MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

panacea

Recently, I was asked about the ‘Dorn Method’. In alternative medicine, it sometimes seems that everyone who manages to write his family name correctly has inaugurated his very own therapy. It is therefore a tall order to aim at blogging about them all. But that’s been my goal all along, and after more than 1 000 posts, I am still far from achieving it.

So, what is the Dorn Method?

A website dedicated to it provides some first-hand information. Here are a few extracts (numbers in brackets were inserted by me and refer to my comments below):

START OF QUOTE

Developed by Dieter Dorn in the 1970’s in the South of Germany, it is now fast becoming the widest used therapy for Back Pain and many Spinal Disorders in Germany (1).

The Dorn Method ist presented under different names like Dornmethod, Dorntherapy, Dorn Spinal Therapy, Dorn-Breuss Method, Dorn-XXname-method and (should) have as ‘core’ the same basic principles.

There are many supporters of the Dorn Method (2) but also Critics (see: Dorn controversy) and because it is a free (3) Method and therefore not bound to clear defined rules and regulations, this issue will not change so quickly.

The Method is featured in numerous books and medical expositions (4), taught to medical students in some universities (5), covered by most private medical insurances (6) and more and more recognized in general (7).

However because it is fairly new and not developed by a Medical Professional it is often still considered an alternative Healing Method and it is meant to stay FREE of becoming a registered trademark, following the wish of the Founder Dieter Dorn (†2011) who did NOT execute his sole right to register this Method as the founder, this Method must become socalled Folk Medicine.

As of now only licensed Therapists, Non Medical Practitioners (in Germany called Heilpraktiker (Healing Practitioners with Government recognition) (8), Physical Therapists or Medical Doctors are authorized to practice with government license, but luckily the Dorn Method is mainly a True Self Help Method therefore all other Dorn Method Practitioners can legally help others by sharing it in this way (9).

What conditions can be treated with the Dorn Method? Every disease, even up to the psychological domain can be treated (positively influenced) unless an illness had already led to irreversible damages at organs (10). The main areas of application are: Muscle-Skeletal Disorders (incl. Back Pain, Sciatica, Scoliosis, Joint-Pain, Muscular Tensions, Migraines etc.)

END OF QUOTE

My brief comments:

  1. This is a gross exaggeration.
  2. Clearly another exaggeration.
  3. Not ‘free’ in the sense of costing nothing, surely!
  4. Yet another exaggeration.
  5. I very much doubt that.
  6. I also have difficulties believing this statement.
  7. I see no evidence for this.
  8. We have repeatedly discussed the Heilpraktiker on this blog, see for instance here, here and here.
  9. Sorry, but I fail to understand the meaning of this statement.
  10. I am always sceptical of claims of this nature.

By now, we all are keen to know what evidence there might be to suggest that the Dorn Method works. The website of the Dorn Method claims that there are 4 different strands of evidence:

START OF QUOTE

1. A new form of manual therapy and self help method which is basically unknown in conventional medicine until now, with absolutely revolutionary new knowledge. It concerns for example the manual adjustment of a difference in length of legs as a consequence of a combination of subluxation of the hip-joint (subluxation=partly luxated=misaligned) and a subluxation of the joints of sacrum (Ilio-sacral joint) and possible knee and ankle joints. The longer leg is considered the ‘problem’-leg and Not the shorter leg as believed in classical medicine and chiropractic.

2. The osteopathic knowledge that there is a connection of each vertebra and its appropriate  spinal segment to certain inner organs. That means that when there are damages at these structures, disturbances of organic functions are the consequence, which again are the base for the arising of diseases.

3. The knowledge of the Chinese medicine, especially of acupuncture and meridian science that the organic functions are stirred and leveled, also among each other, via the vegetative nervous system

4. The natural-scientific  knowledge of anatomy, physiology, physics, chemistry and other domains.

END OF QUOTE

One does not need to be a master in critical thinking to realise that these 4 strands amount to precisely NOTHING in terms of evidence for the Dorn Method. I therefore conducted several searches and have to report that, to the best of my knowledge, there is not a jot of evidence to suggest that the Dorm Method is more than hocus-pocus.

In case you wonder what actually happens when a patient – unaware of this lack of evidence – consults a clinician using the Dorn Method, the above website provides us with some interesting details:

START OF QUOTE

First the patients leg length is controlled and if necessary corrected in a laying position. The hip joint is brought to a (more or less) 90 degree position and the leg is then brought back to its straight position while guiding the bones back into its original place with gentle pressure.

picture link to dorn therapy pictures

This can be done by the patient and it is absolutely safe, easy and painless!

The treatment of Knees and Ankles should then follow with the same principals: Gentle pressure towards the Joint while moving it from a bended to a more straight position.

After the legs the pelvis is checked for misalignment and also corrected if necessary in standing position.

Followed by the lumbar vertebrae and lower thoracic columns, also while standing upright.

Then the upper thoracic vertebrae are checked, corrected if necessary, and finally the cervical vertebrae, usually in a sitting position.

The treatment often is continued by the controlling and correction of other joints like the shoulders, elbow, hands and others like the jaw or collarbone.

END OF QUOTE

Even if we disregard the poor English used throughout the text, we cannot possibly escape the conclusion that the Dorn Method is pure nonsense. So, why do some practitioners practice it?

The answer to this question is, of course, simple: There is money in it!

“Average fees for Dorn Therapy sessions range from about 40€ to 100€ or more…  Average fees for Dorn Method Seminars range from about 180€ to 400€ in most developed countries for a two day basic or review or advanced training.”

SAY NO MORE!

 

 

 

This is a blog about alternative medicine! A blog that promised to cover all major forms of alternative medicine. So, how could I have so far ignored the incredible health benefits of Apple Cider Vinegar (ACV)? Realising that this omission is quite frankly scandalous, I now quickly try to make amends by dedicating this entire post to ACV and its fantastic properties.

There is no shortage of information on the subject (almost 1.5 million websites!!!); this article entitled “13 Reasons Apple Cider Vinegar Is the Magic Potion You Need in Your Life”, for instance, tells us about the ’13 Real Benefits of vinegar’. As it was published in the top science journal ‘COSMOPOLITAN’, it must be reliable. The article makes the wonders of ACV very clear:

START OF QUOTE

1. It reduces bloating. Vinegar increases the acidity in the stomach, which allows it to digest the food you’ve eaten and helps propel it into the small intestine, according to Raphael Kellman, MD, founder of the Kellman Center for Integrative and Functional Medicine in New York City. Because slow digestion can cause acid reflux, a burning sensation that occurs when food in your stomach backs up all the way into your esophagus and triggers feelings of fullness, consuming vinegar to move things along can stop you from feeling like the Pillsbury Dough Boy.

2. It increases the benefits of the vitamins and minerals in your food. “When your stomach isn’t producing enough acid, this impairs the absorption of nutrients as well as B6, folate, calcium, and iron,” Dr. Kellman explains. Help your body by ingesting a bit more acid in the form of vinegar, and you’ll actually be able to use all the good stuff you consumed by ordering the side salad instead of fries.

3. It cancels out some of the carbs you eat. The acetic acid found in vinegar interferes with the enzymes in your stomach responsible for digesting starch so you can’t absorb the calories from carbs you’ve eaten.

4. It softens your energy crash after eating lots of sugar or carbs. Consuming vinegar before a meal can help by slowing the rush of sugar to your blood stream, so your blood sugar spike resembles a hill instead of a mountain and you don’t crash quite as hard.

5. It keeps you full longer. In a small but thorough study, researchers found that people who consumed vinegar before eating a breakfast of white bread felt more satisfied 90 minutes after eating compared to people who only ate the bread. (Worth noting: Two hours after eating, both groups were equally hungry. It just goes to show why white bread doesn’t make a stellar breakfast food — with or without vinegar.)

6. It can help your muscles produce energy more efficiently before a major push. Endurance athletes sometimes drink diluted vinegar before they carb-load the night before competing because acetic acid can helps the muscles turn carbs into energy to fuel intense exercise, according to well-regarded research conducted on animals.

7. It could lower your blood pressure. Animal studies suggest that drinking vinegar can lower your blood pressure by a few points. Researchers don’t understand exactly how this works or whether it is equally effective among humans, but Johnston is pretty confident it can make at least a modest difference.

8. It cleans fruits and veggies. The best way to clean produce, according to Johnston, is with diluted vinegar: Research suggests its antibacterial properties can significantly reduce pathogens such as Salmonella. Just fill an empty spray bottle with diluted vinegar and spritz your produce (salad stuff, fruits, etc.) then rinse in regular water before serving.

9. It kills bad breath. You might have heard that the antibacterial properties of vinegar can kill microorganisms responsible for bad breath — and in theory, this is true. However, Johnston warns, “it’s no more effective than any other antibacterial agents, and there are better products designed for this purpose.”

10. It deodorizes smelly feet. Just wipe down your clompers with a paper towel dipped in diluted vinegar. The antibacterial properties of vinegar will kill the smelly stuff.

11. It relieves jellyfish stings. In case you’re ever stung by a jellyfish and just so happen to have diluted vinegar on hand, you’ll be awfully lucky: Vinegar deactivates the jellyfish’s sting better than many other remedies — even though hot water still works best, according to a study that compared both techniques.

12. It balances your body’s pH levels, which could mean better bone health. Although vinegar is obviously acidic, it actually has a neutralizing effect once it’s inside of you. Meaning: It makes your body’s pH more basic (i.e., alkaline).

13. It alleviates heartburn — sometimes, according to Johnston, who just wrapped up a study on using vinegar to treat this condition. Vinegar’s effectiveness depends on the source of your heartburn: If you have erosive heartburn caused by lesions in your esophagus or stomach ulcers, a dose of vinegar will only aggravate the problem. But if your heartburn stems from something you ate, adding acetic acid to your stomach can help neutralize the acid in there and help fix the problem, providing you with at least a little bit of comfort.

END OF QUOTE

What, you are not impressed by these claims nor the references? I found another website that offers plenty more science:

  1. Katie J. Astell, Michael L. Mathai, Andrew J. McAinch, Christos G. Stathis, Xiao Q. Su. A pilot study investigating the effect of Caralluma fimbriata extract on the risk factors of metabolic syndrome in overweight and obese subjects: a randomised controlled clinical trial. Biomedical and Lifestyle Diseases (BioLED) Unit, College of Health and Biomedicine, Victoria University, Melbourne, Victoria 3021, Australia.
  2. Niedzielin, K., Kordecki, H.,
    http://journals.lww.com/eurojgh/Abstract/2001/10000/A_controlled,_double_blind,_randomized_study_on.4.aspx
  3. M. Million, et al. Obesity-associated gut microbiota is enriched in Lactobacillus reuteri and depleted in Bifidobacterium animalis and Methanobrevibacter smithii. International Journal of Obesity (2012) 36, 817–825; doi:10.1038/ijo.2011.153; published online 9 August 2011
  4. Rastmanesh R., et al. High polyphenol, low probiotic diet for weight loss because of intestinal microbiota interaction. Chemico-Biological InteractionsPublished 15 October 2010.
  5. Thielecke F, et al. Epigallocatechin-3-gallate and postprandial fat oxidation in overweight/obese male volunteers: a pilot study Eur J Clin Nutr. 2010 Jul;64(7):704-13. doi: 10.1038/ejcn.2010.47.
  6. Wang H., Effects of catechin enriched green tea on body composition. Obesity (Silver Spring). 2010 Apr;18(4):773-9. doi: 10.1038/oby.2009.256.
  7. Bitange Nipa Tochi, Zhang Wang, Shi – Ying Xu and Wenbin Zhang, 2008. Therapeutic Application of Pineapple Protease (Bromelain): A Review. Pakistan Journal of Nutrition, 7: 513-520.
  8. Date K, Satoh A, Iida K, Ogawa H. Pancreatic α-Amylase Controls Glucose Assimilation by Duodenal Retrieval through N-Glycan-specific Binding, Endocytosis, and Degradation. J Biol Chem. 2015 May 28. pii: jbc.M114.594937.
  9. Perano SJ,Couper JJ,Horowitz M, Martin AJ, Kritas S, Sullivan T, Rayner CK. Pancreatic enzyme supplementation improves the incretin hormone response and attenuates postprandial glycemia in adolescents with cystic fibrosis: a randomized crossover trial.J Clin Endocrinol Metab. 2014 Jul;99(7):2486-93. doi: 10.1210/jc.2013-4417. Epub 2014 Mar 26.

Ok, not plenty; and not very sound or relevant either.

So, let’s do a Medline search! This is sure to produce convincing clinical trials on human patients that back up all of the above claims.

Yes! Medline does indeed generate 58 hits for ACV (just to give you a comparison, searching for ‘atenolol’, a fairly ancient beta-blocker, for instance, generates 7877 hits and searching for ‘acupuncture’ provides more that 27 000 hits):

The first human study of ACV listed on Medline is from one of my favourite journals, the . It is not a clinical trial, but a case report:

A 32-y-old married woman was admitted with intense vaginal discharge with foul odor, itching, groin pain, and infertility for the past 5 y. Candida albicans was isolated from the culture of vaginal swab. The patient was diagnosed with chronic vaginal candida infection. She failed to respond to integrative medicine methods prescribed. Recovery was achieved with the application of apple cider vinegar. Alternative treatment methods can be employed in patients unresponsive to medical therapies. As being one of these methods, application of apple cider vinegar can cure vaginal candida infection.

But surely that cannot be all!

No, no, no! There is more; a pilot study has also been published. It included all of 10 patients and concluded that vinegar affects insulin-dependent diabetes mellitus patients with diabetic gastroparesis by reducing the gastric emptying rate even further, and this might be a disadvantage regarding to their glycaemic control.

That’s what I like! A bold statement, even though we are dealing with a tiny pilot. He who dares wins!

Anything else?

Afraid not! The rest of the 58 references are either animal studies, in vitro experiments or papers that were entirely irrelevant for the clinical effects of ACV.

But how can this be?

Does this mean that all the claims made by ‘COSMOPOLITAN’ and thousands of other publications are bogus?

I cannot imagine – no, it must mean that, yet again, science has simply not kept up with the incredible pace of alternative medicine.

 

Yes, I did promise to report on my participation in the ‘Goldenes Brett’ award which took place in Vienna and Hamburg on 23/11/2017. I had been asked to come to Vienna and do the laudation for the life-time achievement in producing ridiculous nonsense. This year, the award went to the ‘DEUTSCHER ZENTRALVEREIN HOMOEOPATHISCHER AERZTE’ (DZVhÄ), the German Central Society of Homoeopathic Doctors.

In my short speech, I pointed out that this group is a deserving recipient of this prestigious negative award. Founded in 1829, the DZVhÄ  is a lobby-group aimed at promoting homeopathy where and how they can. It is partly responsible for the fact that homeopathy is still highly popular in Germany, and that many German consumers seem to think that homeopathy is an evidence-based therapy.

Cornelia Bajic, the current president of this organisation stated on her website that “Homöopathie hilft bei allen Krankheiten, die keiner chirurgischen oder intensivmedizinischen Behandlung bedürfen“ (homeopathy helps with all diseases which do not need surgical or intensive care), advice that, in my view, has the potential to kill millions.

The DZVhÄ also sponsors the publication of a large range of books such as ‘Was kann die Homoeopathie bei Krebs’ (What can homeopathy do for cancer?). This should be a very short volume consisting of just one page with just one word: NOTHING. But, in fact, it provides all sorts of therapeutic claims that are not supported by evidence and might seriously harm those cancer patients who take it seriously.

But the DZVhÄ does much, much more than just promotion. For instance it organises annual ‘scientific’ conferences – I have mentioned two of them previously here, here and here. In recent years one of its main activity must have been the defamation of certain critics of homeopathy. For instance, they supported Claus Fritzsche in his activities to defame me and others. And recently, they attacked Natalie Grams for her criticism of homeopathy. Only a few days ago, Cornelia Bajic attacked doctor Gram’s new book – embarrassingly, Bajic then had to admit that she had not even read the new book!

The master-stroke of the DZVhÄ , in my opinion, was the fact that they supported the 4 homeopathic doctors who went to Liberia during the Ebola crisis wanting to treat Ebola patients with homeopathy. At the time Bajic stated that “Unsere Erfahrung aus der Behandlung anderer Epidemien in der Geschichte der Medizin lässt den Schluss zu, dass eine homöopathische Behandlung die Sterblichkeitsrate der Ebola-Patienten signifikant verringern könnte” (Our experience with other epidemics in the history of medicine allows the conclusion that homeopathic treatment might significantly reduce the mortality of Ebola patients).

As I said: the DZVhÄ are a well-deserving winner of this award!

 

Chiropractic may not be effective (as discussed often here); it also is not nearly as safe as chiropractors claim (as discussed often here), but it is excellent for making me – and I hope many others too – laugh heartily. If you doubt it, please read this article:

START OF QUOTE

… “People come in with back pain, but after adjustments, they come back and tell me their sex life is so much better,” says [the chiropractor] Jason Helfrich… “It’s no surprise to us—it’s amazing what the body will do when you take away the pressure on the nervous system.”

… Every function in your body is controlled from the nervous system, but when vertebra are off position—known as a subluxation—the nerves traveling between your brain and your muscles can become blocked, compromising your body’s ability to function as it needs to. Every chiropractor’s goal is to remove these subluxations, since they can both cause pain and impede feeling, Helfrich says. But these fixes help more than just back pain. The lumbar region (your lower back) is a huge hub for the nerves that extend into your reproductive regions. Removing lumbar subluxations can improve nerve flow to your sexual organs, increasing things like blood flow to your clitoris or, for your husband, the penis.

The flow of nerve signals is a two-way street, though, meaning that adjustments also allow your organs to send messages to the brain more easily. This means that you not only do you become physically aroused faster, but your brain also registers that ready-for-action, heightened sense of pleasure more quickly, so you move past the mental obstacles that may be keeping you from orgasming, Helfrich explains… “Libido and fertility require a delicate balance of estrogen, progesterone, and other hormones, many of which are released in the upper cervical and neck area,” he explains. If there are any blockages right out of the brain, the impingement up there will have an effect all the way down… “We want to improve people’s health, and health is about living life as its intended. Having a great sex life is huge part of that,” Helfrich adds. No arguments here!

No arguments here???

Perhaps because anyone with an iota of understanding of human physiology is quite simply speechless after reading such baloney!

Or perhaps any critical thinker would be laughing so much that an argument cannot be formulated!

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.

The fact that much of chiropractic might be bogus has frequently been discussed on this blog. A recent press-release provided me with more evidence for this notion. It proudly announced a new book entitled “Beyond the Back: The Chiropractic Alternative For Conditions Beyond Back Pain”

The text claimed that shortly after the launch, the book hit #1 on the Amazon.com best seller list out of all Chiropractor books and also reached #1 for the category of Holistic Medicine.

When I checked (22/12/2016), I was not able to confirm this statement: #47 in Kindle Store > Kindle eBooks > Medical eBooks > Alternative & Holistic > Holistic Medicine, #58 in Books > Medical Books > Allied Health Professions > Chiropractic. But let’s not be petty; let’s rather see what the book has to offer.

‘Beyond the Back’ focuses on how Chiropractic care can do so much more than just alleviate back pain, the press-release says. From avoiding knee surgery to resolving athletic injuries, chiropractic care allegedly is a 100% natural health solution for a wide variety of conditions… In fact, in some cases, chiropractors can help their patients get off medications entirely and even avoid surgery, the press-release continues.

In the book itself, the authors claim that chiropractic is effective for a multitude of conditions, including asthma and colic (in fact, the authors try to give the impression that chiropractic is a veritable panacea), and that there is sound evidence for all these indications from hundreds, if not thousands of studies. The authors make it very clear – even on the book cover – that chiropractic is not an adjunct to conventional healthcare but an alternative to it; an idea, of course, that goes back to the founding fathers of chiropractic. As if this were not enough, the book also promotes diagnostic techniques such as applied kinesiology.

Some commentators on this blog have argued that the chiropractic profession is in the midst of giving up much of the nonsense upon it was originally based and to which it has clung on for more than hundred years. This book, written by 9 US authors of the new generation of chiropractors, seems to demonstrate the opposite.

On Amazon, the book currently has one single customer review: Value information and an easy read! I am a strong believer of chiropractic and this makes it easy for me to share this info with my friends ! 

This comment is apt because it makes clear that chiropractic is a belief system. We must not expect rational thoughts or facts from what, in effect, is a religion for many. I can understand this in a way: belief can be a cosy shelter from the truth; it does not require much thinking; it hardly needs any learning, no changing of minds, etc. However, belief can never be a basis for good healthcare. In my view, ‘Beyond The Back’ provides a perfect example of that.

We have heard often, here and elsewhere, that chiropractic is neither effective nor safe. But now I found that it is not useless after all!!! It is an effective preventative measure against infections like the common cold and the flu.

You find this hard to believe? But it must be true!

It is the message given to chiropractors on this website:

Chiropractic care raises your body’s natural resistance to disease by removing serious interference to its proper function, vertebral subluxations. For that reason, it’s important to explain to clients that their lymphatic system is basically their body’s drainage system. Lymph is a clear fluid composed of immune cells and the greater lymphatic system is made up of a network of ducts and lymph nodes that help filter out viruses, bacteria, and other harmful elements. Remind your patients that when they go to a medical doctor and complain of a cold or the flu, the first thing he or she checks is their lymph glands, feeling for enlarged lymph nodes on the neck under the jaw. Enlarged nodes, or swollen glands as we often call them, are a sign that the lymphatic system is actively fighting an infection or imbalance.
 
Here’s where chiropractic care comes in: when the body is healthy and working correctly, the bad things your lymph nodes collects drains out through the lymph ducts, some of which are located along the spine and in the neck. But when the neck and spine are out of alignment from muscle tension, a musculoskeletal condition or other injury, those lymph ducts can become blocked and congested. Fortunately, chiropractic adjustments restore the neck and spine to proper alignment, taking pressure off of the congested lymph ducts. That allows the lymphatic system to start flowing and working correctly again, naturally decongesting and helping your body’s immune system to work properly in the fight against colds, flu, and illness.
 
It’s hard to quantify the health benefits of a strong immune system, but one recent study found that patients who had chiropractic adjustments had a 200-400% stronger immune system than those who weren’t adjusted. Another study published in the Journal of Vertebral Subluxation Research showed that regular chiropractic care resulted in a 15% average decrease in the incidence of colds and the flu. For that reason, regular chiropractic adjustment and lymphatic massage will help keep a patient’s immune system strong and functioning optimally, and even will help minimize the symptoms and speed recovery once a patient already comes down with the flu.

And you thought that chiropractors had all but given up the notion of ‘subluxation’? No, they haven’t!

Subluxations are real, alive and kicking!

The germ theory of disease is false!

Chiropractic adjustments are the only cure and prevention!

Immunisations are just poison in your body!

What, I have not convinced you? Then you are not a chiropractor, perhaps?

You say they make numerous such claims because it keeps them in clover? Oh, you are cynical – shame on you!

Don’t get me wrong, I have nothing against systematic reviews. Quite to the contrary, I am sure they are an important source of information for patients, doctors, scientists, policy makers and others – after all, I have published more than 300 of such papers!

Having said that, I do dislike a certain type of systematic review, namely systematic reviews by Chinese authors evaluating TCM therapies and arriving at misleading conclusions. Such papers are currently swamping the marked.

At first glance, they look fine. On closer scrutiny, however, most turn out to be stereotypically useless, boring and promotional. The type of article I mean starts by stating its objective which usually is to evaluate the evidence for a traditional Chinese therapy as a treatment of a condition which few people in their right mind would treat with any form of TCM. It continues with details about the methodologies employed and then, in the results section, informs the reader that x studies were included in the review which mostly reported encouraging results but were wide open to bias. And then comes the crucial bit: THE CONCLUSIONS.

They are as predictable as they are misleading. let me give you two examples only published in the last few days.

The first review drew the following conclusions: This systematic review suggests that Chinese Herbal Medicine as an adjunctive therapy can improve cognitive impairment and enhance immediate response and quality of life in Senile Vascular Dementia patients. However, because of limitations of methodological quality in the included studies, further research of rigorous design is needed.

The second review concluded that the evidence that external application of traditional Chinese medicine is an effective treatment for venous ulcers is encouraging, but not conclusive due to the low methodological quality of the RCTs. Therefore, more high-quality RCTs with larger sample sizes are required.

Why does that sort of thing frustrate me so much? Because it is utterly meaningless and potentially harmful:

  • I don’t know what treatments the authors are talking about.
  • Even if I managed to dig deeper, I cannot get the information because practically all the primary studies are published in obscure journals in Chinese language.
  • Even if I  did read Chinese, I do not feel motivated to assess the primary studies because we know they are all of very poor quality – too flimsy to bother.
  • Even if they were formally of good quality, I would have my doubts about their reliability; remember: 100% of these trials report positive findings!
  • Most crucially, I am frustrated because conclusions of this nature are deeply misleading and potentially harmful. They give the impression that there might be ‘something in it’, and that it (whatever ‘it’ might be) could be well worth trying. This may give false hope to patients and can send the rest of us on a wild goose chase.

So, to ease the task of future authors of such papers, I decided give them a text for a proper EVIDENCE-BASED conclusion which they can adapt to fit every review. This will save them time and, more importantly perhaps, it will save everyone who might be tempted to read such futile articles the effort to study them in detail. Here is my suggestion for a conclusion soundly based on the evidence, not matter what TCM subject the review is about:

OUR SYSTEMATIC REVIEW HAS SHOWN THAT THERAPY ‘X’ AS A TREATMENT OF CONDITION ‘Y’ IS CURRENTLY NOT SUPPORTED BY SOUND EVIDENCE.

Chiropractors are back pain specialists, they say. They do not pretend to treat non-spinal conditions, they claim.

If such notions were true, why are so many of them still misleading the public? Why do many chiropractors pretend to be primary care physicians who can take care of most illnesses regardless of any connection with the spine? Why do they continue to happily promote bogus treatments? Why do chiropractors, for instance, claim they can treat gastrointestinal diseases?

This recent narrative review of the literature, for example, was aimed at summarising studies describing the management of disorders of the gastrointestinal (GI) tract using ‘chiropractic therapy’ broadly defined here as spinal manipulation therapy, mobilizations, soft tissue therapy, modalities and stretches.

Twenty-one articles were found through searching the published literature to meet the authors’ inclusion criteria. The retrieved articles included case reports to clinical trials to review articles. The majority of articles chronicling patient experiences under chiropractic care reported that they experienced mild to moderate improvements in GI symptoms. No adverse effects were reported.

From this, the authors concluded that chiropractic care can be considered as an adjunctive therapy for patients with various GI conditions providing there are no co-morbidities.

I think, we would need to look for a long time to find an article with conclusions that are more ridiculous, false and unethical than these.

The old adage applies: rubbish in, rubbish out. If we include unreliable reports such as anecdotes, our finding will be unreliable as well. If we do not make this mistake and conduct a proper systematic review, we will arrive at very different conclusions. My own systematic review, for instance, of controlled clinical trials drew the following conclusion: There is no supportive evidence that chiropractic is an effective treatment for gastrointestinal disorders.

That probably says it all. I only want to add a short question: SHOULD THIS LATEST CHIROPRACTIC ATTEMPT TO MISLEAD THE PUBLIC BE CONSIDERED ‘SCIENTIFIC MISCONDUCT’ OR ‘FRAUD’?

Few alternative remedies are more popular than colloidal silver, i.e. tiny particles of silver suspended in a liquid, and few represent more irresponsible quackery. It is widely promoted as a veritable panacea. Take this website (one of thousands), for instance; it advertises colloidal silver in the most glowing terms:

Here are some of the diseases against which Colloidal Silver has been used successfully Acne, Allergies, Appendicitis, Arthritis, Blood parasites, Bubonic plague, Burns (colloidal silver is one of the few treatments that can keep severe burn patients alive), Cancer, Cholera, Conjunctivitis, Diabetes, Gonorrhoea, Hay Fever, Herpes, Leprosy, Leukaemia, Malaria, Meningitis, Parasitic Infections both viral and fungal, Pneumonia, Rheumatism, Ringworm, Scarlet Fever, Septic conditions of eyes, ears, mouth, throat, Shingles, Skin Cancer, Syphilis, all viruses, warts and stomach ulcer.In addition it also has veterinary uses, such as for canine Parvo virus. You’ll also find Colloidal Silver very handy in the garden since it can be used against bacterial, fungal / viral attacks on plants.It would also appear highly unlikely that any germ warfare agents could survive an encounter with CS, as viruses such as E Bola and Hanta are in the end merely viruses and bacteria.Colloidal Silver is non-toxic, making it safe for both children, adults and pets. Colloidal Silver is in fact a pre 1938 healing modality, making it exempt from FDA jurisdiction.

So why haven’t you heard of it? It’s suspected that the user friendly economics of Colloidal Silver may have something to do with its low profile in the media. Colloidal Silver shines a spotlight on the over expensive and deadly nature of the pharmaceutical industry, who are larger than the Pentagon economically.

That’s right, plenty of bogus claims (it goes without saying that there is no good evidence to support any of them) and, for good measure, some conspiracy theory as well – the perfect mix for making a fast buck!

But sometimes things do not work out as planned. The following text was recently published on the website of Essex County Council:

A man claiming to sell a cure for cancer has been fined £750 following an investigation by Essex Trading Standards. Steven Cook, 54, of East Road, West Mersea, was charged with an offence under the Cancer Act after suggesting Colloidal Silver was a treatment for cancer.

Mr Cook pleaded guilty at Colchester Magistrates’ Court on Friday 12 September. Magistrates imposed a fine of £750 and ordered him to pay £1,500 costs. Cllr Roger Hirst, Essex County Council’s cabinet member for Trading Standards, said: “Trading Standards’ advice to people who are considering whether to take any substance not prescribed for a medical purpose, either preventative or as a treatment, is to consult their doctor first.

“I hope the public feel safer knowing that Essex Trading Standards will take action where traders are trying to sell products which are neither medically proven nor safe.”

Mr Cook runs a website, www.colloidalsilveruk.com, selling various products containing silver. One of the products on sale was “Ultimate Colloidal Silver”, a liquid containing silver that Mr Cook made in his own home. Trading Standards said the website implied that the product can cure cancer – and this is an offence under the Cancer Act. Mr Cook has now updated the website and removed any claims that colloidal silver can cure some cancers.

So, there is some hope! Occasionally, fraudsters are being found out and punished. But the bad news, of course, is that this sort of thing occurs far too rarely and when it does happen, the punishment is far too lenient. Consequently, the public’s protection from fraudsters exploiting the most vulnerable patients is woefully insufficient.

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