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

Coffee enemas consist of the administration of warm coffee via the rectum into a patient’s intestines. They are popular, not least because they cause profuse bowel movements and thus lead to immediate relief of constipation and therefore to short-lasting weight loss.

Coffee enemas are promoted for detox under the erroneous assumption that that the content of our colon is toxic, an obsolete theory known as ‘autointoxication’. Other notions assume that coffee enemas have beneficial antioxidant effects or stimulate the liver. Supporters of coffee enemas also claim they are effective treatments for:

  • boosting immunity
  • increasing energy
  • preventing yeast overgrowth
  • treating autoimmune diseases
  • excreting parasites from the digestive tract
  • removing heavy metals from the body
  • alleviating depression
  • treating cancer

Coffee enemas can cause adverse reactions some of which can be severe and have even caused fatalities:

  • electrolyte imbalances
  • rectal burns
  • nausea
  • vomiting
  • cramping
  • bloating
  • dehydration
  • bowel perforation

This new systematic review was conducted to investigate the safety and effectiveness of self-administered coffee enema and to provide evidence about its benefits and risks.

Relevant studies were retrieved from multiple electronic literature searches. Considering self-administered coffee enema being used in a various indication, study population was not restricted. Any types of published studies that included outcomes of effectiveness or safety of self-administered coffee enema with or without comparators were eligible for inclusion in this systematic review. Data on biomedical indications, patient-reported outcomes, and adverse events were collected. Descriptive analyses were planned because diverse health conditions and outcome variables did not allow for quantitative synthesis.

Nine case reports that describe adverse events were identified and included in the analysis. The reported problems included:

  • colitis,
  • proctocolitis,
  • rectal perforation, peritonitis,
  • rectal burn,
  • cardiorespitatory arrest, followed by death,
  • hepatic failure, followed by death,
  • vomiting, dyspnoea, followed by death.

No study reporting on the effectiveness of coffee enema was found.

The authors concluded that, based on the evidences reviewed, this systematic review does not recommend coffee enema self-administration as a SCAM modality that can be adopted as a mean of self-care, given the unsolved issues on its safety and insufficient evidence with regard to the effectiveness.

So-called alternative medicine (SCAM) is full of truly barmy ideas, but coffee enems are amongst the worst. They are disgusting, uncomfortable, useless and risky. I am posting this article with the sincere hope that nobody reading it will ever consider using such nonsense.

98 Responses to Coffee enema: a tragically foolish way to die

  • Yet a charity promotes this: https://gersonsupportgroup.org.uk

    and the Charity Commission refuses to do any thing about it.

  • “Rectal Burn” would be braw as a punk band. As a medical treatment, not so much.

  • They only managed to find nine cases. They could add the 3 that JMK mentioned making a total of 12 or as I understand it n=12 (that is < than the 14 mentioned elsewhere and ridiculed for being too small a “sample” to prove anything).

    How about asking for positive outcomes? They work for me (at average 1 and ½ per day, that’s over 1,100 so far) and also Micheal Gearing-Tosh in his book, Living Proof – he presumably was still on Gerson for ten years later, until he died?

    They work by accelerating bile excretion by expanding the bile ducts:
    Quote page 191 of Gerson’s book, A Cancer Therapy:
    “The fluid should be retained 10 to 15 minutes, Our experiments have shown that after 10 to 12 minutes almost all caffeine is absorbed from the fluid. It goes through the hemorrhoidal veins directly into the portal veins and into the liver. Patients have to know that the coffee enemas are not given for the function of the intestines but for the stimulation of the liver.”
    End-of-quote.

    Pages 194~5 give descriptions of the four different types of enema, their preparation and frequency.

    Quote from appendix at the end (the impromptu speech while on holiday – quoted in MGT’s book too):
    “Where do we begin? The most important first step is the detoxification. So let us go into that. First, we gave some different enemas. I found out that the best enema is the coffee enema as it was first used by Prof, 0. A. Meyer in Goettingen. This idea occurred to him when together with Prof. Heubner he gave caffeine solution into the rectum of animals. He observed that the bile ducts were opened and more bile could flow. I felt that this was very important and I worked out coffee enemas. We took three heaping tablespoons of ground coffee for one quart of water, let it boil for three minutes, then simmer 10 to 20 minutes, and then gave it at body temperature. The patients reported that this was doing them good. The pain disappeared even though in order to carry through the detoxification, we had to take away all sedation. I realized that it is impossible to detoxify the body on the one hand and put in drugs and poisons on the other, such as sedation medication demerol, codeine, morphine, scopolamine, etc. So. we had to put the medication aside which again was a very difficult problem. One patient told me that he had one grain of codeine every two hours and he got morphine injections… how can you take these away? I told him that the best sedation is a coffee enema. After a very short time he had to agree with that. Some of the patients who had been in severe pain didn't take coffee enemas every four hours as I prescribed—they took one every two hours. But no more sedation. After just a few days there was very little pain, almost none. I can give you an example. A lady came to me not so long ago. She had cancer of the cervix and then two large tumor masses around the uterus. The cervix was a large crater, necrotic, producing blood and pus, and the poor lady couldn't sit any more. The condition was inoperable. She had been given X-rays and vomited any food she took in. She couldn't lie down anymore. She could not sit. She walked around day and night. When she came to my clinic the manager told me, "Doctor, you can't keep her here. This moaning and walking day and night is keeping the other patients from sleeping." After four days she was able to sleep with no sedative whatsoever—which had not helped her much anyway. The sedation had worked for perhaps half an hour or so. After 8 to 10 days, she asked me for just one thing: let her omit that night enema at 3 or 4 o'clock In the morning. These patients who absorb the big tumor masses are awakened with an alarm clock every: because they are otherwise poisoned by the absorption of these masses. If I give them only one or two or three enemas, they die of poisoning. I did not have the right as a physician to cause the body to absorb all the cancer masses and then not to detoxify enough. With two or three enemas they were not detoxified enough. They went into a coma hepaticum (liver coma). Autopsies showed that the liver was poisoned. I learned from these disasters that you can't give these patients too much detoxification. So I told this lady that for one night she could sleep for seven hours—but only for one night. I wouldn't risk more! When I didn't give these patients the night enemas, they were drowsy and almost semi-conscious in the morning. The nurses confirmed this and told me that it takes a couple of enemas till they are free of this toxic state again. I cannot stress the detoxification enough. Even so with all these enemas, this was not enough! I had to give them also castor oil by mouth and by enema every other day, at least for the first week or so. After these two weeks you wouldn't recognize these patients any more! They had arrived on a stretcher and now they walked around. They had appetite. They gained weight and the tumors went down. You will ask, "How can such a cancerous tumor go down?" That was a difficult question for me to understand. I had learned in my treatment of tuberculosis patients that I had to add potassium, iodine, and liver injections to help the liver and the whole body to restore the potassium. Now as far as I can see this is the situation. At first we give the patient the most salt-free diet possible So, as much salt (sodium) is removed from the body as can be- During the first days, 3 grams, 5 grams, up to 8 grams a day of sodium are eliminated while the patients receive only about one half gram of sodium content in the diet and no sodium is added.
    The patients are given thyroid and lugol solution.* I learned first through the so-called Gudenath
    tadpole experiment that iodine is necessary to increase and help the oxidation ability. Then we gave the patients large amounts of potassium." It took about 300 experiments until I found the right potassium combination. It is a 10% solution of potassium gluconate, potassium phosphate.(monobasic), and potassium acetate. From that solution the patient is given four teaspoons full 10 times a day in juices. That large amount of potassium is introduced into the body." At the same time 5 times one grain of thyroid and 6 times three drops of lugol solution, Vz strength. That's 18 drops of lugol which is a large dose. Nobody was observed to develop heart palpitations from that, even if some patients told me that they could previously not take thyroid because they would develop heart palpitation. And all allergies disappeared! Some patients claimed that they could previously not take one teaspoonful of lemon juice or orange juice—they were allergic. But when they are well detoxified and have plenty of potassium…”
    end-of-quote

    • you don’t need to go to so much truble to demonstrate your ignorance; we believe you even with shorten nonsensical comments.

    • “They only managed to find nine cases.”

      Nice cases formally documented in the available research papers. Not nine cases around the world, in total.

      While AltMed may be famous for touting its testimonials, it’s not exactly known for rigorously recording its failures. You’d think with people’s lives on the line they’d want to do that due dilligence for themselves, but I guess not.

      BTW, is there any form of SCAM you won’t prostrate yourself flying to defend? Honestly, it’s like watching Sisyphus trying to roll water up a hill. Whatever Big Quackery’s been paying you to shill for them, they’ve been robbed.

    • @old douchbob: If I may make 2 suggestions: 1. Next time simply let your cat walk on your keyboard for a few minutes as it would be far more valuable than what you typed. 2. Try your next Starbucks-enema with the coffee at 211 degrees.

    • Unfortunately, there are never going to be truthful reports on this as they are so few direct reports on a number of alternative health methods; the reason is simple, the establishment. Big Pharma cannot make money on things like this, so they discourage their use as quackery when they are not. As I recall, Gerson has a cure rate six times better than allopathic methods; that would seem a hard number to ignore. I wish there were more honesty when it comes to non-traditional approaches, but we know why.

      • Mark Frank on Tuesday 10 November 2020 at 21:39 said:
        “…the reason is simple…”

        From casual experience there seems to be an “underground” movement of the “common folk” that is totally disconnected from “the Establishment”, medicine-wise – and there is no particular emotion to it, folks just discover something that works and that’s that.

        The antagonism comes from folks who are disgruntled for whatever reason.

        Last night, watching TV, this surgeon had just removed some tumors, and the patient said “Will it come back?”
        The surgeon hesitated…

        If this guy had responded to Gerson Therapy, his tumors would have shrunk and he would ask no such question.

        Ideally the surgeon should have immediately responded with,
        “Not if you eat properly and avoid smoking, alcohol, added salt, etc.”
        And then added,
        “Using the same excellent food we serve in this hospital, grown organically in the hospital grounds, or sourced likewise, locally.”

      • Mr Frank,

        As I recall, Gerson has a cure rate six times better than allopathic methods; that would seem a hard number to ignore.

        It would be if it were true. The Gerson Foundation makes many improbable claims, but few of them have been verified independently.

      • Mark Frank
        “Big Pharma cannot make money on things like this, so they discourage their use as quackery when they are not.”

        Did you miss the big red banner at the top of the page? What evidence do you have to support this? Give us the name of one pharma company or employee who has funded attacks on alt med. Do you think The Gerson Institute is not making money out of selling this poppycock?

      • Mark Frank – “as you recall”? What do you mean? From where do you recall this?

        As you know, extraordinary claims require extraordinary proofs. A vague recollection by Mr Mark Frank doesn’t cut it as medical evidence sufficent to cause a revolution in cancer treatment.

        Do you really suggest, Mr Frank, that in the almost-a-century since Gerson propounded his ideas, oncologists the world over have been fooled regarding a much more successful treatment? And Mr Frank, when you speak of results “six times better”, do you mean better than was the case a century ago when Gerson started, or better than results today? Where are you getting your figures?

        Can you not see, Mr Frank, that it is casual cruelty on your part to swan in here, where there are people currently getting cancer treatment, or have friends who are undergoing cancer treatment, and tell everyone that there is a method six times better?

        On your vague memory, then, those affected should quickly get into debt to fly out to a Gerson centre?

        You are like someone dropping in to an amputees’ support meeting and casually saying “Oh yes, my friend grew back his amputated leg using Granny’s Chickweed Cream and exercises”.

        It can’t be put better than James Randi put it, when the team from Nature magazine investigated the Benveniste affair (recalling as exactly as I can):
        “If someone says James Randi keeps a goat in his backyard, it would probably be enough to phone a neighbour and ask him to look over the fence and report Yes, there’s a goat there. That would be an acceptable level of verification for such a claim. But if someone says James Randi keeps a unicorn in his backyard, you’ll want a much higher level of verification before you believe it”.

        Mark Frank, there are people in here whose lives are on the line with cancer or who have friends in that position. You’ve made your extraordinary claim. You have a responsibility now to justify it.

      • Mark Frank, I think I have realised where an error may have crept in. It is with your “As I recall”. Your faulty recall has swiched things around. Gerson has clinical outcomes six times WORSE than conventional treatments.

        Unless of course, you have evidence to the contrary? (Remembering that anecdote is not evidence).

        There are people here, and those who know people, currently undergoing treatment for cancer, so your speedy response will be appreciated. You would not, I am sure, have persons delay effective treatment, and suffer unnecessarily.

    • A link from a cancer survivor. That explains everything he did of the Gerson Therapy. I didn’t read the book but now I see it’s important to keep doing many enemas to eliminate the cancer bio so it doesn’t poison you which may be the reasons for deaths. This guy did 5 a day probably to make sure he wasn’t poisoned. A must watch
      https://m.youtube.com/watch?v=5WyEsN9DzSo

      • Debt
        I have reported that video as dangerously misleading.

        • Good man. Alas, they spread like roaches on garbage and it’s not as if Alphabet cares, because Engagement. Let’s just hope future generations are a lot more wise to online scams and BS, because ours is a fricking embarrassment.

        • I’m pleased to hear it.

          The video is nearly two-and-a-half hours long, but it has had thirteen thousand likes and 1,662 comments, which does make me wonder who all these people are who have the time and the patience to sit through it. The comments themselves are pretty scary as they mainly seem to be from people affected in some way by cancer themselves who are reacting as if an important truth has just been revealed to them.

          Just to reiterate what I have said elsewhere on this blog:
          When I was a trainee oncologist my boss had agreed to provide medical supervision to people undergoing Gerson therapy, I suppose to ensure that they did see a real doctor as well from time to time. Those that I looked after found the treatment very hard going (none could manage the recommended five coffee enemas a day), it made them feel terrible, their blood tests became very abnormal and all but one were dead within three weeks of starting it.

          I know this is anecdotal, but so are all the testimonials in favour of it (many from people who subsequently died of their cancer after being convinced that they had been cured). Gerson treatment is based on very strange ideas about cancer and about physiology in general and has not been updated in the 70 years or so since it was first invented. There is no reason to suppose that it is anything other than harmful and it is also expensive.

          • thank you

          • Dr Julian Money-Kyrle on Tuesday 26 January 2021 at 17:55 said:

            “The video is nearly two-and-a-half hours long, but it has had thirteen thousand likes and 1,662 comments, which does make me wonder who all these people are who have the time and the patience to sit through it. The comments themselves are pretty scary as they mainly seem to be from people affected in some way by cancer themselves who are reacting as if an important truth has just been revealed to them…”

            Why do you think this is?

            Folks don’t start this way, most believe in conventional medicine simply because it removes their appendix or gall bladder or teeth and health is restored. The question is how come they change?

            Do you really believe that force should be used against them?

          • Folks don’t start this way, most believe in conventional medicine simply because it removes their appendix or gall bladder or teeth and health is restored. The question is how come they change?

            [citations required]

            Do you really believe that force should be used against them?

            [citation most definitely required]

      • “keep doing many enemas to eliminate the cancer”

        You are a dangerous lunatic. That is not how cancer works. That is not how anything works, except for cruel predatory frauds that exploit the frightened and desperate.

        For those who honestly want to understand how cancers work (and how real medicine is making progress in treating them), start here. And avoid these YouTube grifters and quacks like the social plague they are.

  • I have an old British Army medical manual from the 1920’s where coffee enemas are listed as an emergency treatment for asthma. I would imagine that they would work as the rectal route is an effective way of getting a drug into the body very quickly if you don’t have venous access (absorption is much quicker than by mouth, although some drugs are designed to be absorbed through the oral mucosa for rapid effect). Caffeine has a bronchodilator effect, although related drugs such as theophylline (also found in tea) and particularly aminophylline, are used these days as their effect is more specific; aminophylline is available as in IV preparation and as an inhaler. Of course, the treatment of asthma has improved a bit over the course of the last century or so.

    Personally I find too much coffee makes me feel jumpy and on-edge, (I prefer green tea, which I have sent from China as the only ones available in the UK, even from specialist tea shops, are stale and flavourless) and I can’t imagine that the huge caffeine dose absorbed by rectal administration would be very pleasant.

    Old Bob,

    My three patients who died within three weeks of starting Gerson therapy would not be counted anywhere as having died from coffee enemas, though I would imagine that these contributed to the marked electrolyte abnormalities that we found in their blood tests, and probably hastened their demise.

    With regard to Michael Gearin-Tosh, I read his book a few months ago at the suggestion of somebody on this blog (was it you?). I was struck by the fundamental difference in approach between academics who work in the arts / humanities rather than the sciences (Douglas Adams, author of the Hitchihker’s Guide to the Galaxy, wrote about this). In the arts, everybody’s ideas are considered equally valid, and what is accepted is a matter of fashion. In the sciences, of course, the only arbiter of truth is Nature. Gearing-Tosh, a specialist in English literature, was completely uncritical in accepting Gerson treatment and other things that he tried, and chose to believe what appealed to him. In particular he seemed completely unaware of the behaviour of numbers, and the fact that measures such as median survival and life expectancy can only be applied to groups, not individuals. It is a very good example of what can happen when an intelligent man strays beyond his area of expertise.

    From what I remember, he had what was expected to behave as a high-grade lymphoma, but which actually behaved like a low-grade lymphoma (survival for 10 years or more is quite common here). Lymphomas are notoriously difficult to categorise on the basis of the microscopic appearance of biopsies, even by world-class experts, and these days diagnosis involves the use of antibody-based markers and DNA analysis. I suspect that if he had gone through the normal diagnostic process these days the conclusion and treatment recommendations would have been different.

    • It’s interesting to hear about the broncodilating effect of caffeine. In the early 1990s I was starting to get episodes of wheezing – mild asthma attacks really – without knowing much about atopy.

      Skin problems which turned out to be atopic eczema led to dermatology consultations at the local hospital, and patch tests in Glasgow and RAST tests locally. I turned out to have high IgE to cat dander, and had lived with cats (I love cats) for years.

      I had noticed that if I had a coffee, which i take without milk or sugar, when wheezy, I got some relief. This was quite a reliable effect, for me. It wasn’t an aspect I ever looked into, as I was caught up in skin management (very successful) and allergen avoidance (also successful).

      So now I know why the coffee helped!

      But I will stick to the oral route…..

    • Dr Julian Money-Kyrle on Saturday 31 October 2020 at 15:38 said:
      “From what I remember, he had what was expected to behave as a high-grade lymphoma, but which actually behaved like a low-grade lymphoma (survival for 10 years or more is quite common here).”

      No it was multiple myeloma:
      Quote from pages 20 to 21, of Living Proof:
      “…What about the library? Each Oxford college includes most disciplines, and we take medical students.

      I find a book, Rees, Goodman and Bullimore, Cancer in Practice (1993). Myeloma is in the index, and p. 193 reads:

      Multiple myeloma is incurable. The median survival time from clinical confirmation to death is under a year in untreated patients, and two to three years with treatment. Some 15% die within the first three months. Underneath there are:

      SYMPTOMS AND SIGNS
      Bone pain, pathological fracture, anaemia, symptoms of hypercalcaemia and renal failure, fever due to infection.

      So here is my anaemia and fever. Also bone pain…”
      End of quote

      • Old Bob
        “Multiple myeloma is incurable. The median survival time from clinical confirmation to death is under a year in untreated patients, and two to three years with treatment.”

        That book cites 30-year-old data. When my myeloma was diagnosed 12 years ago I was told that median survival was 3-5 years. I am still here and well, without treatment. What Gearin-Tosh didn’t grasp (among many such) is that a distribution curve has tails. If you don’t understand that, learn some basic statistics.

        • Les Rose on Sunday 01 November 2020 at 14:13 said:
          “When my myeloma was diagnosed 12 years ago I was told that median survival was 3-5 years. I am still here and well, without treatment.”

          That is excellent news, you must be ecstatic? – what food do you take? Or exercise? Or how much sunshine? Do you restrict animal protein intake? Salt?

          • Old Bob
            “That is excellent news, you must be ecstatic? – what food do you take? Or exercise? Or how much sunshine? Do you restrict animal protein intake? Salt?”

            I was not advised to change anything. I have the same diet as before, hate exercise. and stay indoors mostly. No particular salt restriction. Can you understand that when there is a distribution of prevalence versus prognosis some people get lucky? I could easily have gone full Gerson and written a book about it, and you would have attributed my success to Gerson and not luck. However so far I have not died of sepsis because I refused antibiotics, as Gearin-Tosh did.

            I am not ecstatic. just grateful that the dice rolled in my favour.

          • Les Rose on Sunday 01 November 2020 at 14:58 said:
            “I could easily have gone full Gerson and written a book about it, and you would have attributed my success to Gerson and not luck.”

            Maybe, that depends on what is written, not how it is written.

            But the “how” sells the book and even SJ Haught (newspaperman) and MGT (English academic) both quote Gerson extensively because they recognise the superior writing – and writing (and English) were not Gerson’s first line – Gerson is still in print, the others have faded away.

          • Old Bob
            “…even SJ Haught (newspaperman) and MGT (English academic) both quote Gerson extensively because they recognise the superior writing…”

            Do any scientists quote and recognise Gerson? What is more valid, robust evidence poorly presented, or nonsense beautifully written?

          • Les Rose on Monday 02 November 2020 at 09:43 said:
            “…What is more valid, robust evidence poorly presented, or nonsense beautifully written?”

            The presentation and the thing-presented are the same thing e.g.
            E == mc^2
            Or
            “A is A”
            I.e. a hierarchy of concepts, the trick that allows the mind to hold unlimited knowledge: language – which is, in itself, beautiful because that is what beauty is: truth.

            Try to do the opposite: think of something “beautiful” that is false such as “…beautiful truth slain by ugly fact…” – that has a certain roughness, an ugliness, why? Because ugly-fact or uglyfact clash in the back of the mind (unless that mind hates facts) likewise beautiful-truth-slain, grates (unless that mind rejoices in destruction).

          • Old Bob
            “The presentation and the thing-presented are the same thing…”

            So the medium is the message? No, that’s meaningless twaddle. Try to keep on topic please.

          • superior writing

            Define “superior”. Being slickly written and factually correct are not the same things.

            Lies sell. Just look at Trump voters.

          • Les Rose on Monday 02 November 2020 at 14:56 said:
            “So the medium is the message?”

            From here:
            https://en.wikipedia.org/wiki/The_medium_is_the_message
            quote
            “McLuhan describes the “content” of a medium as a juicy piece of meat carried by the burglar to distract the watchdog of the mind.[11]”
            End of quote

            For example the medium is the WWW and e.g. these posts the content. The result: endless personal attacks without resolution. The medium is the message: shallow thoughtless exchanges because of instant electronic comms – going back in history, the reverse happens: folks have to think in isolation, without constant external interruptions, allowing contemplation and discovery and great art: the barometer of the age.

          • has on Monday 02 November 2020 at 15:49 said:

            “Define “superior”. Being slickly written and factually correct are not the same things.”

            You have chosen to define “superior” as “slick” in this instance – that is your choice.

          • And you have chosen to evade, Bob. Again.

            That is a choice which speaks volumes about both your arguments and the type of person you are.

          • I hope so.

        • You guys… truly, you have a dizzying intellect!

      • Old Bob,

        The memory does play strange tricks. I was diagnosed with multiple myeloma about four years ago, having had symptoms for six months beforehand. I’m quite surprised that I didn’t remember that Gearin-Tosh had the same thing. Though myeloma and lymphoma are both haematological malignancies arising from lymphocytes.

        According to Cancer Research UK (https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/myeloma/survival#heading-Zero), the proportion of newly-diagnosed cases of myeloma expected to live five years is about 50%, and for ten years it is about 30%. By comparison, they give five-year survival in the 1980’s to be about 25%. As Les Rose points out, the distribution curve of median survival is quite wide, so it is not surprising to find individuals towards the tails (this is something that Gearin-Tosh fundamentally failed to understand). And of course if he hadn’t been among this fortunate minority he would never had lived long enough to write his book.

        The figures on the CRUK Web site show a clear, steady and very marked improvement over the past few decades. Do you suppose this change is due to improved diet, particularly with regard to salt and animal protein intake, a tendency towards more exercise and more exposure to sunlight over this period? Or perhaps a widespread adoption of Gerson therapy among haematology patients?

        From my own experience I attribute my survival so far to advances in modern medicine. In the six months before my diagnosis I lost 15Kg in weight, became markedly anaemic, sustained two pathological fractures in my spine and eventually had to stop working when I had an unstoppable nosebleed from which I lost over a litre of blood. I started to improve with standard treatment (bortezumib, thalidomide and dexamethasone) though two months later I was admitted to ITU with acute epiglottitis after having an obstructive respiratory arrest in my own hospital. Epiglottitis, by the way, was regularly a killer when I was a junior doctor, but is rare these days as babies are routinely vaccinated agaist Haemophilus influenzae in the UK; I am too old to have benefited from this policy. Unfortunately my response to treatment was short-lived, and my myeloma progressed through second-line (daratumumab and lenolidamide) and third-line (heavy combination chemotherapy including doxorubicin, cyclophosphamide, etoposide and cisplatin, which has left me with high-tone deafness and steady magnesium loss from my kidneys, though ever since my hair grew back it has been curly). For the past three-plus years I have been on daratumumab and pomalidomide, which has kept everything steady, and I have been reasonably well as a result, if rather immunosuppressed as daratumumab prevents me from making antibodies and lenolidamide suppresses neutrophil and lymphocyte production in the bone marrow (of course myeloma itself is very immunosuppressive when it takes over the marrow).

        I am overweight, I don’t exercise enough, and loss of smell following an infection three years ago means that I tend to put more salt on my food than I used to. I have also given up coffee, which now tastes revolting, though I haven’t tried the rectal route.

        • Again, thanks for excellent knowledge passed on 🙂 I still savour previous knowledge about dexamethasone on other post (about coming off it too quickly – that fit with some disconnected stuff I only half-remembered, but now is locked solid) Thanks!

          That thalidomide chirality? Was it the “bad” handedness of its past history? Or the “proper” one?

        • Dr Julian Money-Kyrle on Monday 02 November 2020 at 09:55 said:
          “The memory does play strange tricks. I was diagnosed with multiple myeloma…”

          from here:
          https://ia803008.us.archive.org/18/items/Linus_Pauling_PDF/Cancer%20and%20vitamin%20C%20_%20a%20discussion%20of%20the%20-%20Cameron%2C%20Ewan%3BPauling%2C%20Linus%2C%201901-1994%2C%20j.pdf

          [Quote, page 173 – 174 (Chapter 21) of Cancer and Vitamin C by Pauling and Cameron]
          “Case r (multiple myeloma)
          A man living in Florida had become progressively unwell throughout the whole of 1976 with a puzzling illness of increasing weakness, bone pain, and rectal and nasal bleeding. The correct diagnosis of multiple myeloma was established in February 1977.

          He had a markedly elevated gamma globulin concentration in his blood, a diagnostic feature of this form of malignancy. As soon as the diagnosis was established he began taking ascorbic acid, rapidly building up to a tolerance level of 40 g per day. Within 5 days his rectal bleeding ceased. While still continuing his ascorbic acid, he commenced a 5-drug chemotherapeutic regime, and after 10 months his blood values had returned to normal and a repeat bone-marrow biopsy showed no evidence of any residual myeloma cells.

          It is interesting to note that as his condition improved his tolerance level for ascorbate fell from 40 to around 20 g per day, indicating a diminished requirement as his disease was brought under control. At the time this man’s illness was diagnosed he was in constant pain and barely able to get out of bed; even before chemotherapy was commenced he was aware of distinct symptomatic improvement, and when last heard from he was busily constructing an extension to his home. The skilled chemotherapy undoubtedly contributed to this man’s present well-being, but his early response was so rapid and so good that we have no doubt that his vitamin C also contributed to the outcome.”
          [end-of-quote]

  • 9 people! Another pandemic! Lets lockdown all sources of coffee.
    Gerson therapy has been dramatically helping people since the mid 20th century, more than 50 years, with only 9 reported adverse events from coffee enema. Pretty remarkable record of safety. Gerson therapy helped me a lot.
    A coffee enema does more than just empty the colon. The caffeine entering a vein to the liver triggers a response that is supposed to be cleansing.

    • hot air, unless you have evidence for your claims.

    • Gerson therapy has been dramatically helping people since the mid 20th century, more than 50 years, with only 9 reported adverse events from coffee enema.

      Genuinely impressed by how many flat-out lies you can squeeze into a single sentence. Shame there’s no room left for any evidence.

        • so old and still doesn’t know what evidence is!

          • Doesn’t know, doesn’t care. Propaganda works. Confirmation bias works. Bob wants to believe; hence everything that strengthens that belief is “evidence”, whereas everything that threatens it is “BigPharmaShillIlluminatiConspiracy” wharrgarbl. As an ontological exercise it’d make even Aristotle cringe (and he’s been dead for 2000 years), but it works for Bob and is foundational to his ego so why should he change? All other considerations—including other people’s lives—are secondary.

            It’s a kind of prepubescent narcissism, and if it was just them that suffered from it then we couldn’t care less. But like any religion they must propagate that belief to vulnerable others as part of its reinforcement, who then end up dead because of it. Their right to swing their fist ends wherever they damn well please, and you can’t tell them otherwise because they’re Special and you’re not.

            There’s a fundamental dishonesty to people like Bob; one that runs right to the core of everything they are and believe themselves to be. It’s not that they lie to us, it’s that they lie to themselves; and that is a very hard habit to give up.

          • It’s better to avoid personal attacks – it’s not a good look 🙂

          • @Bob: To really understand AltMed, one should read its personalities, not the drivel they espouse.

            Besides, vivisecting your psychopathologies is fun.

          • You are welcome.

          • More like firehosing and then weaseling when called on it, Bob. Fooling no-one but yourself.

        • Please tell me why Gerson never published this stuff in a peer-reviewed journal, or did any randomised controlled trials.

          • Les Rose on Sunday 01 November 2020 at 10:01 said:
            “Please tell me why Gerson never published…”

            Gerson M. [Aus der innern Abteilung des Stadt. Krankenhauses im Friedrichshain zu Berlin. Eine Bromoformvergiftung.] Aerztiliche Sachverstandigen-Zeitung 1910-01-01;(1):7-8.

            Gerson M. [Zur Aetiologie der myasthenischen Bulbarparalyse.] Berl. Klin. Wchnschr. 1916-12-18;53(51):1364.

            Gerson M. [Uber Lahmungen bei Diphtherieban-zillentrazern.] Berl. Klin. Wchnschr. 1919-03-24;56(12):274-277

            Gerson M. [Zur Aetiologie der multiplen Sklerose.] Deutsche. Atschr. f. Nervenh., Leipz. 1922;74:251-259

            Gerson M. [Uber die konstitutionelle Frundlage von nervosen Krankheitserscheinugen und deren therapeutische Beeinflussung.] Fortschr. d. Med., Berl. 1922;42:9-11.

            Gerson M. [Uber die konstitutionelle Grundlage von nervosen Krankheitsercheinungen und deren therapeutische Beeinflussung.] Fortschr. d. Med., Berl. 1924;42(1):9-11.

            Gerson M. [Entstchung und Entwicklung des Tuberkulose Ernahrungenverfahrens.] Munch Med Wochenschr 1926-01-08;73(2):51.

            Gerson M. The origin and rationales of dietary treatment of tuberculosis [DieEntstehung und Begrundung der Diatbehandlung der Tuberkulose.] Med Welt 1929-09-14;3(37):1313-1317

            Gerson M. [Korrespondenzen. Rachitis und Tuberkulosebehandlung.] Dtsch Med Wochenschr 1929-09-20;55(38):1603.

            Gerson M. [Phosphorlebertran und die Gerson-Herrmannsdorfersche Diat zur Geilung der Tuberkulose.] Dtsch Med Wochenschr 1930-03-21;56(2):478-480

            Gerson M. Comment on Wichmann’s article of December 17. Klin Wochenschr 1930-04-12;9(15):693-694

            Gerson M. [Grundsatzlich Anleitungen zur “Gerson-Diat”.] Munch Med Wochenschr 1930-06-06;77(23):967-971

            Gerson M. [Einige ergebnisse der Gerson-Diat bei Tuberkulose.] Med Welt 1930-06-07;4(23):815-820

            Gerson M. [Erwiderung auf die Arbeit; Die Grunde der Abelhung der salzlosen Diat durch die Tuberkuloseheilanstalten von Prof. O. Ziegler.] Dtsch Med Wochenschr 1931-02-20;57(8):334-335

            Gerson M. [Einiges uber die kochsalzarme Diat.] Hippokrates 1931-03;3:627-634

            Gerson M. [Einige resultate der Diattherapie bei Kavernen nach vorausgegangener chirurgischer Behandlung.] Verhandl. d. deutsch. Gesellsch. f. inn. Med. Kong. 1932;44:222-224

            Gerson M. [Blutsenkung bei Diatbehandlung der Lungentuberkulose.] Zeitschr. f. Tuberk. 1932;63(5):327-337

            Gerson M. [Diatbehandlung bei Migrane und Lunentuberkulose.] Wien Klin Wochenschr 1932-06-10;45(24):744-748

            Gerson M. [Erwiderung auf die Arbeit C. v. Noordens “Kritische Betrachtungen uber Gerson-Diat in besondere bei Tuberkulose”.] Med. Klin.Wchnschr. 1932-09-09;45(31):1116-1117

            Gerson M. [Psychische Reaktionen wahrend der Gerson-Diat bei Lungentuberkulose.] Psychotherapeut. Praxis 1934-12;1:206-213

            Gerson M. Diet therapy of lung tuberculosis [Diatbehandlung der Tuberkulose.] Leipzig and Vienna; Franz Deuticke; 1934.

            Gerson M. Liver Medications with the Dietary Therapy of Chronic Diseases. Wien Med Wochenschr 1935;40:1095

            Gerson M. [Bemerkngen zum Aufsatz von Neumann “Ernahrung der Tuberkulosen”.] Wien Klin Wochenschr 1935-03-01;48(9):272-275

            Gerson M, von Weisl W. Fluid rich potassium diet as treatment for cardiorenal insufficiency. [Flussigkeitsreiche Kalidiat als Therapie bei cariorenaler Insuffizienz.] Wien Med Wochenschr 1935-04-11;82(15):571-574

            Gerson M. [Unspezifische Desensibilsierung durch Diat bei allergischen Hautkrankheiten.] Dermatol Wochenschr 1935-04-20;100(16):441-447

            Gerson M. [Unspezifische Desensibilsierung durch Diat bei allergischen Hautkrankheiten.] Dermatol Wochenschr 1935-04-27;100(17):478-486

            Gerson M. [Ruckbildung von Entzundungen bei Gerson-Diat unter besonderer Berucksichtigung der Tuberkulosen Entzundung.] Wien Klin Wochenschr 1935-06-21;48(25):847-853

            Gerson M. [Anmerkung zur obigen Ausfuhrung von W. Newmann.] Wien Klin Wochenschr 1935-08-23;48(34):1069

            Gerson M, von Weisl W. [Lebermedikamentur bei der Diattherapie chronischer Krankheiten.] Wien Med Wochenschr 1935-09-28;85(40):1095-1098

            Gerson M. Feeding the German Army. N Y State J Med 1941-07-15;41(14):1471-1476

            Gerson M. Some aspects of the problem of fatigue. Med.Record. 1943;156(6):341

            Gerson M. Dietary considerations in malignant neoplastic disease; preliminary report. Rev. Gasroenterol 1945-11/12;12:419-425

            Gerson M. Effects of combined dietary regime on patients with malignant tumors. Exp Med Surg 1949-11;7:299-317

            Gerson M. [Diattherapie boesartiger Erkankungen (Krebs).] Vienna; Scala, Hanbuch der Diatetik Separatabdruck; 1954.

            Gerson M. No cancer in normal metabolism; Outcomes of a specific therapy. [Kein Krebs bei normalen Stoffwechsel; Ergebnisse einer speziellen Therapie.] Med Klin 1954-01-29;49(5):175-179

            Gerson M. Cancer, a problem of metabolism. [Krebskrankheit, ein Problem das Stoffwechsels.] Med Klin 1954-06-25;49(26):1028-1032

            Gerson M. On the medications of cancer management in the manner of Gerson. [Zur medikamentosen Behandlung Krebskranker nach Gerson.] Med Klin 1954-12-03;49(49):1977-1978

            Gerson M. [Sind boden, Nahrung und Stoffwechselschadigungen grundlegend fur die Krebsentwicklung?] Ernahrungs UMSCHAU 1955;6:128-130

            Gerson M. A New Therapeutical Approach to Cancer. Herald of Health 1957-04;

          • and which of these papers are clinical trials?

          • Edzard on Sunday 01 November 2020 at 12:14 said
            “and which of these papers are clinical trials?”

            Let Gerson himself, reply (Chapter XXVIII, page 212, A Cancer Therapy):
            Quote:
            “Retrospectively, I think the results were arrived at because I did not follow most of the
            scientific literature nor the laboratory findings, as far as they did not accord with the clinical
            confirmations. “Der Erfolg am Krankenbett ist entscheidend,” Professor Kussmaul said. (The
            result at the sick-bed is decisive.) I do not want to make the mistake Winston Churchill
            expressed so clearly: “Men occasionally stumble over the Truth, but most pick themselves up
            and hurry off as if nothing had happened.”

          • THANK YOU FOR CONFIRMING THAT GERSON DID NOT PUBLISH ANY CLINICAL TRIALS

          • “Let Gerson himself, reply”

            Gerson’s dead, Bob.

            Les and Edzard both asked you. And your evasions speak louder than any words could.

          • has on Sunday 01 November 2020 at 13:38 said:
            “Gerson’s dead, Bob.”

            So why bother with the personal attacks? Unless you realise he lives!

          • Calling it a “personal attack” doesn’t make it one, Bob. There is something fundamentally wrong with your thinking, and the thinking of your fellow AltMedders. Figuring out what that wrongness is and why it persists helps to explain why AltMed exists. In any case, all criticisms of AltMed are attacks on your egos, since you’ve welded one to the other, so it’s funny you should get huffy now. I’m just trying to get to the heart of the problem, because people die when these beliefs are wrong and I think that’s rather important; what’s your motive?

          • has on Monday 02 November 2020 at 09:33 said:
            “…what’s your motive?”

            I am addicted to verbal abuse 🙂

          • More like firehosing and then weaseling when called on it, Bob. You fool no-one but yourself.

          • Peace and love man.

          • Evidence or GTFO Bob.

          • this guy just broke my BS-detector!

          • Oh Bob!
            Did you really spend 2 hours of your life watching that video?
            It would take far less time to read one of EE’s pieces on what constitutes evidence.
            And if you have a bit more time, one of the statistics books that Dr JMK recommended.

          • zebra on Tuesday 03 November 2020 at 14:00 said:
            “Did you really spend 2 hours of your life watching that video?
            It would take far less time to read one of EE’s pieces on what constitutes evidence.”

            And far less time to do nothing at all 🙂 – but this assumes the video is false and that EVB is true – excluding others e.g. that both are true.

    • right, and how many people didn’t survive chemotherapy. The Gerson therapy uses the correct ways to heal people I have healed my own, high blood pressure, diabetes, kidney stones; my daughter who was doomed to die with megacolon actually has survived when all doctors have said there was no hope for her.
      The pharmaceutical companies have alot to fear from Gerson’s method, because they make no money when people use the therapy. the bottom line is money. first time in history America is the only country squelching new methods of healing. India has been using these methods for 1000s of years. they have hospitals that follow homeopathic and modern medicine combination. so are other countries following. It is important to learn the procedure and do it exactly as it is instructed. we cannot make our own changes to it. and the instructions are available in several books.

      • “The Gerson therapy uses the correct ways to heal people”
        do you have more than anecdotes; do you have evidence?

      • feruky
        “The Gerson therapy uses the correct ways to heal people….” Who says so? All you have to do is to cite one good quality randomised controlled trial that supports this statement. And any conspiracy theories also need evidence, so don’t bother with those.

        • Les Rose on Wednesday 11 November 2020 at 14:45 said:
          “All you have to do is to cite one good quality randomised controlled trial that supports this statement.”

          That is not as simple as that. Gerson’s patients were mostly “gonners”, on stretchers or unconscious – there was no luxury of “controlled” anything.

          • Old Bob:
            “That is not as simple as that. Gerson’s patients were mostly “gonners”, on stretchers or unconscious – there was no luxury of “controlled” anything.”

            Special pleading.

          • Old Bob,

            That is not as simple as that. Gerson’s patients were mostly “gonners”, on stretchers or unconscious – there was no luxury of “controlled” anything.

            That doesn’t seem to prevent clinical trials in patients treated in intensive care units.

          • why do you say such nonsense, when I have just shown you the only RCT of a gerson-like therapy?
            https://edzardernst.com/2020/11/the-gerson-therapy-possibly-the-worst-cancer-quackery-of-them-all/

          • Edzard on Thursday 12 November 2020 at 15:55 said:
            “why do you say such nonsense, when I have just shown you the only RCT of a gerson-like therapy?
            https://edzardernst.com/2020/11/the-gerson-therapy-possibly-the-worst-cancer-quackery-of-them-all/”

            It is impossible to do a RCT of Gerson Therapy because the control arm would notice the lack of enemas and juices for starters 🙂 – the lack of a 13 hour day of hard labour 🙂 (for the first month).

            Gerson therapy depends on whole organic vegetables cooked for hours in their own juices + Hippocrates soup – the control arm would notice *not* eating this 🙂

            Everyone would know who was doing Gerson and who was not doing Gerson.

            Suppose the “doublt-blind” is accepted as impossible 🙂 What food is the control arm going to eat? Fast food! 🙂 Alcohol! 🙂 of course not, but they would have to eat something “standard” that was the “opposite” of whole organic vegetables – who would want to volunteer to do that, with terminal cancer!!!

            There is no alternative to Gerson because the world is rediscovering Gerson Therapy, slowly, by fixating on less salt, more vegetables, juicing, less animal protein, no smoking, no alcohol, more fruit, drinking more fluids, going organic, eating whole foods etc.

            Gerson says, in the first line of his book that the secret of Gerson Therapy is that there is no secret! (the AMA always claimed that Gerson kept his diet secret).

            The land is our external gut, poison that and we poison ourselves. Likewise the air and the water. That the philosophy of Gerson, there is no control arm that is the opposite, except death.

          • an RCT is a controlled trial where patients are randomised to two groups. there is no reason why this is not possible with Gerson. one group does Gerson, the other chemo. no need for blinding, or placebos.

          • Prof Ernst: “an RCT is a controlled trial where patients are randomised to two groups. there is no reason why this is not possible with Gerson. one group does Gerson, the other chemo. no need for blinding, or placebos.”

            IANAS but I believe a randomized trial of Gerson-only vs chemo-only would be highly unethical, since you’d be deliberately depriving some participants of the the current standard of care (i.e. an RCT ought to compare current-standard-of-care plus placebo vs current-standard-of-care vs treatment-being-tested). And even a chemo+Gerson vs chemo+placebo comparison would be highly problematic, given that both are stressors and it’s tough enough dealing with either one never mind the two at once.

            An observational study of self-selecting Gerson-only vs chemo-only patients could be done, as those participants have already made their own personal choices and the study is merely watching to see how those choices turn out for them. Since the outcome being measured—[time to] death—is entirely quantitative and impossible to miss, individuals in one group can be compared to individuals in the other who are at the same disease stage. The big challenge is to minimize the bias created by other differences between them (e.g. general lifestyle) which is what an up-front randomization would normally do. Thus the results won’t be as good as for a randomized trial, but it can be done with the appropriate error bars and caution in drawing conclusions.

            The real reason Gerson advocates won’t conduct such a trial is that they don’t want to risk it yielding them the “wrong” answer; in addition to already knowing what the “right” answer is, of course. Although that’s true of all AltMed modalities (and irrational belief systems in general), where the goal is to reinforce and propagate one’s deeply-held beliefs, not to question or challenge them.

          • agreed! this is precisely the problem that occurred when an RCT was planned and then changed into a non-randomised controlled clinical trial (so I was wrong, if I calimed that an RCT exists; it’s a CCT):
            The only controlled clinical trial of a Gerson-like therapy that I know of is this one (rarely cited by Gerson fans):

            Conventional medicine has had little to offer patients with inoperable pancreatic adenocarcinoma; thus, many patients seek alternative treatments. The National Cancer Institute, in 1998, sponsored a randomized, phase III, controlled trial of proteolytic enzyme therapy versus chemotherapy. Because most eligible patients refused random assignment, the trial was changed in 2001 to a controlled, observational study.

            METHODS

            All patients were seen by one of the investigators at Columbia University, and patients who received enzyme therapy were seen by the participating alternative practitioner. Of 55 patients who had inoperable pancreatic cancer, 23 elected gemcitabine-based chemotherapy, and 32 elected enzyme treatment, which included pancreatic enzymes, nutritional supplements, detoxification, and an organic diet. Primary and secondary outcomes were overall survival and quality of life, respectively.

            RESULTS

            At enrollment, the treatment groups had no statistically significant differences in patient characteristics, pathology, quality of life, or clinically meaningful laboratory values. Kaplan-Meier analysis found a 9.7-month difference in median survival between the chemotherapy group (median survival, 14 months) and enzyme treatment groups (median survival, 4.3 months) and found an adjusted-mortality hazard ratio of the enzyme group compared with the chemotherapy group of 6.96 (P < .001). At 1 year, 56% of chemotherapy-group patients were alive, and 16% of enzyme-therapy patients were alive. The quality of life ratings were better in the chemotherapy group than in the enzyme-treated group (P < .01). CONCLUSION Among patients who have pancreatic cancer, those who chose gemcitabine-based chemotherapy survived more than three times as long (14.0 v 4.3 months) and had better quality of life than those who chose proteolytic enzyme treatment. https://pubmed.ncbi.nlm.nih.gov/19687327/

          • an RCT is a controlled trial where patients are randomised to two groups. there is no reason why this is not possible with Gerson. one group does Gerson, the other chemo. no need for blinding, or placebos

            Such a trial would never get approval from an Ethics Committee, and more to the point, you would have a lot of trouble getting anybody to agree to be recruited, since patients tend to have quite strong views about broadly what kind of treatment they want. This was the case a few years ago with a randomised trial comparing surgery with radiotherapy for prostate cancer, which collapsed as a result of poor recruitment (though it probably didn’t help that the surgeons involved already thought they knew what was best and didn’t see the reason for a trial in the first place).

            Most cancer trials of new treatment are in patients who have run out of existing options, and the randomisation is between treatment and best existing care, which generally means palliative care. At least then if the treatment under investigation turns out to be useless or harmful the subjects haven’t lost the opportunity to have something of proven efficacy.

      • Feruky,

        The pharmaceutical companies have alot to fear from Gerson’s method, because they make no money when people use the therapy.

        The Gerson Foundation seems to be doing all right.

  • Old Bob
    Can you explain why there is nothing since 1978, and most papers are from the 1930s? Why was this ground-breaking discovery not progressed by anyone else? There are no clinical trials of Gerson therapy on PubMed. Why did Gerson not do any controlled clinical trials? Ah, don’t tell me, there is a conspiracy to suppress results.

    Are all these papers relevant to the discussion? EG:

    Gerson M. Feeding the German Army. N Y State J Med 1941-07-15;41(14):1471-1476

    is about bread.

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