evidence
Homeopathy is harmless – except when it kills you!
Death by homeopathy has been a theme that occurred with depressing regularity on my blog, e.g.:
- Death by homeopathy
- Another death by homeopathy
- Death by homeopathy?
- The case of a boy tortured to death with homeopathy
- Homeopathy is the death of the patient suffering from gangrene
Now, there is yet another sad fatality that must be added to the list. This case report presents a 61-year-old woman with metastatic breast cancer who opted for homeopathic treatments instead of standard oncological care. She presented to the Emergency Department with bilateral necrotic breasts, lymphedema, and widespread metastatic disease. Imaging revealed extensive lytic and sclerotic lesions, as well as pulmonary emboli. Laboratory results showed leukocytosis, lactic acidosis, and hypercalcemia of malignancy.
During hospitalization, patient was managed with anticoagulation and broad-spectrum antibiotics. Despite disease progression, patient declined systemic oncological treatments, leading to a complicated disease trajectory marked by frailty, sarcopenia, and functional quadriplegia, ultimately, a palliative care approach was initiated, and she was discharged to hospice and died.
This case highlights the complex challenges in managing advanced cancer when patients choose alternative therapies over evidence-based treatments. The role of homeopathy in cancer care is controversial, as it lacks robust clinical evidence for managing malignancies, especially metastatic disease.
Although respecting patient autonomy is essential, this case underscores the need for healthcare providers to ensure patients are fully informed about the limitations of alternative therapies. While homeopathy may offer emotional comfort, it is not a substitute for effective cancer treatments. Earlier intervention with conventional oncology might have altered the disease course and improved outcomes. The eventual transition to hospice care focused on maintaining the quality of life and dignity at the end-of-life, emphasizing the importance of integrating palliative care early in the management of advanced cancer to enhance patient and family satisfaction.
Even though such awful stories are far from rare, reports of this nature rarely get published. Clinicians are simply too busy to write up case histories that show merely what sadly must be expected, if a patient refuses effective therapy for a serious condition and prefers to use homeopathy as an “alternative”. Yet, the rather obvious truth is that homeopathy is no alternative. I have pointed it out many times before: if a treatment does not work, it is dangerously misleading to call it alternative medicine – one of the reasons why I nowadays prefer the term so-called alternative medicine (SCAM).
But what about homeopathy as an adjunctive cancer therapy?
In 2011, Walach et al published a prospective observational study with cancer patients in two differently treated cohorts: one cohort with patients under complementary homeopathic treatment (HG; n = 259), and one cohort with conventionally treated cancer patients (CG; n = 380). The authors observed an improvement of quality of life as well as a tendency of fatigue symptoms to decrease in cancer patients under complementary homeopathic treatment.
Walach and other equally deluded defenders of homeopathy (such as Wurster or Frass) tend to interpret these findings as being caused by homeopathy. Yet, this does not seem to be the case, as they regularly forget about the possibility of other, more plausible explanations for their results (e.g. placebo or selection bias). I am not aware of a rigorous trial showing that adjunctive homeopathy has specific effects when used by cancer patients (if a reader knows more, please let me know; I am always keen to learn).
So, is there a role for homeopathy in the fight against cancer?
My short answer:
No!
I has been reported that a man is pleading to steer clear of chiropractors. Last year, Tyler Stanton endured “the worst pain I had ever experienced in my life,” a hospital stay, and the beginning of an ongoing struggle that has left him unable to work. All started immediately after a chiropractor cracked his neck — and something popped.
After adjusting Stanton’s back, the chiropractor moved on to his neck. “It didn’t crack on the first time. On the second time where he tried to crack my neck, he put a lot of force behind it, and I heard one huge and painful pop. I knew immediately that something was wrong.” Stanton recalled that when he tried to sit up, the room began to spin. “My equilibrium was just completely f—ked. I was instantly, profusely sweating.”
After laying on the table for half an hour, Stanton made the short trip back to his home, where he became “violently ill.” Throwing up uncontrollably and unable to see straight, he got into bed, hoping rest would alleviate his symptoms. The following morning, Stanton woke up to “the worst pain I had ever experienced in my life. The entire right side of my body was numb. It was really scary.”
He was taken to the hospital, where he was diagnosed with a herniated disc between the C5 and C6 vertebrae in his neck. Due to the acute pain he was experiencing, he stayed in the hospital for several weeks. “They ended up giving me epidural injections into my spine, and they didn’t even make a dent into the pain,” he said. Ultimately, doctors gave him two choices: spinal fusion therapy or physical therapy to manage his discomfort.
Fearful of the consequences of surgery, Stanton opted for PT. “I had a pharmacy of pain medication to help the nerves be less inflamed so I can get mobility and feeling back into the right side of my body. Essentially, I just had to go home and lay down for about two more months.”
Unable to work, Stanton burned through his savings, and six months into his recovery, he is just beginning to regain sensation in his right arm. “I still deal with pain. I’m still limited in what I can do physically. It just destroyed me. Mentally, financially, physically, all of it.” With limited mobility and mounting medical bills, Stanton is consulting with lawyers and considering legal action. “I kinda feel like I just don’t have another choice because this really just derailed my entire life overnight,” he said.
While proponents say chiropractors help alleviate pain, many doctors describe the field as pseudoscience — and warn that it can actually lead to serious problems. ““There are reports of severe side effects with chiropractic treatment, including blood clot formation, herniated discs, fractures, artery dissection, stroke, paralysis, and death,” explained Gbolahan Okubadejo, MD, a spinal surgeon and the head of The Institute for Comprehensive Spine Care. Dr. Charles R. Wira III, an emergency medicine doctor at Yale Medicine, told the Huffington Post that there’s a known link between chiropractic neck manipulations and major artery tears that can cause strokes. “Thankfully, overall the incidence of neck dissections are small,” he said. “But intentional and aggressive manipulations of the neck merits strong consideration for concern.” Cardiologist Dr. Danielle Belardo said she was “heartbroken” to see a young patient with “dissection of the vertebral artery” following a neck adjustment. “How can we live in a world where it’s legal to perform something with zero evidence for benefit (neck adjustment from a chiro) when there are such incredibly dangerous and life changing risks?” she wrote on Twitter. “[My patient] trusted a licensed healthcare practitioner to provide care that has more benefit than harm. This is a disgrace.”
Stanton hopes his story can serve as a warning for others. “I think it’s important that I share this story because I just don’t want what happened to me to happen to someone else,” he said. “Please don’t go to the chiropractor, OK? If I can do anything with my platform to share the story and save somebody from experiencing what I had to experience, then hopefully, something positive can come out of what I went through. Please hear me when I say this: Please be careful. This is the last thing that you want to experience.”
In a disturbing parallel, a young woman who felt a “crack to her neck” during a gym workout in 2021 died weeks later after going to a chiropractor to treat her neck pain. In 2022, a Georgia woman became paralyzed after a routine neck adjustment ended up rupturing her spinal arteries in several spots. In 2023, an Australian man suffered a stroke after cracking his neck in an ill-advised attempt to cure his chronic back pain.
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None of these are proper case reports in a medical sense, of course. Such publications are relatively rare.
I wonder why.
Could it be related to the fact that many chiropractors are in denial and, as a profession, they still have no adequate monitoring system for adverse event?
Robert F. Kennedy Jr. is coming out with so much stupidity, ignorance and quackery that it is getting difficult to keep up. A recent article reported that he touted two particular medications that have not been shown to work as first-line treatments for measles:
- the steroid budesonide,
- the antibiotic clarithromycin.
Kennedy claimed on X that the medications had been instrumental in treating around 300 children in Texas, and told Fox News that doctors prescribing them had seen “very, very good results.”
Consequently, families in Texas have turned to questionable remedies — in some cases, also prompted by the recommendation of two Texas doctors, Dr. Ben Edwards and Dr. Richard Bartlett. Kennedy called Edwards and Bartlett “extraordinary healers” who have “treated and healed” hundreds of children with budesonide and clarithromycin, sharing a photo of himself and the doctors with three Mennonite families whose children had become ill. Two of the families had each recently lost a daughter to measles: 6-year-old Kayley Fehr died in February and 8-year-old Daisy Hildebrand died last week. Neither child was vaccinated.
Edwards, a conventionally trained doctor who has shifted to promoting natural remedies and prayer, has been operating a makeshift clinic in Seminole, offering children these unproven treatments — including, according to a video posted by an anti-vaccine group, while he said he was sick with measles. Edwards has allied himself with the anti-vaccine movement in recent months, hosting influencers and activists on his podcast, including Andrew Wakefield.
“There is no evidence to support the use of either aerosolized budesonide or clarithromycin for treatment of children with measles,” said Dr. Adam Ratner, a spokesman for the American Academy of Pediatrics. Prescribing treatments that have not been vetted in clinical trials amounts to experimenting on patients, added Dr. Susan McLellan, a professor in the infectious diseases division at the University of Texas Medical Branch.
During the measles outbreak, both Edwards and Bartlett have each warned of risks associated with the MMR vaccine: Edwards claimed, falsely, that it causes “potentially” hundreds of deaths a year and Bartlett has said that the complications caused by measles, including brain swelling and pneumonia, can also be caused by the vaccine. In reality, the MMR vaccine, which is only given to children with healthy immune systems, has been overwhelmingly safe since its approval more than five decades ago, and has saved an estimated 94 million lives worldwide.
Public health experts said touting these medications as first-line treatments sends the wrong message. “By mentioning such treatments without that context, RFK Jr. continues to distract away from the prevention measure that incontrovertibly works — the vaccine,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security
A national public health organization is calling for RFK Jr. to resign citing “implicit and explicit bias and complete disregard for science.” Georges Benjamin, executive director of the American Public Health Association, said in a statement that concerns raised during Kennedy’s confirmation hearing last month have been realized, followed by massive reductions in staff at key health agencies.
What’s next? I aslk myself.
Perhaps homeopathy as a savior of the US healthcare system?
Watch this space.
Patients with headaches often seek so-called alternative medicine (SCAM), including chiropractic care. Chiropractic spinal manipulation is one of the most commonly used techniques for these patients; however, its effectiveness remains unclear. This systematic review aimed to evaluate the effectiveness of chiropractic spinal manipulation in reducing headache days, episode duration, episode intensity, and medication intake in patients with headaches.
MEDLINE (Pubmed), PEDro, SCOPUS, Cochrane Library and Web of Science databases were searched from inception to April 2024. PICO search strategy was used to identify randomized controlled trials applying chiropractic spinal manipulations versus sham manipulation, no additional intervention, or other conservative non-pharmacological interventions in patients with headaches. Eligible studies and data extraction were conducted independently by two reviewers. Quality of the studies was assessed with Physiotherapy Evidence Database scale, and risk of bias with Cochrane Collaboration tool. Certainty of the evidence was evaluated using GRADE approach.
Eight studies ranging from low to high methodological quality were included. The results were categorized into three subgroups: chiropractic manipulation versus sham, chiropractic manipulation versus control, and chiropractic manipulation versus deep friction massage. Among the five studies comparing chiropractic manipulation to sham, two found a significant reduction in the number of headache days. Of the three studies comparing chiropractic manipulation to another control, one reported a decrease in headache episode duration. No significant differences were observed for any other variable across the subgroups. The certainty of evidence was downgraded to very low.
We concluded that it is uncertain if chiropractic spinal manipulation is more effective than sham, control, or deep friction massage interventions for patients with headaches.
These conclusions might not surprise many readers. Yet, in at least one way, they are quite surprising: the version of the article we submitted to the ‘European Journal of Integrative Medicine’ had a substantially different conclusion; it was as follows:
What happened?
You may well ask!
The journal wanted us to change our conclusion! Because the main authors of our paper needed, for academic reasons, to publish without any further delay, they agreed to the demand. As far as I remember, such a thing is unprecedented in my ~50 years of publishing research in medical journals.
PS
It is also the last time I will have any dealings with the European Journal of Integrative Medicine
World Homeopathy Day is celebrated on April 10 every year. It aims at marking the importance of homeopathy and its contributions to medicine. It also honors the memory of Dr. Christian Friedrich Samuel Hahnemann — the founder of homeopathy.
Samuel Hahnemann (1755-1843) was born in Meissen, Germany. He studied medicine in Germany and Austria and received his doctorate in 1779 from the university of Erlangen. He practised as a physician but soon became disenchanted with the medicine of his time which he felt was neither effective nor safe. Eventually, he stopped practising and lived from translating medical texts. In the course of this work, he came across a remark about the action of Cinchona bark which prompted him to do experiments on himself. These experiments eventually led to the creation of homeopathy. Hahnemann’s new therapy was controversial but soon became a worldwide success. When Hahnemann was about to retire at the age of 75, he was visited by a young women from Paris. The two were soon married and Hahnemann started a new career in the French metropole where he died in 1843.
Hahnemann’s followers have suffered one defeat after the next, in recent years. More and more countries have stopped reimbursing homeopathy, and the fact that homeopathics are pure placebo has become undeniable. For some of them, this is reason to retreat into their traditional position claiming that homeopathy is, in this or that way, so special that it cannot be squeezed into the straight jacket of science. Here is a very recent article that might serve as an apt example of this notion:
Integrating homeopathy into mainstream medical practice requires a thorough understanding of how the medicine works and what it involves. However, homeopathy, a highly individualized and philosophically alternative medicine, may not be accurately captured by the existing EBM hierarchy. Despite the utility EBM may have as a systematic tool for recognizing evidence-laden treatment options, it overlooks the relevant complexities related to homeopathy. The EBM hierarchy’s narrow focus on statistical significance and empirical data may not be sufficient to capture the complexities and unique principles of homeopathic medicine. A more inclusive, unbiased, and flexible approach that values individualization, mechanistic reasoning, as well as historical and traditional evidence within homeopathy, is needed to develop a nuanced understanding of this alternative medical practice. To bridge this gap, it is crucial to develop an alternative epistemic framework that is consistent with the underlying principles of homeopathy. Such a framework should envelope a more diverse range of data such as mechanistic and experiential evidence. Collaboration between homeopathic practitioners, researchers, and experts in evidence-based methodology could help establish a more comprehensive and inclusive approach to evaluating the evidence for homeopathic treatments.
The article itself explains it as follows:
An appropriate design for assessing homeopathy would consider its unique healing philosophy, thus accurately reflecting the practice under study. To achieve this, we must assess the mechanistic underpinnings that contribute to the treatment’s effectiveness. Homeopathy’s healing philosophy emphasizes individualization and potentization. These practices rely on the practitioner’s assessment of the individual and the resulting design of the medicine prescribed. Furthermore, such a study would not conflate different homeopathic medicines; instead, it would elucidate the effectiveness of the mechanisms giving rise to homeopathy’s healing capacity. For instance, if a certain potency of Ignatia works for one individual, it may be ineffective if prescribed to another without considering their constitution. This relationship regarding the efficiency of homeopathy is backed by the treatment’s medical philosophy. Therefore, it is unfair to reject homeopathy as a medical treatment in its entirety based on a few cases of ineffectiveness, especially when the source of the ineffectiveness can’t be pinpointed.
These arguments sum up the somewhat delusional feelings of many homeopaths. These defenders of the indefensible seem to live on a different planet than the rest of us. Here on planet earth, we have many rational, fair, independent and thus reliable assessments of homeopathy – let me remind you of some of their conclusion:
• “The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available” (Russian Academy of Sciences, Russia)
• “Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.” (National Health and Medical Research Council, Australia)
• “Homeopathic remedies don’t meet the criteria of evidence-based medicine.” (Hungarian Academy of Sciences, Hungary)
• “The incorporation of anthroposophical and homeopathic products in the Swedish directive on medicinal products would run counter to several of the fundamental principles regarding medicinal products and evidence-based medicine.” (Swedish Academy of Sciences, Sweden)
• “There is no good-quality evidence that homeopathy is effective as a treatment for any health condition” (National Health Service, England)
So, on the occasion of World Homeopathy Day, rational thinkers might conclude that:
- there is a wide consensus stating that homeopathy is a placebo therapy;
- only homeopaths do not agree with this consensus;
- those homeopaths who disagree use transparently bogus arguments in defence of their trade;
- closer inspection reveals that they are, in fact, members of a cult.
This systematic review/network meta-analysis assessed whether relaxation and stress management techniques are useful in reducing blood pressure in individuals with hypertension and prehypertension. The authors retrieved all studies published in English of adults with hypertension (blood pressure ≥140/90 mm Hg) or prehypertension (blood pressure ≥120/80 mm Hg but <140/90 mm Hg). Studies were considered that compared non- pharmacological interventions used to promote relaxation or reduce stress with each other, or with a control group (eg, no intervention, waiting list, or standard care). Studies were assessed with the risk of bias 2 tool (RoB2), and those at high risk of bias were excluded from the primary analysis. The certainty of the evidence was assessed with CINeMA (Confidence in Network Meta- Analysis).
A total of 182 studies were included (166 for hypertension and 16 for prehypertension). Results from a random effects network meta-analysis showed that, at short term follow- up (≤3 months), most relaxation interventions appeared to have a beneficial effect on systolic and diastolic blood pressure for individuals with hypertension. Between study heterogeneity was moderate (τ=2.62- 4.73). Compared with a passive comparator (ie, no intervention, waiting list, or usual care), moderate reductions in systolic blood pressure were found for breathing control (mean difference −6.65 mm Hg, 95% credible interval −10.39 to −2.93), meditation (mean difference −7.71 mm Hg, −14.07 to −1.29), meditative movement (including tai chi and yoga, mean difference −9.58 mm Hg, −12.95 to −6.17), mindfulness (mean difference −9.90 mm Hg, −16.44 to −3.53), music (mean difference −6.61 mm Hg, −11.62 to −1.56), progressive muscle relaxation (mean difference −7.46 mm Hg, −12.15 to −2.96), psychotherapy (mean difference −9.83 mm Hg, −16.24 to −3.43), and multicomponent interventions (mean difference −6.78 mm Hg, −11.59 to −1.99). Reductions were also seen in diastolic blood pressure. Few studies conducted follow-up for more than three months, but effects on blood pressure seemed to lessen over time. Limited data were available for prehypertension; only two studies compared short term follow- up of relaxation therapies with a passive comparator, and the effects on systolic blood pressure were small (mean difference −3.84 mm Hg, 95% credible interval −6.25 to −1.43 for meditative movement; mean difference −0.53 mm Hg, −2.03 to 0.97 for multicomponent intervention). The certainty of the evidence was considered to be very low based on the CINeMA framework, owing to the risk of bias in the primary studies, potential publication bias, and imprecision in the effect estimates.
The authors concluded that the results of our study indicated that many relaxation interventions show promise for reducing blood pressure in the short term but the longer term effects are unclear. Future studies in this area should include adequate follow-up to establish whether the effects on blood pressure persist over time, both while the relaxation interventions are ongoing and after they have been completed. Researchers should also use rigorous study methods and reporting to minimise the risk of bias in the results. Finally, we encourage researchers to assess all relevant outcomes, including cardiovascular events and adverse events, as well as blood pressure itself.
I was asked to provide a comment on this paper for a ‘Science Media Centre Roundup’ – here is what I wrote:
“This is a rigorous and important review. Its findings are eminently plausible: just like stress would increase blood pressure, so does relaxation decrease it. The problem, as I see it, might be compliance. Stressed people tend to be chronically pressed for time, and relaxation techniques take considerably more time than simply swallowing an antihypertensive pill.”
In a recent post, I mentioned a new report which allegedly claimed that “employing chiropractors in the [English] health service could save £1.5 billion“. Thanks to ‘Blue Wode’, we can now read the original report, and I had a critical look at it. Here are some quotes of crucial passages from the report:
The objective of this analysis was to establish how chiropractors could help to address the unmet need of people with MSK [musculoskeletal] conditions, who are currently absent from work due to these conditions, on NHS MSK physiotherapy waiting lists …
To assess the available evidence on the relative effectiveness of chiropractors, physiotherapists and osteopaths a pragmatic literature review was undertaken. This consisted of a rapid, pragmatic search of existing literature evidence to explore the effectiveness of chiropractic interventions (in terms of productivity/return to work) compared with physiotherapists and/or osteopaths … The strategies were not designed to be ‘comprehensive’ but focused to target records for relevant studies whilst retrieving record numbers that were manageable within the project timescales and available resources…
The results of the analysis are based on the assumption that there are equivalent work-related outcomes associated with MSK physiotherapy and chiropractic care…
1,270 records were retrieved from the database searches and 41 records were sent by the BCA. 101 duplicates were removed, and the remaining 1,210 references were screened for inclusion. 18 studies met the eligibility criteria and were included in data extraction (see Appendix B for the study flow diagram). Included studies had the following study designs: five systematic reviews [29-32] (of which one was only a summary [33]), three non-systematic reviews [34, 35] with one running a meta analysis [36], five randomised controlled trials [37-41], three cohort studies [42-44], and two case series studies [26, 45]…
A pragmatic review of literature found that evidence of the effectiveness of chiropractors in helping people with MSK conditions to get back to work is sparse and poor quality. There is weak evidence to suggest that chiropractors treating MSK conditions would be able to achieve equivalent return-to-work outcomes as physiotherapists. If more robust evidence could be developed, it is feasible that chiropractors could be used to address supply shortages in treatment for MSK conditions. This would require the NHS to consider closely the clinical governance arrangements it would need to put in place to ensure patient safety. It would also need to review the type of treatment and advice that chiropractors were able to provide for people with MSK conditions.
The initial analysis carried out for this study estimated that there are almost 1.6 million people unable to work due to an MSK condition in the UK. Spare capacity in the chiropractic profession indicates that around 114,000 more people per year could be treated by chiropractors. This represents around 7% of the current waiting list. Chiropractors have an average waiting time of 1.5 weeks compared with a minimum of 11 weeks for physiotherapists.
If the spare chiropractor capacity was used to address MSK conditions preventing people from working, then this could improve workforce productivity by reducing the time people are waiting for treatment. Adopting a simple analysis, assuming that all of the spare capacity could be used in the most efficient way, the estimated value of the improvement in productivity is £612 million per year. Using the Markov model to factor in a wider range of potential outcomes provides a more conservative, more robust estimated value of £399 million per year. If minimum rather that median wages are used to value the productivity gain based on an 11 week wait then it would reduce to £258 million.
A range of factors may increase or decrease the potential productivity gains. If the 11-week waiting time for physiotherapists is an under-estimate and the waiting times are 18 or 24 weeks, then the productivity gain would increase to £713 million and £1 billion respectively.
This analysis focused on productivity costs only, but people may also potentially have better health outcomes and lower treatment costs if they are treated more quickly.
Recommendations
Key recommendations emerging from this research are:
- The NHS should consider commissioning pilot research studies to generate evidence to make the case for the use of chiropractors in providing treatment for people with MSK conditions to allow them to return to work more quickly.
- The NHS should consider how the potential use of chiropractors to provide treatment and advice for people with MSK conditions can help to address the demand, capacity and financial challenges facing the health and social care system. This would need to be within the constraints of clinical guidelines and governance, to ensure safety and effective outcomes.
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And here are a few critical points:
- What on earth is a “pragmatic literature review”; was the term invented to disguise tha fact that the review is not systematic and thus is a bonanza in cherry-picking? I had a look at the cited literature and can confirm that any critical assessment of chiropractic has been excluded.
- “The results of the analysis are based on the assumption that there are equivalent work-related outcomes associated with MSK physiotherapy and chiropractic care.” Are you kidding me? I thought the aim was to “assess the available evidence on the relative effectiveness of chiropractors, physiotherapists and osteopaths”. How can you then assume equivalent outcomes as a basis for conducting the research?
- “Included studies had the following study designs: five systematic reviews [29-32] (of which one was only a summary [33]), three non-systematic reviews [34, 35] with one running a meta analysis [36], five randomised controlled trials [37-41], three cohort studies [42-44], and two case series studies [26, 45].” So, just 5 RCTs are the basis of the evaluations? What did you do with the dozens of other RCTs in this area? Did they perhaps not fit your conclusions?
- “If more robust evidence could be developed, it is feasible that chiropractors could be used to address supply shortages in treatment for MSK conditions.” However, I predict that more robust evidence will show the opposite of what you seem to wish!
- “Ensure patient safety”. Yes, thanks for mentioning safety. The report neglects safety completely. In view of the known risks of chiropractic this seems a serious mistake!
- “The estimated value of the improvement in productivity is £612 million per year.” From my comments above, it follows that this wild and largely unsubstantiated estimate was guided by little more than wishful thinking.
- “This analysis focused on productivity costs only, but people may also potentially have better health outcomes and lower treatment costs if they are treated more quickly.” More likely people experience health outcomes that are very similar to those of doing nothing at all. In this case, it would follow that a lot of money might be saved if we scrap MSK treatments altogether.
This report is a transparent and dilettante attempt to push more chiropractic on the NHS, a move that would not improve much and could even put a few patients in wheelchairs.
It has been reported that a five-year-old boy died after being “incinerated” inside a pressurised oxygen chamber while undergoing alternative treatment for ADHD and sleep apnoea. Thomas Cooper was pronounced dead at the scene on Jan 31 at the Oxford Center in Detroit. The following people have been charged in connection with the boy’s death:
- The center’s founder and chief executive, Tamela Peterson, 58, was charged with second-degree murder.
- The facility’s manager Gary Marken, 65, and safety manager Gary Mosteller, 64, were charged with second-degree murder and involuntary manslaughter.
- The operator of the chamber when it exploded, Aleta Moffitt, 60, was charged with involuntary manslaughter and intentionally placing false medical information on a medical records chart.
The boy was undergoing hyperbaric oxygen therapy, which involves breathing pure oxygen in a pressurised chamber.
A hyperbaric chamber at the Oxford Center Credit: David Guralnic
“A single spark it appears ignited into a fully involved fire that claimed Thomas’s life within seconds,” Dana Nessel, Michigan’s Attorney General, explained. “Fires inside a hyperbaric chamber are considered a terminal event. Every such fire is almost certainly fatal and this is why many procedures and essential safety practices have been developed to keep a fire from ever occurring,” she added.
Thomas had been undergoing unapproved treatment for ADHD and sleep apnoea
Ms Nessel accused those charged of putting children’s bodies at risk through unaccredited and debunked treatments for profit. Raymond Cassar, the attorney for centre manager Mr Marken, said the second-degree murder charge comes as “a total shock”. “This was a tragic accident and our thoughts and our prayers go out to the family of this little boy. “I want to remind everyone that this was an accident, not an intentional act. We’re going to have to leave this up to the experts to find out what was the cause of this.”
Ms Nessel said. “The Oxford Center routinely operated sensitive and lethally dangerous hyperbaric chambers beyond their expected service lifetime and in complete disregard of vital safety measures and practices considered essential by medical and technical professionals.”
The fact that animal parts are used for so-called alternative medicine (SCAM) is well-known. The problem has so far been related mostly to China and TCM. A recent article reminds us of the fact that the abuse of animals for SCAM is also an African issue:
The use of animals for zootherapeutic purposes has been reported worldwide, and with the patronage of complementary and alternative medicines being on the ascendency, the trade and use of animal parts will only escalate. Many more of these animals used in traditional medicine will be pushed to extinction if policies for their sustainable use and conservation are not formulated. There have been studies across the world which assessed the trade and use of animals in traditional medicine including Ghana. However, all previous Ghanaian studies were conducted in a few specific cities. It therefore makes it imperative for a nationwide study which would provide more comprehensive information on the trade and use of animals in traditional medicine and its conservation implications. Using direct observation and semi-structured questionnaires, data were collected from 133 vendors of animal parts used in traditional medicines in 48 markets located across all 16 administrative regions of Ghana. Analysis of the data showed that the trade in wild animal parts for traditional medicine was more prevalent in the urban centres of Ghana. Overall, 75 identifiable animal species were traded on Ghanaian traditional medicine markets. Using their relative frequency of citation values, chameleons (Chamaeleo spp.; 0.81), lions (Panthera leo; 0.81) and the West African crocodile (Crocodylus suchus; 0.67) were the most commonly traded animals in Ghana. Majority of the vendors (59.1%) indicated that their clients use the animal parts for medicinal purposes mainly for skin diseases, epilepsy and fractures, while clients of 28.2% of the vendors use the animal parts for spiritual or mystical purposes, such as protection against spiritual attacks, spiritual healing and money rituals. Up to 54.2% of the animals were classified as Least Concern by IUCN, 14.7% were threatened, with 51.2% of CITES-listed ones experiencing a decreasing population trend. This study also found that 68.5% of the traded animal species are not listed on CITES, but among those listed, 69.6% are classified under Appendix II. Considering the level of representation of animals of conservation concerns, the harvesting and trade of animal parts for traditional medicine must be regulated. This call is even more urgent since 40.0% of the top ten traded animals are mammals; a class of animals with long gestation periods and are not prolific breeders.
The authors concluded that the trade of animal parts and products for traditional medicine in Ghana is widespread, especially in market centres in the urban area. These animals are used mainly for medicinal purposes, especially skin diseases, but their use for mystical purposes is also prevalent. Again, with the topmost traded animals being those in CITES Appendices I and II, means there is some laxity in the enforcement of laws that are to ensure sustainable use of animal resources. Although a majority of animals traded for traditional medicine may not be currently of conservation concern and not listed under CITES, policymakers and other stakeholders in Ghana and beyond would have to start working on ensuring the survival of the threatened ones and prevent the sliding of the non-threatened species into extinction so the biodiversity will be conserved for the use of the future generation.
All I want to add here is the fact that there is not a shred of evidence that animal parts in SCAM have any positive health effects. It is high time that this barbaric and useless trade stops!
This “randomized controlled clinical trial” (has anyone ever seen a randomized trial without a control group? – No, therefore, the correct term is “ramdomized clinical trial (RCT)”) aimed to compare the effectiveness of wet cupping therapy (WCT) and Acupuncture in treating migraine patients. It was conducted between 01.03.2022 and 01.10.2023 in a Traditional and Complementary Medicine Center of a tertiary hospital. Patients diagnosed with migraine were included in the study and randomized into three groups.
- The WCT group received wet cupping 3 times, once a month.
- The acupuncture group received 10 sessions of acupuncture once a week.
- The waiting list group served as the control group.
VAS and MIDAS scales were used for all groups at the beginning and the end of the treatment, and the results were compared.
Initially, 168 patients were enrolled. However, there were some dropouts throughout the study period. In the acupuncture group, 11 patients did not attend subsequent sessions, with one dropout occurring due to adverse effects. In the wet cupping (WCT) group, three patients discontinued their participation following the initial treatment. Ultimately, a total of 153 patients were included.
The findings show that all three groups were similar regarding age and sex. Migraine Disability Assessment Scale (MIDAS) and Visual Analogue Scale (VAS) pain scores decreased significantly in both treatment groups after the applications, while they remained similar for the same period in the control group. Additionally, the post-treatment values of MIDAS and VAS in both the WCT and acupuncture groups were significantly lower compared to controls, while they were similar when compared in between.
The authors concluded that both of these applications were found to be similarly effective in improving disability status and pain intensity in patients with migraine.
I beg to differ!
Apart from all other flaws of this trial, it did not control for placebo effects. Both WCT and acupuncture are invasive treatments that are bound to cause sizeable placebo responses. The waiting list control might account for the natural history of the disease and for regression towards the mean, but it is not a method for allowing for placebo effects. In view of this fundamental limitation of the study, its conclusions should be re-written as follows:
Both of these applications were similarly effective in producing sizeable placebo effects which in turn improved disability status and pain intensity in patients with migraine.
For migraine patients, this means that neither of these therapies are likely to be the best available option.
