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

Prince Charles

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The definitions of a quack as used in healthcare vary somewhat:

Richard Lanigan, in his post entitled Skeptics like Edzard Ernst remind me of Humpty Dumpty in their use of words. They make them up as they go along prefers the the definition from the Oxford dictionary: “a person who dishonestly claims to have special knowledge and skill in some field, typically medicine” (actually, the version of the Oxford dictionary I accessed defines a quack not quite like this but as a person who dishonestly claims to have medical knowledge or skills).

More importantly, Richard claims in an oddly incoherent post that not the chiropractors but the critics of chiropractic are are the true quacks:

It would appear “quacks” are people who pretend to have expertise in subjects they know little about, presumably subjects like, chiropractic medicine or acupuncture. I practice chiropractic, I dont diagnose or treat illness or disease, I dont make medical claims. You may not like chiropractic or understand it, however practicing chiropractic would not appear to conform to the definition of “quackery”, however claiming to have “special knowledge” about chiropractic and having only been trained as a medical practitioner may in fact make you a “quack” professor Ernst. All I do is maintain movement in spinal joints that become stiff from sedentary lifestyles, movement effects function of mechano receptors(nerves) in spinal joints. You may not believe that is possible, you may not believe maintaining joint function is important or that it effects wellbeing, you are perfectly entitled to your opinion, however I am not so confident of you depth and breath knowledge in anatomy and physiology. You might start by asking, why joints were immobility post surgery in the 80s and now post surgical treatment is all about maintaining joint motion as chiropractors have been advocating for years.

If I understand this correctly, this means: any non-chiropractor who criticises chiropractic is a quack. Moreover, it means that, as chiropractic is very rarely criticised by a chiropractor, chiropractors cannot be quacks.

I find this fascinating. It amounts to the legitimisation of any healthcare profession, however bizarre, unproven, disproven or dangerous their practice might be:

  • crystal therapists cannot be accused of quackery, because only their kind understand their business;
  • rebirthing practitioners cannot be accused of quackery, because only their kind understand their business;
  • applied kinesiologists cannot be accused of quackery, because only their kind understand their business;
  • bioresonance practitioners cannot be accused of quackery, because only their kind understand their business;
  • Bach flower therapists therapists cannot be accused of quackery, because only their kind understand their business;
  • colour therapists cannot be accused of quackery, because only their kind understand their business;
  • colon therapists cannot be accused of quackery, because only their kind understand their business;
  • dowsers cannot be accused of quackery, because only their kind understand their business;
  • ear candle practitioners cannot be accused of quackery, because only their kind understand their business;
  • feng shui practitioners cannot be accused of quackery, because only their kind understand their business;
  • faith healers cannot be accused of quackery, because only their kind understand their business;
  • gua sha practitioners cannot be accused of quackery, because only their kind understand their business;
  • iridologists cannot be accused of quackery, because only their kind understand their business;
  • homeopaths cannot be accused of quackery, because only their kind understand their business;
  • naprapathy therapists cannot be accused of quackery, because only their kind understand their business;
  • neurolinguistic programmers cannot be accused of quackery, because only their kind understand their business;
  • osteopaths cannot be accused of quackery, because only their kind understand their business;
  • pranic healers cannot be accused of quackery, because only their kind understand their business;
  • psychic surgeons cannot be accused of quackery, because only their kind understand their business;
  • radionics practitioners cannot be accused of quackery, because only their kind understand their business;
  • reflexologists cannot be accused of quackery, because only their kind understand their business;
  • Reiki masters cannot be accused of quackery, because only their kind understand their business;
  • shiatsu practitioners cannot be accused of quackery, because only their kind understand their business;
  • therapeutic touchers cannot be accused of quackery, because only their kind understand their business;
  • vaginal steamers cannot be accused of quackery, because only their kind understand their business;
  • etc, etc.

I can, of course, easily see why Richard Lanigan would like this concept to be true. Alas, Richard (and all the other SCAM-enthusiasts who make similar arguments), it does not work like this! A quack might be defined as listed above or in many other ways. But, in so-called alternative medicine (SCAM), a quack foremost is a person who habitually misleads the public by making claims that are not supported by sound evidence. And as some wise guy once observed: honest conviction renders a quack only more dangerous. As to the professional background of a quack:

I do not care a hoot!

I have done my best to disclose quackery no matter whether it came from a medic or a SCAM-practitioner, a physio or a nurse, an entrepreneur or a fruitcake, an evangelist or a politician, royalty or commoner. And, believe me, Richard (plus all the other SCAM-enthusiasts who make similar arguments), I will carry on doing so, whether it fits into your little scheme of wishful thinking or not.

Prof Ernst is far too critical about homeopathy!

He is biased against it!

He cherry-picks the evidence!

He does not understand homeopathy!

If you are one of the many who believe such notions, please read on.

The website of the NHS England has a fairly detailed account of homeopathy. Here is the section entitled ‘What can we conclude from the evidence?‘ – but I recommend reading the full text:

There have been several reviews of the scientific evidence on the effectiveness of homeopathy.

The House of Commons Science and Technology Committee said there’s no evidence that homeopathy is effective as a treatment for any health condition.

There’s no evidence behind the idea that substances that cause certain symptoms can also help treat them.

Nor is there any evidence behind the idea that diluting and shaking substances in water can turn those substances into medicines.

The ideas that underpin homeopathy aren’t accepted by mainstream science, and aren’t consistent with long-accepted principles on the way the physical world works.

The Committee’s 2010 report on homeopathy said the “like cures like” principle is “theoretically weak”, and that this is the “settled view of medical science”.

For example, many homeopathic remedies are diluted to such an extent that it’s unlikely there’s a single molecule of the original substance remaining in the final remedy. In cases like these, homeopathic remedies consist of nothing but water.

Some homeopaths believe that, as a result of the succussion process, the original substance leaves an “imprint” of itself on the water. But there’s no known mechanism by which this can occur.

The 2010 report said: “We consider the notion that ultra-dilutions can maintain an imprint of substances previously dissolved in them to be scientifically implausible.”

Some people who use homeopathy may see an improvement in their health condition as the result of a phenomenon known as the placebo effect.

If you choose health treatments that provide only a placebo effect, you may miss out on other treatments that have been proven to be more effective.

__________________________________

Since 1948, homeopathy had been part of the NHS, there were 5 homeopathic NHS hospitals, and the costs for homeopathy were covered. Why would the NHS decision makers suddenly turn against it? They must have loved homeopathy for at least 4 reasons:

      1. It is inexpensive.
      2. It has support in high places.
      3. It did not cause any direct harm.
      4. It had many supporters who fought tooth and nail for it.

It is therefore hardly reasonable to assume that the NHS is biased against homeopathy. But, why do they now say that it is

  • implausible,
  • not effective beyond placebo,
  • and can cause harm by making people miss out on effective therapies?

 

The answer is simple: BECAUSE THESE STATEMENTS ARE IN ACCORDANCE WITH THE OVERWHELMING MAJORITY OF THE BEST EVIDENCE AVAILABLE TO DATE.

So, here you are: the NHS now confirms what I (and many other experts) have been saying since years. And we all insist on the fact that this not because we are biased, stupid, uninformed, paid by BIG PHARMA, or want to deprive anyone of anything. We do it for one reason only:

BECAUSE IT’S THE TRUTH!

Michael Dixon LVOOBEMAFRCGP has been a regular feature of this blog (and elsewhere). He used to be a friend and colleague until … well, that’s a long story. Recently, I came across his (rather impressive) Wikipedia page. To my surprise, it mentions that Dixon

See the source image“has been criticised by professor of complementary medicine and alternative medicine campaigner Edzard Ernst for advocating the use of complementary medicine. Ernst said that the stance of the NHS Alliance on complementary medicine was “misleading to the degree of being irresponsible.”[31] Ernst had previously been sympathetic to building a bridge between complementary and mainstream medicine, co-writing an article with Michael Dixon in 1997 on the benefits of such an approach.[32] Ernst and Dixon write “missed diagnoses by complementary therapists giving patients long term treatments are often cited but in the experience of one of the authors (MD) are extremely rare. It can also cut both ways. A patient was recently referred back to her general practitioner by an osteopath, who was questioning, as it turned out quite correctly, whether her pain was caused by metastates. Good communication between general practitioner and complementary therapist can reduce conflicts and contradictions, which otherwise have the potential to put orthodox medicine and complementary therapy in an either/or situation.”

REFERENCES

31) February 2009, 24. “Academics and NHS Alliance clash over complementary medicine”. Pulse Today.

32) ^ Update – the journal of continuing education for General Practitioners, 7th May 1997

I have little recollection of the paper that I seem to have published with my then friend Michael, and it is not listed in Medline, nor can I find it in my (usually well-kept) files; the journal ‘Update’ does not exist anymore and was obviously not a journal good enough for keeping a copy. But I do not doubt that Wiki is correct.

In fact, it is true that, in 1997, I was still hopeful that bridges could be built between conventional medicine and so-called alternative medicine (SCAM). But I had always insisted that they must be bridges built on solid ground and with robust materials.

Put simply, my strategy was to test SCAM as rigorously as I could and to review the totality of the evidence for and against it. Subsequently, one could consider introducing those SCAMs into routine care that had passed the tests of science.

Dixon’s strategy differed significantly from mine. He had no real interest in science and wanted to use SCAM regardless of the evidence. Since the publication of our paper in 1997, he has pursued this aim tirelessly. On this blog, we find several examples of his activity.

And what happened to the bridges?

I’m glad you ask!

As it turns out, very few SCAMs have so far passed the test of science and hardly any SCAM has been demonstrated to generate more good than harm. The material to build bridges is therefore quite scarce, hardly enough for solid constructions. Dixon does still not seem to be worried about this indisputable fact. He thinks that INTEGRATED MEDICINE is sound enough for providing a way to the future. I disagree and still think it is ‘misleading to the degree of being irresponsible’.

Who is right?

Dixon or Ernst?

Opinions about this differ hugely.

Time will tell, I suppose.

Yesterday, it was announced that UK universities are not doing well according to international league tables. Of the UK’s 84 ranked universities, 66 saw their staff to student ratio decline while 59 had a drop in research citations. International student numbers at 51 universities also fell.

No reason to despair; help is on the way!

The University of Exeter reported that “as International Education Champion, Sir Steve will have a leading role in a 10-year strategy to both increase the number of international students choosing to study in the UK higher education system to 600,000 and increase the value of education exports to £35 billion per year by 2030. The University of Exeter is delighted and proud with this appointment…

The role of International Education Champion will be to work with organisations across the breadth of the education sector, including universities, schools, the EdTech industry, vocational training, and early years schooling providers. Steve will also help target priority regions worldwide to build networks and promote the UK as the international education partner of choice. The role will additionally help to boost the numbers of international students in the UK.

The appointment of Sir Steve Smith fulfils a priority action from the International Education Strategy, published by the Department for Education and the Department for International Trade. Sir Steve will spearhead overseas activity and address a number of market access barriers on behalf of the whole education sector, including concerns over the global recognition of UK degrees and other qualifications. Sir Steve’s experience, knowledge and global connections will help to develop long-term relationships with international governments and overseas stakeholders…”

Shortly after becoming VC at Exeter, Prof Smith closed two Departments: Music and Chemistry. Apparently, they were not bringing in enough cash. Several years later, he had a key role in closing my unit. It had attracted a complaint from Prince Charles’ 1st private secretary (full story here, in case you are interested).

I hope Sir Steve is more productive in boosting international education. One thing seems certain to me: post-Brexit/post-COVID academia in the UK will need a boost after what our current government has done to it.

The Foundation for Integrated Health (FIH) does no longer exist. But it is historically important, in my view. So, I decided to do some research in order to document its perplexing history. In the course of this activity, I found that someone had beaten me to it. This article that does the job very well; I therefore take the liberty of copying it here and adding a few points at the end:

The Foundation for Integrated Health (FIH) was a controversial charity run by Charles, Prince of Wales, founded in 1993. The Foundation promoted complementary and alternative medicine, preferring to use the term “integrated health”, and lobbied for its inclusion in the National Health Service. The charity closed in 2010 after allegations of fraud and money laundering led to the arrest of a former official.

History

Prince Charles established the charity in 1993 to explore “how safe, proven complementary therapies can work in conjunction with mainstream medicine”. [1]

Dr Michael Dixon was appointed the Foundation’s medical director. From 2005 to 2007, FIH received a grant from the Department of Health to help organise the self-regulation of complementary therapies. There had been concern that with a large proportion of the public turning to complementary approaches, there were few safeguards in place to ensure that non-statutorily regulated therapists were safe, trained and would act in an appropriate way. FIH worked to bring together the representative bodies of many complementary professions to talk and agree standards. [2] The result was the formation of the Complementary and Natural Healthcare Council (CNHC) which had hoped to register 10,000 practitioners of complementary medicine by the end of 2009 but which by September 2009 had succeeded in enrolling less than a tenth of that number due to lack of interest on the part of some of their professional associations. The Department of Health is currently continuing to fund the CNHC but future funding will be dependent on substantial progress being made towards the target (which has now been reduced to 2,000). Alternative medicine campaigners argued that the move toward regulation conferred undue respectability on unproven and possibly unsafe complementary & alternative medicine (CAM) approaches.

FIH also worked with medical schools to increase the understanding of complementary approaches amongst new doctors and ran an annual awards ceremony for integrated health schemes both within the medical world and in the community.

The papers of the Foundation for Integrated Health are held at the Wellcome Library, Archives and Manuscripts, and are available for consultation by appointment. Further details about the collection can be found on the Wellcome online catalogue. [3]

Controversy

The Prince of Wales has demonstrated an interest in alternative medicine, the promotion of which has occasionally resulted in controversy. [4] In 2004, the Foundation divided the scientific and medical community over its campaign encouraging general practitioners to offer herbal and other alternative treatments to National Health Service patients, [5] [6] and in May 2006, The Prince made a speech to an audience of health ministers from various countries at the World Health Assembly in Geneva, urging them to develop a plan for integrating conventional and alternative medicine. [7]

In April 2008, The Times published a letter from Professor Edzard Ernst that asked the Prince’s Foundation to recall two guides promoting “alternative medicine”, saying: “the majority of alternative therapies appear to be clinically ineffective, and many are downright dangerous.” A speaker for the foundation countered the criticism by stating: “We entirely reject the accusation that our online publication Complementary Healthcare: A Guide contains any misleading or inaccurate claims about the benefits of complementary therapies. On the contrary, it treats people as adults and takes a responsible approach by encouraging people to look at reliable sources of information… so that they can make informed decisions. The foundation does not promote complementary therapies.” [8] Ernst has recently published a book with science writer Simon Singh condemning alternative medicine called Trick or Treatment: Alternative Medicine on Trial . The book is ironically dedicated to “HRH the Prince of Wales” and the last chapter is very critical of his advocacy of “complementary” and “alternative” treatments. [9]

The Prince’s Duchy Originals have produced a variety of CAM products including a “Detox Tincture” that Ernst has denounced as “financially exploiting the vulnerable” and “outright quackery“. [10] In May 2009, the Advertising Standards Authority criticised an email that Duchy Originals had sent out to advertise its Echina-Relief, Hyperi-Lift and Detox Tinctures products saying it was misleading. [11]

In Ernst’s book More Good Than Harm? The Moral Maze of Complementary and Alternative Medicine he and ethicist Kevin Smith call Charles “foolish and immoral” and “conclude that it is not possible to practice alternative medicine ethically”. Ernst further claims that the private secretary of the Prince contacted the vice chancellor of Exeter University to investigate Ernst’s complaints against the “Smallwood Report” which the Prince had commissioned in 2005. While Ernst was “found not to be guilty of any wrong-doing, all local support at Exeter stopped, which eventually led to my early retirement.” [12]

Between 2005 and 2007 the charity’s annual turnover was about £1.2 million. [13] In 2007 it received significant funding from The Prince’s Charities Foundation, and a £300,000 grant from the Department of Health for the regulation of complementary medicine. [14]

Lobbying allegations

The Prince personally wrote at least seven letters [15] to the Medicines and Healthcare products Regulatory Agency (MHRA) shortly before they relaxed the rules governing labelling of herbal products such as the ones sold by his duchy, a move that has been widely condemned by scientists and medical bodies. [16]

On 31 October 2009 it was reported that Prince Charles had personally lobbied Health Secretary Andy Burnham regarding greater provision of alternative treatments on the NHS. [10]

Charity Commission complaint

In March 2010, the political organisation Republic, which campaigns for an elected head of state, registered a complaint with the Charity Commission for England and Wales over a possible breach of charity regulations, suggesting that the foundation’s staff had pursued a public vendetta against Ernst. [17]

Fraud allegations and closure

In 2010, following accounting irregularities noted by the foundation’s auditor, it was reported that the Metropolitan Police Economic and Specialist Crime Command had begun an inquiry into alleged fraud. [18] Within weeks, two former officials at the Prince’s Foundation were arrested for fraud believed to total £300,000. [1] [19] Four days later, on 30 April 2010, the foundation announced [20] that it would close. The foundation stated that its closure was the result of the fraud allegations. [21]

The charity’s finance director, accountant George Gray, was convicted of theft totalling £253,000 and sentenced to three years in prison. [22] [23]

Rebranding as “The College of Medicine”

Following the disbanding of the Prince’s Foundation, many of the individuals and organisations involved launched a new organisation in late 2010 called The College of Medicine, with which the Prince of Wales was not overtly involved. Several commentators writing in The Guardian and The British Medical Journal, have expressed the opinion that the new organisation is simply a re-branding of the Prince’s Foundation, [22] [24] [25] [26] [27] describing it as “Hamlet without the Prince”. [28]

In support of this connection with Prince Charles, alternative medicine critic and pharmacologist David Colquhoun has argued that the College (originally called “The College of Integrated Health”) is extremely well-funded [29] and seemed from the beginning to be very confident of the Prince’s support; explicitly describing its mission as “to take forward the vision of HRH the Prince of Wales”. [30]

These claims have been contested by the College. [31]

  1. Robert Booth (26 April 2010). “Prince Charles’s aide at homeopathy charity arrested on suspicion of fraud”. London: guardian.co.uk.
  2. ↑ Regulating complementary therapies – Prince’s Foundation for Integrated Health
  3. ↑ “Wellcome Library Western Manuscripts and Archives catalogue”. Archives.wellcomelibrary.org. Retrieved 2015-09-07.
  4. ↑ Barnaby J. Feder, Special To The New York Times (9 January 1985). “More Britons Trying Holistic Medicine — New York Times”. Query.nytimes.com. Retrieved 2008-10-12.
  5. ↑ Carr-Brown, Jonathon (14 August 2005). “Prince Charles’ alternative GP campaign stirs anger”The Times. London. Retrieved 11 March 2009.
  6. ↑ Revill, Jo (2004-06-27). “Now Charles backs coffee cure for cancer”. London: The Observer. Retrieved 2007-06-19.
  7. ↑ Cowell, Alan (2006-05-24). “Lying in wait for Prince Charles”The New York Times. Retrieved 2009-10-15.
  8. ↑ Henderson, Mark (17 April 2008). “Prince of Wales’s guide to alternative medicine ‘inaccurate. London: Times Online. Retrieved 2008-08-30.
  9. ↑ Singh, S. & Ernst, E. (2008). Trick or Treatment: Alternative Medicine on Trial. Corgi.
  10. Tim Walker (31 Oct 2009). “Prince Charles lobbies Andy Burnham on complementary medicine for NHS”. London: Daily Telegraph. Retrieved 2010-04-01.
  11. ↑ “Duchy Originals Pork Pies”The Quackometer Blog. 11 March 2009.
  12. ↑ Ernst, Edzard (2018). “Why Did We Call Prince Charles Foolish and Immoral?”. Skeptical Inquirer. Committee for Skeptical Inquiry. 42 (3): 8–9.
  13. ↑ Charity CommissionThe Prince’s Foundation for Integrated Health, registered charity no. 1026800.
  14. ↑ The Prince’s Foundation for Integrated Health – 2007 accounts (PDF), Charity Commission, retrieved 2010-04-30
  15. ↑ “HRH “meddling in politics. DC’s Improbable Science. March 12, 2007.
  16. ↑ Nigel Hawkes & Mark Henderson (September 1, 2006). “Doctors attack natural remedy claims”The Times. London.
  17. ↑ Booth, Robert (19 March 2010). “Prince Charles health charity accused of vendetta against critic”. London: The Guardian.
  18. ↑ Delgado, Martin; Young, Andrew (4 April 2010). “Police probe into missing £300k at Prince Charles’ charity after bosses fail to file accounts”Daily Mail. London.
  19. ↑ “Prince Charles charity to close amid fraud inquiry”BBC News. 30 April 2010.
  20. ↑ Robert Booth (30 April 2010). “Prince of Wales’s health charity wound up in wake of fraud investigation”The Guardian.
  21. ↑ Laura Donnelly (15 May 2010). “Homeopathy is witchcraft, say doctors”. London: The Telegraph.
  22. Ian Sample (August 2, 2010). “College of Medicine born from ashes of Prince Charles’s holistic health charity”. London: The Guardian.
  23. ↑ Peter Dominiczak (20 August 2010). “Three years jail for accountant at Charles charity who stole £253,000”. Evening Standard. Archived from the original on 30 June 2011. Retrieved 2 February 2011.
  24. ↑ Jane Cassidy (15 June 2011). “Lobby Watch: The College of Medicine”British Medical Journal343: d3712. doi:10.1136/bmj.d3712PMID   21677014.
  25. ↑ David Colquhoun (12 July 2011). “The College of Medicine is Prince’s Foundation reincarnated”British Medical Journal343: d4368. doi:10.1136/bmj.d4368PMID   21750061.
  26. ↑ James May (12 July 2011). “College of Medicine: What is integrative health?”British Medical Journal343: d4372. doi:10.1136/bmj.d4372PMID   21750063.
  27. ↑ Edzard Ernst (12 July 2011). “College of Medicine or College of Quackery?”British Medical Journal343: d4370. doi:10.1136/bmj.d4370PMID   21750062.
  28. ↑ Nigel Hawkes (2010). “Prince’s foundation metamorphoses into new College of Medicine”341. British Medical Journal. p. 6126. doi:10.1136/bmj.c6126.
  29. ↑ David Colquhoun (July 25, 2010). “Buckinghamgate: the new “College of Medicine” arising from the ashes of the Prince’s Foundation for Integrated Health”. DC’s Improbable Science.
  30. ↑ David Colquhoun (29 October 2010). “Don’t be deceived. The new “College of Medicine” is a fraud and delusion”.
  31. ↑ Lewith, G. T.; Catto, G; Dixon, M; Glover, C; Halligan, A; Kennedy, I; Manning, C; Peters, D (12 July 011). College of Medicine replies to its critics”British Medical Journal343: d4364. :10.1136/bmj.d4364.    21750060.

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This article is, as far as I can see, factually correct. I might just add some details:

  • Dixon became medical director of the FIH only a few months before it had to close.
  • The FIH was also involved in Prince Charles’ complaint about me alleging I had breached confidence in relation to the Smallwood report, even though the FHI had officially nothing to do with the report.
  • Mr Smallwood told me that, at that stage, Prince Charles considered the FIH to be ‘a waste of space’.
  • Some time ago, the College of Medicine quietly re-named itself as the ‘College of Medicine and Integrated Health’.
  • Prince Charles recently became the patron of the College of Medicine and Integrated Health.

Many experts are wondering whether it is possible to stimulate our immune system such that we are better protected against getting infected with the coronavirus. Several options have been considered.

An innovative approach, for instance, seems to be this one:

Recently, we showed that intravenous immunoglobulin (IVIg) treatment reduces inflammation of intestinal epithelial cells and eliminates overgrowth of the opportunistic human fungal pathogen Candida albicans in the murine gut. Immunotherapy with IVIg could be employed to neutralize COVID-19. However, the efficacy of IVIg would be better if the immune IgG antibodies were collected from patients who have recovered from COVID-19 in the same city, or the surrounding area, in order to increase the chance of neutralizing the virus. These immune IgG antibodies will be specific against COVID-19 by boosting the immune response in newly infected patients. Different procedures may be used to remove or inactivate any possible pathogens from the plasma of recovered coronavirus patient derived immune IgG, including solvent/detergent, 60 °C heat-treatment, and nanofiltration. Overall, immunotherapy with immune IgG antibodies combined with antiviral drugs may be an alternative treatment against COVID-19 until stronger options such as vaccines are available.

Another suggestion involves monoclonal antibodies:

The therapeutic potential of monoclonal antibodies has been well recognized in the treatment of many diseases. Here, we summarize the potential monoclonal antibody based therapeutic intervention for COVID-19 by considering the existing knowledge on the neutralizing monoclonal antibodies against similar coronaviruses SARS-CoV and MERS-CoV. Further research on COVID-19 pathogenesis could identify appropriate therapeutic targets to develop specific anti-virals against this newly emerging pathogen.

These and several further options have in common that they are not backed by robust clinical evidence. Such a lack of data rarely bothers charlatans who use the corona-panic for promoting their bizarre concepts. Numerous promoters of so-called alternative medicine (SCAM) are trying their very best to mislead the public into thinking that their particular SCAM will do the trick.

In comes the PYROMANIAC IN A FIELD OF (INTEGRATIVE) STRAW-MEN, Dr Michael Dixon who recently proclaimed that ‘boosting immunity against coronavirus: ‘Now’s the time to turn to antioxidants and polyphenols’. Specifically, he recommended:

‘Eat dark greens, broccoli, spinach or any coloured root vegetable such as beetroot or carrots and any fruit ending in the word berry; black, blue… The alliums, such as leeks and garlic and onions, are very strong in the same sort of chemicals and also even things like dark chocolate and certain teas, particularly green tea. Those who want a glass of red wine, well that’s something that’s very much permitted too.’

Inspired by such positive thinking, I ventured to find some evidence for Dixon’s infinite wisdom. It could be that I am not very gifted at locating evidence – or perhaps there isn’t any?

Well, not quite; there is some on garlic that Dixon praises for its immune-boosting activity. Here is the abstract of a Cochrane review:

Background

Garlic is alleged to have antimicrobial and antiviral properties that relieve the common cold, among other beneficial effects. There is widespread usage of garlic supplements. The common cold is associated with significant morbidity and economic consequences. On average, children have six to eight colds per year and adults have two to four.

Objectives

To determine whether garlic (Allium sativum) is effective for the prevention or treatment of the common cold, when compared to placebo, no treatment or other treatments.

Search methods

We searched CENTRAL (2014, Issue 7),OLDMEDLINE (1950 to 1965),MEDLINE (January 1966 to July week 5, 2014), EMBASE(1974 to August 2014) and AMED (1985 to August 2014).

Selection criteria

Randomised controlled trials of common cold prevention and treatment comparing garlic with placebo, no treatment or standard treatment.

Data collection and analysis

Two review authors independently reviewed and selected trials from searches, assessed and rated study quality and extracted relevant data.

Main results

In this updated review, we identified eight trials as potentially relevant from our searches. Again, only one trial met the inclusion criteria. This trial randomly assigned 146 participants to either a garlic supplement (with 180 mg of allicin content) or a placebo (once daily)for 12 weeks. The trial reported 24 occurrences of the common cold in the garlic intervention group compared with 65 in the placebo group (P value < 0.001), resulting in fewer days of illness in the garlic group compared with the placebo group (111 versus 366). The number of days to recovery from an occurrence of the common cold was similar in both groups (4.63 versus 5.63). Only one trial met the inclusion criteria, therefore limited conclusions can be drawn. The trial relied on self reported episodes of the common cold but was of reasonable quality in terms of randomisation and allocation concealment. Adverse effects included rash and odour.

Authors’ conclusions

There is insufficient clinical trial evidence regarding the effects of garlic in preventing or treating the common cold. A single trial suggested that garlic may prevent occurrences of the common cold but more studies are needed to validate this finding. Claims of effectiveness appear to rely largely on poor-quality evidence.

Of course, this is not about corona but about the common cold. As for green tea, a recent review found a lack of reliable clinical data demonstrating its immune-boosting activities, a deficit also noted for chocolate.

But where IS the evidence that any of the above claims are true?

Could it be that there is no sound evidence to support Dixon’s recommendations?

Impossible!!!

That would mean that Dixon, advisor to Prince Charles, is stating nonsense in the name of his COLLEGE OF MEDICINE AND INTEGRATED HEALTH. This organisation has many very respectable people as members and officers. They would never allow that sort of thing to happen!

Or would they?

Yesterday, it was announced that Prince Charles, a long-time advocate of so-called alternative medicine (SCAM), has been taken ill with the corona virus. Since then, I have been inundated with messages about this fact. Many thought that, because Charles and I have a bit of history (details here), I might now ‘have a cup of tea and a malicious smile on [my] face thinking about it’, as someone put it on Twitter. Others made sarcastic comments suggesting that he will be fine because of all the help of the homeopathic cult.

I cannot join these sentiments. On the contrary, I sincerely wish him well – not because he is royalty, but because I wish everyone well who has been infected with this virus.

And I honestly do not think that Charles will be popping homeopathic placebos to save his life. Whenever a member of his (usually pro-homeopathy) family had fallen seriously ill in the past, they very quickly sought the help of the very best evidence-based medicine could offer. Charles’ present illness will be no exception, I am sure. If his infection becomes serious, he will have the benefit of everything modern scientific healthcare has to offer.

When he recovers – and I do hope he does – he will have plenty of time to think. Chances are that he never before had been afflicted with a killer disease. This should make him see things from an entirely new perspective. He must realise that so-called alternative medicine (SCAM) is an option only as long as one is healthy. Once the battle for saving a life is on, real medicine must save the day.

I am a born optimist, and therefore I hope that Charles on his sick-bed might even think a little further. He might realise that a health crisis, like the current corona pandemic, regularly brings out the charlatans who are trying to flog their wares or services to the unsuspecting public. On my blog, I have discussed some of these irresponsible rogues:

With a bit of luck, Charles might even reflect that his past endorsement of these quacks has been less than helpful; in the present crisis, it might even cost lives. Charles, I hope, will thus reconsider his attitude towards medicine, heaven knows, he might even become an outspoken advocate fro EBM!

So yes, I am an incurable optimist. Yet, I realise, of course, that Charles might not have any of these insights. That would be regrettable, but it does not deter me from wishing him a speedy recovery:

GET WELL SOON, CHARLES!

The website of this organisation is always good for a surprise. A recent announcement relates to a course of Thought Field Therapy (TFT):

As part of our ongoing programme to explore prospects for improved healthcare, the College is pleased to announce a course on TFT – a “Tapping” therapy – independently provided by Janet Thomson MSc.

In healthcare we may find ourselves exhausting the evidence-based options and still looking for ways to help our patients. So when trusted practitioners suggest simple and safe approaches that appear to have benefit we are interested.

TFT is a simple non-invasive, technique that anyone can learn, for themselves or to pass on to their patients, to help cope with negative thoughts and emotions. It was developed by Roger Callahan who discovered that tapping on certain meridian points could help counter negative emotions. Janet trained with Roger and has become an accomplished exponent of the technique.

Janet has contracted her usual two-day course into one: to get the most from this will require access to her Tapping For Life book and there will be pre-course videos demonstrating some of the key techniques.  The second consecutive day is available for advanced TFT training, to help in dealing with difficult cases, as well as how to integrate TFT with other modalities.

How much does it cost (excluding booking fee)?  Day One only – £195; Day Two only – £195 (only available if you have previously completed day one); Both Days – £375.

When is it?  Saturday & Sunday 7th-8th March – 09:30-17:30

What, you don’t know what TFT is? Let me fill you in.

According to Wiki, TFT is a fringe psychological treatment developed by an American psychologist, Roger Callahan.[2] Its proponents say that it can heal a variety of mental and physical ailments through specialized “tapping” with the fingers at meridian points on the upper body and hands. The theory behind TFT is a mixture of concepts “derived from a variety of sources. Foremost among these is the ancient Chinese philosophy of chi, which is thought to be the ‘life force’ that flows throughout the body”. Callahan also bases his theory upon applied kinesiology and physics.[3] There is no scientific evidence that TFT is effective, and the American Psychological Association has stated that it “lacks a scientific basis” and consists of pseudoscience.[2]

Other assessments are even less complimentary: Thought field therapy (TFT) is a New Age psychotherapy dressed up in the garb of traditional Chinese medicine. It was developed in 1981 by Dr. Roger Callahan, a cognitive psychologist. While treating a patient for water phobia:

He asked her to think about water, tap with two fingers on the point that connected with the stomach meridian and much to his surprise, her fear of water completely disappeared.*

Callahan attributes the cure to the tapping, which he thinks unblocked “energy” in her stomach meridian. I don’t know how Callahan got the idea that tapping on a particular point would have anything to do with relieving a phobia, but he claims he has developed taps for just about anything that ails you, including a set of taps that can cure malaria (NPR interview).

TFT allegedly “gives immediate relief for post traumatic stress disorder (PTSD ), addictions, phobias, fears, and anxieties by directly treating the blockage in the energy flow created by a disturbing thought pattern. It virtually eliminates any negative feeling previously associated with a thought.”*

The theory behind TFT is that negative emotions cause energy blockage and if the energy is unblocked then the fears will disappear. Tapping acupressure points is thought to be the means of unblocking the energy. Allegedly, it only takes five to six minutes to elicit a cure. Dr. Callahan claims an 85% success rate. He even does cures over the phone using “Voice Technology” on infants and animals; by analyzing the voice he claims he can determine what points on the body the patient should tap for treatment.

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Yes, TFT seems utterly implausible – but what about the clinical evidence?

There are quite a few positive controlled clinical trials of TFT. They all have one thing in common: they smell fishy to me! I know, that’s not a very scientific judgement. Let me rephrase it: I am not aware of a single trial that proves TFT to have effects beyond placebo (if you know one, please post the link).

And Janet Thomson, MSc (the therapist who runs the course), who is she? Her website is revealing; have a look if you are interested. If not, it might suffice to say that she modestly claims that she is an outstanding Life Coach, Therapist & Trainer.

So, considering that TFT is so very implausible and unproven, why does the ‘College of Medicine and Integrated Healthcare’ promote it in such strong terms?

I have to admit, I do not know the answer – perhaps they want at all costs to become known as the ‘College of Quack Medicine’?

I missed this article by Canadian vascular surgeons when it came out in 2018. It is well-argued, and I think you should read it in full, if you can get access (it’s behind a pay wall). It contains interesting details about the anti-vax attitude of doctors of integrative medicine (something we discussed before), as well as the most dubious things that go on in the ‘Cleveland Clinic’. Here is at least the abstract of the article:

Evidence-based medicine, first described in 1992, offers a clear, systematic, and scientific approach to the practice of medicine. Recently, the non-evidence-based practice of complementary and alternative medicine (CAM) has been increasing in the United States and around the world, particularly at medical institutions known for providing rigorous evidence-based care. The use of CAM may cause harm to patients through interactions with evidence-based medications or if patients choose to forego evidence-based care. CAM may also put financial strain on patients as most CAM expenditures are paid out-of-pocket. Despite these drawbacks, patients continue to use CAM due to media promotion of CAM therapies, dissatisfaction with conventional healthcare, and a desire for more holistic care. Given the increasing demand for CAM, many medical institutions now offer CAM services. Recently, there has been controversy surrounding the leaders of several CAM centres based at a highly respected academic medical institution, as they publicly expressed anti-vaccination views. These controversies demonstrate the non-evidence-based philosophies that run deep within CAM that are contrary to the evidence-based care that academic medical institutions should provide. Although there are financial incentives for institutions to provide CAM, it is important to recognize that this legitimizes CAM and may cause harm to patients. The poor regulation of CAM allows for the continued distribution of products and services that have not been rigorously tested for safety and efficacy. Governments in Australia and England have successfully improved regulation of CAM and can serve as a model to other countries.

Those who have been following this blog a little know how much I agree with these authors. In fact, in the peer-reviewed literature, I have been publishing similar arguments for almost 20 years, e.g:

The Indian AYUSH quacks are rarely out of the headlines these days. After recently promoting homeopathy for the coronavirus epidemic, they are at it yet again. This time they seem to want us to believe that homeopathy is an effective cancer therapy. And guess who is helping them promote this dangerous claim? Yes, it’s the “Pyromaniac In a Field of (Integrative) Straw Men”, Michael Dixon!

“Time for integration has come and it is not because allopathic medicines fail in treatment but rather it is the demand of the people and patients worldwide,” said Dr Michael Dixon, Chair-College of Medicine and Integrated Health, UK, and Visiting Professor, University of Westminster and University College London, while inaugurating the two-day ‘International Conference on Integrative Oncology 2020. The ICIO 2020 is held in Indai in association with Central Health & FW Ministry, AYUSH/TCAM Ministry, all AYUSH/TCAM research councils and the governments of Kerala and Maharashtra, and National AYUSH Mission and organised by the Global Homeopathy Foundation (GHF).

Dr Dixon called upon integration of various medical streams while combating diseases. He pointed out that anti-microbial resistance, over-prescription of opiates and over-prescription of conventional medicines have compounded the situation. “Enormous issues persist back in United Kingdom (UK), National Health Services (NHS) England banned herbal and homoeopathic medicines while Royal College of General Practitioners asked general practitioners not to offer Homoeopathy and National Institute for Clinical Excellence changed guidelines on palliative care and back pain,” said Dr Dixon.

However, he said the good news is that at last AYUSH has arrived in UK with the College of Medicine and Integrated Health taking the lead. “Integration of medical systems is of paramount importance in oncology for prevention, treatment, treating side-effects of conventional medicine and preventing recurrence.”

Those who address the inaugural function include:

  • Dr Jayesh Sanghavi, vice- chairman GHF,
  • Dr T K Harindranath, president, Indian Homoeopathic Medical Association,
  • Dr Piyush Joshi, secretary general, Homoeopathic Medical Association of India,
  • Dr Eswaradas, chairman, GHF, Dr Issac Mathai, Soukya Holistic Clinic,
  • Dr Velavan, Radiation Oncologist, Erode Cancer Centre,
  • Dr Sandeep Roy, chairman, organising committee ICIO 2020,
  • Dr Madhavan Nambiar IAS (retd), Patron GHF
  • Dr Sreevals G Menon, Managing Trustee, GHF

Around 25 papers are being presented at the summit. Two of them stand out, in my view:

  • Dr Vinu Krishnan, member, sub-committee on cancer, Central Council for Research in Homoeopathy, New Delhi, Analysis and observations of stage 3 and 4 lung cancers using homoeopathic interventions
  • Dr Ravi, associate professor with Virar Homoeopathic Medical College, Mumbai, Clinical assessment of homeopathy and its role in survival in 3rd and 4th stage cancers

I find it imperative to point out that, according to the best evidence available to date, there is no reason to believe that:

  • Homeopathy is effective in stage 3 and 4 lung cancers
  • Homeopathy has positive effects on cancer survival

In my view, anyone who makes desperate cancer patients believe otherwise or supports conferences where such notions are being promoted is a dangerous charlatan.

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PS

In case you are new to this blog and have not heard of Dr Dixon, allow me to alert you to 4 previous posts:

Should homeopathy be blacklisted in general practice? Dr Michael Dixon’s profoundly misleading comments

Johrei healing and the amazing Dr Dixon (presidential candidate for the RCGP)

Dr Dixon’s safe herbal medicine

Prince Charles becomes patron of the ‘College of Medicine and Integrated Health’

 

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