Sex abuse article missing content?

I’ve just been reading my Summer 2012 edition of New Zealand Skeptic, but I think there is a piece missing from my version.

On page 15-17 there is an article by Gordon Waugh that is missing both a chunk of text and his references. There is clearly a gap between the first section which ends with “it caused mental injury” and the next which starts with “Do sexually assaulted people exhibit …”. In the later section he talks at length about the lack of a defined ‘syndrome’ caused by sexual abuses. This doesn’t make any sense unless there is a paragraph on why the ‘mental injury’ should be a ‘syndrome’ in order to be real. There’s no specific ‘falling off a ladder’ syndrome, either, but I wouldn’t argue that that means people aren’t injured in falls. Without Mr Waugh’s explanation of why he is using this narrow definition of ‘mental injury’ his argument becomes ridiculous.

I’m also concerned that his references have been lost. He talks about what counsellors believe and think, but the survey or research that backs this up is missing. I find it hard to believe an author calling for ACC to demand testable evidence in relation to sexual abuse cases would fail to provide the evidence to back up his own assertions. He also talks only about counsellors, and I assume that the section of his article that deals with what it means to be an ACC registered counsellor is also missing. Without it, it looks as though anybody can can set themselves up and start referring patients for claims. This is obviously absurd and without the missing section Mr Waugh’s credibility takes a serious knock.

Perhaps these could be printed alongside part two of this article, which I assume will be covering the legislative aspects. Mr Waugh refers twice to laws that are being broken, but never actually sets out which statutes these are. He also calls for the criminalisation of ACC claims that fail to provide “proper evidence” of sexual abuse and I assume he will talk more about how “proper evidence” is defined and how it would be collected. And how its collection will be consistent with the evidence required by other types of injury.

Renee Maunder

Peppering is back

Not possums … rabbits!

I was horrified to see a Country Calendar this morning (made in 2011) where the increase in rabbits was being discussed. One of the farmers said he had been told to shoot a rabbit, skin it, burn the skin, and scatter the ash in order to have the desired effect. He just hoped the rabbits would go elsewhere! He admitted his other farmer friends were doubtful but were waiting to see what happened. He said he was four weeks into the trial but that positive results might not show up until at least six weeks.

Well, this might work if he shot lots of rabbits to get the skins to burn … shooting would remove a few.

Else I have this mental picture of hundreds of little bunnies all sitting in Easter baskets and madly paddling away back to England…

Louette McInnes

Amber teething beads: something to chew on

A ‘natural’ way to manage teething pain has no plausible mechanism.

Parents, especially new parents like myself, are a vulnerable group. We tend to be full of anxiety that we are doing the ‘right thing’ by our children. Wherever you find a vulnerable group like this you also tend to find those who prey on such fears.

Being a new parent and a skeptic I have been on guard regarding dubious advice and practices, but so far I have actually been pleasantly surprised: I have not, as far as I’ ve noticed, been subjected to any dubious advice. But recently I was confronted by a practice of a fellow new parent that I found a little disturbing. I’ m taking about using necklaces of amber beads to reduce the pain of teething for babies.

Teething can be an especially stressful time for parents and children. The child may be experiencing pain as the new teeth break through the gums; this means an irritable child and frazzled parents. Anything that promises to relieve or prevent this harrowing time is gratefully embraced.

On to the amber beads. This practice disturbs me for several reasons. First is safety. The necklace, if left on the baby for long periods, may pose a strangling hazard if it becomes caught on something. Most advertise that they are made to break easily to prevent this and that the beads are individually knotted onto the necklace to prevent scattering on breakage. However, this still seems to leave a broken string of beads in reach of a baby, and as most people know – anything a baby can get its hands on goes straight into the mouth. So choking is also a concern.

Now, I’m not one to be a worry wart over every little potential hazard; used correctly under parental supervision I suspect that the likelihood of a tragedy of this kind is low. But not zero. This, coupled with the low probability that the necklace actually does anything, is what worries me. The second disturbing thing is that parents are accepting that the necklaces work via word of mouth, and apparently not consulting their doctors before subjecting their child to an intervention of unknown safety and efficacy.

I have three main points I believe parents should consider before trying these beads (in addition to the physical safety above). The first relates to basic plausibility. There are several explanations for how the beads are supposed to work floating around the intertubes, many of the tinfoil hat brigade variety ([… it generates pain relieving magnetic field[). Only one explanation I have found makes biological sense so that’s the one I’ll be focusing on.

Baltic amber is known to contain between three and eight percent succinic acid. According to proponents this is released from the beads and into your baby. The succinic acid then allegedly has an analgesic effect and so reduces the pain of teething. Here is where my first point regarding plausibility comes in.

Amber is tough. Really tough. This is a material that has persisted for thousands and in some cases millions of years unchanged. Suffering through innumerable climatic cycles of heating and cooling. Yet this same tough unchanging material will happily give up its chemical components upon the gentle heating it receives on being placed next to your baby’s skin? Colour me unconvinced. I found a 2010 paper on volatile degradation products from Baltic amber that doesn’t mention succinic acid as an identified component. Related to this point, amber has a hardness on the Mohs scale of between 1 and 3. Baltic amber, which is usually touted as the therapeutic variety (because of the high succinic acid content), is at the high end of this scale at 2 – 2.5. To put this in perspective, Tin has a hardness of about 1.5 and Gold is 2.5-3. But let’s say for argument’s sake that clinically relevant amounts of succinic acid are released by the amber and absorbed by your baby’s skin.

My second point then, relates directly to the claims made for succinic acid. Succinic acid is made in the body (and in plants) as part of the citric acid cycle (aka the Krebs cycle). It is also used in the food and beverage industry as a food acid (additive #363 to be precise). Interestingly, in this capacity there are recommendations from some quarters to avoid the substance ([avoid it, banned in some countries[,

Even so, apart from its early use as a topical treatment for rheumatic pain, there is no evidence that I could find (searching Pubmed at least, where I would expect a decent study to be referenced) that it is effective as either an anti-inflammatory or general analgesic. Let me be clear on that. I don’t mean low-quality evidence, I don’t mean small, poorly designed trials with equivocal effects, I mean nothing. Zip. Nada. In fact if anyone knows of any let me know because I find this complete lack quite surprising. I’m open to the idea that I was looking in the wrong place or was using incorrect search terms. So, unless there is late breaking news, it fails on that count as well. But what do we care about evidence of efficacy anyway? Let’s throw this point out too, and move on to my final point to consider.

Let’s say that (a): the beads do indeed release succinic acid into your baby and (b): this succinic acid has an analgesic effect once it enters your baby’s body. Doesn’t the very fact that an unknown amount of a drug is being put into your baby’s body bother you? (If it has biologic activity that can be used in a therapeutic fashion, it’s a drug, no quibbling on that point please.)

What is that I hear? It’s natural? Oh, well, that’s okay then. No wait, it’s not. I don’t care what the origin of a compound is, the question is what are its effects on the body and do the benefits outweigh the risks. Let’s replace succinic acid with some other naturally occurring substance, salicylic acid. This is a compound with known anti-inflammatory properties. Would you be happy with a product that introduced unknown levels of this compound into your baby? What if I said that overdoses with this compound could lead to a one percent chance of death ( It’s natural; it’s also the precursor to acetylsalicylic acid, otherwise known as Aspirin.

Now, lest I be accused of unnecessary fear-mongering and drawing false comparisons I would like to admit that at present there is no evidence to suggest that succinic acid is hazardous, nor even that it is potentially hazardous. This does not detract from my main point however. It isn’t whether this particular compound is safe or not but that the reasoning around its use (ie [It’s got to be good, it’s natural[) is faulty and cannot be used as a substitute for evidence.

Based on the complete lack of plausibility on any level of efficacy any potential for harm, however small, must tip the balance of the equation away from the use of this product. But don’t trust me; talk to your doctor. I suspect though that given the complete lack of reliable information on this topic they will be left to rely on their own philosophy of harm vs benefit. In the final analysis, there are not always clear answers, but developing good critical thinking skills will at least provide you with a small light in the darkness.

Having our say on natural health

As part of the Memorandum of Understanding between the National and Green parties, the Ministry of Health has been developing proposals for a natural health products scheme to regulate such products on the New Zealand market. To kick this process off the ministry has produced a consultation paper setting out high-level proposals for the scheme and called for submissions on it. The NZ Skeptics were among those who sent in a submission in time for the closing date on 17 May. Vicki Hyde and Michelle Coffey were the principle authors, with contributions from several other society members.

In general, the NZ Skeptics support the scope, purpose and principles of the proposed legislation. We think it’s important that the industry has some regulatory oversight to support consumer protection, particularly in the area of claims and proof of efficacy, as well as safety, marketing material and labelling. The use of terms such as ‘natural’ concerns us as it is used to imply benign, which is not a supportable claim.

In addition we are concerned that there appears to be very little in the way of supervisory oversight or quality control in this industry, particularly with regard to imported products. This is potentially of major concern as, on the rare occasion when such checks have been made, product quality has been found to be severely compromised.

Some ‘natural health products’ have been found to have significant levels of contaminants such as heavy metals, or to contain pharmaceutical products, such as viagra and paracetamol, deliberately introduced to give the product a measurable effect not obtainable from the ‘natural’ products.

We believe that informed choice for the consumer is critical in this area, as in all areas relating to health. Labelling requirements need to be clearly defined to ensure that the natural health industry does not use archaic, misleading or inappropriate terminology to boost its claims to the detriment of consumer understanding.

Also, the definition of ‘natural health product’ needs careful deliberation. This industry has been seen in the past as quick to claim any and all modalities that suit their business. ‘Natural health’ should be regarded as a marketing term, not a scientific one. The extension of this business into ‘synthetic equivalents’ gives this industry even more scope for misleading consumers (cf the claims of BZP as providing a ‘herbal’ high).

There is a link to the full submission on the NZ Skeptics home page (


Flaky diagnostic tool fans toxin scare fire

Hard on the heels of the Bent Spoon awarded to the Poisoning Paradise ‘documentary’, the NZ Herald has produced an appalling piece on alleged pesticide poisoning of people and wildlife in Auckland (27 September).

According to the report, Waiheke Island environmental group Ocean Aware claimed samples from marine birds, oysters and dog vomit, taken from Waiheke and Rangitoto Islands, tested positive for brodifacoum and 1080.

The samples were tested by EAV machine, though nothing in the article explained what this means. EAV stands for ‘Electroacupuncture according to Voll’ – in the 1950s Reinhold Voll combined acupuncture theory with galvanic skin differentials to produce a machine which, when homeopathic solutions were introduced into the circuit, could be used to ‘diagnose’ all manner of toxin-related ailments (see NZ Skeptic 56). Needless to say the machine has no scientific basis.

A woman who became mildly ill after eating local snapper also tested positive for brodifacoum, said Ocean Aware’s Sarah Silverstar. Brodifacoum poisoning, however, causes internal bleeding, which the woman was not reported to suffer from, and does not otherwise generate feelings of illness. This is what makes it such an effective rat poison.

The electroacupuncture testing was done after the Department of Conservation dropped 147 tonnes of brodifacoum bait on Rangitoto and Motutapu Islands in August. Soon after, several marine animals were found dead on Auckland’s North Shore, and dogs which had walked on the beaches became ill or died. At least some of these cases were later linked to tetrodotoxin, a bacterial toxin found in several marine organisms, most famously the Japanese fugu puffer fish.

DoC, in alliance with Auckland Regional Public Health, MAF Biosecurity, Auckland Regional Council and North Shore and Auckland City Councils, says independent scientists have carried out extensive testings and determined none of the deaths were caused by brodifacoum. DoC spokeswoman Nicola Vallance said the department offered to have independent scientists test Silverstar’s samples, but she declined.

Dioxin risk over-rated

At least Bob Brockie brought some sense to the fraught subject of environmental toxins with his Dominion Post column (6 July) on the dioxin scare in New Plymouth.

Residents there were up in arms when it was discovered soils in a local park had minute traces of dioxin. But as Bob Brockie pointed out, dioxin at far higher levels than found in Taranaki generates no symptoms other than a form of acne. When Ukrainian presidential candidate Viktor Yushchenko had his soup laced with dioxin he was badly scarred, but today his face has largely healed and he appears in good health. Following the Seveso chemical factory explosion in 1976 residents were found to have up to 10,000 times the typical human tissue concentration. Fifteen years of testing revealed no excess cancer, stillbirths or genetic disorders – just the temporary acne.

Sadly, says Brockie, this is an argument that science and objectivity can never win. “The testimony of one or two residents carries more weight in New Plymouth than truckloads of refuting world statistics.”

Conspiracy? What conspiracy?

The Sunday Star Times (20 September) had a good piece on Matthew Dentith’s study of conspiracy theories at Auckland University. Why, asked reporter Mark Broatch, do otherwise ruthlessly rational people reject out of hand most conspiracies, yet give time and angst to ideas others find quite wacky?

Matthew Dentith says the problem is two-fold. Schools don’t teach critical thinking skills that might help us unravel our confusion, and we humans are exceptional at compartmentalising our beliefs. “It’s really easy to be absolutely staunch in, say, your adherence to evolutionary theory by natural selection. But when it comes to medical quackery…”

Look for more on this subject from Matthew Dentith in an upcoming issue of NZ Skeptic.

Placebo prescriptions widespread

Three out of four New Zealand doctors have prescribed placebo medications to patients, according to medical researcher Shaun Holt, who says the practice could cost the taxpayer several million dollars (Dominion Post 4 July).
Seventy-two percent of the 157 doctors surveyed admitted giving placebos, including vitamins, herbal supplements, salt water injections and sugar pills.

“But what surprised us was the most commonly prescribed placebos were antibiotics, which is obviously a concern because of the rise of antibiotic resistance and potential side-effects for patients,” Dr Holt said.

Patients’ unjustified demands for medication was cited as the most common reason for prescribing placebos (34 percent), followed by non-specific complaints (25 percent), and exhausting other treatment options (24 percent).

Dr Holt said he believed placebos were ethical as long as the doctor considered them to be in the best interests of the patient. “The placebo effect is quite powerful,” he said.

Rather than prescribing medications which were ineffective for the condition treated – such as antibiotics for viral infections – he said “there could be an argument for bringing back sugar pills, which are safer, just as effective and certainly cheaper.”

Pharmac medical director Peter Moodie said data showed doctors were prescribing antibiotics responsibly. He agreed it was not acceptable to waste money prescribing medicines with no effect.

Alternative therapies ‘too good to be true’

The Sunday News (20 September) has come up with a surprisingly sceptical article about alternative health treatments. Belief, says Barbara Docherty, a registered nurse and clinical lecturer at the Auckland University School of Nursing, is becoming a most important factor in a world where ‘alternative health’ has become a major growth industry.

After noting the most popular alternative therapies include naturopathy, chiropractic, homeopathy herbal remedies and acupuncture, she asks if this is the stuff of quacks and witch doctors.

Despite a wealth of available information, there is little or no strong scientific evidence and very little regulation about who and what is safe. Herbal and natural medicines, although widely used, are not subject to the same scrutiny as prescription or over-the-counter medications.

Skeptics might question the value of her advice to check out practitioners’ qualifications carefully – an ineffective treatment is ineffective no matter who is administering it – but not her final comment: “…bear in mind that anything that sounds too good to be true probably is.”

Ghost hunters hit the capital

Those who were at the conference this year will already know about James Gilberd and his Paranormal Occurrences team. They got a write-up in the Capital Times recently (26 August – 1 September). Reporter Dawn Tratt joined them for a ghost hunt at the Museum of Wellington City and Sea.

Claiming to be sceptical, though carrying baggage from a Pentecostal upbringing, Tratt’s scariest moment came when her colleague mistook one of the investigators, sitting on the floor, for a ghost.

It was only after she left that things supposedly got really spooky. One of the team says she saw the spirit of a Maori man.

I felt like he was upset with James. He kept trying to tell me something but I couldn’t pick up what it was.

It may, just possibly, be significant that the museum ran paranormal tours during one of the winter public programmes three years ago, and marketing manager Angela Varelas says they are looking to bring them back early next year.

As for James Gilberd, he brings a distinctly sceptical approach to his ghost-hunting, treating it as a form of performance art. In his day job he runs a photographic gallery, Photospace, and his conference presentation was mainly about the technical glitches that cameras, and particular digital cameras, can have that lead people to think they’ve photographed a ghost. Something else to look out for in an upcoming NZ Skeptic.

Anti-oxidants: the key to nutritional success?

Extravagant claims are often made for the health-giving effects of anti-oxidants in the foods we eat. But sorting out the truth from the hype is not at all easy.

In the window of a health-food shop, I saw an advertisement extolling the merits of Goji berries. The advertisement said that an ‘ORAC test’ had shown that Goji berries have a lot of anti-oxidants in them. ‘ORAC test’ has a scientific ring about it-Goji berries must be good!

Anti-oxidants have attracted a reputation as beneficial ingredients of foods, nutritional supplements and cosmetics. So I thought I would try to describe what anti-oxidants are, and explain what the ORAC test is and its limitations. I’ll also give some examples of anti-oxidants in fruits and vegetables, and make some comments as to whether it’s worthwhile taking supplements containing these anti-oxidants in an attempt to get more of them inside you than is usual from a healthy diet.

What are anti-oxidants? Let’s start with oxidation and move onto food. Oxidation is a process in which electrons are removed from atoms and molecules. Oxygen is the classic oxidising agent. Digestion of food and extraction of energy from it is essentially an oxidative process. It occurs over many steps but one of the final outcomes is the transfer of electrons to oxygen (which is why our existence is dependent on a supply of this gas*). When the electrons are passed to oxygen, water is formed but oxygen ‘radicals’ are also formed as a side effect. Radicals are atoms or molecules which have one or more unpaired electrons. By virtue of the unpaired electrons, radicals (sometimes referred to as ‘free radicals’) are extremely reactive. The oxygen radicals are no exception and if not mopped up will cause all sorts of havoc by reacting with molecules that they shouldn’t react with. In short, oxygen radicals are toxic.

An example of an oxygen radical generated in our bodies is the ‘superoxide radical’: O2.-, two oxygen atoms linked together to form a molecule that has an unpaired electron (the dot) and a negative charge (the dash). It’s been estimated that an adult weighing 70 kg makes about 1.7 kg of superoxide radicals a year. This is equivalent to about one percent of total oxygen consumption.

Molecules that can neutralise free radicals are called anti-oxidants. Anti-oxidants do not react only with oxygen radicals. Other ‘reactive species’ capable of causing oxidative damage and that react with anti-oxidants may contain, for example, nitrogen and sulphur. Barry Halliwell and John Gutteridge give a more formal definition of an anti-oxidant in Free Radicals and Biology in Medicine (2007), which is: “any substance that delays, prevents or removes oxidative damage to target molecules”.

Reactive species in addition to oxygen radicals also end up in our bodies. Cigarette smoke, for example, contains free radicals. Given the toxicity of oxygen radicals and other reactive species, it’s not suprising that anti-oxidants are considered a good thing, and that it’s thought a good idea to make sure we have as much of them inside our bodies as possible. Fortunately, our bodies have a number of built-in anti-oxidant systems to protect us against oxygen radicals formed as we breathe, and other reactive species. I am not going to deal with these systems but will confine my attention to dietary sources of anti-oxidants as it is these which are usually discussed in dietary advice and turn up in nutritional supplements. These anti-oxidants are, by and large, derived from plants.

Measuring Anti-oxidants

The ORAC test is one of the principal assays used to estimate the anti-oxidant content of such materials. (If all this seems a bit dry, bear with me because the nature of assays for anti-oxidants is central to claims that supplements, foods, etc, contain a lot of them.)

When an analyst is faced with developing a chemical assay to find out how much of something is in a sample of fruit or vegetable, one approach is to find some reagents which when added to the sample react with the substance(s) in question and in so doing exhibit a measurable change in some property of the mixture, eg an increase in colour intensity. Hopefully the technique is sufficiently sensitive (will measure quantities that are of interest to the analyst), selective (ideally the reagents react only with the substance(s) in question) and quantitative (the properties of the mixture change in a regular way as the amount of substance changes). Many assays are quite selective; others only give an indication of the amount of a class of compound. The ORAC test is of this latter type.

There are dozens of molecules that can be classed as anti-oxidants and it would be a lengthy and expensive task to identify the compounds in a sample every time an estimate of the overall level of anti-oxidant activity was required. Tests like the ORAC assay are used to estimate overall activity in a sample, the amount of activity being expressed as ‘equivalent to’ an amount of a ‘standard’ anti-oxidant compound.

ORAC stands for Oxygen Radical Absorbance Capacity. The basic premise behind this assay is that the ability of a sample to neutralise free radicals indicates the presence of anti-oxidants. When exposed to light, a substance called fluorescein emits light of a longer wavelength than that shining on it; this ‘fluorescence’ can be measured using a fluorimeter. Fluorescein also has the useful property that its fluorescence is diminished in the presence of free radicals. We would have the basis of an assay if we mixed our sample with fluorescein and a source of free radicals and saw that the decrease in fluorescence was less than in the absence of the sample because of the protective effect of anti-oxidants. This wouldn’t get us very far as about all we could do would be to say that one sample had more or less anti-oxidant activity than another. The assay could be made more quantitative if we were able to compare estimates of activity from various samples with those obtained using a known standard anti-oxidant. A commonly used one is Trolox, a synthetic analogue of vitamin E.

So in the complete assay we would measure the fluorescence coming from a series of solutions containing increasing amounts of Trolox but constant amounts of fluorescein and free radicals. If we run everything correctly there will be a regular and positive relationship between the fluorescence emitted and the amount of Trolox present. We would also measure the fluorescence coming from solutions containing the free radicals and our extract of Goji berries (no Trolox), and calculate that a measured amount of Goji berries contained an anti-oxidant activity equivalent to that provided by a known amount of Trolox. Another way of looking at this is that we have estimated so many grams of berries as having the same ability as a certain amount of Trolox to protect fluorescein from oxidation by the free radicals.

Remember that the ORAC test only gives a measure of the ability of our extract to protect fluorescein from the action of free radicals in vitro (in vitro-in the test tube; in vivo-in the living body). It says nothing about the anti-oxidant activity of the extract once it has been ingested (in vivo). A high ORAC value simply tells us that the extract contains molecules that might have some anti-oxidant activity in vivo.

The principal value of an assay of this type lies in the ability to compare different samples of plants, foods etc according to a single property. The table below contains some ORAC values for anti-oxidant levels in some fruits and vegetables. These values have been taken from a larger set published by the United States Department of Agriculture (USDA, 2007).

The units of measurement are µmol Trolox Equivalents per 100 g fresh weight (FW) of fruit or vegetable. Fresh weight is the weight of the leaf, fruit etc as it is harvested with no adhering dirt, fully hydrated but with no surface drops of water. A mole (abbreviated as mol) is a measure of the amount of Trolox and 1 µmol of Trolox has a mass of 0.00025 g. So, if a vegetable has an ORAC value of 1000 TE per 100 g FW, then 100 g FW of the vegetable has the same ability, in the test-tube, to neutralise free radicals as 1000 µmol or 0.25 g of Trolox.

µmol TE / 100 g FW
Turmeric 119346
Curry powder 6665
Blueberries 6552
Apples, Granny Smith, raw with skin 3898
without skin 2573
Cashew nuts, raw 1948
Avocadoes, Hass 1933
Onions, raw 1034
Green peppers, raw 923
Bananas,raw 879
Carrots, raw 666
Cabbage,raw 508
Tomatoes, raw 367
…and Goji berries? It’s not easy to find a reputable ORAC value but it does seem to be considerably higher than most other plants tested.

Examples of anti-oxidants

What are these anti-oxidants of plant origin? Here are a few examples, with some comments as to whether they exert a beneficial effect in vivo.

Vitamin C or ascorbic acid: This is an essential nutrient, famous for its role in the prevention of scurvy. It is an anti-oxidant in vitro but it is uncertain as to whether it has any major effects as an anti-oxidant in vivo. Sufficient vitamin C to maintain health can be obtained from a diet including fruits and vegetables. With such a diet, there is no evidence of beneficial effects of supplementary doses.

(Scurvy is a deficiency disease of connective tissue. The role of vitamin C here is not that of an anti-oxidant but to ensure that enzymes involved in the synthesis of connective tissue function effectively.)

Vitamin E: Vitamin E was first defined as a fat-soluble ‘factor’ necessary for reproduction in rats. It is not a single compound, a number of substances having vitamin E activity. The principal ‘natural’ form is α-tocopherol. Mixtures of tocopherols are found, for example, in soybean, corn, walnut and rapeseed oils. The evidence for anti-oxidant effects in well-nourished humans is limited.

Carotenoids: These are orange and yellow pigments found in plants, most typically in carrots. ß-carotene is a common carotenoid. There is only weak evidence that they have an anti-oxidant role in vivo. (They do have an important role in the diet for other reasons, principally as a precursor for vitamin A.)

Polyphenols: Polyphenols are compounds that have groups of six carbon atoms linked together in rings. The rings have hydroxyl groups (-OH) attached to them. Polyphenols of plant origin are excellent anti-oxidants in vitro, but it does not follow that they have the same effect in vivo. This group contains the compounds found in blueberries and blackcurrants and some have become quite well known through discussion of their potential anti-oxidant properties, eg resveratrol from red wine, quercetin in teas and onions, and curcumin from turmeric.


There is evidence from epidemiological studies of correlations between anti-oxidant levels in the body and good health, and between good health and diets rich in fruit and vegetables. Correlations however do not prove causation and it remains uncertain whether the correlations observed are due to compounds exerting anti-oxidant effects in vivo. A further problem in interpreting epidemiological studies is that it is difficult to be accurate about the relationship between dietary intake and incidence of disease, particularly when studies seek to understand data gathered across different countries. Intervention studies

Intervention studies (where one group of subjects is provided with a supplement, and their health and physiological status is compared to a matched group receiving a placebo) might help us decide whether supplements are worth taking, but it has proved difficult to obtain evidence of a cause and effect relationship in these. Halliwell & Gutteridge (2007) describe the literature on intervention studies seeking to demonstrate a link between diet and supplementary anti-oxidants as a “morass of confusing data”.

Some clarity on the effects of supplements of some anti-oxidants (ß-carotene, vitamins A, C, E) and selenium has been given by a recent Cochrane review (Bjelakovic et al., 2008). This review considered 67 trials, involving 232,550 people, of the effects of taking supplements of these anti-oxidants. The principal conclusion from consideration of all this data was that overall, there is no evidence for an effect of these supplements on mortality in healthy people or those with various diseases. When the effects of different supplements were looked at separately, there was an increased risk (which only just reached statistical significance) of mortality associated with supplements of vitamins A, E and beta-carotene. There were no significant effects on mortality from vitamin C or selenium supplementation. (Selenium is an essential nutrient and is a component of several enzymes, some of which are thought to have anti-oxidant functions.)


What to do? If we take the epidemiological evidence as our guide, eating lots of fruit and vegetables is sensible advice. They have established beneficial effects, such as being enjoyable to eat, providing fibre and helping to maintain adequate levels of vitamins and minerals. The anti-oxidants they contain might exert a direct beneficial effect in vivo. At this point in our knowledge of dietary anti-oxidants and their effects in vivo, there seems little, if any, point in spending money on supplements of anti-oxidants.

Alan Hart spent over 30 years doing biology research. The last 15 were spent developing assays of various kinds. He has an interest in the meaning and practice of biological measurement.

*An excellent and readable account of the role of oxygen in our world, including a discussion of oxygen radicals and anti-oxidants, is Nick Lane, 2002: Oxygen, The molecule that made the world, Oxford University Press.

Natural products chemistry – the road from nature to pharmaceutical

Many pharmaceuticals originate from nature, but their development is very different from that of so-called natural health products. This article was originally presented at the 2005 Skeptics Conference.

The field of natural products chemistry deals with the scientific study of chemicals isolated from living organisms. This can be anything from isolating indigo dye from woad, distilling lavender oil from the lavender plant, working with plant oils and animal fats to make soap, to trying to find the active ingredient in a plant extract that reduces fever.

Interest in compounds from living organisms dates back to the beginnings of civilisation. More recently it also gave birth to what we now call ‘organic chemistry’. Initially, organic chemistry was natural products chemistry, when people thought that carbon containing molecules were imbued with a ‘vital force’ and could only be made by living organisms — hence the name ‘organic’. Friedrich Wöhler shattered that idea in 1828 when he became the first to make urea (an organic molecule) from inorganic precursors. Now we define organic chemistry simply as the chemistry of carbon containing compounds.

Unfortunately this mystical feeling that “natural” things are somehow better, or special, has survived till today, and many people are still convinced that “it’s natural, so it’s got to be good!” When dealing with natural substances that have biological activity, one must ask why they have any physiological effect. The answer is chemical defense: plants that do not have thorns, for example, have evolved chemical substances to poison animals that would otherwise eat them. The ‘natural’ effect of any herbal product then, is to make the user sick! We should not be talking about ‘natural is good’, but about chemical warfare.

Chemical warfare

The mould Penicillium notatum produces and secretes an antibiotic, a compound that inhibits bacteria that could compete with it for food or resources. This is chemical warfare on the microscale, a life and death battle for survival between the mould and its enemy. The mould certainly does not make the antibiotic for the benefit of mankind — any beneficial effect to us is an accidental advantage. But we can certainly make good use of that! The antibiotic in question is of course penicillin, the first discovered antibiotic. It has revolutionised medical treatment of bacterial infections and earned its discoverers Sir Alexander Fleming, Ernst Chain and Sir Howard Florey the 1945 Nobel Prize in Medicine.

We certainly exploit this type of biological activity to our great advantage. Natural products, or compounds derived from natural products, comprise the majority of pharmaceuticals in use today. So what is the difference between them and ‘herbal remedies’ that are sold in health shops and supermarkets?

The big difference is that herbal remedies are not tested. Not tested for efficacy (we don’t know whether or how they work), they are not tested for safety (we don’t know whether they are toxic or have side effects). They are not regulated in any way, so you don’t know what you are buying at all!

Drug development process

Before a natural product can be approved for use as a human pharmaceutical, it must go through a rigorous process of testing during clinical trials. And before it even enters those, it must be fully identified and characterised. This precise analysis is what makes the known and well understood pharmaceuticals stand apart from herbal remedies. For the most part, we know very little, if anything, about their chemical composition and effects.

Once the initial discovery process is complete, the natural product is subjected to a barrage of tests in vitro (in the test tube) and in vivo (in lab animals). Once biological activity and initial safety is demonstrated, the potential pharmaceutical can be admitted to the Phase I clinical trial. This involves a small group of healthy volunteers who are given the compound to determine its safety (that is, evaluate any toxicity and side effects) and tolerated dosage. Phase II trial follows, where the effectiveness of the compound at curing a disease is finally tested on a small number of human patients.

Finally, Phase III is a large scale trial on 1000 to 3000 patients, verifying effectiveness and monitoring any adverse effects from long term use. At the end, all the data are submitted to the monitoring agency (in the US this is the Food and Drug Administration) for evaluation. Once approval is given, the drug can be launched onto the market, where it still undergoes long-term safety monitoring and additional tests during the so-called Phase IV trial.

On average, out of 5000 compounds that undergo pre-clinical testing, only five are deemed promising enough to enter clinical trials. Out of those five, only one is approved — others fail because they do not show effectiveness once trialled in humans, or exhibit unacceptable levels of toxicity or side effects. From discovery to prescription, the whole process takes on average 12 years, with costs estimated to be in the hundreds of millions of US dollars.

While the process may not be perfect, it does attempt to ensure that the medication we are prescribed is first of all safe, and that it works. Herbal remedies cannot claim the same.

The Story of Taxol

In the 1960s the National Cancer Institute (NCI) launched a screening programme to test various plants for potential anti-cancer activity. Over the next two decades they screened more than 114,000 plant extracts. This included, in 1962, a collection of bark from the Pacific Yew, Taxus brevifolia. Immediately, this shrub generated great excitement as it showed interesting activity in biological assays. A research project was launched to investigate these properties, and in 1967 the active ingredient was isolated and named paclitaxel. The structure was not solved until four years later in 1971, a reflection of its high degree of complexity. Paclitaxel exhibited a broad spectrum of activity against cancer cells in vitro, and in 1979 scientists discovered its mode of action in the cell — a completely novel way of stopping and killing cancerous cells. In vivo testing showed phenomenal successes — paclitaxel stopped the growth and even shriveled breast cancer tumours in mice. All of these results made paclitaxel the hottest natural product around. Everyone wanted to get their hands on some, but paclitaxel had many hurdles yet to overcome.

Researchers rushed the compound into clinical trials, but immediately faced a problem. Paclitaxel was not soluble in anything. As one researcher put it, “it had the solubility of a brick.” How were they going to administer it to patients? Finally a concoction consisting mainly of castor oil was found to be effective, but was almost the drug’s undoing. Paclitaxel proceeded to clinical trials, and was almost rejected right then and there, as it showed unacceptable levels of side-effects. Fortunately, someone figured out that most of these were due to the castor oil, and after the formulation was changed somewhat, the drug continued to Phase II clinical trials.

The results were astonishing: against the most virulent forms of ovarian cancer, paclitaxel showed unheard of levels of response. Doctors and researchers were suddenly clamouring for more and more of the drug. But Taxol faced its greatest challenge yet: that of supply.

The compound paclitaxel is present in only minute amounts in the bark of Taxus brevifolia. Fifteen kilograms of the bark yield barely half a gram of the active compound, which means it would take six 100-year-old trees to treat one patient. Quite aside from the ecological impact of the large scale logging operation required, there simply are not enough Pacific Yew trees in the world to treat all the cancer patients.

Making the compound in the lab was not an option. Though a successful synthesis of paclitaxel was reported in the literature, the molecule was too complex for this to be a viable route to obtaining large quantities. Fortunately however, researchers discovered that the much more common English Yew (Taxus baccata) contained relatively large quantities of a compound that is related to paclitaxel. Eventually in 1989 they succeeded in transforming this 10-deacetylbaccatin into paclitaxel. This semi-synthetic pathway is how Taxol is made even today.

The billion dollar wonder molecule

Having successfully completed clinical trials, paclitaxel was launched onto the market in 1993 under the trade name Taxol as a drug to treat ovarian cancer. Sales of Taxol grew exponentially, rapidly reaching and passing the US$1 billion mark. Today, Taxol remains the leading treatment against ovarian, breast and lung cancers, and Karposi’s sarcoma. Yet it had not been an easy journey: from bark to drug it took 31 years, and with an estimated cost in excess of US $300 million.

Victoria University Marine Chemistry Lab

Most of the natural products that have “made it” as pharmaceuticals come from the terrestrial environment, not surprisingly, as terrestrial plants, animals and fungi are most easily accessible to researchers. In the last few decades however, with the advent of scuba diving, a whole new world has opened up: the marine environment. The Marine Chemistry Lab at Victoria University studies chemical compounds found in marine plants and animals. We examine a wide variety of organisms, including sponges, seaweeds, sea-slugs and others. Our ultimate goal is to discover new, biologically active chemicals from marine organisms and develop them into pharmaceuticals.

Discovery of peloruside

In 1998, Lyndon West (who was at that time doing his PhD in our lab), discovered a new compound from the sponge Mycale hetsheli. He named it peloruside, after Pelorus Sound where the sponge came from. The compound looked very interesting right from the start, so patents were filed right away, and biological testing initiated. Indeed, exhaustive in vitro tests revealed that peloruside had the same mode of action as Taxol! This news generated a lot of interest, and in 2004 a deal was signed with Reata, a US Pharmaceutical company. Their tests in mice showed very promising results: injections of peloruside into grafted tumours radically reduced their growth. With exciting results like that, everyone is now keen to start clinical trials.

Unfortunately, we face a supply problem even worse than the Taxol people did: the compound is once again present in only small amounts in the sponge. In addition, sponge populations are scarce in the wild, and difficult to reach. They also show a large variability in the amounts of peloruside they produce, depending on depth, season, geographical location and even individual animal.


But, we have a solution: aquaculture! Fortunately for the project, the sponge can be propagated from small cuttings. We have taken bits of wild sponges and tied them to ropes that have been suspended off the anchor lines of a mussel farm in the Marlborough Sounds. The sponge has grown well — our sponge farm yielded almost 100 kilograms of the sponge in 2005. Some of this mass was returned to the ropes to grow again for this year, the rest has been harvested and is now being processed in our lab. We hope to get gram amounts of peloruside and hopefully start clinical trials with Reata Pharmaceuticals in the US this year.

Could peloruside be the next wonder drug against cancer? Well, it has a long way to go yet. But it certainly shows promise, so watch this space.

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


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

Chinese herbal specialists treat Hong Kong Sars patients

Traditional Chinese medical practitioners have given herbal remedies to Hong Kong Sars patients along with Western drugs, and public hospital officials said more patients might get similar treatment despite uncertainties about whether it helps.

The experts from mainland China visited 23 patients, and while two refused to take the herbs in conjunction with Western antiviral drugs and steroids, 21 received a combination of the two treatments.

Five of the patients have now been discharged and one died — numbers that are in line with Hong Kong’s broader experience with severe acute respiratory syndrome (Sars). So far, 1213 people have recovered from Sars in Hong Kong but 251 have died.

Professor Lin Lin and Professor Yang Zhimin, both from the Guangdong Provincial Hospital of Traditional Chinese Medicine, said the herbal treatments can work, although the rest of the patients are still hospitalised.

Western experts say there is no scientific proof that traditional remedies are effective and remain sceptical about any benefits. Meeting with local journalists, Lin and Yang declined to say which herbs they gave to the Sars patients.

Hong Kong’s hospital authority invited the herbalists to assist in the fight against Sars — the first time that public hospitals there have allowed traditional medicines to be part of their official treatment. Herbs have been used previously on a voluntary basis for some patients or in research by universities.

An executive manager of professional services at the Hospital Authority, Dr Choy Khai-meng, declined to say whether the herbs were helping anybody. But he said the mainland experts have been asked to stay for another three months so officials can learn more.

Some of the patients who received the combination Chinese-Western treatment did better, Choy said, but there is no evidence to explain why.

“I think we are not making any comment that it is Chinese medicine or Western medicine that has led to this result,” he said.

The Price of Water

Insecurities about water quality have led to a boom in sales of bottled water. But the health benefits of the phenomenon are probably minimal.

We were surprised to hear recently that sales of drinking water are now the fifth largest earner of overseas currency for Fiji. A little investigation suggested that that figure may well be correct, but threw up further surprises.

Much of Fiji has high rainfall, but water is in short supply in some areas. Villagers can easily dig shallow wells, and Aid agencies have dug deep wells for some villages. But deep water is often mineralised. We have stayed on islands were rain is the only supply of drinking water. As populations have grown, water extraction has allowed intrusion of salt water, and the well water is brackish. After weeks of washing in brackish water, a fresh shower is a great luxury. Tourist resorts build de-salination plants but that is not an option for villagers.

According to the Australian Financial Review, Aid money was used to develop a mountain spring as a source of export water. The main market is the USA where Fiji water is now the 6th highest-selling bottled water after advertising endorsements from Tiger Woods and Elle Macpherson. Good luck to the entrepreneurs, but I wonder if the contributors realised the destination of their charitable dollars.

Something is odd about a third world country exporting drinking water to the USA. Fifty years ago American travellers had one main grumble about Europe; the tap water was unsafe to drink. This implied that the tap water was drinkable back home where the only people refusing US tap water were right-wing conspiracy theorists who claimed that somebody (either the government or the commies) were adding chemicals to damage the mental health of citizens.

Bottled water was then almost entirely ‘mineral water’, either naturally carbonated water from a few famous springs or the much cheaper alternative invented by Schweppes. Scandals about contamination of some famous springs damaged the market, but some genius discovered that bottled drinking water did not need to be carbonated and any source of clean water would do.

Until that time the manufacturers of soft drinks were regarded as the epitome of value improvers; the addition of carbon dioxide and a few drops of syrup converted water at low cost to a marketable product. But the drinking water industry changed this perception. All the costs are in bottling and transport, the cost of the water in the bottle is as near zero as makes no difference.

The industry started in the USA but then took Europe by storm, 15 years ago British sales of bottled water had reached £216 million and London restaurants were charging £1 per glass. It took longer to reach Australia and NZ but the sight of all those tourists clutching their bottles had an effect.

Have a look in your local supermarket, there are a variety of brands and unless you buy it in very large containers it is more expensive than petrol. Marketing has been closely targeted, using magazines and radio stations rather than TV. The sales people know their main clientele, young, affluent travellers.

By a strange bit of timing the tap water in Europe had become safe to drink just before bottled water became popular. In fact one of the priorities of government has been the provision of safe tap water (it is even safe to drink on the main Fiji island), but as it became safe, tourists stopped drinking it.

So what is the motive? At least partly it is fashion, backpackers have been seen furtively refilling their bottles at the tap so later they can be seen with the right brand. But most clearly believe it is healthier to drink ‘natural spring water’. Some brands will tell you they are ‘fat free’! Ironically the quality standards on most tap water is probably higher than those on much bottled water. But backpackers are all aware of the high incidence of ‘traveller’s diarrhoea’, one estimate is 20 million cases per year world-wide, though it could be much higher.

Herbert DuPont is Chief of Internal Medicine at St Luke’s Episcopal Hospital Houston Texas and an expert in diseases of the alimentary tract. His opinion is that although “Most people think it (diarrhoea) is caused by the water”, it is not. “Bad food is responsible for 90% of traveller’s diarrhoea.”

Even in the USA, eating out is twice as dangerous as eating at home. Scientific American July 2000 contained some amazing statistics. A large percentage of outbreaks of food poisoning could not be traced to a particular source, however of those that could be so traced, the most dangerous foods were not those I would have suspected:

Food that caused a problem % of outbreaks
Salads 12.4
Fruit and vegetables 6.0
Beef 2.3
Chicken 2.1
Fish (including shellfish) 1.3
Milk and eggs 1.0
Pork 0.4

Vegetarians beware; the most dangerous items are those generally considered the most healthy! However going back to Professor DuPont, he warned that the really dangerous items were sauces and condiments, particularly if they were not properly refrigerated. I suspect (without any evidence) that this may be the case here.

It seems obvious that these percentages would be quite different in other countries, but if you cannot trust the salads in the USA, those bought from street vendors in Asia must be pretty dodgy.

In the past, epidemics of the great water-born diseases, typhoid and cholera, killed millions- and they were a threat to the traveller. But in countries were most of the bottled water is being drunk, this is no longer the case. The last major outbreak of cholera from a public water supply was in a South American country where activists had opposed chlorination. Chlorine of course is a chemical, and a poison, and they should not be putting it in our drinking water! I suspect that if travellers were questioned, many would give ‘chlorination’ as a reason for not drinking tap water. I just wonder, how safe is bottled water?

Hokum Locum

Another Alternative to Evidence Based Medicine

Vehemence based medicine: The substitution of volume for evidence is an effective technique for brow-beating your more timorous colleagues and for convincing relatives of your ability. New Zealand Medical Journal Vol 113 No 1122 p479


This pseudoscience is now being advertised on television. In the same way that acupuncture can be easily learned during a one-hour lecture, anyone can learn how to make the spine go “click”. Many lay people have discovered this for themselves. Four or more years of training are unnecessary when a modality has no scientific basis. You only need to learn how to produce a pleasing noise from the spine without harming the patient. Osteopaths extend this effect to include the joints. If you pull firmly on your fingers you get the same effect, often a dramatic crack. Various theories have been proposed for this such as air bubbles, but I have noticed that large joints frequently produce all sorts of noises when they are being examined. When the neck is forcibly manipulated in this way there is a real risk of serious injury to major arteries in the neck. The shearing forces cause a tear in the arterial wall (a “dissection”) and this interruption to the blood supply to the brain can cause a stroke. If you have a sore neck and simply wait for it to get better you are not exposed to this risk. I used to do a lot of spinal manipulation but gave it up because patients started coming back all the time to have their spine “put back in”. I had unwittingly stumbled upon the secret of chiropractic! This became very tiresome and I stopped the practice after giving myself a nasty fright when a patient fainted and I thought I had killed her. Chiropractors talk about “adjustments” and this is the source of their income – adjustments to their bank accounts. Once the patient is convinced of the need for frequent adjustments, the chiropractor has a regular patient for life. For a detailed view of the pseudoscience of chiropractic visit

For a review of serious adverse effects of chiropractic refer Ernst E. Medical Journal of Australia 2002; 176: 376-380

Good Health

I have forwarded a copy of this publication to the editor. It is an advertising supplement for alternative medicine. Good Health employs a resident naturopath, Lani Lopez, complete with a Kentucky fried medicine qualification – N.D. Dip J. Herb. We learn that Mandy Smith owes everything to a diet rich in pond scum (spirulina aka blue/green algae). Auckland-based readers will be delighted to know that NZQA loans and allowances are available if they wish to obtain such qualifications from Wellpark College of Natural Therapies. Refer, although their website was down when I visited. I was particularly taken with an article on joints with metaphors such as “creaking hinges and rusty joints.” My left knee has osteoarthritis and I learned that “essential oils, Clove, Frankincense, and Cajuput oil penetrate deeply into swollen areas and support normal joint articulation.” The only problem with that claim is that human skin is actually impervious to such treatments as it is a very effective barrier. However, I had a biomechanical brainwave. Why not insert grease nipples over troublesome joints and use a modified grease gun to pump the “two main natural ingredients Glucosamine and Chondroitin” directly into the joint? The next time I take the car for an oil change and grease I’ll have my knee done as well, and if that fails there’s always…

Doctor Levine’s Patented Power Knee Strap

There must be plenty of money in this product as it has recently featured in several half-page advertisements. It is claimed the strap provides relief from arthritis and chronic knee pain. The strap costs $24.95 and is designed to sit just beneath the kneecap. Dr Levine is described as a “nationally famous physician and former head of orthopaedic surgery at one of New York’s leading hospitals.” I decided to check these claims and the website of the American Medical Association ( had a search engine by doctor’s name. This confirmed the existence of Dr Jack Levine. The website also had a statement of the ethical standards for the AMA members and it appears that this advertising is a breach of Article 2. I emailed the AMA pointing this out and will report back, assuming they bother to reply. The strap is obviously a placebo. It might work if it was tightly placed around the upper thigh where it could cut off the circulation, compress the nerves and produce a pleasing numbness – a sensation that frequently comes over me when I am confronted with American consumerism.

Slimming the easy way

A 44-year-old woman was referred to hospital with anxiety symptoms, weight loss and hypertension after taking a Chinese herbal remedy for weight loss. Her doctor was obviously suspicious about the composition of this preparation because it had actually worked. These preparations are normally useless. The initial suspicion was that the herbal remedy contained ephedrine (“Ma Huang”), which is a dangerous but commonly used preparation. Gas chromatography revealed, however, that the herbal preparation was adulterated with fenfluramine, a potent and dangerous amphetamine derivative. One can only agree with the author of the report: “stringent regulation of traditional medicines, at least to the standards of conventional practice, is urgently needed”. British Medical Journal Vol 324 16 March 2002 p679

Recovered Memory

This contemptible pseudo-science is still blighting lives all around the world despite being condemned by most authoritative Psychiatric Colleges. Psychologists at the University of Otago have found that children can only explain early childhood events using the language they knew at the time. The researchers are quoted: “If you take our data to their logical conclusion, then one implication would be that we need to express scepticism about very early verbal memories that are recovered during the course of therapy”.

The merciless badgering of self-deluded therapists is a process very similar to “facilitated communication”. This is where the “facilitator” guides a handicapped person’s fingers on a keyboard to produce written communication, which the person is incapable of when unaided. This is of course a complete delusion and we have experimental psychologists to thank for exposing this nonsense which should not be either encouraged nor funded by ACC.

Article Published in US Psychological Science-reported in Sunday Star Times 28 Jul 2002

Hokum Locum

The Women’s Weekly and Other Medical Journals

Dr John Welch goes eyeball to eyeball with the iridologists, and takes a look at some famous faces

Chiropractic Treatment of Infertility

During idle moments I read medical journals such as the Australian Women’s Weekly. In this case the issue was March 1999 and I really must speak to the Librarian about the disgracefully outdated journals currently held by the medical library.

Following extensive investigations for infertility, our reporter consulted Dr Naomi Perry, an Adelaide chiropractor, who “was doing revolutionary work treating women with infertility by manipulating their spines.” The chiropractor discovered that “Concepta” (not her real name) had a spinal curvature (scoliosis). This is hardly surprising since chiropractors diagnose this disorder in 100% of their patients, it being a central tenet of the chiropractic theory of subluxations. After four months of manipulation a pregnancy was confirmed. If the writer had stood on her head for two hours every night , a pregnancy would have eventually occurred since this event is a function of time for most couples.

Gypsies have the greatest success in predicting pregnancy. This is because they have crystal balls and can see it coming.

The White Stuff?

I was disappointed to miss the International Iridiology & Sclerology Conference held recently in Auckland. Iridologists have now discovered new secrets of divination using the sclera (white of the eye). This immediately reminded me of Ken Ring’s demonstration of “reading” elbows, knees or any part of the body for that matter. As far as iridology is concerned it doesn’t matter whether the iris, sclera, eyelid or the nostril are “examined”. Given a gullible customer, iridologists can spout any old rubbish and they will be believed. Nevertheless, there were some inspirational papers: “Pupillary ruff phenomena in the iris” presented by a senior iridology lecturer at the South Pacific College of Natural Therapies, and “Emotional resistance patterns in the sclera” by a US visitor whose qualifications included a ND (doctor of naturopathy) and a PhD from the University of Wakula Springs, the same one attended by Tarzan. The rather alarming claim is made that “it (iridology) is poised to become mainstream within this decade in many countries like NZ”.

Given the composition of the Health Minister’s committee on alternative medicine, this is a distinct and unwelcome possibility.

Health Secrets of Your Face

Each of the five elements which form the basis of acupuncture-earth, fire, water, wood and metal-have a corresponding face shape which tells the analyst about a person’s talents, personality and potential health problems. Kate Winslet sought the help of a facial analyst when she needed to shed 25 kg of weight gained during her pregnancy. For her “wood” face she was told to “prune” back on sugar, wheat and dairy products. The diet worked so well she not only shed some ugly fat but got rid of her husband…

The face is viewed as a map with different areas representing parts of the body. For example, the forehead represents the bladder and the area between the eyes relates to the spleen and gall bladder. Never be tempted therefore, to squeeze any pimples in this area!

Catherine Zeta-Jones has a “metal-type” face that doubtless describes her attraction to Michael Douglas who is certainly “well-metalled”.

New Zealand Woman’s Weekly 15 October 2001

US cancer institute funds trials of complementary therapy

The Gonzalez regime is a program of dietary modification, supplements and “detoxification” using coffee enemas. The supplements include animal glandular extracts, vitamins, trace minerals, papaya and magnesium citrate. Gonzalez has based his treatment on pseudoscience and anecdotal evidence of success has seen US$1.4 million dollars wasted on a formal clinical trial. I predict that the treatment will be a complete failure but this will not deter Dr Gonzalez from continuing to promote this worthless treatment. Neither will this deter gullible individuals from wasting money on this fraud. Rectal coffee could well be dangerous as the following account will demonstrate.

British Medical Journal Vol 320 24 June 2001 p1690

Fatal heart attack from a health food product

A woman collapsed and died soon after drinking a “natural” health drink containing guarana and ginseng. She had a faulty heart valve as well as a history of palpitations and had been warned to avoid caffeine, which is a heart stimulant. Her blood caffeine level was 19mg/L, the equivalent of drinking about 20 cups of coffee. The caffeine concentration in the drink was 60 times greater than levels found in cola drinks. Guarana seeds contain about 5 percent caffeine.

Medical Journal of Australia 174:520-1, 21 May 2001

Dangerous Chinese Medicines

Traditional Chinese medicines are basically placebos and when they do seem to work it is largely due to the illegal insertion of potent western medicines such as steroids. They can also contain mercury and arsenic, as well as toxic herbs and even banned animal species.

An Indonesian man was brought to a Hospital emergency department and was found to be confused due to a low blood sugar. After an injection of glucose he recovered and was able to tell his medical attendants that he was taking a Chinese remedy called “Zhen Qi”. The label on the bottle listed the ingredients as ginseng, pearl, ram’s horn, bark and “frog extract”. Gas chromatography revealed that the mixture also contained glibenclamide, a potent oral hypoglycaemic agent used for treating diabetes!

For once I join with naturopaths, homeopaths and alternative health practitioners everywhere, in condemning this cynical attempt to make sure harmless and ineffective quack remedies actually work by the inclusion of dangerous but effective drugs.

British Medical Journal Vol 323 6 Oct 2001 p702, p770