test of time
So-called alternative medicine (SCAM) is widely used in Arabia. One of the commonly used methods is camel urine alone or mixed with camel milk. Camel urine is a liquid by-product of camel metabolism. Urine from camels has been used as prophetic medicine for centuries, being a part of ancient Bedouin practices. Camel urine comes out as a concentrated, viscous syrup because the kidneys and intestines of a camel are very efficient at reabsorbing water.
Camel urine is consumed and used for treating numerous ailments. Some employ it as a treatment for hair loss, for instance. The camel urine from a virgin camel is priced at twenty dollars per liter, with herders saying that it has curative powers.
A recent paper offers more information:
Camel is one of the important livestock species which plays a major role in the pastoral mode of life by fulfilling basic demands of livelihood. Traditionally, camel urine has been used in the treatment of human diseases. With regard to the health benefits of drinking the urine of camels, it has been proven by modern scientific researches. Camel urine has an unusual and unique biochemical composition that contributes to medicinal values. The chemical composition of camel urine showed the presence of purine bases, hypoxanthine, sodium, potassium, creatinine, urea, uric acid, and phosphates. The nano-particles in the camel’s urine can be used to fight cancer. Camel urine has antimicrobial activity against pathogenic bacteria. Its chemical and organic constituents have also inhibitory properties against fungal growth, human platelets, and parasitic diseases mainly fasciollosis in calves. The healthy status of the liver can be restored through ingestion of diet and minerals in camel urine. Camel urine is used by the camel owners and Bedouins as medicine in different ways. The Bedouin in the Arab desert used to mix camel urine with milk. Recently; the WHO has warned against drinking camel urine due to the modern attempt to limit Outbreaks of Respiratory Syndrome (MRS) in the Middle East. There is no scientific dosage for camel urine to be applied as medicine for different diseases and the ways of camel urine formulation and utilization for the care of patients varies from country to country. Therefore, the purposes of the present review describe the biochemical composition of camel urine will be scientifically extracted and formulated as a therapy rather than drinking raw urine and people’s health impact.
Researchers from the Medical Oncology Department, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia wanted to determine whether camel urine shows promise in the treatment of cancer. The aim of their study was to observe cancer patients who insisted on using camel urine and to devise some clinically relevant recommendations.
The authors observed 20 cancer patients (15 male, 5 female) from September 2020 to January 2022 who insisted on using camel urine. They documented the demographics of each patient, the method of administering camel urine, the reasons for refusing conventional treatment, the period of follow-up, and the outcome and side effects.
All the patients had radiological investigations before and after finishing treatment with camel urine. All patients used a combination of camel urine and milk, and treatment ranged from a few days up to 6 months. The average amount of urine/milk consumed was 60 ml/day. No clinical benefit was observed and two patients developed brucellosis. Eleven patients changed their minds and eventually accepted conventional antineoplastic treatments but 7 were too weak to receive further treatment and died from their disease.
The authors concluded that camel urine had no clinical benefits in cancer patients, and may even have caused zoonotic infection. The promotion of camel urine as a traditional medicine should be stopped because there is no scientific evidence to support it.
I fear that, yet again, ‘ancient wisdom’ turns out to be just ‘old bullshit’.
The impact of drug-induced liver injury (DILI) on patients with chronic liver disease (CLD) is unclear. There are few reports comparing DILI in CLD and non-CLD patients. In this study, the researchers aimed to determine the incidence and outcomes of DILI in patients with and without CLD.
They collected data on eligible individuals with suspected DILI between 2018 and 2020 who were evaluated systematically for other etiologies, causes, and the severity of DILI. They compared the causative agents, clinical features, and outcomes of DILI among subjects with and without CLD who were enrolled in the Thai Association for the Study of the Liver DILI registry. Subjects with definite, or highly likely DILI were included in the analysis.
The researchers evaluated the causal relationship between the clinical pattern of liver injury and the suspected drugs or SCAM products with the Roussel Uclaf Causality Assessment Method (RUCAM) system. RUCAM is a validated and established tool to quantitatively assess causality in cases of suspected DILI and/or SCAM product-induced liver injury. They also used the Clinical Assessment of Causality Scale to assess the association as definite (>95% likelihood), highly likely (75–95%), probable (50–74%), possible (25–49%) or unlikely (<25%).
A total of 200 subjects diagnosed with DILI were found in the registry. Of those, 41 had CLD and 159 had no evidence of CLD. So-called alternative medicine (SCAM) products were identified as the most common class of DILI agents. Approximately 59% of DILI in the CLD and 40% in non-CLD group were associated with SCAM use. Individuals with pre-existing CLD had similar severity including mortality. Twelve patients (6%) developed adverse outcomes related to DILI including seven (3.5%) deaths and five (2.5%) with liver failure. Mortality was 4.88% in CLD and 3.14% in non-CLD subjects over median periods of 58 (8-106) days and 22 (1-65) days, respectively.
The authors concluded that, in this liver disease registry, the causes, clinical presentation, and outcomes of DILI in subjects with CLD and without CLD patients were not different. Further study is required to confirm our findings.
Consumers often prefer SCAM to conventional medicine because SCAM is viewed as gentle and safe. The notions are that they
- are natural and therefore harmless;
- have been in use for ages and thus have stood the test of time.
Readers of this blog will appreciate that both notions are, in fact, fallacies:
- appeal to nature;
- appeal to tradition.
This new paper is an impressive reminder that SCAM’s reputation as a safe option is not justified, and that SCAM relies more on fallacies than on facts.
Our ‘Memorandum Integrative Medicine‘ seems to be causing ripples. A German website that claims to aim at informing consumers objectively posted a rebuttal. Here is my translation (together with comments by myself inserted via reference numbers in brackets and added below):
With drastic words and narrow-mindedness bordering on ideology (1), the Münster Circle, an association of opponents to complementary therapies such as homeopathy (2), takes issue with the treatment concept of integrative medicine in a memorandum (3). By integrative medicine physicians understand the combination of doctor-led medicine and doctor-led complementary medicine to a meaningful total concept with the goal of reducing side effects and to treating patients individually and optimally (4). Integrative medicine focuses primarily on chronic diseases, where conventional acute medicine often reaches its limits (5)In the memorandum of the Münsteraner Kreis, general practitioner Dr. Claudia Novak criticizes integrative medicine as “guru-like self-dramatization” (6) by physicians and therapists, which undermines evidence-based medicine and leads to a deterioration in patient care. She is joined by Prof. Dr. Edzard Ernst, Professor Emeritus of Alternative Medicine, who has changed from Paul to Saul with regard to homeopathy (7) and is leading a veritable media campaign against proponents of treatment procedures that have not been able to prove their evidence in randomized placebo-controlled studies (8). The professor ignores the fact that this involves a large number of drugs that are used as a matter of course in everyday medicine (9) – for example, beta-blockers or other cardiological drugs (10). “Like the devil fears the holy water” (11), the Münsteraner Kreis seems to fear the concept of integrative medicine (12). The vehemence coupled with fear with which they warn against the treatment concept makes one sit up and take notice (13). “As an experienced gynecologist who has successfully worked with biological medicine as an adjunct in his practice for decades, I can only shake my head at such narrow-mindedness”, points out Fred-Holger Ludwig, MD (14). Science does not set limits for itself, but the plurality of methods is immanent (15). “Why doesn’t Prof. Ernst actually give up his professorial title for alternative medicine? That would have to be the logical consequence of its overloud criticism of established treatment concepts from homeopathy to to integrative medicine”, questions Dr. Ludwig (16).
The concept of integrative medicine is about infiltrating alternative procedures into medicine, claim the critics of the concept, without mentioning that many naturopathic procedures have been used for centuries with good results (17) and that healthcare research gives them top marks (18). “Incidentally, the scientists among the representatives of the Münster Circle should know that it is difficult to capture individualized treatment concepts with the standardized procedures of randomized, placebo-controlled studies (19). Anyone who declares the highest level of evidence to be the criterion for approval makes medicine impossible and deprives patients in oncology or with rare diseases, for example, of chances of successful treatment (20). Even there, drugs are used that cannot be based on high evidence, tested in placebo-controlled studies, because the number of cases is too low (21),” notes Dr. Ludwig .
- Ideology? Evidence is not ideology, in my view.
- We are an association of multidisciplinary experts advocating a level playing field with sound evidence in all areas of healthcare.
- The actual memorandum is not linked in this text; does the author not want his readers to form the own opinion?
- In our memorandum, we offer various definitions of integrative medicine (IM), none of which is remotely similar to this one.
- No, IM is usually being promoted in a much wider sense.
- This term does not appear in our memorandum.
- I am not aware that I changed from Paul to Saul with regard to homeopathy; I know that I was led mostly by the evidence.
- I feel flattered but don’t think that my humble work is a ‘media campaign’.
- True, I do not pretend to understand all areas of medicine and tend to be silent in the ones that I lack up-to-date expertise.
- Is he really saying that beta-blockers are not evidence-based?
- The holy water comparison from a homeopath, who arguably makes a living from dishing out ‘holy water’, made me laugh!
- It is most revealing, I think, that he thinks our motivation is fear.
- FHL is the author of the article, and it is thus charmingly naive that he cites himself in this way
- I somehow doubt that he understands what he is expressing here.
- I find this rather a bizarre idea but I’ll think about it.
- Argumentum ad traditionem.
- Those that get ‘top marks’ belong to evidence-based medicine and not to IM.
- Here the author reveals that he does not understand the RCT methodology and even fails to know the trial evidence on homeopathy – RCTs of individualised homeopathy are possible and have been published (e.g. this one).
- If he really believes this, I fear for his patients.
- Pity that he does not provide an example.
To understand FHL better, it is worth knowing that he claims to treat cancer patients with conventional and homeopathic medicine. He states that this approach reduces side effects – without providing evidence, of course.
Altogether, FHL does not dispute a single fact or argument from our memorandum. In fact, I get the impression that he never actually read it. To me, it feels as though he merely read an article ABOUT the document. In any case, his critique is revealing and important, in my view. It demonstrates that there are no good arguments to defend IM.
So, thank you FHL!
Advocates of so-called alternative medicine (SCAM) often sound like a broken record to me. They bring up the same ‘arguments’ over and over again, no matter whether they happen to be defending acupuncture, energy healing, homeopathy, or any other form of SCAM. Here are some of the most popular of these generic ‘arguments’:
1. It helped me
The supporters of SCAM regularly cite their own good experiences with their particular form of treatment and think that this is proof enough. However, they forget that any symptomatic improvement they may have felt can be the result of several factors that are unrelated to the SCAM in question. To mention just a few:
- Regression towards the mean
- Natural history of the disease
2. My SCAM is without risk
Since homeopathic remedies, for instance, are highly diluted, it makes sense to assume that they cannot cause side effects. Several other forms of SCAM are equally unlikely to cause adverse effects. So, the notion is seemingly correct. However, this ‘argument’ ignores the fact that it is not the therapy itself that can pose a risk, but the SCAM practitioner. For example, it is well documented – and, on this blog, we have discussed it often – that many of them advise against vaccination, which can undoubtedly cause serious harm.
3. SCAM has stood the test of time
It is true that many SCAMs have survived for hundreds or even thousands of years. It is also true that millions still use it even today. This, according to enthusiasts, is sufficient proof of SCAM’s efficacy. But they forget that many therapies have survived for centuries, only to be proved useless in the end. Just think of bloodletting or mercury preparations from past times.
4 The evidence is not nearly as negative as skeptics pretend
Yes, there are plenty of positive studies on some SCAMs This is not surprising. Firstly, from a purely statistical point of view, if we have, for instance, 1 000 studies of a particular SCAM, it is to be expected that, at the 5% level of statistical significance, about 50 of them will produce a significantly positive result. Secondly, this number becomes considerably larger if we factor in the fact that most of the studies are methodologically poor and were conducted by SCAM enthusiasts with a corresponding bias (see my ALTERNATIVE MEDICINE HALL OF FAME on this blog). However, if we base our judgment on the totality of the most robust studies, the bottom line is almost invariably that there is no overall convincingly positive result.
5. The pharmaceutical industry is suppressing SCAM
SCAM is said to be so amazingly effective that the pharmaceutical industry would simply go bust if this fact became common knowledge. Therefore Big Pharma is using its considerable resources to destroy SCAM. This argument is fallacious because:
- there is no evidence to support it,
- far from opposing SCAM, the pharmaceutical industry is heavily involved in SCAM (for example, by manufacturing homeopathic remedies, dietary supplements, etc.)
6 SCAM could save a lot of money
It is true that SCAMs are on average much cheaper than conventional medicines. However, one must also bear in mind that price alone can never be the decisive factor. We also need to consider other issues such as the risk/benefit balance. And a reduction in healthcare costs can never be achieved by ineffective therapies. Without effectiveness, there can be no cost-effectiveness.
7 Many conventional medicines are also not evidence-based
Sure, there are some treatments in conventional medicine that are not solidly supported by evidence. So why do we insist on solid evidence for SCAM? The answer is simple: in all areas of healthcare, intensive work is going on aimed at filling the gaps and improving the situation. As soon as a significant deficit is identified, studies are initiated to establish a reliable basis. Depending on the results, appropriate measures are eventually taken. In the case of negative findings, the appropriate measure is to exclude treatments from routine healthcare, regardless of whether the treatment in question is conventional or alternative. In other words, this is work in progress. SCAM enthusiasts should ask themselves how many treatments they have discarded so far. The answer, I think, is zero.
8 SCAM cannot be forced into the straitjacket of a clinical trial
This ‘argument’ surprisingly popular. It supposes that SCAM is so individualized, holistic, subtle, etc., that it defies science. The ‘argument’ is false, and SCAM advocates know it, not least because they regularly and enthusiastically cite those scientific papers that seemingly support their pet therapy.
9 SCAM is holistic
This may or may not be true, but the claim of holism is not a monopoly of SCAM. All good medicine is holistic, and in order to care for our patients holistically, we certainly do not need SCAM.
1o SCAM complements conventional medicine
This argument might be true: SCAM is often used as an adjunct to conventional treatments. Yet, there is no good reason why a complementary treatment should not be shown to be worth the effort and expense to add it to another therapy. If, for instance, you pay for an upgrade on a flight, you also want to make sure that it is worth the extra expenditure.
11 In Switzerland it works, too
That’s right, in Switzerland, a small range of SCAMs was included in basic health care by referendum. However, it has been reported that the consequences of this decision are far from positive. It brought no discernible benefit and only caused very considerable costs.
I am sure there are many more such ‘arguments’. Feel free to post your favorites!
My point here is this:
the ‘arguments’ used in defense of SCAM are not truly arguments; they are fallacies, misunderstandings, and sometimes even outright lies.
One of my recent posts prompted the following comment from a chiropractor: “… please don’t let me stop you…while we actually treat patients“. It was given in the context of a debate about the evidence for or against chiropractic spinal manipulations as a treatment of whiplash injuries. My position was that there is no convincing evidence, while the chiropractor argued that he has been using manipulations for this indication with good results. Here I do not want to re-visit the pros and cons of that particular debate. Since similar objections have been put to me so many times, I want rather to raise several more principal points.
Before I do this, I need to quickly get the personal stuff out of the way: the comment implies that I don’t really know what I am talking about because I don’t see patients and thus don’t understand their needs. The truth is that I started my professional life as a clinician, then I went into basic science, then I went back into clinical medicine (while also doing research), and eventually, I became a full-time clinical researcher. I have thus seen plenty of patients, certainly enough to empathize with both the needs of patients and the reasoning of clinicians. In fact, these provided the motives for my clinical research during the last decades of my professional career (more details here).
Now about the real issue that is at stake here. When offered by a clinician to a scientist, the comment “… please don’t let me stop you…while we actually treat patients” is an expression of an arrogant feeling of superiority that clinicians often harbor vis a vis professionals who are not at the ‘coal face’ of healthcare. Stripped down to its core, the argument implies that science is fairly useless because the only knowledge worth having stems from dealing with patients. In other words, it is about the tension that so often exists between clinical experience and scientific evidence.
Many clinicians feel that experience is the best guide to correct decision-making.
Many scientists feel that experience is fraught with errors, and only science can lead us towards optimal decisions.
Such arguments emerge regularly on this blog and are constant company to almost any type of healthcare. The question is, who is right and who is wrong?
As I indicated, I can empathize with both positions. I can see that, in the context of making therapeutic decisions in a busy clinic, for instance, the clinician’s argument weighs heavily and can make sense, particularly in areas where the evidence is mixed, weak, or uncertain.
However, in the context of this blog and other discussions focused on critical evaluation of the science, I am strongly on the side of the scientist. In fact, in this context, the argument “… please don’t let me stop you…while we actually treat patients” seems ridiculous and resembles an embarrassing admission of having no rational argument left for defending one’s own position.
To put my view of this in a nutshell: it is not a question of either or; for optimal healthcare, we obviously need both clinical experience AND scientific evidence (an insight that is not in the slightest original, since it is even part of Sackett’s definition of EBM).
Anyone who has followed this blog for a while will know that advocates of so-called alternative medicine (SCAM) are either in complete denial about the risks of SCAM or they do anything to trivialize them. Here is a dialogue between a SCAM proponent (P) and a scientist (S) that is aimed at depicting this situation. The conversation is fictitious, of course, but it is nevertheless based on years of experience in discussing these issues with practitioners of various types of SCAM. As we shall see, the arguments turn out to be perfectly circular.
P: My therapy is virtually free of risks.
S: How can you be so sure?
P: I am practicing it for decades and have never seen a single problem.
S: That could have several reasons; perhaps the patients who experience problems did simply not come back.
P: I find this unlikely.
S: I don’t, and I know of reports where patients had serious complications after the type of SCAM you practice.
P: These are isolated case reports. They do not amount to evidence.
S: How do you know they are isolated?
P: They must be isolated because, in the many clinical trials of my therapy available to date, you will not find any evidence of serious adverse effects.
S: That is true, but it has been repeatedly shown that these trials regularly fail to mention side effects altogether.
P: That’s because there aren’t any.
S: Not quite, clinical trials should always mention adverse effects, and if there were none, they should mention this too.
P: So, you admit that you have no evidence that my therapy causes adverse effects.
S: The thing is, I don’t need such evidence. It is you, the practitioners of this therapy, who should provide evidence that your treatments are safe.
P: We did! The complete absence of reports of side effects constitutes that evidence.
S: Except, there is some evidence. I already told you that there are several case reports of serious problems.
P: But case reports are anecdotes; they are no evidence.
S: Look, here is a systematic review of all the case reports. You cannot possibly deny that this is a concern.
P: It’s still merely a bunch of anecdotes, nothing more.
S: Only because your profession does nothing about it.
P: What do you think we need to do about it?
S: Like other professions, you need to systematically record adverse effects.
P: How would that help?
S: It would give us a rough indication of the size and severity of the problem.
P: This sounds expensive and complicated to organize.
S: Perhaps, but it is necessary if you want to be sure that your therapy is safe.
P: But we are sure already!
S: No, you believe it, but you don’t know it.
P: You are getting on my nerves with your obsession. Don’t you know that the true danger in healthcare is the adverse effects of pharmaceutical drugs?
S: But these drugs are also effective.
P: Are you saying my therapy isn’t?
S: What I am saying is that the drugs you claim to be dangerous do more good than harm, while this is not at all clear with your SCAM.
P: To me, that is very clear. My therapy helps many and harms nobody!
S: How do you know that it harms nobody?
… At this point, we have gone full circle and we can re-start this conversation from its beginning.
Acupuncture for animals has a long history in China. In the West, it was introduced in the 1970s when acupuncture became popular for humans. A recent article sums up our current knowledge on the subject. Here is an excerpt:
Acupuncture is used mainly for functional problems such as those involving noninfectious inflammation, paralysis, or pain. For small animals, acupuncture has been used for treating arthritis, hip dysplasia, lick granuloma, feline asthma, diarrhea, and certain reproductive problems. For larger animals, acupuncture has been used for treating downer cow syndrome, facial nerve paralysis, allergic dermatitis, respiratory problems, nonsurgical colic, and certain reproductive disorders.Acupuncture has also been used on competitive animals. There are veterinarians who use acupuncture along with herbs to treat muscle injuries in dogs and cats. Veterinarians charge around $85 for each acupuncture session.Veterinary acupuncture has also recently been used on more exotic animals, such as chimpanzees (Pan troglodytes) and an alligator with scoliosis, though this is still quite rare.
To put it in a nutshell: acupuncture for animals is not evidence-based.
How can I be so sure?
Because ref 1 in the text above refers to our paper. Here is its abstract:
Acupuncture is a popular complementary treatment option in human medicine. Increasingly, owners also seek acupuncture for their animals. The aim of the systematic review reported here was to summarize and assess the clinical evidence for or against the effectiveness of acupuncture in veterinary medicine. Systematic searches were conducted on Medline, Embase, Amed, Cinahl, Japana Centra Revuo Medicina and Chikusan Bunken Kensaku. Hand-searches included conference proceedings, bibliographies, and contact with experts and veterinary acupuncture associations. There were no restrictions regarding the language of publication. All controlled clinical trials testing acupuncture in any condition of domestic animals were included. Studies using laboratory animals were excluded. Titles and abstracts of identified articles were read, and hard copies were obtained. Inclusion and exclusion of studies, data extraction, and validation were performed independently by two reviewers. Methodologic quality was evaluated by means of the Jadad score. Fourteen randomized controlled trials and 17 nonrandomized controlled trials met our criteria and were, therefore, included. The methodologic quality of these trials was variable but, on average, was low. For cutaneous pain and diarrhea, encouraging evidence exists that warrants further investigation in rigorous trials. Single studies reported some positive intergroup differences for spinal cord injury, Cushing’s syndrome, lung function, hepatitis, and rumen acidosis. These trials require independent replication. On the basis of the findings of this systematic review, there is no compelling evidence to recommend or reject acupuncture for any condition in domestic animals. Some encouraging data do exist that warrant further investigation in independent rigorous trials.
This evidence is in sharp contrast to the misinformation published by the ‘IVAS’ (International Veterinary Acupuncture Society). Under the heading “For Which Conditions is Acupuncture Indicated?“, they propagate the following myth:
Acupuncture is indicated for functional problems such as those that involve paralysis, noninfectious inflammation (such as allergies), and pain. For small animals, the following are some of the general conditions which may be treated with acupuncture:
- Musculoskeletal problems, such as arthritis, intervertebral disk disease, or traumatic nerve injury
- Respiratory problems, such as feline asthma
- Skin problems such as lick granulomas and allergic dermatitis
- Gastrointestinal problems such as diarrhea
- Selected reproductive problems
For large animals, acupuncture is again commonly used for functional problems. Some of the general conditions where it might be applied are the following:
- Musculoskeletal problems such as sore backs or downer cow syndrome
- Neurological problems such as facial paralysis
- Skin problems such as allergic dermatitis
- Respiratory problems such as heaves and “bleeders”
- Gastrointestinal problems such as nonsurgical colic
- Selected reproductive problems
In addition, regular acupuncture treatment can treat minor sports injuries as they occur and help to keep muscles and tendons resistant to injury. World-class professional and amateur athletes often use acupuncture as a routine part of their training. If your animals are involved in any athletic endeavor, such as racing, jumping, or showing, acupuncture can help them keep in top physical condition.
And what is the conclusion?
Never trust the promotional rubbish produced by SCAM organizations.
On Amazon, someone commented as follows on my biography of Prince Charles:
… Dr. Ernst goes on digressions that mostly seem intended to make Prince Charles look bad. There’s a long chapter on Laurens van der Post, who influenced Prince Charles as a youth, and a lot about somewhat unsavory things he did. So what? …
This made me think. I read the chapter again and find it hard to agree with the comment. To me, this chapter is a short (~2000 words) and essential part of the book. Judge for yourself; here are a few excerpts from it:
“It seemed to have been a union of mutual needs, between a Prince longing to find meaning in his existence and a storyteller who could weave apparent answers out of thin air.” Laurence van der Post was oozing charm and charisma and sensed that “for the Prince, there was a missing dimension”, as Jonathan Dimbleby put it. By 1975, the two men had formed such a close rapport that van der Post felt able to counsel him about spiritual matters, urging him to explore the ‘old world of the spirit’ and ‘the inward way’ towards truth and understanding. Van der Post suggested the two make a seven week journey into the Kalahari desert. This, he believed, would introduce Charles to the spirit world. Preparations were made in 1977 but, in the end, the plan had to be abandoned. Instead, the two later went to Kenya where they spent 5 days of long walks and “intense conversation”.
Van der Post urged Charles to play “a dynamic and as yet unimagined role to suit the future shape of a fundamentally reappraised and renewed modern society”, a reappraisal that would be “so widespread and go so deep that it will involve a prolonged fight for all that is good and creative in the human imagination.” An aspect of this fight, he claimed, would be “to restore the human being to a lost natural aspect of his own spirit; to restore his relevance for life and his love of nature, and to draw closer to the original blueprint and plan of life…”
Laurence left an interview for posthumous publication; in it, he expressed his hope that Charles would never become king, as this would imprison him, it would be more important that Charles continues to be a great prince. “He’s been brought up in a terrible way … He’s a natural Renaissance man, a man who believes in the wholeness and totality of life … Why should it be that if you try to contemplate your natural self that you should be thought to be peculiar?”
“For 20 years they had most intimate conversations and correspondence … with a steady flow of reassurance and encouragement, political and diplomatic advice, memoranda, draft speeches and guidance for reading”. Van der Post introduced Charles to the teachings of Carl Jung and his concept of the ‘collective unconscious’ that binds all humans together regardless whether they are Kalahari bushmen or princes. On the behest of van der Post, Charles began to record his dreams which van der Post then interpreted according to Jung’s theories. In the late 1970s van der Post tried to convince Charles to give up all his duties and withdraw from the world completely in search for an ‘inner world truth’. This plan too was aborted.
All biographers agree that van der Post was the strongest intellectual influence of Charles’ life.
- Charles sought van der Post’s advice and spiritual guidance on numerous occasions.
- When William was born, he made van der Post his godfather.
- When Charles’ marriage to Diana ran into difficulties, the couple was counselled by van der Post.
- Charles invited Laurence regularly to Highgrove, Sandringham and Balmoral.
- Charles visited van der Post on his deathbed.
- After Laurence’s death, Charles created a series of annual lectures hosted in van der Post’s memory which he hosted in St James’ Palace.
Charles’ notions about medicine were unquestionably inspired by van der Post. Laurence. He, for instance, bemoaned the inadequacy of conventional medicine and wrote: “Even if doctors did … use dreams and their decoding as an essential part of their diagnostic equipment and perhaps could confront cancer at the point of entry, how are they to turn it aside, unless they are humble enough to keep their instruments in their cases and look for some new form of navigation over an uncharted sea of the human spirit?” As we will see in the next chapters, van der Post’s influence shines through in many of Charles’ speeches. Moreover, it contributed to the attitude of many critical observers towards Charles. Christopher Hitchens is but one example for many:
“We have known for a long time that Prince Charles’ empty sails are so rigged as to be swelled by any passing waft or breeze of crankiness and cant. He fell for the fake anthropologist Laurens van der Post. He was bowled over by the charms of homeopathic medicine. He has been believably reported as saying that plants do better if you talk to them in a soothing and encouraging way… The heir to the throne seems to possess the ability to surround himself—perhaps by some mysterious ultramagnetic force?—with every moon-faced spoon-bender, shrub-flatterer, and water-diviner within range.”
The following chapters will show that Hitchens might not have been far off the mark.
Yes, I do feel that the chapter is essential for the book. It explains how Charles’ love affair with alternative medicine got started and why it would become so intense and durable. Without it, the reader would not be able to understand the rest of the book. Moreover, it is important to demonstrate that van der Post was a charlatan and an accomplished liar. This is relevant because, in later life, Charles’ skill to choose adequate advisors was often wanting.
Bloodletting therapy (BLT) has been widely used for centuries until it was discovered that it is not merely useless for almost all diseases but also potentially harmful. Yet in so-called alternative medicine (SCAM) BLT is still sometimes employed, for instance, to relieve acute gouty arthritis (AGA). This systematic review aimed to evaluate the feasibility and safety of BLT in treating AGA.
Seven databases were searched from the date of establishment to July 31, 2020, irrespective of the publication source and language. BLT included fire needle, syringe, three-edged needle, and bloodletting followed by cupping. The included articles were evaluated for bias risk by using the Cochrane risk of bias assessment tool.
Twelve studies involving 894 participants were included in the final analysis. A meta-analysis suggested that BLT was highly effective in relieving pain (MD = -1.13, 95% CI [-1.60, -0.66], P < 0.00001), with marked alterations in the total effective (RR = 1.09, 95% [1.05, 1.14], P < 0.0001) and curative rates (RR = 1.37, 95%CI [1.17, 1.59], P < 0.0001). In addition, BLT could dramatically reduce serum C-reactive protein (CRP) level (MD = -3.64, 95%CI [-6.72, -0.55], P = 0.02). Both BLT and Western medicine (WM) produced comparable decreases in uric acid (MD = -18.72, 95%CI [-38.24, 0.81], P = 0.06) and erythrocyte sedimentation rate (ESR) levels (MD = -3.01, 95%CI [-6.89, 0.86], P = 0.13). Lastly, we demonstrated that BLT was safer than WM in treating AGA (RR = 0.36, 95%CI [0.13, 0.97], P = 0.04).
The authors concluded that BLT is effective in alleviating pain and decreasing CRP level in AGA patients with a lower risk of evoking adverse reactions.
This conclusion is optimistic, to say the least. There are several reasons for this statement:
- All the primary studies came from China (and we have often discussed that such trials need to be taken with a pinch of salt).
- All the studies had major methodological flaws.
- There was considerable heterogeneity between the studies.
- The treatments employed were very different from study to study.
- Half of all studies failed to mention adverse effects and thus violate medical ethics.
The British Royal Family have been proponents of homeopathy for generations. Homeopathy was originally introduced into the UK by Frederic Hervey Foster Quin who, as a young physician, had visited Hahnemann in Koethen, Germany. Quin was soon fully converted to homeopathy and returned to England. Being well-connected to the European aristocracy, he managed to attract many influential personalities to homeopathy. In 1844, he founded the British Homeopathic Society and, in 1850, he opened the predecessor of the Royal London Homeopathic Hospital which is today called the Royal London Hospital for Integrated Medicine.
Our Queen has many times been reported to swear by her homeopathic remedies. Some went as far as claiming her good health in old age must be due to her using homeopathy to keep well. Here is just one example from ‘THE OFFICIAL HOMEOPATHY RESOURCE’ of 2016:
On her 90th birthday, the London Weekly News reports that in spite of criticism the Queen has used homeopathy all her life and has remarkable good health. In fact, many generations of the Royal family have used homeopathy
For as The Queen marks her 90th birthday on April 21, that she has reached such an excellent age is largely due to her lifelong trust in homeopathy. Everywhere that Her Majesty goes she is accompanied by a small case of special cures and tinctures and, although doctors no not care to admit it, it is because of her herbal little helpers that she rarely gets a cold or any other sort of complaint.
Empiricists would argue that as both The Queen and the late Queen Mother have been avid fans of homeopathy and as The Queen Mum died at the age of 101, the glaring probability that it works seems to be rather evident.
Sadly, her good health cannot last forever, and we have all seen recent reports of her being unwell, spending one night in hospital, and announcing the cancellation of all her engagements during the next two weeks resting on doctors’ orders.
Peter Fisher was her homeopath, but he tragically died three years ago. Did the Queen appoint another homeopath to look after her? Did she go into the Royal London Hospital for Integrated Medicine when she was ill? Was she reported to be taking homeopathic remedies during her recovery? The answer to all those questions seems to be NO.
What does that tell us?
I have often observed that our Royals use homeopathy while they are well and conventional medicine when they are ill. The Queen might have followed this strategy too. But not appointing a successor to Peter Fisher suggests something quite different. Does it indicate, I ask myself, that the Queen has recently had the occasion to look at the evidence and concluded – as most intelligent people did some time ago – that homeopathy does not work beyond placebo?
I certainly hope so, not least because refusing to rely on homeopathy would significantly increase her chances of remaining our Queen for some time to come.