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

Monthly Archives: January 2024

Dragons’ Den is a British reality television business programme, presented by Evan Davis and based upon the original Japanese series. The show allows several entrepreneurs an opportunity to present their varying business ideas to a panel of five wealthy investors, the “Dragons” of the show’s title, and pitch for financial investment while offering a stake of the company in return.

It has been reported that Giselle Boxer began selling needle-free acupuncture kits for ears after being diagnosed with myalgic encephalomyelitis (ME). She said the technique had helped improve her own health. Ms Boxer worked for advertising agency before starting her business. A researcher on the show had contacted her to ask if she would like to take part.

Entrepreneur and former footballer Gary Neville was so impressed with her pitch he made her an offer in full before the Dragons had a chance to begin asking questions. She said the impact on the business since the show aired had been “bonkers”. “It’s just been a complete whirlwind,” she said.

Acu Seed kit

The tiny beads are a needle-free form of auriculotherapy, designed to stimulate specific points of the ear to address physical and emotional health concerns. “It completely transformed my life alongside lots and lots of other things like diet, lifestyle changes, meditation, breathwork and movement,” said Ms Boxer. She has since had a child and claimed she was fully healed within a year. “It was like a full overhaul of my life,” Ms Boxer said. Her business, Acu Seeds, sells kits for people to use at home and made a £64,000 profit in its first year, she added.

On the Acu Seed website, we learn the following:

Ear seeds are a form of auriculotherapy, which is the stimulation of specific points of the ear to support physical and emotional health concerns. They are a needle-free form of acupuncture that have been used in Traditional Chinese Medicine (TCM) for thousands of years. TCM teaches that the ear is a microsystem of the whole body, where certain points on the ear correspond to different organs or body parts. Energy pathways (or ‘qi’ or vital life energy) pass through the ear and ear seeds stimulate specific points which send an abundant flow of energy to the related organ or area that needs attention. Think of it like reflexology, but for the ears instead of feet.

Ear seeds also create continual, gentle pressure on nerve impulses in the ear which send messages to the brain that certain organs or systems need support. The brain will then send signals and chemicals to the rest of the body to support whatever ailments you’re experiencing, releasing endorphins into the bloodstream, relaxing the nervous system, and naturally soothing pain and discomfort. Some people use ear seeds alongside acupuncture treatments as they may help the effects of acupuncture last longer between sessions.

I am impressed by the lingo used here:

  • support physical and emotional health concerns – the seeds support the concerns but not the health?
  • a needle-free form of acupuncture – sorry, the seeds don’t puncture anything; they exert pressure; therefore it’s called acuPRESSURE.
  • have been used in Traditional Chinese Medicine (TCM) for thousands of years – no, it was invented just a few decades ago by Paul Nogier.
  • TCM teaches that the ear is a microsystem of the whole body – TCM teaches plenty of nonsense but not this one.
  • Energy pathways (or ‘qi’ or vital life energy) pass through the ear –Qi is nothing more than a figment of the imagination of TCM advocates.
  • send an abundant flow of energy to the related organ or area – only if you believe in your own fictional form of physiology.
  • Think of it like reflexology – which btw is also nonsense.
  • nerve impulses in the ear send messages to the brain that certain organs or systems need support – only if you believe in your own fictional form of physiology.
  • The brain will then send signals and chemicals to the rest of the body – only if you believe in your own fictional form of physiology.
  • help the effects of acupuncture last longer – help the non-existing effects of acupuncture last longer?

One the website, we also learn what for which conditions the treatment is effective:

Ear seeds may support a broad spectrum of health concerns including anxiety, stress, headaches, digestion, immunity, focus, sleep and fatigue. Our ear seed kits include the protocol ear maps for these eight health concerns and each protocol uses between 3 to 5 ear seeds. Ear seeds have also been found to support with women’s health issues like menstrual issues, libido, fertility, postpartum issues, inflammation, menopause and weight loss. The ear maps for these issues are given in our women’s health ear seed kit bundles. The specific combination of seed placements will support your chosen health concern. Further issues that they may support with are addiction, pain, tinnitus, vertigo, thyroid health and more.

Here, I am afraid, we might have a major problem:

THERE IS NO GOOD EVIDENCE TO SUPPORT ANY OF THESE CLAIMS!

I thus do wonder whether the venture of Giselle Boxer might be a case for the Advertising Standards Authority.

I have been banging on about informed consent many times; not because I have a bee in my bonnet, I hope, but because it is of vital importance. Here are a few examples:

I am convinced that informed consent is a key issue in so-called alternative medicine (SCAM). Thus I was delighted to find an article that fully agrees with my view. Even though it has been published a few years ago, it is, I feel, important enough to cite it here:

The demand for informed consent in clinical medicine is usually justified on the basis that it promotes patient autonomy. In this article I argue that the most effective way to promote autonomy is to improve patient understanding in order to reduce the epistemic disparity between patient and medical professional. Informed consent therefore derives its moral value from its capacity to reduce inequalities of power as they derive from epistemic inequalities. So in order for a patient to have given informed consent, she must understand the treatment. I take this to mean that she has sufficient knowledge of its causal mechanisms and has accepted the explanations in which the treatment is implicated. If this interpretation of informed consent is correct, it is unethical for medical professionals to offer or endorse ‘alternative medicine’ treatments, for which there is no known causal mechanism, for if they do, they may end up widening the epistemic disparity. In this way, informed consent may be understood as an effective way of ruling out particular treatments in order to improve patient autonomy and maintain trust in the medical profession.

In other words, if we apply one of the most fundamental rule of medical ethics to SCAM, it would bring about the end of most of SCAM. If we fail to do this, we accept that SCAM is unethical which, in my view, is not a reasonable option.

Only a few years ago, measles – a potentially lethal disease – were deemed to be almost eradicated. Now we hear that, in the UK and the US, cases of measles have been rising again. The latest UK outbreaks are centered in the West Midlands and London. The UK Health Security Agency has thus declared a national incident after the outbreaks in the UK West Midlands. Health officials are encouraging people to have the measles, mumps and rubella (MMR) jab, after figures showed uptake at the lowest level for more than a decade.

I have long warned that the rise in measle cases is due to proponents of so-called alternative medicine (SCAM). Particularly implicated are:

  • doctors of anthroposophical medicine,
  • chiroparactors,
  • homeopaths,
  • naturopath,
  • other healthcare professionals who employ these methods.

A recent case seems to suggest that this is as true today as it was years ago.

A midwife in New York administered nearly 12,500 bogus homeopathic pellets to roughly 1,500 children in lieu of providing standard, life-saving vaccines, the New York State Department of Health reported yesterday. Jeanette Breen, a licensed midwife who operated Baldwin Midwifery in Nassau County, began providing the oral pellets to children around the start of the 2019–2020 school year, just three months after the state eliminated non-medical exemptions for standard school immunizations. She obtained the pellets from a homeopath outside New York and sold them as a series called the “Real Immunity Homeoprophylaxis Program.” The program falsely claimed to protect children against deadly infectious diseases covered by standard vaccination schedules, including diphtheria, tetanus, and pertussis (covered by the DTaP or Tdap vaccine); hepatitis B; measles, mumps and rubella (MMR vaccine); polio; chickenpox; meningococcal disease; Haemophilus influenzae disease (HiB); and pneumococcal diseases (PCV).

You might say that this is just one silly midwife, but I’m afraid you would be mistaken. Here is the very first websites that appeared today on my search for measles/alternative medicine:

Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for measles based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person’s constitutional type, includes your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

    • Aconitum , for symptoms that come on suddenly including fever, conjunctivitis, dry cough, and restlessness. It is best used very early in the course of the disease.
    • Apis mellifica , for individuals with swollen lips and eyes and a rash that is not fully developed. Warmth increases itchiness as well as swelling.
    • Belladonna , can be used either during early stages of measles or after the rash has erupted. It is useful for those who have difficulty sleeping and symptoms that include fever, headache, and drowsiness.
    • Bryonia , for individuals with a delayed rash who have a dry, painful cough, headaches, and muscle pain that worsens with movement and warmth. This remedy is most appropriate for people with a rash primarily on the chest, a dry mouth, and a desire for cold drinks.
    • Euphrasia , for nasal discharge, red eyes, and tears associated with measles. This remedy is most appropriate for people who have a strong sensitivity to light.
    • Gelsemium , for the early stages of measles when there is a slow onset of fever and chilliness, cough, headache, weakness, and a watery nasal discharge that burns the upper lip. This remedy is most appropriate for people who are apathetic and have little or no thirst.
    • Pulsatilla , can be used at any stage of the measles but often used after fever has resolved. This remedy is most appropriate for people who may have thick, yellow nasal discharge, a dry cough at night, a productive cough in the daytime, and mild ear pain. Symptoms are frequently mild.
    • Sulphur , for measles in which the skin has a purplish appearance. The individual for whom this remedy is appropriate may have red mucus membranes with a cough and diarrhea that is worse in the mornings.

Similar nonsense can easily be found on ‘X’; here are but a few examples of the dangerous BS that fans of SCAM posted recently:

  • Measles are extremely mild, alternative medicine is better than petroleum-based drugs that don’t even promise to cure anything, and JK Rowling is a Christian.
  • 1. Can we now talk about the fact that MMR does not produce life long immunity? 2. Can we talk about the Hep A, tuberculosis and measles that are now community spread due to not vetting the health of illegals? 3. Can we finally discuss actual homeopathy remedies that work?
  • I so regret obeying our local school district and having my kids vaccinated. Homeopathy has SAFE medicines to prevent childhood illnesses such as chicken pox, measles, polio, small pox, etc, and more SAFE medicines to cure these illnesses. 
  • My kids had chicken pox and pertussis & covid. Cured all 3 with homeopathy. Never had measles.
  • How to Treatment of Measles with Dr.Reckweg R.No.62 Homeopathy Medicine

I think it is high time that:

  1. we realize that SCAM providers can be dangerous through the irresponsible advice they tend to give,
  2. we change their attitude through educating them adequately and, failing this, penalize them for endangering our health.

Proponents of so-called alternative medicine (SCAM) are often – as we had many opportunities to observe here on this blog – not impressed with the safety and efficacy of COVID vaccinations. This is despite the fact that several studies have demonstrated the huge number of lives saved by them, both at national and multi-country level in the earlier stages of the pandemic. I wonder whether the doubters will be convinced by new evidence.

This analysis estimates how many lives were directly saved by vaccinating adults against COVID in the Region, from December 2020 through March 2023.

The researchers estimated the number of lives directly saved by age-group, vaccine dose and circulating Variant of Concern (VOC) period, both regionally and nationally, using weekly data on COVID-19 mortality and COVID-19 vaccine uptake reported by 34 European areas and territories (CAT), and vaccine effectiveness (VE) data from the literature. They calculated the percentage reduction in the number of expected and reported deaths.

The authors found that vaccines reduced deaths by 57% overall (CAT range: 15% to 75%), representing ∼1.4 million lives saved in those aged ≥25 years (range: 0.7 million to 2.6 million): 96% of lives saved were aged ≥60 years and 52% were aged ≥80 years; first boosters saved 51%, and 67% were saved during the Omicron period.

The authors concluded that over nearly 2.5 years, most lives saved by COVID-19 vaccination were in older adults by first booster dose and during the Omicron period, reinforcing the importance of up-to-date vaccination among these most at-risk individuals. Further modelling work should evaluate indirect effects of vaccination and public health and social measures.

The authors feel that their results reinforce the importance of up-to-date COVID-19 vaccination, particularly among older age-groups. Communication campaigns supporting COVID-19 vaccination should stress the value of COVID-19 vaccination in saving lives to ensure vulnerable groups are up-to-date with vaccination ahead of periods of potential increased transmission.

Those SCAM proponents who are not convinced of the merits of COVID and other vaccinations will undoubtedly claim that this new analysis was biased and thus unreliable. Therefore, it seems worth stating that this work was supported by a US Centers for Disease Control cooperative agreement, who had no role in data analysis or interpretation. The authors affiliated with the World Health Organization (WHO) are alone responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of the WHO.

Patients are increasingly using and requesting so-called alternative medicine Medicine (SCAM), especially during the COVID-19 pandemic. However, it remains unclear whether they use SCAMs in conjunction with conventional medicine or to replace vaccination or other approaches and whether they discuss them with their physicians as part of shared decision-making. This study aimed to evaluate the use and initiation of SCAM during the COVID-19 pandemic, focusing on the association between SCAM-use and COVID-19 vaccination status.

It was a part of the longitudinal cohort of the CoviCare program, which follows all outpatients tested for COVID-19 at the Geneva University Hospitals. Outpatients tested for COVID-19 were contacted 12 months after their positive or negative test between April and December 2021. Participants were asked about their vaccination status and if they had used SCAM in the past 12 months. SCAM-use was defined based on a list of specific therapies from which participants could choose the options they had used. Logistic regression models adjusting for age, sex, education, profession, severe acute respiratory system coronavirus 2 (SARS-CoV-2) infection, and pre-existing conditions were used to evaluate the association between being unvaccinated and complementary medicine use. SARS-CoV-2 infection status was evaluated for effect modification in the association between being unvaccinated and complementary medicine use.

This study enrolled 12,246 individuals (participation proportion = 17.7%). Their mean age was 42.8 years, 59.4% were women, and 63.7% used SCAM. SCAM-use was higher in women, the middle-aged, and those with a higher education level, a SARS-CoV-2 infection, or pre-existing co-morbidities. A third of cases initiated SCAM as prevention against COVID-19. Being unvaccinated was associated with higher levels of SCAM-use (adjusted odds ratio [aOR] 1.22 [1.09–1.37]). SCAMs were frequently used for COVID-19 prevention (aOR 1.61 [1.22–2.12]). Being unvaccinated was associated with the use of several specific SCAMs:

  • zinc (OR 2.25 [1.98–2.55]),
  • vitamin D (OR 1.45 [1.30–1.62]),
  • vitamin C (OR 1.59 [1.42–1.78]).

Only 4% of participants discussed using SCAM with their primary care physicians.

The authors concluded that, while SCAM is increasingly used, it is rarely discussed with primary care physicians. SCAM-use, especially for COVID-19 prevention, is associated with COVID-19 vaccination status. Communication between physicians, patients, and SCAM therapists is encouraged to facilitate a truly holistic approach to making a shared decision based on the best available information.

This survey confirmed the findings of several previous investigations. It also shows that the terminologies often employed are inadequate:

  • alternative medicine: as it does not work, it cannot be an alternative;
  • complementary medicine: many patients do not use it to complement real medicine.

As I have explained many times, I thus find SCAM a much more appropriate term.

The last sentence of the authors conclusion is puzzeling. What can SCAM pratitioners contribute to a ‘truly holistic approach’ to decisions about vaccinations? I feel this sentence should be changed into something like the following:

Communication between physicians and patients should be encouraged.  To facilitate an effective approach to making shared decisions on vaccinations, SCAM practitioners should be excluded until they are able to convincingly demonstrate that their advice is based on sound evidence.

The aim of this study was to investigate whether there is a difference in outcome between participants with high compared to low pain self-efficacy (PSE) receiving manual therapy, acupuncture, and electrotherapy.

Participants were stratified into high or low baseline (i) PSE, (ii) shoulder pain and disability index (SPADI), and (iii) did or did not receive the treatment. Whether the effect of treatment differs for people with high compared to low PSE was assessed using the 95% confidence interval of the difference of difference (DoD) at a 5% significance level (p < 0.05).

Treatment was labelled using 3 categories, 2 of which were subcategories of the first

  • “Any passive treatment” – any form of manual therapy and/or acupuncture and/or electrotherapy.
  • “Any manual therapy” – shoulder or spine joint mobilisations, deep transverse frictions, capsular stretches, trigger point therapy, muscle facilitation, or other techniques listed by the treating physiotherapist.
  • “Spinal/shoulder joint mobilisation” – for example, Maitland, Kaltenborn or Mulligan techniques.

To be categorised, treatment must have been delivered by the physiotherapist at least once and may have been delivered in conjunction with other treatments.

Six-month SPADI scores were consistently lower (less pain and disability) for those who did not receive passive treatments compared to those who did (statistically significant less pain and disability in 7 of 24 models). However, DoD was statistically insignificant.

The authors concluded that PSE did not moderate the relationship between treatment and outcome. However, participants who received passive treatment experienced equal or more pain and disability at 6 months compared to those who did not. Results are subject to confounding by indication but do indicate the need for further appropriately designed research.

This analysis suggests that manual therapy, electrotherapy, or acupuncture in addition to advice and exercise offered no improvement in pain or disability at six months, irrespective of PSE. Some patients who receive these treatments experienced more pain and disability at six months compared to those who do not.

I am not aware of compelling evidence that either of these treatments, all of which are often recommended, are effective for shoulder pain, and the results of this new study certainly do not suggest they are. However, as the design of the study was not primarily for this research question, these findings are, of course, merely tentative and need to be investigated further.

I had the rare pleasure to give an interview for the ‘Frankfurter Allgemeine’. As it was, of course, in German, I took the liberty to translate it for my non-German speaking readers:

You have researched so-called alternative medicine over several decades, including homeopathy. What is your conclusion?

We are talking about far more than 400 methods – to draw one conclusion about all of them
is completely impossible. Except perhaps for this one: if something sounds too good to be true, it probably is.

Does this apply to homeopathy?

Highly diluted homeopathic remedies are popular because they have no side-effects. But there is also no effect. They are touted as a panacea. This is certainly not the case, on the contrary, they are
ineffective. And any therapy that is ineffective and promoted as a panacea is also dangerous.

How do you explain the fact that so many people swear by homeopathy?

There are several reasons for this. In Germany, homeopathy has an unbroken tradition, it was, for instance, promoted by the Nazis and later in the Federal Republic of Germany. It has a reputation for being gentle and effective. It might be gentle, but it is certainly not effective. It is also supported by lobby groups such as the manufacturers. And most people who use it don’t even understand what it actually is.

In any case, the placebo effect helps. What’s so bad about that??

Nothing at all, on the contrary: it is to be advocated. When we talk about placebo effects, we subsume many things under this umbrella that do not actually belong to it, such as the extensive, empathetic conversation that homeopaths often have with their patients. Besides, a common cold goes away whether you treat it or not. If you then use homeopathy, you can easily get the impression that it worked. Every good, empathetic doctor tries to maximize the placebo effect. To put it bluntly: you don’t need a placebo to generate a placebo effect. Patients also benefit from it when I give an effective remedy with empathy. In addition they benefit from the specific effect of my therapy, which should make up the lion’s share of the therapeutic response. If I withhold the most important thing I mistreat my patient.

But there are diseases for which there are no good remedies.

I often hear that argument. But there is practically always something we can do that at least
improves symptoms. Otherwise you should also say that instead of lying and recommending homeopathy – and thinking that, although there is nothing in it and it doesn’t work, but the patient, being an idiot, should take it nevertheless. It is unethical to use placebos as much as it is to use homeopathy.

Neurophysiologically, the placebo effect is becoming better and better understood.

The Italian neuroscientist Fabrizio Benedetti in particular has done very good work.  But he also warns that this does not justify the use of homeopathy, for example.

Are there any studies on whether the placebo effect of homeopathy with its esoteric superstructure is greater than that giving just a piece of sugar?

There are analyses of what makes a particularly effective placebo. From this, we can learn that effective therapies in evidence-based medicine must be applied with empathy and sufficient time in order to maximize the ever-present placebo effect. So-called alternative medicine often does this quite well, and we can learn something from it. But the reason is that it often has nothing else. Homeopaths are a serious danger because they see homeopathy as a panacea. If someone has homeopathically treated their cold “successfully” for years and then gets cancer, they might think of turning to homeopathy for their cancer. It sounds crazy, but many homeopaths do offer cancer treatments on the internet, for instance. That sends shivers down my spine.

How should doctors and pharmacists react to the demand for homeopathic remedies?

Pharmacists are not primarily salespeople, they are a medical profession – they have to adhere to ethical guidelines. In this respect, evidence-based information of their clients/patients is very important.

Thomas Benkert, President of the German Federal Chamber of Pharmacists, has stated that he would not be able to stop giving advice if he always had to explain the lack of proof of efficacy.

He should perhaps read up on what his ethical duty to patients is.

What if doctors or pharmacists themselves believe in the effect?

Belief should not play a role, but evidence should.

Are you pleased with Lauterbach’s plan to no longer reimburse homeopathy?

I think it’s a shame that he justifies it by saying it’s ineffective. That is true. But the justification should be that it’s esoteric nonsense and therefore ineffective – and dangerous.

In the end, the Bundestag will decide.

I think Lauterbach has a good chance because things have started to move. Medical associations in Germany have spoken out against the additional designation of homeopathy, for example, and overall the wind has changed considerably.

What is it like in the UK, where you live?

The UK healthcare system, NHS, said goodbye to reimbursement of homeopathy about five years ago, even before France. The pharmacists’ association has distanced itself very clearly from homeopathy. However, most pharmacists still sell the remedies and many continue to support them.

You have also had disputes with the current head of state, King Charles. How did that come about?

A few years ago, he commissioned a paper claiming that so-called alternative medicine could save the British health service a lot of money. I protested against this – Charles accused me of leaking it to The Times before it was published. My university launched an investigation, which eventually found me innocent, but it led to the demise of my department. That caused me to retire two years early.

So Charles managed to close down the only research unit in the world that conducted critical and systematic research into so-called alternative medicine. Most researchers in this field only want to confirm their own prejudices and not disprove hypotheses. This is a serious misunderstanding of how science works. If someone reports only positive results for their favorite therapy in all conditions, something is wrong.

Some people say that homeopathy should not be researched because nothing positive can come out of it anyway.

There are certainly some SCAMs that are so nonsensical that they should not be researched, as is currently the case with homeopathy. I put it this way because I have researched homeopathy myself and, from my point of view, the situation was not so crystal clear 30 years ago.

Would you say that you have approached the matter with a sufficiently open mind?

No one can be completely unbiased. That’s why it’s important to do science properly, then you minimize bias as much as possible. When I took up my position at Exeter in 1993, I was perhaps somewhat biased towards homeopathy in a positive sense, because I had learned and used it myself, as well as other alternative medicine methods. The fact that the results then turned out to be negative in the vast majority of cases initially depressed me. But I have to live with that.

Every researcher prefers positive results, also because they are easier to publish. It was clear to me that, if I had succeeded in proving homeopathy right, I wouldn’t get one Nobel Prize, but two. Who wouldn’t want that?

(The interview was conducted by Hinnerk Feldwisch-Drentrup.)

When I decided to write my recent post about bizarre things going on with the GWUP (the German Skeptics), I knew, of course, that it would cause a few ripples. As a member of the GWUP scientific committee, I had been on the receiving end for the best part of a year of virtually hundreds emails and other exchanges directly releted to the matter. Initially, I had decided to stay out of all this. Therefore, I had read most of this material but had not responded to it even once.

Eventually, I had come to the conclusion that I ought to resign from the GWUP. There were two main reasons for that conclusion:

  1. Even though I had had plenty of time and information to form my own opinion, I had little to contribute to the affair.
  2. At the best of time, I am not a person who fits well into or likes to belong to clubs, associations, etc., and I was getting increasingly frustrated with the whole ting.

Before formulating my resignation letter, I discussed the GWUP with a trusted friend. This changed my attitude: I now felt that, before resigning, I should give it a try and make my position public in the hope that this might help the GWUP to get their act together.

Consequently, I posted my article precisely a week ago, well-aware of the fact that this would be controversial and might lead to attacks on my integrity. Having previously survived much bigger battles than that, I was not worried – at least, here I will be dealing with rational people, I thought.

As predicted, the reactions to my blog post (which was later translated and also published in German) were multipe, often fierce, and occasionally insulting. As not predicted, my assumption about dealing with rational people was erroneous.

I received (and posted) ~ 120 comments on the blog (only discarding less than a handful that were too far below the belt) and even more on social media. Many of you asked questions, and I tried to answer them the best I could. I even added a clarification to my original post. Soon I had to realize that emotions were flying high and reached into spheres that I understand little about and had even less intention to go into.

With hindsight, would I do it again?

Probably not!

Why not? Mainly because my attempt to help the GWUP was naive. I got the feeling that the rift amongst the German skeptics is too deep, too emotional, and too irrational. More than once I got the impression that it might be beyond repair.

More worringly perhaps, I also feel that some people who think of themselves ‘skeptics’ lack some of the qualities that I consider to be hallmarks of skepticism – to name just three: openness, rationality, and (self)critical thinking.

If someone voices his/her opinion (as has happened repeatedly, e.g. on social media) that I have been mistaken in what I stated about the GWUP, openness and rationality require, in my view, that this opinion is substantiated by stating exactly where I was mistaken. Just claiming “you were misinformed”, for instance, is hardly enough! After all, my post was written not least with the intention of identifying errors and misunderstandings. I never assumed that I am infallible, and therefore I invited my critics to use my blog for pointing out any errors, mistakes, misunderstandings, sources of misinformation, etc. Quite frankly, I was reminded of Randi’s bon mot: “The first thing a cult does is tell you everyone else is lying.”

And what happened?

Were my critics able to demonstrate where I have made errors or false allegations?

No – at least, I am not aware of such demonstrations which, of course, would require written statements that can be checked not just by me but by everyone else who is in the know.

Based on this situation, I feel tempted to conclude that the multiple claims of me having made false allegations are, in fact, false allegations.

Of course, I could be wrong!

And because I could be wrong, I am issuing herewith yet another invitation: if you are in possession of facts that contradict my previous post, here is your chance to disclose them by posting a comment below.

_____________________

And where do we go from here?

I will postpone my decision to leave the GWUP for a few weeks and hope that, contrary to my pessimism, the GWUP might manage to get its act together. The more I try to understand the reasons for the rift, the more I feel that they are emotionally hyped trivialities. With a healthy dose of openness, rationality, and (self)critical thinking, the rift might still be repairable.

 

 

I am sure that I am not the only one who feels with or friend, regular contributor, and expert in uncritical thinking, Dana Ullman. His heart-warming defence of homeopathy entirely depends on the notion that homeopathy is nano-medicine. As Dana’s views are more and more discredited, the poor man understandably gets more and more desperate. This development has now gone so far that Dana seems on the brink of cracking up.

Who would not feel with him?

What we urgently need to save Dana’s sanity is a new concept that could be used to defend the indefensible.

In the nick of time, here comes a lone researcher of homeopathy from India. Amarnath Sen has just published his hypothesis that will surely save the endangered mental stage of our friend, Dana Ullman. Here is the abstract:

The apparent absence of drugs in ultra-diluted homeopathic medicines and contested clinical trial results plague homeopathy. In this paper, it is argued that other than drugs, homeopathic medicines contain proteins as components of microbial lysates (products of lysis or disintegration of microbial cells), given that ubiquitous microorganisms from the surrounding environment are unknowingly and unavoidably incorporated into the homeopathic medicines during their preparation and are killed and lysed in ethanol/water drug vehicle forming immunomodulatory microbial lysates during ‘potentization’ (dilution and vigorous shaking) of the medicines. The drugs present in the homeopathic medicines bind to the proteins, which are the major ingredients of the microbial lysates. The drug/protein interaction modulates the conformations and in effect, the immunogenicity of the proteins (designated as modulated proteins). In ultra-diluted medicines even in the absence of drugs, unmodulated proteins are modulated through interactions with allosterically coupled modulated proteins (protein-protein interaction). The modulated proteins of characteristic immunogenicity present in the homeopathic medicines mediate antigen-specific mucosal (sublingual) immunotherapy like vaccine therapy via ‘similia principle’. In addition, immunomodulatory microbial lysates present in the homeopathic medicines mediate non-specific immunotherapy and also provide adjuvants for antigen-specific immunotherapy. The proposed hypothesis without invoking any controversial concept can explain the basic ‘laws’ of homeopathy. Incidentally, immunomodulatory activities of homeopathic medicines reported by different workers support the hypothesis. As immunotherapy in homeopathy is accidental and hence, in crude form, clinical trial results may occasionally show inconsistencies. However, probing and refining homeopathy from the perspective of immunotherapy may bring forth a simple, reliable and affordable immunotherapy for various diseases.

Convinced?

Me neither!

The concept is clearly as bonkers as all the others trying to explain homeopathy. Yet, I am optimistic that it might save our friend Dana Ullman. After all, it is not more silly than the notion that homeopathy is nano-medicine – and remeber: even an US judge certified Dana:

The Court found Mr. Ullman’s testimony to be not credible. Mr. Ullman’s bias in favor of homeopathy and against conventional medicine was readily apparent from his testimony. He admitted that he was not an impartial expert but rather is a passionate advocate of homeopathy. He posted on Twitter that he views conventional medicine as witchcraft. He opined that conventional medical science cannot be trusted.

So, there is hope!

Amarnath Sen and is ‘concept’ might just do the trick and restore Dana’s state of mind.

Craniosacral therapy (CST) is a widely taught component of osteopathic medical education. It is included in the standard curriculum of osteopathic medical schools, despite controversy surrounding its use. This paper seeks to systematically review randomized clinical trials (RCTs) assessing the clinical effectiveness of CST compared to standard care, sham treatment, or no treatment in adults and children.

A search of Embase, PubMed, and Scopus was conducted on 10/29/2023 with no restriction placed on the date of publication. Additionally, a Google Scholar search was conducted to capture grey literature. Backward citation searching was also implemented. All RCTs employing CST for any clinical outcome were included. Studies not available in English as well as any studies that did not report adequate data for inclusion in a meta-analysis were excluded. Multiple reviewers were used to assess for inclusions, disagreements were settled by consensus. PRISMA guidelines were followed in the reporting of this meta-analysis. Cochrane’s Risk of Bias 2 tool was used to assess for risk of bias. All data were extracted by multiple independent observers. Effect sizes were calculated using a Hedge’s G value (standardized mean difference) and aggregated using random effects models.

The primary study outcome was the effectiveness of CST for selected outcomes as applied to non-healthy adults or children and measured by standardized mean difference effect size. Twenty-four RCTs were included in the final meta-analysis with a total of 1,613 participants. When results were analyzed by primary outcome, no significant effects were found. When secondary outcomes were included, results showed that only Neonate health, structure (g = 0.66, 95% CI [0.30; 1.02], Prediction Interval [-0.73; 2.05]) and Pain, chronic somatic (g = 0.34, 95% CI [0.18; 0.50], Prediction Interval [-0.41; 1.09]) showed statistically significant effects. However, wide prediction intervals and high bias limit the real-world implications of this finding.

The authors concluded that CST did not demonstrate broad significance in this meta-analysis, suggesting limited usefulness in patient care for a wide range of indications.

To this, one should perhaps add that CST is one of those forms of so-called alternative medicine (SCAM) that is utterly implausible; there is not conceivable mechanism by which CST might work other than a placebo effects. Therefore, the finding that it is ineffective (positive effects on secondary outcomes are most likely due to residual bias and possibly fraud) is hardly surprising. The most sensible conclusion, in my view, is that CST too ridiculous to merit further research because that would, in effect, be an unethical waste of resources.

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