charlatan
A German newspaper reported the experience of two journalists who went undercover to consult several practitioners of so-called alternative medicine to receive treatment for Hodgkin lymphoma. Here are several passages from their important article (my translation, my bolding)
… Doctor Uwe Reuter invites us in. He is sitting behind an iMac on which he sometimes shows me pictures of his therapies. He is around 50, tall and lean, his face looks particularly serious through frameless glasses. I tell him my story. He listens attentively, and then it seems for a while as if he can’t decide what to advise me. Finally, he has it: I should first do a “diagnostic series” in his clinic, three or even better five days, for about 1000 Euros. This would include “electromagnetic measurements” for the “energy balance of individual organs”. Only then can he determine which therapy might be indicated in my case. “Hypnosis, homeopathy, vitamin B17 infusions” will probably play a role, says Reuter, and a “fever therapy” in which I will be injected with dead bacteria.
“In addition to chemotherapy or alone?”, I ask. The doctor says he can’t make this decision for me, I should make it from my “inside”. I have to understand that my illness does not come from the outside and that therapies only have a supporting effect – the healing “has to come from within”.
… In the end, Reuter suggests postponing chemotherapy for a quarter of a year and using his therapy to “push aside everything that prevents healing” – toxins, distractions, and fears. The cost? Around 10,000 Euros for the entire therapy…
[Next doctor is] the well-known alternative doctor Klaus Maar in Düsseldorf… His wrinkled face is dominated by a large nose, his hair is enviably thick and black for a man of his age. “Well,” he says in his comforting voice, “why don’t you describe what happened to you?” I am nervous. Will he believe that I am terminally ill? I stammer and tell my story. He listens to me, looks at me, answers calmly, and takes his time – and attention that few orthodox doctors can afford today, which is one of the reasons that drive people into the arms of alternative healers.Finally, Maar advises a “heat therapy” in which the tumor is heated locally. Yet Klaus Maar is still one of the more serious healers. He does not directly advise against chemotherapy, but warns about the side effects. In the end, he recommends postponing it for a fortnight and starting the 8,000-euro heat treatment as soon as possible. “But don’t delay, don’t blame me and say I delayed the chemotherapy,” Maar says. I guess that’s his way of hedging his bets: If he were to successfully dissuade me from chemotherapy, my family could sue him one day. I come across such phrases again and again.
… next visit; the alternative practitioner Ursula Stoll specializes in “Germanic New Medicine”. Ryke Geerd Hamer, a former doctor, founded this doctrine in the early 1980s as a reaction to “Jewish” orthodox medicine. No wonder it enjoys great popularity in völkisch circles. Hamer’s abstruse and dangerous theories led to the withdrawal of his license. He continued to practice illegally, however, and several of his patients died… Even Ursula Stoll thinks he was crazy – but not his theory… Stoll practices in Öhringen, an idyllic little town north of Stuttgart, in her nondescript detached house. She wears a white shirt and horn-rimmed glasses, her brown hair pinned back in a plait, an accurate governess with a stern look.
As I tell her about my suffering, she quickly interrupts me: “What is cancer?” she asks. We have to get rid of the term. There is no such thing as cancer. All I have is a swelling of the lymph nodes in my neck. That’s all. The cause: a self-deprecation of a professional nature. In my case, there is also an existential fear, and like a fish on land, I store water in my body in order to survive. Hence the swollen lymph nodes. Metastases? There are none. The medical report? She skims over it casually and asks: Did you sweat when you were sick? Did the sweat smell? Did it have a color? Where exactly was the itch?
I tell her about the lecture I gave and that my boss didn’t like. Yes! That could be the reason for the cancer. She says my symptoms are a reaction to this slight, my body is trying to heal itself, but the first chemotherapy interrupted and disrupted the process. Her advice to beat the cancer: I should move back in with my parents, life as a single person is too much for me, Berlin is a terrible city anyway… I ask again about chemotherapy. “I personally wouldn’t do it,” she says, “and for my children and my parents I would decide the same.” There it is again, this nappy-soft formulation with which the healers evade their legal responsibility. One more question: isn’t it dangerous to forego chemotherapy? The alternative practitioner Ursula Stoll: “Humans can withstand a lot.”
… Since the spiritual healers Wolfgang Bittscheidt and Teresa Schuhl were favorably discussed on German TV, their practice in Siegburg near Bonn has enjoyed great popularity: appointments are made only months in advance. When we are asked into the treatment room, it is dark, the blinds are half closed. A candle burns on the dark wooden desk. Teresa Schuhl is blond, has blue eyes, and seems cool and aloof, gesticulating strangely with her hands. She whispers more than she speaks; I have to lean forward to understand her. Her advice? “If you were my son right now, I would say, hands off chemo!” For herself, she would decide the same. “One possibility is vitamin B17. Have you heard of it?”
I have heard of it. The so-called vitamin B17 is in fact not a vitamin at all, but a toxic substance, related to prussic acid. It is currently experiencing a boom in the alternative scene and has no proven benefit for cancer. Several people have died from overdoses.
Schuhl is now poking around in my spiritual life and in the relationship between me and my parents. She also suspects a trauma behind my cancer. “The thyroid represents the hormonal. The balance between male and female. Do you know where you belong? Male or female?” What is she trying to say?
“I come from Tajikistan,” he says, “where they say: sickness is a sacred time. When you are sick, God talks to you. He tells you what life really is. What we live is not life, it’s shit. Sickness asks us to make a change.” He continues, “Death is the most beautiful thing there is. Like a trip to the Caribbean. Why are we afraid of it? On this tortured planet here?”
After this introduction, my head is spinning, but now the actual treatment begins. I lie down on a couch. Schuhl runs her hands over my stomach and holds my shoulder. At the same time, she says prayers. She changes into the extinct Aramaic that is sometimes used in Christian services. Then she leaves me alone. Later, her partner, a licensed doctor, recommends that I read up on vitamin B17, come to them once a month and light a candle in a church in Cologne. I walk out of the practice befuddled…
The practitioners protect themselves legally. They make the patients sign contracts stating that the patient has been informed about orthodox medicine and that they reject it willy-nilly, even though the information is often not worth mentioning. What would be the solution?
… The doctor Achim Schuppert in Bonn suspects mobile phone radiation as the cause of my tumor and wants to measure my magnetic aura. It was important to him to “exclude electrosmog as a possible damaging factor”, he writes later.
Lothar Hollerbach, who runs an alternative practice in a Heidelberg city villa, gives a philosophical lecture: “We are spiritual beings and only for a short time in a mobile home we call a body.” Every crisis is a lesson, he says, but perhaps that lesson is for the next life. One of the things he recommends to me for recovery is Rudolf Steiner‘s lectures. How many patients has he successfully treated? He doesn’t count them, Hollerbach waves off. And after all, it’s not just about surviving. Some of his patients could have led a totally different life “in the next incarnation”. For those who long for death – his practice is highly recommended…
… The “medical director” Elke Tegel, a blonde alternative practitioner, leads me through the bright house, shows me the “inner world travel room” where traumatic situations are processed, the room for “healing music“, and also the impressive machine for “high-frequency therapy“, in which electrical energy is supplied to the cells. Costs: 13670 Euros for five weeks.
Cancer, says the alternative practitioner, is “suppressed anger and suppressed resentment”; Hodgkin’s lymphoma in particular is about guilt. She asks: “Where do you feel guilty? Guilty of being a man?” Later she advises a “biological chemotherapy” of highly concentrated vitamin C. This, she says, is far superior to conventional chemo. She confuses my well-treatable Hodgkin’s lymphoma with the fundamentally different non-Hodgkin’s lymphoma. And justifies herself: “With us, it’s not about diagnosis, that’s not of interest.” …
________________________
What I like about this report is that they exposed both doctors and non-medically trained practitioners, i.e. Heilpraktiker. We see yet again that the study of medicine does not protect people from becoming dangerous charlatans. Yet, there are important differences between doctors and Heilpraktiker:
- Only a very small proportion of doctors would treat Hodgkin lymphoma with ineffective quackery, whereas the proportion with Heilpraktiker would, I guess, be not far from 100%.
- Doctors will get struck off for such behavior, whereas this happens to Heilpraktiker as good as never.
Sure, the LP is dangerous nonsense, but this begs the question of whether so-called alternative medicine (SCAM) has anything to offer for patients suffering from ME/CFS. If the LP story tells us anything, then it must be this: we should not trust single trials, particularly if they seem dodgy. In other words, we should look at systematic reviews that synthesize ALL clinical trials and evaluate them critically.
To locate this type of evidence I conducted several Medline searches and found several recent systematic reviews that address the issue:
Context: A variety of interventions have been used in the treatment and management of chronic fatigue syndrome (CFS). Currently, debate exists among health care professionals and patients about appropriate strategies for management.
Objective: To assess the effectiveness of all interventions that have been evaluated for use in the treatment or management of CFS in adults or children.
Data sources: Nineteen specialist databases were searched from inception to either January or July 2000 for published or unpublished studies in any language. The search was updated through October 2000 using PubMed. Other sources included scanning citations, Internet searching, contacting experts, and online requests for articles.
Study selection: Controlled trials (randomized or nonrandomized) that evaluated interventions in patients diagnosed as having CFS according to any criteria were included. Study inclusion was assessed independently by 2 reviewers. Of 350 studies initially identified, 44 met inclusion criteria, including 36 randomized controlled trials and 8 controlled trials.
Data extraction: Data extraction was conducted by 1 reviewer and checked by a second. Validity assessment was carried out by 2 reviewers with disagreements resolved by consensus. A qualitative synthesis was carried out and studies were grouped according to type of intervention and outcomes assessed.
Data synthesis: The number of participants included in each trial ranged from 12 to 326, with a total of 2801 participants included in the 44 trials combined. Across the studies, 38 different outcomes were evaluated using about 130 different scales or types of measurement. Studies were grouped into 6 different categories. In the behavioral category, graded exercise therapy and cognitive behavioral therapy showed positive results and also scored highly on the validity assessment. In the immunological category, both immunoglobulin and hydrocortisone showed some limited effects but, overall, the evidence was inconclusive. There was insufficient evidence about effectiveness in the other 4 categories (pharmacological, supplements, complementary/alternative, and other interventions).
Conclusions: Overall, the interventions demonstrated mixed results in terms of effectiveness. All conclusions about effectiveness should be considered together with the methodological inadequacies of the studies. Interventions which have shown promising results include cognitive behavioral therapy and graded exercise therapy. Further research into these and other treatments is required using standardized outcome measures.
Introduction: Chronic fatigue syndrome (CFS) affects between 0.006% and 3% of the population depending on the criteria of definition used, with women being at higher risk than men.
Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for chronic fatigue syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
Results: We found 46 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: antidepressants, cognitive behavioural therapy (CBT), corticosteroids, dietary supplements, evening primrose oil, galantamine, graded exercise therapy, homeopathy, immunotherapy, intramuscular magnesium, oral nicotinamide adenine dinucleotide, and prolonged rest.
Background: Throughout the world, patients with chronic diseases/illnesses use complementary and alternative medicines (CAM). The use of CAM is also substantial among patients with diseases/illnesses of unknown aetiology. Chronic fatigue syndrome (CFS), also termed myalgic encephalomyelitis (ME), is no exception. Hence, a systematic review of randomised controlled trials of CAM treatments in patients with CFS/ME was undertaken to summarise the existing evidence from RCTs of CAM treatments in this patient population.
Methods: Seventeen data sources were searched up to 13th August 2011. All randomised controlled trials (RCTs) of any type of CAM therapy used for treating CFS were included, with the exception of acupuncture and complex herbal medicines; studies were included regardless of blinding. Controlled clinical trials, uncontrolled observational studies, and case studies were excluded.
Results: A total of 26 RCTs, which included 3,273 participants, met our inclusion criteria. The CAM therapy from the RCTs included the following: mind-body medicine, distant healing, massage, tuina and tai chi, homeopathy, ginseng, and dietary supplementation. Studies of qigong, massage and tuina were demonstrated to have positive effects, whereas distant healing failed to do so. Compared with placebo, homeopathy also had insufficient evidence of symptom improvement in CFS. Seventeen studies tested supplements for CFS. Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium.
Conclusions: The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted.
Background: There is no curative treatment for chronic fatigue syndrome (CFS). Traditional Chinese medicine (TCM) is widely used in the treatment of CFS in China.
Objective: To evaluate the effectiveness and safety of TCM for CFS.
Methods: The protocol of this review is registered at PROSPERO. We searched six main databases for randomized clinical trials (RCTs) on TCM for CFS from their inception to September 2013. The Cochrane risk of bias tool was used to assess the methodological quality. We used RevMan 5.1 to synthesize the results.
Results: 23 RCTs involving 1776 participants were identified. The risk of bias of the included studies was high. The types of TCM interventions varied, including Chinese herbal medicine, acupuncture, qigong, moxibustion, and acupoint application. The results of meta-analyses and several individual studies showed that TCM alone or in combination with other interventions significantly alleviated fatigue symptoms as measured by Chalder’s fatigue scale, fatigue severity scale, fatigue assessment instrument by Joseph E. Schwartz, Bell’s fatigue scale, and guiding principle of clinical research on new drugs of TCM for fatigue symptom. There was no enough evidence that TCM could improve the quality of life for CFS patients. The included studies did not report serious adverse events.
Conclusions: TCM appears to be effective to alleviate the fatigue symptom for people with CFS. However, due to the high risk of bias of the included studies, larger, well-designed studies are needed to confirm the potential benefit in the future.
Background: As the etiology of chronic fatigue syndrome (CFS) is unclear and the treatment is still a big issue. There exists a wide range of literature about acupuncture and moxibustion (AM) for CFS in traditional Chinese medicine (TCM). But there are certain doubts as well in the effectiveness of its treatment due to the lack of a comprehensive and evidence-based medical proof to dispel the misgivings. Current study evaluated systematically the effectiveness of acupuncture and moxibustion treatments on CFS, and clarified the difference among them and Chinese herbal medicine, western medicine and sham-acupuncture.
Methods: We comprehensively reviewed literature including PubMed, EMBASE, Cochrane library, CBM (Chinese Biomedical Literature Database) and CNKI (China National Knowledge Infrastructure) up to May 2016, for RCT clinical research on CFS treated by acupuncture and moxibustion. Traditional direct meta-analysis was adopted to analyze the difference between AM and other treatments. Analysis was performed based on the treatment in experiment and control groups. Network meta-analysis was adopted to make comprehensive comparisons between any two kinds of treatments. The primary outcome was total effective rate, while relative risks (RR) and 95% confidence intervals (CI) were used as the final pooled statistics.
Results: A total of 31 randomized controlled trials (RCTs) were enrolled in analyses. In traditional direct meta-analysis, we found that in comparison to Chinese herbal medicine, CbAM (combined acupuncture and moxibustion, which meant two or more types of acupuncture and moxibustion were adopted) had a higher total effective rate (RR (95% CI), 1.17 (1.09 ~ 1.25)). Compared with Chinese herbal medicine, western medicine and sham-acupuncture, SAM (single acupuncture or single moxibustion) had a higher total effective rate, with RR (95% CI) of 1.22 (1.14 ~ 1.30), 1.51 (1.31-1.74), 5.90 (3.64-9.56). In addition, compared with SAM, CbAM had a higher total effective rate (RR (95% CI), 1.23 (1.12 ~ 1.36)). In network meta-analyses, similar results were recorded. Subsequently, we ranked all treatments from high to low effective rate and the order was CbAM, SAM, Chinese herbal medicine, western medicine and sham-acupuncture.
Conclusions: In the treatment of CFS, CbAM and SAM may have better effect than other treatments. However, the included trials have relatively poor quality, hence high quality studies are needed to confirm our finding.
Objectives: This meta-analysis aimed to assess the effectiveness and safety of Chinese herbal medicine (CHM) in treating chronic fatigue syndrome (CFS). Methods: Nine electronic databases were searched from inception to May 2022. Two reviewers screened studies, extracted the data, and assessed the risk of bias independently. The meta-analysis was performed using the Stata 12.0 software. Results: Eighty-four RCTs that explored the efficacy of 69 kinds of Chinese herbal formulas with various dosage forms (decoction, granule, oral liquid, pill, ointment, capsule, and herbal porridge), involving 6,944 participants were identified. This meta-analysis showed that the application of CHM for CFS can decrease Fatigue Scale scores (WMD: -1.77; 95%CI: -1.96 to -1.57; p < 0.001), Fatigue Assessment Instrument scores (WMD: -15.75; 95%CI: -26.89 to -4.61; p < 0.01), Self-Rating Scale of mental state scores (WMD: -9.72; 95%CI:-12.26 to -7.18; p < 0.001), Self-Rating Anxiety Scale scores (WMD: -7.07; 95%CI: -9.96 to -4.19; p < 0.001), Self-Rating Depression Scale scores (WMD: -5.45; 95%CI: -6.82 to -4.08; p < 0.001), and clinical symptom scores (WMD: -5.37; 95%CI: -6.13 to -4.60; p < 0.001) and improve IGA (WMD: 0.30; 95%CI: 0.20-0.41; p < 0.001), IGG (WMD: 1.74; 95%CI: 0.87-2.62; p < 0.001), IGM (WMD: 0.21; 95%CI: 0.14-0.29; p < 0.001), and the effective rate (RR = 1.41; 95%CI: 1.33-1.49; p < 0.001). However, natural killer cell levels did not change significantly. The included studies did not report any serious adverse events. In addition, the methodology quality of the included RCTs was generally not high. Conclusion: Our study showed that CHM seems to be effective and safe in the treatment of CFS. However, given the poor quality of reports from these studies, the results should be interpreted cautiously. More international multi-centered, double-blinded, well-designed, randomized controlled trials are needed in future research.
What does all that tell us?
Disappointingly, it tells me that SCAM has preciously little to offer for ME/CFS patients.
But what about the TCM treatments? Aren’t the above reviews quite positive TCM?
Yes, they are but I nevertheless recommend taking them with a healthy pinch of salt.
Why?
Because we have seen many times before that, for a range of reasons, Chinese researchers of TCM draw false positive conclusions. That may sound unfair, harsh, or even racist, but I think it’s true. If you disagree, please show me a couple of systematic reviews of TCM for any human disease by Chinese researchers that have drawn negative conclusions.
And what is my advice to patients suffering from ME/CSF?
I think the best I can offer is this: be very cautious about the many claims made by SCAM enthusiasts; if it sounds too good to be true, it probably is!
The Lightning Process (LP) is a therapy for ME based on ideas from osteopathy, life coaching, and neuro-linguistic programming. LP is claimed to work by teaching people to use their brains to “stimulate health-promoting neural pathways”. One young patient once described it as follows: “Whenever you get a negative thought, emotional symptom, you are supposed to turn on one side and with your arm movements in a kind if stop motion, just say STOP very firmly and that is supposed to cut off the adrenaline response.”
Allegedly, the LP teaches individuals to recognize when they are stimulating or triggering unhelpful physiological responses and to avoid these, using a set of standardized questions, new language patterns, and physical movements with the aim of improving a more appropriate response to situations. The LP involves three group sessions on consecutive days where participants are taught theories and skills, which are then practiced through simple steps, posture, and coaching.
Does LP work?
Some think it does, particularly in Norway, it seems.
Proponents of the ‘LP’ in Norway claim that 90% of all ME patients get better after trying it. However, such claims seem to be more than questionable.
- In the Norwegian ME association’s user survey from 2012 with 1,096 participants, 164 ME patients stated that they had tried LP. 21% of these patients experienced improvement or great improvement and 48% got worse or much worse.
- In Norway’s National Research Center in Complementary and Alternative Medicine, NAFKAM’s survey from 2015 amongst 76 patients 8 had a positive effect and 5 got worse or much worse.
- A survey by the Norwegian research foundation, published in the journal Psykologisk, with 660 participants, showed that 62 patients had tried LP, and 5 were very or fairly satisfied with the results.
Such figures seem to reflect the natural history of the condition and may be totally unrelated to LP.
The LP instructors’ claims of a 90% positive effect are used for marketing and for lobbying. Their aim is to influence politicians, health authorities, and welfare and disability benefits authorities. They want to get the LP course approved as part of the public health service.
The company ‘Aktiv Prosess’ was started by LP instructors Live Landmark and Vibeke C. Hammer. In an article in the Norwegian medical journal Tidsskriftet in 2016, Landmark describes her own customer satisfaction survey from 2008 as «generating a hypothesis». Landmark has also written a book about her personal story and holds lectures for medical students, medical doctors, and nurses. Now she is trying to run a clinical trial which, many experts believe, is far from rigorous and set up to produce a positive result.
Positive experiences with LP have received massive media coverage for 15 years. Anecdotes are recycled in the media and give the impression of being a higher number than reality. We rarely hear about those who deteriorated: https://lp-fortellinger.no/ (English language link here).
The NICE guidelines for ME/CFS specifically (and in my view rightly) warn against offering LP to ME patients.
‘Bio’ – from biology
‘kin’ – from kinetics
‘ergy’ – not from energy as in physics but vital force as in chi and TCM
Together, these three terms give BIOKINERGY
Biokinergy is hardly well-known in most countries. Yet, in France, it’s all the rage. It is a manual therapy that allegedly restores the mobility of the patient’s body and increases the elasticity of its tissues while supporting the circulatory and nervous systems as well as our biological and psycho-emotional balance. It is said to incorporate concepts from osteopathy, fascia techniques, and Traditional Chinese Medicine.
Am I the only one who finds this more than a bit vague and full of platitudes?
So, what is biokinergy really?
Apparently, it is based on 4 main principles:
- Biomechanics
Biokinergy takes into account the release of blockages and the rebalancing of the mobility of the different structures and tissue layers (bones, viscera, muscles, subcutaneous tissues, skin), through innovative neuro-informational processes
2. Fasciatherapy
Richly innervated, the fascias envelop, partition, and connect all our structures without discontinuity from head to toe and, as Dr. Guimberteau’s work has shown, from the skin to the depths of the bone. Their tensions are at the origin of pain, visceral dysfunctions, and disturbances of vascular and nervous exchanges which alter the functional balance of the organism. The fascia techniques developed at CERB aim, through specific treatment of the different strata of fascia, to cure all these disturbances
3. Energetics
The energetic action aims to regulate the metabolic and biochemical activity and the exchange of information that is constantly taking place between the different tissues of the body by circulatory, nervous, and electromagnetic means and by means of the meridians of Traditional Chinese Medicine.
4.Psychosomatic
As a place of affects, representations, emotions, and a tool for relationships, the body expresses our emotional damage through its tissue tensions and dysfunctions. By using the body as a mediation, Biokinergie develops a psycho-corporal approach with a therapeutic, prophylactic, and preventive aim. By going back to the origin of the stress, inscribed in the tissues, it allows patients to free themselves from their conscious and unconscious blockages in order to find a physical, emotional, and mental balance.
Biokinergy was developed by Michel LIDOREAU, a physiotherapist and osteopath, who studied shiatsu and Chinese massage. At the beginning of the 1980s, he claims to have discovered specific tissue tensions in our body, associated with both joint blockages and energetic imbalances. This led to the invention of biokinergy.
Personally, I am still puzzled and unclear about what all this is supposed to mean. Perhaps we get a bit further if we ask what the therapy is used for.
The aim of biokinergy, I learn from this seemingly competent source, is not to treat only the symptoms but to takle their causes. The body is a whole, and its imbalances can be expressed symptomatologically very far from their origin. It is important to understand that pathology is not a coincidence, but results from the accumulation of a multitude of imbalances that must be treated together if we want to be effective quickly and in the long term.
The body has an amazing memory capacity. It keeps track of all our traumas (falls, repetitive gestures, false movements, emotional shocks, fatigue, stress) in the form of tensions, blockages, and energetic [biological, metabolic] imbalances. Initially, the body compensates and adapts, but gradually these disorders add up. They then end up hampering the functioning of the joints, disturbing the activity of the organs and compressing the blood vessels and nerves. The conduction of blood and nerve impulses is no longer done correctly, which favors the installation of biological disorders, the inflammation of tissues, and the appearance of pain (tendonitis, arthritis, gastritis, colitis, etc.). This can gradually lead to tissue degeneration.
The aim of a Biokinergy treatment is therefore to restore the body’s optimal functioning by restoring the function of all systems (locomotor, visceral, vascular, nervous, hormonal, etc.); this is done by releasing areas of tension and blockages, to restore flexibility to the tissues and free up, among others, the vascular and nervous axes.
Blast! I am getting more and more lost here. This just does not make much sense. Perhaps it is best to ask what actually happens during a therapy session. Again, the seemingly competent source offers some information:
A Biokinergy session lasts about 1 hour. After a precise interrogation, it consists in “reading” the body to find the tissue windings in order to reharmonize them. Bearing in mind that the human organism forms a whole, the biokinergist applies, from coil to coil, the corrections adapted to the disorders encountered. The techniques are gentle.
Well, this isn’t all that clear either.
Let’s take another approach: is there any evidence that biokinergy works? My Medline search gives a very clear answer: “Your search for biokinergy retrieved no results.”
So, now we know!
Biokinergy serves only one proven purpose: it improves the bank balance of the therapist.
I have been informed by the publisher, that my book has been published yesterday. This is about two months earlier than it was announced on Amazon. It is in German – yes, I have started writing in German again. But not to worry, I translated the preface for you:
Anyone who falls ill in Germany and therefore needs professional assistance has the choice, either to consult a doctor or a non-medical practitioner (Heilpraktiker).
– The doctor has studied and is licensed to practice medicine; the Heilpraktiker is state-recognized and has passed an official medical examination.
– The doctor is usually in a hurry, while the Heilpraktiker takes his time and empathizes with his patient.
– The doctor usually prescribes a drug burdened with side effects, while the Heilpraktiker prefers the gentle methods of alternative medicine.
So who should the sick person turn to? Heilpraktiker or doctor? Many people are confused by the existence of these parallel medical worlds. Quite a few finally decide in favor of the supposedly natural, empathetic, time-tested medicine of the Heilpraktiker. The state recognition gives them the necessary confidence to be in good hands there. The far-reaching freedoms the Heilpraktiker has by law, as well as the coverage of costs by many health insurances, are conducive to further strengthening this trust. “We Heilpraktiker are recognized and respected in politics and society,” writes Elvira Bierbach self-confidently, the publisher of a standard textbook for Heilpraktiker.
The first consultation of our model patient with the Heilpraktiker of his choice is promising. The Heilpraktiker responds to the patient with understanding, usually takes a whole hour for the initial consultation, gives explanations that seem plausible, is determined to get to the root of the problem, promises to stimulate the patient’s self-healing powers naturally, and invokes a colossal body of experience. It almost seems as if our patient’s decision to consult a Heilpraktiker was correct.
However, I have quite significant reservations about this. Heilpraktiker are perhaps recognized in politics and society, but from a medical, scientific, or ethical perspective, they are highly problematic. In this book, I will show in detail and with facts why.
The claim of government recognition undoubtedly gives the appearance that Heilpraktiker are adequately trained and medically competent. In reality, there is no regulated training, and the competence is not high. The official medical examination, which all Heilpraktiker must pass is nothing more than a test to ensure that there is no danger to the general public. The ideas of many Heilpraktiker regarding the function of the human body are often in stark contradiction with the known facts. The majority of Heilpraktiker-typical diagnostics is pure nonsense. The conditions that they diagnose are often based on little more than naive wishful thinking. The treatments that Heilpraktiker use are either disproven or not proven to be effective.
There is no question in my mind that Heilpraktiker are a danger to anyone who is seriously ill. And even if Heilpraktiker do not cause obvious harm, they almost never offer what is optimally possible. In my opinion, patients have the right to receive the most effective treatment for their condition. Consumers should not be misled about health-related issues. Only those who are well-informed will make the right decisions about their health.
My book provides this information in plain language and without mincing words. It is intended to save you from a dangerous misconception of the Heilpraktiker profession. Medical parallel worlds with the radically divergent quality standard – doctor/Heilpraktiker – are not in the interest of the patient and are simply unacceptable for an enlightened society.
When I was still at Exeter, I used to do an average of about 4 peer reviews per week of articles that had been submitted to all sorts of journals for publication. Now I reject most of these invitations and do perhaps just one per month.
Why?
Conducting a peer review is by no means an easy task. You have to realize that the authors have usually put a lot of hard work into their paper and a lot may depend on it in terms of their future. They thus have the right to receive a fair and responsible review. To do the job properly, it took me (even with plenty of experience in reading scientific papers) between 1 and 3 hours per article. Crucially, low-quality articles typically submitted to low-quality journals are more work than papers that adhere to a certain standard.
I do not think that the journal editors who send the submissions out for review appreciate how much work they ask from the reviewers. They normally pay nothing (even if they charge exorbitant handling fees from the authors) and offer you no benefit at all. In addition, many have systems that are more than tedious asking you to register, create a pin number, etc., etc. Then you have to follow certain rules and formats that differ from journal to journal. In a word, they add an administrative burden to the task of reading, understanding, checking a paper, and composing your judgment on it.
All this can be cumbersome but it’s not the reason why I do less and less peer reviews. The true reason is that research papers on so-called alternative medicine (SCAM) are now mostly published in one of the many 3rd class SCAM journals that have recently sprung up. There are so many of them that they, of course, struggle to get enough articles to fill their pages. In turn, this means that they are far too keen to publish anything regardless of its quality or validity. As a consequence, the quality of these articles and their authors are often dismal.
Here is an example of a (rather shocking but not unusual) email I received only today; it might show you what I mean:
Dear Professor!
…
I want to publish some papers in “Areas related to your research field”. Can you help me? I can provide a thank you fee!
For example, I will give you a $2000 thank you fee for helping me write articles. For example, if you add my name to your article, I will give you a $1000 thank you fee. Or I can help you pay for APC.
I know this email is presumptuous, but my friends and I need to publish dozens of papers every year. If you can help me, we can cooperate for a long time. I’m not kidding, I’m very sincere!
If you are offended, please forgive me!
Look forward to your reply!
Warmly Wishes, …
When I do a review for a low-quality SCAM journal and find major defects in an article, my experience has been that the editor then decides to publish it nonetheless. When this happens, I feel frustrated and ask myself: WHY DID THEY ASK FOR MY OPINION IF THEY DO NOT ABIDE BY IT?
Thus I decided that these journals are just as well off without my contributions. So, if you are an editor of a SCAM journal, do me a favor and do not molest me with your invitations to conduct a peer review and
COUNT ME OUT!
Homeopathy is touted as a panacea, we all know that. It is thus hardly surprising that it is also claimed to be an effective detox option. Here is a German article on the subject that I translated for you:
It was published on the independent health portal Lifeline. It claims that it “offers comprehensive, high-quality and understandably written information on health topics, diseases, nutrition, and fitness. Our editorial team is supported by doctors and freelance medical authors in the continuous creation and quality assurance of our content. Much of our information is multimedia-based with videos and informative image galleries. Numerous self-tests encourage interaction. In our expert advice and forums on various topics, Lifeline users can discuss topics with experts or exchange information with other users. Our information is in no way intended to be a substitute for a visit to the doctor. Rather, our aim is to qualitatively improve and support the relationship between doctor and patient through the information provided. Therefore, our contents do not serve the purpose of arbitrary diagnosis or treatment.”
And here is the article in question:
Environmental toxins, medications, nicotine, alcohol, unhealthy food – the human body is burdened daily by many substances, waste products and toxins. It is therefore sensible and beneficial to detoxify the liver regularly – preferably naturally. With these homeopathic remedies, this can be done gently.
To stay healthy or to prevent acute diseases from becoming chronic: The reasons to regularly rid the body of accumulated toxins are many. Toxins and waste products weaken the organism or can even cause illness themselves. Especially after drug treatments with antibiotics or cortisone, with frequently recurring colds and flu-like infections, it can be useful to detoxify the body naturally – with homeopathy.
In the body, the liver is the central organ where toxins are broken down. The kidneys, as organs of elimination, also play an important role in detoxification. To support the liver and kidneys in natural detoxification, various medicines are available. In homeopathy, detoxification is also called elimination.
Homeopathic medicines particularly suitable for the detoxification cure:
Sulfur: This classic homeopathic medicine has a strong detoxifying effect on connective tissue and mucous membranes, as well as a cleansing effect on the entire organism. In homeopathy, sulfur is mainly used for natural detoxification after drug treatments with antibiotics and cortisone. If the body is so heavily burdened with waste products that other homeopathic medicines have no effect, Sulfur can be used for natural detoxification.
Nux vomica: A very versatile homeopathic medicine is Nux vomica. It is particularly suitable for detoxifying the body naturally when one has consumed too many stimulants such as coffee or alcohol. It can also be used to eliminate harmful substances caused by medication. Nux vomica has proven particularly useful for the accompanying treatment of side effects after chemotherapy.
Pulsatilla: In homeopathy, Pulsatilla is considered an important natural remedy for detoxification, acting primarily on the mucous membranes and the stomach and intestines. Pulsatilla helps alleviate physical discomfort caused by eating too fatty, unhealthy foods, drinks that irritate the stomach such as coffee and alcohol, and taking medications. Pulsatilla works similarly to the detoxification classic sulfur, only the natural detoxification of liver and kidneys as well as connective tissue proceeds even more gently.
Arsenicum album: Within homeopathy, the remedy Arsenicum album is considered a universal remedy for poisoning, for example by heavy metals. It is mainly used for physical signs of exhaustion and weakness and can compensate for negative consequences of unhealthy nutrition. In addition, Arsenicum album is also said to have an anxiety-relieving effect.
Okoubaka: Okoubaba is also considered a medicine with a strong detoxifying effect, acting mainly on the gastrointestinal tract and used for abdominal cramps, flatulence, constipation, as well as acute diarrhea. Especially after a treatment with antibiotics or after having gone through an illness with norovirus, rotavirus or salmonella, Okoubaba can help to detoxify naturally and restore the intestinal flora.
Magnesium fluoratum: When cold symptoms such as cough and cold flare up again and again after administration of fever-reducing medications and other cold preparations, recovery is protracted and the body is weakened, natural detoxification with magnesium fluoratum can help.
Echinacea: Echinacea is known to increase the body’s defenses. As a homeopathic medicine, it can also help to naturally detoxify underlying conditions that have not been cured.
Detoxify naturally: Typical potencies and their dosage
Low potencies from D3 to D12 are commonly used for self-treatment in natural detoxification. However, choosing the right homeopathic remedy is not always easy. If there are uncertainties, an experienced homeopath should be asked for advice, if possible, in order to determine the drug, potency and dosage on the basis of a detailed anamnesis.
___________________________
Impressed?
No?
But I am – though not in a positive sense.
The article contains far too many unsubstantiated statements to mention. In fact, they are not just unsubstantiated, they are false! As the author does not even attempt to provide evidence for them, one cannot even dispute it. Suffice to say that ‘detox’ is BS and homeopathy too. And in healthcare ‘minus X minus’ does sadly not give ‘plus’.
What renders this otherwise trivial article rather important, in my view, is this: such web-based information is not the exception; quite the opposite: German consumers are bombarded with BS of this type.
Ever wondered why Germany is such a huge market for health fraud?
Now you know the answer!
It has been reported that Goop founder Gwyneth Paltrow now has taken to promoting the weirdest wellness thing she’s ever done: rectal ozone therapy. ‘I have used ozone therapy, rectally. Can I say that?’ she told Dear Media podcast The Art of Being Well. ‘It’s pretty weird. It’s pretty weird, yeah. But it’s been very helpful.’
The benefits of rectal ozone therapy are said to be reduced pain/inflammation, increased energy, improved metabolism/circulation, stimulated immune system, detoxification, anti-aging, and fighting bacterial/viral infections.
But who am I to criticize an authority like Gwyneth?
Therefore, I better look up the evidence! And if you had speculated that there is none, you would have been mistaken. Here are some of the more recent clinical studies listed in Medline:
Objective: Fibromyalgia is a chronic disorder with a very complex symptomatology. Although generalized severe pain is considered to be the cardinal symptom of the disease, many other associated symptoms, especially non-restorative sleep, chronic fatigue, anxiety, and depressive symptoms also play a relevant role in the degree of disability characteristic of the disease. Ozone therapy, which is used to treat a wide range of diseases and seems to be particularly useful in the treatment of many chronic diseases, is thought to act by exerting a mild, transient, and controlled oxidative stress that promotes an up-regulation of the antioxidant system and a modulation of the immune system. According to these mechanisms of action, it was hypothesized that ozone therapy could be useful in fibromyalgia management, where the employed therapies are very often ineffective.
Patients and methods: Sixty-five patients with fibromyalgia, according to the definition of the American College of Rheumatology (Arthritis Rheum 1990; 33: 160-172), were treated at the MEDE Clinic (Sacile, Pordenone, Italy) from February 2016 to October 2018. Females were 55 and males were 10; age ranged from 30 to 72 years, and the time from fibromyalgia diagnosis ranged from 0.5 to 33 years. Treatment was made by autohemotransfusion in 55 patients and by ozone rectal insufflations in 10 patients, according to SIOOT (Scientific Society of Oxygen Ozone Therapy) protocols, twice a week for one month and then twice a month as maintenance therapy.
Results: We found a significative improvement (>50% of symptoms) in 45 patients (70%). No patient reported important side effects. In conclusion, at our knowledge, this is the largest study of patients with fibromyalgia treated with ozone therapy reported in the literature and it demonstrates that the ozone therapy is an effective treatment for fibromyalgia patients without significant side effects.
Conclusions: At the moment, ozone therapy seems a treatment that, also because without any side effect, is possible to be proposed to patients with fibromyalgia that are not obtaining adequate results from other available treatments and it can be considered as complementary/integrative medicine.
No2:
Introduction: The Corona virus disease 19 (COVID-19) has accounted for multiple deaths and economic woes.While the entire medical fraternity and scientists are putting their best feet forward to find a solution to contain this deadly pandemic, there is a growing interest in integrating other known alternative therapies in to standard care. This study is aimed at evaluating the safety and efficacy of ozone therapy (OT), as an adjuvant to the standard of care (SOC).
Methods: In the current randomized control trial, 60 patients with mild to moderate score NEWS score were included in two parallel groups (n = 30/group). The interventional group (OZ) received ozonized rectal insufflation and minor auto haemotherapy, daily along with SOC, while the control group (ST) received SOC alone. The main outcome measures included changes in clinical features, oxygenation index (SpO2), NEWS score, Reverse transcription polymerase chain reaction(RT-PCR), inflammatory markers, requirement of advanced care, and metabolic profiles.
Results: The OZ group has shown clinically significant improvement in the mean values of all the parameters tested compared to ST Group. However, statistical significance were only observed in RT-PCR negative reaction (P = 0.01), changes in clinical symptoms (P < 0.05) and requirement for Intensive care (P < 0.05). No adverse events were reported in OZ group, as against 2 deaths reported in ST group.
Conclusion: OT when integrated with SOC can improve the clinical status and rapidly reduce the viral load compared to SOC alone, which facilitate early recovery and check the need for advanced care and mortality as demonstrated in this study.
Introduction: IgA deficiency is a primary immunodeficiency predominantly due to an antibody defect, for which there is no replacement therapy. Treatment consists of prevention and treatment of infections and other associated conditions. Given the immunomodulatory and regulatory properties of the redox balance of ozone therapy in infectious and inflammatory conditions, evaluation of its effect on IgA deficiency is of interest.
Objective: Assess the benefits and possible adverse effects of ozone treatment in patients with IgA deficiency.
Methods: A monocentric randomized controlled phase 2 clinical trial (RPCEC 00000236) was carried out, after approval by the Institutional Ethics Committee of the Roberto Rodríguez Fernández Provincial General Teaching Hospital in Morón, Ciego de Ávila Province, Cuba. Included were 40 patients aged 5-50 years, distributed in 2 groups of 20, after agreeing to participate and signing informed consent. The experimental group received 2 cycles of ozone by rectal insufflation for 20 days (5 times a week for 4 weeks each cycle) with a 3-month interval between cycles, for a total of 40 doses, with age-adjusted dose ranges. The control group was treated with leukocyte transfer factor (Hebertrans), 1 U per m2 of body surface area subcutaneously, once weekly for 12 weeks. Frequency of appearance and severity of clinical symptoms and signs of associated diseases, serum immunoglobulin concentrations and balance of pro-oxidant and antioxidant biomarkers were recorded at treatment initiation and one month after treatment completion. Therapeutic response was defined as complete, partial, stable disease or progressive disease. Descriptive statistics and significance were calculated to compare groups and assess effect size.
Results: One month after treatment completion, 70% of patients in the experimental group experienced significant increases in IgG(p = 0.000) and IgM (p = 0.033). The experimental group also displayed decreased pro-oxidation biomarkers, glutathione modulation and increased antioxidant enzymes, with reduced oxidative stress; none of these occurred in the control group. Complete therapeutic response was achieved in 85% of patients in the experimental group and only 45% in the control group. Mild, transient adverse events were reported in both groups.
Conclusions: Ozone therapy by rectal insufflation is a suitable therapeutic option for treating IgA deficiency because it produces antioxidant and immunomodulatory effects and is feasible, safe and minimally invasive.
Background: Ozone therapy may stimulate antioxidant systems and protect against free radicals. It has not been used formerly in patients with pulmonary emphysema.
Aim: To assess the effects of rectal ozone therapy in patients with pulmonary emphysema.
Material and methods: Sixty four patients with pulmonary emphysema, aged between 40 and 69 years, were randomly assigned to receive rectal ozone in 20 daily sessions, rectal medicinal oxygen or no treatment. Treatments were repeated three months later in the first two groups. At baseline and at the end of the study, spirometry and a clinical assessment were performed.
Results: fifty patients completed the protocol, 20 receiving ozone therapy, 20 receiving rectal oxygen and 10 not receiving any therapy. At baseline, patients on ozone therapy had significantly lower values of forced expiratory volume in the first second (fEV1) and fEV1/forced vital capacity. At the end of the treatment period, these parameters were similar in the three treatment groups, therefore they only improved significantly in the group on ozone therapy. No differences were observed in other spirometric parameters.
Conclusions: Rectal ozone therapy may be useful in patients with pulmonary emphysema.
Background: Pain secondary to chemotherapy-induced peripheral neuropathy (CIPN) can limit the administration of chemotherapy, cancer-treatment outcomes, and the quality of life of patients. Oxidative stress and inflammation are some of the key mechanisms involved in CIPN. Successful treatments for CIPN are limited. This report shows our preliminary experience using ozone treatment as a modulator of oxidative stress in chronic pain secondary to CIPN. Methods: Ozone treatment, by rectal insufflation, was administered in seven patients suffering from pain secondary to grade II or III CIPN. Pain was assessed by the visual analog scale (VAS). Results: All patients, except one, showed clinically relevant pain improvement. Median pain score according to the VAS was 7 (range: 5-8) before ozone treatment, 4 (range: 2-6) at the end of ozone treatment (p = 0.004), 5.5 (range: 1.8-6.3) 3 months after the end of ozone treatment (p = 0.008), and 6 (range: 2.6-6.6) 6 months after the end of ozone treatment (p = 0.008). The toxicity grade, according to the Common Terminology Criteria for Adverse Events (CTCAE v.5.0), improved in half of the patients. Conclusion: This report shows that most patients obtained clinically relevant and long-lasting improvement in chronic pain secondary to CIPN after treatment with ozone. These observed effects merit further research and support our ongoing randomized clinical trial.
Background: Medical ozone is more bactericidal, fungicidal, and virucidal than any other natural substance. Some studies proved that ozone infused into donated blood samples can kill viruses 100% of the time. Ozone, because of its special biologic properties, has theoretical and practical attributes to make it a potent hepatitis C virus (HCV) inactivator, which suggests an important role in the therapy for hepatitis C.
Aim: The study aim is to evaluate the role of ozone therapy in decreasing HCV ribonucleic acid (HCV RNA) load and its effect on the liver enzymes among patients with chronic hepatitis C.
Methods: This study included 52 patients with chronic hepatitis C (positive polymerase chain reaction [PCR] for HCV RNA and raised serum alanine transaminase [ALT] for more than 6 months). All patients were subjected to meticulous history taking and clinical examination. Complete blood count, liver function tests, and abdominal ultrasonography were requested for all patients. The ozone group included 40 patients who received major autohemotherapy, minor autohemotherapy, and rectal ozone insufflation. The other 12 patients (conventional group) received silymarin and/or multivitamins.
Results: There were significant improvements of most of the presenting symptoms of the patients in the ozone group in comparison to the conventional group. ALT and aspartate transaminase (AST) levels normalized in 57.5% and 60% in the ozone group, respectively, in comparison to 16.7% and 8% in the conventional group, respectively. Polymerase chain reaction (PCR) for HCV RNA was negative among 25% and 44.4% after 30 and 60 sessions of ozone therapy, respectively, in comparison to 8% among the conventional group.
Conclusions: Ozone therapy significantly improves the clinical symptoms associated with chronic hepatitis C and is associated with normalized ALT and AST levels among a significant number of patients. Ozone therapy is associated with disappearance of HCV RNA from the serum (-ve PCR for HCV RNA) in 25%-45% of patients with chronic hepatitis C.
Oxidative stress is suggested to have an important role in the development of complications in diabetes. Because ozone therapy can activate the antioxidant system, influencing the level of glycemia and some markers of endothelial cell damage, the aim of this study was to investigate the therapeutic efficacy of ozone in the treatment of patients with type 2 diabetes and diabetic feet and to compare ozone with antibiotic therapy. A randomized controlled clinical trial was performed with 101 patients divided into two groups: one (n = 52) treated with ozone (local and rectal insufflation of the gas) and the other (n = 49) treated with topical and systemic antibiotics. The efficacy of the treatments was evaluated by comparing the glycemic index, the area and perimeter of the lesions and biochemical markers of oxidative stress and endothelial damage in both groups after 20 days of treatment. Ozone treatment improved glycemic control, prevented oxidative stress, normalized levels of organic peroxides, and activated superoxide dismutase. The pharmacodynamic effect of ozone in the treatment of patients with neuroinfectious diabetic foot can be ascribed to the possibility of it being a superoxide scavenger. Superoxide is considered a link between the four metabolic routes associated with diabetes pathology and its complications. Furthermore, the healing of the lesions improved, resulting in fewer amputations than in control group. There were no side effects. These results show that medical ozone treatment could be an alternative therapy in the treatment of diabetes and its complications.
___________________________
What does that tell us?
That rectal ozone therapy is a panacea?
No, I don’t think so.
In my view, it tells us that strange journals publish a lot of dodgy research from strange research groups that use dodgy methodologies to confirm their odd belief that bogus treatments work for everything.
PS
I wonder which orifice Gwyneth will employ next to get the attention of the public.
It has been reported that King Charles refused to pay Prince Andrew’s £ 32,000-a-year bill for his personal healing guru. The Duke of York has allegedly submitted the claim to the Privy Purse as a royal expense having sought the help of a yoga teacher.
However, the claim has reportedly been denied by the King, who is said to have told Andrew the bill will need to be covered using his own money. It comes after sources claimed Andrew has been using the Indian yogi for a number of years for chanting, massages, and holistic therapy in the privacy of his mansion. The healer has reportedly enjoyed month-long stays at a time at the £30 million Royal Lodge in Windsor.
Previously, the Queen seems to have passed the claims. But now Charles is in control. A source said: “While the Queen was always happy to indulge her son over the years, Charles is far less inclined to fund such indulgences, particularly in an era of a cost-of-living crisis. “Families are struggling and would rightly baulk at the idea of tens of thousands paid to an Indian guru to provide holistic treatment to a non-working royal living in his grace and favour mansion. This time the King saw the bill for the healer submitted by Andrew to the Privy Purse and thought his brother was having a laugh.”
________________________
Poor Andrew!
How is he going to cope without his guru?
Will he be able to recover from the mysterious condition that prevents him to sweat?
Will his ego take another blow?
How will he be able to afford even the most basic holistic wellness?
How can Charles – who knows only too well about its benefits – be so cruel to his own brother?
Should I start a collection so that Andrew can pay for his most basic needs?
____________________________
Yes, these are the nagging questions and deep concerns that keep me awake at night!
PS
I have just been asked if, by any chance, the yoga teacher is a 16-year-old female. I have to admit that I cannot answer this question.
I recently came across this editorial from the NEJM. I find it extremely relevant to the many discussions we have about so-called alternative medicine (SCAM) we have on this blog. I, therefore, take the liberty to copy a small section of it here without further comment, and encourage everyone to read the full paper:
…expertise and authority are increasingly seen as means for elites to establish and support existing hierarchies. There is, of course, some substance to this argument: although orthodox doctors may believe that their dominance and privilege are attributable to the rigor of the methods they use and that other schools of medicine were vanquished because of the superior results achieved by science-based practice, another version of the story sees the suppression of other approaches to healing (e.g., naturopathy, homeopathy, or chiropractic) as the result of ruthless actions by the American Medical Association and other forms of organized medicine. These critiques aren’t new; as Lewis Grossman writes in Choose Your Medicine, “medical freedom” arguments have long been used to oppose institutions intended to protect consumers, such as medical licensure and the FDA.3 The difference today is that the antiexpertise perspective has moved into the mainstream. With Google and Amazon having created a world in which people can frictionlessly obtain both information and nearly any product they want, it’s not hard to portray expert gatekeepers as barriers to patients’ ability to exercise choice.
Perhaps the most substantial threat to expertise is that members of the public are coming to believe that facts don’t exist — that all facts are political and therefore a matter of opinion. This mindset is fundamentally incompatible with the scientific practice of medicine, which depends on a shared commitment to backing up hypotheses with empirical evidence. Indeed, modern medicine owes much of its privileged position to a broad acceptance that the methods it uses can be relied on to make medical choices that are likely to do more good than harm.
A 1902 Supreme Court case, American School of Magnetic Healing v. McAnnulty, offers an instructive example of what could happen if all medical facts were seen as purely matters of opinion. The American School of Magnetic Healing in Nevada, Missouri, received 3000 pieces of mail every day, largely consisting of checks, money orders, and cash to purchase the healing services that the school advertised in newspapers throughout the United States. Patients who sent payments were instructed to lie down at a specified time wherever they were, and the healers at the magnetic school would, from Nevada, channel the healing energy of the universe into their bodies to heal them.3 The Post Office Department (which predated the Postal Service) concluded that this practice was a fraudulent operation using the mail and, after a hearing conducted by the postmaster general, stopped delivering mail to the school. The school sued, and the case went to the Supreme Court, which found in its favor.
Writing for the Court, Justice Rufus Peckham essentially rejected the existence of medical facts. “Just exactly to what extent the mental condition affects the body,” he wrote, “no one can accurately and definitely say.… Because the [school] might or did claim to be able to effect cures by reason of working upon and affecting the mental powers of the individual… who can say that it is a fraud?… Those who might deny the existence or virtue of the remedy would only differ in opinion from those who assert it. There is no exact standard of absolute truth by which to prove the assertion false and a fraud.”4 Although this decision was never expressly overruled, both Congress and the courts have since rejected the premise that the efficacy of treatments is purely a matter of opinion.
Differences of opinion within medicine are necessary for progress, and both licensing and certifying boards must therefore be careful to leave room for the expression of divergent views. Moreover, there is ongoing debate regarding the extent to which free-speech protections cover professional speech. But despite the existence of divergent views and areas for legitimate debate, there are some opinions that have been so thoroughly repudiated by existing evidence as to be considered definitively wrong.5 Constructive debates are possible only within a shared epistemic framework and with a commitment to the idea of verifiable facts. It’s incumbent on licensing and certifying boards to defend the existence of facts and to give the public a way to know when practitioners are making claims that are incompatible with reality.
When it comes to disciplining doctors, boards haven’t always lived up to public expectations — but that’s not a reason they should fall short yet again, especially during a lethal pandemic. Although there are many gray areas in medicine, some propositions are objectively wrong. For example, when a licensed physician insists that viruses don’t cause disease or that Covid-19 vaccines magnetize people or connect them to cell towers, professional bodies must be able to take action in support of fact- and evidence-based practice.
The public relies on the medical profession in times of grievous vulnerability and need. For the profession to earn and maintain the public’s trust — along with the privileges associated with the status of being licensed practitioners — medical boards must be able to differentiate practitioners who are providing fact-based advice from those who are not.
