Archive for the ‘complementary medicine’ Category
kinesiology, TCM and depression
a kinesiology wheel – proof positive of profundity
Jacinta: So, Canto, the new USSR hasn’t posted recently on old Wesley Smith and his wellness treatments. I think we should post on another one of those.
Canto: Oh god, do we have to? I’d rather talk about black holes or the edge of the universe…
Jacinta: I know I know, but, you could think of Wesley’s treatment centre as a black hole of sorts…
Canto; Yes, and like the other kind, the more you look for them the more you find them, and they all have similar properties…
Jacinta: Hopefully, though, they’re not as dangerous…
Canto: Well, that depends. The real black holes are light years away, whereas there’s a black hole of a wellness centre just around the corner from me.
Jacinta: Kinesiology. That’s the subject for today. Know anything about it?
Canto: No, except that, presumably, old Wesley offers it as a treatment. And kinetic energy is energy of motion, right? So, let me guess, kinesiology is the science of getting your energy system moving so fast that it flings your toxins out of every available orifice leaving you feeling not only light-headedly well, but thoroughly exercised, and of course exorcised.
Jacinta: Well I doubt if it’s as scientific as that, but you’re on the right track. Actually there are two meanings of kinesiology. It’s the scientific study of bodily movement, in humans and other animals, which means applying anatomy, physiology, biomechanics, neuroscience, and even robotics, to the understanding of movement. And then there’s the naturopathically bullshittical meaning of kinesiology as deepily ancient chi-based treatment, much along the lines you just mentioned. And it’s this second meaning, as presented by the Australian Kinesiology Association (AKA), that we’ll be focusing on.
Canto: Chi wizz, this could be fun. Are they really into chi?
Jacinta: Oh yes. Their website gushes with it. It’s teeth-gnashing stuff actually. Apparently it combines western science with traditional Chinese medicine (TCM) to promote your spiritual well-being, among other things.
Canto: Hey, I’ve got an idea. You’ve heard about James Randi’s million-dollar challenge?
Jacinta: The one to psychics, promising a million to anyone who can provide scientific proof of their psychic abilities?
Canto: That’s the one, and I don’t know the details, and of course they all argue that it’s rigged against them, but it’s a good kind of bad publicity for psychics at least, but what if we offered a million dollars to anyone who can provide solid, or liquid, or gaseous evidence of the existence of chi?
Jacinta: Canto, we don’t have a million dollars.
Canto: But we don’t need a million dollars, we know there’s no such thing, right?
Jacinta: Uhhh I don’t think it would work that way. We’d need a rich backer, but in any case we wouldn’t get any takers. Having looked at a few forums discussing chi, its supporters usually say that, though it’s undoubtedly real, it’s not detectable or measurable by western methods, because it’s part of a wholly different mindset, a different way of knowing, a spiritual understanding that takes years to develop. They say, for example, that only by believing in chi can you unlock its healing powers.
Canto: So it’s placebo energy?
Jacinta: Okay small-minded little-faith man, let’s move on to kinesiology. The practice clearly takes advantage of the scientific cachet of kinesiology as body movement studies. Here’s what the AKA has to say about it:
Kinesiology encompasses holistic health disciplines which use the gentle art of muscle monitoring to access information about a person’s well being. Originating in the 1970’s, it combines Western techniques and Eastern wisdom to promote physical, emotional, mental and spiritual health. Kinesiology identifies the elements which inhibit the body’s natural internal energies and accessing the life enhancing potential within the individual.
Canto: aka bullshit.
Jacinta: Ha ha, but get what it has to say next:
The maturity of ‘Complementary Therapies’ is shown by some of Australia’s major health funds now paying rebates for many therapies, including Kinesiology. This acknowledges what is happening in the health sciences in the 21st Century. Australians spend over $1 billion annually on therapies not part of mainstream medicine. Kinesiology is one of the fastest growing of these and is now practised in over 100 countries.
Canto: Popularity as evidence. They’re really keen to show how legit they are.
Canto: Their choice, isn’t it? Survival of the brightest?
Jacinta: Maybe so, but I think the phenomenon’s worth pondering more deeply. How long does it take to become a qualified doctor in this country?
Canto: A GP? Well, for example, the University of Adelaide offers a six-year MBBS, that’s a Bachelor of Medicine and Bachelor of Surgery, to start off, but in order to get into that you need really good year 12 results – what they call your ATAR score (Australian Tertiary Admissions Rank) plus you have to pass a UMAT test, that’s a 3 hour multiple choice thing. UMAT stands for Undergraduate Medicine and Health Sciences Admission Test. Oh, and then you have to do well in an interview before a medical panel. So once you’ve been accepted and done your 6-year MBBS, you can apply to do Australian General Practice Training (AGPT) – or maybe you can apply while you’re doing the MBBS and integrate it into your undergraduate degree, I’m not sure. Anyway the AGPT takes another 3 0r 4 years, so it’s a pretty long journey.
Jacinta: Well, thanks for that fulsome response, it well illustrates the gap between evidence-based medicine and naturopathy. I see they’re very much into four-letter acronyms (FLAs) in that field. TLAs aren’t good enough?
Canto: Yes they like to consider themselves more lettered than others. But I should also point out that once they’ve been accepted into the ranks of GPs, or any other medical specialisation, they’ll automatically be able to access the latest medical knowledge in their field. In fact they’ll be bombarded with it, and will be expected to keep up to date. Whereas naturopaths are usually relying on ‘traditional’ techniques and ‘ancient’ herbal treatments, none of this new-fangled invasive or big pharma stuff.
Jacinta: Well I suppose there are a few properly qualified doctors who are into naturopathy, but by and large you’re right. So why is it that so many people are choosing naturopaths over these highly-trained and knowledgable practitioners of the latest evidence-based medicine?
Canto: Well, isn’t it because they aren’t getting what they want from GPs or other specialists? Whatever that might be. Holistic treatment, as they like to call it. A sense of trust. Something psychological, I suspect.
Jacinta: Yes, there’s that – some doctors are still not getting the message about how to share information with their clients, and how to see the approach to health as an interactive process. But it could be that evidence-based medicine is the victim of its own success?
Canto: How so?
Jacinta: Well these days, and WHO figures bear this out, patients are increasingly presenting with chronic conditions. That’s to say, the ratio of chronic illness to acute illness is increasing, and I’d say that’s largely due to the success of evidence-based medicine in the treatment of acute illness. Now of course chronic conditions can be serious and life-threatening – 60% of the world’s population die of them, according to the WHO – but they represent a whole gamut of complaints, from degenerative diseases to niggling backaches, neuralgia and the more difficult to pin down stuff such as chronic fatigue syndrome and fibromyalgia, or the chronic itching that some attribute to Morgellons disease. And then there’s depression…. So some of these ailments are met with skepticism or at least contradictory responses from trained medicos…
Canto: ‘Medical experts are baffled… ‘
Jacinta: Precisely, and many naturopaths see this area as their niche. They can get in and ‘listen’ to the client and treat her ‘holistically’ – that’s to say sympathetically. Much of it is feel-good treatment, so much more pleasant than what’s offered by hard-nosed, know-it-all, condescending doctors.
Canto: So it’s all perfectly harmless, then?
Jacinta: Well perhaps mostly, but there are obvious problems with giving too much legitimacy to these largely bogus treatments. An example of this is precisely what the AKA says on its website, that the ‘maturity’ of naturopathy is proven by the fact that many of their therapies are attracting health fund rebates. This is complete BS, it’s simply a populist move from the health funds, who know full well that naturopathy is here to stay, regardless of evidence. This of course gives the Wesley Smiths of the world more legitimacy and increases the chances of people with serious health issues being led to think that naturopathic shite can cure them.
Canto: Well, doesn’t that get back to survival of the brightest?
Jacinta: Maybe, but what about the scenario – and this has been played out – that a seriously sick child has been given a bogus treatment in lieu of real medicine, and has died of something perfectly curable, courtesy of her parents?
Canto: Mmm, couldn’t that be handled case by case? The parents could be up for gross neglect, and the associated naturopath could be had up for bogus claims leading to the death of a minor or something, and be barred from practising… or given some more serious penalty. Anyway we need to wind this up. Is there anything more specific about kinesiology we should be concerned about?
Jacinta: Kinesiology is generally associated with chiropractic, which is about as bad as it gets. As with naturopaths in general, some kinesiacs are more into woo than others, but the AKA website goes on about acupressure and meridians, and no credible evidence has ever been presented that acupressure points or meridional points actually exist. They’re of course part of TCM, along with vital energy and various other concepts and treatments that have no evidence or coherent mechanism of action to back them up.
Canto: You mean rhino horns and the penis bones of dogs don’t cure anything?
Jacinta: Sorry but rhinos are going extinct for an ignorant fantasy, not to mention the 12,000 or so asiatic black bears being kept on farms so that their bile can be extracted for ‘medicine’, which often drives them to suicidal frenzy. Other creatures being decimated by TCM include sharks, seahorses, tigers, turtles and saiga antelopes….
Canto: OK enough, I’m getting depressed. The final verdict on kinesiology?
Jacinta: Well it seems to be just a variant of chiropractic stuff, though probably even more unregulated, with a greater admixture of TCM woo. I have nothing more positive to say about it than that.
Canto: Whatever next…
it’s all about evidence, part 2: acupuncture and cupping
a picture of health
Okay, having been sick myself with my usual bronchial issues, I haven’t made much progress on researching the ‘alternative’ treatments offered by Wesley Smith and his colleagues at the Wellness Centre. I must admit, too, that I’ve found it a bit depressing focusing on these negatives, so I’ve been working a bit on my Solutions OK blog (a few posts still in preparation) which focuses on being positive about global issues.
So before briefly dealing with acupuncture, I’ve discovered accidentally through looking up Mr Smith that ‘wellness centres’ or ‘total wellness centres’ are everywhere around the western world, including at least one more in Canberra itself. It seems that this is a moniker agreed on by practitioners of holistic medical pseudoscience world-wide, to create a sense of medical practice while avoiding the thorny issue of medicine and what it actually means. But maybe it does partially mean treating people kindly? I’m all for that. Laughter is often quite good medicine, especially for chronic rather than acute ailments.
It’s an interesting point – ‘alternative’ medicine is on the rise in the west, and the WHO informs us that by 2020, due to its own great work and that of other science-based medical institutions, the proportion of chronic ailments to acute ones will have risen to over 3 to 1. It’s in the area of chronic conditions that naturopathy comes into its own, because psychology plays a much greater part, and vague ‘toxins’ and dubious ‘balance’ assume greater significance. That’s why education and evidence is so important. There are a lot of people out there wanting to smile and seduce you out of your money.
Acupuncture
There’s no reason to suppose acupuncture is anything other than pure placebo. It’s similar to homeopathy in that it proposes a treatment involving physical forces that, when tapped, can produce miraculous cures, and it’s also similar in that these forces have never been isolated or measured or even much researched. In the case of homeopathy, Samuel Hahnemann, its inventor, conducted ‘research’, but with no apparent rigour. See this excellent examination of his approach.
Acupuncture posits Qi (pronounced ‘chee’) as an energy force – apparently invisible and undetectable by mere science – which operates under the skin and is ‘strongest’ at certain nodes where experts insert needles to stimulate it. There’s not much agreement as to where exactly these nodes are, how many there are, or how deep under the skin they’re to be found. Is everybody’s Qi the same? Is the Qi of other mammals identical? If you haven’t enough Qi, can you have a Qi transfusion, or will you be contaminated by the wrong Qi and suffer a horrible death? Amazingly, acupuncture practitioners have no interest whatever in these life and death questions. Why has nobody thought to operate on a patient and withdraw a sample of her Qi, considering that the stuff has been known about since ancient times? It’s a puzzlement. And with that I’ll say no more about acupuncture.
Cupping
Cupping, or cupping therapy, is fairly new to me – I mean I’ve heard about it over the years but I’ve never bothered to research it. It was apparently used in Egypt 3,000 years ago, and it’s considered a part of TCM (traditional Chinese medicine). How it got from Egypt to China is anyone’s guess, but when used there, it’s associated with our old friend, the non-existent Qi. Yes, according to TCM, much disease is due to blocked Qi, and cupping is one way to fix it.
Briefly, there are two kinds of cupping, wet and dry, with wet cupping being the more ‘invasive’ and used for more acute treatments. The idea is to create a vacuum which draws the skin up in the cup and increases the blood flow. The cup, or the air inside it, is heated, and when the cup is applied to the skin and allowed to cool, the air contracts, ‘sucking up’ the skin. With wet cupping the skin is actually punctured, so that those nasty but never-quite-indentifial ‘toxins’ can ooze out. By the way, next time you go to your naturopath to get your toxins removed, ask them for a sample, and don’t forget to ask them to name those toxins. Perhaps you could look at them under a microscope together.
There’s very little in the way in the way of evidence to support the effectiveness of cupping, and as you might expect, the best ‘evidence’ comes from the most poorly controlled trials. Serious and obviously dangerous claims have been made that cupping can cure cancer. Here’s the American Cancer Society’s response:
“There is no scientific evidence that cupping leads to any health benefits….No research or clinical studies have been done on cupping. Any reports of successful treatment with cupping are anecdotal. There is no scientific evidence that cupping can cure cancer or any other disease.”
If cupping was effective, this would be easily provable. No proof has been offered in thousands of years, and there’s no credible scientific mechanism associated with the treatment. You’ve been warned. It’s your money. Why hand it over to these parasites?
it’s all about evidence – part 1
I wrote an open letter to a homeopath recently, and received an interesting response, which I’ve promised to deal with publicly. My letter was sent by email at the same time that it was posted on this blog, and this was followed by another couple of emails back and forth. Here they are.
Wesley Smith to myself, April 13 2015
Hi Stewart
I thank you for the courtesy of bringing your article to my attention.
Can you please publish the following corrections to your blog:
To the best of my knowledge, Wesley Smith has never made any claim to be a medical practitioner and I wish to correct any inference in my article “An open letter to a Homeopath” that Wesley Smith misrepresented his qualifications or is not suitably qualified under Australian law to practice or write about complementary medicine. At the time of publishing I was unaware that Wesley Smith is a AHPRA registered Chinese Medicine practitioner (CMR0001709253). Furthermore I withdraw any implication that the phrase “the depth of crazy in which our Wesley is mired” may suggest that Wesley is not of sound mind, or is not fit to either educate people about or practice complementary medicine. Furthermore I acknowledge that I have no knowledge of the appropriateness or otherwise of the qualifications of any of the practitioners at the Live Well Spa & Wellness Centre and therefore I withdraw any inference that any of Live Well’s practitioners may be practicing in their chosen fields without appropriate qualifications.Stewart I have absolutely no interest in debating you, please advise me when you have published the corrections.
Kind regards
Wesley
Myself to Wesley Smith, April 18 2015
Hello Wesley
At no place in my blog post did I write that you claimed to be a medical practitioner, I simply pointed out that you were not one, as far as I could ascertain. Whether you (or your colleagues) are permitted under law to practise complementary medicine is neither here nor there, and I didn’t address that matter in my article. My concern is to point out that homeopathy is not a valid treatment, a view with which the NHMRC concurs. Nor are the other treatments I mentioned in my piece, none of which have scientific evidence to support them. I will of course not be making any changes to my article. Of course it doesn’t surprise me that you absolutely don’t want to debate me, as it would absolutely not be in your interest to do so.
Regards
Stewart Henderson
Wesley Smith to myself, April 20 2015
Hi Stewart
I would have had absolutely no concern if you kept your criticism focused on homeopathy or acupuncture. I don’t agree with you but I’m hardly going to loose sleep over that.
My concern is that you were lazy with your research and published your opinions as if they were fact. You also weakened your argument when you made it personal by disparaging me, Live Well and it’s practitioners. Not only is that sloppy writing and a lazy way to make an argument it is also defamation. I have given you the opportunity to make the appropriate corrections which you have rejected, therefore I will pursue the matter via legal action.
Stewart, my research into your background tells me that you have an arts degree, it’s interesting that you choose to write about a topic for which you seem to have no qualifications. Apparently you work, or have worked at Centacare in Adelaide? Their website homepage states “we believe that everyone has the right to be treated with respect and dignity.” Sounds like great advice and perhaps a tenet you personally would do well to reflect upon especially when dealing with people with whom you disagree.
Kind regards
Wesley
Myself to Wesley Smith, April 23 2015
Dear Wesley
Thanks for your response, which I will be posting in toto on my blog in the near future, together with my response. Your complete lack of interest in addressing the matter of evidence, which was clearly the issue of my blog post, is well noted. I don’t wish to have a private email correspondence with you, as I’m interested in complete transparency and openness. I’ll address all your ‘concerns’ on my blog, with my usual gusto and good humour.
Thanks
Stewart
So now we’re up to date, and I’ll try to suppress the sense of disgust and contempt I feel for this individual, and deal with the issues.
Firstly, let’s look at Wesley’s email number 1. It is, of course, intended to be threatening – ‘make these corrections to your blog, or else…’. The first ‘correction’ is to my ‘inference’ (it looks like old Wesley has been consulting a lawyer) that Wesley has been claiming to be a doctor when he isn’t. As I pointed out in my response, I made no such inference. The point is, when someone heads up an institution called the ‘Live Well Spa and Wellness Centre’, any reasonable soul might expect that individual to be a medical practitioner, working with a staff of medical practitioners. In fact that was exactly what I expected (oh and I think a court of law would agree, Wesley). Imagine my surprise when I found that there were no MDs on the premises!
The second ‘correction’ he wanted was the removal of the phrase ‘the depth of crazy in which our Wesley is mired’, because it suggested he wasn’t of sound mind. I’ll look more closely at that ‘depth of crazy’ shortly, but first I’ll make the obvious point that people believe all sorts of crazy things (though they don’t usually make their living out of them) – that the moon landing was a fake, that September 11 was an inside job, that vaccines cause all sorts of diseases, etc, but we don’t think they should be committed, we just try to get them (usually unsuccessfully) to think more reasonably. I’ve tried to do this with Wesley by pointing out the absurdity of homeopathy from a scientific perspective – again unsuccessfully, because he’s completely unwilling to even discuss the matter.
When I wrote of the ‘depth of crazy’, I really meant it, and this is not my opinion. My opinion isn’t worth a pinch of shit, actually, and nor is Wesley’s. All that matters is EVIDENCE.
EVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCEEVIDENCE
Get it, Wesley?
So let’s do a review of the treatments Wesley’s clinic, or whatever he calls it, offers.
Homeopathy
I gave a fairly full account of homeopathy here, where I referenced Dr Ben Goldacre’s Bad Science, Chapter 4 of which gives an even more comprehensive account of the pseudoscience. I’ve also written more recently about it here, and of course in my criticism of Wesley Smith. I’ve also referenced Wikipedia’s excellent article on Homeopathy, and while I’m at it I’d like to defend Wikipedia as an excellent, and well-referenced source of reliable scientific information. If you feel unsure about what it presents, you can always check the references for original sources. I should remind readers, too, that Wikipedia has been put under pressure by practitioners of ‘holistic medicine’ to give more credence to their methods, and its founders and gatekeepers have heroically refused. I won’t go into detail here, but the story is well-presented by Orac on his Respectful Insolence blog.
So I’m not going to rehash the absurdity of homeopathy here, but since Wesley makes the claim that I was ‘lazy with my research’ and ‘published my opinions as if they were fact’ (when in fact I focused entirely on the NHMRC’s comprehensive and negative findings regarding the practice), I will give here a list of just some of the books, academic papers, scientific articles and government and medical society factsheets that report negatively on the multi-million dollar homeopathy industry, and pseudoscience in general, as well as the major figures in debunking medical pseudoscience. They’re in no particular order.
Dr Ben Goldacre, Bad Science, esp Chapter 4 ‘Homeopathy’ – Dr Goldsworthy works for the NHS in Britain and is a broadcaster, blogger and writer on science-based medicine
Raimo Tuomela, ‘Science, protoscience and pseudoscience’, in Rational changes in science.
Stephen Barrett, M.D, ‘Homeopathy, the ultimate fake’, on Quackwatch – a well-referenced site, but note the hilarious-sad reader responses!
Orac, aka Dr David Gorski – Gorski is a surgeon and scientist, and writer of the Respectful Insolence blog, which deals mostly with the health claims of pseudo-scientists. His posts on homeopathy are too numerous to mention here, just type in homeopathy on his blog.
Edzard Ernst, “A systematic review of systematic reviews of homeopathy”, and “Homeopathy: what does the ‘best’ evidence tell us?’ – Ernst, a former professor of complementary medicine, has published innumerable articles on the subject in academic journals. He co-wrote Trick or treatment? with Simon Singh, which deals critically with homeopathy, acupuncture and various other pseudoscientific treatments. His emphasis on scientific evidence has made him many enemies among the CAM (Complementary and Alternative Medicine) camp.
The Cochrane Collaboration – an independent, non-profit NGO – partnered since 2011 with the WHO – in which over 30,000 volunteers work together to provide the best healthcare evidence.
Shang et al, ”Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy”, The Lancet 366 (9487): 726–732 – This study, conducted by a number of scientific collaborators, is regarded as one of the best and most relevant studies available for proof of homeopathy’s lack of efficacy. To quote from its conclusion: ‘Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects’.
World Health Organisation – the WHO has warned against the use of homeopathy for major diseases, though, generally speaking it has taken a softly, softly approach to the pseudoscience, presumably for political reasons. Here and here are reports about the WHO’s warnings.
NHMRC – Australia’s National Health and Medical Research Council. It has conducted a comprehensive review of homeopathy, which I reported on in my criticism of Mr Smith’s ‘wellness centre’.
Science-based medicine and the FDA (the US Food and Drug administration). The Science-based medicine blog, contributed to by a number of writers, is dedicated to expose as quackery everything that Mr Smith and his ilk are promoting. The report linked to above criticises the FDA for abdication of responsibility in dealing with homeopathy. It also points out that American pharmacists are calling for tighter regulations. Homeopaths have had it too easy for too long. The FDA is finally beginning its own investigation into the pseudoscience.
I could go on – there are many many more articles and sites I could mention, but you get the point. Homeopathy is a joke, and there are many videos poking fun at its ‘science’ – for example, here, here and here. A movement designed to expose its fraudulence, the 10:23 campaign, had people ‘overdosing’ on homeopathic pills, which usually have warnings about dosage levels on the bottles(!) And yet we still have people buying into this shite – quite possibly in increasing numbers.
I don’t know Mr Smith personally. It might be that he’s a very nice if deluded fellow who treats his clients very well, adding to the placebo effect of his ‘remedies’. The placebo effect appears to be very real and we’ve only just begun to investigate its power. On the other hand, Mr Smith may be a charlatan who is cynically exploiting the vulnerability of his rich but deluded patients – his ‘wellness centre’ is in a leafy suburb of Canberra, not exactly the poorest region of Australia. Of course it’s more likely that he’s a bit of both – we deceive others best when we’ve already deceived ourselves.
However, to judge by his email responses, Wesley isn’t as much of a sincere believer as he should be, because he’s far far more concerned with protecting his reputation and with making threats, than with exploring the evidence, and thence, the further application of these homeopathic treatments (I mean, if the ‘like cures like, in infinitesimal doses’ system works, then why couldn’t it cure every cancer known to humans?). In my earlier post I suggested to him an exciting project of getting his fellow homeopaths and their satisfied clients together to ‘crowd fund’ research which would prove homeopathy to be true once and for all. And yet Wesley doesn’t even effing mention the idea. AMAZING!!!!
Well, not, actually. Mention this idea to any homeopath, and the response would be the same. They’re totally uninterested in any real research. Testimonials and anecdotes are enough for them. They just want the evidence to be less rigorous – less real and more ‘imaginary’.
Wesley has made threats about defamation, presumably because I wrote that he’s mired in crazy – which he is. This post is already too long, so I’ll investigate the other crazy treatments he and his team offer in later posts, starting with acupuncture. But as to his threats, the man must be living on another planet if he’s not aware of the many websites, some of which are mentioned above, dedicated to exposing the pseudoscience practiced by people like himself, for financial gain. They generally use far harsher language than I have. If you’re going to set up a practice devoted to procedures which seem to share only one feature – that none of them are accepted as established science – then you’ll need to develop a thicker skin, even if you can’t develop any sensible arguments to support them.
And one more thing – Wesley has tried to cast aspersions on me as a mere English graduate. I think on my ‘about’ page I describe myself as a dilettante, which most certainly and proudly is what I am. However, as a blogger, I suppose my official position is that of a journalist. Freelance of course, with the emphasis on ‘free’, as I’ve never earned a cent from it. No defamation action could ever succeed against a journalist who’s trying to expose ‘sharp practice’ through the investigation of evidence, but perhaps Wesley thinks he can intimidate ‘small fry’ like me with his threats and arrogance. I don’t get much traffic here because I’m hopeless at and positively resistant to networking. But I do know how tight-knit and supportive the sceptical community is when anyone tries to threaten it as Wesley has, because I’ve been observing it for years, and if Wesley tries any further intimidation, I suppose I’ll have to pull my finger out and start letting people know what’s happening. It’ll probably do me a power of good.
Anyway, in later posts I’ll be looking at acupuncture (briefly, as I’ve already dealt with this one before), cupping, kinesiology, bowen therapy and other treatments offered by Wesley and his team.
acupuncture promotion in australia
I tried to find a picture of the chi energy system online, but guess what, nothing to be found. Here’s a chi-reflexology map instead – from the Australian College of Chi-Reflexology, no less!
On the ever-reliable US-based NeuroLogica blog, Steven Novella reports on an interesting case of acupuncture promotion here in Oz, via Rachel Dunlop. As Novella reports, acupuncture has been studied many times before, and Cosmos, our premier science mag, did a story on the procedure a while back, reporting no evidence of any benefits except in the notoriously vague areas of back pain and headaches.
Not surprisingly, lower back pain was one of the conditions that supposedly benefited from acupuncture, according to media hype about the latest study. The trouble is, this study was being reported on before being published and peer reviewed, which, to put it mildly, is highly irregular and raises obvious questions. The Sydney Morning Herald is the offending news outlet, and Dr Michael Ben-Meir the over-enthusiastic researcher. As the article points out, Ben-Meir is already a ‘convert’ to acupuncture, having used it for some time in acute cases at two Melbourne hospitals. That’s fine, if a bit unorthodox, but it doesn’t accord with other findings, and there are therefore bound to be questions about methodology.
One of the obvious difficulties is that acupuncture can hardly be applied to patients without them knowing it. It’s a much more hands-on and ‘invasive’ experience than swallowing a tablet, and this will undoubtedly have a psychological effect. It seems to me, just off the top of my head, that acupuncture, with its associated rituals, its aura of antiquity and its oriental cultural cachet, would carry greater weight as a placebo than, say, a homeopathic pill. But in fact I don’t have to speculate here, as there is much clinical evidence that injections have a greater placebo effect than pills, and big pills have a greater placebo effect than small ones. So it doesn’t greatly surprise me that people will report a lessening, and even a dramatic lessening, of acute pain, after an acupuncture treatment, however illegitimate. I presume there are illegitimate treatments, because the ‘key meridional points’ where the needles are applied are precisely know by legitimate acupuncturists, and they apply their treatments with rigorous accuracy.
Well, actually there’s a big question as to whether or not there are any legitimate acupuncturists, because acupuncture is based on an energy system known as ‘chi’, which supposedly has meridional points at which needles can be inserted quite deeply into the skin, but there’s no evidence whatever that such an energy system exists, let alone about how such a system might function – for example, its mode of energy transmission (whatever ‘energy’ might mean in this case). Considering that we know a great deal about the autoimmune system and the central and peripheral nervous systems, it seems astonishing that this other bodily system has gone undetected by scientists for so long, and especially in recent times, with our ultra-sophisticated monitoring devices. When you look up ‘chi, sometimes spelt ‘qi’ or with other variants, you’ll find nothing more specific than ‘energy’, ‘life force’ or something similar – nothing corpuscular or in any sense measurable by modern medicine. Even so, researchers into acupuncture have come up with an attempt to measure its efficacy by comparing it to ‘sham acupuncture’ in clinical trials. Sham acupuncture uses the ‘wrong’ meridians and the ‘wrong’ depths to which the needle goes.
But herein lies an obvious problem. Sham acupuncturists insert needles only millimetres deep, while real acupuncturists put their needles between one and three or four centimetres deep: ‘Depth of insertion will depend on nature of the condition being treated, the patients’ size, age, and constitution, and upon the acupuncturists’ style or school’, according to an acupuncture site I visited at random. These are rather wide parameters, but the point that interests me is this. If you don’t put your needle in deep enough, you won’t make contact with the chi that needs to be stimulated or other wise modified to heal the patient. So goes the rationale, surely. It’s like, if you don’t put the needle for a standard vaccination in the right place, you’ll miss the vein. But veins are clearly real. If you go dissecting, you’ll find veins and arteries and nerves and muscle and fat and so on. But you won’t find chi. Yet, apparently it does have real existence. It’s between one and four centimetres down, according to real acupuncturists, depending on the above-mentioned variables (and no doubt many others).
So we can’t actually see it, or find it on dissection, but it’s locatable in space, vaguely. Or is it that chi is everywhere in the body but the right kind of chi, the bit that’s causing the pain and needs to be treated with needles at certain precise meridional points, is at a certain distance from the surface of the skin?
It all begins to sound a bit like theology, doesn’t it?
Here’s the ‘take-home’ for me. If you read about treatments that ‘work’ but you get virtually nothing about the mechanism of action, as is the case, for example, with homeopathy and acupuncture, be very skeptical. In the end I’m not impressed with clinical trials that show a ‘real effect’, even a startling one, because I know about regression to the mean, and I particularly know about the placebo effect. I want ‘proof of concept’. In this case proof of the concept of chi and of meridians. I’ve heard homeopaths defend their pills on TV recently by claiming that, ‘whatever the mechanism, clinical trials consistently prove that this treatment works’, and I can’t be bothered chasing up those clinical trials and testing their legitimacy, I go straight to the concepts and processes behind the treatment – the law of similars, the law of infinitesimals, and don’t forget succussion. These concepts are so intrinsically absurd that we needn’t bother looking at the clinical data. If there are positive results, they haven’t been produced by homeopathy. The fact that homeopaths themselves are largely uninterested in the mechanisms is a dead giveaway. You’d think that the law of infinitesimals and the law of similars would surely have myriad applications far beyond their current ones. They would revolutionise science and technology, if only they were real (and they’d also render obsolete much that we currently know).
The same goes for acupuncture, and chi. If this bodily system were real, and chi could be captured in a test tube, and its constituents examined and isolated under a microscope, how revolutionary that would be. How transformative. Chi pills, chi soap, chi breakfast cereal…
Ah but I’m thinking like one of those limited westerners, so modern, so smug, so lacking in the insight of the ancients…
natural remedies, bogus cures, regulation and government – a mish-mash of preliminary observations
aka quackology monthly
Well, having just completed the onerous task of ‘debating’ William Lane Craig, it’s time to refresh with something new, and local – or at least national. Or perhaps local, because one of the leading writers behind this story is Tory Shepherd, who writes for Adelaide’s Advertiser and The Punch, and who is always excellent on pseudo-science, religion and many other issues, as well as being a far more entertaining writer than myself, as for example in this enjoyable but thought-provoking article on alcohol and anti-social behaviour (but don’t bother reading the comments, they’re mostly depressing, and give me the distinct impression that most people who comment on news articles are rather sad, angry souls who nobody else would want to talk to after five minutes).
Shepherd has recently written this piece on proposed new federal laws to deregister bogus medical treatments with the Australian Register of Therapeutic Goods. The opposition has provided in-principle support, which is great, as it might allow a smooth path to legislation in late June. However, if the opposition sniffs a vote in opposing it, there could be trouble. I’d like to keep an eye on this one. She also wrote this interesting piece in early February, about setting up a quackometer-style website to expose medical frauds, though I felt a bit confused about how it might work, funding-wise, and I can’t quite believe that quack peddlers would fall into the trap of getting listed on such a site. They’re pretty canny operators.
Let’s look, though, at the proposed legislation and why the government’s trying to act. Shepherd quotes Dr Ken Harvey, of LaTrobe Uni, a public health advocate and campaigner against bogus treatments, as welcoming the move, but with warnings about loopholes and various ways and means for the companies pedalling these products to dodge regulators (and there’s considerable concern about the rise of ‘fatblaster’ products, where big money can be made, and where the claims made are pretty extraordinary). I haven’t kept up with these issues, but a bit of research into Dr Harvey reveals these treatment peddlars to be more than just sneaky. The director of a company called Sensaslim Australia Pty Ltd, manufacturers of a completely bogus ‘slimming spray’, tried to bring a lawsuit against Harvey for defamation, citing a ridiculous amount of money. The whole thing eventually collapsed as more of the company’s shonkiness was revealed, but not before having caused much distress to the doctor. Shades of the Simon Singh case. But this case and others have highlighted weaknesses in the way the Therapeutic Goods Administration deals with the ever-increasing number of dodgy cures in the market-place.
The Australian Register of Therapeutic Goods (ARTG), which comes under the Therapeutic Goods Administration (TGA), which in turn comes under the federal government’s Department of Health and Ageing, is a compulsory register for anyone wanting to sell therapeutic goods (defined on the TGA website) within Australia or for export. A click on the website tells me that some 25 products were registered yesterday (March 28), and if that’s an average day, that’s an awful lot of products – thousands per year. There’s a lot of info on the TGA website relating to counterfeit medicines and complementary medicines, a lot to get my little head around, but I note they have a two-tiered system in which a medicine or device has to be either registered or listed. Heavy-hitting stuff, including all prescription medicine, has to be registered, which means going through an assessment process for quality, safety and efficacy. Most OTC medicines have to be registered, as well as some complementary medicines, but within the registration process is another two-tiered system, ‘high risk’ and ‘low risk’. Clearly the more low-risk the treatment, the less it will be scrutinised, but this means that treatments which are ineffectual but without evident risk, such as homeopathy, irridology, reflexology and the like, get through the system with minimum if any scrutiny largely due to their inefficacy. They do no harm, so they’re ‘okay’. What needs to be strengthened is the scrutiny of goods that just don’t do what they claim to do. There also needs to be an active recognition that dodgy products are harmful precisely because of their false claims, so that unsuspecting consumers buy them instead of more genuine products. The new legislation will provide stiff penalties for false and misleading information, as well as deregistration, which in effect would be an official ban on sale. Does this mean homeopathy might be banned in Australia soon? Don’t hold your breath on that one. One way that the homeopathy industry flies under the radar is by avoiding claims on its labels, and relying on word-of-mouth and its reputation, especially among the ‘new age’ and generally disaffected-with-mainstream-medicine crowd, to maintain sales. My (minimal) research suggests that this ‘medicin douce’ is listed rather than registered, and the TGA probably doesn’t have the resources or teeth to verify low-risk listed products for efficacy.
However, there are other government agencies such as the ACCC (Australian Competition and Consumer Commission) and the NHMRC (National Health and Medical Research Council) ready to do their bit in protecting consumers. The NHMRC is currently reviewing the effectiveness of homeopathy in a systematic ‘review of reviews’, and will be asking for public feedback in mid 2013. This will be part of an overview of various CAM modalities, with a view to possible changes to the government rebate on private health insurance for natural therapies. Interesting, but with the slowness of this process, and the likely demise of this government come September, we can’t expect too much.