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

satire

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I almost forgot!

This would have been no good, after all, Charles has for decades been the most influential supporter of so-called alternative medicine (SCAM) in the UK. He is one of SCAM’s greatest proponent.

So, here is my up-dated, extended and illustrated summary of his achievements in this area.

HAPPY BIRTHDAY CHARLES!

Charles went on a journey of ‘spiritual discovery’ into the wilderness of northern Kenya. His guru and guide at the time was Laurens van der Post (later discovered to be a fraud and compulsive fantasist and to have fathered a child with a 14-year old girl entrusted to him during a sea voyage).

Van der Post wanted to awake Charles’ mind and attune it to the vitalistic  ideas of Carl Jung’s ‘collective unconscious’, and it is this belief in vitalism that provides the crucial link to alternative medicine: virtually every form of alternative therapies is based on the assumption that some sort of vital force exists. Charles was so taken by van der Post that he made him the godfather of Prince William. After Post’s death, he established an annual lecture in his honour (the lecture series was discontinued after Van der Post was discovered to be a fraud).

Some time in the 1970s, Charles met Jimmy Saville and befriended him. Apparently, Saville later advised Charles on several occasions in various health-related matters.

Throughout the 1980s, Charles lobbied for the statutory regulation of chiropractors and osteopaths in the UK. In 1993, this finally became reality. These two SCAM professions are to this day the only ones regulated by statute in the UK.

Osteopathy has strong Royal links: Prince Charles is the President of the GOsC; Princess Diana was the President of the GCRO; and Princess Anne is the patron of the British School of Osteopathy (statement dated 2011).

In 1982, Prince Charles was elected as President of the British Medical Association (BMA) and promptly challenged the medical orthodoxy by advocating alternative medicine. In a speech at his inaugural dinner as President, the Prince lectured the medics: ‘Through the centuries healing has been practised by folk healers who are guided by traditional wisdom which sees illness as a disorder of the whole person, involving not only the patient’s body, but his mind, his self-image, his dependence on the physical and social environment, as well as his relation to the cosmos.’ The BMA-officials ordered a full report on alternative medicine which promptly condemned this area as implausible nonsense.

Six years later, a second report, entitled Complementary Medicine – New Approaches to Good Practice, heralded an astonishing about-turn stating that: “the demand for non-conventional therapies had become so pressing that organised medicine in Britain could no longer ignore its contribution”. At the same time, however, the BMA set in motion a further chapter in the history of SCAM by insisting that it was “unacceptable” to allow the unrestricted practice of non-conventional therapies, irrespective of training or experience.

In 1993, Charles founded his lobby group which, after being re-named several times, ended up being called the ‘Foundation for Integrated Health’ (FIH). It was closed down in 2010 amidst allegations of money laundering and fraud. Its chief executive, George Gray, was later convicted and went to jail. The FIH had repeatedly been a little economical with the truth.

In 2000, Charles wrote an open letter to The Times stating that…It makes good sense to evaluate complementary and alternative therapies. For one thing, since an estimated £1.6 billion is spent each year on them, then we want value for our money. The very popularity of the non-conventional approaches suggests that people are either dissatisfied with their orthodox treatment, or they find genuine relief in such therapies. Whatever the case, if they are proved to work, they should be made more widely available on the NHS…But there remains the cry from the medical establishment of “where’s the proof?” — and clinical trials of the calibre that science demands cost money…The truth is that funding in the UK for research into complementary medicine is pitiful…So where can funding come from?…Figures from the department of complementary medicine at the University of Exeter show that less than 8p out of every £100 of NHS funds for medical research was spent on complementary medicine. In 1998-99 the Medical Research Council spent no money on it at all, and in 1999 only 0.05 per cent of the total research budget of UK medical charities went to this area…

In 2001, Charles worked on plans to help build a model hospital of integrated medicine. It was to train doctors to combine conventional medicine and alternative treatments, such as homeopathy, Ayurvedic medicine and acupuncture, and was to have up to 100 beds. The prince’s intervention marked the culmination of years of campaigning by him for the NHS to assign a greater role to alternative medicine. Teresa Hale, founder of the Hale Clinic in London, said: “Twenty-five years ago people said we were quacks. Now several branches, including homeopathy, acupuncture and osteopathy, have gained official recognition.” The proposed hospital, which was due to open in London in 2003/4, was to be overseen by Mosaraf Ali, who runs the Integrated Medical Centre (IMC) in London. But the hospital never materialised.

This might be due to Mosaraf Ali falling in disrepute: Raj Bathija, 69 and from India, went for a massage at the clinic of Dr Mosaraf Ali and his brother Imran in 2005 after suffering from two strokes. However, he claims that shortly after the treatment, his legs became pale and discoloured. Four days afterwards, Mr Bathija was admitted to hospital, where he had to have both legs amputated below the knee due to a shortage of blood. According to Mr Bathija, Dr Ali and his brother were negligent in that they failed to diagnose his condition and neglected to advise him to go to hospital. His daughter Shibani said: “My father was in a wheelchair but was making progress with his walking. He hoped he might become a bit more independent. With the amputations, that’s all gone.” Dr Ali was sued (if anyone knows the outcome of this case, please let me know).

At the age of 53, Mrs Parker Bowles went on a trek to the Himalayas to ‘re-energise’ her spirits and encourage her to give up smoking. She was in a party of 12 accompanied by the Prince of Wales’s favourite health guru, Dr Mosaraf Ali. Mrs Parker Bowles subsequently became a regular visitor to Dr Ali’s London practice where she has been encouraged to take up yoga both to combat her back pain and to help her give up smoking.

In the same year, Charles published an editorial in the BMJ promoting his ideas around integrative medicine. Its title: THE BEST OF BOTH WORLDS.

In 2003, Prince Charles’ FIH launched a five-year plan which outlined how to improve access to alternative therapies.

In 2004, Charles publicly supported the Gerson diet as a treatment for cancer and Prof Baum, an eminent oncologist, was invited to respond in an open letter to the British Medical Journal: …Over the past 20 years I have treated thousands of patients with cancer and lost some dear friends and relatives to this dreaded disease…The power of my authority comes with knowledge built on 40 years of study and 25 years of active involvement in cancer research. Your power and authority rest on an accident of birth. I don’t begrudge you that authority but I do beg you to exercise your power with extreme caution when advising patients with life-threatening diseases to embrace unproven therapies.

In 2005, the ‘Smallwood-Report’ was published; it had been commissioned by Charles and paid for by Dame Shirley Porter to inform health ministers. It stated that up to 480 million pounds could be saved, if one in 10 family doctors offered homeopathy as an “alternative” to standard drugs for asthma. Savings of up to 3.5 billion pounds could be achieved by offering spinal manipulation rather than drugs to people with back pain. Because I had commented on this report, Prince Charles’ first private secretary asked my vice chancellor to investigate my alleged indiscretion; even though I was found to be not guilty of any wrong-doing, all local support at Exeter stopped which eventually led to my early retirement. ITV later used this incident in a film entitled THE MEDDLING PRINCE, I later published a full account of this sad story in my memoir.

In a 2006 speechPrince Charles told the World Health Organisation in Geneva that alternative medicine should have a more prominent place in health care and urged every country to come up with a plan to integrate conventional and alternative medicine into the mainstream. But British science struck back. Anticipating Prince Charles’s sermon in Geneva, 13 of Britain’s most eminent physicians and scientists wrote an “Open Letter” which expressed concern over “ways in which unproven or disproved treatments are being encouraged for general use in Britain’s National Health Service.” The signatories argued that “it would be highly irresponsible to embrace any medicine as though it were a matter of principle.”

In 2008, The Times published my letter asking the FIH to withdraw two guides promoting alternative medicine, stating: “the majority of alternative therapies appear to be clinically ineffective, and many are downright dangerous.” A speaker for the FIH 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.”

In 2009, the Prince held talks with the health Secretary to persuade him to introduce safeguards amid a crackdown by the EU that could prevent anyone who is not a registered health practitioner from selling remedies. This, it seems, was yet another example of Charles’ disregard of his constitutional role.

In the same year, Charles urged the government to protect alternative medicine because “we fear that we will see a black market in herbal products”, as Dr Michael Dixon (LVO,2015; OBE 2001), then medical director of Charles’ FIH, put it.

In 2009, the health secretary wrote to the prince suggesting a meeting on the possibility of a study on integrating complementary and conventional healthcare approaches in England. The prince had written to Burnham’s predecessor, Alan Johnson, to demand greater access to complementary therapies in the NHS alongside conventional medicine. The prince told him that “despite waves of invective over the years from parts of the medical and scientific establishment” he continued to lobby “because I cannot bear people suffering unnecessarily when a complementary approach could make a real difference”. He opposed “large and threatened cuts” in the funding of homeopathic hospitals and their possible closure. He complained that referrals to the Royal London homeopathic hospital were increasing “until what seems to amount to a recent ‘anti-homeopathic campaign’”. He warned against cuts despite “the fact that these homeopathic hospitals deal with many patients with real health problems who otherwise would require treatment elsewhere, often at greater expense”.

In 2009, it was announced that the ‘College of Integrated Medicine’ (the name was only later changed to ‘College of Medicine’, see below) was to have a second base in India. An Indian spokesman commented: “The second campus of the Royal College will be in Bangalore. We have already proposed the setting up of an All India Institute of Integrated Medicine to the Union health ministry. At a meeting in London last week with Prince Charles, we finalized the project which will kick off in July 2010”.

In 2010, Charles publicly stated that he was proud to be perceived as ‘an enemy of the enlightenment’.

In 2010, ‘Republic’ filed an official complaint about FIH alleging that its trustees allowed the foundation’s staff to pursue a public “vendetta” against a prominent critic of the prince’s support for complementary medicines. It also suggested that the imminent closure of Ernst’s department may be partly down to the charity’s official complaint about him after he publicly attacked its draft guide to complementary medicines as “outrageous and deeply flawed”.

In 2010, former fellows of Charles’ disgraced FIH launched a new organisation, The College of Medicine’ supporting the use of integrated treatments in the NHS. One director of the college is Michael Dixon, a GP in Cullompton, formerly medical director of the Foundation for Integrated Health. My own analysis of the activities of the new college leaves little doubt that it is promoting quackery.

In 2010, Charles published his book HARMONY which is full of praise for even the most absurd forms of alternative therapies and even bogus diagnostic tests used by alternative practitioners.

In 2011, after the launch of Charles’ range of herbal tinctures, I had the audacity to publicly criticise Charles for selling the Duchy Herbals detox tincture which I named ‘Dodgy Originals Detox Tincture’.

In 2011, Charles forged a link between ‘The College of Medicine’ and an Indian holistic health centre (see also above). The collaboration was reported to include clinical training to European and Western doctors in ayurveda and homoeopathy and traditional forms of medicine to integrate them in their practice. The foundation stone for the extended campus of the Royal College known as the International Institution for Holistic and Integrated Medicine was laid by Dr Michael Dixon in collaboration with the Royal College of Medicine.

In 2012, Charles was nominated for ‘THE GOLDEN DUCK AWARD’ for his achievements in promoting quackery. However, Andrew Wakefield beat him to it; Charles certainly was a deserving runner-up.

In 2013, Charles called for society to embrace a broader and more complex concept of health. In his article he described a vision of health that includes the physical and social environment, education, agriculture and architecture.

In 2013, Charles’ Highgrove enterprise offered ‘baby-hampers’ for sale at £195 a piece and made a range of medicinal claims for the products it contained. As these claims were not supported by evidence, there is no way to classify them other than quackery.

By 2013, the ‘Association of Osteomyologists’ were seeking to become regulated by statute, with the help of Prince Charles as their patron. The chairman and founder of this organisation was knighted for services to alternative medicine.  Osteomyologists encourage the use of techniques including cranio-sacral therapy and claim that “we all know that Colleges, Institutions, and Medical Practitioners, are brain washed from the very outset into believing that their discipline is the only way to go.”

In November 2013, Charles invited alternative medicine proponents from across the world, including Dean Ornish, Michael Dixon, chair of College of Medicine, UK and Issac Mathai of Soukya Foundation, Bangalore, to India for a ‘brain storm’ and a subsequent conference on alternative medicine. The prince wanted the experts to collaborate and explore the possibilities of integrating different systems of medicines and to better the healthcare delivery globally, one of the organisers said.

In June 2014, BBC NEWS published the following text about a BBC4 broadcast entitled ‘THE ROYAL ACTIVIST’ aired on the same day: Prince Charles has been a well-known supporter of complementary medicine. According to a… former Labour cabinet minister, Peter Hain, it was a topic they shared an interest in. He had been constantly frustrated at his inability to persuade any health ministers anywhere that that was a good idea, and so he, as he once described it to me, found me unique from this point of view, in being somebody that actually agreed with him on this, and might want to deliver it. Mr Hain added: “When I was Secretary of State for Northern Ireland in 2005-7, he was delighted when I told him that since I was running the place I could more or less do what I wanted to do.*** I was able to introduce a trial for complementary medicine on the NHS, and it had spectacularly good results, that people’s well-being and health was vastly improved. And when he learnt about this he was really enthusiastic and tried to persuade the Welsh government to do the same thing and the government in Whitehall to do the same thing for England, but not successfully,” added Mr Hain. On this blog, I have pointed out that the research in question was fatally flawed and that Charles, once again, overstepped the boundaries of his constitutional role.

In 2015, two books were published which are relevant in this context. My memoir A SCIENTIST IN WONDERLAND recounts most of my dealings with Charles and his sycophants, including how an intervention from his first private secretary eventually led to the closure of my department. The book by Catherine Meyer CHARLES, THE HEART OF A KING is far less critical about our heir to the throne; it nevertheless severely criticises his stance on alternative medicine.

In October 2015, the Guardian obtained the infamous “black spider memos” which revealed that Charles had repeatedly lobbied politicians in favour of alternative medicine (see also above).

In 2016, speaking at a global leaders summit on antimicrobial resistance, Prince Charles warned that Britain faced a “potentially disastrous scenario” because of the “overuse and abuse” of antibiotics. The Prince explained that he had switched to organic farming on his estates because of the growing threat from antibiotic resistance and now treats his cattle with homeopathic remedies rather than conventional medication. “As some of you may be aware, this issue has been a long-standing and acute concern to me,” he told delegates from 20 countries “I have enormous sympathy for those engaged in the vital task of ensuring that, as the world population continues to increase unsustainably and travel becomes easier, antibiotics retain their availability to overcome disease… It must be incredibly frustrating to witness the fact that antibiotics have too often simply acted as a substitute for basic hygiene, or as it would seem, a way of placating a patient who has a viral infection or who actually needs little more than patience to allow a minor bacterial infection to resolve itself.”

In 2017, the ‘College of Medicine’ mentioned above was discretely re-named ‘College of Medicine and Integrated Health’

In the same year, Charles declared that he will open a centre for alternative medicine in the recently purchased Dumfries House in Scotland. Currently, the College of Medicine and Integrated Health is offering two-day Foundation Courses at this iconic location. Gabriel Chiu, a US celebrity cosmetic and reconstructive surgeon, and his wife Christine, joined the Prince of Wales as he opened the integrated health and wellbeing centre on the Dumfries House Estate in East Ayrshire in 2019. As he unveiled a plaque at the event, Prince Charles said: “I’m so glad that all of you have been able to get here today, particularly because I could not be more proud to see the opening of this new integrated health centre at Dumfries House. It’s something I’ve been wanting to do for the last 35 years. I’m also so proud of all the team at Dumfries House who built it, an all in-house team.

“To reach this point where we can now offer a range of social prescribing opportunities is enormously encouraging and I hope it will be able to make some difference to a lot of the health issues that exist in this area.”

Also in 2017, ‘Country News’ published an article about our heir to the throne stating that Prince of Wales has revealed he uses homeopathic treatments for animals on his organic farm at Highgrove to help reduce reliance on antibiotics, the article stated. He said his methods of farming tried wherever possible to ‘‘go with the grain of nature’’ to avoid dependency on antibiotics, pesticides and other forms of chemical intervention.

In 2018, The Prince of Wales accompanied the Prime Minister of India, Narendra Modi, to the Science Museum in London, and praised Asian medicine practices. The heir to the throne and the Indian Prime Minister then jointly unveiled a plaque for the UK’s first centre of excellence for Indian traditional medicine.

In the same year, it was revealed that UK farmers are being taught how to treat their livestock with homeopathy “by kind permission of His Royal Highness, The Prince Of Wales”

In 2019, the Faculty of Homeopathy announced that His Royal Highness The Prince of Wales had accepted to become Patron of the Faculty of Homeopathy. Dr Gary Smyth, President of the Faculty of Homeopathy comments, “As the Faculty celebrates its 175th anniversary this year, it is an enormous honour for us to receive the Patronage of His Royal Highness The Prince of Wales and I am delighted to announce this news today.” Charles’ move amazed observers who saw it as a deliberate protest against the discontinuation of reimbursement of homeopathy by the NHS.

In 2019, Prince Charles said that yoga had “proven beneficial effects on both body and mind,” and has “tremendous social benefits” that help build “discipline, self-reliance and self-care.”

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So again, Happy Birthday Your Royal Highness – and please don’t forget: it’s not too late to start doing good in the realm of healthcare by supporting good science, critical thinking and evidence-based medicine.

Sincerely yours

Edzard Ernst

So-called alternative medicine (SCAM) is, compared to ‘Big Pharma’, a tiny and benign cottage industry – at least this is what we are often told and what many consumers believe. If you are one of them, this report might make you rethink your position.

The global market for SCAM is expected to generate a revenue of US$ 210.81 billion by 2026. It is projected to expand by 17.07% from 2019 to 2026. Factors such as the increasing adoption and usage of natural supplements/wellness medicine coupled with government initiatives to promote SCAM are assumed to be the main causes ot this increase. An increase in the costs of conventional medicine and the trend towards wellness are likely to boost the SCAM market.

Further key findings from the report suggest:
• The market is driven by high adoption of herbal dietary supplements and other wellness therapies like yoga, and acupuncture
• Botanical has become the most prominent form of alternative medicine as the segment was observed to hold the largest market share in terms of revenue 2018
• Europe and Asia Pacific in combination are anticipated to hold a major market share in terms of revenue over the forecast period
• Developing regions such as Latin America and Middle East Africa are set to witness considerable growth in demand over the forecast period driven by high cost of conventional medicine and lack of their availability in certain countries
• Some of the key players and wellness institutes active in the complementary and alternative medicine market are Columbia Nutritional Inc.; Herb Pharm; Herbal Hills; Helio USA Inc.; Deepure Plus; Nordic Naturals; Pure encapsulations, Inc.; and other wellness institutes like Iyengar Yoga Institute; John Schumacher’s Unity Woods Yoga Center; Yoga Tree; The Healing Company; and Quantum Touch Inc.

So, little SCAM turns out to be not so little after all!

In fact, there are billions at stake. And that perhaps might explain why little SCAM often behaves as badly as does the dreaded, much maligned ‘Big Pharma’. Just look at what some German homeopathic firms were up to in the past. One could almost think that their ethics have been homeopathically diluted. The ‘dirty methods’ of little SCAM can be at least as dirty as those of ‘Big Pharma’, in my experience.

But don’t let’s be beastly to the Germans!! The SCAM industry in most other countries is much the same.

And who could blame them?

After all, they are fighting against a Ku Klux Klan of evil sceptics.

I have met many acupuncturists who think that homeopathy is bunk. Similarly, I have met many homeopaths who are convinced that acupuncture is a placebo therapy. And, I have met some (not many) practitioners of so-called alternative medicine (SCAM) who think so highly of both SCAMs that they combine the two into one handy treatment: HOMEOPUNCTURE.

I had almost forgotten (or is supressed the correct verb?) but, to be entirely truthful, a long time ago (in the mid 1970s), I even experimented with this odd therapy myself. When I worked as a junior doctor in a homeopathic hospital, several of my collegues practised homeopuncture and taught me how to do it. Essentially, you inject homeopathic remedies into acupuncture points. My colleagues told me that this approach is more powerful than each method alone. I tried it several times but remained unconvinced.

Recently, a German Heilpraktiker (Andreas Maier), reminded me of all this. Here is what he states on his website about homeopuncture:

In traditional Chinese medicine, acupuncture in addition to the herb medicine as well as certain movement therapies (eg. B. Gong Qi) constituting an important element in the treatment of diseases.

By stimulating energy points with the help of fine needles will then attempts to harmonize the flow of vital energy. a disruption of vital energy because (also called Qi), is considered in Chinese medicine as a cause of any disease.

Only when the energy flows freely through all the tissues and organs of the body, the organism can develop normally and is healthy. A similar approach is also the Homeopathy, which originated at the other end of the world, namely in Germany.

Samuel Hahnemann (1755 – 1843), the discoverer of this method of healing, also saw a failure of the life force as a pathogenic factor.

By smallest stimuli the homeopath tries to eliminate these disease-causing disorder and bring about healing. Unlike in the acupuncture reduced drug doses to be used strictly in accordance with the  principle of similarity  are selected.

Mid-19th century was the German physician Dr. August consecration firmly (1840- 1896) that disease with painful spots may accompany the body.

These pain points are often far from the actual disease process. The phenomenon was known to the Chinese for thousands of years in Europe, however, no one had yet busy. Dr. Weihe, himself a keen homeopath, was in the treatment of his patients finally see that by the suitably chosen homeopathic healed not only the disease, but also disappeared the painfulness of the points.

It was surprising that certain homeopathic remedies appear to be well-defined points had a direct bearing on the body.

A few years later, the Chinese medicine and acupuncture also reached the European continent, they took Weihe discoveries closer look. A comparison of the so-called consecration points with acupuncture points showed significant matches.

The more than 300 known Weihe points are also used therapeutically since both diagnosis. Because they can provide information on the pathological processes in the body and on the displayed homeopathic. thus the Homöopunktur brings together the findings from Chinese medicine and homeopathy. The treatment can be done differently.

On the one hand the consecration points can be traditionally stimulated with fine needles, concomitant administration of homeopathic medicine. With the help of injection preparations, means may also be injected directly to the point.

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(sorry about my friend’s poor English; I hope you could make sense of it)

I don’t think I need to tell you what the evidence tells us about homeopuncture. Yes, you guessed it: nothing! But the idea of combining SCAMs is fascinating nevertheless. So, let me suggest a few further SCAM combinations that might be attractive:

  • acupuncture + massage (sorry, that already exists under the name of shiatsu)
  • colonic irrigation + coffea (that to is already taken by the Gerson guys)
  • art therapy + homeopathy (too late: this one too already exists; painting homeopathy on the body surface)
  • detox + meditation (no, the health retreat/wellness entrepreneurs might get upset)

I am clearly not very successful at finding viable SCAM combinations. Let’s look for something innovative, something that nobody has yet thought of. How about:

  • homeo-laugh (homeopathy followed by an explanation what homeopathy is resulting in laughter; not sure that this would sell all that well)
  • kinesiology colour taping (instead of using random colours for kinesiology tape, this approach uses the wisdom of coulourtherapists to match the patient’s individual colour requirements; this means the therapists needs dual qualifications and can thus charge double – I think that might be attractive!)
  • autologous slapping therapy (this combination of slapping and autologous blood therapy (ABT) means the therapist has to hit so hard that the patient develops sizable haematomas which are the ABT part of the intervention; perhaps a bit risky, as some patients might call the police)
  • effective reverse energy transfer counselling, ERETC (the patients is counselled that his money can, with the help of the therapist, be converted into pure healing energy; to make it work, the patient needs to transfer it to the account of the therapist – the more the better)

I think I like ERECT best; in fact, I will start work on it straight away. It still needs to be perfected, but once it’s up and running, it will be just great and, as the name already makes clear, effective – not for the patient, but for the therapist!

I recently saw a tweet by a German homeopath stating that ‘homeopathy is 100% experienced based medicine’. It made me think and realise that there is not just one EBM, there are, in fact, at least three EBMs!

  1. Experience based medicine
  2. Eminence based medicine
  3. Evidence based medicine

I will start with the type which I encountered first when studying medicine all those years ago.

EMINENCE BASED MEDICINE

German healthcare was at the time – 1970s – deeply steeped in this variety of EBM. What the professor said was right, and there was no discussion about it. I don’t even know how my teachers would have reacted, if we had challenged their wisdom, because nobody ever did; it just did not occur to us.

Personally, I never got along too well with this type of EBM. I found it stifling, and this feeling might have contributed to my first ‘escape’ to England in 1979. In the UK, I felt, things were refreshingly different (see also my recent obituary of my former boss).

EXPERIENCE BASED MEDICINE

So-called alternative medicine (SCAM) is almost entirely based on this type of EBM. Practitioners of SCAM pride themselves of their experience and are convinced that it outweighs evidence any time. They rarely miss an occasion to stress that their treatment as stood the test of time. And as such it does not require evidence; if SCAM did not work, it would not have survived all these years.

Little do they know that the appeal to tradition is a logical fallacy. And little do they care that the long tradition of their SCAMs might just signal how obsolete their treatments truly are. Hundreds (homeopathy) or thousands (acupuncture) of years ago, we had little knowledge about physiology, pathology, etc., and clinicians had to make do with the little that got. Seen in this light, experience based medicine is a negative label that indicates the fact that the treatments are likely to be obsolete and out-dated.

EVIDENCE BASED MEDICINE

Providers of SCAM have a deeply rooted dislike for the word evidence. The reason is simple: their SCAMs are usually very shy on evidence; little wonder that they like to focus on experience instead. Yet, try to explain the concept of evidence to someone neutral like a barman, for instance – whenever I made this attempt, I was interrupted by him saying: ‘Hold on, are you saying that before EBM you did not depend on evidence? This is frightening! What on earth did you rely on then?’

It is indeed not logical to rely on eminence or on experience, in my view. And therefore, I have stopped explaining EBM to people who have common sense, like my barman. Let’s try something else instead: imagine you are seriously ill and are able to chose between three clinician who are each the leading head in their type of EMB.

THE EMINENCE IS A PROFESSOR MANY TIMES OVER AND SIMPLY KNOWS THAT HE IS ALWAYS RIGHT

Personally, I would run a mile. I have seen too many of those blundering through the wards of university hospitals. He never makes a mistake, except that things do go wrong quite often; and when they do, it is the fault of some underling, of course.

THE EXPERIENCED CLINICIAN WITH YEARS OF PRACTICE WHO HAS SEEN IT ALL AND HAS ALL THE ANSWERS

With a bit of bad luck, he might be a homeopath. He will tell you endlessly of cases that were similar to yours. Occasionally, there was an aggravation (which, of course, is a good sign in his view), but in the end he cured them all with his treatments that had stood the test of time. He has excellent bedside manners, a lot of charisma, and is a good listener. Who was it that said: “the three most dangerous words in medicine are IN MY EXPERIENCE”?

Yes, you guessed it: run and don’t turn back!

THE CLINICIAN WHO KNOWS WHAT THE CURRENT BEST EVIDENCE HAS TO OFFER

He might not be all that charismatic, perhaps he even is a bit abrupt. But he will know the latest developments and weigh the risks of all therapeutic options against their benefits.

But hold on, my barman would interrupt at this point, this is not either or. One can have both experience and evidence!

I told you my barman was clever. The definition of evidence based medicine is not healthcare based on up-to date knowledge, it is the integration of best research evidence with clinical expertise and patient values. It thus rests on three pillars: external evidence, ideally from systematic reviews, the clinician’s experience, and the patient’s preferences.

Therefore, my barman and I agree that eminence based medicine is highly questionable, experience based medicine can be outright dangerous, and evidence based medicine is the only EBM version that does make sense.

 

 

There is a long-standing debate on the question whether the use of homeopathy saves money. Homeopathy fans usually insist that it does. Even the Smallwood report commissioned by Prince Charles claimed that the NHS could save pots of money, if GPs only used more homeopathy.

And it is true, of course: on average homeopathics are cheaper than drugs. Therefore, replacing drugs with homeopathics would be a cost-saving. But, in healthcare, we cannot think like this; if we did, this logic would tell us that not doing anything at all would be even cheaper.

Somehow, we need to factor into the equation the effectiveness of the interventions that we are evaluating. The way to do this is to conduct proper cost-effectiveness analyses. And the reliable evidence from such assessments fails to confirm the notion that homeopathy might save us money.

So, why did I entitle this post HOW TO SAVE MONEY WITH HOMEOPATHY?

Because, it is true: you can save money, if you adhere to my instructions!

If you or a friend of yours are ill and therefore tempted by the numerous claims of homeopaths, please follow this simple step by step procedure:

  1. Go to your library, find a reliable book (I recommend this one), inform yourself what homeopathy truly is and absorb in the fact that a typical homeopathic remedy contains exactly zero active molecules.
  2. Read a bit further and check out what the best evidence from rigorous clinical trials tells us about the effectiveness of homeopathy.
  3. Go to a pharmacy that specialises in homeopathic products.
  4. Ask the pharmacist which homeopathic remedies she recommends for the ailment you suffer from.
  5. Ask the pharmacist to tell you what these would cost.
  6. Tell the pharmacist what you have just learnt about the evidence.
  7. Ask her kindly not to mislead customers in future.
  8. Go home.
  9. Repeat 3 – 8 as often as you can.

I think you have to agree that by following my instructions, you have saved exactly the amount of money that the pharmacist quoted.

 

 

PS

And for those for whom this advice comes too late, because they already have at home a selection of homeopathic remedies, I have the following cost-saving trick: use them for sweetening your tea or coffee. This saves you the cost of buying sugar – every little bit helps!

 

Some of you might have followed my recent discussion with a homeopath. It followed a typical path, and I decided therefore to try and analyse this exchange here. Perhaps others can learn from this example when debating with homeopaths or other providers of so-called alternative medicine (SCAM).

THE START

These conversations often start ‘out of the blue’ by some falsehood being trumpeted on social media. In the present case, the encounter commenced by someone tweeting this message to me: “…remember that asthma trial whose results you faked?” As I did not even remember having ever met the man, I was perplexed. And as I have not faked the study in question nor any other results, I did not think his remark was credible or funny. My mention of the fact that the aggressor was being libellous seemed to bring an end to this unhappy dialogue.

But not for very long. When the man insulted me again – this time very publicly in a UK newspaper – I decided to look into it a bit closer. The aggressor turned out to be in charge of the well-known UK homeopathic pharmacy, Ainsworth, and thus had an overt conflict of interest in defaming my often critical stance on homeopathy. Intriguingly, he had also published his own study of homeopathy. When I assessed this research, it turned out to be both incompetent and unethical. I had hoped that he would defend his work and discuss its limitations with me in a rational fashion. Yet, at this stage, he remained silent.

I then decided to write a further post in the hope of getting some sort of response from him. Alas, my hope was disappointed again. Even when I challenged him and his ROYAL WARRANT directly, he remained silent.

THE BUILD-UP

It needed a seemingly unrelated post of mine for him to find his voice:

Dear Ezard
We can all go round in endless circles arguing whether the Earth is Flat, but eventually someone has to venture out in a boat to the horizon to determine the fact. A cursory reading of Hahnemann encourages every student of homoeopathy to gain their own experience empirically. We all know you and your friends on this blog are standing on the shore proclaiming the Earth to be flat, but when are you going to pedal out,to bravely cite actual cases you have treated with homoeopathy as evidence of your position? What the audience reading this wants to know is what experience and knowledge any of you actually have of the subject you spend so much time criticising?

At this stage a had grown a little weary of Mr Pinkus and his innuendos. My response was thus a little impatient:

Dear Tony
I don’t think highly of people who
1) are too daft to spell my name correctly,
2) imply I have no experience in homeopathy,
3) pretend that I make a secret of it, while, in fact, I published this multiple times (i.e. https://www.amazon.co.uk/Scientist-Wonderland-Searching-Finding-Trouble/dp/1845407776),
4) accuse others of being flat earthers, while evidently being one themselves,
5) do all this without declaring their massive conflict of interest.
Best regards
Edzard

What followed was Pinkus’ increasingly irrational attempts to defame me by revealing to the world that I (and other critics of homeopathy) lacked sufficient clinical experience with homeopathy and therefore were not competent to discuss the subject. Explanations by myself and others that,

  • firstly I did have knowledge and experience of homeopathy,
  • and secondly no experience is required for a critical evaluation of any treatment,

all fell on deaf ears.

THE END

The conclusion of this odd discussion was Pinkus’ triumphant declaration of victory:

I came to this blog to see if anyone in the discussion had any serious intention to discuss the subject of homoeopathy. In order to do this there are certain prerequisites for a sensible debate and one of these is actual knowledge and experience of the subject matter under discussion. To this end I asked if anyone has case they treated in order to discuss the merits and demerits of the experience. No one offered one. I repeated the request and the silence changed to attacks on me even asking.

Any scientist worthy of the challenge, and certainly someone who proudly styles himself as a Professor of CAM with experience and knowledge, would be only too glad to share this with others. Sadly though I have met with rebuke and insult but no evidence to support the opposition to homoeopathy saving some incoherent rant about the needlessness of empirical experience. The cornerstone of Hahnemann’s work on homoeopathy and the one thing he advocated to other doctors. “Don’t take my word for it, prove it to yourself”

When you find the need to attack me to defend your incessant argument that homoeopathy is implausible I really cannot take you seriously.

Here we have a blog hosted by a chap who claims to be an expert on the subject but now claims he hasn’t practiced it for over 40 years. Won’t say what he did when he practised, what he learned and when asked to give at least once case he treated, refuses and creates some diversion to cover his ignorance of the question. Now that’s what I call a charlatan.

I understand you have made a living out of this but it must be a miserable existence old chap

______________________________________________________________________

I find this exchange rather typical for an argument with  SCAM-fanatics. It follows a fairly standard strategy:

  • aggression form a complete stranger,
  • attempt of a rational defence,
  • more aggression and insults
  • attempts to debate the published evidence,
  • silence from the aggressor who seems unable to defend his evidence,
  • more aggression at an unexpected opportunity,
  • further attempts to rationalise and discuss the facts,
  • the aggressor questions his opponent’s competence,
  • more attempts to rationalise and provide valid explanations,
  • conclusion of the discussion with aggressor trying to occupy the moral high ground.

Of course, this is eerily similar to playing chess with a pigeon.

So, what, if anything, can we learn from this?

Mainly three things, I think:

  1. Either you don’t argue with fanatics at all,
  2. or you realise from the beginning what is about to happen; in this case, have fun exposing irrationality in the hope that others might profit from your experience.
  3. In any case, do not expect that your aggressor will be able to learn anything.

These days, I am often not sure what puzzles me more, Boris Johnson or homeopathy. Come to think of it, our PM seems, in fact, to have a lot in common with homeopathy/homeopaths. With my tongue lodged firmly in my cheek, I can see some communalities:

  • They are both popular in the UK but have their origins elsewhere.
  • They were both laughed at by people who are serious.
  • They have both been around for far too long.
  • They both are useless.
  • They both have plenty of charisma.
  • They both, however, have little more than that.
  • They have a long history of misleading the public.
  • They have both been taken to court.
  • They both failed to accept the judgement when it went against them.
  • They are both particularly successful with the female section of the population.
  • They both thrive on personal attacks.
  • They both make far-reaching claims which turn out to be false.
  • They both claim to want only the best for the public.
  • They both consider themselves as progressive.
  • In truth, however, they are both deeply regressive.
  • They both do not to think that ethics are all that important.
  • They both irritate people who are rational thinkers.
  • They both negate the evidence and act in overt contradiction to the evidence.
  • They both tend to think that popularity is a measure of efficacy.
  • They both managed to mislead even the Queen.
  • Nevertheless, they both enjoy royal support (at least for the time being).
  • They both seem to think that the laws (of the land/of nature) do not apply to them.
  • They are both only bearable when highly diluted.
  • They are both a complete waste of money.
  • They are both dangerous when the public follow their advice.

Have I forgotten anything?

Do tell me, please.

The Society of Homeopaths (SoH) is the professional organisation of UK lay homeopaths (those with no medical training). The SoH has recently published a membership survey. Here are some of its findings:

  • 89% of all respondents are female,
  • 70% are between the ages of 35 and 64.
  • 91% of respondents are currently in practice.
  • 87% are RSHoms.
  • The majority has been in practice for an average of 11 – 15 years.
  • 64% identified their main place of work as their home.
  • 51% work within a multidisciplinary clinic.
  • 43% work in a beauty clinic.
  • 85% offer either telephone or video call consultations.
  • Just under 50% see 5 or fewer patients each week.
  • 38% are satisfied with the number of patients they are seeing.
  • 80% felt confident or very confident about their future.
  • 65% feel supported by the SoH.

What can we conclude from these data?

Nothing!

Why?

Because this truly homeopathic survey is based on exactly 132 responses which equates to 14% of all SoH members.

If, however, we were able to conclude anything at all, it would be that the amateur researchers at the SoH cause Hahnemann to turn in his grave. Offering telephone/video consultations and working in a beauty salon would probably have annoyed the old man. But what would have definitely made him jump with fury in his Paris grave is a stupid survey like this one.

It is hot, very hot? People have difficulties sleeping at night, not to mention working during the day. If you are one of the millions suffering, do not despair. Luckily, we have so-called alternative medicines (SCAM) that can help.

This article, for instance explains what homeopathy can do for you:

Glonoine:

This is one of the top remedies to consider in heat stroke especially in the following symptoms are present; eyes fixed without expression, glassy eyes, pupils contracted, pulse either barely perceptible or so quick it can’t be counted, loss of speech, face pale, white or yellowish-red; cold sweat, body cold and head hot to the touch.

Belladonna:

It is easy to confuse Belladonna and Glonoine (see above).  They both have cold body with a hot head, fixed or staring eyes etc.  However, there are some differences.  Typically you would see dilated pupils in Belladonna.  In addition, the face will typically be red.  Other symptoms that indicate Belladonna can include involuntary stool or urination, twitching or trembling of the limbs, bending the head backwards and an unusually heavy sleep.

Aconite:

Aconite can also be useful.  Symptoms calling for this remedy can include heat in the whole body (and not as much in the head as in Belladonna and Glonoine), contracted pupils, hard and full pulse.  One way to differentiate Aconite is its characteristic anxiety and restlessness.

Another article recommends acupuncture:

Acupuncture is always a great option, too.  Your practitioner will focus on clearing the heat, and if you have the damp type, they will also resolve the dampness and calm your digestion down.  There are also some really effective Chinese herbal formulas specifically designed for Summerheat.  So be cool and don’t let the hot weather get you down.

And yet another article advises us to use Bach flower remedies:

Into a glass of water, put 4 drops of Rescue Remedy and 2 drops each of Beech and Olive and sip through out the day.  If you’re travelling, into a 500ml bottle of mineral water, put 6-8 drops of Rescue and 3-4 drops of the single remedies into the bottle and sip.

Find it hard to decide which one to try? Let me make the choice easier for you:

  • Homeopathy is ineffective.
  • Acupuncture is ineffective.
  • Bach flower remedies are ineffective.

But you knew that anyway, didn’t you?

His name is Uriel. He been studying and controlling energy for over 20 years. Growing up as a young boy in a family that has been doing spiritual healing for over 800 years, he started to feel other people’s emotions, feelings, and illnesses without having to speak to them directly.

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  • Spiritual healing and blessing for mind, body and soul – $499.
  • Full service energy healing – $499.
  • Clearing and removing black magic, curses, evil eye and witchcraft – $259.
  • Advice, blessings and special requests – $150.
  • Spiritual healing to attract money and finances – $200.
  • Chakra clearing and balancing service – $200.
  • Spiritual healing for rekindling your relationship – $499.
  • Spiritual healing for attracting good luck and opening your luck – $200.
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I was particularly taken by Uriel’s ability to program crystals. These can then be bought and will send positive energy to the happy customer. This is what he says about it:

Crystals have been used for thousands of years by many practitioners of healing. Every crystal has a unique energy and vibration that allows it to be programmed for specific use or purpose.

Some crystals will bring good fortune while others are meant to bring luck, physical healing, love, protection from evil eye, black magic, voodoo and jealousy. Every crystal has a unique purpose and benefit. These days with the advancement of technology not many people are familiar with crystal programming or crystals in general.

Programming crystals takes a lot of effort, it isn’t a simple process and is extremely time consuming. The process starts with clearing the practitioners energy field and then using angels, ancestors, the sun, the stars and loved ones in spirit to properly clear and program the crystal such as a bracelet, necklace or stone. Each crystal can be programmed to your unique requirements. The process requires your name and birth date to insure the crystal is programmed specifically to you. This lengthily process when done properly will create miracles for the person wearing the crystal.

A skilled and experienced practitioner must know how to control angels, master the art of energy manipulation and be extremely careful  when programming the crystals to insure only positive energy is entered in to the stone as any negative vibrations will have the opposite effect on the person who will be using or wearing the stone.

Buying crystals from random places without any proper programming will not bring you any positive results. These must be properly programmed or they are nothing more then a decorative piece of jewelry. I offer a wide selection of crystal products such bracelets, necklaces and energy generators. These are programmed to your unique requirements and take me over 14 hours to properly program each unit, please visit my products page to see everything that I offer.

These crystals can be purchased for friends, family members and you can also own multiple different pieces. They will make the perfect gift to your loved ones. If you have any questions about crystal programming or my process please feel free to contact me for more information.

I find it really difficult to decide what product to try first; the choice is just far too impressive … Hold on, I know, what I am going to buy: THE ULTIMATE BLACK MAGIC PROTECTION NECKLACE. At just $199, it seems a bargain! And it might even protect me from quacks!!!

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