fraud
The orgone accumulator (ORAC) is an invention of the psychiatrist Wilhelm Reich which he developed along with his ‘orgone hypothesis’ while residing in the US from 1939 on. It is a device that is used to collect the hypothetical ‘orgone energy’ from the environment and to concentrate it.
One provider of the ORAC claims he had received the exact building instructions in interviews with Wilhelm Reich. The conversation with the deceased Reich was allegedly realized with the assistance of a medium and in close cooperation with angels. Since his death, Reich allegedly has been able to vastly improve the ORAC. The correct arrangement of eight rose quartzes in every corner is said to be essential. The book “Der Engel-Energie-Akkumulator nach Wilhelm Reich” (The Angel-Energy-Accumulator by Wilhelm Reich) does not only quote the late Reich, but also Archangel Raphael and Jesus Christ have their say.
Wilhelm Reich developed the ORAC believing that the box trapped orgone energy that he could harness in groundbreaking approaches towards psychiatry, medicine, the social sciences, biology, and weather research. His discovery of orgone began with his research of a physical bio-energy basis for Sigmund Freud’s theories of neurosis in humans. Wilhelm Reich believed that traumatic experiences blocked the natural flow of life energy in the body, leading to physical and mental disease. Reich concluded that the Freudian libidinal energy was the primordial energy of life itself, connected to more than just sexuality. Orgone was everywhere and Reich measured this energy in motion over the surface of the earth and even determined that its motion affected weather formation.
In 1940, Wilhelm Reich constructed the first ORAC: a six-sided box constructed of alternating layers of organic materials (to attract the energy) and metallic materials (to radiate the energy toward the center of the box). Patients would sit inside the ORAC and absorb the energy through their skin and lungs. The accumulator allegedly had beneficial effects on blood and body tissue by improving life-energy flow and releasing energy blocks.
But Reich’s work with cancer patients and the ORAC received negative press and the Federal Drug Administration (FDA) sent an agent to investigate Reich’s research center. In 1954, the FDA issued an injunction against Reich, claiming that he had violated the Food, Drug, and Cosmetic Act by delivering misbranded and adulterated devices in interstate commerce and by making false and misleading claims. The FDA called the ORAC a sham and orgone energy non-existent. A judge ordered all accumulators rented or owned by Reich and those working with him destroyed and all labeling referring to orgone energy to be destroyed. Two years later, Reich was imprisoned for contempt of the injunction. On November 3, 1957, Wilhelm Reich died in his jail cell of heart failure. In his last will and testament, he ordered that his works be sealed for fifty years, in hopes that the world would someday be a place better to accept his work.
The FBI does have a whole section on its website dedicated to Wilhelm Reich. This is what they had to say:
This German immigrant described himself as the Associate Professor of Medical Psychology, Director of the Orgone Institute, President and research physician of the Wilhelm Reich Foundation, and discoverer of biological or life energy. A 1940 security investigation was begun to determine the extent of Reich’s communist commitments. In 1947, a security investigation concluded that neither the Orgone Project nor any of its staff were engaged in subversive activities or were in violation of any statue within the jurisdiction of the FBI. In 1954 the U.S. Attorney General filed a complaint seeking permanent injunction to prevent interstate shipment of devices and literature distributed by Dr. Reich’s group. That same year, Dr. Reich was arrested for a Contempt of Court for violation of the Attorney General’s injunction.
The Wilhelm Reich Orgon Institut Deutschland currently state that they have been able to teach some Americans the proper way to build an ORAC:
Our teacher has been Dr. Walter Hoppe, the best student of Wilhelm Reich. He had lived over 40 years in Israel, and had done there very successful work with the orgone accumulator. Since 1974 he has been teaching psychiatric orgone therapy and the construction of the orgone accumulator in Germany.
So the triumphal procession of this model was starting up there. Dr. Hoppe gave the construction of the accumulator in the hands of Joachim Trettin. He said: orgone therapy is for few people while the orgone accumulator is for everybody. Meanwhile the Americans orientate themselves by this model today. So this accumulator is the best you can get.
We produce this accumulator with 5, 7, 10, 15 and 20 double layers. Every accumulator has a autonomous shooter which you can take out and use separately.
We also offer the accumulator with a breast and pelvis shield. We have a special packaging and ship our accumulator to every part of the world.
The orgone accumulator with 20- double layers, inside dimensions 120 x 70 x 55 cm, is available for the price of 7,250 EUR
Quackery is rife in India. On this blog, I have occasionally reported on this situation, e.g.:
- The new ‘WHO Global Centre for Traditional Medicine’ in India
- Mucormycosis (black fungus): is the Indian AYUSH ministry trying to decimate the population?
- Homeopathy, COVID, India and Prince Charles: not a good mixture!
- Has homeopathy caused the dramatic decline of COVID-19 cases in India?
- Homeopathy research from India is far from trustworthy, and today I can show you why
- Brazil and India collaborate in the promotion of quackery
- Taking the piss again? The story of urine therapy in India
- The intriguing case of homeopathy in India
- Prince Charles’ advocacy of quackery is by no means harmless
- Patient Dies After Homeopath Gives Wrong Injection
- Herbal remedies are good for you … except for the ones that injure your liver
- The ‘AYUSH COVID-19 Helpline’: have they gone bonkers?
Now the Chief Justice of India (CJI) NV Ramana has pointed out that legislation needs to be brought in to save people “from falling prey to fraudulent practices in the name of treatment”. Speaking at the inaugural National Academy of Medical Sciences on ‘Law and Medicine’, the CJI said: “Quackery is the biggest disease affecting India” and that hospitals are “being run like companies, where profit-making is more important than service to society”. The CJI added, “another side of lack of accessible healthcare is giving space to quacks. Quackery begins where awareness ends. Where there is room for myths, there is room for quackery”. He continued, “Owing to the financial and time constraints, a huge majority of the Indian population approaches these untrained and uncertified doctors. Lack of awareness and knowledge, misplaced belief, and sheer inaccessibility have massive ramifications on the health of the country, particularly the rural and underprivileged Indian … The need of the hour is to bring in legislation to save people from falling prey to fraudulent practices in the name of treatment … Private hospitals are being opened at an exponential rate. This is not necessarily a bad thing, but there is a glaring need for balance. We are seeing hospitals being run like companies, where profit-making is more important than service to society.”
I am sure the CJI is correct; India does have a quackery problem. If nothing else, the fact that one website lists a total of 746 Alternative Medicine Colleges in India, leaves little doubt about it.
It has been reported that America’s Frontline Doctors (a right-wing organization that is associated with the ‘Tea Party’) is suing one of its founders in a battle for control over the controversial group, which gained national notoriety for spreading misinformation about COVID-19 treatments and vaccines during the pandemic.
The organization and its current board chairman have sued Simone Gold, MD, alleging that she misused the nonprofit organization’s funds to buy a $3.6 million Florida mansion, purchase a Mercedes-Benz and other luxury vehicles, and take trips on private planes.
The lawsuit, filed November 4 in federal court, comes just months after Gold was released from prison for her role in the January 6 US Capitol insurrection. Gold pleaded guilty to trespassing in the Capitol and was sentenced to 60 days in federal prison.
The group and the board chairman, Joseph Gilbert, claim that after her release from prison, Gold attempted to reassert control of the group, take over its website, and fraudulently represent herself as its director, according to the complaint. The complaint referred to Gold as a “rogue founder,” alleging that she spent almost $50,000 monthly on personal expenses using the organization’s credit cards.
Gold resigned from the group’s board in February ― before she pled guilty ― so that she could pursue her goal of opening health and wellness centers nationwide, according to the complaint. At that time, the board voted Gilbert to be its chairman and agreed to have Gilbert negotiate an agreement for Gold to serve as a consultant. Gold sought a “signing bonus” of $1.5 million, along with $50,000 to be paid monthly as a consulting fee, according to the complaint.
Another report has more details on Gold’s alleged wrong-doing: The complaint claims that in November 2021, Gold used “AFLDS charitable funds to purchase a $3.6 million home in Naples, Florida for her personal rent-free use, and at least three vehicles and has otherwise used AFLDS funds to resource her personal lifestyle and expenses since she formed AFLDS.” Plaintiffs also allege that Gold “currently lives in this home with John Strand, rent free.” Strand is a former underwear model and boyfriend of Gold’s who was arrested with her in connection with the January 6, 2021 insurrection in the U.S. Capitol. She moved with Strand to Florida this year from Los Angeles, where she had been an emergency room physician. Strand allegedly was paid $10,000 per month as an AFLDS employee and allegedly spent $15,000 to $17,000 a month using those credit cards. He was terminated from AFLDS in summer 2022, according to the complaint. In addition to purchasing the house with AFLDS funds, the complaint said Gold purchased a Mercedes Benz Sprinter van, a Hyundai Genesis, and a GMC Denali. After taking possession of the Naples home, she used AFLDS funds to pay a personal security officer $12,000, a personal housekeeper $5,600 a month, and charged “nearly $50,000 per month” to AFLDS credit cards.
I tried to find some information on th health and wellness centers that Simone Gold wanted or did open. Alas I was unsuccessful in my endeavor. However, I found an interesting passage she once wrote:
The World Health Organization, the FDA, the NIH, and the CDC are proven liars who have lost all credibility and common-sense, while jeopardizing YOUR health and safety. What disgusts me most is how their failed prescriptions have exposed the most vulnerable: our elderly and our children. The New York Times, CNN, NPR, and hundreds of other news outlets have censored the truth in order to preserve their power. Twitter, Facebook, Google/YouTube, Apple, and dozens of other Tech companies are throttling down content, suppressing information, and de-platforming those with whom they disagree.
I find it hard to find words for a comment – except perhaps this: maybe it is not such a bad thing when anti-vaxxers fight each other; it means they have less time, energy, and money to confuse the public with their lies.
Guest post by Norbert Aust and Viktor Weisshäupl
Readers of this blog may remember the recent study of Frass et al. about the adjunct homeopathic treatment of patients suffering from non-small cell lung cancer (here). It was published in 2020 by the ‘Oncologist’, a respectable journal, and came to stunning results about to the effectiveness of homeopathy.
In our analysis, however, we found strong indications for duplicity: important study parameters like exclusion criteria or observation time were modified post hoc, and data showed characteristics that occur when unwanted data sets get removed.
We, that is the German Informationsnetzwerk Homöopathie and the Austrian ‘Initiative für wissenschaftliche Medizin’, had informed the Medical University Vienna about our findings – and the research director then asked the Austrian Agency for Scientific Integrity (OeAWI) to review the paper. The analysis took some time and included not only the paper and publicly available information but also the original data. In the end, OeAWI corroborated our findings: The results are not based on sound research but on modified or falsified data.
Here is their conclusion in full:
The committee concludes that there are numerous breaches of scientific integrity in the Study, as reported in the Publication. Several of the results can only be explained by data manipulation or falsification. The Publication is not a fair representation of the Study. The committee cannot for all the findings attribute the wrongdoings and incorrect representation to a single individual. However following our experience it is highly unlikely that the principal investigator and lead author, but also the co-authors were unaware of the discrepancies between the protocols and the Publication, for which they bear responsibility. (original English wording)
Profil, the leading news magazine of Austria reported in its issue of October 24, 2022, pp 58-61 (in German). There the lead author, Prof. M. Frass, a member of Edzard’s alternative medicine hall of fame, was asked for his comments. Here is his concluding statement:
All the allegations are known to us and completely incomprehensible, we can refute all of them. Our work was performed observing all scientific standards. The allegation of breaching scientific integrity is completely unwarranted. To us, it is evident that not all documents were included in the analysis of our study. Therefore we requested insight into the records to learn about the basis for the final statement.
(Die Vorwürfe sind uns alle bekannt und absolut unverständlich, alle können wir entkräften. Unsere Arbeit wurde unter Einhaltung aller wissenschaftlichen Standards durchgeführt. Der Vorhalt von Verstößen gegen die wissenschaftliche Intergrität enbehrt jeder Grundlage. Für uns zeigt sich offenkundig, dass bei der Begutachtung unserer Studie nicht alle Unterlagen miteinbezogen wurden. Aus diesem Grunde haben wir um Akteneinsicht gebeten, um die Grundlagen für das Final Statment kennenzulernen.)
The OeAWI together with the Medical University Vienna asked the ‘Oncologist’ for a retraction of this paper – which has not occurred as yet.
Here in the UK, we are looking yet again for a new Prime Minister (PM). Did I say ‘we’? That’s not quite true; the Tory party is hunting for one, and it seems a difficult task for the talent-depleted conservatives. Eventually, the geriatric group of Tory members might again have the say. Amazingly, some senior Tories are already suggesting Boris Johnson (BJ).
To me, this demonstrates how common cognitive decline and memory loss seem to be among the elderly. They evidently have already forgotten that, only a few months ago, BJ has already been our PM.
Yes, it is often the short-term memory that suffers first!
It might, therefore, help to remind the Tory membership thus affected that BJ:
- was elected as PM in 2019,
- he then created scandal after scandal,
- he was even found guilty of breaking the law,
- he is still under investigation for misleading the Parliament,
- eventually, in 2022, he was removed from office after mishandling a sexual abuse scandal.
I hope this helps to refresh your memory, Tory members suffering from cognitive decline. Considering this blog is about so-called alternative medicine (SCAM), I should perhaps also offer you some treatments for the often progressive deterioration of mental capacity. Here is a recent paper that might point you in the right direction:
Senile ages of human life is mostly associated with developmental of several neurological complicated conditions including decreased cognition and reasoning, increased memory loss and impaired language performance. Alzheimer’s disease (AD) is the most prevalent neural disorder associated with dementia, consisting of about 70% of dementia reported cases. Failure of currently approved chemical anti-AD therapeutic agents has once again brought up the idea of administering naturally occurring compounds as effective alternative and/or complementary regimens in AD treatment. Polyphenol structured neuroprotecting agents are group of biologically active compounds abundantly found in plants with significant protecting effects against neural injuries and degeneration. As a subclass of this family, Flavonoids are potent anti-oxidant, anti-inflammatory and signalling pathways modulatory agents. Phosphatidylinositol 3-kinase (PI3K)/AKT and mitogen activated protein kinase (MAPK) pathways are both affected by Flavonoids. Regulation of pro-survival transcription factors and induction of specific genes expression in hippocampus are other important anti AD therapeutic activities of Flavonoids. These agents are also capable of inhibiting specific enzymes involved in phosphorylation of tau proteins including β-secretases, cyclin dependent kinase 5 and glycogen synthase. Other significant anti AD effects of Flavonoids include neural rehabilitation and lost cognitive performance recovery. In this review, first we briefly describe the pathophysiology and important pathways involved in pathology of AD and then describe the most important mechanisms through which Flavonoids demonstrate their significant neuroprotective effects in AD therapy.
Sorry, I forgot that this might be a bit too complex for semi-senile Tories. Put simply, this means consuming plenty of:
- berries,
- apples,
- garlic,
- onion,
- green tea,
- beans (beware flatulence in Parliament!)
In addition, I might advise you to stay off the Port, get enough rest, avoid stress of any type, and do plenty of aerobic exercise. And please:
- not too much excitement,
- stimulate your brain (this means avoid reading right-wing papers),
- no major scandals,
- no further deterioration of moral standards,
- no more lies,
- no more broken promises!
In other words, no vote for BJ!!!
Yesterday, L’EXPRESS published an interview with me. It was introduced with these words (my translation):
Professor emeritus at the University of Exeter in the United Kingdom, Edzard Ernst is certainly the best connoisseur of unconventional healing practices. For 25 years, he has been sifting through the scientific evaluation of these so-called “alternative” medicines. With a single goal: to provide an objective view, based on solid evidence, of the reality of the benefits and risks of these therapies. While this former homeopathic doctor initially thought he was bringing them a certain legitimacy, he has become one of their most enlightened critics. It is notable as a result of his work that the British health system, the NHS, gave up covering homeopathy. Since then, he has never ceased to alert us to the abuses and lies associated with these practices. For L’Express, he looks back at the challenges of regulating this vast sector and deciphers the main concepts put forward by “wellness” professionals – holism, detox, prevention, strengthening the immune system, etc.
The interview itself is quite extraordinary, in my view. While UK, US, and German journalists usually are at pains to tone down my often outspoken answers, the French journalists (there were two doing the interview with me) did nothing of the sort. This starts with the title of the piece: “Homeopathy is implausible but energy healing takes the biscuit”.
The overall result is one of the most outspoken interviews of my entire career. Let me offer you a few examples (again my translation):
Why are you so critical of celebrities like Gwyneth Paltrow who promote these wellness methods?
Sadly, we have gone from evidence-based medicine to celebrity-based medicine. A celebrity without any medical background becomes infatuated with a certain method. They popularize this form of treatment, very often making money from it. The best example of this is Prince Charles, sorry Charles III, who spent forty years of his life promoting very strange things under the guise of defending alternative medicine. He even tried to market a “detox” tincture, based on artichoke and dandelion, which was quickly withdrawn from the market.
How to regulate this sector of wellness and alternative medicines? Today, anyone can present himself as a naturopath or yoga teacher…
Each country has its own regulation, or rather its own lack of regulation. In Germany, for instance, we have the “Heilpraktikter”. Anyone can get this paramedical status, you just have to pass an exam showing that you are not a danger to the public. You can retake this exam as often as you want. Even the dumbest will eventually pass. But these practitioners have an incredible amount of freedom, they even may give infusions and injections. So there is a two-tier health care system, with university-trained doctors and these practitioners.
In France, you have non-medical practitioners who are fighting for recognition. Osteopaths are a good example. They are not officially recognized as a health profession. Many schools have popped up to train them, promising a good income to their students, but today there are too many osteopaths compared to the demand of the patients (knowing that nobody really needs an osteopath to begin with…). Naturopaths are in the same situation.
In Great Britain, osteopaths and chiropractors are regulated by statute. There is even a Royal College dedicated to chiropractic. It’s a bit like having a Royal College for hairdressers! It’s stupid, but we have that. We also have professionals like naturopaths, acupuncturists, or herbalists who have an intermediate status. So it’s a very complex area, depending on the state. It is high time to have more uniform regulations in Europe.
But what would adequate regulation look like?
From my point of view, if you really regulate a profession like homeopaths, it means that these professionals may only practice according to the best scientific evidence available. Which, in practice, means that a homeopath cannot practice homeopathy. This is why these practitioners have a schizophrenic attitude toward regulation. On the one hand, they would like to be recognized to gain credibility. But on the other hand, they know very well that a real regulation would mean that they would have to close shop…
What about the side effects of these practices?
If you ask an alternative practitioner about the risks involved, he or she will take exception. The problem is that there is no system in alternative medicine to monitor side effects and risks. However, there have been cases where chiropractors or acupuncturists have killed people. These cases end up in court, but not in the medical literature. The acupuncturists have no problem saying that a hundred deaths due to acupuncture – a figure that can be found in the scientific literature – is negligible compared to the millions of treatments performed every day in this discipline. But this is only the tip of the iceberg. There are many cases that are not published and therefore not included in the data, because there is no real surveillance system for these disciplines.
Do you see a connection between the wellness sector and conspiracy theories? In the US, we saw that Qanon was thriving in the yoga sector, for example…
Several studies have confirmed these links: people who adhere to conspiracy theories also tend to turn to alternative medicine. If you think about it, alternative medicine is itself a conspiracy theory. It is the idea that conventional medicine, in the name of pharmaceutical interests, in particular, wants to suppress certain treatments, which can therefore only exist in an alternative world. But in reality, the pharmaceutical industry is only too eager to take advantage of this craze for alternative products and well-being. Similarly, universities, hospitals, and other health organizations are all too willing to open their doors to these disciplines, despite the lack of evidence of their effectiveness.
The objective of this study was to evaluate the effect of acupuncture on cognitive task performance in college students.
Sixty students aged 18-25 years were randomly allocated into acupuncture group (AG) (n=30) and control group (CG) (n=30). The AG underwent 20 min of acupuncture/day, while the CG underwent their normal routine for 10 days. Assessments were performed before and after the intervention.
Between-group analysis showed a significant increase in AG’s six-letter cancellation test (SLCT) score compared with CG. Within-group analysis showed a significant increase in the scores of all tests (i.e. SLCT, forward and backward Digit span test [DST]) in AG, while a significant increase in backward DST was observed in CG.
The authors concluded that acupuncture has a beneficial effect on improving the cognitive function of college students.
I am unable to access the full paper [it is behind a paywall]. Thus, I am unable to assess the study in further detail. As I am skeptical about the validity of the effect, I can only assume that it is due to the expectation of the volunteers receiving acupuncture. There was not even an attempt to control for placebo effects!
The over-stated conclusion made me wonder what else the 1st author has published. It turns out he has three more Medline-listed papers to his name all of which are about so-called alternative medicine (SCAM).
The 1st one is an RCT similar to the one above, i.e. without an attempt to control for placebo effects. Its conclusion is equally over-stated: Acupuncture could be considered as an effective treatment modality for the management of primary dysmenorrhea.
The other two papers refer to one case report each. Despite the fact that case reports (as any researcher must know) do not lend themselves to conclusions about the effectiveness of the treatments employed, the authors’ conclusions seem to again over-state the case:
- This suggests that integrative Naturopathy and Yoga therapies could be considered as an adjuvant to conventional medicine in rheumatoid arthritis associated with type-2 diabetes and essential hypertension.
- Though the results are encouraging, further studies are required with larger sample size and advanced inflammatory markers.
What does that tell us?
I don’t know about you, but I would not rely on acupuncture to improve my mental performance.
Advocates of so-called alternative medicine (SCAM) often sound like a broken record to me. They bring up the same ‘arguments’ over and over again, no matter whether they happen to be defending acupuncture, energy healing, homeopathy, or any other form of SCAM. Here are some of the most popular of these generic ‘arguments’:
1. It helped me
The supporters of SCAM regularly cite their own good experiences with their particular form of treatment and think that this is proof enough. However, they forget that any symptomatic improvement they may have felt can be the result of several factors that are unrelated to the SCAM in question. To mention just a few:
- Placebo
- Regression towards the mean
- Natural history of the disease
2. My SCAM is without risk
Since homeopathic remedies, for instance, are highly diluted, it makes sense to assume that they cannot cause side effects. Several other forms of SCAM are equally unlikely to cause adverse effects. So, the notion is seemingly correct. However, this ‘argument’ ignores the fact that it is not the therapy itself that can pose a risk, but the SCAM practitioner. For example, it is well documented – and, on this blog, we have discussed it often – that many of them advise against vaccination, which can undoubtedly cause serious harm.
3. SCAM has stood the test of time
It is true that many SCAMs have survived for hundreds or even thousands of years. It is also true that millions still use it even today. This, according to enthusiasts, is sufficient proof of SCAM’s efficacy. But they forget that many therapies have survived for centuries, only to be proved useless in the end. Just think of bloodletting or mercury preparations from past times.
4 The evidence is not nearly as negative as skeptics pretend
Yes, there are plenty of positive studies on some SCAMs This is not surprising. Firstly, from a purely statistical point of view, if we have, for instance, 1 000 studies of a particular SCAM, it is to be expected that, at the 5% level of statistical significance, about 50 of them will produce a significantly positive result. Secondly, this number becomes considerably larger if we factor in the fact that most of the studies are methodologically poor and were conducted by SCAM enthusiasts with a corresponding bias (see my ALTERNATIVE MEDICINE HALL OF FAME on this blog). However, if we base our judgment on the totality of the most robust studies, the bottom line is almost invariably that there is no overall convincingly positive result.
5. The pharmaceutical industry is suppressing SCAM
SCAM is said to be so amazingly effective that the pharmaceutical industry would simply go bust if this fact became common knowledge. Therefore Big Pharma is using its considerable resources to destroy SCAM. This argument is fallacious because:
- there is no evidence to support it,
- far from opposing SCAM, the pharmaceutical industry is heavily involved in SCAM (for example, by manufacturing homeopathic remedies, dietary supplements, etc.)
6 SCAM could save a lot of money
It is true that SCAMs are on average much cheaper than conventional medicines. However, one must also bear in mind that price alone can never be the decisive factor. We also need to consider other issues such as the risk/benefit balance. And a reduction in healthcare costs can never be achieved by ineffective therapies. Without effectiveness, there can be no cost-effectiveness.
7 Many conventional medicines are also not evidence-based
Sure, there are some treatments in conventional medicine that are not solidly supported by evidence. So why do we insist on solid evidence for SCAM? The answer is simple: in all areas of healthcare, intensive work is going on aimed at filling the gaps and improving the situation. As soon as a significant deficit is identified, studies are initiated to establish a reliable basis. Depending on the results, appropriate measures are eventually taken. In the case of negative findings, the appropriate measure is to exclude treatments from routine healthcare, regardless of whether the treatment in question is conventional or alternative. In other words, this is work in progress. SCAM enthusiasts should ask themselves how many treatments they have discarded so far. The answer, I think, is zero.
8 SCAM cannot be forced into the straitjacket of a clinical trial
This ‘argument’ surprisingly popular. It supposes that SCAM is so individualized, holistic, subtle, etc., that it defies science. The ‘argument’ is false, and SCAM advocates know it, not least because they regularly and enthusiastically cite those scientific papers that seemingly support their pet therapy.
9 SCAM is holistic
This may or may not be true, but the claim of holism is not a monopoly of SCAM. All good medicine is holistic, and in order to care for our patients holistically, we certainly do not need SCAM.
1o SCAM complements conventional medicine
This argument might be true: SCAM is often used as an adjunct to conventional treatments. Yet, there is no good reason why a complementary treatment should not be shown to be worth the effort and expense to add it to another therapy. If, for instance, you pay for an upgrade on a flight, you also want to make sure that it is worth the extra expenditure.
11 In Switzerland it works, too
That’s right, in Switzerland, a small range of SCAMs was included in basic health care by referendum. However, it has been reported that the consequences of this decision are far from positive. It brought no discernible benefit and only caused very considerable costs.
I am sure there are many more such ‘arguments’. Feel free to post your favorites!
My point here is this:
the ‘arguments’ used in defense of SCAM are not truly arguments; they are fallacies, misunderstandings, and sometimes even outright lies.
This randomized clinical trial (RCT) tested whether acupuncture is effective for the prevention of chronic tension-type headaches (CTTH). The researchers recruited 218 participants who were diagnosed with CTTH.
- The participants in the intervention group received 20 sessions of true acupuncture (TA group) over 8 weeks. The acupuncture treatments were standardized across participants, and each acupuncture site was needled to achieve deqi sensation. Each treatment session lasted 30 minutes.
- The participants in the control group received the same sessions and treatment frequency of superficial acupuncture (SA group)—defined as a type of sham control by avoiding deqi sensation at each acupuncture site.
The main outcome measure was the responder rate at 16 weeks after randomization. Followed-up was 32 weeks. A responder was defined as a participant who reported at least a 50% reduction in the monthly number of headache days (MHDs).
The responder rate was 68.2% in the TA group (n=110) versus 48.1% in the SA group (n=108) at week 16 (odds ratio, 2.65; 95%CI, 1.5 to 4.77; p<0.001); and 68.2% in the TA group versus 50% in the SA group at week 32 (odds ratio, 2.4; 95%CI, 1.36 to 4.3; p<0.001). The reduction in MHDs was 13.1±9.8 days in the TA group versus 8.8±9.6 days in the SA group at week 16 (mean difference, 4.3 days; 95%CI, 2.0 to 6.5; p<0.001), and the reduction was 14±10.5 days in the TA group versus 9.5±9.3 days in the SA group at week 32 (mean difference, 4.5 days; 95%CI, 2.1 to 6.8; p<0.001). Four mild adverse events were reported; three in the TA group versus one in the SA group.
The authors concluded that the 8-week TA treatment was effective for the prophylaxis of CTTH. Further studies might focus on the cost-effectiveness of the treatment.
“Our study showed that deqi sensation could enhance the effect of acupuncture in the treatment of chronic TTH, and the effect of acupuncture lasted at least 6 months when the treatment was stopped,” said co-investigator Ying Li, MD, PhD, The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Why am I not convinced?
Assuming that all the findings are correctly reported, the study does not at all show that the treatment was effective. It merely demonstrates that those patients who knew that were receiving TA told the researcher that they improved more than those who knew they has sham acupuncture. The difference in outcomes is not in the least surprising: patients’ knowledge of having had the verum leads to a placebo effect and to social desirability (patients giving the researchers positive responses simply because they were thankful for being looked after). Patients’ knowledge of having had the sham treatment leads to disappointment and thus worse outcomes.
But this is not the only reason why I am skeptical about this study. The authors claim they achieved deqi at every treatment. That is 20 treatments in 110 patients or 2 200 deqis! I think someone might be telling porkies here. Deqi cannot reliably be elicited on every single occasion. I, therefore, feel that perhaps the authors of this trial were a bit more than generous when writing up their study, and I am reminded of the recent report claiming that more than 80% of clinical trial data from China are fabricated.
If you go on Twitter you will find that chiropractors are keen like mustard to promote the idea that, after a car accident, you should consult a chiropractor. Here is just one Tweet that might stand for hundreds, perhaps even thousands:
Recovering from a car accident? If you have accident-related injuries such as whiplash, chiropractic care may provide relief. Treatments like spinal manipulation and soft tissue therapy can aid in your recovery.
In case you don’t like Twitter, you could also go on the Internet where you find hundreds of websites that promote the same idea. Here are just two examples:
There is no question, chiropractors earn much of their living by treating patients suffering from whiplash (neck injury caused by sudden back and forth movement of the neck often causing neck pain and stiffness, shoulder pain, and headache) after a car accident with spinal manipulation.
Why?
There are two not mutually exclusive possibilities:
- They think it is effective.
- It brings in good money.
I have no doubt about the latter notion, yet I think we should question the first. Is there really good evidence that chiropractic manipulations are effective for whiplash?
When I was head of the PMR department at the University of Vienna, treating whiplash was my team’s daily bread. At the time, our strategy was to treat each patient according to the whiplash stage and to his/her individual signs and symptoms. Manipulations were generally considered to be contra-indicated. But that was about 30 years ago. Perhaps the evidence has now changed. Perhaps manipulation therapy has been shown to be effective for certain types of whiplash injuries?
To find out, I did a few Medline searches. These did, however, not locate compelling evidence for spinal manipulation as a treatment of any stage of whiplash injuries. Here is an example of the evidence I found:
In 2008, the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force) found limited evidence on the effectiveness of manual therapies, passive physical modalities, or acupuncture for the management of whiplash-associated disorders (WAD) or neck pain and associated disorders (NAD). This review aimed to update the findings of the Neck Pain Task Force, which examined the effectiveness of manual therapies, passive physical modalities, and acupuncture for the management of WAD or NAD. Its findings show the following: Evidence from 15 evaluation studies suggests that for recent neck pain and associated disorders grades I-II, cervical and thoracic manipulation provides no additional benefit to high-dose supervised exercises.
But this is most puzzling!
Why do chiropractors promote their manipulations for whiplash, if there is no compelling evidence that it does more good than harm? Again, there are two possibilities:
- They erroneously believe it to be effective.
- They don’t care but are in it purely for the money.
Whatever it is – and obviously not all chiropractors would have the same reason – I must point out that, in both cases, they behave unethically. Not being informed about the evidence related to the interventions used clearly violates healthcare ethics, and so does financially not informing and exploiting patients.
