alternative therapist
So-called alternative medicine (SCAM) likes to present itself as a champion of disease prevention. Its advocates routinely claim to promote health before disease develops, to strengthen the body’s defences, and to address root causes rather than symptoms. This rhetoric is highly attractive, because prevention sounds proactive, humane, and economical. Crucially, it is also good for the SCAM practitioner’s bank account. Yet there is a snag: almost none of the preventive claims made for SCAM are supported by reliable evidence, whereas the prevention that works comes overwhelmingly from conventional medicine and science.
To show preventive benefit, an intervention must demonstrably reduce the incidence of symptom, disease, complication, or mortality in properly designed studies. That may require randomised trials, epidemiological studies, large cohorts, reproducible findings, and enough follow-up to show that fewer people actually experienced the given endpoint. Mainstream medicine has repeatedly met this standard. Immunization, blood pressure control, smoking cessation, lipid lowering, cancer screening, and risk-factor modification are all products of biomedical research, not of alternative healing traditions.
SCAM, by contrast, tends to use prevention in a loose, impressionistic, and unfalsifiable way. A practitioner may claim that a treatment “balances energy,” “supports immunity,” or “keeps the body in harmony,” but such phrases do not establish a preventive effect. They are placeholders for evidence, not evidence itself. In practice, the absence of disease after treatment is treated as proof that the treatment worked, even though the same outcome occurs every day without any intervention at all.
Acupuncture is a good example. Its defenders portray it as a preventive system capable of preserving general health or warding off illness, but the evidence base does not support that claim. Some reviews do suggest that acupuncture may help with some pain-related and symptom-focused conditions, yet its preventive value is largely unproven. I am not aware of solid evidence to show that acupuncture prevents anything – but, if I am wrong, please do correct me.
Chiropractic care is even more revealing because preventive claims are often tied to the doctrine of spinal “subluxation” and nervous system dysfunction. Yet the literature on prevention is thin and methodologically weak. I am not aware of solid evidence to show that chiropractic prevents anything – but, if I am wrong, please do correct me.
Herbalism benefits from the romantic appeal of “natural” remedies, but that appeal should not be confused with demonstrated preventive efficacy. Individual plant compounds have certainly inspired real drugs, yet that is a triumph of pharmacology, not of herbalism as a system. When herbal medicines are tested for prevention, results are usually weak, inconsistent, or insufficient to support recommendation. I am not aware of solid evidence to show that herbal medicine prevents anything – but, if I am wrong, please do correct me.
Homeopathy is one of the most extreme cases within SCAM. It is often sold as gentle, individualized, and even preventive, but its basic principles are scientifically implausible, and its clinical evidence is either flawed or negative. Preventive homeopathy, including ideas such as “homeoprophylaxis,” is particularly problematic because it can give people a false sense of security while displacing interventions that genuinely prevent disease, such as vaccination. I am not aware of solid evidence to show that homeopathy prevents anything – but, if I am wrong, please do correct me.
SCAM speaks almost constantly about prevention, but the evidence for actual preventive benefit is close to non-existent. What we know about prevention, what truly reduces disease incidence and improves population health, comes from conventional medicine, epidemiology, public health, and biological science. SCAM will no doubt continue to borrow the language of medicine and prevention, but – as far as I can see – it has failed to supply the proof.
During outbreaks of Ebola Virus Disease (EVD), public health organizations like the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) combat “infodemics”, i.e. surges of false information and unproven so-called alternative medicine (SCAM) polluting social media (Bedrosian et al., 2016; Fung et al., 2016; Obol & Nzedibe, 2024). Because these SCAMs are ineffective and frequently dangerous, authorities issue warnings against their use. Here are just a few of the many claims that can be found:
- Bathing in or drinking hot, highly saturated saltwater solutions can sweat out or kill the Ebola virus (Fung et al., 2016). Public health agencies strongly advise against this practice. It does nothing to prevent or treat EVD and can cause severe illness and death from acute hypernatremia (Vijaykumar et al., 2019).
- Solutions containing silver nanoparticles act as powerful natural antimicrobials capable of neutralizing the Ebola virus inside the body (Fung et al., 2016). The WHO has explicitly stated that Nano Silver is an unproven compound with no demonstrated efficacy against Ebola. Authorities recommend avoiding these products, as silver accumulation can cause irreversible organ damage and a condition called argyria (which permanently turns the skin blue/gray).
- Consuming large quantities of specific botanical items, such as raw onions, ginger, or alligator peppers, can stave off infection (Nsoesie & Oladeji, 2020). These “natural cures” possess no therapeutic effects capable of stopping viral replication of the filovirus family. Relying on them creates a false sense of security, which delays life-saving, evidence-based triage and supportive care (Fridman et al., 2025; Nsoesie & Oladeji, 2020).
- Ebola has been attributed to spiritual curses or witchcraft that can only be reversed by traditional spiritual cleansing (Bedrosian et al., 2016). Public health organizations work alongside local communities to pivot away from these practices. Delaying medical intervention to seek traditional spiritual healing drastically increases community transmission and prevents patients from receiving SOTA antiviral therapies and fluid replacement, lowering survival rates (Obol & Nzedibe, 2024).
- A homeopath market “e-remedies” online, claiming that the “energy signature” of a remedy could be digitized into an audio file (Moffitt, 2018). He claimed that listening to a specific, hissing MP3 file could stimulate the body’s immune system to fight off Ebola. This prompted an investigation by the Medical Board of California into the doctor’s license for promoting unscientific and unproven online remedies (Moffitt, 2018).
- Some chiropractors claim that spinal manipulations can prevent Ebola infections, because misalignments interfere with the nervous system. Since the nervous system coordinates the immune responses, these misalignments weaken the body’s ability to recognize and destroy the Ebola virus (Terry Chiropractic Boulder). People “have nothing to fear but fear itself” regarding outbreaks if they keep their spines properly aligned to maximize their natural innate immunity. Global public health authorities and mainstream scientific institutions strongly reject these claims. There is zero credible scientific evidence demonstrating that manual spinal manipulation enhances immune competence or protects an individual against Ebola (Côté et al., 2020).
Ebola infection requires immediate, professional medical treatment. Treatments include monoclonal antibody therapeutics along with intensive supportive care. Relying on internet remedies significantly delays proper clinical treatment and increases the risk of mortality.
References
Bedrosian, S. R., Young, E. C., Smith, L. A., Cox, J. D., Manning, C., Pechta, L., Telfer, J. L., Gaines-McCollom, M., Harben, Kathy, Holmes, Wendy, Lubell, K. M., McQuiston, J. H., Nordlund, Kristen, O’Connor, John, Reynolds, B. S., Schindelar, J. A., Shelley, Gene, & Daniel, K. L. (2016). Lessons of Risk Communication and Health Promotion — West Africa and United States. MMWR Supplements, 65(3), 68–74. https://doi.org/10.15585/mmwr.su6503a10
Fridman, I., Boyles, D., Chheda, R., Baldwin-SoRelle, C., Smith, A. B., & Elston Lafata, J. (2025). Identifying Misinformation About Unproven Cancer Treatments on Social Media Using User-Friendly Linguistic Characteristics: Content Analysis. JMIR Infodemiology, 5, e62703. https://doi.org/10.2196/62703
Fung, I. C.-H., Fu, K.-W., Chan, C.-H., Chan, B. S. B., Cheung, C.-N., Abraham, T., & Tse, Z. T. H. (2016). Social Media’s Initial Reaction to Information and Misinformation on Ebola, August 2014: Facts and Rumors. Public Health Reports®, 131(3), 461-473. https://doi.org/10.1177/003335491613100312
Moffitt, M. (2018). State doubts Los Gatos doctor can cure ebola with hissing MP3 files. SFGATE. https://www.sfgate.com/bayarea/article/dr-bill-gray-medical-license-homeopathy-treatment-12954925.php
Nsoesie, E. O., & Oladeji, O. (2020). Identifying patterns to prevent the spread of misinformation during epidemics. Harvard Kennedy School Misinformation Review. https://doi.org/10.37016/mr-2020-014
Obol, S. J., & Nzedibe, O. (2024). Critical perspective on infodemic and infodemic management in previous Ebola outbreaks in Uganda. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1375776
Terry Chiropractic Boulder. (2014). Hold On Ebola: How Bolstering Your Immune System Can Help You Avoid Disease. https://terrychiropracticboulder.com/blog/hold-on-ebola-how-bolstering-your-immune-system-can-help-you-avoid-disease/
Vijaykumar, S., Jin, Y., & Pagliari, C. (2019). Outbreak communication challenges when misinformation spreads on social media. Revista Eletrônica de Comunicação, Informação e Inovação em Saúde, 13(1). https://doi.org/10.29397/reciis.v13i1.1623
I found an interesting article in the hilarity-prone journal ‘HOMEOPATHY’. I hope it might amuse you:
The concept of antidotes in homeopathy holds a central place in classical doctrine and daily clinical practice, yet remains l argely unexplored in scientific literature. Antidotes are traditionally defined as substances, remedies, environmental factors or physiological and emotional influences capable of suppressing, altering or interrupting the action of a homeopathic medicine. From a classical homeopathic perspective, any factor capable of modifying the totality of symptoms—thereby influencing remedy selection and follow-up—may be regarded as a potential antidoting influence. Unlike conventional pharmacological antidotes, which act through molecular interactions, homeopathic antidoting is conceived as an interference with the organism’s adaptive and regulatory response. This review revisits the historical foundations of antidotes, examines their clinical importance and explores potential scientific re-interpretations grounded in contemporary neurobiology, psychophysiology and systems medicine. Classical authors, including Hahnemann, Kent, Allen and Boericke, are critically reviewed, and the phenomenon of antidoting is discussed in light of stress physiology, placebo–nocebo mechanisms, hormesis and network regulation. We propose that antidotes represent early empirical descriptions of system-level modulation rather than substance antagonism. Finally, research perspectives are outlined to encourage methodological investigation of antidoting using modern biomedical tools.
Homeopaths administer an antidote when they fear a remedy produces too strong a reaction, to moderate the response. According to homeopathic belief, accidental antidoting commonly occurs through exposure to things like:
- coffee,
- camphor,
- mint,
- menthol,
- eucalyptus,
- strong odors.
- essential oils,
- perfumes,
- toothpaste,
- emotional shock,
- physical shock,
- dental work,
- numerous drugs.
An antidote, according to homeopathic teaching, specifically stops the previous remedy’s action. Each remedy has particular antidotes; for example, Natrum muriaticum is antidoted with mint, while Arnica may be antidoted by coffee. I should add that this concept is, of course, not scientifically validated and therefore pure fantasy.
Has anyone seen a reaction to a homeopathic remedy that is too strong and needs moderation?
No?
Me neither!
Hold on, Arsenic D1 perhaps?
But I am sure the author does not refer to this scenario. Homeopathic remedies are understood to be highly diluted; they contain nothing – even if it says Arsenic on the label. Placebos do not need antidotes because they don’t cause strong reactions.
Therefore, antidotes to homeopathy are a nonsense!
Hold on, this might not be correct. I just thought of a powerful antidote to homeopathy:
SCIENCE!
I came across an interesting article about chiropractic. Let me try to summarise it for you:
Texas’s system for disciplining chiropractors has become much less transparent, making it harder for patients to know whether a provider has faced regulatory action or not. Disciplinary cases reported by the Texas Board of Chiropractic Examiners and the National Practitioner Data Bank have dropped sharply even as the number of licensed chiropractors has risen, which prompted patient advocates to ask whether the public is being misled.
A rule change adopted in 2019 that narrowed what the chiropractic board can publicly disclose seems at the heart of this. According to board executive director Boyd Bush, the result is that roughly 70 cases, mostly minor administrative matters such as late license renewals, are no longer appearing in the public-facing record. Bush argues the change was intended to prevent chiropractors from suffering disproportionate consequences, such as losing patients or paying higher insurance premiums, for technical violations that do not directly affect patient care.
That explanation contrasts with the view of patient advocate Ware Wendell of Texas Watch, who says the public needs clearer, more usable information when choosing care. His concern is that a chiropractor can have regulatory action behind the scenes while still appearing to have “no board action taken” in public-facing materials, leaving patients unaware of relevant history.
Moreover, not all chiropractor-related enforcement is handled by the chiropractic board. In some cases, the Texas Medical Board has issued cease-and-desist orders against chiropractors accused of practicing medicine without a license, including claims involving neurology expertise, stem cell therapy, diabetes treatment, thyroid disorders, and chronic degenerative diseases. That overlap between boards adds confusion and can make it even harder for the public to interpret what level of discipline or risk a practitioner has faced.
A broader policy debate sits behind the story. Lawmakers tried to reduce inter-board oversight last session through Senate Bill 268, but Governor Greg Abbott vetoed it, citing public health and safety concerns. The Texas Chiropractic Association, meanwhile, says complaints should be handled by the boards with direct oversight, while a 2017 Sunset Advisory Commission review had already criticized the chiropractic board for slow complaint resolution and weak enforcement.
The article closes by noting that the board says it has improved the backlog, but the transparency issue is likely to return in the next legislative session. Evidently, a tension exists between protecting chiropractors from over-penalization for minor offenses and ensuring patients can see meaningful disciplinary history before seeking treatment.
On this blog, we have discussed repeatedly that dishonesty and transgressions are by no means rare events in the realm of chiropractic. I think it is time that this profession gets its act together, puts more emphasis on ethics during education/training, and becomes transparent, even if it might not enhance their public image in the short-term.
This AI-verdict made me wonder: Who is for and who against the critical evaluation of so-called alternative medicine? And I asked a follow-up question:
Can you try to quantify this and give me % figures who is against a critical evaluation of alternative medicine, who is for it, and who is neutral. Can you do this for 1. the general population, 2. proponents of alternative medicine and 3. skeptics?
Here is the reply I got from Gemini:
To quantify these dynamics accurately, we have to look at large-scale sociological data on public attitudes toward science, peer-reviewed medical data (such as surveys by Pew Research, YouGov, and the European Commission), and the behavioral patterns of online discourse.
When it comes to a “critical evaluation” (meaning scientific testing to prove if a therapy works beyond a placebo), the groups break down along very distinct ideological lines. Here is how the percentages estimate across your three requested demographics:
Breakdown of Attitudes Toward Critical Evaluation
1. The General Population
The broader public is largely pragmatic, but a major chunk is passively open to alternative therapies without strictly demanding clinical trial proof.
- Against Critical Evaluation (~15% – 20%): These individuals hold a strong distrust of mainstream pharmaceutical companies and medical institutions. They believe alternative medicine operates on a different “energy” or “holistic paradigm” that standard science is fundamentally incapable of or biased against measuring.
- For Critical Evaluation (~35% – 45%): This group highly values evidence-based medicine, expects consumer safety protection, and agrees that if a therapy claims to cure an illness, it should prove it under a microscope or in a randomized controlled trial.
- Neutral / Passive Consumers (~40% – 50%): This is the massive middle. They don’t track clinical trials, but they will try acupuncture for back pain or take turmeric if a friend recommends it. They view alternative medicine through a lens of “well, it can’t hurt to try,” evaluating it based on personal anecdotes rather than scientific data.
2. Proponents of Alternative Medicine
This group includes dedicated practitioners, wellness influencers, and avid consumers of Complementary and Alternative Medicine (CAM).
- Against Critical Evaluation (~70% – 80%): The vast majority actively resist standard scientific evaluation, often viewing figures like Edzard Ernst as hostile prosecutors rather than objective evaluators. They argue that randomized controlled trials are “too reductionist” to capture holistic healing or claim that clinical science is rigged by corporate interests.
- For Critical Evaluation (~5% – 10%): A small minority of CAM practitioners (often in fields like medical acupuncture or osteopathy) welcome rigorous trials, hoping to find a mechanism of action that will grant them mainstream medical legitimacy and insurance coverage.
- Neutral (~10% – 15%): These are individuals who focus strictly on the individual client experience. They don’t care about data or institutional pushback either way; their attitude is simply “if my client says they feel better, that is the only science I need.”
3. Skeptics & Pro-Science Advocates
This demographic comprises secular organizations, evidence-based medical professionals, and science communicators who actively follow work like Ernst’s.
- Against Critical Evaluation (<1%): Virtually non-existent in this group, as evaluation is their core tenet. The only micro-fraction here might be extreme fringe elements who feel certain alternative therapies are so fundamentally absurd (like breatharianism) that evaluating them is a waste of scientific funding.
- For Critical Evaluation (~90% – 95%): The overwhelming majority. They strongly defend the stance that there is no such thing as “alternative” medicine—there is only medicine that has been proven to work and medicine that hasn’t. They view critical evaluation as an ethical necessity for patient safety.
- Neutral (~5%): A tiny sliver who may agree with the premise of science but feel indifferent about fighting the cultural battle against wellness trends, preferring to let people believe what they want as long as it isn’t directly killing them.
The Reality of the “Viral Sharing Power”
The Disparity: While alternative health advocates outnumber skeptics in raw volume and content creation—churning out high-yield, emotionally comforting narratives—the pro-science corrections achieve highly concentrated “viral bursts.”
When a prominent alternative health claim is cleanly and definitively debunked by data, it provides a highly shareable, “gotcha” piece of content for the large, silent neutral majority and the highly active skeptic network. A data-driven correction acts as a high-utility intellectual tool, allowing regular people to cut through multi-million dollar wellness marketing, which is why a single well-structured critique can match or outpace the reach of thousands of individual wellness posts.
______________________
I know, there are good reasons for being cautious about such AI analyses. Yet, unless someone can point me to more reliable data, I will go with this one – not least because it coincides with my own experience and also because I quite like its findings.
Yesterday, I received a comment that ended stating: “… this site, and quite possibly Edzard, has well and truly lost the plot.” The author has made many comments before that led me to ignore him; so, I did not think twice about what he had to express. Yet, later it started me wondering what people feel about my blog and my work in general. I have to admit that I know very little about these questions. What is more, I have no idea how to find out.
What does one do in such a situation?
Yes, you guessed it, one asks AI. Specifically, I asked AI (Gemini) what people state about me and my work on social media.
Here is the response:
Edzard Ernst, Emeritus Professor of Complementary Medicine at the University of Exeter and the world’s first professor in this field, occupies a highly polarized space in public and academic discourse. Because he evaluates alternative therapies strictly through the lens of evidence-based medicine, opinions of him are cleanly split based on how the observer views the relationship between science and complementary and alternative medicine (CAM).
1. The Pro-Evidence & Skeptical Community
Within mainstream medicine, scientific research, and skeptical organizations, Ernst is widely praised as a heroic, objective defender of public health.
- Rigorous Science First: Proponents point out that Ernst is uniquely qualified to critique CAM because he is formally trained in multiple modalities and practiced them early in his career. Online advocates frequently rally around his blunt philosophy on medicine. As Ernst famously co-wrote in his book Trick or Treatment:
“There is either medicine that is effective or not, medicine that is safe or not. So-called alternative therapies need to be assessed and then classified as good medicines or bogus medicines.”
- The Defender of Patient Safety: On social media, users routinely share his warnings regarding the “indirect harm” of alternative medicine, arguing that unscientific advice can be fatal. Ernst summarized this stance sharply in a peer-reviewed paper: “Alternative practitioner’s claims about ‘root causes’ and holistic care are usually pure nonsense; their pampering may be agreeable, but it can undoubtedly cost lives.”
- A “Whistleblower” Against Pseudo-Science: Proponents view him as a courageous figure who faced severe institutional backlash—including losing his department’s funding after publicly criticizing King Charles III (then the Prince of Wales) for promoting homeopathy. On platforms like Reddit, supporters echo the sentiment that Ernst “stands up for clinical truth when institutions bow to royal influence and political correctness.”
2. The CAM Practitioner & Advocate Community
Among alternative healthcare providers, natural health advocates, and some “integrated medicine” proponents, Ernst is viewed with deep hostility and suspicion.
- “The Scourge of Alternative Medicine”: Detractors frequently use social media to label him as a close-minded dogmatist who is fundamentally biased. A common refrain in CAM forums and X replies accuses him of severe bias: “Ernst does not investigate alternative medicine to see if it works; he designs reviews with the explicit purpose of proving it doesn’t.”
- Accusations of Scientific Flaws: Specific professional groups have actively challenged his data. For example, within the chiropractic community, critics point to his reviews on the dangers of spinal manipulation and claim he misattributed injuries caused by untrained practitioners to qualified chiropractors. In a formal response published in the International Journal of Clinical Practice, chiropractic researchers directly attacked his methodology, stating:
“Ernst, by incorrectly labelling care providers as chiropractors… has added to the over-reporting of deaths… the fact that the care providers were not chiropractors is easily confirmed.”
- Institutional Deafness: On wellness blogs and natural health spaces, critics state that his clinical, data-first approach misses the point of holistic healing entirely. As one practitioner noted in an online debate: “He treats patients like spreadsheets. He completely disregards the mind-body connection, individual patient testimony, and the cold reality that conventional medicine fails millions of people every day, forcing them to look elsewhere.”
While Edzard Ernst is swimming against a massive volume of alternative health advocates who view him as their “nemesis reserving his most poisonous venom for their professions,” his data-driven, pro-science corrections achieve significantly higher viral sharing power among the public.
_____________
Nothing truly new, of course, but quite interesting nevertheless, I thought.
Chronic non-specific low back pain (CNSLBP) is a major cause of disability worldwide. Conventional pharmacological treatments offer limited benefits and carry potential risks, prompting interest in alternative approaches, including homeopathy. The objective of this study was to evaluate the short-term efficacy and safety of a standardised homeopathic biotherapic (Lumbar Vertebra, LM2 potency) for CNSLBP.
A randomised, double-blind, crossover, placebo-controlled clinical trial was conducted with 120 participants diagnosed with CNSLBP. Participants received both the biotherapic and placebo in two treatment phases separated by a washout period. The primary outcome was pain intensity (numeric rating scale); secondary outcomes included functional disability (Oswestry Disability Index), adverse events and use of pain medications. Data were analysed using random effects generalised linear models.
Both the biotherapic and placebo interventions led to significant within-group reductions in pain and disability (p = 0.001 and p < 0.001 respectively). However, no statistically significant differences were observed between the two interventions for either outcome (pain: p = 0.435; disability: p = 0.840). The magnitude of change in pain intensity did not reach the pre-defined minimal clinically important difference (MCID), and mean pain scores at the study endpoint remained above the inclusion threshold. Adverse events were mild and comparable across groups.
The authors concluded that no specific effect of the Lumbar Vertebra LM2 biotherapic was demonstrated. Improvements are likely due to non-specific effects such as the therapeutic environment, patient expectations and placebo response. Clinicians should consider the substantial role of non-specific responses in CNSLBP and avoid medications with unfavourable risk–benefit profiles.
One the one hand, the authors from the Department of Medicine, Federal University of São Carlos, São Carlos, Sao Paulo, the School Health Unit, Federal University of São Carlos, São Carlos, Sao Paulo, and the epartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil should be congratulated for publishing a squarely negative result in the journal ‘Homeopathy’ that is known for publishing even the most implausible positive findings.
On the other hand, one might criticise them: why on earth did they ever conceive the hypothesis that homeopathy in general or “Lumbar Vertebra LM2 biotherapic” in particular might be effective for CNSLBP (the study did not receive any funding or financial support, apart from the study medications donated by HN-Cristiano Pharmacy (Santana, São Paulo, Brazil), which had no role in the study design, data collection, analysis, interpretation or discussion of the results)? I have never met a homeopaths who would make such a claim, and one could easily argue that such a trial is an unethical waste of resources.
I came across an interesting paper entitled “The Ethics of Tawas and Other Rituals in Medical Practices“. Here is its abstract:
Rituals in medical practice have either been seen as an anthropological aspect of current biomedical processes or as a pre-scientific aspect of complementary and alternative medicine (CAM). In either tendency, the literature has since failed to account for these rituals as rituals—conveyors of meaning, expressions of identity, and even as a rite of passage from illness to wellness. As an alternative to current discussions, this paper presents the case study of tawas, a diagnostic ritual from Philippine traditional medicine that determines personalistic and mystical causes of illnesses. As a non-intrusive procedure, tawas involves incantations and some ritual objects, e.g., rice, candle, axe, etc., that do not pose any direct harm nor benefit to the patient. While complete reliance on tawas at the expense of proper medical procedures could harm patients, the very ritual of tawas itself occupies a limbo within non-beneficence and non-maleficence. Following a Wittgensteinian perspective of treating rituals as meaning-laden human activities, this paper argues that rituals like tawas, much like other rituals embedded in biomedical practices, should be understood as rituals and not as empirical cures, thereby allowing their tolerance in medical practice in general.
The author seems to advocate for the cultural integration of traditional practices like tawas into a broader medical framework. They categorize tawas not as a physiological intervention, but define it as a conveyor of meaning. By addressing the “meaning-laden” aspect of illness, the ritual may address the psychological and social dimensions of a patient’s health, even if it has no effect on their physical pathology.
It is claimed that, since tawas involves non-intrusive objects (candles, rice), it is physically benign. At the same time it is acknowledged that “complete reliance” on tawas could harm patients. From a clinical safety standpoint, the “limbo” is only maintained if the ritual is strictly adjunctive rather than alternative.
The text uses a Wittgensteinian perspective, focusing on rituals as expressions rather than theories. Modern neuroscience suggests that the “ritual” of care—the white coat, the focused attention, the diagnostic process—triggers real neurobiological changes (e.g., dopamine and endorphin release). Aacknowledging the symbolic healing power that rituals have on patient anxiety and the “meaning response,” which can objectively improve health outcomes by reducing cortisol and stress.
The author identifies tawas as a diagnostic ritual which might well be the most contentious point. In science, a “diagnosis” must be reliable and valid. Tawas clearly fails the scientific criteria for validity. The author’s defence is that tawas shouldn’t be judged by those criteria at all. While this might be philosophically sound, in a clinical setting, a “mystical diagnosis” must conflict with a biological one, potentially leading to patient non-compliance with life-saving treatments.
This study was conducted to determine the effect of Reiki performed on children with leukemia between the ages of 5-7 years on pain, vital signs, oxygen saturation, and quality of life. It was a double-blind, pre-test-post-test randomized controlled experimental study. The research sample consisted of 66 children with leukemia aged 5-7 years who were hospitalized in pediatric oncology wards of a university hospital between December 2020 and November 2021. The balanced block randomization method was used for randomization. The data were collected using Information Form, Wong-Baker FACES Pain Scale (W-BPS), Vital Signs Follow-up Form, The Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module. Reiki was performed to the Reiki group for 20-30 min once per day, for 3 consecutive days and pseudo-Reiki was applied to the pseudo-Reiki group by an independent nurse during the same application period.
There was no statistically significant difference in vital signs (heart rate, respiratory rate, body temperature) and SpO2 values among the groups (p > 0.05). However, both children’s and mothers’ evaluations on days 1, 2, and 3 after the intervention showed that pain scores in the Reiki group were significantly lower than in the pseudo-Reiki and control groups (p < 0.001), and quality of life was significantly higher (child:p < 0.001; mother:p < 0.01) compared to the pseudo-Reiki and control groups.
The authors concluded that Reiki did not affect the vital signs of the children but was effective in reducing pain and increasing the quality of life compared with the pseudo Reiki and control groups. It is recommended that Reiki therapy be used in addition to medical treatment to reduce pain and improve quality of life in children with leukemia aged 5-7 years.
The whole point of having a control group receiving pseudo-Reiki is to control for placebo effects. For this purpose, it is necessary to fool the patients well and make sure that they are unable to tell Reiki from pseudo-Reiki. I would guess – I have no aceess to the full paper – that this was not the case in this study. If I am correct, the positive outcome is likely to be due to expectation of a positive healing effect and unrelated to any specific effect of Reiki.
In any case, it is irresponsible nonsense to recommend Reiki – or any therapy – on the basis of just one positive study. For that one would need several independent confirmations with high quality studies that firmly establish a cause effect relationship. The current study does not fall into that category, and I am not aware of a single trial that does.
Spinal manipulative therapies, including chiropractic and osteopathic maneuvers, are widely practiced for musculoskeletal complaints. However, serious complications such as cerebrospinal fluid (CSF) leak with subsequent intracranial hypotension (IH) have been described. The pathophysiological mechanism is presumed to involve mechanical stress on the spinal dura during high-velocity movements, leading to dural tears, particularly in the cervicothoracic region.
A team of Italian neuroscientists conducted a scoping review in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines, through a comprehensive search of PubMed and Scopus. They complemented the review with an illustrative case from their own institution.
The researchers identified 21 eligible papers, including 21 patients with IH following spinal manipulation. Most patients were women (81%), aged 29-54 years, and the majority underwent cervical maneuvers.
SMT techniques vary, most often involving high-velocity cervical maneuvers. The most frequent were axial tension with rotation in seven cases (33.3%), unspecified cervical manipulation in four cases (19%), and thoracic spinal manipulation in two cases (9.5%). Less common single-case techniques included rotation with hyperextension, combined cervical and thoracic mobilization, axial tension with lateral flexion, and occipital/shoulder tension technique (n = 1 case each).
Symptom onset was typically within the first week, and all presented with orthostatic headache, often accompanied by nausea, neck pain, tinnitus, or visual disturbances. Neuroimaging consistently revealed features of IH, with pachymeningeal enhancement and subdural collections as the most frequent findings; spinal imaging frequently demonstrated extradural CSF collections. Management was conservative in about one-third of cases, but most required epidural blood patching, which was effective in the majority. Surgical repair was necessary in rare, refractory cases, particularly in the presence of structural spinal abnormalities. Overall prognosis was favorable, with 95% of patients achieving full recovery.
The authors’ illustrative case highlights the potential for severe complications such as subdural hematomas and recurrence if the underlying leak is not addressed:
A 65-year-old patient without a previous history of headache presented with a progressively worsening headache, with orthostatic features, poorly responsive to medical therapy, that has lasted for the past 20 days. The patient denied any recent trauma. He reported having undergone cervical osteopathic manipulations within the past 3 months for recurrent cervicalgia. A brain MRI without contrast was performed, showing a large bilateral subdural hematoma with significant mass effect on the cortical gyri. The patient was admitted to the emergency department and underwent neurosurgical evacuation of a bilateral chronic subdural hematoma via burr holes. Subsequently, endovascular embolization of the middle meningeal arteries was performed as an adjunctive treatment to reduce the risk of recurrence. The surgical procedure was performed without complications. A cranial CT scan showed a reduction in the volume of the hematoma. Therefore, the patient was discharged. However, after a transient improvement in the symptoms, the patient continued to present a fluctuating headache without positional features, with four to five episodes per month. He was readmitted to our clinic and, upon arrival at the ER, a head CT scan showed an increase in pneumocephalus and a recurrence of the hematoma. The following day, an MRI of the neuraxis with contrast was performed, which revealed radiological findings suggestive of IH: pachimeningeal enhancement, subdural fluid collection, dural venous engorgement, cervical spinal longitudinal extradural collection, and effacement of the suprasellar cistern. The Bern score was 7. Given these findings, a surgical revision of the previous burr holes was performed without periprocedural complications. After the first day, a non-targeted epidural blood patch (EBP) was performed under local anesthesia by injecting 16 mL of autologous blood into the L3–L4 epidural space. The procedure was uneventful. A cranial CT scan showed satisfactory surgical outcomes, highlighting a reduction in the volume of the hematoma and of the pneumoencephalus. The patient was subsequently discharged with complete resolution of the headache.
The authors concluded that clinicians should recognize the possibility of CSF leaks after spinal manipulation, especially in patients with new-onset orthostatic headache.
I feel compelled to point out that, considering the multiple risks of upper spinal manipulations and the almost total lack of evidence of benefit from such treatments, the risk/benefit balance of spinal manipulation is clearly not positive. It follows, I think, that it would be wise for patients not to allow such therapies being carried out, and for healthcare professionals to discourage them.
