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

Ernst’s law

DOCTOR Jeffrey Collins, a chiropractor from the Chicago area, just sent me an email which, I think, is remarkable and hilarious – so much so that I want to share it with my readers. Here it is in its full length and beauty:

If you really think you can resolve all back pain syndromes with a pill then you are dumber than you look. I’ve been a chiropractor for 37 years and the primary difference between seeing me vs. an orthopedic surgeon for back pain is simple. When you have ANY fixation in the facet joint, the motor untitled is compromised. These are the load bearing joints in the spine and only an idiot would not realize they are the primary source of pain. The idea of giving facet blocks under fluoroscopy is so dark ages. Maybe you could return to blood letting. The fact that you attack chiropractors as being dangerous when EVERY DAY medical doctors kill people but that’s OK in the name of science. Remember Vioxx? Oh yeah that drug killed over 80,000 patients that they could find. It was likely double that. Oddly I have treated over 10,000 in my career and nobody died. Not one. I guess I was just lucky. I went to Palmer in Iowa. The best chiropractors come out of there. I should qualify that. The ones that have a skill adjusting the spine. 

I will leave you with this as a simple analogy most patients get. Anyone who has ever “cracked their knuckles” will tell you that they got immediate relief and joint function was restored instanter. That’s chiropractic in a nutshell. Not complicated and any chiropractor worth his salt can do that for 37 years without one adverse incident. A monkey could hand out pain pills and you know it. Only in America do you have to get a script to get to a drugstore so everybody gets a cut. What a joke. Somehow mitigating pain makes you feel better about yourselves when you are the real sham. Funny how chiropractors pay the LOWEST malpractice rates in the country. That must be luck as well. Where’s your science now? I would love to debate a guy like you face to face. If you ever come to Chicago email me and let’s meet. Then again guys like you never seem to like confrontation. 

I’ve enjoyed this and glad I found your site. Nobody reads the crap that you write and I found this by mistake. Keep the public in the dark as long as you can. It’s only a matter of time before it’s proven DRUGS ARE WORTHLESS.

I am pleased that DOCTOR Collins had fun. Now let me try to have some merriment as well.

This comment is a classic in several ways, for instance, it

  • starts with a frightfully primitive insult,
  • boasts of the author’s authority (37 years of experience) without mentioning anything that remotely resembles real evidence,
  • provides pseudoscientific explanations for quackery,
  • returns to insults (only an idiot return to blood letting),
  • uses classical fallacies (…medical doctors kill people),
  • returns to more boasting about authority (I went to Palmer in Iowa. The best chiropractors come out of there…),
  • injects a little conspiracy theory (…everybody gets a cut),
  • returns to insults (…you are the real sham… guys like you never seem to like confrontation.) 
  • and ends with an apocalyptic finish: It’s only a matter of time before it’s proven DRUGS ARE WORTHLESS.

I should not mock DOCTOR Collins, though; I should be thankful to him for at least two reasons. Firstly, he confirmed my theory that “Ad hominem attacks are signs of victories of reason over unreason“. Secondly, he made a major contribution to my enjoyment of this otherwise somewhat dreary bank holiday, and I hope the same goes for my readers.

‘Homeopathy in perspective’ is the title of a book by Anthony Campbell, the revised edition of which has recently become available. Dr Campbell has been a consultant at the Royal London Homeopathic Hospital (RLHH, as it was called then) for ~20 years and also served as the editor of the journal ‘Homeopathy‘ (as it is now called) for many years. He retired in 1998 but is still active in writing and teaching. His book is well-written, informative and far less promotional than one would expect. It summarizes the history of homeopathy in some detail and then discusses the scientific evidence – and it is, of course, this section that might be of particular interest for this blog and its readers.

I think Campbell is correct when he writes that it is wrong to say, as some critics do, that there is no objective evidence for homeopathy. There is, but most of it is of rather poor quality. Even at its best there is evidence for only a small effect, and when an effect is as small as this it may not be there at all. It is also disturbing that the better the quality of a trial the less likely it is to show a positive effect.

Amazing, coming from a retired consultant of the RLHH, isn’t it? It gets even more surprising as we read on: I conclude that there are no firm answers to questions about the efficacy of homeopathy to be found in the research that has been done up to now. Homeopathy has not been proved to work but neither has it been conclusively disproven – it is of course notoriously difficult to prove a negative.

A few paragraphs further on, Campbell provides his final conclusions on the evidence and gets even more explicit: My own assessment of homeopathy is that, while it is impossible to say categorically that all the remedies are without objective effect, any effect there may be is small and unimportant. The great majority, at least, of the improvement that patients experience is due to non-specific causes.

When I began saying and writing things like this, the world of homeopathy decided that I was a fraud and imposter who had no training in or knowledge of homeopathy; therefore, they almost unanimously agreed, my verdict was not to be trusted. I wonder how they are going to try to invalidate the words of someone who was for 20 years a consultant and director of the RLHH.

PS 

While I agree with much of what Campbell writes here, I have reservations about one particular aspect and will explain in the next post.

One of the perks of researching alternative medicine and writing a blog about it is that one rarely runs out of good laughs. In perfect accordance with ERNST’S LAW, I have recently been entertained, amused, even thrilled by a flurry of ad hominem attacks most of which are true knee-slappers. I would like to take this occasion to thank my assailants for their fantasy and tenacity. Most days, these ad hominem attacks really do make my day.

I can only hope they will continue to make my days a little more joyous. My fear, however, is that they might, one day, run out of material. Even today, their claims are somewhat repetitive:

  • I am not qualified
  • I only speak tosh
  • I do not understand science
  • I never did any ‘real’ research
  • Exeter Uni fired me
  • I have been caught red-handed (not quite sure at what)
  • I am on BIG PHARMA’s payroll
  • I faked my research papers

Come on, you feeble-minded fantasists must be able to do better! Isn’t it time to bring something new?

Yes, I know, innovation is not an easy task. The best ad hominem attacks are, of course, always based on a kernel of truth. In that respect, the ones that have been repeated ad nauseam are sadly wanting. Therefore I have decided to provide all would-be attackers with some true and relevant facts from my life. These should enable them to invent further myths and use them as ammunition against me.

Sounds like fun? Here we go:

Both my grandfather and my father were both doctors

This part of my family history could be spun in all sorts of intriguing ways. For instance, one could make up a nice story about how I, even as a child, was brain-washed to defend the medical profession at all cost from the onslaught of non-medical healers.

Our family physician was a prominent homeopath

Ahhhh, did he perhaps mistreat me and start me off on my crusade against homeopathy? Surely, there must be a nice ad hominem attack in here!

I studied psychology at Munich but did not finish it

Did I give up psychology because I discovered a manic obsession or other character flaw deeply hidden in my soul?

I then studied medicine (also in Munich) and made a MD thesis in the area of blood clotting

No doubt this is pure invention. Where are the proofs of my qualifications? Are the data in my thesis real or invented?

My 1st job as a junior doctor was in a homeopathic hospital in Munich

Yes, but why did I leave? Surely they found out about me and fired me.

I had hands on training in several forms of alternative medicine, including homeopathy

Easy to say, but where are the proofs?

I moved to London where I worked in St George’s Hospital conducting research in blood rheology

Another invention? Where are the published papers to document this?

I went back to Munich university where I continued this line of research and was awarded a PhD

Another thesis? Again with dodgy data? Where can one see this document?

I became Professor Rehabilitation Medicine first at Hannover Medical School and later in Vienna

How did that happen? Did I perhaps bribe the appointment panels?

In 1993, I was appointed to the Chair in Complementary Medicine at Exeter university

Yes, we all know that; but why did I not direct my efforts towards promoting alternative medicine?

In Exeter, together with a team of ~20 colleagues, we published > 1000 papers on alternative medicine, more than anyone else in that field

Impossible! This number clearly shows that many of these articles are fakes or plagiaries.

My H-Index is currently >80

Same as above.

In 2012, I became Emeritus Professor of the University of Exeter

Isn’t ’emeritus’ the Latin word for ‘dishonourable discharge’?

I HOPE I CAN RELY ON ALL OF MY AD HOMINEM ATTACKERS TO USE THIS INFORMATION AND RENDER THE ASSAULTS MORE DIVERSE, REAL AND INTERESTING.

This article was posted a few months ago. Then it mysteriously vanished without a trace; nobody knows quite why or how. Today I found an old draft on my computer, so I post the article again. It might not be identical with the original but it is close enough, I think.

Some time ago, Andy Lewis formulated a notion which he called ‘Ernst’s law’. Initially, I felt this was a bit o.t.t., then it made me chuckle, and eventually it got me thinking: could there be some truth in it, and if so, why?

The ‘law’ stipulates that, if a scientist investigating alternative medicine is much liked by the majority of enthusiasts in this field, the scientist is not doing his/her job properly. In any other area of healthcare, such a ‘law’ would be absurd. Why then does it seem to make sense, at least to some degree, in alternative medicine? The differences between any area of conventional and alternative medicine are diverse and profound.

Take neurology, for instance: here we have an organ-system, anatomy, physiology, pathophysiology, etiology and nosology all related more or less specifically to this field and all based on facts, rigorous science and substantial evidence. None of this knowledge, science and evidence is static, but each has evolved and can be predicted to do so in future. What we knew about neurology 50 years ago, for example, was dramatically different from what we know today. Scientific discovery discoveries in neurology link up with the knowledge gathered in other areas of medicine to generate a (more or less) complete bigger picture.

In alternative medicine or any single branch thereof, we have no specific organ-system, anatomy, physiology, pathophysiology, etiology or nosology to speak of. We also have few notions that are transferable from one branch of alternative medicine to another – on the contrary, the assumptions of homeopathy, for example, are in overt contradiction to those of acupuncture which, in turn, are out of sync with those of reflexology, aromatherapy and Reiki.

Instead, each branch of alternative medicine has its own axioms that are largely detached from reality or, indeed, from the axioms of other branches of alternative medicine. In acupuncture, for instance, we have concepts such as yin and yang, qi, meridians and acupuncture points, and there is hardly any development of these concepts. This renders them akin to dogmas, and there is no chance in hell that the combination of all the branches of alternative medicine would add up to provide a sensible ‘bigger picture’.

If a scientist were to instill scientific, critical, progressive thought in a field like neurology, thus overthrowing current concepts and assumptions, they would be greeted with open arms among many like-minded researchers who all pursue the aim of advancing their field and contributing to the knowledge base by overturning wrong assumptions and discovering new truths. If researchers were to spend their time trying to analyse the concepts or treatments of alternative medicine, thus overthrowing current concepts and assumptions, they would not only not be appreciated by the majority of the experts working in this field, they would be castigated for their actions.

If a scientist dedicated decades of hard work to the rigorous assessment of alternative medicine, that person would become a thorn in the flesh of believers. Instead of welcoming him with open arms, some disappointed enthusiasts of alternative treatments might even pay for defaming them.

On the other hand, if a researcher merely misused the tools of science to confirm the implausible assumptions of alternative medicine, he would quickly become the celebrated ‘heroes’ of this field.

This is the bizarre phenomenon that ‘Ernst’s law’ seems to capture quite well – and this is why I believe the ‘law’ is worth more than a laugh and a chuckle. In fact, ‘Ernst’s law’ might even describe the depressing reality of retrograde thinking in alternative medicine more accurately than most of us care to admit.

What do my readers feel? Their comments following this blog may well confirm or refute my theory.

Subscribe via email

Enter your email address to receive notifications of new blog posts by email.

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories