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

bogus claims

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When I previously wrote about Pranic Healing I boldly asked whether it is a hoax. This prompted several furious reactions of believers who thought my question was insulting. Meanwhile, I informed myself more thoroughly and am happy to confirm that Pranic Healing is not a hoax at all. In fact, it is much worse.

What, you forgot what Pranic Healing is?

How could you?

According to one website, Pranic Healing is a

no touch, non-invasive healing technique that was founded by Grand Master Choa Kok Sui. It is a synthesis of healing techniques from ancient China, Tibet and India in which Prana is used to heal a wide variety of illnesses. Pranic Healing is not only used to cure illness or physical ailments but also can be cure person of his psychological ailments. To be very simple in this computer age as the computer contains the hardware and the software. In human body hardware is our physical body and the software’s are the Human emotions which includes Anger, Grief, Anxiety, Stress , fatigue, our karmas, pride, fear, Phobias and many more.

These human viruses affect the physical body of a person. In Pranic healing Grand Master Choa kok Sui has taught to remove these negative emotions from our system in a very simple but powerful and effective way. Grand Master Choa Kok Sui did lot of research and experiment for treating different diseases and ailments and made is very simple so that anybody can learn it. Today Pranic healing is taught and practiced in more than 80 countries of the world and its books are available in more than 34 languages. Pranic Healing is not intended to replace orthodox western medicine, but rather to complement it. Countless people and their families have been treated and are enjoying a better quality of life through Pranic Healing.

‘Grand Master’ Choa was born August 15, 1952, in the Philippines. His parents were of Chinese descent and became successful business people. Choa was raised in this environment of business and absorbed its lessons only too well. Sadly, he seemed to have been immune to his own healing innovation, as he died young in 2007. But his Pranic Healing empire lives on and today it is a hugely profitable business.

Prana Crystals sell a wide range of products, for instance ‘healing wants’ which they advertise as follows:

Healing Wands made from various stones and crystals have been used round the globe Rare 496 grams Quartz crystal wand Imagefor healing purposes since ages. They help in cleansing of the entire body or aura or they can also be used to heal an affected part of the body or chakra. These wands can also be used for massaging purpose. They absorb the negative energy and release stress and pressure and help in transferring the positive energy of the stone. Healing Wands are available in variety of stones and crystals in different sizes. Each one of them have specific characteristics and uses. We have a variety of Wands available to meet your requirements.

My favourite wand is the one pictured on the right here. It is the Rolls Royce of all the wands on offer and therefore it can obviously not come cheap. But at US$ 1999 (yes, one thousand nine hundred and ninety-nine American dollars) it is still a bargain, because it rids you of all the diseases and negative energy that you can dream of.

During my recent crash course in Pranic Healing, I came across dozens of websites, hundreds of testimonials, uncounted comments and a plethora of curious things. Let me share just one of them with you:

Pranic Weight Loss Body Sculpting Face Lift is a fascinating area of the applications of the teachings of Master Choa Kok Sui for health and beauty. This workshop helps you look prettier and loose weight without surgery, exhausting exercises and medicine, just by using the knowledge of subtle energy.

Using specific combination of colour pranas and techniques, your skin can look 10 to 20 years younger. In fact the lines and wrinkles of the face are storage of negative and unpleasant feelings and experiences such as anger, fear and grief. When this emotional garbage is cleared and released, the face will look younger, brighter and revitalized.

Certain colour Pranas have the power to disintegrate and remove fat, wrinkles and lines from your system to create a healthier and better-looking body. In fact the lines and wrinkles of the face are storage of negative and unpleasant feelings and experiences such as anger, fear and grief. When this emotional garbage is cleared and released, the face will look younger, brighter and revitalized.

No, Pranic Healing is most certainly not  hoax, and I was wrong to imply it. My sincere apologies! It is pure and simple exploitation of  vulnerable people who have not had the opportunity to learn how to think critically.

 

Michael Dixon LVOOBEMAFRCGP has been a regular feature of this blog (and elsewhere). He used to be a friend and colleague until … well, that’s a long story. Recently, I came across his (rather impressive) Wikipedia page. To my surprise, it mentions that Dixon

See the source image“has been criticised by professor of complementary medicine and alternative medicine campaigner Edzard Ernst for advocating the use of complementary medicine. Ernst said that the stance of the NHS Alliance on complementary medicine was “misleading to the degree of being irresponsible.”[31] Ernst had previously been sympathetic to building a bridge between complementary and mainstream medicine, co-writing an article with Michael Dixon in 1997 on the benefits of such an approach.[32] Ernst and Dixon write “missed diagnoses by complementary therapists giving patients long term treatments are often cited but in the experience of one of the authors (MD) are extremely rare. It can also cut both ways. A patient was recently referred back to her general practitioner by an osteopath, who was questioning, as it turned out quite correctly, whether her pain was caused by metastates. Good communication between general practitioner and complementary therapist can reduce conflicts and contradictions, which otherwise have the potential to put orthodox medicine and complementary therapy in an either/or situation.”

REFERENCES

31) February 2009, 24. “Academics and NHS Alliance clash over complementary medicine”. Pulse Today.

32) ^ Update – the journal of continuing education for General Practitioners, 7th May 1997

I have little recollection of the paper that I seem to have published with my then friend Michael, and it is not listed in Medline, nor can I find it in my (usually well-kept) files; the journal ‘Update’ does not exist anymore and was obviously not a journal good enough for keeping a copy. But I do not doubt that Wiki is correct.

In fact, it is true that, in 1997, I was still hopeful that bridges could be built between conventional medicine and so-called alternative medicine (SCAM). But I had always insisted that they must be bridges built on solid ground and with robust materials.

Put simply, my strategy was to test SCAM as rigorously as I could and to review the totality of the evidence for and against it. Subsequently, one could consider introducing those SCAMs into routine care that had passed the tests of science.

Dixon’s strategy differed significantly from mine. He had no real interest in science and wanted to use SCAM regardless of the evidence. Since the publication of our paper in 1997, he has pursued this aim tirelessly. On this blog, we find several examples of his activity.

And what happened to the bridges?

I’m glad you ask!

As it turns out, very few SCAMs have so far passed the test of science and hardly any SCAM has been demonstrated to generate more good than harm. The material to build bridges is therefore quite scarce, hardly enough for solid constructions. Dixon does still not seem to be worried about this indisputable fact. He thinks that INTEGRATED MEDICINE is sound enough for providing a way to the future. I disagree and still think it is ‘misleading to the degree of being irresponsible’.

Who is right?

Dixon or Ernst?

Opinions about this differ hugely.

Time will tell, I suppose.

Some chiropractors seem too uninformed, stupid or greedy to stop claiming that spinal manipulation boosts the immune system. In the current situation, this is not just annoying, it is positively dangerous.

Here is a fine example of such a person; he is even so convinced of his views that he felt like giving an interview:

How can/does chiropractic care improve your immune system? What happens to our bodies physiologically when we get chiropractic adjustments?

Chiropractic care addresses the vertebral subluxation. This occurs when a vertebra becomes misaligned. This misalignment can result in irritation to the spinal nerve roots, which exit the spinal cord.

When a spinal nerve root is irritated, it stresses the nervous system — thus the potential to weaken the immune system. When we evaluate the spine for these subluxations and identify a misalignment, chiropractors can adjust the spine to alleviate the irritation to the spinal nerve root. This in turn helps to remove the stress from the nervous system.

If people have problems with their immune systems, can chiropractic care help make them better?

Chiropractic care is not a panacea for disease. Its main role is to remove the interference on the nervous system. The three main stresses on the nervous system are thoughts, traumas, and toxins. These are mainly caused by poor lifestyle choices.

Negative thoughts and self-doubt, physical trauma, and environmental toxins all affect the body in ways that stress the nervous system, thus weakening the immune response. Chiropractic care can address the entire nervous system by not only creating a physiological change, but also inducing a reduction of stress, which results in emotional regulation.

Is there any particular research that gives evidence on how chiropractic care can improve your immune system?  

Three past studies suggest that manipulation consistently reduced the production of pro-inflammatory mediators associated with tissue damage and pain from articular structures. Two studies provide evidence that manipulation consistently reduced the production of pro-inflammatory mediators associated with tissue damage and pain from articular structures.

Two studies provide evidence that manipulation may induce and enhance production of the immunoregulatory cytokine IL-2 and the production of immunoglobulins as well.

There are a multitude of clinical studies demonstrating the effects of stress on the body and the correlation between stress and immune function. More double blind, randomized clinical trials need to be conducted on the direct relationship between spinal subluxation and the effect on the immune system. In private practice, we observe the impact that adjusting the spine has on overall wellness and its undeniable effect on boosting the body’s ability to adapt to stress and improve your immune system.

Is there anything else about the physiology of how chiropractic care impacts the immune system that you think is important for readers to know?

Our health is our wealth. Taking responsibility for our wellbeing and being preventative affords the body the best possible chance of protecting itself from illness and disease.

Chiropractic care is rooted in the fundamentals that our negative thoughts, traumas, and toxins can lead to disease. By properly evaluating every patient and addressing their physical and emotional challenges, we as a profession can be the leaders of preventative care and restore health naturally and effectively.

On the one hand this is embarrassing, as it exposes almost everything that is wrong with chiropractic. On the other hand, it is informative, as it demonstrates how deeply some chiropractors are entrenched in platitudes, half-truths and blatant lies. The inevitable question is: do these chiropractors really believe this nonsense, or do they merely promote it because it is good for business?

Whatever the answer may be, one thing is fairly obvious: the ones who are being harmed by such drivel are the patients who lack sufficient critical thinking abilities to look through it. They pay not just with their money, but also with their health.

SO, PLEASE LEARN TO THINK CRITICALLY, FOLKS!

The U.S. Food and Drug Administration has issued warning letters to four companies for selling unapproved injectable drug products labelled as homeopathic that can pose serious risks to patient health and violate federal law, as part of the agency’s efforts to protect Americans from potentially harmful products that are labelled as homeopathic.

The FDA is particularly concerned about unapproved injectable drug products labelled as homeopathic because they are injected directly into the body, often directly into the bloodstream and bypass some of the body’s key natural defences against toxins, toxic ingredients and dangerous organisms that can cause serious and life-threatening harm. Additionally, unapproved drugs that claim to cure, treat or prevent serious conditions may cause consumers to delay or stop medical treatments that have been found safe and effective through the FDA review process.

“The FDA’s drug approval requirements are designed to protect patients by ensuring, among other things, that drugs are safe and effective for their intended uses. These unapproved injectable drugs are particularly concerning because they inherently present greater risks to patients because of how they are administered,” said Donald D. Ashley, director of the Office of Compliance in the FDA’s Center for Drug Evaluation and Research. “These products are further concerning given that they are labelled to contain potentially toxic ingredients intended for injection directly into the body. These warning letters reflect our continued commitment to patient safety.”

No currently marketed drug products labelled as homeopathic have been approved by the FDA for any use and the agency cannot assure these drugs meet modern standards for safety, effectiveness and quality. Products labelled as homeopathic can be made from a wide range of substances, including ingredients derived from plants, healthy or diseased animal or human sources, minerals and chemicals, and they can include known poisons or toxins. These drugs are often marketed as natural, safe and effective alternatives to approved prescription and non-prescription products and are widely available in the marketplace. Additionally, the lack of premarket quality review is particularly concerning for injectable drugs, which generally pose a greater risk of harm to users because the route of administration for these products bypasses some of the body’s natural defences.

The FDA issued the warning letters to Hevert Pharmaceuticals, LLCMediNatura, Inc.8046255 Canada, Inc., doing business as Viatrexx; and World Health Advanced Technologies, Ltd. The products included in the warning letters are new drugs because they are not generally recognized as safe and effective for their labelled uses, and FDA has not approved these products. Some drugs, such as “Enercel,” marketed by World Health Advanced Technologies, Ltd., are intended for serious diseases such as tuberculosis and hepatitis B and C.

Many of the drugs were labelled to contain potentially toxic ingredients such as nux vomica, belladonna (deadly nightshade), mercurius solubilis (mercury), and plumbum aceticum (lead). For example, nux vomica contains strychnine, which is a highly toxic, well-studied poison that is used to kill rodents. The agency is concerned that these potentially toxic ingredients present additional risks of serious harm when delivered directly into the body, including directly into the bloodstream.

Drugs labelled as homeopathic may also cause significant and even irreparable harm if they are poorly manufactured. Viatrexx was also cited for substandard manufacturing practices for sterile drugs.

The foreign manufacturers of the injectable drugs sold by Hervert Pharmaceuticals, LLC; MediNatura New Mexico, Inc.; and Viatrexx were also placed on import alert 66-41 to stop these drugs from entering the U.S.

The FDA has taken steps to clarify for both consumers and industry how the potential safety risks of these products are assessed. On Oct. 24, 2019, the FDA withdrew Compliance Policy Guide (CPG) 400.400 “Conditions Under Which Homeopathic Drugs May be Marketed,” because it was inconsistent with the agency’s risk-based approach to regulatory and enforcement actions. The FDA also issued a revision of its draft guidance, titled Drug Products Labeled as Homeopathic: Guidance for FDA Staff and Industry, for public comment. When finalized, this guidance will explain the categories of homeopathic drug products that we intend to prioritize under our risk-based enforcement approach. In the interim, before the draft guidance is finalized, the FDA intends to apply its general approach to prioritizing risk-based regulatory and enforcement action.

The FDA encourages health care professionals and consumers to report adverse events or quality problems experienced with the use of any of these products to the FDA’s MedWatch Adverse Event Reporting program. To report adverse drug events in animals, see How to Report Animal Drug Side Effects and Product Problems

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Hevert is of course well known to readers of this blog for their attempt to silence critics of homeopathy in Germany. The FDA’s warning letter refers to their following injectable products:

  • “Arnica,”
  • “Calmvalera comp.,”
  • “Gelsemium comp.,”
  • “Hepar comp.,”
  • “Lymphaden comp.”

The FDA referred to the following injectable homeopathic products from 8046255 Canada:

  • “Articula,”
  • “Mesenchyme,”
  • “Connectissue,”
  • “MuSkel-Neural,”
  • “Ouch,”
  • “Ithurts,”
  • “Adipose,”
  • “Systemic Detox,”
  • “Hair,”
  • “Neuro 3,”
  • “Infla,”
  • “Collagen,”
  • “Prolo,”
  • “Lymph 1,”
  • “GI,”
  • “Neuro,”
  • “Arthros,”
  • “Male+,”
  • “Immunexx,”
  • “Relief+,”
  • “Intra-Cell,”
  • “Facial,”
  • “ANS/CNS”.

The FDA warning to World Health Advanced Technologies, Ltd referred to:

  • “Enercel AM,”
  • “Enercel Forte,”
  • “Enercel Max,”
  • “Enercel Mist-Nasal,”
  • “Enercel Mist Nebulizer,”
  • “Enercel PM,”
  • “Vanicel,”
  • “Enercel Plus,”
  • “Enercel Plus IM.”

The FDA warning referred to the following products by MediNatura, and the claims made for them include:

  • Zeel Injection Solution: “… treatment of arthrosis/osteoarthritis, and/or rheumatic joint diseases and for the relief of symptoms such as pain and joint stiffness.”
  • Traumeel Injection Solution: … treatment of injuries, inflammatory and degenerative conditions of the musculoskeletal system and for the relief of associated symptoms such as pain.”
  • Engystol Injection Solution:  support of the immune system to reduce severity and duration of symptoms in viral infections, particularly in the early stages of colds and influenza-like illnesses.”
  • Neuralgo-Rheum Injection Solution: “… treatment of nerve pain, soft tissue rheumatism and symptoms of disc protrusion.”
  • Lymphomyosot X Injection Solution: “… improvement of lymphatic drainage, the non-specific immune defense, and conditions such as benign hypertrophy of lymph nodes, chronic tonsillitis, tonsillar hypertrophy and lymphatic edema.”
  • Spascupreel Injection Solution: “… relief of spasms of the smooth musculature of the gastrointestinal and urogenital tract as well as general muscle spasms.”

The FDA has requested the companies to respond within 15 working days. The letter also states that failure to correct any violations could result in legal action against the company, including seizure and injunction.

Asked for comment, Cliff Clive, founder and CEO for MediNatura, stated that he is disappointed with the FDA’s actions and the company is in the process of developing their response. “The FDAs statements that the MediNatura injectable products present greater risk to consumers is without factual basis,” Clive said. “The MediNatura injectable products are labelled for use only under the care of licensed practitioners [and] are manufactured in [Good Manufacturing Practice]-compliant facilities to assure their quality and sterility.”

Disputing several of the claims made in the letter, Clive noted that rather than protecting patients, “the FDA’s actions threaten to remove valuable alternatives relied upon by medical practitioners in treating their patients. These injections have been used legally by thousands of medical doctors for more than 30 years in the U.S., and in over 50 other countries for more than 60 years, with rigorous monitoring of adverse events,” Clive said. “As a result, there is a substantial amount of epidemiological data which shows that MediNatura’s injection products have a superb safety profile.”

As far as I can see, none of the above-named products are supported by sound evidence. If you ask me, it is time that homeopaths understand what proofs of safety and efficacy amount to, that they stop confusing the public, and that they stop marketing illegal products.

Yesterday, I received a tweet from a guy called Bart Huisman (“teacher beekeeping, nature, biology, classical homeopathy, agriculture, health science, social science”). I don’t know him and cannot remember whether I had previous contact with him. His tweet read as follows:

“Why should anyone believe what Professor Edzard Ernst says, after he put his name to a BBC programme, he now describes as “deception”.”

This refers to a story that I had almost forgotten. It’s a nice one with a ‘happy ending’, so let me recount it here briefly.

In 2005, the BBC had hired me as an advisor for their 4-part TV series on alternative medicine.

The first part of the series was on acupuncture, and Prof Kathy Sykes presented the opening scene taking place in a Chinese operation theatre. In it a Chinese women was having open heart surgery with the aid of acupuncture. Kathy’s was visibly impressed and said on camera that the patient was having the surgery “with only needles to control the pain.”  However, the images clearly revealed that the patient was receiving all sorts of other treatments given through intra-venous lines. So, Prof Sykes was telling the UK public a bunch of porkies. This was bound to confuse many viewers.

One of them was Simon Singh. At the time, I did not know Simon (to be honest, I did not even know of him) and was surprised to receive a phone call from him. He politely asked me to confirm that I had been the adviser of the BBC on this production. I was happy to confirm this fact. Then he asked why I had missed such a grave error. I replied that I could not possibly have spotted it, because all I had been asked to do was to review and correct the text of the programme which the BBC had sent to me by email. Before it was broadcast, I had not seen a single passage of the film.

Correcting the text had already led to several problems (not so much regarding the acupuncture part but mostly the other sections), because the BBC was reluctant to change several of the mistakes I had identified. When I told them that, in this case, I would quit, they finally found a way to alter them. But the cooperation had been far from easy. I explained all this to Simon and eventually he asked me whether I would be willing to support the official complaint he was about to file with the BBC. I agreed. This is probably where I used the term ‘deception’ that Mr Huisman mentioned in his tweet.

So, Simon submitted his complaint and eventually won the case.

But this is not the happy ending I was referring to.

During the course of the complaint, Simon and I realised that we were thinking alike and were getting on well. A few months later, he suggested that the two of us write a book together about alternative medicine. At first, I was hesitant. Simon said, “let’s try just one chapter, and see how it works out.” So we did. It turned out to be fun and instructive for both of us. So we did the other chapters as well. The book was published in 2008 and is called TRICK OR TREATMENT. It was published in about 20 different languages and the German version became ‘science book of the year in 2011 (I think).

And that’s not the happy ending either (in fact, it caused a lot of hardship for Simon who was sued by the BCA; luckily, he won that case too).

The real happy ending is the fact that Simon and I became friends for life.

Thank you Bart Huisman for reminding me of this rather lovely story.

 

‘HOMEOPATHY RESOURCE’ claim they are the online web site for accurate information on homeopathy, homeopaths and homeopathic organizations. On 18 June, they published an article entitled “Another Remarkable Demonstration of Homeopathy’s Effectiveness in Covid-19: ONLY 19 Deaths out of 35 million in Kerala, India”. Here it is in its full beauty:

The State of Kerela India has shown that homeopathy and grassroots health care works dramatically well in epidemic and pandemic situations.. The state, in spite of areas of great density, has reported only 19 deaths. This compares to the UK which has a population of 66 million people but a tragic 41,698 deaths.

The region’s Health Minister Shailaja Teacher has been called the “Coronavirus Slayer” after introducing homeopathy as a primary means of dealing with the epidemic. Kerala India has already come through two Nipah virus epidemics under her watch.

Tactics used by Shailaja included encouraging the use of homeopathy. In a recent media meeting, she talked about the need “to improve the immunity and resistance power of each individual not yet positive to Coronavirus, with the help of Homeopathic/ Ayurvedic medicines. That will help them resist the Coronavirus infection, help them to tide over the infection well, if at all they contract it…… everyone should take Homeopathic & Ayurvedic preventative treatments available.”

According to Dr E.S.Rajendran who practices in Kerala “The total number of people who received the homeopathic preventive medicine Ars alb 30 through Kerala government as on June 1st was 10 million. An equal number of people have also received the same through voluntary organisations. The remaining population is expected to receive the preventive medicine in another one month.” This distribution was carried out in each district with the help of resident associations and was achievable because there is a huge demand for homeopathy from the people.

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Do ‘HOMEOPATHY RESOURCE’ really think that this is ‘accurate information’?

Do they feel that it amounts to evidence that homeopathy prevents COVID-19 infections?

Do they believe that it is responsible to promote such a message?

If so, they are more deluded than their homeopathic remedies are diluted!

There is a plethora of factors that might have contributed to the low infection rate in Kerela. Here are some that spring into my mind (in descending order of probability):

  1. Social distancing measures might have been put in place at the right time.
  2. Hand-washing might have been better accepted than in the UK.
  3. Face-masks might have been more common.
  4. The government might have been less incompetent than the one in the UK.
  5. The pandemic might be arriving with some delay in Kerela (in the last 2 days the COVID cases have more than doubled in Kerela).
  6. The hot weather might have inhibited the spread of the infection.
  7. The Ayurvedic medicine mentioned by the health minister might have worked.
  8. There might be many more cases due to under-diagnosis and poor testing.
  9. The holy cows might have prevented infections.
  10. Homeopathy works dramatically well in epidemic and pandemic situations.

Call me a sceptic, but – whatever turns out to be true (and I sincerely hope that the case numbers stay low in Kerela) – I do not think that ‘HOMEOPATHY RESOURCE’ is providing accurate information with their recent post.

And call me a pessimist, but I fail to see any good evidence to assume that homeopathic remedies have any effect in treating or preventing viral infections. In fact,

HIGHLY DILUTE HOMEOPATHIC REMEDIES ARE PURE PLACEBOS! 

Siddha medicine is based on a combination of ancient medicinal practices and spiritual disciplines as well as alchemy and mysticism. It is thought to be one of the oldest system of healthcare of India that developed during the Indus civilization, which flourished between 2500 and 1700 BCE.

It has been reported that the Indian ‘National Institute of Siddha’ (NIS) claim to have successfully treated 160 COVID-19 positive patients. Subsequently, they have requested the government to hand over all COVID-19 Care Centres in Chennai and let Siddha doctors treat all COVID-patients. They say they are confident of flattening the curve in Chennai and convert it into a safe zone in just matter of days.

The NIS claim to have three potent combinations of Siddha drugs. “Depending upon the availability and quantity required for treating Coronavirus positive patients, we have after thorough research, come out with three different effective combinations of the Siddha preparations,” Dr R Meenakumari, Director of NIS, said. The treatment low-cost compared to the prohibitive cost in corporate hospitals and all the Siddha medicines are locally available, she added. “We have requested the state government to hand over all the COVID-19 Care Centres to us and allow us to treat all the patients. Our Siddha drug combination is potent enough to convert a positive patient into Coronavirus negative in three days’ time,” she claimed.

Her confidence stems from the fact that the Siddha doctors here have “successfully” treated 160 patients besides
23 inmates of the Puzhal Central Prison. “Initially, we treated 85 patients with SRM Medical College and Hospital and another 75 at the Greater Chennai Corporation… They all recovered and tested negative after five days of successful treatment,” she claimed. “The combination that we have prepared will help to cure the infected patient within three days… Siddha medicine has huge potential to treat the patients and there are possibilities to use the medicine to save precious human lives”.

The combination drug in question seems to be similar to or identical with Kabasura KudineerAlso termed ‘Nilavembu Kudineer‘, this drug is a powder form of medicine mainly used in the treatment of respiratory problems such as fever, cold, severe phlegm and flu. This polyherbal Siddha medicine is also widely used as a prophylactic during times of viral epidemics. To get the proper benefits, it should be made into a decoction and then consumed. 
Kabasura Kudineer
is made up of 15 different ingredients:

  1. ginger,
  2. cloves,
  3. aakarkara,
  4. harad,
  5. oregano,
  6. giloy,
  7. chiretta,
  8. nagarmotha,
  9. kali mirch
  10. tragiainvolucrata,
  11. vajradanti,
  12. malabar nut,
  13. kuth,
  14. ajwain,
  15. leghupatha.

In 2009, it allegedly helped containing the spread of swine flu and, in 2012, the then Chief Minister Jayalalithaa had requested public to use Nilavembu Kudineer prepared by the Institute to prevent dengue.

Meanwhile, the ‘Central Council for Research in Siddha’ has sent a proposal to the state government to include the
traditional medicine in the treatment protocols at the state-run CCCs. “We have also urged the state government to include the Brahmananda Bhairava Mathirai a herbo-mineral preparation, which has already been approved by the AYUSH ministry to treat persons with COVID-19 related fever, at all the COVID-19 wards,” a senior doctor at the CCRS said.

Of course, we all wish that an effective treatment against COVID-19 will be found soon. However, what the NIS calls THOROUGH RESEARCH looks like a flimsy bit of pseudo-research. And their assertion that their herbal mixture turns positive into negative patients within three days is a claim that sounds far too good to be true.

I have no reason to doubt that the NIS is full of good intentions. But I am reminded of Bert Brecht’s bon mot: ‘the opposite of good is not evil, but good intentions’.

Am I the only one who is tired of hearing that, in India, homeopathy is doing wonders for the current pandemic? All of the reports that I have seen are based on little more than hearsay, anecdotes or pseudo-science. If anyone really wanted to find out whether homeopathy works, they would need more than that; in fact, they would need to conduct a clinical trial.

But wait!

As it happens, there are already ~500 clinical trials of homeopathy. Many show positive effects, but the reliable ones usually don’t. Crucially, the totality of the evidence fails to be positive. So, running further studies is hardly a promising exercise. In fact, considering how utterly implausible homeopathy is, it even seems like an unethical waste of resources.

But many homeopaths disagree, particularly those in India. And it has been reported that several trials have been given the go-ahead in India and are now up and running. This regrettable fact is being heavily exploited for swaying public opinion in favour of homeopathy. The way I see it, the situation is roughly this:

  • a few trials of homeopathy are being set up;
  • they are designed by enthusiasts of homeopathy who lack research expertise;
  • therefore their methodology is weak and biased towards generating a false-positive result;
  • while this is going on, the homeopathic propaganda machine is running overtime;
  • when the results will finally emerge, they will get published in a 3rd rate journal;
  • homeopaths worldwide will celebrate them as a triumph for homeopathy;
  • critical thinkers will be dismayed at their quality and will declare that the conclusions drawn by over-enthusiastic homeopaths are not valid;
  • in the end, we will be exactly where we were before: quasi-religious believers in homeopathy will feel vexed because their findings are not accepted in science, and everyone else will be baffled by the waste of time, opportunity and resources as well as by the tenacity of homeopaths to make fools of themselves.

But criticising is easy; doing it properly is often more difficult.

So, how should it be done?

The way I see it, one should do the following:

  • carefully consider the implausibility of homeopathy;
  • thoroughly study the existing evidence on homeopathy;
  • abandon all plans to study homeopathy in the light of the above.

But this hardly is inconceivable considering the current situation in India. If further studies of homeopathy are unavoidable, the following procedure might therefore be reasonable:

  1. assemble a team of experts including trial methodologists, statisticians, epidemiologists and homeopaths;
  2. ask them to design a rigorous protocol of one or two studies that would provide a definitive answer to the research question posed;
  3. make sure that, once everyone is happy with the protocol, all parties commit to abiding by the findings that will emerge from these trials;
  4. conduct the studies under adequately strict supervision;
  5. evaluate the results according to the protocol;
  6. publish them in a top journal;
  7. do the usual press-releases, interviews etc.

In India, it seems that the last point in this agenda came far too early. This is because, in this and several other countries, homeopathy has become more a belief system than a medicine. And because it is about belief, the believers will avert any truly meaningful and rigorous test of homeopathy’s efficacy.

 

 

The Lightning Process  (LP) is a commercial programme developed by Phil Parker based on ideas from osteopathy, life coaching and neuro-linguistic programming. It has been endorsed by celebrities like Martine McCutcheon and Esther Rantzen, who credits it for her daughter’s recovery from ME. Parker claims that LP works by teaching people to use their brain to “stimulate health-promoting neural pathways”. One young patient once described it as follows: “Whenever you get a negative thought, emotional symptom, you are supposed to turn on one side and with your arm movements in a kind if stop motion, just say STOP very firmly and that is supposed to cut off the adrenaline response.”

Allegedly, the LP teaches individuals to recognize when they are stimulating or triggering unhelpful physiological responses and to avoid these, using a set of standardized questions, new language patterns and physical movements with the aim of improving a more appropriate response to situations. The LP involves three group sessions on consecutive days where participants are taught theories and skills, which are then practised through simple steps, posture and coaching.

A few days ago, someone asked my help writing to me: Norwegian newspaper is attacking patients for objecting to a clinical trial of the lightning process which is horrible quackery. LP is being backed by some people in Norwegian health authorities. Could you bring attention to how disgraceful this is please? I promised to look into it. Hence this post.

My searches located just one single trial. It seems to be the only controlled clinical study available. Here it is:

Design: Pragmatic randomised controlled open trial. Participants were randomly assigned to SMC or SMC+LP. Randomisation was minimised by age and gender.

Setting: Specialist paediatric CFS/ME service.

Patients: 12-18 year olds with mild/moderate CFS/ME.

Main outcome measures: The primary outcome was the the 36-Item Short-Form Health Survey Physical Function Subscale (SF-36-PFS) at 6 months. Secondary outcomes included pain, anxiety, depression, school attendance and cost-effectiveness from a health service perspective at 3, 6 and 12 months.

Results: We recruited 100 participants, of whom 51 were randomised to SMC+LP. Data from 81 participants were analysed at 6 months. Physical function (SF-36-PFS) was better in those allocated SMC+LP (adjusted difference in means 12.5(95% CI 4.5 to 20.5), p=0.003) and this improved further at 12 months (15.1 (5.8 to 24.4), p=0.002). At 6 months, fatigue and anxiety were reduced, and at 12 months, fatigue, anxiety, depression and school attendance had improved in the SMC+LP arm. Results were similar following multiple imputation. SMC+LP was probably more cost-effective in the multiple imputation dataset (difference in means in net monetary benefit at 12 months £1474(95% CI £111 to £2836), p=0.034) but not for complete cases.

Conclusion: The LP is effective and is probably cost-effective when provided in addition to SMC for mild/moderately affected adolescents with CFS/ME.

The trial was designed as an ‘A+B versus B’ study which practically always generates a positive outcome. It did not control for placebo effects and is, in my humble view, worthless and arguably unethical. It certainly does not warrant the conclusion that LB is effective or cost-effective.

I do not doubt that the LP-children improved, but I see no reason to believe that this had anything to do with LP. It could have been (and most likely was) caused by the intense attention that these kids received over three days. Giving them a daily ice-cream and some kindness might (and probably would) have produced even better outcomes.

So, what do we call a therapy for which numerous, far-reaching claims are being made, which is based on implausible assumptions, which is unproven, and for which people have to pay dearly?

The last time I looked, it was called quackery.

Have you ever noticed that, according to its proponents, many forms of so-called alternative medicine (SCAM) must be applied a long time before there is a noticeable benefit?

As so often, homeopathy is a good example. If you consult a homeopath, she will, in all likelihood, explain that it would be unwise to expect immediate effects. The treatment needs to be taken for weeks; perhaps she even needs to change the prescription once or twice. And the longer you have suffered from your illness, the longer it will take to get rid of it. Sometimes it takes years!

Those homeopathy-fans who have experienced instant effects will, of course, disagree. But these cases are almost certainly due to the placebo response which is known to be fast. The majority of patients will be told to persevere and show patience.

And unquestionably some patients will eventually experience a reduction of symptoms. Thus the homeopaths is proven correct: homeopathy takes time to work!

But hold on, how plausible is this explanation?

Let’s assume a child is cured of asthma after many months of religiously taking the prescribed homeopathic remedies. Is the cure due to the treatment, or might there be other phenomena at play? The most obvious explanation by far is the fact that children frequently grow out of diseases like asthma. So, this and other self-limiting conditions are not good examples.

What about a disease that is clearly not self-limiting? What about a MS patient who feels much improved after taking his homeopathic remedies for three months? Again, the best explanation for the improvement would be the natural history of the disease. The severity of the symptoms of many conditions fluctuate in such a way that there will be periods of relative well-being followed by deterioration.

And what, if we are dealing with a disease that normally gets progressively worse over time, if untreated ? What if a cancer patient claims to be cured after months of homeopathic therapy? Such cases do not exist! The few such ‘cures’ that have been reported have explanations that are unrelated to homeopathy. They are due to one of the three phenomena:

  • false diagnosis,
  • concomitant treatments,
  • spontaneous recovery.

It turns out that the notion of homeopathy (or any other SCAM) requiring a long period of time until the benefit kicks in is mostly a myth.

Well, perhaps not entirely!

The benefit of SCAM does unquestionably need time before a significant benefit ($$$, £££) for the SCAM provider kicks in. So, let’s not sneer at the notion. Let’s be positive. Let’s recognise the reason why the myth is being kept alive. We all must make a living!

 

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