MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

This article was posted a few months ago. Then it mysteriously vanished without a trace; nobody knows quite why or how. Today I found an old draft on my computer, so I post the article again. It might not be identical with the original but it is close enough, I think.

Some time ago, Andy Lewis formulated a notion which he called ‘Ernst’s law’. Initially, I felt this was a bit o.t.t., then it made me chuckle, and eventually it got me thinking: could there be some truth in it, and if so, why?

The ‘law’ stipulates that, if a scientist investigating alternative medicine is much liked by the majority of enthusiasts in this field, the scientist is not doing his/her job properly. In any other area of healthcare, such a ‘law’ would be absurd. Why then does it seem to make sense, at least to some degree, in alternative medicine? The differences between any area of conventional and alternative medicine are diverse and profound.

Take neurology, for instance: here we have an organ-system, anatomy, physiology, pathophysiology, etiology and nosology all related more or less specifically to this field and all based on facts, rigorous science and substantial evidence. None of this knowledge, science and evidence is static, but each has evolved and can be predicted to do so in future. What we knew about neurology 50 years ago, for example, was dramatically different from what we know today. Scientific discovery discoveries in neurology link up with the knowledge gathered in other areas of medicine to generate a (more or less) complete bigger picture.

In alternative medicine or any single branch thereof, we have no specific organ-system, anatomy, physiology, pathophysiology, etiology or nosology to speak of. We also have few notions that are transferable from one branch of alternative medicine to another – on the contrary, the assumptions of homeopathy, for example, are in overt contradiction to those of acupuncture which, in turn, are out of sync with those of reflexology, aromatherapy and Reiki.

Instead, each branch of alternative medicine has its own axioms that are largely detached from reality or, indeed, from the axioms of other branches of alternative medicine. In acupuncture, for instance, we have concepts such as yin and yang, qi, meridians and acupuncture points, and there is hardly any development of these concepts. This renders them akin to dogmas, and there is no chance in hell that the combination of all the branches of alternative medicine would add up to provide a sensible ‘bigger picture’.

If a scientist were to instill scientific, critical, progressive thought in a field like neurology, thus overthrowing current concepts and assumptions, they would be greeted with open arms among many like-minded researchers who all pursue the aim of advancing their field and contributing to the knowledge base by overturning wrong assumptions and discovering new truths. If researchers were to spend their time trying to analyse the concepts or treatments of alternative medicine, thus overthrowing current concepts and assumptions, they would not only not be appreciated by the majority of the experts working in this field, they would be castigated for their actions.

If a scientist dedicated decades of hard work to the rigorous assessment of alternative medicine, that person would become a thorn in the flesh of believers. Instead of welcoming him with open arms, some disappointed enthusiasts of alternative treatments might even pay for defaming them.

On the other hand, if a researcher merely misused the tools of science to confirm the implausible assumptions of alternative medicine, he would quickly become the celebrated ‘heroes’ of this field.

This is the bizarre phenomenon that ‘Ernst’s law’ seems to capture quite well – and this is why I believe the ‘law’ is worth more than a laugh and a chuckle. In fact, ‘Ernst’s law’ might even describe the depressing reality of retrograde thinking in alternative medicine more accurately than most of us care to admit.

What do my readers feel? Their comments following this blog may well confirm or refute my theory.

14 Responses to ERNST’S LAW

  • Can you expand on the contraditions between homeopathy, reiki etc.? I can see that the axioms are different, but it would be nice to be able to point to clear contradictions.

    • ‘like cures like’ is not what reiki-masters adhere to, for instance.

      • I was hoping for a clear contradiction: something that i can point to and say “if you think homeopathy works, then you cannot think acupunture works”.

        Of course it may not work, because those advocating either are ofen not very logical….

        • I take your point, but this question only serves to make the point that it would be difficult to find anything that underlies or connects a myriad of modalities. Most have a basis in vitalistic thinking and work toward “balance” of qi, or whatever the culture of origin calls it’s vitalistic force. Homeopathy, being newer and Western, takes a bit different tack and pretends to be somewhat of an offshoot “improvement”over medicine. People seem to ignore this and carry on with the idea that one tries something to see if it’s personally “matched” to the ailment, and if not, move to the next. People do the same with churches. Each denomination claims to be the special pets of god, yet people often leave one and join another, some multiple times. I know people who have been Catholics, Mormons, and Jehovah’s Witnesses.

          It is this very feature that I point out to devotees–especially those who use multiple modalities. I ask them if acupuncture is THE treatment, then why bother with homeopathy as well? Fill in any two others and you will have the same problem. Same with diets, whether they are touting weight loss or cure for cancer. Each claims to have a special food, food group, or method of combining that is the “One True Way”. Some of these offer very clear contradictions. It’s the fat! It’s the carbs! Or, It’s the toxins! It’s the cooking! Well, it IS the fat (and sugar and salt), but you get the idea, I hope. 🙂

      • What Reiki Masters would like to see however is that when they substantiate their claims and state that, actually this particular one comes from a medical background, these comments are not published on the blog.

        Shame on you Prof Ernst. It seems that is the true meaning of Ernst’s Law. Tsk tsk.

        • marie said:

          What Reiki Masters would like to see however is that when they substantiate their claims and state that, actually this particular one comes from a medical background, these comments are not published on the blog.

          Eh?

          Shame on you Prof Ernst. It seems that is the true meaning of Ernst’s Law. Tsk tsk.

          What are you on about?

  • Graeme,

    I would doubt if you could nail it down so easily on the axioms alone. They seem pretty simple, as this ‘like cures like’, but you would not be able to see, if this really is contradicted by acupuncture or if this is just an additional feature, simply left aside in the axioms there.

    You should dig a little more deeply to find what you look for. A good choice would be what is thought to be health or disease in the different regimes. Homeopathy states that there is one vital force, that can be unbalanced, and by administering the proper remedy, this illness can be dissolved by the illness created by the remedy, which then somehow should restore the vital force.

    I do not know acupuncture very well, but what I heard it is something about flowing of some chi (or was it energy?) through the body, which is blocked and the channels are to be reopened again by inserting these needles at certain points.

    These two pictures look mutually excluding each other – as long as you do not think an unbalanced vital force and blocked flow of energy are two faces of the same medal, that is.

  • My issue is that we see now if one part of CAM is seen as unproven most now throw the baby out with the bath water. My main gripe is herbal medicine and now people very astute scientist skeptics consider herbal medicine and homeopathy as the same thing. Also In reguards to the law there are differences in practitioners. Alternative medical practice is so varied and one acupuncturist to the next uses different strategies. . To say a well known practitioner is using theatrical sham techniques after a long practice of serious introspection client notes and clear strategies is well disrespectful for one. However to say a standard practice does not fair well in the research is another. If CAM was accepted into thw university system then this law would be invalid. Untill then ir ia still a side show circus to be observed from afar. Like the anthropologists who think by watching a ayawaska ceremony they have some understanding of the inner dream world. We need more honest interactions between medicine and CAM both are afraid to talk because of politics class vocabulary education and belief structures.

  • In Germany, a “university for homeopathy” is planned to be established in 2014. They are offering a bachelor degree “on a scientific level”. Maybe science has a deep basement level? Read more: http://scienceblogs.de/gesundheits-check/2013/11/23/hogwarts-bald-auch-in-traunstein/

    • A Science Dungeon, awesome!

      • One of the things Private Eye magazine has always been good at is people’s inflated, yet shallow, use of language, such as Neasdiloaf ‘Bread-style substitute’. Maybe this university will offer ‘ Science-style degrees’ in homeopathy.

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