The Skeptical Hairdresser

“Mind my left ear.” cautioned Mrs X, “there’s a needle in it.”

“A needle?” I said, combing up a section of hair on the side of her head to check it out.

“An acupuncture needle,” she said.

Sure enough, there it was, just up from a normal earring hole, a tiny needle with a wee piece of tape over it to hold it in place.

“Fascinating,” I said.

She produced a small metallic rod and held it against the needle. “It’s a magnet,” she explained. “I’m supposed to keep it magnetised.”

I racked my mind for information on magnetism and came up with nothing except a vague recollection that therapeutic use fizzled out around the time of Mesmer. But of course, this is the very hallmark of New Age ideas — they’re always old.

“What’s the treatment for?” I inquired.

“Tennis elbow.”

I deemed it wisest to move on to a new subject. But in one of my rare instances of foreseeing the future, I suddenly knew that it was going to be one of those days.

It was one of those days. Next I got a woman with two sniffly, whinging kids. She assured me that as soon as she got home she’d put them on the colour machine for a good hour.

I didn’t even ask. I’d seen variations of these things before. Of all the New Age gadgets (NAGs) I’ve run into, these may rank among the most exasperating. Most NAGs at least seem to be doing something; they hum or strobe, make pink noise, cause meters to flicker, hurt, relax or irritate… but the colour machine does absolutely nothing whatsoever. It’s just a small black box with a lightbulb of the selected colour on the outside. The box plugs into an ordinary wall socket and the patient is attached by means of a wire with a sort of bracelet on the end. Sometimes an alligator clip is used instead of the bracelet, and is simply clipped onto the patient’s clothes or hair.

The machine supposedly generates a flow of the patient’s own personal colour vibration (determined by the therapist who prescribes the machine) and thus augments the healing process. Call it an irrational fear of the unknown, but I hate them.

After she left I made a desperate attempt to slip out for a cigarette, but I wasn’t fast enough. A brisk young chap requiring a precision flat-top bustled in. He seemed innocuous enough at first, but by the time he left he had not only examined my eyes but had written out a list of at least a hundred and fifty dollars worth of vitamins I urgently needed. He was an iridologist.

Described by some as “living fossils,” iridologists just won’t go away. Iridology appeared on the scene in the 1880s, though undoubtedly variations on the theme go way back. It died a natural death not long after the turn of the century because of its failure to diagnose with any more accuracy than chance.

I was reaching for a pack of cigarettes when Slasher, a guy I met years ago during a lengthy investigation into the Hare Krishna movement, sauntered in to get his sides buzzed. Slasher left the movement during the great guru scandles of the late 1980s, when many of the top dogs were dumped for corruption and drastic disregard for the precepts, but like most Hare defectors, he had never fully readjusted to earth life.

Slasher was deeply concerned about the Alien Menace; in particular the small, grey, paranormal fiends known in the trade as Greys, famous for abducting human beings and performing bizarre experiments on them.

“It’s these damned surgical cattle mutilations,” he said seriously. “It’s intense man.”

“Yes; its…it’s…”

“It’s the Greys,” he said.

The alien menace people believe that mankind is caught in the middle of an invisible war between the sinister Greys and the blond, beautiful Space Brothers. It all boils down to an updated version of the old angels and devils gambit, and as always, is ancient history.

“Four of us saw it. It was a good sighting,” Slasher was saying as I whisked the cape off him.

“Yeah; I heard about it,” I said.

“Maybe you should write up a report,” he suggested.

“I thought about it… but the fact that you were all on acid at the time kind of throws a spanner in the works.”

“Mushrooms, actually,” he pointed out.

“Whatever,” I said.

By sundown I was on the brink of madness. It was as though the sky had opened up and rained dingbats. “It’s the Dark Ages all over again,” I moaned, glancing forlornly at the unattainable cigarettes hardly an arm’s-length away. “Investigative thinking has proved too tough for poor homo sap. It’s the end…”

I said little as I attended my last client. I was sure she was into Reichian orgone accumulators and I just didn’t want to know about it. But my fears were unjustified — she was clean.

It wasn’t until she was about to leave, she turned and said: “Carl, do you know that Jesus loves you…”

I was last seen running screaming down Wyndham Street, apparently stark staring mad…

Psychics’ Predictions Fizzle for 1992

President Bush was not re-elected. Madonna did not become a gospel singer, and a UFO base was not found in the Mexican desert. These were just a few of the many predictions that had been made for 1992 by famous “psychics”, but were dead wrong, as chronicled by the Bay Area Skeptics.

At the end of each year, many well-known “psychics” issue predictions for the year to come. Twelve months later, they issue another set of predictions, conveniently forgetting those made the year before, which are always nearly 100% wrong. Each year, however, the Bay Area Skeptics dig up the predictions made the year before, to the embarrassment of those who made them.

Many of the “psychic” predictions made are so vague that it is impossible to say if they came true or not: for example, Jeane Dixon’s prediction that Tracey Gold “faces perilous periods in July and October” [The Star, April 14, 1992] is not obviously true or false. Many other “predictions” involve things that happen every year, or else are not difficult to guess, such as terrorist incidents, marital strife for Charles and Diana, or severe winter storms. Many supposed “predictions” simply state that ongoing events and trends will continue, such as economic uncertainty, or conflict in the Middle East. Some predictions did of course come true, especially those that were unspecific, or not at all difficult to guess: several “psychics” correctly predicted that a hurricane would cause major destruction in Florida or Cuba, but not one was specific as to the date or principal location of the damage. Hurricanes occur, of course, every season in the Caribbean. Significantly, not one prediction which was both specific and surprising came true.

Other supposed “predictions” are not really predictions at all, but are actually disclosures of little-known events which are already under way, such as movie productions, marriage plans, business ventures, or developing scandals. Because questionable claims of having made an amazing prediction are frequently made in the wake of major news stories, the Bay Area Skeptics only evaluates predictions that were published or broadcast before the events they claimed to foretell.

New York “psychic” Lou Wright predicted that three men would unsuccessfully attempt to kidnap Candice Bergen in Paris, and Marlon Brando would be arrested for trying to bust his son out of jail [National Enquirer, Jan. 2, 1992].

Los Angeles “psychic” Maria Graciette predicted that a secret UFO base would be found deep in the Mexican desert, thousands of years old, and that Vice-President Dan Quayle, attending a World Series game, would impulsively interfere with a play [National Enquirer, June 9, 1992].

New York “psychic” John Monti predicted that “a massive hurricane will devastate Cuba and topple Castro’s regime,” that a huge AIDS epidemic would “threaten to end professional sports” [National Enquirer, Jan. 2, 1992], and that a scientific advance would allow women to delay menopause, allowing them to have children into their 60s [National Enquirer, June 9, 1992].

The famous Washington, D. C. “psychic” Jeane Dixon, who supposedly has a “gift of prophecy”, saw that Fidel Castro would be overthrown, possibly resulting in Cuba becoming part of the U. S., and Virginia governor Douglas Wilder would gain enough support for a “vice-presidential invitation”. President-elect Bill Clinton, however, she described as “the Democratic shooting star,” for whom “an organization of women will try to block his path” [The Star, Jan. 21, 1992]. President Bush’s ratings would climb, resulting in his re-election [The Star, July 7, 1992]. She also predicted “a promising economic upturn in the spring,” and that “broccoli will become the miracle vegetable of the ’90s” [The Star, Jan. 21, 1992].

Chicago “psychic” Irene Hughes predicted that Vanna White and her husband would purchase a “haunted” mansion in Beverly Hills, from which they would flee in terror a week later. Madonna’s career would be interrupted by a “mystery illness,” but she would recover after having a religious vision, and become a gospel singer [National Enquirer, June 9, 1992].

New York “psychic” Laura Steele predicted that an earthquake would topple the Gateway Arch in St. Louis, and that William Kennedy Smith would enter the priesthood to become a missionary in Africa [National Enquirer, Jan. 2, 1992].

Los Angeles “psychic” Judy Hevenly predicted that George Bush would be re-elected “by a landslide,” that Madonna would be hit by a car while jogging in New York’s Central Park [National Enquirer, Jan. 2, 1992], and that Gennifer Flowers would join the cast of a popular daytime soap opera [National Enquirer, June 9, 1992].

Another Southern California “psychic,” Clarisa Bernhardt, who is claimed to make “uncanny earthquake predictions,” warned that scientists would be “shocked” in October when supposedly earthquake-proof Florida is hit by a trembler, only weeks after being hit by “the worst hurricane in the state’s history.” The prediction that this year’s hurricane season would produce Florida’s worst destruction yet was correct, but the earthquake prediction was dead wrong. Bernhardt also predicted that Joan Lunden would renew her marriage vows on her TV show, “Good Morning America” [National Enquirer, June 9, 1992], that Michael Jackson would lose his voice and quit singing, and that Joan Rivers would be plagued by three look-alikes created through “extensive plastic surgery” [National Enquirer, Jan. 2, 1992].

Joan Quigley of San Francisco, White House astrologer to the Reagans, predicted that Bill Clinton would run out of money toward the campaign’s end, and that the total eclipse of the sun on June 30 will cause earthshaking events in China [Washington Post, April 18, 1992].

Here in Northern California, the date of that devastating California earthquake everybody keeps predicting was pegged for Oct. 17, the third anniversary of the Loma Prieta quake, by “psychic” Ernesto A. Moshe Montgomery, who claims an accuracy of 99 1/2 percent [San Jose Metro, Feb. 27, 1992].

Based on the continuing failure of the “psychics” to make accurate predictions over the years, the Bay Area Skeptics urges everyone — especially the media — to exercise some healthy skepticism when “psychics” and other purveyors of the paranormal make extra-ordinary claims or predictions. Anyone who swallows the “psychics'” claims year after year without checking the record is setting a bad example for students and for the public.

It is important to note that no “psychic” succeeded in predicting the genuinely surprising news stories of 1992: The destructive fire in Windsor Castle; the feud between Vice-President Quayle and Murphy Brown; the surprising presidential campaign of Ross Perot. These major news stories were so totally unexpected that someone would have had to be genuinely “psychic” to have predicted them twelve months ago! Given the sheer number of so-called “psychics” out there, one would expect that if even one of them were genuine, these things would have been correctly predicted; and since they were not, it suggests that all such claims of “psychic powers” are without foundation.

“Mystical explanations are considered deep. The truth is that they are not even superficial.”
– Friedrich Nietzsche (The Gay Science: 126)

A Skeptic’s Bibliography

This is an excerpt from Thomas and Rusk’s lengthy bibliography of works with skeptical viewpoints. Prices noted are in US dollars.

General

Abell, George and Barry Singer, eds., Science and the Paranormal, Scribners, 1983, P-$13.95, ISBN 0-684-17820-6.

Asimov, Isaac, The Roving Mind, Prometheus Books, 1983, H-$21.95, ISBN 0-87975-201-7; P-$15.95, ISBN 0-87975-315-3.

Cazeau, Charles J. and Stuart D. Scott, Jr., Exploring the Unknown: Great Mysteries Reexamined, Plenum Press, 1979, H-$18.95, ISBN 0-306-40210-6.

de Camp, L. Sprague, The Fringe of the Unknown, Prometheus Books, 1983, P-$14.95, ISBN 0-87975-217-3.

de Camp, L. Sprague, The Ragged Edge of Science, Owlswick Press, 1980, H-$16.00, ISBN 0-913896-06-3.

Frazier, Kendrick, ed., Paranormal Borderlands of Science, Prometheus Books, 1981, P-$17.95, ISBN 0-87975-148-7.

Frazier, Kendrick, ed., Science Confronts the Paranormal, Prometheus Books, 1985, P-$17.95, ISBN 0-87975-314-5.

Gardner, Martin, Fads and Fallacies in the Name of Science, Dover, 1957, P-$6.50, ISBN 0-486-20394-8.

Gardner, Martin, Science: Good, Bad, and Bogus, Prometheus Books, 1981, P-$15.95, ISBN 0-87975-573-3.

Goran, Morris, Fact, and, and Fantasy: The occult and Pseudosciences, Littlefield, 1980, P-$7.95, ISBN 0-8226- 0356-X.

Hines, Terence, Pseudoscience and the Paranormal: A Critical Examination of the Evidence, Prometheus Books, 1987, P-$17.95, ISBN 0-87975-419-2.

MacKay, Charles, Extraordinary Popular Delusions and the Madness of Crowds, Templeton, 1985 (original 1841), H- $24.95, ISBN 0934405-00-X; P- 3 editions available.

Nickell, Joe and John F. Fischer, Secrets of the Supernatural: Investigating the World’s Occult Mysteries, Prometheus Books, 1988, H-$18.95, ISBN 0-87975-461-3.

Paulos, John Allen, Innumeracy: Mathematical Illiteracy and Its Consequences, Hill and Wang, 1988, H-$16.95, ISBN 0-8090-74478.

Randi, James, Flim-Flam! Psychics, ESP, Unicorns and Other Delusions, Prometheus Books, 1982, P-$12.95, ISBN 0-87975-1983.

Rothman, Milton A., A Physicist’s Guide to Skepticism, Prometheus Books, 1988, H-$19.95, ISBN 0-87975-440-0.

Sagan, Carl, Broca’s Brain: Reflections on the Romance of Science, Random House, 1979, H-$14.95, ISBN 0-394-50169-1.

Schultz, Ted, ed., The Fringes of Reason: A Whole Earth Catalog, Harmony Books, 1989, P-$14.95, ISBN 0-517-57165-X.

Stanovich, Keith E., How to Think Straight About Psychology, 2nd ed., Scott Foresman and Company, 1989, P-price not set, ISBN 0-67338412-8.

Astrology

Bok, Bart J. and Lawrence E. Jerome, Objections to Astrology, Prometheus Books, 1975, P-$10.95, ISBN 0-87975-059-6.

Culver, Roger B., Sun Sign Sunset: A Statistical Investigation of the Claims of Sun Sign Astrology, Pachart Publishing House, 1980, P$9.95, ISBN 0-912918-00-4.

Culver, Roger B. and Phillip A. Ianna, Astrology: True or False? A Scientific Evaluation, Prometheus Books, 1988, P- $14.95, ISBN 087975-483-4.

Gauquelin, Michel, Dreams and Illusions of Astrology, Prometheus Books, 1979, H-$19.95, ISBN 0-87975-099-5.

Jerome, Lawrence, Astrology Disproved, Prometheus Books, 1977, H$22.95, ISBN 0-87975-067-7.

Beware – This Tea Could Be Dangererous

Where’er you be
Don’t drink comfree
For drinking such tea
Could be the death of thee!

John R. L. Walker

Our everyday “cuppa” comes from the plant Camellia sinensis and it, together with a number of other common drinks including coffee, cocoa, guarana and maté contain small quantities (10-100 mg per cup) of caffeine, a mildly stimulatory alkaloid. In addition many people enjoy hot and cold beverages made from a wide variety of other herbs such as chamomile and dried raspberry leaves.

Unfortunately, an uncritical mythology has developed regarding herbal teas made from other plants that maybe very dangerous. Notable among these are herbal teas made from comfrey, coltsfoot and sassafras; the former contain toxic alkaloids while the latter contains the carcinogen safrole. Recently, the German government’s health authority, the Bundesgesundheitampt (BGA), has decided to ban some fifty herbal and homeopathic remedies because they are ineffective or contain toxic alkaloids. High on their list is comfrey.

They comment that although a medicament is derived from a common plant, it can be just as dangerous as any laboratory-synthesised chemical. This fact has been well known since the death of Socrates from a dose of hemlock (which contains the alkaloid coniine), but is all too often conveniently ignored by the herbal mystics.

Here in New Zealand there are many recorded animal deaths from ingestion of tutu (Coraria arborea) which contains “tutin”, a poisonous picrotoxinin.

Comfrey (Symphytum officinale) has aquired an almost magical status in herbal medicine, comparable almost to that of ginseng. It is one of the most often sold herbal remedies. However, unlike ginseng, comfrey has been shown to contain highly toxic alkaloids, yet many modern herbalists still wax lyrical about its safety and almost universal healing properties.

Comfrey is frequently used in folk medicine as an externally applied poultice for wound healing, and such treatments may be useful since comfrey contains allantoin, which promotes cell proliferation, tannins and mucilage.

So far so good, but comfrey is also recommended by many herbalists to be taken internally as a “blood purifier” and as a universal panacea for numerous other ailments including respiratory complaints and ulcers of the bowels, stomach, liver or gall bladder.

Now, in the light of much well-documented research, the German BGA has banned the sale of herbal remedies containing comfrey. This is because comfrey contains a group of chemicals known as the pyrrolizidine alkaloids which have been shown to be carcinogenic and to cause severe, even fatal, damage to the liver.

Coltsfoot (Tussilago farfara) and Senecio species, such as groundsel, are other common herbal remedies which also contain these dangerous pyrrolizidine alkaloids, although for many years coltsfoot has been prescribed as an ingredient of herbal cough syrups and smoking mixtures. Japanese and other research workers have shown that these preparations may be potential causes of liver damage.

Problems with herbal remedies nay also arise from other causes such as adulteration, contamination and misidentification. The latter should be of major concern since, for most herbal products, there is no guarantee that the original plant(s) were unequivocally identified by a competent botanist.

As with any drug, susceptibility to poisoning varies between individuals and may be affected by gender, age and state of health. in a recent paper Dr Ryan J. Huxtable comments that, in North America, more people are killed or injured by plant derived substances than by animals. Yet, despite this, the US herbal industry is still virtually unregulated and without legal safeguards to demonstrate the safety or efficacy of its products.

Locally sourced herbal teas from New Zealand native plants are now becoming available, but we should remember that many of our native plants produce alkaloids and other toxins which are dangerous if ingested. I therefore caution anyone who buys a herbal beverage to require not only a list of its plant components but also to be sure that these plants were competently identified.

For the edification of readers I append a list of a few common poisonous plants found in New Zealand and which I would not want in “my cup of tea”.

Common Poisonous Plants
Plant Botanical Name Toxic Principle
Apricot (kernals) Persea armeniaca Cyanogenic glycosides
Bittersweet Solanum dulcamara Alkaloids
Foxglove Digitalis purpurea Steroidal glycosides
Hellebore Helleborus sp Steroidal glycosides
Karaka (fruit) Cornyocarpus laevigatus Cyanogenic glycosides
Kowhai Sophora sp Alkaloids
Ngaio Myoporum laetum Ngaione
Peach (kernals) Prunus persica Cyanogenic glycosides
Porporo solanum aviculare steroidal glycoalkaloids
Ragworts Senecio sp Pyrrolizidine alkaloids
Tutu Coraria sp Tutin

Bibliography

Connor, H.E. The Poisonous Plants in New Zealand. (1977) Govt Printer, Wgtn.

Huxtable, R.J. (1992) The Myth of Benificent Natue; the risks of herbal preparations. Annals of Internal Medicine 117; 165-166.

Stewart, J. Plants in New Zealand Poisonous to Man. (1975) Govt Printer, Wgtn.

Tyler, V.E. The New Honest Herbal (1987) George F Stickley Co. Philadelphia. (Highly recommended).

Moa Mania

Some Skeptics have been surprised that our organisation has been so restrained in its response to the purported moa sighting near Cragieburn. As we see it, the whole issue is fraught with difficulty.

The notion of a colony of large moas escaping detection till now, despite its location in the Southern Alps accessible to Christchurch, almost defies the imagination. Almost, but not entirely: there is a lot of dense country out there, and the notion of a surviving moa — or two, or twenty — cannot be classed with Bigfoot or UFO abductions.

To this, we have to add the perceived credibility of the witnesses. The Press reporter who broke the story, Dave Wilson, is a previous winner of one of the Skeptics’ “excellence in journalism” awards. He’s an intelligent, persistent, hard-headed bloke who has spent a lot of time interviewing the trio who saw the beast, and he’s strongly inclined to the view that they are at least sincere. Wilson is a world away, for instance, from the cynical, exploitative Australian journalists who a few years ago got their hands on a family that had seen a blinding light on sky over the Nullarbor desert. Wilson has, to the contrary, been careful and measured in his approach.

The New Zealand Skeptics, it seems to me, cannot simply disregard Wilson’s convictions on this issue. If the trio is lying, it’s a particularly skillful and cruel hoax on Wilson personally, not to mention the rest of us. Still, for my part, I found the watery “footprint” of the beast, a photograph of which the three trampers produced at the very beginning of the flap, cause for the most skepticism. It was all wrong for a print left by a running bird, or a standing moa. The fuzzy photograph of the bird itself was plausible; the footprint looked outright fake.

If the sighting is not a hoax, then something like a loose emu still is far more likely than a moa. Nevertheless, hope springs eternal in the hearts of most skeptics that something as wondrous as the recovery of the moa might just turn out to be true. Wouldn’t we all cheer?

When I was musing on this the other day, Vicki Hyde brought me back down to earth with a stern lecture on the real, numerical probabilities of there being large, undetected moas in one of our more accessible parks. She was right, of course. But then I never claimed to have a skeptic’s soul. If anything, I more-and-more consider myself temperamentally gullible, and in need of occasional dressings-down by more tough-minded types like Vicki. Nevertheless, if the Skeptics are to err in this case or any other, better perhaps to be slightly on the side of a splendid possibility, than to dismiss without any consideration some extraordinary claim.

One of the highlights of our upcoming conference will be a symposium on cryptozoology. Dave Wilson will be there, and we may even be able to bring along the moa spotters themselves. Meanwhile, Vicki is organising a “fuzzy-photo” contest for Skeptics who can produce evidence demonstrating the existence of some extinct or extraterrestrial beast. Or perhaps a tossed hubcap, a floating log, or a chicken-wire moa.

Hokum Locum

Quackery

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

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

More on Bands of Hope

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

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

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

Pharmaceuticals Around the World

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

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

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

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

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

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

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

Blunderbuss Treatment

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

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

Drug Licensing

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

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

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

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

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

Thalassotherapie

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

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

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

More on RSI

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

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

Even More on Chronic Fatigue Syndrome

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

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

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

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

Chelation Therapy

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

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

Monkey Business

From Jerusalem comes news that Israel’s former Chief Rabbi Ovadia Yosef has ruled that trained monkeys may turn off lights or do other domestic chores forbidden to Jews on the sabbath. But only a borrowed monkey — or a dog or other animal capable of performing such tasks — can be used because their own beasts must be allowed to rest.

Skeptic Carl Wyant, who has sent us this information, says that it bugs him: “Apparently God doesn’t care if gentile monkeys get a day of rest or not.”

The Placebo Effect

Many people will remember Dr Bill Morris’s entertaining autobiographical talk at the last Skeptics’ conference in Wellington. From his presentation, we extract this discussion of what is still the most persistent and potent medical effect known to the human race.

The word “placebo” may or may not be recognisable to you as being of Latin origin, from the verb placeo, placere, to please, and placebo is the first person singular of the future indicative tense, or “I shall please.” Its first recorded use in the English language was in 1225 in reference to Vespers in the Office for the Dead, and the word was derived from the first word of Psalm 116 v 9 “Placebo Domino in regione vivorum.” This is usually translated as “I shall walk before the lord in the land of the living,” but as the Vespers for the dead was in effect a request for the dead to intercede with God for the benefit of the living, it is better translated as “I shall please or intercede with God on behalf of those in the land of the living.”

By 1386 it had appeared in Chaucer’s Merchant’s Tale to mean a flatterer and by 1811 it had acquired one of its modern senses as “…an epithet given to a medicine adapted more to please than to benefit the patient.”

It may surprise you to learn that it was as late as 1938 before the word appeared in its other modern sense, that of a dummy medication used as a control, and probably the first well documented randomised placebo controlled trial was that of streptomycin for the treatment of tuberculosis of the lung, in 1948.

The Medical Research Council pointed out that the natural history of tuberculosis of the lung was so variable that “evidence of improvement or cure following the use of a new drug in a few cases cannot be accepted as proof of the effect of that drug” by contrast with tuberculous meningitis which was invariably fatal without treatment.

The placebo treatment was bed rest alone, whereas the streptomycin group received both bed rest and streptomycin. In this instance the patients obviously knew they were getting streptomycin as it has to be given by injection, but the progress of the disease was followed on chest X-rays which were assessed without knowledge of which treatment the patients had received.

Ethical considerations did not apply, as the only possible alternative treatment at that time was bed rest, and in any case only limited amounts of streptomycin were available. Nearly forty five years on, it is difficult to accept that bed rest alone was perceived to be an effective treatment.

By 1950 the Journal of Clinical Investigation wrote, “It is customary to control drug experiments on various clinical syndromes with placebos, especially when the data to be evaluated are chiefly subjective.” and so by this date, the use of dummy medication in drug trials was firmly established.

It soon became clear that many people reported side effects or improvement when receiving placebos in trials and it soon became possible, though perhaps not useful, to say that the placebo effect was that which all treatments have in common. Perhaps more useful is to combine the two definitions and say that it is a non-specific effect of a treatment attributable to it but not to its pharmacological properties.

Any form of treatment can act as a placebo, and the strength of the reaction varies with the supposed potency of the treatment so that a capsule is better than a tablet, an injection is better than a capsule, an injection that stings is better than one that doesn’t and an operation is even better than an injection that stings.

In 1939 it was suggested in Italy that tying off the internal mammary arteries could greatly reduce the pain of angina pectoritis. The operation eventually became fashionable in the USA with quite spectacular results. The patients said they felt better and there was objective evidence to support this in that they could walk further and their consumption of angina pills decreased.

Eventually a double blind controlled study was done in which half the patients had their internal mammary arteries tied and the other half simply had them exposed without tying them. Neither the patients nor those who assessed them knew until the study was completed who belonged to which group. It turned out that ligation had no greater effect than the dummy operation. Since ligation of the internal mammary arteries was quite a major operation with potential for harm as well as good, and there was genuine doubt that it was useful, not only was the trial ethical, but it would have been unethical not to have done it.

Placebos can also cause toxic effects just like those of an active drug, and in a study of 25 patients given placebos, ten reported sleepiness, nine palpitations, eight irritability, five weakness with a fall in blood pressure of more than 20 mm of mercury, four reported diarrhoea, two collapse and two itching. Three of the patients also developed dependence on the placebo (lactose) and had withdrawal symptoms when it was stopped.

Now one suspects that if we stopped people in the street at random they might report a similar rate of these symptoms, and at the 1992 Skeptics Conference, on asking for a show of hands, I found that the proportions enjoying the symptoms listed above were greatly exceeded.

As soon as the placebo effect became clear, investigators began to look for factors which might identify the placebo responder in the hope that eliminating them from the studies would make the data much clearer.

A variety of psychological studies has been done but there are so many inconsistencies among the results that one can conclude that there is no single personality trait that characterises the positive placebo reactor, with the possible exception that stress or anxiety has been rather consistently associated with placebo reactivity. Expectation has been cited as a possible mechanism.

In one study, experimenters were told that their rats had been bred especially either for intelligence or dullness, although in fact all the rats were from the same genetic strain. The experimenters then performed learning experiments on the rats and obtained results that conformed to their expectation.

Brody cites this as possible support for the idea that if experimenters can somehow communicate their expectations of the rats’ behaviour to the rats “It seems reasonable to assume that physicians can unknowingly communicate their expectations and attitudes to the patients, altering the patients’ therapeutic outcomes as a result.” My own view is that old Procrustes is at it again, altering the accuracy of the experimenters’ observations rather than the rats’ behaviour.

Theories of placebo action have been largely psychological or psychoanalytical, but a reductionist like myself sees behaviour, feelings, thoughts and so on in terms of as yet poorly understood physico-chemical activities in the brain and peripheral nervous system, rather than as something happening somewhere in a bubble marked “psyche.” A little support for this view comes from a randomised double blind placebo controlled study by Levine and others into the mechanism of pain relief following extraction of impacted lower wisdom teeth. A third were given naloxone, a substance which is believed to inhibit the action of naturally occurring pain relieving substances in the brain called endorphins, a third were given a placebo and a third were given morphine. Those given naloxone reported significantly more pain than those given the placebo.

Levine hypothesised on this basis that placebo pain relief is mediated by endorphin release, but as Skrabanek pointed out later, they did not test their hypothesis by actually measuring endorphin levels, and in any case the results were exactly what might be expected if the naloxone were acting as a placebo itself. The paper was also severely criticised by Korczyn, but nevertheless it continues to be quoted quite extensively as “demonstrating” that pain relief by placebos is mediated by endorphins, a claim, incidentally, that is also made for pain relief by acupuncture.

We simply do not know why about thirty percent of patients experience relief of symptoms when given a therapy that cannot be expected to have any effect. In a sense, the history of medicine up to about 1950 is largely the history of placebos. We may find it amusing to look at some of the truths of yesterday which are the falsehoods of today, like the fashion for enemata in eighteenth and nineteenth century France. Sometimes enemata even of tobacco smoke were administered, and while we cannot feel entirely confident that the Tobacco Institute would disapprove of this, we can feel sure that many of our present day medical practices will appear stupid and ignorant to our great grand-children.

For the last forty five years we have had the means to set a limit to our errors, and yet colleagues tend to set store by anecdotes and case series which are in truth little better than a succession of anecdotes. The results of poorly designed case control studies continue to be accepted without proper caution. If physics is the queen of the sciences, then the randomised double blind placebo controlled study is the queen of medical investigation, though for events that occur relatively rarely, cohort studies and case control studies are inevitable second and third best choices.

People, including I am sad to say, doctors, have said to me “What does it matter whether a treatment is a placebo or not as long as it works? Surely the thing is to cure the patient and when you cannot cure, to comfort.” I can certainly agree with the aim, but not that it does not matter how we do it. If we do not make sure of the truth then we shall not be able to separate the wheat of science from the chaff of falsehood, and as Berthold Brecht put it, the aim of science is not to open a door to infinite wisdom, but to set a limit to infinite error.

Magic Medicine Turns Businessman into Sex Zombie

Magic potions made from natural ingredients are generally hailed as environmentally friendly. But is this necessarily true? Not if you’re a rhinocerous!

Rhino horn is highly valued for its alleged power as an aphrodisiac and can sell for up to three times the price of gold.

In 1968 there were 18,000 rhinos cantering playfully on the plains of Kenya; now there are 400. Organic horn harvesters have hunted the rhino to virtual extinction. But hey, there are culturally sensitive traditions to uphold… not to mention the oldest tradition of them all — wrangling money from the gullible.

TVNZ Newsman Writes Book!

The TVNZ fortnightly newsletter, Networks, recently carried the welcome news that a Senior Editor in TVNZ’s news division has written a book. The Astrologer and the Paradigm Shift will, according to Networks “clear up many common misconceptions about astrology.”

According to the author of the book, “Astrology is loosely grouped with modern New Age beliefs but it is in fact an ancient philosophical tradition out of which modern science arose.”

The newsman, a physics graduate, gave up his intention to pursue a scientific career when he found “physics didn’t address the connection between the human being and the environment, so was too divorced from reality.”

His book is 468 pages long. When asked how his colleagues felt about having the author of a book in their midst, he said that some of them didn’t know how to handle it, “although lots are intuitively sympathetic to where I’m coming from. I’ve done chart readings for several people” at TVNZ.

As is so often obvious, TVNZ news has no qualified specialist science or medical reporters. (In the recent flap over their carcinogenic potential, cellphones were in one TVNZ report repeatedly referred to as “radioactive.”) Nevertheless, it is heartening to learn that it now has a qualified astrologer to cast horoscopes for the staff.

Video Library Update – New Titles, July 1992

A CSICOP video library is run by Alastair Bricknell, RD2 Kuaotunu, Whitianga. Tapes may be hired for the cost of postage and packing, around $5 (extra donations gratefully accepted).

Homeopathy — Medicine or Magic?, QED (BBC TV), 1990, 30 minutes

A very interesting look at the state of homeopathy in the UK in the ’90s including its use by some “conventional” doctors and vets. Details are given of a few trials (some double and triple blind) that have been conducted claiming to give support to homeopathic techniques. Unfortunately, relatively little time is permitted for dissenting views and I am sure many of our rural members will have other explanations for some of the “miraculous” animal cures presented. A thought provoking programme nevertheless; it should be essential viewing for any skeptic confronting homeopathic enthusiasts.

Secrets of Sedona, 48 Hours (CBS), 1991, 60 minutes

A visit to Sedona, Arizona, a centre for “New Age” thinking(?) in the US. Topics covered include fire walking, astrology, UFOs, vortexes (vortices?), pendulums, channelling, reincarnation, and New Age music — surely there is something for every skeptic in this one. The programme shows how some successful businessmen and women use New Age techniques to influence their business decisions and the industry that has built up around this philosophy in a beautiful part of the American west. A good balanced look at a phenomenon that is starting to become increasingly popular in New Zealand,

Spiritual Healing, Foreign Correspondent (TVNZ), 1992, 15 minutes

A brief but interesting and relatively balanced look at the healing scene in the UK. Topics covered include New Age healing methods, “Touch for Health” healing (some skeptics might say “Clutch for Wealth” would be more appropriate), the charismatic Christian movement, and several other alternative medical practices. A revealing discussion with a conventional medical practitioner illustrates the tragic consequences that can arise for those relying on these fringe methods while cancers continue to grow.

Chelation Therapy, Frontline (TVNZ), 1992, 15 minutes

A good introduction to chelation therapy as practised in New Zealand at present. Discusses the double blind trial currently underway in Dunedin that is due to end in a few months. Sensible comments from conventional medical practitioners about the merits of this controversial therapy provide some balance to this interesting program.

Acupuncture Exchange

In the medical magazine Patient Management, Denis Dutton last year presented a tongue-in-cheek account of how GPs might incorporate alternative techniques into their practices. The article generated an interesting exchange.

Dr Denis Dutton’s original article in the March edition (“Increasing Your Income While Appeasing Your Patients”, pp. 9-11), and his more recent reply to Dr Campbell’s letter in the June edition (“One rule for Orthodoxy, Another for the Rest of Us”, p. 7) raise several interesting issues.

Our society comprises Western-trained doctors who study and practise acupuncture. For many of us, enthusiasm was first sparked by noticing the beneficial effects of acupuncture in the clinical setting. Most of our members are experienced clinicians and in their opinion, the effects of acupuncture amount to more than the sum of willing, motivated doctors enhancing a placebo response.

Many have been motivated to study the philosophies and pathophysiology of Eastern medicine, in particular traditional Chinese medicine. The collection of clinical material has been meticulously recorded by the Chinese for centuries, but it is only in the last 15 years that textbooks have been available to us, showing the logic and complexity of this study of medicine.

The marriage of Eastern and Western medicines is an exciting and vital factor in many parts of the world. The double-blind crossover trial, which all doctors would agree has been a cornerstone for the development of safe, effective Western medicine, is, however, an inappropriate measure of acupuncture. The reasond for this become obvious when Western doctors study the basics of acupuncture. The observations of the Chinese seem to fit in with modern advances in biophysics and it is ultimately the advancement of these basic sciences which will make the who subject more understandable to non- clinicians like Denis Dutton.

By reacting to acupuncture and claiming Chinese medicine is based on primitive and fanciful concepts, the American NCAHF exposes itself as being either unaware of the complexities of the subject, or worse still, threatened by them.

The medical profession, if it is to continue to earn the respect of the public, should study both Western and Eastern medicine with open minds.

Only then can valued judgements be made.

Dr Robin Kelly, President, Medical Acupunture Society (NZ)

Dr Dutton’s Reply

According to Dr Kelly, modern advances in biophysics will make acupuncture finally understandable to stubbornly sceptical non- clinicians like me. Wrong: the mechanism of the treatment is not the issue. I don’t know how Panadeine works, but I accept that it does. It is not the failure of acupuncture’s supporters to demonstrate an intelligible mechanism that is in question, but the straightforward clinical claims made on its behalf. The history of medicine is littered with episodes of “willing, motivated doctors enhancing a placebo response”. There need be nothing the least bit stupid or venal about this; in their eagerness to help their patients, an intelligent doctor can develop a sincere faith in an ineffective treatment modality. Blind testing routines are our best defence agaist this possibility.

On the subject of mechanism, it is worth remarking that I am aware of two local medical practitioners who were trained in acupuncture (one in Beijing, the other in Auckland) and who have used it extensively. Becoming increasingly suspicious, both of these practitioners had the idea of intentionally placing their needles at the wrong points, according to the Chinese charts (which don’t all agree with one another, incidentally). They found no difference in the perceived effect. One of these doctors has stopped using acupuncture, and the other continues to use it in the opinion that it is the time and attention he is giving the patient that produces the benefit, rather than a psychological effect of turning the patient into a pin-cushion.

Claim and counter-claim about the clinical effectiveness of acupuncture is all fair enough, and I hope doctors interested in these issues will consult both sides of the debate [start with P. Skrabanek, Lancet 1: 1169-1171, 1984; Irish Med J 79(12): 334-335, 1986]. What I find deeply disturbing is that Dr Kelly would claim that blind trials, though they are a cornerstone of safe, effective Western medicine, are “an inappropriate measure of acupuncture”.

This is a claim frequently made on behalf of alternative treatments and I believe it should be regarded with the utmost contempt. When a patient asks about the symptoms that might be alleviated by acupuncture, a definite answer is forthcoming; no one ever says “Oh, we have no idea what symptoms acupuncture is good for”. When the patient asks how much it costs, again a definite answer is immediately ascertainable. But in the present case, when we further ask if the modality has been shown through blind testing to be clinically effective, we’re told by the President of the Medical Acupuncture Society of New Zealand that this would be inappropriate. Not that it hasn’t been done, or that the results have been in his view indecisive, but that it would be inappropriate. Why? His society’s members deem acupuncture appropriate for the patient’s symptoms, which are demonstrably real. Real money is deemed appropriate for the demonstrably real account the doctor sends out. Why shouldn’t the paying patient demand that her treatment be just as real, as demonstrated by scientific tests? How can anything else be “appropriate” except the magic question: is acupuncture clinically effective beyond the usual placebo responses?

The “exciting and vital” marriage Dr Kelly describes looks to me like one in which Western medicine has taken Eastern superstition as a mail-order bride.

Dr Denis Dutton, School of Fine Arts, University of Canterbury