Manipulation of the Colon
Some time ago I remember reading a letter in the Listener from a frustrated doctor who accused the public of being medically illiterate. Sometimes I feel this way myself but it is not a good practice to attack one’s audience. Public education cannot be achieved within the context of traditional ten-minute medical consultations compared with quacks who may spend up to an hour providing mis-information. Drug companies are on record as cynically exploiting a gullible public eg. “…neither government agencies nor industry, including the supplement industry, should be protecting people from their own stupidity”.
Letter to Hoffman-Laroche, quoted in NCAHF Vol 15 No.4
In a letter to Little Treasures, a writer who would probably prefer to remain anonymous claimed that her child’s constipation was cured by chiropractic manipulations because “one leg was slightly longer than the other and the passage to the bowel was obstructed by this”. The anatomical possibilities are intriguing! George Dunea writes a regular letter on the US medical scene for the BMJ and in an article reviewed the current activities of chiropractors in the US. Using aggressive marketing techniques they are claiming to treat an even wider range of self-limiting conditions such as colds and colic. One third of Americans use such unconventional treatments at a cost of $10 billion annually and one third of this cost is borne by public funds or private insurance. Dunea goes on to say: “Alternative treatments have also become popular for pets…one large dog, afraid to sleep because he had been beaten badly as a puppy, was described as taking his first afternoon nap after his spinal cord had been adjusted”.
Realigning the Spine. BMJ Vol 307 p71
An American doctor, posing as a concerned parent, surveyed 100 chiropractors and found that 80% of them would treat middle ear infections with cervical spine “adjustments”. Some 78% also sold vitamin supplements from their offices.
Chiros treating children. NCAHF Vol 16, No.6
This is a treatment based on the teachings of the Peto Centre. Children suffering from cerebral palsy are treated with an intensive (and expensive) series of exercises aimed at developing alternative neurologic circuits to their paralysed limbs. These treatments have no scientific basis and a government financed controlled trial confirmed that the Peto system gives no better results than conventional treatment. There are frequent public appeals to raise money for this treatment but the money could be put to much better use by organisations such as the Crippled Children’s Society.
BMJ Vol 307 p812
Enough has already been said on the enduring myth of homeopathy. An Australian GP was rebuked for recording a homeopathic-type immunisation in a child’s health records and the Medical Defence Union said that such action makes the GP potentially liable if the child subsequently develops a serious illness such as whooping cough or measles.
NZ Doctor 11/11/93
Psychic Surgery revisited
Shirley MacLaine, the high priestess of new-age (rhymes with sewage) silliness has regained her health and happiness after visiting a Filipino psychic surgeon. In Shirl’s own words: “He inserted his hands into my body and withdrew clots of blood and internal matter of some kind, then withdrew his hands”. In defence of Woman’s Day they did add at the end of the article “Oh Really!”
Woman’s Day 31/8/93
Yin Yang Tiddle I Po
So went the song of the Goons (actually Yin tong..) making about as much sense as an article on Chinese medicine which appeared in NZ Doctor 22/7/93 entitled “Look to natural forces to maintain health”. It is written by a trained veterinarian (Massey 1980) who is now practising as a doctor of Chinese herbal medicine. If that isn’t a paradigm shift I don’t know what is! I would love to know what prompted him to change from scientifically based veterinary practice to this nonsense. The treatment of subclinical diseases is prompted by examination of the tongue and pulse. This is a wonderful scheme because all sorts of diseases can be treated and there is no way of disproving that they ever existed. “Iced food and drinks should be avoided like the plague, as these are discordant with the prevailing Qi of summer and will stress the body”.
In a child with eczema the Chinese diagnosis was “blood deficiency complicated with wind and damp. The prescription was designed to “nourish blood, expel wind, strengthen digestion, remove damp, and cool the emotions”. As I have mentioned before, Chinese herbs sometimes contain unexpected substances. A chronically ill man developed muscle wasting which proved to be due to triamcinolone (a potent steroid) contained in “herbal” tablets. Each “herbal” tablet contained 5.4 milligrams of triamcinolone.
GP Weekly 17/11/93
Japanese Herbal Medicine
Japanese doctors will soon be able to gain a degree in Japanese herbal medicine. Seventy percent of Japanese doctors already prescribe such remedies known as kampoyaku. In response to side-effects of modern drugs and a consumer sense of depersonalisation in western medicine, such remedies are now state funded to the tune of US$1.5 billion and increasing by 15% annually. Kampo is based on 4000-year-old medical texts and diagnosis depends on the skill and intuition of individual doctors. (Where have I heard that before?) Such clinical instincts have already been shown to be weak in Western medicine, eg. “only about 50% of gastroscopies, coronary artery grafts, and carotid endarterectomies could be justified by independent panels of experts”.
Viewpoint, The Lancet Vol 341, p878
It is interesting that the Japanese community sees fit to waste money in this area when they have a chronic shortage of trained anaesthetists, causing Japan to have a maternal mortality (during childbirth) twice as high as the UK. There is also a complete lack of information about crude surgical mortality rates because the large numbers of private hospitals are not required to report their operation numbers.
Their hospitals have also been struck by an epidemic of methicillin resistant staphylococcus aureus (MRSA) due to the widespread overprescribing of antibiotics (BMJ Vol 306, p740). MRSA is a nasty bacterium which becomes prevalent whenever antibiotics are prescribed either inappropriately or excessively. This epidemic occurred because doctors are paid a set price for drugs used, whereas the drug companies supply these at a discounted rate with the doctors pocketing the difference.
New life for old medicine, The Lancet Vol 342, p485; Health Research in Japan, Letter, The Lancet Vol 342 p500
The Cocaine and Guinea-pig Diet
Move over Jenny Craig! An entrepreneurial father and son have set up a weight loss clinic on the shores of Lake Titicaca, Bolivia, at 3810m above sea level. Obese guests are invited to chew a syrupy extract from coca leaves (cocaine in its crudest form!) and if that is not enough they can enjoy having their skin rubbed down with a live guinea pig. These attractions are hoped to restore the flagging tourist industry but it is bad news for the guinea pigs.
Economist August 31st 1992, p36
Generalised Chemical Sensitivity
This is a diagnosis beloved of quacks who validate essentially depressive symptoms that some patients develop after a real or imagined chemical exposure. Glutaraldehyde is a highly effective disinfectant which has good activity against both the hepatitis and HIV viruses, but can cause skin and other sensitivity. A nurse who used this chemical developed baffling symptoms and was seen by a number of specialists who are described as suggesting that “her illness may have had an `emotional’ component”. Note the implied suggestion that an emotional cause is somehow less honorable than a “real” illness.
Her most distressing symptoms were “mood swings, irritability, loss of judgement, poor concentration and short-term memory loss” which are classic depressive symptoms. She is described as being unable to enjoy a lengthy conversation without becoming exhausted. An occupational physician dogmatically stated “There’s no doubt in my mind that the chemical has affected her immune system, leading to a multi-system pathology”. He went on to decry the patient’s “degrading and demeaning experience in failing to have her condition acknowledged by specialists” and “they go away thinking it’s all in their minds”.
Here again is the implication that physical symptoms are either “real” or imaginary. As we know, symptoms are almost always real, but can be produced by anxiety or notional beliefs (somatisation, for example headaches with depression). The result is a person who is now chronically unwell and unemployed and who has received both the wrong treatment and the wrong diagnosis. Exposure to other foods and chemicals now “causes an immediate deterioration in her ability to think clearly”.
This is a classic case of somatisation and is clearly not an occupational disease. This patient’s illness has arisen from the notion that she has somehow been “poisoned” and the availability of compensation completes the process. Doctors who continue to deny the importance of psychological factors paradoxically encourage the abnormal illness behaviour while no doubt sincerely believing that they are acting in the patient’s best interests.
This whole area was briefly reviewed by NCAHF (Vol 16 No. 6) who coined the phrase “environmental anxiety disorder” and quoted research in which immunologic testing did not differentiate patients with chemical sensitivities from controls. Finally NCAHF says “the power of the imagination, operant conditioning, and practitioner influence can reinforce imaginary sensitivities”.
GP Weekly 17 Feb 93
Quackery in the US
The US National Institutes of Health Office (Alternative Medicine) has awarded nearly $1 million in research grants for topics which include: t’ai chi for balance disorders; massage for HIV-exposed babies; dance movement for cystic fibrosis patients; biofeedback for diabetics and acupuncture for depression. I predict that all of these trials will produce glowing reports of improvements, having failed to make any allowance for the placebo effect, natural disease variation and spontaneous improvement.