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

The 30 most recent comments from all posts are listed below. Click on the post title to go to the comment on the post’s page.

  • Comment by Ron Jette on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 19:04 "There are far more deaths caused by modern medicine than by herbal medicine." As indicated above, please remember: if you make a claim in a comment, support it with evidence. Is it even possible to measure that? Please pass along the evidence.
  • Comment by Ron Jette on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 19:04 Come on, DC. You asking for evidence made me spit out my tea. Now, the whole table's a mess!
  • Comment by Ron Jette on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 19:04 Hey! Let's leave fortune tellers out of this, okay? I think they deserve better than to be compared with the quackery of chiropractic. At least they have really cool outfits.
  • Comment by Ron Jette on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 19:04 Excuse with for troubling YOU with the fact that subluxations don't exist, no matter how successful you've been at convincing WHO they do. It's wonderful what science can teach us!.
  • Comment by Edzard on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 19:04 "a case report ... should be validated by detailed clinical studies" YOU SEEM TO HAVE AN EXCELLENT UNDERSTANDING OF BOTH THESE METHODOLOGIES!
  • Comment by Moosadum on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 19:04 Just look at the dose... Every medicine is toxic if not taken in appropriate doses. The biggest problem is self medication is so prevalent in using herbal medicine thinking that it 'it is natural/herbal so it would have no harm'. A qualified physician in traditional medicinal systems would know that the dosage is extremely important. And this is only a case report and should be validated by detailed clinical studies. These types of publication is only guiding the public to revere these herbal medicines.
  • Comment by DC on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 18:04 Bjorn...How does taking a proper history and exam make chiropractic safer? Do you mean spinal manipulation? Bjorn...From what I have experienced and seen... So now we are swamping personal experiences? Bjorn...Use of in office x-ray, “Subluxation Station”, “Nervoscope” and other gimmicks seems standard... Evidence that these are "standard"? Bjorn...Chiropractors regularly ignore clear signs of osteopenia, disregard age-related risks Evidence?
  • Comment by jm on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 18:04 Julian, "The point is that when a doctor prescribes a drug, he has a lot of information available including exactly what is in it and what it does. The same can’t be said for those prescribing herbal medicines." This (https://www.washingtonpost.com/news/wonk/wp/2015/07/23/one-big-myth-about-medicine-we-know-how-drugs-work/?noredirect=on&utm_term=.6a4ca0f060be) is from a Washington Post article is from 2015, so maybe things are different now. But at the time, they wrote: "Knowing why a drug works has historically trailed the treatment, sometimes by decades. Some of the most recognizable drugs -- acetaminophen for pain relief, penicillin for infections, and lithium for bipolar disorder, continue to be scientific mysteries today." I always assumed that the main danger with herbal prescriptions was that in a lot of places, anyone can hang out a shingle and call themselves an herbalist - with minimal or no training. Or google your symptoms, and buy herbal medicines on Amazon. A prescription from a Doctor of Traditional Medicine really isn’t all that different than a prescription from a modern MD of allopathic medicine, if the Post article is accurate: "Here’s how we actually develop a surprising number of treatments: good old-fashioned observation, trial and error, and luck. Detailed scientific understanding of how a drug works often comes, ironically enough, near the end of the process.” The process is the same in traditional systems. Traditional Medicine doctors use different models for anatomy, physiology, and pathology - and if someone doesn't understand the models, they might argue the “detailed scientific understanding” part. But I have yet to meet anyone that has taken the time to (even superficially) understand a traditional model and come to the conclusion that the model is “unscientific”. Whatever system you prefer, medicine has inherent risks. So it goes.
  • Comment by Marianne Creyf on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 18:04 I agree with Helen Murray. Also, the person who died could have had previous undetected liver issues. One swallow does not make a summer. There are far more deaths caused by modern medicine than by herbal medicine. Now that doesn't mean it's information that should be ignored, but investigated and put in perspective. Herbal medicine has a really great long term safety record, it is true that certain herbs should be prescribed only by qualified herbalists with robust training. Attacking herbal medicine over an isolated case seems like using any means to justify a position. I don't mind a logical, well supported view, but unfortunately ( at least in this article) I haven't found any evidence of such reasoning.
  • Comment by Edzard on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 16:04 why don't you book a course of critical thinking? and subsequently, please read this: https://sciencebasedmedicine.org/are-medical-errors-really-the-third-most-common-cause-of-death-in-the-u-s-2019-edition/
  • Comment by RG on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 16:04 Pharma meds kill https://www.npr.org/2011/09/27/140849083/prescription-drug-deaths-major-killer-in-the-u-s
  • Comment by Edzard on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 15:04 thank you for posting another idiotic comment.
  • Comment by Edzard on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 15:04 too generous!
  • Comment by Dr. G. Almog on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 15:04 "the WHO is a joke when it comes to alternative medicine, you know that, don’t you?" Since Chiropractic is not an alternative medicine the WHO position on that matter is irrelevant. I guess you have difficulties with the definition of Chiropractic as a health care profession and its OK... you are entitled to your own personal thoughts and believes.
  • Comment by Dr Julian Money-Kyrle on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 15:04 There are lots of drugs which can cause liver damage. We monitor them with regular blood tests to pick up the early signs of toxicity so that they can be discontinued. As far as I can see, the main difference between herbal medicines and pharmaceuticals is that the latter are strictly quality-controlled, particularly with regard to dose, and the effects, including toxicities, are well-characterised. This includes the pharrmacokinetics (how the drugs is absorbed and distributed through the various tissues of the body, how the levels vary following dosing, how it is metabolised and eliminated). There are also idiosyncratic reactions, which are rare, but information about them is still usually available in the data sheet. These might be when an individual is missing an enzyme involved in the usual metabolic pathway of the drug, for instance. An example from oncology is 5-fluorouracil and diphyridamole dehydrogenase deficiency leading to catastrophic toxicity from a commonly-prescribed chemotherapy drug. "necessarily with less history" However interesting it may be to medical historians, as a prescriber, I would much rather know what a drug does in the body, its mechanism of action, pharmakokinetics, toxicity, interactions, what effect reduced liver or kidney function has on it, what monitoring is required in order to use it safely etc. than its history of use by practitioners with little knowledge of physiology, pathology or pharmacology. Just because something has been used as a treatment for a long time doesn't mean that anybody knows very much about it. As has has pointed out, plants (and poisonous animals) have evolved to produce pharmacologically active substances in order to defend themselves and also to attract other species. Anything which has enough of an effect on the body to be useful as a medicine also has the potential to be toxic. The point is that when a doctor prescribes a drug, he has a lot of information available including exactly what is in it and what it does. The same can't be said for those prescribing herbal medicines.
  • Comment by Helen Murray on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 15:04 Oh what a pointless 'exposure' again. Far more people die or suffer damage to their health from statins, alcohol, over the counter medicines, chemo therapy et al. Move on, nothing to see here.
  • Comment by Björn Geir on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 14:04 @Will Is there different liver damage in the west than the east? Or north, or south?
  • Comment by Björn Geir on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 14:04 “RG” Why don’t you find some citations about the flatness of the earth?
  • Comment by Björn Geir on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 14:04 @DC How does taking a proper history and exam make chiropractic safer? Noting that (most?) chiropractors do not have medical training necessary to know what to do with many of the the results. From what I have experienced and seen, chiropractors do not take history and physical examination to medical standards, far from it. Much of the chiropractic examination seems more suited to impress than discover clinically significant findings. Use of in office x-ray, “Subluxation Station”, “Nervoscope” and other gimmicks seems standard and we even have chiropractors using applied kinesiology and fake gizmo’s with blinking lights and fancy screen images, pretending to measure food sensitivity and similarly fraudulent pseudodiagnostics. Chiropractors regularly ignore clear signs of osteopenia, disregard age-related risks (like we see in the case being discussed) and if you know a chiro who measures blood pressure, listens to heart-sounds or does a proper neurological examination he is may very likely be faking it?
  • Comment by Michael Kenny on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 13:04 Entrepreneurial theatrics masquerading as healthcare. Since 70% of chiroquackers use Activators and other “adjusting guns” claiming equal or superior efficacy to manual methods....I’m not sure chiroquackers can be left to their own devices as to what constitutes evidence, efficacy and healthcare. “Adjusting the spinal bones as a healthcare method” really shouldn’t be allowed to perpetuate as a “doctor” profession. It certainly shouldn’t be allowed to bilk insurance. It should be recognized on a par with fortune tellers and dowsers....pay cash knowing there’s more doubt than proof.
  • Comment by DC on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 12:04 those open to applying new evidence would evolve.
  • Comment by DC on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 12:04 Really? That means anyone can call themselves a chiropractor and do spinal manipulation without doing a proper history and exam. You may want to rethink your position.
  • Comment by Will on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 10:04 Is there an alternative hypothesis to this conclusion, which appears to be derived from marginal anecdote? In comparison, I wonder if there are any established, trusted "Western medicine" substances (necessarily with less history) which may also cause liver damage in the West.
  • Comment by has on Fatal liver failure after long-term intake of a popular and ‘time-tested’ herbal remedy Friday 19 April 2019: 09:04 “Natural” is plants evolving toxins to sicken and kill the animals that would otherwise eat them. Why is it that “healthy-living” alties are so keen to fill their bodies with plant-manufactured poisons?
  • Comment by Edzard on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 08:04 the WHO is a joke when it comes to alternative medicine, you know that, don't you?
  • Comment by Dr. G. Almog on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 08:04 "A health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation with a particular focus on subluxations" The WHO definition World Health Organization, Guidelines on Chiropractic, 2005 excuse me for troubeling you with the FACTS!!!
  • Comment by Edzard on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 07:04 "one last comment for previous remarks… although some may wish it was so Chiropractic is NOT ALTERNATIVE MEDICINE." do you wish to say it is worse - IT IS PURE QUACKERY?
  • Comment by Dr. G. Almog on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 07:04 indeed... if anyone should be alarmed is the local health authority for lack of regulation. who is performing manipulation in Taiwan? with what training? under which protocols? with what rational? with what kind of insurance? are there any proper record of treatments? if a patient is hurt or mis-treated who should he turn to? taking care of the public health and safety is first of all the Ministry of Health responsibility. of course each profession has H&S issues at its core but this cannot replace legislation and regulation by the state. one last comment for previous remarks... although some may wish it was so Chiropractic is NOT ALTERNATIVE MEDICINE.
  • Comment by darwinslapdog on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 05:04 If chiropractors were open to new evidence, they would stop being chiropractors.
  • Comment by darwinslapdog on Another serious complication after chiropractic neck manipulation Friday 19 April 2019: 05:04 That’s good news!
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