Edzard Ernst

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

Guest post by Tobias Katz

What do we know?

ICU admission

Taken from the BMJ (Ref 1): ICNARC latest report 31/12/21 showed that the proportion of patients admitted to critical care in December 2021 with confirmed covid-19 who were unvaccinated was 61%.

Prevention of infection

The government’s week 45 Covid surveillance report (Ref 3) is clear that vaccination prevention of infection (positive PCR, for Delta) effectiveness is estimated at 65% for Oxford-AstraZeneca and 80% for Pfizer.

Prevention of transmission

The Lancet’s (Ref 4) paper, suggests once infected, initial viral load is similar for vaccinated and unvaccinated individuals, suggesting likely equal chance of transmitting on the virus.

Protection of the individual

Ref 3, is clear cut that vaccination protects individuals from hospitalisation and severe infection (for Delta).

(Omicron) “Among those who had received 2 doses of AstraZeneca, there was no effect against Omicron from 20 weeks after the second dose. Among those who had received 2 doses of Pfizer or Moderna effectiveness dropped from around 65-70% down to around 10% by 20 weeks after the 2nd dose. 2 to 4 weeks after a booster dose vaccine effectiveness ranged from around 65 to 75%, dropping to 55 to 70% at 5 to 9 weeks and 40-50% from 10+ weeks after the booster.” (Ref 2)

Effectiveness here is measured by admission to hospital and shows the necessity for booster jabs when fighting Omicron.

Who are Dr James and Dr Malhotra?

Steven James, consultant anaesthetist, has recently been in the news for confronting Sajid Javid RE mandatory vaccinations for hospital and nursing staff. “The science isn’t strong enough” to support the policy he stated and “I’ve got antibodies”, suggesting that he’s as protected as he would be if he had a vaccine.

Aseem Malhotra, who goes by the name of ‘lifestylemedicinedoctor’ on Instagram is an extremely controversial cardiology consultant who seems to be Djokovic’s biggest fan and whose tweets are passionately quoted and forwarded by anti-vaxxers.

With tweets such as “Mark my words, with everything we know and don’t know about the current vaccine Novak Djokovic will ultimately be proven to be on the right side of history #BadPharma #truth #transparency #InformedConsent”:

And a retweet: “Dr Jordan Peterson Oh well. It’s just fertility. Women’s Periods May Be Late After Coronavirus Vaccination, Study Suggests”; he stirs the cooking pot of anti-establishment rhetoric and only deepens an already fractured relationship between doctors and their patients caused by the pandemic.

You’d think a mature, well-researched doctor would be able to tell the difference between the menstrual cycle and becoming fertile. You’d also hope he would not be short-sighted enough to support one of the most anti-science/anti-conventional medicine public figures in the world (see here)… Alas, no.

I feel as though both of these figures need to be reminded of their ethical duty of candour as doctors and reminded that their public actions have consequences. I may not completely disagree with Dr James (RE mandatory vaccinations) but the way in which he conducted himself during this nationally broadcasted video left many shaking with rage as it undermines many of his health professional colleagues. Me, included.

When a doctor appears on national news, opposing [mandatory] vaccination and offering incorrect explanations of why this is so, it should be obvious to them that their opinion will inevitably act as anti-vaccine propaganda, whether meant for this or not.

Malhotra’s ideas (cutting back on statins, healthy diet etc.) are often worth consideration/evaluation and as a new-age medical ‘influencer’ with 130k+ followers on Twitter, with ample publications behind him, he deserves to be listened to. Not necessarily agreed with, but listened to. But he also has a duty as a doctor to guard against complacency. Similar to James’ public actions, Malhotra’s tweets that are so one-sided give a biased, inaccurate and frankly dangerous view on the efficacy and safety profile of COVID vaccinations that have been safely and effectively used in millions of people to prevent hospitalisations. Is he doing it for the views? The hits? The likes? The retweets? To have people recognise him for his Pioppi diet?

What should we do?

Candour

Doctors, including James and Malhotra have an ethical responsibility not to spread imperfect information to a wide-receiving audience where their actions can be misconstrued and misrepresented so easily. Doing so may bolster anti-vaccine views, cause less ‘on-the-fence’ people to get the jabs and essentially lead to more preventable deaths.

More and more we are seeing social media take over and often act as the public’s primary source of news. More doctors than ever are now in the [social] media limelight. Some, such as Dr Alex George (mental health advocate) are promoting health responsibly. Others, seek to undermine it. In an era when Joe Rogan has more daily views than Fox News’ Tucker Carlson, to ignore and not rebut [health] social media giants like Malhotra would just worsen the situation. Malhotra and James need to be challenged by the scientific community, as the BBC so brilliantly did here.

Complacency

If doctors want to become socialite Instagram influencers, they must do this without complacency. I think this means being responsible when offering controversial and potentially public health implicating opinions where evidence isn’t clear cut.

Final thoughts

Using all the possible information above, as the vaccines are not 100% without risk, transmission is not completely cut post-vaccine and as we have a decent-ish way of monitoring infection (lateral flows and PCRs), I feel as though mandating vaccines for all NHS staff is currently unjust. I see Steve’s point. But I’d be extremely careful in how I’d make this point. And certainly not on live Sky News when the nation is watching, where it will inevitably be seized upon by the anti-vax community.

Saying this, the data is pretty clear that there is evidence that the vaccines offer protection against infection, reducing viral load quicker once infected and against hospitalisation and so if you’re a rational doctor who thinks that at least one time your lateral flow test may give a false negative, it makes complete sense to get your vaccine to protect your patients…

References

  1. https://www.bmj.com/content/376/bmj.o5?fbclid=IwAR2MgoD_vYo0FsaVsQdLxfeYCukuRu2RegcJa-HclA13byhH71g-AnNhnP8
  2. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1045329/Vaccine_surveillance_report_week_1_2022.pdf
  3. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1032859/Vaccine_surveillance_report_-_week_45.pdf
  4. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00690-3/fulltext

 

I have decided to herewith start

The ‘WORST PAPER OF 2022’ competition

And I have already come across an article that I can nominate for it. It is entitled ‘What is the goal of science? ‘Scientific’ has been co-opted, but science is on the side of chiropractic. It is worth reading it in full, but in case you are in a hurry, I have extracted some bon mots for you:

  • Most of what chiropractors do in natural health care is scientific; it just has not been proven in a laboratory at the level we would like.
  •  It might be useful to review scientific method here. First, you make an observation, then pose a testable question based on that observation. You state your hypothesis, then design and perform an experiment, collect data and draw a conclusion.
  • A lot of our information is based on observations or hypotheses, and that is not a bad thing.
  • [conventional] medicine fails to be scientific because it ignores clinical observations out of hand.
  •  the majority of the observations that we in the natural health community work with are not even taken seriously. We would like to think that this is not because the medical “scientific” journals sell ads to drug companies.
  • we have multibillion-dollar corporations controlling our observations and our conversations about health — not very scientific.
  • When something is labeled anecdotal, to the medical community it means it is unimportant. That is not necessarily true; it means a lot of people have made the same observation.
  • [the pharma industries] have positioned themselves to be the ones who decide what is or is not true in our health care system.
  • Combining the “anecdotal” information from colleagues and one’s individual clinical observations, elegant and effective models for disease and strategies for treatment begin to emerge.
  • everyone in natural health care knows to combine therapies and the effects are often cumulative. For example, many asthmatics respond to magnesium supplementation. Some respond to taking vitamin C or another antioxidant. Most of us know that combining the two supplements increases favorable results.
  • drugs have side effects and often harm the patient. They often work against each other. We don’t have that problem with vitamins and minerals; you will not harm the patient.
  • we are not treating a disease, we are correcting a deficiency. If the asthmatic is deficient in magnesium, symptoms will improve. Giving magnesium is not a treatment of the asthma; it is fixing infrastructure.
  • We don’t really treat disease; we improve infrastructure.
  • When our patients improve, we know we are on the right track. That is what the scientific method is all about.
  • Finding errors in physiology and correcting them may produce results where medicine has failed so miserably. We are following scientific method, but studies are expensive and some things, even though they seem to hold up anecdotally, have not been proven.

As the year is still young, this paper might not actually win the competition but I hope you agree that it is a worthy competitor.

Some of you will ask what is there to win in the ‘WORST PAPER OF 2022’ competition? I agree: a competition without a prize is no fun. Therefore, I suggest donating to the winner one of my books that best fits his/her subject. I am sure this will over-joy him or her.

Now we only need to determine how we identify the winner. I suggest that I continue blogging about nominated papers (I hope to identify about 10 in total), and towards the end of the year, I let my readers decide democratically.

Please take a moment to read this short letter by the ‘LIGA MEDICORUM HOMOEOPATHICA INTERNATIONALIS’:

As you know, the World Health Organization (WHO) is predicting that civilization faces a crisis of antibiotic-resistant diseases that may soon result in as many as 10 million deaths per year while pushing as many as 24 million people into extreme poverty.

We, the undersigned, are duly licensed healthcare professionals practicing homeopathy, with the authority to diagnose and treat disease, who have reviewed the extensive research literature demonstrating the clear therapeutic value of homeopathy.  Each of us has had extensive clinical experience successfully treating hundreds of thousands of patients suffering from infectious diseases worldwide.

Homeopathy works, does not cause further antibiotic resistance, is generally devoid of side effects, is inexpensive, and is good for health of the planet.

We are calling upon the WHO to encourage the international medical community to immediately begin training in homeopathy as an adjunctive therapeutic measure to avoid this catastrophic loss of life and would like a meeting with you or your representative to discuss the grave challenge of antibiotic resistance at your earliest convenience.

Thank you for considering this urgent appeal.

________________________

I stated above that this is a letter. In fact, it is more – it is a petition directed to the Director-General of the World Health Organization (WHO), Dr. Tedros Adhanom Ghebreyesus, to immediately begin training physicians in homeopathy as an adjunctive therapeutic measure to combat the looming crisis of antibiotic-resistant diseases.

The Liga Medicorum Homoeopathica Internationalis (LMHI) represents homeopathic physicians in more than 70 countries all over the world. The purposes of the association are the development and securing of homeopathy worldwide and the creation of a link among licensed homeopaths with medical diplomas and societies and persons who are interested in homeopathy. The LMHI is exclusively devoted to non-profit activities serving philanthropic benefits.

The LMHI might ring a bell for regular readers of this blog. A few years ago, I reported that its president advocates curing cancers with homeopathy. And in 2014, I reported that a journey to Liberia of leading homeopaths was co-organized by the LMHI; its purpose was to cure Ebola patients of their disease with homeopathy.

I find all of this seriously worrying – not because I fear that the WHO will now start training physicians across the globe in homeopathy. It is worrying, I feel, because it shows how hopelessly deluded homeopaths are. The fact that clinicians so far detached from reality treat ill and vulnerable patients frightens me.

On this blog and elsewhere, I have heard many strange arguments against COVID-19 vaccinations. I get the impression that most proponents of so-called alternative medicine (SCAM) hold or sympathize with such notions. Here is a list of those arguments that have come up most frequently together with my (very short) comments:

COVID is not dangerous

It’s just a flu and nothing to be really afraid of, they say. Therefore, no good reason exists for getting vaccinated. This, I think, is easily countered by pointing out that to date about 5.5 million people have died of COVID-19. In addition, I fear that the issues of ‘long-COVID’ is omitted in such discussions

It’s only the oldies who die

As an oldie myself, I find this argument quite distasteful. More importantly, it is simply not correct.

Vaccines don’t work

True they do not protect us 100% from the infection. But they very dramatically reduce the likelihood of severe illness or death from COVID-19.

Vaccines are unsafe

We have now administered almost 10 billion vaccinations worldwide. Thus we know a lot about the risks. In absolute terms, there is a vast amount of cases, and it would be very odd otherwise; just think of the rate of nocebo effects that must be expected. However, the risks are mostly minor, and serious ones are very rare. Some anti-vaxxers predicted that, by last September, the vaccinated population would be dead. This did not happen, did it? The fact is that the benefits of these vaccinations hugely outweigh the risks.

Vaccines are a vicious tracking system

Some claim that ‘they‘ use vaccines to be able to trace the vaccinated people. Who are ‘they‘, and why would anyone want to trace me when my credit card, mobile phone, etc. already could do that?

Vaccines are used for population control

They‘ want to reduce the world population through deadly vaccines to ~5 billion, some anti-vaxxers say. Again, who are ‘they‘ and would ‘they‘ want to do that? Presumably ‘they‘ need us to pay taxes and buy their goods and services.

There has not been enough research

If those who make this argument would bother to go on Medline and look for COVID-related research, they might see how ill-informed this argument is. Since 2021, more than 200 000 papers on the subject have emerged.

I trust my immune system

This is just daft. I am triple-vaccinated and also hope that I can trust my immune system – this is why I got vaccinated in the first place. Vaccinations rely on the immune system to work.

It’s all about making money

Yes, the pharma industry aims to make money; this is a sad reality. But does that really mean that their products are useless? I don’t see the logic here.

People should have the choice

I am all for it! But if someone’s poor choice endangers my life, I do object. For instance, I expect other people not to smoke in public places, stop at red traffic lights and drive on the correct side of the street.

Most COVID patients in hospitals have been vaccinated

If a large percentage of the population has been vaccinated and the vaccine conveys not 100% protection, it would be most surprising, if it were otherwise.

I have a friend who…

All sorts of anecdotes are in circulation. The thing to remember here is that the plural of anecdote is anecdotes and not evidence.

SCAM works just as well

Of course, that argument had to be expected from SCAM proponents. The best response here is this: SHOW ME THE EVIDENCE! In response SCAM fans have so far only been able to produce ‘studies’ that are unconvincing or outright laughable.

In conclusion, the arguments put forward by anti-vaxxers or vaccination-hesitant people are rubbish. It is time they inform themselves better and consider information that originates from outside their bubble. It is time they realize that their attitude is endangering others.

 

Like so many other anti-vaxxers, Djokovic is deep into so-called alternative medicine (SCAM).

An article in THE TELEGRAPH explains it quite clearly. Here are a few passages:

Here is an anti-scientific crank hiding in plain sight … [In his book Djokovic explains] how he suffered from recurring physical ailments – allergies, breathing difficulties, blocked sinuses – until he gave up gluten.

Nothing especially weird so far – until he explains how his gluten intolerance was diagnosed. A Serbian nutritionist called Dr Igor Cetojevic asked Djokovic to hold his right arm out at right angles and resist the pressure as he pushed down on it. Then the exercise was repeated, only this time while Djokovic held a slice of bread against his stomach. “I was noticeably weaker,” writes Djokovic, who adds that “kinesiological arm testing [has] long been used as a diagnostic tool by natural healers.” Yes, and mediums have long claimed to speak to the dead …

Here is a man who broke up his visits to Wimbledon with trips to the nearby Buddhapadipa Temple to meditate by a lake. A man who revealed two years ago that he has a “friend” in Melbourne’s Botanical Gardens – “a Brazilian fig tree that I like to climb”. Yes, Djokovic’s jet-setting spiritualism might sound charming in itself. But its side-effect has been credulousness.

Serve To Win [ND’s book] describes a so-called “researcher” taking two glasses of water and directing loving energy towards one, while swearing angrily at the other. “After a few days … [the angry glass] was tinted slightly green … the other glass was still bright and crystal clear”. Harmless, perhaps, if deeply dippy. But then, last year, Djokovic could be found hosting a former estate agent called Chervin Jafarieh on his Instagram Live channel. Jafarieh was selling bottles of Advanced Brain Nutrients at $50 apiece, which – like Djokovic’s resistance to the Covid vaccination – sounded contrary to the interests of public health…

… Djokovic expressed in a 2018 interview with Shortlist magazine. “I believe that it is our mission to reach a higher frequency through self-care by exploring and respecting our own avatar, our body and, by doing that, raising the vibration of the planet.” …

And so we return to the dark side of this whole peculiar tale. Were Djokovic just a journeyman player, his pseudo-scientific beliefs would be no more than a bizarre footnote. As it is, he is a powerful role model, particularly in the Balkans. Thousands of people have probably emulated his stance on vaccines. Some are likely to suffer consequences as a result…

Another article explains:

New York Times tennis reporter Ben Rothenberg tweeted out after the news of Djokovic’s visa rejection that the Serbian had been “wildly anti-science” over the years.

“Let’s not lose sight of how wildly anti-science Djokovic has publicly been for years,” Rothenberg began. “Here he was last year preaching about how you can change water with emotion.

“Naive, but maybe these real consequences today can be a reality check for his nonsense?”

Former New York Times reporter Steven Greenhouse said it was “sad to see such a brilliant tennis player join the anti-science, pro-poppycock anti-vaxxers”.

Tennis Channel producer David Kane added: “I sort of don’t care whether Australia bungled L’Affaire Novak because of political/media pressure. This is about someone who has been stridently anti-science and never indicated a good faith effort to receive this essentially mandatory vaccine.F around & find out, as they say.”

And a Guardian article provides further information:

His belief in alternative medicine is complemented by his commitment to alternative history. He frequently retreats to Visoko, in the hills of Bosnia and Herzegovina, where he meets up with the businessman Semir Osmanagic – whose claims that there are ancient man-made structures with magical healing powers, refuted by scientists, have turned the hills into a lucrative tourist destination. Djokovic has also expressed his support for the ultranationalist alternative historian Jovan Deretic, whose writings claim, among other things, that numerous European cultures, including ancient Greeks, Celts and Etruscans, are descended from Serbs.


I am quite confident that I play tennis as splendidly as Djokovic understands medicine. Yet, I do not pretend to be able to teach you how to do a perfect ‘top slice’. In contrast, Djokovic loves to take the role of ambassador for SCAM and other weird stuff.

His father stated that “Novak is the Spartacus of the new world who does not tolerate injustice, colonialism and hypocrisy but fights for the equality of all on this planet, regardless of skin color, religious belief and money they have.” Personally, I see this differently: Djokovic is badly affected by proctophasia; he tolerates no end of BS and fights for pseudoscience. And sadly, his views are all too persuasive to gullible consumers – not exactly what we need in a global health crisis!

In so-called alternative medicine (SCAM) we have an amazing number of ‘discoveries’ which – IF TRUE – should have changed the world. Here I list of 10 of my favorites:

  1. Diluting and shaking a substance makes it not weaker but stronger.

Homeopaths call this process ‘potentisation’. They use it to produce highly ‘potent’ remedies that contain not a single molecule of the original substance. The assumption is that potentisation transfers energy or information. Therefore, they claim, molecules are no longer required for achieving a clinical effect.

2. A substance that causes a certain symptom in a healthy person can be used to cure that symptom when it occurs in a patient.

The ‘like cures like’ principle of homeopathy is based on the notion that the similimum provokes an artificial disease which in turn defeats the condition the patient is suffering from.

3. Subluxations of the spine are the cause of most diseases that affect us humans.

DD Palmer, the inventor of chiropractic, insisted that almost all diseases are due to subluxations. These misplaced vertebrae, he claimed, are the root cause of any disease by inhibiting the flow of the ‘innate’ which in turn caused ill health.

4. Adjusting such subluxations is the best way to restore health.

Palmer, therefore, was sure that only adjustments of these subluxations were able to restore health. All other medical interventions were useless or even dangerous, in his view. Thus Palmer opposed medicines or vaccinations.

5. An imbalance of two life forces is the cause of all illnesses.

Practitioners of TCM believe that all illnesses originate from an energetic imbalance. Harmony between the two life forces ‘yin and yang’ means health.

6. Balance can be restored by puncturing the skin at specific points.

Acupuncturists are convinced that their needling is nothing less than attacking the root cause of his or her problem. Therefore, they are convinced that acupuncture is a cure-all.

7. Our organs are represented in specific areas on the sole of our feet.

Reflexologists have maps of the sole of a foot where specific organs of the body are located. They palpate the foot and when they feel a gritty area, they conclude that the corresponding organ is in trouble.

8. Massaging these areas will positively influence the function of specific organs.

Once the diseased or endangered organ is identified, the area in question needs to be massaged until the grittiness disappears. This intervention, in turn, will have a positive influence on the organ in question.

9. Healing energy can be sent into our body where it stimulates the self-healing process and restores health.

Various types of energy healers are convinced that they can transmit energy that comes from a divine or other source into a patient’s body. The energy enables the body to heal itself. Thus, energy healing is a panacea and does not even require a proper diagnosis to be effective.

10. Toxins accumulate in our bodies and must be eliminated through a wide range of SCAMs.

The toxins in question can originate from within the body and/or from the outside. They accumulate and make us sick. Therefore, we need to eliminate them, and the best way to achieve this is to use this or that SCAM

 

I could, of course, list many more such ‘discoveries’ – SCAM is full of them. They are all quite diverse but have one important thing in common: they are false (i.e. there is no good evidence for them and they fly in the face of science).

If they were true, they would have changed the world by revolutionizing science, physics, physiology, anatomy, pathology, therapeutics, etc.

ALL THESE UGLY FACTS DESTROYING SUCH BEAUTIFUL THEORIES!

WHAT A SHAME!!!

As you know, I am not in the habit of telling personal stories on this blog. Today, allow me to make an exception by taking you back 40 years into my own history.

Back in the 1980s, I spent much of my time doing research in hemorheology (flow properties of blood). At the time, this was a buoyant area of research, and my late friend Arpad Matrai and I were enthusiastically investigating it, first in London under John Dormandy and later at the LMU in Munich. But we were by no means the only team working in hemorheology. Another group at Aachen was much larger, better-funded, and in many ways way ahead of us. One member of that group regularly irritated us; this was Holger Kiesewetter, the ‘hero’ of my story.

Arpad was sure that much of Kiesewetter’s work and even more of his financial dealings were suspect (“How come a junior research can afford driving a Porsche?”, he used to wonder). Something did not seem quite right. Despite our reservations, we did collaborate occasionally. In 1984, we even managed to co-organize a conference and jointly publish its proceedings.

After my friend and co-worker Arpad had died of leukemia, I gradually drifted back into clinical medicine, became a professor of rehab medicine first in Hannover and then in Vienna. This also meant that I completely lost touch with Holger Kiesewetter. I was, therefore, more than a little surprised to one day receive a phone call from him in Vienna. He told me that he had applied for a professorship at my Uni and asked me to support his application. I did not promise to do so and I certainly did not lend my support to his application. Quite simply, I remembered too many instances that gave me reasons to be concerned about my ‘friend’s’ integrity.

Kiesewetter did not get the Vienna post but I later learned that he had become a professor of transfusion medicine at the Charite in Berlin. In the mid-1990s, a chance meeting at an airport occurred when we were both catching flights. He told me that he was doing fine, and he seemed to have his fingers in many pies.

Then I lost sight of him completely.

Until yesterday, that is.

I was doing some searches on herbal remedies when I came across the intriguing subject of ‘BIO VIAGRA‘. A German article reported this:

“In clinical trials, 50 men had much better sex afterward, more fun in bed, and just generally felt better about themselves,” the Sueddeutsche Zeitung daily cited Olaf Schroeder from Berlin’s Charite hospital as saying. “Their libido was even higher than the control group taking Viagra,” he said. The potent cocktail includes tribulus terrestris, a herb already used in alternative medicine, a root vegetable found in the Andes called maca and grape juice extract, newspapers said. The treatment, dubbed “Plantagrar”, is due to be launched in early 2010, the Bild daily said.

Having published a review of maca, I was interested and continued searching.

Another article stated that a certain Mr. Schröder had stated that he had investigated the efficacy of the remedy on 50 test persons. However, the data of the experiment have not been published. In addition, the researchers’ procedure has been massively criticized: 25 men were given the bio-potency drug, 25 others a placebo, i.e. a tablet without active ingredients. Afterward, the test persons were to compare their experiences with those they had had with Viagra. Fritz Sörgel, director of the Nuremberg Institute for Biomedical and Pharmaceutical Research, calls the procedure “completely dubious”. “This is a completely new kind of study that this doctoral student has invented.” The number of test persons is much too low, the comparison with Viagra cannot be taken seriously.

This sounded already quite dodgy, and a third article in the usually reliable German Medical Journal provided more details:

For several months, those involved kept a low profile, but now the affair surrounding the development of a herbal aphrodisiac at Berlin’s Charité University Hospital has consequences: Last week, the head of the Institute for Transfusion Medicine, Prof. Dr.-Ing. Dr. med. Holger Kiesewetter, was given leave of absence. This step was taken “at his own request”, said hospital spokesperson Claudia Peter. The withdrawal came about two weeks after the public prosecutor’s office searched his work and private rooms as well as other locations.

The “Bio-Viagra affair” had caused a furore in mid-March. A doctoral student of Kiesewetter’s had claimed to the Deutsche Presse-Agentur that he had successfully developed an aphrodisiac on a purely herbal basis. Some daily newspapers reported on the remedy, which was called “Plantagrar”. A little later, however, the Charité management denied it. It was “the activity of an employee (. . .) on his own responsibility”. The case also came to the attention of the drug supervisory authority. Erectile dysfunctions are recognised diseases according to the ICD-10 classification system. The “Bio-Viagra” was therefore a drug whose development should have been controlled, the state office for health and social affairs said.

A spokesperson for the Berlin public prosecutor’s office confirmed the presumption of a violation of the German Medicines Act to the Deutsches Ärzteblatt. In addition, Kiesewetter is being investigated for bribery, corruption and breach of trust to the detriment of the Charité. The head of the institute had apparently been promised benefits by private companies.

That sounded very much like the Kiesewetter I remembered. I was unable to find the actual trial or more details about the herbal remedy. The scandal seems to have put an end not only to the university career of the researchers but also to the aphrodisiac.

However, I did find a Wiki page about Kiesewetter that suggests that ‘bio viagra’ was by no means the only escapade from the straight and narrow. But what is he up to today? Did he retire? No, after the debacle at the Charite, he seems to have gone into private practice:

After working as director of the Institute for Transfusion Medicine and Immunohaematology at the Charité and head of the coagulation outpatient clinic at the Charité, he has been providing patient care at the Hämostaseologicum Berlin-Mitte since 2010.

This is also the address he used for his most recent (2020) publication.

Am I worried about my old ‘friend’?

No, I am confident that he is doing just fine … financially, I mean.

 

Cupping is a so-called alternative medicine (SCAM) that has been around for millennia in many cultures. We have discussed it repeatedly on this blog (see, for instance, here, here, and here). This new study tested the effects of dry cupping on pain intensity, physical function, functional mobility, trunk range of motion, perceived overall effect, quality of life, psychological symptoms, and medication use in individuals with chronic non-specific low back pain.

Ninety participants with chronic non-specific low back pain were randomized. The experimental group (n = 45) received dry cupping therapy, with cups bilaterally positioned parallel to the L1 to L5 vertebrae. The control group (n = 45) received sham cupping therapy. The interventions were applied once a week for 8 weeks.

Participants were assessed before and after the first treatment session, and after 4 and 8 weeks of intervention. The primary outcome was pain intensity, measured with the numerical pain scale at rest, during fast walking, and during trunk flexion. Secondary outcomes were physical function, functional mobility, trunk range of motion, perceived overall effect, quality of life, psychological symptoms, and medication use.

On a 0-to-10 scale, the between-group difference in pain severity at rest was negligible: MD 0.0 (95% CI -0.9 to 1.0) immediately after the first treatment, 0.4 (95% CI -0.5 to 1.5) at 4 weeks and 0.6 (95% CI -0.4 to 1.6) at 8 weeks. Similar negligible effects were observed on pain severity during fast walking or trunk flexion. Negligible effects were also found on physical function, functional mobility, and perceived overall effect, where mean estimates and their confidence intervals all excluded worthwhile effects. No worthwhile benefits could be confirmed for any of the remaining secondary outcomes.

The authors concluded that dry cupping therapy was not superior to sham cupping for improving pain, physical function, mobility, quality of life, psychological symptoms or medication use in people with non-specific chronic low back pain.

These results will not surprise many of us; they certainly don’t baffle me. What I found interesting in this paper was the concept of sham cupping therapy. How did they do it? Here is their explanation:

For the experimental group, a manual suction pump and four acrylic cups size one (internal diameter = 4.5 cm) were used for the interventions. The cups were applied to the lower back, parallel to L1 to L5 vertebrae, with a 3-cm distance between them, bilaterally. The dry cupping application consisted of a negative pressure of 300 millibars (two suctions in the manual suction pump) sustained for 10 minutes once a week for 8 weeks.

In the control group, the exact same procedures were used except that the cups were prepared with small holes < 2 mm in diameter to release the negative pressure in approximately 3 seconds. Double-sided adhesive tape was applied to the border of the cups in order to keep them in contact with the participants’ skin.

So, sham-controlled trials of cupping are doable. Future trialists might now consider the inclusion of testing the success of patient-blinding when conducting trials of cupping therapy.

WARNING: after reading this, you might no longer enjoy your favorite breakfast cereal!

‘Biologic living’ is the name John Harvey Kellogg (1852-1943), an influential medical doctor and best-known as the inventor of the cornflakes gave to his health reforms. Biologic living was practiced in Kellogg’s Battle Creek Sanatorium, an institution for re-educating Americans and training of healthcare professionals. Kellogg’s religious beliefs bled into his medicinal practices and the Battle Creek Sanatorium was as much health spar as it was a rehabilitation facility. [1]

In the sanatorium, there was a strict focus on diet which was meant to cure a person of practically all ills, leading to a kind of purity of the soul. Meat and certain spicy, overly flavourful foods, as well as alcoholic beverages, were thought to overexcite the mind and lead to sinful behavior. A bland dull diet was thus recommended. Kellogg intended for ‘cornflakes’ to become the staple of this diet. Other treatments included the following [2]:

  • Vegetarian diet; Kellogg invented an artificial meat substitute based mainly on peanuts, called ‘nuttose’
  • ‘Light bath’, a bath under lights lasting hours, days, sometimes even weeks
  • Regular exercise
  • Various forms of electrotherapy
  • Vibrational therapy
  • Massage therapy
  • Breathing techniques
  • Colonic irrigation delivered by specially designed machines that could deliver 14 liters of water followed by a pint of yogurt, half of which was to be eaten, while the other half would be delivered via a second enema
  • Water cures of various types
  • Sexual abstinence, including various measures to avoid masturbation. For boys, he recommended circumcision without anesthetic, thinking the trauma it caused and several weeks of pain that would follow would curb masturbation. If that did not suffice, Kellogg recommended sewing the foreskin shut, preventing an erection. For girls, he applied carbolic acid to the clitoris as ‘an excellent means of allaying the abnormal excitement.’ He would also recommend binding people’s hands, covering genitalia in specially designed cages, or electroshock therapy, such was his hatred of masturbation.

Biologic living was centered around purity, not merely of the soul but racial purity too. Meat and alcohol were not just bad, they were considered ‘race poisons’. He was a staunch advocate of ‘race suicide’, a term that summed up the fear of white America that their racial purity would be eroded, and they would disappear into ‘inferior races’. Kellogg helped implement a law whereby genetically ‘inferior’ humans such as epileptics or people with a learning disability could be a target. Michigan’s forced sterilization law, which Kellogg himself had a hand in, would not be repealed until 1974.

Today, Kellogg’s biologic living is mostly of historical interest. Yet, it is relevant for understanding some of the more extreme trends in the US related to so-called alternative medicine (SCAM).

 

[1] The Living Temple: Amazon.co.uk: Kellogg, John Harvey: 9781296696375: Books

[2] John Harvey Kellogg And His Anti-Masturbation Cereals | by Danny | Medium

Astrology is nonsense!

Hold on, did we not recently discuss an RCT showing that being born under the sign of Pisces was associated with a decreased risk of death? Yes, indeed, we did!

And isn’t there a branch of homeopathy that heavily relies on astrology? Yes, indeed, astro-homeopathy does exist.

This suggests to me that a sizable proportion of my readers do believe in astrology. As I have made a New Year’s resolution to try to be nice and patient to even the weirdest of them, I herewith offer astrology fans an insight into what 2022 will bring. For that purpose, I have taken one key prediction for each star sign from a website fittingly entitled YEARLY HOROSCOPE:

  • Aries will have big surprises from his life partner.
  • Taurus: dept can increase by leaps and bounds.
  • Gemini: expect big developments.
  • Cancer: You will have a hard time keeping up with messages and appointments.
  • Leo: your abilities will be appreciated.
  • Virgo: you should seriously consider advancing your education.
  • Libra: you’ll need to work closely with others.
  • Scorpio: you, and everyone around you will focus on a variety of challenges.
  • Sagittarius: you’ll refuel what might be called your inspiration tank.
  • Capricorn: you may meet a fortunate contact.
  • Aquarius: don’t burn any bridges that you don’t have.

Being an Aquarius myself, I am struck by the wisdom of not burning bridges that I don’t have. It is brilliant! And so fitting!!!

But then I look at the predictions for all the other signs, and I must say: they also apply to me. In fact, ALL of them apply to me, and not just me – they all apply to everyone.

Does that mean that astrology is nonsense after all?

Does that mean that my attempt to be nice to and patient with even the weirdest of the proponents of so-called alternative medicine (SCAM) has already ended in defeat?

I hope not!

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