Prayer – Not so effective after all

A widely publicised trial which appeared to show prayer was effective in enhancing fertility now appears to have been fraudulent.

In 2001 an extraordinary paper, from the highly regarded Columbia University Medical Center, New York, appeared in the also highly regarded Journal of Reproductive Medicine. About 100 women in South Korea who were undergoing in vitro fertilisation treatment were divided into two groups; half had their photographs prayed over anonymously by persons in the US, the other half were not so prayed over. Astoundingly, the conception rate in the “prayed for” group was twice that in the “not prayed for” group. The work was hard to fault from internal evidence, as it had apparently been done using all the procedures of a modern clinical trial, and it became widely quoted as firm evidence for the efficacy of prayer. Publicity was aided by a press release from the university.

This intrigued Dr Bruce Flamm, clinical professor of obstetrics and gynecology at California University. The scandalous nature of his findings is described in a recent Skeptical Inquirer. He wrote to the three authors and the journal editor, asking, as one would of a colleague in the same field, for access to the raw data of the experiments. Over a period of some years repeated similar inquiries have elicited no answer, not even an acknowledgment, from either journal or authors. Such behaviour is not only unusual and discourteous, it is also unethical, and inviting of suspicion.

Complications

In his article, Dr Flamm first comments on the unnecessary complication of the praying arrangements. Not only were the Korean women prayed for, but the Americans who were praying for them had their prayers “fortified” by themselves being prayed for by another group. And yet a third tier of prayers was added, praying that the prayers of the middle tier would be answered. The paper offered no reasons for this complexity, which would seem to introduce unnecessary confusion into the trial. Some prayers asked that “God’s will be done”, so, in the absence of knowledge of what God’s will is, any result is a “success”. How much prayer was offered, and whether the prayer and the prayed-for acknowledge the same God, were not enquired into.

The Korean women were quite unaware of all this praying, and the university had later to admit it was wrong not to have obtained informed consent. The university had initially described one man (Lobo) as lead author, but when Dr Flamm did get a reply from the vice-chancellor, this person was said to have not known of the work until well after it was done, and had had a merely editorial role in the paper. Another author had recently left the university, while the third has a long criminal history, and is now in jail for fraud. This man, Daniel Wirth, has also a history of publishing reports of “healing” in several papers in obscure paranormal journals.

Why a respectable journal was conned into publishing such a bizarre paper remains a mystery, because the editor refuses to communicate with Dr Flamm, or media inquirers. Despite the criticisms of Dr Flamm and others, the journal kept this paper on its website until a few months ago. Were the claims made in this paper true, they would represent possibly the greatest discovery of all time. That the journal was so incredibly sloppy in its editing, and so obdurate in retracting the paper, is highly damaging to its reputation, and suggests the editor is blinded by his religion.

Another miracle paper

Reading Dr Flamms critique, I am reminded of the now notorious homeopathy claim of Benveniste et al published in Nature. Some useful comparisons can be made. In 1988, as in 2001, reports containing claims of events that should not have occurred according to current scientific understanding, arrived in the respective editorial offices. We are told that the question of publishing Benveniste’s was fiercely argued at Nature, and printed, most unusually, with an explanatory note. As far as is known, the other paper, from workers at the Columbia University Medical Center, had a smooth ride editorially, and was printed without comment.

Nature received a flood of letters to the editor, and several critical of the paper and of the editor for publishing it were printed. Whether anything similar happened at JRM was never admitted. Dr Flamm’s repeated requests for information and discussion were never acknowledged.

Benveniste’s extraordinary claims led the Nature editor to an extraordinary action; he sent a team of investigators to Benveniste’s laboratory in Paris to observe what was done “at the bench”. The flaws in technique thus revealed destroyed Benveniste’s claims. The team’s findings, when published in Nature, caused the authorities to close Benveniste’s laboratory, and almost ended his scientific career. The Columbia University Medical Center appears unmoved and unchanged in the face of Dr Flamm’s criticisms, and two of the three authors of the “Prayer” paper are pursuing their careers apparently unhindered.

L’Affaire Benveniste is now well in the past. Science is still, as before, opposed to homeopathy, and Nature retains its position at the top of the heap of scientific journals. On the contrary, thanks to Columbia University Medical Center and the Journal of Reproductive Medicine, the issue of the efficacy of prayer remains to clog the stream of medical thinking and inhibits progress. And what researcher who values his reputation and the standards of his work will now wish to offer papers to the JRM?

Published with acknowledgment to, and approval of, Skeptical Inquirer, Buffalo, NY,USA.

Loose Talk from an Old Smoothie

Bob Brockie samples a health food that saw the dinosaurs come and go

We’ve all seen the claims – Spirulina! Nature’s Health Solution! The World’s Healthiest Superfood! Soulfood!
“Spirulina – the ancient blue-green micro-algae found growing in the lakes of Africa and Central and South America, derives its energy directly from the sun, contains 100 nutrients, is a rich source of iron, is extremely alkalising, energy-packed, supports the maintenance of the beneficial gut flora, is rich in antioxidants, contains 65% protein, etc.” Many firms claim that Spirulina “will reduce diabetes, cancer, hives, cataracts, wrinkles, anaemia, eczema, HIV, hypertension, detoxify the kidneys, help balance your RNA and DNA nucleic acids, and protect you against radiation.”

Small wonder that huge volumes of this cure-all are drunk or eaten daily. One US firm sells over $50 million worth of Spirulina every year. But most chemists and medicos think these claims are laughable.

“Found growing in the lakes of Africa and Central and South America?” Yes, this is true but Spirulina also grows in almost any stagnant fresh or brackish pool near you in New Zealand. Nevertheless, a lot of the Spirulina sold in New Zealand is produced in industrial vats in the US.

As for the nutritional claims – the same could be said about almost any green vegetable on Earth. Spinach or broccoli also contain 100 nutrients, are a rich source of iron and vitamins, are extremely alkalising in the stomach, support the maintenance of the beneficial gut flora, and are rich in antioxidants. If you want protein it’s cheaper to eat an egg, which is 87% protein. And what’s this? “Spirulina contains antioxidant ammunition in the form of the enzyme Superoxide dismutase!” Nobody can deny this but it’s a silly claim. Superoxide dismutase is the most abundant enzyme in the world. Every green plant is full of the stuff.

To be really pedantic, Spirulina is not an alga at all, it’s a bacterium. Ancient? Yes. Because Spirulina has a long fossil history it is often promoted as a “Dinosaur Drink”. “It must be good for you because it’s so old” but the promotion people got the date wrong. Spirulina was around 600 million years before dinosaurs trod the Earth. We should call it “The Proterozoic Drink”.

Raw Spirulina tastes vile, which is why Spirulina smoothies must be masked with pureed banana, kiwifruit and apricot. These additives provide more energy and vitamins than the Spirulina itself.

Who’s for a broccoli smoothie?
Originally published in the Dominion Post, 11 November 2002

Acupuncturist Charms the Worms

A London-based New Zealander has been named “World Champion Worm Charmer” after a competition in Devon. Garry Trainer, from Auckland, won the award by convincing 51 worms to come to the surface of a metre-square section of a field in 15 minutes.

The Harley Street osteopath and acupuncturist entered the competition at Awton at the last minute.

He said: “People were trying all sorts of things, like using watering cans to replicate the sound of rain or connecting their mobile phones to a computer to send vibrations into the ground.” He said he used his acupuncture needles and a secret elixir.
Christchurch Press

Hokum Locum

Selenium – Too Much of a Good Thing?

New Zealand soils are deficient in selenium and this can cause serious health problems for animals. A 500kg animal needs about 1mg selenium daily. There is no evidence that New Zealand adults need selenium supplements and this situation has been described as “a deficiency in search of a syndrome”.

A 52-year-old dairy farmer presented to her doctor with chronic aches and pains, lethargy, sore throat and painful swallowing. After some weeks of fruitless investigations she admitted to taking 0.5ml daily of a solution containing 5mg/ml of selenium, several times the recommended daily human dose. All of her symptoms disappeared once she stopped taking the supplement.

Despite the lack of proof for any deficiency syndrome in adults, local pharmacy leaflets stated “selenium is an essential trace element” and that “low levels of selenium are linked to a higher risk for cancer, cardiovascular disease, inflammatory diseases and other conditions associated with free radical damage, including premature ageing and cataract formation.”

It is quite clear that it would have been much safer for this woman to have taken a homeopathic selenium remedy and there would have been no risk at all of any toxicity from over dosage.
NZ Family Physician Vol 30 Number 6, Dec 2003

Animal Homeopathy

I know that homeopathy has been done to death but it crops up everywhere, even in the treatment of animals. People defend this delusion by claiming that the placebo effect does not work in animals, therefore any observed effect must be real. Any observed effect is clearly due to expectation on the part of the person administering the water, sorry, I mean the homeopathic remedy. An article in the Christchurch Press (March 12, 2004) described how Taranaki’s first qualified animal homeopath has gained an “advanced diploma of homeopathy”. She also has a BSc and it beggars belief that someone with that background can take up a pseudoscience such as homeopathy. This is what HL Mencken was referring to when he said: “How is it possible for a human brain to be divided into two insulated halves, one functioning normally, naturally, and even brilliantly, and the other capable of ghastly balderdash?”

I find it amusing reading such accounts because the clue to the belief system is usually contained in the article but is unrecognised. In this case the animals are described as “glowing with health in a way that suggests good feeding and love but their appearance is so striking it indicates there is another ingredient as well”. You guessed it — the other ingredient is homeopathy! It’s obvious that the animals’ condition is due to the “good feeding and love” and to claim otherwise is a delusion.

It would not in the least surprise me if the diploma of advanced homeopathy is NZQA approved.

Snake Oil Flunks for Snake Bite

Boonreung Bauchan was known in Thailand as the “Snake Man” and held a Guinness world record for spending seven days in a snake enclosure. The Mamba family of snakes are extremely venomous and when one of them bit him on the elbow he relied on a traditional herbal remedy and a shot of whisky. As we all know, herbal remedies are mostly placebos and should not be used for serious or life-threatening conditions and Boonreung is sadly no longer with us. Had he taken a proper antidote, his chances of survival would have been excellent.
Christchurch Press March 23, 2004

Counsellors

If you get up in the morning and find your letterbox has been vandalised, don’t worry, counselling is available to help with your distress and grief. (Dominion Post March 6, 2004).

Following September 11, an estimated 9000 grief counsellors turned up in New York and one hotel was booked out by a single group of 350 counsellors. This absurd behaviour is of course defended by the counselling “industry” despite the existence of research that shows that many of such interventions are actually harmful. Counsellors defend their behaviour by claiming that it cannot be scientifically tested. For example: “People working from the scientific model want to measure outcomes. A lot of people would say, ‘I feel better’, but that doesn’t fit a scientific model.”

Such claims should be treated with complete contempt. This sort of reasoning could be used to justify the implementation of all sorts of quackery because it makes people “feel better”.

To put it bluntly, counselling is a placebo therapy. Third-party funding ensures that an industry has been able to develop. This has disempowered people from learning to deal with personal trauma by simply talking to a friend or other family members.

Hair Analysis

Last year I spent some time working in Westport and noticed an advertisement for hair analysis. Hair analysis does have a scientific basis but it has been taken over by quacks who offer all sorts of ridiculous assessments. When I got home I wrote to the address and sent hair from my wife Claire and my oldest daughter Eve, under their own names, and some hair from “Russell”. “Russell” was actually my daughter’s dog, a wheaten terrier.

For $40 I received a detailed four-page handwritten report and after reading it I felt quite mean because the writer’s sincerity was obvious. I have sent a copy of the letter to the Editor but will summarise the main findings. I see no value in exposing the writer because the letter was written in good faith but note that sincerity and good faith can go hand in hand with gullibility and foolishness. His findings were as follows:

Claire needs natural estrogen — “raspberry leaf” two tabs daily. Wormwood — 5 drops in water daily. Bach flower remedies — “Mimulus, Rock Rose”. Conscious deep breathing — practise six times daily. There was also a recommendation to have “faith” and consider the Bahai religion for that reason.

Eve had a systemic yeast infection. Recommended treatment: nystatin, aloe vera juice, Blackmores chewable tablets, wheatgerm capsules, super strength kelp, rescue remedy (Homeopathic), extra progesterone in the form of “wild yam cream”.

Russell also had a systemic yeast infection, and iodine deficiency. Recommended treatment: nystatin (oral antifungal agent), self heal tincture — 50 drops twice daily, herbal B vitamins — six tabs daily, super strength kelp — three tabs daily. Repeat hair analysis in three months.

It is easy to see that such a “scatter gun” approach to treatment would be bound to work in a well-motivated believer. I did not inquire as to the method of hair analysis but this is unimportant because any diagnostic method will work provided it is plausible and the treatment offered is congruent with the particular belief system. The homeopathic vet would no doubt approve of Russell’s diagnosis and treatment.

Shockwaves for chronic heel pain

High energy sound waves are now being used to treat various conditions such as tennis elbow and other painful areas such as the heel, knee and shoulder. It is claimed that 60-70 per cent of patients will gain relief from the treatment.

The same technology (extra-corporeal shockwave therapy or ESWT) is used to disintegrate kidney stones.

In the case of kidney stones there is no need for a randomised controlled trial (RCT) because it is obvious when a large stone has been broken down into smaller pieces.

When treating various painful conditions with no such “marker”, one has to be much more cautious and this therapy is crying out for a randomised controlled trial with a placebo group who would receive treatment administered when neither the patient nor the technician were aware that the machine was actually switched off. I predict that when such trials are carried out, there will be no advantage over placebo.
NZ GP November 12, 2003

You support quackery!

Government hypocrisy is rife amid the talk of a “knowledge-based economy”

Homeopathy does not work. There is no debate about this fact among rational, informed people.

Homeopathy is a sham system of medicine. It is based on two false ideas that were dreamed up by a German, Samuel Hahnemann, around 1800, before the era of scientific medicine. The first of these principles is the notion that a patient can be helped by giving a substance that would cause the symptoms in a healthy person. Thus, a homeopath gives pepper to a patient who has a fever because taking pepper makes a healthy person feel hot. Of course, there is no reason why such a treatment would work. The second idea is that the so-called medicine is made more powerful by diluting it many times — to the point where only water is left. Homeopaths claim the water somehow remembers the original speck of substance that was in it. Of course, this idea is fanciful. In other words, homeopaths give patients ordinary water, perhaps in a sugar cube. Thus, homeopathy can not work.

The danger is that homeopathy plays with people’s health, which is a serious subject. As we see too often, quackery can be a matter of life and death. Instead of seeking proper medical advice, people can waste time — which is precious in the case of a worsening illness — and money, on pseudomedicine. The winter 1995 edition of Mothering magazine listed supposed homeopathic remedies for such serious childhood diseases as measles and whooping cough. These “remedies” are as effective as waving a forked stick. In their ignorance, some homeopaths speak against antibiotics and vaccinations. Meanwhile, so-called homeopathic vaccines, which were for sale in an Auckland pharmacy, give nothing but a false sense of security. (Dr Leo Revell’s recent statement in his Waikato Times column that “vaccination is a form of homeopathy” was inaccurate and unhelpful.) Lots of dangerous nonsense is on show at the Auckland College of Classical Homeopathy’s page at http://www.nzhomeopath.com/auck/seventh_organon.htm. Inadequate law means homeopaths practice without a medical licence. Even Ricky Gorringe, the disgraced and banned Hamilton doctor who uses homeopathy and other quackery, can continue to see patients as an alternative therapist. Because it is no good and leads to dangers, homeopathy deserves oblivion.

The homeopathic industry is well established in New Zealand. It includes the New Zealand Council of Homeopaths, insurers, manufacturing pharmacies and health professionals. Caring more for profit than for patients, Southern Cross Healthcare has started selling The Wellbeing Plan, which can cover homeopathy and other nonsense, such as acupuncture and naturopathy. It is also shocking that some chemists have chosen to leave behind their ethics by selling homeopathic “medicines”. A chemist who does not know homeopathy is useless is incompetent and should be out of the field.

Worse, the Government is using our hard-earned dollars to support this twaddle. Career Services, which is a Crown Entity and reports to the Minister of Education, says it is “New Zealand’s leading provider of career information, advice and guidance.” Its government-funded website, http://www.careers.co.nz, links to the Bay of Plenty College of Homeopathy and publicises the joke qualifications available there. Indeed, homeopathy is widely taught in New Zealand, with government support. The Wellpark College of Natural Therapies, located in Grey Lynn, is a New Zealand Qualifications Authority-accredited training institution that teaches homeopathy and other quackery, such as iridology and Ayurvedic medicine. The Waikato Institute of Technology and some other tertiary education facilities teach homeopathy. Three NZQA accredited colleges teach homeopathy: the Auckland College of Classical Homeopathy, the Wellington College of Homeopathy, and the Bay of Plenty College of Homeopathy, which has branches in Tauranga, Auckland and Christchurch. The Tauranga branch, which teaches at the local polytechnic, is the country’s largest homeopathic training provider. Because it has NZQA accreditation, the college has approval for student loans and allowances by the Ministry of Education. A ridiculous course of Homeopathy for Animals is sold at the Auckland University of Technology and by videotape. It, too, is approved by the NZQA and for loans and allowances by the Ministry of Education. Fees and costs for those paying through WINZ/Student Loans for training as homeopaths can be $10,000. Thus, misguided students are wasting our money to learn quackery, with government approval.

Unless rational and informed people speak up, the situation will get even worse. The Ministerial Advisory Committee on Complementary and Alternative Health, which is dominated by supporters of quackery, is pushing for the integration of homeopathy and other nonsense into our health system. Already, our taxes pay for acupuncture and sacro-cranial massage through ACC. Is homeopathy next? So much for a knowledge-based economy!

Hokum Locum

Confidence Based Medicine

This is restricted to surgeons.

British homeopath suspended

The British General Medical Council (GMC) has found family practitioner Michelle Langdon guilty of serious professional misconduct and banned her from practising for three months. According to press reports, Langdon had advised a couple that the gastrointestinal symptoms of their 11-month-old were caused by “geopathic stress patterns” beneath their home and then “dowsed” for a remedy by swinging a crystal attached to a chain over a book of herbal remedies. A hospital emergency department subsequently found that the child had gastroenteritis. The GMC also examined evidence that another patient had been prescribed an herbal remedy for a sore throat after the doctor dowsed for the treatment.
http://www.homeowatch.org/reg/langdon.html

Bi-Digital O-Ring Test

This is what got Dr Gorringe into trouble with the Medical Practitioners Disciplinary Tribunal (MPDT). This test is part of the pseudoscience known as kinesiology. Dr Gorringe got the patient to pinch the thumb and forefinger together and then attempted to separate them. By introducing several homeopathic substances into an electrical “circuit” he claimed to be able to demonstrate a weakness of pinch-strength caused by “paraquat poisoning” and other equally ridiculous diagnoses. Dr Gorringe refused an offer to test his diagnostic method. Several patients suffered illhealth as a result of Dr Gorringe’s diagnostic methods and treatments and he has been struck off the Medical Practitioners Register and ordered to pay more than $100,000 in costs.

The full judgment is at www.mpdt.org.nz under Recent Events. It runs to 142 pages but makes fascinating reading. I often wonder how anybody can go through several years at medical school and then fall victim to these foolish and unscientific sidelines. Gulp! I just remembered that I did — acupuncture and spinal manipulation — but I was protected from getting too excited and committed to these modalities by a natural curiosity about how they worked. After all, curiosity or thoughtfulness is what scepticism is all about. Once I looked at the evidence and learned the significance of the placebo effect, I ceased these practices.

Gulf War Syndrome — the Continuing Quest for Compensation

Despite all of the evidence showing that there is no such thing as Gulf War Syndrome (GWS), the alleged victims are now suing the various corporations that supplied Iraq’s chemical weapons programme. This is to be expected and follows the same pattern that has been followed over nuclear test veterans and those exposed to Agent Orange. GWS is in reality a “post-war” syndrome, formerly called war neurosis or shell shock. The symptoms are presented in a context appropriate to the conflict. In the case of GWS the alleged list of causes includes chemical poisoning, immunisations, pollution, depleted uranium. Every conceivable cause has been investigated and scientists, whose naivety is exceeded only by their ignorance of history, continue to clamour for research funds to investigate ever more ludicrous theories.

For an excellent account read Hystories, by Elaine Showalter, Columbia University Press, 1997.

I can also forward by email an electronic copy of a paper I presented to a Military Medicine Conference.
Gulf War Syndrome — A Historical Context, 8th Asia Pacific Military Medicine Conference, 3-8 May 1998, Auckland.

Chemical Phobia?

Firemen had to wear breathing apparatus to clean up a hydrogen peroxide spill. This “toxic chemical” was described as “fizzing and bubbling” as it “reacted with the asphalt”. Of course it was fizzing and bubbling! The hydrogen peroxide was breaking down and releasing “toxic” oxygen and water. These emotively worded reports foster ignorance and hysteria about common chemicals. I recall a similar piece of ignorant journalism where a toxic spill was revealed to be the chemical equivalent of rust!
Dominion Post 6/8/03

Bee Products (Pollen-ate?)

These are currently popular with that segment of the NZ population who would eat sheep dropping sandwiches if they were properly advertised as benefiting health. That reminds me of the cruel jibe by Dame Edna Everidge (aka Barry Humphries) that NZ was a country of 60 million sheep, 3 million of which think they are people.

An advertisement in the Sunday Star Times, (20 July) contains the claim that “BIO BEE” is “the only Potentiated Pollen available that uses Dr Kelly Duncan’s (former Dean of Science, Canterbury) patented potentiation process”. Refer http://www.biobee.co.nz

I duly visited the website and some of the claims made for this product appear suspiciously close to health claims. I would welcome readers’ opinions.

I subjected Dr Duncan to a “google” which produced a number of interesting hits including him being a party to a complaint to the Advertising Standards Complaints Board. www.asa.co.nz/decisions/FULL/Fd0106.rtf

[Chair-entity’s note: A concerned member has been forced to tout bee products as part of his media-related job. We now have a new information flyer examining the case for various bee products available as a PDF here]

Herbal Medicine

“Kentucky Fried Medicine” is such an easy target but can always be counted on to provide material for your correspondent. As we all know, most, if not all such preparations are completely useless. The latest ploy is to illegally include effective prescription medicines, particularly in the area of erectile dysfunction. (New Ethical Journal, July 2003) It is perfectly obvious to a consumer when a product has not worked for erectile dysfunction so it makes perfect sense to cheat by adding a drug that does work. Such fraud invites a stiff fine.

Hua Fo VIGORMAX was withdrawn in Canada when it was found to contain tadalafil, marketed as the legitimate drug “Cialis” in New Zealand.

Likewise in the US, a product called Viga was withdrawn because it contained sildenafil, marketed in New Zealand as “Viagra”.

One possible benefit of these frauds is at least the Chinese might stop trafficking in endangered animal species in the preparation of these products.

An American study of 443 Web sites (reported in Manawatu Evening Standard, 24 September) found that most Web sites marketed herbal remedies with misleading or unproven health claims that violate US Law. I suspect that there would be similar findings in any survey of such sites in New Zealand.

Claytons Vaccines, Claytons Protection

This article was originally presented on National Radio’s Sunday Supplement

Be wary of “the health professional you see most often”. In some cases be afraid, be very afraid.

Why? Well in some cases, the advice you get from your friendly pharmacist could be deadly.

I try to ignore the herbs of dubious quality, the effusive claims for magnetic bracelets, the offers to feel my feet to see what ails me – all those things which seem a core part of pharmacy stock and trade. I do wonder about the business and medical ethics. After all, what’s worse – a pharmacist who apparently can’t distinguish between tested, regulated medicines and the hope and hokum variety; or the pharmacist who does know and doesn’t care because such stuff sells?

But the whole sorry state of that industry took a chilling turn recently with the report of an Auckland pharmacy selling a homeopathic meningococcal vaccine.

Many homeopaths would argue that the 300-year-old practice of diluting substances into infinitesimal amounts is akin to taking a vaccine. “Like cures like” as they say. What they don’t say is that the massive dilutions they use would require you to drink almost 8,000 gallons of homeopathic solution to get just one molecule of any medicinal substance involved.

You can pay a hefty price for this diluted water, but you can pay a much bigger price if you use it in place of stuff that actually works.

The Council of the Faculty of Homeopathy, the registered organisation for UK doctors qualified in homeopathy, recommends immunisation with conventional vaccines. As GPs, they know you ignore real vaccination at your peril. It’s a pertinent warning here when we’re considering a large-scale vaccination programme against meningitis.

Small wonder that the head of our Health Ministry’s meningococcal vaccine strategy was concerned about the sale of homeopathic vaccines, warning in a Herald article that it could give people a false sense of security.

However, I think the real false sense of security comes from the hopeful notion that we have some legislative protection from purveyors of such patently misleading products. There’s no protection under the Medicines Act it seems, for the Health Ministry’s compliance team leader Peter Pratt noted in the same Herald item that such preparations are permissible so long as they were “sufficiently diluted”.

Yet it’s the dilution that make this approach to vaccination so dubious in the first place, and not just to the skeptical. Alternative practitioner and homeopath Dr Dominik Marsiello states unequivocally that “there is no such thing as a homeopathic vaccine”. He goes on to acknowledge that “homeopathic remedies are too dilute to stimulate an immune response and confer immunity. There is no basis, historically or scientifically, for such a practice.”

Yet we have bottles of water labelled “meningococcal vaccine” and “hepatitis B vaccine” in our pharmacies, sold by health professionals, as a protection against these terrible diseases. Some apologists have said that “vaccine” in this case actually means “immune booster”. But “vaccine” has a specific meaning – it’s something which confers immunity through the production of antibodies. This is an easily testable claim, but apparently not one our Ministry of Health considers worth bothering about.

I shouldn’t be too surprised. After all, last time concerns were raised about a comparable product, our Commerce Commission – the organisation charged with protecting us from fraudulent claims – passed the buck to the Ministry of Health, saying it was a health issue. The health ministry, in turn, washed its hands of the business saying that “water is not a medicine”, thus it had nothing to do with them.

Contrast this with the activities of the Australian Competition and Consumer Commission, their state Health Care Complaints Commissions, their Fair Trading Ministers, and the Australian Therapeutic Goods Administration. They are taking an increasing interest in those areas where bogus medicines, fraudulent claims and consumer rights intersect. The TGA took a very dim view of having a fake vaccine on the Australian market, banning it and warning consumers. And the New South Wales Fair Trading Minister referred to the earlier incident where people were paying a 400,000 percent mark-up on a small bottle of water as “a New Age spin on an old-fashioned rip-off”.

Strong words, but ones which need to be said, and said loudly. I know of one New Zealand baby dead of meningitis because homeopathic treatment was chosen over real medicine. I don’t want to see any more. I just wish our Health Ministry felt the same.

Hokum Locum

Providence based medicine

If the caring practitioner has no idea of what to do next, the decision may be best left in the hands of the Almighty. Too many clinicians, unfortunately, are unable to resist giving God a hand with the decision-making.
New Zealand Medical Journal Vol 113 No 1122 p479

Acupuncture and ACC

I am pleased to report that I received a reply from Dr David Rankin acknowledging the dearth of evidence for the widespread use of acupuncture. ACC are taking a responsible attitude and are commissioning a wide range of studies looking at current treatments in order to assess which of them are truly effective in speeding recovery and the return to work.

Saint Goncalo of the Immaculate Perineum?

Haemorrhoid sufferers are flocking to a church in Portugal in the belief that exposing their afflicted behinds to the statue of a local saint will cure them. I have named this pious act “anoflection”. However, the local Priest drew the line at allowing a young woman to pray naked in the hope that this would cure her severe acne. Given the revelations of widespread sexual abuse by priests, it would appear most unwise to expose oneself in this manner in a church.

Saint Goncalo, a 13th Century priest, also has a history of helping women find husbands. Every June, during a festival in his honour, unmarried men and women exchange penis-shaped cakes as tokens of their affection.

There is clearly no need for our organisation to attack or ridicule religious belief when the Catholic Church is doing it for us. I believe that we should sincerely welcome these quaint rituals into our culture. I look forward to a new range of phallic pastries at my local bakery.
Dominion Post 14/1/03

Placebos and homeopathy

The business of science is generating testable hypotheses. This is the classical approach espoused by Popper who put it in a negative sense in that he proposed that for something to fall within the realms of science, it had to be capable of being falsified (proved wrong). This approach has been criticised by Skrabanek in particular because he felt that nonsensical propositions should not be tested. In this respect Skrabanek raised the idea of having some kind of demarcation of the absurd which would avoid dignifying pseudoscience by testing it. For example, the Popperian approach requires us to test homeopathy in double-blind placebo controlled trials. Skrabanek’s approach would be to argue that homeopathy breaches so many scientific laws that it is already outside the tenure of science.

With respect to homeopathy, it is clear that placebo controlled trials of homeopathy are trials of one placebo against another. This explains the tendency for published trials to fluctuate around a midpoint with some showing a small positive effect and some no effect. The philosophy of David Hume teaches us to suspect either self-delusion or fraud if any published trial of homeopathy shows a dramatic effect of homeopathic solutions in any biological sense. The best example of this is the famous Benveniste study published in Nature. (Davenas et al., Nature, 1988, 333:816). This study could not be replicated by any other laboratory unless the experimental work was done under the supervision of Elizabeth Davenas.

After a team of skeptics (Randi et al) supervised a repeat of the work under their close scrutiny the original results were shown to be a delusion with implications of fraud and Benveniste was summarily sacked. People who believe in homeopathy are in the grip of an enduring delusion. Benveniste is a classic example of this and he has recently published a paper titled “Transatlantic transfer of digitised antigen signal by telephone link” (J. Allergy Clin. Immunol. 99:S175, 1997).

The claim is made that “ligands so dilute that no original molecule remained still retained biological activity”. The abstract is classically incomprehensible pseudoscience and Benveniste has the Gallic arrogance to quote his original discredited trial in the references!

Ginkgo flunks

Ginkgo is an herbal type product claimed to enhance and improve memory. Given what I have just written about placebo controlled trials it will come as no surprise that ginkgo provides no measurable benefit in memory or other related cognitive function. This will have absolutely no effect on the sales of this product because if people believe that it works then they will continue to buy it. Those people who sell the product will find endless reasons to defend their promotion of this useless remedy. I referred earlier to science involving the generation of a testable hypothesis. The practitioners and promoters of pseudoscience have become very skilled at generating endless secondary hypotheses to the point where further testing is impossible. Here are some examples:

  • The trial was too short/long
  • They should have used “x” and not “y” strength ginkgo
  • They should have used added vitamin C, selenium etc. etc

Ginkgo for memory enhancement: a randomised controlled trial. Solomon et al. JAMA. 21 Aug 2002. Vol. 288. No.7. p835-40

Chelation Fraud

A reader of the New Zealand Family Physician (Vol 29 Number 6, December 2002 p366) recently took issue with a review of a paper (Knudston et al., JAMA 23 Jan 2002, Vol 287 No. 4 pp481-6) which concluded “there is no evidence to support a beneficial effect of chelation therapy in patients with ischaemic heart disease, stable angina, and a positive treadmill test for ischaemia”. This was a placebo-controlled trial and the conclusions are the same as for similar published trials. The reader, however, objected to the use of an active placebo and claimed that this rendered the conclusions invalid. The debate raises several important issues.

  1. Chelation quackery is a worldwide growth industry worth millions of dollars. The hypothesis is that symptoms of coronary artery disease (CAD) will improve following the removal (by chelation) of calcium from atherosclerotic plaques in the coronary arteries. Despite an overly simplistic view of CAD it seems like this is a testable hypothesis but wait a minute. Chelation clinics exist all over New Zealand and as yet there are no, and I repeat no double blind placebo controlled trials proving that chelation is more than a placebo. In fact, the Knudston trial is further evidence that chelation is ineffective. There is a worrying trend here, seen also with acupuncture, where unproven therapies are introduced into practice and opponents of such quackery are then challenged to prove that the given therapy is ineffective. I object to this argument. It is up to the proponents of new therapies to prove that their treatments are superior to placebo. In other words, put up or shut up.
  2. The reader wrote in and objected that the Knudston trial used an active placebo. A placebo is by definition an inert substance. However, some drugs or treatments produce marked effects. For example, if the drug under test caused the patient’s skin to turn green it would be easy for both patient and doctor to determine who was receiving the drug or the placebo. The experiment has become “unblinded” and this is fatal to any conclusions that might be drawn. This problem is well recognized and some trials even invite participants to try and predict whether they received the test drug or the placebo. This is a sensible test of the blinding. Chelation mixtures are based around EDTA, which allegedly leaches calcium out of atherosclerotic plaques. Along with EDTA the preparations contain other drugs such as lignocaine, magnesium, vitamin C. Many of these are vasoactive and cause people to feel flushed or a little euphoric. If a true placebo was used it would not cause these effects and therefore the experiment would have become unblinded. It is therefore sometimes important to use active placebos whose side effects mimic those of the drug under evaluation. For example and I quote: “forty (59%) of 68 of the antidepressant studies published between 1968 and 1972 using an inert placebo control reported the antidepressant as effective, compared to only one (14%) of seven studies using an active placebo (atropine)”. (The Powerful Placebo, Shapiro, page 206). The antidepressants under test all caused a dry mouth and slightly blurred vision as does atropine. The use of an active placebo was clearly very important and shows once again how the expectations and optimism of researchers can lead to a serious overestimate of the efficacy of new drugs.
  3. Chelation mixtures are non-standard and contain a wide range of drugs in addition to the chelating agent EDTA. This allows quacks to get maximum effect from the generation of endless secondary hypotheses. Suppose we test just EDTA versus placebo and produce the expected result of no effect. The quacks will start bleating that we didn’t have Vitamin C, magnesium, rhubarb, senna pods (pick anything you like) so back to the laboratory. No sooner do you test one combination and they will come up with another. This is the generation of the endless secondary hypotheses and this is a sure sign of a pseudoscience. The hallmark of science is the generation of what Staudenmayer (Environmental Illness: Myth and Reality, Lewis 1999) calls a “hard core postulate” and he goes on to say: “When hard-core postulates cannot explain a phenomenon, auxiliary postulates (ie. Secondary hypotheses) are often invoked to protect them from refutation (ie. being proved wrong).

Newsfront

Death was “the Biggest Gift”

A Feng Shui practitioner who died while on a life mastery course in Fiji was ready to leave his body, his widow believes. Stephanie Challis, pictured in the Nelson Mail (11 December 2002) smiling happily with her three children, told how her 41 year old husband Will had undergone a course of body cleansing which involved colonic hydrotherapy and drinking quantities of good quality water.

“He always played full out,” she said. “My guess is that he had seven or eight litres of water, thinking, ‘the more I drink, the cleaner I am’.” Mr Challis mentioned that he had been throwing up, but Mrs Challis, having previously done that when detoxifying, didn’t think too much of it. She said his sodium levels had become unbalanced, leading to loss of consciousness. Because they were on an island facilities were not available to rectify his sodium balance, and he was not given any oxygen.

“It appears his brain suffered massive oxygen starvation in that first 24 hours. The doctors tell me they will never know.”

Mrs Challis said she met her husband through training in Qi Gong, an ancient form of energy cultivation, and the basis of their relationship had always been spiritual. In the months leading up to his death, they had been “full out” on various courses. She believes he was on an unconscious level preparing to leave his body. “There are so many amazing coincidences. It all points to the fact that this was his time.”

Mrs Challis said she had remained positive throughout the ordeal, and did not blame anyone for what happened and, in fact, feels privileged that her husband shared the experience with her. “I was keeping the bigger picture in mind the whole time. When he died I felt incredibly peaceful and even joyful. I realise since that what he’s done has been the biggest gift he’s ever given me. I feel closer to him now than I’ve ever felt and deeply grateful for what he has taught me about life through his dying.”

Out-of-Body Experiences at the Flick of a Switch

Doctors say that out-of-body experiences (OBEs) may be triggered by stimulation in one part of the brain (Dominion, 23 September 2002). Writing in Nature, the Swiss researchers say they were able to trigger OBEs in a female patient. They say their work may explain the phenomenon of people reporting having “left” their body and watched it from above. The doctors were studying epilepsy by using electrodes to stimulate the woman’s brain. They found that stimulating the angular gyrus in the right cortex repeatedly caused OBEs. At first, the stimulations caused the woman to feel she was sinking into the bed, or falling from a height. When the strength of the current was increased, she reported feeling she had left her body. The doctors believe the angular gyrus matches up visual information and the representation of the body formed by the brain’s touch and balance faculties. When the two become dissociated, an OBE may result.

Mormon Researcher gets the Wrong Answer

Anthropologist Thomas Murphy faces expulsion from the Mormon Church after showing by DNA analysis that native Americans are not descended from ancient Israelites, as the church claims (Dominion Post, 9 December).

The Book of Mormon, made public by Joseph Smith in 1830, is a cornerstone of church doctrine and taken literally by the faithful. It teaches, among other things, that America was populated by Israelites who went to North America 600 years before Christ – a time within the reach of archaeology and genetics. Mr Murphy, of the anthropology department at Edmonds Community College in Lynnwood, Washington, set out to test this, and his negative findings saw him charged with apostasy. It appears this is the first time a member of the Mormon Church has faced expulsion for genetic research.

Church leaders declined to comment on specifics of the case, but critics said they feared his excommunication would have a chilling effect on Mormon scholars who wanted to stay in the church.

Clone Petition Dismissed

The Raelians, of course, know full well that native Americans are not descended from Israelites. According to the cult they, and everyone else, owe their origin to extraterrestrials, who cloned themselves to produce the human race some 25 000 years ago. They’ve gained themselves a lot of publicity in the last few months with their claims to have produced human clones of their own (eg Dominion Post, 30 December). More recently (Reuters, 29 January) a Florida judge has dismissed a petition to appoint a state guardian for “Eve”, the first of three allegedly cloned babies, reportedly born on December 26. Clonaid, the company which claims to have produced the clones, says the baby is in Israel.

Expressing skepticism that a cloned child even existed, but expressing concern for its welfare if it did, Juvenile Court Judge John Frusciante said his court had no jurisdiction in the case. Clonaid president Brigitte Boisselier testified that the baby had never been anywhere near the United States.

Clonaid has produced no evidence for any of the clones. Scientists widely believe the assertions are a hoax to make money or garner publicity for the Raelians.

Boisselier, a French-born chemist who is a member of the Raelians, would not say where in Israel the child was, adding she did not know as she was no longer in contact with the parents. She also told the court that she had not seen the baby, although she had seen videotapes.

Bernard Siegel, a private citizen and attorney, filed the petition earlier this month asking for the state to appoint a guardian to supervise her care. He said that if “Eve” were indeed a cloned child she could face serious medical problems.

In dismissing the case, Frusciante made plain his concerns about cloning, citing at one point President Bush’s remarks during his State of the Union address on Tuesday in which Bush said no human should be started or ended as the object of an experiment and asked Congress to ban cloning.

Clonaid, which made the initial announcement of “Eve’s” birth at a hotel in Hollywood, Florida, backed away from its earlier promise to provide DNA proof of the cloning after Siegel filed his petition. The company, which does not reveal where it is located or anything about its finances, now says that it has deliberately cut links with “Eve’s” parents to ensure their privacy.

The lawyers representing Clonaid had urged Frusciante to dismiss the petition. “The case was a preposterous case, there was no basis for it,” attorney Jonathan Schwartz said after Wednesday’s hearing.

But Siegel said he was glad he presented the petition even though it failed, not least because it had prompted Boisselier’s testimony under oath that a cloned child existed and was in Israel. He added he hoped the Florida Department of Children and Families, which had representatives in court on Wednesday, would alert the relevant authorities in Israel to the possibility of a child in need of protection.

And now it’s Homeopathic Vets

The first output from a new diploma course in homeopathy graduated at the end of last year (Rural News, December 2). The four women are mostly veterinarians who have taken the course at the Bay of Plenty College Auckland Campus. New Zealand Homeopathic Council president Joan Goddard says the qualification is unique, and is the first time that basic medical knowledge has been taught beside homeopathic treatment and diagnosis in an animal health course.

Students take a part-time one-year foundation course before electing to complete the two or three-year diploma.

Goddard says most of the students graduating this year are veterinarians looking to extend their treatment capabilities.

“Vets treat the diploma as an additional skill to use on herds and do not rely solely on homeopathics.”

She hopes the course will set up a list of standard homeopathic treatments for various animal conditions, as many current practitioners depend on personal experiences to treat animals. Twelve students should graduate in 2004, with similar numbers going through the course.

Goddard hopes course numbers will gradually grow but says there are only a limited number of people to teach students. Well that’s something, I suppose.

Alternatives to Evidence Based Medicine

Alternatives to Evidence Based Medicine

I will detail these seven alternatives in forth-coming issues of the magazine. For now here is Eminence based medicine: The more senior the colleague, the less importance he or she places on the need for anything as mundane as evidence. Experience, it seems, is worth any amount of evidence. These colleagues have a touching faith in clinical experience, which has been defined as “making the same mistakes with increasing confidence over an impressive number of years.” New Zealand Medical Journal Vol 113 No 1122 p479

Homeopathy Flunks

It’s most unusual to see published trials showing that homeopathy is ineffective. The common term for this is “publication bias” where trials tend to be published only when they show something positive. One of the authors is GT Lewith, a long time apologist for homeopathy and that makes it even more remarkable. Should we give them one of our awards?

A double blind, randomised trial evaluated the efficacy of homeopathic immunotherapy on lung function. The conclusion: homeopathic immunotherapy is not effective in the treatment of patients with asthma. BMJ 2002;324:520-3

An accompanying editorial comments: “we believe that new trials of homeopathic medicines against placebo are no longer a research priority.”

All responsible health professionals must ensure that homeopathy is never funded by the health system. It would be grossly irresponsible to waste public money on “dilutions of grandeur”.

Ministerial Advisory Committee on Complimentary and Alternative Medicine (MACCAH)

Have a look at their Website: www.newhealth.govt.nz/MACCAH/. I have been visiting from time to time in keen anticipation of the result of their deliberations and to see what quackery will be introduced into our failing health system. The committee comprises a sociologist (chairperson), iridologist, doctor of medicine, naturopath, acupuncturist, paediatric nurse (and massage therapist), and teacher. The iridologist is David Holden who organised the International Iridology and Sclerology Conference that I mentioned in an earlier column.

Certain members of the committee have asterisks alongside their names as a reflection of a possible conflict of interest. Readers will recall that our organisation was unsuccessful in getting any skeptics on this committee. Would such a putative member have warranted an especially large asterisk?

There is a similar committee in the USA. It has become a scandal that the National Institute of Health (NIH) has distributed (wasted?) hundreds of millions of dollars on testing what Americans refer to as CAM, or complimentary and alternative medicine. They spent $1 million testing “magnet therapy”. The majority of the studies have been inconclusive and have led to the need for more tests. This has tended to give such quackery a spurious degree of acceptability. As critics point out, how many studies have been published showing that CAM doesn’t work? Read a very good critique of this area at www.washingtonmonthly.com/features/2001/0204.mooney.html

It is quite clear, given the US experience, that the MACCAH will produce nothing of any value and furthermore I predict that they will never publish a single article stating that any CAM modality is useless. I sincerely hope to be proved wrong.

Laying on of Hands

Every doctor of medicine knows the importance of properly examining patients even when they do not expect to find anything wrong. The act of touching people in a therapeutic context carries a very powerful placebo effect. This is a legitimate part of the "art" of medicine and when coupled with good communication leads to a good outcome. This effect is sometimes referred to as the “laying on of hands”, itself derived from the concept of mediated divine healing. For example, the King’s touch was supposed to cure scrofula, a cutaneous form of tuberculosis.

The extreme version of this is the absurd delusion of therapeutic touch where the patient is not actually touched but their energy fields are "corrected". Don’t laugh; this is part of mainstream nursing at Wellington Hospital!

The laying on of hands effect explains the apparent success of many physical treatment modalities such as osteopathy and chiropractic. They all do exceptionally well out of ACC-provided funding and it is no wonder that a recent provider survey found a high level of satisfaction from chiropractors (79%) and physiotherapists (76%). I once asked an ACC Colleague why they funded quackery such as osteopathy and chiropractic and his reply was that ACC didn’t care about anything except getting people back to work. Applying that logic I could set up a military consultancy (Boot Camp Rehabilitation Inc) and get people back to work by threatening them with military-style discipline.

Here is an extract from an advertisement from my local paper: "cranial osteopathy for babies and children to help with poor sleeping patterns, restlessness, crying and poor concentration". This quackery involves allegedly manipulating the bones of the skull to regulate the flow of cerebrospinal fluid. It is complete and utter nonsense that relies for its effect on the touching, a plausible patter and a gullible consumer.

ACC News October 2001 Issue 39

Bye, Bye, Bivalve

Trials of green-lipped mussel extract have been stopped after it was found that “the extract didn’t work.” (Marlborough Express March 11, 2002). Green-lipped mussel extract was marketed in NZ as Lyprinol and more than $1 million of the product was sold after it was claimed that it was a cure for cancer. Successful prosecutions were taken against those responsible for the scam.

The media frenzy showed that journalists had learned nothing from the Milan Brych affair.

I feed our cat (Gilgamesh) on green-lipped mussels, and as well as a lustrous coat he has shown no sign of developing cancer. I rest my case. In order to satisfy the most sceptical of journalists I enclose this picture as proof as he and Claire read the Lyprinol story.

Healthy Options

This is the title of a magazine that contains some of the most nonsensical rubbish I have ever seen. The editor is the woman responsible for promoting the Hoxsey quackery in Tauranga, which led to dozens of desperate cancer suffers taking one-way trips to Mexico to receive treatment. Tauranga travel agents made a killing in every sense of the word. This magazine should be read by all Skeptics in order to get a taste of what could be inflicted on the health system by the MACCAH. One ray of hope however – they mentioned www.quackwatch.com and stated that “this leads the public to believe that natural medicines are a fraud.” Well-enough said!

Possum Peppering

Is this delusion never going to go away? How many trials does it take to show that burnt possum testicles do not deter possums from eating vegetation sprinkled with said preparation? The Green party are already a bit of a joke and this latest nonsense makes me wonder whether they have all been partaking of ganja while worshipping with Nachos Tandoori. However, there is more to this than meets the eye, or testicle. I tried sprinkling some of a late relative’s ashes around our garden and I haven’t seen the mother-in-law for months. I rest my case. It must also be horribly lonely for all of those people living downwind of a crematorium – they never get any visitors at all!