During the last two decades, I have had ample occasion to study the pseudo-arguments of charlatans when trying to defend the indefensible. Here I will try to disclose some of them in the hope that this might help others to identify charlatans more easily and to react accordingly.
Let’s say someone publishes a document showing evidence that homeopathy is a useless therapy. Naturally, this will annoy the many believers in homeopathy, and they will counter by attempting to make a range of points:
- THEY WILL STATE THAT THERE IS EVIDENCE TO THE CONTRARY. For instance, proponents of homeopathy can produce studies that seem to ‘prove’ homeopathy’s efficacy. The facts that these are flawed or irreproducible, and that the totality of the evidence is not positive does hardly ever bother them. Charlatans are born cherry-pickers.
- THEY WILL SUGGEST THAT THE EXISTING EVIDENCE HAS BEEN MIS-QUOTED. Often they will cite out of context from original studies one or two sentences which seem to indicate that they are correct. Any reminders that these quotes are meaningless fall on deaf ears.
- THEY WILL SAY THAT THE PUBLISHED EVIDENCE WAS MISINTERPRETED. Often the evidence is complex and can therefore be open to interpretation. Charlatans use this fact and spin the evidence such that it suits their needs. Charlatans are spin-doctors.
- THEY WILL SAY THAT SCIENTIFIC EVIDENCE IS OVER-RULED BY CENTURIES OF EXPERIENCE. The notion that millions of satisfied customers cannot be wrong is used frequently to distract from negative evidence. The fact that such experience can be due to a host of non-specific effects, the natural history of the condition or regression to the mean will not convince the charlatan.
- THEY WILL SUGGEST THAT THE AUTHOR IS PAID BY BIG PHARMA TO TRASH HOMEOPATHY. Whenever seemingly reasonable arguments have been exhausted, overtly irrational notions or blatant lies will come into play. The allegation that anyone criticising homeopathy is corrupt is one of the most popular such notion. The truth does not have a high value in charlatanry.
- THEY WILL SAY THAT THE CRITIC HAS NO TRAINING IN HOMEOPATHY AND IS THUS NOT COMPETENT. Equally popular is the claim that only trained and experienced homeopaths are able to judge over homeopathy. This pseudo-argument is most handy: experienced homeopaths are invariably believers, and the notion essentially claims that only those who believe in it can judge homeopathy. In other words, criticism of homeopathy is by definition invalid.
- THEY WILL SAY THAT THE CRITIC HAS PREVIOUSLY BEEN CRITICISED FOR HIS POOR RESEARCH. Similarly, homeopaths might claim that the critic is someone who is being criticised for being a very bad scientist; therefore, it would be a mistake to trust anything he or she says. Ad hominem is the name of the game!
- THEY WILL TRY TO RIDICULE THE CRITIC. Readers of this blog will have noticed how some commentators belittle their opponents by giving them laughable nicknames thus undermining their authority. The obvious aim is to make them look less than credible. Charlatans are like little children.
- THEY WILL CLAIM THAT IN OTHER AREAS OF HEALTHCARE THE EVIDENCE IS ALSO NOT CONVINCING. The ‘tu quoque’ fallacy is popular for distracting from the embarrassingly negative evidence in quackery – never mind that problems in the aviation industry are no argument for using flying carpets.
- THEY WILL POINT OUT HOW SAFE HOMEOPATHY IS COMPARED TO OTHER DRUGS. This is another form of the ‘tu quoque’ fallacy; it works very well for distracting from the problems with homeopathy and regularly convinces lay people.
- THEY WILL SAY THAT MEDICAL RESEARCH IS GENERALLY SO FLAWED THAT IT CANNOT BE TRUSTED. The fact that some medical research is less than rigorous is used here to claim that evidence in general is unreliable. The best solution is therefore to go by experience – a big step into the dark ages, but charlatans don’t seem to mind.
- THEY WILL REVERSE THE BURDEN OF PROOF. Homeopathy (or any other alternative therapy) may not have been proven to be effective, they claim, but it has not been proven to be ineffective. Therefore, they say, we must give it the benefit of the doubt. The facts that a) science cannot prove a negative and that b) we therefore should use those treatments that are supported by positive evidence is being ignored by charlatans.
These 12 pseudo-arguments are in my experience the most common defences of charlatanry. I am sure there are others – and I would be delighted if you did elaborate on them in the comments section below. Thanks!
Being exposed to a lot of gibberish in the comments’ section, some of my readers are probably wondering how much it takes to get blocked from commenting here. The ‘rules’ for this blog have been set out quite clearly from the start:
I do like clearly expressed views and intend to be as outspoken as politeness allows. I hope that commentators will do the same, no matter whether they agree or disagree with me. Yet a few, simple, principles should be observed by everyone commenting on my blog.
All posts have to be in English.
Libellous statements are not allowed.
Comments must be on topic.
Nothing published here should be taken as medical advice.
All my statements are comments in a legal sense.
Conflicts of interest should always be disclosed.
I will take the liberty of stopping the discussion on any particular topic, if I feel that enough has been said and things are getting boring or repetitive.
I will not post comments which are overtly nonsensical or in such poor English that I cannot understand them.
I will prevent commentators from monopolizing the discussion.
In the past, many of us – I included – have broken these rules. I felt that this was regrettable yet tolerable and let it pass. Nevertheless, I would like to take this opportunity to remind myself and everyone else to try their best to be polite, even when responding to someone who might seem utterly unhinged.
In the past, some commentators got banned for being consistently and intolerably offensive. The ‘rules’, however, fail to state when this should happen. So, let me try to explain it now: I take the liberty of blocking someone when he or she has repeatedly insults others without contributing meaningfully to the debate, particularly if there is no sign or hope of improvement.
These things are perhaps best explained by using an example.
So, here is one:
I am today blocking ‘zet1’ from making further comments on this blog.
As I take this step, I am already regretting it a little bit: zet1 has been a reliable, daily source of amusement for me, and I suspect others had to laugh just as much as I did about his ramblings – I assume zet1 is a male person. His comments are full of unintended humour, I find. Others may have enjoyed getting a glimpse at the sick mind of a fanatic believer in alternative medicine. Others again might have found zet1 an interesting study of increasingly paranoid behaviour.
Why then am I blocking him?
He has insulted just about everyone who does not share his bizarre creed; he has consistently posted utter nonsense; he does not contribute to any meaningful discussion; he seems far too deluded to ever make any sense whatsoever; he shows no signs of improvement. In case you feel that my judgement is too harsh, here are some excerpts from his recent comments:
Edzard Bastard… Yes, the seno doggy style!
Mojo, as you knows tour “skeptical activism” is part of the problem: fraud.
Ernst is clearly a fraud with extreme bias and severe conflicts of interests!
Not data little liar?
Tell me more zeno. tell me more. Can you need the help of Björn? Coward.
Fraud in NHMRC
Fraud in Evidence Check report
Caroline Watt the schizoid pseudoskeptic and paranormal “believer” against homeopathy.
Ernst the UFO pseudobeliever and modern Clinton propagandist.
Tracey Brown the corporate manager L & Reskin, Syngenta and Monsanto cofunder in Genetic Literacy.
David Gorski, H Hall and S. Novella the others…
The true Amaz!ing believers and gangster team of pseudoskepticsm, LOL!
The lack of coherence, fraud, links with industrial interests or ghost pseudoGNO (example: Nightingale Collaboration) or ex-“quacks”, is an strong indication of your biased propaganda. In the future, Ernst will appear as the boss of pseudoskeptical incoherence and big international fraud.
END OF QUOTES
Yes, this is hilariously funny comedy gold – and, in a way, we will miss him for that. On the other hand, it is unproductive and I feel increasingly embarrassed to give someone the opportunity to make such a fool of himself.
And this is what it really takes to get evicted from this blog.
Chiropractors have been shown to over-use X-rays (a worry about which I cautioned almost 20 years ago) and to refer for lumbar radiography inconsistent with the current clinical guidelines for low back pain. It is unknown whether this is due to lack of adherence with, or a lack of awareness of relevant guidelines. The aim of this study was to clarify this issue; more specifically, the authors wanted to determine Australian chiropractors’ awareness of, and reported adherence to, radiographic guidelines for low back pain.
An online survey was distributed to Australian chiropractors from July to September, 2014. Survey questions assessed demographic, chiropractic practice and radiographic usage characteristics, awareness of radiographic guidelines for low back pain and the level of agreement with current guidelines. Results were analysed with descriptive statistics and logistic regression analysis.
A total of 480 surveys were completed online. Only 49.6 % of the responders reported awareness of radiographic guidelines for low back pain. Chiropractors reported a likelihood of referring for radiographs for low back pain: in new patients (47.6 %); to confirm biomechanical pathologies (69.0 %); to perform biomechanical analysis (37.5 %); or to screen for contraindications (39.4 %). Chiropractors agreed that radiographs for low back pain could be useful for: acute low back pain (54.0 %); screening for contraindications (55.8 %); or to confirm diagnosis and direct treatment (61.3 %). Poorer adherence to current guidelines was seen, if the chiropractor referred to in-house radiographic facilities, practiced a technique other than diversified technique or was unaware or unsure of current radiographic guidelines for low back pain.
The authors of this paper concluded that only 50 % of Australian chiropractors report awareness of current radiographic guidelines for low back pain. A poorer awareness of guidelines is associated with an increase in the reported likelihood of use, and the perceived usefulness of radiographs for low back pain, in clinical situations that fall outside of current guidelines. Therefore, education strategies may help to increase guideline knowledge and compliance.
I am tempted to rephrase the last sentence: EDUCATION STRATEGIES MAY HELP TO INCREASE THE KNOWLEDGE THAT RESPONSIBLE HEALTHCARE PROFESSIONALS SHOULD WORK PRIMARILY FOR THE BENEFIT OF THEIR PATIENTS RATHER THAN FOR THE BENEFIT OF THEIR BANK ACCOUNTS.
In my view, this investigation confirms that:
- chiropractors still grossly over-use X-rays (it probably is fair to assume that the responders of this survey were relatively guideline-conform compared to non-responders; if that were true, the true figures of X-ray overuse would be even higher)
- they use X-rays for spurious reasons;
- they are ill-informed about the existing evidence;
- they have not abandoned the myth of ‘subluxation’, i. e. ‘biomechanical pathologies’.
Of course, the data are from Australia, and chiros elsewhere might claim that they are more guideline-conform than their Australian colleagues. But, in their discussion section, the authors of the present paper point out that “three previous studies have quantitatively assessed the adherence of registered chiropractors to radiographic guidelines for the management of low back pain (LBP). Two surveys performed in Canada with 26 and 32 responses respectively found that 63 and 59 % would use radiography for acute LBP without indicators of potential pathology and 68 and 66 % thought that radiography was useful in the evaluation of acute LBP.”
Are you or a family member ill?
No need to call a doctor or other healthcare professional!
Homeopathy DIY is the answer. The website of the NATIONAL CENTER FOR HOMEOPATHY tells you how and gives you concrete advice for specific conditions – at closer inspection, it turns out to be an instruction for killing off your entire family:
START OF QUOTE
It’s easy to get started using homeopathy at home. You don’t need to be an expert in anatomy, physiology, or pharmacology. You only need to be able to observe your and your family’s symptoms and any changes you might see in those symptoms. By using the information on this site you can quickly learn enough about homeopathy to use it at home to care for yourself and your family to address minor illnesses and injuries that don’t necessarily need a doctor’s care.
Asthma attacks occur for a variety of reasons. You can help treat asthma attacks with homeopathic remedies based on the type of attack that it is.
- Arsenicum album: anxiety, restlessness, unable to lie down because of feeling of suffocation shortly after midnight.
- Carbo vegetabilis: asthma attach occurs after long, spasmodic coughing spell with gagging or vomiting; patient feels worst after eating or talking; worse in the evening.
- Ipecacuanha: sudden onset of wheezing and feeling of suffocation; coughs constantly, but unable to bring up mucus; feeling of weight on chest.
- Nux vomica: attack often follows stomach upset with much belching; patient very irritable.
- Arnica: injury, shock.
- China: loss of blood.
- Carbo vegetabilis: steady oozing of dark blood; cold breath, cold limbs; cold, clammy sweat; air hunger.
- Ipecac: gushes of bright red blood, nausea, cold sweat.
- Sabina: threatened abortion and uterine hemorrhage.
- Phosphorus: profuse nosebleed, especially after vigorous blowing, or any hemorrhage; when small wounds bleed profusely.
Chicken pox can be uncomfortable and painful (for both the child and the parent) and the only way to deal with it is to wait for it to run its course. However, homeopathy can help speed up the healing process – and quickly calm the itch and irritation of this childhood illness.
Let’s look at the handful of remedies that are often called for in cases of chicken pox:
- Aconite: Early cases, with restlessness, anxiety and high fever.
- Antimonium tart: Delayed or receding, blue or pustular eruptions. Drowsy, sweaty and relaxed; nausea. Tardy eruption, to accelerate it. Associated with bronchitis, especially in children.
- Belladonna: Severe headache: face flushed; hot skin. Drowsiness with inability to sleep.
- Mercurius: To be used should vesicles discharge pus.
- Rhus toxicodendron: Intense, annoying itching. Generally the only remedy required; under its action the disease soon disappears.
- Sulphur: like with Rhus toxicodendron, rash is extremely annoying; very thirsty and hungry but takes more than can eat.
Croup can be very scary for parents… your child awakens at night coughing and gasping for air. Homeopathy works very well for these young patients.
There are a number of great homeopathic remedies to consider first when you confront this condition late some night:
- Aconite: This remedy should always be given at the first; it will often prove to be the only one needed, if given right, unless some other remedy is strongly, indicated. Aconite will be called for if there is a high fever, skin dry, much restlessness and distress. Cough and loud breathing during inspiration. Every expiration ends with a hoarse hacking cough.
- Arsenicum album: For croup with suffocative attacks at night; especially after midnight; croup before or after rashes or hives; patient cannot breath through nose; complaints with much restlessness and thirst, but for less quantity of water; aggravation after drinking.
- Bromine: Spasms of the larynx, suffocative cough, horse whistling, croupy sound with great effort; rattling breathing; gasping; impeded respiration, heat of the face, much rattling in larynx when coughing.
- Hepar sulph: If there is a rattling, choking cough, becoming worse particularly in the morning part of the night. Patient tends to be chilly. Cough can be worse from cold drafts or cold room – better warm moist air.
- Spongia: The cough is dry and silibant; or it sounds like a saw driven through a pine board, each cough corresponding to a thrust of the saw.
…The good news is that a small international team of experienced and heroic homeopaths have arrived in West Africa, and are currently on the ground working hard to examine patients, work out the “genus epidemicus,” and initiate clinical trials. This work is being done alongside the current conventional supportive measures and treatments already in place. We applaud and congratulate this team’s dedication and courage in joining the front lines in treating Ebola with homeopathy. The answer to whether homeopathic medicine has an important role in the Ebola epidemic could be forthcoming quite soon.
The flu can come on suddenly and stop you in your tracks – but there are many homeopathic remedies that can help bring relief and shorten the duration of the flu.
The following are some remedies that can bring relief during the flu:
- Arsenicum album: great prostration with extreme chilliness and a thirst for frequent sips of warm drinks. The eyes and nose stream with watery, acrid discharges. Feels irritable and anxious.
- Baptista: gastric flu with vomiting and diarrhea. Comes on suddenly. Feels sore and bruised all over. Profuse perspiration with a high fever and extreme thirst. Feels (and looks) dazed and sluggish.
- Bryonia: flu comes on slowly. Aching pains in all the joints are worse for the slightest motion. Painful dry cough that makes the head hurt. Extreme thirst at infrequent intervals. Feels intensely irritable and wants to be alone.
- Eupatorium perfoliatum: the pains are so severe it feels as if the bones are broken. The muscles ache and feel sore and bruised as well. A bursting headache with sore, aching eyeballs. The nose runs with much sneezing, and the chest feels sore and raw. Thirsty for cold water even though it brings on violent chills in the small of the back.
- Ferrum phosphoricum: a fever develops, a flu is likely but the symptoms aren’t clearly developed yet (and Aconite didn’t help). Take 3 doses every 2-4 hours.
- Gelsemium: flu comes on slowly especially when the weather changes from cold to warm. The muscles feel weak and achy. There’s a great feeling of heaviness everywhere-the head (which aches dully), limbs, eyelids, etc. No thist at all. Fever alternative with chills and shivers that run up and down the spine. Feels (and looks) apathetic, dull, and drowsy.
- Mercurius solubilis: fever with copious, extremely offensive perspiration that doesn’t provide any relief (unlike most feverish sweats). The breath smells bad, there’s more salivation than normal and an extreme thirst.
- Nux vomica: gastric flu with vomiting and diarrhea. The limbs and back ache a great deal. The nose runs during the day and is stopped up at night. Fever with chills and shivering especially after drinking. Very chilly and sensitive to the slightest draught of air or uncovering. Feels extremely impatient and irritable.
- Pyrogenium: serious flu with severe pains in the back and the limbs and a terrible, bursting headache. Feels beaten and bruised all over. Very restless and feels better on beginning to move. Chills in the back and the limbs with a thumping heart.
- Rhus toxicodendron: flu in cold, damp weather. Great restlessness: aching and stiffness in the joints is worse for first motion, it eases with continued motion and then they feel weak and have to rest after which they stiffen and have to move again. Pains are better for warmth. Feels anxious and weepy.
Hand, foot, and mouth disease (HFM) starts with a fever and shortly after, the spots appear. The spots are more like blisters and can show up on the soles of the feet, palms of the hands, and/or inside the mouth and back of the throat. The blisters in the mouth can be very painful, especially when your little one is trying to swallow or eat.
A child also might:
- develop fever, muscle aches, or other flu-like symptoms.
- become irritable or sleep more than usual.
- begin drooling (due to painful swallowing).
- gravitate toward cold fluids.
Try the following remedies when HFM makes an appearance in your house.
- Mercurius solubis: Mouth sores can be very severe, and the person is very sensitive to hot and cold; may have a fever before getting the blisters and may alternate between getting too hot with perspiration and becoming chilled at night; becoming too hot or too cold makes the person worse in general; blisters tend to be more painful at night; one of the characteristic symptoms of Mercurius is the tendency to drool or to have an excess of saliva in the mouth; the breath may be quite offensive with pus visible on the tonsils or elsewhere in the mouth.
- Antimonium tart: Chill stage of fever: gooseflesh and icy cold skin; heat stage of fever: clings to those around and wants to be carried; does not want to be touched or looked at; thirstless despite the dry parched tongue; wweat stage of fever: profuse, cold, clammy or sticky; dry, cracked, parched tongue with whitish discoloration in the centre; tongue tip and sides clean, moist and red; thrush; may crave apples or apple juice.
- Borax: Refuses to talk during fever; desire for cold drinks and cold food during fever; great heat and dryness of mouth with white ulcers (aphthae); white fungus-like growth; tender; ulcers bleed on touch and eating; painful red blisters on tongue; sore mouth prevents infants from nursing; fear of downward motion; startle easily; very sensitive to sudden noises.
While measles is probably best known for its full-body rash, the first symptoms of the infection are usually a hacking cough, runny nose, high fever, and red eyes that can be very sensitive to light. Characteristic markers of measles are Koplik’s spots, small red spots with blue-white centers that appear inside the mouth. The rash first appears on the face and then moves downwards and from the face downward.
- Euphrasia: Lots of mucus; a mouthful hawked up on cough; clears the throat frequently; cough during the day only and worse in the morning; better lying down; eyes – burning, watery and sensitive to light; eyelids burning, red and swollen; wind and light aggravate; nose – bland, watery unlike the watery discharge of the eyes which burns; throat might be sore with burning pain.
- Pulsatilla: thirstless; clinging and weepy; warm rooms and becoming warm aggravate; open air ameliorates; low fever and the itchy skin/eruptions are worse for heat; eruptions itching and worse for warmth with white or yellow discharge.
- Apis: eruptions painful, burning, hot, stinging with swelling where the skin looks shiny/puffy; thirstless; itching better for cold applications and worse for heat, especially heat of bed; if rash is slow to develop or is suppressed; better in general for fresh air, better with cold drinks.
- Bryonia: Rash/eruptions slow to come out or suppressed; warmth of the bed ameliorates; dryness and dislike of movement; headache has pain behind the eyeballs, bursting and violent, worse for moving; better for cold compresses and pressure; thirsty for large quantities of water all at once; motion aggravates; grumpy bear remedy – want to be left alone; throbbing/pulsating pains; dryness throughout all mucous membranes.
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I have only selected conditions that are potentially serious. Originally, I had intended to include all of them in this post, but half way through I gave up: there were just too many.
I am sure that most readers of the above advice would have – like I did – first have giggled a bit and then have felt increasingly angry and eventually slightly depressed: this glimpse into the way homeopaths think is revealing and frightening in equal measure.
I already hear the apologists say: This is unnecessarily alarmist; homeopathic remedies are safe, much safer than conventional medicines. My answer to these two points are as follows:
- Homeopathy does not normally harm patients via its remedies but by neglect: it is a non-treatment; and a non-treatment of a serious condition is always life-threatening.
- Sure, real medicines have risks, but they also have benefits. Responsible healthcare practitioners use those treatments where the benefits outweigh the risks.
I am so sorry we all missed this conference on ‘HOMEOPROPHYLAXIS’ !
The three-day meeting has ended yesterday.
It could have been a real eye-opener.
This is how it has been advertised:
This is THE conference for medical professionals, parents, and natural-minded healthcare providers to learn more about the evidence supporting the 200 year old practice of Homeoprophylaxis (HP), an immune boosting method that is safe and natural.
Homeoprophylaxis is internationally popular and proven method of protection against infectious disease. It is safe, natural, and does no harm. There are no toxins, preservatives, chemicals, or pathological particles. It works by naturally educating your child’s immune system to recognize and combat disease. Learn from our international panelists of doctors and researchers from across many field and schools of medicine at the upcoming HP Conference. Internationally recognized, our speakers have conducted research across the globe on HP immunization, and will be providing you with answers on their safety, effectiveness, and proven success.
You have to admit that this is eye-opening. If anyone ever doubted that (some) homeopaths were deluded to the point of being dangerous, they now have to see that they were mistaken.
- HP does not convey ‘natural immunity’.
- HP does not boost anything.
- HP is not safe; in fact it has the potential to kill millions through non-immunisation.
- HP is not natural.
- HP is luckily not popular; it is pursued merely by some extreme loons.
- HP is not proven.
- HP does not protect from infectious diseases.
- HP goes absolutely nothing to the immune system or any other organ function.
- HP does not combat disease.
- HP is certainly not ‘internationally recognised’ for anything but a criminally dangerous replacement of proper immunisation.
- HP is not of ‘proven success’.
All that HP truly provides is an indication as to how recklessly unethical and dangerously misleading homeopaths can be. As I wrote previously on this blog: I cannot think of anything in the realm of homeopathy that is more irresponsible than the promotion of HP.
A new nationally representative study from the US analysed ∼9000 children from the Child Complementary and Alternative Medicine File of the 2012 National Health Interview Survey. Adjusting for health services use factors, it examined influenza vaccination odds by ever using major CAM domains: (1) alternative medical systems (AMS; eg, acupuncture); (2) biologically-based therapies, excluding multivitamins/multiminerals (eg, herbal supplements); (3) multivitamins/multiminerals; (4) manipulative and body-based therapies (MBBT; eg, chiropractic manipulation); and (5) mind–body therapies (eg, yoga).
Influenza vaccination uptake was lower among children ever (versus never) using AMS (33% vs 43%; P = .008) or MBBT (35% vs 43%; P = .002) but higher by using multivitamins/multiminerals (45% vs 39%; P < .001). In multivariate analyses, multivitamin/multimineral use lost significance, but children ever (versus never) using any AMS or MBBT had lower uptake (respective odds ratios: 0.61 [95% confidence interval: 0.44–0.85]; and 0.74 [0.58–0.94]).
The authors concluded that children who have ever used certain CAM domains that may require contact with vaccine-hesitant CAM practitioners are vulnerable to lower annual uptake of influenza vaccination. Opportunity exists for US public health, policy, and medical professionals to improve child health by better engaging parents of children using particular domains of CAM and CAM practitioners advising them.
The fact that chiropractors, homeopaths and naturopaths tend to advise against immunisations is fairly well-documented. Unfortunately, this does not just happen in the US but it seems to be a global problem. The results presented here reflect this phenomenon very clearly. I have always categorised it as an indirect risk of alternative medicine and often stated that EVEN IF ALTERNATIVE THERAPIES WERE TOTALLY DEVOID OF RISKS, THE ALTERNATIVE PRACTITIONERS ARE NOT.
I have warned you before to be sceptical about Chinese studies. This is what I posted on this blog more than 2 years ago, for instance:
Imagine an area of therapeutics where 100% of all findings of hypothesis-testing research are positive, i.e. come to the conclusion that the treatment in question is effective. Theoretically, this could mean that the therapy is a miracle cure which is useful for every single condition in every single setting. But sadly, there are no miracle cures. Therefore something must be badly and worryingly amiss with the research in an area that generates 100% positive results.
Acupuncture is such an area; we and others have shown that Chinese trials of acupuncture hardly ever produce a negative finding. In other words, one does not need to read the paper, one already knows that it is positive – even more extreme: one does not need to conduct the study, one already knows the result before the research has started. But you might not believe my research nor that of others. We might be chauvinist bastards who want to discredit Chinese science. In this case, you might perhaps believe Chinese researchers.
In this systematic review, all randomized controlled trials (RCTs) of acupuncture published in Chinese journals were identified by a team of Chinese scientists. A total of 840 RCTs were found, including 727 RCTs comparing acupuncture with conventional treatment, 51 RCTs with no treatment controls, and 62 RCTs with sham-acupuncture controls. Among theses 840 RCTs, 838 studies (99.8%) reported positive results from primary outcomes and two trials (0.2%) reported negative results. The percentages of RCTs concealment of the information on withdraws or sample size calculations were 43.7%, 5.9%, 4.9%, 9.9%, and 1.7% respectively.
The authors concluded that publication bias might be major issue in RCTs on acupuncture published in Chinese journals reported, which is related to high risk of bias. We suggest that all trials should be prospectively registered in international trial registry in future.
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Now an even more compelling reason emerged for taking evidence from China with a pinch of salt:
A recent survey of clinical trials in China has revealed fraudulent practice on a massive scale. China’s food and drug regulator carried out a one-year review of clinical trials. They concluded that more than 80 percent of clinical data is “fabricated“. The review evaluated data from 1,622 clinical trial programs of new pharmaceutical drugs awaiting regulator approval for mass production. Officials are now warning that further evidence malpractice could still emerge in the scandal.
According to the report, much of the data gathered in clinical trials are incomplete, failed to meet analysis requirements or were untraceable. Some companies were suspected of deliberately hiding or deleting records of adverse effects, and tampering with data that did not meet expectations.
“Clinical data fabrication was an open secret even before the inspection,” the paper quoted an unnamed hospital chief as saying. Contract research organizations seem have become “accomplices in data fabrication due to cutthroat competition and economic motivation.”
A doctor at a top hospital in the northern city of Xian said the problem doesn’t lie with insufficient regulations governing clinical trials data, but with the failure to implement them. “There are national standards for clinical trials in the development of Western pharmaceuticals,” he said. “Clinical trials must be carried out in three phases, and they must be assessed at the very least for safety,” he said. “But I don’t know what happened here.”
Public safety problems in China aren’t limited to the pharmaceutical industry and the figure of 80 percent is unlikely to surprise many in a country where citizens routinely engage in the bulk-buying of overseas-made goods like infant formula powder. Guangdong-based rights activist Mai Ke said there is an all-pervasive culture of fakery across all products made in the country. “It’s not just the medicines,” Mai said. “In China, everything is fake, and if there’s a profit in pharmaceuticals, then someone’s going to fake them too.” He said the problem also extends to traditional Chinese medicines, which are widely used in conjunction with Western pharmaceuticals across the healthcare system.
“It’s just harder to regulate the fakes with traditional medicines than it is with Western pharmaceuticals, which have strict manufacturing guidelines,” he said.
According to Luo, academic ethics is an underdeveloped field in China, leading to an academic culture that is accepting of manipulation of data. “I don’t think that the 80 percent figure is overstated,” Luo said.
And what should we conclude from all this?
I find it very difficult to reach a verdict that does not sound hopelessly chauvinistic but feel that we have little choice but to distrust the evidence that originates from China. At the very minimum, I think, we must scrutinise it thoroughly; whenever it looks too good to be true, we ought to discard it as unreliable and await independent replications.
A website I recently came across promised to teach me 7 things about acupuncture. This sort of thing is always of interest to me; so I read them with interest and found them so remarkable that I decided to reproduce them here:
1. Addiction recovery
Acupuncture calms and relaxes the mind making it easier for people to overcome addictions to drugs, cigarettes, and alcohol by reducing the anxiety and stress they feel when quitting.
2. Helps the body heal itself
The body contains natural pain relief chemicals, such as endorphins and has an amazing capacity for self-healing. Acupuncture helps stimulate the natural healing mechanisms and causes the body to manufacture pain relieving chemicals.
3. Builds a stronger immune system
The body’s immune system is negatively affected by stress, poor diet, illness and certain medical treatments, but acupuncture targets the underlying imbalances naturally and helps it to regain balance.
4. Eliminate that killer hangover
While it may not have been the best choice to finish off that bottle of wine, acupuncture can help the body detox and flush out the morning side effects.
5. Mood stabilizer
If you find yourself snapping at friends, family, or co-workers for unexplained reasons, acupuncture can get to the root of the problem, find the imbalance and help your body return to a healthier state of mind.
6. Chronic stomach problems
Some people suffer from stomach problems and never find the cause. Acupuncture targets your whole body, including the digestive tract and helps it to work in harmony with the rest of the body’s systems.
7. Coping with death
Grief can have an overwhelming effect on the body and manifest itself physically. Acupuncture helps reduce the anxiety of dealing with loss and help you cope with the stress.
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The ‘7 things’ are remarkably mislabelled – they should be called 7 lies! Let me explain:
- There are several Cochrane reviews on the subject of acupuncture for various addictions. Here are their conclusions: There is currently no evidence that auricular acupuncture is effective for the treatment of cocaine dependence. The evidence is not of high quality and is inconclusive. Further randomised trials of auricular acupuncture may be justified. There is no clear evidence that acupuncture is effective for smoking cessation. There is currently no evidence that auricular acupuncture is effective for the treatment of cocaine dependence. The evidence is not of high quality and is inconclusive. Further randomised trials of auricular acupuncture may be justified.
- Even if the ‘endorphin story’ is true (in my view, it’s but a theory), there is no good evidence that acupuncture enhances our body’s self-healing mechanisms via endorphins or any other mechanism.
- Stronger immune system? My foot! I have no idea where this claim comes from, certainly not from anything resembling good evidence.
- Acupuncture for hangover or detox? This is just a stupid joke with no evidential support. I imagine, however, that it is superb marketing.
- The same applies to acupuncture to ‘stabilize’ your mood.
- Unexplained stomach problems? Go and see a doctor! Here is the conclusion of a Cochrane review related to IBS which is one of the more common unexplained stomach complaint: Sham-controlled RCTs have found no benefits of acupuncture relative to a credible sham acupuncture control for IBS symptom severity or IBS-related quality of life.
- I am not aware of any good evidence to show that acupuncture could ease the grieving process; I even doubt that this would be such a good or desirable thing: grieving is a necessary and essential process.
So, what we have here are essentially 7 fat lies. Yes, I know, the literature and the internet are full of them. And I suspect that they are a prominent reason why acupuncture is fairly popular today. Lies are a major marketing tool of acupuncturists – but that does not mean that we should let them get away with them!
Bogus claims may be good for the cash flow of alternative practitioners, but they are certainly not good for our health and well-being; in fact, they can cost lives!!!
IN THIS SPIRIT, LET ME ADD SEVEN THINGS YOU DO NEED TO KNOW ABOUT ACUPUNCTURE
- Traditional acupuncture is based on complete hocus pocus and is therefore implausible.
- ‘Western’ acupuncture is based on endorphin and other theories, which are little more than that and at best THEORIES.
- Acupuncture is often promoted as a ‘cure all’ which is implausible and not supported by evidence.
- Meridians, acupoints chi and all the other things acupuncturists claim to exist are pure fantasy.
- For a small list of symptoms, acupuncture is backed up by some evidence, but this is less than convincing and could well turn out to rely on little more than placebo.
- The claim of acupuncturists that acupuncture is entirely safe is false.
- Acupuncture studies from China cannot be trusted.
Chiropractic for animals?
Yes, it can!!!
Animal Chiropractic “is a field of animal health care that focuses on the preservation and health of the neuro-musculo-skeletal system. Why? Nerves control everything that happens in your animals. Anything adversely affecting the nervous system will have detrimental effects that will resonate throughout the entire body. The command centers of the nervous system are the brain and spinal cord which are protected by the spine. The spine is a complex framework of bones (vertebra), ligaments, muscles and nerves. If the movement and biomechanics of the vertebra become dysfunctional, they can interfere with the performance of the nerves that are branching off of the spinal cord and going to the all of the muscles and organs. As this occurs, your animal can lose normal mobility; resulting in stiffness, tension, pain and even organ dysfunction. Additionally, when normal movement is affected, and left unattended, it will ultimately impact your animal’s entire wellbeing and quality of life…”
As you see, much the same nonsense as for human chiropractic is now also advertised for animals, particularly horses. Chiropractic for horses and other animals has become a thriving business; today there are even colleges that specialise in ‘educating’ animal chiropractors, and the ‘AMERICAN VETERINARY CHIROPRACTIC ASSOCIATION promotes “animal chiropractic to professionals and the public, and [acts] as the certifying agency for doctors who have undergone post-graduate animal chiropractic training. Members working together within their disciplines to expand and promote the knowledge and acceptance of animal chiropractic to their professions, the public and governments; locally, nationally and internationally.”
Recently I came across a remarkable website which promoted chiropractic specifically for horses. Here are a few paragraphs from the promotional text:
In recent years, the demand among horse owners for alternative equine therapies has spurred many veterinarians to explore therapies like acupuncture and chiropractic. Equine chiropractic techniques provide relief by restoring movement to the spinal column and promoting healthy neurologic functioning. In turn, the entire musculoskeletal system benefits, and the overall health of the animal increases.
Perhaps the greatest clinical application of chiropractic techniques is for animals with a vague sort of lameness that is not localized to any specific area, and for horses that experience a sudden decline in performance for seemingly no reason. These issues often relate back to musculoskeletal disorders that can be diagnosed through chiropractic techniques.
Some horse owners use chiropractic as a preventative measure. Subclinical conditions, meaning those that do not yet show symptoms, can often be detected by an equine chiropractor, as can abnormal biomechanics that could cause lameness down the road. Conditions that originate in the spine often result in a changed gait that can affect how force is applied to joints in the lower limbs. Over time, this shifted force can cause lameness, but chiropractic attention may help identify and deal with problems before they become a real issue…
Several situations can benefit from meeting with an equine chiropractor. The most significant sign that a horse could benefit from chiropractic treatment is pain. If the animal’s behavior suddenly changes or its posture seems abnormal, the horse may be experiencing pain. Similarly, reduced performance, refusing to jump, and tossing the head under saddle can indicate pain.
Owners should familiarize themselves with the many signs that a horse is experiencing pain. Some other indicators include chronic weight loss, sensitivity when being groomed, and difficulty turning. A chiropractor is a great option for identifying the issues leading to these behaviors and correcting them as quickly as possible — before the problems compound.
While pain is a great reason to seek equine chiropractic therapy, individuals may also want to consider the option if the horse is not responding to more conventional therapies. Chiropractors can also aid in recovery after significant trauma or lameness. However, horse owners should recognize that chiropractic therapy does not reverse degenerative changes already present, so working with a practitioner early in a disease’s progression can slow its advancement. Chiropractic may also help manage chronic conditions and prevent them from worsening…
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And where is the evidence for all this? I did a quick search and found virtually nothing to write home about. A review which I did locate made it clear why: “…only anecdotal evidence exists in horses…”
And that statement does, of course, prompt me to quickly remind everyone: THE PLURAL OF ANECDOTE IS ANECDOTES, NOT EVIDENCE!
What? Holistic dentistry? Dentists drilling holes in our teeth?
No, it is something quite different; this article tries to explain it in some detail:
… holistic dentistry involves an awareness of dental care as it relates to the entire person, with the belief that patients should be provided with information to make choices to enhance their personal health and wellness…
Some of the philosophies include:
— Alternatives to amalgam/mercury fillings
— Knowing and following proper mercury removal
— Multi-disciplinary, or integrated, health care
— Nutritional and preventive therapies and temporomandibular joint disorder therapy.
Personally, I find this sounds a bit like a string of platitudes designed to lure in new customers and boost the dental business. An awareness that the mouth and its content is part of the whole body is not a philosophy; alternatives to amalgam have existed since decades and are used by ‘normal’ dentists, integrated health care is a con, nutrition is part of conventional healthcare and temporomandibular joint disorders are most certainly an issue for conventional dentistry. Perhaps another article might do a better job at explaining what ‘holistic dentistry’ is all about:
…Holistic dentistry is not considered a specialty of the dental profession, but a philosophy of practice. For those dentists who take the concept to its core, holistic dentistry includes an understanding of each patient’s total well-being, from their specific cosmetic, structural, functional, and health-related dental needs to the concerns of their total body and its wellness. Holistic dentists tend to attract very health-conscious individuals.
Some of the things holistic dentists are especially concerned about are the mercury found in traditional amalgam dental fillings, fluoride in drinking water, and the potential relationship of root canal therapy to disease in other parts of the body. Holistic dentists’ primary focus is on the underlying reasons why a person has dental concerns, and then help correct those issues by strategic changes in diet, hygiene and lifestyle habits.
Natural remedies to prevent and arrest decay and periodontal (gum) disease can also be utilized. Many holistic dentists are skilled in advanced levels of nutritional physiology and use natural means of healing patients, often avoiding the more standard use of systemic antibiotics, pain control management and surgical procedures.
This partly describes what good dentists have always done and partly it seems to be nonsense. For instance, natural remedies for tooth decay and gum disease? Really? Which remedies precisely? I know of no such treatments that are backed by sound evidence. Let me try a third quote; this one is directly from the horse’s mouth (pun intended), i. e. from a holistic dentist:
Holistic Dentistry, many times referred to today as “Biological” or “Biocompatible” Dentistry, is based on the concept that the mouth and oral structures are an integrated part of the body. It is a paradigm or a philosophy within dentistry and not a specialty.
Holistic dentistry supports your choice to live a healthier, more natural and less toxic life. We bridge the gap between conventional clinical dentistry and natural healing modalities. All holistic health care models share basic philosophical foundations. They all promote health and well being through healthful nourishment, elimination of toxins, and the promotion of physical, mental and energetic balance.
|As holistic dentists we recognize that the mouth is connected to the body and that it cannot be viewed as an independent system. It is a reflection of the overall health of the body and much can be done to impact it both positively and negatively. Like many conventional dentists we first look to see if the foundation is solid. Are your gums bleeding and swollen? Is this a reflection of poor nutritional habits? Or are there signs of infection and disease? Are the teeth moving? Is there a stable bite? Can you chew comfortably on both sides of your mouth? Do you get frequent headaches? Are your teeth in harmony with your jaw joint? Are there signs of oral cancer?|
|We check the condition of the teeth themselves. Is there more filling than tooth structure? Are the fillings made from the most non-toxic materials available? Are they supporting the bite correctly? Will they be there in five years? Is there decay? Does your diet support your oral health? Then together with our patients we formulate a plan to determine what we can do to help you achieve a stable and healthy mouth. This examination can be a first visit scenario in many dental offices.|
|Holistic dentists also make fillings, take x-rays and use anesthesia to numb your mouth. However we only use mercury-free white fillings. More importantly, we take extra precautions when removing your old silver fillings to minimize your exposure to mercury vapor. Why don’t we use Mercury? Mercury is one of the heavy metal toxins implicated in Alzheimer’s Disease and autism. However according to the American Dental Association, it is a safe filling material and, as recently as two years ago, the Florida board of dentistry attempted to pass legislation to prevent doctors from advertising as mercury-free dentists.
In holistic dentistry we minimize your exposure to toxic substances in every area of our work. Therefore we use a digital computer generated x-ray unit to take your x-rays which reduces your exposure to radiation by as much as 90%. We don’t advocate the indiscriminant use of fluoride in adults or children, for it is a known poison (check the label on your toothpaste tube) and a commonly used pesticide. We have installed distilled water sources in our office to minimize bacterial contamination. We research and attend courses to find the safest and most biocompatible materials available for dental work. Further, because we recognize that each individual has a different threshold of tolerance for dental materials, we sometimes suggest further testing to determine an individual’s ability to tolerate particular restorative material over long periods of time.
Ultimately you are responsible for your own health. You can choose your health care partners consciously. You can reunite with a part of your body that has been disenfranchised and polluted with toxins. You can reclaim your own unity and wholeness by taking the time to notice what goes into your mouth and how it comes out of it. Your mouth is a sacred portal through which breath, mantra and food travel in and out of your body.
See what I mean?
This is more of the same again. PHILOSOPHY? PARADIGM? REUNITE WITH DISENFRANCHISED PARTS OF THE BODY? The more I read about holistic dentistry, the more I suspect that it is the equivalent of integrative/integrated medicine: a smoke-screen for smuggling bogus treatments into conventional care, a bonanza of BS to attract gullible customers, a distraction for highjacking a few core principles from real medicine/dentistry without getting noticed, and a dubious con for maximizing income.
‘Holistic dentistry’ makes not much more sense than holistic banking, holistic hairdressing, holistic pedicure, holistic car-repair, etc., etc. Dentistry, medicine, hairdressing, etc. are either good, not so good, or bad. The term holistic as it is currently used in dentistry is just a gimmick, I am afraid.
If I am wrong, please tell me so, and explain what, in your view, ‘holistic dentistry’ means.