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

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‘Acupuncture in the Treatment of COVID-19: An Exploratory Study’ is the title of a paper that I was alerted to. Here is its abstract:

The coronavirus COVID-19 has presented a serious new threat to humans
since the first case was reported in Wuhan, China on 31 December 2019.
By the end of February 2020 the virus has spread to 57 countries with
nearly 86,000 cases, and there is currently no effective vaccination
available. Chinese herbal medicine has been used in this epidemic with
encouraging results, but with concerns regarding disturbance of patients’
digestive function. This study aims to explore the role of acupuncture in
treating COVID-19 by investigating relevant current literature along with
classical Chinese medicine texts on epidemics. Based on this analysis,
acupuncture points and strategies are suggested for practitioners to use
as a guide to treatment.

The paper is largely devoid of what I would call evidence. Here are a few excerpts to give you a flavour:

Epidemic qi attacks the body rapidly and violently,
therefore clinical features can change dramatically and vary
significantly between cases. Severe symptoms can develop
within just a few days. The following clinical possibilities
should be borne in mind:
• Once damp-cold becomes significant, it can: a) block
the Lungs causing dypnoea; b) attack the Pericardium
causing chest tension, nausea, cold sweat and shock;
c) cause Kidney yang failure, inducing haematuria,
dehydration, abnormal urination and weight loss; and
d) damage the Stomach and Spleen, leading to vomiting
and diarrhoea.
• Once damp-cold turns to heat, it will occlude the Lungs
and yangming (Stomach and Large Intestine) resulting
in fever, coughing, chest tension and shortness of breath,
fatigue, poor appetite, nausea, vomiting, bloating,

diarrhoea or constipation, eventually destroying the
body’s yin and evolving into endogenous wind syndrome.

How can one avoid contracting such a ferocious epidemic
virus? The Nei jing (Inner Classic) provides the answer:
people with strong zheng (upright) qi will avoid the
worst effects of epidemic infection despite the fact
that everybody, no matter their age or gender, may be
affected.24 Because each individual has a different physical
constitution, the manifestations of the disease will vary,
and so a single herbal prescription cannot be universally
effective for every patient. Acupuncture is conducted
with patients on a one-to-one basis, and is oriented more
to provide symptomatic relief than the generic herbal
decoctions applied during epidemic periods. The relevant
acupuncture protocols, based on the Chinese government
four-stage differentiation scheme for treating COVID-19,
are outlined below.

Oddly, the authors come closest to providing actual clinical evidence in their strange and somewhat lengthy conclusions:

… Historically, acupuncture has been used effectively to treat epidemic
infectious diseases, and despite historical neglect, it could
become a crucial weapon in the battle against COVID-19
and other future epidemics. Of course, practitioners should
ensure that they are properly protected when working with
infected patients, which means wearing a protective suit
and administering acupuncture in a hospital environment
(which brings its own challenges).
Inspiring evidence of the role of acupuncture has been
appearing since the beginning of March 2020. Professor
Zou Xu is a critical care medical expert from Guangdong
TCM hospital. As one of the supporting medical staff in
Wuhan Leishenshan hospital, he always takes acupuncture
needles during his ward inspections to help COVID-19
infected patients, especially those with acute symptoms
such as shortness of breath, coughing, dizziness, insomnia,
restlessness, palpitations, diarrhoea or vomiting. The
effect of his acupuncture was often instantaneous. A 72
year old female patient with high blood pressure and
diabetic chronic illness complained of a lower back ache,
whereupon Zou needled the point Taixi KID-3 and the
patient was able to stand upright immediately. Zou
explains that acupuncture can improve the patients’
oxygen supply and consumption, helping them regain
yuan-original qi while blocking the toxicity attacking the
Lung. Most importantly, acupuncture is not aiming to
destroy the epidemic qi, but instead it can influence the
conditions of its survival in the body.31 Zou’s team was in
charge of 16 patients, of which six patients
volunteered for Chinese medicine treatment alone;
as of 1st March 2020, all six have fully recovered and
have been discharged from hospital. In another ‘Report
from the Front Line in Wuhan’, Professor Liu Li Hong has
also documented the work of his team treating patients
with COVID-19 in Wuhan, emphasising the importance
of acupuncture in helping patients immediately with
symptoms such as stuffiness in the chest, shortness of
breath, abdominal discomfort, itchy throat, cough,
dizziness, pain and sweating.

In my view, this sentence alone merits an admission to my ‘corona-virus quackery club’ (CVQC): Historically, acupuncture has been used effectively to treat epidemic infectious diseases, and despite historical neglect, it could become a crucial weapon in the battle against COVID-19 and other future epidemics. And, of course, there are plenty other acupuncturists claiming similar things on the Inernet.

So:

Welcome to the CVQV, traditional acupuncturists!

Guest post by Björn Leifsson

I stumbled upon a web-article (in Icelandic) in which a local homeopath expresses her concerns over a public statement made by the national medical society suggesting that mention of homeopathic “drugs” should be removed from the legislation because homeopathy was an outdated approach and belief that is “neither based on scientific knowledge nor research”. The indignant homeopath referred to a YouTube video (really!) in support of her claim that many studies exist about the efficacy of homeopathy, as evidenced in the video.

Curiosity led me to browse through it. Towards the end of the video, Rachel Richards, a homeopath described, a seemingly remarkable study on hundreds of piglets that showed homeopathic treatment to significantly reduce infectious diarrhoea in newborn piglets. This, she claimed, is proof that homeopathy works through more than the placebo effect because placebo does not work on animals, right?

Here is the abstract of the paper:

Background: The use of antibiotics in the livestock sector is increasing to such an extent that it threatens negative consequences for human health, animal health and the environment. Homeopathy might be an alternative to antibiotics. It has therefore been tested in a randomised placebo-controlled trial to prevent Escherichia coli diarrhoea in neonatal piglets.

Method: On a commercial pig farm 52 sows of different parities, in their last month of gestation, were treated twice a week with either the homeopathic agent Coli 30K or placebo. The 525 piglets born from these sows were scored for occurrence and duration of diarrhoea.

Results: Piglets of the homeopathic treated group had significantly less E. coli diarrhoea than piglets in the placebo group (P<.0001). Especially piglets from first parity sows gave a good response to treatment with Coli 30K. The diarrhoea seemed to be less severe in the homeopathically treated litters, there was less transmission and duration appeared shorter.

This is a badly written paper. The description of methods and material is unclear and confusing. But I am not going to delve into the curious design and reporting details, such as their vague and conflicting description of the blinding or the rather peculiar description of the treatment procedure. I find the statistical design and analysis incriminating enough.

The study was conducted in four groups (batches). The researchers treated in total 52 sows; 26 were randomly allocated to an arm treated by spraying either dissolved “Coli, 30C” nosode sugar tablets. Another 26 sows were sprayed with the same liquid but without the homeopathic substance. They describe how they sprayed the stuff in[sic] the sow’s vulva’s, twice a week, during four weeks before expected delivery. How they sprayed “in” the vulva of the sows escapes my understanding. Perhaps they just misspelled “in” for “on”? Anyway, the authors curiously postulate that the “homeopathic substance” is absorbed from the vulva.

Ah, I forget… I did not plan to delve into the minor oddities of this eccentric opus.

So, 26 sows were “treated” with the good stuff and 26 with the fake. So far so good.

But this only produces a very small study, nothing more than a pilot – really. Not so good.

Instead of carrying on with this inexpensive study to procure proper power for the analysis, the authors counted the piglets! Approximately ten piglets were produced per sow so the total number of observed piglets became 525! That can certainly seem an impressive number of research subjects. Counting the piglets and not the sows, increased the study material tenfold, making it appear to be well powered study.

This is cheating in my opinion, nothing less, nothing more.

But why not do it this way?

In the week after the piglets were delivered, an observer, blinded to the treatment allocation, regularly noted which piglets got diarrhoea typical for enteropathogenic E. coli infection.

The authors made a big deal about confounding factors such as parity (how many prior litters the sow has produced) and its purported effect on piglet infection risk. They use an elaborate statistical program to perform an advanced (and wrong) analysis called “GLM – Generalised Linear Modelling”, and entered corrections for parity, season and treatment group (batch). But they forgot (omitted?) to correct for the obvious common risk factors to piglets in a litter.

On average ten piglets in each litter shared at least two litter-dependent risk factors, i.e. a sow (mother) and a pen. Thus the risk exposure is not independent between piglets, only between litters/sows.

Sow and pen dependent factors are likely to affect the number of infected piglets in affected litters. If a sow or pen is colonised, a number if not all piglets in that litter may be affected, by a common cause, thereby erroneously multiplying the effect of the studied endpoint. Possible genetic paternal and/or maternal factors may also be at play to affect the vulnerability of the litter as a group rather than individually.

In short, the authors did not have 525 study subjects, only 50.

But they might have tried to make do with this. There was actually an apparent difference between the groups, favouring the nosode arm as shown in the table. To an untrained reader (which most people are) this could easily be interpreted as proof  that the stuff really worked. One might see only the double number of affected litters in the placebo group? But this is far from relevant because the study is severely under-powered. To be able to call this study significant they would at the very least have needed to double this number. You would then still need to individually confirm the results in other separate studies, not the least for an extremely unlikely drug candidate as sugar dissolved in water.

The authors must have somehow realised that their study is abjectly under-powered and therefore resorted to using this veritable trick of mirrors and theatrical smoke to make it look like this was a trustworthy study of over 500 subjects.

Treatment:
Outcome: E. coli nosode Placebo Row totals:
Diarrhoea 7 16 23
No diarrhoea 17 10 27
Column totals: 24 26 Grand total: 50

Table showing the relative ratios of infected litters.

If we do a statistical test despite it being pointless, the P-value (Chi square) is 0.02176. Any P-value that falls below the 0.05 limit may seem important to the novice reader and probably be super exciting to a believer in homeopathy. But in this very small study such a result suggests absolutely nothing. It may be due to a multitude of factors other than the tested treatment, most likely pure chance perhaps aided by some flaws in the exclusion of bias.

And then there is the big problem with interpreting P-values.

My assessment is that, in compliance with Hanlon’s razor, this charade of scientific method is most likely due to a combination of incompetence and religiously wishful thinking rather than deliberate fraud. It being published in Homeopathy says much about that paper’s lacking editorial qualities.

Papillomas of dogs are benign growths caused by the canine papillomavirus. The oral mucosa and commissures of the lip are most frequently involved. Papillomas often regress spontaneously within a few weeks, and treatment is usually not necessary.

This Indian study tested the combination of 4 homeopathic drugs (Sulfur 30C, Thuja 30C, Graphites 30C, and Psorinum 30C) in 16 dogs affected with oral papillomatosis which was not undergone any previous treatment. Dogs affected with oral papillomatosis, which have not undergone any initial treatment and fed with a regular diet. They were randomly divided into two groups, namely, homeopathic treatment group (n=8) and placebo control group (n=8). The homeopathic combination and placebo (distilled water) was administered orally twice daily for 15 days. Clinical evaluation in both groups of dogs was performed by the same investigator during 12 months. Dogs were clinically scored for oral lesions on days 0, 5, 7, 10, 15, 20, 25, 30, 45, 60, 90, 120, and 150 after initiation of treatment.

The homeopathic treatment group showed early recovery with a significant reduction in oral lesions reflected by clinical score (p<0.001) in comparison to placebo-treated group. Oral papillomatous lesions regressed in the homeopathic group between 7 and 15 days, whereas regression of papilloma in the placebo group occurred between 90 and 150 days. The homeopathic treated group was observed for 12 months post-treatment period and no recurrence of oral papilloma was observed.

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The authors concluded that the current study proves that the combination of homeopathy drugs aids in fastening the regression of canine oral papilloma and proved to be safe and cost-effective.

This could well become the worst SCAM study of 2020. In case you have not already spotted its flaws, here are some of them:

  • the trial was truly tiny; thus the results could easily be false-positive;
  • to make any conclusion about safety after treating 16 subjects is nonsensical;
  • cost-effectiveness was not assessed and therefore conclusions about it are not warranted; if, however, one made a ‘back of the envelope’ calculation, one would be hard-pressed to not find tap water more cost-effective than 4 homeopathic remedies;
  • the graph looks to me very suspect – could it be that someone has been busy prettifying the data?

Nevertheless, I think this paper is remarkable, if only in the way it teaches us how NOT to formulate conclusions of a study. Even if we had 200 dogs in this trial, its findings would not PROVE the efficacy of the intervention. Proof is something a single trial will never deliver. Proof is a debatable concept even after several independent replications, particularly when dealing with something as implausible as homeopathy.

In any case, if your dog has papillomas, do me a favour and avoid homeopathic vets!

I first wrote about Dr Grams when, 5 years ago, she published her book HOMOEOPATHIE NEU GEDACHT (which has recently also been published in English under the title HOMEOPATHY RECONSIDERED). In it, she explains that, after having practised as a homeopath in Germany for several years, she did some research. Her initial intention was to prove critics (like myself) wrong. As she read more and more of the original research, she arrived at the conclusion that the critics of homeopathy had been correct all along.

At the time, my post concluded with the following remarks:

When reading her account, I could repeatedly feel the agony she must have felt through her discoveries. Eventually, she had no choice but to agree with most of the arguments of homeopathy’s critics and disagreed with practically all of the arguments of her fellow homeopaths.

I predict that Natalie’s painful ‘journey’ has not yet come to an end; she now argues that the 200 year old assumptions of homeopathy are all obsolete and homeopathy is certainly not an effective drug therapy. However, it may turn out to be a valuable ‘talking therapy’, she believes.

I hate to say it, but I am fairly certain that she will have to go through further agony and find that her discovery is not truly workable. It might have some theoretical value but, for a whole number of reasons, it will not function in real life heath care.

My hope is that Natalie will find her way back to what she calls ‘normal medicine’ (there is, of course, the danger that she does the opposite and wanders off into even more esoteric grounds). We need doctors like her who have empathy, compassion and understanding for their patients. These are qualities many homeopaths who I have met have in abundance – but these are qualities that belong not into the realm of quackery, they belong into real medicine.

Today I must admit that my predictions were mostly wrong. Yes, Dr Grams had to go through further agony, I am sure, but she certainly did not wonder off into further eccentricities of esoteric medicine. On the contrary, she has become one of Germany’s most vociferous sceptic with many feathers in her cap:

Unsurprisingly, Natalie has, during the last 5 years, become a thorn in the flesh of homeopaths and their supporters. One German firm even went as far as sending her a desist letter demanding she never again to claim that homeopathy does not work beyond placebo, or else she would be heavily fined.

The argument homeopaths most regularly use for their attacks is that, as a clinician, she was an under-qualified, unexperienced homeopath who failed and thus turned against her trade in anger and frustration.

I have always been intrigued by this argument and want to take a minute or two and scrutinise it a little closer:

  • Dr Grams had all the qualifications needed for practising as a homeopath.
  • She had practised as a homeopath for around 6 years.

This means the often-voiced claim that she was under-qualified, unexperienced, etc. is truthful only in homeopathic doses.

But let’s have a little fun and assume it is true. Let’s disregard the ad hominem attacks. Let’s just for a moment agree with the German homeopathy lobby that Dr Grams was a very poor and utterly ungifted homeopath. Let’s assume that therefore her experience with homeopathy became more and more unsatisfactory, and that consequently she turned into an anti-homeopath.

And now, let’s take a step backwards and think. If all this were true, what would follow from this line of reasoning?

Clearly, it would follow that homeopathy does not need any homeopathic skills for generating a loyal following. Because the facts are demonstrably clear: as a homeopaths, Dr Grams was highly successful.

  • She had a full practice.
  • She enjoyed a good income.
  • Her patients were satisfied and loyal.
  • There even was a waiting list for getting an appointment.

So, if (in the view of homeopaths) an under-qualified, unexperienced clinician can practice homeopathy with such outstanding success, what does that tell us about homeopathy?

It tells us, I am sure, that Dr Grams’ conclusions stated in her first book are true: the effects of homeopathy do not rely on the specifics of the skilfully chosen remedy, they rely on placebo and other non-specific effects.

In other words, those homeopaths who attack Dr Grams for being not up to the job, tacidly concede that homeopathy is a placebo treatment!

HOMEOPATHY = THE ART OF SHOOTING SPECTACULAR SELF-GOALS!

 

 

The newest recruit to the (by now quite crowed) coronavirus bandwagon is orthomolecular medicine. In case you are unsure what hides beind this pseudoscientific name, here is a (slightly abbreviated) explanation from my book:

Orthomolecular medicine is the term for a mega-vitamin therapy coined in the 1960s by Linus Pauling (1901-1994). Pauling had two Nobel prizes to his name and was once called one of the 20 greatest scientists of all time. In 1968, he published a paper stating that the functioning of the brain is affected by the molecular concentrations of many substances that are normally present in the brain. The optimum concentrations of these substances for a person may differ greatly from the concentrations provided by his normal diet and genetic machinery. Biochemical and genetic arguments support the idea that orthomolecular therapy, the provision for the individual person of the optimum concentrations of important normal constituents of the brain, may be the preferred treatment for many mentally ill patients. It was the start of his (and the world’s) obsession with mega-doses of vitamins.

Orthomolecular medicine assumes that an optimum nutritional environment in the body is a precondition for good health and suggests that diseases reflect nutritional deficiencies. Treatment for disease, according to this view, involves the correction of imbalances or deficiencies based on individual biochemistry by use of high doses of vitamins, minerals, amino acids, trace elements and fatty acids. The assumptions of orthomolecular medicine lack biological plausibility. Although there are some encouraging reviews, no compelling evidence exists that orthomolecular treatments are clinically effective for patients who do not suffer from nutritional deficiencies. (references: see original book)

But perhaps I was too harsh in my judgement?

Perhaps there is something to orthomolecular medicine after all?

Perhaps Linus Pauling (photo) was right?

Perhaps it even helps against the coronavirus infection?

Dr. Andrew W. Saul, an international expert on vitamin therapy, says, “The coronavirus can be dramatically slowed or stopped completely with the immediate widespread use of high doses of vitamin C.” Yes, this is what proponents of orthomolecular medicine are trying to tell us. They go on to persuade the unexpecting public that:

Physicians have demonstrated the powerful antiviral action of vitamin C for decades. There has been a lack of media coverage of this effective and successful approach against viruses in general, and coronavirus in particular.

It is very important to maximize the body’s anti-oxidative capacity and natural immunity to prevent and minimize symptoms when a virus attacks the human body. The host environment is crucial. Preventing is obviously easier than treating severe illness. But treat serious illness seriously. Do not hesitate to seek medical attention. It is not an either-or choice. Vitamin C can be used right along with medicines when they are indicated.

“I have not seen any flu yet that was not cured or markedly ameliorated by massive doses of vitamin C.”
(Robert F. Cathcart, MD)

The physicians of the Orthomolecular Medicine News Service and the International Society for Orthomolecular Medicine urge a nutrient-based method to prevent or minimize symptoms for future viral infection. The following inexpensive supplemental levels are recommended for adults; for children reduce these in proportion to body weight:

  • Vitamin C: 3,000 milligrams (or more) daily, in divided doses.
  • Vitamin D3: 2,000 International Units daily. (Start with 5,000 IU/day for two weeks, then reduce to 2,000)
  • Magnesium: 400 mg daily (in citrate, malate, chelate, or chloride form)
  • Zinc: 20 mg daily
  • Selenium: 100 mcg (micrograms) daily
  • Vitamin C [1], Vitamin D [2], magnesium [3], zinc [4], and selenium [5] have been shown to strengthen the immune system against viruses.

The basis for using high doses of vitamin C to prevent and combat virus-caused illness may be traced back to vitamin C’s early success against polio, first reported in the late 1940s.[6] Many people are unaware, even surprised, to learn this. Further clinical evidence built up over the decades, leading to an anti-virus protocol published in 1980.[7]

It is important to remember that preventing and treating respiratory infections with large amounts of vitamin C is well established. Those who believe that vitamin C generally has merit, but massive doses are ineffective or somehow harmful, will do well to read the original papers for themselves. To dismiss the work of these doctors simply because they had success so long ago sidesteps a more important question: Why has the benefit of their clinical experience not been presented to the public by responsible governmental authorities, especially in the face of a viral pandemic?

____________________________________________________________________

Yes, exactly: Why has the benefit of their clinical experience not been presented to the public by responsible governmental authorities, especially in the face of a viral pandemic?

Does anyone know the answer to this question?

I suspect it goes something like this:

Their clinical experience is misleading and orthomolecular medicine is bogus.

It has been reported that the coronavirus outbreak might have spread from bats to humans via pangolins, the scaly mammal prized in Traditional Chinese Medicine (TCM). The pangolin is protected by law, yet it is one of Asia’s most trafficked mammals, not least because its scales and meat are used in TCM. “This latest discovery will be of great significance for the prevention and control of the origin (of the virus),” South China Agricultural University, which led the research, stated.

All pangolin species (Manis spp.) have been included in CITES Appendix II since 1975 and a “zero quota” has been in place since 2000 for trade in the Asian pangolin species: M.crassicaudata, M. pentadactyla, M. javanica and M. culionensis. This effectively bans all international commercial trade of Asian pangolins.  Despite the trade restrictions, more than a million pangolins (including Asian and African species) have been poached and illegally traded globally over the past decade to satisfy demand from consumers in Asia, particularly in China.

________________________________________________________________

The Effect of Pangolin Scales

Property

Salty, slightly cold; liver and stomach meridians entered.

Actions

Activate blood and dispel stasis, dredge meridians and promote lactation, resolve swelling and expel pus.

Indications

Mass, amenorrhea due to stasis, wind-damp arthralgia, lactation blockage, abscess, swelling and sore, scrofula.

Dosage and Administrations

Decoct 3~10 g. Make powder and take 1~1.5 g.

Cautions

Use with cautions for the pregnant women.

____________________________________________________________________

Experts think the coronavirus outbreak may have originated in bats and then passed to humans, possibly via pangolins. The genome sequence of the novel coronavirus strain separated from pangolins was 99% identical to that from infected people, China’s official Xinhua news agency reported. The research concluded that pangolins to be “the most likely intermediate host.” But Dirk Pfeiffer, professor of veterinary medicine at Hong Kong’s City University, cautioned that the study was a long way from proving pangolins had transmitted the virus. “You can only draw more definitive conclusions, if you compare prevalence (of the coronavirus) between different species based on representative samples, which these almost certainly are not,” he said.

I have often wondered why some, mostly US authors include prayer as an so-called alternative medicine (SCAM). According to this author, for instance, prayer therapy is professional quality therapy where a Christian counselor uses prayer intervention to bring healing to people’s  lives and core beliefs so that one can live out of a healthier identity and self-concept. Some studies even suggested that religious practices might be associated with longer survival, and it has been hypothesised that, for some, praying provides assurance with, in turn, affects a range of physiological variables.

However, whether religiosity influences survival among patients discharged from the hospital after an acute coronary syndrome (ACS) is unclear. This recent study examined the relationship between religious practices and 2-year all-cause mortality among survivors of an ACS.

Patients hospitalized for an ACS were recruited from 6 medical centers in Massachusetts and Georgia between 2011 and 2013. Study participants self-reported three items assessing religiosity: strength/comfort from religion, petition prayers for health, and awareness of intercessory prayers by others. All cause-mortality within 2-years of hospital discharge was ascertained by review of medical records at participating study hospitals and from death certificates. Cox proportional hazards models were used to estimate the multivariable adjusted risk of 2-year all-cause mortality.

Participants (n = 2,068) were on average 61 years old, 34% were women, and 81% were non-Hispanic White. Approximately 85% derived strength/comfort from religion, 61% prayed for their health, and 89% were aware of intercessions. In total, 6% of all patients died within 2 years post-discharge. After adjusting for sociodemographic variables, petition prayers were associated with an increased risk of 2-year all-cause mortality. With further adjustment for several clinical and psychosocial measures, this association was no longer statistically significant. Strength and comfort from religion and intercessory prayers were not significantly associated with mortality.

The authors concluded that most ACS survivors acknowledge deriving strength and comfort from religion, praying for their health, and intercessions made by others for their health. Although the reported religious practices were not associated with post-discharge survival after multivariable adjustment, acknowledging that patients utilize their religious beliefs and practices as strategies to improve their health would ensure a more holistic approach to patient management and promote cultural competence in healthcare.

On this blog, we had several previous posts on prayer; so, I do probably not need to repeat my stance on the issue:

Prayer as a therapy: a new randomised study

Prayer as a medical therapy? Time to stop this nonsense!

Daniel P Wirth, his dubious research, and the remarkable apathy of some medical journals

Is God an alternative to healthcare?

Personally, I don’t consider prayer as a therapy. Those who do, might now have to concede that yet another SCAM has been shown to have no positive effects on post-operative survival.

I have recently reported that some homeopaths recommend homeopathics against the corona virus. Since I wrote last about this subject, numerous further sites have sprung up where homeopaths try to make a fast buck on the increasing panic of large sections of the population. Here is an apt example:

We all know that in homeopathy we treat patients according to the symptoms. According to these symptoms, the homeopathic medicine influenzam 30 drug can prove to be very effective. If you want to protect yourself from the corona virus, then you can take this medicine two to three drops three to four times a day. You can also get this medicine online at home.

And if you read French, you might want to read this hair-raising nonsense under the title ‘Quelques conseils pour s’armer contre le coronavirus et autres virus de l’hiver‘:

L’un des piliers de la défense antivirale est la thymuline. Elle permet aux cellules thymiques de communiquer entre elles, et en particulier aux cellules mères d’initier les cellules jeunes et immatures. Elle est toujours conseillée en homéopathie, en 9 CH, seule dilution homologuée par les travaux du professeur Madeleine Bastide. Vous pouvez donc, quels que soient votre âge ou votre poids, prendre quatre granules de thymuline 9 CH le matin (idem pour un nourrisson de quelques semaines) pour renforcer vos défenses immunitaires.

As though this is not bad enough, now the Indian government has followed suit. The Indian ‘AYUSH’ ministry has issued recommendations that homeopathic and Unani medicines could be effective in the prevention of novel coronavirus (nCoV) infections. The advisory was issued following a meeting of the scientific advisory board of the Central Council for Research in Homoeopathy (CCRH) under the Ministry of AYUSH to discuss ways and means for prevention of the nCoV infection through homoeopathy, the ministry said in a statement. The original press-release from the ministry beggars belief; it can be viewed here.

The ministry recommended that homoeopathic medicine Arsenicum album 30 could be taken on an empty stomach daily for three days as a prophylactic medicine against the infection. The dose should be repeated after one month by following the same schedule in case the nCoV infection prevails in the community, the advisory said, adding that the same has also been advised for prevention of influenza-like illness. It also suggests some Ayurvedic medicines, Unani decoctions and home remedies which can be useful in symptomatic management of nCoV infections. The advisory also recommended prophylactic measures/ immunomodulatory drugs as per Ayurvedic practices and taking measures to strengthen the immune system through a healthy diet and lifestyle practices.

Regular readers of this blog will, of course, understand what homeopathy is. But what is Unani, some might ask. This excerpt from my book explains:

Unani (or Yunani) is an Islamic healing philosophy that combines elements of ancient Greek medicine with those of Ayurvedic medicine. In the course of the current boom in alternative medicine, Unani has become popular also in the West.[1]

    1. Unani means “Greek” in Arabic. Ancient Greek medicine was based on the erroneous concept of four elements: earth, fire, water, air, corresponding to four humours: Phlegm (balgham), Blood (dam), Yellow bile (safra) and Black bile (sauda).
    2. Unani is popular in the Middle East, India, Pakistan and their neighbouring countries.
    3. It is based mainly on Ibn Sina’s The Canon of Medicine from the 11th century. Ibn Sina (or Avicenna) is regarded as one of the most significant physicians, astronomers, thinkers and writers of the Islamic Golden Age.
    4. According to proponents of Unani, the health of the human body is maintained by the harmonious arrangement of al-umoor al-tabiyah, the seven basic physiological principles of the Unani doctrine. These principles include (1) arkan, or elements, (2) mizaj, or temperament, (3) akhlat, or bodily humours, (4) aaza, or organs and systems, (5) arwah, or vital spirit, (6) quwa, or faculties or powers, and (7) afaal, or functions. Interacting with each other, these seven natural components maintain the balance in the natural constitution of the human body. Each individual’s constitution has a self-regulating capacity or power, called tabiyat (or mudabbira-e-badan; vis medicatrix naturae in Latin), or to keep the seven components in equilibrium[2].
    5. Unani treatments can consist of diet, massage, exercise, blood-letting, leeching, and medication.
    6. There are very few rigorous clinical trials of Unani. Their results vary and depend on the modality tested.[3],[4]
    7. Unani remedies can include substances or products, including herbs, minerals, that are not safe for human consumption.[5] The risks may therefore be considerable.

[1] https://www.ncbi.nlm.nih.gov/pubmed/27604201

[2] https://www.britannica.com/science/Unani-medicine

[3] https://www.ncbi.nlm.nih.gov/pubmed/29749363

[4] https://www.ncbi.nlm.nih.gov/pubmed/26687754

[5] https://www.ncbi.nlm.nih.gov/pubmed/12408732

And what do Unani and homeopathy have in common?

Not a lot!

But one thing is for sure: neither of the two approaches are supported even by a shred of evidence to suggest that they might help against the corona virus pandemic. And another thing is almost equally sure: the above advice is not just governmental, it is mental!

 

 

Last week I was in Prague for a lecture which was great fun. On this occasion, I was interviewed by 5 different journalist. One of them asked a question that I had not often heard before: ‘how do they react to criticism?’

What he was inquiring about was the responses I get after publishing results, articles, interviews or blog posts that do not live up to the expectations of proponents of so-called alternative medicine (SCAM). I think the journalist was taken aback by the detail of my response:

  1. They denounce tell lies about me. I have written about some of such lies on my blog. But this was just the tip of the iceberg; if you go on the internet, you could find much, much more. Here is a nice example: Prof. Ernst has published little original primary research. His clinical trials have nearly all encountered severe methodological criticism and have often been published in low impact journals.
  2. They claim that I falsified my qualifications.
  3. They state that I am a killer.
  4. They say that my research was sub-standard: the reviews and evaluations he publishes have often met with substantial methodological criticism. In situations where reviews were conducted simultaneously by other research groups, other scientists frequently came to entirely different, and usually more positive, conclusions.
  5. They claim that I am not adequately qualified to do what I do and unqualified or unwilling to judge the evidence fairly.
  6. They write that I am dishonest and fabricate data.
  7. They claim that I have violated medical research ethics (more details here).
  8. They specifically claim that I do not have a clue about the homeopathy of Hahnemann.
  9. They sue me and people who work with me. The BCA famously sued Simon Singh. I have also had numerous legal actions against me from various SCAM advocates/entrepreneurs.
  10. They file complaints with my university. I remember about a dozen such actions but, as I failed to keep a record, there could have been even more.
  11. They try to get me struck off the medical register. That happened thankfully only once, yet it was one of the most unpleasant experiences of them all.
  12. They claim that I am paid by ‘Big Pharma’ almost on a daily basis.
  13. They stop inviting me to their conferences. Since the publication of TRICK OR TREATMENT, I have rarely been invited to SCAM conferences (before, this used to be almost my ‘daily bread’).
  14. They send me hate-mail. On this blog, I have written about the many ‘love letters’ I receive (see for instance here and here).
  15. They threaten me with physical violence or death. At one stage we had to call the police because there were threats of letter bombs coming my way (more details here).
  16. Some have even used their influence to close my department. Yes, I almost forgot Prince Charles in this long list of opprobrium.

So, how do they react to criticism?

In a word: badly!

To make it clear from the outset: do not watch Gwyneth Paltrow’s 6-part Netflix series. It’s not worth it!

I could have guessed that too, of course. But the BBC had asked me to watch some of it and, wanting to help, I agreed and then joined a small group of scientists to discuss what we had seen (here is link to the broadcast).

The 6 episodes follow a similar pattern; two ‘experts’ (often decorated with a PhD, DC, DO, or similar title) are talking to well-groomed middle-aged women (including Gwyneth) and reveal their insights into different topics including anti-ageing, sex, psychedelic drugs, cryotherapy, energy healing, clairvoyance, etc. Normally, one would expect the two ‘experts’ to come from different perspectives, disagree on certain issues and discuss them productively. Not so here!

On the contrary, one ‘expert’ tends to be more outrageous than the other, and the two support each other in producing the most embarrassing nonsense (just one exception: the episode on sex). The amount of utter bullshit is completely overwhelming; so much so that even a sceptical listener is bound to fall silent with embarrassment. I find it futile to do another fact check, as others have published one in addition to ours on the BBC (see above).

In no time at all, the ‘experts’ then manage to re-write the laws of nature and throw almost everything we know about health and disease out the window. Gwyneth is often the focus of the camera looking pretty, and exclaiming ‘so cool’, ‘how the fuck does that work’ or similarly profound comments. The other ladies can be seen nodding obediently.

‘Science is just one way of knowing; intuition is another’, the ‘experts’ explain. Yet, in nearly every second sentence, they proudly impress the audience with their cutting edge ‘science’. At closer inspection, this ‘science’ turns out to be a mixture of platitudes and the worst pseudoscience imaginable. To any informed listener, this can only be cringingly embarrassing; to the lay audience, however, it might even look impressive.

The videos involves many volunteers who receive this or that form of quackery and usually start crying as soon as the camera catches them. They are clearly impressed with the idea to be on a Netflix video together with a film diva. Several volunteers stress that, in fact, they approached all this as sceptics – only to display minutes later the exact opposite of scepticism.

On returning from the BBC, got more and more depressed about these Netflix videos and our post-truth society. The misinformation promoted in the videos is as dangerous as any other fake news, I felt. So, what can be done about it?

There are several options, as far as I can see:

  1. We can ignore it. That would have been my preferred choice, but sadly this is hardly possible. The news about Paltrow’s Netflix foray is all over the place. To pretend it does not exist is to give way to her attempts to mislead the public.
  2. We can approve of it. I fear that this is exactly what millions will do. Sadly, this will increase the harm such misleading information does – not just in terms of healthcare, but more importantly in undermining rational thinking in our society.
  3. We can oppose and publish what we think. That’s what I did (and I did not mince my words; the BBC might even edit much of what I said). But will it have the desired effect? My fear is that the comments of the small troop of critical thinkers assembled by the BBC will, in the end, merely help Miss Paltrow and her fellow charlatans to get even richer by defrauding the gullible public.
  4. We can ridicule it. I have recently tried this as well. But I am perhaps not best suited to do this. It would be good if comedians would pick up this theme. I suspect that this could be the most effective way of making progress in preventing harm to the public.

 

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