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

panacea

I recently came across the ‘Sutherland Cranial College of Osteopathy’.

Sutherland Cranial College of Osteopathy?

Really?

I know what osteopathy is but what exactly is a ‘cranial college’?

Perhaps they mean ‘Sutherland College of Cranial Osteopathy’?

Anyway, they explain on their website that:

Cranial Osteopathy uses the same osteopathic principles that were described by Andrew Taylor Still, the founder of Osteopathy. Cranial osteopaths develop a very highly developed sense of palpation that enables them to feel subtle movements and imbalances in body tissues and to very gently support the body to release and re-balance itself. Treatment is so gentle that often patients are quite unaware that anything is happening. But the results of this subtle treatment can be dramatic, and it can benefit whole body health.

Sounds good?

I am sure you are now keen to become an expert in cranial osteopathy. The good news is that the college offers a course where this can be achieved in just 2 days! Here are the details:

This will be a spacious exploration of the nervous system.  Neurological dysfunction and conditions feature greatly in our clinical work and this is especially the case in paediatric practice. The focus of this course is how to approach the nervous system in a fundamental way with reference to both current and historical ideas of neurological function.  The following areas will be considered: 

    1. Attaining stillness and grounding during palpation of the nervous system. It is within stillness that potency resides and when the treatment happens. The placement of attention.  
    2. The pineal and its relationship to the tent, the pineal shift.
    3. The relations of the clivus and the central importance of the SBS, How do we assess and treat compression?
    4. The electromagnetic field and potency.
    5. The suspension of the cord within the spinal canal, the cervical and lumbar expansions.
    6. Listening posts for the central autonomic network.
Hawkwood College accommodation

Please be aware that accommodation at Hawkwood will be in shared rooms (single sex). Some single rooms are available on a first-come-first-served basis and will carry a supplement. Requesting a single room is not a guarantee that one will be provided.

£390.00 – £490.00

29 – 30 APRIL 2023 STROUD, UK
This will be a spacious exploration of the nervous system. Neurological dysfunction and conditions feature greatly in our clinical work and this is especially the case in pediatric practice.

_________________________

You see, not even expensive!

Go for it!!!

Oh, I see, you want to know what evidence there is that cranial osteopathy does more good than harm?

Right! Here is what I wrote in my recent book about it:

Craniosacral therapy (or craniosacral osteopathy) is a manual treatment developed by the US osteopath William Sutherland (1873–1953) and further refined by the US osteopath John Upledger (1932–2012) in the 1970s. The treatment consists of gentle touch and palpation of the synarthrodial joints of the skull and sacrum. Practitioners believe that these joints allow enough movement to regulate the pulsation of the cerebrospinal fluid which, in turn, improves what they call ‘primary respiration’. The notion of ‘primary respiration’ is based on the following 5 assumptions:

  • inherent motility of the central nervous system
  • fluctuation of the cerebrospinal fluid
  • mobility of the intracranial and intraspinal dural membranes
  • mobility of the cranial bones
  • involuntary motion of the sacral bones.

A further assumption is that palpation of the cranium can detect a rhythmic movement of the cranial bones. Gentle pressure is used by the therapist to manipulate the cranial bones to achieve a therapeutic result. The degree of mobility and compliance of the cranial bones is minimal, and therefore, most of these assumptions lack plausibility.

The therapeutic claims made for craniosacral therapy are not supported by sound evidence. A systematic review of all 6 trials of craniosacral therapy concluded that “the notion that CST is associated with more than non‐specific effects is not based on evidence from rigorous RCTs.” Some studies seem to indicate otherwise, but they are of lamentable methodological quality and thus not reliable.

Being such a gentle treatment, craniosacral therapy is particularly popular for infants. But here too, the evidence fails to show effectiveness. A study concluded that “healthy preterm infants undergoing an intervention with craniosacral therapy showed no significant changes in general movements compared to preterm infants without intervention.”

The costs for craniosacral therapy are usually modest but, if the treatment is employed regularly, they can be substantial.

______________________________

As the college states “often patients are quite unaware that anything is happening”. Is it because nothing is happening? According to the evidence, the answer is YES.

So, on second thought, maybe you give the above course a miss?

The ‘My Resilience in Adolescence (MYRIAD) Trial’evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU).

MYRIAD was a parallel group, cluster-randomised controlled trial. Eighty-five eligible schools consented and were randomized 1:1 to TAU (43 schools, 4232 students) or SBMT (42 schools, 4144 students), stratified by school size, quality, type, deprivation, and region. Schools and students (mean (SD); age range=12.2 (0.6); 11–14 years) were broadly UK population-representative. Forty-three schools (n=3678 pupils; 86.9%) delivering SBMT, and 41 schools (n=3572; 86.2%) delivering TAU, provided primary end-point data. SBMT comprised 10 lessons of psychoeducation and mindfulness practices. TAU comprised standard social-emotional teaching. Participant-level risk for depression, social-emotional-behavioural functioning and well-being at 1 year follow-up were the co-primary outcomes. Secondary and economic outcomes were included.

An analysis of the data from 84 schools (n=8376 participants) found no evidence that SBMT was superior to TAU at 1 year. Standardised mean differences (intervention minus control) were: 0.005 (95% CI −0.05 to 0.06) for risk for depression; 0.02 (−0.02 to 0.07) for social-emotional-behavioural functioning; and 0.02 (−0.03 to 0.07) for well-being. SBMT had a high probability of cost-effectiveness (83%) at a willingness-to-pay threshold of £20 000 per quality-adjusted life year. No intervention-related adverse events were observed.

The authors concluded that the findings do not support the superiority of SBMT over TAU in promoting mental health in adolescence.

Even though the results are negative, MYRIAD must be praised for its scale and rigor, and for highlighting the importance of large, well-designed studies before implementing measures of this kind on a population basis. Co-author Tim Dalgliesh, director of the Cambridge Centre for Affective Disorders, said: “For policymakers, it’s not just about coming up with a great intervention to teach young people skills to deal with their stress. You also have to think about where that stress is coming from in the first place.”

“There had been some hope for an easy solution, especially for those who might develop depression,” says Til Wykes, head of the School of Mental Health and Psychological Sciences at the Institute of Psychiatry, Psychology, and Neuroscience, King’s College London. “There may be lots of reasons for developing depression, and these are probably not helped by mindfulness,” she says. “We need more research on other potential factors that might be modified, and perhaps this would provide a more targeted solution to this problem.”

Personally, I feel that mindfulness has been hyped in recent years. Much of the research that seemed to support it was less than rigorous. What is now needed is a realistic approach based on sound evidence and critical thinking.

I came across an interesting case report recently published in an Austrian magazine. Here is my translation for non-German speakers:

A 42-year-old woman from Vienna has suffered from endometriosis since the age of 13. But it was only 8 years later that she found out what made the first two days of her menstruation so unbearable. She was not allowed to take painkillers to help herself during all that time. Her parents listened to medical “gurus” who distrusted conventional medicine.

“I grew up in a household where almost all illnesses were treated with homeopathy,” she wrote on Twitter. That’s exactly what became the IT expert’s undoing. In a recent interview, she looked back bitterly: “All infections and illnesses were treated with Bach flower remedies or homeopathics. Only in case of accidents or broken bones did my parents drive me to the hospital.” Her father suffered from an auto-immune disease. Because conventional medicine could not help him, he tried alternative approaches. “My parents slowly drifted more and more into this scene. At some point, they stopped listening to ‘normal’ doctors. It went downhill from there.”

As a girl, the Viennese had little chance of standing up to her parents’ “whisperers,” as she calls their esoteric advice. “When I got my period, I was in the worst pain. I fainted every month, even falling off my chair when I did it, once even at school. I vomited until I was so exhausted that I fell asleep.”

She begged her family to finally be allowed to consult a gynecologist. But he didn’t take the teenager seriously at the time and simply wanted to prescribe her the pill without a thorough examination. “I then went to my parents’ homeopathic ‘pill pusher’, who gave me homeopathics against my complaints. I wasn’t allowed to take painkillers because they ‘damage the liver’.” The guru persuaded the young woman that her health problems were her fault. “He said I just didn’t accept myself as a woman and that’s why I was in pain. I thought for a long time that I was just not strong and good enough.”

It wasn’t until she was already in her early 20s that her then-boyfriend took her to a gynecologist who finally took her condition seriously. “The ultrasound showed that I had quite a few cysts in my abdomen.” The diagnosis was also finally certain: she was now officially suffering from endometriosis. She was given the right medicine, and most of the endometriotic growths regressed. But a cyst had wrapped itself tightly around her right ovary, damaging it irrevocably over the years. It had died. “Homeopathy cost me my ovary,” the Viennese woman laments.

The fact that she nevertheless was able to become the mother of two children is thanks to her other ovary, which fortunately remained intact. But the feeling of having been treated wrongly, or not treated at all, for such a long time makes her angry. “I don’t blame my parents today. They have apologized and found their own way out of the gurus’ world of thought and out of the scene,” she emphasizes. “But I blame the people who pretend to be able to cure the majority of all diseases with homeopathy. Yet most of the time they can’t even find the right diagnosis and just give patients some stuff that has no side effects.” She now calls for an end to homeopathy.

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How many times have I said it?

His remedy might be risk-free, but the homeopath certainly isn’t!

 

Prof. Fabricio Benedetti is one of the world’s leading experts in the study of placebo effects. I have mentioned his excellent work before, for instance, here where he cautioned that quackery has today one more weapon on its side, which is paradoxically represented by the hard science–supported placebo mechanisms. Now he has expressed his concerns even more clearly in an article entitled “Alternative and natural medicine quackery is on the rise. Here’s why the placebo effect is part of the problem”. Here are a few excerpts from this excellent paper:

For several decades now, many scientists, including me, have been working hard to reveal the full power and scope of the placebo effect — the amazing ability of a simple sugar pill or other non-pharmaceutical “fake intervention” to improve someone’s quality of life. This research has been crucial to giving scientific credibility to a powerful psychological effect. But the advances of science have also backfired, spawning an alternative industry that preys on the vulnerable…

All this means that some alternative medicines can indeed have positive outcomes for patients, though not necessarily through the mechanisms that the therapy’s inventors supposed, but rather through a placebo effect. This holds true for treatments ranging from strange talismans to acupuncture — studies have shown that pain relief is about the same for patients receiving true acupuncture with needles, for example, as for those receiving sham acupuncture with trick needles.

The scientific advances in understanding placebo are fascinating. But one unfortunate outcome of all this work is that profit-seeking companies and individuals now have a new weapon: It is no longer necessary to demonstrate the effectiveness of their proposed therapies; it is enough to assert that these work because of the placebo effect. I receive myriad eccentric proposals for new therapies, ranging from talismans and concoctions to mascots and weird rituals. Their inventors claim that these are capable of inducing substantial health benefits and often seek my endorsement. These proposals have stepped up sharply in recent years. Sadly, the science of the placebo effect is fueling this new breed of pseudoscience…

So, if a salesperson says: “This concoction (or ritual or talisman) will reduce your pain,” it is not necessarily a lie, as the placebo effect may indeed stimulate pain-relieving circuits in the brain. But anyone could truthfully use these words, within limits.

These marketers often overstate the size of the possible response, claim to provide a “cure” rather than pain relief or incorrectly suggest that only their own expensive products will have this effect. Even worse, they may present the products as an alternative to more effective traditional medications for serious conditions such as cancer. In other words, they prey on the vulnerable by making undeliverable promises, purportedly backed by the science of placebo.

Even if taking a placebo can reduce symptoms such as pain, this isn’t always the best course of action. An apparently trivial pain may, for example, be the first sign of something far more serious. Treating the pain alone may prevent diagnosis by a physician or delay important medical treatments…

…Education, communication and honesty are the best friends of medical practice. Patients and health care professionals deserve to know what placebos can and cannot do.

The research and medical communities must be more transparent about the efficacy of many conventional pharmacological and nonpharmacological treatments, by acknowledging that some of them are useful whereas some others are not. Many over-the-counter products have doubtful efficacy, for example. Honesty will boost patients’ trust and confidence in medicine, which are the best antidotes to quackery.

 

BRAVO PROF BENEDETTI!

This story made the social media recently:

Yes, I can well believe that many chiros are daft enough to interpret the incident in this way. Yet I think it’s a lovely story, not least because it reminds me of one of my own experiences:

I was on a plane to Toronto and had fallen asleep after a good meal and a few glasses of wine when a stewardess woke me saying: “We think you are a doctor!?”

“That’s right, I am a professor of alternative medicine”, I said trying to wake up.

“We have someone on board who seems to be dying. Would you come and have a look? We moved him into 1st class.”

Arrived in 1st class, she showed me the patient and a stethoscope. The patient was unconscious and slightly blue in the face. I opened his shirt and used the stethoscope only to find that this device is utterly useless on a plane; the sound of the engine by far overwhelms anything else. With my free hand, I tried to find a pulse – without success! Meanwhile, I had seen a fresh scar on the patient’s chest with something round implanted underneath. I concluded that the patient had recently had a pacemaker implant. Evidently, the electronic device had malfunctioned.

At this stage, two stewardesses were pressing me: “The captain needs to know now whether to prepare for an emergency stop in Newfoundland or to fly on. It is your decision.”

I had problems thinking clearly. What was best? The patient was clearly dying and there was nothing I could do about it. I replied by asking them to give me 5 minutes while I tried my best. But what could I do? I decided that I could do nothing but hold the patient’s hand and let him die in peace.

The Stewardesses watched me doing this and must have thought that I was trying some sort of energy healing, perhaps Reiki. This awkward situation continued for several minutes until – out of the blue – I felt a regular, strong pulse. Evidently, the pacemaker had started functioning again. It did not last long until the patient’s color turned pink and he began to talk. I instructed the pilot to continue our path to Toronto.

After I had remained with the patient for another 10 minutes or so, the Stewardesses came and announced: “We have moved your things into 1st class; like this, you can keep an eye on him.” The rest of the journey was uneventful – except the Stewardesses came repeatedly giving me bottles of champagne and fine wine to take with me into Toronto. And each time they politely asked whether my healing method would not also work for the various ailments they happened to suffer from – varicose veins, headache, PMS, fatigue …

So, here is my message to all the fellow energy healers out there:

We honor the creator’s design.

We know of the potential of the body is limitless.

Remember, you did not choose energy healing.

Energy healing chose you.

You were called for a time like this.

In case you are beginning to wonder whether I have gone round the bend, the answer is NO! I am not an energy healer. In fact, I am as much NOT an energy healer, as the chiropractor in the above story has NOT saved the life of his patient. Chiropractors and stewardesses, it seems to me, have one thing in common: they do not understand much about medicine.

 

PS

On arrival in Toronto, the patient was met by a team of fully equipped medics. I explained what had happened and they took him off to the hospital. As far as I know, he made a full recovery after the faulty pacemaker had been replaced. After my return to the UK, British Airways sent me a huge hamper to thank me.

WARNING: SATIRE

This is going to be a very short post. Yet, I am sure you agree that my ‘golden rules’ encapsulate the collective wisdom of so-called alternative medicine (SCAM):

  1. Conventional treatments are dangerous
  2. Conventional doctors are ignorant
  3. Natural remedies are by definition good
  4. Ancient wisdom knows best
  5. SCAM tackles the roots of all health problems
  6. Experience trumps evidence
  7. People vote with their feet (SCAM’s popularity and patients’ satisfaction prove SCAM’s effectiveness)
  8. Science is barking up the wrong tree (what we need is a paradigm shift)
  9. Even Nobel laureates and other VIPs support SCAM
  10. Only SCAM practitioners care about the whole individual (mind, body, and soul)
  11. Science is not yet sufficiently advanced to understand how SCAM works (the mode of action has not been discovered)
  12. SCAM even works for animals (and thus cannot be a placebo)
  13. There is reliable evidence to support SCAM
  14. If a study of SCAM happens to yield a negative result, it is false-negative (e.g. because SCAM was not correctly applied)
  15. SCAM is patient-centered
  16. Conventional medicine is money-orientated
  17. The establishment is forced to suppress SCAM because otherwise, they would go out of business
  18. SCAM is reliable, constant, and unwavering (whereas conventional medicine changes its views all the time)
  19. SCAM does not need a monitoring system for adverse effects because it is inherently safe
  20. SCAM treatments are individualized (they treat the patient and not just a diagnostic label like conventional medicine)
  21. SCAM could save us all a lot of money
  22. There is no health problem that SCAM cannot cure
  23. Practitioners of conventional medicine have misunderstood the deeper reasons why people fall ill and should learn from SCAM

QED

I am sure that I have forgotten several important rules. If you can think of any, please post them in the comments section.

The new issue of the BMJ carries an article on acupuncture that cries out for a response. Here, I show you the original article followed by my short comments. For clarity, I have omitted the references from the article and added references that refer to my comments.

_________________________________________

Conventional allopathic medicine [1]—medications and surgery [2] used in conventional systems of medicine to treat or prevent disease [3]—is often expensive, can cause side effects and harm, and is not always the optimal treatment for long term conditions such as chronic pain [4]. Where conventional treatments have not been successful, acupuncture and other traditional and complementary medicines have potential to play a role in optimal patient care [5].

According to the World Health Organisation (WHO) 2019 global report, acupuncture is widely used across the world. [6] In some countries acupuncture is covered by health insurance and established regulations. [7] In the US, practitioners administer over 10 million acupuncture treatments annually. [6] In the UK, clinicians administer over 4 million acupuncture treatments annually, and it is provided on the NHS. [6]

Given the widespread use of acupuncture as a complementary therapy alongside conventional medicine, there has been an increase in global research interest and funding support over recent decades. In 2009, the European Commission launched a Good Practice in Traditional Chinese Medicine Research (GP-TCM) funding initiative in 19 countries. [7] The GP-TCM grant aimed to investigate the safety and efficacy of acupuncture as well as other traditional Chinese medicine interventions.

In China, acupuncture is an important focus of the national research agenda and receives substantial research funding. [8] In 2016, the state council published a national strategy supporting universal access to acupuncture by 2020. China has established more than 79 evidence-based traditional Chinese medicine or integrative medicine research centers. [9]

Given the broad clinical application and rapid increase in funding support for acupuncture research, researchers now have additional opportunities to produce high-quality studies. However, for this to be successful, acupuncture research must address both methodological limitations and unique research challenges.

This new collection of articles, published in The BMJ, analyses the progress of developing high quality research studies on acupuncture, summarises the current status, and provides critical methodological guidance regarding the production of clinical evidence on randomised controlled trials, clinical practice guidelines and health economic evidence. It also assesses the number and quality of systematic reviews of acupuncture. [10] We hope that the collection will help inform the development of clinical practice guidelines, health policy, and reimbursement decisions. [11]

The articles document the progress of acupuncture research. In our view, the emerging evidence base on the use of acupuncture warrants further integration and application of acupuncture into conventional medicine. [12] National, regional, and international organisations and health systems should facilitate this process and support further rigorous acupuncture research.

Footnotes

This article is part of a collection funded by the special purpose funds for the belt and road, China Academy of Chinese Medical Sciences, National Natural Science Foundation of China, the National Center for Complementary and Integrative Health, the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine, the Special Project of “Lingnan Modernization of Traditional Chinese Medicine” of the 2019 Guangdong Key Research and Development Program, and the Project of First Class Universities and High-level Dual Discipline for Guangzhou University of Chinese Medicine. The BMJ commissioned, peer reviewed, edited, and made the decision to publish. Kamran Abbasi was the lead editor for The BMJ. Yu-Qing Zhang advised on commissioning for the collection, designed the topic of the series, and coordinated the author teams. Gordon Guyatt provided valuable advice and guidance. [13]

1. Allopathic medicine is the term Samuel Hahnemann coined for defaming conventional medicine. Using it in the first sentence of the article sets the scene very well.

2. Medicine is much more than ‘medications and surgery’. To imply otherwise is a strawman fallacy.

3. What about rehabilitation medicine?

4. ‘Conventional medicine is not always the optimal treatment’? This statement is very confusing and wrong. It is true that conventional medicine is not always effective. However, it is by definition the best we currently have and therefore it IS optimal.

5. Another fallacy: non sequitur

6. Another fallacy: appeal to popularity.

7. Yet another fallacy: appeal to authority.

8. TCM is heavily promoted by China not least because it is a most lucrative source of income.

9. Several research groups have shown that 100% of acupuncture research coming out of China report positive results. This casts serious doubt on the reliability of these studies (see, for instance, here, here, and here).

10. It has been noted that more than 80 percent of clinical data from China is fabricated.

11. Based on the points raised above, it seems to me that the collection’s aim is not to provide objective information but uncritical promotion.

12. I find it telling that the authors do not even consider the possibility that rigorous research might demonstrate that acupuncture cannot generate more good than harm.

13. This statement essentially admits that the series of articles constitutes paid advertising for TCM. The BMJ’s peer-review process must have been less than rigorous in this case.

All this does not bode well for the rest of the collection. Looking at the two further acupuncture papers (see here and here) from the same BMJ issue, my fear that the uncritical promotion of acupuncture will be a prominent feature was amply confirmed.

On 27 January 2022, I conducted a very simple Medline search using the search term ‘Chinese Herbal Medicine, Review, 2022’. Its results were remarkable; here are the 30 reviews I found:

  1. Zhu, S. J., Wang, R. T., Yu, Z. Y., Zheng, R. X., Liang, C. H., Zheng, Y. Y., Fang, M., Han, M., & Liu, J. P. (2022). Chinese herbal medicine for myasthenia gravis: A systematic review and meta-analysis of randomized clinical trials. Integrative medicine research11(2), 100806.
  2. Lu, J., Li, W., Gao, T., Wang, S., Fu, C., & Wang, S. (2022). The association study of chemical compositions and their pharmacological effects of Cyperi Rhizoma (Xiangfu), a potential traditional Chinese medicine for treating depression. Journal of ethnopharmacology287, 114962.
  3. Su, F., Sun, Y., Zhu, W., Bai, C., Zhang, W., Luo, Y., Yang, B., Kuang, H., & Wang, Q. (2022). A comprehensive review of research progress on the genus Arisaema: Botany, uses, phytochemistry, pharmacology, toxicity and pharmacokinetics. Journal of ethnopharmacology285, 114798.
  4. Nanjala, C., Ren, J., Mutie, F. M., Waswa, E. N., Mutinda, E. S., Odago, W. O., Mutungi, M. M., & Hu, G. W. (2022). Ethnobotany, phytochemistry, pharmacology, and conservation of the genus Calanthe R. Br. (Orchidaceae). Journal of ethnopharmacology285, 114822.
  5. Li, M., Jiang, H., Hao, Y., Du, K., Du, H., Ma, C., Tu, H., & He, Y. (2022). A systematic review on botany, processing, application, phytochemistry and pharmacological action of Radix Rehmnniae. Journal of ethnopharmacology285, 114820.
  6. Mutinda, E. S., Mkala, E. M., Nanjala, C., Waswa, E. N., Odago, W. O., Kimutai, F., Tian, J., Gichua, M. K., Gituru, R. W., & Hu, G. W. (2022). Traditional medicinal uses, pharmacology, phytochemistry, and distribution of the Genus Fagaropsis (Rutaceae). Journal of ethnopharmacology284, 114781.
  7. Xu, Y., Liu, J., Zeng, Y., Jin, S., Liu, W., Li, Z., Qin, X., & Bai, Y. (2022). Traditional uses, phytochemistry, pharmacology, toxicity and quality control of medicinal genus Aralia: A review. Journal of ethnopharmacology284, 114671.
  8. Peng, Y., Chen, Z., Li, Y., Lu, Q., Li, H., Han, Y., Sun, D., & Li, X. (2022). Combined therapy of Xiaoer Feire Kechuan oral liquid and azithromycin for mycoplasma Pneumoniae pneumonia in children: A systematic review & meta-analysis. Phytomedicine : international journal of phytotherapy and phytopharmacology96, 153899.
  9. Xu, W., Li, B., Xu, M., Yang, T., & Hao, X. (2022). Traditional Chinese medicine for precancerous lesions of gastric cancer: A review. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie146, 112542.
  10. Wang, Y., Greenhalgh, T., Wardle, J., & Oxford TCM Rapid Review Team (2022). Chinese herbal medicine (“3 medicines and 3 formulations”) for COVID-19: rapid systematic review and meta-analysis. Journal of evaluation in clinical practice28(1), 13–32.
  11. Chen, X., Lei, Z., Cao, J., Zhang, W., Wu, R., Cao, F., Guo, Q., & Wang, J. (2022). Traditional uses, phytochemistry, pharmacology and current uses of underutilized Xanthoceras sorbifolium bunge: A review. Journal of ethnopharmacology283, 114747.
  12. Liu, X., Li, Y., Bai, N., Yu, C., Xiao, Y., Li, C., & Liu, Z. (2022). Updated evidence of Dengzhan Shengmai capsule against ischemic stroke: A systematic review and meta-analysis. Journal of ethnopharmacology283, 114675.
  13. Chen, J., Zhu, Z., Gao, T., Chen, Y., Yang, Q., Fu, C., Zhu, Y., Wang, F., & Liao, W. (2022). Isatidis Radix and Isatidis Folium: A systematic review on ethnopharmacology, phytochemistry and pharmacology. Journal of ethnopharmacology283, 114648.
  14. Tian, J., Shasha, Q., Han, J., Meng, J., & Liang, A. (2022). A review of the ethnopharmacology, phytochemistry, pharmacology and toxicology of Fructus Gardeniae (Zhi-zi). Journal of ethnopharmacology, 114984. Advance online publication.
  15. Wong, A. R., Yang, A., Li, M., Hung, A., Gill, H., & Lenon, G. B. (2022). The Effects and Safety of Chinese Herbal Medicine on Blood Lipid Profiles in Placebo-Controlled Weight-Loss Trials: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM2022, 1368576.
  16. Lu, C., Ke, L., Li, J., Wu, S., Feng, L., Wang, Y., Mentis, A., Xu, P., Zhao, X., & Yang, K. (2022). Chinese Medicine as an Adjunctive Treatment for Gastric Cancer: Methodological Investigation of meta-Analyses and Evidence Map. Frontiers in pharmacology12, 797753.
  17. Niu, L., Xiao, L., Zhang, X., Liu, X., Liu, X., Huang, X., & Zhang, M. (2022). Comparative Efficacy of Chinese Herbal Injections for Treating Severe Pneumonia: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials. Frontiers in pharmacology12, 743486.
  18. Zhang, L., Huang, J., Zhang, D., Lei, X., Ma, Y., Cao, Y., & Chang, J. (2022). Targeting Reactive Oxygen Species in Atherosclerosis via Chinese Herbal Medicines. Oxidative medicine and cellular longevity2022, 1852330.
  19. Zhou, X., Guo, Y., Yang, K., Liu, P., & Wang, J. (2022). The signaling pathways of traditional Chinese medicine in promoting diabetic wound healing. Journal of ethnopharmacology282, 114662.
  20. Yang, M., Shen, C., Zhu, S. J., Zhang, Y., Jiang, H. L., Bao, Y. D., Yang, G. Y., & Liu, J. P. (2022). Chinese patent medicine Aidi injection for cancer care: An overview of systematic reviews and meta-analyses. Journal of ethnopharmacology282, 114656.
  21. Liu, H., & Wang, C. (2022). The genus Asarum: A review on phytochemistry, ethnopharmacology, toxicology and pharmacokinetics. Journal of ethnopharmacology282, 114642.
  22. Lin, Z., Zheng, J., Chen, M., Chen, J., & Lin, J. (2022). The Efficacy and Safety of Chinese Herbal Medicine in the Treatment of Knee Osteoarthritis: An Updated Systematic Review and Meta-Analysis of 56 Randomized Controlled Trials. Oxidative medicine and cellular longevity2022, 6887988.
  23. Yu, R., Zhang, S., Zhao, D., & Yuan, Z. (2022). A systematic review of outcomes in COVID-19 patients treated with western medicine in combination with traditional Chinese medicine versus western medicine alone. Expert reviews in molecular medicine24, e5.
  24. Mo, X., Guo, D., Jiang, Y., Chen, P., & Huang, L. (2022). Isolation, structures and bioactivities of the polysaccharides from Radix Hedysari: A review. International journal of biological macromolecules199, 212–222.
  25. Yang, L., Chen, X., Li, C., Xu, P., Mao, W., Liang, X., Zuo, Q., Ma, W., Guo, X., & Bao, K. (2022). Real-World Effects of Chinese Herbal Medicine for Idiopathic Membranous Nephropathy (REACH-MN): Protocol of a Registry-Based Cohort Study. Frontiers in pharmacology12, 760482.
  26. Zhang, R., Zhang, Q., Zhu, S., Liu, B., Liu, F., & Xu, Y. (2022). Mulberry leaf (Morus alba L.): A review of its potential influences in mechanisms of action on metabolic diseases. Pharmacological research175, 106029.
  27. Yuan, J. Y., Tong, Z. Y., Dong, Y. C., Zhao, J. Y., & Shang, Y. (2022). Research progress on icariin, a traditional Chinese medicine extract, in the treatment of asthma. Allergologia et immunopathologia50(1), 9–16.
  28. Zeng, B., Wei, A., Zhou, Q., Yuan, M., Lei, K., Liu, Y., Song, J., Guo, L., & Ye, Q. (2022). Andrographolide: A review of its pharmacology, pharmacokinetics, toxicity and clinical trials and pharmaceutical researches. Phytotherapy research : PTR36(1), 336–364.
  29. Zhang, L., Xie, Q., & Li, X. (2022). Esculetin: A review of its pharmacology and pharmacokinetics. Phytotherapy research : PTR36(1), 279–298.
  30. Wang, D. C., Yu, M., Xie, W. X., Huang, L. Y., Wei, J., & Lei, Y. H. (2022). Meta-analysis on the effect of combining Lianhua Qingwen with Western medicine to treat coronavirus disease 2019. Journal of integrative medicine20(1), 26–33. https://doi.org/10.1016/j.joim.2021.10.005

The amount of reviews alone is remarkable, I think: more than one review per day! Apart from their multitude, the reviews are noteworthy for other reasons as well.

  • Their vast majority arrived at positive or at least encouraging conclusions.
  • Most of the primary studies are from China (and we have often discussed how unreliable these trials are).
  • Many of the primary studies are not accessible.
  • Those that are accessible tend to be of lamentable quality.

I fear that all this is truly dangerous. The medical literature is being swamped with reviews of Chinese herbal medicine and other TCM modalities. Collectively they give the impression that these treatments are supported by sound evidence. Yet, the exact opposite is the case.

The process that is happening in front of our very eyes is akin to that of money laundering. Unreliable and often fraudulent data is being white-washed and presented to us as evidence.

The result:

WE ARE BEING SYSTEMATICALLY MISLED!

I have studied so-called alternative medicine for decades, and yet, I have to admit that I am learning every day. There is so much I did not know. Take this statement, for instance:

All alternative healing methods work specifically on a certain level, they are a part of the zero point energy/tachyon energy and therefore optimal to combine. For example, very good experiences have been made with homeopathy, plant extracts, Bach flowers, aura soma, bodywork, oxygen and gemstone therapy by doctors and alternative practitioners. Here, zero-point energy products were used together with other forms of therapy. Sometimes the applied remedies (e.g. Bach flowers, homeopathy) were combined with a zero-point energy product. This is done by simply placing the remedy on e.g. a zero point energy cork plate. Very good results were achieved when an applied remedy was directly converted into a zero-point energy antenna. Silica, healing earth, herbal teas and extracts, and especially water are particularly suitable for this.

The statement comes from a manufacturer that sells no end of fascinating products. This advertisement (my translation) does not hold back, for example:

Through the rediscovery of “old” Atlantic knowledge, it is now possible to use this directly for everyone.

This also includes the Atlantic energy grid. It consists of copper wire, is tuned exactly according to the sacred geometry and connected to form a grid.

In connection with a healing generator, which among other things consists of a large natural rock crystal, this copper grid has a very balancing effect on one’s own energy balance. Measurements with the Prognos measuring method (meridian skin zone measuring device) have already been carried out with success.

This therapy device has also been converted into a zero-point energy antenna. Thus the energy buffet is enlarged, the strong Atlantic energies are harmonised and the body can elegantly help itself to the energies. More detailed descriptions of the energy grid are difficult to formulate in words. Here we recommend simply testing the energy grid and feeling into it. One’s own experiences convey more than words.

All users who have used it so far are simply thrilled.

_______________________

In case you find the price for the ‘Atlantic Energy Grid’ of 5.500 Euro unconvincingly low, I recommend another product from the same manufacturer. Here is what they say about it:

Our T 33, the Torus Tesla coil, has been newly designed and specially developed to harmonise the problems of microwave radiation, especially 5G. The combination of the Torus energy with a Tesla coil has the possibility to additionally connect a frequency generator.

The cells align themselves energetically again according to their origin, the polarity in the cells is readjusted. A true fountain of youth!

Introductory price of 7890 € is valid until all test results are available.

_____________________

Gadgets like this never fail to remind me of a post I published 10 years ago entitled How to become a charlatan. I cannot help thinking that the entrepreneurs who market them have studied my advice thoroughly and followed every word I said.

:

 

“There’s a sucker born every minute”. This phrase was allegedly coined by P. T. Barnum, an American showman of the mid-19th century pictured below. It describes the tendency of the gullible of us to believe all too readily and therefore to be easily deceived.

Gullibility can be described as a failure of social intelligence in which a person is easily tricked or manipulated into a course of action for which there is no plausible evidence. To express it positively, gullible people are naively trusting and thus fall for nonsensical propositions. This renders them easy prey for exploiters.

On this blog, we see our fair share of this phenomenon, e.g.:

  • people who are easily persuaded by anecdotes,
  • who disregard evidence
  • who fall for pseudoscience,
  • who have irrational belief systems,
  • who thrive on fallacies,
  • who cherry-pick the evidence that fits their belief,
  • who are unable to change their views in the face of evidence,
  • who interpret even contradictory facts such that they confirm their belief,
  • who have no ability to think critically,
  • who would do just about anything to avoid cognitive dissonance.

Let me give you just three well-known examples from the realm of so-called alternative medicine (SCAM).

  1. Advocates of SCAM believe that natural means safe. Yet the therapies used in SCAM are neither natural nor devoid of risks.
  2. Advocates of SCAM believe that treatments that have a long tradition of usage must be fine. Yet a long history might just signify that the therapy in question is based on obsolete principles.
  3. Advocates of integrative medicine believe that, by adding unproven therapies to our medicine bag, we might improve healthcare. Yet it is clear that such a move can only make it less effective.

If I look back on 30 years of research into SCAM, I have to say that it very much looks as though a sucker is indeed born every minute.

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