MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

charlatan

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

The homeopath and homeopathic entrepreneur Fran Sheffield has made appearances on this blog before; for instance, I quoted her stating that homeoprophylaxis has a remarkable record of safety – vaccines less so. From the homeopath’s point of view they are still associated with risks: the dose is too strong, they have toxic additives, and they’re given by inappropriate pathways. Homeoprophylaxis has avoided these problems. It’s also versatile, inexpensive, quick to produce and easy to distribute…

I believe such irresponsible nonsense brought her into trouble; a Federal judge concluded that: “there is no reasonable basis, in the sense of an adequate foundation, in medical science to enable the First Respondent and the Second Respondent to state that Homeopathic Treatments are safe and effective as an alternative to the Vaccine for the Prevention of Whooping Cough”.

Perhaps this is why Fran is now focussing on less contentious (but equally profitable) subjects? In any case, Fran is back with an article claiming that homeopathy is effective for treating over-sexed children and adults.

If you happen to be a bit under the weather today, you should read it – it will cheer you up, I am sure:

START OF QUOTE

Hyos [Hyoscyamus niger]…is frequently well-suited to over-sexualised behaviour in either children or adults. Other helpful remedies also exist but Hyos is especially useful when the child is prone to jealousy, foolishness, silly, irritating behaviour they refuse to stop, anxiety about water, twitching, jerking and grimacing, and restless hands that constantly move, touch and pull at things. While not all these symptoms have to be present before Hyos can be prescribed, some degree of similarity should exist. In pronounced cases, epilepsy and mania may be present.

When parents in my clinic first hear that a homeopathic remedy like Hyos can return their child’s over-sexualised behaviour back to normal they usually look at me with disbelief but within a week of taking a dose, significant changes have usually taken place. By the next appointment, some weeks later, I normally hear that the silly behaviour and jealousy have reduced – or gone completely – along with the inappropriate sexuality. All this and more from one simple remedy.

On reading this, if you are wondering if treatment has to be forever, the answer is no. As with any form of homeopathic treatment, when physical and behavioural symptoms improve, the remedy is given less often. Once the symptoms have stopped so is the remedy as the child is back to a healthy state and no further treatment is needed.

If your child has this embarrassing and annoying problem, hopefully it helps to know that its not “just the way they are” but  an imbalance that can be corrected. To achieve this, please see a reputable and qualified homeopath who can help you in your child’s treatment. The bonus is that as their precocious behaviour improves with treatment, so will their other health problems and life will become easier and more pleasant for all.

Fran Sheffield (Homeopath)

References

http://www.news.com.au/national/red-light-on-abnormal-child-sex-behaviour/story-e6frfkvr-1226264224011 

END OF QUOTE

If you think that Fran is an oddity amongst homeopaths in prescribing homeopathic remedies for sexual problems (or if you assume that there is a jot of evidence for homeopathic treatments of such conditions), you are mistaken. The Internet is full with similar advice. My favourite site must be this one because it offers very concrete help. Here are some of the prescriptions:

Some of the common and effective homeopathic remedies for treatment of loss of libido are Iodium, Plumbum Metallicum, Argentum Nitricum.

  • Iodium: A useful remedy in men with loss of sexual power, with atrophied testes.
  • Plumbum Metallicum: Valuable remedy in men with loss of sexual desire with constricted feeling of the testicles, and loss of sexual desire with progressive muscular atrophy.
  • Argentum Nitricum: Useful remedy in nervous and anxious men with Complete loss of libido or in whom erection fails when coition is attempted.

Some of the common remedies used in treatment of impotence are Agnus castus, Argentum nitricum, Caladium, Causticum, Lycopodium, Selenium metallicum, Staphysagria.

  • Agnus castus: If impotence develop after you have led a life of intense and frequent sexual activity for many years Agnus castus may be useful. If you feel a cold sensation in the genitals Agnus castus is indicated.
  • Argentum nitricum: Useful remedy in men whose erection fails when sexual intercourse is attempted, particularly if thinking about the problem makes it worse.
  • Caladium: Useful remedy for men whose genitals are completely limp…

The question that occurred to be when reading this is the following: Is there any conceivable stupidity in which homeopaths do not indulge?

 

After almost a life-time of exposure to seriously compact BS about alternative medicine, you would expect me to be used to it. And it’s true, I usually don’t bat an eyelash when someone writes nonsense about this or that therapy. But every once in a while, I come across an exception, some statement that is outstanding in its ‘naiveness’ (see below) or ground-breaking in its stupidity. When I found this article, for instance, I almost fell off my chair. So, please hold on tight, if you want to read on:

START OF QUOTE

Dr Edward Bach was a qualified allopathic physician. Later he got his degree in homoeopathy. He discovered 38 Bach flower remedies. Bach remedies are prescribed on basis of mental state of the patient it does not mean that this treatment is confined to the mental cases only. It simply means that the patient is cured physically and mentally by the remedy which is prescribed on the basis of mental symptoms only. ADHD is the disorder which shows the spectrum of signs & symptoms in both mental and physical plane hence Bach flower remedies are helpful in treating this condition.

Chestnut Bud

This is the remedy prepared by boiling the young twigs with shoots. This remedy has a lack of sufficient interest in present circumstances. Chestnut Bud relates to a state of a flighty mind, inattention, and a soul not yet grounded in maturity. Learning experiences of either a factual or moral kind are not integrated into the consciousness to the person’s full benefit. Chestnut bud child is restless and impulsive. The child lacks the power of concentration because of mental hurriedness or precipitation of thoughts. Chestnut child exhibits childish and foolish behaviour which we can relate to the remedies like Bufo, Baryta carb etc. These children are reckless, careless, they lack the power of reasoning. Chestnut bud has general weakness of memory, failure to retain learned material, this being either of factual or moral content. Chestnut bud also has naiveness, immaturity of mind/emotions, developmental delay. Children’s are hyperactive and impulsive they may show impulsive movements; lack of serenity and focused gaze. Chestnut bud is also helpful in kids who have symptoms like disobedience, commit anti-social acts, sins, crimes, again and again, factitious disorders and malingering.

Chestnut Bud has general weakness of memory, failure to retain learned material, this being either of factual or moral content. Chestnut Bud also has naiveness, the immaturity of mind/emotions, developmental delay. Children’s are hyperactive and impulsive they may show impulsive movements; lack of serenity and focused gaze. Chestnut bud is also helpful in kids who have symptoms like disobedience, commit anti-social acts, sins, crimes, again and again, factitious disorders and malingering.

Conclusion
Chestnut Bud helps to improve concentration power and moral growth in ADHD patients which are suffering from other behavioural disorders. It improves the power of reasoning. Many other Bach flower remedies depending upon the mental state of the child can be prescribed.

END OF QUOTE

This is a true treasure trove of fallacious reasoning!

My favourite is the opening argument: “Bach remedies are prescribed on basis of mental state of the patient… [which] means that the patient is cured physically and mentally by the remedy…” 

My runner-up is this statement: “ADHD is the disorder which shows the spectrum of signs & symptoms in both mental and physical plane hence Bach flower remedies are helpful in treating this condition.”

What sharp logic!

What tightly argued thought!

I think this is brilliant and totally convincing  (provided you suffer from terminal stupidity).

I was surprised to receive this email yesterday: “Hello Edzard Ernst, You may remember I got in touch last week regarding losing a loved one to the ravages of drugs or alcohol. I just wanted to remind you that Narconon is here to help. For over fifty years Narconon drug and alcohol rehabilitation centres have been successfully reversing the tide of addiction for men and woman from all walks of life. The Narconon programme has saved them from the misery of addiction, and the potential of an early grave. We not only address the cause of the addiction, we resolve them…”

The email was signed by a man from ‘Narconon International’. First I thought someone has been counting the empty bottles in my bin, then I read it again and noticed the word ‘NARCONON’ and remembered that I once wrote about it. A quick search located my article from THE GUARDIAN 2012:

Imagine a therapy that “enables an individual to rid himself of the harmful effects of drugs, toxins and other chemicals that lodge in the body and create a biochemical barrier to spiritual well-being“. If you were told that the treatment was entirely natural and had already “enabled hundreds of thousands to free themselves from the harmful effects of drugs and toxins and so achieve spiritual gains”, wouldn’t you be tempted to try it?

Who doesn’t want a body free of nasty chemicals? And who wouldn’t be delighted at the chance to counter a growing threat to an “advancement in mental … wellbeing”?

These claims are being made for the “Purification Rundown” (“Purif” for short) and the closely related Narconon detox programmes, which mainly consist of regular exercise, sauna and nutrition, with industrial doses of vitamins and minerals added for good measure. Some of the claims are quite specific: the Purif programme is supposed to increase your IQ, reduce the level of cancer-causing agents in your body, and even enable you to lose weight easily and quickly. The Narconon programme is more specifically targeted at drug and alcohol dependency and is claimed to have an impressive success rate of 75%.

Both programmes were developed by L Ron Hubbard (1911-1986) and are currently marketed by the Church of Scientology. The CoS is not generally known to be an organisation that promotes healthcare programmes. Hubbard, the pulp-fiction writer who founded the CoS, portrayed himself somewhat over-optimistically as a pioneer, innovator and nuclear physicist.

He taught his followers that, at their core, humans contain a “thetan”. After creating the universe, thetans accidentally became trapped in physical bodies and, through scientology, we can restore the immortal, omnipotent, god-like powers of the “thetan” within us. Weird stuff that is the preserve of Hollywood eccentrics, you might think, but perhaps the CoS’s detox-ventures are an attempt to conquer new territory?

A typical course of treatment lasts several weeks and consists of many hours of exercise and sauna every day. This regimen is supplemented with megadoses of vitamins and minerals, which can cause problems. Niacin, one vitamin that is given in high doses as part of the regimen, can be particularly dangerous. The US National Institutes of Health warns that at high doses it can cause “liver problems, gout, ulcers of the digestive tract, loss of vision, high blood sugar, irregular heartbeat, and other serious problems.” It should not be taken by people who already have liver damage.

Seven fatalities of people undergoing the Narconon programme are currently being investigated in Oklahoma, although the CoS says these deaths are not connected with the treatment regimen itself.

Whatever the truth regarding these deaths, a review of the evidence about the treatment regimen’s effectiveness – carried out by the Norwegian Knowledge Centre for the Health Services in 2008 – found no good evidence that the Narconon programme works:

There is currently no reliable evidence for the effectiveness of Narconon as a primary or secondary drug prevention program. This is partly due to the insufficient research evidence about Narconon and partly due to the non-experimental nature of the few studies that exist.

The claim that such detox treatments eliminate toxins from the body is, of course, easily testable. All we would need to do is define what toxin we are talking about and measure the change in levels of that toxin compared with a control group of volunteers who did not receive the detox.

But such studies are not available. Why? Do the marketing men believe in their own claims? Maybe they feel that profits and evidence are like fire and water? Or possibly the thetans have an aversion to science?

If you think that the Purif, Narconon or any other form of alternative detox eliminates toxins, you might be mistaken. Most clients have lost some money, many have lost their ability to think straight, some may even have lost their lives. But there is no reliable evidence that they have actually lost any toxins.

END OF MY 2012 ARTICLE

In 2012, I found no evidence to suggest that NARCONON works. Now, I looked again and found this article reporting a non-randomised, controlled study:

“In 2004, Narconon International developed a multi-module, universal prevention curriculum for high school ages based on drug abuse etiology, program quality management data, prevention theory and best practices. We review the curriculum and its rationale and test its ability to change drug use behavior, perceptions of risk/benefits, and general knowledge. After informed parental consent, approximately 1000 Oklahoma and Hawai’i high school students completed a modified Center for Substance Abuse Prevention (CSAP) Participant Outcome Measures for Discretionary Programs survey at three testing points: baseline, one month later, and six month follow-up. Schools assigned to experimental conditions scheduled the Narconon curriculum between the baseline and one-month follow-up test; schools in control conditions received drug education after the six-month follow-up. Student responses were analyzed controlling for baseline differences using analysis of covariance. At six month follow-up, youths who received the Narconon drug education curriculum showed reduced drug use compared with controls across all drug categories tested. The strongest effects were seen in all tobacco products and cigarette frequency followed by marijuana. There were also significant reductions measured for alcohol and amphetamines. The program also produced changes in knowledge, attitudes and perception of risk. The eight-module Narconon curriculum has thorough grounding in substance abuse etiology and prevention theory. Incorporating several historically successful prevention strategies this curriculum reduced drug use among youths.”

The question arises: would I send anyone to the NARCONON programme?

My answer is NO!

Not because the trial is lousy (which it is) and not because the programme is too expensive (which it is); I would not send anyone to any institution that has even the slightest links to Scientology.

 

Dr Gabriella Day is a GP in England who describes herself and her beliefs as follows: “I began training in homeopathy as it is clear that for many conditions conventional treatment options are not effective and can have unwanted side effects. It seemed to me that there must be another way to help people suffering from symptoms such as these… I believe in whole person medicine. No illness exists in isolation. The human body is immensely sophisticated and complicated and we do not understand it fully. Therefore the illness cannot be separated from the person suffering the disease. This may be as simple as stress impairing the immune system to far more complex interactions. Homeopathic treatment seeks to match the underlying disturbance in the system and stimulate the body to correct itself.”

I do not know Dr Day, but she caught my attention recently when she published an article in THE HIPPOCRATIC POST (I had never heard of this publication before!). It is, I think, sufficiently noteworthy to show you some excerpts (the references [in square brackets] were added by me, and they refer to my comments below):

START OF QUOTES

…Homeopathy can be helpful for pretty much any condition [1], whether as the main treatment [1], as a complement to a conventional treatment [2] to speed up the healing process [1], or to lessen the side-effects of a pharmacological medication [1]. It can be helpful in the treatment of emotional problems [1], physical problems [1] and for multi-morbidity patients [1]. I find it an invaluable tool in my GP’s toolbox and regularly see the benefits of homeopathy in the patients I treat [3]…

There are many conditions for which I have found homeopathy to be effective [1]… There are, however, a multitude of symptomatic treatments available to suppress symptoms, both on prescription and over-the-counter. Most symptoms experienced by patients in this context result from the body’s attempt to eliminate the infection. Our immune systems have spent thousands of years refining this response; therefore it seems counter-intuitive to suppress it [4].
For these types of acute conditions homeopathy can work with the body to support it [1]. For instance, homeopathic Arsenicum album (arsenic) is a classic remedy for diarrhoea and vomiting that can be taken alongside essential oral rehydration [1]. And in influenza I’ve found Eupatorium perfoliatum (ague or feverwort) to be very helpful if the patient is suffering with bony pain [3].
…Unless it is clinically imperative for a pharmacological intervention, I will always consider homeopathy first [5] and have successfully prescribed the homeopathic remedy Nux vomica (strychnine) for women suffering from morning sickness [5]. Problems associated with breastfeeding such as mastitis have also responded well to the classic remedies Belladonna (deadly nightshade) and Phytolacca (pokeweed), while I have found Urtica urens (dog nettle) effective in switching off the milk supply to prevent engorgement when the mother stops breastfeeding [3].
…“heart sink” patients are clearly suffering from pain and discomfort, which is blighting their lives. This is understandably frustrating for them, for they know full well something is awry but there is no medical evidence for this… Homeopathy affords me another approach in trying to help these patients [1,3]. It doesn’t work for them all, but I’m frequently surprised at how many it does help [3].

Positive side-effects

The beauty of homeopathy is that it combines mental and emotional symptoms with physical symptoms [3]. When the right remedy is found it appears to stimulate the body to recognise how it is being dysfunctional and corrects this, with no suppression, just a correction of the underlying disturbance [3]. Thus homeopathy not only eliminates unwanted symptoms [1], it dramatically improves a patient’s overall well-being [1].
…homeopathy… enables me to reduce the number of painkillers and other drugs I’m prescribing [1,3]. This is particularly true for older multi-morbidity, polypharmacy patients [1] who are often taking huge amounts of medication.
Contrary to what most homeopaths will tell you, I believe homeopathic treatment does have side-effects – positive side-effects! [1] It fosters an enhanced doctor patient relationship [1]. The process of eliciting the relevant information to select a remedy enables me to better understand the patient’s condition and helps me to get to know them better [3]. And the patient, seeing that the doctor is interested in the idiosyncrasies and detail of their disease, finds themselves heard and understood [3]. In short, since training in homeopathy I enjoy my job as a GP and my relationship with patients so much more [3].
Dr Gabriella Day BSc, MBBS, MRCP, DCH, MRCGP, MFHom

END OF QUOTES

MY COMMENTS:

  1. statement without good evidence,
  2. Hahnemann was vehemently against combining homeopathy with other treatments and called clinicians who disregarded this ‘traitors’,
  3. statement of belief,
  4. wrong assumption,
  5. questionable ethics.

I have recently attempted to slip into the brain of lay-homeopaths and shown how illogical, misguided and wrong the arguments of such enthusiasts really are. Surely, the logic of a doctor homeopath must be better, I then thought. Once you have studied medicine, you have learnt an awful lot of things about the body, disease, therapy, etc., etc., I felt.

Judging from the above article, I might have been wrong.

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

START OF QUOTE

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

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

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

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

END OF QUOTE

I find this story interesting. It reveals several things:

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

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

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

Currently, over 50 000 000 websites promote alternative medicine, and consumers are bombarded with information not just via the Internet, but also via newspapers, magazines and other sources. This has the potential of needlessly separating them from their cash or even seriously harming their health. As there is little that protects us from greedy entrepreneurs and over-enthusiastic therapists, we should think about protecting ourselves. Here I will provide five simple tips that may fortify you against fake news in the realm of alternative medicine.

Imagine you read somewhere that the condition you are affected by is curable (or at least improvable) by THERAPY XY. It is only natural that you are exited by this news. Before you now rush to the next health shop or alternative medicine centre, it is worth asking yourself the following questions:

  • Is the claim plausible? As a rule of thumb, it is fair to say that, if it sounds too good to be true, it probably is too good to be true. Not so long ago, UK newspapers reported that a herbal mixture called ‘CARCTOL’ had been discovered to be an efficacious and safe cancer cure (before that, it was Essiac, shark cartilage, Laetrile and many more). I only needed a minimal amount of research to find that the claim had no basis in fact. Come to think of it, it is not plausible that any alternative therapy will ever emerge as a miracle cure for any condition, particularly a serious disease like cancer. It is also not plausible that a herbal mixture would ever prove to be a cure for a wide range of different cancers. The very idea of such ‘cures’ is a contradiction in terms. If an alternative therapy ever did turn out to be efficacious, it would become mainstream even before the clinical tests to prove its efficacy are fully concluded. The notion of an alternative cure presumes that conventional scientists and clinicians reject a treatment simply because it originated from the realm of alternative medicine. There is no precedent that this has ever occurred, and I am sure it will never happen in future.
  • What is the evidence for the claim? In the case of CARCTOL, the claim was based on a UK doctor apparently observing that, in several patients, tumours had been melting like butter in the sun after they took this herbal mixture. One particularly irresponsible headline read: “I’ve seen herbal remedy make tumours disappear, says respected cancer doctor.” This, however, is no evidence but mere anecdotes, and we confuse the two at our peril. Remember: the plural of anecdote is anecdotes, not evidence. With anecdotes, we can never be sure about cause and effect. Therapeutic claims must be based on good evidence, e.g. controlled clinical trials.
  • Who is behind the claim? In the UK, the CARCTOL claim emerged around 2004 and originated mainly from Dr Rosy Daniel. In the above newspaper article, she was called ‘a respected cancer doctor’. Personally, I do NOT ‘respect’  someone who makes claims of this nature without having good evidence. And a ‘cancer doctor’ is usually understood to be an oncologist; to the best of my knowledge, Dr Daniel is NOT an oncologist. In fact, she now calls herself a ‘Lifestyle and Integrative Medicine Consultant’. Faced with an important new health claim, one should always check who is behind it. Check out whether this person is reputable and free of conflicts of interest. An affiliation to a reputable university is usually more convincing than being a director of your own private heath centre.
  • Where was the claim published? The CARCTOL story had been published in newspapers – and nowhere else! Even today, there is only one Medline-listed publication on the subject. It is my own review of the evidence which, in 2004, concluded that “The claim that Carctol is of any benefit to cancer patients is not supported by scientific evidence.”   *** If important new therapeutic claims like ‘therapy xy cures cancer’ are reported in the popular media, you should always check where they were first published (or simply dismiss it without researching it). It is unthinkable that such an important claim is not made first in a proper, peer-reviewed article in a good medical journal. Go on ‘Medline’, conduct a quick search and find out whether the new findings have been published. If the claim does not come from peer-reviewed journals, forget about it. If it has been published in any journal that has alternative, complementary, integrative or similar terms in its name, take it with a good pinch of salt.
  • Is there money involved? In the case of CARCTOL, the costs were high. I was called once by a woman who had read my article telling me that she was pursued by the doctor who had treated her husband. Tragically, the man had nevertheless died of his cancer, and the widow was now pursued for £8 000 which she understandably was reluctant to pay. Many new treatments are expensive. So, high costs are not necessarily suspicious. Still, I advise you to be extra cautious in situations where there is the potential for someone to make a fast buck. Financial exploitation is sadly rife in the realm of alternative medicine.

A similar checklist originates from a team of experts. Researchers from Uganda, Kenya, Rwanda, Norway, and England, worked to identify the most important ideas a person would need to grasp thinking critically about health claims. They came up with excellent points:

  1. Just because a treatment is popular or old does not mean it’s beneficial or safe.
  2. New, brand-name, or more expensive treatments may not be better than older ones.
  3. Treatments usually come with both harms and benefits.
  4. Beware of conflicts of interest — they can lead to misleading claims about treatments.
  5. Personal experiences, expert opinions, and anecdotes aren’t a reliable basis for assessing the effects of most treatments.
  6. Instead, health claims should be based on high-quality, randomized controlled trials.

Alternative medicine can easily turn into a jungle or even a nightmare. Before you fall for any dubious claim that THERAPY XY is good for you, please go through the simple sets of questions above. This might protect you from getting ripped off or – more importantly – from getting harmed.

 

*** After this article had been published, I received letters from layers threatening me with legal action unless I withdrew the paper. I decided to ignore them, and no legal action followed.

The title of the article actually was ‘SIX REASONS TO TRY A WEATGRASS COLONIC’. I will only repeat parts of the introduction, but please do take the time to read the full text, particularly if you feel sad or depressed – it is hilarious!

START OF QUOTE

If you’ve ever had a colonoscopy, then you may be familiar with colonics. Colon cleansing is normally used to prepare for medical procedures. However, some alternative medicine practitioners might offer colon cleansing for other reasons, such as detoxification. During a colon cleanse, large amounts of water are flushed through the colon, along with other ingredients, such as herbs, teas, juice or coffee. This takes place with a tube that’s inserted into the rectum. In some cases, and depending on the colonic, smaller amounts of water along with other substances are left in the colon for about 30 minutes before being removed.

Wheatgrass is a humble weed that has a wide variety of health benefits for the body due to high concentrations of chlorophyll, active enzymes, vitamins and other nutrients. According to Israeli research on wheatgrass, lab studies suggest that it may have anticancer potential. In animal experiments, wheatgrass demonstrated possible benefits in cancer prevention and as an aid to cancer treatment — particularly chemotherapy. In clinical trials wheatgrass was found to improve chemotherapy and decrease chemotherapy-related side effects.

Wheatgrass has also been found to support the immune system and help repair damaged cells. It’s also shown promise for conditions such as:

  • Rheumatoid arthritis
  • Ulcerative colitis
  • Hematological diseases
  • Diabetes
  • Obesity
  • Oxidative stress (the body’s ability to repair damage)

Wheatgrass colonics cleanse and nourish the colon, according to digestive wellness center Vitallife. And effects are felt almost immediately. This is attributed to wheatgrass’s dense nutrient profile, which contains over 90 minerals, and the high absorption rate of the colon. Both factors allow for easy and fast entry into the bloodstream.

END OF QUOTE

The article motivated me to come up with my SIX REASONS TO AVOID A WHEATGRASS COLONIC. Here they are:

  1. The treatment is not effective.
  2. It is uncomfortable.
  3. It is not safe.
  4. It costs money.
  5. It has no plausibility.
  6. There are better therapeutic options for whatever condition you want to treat.

I know, some of my reasons are not entirely scientific or fully evidence-based. But, if you read the article which inspired me to write this post, you will discover, I am sure, that my version is a whole dimension better than the original.

In their now famous 1998 NEJM editorial about alternative medicine, Angell and Kassirer concluded that “It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments.”

Then and today, I entirely agree(d) with these sentiments. Years later, the comedian Tim Minchin brought it to the point: “You know what they call alternative medicine that’s been proved to work? – Medicine.”  So, comedians have solved the terminology problem, but we, the experts, have not managed to get rid of the notion that there is another type of medicine. Almost 20 years after the above editorial, we still struggle to find the ideal name.

Despite their desperate demand ‘THERE CANNOT BE TWO KINDS OF MEDICINE’, Angell and Kassirer still used the word ALTERNATIVE MEDICINE. On this blog, I usually do the same. But there are many terms, and it is only fair to ask: which one is the most suitable?

  1. ALTERNATIVE MEDICINE is strictly speaking an umbrella term for modalities (therapy or diagnostic technique) employed as a replacement of conventional medicine; more commonly the term is used for all heterodox modalities.
  2. CHARLATANERY treatment by someone who professes to have expertise that he does not have.
  3. COMPLEMENTATY MEDICINE is an umbrella term for modalities usually employed as an adjunct to conventional healthcare.
  4. COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) an umbrella term for both 1 and 3 often used because the same alternative modality  can be employed either as a replacement of or an add-on to conventional medicine.
  5. COMPLEMENTARY AND INTEGRATIVE MEDICINE (CIM) a nonsensical term recently created by authors of an equally nonsensical BMJ review.
  6. DISPROVEN MEDICINE is an umbrella term for treatments that have been shown not to work (as proving a negative is usually impossible, there are not many such therapies).
  7. FRINGE MEDICINE is the term formerly used for alternative medicine.
  8. HETERODOX MEDICINE is the linguistically correct term for unorthodox medicine (this could be the most correct term but has the disadvantage that consumers are not familiar with it).
  9. HOLISTIC MEDICINE is healthcare that emphasises whole patient care (as all good medicine is by definition holistic, the term seems problematic).
  10. INTEGRATED MEDICINE describes the use of treatments that allegedly incorporate ‘the best of both worlds’, i.e. the best of alternative and conventional healthcare (integrated medicine can be shown to be little more than a smokescreen for adopting bogus treatments in conventional medicine).
  11. INTEGRATIVE MEDICINE is the same as 10 (10 is more common in the UK, 11 is more common in the US).
  12. NATURAL MEDICINE is healthcare exclusively employing the means provided by nature for treating disease.
  13. QUACKERY is the deliberate misinterpretation of the ability of a treatment or diagnostic technique to treat or diagnose disease (quackery exists in all types of healthcare).
  14. TRADITIONAL MEDICINE is healthcare that has been in use before the scientific era (the assumption is that such treatments have stood the test of time).
  15. UNCONVENTIONAL MEDICINE is healthcare not normally used in conventional medicine (this would include off-label use of drugs, for instance, and therefore does not differentiate well).
  16. UNORTHODOX MEDICINE the linguistically incorrect but often used term for healthcare that is not normally used in orthodox medicine.
  17. UNPROVEN MEDICINE is healthcare that lacks scientific proof (many conventional therapies fall in this category too).

These terms and explanations (mostly my own) are meant to bring out clearly that:

  • none of them is perfect,
  • none has ever been clearly defined,
  • none describes the area completely,
  • none is without considerable overlap to other terms,
  • none is really useful.

My conclusion, after pondering about these terms for many years (it can be an intensely boring issue!), is that the best solution would be to abandon all umbrella terms (see Angell and Kassirer above). Alas, that hardly seems practical when running a blog on the subject. I think therefore that I will continue to (mostly) use the term ALTERNATIVE MEDICINE (consumers understand it best, in my experience) … unless, of course, someone has a better idea.

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

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

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

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

NON-EXISTING DIAGNOSES

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

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

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

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

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

MEDICALIZING TRIVIALITIES

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

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

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

DEMONIZING CONVENTIONAL MEDICINE

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

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

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

DISEASE PREVENTION

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

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

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

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

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

CONCLUSIONS

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

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