Resistance to science

Alison Campbell reviews a study of why so many struggle with scientific concepts.

One of the topics that comes up for discussion with my Sciblogs colleagues is the issue of ‘resistance to science’ – the tendency to prefer alternative explanations for various phenomena over science-based explanations for the same observations. It’s a topic that has interested me for ages, as teaching any subject requires you to be aware of students’ existing concepts about it, and coming up with ways to work with their misconceptions. So I was interested to read a review paper by Paul Bloom and Deena Weisberg, looking at just this question.

Bloom and Weisberg conclude there are two key reasons why people can be resistant to particular ideas in science. One is that we all have “common-sense intuitions” about how the world works, and when scientific explanations conflict with these, often it’s the science that loses out. The other lies with the source(s) of the information you receive. They suggest that “some resistance to scientific ideas is a human universal” – one that begins in childhood and which relates to both what students know and how they learn.

Before they ever encounter science as a subject, children have developed their own understandings about how the world works. This means they may be more resistant to an idea if it’s an abstract concept and not one that they have experienced – or can experience – on the personal level. Bloom and Weisberg cite research showing that the knowledge that objects are solid, don’t vanish just because they’re out of sight, fall if you drop them, and don’t move unless you push them, is developed when we are very young children. And we develop similar understandings about how people operate (eg, that we’re autonomous beings whose actions are influenced by our goals) equally early.

Unfortunately for science educators, these understandings can become so ingrained that if they clash with scientific understandings, those particular science facts can be very hard to learn. It’s not a lack of knowledge, but the fact that students have “alternative conceptual frameworks for understanding [these] phenomena” that can make it difficult to move them to a more scientific viewpoint. The authors give an example based on the common-sense understanding that an unsupported object will fall down – for many young children, this can result in difficulty seeing the world as a sphere, because people on the ‘downwards’ side should just fall right off. This idea can persist until the age of eight or nine.

And it seems that psychology also affects how receptive people are to scientific explanations. When you’re four, you tend to view things “in terms of design and purpose”, which means (among other things) that young children will provide and accept creationist explanations about life’s origins and diversity. Plus there’s dualism: “the belief that the mind is fundamentally different from the brain”, which leads to claims that the brain is responsible for “deliberative mental work” but not for emotional, imaginative, or basic everyday actions. This in turn can mean that adults can be very resistant to the idea that the things that make us who and what we are can emerge from basic physical processes. And that shapes how we react to topics such as abortion and stem cell research.

In other words, those who resist the scientific view on given phenomena do so because the latter is counterintuitive, although this doesn’t really explain the fact that there are cultural differences in willingness to accept scientific explanations. For example, about 40 percent of US citizens accept the theory of evolution – below every country surveyed with the exception of Turkey (Miller et al. 2006). Part of the problem seems to lie with the nature of ‘common knowlege’: if everyone regularly and consistently uses such concepts, children will pick them up and internalise them (believing in the existence of electricity, for example, even though it’s something they’ve never seen). For other concepts, the source of information is important. Take evolution again: parents may say one thing about evolution, and teachers, another. Who do you believe? It seems, according to Bloom and Weisberg, that it all depends on how much you trust the source.

The authors conclude:

“These developmental data suggest that resistance to science will arise in children when scientific claims clash with early emerging, intuitive expectations. This resistance will persist through adulthood if the scientific claims are contested within a society, and it will be especially strong if there is a nonscientific alternative that is rooted in common sense and championed by people who are thought of as reliable and trustworthy.”

Yet we live in a society where ‘ alternative’ explanations are routinely presented by media in a desire to present ‘ balance’ where there isn’ t any, or indeed, without any attempt at balance at all. And the internet makes it even easier to present non-scientific views of the world in an accessible, authoritative and reasonable way. As science communicators and educators, my colleagues and I really are up against it, and I would say there’s a need for Bloom and Weisberg’s findings to be much more widely read.

Bloom, P; Weisberg, DS (2007): Childhood origins of adult resistance to science. Science 316 (5827), 996-7.
Miller, JD; Scott, EC; Okamoto, S 2006: Public acceptance of evolution. Science 313: 765 – 766.

Oxygenated food for the brain?

Alison Campbell finds some claims about raw foods hard to swallow.

I was reading a couple of articles about ‘raw foods’ today. This is ‘raw foods’ as in ‘foods that you don’t heat above 40°C in processing them.’ It’s also as in, a vegetarian diet. (I do rather enjoy vegetarian food, but I don’t think I could eat nothing but, all the time; I like meat too much.) Anyway, what caught my eye wasn’t so much the diet programme itself but the mis-use of science to promote it. That did rather get my goat broccoli.

Apparently you should get your kids to eat their greens (along with the rest of the diet) by telling them that plants do this wonderful thing: they turn sunlight into chlorophyll and – when you eat it – it will give you extra oxygen. Sigh&#8230 This concept was repeated in the second article, which told me that raw (but not cooked) foods are ‘oxygenated’ and thus better for your brain, which needs to be fully oxygenated to work properly.

Well, yes, and so do all your other bits and pieces, and they don’t get the oxygen from food. As Ben Goldacre once said, even if chlorophyll were to survive the digestive process and make it through to the intestine, it needs light in order to photosynthesise, quite apart from the fact that you don’t normally absorb oxygen across the gut wall. And it’s kind of dark inside you.

The second shaky claim related to digestive enzymes. Because raw foods are ‘alive’ then they are full of enzymes. And so we’re told that eating them will help you to digest your meals better.

Er, no. First, because when said enzymes – being proteins – hit the low pH environment of your stomach they are highly likely to be denatured. This change in shape means that they lose the ability to function as they should, and in fact they’ll be chopped up into amino acids like any other protein in your food, before being absorbed and then used by your cells to make their own enzymes.

And second – the raw foods diet is plant-based. Yes, plants and animals are going to have some enzymes in common. I’d expect that those involved in cellular respiration and DNA replication/protein synthesis would be very similar, for example, because these are crucial processes in any cell’s life and any deviations in form and function are likely to be severely punished by natural selection. But we already have those enzymes; they’re manufactured in situ as required. In other words, even if the plant enzymes somehow made it into cells intact and capable of functioning, they’d be redundant.

However, with a very few exceptions, plants aren’t in the habit of consuming other organisms so, in regard to plant cells being a good source of the digestive enzymes required for the proper functioning of an omnivore’s gut – no, I don’t think so. No.

Some might ask, why on earth do I bother about this stuff? After all, it’s not doing any harm. But the thing is – science is so cool, so exciting; it tells us so much about the world – why do people have to prostitute it in this way? Kids (and others) are fascinated by the way their bodies’ organ systems work, and I can’t see why there seems to be a need to provide ‘simple’ – and wrong! – alternative ‘explanations’ when the real thing is so wonderful.

Belief and knowledge: a plea about language

Alison Campbell looks at some words that cause scientific misunderstandings.

I suspect that for many of my first-year Biology students, the sheer weight of new terms they come across is perhaps the most daunting thing about the course. In some ways learning biology is rather like learning a new language, with several thousand new words swamping the page (and the brain).

But there’s more than just the new words – there’s the meaning of the words to come to terms with. This is the focus of Helen Quinn’s paper in Physics Today (2007): Belief and knowledge – a plea about language. There are many words whose meaning to a scientist may be quite different from what they mean to a layperson. Quinn feels, and I agree, that some words “are the root of considerable public misunderstanding about science: belief, hypothesis, theory and knowledge.”

‘Belief’ isn’t really a word that sits well with science. As Quinn says, it can be “an article of faith” ie religious belief. Or – conversely – in the phrase “I believe he is coming at 5pm”, you get the meaning “but I’m not really sure.” So how are we to take those news stories that begin “Scientists believe”? A statement like “most biologists believe in evolution” could be used to claim that evolution is as much faith-based as organised religion. (I tell my students that I don’t ‘believe’ in evolution, but accept it as the best available current explanation for life’s diversity. This can engender some interesting discussions…)

But what the statement “most scientists believe” means – to scientists – is that most scientists agree that the weight of evidence favours a particular interpretation. Quinn suggests we should say “scientific evidence supports the conclusion that…” I like this – it leaves open the possibility that this conclusion could change, if sufficient evidence to the contrary comes to light. Which is a much better reflection of the nature of science. Unfortunately there tends to be a perception that scientific ‘facts’ don’t change. (Also unfortunate is the fact that if scientists do change their interpretation of the data, they’re accused of not really knowing what they’re talking about. Sometimes I think we just can’t win!) Like Quinn, I feel that as scientists we shouldn’t be using the ‘b’ word – it gives the appearance that science is “just another belief system.”

‘Theory’ is another word that means different things to different people. “I’ve got a theory about that” really means, ‘I’ve got a hunch or an idea, a guess.’ But to scientists ‘theory’ means a well-established explanation for a large body of data: the theories of relativity, plate tectonics, evolution… These are definitely not guesses (nor are they belief systems!), but comprehensive explanations that have strong predictive power and have been tested time and time again. They are also incomplete, but that again is the nature of science. Scientific theories may well be modified if new evidence comes to hand: Newton’s laws are an example. (Quinn notes that Newton’s laws still hold, under certain well-defined conditions.)

It’s worth repeating Quinn’s description of how scientific theories are developed, because this is a valuable description of how science operates and what sets it apart from ‘other ways of knowing’:

When we seek to extend and revise our hypothetical frameworks, we make hypotheses, build models, and construct untested, alternate, extended theories. These last must incorporate all the well-established elements of prior theories. Experiment not only tests the new hypotheses; any unexplained result both requires and constrains new speculative theory building – new hypotheses. Models … play an important role here. They allow us to investigate and formulate the predictions and tests of our theory in complex situations. Our theories are informed guesses, incorporating much that we know. They may or may not pan out, but they are motivated by some aspects or puzzles in the existing data and theory. We actively look for contradictions.

The Spiritual Science of Alpha Beta

This excerpt from an NZ Skeptic article of 20 years ago reviewed an evening with self-styled New Zealand ‘magnetic healer’ Colin Lambert. Presumably the pseudonym ‘Alpha Beta’ was used to minimise the chances of legal action should Lambert have considered anything in it defamatory. Lambert died in 2006, but his disciples maintain a website, www.magnetichealers.org.nz, where some of his books and CD’s can be purchased, and workshops are promoted.

The spiritual Science of Alpha Beta, healer to the stars

The skeptics having been invited to Mr Beta’s lecture, I went along to clutch, if not wave, the flag. I duly arrived at the local spiritualist church, a commanding fading edifice at 14, Gullible St. A chap with a withered leg hobbled up the front steps; things were auguring well. An audience of approximately 100 slowly assembled, 90% women, mostly middle aged.

Mr Beta began the first part of his three part lecture with a long series of slides, providing ‘positive proof’ of various paranormal goings on. He kicked off with a spirited defence of Philippino psychic surgeons. Various gory slides quickly had the audience glued. Anyone who suspects these Philippinos of trickery is an ‘idiot’. An anonymous New Zealand G.P. has carefully examined these photographs and concluded that the surgery ‘must be genuine’. An anonymous German eye specialist who doubted that the human eye ball can be removed from its socket and placed on the cheek, still attached, was ‘ignorant’. When one puts the question to these ‘scoffers’; “How long have you studied this surgery in the Philippines?”, that always gets them (approving nods and smiles from the audience). The audience marvelled at a shot of an open Bible being held over a patient. The surgeon wafts the ‘healing energy’ in the book down into the patient helping the release of particularly stubborn growths. Then a piece of goo, the size of an orange, is flashed onto the screen. “How could anyone hide a thing like that up his sleeve, especially as they always work with their sleeves rolled up?” (positive hums of appreciation). After spending a long time studying these ‘wonderfully skilled’ healers, Mr Beta has refined their technique to the point where he now completely ‘dematerialises’, tumours, clots etc and then throws them away, in their still dematerialised state.

Many Hollywood stars have benefited from Mr Beta’s ministrations. A slide of the late Lee Marvin surrounded by his many fishing trophies and Mr Beta impressed the audience. So too did a slide of ‘old timer’ James Coburn. Mr Beta also ‘absent healed’ actor Martin Sheen over the telephone ‘the night before Sheen was shot doing the Kennedy film’ (laughter and warmth abounding). Rita Coolidge (Rita who?) and her sister pleaded with Mr Beta to absent heal their father, Dick. Dick was in San Francisco and Mr Beta in Malibu… David Shanks, NZ Skeptic 14, August 1989.

The vertical limit for randomised trials

Alison Campbell considers the evidence for the efficacy of parachutes.

Recently a teacher sent me a paper titled: ‘Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials‘ (Smith and Pell, 2003, BMJ 327: 1459-1460). I have to say I chuckled when I read this – a common charge levelled against current medical practice by the alternative health lobby is that many medical techniques haven’t been subjected to randomised controlled trials (with the corollary that it’s thus unfair to demand evidence from such trials on alternative practices).

The authors state they conducted a literature search of some of the major science sources, using the search words ‘parachute’ and ‘trial’. However (and unsurprisingly), they found no randomised controlled trials (RCTs) of parachute use. Smith and Pell begin their discussion with the following inspired statement:

“It is a truth universally acknowledged that a medical intervention justified by observational data must be in want of verification through a randomised controlled trial.”

Many medical interventions probably fall into this category – for example, I doubt that surgery for severe appendicitis has ever been subjected to such a trial. That’s not to say that, where appropriate (and in the case of appendicitis it almost certainly isn’t!) such trials shouldn’t be performed. As Smith and Pell point out, hormone therapy for post-menopausal women seemed – on the basis of observational studies – to convey a number of health benefits. But RCTs showed that hormone replacement therapy actually increased the risk of ischaemic heart disease.

As the authors say, RCTs avoid a major weakness of observational studies: that of bias (eg selection bias and reporting bias). They note that individuals jumping from aircraft without the help of a parachute are likely to have a high prevalence of pre-existing psychiatric morbidity (ie they are probably not in their right minds when they jump. You have got to love this paper!). So any study of parachute use could well be subject to selection bias, in that those using them are likely to have fewer psychiatric problems than those who don’t. Smith and Pell also put forward the possibility that enforced parachute use is simply a case of mass medicalisation of the population by out-of-control doctors – or worse, by evil multinational corporations. (These are, of course, charges frequently levelled at the medical world, eg by those who are against interventions such as vaccination.)

This little gem of a paper contains some valuable lessons on the nature of science (and more particularly, science-based medicine). And it should be read by anyone who doubts that scientists have both creativity and a good sense of humour.

Hokum Locum

Money well spent?

Tim Hume (Sunday Star Times June 21) has written a good account of traditional Maori Medicine (Rongoa Maori). The Health Ministry provides $1.9 million annually for this nonsense. That money would pay for approximately 1000 hip replacements.

One woman is described as taking her “traveling medicine show” overseas. It has all the elements of quackery – the laying on of hands, mysterious signs, mysticism and spiritualism. Her grandson is described as already showing the healing gifts.

Maori curses (makutu) are no problem. These can be cured, even remotely. We are told that the spiritual healer performed a “remote cleansing” in America but knocked over a chair while leaving the room. Tim Hume comments: “statements like this … tend to invite disbelief, if not ridicule”. And so they should!

One of these practitioners was recently convicted of “sexually assaulting two women with potatoes”. Why potatoes? I thought carrots or a cucumber would have been more useful. He had diagnosed a woman as having both breast cancer and liver disease. She had neither. He claimed to be able to detect abuse by smelling the patient. Unfortunately for him, the patient smelled a rat. Still, smelling the patient makes as much sense as recovered memory.

Rongoa can even cure orthopaedic conditions such as one leg shorter than the other (the leg pull?).

A woman who had failed to achieve pregnancy after one year went for treatment that involved deep massage “dislodging afterbirth remaining from her first pregnancy”. The only way quacks can flourish is when people are ignorant and gullible. The cure is education and an appropriate degree of scepticism starting during early education.

Tim Hume is right on target when he comments: “it sounds like the placebo effect dressed up in cultural justifications.”

At a time when Maori are afflicted with diabetes, obesity, hypertension and renal failure, Rongoa Maori is a colossal waste of money. Anyone daring to criticise it will of course be labeled as a racist.

Deadly allergy treatments

A Dublin man died while receiving treatment for peanut allergy from a kinesiologist. The kinesiologist was using an elimination technique called muscle testing. This is total quackery and I know of at least one NZ doctor who was struck off for harming patients while using this technique. The perpetrator in the Irish case is described as “Dr Brett Stevens”. I was unable to find any such registered doctor of that name on the Irish Medical Register so I can only conclude that this is yet another example of pretentious quacks giving themselves airs.

While I was doing an acupuncture course I saw a demonstration of this nonsense, not realising at the time exactly what was going on. I certainly recognised it as nonsense and I have written before about how astounded I was at the credulity of the other doctors present. Briefly, a patient was presented allegedly suffering from an allergy to tomatoes. While the patient pinched his index finger and thumb together the examiner tried to separate them (the muscle testing, sometimes called bidigital O ring testing) demonstrating a baseline measure of strength. When the patient held a tomato the examiner showed how the pinch grip was weaker. There is absolutely no scientific basis for this absurd test which is totally subjective. There are still quacks using it in New Zealand as well as some doctors but they keep pretty quiet about it for obvious reasons. If I heard of any registered medical practitioner using this test I would not hesitate to report them to the Medical Council.

The unfortunate Irishman collapsed and died on the way to the hospital. The coroner expressed concern but instead of denouncing the quack treatment he “called for re-evaluation of the allergy elimination technique.” This technique doesn’t need re-evaluation, it needs condemnation and the kinesiologist should have been prosecuted for manslaughter.

Allergy Today, Winter 2009

Acupuncture flunks again A trial subjected randomised chronic back pain sufferers to either sham acupuncture, normal care or real acupuncture. Sham acupuncture was administered using toothpicks concealed inside guide tubes. The two acupuncture groups did equally well and significantly better than the normal care group. The improvement gradually waned over a year.

ACC has also examined acupuncture in the context of acute back pain and any effect is short-lived and soon disappears.

It is unclear whether the chronic back pain group showed any functional improvement since the measurements of improvement were all subjective. For example, did large numbers return to work? This is the true test of a treatment, whether it is clinically important rather than just showing some statistical improvement.

What this trial essentially shows is that gimmick + fake gimmick is superior to normal care. What needs to be done next is the same trial using laser acupuncture. The same patients are randomised to normal care, laser acupuncture and (blinded) laser simulated acupuncture. Whilst not given to divination I will modestly predict the results of such an experiment. Both treatment groups will show the same degree of improvement which will be superior to normal care. Just to add a twist, you could add a fourth group being treated by some really motivational and enthusiastic physiotherapists. This of course enhances the placebo effect and could just close the gap between the “normal care” and the two active treatment groups.

Arch Intern Med. 2009; 169(9): 858-866.

And again I was at a conference recently and was alerted to a trial published in the BMJ that allegedly showed that acupuncture led to improved outcomes during IVF therapy for childless couples. In other words, an improved pregnancy rate. This is a load of rubbish and I recommend you look up the article and in particular read the rapid responses. The best one was from Edzard Ernst and after reading it I recalled something I had read in his book Healing, Hype or Harm. Sure enough, it was in a commentary by James Randi who was commenting on scientific misbehaviour around a published article purporting to show improved pregnancy rates for IVF patients who were subjected to prayer from total strangers from around the world. These results were a fraud.

I am not claiming that the BMJ paper is a fraud. It is simply absurd and should be treated in the same way as a paper purporting to show a beneficial effect from homeopathy. As a skeptic you simply think along the following lines: Is it more likely that this is a true effect or more likely to be a mistake or even fraud? A more crude response on this paper would be “bullshit baffles brains”.

Skrabanek has a good take on this as well: Extraordinary claims require extraordinary evidence, and randomised clinical trials, applied to absurd claims, are more likely to mislead than illuminate.

BMJ, doi: 10.1136/bmj. 39471.430451.BE (Published 7 February 2008). Skranabek P. Demarcation of the absurd. Health Watch Newsletter (5) 1990, 7.

Hokum Locum

Bogus chiropractor?

I thought they were all bogus! A Motueka man, Michael Dawson, was fined $4000 for describing himself as a chiropractor. This upset Nelson chiropractor Dr John Dawson who was quoted as saying his “unrelated namesake tainted the industry.” Quite apart from Dr Dawson’s pretentious use of the title ‘Dr’, his description of chiropractic as an industry is particularly apt. It is a massage business based on aggressive marketing and creating a non-existent need for gullible people to have their backs rubbed and clicked.

‘Dr’ Dawson was further quoted: “I’m sure there are a few people out there who have written off chiropractors because of him.” One can only hope.

It’s ironic that Michael Dawson was prosecuted by the Ministry of Health, a body supposedly watching over the health system and now seen to be protecting quacks by picking on unregistered quacks. Michael Dawson claims to be able to cure Hepatitis C and wake people from comas. These are claims that can readily be checked and will prove to be false, like most chiropractic claims.

ACC is currently experiencing budget woes and a great deal of this relates to treatment costs. Chiropractors favour prolonged and expensive treatments which have contributed to this problem. A recent study of back pain found conclusively that chiropractic manipulation was of no benefit (www.medscape.com/viewarticle/580409). This is consistent with earlier findings of the Cochrane Database.

I discovered another reference to an article in the Nelson Evening Mail which confirmed Michael Dawson did in fact have a chiropractic qualification but had failed to gain registration in New Zealand. This registration process is a farce and merely gives spurious respectability to an absurd belief system.

Consider the following; a patient goes to a chiropractor and receives a diagnosis of cervical spine subluxations for which manipulation is administered. The patient suffers an injury to arteries in the neck and has a stroke. The Health and Disability Commissioner (HDC) investigates by asking his ‘expert’ chiropractor whether the treatment was properly administered according to chiropractic tenets. The answer is yes so does this mean the chiropractor is off the hook? The patient can file an ACC claim for treatment injury and loses the right to sue as a result. ACC picks up the tab for an unnecessary and dangerous quack treatment.

While working at the hospital the other night a young man came in with toothache. He knew he had an impacted wisdom tooth because he had been x-rayed by his chiropractor whose course of treatments had extended out to 15 weeks. That’s a lot of subluxations. In a fit of whimsy I recently labeled such extended treatments as ‘chiroprotracted’.

Marlborough Express 22 August 2008

Cosmetic Acupuncture

It appears that there is no end to the absurd claims made of acupuncture. Acupuncture face renewal is now available at Arch Hill Acupuncture. A credulous journalist visited the clinic and reported after only one treatment: “I felt – and looked – like I had spent a week in Fiji.” A complete treatment usually involves 12 visits and I would commend the journalist on the Fiji suggestion, a far better use of one’s money.

Have a browse around the website www.archhillacupuncture.co.nz It contains the usual testimonials seen on such web pages as well as some clues to the success of this particular option. The owner of the business comes across as attractive, pleasant and supportive, all of which are good qualities to elicit an excellent placebo response. As a lot of readers will know, I can teach anyone to be a competent and safe acupuncturist in the course of a one-hour lecture. There is no need for several years’ training when something has no scientific basis.

The owner is quoted as saying: “I liken cosmetic acupuncture treatment to a gardener tending the soil of a plant to produce a healthy flower.” Isn’t that what manure is for?

Sunday Star Times 26 October 2008

The loopy left?

The Labour-run Lambeth Council in South London is spending 90,000 to send reflexologists into schools to massage the feet of unruly pupils. Reflexology is based on the same nonsensical ideas behind acupuncture, that pressure applied to areas on the foot can influence health and behaviour. The article contains a very interesting and important statement linked to what I was saying earlier: “Refexology is not a regulated therapy and medical authorities have raised concerns that qualifications are not needed to perform the massages.” The medical authorities ought to be denouncing this nonsense, not wittering on about ‘regulation’. Regulation merely provides spurious recognition, similar to the ridiculous situation of having ‘unregistered chiropractors’ versus ‘registered chiropractors’.

I fear that political considerations are behind a lot of these dopey decisions. At one of our conferences somebody asked a senior ACC doctor why ACC continued to fund acupuncture when it is an expensive and useless treatment. The answer was given that whenever they tried to cut back on acupuncture spending patients complained to their MP and he would get a call from the Minister asking, “why aren’t you funding acupuncture?”

Given the financial woes of ACC, one can only hope that the new Minister instructs ACC to do something about treatment spending. There are too many snouts in the trough!

Christchurch readers interested in reflexology training will be pleased to know they can do a Diploma course (NZQA accredited level 6) at the Canterbury College of Natural Medicine.

www.dailymail.co.uk

Fluoridation

Bruce Spittle (Forum 89) invited me to review his book entitled Fluoride Fatigue. I can report that I have read parts of it but had to stop because I became depressed. I will leave readers to make their own assessment. It is available free at www.pauapress.com

I would certainly not pay to buy this book which is a collection of anecdotal case reports and quotes from other people who share the author’s views. It is written in the style of the sort of books found in the New Age section of a bookshop or library. Here is an example:

“Neither in the hospital nor after her discharge was she given any medication. Instead, she was instructed to avoid fluoridated water strictly, not only for drinking but also for cooking her food as well. She was also told to avoid both tea and seafood because of their high fluoride content. The headaches, eye disturbances, and muscular weakness disappeared in a most dramatic manner. After about two weeks her mind began to clear, and she underwent a complete change in personality. For the first time in two years she was able to undertake her household duties without having to stop and rest. Within a four-week period she had gained five pounds.”

This is a classic description of the sort of person who gets chronic fatigue syndrome, gulf war syndrome, multiple chemical sensitivity – take your pick. A person with vague symptoms looking for some convenient attribution.

I was interested however in the link to the author’s website on moa sightings. At least the extinction of the moa can’t be blamed on fluoridation.

Apart from both words starting with ‘F’, there is no medical evidence to link fluoride with fatigue (or depression). Fatigue is common and is not a diagnosis. In a random survey of the US population in 1974-75, 14 percent of the men and 20 percent of the women said they suffered from fatigue.

The best place to read well- balanced accounts of fluoridation is a Ministry of Health web page. In contrast, a casual browse through the many anti-fluoridation web pages would make anybody justified in using the term ‘crackpot’.

Bionase

I was forwarded an email from Rod who was interested in some product that shines red light up the nose for treatment of hay fever. I googled “shine red light up nose” and immediately arrived at the web page of Bionase. The product has two nasal probes that shine a red light up the nose. It was claimed that this had been scientifically tested and there was a link to an impressive looking study published in the Annals of Allergy Asthma & Immunology. A search of Medline revealed that this was the only study, described as double-blind and placebo-controlled. The paper appeared plausible but continued reading revealed a fatal flaw. Use of the probes caused the nose to light up red. The placebo device did not do this. The experiment is therefore not double-blind. Whilst not given to predictions I will say that if this trial is repeated with a proper blinding this device will be shown to be useless. It is simply biologically implausible, just like homoeopathic trials claiming to treat hay fever. As somebody once said, if any homoeopathic trail showed a beneficial effect your first action is to question the conduct and design of the trial (google Benveniste).

Hokum Locum

Poison for Profit

There is something rotten in the state of China, a country where greedy people are quite happy to poison their own citizens in the name of profit. Milk powder is assayed for protein content by detecting nitrogen levels. Melamine, being a nitrogen-rich compound, gives a return in this test which indicates for protein, so if you have a poor milk product or it has been watered down, melamine can be added to make the product look as if it is up to normal protein levels.

The Chinese have been down this path before when they used melamine in pet food and it caused similar problems with kidney stones.

They also have a history of adding effective western drugs such as Viagra and steroids to enhance useless herbal remedies.

Melamine is relatively non-toxic but is relatively insoluble so tends to precipitate out and form stones in any animal that has the ability to concentrate urine.

Some animals such as cats and dogs are at a higher risk than humans because their urine is acidic and melamine has a lower solubility in acid urine.

I recall a previous scandal in the Chinese health system where the chief culprit was convicted and immediately shot. Despite my reservations about capital punishment one is tempted to wish the same fate on the criminals who have visited so much illness and suffering on small children.

Herbal Remedies for long life?

Folk wisdom is often seen as being somehow superior to modern medicine. Inductive logic is frequently used as a justification for quaint belief, reasoning from the specific case to the general case. For example, Great Uncle Fred took arsenic every day and lived to be 100 so therefore…

A nutritionist found a book in her late mother’s attic and has used it on a website promoting folk remedies such as pepper for earache, plantain leaves for toothache and horseradish mixed with gin for premenstrual tension. (Just as an aside, do women have postmenstrual docility?)

www.howtolive100years.com/index.html

You can even download the book, How to Live 100 Years. The nutritionist recalled her father treating her for mumps -“he put boiled onions on my neck.” This sounds remarkably like the medieval philosophy known as the doctrine of signatures where it was believed that God provided a ‘signature’ to plants as a sign for what ailments they might be useful for. An onion resembles the swelling of the neck with mumps so according to this doctrine an onion is the appropriate cure.

Marlborough Express 16 July 2008

Quackupuncture

An article in the Australian Medical Journal ( 2007; 187:337- 341) claimed to show that acupuncture was an effective treatment for allergic rhinitis. This struck me as absurd and also drew a sharp criticism from Edzard Ernst, Professor of Complementary Medicine, University of Exeter. Ernst has experience of a wide variety of modalities such as acupuncture, spinal manipulation and homeopathy. Despite what you might expect of his appointment he has proved to be something of a gadfly for those who make claims about alternative medicine.

The study had a fatal flaw as outlined by Ernst. It was supposed to be a ‘randomised sham controlled trial’ as follows. Needles were inserted into acupuncture points and stimulated when ‘chi’ was elicited. Chi is the subjective sensation associated with the needling of an acupuncture point. In the sham group needles were inserted at non-acupuncture points, where according to acupuncture theory no chi would be experienced! Ernst commented: ‘Thus the intervention patients were experiencing chi, and the control patients were not. This means that neither the patients nor the therapist were blinded.’ (just as an aside, ‘ blinding’ could have been achieved with acupuncture needles – the ‘ King Lear’ trial).

Another study I came across had the grand title ‘Laser acupuncture in children with headache: A double blind, randomized, bicentre, placebo controlled trial.’ Some years ago, when I reviewed the literature on acupuncture, I found the most poorly designed trials were the ones claiming the greatest results. A similar trial claimed to show laser stimulation of acupuncture points produced a ‘dramatic’ relief of pain in patients with rheumatoid arthritis. Some more sceptical people repeated the study and obtained the same improvement even when the laser was switched off!

Ancient Wisdom

While in Australia recently I saved an article from the Sunday Telegraph (21 September).

It claimed that the overburdened Australian Health System is causing large numbers of people to seek out traditional Chinese remedies.

According to Dr Alan Bensoussan, ‘The Chinese have linked particular signs together, connecting not only physical symptoms, such as the colour of the tongue and the quality of the pulse on the wrist, but also their predominant emotions, to make a diagnosis.’ What happens if you have a consultation straight after eating a raspberry ice block?

The article contains the usual anecdotal reports. A woman with asthma claimed that repeated courses of antibiotics had failed to cure chest infections which aggravated her asthma. She was cured by a one-week course of some unspecified herb.

The majority of chest infections in asthmatics are in fact caused by viruses so I have no argument there. As to the herb: probably as effective as powdered fox lung, a traditional English remedy for asthma.

Another person complained that he got the flu despite being immunised and taking a course of antibiotics. He now takes regular doses of herbal medicine and no longer gets the flu.

Immunisation is not 100 percent effective and as we all know antibiotics are ineffective against viruses. I wish journalists would challenge people on these issues instead of promulgating myths about antibiotics.

An example is given of the difference ( East vs West) between traditional Chinese and western medicine.

Six patients are found to have peptic ulcers and are all treated the same way by western doctors, regardless of sex, age and emotional state.

The Chinese traditional medicine practitioner however, takes into account differences in build, pulse quality, complexion, tongue colour, moods, sleeping patterns and length of nostril hairs. (No, I made that last one up). Each patient is diagnosed with a different root ( unintentional pun here) cause for their ulcer, based on their unique clinical picture.

I deliberately highlighted the last bit because this sort of treatment requirement is often quoted as a reason why such traditional treatments cannot be subjected to traditional drug trials. In order to give a patient an individual treatment they cannot by definition be randomised into a clinical trial. This often quoted as the ‘ plea for special dispensation.’ The other argument used is: ‘ we know our treatments work so there must be something wrong with your trial.’

However, I am mindful of the fact, pointed out by Professor Sir John Scott at last year’s conference, that a great deal of traditional western treatments and practices have never been put to the test. This is true but at least modern medicine is based on plausible ideas derived from scientific study of anatomy, physiology and pathology.

Chinese traditional medicine is based on highly implausible beliefs that defy logic and common sense.