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The sting

Following his own empirical observations that bee “treatments” helped his arthritis, a Levin bee-keeper is claiming that he is being ignored by the medical profession. (Press 3/8/93) Not surprisingly, his trial of 11 patients failed to impress skeptical observers. Two patients dropped out and the remainder reported that the “sting” was effective. Having paid for the privilege of being stung, a sensation to be normally avoided, they are hardly likely to say that the treatment was worthless.

In the middle ages, hornets were applied to the skin as a treatment for plague. Nothing appears to have been learned from such unpleasant, not to say dangerous, treatments.

Bogus professor

An unqualified woman who posed as a doctor and professor, was sent to prison for 6 months for fraudulently claiming that she could cure cancer and AIDS. Analysis of her product, Cancelle, or CH6, showed “it had no medicinal properties and contained toxic elements.” (BMJ 306 p1499).

It is ironic that the courts (in the UK at least) will move swiftly to deal with quacks, but the medical profession has failed to take action against registered medical practitioners who practice quackery such as homeopathy and EAV diagnosis.

Caesarean sections

Australia has a high rate (30-35%) of caesarean sections among private patients, and the introduction of a global obstetric fee that applied irrespective of the mode of delivery did not change the proportion of caesarean deliveries. (BMJ 306 p1218) The caesarean rate in Brazil is an amazing 50% on average, with the highest rates among the poor. Two reasons for this are a virtual absence of midwives and the belief (encouraged by obstetricians) that a vaginal delivery will permanently impair normal intercourse afterwards. Both of these examples demonstrate how doctors can develop bad practices when the socio-cultural environment allows this to happen. Only patient education with strong and ethical professional medical leadership, can prevent this kind of surgical abuse.

Low back pain

Readers will remember Denis Dutton reporting his experiences with an episode of low back pain, or lumbago (Skeptic 24). A Canadian study (British Journal of Industrial Medicine 1993; 50:385-8) found that the best treatment for uncomplicated lumbago was to remain active. The traditional treatment of bed rest was thought to encourage chronic invalidism.

This theme was continued by Robin McKenzie (Press 11/6/93) who attacked the current traditional approach to low back pain. Of physiotherapy, he said “it had for 75 years relied on unproven methods and `hocus-pocus’ electrical gadgetry” and he went on to say that “doctors should prescribe active rather than passive therapies.” Most controversial was his statement that “50% of workers on compensation were feigning illness.”

I am sure that there is an element of truth here. Physiotherapists use a wide variety of treatments and machines, many of which have not been adequately tested. It is too easy for people to refuse to accept responsibility for their own recovery and become chronically dependent on ACC. This applies not only to back injuries but other conditions such as chronic fatigue syndrome (CFS) and occupational overuse syndrome (OOS).

Work-related illness

Readers will be familiar with my position with respect to OOS, which has its roots in abnormal illness behaviour and psychological factors. It is interesting to compare it with the “sick building syndrome” (SBS), another new age medical invention. At last someone has done a trial of randomly increasing the ventilation rate while getting workers to report their perception of the indoor environment. (NEJE 328: 821-7)

To quote the authors: “Increases in the supply of outdoor air did not appear to affect workers’ perceptions of their office environment or their reporting of symptoms considered typical of the sick building syndrome.”

I would like to offer what I regard as a more likely explanation of the SBS which also relates to OOS. People crowded into a large building, working at VDUs and perhaps isolated from each other are always going to be vulnerable to a belief that the working environment is in some way responsible for vague and ill-defined malaise.

A report of a survey in the Christchurch Press (21/5/93) confirmed a high level of stress and dissatisfaction in the workplace. Half of the respondents said they would change jobs if they could and many felt that changes in conditions had resulted in more work for less pay. Most felt that they had less power to control their work environment.

Such surveys are extremely valuable because they provide a clue to the origin of conditions such as CFS, SBS, and OOS. I have no difficulty in accepting job-related stress, but I would prefer to see some honest acknowledgement of this by patients and doctors instead of the fraudulent collusion which creates mythical conditions as CFS, SBS and OOS.

Placebo controlled trials

Since such trials appeared in the late 1940s they have continued to be a valuable tool for investigating the efficacy of new treatments and drugs. Fish oil supplements were tested against placebo capsules for the treatment of psoriasis and there was no significant improvement in either group (NEJM — reported in GP Weekly 7 July 93). Refer also Skeptic 27 for an excellent review of the placebo effect by Dr Bill Morris.

Weight loss delusions

The diet industry is worth millions as women strive to achieve the impossible standards set by the fashion industry. Journalists have even invented a new term for fat, “cellulite”, which apparently looks and feels different from other body fat. (Marlborough Express 24 Sep 92) It can be removed by massage and body treatment products. Obese subjects can pay $180 to be blasted with water jets which “eliminate fat deposits and excess fluid” while hydrotherapy with miracle algae can “restore a balanced energy flow to the body”. (New Scientist 1 June 1991 p47) I hope this particular clinic has good grease traps in its drains.

Other researchers try and tell us that obesity is inherited and therefore nothing can be done. This ignores the success of weight-watchers and the obvious argument that if weight can be gained it must also be able to be lost.

A study (NEJM reported in Patient Management June 1993) found that diet-resistant patients under-reported their actual food intake by 47% and over-reported their physical activity by 51% and “diet-resistant patients were significantly more likely than control subjects to believe that they had a genetic or metabolic cause for their obesity, and to describe their eating behaviour as relatively normal”. This important work clearly demonstrates yet again the importance of patient beliefs in relation to illness behaviour.

While on the subject of over-eating, I note that a typical cat living in Britain is given twice as much protein a day as that eaten by a typical poor African.(BMJ Vol 306 p1078)


In Skeptic 26 I offered to go into business with anyone prepared to join me in selling pure water labelled as “homeopathic preparations”. Two homeopaths were indignant about the use of active ingredients in the case of herbal medicine poisoning I described in Skeptic 28 and one went on to say “it is absolutely unethical for any medicine to be sold as natural and especially as homeopathic if it were to include pharmacologically active ingredients”. (Letters – BMJ Vol 306 p656)

I still think it would be a bit of fun to sell some pure water (labelled as homeopathic preparations), invite prosecution and argue it out in court. It could prove to be a more useful arena in which to examine the enduring scam of homeopathy. I could enjoy hearing homeopaths being cross-examined by a skeptical lawyer. At least selling pure water is honest!

Poached Tiger?

Not content with exterminating tigers in their own country, the Chinese have over 110 factories turning tiger bone into tablets, wine and various confections. Presumably the ingestion of such products is believed to confer some of the vigor and vitality of the unfortunate tiger. There are only about 6,000 tigers globally and trading in tiger products is banned by international convention. What a monumental folly that these magnificent and intelligent animals end up being turned into useless traditional medicines because of human stupidity and superstition. (Lancet Vol 341 p46)

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Skin Lighteners

The pop star Michael Jackson has denied that he uses chemicals to lighten his skin and claimed to be suffering from a disorder called “vitiligo,” which is a spontaneous loss of skin pigment. Jackson said “There is no such thing as skin bleaching. I’ve never seen it. I don’t know what it is.” (GP Weekly 24 Feb, 1993)

In fact, skin lighteners are used extensively by Afro-Caribbean women in response to social pressures. These preparations contain hydroxyquinone which inhibits the production of melanin (normal skin pigment) but cause skin damage with prolonged usage.

“Because the creams are cosmetics rather than drugs they are not subject to stringent tests or regulations and of 33 skin lighteners for sale in Southwark, half were wrongly labelled; six had illegally high hydroxyquinone contents; three contained mercury, which is banned by European law; and two contained cortisone, which should be available only on prescription.” (BMJ Vol 305 p333)

This is a classic illustration of the abuses that occur when potent drugs are allowed to be dispensed as “cosmetics”. I do not know whether Michael Jackson truly does suffer from vitiligo, but with his history of repeated cosmetic surgery and hyperbaric oxygen treatment I would not be surprised if he is using skin lighteners.

Addicted to Sugar

Woman’s Weekly 14/12/92 carries the story of a woman who was chronically depressed until she saw an iridologist who proclaimed the patient “a sugar addict. Her exceptionally high sugar-loaded diet had filled her body with toxins. The whites of her eyes were yellow, and her colon contained faeces which had been present for years.”

This story has all the elements of quackery. Iridology is arrant nonsense adequately dealt with in one of our truth kits, and just what are the “toxins” so favoured by quacks? Can the colon really hold faeces that “have been present for years”? The world’s record for constipation is held by a man who resisted the temptations of the toilet for 368 days. He is said to have become weak after delivering 36 litres of faeces on June 21, 1901, but “there was much rejoicing in the family.” (CMA Journal May 22, 1976/Vol. 114)

This woman clearly suffered from a depression and wasted years in looking for outside “causes”. The iridology diagnosis and treatment is a form of placebo validation of her symptoms, which has allowed her to get better without facing up to more important psychosocial issues. The standard of such stories in the Woman’s Weekly is so pathetic that the staff surely deserve a permanent bent spoon award.

Sports Enhancement

It appears that athletes will do anything to enhance their performance in their chosen sport. Ben Johnson could not give up the use of anabolic steroids and has earned himself a permanent disqualification. Other athletes, such as Katrina Krabbe, have received feeble punishments for the same abuses. Some athletes go to extraordinary lengths to either justify or rationalise their use of performance enhancing drugs. A swimmer (Marlborough Express 16/3/93) complained that a heavy beer-drinking session led to her urine test showing twice the permitted testosterone levels.

A survey of private gymnasiums (British Journal of Sports Medicine 1992;26:259-61) found that 62 out of 160 customers had taken anabolic steroids, along with other drugs to counter the side effects of the steroids. Steroids have been used by some occupational groups, such as debt collectors and bouncers, to enhance physical size and improve employment prospects.

Users have also been observed to participate in needle exchange services through their requirement to administer the drugs intramuscularly. (BMJ Vol 306 13/1/93 p459)

Cooking with Radon

Disused uranium mines are finding a new use as chronically ill people rush to sit in the “health mines” in order to inhale radon gas which is touted to cure everything from migraine to blindness. For as little as $2.50 you receive exposure to radiation while “having a good time playing cards, doing jigsaw puzzles, and reading magazines.” (People Magazine)

(Un) Natural Remedies

Readers will remember the tragic deaths of twin infants from congenital infection of the mother with Listeria, a type of bacteria widely found in seawater and in particular, mussels. It is alleged that the infection was acquired through mussels eaten by the woman as a “natural” source of iron. If only she had taken the completely safe iron tablets available from her local chemist but then, they are not “natural.”

In Belgium, many women have suffered renal failure and died through taking slimming powders containing Chinese herbs, in some cases prescribed by doctors! (GP Weekly 3/3/93) Women are cynically targeted by the diet industry, and it is not surprising that obese people continue to be attracted to slimming remedies which can be eaten.

Oddities of the East

In China, ants are being used in the treatment of Hepatitis B and various rheumatoid diseases. 28000 patients have been treated using medicine made from ants which are rich in zinc and (unspecified) trace elements. 20 percent of a survey of 339 patients were described as “cured,” 77 percent were helped and only 2 percent remained unchanged. No one was made worse. The application of percentages and vague reports of “improvement” does not improve a fundamentally implausible study. (GP Weekly 20/1/93) Applying Skrabanek’s demarcation of the absurd theory, a clinical trial is not indicated.

Chinese herbal preparations often have inscrutable ingredients. A post-menopausal woman attending gynaecology outpatients had a biopsy taken from her uterus, which showed tissue changes consistent with the use of hormones. She was on no medication apart from a herbal remedy prescribed by a homeopath. The doctors found that the list of ingredients included 10 [micro]g of ethinyl-oestradiol (a potent female sex-hormone) with no warnings about long term use. (BMJ Vol 306 16 Jan 93 p212)

The irony of a homeopath prescribing a potent remedy will not be lost on readers. Homeopaths should confine their prescribing to their harmless placebos.

Continuing the theme of arcane Eastern practices, even forms of therapeutic massage are not without side effects. Following a vigorous bout of Shiatsu (Japanese style massage) a patient developed an attack of shingles caused by a reactivation of latent Herpes zoster infection of the affected skin area. (NZ Doctor 18 March 1993)

A man from Belize (Central America) was admitted to hospital with an abscess on his arm which was leaking a shiny pus. He admitted to injecting “white magic” into his forearm a month earlier and an X-Ray showed high density globules in the muscle of his arm.

The material in the injection was mercury, used according to Mayan superstition to ward off evil spirits and increase sexual potency. Tubes of mercury are cheap and freely available in Belize. Historical figures such as Henry VIII were treated for syphilis with mercury, which led to the expression “a night with Venus and a lifetime with mercury.”

The herb chaparral (aka. creosote bush) has been in the news lately, implicated as a cause of toxic liver hepatitis. It is under scrutiny in the US (NCAHF Vol 16 No 1), but as usual our own Health Department is dithering instead of banning it and putting the onus on the distributor to prove that it is safe. I have sent them a copy of the NCAHF article.

Natural Remedies Neglected

Neglect of proven health and hygiene measures can lead to disease as well. 46 people were infected with Salmonella from an imported Irish cheese made with unpasteurised milk. The infection was traced to four cows excreting the same strain of Salmonella in their faeces. There is no excuse for these human infections because pasteurisation kills all disease-producing bacteria commonly transmitted in milk. (BMJ Vol 306 13/2/93 p464)

Soviet Russia had fewer than 60 cases of Diptheria during the mid-1970s. The present social and economic chaos has led to a resurgence of this disease and almost 4000 cases occurred in 1992. Immunisation used to be compulsory but there are now fears that the vaccine is dangerous and AIDS may be caught from the needles. Diptheria has become endemic in rural areas where the standard of health care is very low. (BMJ Vol 306 13/2/93)

Even New Zealand has groups of ignorant people actively campaigning against immunisation. Those who forget the past are condemned to repeat it!


Thoracic outlet syndrome (TOS) is characterised by subjective complaints of pain and sensory changes in the upper limbs. Skepticism in the literature prompted researchers to examine data, which showed that the diagnosis of TOS is heavily influenced by a patient’s insurance coverage. Those without such cover are rarely diagnosed as having TOS. (NCAHF Vol 16 No1)

There are many operations performed by surgeons which are of questionable indication. Surgery has a potent placebo effect and most surgeons would be reluctant to put operations to the test of a placebo controlled trial as outlined by Dr Bill Morris in the last issue of this journal.

Black Spot Mystery

Many mysteries turn out to have mundane explanations which are seldom accorded the same publicity as, for example, alien abduction stories (actually due to a dream state in susceptible individuals). Local health authorities in Green River, Wyoming sent out questionnaires, mapped homes and exhaustively tested scabby spots from the scalps of school children before concluding that the spots were flakes of tar which had blown off the school roof! (NZ Doctor 1/4/93)

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In the last issue I discussed how quackery can be practised by New Zealand doctors with impunity, “if they do so honestly and in good faith.” Alaska has a similar clause which only disciplines maverick doctors if they harm their patients. In fact, the latest NCAF newsletter outlines how a Dr Rowen has been appointed to the state medical board after “curing” the governor’s wife of lumbago by extracting one of her teeth. The link between the tooth and the back was made by an electro-acupuncture circuit using a Vega machine.

Dr Rowan also practises chelation, homeopathy and is described as “anti-fluoridation, anti-aluminium cookware, and anti-dental amalgam.” The Alaskan State Medical Association has strongly protested and one medical board member has resigned.

More on Bands of Hope

Sea Bands are available from NZ Pharmacies as well as Elekiban which is another form used for musculoskeletal complaints. As outlined in Skeptic 26, these are acupressure devices which have no scientific effect other than placebo. I was interested to read that the Institute of Naval Medicine (INM) had tested Sea Bands because on my recent overseas trip I spent a day a day at INM having a look at their research programs on Hypothermia and Diving Medicine.

Acupressure is an equally false derivative of acupuncture which works through a combination of the placebo effect and suggestion. Having written a truth kit on acupuncture I was alarmed to read that the Medical Acupuncture Society of NZ (MASNZ) is setting up a register of medical acupuncturists (150 hours training minimum)(NZ Doctor 21/1/93). Since acupuncture has no proven basis this is totally unnecessary, rather like setting up an appreciation society for the emperor’s new clothes.

As a former acupuncturist, I can teach anyone to be a safe and confident acupuncturist in about one hour. Perhaps I should give a demonstration at our next conference in the style of Dr Bill Morris and his vivid demonstration of homeopathy.

Pharmaceuticals Around the World

I have long held the belief that NZ doctors tend to overprescribe drugs. While working in general practice myself, I was often aware of pressure from patients to prescribe drugs. However, until now I haven’t come across any comparative data from other western countries. A survey of 495 randomly chosen Australian GPs (Patient Management Nov 1992) found that a prescription item was issued for every consultation (a reduction from 1974 when 136 prescription items were issued per 100 consultations!)

In NZ our annual drug bill is about $600 million, or $185 per head, per annum. My family of four definitely does not consume $740 worth of drugs in a year! Some people must be consuming a lot of drugs. British doctors are described as “low prescribers of medicines” yet their costs were roughly the same at $165 per head per annum.(The Lancet Vol 340 August 8, 1992 page 364). Patients expect drugs, and doctors want to help their patients, so it is not surprising that prescription rates are high. The writing of a prescription is often a convenient way to end a consultation.

One of the major problems for third world countries is getting cheap, effective drugs which are truly necessary. Multinational drug companies continue to cynically exploit these countries by marketing both dangerous and useless drugs. In a letter to The Lancet (Vol 339: Feb 22, 1992 page 498), a Pakistani doctor explained how a child died after being given drops containing an anticholinergic drug and phenobarbitone. Such a preparation has no scientific medical indication and its use in NZ would not be allowed.

A survey from Peshawar (reported in The Lancet Vol 338:August 17, 1991 p438) found that 90% of general practitioners were using antibiotics and anti-diarrhoeals to treat diarrhoea instead of using the correct treatment of oral rehydration therapy.

In Bangladesh, (GP Weekly International 2/12/92), hundreds of children have been injured or killed by cheap brands of paracetamol containing toxic ethylene glycol.

Datura is a drug which is commonly abused by drug addicts. It contains atropine, which in high doses causes hyperactivity and hallucinations. Incredibly, cigarettes containing datura are licenced for the treatment of asthma in France because “many old people rely on the treatment because they don’t believe modern methods help them.” This is a classic example of the need to have a rational, scientifically-based pharmaceutical industry. Datura-containing cigarettes would not be allowed here (we used to have cannabis cigarettes on prescription up until the 1920s!) and their persistence in France is based on delusion, placebo effect and anecdotal reports of efficacy. (New Scientist 22 August 1992).

Drug treatment can also be irrational when it is used for a condition which has no clinical basis. On the European continent there is a widely held belief that low blood pressure is associated with specific symptoms and is a pathological state requiring treatment. There is no basis for this belief, because complaints of faintness and fatigue are made as often by patients with a normal blood pressure.

Blunderbuss Treatment

A doctor whose daughter fainted on a hot day (BMJ Vol 299, 18 Nov 1989, p1284) reported that a French doctor prescribed a proprietary preparation called Tensophoril which contains the following ingredients: dopamine hydrochloride 15 mg, boric acid 15 mg, amylobarbitone 15 mg, and ascorbic acid 250 mg.

This sort of combination has been rightly criticised as “blunderbuss” drug treatment. Dopamine is inactive when given by mouth; boric acid is toxic and should not be taken by mouth; amylobarbitone is a long acting barbiturate sedative and the ascorbic acid dose is that which would be found in about 5 oranges. Fortunately the doctor’s daughter elected not to take the treatment and recovered fully.

Drug Licensing

I was much more impressed with a letter (The Lancet Vol 340: August 15 1992, p432) which detailed how Israel dealt with homeopathy. Drug registration required proof of efficacy and this was still not forthcoming after three years. Unfortunately the new legislation did not apply to raw materials and homeopathic preparations were able to be imported as such. The author regretted that “the compromise is not entirely satisfactory in that scientific assessment of efficacy cannot be applied.”

The situation in Germany is hardly credible. Drug licencing does not depend on clinical trials, but on anecdotal evidence supplied by medical practitioners, many of whom are paid by the same companies whose products they are endorsing. This is hardly surprising when 7 out of 10 general practitioners practise alternative medicine.

For example, the Federal Health Office (BGA) was forced to licence a totally useless product containing “1 g loess soil” for the treatment of diarrhoea, because “German law does not define the term efficacy.”

Another useless drug is Arteparon, an extract of bovine lung used for the treatment of osteoarthritis when given by injection. The drug is licenced because the courts have determined that “the efficacy of old drugs must not be judged by modern scientific standards.” Arteparon causes severe allergic reactions, a fact not recognized by the courts because “proof of causality beyond any doubt was needed for each case of adverse reaction.” The judges obviously overlooked the irony of demanding a higher standard of proof of side effects than of efficacy. The cost of these crazy decisions is a huge drain on the German health system. One quarter of the DM20.7 billion spent annually on pharmaceuticals is for useless drugs.

I have no idea whether our own drug lists contain either questionable or useless drugs and these reports have prompted me to have a browse through the GP’s pharmacopoeia New Ethicals. Watch this space!


While overseas I collected a number of articles worthy of skeptical attention. Although a confirmed Francophile, I wonder whether they have any effective organised groups of skeptics. Homeopathy is part of mainstream medicine and astrology is big business.

Thallasotherapie is described as a treatment modality using seawater and its products. Patients (or, in newspeak, clients) can either float in seawater or apply heated mud made from seaweed. Obese subjects will be delighted to know that their tissues can be “deflated by various jets and massages.”

It is claimed that elements such as magnesium and calcium are able to “get into human tissues” and “engender the same consequences as a hoemeopathic treatment: stronger immune system and stimulation of cells.” In fact, human skin is relatively impermeable and certainly does not behave like a semipermeable membrane. Essentially this therapy can be carried out for nothing in the privacy of your own home by having a long soak in a hot bath. If you feel so inclined, toss in a handful of seaweed.

More on RSI

There has been a lot written on this subject, but so far little written to explore alternative explanations for these spurious symptoms which are essentially a conversion disorder (well described in basic psychology texts).

Whole forests have ended up as publications on ergonomics and an army of occupational physicians continue to pontificate over the delusion of RSI. It is therefore refreshing to read letters (Medical Journal of Australia Vol 157, Sep 21 1992, page 427) from skeptical occupational physicians who have both correctly diagnosed this condition as a conversion disorder and correctly treated it by “helping patients sort out their personal, social, family and financial problems.”

Even More on Chronic Fatigue Syndrome

In Skeptic 21 I summarised the key research in this area, which does not support any infectious cause and shows clearly that the condition is a somatisation disorder.

If any readers are interested in further reading on this subject, there is a very good article in Patient Management Nov 1992, p13 by Robert Loblay. He reviews the historical development of immunology and demonstrates conclusively how history tends to repeat itself. For example, neurasthenia has been resurrected as chronic fatigue syndrome.

Many symptoms which people present to their doctors are often functional (somatisation disorders) and have no basis in serious disease. Some doctors have difficulty in accepting their own limitations in this respect, or the existence of psychological disorders, and it is easy for these practitioners to seek “magic” solutions such as acupuncture, homeopathy and dietary manipulations.

Psychological disorders cannot be explored within the context of the traditional five-minute NZ consultation and it is hardly surprising that alternative medical practitioners have more success when they give the patient one or two hours of their undivided attention (itself a form of psychotherapy).

Chelation Therapy

This is an intravenous treatment with a cocktail of vitamins and the drug EDTA, which is believed to chelate calcium which has been deposited in atheromatous plaques. Atheroma (Greek for porridge!) is an ageing process leading to fatty deposits in arteries (accelerated by smoking, high blood pressure, excessive dietary fat and diabetes) leading to coronary artery disease (CAD) and peripheral vascular disease (PVD). Poor blood supply through the narrowed vessels leads to chest pain in the case of CAD and painful legs in the case of PVD.

There is a proper double blind placebo controlled trial of chelation therapy for PVD currently under way in Dunedin Hospital. A similar study in America (Journal of Internal Medicine 1992, pp 231-267) showed no difference between chelation and placebo treatment. I hope to do a similar study of chelation treatment for CAD. We await the outcome.

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More on Chronic Fatigue Syndrome

An American study reported in the GP Weekly (2 Sep 1992) found that chronic fatigue syndrome was indistinguishable from depressive disorders. (Refer also Skeptic 21) Patients diagnosed as having CFS were likely to believe that their illness had a viral cause, but it is more likely that CFS is a new age variant of the 19th century neurasthenia.1

A large study reported in the BMJ is worth looking at in detail. 200 patients with CFS were studied. Many of the patients had tried alternative therapies which were “not helpful,” namely diets (27%), homeopathy (20%), hypnosis (5%). This has been confirmed in NZ by Murdoch, writing in the NZ Family Physician (Autumn 1992).

Again, most patients believed that their illness was caused by a virus and the study found that most patients had an emotional disorder. Despite this, most patients had recovered after two years and this outcome is also confirmed by Murdoch in an unpublished survey of New Zealanders with CFS. At all stages in the illness, “functional impairment was associated with several patient factors, including belief in a viral cause, leaving or changing employment, coping with illness by avoidance of exercise and alcohol, membership of a patient organisation, and emotional disorder.” The authors acknowledge that these factors may reflect a more severe illness and call for more prospective studies.

Despite the high incidence of emotional disorder, very few of the patients had been referred to a psychiatric outpatient clinic.

Despite the considerable evidence against an infectious cause of CFS, an Australian doctor has been treating patients with intravenous gamma globulin2 in what is described as a placebo controlled trial. Unfortunately, no reference is given to the trial and until I can get these details I will have to reserve judgement. Watch this space!

Clearly patients resist the suggestion that chronic fatigue has a psychological basis, and unfortunately some members of the medical profession continue to foster this belief. Of concern is the activity of quacks touting EAV, homeopathy, anti-candida diets and other useless nostrums. Patients should not be allowed DSW benefits unless they have willingly cooperated with a program of cognitive based psychotherapy.


1. Chronic Fatigue Syndrome. American Family Physician March 1992 p1205.
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2. Acceptance and treatment of CFS is improving. NZ Doctor International Oct 1st 1992.
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Follow up of patients presenting with fatigue to an infectious diseases clinic. British Medical Journal July 18th 1992 (also reported in New Zealand Medical Journal Sep 9th 1992, p366)

Chronic fatigue syndrome. The Lancet May 30th 1992, p1349

Psychiatric diagnosis and CFS link. GP Weekly Sep 2nd 1992

Fake GP

I was only mildly surprised to read in the BMJ (June 27th 1992, p1652) that a doctor with no medical qualifications had worked for 30 years as a general practitioner. All that is required to be a successful GP is the ability to listen sympathetically to patients. This is more effective than the millions of dollars wasted on drugs such as tranquilisers and antidepressants.

It took some time before the local chemists became suspicious and I quote one of them:

“If one 5 ml spoonful of hair shampoo is to be taken three times a day you tend to think there is something wrong. Time and time again there were inhalers to be injected, tablets to be rubbed in — all very unusual.”

Unfortunately no information was given as to whether any patients had been harmed and, conversely nothing from grateful patients. How on earth did he last 30 years before being exposed? I conclude that he must have been helping enough of his patients to forestall complaints about his eccentric prescribing. The English have a reputation for eccentricity and they certainly must have indulged themselves with this doctor!

Fishy Tale?

In a tribute to anthropomorphism, a Dr Motha will be birthing mothers in the company of dolphins who can “make ultrasonic communications with the fetuses.” All becomes clear when we are told that Dr Motha runs an alternative medicine clinic “including aromatherapy and reflexology.”

Personally I have always thought that dolphin intelligence was over rated since reading Restaurant at the End of the Universe when, at the end of the world, dolphin squeaks were translated as “goodbye and thanks for all the fish.”
GP Weekly August 19th 1992

Fringe Medicine and the Medical Practitioner

The New Zealand Medical Council normally does not involve itself in criticising unorthodox treatments unless the patient suffers harm. Doctors practising quackery are protected by a clause in Section 58, subsection 4 (2) of the medical registration legislation, which states: “no person shall be guilty of infamous conduct merely because of the adoption and practice of any theory of medicine or surgery if in doing so he has acted honestly and in good faith.” I find this statement disappointing, because a medical degree surely implies a knowledge and acceptance of scientific principles.

This clause has been dropped from the same legislation in Australia, Britain and Canada. However, the Medical Council has made it quite clear that quack doctors have to satisfy the doctrine of informed consent by fully briefing their patients “that these treatments are not part of conventional medicine and hence he or she is not practising as a registered medical practitioner in providing these therapies.” The medical registration authorities in Ontario, Canada obtained a change in their act which allowed them to ban such unproven remedies as amnion implants and chelation therapy. They also erased from the register a doctor who combined pendulum dowsing with a form of vega testing. I look forward to similarly robust attitudes towards dealing with quackery by our own authorities.

Having enjoyed the study of general science, I am amazed at the capacity of some doctors to believe in quackery. As H. L. Mencken said, “How is it possible for a human brain to be divided into two insulated halves, one functioning normally, naturally, and even brilliantly, and the other capable of ghastly balderdash?” The reference quoted below is well worth reading.

Unorthodoxy and the Registered Medical Practitioner. David Cole. Patient Management Vol 21 No 9.

Irlen Lenses

In Skeptic 22 I criticised the promotion of Irlen lenses in New Zealand and called these a quack remedy. Since then I have been criticised by Matthew Hobbs (Skeptic 24 — nice to have some feedback) on the grounds that it remains to be seen whether these lenses are a proven remedy for reading difficulties such as scotopic sensitivity.

My use of quack in this context is straight from the Concise English Dictionary: “one who offers wonderful remedies or devices.” Firstly, there is no evidence of the existence of the condition “scotopic sensitivity” and secondly, as the coloured lenses have not been tested they should not be used, as efficacy has not been established.

An article in the Marlborough Express (Sep 24th 1992) outlined how a 10 year old with reading difficulties was fitted with coloured plastic lenses. After six months his reading had improved 100 percent. What alternative explanation is there for this improvement, and how was the improvement measured? It is most likely that his reading disorder was related to aberrant conditioning. The more his parents expressed concern, the more reinforcement was given to the “poor reading.” The coloured lenses are a placebo associated with a change in management which, along with the passage of time, has lead to an improvement in his reading.

Faith Healing

Dr Keith Davidson kindly informed me of the source of the quote mentioned in Skeptic 24 “Every day in every way, I’m getting better and better.” It came from someone called Emile Cove. Keith also sent me a cutting from the Christchurch Press detailing the activities of an American faith-healer by the name of Morris Cerullo.

The article demonstrates the obscene side of evangelical fervor. People were warned “Cynicism will sour you, bring cancer to you, and disable you.” The audience revelled in an atmosphere of mass hysteria and were told by an expert on “biblical economics” that there was no pressure to give money but the amount given would determine how far God would move towards miracles! The cartoon that came with the article is great. It shows Cerullo gesticulating while his shadow is the outline of a devil.

The evidence for faith healing is not good. As most deluded beliefs rest on faith, and faith is not amenable to testing, it is unlikely that testing will ever be done. In fact believers are on record as saying that testing claims of faith healing would be disrespectful to God.

Skeptics and Consumerism

Members of the NZ Skeptics have enjoyed some media exposure lately. Denis Dutton has been conducting a vigorous rebuttal of acupuncture beliefs (Patient Management, September 1992) and Vicki Hyde is “Eyeing Alternative Medicine” in the August edition of the NZ Science Monthly.

Consumer magazine were so unhappy with our criticisms of their alternative medicine story that they came out fighting and awarded us with a magnifying glass. I have used it in vain to re-examine their original article, but I have not changed my mind about its feeble journalism. Consumer journalists should read NZSM to see how their story should have been treated.

A new development is Maori medicine, or rongoa, (NZ Doctor, August 20th 1992) Given reasons for its use by Maori are an inability to pay for prescriptions and a belief that rongoa can provide something that western medicine cannot. The Bay of Plenty Area Health Board has provided $15,000 for traditional Maori remedies, such as red matipo to purify the blood and para blue gum for asthma. These treatments are administered in an atmosphere of “love and kindness.”

I doubt whether any of these remedies will ever be subjected to a clinical trial, because such treatments have to have some kind of rational basis to start with, and any results are clearly explained by the very powerful and under-rated placebo effect. At a time when Maori health has never been worse (e.g. smoking-related disease) I find it incredible that an AHB can waste money on this nonsense.


After our little tiff with Consumer magazine, I wrote to the School of Pharmacy in Dunedin to ask whether they would consider doing some tests of homeopathic solutions. Peter Hayes (Lecturer) kindly replied to my letter and enclosed a copy of a paper entitled “A case for homeopathy” written by a Scottish pharmacist, Dr Steven Kayne.

It is fascinating to read the intellectual rationalisations used by otherwise intelligent people in order to indulge their deluded beliefs.

Kayne concedes that increasing dilutions leave no discernible molecules in solution and then goes on to say “chemical analysis is therefore inappropriate”!!!

He further concedes that he cannot explain the mechanism of action but goes on to say “it is extremely difficult not to be impressed when one sees therapeutic efficacy clearly demonstrated.”

Evidently he discounts the placebo effect and refers to “published work in human and veterinary environments.” None of the references quoted support these claims. Furthermore, he says “It is inconceivable that consumers would continue to buy these [homeopathic] products if it was all a giant confidence trick.” He obviously needs to have a chat to some of our skeptical psychologists.

Finally, he refers to the enormous volume of circumstantial evidence “that the remedies actually work — patients do get better.” This is called the “Bellman’s fallacy” — because something has been said many times it must be true. His last word is “homeopathy should be available because patients want it, because it is safe and because it works.”

The Dean of the Pharmacy School also wrote and pointed out “because of patients’ belief in complementary medicine, I doubt that even if we were to show that they were purchasing pure water, it would cause any change in attitudes.”

I am forced to agree with him, but I could not help wondering what would happen if I started selling pure water labeled as various homeopathic remedies. I could make a fortune and it would be difficult to be prosecuted for fraud. Anybody want to go into business?


The same day that I was writing all this, I received an article from Bernard Howard written by one of my favourite skeptics, Petr Skrabanek. One of his best articles on the philosophy of skepticism is “Demarcation of the Absurd,” The Lancet April 26th 1986, in which he argues that it is possible to be too open minded.

Briefly, he argues that we need a demarcation of the absurd so that we don’t bother spending our whole lives on the look-out for flying pigs. Instead, we accept that the probability is so low that we don’t waste our time either looking or testing for airborne swine.

The article that Bernard sent is called “Why we must keep the lid on the black magic box” (Healthwatch Newsletter Summer 1992) and in it Skrabanek argues that testing of irrational beliefs can give them spurious respectability and “no amount of testing will convince a believer that he is mistaken.” Skrabanek also reviews the development of “black-box” quackery, which I have already mentioned can be practised in NZ with impunity due to our feeble medical registration legislation.

That reminds me of a television program on water divining where James Randi tested the top water diviners in Australia. None of them detected water flowing through one of ten pipes any better than chance. At the conclusion of the experiment he asked them about their beliefs which were totally unshaken!

Hokum Locum


One of the techniques used by quacks is to attack conventional medicine as being a conspiracy against the laiety.

For example, in an article entitled “GP says vitamins wrongly dismissed as quackery”, a Dr Piesse criticises clinical trials and then outlines how he uses intravenous injections of vitamin C for flu and vitamin B12 for genital herpes.

He claims, “If you had genital herpes I’d give you an injection of B12 and the herpes would heal up within 36 hours” and “If you came to me having had flu for three or four hours, I’d give you a couple of syringes of ascorbate and you’d walk out without the flu.”

He alleges that vitamins are ignored because “they had not met the ‘semi-religious’ tests of validity.”
GP Weekly, 25-3-92

I wish I had an injection that would cure such a breathtaking ignorance of infectious diseases! How many people go to the doctor after having had the flu for 3-4 hours? It would be nothing short of miraculous if an infectious disease could be eliminated by intravenous vitamin C. Who was it who said if a miracle is proposed suspect a fraud?

Of course genital herpes could heal up within 36 hours of an injection of vitamin B12 but only if it was due to heal anyway. Any other effect from these injections is obviously mediated by the placebo effect, which is very strong from injections.

If this doctor thinks that he is on to some fantastic advance in the treatment of infectious diseases he is duty bound to publish his results in a peer-reviewed journal. I find it ironical that Dr Piesse criticises this process as being “semi-religious” but then expects us to accept his own results on faith.

Wholly Water?

While on the subject of faith, thousands of people are flocking to a small town in Mexico where a quack is touting his special well water as a cure for everything from AIDS to terminal cancer.

This special water weighs less than ordinary water, a fact confirmed by a laboratory in Mexico City. Being ignorant of physics, I can only assume that they do not perform their laboratory tests with the same gravity as the rest of us. The well owner has been dispensing free water so far but acknowledges that his product is “worth its weight in gold”, and he plans to start selling it soon.

This has all the hallmarks of a scam. Take an alleged miracle (or more likely a lie) and after a few endorsements and accounts of miraculous recoveries, have an entrepreneur market the cure to a population who are both devout and ignorant.
Christchurch Press

Pyramid Selling

Remember pyramid selling? It’s arrived in the health market. A 10-metre high replica of the Great Pyramid of Egypt is currently being “tuned in” by the Havalona Spiritual Health Centre and will then “aid the healing process by supplying additional energy so the body can heal itself more quickly and effectively.”

Pyramids are supposed to sharpen blunt razor blades and we are told that cut flowers placed under the structure were still alive 3 weeks later. I wonder whether any members would be prepared to participate in such a clinical trial?
Christchurch Press 17/1/92

Silly Smorgasboard

A quick review of the Christchurch Press Making It Happen column (27/4/92) shows a smorgasboard of silly beliefs and practices. A naturopath planned a talk on natural immunity, which means not being immunised and being protected by everyone else who is.

If that doesn’t interest you, try Pulsing, a gentle rocking technique costing $80, which brings a state of deep relaxation and awareness, surely a contradiction in terms. Personal empowerment using creative visualisation reminds me of a long forgotten guru who taught his adherents to chant “Every day, in every way, I’m getting better and better.” Can anyone remind me who taught this?

In addition to Ayuverdic medicine, there is now Vipassana, an “ancient Indian meditation technique, said to get you in touch with the universal truths of impermanence, suffering and egolessness.”

This could be useful for Housing Corporation staff. Perhaps the Christchurch Skeptics should start advertising their meetings in this same column. Skepticism clearly needs attractive marketing.

Doctor’s Gender Diet

Doctors have a distinct advantage over lay practitioners when it comes to promoting quack treatments. Doctors are already respected (personally, I’d rather be feared!) and the placebo component of any treatment is already assured. In addition, doctors will already have read Denis Dutton’s article “Increasing Your Income while Pleasing Your Patients” (Patient Management Vol 21 No 3, March 1992).

A Dr Hewitt is recommending a strict preconceptual diet in order to guarantee a child of the desired sex. This is a considerable advance over the unpopular practice of ligating the left testicle in order to increase the chances of a male child.

Dr Hewitt’s diet works by altering the ratio of sodium and potassium to that of calcium and magnesium consumed during the six weeks prior to conception. Women wishing to have a boy are advised to eat a diet rich in foods such as mushrooms.

After putting my wife on this diet in order to guarantee a son we had a daughter who flatly refuses to eat mushrooms.

Dr Hewitt can play it both ways. If parents fail to produce the correct gender in their offspring then he can say that they failed to follow his diet (described as “rigid and unpalatable”), and if they are lucky enough to be satisfied he takes all the credit.

This diet could be tested by Dr Hewitt but it is not in his interests, as the results are predictable — that is, it would turn out that children would continue to be born in the ratios predicted by the effects of known biological factors and chance.

As psychologists have explained, people do not go out of their way to test their own beliefs.

Chemical Phobia

This is extremely prevalent and can be responsible for episodes of mass hysteria, for example the aftermath of the ICI Fire in Auckland when firemen developed conversion disorders. That is, their stress and beliefs led them to develop symptoms of ill-health.

The Marlborough Express (19/5/92) featured a US account of a farmer who had been poisoned by a fungicide used on his farm. The predominant symptom was “generalised shaking”. Even a cursory knowledge of medicine suggests such symptoms are more likely to be due to anxiety or perhaps hyperventilation.

When claims of chemical poisoning are not supported by proper scientific enquiry, claimants seeking to legitimise such claims in the media and the courts.

Some of these people establish the most fantastic rituals:

Debra Lynn Dadd’s mattress is stuffed with wool humanely shorn from organically raised sheep and processed in a solar-powered mill. Her pillows are filled with organically grown cotton. Her floors are strictly hardwood. Even her hairbrush is made entirely of wood. In fact, there’s not a single synthetic fibre to be found in her house. Neith are there any synthetic chemicals, toxic substances or non-organic food.”
Christchurch Press 29/1/91

I found an excellent review of this subject in Psychosomatics (August 1983, Vol 24 No 8) entitled “Allergic to everything: A medical subculture.”

The author is a professor of psychiatry and he was examining the pseudoscience of clinical ecology which promotes chemical phobia. Factors contributing to a belief in clinical ecology include:

  • a society with a heightened awareness of the potential dangers of inhaling and ingesting noxious substances in usual enviroments
  • a group of professionals who develop a theory that utilizes concepts from allergy and immunology to explain symptom patterns formerly explained by psychological theories
  • dissatisfaction with and non-acceptance of psychological explanations suggesting that the defects are in the patients rather than external to them
  • a compensation system designed by law to favour the applicant and in the process to favour his or her explanation of the symptoms
  • a support system of lawyers and doctors who themselves may not espouse the allergic and immunologic explanation but who support the patient in the drive to convince others

This unitary theory is already operating to explain the false beliefs which underlie ME (see Skeptic #21) and RSI (see Skeptic #18).

I was reassured to see that the courts are capable of dealing with unsupported claims of chemical sensitisation. (Lancet Vol 339; 297 Feb 1, 1992).

A woman claimed 250,000 GBP for alleged chemical poisoning which had spread to include aftershave, perfume and car fumes. The judge criticised the doctor’s supporting evidence as “in many respects bizarre and unscientific” and slated the GP for giving out “sick notes rather like confetti”.

The judge concluded that the various evidential reports “grossly inflated the plaintiff’s claim without any sensible basis at all”.