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

quackery

1 2 3 55

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.

_____________________________________________________________

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’?

In his writings, DD Palmer (the father of chiropractic), left little doubt about how he felt about himself and his achievements. A few quotes will suffice to give an impression:

  • I was the first to adjust the cause of disease
  • Chiropractors adjust causes instead of treating effects
  • Vaccination and inoculation are pathological; chiropractic is physiological
  • It was my ingenious brain which discovered [chiropractic’s] first principle; I was its source; I gave it birth; to me all chiropractors trace their chiropractic lineage
  • Among the wonderful achievements of this century, the discovery and development of chiropractic is preeminent; it is destined to replace all methods which treat effects

With this post, I will simply outline DD’s extraordinary life. I intend to leave it to you, the reader of this post, to decide whether it was the life of a genius or that of a charlatan.

  • 1845, 7 March: birth in Port Perry, near Toronto, Canada
  • 1865, April: Palmer family immigrate to the US
  • 1867: DD Palmer starts as a teacher in Concord, Iowa
  • 1869, November: DD and his younger brother TJ become beekeepers in Letts, Iowa
  • 1871, 20 January: DD marries Abba Lord who calls herself a ‘psychometrist, clairvoyant physician, soul reader and business medium’.
  • 1872, 6 July: DD publishes an article in the ‘ Religio Philosophical Journal’ calling himself an atheist
  • 1872: DD later states that he started his career as a ‘healer’ during this period
  • 1873: Abba leaves DD and later becomes a ‘homeopathic physician’ in Mineapolis.
  • 1876, 7 October: DD marries Louvenia Landers, a widow; they have 4 children together, including BJ who later becomes DD’s partner in the chiropractic business.
  • 1878, 19 April: the Palmer’s 5-months old daughter dies
  • 1878, May: DD is elected president of the ‘Western Illonois and Eastern Iowa Society of Bee Keepers’
  • 1880: DD publishes a pamphlet about spiritualism and refers to himself as a ‘spiritualist’
  • 1881 BJ Palmer is born; he later all but took over the chiropractic business and is often referred to as the ‘developer of chiropractic’
  • 1882 DD sells his beekeeping business, moves to What Cheer, Iowa where the rest of his family live
  • 1883, 30 May: DD opens a grocery store in What Cheer
  • 1884, 20 November: Louvenia dies of consumption
  • 1885, February: DD sells his grocery store and ‘moves on’
  • 1885, 25 May: DD marries Martha Henning. The marriage is short-lived; on 8 July of the same year, DD posted a public notice in the ‘What Cheer Patriot’ disowning her
  • 1885: DD moves back to Letts where he teaches at the local school
  • 1886: DD moves to Iola, Kansas where he practices as a magnetic healer and calls himself ‘Dr Palmer, healer’
  • 1886, 3 September: DD advertises his services as a ‘vitalist healer’ in Burlington, Iowa
  • 1887, 9 October: DD advertises ‘dis-ease is a condition of not ease, lack of ease’, a theme that he later uses regularly for chiropractic
  • 1887, 25 October: one of DD’s patients has died and there is an inquest. The local paper describes DD with the term ‘dense ignorance’ and the coroner states that ‘we censure the so-called doctor, DD Palmer, attending physician, for his lack of treatment and ignorance in the case’. DD leaves Burlington to avoid persecution (a new law requires all healers to register with the state medical board. DD does not have such a registration)
  • 1887: DD moves to Davenport and advertises: DD Palmer, cures without medicine…’
  • 1888, 6 November: DD marries Villa; they stay together until her death in 1905
  • 1894: DD publishes his views on smallpox vaccination: ‘…the monstrous delusion … fastened on us by the medical profession, enforced by the state boards, and supported by the mass of unthinking people …’
  • 1894: DD publishes his views about ‘greedy doctors’ and the ‘medical monopoly’
  • 1895, January: DD starts a business selling gold fish
  • 1895, 18 September: DD administers the 1st spinal manipulation to Harvey Lillard (DD later seems confused about this date stating that this ‘was done about Dec. 1st, 1895’)
  • 1896, 14 January is the date when, according to DD, chiropractic received its name with the help of Reverent Weed
  • 1896: DD publishes an article in ‘The Magnetic’ stating ‘ the magnetic cure: how to get well and keep well without using poisonous drugs’
  • 1896: DD publishes on bacteria outlining his theory that bacteria cannot grow on healthy tissue; keeping tissue healthy is therefore the best prevention against infections; and this is best achieved by magnetic healing
  • 1896: DD claimed that 4 years earlier, in 1892, he had discovered the magnetic cure for cancer; it involved freeing the stomach and spleen of poisons
  • 1896: DD formulates his concept of treating the root cause of any disease
  • 1896, 10 July: DD, his wife and his brother turn the ‘Palmer School of Magnetic Cure’ in Davenport into an officially registered corporation
  • 1897: DD defines chiropractic as ‘a science of healing without drugs’
  • 1898: DD opens his first school of chiropractic in Davenport, the ‘Palmer School of Chiropractic’ which has survivied to the present day.
  • 1902, 27 April: DD first used the term ‘subluxation’ in a letter to his son BJ (‘… where you find the greatest heat, there you will find the subluxation causing the inflammation which produces the fever…’)
  • 1902: DD leaves suddenly for California, apparently to open a West Coast branch of the Palmer School; he stays for about two years and then returns to Davenport leaving behind substantial depts
  • 1902, 6 September: DD is arrested in Pasadena when a patient suffering from consumption dies after DD’s second adjustment; in October, the charges were dropped because of a technicality
  • 1903: DD opens the ‘Palmer Chiropractic School in Santa Barbara, California, together with his former student Oakley Smith
  • 1903 DD is charged with practising medicine without licence but, before the case goes to trial, DD goes to Chicago where he charters a school together two other chiropractors (Smith and Paxson); the project fails
  • 1903, 30 April: DD is back in Davenport for the wedding of BJ with Mabel
  • 1904, December: DD starts his new journal ‘The Chiropractor’ which survives until 1961. DD’s very first article is entitled ’17 Years of Practice’
  • 1905: DD’s former students Langworthy and Smith accuse DD of stealing the concepts of chiropractic from the Bohemian bonesetters of Iowa
  • 1905, 9 November: DD’s wife Villa overdoses on morphine and dies; the coroner is unable to tell whether she committed suicide or intended it for pain relief
  • 1906, 11 January: DD marries Mary Hunter, apparently his first love from Letts
  • 1906, 26 March: DD is again on trial for practising medicine without a licence. He is found guilty the next day. The penalty is US$ 350 or 105 days in jail. DD choses jail. However, his new wife, Mary, bails him out after 23 days.
  • 1906: DD sells his share in the chiropractic business to his son and moves to Medford Oklahoma. The reasons for this split are said to be personal, financial and professional
  • 1906, 4 June: in a letter to John Howard, DD accuses his son of dishonesty and of running the school badly
  • 1906: BJ and DD publish their opus maximus ‘Science of Chiropractic’; DD claims that most of the chapters were written by him
  • 1907, January: DD opens another grocery store
  • 1908: together with a colleague, DD opens the ‘Palmer-Gregory Chiropractic College’; it lasts only 9 weeks. DD leaves because he discovered that Alva Gregory, a medical doctor, was teaching medical ideas
  • 1908, 9 November: DD opens the ‘Palmer College of Chiropractic’ in Portland, Oregon
  • 1908, December: DD starts a new journal, ‘The Chiropractor’s Adjuster’; many of his articles focus on criticising BJ. The journal only seems to have survives until 1910
  • 1910, December: DD publishes his book ‘The Chiropractor’s Adjuster’.
  • 1911: DD toys with the idea of turning chiropractic into a religion, as this would avoid chiropractors being sued for practising medicine without a license
  • 1913: DD visits Davenport for the ‘Lyceum Parade’ where he is injured. Mary accuses BJ of striking his father with his car and thus indirectly causing his death, a version of events which is disputed
  • 1913, September: DD is back in California and writes to JB Olson that he gave 22 lectures in Davenport. DD also reports: ‘… On the return I cured a man of sun stroke by one thrust on the 5th dorsal. That is what I call definitive, specific, scientific chiropractic…’
  • 1913, 20 October: DD dies; the official cause of death is typhoid fever, a condition that he repeatedly claimed to be curable by a single spinal adjustment.
  • 1914: DD Palmer’s book ‘The Chiropractor’ is published.

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:

James Orsen (Jim) Bakker is quite a character. Wiki informs us that he is an American televangelist and former Assemblies of God minister. With his former wife Tammy Faye he hosted the The PTL Club, an evangelical Christian television program from 1974 to 1989. He also developed Heritage USA, a now-defunct Christian theme park in Fort Mill, South Carolina.
A cover-up of hush money paid to a church secretary, Jessica Hahn, for an alleged rape led to his resignation from the ministry. Subsequent revelations of accounting fraud brought about his conviction on felony charges, imprisonment and divorce. Bakker later remarried and returned to televangelism, founding the Morningside Church in Blue Eye, Missouri. He currently hosts The Jim Bakker Show, which focuses on the end time and the Second Coming of Christ while promoting emergency survival products. He has written several books, including I Was Wrong and Time Has Come: How to Prepare Now for Epic Events Ahead.
The televangelist has recently taken to selling all sorts of stuff to his followers – anything from food buckets to water bottles to vitamins — and that includes his “Silver Solution,” which the pastor claims will get rid of “all venereal diseases.” 
But according to the Friendly Atheist, Bakker allowed a guest on his show to tell his followers an even more dangerous falsehood: that the colloidal silver concoction will also “deactivate” the coronavirus in under 12 hours.
Speaking with Dr. Sherrill Sellman on his show, Bakker said, “This influenza, that is now circling the globe, you’re saying that Silver Solution would be effective?” Sellman — who is not a medical doctor but “a naturopath who boasts of having ‘simple solutions to complex issues’” — replied, “Well, let’s say it hasn’t been tested on this strain of the coronavirus, but it’s been tested on other strains of the coronavirus and has been able to eliminate it within 12 hours.”

“Totally eliminates it. Kills it. Deactivates it,” she said. “And then it boosts your immune system, so then you can support the recovery, ’cause when you kill the virus then your immune system comes into action to clear it out. So you want a vibrant immune system as well as an ability to deactivate these viruses.”

In a test-tube, colloidal silver might kill the virus. But in a living organism?

No!

And there is plenty of evidence to show that, when taken by mouth, colloidal silver can have serious side effects. According to the National Institutes of Health, one of the most common effects is “argyria, a bluish-gray discoloration of the skin, which is usually permanent” (see ‘before/after pictures on the right).

Furthermore, it can also cause “poor absorption of some drugs, such as certain antibiotics and thyroxine (used to treat thyroid deficiency).”

Question: is it really ‘Christian’ to promote bogus treatments to desperate people?

I very regularly get comments criticising me for being negative and destructive rather than using my time being positive and constructive. Here is a recent such remark:

Edzard, with his string of qualifications, should offer a remedy to the coronavirus. Ok, I get it, homeopaths are “quacks” but what has Edzard got to offer. Talk is cheap. Rather than warming on the “inability” of the homeopaths to prove their worth, Edzard should prove that he is better than them but sadly he is simply someone who has no substance. What good is he to mankind and the patients when he cannot offer a solution but rather finds faults with “quacks”. That even a beggar can do better than him. Until he is able to offer a cure, he has no business going around finding fault with others.

It is true that many if not most of my posts are about disclosing bogus claims of practitioners of so-called alternative medicine (SCAM) or revealing the limitations of SCAM research. I see why SCAM proponents see this as a negative activity. However, I view it as a positive contribution: if I show today that this or that claim or therapy is not evidence-based, I might prevent some patients from using it tomorrow. In turn, this would prevent them from wasting their money and – more importantly – would guide them towards making prudent therapeutic decisions which, in some cases, could even save lives.

Other critics of my work are keen to point out that I should not constantly criticise SCAM but rather do something about the many weaknesses of conventional medicine. I feel that my work might be helpful for that as well. Let me explain.

Pointing out how much of SCAM is bogus begs the question, why then are so many people using it? One answer which I have often given (here and elsewhere) is that consumers are looking not so much for effective treatments but for what used to be called the ‘art’ of medicine:

  • compassion,
  • undersatnding,
  • empathy,
  • sufficient time with their clinician,
  • a warm therapeutic relationship.

These are things they often do not find when consulting their conventional physicians, and these are things they often get from their SCAM practitioner. This insight should lead to the next logical step, namely to boost compassion, emapthy, etc. in conventional medicine.

Clearly, these qualities are at the core of good healthcare, and clearly we do not require SCAM for patients to benefit from them. The science and the ‘art’ of medicine are not mutually exclusive; there is no good reason why they should not go together. And it is time to put the ‘art’ back into science-based medicine. Delegating it to SCAM practitioners is a disservice to patients.

So, what good is my work to mankind and patients? This is a question that I cnnot answer. All I can do is hope that my criticism will make a small contribution towards improving future healthcare.

 

Today is Valentine’s Day, a good moment to take a critical look at some of the libido-boosters so-called alternative medicine (SCAM) has to offer. The Internet offers plenty; this website, for instance, advertises over 20 different natural (mostly botanical) products. But such sites are typically thin on evidence.

A quick Medline search locates plenty of research. Much of it seems to be on rats which is not so relevant – unless, of course, your husband is a rat. In terms of clinical trials, Medline too is not all that informative. Here are some of the studies I found:

Eurycoma longifolia is reputed as an aphrodisiac and remedy for decreased male libido. A randomized, double-blind, placebo controlled, parallel group study was carried out to investigate the clinical evidence of E. longifolia in men. The 12-week study in 109 men between 30 and 55 years of age consisted of either treatment of 300 mg of water extract of E. longifolia (Physta) or placebo. Primary endpoints were the Quality of Life investigated by SF-36 questionnaire and Sexual Well-Being investigated by International Index of Erectile Function (IIEF) and Sexual Health Questionnaires (SHQ); Seminal Fluid Analysis (SFA), fat mass and safety profiles. Repeated measures ANOVA analysis was used to compare changes in the endpoints. The E. longifolia (EL) group significantly improved in the domain Physical Functioning of SF-36, from baseline to week 12 compared to placebo (P = 0.006) and in between group at week 12 (P = 0.028). The EL group showed higher scores in the overall Erectile Function domain in IIEF (P < 0.001), sexual libido (14% by week 12), SFA- with sperm motility at 44.4%, and semen volume at 18.2% at the end of treatment. Subjects with BMI ≥ 25 kg/m(2) significantly improved in fat mass lost (P = 0.008). All safety parameters were comparable to placebo.

Yoga is a popular form of complementary and alternative treatment. It is practiced both in developing and developed countries. Use of yoga for various bodily ailments is recommended in ancient ayvurvedic (ayus = life, veda = knowledge) texts and is being increasingly investigated scientifically. Many patients and yoga protagonists claim that it is useful in sexual disorders. We are interested in knowing if it works for patients with premature ejaculation (PE) and in comparing its efficacy with fluoxetine, a known treatment option for PE.  Aim: To know if yoga could be tried as a treatment option in PE and to compare it with fluoxetine.  Methods: A total of 68 patients (38 yoga group; 30 fluoxetine group) attending the outpatient department of psychiatry of a tertiary care hospital were enrolled in the present study. Both subjective and objective assessment tools were administered to evaluate the efficacy of the yoga and fluoxetine in PE. Three patients dropped out of the study citing their inability to cope up with the yoga schedule as the reason.  Main outcome measure: Intravaginal ejaculatory latencies in yoga group and fluoxetine control groups.  Results: We found that all 38 patients (25-65.7% = good, 13-34.2% = fair) belonging to yoga and 25 out of 30 of the fluoxetine group (82.3%) had statistically significant improvement in PE.  Conclusions: Yoga appears to be a feasible, safe, effective and acceptable nonpharmacological option for PE. More studies involving larger patients could be carried out to establish its utility in this condition.

Antidepressants including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs) are known to cause secondary sexual dysfunction with prevalence rates as high as 50%-90%. Emerging research is establishing that acupuncture may be an effective treatment modality for sexual dysfunction including impotence, loss of libido, and an inability to orgasm.  Objectives: The purpose of this study was to examine the potential benefits of acupuncture in the management of sexual dysfunction secondary to SSRIs and SNRIs.  Subjects: Practitioners at the START Clinic referred participants experiencing adverse sexual events from their antidepressant medication for acupuncture treatment at the Mood and Anxiety Disorders, a tertiary care mood and anxiety disorder clinic in Toronto.  Design: Participants received a Traditional Chinese Medicine assessment and followed an acupuncture protocol for 12 consecutive weeks. The acupuncture points used were Kidney 3, Governing Vessel 4, Urinary Bladder 23, with Heart 7 and Pericardium 6. Participants also completed a questionnaire package on a weekly basis.  Outcomes measured: The questionnaire package consisted of self-report measures assessing symptoms of depression, anxiety, and various aspects of sexual function.  Results: Significant improvement among male participants was noted in all areas of sexual functioning, as well as in both anxiety and depressive symptoms. Female participants reported a significant improvement in libido and lubrication and a nonsignificant trend toward improvement in several other areas of function.  Conclusions: This study suggests a potential role for acupuncture in the treatment of the sexual side-effects of SSRIs and SNRIs as well for a potential benefit of integrating medical and complementary and alternative practitioners.

The primary objectives were to compare the efficacy of extracts of the plant Tribulus terrestris (TT; marketed as Tribestan), in comparison with placebo, for the treatment of men with erectile dysfunction (ED) and with or without hypoactive sexual desire disorder (HSDD), as well as to monitor the safety profile of the drug. The secondary objective was to evaluate the level of lipids in blood during treatment.  Participants and design: Phase IV, prospective, randomized, double-blind, placebo-controlled clinical trial in parallel groups. This study included 180 males aged between 18 and 65 years with mild or moderate ED and with or without HSDD: 90 were randomized to TT and 90 to placebo. Patients with ED and hypertension, diabetes mellitus, and metabolic syndrome were included in the study. In the trial, an herbal medicine intervention of Bulgarian origin was used (Tribestan®, Sopharma AD). Each Tribestan film-coated tablet contains the active substance Tribulus terrestris, herba extractum siccum (35-45:1) 250mg which is standardized to furostanol saponins (not less than 112.5mg). Each patient received orally 3×2 film-coated tablets daily after meals, during the 12-week treatment period. At the end of each month, participants’ sexual function, including ED, was assessed by International Index of Erectile Function (IIEF) Questionnaire and Global Efficacy Question (GEQ). Several biochemical parameters were also determined. The primary outcome measure was the change in IIEF score after 12 weeks of treatment. Complete randomization (random sorting using maximum allowable% deviation) with an equal number of patients in each sequence was used. This randomization algorithm has the restriction that unequal treatment allocation is not allowed; that is, all groups must have the same target sample size. Patients, investigational staff, and data collectors were blinded to treatment. All outcome assessors were also blinded to group allocation.  Results: 86 patients in each group completed the study. The IIEF score improved significantly in the TT group compared with the placebo group (Р<0.0001). For intention-to-treat (ITT) there was a statistically significant difference in change from baseline of IIEF scores. The difference between TT and placebo was 2.70 (95% CI 1.40, 4.01) for the ITT population. A statistically significant difference between TT and placebo was found for Intercourse Satisfaction (p=0.0005), Orgasmic Function (p=0.0325), Sexual Desire (p=0.0038), Overall Satisfaction (p=0.0028) as well as in GEQ responses (p<0.0001), in favour of TT. There were no differences in the incidence of adverse events (AEs) between the two groups and the therapy was well tolerated. There were no drug-related serious AEs. Following the 12-week treatment period, significant improvement in sexual function was observed with TT compared with placebo in men with mild to moderate ED. TT was generally well tolerated for the treatment of ED.

What makes me suspicious about these trials is that:

  • they are mostly on the flimsy side,
  • there are as good as no independent replications,
  • they all report positive outcomes. I was unable to find a single study where the authors concluded: SORRY, BUT THIS STUFF IS USELESS!

Disappointed with the quality and the content of the existing trials, I am now off to buy some oysters!

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.

_________________________________________________________

 

 

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’

 

What should we make of a discipline whose disciples are unsure of what the discipline is?

Yes, I am talking of chiropractic!

Surely, the inventor of chiropractic has told them what it is. True, DD Palmer left them no end of definitions; here are just 4 to choose from:

  • Chiropractic is the science of healing without drugs.
  • Chiropractic is the art of adjusting by hand all subluxations of the three hundred articulations of the human skeletal frame, more especially the 52 articulations of the spinal column, for the purpose of freeing impinged nerves, as they emanate thru the intervertebral foramina, causing abnormal function, in excess or not, named disease.
  • Chiropractic is a name I originated to designate the science and art of adjusting vertebrae.
  • Chiropractic is a philosophical science; it has solved one of the most profound and perplexing problems of the age, namely, what is life?

Despite this plethora of definitions, chiropractors are still struggling to define their trade. This article, entitled ‘So What Is Chiropractic?’, marks the end of a recent series of papers published in a chiro-journal trying to make progress in this regard. They revealed deeply rooted disagreements within the chiropractic profession about what chiropractic is, and what it should be, as a profession [13, 19, 20], as well as disagreements and variation in relation to education of chiropractors [14, 15] and chiropractic clinical practice [11].

In the opinion of the authors’ paper, it is ironic that, while chiropractic has a strong presence in large parts of the world [3], is taking on increasingly important roles in disability prevention [6, 7, 17], in the military [5] and in interprofessional care [8] as well as growing research capacity [16], discussions about fundamental values and direction of the profession are unresolved. They believe that this unresolved issue creates confusion for stakeholders and threatens to impede professionalization and cultural authority. If chiropractors are to remain relevant in today’s evidence-based healthcare environment, they argue, there is an urgent need to agree on, and further describe, what chiropractic is, what chiropractors do and importantly to provide evidence for value of these activities to patients and societies.

So, what do we make of chiropractic in view of the fact that chiropractors seem to be unsure what it is?

I let you decide.

I am currently studying DD Palmer’s TEXTBOOK OF THE SCIENCE, ART, AND PHILOSOPHY OF CHIROPRACTIC. It is a 1 000 page volume full of ignorance, repetition, allegation, pomp, overstatement and utter nonsense. I strongly advise everyone to stay well clear of it.

However, skimming through this accumulation of flimflam, I was repeatedly reminded of the origin of the anti-vax stance to which so many chiropractors still subscribe. Yes, I did mention this before: Far too many chiropractors believe that vaccinations do not have a positive effect on public health.

In his book, originally published in 1910,  Palmer tried (unsuccessfully, I fear) to explain the basic principles of chiropractic. Most chiropractors would have read at least some of this ‘textbook’. It therefore stands to reason that Palmer’s views still colour those of today’s chiropractors.

Here are a few quotes about immunisation directly from the book:

  • On May 14, 1796, Jenner first committed the crime of vaccination…
  • No person is improved by being poisoned by either smallpox or vaccination.
  • [Vaccination] is the biggest piece of quackery and criminal outrage ever foisted upon any civilized people. Medical ignorance by which criminal outrages are murdering our children all over this country…
  • Vaccination and inoculation are pathological; Chiropractic is physiological.
  • Compulsory vaccination is an outrage and a gross interference with the liberty of the people in a land of freedom.

The question is, where did Palmer get this from? What is the reason for his anti-vax attitude? Reading the book, I get the impression that it might have been based on two main pillars: 1) his amazing ignorance and blinkered view on most things and 2) his deep antipathy of conventional medicine. To show you a little of the latter, here are just two further quotes:

  • It is a pity that the medical profession are possessed of arrogance instead of liberality; that instead of encouraging and fostering advanced ideas, they stifle and discourage advancement; that they only adopt advanced ideas when they are compelled to do so by public opinion.
  • The physician believes in his prescriptions; the pharmacist in the hidden power of drugs – superstitious therapeutics.

To this, I am tempted to add: … and chiropractors believe in the drivel written by DD Palmer over 100 years ago.

What is pseudoscience and how can it be differentiated from science? This ‘demarcation problem’ has occupied many of our best minds and which nevertheless is largely unresolved. Two brave academics have recently published a paper aimed at providing organisations within the justice system with an overview of:

a) what science is and is not;

b) what constitutes an empirically driven, theoretically founded, peer-reviewed approach;

c) how to distinguish science from pseudoscience.

In it, they demonstrate that not all information which is presented as comprehensively evaluated is methodologically reliable for use in the justice system. Even though it does not really solve the old demarcation problem, I found their article important and informative and therefore take the liberty of quoting a brief excerpt here:

Organisations within the justice system do use empirically and theoretically supported approaches. However, some implemented approaches lack empirical evidence. In more perturbing cases, police officers, lawyers and judges may resort to pseudoscience – that is, bodies of information that may appear to be scientific but, in reality, lack the characteristics of scientific knowledge. … if members of the justice community are not advised about the publishing process then pseudoscientists can be fairly proficient at providing counterarguments. In addition, pseudoscientists can use several other fallacious arguments to achieve maximum support for their approaches.

For example, pseudoscientists might argue that their approaches are supported by a select number of articles, theses or books, and that they are reliable due to their acceptance by important organisations. However, if upon reading such literature it becomes apparent that there is no empirical or theoretical support, or that the steps leading to the conclusions are not thoroughly justified (be this methodologically or through evaluation), the implementation of their approaches remains merely destitute of vision. In addition, such reference to important organisations – often known as ‘name-dropping’–is detrimental by nature; doing so lends support to the notion that one might be unable to distinguish pseudoscience from science and may not understand the role that science plays in developing better professional practice.

Fallacious arguments from pseudoscientists can also address negative comments in a way that attempts to discourage further criticism from members of the scientific community. They can engage in legal threats and ad hominem attacks – that is, opposition to an argument ‘by questioning the personal circumstances or personal trustworthiness of the arguer who advanced it’. For example, if academics raise concerns regarding a particular pseudoscience without having attended its associated seminars, pseudoscientists might assert that the academics do not have the required understanding and that, as such, their criticism is of no value. If the academics had indeed attended the seminars, the pseudoscientists might instead suggest that their concerns are raised out of obscure or malicious reasons. Pseudoscientists might even state that they are criticised due to their revolutionary approach and refer to a quote dubiously attributed to the German philosopher Arthur Schopenhauer: ‘All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as self-evident’. However, as Sagan rightly points out,

the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright brothers. But they also laughed at Bozo the Clown.

1 2 3 55
Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories