doctors
WARNING: after reading this, you might no longer enjoy your favorite breakfast cereal!
‘Biologic living’ is the name John Harvey Kellogg (1852-1943), an influential medical doctor and best-known as the inventor of the cornflakes gave to his health reforms. Biologic living was practiced in Kellogg’s Battle Creek Sanatorium, an institution for re-educating Americans and training of healthcare professionals. Kellogg’s religious beliefs bled into his medicinal practices and the Battle Creek Sanatorium was as much health spar as it was a rehabilitation facility. [1]
In the sanatorium, there was a strict focus on diet which was meant to cure a person of practically all ills, leading to a kind of purity of the soul. Meat and certain spicy, overly flavourful foods, as well as alcoholic beverages, were thought to overexcite the mind and lead to sinful behavior. A bland dull diet was thus recommended. Kellogg intended for ‘cornflakes’ to become the staple of this diet. Other treatments included the following [2]:
- Vegetarian diet; Kellogg invented an artificial meat substitute based mainly on peanuts, called ‘nuttose’
- ‘Light bath’, a bath under lights lasting hours, days, sometimes even weeks
- Regular exercise
- Various forms of electrotherapy
- Vibrational therapy
- Massage therapy
- Breathing techniques
- Colonic irrigation delivered by specially designed machines that could deliver 14 liters of water followed by a pint of yogurt, half of which was to be eaten, while the other half would be delivered via a second enema
- Water cures of various types
- Sexual abstinence, including various measures to avoid masturbation. For boys, he recommended circumcision without anesthetic, thinking the trauma it caused and several weeks of pain that would follow would curb masturbation. If that did not suffice, Kellogg recommended sewing the foreskin shut, preventing an erection. For girls, he applied carbolic acid to the clitoris as ‘an excellent means of allaying the abnormal excitement.’ He would also recommend binding people’s hands, covering genitalia in specially designed cages, or electroshock therapy, such was his hatred of masturbation.
Biologic living was centered around purity, not merely of the soul but racial purity too. Meat and alcohol were not just bad, they were considered ‘race poisons’. He was a staunch advocate of ‘race suicide’, a term that summed up the fear of white America that their racial purity would be eroded, and they would disappear into ‘inferior races’. Kellogg helped implement a law whereby genetically ‘inferior’ humans such as epileptics or people with a learning disability could be a target. Michigan’s forced sterilization law, which Kellogg himself had a hand in, would not be repealed until 1974.
Today, Kellogg’s biologic living is mostly of historical interest. Yet, it is relevant for understanding some of the more extreme trends in the US related to so-called alternative medicine (SCAM).
[1] The Living Temple: Amazon.co.uk: Kellogg, John Harvey: 9781296696375: Books
[2] John Harvey Kellogg And His Anti-Masturbation Cereals | by Danny | Medium
For my last post of the year 2021, I take the liberty to borrow parts of a BMJ editorial entitled A NEW YEAR’S RESOLUTION OF HEALTH WORKERS:
The prospect of a return to normality seems within reach. But what will that normality look like? We believe that health workers, who have been at the frontline of the pandemic, must offer a vision of a healthier future. We must not let the terrible events of this year recast the pre-pandemic world in a glowing light. The normality we departed from at the onset of the pandemic was unjust, unsustainable, and shaped the evolution of, and responses to, the pandemic with devastating consequences, particularly for the most deprived and vulnerable.
The start of a new year offers an opportunity to question old ways of working and to ask how we can create a better future for everyone. It is a cliché to say that you should never waste a crisis. Just as in wartime and in the global financial crisis, many have profited greatly from the pandemic, whether as providers of online services or by taking advantage of the rush to procure essential goods such as personal protective equipment.
But many were far less fortunate, living in circumstances that rendered them vulnerable to an infection that spread especially rapidly through communities where successive generations had been living ever more precarious lives. As the recovery begins, the powerful groups who benefited from the social and economic systems that created those conditions will, once again, seek to shape the world to their advantage. Health workers cannot remain silent. They must offer a compelling vision of how we should reconfigure the world so that it produces and sustains health for all, resilient in the face of future threats…
A country navigating the pandemic is like a ship navigating treacherous and unpredictable waters in a storm. If the ship, its crew, and its passengers are to come through the experience unscathed it needs three things. First, it needs an experienced captain who understands the ship and commands the trust of the crew. Unfortunately, in some of the countries worst affected, captains were either away from the bridge, denied there was a storm, or had lost the trust of those on whom they depended.
Second, it needs a crew that is adequate for the size of the ship, that is well trained, and that is working as a team to achieve the same goal. Yet in too many countries, skeleton crews were working in health systems that were highly fragmented. Dissenting voices who raise the alarm about the integrity of the ship, the working of the team, or its leadership must not be silenced or lives can be lost. It also needs passengers who are as seaworthy as possible so that they can withstand the storm. One of the sentinel challenges of covid-19 was finding large segments of the population weighted by a disproportionate burden of preventable disease that predisposed them to severe covid-19 once infected.
Third, we need a ship that is securely constructed. Yet in many of the countries that have fared worst, we have been working in vessels that are full of holes. Social safety nets have been ripped asunder, allowing too many people to fall through the holes. We have made many demands on our people—to stay at home, to face loss of income—and we have added greater uncertainty to what were already difficult situations, particularly for certain racially and economically marginalised groups. The disproportionate exposure to covid-19 of many in these groups—a consequence of precarious jobs and social circumstances that denied them the luxury of social distancing—drove, in large part, the high burden of covid-19 among minority and marginalised groups worldwide.
As we look to the prospect of a covid-19 secure future, with effective vaccines, new treatments, and continued countermeasures as necessary, we must ask how we can strengthen the foundations of our societies, coming together to repair the torn safety nets. We must never be afraid to challenge our political leaders when they are going in the wrong direction, and we must insist that they really are guided by the science, and not just those bits that support their beliefs. And we must ensure that our fellow citizens are as healthy as possible so they can withstand the inevitable storms that lie ahead. We must insist that our health systems and other public systems are adequately staffed, with the tools needed to do the job, with teams that are working together, pulling in the same direction. If we do all this, then we, and the populations we serve, can be confident that we can weather any future storms.
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The editorial was written by 4 authors:
- Martin McKee, professor of European public health
- May C I van Schalkwyk, NIHR doctoral research fellow
- Nason Maani, assistant professor in public health evaluation
- Sandro Galea, dean
I think it is most sensible and thought-provoking and I suspect many of us agree with its sentiments. If it did not make you think, perhaps this information will do so:
The editorial was published one year ago in the Christmas issue of the BMJ
2020!
Yes, 2021 has disappointed many of our hopes and turned out to be a difficult year.
I wish us all that 2022 will be better, much better.
A remarkable case of a German doctor homeopath from the Lake Constance district in Germany has been reported. The public prosecutor’s office in Constance is currently investigating the physician on suspicion of causing bodily harm.
Several hundred people seem to have received an ineffective Corona vaccination from her. According to a spokesperson from the office of the Lake Constance district, 430 people who had been vaccinated against the Coronavirus in the doctor’s practice in Markdorf have now received mail from the public health department.
The recipients of the letter were instructed to take an antibody test to clarify their vaccination status. The officials are also interested in their testimonies on the circumstances of the vaccination. It is suspected that the doctor added “something homeopathic” to the injections which presumably were saline solutions.
One of the victims has now filed an official complaint. At the request of the Constance public prosecutor’s office, a judge of the district court issued a search warrant for the medical practice concerned, whereupon officers of the Ravensburg police headquarters seized evidence.
The case had come to the attention of the authorities after no antibodies against the coronavirus could be detected initially in three patients despite them having received first and second vaccinations and no plausible medical reasons for this lack of response could be found.
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It is true that some homeopaths reject vaccinations and believe that homeopathic vaccinations are an effective alternative. It is also clear to anyone who has followed the discussions on this blog that some homeopaths are severely deluded and might therefore try this method on patients, even though there is not a jot of evidence that it works. The fact that this is done dishonestly and without the informed consent of the patient is nevertheless astonishing. Even more surprising, I find, is the notion that such a crime should be committed by a doctor who must know better.
Dr. Mehmet Oz is one of the most influential promoters of outright quackery. I once (many years ago) met him at a meeting where we both were lecturing. My impression was that he does not believe a single word he speaks. Oz later became a TV star and had ample occasion to confirm my suspicion.
Oz’s wife, Lisa, is a Reiki master and has spoken widely of her insights into energy and health. Mehmet Oz appeared as a health expert on The Oprah Winfrey Show. In 2009, Winfrey offered to produce a syndicated series. The Dr. Oz Show debuted in September 2009 and became the most successful promotion of charlatanery in the US. During a Senate hearing on consumer protection in 2014, Senator Claire McCaskill stated that “the scientific community is almost monolithic against you” for airing segments on weight loss products that are later cited in advertisements, concluding that Oz plays a role, intentional or not, in perpetuating these scams, and that she is “concerned that you are melding medical advice, news, and entertainment in a way that harms consumers.” This judgement was supported by a 2014 analysis published in the BMJ; here is the abstract:
Objective To determine the quality of health recommendations and claims made on popular medical talk shows.
Design Prospective observational study.
Setting Mainstream television media.
Sources Internationally syndicated medical television talk shows that air daily (The Dr Oz Show and The Doctors).
Interventions Investigators randomly selected 40 episodes of each of The Dr Oz Show and The Doctors from early 2013 and identified and evaluated all recommendations made on each program. A group of experienced evidence reviewers independently searched for, and evaluated as a team, evidence to support 80 randomly selected recommendations from each show.
Main outcomes measures Percentage of recommendations that are supported by evidence as determined by a team of experienced evidence reviewers. Secondary outcomes included topics discussed, the number of recommendations made on the shows, and the types and details of recommendations that were made.
Results We could find at least a case study or better evidence to support 54% (95% confidence interval 47% to 62%) of the 160 recommendations (80 from each show). For recommendations in The Dr Oz Show, evidence supported 46%, contradicted 15%, and was not found for 39%. For recommendations in The Doctors, evidence supported 63%, contradicted 14%, and was not found for 24%. Believable or somewhat believable evidence supported 33% of the recommendations on The Dr Oz Show and 53% on The Doctors. On average, The Dr Oz Show had 12 recommendations per episode and The Doctors 11. The most common recommendation category on The Dr Oz Show was dietary advice (39%) and on The Doctors was to consult a healthcare provider (18%). A specific benefit was described for 43% and 41% of the recommendations made on the shows respectively. The magnitude of benefit was described for 17% of the recommendations on The Dr Oz Show and 11% on The Doctors. Disclosure of potential conflicts of interest accompanied 0.4% of recommendations.
Conclusions Recommendations made on medical talk shows often lack adequate information on specific benefits or the magnitude of the effects of these benefits. Approximately half of the recommendations have either no evidence or are contradicted by the best available evidence. Potential conflicts of interest are rarely addressed. The public should be skeptical about recommendations made on medical talk shows.
During the presidential campaign in 2016, Oz supported Trump and hosted him on his TV show. In 2018, Donald Trump appointed him to the President’s Council on Sports, Fitness, and Nutrition, Oz was criticized as an example of choosing “pundits over experts”. Recently, Oz announced he intends to run for the U.S. Senate as a Republican.
In April 2020, Oz also spurred controversy because he said that children should be sent back into schools despite the fact that the novel coronavirus pandemic had only just begun and there were no vaccines or therapeutics yet available. “I tell you, schools are a very appetizing opportunity,” he said, claiming that resuming classes “may only cost us 2 to 3 percent in terms of total mortality,” according to his “reading” of medical journals. The mistake was so substantial that Oz later provided a kind of half-apology, saying that he “misspoke.”
In a recently published study, the willingness to be vaccinated of parents of underage children and persons without underage children was examined. The study was based on a random sample (telephone survey, n = 2014, survey between 12.11.2020 and 10.12.2020).
The results revealed that parents consistently show a lower propensity to vaccinate with a COVID-19 vaccine than respondents without minor children (54.1% vs. 71.1%). Fathers showed a more pronounced own willingness to vaccinate than mothers. Furthermore, men were more willing than women to have their own child vaccinated with a COVID-19 vaccine.
The overall sample also showed that a rejection of so-called alternative medicine (SCAM) was associated with a significantly higher willingness to be vaccinated. There was also a significant correlation between the attitude towards homeopathy and one’s own willingness to be vaccinated. If homeopathy was supported, the willingness to vaccinate was lower. This correlation between the attitude towards homeopathy and willingness to vaccinate was also evident in the sub-sample of parents. Among the parents, it was again the women who significantly more often had a positive attitude towards homeopathy than men, who more often do not think anything of it.
This new evidence ties in neatly with many of my previous posts on the subject of SCAM and vaccination, for instance:
- More information on homeopaths’ and anthroposophic doctors’ attitude towards vaccinations
- The anti-vaccination movement is financed by the dietary supplement industry
- The UK Society of Homeopaths, a hub of anti-vaccination activists?
- HOMEOPATHY = “the complete alternative to vaccination” ?!?!
- Are anthroposophy-enthusiasts for or against vaccinations?
- Far too many chiropractors believe that vaccinations do not have a positive effect on public health
- Andrew Wakefield, Donald Trump, SCAM, and the anti-vaccination cult
- Naturopaths’ counselling against vaccinations could be criminally negligent
- HOMEOPATHS AGAINST VACCINATION: “The decision to vaccinate and how you implement that decision is yours and yours alone”
- Use of alternative medicine is associated with low vaccination rates
- Integrative medicine physicians tend to harbour anti-vaccination views
- Vaccination: chiropractors “espouse views which aren’t evidence based”
- Faith-healing as an alternative to vaccination?
- Learning about homeopathy the hard way: the story of Aaron Rodgers
- Patients consulting chiropractors, homeopaths, or naturopaths are less likely to agree to the flu jab
- Parents’ Willingness to Vaccinate with a COVID-19 Vaccine: strongly influenced by homeopathy
- “The uncensored truth” about COVID-19 vaccines” … as told by some chiro loons
- Beliefs and behaviors of US chiropractors
- Many naturopaths, homeopaths, and chiropractors are a risk to public health
- Homeopaths (and other SCAM practitioners) are peddling dangerous myths
- Misinformation and fraudulent claims about boosting immunity during the pandemic
Collectively, this evidence tells us that:
- the effect has been shown in many different ways,
- it can therefore be assumed to be real,
- it is not confined to COVID vaccinations,
- it is not confined to one particular branch of SCAM,
- it even affects MDs (who surely should know better) dabbling in SCAM,
- it has a long history,
- it is prevalent in many, if not most countries,
- it does real harm.
So, the next time someone tells you that SCAM and SCAM practitioners have a positive influence on public health, tell them to think again.
I have said it often before, and I will say it again:
Homeopathy and other ineffective so-called alternative medicines (SCAMs) are dangerous mostly because they might replace effective treatments.
The tragic death of an Austrian boy is a stark reminder of this fact. Even though this happened a decade ago, I only just came across this case. It was, to the best of my knowledge, never published in English. Allow me, therefore, to summarize it here:
In 2011, a judge sentenced a couple from East Tyrol to a one-year suspended sentence. Their son, who suffered from a rare congenital immune system disorder (SCID*), had been treated only with homeopathy until he died. The doctor who treated the boy in this way received the same sentence.** The verdicts took into account that the parents and the family doctor did not act out of sheer ignorance, but had been informed about the nature of the disease and its consequences.
The parents told the court that they had previously had extremely negative experiences with conventional medicine when their first two children, who suffered from the same condition, had died. When their third child fell ill, the parents took him to a clinic where a bone marrow transplant was to be carried out, which, according to an expert witness, would have had a 95 % chance of curing the boy. Because the parents were put off by the sight of other children in the hospital, they took their son home again and withheld all further conventional treatments or appropriate examinations. Instead, they instructed their family doctor to cure the boy with homeopathy. The doctor refrained from administering antibiotics when the illness worsened due to an infection and failed to admit the boy to a hospital when he became severely ill.
The child then died of sepsis. The autopsy revealed that he was malnourished and one of his ear canals as well as his lungs were necrotic with inflammation.
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It is hard not to be repulsed and nauseated by such stories. They show how dangerously unreasonable some homeopaths and their followers are. And they remind us that even a seemingly harmless SCAM will cost lives in the hands of such fanatics.
* Severe combined immunodeficiency (SCID) is a group of rare disorders caused by mutations in different genes involved in the development and function of infection-fighting immune cells. Infants with SCID appear healthy at birth but are highly susceptible to severe infections. The condition is fatal, usually within the first year or two of life, unless infants receive immune-restoring treatments, such as transplants of blood-forming stem cells, gene therapy, or enzyme therapy.
**Personally, I find the sentence for the doctor far too lenient. One could argue that the parents had been punished by the loss of their child and thus deserve merci, but the doctor?
Remember the 10:23 Campaign? It was an awareness and protest campaign against homoeopathy organised by the Merseyside Skeptics Society, a non-profit organisation, to oppose the sale of homoeopathic products in the UK. It consisted of volunteers publicly taking overdoses of homeopathic remedies. With their actions, they wanted to demonstrate that homeopathic remedies are devoid of active ingredients and physiological effects. Suicide by homeopathy, they showed us, was impossible.
But they were mistaken – it is possible after all!
A few days ago, it was reported that an Italian doctor has died of a COVID-19 infection. This is tragic, no doubt, but in itself, it is not all that newsworthy in the context of this blog. What makes it remarkable is the fact that the doctor was a convinced homeopath who had refused to get vaccinated and was adamant that homeopathy would protect him.
Domenico Giannola, a doctor homeopath from Cinisi, died of complications due to Covid-19 at Palermo’s Cervello hospital. Dr. Giannola had not been vaccinated and after he got infected with COVID-19, he had tried to treat himself with homeopathic remedies.
Domenico Giannola was a well-known advocate of anthroposophical and homeopathic medicine. In a Youtube video from last year, he described his ‘methods of treatment. As he had a preexisting heart condition, he was a high-risk patient.
After he fell ill, he had been in home isolation for several days and was followed by the special continuity care unit (Usca) of the Palermo hospital. He had always insisted that he had no intention of becoming infected and would treat himself at home with lactoferrin and homeopathic remedies. Lactoferrin is one of the components of the immune system of the body; it has antimicrobial activity against bacteria and fungi.
As his condition worsened, Domenico Giannola was eventually transported to the emergency room of the Cervello hospital in Palermo by a 118 ambulance. He died an hour after his arrival at the hospital.
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I find such reports tragic beyond words. At the same time, they are deeply worrying. A question that one needs to ask is this: if some homeopaths do this to themselves, what are they capable of inflicting on their patients?
The 13th European Congress for Integrative Medicine is about to take place online between 4 and 7 November 2021. It will host 125+ speakers presenting from around the world. The programme will cover the following topics.
- Anthroposophic Medicine
- Arts in Healthcare
- Acupuncture
- Antimicrobial Resistance
- Ayurveda
- Covid Research
- Diabetes
- Homeopathy
- Immunology
- Integrative Oncology
- Lifestyle Medicine
- Medical Education
- Mental Health & Stress Management
- Mind and Body Connection
- Mistletoe Therapy
- Nutrition, Gut Health & Microbiome
- Pain Management
- Patient Activation & Self-Management
- Planetary & Environmental Health
- Research and Evaluation
- Social Prescribing
- Traditional Health
- Yoga
Even looking at the more detailed list of lectures, I did not find a single contribution on conventional medicine (“Integrative medicine combines conventional medicine with…” [see below]) or a lecture that is remotely critical of integrative medicine. The definition of INTEGRATED MEDICINE (IM) adopted here seems similar to the US definition we recently discussed. Here is the European definition:
Integrative medicine combines conventional medicine with evidence-informed complementary medicine and therapies to achieve the optimum health and wellbeing of the patient. Focusing on a holistic, patient-centred approach to healthcare, it takes into consideration the patient’s physical and psychological wellbeing and treats the whole person rather than just the disease.
Allow me to do a quick analysis of this definition by looking at its key elements:
- Evidence-informed: While proper medicine is BASED on evidence, IM is merely INFORMED by it. The difference is fundamental. It allows IM clinicians to use any un- or disproven so-called alternative medicine (SCAM) they can think of or invent. The evidence for homeopathy fails to show that it is effective? Never mind, IM does not need to be evidence-based, it is evidence-informed. IM physicians know homeopathy is a placebo therapy (if not they would be ill-informed which would make them unethical), but they nevertheless use homeopathy (try to find an IM clinic that does not offer homeopathy!), because IM is not EBM. IM is evidence-informed!
- Therapies that achieve optimum health and wellbeing. This is odd because the website also states that “therapies can include anything from acupuncture, yoga, massage, aromatherapy, herbal medicine, nutrition, exercise along with many more approaches, tailored to the needs of the individual” indicating that virtually anything can be included. Anyway, “optimum health and wellbeing” seems a strange and unachievable criterion. In fact, it is nothing but a ‘bait and switch‘ salesmen’s trick.
- Holistic: This is a little trick that IM proponents love. With it, they imply that normal medicine is not holistic. However, this implication is demonstrably wrong. Any good medicine is holistic, and if a sector of healthcare fails to account for the whole person, we need to reform it. (Here are the conclusions of an editorial I published in 2007 entitled ‘Holistic heath care?‘: good health care is likely to be holistic but holistic health care, as it is marketed at present, is not necessarily good. The term ‘holistic’ may even be a ‘red herring’ which misleads patients. What matters most is whether or not any given approach optimally benefits the patient. This goal is best achieved with effective and safe interventions administered humanely — regardless of what label we put on them.) Creating a branch of medicine that, like IM, pretends to have a monopoly on holism is grossly misleading and can only hinder this process.
- Patient-centred: This is the same mean little trick in a different guise. They imply that conventional medicine is not patient-centred. Yet, all good medicine is, of course, patient-centred. To imply otherwise is just daft.
- Consideration of the patient’s physical and psychological wellbeing and treating the whole person rather than just the disease: Same trick yet again! The implication is that physical and psychological wellbeing and the whole person are not all that relevant in conventional medicine where only disease labels are being treated.
Altogether, this definition of IM is unworthy of anyone with the slightest ability to think critically. I find it much worse than the latest US definition (which already is fairly awful). In fact, it turns out to be a poorly disguised bonanza of strawman fallacies combined with ‘bait and switch’ deception.
How can this be?
How can a professional organisation engage in such mean trickery?
Perhaps a look at the list of speakers will go some way towards answering the question. Have a good look, you might recognize many individuals as members of our ALTERNATIVE MEDICINE HALL OF FAME.
PS
Registration costs £ 249 (standard rate)
PPS
Perhaps I should also mention at least 4 of the many commercial sponsors of the conference:
- Boiron
- Helixor
- Iscador
- Weleda
Guest post by Emeritus Professor Alastair MacLennan AO, MB ChB, MD, FRCOG, FRANZCOG
The sale and promotion of a therapeutic drug in most countries require rigorous assessment and licencing by that country’s therapeutic regulatory body. However, a new surgical technique can escape such checks and overview unless the technique is subject to local medical ethics review in the context of a research trial. New medical devices in Australia such as carbon dioxide or Er-YAG lasers can be listed on its therapeutic register without critical review of their efficacy and safety. Thermal injury to the postmenopausal vaginal wall in the hope of rejuvenating it has become a lucrative fad for some surgeons outside formal well-conducted clinical trials.
There are many published studies of this technique but the large majority are small, uncontrolled and observational. The few randomised controlled trials using sham controls show a placebo effect and debatable clinical efficacy with limited follow-up of adverse effects. A review of these therapies in July 2020 published by The National Institute for Health and Care Excellence summarised apparent claims for some efficacy in terms of vaginal dryness, dyspareunia, sexual function, and incontinence but noted confounding in the study’s designs such as concurrent breast cancer treatments, local oestrogen therapy and lubricants (!). Most studies had very limited follow up for adverse events but elsewhere the literature has reported burns, infection, increased dyspareunia and scarring. There is no physiological mechanism by which burning atrophic vaginal epithelium will magically rejuvenate it.
A recent well-conducted randomised sham-controlled trial with a 12-month follow-up of Fractional Carbon Dioxide Laser for the treatment of vaginal symptoms associated with menopause has been published in JAMA by Li et al has shown no efficacy for this treatment(2).
At 12 months, there was no difference in overall symptom severity based on a 0-100 scale (zero equals no symptoms), with a reduction in symptom severity of 17.2 in the treatment group compared with 26.6 in the sham group.
The treatment had no impact on quality of life. “Sexual activity rates and quality of sex were not significantly different between the groups at baseline or 12 months”. The study compared 46 paired vaginal wall biopsies, taken at baseline and six months into treatment, and no significant histological improvement with laser was evident.
“The annual cost of laser treatment to the individual for management of vaginal menopausal symptoms was reported to be AUD$2,733, and because there is no demonstrable difference versus sham treatment, it cannot be considered to be cost-effective.”
Although one could still call for more quality sham-controlled randomised trials in different circumstances there is no justification for touting this therapy commercially. Complications following this therapy outside of ethical trials could become the next medico-legal mine-field.
Vaginal atrophy in the years after menopause is almost universal and is primarily due to oestrogen deficiency. The efficient solution is local vaginal oestrogen or systemic hormone replacement therapy. However, the misreporting of the Women’s Health Initiative and Million Women’s Study has created exaggerated fear of oestrogen therapies and thus a market for alternative and often unproven therapies (3). The way forward is education and tailoring of hormonal therapies to minimise risk and maximise efficacy and quality of life and not to resort to quackery.
References
1. https://www.nice.org.uk/guidance/ipg697/documents/overview
2. Li FG, Maheux-Lacroix S, Deans R et al. Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms A Randomized Clinical Trial. JAMA. 2021;326:1381-1389.
3. MacLennan AH. Evidence-based review of therapies at the menopause. Int J Evid Based Healthc 2009; 7: 112-123.
The bad news for German homeopathy just keeps on coming. As I reported, recent events must be depressing for homeopaths, e.g.:
- A recent investigation disclosed that the German homeopathy cult is at the heart of Germany’s anti-vax movement.
- In July 2021, a German court ruled against a homeopathic HCG remedy.
- In 2020, a German study failed to show that homeopathy is cost-effective.
- In 2019, the attempt by a German homeopathy manufacturer to silence critics backfired spectacularly.
- About 10 years ago, 5 German firms clubbed together supporting a journalist at the tune of Euro 30 000/year to defame me (at the time I was one of the few who regularly informed the public about the evidence on homeopathy). The plot was discovered and published whereupon the journalist committed suicide.
After heated debates in the run-up, the Bavarian Medical Association decided yesterday to ditch the postgraduate education program in homeopathy for its doctors. This means that, of the 17 regional medical associations in Germany, 12 have now discontinued their further education efforts in homeopathy. The ones that have not yet done so are:
- Baden-Württemberg,
- Rhineland-Palatinate,
- Saxony,
- Thuringia,
- Westphalia-Lippe.
In the past months, homeopaths had collected 11,597 signatures in favor of maintaining the additional qualification of homeopathy. The ~ 400 doctors in Bavaria, who have acquired ‘homeopathy’ as an additional title, will be permitted to continue to use it.
The spokesperson of the Information Network Homeopathy, Dr. Christian Lübbers, welcomed the decision of the Medical Association. It was a “landslide victory for patient safety”, he said. The Bavarian regional chairman of the German Central Association of Homeopathic Doctors, Dr. Ulf Riker, regretted the outcome of the vote and added: “We will consider legal steps very seriously.” I would advise against such a step which would only render homeopaths more ridiculous than they already are.
Yes, it’s bad news for German homeopaths – very bad news indeed. Of course, homeopathy fans will claim that it is all a sinister conspiracy against them. Sadly, they are unable to realize that the only driving force behind the long-overdue decline of German homeopathy is the evidence: HOMEOPATHY DOES NOT WORK BEYOND PLACEBO and therefore it has no place in the evidence-based medicine of the 21st century.
