Homeopathy is very popular in India – at least this is what we are being told over and over again. The notion goes as far as some sources assuming that homeopathy is quintessential Indian (see below). One Website, informs us that homeopathy is the third most popular method of treatment in India, after Allopathy and Ayurveda. It is estimated that there are about quarter million homeopaths in India. Nearly 10,000 new ones add to this number every year. The legal status of homeopathy in India is very much at par with the conventional medicine.
Another website currently advises the Indian population as well as heath tourists from abroad about homeopathy in the following terms:
Homeopathic medicines have various benefits. Some of them are as follows:
- Such medicines can be given to infants, children, pregnant or nursing woman
- If by chance, wrong medication is prescribed, it is not going to have any ill-effect
- These medicines can be taken along with other medications
- Homeopathic treatment can be used by anyone
- The medicines work on the eradication of the symptoms so that illness never comes back
- These medicines can be stored for a longer span of time and are inexpensive as well
- Homeopathy has a holistic approach and deals with mind, body and emotions
- These medicines are non-invasive and extremely effective
- These medicines can be administered easily
- Homeopathy useful in a number of health problems
Homeopathic Remedies, for Diseases and Conditions
- Acute fevers
- Sore throats
- Mild depression
- Injuries with blunt objects
- Loss of appetite
But is it really true that so many Indian consumers swear by homeopathy, or is that just one of the many myths from the realm of quackery that stubbornly refuse to disappear ?
A survey recently conducted by Indian National Sample Survey Office might provide some answers. It revealed that 90 per cent of the Indian population rely on conventional medicine. Merely 6% trusted what the investigators chose to call ‘Indian systems of medicine’, e. g. ayurveda, unani and siddha, homeopathy and yoga and naturopathy.
Odd? Not really! There are several plausible explanations for this apparent contradiction:
- The popularity of homeopathy in India could be a myth promoted by apologists.
- The figures could be correct, and many Indian patients could use homeopathy not because they believe in it but because they cannot afford effective treatments.
- The claim of homeopathy’s popularity could refer to the past, while the recent survey clearly relates to the present.
Whatever the true answer might be, I think this little news story is an instructive example for the fact that the ‘argumentum ad populum’ is a fallacy that easily can mislead us.
For ‘my’ journal FACT, I review all the new articles that have emerged on the subject of alternative medicine on a monthly basis. Here are a few impressions and concerns that this activity have generated:
- The number of papers on alternative medicine has increased beyond belief: between the year 2000 and 2010, there was a slow, linear increase from 335 to 610 Medline-listed articles; thereafter, the numbers exploded to 1189 (2011), 1674 (2012) and 2236 (2013).
- This fast growing and highly lucrative ‘market’ has been cornered mainly by one journal: ‘EVIDENCE BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE’ (EBCAM), a journal that I mentioned several times before (see here, for instance). In 2010, EBCAM published 76 papers, while these figures increased to 546, 880 and 1327 during the following three years.
- Undeniably, this is big business, as authors have to pay tidy sums each time they get published in EBCAM.
- The peer-review system of EBCAM is farcical: potential authors who send their submissions to EBCAM are invited to suggest their preferred reviewers who subsequently are almost invariably appointed to do the job. It goes without saying that such a system is prone to all sorts of serious failures; in fact, this is not peer-review at all, in my opinion, it is an unethical sham.
- As a result, most (I estimate around 80%) of the articles that currently get published on alternative medicine are useless rubbish. They tend to be either pre-clinical investigations which never get followed up and are thus meaningless, or surveys of no relevance whatsoever, or pilot studies that never are succeeded by more definitive trials, or non-systematic reviews that are wide open to bias and can only mislead the reader.
- Nowadays, very few articles on alternative medicine are good enough to get published in mainstream journals of high standing.
The consequences of these fairly recent developments are serious:
- Conventional scientists and clinicians must get the impression that there is little research activity in alternative medicine (while, in fact, there is lots) and that the little research that does emerge is of poor quality.
- Consequently alternative medicine will be deemed by those who are not directly involved in it as trivial, and the alternative medicine journals will be ignored or even become their laughing stock.
- At the same time, the field of alternative medicine and its proponents (the only ones who might actually be reading the plethora of rubbish published in alternative medicine journals) will get more and more convinced that their field is supported by an ever- abundance of peer-reviewed, robust science.
- Gradually, they will become less and less aware of the standards and requirements that need to be met for evidence to be called reliable (provided they ever had such knowledge in the first place).
- They might thus get increasingly frustrated by the lack of acceptance of their ‘advances’ by proper scientists – an attitude which, from their perspective, must seem unfair, biased and hostile.
- In the end, conventional and alternative medicine, rather than learning from each other, will move further and further apart.
- Substantial amounts of money will continue to be wasted for research into alternative medicine that, whenever assessed critically, turns out to be too poor to advance healthcare in any meaningful way.
- The ones who medicine should be all about, namely the patients who need our help and rely on the progress of research, are not well served by these developments.
In essence this suggests, I think, that alternative medicine is ill-advised and short-sighted to settle for standards that are so clearly below those generally deemed acceptable in medicine. Similarly, conventional medicine does a serious disfavour to progress and to us all, if it ignores or tolerates this process.
I am not at all sure how to reverse this trend. In the long-term, it would require a change of attitude that obviously is far from easy to bring about. In the short-term, it might help, I think, to de-list journals from Medline that are in such obvious conflict with publication ethics.
‘Doctor’ Don Harte is former medical student who prematurely left medical school and currently works as a chiropractor in California. He, has served on the Boards of the World Chiropractic Association and the Council on Chiropractic Practice. He has published extensively; on his website, he offers a list of his articles:
- July 16, 2015: “CA SB277: Marin Chiropractor Says Power Structure Bigoted Against Boy in Wheelchair, vs. Leukemia Boy”
- July 1, 2015: “SB277: Marin Chiropractor Charges California with Chemical Child Molestation”
- June 15, 2015: Press release: “Dr. Don Harte warns about the Failure of Big Pharma and Growing Opioid Addiction Crises”
- May, 2015: “The Biological, Economic and Political Case Against Vaccination” in North Bay Biz magazine
- May 15, 2015: “Dr. Don Harte Calls Draconian SB277 Vaccination Initiative Sacramento’s Syringe of Shame”
- April 21, 2015: “End of a Made-up Measles Crisis”
- February 12, 2015: “It’s a childhood disease, not a tragedy” Letter to the Editor in the Pacific Sun, about the measles hysteria.
- January 27, 2015: “California Straight Chiropractor Fights Disney Measles Mania”
- March 5, 2015: “You cannot have vaccination that works, yet doesn’t work” Letter to the Editor in the Pacific Sun. “The grotesque level of bigotry, backed up by the lack of any comprehension of immunology, toxicology and the vitalistic paradigm of Chiropractic, is astounding.”
- April, 2009: “Seize the Time” in The Chiropractic Journal. The future of Chiropractic, as Medicine is breaking down, and bankrupting the country.
- April, 2009: “Refusal to Vaccinate Puts Kids At Risk”Dr. Harte quoted, “Vaccination is based on the medical fallacy that our bodies are stupid.”
- Spring, 2008: “The Future of Chiropractic” Journal of the California Chiropractic Association. For chiropractors, my view on the future of Chiropractic.
- November, 2007: “Is There a Vaccine That Protects Against ‘Non-Science?’”Marin Independent Journal. Discussion of Guardisil, the HPV vaccine, the flu vaccine, and the general foolishness of vaccination, the lack of science and efficacy, etc.
- May, 2005: ”Generations of Unbridled Power” The Chiropractic Journal. In a publication for chiropractors, I am standing up against the harassment and debasement of the chiropractic profession, specifically by the California Board of Chiropractic Examiners.
- October, 2004: “Time for regime Change in Attitude about Medicine” San Francisco Chronicle. The very popular anti-inflammatory medication, Vioxx, was just pulled off the market, at the same time as a massive contamination of flu vaccine.
- January, 2004: “Alternative to the Sting of a Failed Flu Vaccine” San Francisco Chronicle. Discusses the absurdity and the dangers of the annual flu vaccine ritual. The heroic role of Chiropractic in the Great Flu Pandemic of 1918.
- May, 2003: “Where is the Danger in Chiropractic?” San Francisco Chronicle. Responding to another baseless attack upon Chiropractic by medical bigots, noting the extreme risks of Medicine, and the extreme safety of Chiropractic.
- January, 2002: “To X-Ray or Not to X-Ray” The Chiropractic Journal. An article to chiropractors about how essential X-ray is to the practice of Chiropractic. Sadly, very few chiropractors X-ray these days.
- May, 2000: “By Giving Our Kids Certain Drugs, We’re Playing Russian Roulette With Their Lives” Marin Independent Journal. Ritalin and anti-depressants for children, the Columbine massacre, the role of Chiropractic in children’s health.
- December, 1999: “It’s a Myth that Children Need Vaccines” Marin Independent Journal.
- July, 1999: “Too Little Drugs, Too Many Organs” Marin Independent Journal. Does the medical paradigm really make sense? Is it logical?.
- November, 1979: “Interferon and Beyond” OMNI Magazine “Forum,” (Response to a cover story, “Cancer Cure at a Billion Dollars a Pound.”
His website also reveals that Harte views chiropractic as a ‘cure all’ and believes that the “Vertebral Subluxation Complex (VSC) is THE most serious threat to your health and well-being.”
Harte is not impressed with conventional medicine: “Virtually everyone has lost loved ones to medical mistakes and indifference. I, myself, count my father, my favorite uncle and two cousins amongst this unnecessary medical death toll. Though people concoct all kinds of charges against Chiropractic, nobody knows of any deaths from Chiropractic, because there just aren’t any. You might want to read the article that I wrote on this subject in the San Francisco Chronicle, “Where is the Danger in Chiropractic.”
In particular, Harte is no friend of immunisation. Here are some of the things he has been quoted as saying recently about the subject:
- He charged the media with “an evil bigotry” in relation to vaccination.
- He said that “The mass media refuses to acknowledge the existence of vaccine-injured children. This is quite a trick, since we are talking millions of children.”
- He explained that “their whole con game relies on fear, trying to convince you that you and your children have nothing inside to protect them from all those evil germs. That you need their HOLY WATER, the vaccines, or you will die.” Once again, Harte charged the California Governor and the legislature “as Destroyers of the family, as Enemies of liberty, as CHEMICAL CHILD MOLESTERS.”
- He claimed that “His (Mr J Coleman’s) son, Otto, who was paralyzed by a vaccine reaction, was there, in his wheelchair; as were other vaccine-damaged children. Some participants held up photos of their children who had died from vaccines.” And he said, “There were no photos of these children, nor any mention of them in news accounts. Establishment media refuses to put a human face on the suffering caused by vaccinations. I don’t know whether to call them ‘chicken’ or ‘evil.’”
- Harte also stated that “The claim that non-vaccinated children are a threat to Rhett has ZERO scientific basis. First of all, less-vaccinated and non-vaccinated kids tend to be healthier. And more specifically, children recently vaccinated with live virus vaccines will shed viruses, and thus, be contagious, for up to 28 days.”
- “Here we have a case,” explained Harte, “of one boy held up as a potential victim of unvaccinated or less-vaccinated children, who has had, in reality, no harm done by those children. The millions of children who have endured great harm, up to and including paralysis and death, are ignored. This is not science, nor is it reputable news reporting nor reputable public policy. It is naked propaganda, paid for by Big Pharma.”
It seems that Harte is an altogether dangerous person.
Of course, chiropractors will (yet again) claim that Harte does in no way stand for chiropractic as a whole and that chiropractors are just as appalled by such dangerous anti-vaccination propaganda as we are. They will say he is just ‘a rotten apple’ within a mostly laudable profession.
But is that true? What have the professional bodies of chiropractic done against him and his hazardous views? Have they excluded or reprimanded him, or requested that he seeks treatment for what seems to be rampant paranoia?
The answer, I am afraid, is NO! What they did do instead was to name him, in 2006, as “Chiropractor of the Year” – an honour bestowed on him by the World Chiropractic Alliance.
Chiropractors are back pain specialists, they say. They do not pretend to treat non-spinal conditions, they claim.
If such notions were true, why are so many of them still misleading the public? Why do many chiropractors pretend to be primary care physicians who can take care of most illnesses regardless of any connection with the spine? Why do they continue to happily promote bogus treatments? Why do chiropractors, for instance, claim they can treat gastrointestinal diseases?
This recent narrative review of the literature, for example, was aimed at summarising studies describing the management of disorders of the gastrointestinal (GI) tract using ‘chiropractic therapy’ broadly defined here as spinal manipulation therapy, mobilizations, soft tissue therapy, modalities and stretches.
Twenty-one articles were found through searching the published literature to meet the authors’ inclusion criteria. The retrieved articles included case reports to clinical trials to review articles. The majority of articles chronicling patient experiences under chiropractic care reported that they experienced mild to moderate improvements in GI symptoms. No adverse effects were reported.
From this, the authors concluded that chiropractic care can be considered as an adjunctive therapy for patients with various GI conditions providing there are no co-morbidities.
I think, we would need to look for a long time to find an article with conclusions that are more ridiculous, false and unethical than these.
The old adage applies: rubbish in, rubbish out. If we include unreliable reports such as anecdotes, our finding will be unreliable as well. If we do not make this mistake and conduct a proper systematic review, we will arrive at very different conclusions. My own systematic review, for instance, of controlled clinical trials drew the following conclusion: There is no supportive evidence that chiropractic is an effective treatment for gastrointestinal disorders.
That probably says it all. I only want to add a short question: SHOULD THIS LATEST CHIROPRACTIC ATTEMPT TO MISLEAD THE PUBLIC BE CONSIDERED ‘SCIENTIFIC MISCONDUCT’ OR ‘FRAUD’?
The ‘Homeopathy Action Trust’ (HAT) is a charity that claims to encourage and support public understanding of homeopathy. They believe that homeopathy is invaluable to many people and plays an important role in maintaining their health and wellbeing. The HAT advocates that patients have a right to choose homeopathic treatments and access to it on the NHS or privately. Many of HAT’s projects are about promoting to use of homeopathy in Africa, for instance, where they advocate homeopathy as a treatment for all sorts of serious diseases.
Recently HAT embarked on another project: a campaign against the current Wiki-page on homeopathy which HAT believes to be biased against homeopathy. Thus they issued a ‘position statement’ on their website. Here is a short paragraph from that statement which I find worthy of a comment (the numbers were inserted by me and refer to my comments below; otherwise the text in bold is by HAT):
We acknowledge that the scientific evidence in support of Homeopathy remains inconclusive (1), but it is by no means definitively negative (2) and there is in fact an active and growing field of research worldwide (3). We acknowledge that the mechanism of action of homeopathic remedies is unknown (4) – as it is for some conventional medicines – but this does not preclude their usage in clinical situations (5). We welcome honest and open-minded debate (6) about Homeopathy and fully support the call for high quality (7), appropriately designed research studies (8) into the effectiveness of homeopathy as it is practised by both medical and professional homeopaths (9).
- The evidence is not ‘inconclusive’ but the most reliable evidence fails to convincingly show efficacy (see here, for instance).
- In healthcare, we do not focus on the question whether the evidence for anything is ‘definitely negative’, but we base our decisions on the question whether or not the evidence is positive. In other words, we use those treatments that are backed up with positive evidence and not those where this is in serious doubt.
- The research activity in homeopathy has been in decline for some time; this can easily be verified by searching Medline.
- No, we know that there cannot be a mechanism of action that is in line with the laws of nature.
- If such therapies are used in conventional healthcare, it is because they are (contrary to homeopathy) supported by sufficiently strong clinical evidence.
- So far, this ‘position statement’ is neither honest nor open-minded, in my view.
- More research seems unnecessary, perhaps even unethical, and most research in this area is not of high quality.
- ‘Appropriately designed’ sounds frightfully suspicious to me, because homeopaths tend to see any trial that fails to confirm their bizarre notions as ‘not appropriately designed’.
- ‘Professional homeopath’ is a term designed to mislead the public; lay homeopaths would be more to the point, I think.
I will state my position up front: THERE IS NO CHILDHOOD CONDITION FOR WHICH CHIROPRACTIC SPINAL MANIPULATION GENERATES MORE GOOD THAN HARM. What is more, I have published evidence (published here, here, here, and here, for instance) to support this statement. If you disagree with it, this is the place and time to do so – and please don’t forget to cite the evidence that supports your statements.
Given that there is very little reliable evidence in this area, I find it surprising that so many chiropractors continue to treat kids. Not true! I hear some chiropractors shout, we do not often treat children. Who is correct? Clearly, we need data to answer this question.
The objective of a new paper was to investigate characteristics of clinical chiropractic practice, including the age of pediatric patients, the number of reports of negative side effects (NSEs), the opinions of doctors of chiropractic on treatment options by patient age groups, the conditions seen and the number of treatment sessions delivered by conditions and by patient age.
An Internet cross-sectional survey was conducted in 20 European countries with 4109 chiropractors invited to reply. The 19 national associations belonging to the European Chiropractic Union and the Danish Chiropractic Association were asked to participate. Respondents were asked to self-report characteristics of their practices.
Of the 956 (23.3%) participating chiropractors, 921 reported 19821 pediatric patients per month. Children represented 8.1% of chiropractors’ total patient load over the last year. A total of 557 (534 mild, 23 moderate, and 0 severe) negative (adverse) side effects were reported for an estimated incidence of 0.23%. On the given treatment statements, chiropractors reported varying agreement and disagreement rates based on patient age. The 8309 answers on conditions were grouped into skeletal (57.0%), neurologic (23.7%), gastrointestinal (12.4%), infection (3.5%), genitourinary (1.5%), immune (1.4%), and miscellaneous conditions (0.5%). The number of treatment sessions delivered varied according to the condition and the patient age.
The authors of this survey concluded that this study showed that European chiropractors are active in the care of pediatric patients. Reported conditions were mainly skeletal and neurologic complaints. In this survey, no severe NSEs were reported, and mild NSEs were infrequent.
In my view, a more appropriate conclusion might be that MANY EUROPEAN CHIROPRACTORS ARE ACTIVE IN QUACKERY.
Many people seem to believe that homeopathy is harmless. It is a belief that can easily be shown to be wrong, and this blog has repeatedly done just that. Perhaps the best researched issue here is the stance of many homeopaths against vaccination. But this is by no means all.
There are uncounted books, articles and websites which mislead consumers into believing that they can cure their illnesses with homeopathy. Take the website of ‘STAR HOMEOPATHY’ for instance. This organisation makes fantastic promises:
Star homeopathy, a chain of super specialty homeopathic clinic’s founded by a group of practically high qualified doctors with the vision to provide the best medical treatment in a scientific and most advanced way with the use of latest clinical knowledge and medical diagnostic equipment.
We boast of a combined experience of 200 years in the science of Homeopathy. We have 35 years of personal experience to provide you world-class solutions in health care. Experience the odour of advanced and New-Age Homeopathy–only at Star Homeopathy Clinics. It is no more a slow and long drawn treatment process.
You can rely on us to get world class homeopathic solutions for your problems like : Hair loss, Dandruff , Joint pains, Neck pain, Knee pain, Gastric and duodenal ulcer, Piles, Fissure, Fistula, Asthma, Skin and respiratory allergies , Sinusitis, Acne ,Hyperpigmentation , Psoriasis, Migraine , Headache, Anxiety, Depression , Sexual problems like Erectile dysfunction ,Premature ejaculation, Hormonal imbalance in female, Low sperm count in men…
We at star homeopathy, confidently say that we accurately diagnose the disease condition and treat all chronic diseases very efficiently without harming the patient’s body.
Such statements are bound to inspire confidence to many people who are chronically ill and frustrated with the fact that they need to take drugs for the rest of their lives to stay alive. Patients suffering from diabetes, for instance. They might hope that STAR HOMEOPATHY has a solution for them. And true enough, they do:
How Homoeopathy helps to cure Diabetes?
In homeopathy, diabetes is seen as a reflection of the body’s inability to function optimally. There is an imbalance that results in the body’s incapacity to effectively utilize the insulin that it produces, or to produce sufficient insulin for its needs. While symptoms often disappear after conventional treatment, the vital force does not. Homoeopathy can be used effectively in the treatment of diabetes. Here we mainly concentrate on functioning of the pancreas in efficient insulin production. The metabolic condition of a patient suffering from diabetes requires both therapeutic and nutritional measures to correct the illness. Homeopathy can regulate sugar metabolism while helping to resolve the metabolic disturbances that lead to diabetes. Furthermore, homeopathy helps stimulate the body’s self-healing powers in order to prevent complications such as open leg sores and other dysfunctions of the blood vessel, loss of vision, kidney failure. Homeopathic treatment does not target one illness, an organ, a body part or a symptom. Remedies are prescribed based on an assembly of presenting symptoms, their stresses in life.
Commonly indicated Homoeopathic remedies:
Syzygium: A most useful remedy in diabetes mellitus. No other remedy causes in so marked degree the diminution and disappearance of sugar in the urine. Prickly heat in upper part of the body; small red pimples itch violently. Great thirst, weakness, emaciation. Very large amounts of urine.. Diabetic ulceration.. Syzygium Jambolanum has marked action on diabetes mellitus as it causes marked diminution of sugar in urine. Great thirst with weakness, emaciation inspite of proper nutritious diet. Profuse urination of high specific gravity. Small red pimples with much itching. Syzygium Jambolanum also helps in treating old ulcers of skin associated with diabetes mellitus.
Uranium nitricum: Uranium Nitricum is a chief diuretic remedy. There is copious urination with incontinence of urine. It is indicated in glycosuria with increased urination, emaciation and tympanites. Uranium Nitiricum also helps in enuresis, the patient is unable to retain urine without pain. Burning in urethra, with very acid urine. There is a tendency to great emaciation, debility and general dropsy. Causes glycosuria and increased urine. Is known to produce nephritis, diabetes, degeneration of the liver, high blood pressure and dropsy. Its therapeutic keynote is Great emaciation, debility and tendency to ascites and general dropsy. Backache and delayed menses. Dry mucous membranes and skin.
Lycopodium: Diabetes. Anger during disease. Lost of self confidence. The right side conditions works well and thus improve the liver and kidney functioning as conditions Neuropathy. There is constipation due to inactivity of the rectum. Impotence. Intense desire for sweets.
So, if you think that homeopathy is harmless, think again!
Following this advice, could mean the death of many diabetics.
No treatment for which hugely exaggerated claims abound can ever be safe.
Many chiropractors try to tell us that vaccinations are not necessary, if we receive regular spinal adjustments. This claim is based on the assumption that spinal manipulations stimulate the immune system. Take the text published on this website, for instance:
The nervous system and immune system are hardwired and work together to create optimal responses for the body to adapt and heal appropriately. Neural dysfunctions due to spinal misalignments are stressful to the body and cause abnormal changes that lead to a poorly coordinated immune response. Chiropractic adjustments have been shown to boost the coordinated responses of the nervous system and immune system…
Subluxation is the term for misalignments of the spine that cause compression and irritation of nerve pathways affecting organ systems of the body. Subluxations are an example of physical nerve stress that affects neuronal control. According to researchers, such stressful conditions lead to altered measures of immune function & increased susceptibility to a variety of diseases.
Inflammatory based disease is influenced by both the nervous, endocrine, and immune systems. Nerve stimulation directly affects the growth and function of inflammatory cells. Researchers found that dysfunction in this pathway results in the development of various inflammatory syndromes such as rheumatoid arthritis and behavioral syndromes such as depression. Additionally, this dysfunctional neuro-endo-immune response plays a significant role in immune-compromised conditions such as chronic infections and cancer.
Wellness based chiropractors analyze the spine for subluxations and give corrective adjustments to reduce the stress on the nervous system. A 1992 research group found that when a thoracic adjustment was applied to a subluxated area the white blood cell (neutrophil) count collected rose significantly.
Other websites go even further:
The best way to prevent meningitis, and other illness, is to develop a robust immune system. The most important element in developing a robust immune system is optimum communication between all systems of the body. Chiropractic does this. The goal of chiropractic is to remove interference in the nervous system, the system that controls and coordinates all other parts of the body. Interference is caused by subluxations or misalignments in the spine. When subluxations are corrected, the body’s nervous system functions optimally and boosts the immune functioning. In fact, individuals who receive chiropractic care have 200% greater immune competence than individuals who don’t. This is why it is vital to receive regular chiropractic adjustments…
If we look at the actual research that might support such strange claims, we find that that it is scarce, flimsy and unconvincing. To the best of my knowledge, nobody has yet shown that people who receive regular chiropractic care are protected from conditions mediated via the immune system. Unless such a phenomenon can be demonstrated beyond reasonable doubt, we should be highly sceptical of the claim that chiropractic care stimulates the immune system and thus generates better health. In my view, regular chiropractic adjustments stimulate only one thing: the cash flow of the therapist.
My conclusion: The claim that chiropractic adjustments have such profound effects on human health is highly irresponsible.
A paper entitled ‘Real world research: a complementary method to establish the effectiveness of acupuncture’ caught my attention recently. I find it quite remarkable and think it might stimulate some discussion on this blog. Here is its abstract:
Acupuncture has been widely used in the management of a variety of diseases for thousands of years, and many relevant randomized controlled trials have been published. In recent years, many randomized controlled trials have provided controversial or less-than-convincing evidence that supports the efficacy of acupuncture. The clinical effectiveness of acupuncture in Western countries remains controversial.
Acupuncture is a complex intervention involving needling components, specific non-needling components, and generic components. Common problems that have contributed to the equivocal findings in acupuncture randomized controlled trials were imperfections regarding acupuncture treatment and inappropriate placebo/sham controls. In addition, some inherent limitations were also present in the design and implementation of current acupuncture randomized controlled trials such as weak external validity. The current designs of randomized controlled trials of acupuncture need to be further developed. In contrast to examining efficacy and adverse reaction in a “sterilized” environment in a narrowly defined population, real world research assesses the effectiveness and safety of an intervention in a much wider population in real world practice. For this reason, real world research might be a feasible and meaningful method for acupuncture assessment. Randomized controlled trials are important in verifying the efficacy of acupuncture treatment, but the authors believe that real world research, if designed and conducted appropriately, can complement randomized controlled trials to establish the effectiveness of acupuncture. Furthermore, the integrative model that can incorporate randomized controlled trial and real world research which can complement each other and potentially provide more objective and persuasive evidence.
In the article itself, the authors list seven criteria for what they consider good research into acupuncture:
- Acupuncture should be regarded as complex and individualized treatment;
- The study aim (whether to assess the efficacy of acupuncture needling or the effectiveness of acupuncture treatment) should be clearly defined and differentiated;
- Pattern identification should be clearly specified, and non-needling components should also be considered;
- The treatment protocol should have some degree of flexibility to allow for individualization;
- The placebo or sham acupuncture should be appropriate: knowing “what to avoid” and “what to mimic” in placebos/shams;
- In addition to “hard evidence”, one should consider patient-reported outcomes, economic evaluations, patient preferences and the effect of expectancy;
- The use of qualitative research (e.g., interview) to explore some missing areas (e.g., experience of practitioners and patient-practitioner relationship) in acupuncture research.
Furthermore, the authors list the advantages of their RWR-concept:
- In RWR, interventions are tailored to the patients’ specific conditions, in contrast to standardized treatment. As a result, conclusions based on RWR consider all aspects of acupuncture that affect the effectiveness.
- At an operational level, patients’ choice of the treatment(s) decreases the difficulties in recruiting and retaining patients during the data collection period.
- The study sample in RWR is much more representative of the real world situation (similar to the section of the population that receives the treatment). The study, therefore, has higher external validity.
- RWR tends to have a larger sample size and longer follow-up period than RCT, and thus is more appropriate for assessing the safety of acupuncture.
The authors make much of their notion that acupuncture is a COMPLEX INTERVENTION; specifically they claim the following: Acupuncture treatment includes three aspects: needling, specific non-needling components drove by acupuncture theory, and generic components not unique to acupuncture treatment. In addition, acupuncture treatment should be performed on the basis of the patient condition and traditional Chinese medicine (TCM) theory.
There is so much BS here that it is hard to decide where to begin refuting. As the assumption of acupuncture or other alternative therapies being COMPLEX INTERVENTIONS (and therefore exempt from rigorous tests) is highly prevalent in this field, let me try to just briefly tackle this one.
The last time I saw a patient and prescribed a drug treatment I did all of the following:
- I greeted her, asked her to sit down and tried to make her feel relaxed.
- I first had a quick chat about something trivial.
- I then asked why she had come to see me.
- I started to take notes.
- I inquired about the exact nature and the history of her problem.
- I then asked her about her general medical history, family history and her life-style.
- I also asked about any psychological problems that might relate to her symptoms.
- I then conducted a physical examination.
- Subsequently we discussed what her diagnosis might be.
- I told her what my working diagnosis was.
- I ordered a few tests to either confirm or refute it and explained them to her.
- We decided that she should come back and see me in a few days when her tests had come back.
- In order to ease her symptoms in the meanwhile, I gave her a prescription for a drug.
- We discussed this treatment, how and when she should take it, adverse effects etc.
- We also discussed other therapeutic options, in case the prescribed treatment was in any way unsatisfactory.
- I reassured her by telling her that her condition did not seem to be serious and stressed that I was confident to be able to help her.
- She left my office.
The point I am trying to make is: prescribing an entirely straight forward drug treatment is also a COMPLEX INTERVENTION. In fact, I know of no treatment that is NOT complex.
Does that mean that drugs and all other interventions are exempt from being tested in rigorous RCTs? Should we allow drug companies to adopt the RWR too? Any old placebo would pass that test and could be made to look effective using RWR. In the example above, my compassion, care and reassurance would alleviate my patient’s symptoms, even if the prescription I gave her was complete rubbish.
So why should acupuncture (or any other alternative therapy) not be tested in proper RCTs? I fear, the reason is that RCTs might show that it is not as effective as its proponents had hoped. The conclusion about the RWR is thus embarrassingly simple: proponents of alternative medicine want double standards because single standards would risk to disclose the truth.
I thought I had seen everything that is lamentable about homeopathy. When I came across this article, I had to change my opinion. It is a more despicable, unethical and dangerous promotion of falsehoods than I could have imagined.
Strong words? Read for yourself:
There are treatments that can heal vaccine damage, but few physicians in the conventional medical care system know about them, since vaccine injuries are usually denied as the cause of any illness. Some parents with autistic children report that homeopathy has completely reversed their children’s autism and healed other serious health conditions caused by vaccines. This article explains how homeopathic remedies can bring about healing for many types of vaccine injuries.
Homeopathy is not the only treatment that has helped children and adults recover from vaccine damage, but it is the one that is the focus of this article. I will describe how homeopathy can bring about a true cure for the harm that vaccines have caused to children and adults…
It is a tragedy when a normal young child suddenly starts losing the ability to speak sentences or even to speak words after receiving vaccines. The ability to have positive social interactions with other children or adults can disappear in a matter of days after vaccines have been given to children. Intellectual development can be lost and even successful potty training skills can disappear. The ability to sit quietly, listen to a story being read, and the ability to learn can suddenly be replaced with hand flapping, body spinning, head banging, food allergies, asthma, agitation, hyperactivity, learning disabilities, chronic colds and fevers, constant stomach pain, constipation, and a general failure to grow and thrive. There are also serious consequences for adults who use vaccines. Formerly productive adults can lose their independence and become paralyzed, infertile, chronically ill, and even die, because of vaccine damage. It happens every day, yet few people make the connection between their illnesses and vaccine use…
By the time parents fully awaken to the harm that has occurred to their children, many have already resigned themselves to a lifetime of caretaking their disabled children. Some parents will even receive counsel from their physicians to give up their children to the care of the state, because they have no treatments to offer and can offer no hope of recovery. Some physicians will try to convince parents that this is a genetic problem that might be cured someday, but not in the near future. The conventional medical care system leaves parents feeling like helpless victims without any good options. The truth is there are good options for restoring health after vaccine damage, and homeopathy is one of them!…
Homeopathy does not wage war on disease and seek to destroy the symptoms of disease through brute force. It does not bring substances into the body as is done with allopathic drugs, for the purpose of doing hand to hand combat against disease. Instead, homeopathy and its remedies are intended to gently stimulate and strengthen the body so that it can overcome illness through its own vital force and strength. Homeopathic remedies restore the natural ability of the body to defend itself against illness and to heal itself. When this happens, a person is truly cured of what ails him…
Allopathic drugs and treatments do not have a positive effect upon the vital force in the body. They do not improve the strength of a person, and they do not provide for physical, emotional, or mental renewal. Rather, they just suppress symptoms, and add side effects…
You may also wish to ask for a referral from your chiropractor, osteopath, or acupuncturist. Such practitioners are often aware of good homeopaths in the area. Sometimes the person who is responsible for managing supplements and remedies sold at health food stores will be aware of experienced homeopaths as well…
I know, apologists will claim that such extreme idiocy is always the work of a few ‘rotten apples’, even most homeopaths would object to such dangerous and amoral lunacy. But the fact is, they don’t! If you disagree, please show me the protests from homeopaths or other alternative practitioners.
When Wakefield was shown to be a fraud endangering public health with his bogus claims about vaccine damage, there were protests in abundance, and he was ousted by the medical and scientific communities. Where are the protests by the alternative medicine fraternity against this article and the many, many others like it?
NOBODY SHOULD BE ALLOWED TO ENDANGER PUBLIC HEALTH IN THIS WAY.
In case you wonder who wrote the above article, it is John P. Thomas. He is a health writer for Health Impact News. He holds a B.A. in Psychology from the University of Michigan, and a Master of Science in Public Health (M.S.P.H.) from the School of Public Health, Department of Health Administration, at the University of North Carolina at Chapel Hill. John specializes in environmental health, but writes on a variety of issues.