Posts Tagged ‘alternative medicine’
Always chemical: how to reflect upon naturopathic remedies
most efficacious in every case
So here’s an interesting story. When I was laid up with a bronchial virus (RSV) a few weeks ago, coughing my lungs up and having difficulty breathing, with a distinct, audible wheeze, I was offered advice, as you do, by a very well-meaning person about a really effective treatment – oregano oil. This person explained that, on two occasions, he’d come down with a bad cough and oregano oil had done the trick perfectly where nothing else worked.
I didn’t try the oregano oil. I followed my doctor’s recommendation and used the symptom-relieving medications described in a previous post, and I’m much better now. What I did do was look up what the science-based medicine site had to say about the treatment (I’d never heard of oregano oil, though I’ve had many other plant-based cures suggested to me, such as echinacea, marshmallow root and slippery elm – well ok I lied, I found the last two on a herbal medicine website).
I highly recommend the science-based medicine website, which has been run by the impressively-credentialed Drs David Gorski and Steve Novella and their collaborators for years now, and which thusly has a vast database of debunked or questionable treatments to explore. It’s the best port of call when you’re offered anecdotal advice about any treatment whatsoever by well-wishers. Not that they’re the only people performing this service to the public. Quackwatch, SkepDoc, and Neurologica are just some of the websites doing great work, but they’re outnumbered vastly by sites spreading misinformation and bogus cures, unfortunately. It’s almost a catch-22 of the internet that you have to be informed enough to use it to get the best information out of it.
As to oregano oil specifically, Scott Gavura at science-based medicine proves a detailed account. I will summarise here, while also providing my own take. Firstly people need to know that when a substance, any substance – a herb or a plant, an oil extracted therefrom, or a tablet, capsule or mixture,something injectable or applied to the skin, whatever – is suggested as a treatment for a condition, they should consider this simple mantra – always chemical. That’s to say, a treatment will only work because it has the right chemistry to act against the treated condition. In other words you need to know something (or rather a lot) about the chemistry of the treating substance and the chemistry of the condition being treated. It’s no good saying ‘x is great for getting rid of coughs – it got rid of mine,’ because your cough may not have the same chemical cause as mine, and your cough in February 2007 may not have the same chemical cause as your cough in August 2017. My recent cough was caused by a virus (and perhaps I should change the mantra – always biochemical – but still it’s the chemistry of the bug that’s causing the problem), but no questions were asked about the cause before the advice was given. And you’ll notice when you look at naturopathic websites that chemistry is very rarely mentioned. And I’m not talking about toxins.
Gavura gives this five-point test for an effective treatment:
When we contemplate administering a chemical to deliver a medicinal effect, we need to ask the following:
- Is it absorbed into the body at all?
- Does enough reach the right part of the body to have an effect?
- Does it actually work for the condition?
- Does it have any hazardous, unwanted effects?
- Can it be safely eliminated from the body?
The answer to Q1 is that oregano oil contains a wide variety of chemical compounds, particularly phenolic compounds (71%). It’s these phenolic compounds that are touted as having the principal beneficial effects. However, though we know that there’s some absorption, we don’t have a chemical breakdown. We just don’t know which phenolic compounds are being absorbed or how much.
Q2 – No research on this, or on absorption generally. Topical effects (ie effects on the skin) are more likely to be beneficial than ingested effects, as the oil can maintain high concentration. This would have no effect on a cough.
Q3 – According to one manufacturer the oil has ‘scientifically proven results against almost every virus, bacteria, parasite, and fungi…’ (etc, etc, but shouldn’t that be bacterium and fungus?). In fact, no serious scientific research has ever been conducted on oregano oil and its effectiveness for any condition whatsoever. So the answer to this question is – no evidence, beyond anecdote.
Q4 – There have been reports of allergic reactions and gastro-intestinal upsets, but the naturopathy industry is more or less completely unregulated so you can never be sure what you’re getting with any bottle of pills or ‘essential oils’. As Gavura points out, the lack of research on possible adverse effects, for this and other ‘natural’ treatments, is of concern for vulnerable consumers, such as pregnant women, young or unborn children, and those with pre-existing conditions.
Q5 – At low doses, there’s surely no concern, but nobody has done any research about dosing up on carvacrol, the most prominent component of oregano oil, which gives the plant its characteristic odour. Other organic components are thymol and cymene.
So there’s no solid evidence about oregano oil, or about the mechanism for its supposed efficacy. But what if my well-wisher was correct, and something in the oregano oil cleared up his cough – twice? And did so really really well? Better than several other treatments he tried?
Well, then we might be onto something. Surely a potential billion-dollar gold-mine, considering how debilitating your common-or-garden cough can be. And how, if not cleared up, it can leading to something way more serious.
So how would a person who is sure that oregano oil has fantastic curative properties (because it sure worked for him) go about capitalising on this potential gold-mine? Well, first he would need evidence. His own circle of friends would not be enough – perhaps he could harness social media to see if there were sufficient people willing to testify to oregano oil curing their cough, where other treatments failed. Then , if he had sufficient numbers, he might try to find out the causes of these coughs. Bacterial, viral, something else, cause unknown? It’s likely he wouldn’t make much headway there (most people with common-or-garden coughs don’t go to the doctor or submit to biochemical testing, they just try to ride it out), but no matter, that might just be evidence that the manufacturer was right – it’s effective against a multitude of conditions. And yet, it seems that oregano oil is a well-kept secret, only known to naturopathic companies and health food store owners. Doctors don’t seem to be prescribing it. Why not?
Clearly it’s because Big Pharma doesn’t support the stuff. Doctors are in cahoots with Big Pharma to sell attractive pills with long pharmacological names and precise dosages and complex directions for use. Together they like to own the narrative, and a multi-billion dollar industry is unlikely to be had from an oil you can extract from a backyard plant.
Unless…
Our hero’s investment of time and energy has convinced him there’s heaps of money to be made from oregano oil’s miraculous properties, but that same investment has also convinced him that it’s the chemical properties that are key, and that if the correct chemical formula can be isolated, refined and commercialised, not only will he be able to spend the rest of his life in luxury hotels around the globe, but he will have actually saved lives and contributed handsomely to the betterment of society. So he will join Big Pharma rather than trying to beat it. Yes, there would have to be a massive upfront outlay to perform tests, presumably on rats or mice at first, to find out which chemical components or combinations thereof do the best job of curing the animals, who would have to be artificially infected with various bugs affecting the respiratory system, or any other bodily system, since there are claims that the oil, like Lily the Pink’s Medicinal Compound™, is ‘most efficacious in every case’.
But of course it would be difficult for any average bloke like our hero to scratch up the funds to build or hire labs testing and purifying a cure-all chemical extract of oregano oil. Crowdsourcing maybe, considering all the testimonials? Or just find an ambitious and forward-thinking wealthy entrepreneur?
Is that the only problem with the lack of acceptance, by the medical community, of all the much-touted naturopathic cures out there? Lack of funds to go through the painstaking process of getting a purefied product to pass through a system which ends with double-blind, randomised, placebo-controlled human studies with large sample sizes?
Permit me to be sceptical. It’s not as if the chemical components of most herbal remedies are unknown. It’s highly unlikely that pharmacologists, who are in the business of examining the chemistry of substances and their effects for good or ill on the human body, haven’t considered the claimed cornucopia of naturopathic treatments and the possibility of bringing them into the mainstream of science-based medicine to the benefit of all. Yes, it’s possible that they’ve missed something, but it’s also possible, indeed more likely, that people underestimate the capacity of our fabulous immune system, the product of millions of years of evolution, to bring us back to health when we’re struck down by the odd harmful bug. When we’re struck down like this, we either recover or we die, and if we don’t die, we tend to attribute our recovery to any treatment applied. Sometimes we might be right, but it pays to be skeptical and to do research into a treatment, and into what ails us, before making such attributions. And to do so with the help of a good science-based medical practitioner. And remember again that motto: always chemical.
Why science?
why is it so?
Ever since I was a kid I was an avid reader. It was my escape from a difficult family situation and a hatred or fear of most of my teachers. I became something of a quiet rebel, rarely reading what I was supposed to read but always trying to bite off more than I could chew in terms of literature, history, and occasionally science. I did find, though, that I could chew almost anything – especially in literature and history. And I loved the taste. Science, though, was different. It certainly didn’t come naturally to me. I didn’t know any science buffs and in fact I had no mentors for any of my reading activities. We did have encyclopaedias, though, and my random reading turned up the likes of Einstein, Newton, Darwin, Pasteur and other Big Names in science. Of course I was more interested in their bios than in the nature of their exotic researches, but in my idealised view they seemed very pure in their quest for greater understanding of the material world. I sometimes wished I could be like them but mostly I just dived into ‘literature’, a more comfortable world in which ordinary lives were anatomised by high-brow authors like Austen, Eliot and James (I had a fetish for 19th century lit in my teens). I took silent pride in my critical understanding of these texts, it surely set me above my classmates, though I remember one day walking home with one of the smartest kids in my class, who regaled me with his exploration of the electronics of a transistor radio he was pulling apart at home. I remember trying to listen, half ashamed of my ignorance, half hoping to change the subject to something I could sound off about.
Later, having dropped out of my much-loathed school, I started hanging out, or trying to, with other school drop-outs in my working-class neighbourhood. I didn’t fit in with them to say the least, but the situation worsened when they began tinkering with or talking about cars, which held no interest for me. I was annoyed and impressed at how articulate they were about carbies, distributors and camshafts, and wondered if I was somehow wasting my life.
Into my twenties, living la vie boheme in punk-fashionable poverty among art students and amateur philosophers, I read and was definitely intrigued by Alan Chalmers’ unlikely best-seller What is this thing called science? It sparked a brief interest in the philosophy of science rather than science itself, but interestingly it was a novel that really set me to reading and trying to get my head around science – a big topic! – on a more or less daily basis. I was about 25 when I read Thomas Mann’s The Magic Mountain, in which Hans Castorp, a young man of about my age at the time, was sent off to an alpine sanatorium to be cured of tuberculosis. Thus began a great intellectual adventure, but it was the scientific explorations that most spoke to me. Wrapped up in his loggia, reading various scientific texts, Castorp took the reader on a wondering tour of the origin of life, and of matter itself, and it struck me that these were the key questions – if you want to understand yourself, you need to understand humanity, and if you want to understand humanity you need to understand life itself, and if you want to understand life, you need to understand the matter that life is organised from, and if you need to understand matter…
I made a decision to inform myself about science in general, via the monthly magazine, Scientific American, where I learned at least something about oncogenes, neutrinos and the coming AIDS epidemic, inter alia. I read my first wholly scientific book, Dawkins’ The Selfish Gene, and, as I was still living la vie boheme, I enjoyed the occasional lively argument with housemates or pub philosophers about the Nature of the Universe and related topics. In the years since I’ve read and half-digested books on astronomy, cosmology, palaeontology and of course the history of science in general. I’ve read The origin of species, Darwin’s Voyage of the Beagle and at least four biographies of Darwin, including the monumental biography by Adrian Desmond and James Moore. I’ve also read a biography of Alfred Russell Wallace, and more recently, Siddhartha Mukherjee’s The Gene, which traces the search for the cause of the random variation essential to the Darwin-Wallace theory. And I still read science magazines like Cosmos on a more or less daily basis.
These readings have afforded me some of the greatest pleasures of my life, which would, I suppose, be enough to justify them. But I should try to answer the why question. Why is science so thrilling? The answer, I hope, is obvious. It isn’t science that’s thrilling, it’s our world. I’m not a science geek, it doesn’t come easily to me. When, for example, a tech-head explains how an electronic circuit works, I have to watch the video many times over, look up terms, refer to related videos, etc, in order to fix it in my head, and then, like most people, I forget the vast majority of what I read, watch or listen to. But what keeps me going is a fascination for the world – and the questions raised. How did the Earth form? Where did the water come from? How is it that matter is electrical, full of charge? How did language evolve? How has our Earth’s atmosphere evolved? How are we related to bananas, fruit flies, australopithecines and bats? How does our microbiome relate to obesity? What can we expect from CRISPR/Cas9 editing technology? What’s the future for autonomous vehicles, brain-controlled drones and new-era smart phones?
This all might sound like gaga adolescent optimism, but I’m only cautiously optimistic, or maybe not optimistic at all, just fascinated about what might happen, on the upside and the downside. And I’m endlessly impressed by human ingenuity in discovering new things and using those discoveries in innovative ways. I’m also fascinated, in a less positive way, by the anti-scientific tendencies of conspiracy theorists, religionists, new-agers and those who identify with and seem trapped by ‘heavy culture’. Podcasts such as The Skeptics’ Guide to the Universe, Skeptoid and Australia’s The Skeptic Zone, as well as various science-based blogs like Why Evolution is True and Skeptical Science are fighting a seemingly never-ending fight against the misinformation churned out by passionate supporters of fixed non-evidence-based positions. But spending too much time arguing with such types does your head in, and I prefer trying to accentuate the positive than trying to eliminate the negative.
And on that positive side, exciting things are always happening, whether it’s battery technology, cancer research, exoplanetary discoveries, robotics or brain implants, more developments are occurring than any one person can keep abreast of.
So I’ll end with some positive and reassuring remarks about science. It’s not some esoteric activity to be suspicious of, but neither is it something easily definable. It’s not a search for the truth, it’s more a search for the best, most comprehensive, most consistent and productive explanation for phenomena. I don’t believe there’s such a thing as the scientific method – the methods of Einstein can’t easily be compared with those of Darwin. Methods necessarily differ with the often vast differences between the phenomena under investigation. Conspiracy theories such as the moon landings ‘hoax’ or the climate science ‘fraud’ would require that scientists and their ancillaries are incredibly disciplined, virtually robotic collaborators in sinister plots, rather than normal, questing, competitive, collaborative, inspired and inspiring individuals, struggling desperately to make sense and make breakthroughs. In the field of human health, scientists are faced with explaining the most complex organism we know of – the human body with its often perverse human mind. It’s not at all surprising that pseudo-science and quackery is so common in this field, in which everyone wants to live and thrive as long as possible. But we need to be aware that with such complexity we will encounter many false hopes and only partial solutions. The overall story, though, is positive – we’re living longer and healthier, in statistical terms, than ever before. The past, for the most part, is another country which we might like to briefly visit, but we wouldn’t want to live there. And science is largely to be thanked for that. So, why not science? The alternatives do nothing for me.
The SGU team – science nerds fighting the good fight
Traditional Chinese medicine? You must be joking
bear bile, a TCM that tortures and kills bears and prevents humans from receiving effective treatments – just one of the horrors of TCM
If we don’t know what’s in them, it’s very difficult to predict the interactions, … that’s obviously of great concern if they are been given to children, or pregnant women, the potential outcomes there are very serious.
Murdoch University biochemist Dr Garth Maker
There’s nothing particularly positive to say about naturopathic treatments generally – some of which (homeopathy, reflexology, iridology, acupuncture and cupping, to name a few) are not so much ‘natural’, whatever that means, as examples of comprehensively failed hypotheses (hardly worthy of the name). But so-called traditional Chinese medicine is on the lowest rung, considering how much damage it has done, not only to humans but to other species that have been horribly exploited in its name. The latest damning finding about what is actually contained in many of these unregulated pills will probably barely create a ripple amongst the anti-science crowd, but nevertheless it needs to get as much publicity as possible. You never know, maybe someone, somewhere will take notice (and we’re fighting a real battle here, because if you go online to find out about TCM, you’ll find the whole internet disturbingly skewed towards the positive). Please, if only for the sake of the children exposed to this crap by ignorant parents, let’s do something about this. It’s an effing outrage.
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.
an open letter to a homeopath
When I was in Canberra last year I came across an article in the Canberra Weekly, written by one Wesley Smith, director of the ‘Live Well Spa & Wellness Centre’ in Manuka, a Canberra suburb. It was called ‘Homeopathy in the cross-hairs’, and you can probably guess the rest.
I tore out the article, vaguely intending to do something about it, and promptly forgot about it, but having rediscovered it today, I’m thinking it’s not too late. An online version of Mr Smith’s (he’s not a doctor) article is here. On this centre’s website, I note that it advertises ‘holistic’ wellness (see my recent post), and offers ‘acupuncture, herbal medicine, kinesiology, naturopathy, remedial massage, meditation and yoga’ as some of its treatments – and reading the bios of Wesley’s quite large team tells me that cupping, EFT (Emotional Freedom Techniques), dry needling and ‘soft tissue therapy’ are also on offer, though I note that nowhere in these extensive bios is there any mention of a medical degree. The only mention of qualifications is in Wesley’s own bio – he has a Bachelor of Applied Science in Acupuncture from the University of Technology, Sydney (shame on the institution). But this gladbag of BS is too large to deal with, though it does indicate the depth of crazy in which our Wesley is mired. I’ll just keep to homeopathy, with maybe a dash of acupuncture (I can’t help myself).
So here’s a letter, which I’ll send by email to Mr Wesley Smith. It may mark the beginning of a rich relationship.
Dear Mr Smith
In reference to your article ‘Homeopathy in the cross-hairs’ published in the Canberra Weekly some time last year, I would like to point out some problems with your analysis of the situation with homeopathy.
Firstly, as you know, the NHMRC has now completed its review on homeopathy and its findings were made available online in March 2015. They are clear: there are no health conditions for which there is reliable evidence that homeopathy is effective. The review also states that
People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness. People who are considering whether to use homeopathy should first get advice from a registered health practitioner.
Having visited your website and read your biography, I’ve found that you’re not on the APHRA list of registered health practitioners. I could check out your team, but as I notice that no medical qualifications are mentioned for any of them, it’s probably reasonable to assume that none of them are in fact registered health practitioners.
I find it strange that in your summary of homeopathy in your article, which is reasonably accurate as far as it goes, you describe its principles as ‘challenging’, and suggest that it would be particularly so for those with some knowledge of basic chemistry and ‘a lack of imagination’.
While imaginative insight is indeed required to postulate a new theory, as with Maxwell’s insight about the relationship between electricity and magnetism, Einstein’s insight about the relationship between space and time, and Darwin’s insights about competition and variation, the really hard work involves proving the theory to be true, as I’m sure you’ll agree. Maxwell and Einstein had to develop accurate, watertight, explanatory equations as proofs of their theories, to enable them to be tested ad infinitum by others. Newton developed a whole mathematical calculus, which has since become one of the most valuable tools available to science, in order to precisely calculate his revolutionary laws of motion. Darwin devoted a whole lifetime to providing detailed evidence of adaptive development in a wide variety of species…
Yet it’s remarkable how little work has been done, especially by self-proclaimed homeopaths, to provide proofs of the efficacy of homeopathy. Imagination is hardly sufficient. It seems that, out of exasperation, as well as a sense of ‘duty of care’, the NHMRC, representing medical professionals, has decided to take on this proof-providing responsibility, and the results have been damning, but unsurprising to any one with a scientific bent and a respect for evidence.
You’ve defended homeopathy by claiming there ‘must be’ hundreds of thousands of Australians who’ve been ‘astounded’ at how their bruises respond to homeopathic arnica. Surely you can’t expect any medically trained person to accept such claims as evidence. It would be like accepting someone’s word that hundreds of thousands of people have had their prayers answered by their god, therefore their god really exists and really does answer prayers. In order for such claims to be counted as evidence – as you well know – information would have to be gathered about this multitude of individuals, the nature of their ‘bruises’, and the mechanism by which the bruises responded to the treatment. You would think that homeopaths the world over would be enormously interested in how arnica, in such infinitesimally minute doses, has this miraculously curative effect. The fact is surely sensational and would revolutionise the treatment of bruising – essentially, internal haemorrhaging – around the world, saving millions of lives. Yet homeopaths appear not to have the slightest interest in causal mechanisms. They’re only interested in claimed effects. There are no laboratories working on how homeopathic treatments work, in testing and developing their theoretical underpinnings, in finding further applications for these truly extraordinary ‘principles’. Why ever not? How can homeopaths be so irresponsible? So completely incurious?
You claim that it’s impossible to dismiss the curative effects of this treatment as due to placebo. In other words, you know that it works. That’s fantastic news, now all you have to do is prove it. I cannot believe that this would be difficult for you, since you claim that hundreds of thousands of Australians (and presumably hundreds of millions worldwide) are astounded at the treatment’s efficacy. Considering this, you must be astounded, in your turn, at the NHMRC’s final report. How could they have got it so wrong? Furthermore, how is it that in Britain a study by Edzard Ernst (himself a professor of complementary medicine), which made a systematic review of the Cochrane Database of reviews (the Cochrane Database being justly famous for its rigour), found, again, that homeopathy had no discernible effect beyond placebo? Is there a conspiracy happening here? You seem to be suggesting as much when you write of the huge profits for pharmaceutical companies in successfully trialling their products, compared to the difficulties for poor homeopaths. But homeopaths could surely unite, with each other and with these millions of delighted clients, to provide the proof you need in the form of double-blind, placebo-controlled, randomised trials with large sample sizes. After all, you yourself have testified that the treatment is nothing short of sensational. It would surely haver wider application than simply healing bruises. If these principles really work, why wouldn’t they be effective for curing cancer, ebola, malaria, or any other scourge to humanity? The benefits would be such that you would be criminally negligent not to pool your resources and provide these proofs for humanity’s sake. There would certainly be a Nobel Prize for medicine in it for you if you were to organise the trials that led to these revolutionary cures, not to mention eternal fame and the gratitude of billions…
But let’s not get carried away. The ‘revolution’ of homeopathy has been around for over two hundred years, and it has never progressed beyond the French characterisation of it as médicine douce, the kind of medicine you take when you don’t need medicine, our fabulous immune system being what it is. If it really was as effective as you claim, pharmaceutical companies would have financed the research trials in a jiff, thereby turning their millions of dollars of profits into billions. Not to mention the fact that if homeopathic ‘principles’ worked, much of the science we know would be up-ended, and most of our modern physics and chemistry would have to be scrapped.
The real situation is as described by Dr Steven Novella at Science-based medicine:
… proponents of homeopathy would have the world believe that one man, Samuel Hahnemann, stumbled upon a fantastic secret two centuries ago (actually, multiple secrets) that defy scientific explanation, have been ignored by 200 years of scientific progress, and yet to this day would turn our scientific understanding of the world upside down. For some reason, however, believers just can’t seem to produce any convincing evidence for any of it, not even that homeopathic products have any properties at all, let alone clinical efficacy. After 200 years all they can produce are endless excuses and demands for more research.
And what do we have in your article, Mr Smith? In its last lines, true to form, you make excuses about (200 plus years of) limited funding, and demands for more research. QED.
the myth of holistic medicine
It does get my goat rather that so-called naturopaths, in spite of having varied and often contradictory therapies, love to call themselves practitioners of holistic medicine. It’s a feel-good term that, like spirituality, seems to make a virtue of its own vagueness. Of course, holistic medicine can be defined in a superficial sense – it’s treating the whole person, right? But how does that work in reality, and how do naturopaths manage it?
Well, the obvious answer is, they don’t. It’s nothing more than a propaganda term.
Clearly, holistic, whole-person treatment would be fabulous if it could be achieved, but it would entail not only knowing the whole anatomy and physiology of the client, but her psychology and her entire medical history from birth, and even before. Would there be any other way of treating ‘the whole person’?
Personalised medicine may in fact become the way of the future – I’ve heard as much – but that has nothing to do with naturopathy. That has to do with science – your personal microbiome, your heart rhythms, your cholesterol, your triglycerides, your lung function, your bowel movements, your bone density (not to mention your sequenced genome), taking more responsibility for those things as far as is possible and in co-operation with healthcare providers. Naturopathy is something else altogether – it’s about herbs instead of pills (unless they’re homeopathic), ‘age-old’ treatments such as reflexology and TCM rather than invasive tests and vaccinations, getting in tune with or detoxifying your body rather than taking impersonal prescriptions to your local impersonal pharmacist.
So the question is – how did taking an entirely chemical herbal treatment from a naturopath come to seem more holistic than taking a chemical such as theophylline prescribed by your specialist?
I don’t see how a naturopath would or could treat a client as a ‘whole person’ any more than a conventional GP could. Limited info, limited time, it’s the same whether your treatments are science-based or traditional. But I do know at least one happy client who swears by her naturopath, who really does treat the whole person, unlike the medical establishment, according to her. I haven’t pressed her to explain this, but I have my own nasty theory. The woman is clearly obese, and wouldn’t take kindly to being told so, and she’s found a practitioner whose greatest skill is to tell her everything but what she most needs to hear. At last, someone who really understands her, who really listens and accepts her own expertise about her own body. And it must be said that many doctors, full to the brim of years and years of training and practice, do sometimes treat their clients in an offhand or specimen-like way. The psychological effects of healthcare practice are surely underestimated. So many people, but especially the unhealthy, want to be seen as, or made, whole. ‘Holistic medicine’ therefore, makes for a very effective propaganda label.
Yet many treatments that eagerly make use of the holistic banner are about as far from being individualised as can be imagined.
Acupuncture supposedly manipulates your ‘chi’ or ‘qi’, a system of energy flow that, if it existed, could be individualised to the client. Some clients might have a different chi from others, just as we have different blood types, different hormonal levels, different cholesterol levels, different insulin levels, etc, all of which can be measured. But acupuncturists don’t measure our chi levels and give us a read-out. Why ever not? Surely that would be the holistic, personalised thing to do. The fact is, nobody, in the supposedly thousands of years of acupunctural history, has ever thought to isolate this energy force and describe its wave function or the molecules or particles associated with its action. Nobody has even shown the slightest curiosity about the physical properties of what is advertised as a fundamental energy source in humans and perhaps all other living things. That’s fucking amazing – the only amazing thing I can say about acupuncture. Yet, apparently, there are particular points in the body where chi is more abundant, and that’s where you should stick your needles, and at a certain depth, otherwise you won’t be in touch with the chi. So acupuncture depends entirely upon chi being a physical, measurable entity…
Say no more. Your chi can’t be personalised and made a part of your whole-person profile because it doesn’t exist.
Homeopathy also likes to travel under the holistic banner, and you’ll find it advertised in all those brochures featuring glowingly healthy individuals, often dressed in white, meditating or staring lovingly at the sky-spirits. The trouble is, homeopathic treatments are designed to treat the illness, not the individual. The bogus ‘law of similars’ involves swallowing pills which are supposed to contain material ‘like’ whatever it was that made you sick. If that doesn’t sound very scientific, don’t blame me. It’s obviously a problem if you don’t know what made you sick, but the solution is simple. Just pay attention to your symptoms – say itchy skin or funny-coloured urine – and take pills containing a substance that produces similar symptoms. But hang on, won’t that just make you more sick? No, not at all, because the offending substance will be diluted to infinitesimal proportions. Okay, but won’t that render it useless? Ah but you’re clearly unaware of the ‘law of infinitesimals’ which defines a substance as increasing in potency the more it’s diluted. Welcome to the world of homeopathy, where the more truth is watered down, the more obviously true it becomes.
But the point I wanted to make here, before becoming entranced by the homeopathic mindset, was a simple one. Far from treating clients as ‘whole people’, it is solely concerned with physical symptoms. A homeopathic treatment would work just as well on a horse or a hedgehog as on a human. The client’s humanity, let alone her particular history or psychological make-up, isn’t a factor. It’s as far removed from holistic medicine as you can get.
I could go on – reflexology, iridology, reiki, chiropractic – these are all bogus, and the fact that they all jump eagerly onto the holistic bandwagon is further evidence of their crappiness. Holistic medicine is an impossible ideal, though personalised medicine, where you take personal responsibility to educate yourself about and keep records of your own health and physical maintenance, in collaboration with health specialists, is a great way to go. And that involves a lot more than just holding hands in a smiley circle.
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.