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

Can I invite you to join me in a little thought experiment?

Think of a totally useless therapy. I would suggest homeopathy but there are always some who would disagree with this classification. I need a TOTALLY useless therapy, and one where we ALL can agree on the label.

What about ‘Potentised Toe-Nail Powder’ (PoToNaPo)?

PoToNaPo is made from nail clippings, thoroughly sterilised, ground to a powder, serially diluted and potentised. Does anyone claim this remedy to be effective for any condition?

No?

Splendid!

So, we all agree that PoToNaPo is completely ineffective.

Now imagine some charlatan claiming that PoToNaPo is a highly effective cancer cure. Let’s furthermore imagine that he is very successful with his claim.

(No, this is not far fetched! Think of Laetrile, Essiac, etc.)

Imagine our charlatan makes millions with PoToNaPo.

There would soon be some opposition to his quackery. The FDA would issue a statement that PoToNaPo is unproven. Perhaps the NEJM would publish an editorial saying something similar. Ethicists would frown publicly. And many sceptics would head to the pubs where clever guys would give talks about ‘the scandal of PoToNaPo’.

We all know it would happen, because it has happened with PoToNaPo-like remedies many times before.

______________

Now imagine a different scenario, namely one in which our charlatan does not claim that PoToNaPo is a cancer cure; imagine instead he had claimed that PoToNaPo is a holistic medicine that boosts your well-being via re-balancing your vital energies which, in turn, helps with anxiety which in turn might have positive effects on things like mild chronic pain, depressive mood, tension headache, insomnia, erectile dysfunction and many more symptoms of daily life.

Let’s furthermore imagine that our charlatan is very successful with these claims.

No, this is not far fetched! Think of … well … think of any SCAM really.

Imagine the charlatan makes millions with PoToNaPo.

What would happen?

  • He would be invited to conferences on integrative medicine.
  • Become an honorary member/sponsor of the ‘College of Medicine and Integrated Health’.
  • He would be interviewed on the BBC.
  • The Daily Mail would publish advertorials.
  • HRH would perhaps invite him for tea.
  • Trump might hint that PoToNaPo cures virus infections.
  • Ainsworth might buy his patent.
  • There could even be a gong waiting for him.
  • And yes … some sceptics would mutter a bit, but the public would respond: what’s the harm?

We all know that things of this nature might happen, because they have happened before with PoToNaPo-like remedies.

__________________

So what’s the difference?

In both scenarios, our charlatan has marketed the same bogus remedy, PoToNaPo.

In both scenarios, he has made unsubstantiated, even fraudulent claims.

Why does he get plenty of stick in the 1st and becomes a hero in the 2nd case?

Yes, I know, the difference is the nature of the claims. But the invention, production, marketing and selling of a bogus treatment, the lying, the deceit, the fraud, the exploitation of vulnerable people are all the same.

Why then are we, as a society, so much kinder to the charlatan in the 2nd scenario?

I think we shouldn’t be; it’s not logical or consequent. I feel we should name, shame and punish both types of charlatans. They are both dangerous quacks, and it is our ethical duty to stop them.

END OF THOUGHT EXPERIMENT

 

13 Responses to A totally useless therapy for benign and malign conditions – where is the difference?

  • Scandal of Conium (Hemlock- not to confound with NoToNaPo)
    https://pubmed.ncbi.nlm.nih.gov/31104055/
    https://studylibde.com/doc/1435068/adjuvante-hom%C3%B6opathische-therapie-bei

    I admid, I made a mistake! I should have said and written:
    “Conium (Hemlock) is a holistic medicine that boosts your well-being via re-balancing your vital energies which, in turn, helps with anxiety which in turn might have positive effects on things like mild chronic pain, depressive mood, tension headache, insomnia, erectile dysfunction and many more symptoms of daily life.”

  • A most excellent experiment! The additive making it even more compelling would of course be: “that this remedy was recently “re-discovered” from the archives of a centuries old church where thousands of believers knew of its miraculous powers…nearly lost to the ages but now reformulated for the modern world….and with free shipping if you enroll in our monthly subscription service”.

  • I don’t think there is much difference between toenail clippings and rhinoceros horn; they are both keratin, after all. On the other hand I’m not sure that rhinoceros horn is routinely sterilised before use.

    • in this case, rhino horn would even have an effect – albeit a negative one.

    • The rudimentary toe-nail of a horse is already available from Helios homeopathy. And its utility has been “proven” by eminent homeopathists to “.,..be highly useful remedy in cracked and ulcerated nipples. Affects principally female organs. Acts on the nails and bones; pain in right tibia and coccyx. Warts on forehead. Warts on breast. Chapped hands.”

      I would love to know why it only works on pain in the right tibia and not in the left??

      • I would love to know why it only works on pain in the right tibia and not in the left??

        It is probably to do with the chirality of organic molecules. Possibly somebody could develop an enantomeric version for use on the contralateral side. Though I am guessing here. It might, of course, be related to the rotation of the gut in the developing embryo, in which case it woiuld be interesting to see what effect it has in individuals with situs inversus, or with mutations in the sonic hedgehog gene.

  • What if PoToNaPo was not an extract, but some kind of talking therapy?
    What if this therapy was trialled and published in mainstream journals (of course only with small sample sizes, unblinded, subjective outcomes only and no long term followups)?
    What if the patients who pointed out the therapies were bunk (and past and proposed future trials are of very low scientific quality), are regularly accused of being anti-science in the mainstream press by medical professionals advising national health policies in western democracies?

    This is not a hypothetical scenario.

    This “therapy” is listed as a “topic characterized as pseudoscience” on Wikipedia, but yet it does not seem to be treated as such by the medical mainstream.

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