bogus claims
This study aimed to evaluate the effect of Traditional Chinese Medicine (TCM) on patients with gastric cancer following surgery and adjuvant chemotherapy in Taiwan. The cohort sampling data set was obtained from the Registry of Catastrophic Illness Patient Database, a research database of patients with severe illnesses from the National Health Insurance Research Database, Taiwan. Patients who had received a new diagnosis of gastric cancer and had undergone surgery were enrolled. the researchers matched TCM users and nonusers at a ratio of 1 : 3 based on the propensity score, and TCM users were also grouped into short-term and long-term users.
The number of TCM users and nonusers was 1701 and 5103 after applying the propensity score at a ratio of 1 : 3. Short-term users and long-term TCM users were independently associated with a decreased risk of death with HRs of 0.59 (95% confidence interval (CI), 0.55-0.65) and 0.41 (95% CI, 0.36-0.47), respectively, compared with TCM nonusers. The researchers also obtained similar results when they adjusted for covariates in the main model, as well as each of the additional listed covariates. They also observed similar HR trends in short-term users and long-term TCM users among men and women aged <65 years and ≥65 years. The most commonly prescribed single herb and herbal formula in our cohort were Hwang-Chyi (Radix Hedysari; 11.8%) and Xiang-Sha-Liu-Jun-Zi-Tang (15.5%), respectively.
The authors concluded that TCM use was associated with higher survival in patients with gastric cancer after surgery and adjuvant chemotherapy. TCM could be used as a complementary and alternative therapy in patients with gastric cancer after surgery and adjuvant chemotherapy.
This is an interesting study which seems well-done – except for one fatal mistake: even in the title, the authors imply a causal relationship between TCM and survival. Their conclusion has two sentences; the first one speaks correctly of an association. The second, however, not only implies causality but goes much further in suggesting that TCM should be used to prolong the life of patients. Yet, there are, of course, dozens of factors that could interfere with the findings or be the true cause of the observed outcome.
Anyone with a minimum of critical thinking ability should know that CORRELATION IS NOT CAUSATION; sadly, the authors of this study seem to be the exception.
Scientists from Israel and Iceland recently suggested that an extract of spirulina algae has the potential to reduce the chances of COVID-19 patients developing a serious case of the disease. Here is the abstract of their paper:
An array of infections, including the novel coronavirus (SARS-CoV-2), trigger macrophage activation syndrome (MAS) and subsequently hypercytokinemia, commonly referred to as a cytokine storm (CS). It is postulated that CS is mainly responsible for critical COVID-19 cases, including acute respiratory distress syndrome (ARDS). Recognizing the therapeutic potential of Spirulina blue-green algae (Arthrospira platensis), in this in vitro stimulation study, LPS-activated macrophages and monocytes were treated with aqueous extracts of Spirulina, cultivated in either natural or controlled light conditions. We report that an extract of photosynthetically controlled Spirulina (LED Spirulina), at a concentration of 0.1 µg/mL, decreases macrophage and monocyte-induced TNF-α secretion levels by over 70% and 40%, respectively. We propose prompt in vivo studies in animal models and human subjects to determine the putative effectiveness of a natural, algae-based treatment for viral CS and ARDS, and explore the potential of a novel anti-TNF-α therapy.
The Jerusalem Post reported that the research was conducted in a MIGAL laboratory in northern Israel with algae grown and cultivated by the Israeli company VAXA, which is located in Iceland. VAXA received funding from the European Union to explore and develop natural treatments for coronavirus. Iceland’s MATIS Research Institute also participated in the study.
In a small percentage of patients, infection with the coronavirus causes the immune system to release an excessive number of TNF-a cytokines, resulting in what is known as a cytokine storm. The storm causes acute respiratory distress syndrome and damage to other organs, the leading cause of death in COVID-19 patients. “If you control or are able to mitigate the excessive release of TNF-a, you can eventually reduce mortality,” said Asaf Tzachor, a researcher from the IDC Herzliya School of Sustainability and the lead author of the study. During cultivation, growth conditions were adjusted to control the algae’s metabolomic profile and bioactive molecules. The result is what Tzachor refers to as “enhanced” algae.
Tzachor said that despite the special growth mechanism, the algae are a completely natural substance and should not produce any side effects. Spirulina is approved by the US Food and Drug Administration as a dietary substance. It is administrated orally in liquid drops. “This is natural, so it is unlikely that we would see an adverse or harmful response in patients as you sometimes see in patients that are treated with chemical or synthetic drugs,” he said. The algae have been shown to reduce inflammation. Tzachor said that if proven effective, spirulina could also be used against other coronaviruses and influenza. “If we succeed in the next steps,” said Dr. Dorit Avni, director of the laboratory at MIGAL, “there is a range of diseases that can be treated using this innovative solution – as a preventative treatment or a supportive treatment.”
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This is undoubtedly interesting, and one can only hope that their research is successful. However, it is a far cry from what some journalists are already making of the news. One headline read: “Scientists Discover ‘All-Natural’ COVID Treatment That Can Prevent ‘Cytokine Storm’ In Severe Patients.”
The drop in cases and deaths due to COVID-19 infections in India has been attributed to India’s national policy of using homeopathy. Early in the epidemic, the national “Ministry of AYUSH, recommended the use of Arsenic album 30 as preventive medicine against COVID-19. Its prophylactic use has been advised in states like Karnataka, Tamil Nadu, Kerala, and Maharashtra. The ‘OFFICIAL HOMEOPATHY RESOURCE’ is now claiming that homeopathy is the cause of the observed outcome:
And now the results of that policy and use are clear, even though skeptics and other scientists in the conventional paradigm are mystified as to why the drop is so dramatic. They know nothing about homeopathy and its history of successfully treating epidemics.
India has a population of 1 billion, 300 million people. Relative to this massive population the number of cases per day and especially the number of deaths per day are now exceptionally low. According to the Daily Mail:
“Scientists are trying to work out why coronavirus cases in India are falling when at one point it looked like the country might overtake the US as the worst-hit nation.
In September the country was reporting some 100,00 new cases per day, but that went into decline in October and is now sitting at around 10,000 per day – leaving experts struggling to explain why.”
END OF QUOTE
According to my sources, the number of daily new cases in India rose steadily to reach its maximum of almost 100000 new cases per day in mid-September. Thereafter, the figure fell in almost the same fashion as they had previously risen.
Currently, they have reached a plateau of about 13000 cases per day, and around 100 patients per day are reported to dies of COVID-19 every day. There are several possible contributors to these relatively positive outcomes:
- India has administered the Covid-19 vaccine to about 10 million people in one month since launching the world’s largest vaccination program on Jan. 16. However, this timing cannot explain the fall of cases before mid-January.
- The Indian government has attributed the dip in cases partly to mask-wearing, which is mandatory in public in India and violations can draw hefty fines.
- Large areas of India have reached herd immunity.
- Some of the various non-homeopathic remedies that have been recommended by the Ministry of AYUSH might be effective.
- There might be a host of other factors that I don’t know about.
- The figures coming out of India may not be reliable.
- The homeopathic remedy Arsenic album 30 might indeed be an effective preventative.
Which of these explanations are valid?
Most likely, it is not one but several working together. However, the hypothesis that homeopathy has anything to do with the course of the pandemic in India seems most unlikely. Apart from the fact that highly diluted homeopathic remedies are implausible and have not been shown to be effective, the timing of events is clearly against this explanation: if I am correctly informed, the homeopathic remedies were dished out months before the decline in cases started. In fact, simply going by the timing, one would need to assume that homeopathy led to the enormous increase before the remarkable drop.
Of course, it would be interesting to see the results of the homeopathy trials that allegedly started in India about 8 months ago. They could bring us closer to the truth. But somehow, I am not holding my breath.
The fact that the NHS England has stopped reimbursing homeopathy in 2018 is probably quite well known. France followed more recently, and then Germany too reported trouble for homeopaths on various levels. About two years ago, the manufacturer of homeopathic products, Hevert (Germany), threatened legal action against several German critics of homeopathy for expressing the fact that highly diluted homeopathic remedies do not work beyond placebo. Crucially, the medical associations of many regions in Germany have – one after the next – discontinued their training in and recognition of homeopathy.
Now similar difficulties are being felt also by Austrian homeopaths. In 2019, the Vienna medical school closed its course on homeopathy because students had filed a complaint about its unethical content. And recently, it was reported by the Austrian ‘Initiative für Wissenschaftliche Medizin‘ that at a secret webinar run by lobbyists in Vienna things were reported to no longer going well for homeopathy. Faced with such problems, the lobbyist, Dr. Jens Behnke, recommended in the above-mentioned secret webinar an alliance of all so-called alternative medicine (SCAM):
“…..and if we do not form this broad alliance now, in order to make appropriate professional PR and lobbying … then everything will fall apart….”
Now a union of pseudomedicine and politics is being forged with the aim of stopping the decline of quackery and paving the way for pseudomedicine in Austria. A resolution has been tabled in the Austrian parliament with the following demands:
- Institutionalising of the field of “Complementary Medicine” as “Integrative Medicine” in the academic education at all medical schools.
- Appropriate support for and funding of complementary medicine research, especially in the university sector.
- Establishment of a broad range of complementary medicine in the hospital sector, in outpatient but also inpatient healthcare.
- Promotion of active knowledge transfer in the area of integrative and complementary medicine within the Austrian medical profession.
- Securing of complementary diplomas by the Austrian Medical Association.
The motion was introduced by the Freedom Party (FPÖ, the Austrian far-right party) on 21.12.2020, forwarded to the Health Committee for consultation, and is now scheduled for consultation there. The application was introduced by the FPÖ-Nationalratsabgeordnete Mag. Gerhard Kaniak (Chairman of the Health Committee of Parliament, pharmacist), Peter Wurm (entrepreneur), Dr. Dagmar Belakowitsch (physician), and “other deputies”. It is supported by members of the “Initiative Complementary Medicine at Austrian Universities” of the Austrian Society for Homeopathic Medicine. The list of signatories of the motion reads like the “Who’s Who” of pseudo-medicine procedures in Austria – foremost homeopathy, but also anthroposophic medicine, ozone therapy, functional myo-diagnostics (= kinesiology), Ayurvedic medicine, orthomolecular medicine, TCM, etc. It almost goes without saying that it also includes Prof Michael Frass (a prominent member of THE ALTERNATIVE MEDICINE HALL OF FAME), who regular readers of my blog would have met several times before.
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Instead of a comment (other than I sincerely wish that reason prevails in Austria and the motion is going to be defeated), I think I will quote the concluding phrases from my memoir (which incidentally also covers my most turbulent time in Vienna):
When science is abused, hijacked, or distorted in order to serve political or ideological belief systems, ethical standards will inevitably slip. The resulting pseudoscience is a deceit perpetrated on the weak and the vulnerable. We owe it to ourselves, and to those who come after us, to stand up for the truth, no matter how much trouble this might bring.
I am pleased to report that our ‘resident homeopathic doctor’ from Germany, Dr. Heinrich Huemmer, posted a review of my new book on Amazon. As his comments are in German, I translated them which was not easy because they are confusing and confused. Now that it’s done, I cannot resist the temptation to show them to you (the references were inserted by me, and refer to my comments below):
First of all, the author, who as a scientist [1] once had a thoroughly positive attitude towards homeopathy [and in a meta-analysis even attested to it significantly positive results in a certain clinical picture [2]], explains the principles and procedures in homeopathy in a clear and objective manner.
In explaining the principle of potentization, however, Ernst’s one-dimensional and completely unscientific matter-bound, quasi-medieval understanding of science shines through for the first time. With the assertion, “both the dilution and the similarity rule contradict the laws of nature” he clearly reveals his unscientific thinking, whereby he could have easily relativized this by an inserted differentiation “presently, known laws of nature”. [3]
And not even the following sentence “…we understand very well that it can function only if the known laws of nature would be invalid” is agreed by critically thinking natural scientists. [3]
Also the assertion: “The totality of this evidence does not show that homeopathic remedies would be no more than placebo”, is countered by a well-known – belonging to the skeptic movement – expert of the homeopathic study situation with the remark: “Furthermore, you should read my statements and those of the INH more carefully again: Our statement is that there is no robust/reliable/convincing evidence for efficacy beyond placebo. ALSO NOT “NONE” but “none conclusive”, which yes makes a difference in absolute numbers. Just like “no beer” is different than “not a good beer”. ” [4]
Since patients usually turn to homeopathy only when so-called scientific medicine negates their illnesses and accordingly has nothing to offer them [5], Ernst’s reference to the fact that patients could “endanger their health” is to be seen as a cheap attempt at discrediting. [6] The reference that this assessment comes from the Australian National Health and Medical Research Council is not without a particularly piquant note, since this NHMRC may have to be held responsible for a particularly infamous attempt at scientific fraud to the disadvantage of homeopathy. [7]
Also, the alleged “fact” that “[positive] experiences […] are the result of a long, empathetic, sympathetic encounter with a homoeopath…” can be disproved by immediate – also diagnostically verified – cures, which occurred immediately without a long admission or which failed to appear even after several intensive anamneses under most sympathetic admission against all expectations…..[8]
Finally Ernst’s argument “the benefit-cost-argument of homeopathy is not positive” is an absolute air number, because the saving of 1 €/patient and year (in case of abolition of the homeopathy-reimbursement) would not even allow a free new glasses-nose-pad…. [9]
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- I am not sure where Homeopathy Heinrich Huemmer (HHH) got the claim from that I, as a scientist, once had a thoroughly positive attitude towards homeopathy. This is not even remotely true! As a very young clinician (40 years ago), I once was quite impressed by homeopathy, never as a scientist (for full details, see my memoir). What HHH seems to display here is his very own misunderstanding about science and scientists: if they are for real (i.e. not pseudoscientists like many of those who research homeopathy), scientists try not to let their personal attitudes get in the way of good science.
- I presume that HHH refers here to this meta-analysis: Homeopathy for postoperative ileus? A meta-analysis. I fear that HHH has yet to learn how to read a scientific paper. Our conclusions were: There is evidence that homeopathic treatment can reduce the duration of ileus after abdominal or gynecologic surgery. However, several caveats preclude a definitive judgment. These results should form the basis of a randomized controlled trial to resolve the issue.
- This made me laugh! Does HHH think that only the handful of homeopathic loons who claim that homeopathy has a scientific basis in the unknown laws of nature are truly scientific? And all the rest are unscientific?
- I doubt that anyone can understand this passage, perhaps not even HHH. My conclusion that “the totality of this evidence does not show that homeopathic remedies are more than placebo” merely expresses what even most homeopaths would admit and is unquestionably correct.
- This statement is untrue in more than one way. Firstly, responsible clinicians never tell a patient that they have nothing more to offer, simply because this is never the case – there is always something a good clinician can do for his/her patient, even if it is just in terms of palliation or moral support. Secondly, we know that German patients opt to use homeopathy for all sorts of reasons, including as first-line therapy and not as a last resort.
- In the book, I refer (and reference the source) to the phenomenon that many homeopaths discourage their patients from vaccination. Unfortunately, this is no ‘cheap attempt’, it is the sad reality. HHH does not even try to dispute it.
- HHH does not like the NHMRC report. Fair enough! But he omits to mention that, in the book, I list a total of 4 further official verdicts. Does HHH assume they are all fraudulent? Is there perhaps a worldwide conspiracy against homeopathy?
- We all know that HHH is enormously proud of his only publication to which he refers here (on this blog, he must have mentioned it a dozen times). However, in the book, I refer to an RCT for making my point. Which is more convincing, a case report or an RCT?
- Here HHH simply demonstrates that he has not understood the concept of cost-effectiveness.
So, what we have here is a near-perfect depiction of a homeopath’s way of thinking. But there is worse in HHH’s comment< I fear.
My book (of 224 pages) scrutinizes – as even its title states – not one but 40 types of so-called alternative medicine (SCAM); 20 of the most effective and 20 of the most dangerous SCAMs. In addition, it covers (in ~ 50 pages) many general topics (like ‘WHAT IS EVIDENCE? or WHY IS SCAM SO POPULAR?). It includes over 200 references to published papers. Yet, HHH reviews and judges the book by commenting exclusively on the meager 5 pages dedicated to homeopathy!
If that does not exemplify the limitations of the homeopathic mind, please tell me what does.
THANK YOU, HHH, FOR MAKING THIS SO CLEAR TO US!
Physicians who include so-called alternative medicine (SCAM) in their practice are thought to have an understanding of health and disease different from that of colleagues practicing conventional medicine. The aim of this study was to identify and compare the thoughts and concepts concerning infectious childhood diseases (measles, mumps, rubella, chickenpox, pertussis, and scarlet fever) of physicians practicing homeopathic, anthroposophic and conventional medicine.
This qualitative study used semistructured interviews. Participating physicians were either general practitioners or pediatricians. Data collection and analysis were guided by a grounded theory approach.
Eighteen physicians were interviewed (6 homeopathic, 6 anthroposophic, and 6 conventional). All physicians agreed that while many classic infectious childhood diseases such as measles, mumps, and rubella are rarely observed today, other diseases, such as chickenpox and scarlet fever, are still commonly diagnosed. All interviewed physicians vaccinated against childhood diseases.
- A core concern for physicians practicing conventional medicine was the risk of complications of the diseases. Therefore, it was considered essential for them to advise their patients to strictly follow the vaccination schedule.
- Homeopathic-oriented physicians viewed acute disease as a biological process necessary to strengthen health, fortify the immune system and increase resistance to chronic disease. They tended to treat infectious childhood diseases with homeopathic remedies and administered available vaccines as part of individual decision-making approaches with parents.
- For anthroposophic-oriented physicians, infectious childhood diseases were considered a crucial factor in the psychosocial growth of children. They tended to treat these diseases with anthroposophic medicine and underlined the importance of the family’s resources. Informing parents about the potential benefits and risks of vaccination was considered important.
All physicians agreed that parent-delivered loving care of a sick child could benefit the parent-child relationship. Additionally, all recognized that existing working conditions hindered parents from providing such care for longer durations of time.
The authors concluded that the interviewed physicians agreed that vaccines are an important aspect of modern pediatrics. They differed in their approach regarding when and what to vaccinate against. The different conceptual understandings of infectious childhood diseases influenced this decision-making. A survey with a larger sample would be needed to verify these observations.
The authors (members of a pro-SCAM research group) stress that the conventional physicians saw many risks in the natural course of classic childhood illnesses and appreciated vaccinations as providing relief for the child and family. By contrast, the physicians trained in homeopathy or anthroposophic medicine expected more prominent unknown risks because of vaccinations, due to suppression of the natural course of the disease. Different concepts of disease lead to differences in the perceptions of risk and the benefit of prevention measures. While prevention in medicine aims to eliminate classic childhood diseases, anthroposophic and homeopathic literature also describes positive aspects of undergoing these diseases for childhood development.
This paper thus provides intriguing insights into the bizarre thinking of doctors who practice homeopathy and anthroposophical medicine. The authors of the paper seem content with explaining and sometimes even justifying these beliefs, creeds, concepts, etc. They make no attempt to discuss the objective truths in these matters or to disclose the errors in the thought processes that underly homeopathy and anthroposophical medicine. They also tell us that ALL the interviewed physicians vaccinated children. They, however, fail to provide us with information on whether these doctors all recommend vaccinations for all patients against all the named infectious diseases. From much of previous research, we have good reasons to fear that their weird convictions often keep them from adhering strictly to the current immunization guidelines.
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.“
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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:
- Is there any reliable evidence about dry cupping for children? No
- Is it demonstrably effective for any paediatric condition? No
- Is it harmful? Probably not that much (other than undermining common sense and rationality).
Yes, I have just published a new book! Its title is ‘Alternativmedizin – was hilft, was schadet: Die 20 besten, die 20 bedenklichsten Methoden’ (Alternative medicine – treatments that help and treatments that harm: The 20 best and the 20 most worrying methods). Yes, it is in German, and somehow I doubt that there will be an English version of it. Therefore I take the liberty of translating a short section for those who do not read German. 
But first, let me tell you about the book’s concept.
Some people who read this blog seem to have the impression that I am dead against so-called alternative medicine (SCAM) – my friend Dana Ullman, for instance, is convinced of it. This, however, is not quite correct (Dana rarely is). The truth is that I am
- FOR evidence-based medicine,
- FOR a level playing field in all areas of healthcare,
- FOR critically evaluating all options.
This also means, of course, that I am against misleading consumers about the value of SCAM. And therefore I am FOR any SCAM that demonstrably does more good than harm.
This attitude should have been clear from all my books. However, it seems to be difficult to understand for those who are on the more fanatical end of the SCAM spectrum. And because it is not that obvious, I decided to write a book that analyses (understandably yet analytically [including ~300 references of the original science]) the evidence for 20 SCAMs that are supported by reasonably sound evidence together with 20 for which this is not the case. My hope is that, with this approach, I might reach more consumers who are in favour of SCAM.
There is a risk, of course. Chances are that, instead of reaching more people from the pro-camp, I will merely offend both the sceptics as well as the enthusiasts.
We shall see.
Anyway, here is the promised bit that I translated for you. It is the postscript of the book, and I hope it gives you a flavour of what it is all about. Here we go:
In the first chapter of the book, I promised that I would neither uncritically hype alternative medicine nor unfairly condemn it. I have taken great pains to keep this promise.
Have I succeeded?
I fear there will be many who answer this question in the negative. And I can’t even blame my critics! Who likes to be criticized for something in which he deeply believes? Who likes to hear that his prejudices against everything called alternative medicine are wrong and counter-productive? Who doesn’t mind an ugly fact that destroys his beautiful theory? Both the dogmatic naysayers and the naive believers will be dissatisfied with my book (or at least parts of).
That’s a shame, but ultimately it is irrelevant. My point was not to take the word of one camp or another in the endless trench warfare that is alternative medicine. My main concern was to present the evidence as up-to-date, understandable, and objective as possible, and to serve those who are seriously interested in facts.
The book is thus not for dogged trench warriors; rather, it is aimed at ordinary consumers with an interest in their health. After all, the vast majority of the population is not among the unteachables of one camp or the other. Most people don’t want ideology, they want effective medicine. And most of them are baffled by the unmanageable variety of alternative medicine on offer, the grandiose promises of healing, and the vehement emotions that it all triggers.
In the area of alternative medicine, there is undoubtedly a lot of nonsense, charlatanry, and danger. But there are also some things that demonstrably do more good than harm. In order to separate the wheat from the chaff, consumers don’t need creeds. What they need above all is reliable evidence!
You can read about this evidence in my book. How you then deal with it is solely your decision. I do not want to tell anyone what to do with my presentation of the facts. But I know that the abundance of misinformation in the field of alternative medicine causes great damage and that the consumer and reader of my book, deserve better than to be led up the garden path.
If this book helps readers to make wise treatment decisions, my efforts will have been worthwhile. And if they get half as much pleasure from reading it as I did from writing it, my goal has been achieved.
THE END
(If by any chance you do read German and are in the position to publish a book review, please let me know and I will see that you get a free review copy of my book)
The objective of this review (entitled ‘Systematic Review on the Use of Homeopathy in Dentistry:
Critical Analysis of Clinical Trials‘) was to map the literature on homeopathy in dentistry and to evaluate the effectiveness of using homeopathy in dental practice through the critical analysis of clinical studies.
The search for scientific articles in any language, year, and place of publication was made in the databases of Public Medline (PUBMED), Web of Science, Cochrane, and Virtual Health Library; the articles selected were later classified according to the type of study. Gray literature was accessed through Google Scholar. Clinical trials were analyzed for methodological quality. Two trained reviewers accomplished the entire process independently.
Of the 281 studies retrieved by means of the search, 44 met the eligibility criteria. The included papers were:
- literature reviews (56.8%),
- clinical trials (34.1%),
- cross-sectional studies (6.8%),
- laboratory research (6.8%),
- longitudinal observational studies (4.5%).
The clinical trials were published from 1965 to 2019, using homeopathy in several dental specialties:
- Endodontics,
- Periodontics,
- Orofacial Pain,
- Surgery,
- Pediatric Dentistry,
- Stomatology,
- dental anxiety.
Qualitative failures, in all criteria investigated, and positive influences of the individual prescriptions on the results of treatments reported were observed.
The authors concluded that there is still a scarcity of studies about homeopathy and dentistry. The clinical trials selected showed positive effects on oral health; however, when they were critically evaluated, it was possible to recognize qualitative failures, mainly relative to double-blinding. It is necessary to encourage research on the subject, using standardized methodological procedures, to obtain better evaluation of the clinical applicability.
According to the authors, their review adhered to the PRISMA guideline of systematic reviews. This is, however, not the case. The authors correctly point out that the primary studies had many flaws: methodological failures were observed in the clinical trials, mainly related to double-blinding (66.7%). Significant failures were also observed in similarity (61.1%), randomization (27.8%), description of losses and exclusions (27.8%), and exclusion criteria (27.8%). They do not seem to realize that flaws of this nature and frequency should prevent positive conclusions.
So, what does this paper actually demonstrate? In my view, it shows that:
- the peer-review process at the JACM continues to be a joke;
- poor quality trials run by enthusiasts tend to produce false-positive results;
- in so-called alternative medicine (SCAM), people get away with publishing even the most obvious falsehoods.
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!’
