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

Craniosacral Therapy

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

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

Medical Overinvestigation

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

Fraudulent Skin Treatments

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

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

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

Analysis of Chinese herbal creams

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

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

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

Chicken Soup

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

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

Dental Amalgam

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

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

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

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

Buteyko and Asthma

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

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

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