Homeopathy – Witchcraft for the Times

For a host of reasons which the NZ Skeptic will examine further in a later issue, the so-called “natural health” industry is enjoying a remarkable resurgence. One cannot refute the argument that we should take responsibility for our own health and that we should not expect modern medicine to provide on demand pills to cure all our ills, particularly those which are self-induced or the result of old age. Moderation in all things (including moderation) will generally help any of us to lead a vital and active life.

However, a host of charlatans have now hitched their star to this valid need to take some responsibility for our own health, and are busy peddling nostrums which are useless at best and harmful at worst. These new medical and psycho therapists follow the proven pattern of the Greenshirts by promoting fears and frights and then providing the cure to the fancied ills. Read any natural therapy propaganda and you would think that rather than being the best fed, healthiest and longest lived population that has ever lived, we are all being poisoned and driven to untimely deaths by a combination of conspiracy theories and the fruits of civilisation. It’s a dirty trick but it seems to work.

Just as people who don’t believe in astrology believe in it, so homeopathy in particular seems to have crossed the border from fringe medicine into widespread acceptance. A commitment to homeopathic practice is now presented as evidence that some natural healing clinic is legitimate rather than promoting plain quackery.

The best way to deal with this belief is to set down in print the principles of homeopathy as first espoused by its inventor Dr Hahnemann. Readers can then judge for themselves whether they are can seriously subscribe to such a treatment regime as we near the end of the twentieth century or whether they should laugh it off as voodoo magic in modern dress or drag.

Any medical historian will recognise that Dr Hahnemann got off to a good start. He developed his system towards the end of the eighteenth century at a time when a trip to your doctor was almost certain to make your condition worse and probably kill you. All of Louis XV’s brothers and sisters were killed by their doctors. Louis XV survived only because his nanny hid him whenever the doctors made a palace-call. In such dangerous times any system of treatment which genuinely did no harm was bound to look successful by comparison. If Louis XV’s nurse had been really smart she could have promoted a new medical regime called “underbed-therapy” or similar based on forcing the patient to lie under the bed for an hour at a time. After all, it had saved the life of a future king. The royals of Europe were a tight-knit club. Hahnemann’s success with the royal families of 18th century Europe is evidenced by the house of Windsor’s belief in homeopathy to this day.

If any of us had been alive as commoners in those times, we too would have been well advised to visit Dr Hahnemann rather that suffer exposure to the contemporary regimes of bleeding, emetics, enemas and other horrors. (Curiously, enemas, in the form of colonic irrigation, are making a natural therapy comeback. Learning to water-ski is probably just as effective and more fun.) However, modern medicine has made great strides and most of us expect some systematic diagnosis and intervention from the medical profession rather than a programme of benign neglect.

Here are the cardinal principles of homeopathy according to the man himself:

The Psora (Itch) and Vitalism

The psora is the sole, true and fundamental cause that produces all the other countless forms of disease — the long list which follows includes insanity, rickets, cancer and paralysis. Hahnemann believed that diseases represent a disturbance in the body’s ability to heal itself and that only a small stimulus is needed to begin the healing process. As a man of his time, he believed in the principle of vitalism, which held that life is a spiritual non-material process which can be influenced by dynamic forces such as magnetic influences, the moon and the tides, and so on. [Can they really teach this stuff in a Polytech?]

The Law of Similia

Hahnemann was led to the homeopathic principle after he took a dose of quinine and noticed that the effect of the quinine was similar to that of malaria. He was also drawing on the primitive monism of the time which held that “like is like”, (eating the heart for courage) “like makes like” (idolatry) and “like cures like” (snake-root was used for curing snake-bite). Hahnemann revived Paracelsus’s “Doctrine of Signatures” which declared that herbs would cure conditions associated with the anatomical parts they resembled. [Or this stuff too?] Surely any patient today would run out of the waiting room if a GP suggested such nonsense. But if patients buy into homeopathy they are buying into this whole set of beliefs.

The Law of Infinitesimal Potentising

This law holds that the smaller the dose of a medication, the more powerful its healing effects. Hahnemann taught that substances could be potentised (i.e. “their immaterial and spiritual powers released”) by sequential dilution of remedial agents by “succussion”, in which mixtures would be shaken “at least 40 times”, nine parts dumped and nine parts solvent added and shaken again. Hahnemann held that tapping on a leather pad or the heel of the hand would double the dilution — which is patent nonsense. [How do you present this in the class without bursting out laughing?] The laws of chemistry tell us that there is a limit to which a substance can be diluted without losing the original substance altogether. This limit, called Avogadro’s number, corresponds to “homeopathic potencies of 12C” or 1 part in 1024. At this dilution there is less than a 50% chance that even one molecule of the original active material remains. Hahnemann recognised this apparent anomaly but explained it away in metaphysical terms — i.e. by witchcraft.

So we find that Hahnemann’s texts recommended highly diluted coffee as a cure for “sleeplessness, digestive, urinary, respiratory and heart symptoms” and diluted tincture of tarantula (that’s right, the big hairy spider) to treat “mania, hyper-activity, chorea and septic outbreaks”. One suspects he was shrewd enough not to recommend highly diluted alcohol as the rapid route to drunkenness.

What all this means is that if you visit your pharmacist and buy a liquid homeopathic remedy, you are buying “diluted water”. If it comes in crystal form then the diluted water will have been dropped onto sugar crystals, and you are parting with your hard-earned cash for “evaporated diluted water”. We can see why there is a buck in it and why naturopaths are so keen on homeopathic remedies. Selling diluted water beats the hell out of spending millions of dollars on systematic research to find some effective pharmaceutical and then spending hundreds of millions on clinical trials and registration procedures around the world. Of course, such a “medicine” can do no harm and nine times out of ten the body truly does heal itself just as the naturopaths claim. Again the homeopaths keep well away from broken bones, severe bleeding, brain tumours, or raging infections where the patient demands real and immediate results.

The defenders of homeopathy argue that even though the whole system appears to contradict common sense (i.e. that a diluted scotch will be more intoxicating than a neat shot) there is evidence that the system works and that numerous publications endorse this efficacy. (John Eisen of the AIT Press quotes the famous 96 papers at every opportunity)

The most famous recent study which appeared to demonstrate an operative mechanism was a report by a French scientist working at that country’s prestigious INSRM institute. His paper claimed that high dilutions of substances in water left a “memory” which explained their “efficacy”. Subsequent investigations proved that the research, which was funded by a major manufacturer of homeopathic medicine, was “improperly carried out” and the scientist was subsequently suspended.

A 1991 survey of 107 controlled trials appearing in the 96 published reports (the list quoted by John Eisen) found that “the evidence of clinical trials is positive but not sufficient to draw definite conclusions because most trials are of low methodological quality and because of the unknown role of publication bias.” An earlier study (1984) also concluded “It is obvious from this review that despite much experimental and clinical work there is only little evidence to suggest that homeopathy is effective. This is because of bad design, execution, reporting, analysis and particularly the failure to repeat promising experimental work…”

In the tradition of scientific literature this is “damning with faint praise”. We should take of note of Thomas Paine’s famous question “Is it easier to believe that nature has gone out of her course or that a man would tell a lie?”

The NZ Skeptic is not suggesting that homeopathy be banned. But this short essay should encourage readers to ask themselves whether they should be tempted to buy overpriced dilute water — given that homeopathic theory would suggest that a quick dip in a spa pool should cure every disease known to man — or at least those of those who have dipped before you. And we should also ask if such mumbo jumbo can be taught in a tertiary class-room given that it cannot possibly be the subject of informed and critical debate. It is simply not possible to believe in modern physics and chemistry, or even the principles of mathematics, while believing in homeopathy. If the New Zealand Qualifications Authority decides to endorse the establishment of a School of Witchcraft, then homeopathy will have found a home, for that is where it belongs.

The Challenge to Reason

Tertiary institutes around the country are beginning to offer courses, and even entire degrees, in subjects that are pure pseudoscience.

The Aoraki Polytechnic has applied to the New Zealand Qualifications Authority seeking approval for its proposed Bachelor’s Degree in Naturopathy. If approved it will be the first degree programme of its kind in this country.

With generous assistance from all of us, the Northland Polytechnic is offering a course in Astrology. (Only $25.40 on study-right, but the full $50.70 non-study-right). Evidently the tutor was a scientist until his teacher “who was recognised as an incarnate lama or tunku by the Tibetans” instructed him in Tibetan Tantric Buddhism. After several months’ psychotherapy in Morocco he went to India where he was empowered by the Sakyapa Lama. Evidently this powered him to Kerikeri where he now lives in a bus.

In the meantime, the Auckland Institute of Technology Press has been pouring out a stream of pseudoscientific books dealing with subjects ranging from faces on Mars to conspiracies to repress benevolent inventions and most recently The Poisoning of New Zealand.

This last book promotes the homeopathic line that increased dilution increases potency. (Sadly it doesn’t work with alcohol.) This leads to the remarkable conclusion that while concentrations of pesticides in our food and water may be well below those found toxic in laboratory experiments, extreme dilutions, of say one part per billion, are much more dangerous than concentrations of one part per hundred thousand.

In sum we have tertiary educational institutions subsidised by taxpayers offering courses and publishing books which are based on pseudoscience and superstition.

Does this matter?

It depends on your point of view. The Minister of Education has suggested that if there is a demand for these subjects then maybe the institutions have a duty to offer them –although he sounded as though he did not want to be seen as putting himself in the way of an employment opportunity. And we have to admit that naturopathy signboards (untreated timber only) are springing up like daffodils around our suburbs.

Science and Democracy

I happen to believe, along with Karl Popper and his many disciples, that there is a connection between the proper functioning of democracy and the rational or scientific approach to solving problems and learning about the world.

Since the days of the Enlightenment we have tended to the view that rational thought is the best basis for political action. Democratic government knows that there is no Utopian model of the static perfect society, just as science knows that no theory is ever finally proven to be true. The scientific method progresses towards truth without ever reaching it, while the democratic process “muddles through” to a better world by a process of continual experiment, debate and reform.

It is no coincidence that those who attack democracy look to pseudoscience to support their cases. The Socialists looked to the pseudoscience of Marxism, the laissez-faire anarchists of the nineteenth century looked to social (pseudo) Darwinism, while the Nazis blended social Darwinism and eugenics (pseudo-genetics) to boost their nationalistic dreams of a master race.

These days the centralists find support in the pseudoscience of the apocalyptic environmentalists, whose message is that democracy is unable to meet the challenge of the forces which “threaten the planet”. They make these claims even though the centrally planned states of the Eastern block appear to have committed ecocide. The miracle is that they could pollute so much while producing so little.

University Unreason

Yet contemporary Western society now seems hell-bent on destroying its faith in reason. The deconstructionists and post-structuralists in our universities now argue that there is no knowable truth, that science is no different to any other body of knowledge or superstition, and that students should not be taught a body of knowledge but should be encouraged to construct their personal models of the world. American universities, cringing under a wave of political correctness and an extreme form of “multi-culturalism”, are abandoning programmes which present the history of Western Civilisation as anything other than the history of the rape and plunder of minorities and other victims by a conspiracy of middle-class white males.

Given this widespread attack on science and rationality, it comes as no surprise to find that our tertiary institutions appear to be ready and willing to mount degree courses in naturopathy, including homeopathy and iridology.

The test of a scientific theory is that it can be refuted by an experiment or trial. Homeopathy has been subject to numerous trials and has yet to demonstrate any benefit other than those attributable to the placebo effect. This is not surprising, given that homeopathic medicine is water in which a potent substance has been diluted to levels where there is virtually no chance that an original molecule of the potent substance survives.

These are truly “dilutions of grandeur”. Frequently this “diluted water” is absorbed into a sugar crystal for packaging and will have typically evaporated by the time the patient gets round to taking it. The argument that homeopathic medicine can do no harm is almost certainly sound –what harm can be done by a dose of evaporated diluted water?

Against all this evidence the belief in homeopathy survives.

This raises the question of how a tertiary institution can possibly teach such subjects within a genuine environment of learning and research. Universities and polytechnics are supposed to encourage free and informed debate. If students of homeopathy come to an examination armed with all the published refutations of the practice, would they be able to pass the course? Probably not. Homeopathy is a belief system like astrology or witchcraft. You either believe it or you don’t, and any refutational evidence is dismissed as somewhat irrelevant. The standard argument is that sceptical observers cause bad vibrations which interfere with the efficacy of the treatment.

Can we really tolerate a course within a tertiary institution which argues that healthy scepticism interferes with proper analysis?

Wheat Amongst the Chaff

The proper place to present the field of natural medicine, or its more legitimate cousin, the whole body approach to medicine, is within the school of medicine itself. At least it will be subject to debate, and the wheat can be sorted from the chaff. And there is real wheat in there. Modern medicine has gone too far in the pursuit of the science of medicine as opposed to the art of healing. The placebo effect is powerful and we need to learn how to harness its potential to achieve maximum benefit. But we will make no progress while such investigations are accompanied by nonsense such as iridology or EVA, and where belief cannot be subject to critical experiment and refutation.

Where does the AIT Press fit into this? There are a host of publishers making money out of publishing the latest hocus pocus on the works of Nostradamus or whatever else is providing the latest means of extracting dollars from the gullible. Many readers are trying consciously to make sense of the widely differing views of the world presented by the Uri Gellers on one hand and the Stephen Hawkings on the other. If they wander into a library or bookshop and find a book on repressed inventions, or the international conspiracy to poison us all with pesticides, such readers are likely to assume that books published by the Auckland Institute of Technology (which could be expected to share the aspirations of MIT — otherwise why did the ATI change their name to AIT?) will have been subject to a higher standard of editorial criticism and intellectual rigour than the latest piece of flim flam from the “Centre for Zodiacal Peace Freedom and Inner Radiance”.

Well, I am sorry, they would be wrong. It looks as though the AIT has decided if there is a buck in it, they publish. And no doubt their response to this criticism will be to blame the government for not giving them enough money to start with. Is this an excuse to abandon principles?

Surely this is simply bad business practice on the part of the AIT. The AIT teaches courses in business, which presumably advise students that the most important asset of a modern organisation is its intellectual property. I would have thought that a critical part of the intellectual property of any tertiary institution would be its reputation for intellectual rigour and honesty. This reputation must surely be debased by a publishing house which is fast becoming a bad joke among the critical and informed readers of this country. I certainly would not recommend attendance at AIT to anyone I know if these publications represent the polytechnic’s attitude to the pursuit and dissemination of knowledge.

So the Qualifications Authority should stand firm and give accreditation only to those courses in medicine, science and technology which admit to critical analysis and are prepared to expose themselves to the normal standards of the scientific process — which means that if a belief is disproved then it must be abandoned.

Do Believers Really Believe?

One of the problems with naturopathy and similar belief systems is that even people who don’t believe in them believe in them. This may sound like nonsense. But if you are one of the many readers who are upset by these arguments and have some belief in naturopathy in any of its manifestations, ask yourself this question:

You have just had a terrible car accident. You are lying in the road and feel your life ebbing away and you suspect that other members of your family are in a similar state. A crowd has gathered around, but no-one is equipped to deal with the carnage. Then you hear dimly that wonderful sound, “Step back, make way! Step back, make way!” At last, you think, help is at hand. And then the final chant is “Step back, make way, here I am — and I’m a qualified naturopath”.

What do you believe in now?

We have to recognize the inability of modern medicine to meet the unrealistic expectations it created in the fifties and sixties. These have created a market driven by those who believe that their chronic ailments must be able to be cured by some magic medicine and will keep on searching until they find it. During the process the body often cures itself — and so success is frequently found and the last treatment is declared effective.

This process has opened the door for the irrational to enter our institutions of higher learning and to further close the door on freedom of speech and expression. You may not think this is a bad thing — especially if it provides a few more people with work and earns some money for the education system.

But how would the Minister of Education respond to a proposal to set up the Divine School of Engineering, or the Natural Light School of Veterinary Science, or the Tantric School of Economics? How will you feel when the building inspector uses an EAV meter to decide whether your building is earthquake proof or an acupuncturist is called in to test your herd for bovine TB or a Tantric Guru is appointed Governor of the Reserve Bank?

How come we would be prepared to let these people play games with our health, but not with our buildings, our cattle or our economy?

Hokum Locum

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

Conductive Education

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

Homeopathic Immunisation

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.

Hokum Locum

The sting

Following his own empirical observations that bee “treatments” helped his arthritis, a Levin bee-keeper is claiming that he is being ignored by the medical profession. (Press 3/8/93) Not surprisingly, his trial of 11 patients failed to impress skeptical observers. Two patients dropped out and the remainder reported that the “sting” was effective. Having paid for the privilege of being stung, a sensation to be normally avoided, they are hardly likely to say that the treatment was worthless.

In the middle ages, hornets were applied to the skin as a treatment for plague. Nothing appears to have been learned from such unpleasant, not to say dangerous, treatments.

Bogus professor

An unqualified woman who posed as a doctor and professor, was sent to prison for 6 months for fraudulently claiming that she could cure cancer and AIDS. Analysis of her product, Cancelle, or CH6, showed “it had no medicinal properties and contained toxic elements.” (BMJ 306 p1499).

It is ironic that the courts (in the UK at least) will move swiftly to deal with quacks, but the medical profession has failed to take action against registered medical practitioners who practice quackery such as homeopathy and EAV diagnosis.

Caesarean sections

Australia has a high rate (30-35%) of caesarean sections among private patients, and the introduction of a global obstetric fee that applied irrespective of the mode of delivery did not change the proportion of caesarean deliveries. (BMJ 306 p1218) The caesarean rate in Brazil is an amazing 50% on average, with the highest rates among the poor. Two reasons for this are a virtual absence of midwives and the belief (encouraged by obstetricians) that a vaginal delivery will permanently impair normal intercourse afterwards. Both of these examples demonstrate how doctors can develop bad practices when the socio-cultural environment allows this to happen. Only patient education with strong and ethical professional medical leadership, can prevent this kind of surgical abuse.

Low back pain

Readers will remember Denis Dutton reporting his experiences with an episode of low back pain, or lumbago (Skeptic 24). A Canadian study (British Journal of Industrial Medicine 1993; 50:385-8) found that the best treatment for uncomplicated lumbago was to remain active. The traditional treatment of bed rest was thought to encourage chronic invalidism.

This theme was continued by Robin McKenzie (Press 11/6/93) who attacked the current traditional approach to low back pain. Of physiotherapy, he said “it had for 75 years relied on unproven methods and `hocus-pocus’ electrical gadgetry” and he went on to say that “doctors should prescribe active rather than passive therapies.” Most controversial was his statement that “50% of workers on compensation were feigning illness.”

I am sure that there is an element of truth here. Physiotherapists use a wide variety of treatments and machines, many of which have not been adequately tested. It is too easy for people to refuse to accept responsibility for their own recovery and become chronically dependent on ACC. This applies not only to back injuries but other conditions such as chronic fatigue syndrome (CFS) and occupational overuse syndrome (OOS).

Work-related illness

Readers will be familiar with my position with respect to OOS, which has its roots in abnormal illness behaviour and psychological factors. It is interesting to compare it with the “sick building syndrome” (SBS), another new age medical invention. At last someone has done a trial of randomly increasing the ventilation rate while getting workers to report their perception of the indoor environment. (NEJE 328: 821-7)

To quote the authors: “Increases in the supply of outdoor air did not appear to affect workers’ perceptions of their office environment or their reporting of symptoms considered typical of the sick building syndrome.”

I would like to offer what I regard as a more likely explanation of the SBS which also relates to OOS. People crowded into a large building, working at VDUs and perhaps isolated from each other are always going to be vulnerable to a belief that the working environment is in some way responsible for vague and ill-defined malaise.

A report of a survey in the Christchurch Press (21/5/93) confirmed a high level of stress and dissatisfaction in the workplace. Half of the respondents said they would change jobs if they could and many felt that changes in conditions had resulted in more work for less pay. Most felt that they had less power to control their work environment.

Such surveys are extremely valuable because they provide a clue to the origin of conditions such as CFS, SBS, and OOS. I have no difficulty in accepting job-related stress, but I would prefer to see some honest acknowledgement of this by patients and doctors instead of the fraudulent collusion which creates mythical conditions as CFS, SBS and OOS.

Placebo controlled trials

Since such trials appeared in the late 1940s they have continued to be a valuable tool for investigating the efficacy of new treatments and drugs. Fish oil supplements were tested against placebo capsules for the treatment of psoriasis and there was no significant improvement in either group (NEJM — reported in GP Weekly 7 July 93). Refer also Skeptic 27 for an excellent review of the placebo effect by Dr Bill Morris.

Weight loss delusions

The diet industry is worth millions as women strive to achieve the impossible standards set by the fashion industry. Journalists have even invented a new term for fat, “cellulite”, which apparently looks and feels different from other body fat. (Marlborough Express 24 Sep 92) It can be removed by massage and body treatment products. Obese subjects can pay $180 to be blasted with water jets which “eliminate fat deposits and excess fluid” while hydrotherapy with miracle algae can “restore a balanced energy flow to the body”. (New Scientist 1 June 1991 p47) I hope this particular clinic has good grease traps in its drains.

Other researchers try and tell us that obesity is inherited and therefore nothing can be done. This ignores the success of weight-watchers and the obvious argument that if weight can be gained it must also be able to be lost.

A study (NEJM reported in Patient Management June 1993) found that diet-resistant patients under-reported their actual food intake by 47% and over-reported their physical activity by 51% and “diet-resistant patients were significantly more likely than control subjects to believe that they had a genetic or metabolic cause for their obesity, and to describe their eating behaviour as relatively normal”. This important work clearly demonstrates yet again the importance of patient beliefs in relation to illness behaviour.

While on the subject of over-eating, I note that a typical cat living in Britain is given twice as much protein a day as that eaten by a typical poor African.(BMJ Vol 306 p1078)

Homeopathy

In Skeptic 26 I offered to go into business with anyone prepared to join me in selling pure water labelled as “homeopathic preparations”. Two homeopaths were indignant about the use of active ingredients in the case of herbal medicine poisoning I described in Skeptic 28 and one went on to say “it is absolutely unethical for any medicine to be sold as natural and especially as homeopathic if it were to include pharmacologically active ingredients”. (Letters – BMJ Vol 306 p656)

I still think it would be a bit of fun to sell some pure water (labelled as homeopathic preparations), invite prosecution and argue it out in court. It could prove to be a more useful arena in which to examine the enduring scam of homeopathy. I could enjoy hearing homeopaths being cross-examined by a skeptical lawyer. At least selling pure water is honest!

Poached Tiger?

Not content with exterminating tigers in their own country, the Chinese have over 110 factories turning tiger bone into tablets, wine and various confections. Presumably the ingestion of such products is believed to confer some of the vigor and vitality of the unfortunate tiger. There are only about 6,000 tigers globally and trading in tiger products is banned by international convention. What a monumental folly that these magnificent and intelligent animals end up being turned into useless traditional medicines because of human stupidity and superstition. (Lancet Vol 341 p46)

Hokum Locum

Quackery

In the last issue I discussed how quackery can be practised by New Zealand doctors with impunity, “if they do so honestly and in good faith.” Alaska has a similar clause which only disciplines maverick doctors if they harm their patients. In fact, the latest NCAF newsletter outlines how a Dr Rowen has been appointed to the state medical board after “curing” the governor’s wife of lumbago by extracting one of her teeth. The link between the tooth and the back was made by an electro-acupuncture circuit using a Vega machine.

Dr Rowan also practises chelation, homeopathy and is described as “anti-fluoridation, anti-aluminium cookware, and anti-dental amalgam.” The Alaskan State Medical Association has strongly protested and one medical board member has resigned.

More on Bands of Hope

Sea Bands are available from NZ Pharmacies as well as Elekiban which is another form used for musculoskeletal complaints. As outlined in Skeptic 26, these are acupressure devices which have no scientific effect other than placebo. I was interested to read that the Institute of Naval Medicine (INM) had tested Sea Bands because on my recent overseas trip I spent a day a day at INM having a look at their research programs on Hypothermia and Diving Medicine.

Acupressure is an equally false derivative of acupuncture which works through a combination of the placebo effect and suggestion. Having written a truth kit on acupuncture I was alarmed to read that the Medical Acupuncture Society of NZ (MASNZ) is setting up a register of medical acupuncturists (150 hours training minimum)(NZ Doctor 21/1/93). Since acupuncture has no proven basis this is totally unnecessary, rather like setting up an appreciation society for the emperor’s new clothes.

As a former acupuncturist, I can teach anyone to be a safe and confident acupuncturist in about one hour. Perhaps I should give a demonstration at our next conference in the style of Dr Bill Morris and his vivid demonstration of homeopathy.

Pharmaceuticals Around the World

I have long held the belief that NZ doctors tend to overprescribe drugs. While working in general practice myself, I was often aware of pressure from patients to prescribe drugs. However, until now I haven’t come across any comparative data from other western countries. A survey of 495 randomly chosen Australian GPs (Patient Management Nov 1992) found that a prescription item was issued for every consultation (a reduction from 1974 when 136 prescription items were issued per 100 consultations!)

In NZ our annual drug bill is about $600 million, or $185 per head, per annum. My family of four definitely does not consume $740 worth of drugs in a year! Some people must be consuming a lot of drugs. British doctors are described as “low prescribers of medicines” yet their costs were roughly the same at $165 per head per annum.(The Lancet Vol 340 August 8, 1992 page 364). Patients expect drugs, and doctors want to help their patients, so it is not surprising that prescription rates are high. The writing of a prescription is often a convenient way to end a consultation.

One of the major problems for third world countries is getting cheap, effective drugs which are truly necessary. Multinational drug companies continue to cynically exploit these countries by marketing both dangerous and useless drugs. In a letter to The Lancet (Vol 339: Feb 22, 1992 page 498), a Pakistani doctor explained how a child died after being given drops containing an anticholinergic drug and phenobarbitone. Such a preparation has no scientific medical indication and its use in NZ would not be allowed.

A survey from Peshawar (reported in The Lancet Vol 338:August 17, 1991 p438) found that 90% of general practitioners were using antibiotics and anti-diarrhoeals to treat diarrhoea instead of using the correct treatment of oral rehydration therapy.

In Bangladesh, (GP Weekly International 2/12/92), hundreds of children have been injured or killed by cheap brands of paracetamol containing toxic ethylene glycol.

Datura is a drug which is commonly abused by drug addicts. It contains atropine, which in high doses causes hyperactivity and hallucinations. Incredibly, cigarettes containing datura are licenced for the treatment of asthma in France because “many old people rely on the treatment because they don’t believe modern methods help them.” This is a classic example of the need to have a rational, scientifically-based pharmaceutical industry. Datura-containing cigarettes would not be allowed here (we used to have cannabis cigarettes on prescription up until the 1920s!) and their persistence in France is based on delusion, placebo effect and anecdotal reports of efficacy. (New Scientist 22 August 1992).

Drug treatment can also be irrational when it is used for a condition which has no clinical basis. On the European continent there is a widely held belief that low blood pressure is associated with specific symptoms and is a pathological state requiring treatment. There is no basis for this belief, because complaints of faintness and fatigue are made as often by patients with a normal blood pressure.

Blunderbuss Treatment

A doctor whose daughter fainted on a hot day (BMJ Vol 299, 18 Nov 1989, p1284) reported that a French doctor prescribed a proprietary preparation called Tensophoril which contains the following ingredients: dopamine hydrochloride 15 mg, boric acid 15 mg, amylobarbitone 15 mg, and ascorbic acid 250 mg.

This sort of combination has been rightly criticised as “blunderbuss” drug treatment. Dopamine is inactive when given by mouth; boric acid is toxic and should not be taken by mouth; amylobarbitone is a long acting barbiturate sedative and the ascorbic acid dose is that which would be found in about 5 oranges. Fortunately the doctor’s daughter elected not to take the treatment and recovered fully.

Drug Licensing

I was much more impressed with a letter (The Lancet Vol 340: August 15 1992, p432) which detailed how Israel dealt with homeopathy. Drug registration required proof of efficacy and this was still not forthcoming after three years. Unfortunately the new legislation did not apply to raw materials and homeopathic preparations were able to be imported as such. The author regretted that “the compromise is not entirely satisfactory in that scientific assessment of efficacy cannot be applied.”

The situation in Germany is hardly credible. Drug licencing does not depend on clinical trials, but on anecdotal evidence supplied by medical practitioners, many of whom are paid by the same companies whose products they are endorsing. This is hardly surprising when 7 out of 10 general practitioners practise alternative medicine.

For example, the Federal Health Office (BGA) was forced to licence a totally useless product containing “1 g loess soil” for the treatment of diarrhoea, because “German law does not define the term efficacy.”

Another useless drug is Arteparon, an extract of bovine lung used for the treatment of osteoarthritis when given by injection. The drug is licenced because the courts have determined that “the efficacy of old drugs must not be judged by modern scientific standards.” Arteparon causes severe allergic reactions, a fact not recognized by the courts because “proof of causality beyond any doubt was needed for each case of adverse reaction.” The judges obviously overlooked the irony of demanding a higher standard of proof of side effects than of efficacy. The cost of these crazy decisions is a huge drain on the German health system. One quarter of the DM20.7 billion spent annually on pharmaceuticals is for useless drugs.

I have no idea whether our own drug lists contain either questionable or useless drugs and these reports have prompted me to have a browse through the GP’s pharmacopoeia New Ethicals. Watch this space!

Thalassotherapie

While overseas I collected a number of articles worthy of skeptical attention. Although a confirmed Francophile, I wonder whether they have any effective organised groups of skeptics. Homeopathy is part of mainstream medicine and astrology is big business.

Thallasotherapie is described as a treatment modality using seawater and its products. Patients (or, in newspeak, clients) can either float in seawater or apply heated mud made from seaweed. Obese subjects will be delighted to know that their tissues can be “deflated by various jets and massages.”

It is claimed that elements such as magnesium and calcium are able to “get into human tissues” and “engender the same consequences as a hoemeopathic treatment: stronger immune system and stimulation of cells.” In fact, human skin is relatively impermeable and certainly does not behave like a semipermeable membrane. Essentially this therapy can be carried out for nothing in the privacy of your own home by having a long soak in a hot bath. If you feel so inclined, toss in a handful of seaweed.

More on RSI

There has been a lot written on this subject, but so far little written to explore alternative explanations for these spurious symptoms which are essentially a conversion disorder (well described in basic psychology texts).

Whole forests have ended up as publications on ergonomics and an army of occupational physicians continue to pontificate over the delusion of RSI. It is therefore refreshing to read letters (Medical Journal of Australia Vol 157, Sep 21 1992, page 427) from skeptical occupational physicians who have both correctly diagnosed this condition as a conversion disorder and correctly treated it by “helping patients sort out their personal, social, family and financial problems.”

Even More on Chronic Fatigue Syndrome

In Skeptic 21 I summarised the key research in this area, which does not support any infectious cause and shows clearly that the condition is a somatisation disorder.

If any readers are interested in further reading on this subject, there is a very good article in Patient Management Nov 1992, p13 by Robert Loblay. He reviews the historical development of immunology and demonstrates conclusively how history tends to repeat itself. For example, neurasthenia has been resurrected as chronic fatigue syndrome.

Many symptoms which people present to their doctors are often functional (somatisation disorders) and have no basis in serious disease. Some doctors have difficulty in accepting their own limitations in this respect, or the existence of psychological disorders, and it is easy for these practitioners to seek “magic” solutions such as acupuncture, homeopathy and dietary manipulations.

Psychological disorders cannot be explored within the context of the traditional five-minute NZ consultation and it is hardly surprising that alternative medical practitioners have more success when they give the patient one or two hours of their undivided attention (itself a form of psychotherapy).

Chelation Therapy

This is an intravenous treatment with a cocktail of vitamins and the drug EDTA, which is believed to chelate calcium which has been deposited in atheromatous plaques. Atheroma (Greek for porridge!) is an ageing process leading to fatty deposits in arteries (accelerated by smoking, high blood pressure, excessive dietary fat and diabetes) leading to coronary artery disease (CAD) and peripheral vascular disease (PVD). Poor blood supply through the narrowed vessels leads to chest pain in the case of CAD and painful legs in the case of PVD.

There is a proper double blind placebo controlled trial of chelation therapy for PVD currently under way in Dunedin Hospital. A similar study in America (Journal of Internal Medicine 1992, pp 231-267) showed no difference between chelation and placebo treatment. I hope to do a similar study of chelation treatment for CAD. We await the outcome.

Video Library Update – New Titles, July 1992

A CSICOP video library is run by Alastair Bricknell, RD2 Kuaotunu, Whitianga. Tapes may be hired for the cost of postage and packing, around $5 (extra donations gratefully accepted).

Homeopathy — Medicine or Magic?, QED (BBC TV), 1990, 30 minutes

A very interesting look at the state of homeopathy in the UK in the ’90s including its use by some “conventional” doctors and vets. Details are given of a few trials (some double and triple blind) that have been conducted claiming to give support to homeopathic techniques. Unfortunately, relatively little time is permitted for dissenting views and I am sure many of our rural members will have other explanations for some of the “miraculous” animal cures presented. A thought provoking programme nevertheless; it should be essential viewing for any skeptic confronting homeopathic enthusiasts.

Secrets of Sedona, 48 Hours (CBS), 1991, 60 minutes

A visit to Sedona, Arizona, a centre for “New Age” thinking(?) in the US. Topics covered include fire walking, astrology, UFOs, vortexes (vortices?), pendulums, channelling, reincarnation, and New Age music — surely there is something for every skeptic in this one. The programme shows how some successful businessmen and women use New Age techniques to influence their business decisions and the industry that has built up around this philosophy in a beautiful part of the American west. A good balanced look at a phenomenon that is starting to become increasingly popular in New Zealand,

Spiritual Healing, Foreign Correspondent (TVNZ), 1992, 15 minutes

A brief but interesting and relatively balanced look at the healing scene in the UK. Topics covered include New Age healing methods, “Touch for Health” healing (some skeptics might say “Clutch for Wealth” would be more appropriate), the charismatic Christian movement, and several other alternative medical practices. A revealing discussion with a conventional medical practitioner illustrates the tragic consequences that can arise for those relying on these fringe methods while cancers continue to grow.

Chelation Therapy, Frontline (TVNZ), 1992, 15 minutes

A good introduction to chelation therapy as practised in New Zealand at present. Discusses the double blind trial currently underway in Dunedin that is due to end in a few months. Sensible comments from conventional medical practitioners about the merits of this controversial therapy provide some balance to this interesting program.

Hokum Locum

More on Chronic Fatigue Syndrome

An American study reported in the GP Weekly (2 Sep 1992) found that chronic fatigue syndrome was indistinguishable from depressive disorders. (Refer also Skeptic 21) Patients diagnosed as having CFS were likely to believe that their illness had a viral cause, but it is more likely that CFS is a new age variant of the 19th century neurasthenia.1

A large study reported in the BMJ is worth looking at in detail. 200 patients with CFS were studied. Many of the patients had tried alternative therapies which were “not helpful,” namely diets (27%), homeopathy (20%), hypnosis (5%). This has been confirmed in NZ by Murdoch, writing in the NZ Family Physician (Autumn 1992).

Again, most patients believed that their illness was caused by a virus and the study found that most patients had an emotional disorder. Despite this, most patients had recovered after two years and this outcome is also confirmed by Murdoch in an unpublished survey of New Zealanders with CFS. At all stages in the illness, “functional impairment was associated with several patient factors, including belief in a viral cause, leaving or changing employment, coping with illness by avoidance of exercise and alcohol, membership of a patient organisation, and emotional disorder.” The authors acknowledge that these factors may reflect a more severe illness and call for more prospective studies.

Despite the high incidence of emotional disorder, very few of the patients had been referred to a psychiatric outpatient clinic.

Despite the considerable evidence against an infectious cause of CFS, an Australian doctor has been treating patients with intravenous gamma globulin2 in what is described as a placebo controlled trial. Unfortunately, no reference is given to the trial and until I can get these details I will have to reserve judgement. Watch this space!

Clearly patients resist the suggestion that chronic fatigue has a psychological basis, and unfortunately some members of the medical profession continue to foster this belief. Of concern is the activity of quacks touting EAV, homeopathy, anti-candida diets and other useless nostrums. Patients should not be allowed DSW benefits unless they have willingly cooperated with a program of cognitive based psychotherapy.

References:

1. Chronic Fatigue Syndrome. American Family Physician March 1992 p1205.
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2. Acceptance and treatment of CFS is improving. NZ Doctor International Oct 1st 1992.
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Follow up of patients presenting with fatigue to an infectious diseases clinic. British Medical Journal July 18th 1992 (also reported in New Zealand Medical Journal Sep 9th 1992, p366)

Chronic fatigue syndrome. The Lancet May 30th 1992, p1349

Psychiatric diagnosis and CFS link. GP Weekly Sep 2nd 1992

Fake GP

I was only mildly surprised to read in the BMJ (June 27th 1992, p1652) that a doctor with no medical qualifications had worked for 30 years as a general practitioner. All that is required to be a successful GP is the ability to listen sympathetically to patients. This is more effective than the millions of dollars wasted on drugs such as tranquilisers and antidepressants.

It took some time before the local chemists became suspicious and I quote one of them:

“If one 5 ml spoonful of hair shampoo is to be taken three times a day you tend to think there is something wrong. Time and time again there were inhalers to be injected, tablets to be rubbed in — all very unusual.”

Unfortunately no information was given as to whether any patients had been harmed and, conversely nothing from grateful patients. How on earth did he last 30 years before being exposed? I conclude that he must have been helping enough of his patients to forestall complaints about his eccentric prescribing. The English have a reputation for eccentricity and they certainly must have indulged themselves with this doctor!

Fishy Tale?

In a tribute to anthropomorphism, a Dr Motha will be birthing mothers in the company of dolphins who can “make ultrasonic communications with the fetuses.” All becomes clear when we are told that Dr Motha runs an alternative medicine clinic “including aromatherapy and reflexology.”

Personally I have always thought that dolphin intelligence was over rated since reading Restaurant at the End of the Universe when, at the end of the world, dolphin squeaks were translated as “goodbye and thanks for all the fish.”
GP Weekly August 19th 1992

Fringe Medicine and the Medical Practitioner

The New Zealand Medical Council normally does not involve itself in criticising unorthodox treatments unless the patient suffers harm. Doctors practising quackery are protected by a clause in Section 58, subsection 4 (2) of the medical registration legislation, which states: “no person shall be guilty of infamous conduct merely because of the adoption and practice of any theory of medicine or surgery if in doing so he has acted honestly and in good faith.” I find this statement disappointing, because a medical degree surely implies a knowledge and acceptance of scientific principles.

This clause has been dropped from the same legislation in Australia, Britain and Canada. However, the Medical Council has made it quite clear that quack doctors have to satisfy the doctrine of informed consent by fully briefing their patients “that these treatments are not part of conventional medicine and hence he or she is not practising as a registered medical practitioner in providing these therapies.” The medical registration authorities in Ontario, Canada obtained a change in their act which allowed them to ban such unproven remedies as amnion implants and chelation therapy. They also erased from the register a doctor who combined pendulum dowsing with a form of vega testing. I look forward to similarly robust attitudes towards dealing with quackery by our own authorities.

Having enjoyed the study of general science, I am amazed at the capacity of some doctors to believe in quackery. As H. L. Mencken 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?” The reference quoted below is well worth reading.

Unorthodoxy and the Registered Medical Practitioner. David Cole. Patient Management Vol 21 No 9.

Irlen Lenses

In Skeptic 22 I criticised the promotion of Irlen lenses in New Zealand and called these a quack remedy. Since then I have been criticised by Matthew Hobbs (Skeptic 24 — nice to have some feedback) on the grounds that it remains to be seen whether these lenses are a proven remedy for reading difficulties such as scotopic sensitivity.

My use of quack in this context is straight from the Concise English Dictionary: “one who offers wonderful remedies or devices.” Firstly, there is no evidence of the existence of the condition “scotopic sensitivity” and secondly, as the coloured lenses have not been tested they should not be used, as efficacy has not been established.

An article in the Marlborough Express (Sep 24th 1992) outlined how a 10 year old with reading difficulties was fitted with coloured plastic lenses. After six months his reading had improved 100 percent. What alternative explanation is there for this improvement, and how was the improvement measured? It is most likely that his reading disorder was related to aberrant conditioning. The more his parents expressed concern, the more reinforcement was given to the “poor reading.” The coloured lenses are a placebo associated with a change in management which, along with the passage of time, has lead to an improvement in his reading.

Faith Healing

Dr Keith Davidson kindly informed me of the source of the quote mentioned in Skeptic 24 “Every day in every way, I’m getting better and better.” It came from someone called Emile Cove. Keith also sent me a cutting from the Christchurch Press detailing the activities of an American faith-healer by the name of Morris Cerullo.

The article demonstrates the obscene side of evangelical fervor. People were warned “Cynicism will sour you, bring cancer to you, and disable you.” The audience revelled in an atmosphere of mass hysteria and were told by an expert on “biblical economics” that there was no pressure to give money but the amount given would determine how far God would move towards miracles! The cartoon that came with the article is great. It shows Cerullo gesticulating while his shadow is the outline of a devil.

The evidence for faith healing is not good. As most deluded beliefs rest on faith, and faith is not amenable to testing, it is unlikely that testing will ever be done. In fact believers are on record as saying that testing claims of faith healing would be disrespectful to God.

Skeptics and Consumerism

Members of the NZ Skeptics have enjoyed some media exposure lately. Denis Dutton has been conducting a vigorous rebuttal of acupuncture beliefs (Patient Management, September 1992) and Vicki Hyde is “Eyeing Alternative Medicine” in the August edition of the NZ Science Monthly.

Consumer magazine were so unhappy with our criticisms of their alternative medicine story that they came out fighting and awarded us with a magnifying glass. I have used it in vain to re-examine their original article, but I have not changed my mind about its feeble journalism. Consumer journalists should read NZSM to see how their story should have been treated.

A new development is Maori medicine, or rongoa, (NZ Doctor, August 20th 1992) Given reasons for its use by Maori are an inability to pay for prescriptions and a belief that rongoa can provide something that western medicine cannot. The Bay of Plenty Area Health Board has provided $15,000 for traditional Maori remedies, such as red matipo to purify the blood and para blue gum for asthma. These treatments are administered in an atmosphere of “love and kindness.”

I doubt whether any of these remedies will ever be subjected to a clinical trial, because such treatments have to have some kind of rational basis to start with, and any results are clearly explained by the very powerful and under-rated placebo effect. At a time when Maori health has never been worse (e.g. smoking-related disease) I find it incredible that an AHB can waste money on this nonsense.

Homeopathy

After our little tiff with Consumer magazine, I wrote to the School of Pharmacy in Dunedin to ask whether they would consider doing some tests of homeopathic solutions. Peter Hayes (Lecturer) kindly replied to my letter and enclosed a copy of a paper entitled “A case for homeopathy” written by a Scottish pharmacist, Dr Steven Kayne.

It is fascinating to read the intellectual rationalisations used by otherwise intelligent people in order to indulge their deluded beliefs.

Kayne concedes that increasing dilutions leave no discernible molecules in solution and then goes on to say “chemical analysis is therefore inappropriate”!!!

He further concedes that he cannot explain the mechanism of action but goes on to say “it is extremely difficult not to be impressed when one sees therapeutic efficacy clearly demonstrated.”

Evidently he discounts the placebo effect and refers to “published work in human and veterinary environments.” None of the references quoted support these claims. Furthermore, he says “It is inconceivable that consumers would continue to buy these [homeopathic] products if it was all a giant confidence trick.” He obviously needs to have a chat to some of our skeptical psychologists.

Finally, he refers to the enormous volume of circumstantial evidence “that the remedies actually work — patients do get better.” This is called the “Bellman’s fallacy” — because something has been said many times it must be true. His last word is “homeopathy should be available because patients want it, because it is safe and because it works.”

The Dean of the Pharmacy School also wrote and pointed out “because of patients’ belief in complementary medicine, I doubt that even if we were to show that they were purchasing pure water, it would cause any change in attitudes.”

I am forced to agree with him, but I could not help wondering what would happen if I started selling pure water labeled as various homeopathic remedies. I could make a fortune and it would be difficult to be prosecuted for fraud. Anybody want to go into business?

Open-mindedness

The same day that I was writing all this, I received an article from Bernard Howard written by one of my favourite skeptics, Petr Skrabanek. One of his best articles on the philosophy of skepticism is “Demarcation of the Absurd,” The Lancet April 26th 1986, in which he argues that it is possible to be too open minded.

Briefly, he argues that we need a demarcation of the absurd so that we don’t bother spending our whole lives on the look-out for flying pigs. Instead, we accept that the probability is so low that we don’t waste our time either looking or testing for airborne swine.

The article that Bernard sent is called “Why we must keep the lid on the black magic box” (Healthwatch Newsletter Summer 1992) and in it Skrabanek argues that testing of irrational beliefs can give them spurious respectability and “no amount of testing will convince a believer that he is mistaken.” Skrabanek also reviews the development of “black-box” quackery, which I have already mentioned can be practised in NZ with impunity due to our feeble medical registration legislation.

That reminds me of a television program on water divining where James Randi tested the top water diviners in Australia. None of them detected water flowing through one of ten pipes any better than chance. At the conclusion of the experiment he asked them about their beliefs which were totally unshaken!