Hokum Locum

Diffidence based medicine

Some doctors see a problem and look for an answer. Others merely see a problem. The diffident doctor may do nothing from sense of despair. This, of course, may be better than doing something merely because it hurts the doctor’s pride to do nothing.
New Zealand Medical Journal Vol 113 No 1122 p479

Maori Traditional health (Rongoa Maori)

I have received a letter dated Sep 30 2002 answering some questions I had asked on this matter. $1,190,000 has been allocated nationwide to 12 contracted Rongoa Maori Providers. The Marlborough share amounts to $100,000. This seemed to me a golden opportunity to have Rongoa Maori evaluated by the Ministerial Advisory Committee on Alternative Health (MACAH) but the letter tells me “The Rongoa Traditional Healing services will not be referred for evaluation by the MACAH at this time as it does not fall within their terms of reference”.

It seems to me that MACAH has become a redundant quango, much like the similar body in the US (National Institute of Health) which has also failed to make any meaningful comments on the efficacy or otherwise of any alternative medical modality. It would of course be disrespectful to Maori to test Rongoa medicine and show that it was useless.
Letter from Deputy Director-General, Maori Health, dated 30 Sep 2002.

Nuclear Test Veterans

When people believe that their health has suffered from some experience they can become obsessional and develop all sorts of strategies for defending their delusional beliefs. A British study found that veterans of nuclear tests were no more susceptible to cancers than members of the public. Sound familiar? Just think about Gulf War Syndrome and the current fuss over the spraying of the painted apple moth in Auckland.

A spokesman for the veterans was quoted as saying that the findings would not affect the push for compensation. I have seen claims from these people that as various tests were conducted they could see an Xray of their hand bones during the flash! This is fantasy and the whole thrust of the compensation issue is the belief that they were used as “guinea pigs”. There has never been any evidence that servicemen were deliberately exposed to radiation as an experiment.
Dominion Post 26/2/03

Sudden Infant Death Syndrome (Sids), Murder and logic

After a family had suffered four deaths from Sids, a woman’s estranged husband found her diary in which she documented how she had actually murdered the children. Post-mortem examinations at the time were inconclusive (Marlborough Express 2/4/03).

This case reminded me of another similar episode where a plausible woman murdered five children and was written up by a gullible paediatrician as a case of “familial Sids”, despite the protestations of an experienced pathologist who is quoted as saying: “One unexplained infant death in a family is Sids. Two is very suspicious. Three is homicide”. There is a book about this case and in my opinion it is essential reading for all Skeptics because it has so many lessons about belief, logic, flawed research and delusional thinking.
The Death of Innocents by Richard Firstman & Jamie Talan, Bantam Books

Severe Acute Respiratory Syndrome(Sars)

The media have been doing their usual excellent job of fostering panic and hysteria over a viral illness that has a mortality rate of only about 3 per cent and kills mainly old sick people. The reporting has been abysmal with no attempt to compare Sars with, say, influenza, and no intelligent discussion about mortality rates as compared to other common infectious illnesses. In my hometown of Picton there has been a run on facemasks and pharmacies are having to restock. After about 15 minutes of use facemasks become useless.

I have heard only one commentator reminding us that millions of people die every year from tuberculosis, malaria and Aids.

Variations on a Theme

When a placebo therapy becomes commonplace, it can be a good marketing tool to introduce some subtle variation which adds novelty and appeal. Chiropractic is a placebo therapy based on a plausible but unproven theory and using the power of touch (laying on of hands). The “McTimoney is a more gentle form of chiropractic involving small fast movements to release key muscles, allowing the bones to naturally move back into place”. A new local practitioner is quoted as saying “It’s very exciting. I feel a bit like a missionary”.This is quite an appropriate metaphor because many alternative practitioners have an air of religious fervour and this type of personality enhances the placebo effect.

These subtle variations of alternative medicine are unlimited and it makes good sense to use them in combination. This maximises the placebo effect.
Marlborough Express 9/4/03


Placebos are sometimes referred to as “sugar pills”.It is rather fitting that Ambrotose is made from eight sugars, aloe vera and vegetable extracts. A month’s supply costs $300 so the profit margin must be huge. It appears that New Zealand has a vast population of gullible consumers with too much money. As WC Fields said: “Never give a sucker an even break”.

I have thought of a product for such people:

“Gullitose” is made from only natural sugars and salts. It is a health supplement (insert here 20 fictitious testimonials from cripples, mother of six and Aids victims) and assists the natural healing of the body. Send $400 to (insert PO Box number). Discovered by Professor Leiw PhD (University of Wakula Springs) (insert picture of jovial bearded man).

All joking aside, it is sad to think that people are wasting their money on sugar pills. $300 is a week’s wages for many people.
Dominion Post 12/3/03

Hokum Locum

Providence based medicine

If the caring practitioner has no idea of what to do next, the decision may be best left in the hands of the Almighty. Too many clinicians, unfortunately, are unable to resist giving God a hand with the decision-making.
New Zealand Medical Journal Vol 113 No 1122 p479

Acupuncture and ACC

I am pleased to report that I received a reply from Dr David Rankin acknowledging the dearth of evidence for the widespread use of acupuncture. ACC are taking a responsible attitude and are commissioning a wide range of studies looking at current treatments in order to assess which of them are truly effective in speeding recovery and the return to work.

Saint Goncalo of the Immaculate Perineum?

Haemorrhoid sufferers are flocking to a church in Portugal in the belief that exposing their afflicted behinds to the statue of a local saint will cure them. I have named this pious act “anoflection”. However, the local Priest drew the line at allowing a young woman to pray naked in the hope that this would cure her severe acne. Given the revelations of widespread sexual abuse by priests, it would appear most unwise to expose oneself in this manner in a church.

Saint Goncalo, a 13th Century priest, also has a history of helping women find husbands. Every June, during a festival in his honour, unmarried men and women exchange penis-shaped cakes as tokens of their affection.

There is clearly no need for our organisation to attack or ridicule religious belief when the Catholic Church is doing it for us. I believe that we should sincerely welcome these quaint rituals into our culture. I look forward to a new range of phallic pastries at my local bakery.
Dominion Post 14/1/03

Placebos and homeopathy

The business of science is generating testable hypotheses. This is the classical approach espoused by Popper who put it in a negative sense in that he proposed that for something to fall within the realms of science, it had to be capable of being falsified (proved wrong). This approach has been criticised by Skrabanek in particular because he felt that nonsensical propositions should not be tested. In this respect Skrabanek raised the idea of having some kind of demarcation of the absurd which would avoid dignifying pseudoscience by testing it. For example, the Popperian approach requires us to test homeopathy in double-blind placebo controlled trials. Skrabanek’s approach would be to argue that homeopathy breaches so many scientific laws that it is already outside the tenure of science.

With respect to homeopathy, it is clear that placebo controlled trials of homeopathy are trials of one placebo against another. This explains the tendency for published trials to fluctuate around a midpoint with some showing a small positive effect and some no effect. The philosophy of David Hume teaches us to suspect either self-delusion or fraud if any published trial of homeopathy shows a dramatic effect of homeopathic solutions in any biological sense. The best example of this is the famous Benveniste study published in Nature. (Davenas et al., Nature, 1988, 333:816). This study could not be replicated by any other laboratory unless the experimental work was done under the supervision of Elizabeth Davenas.

After a team of skeptics (Randi et al) supervised a repeat of the work under their close scrutiny the original results were shown to be a delusion with implications of fraud and Benveniste was summarily sacked. People who believe in homeopathy are in the grip of an enduring delusion. Benveniste is a classic example of this and he has recently published a paper titled “Transatlantic transfer of digitised antigen signal by telephone link” (J. Allergy Clin. Immunol. 99:S175, 1997).

The claim is made that “ligands so dilute that no original molecule remained still retained biological activity”. The abstract is classically incomprehensible pseudoscience and Benveniste has the Gallic arrogance to quote his original discredited trial in the references!

Ginkgo flunks

Ginkgo is an herbal type product claimed to enhance and improve memory. Given what I have just written about placebo controlled trials it will come as no surprise that ginkgo provides no measurable benefit in memory or other related cognitive function. This will have absolutely no effect on the sales of this product because if people believe that it works then they will continue to buy it. Those people who sell the product will find endless reasons to defend their promotion of this useless remedy. I referred earlier to science involving the generation of a testable hypothesis. The practitioners and promoters of pseudoscience have become very skilled at generating endless secondary hypotheses to the point where further testing is impossible. Here are some examples:

  • The trial was too short/long
  • They should have used “x” and not “y” strength ginkgo
  • They should have used added vitamin C, selenium etc. etc

Ginkgo for memory enhancement: a randomised controlled trial. Solomon et al. JAMA. 21 Aug 2002. Vol. 288. No.7. p835-40

Chelation Fraud

A reader of the New Zealand Family Physician (Vol 29 Number 6, December 2002 p366) recently took issue with a review of a paper (Knudston et al., JAMA 23 Jan 2002, Vol 287 No. 4 pp481-6) which concluded “there is no evidence to support a beneficial effect of chelation therapy in patients with ischaemic heart disease, stable angina, and a positive treadmill test for ischaemia”. This was a placebo-controlled trial and the conclusions are the same as for similar published trials. The reader, however, objected to the use of an active placebo and claimed that this rendered the conclusions invalid. The debate raises several important issues.

  1. Chelation quackery is a worldwide growth industry worth millions of dollars. The hypothesis is that symptoms of coronary artery disease (CAD) will improve following the removal (by chelation) of calcium from atherosclerotic plaques in the coronary arteries. Despite an overly simplistic view of CAD it seems like this is a testable hypothesis but wait a minute. Chelation clinics exist all over New Zealand and as yet there are no, and I repeat no double blind placebo controlled trials proving that chelation is more than a placebo. In fact, the Knudston trial is further evidence that chelation is ineffective. There is a worrying trend here, seen also with acupuncture, where unproven therapies are introduced into practice and opponents of such quackery are then challenged to prove that the given therapy is ineffective. I object to this argument. It is up to the proponents of new therapies to prove that their treatments are superior to placebo. In other words, put up or shut up.
  2. The reader wrote in and objected that the Knudston trial used an active placebo. A placebo is by definition an inert substance. However, some drugs or treatments produce marked effects. For example, if the drug under test caused the patient’s skin to turn green it would be easy for both patient and doctor to determine who was receiving the drug or the placebo. The experiment has become “unblinded” and this is fatal to any conclusions that might be drawn. This problem is well recognized and some trials even invite participants to try and predict whether they received the test drug or the placebo. This is a sensible test of the blinding. Chelation mixtures are based around EDTA, which allegedly leaches calcium out of atherosclerotic plaques. Along with EDTA the preparations contain other drugs such as lignocaine, magnesium, vitamin C. Many of these are vasoactive and cause people to feel flushed or a little euphoric. If a true placebo was used it would not cause these effects and therefore the experiment would have become unblinded. It is therefore sometimes important to use active placebos whose side effects mimic those of the drug under evaluation. For example and I quote: “forty (59%) of 68 of the antidepressant studies published between 1968 and 1972 using an inert placebo control reported the antidepressant as effective, compared to only one (14%) of seven studies using an active placebo (atropine)”. (The Powerful Placebo, Shapiro, page 206). The antidepressants under test all caused a dry mouth and slightly blurred vision as does atropine. The use of an active placebo was clearly very important and shows once again how the expectations and optimism of researchers can lead to a serious overestimate of the efficacy of new drugs.
  3. Chelation mixtures are non-standard and contain a wide range of drugs in addition to the chelating agent EDTA. This allows quacks to get maximum effect from the generation of endless secondary hypotheses. Suppose we test just EDTA versus placebo and produce the expected result of no effect. The quacks will start bleating that we didn’t have Vitamin C, magnesium, rhubarb, senna pods (pick anything you like) so back to the laboratory. No sooner do you test one combination and they will come up with another. This is the generation of the endless secondary hypotheses and this is a sure sign of a pseudoscience. The hallmark of science is the generation of what Staudenmayer (Environmental Illness: Myth and Reality, Lewis 1999) calls a “hard core postulate” and he goes on to say: “When hard-core postulates cannot explain a phenomenon, auxiliary postulates (ie. Secondary hypotheses) are often invoked to protect them from refutation (ie. being proved wrong).

Hokum Locum

Yet Another Alternative to Evidence Based Medicine

Eloquence based medicine

The year round suntan, carnation in the button hole, silk tie, Armani suit and tongue should all be equally smooth. Sartorial elegance and verbal eloquence are powerful substitutes for evidence.
New Zealand Medical Journal Vol 113 No 1122 p479

Acupuncture Flunks

A comprehensive literature search has concluded that there is no strong evidence for the effectiveness of acupuncture in treating and rehabilitating musculoskeletal injuries when compared to other forms of treatment. This is similar to the conclusion of Ernst & White, who reviewed 600 references and concluded, “the only compelling evidence is that acupuncture is efficacious for the treatment of backache, nausea and dental pain.” (Acupuncture: a scientific appraisal, Ed. Ernst & White, Butterworth-Heinemann, 1999)

The National Council Against health Fraud (NCAHF) concluded in 1997 that “acupuncture is mostly a powerful placebo and/or a psychological aid for use in managing behavioural disorders.”

I intend writing to David Rankin at ACC Healthwise, to ask him how they will justify continuing to pay for unproven treatments such as acupuncture.
ACC News August 2002 Issue 48
NCAHF Newsletter Vol 20, No. 6

Water births have no proven benefit

Considering man’s status as a terrestrial mammal, the pre-occupation with water births has appeared on the scene like some kind of antediluvian regression. It seems like the more advances are made by medical science, the more people want to revert to medieval superstition or New Age silliness.

There have been few trials of water births but plenty of reports of near-drownings of newborn infants. Many years ago I was invited to attend one such birth, but my attendance was cut short when I asked if I could bring my dive gear and speargun. Those slippery newborns can be elusive! Seriously though, what’s next? Water births attended by orcas and dolphins at Napier’s Marineland? Hmmm, could be a great new tourist attraction. A clever dolphin could soon be trained to flick the newborn infant up out of the water and into the arms of the waiting midwife. There has to be an idea there for some tasteless new TV program.
Marlborough Express 12/8/02

Oxygen Therapy

As we all know, oxygen is essential for life. If something’s good for us it stands to reason that a lot more must be even better. This is the rationale for extra vitamins, food supplements and so on. Oxygen clinics are an excellent scam because if properly run there is an unlimited crowd of gullible customers. All you need is some convenient threat, for example air pollution, and you have a perfectly reasonable excuse to remedy that problem by offering people oxygen in pleasant and soothing surroundings. A clinic based in Calcutta offers twenty minutes of oxygen via nasal prongs “where customers can sink back into soft leather chairs, inhale oxygen flavoured with various scents and be lulled by soothing music.” There’s only one small problem. Our haemoglobin, the oxygen carrying pigment in the blood, is about 98% saturated with oxygen at the earth’s surface. Inhaling extra oxygen does not improve this saturation at all. In fact, I would bet anything you like that if the oxygen was substituted for clean air the subjects would feel just as refreshed and still cheerfully pay their 175 rupees. This is a classic placebo scam. Someone should start a similar clinic in Auckland aimed at the same sort of people who buy energy drinks. As WC Fields was fond of saying – never give a sucker an even break!


Imagine a doctor’s surgery. A patient complains of tender areas everywhere. This is what I call “und here” after the German syndrome of the same name. The patient has pain here, und here und here. The doctor examines the patient and finds that they are indeed tender in the areas where they say they are tender! This ridiculous folie-a-deux has been sturdily defended by a few remaining rheumatologists. It has taken a judge to rule “evidence of physical symptoms is not evidence of physical injury” and “is not compensable by ACC”.

Fibromyalgia (aka “fibro-sitis”) is a typical psychosomatic complaint where vague malaise and non-specific aches and pains get endorsed by a group of specialists. Skeptics noted that four fifths of patients were women and it is now recognized that the syndrome is indistinguishable from chronic fatigue syndrome. (Shorter Pg313)
ACC News September 2002 Issue 49
From Paralysis to Fatigue, Edward Shorter, 1992 The Free Press

Get an Educayshun??

Until I looked at the site www.massagecollege.co.nz I had no idea that ridiculous pseudo-science such as holistic pulsing and polarity therapy could be studied and rewarded by NZQA recognition. It gets worse. Student subsidies are available from Winz. I have written to both Winz and the NZQA asking how taxpayer funds can be wasted in this manner. Watch this space.

The Wisest Fool in New Zealand?

A GP colleague forwarded me a portion of letterhead from a doctor who practises chelation therapy as well as using Electro acupuncture of Voll. I have discussed this latter quackery before. It is an evolution of the “black box” and its use by registered medical practitioners should occasion a referral to the Medical Practitioners Disciplinary Committee. When I read the list of qualifications held by this doctor I was reminded of the famous description of James 1 of England as “the wisest fool in Christendom.”

Here is the list – the meaning of most is obvious: B.Med Sc. MBChB. Dip Bus Admin. MRNZCGP, ANZIM, BSc, Dip Obst., MRACGP, MSc, FAMS, BA, Dip AvMed, MRSNZ.

The Diary of Inspector Melas

I cannot reveal how this diary excerpt came into my possession but it gives an insight into police methods in relation to the Christchurch Civic Crèche case. I reproduce it verbatim. The original has been placed with my lawyer.

Monday That damned book has won a Montana award! Called a meeting to discuss how to counter these attacks on our integrity. Det. Dixon suggested contacting the Counsellor who has been seeing B. and making good progress with regression therapy. ACC have agreed to pay for a further 1500 counselling sessions. (1703 for the mother – she’s making good progress).

Tuesday Wonderful news. B. has recovered more memories. The tunnels. I knew they existed! Material very detailed – dates, times etc. Regular underground trips involving other Cr&egraveche children in the company of known Christchurch Satanists and pornographers. Contacted Karen who confirmed that these are absolutely classical descriptions of systematic child abuse. Ordered Det. Green to obtain ground-penetrating radar.

Wednesday Phoned by some loony in Fendalton who claimed his dog was psychic and could help our investigations. Told him we don’t use that sort of unscientific rubbish. 1430: Green phoned. Promising radar returns from under the Civic crèche. The tunnel complex!!! Decide to hold press conference after we have the evidence. Told them we were on the verge of a breakthrough. Great excitement.

Thursday Meet on site with excavation team. B. present with whanau. (All our supporters.) B. has apparently remembered “dancing, poos, clowns and somebody called Lara Croft”. (NB. not one of the original accused) Probably need Karen to interpret that when we interview the suspects again and lay charges. Det. Green offered to let me break into the tunnel. Most unfortunate – hit the main sewer. Bugger. Green apologetic. Told him to sort out the mess. B. very upset and will probably need more therapy. Went home and changed uniform. Cancelled press conference.

Friday Depressing day. On the phone mostly sorting out the repair of the sewer. Called up to see the Boss – he was not happy at all. No more tunnel searches. Found two copies of the book in a second-hand shop on my way home and burnt them. Cheered up a bit. Rem – must follow up the Lara Croft lead on Monday (and clowns).

Hokum Locum

Another Alternative to Evidence Based Medicine

Vehemence based medicine: The substitution of volume for evidence is an effective technique for brow-beating your more timorous colleagues and for convincing relatives of your ability. New Zealand Medical Journal Vol 113 No 1122 p479


This pseudoscience is now being advertised on television. In the same way that acupuncture can be easily learned during a one-hour lecture, anyone can learn how to make the spine go “click”. Many lay people have discovered this for themselves. Four or more years of training are unnecessary when a modality has no scientific basis. You only need to learn how to produce a pleasing noise from the spine without harming the patient. Osteopaths extend this effect to include the joints. If you pull firmly on your fingers you get the same effect, often a dramatic crack. Various theories have been proposed for this such as air bubbles, but I have noticed that large joints frequently produce all sorts of noises when they are being examined. When the neck is forcibly manipulated in this way there is a real risk of serious injury to major arteries in the neck. The shearing forces cause a tear in the arterial wall (a “dissection”) and this interruption to the blood supply to the brain can cause a stroke. If you have a sore neck and simply wait for it to get better you are not exposed to this risk. I used to do a lot of spinal manipulation but gave it up because patients started coming back all the time to have their spine “put back in”. I had unwittingly stumbled upon the secret of chiropractic! This became very tiresome and I stopped the practice after giving myself a nasty fright when a patient fainted and I thought I had killed her. Chiropractors talk about “adjustments” and this is the source of their income – adjustments to their bank accounts. Once the patient is convinced of the need for frequent adjustments, the chiropractor has a regular patient for life. For a detailed view of the pseudoscience of chiropractic visit www.quackwatch.com.

For a review of serious adverse effects of chiropractic refer Ernst E. Medical Journal of Australia 2002; 176: 376-380

Good Health

I have forwarded a copy of this publication to the editor. It is an advertising supplement for alternative medicine. Good Health employs a resident naturopath, Lani Lopez, complete with a Kentucky fried medicine qualification – N.D. Dip J. Herb. We learn that Mandy Smith owes everything to a diet rich in pond scum (spirulina aka blue/green algae). Auckland-based readers will be delighted to know that NZQA loans and allowances are available if they wish to obtain such qualifications from Wellpark College of Natural Therapies. Refer www.wellpark.co.nz, although their website was down when I visited. I was particularly taken with an article on joints with metaphors such as “creaking hinges and rusty joints.” My left knee has osteoarthritis and I learned that “essential oils, Clove, Frankincense, and Cajuput oil penetrate deeply into swollen areas and support normal joint articulation.” The only problem with that claim is that human skin is actually impervious to such treatments as it is a very effective barrier. However, I had a biomechanical brainwave. Why not insert grease nipples over troublesome joints and use a modified grease gun to pump the “two main natural ingredients Glucosamine and Chondroitin” directly into the joint? The next time I take the car for an oil change and grease I’ll have my knee done as well, and if that fails there’s always…

Doctor Levine’s Patented Power Knee Strap

There must be plenty of money in this product as it has recently featured in several half-page advertisements. It is claimed the strap provides relief from arthritis and chronic knee pain. The strap costs $24.95 and is designed to sit just beneath the kneecap. Dr Levine is described as a “nationally famous physician and former head of orthopaedic surgery at one of New York’s leading hospitals.” I decided to check these claims and the website of the American Medical Association (www.ama-assn.org) had a search engine by doctor’s name. This confirmed the existence of Dr Jack Levine. The website also had a statement of the ethical standards for the AMA members and it appears that this advertising is a breach of Article 2. I emailed the AMA pointing this out and will report back, assuming they bother to reply. The strap is obviously a placebo. It might work if it was tightly placed around the upper thigh where it could cut off the circulation, compress the nerves and produce a pleasing numbness – a sensation that frequently comes over me when I am confronted with American consumerism.

Slimming the easy way

A 44-year-old woman was referred to hospital with anxiety symptoms, weight loss and hypertension after taking a Chinese herbal remedy for weight loss. Her doctor was obviously suspicious about the composition of this preparation because it had actually worked. These preparations are normally useless. The initial suspicion was that the herbal remedy contained ephedrine (“Ma Huang”), which is a dangerous but commonly used preparation. Gas chromatography revealed, however, that the herbal preparation was adulterated with fenfluramine, a potent and dangerous amphetamine derivative. One can only agree with the author of the report: “stringent regulation of traditional medicines, at least to the standards of conventional practice, is urgently needed”. British Medical Journal Vol 324 16 March 2002 p679

Recovered Memory

This contemptible pseudo-science is still blighting lives all around the world despite being condemned by most authoritative Psychiatric Colleges. Psychologists at the University of Otago have found that children can only explain early childhood events using the language they knew at the time. The researchers are quoted: “If you take our data to their logical conclusion, then one implication would be that we need to express scepticism about very early verbal memories that are recovered during the course of therapy”.

The merciless badgering of self-deluded therapists is a process very similar to “facilitated communication”. This is where the “facilitator” guides a handicapped person’s fingers on a keyboard to produce written communication, which the person is incapable of when unaided. This is of course a complete delusion and we have experimental psychologists to thank for exposing this nonsense which should not be either encouraged nor funded by ACC.

Article Published in US Psychological Science-reported in Sunday Star Times 28 Jul 2002

Alternatives to Evidence Based Medicine

Alternatives to Evidence Based Medicine

I will detail these seven alternatives in forth-coming issues of the magazine. For now here is Eminence based medicine: The more senior the colleague, the less importance he or she places on the need for anything as mundane as evidence. Experience, it seems, is worth any amount of evidence. These colleagues have a touching faith in clinical experience, which has been defined as “making the same mistakes with increasing confidence over an impressive number of years.” New Zealand Medical Journal Vol 113 No 1122 p479

Homeopathy Flunks

It’s most unusual to see published trials showing that homeopathy is ineffective. The common term for this is “publication bias” where trials tend to be published only when they show something positive. One of the authors is GT Lewith, a long time apologist for homeopathy and that makes it even more remarkable. Should we give them one of our awards?

A double blind, randomised trial evaluated the efficacy of homeopathic immunotherapy on lung function. The conclusion: homeopathic immunotherapy is not effective in the treatment of patients with asthma. BMJ 2002;324:520-3

An accompanying editorial comments: “we believe that new trials of homeopathic medicines against placebo are no longer a research priority.”

All responsible health professionals must ensure that homeopathy is never funded by the health system. It would be grossly irresponsible to waste public money on “dilutions of grandeur”.

Ministerial Advisory Committee on Complimentary and Alternative Medicine (MACCAH)

Have a look at their Website: www.newhealth.govt.nz/MACCAH/. I have been visiting from time to time in keen anticipation of the result of their deliberations and to see what quackery will be introduced into our failing health system. The committee comprises a sociologist (chairperson), iridologist, doctor of medicine, naturopath, acupuncturist, paediatric nurse (and massage therapist), and teacher. The iridologist is David Holden who organised the International Iridology and Sclerology Conference that I mentioned in an earlier column.

Certain members of the committee have asterisks alongside their names as a reflection of a possible conflict of interest. Readers will recall that our organisation was unsuccessful in getting any skeptics on this committee. Would such a putative member have warranted an especially large asterisk?

There is a similar committee in the USA. It has become a scandal that the National Institute of Health (NIH) has distributed (wasted?) hundreds of millions of dollars on testing what Americans refer to as CAM, or complimentary and alternative medicine. They spent $1 million testing “magnet therapy”. The majority of the studies have been inconclusive and have led to the need for more tests. This has tended to give such quackery a spurious degree of acceptability. As critics point out, how many studies have been published showing that CAM doesn’t work? Read a very good critique of this area at www.washingtonmonthly.com/features/2001/0204.mooney.html

It is quite clear, given the US experience, that the MACCAH will produce nothing of any value and furthermore I predict that they will never publish a single article stating that any CAM modality is useless. I sincerely hope to be proved wrong.

Laying on of Hands

Every doctor of medicine knows the importance of properly examining patients even when they do not expect to find anything wrong. The act of touching people in a therapeutic context carries a very powerful placebo effect. This is a legitimate part of the "art" of medicine and when coupled with good communication leads to a good outcome. This effect is sometimes referred to as the “laying on of hands”, itself derived from the concept of mediated divine healing. For example, the King’s touch was supposed to cure scrofula, a cutaneous form of tuberculosis.

The extreme version of this is the absurd delusion of therapeutic touch where the patient is not actually touched but their energy fields are "corrected". Don’t laugh; this is part of mainstream nursing at Wellington Hospital!

The laying on of hands effect explains the apparent success of many physical treatment modalities such as osteopathy and chiropractic. They all do exceptionally well out of ACC-provided funding and it is no wonder that a recent provider survey found a high level of satisfaction from chiropractors (79%) and physiotherapists (76%). I once asked an ACC Colleague why they funded quackery such as osteopathy and chiropractic and his reply was that ACC didn’t care about anything except getting people back to work. Applying that logic I could set up a military consultancy (Boot Camp Rehabilitation Inc) and get people back to work by threatening them with military-style discipline.

Here is an extract from an advertisement from my local paper: "cranial osteopathy for babies and children to help with poor sleeping patterns, restlessness, crying and poor concentration". This quackery involves allegedly manipulating the bones of the skull to regulate the flow of cerebrospinal fluid. It is complete and utter nonsense that relies for its effect on the touching, a plausible patter and a gullible consumer.

ACC News October 2001 Issue 39

Bye, Bye, Bivalve

Trials of green-lipped mussel extract have been stopped after it was found that “the extract didn’t work.” (Marlborough Express March 11, 2002). Green-lipped mussel extract was marketed in NZ as Lyprinol and more than $1 million of the product was sold after it was claimed that it was a cure for cancer. Successful prosecutions were taken against those responsible for the scam.

The media frenzy showed that journalists had learned nothing from the Milan Brych affair.

I feed our cat (Gilgamesh) on green-lipped mussels, and as well as a lustrous coat he has shown no sign of developing cancer. I rest my case. In order to satisfy the most sceptical of journalists I enclose this picture as proof as he and Claire read the Lyprinol story.

Healthy Options

This is the title of a magazine that contains some of the most nonsensical rubbish I have ever seen. The editor is the woman responsible for promoting the Hoxsey quackery in Tauranga, which led to dozens of desperate cancer suffers taking one-way trips to Mexico to receive treatment. Tauranga travel agents made a killing in every sense of the word. This magazine should be read by all Skeptics in order to get a taste of what could be inflicted on the health system by the MACCAH. One ray of hope however – they mentioned www.quackwatch.com and stated that “this leads the public to believe that natural medicines are a fraud.” Well-enough said!

Possum Peppering

Is this delusion never going to go away? How many trials does it take to show that burnt possum testicles do not deter possums from eating vegetation sprinkled with said preparation? The Green party are already a bit of a joke and this latest nonsense makes me wonder whether they have all been partaking of ganja while worshipping with Nachos Tandoori. However, there is more to this than meets the eye, or testicle. I tried sprinkling some of a late relative’s ashes around our garden and I haven’t seen the mother-in-law for months. I rest my case. It must also be horribly lonely for all of those people living downwind of a crematorium – they never get any visitors at all!

Hokum Locum

Get in Now While the Getting’s Good

John Welch finds that the sexual abuse industry rolls on unabated.

Sexual Abuse Rort

ACC (aka “Aggrieved Clamouring Claimants”) has thrown the doors wide open for sexual abuse claimants. They have budgeted 60 million dollars for sufferers who can claim up to $175,000 “without having to complain to the Police or name their abuser.” Not surprisingly, a Christchurch Law Firm has shown commendable initiative in touting for business with a leaflet drop because “lawyers had a professional obligation to make the public aware of entitlements.”

It is highly significant that a Christchurch firm has seen fit to profit from this ludicrous state of affairs. Proof of sexual abuse has never been required in Christchurch, the Salem of the South Pacific. Dozens of families pocketed tens of thousands of dollars for sexual abuse that never happened while dedicated and talented Christchurch Civic Creche workers had their lives ruined.

I am not sure that James Randi would approve of my challenge but here it is. I offer my endorsement of any claimant who is prepared to claim for ‘ritual satanic alien abuse’, especially if it occurs in a parallel universe.

Given the refusal of the Minister of Justice to read Lynley Hood’s book on the Christchurch Civic Creche debacle, readers could be forgiven for thinking that he and key members of the legal profession currently inhabit a parallel universe.

Several years ago a man spent $80,000 defending himself against charges of sexual abuse “remembered” by his two daughters. He was acquitted as he was able to prove that the alleged abuse not only did not happen but it was impossible for it to happen. A reporter reasonably asked the question of ACC whether the two daughters would have to repay their compensation. “Oh no,” said the Spokesperson, “they are entitled to it for their suffering.”

The budgeted sum of 60 million dollars will experience a blowout version of “Welch’s Law” which states that claims expand to take up the amount of compensation available.

Marlborough Express 9 Jan 2002

The Vigorex Products – Oat cuisine?

These are homeopathic extracts of ‘avena sativa’ and contain nothing injurious to health. Readers familiar with homeopathic theory will know that such a product description is entirely true. Homeopathic preparations contain precisely nothing and placebo controlled trials of homeopathic preparations are in fact trials of one placebo versus another. This explains why placebo controlled trials of homeopathy will sometimes produce a result favouring the homeopathic wing of the trial. This led one wag to suggest that what was needed were “double-strength” placebos!

Vigorex is a product developed from oats. Readers will be interested in the admission that “skeptics have doubted the existence of an effective sex enhancer.”

Reports indicated that “some fell (sic) an increase in energy within one or two hours and use it instead of coffee to get going in the morning … some say they start taking it on a Thursday or Friday in anticipation of a sexual weekend.”

I decided to rise to the challenge, hopefully in every sense. After extensive product testing I have to say that my wife developed a headache which was not relieved by another homeopathic preparation.

The Scots have eaten porridge for years so there may be more to this than meets the eye.

Pamphlet Supplied

Homeopathy useless against Malaria

Because of conventional drug side effects, a woman decided to rely on homeopathic drugs for malaria protection whilst holidaying in Africa. These homeopathic products were made from “African swamp water containing impurities, algae and plants as well as mosquito slough, larvae and eggs.” Following her return home she became very unwell and was admitted to an intensive care unit with multiple organ system failure due to malaria infection.

There will be no claim for medicolegal liability because “the manufacturer, who has performed no clinical trials on this drug, declines all responsibility regarding its use.”

Homeopathic remedies should only be used for harmless self-limiting disorders that require no treatment, which is precisely what homeopathy is all about.

BMJ Vol 321 18 Nov 2000 p 1288

Kentucky Fried Medicine

The NZ Health Authorities recently had to warn all doctors that two Chinese herbal medicine capsules contained the potent corticosteroid betamethasone. These were Cheng Kum and Shen Loon. The Ministry of Health had earlier removed Cheng Kum from the market when it was shown to contain the antihistamine chlorpheniramine.

Since most Chinese herbal remedies are either useless or dangerous it is hardly surprising that they are incorporating effective Western drugs in a fraudulent attempt to demonstrate effectiveness. The same problem has occurred in the UK where random tests were still finding banned substances such as mercury, arsenic and steroids in traditional Chinese medicine. Some also contained parts from endangered animal species.

Why should we respect medieval beliefs that endanger the continued existence of magnificent animals such as tigers because superstition demands the use of their bones? The criminals responsible for these excesses should be ground up themselves and processed into traditional remedies, and in this spirit I have formed a company marketing a new herbal remedy for cats called Meow Zedung.

BMJ Vol 323 6 Oct 2001 p770; MEDSAFE 14 Dec 2001

Flux for Flux?

While in Ireland recently I kept a watchful eye for useful material and was not disappointed by an article in the Irish Examiner of 14-11-01. A company managed to sell to over 485 schools, a $70 magnetic clip designed to be attached to the underwear and claimed to “banish the misery of painful periods.” The device is the size of a 10p piece and it is claimed “sends out a magnetic field which penetrates up to 7 inches into the body.”

This device is a classic placebo and it is easy to see how successful it would be in a Priest-ridden country where the Catholic religion ensures young women are made to feel bad about their emerging sexuality.

The article goes on to make the following claim “…66 out of 100 painful period sufferers took significantly less medication when wearing the device during their periods.” If these young women received sympathetic advice and explanation about their periods in a climate of healthy acceptance, there would be an equally impressive improvement.

I know of a much better market for this device. Some enterprising person should promote it for male impotence.

Fad Allergies

Around 20 in 100 Britains believe they suffer from allergies and intolerance to dairy foods and wheat-based products. However, nutritional research reveals the true figure is less than 1 per 100.

This is an area rife with quacks conducting all sorts of unscientific tests and giving potentially dangerous advice. People are using food allergies and intolerance as an excuse for weight gain and niggling health problems such as every GP’s fear – TATT (tired all the time) syndrome. The very idea that you can have a food allergy and gain weight is preposterous.

The Daily Telegraph 5 Nov 2001

Hokum Locum

The Women’s Weekly and Other Medical Journals

Dr John Welch goes eyeball to eyeball with the iridologists, and takes a look at some famous faces

Chiropractic Treatment of Infertility

During idle moments I read medical journals such as the Australian Women’s Weekly. In this case the issue was March 1999 and I really must speak to the Librarian about the disgracefully outdated journals currently held by the medical library.

Following extensive investigations for infertility, our reporter consulted Dr Naomi Perry, an Adelaide chiropractor, who “was doing revolutionary work treating women with infertility by manipulating their spines.” The chiropractor discovered that “Concepta” (not her real name) had a spinal curvature (scoliosis). This is hardly surprising since chiropractors diagnose this disorder in 100% of their patients, it being a central tenet of the chiropractic theory of subluxations. After four months of manipulation a pregnancy was confirmed. If the writer had stood on her head for two hours every night , a pregnancy would have eventually occurred since this event is a function of time for most couples.

Gypsies have the greatest success in predicting pregnancy. This is because they have crystal balls and can see it coming.

The White Stuff?

I was disappointed to miss the International Iridiology & Sclerology Conference held recently in Auckland. Iridologists have now discovered new secrets of divination using the sclera (white of the eye). This immediately reminded me of Ken Ring’s demonstration of “reading” elbows, knees or any part of the body for that matter. As far as iridology is concerned it doesn’t matter whether the iris, sclera, eyelid or the nostril are “examined”. Given a gullible customer, iridologists can spout any old rubbish and they will be believed. Nevertheless, there were some inspirational papers: “Pupillary ruff phenomena in the iris” presented by a senior iridology lecturer at the South Pacific College of Natural Therapies, and “Emotional resistance patterns in the sclera” by a US visitor whose qualifications included a ND (doctor of naturopathy) and a PhD from the University of Wakula Springs, the same one attended by Tarzan. The rather alarming claim is made that “it (iridology) is poised to become mainstream within this decade in many countries like NZ”.

Given the composition of the Health Minister’s committee on alternative medicine, this is a distinct and unwelcome possibility.

Health Secrets of Your Face

Each of the five elements which form the basis of acupuncture-earth, fire, water, wood and metal-have a corresponding face shape which tells the analyst about a person’s talents, personality and potential health problems. Kate Winslet sought the help of a facial analyst when she needed to shed 25 kg of weight gained during her pregnancy. For her “wood” face she was told to “prune” back on sugar, wheat and dairy products. The diet worked so well she not only shed some ugly fat but got rid of her husband…

The face is viewed as a map with different areas representing parts of the body. For example, the forehead represents the bladder and the area between the eyes relates to the spleen and gall bladder. Never be tempted therefore, to squeeze any pimples in this area!

Catherine Zeta-Jones has a “metal-type” face that doubtless describes her attraction to Michael Douglas who is certainly “well-metalled”.

New Zealand Woman’s Weekly 15 October 2001

US cancer institute funds trials of complementary therapy

The Gonzalez regime is a program of dietary modification, supplements and “detoxification” using coffee enemas. The supplements include animal glandular extracts, vitamins, trace minerals, papaya and magnesium citrate. Gonzalez has based his treatment on pseudoscience and anecdotal evidence of success has seen US$1.4 million dollars wasted on a formal clinical trial. I predict that the treatment will be a complete failure but this will not deter Dr Gonzalez from continuing to promote this worthless treatment. Neither will this deter gullible individuals from wasting money on this fraud. Rectal coffee could well be dangerous as the following account will demonstrate.

British Medical Journal Vol 320 24 June 2001 p1690

Fatal heart attack from a health food product

A woman collapsed and died soon after drinking a “natural” health drink containing guarana and ginseng. She had a faulty heart valve as well as a history of palpitations and had been warned to avoid caffeine, which is a heart stimulant. Her blood caffeine level was 19mg/L, the equivalent of drinking about 20 cups of coffee. The caffeine concentration in the drink was 60 times greater than levels found in cola drinks. Guarana seeds contain about 5 percent caffeine.

Medical Journal of Australia 174:520-1, 21 May 2001

Dangerous Chinese Medicines

Traditional Chinese medicines are basically placebos and when they do seem to work it is largely due to the illegal insertion of potent western medicines such as steroids. They can also contain mercury and arsenic, as well as toxic herbs and even banned animal species.

An Indonesian man was brought to a Hospital emergency department and was found to be confused due to a low blood sugar. After an injection of glucose he recovered and was able to tell his medical attendants that he was taking a Chinese remedy called “Zhen Qi”. The label on the bottle listed the ingredients as ginseng, pearl, ram’s horn, bark and “frog extract”. Gas chromatography revealed that the mixture also contained glibenclamide, a potent oral hypoglycaemic agent used for treating diabetes!

For once I join with naturopaths, homeopaths and alternative health practitioners everywhere, in condemning this cynical attempt to make sure harmless and ineffective quack remedies actually work by the inclusion of dangerous but effective drugs.

British Medical Journal Vol 323 6 Oct 2001 p702, p770

Hokum Locum

Re-birthing Finale

A Colorado colour therapist was jailed for 16 years after being found guilty of causing the death of a 16 year old girl. It must have been quite traumatic for the jury who watched a videotape of the session in which the girl begged for air and screamed that she was dying”. What we need in New Zealand are equally tough laws that protect children from acts of omission, particularly where children are denied safe and effective medical treatment in favour of ludicrous quackery. (Dominion June 20th, Hokum Locum #59)

Weight-loss scam

The diet business is worth a lot of money and the latest scam has been to persuade people to part with up to $300 for a three month supply of plasters containing a seaweed extract guaranteed to “lose between two and four kilograms a week”. This degree of weight loss is not only unsafe but extremely unlikely as there is no possible mechanism for it.

I have been on a self-imposed diet which involves modest restriction of food intake and a modest increase in exercise and I have lost 7 Kg over a four month period. This is within dietitian’s guidelines that recommend no more than 500g weight loss per week. It has been easy and not involved spending any money.

It appears that all I need is a beard, a website and a catchy title for my diet (suggestions please) and hordes of gullible New Zealanders will pay me vast sums of money. The secret is to give no guarantees and avoid breaches of Consumer laws.


An enduring urban myth has been tales of children being raised by animals. The latest such story by credulous journalists appeared in the Dominion 20 June 2001. The 10 year old was alleged to have lived in a cave with wild dogs and suckled from one of the females. However, a Police spokesperson put an appropriate spoke in this suggestion by stating “we can’t tell whether he had been suckled or not.”

This story will now enter popular mythology along with all the other stories that have been repeated since the days of Romulus and Remus, two Roman orphans who were fed by flying pigs.

True lies

This is the title of an article appearing in New Scientist 7 April 2001. Experimental Psychologists found that 30% of a group of children recalled “uncomfortable touching” episodes which had not happened to them but were mentioned in a story scenario. Their recall accuracy was even worse when they were asked questions that required a yes/no answer.

This was the problem in the Christchurch Civic Creche case where faulty interviewing techniques were used by people (the new witchfinders) who had a particular belief structure and looked for evidence to prove their loony theories (aided by a loony complainant). In the process they ruined the lives of a group of children and their caregivers, and contrived to send Peter Ellis to prison. The Judicial review was laughable but carried out with the same careful examination of evidence as would have been accorded a claim of alien abduction.

The Australasian Journal of Integrative Medicine

I have forwarded my copy of Vol. 1 No. 1 to the Editor. It could become a valuable archival item in our reference collection.

I am not going to bother analyzing the content but one thing that bothers me is the array of recognized training for pseudo-scientific rubbish. Various Medical Colleges award re-accreditation points for courses on homeopathy, acupuncture and herbal medicine. It seems that as long as a training process has been set up it doesn’t matter about the content. Skeptics have already successfully attacked a proposal in New Zealand for a BSc in Naturopathy.

The overall method of practising alternative medicine is to spend about an hour with patients taking a detailed history which in itself is a form of psychotherapy and engenders a very powerful placebo effect. You then throw in a gimmick such as herbs, acupuncture, or homeopathy to add the “magic” which produces a grateful patient who “feels” better.

When skeptical investigators test all of these things by controlling for the placebo effect, they find no change in objective measurements of health parameters.

More on Buteyko Breathing technique (BBT)

This is a belief that asthma can be treated by deliberate shallow breathing which raises carbon dioxide levels in the lung. The respiratory rate is closely controlled by CO2 levels. When you hold your breath, CO2 levels rise and eventually you are forced to take a breath. If you deliberately over-breathe then CO2 is “blown off” and this causes people to feel dizzy and peculiar (hyperventilation).

Professor Buteyko believes that the fundamental cause of asthma is hyperventilation and his method is aimed at getting patients to deliberately hypoventilate. Several studies have been done and one would obviously expect to find raised levels of CO2 in people practising BBT. There was none.

Patients practising BBT felt better but there was no change in their use of asthma medication.

BBT produces a classic placebo effect which is what one would expect since the cause of asthma is known to be inflammatory changes in the airways of the lung.


I thought it would be interesting to review what’s on offer from the Sunday News on July 1st.

“Stop snoring or your money back”….not a good claim to make when it’s very hard to see how a “natural blend of enzymes and herbs” can possibly stop snoring. This preparation is marketed as “Dr Harris Snore Tablets”. Shouldn’t that be “anti-snore?”

Clive Clinics have been around for decades and their itinerant trichologists are promising assistance through hair analysis which “can indicate vitamin, mineral or toxic problems…” It is claimed that “your parents are the reason for your baldness” but there may be “treatments that block the genetic messages…”

The words and language in this advertisement illustrate how the promoters incorporate scientific advances into their sales pitch. The before and after photographs are great and I recommend readers check out the website <www.cliveclinics.com>

Dr Archer’s FATBUSTERS is a good example of the classic weight loss promotion. Using a new dietary supplement “more than 25 000 Nz’ers have lost weight!” The pills “soak up fat from food and stop fat being absorbed into the body…Just eat your usual meals”. This is an irresistible formula for the obese – an eating cure! Although there are two ‘before’ photographs of “Tania” and “Mike” there are no ‘after’ pictures. Could this mean that the product failed to work? Curious readers should call 0800-78-2000 to find out.

Hokum Locum

Recently returned from a posting in Saudi Arabia and now suffering from a cold and a bleeding nose, John Welch continues his column on medical matters.

Dilutions of Grandeur

As a Fellow of the Royal NZ College of General Practitioners (it came in the cornflakes) I receive a regular copy of their journal, the NZ Family Physician. There are some good contributions but I find it irritating to see reviews of homeopathy studies appearing in what should be a serious and scientifically based journal. In Vol 27 Issue 5, a study is reviewed in which mice were given nux vomica 30c, 200c and 1000c. 30c means that the “active” substance has been diluted 10 to the power 30 times. A mole of a substance contains about 10 to the power 24 atoms (Avogadro’s number) and this means that the 10-30 dilution is extremely unlikely to contain any active material. This is the main failing point of homeopathy, which depends on faith and the placebo effect. In the study reviewed a positive finding was made that mice treated with various dilutions of nux vomica, and then challenged with ethanol, regained their righting reflex more quickly. Such a result is a delusion.

I would add from my perspective: “The abuse of science will cause discomfort for many scientists.”

Integrated Medicine?

The same issue contains an article which should not have been published as it is a commercial for the use of Vega (read “vaguer” and you are on the right track) testing. There is no place for this unscientific rubbish to be practised by any medical practitioner and it is a matter of regret that the Medical Council do not have the power to ban the use of such machines. I have written before on the subject of this quackery and at the last Auckland Conference Dr David Cole gave an excellent presentation on the evolution of “black-boxes” which allegedly test “biofields”. The article frequently uses the following words and expressions (with my translations):

  • Biofield = imaginary energy aura which can only be detected by trained observers
  • Paradigm shift = more of a lurch into another dimension of foolishness
  • Energy based Quantum Physics = the author is ignorant of any physics
  • Dramatically improve = an excellent placebo effect was obtained

A double-blind randomised study of Vega-testing published in the BMJ (Vol 322, 20 Jan p131) concluded predictably: “Electrodermal testing cannot be used to diagnose environmental allergies.”

Re-birthing Backfires

Because a young girl was having trouble bonding with her adoptive mother, a couple of loony therapists decided she had a “reactive attachment disorder” and decided that a spot of rebirthing was in order. This unfortunately went tragically wrong when the girl suffocated inside the sheet which had been wound around her. This is a graphic reminder of the sometimes appalling outcomes associated with the activities of the lunatic fringe. It need not actively cause death as in this case, but can cause death by neglect when effective measures are denied such as in the Liam Holloway case.
(Sunday Star Times 22/4/01)

Aromatherapy Flunks

Subjects had their reaction times tested with and without the benefit of essential oils sprinkled onto surgical masks they were wearing. I will quote directly from the article: “The essential oils appeared to make no difference to reaction times, but the volunteers who rated the oils highly showed small improvements in their reaction times.” (Presumably not a significant difference).

“Dr Richard Tonkin, president of the Research Council for Complementary Medicine, said the power of suggestion was a big factor in all medicine.”

I would only add that the power of suggestion is the main factor in all complemetary medicine.
(The Dominion, 20 April)

Teething, Feeding, Wind and Worms

One of the problems of an aging population is that there are too many “old wives” promulgating myths about childhood illness. Twenty-five years ago, my old Professor of Paediatrics, Fred Shannon, gave a lecture to us with the above title, and observed among other things, that wind was a meteorological phenomenon. He must have been ahead of his time because Australian researchers found no link between ill-health and teething in a cohort of infants over the period of 6-24 months of age. It is obvious that chance events such as a minor illness will occur when a tooth is erupting and a folk myth is soon created. When death certification began in the UK in the early 1800s, as many as 4000 deaths annually were attributed to “teething”. As Fred Shannon observed: “teething causes teeth”. I certainly found this to be true with my own series (N=2 daughters) of cases.
(Pediatrics 2000;106:1374-9)

Head-drilling again?

I have mentioned this subject before but thought it to be an uncommon procedure. In the US (where else?) two men pleaded guilty to practising medicine without a licence after drilling a hole in the head of a woman’s skull in order to “restore her childhood buoyancy”. Now I have been doing quite a bit of swimming lately and I am very sure that a hole in the head would not help my bouyancy at all!

It’s about time!

At a medicolegal conference reported in Doctor 14/3/2001, Fiona McCrimmon called for the Ministry of Health to act against the manufacturers of complementary medicines where misleading claims are made. Pharmacies are full of such products which are not registered and are only lawful if they do not make any therapeutic claims. Ms McCrimmon went on to observe: “It is a challenge to find a flyer (for complementary therapies) that complies with the law.”

Hokum Locum

Quack Aids Remedies

The Prevalence of HIV disease has continued to increase across the African continent and is a major public health concern due to cultural attitudes to sexuality and a degree of poverty which precludes effective pharmacological interventions. A quack Nigerian surgeon has been charging patients US$1000-1500 for a course of his vaccine which he claims has successfully treated 900 patients for HIV/AIDS. The Nigerian Academy of Sciences deemed the vaccine “untested and potentially dangerous”. The Surgeon’s response has been to allege that “he has been the victim of a conspiracy by transnational pharmaceutical companies, in league with the Nigerian Health Ministry, to steal his ‘wonder vaccine’….” This is the familiar paranoid conspiracy theories of the quack.

HIV/AIDS disease has continued to attract the same sort of quack attention as has terminal cancer, which is not surprising given that both progress to a fatal conclusion. Desperate people are given false hope as well as being robbed of their remaining wealth, which is siphoned away into the pockets of charlatans instead of passing to the descendants of the unfortunate victims. Using the late Petr Skrabanek’s rules (demarcation of the absurd) I would not even bother to test this AIDS “vaccine” and predict with complete confidence that should someone conduct a test the preparation will be found to be worthless.
Lancet Vol 356 August 5 2000 p 493

Acupuncture wins BMA approval

Like homeopathy practitioners, acupuncturists are irrepressible and in a neat example of Bellman’s fallacy (repetition leads to recognition) have prevailed long enough that they now have the imprimatur of none less than the British Medical Association. The full report is available at the BMA website (www.bma.org.uk) but seems to have been largely motivated by the fact that acupuncture is both widely requested and safe. I wonder if the BMA visited www.quackwatch.com or any of the other skeptical websites.

The study claimed that greater use of acupuncture could save the National Health Service “millions of pounds each year”. There was a call for minimum standards of training. As you will recall from Conference 1998, I modestly set the training standard by showing that a one hour training session was adequate for any lay audience. It may be necessary to gild the lily somewhat by devoting more time and training for a credulous medical audience. (BMJ Vol 321 1 July 2000 p11)

Perhaps this would be the time to share with you my memories of my acupuncture training course, during which the trainer demonstrated a popular alternative medical technique known as kinesthesiology. A patient with an allergy to tomatoes was shown to have reduced muscle strength when exposed to the alleged allergen. The test was an attempt by the examiner to separate the patient’s apposed index finger and thumb. The next step was to have the patient hold a packet containing a vial of depomedrol, a steroid. This was meant to show that the reduced muscle strength would be countered by the contact with this potent steroid. Unfortunately one of the other observers had mischievously removed the steroid vial from the packet and once the “patient improvement” had been triumphantly demonstrated he revealed his subterfuge. The trainer was unfazed and quick as a flash claimed that the improvement was maintained owing to “homeopathic residues on the packet”. It was at this point, as I gazed at the bovine and credulous faces of my fellow course members, that I became a confirmed skeptic.

Canadian Idyll

While recently in Canada for a military conference I suffered a recurring nightmare that I would arrive home to find a peremptory missive from our editor demanding a contribution for the next issue. (I did.) I was therefore relieved to find a supplement in the Vancouver Sun of Nov 16th 2000 outlining a “health show” and decided this must be worth a few column inches. I will summarise a few key points. Naturopathy/Naturopathic medicine diverges from allopathic medicine (translation: ordinary “scientific” medicine as practised by JC Welch) only “at that point where professionals in common possession of scientific facts conscientiously disagree on how best to use their shared knowledge in treating patients”. Before scoffing, I caution readers to be aware that “there is a common assumption that naturopathic treatments are placebos”.

Not surprisingly, there is a wealth of research carried out at Naturopathic Colleges showing that naturopathic remedies are very effective. You can choose from “Khamut”, a wheat grown from grain recovered from Tutankhamen’s tomb, Light therapy which uses biostimulation to promote efficient cell function, and “Trilovin” – the natural sex formula of the Ancient Greeks.

As a keen scientist I decided to administer some of this product to my wife and I am amazed to report that she has increased pain tolerance, enhancement of the immune system, improved mood and a sense of well being, reduced cholesterol and blood pressure and can now play tennis and ride a bike, but for some reason I’m tired and seem to have a constant headache.

Attention Deficit Hyperactivity Disorder (ADHD)

When I was at school 30 years ago I recall widespread concern that global cooling was going to lead to a new ice age. Now it’s global warming! I do not however, recall my fellow students exhibiting the behaviour alleged by those suffering from ADHD. I have long been suspicious that this is a fad disorder created by doctors in order to explain the exuberant but normal behaviour of some children. I will therefore conclude by quoting in full from the Guardian Weekly Vol 163/20 “Notes and Queries” column.

At school in the 40s I cannot remember pupils being hyperactive, disruptive or showing symptoms similar to ADHD. Is its growth due to a lack of discipline, or to pollution, radiation, junk food, etc.? There are always fashions in mental illnesses. In Freud’s day conversion hysteria was popular. Now it is rarely found. In Sydney, where I was working as an educational psychologist, any child with a behavioural or learning disability was likely to be labeled as autistic. Since then this diagnosis has come to be used much more discriminatingly.

Nowadays the psychiatric profession, supported by the drug companies, readily creates fashions in diagnosis. The committee that decides on the contents of the Diagnostic and Statistical Manual of the American Psychiatric Association needs only to ascertain that a group of psychiatrists agrees that a mental disorder exists to include this disorder in the manual. Another committee could reliably agree that the moon is made of green cheese. There have always been children who do not behave in the ways in which adults around them want. A few of these children have actual brain dysfunction. Many more, living under conditions that they find stressful, are constantly distracted by anxiety, and so are hyperactive and disruptive. Other children have parents and teachers who cannot tolerate the exuberant behaviour of ordinary children. The popularity of the recently created mental disorder ADHD means that many children are diagnosed as ADHD and prescribed Ritalin or other similarly potentially addictive drugs. These drugs’ long-term effects on a developing brain are yet to be discovered.

Hokum Locum

Colon Cleansing

Thanks to reader Alan Pickmere for drawing my attention to colon cleansing. In a radio advertisement Alan heard the claim that the average adult has up to 10kg of preservatives and toxic waste in their colon. The actor, John Wayne had 20kg removed at autopsy, doubtless dating from the time spent venting his spleen against commie actors facing Senator Joe McCarthy’s inquisition. Come to think of it, perhaps he should have “vented” more often.

These accumulations are not at all surprising to a skeptical doctor as I am frequently exposed to views espoused by people whose bodies hold far more toxic waste than this and it goes all the way up to their heads. If any readers would like to cleanse their colons please call 0800-CLYSTER.

Herbs Flunk

Although it makes sense to test herbs for therapeutic efficacy, there are few acceptable trials. An Australian study of herbal and Ayurvedic preparations found that only tumeric had any anti-inflammatory effect and 5 of 23 celery preparations had an anti-arthritic effect equivalent to 50mg of ibuprofen. Given the wide variation in the bioavailability of herbal medicines I recommend stick to ibuprofen, normally taken in a daily dose of 1600mg costing around 75 cents. I bet that herbal medicines cost a lot more than that. It’s important for any useless treatment to cost a lot because that helps people believe that it actually works. (NZ Doctor 19 Jul 2000)


Third world countries such as India frequently seek pragmatic solutions to their health problems and in this case they have encouraged traditional practices such as ayurveda, sidha, unani, yoga, naturopathy, Tibetan medicine and homeopathy. I was reassured to see the addition of homeopathy and naturopathy, so much a part of mainstream New Zealand medicine. The Indian Health Minister has asked all other Ministries to ensure that its employees can be reimbursed for the cost of such treatments.

Perhaps this is where our own Health Minister got the idea for allocating a large sum of money for the evaluation of alternative medicine. The increasingly third world Wellington Hospital is reduced to waving its hands at patients. Will they soon be encouraging them to start the day with a freshly steaming glass of their own urine, perhaps followed by pills made out of lama’s faeces, a traditional Tibetan remedy. (Lancet Vol 355, p1252)

Silicon Implants

As Shakespeare so eloquently put it “God has given woman one breast and she gives herself another”. Minerva (BMJ Vol 320 p 882) reports a fourth extensive study finding no association between ill health and silicon implants. However, this will not have any effect on the millions of dollars given to litigants because the standard of proof is to have one’s personal account of suffering published in any women’s magazine. In the true spirit of the post-modern age I look forward to the first litigation for alien abduction. Those anal probes can hurt! All we need is a New Zealand Doctor brave enough to fill in the ACC forms.

This is yet another example of Welch’s law: “Claims expand to take up the amount of compensation available”.

Surgeon Amputates Healthy Legs

Since I have raised the topic of post-modernism, readers will be interested in this account from the BMJ (Vol 320 p332). Both patients reported on suffered from a rare body dysmorphic disorder known as apotemnophilia which makes them believe that they can only be normal once they have had a limb removed. The patients were delighted after each had a leg removed in a below-knee amputation. The hospital administration was quoted as saying that no more of these operations will be done.


Obesity has been raised to an art form in North America and it is fitting that the American food industry has launched “Stokabunga”, a cookie containing more calories than an average meal, including 48g fat. Such excess is a fitting accompaniment to a recent announcement that for the first time the number of overweight people in the world equalled the number who were malnourished. In Britain, the average cat receives more protein per day than the average poor African. Sales of Stokabunga have been particularly strong in Belgium.

Ineffective Drugs

Of the 50,000 prescription drugs currently available in Germany, 33,000 have never been subject to clinical trials. They include homeopathic preparations, herbal remedies and in one case a useless preparation containing loess (a fine soil) used for the treatment of diarrhoea. Drug companies were able to suppress a report that gave advice on how to substitute cheaper effective drugs in place of the useless ones. During World War 2, Hitler’s doctor treated him with capsules containing faecal bacteria from “finest Bulgarian peasant” and such a product is conceivably still available. (New Scientist 4 Oct 97 p20)

As recently as 1997 it was possible to receive rejuvenating injections of fetal sheep cells. This treatment was popularised by Konrad Adenaur, the German Chancellor who remained in power until he was 87 years old. Unfortunately the Germans have a bad habit of blindly following rogue Chancellors.

It is quite clear now what has happened to their Pharmaceutical Regulatory authorities. Instead of a feral and vigorous staff dedicated to removing quack remedies, the excessive use of fetal cells has turned them all into sheep in sheep’s clothing. (New Scientist 25 Jan 1997 p6)

Finger-Licking Bad For Waist Reduction?

The herb Aristolochia gangchi was mistakenly used in weight loss pills by the Kentucky Fried medicine brigade. As well as causing kidney failure it is now thought to be responsible for cancers of the urinary tract. Staff at a Belgian weight loss clinic had prescribed the herb Stephania tetranda but the mixture also contained Aristolochia which has a similar sounding Chinese name.

Dr David Kessler, former Commissioner of the United States Food and Drug Administration (FDA) notes that there are no controls over the quality of such products or their composition. The cause of this was the passage of the Dietary Supplement Health and Education Act of 1994, which deregulated the industry by limiting the role of the FDA and opening up this $15 billion-a- year industry. This ridiculous legislation does not require that dietary supplements be shown to be safe or effective. I have no doubt that an epidemic of renal failure and cancer will soon peel the weight off those hordes of fatties seen in every US shopping mall. (New England Journal of Medicine June 8 2000, p1742; BMJ Vol 320, p1623)

Tissue Samples and Cryptopathology

When confronted with unusual lumps and swelling it is a common medical practice to get some tissue examined by a pathologist and this will often reveal the diagnosis.

As a keen hunter I feel the same exemplary approach should be taken when examining phenomena such as “Bigfoot”, the Loch Ness monster and our very own Australasian “Yowie”. The Yowie is believed to be named thus after the cries recorded when it had come into contact with hunters and been wounded. It would be a matter of some pride to me if I were the first person to bag either of these trophies. Nessie would obviously require a large harpoon but depth charges would soon bring the shy and expiring creature to the surface. Bigfoot should prove no problem for my Winchester 0.243. I was therefore disappointed to read that a county in Washington has declared it illegal to kill Bigfoot. However, fur samples have been gathered from “close encounters” and delivered to Ken Goddard at a wildlife forensic laboratory. Ken found that Bigfoot has made a remarkable adaptation to its cold environment-polyester fur. Ken is waiting for a “close encounter of the turd kind” so he can examine the creature’s diet for evidence of Stokabunga. (New Scientist 22 Jan 2000 p40)

I predict that once tissue samples have been obtained, all of these secretive creatures will be found to share a puzzling 100 percent of their DNA with humans.

Hokum Locum

John Welch started writing for the magazine in Issue 16, but a posting with UNSCOM to Iraq meant he had to relinquish responsibility for the column. He is delighted to once again have the opportunity to indulge his interest in bizarre medical beliefs and wishes to thank Dr Neil McKenzie for his efforts to date.

Craniosacral Therapy

Manipulative therapists such as osteopaths and chiropractors continue to provide a rich source of deluded ideas. Here is Clemens Franzmayr writing in NZ Doctor (10 May) on the treatment of dizziness: “Colleagues experienced in craniosacral therapy have good results by freeing tentorium cerebelli from restriction and by mobilising the temporal bone on the disturbed side, including the ear pull.” For once I am in complete agreement but I have always obtained far more impressive results from the “leg-pull.”

The good Doktor goes on to say: “with one single manipulation of the upper cervical spine the patient could be free of all complaint.” The patient could also be dead from spinal cord damage due to the wholly unnecessary and unscientific intervention.

Medical Overinvestigation

Your correspondent has been recently refreshing his medical skills in the Casualty Department of a large urban hospital where many of the patients present with trauma due to alcoholic decelerations. It is fascinating to experience the change in attitudes due to medicolegal fears and the consequent extensive use of sophisticated investigations such as radiological imaging techniques, recently satirised by one writer as the “gropagram”. However, a note of caution. When arriving at the hospital please do not ask for your NMR (Nuclear Magnetic Resonance) as I fear you could experience a nasty rectal invasion by an agency nurse from Sri Lanka. (New Scientist 17 April 99).

Fraudulent Skin Treatments

There is widespread belief and acceptance of treatment with secret mixtures by a section of the community who do not understand that such preparations are not subject to any form of scientific testing, standard or even basic tests of efficacy. A London clinic sold a 50g pot of cream that cost $2000 which was found to contain white paraffin and a small amount of the steroid fluocinolone, sold in New Zealand as Synalar and costing $5.92 for 30g. The great irony here is the use of a powerful and effective remedy secretly used within the context of quack therapy. Herbalists, not to mention Homeopaths, will no doubt join me in general indignation at this totally unethical behaviour.

This “Kentucky Fried medicine” (secret herbs and spices?) is a perfect accompaniment to the age of post-modern consumerism. One Wellington GP has even received approval from the Medical Council to sell similar products to her patients.

I wish I had patients like that when I was in General Practice. Even Dermatologists would envy me earning over $100,000 a year from the sale of one pot of cream a week. Damn that troublesome conscience; I could have been rich!

Analysis of Chinese herbal creams

Patients with chronic problematic skin conditions often resort to herbal remedies which are seen as “natural” and therefore safe and free of side effects. Since chronic skin conditions are commonly treated with potent steroids there are genuine concerns about side effects. Some researchers (BMJ 1999;318:563-4) found that eight out of eleven herbal creams contained dexamethasone, a potent topical steroid.

I know it’s fraud, but I still find it amusing that people using a “natural and safe” herbal remedy are in fact gaining relief from a potent nasty dangerous steroid, normally prescribed by nasty dangerous doctors in the pockets of multinational drug companies. Me paranoid? I know they are out to get me!

This reminds me of a very popular cough mixture in the early 1900s whose “magic” ingredient was heroin.

Chicken Soup

Two Israeli doctors are calling for the World Health Organisation to include chicken soup on its list of essential drugs. This will come as a great burden to the inhabitants of many Third World countries where the daily walk for water will now have to be extended for chickens. Since the WHO already lists a variety of conditions amenable to acupuncture, including myopia, the inclusion of chicken soup is entirely appropriate as an unspecified remedy for whatever ails you. Don’t be put off by the lack of evidence — “Chicken soup is over 2000 years older than the randomised trial.” They said the same thing about acupuncture.

I can assure readers that chicken soup will cure anything if you strongly believe that it will. Disclaimer: I have no shares in any chicken soup companies.

Dental Amalgam

Readers will be pleased to hear of the retirement of one of the worst medically qualified quacks in recent memory. This individual who cannot be identified for obvious legal reasons, used a dental amalgameter to diagnose “mercury poisoning.” This fraud was practised on countless patients who then paid to have all of their amalgam fillings removed, a practice condemned by the Dental Council as there is no link with any form of illness and the number of such fillings. I have written before on the subject of dental amalgameters which are basically a fraudulent blackbox device of the type discussed at our last conference. (See lead article – ed.)

This quack also railed against immunisation which prompted me to write a letter of complaint to the Medical Practitioners Disciplinary Committee (MPDC) who are essentially toothless when dealing with quack doctors. I was informed anecdotally by the MPDC that they had received dozens of complaints about this individual but were powerless to act unless they received a complaint from an actual patient who had been harmed. The MPDC forwarded me a copy of the doctor’s reply and if anybody would like a copy please send me a SAE. It is a fascinating, self-deluded and paranoid document from which I have deleted any identifying details.

Rudolf and Bailer, psychologists at the University of Heidelberg, looked at 40 patients who claimed health problems connected with their amalgam fillings. When compared with other people with amalgam fillings but no such complaints there was no correlation with any measurements of mercury in blood, saliva or urine. The researchers found that the complainants had histories of psychological problems, were emotionally unstable and had an obsessive attitude towards their health.

I have a mouthful of amalgam fillings and my health is perfect. I rest my case.

Buteyko and Asthma

The Buteyko breathing technique (BBT) is merely one more of a long line of quack therapies for asthma. (Try the medieval remedy – powdered fox lung.) Central to the theory is the belief that all patients with asthma hyperventilate (over-breathe). Deliberately slowing breathing increases carbon dioxide levels which could dilate restricted airways. However, the overwhelming scientific consensus is that asthma is an inflammatory disorder. Since quack treatments are seldom put up for testing, I was surprised to read of a trial of BBT reported in the Lancet (1998; 352:1993). It flunked. Although BBT patients were able to reduce their medication there was no objective change in key indicators of lung function. This is not at all surprising as patients receiving acupuncture treatment for asthma also reported marked improvement which was not confirmed by objective measurements of lung function. This is the classic placebo effect which is the cause of perceived improvement in most alternative medical treatments.

When people strongly believe in something and that belief becomes an unshakeable faith, they are immune to reason. When the above results became apparent the researcher from the BBT Clinic withdrew her authorship from the paper.