This article is hilarious, I think. It was written by Heike Bishop, a homeopath who works in Australia. Here she tries to advise colleagues how best to defend homeopathy and how to deal effectively with the increasingly outspoken criticism of homeopathy. Below is the decisive passage from her article; I have not changed or omitted a word, not even her grammatical or other mistakes [only the numbers in brackets were inserted by me; they refer to my comments added below]:
Getting up in the morning and hearing that all the television and radio station report that it is dangerous for people to see their homoeopath, is utterly heart breaking. Even more so because I grew up in East Germany where the government suppressed free speech and anything that was off the beaten path . So what can we do in times like these?
First of all, watch out for Government inquiries. History has shown that they are usually not favourable towards homoeopathy  unless you live in Switzerland . It is vitally important in times like these to put differences aside amongst our professional peers. Every association should be mobilised to take an active and ONGOING role to educate and advertise the benefits of homoeopathy . If things have gone too far already, talk about freedom of choice . Write articles and join blogs talking about what you can do specifically for certain conditions . Encourage your patients to tell their success stories in blogs and other social media forums . It is in most cases utterly useless to engage in any conversation  online with trolls .
Try to develop a calloused skin when it comes to criticism. Your patients don’t want to hear how difficult it is to be a homeopath , they want you to be in control and to be reassured that their treatment continues . When someone asks you to comment on an attack on homoeopathy, put your best smile on and state how threatened the pharmaceutical industry must be to resort to such tactics .
Staphysagria is indeed a good remedy. Hahnemann also knew its benefits and even alternated it with Arsenicum the day his first wife died and he got a letter that the hospital built in his name allowed patients to choose their treatment between allopathy and homoeopathy . That was the only time he took two remedies on the same day! 
Find out what you can about your country’s own internet trolls . However, don’t underestimate their effectiveness in swaying popular opinion . There is no denying that their methods are very effective . It doesn’t matter how ludicrous their comments are, don’t go into direct explanation . Learn from the enemy  and repeat a positive message over and over again so it can’t be contorted .
Our colleges should support post-graduate studies featuring marketing and media courses . I once met a Homoeopath from the UK and she pointed out that part of the training in the UK is for students to hold homoeopathic first aid courses to promote homoeopathy . Everyone is different – some of us are happy to stand in front of an audience others choose the pen as their sword . The main thing is to do something to save the image of our healing art .
- Is she implying that facing criticism of homeopathy is akin to living in a totalitarian state? Or that criticism is a violation of free speech?
- I wonder why this is so – nothing to do with the evidence, I presume?
- Does she refer to the famous ‘Swiss Government report’ which was not by the Swiss Government at all?
- ‘Advertise and educate’ seems to be homeopathic speak for ‘MISLEAD’
- Good idea! Freedom of choice is a perfect argument (in this case, my choice would be to have a bottle of champagne at around 6 pm every day – on the NHS, of course).
- Certain conditions??? And I thought homeopaths do not treat conditions, only whole people.
- And forbid them to disclose stories where things did not work out quite so well?
- Very wise! Conversations are fraught with the danger of being found wrong.
- Critics are not critics but ‘trolls’ – makes sense.
- I would have thought that practising as a homeopath is not difficult at all – in most countries, they don’t even check whether you can spell the name correctly.
- Is it not rather the homeopath who wants the treatment to continue – after all, it is her livelihood?
- Ah yes, BIG PHARMA, the last resort of any quack!
- Did she not just praise patient choice as an important virtue?
- Hahnemann was famously cantankerous and argumentative all his life; does that mean that his remedies did not work?
- Homeopaths might need that for your ad hominem attacks.
- Never underestimate the power of truth!!!
- This might show that it is you and not the ‘trolls’ who are ludicrous.
- Particularly as there are no direct explanations for homeopathy.
- First the critics were ‘trolls’, now they have been upgraded to ‘enemy’! Is it really a war?
- You need to repeat it at least regularly so that eventually you believe it yourself.
- Are marketing and media a substitute for evidence?
- Really, first aid? Do homeopaths know what this is? Obviously not!
- But real clinicians, homeopaths call them allopaths, are quite happy simply with effective treatments that help patients to improve.
- And I thought the main thing was to treat patients with the most effective therapies available.
ENOUGH JOKING AND SARCASM!
There is, of course, a very serious message in all of this: when under pressure, homeopaths seem to think of all sorts of things in their (and homeopathy’s) defense – some more rational than others – but the ideas that criticism might be a good way to generate progress, and that a factual debate about the known facts might improve healthcare, do not seem to be amongst them.
The Americans call it ‘INTEGRATIVE MEDICINE’; in the UK, we speak of ‘INTEGRATED MEDICINE’ – and we speak about it a lot: these terms are, since several years, the new buzz-words in the alternative medicine scene. They sound so convincing, authoritative and politically correct that I am not surprised their use spread like wild-fire.
But what is INTEGRATED MEDICINE?
Let’s find out.
If the BRITISH SOCIETY OF INTEGRATED MEDICINE (BSIM) cannot answer this question, who can? So let’s have a look and find out (all the passages in bold are direct quotes from the BSIM):
Integrated Medicine is an approach to health and healing that provides patients with individually tailored health and wellbeing programmes which are designed to address the barriers to healing and provide the patient with the knowledge, skills and support to take better care of their physical, emotional, psychological and spiritual health. Rather than limiting treatments to a specific specialty, integrated medicine uses the safest and most effective combination of approaches and treatments from the world of conventional and complementary/alternative medicine. These are selected according to, but not limited to, evidence-based practice, and the expertise, experience and insight of the individuals and team members caring for the patient.
That’s odd! If the selected treatments are not limited to evidence, expertise, experience or insight, what ARE they based on?
Fascinated I read on and discover that there are ‘beliefs’. To be precise, a total of 7 beliefs that healthcare
- Is individualised to the person – in that it takes into account their needs, insights, beliefs, past experiences, preferences, and life circumstances
- Empowers the individual to take an active role in their own healing by providing them with the knowledge and skills to meet their physical and emotional needs and actively manage their own health.
- Attempts to identify and address the main barriers or blockages to a person experiencing their health and life goals. This includes physical, emotional, psychological, environmental, social and spiritual factors.
- Uses the safest, most effective and least invasive procedures wherever possible.
- Harnesses the power of compassion, respect and the therapeutic relationship
- Focuses predominantly on health promotion, disease prevention and patient empowerment
- Encourages healthcare practitioners to become the model of healthy living that they teach to others.
I cannot say that, after reading this, I am less confused. Here is why:
- All good medicine has always been ‘individualised to the person’, etc.
- Patient empowerment is a key to conventional medicine.
- Holism is at the heart of any good health care.
- I do not know a form of medicine that focusses on unsafe, ineffective, unnecessarily invasive procedures.
- Neither am I aware of one that deliberately neglects compassion or disrespects the therapeutic relationship.
- I was under the impression that disease prevention is a thing conventional medicine takes very seriously.
- Teaching by example is something that we all know is important (but some of us find it harder than others; see below).
Could it be that these ‘beliefs’ have been ‘borrowed’ from the mainstream? Surely not! That would mean that ‘integrated medicine’ is not only not very original but possibly even bogus. I need to find out more!
One of the first things I discover is that the ‘Founder President’ of the BSIM is doctor Julian Kenyon. Now, that name rings a bell – wasn’t he mentioned in a previous post not so long ago? Yes, he was!
Here is the post in question; Kenyon was said to have misdiagnosed/mistreated a patient, exposed on TV, and eventually he ended up in front of the General Medical Council’s conduct tribunal. The panel heard that, after a 20-minute consultation, which cost £300, Dr Kenyon told one terminally-ill cancer patient: “I am not claiming we can cure you, but there is a strong possibility that we would be able to increase your median survival time with the relatively low-risk approaches described here.” He also made bold statements about the treatment’s supposed benefits to an undercover reporter who posed as the husband of a woman with breast cancer. After considering the full details of the case, Ben Fitzgerald, for the General Medical Council, called for Dr Kenyon to be suspended, but the panel’s chairman argued that Dr Kenyon’s misconduct was not serious enough for this. The panel eventually imposed restrictions on Kenyon’s licence lasting for 12 months.
Teaching by example, hey???
This finally makes things a bit clearer for me. There is only one question left to my mind: DOES BSIM PERHAPS STAND FOR ‘BULL SHIT IN MEDICINE’?
Necessity, they say, is the mother of invention. The meaning of this proverb is fairly clear:
- In the Oxford Dictionary the proverb has been defined as– when the need for something becomes imperative, you are forced to find ways of getting or achieving it.
- According to the Cambridge Dictionary, this is “an expression that means that if you really need to do something, you will think of a way of doing it.”
- Finally, the Longman dictionary has defined the proverb as– “if someone really needs to do something, they will find a way of doing it.”
In the world of chiropractic the proverb acquires a special meaning: chiropractic relies almost entirely on inventions. A few examples have to suffice:
- first, instead of pathophysiology, they invented subluxations,
- this required the invention of adjustments which were needed for their imagined subluxation,
- then they invented the ‘inate’,
- then they invented the idea that all sorts of conditions are caused by subluxations and therefore require adjustments,
- finally, they invented the notion that regular adjustments are needed for a healthy person to stay healthy.
I was reminded of the unique inventive capacity of chiropractic when I came across the website of the Foundation for Chiropractic Progress (F4CP). The F4CP is, according to their own statements, a not-for-profit organization dedicated to raising awareness about the value of chiropractic care (which is, of course, another invention).
Experts at the F4CP point out that a growing number of professional athletic teams utilize chiropractic care to maximize overall health and maintain peak performance. “Repetitive motion injuries, including shoulder tendinitis, elbow, lower back pain and muscle spasms, are common conditions and injuries among professional baseball players that can be successfully prevented, managed and treated with chiropractic care,” says Hirad N. Bagy, DC. “Chiropractic adjustments, in conjunction with soft tissue mobilization, provide athletes with proper structure, function and balance to reduce the risk of injury, accelerate recovery time and improve overall performance,” he continues – and he must know, because he has received specialized training and certifications specific to sports medicine, which include the Graston Technique®, Active Release Technique®, Myofascial Release Technique, Impact Concussion Testing and Functional Dry Needling. Dr. Bagy continues: “A number of athletes that I treat regularly understand the importance of chiropractic maintenance care, and also seek treatment when an injury arises. Through the restoration of proper bio-mechanics, doctors of chiropractic are now positioned as key health care providers throughout all of the sports teams that I work with.”
BRAVO! We are impressed! So much so, that we almost forgot to ask: “Is there any evidence for all of these therapeutic claims?”
Just as well! Because had we asked and perhaps even did a bit of research, we would have found that almost none of these far-reaching claims are evidence-based.
But who would be so petty? Instead of criticising the incessant flow of bogus claims made by chiropractors worldwide, we should really admire their remarkable skill of invention:
- When the need for profit becomes imperative, CHIROPRACTORS are forced to find ways of getting or achieving it.
- If CHIROPRACTORS really need to do something, they will think of a way of doing it.
- If a CHIROPRACTOR really needs money, he will advocate ‘maintenance care’.
AND THAT’S WHAT IS CALLED ‘CHIROPRACTIC PROGRESS’!
It is now about three years that I retired from my Exeter post. Sadly, my unit was closed down under circumstances that were not all that happy. But my university is doing its very best to keep up the good work, I am proud to report.
The university’s website informs us, for instance, that, during the ‘staff festival, alternative medicine is very much alive and kicking: Our complementary therapists will be offering 15-20 minute taster sessions in our complementary therapies yurt. The therapy taster sessions on offer will include: shaitsu bodywork, reflexology, indian head Massage, seated back massage and much more. To take advantage of these free taster sessions just pop along to the yurt on the day of the festival.
What about outside the festival? Fear not, the Exeter student guild offers homeopathy for those who need a quick, cheap, safe and effective cure of their ailments.
And what about research? Yes, even on the academic level, there still is lots going on. Only notoriously negative sceptics like David Colquhoun would dare to criticise its quality. He has analysed the scientific rigor of one specific paper here and concluded that:
(1) This paper, though designed to be susceptible to almost every form of bias, shows staggeringly small effects. It is the best evidence I’ve ever seen that not only are needles ineffective, but that placebo effects, if they are there at all, are trivial in size and have no useful benefit to the patient in this case..
(2) The fact that this paper was published with conclusions that appear to contradict directly what the data show, is as good an illustration as any I’ve seen that peer review is utterly ineffective as a method of guaranteeing quality. Of course the editor should have spotted this. It appears that quality control failed on all fronts.
David also made interesting and important comments about Simon Mills. Those of you who have read my memoir know that Simon, a top class critical thinker and fierce defender of traditional herbalism, has long been associated with Exeter; the website of the College of Medicine tells us that, at Peninsula Medical School (Exeter), he developed the first taught MSc programme in Integrated Health care at a UK medical school and co-founded the world’s first University centre dedicated to studying complementary health care. More about this particular story can be found here.
So, altogether a very satisfactory picture, I’d say: Exeter university is doing all that is necessary to train its staff and students in the all-important task of critical thinking. It is good to know that at least some British universities take their moral and ethical duties seriously.
I wish my university well and am proud that they carry on the good work that I have started.
All this recent attention to Charles’ amazing letters and unconstitutional meddling made me think quite a lot about STUPIDITY. Thus I came across the writings of Carlo Maria Cipolla who seemed to have thought deeply about human stupidity. He described “The Basic Laws of Human Stupidity” and viewed stupid people as a group of individuals who are more powerful by far than even major organizations. I liked his approach; it made me think of Prince Charles, strangely enough.
It might be interesting, I concluded, to analyse Charles’ actions against Cipolla’s 5 laws.
Here are Cipolla’s 5 basic laws of stupidity:
- Always and inevitably each of us underestimates the number of stupid individuals in circulation.
- The probability that a given person is stupid is independent of any other characteristic possessed by that person.
- A person is stupid if they cause damage to another person or group of people without experiencing personal gain, or even worse causing damage to themselves in the process.
- Non-stupid people always underestimate the harmful potential of stupid people; they constantly forget that at any time anywhere, and in any circumstance, dealing with or associating themselves with stupid individuals invariably constitutes a costly error.
- A stupid person is the most dangerous type of person there is.
How does Charles measure up against these criteria, I ask myself? Let’s go through the 5 ‘laws’ one by one.
Charles is just a ‘study of one’, so this point is irrelevant as far as he is concerned. However, he surrounds himself with yes-men of the Dixon-type (I have blogged about him here and here and here), and this evidence seems to confirm this point at least to a certain degree.
Charles had a good education, he is rich, he has influence (just read my previous post on how he made his influence felt in Exeter), and he has many other characteristics which make him unlikely to appear stupid. So, this point seems to be spot on.
Read my previous post and you will agree that this ‘law’ applies to Charles quite perfectly.
Yes, I did underestimate Charles influence. In particular, I did not appreciate the importance and impact of the KNIGHTHOOD STARVATION SYNDROME.
I think that this is a valid point. His ‘black spider memos’ reveal that he is obsessed with integrating bogus treatments into the NHS to the inevitable detriment of public health. And what could be more dangerous than that?
CONCLUSION: FROM THIS BRIEF ANALYSIS, IT SEEMS AS THOUGH THE ‘FIVE BASIC LAWS OF STUPIDITY’ ARE CONFIRMED BY THE ACTIONS OF PRINCE CHARLES
Time for some fun!
In alternative medicine, there often seems to be an uneasy uncertainty about research methodology. This is, of course, regrettable, as it can (and often does) lead to misunderstandings. I feel that I have some responsibility to educate research-naïve practitioners. I hope this little dictionary of research terminology turns out to be a valuable contribution in this respect.
Abstract: a concise summary of what you wanted to do skilfully hiding what you managed to do.
Acute: an exceptionally good-looking nurse.
Adverse reaction: a side effect of a therapy that I do not practise.
Anecdotal evidence: the type of evidence that charlatans prefer.
Audit: misspelled name of German car manufacturer.
Avogadro’s number: telephone number of an Italian friend.
Basic research: investigations which are too simplistic to bother with.
Best evidence synthesis: a review of those cases where my therapy worked extraordinarily well.
Bias: prejudice against my therapy held by opponents.
Bioavailability: number of health food shops in the region.
Bogus: a term Simon Singh tried to highjack, but chiropractors sued and thus got the right use it for characterising their trade.
Chiropractic manipulation: a method of discretely adjusting data so that they yield positive results.
Confidence interval: the time between reading a paper and realising that it is rubbish.
Confounder: founder of a firm selling bogus treatments.
Conflict of interest: bribery by ‘Big Pharma’.
Data manipulation: main aim of chiropractic.
Declaration of Helsinki: a statement by the Finnish Society for Homeopathy in favour of treating Ebola with homeopathy.
Dose response: weird concept of pharmacologists which has been disproven by homeopathy.
Controlled clinical trial: a study where I am in control of the data and can prettify them, if necessary.
Critical appraisal: an assessment of my work by people fellow charlatans.
Doctor: title mostly used by chiropractors and naturopaths.
EBM: eminence-based medicine.
Error: a thing done by my opponents.
Ethics: misspelled name of an English county North of London.
Evidence: the stuff one can select from Medline when one needs a positive result in a hurry.
Evidence-based medicine: the health care based on the above.
Exclusion criteria: term used to characterise material that is not to my liking and must therefore be omitted.
Exploratory analysis: valuable approach of re-analysing negative results until a positive finding pops up.
Focus group: useful method for obtaining any desired outcome.
Forest plot: a piece of land with lots of trees.
Funnel plot: an intrigue initiated by Prof Funnel to discredit homeopathy.
Good clinical practice: the stuff I do in my clinical routine.
Grey literature: print-outs of articles from a faulty printer.
Hawthorne effect: the effects of Crataegus on cardiovascular function.
Hierarchy of evidence: a pyramid with my opinion on top.
Homeopathic delusion: method of manufacturing a homeopathic remedy.
Informed consent: agreement of patients to pay my fee.
Intention to treat analysis: a method of calculating data in such a way that they demonstrate what I intended to show.
Logic: my way of thinking.
Mean: attitude of chiropractors to anyone suggesting their manipulations are not a panacea.
Metastasis: lack of progress with a meta-analysis.
Numbers needed to treat: amount of patients I require to make a good living.
Odds ratio: number of lunatics in my professional organisation divided by the number of people who seem normal.
Observational study: results from a few patients who did exceptionally well on my therapy.
Pathogenesis: a rock group who have fallen ill.
Peer review: assessment of my work by several very close friends of mine.
Pharmacodynamics: the way ‘Big Pharma’ is trying to supress my findings.
Pilot study: a trial that went so terribly wrong that it became unpublishable – but, in the end, we still got it in an alt med journal.
Placebo-effect: a most useful phenomenon that makes patients who receive my therapy feel better.
Pragmatic trial: a study that is designed to generate the result I want
Silicon Valley: region in US where most stupid fraudsters are said to come from.
Standard deviation: a term describing the fact that deviation from the study protocol is normal.
Statistics: a range of methods which are applied to the data until they eventually yield a significant finding.
Survey: popular method of interviewing a few happy customers in order to promote my practice.
Systematic review: a review of all the positive results I could find.
Like it? If so, why don’t you suggest a few more entries into my dictionary via the comment section below?
In the world of homeopathy, the truth is often much weirder than fiction. Take this recent article, for instance; it was published by the famous lay homeopath Alan Schmukler in the current issue of ‘HOMEOPATHY 4 EVERYONE’.
Before you read the text in question, it might be relevant to explain who Schmukler is: he attended Temple University, where he added humanistic psychology to his passions. After graduating Summa Cum Laude, Phi Beta Kappa and President’s Scholar, he spent several years doing workshops in human relations. Alan also studied respiratory therapy and worked for three years at Einstein Hospital in Philadelphia. Those thousands of hours in the intensive care and emergency rooms taught him both the strengths and limitations of conventional medicine. Schmukler learned about homeopathy in 1991 when he felt he had been cured of an infection with Hepar sulph. He later founded the Homeopathic Study Group of Metropolitan Philadelphia, giving free lectures and hosting the areas best homeopaths to teach. He also helped found and edit Homeopathy News and Views, a popular culture newsletter on homeopathy. He taught homeopathy for Temple University’s Adult Programs, and has been either studying, writing, lecturing or consulting on homeopathy since 1991. He wrote Homeopathy An A to Z home Handbook, which is now available in five languages. Alan Schmukler has been practicing homeopathy for more than two decades and is Chief Editor of Hpathy.com and of Homeopathy4Everyone. He says that his work as Editor is one of his most rewarding experiences.
Now, brace yourself, here is the promised text/satire (in bold); I promise, I did not change a single word:
EIGHT REASONS TO VACCINATE YOUR CHILD
- Your child is deficient in Mercury, Aluminum, Formaldehyde, viruses, foreign DNA or other ingredients proven to cause neurological damage.
- Your child has an excess of healthy, functioning brain cells.
- You need more cash. The National Vaccine Injury Compensation program has paid out 2.8 billion dollars to parents of children injured or killed by vaccines.
- You and your husband are feeling alienated and you need a crisis to bring you together.
- You believe that pharmaceutical conglomerates which earn billions from vaccines are more credible than consumer groups.
- You think thousands of parents who report that their children became autistic two weeks after vaccination are lying.
- You don’t see a problem in logic when the government tells you that vaccines work, but that vaccinated children can catch diseases from unvaccinated children.
- You think the government should dictate which healing methods you and your children are allowed to use.
Bad taste? Very much so!
Barmy? I think so!
Irresponsible? Most certainly!
Characteristic for lay homeopathy? Possibly!
A few years ago, I fell ill with shingles. When patients had consulted me for this condition, during the times when I still was a clinician, I always had to stop myself smiling; they complained bitterly but, really, this was far from serious. Now, affected myself, I did not smile a bit: this was incredibly painful!
I promptly saw my GP in Exeter who, to my utter amazement, prescribed paracetamol. She too seemed to think that this was really nothing to bother her with. As I had feared, the paracetamol did absolutely nothing to my pain. After a few sleepless nights, I went back and asked for something a little more effective. She refused, and I decided to change GP.
Meanwhile, we went on a scheduled holiday to France. I had hoped my shingles would come to a natural end, but my pain continued unabated. People could see it on my face; so our kind neighbour asked whether she could help. I explained the situation, and she instantly claimed to have just the right treatment for me: she knew a healer who lived just round the corner and had helped many of her friends when they had suffered from pain.
“A healer?” I asked, “you cannot be serious.” I explained that I had conducted studies and done other research into this particular subject. Without exception, the results had shown that healing is a pure placebo. “I prefer to carry on taking even something as useless as paracetamol!” I insisted.
But she would have none of it. The next time I saw her, she declared triumphantly that she had made an appointment for me, and there was no question: I had to go.
As it happened, the day before she announced this, I had met up with a doctor friend of mine who, seeing I was in agony, gave me a prescription for gabapentin. In fact, I was just on the way to the pharmacist to pick it up. Thus I was in hopeful that my ordeal was coming to an end. In this optimistic mood I thanked my neighbour for her effort and concern and said something non-committal like “we shall see”.
A few days later, we met again. By this time, the gabapentin had done it’s trick: a was more or less pain-free, albeit a little dazed from the powerful medication. When my neighbour saw me, she exclaimed: “I see that that you are much improved. Wonderful! Yesterday’s healing session has worked!!!”
In my daze, I had forgotten all about the healing, and I had, of course, not been to see the healer. She was so delighted with her coup, that I did not have the heart to tell her the truth. I only said “yes much better, merci”
These events happened a few years ago, but even today, my kind and slightly alternative neighbour believes that, despite having been highly sceptical, healing has cured me of my shingles. To my embarrassment, she occasionally mentions my ‘miraculous cure’.
One day, I must tell her the truth… on second thoughts, perhaps not, she might claim it was distant healing!
One of the UK’s most ardent promoters of outright unproven and disproven therapies must be Dr Michael Dixon. He has repeatedly and deservedly received a mention on this blog. Steven Novella even called him once a ‘pyromaniac in a field of (integrative) straw men’. This is because Steven felt that Dixon uses phony arguments to promote dodgy therapies. If you find this hard to believe (after all Dixon is a GP who heads important organisations such as the NHS Alliance and the College of Medicine), just look at him dabbling in spiritual healing. Unusual, to say the least, I’d say. If you want to learn more about the strange Dr Dixon, you should read my memoir where he makes several remarkable appearances.
I always delight when I stumble over something that one of my former co-workers (yes, Dixon and I did collaborate for many years) has said to the press. This is why an otherwise silly article in the Daily Mail (yes, I know!) caught my attention; here is the relevant section: Dr Mike Dixon, a GP in Cullompton, Devon, and chairman of the College of Medicine, says he is a ‘fan’ of herbal medicines because they are ‘safe, help to encourage self-care by patients and, in cases such as mint and aloe vera, can be grown by the patients themselves, making them virtually free’.
As I already pointed out, Dixon does tend to promote bizarre concepts. The generalisation that herbal remedies are safe is not just bizarre, it also put the public at risk. One does not need to search long to find an article that makes this clear:
Various reports suggest a high contemporaneous prevalence of herb-drug use in both developed and developing countries. The World Health Organisation indicates that 80% of the Asian and African populations rely on traditional medicine as the primary method for their health care needs. Since time immemorial and despite the beneficial and traditional roles of herbs in different communities, the toxicity and herb-drug interactions that emanate from this practice have led to severe adverse effects and fatalities. As a result of the perception that herbal medicinal products have low risk, consumers usually disregard any association between their use and any adverse reactions hence leading to underreporting of adverse reactions. This is particularly common in developing countries and has led to a paucity of scientific data regarding the toxicity and interactions of locally used traditional herbal medicine. Other factors like general lack of compositional and toxicological information of herbs and poor quality of adverse reaction case reports present hurdles which are highly underestimated by the population in the developing world. This review paper addresses these toxicological challenges and calls for natural health product regulations as well as for protocols and guidance documents on safety and toxicity testing of herbal medicinal products.
Dixon once told me that GPs do not any longer read scientific papers. I think, however, that he should start doing so before the next time he misinform the public and endangers the health of vulnerable people.
Henry Louis Mencken (1880-1956) was an outspoken American journalist, essayist and literary critic famous for his vitriolic attacks on what he considered to be the hypocrisy of much of American life. In 1924, he published an essay on chiropractic which, I think, is still poignant today. I take the liberty of reproducing here in a slightly abbreviated form.
This preposterous quackery [chiropractic] flourishes lushly in the back reaches of the Republic, and begins to conquer the less civilized folk of the big cities. As the old-time family doctor dies out in the country towns, with no competent successor willing to take over his dismal business, he is followed by some hearty blacksmith or ice-wagon driver, turned into a chiropractor in six months, often by correspondence… [Chiropractic] pathology is grounded upon the doctrine that all human ills are caused by pressure of misplaced vertebrae upon the nerves which come out of the spinal cord — in other words, that every disease is the result of a pinch. This, plainly enough, is buncombe. The chiropractic therapeutics rest upon the doctrine that the way to get rid of such pinches is to climb upon a table and submit to a heroic pummeling by a retired piano-mover. This, obviously, is buncombe doubly damned.
…Any lout with strong hands and arms is perfectly equipped to become a chiropractor. No education beyond the elements is necessary. The takings are often high, and so the profession has attracted thousands of recruits — retired baseball players, work-weary plumbers, truck-drivers, longshoremen, bogus dentists, dubious preachers, cashiered school superintendents. Now and then a quack of some other school — say homeopathy — plunges into it. Hundreds of promising students come from the intellectual ranks of hospital orderlies.
…[The chiropractor’s] trade is mainly with ambulant patients; they must come to his studio for treatment. Most of them have lingering diseases; they tour all the neighborhood doctors before they reach him. His treatment, being nonsensical, is in accord with the divine plan. It is seldom, perhaps, that he actually kills a patient, but at all events he keeps any a worthy soul from getting well.
…But chiropractic, of course, is not perfect. It has superb potentialities, but only too often they are not converted into concrete cadavers. The hygienists rescue many of its foreordained customers, and, turning them over to agents of the Medical Trust, maintained at the public expense, get them cured. Moreover, chiropractic itself is not certainly fatal: even an Iowan with diabetes may survive its embraces. Yet worse, I have a suspicion that it sometimes actually cures. For all I know (or any orthodox pathologist seems to know) it may be true that certain malaises are caused by the pressure of vagrant vertebra upon the spinal nerves. And it may be true that a hearty ex-boilermaker, by a vigorous yanking and kneading, may be able to relieve that pressure. What is needed is a scientific inquiry into the matter, under rigid test conditions, by a committee of men learned in the architecture and plumbing of the body, and of a high and incorruptible sagacity. Let a thousand patients be selected, let a gang of selected chiropractors examine their backbones and determine what is the matter with them, and then let these diagnoses be checked up by the exact methods of scientific medicine. Then let the same chiropractors essay to cure the patients whose maladies have been determined. My guess is that the chiropractors’ errors in diagnosis will run to at least 95% and that their failures in treatment will push 99%. But I am willing to be convinced.
Where is there is such a committee to be found? I undertake to nominate it at ten minutes’ notice. The land swarms with men competent in anatomy and pathology, and yet not engaged as doctors. There are thousands of hospitals, with endless clinical material. I offer to supply the committee with cigars and music during the test. I offer, further, to supply both the committee and the chiropractors with sound wet goods. I offer, finally, to give a bawdy banquet to the whole Medical Trust at the conclusion of the proceedings.
I imagine that most chiropractors would find this comment rather disturbing. However, I do like it for several reasons:
- it is refreshingly politically incorrect; today journalists seem to be obsessed with the notion of ‘balance’ thus often creating the impression that there are two valid sides to an issue where, in fact, there is only one;
- it gets right at the heart of several problems which have plagued chiropractic from its beginning;
- it even suggests a way to establishing the truth about the value of chiropractic which could easily been followed some 90 years ago;
- finally it predicts a result of such a test – and I would not be surprised, if it turned out to be not far from the truth.
Please let me know what you think, regardless of whether you are a chiropractor or not.