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

medical ethics

As mentioned before, the US ‘Agency for Healthcare Research and Quality (AHRQ) have published a most comprehensive review update entitled ‘Noninvasive Nonpharmacological Treatment for Chronic Pain‘. It followed the AHRQ Methods Guide for Effectiveness and Comparative Effectiveness. The conditions included were:

  • Chronic low back pain
  • Chronic neck pain
  • Osteoarthritis (knee, hip, hand)
  • Fibromyalgia
  • Chronic tension headache

 

Here are the main findings related to spinal manipulation:

LOW BACK PAIN

  • Spinal manipulation was associated with small improvements compared with sham manipulation, usual care, an attention control, or a placebo intervention in short-term (3 trials) and intermediate-term (3 trials) function (strength of evidence : low). There was no difference between spinal manipulation versus sham manipulation, usual care, an attention control, or a placebo intervention in short-term pain (3 trials), but manipulation was associated with a small improvement compared with controls on intermediate-term pain (3 trials) (SOE: low for short term, moderate for intermediate term).

CHRONIC TENSION HEADACHE

  • Spinal manipulation therapy was associated with small improvements in function and moderate improvements in pain compared with usual care over the short term in one trial (: low). Approximately a quarter of the patients had comorbid migraine.

HARMS

It was noted that many trails failed to report on adverse effects (AEs). Non- serious AEs reported included mild to moderate increase in pain, local discomfort and tiredness (2 RCTs).

___________________

Hardly impressive, is it?

Yet, some chiropractors treating chronic pain claim they practice Evidence-based medicine. This review seems to disclose this claim as bogus. What chiropractors do practice on virtually all patients is spinal manipulation which generates more harm than it produces benefit.

Please note yet again that:

  • many chiro trials fail to mention AEs (thus violating research ethics),
  • clinical trials are always too small to give a reliable impression about safety,
  • no post-marketing surveillance exists in chiropractic,
  • we thus have to rely mostly on case reports and similar articles,
  • and the collective evidence from such reports shows quite clearly that spinal manipulations are not safe,
  • chiropractors tend to deny all of the above,
  • this is because they have a monumental conflict of interest.

Can I invite you to join me in a little thought experiment?

Think of a totally useless therapy. I would suggest homeopathy but there are always some who would disagree with this classification. I need a TOTALLY useless therapy, and one where we ALL can agree on the label.

What about ‘Potentised Toe-Nail Powder’ (PoToNaPo)?

PoToNaPo is made from nail clippings, thoroughly sterilised, ground to a powder, serially diluted and potentised. Does anyone claim this remedy to be effective for any condition?

No?

Splendid!

So, we all agree that PoToNaPo is completely ineffective.

Now imagine some charlatan claiming that PoToNaPo is a highly effective cancer cure. Let’s furthermore imagine that he is very successful with his claim.

(No, this is not far fetched! Think of Laetrile, Essiac, etc.)

Imagine our charlatan makes millions with PoToNaPo.

There would soon be some opposition to his quackery. The FDA would issue a statement that PoToNaPo is unproven. Perhaps the NEJM would publish an editorial saying something similar. Ethicists would frown publicly. And many sceptics would head to the pubs where clever guys would give talks about ‘the scandal of PoToNaPo’.

We all know it would happen, because it has happened with PoToNaPo-like remedies many times before.

______________

Now imagine a different scenario, namely one in which our charlatan does not claim that PoToNaPo is a cancer cure; imagine instead he had claimed that PoToNaPo is a holistic medicine that boosts your well-being via re-balancing your vital energies which, in turn, helps with anxiety which in turn might have positive effects on things like mild chronic pain, depressive mood, tension headache, insomnia, erectile dysfunction and many more symptoms of daily life.

Let’s furthermore imagine that our charlatan is very successful with these claims.

No, this is not far fetched! Think of … well … think of any SCAM really.

Imagine the charlatan makes millions with PoToNaPo.

What would happen?

  • He would be invited to conferences on integrative medicine.
  • Become an honorary member/sponsor of the ‘College of Medicine and Integrated Health’.
  • He would be interviewed on the BBC.
  • The Daily Mail would publish advertorials.
  • HRH would perhaps invite him for tea.
  • Trump might hint that PoToNaPo cures virus infections.
  • Ainsworth might buy his patent.
  • There could even be a gong waiting for him.
  • And yes … some sceptics would mutter a bit, but the public would respond: what’s the harm?

We all know that things of this nature might happen, because they have happened before with PoToNaPo-like remedies.

__________________

So what’s the difference?

In both scenarios, our charlatan has marketed the same bogus remedy, PoToNaPo.

In both scenarios, he has made unsubstantiated, even fraudulent claims.

Why does he get plenty of stick in the 1st and becomes a hero in the 2nd case?

Yes, I know, the difference is the nature of the claims. But the invention, production, marketing and selling of a bogus treatment, the lying, the deceit, the fraud, the exploitation of vulnerable people are all the same.

Why then are we, as a society, so much kinder to the charlatan in the 2nd scenario?

I think we shouldn’t be; it’s not logical or consequent. I feel we should name, shame and punish both types of charlatans. They are both dangerous quacks, and it is our ethical duty to stop them.

END OF THOUGHT EXPERIMENT

 

The US ‘Agency for Healthcare Research and Quality (AHRQ) have published a most comprehensive review update entitled ‘Noninvasive Nonpharmacological Treatment for Chronic Pain‘. It followed the AHRQ Methods Guide for Effectiveness and Comparative Effectiveness. The conditions included were:

  • Chronic low back pain
  • Chronic neck pain
  • Osteoarthritis (knee, hip, hand)
  • Fibromyalgia
  • Chronic tension headache

Here are the main findings related to acupuncture:

LOW BACK PAIN

  • Acupuncture was associated with a small improvement in short-term function compared with sham acupuncture or usual care (4 trials); there was no difference between acupuncture and controls in intermediate-term (3 trials) or long-term (1 trial) function (: low). Acupuncture was associated with small improvements in short-term (5 trials) and long-term (1 trial) pain compared with sham acupuncture, usual care, an attention control, or a placebo intervention but there was no difference in intermediate-term pain (5 trials) (SOE: moderate for short term, low for intermediate term and long term).

NECK PAIN

  • Acupuncture was associated with small improvements in short-term (5 trials) and intermediate-term (3 trials) function versus sham acupuncture, a placebo (sham laser), or usual care; one trial reported no difference in function in the long term (: low for all time periods). For pain, there were no differences for acupuncture versus sham acupuncture or placebo interventions in the short (4 trials), intermediate (3 trials), or long (1 trial) term (SOE: low for all time periods).

PAIN FROM KNEE OSTEOARTHRITIS

  • No differences were seen between acupuncture and control interventions (sham acupuncture, waitlist, or usual care) for function in the short term (4 trials) or the intermediate term (4 trials) (: low for short term; moderate for intermediate term). Stratified analysis showed no differences between acupuncture and sham treatments (4 trials) but moderate improvement in function compared with usual care (2 trials) short term. For pain, there were no differences between acupuncture versus control interventions in the short term (6 trials) or clinically meaningful differences in the intermediate term (4 trials) (SOE: low for short term; moderate for intermediate term). Short-term differences in pain were significant for acupuncture versus usual care but not for acupuncture versus sham acupuncture.

CHRONIC TENSION HEADACHE

  • Laser acupuncture was associated with small, short-term improvements in pain intensity and in the number of headache days per month versus sham in one trial (: low).

FIBROMYAGGIA

  • Acupuncture was associated with a small improvement in function compared with sham acupuncture at short-term (3 trials [1 new]) and intermediate-term (2 trials) follow-up (: moderate). There was no effect for acupuncture versus sham acupuncture on pain in the short term (4 trials [1 new]) or intermediate term (3 trials) (SOE: low) or based on pooled estimates across control conditions (sham or attention control, 5 trials [2 new]) SOE: low).

HARMS

Treatment-related SAEs were rare (across 5 , 5 neck pain, 4 , 1 knee , and 1  trial); only one event (needle insertion site pain lasting1 month) in a LBP patient (<1%) in one trial was considered related to treatment,

SAEs not considered to be related to acupuncture or the study conditions (range 0% to 9% across 5 , 5 neck pain, 4 , 1 knee , and 1  trial). These included hospitalization (primarily) or outpatient treatment; reasons were not specified.

The most commonly reported non-serious AEs: swelling, bruising, bleeding or pain at the acupuncture site (1% to 61%, 12 RCTs; or 1% to 18% excluding an outlier trial)); numbness, discomfort, pain or increase in symptoms (1% to 14%; 11 RCTs), dizziness, nausea, fainting (1% to 7%, 7 RCTs), headache (1% to 2%; 4 RCTs), vasovagal symptoms (1% to 4%; 2 RCTs), respiratory problems, chest discomfort (1%; 2 neck pain RCTs), and infection at needle insertion site [1%; 1  (knee )]

____________________

I find this interesting, especially if we consider that chronic pain is THE domain for acupuncture (as practised in the West). It shows that, contrary to what so many enthusiasts try to tell us, the evidence for acupuncture is very weak. It also demonstrates that, contrary to what some sceptics assume, the evidence is not totally negative.

As far as harms are concerned, we need to be aware of the fact that the above conclusions are based on clinical trials. We and others have repeatedly shown that in the real of SCAM many, if not most clinical studies fail to mention adverse effects. This means two things: firstly, the trialists violate research ethics; secondly, the above information is woefully incomplete.

I should never claim that I know all the cancer quackery that is out there! Because I don’t. There are just too many of them; and a new one seems to crop up every week.

For instance, I did not know about POWERLIGHT, a SCAM that is being promoted against many serious diseases, including cancer. Here is what the website states:

The very word “cancer” for patients is such a heavy burden, that psychological support actualy is necessary when a patient gets such a diagnosis. In this section we are pleased and proud to set an end to this terrifying illness.

A lot of different tumors in current language are called cancer. A cancer is based on epithelian tissue. This tissue occures in different organs. Because of that we find this tumore: as an

– Anal carcinoma

– Bronchial carcinoma

– Testicle carcinoma

– Laryngeal cancer

– Colon cancer

– Oesophageal cancer

– Gastric cancer

– Breast cancer

– Kidney carcinoma

– Ovary carcinoma

– Pancreas carcinoma

– Pharynx (throat) carcinoma

– Prostate carcinoma

Cancer is one of the most dreaded diseases we know.

We found the possibility to heal every kind of cancer, anyway what staging the tumor has. Also patients in the final stadium feel better after the third ampoule* and will be healed completly. The first ampoule brings a patient a better psychic situation.

For other tumors we have special medicines in our product list. Before taking Powerlight medicine it is necessary to have an exact diagnosis from a hospital. For example it was necessary to develope against carcinomas in the childhood other cluster stuctures – this is now our drug KIC. Tumores spreading from other tissues are to be treated with Powerlight NR, Powerlight H+NH and Powerlight LE.

If a patient started his treatment with conventional chemotherapy, the side effects will be bettered, when the patient gets Powerlight EG. The intake of Powerlight CA and Powerlight EG in the same period is not possible. In serious cases it has to be proved, whether the dangerous situation is caused primarily by the tumor or by the chemotherapy. According to this the heaviest burden has to be treated first.

All tumores that are not cancers, will not be healed by Powerlight CA. In these cases find an other correct medicine under  “Product list” in this homepage.

And how does POWERLIGHT work? The website provides the amazing answer:

The scientific background of our products is the physics of antimatter. With the help of positron radiation we can represent order patterns of living matter. Antimatter is able to copy patterns of organisms, when we put them into the electromagnetic field of antimatter. Such patterns show irregularities in the living matter. Normally living matter is structured by strict order patterns. The irregularities are causes of illness. Powerlight reconditions order patterns of living systems, because these order patterns also by heavy illnesses are not destroyed but only overlapped. The original order patterns are guide rails of the electron transfer by Clusters.

It has been reported that POWERLIGHT and some of the quacks offering it are now being sued in Austria after several cancer patients died who were naïve enough to believe this BS. According to the website, the firm originates in the Netherlands, however, MedWatch found out that it is not registered there either. This probably means that, officially, the firm does not even exist.

 

 

*the content has been analysed and seems to be a pure isotonic NaCl solution.

During the last few months, I have done little else on this blog than trying to expose misinformation about COVID-19 in the realm of so-called alternative medicine (SCAM). However, the usefulness and accuracy of most viewed YouTube videos on COVID-19 have so far not been investigated. Canadian researchers have just published a very nice paper that fills this gap.

They performed a YouTube search on 21 March 2020 using keywords ‘coronavirus’ and ‘COVID-19’, and the top 75 viewed videos from each search were analysed. Videos that were duplicates, non-English, non-audio and non-visual, exceeding 1 hour in duration, live and unrelated to COVID-19 were excluded. Two reviewers coded the source, content and characteristics of included videos. The primary outcome was usability and reliability of videos, analysed using the novel COVID-19 Specific Score (CSS), modified DISCERN (mDISCERN) and modified JAMA (mJAMA) scores.

Of 150 videos screened, 69 (46%) were included, totalling 257 804 146 views. Nineteen (27.5%) videos contained non-factual information, totalling 62 042 609 views. Government and professional videos contained only factual information and had higher CSS than consumer videos (mean difference (MD) 2.21, 95% CI 0.10 to 4.32, p=0.037); mDISCERN scores than consumer videos (MD 2.46, 95% CI 0.50 to 4.42, p=0.008), internet news videos (MD 2.20, 95% CI 0.19 to 4.21, p=0.027) and entertainment news videos (MD 2.57, 95% CI 0.66 to 4.49, p=0.004); and mJAMA scores than entertainment news videos (MD 1.21, 95% CI 0.07 to 2.36, p=0.033) and consumer videos (MD 1.27, 95% CI 0.10 to 2.44, p=0.028). However, they only accounted for 11% of videos and 10% of views.

The authors concluded that over one-quarter of the most viewed YouTube videos on COVID-19 contained misleading information, reaching millions of viewers worldwide. As the current COVID-19 pandemic worsens, public health agencies must better use YouTube to deliver timely and accurate information and to minimise the spread of misinformation. This may play a significant role in successfully managing the COVID-19 pandemic.

I think this is an important contribution to our knowledge about the misinformation that currently bombards the public. It explains not only the proliferation of conspiracy theories related to the pandemic, but also the plethora of useless SCAM options that are being touted endangering the public.

The authors point out that the videos included statements consisting of conspiracy theories, non-factual information, inappropriate recommendations inconsistent with current official government and health agency guidelines and discriminating statements. This is particularly alarming, when considering the immense viewership of these videos. Evidently, while the power of social media lies in the sheer volume and diversity of information being generated and spread, it has significant potential for harm. The proliferation and spread of misinformation can exacerbate racism and fear and result in unconstructive and dangerous behaviour, such as toilet paper hoarding and mask stealing behaviours seen so far in the COVID-19 pandemic. Consequently, this misinformation impedes the delivery of accurate pandemic-related information, thus hindering efforts by public health officials and healthcare professionals to fight the pandemic.

Good work!

I suggest to critically evaluate the statements of some UK and US politicians next.

 

An international team of students of chiropractic have published a paper protesting against those chiropractors and chiropractic organisations that claim their treatments boost the immune system and thus protect the public from the corona-virus infection. Here their abstract:

Background

The 2019 coronavirus pandemic is a current global health crisis. Many chiropractic institutions, associations, and researchers have stepped up at a time of need. However, a subset of the chiropractic profession has claimed that spinal manipulative therapy (SMT) is clinically effective in improving one’s immunity, despite the lack of supporting scientific evidence. These unsubstantiated claims contradict official public health policy reflecting poorly on the profession. The aim of this commentary is to provide our perspective on the claims regarding SMT and clinically relevant immunity enhancement, drawing attention to the damaging ramifications these claims might have on our profession’s reputation.

Main text

The World Federation of Chiropractic released a rapid review demonstrating the lack of clinically relevant evidence regarding SMT and immunity enhancement. The current claims contradicting this review carry significant potential risk to patients. Furthermore, as a result of these misleading claims, significant media attention and public critiques of the profession are being made. We believe inaction by regulatory bodies will lead to confusion among the public and other healthcare providers, unfortunately damaging the profession’s reputation. The resulting effect on the reputation of the profession is greatly concerning to us, as students.

Conclusion

It is our hope that all regulatory bodies will protect the public by taking appropriate action against chiropractors making unfounded claims contradicting public health policy. We believe it is the responsibility of all stakeholders in the chiropractic profession to ensure this is carried out and the standard of care is raised. We call on current chiropractors to ensure a viable profession exists moving forward.

In the paper, the authors also state that significant reputational damage can follow when unfounded claims are made that undermine public health policy… We call for a strong stance to be taken against these unsubstantiated claims and do not condone this unacceptable behaviour. As students, we are worried for the profession’s reputation and call on current chiropractors to ensure we have a viable profession moving forward. 

BRAVO!!!

Now that the students have realised that the immunity claim is bogus, it would be only a small step to realise that so many other claims chiropractors make on a daily basis are false as well. There may be a difference in terms of severity, but there is none in terms of principle. As responsible healthcare professional to be, the student must rebel against ALL false claims made in their name.

So, will these students and other like-minded chiropractors please not stop here. I urge them to have a serious look at the claims their profession makes. Subsequently, they ought to take the ethically appropriate action.

And what might that be?

I see two possibilities:

  1. Get rid of the abundance of lies that dominate chiropractic.
  2. Find a different, more honest profession.

The aim of this systematic review was to assess the efficacy of homeopathic remedies (HRs) in the treatment of mental disorders.

Italian psychiatrists performed a Medline/Embase search for studies written in English and published from any date to October 23, 2018. All randomized controlled trials enrolling patients with any psychiatric disorder and comparing HR with placebo, no treatment, or other psychotropic drugs were included.

A total of 212 studies were screened, 9 met all selection criteria and reported data on major depressive disorder (MDD) (n = 4), generalized anxiety disorder (n = 1), attention-deficit/hyperactivity disorder (n = 2), and premenstrual syndrome/dysphoric disorder (n = 2). Eight of 9 randomized controlled trials showed high risk of bias. Homeopathy showed greater efficacy in MDD compared with fluoxetine, and in premenstrual syndrome/dysphoric disorder compared with placebo, whereas no difference emerged between homeopathy and placebo in MDD and attention deficit/hyperactivity disorder.

The authors concluded that the available data on homeopathy in psychiatric disorders are insufficient to support their use in clinical practice.

In their discussion section, they also add an interesting note of caution: Ethical considerations should therefore prevent clinicians from recommending HRs, which have a cost either for patients or for health care systems, until when a sufficient amount of solid evidence becomes available. In addition, systematic reviews of randomized trials, if unavailable, are advisable for all medical conditions for which homeopathy is currently prescribed.

This is a rigorous, transparent and clear review which generates no surprises. Few critical thinkers would have expected a positive result. It also teaches us, I think, a valuable lesson about the difference between a rigorous and a flimsy review, between independent and biased research. In 2011, evidently pro-homeopathy authors published a paper of the latter kind. Here is its abstract:

Objective: To systematically review placebo-controlled randomized trials of homeopathy for psychiatric conditions.

Data sources: Eligible studies were identified using the following databases from database inception to April 2010: PubMed, CINAHL, PsycINFO, Hom-Inform, Cochrane CENTRAL, National Center for Complementary and Alternative Medicine grantee publications database, and ClinicalTrials.gov. Gray literature was also searched using Google, Google Scholar, the European Committee for Homeopathy, inquiries with homeopathic experts and manufacturers, and the bibliographic lists of included published studies and reviews. Search terms were as follows: (homeopath* or homoeopath*) and (placebo or sham) and (anxiety or panic or phobia or post-traumatic stress or PTSD or obsessive-compulsive disorder or fear or depress* or dysthym* or attention deficit hyperactivity or premenstrual syndrome or premenstrual disorder or premenstrual dysphoric disorder or traumatic brain injury or fibromyalgia or chronic fatigue syndrome or myalgic encephalitis or insomnia or sleep disturbance). Searches included only English-language literature that reported randomized controlled trials in humans.

Study selection: Trials were included if they met 7 criteria and were assessed for possible bias using the Scottish Intercollegiate Guidelines Network (SIGN) 50 guidelines. Overall assessments were made using the Grading of Recommendations Assessment, Development and Evaluation procedure. Identified studies were grouped into anxiety or stress, sleep or circadian rhythm complaints, premenstrual problems, attention-deficit/hyperactivity disorder, mild traumatic brain injury, and functional somatic syndromes.

Results: Twenty-five eligible studies were identified from an initial pool of 1,431. Study quality according to SIGN 50 criteria varied, with 6 assessed as good, 9 as fair, and 10 as poor. Outcome was unrelated to SIGN quality. Effect size could be calculated in 16 studies, and number needed to treat, in 10 studies. Efficacy was found for the functional somatic syndromes group (fibromyalgia and chronic fatigue syndrome), but not for anxiety or stress. For other disorders, homeopathy produced mixed effects. No placebo-controlled studies of depression were identified. Meaningful safety data were lacking in the reports, but the superficial findings suggested good tolerability of homeopathy. A funnel plot in 13 studies did not support publication bias (χ(2)(1) = 1.923, P = .166).

Conclusions: The database on studies of homeopathy and placebo in psychiatry is very limited, but results do not preclude the possibility of some benefit.

The two conclusions speak for themselves, I think. They should remind us that, although systematic reviews are in principle the most reliable source of evidence, it is still necessary to check the quality of the work and the independence of the worker.

Just when I thought I had seem all of the corona-idiocy, I found this paper by Dr Kajal Jain MD Homoeopathy (Materia Medica ) Medical Officer under Uttar Pradesh Public Service Commission. It promotes specific nosodes and other homeopathics against the current pandemic. In my view, it discloses a new dimension of the delusion which seems to have engulfed so many homeopaths. Allow me to copy a short passage from it:

TUBERCULINUM

A glycerine extract of a pure cultivation of tubercle bacilli (human).

As per Lectures on Homoeopathic Materia Medica by Dr Kent (page 1000) the Tuberculin nosode can prevent TB infection in those having predisposition to miasma. “If Tuberculinum bovinum be given in 10m, 50m, and CM potencies, two doses of each at long intervals, all children and young people who have inherited tuberculosis may be immuned from their inheritance and their resiliency will be restored

Burnett treated 54 cases of different types of TB Tuberculinum(Tub)/Bacillinum(Bac) 3

As stated in an article published in economic times ,countries without universal policies of BCG vaccination, such as Italy, the Netherlands, and the United States, have been more severely affected compared to countries with universal and long-standing BCG policies,” noted the researchers led by Gonzalo Otazu, assistant professor of biomedical sciences at NYIT.

The study noted that Australian researchers have recently announced plans to fast track large-scale testing to see if the BCG vaccination can protect health workers from the coronavirus.

The team compared various nations’ BCG vaccination policies with their COVID-19 morbidity and mortality and found a “significant positive correlation” between the year when universal BCG vaccination policies were adopted and the country’s mortality rate.

Iran, for instance, which has a current universal BCG vaccination policy that only started in 1984, has an elevated mortality rate with 19.7 deaths per million inhabitants, they said.

In contrast, Japan, which started its universal BCG policy in 1947, has approximately 100 times fewer deaths per million people, with 0.28 deaths, according to the study.

Brazil, which started universal vaccination in 1920 has an even lower mortality rate of 0.0573 deaths per million inhabitants, the scientists noted.

The researchers noted that among the 180 countries with BCG data available today, 157 countries currently recommend universal BCG vaccination.

The remaining 23 countries have either stopped BCG vaccination due to a reduction in TB incidence or have traditionally favoured selective vaccination of “at-risk” groups, they said.4

Thus we can see that Tuberculinium is reputed since a long timeas homoeoprophylactic in place of BCG. So Tuberculinum in high potency can act as an effective and dependable prophylactic in corona Virus .

PNEUMOCOCCINUM-

Pneumococcinum is reputed to prevent pneumonia. 5

In end stages OF CORONA VIRUS when we encounter symptoms like high fever ,pneumonia,pleurisy , -Pneumococcinum can be considered due to it being most similar to exisiting disease condition. Historically Pneumococcinum along with Influenzinum has been seen in eliciting drastic immunological responses in disease conditions following flu since it creates picture of pneumonia..

INFLUENZINUM and Oscillococcinum

Influenzinum is reputed to prevent flu and flu line symptoms 5

Oscilllococcinum –prepared from liver of wild duck has been observed to reduce course of illness due to influenza this it can be included as one of the probable medicnes in treatment of corona virus in earlier stages 6

A study conducted by Colombo GL1, Di Matteo S2 et al suggests that the treatment with Oscillococcinum could be helpful in preventing RTIs and improving the health status of patients who suffer from respiratory diseases7

Comparison of Allopathic vaccines and Nosodes

Allopathic vaccines are isopathic in nature, cude in nature unlike nosodes which are dynamic in nature with deeper penetrative abilities ..Nosodes when administered mimic the sickness and by natures law of cure prevent and treat illness.Nosodes being the same as original disease are more similar to the disease condition and are deeper in action since they are potentised

Thus realising effectiveness of nosodes in prevention and treatment of epidemics Nosodes are suggested as one of the probable approaches for COVID 19

This paper is so full of utter nonsense that I am unable to point it all out in a short blog-post. I trust you can easily identify it yourself. Let me therefore just focus on one specific point.

I did highlight reference 6 in the text for a special reason. Here is the reference provided by Dr Jain:

6. Vickers AJ, Smith C. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database Syst Rev 2000;(2):CD001957

It does not take much research to find out what is wrong with it. It refers to a Cochrane review which, of course, seems most laudable. To be precise, it refers to the 2000 version of this review which concluded that Oscillococcinum probably reduces the duration of illness in patients presenting with influenza symptoms. Though promising, the data are not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndrome. Further research is warranted but required sample sizes are large. Current evidence does not support a preventative effect of homeopathy in influenza and influenza-like syndromes.

This review is today obsolete, as it has meanwhile up-dated no less than 4 (!) times.

The latest version of this review is from 2015 (authored by well-known proponents of homeopathy) and concluded as follows: There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum® in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum® could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling. There was no evidence of clinically important harms due to Oscillococcinum®.

It is virtually impossible to not realise all this when accessing the reviews via Medline. And that leads me to fear that the author of the above paper, Dr Kajal Jain MD Homoeopathy (Materia Medica ) Medical Officer under Uttar Pradesh Public Service Commission, is not just deluded, but fraudulent.

As we have discussed repeatedly, chiropractors tend to be critical of vaccinations. This attitude is easily traced back to DD Palmer, the founding father of chiropractic, who famously wrote about smallpox vaccinations: ‘…the monstrous delusion … fastened on us by the medical profession, enforced by the state boards, and supported by the mass of unthinking people …

In Canada, the anti-vaccination attitude of chiropractors has been the subject of recent media attention. Therefore, researchers explored the association between media attention and public dissemination of vaccination information on Canadian chiropractors’ websites.

In 2016, an international team of investigators identified all Canadian chiropractors’ websites that provided information on vaccination by extracting details from the regulatory college website for each province using the search engine on their “find a chiropractor” page. The researchers assessed the quality of information using the Web Resource Rating Tool (scores range from 0% [worst] to 100% [best]), determined whether vaccination was portrayed in a positive, neutral or negative manner, and conducted thematic analysis of vaccination content. Now the researchers have revisited all identified websites to explore the changes to posted vaccination material.

Here are their findings:

In July 2016, of 3733 chiropractic websites identified, 94 unique websites provided information on vaccination:

  • 59 (63%) gave negative messaging,
  • 19 (20%) were neutral,
  • 16 (17%) were positive.

The quality of vaccination content on the websites was generally poor, with a median Web Resource Rating Tool score of 19%. Four main themes were identified:

  1. there are alternatives to vaccination,
  2. vaccines are harmful,
  3. evidence regarding vaccination,
  4. health policy regarding vaccination.

From 2012 to 2016, there was one single Canadian newspaper story concerning anti-vaccination statements by chiropractors, whereas 51 news articles were published on this topic between 2017 and 2019. In April 2019, 45 (48%) of the 94 websites originally identified in 2016 had removed all vaccination content or had been discontinued.

The authors of this investigation concluded that in 2016, a minority of Canadian chiropractors provided vaccination information on their websites, the majority of which portrayed vaccination negatively. After substantial national media attention, about half of all vaccination material on chiropractors’ websites was removed within several years.

I find these findings encouraging. They demonstrate that media attention can produce change for the better. That gives me the necessary enthusiasm to carry on my work in putting the finger on the dangers of chiropractic and other forms of so-called alternative medicine (SCAM). At the same time, the findings of this investigation are also disappointing. About half of all the chiropractors had not removed their misleading content from their websites despite the 51 articles highlighting the problem. This shows, I think, how deeply entrenched this vitalistic nonsense is in the heads of many chiropractor.

This means there is still a lot to do – so, let’s get on with it!

THE INTEGRATED HEALTHCARE COLLABORATIVE‘ claim to be a collection of the leading organisations within the field, who are committed to working together to improve healthcare in the UK. They believe that a truly integrated healthcare service would improve patient experiences, bring about better patient outcomes, and provide a framework for a more cost-effective delivery of healthcare services.​

Their purpose is as follows:

To bring together professional associations and stakeholders within complementary, traditional and natural healthcare, to identify common areas of interest, and to collectively take forward agreed objectives to promote greater integration with conventional Western medicine.

Objectives:

  • To increase public awareness, knowledge and understanding of complementary, traditional and natural healthcare.
  • To raise issues in integrated healthcare with government and decision-makers.
  • To provide information on complementary, traditional and natural healthcare to the media and interested parties.
  • To promote the benefits to public health of greater provision and integration of complementary, traditional and natural healthcare.
  • To develop co-ordinated strategies to help patients access accurate information on integrated healthcare.
  • To facilitate better access to, and choice of, appropriate complementary, traditional and natural healthcare within the NHS.
  • To empower the public to share responsibility for their own health and wellbeing.
  • To encourage whole-person, individualised healthcare.
  • To advocate collaboration with conventional Western healthcare professionals.
  • To support the development of a robust and appropriate evidence base.

​They sate that Integrated Healthcare involves combining the best of conventional Western Medicine with a range of complementary, traditional and natural therapies.

The IHC brings together the following leading organisations, who are Core Members and lead our work.

  • Alliance of Registered Homeopaths (ARH)
  • Association of Energy Therapists (AET)
  • Association of Naturopathic Practitioners (ANP)
  • Association of Physical and Natural Therapists (APNT)
  • Association of Reflexologists (AoR)
  • Association of Traditional Chinese Medicine and Acupuncture (ATCM)
  • British Complementary Medicine Association (BCMA)
  • British Reflexology Association (BRA)
  • Chinese Medical Institute and Register (CMIR)
  • Craniosacral Therapy Association (CSTA)
  • General Council and Register of Naturopaths (GCRN)
  • Faculty of Homeopathy (FoH)
  • Federation of Holistic Therapists (FHT)
  • International Federation of Professional Aromatherapists (IFPA)
  • Kinesiology Federation (KF)
  • McTimoney Chiropractic Association (MCA)
  • National Institute of Medical Herbalists (NIMH)
  • Shiatsu Society UK (SSUK)
  • Society of Homeopaths (SoH)
  • Society of Teachers of the Alexander Technique (STAT)
  • UK Reiki Federation (UKRF)

The IHC also provide revealing paragraphs about several so-called alternative medicines (SCAMs) on their website. This is where I have found a host of interesting statements. Here are just 6 examples:

  1. Chiropractic treatment mainly involves safe, specific spinal manipulation to free joints in the spine or other areas of the body that are not moving properly.
  2. Science is starting to understand the mechanism of action of ultra-high dilutions in the body, and homeopathic medicines are gentle, safe to use and in widespread use across the world.
  3.  By testing … muscles the kinesiologist can get a picture of what is happening in your meridian system and how this may be affecting you.
  4. Radionics is a healing technique in which your natural intuitive faculties are used both to discover the energetic disturbances underlying illness and to encourage the return of a normal energetic field that supports health.
  5. Reflexology is a complementary therapy based on the belief that there are reflex areas in the feet and hands which are believed to correspond to all organs and parts of the body.
  6. [Reiki] is a tradition that is open to any belief system and benefits may include deep relaxation and the promotion of a calm peaceful sense of wellbeing.

And here are 6 corrections of the above-listed statements:

  1. Chiropractic involves unsafe spinal manipulation to free customers of their cash.
  2. Science has long understood that there is no mechanism that could possibly explain homeopathy.
  3. By testing muscles, the kinesiologist pretends to do something meaningful in order to be able to bill the customer.
  4. Radionics is a con technique that is counter-intuitive, implausible and unrelated to energy.
  5. Reflexologists believe to have shown conventional anatomy and physiology to be mistaken.
  6. Reiki is a tradition and a belief system demonstrably out of touch with reality.

PS

If the IHC want to change their text and adopt my corrections, I would waive my fee for this efforts.

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