Joint Manipulation

An article in NCAHF reminded me of past activities with respect to joint manipulation. Following a one week course I embarked on a short-lived career in spinal manipulation which is very easy to learn and causes a greatly inflated belief in one’s ability to “cure” spinal ailments.

The first problem was that patients kept coming back repeatedly to have their back or neck “put back.” I soon realised that if, as the quacks claim, the spine can easily be “put back” then it can just as easily “go out” again. All I had done was create a perception with the patients that every time their back or neck hurt it required a specific manipulation. If only I was more unscrupulous…what a wonderful money-making idea!

What finally cured me of such activities was the day I manipulated a patient’s neck with the usual psychologically satisfying crack from the spine. She sat up, went pale and slumped back onto the couch. Distraught, and thinking that I had killed her I rushed through to get the assistance of my receptionist who took one look and said to me “You twit. She’s only fainted.”

As a reformed manipulator, I was therefore interested in the following which I will quote in full:

“The popping sound associated with ‘putting bones back-into-place’ (though it may be accomplished by manipulating a normal joint) is one of the cleverest and most effective forms of suggestive therapy ever devised. This has a tremendous psychological influence over the mind. While the popping sound itself is quite meaningless, this influence might possibly be used to advantage in curing psychosomatic conditions — provided the patient is informed that the bone is ‘back-in-place’ and will stay there. By the same token, however, such treatment can cause a great deal of harm; that is by perpetuating a psychosomatic condition or even creating a new psychological illness.”

Manipulative therapy is well documented as leading to spinal cord damage and paralysis. Quacks will claim that this only occurs in a few cases per 100,000 patients treated but the easy answer to this is that all of these conditions get better without the risk of paralysis from manipulation, therefore any risk of spinal cord damage is unacceptable. (NCAHF Vol 18, No 3)

Alleged Allergies

Although I don’t see many children in the course of my work, I am amazed at how often mothers allege that their children can’t have milk because of various allergies. In one study, researchers found that people who perceive that they are allergic to milk simply misinterpret ordinary abdominal feelings. From a group of 30 subjects, 21 were identified who were genuinely intolerant of lactose. They were divided into two groups and given either normal milk or lactose-free milk. There was no difference in the amount of abdominal distress reported by the two groups.

Full of Wind?

A report on a new breathing therapy for asthma initially looked quite interesting until I came across the following statement: “by learning to saturate their bodies with carbon dioxide, patients can lessen muscle tension and slow breathing to a normal rate.” After reading this I was still interested until I came to the end: “the technique is also used to treat angina, high and low blood pressure, piles, varicose veins and even cancer.” This is an absurd range of indications for any one treatment and such claims are absolutely diagnostic of quack therapies.

Carbon dioxide is one of the most potent stimuli of the respiratory centre which triggers breathing. Any attempt to saturate the body with carbon dioxide will stimulate the breathing reflex so the whole therapy concept is a contradiction in terms.

Silicon Implants

Are there any American female actors who have not had their breasts surgically enhanced? I was reading a magazine which was profiling Baywatch star Pamela Anderson. Pamela cannot stay in cold water for very long because her implants start to solidify and ruin her mammary profile.

In Skeptic 34 I outlined how women could claim for silicon disease if they had vague symptoms such as chronic fatigue, muscle weakness and memory loss. A study reported in the British Medical Journal (Vol 311, p138) found no connection between silicon breast implants and connective tissue disorders.

Gulf War Syndrome

A study of 10,020 Gulf War veterans found that the range of complaints they had was no different to the general population. I imagine that this conclusive study will not settle the matter as long as there is the prospect for compensation. There was very little actual fighting in the Gulf War and more Americans were killed in accidents than in actual combat.

Like most sensible people in the military, I am opposed to ritual combat as a means of solving disputes. In future wars, I can see soldiers going into battle followed by support companies of psychologists and counsellors, available to give emotional first-aid following the shock of finding that the enemy are firing live rounds.

The American study confirmed a British study of 45,000 soldiers which concluded “no evidence has emerged that any organic disorder has occurred more commonly in Gulf veterans than in any similar population over a similar four year period.” Hopefully this will be the last we hear of “Gulf War syndrome.” (GP Weekly 16/8/95, BMJ Vol 310, p1073)

Size Does Matter!

Before being released from prison, convicted sex offenders in the UK are being subjected to penile plethysmography (PPG). PPG detects minute changes to the penile blood supply while the prisoners are shown sexually explicit material. Sexual arousal is defined as a “deviant response”. The psychologist in charge of this program claims that the scientific literature says that the test is “valuable”. Another psychiatrist condemned it as a “gross abuse of human rights”. As a rational skeptic (after Skrabanek) I suspect that PPG is an unproven and extremely unlikely test which is likely to have a very high false positive response. Sexual arousal in males can occur at all sorts of embarrassing moments and it is likely that most males would show a degree of arousal when exposed to sexually explicit material. (Christchurch Press 1/6/95)

Berry Silly

The Auckland Sunday paper (27/8/95) carried a small article which claimed that World War Two airmen improved their night vision by eating blueberry jam. This contains “anthocyanosides” which are alleged to improve night vision and treat visual fatigue. It is no surprise that a drug company is now marketing pills containing this substance. This is another good situation for Skrabanek’s rules. Is this claim at all plausible and is there any more likely explanation for claimed improvements in night vision? Clearly, the placebo effect is at work here and no further testing is warranted.

Quackery and Chemists

If you go into the average chemist’s shop you will often see displays of homeopathic remedies along with vitamins and other dubious preparations. Most chemists derive the majority of their income from OTC sales and if they didn’t sell these things, someone else would. I draw the line, though, when chemists start promoting quack ideas and remedies.

A member handed me a newspaper clipping which quoted a chemist as saying “zinc detoxifies chemicals like alcohol, improves behavioural problems such as depression, anorexia, bulimia, fatigue and loss of libido.”

Prior to rushing off to get some zinc, readers will be pleased to know that there is a simple test for zinc deficiency. A sip of zinc septahydrate solution is held in the mouth and “from the taste the zinc level is determined.” I tried it and got a taste reminiscent of bullshit.

I forwarded this clipping to the Pharmaceutical Society of NZ and got the following reply: “whilst not every pharmacist would share these views, it is not considered that they bring the profession into disrepute. There have been many studies carried out on zinc which would appear to support the general thrust of these claims.”

Sick Building Syndrome (SBS)

Investigators have finally done the obvious and looked at buildings for which there are no complaints of SBS. Measured levels of contaminants were low and the authors found that complaints about the working environment were related to “perceptions about air movement, dryness, odours and noise.”

As I have said before, SBS, like CFS and OOS, is based on a notional but false belief that psychogenic symptoms have some exterior cause. The availability of compensation completes the picture although, in the case of SBS, compensation is not available for any occupational disease associated with air-conditioning and this is probably why there has not been a flood of claims.

Occupational health workers continue to perpetuate false ideas in their own literature because they lack a perspective on history and human behaviour. The Lancet (Vol 345, p1361) reviews such a publication which claims that SBS is due to environmental factors. It is time that this false concept of SBS was laid to rest. (Occupational Health May 1995, p174)

Other Readers Write

Thanks to Dr Graham Sharpe who wrote from Wellington and enclosed some material about interesting developments in midwifery. Homeopathy is popular with midwives who use it during childbirth. Dr Sharpe also mentions a case known to him where a child died from a brain abscess due to a delay while homeopathic remedies were administered. The other case concerned a case of poisoning when a naturopathic remedy contained aconite. Aconite is severely toxic to the heart and this example shows why naturopathic remedies should be subject to the same restrictions and controls as other drugs.

Denis Dutton forwarded two articles as well. One from Annals of Internal Medicine (Vol 121, No.10) outlined the well-known complication of liver damage which can be caused by a wide variety of Chinese herbal treatments, in this case “Jin Bu Huan” tablets. The other article, entitled “Bitter Herbs: Mainstream, Magic, and Menace”, is an editorial from the same issue as the journal above.

The FDA managed to ban the use of Jin Bu Huan, but their job will be made more difficult by the Hatch bill. This is “The Dietary Supplement Health and Education Act of 1994” which was shepherded through the US Congress by the quack-apologist Senator Hatch. Its language is so imprecise as to be a triumph for the promoters of quackery everywhere. The editorial ends with a plea for doctors to spend more time with patients exploring the “human interactions that are central to the physician-patient relationship.”

Hoxsey Cancer Quackery

Soon after I returned home from our annual conference, Bernard Howard sent me a travel guide for patients planning to go to Mexico and gift their money to a pack of criminal fraudsters who know that the Hoxsey treatment is useless. As well as the airfares to the US, the Hoxsey clinic charges are US$1250-1600. Presumably this is to cover the costs of the “tonics” or as I call them, Kentucky fried medicine. As I explained at the conference, we know what these quack formulae contain and they could be made up in New Zealand for a few dollars.

MVA Insurance Fraud

Los Angeles is the capital for staged motor vehicle accidents (MVAs) where professional criminals, unscrupulous lawyers and doctors participate in phony insurance claims. Until I read about this I was aware of a problem with “whiplash” (also known as chronic remunerative neck injury), which has been a rich source of money for litigants. Phony claims fall into several groups: personal injury, claims for accidents that never happened or actual crashes involving unsuspecting drivers and staged accidents involving previously damaged vehicles. (Christchurch Press 24/7/95)

Faking It?

Vicki Hyde passed on to me a peculiar letter from a Dr Hussein of Jordan asking us to participate in research in the paranormal immunity of fakirs to pain. The letter is the usual mixture of pseudoscience. In fact, no individuals possess any “paranormal” immunity to pain, unless of course they are lucky enough to lack the spinothalamic tracts which carry pain messages to the brain.

Humans possess widely varying responses to pain stimuli which are subject to attenuation by cultural factors, conditioning and belief. Slowly rising pain stimuli can be centrally blocked. I have seen (and discouraged!) my daughter pushing needles through her finger. I reviewed the question of pain control in my paper on acupuncture which is available from our organisation.

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