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

Monthly Archives: January 2022

On this blog and elsewhere, I have heard many strange arguments against COVID-19 vaccinations. I get the impression that most proponents of so-called alternative medicine (SCAM) hold or sympathize with such notions. Here is a list of those arguments that have come up most frequently together with my (very short) comments:

COVID is not dangerous

It’s just a flu and nothing to be really afraid of, they say. Therefore, no good reason exists for getting vaccinated. This, I think, is easily countered by pointing out that to date about 5.5 million people have died of COVID-19. In addition, I fear that the issues of ‘long-COVID’ is omitted in such discussions

It’s only the oldies who die

As an oldie myself, I find this argument quite distasteful. More importantly, it is simply not correct.

Vaccines don’t work

True they do not protect us 100% from the infection. But they very dramatically reduce the likelihood of severe illness or death from COVID-19.

Vaccines are unsafe

We have now administered almost 10 billion vaccinations worldwide. Thus we know a lot about the risks. In absolute terms, there is a vast amount of cases, and it would be very odd otherwise; just think of the rate of nocebo effects that must be expected. However, the risks are mostly minor, and serious ones are very rare. Some anti-vaxxers predicted that, by last September, the vaccinated population would be dead. This did not happen, did it? The fact is that the benefits of these vaccinations hugely outweigh the risks.

Vaccines are a vicious tracking system

Some claim that ‘they‘ use vaccines to be able to trace the vaccinated people. Who are ‘they‘, and why would anyone want to trace me when my credit card, mobile phone, etc. already could do that?

Vaccines are used for population control

They‘ want to reduce the world population through deadly vaccines to ~5 billion, some anti-vaxxers say. Again, who are ‘they‘ and would ‘they‘ want to do that? Presumably ‘they‘ need us to pay taxes and buy their goods and services.

There has not been enough research

If those who make this argument would bother to go on Medline and look for COVID-related research, they might see how ill-informed this argument is. Since 2021, more than 200 000 papers on the subject have emerged.

I trust my immune system

This is just daft. I am triple-vaccinated and also hope that I can trust my immune system – this is why I got vaccinated in the first place. Vaccinations rely on the immune system to work.

It’s all about making money

Yes, the pharma industry aims to make money; this is a sad reality. But does that really mean that their products are useless? I don’t see the logic here.

People should have the choice

I am all for it! But if someone’s poor choice endangers my life, I do object. For instance, I expect other people not to smoke in public places, stop at red traffic lights and drive on the correct side of the street.

Most COVID patients in hospitals have been vaccinated

If a large percentage of the population has been vaccinated and the vaccine conveys not 100% protection, it would be most surprising, if it were otherwise.

I have a friend who…

All sorts of anecdotes are in circulation. The thing to remember here is that the plural of anecdote is anecdotes and not evidence.

SCAM works just as well

Of course, that argument had to be expected from SCAM proponents. The best response here is this: SHOW ME THE EVIDENCE! In response SCAM fans have so far only been able to produce ‘studies’ that are unconvincing or outright laughable.

In conclusion, the arguments put forward by anti-vaxxers or vaccination-hesitant people are rubbish. It is time they inform themselves better and consider information that originates from outside their bubble. It is time they realize that their attitude is endangering others.

 

Like so many other anti-vaxxers, Djokovic is deep into so-called alternative medicine (SCAM).

An article in THE TELEGRAPH explains it quite clearly. Here are a few passages:

Here is an anti-scientific crank hiding in plain sight … [In his book Djokovic explains] how he suffered from recurring physical ailments – allergies, breathing difficulties, blocked sinuses – until he gave up gluten.

Nothing especially weird so far – until he explains how his gluten intolerance was diagnosed. A Serbian nutritionist called Dr Igor Cetojevic asked Djokovic to hold his right arm out at right angles and resist the pressure as he pushed down on it. Then the exercise was repeated, only this time while Djokovic held a slice of bread against his stomach. “I was noticeably weaker,” writes Djokovic, who adds that “kinesiological arm testing [has] long been used as a diagnostic tool by natural healers.” Yes, and mediums have long claimed to speak to the dead …

Here is a man who broke up his visits to Wimbledon with trips to the nearby Buddhapadipa Temple to meditate by a lake. A man who revealed two years ago that he has a “friend” in Melbourne’s Botanical Gardens – “a Brazilian fig tree that I like to climb”. Yes, Djokovic’s jet-setting spiritualism might sound charming in itself. But its side-effect has been credulousness.

Serve To Win [ND’s book] describes a so-called “researcher” taking two glasses of water and directing loving energy towards one, while swearing angrily at the other. “After a few days … [the angry glass] was tinted slightly green … the other glass was still bright and crystal clear”. Harmless, perhaps, if deeply dippy. But then, last year, Djokovic could be found hosting a former estate agent called Chervin Jafarieh on his Instagram Live channel. Jafarieh was selling bottles of Advanced Brain Nutrients at $50 apiece, which – like Djokovic’s resistance to the Covid vaccination – sounded contrary to the interests of public health…

… Djokovic expressed in a 2018 interview with Shortlist magazine. “I believe that it is our mission to reach a higher frequency through self-care by exploring and respecting our own avatar, our body and, by doing that, raising the vibration of the planet.” …

And so we return to the dark side of this whole peculiar tale. Were Djokovic just a journeyman player, his pseudo-scientific beliefs would be no more than a bizarre footnote. As it is, he is a powerful role model, particularly in the Balkans. Thousands of people have probably emulated his stance on vaccines. Some are likely to suffer consequences as a result…

Another article explains:

New York Times tennis reporter Ben Rothenberg tweeted out after the news of Djokovic’s visa rejection that the Serbian had been “wildly anti-science” over the years.

“Let’s not lose sight of how wildly anti-science Djokovic has publicly been for years,” Rothenberg began. “Here he was last year preaching about how you can change water with emotion.

“Naive, but maybe these real consequences today can be a reality check for his nonsense?”

Former New York Times reporter Steven Greenhouse said it was “sad to see such a brilliant tennis player join the anti-science, pro-poppycock anti-vaxxers”.

Tennis Channel producer David Kane added: “I sort of don’t care whether Australia bungled L’Affaire Novak because of political/media pressure. This is about someone who has been stridently anti-science and never indicated a good faith effort to receive this essentially mandatory vaccine.F around & find out, as they say.”

And a Guardian article provides further information:

His belief in alternative medicine is complemented by his commitment to alternative history. He frequently retreats to Visoko, in the hills of Bosnia and Herzegovina, where he meets up with the businessman Semir Osmanagic – whose claims that there are ancient man-made structures with magical healing powers, refuted by scientists, have turned the hills into a lucrative tourist destination. Djokovic has also expressed his support for the ultranationalist alternative historian Jovan Deretic, whose writings claim, among other things, that numerous European cultures, including ancient Greeks, Celts and Etruscans, are descended from Serbs.


I am quite confident that I play tennis as splendidly as Djokovic understands medicine. Yet, I do not pretend to be able to teach you how to do a perfect ‘top slice’. In contrast, Djokovic loves to take the role of ambassador for SCAM and other weird stuff.

His father stated that “Novak is the Spartacus of the new world who does not tolerate injustice, colonialism and hypocrisy but fights for the equality of all on this planet, regardless of skin color, religious belief and money they have.” Personally, I see this differently: Djokovic is badly affected by proctophasia; he tolerates no end of BS and fights for pseudoscience. And sadly, his views are all too persuasive to gullible consumers – not exactly what we need in a global health crisis!

In so-called alternative medicine (SCAM) we have an amazing number of ‘discoveries’ which – IF TRUE – should have changed the world. Here I list of 10 of my favorites:

  1. Diluting and shaking a substance makes it not weaker but stronger.

Homeopaths call this process ‘potentisation’. They use it to produce highly ‘potent’ remedies that contain not a single molecule of the original substance. The assumption is that potentisation transfers energy or information. Therefore, they claim, molecules are no longer required for achieving a clinical effect.

2. A substance that causes a certain symptom in a healthy person can be used to cure that symptom when it occurs in a patient.

The ‘like cures like’ principle of homeopathy is based on the notion that the similimum provokes an artificial disease which in turn defeats the condition the patient is suffering from.

3. Subluxations of the spine are the cause of most diseases that affect us humans.

DD Palmer, the inventor of chiropractic, insisted that almost all diseases are due to subluxations. These misplaced vertebrae, he claimed, are the root cause of any disease by inhibiting the flow of the ‘innate’ which in turn caused ill health.

4. Adjusting such subluxations is the best way to restore health.

Palmer, therefore, was sure that only adjustments of these subluxations were able to restore health. All other medical interventions were useless or even dangerous, in his view. Thus Palmer opposed medicines or vaccinations.

5. An imbalance of two life forces is the cause of all illnesses.

Practitioners of TCM believe that all illnesses originate from an energetic imbalance. Harmony between the two life forces ‘yin and yang’ means health.

6. Balance can be restored by puncturing the skin at specific points.

Acupuncturists are convinced that their needling is nothing less than attacking the root cause of his or her problem. Therefore, they are convinced that acupuncture is a cure-all.

7. Our organs are represented in specific areas on the sole of our feet.

Reflexologists have maps of the sole of a foot where specific organs of the body are located. They palpate the foot and when they feel a gritty area, they conclude that the corresponding organ is in trouble.

8. Massaging these areas will positively influence the function of specific organs.

Once the diseased or endangered organ is identified, the area in question needs to be massaged until the grittiness disappears. This intervention, in turn, will have a positive influence on the organ in question.

9. Healing energy can be sent into our body where it stimulates the self-healing process and restores health.

Various types of energy healers are convinced that they can transmit energy that comes from a divine or other source into a patient’s body. The energy enables the body to heal itself. Thus, energy healing is a panacea and does not even require a proper diagnosis to be effective.

10. Toxins accumulate in our bodies and must be eliminated through a wide range of SCAMs.

The toxins in question can originate from within the body and/or from the outside. They accumulate and make us sick. Therefore, we need to eliminate them, and the best way to achieve this is to use this or that SCAM

 

I could, of course, list many more such ‘discoveries’ – SCAM is full of them. They are all quite diverse but have one important thing in common: they are false (i.e. there is no good evidence for them and they fly in the face of science).

If they were true, they would have changed the world by revolutionizing science, physics, physiology, anatomy, pathology, therapeutics, etc.

ALL THESE UGLY FACTS DESTROYING SUCH BEAUTIFUL THEORIES!

WHAT A SHAME!!!

As you know, I am not in the habit of telling personal stories on this blog. Today, allow me to make an exception by taking you back 40 years into my own history.

Back in the 1980s, I spent much of my time doing research in hemorheology (flow properties of blood). At the time, this was a buoyant area of research, and my late friend Arpad Matrai and I were enthusiastically investigating it, first in London under John Dormandy and later at the LMU in Munich. But we were by no means the only team working in hemorheology. Another group at Aachen was much larger, better-funded, and in many ways way ahead of us. One member of that group regularly irritated us; this was Holger Kiesewetter, the ‘hero’ of my story.

Arpad was sure that much of Kiesewetter’s work and even more of his financial dealings were suspect (“How come a junior research can afford driving a Porsche?”, he used to wonder). Something did not seem quite right. Despite our reservations, we did collaborate occasionally. In 1984, we even managed to co-organize a conference and jointly publish its proceedings.

After my friend and co-worker Arpad had died of leukemia, I gradually drifted back into clinical medicine, became a professor of rehab medicine first in Hannover and then in Vienna. This also meant that I completely lost touch with Holger Kiesewetter. I was, therefore, more than a little surprised to one day receive a phone call from him in Vienna. He told me that he had applied for a professorship at my Uni and asked me to support his application. I did not promise to do so and I certainly did not lend my support to his application. Quite simply, I remembered too many instances that gave me reasons to be concerned about my ‘friend’s’ integrity.

Kiesewetter did not get the Vienna post but I later learned that he had become a professor of transfusion medicine at the Charite in Berlin. In the mid-1990s, a chance meeting at an airport occurred when we were both catching flights. He told me that he was doing fine, and he seemed to have his fingers in many pies.

Then I lost sight of him completely.

Until yesterday, that is.

I was doing some searches on herbal remedies when I came across the intriguing subject of ‘BIO VIAGRA‘. A German article reported this:

“In clinical trials, 50 men had much better sex afterward, more fun in bed, and just generally felt better about themselves,” the Sueddeutsche Zeitung daily cited Olaf Schroeder from Berlin’s Charite hospital as saying. “Their libido was even higher than the control group taking Viagra,” he said. The potent cocktail includes tribulus terrestris, a herb already used in alternative medicine, a root vegetable found in the Andes called maca and grape juice extract, newspapers said. The treatment, dubbed “Plantagrar”, is due to be launched in early 2010, the Bild daily said.

Having published a review of maca, I was interested and continued searching.

Another article stated that a certain Mr. Schröder had stated that he had investigated the efficacy of the remedy on 50 test persons. However, the data of the experiment have not been published. In addition, the researchers’ procedure has been massively criticized: 25 men were given the bio-potency drug, 25 others a placebo, i.e. a tablet without active ingredients. Afterward, the test persons were to compare their experiences with those they had had with Viagra. Fritz Sörgel, director of the Nuremberg Institute for Biomedical and Pharmaceutical Research, calls the procedure “completely dubious”. “This is a completely new kind of study that this doctoral student has invented.” The number of test persons is much too low, the comparison with Viagra cannot be taken seriously.

This sounded already quite dodgy, and a third article in the usually reliable German Medical Journal provided more details:

For several months, those involved kept a low profile, but now the affair surrounding the development of a herbal aphrodisiac at Berlin’s Charité University Hospital has consequences: Last week, the head of the Institute for Transfusion Medicine, Prof. Dr.-Ing. Dr. med. Holger Kiesewetter, was given leave of absence. This step was taken “at his own request”, said hospital spokesperson Claudia Peter. The withdrawal came about two weeks after the public prosecutor’s office searched his work and private rooms as well as other locations.

The “Bio-Viagra affair” had caused a furore in mid-March. A doctoral student of Kiesewetter’s had claimed to the Deutsche Presse-Agentur that he had successfully developed an aphrodisiac on a purely herbal basis. Some daily newspapers reported on the remedy, which was called “Plantagrar”. A little later, however, the Charité management denied it. It was “the activity of an employee (. . .) on his own responsibility”. The case also came to the attention of the drug supervisory authority. Erectile dysfunctions are recognised diseases according to the ICD-10 classification system. The “Bio-Viagra” was therefore a drug whose development should have been controlled, the state office for health and social affairs said.

A spokesperson for the Berlin public prosecutor’s office confirmed the presumption of a violation of the German Medicines Act to the Deutsches Ärzteblatt. In addition, Kiesewetter is being investigated for bribery, corruption and breach of trust to the detriment of the Charité. The head of the institute had apparently been promised benefits by private companies.

That sounded very much like the Kiesewetter I remembered. I was unable to find the actual trial or more details about the herbal remedy. The scandal seems to have put an end not only to the university career of the researchers but also to the aphrodisiac.

However, I did find a Wiki page about Kiesewetter that suggests that ‘bio viagra’ was by no means the only escapade from the straight and narrow. But what is he up to today? Did he retire? No, after the debacle at the Charite, he seems to have gone into private practice:

After working as director of the Institute for Transfusion Medicine and Immunohaematology at the Charité and head of the coagulation outpatient clinic at the Charité, he has been providing patient care at the Hämostaseologicum Berlin-Mitte since 2010.

This is also the address he used for his most recent (2020) publication.

Am I worried about my old ‘friend’?

No, I am confident that he is doing just fine … financially, I mean.

 

Cupping is a so-called alternative medicine (SCAM) that has been around for millennia in many cultures. We have discussed it repeatedly on this blog (see, for instance, here, here, and here). This new study tested the effects of dry cupping on pain intensity, physical function, functional mobility, trunk range of motion, perceived overall effect, quality of life, psychological symptoms, and medication use in individuals with chronic non-specific low back pain.

Ninety participants with chronic non-specific low back pain were randomized. The experimental group (n = 45) received dry cupping therapy, with cups bilaterally positioned parallel to the L1 to L5 vertebrae. The control group (n = 45) received sham cupping therapy. The interventions were applied once a week for 8 weeks.

Participants were assessed before and after the first treatment session, and after 4 and 8 weeks of intervention. The primary outcome was pain intensity, measured with the numerical pain scale at rest, during fast walking, and during trunk flexion. Secondary outcomes were physical function, functional mobility, trunk range of motion, perceived overall effect, quality of life, psychological symptoms, and medication use.

On a 0-to-10 scale, the between-group difference in pain severity at rest was negligible: MD 0.0 (95% CI -0.9 to 1.0) immediately after the first treatment, 0.4 (95% CI -0.5 to 1.5) at 4 weeks and 0.6 (95% CI -0.4 to 1.6) at 8 weeks. Similar negligible effects were observed on pain severity during fast walking or trunk flexion. Negligible effects were also found on physical function, functional mobility, and perceived overall effect, where mean estimates and their confidence intervals all excluded worthwhile effects. No worthwhile benefits could be confirmed for any of the remaining secondary outcomes.

The authors concluded that dry cupping therapy was not superior to sham cupping for improving pain, physical function, mobility, quality of life, psychological symptoms or medication use in people with non-specific chronic low back pain.

These results will not surprise many of us; they certainly don’t baffle me. What I found interesting in this paper was the concept of sham cupping therapy. How did they do it? Here is their explanation:

For the experimental group, a manual suction pump and four acrylic cups size one (internal diameter = 4.5 cm) were used for the interventions. The cups were applied to the lower back, parallel to L1 to L5 vertebrae, with a 3-cm distance between them, bilaterally. The dry cupping application consisted of a negative pressure of 300 millibars (two suctions in the manual suction pump) sustained for 10 minutes once a week for 8 weeks.

In the control group, the exact same procedures were used except that the cups were prepared with small holes < 2 mm in diameter to release the negative pressure in approximately 3 seconds. Double-sided adhesive tape was applied to the border of the cups in order to keep them in contact with the participants’ skin.

So, sham-controlled trials of cupping are doable. Future trialists might now consider the inclusion of testing the success of patient-blinding when conducting trials of cupping therapy.

WARNING: after reading this, you might no longer enjoy your favorite breakfast cereal!

‘Biologic living’ is the name John Harvey Kellogg (1852-1943), an influential medical doctor and best-known as the inventor of the cornflakes gave to his health reforms. Biologic living was practiced in Kellogg’s Battle Creek Sanatorium, an institution for re-educating Americans and training of healthcare professionals. Kellogg’s religious beliefs bled into his medicinal practices and the Battle Creek Sanatorium was as much health spar as it was a rehabilitation facility. [1]

In the sanatorium, there was a strict focus on diet which was meant to cure a person of practically all ills, leading to a kind of purity of the soul. Meat and certain spicy, overly flavourful foods, as well as alcoholic beverages, were thought to overexcite the mind and lead to sinful behavior. A bland dull diet was thus recommended. Kellogg intended for ‘cornflakes’ to become the staple of this diet. Other treatments included the following [2]:

  • Vegetarian diet; Kellogg invented an artificial meat substitute based mainly on peanuts, called ‘nuttose’
  • ‘Light bath’, a bath under lights lasting hours, days, sometimes even weeks
  • Regular exercise
  • Various forms of electrotherapy
  • Vibrational therapy
  • Massage therapy
  • Breathing techniques
  • Colonic irrigation delivered by specially designed machines that could deliver 14 liters of water followed by a pint of yogurt, half of which was to be eaten, while the other half would be delivered via a second enema
  • Water cures of various types
  • Sexual abstinence, including various measures to avoid masturbation. For boys, he recommended circumcision without anesthetic, thinking the trauma it caused and several weeks of pain that would follow would curb masturbation. If that did not suffice, Kellogg recommended sewing the foreskin shut, preventing an erection. For girls, he applied carbolic acid to the clitoris as ‘an excellent means of allaying the abnormal excitement.’ He would also recommend binding people’s hands, covering genitalia in specially designed cages, or electroshock therapy, such was his hatred of masturbation.

Biologic living was centered around purity, not merely of the soul but racial purity too. Meat and alcohol were not just bad, they were considered ‘race poisons’. He was a staunch advocate of ‘race suicide’, a term that summed up the fear of white America that their racial purity would be eroded, and they would disappear into ‘inferior races’. Kellogg helped implement a law whereby genetically ‘inferior’ humans such as epileptics or people with a learning disability could be a target. Michigan’s forced sterilization law, which Kellogg himself had a hand in, would not be repealed until 1974.

Today, Kellogg’s biologic living is mostly of historical interest. Yet, it is relevant for understanding some of the more extreme trends in the US related to so-called alternative medicine (SCAM).

 

[1] The Living Temple: Amazon.co.uk: Kellogg, John Harvey: 9781296696375: Books

[2] John Harvey Kellogg And His Anti-Masturbation Cereals | by Danny | Medium

Astrology is nonsense!

Hold on, did we not recently discuss an RCT showing that being born under the sign of Pisces was associated with a decreased risk of death? Yes, indeed, we did!

And isn’t there a branch of homeopathy that heavily relies on astrology? Yes, indeed, astro-homeopathy does exist.

This suggests to me that a sizable proportion of my readers do believe in astrology. As I have made a New Year’s resolution to try to be nice and patient to even the weirdest of them, I herewith offer astrology fans an insight into what 2022 will bring. For that purpose, I have taken one key prediction for each star sign from a website fittingly entitled YEARLY HOROSCOPE:

  • Aries will have big surprises from his life partner.
  • Taurus: dept can increase by leaps and bounds.
  • Gemini: expect big developments.
  • Cancer: You will have a hard time keeping up with messages and appointments.
  • Leo: your abilities will be appreciated.
  • Virgo: you should seriously consider advancing your education.
  • Libra: you’ll need to work closely with others.
  • Scorpio: you, and everyone around you will focus on a variety of challenges.
  • Sagittarius: you’ll refuel what might be called your inspiration tank.
  • Capricorn: you may meet a fortunate contact.
  • Aquarius: don’t burn any bridges that you don’t have.

Being an Aquarius myself, I am struck by the wisdom of not burning bridges that I don’t have. It is brilliant! And so fitting!!!

But then I look at the predictions for all the other signs, and I must say: they also apply to me. In fact, ALL of them apply to me, and not just me – they all apply to everyone.

Does that mean that astrology is nonsense after all?

Does that mean that my attempt to be nice to and patient with even the weirdest of the proponents of so-called alternative medicine (SCAM) has already ended in defeat?

I hope not!

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