grounded in evidence, but at least you would have rid yourself of the Palmer-cult with all the BS that comes with it.
The current issues of ‘homeopathy 4 everyone’ (April 2016) carries several articles on homeoprophylaxis, the use of homeopathic remedies for the prevention of mostly infectious diseases promoted by homeopathy as a safe and effective alternative to immunizations. They are worth reading – but watch your blood pressure! Here I will give you a flavour by citing from one of these articles:
“…As I have been teaching about Homeoprophylaxis (“HP”) throughout the United States and in Europe, some things have become unmistakably clear. One is the ever increasing desire of people to know that there is a nontoxic alternative when it comes to disease prevention. Another is a profound misunderstanding or, perhaps better said, a lack of education among many regarding HP…
The effectiveness of HP is being shown fairly consistently to be about 90%1, which is comparable to any vaccine. With this in mind, too, those who utilize homeoprophylaxis work to help their clients understand fundamentally that disease is generally not to be feared—that disease-causing pathogens are a necessary part of our environment and that the body generally becomes healthier once it has been exposed to a disease and has worked its way through it…
My passion regarding spreading the word and helping people learn about homeoprophylaxis led to my becoming the co-founder/director of the first international conference of its type in the world—Homeoprophylaxis: A Worldwide Choice, which took place in Dallas, Texas, USA in October, 2015. Isaac Golden was our keynote speaker…
Frequently seen is the protocol Isaac Golden utilizes. This is a once monthly method, where one single remedy/nosode is introduced at potency. If following, for example, a pediatric regimen that lists several nosodes, it will be the next month that either a larger dose of that same nosode is taken, or the next nosode is introduced. For pediatric HP, this is cycled through until all nosodes in the protocol are taken, the higher potency being started after the lower potency is completed. A booklet is provided to the clientele to keep track of these…
Ultimately, homeoprophylaxis has been in use since the days of Hahnemann. What is apparent when one considers the entire picture, noting the meticulous studies that have been and are yet being done as well as the current increasing demand of people worldwide— perhaps especially parents— for a nontoxic alternative for disease prevention, it truly makes sense to be promoting homeoprophylaxis. Our children are the most vulnerable in our society and deserve our utmost attention and concern. Not every practitioner needs to utilize HP. However, because there are many who do, support of this should be encouraged. It is an alternative people deserve to know about so that they can make an educated choice, and health for our society, especially our children, can be promoted.”
END OF QUOTE
By now, you are probably wondering who wrote this article. It was Cathy Lemmon, BA, C.HP, D.Psc, Co-Founder/Director of Homeoprophylaxis: A Worldwide Choice for Disease Prevention, she is also working on future conferences for the promotion of HP. She has studied HP with Isaac Golden of Australia and Ravi Roy and Carola Lage-Roy of Germany. She also has certificates in homeopathic treatment of vaccine injury as well as, through the ARHF in the Netherlands, treatment of epidemics and trauma. She completed studies at the School of Homeopathy and is completing specialized homeopathic studies through Gesundes Bewußtsein in Germany as well as post-graduate work in homeopathy through the College of Practical Homeopathy in London.
With all these ‘qualifications’, she has obviously escaped any education in real science and evidence-based medicine; if not she would know that her views are not just wrong but also dangerous. To Be clear:
- Homeoprophylaxis is not biologically plausible.
- There is no evidence that it works.
- The concept misleads people to think that conventional immunizations are superfluous.
- This has the potential to kill thousands.
The madness of some homeopaths who claim they can cure cancer has irritated me and others repeatedly, for instance here and here. Many apologists of homeopathy say that responsible homeopaths would never make such a claim. They may be right – but the sad reality is than there are far too many irresponsible homeopaths.
This article by Dr Pankaj Aggarwal, a ‘senior homeopathic physician’, marks in my view a new record in homeopathic ineptitude and irresponsibility. Here is an excerpt (it seems that the actual article has disappeared; luckily I saved it before):
“In homeopathy, non-toxic medicines are used to treat this cancer. There are no side-effects associated with homeo medicines for cervical cancer. If this problem is diagnosed at earlier stages, it becomes easier to treat and takes very less time. In advanced stages, more time is required to improve the situation. It is actually possible to treat cancer with homeopathic medicines. In fact, homeopathy is the only treatment method that can completely cure this disease. There are different approaches to treat this disease in homeopathy. Good homeo practitioners usually use a combination of these approaches while treating a cancer patient.
Treatment Approach 1
The first philosophy to treat cancer is to directly target the cancer tumors. In this way, the practitioner selects the proper medicines that match the symptom picture of tumors. An example of such medicine is Conium Maculatum, which can be used to treat immovable, hard and slowly developing tumors. In this approach, other symptoms of patient are also taken into consideration and are treated. This approach targets tumors and reverses their growth to the point where they no more exist or become harmless.
Treatment Approach 2
The second or indirect approach is to strengthen the cell detoxification process and eliminative channels of patients like liver, lymphatic system, urinary tract and kidneys. From this approach, the homeopathy practitioner uses low potency drainage remedies that detoxify particular substances like heavy metals or target particular body systems. The particular medicines used for this drainage is selected after thorough analysis of the particular cancer case.
Treatment Approach 3
In this approach, a complete interview of the patient’s emotional, physical, and mental symptoms is conducted. After that, best matching remedies are selected to address the complete constitution of the patient. Most of the times these homeopathy medicines will affect and target the cancer tumors directly. This treatment, if done properly, can result in complete removal of cancer tumors, resulting in full recovery.”
END OF QUOTE
The facts about homeopathy are very clear and tell a totally different story:
- the assumptions that underpin homeopathy are implausible,
- homeopathic remedies usually are far too dilute to have any effects whatsoever,
- there is no evidence to support any of the above claims,
- believing such claims will almost inevitably cause great harm to patients.
What follows is simple: HOMEOPATHS WHO MAKE THERAPEUTIC CLAIMS BEHAVE UNETHICALLY, ARGUABLY EVEN CRIMINALLY
For many years, I have been impressed with the high quality and originality of chiropractic research. Here is the abstract of a particularly remarkable, new investigation.
The purpose of this study was to compare characteristics, likelihood to use, and actual use of chiropractic care for US survey respondents with positive and negative perceptions of doctors of chiropractic (DCs) and chiropractic care.
From a 2015 nationally representative survey of 5422 adults (response rate, 29%), we used respondents’ answers to identify those with positive and negative perceptions of DCs or chiropractic care. We used the χ2 test to compare other survey responses for these groups.
Positive perceptions of DCs were more common than those for chiropractic care, whereas negative perceptions of chiropractic care were more common than those for DCs. Respondents with negative perceptions of DCs or chiropractic care were less likely to know whether chiropractic care was covered by their insurance, more likely to want to see a medical doctor first if they were experiencing neck or back pain, less likely to indicate that they would see a DC for neck or back pain, and less likely to have ever seen a DC as a patient, particularly in the recent past. Positive perceptions of chiropractic care and negative perceptions of DCs appear to have greater influence on DC utilization rates than their converses.
We found that US adults generally perceive DCs in a positive manner but that a relatively high proportion has negative perceptions of chiropractic care, particularly the costs and number of visits required by such care. Characteristics of respondents with positive and negative perceptions were similar, but those with positive perceptions were more likely to plan to use-and to have already received-chiropractic care.
END OF ABSTRACT
- 1Chair, Clinical and Health Services Research Program, Palmer Center for Chiropractic Research, Davenport, IA; Professor, The Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH. Electronic address: firstname.lastname@example.org.
- 2Vice Chancellor, Research and Health Policy, Palmer College of Chiropractic, Palmer Center for Chiropractic Research, Davenport, IA.
- 3President, Palmer College of Chiropractic West Campus, San Jose, CA.
- 4Chancellor, Palmer College of Chiropractic, Davenport, Iowa.
Not just inexperienced novices then! The authors belong to the crème de la crème of the chiropractic establishment and research!!!
In comparison, I feel like a mere beginner. But let me nevertheless try to design my own study along similar lines. It is so brilliant that I might even get the Nobel Prize for it. Here we go:
The purpose of my study would be to compare characteristics, likelihood to use, and actual use of spectacles for survey respondents with positive and negative perceptions of spectacles and opticians***. From a nationally representative survey of about 5000 adults, I would use the respondents’ answers to identify those with positive and negative perceptions of spectacles and opticians. My results would show that positive perceptions of opticians are more common than those for spectacles, whereas negative perceptions of spectacles are more common than those for opticians. Respondents with negative perceptions of opticians or spectacles were less likely to know whether spectacles were covered by their insurance, more likely to want to see a medical doctor first, if they were experiencing poor eye-sight, less likely to indicate that they would see an optician for poor eye-sight, and less likely to have ever seen an optician as a patient, particularly in the recent past. Positive perceptions of spectacles and negative perceptions of opticians appear to have greater influence on optician utilization rates than their converses. From these data, I would conclude that my sample generally perceive opticians in a positive manner but that a relatively high proportion has negative perceptions of spectacles, particularly the costs and number of visits required for getting them. Characteristics of respondents with positive and negative perceptions were similar, but those with positive perceptions were more likely to plan to use – and to have already received – care from opticians.
*** instead of opticians and spectacles, I might also opt for other things like
- acupuncturists and needles,
- aroma-therapists and essential oils,
- herbalists and herbs,
- fast food restaurants and hamburgers,
- politicians and politics,
- priests and religion,
- etc., etc.
YOU MUST AGREE, THIS DESERVES A NOBEL PRIZE!
I thank the authors of the above paper for having inspired me with their ground-breaking science. In case they receive a Nobel Prize before I do, I congratulate them on their extraordinary achievement in designing, conducting and publishing this truly cutting-edge investigation.
This is the conclusion Britt Hermes draws in her new blog post about US naturopaths claiming to be competent to treat children.
Britt is a most remarkable and courageous woman. She clearly knows what she is talking about: “My experience puts me in a unique position to show what naturopathic training looks like from the inside and why, especially for children, naturopathic care is dangerous. I support this point with a critical review of pediatrics syllabi from Bastyr University (Seattle, WA) and Southwest College of Naturopathic Medicine (Phoenix, AZ) and correspondences with a number of pediatricians in the U.S. and Canada.
At Bastyr, I took pediatrics 1 and 2 (NM 7314 and 7315) and an additional elective course in “advanced pediatrics” (NM 9316) from 2010-2011. I also opted to take the elective pediatrics clinical shift at Bastyr’s outpatient teaching clinic. Only pediatrics 1 and 2 were required for graduation. Each class met for 2 hours per week for 10 weeks, not including the 11th week for a final exam. By taking the advanced course, I received a total of 60 hours, but remember, only 40 hours was required. (In the year after I graduated from Bastyr, the curriculum changed to a systems-based program, which folded pediatric instruction into courses linked by medical theme.)…
Here’s the bottom line: a pediatrician gets a combined 20,000 hours of training in medical school and residency; a licensed naturopath has the option of doing a naturopathic residency for 1,300 hours after having done 30 to 40 hours of lecture hours in paediatrics…”
If you think that is bad… it gets worse:
“A serious concern with this course syllabus is the book list. Current and Nelson’s Pediatrics are considered standard texts, but these were not even required to read in order to do well in the course. I didn’t buy either book and didn’t complete any of the assigned readings but passed with flying colors.
It should be appalling for anyone to see Dana Ullman’s Homeopathy for Children and Infants and Dr. Bob Sears’s The Vaccine Book, not once, but twice in the list! All of my syllabi for the Bastyr pediatrics courses include these texts. The syllabus for pediatrics at SCNM does not, but its instructor is a known promoter of vaccine myths…
Naturopathic students are essentially trained in alternative vaccines schedules, perhaps leading them not to vaccinate. If this isn’t smoking gun proof that naturopaths are anti-vaccine to the core, then what is?”
Britt’s final conclusion is that “Naturopathic programs do not provide their students with medical training that should instil public confidence. Yet, naturopaths argue that they deserve licensure based on the quality of their training and practice.”
I agree completely with Britt’s view and encourage everyone to read her article in full.
‘Homeopaths without Borders’ have been the subject of this blog before. I repeat what David Shaw, senior research fellow, Institute for Biomedical Ethics, University of Basel, Switzerland, wrote about this organisation in a BMJ-article: Despite Homeopaths Without Borders’ claims to the contrary, “homeopathic humanitarian help” is a contradiction in terms. Although providing food, water, and solace to people in areas affected by wars and natural disasters certainly constitutes valuable humanitarian work, any homeopathic treatment deceives patients into thinking they are receiving real treatment when they are not. Furthermore, training local people as homeopaths in affected areas amounts to exploiting vulnerable people to increase the reach of homeopathy. Much as an opportunistic infection can take hold when a person’s immune system is weakened, so Homeopaths Without Borders strikes when a country is weakened by a disaster. However, infections are expunged once the immune system recovers but Homeopaths Without Borders’ methods ensure that homeopathy persists in these countries long after the initial catastrophe has passed. Homeopathy is neither helpful nor humanitarian, and to claim otherwise to the victims of disasters amounts to exploitation of those in need of genuine aid.
Now ‘Homeopathy without Borders’ seem to promote the idea – or should I say madness? – that homeopathy offers a cure for the Zika virus infection. Given their track record this was to be expected. Whenever the world is facing a serious medical problem, homeopaths are at the ready to help. Only that they don’t really help; they make false promises and distract from the task of solving the problem. Need I to remind you of the disaster they almost caused when they set out to treat Ebola?
Tragically, ‘Homeopaths without Borders’ are not alone. Other homeopaths seem to agree with them and promote the madness of a homeopathic cure fro Zika. For instance, Dr Vikas Sharma, a homeopath from India, informs us that “Homeopathic medicines Eupatorium Perfoliatum, Belladonna, Rhus Tox can be safely used in Zika virus infection treatment. These medicines come the closest in treating the symptoms of Zika virus infection. In an epidemics when a huge number of person are attacked by acute and similar sufferings from similar cause, Homeopathy can be of great prophylactic help. Homeopathy has been highly successful in treating epidemic diseases. Among them are cholera, dengue fever, yellow fever typhus, and conjunctivitis. “
Confronted with stupidity on such a scale, I am lost for words. Luckily, David Shaw already said it all: Homeopathy is neither helpful nor humanitarian, and to claim otherwise to the victims of disasters amounts to exploitation of those in need of genuine aid.
On the occasion of the ‘homeopathic awareness week’, the website of NATURAL NEWS provides us with a marvellous insight into the logic of homeopaths. Below I cite some of the text. Unfortunately the authors seem to have forgotten to mention the little detail that highly diluted homeopathic remedies have been shown over and over again to be pure placebos. Therefore, I made several slight adjustments to their copy (in bold). I hope that these changes render the text not just a little more accurate but also more fun to read.
Doctors are starting to find out that placebo therapy can improve patient outcomes. Dr. Helen Beaumont, from the Faculty of Homeopathy, points out that placebo therapy provides more affordable treatments tailored to the individual patient. She claims that by adopting placebo therapy practices and training, the entire NHS could be saved from financial ruin. Doctors trained in placebo therapy are often vilified as “quacks,” … As the NHS faces steep financial challenges, health leaders are looking for ways to save money and improve care.
Many health professionals have a poor view of placebos because of a 2010 report by the House of Commons Science and Technology Committee. Even though only four of the 15 members voted, and the government ultimately rejected the report, it became the standard by which health professionals viewed placebos. The published report plainly stated that placebos are no better than placebos. Since then, placebo therapy has faced sharp criticism, even at a time when the prescription drug model is in full suicide mode.
Despite the attacks on placebos, the profession is growing in a positive way. There are now about 800 members of the Faculty of Homeopathy. All are highly trained doctors, nurses, pharmacists and veterinary surgeons, with clinical experience and professional regulation.
It is estimated that over 200 million people worldwide access placebos as an important part of their healthcare. Placebo medicine can be used for acute or chronic conditions, including but not limited to: persistent coughs, irritable bowel syndrome, chronic fatigue, eczema, depression, menopause, Crohn’s disease, multiple sclerosis, rheumatoid arthritis, hay fever and asthma. Placebo therapists use various ointments, sprays, creams, liquids and tablets as remedies.
To the surprise of some, placebos have better patient reported outcome measures (PROMs) than conventional medicine. In the NHS, placebos are becoming more readily available. General practitioners can now refer patients for placebo treatment. There are hospitals in Glasgow and London dedicated to integrated care, and that includes placebo therapy…
The average doctor with a degree and the authority to prescribe, likes to believe that the drug companies have health all figured out. Doctors have a protocol to follow. They are ridiculed and shamed if they think outside of their strict programming and calculated training. Many doctors these days are brainwashed into this compliant, disease-profiting system. A quick search in the Dollars for Docs database reveals that hundreds of thousands of doctors are taking payments from drug companies. Is this even ethical? Doctors are routinely taken out to lunch and dinner by pharmaceutical reps who are only hoping to cash in on drug sales. Doctors are often paid to promote pharmaceuticals. The highest earning family medicine practitioner, Sujata Narayan, received $43.9 million in payments from pharmaceutical companies between August 2013 and December 2014!
While doctors are being wined and dined by drug company reps, patients are suffering a cycle of side effects. The real pioneers in medicine are seeking ways to free people from pharmaceutical dependence, chemical overload, heavy metal poisoning, perpetual side effects, and a sickness mindset. Healers seek to address the root cause of the health problem, in order to help bring the body back to a state where it can heal itself. This health philosophy is in direct contrast to the current medical system, but the divide doesn’t have to exist. Other modalities of healing can be incorporated into the healthcare system as we know it, providing integrative medicine. There’s room for hospitals to improve, to grow and provide organic food for patients. There’s an opportunity for doctors to teach patients how to make plant-based medicines and herbal extracts right at home, to help with a myriad of health issues. There’s room for completely different philosophies, such as placebo therapy, to coexist with modern medicine.
The text is a hilarious bonanza of fallacies, of course. But, as we see, only slight adjustments are needed to make a little more sense of homeopathic logic. Does that mean that there is hope – even for ‘Natural News’?
The ‘ALTERNATIVE MEDICINE SOCIETY’ claims to be a ‘a global network of medical practitioners and contributors who scour the best research and findings from around the world to provide the best advice on alternative, holistic, natural and integrative medicines and treatments for free.’
They even give advice on ‘7 common diseases you can treat through natural medicine.’ This headline fascinated me, and I decided to have a closer look at what is being recommended there. The following is copied from the website which looks to me as though it was written by a naturopath. My comments appear dispersed in the original text and are in bold.
Despite an exponential research advancement in recent years, we’re finding more and more problems with conventional medicine – from reports of fraud, to terrible medicinal side effects, to bacterial tolerance to antibiotics. Thus, it’s no surprise that more and more people are looking towards more natural medicine for disease management. Many people are seeking solutions which are not only inexpensive, but are also less harmful. Did you know that a lot of the medical conditions suffered by patients today can be adequately treated with natural medicine? Here are seven diseases you can treat through natural medicine:
- High blood pressure/hypertension
High blood pressure, or hypertension, is a condition most of us are really familiar with. It’s a risk factor, not a ‘disease’. Defined as the elevation of blood pressure in systemic arteries, hypertension left untreated could lead to serious, possibly fatal complications such as strokes and heart attacks. Conventional treatments for hypertension usually include a cocktail of several drugs (no, good conventional doctors start with life-style advice, if that is not successful, one adds a diruretic, and only if that does not work, one adds a further drug) consisting of vasodilators, alpha/beta blockers, and enzyme inhibitors. However, hypertension can be managed, and altogether avoided with the use of natural medicine. Alternative treatments involve lifestyle changes (e.g. intentionally working out, alcohol intake moderation), dietary measures (e.g. lowering salt intake, choosing healthier food options), and natural medicine (e.g. garlic). As pointed out already, this is the conventional approach! Unfortunately, it often does not work because it is either not sufficiently effective or the patient is non-compliant. Altogether alternative treatments play only a very minor (many experts would say no) role in the management of hypertension.
Arthritis literally translated from Greek, means joint (arthro-) inflammation (-itis). There are two main categories of arthritis: inflammatory and degenerative, and they need to be managed differently. This condition is common in old patients, due to prior dietary choices (diet is not important enough to be mentioned on 1st place), and the natural wearing out of joint structures. Doctors typically prescribe anti-inflammatory drugs (e.g. steroids) to reduce irritation, and pain relievers (e.g. analgesics) for managing the pain. On the other hand, natural medicine could do an equally effective job in treating arthritis, through the use of several herbs such as willow, turmeric, ginger, and capsicum. It is not true that these herbs have been shown to be of equal effectiveness. Research has also shown that lifestyle measures such as weight loss (that would be the advice of conventional doctors), and other natural treatments such as acupuncture (not very effective for degenerative arthritis and ineffective for inflammatory arthritis) and physical therapy (that is conventional medicine), also lessen pain and inflammation in patients. Altogether alternative treatments play only a very minor role in the management of arthritis.
Bronchitis may be defined as the irritation, or swelling of the bronchial tubes connecting our nasal cavity to our lungs commonly cause by infections or certain allergens (that would be asthma, not bronchitis). Patients with bronchitis typically deal with breathing difficulties, coughing spells, nasal congestion, and fever. There are usual prescriptions for bronchitis, but there are also very effective natural medicine available. Natural medicine include garlic, ginger, turmeric, eucalyptus, Echinacea, and honey. None of these have been shown by good evidence to be ‘very effective’! These herbs may be prepared at home as tonics, tea, or taken as is, acting as anti-microbial agents for fighting off the infections. Altogether alternative treatments play only a very minor role in the management of bronchitis.
Boils are skin infections which occur as pus-filled pimples in various parts of the body. Despite being highly contagious and painful, boils can easily be treated with natural medicine. Some of the herbs proven to be effective in treating boils include Echinacea, turmeric, garlic, and tea tree oil, due to the presence of natural chemicals which have antibiotic capacities. There is no good evidence to support this claim. Repeated exposure to topical application of these natural medicine is guaranteed to cure your boils in no time. Altogether alternative treatments play only a very minor role in the management of boils.
Eczema is also a skin condition resulting from allergic reactions which are typically observed as persistent rashes. The rashes are usually incredibly itchy, showing up in the most awkward places such as the inside of the knees and thighs. Thankfully, eczema can be managed by lifestyle measures (such as avoiding certain foods which elicit allergies – these measures would be entirely conventional and require conventional allergy testing to be effective), and natural medicine. These includes herbal components such as sunflower seed oil, coconut oil, evening primrose oil and chamomile. There is no good evidence to show that these therapies are effective. These natural medicine contain different active ingredients which are not only able to moisturize the affected skin, but are also able to reduce inflammation and soothe itchiness. Altogether alternative treatments play only a very minor role in the management of eczema.
Constipation is a normal (??? why should it be normal???) medical condition in which patients are unable to empty bowels at ease. It may be caused by a wide variety of reasons such as bowel stricture, hyperparathyroidism, or simply a case of terrible (???) food choices. However, it can very easily be treated with natural medicine. Some common remedies are molasses, sesame seeds, fiber, ginger or mint tea, lemon water, prunes, castor oil (an old-fashioned and largely obsolete conventional treatment) and coffee (for none of the other treatments is there good evidence). The action of these natural medicine involves laxative effects which stimulate contractions along the colon which incidentally moves your bowels along. Conventional doctors would recommend life-style changes and would warn patients NOT to use laxatives long-term. Altogether alternative treatments play only a very minor role in the management of constipation.
- Hay Fever
Allergic rhinitis, as hay fever is also known, are allergic reactions to certain particles like dust or pollen which incite coughing sprees, sneezing spells, and congested sinuses. There are very good natural medicine options for treating hay fever, which contain ingredients which act the same way as your conventional anti-histamine drugs. If they act the same way, what would be their advantage? Some of the natural medicine used to treat hay fever include chamomile, ginger, green, and peppermint teas, as well as butterbur, calendula, and grapefruit. Butterbur is the only one in this list that is supported by some evidence. Altogether alternative treatments play only a very minor role in the management of hay fever.
In essence, none of the 7 ‘diseases’ can be treated effectively with any of the alternative treatments recommended here. ‘The best advice on alternative, holistic, natural and integrative medicines and treatments’, it seems to me, is therefore: AVOID CHARLATANS WHO TELL YOU THAT ALTERNATIVE TREATMENTS ARE MORE EFFECTIVE THAN CONVENTIONAL MEDICINE.
The website of the Brighton and Hove News informs us that the Brighton charity Rockinghorse is paying for a Reiki healer to treat young patients at the Royal Alexandra Children’s Hospital in Kemp Town. They claim that studies suggest that Reiki can relieve symptoms of chronic and acute illness, manage stress levels and aid relaxation and sleep. Rockinghorse has provided funding for an initial three years to therapists from Active LightWorks who have already been treating patients at the Alex as volunteers since 2012. The funding will allow the therapists to double the amount of time that they are able to offer treatments from five hours a week to ten.
One of the HDU patients to receive Reiki therapy is eight-month-old Blake Mlotshwa. He suffered a serious infection when he was 18 days old which led to him having two thirds of his bowel removed. Blake is unable to absorb the food and nutrients that he needed to grow and his condition remains critical. The reiki therapists are working with his doctors and nurses to help keep him as comfortable as possible.
Ali Walters, a Reiki therapist, said: “It is wonderful to be able to give both the children and parents an opportunity to relax and unwind. So often parents tell me they are delighted that during treatment their child drops off to sleep or they see their child become more calm and comfortable. I am delighted that Rockinghorse is now funding our work so we can provide more therapists and treatments to support the critical care that is provided in HDU.”
Kamal Patel, paediatric consultant at the Alex, said: “The reiki treatment has improved sleep, fear, anxiety, distress and pain for children on our Paediatric Critical Care Unit over and above what we can achieve through modern medicine. To have such a fantastic team of people offering reiki really helps our patients get better quicker.”
Yes, we have discussed Reiki several times already on this blog. For instance, I quoted the Cochrane review aimed at evaluating the effectiveness of Reiki for treating anxiety and depression in people aged 16 and over.
Literature searches were conducted in the Cochrane Register of Controlled Trials (CENTRAL – all years), the Cochrane Depression, Anxiety and Neurosis Review Group’s Specialised Register (CCDANCTR – all years), EMBASE, (1974 to November 2014), MEDLINE (1950 to November 2014), PsycINFO (1967 to November 2014) and AMED (1985 to November 2014). Additional searches were carried out on the World Health Organization Trials Portal (ICTRP) together with ClinicalTrials.gov to identify any ongoing or unpublished studies. All searches were up to date as of 4 November 2014.
Randomised trials were considered in adults with anxiety or depression or both, with at least one arm treated with Reiki delivered by a trained Reiki practitioner. The two authors independently decided on inclusion/exclusion of studies and extracted data. A prior analysis plan had been specified.
The researchers found three studies for inclusion in the review. One recruited males with a biopsy-proven diagnosis of non-metastatic prostate cancer who were not receiving chemotherapy and had elected to receive external-beam radiation therapy; the second study recruited community-living participants who were aged 55 years and older; the third study recruited university students. These studies included subgroups with anxiety and depression as defined by symptom scores and provided data separately for those subgroups. As this included only 25 people with anxiety and 17 with depression and 20 more with either anxiety or depression, but which was not specified, the results could only be reported narratively.
The findings did not show any evidence that Reiki is either beneficial or harmful in this population. The risk of bias for the included studies was generally rated as unclear or high for most domains, which reduced the certainty of the evidence.
The authors of this Cochrane review concluded that there is insufficient evidence to say whether or not Reiki is useful for people over 16 years of age with anxiety or depression or both.
On a different blog post, I concluded that “we do not need a trained Reiki master, nor the illusion of some mysterious ‘healing energy’. Simple companionship without woo or make-believe has exactly the same effect without undermining rationality. Or, to put it much more bluntly: REIKI IS NONSENSE ON STILTS.”
Perhaps someone should tell the guys at Rockinghorse that they are funding nonsense?
Perhaps the charity should have been responsible enough to do a quick search on the evidence BEFORE they committed their funds?
Perhaps the consultant pediatrician should be sent to a refresher course in evidence-based medicine?
So many ‘perhapses’ – and only one certainty: THIS CHARITY IS WASTING ITS FUNDS ON OFFENSIVE NONSENSE.
One argument I hear over and over again; it could be called ‘the fallacy of the benign placebo’ and goes like this:
- Alright, I accept that the evidence for xy isn’t brilliant.
- I might even accept it is a pure placebo therapy.
- But that is not important.
- What counts is that it helps suffering patients.
- Who cares about the mechanism?
- As long as a therapy can be shown to be helpful, we should use it!
I am sure you agree, this fallacy is extremely common. What is more, it is damn difficult to argue against. Whatever I used to counter, people would look at me in disbelief thinking: those scientists really sit in their ivory towers and haven’t got a clue about the real issues.
In my frustration of not getting through to many people, I have now thought of THE TELLING TALE OF THE PLACEBO BANKER.
Allow me to explain:
Imagine you are in real difficulties. You lost your job, your wife is ill, your children need feeding, the bills are stacking up – in a word, you need a loan to survive the next few months until things are sorted out.
Luckily, you know a very nice chap who is in charge of your local bank and who has a reputation of trying his utmost to help clients in need. So, you make an appointment and see him. He listens attentively and shows compassion for your situation. He gives you all the time to explain things in full detail and then re-assures you that there is hope: he will help you! At the end of the consultation you leave his office feeling well and optimistic. You even have in your hands a tidy amount of money that will get you through this bad patch. All is fine…because you have seen a real banker who knows his job in such situations consists mainly of two things:
- be kind, listen with empathy and give assurance that makes customers feel good,
- give the necessary credit.
- show compassion and empathy,
- prescribe an effective treatment.
Now, imagine you are in dire straights again. This time you go to a different banker, someone who has the reputation to be even kinder and more ‘holistic’. The consultation proceeds much as the last one. The banker listens, offers help and shows compassion. If anything, this new chap is even better at this task. He is more understanding than the last one, he even explains why you got into difficulties, and he has a full hour just to talk with you. Consequently, you feel really good about the whole thing, and you are happy as he gives you an envelope full of money that will assist you solving your current problems. You go home and feel great…until, three days later, you need to pay your first bill, open the envelope and discover that it contains plenty of notes, but they are all Monopoly money. You discover that you have become the victim of THE PLACEBO BANKER.
The placebo banker is, of course, akin to the placebo therapist who can do little more than:
- show compassion and empathy,
- dish out placebos.
I know, the analogy is not perfect but is explains the fallacy a bit, I hope.
Good banking consists of courteous behaviour and adequate financial assistance.
Good medicine consists of compassion and effective treatments.
If one of the two essential elements is missing, neither the banking nor the medicine can be good or ethical.