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During my recent overseas trip I had two stopovers in Hong Kong. The South China Morning Post (3 October) reports that demand from patients has led to a policy where acupuncture treatment will be allowed for patients recovering from stroke and cancer. This is rather an unfortunate move because a very recent study found no difference between acupuncture and sham acupuncture in their ability to perform daily activities of living or in their healthrelated quality of life. The study involved 116 patients who received 12 treatment sessions during a two-week period. [Park J and others, 2005: Acupuncture for subacute stroke rehabilitation. Archives of Internal Medicine 165: 2026-2031, 2005].

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Body Enhancer’s benefits are Bogus

Fresh from a visit to Iraq, John Welch is ready to embark on a jihad against quackery…

The product Body Enhancer, marketed by the Zenith Corporation, costs $95 per bottle and is “claimed to assist fat burning, muscle growth and liver detoxification.” A judge, however, found that the product offered ‘bogus benefits’ although the couple behind the company remained defiant and claimed that they were “scapegoats for the natural remedy industry.”

Judge Lindsay Moore was reported as describing Lindsay Gallot as ‘calculatedly dishonest’ and accused his partner of making blatantly false claims. This is perfectly understandable criticism as Mr Gallot is described as an ex-geologist and his wife as an ex-physics teacher. One would be entitled to expect that two people with a scientific background would not get involved in such pseudo-scientific nonsense. In their defence the couple claim that the product was tested by a Maori health provider and their clinical advisor Dr Tane Taylor was quoted as saying “he understood the results were positive”. According to the NZ Medical Council website, Dr Taylor has a medical degree from Albania and I know from my time in Auckland that he was involved with a chelation clinic, and I think that ends any scientific credibility that he might lend to the subject. For a full report as published in the Sunday Star Times go to: www.stuff.co.nz/stuff/0,2106,3303250a10,00.html

The next website, www.zenith.co.nz/ComComm_Rebuttal07.html, describes some kind of pseudoscientific trial and then goes on to say that the results cannot be published on the web. Testimonials are called on in support, which is a hallmark of quackery. It is not a good business practice to test your own product and find that it is useless. Much better to rip off the punters who feel compelled after wasting $95 to give it an endorsement. However, one unusually sceptical ustomer described the product as “the most putrid stuff I’ve ever tried”. I bet that testimonial was never used!

Guns will make us powerful; butter will only make us fat

Herman Goering obviously didn’t follow his own advice and now it seems remarkable that his huge frame ever fitted the cockpit of a World War One fighter aircraft where he was an acknowledged fighter ace. Morphine addiction must have addled his brains.

No such excuse for John Keitz who weighs 283kg and has been bedridden since August, 1998. He even cooks from his bed and this recipe gives some clue to his problem: six chicken breasts, a pound of butter……need I go on? John is now in receipt of disability benefits and can be cared for in a home funded by Medicare benefits of US$313 per day. This sort of grotesque celebration of excess is made all the worse by the excuses made by those people who specialise in medicalising human behaviour and the denial of personal responsibility. As Ivan Illich pointed out, the medical profession among others has always looked to extend its sphere of influence by “expropriating the power of the individual to heal himself.” This means that people exhibiting sick behaviour need to be allowed to suffer the consequences of such behaviour in order to make changes. Here, a parody of the American dream of ‘success’ is looked after in such a way that he can afford to buy even more chicken breasts and even more butter. At least he had the good sense not to bother with any of the useless products from the Zenith Corporation.

Dominion Post 2 July 2005

Something is rotten in the state of Sweden (and Denmark?)

Dr Elinder was a paediatrician in New Zealand and after returning to his native Sweden he criticised the tendency of his colleagues to over-diagnose such conditions as ADHD, minimal brain dysfunction and autism spectrum disorder, as well as the excessive use of Ritalin in treating such conditions. He was supported by a colleague, Dr Karve, who found serious flaws in the work done by a group led by a Professor Gilberg. In 1998, Dr Elinder asked to see Prof Gilberg’s research data but this request was refused and subsequently the data was destroyed with the connivance of the University of Gothenburg. This sort of disgraceful behaviour is the antithesis of science, which depends on independent verification and reproducibility. One tends to view the Scandinavians as somewhat placid and serious people but all that changed with the extraordinary attack on Bjorn Lomborg (The Skeptical Environmentalist) by the Danish Committee on Scientific Dishonesty. Lomborg was cleared of any wrongdoing but I sincerely hope the DCSD is going to examine the behaviour of Prof Gilberg.
NZ Doctor 18 May 2005

Remunerative Post Traumatic Stress Disorder (RPTSD)

Is there anyone in New Zealand who has suffered some traumatic experience and not been diagnosed with PTSD? I can think of my late father who came back from the war, handed in his Thompson submachine gun, got on with his life and never spoke of the war again. Is there anybody else? I would like to hear from you.

A woman has been denied ACC compensation after having unprotected sex with a partner who concealed his HIV status from her. She has not contracted HIV but has been diagnosed with PTSD, or more properly called RPTSD because the motivation is to obtain money. I wonder whether the doctors or therapists who endorse this nonsense ever stop to think that they make themselves a laughing stock. I am reminded of the story told by Andrew Malleson (Need Your Doctor be so Useless) where a housing authority ignored people wanting better housing because all of them had the required letters of support from their doctors.

Another woman tried to get ACC cover because she was “retraumatised” while reliving a 20-year-old rape experience with a therapist. She alleged a ‘new injury’ on top of her existing PTSD. Why on earth somebody would either want or need therapy for something that happened 20 years ago is beyond me.

Perhaps I should ask Jeanette Wilson to contact my late father and see whether he wants to file a claim for PTSD from beyond the grave. I have never seen better examples of Welch’s Law, where claims expand to take up the amount of compensation available.

Pharmacists and alternative medicine

I went into my local pharmacy recently and was astonished to see that products that I would describe as ‘fringe’ medicines dominated the OTC medicine section. A full page infomercial in a local paper was clearly advertising one of these products but there is no acknowledgement that it is an advertisement. I wonder at the ethics of this. The same pharmacy had a similar article promoting ear candling and I hope the conference organisers are able to set up a demonstration of this bizarre practice.

One such pharmacy product is Esberritox. It contains various herbal products such as echinacea. A Google search produced 25,000 hits and echinacea is also well covered on www.quackwatch.com There is also a good article on that site by Dr Barrett about the unethical behaviour of pharmacists, which has them selling unproven remedies with a huge profit margin. It’s rather ironic that government policies to restrict pharmaceutical access to cheap and proven drugs has seen a parallel increase in the use of quack remedies as pharmacists stock them in order to maintain their incomes.

Acupuncture Flunks, not once but twice!

A German study found that sham acupuncture was just as effective as ‘real’ acupuncture for migraine headaches. The study was published in the Journal of the American Medical Association. I did the same experiments over 15 years ago and satisfied myself that the needles could be stuck anywhere and the same results were obtained. It follows that acupuncture theory and training is a delusion and as I demonstrated at one of our meetings, an intelligent group of skeptics can become ‘trained acupuncturists’ after a one-hour lecture. It is a disgrace and a fraud that ACC continues to fund acupuncture as well as many other unproven treatments such as chiropractic and osteopathy. GPs are able to claim credits for acupuncture training. This should be stopped. It would be interesting to do a study of treating migraine with sham acupuncture versus therapeutic touch. I predict that such a study would show little or no difference in outcome because both treatments are placebos.

Christchurch Press 5 May 2005

This graph shows once again how sham acupuncture and ‘real’ acupuncture achieve the same results. In contrast, oestrogen replacement is very effective in reducing hot flushes in postmenopausal women. I will leave the last word to the editor of Bandolier: “when will alternative therapies really prove that they work? While we wait, will they stop fleecing people of huge amounts of cash for doing nothing?”

Methyl bromide and hysteria

Workers at Port Nelson are complaining that the gas methyl bromide is responsible for ill health and has caused the deaths of former workers from motor neurone disease. A local woman who lives 300m from the fumigation facility has demanded that the port company notify her of fumigation work so she can evacuate herself and her children. An investigation found that the more likely cause of the workers’ complaints was not methyl bromide but chemicals used in the preservation of timber. The deaths from motor neurone disease were due to an epidemiological effect known as clustering. One worker is described as having symptoms of “chronic fatigue, a persistent dry cough and lack of concentration.” These are typical symptoms of the fixed illness belief of ‘chemical poisoning’. Note that the symptoms are all subjective and therefore difficult to disprove. Staudenmayer (Environmental Illness: Myth and Reality) has shown conclusively that these symptoms are caused by personal psychological factors.

Christchurch Press 26 July 2004, 1 January 2005

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Now that Terri Schiavo has been allowed to die peacefully there is an opportunity to reflect on the matter free from the hysteria and religious arguments advanced as an excuse to maintain her in a vegetative state. When discussing the ethics of the situation with a local surgeon he commented that the main problem was that the feeding tube should never have been inserted in the first place. A feeding tube is surgically inserted into the stomach through a hole in the abdominal wall. Once such medical interventions have been made it is very hard to reverse them. In this case the debate appears to have been hijacked by Catholic pressure groups.

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If you don’t get the answers you want from a Government inquiry, press for another inquiry. Vietnam war veterans have continued such a campaign and have produced a map to confirm that they were present in areas that were sprayed with the defoliant under the US Army “Operation Ranch Hand”.

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Dioxin “Poisoning” or Hormesis in action?

It will be interesting to see how the government handles the latest health scare which is being helped along by the usual sensationalist media reporting. How about this example: “The men who made the poisons that blighted a New Plymouth community….” (Sunday Star Times, 12 September 2004).

There are many dioxins and the most toxic is considered to be TCDD, a contaminant found during the manufacture of the herbicide 2,4,5-T but also occurring naturally as a result of combustion, forest fires and smoking. Dioxin has been isolated from soot in prehistoric caves. Dioxin is found in body fat (lipid) and has a half life of around 7-10 years, meaning that a total body load diminishes by half during each such interval. The national average body level of TCDD is 3.5 picograms per gram of lipid. A picogram is one trillionth of a gram (ie. 1 x 10-12 grams, or if you like a lot of noughts: 0.000000000001 g). The mean TCDD level in residents of Paritutu was 10.8 picograms per gram of lipid with a range of 1.3-33.3. To date, there is no evidence of increased disease rates in the studied population. To put it bluntly, the Paritutu residents have 3-10 times the infinitesimal amount found in the general population, still well within international limits. I would like to see a similar study examining the levels of dioxin and mercury downwind from the local crematorium!

Hormesis is an effect where small doses of a toxic substance seem to promote health. A good example is alcohol, as was the Victorian habit of consuming small doses of arsenic and strychnine as a “tonic”. Rather than concentrating on looking at ill-health, researchers should be examining whether Paritutu residents are in fact healthier than most other New Zealanders.

Nevertheless, research will be ongoing and although not given to making predictions I offer the following observations:

  1. Residents will claim that every possible health problem they have ever had was caused by dioxin exposure.
  2. Residents will demand compensation in accordance with Welch’s Law (Claims expand to take up the amount of compensation available).
  3. Scientific evidence will be distorted and misinterpreted to justify any possible viewpoint.
  4. The “Greens” will claim that any amount of dioxin is “unsafe” and at some stage the phrase “cover up” will be used.

A former manager of the Paritutu chemical plant is quoted as saying that he worked there for 30 years and is still in perfect health at 85 years of age. Hormesis in action surely?

More Healthy Additives?

Britain is in the grip of such a serious depression that prescriptions for the anti-depressant “Prozac” (fluoxetine) have risen from nine million to 24 million per year. I read this as I sipped my ale in the Pint and Prozac, a quaint canal-side pub which I discovered while on my recent overseas trip to research taro cultivation by the gay and lesbian community (funded by a Community Education Grant – thanks Steve!).

Prozac is finding its way into ground water and hence into supplies of drinking water.

It is clear that I have been on the right track in calling for Ritalin (methyphenidate – a stimulant) to be added to the water supply as a Public Health measure. This combination of stimulant and antidepressant will surely lead to a euphoric and happy population. I am however concerned about problems of dosage as the Authorities have claimed that the Prozac is so “watered down” that it is unlikely to pose a health risk, except to those who believe in homeopathy.<br> Christchurch Press, 10 August

Touting for Business – “Chiropractic Kidz Week”

What better way to build up business than to convince parents and children of the need for regular assessment and treatment of “subluxations”, the core tenet of chiropractic pseudoscience. It is a matter of concern that “chiropractic kidz week” is a nationwide programme aimed at those “parents or caregivers or the child themselves (who) are not aware of a spinal problem.”

The reason such people are “unaware” is because they do not have any such “spinal problem”, which exists only in the self-deluded imagination of the chiropractor. Chiropractors interpret minor postural variations as signs of “disease” and requiring treatment. I wonder if any chiropractor has ever diagnosed a “perfect spine” unless it was achieved at the expense of 60 “treatments”. It is a national disgrace that this pseudo-science is funded by ACC and chiropractors should not be allowed to either take or bill the Health Service for x-rays.

Please keep an eye out for this scam next year and if possible get as many members as possible to take their children for a free assessment and report back to me what happens. Some tape recordings would be useful. A woman recently wrote to the paper and took Frank Haden to task for criticising alternative medicine. She went on to claim that chiropractic manipulations had cured her of migraine, cured her child’s squint and cured another child’s gait abnormality!

With such gullible beliefs out in the community it is no wonder that chiropractors continue to work their rich scams.
Blenheim Sun, 11 August
Letter to Editor, Sunday Star Times, 26 September

Anyone for Tennis?

A millionaire property owner has been getting $600 per week from ACC since 1974, despite earning $2400 per week from his investment portfolio. In a bizarre example of Welch’s Law, his claim was accepted under medical misadventure for psychological damage caused by prescription medicines, in this case benzodiazepines (Valium). His disability is “psychological” and prevents him from working at all but readers will be thrilled to know that the poor fellow is able to play tennis three days a week and in his own words “it’s better to have a peaceful life”. ACC have done a great service to tennis as the claimant is now in the top third of senior players in Auckland. Employers and taxpayers alike will be thrilled to know that their ACC levies are being put to such good use. Sunday Star Times, 26 September

In Brief

  • Despite local doctors showering sick notes like confetti, teachers at Hamilton’s Fraser High School failed in their bid for compensation from MAF for “illness” caused by the spray used to eradicate the Asian gypsy moth. Sorry people, no money for mass hysteria. Better to track down the millionaire’s doctor and go for PTSD caused by unruly pupils. (Dominion Post, 30 September)
  • In France the Académie de Médecine has upset homeopaths by issuing a damning report challenging the continued funding of homeopathy through the national health service. (Dominion Post, 9 June).
  • Acupuncture is ineffective for the treatment of tennis elbow. Hardly surprising given that “good evidence indicates that acupuncture does not work.” (Bandolier 126 Vol 11, Issue 8, www.bandolier.com).
  • Remember the Aoraki Polytechnic and their stupid proposal to run a degree course in naturopathy? They are at it again. They got $8165 community education funding for the New Zealand Council of Homeopaths’ Conference. (Sunday Star Times, 3 October).
  • For most of October I will be touring northern India by motorcycle and I intend filming and recording as much as possible. I have been asked by Paul Trotman to find him a “nose kettle”. If you want to know what that is you will just have to come to next year’s conference!

John Welch lives in Picton and is a retired RNZAF medical officer.

Hokum Locum

Vitamin B12-the new placebo?

A drug company has been perplexed at a shortage of Vitamin B12 created by a surge in use. A spokesman for the company said “doctors had so far failed to come up with a convincing explanation” and “Vitamin B12 was also used to treat chronic fatigue syndrome (CFS) and as a vitamin booster.”

It is clear from these comments that Vitamin B12 is being used as a placebo as there is no evidence at all that it is of any benefit in the treatment of CFS. In the course of my employment as a locum I have seen plenty of evidence that a lot of doctors are administering Vitamin B12 when there is no scientific indication. The deliberate use of placebos in this manner shows a complete lack of understanding of the consultation dynamic, a failure to understand the nature of the placebo effect, and a superficial grasp of basic science. If these doctors allowed patients sufficient time, listened and acknowledged their concerns in an empathetic manner, there would be no need for placebo injections.

Placebo vitamins can be dangerous. A three-year-old child choked to death after inhaling an animal-shaped vitamin C and echinacea tablet. A pathologist was of the opinion that “the tablet was too large for a child of three to be able to swallow”. Nowhere in the article was there any comment or criticism of the dietary supplement industry which promotes these totally unnecessary products.
Dominion Post June 25, 2004
Dominion Post May 26, 2003

Hey Noni Noni?

There is indeed “much ado about nothing” over Noni juice. It comes from a Polynesian plant and is widely touted as a cure-all for everything and anything, a sure sign of a quack remedy. A recent review (Bandolier 122) found no evidence that it is effective for any medical condition and commented: “Diluted noni juice does funny things to cells in test tubes, but then so might diluted orange juice.”

A Google search found over 600 websites complete with a medical PhD endorsement and the usual pseudoscientific language and testimonials.

Breast Implants — a silly con?

Welch’s law has struck again as claimants prepare to take their share of a US$2.35 billion fund set up by Dow Corning Corp in response to thousands of silicon breast implant liability lawsuits. This is despite the fact that a number of studies have conclusively proved that the claims of silicon-related illness were a delusion. These lawsuits caused a major upheaval in the American justice system and a review of the definition of an expert witness. Legal process was suborned by “expert” witnesses who managed to convince the courts that claimants should be rewarded and in today’s culture of complaint, it pays to attribute your “illness” to someone with deep pockets. The US insurance industry often influences the outcome of these cases as it is frequently cheaper to settle than to fight a long and expensive legal battle.

Abuse Claims

Medical practices are constantly changing but this has not stopped litigants from seeking to apply today’s standards in order to prove abuse and mistreatment in the past, in some cases going back several decades. An article in the Dominion Post (June 17, 2004) reports “invasive internal examinations” by a health camp doctor around 1983. An Act NZ MP has accused the doctor of committing and misdiagnosing sexual abuse.

At this time there were many erroneous beliefs about the examination of children and the signs that might be present indicating sexual abuse. It was believed, for example, that “reflex anal dilatation” was an indicator that abuse had taken place. Many children were taken from their families, and parents, normally the male, were accused of sexual abuse. It is now known that such simplistic forensic tests were flawed and we all know what happened when similar deluded ideas were applied to the behaviour of children at the Christchurch Civic Creche.

Hangover Cure

The product RU-21 contains dextrose and ascorbic acid and the makers claim that it prevents the build up of acetaldehyde which causes the hangover. Dr Mike MacAvoy of ALAC is quoted as describing the product as “ridiculous”. There is an associated claim that the pill was developed by the KGB so its spies would not suffer hangovers after drinking sessions. There is no scientific evidence that such a product will have any effect at all on the metabolism of alcohol.

This is the perfect product for silly binge-drinking yuppies (RU-stupid?), the same sort of people who buy energy drinks. These products are placebos and with proper marketing will prove hugely successful and make some people very rich.
Sunday Star Times June 13, 2004

Benefit Fraud

Many political commentators have noted the tendency of the latest budget to create a new class of beneficiaries. The Labour Government (aka the Nanny state) knows what’s best for us and will not be satisfied until we are all receiving some kind of targeted benefit. This mentality is behind the large increases in people on invalid (IB) and sickness benefits (SB). WINZ figures show that those receiving the IB rose from 45,519 to 71,394 over a seven-year period while the SB rose from 34,044 to 41,948. I have said before that the reason so many people receive these benefits is because they can!

A Christchurch GP has finally made a stand and refused to assess casual patients being referred from a neighbouring Work and Income Office. I support him as there are too many “rubber stamp GPs” signing these applications and there is no audit process at all. I have challenged various ministers about these abuses and they fall back on the same tired arguments that only doctors can assess work capacity. It is also remarkable how many career criminals appear in the courts described as either invalid or sickness beneficiaries.

The latest scam that I heard about is university students who want to have a holiday so they get their student health office to endorse them as being “stressed” or “depressed”. I recently did a locum on the West Coast and met plenty of people who met the criteria of “benefit bludgers”. One young man proudly told me that he had saved enough money from whitebaiting to pay for a new car. He was on a sickness benefit for “stress”.

In a truly amazing development, the same Christchurch GP is now the subject of a complaint by aggrieved beneficiaries!
Christchurch Press June 14, 2004

Taking the P*ss?

In a letter to the editor, a correspondent claimed that there were definite health benefits from drinking a daily glass of your own urine. I had a look on the internet and found a staggering 365,000 links to some truly disgusting websites. Deciding that New Zealanders couldn’t be that daft I narrowed the search to “NZ” and got 2000 hits and found none that directly referred to drinking urine. This could be a good test for the next conference — make a 30C dilution of urine and see if anyone is prepared to drink this homeopathic preparation.

John WelchJohn Welch

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Selenium – Too Much of a Good Thing?

New Zealand soils are deficient in selenium and this can cause serious health problems for animals. A 500kg animal needs about 1mg selenium daily. There is no evidence that New Zealand adults need selenium supplements and this situation has been described as “a deficiency in search of a syndrome”.

A 52-year-old dairy farmer presented to her doctor with chronic aches and pains, lethargy, sore throat and painful swallowing. After some weeks of fruitless investigations she admitted to taking 0.5ml daily of a solution containing 5mg/ml of selenium, several times the recommended daily human dose. All of her symptoms disappeared once she stopped taking the supplement.

Despite the lack of proof for any deficiency syndrome in adults, local pharmacy leaflets stated “selenium is an essential trace element” and that “low levels of selenium are linked to a higher risk for cancer, cardiovascular disease, inflammatory diseases and other conditions associated with free radical damage, including premature ageing and cataract formation.”

It is quite clear that it would have been much safer for this woman to have taken a homeopathic selenium remedy and there would have been no risk at all of any toxicity from over dosage.
NZ Family Physician Vol 30 Number 6, Dec 2003

Animal Homeopathy

I know that homeopathy has been done to death but it crops up everywhere, even in the treatment of animals. People defend this delusion by claiming that the placebo effect does not work in animals, therefore any observed effect must be real. Any observed effect is clearly due to expectation on the part of the person administering the water, sorry, I mean the homeopathic remedy. An article in the Christchurch Press (March 12, 2004) described how Taranaki’s first qualified animal homeopath has gained an “advanced diploma of homeopathy”. She also has a BSc and it beggars belief that someone with that background can take up a pseudoscience such as homeopathy. This is what HL Mencken was referring to when he 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?”

I find it amusing reading such accounts because the clue to the belief system is usually contained in the article but is unrecognised. In this case the animals are described as “glowing with health in a way that suggests good feeding and love but their appearance is so striking it indicates there is another ingredient as well”. You guessed it — the other ingredient is homeopathy! It’s obvious that the animals’ condition is due to the “good feeding and love” and to claim otherwise is a delusion.

It would not in the least surprise me if the diploma of advanced homeopathy is NZQA approved.

Snake Oil Flunks for Snake Bite

Boonreung Bauchan was known in Thailand as the “Snake Man” and held a Guinness world record for spending seven days in a snake enclosure. The Mamba family of snakes are extremely venomous and when one of them bit him on the elbow he relied on a traditional herbal remedy and a shot of whisky. As we all know, herbal remedies are mostly placebos and should not be used for serious or life-threatening conditions and Boonreung is sadly no longer with us. Had he taken a proper antidote, his chances of survival would have been excellent.
Christchurch Press March 23, 2004

Counsellors

If you get up in the morning and find your letterbox has been vandalised, don’t worry, counselling is available to help with your distress and grief. (Dominion Post March 6, 2004).

Following September 11, an estimated 9000 grief counsellors turned up in New York and one hotel was booked out by a single group of 350 counsellors. This absurd behaviour is of course defended by the counselling “industry” despite the existence of research that shows that many of such interventions are actually harmful. Counsellors defend their behaviour by claiming that it cannot be scientifically tested. For example: “People working from the scientific model want to measure outcomes. A lot of people would say, ‘I feel better’, but that doesn’t fit a scientific model.”

Such claims should be treated with complete contempt. This sort of reasoning could be used to justify the implementation of all sorts of quackery because it makes people “feel better”.

To put it bluntly, counselling is a placebo therapy. Third-party funding ensures that an industry has been able to develop. This has disempowered people from learning to deal with personal trauma by simply talking to a friend or other family members.

Hair Analysis

Last year I spent some time working in Westport and noticed an advertisement for hair analysis. Hair analysis does have a scientific basis but it has been taken over by quacks who offer all sorts of ridiculous assessments. When I got home I wrote to the address and sent hair from my wife Claire and my oldest daughter Eve, under their own names, and some hair from “Russell”. “Russell” was actually my daughter’s dog, a wheaten terrier.

For $40 I received a detailed four-page handwritten report and after reading it I felt quite mean because the writer’s sincerity was obvious. I have sent a copy of the letter to the Editor but will summarise the main findings. I see no value in exposing the writer because the letter was written in good faith but note that sincerity and good faith can go hand in hand with gullibility and foolishness. His findings were as follows:

Claire needs natural estrogen — “raspberry leaf” two tabs daily. Wormwood — 5 drops in water daily. Bach flower remedies — “Mimulus, Rock Rose”. Conscious deep breathing — practise six times daily. There was also a recommendation to have “faith” and consider the Bahai religion for that reason.

Eve had a systemic yeast infection. Recommended treatment: nystatin, aloe vera juice, Blackmores chewable tablets, wheatgerm capsules, super strength kelp, rescue remedy (Homeopathic), extra progesterone in the form of “wild yam cream”.

Russell also had a systemic yeast infection, and iodine deficiency. Recommended treatment: nystatin (oral antifungal agent), self heal tincture — 50 drops twice daily, herbal B vitamins — six tabs daily, super strength kelp — three tabs daily. Repeat hair analysis in three months.

It is easy to see that such a “scatter gun” approach to treatment would be bound to work in a well-motivated believer. I did not inquire as to the method of hair analysis but this is unimportant because any diagnostic method will work provided it is plausible and the treatment offered is congruent with the particular belief system. The homeopathic vet would no doubt approve of Russell’s diagnosis and treatment.

Shockwaves for chronic heel pain

High energy sound waves are now being used to treat various conditions such as tennis elbow and other painful areas such as the heel, knee and shoulder. It is claimed that 60-70 per cent of patients will gain relief from the treatment.

The same technology (extra-corporeal shockwave therapy or ESWT) is used to disintegrate kidney stones.

In the case of kidney stones there is no need for a randomised controlled trial (RCT) because it is obvious when a large stone has been broken down into smaller pieces.

When treating various painful conditions with no such “marker”, one has to be much more cautious and this therapy is crying out for a randomised controlled trial with a placebo group who would receive treatment administered when neither the patient nor the technician were aware that the machine was actually switched off. I predict that when such trials are carried out, there will be no advantage over placebo.
NZ GP November 12, 2003

Hokum Locum

Cellulite – Just a Euphemism for Fat

Cellulite is the term used by women’s magazines to describe dimpled fat. It has no scientific or anatomical validity and it is simply ordinary fatty tissue that assumes a waffled appearance because fibrous tissue prevents the skin from fully expanding in areas where fatty tissue accumulates. This has been confirmed by a study where biopsies of fat and cellulite were microscopically indistinguishable by pathologists who were blinded as to the samples’ origin. Calling fat “cellulite” is part of the modern trend to seeking alternatives to the (unpalatable) truth, in this case an adipose euphemism.

The latest treatment for Cellulite involves a machine called Cellu-M6. It is described as having “even been approved by the strict Amer-ican Food and Drugs Administration”. I checked the FDA website and although I could not find the machine specifically mentioned it did refer to a “Dermosonic Non-Invasive Subdermal Therapy System”, presumably using ultra-sonic stimulation of the skin. The FDA “approval” is nothing of the sort, merely an acknowledgement that the machine is similar to others already on the market. There is nothing in the FDA response indicating any approval or endorsement of the device beyond noting that it “temporarily reduces the appearance of cellulite”.

Given that about half of the New Zealand population are obese, and roughly half of these are women, this makes for a huge and lucrative market. The Cellu-M6 machine is described as “breaking down the cellulite, toxins and abnormal water build-up are expelled and the increased blood flow stimulates enzymes which encourage fat cells to break down.” Journalists sometimes inadvertently get close to the truth and the article states in part “While it seems almost too good to be true…” Well, yes, it is.

With all worthless treatments it is essential to get the punters to do something for themselves, which in itself is actually effective, for example: “You’ll still need to do some work. Walking, exercise and watching what you eat.” The most well-motivated customers will be the ones who actually do exercise and lose weight. They will be thrilled with the results, happy with the cost and completely oblivious as to the real reason for their loss of cellulite (weight).
New Idea 4/1/03

Cannabis

For various legislative and historical reasons, cannabis use is illegal in New Zealand. My feeling is, why legalise cannabis when we already have so much suffering from the abuse of tobacco and alcohol? Nevertheless, on the medical evidence available, moderate indulgence in cannabis has little ill effect on health. Cannabis has been studied for possible use in various medical conditions but there are problems with drug delivery as most researchers feel that it is unacceptable to administer it through smoking and oral bioavailability is variable.

A recent Lancet study of patients with multiple sclerosis found that cannabis had no measurable effect on muscle stiffness or jerkiness. The patients, however, stated, “it had reduced their symptoms and improved their mobility.” I went to the Lancet website and there are problems with this study. Fifty percent of the placebo wing of the trial claimed benefit and because of the psychoactive effect of the cannabis, subjects knew whether they were taking cannabis or placebo. I have written before on the problems of clinical trials becoming “unblinded” through this effect. The researchers should have used an ‘active’ placebo, something that mimicked the effects of cannabis. It appears that researchers still lack an understanding of this process. Perhaps they should call in James Randi to help them?

Despite the lack of evidence for the medical use of cannabis, “a wealthy Christchurch businessman caught growing cannabis has escaped without a conviction after convincing a High Court judge that he used it medically.”

I can just see future headlines at the next sitting of the Dargaville Court: “Unemployed Maori youth of no fixed abode acquitted of growing cannabis after convincing the Judge he used it for a medical condition”. Yeah, right.

But wait! The businessman, we are told, suffered from a painful bowel condition diagnosed as “pyloric sphincter”. That explains everything. We all have a pyloric sphincter. It is a thickened muscular valve at the outlet of the stomach.

All of us can now smoke cannabis with a clear conscience (write or email me for a medical certificate, but only if you are rich, say $5000 per certificate will be fine).
Dominion Post, 8/11/03, 14/12/03

Veterinary Homeopathy

I don’t normally concern myself in this area although I did recently correspond with the Veterinary Council and their policy over alternative medicine is very similar to that of the Medical Council with Doctors.

The Press (18/11/03) carried an article, which I thought was unintentionally very funny. A trainer was fined for injecting a horse with a homeopathic remedy. It was further reported, “another horse injected with it had won, been swabbed and tested negative in the past.”

Of course it tested negative! Homeopathic solutions are water and this simple fact seems to have completely escaped notice by the Judicial Control Authority. I thought I would have a bit of fun by writing to them and pointing this out so will keep you posted.

The homeopathic remedy was “Vetradyne” and was easily found by Google. A 50ml bottle costs $215 but I was unable to find its composition, or any given therapeutic indication, apart from the cryptic comment “no claims made.” It was also detailed as being for “oral” use only so it does seem strange that it was given by injection. An inquiry of the website was no more forthcoming over composition or dilution factor.

Counsellors

Every time something unpleasant happens we hear the dreaded phrase “counselling has been arranged.” Can we do anything to stop this clichéd response?

Following the illegal viewing of pornography at a school, pupils have been offered counselling. What’s wrong with today’s teachers? Can’t they handle a situation like this in a reasonable and intelligent manner? It seems that our population are willing to hand over all responsibility whenever they can. Is it because they lack confidence or is this a deliberate social policy on the part of the government? It’s certainly consistent with Government policies that encourage dependency and allow hundreds of thousands of people to indefinitely remain on welfare payments.
Dominion Post 27/8/03

Badly Behaved Children

Readers will know my attitude towards the socially engineered fad diagnosis of attention deficit hyperactivity disorder (ADHD). ADHD is treated with methylphenidate (Ritalin) and there was a 17% increase in prescriptions over the past year. The drug is being sold by parents on the black market. This does not surprise me but readers may be surprised to know that most street drugs are sourced from legal prescriptions. There are doctors in every part of New Zealand who over-prescribe a wide range of psychoactive drugs, which are then sold.

To paraphrase a well-known psychiatrist: “any behaviour of a child can be consistent with ADHD.” We must act now and add Ritalin to the drinking water. This will have the dual benefit of removing the need for parents to discipline their children and of destroying the illicit drug trade. The whole population will be happy, well behaved and in no need of counselling.
Marlborough Express 1/12/03

Multiple Chemical Sensitivity

This is a pseudoscientific diagnosis where people develop a fixed illness belief about chemical exposures. It is increasingly becoming an employment issue and is a classic example of psychosomatic illness. In a typical case, a radiographer is reported as needing a face mask before leaving home because “when I have a new dose of chemicals I become unreasonably upset about anything and everything, and become ill and extremely tired, plus a host of other physical effects.” Such patients have been studied by Staudenmayer (Environmental Illness: Myth and Reality). He tested 20 patients complaining of universal sensitivity to multiple chemicals and found that “the patients’ appraisals were no different from chance performance” (ibid. p. 99). In other words, the patients’ beliefs were disproved. There is an urgent need for such testing to be available in Australasia, otherwise there will be an increasing number of these spurious claims, misattributed to employment conditions.
Marlborough Express 10/10/2003

Hokum Locum

Confidence Based Medicine

This is restricted to surgeons.

British homeopath suspended

The British General Medical Council (GMC) has found family practitioner Michelle Langdon guilty of serious professional misconduct and banned her from practising for three months. According to press reports, Langdon had advised a couple that the gastrointestinal symptoms of their 11-month-old were caused by “geopathic stress patterns” beneath their home and then “dowsed” for a remedy by swinging a crystal attached to a chain over a book of herbal remedies. A hospital emergency department subsequently found that the child had gastroenteritis. The GMC also examined evidence that another patient had been prescribed an herbal remedy for a sore throat after the doctor dowsed for the treatment.
http://www.homeowatch.org/reg/langdon.html

Bi-Digital O-Ring Test

This is what got Dr Gorringe into trouble with the Medical Practitioners Disciplinary Tribunal (MPDT). This test is part of the pseudoscience known as kinesiology. Dr Gorringe got the patient to pinch the thumb and forefinger together and then attempted to separate them. By introducing several homeopathic substances into an electrical “circuit” he claimed to be able to demonstrate a weakness of pinch-strength caused by “paraquat poisoning” and other equally ridiculous diagnoses. Dr Gorringe refused an offer to test his diagnostic method. Several patients suffered illhealth as a result of Dr Gorringe’s diagnostic methods and treatments and he has been struck off the Medical Practitioners Register and ordered to pay more than $100,000 in costs.

The full judgment is at www.mpdt.org.nz under Recent Events. It runs to 142 pages but makes fascinating reading. I often wonder how anybody can go through several years at medical school and then fall victim to these foolish and unscientific sidelines. Gulp! I just remembered that I did — acupuncture and spinal manipulation — but I was protected from getting too excited and committed to these modalities by a natural curiosity about how they worked. After all, curiosity or thoughtfulness is what scepticism is all about. Once I looked at the evidence and learned the significance of the placebo effect, I ceased these practices.

Gulf War Syndrome — the Continuing Quest for Compensation

Despite all of the evidence showing that there is no such thing as Gulf War Syndrome (GWS), the alleged victims are now suing the various corporations that supplied Iraq’s chemical weapons programme. This is to be expected and follows the same pattern that has been followed over nuclear test veterans and those exposed to Agent Orange. GWS is in reality a “post-war” syndrome, formerly called war neurosis or shell shock. The symptoms are presented in a context appropriate to the conflict. In the case of GWS the alleged list of causes includes chemical poisoning, immunisations, pollution, depleted uranium. Every conceivable cause has been investigated and scientists, whose naivety is exceeded only by their ignorance of history, continue to clamour for research funds to investigate ever more ludicrous theories.

For an excellent account read Hystories, by Elaine Showalter, Columbia University Press, 1997.

I can also forward by email an electronic copy of a paper I presented to a Military Medicine Conference.
Gulf War Syndrome — A Historical Context, 8th Asia Pacific Military Medicine Conference, 3-8 May 1998, Auckland.

Chemical Phobia?

Firemen had to wear breathing apparatus to clean up a hydrogen peroxide spill. This “toxic chemical” was described as “fizzing and bubbling” as it “reacted with the asphalt”. Of course it was fizzing and bubbling! The hydrogen peroxide was breaking down and releasing “toxic” oxygen and water. These emotively worded reports foster ignorance and hysteria about common chemicals. I recall a similar piece of ignorant journalism where a toxic spill was revealed to be the chemical equivalent of rust!
Dominion Post 6/8/03

Bee Products (Pollen-ate?)

These are currently popular with that segment of the NZ population who would eat sheep dropping sandwiches if they were properly advertised as benefiting health. That reminds me of the cruel jibe by Dame Edna Everidge (aka Barry Humphries) that NZ was a country of 60 million sheep, 3 million of which think they are people.

An advertisement in the Sunday Star Times, (20 July) contains the claim that “BIO BEE” is “the only Potentiated Pollen available that uses Dr Kelly Duncan’s (former Dean of Science, Canterbury) patented potentiation process”. Refer http://www.biobee.co.nz

I duly visited the website and some of the claims made for this product appear suspiciously close to health claims. I would welcome readers’ opinions.

I subjected Dr Duncan to a “google” which produced a number of interesting hits including him being a party to a complaint to the Advertising Standards Complaints Board. www.asa.co.nz/decisions/FULL/Fd0106.rtf

[Chair-entity’s note: A concerned member has been forced to tout bee products as part of his media-related job. We now have a new information flyer examining the case for various bee products available as a PDF here]

Herbal Medicine

“Kentucky Fried Medicine” is such an easy target but can always be counted on to provide material for your correspondent. As we all know, most, if not all such preparations are completely useless. The latest ploy is to illegally include effective prescription medicines, particularly in the area of erectile dysfunction. (New Ethical Journal, July 2003) It is perfectly obvious to a consumer when a product has not worked for erectile dysfunction so it makes perfect sense to cheat by adding a drug that does work. Such fraud invites a stiff fine.

Hua Fo VIGORMAX was withdrawn in Canada when it was found to contain tadalafil, marketed as the legitimate drug “Cialis” in New Zealand.

Likewise in the US, a product called Viga was withdrawn because it contained sildenafil, marketed in New Zealand as “Viagra”.

One possible benefit of these frauds is at least the Chinese might stop trafficking in endangered animal species in the preparation of these products.

An American study of 443 Web sites (reported in Manawatu Evening Standard, 24 September) found that most Web sites marketed herbal remedies with misleading or unproven health claims that violate US Law. I suspect that there would be similar findings in any survey of such sites in New Zealand.

Hokum Locum

Nervousness based medicine

Fear of litigation is a powerful stimulus to over-investigation and over treatment. In an atmosphere of litigation phobia, the only bad test is the test you didn’t think of ordering.
NZ Medical Journal Nov 24 2000 p. 479

Magnet Quackery

While setting the VCR the other day I caught a segment on TV where a particularly slimy and irritating Australian was extolling the virtues of magnetic pillows and underlays. I was further reminded of this incident when Dr Keith Davidson of Blenheim, gave me a brochure on “Magnetic Energy”. Ever the humorist, Keith had scrawled across the bottom the words “doesn’t attract me!”

The web address is www.magneticenergy.com.au (shouldn’t that be ‘dot.con’?)

One of the great things about quackery is that it can be recycled after a period of time when people have forgotten the lessons of history. Charles Mackay — “Extraordinary Popular Delusions and the Madness of Crowds”, outlines the last great era of magnetic therapy in his book. Refer page 304.

When recycling an old fraud it is important to modernise it for a more sophisticated New Zealand audience (don’t laugh). It also helps to link it with other modalities such as acupressure and auricular acupuncture. Some highlights from the brochure: Magnetic water. Placing a jug of boiled water on top of the Mega Multi Magnet for 2-3 hours makes this. The daily use of “magnetised water may keep your negative and positive ions and pH levels balanced.”

What about an antinauseant magnet with the unfortunate acronym of “SCAT”. (Sea, Car, Air, Train). Scat is a North American term for animal sh*t which pretty much sums up these useless magnetic products.

Sexual abuse claims set to spiral

In Vol 62 I predicted that moves to allow lump sum compensation for sexual abuse claims would then be subjected to Welch’s Law. (Claims expand to take up the amount of compensation available).

Since the Government announced the reintroduction of lump-sum payments, 12,000 people have lodged “sensitive claims” and may be in line for $100K each regardless of whether police have investigated the complaint (they have been too busy collecting speeding fines) and claimants are not required to name the perpetrator.

I am very concerned that this absurdly unfair legislation excludes people who have really suffered through alien abduction. It should not matter that such claimants are unsure as to the identity of their abductor. In the half-light a Martian can resemble a Raelian. Unless the spaceship was speeding, it’s unlikely the event would come to the attention of the police. In passing, I wonder what the penalty is for doing Warp 9 in Taihape?
Marlborough Express 29 April, 2003

Work Stress

Employers have much to fear from proposed changes to the Health and Safety in Employment Act. Employers are about to become responsible for managing stress in the workplace. If this foolish proposal is implemented I predict that there will be a surge of complaints followed by requests for compensation as disaffected workers struggle to get their snouts into the ACC trough. Many already have by successfully claiming for spurious conditions such as chemical “poisoning”, multiple chemical sensitivity, and occupational overuse syndrome (OOS). These are all classical conversion disorders where personal stress and anxiety is manifest as physical complaints. Workers are now being given the opportunity to take their own personal worries to work and make them the responsibility of their employer and ACC.
Dominion Post May 5 2003-05-16

Food Supplements

These have been in the news lately and thanks to Alan Pickmere for sending me a range of what’s on offer in Whangarei. In an accompanying letter Alan recounted how his queries to various suppliers were met with a dose of “vehemence medicine”.

Zenith Corporation are promoting “Body Enhancer” and “Bee V Balm” via their website www.zenith.co.nz. Claims are made that their products are backed by research but none is evident, only the usual testimonials which are the hallmark of snake-oil salesmen. The language is very carefully chosen, for example: “Under NZ law and the Medicines Act 1981 we are prohibited from telling you how our products and the ingredients they contain will work for your benefit.” Wrong. They are prohibited by law from making claims for which they have no evidence.

Malcolm Harker’s website www.malcolmharker.co.nz tells us that he has been making traditional herbal medicines since 1981. The website is a bit “clunky” and lacks functionality but is worth a visit, if only to enjoy some of the product names. Troubled by “brain fatigue”? Try “E-sense”, a mixture of sage (geddit?), rosemary, gingko, kelp and fucus. That last ingredient sounds a trifle unpleasant.

I urge all readers to visit these websites and send in questions about these products. The alternative health literature is an endless source of whacky ideas and because so many of the people involved are scientifically illiterate, there are some wonderful howlers. Take this one for example:

“The activity (ie “hotness”) of the capsicum family is measured by British Thermal Units (BTU). Good quality cayenne capsules come in extra hot which is 100,000 BTU.”

One BTU is the energy required to raise the temperature of 1lb of water by 1°F. It has nothing to do with the perceived “hotness” of cayenne pepper. Consider a hot water cylinder containing 200lbs of water. 100,000 BTU by my calculations would raise the temperature of your cylinder by 500°F. I will leave you with Alan Pickmere’s comment: “rather a cheap way to heat your bathwater”.

Yoga for Sickness Beneficiaries

For many years I have been corresponding with various officials and bureaucrats about the continuing scandal of the sickness benefit. A short-term benefit for illness has been turned into a lifestyle and all that is required to gain this benefit is a signed certificate from a doctor. It is a matter of some regret to me that members of my own profession have been largely responsible for an increase of 3000 on the sickness benefit since July 2000. Over 4000 people have been on a sickness benefit for more than five years, 182 for more than 15 years and five for over 20 years.

At the expense of sounding like a redneck I get particularly annoyed when I read in the paper of professional criminals described as “sickness beneficiaries”. They are too sick to work but well enough to commit burglaries and serious criminal offences. All of my attempts to find out details of these cases have been thwarted by “privacy considerations”. This means that a third party (a doctor) can commit the state to providing a benefit with no independent means of auditing these decisions. The Government continues to express concerns as to why so many people are going on to sickness benefits. The answer is simple: because they can!

But wait … a novel solution has been found. Selected sickness beneficiaries are being offered “yogic breathing to help them get a job”. This has been described by critics as “unscientific, dangerous, and bullshit”.

However, let’s not write it off completely. If they also offered yogic “flying” this could offer the dual benefit of a return to work and a means of getting there. But what next? I predict language courses in Klingon?
Sunday Star Times May 18 2003