One hand wash for the road?

A surgeon claimed that an alcohol-based hand wash had been responsible for a failed evidential breath alcohol test (EBA). He had been operating all day, went home, had two glasses of wine went out again, and failed an EBA. He argued that “the moderate amount he had drunk was not enough to have put him over the limit.” He claimed that an alcohol-based hand wash had been absorbed by his skin. What was he doing? Drinking it?

I use such products every day at work and have never noticed any degree of intoxication. The human skin is relatively impervious to chemicals. The alcohol contained in such hand washes evaporates very rapidly and requires frequent re-application.

Assuming for a moment that it was possible for alcohol to be absorbed in such a manner, it would mean that all over the country, surgeons who used this hand wash were operating under the influence of alcohol! The flaw in this whole argument is the self-reported consumption of a “couple of wines”.

This episode reminded me of the conundrum presented at one of our conferences. Peter is taller than Bill, and Bill is taller than Peter. All sorts of esoteric explanations were advanced and we all forgot the obvious ones. The statement was either a mistake or a lie.

The same logical approach can be applied to the alcohol hand wash issue. Whilst not normally given to divination, my recent examination of the entrails of a goat predicts that the alcohol hand wash defence is doomed to fail.

Dominion Post
14 March


If you are facing some serious legal problems it’s good to have a medical certificate. This process is well described by Dr Andrew Malleson (Whiplash and Other Useful Illnesses).

A funeral director was facing charges of tax evasion which he excused by claiming he was suffering from Post Traumatic Stress Disorder (PTSD). The article did not make it clear whether a medical certificate was presented.

I still enjoy a judge’s criticism of a doctor for “showering sick notes like confetti”. If you are facing charges of any kind it is extremely helpful if you can present a doctor’s certificate stating that you were depressed or your budgie had died. Such certificates are always supplied after the offence, never before.

Marlborough Express
10 March


I had never heard of this treatment method so went straight to and there it was under the index of questionable treatments.

The article, (Marlborough Midweek, 12 March 2008) explains that “a simple muscle testing technique is used to find imbalances within the body.”

This smells of the discredited pseudoscience of applied kinesiology. As Quackwatch explains:

“For every malfunctioning energy circuit that is found, the practitioner or client contacts the corresponding ‘points’ with their hands. The practitioner then lightly taps the client on the top of the head, which stimulates the brain centers and causes the brain to re-evaluate the state of the body’s health. The result is that the general energy balance of the body is greatly improved.”

The ‘Bodytalk’ system was evidently developed by a Dr John Velthiem. Needless to say, he is not a qualified doctor but a pretentious chiropractor. Have a look at his web page. If you feel the need, there are study modules as follows: “right brain practical, mind crystals, and manual lymph drainage”. The last one sounds a bit painful.

I am formulating a theory that wacky ideas are promoted by people who are bald and have beards. Think Andrew Weil for example.

Perhaps Bertillon’s ideas should be revived as the “anthropometry of quackery”?

Reinventing the Wheel

A doctor studying musculoskeletal medicine has found that saline (read ‘placebo’) injections are remarkably effective in treating conditions such as fibromyalgia. There is nothing new here. Fashionable society doctors used to inject neurotic patients with water in the 1930s. (Read The Citadel, by AJ Cronin.)

Saline given by injection is a potent placebo. Fibromyalgia is a condition affecting mainly women who have tender areas all over the body. It is a psychosomatic condition. The tender areas have been studied and are indistinguishable from any other part of the body. It is hardly surprising that the condition responds to a placebo treatment. The doctor speculates that the saline blocks the sodium channels. This is simplistic. Many medical conditions respond well to placebos. They are usually conditions where belief and psychosocial factors are important. The administration of a placebo by an enthusiastic doctor merely empowers the patient to recover. I have seen this effect on many occasions but have not been taken in by believing I have discovered some new miracle cure! Acupuncture and homoeopathy are examples of placebo treatments that can produce quite marked improvements in well-being. The credulous practitioners of these treatments are taken in by their own placebo.

Dominion Post
4 February


“Every needle has a sharp end that goes into the patient and a blunt end that is attached to a health care provider. Anyone who thinks that all of the action occurs at the sharp end does not understand human behavior.”

Dr John Loeser, 2004: Spine, 29(1): 9-16.

Buccaline Berna

This product is no longer sold in Australia but has been heavily marketed in New Zealand. It is a grandfathered product for which there is no evidence of efficacy. It contains the bacteria Pneumococcus, Streptococcus and Haemophilus. In a pharmacy advertisement it is claimed to “protect against the bacterial complications of colds.” It clearly is of no value in colds which are caused by viruses and I doubt whether anyone needs to take it. How often do people suffer from bacterial infections after a cold? I can’t see any reason why this product should work and neither did Medsafe when they classified it as a pharmacy only medicine.

It had earlier been classified as a restricted medicine which meant that it could not be openly displayed or easily advertised. Needless to say, pharmacists were upset and made representations to change its status. According to the company’s submission sales total 150,000 units annually and there are an estimated 75-120,000 users in New Zealand. At $10 per box that’s $1.5 million, a tidy sum for a useless and unnecessary product. The research quoted in support of the product was laughable. One trial involved 16 women and another studied nine children. Any effect that this product has on antibody levels is likely minor and non-contributory. Whilst not given to predictions I see a great future for this product which is being aggressively marketed and promoted.

Full Page Advertisement, Marlborough Midweek
5 March

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