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

One argument that we hear regularly in the comment sections of this blog and elsewhere goes something like this:

“Why worry about a bit of so-called alternative medicine (SCAM like homeopathy or chiropractic, or Reiki, or Bach flower remedies, or detox, etc.)? Why should it bother us? Why not let everyone use what they want? Why not be a bit more tolerant?”

Tolerance is defined as sympathy or indulgence for beliefs or practices differing from or conflicting with one’s own. It is, of course, a quality that normally should be welcomed, taught, and celebrated. So, why not be more tolerant with enthusiasts of pseudoscientific SCAM?

In my view, there are several reasons.

  1. Ineffective therapies harm patients. The public tends to believe that SCAM is inherently safe. This is, of course, not true – think of chiropractic, for instance. But some treatments seem entirely harmless. Homeopathy might be a good example; its remedies contain nothing and therefore homeopathy can do no harm. Sadly, this is not true either. If a patient uses homeopathy to treat a serious condition, she is likely to harm herself by not treating that condition effectively. In extreme cases, this course of action can be fatal.
  2. Ineffective therapies are a waste of resources. It seems obvious that the money spent on something that does not work is money wasted. This is true whether we buy a car that is beyond repair or a SCAM that does not work beyond placebo.
  3. Pseudoscience makes a mockery of evidence-based medicine. If we are tolerant towards useless SCAM and accept that some people make money on, and mislead the public about SCAM, we basically send out a message that evidence is of secondary importance. This would weaken the trust in evidence-based medicine which, in turn, is bound to render healthcare less effective and stand in the way of progress.
  4. Pseudoscience undermines rationality and one form of irrationality begets another. Perhaps the biggest danger of tolerating promoters of quackery is that this undermines rational thinking far beyond the realm of healthcare. “Those who can make you believe absurdities can make you commit atrocities,” wrote Voltaire. I fear that he might have been correct.

In my view, tolerance about pseudoscientific, implausible, ineffective, or harmful SCAMs is misplaced. On the contrary, I feel that it is our duty to limit the harm they do to the public, patients, and progress by exposing them for what they are.

73 Responses to Tolerance towards pseudo-science?

  • “We should be more tolerant to fraudsters, because.” Oddly, we never hear this when it’s dodgy white van man who convinces your nan that she has shingles loose, and by the time he’s done she has no roof, no windows, no driveway… “But he’s such a nice man, he always gives me a lift down to the cash machine!”

    When it’s blue-collar fraud, society is fit to lynch them; no question. Yet small-scale quasi-religious white-collar fraud is all too often handed carte blanche. Why? Because a lot of its perps believe their own nonsense? Because pampered middle-classes don’t like having their comfy indulgent beliefs challenged?

    This is what bending over backwards for CAM gets you. Everyone should look long and hard and ask themselves “Do I wish to enable that?”

    There is a difference between being nice and being kind. Nice is telling people just what they want to hear. Kind is telling them what they need to hear. The second is much harder. There’s a reason for that.

    • Also the same folks that complain about dodgy white van man are often the first to ask them about a ‘discount for cash’ thereby facilitating tax evasion and ultimately higher taxes for all. (I’d be interested if this is just a UK/Anglo-Saxon phenomenon and absent in societies with higher levels of government and social trust.)

      Just a personal bugbear and not a disagreement with your point.

  • Chiropractic is not a pseudoscience as it is a government registered health care profession in western countries that have significant influence in healthcare policy.

    • … says a chiro.

    • A singularly meaningless statement! As if governments are reliable arbiters of what is and isn’t science, as opposed to what is and isn’t popular with the electorates/special interest groups/military industrial sponsors.

      Chiropracty is a pseudoscience because it is based on a ludicrously simplistic non-scientific understanding of physiology and disease mechanisms, “subluxations”, that flies in the face of everything we’ve learned before and since. Not to mention being the invention of a known serial fraudster, DD Palmer, which alone should be sufficient grounds to see it laughed out the room.

      In an ideal world, the subset concerned with physical therapy for spinal pain and mobility issues would be quietly subsumed into the better-taught, better-regulated physio profession and the rest sacked off as the medically useless nonsense it is. In practice, chiro will almost certainly stay with us for as long as it remains profitable, to the egos and wallets of pratcitioners and consumers, and politicians will happily pander to both for as long as that wins them more votes than it loses.

      • Chiropracty is a pseudoscience because it is based on a ludicrously simplistic non-scientific understanding of physiology and disease mechanisms

        So is osteopathy and modern medicine, but they evolved (most of them).

        Strange how chiropractic isn’t allowed the same opportunity.

        • “Strange how chiropractic isn’t allowed the same opportunity.”
          No! Strange how chiropractic, being based on dogma, does not keep up with the rest of healthcare.

        • Sorry DC, wrong again.
          Chiropractc was invented[sic] at about the same time as medicine was beginning to evolve into a practical science. Chiropractic had exactly the same opportunity.

          • Chiropractic was not given the same opportunity. https://en.wikipedia.org/wiki/Wilk_v._American_Medical_Ass'n

          • @Epstein

            Chiropractic was not given the same opportunity. https://en.wikipedia.org/wiki/Wilk_v._American_Medical_Ass'n

            So chiropractic doesn’t work because the AMA said it doesn’t? You must be joking Mr. Epstein. 😀
            I think chiropractic (the trade) has had all the oportunities it needed to prove its worth, and still has.

          • Chiropractic was not given the same opportunity.

            Chiropractic has had a hundred years to reform itself into a science-based practice. How much more opportunity are you waiting for?

            Pointing to a lawsuit where chiros sued the AMA because the AMA said that its physicians shouldn’t send their patients to anti-science quacks really doesn’t make the argument that you think it makes.

            First you do the thing, then you get rewarded for doing the thing; not the other way around. Good grief, even small children can grasp this simple principle!

            Special pleading is not a substitute for robust, tested evidence. Please go away and come back once you’ve learned the difference.

        • So is osteopathy and modern medicine, but they evolved (most of them).

          Strange how chiropractic isn’t allowed the same opportunity.

          What makes you think it hasn’t had the same opportunity to evolve as osteopathy? They were both invented at about the same time and place.

          • In was in response to has comments that forces a revert back to DD Palmer.

            Chiropractic has evolved. Some chiropractors have not.

            BJ Palmer started a pretty well equipped rehab lab in the 1940s. He stated it was for when chiropractic (spinal manipulation) and medicine wasn’t enough.

            Early colleges were started in which those founders disagreed with DD Palmer “philosophy “ and moved to a more bio mechanical model.

            Today most chiropractors focus on nonpathological back and neck issues. Some areas also now have some prescription rights.

            For most chiropractors DD Palmer is of an historical interest but they have evolved to focus on conservative spinal care.

            It seems only traditionalist chiropractors and pseudo skeptics think what DD Palmer believed must define chiropractors for all time. That’s silly.

        • “Strange how chiropractic isn’t allowd the same opportunity”

          No, no, no!

          Osteopathic doctors (DO’s in the US) go to medical school that is on par with MD schools. It IS unfortunate that they still include osteopathic manipulation in the curriculum, but many (most) ignore it in practice–though those who do use it become quacks in my view, and that is why I avoid them. It may not be fair, but with the advent of the five minute appointment I do not want to spend four of them trying to determine whether or not my doctor is or isn’t committed to this small part of his or her education.

          Chiros go to chiro school–which is just made up subluxation crap. Not the same thing at all.

        • Chiro is has had a century to evolve. It’s not our job to change it, it’s yours.

          A rough analogue is osteopathy, which in the US has more or less discarded the original pseudoscience and remade itself as an MD (although why they don’t just fold it into that…), though remains quackery elsewhere. So it is possible.

          Instead; what have you done? A hundred years of special pleading, and what has that gained you? A better system of medicine? Or a more devout religion? Look at how astonishingly far mainstream medicine has progressed in the time since chiro was invented, while y’all have been happily sitting with your thumbs up your proverbials.

          Really, dudes, put up or shut up. Humanity has more pressing things to be doing than be having this same conversation in another hundred years time.

        • The spelling is chiropractic, not chiropracty. Your comments are worthless.

          • Seriously, that’s the strongest defence you can muster for the validity of chiro: “You’re wrong because of spelling error”??!? And you wonder why you reap scorn.

            Okay, here’s one that’s typo-free: DD Palmer was a serial fraudster, who invented chiropractic because his previous scam, peddling energy medicine, was a failure. That’s the quality of foundation upon which your entire personal belief and professional profit system is built; now what are you going to do about it?

          • has: who invented chiropractic because his previous scam, peddling energy medicine, was a failure.

            “He rented three rooms in the Ryan block. In a few months he added two more. It was not long before he was using eight rooms. In 1892, his business had so increased that he had use for eighteen rooms. These were on the second and third floor. He exchanged these for twenty on the front half of the fourth floor. Business continued to increase until he occupied the entire floor of forty rooms, making over seventeen years in the same building.”

          • I find it amusing that a chiropractor is now reaching for “energy medicine” to defend his own practice. At least chiro can claim a potential mechanism of action (albeit not the one Palmer claimed), which is more than idiot waving of hands has got.

            But, okay, how about you tell us why DD abandoned magnetic waffle for spinal dislocation. And why, in the hundred years since, you and every other chiro has consistently failed to determine if either his nerve-borne “healing energy” or energy-blocking “subluxations” exist. Because all we see is a Courtier’s Reply, built atop fragile whimsy, and y’all are too afraid to touch it; never mind subject it to the merciless kicking that scientific testing involves.

          • Defend my practice? Nah, it was to show that you were wrong, again.

          • I am happy to be corrected that DD Palmer’s energy medicine scam was, in fact, a profitable one†; and chiro was, presumably, an even more profitable riff off the back of that. Because, unlike some people, I have learned how to be wrong; and how to embrace it as an opportunity to correct and improve myself, not doubling down on my wrongness because I’m too proud/embarrassed/crooked to admit it.

            That said, my wrongness only extends to some minor historical facts; yours extends to an entire system of “medicine”. So whether you are actually “winning the game” is another debate entirely.

            † While you failed to cite your source, it was a copy-paste from a DD Palmer hagiography that a Google search quickly turned up.

          • has: yours extends to an entire system of “medicine”

            Yes, historically DD tried to develop a system that would counter the medical approach of that time. Others did as well.

            Today most chiropractors focus on the MSK system addressing mainly nonspecific spinal conditions.

            Most patients come to us for back and neck issues.

            Your issue seems to be with the minority. OK.

          • DC: “most chiropractors focus on the MSK system”

            1. Do you have a reliable citation for the “most”? (My personal impression is that it probably is a majority, but the whole point of science is to eliminate personal impressions as a well-known source of error.)

            2. Do you have evidence that these MSK-focused chiropractors’ understanding and treatment of MSK health issues is now science-based, as opposed to the “energy flow”/“subluxation” garbage taught by Palmer?

            3. If all these chiropractors have indeed abandoned Palmer for science, why are they still self-identifying as “chiropractors” while simultaneously allowing a vocal minority to bring the entire chiropractic profession into disrepute (and endanger patients to boot) with their non-MSK treatment claims, anti-vax evangelism, and the rest of their nonsense? How is that mixed messaging good or trustworthy for patients? Seems to me you should either throw out the quacks or else jump ship yourselves; either is a viable solution.

            Not calling out the incompetents and abusers within the profession is a known problem in conventional medicine (Duntsch, Wakefield, Nassar, etc, etc, etc) which it at least tries to correct (albeit not nearly aggressively enough; ass-covering, management, money, cultural conservatism, and other human and societal factors tend to push back, making it an ongoing battle to do the right thing). So why are chiropractors doing an even worse job of cleaning their own house?

          • Some of your first questions can be answered here or in the references. As for the rest, they have been discussed here many times.

            https://mynbce.org/wp-content/uploads/2020/05/Practice-Analysis-of-Chiropractic-2020-5.pdf

  • I think that the problem is, that some people mix up science an medicine. Medicine is in the first line a high end craft that uses different tools to make people healthy or keep them healthy. Science is one option to bring further development to the toolbox of people working in the field of medicine.

    Reducing medicine to science, we are in danger of falling into the traps of science: reducing the view on a certain aspect and not the entire person, using p-values as triggers for a decison and neglecting more differentiated views like those on distributions of a couple of endpoints that help to assess health status.

    Some people made good experience with medical tools you would regard to be just SCAM.

    And even if these tools just help me as I believe in their functionality and they work for my body as perfect placebo – they have reached their target if I am healthy, again, after treatment.

    I think that even more than scientific results and judgement based on them, it is up to the people to decide what medical tools they prefer and with which tools they made best experience.

    • ” Medicine is in the first line a high end craft that uses different tools to make people healthy or keep them healthy.”
      That’s your definition. Good medicine is the combination of sound science, craft, and compassion.

      • Good medicine? Does that mean there is bad medicine? If so, how much of it is bad medicine?

      • Well said. Alties gasping attempts to claim relevance and value while simultaneously refusing to submit their beliefs to the merciless meat grinder/BS filter that is robust science are, frankly, an embarrassment to human intellect and honesty.

        Oh, and portraying doctors and nurses as mindless unfeeling autonomatons, especially on the back of a global pandemic that has, and continues, to run medical professionals absolutely ragged looking after the rest of us, illustrates better than any science just how insulated and self-obsessed AltMed is. The stench of privilege and entitlement is noted.

    • If I develop a serious health problem, I want to have a treatment that has been proven to work better than placebo.

      • Double blind studies (which is a very good study design) can prove a scientific difference between tested treatment and placebo. However, in most cases we do not know the magnitude of the difference. If the treatment is good and not wanted side effects rarely occur, I would decide for the treatment. If the magnitude of difference to the placebo is small or the medical problem is of low impact and known to vanish in a few days, I would like to take the placebo.

        However, I don’t think that all treatments that come from traditional medicine or homeopathy are just placebos.
        Yesterday I had coryza and a headace. Took a few globuli Aconitum D12 and inhalted medical salt water from a vaporizer. Today, I am fine, again. Don’t know if the development would have been the same without that treatment. My colleague had same problems a week ago and he was fighting (untreated) for a few days with the problem. Of course, this is no scientific proof. However, it is my personal experience that becomes as sum of many experiences an important part of my way to face medical problems.

        If I have medical problems that last a few days and I have to go to the doctor (reason is most of the time that I need a document that confirms my medical problems for my boss) he will give me some “professional” medicine, but also a a prepared not with a few ideas how this kind of disease can be treated in an alternative approach. He gives it to me to enable me to support healing process by these alternative techniques – not as replacement for professional medicine but as additional support. I like my doctor!

        • ” If the magnitude of difference to the placebo is small or the medical problem is of low impact and known to vanish in a few days, I would like to take the placebo.”
          and I would prefer to do nothing in such cases.
          ” I don’t think that all treatments that come from traditional medicine or homeopathy are just placebos.”
          it does not matter in the slightest what you or I think, what counts is the evidence.

          • Yes! Why bother spending money for placeboes when doing nothing–or taking it easy and having a nice cup of tea–will offer the same result? At least you are not supporting quacks!

          • Dear Edzard,

            It is well proven that placebos have their effect. For this reason, I would recommend to take placebos if the professional medicine has only slightly better success and maybe some side effects. Not to take placebos means that you refuse a proven way of healing.

            In the double blinded tests the medicine has to be better than placebos. The medicine is not compared with no treatment at all. The reason is, that placebos have their effect and any pill that does not cause bad adverse effects would be tested to be useful for treatment of the illness as it has its placebo dimension. The task of the medicine is to be better than placebo. And the target is to proove this effect in an statistical analysis as a significantly different success. However, as far as I know there is no demand for a magnitude of the effect. Just being better than placebo and the acutal professional treatment seems to be enough to reach the target.

            I would like to know how much better the medicine does compared to the placebo.

            Regarding evidence, for my actual coryza my treatment did well. Having a large number of cases where it worked successfully, it became evident to me that this is my preferred way to treat simple medical problems.

          • “In the double blinded tests the medicine has to be better than placebos. The medicine is not compared with no treatment at all. ”
            may I suggest you read up about trial design before you make further nonsensical statements?

          • It is well proven that placebos have their effect.

            [citation needed]

          • in fact, the proof is not so solid.
            more importantly, placebos are short-lived, do not work for everyone, and have at best small, purely symptomatic effects.

          • @ Mojo:
            citation of proof that palacebo works.

            Overview paper with a lot of citations of studies:
            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367890/

            Placebo and children, review article:
            https://www.nature.com/articles/pr201366

            Interesting paper regarding the responers – not responders problem:
            https://www.karger.com/Article/FullText/507400

            The last article could explain, why homoepathy wroks for me: I made a couple of very good experiences and this seems to stabilize me as responder for this kind of treatment.

          • Jesus, there’s someone here advocating taking placebos. I didn’t realize time had gone back to 1890.

          • Dear all,

            here another article about the power of placebos:
            https://www.medicalnewstoday.com/articles/306437#examples-of-the-placebo-effect

            This time it is not a scientific paper but an article on a wesite that address to people working in medical business.

            Here another article from Havard Health Medical School:
            https://www.health.harvard.edu/mental-health/the-power-of-the-placebo-effect

            In summary, it looks like placebos don’t treat the disease directly. However, they can make the ill person feel better and could improve professional therapy this way. It’s never just the medicine but the entire system including the ill person, his/her immune system and his/her mental state which have large impact on success of the treatment.

            Thus it is not 1890 but 2021 some doctors make use of this trick to trigger healing in patients.

          • and here is another article about placebo:
            https://pubmed.ncbi.nlm.nih.gov/17467578/

          • @Holger: “make use of this trick to trigger healing in patients”

            Placebos don’t “trigger healing”. Good grief, you sound like one of those spammy “one simple cure that doctors don’t want you to know” advertisments. Placebos can affect the patient’s perception of their own wellbeing, which in turn may affect the patient’s behavior, but they do not in themselves have any therapeutic effect. That’s the whole point.

            What ersatz placebos like homeopathy do is treat a psychological need, as an emotional crutch for needy neurotics and other attention seekers. As I often say, a nice cup of tea and a chat would be an equally effective (and honest) alternative for the positive therapeutic part. However, that wouldn’t feed the need to feel Enlightened and Special, which is what sets AltMed believers above the rest of us. (We’re not talking masters of introspection and humility here.)

            Alas, there’s no cure for childish [quasi-]religions except for growing up; and nobody can make you do that, you have to want to do it for yourself. And a lot of people don’t. So it goes.

        • We know with an incredibly high degree of confidence that homeopathy is a placebo, because its prior plausibility is nil. There is no possible mechanism of action that is compatible with everything we have learned about how our universe works over the last 200 years. Good grief, Oliver Wendell Holmes called it in 1842.

          The only advantage of homeopathy was that, at the time it was created, it was actually better than the conventional medicine of the day, in that homeopathy was merely completely ineffective as opposed to aggressively harmful. Until, shortly after, mainstream medicine got thrown out and replaced wholesale: Galen’s four humors and bloodletting crap all went in the trash, and in its place we got germ theory and anaesthesia, and it hasn’t stopped progressing since.

          Two thousand years of what every western physician knew was Right, destroyed and gone overnight. And if anyone cried for it at the time, they too are long gone. And good riddance too, after having killed who knows how many people from paupers to presidents in their arrogant incompetence.

          And why has homeopathy not gone the same way? Because y’all are cowards, too afraid to discard an emotional crutch that makes you feel special. And often dishonest as well: too venal to give up the (false) status and revenue it affords you. And you think your stubborn sanctimonious inability to admit when you’re wrong deserves an iota of respect? Get out!

        • Double blind studies (which is a very good study design) can prove a scientific difference between tested treatment and placebo. However, in most cases we do not know the magnitude of the difference.

          Yes we do. Clinical trials wouldn’t be very useful otherwise.

      • And if I develop a serious health problem, I want a treatment with less serious side effects than Remdesivir.

        It’s all about risk/benefit…. right ?

        • Of course you do. I want treatments that are much more effective than placebo, and have no side-effects. They don’t yet exist though. But I want them.

          If Remdesivir happens to be the most effective treatment for a serious viral condition that is affecting you, then in consultation with medics, you will have to weigh the risks and benefits.

          • I will never get to that point, because I will have used an alternative approach to Remdesivir. Same goes for a ventilator.
            Both are next to useless for Covid virus. I’ll leave those treatment to you David.

        • Bart,

          And if I develop a serious health problem, I want a treatment with less serious side effects than Remdesivir

          I have been away from clinical practice for a few years so I have no experience of remdesevir. I have just had a look at the data sheet and specifically the prescribing information. As far as I can tell, most of the serious adverse events reported were in people with severe Covid; those with mild-to-moderate Covid found it fairly easy to tolerate, with about 4% having to discontinue treatment due to adverse events (note that reported adverse events are not necessarily caused by the drug in question).

          So…
          If you were unfortunate enough to develop a cancer which was curable by chemotherapy (testicular cancer, acute leukaemia, Hodkgin’s disease, high-grad non-Hodgkin’s leukaemia…) you would refuse treatment?

          If you were involved in a road traffic accident and suffered significant trauma you would refuse life-saving surgery?

          If you had severe Covid you would refuse to be ventilated?

          Personally if I had Covid I would want molnupiravir and Ronapreve as the evidence suggests that they could well save my life (I am on cancer treatment, I am immunocompromised and I have had no response whatsoever to the vaccine). And dexamethasone, of course, if I were sick enough. However, it is likely to be some time before monupiravir is approved and production scaled up so that it is available to be prescribed. In the UK Ronapreve supplies are limited and at the moment the Government is restricting its use to Covid patients already hospitalised, which are the group which the trials showed were least likely to benefit – an example of politics-based medicine.

          • “you would refuse treatment?”

            Patients of sound mind absolutely have the right to decline treatment. We might not personally agree with that choice, but it is their choice to make.

            The problem comes when patients decline conventional treatment because SCAMmers promise them better treatments. They may get away with such behavior for self-limiting conditions but for serious conditions such as cancers SCAM’s blasé self-delusion and willful fraud prove lethal. While the SCAMmers themselves are all too rarely held responsible after the event, and not at all in the lead up to it, even though any honest observer could predict exactly what would happen. Those patients didn’t want to die, they wanted to live! And the SCAMmer seductively promised them an easy, healthy, pain-free way to do it.

            (As if oncologists would continue prescribing painful surgery/radio/chemo procedures if less stressful, effective alternatives existed! They use those tools because, right now, they are the best tools we have.)

            That is what is objectionable about SCAM: it claims to possess superior treatments, yet it refuses to test those treatments rigorously before selling them to patients, and it refuses to acknowledge when patients given those treatments subsequently die of the disease, nor censure the practitioner or abandon the practice.

            The hypocrisy is appalling; the callousness unspeakable. SCAMmers simultaneously insist conventional medicine should be held to impossibly high standards (Nirvana fallacy) while holding their own product to no standards at all, other than “Does is support and reinforce my personal beliefs and prejudices?” At least when the appalling Christopher Deutsch was finally, belatedly, stopped, he received a life sentence. The appalling Miguel Barthéléry got just 2 years. Why? Because he believed in his own bull more? His victims are just as dead. And both were fully preventable.

            If mainstream medicine held itself to the same standards as SCAM, we’d still be bleeding and purging in the style of Galen, and the average lifespan would be 40. With SCAM, it’s impossible to be wrong just as long as you refuse to contemplate even the possibility that you could be. And those corpses don’t exist just as long as you never doubt enough to look behind you.

            It is so very easy to predate desperate frightened people, telling them just what they want to hear instead of what they need to hear, to personal profit and egotistical glory, all in the name of “helping” them. I appreciate that some SCAMmers are Cluster Bs, and some have delusional illnesses. But to the rest: What does it take in order to shame you? To make you catch yourself and ask, “Could I harm somebody else by my words and actions?”

            Please tell us what you need, because we are at a loss.

            “With or without religion, good people can behave well and bad people can do evil; but for good people to do evil—that takes religion.” ― Steven Weinberg

          • * Christopher Duntsch

          • No sir, I would not be treated with chemo.

            Yes Sir
            If I had sever covid I would refuse to be ventilated, oxygen is the solution. I have my own oxygen concentrator machine.
            And yes, I would welcome and accept acute care for an auto accident.

            I wouldn’t take Remdesivir if I was paid.

          • @Bart: “I would refuse to be ventilated, oxygen is the solution”

            LOL, and what do you think the mechanical ventilation is for?

            Personally I’m fine if you choose to die from not getting enough O₂ transferred into your blood, but let’s not pretend you have the first clue what you’re talking about.

            Are you sure you aren’t Roger? You certainly share his fantasy understanding of physiology and disease.

        • If I had sever covid I would refuse to be ventilated, oxygen is the solution. I have my own oxygen concentrator machine

          Mechanical ventilation is rather different from breathing air enriched with oxygen, which is much cheaper, easier and safer. However, there are many situations where it is not adequate.

          For instance, if the patient is retaining carbon dioxide, increasing the proportion of inspired oxygen reduces the respiratory drive, and breathing becomes slower and more shallow. As carbon dioxide continues to accumulate in the body (and oxygen levels continue to fall) it starts to have a narcotic effect, leading to drowsiness, then unconsciousness and finally death. Mechanical ventilation is able to break this cycle.

          Very often with respiratory infections the lungs become oedematous (i.e. waterlogged) which interferes with gas exchange. Mechanical ventilation can shift the balance of pressures and force this fluid back into the bloodstream.

          Also, very often with any illness that causes severe breathing difficulties the patient can become exhausted with the effort of breathing and is no longer able to maintain adequate ventilation. Again mechanical ventilation is the only effective treatment.

          An oxygen concentratos is useful for certain kinds of chronic respiratory illness, but for a severe Covid infection it would be rather like trying to bail out a sinking boat with a teaspoon. Having one at home is also likely to result in false reassurance and a delay in seeking proper help and therefore worse than useless.

          In February 2017 I developed acute epiglottitis, which is an infection of the flap that closes off the trachea to prevent food and liquids from entering the lungs while eating or drinking. It became so swollen that I was having great difficulting getting air in an out, and eventually it obstructed altogether to the point where I lost consciousness from airway obstruction. Luckily by then my wife had driven me to hospital and it was a Thursday morning so there doctors with the right skills were on site and able to get to me in time to pass an endotracheal tube and ventilate me. I spent a week in Intensive Care, during much of which I was unconscious, at the end of which I was so weak that I was unable to stand up. It took me two months to recover, but I am still alive nearly five years on.

          <blockquote<No sir, I would not be treated with chemo.
          The reason that I developed epiglottitis in the first place was that I was immunosuppressed as a result of multiple myeloma, a form of bone marrow cancer, which had been diagnosed two months earlier. Since then I have had a number of different treatments, including chemotherapy and radiotherapy, and I am currently maintained on a combination of drugs including a thalidomide derivative and a monoclonal antibody. I know that this is not a cure, and there are things that I can’t do any more because I don’t have the strength and stamina that I once had, and because of being immunocompromised in this Covid era, but there are many things remaining in life to enjoy.

          Chemotherapy gets very bad press, particularly from people who know very little about it. One thing that a career as an oncologist has taught me is that untreated cancer is usually a great deal worse than any of the treatments that we have for it. The worst thing about having cancer isn’t the chemotherapy, but the changes that you have to make to your life, and the loss of control that you have over many aspects of it.

          Anyway, I am very grateful to my own doctors and to modern medicine generally for what has so far been an additional five years of mainly good-quality life, which has allowed me to hone my wildlife photography skills (see my Facebook page if you are interested), learn to play the organ to a much higher standard than I ever thought possible and watch my grandchildren growing up. Undergoing chemotherapy and ventilation has been a small price to pay in the overall scheme of things.

  • And yet…

    “ Saline injections had been used by 2% to 24% of GPs and placebo pills by 3% to 7%. Instead, use of vitamins was reported by 23% to 75% of GPs, of homeopathic remedies by 33% to 58%, of antibiotics by 17% to 69%, and of supplements by 35% to 59%.”

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6108457/#idm140713170721312title

    • and your point is?

      • That the purpose of AltMed is to pander to needy neurotics, a mutually satisfying transaction of ego pampering for cold hard cash?

        Believe me, I’d be a lot more tolerant of AltMed if it was honest with itself and with patients that this is what it really is and all about. A nice cup of tea and a chat could do wonders for a wide range of non-specific complaints, leaving overworked medical professionals time to deal with recognized organic malfunctions.

        But no, it has to claim it has Special Insights and Miracle Healing Powers far above and beyond just that. Largely, I’ll wager, because its patients’ aren’t even the biggest egos it has to service.

        Too many damn people on this planet have no humility, little self-awareness, and zero capacity to admit when they are wrong. Religion and AltMed just happen to be two of the more popular outlets for the wretches. Why slog for years trying to raise yourself (and in turn others) up, when you can just declare yourself Enlightened and Chosen and skip straight past all the hard work?

        And if a proportion leave bodies in their wake, well I’m sure that is somebody else’s fault too. Eating humble pie is for losers, y’all.

        (And no, I don’t approve of doctors prescribing Go Away And Stop Bothering Me pills either. Though I can at least appreciate what must drive them to do it, and don’t attempt to use it to rationalize others’ bad behavior.)

        • I think we are soulmates. Your comments have done a great deal to offset the Sisyphean despair that bathes my psyche on a daily basis as I encounter pseudoscience on an almost daily basis. Thanks for saying what needs saying in a straightforward way.

        • Rationalize others bad behavior?

          You seem to assume a lot.

  • We in the alternative medical movement call what passes for medical science nowadays which is ghostwritten papers by pharmaceutical company shills to be pseudoscience also. And its far more harmful. And the idea that healthcare is suppressing symptoms is definitely EBM (Evidently Baseless Medicine).

    There is lots of alternative medical evidence that CONmed wont consider. For example the 200+ years of well documented cures in the homeopathy medical literature, for one. Including cures of serious chronic disease that CONmed can begin to equal.

    • one day, you should learn the difference between evidence and experience.

    • Roger, you’re a fantasist. And a painfully tedious, repetitive one at that. The sum total value of homeopathy plus homeopathy literature lies in a plumbed and furnished outhouse. You are incapable of understanding what constitutes good evidence and what does not. All you have is your articles of faith and pathetic need to feel important as you reinforce your emotional crutch with inchoate babble. But your amateur theatrics impress nobody here but yourself, because it’s blindingly apparent even to us lay folks that you don’t have the first clue what you’re talking about.

      Whatever the failings of medical science—and there are many, as frequently pointed out by medical scientists themselves—it at least trends over time towards correcting and improving itself, and the lives of (most of its) patients with it. Because it is prepared to accept and acknowledge when it is wrong, and take measures to prevent the same mistakes being made again.

      Homeopathy sits proudly atop its fantasy castle, atop its fantasy mountain, surrounded by fantasy clouds, and declares that it is Already Correct by the very simple tactic of refusing ever to prove itself wrong. Everything you say and do is done with the sole goal of padding that predetermined conclusion. Homeopathy is incapable of change or growth, because you and your kind are incapable of change or growth. It is a crippled belief system for crippled minds, perpetrated all so that you can declare yourselves Special, without having to do any of the hard work—or run the risks of failure—that actually earning that label requires. All you seek is confirmation of your beliefs; you don’t have the courage ever to ask yourself “But what if I’m wrong?”

      A house of cards at least allows the risk of falling down. Homeopathy is too afraid even to allow that. And it’s obvious as to why: just look at the people in it.

      Sorry, but you are a petty preening childish narcissist, utterly ineffectual, just one of the many useless humans that clutter this world. By your own choice, you will never amount to squat. I would pity you, were it not for the fraud and the occasional killing of other people that your idiot religion costs. But Homeopathy deserves you. You’re the best it’s got.

      • @Has

        Brutal.

        Brilliant.

        Roger will not be able to answer beyond his normal “Do A Proving” nonsense.

        He will never understand quite how and why his position is so wrong. And for all the reasons you have stated.

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