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Healing But Not Curing

Last week I discussed the book Healing, Hype, or Harm? edited by Edzard Ernst. I was particularly struck by one of the essays in that book: “Healing but not Curing” by Bruce Charlton, MD, a reader in evolutionary psychiatry at the Department of Psychology of the University of Newcastle upon Tyne.

Charlton proposes a new way of looking at CAM. He describes three common attitudes:

  •  CAM does good and should be integrated with orthodox medicine. 
  • CAM is worthless and should be discarded.
  •  CAM may or may not do good and this should be decided using science.

He rejects all three. In his view,

  •  Alternative therapies do good.
  •  From a strictly medical perspective they are worthless.
  •  They should not be integrated with orthodox medicine.
  •  Because they are explained non-scientifically, they cannot be evaluated using the criteria of medical science.

He suggests that alternative therapies be regarded as spiritual practices. They are about making people feel better (‘healing’) not about mending their dysfunctional brains and bodies (‘curing’). (more…)

Posted in: Science and Medicine

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Edzard Ernst Does It Again

Publishing one excellent book is an accomplishment; publishing two in one year is a truly outstanding achievement. In 2008 Edzard Ernst and Simon Singh published a landmark book Trick or Treatment: The Undeniable Facts About Alternative Medicine. I reviewed it on this blog last summer.  It is particularly important since Ernst is a former advocate for CAM (complementary and alternative medicine) who was able to objectively look at the scientific evidence and realize that it doesn’t support most CAM methods.

Before the year was out, Ernst had published another book, Healing, Hype or Harm? A Critical Analysis of Complementary or Alternative Medicine. It is a compilation of essays on various general and specific topics in CAM. Ernst is the editor; he and 15 other authors have contributed, mostly from the UK but also including Asbjorn Hrobjartsson from the Nordic Cochrane Centre in Denmark (the author of a landmark paper on placebos), Canadian health activist Terry Polevoy, and our own inimitable James (The Amaz!ng) Randi.

In the preface, Ernst says,

Our book tries to look behind the various smoke screens that tend to obstruct our vision and often prevent us from understanding the truth. The authors of this volume have very different backgrounds and views but they are all well-informed critics who do not dismiss CAM lightly. If they disapprove of certain aspects, they do so for well-argued reasons. (more…)

Posted in: Book & movie reviews, Science and Medicine

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Chiropractic’s Pathetic Response to Stroke Concerns

The chiropractic industry must be feeling the pressure. Billboards, signs on the sides of buses, chiropractic victims’ organizations, and lawsuits are telling the world that chiropractic neck adjustments can cause strokes. The risk is very small, but it is very real. We have addressed the subject before on this blog here, here, and here.

Chiropractors are in denial and are trying to shift the blame elsewhere. A correspondent sent me copies of a pamphlet and a “distribution kit” that the FCER (Foundation for Chiropractic Education and Research) is selling to chiropractors so they can inform the public about cervical artery dissection (CAD). It is advertised as a campaign to help the public recognize warning signs of stroke; but in my opinion, it amounts to a cynical, self-serving ploy to divert attention away from neck manipulation and to spread biased information about the recent study in Spine by Cassidy et al. (more…)

Posted in: Chiropractic

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Amish Home Burn Treatment: B&W Salve and Burdock Leaves

People in the Amish community have been using “The New Concept in Treating Burns” and their experience is recounted in a little booklet by that title. It is a compilation of articles, testimonials, and letters to the editor of a monthly newspaper Plain Interests, published in Millersburg PA.

The treatment, involving B&W ointment and dressings of scalded burdock leaves, was developed by John Keim, an Amish farmer and natural healer. The Amish have a tradition of taking care of their own, and they try to avoid hospitals whenever possible. In the booklet, they even recommend treating hip fractures at home without surgery. (Which, after all, is what we did before we had hospitals and surgery).

They claim that with the B&W burn treatment:

  • Painful burns are rendered non-painful.
  • Healing is faster.
  • Painful debridement is not necessary.
  • Skin grafting is not necessary.
  • Scarring seldom occurs.
  • Iatrogenic harm from hospitals is avoided.
  • Patients can be treated at home at much less expense. (more…)

Posted in: Herbs & Supplements

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Psychiatry-Bashing

Psychiatry is arguably the least science-based of the medical specialties. Because of that, it comes in for a lot of criticism. Much of the criticism is justified, but some critics make the mistake of dismissing even the possibility that psychiatry could be scientific. They throw the baby out with the bathwater. I agree that psychiatry has a lot of very dirty bathwater, but there is also a very healthy baby in there that should be kept, cherished, nourished, and helped to grow – scientifically.

Common criticisms in the media

  • We are over-medicating our children, producing a generation of drugged zombies.
  • We are using medication indiscriminately for people who don’t fit the diagnosis (i.e. antidepressants for people who only have normal mood fluctuations and life problems).
  • Antidepressants lead to violence and suicide.
  • Psychotropic medications all have terrible side effects.
  • Antidepressants are no better than placebo.
  • Psychotherapies are no better than talking to a friend.
  • Electroconvulsive therapy (ECT) is a barbaric, damaging assault with no redeeming value.
  • And we all remember how Tom Cruise attacked Brooke Shields on the issue of postpartum depression.

Thomas Szasz: Mental Illness is a Myth

Thomas Szasz goes even further: he rejects the whole concept of mental illness and considers it a plot to interfere with people’s human rights. He says:

  • Psychiatric diagnoses are not valid because they are based on symptoms rather than on objective tests. (Steve Novella has pointed out that there are other well-established diagnoses like migraine that cannot be verified by any objective tests.)
  • Mental illness is a myth: unusual behavior does not constitute a disease.
  • Psychiatric diagnoses are an arbitrary construct of society to facilitate control of individuals whose behavior does not conform.
  • Involuntary commitment is never justified even for the protection of the patient: patients always have the right to refuse treatment even if that means they will die. (more…)

Posted in: Neuroscience/Mental Health, Science and Medicine, Science and the Media

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Science-based Longevity Medicine

Much nonsense has been written in the guise of longevity medicine. In Fantastic Voyage, Ray Kurzweil explains why he takes 250 pills every day and spends one day a week at a clinic getting IV vitamins, chelation, and acupuncture. He is convinced this regimen will keep him alive long enough for science to figure out how to keep him alive forever. In Healthy Aging, Andrew Weil chips in with his own mixture of science and magic. I pointed out the flaws in their reasoning in a review for Skeptic magazine – available online. There are many other popular books that promise to tell you how to live longer. Most of them amount to little more than speculation based on extrapolations from animal studies, in vitro studies, and odd non-clinical facts.

There simply is no evidence that any intervention will extend the human life span. The most promising idea from animal studies, severe calorie restriction, is not practical or palatable and would make adequate nutrition difficult. We don’t know how to prolong human life to, say, 130 years; but we do know how to prevent a number of diseases from causing premature demise at 60 or 70. That’s what real “longevity medicine” means.

To counteract all the belief-based and speculation-based “longevity medicine,” we needed a science-based longevity book. And now we have it. Carl Bartecchi, MD and Robert W. Schrier, MD have written a book entitled Living Healthier and Longer – What Works, What Doesn’t. The price is right – it is available online for free download. (more…)

Posted in: Book & movie reviews, Science and Medicine

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Playing by the Rules

I recently read Flock of Dodos (no relation to the movie of the same name). It’s a hilarious no-holds-barred send-up of the lies and poor reasoning of the intelligent design movement. I was particularly struck by a quotation from William Dembski’s Intelligent Design.

We are dealing here with something more than a straightforward determination of scientific facts or confirmation of scientific theories. Rather we are dealing with competing world-views and incompatible metaphysical systems.

That cuts to the essence of what we are confronting on Science-Based Medicine. We are trying to evaluate the science behind claims that are often not based on science but on beliefs that are incompatible with science. The claimants are happy to use science when it supports them, but when it doesn’t they are likely to unfairly critique the science or even to dismiss the entire scientific enterprise as a “materialistic world view” or “closed-minded.” We are talking at cross purposes. How can we communicate if we say “this variety of apple is red” and they insist “it feels green to me”?

We get frustrated when we show these folks the scientific evidence and they refuse to accept it. Homeopathy is not only implausible, but it has been tested and has failed the tests. Yet proponents refuse to acknowledge those failures and still want to talk about data from the 19th century and make claims for the memory of water. We have to realize we are not even speaking the same language. We are trying to play a civilized game of gin rummy and they are dribbling a basketball all over the card table. Before getting into a debate, doesn’t it make sense to define what game you’re playing and what the rules are?

Science has been a very successful self-correcting group endeavor. It wouldn’t be successful if it didn’t follow a strict set of rules designed to avoid errors. [Note: there are no rules written in stone; I’m talking about conventions that are generally understood and accepted by scientists, conventions that grow naturally out of reason and critical thinking.] If proponents of alternative medicine want to play the science game, they ought to play by the rules. If they won’t play by the rules, they effectively take themselves out of the scientific arena and into the metaphysical arena. In that case, it is useless for us to talk to them about science.
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Posted in: Science and Medicine

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South Dakota’s Abortion Script: The Hijacking of Informed Consent

In a previous post, I suggested that informed consent could sometimes be misused. South Dakota has provided a clear example of such misuse and has set a frightening precedent reminiscent of Big Brother in George Orwell’s 1984.

A law went into effect in July, 2008, requiring that any woman seeking an abortion in South Dakota must be told that she is terminating the life of “a whole, separate, unique, living human being” with whom she has an “existing relationship” and that abortion terminates “her existing constitutional rights with regards to that relationship.”

It requires that doctors give patients information about medical risks, but it doesn’t leave anything to chance: it specifies what the risks are, including depression, suicide, danger to subsequent pregnancies, and death. The current state of development of the fetus must be described, and the woman must be asked if she wants to see a sonogram of the fetus. All of this must be done in writing, and the woman must sign each page of documentation. Physicians who fail to comply can lose their license or be charged with a misdemeanor. (more…)

Posted in: Politics and Regulation, Surgical Procedures

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The $150,000 Vaccine Challenge

At the request of a correspondent from the Quackwatch Healthfraud discussion list, I recently got embroiled in a debate with a couple of anti-vaccinationists in the pages of an Amish community newspaper, Plain Interests, published in Millersburg PA. They followed the usual pattern: they told the same old lies, they told partial truths distorted out of all recognition, and they omitted all those other truths that contradict their beliefs. Then they both challenged me to take all the recommended baby vaccines adjusted for weight to “demonstrate that vaccines are safe and effective.” If I refuse to do this, they say it will show that vaccinators are dishonest and that I’m afraid of my own medicine. They said I could win $150,000 by taking the challenge.

I did a little investigating. There is indeed a published challenge by Jock Doubleday, although the exact amount of money currently offered is unclear. His challenge reads:

The offer will continued to increase $5,000 per month, in perpetuity, until an M.D. or pharmaceutical company CEO, or any of the 14 relevant members of the ACIP (see below), agrees to drink a body-weight calibrated dose of the poisonous vaccine additives that M.D.s routinely inject into children in the name of health. The mixture will include, but will not be limited to, the following ingredients: thimerosal (a mercury derivative), ethylene glycol (antifreeze), phenol (a disinfectant dye), benzethonium chloride (a disinfectant), formaldehyde (a preservative and disinfectant), and aluminum.

According to Ratbags, this offer is bogus. (more…)

Posted in: Public Health, Vaccines

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Santa Visits the Hospital

Since Val has broken the ice, I thought I would offer some more Christmas humor. The following is a Narrative Summary (a report of a hospitalization) that was circulated at the Plattsburgh Air Force hospital where I worked in 1986. I published it in my memoirs, Women Aren’t Supposed to Fly. Unfortunately I don’t know who wrote it, so I can’t give credit where credit is due.

Kringle, K. AD/Arctic AF 0-7 000-00-0000
D & T: ELF
USAF Hospital Plattsburgh, Plattsburgh AFB, NY 12903
Register number: classified.
Date of admission: 24 December 1986
Date of discharge: AMA 0100 25 December 1986

CHIEF COMPLAINT: Frostbitten tallywhacker.
HISTORY OF THE PRESENT ILLNESS: The patient is a three hundred and eight year old supernatural being employed as a stealth sleigh driver, powered by reindeer, who comes in on Christmas Eve stating that he was coming over the northern part of the Yukon Territory and, unfortunately, the fly of his pants came open, and his member was exposed to some rather cold air flowing by at rather high velocity. Unfortunately, he did not notice right at first and attempted to slide down a chimney at which point, he then scraped his member on the edge of the bricks. He now comes in appearing quite uncomfortable, and complaining of pain in his genital area. He also noted some mild abdominal discomfort, and admits to drinking large amounts of ethylene glycol earlier this evening, prior to his trip. The patient is rather vague about his trip but indicates that he really needs to be on his way, and really just wants something for his pain.
PAST AND FAMILY HISTORY: The patient gives a remarkable lack of much past history despite his age. He notes that about this time every year he does get rather anxious and occasionally requires some sedatives to calm him down. He also has occasional bouts with hemorrhoids, and was recently seen at this hospital for the same complaint while on a supply run. Family history is rather unremarkable, in fact, he doesn’t recall that he has any family other than his wife, twenty-two elves, and eight reindeer – one who seems to be constantly bothered by a red and runny nose. He is employed as a sleigh driver for the Arctic Air Force, but fails to reveal much other detail, saying he is on a “Super-Duper Top Clearance Mission.” He does claim to have recently recharged his batteries. Apparently, by that he means he had a nuclear-powered penile implant because he said even at 308 years old he still does enjoy his sexual activity, and that he just wasn’t quite as potent as he used to be.
PHYSICAL EXAMINATION: The patient has a blood pressure of 168/90. Pulse is 72, and regular. Respiratory rate is 18. He is afebrile. The patient is a rather old, jolly fellow. He is dressed in fur from his head to his foot and his clothes are all tarnished with ashes and soot. His eyes have a twinkle, his dimples how merry. His cheeks are like roses, his nose like a cherry. The stump of a pipe he clenches in his teeth, and the smoke encircles his head like a wreath. He is rather short, and has a little round belly that shakes when he laughs like a bowl full of jelly. The rest of the examination is remarkable for a rather large member. It appears to have some external abrasions, and some very mild frostbite at the tip. An eerie glow seems to emanate from his left femoral region, this is apparently his nuclear-powered implant.
LABORATORY DATA: Is remarkable for an ethylene glycol level of 38.
DIAGNOSIS: 1. Frostbitten penis secondary to exposure with some external abrasions.
  2. Ethylene glycol intoxication.
  3. Obesity, and mild gastritis secondary to number 2 and to excessive intake of snacks tonight.
COURSE IN THE HOSPITAL: The patient was admitted to the Internal Medicine Service. Surgical consultation with Dr. Costanzo was obtained, who debrided some frostbitten area. Right after this, the patient became quite agitated and signed out against medical advice (AMA) stating that he had a trip which he must complete tonight.
DISPOSITION: The patient was advised to keep his member covered for the remainder of the trip, and that we will look forward to seeing him again next year.

Signature of Physician: William Osler, M.D.

Merry Christmas to All!

Posted in: Humor, Science and Medicine

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