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

alternative therapist

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Osteopathy is hugely popular in France. Despite the fact that osteopathy has never been conclusively shown to generate more good than harm, French osteopaths have somehow managed to get a reputation as trustworthy, evidence-based healthcare practitioners. They tend to treat musculoskeletal and many other issues. Visceral manipulation is oddly popular amongst French osteopaths. Now the trust of the French in osteopathy seems to have received a serious setback.

‘LE PARISIEN‘ has just published an article about the alleged sexual misconduct of one of the most prominent French osteopaths and director of one of the foremost schools of osteopathy in France. Here are some excerpts from the article that I translated for readers who don’t speak French:

The public prosecutor’s office of Grasse (Alpes-Maritimes) has opened a judicial investigation against Marc Bozzetto, the director and founder of the school of osteopathy in Valbonne, accused of rape and sexual assault.

In total, “four victims are targeted by the introductory indictment,” said the prosecutor’s office, stating that Marc Bozzetto had already been placed in police custody since the beginning of the proceedings. The daily paper ‘Nice-Matin’ has listed six complaints and published the testimony of a seventh alleged victim.

This victim claims to have been sexually assaulted in 2013, alleging that, during a professional appointment, Bozzetto had massaged her breasts and her intimate area. “He told me that everything went through my vagina and clitoris, that I had to spread my legs and let the energy flow through my clitoris. That I had to learn how to give myself pleasure on my own,” she told Nice-Matin. The newspaper also recorded the testimonies of a former employee, a top-level sportswoman, an employee from the world of culture, and a former student.

“I take note that a judicial inquiry is open. To date, he has neither been summoned nor indicted,” said Karine Benadava, the Parisian lawyer of the 80-year-old Bozzetto. Her client had already responded following initial accusations from students: “This is a normal feeling for women, but if all the women who work on the pelvis complain, you can’t get away with it and you have to stop working as a pelvic osteopath,” replied Bozzetto. In another interview, he had declared himself “furious” and unable to understand the reaction of these two students.

The school of osteopathy trains about 300 students each five years and presents itself as the first holistic osteopathy campus in France.

______________________________

Such stories of sexual misconduct of practitioners of so-called alternative medicine (SCAM) are sadly no rarety, particularly those working in the area of manual therapy. They remind me of a case against a Devon SCAM practitioner in which I served as an expert witness many years ago. Numerous women gave witness that he ended up having his fingers in their vagina during therapy. He did not deny the fact but tried to defend himself by claiming that he was merely massaging lymph-nodes in this area. It was my task to elaborate on the plausibility of this claim. The SCAM practitioner in question was eventually sentenced to two years in prison.

It stands to reason that SCAM practitioners working in the pelvic area are at particularly high risk of going atray. The above case might be a good occasion to have a public debate in France and ask: IS VISCERAL OSTEOPATHY EVIDENCE-BASED? The answer is very clearly NO! Surely, this is a message worth noting in view of the current popularity of this ridiculous, costly, and dangerous charlatanry.

And how does one minimize the risk of sexual misconduct of SCAM professionals? The most obvious answer would be, by proper education during their training. In the case mentioned above, this might have been a problem: if the director is into sexual misconduct, what can you expect of the rest of the school? In many other cases, the problem is even greater: many SCAM practitioners have had no training at all, or no training in healthcare ethics to speak of.

 

My father invented a therapy for which there was no disease, my mother caught it and died.”

This type of scurrility makes me laugh. And it reminds me of the missing link in so-called alternative medicine (SCAM). We have heard about alternative therapies, alternative diagnostic methods, but what about alternative diseases and conditions? Here are some that SCAM practitioners seem to be oddly fond of:

  • – adrenal fatigue
  • – chi deficiency
  • – yeast overgrowth
  • – leaky gut syndrome
  • – leaky brain syndrome
  • – chronic Lyme disease
  • – various food ‘sensitivities’
  • – methylation dysfunction
  • – spinal subluxation
  • – vaccine-induced ‘toxicity’
  • – toxin-overload

But surely, these cannot be enough! For the field of SCAM to make progress, we definitely need many more. So, I had a brainstorm and came up with the following suggestions:

  • Ataxia: the condition (of many SCAM practitioners, but also others) where patients fail to declare their income to the taxman; usually cured by a short stay in the nick.
  • Cardioversion: an insurmountable dislike of conventional clinicians like cardiologists; a self-limiting condition that usually improves after receiving proper medical attention during a serious illness.
  • Collagen: a genetic disorder that shows itself through a strong dislike of experts who have been to college; incurable.
  • Deepak Chopra Syndrome: a serious neurosis where the patient cannot stop uttering BS; incurable.
  • Digitoxin: the unfortunate condition where a spiritual healer sends toxic spirits into the patient via his/her fingers; needs urgent detox.
  • Donovan bodies: a psychiatric affliction where patients are compelled to look and sing like Donavan; requires a sound-proof cell.
  • Duodenal ulcer: an unfortunate condition where the patient has two denal ulcers at the same time; emergency Reiki is advised.
  • Dyspepsia: the pathological preference of Coke over Pepsi; incurable.
  • Familial diseases: an umbrella term for all the few conditions that SCAM practitioners actually know about; can improve with reading a few textbooks.
  • Free radicals: terrorists on the run; call the police!
  • Fungal infection: a rare form of food poisoning where the magic mushrooms were off; needs detox.
  • Iridocyclitis: an obsession that afflicts iridologists who cannot stop riding bicycles; incurable.
  • Keratosis: the dangerous situation where a patient develops an aversion to his/her carer; change of carer is often needed.
  • Murial dyslexia: the inability to be able to read the writing on the wall; incurable.
  • Myositis: is always worse than your ositis.
  • Osteoblast: an event where, after chiropractic manipulation, a bone breaks with an audible noise; see an orthopedic surgeon.
  • Semi-colon: the embarrassing situation where a colonic irrigationist managed to clean out only half of the colon; manageable by changing your therapist.

If you, the reader, can think of more ways to expand the repertoire of SCAM terminology, please feel free to let us all know by posting your ideas below.

My ‘ALTERNATIVE MEDICINE HALL OF FAME’ is filling up nicely. But I noticed that so far we have nobody from Spain. That can be rectified ever so easily. I think I found the ideal candidate to join this group of illustrious experts who never bring themselves to publish a negative conclusion: JORGE VAS.

Jorge Vas works at the ‘Pain Treatment Unit, Doña Mercedes Primary Health Care Center, Dos Hermanas’ in Spain. I have long noticed his research which is focused on ACUPUNCTURE. From memory, I had the impression that his findings are always positive.

But is this true? To find out, I did a Medline search and found 11 clinical trials of acupuncture in his name, published between 2006 and 2019. Here are the conclusions:

  1. After 2 weeks of treatment, ear acupuncture applied by midwives and associated with standard obstetric care significantly reduces lumbar and pelvic pain in pregnant women, improves quality of life and reduces functional disability.
  2. Individualised acupuncture treatment in primary care in patients with fibromyalgia proved efficacious in terms of pain relief, compared with placebo treatment. The effect persisted at 1 year, and its side effects were mild and infrequent. Therefore, the use of individualised acupuncture in patients with fibromyalgia is recommended.
  3. The use of acupuncture to treat impingement syndrome seems to be a safe and reliable technique to achieve clinically significant results and could be implemented in the therapy options offered by the health services.
  4. …all 3 modalities of acupuncture were better than conventional treatment alone…
  5. Moxibustion treatment applied at acupuncture point BL67 can avoid the need for caesarean section and achieve cost savings for the healthcare system in comparison with conventional treatment.
  6. The application of auriculopressure in patients with non-specific spinal pain in primary healthcare is effective and safe, and therefore should be considered for inclusion in the portfolio of primary healthcare services.
  7. The degree of pain relief experienced by patients from acupuncture justifies a more rigorous study.
  8. Moxibustion at acupuncture point BL67 is effective and safe to correct non-vertex presentation when used between 33 and 35 weeks of gestation. We believe that moxibustion represents a treatment option that should be considered to achieve version of the non-vertex fetus.
  9. Single-point acupuncture in association with physiotherapy improves shoulder function and alleviates pain, compared with physiotherapy as the sole treatment. This improvement is accompanied by a reduction in the consumption of analgesic medicaments.
  10. Acupuncture plus diclofenac is more effective than placebo acupuncture plus diclofenac for the symptomatic treatment of osteoarthritis of the knee.
  11. In the treatment of the intensity of chronic neck pain, acupuncture is more effective than the placebo treatment and presents a safety profile making it suitable for routine use in clinical practice.

Eleven of 11 trials with a positive conclusion!

That surely is a rare feast.

Actually, I cheated a tiny bit. The unabridged sentence from the conclusion of paper N4 was: In the analysis adjusted for the total sample (true acupuncture relative risk 5.04, 95% confidence interval 2.24-11.32; sham acupuncture relative risk 5.02, 95% confidence interval 2.26-11.16; placebo acupuncture relative risk 2.57 95% confidence interval 1.21-5.46), as well as for the subsample of occupationally active patients, all 3 modalities of acupuncture were better than conventional treatment alone, but there was no difference among the 3 acupuncture modalities, which implies that true acupuncture is not better than sham or placebo acupuncture. Thus this (multicentre) study was negative with just a touch of positivity.

But still, look at the range of conditions that respond positively to acupuncture in Vas’ hands. Is there anyone who doubts that Jorge Vas does not deserve to join all these other geniuses in THE ALTERNATIVE MEDICINE HALL OF FAME?

I am sure that Vas has more than merited to join them.

WELCOME JORGE VAS!

Since Gwyneth Paltrow, as well as US Olympic swimmers, were publicly sporting their cupping marks, cupping has repeatedly occupied the pages of this blog. Now, cupping is in the news yet again. It has been reported that an image of a self-proclaimed ‘cupping’ expert performing treatment on a newborn baby has caused a major outcry. The photo shows a three-month-old baby’s skin on its back being sucked into a cup with the skin deformed and bright red.

The man, known as Mustafa, who refers to himself as an ‘expert’ at a ’cupping centre’ in the city of Istanbul, recently shared the images on social media where he was apparently treating the baby for ‘gas’. “We provide cupping for everyone from three-month-old babies to 70-year-olds. We do it since it is an Islamic tradition and we believe that everyone should take part in it,“ Mustafa said. “I am not a swindler. I do not demand money from people. They give as much as they choose.”

Child and adolescent psychiatrist associate, Dr Veysi Ceri, slammed the parents who allowed the procedure to be performed on their children. “Children cannot be left at the mercy of their parents,” Dr Ceri said. “Cupping is something that is not based on scientific evidence and children are physically harmed from it.”

On social media, people expressed their fury, labelling the practice as “questionable”. One commenter wrote: “Are these people crazy? They don’t read or learn anything.” But there were also those who shared their positive experiences. “I congratulate the family who had cupping performed on their baby,” one person wrote. “I also do cupping regularly and I haven’t had a headache in years. I do not take any medicine either. It is also beneficial for children to have cupping.“

___________________________

So, is there any reliable evidence about dry cupping for children?

Is it demonstrably effective for any paediatric condition?

Is it harmful?

Believe it or not, there has been at least one clinical trial of dry cupping as a treatment of constipation in children:

One hundred and twenty children (4-18 years old) diagnosed as functional constipation according to ROME III criteria were assigned to receive a traditional dry cupping protocol on the abdominal wall for 8 minutes every other day or standard laxative therapy (Polyethylene glycol (PEG) 40% solution without electrolyte), 0.4 g/kg once daily) for 4 weeks, in an open label randomized controlled clinical trial using a parallel design with a 1:1 allocation ratio. Patients were evaluated prior to and following 2, 4, 8 and 12 weeks of the intervention commencement in terms of the ROME III criteria for functional constipation.

Results: There were no significant differences between the two arms regarding demographic and clinical basic characteristics. After two weeks of the intervention, there was a significant better result in most of the items of ROME III criteria of patients in PEG group. In contrast, after four weeks of the intervention, the result was significantly better in the cupping group. There was no significant difference in the number of patients with constipation after 4 and 8 weeks of the follow-up period.

Conclusion: This study showed that dry cupping of the abdominal wall, as a traditional manipulative therapy, can be as effective as standard laxative therapy in children with functional constipation.

This study is squarely negative, yet the conclusions are clearly positive. I have stopped being amazed by such contradictions. After all, we are dealing with so-called alternative medicine (SCAM)!

For what it’s worth, here is our 2011 overview of all systematic reviews of cupping:

Several systematic reviews (SRs) have assessed the effectiveness of cupping for a range of conditions. Our aim was to provide a critical evaluation and summary of these data. Electronic searches were conducted to locate all SRs concerning cupping for any condition. Data were extracted by two authors according to predefined criteria. Five SRs met our inclusion criteria, which related to the following conditions: pain conditions, stroke rehabilitation, hypertension, and herpes zoster. The numbers of studies included in each SR were small. Relatively clear evidence emerged only for one indication, that cupping may be effective for reducing pain. Based on evidence from the currently available SRs, the effectiveness of cupping has been demonstrated only as a treatment for pain, and even for this indication doubts remain.

And here is our 2011 SR of cupping as a treatment of pain:

The objective of this study was to assess the evidence for or against the effectiveness of cupping as a treatment option for pain. Fourteen databases were searched. Randomized clinical trials (RCTs) testing cupping in patients with pain of any origin were considered. Trials using cupping with or without drawing blood were included, while trials comparing cupping with other treatments of unproven efficacy were excluded. Trials with cupping as concomitant treatment together with other treatments of unproven efficacy were excluded. Trials were also excluded if pain was not a central symptom of the condition. The selection of studies, data extraction and validation were performed independently by three reviewers. Seven RCTs met all the inclusion criteria. Two RCTs suggested significant pain reduction for cupping in low back pain compared with usual care (P < .01) and analgesia (P < .001). Another two RCTs also showed positive effects of cupping in cancer pain (P < .05) and trigeminal neuralgia (P < .01) compared with anticancer drugs and analgesics, respectively. Two RCTs reported favorable effects of cupping on pain in brachialgia compared with usual care (P = .03) or heat pad (P < .001). The other RCT failed to show superior effects of cupping on pain in herpes zoster compared with anti-viral medication (P = .065). Currently there are few RCTs testing the effectiveness of cupping in the management of pain. Most of the existing trials are of poor quality. Therefore, more rigorous studies are required before the effectiveness of cupping for the treatment of pain can be determined.

The included trials frequently were silent about adverse effects. Others reported no adverse effects and one mentioned three cases of vaso-vagal shock. None of the studies was on children.

So, here are my answers to the questions above:

  1. Is there any reliable evidence about dry cupping for children? No
  2. Is it demonstrably effective for any paediatric condition? No
  3. Is it harmful? Probably not that much (other than undermining common sense and rationality).

People who have followed this blog for any length of time will have encountered it:

THE DULLMAN SYNDROME

The DULLMAN SYNDROME (DS) is characterized by the compulsion to publish a comment that has certain features:

  • It flies in the face of rationality and contradicts the known facts.
  • It is made triumphantly and without the slightest hesitation, doubt or self-criticism.
  • It contradicts a statement that someone (usually I) has just published.
  • It is aimed at making the opponent (usually me) look uninformed, naive, or stupid.
  • It discloses the author’s lack of understanding of the subject at hand.
  • It is formulated aggressively and does not invite discussion.
  • It usually is something that the author has stated (many times) before.

What happens next in the course of the DS is important:

NOTHING!

After making his point, the DS-afflicted commentator falls silent as though he is proud of his wisdom, satisfied to have made his mark, and sure that he has convinced the rest of the world with his (non-) argument. Meanwhile, other commentators are active posting comment after comment correcting the DS-victim and trying to make him realize his error. Yet, the DS-victim remains silent; he feels that he has done what needed doing. He has made his point and there is no use entering into a discussion about it. That would only dilute his (non-) argument and might even reveal that he cannot defend it.

And that’s the end of it?

No, not exactly.

A few weeks later, our DS-victim is back.

To do what?

To do it all over again: make his nonsensical point, get corrected, and again remain silent.

This cycle repeats itself ad infinitum. There might be slight variations but the essence of the syndrome does not change.

Experts think that the DS might be a form of obsessive-compulsive behaviour. It displays a way of repeating a point that seems to be very precious to the DS-victim, but which he does not dare to debate, presumably because deep down he feels that it is indefensible.

And the cure?

Unfortunately, the prognosis is not good. Experts say the DS is still a therapeutic enigma. Research has as yet not provided any definitive answers. One hypothesis is based on the observation that the victims are often homeopaths. Thus some scientists have looked up what homeopathy has to offer. Here are the options:

Homeopathic Medicines For Obsessive Compulsive Disorder

Arsenic Album And Calcarea Carb – Best Homeopathic Medicines For Obsessive Compulsive Disorder When Mind Is Obsessed With Thoughts Of Germs

The most common presentation of OCD is constant thoughts of germs and fear of contamination or contracting a contagious disease. In such cases, the most amazing recoveries have been seen with the use of Homeopathic medicines Arsenic Album and Calcarea Carb. The two are rated among the best Homeopathic medicines for obsessive compulsive disorder where the person is obsessed with the idea of every object they touch being contaminated. They believe that they might contract an infection, germs or even a contagious disease from these objects. These thoughts are constant, uncontrollable and get fixated in the mind. Their presence leads to anxiety and restlessness. Arsenic Album and Calcarea Carb are the most effective prescriptions among Homeopathic medicines for obsessive compulsive disorder with the above symptoms.

Medorrhinum And Syphilinum – Top Rated Homeopathic Medicines For Obsessive Compulsive Disorder With Constant Compulsion To Wash Hands

Medorrhinum and Syphilinum are top of the line Homeopathic medicines for obsessive compulsive disorder. They have proved extremely beneficial in OCD cases where compulsive repetitive washing of hands is the main symptom presentation. Persons who wash their hands several times a day for fear every object is carrying germs will benefit greatly from Homeopathic medicines Medorrhinum and Syphilinum. In such cases, the frequency of washing hands is so high that the person starts to neglect his responsibilities towards family and work. Medorrhinum and Syphilinum work wonderfully well in such situations and break the habit. They will prove to be the best choice of Homeopathic medicines for obsessive compulsive disorder of this type.

Iodum And Natrum Mur – Effective Homeopathic Medicines For Obsessive Compulsive Disorder With Compulsion To Check Everything Twice Or More

The most effective Homeopathic medicines for obsessive compulsive disorder where a person feels a compulsion to check everything twice or more are Iodum and Natrum Mur. The guiding symptom is the constant thought that the person is forgetting something. Anxiety, hurriedness, irritability and cross behavior are some accompanying symptoms. Natrum Mur is highly useful in cases where a person checks doors several times for fear of robbers breaking into the house.

Arsenic Album And Carcinosin – Top Grade Homeopathic Medicines For Obsessive Compulsive Disorder With Need For Order

Arsenic Album and Carcinosin are well indicated Homeopathic medicines for obsessive compulsive disorder with the compulsiveness to maintain order. OCD with the compulsive need to maintain order or symmetry in everything can be most effectively dealt with the prescription of Homeopathic medicines Arsenic Album and Carcinosin. A person with these symptoms gets restless if things are not in their proper place and will be constantly seen arranging things in a particular way. Such persons also demand that every place be neat and tidy. They have a kind of cleanliness fetish. They spend much of their useful time in arranging things their way. Family and work suffer.

Psorinum – Best Among Homeopathic Medicines For Obsessive Compulsive Disorder Where The Mind Is Obsessed With Thoughts Of Ill-Health Or Death

Psorinum is one of the best Homeopathic medicines for obsessive compulsive disorder where thoughts of being ill and death consume the mind. Here a person constantly feels that he is in ill health and feels that there is no hope for recovery. Thoughts of death also preoccupy the mind. Such persons make their life as well as the lives of those around them intensely miserable. They are full of fears and anxieties. Homeopathic medicine Psorinum offers great help in treating such cases.

It is too early to tell whether any of these remedies are effective. The studies were slow to start and are still not concluded. Personally, I am skeptical about a homeopathic cure of the DS and have suggested several other SCAMs. From what I hear, they might try slapping therapy next.

 

 

PS

Oh, I almost forgot to explain where the term ‘DULLMAN SYNDROME’ comes from. Some suspect that it is called after a famous US homeopath and DS-victim. This hypothesis is, however, erroneous. The name comes from the fact that most skeptics, when reading the DS-victim’s repetitive posts, exclaim: ‘Oh dear, this is so dull, man!’

 

Unintended consequences are outcomes of a purposeful action that are not intended or foreseen. They exist almost everywhere and often have effects that are the opposite of what was intended.

Just look at our current misery, the pandemic, for instance. Practically all epidemiologists advocated stricter and earlier preventative measures than the ‘anti-lockdown’ brigade in politics and elsewhere wanted and implemented. Had we listened to the epidemiologists, we would almost certainly have had fewer lockdowns and less economic downturn. The unintended consequences of the political decisions to be slow and less than strict with lockdowns are what we can currently observe in many countries:

  • repeated, longer, and less and less effective lockdowns,
  • huge economic damage,
  • more deaths,
  • more long-term illness;
  • financial hardship for many,
  • more psychological problems and frustration.

But I am not here to moan about politicians not listening enough to scientists. I want to vent my anger and concern about much of the research that is currently being published in the realm of so-called alternative medicine (SCAM).

What is happening here – slightly simplified and exaggerated to make my point – is (as often discussed previously) roughly this:

  • more and more enthusiasts of SCAM feel that they should conduct and publish some research;
  • they are largely ignorant of or willfully ignore the accepted standards of science;
  • they have little interest in cause and effect or critical thinking;
  • they aim to promote and not to test SCAM;
  • several SCAM journals have realized that there is good money to be earned from publishing utter rubbish;
  • more and more papers are being published that are flawed to the point of being meaningless;
  • the few relevant SCAM papers with sound science get drowned out and become all but invisible;
  • outsiders glancing at the literature get the impression that SCAM is swamped with rubbish and thus an area that is best avoided;
  • consequently, SCAM research is fast losing all credibility and is becoming the laughing stock of proper scientists;
  • eventually, the notion that ‘ALL SCAM IS RUBBISH’ must filter through into public life;
  • in the end, the pseudo-researchers of SCAM will have provided the nail in SCAM’s coffin.

The INTENDED consequence was to promote SCAM.

The UNINTENDED consequence will be to destroy SCAM.

This self-destructive course of SCAM might be applauded by some skeptics. However, if you believe (as I do) that there are a few good things to be found in SCAM, this development can only be regrettable.

What can be done to avert such a negative outcome?

I wish I knew!

But four productive steps might be the following:

  1. make sure researchers are adequately trained and supervised to do sound science;
  2. motivate funding agencies to stop supporting pseudo-science;
  3. ensure that journal editors and reviewers realize they have the responsibility to avoid publishing nonsense
  4. motivate Medline to de-list a few of the worst SCAM journals.

 

THE TELEGRAPH is not my favourite paper, but occasionally it does publish something worth reading – like, for instance, yesterday when it carried this article:

The head of NHS England warned homeopaths had “crossed the line” after a Sunday Telegraph investigation revealed some were peddling myths that taking duck extract was as effective as the coronavirus vaccines.

Sir Simon Stephens warned people taking their advice from homeopaths were putting themselves at greater risk, and warned they would slow down the nation’s vaccine efforts. His calls were echoed by Professor Stephen Powis, the NHS medical director, who said the findings were the “latest in a long line of disturbing and potentially dangerous online myths”…

Sir Simon told the Sunday Telegraph: “It’s one thing for homeopaths to peddle useless but harmless potions, but they cross a dangerous line when making ridiculous assertions about protecting people from Covid infection. “Anyone who took those seriously would be putting themselves at higher risk of coming to harm from Covid infection.” Prof Powis added: “Spouting claims on social media about Covid cures that are not backed by scientific evidence and accurate public health advice is the latest in a long line of disturbing and potentially dangerous online myths. We urge everyone to ignore misleading claims and get vital protection against Covid when they are invited for their vaccine.” …

Helen Earner, operations director at the Charity Commission, said the findings were being examined as “a matter of urgency”. She added: “Any claims that a charity may be providing misinformation during this time of national emergency is a matter of serious concern to the Commission.” She added that a regulatory compliance case had been opened into the matter and that the commission will be liaising with other agencies as part of the investigation…

These days, I read such articles with mixed feelings. On the one hand, I applaud the fact that UK officials do take note of dangerous quackery and promise to take action. On the other hand, I cannot help feeling a bit frustrated and ask myself: WHY HAS IT TAKEN THEM SO LONG?

I know, for instance, that the Charity Commission has long been dragging its feet to do something about charities that promote overtly dangerous quackery. I have discussed such charities three years ago, and others have done so even before me. As to the UK homeopaths’ (and other practitioners of so-called alternative medicine, SCAM) dangerously bizarre attitude towards vaccinations, I started providing evidence and warning the public as early as 1995.

Perhaps they did not know about it?

Yes, perhaps – I only published these warnings in the

BRITISH JOURNAL OF GENERAL PRACTICE

and in the

BRITISH MEDICAL JOURNAL!

This gets even more frustrating when I consider that the anti-vaccination attitude in SCAM is merely one facet of a much bigger and much more important subject. Starting also in 1995, I published dozens of papers, gave hundreds of lectures on it, and often called it the ‘indirect risks‘ of SCAM. They can be summarised in one single sentence:

EVEN IF A SCAM IS TOTALLY HARMLESS, THE SCAM PRACTITIONER OFTEN ISN’T.

It is therefore tempting to shout:

I TOLD YOU SO!

But that would hardly be helpful. Instead, I let me beg Sir Simon Stephens, Prof Powis, Helen Earner, and anyone else in a position of power to take a minute and consider the wider implications of tolerating SCAM practitioners impose their overtly dangerous health-related views on the unsuspecting public.

Guest post by Ken McLeod

On 31 March 2020, the Chiropractic Board of Australia issued a statement1 to all Australian chiropractors that they:

“should not make advertising claims on preventing or protecting patients and health consumers from contracting COVID-19 or accelerating recovery from COVID-19. To do so involves risk to public safety and may be unlawful advertising. For example, we are seeing some advertising claims that spinal adjustment/manipulation, acupuncture and some products confer or boost immunity or enhance recovery from COVID-19 when there is no acceptable evidence in support.

“Advertisers must be able to provide acceptable evidence of any claims made about treatments that benefit patients/health consumers. We will consider taking action against anyone found to be making false or misleading claims about COVID-19 in advertising. If the advertiser is a registered health practitioner, breaching advertising obligations is also a professional conduct matter which may result in disciplinary action, especially where advertising is clearly false, misleading or exploitative.”

What could be clearer than that?

So what was published by a registered chiropractor on 16 March 2020, two weeks before the Board’s warning, and is still on his website 10 months later? You guessed it, a video on the website of chiropractor Morgan Weber, a video ‘Coronavirus – Balancing the hysteria…’, 2 in which he says:

– the COVID-19 19 pandemic is all ‘hysteria’ and ‘what have we got to worry about’, because ‘Our body, (has) 51 trillion cells’ vs ‘A one single-cell virus,’ (sic.) ‘51 trillion cells that orchestrate our immune system, every function. Yet we seem to have more faith and trust in ‘medicine’ than we do in this amazing body we call home. Crazy, right? Crazy.’

Weber further downplays the crisis by saying ‘Enough of this nonsense about the big bad bug and all the worry about washing your hands.’

Weber, after denigrating evidence-based medicine, recommends instead:

– ‘Keep up with your chiropractic adjustments….’

Weber is a registered chiropractor practicing at Wave Chiropractic, Maroochydore, Queensland, Australia. His AHPRA registration is CHI0001601286. Weber’s webpage home site is at https://www.wavechiropractic.com.au/index.php

WEBER’S VIDEO:

Since 16 March 2020 Weber has posted a video on his website a video ‘Coronavirus – Balancing the hysteria…’. 3

Weber says:

BEGINS TRANSCRIPT

00:00. Hi everyone. Hasn’t it been fascinating lately? The news, the hysteria. Everything has gone almost upside-down. Crazy. I found it so fascinating.

00:12. So today we thought we would have a bit of a chat and sort of balance the scales and the story getting told out there in the mass media. I hope you’ve got your toilet paper stockpiled and sorted ha ha ha ha. It’s hilarious to see people coming and going with huge amounts under their arms as they come out of the grocery store. Crazy isn’t it, crazy times.

00:42. So let’s think about if for a second, and if we bypass all that hysteria and noise and just think a little bit about this. Our body, 51 trillion cells. A one single-cell virus. My gosh. What have we got to worry about? We have this amazing system. 51 trillion cells that orchestrate our immune system, every function. Yet we seem to have more faith and trust in ‘medicine’ than we do in this amazing body we call home. Crazy, right? Crazy.

01:20 ‘The other story, the other sort of facts behind what we do, and I (unintelligible) told a fair few of you of this already, how the immune system works. So, across the road from Waves, we have a really kind of bare patch of grass, just before you go onto the beach. Now if I took a handful of seeds. Now this is an analogy for how our system works, and how amazing our body’s immune system is. If I took a bunch of seeds and dropped them onto the ground, some grass seeds, not all of those seeds would take. There needs to be a hospitable environment, a moist warm sunlit area for those seeds to take, then root and grow into a fully mature grass and perpetuate on and on and on. However that area across the road is barren rocky sandy and yuck. You drop those seeds, most of those are going to blow off and away because that area is a no-go, it’s got a strong resistance, a barrier, a non-hospitable environment.

02:18. Now that is how our immune system works. Now the story I feel that should be out there, is what are you doing to nurture your body to do the best it can be, to have the strongest barrier it can be.

02: 30. Enough of this nonsense about the big bad bug and all the worry about washing your hands. ‘Cause I tell you what, if you are neglecting to nurture your body and the 51 trillion cells to be the best they can be, watch out, that may not be enough, washing your hands.

02:47. So let’s talk about that. How do we orchestrate a healthy system that has a strong immune barrier to anything that’s out there? And really guys, this should be a day-to-day forte (?) for everyone who just wants to be their best.

03:00. So let’s go through it. Boosting your barriers. You need to trust your body. First and foremost, the 51 trillion cells are remarkable. Trust in that.

03: 12. You’ve gotta eat well. Eat well with nutrient-dense, mineral-dense foods. Stay well hydrated. Move. You’ve gotta move well. Exercise your body regularly, moving all parts in all directions. Enjoy healthy sunlight exposure. You’ve gotta think well. Follow your passions and purpose. Think positively. Perhaps switch off the TV.

03:41. Keep up with your chiropractic adjustments. An optimal brain and body communication via the nervous system is vital so ensuring your body is in a surviving state. Do all these things guys. Up the ante of them. Go in harder with your (unintelligible) exercises, your hydration etcetera, and trust in your body. It’s amazing. It’s built with this in-built protective mechanism. Foster it. Help to balance that story out there, and help people to take on a more useful interpretation of this current crisis out there.

04:19. I hope this was of value and you guys enjoy.

END TRANSCRIPT

The regulator has been informed. As the world’s death toll rockets past 2 million, we wait to see if they really meant what they said about disciplinary action.

 

It’s sad but true: not everyone likes THE ALTERNATIVE MEDICINE HALL OF FAME. Take this recent comment, for instance:

It is pathetic to see that Edzard only engages in the systematic harassment of his former colleagues or people who in most cases ignore him. Perhaps because he knows that his battle against homeopathy was totally lost in Germany, Switzerland and Brazil, as could be seen in the imminent failure of the “Questao Da Ciencia Institute”…  Edzard acts as a real bully against Dr. Jacobs by including her in a “hall of fame” to humiliate her before the hoolingans who applaud her, who are always the four guardian trolls who never contribute or benefit to the discussion… 

But then there are others who do appreciate it and recognize that it serves an important purpose: to alert the public to the fact that there is something deeply wrong with much of the published research in so-called alternative medicine (SCAM). Incidentally, this was also the theme of my last post on acupuncture and is the topic of many of my recent articles. Thus the aim of my HALL OF FAME is not to humiliate anyone; it is merely one of many of my attempts to protect the public from misleading information that has the potential to do much harm.

And therefore, I am not likely to close the HALL OF FAME any time soon.

Someone who has been waiting for ages to get admitted is the prolific psychologist Professor Harald Walach. He has in the past changed employment frequently.  After building up a research group in SCAM at the University Hospital in Freiburg he held a research professorship with the University of Northampton, UK from 2005-2009 where he directed the MSc Program of Transpersonal Psychology and Consciousness Studies. From 2010 to 2016, he worked at the European University Viadrina in Frankfurt (Oder), where he headed a postgraduate Master program training doctors in SCAM and cultural sciences. Currently, Walach is affiliated with three institutions:

  • Department of Pediatric Gastroenterology, Medical University Poznan, Poznan, Poland.
  • Department of Psychology, University Witten-Herdecke, Witten, Germany.
  • Change Health Science Institute, Berlin, Germany

In 2012, Walach was elected pseudoscientist of the year, a fact that should almost automatically unlock the HALL’s door for him. But let’s not be hasty; let’s have a look at his publications. My Medline search for ‘Walach H, clinical trial’ generated 40 hits of which 19 related to clinical studies of so-called alternative medicine (SCAM). Here are their conclusions:

  1. Both physiotherapy and PPT improve subacute low back pain significantly. PPT is likely more effective and should be studied further.
  2. One treatment session of enhanced MMT physiotherapy or RegentK can lead to nearly full function and thus recovery of a ruptured ACL after 1 year.
  3. MBSR did not produce cardiac autonomic benefits or changes in daily activity in FM. Furthermore, the lack of an association between patient-experienced clinical improvement and objective physiological measures suggests that subjective changes in the wellbeing of FM patients over time are not related to alterations in the cardiorespiratory autonomic function or activity levels.
  4. Mindfulness therapy may prevent disability pension and it may have a potential to significantly reduce societal costs and increase the effectiveness of care. Accumulated weeks of unemployment and sickness benefit are possible risk factors for BDS.
  5. Mindfulness therapy is a feasible and acceptable treatment. The study showed that mindfulness therapy was comparable to enhanced treatment as usual in improving quality of life and symptoms.
  6. In conclusion, primary outcome analyses did not support the efficacy of MBSR in fibromyalgia, although patients in the MBSR arm appeared to benefit most.
  7. Homeopathic remedies produce different symptoms than placebo.
  8. We, therefore, conclude that homeopathic remedies produce more symptoms typical for a remedy than non-typical symptoms. The results furthermore suggest a somewhat non-classical pattern because symptoms of one remedy appear to be mimicked in the other trial arm. This might be indicative of entanglement in homeopathic systems.
  9. In patients with CFS, distant healing appears to have no statistically significant effect on mental and physical health but the expectation of improvement did improve outcome.
  10. Treatments with QUANTEC may be accompanied by beneficial health effects.
  11. The results showed that both remedies ‘produced’ significantly more symptoms than placebo. With regard to the specificity, the Calendula officinalis group displayed more remedy-specific symptoms than placebo. However, in the Ferrum muriaticum group more Calendula symptoms than placebo were also recorded.
  12. Homeopathic proving symptoms appear to be specific to the medicine and do not seem to be due to a local process.
  13. We conclude that in an unselected sample of headache patients some may indeed be susceptible to the low intensity type of electromagnetic radiation exemplified by sferics pulses.
  14. We conclude that Bach-flower remedies are an effective placebo for test anxiety and do not have a specific effect.
  15. Approximately 30% of patients in homeopathic treatment will benefit after 1 y of treatment. There is no indication of a specific, or of a delayed effect of homeopathy.
  16. There is no indication that belladonna 30CH produces symptoms different from placebo or from no intervention. Symptoms of a homeopathic pathogenetic trial (HPT) are most likely chance fluctuations.
  17. Chronically ill patients who want to be treated by distant healing and know that they are treated improve in quality of life.
  18. Mind machines do not have a specific effect on general well-being and physiological relaxation, although they may produce unusual psychological experiences; people with psychiatric illnesses should not use such devices.
  19.  Group evaluation showed no clearcut differences. The claim that homoeopathic potencies can produce symptoms other than placebo in healthy subjects should be put to further scrutiny.

So, as we see, Prof Walach has published many clinical trials on numerous SCAMs . Their majority arrived at positive conclusions. His TI is therefore sky-high. But he has also published studies that were dramatically negative, even some of homeopathy!

The main criterion for admission to THE ALTERNATIVE MEDICINE HALL OF FAME is to have published SCAM research that hardly ever concludes negatively. Does Walach fulfill it? Should he be allowed to join this illustrious group of people?

I have to admit, the decision was not easy in this case. However, after considering all the evidence, I have decided in favour of admission.

WELCOME PROF WALACH!

 

Professor Andreas Michalsen is the clinical director of the department of naturopathy in a Berlin hospital. He seems most keen to represent the scientific side of so-called alternative medicine in Germany. He has published several (fairly uncritical) books on SCAM and numerous papers in the medical literature. I had a look at those papers and hope you agree that Michalsen should join the other extraordinary experts in THE ALTERNATIVE MEDICINE HALL OF FAME:

My Medline search on 10/1/2021 for ‘Michalsen A, clinical trial’, generated 69 hits. Below I list the key conclusions of the 47 SCAM studies that were published in English by Andreas Michalsen et al:

  1. In this explorative pilot trial, an increase of HRV (more parasympathetic dominance and overall higher HRV) after ten weeks of yoga in school in comparison to regular school sports was demonstrated, showing an improved self-regulation of the autonomic nervous system. (pilot)
  2.  Results showed a contrast between the high agreement of the consented final diagnosis and disagreement on certain diagnostic details.
  3. A single session of leech therapy is more effective over the short term in lowering the intensity of pain over the short term and in improving physical function and quality of life over the intermediate term.
  4. Short term fasting during chemotherapy is well tolerated and appears to improve QOL and fatigue during chemotherapy. Larger studies should prove the effect of STF as an adjunct to chemotherapy. (pilot)
  5. Administering verum (a complex homeopathic drug) resulted in a statistically significantly greater improvement of the Cough Assessment Score than the placebo. The tolerability was good and not inferior to that of the placebo.
  6. Ayurvedic treatment is beneficial in reducing knee OA symptoms.
  7. We did not find any clinically relevant differences between groups in this controlled clinical pilot trial of 8 wk of intermittent fasting in healthy volunteers.
  8. We found positive effects for both groups, which however were more pronounced in the Ayurvedic group. The conversational and counseling techniques in the Ayurvedic group offered more opportunities for problem description by patients as well as patient-centered practice and resource-oriented recommendations by the physician.
  9. Results of this study suggest that prolonged fasting is feasible and might have beneficial clinical effects. (pilot)
  10. This clinical trial indicates comparable efficacy of the herbal combination and antibiotic, although non-inferiority was not proved. However, the results and lessons learned are important for the planning of future trials.
  11. Thus, cycles of a 5-day fasting-mimiking diet are safe, feasible, and effective in reducing markers/risk factors for aging and age-related diseases.
  12. Ayurvedic external treatment is effective for pain-relief in chronic low back pain in the short term.
  13. Focused meditation and self-care exercise lead to comparable, symptomatic improvements in patients with chronic low back pain.
  14. This randomized trial found no effects of yoga on health-related quality of life in patients with colorectal cancer. Given the high attrition rate and low intervention adherence, no definite conclusions can be drawn from this trial.
  15. The Alexander Technique was not superior to local heat application in treating chronic non-specific neck pain.
  16.  In conclusion, meditation may support chronic pain patients in pain reduction and pain coping. 
  17. The herbal preparation of myrrh, chamomile extract and coffee charcoal is well tolerated and shows a good safety profile. We found first evidence for a potential efficacy non-inferior to the gold standard therapy mesalazine, which merits further study of its clinical usefulness in maintenance therapy of patients with ulcerative colitis.
  18. Yoga was more effective in relieving chronic nonspecific neck pain than a home-based exercise program. Yoga reduced neck pain intensity and disability and improved health-related quality of life. Moreover, yoga seems to influence the functional status of neck muscles, as indicated by improvement of physiological measures of neck pain.
  19. In this preliminary trial, yoga appears to be an effective treatment in chronic neck pain with possible additional effects on psychological well-being and QOL.  (pilot)
  20. These results suggest that Gua Sha may be an effective treatment for patients with chronic neck and low back pain.
  21. The data indicate that during needle insertion high dose acupuncture stimulation leads to a higher increase of sympathetic nerve activity than low dose stimulation independent of personality. After needle insertion subjects who tend to augment incoming stimuli might show a lack of psychological relaxation when receiving high dose stimulation.
  22. In patients with METS, phlebotomy, with consecutive reduction of body iron stores, lowered BP and resulted in improvements in markers of cardiovascular risk and glycemic control.
  23. The present study gives preliminary evidence that healing clay jojoba oil facial masks can be effective treatment for lesioned skin and mild acne vulgaris.
  24. In a laboratory setting, an electroacupuncture procedure was as effective as a single dose of an orally administered opiate in reducing experimentally induced ischaemic pain.
  25. In the presence of modern treatments, complementary prescription of comprehensive lifestyle modification has no impact on coronary artery calcium progression but sustainable benefit for blood pressure, heart rate and the need of anti-ischemic medication is demonstrated. 
  26. A single course of leech therapy was effective in relieving pain in the short-term and improved disability in intermediate-term. Leeches might be considered as an additional option in the therapeutic approach to lateral epicondylitis.
  27. Gua sha has beneficial short-term effects on pain and functional status in patients with chronic neck pain.
  28. Alterations in short-chain fatty acids were found in terms of significant changes to increased acetate levels in the fasting group.
  29. In this first study on the efficacy of cantharidin blisters, a clinically relevant pain-relieving short-term effect on lumbar spinal stenosis was observed.
  30. We conclude that cupping therapy may be effective in relieving the pain and other symptoms related to CTS.
  31.  A single course of leech therapy is effective in relieving pain, improving disability and QoL for at least 2 months.
  32. The high effect sizes indicate that repeated rhythmic embrocation with Solum Oil may improve mood, pain perception (sensory PPS), and the ability to cope with pain (affective PPS) in patients with chronic low back pain.
  33. The data indicate, that verum acupuncture and sham acupuncture might have a beneficial influence on the autonomic nervous system in migraineurs with a reduction of the LF power of HRV related to the clinical effect. This might be due to a reduction of sympathetic nerve activity. VA and SA induce different effects on the high-frequency component of HRV, which seem, however, not to be relevant for the clinical outcome in migraine.
  34. Gua Sha increases microcirculation local to a treated area, and that increase in circulation may play a role in local and distal decrease in myalgia. Decrease in myalgia at sites distal to a treated area is not due to distal increase in microcirculation. There is an unidentified pain-relieving biomechanism associated with Gua Sha.
  35. These results are consistent with possible short-term benefits of a comprehensive lifestyle modification program on some aspects of quality-of-life and emotional well-being, but no effects were discernable 12 months after completion of therapy.
  36. In the presence of modern treatments, comprehensive lifestyle modification provides no additional benefits on progression of atherosclerosis but improves autonomic function, angina, and QOL with concomitant reduced need of medication. These responses are more pronounced in GNB3*825T allele carriers.
  37. Neither Mediterranean diet nor fasting treatments affect the microbiologically assessed intestinal flora and sIgA levels in patients with RA and FM.
  38. Women suffering from mental distress participating in a 3-month Iyengar yoga class show significant improvements on measures of stress and psychological outcomes.
  39. Adoption of a Mediterranean diet by patients with medically treated CAD has no effect on markers of inflammation and metabolic risk factors.
  40. A comprehensive lifestyle modification and stress management program did not improve psychological outcomes in medically stable CAD patients. The program did appear to confer psychological benefits for women but not men. Further trials should investigate gender-related differences in coronary patient responses to behavioral interventions.
  41. Mind-body therapy may improve quality of life in patients with UC in remission, while no effects of therapy on clinical or physiological parameters were found, which may at least in part be related to selective patient recruitment.
  42. Leech therapy helps relieve symptoms in patients with osteoarthritis of the knee.
  43. A home-based hydrotherapeutic thermal treatment program improves quality of life, heart-failure-related symptoms and heart rate response to exercise in patients with mild chronic heart failure. The results of this investigation suggest a beneficial adaptive response to repeated brief cold stimuli in addition to enhanced peripheral perfusion due to thermal hydrotherapy in patients with chronic heart failure.
  44. This open pilot study demonstrates that along with a decrease in sleep arousals a 1-week fasting period promotes the quality of sleep and daytime performance in non-obese subjects.
  45. Periarticular application of 4 leeches led to rapid relief of pain with sustained improvement after 4 weeks in the absence of major complications.
  46. Short-term fasting in inpatients with pain and stress syndromes is safe and well tolerated, concomitant mineral supplements have no additive benefit.
  47. The results suggest that the cardiovascular response during whole-body infrared-A irradiation is accompanied by significant changes in autonomic cardiac regulation: A significant decrease of low-frequency power corresponding to depressed vagal activity results in an increase of Iow/high-frequency ratio. During serial hyperthermias the acute response is diminished suggesting an adaption of the autonomic response to hyperthermia.

This list is impressive in several ways: very few SCAM researchers managed to publish 47 Medline-listed clinical studies, and nobody I know has ever conducted clinical trials of so many different SCAMs in so many different medical conditions. They include:

  • Acupuncture
  • Alexander technique
  • Ayrurvedic medicine
  • Blood letting
  • Cupping
  • Diet
  • Embrocation
  • Fasting
  • Gua cha
  • Herbal medicine
  • Homeopathy
  • Hydrotherapy
  • Hyperthermia
  • Meditation
  • Mind/body therapies
  • Leeching
  • Life style modification
  • Yoga

While this is astounding, another fact is even more baffling: with just 2 or 3 exceptions, all these studies yield postive results. Whatever Michalsen touches turns to gold! And if it doesn’t, he spins the findings such that the conclusions are at least partly positive; see for instance No 14, 33, 36, 40 or 41 in the above list.

WELCOME TO THE ALTERNATIVE MEDICINE HALL OF FAME PROFESSOR MICHALSEN!

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