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The Mythology of Larry Dossey

A “Double Standard”?

Last week I had planned to write a comprehensive critique of a recent comment by Larry Dossey. He had posted it on Val Jones’s betterhealth website in response to Dr. Val’s essay, “The Decade’s Top 5 Threats To Science In Medicine,” originally posted here on SBM. Much of what Dr. Val had identified as the top threats involved recent dalliances, by government, medical schools, and the media, with the collection of implausible and mostly nonsensical health claims that advocates have dubbed “CAM.” As uncontroversial as Dr. Val’s assertions ought to have been—similar to suggesting that closing one’s eyes and “using the force” would be a threat to safe driving (even if some might quibble over the top threats to science in medicine)—Dr. Dossey demurred by distraction:

Your article implies that conventional medicine is grounded in evidence-based research and that CAM is not. This is grossly overstated, and suggests that a double standard is being applied to these fields.

Dossey trotted out familiar arguments: “Much, if not most, of contemporary medical practice still lacks a scientific foundation”; “the Congressional Office of Technology Assessment (OTA) found that only an estimated 10 to 20% of the techniques that physicians use are empirically proven”; hospital care is “the third leading cause of death in the United States,” accounting for hundreds of thousands of deaths each year.

He concluded with an appeal to fairness, rationality, and collegiality:

Overwhelming evidence reveals that conventional medicine is, on the whole, woefully unscientific. It’s fashionable and easy to deny this, but the facts say otherwise. So, by all means, Dr. Val, be critical of CAM – but do not fall into a double standard. Let us ruthlessly apply science to ALL we do as physicians. Let us challenge ALL areas of medicine to a higher standard. On that, I’m pretty sure we can agree.

Keep up the good work.

Sincerely yours,
Larry Dossey, MD

I procrastinated with my own rebuttal, and in the meantime David Gorski responded to similar language found in an article by Dossey (and two other magical thinkers) titled “The Mythology of Science-Based Medicine,” published by the Huffington Post. I’ll not repeat Dr. Gorski’s able rebuttal in any detail, and I’ve already written about much of what this matter brings to mind. Examples are here, here, and here on the perils of conflating science-based medicine and Evidence-Based Medicine (EBM); here on the false dichotomy of modern medicine vs. “CAM”; here on a concise definition of “CAM”; here and here on the mischief spawned by demands to “ruthlessly apply science,” in the narrow, EBM sense of the word, to implausible health claims; here (point #7) and here regarding the tu quoque fallacy, the “10-20% empirically proven” claim, and the risks of modern health care; here (scroll down to “this week’s entry”) and here, regarding some of Dossey’s own opinions about science and the future of medicine.

For now I’ll elaborate on a few points. These pertain not only to Dr. Dossey but also to myths common to the advocacy of pseudomedicine, so I hope to provide some useful information.

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Posted in: Energy Medicine, Faith Healing & Spirituality, History, Medical Academia, Politics and Regulation, Science and Medicine, Science and the Media

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CFS: Viral vs somatization

On 10/08/09, the NIH and Science through press releases announced the following remarkable information:  Consortium of Researchers Discover Retroviral Link to Chronic Fatigue Syndrome (CFS.) From Science on line:

Scientists have discovered a potential retroviral link to chronic fatigue syndrome, known as CFS, a debilitating disease that affects millions of people in the United States. Researchers from the Whittemore Peterson Institute (WPI), located at the University of Nevada, Reno, the National Cancer Institute (NCI), part of the National Institutes of Health, and the Cleveland Clinic, report this finding online Oct. 8, 2009, issue of Science.

“We now have evidence that a retrovirus named XMRV is frequently present in the blood of patients with CFS. This discovery could be a major step in the discovery of vital treatment options for millions of patients,” said Judy Mikovits, Ph.D., director of research for WPI and leader of the team that discovered this association. Researchers cautioned however, that this finding shows there is an association between XMRV and CFS but does not prove that XMRV causes CFS.

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Posted in: History, Medical Academia, Neuroscience/Mental Health, Science and Medicine

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Sectarian Insertions

I will write occasional posts instead of being on a regular schedule.  The reasons: There are more contributors than positions. Newer people to the field have more ambition and belly fire.  I have a number of projects and papers to finish in increasingly limited time and decreasing efficiency.  So have at it. Meanwhile, some non-random thoughts.

I am as concerned with social and political expression of pseudoscience as with its errors.  Health care reformers can be just as pseudoscientific as sectarians who want to restructure the scientific edifice.  Political ideologues want to centralize the medical system without solid evidence that their substitute would work, let alone work better.  Sectarians already see a national government system as an opportunity for expansionism. Mark Hyman, the Functional Medicine promoter, met with the White House staff, displaying his vision of medicine under a federal plan. Word is out that other sects have also had input. Many hold  suspicions that the proposals front for more ambitious formulations. I am suspicious of their confidence – that they can fix a complex, fluxing system using epidemiology, mathematical models, treatment paradigms, and top-down control.  I might accept some proposals if it were not that all constructed systems are intrinsically inefficient, political, and corruptible. The closer the agents of control are to the controlled, the more control the controlled have over the controllers – if you can follow that.
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Posted in: Health Fraud, History, Medical Ethics, Politics and Regulation, Science and Medicine

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Oriental Medicine or Medical Orientalism?

The following is the second adapted excerpt of an upcoming article called “The Untold Story of Acupuncture.” It is scheduled to be published in December 2009 in Focus in Alternative and Complementary Therapies (FACT), a review journal that presents the evidence on alternative medicine in an analytical and impartial manner. This section argues that the current flurry of interest in acupuncture and Oriental Medicine stems predominantly out of postmodern opposition to Enlightenment rationalism, and bears witness to Orientalism and consumerism in contemporary medicine.

In five years, from 1971 to 1975, l directly experienced Est [Erhard Seminars Training], gestalt therapy, bioenergetics, rolfing, massage, jogging, health foods, tai chi, Esalen, hypnotism, modern dance, meditation, Silva Mind Control, Arica, acupuncture, sex therapy, Reichian therapy and More House — a smorgasbord course in New Consciousness.1

 Jerry Rubin (1938 – 1994)

Although acupuncture has been known in the US since the 19th Century, its therapeutic claims were dismissed or judged to be “much overrated” by the medical community.2,3 Nonetheless, the publication of a report in the New York Times by James Reston, a reporter in President Nixon’s press corps who had received acupuncture for postoperative cramps in Beijing in 1971 changed this perception, and triggered a flurry of interest amongst the American public and some in the medical community.4 Within the following months, journalists, scientists and physicians rushed to China to withness this peculiar phenomenon, which the popular press and a few scientific journals sensationalized by reporting that thousands of successful operations of all sorts were being carried out in PRC using acupuncture anesthesia; some elaborated on its widespread use for a myriad of conditions, to include paralysis and deafness!5

These unconfirmed claims in the heady social and intellectual climate of the 1970s–meaning the American Counterculture; the rejection of mainstream values, beliefs and ideals; the youth movement, nonconformism and the hippie subculture, the belief in a “New” and  “Cosmic” consciousness and the cult phenomenon; revolutionary ideas mixed with environmentalism; organic farming and the avoidance of pollution, agrochemicals and pharmaceuticals; nonconformism and alternative lifestyles; a syncretistic mix of psychedelic drugs, Eastern religions and Native American spiritualities; the resurgence of the taste for mystic, occult, and magical phenomena;6,7 and the belief in the existence of a separate and non-ordinary reality, as upheld by one of the fathers of the New Age movement, Carlos Castaneda8–gave the justification to view acupuncture as a “heal all” therapy based on alternate perceptions of health and disease.  This amalgamation happened precisely when a whole generation of disenchanted Westerners were eager to find novel solutions for their existential predicaments; one that would be free from the constraints of the so-called “repressive rationality” of modern science in “overdeveloped” societies.9,10. Most Western publications on acupuncture therefore fostered the belief that Eastern healing arts have crucial characteristics directly and unequivocally opposite to the repressive rationalism of the West.
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Posted in: Acupuncture, History, Science and Medicine

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James Reston’s Tooth of Gold

One of the fathers of critical thinking and skeptical inquiry, the French philosopher Bernard le Bovier de Fontenelle (1657–1757) recounts in 1687 in his Histoire des oracles–a debunking book on popular beliefs, myths and superstitions that caused tremendous stir in theological and philosophical circles of his time–a colorful story that could very well illustrate the flurry of interest and research in acupuncture that followed a 1971 anecdotal account of its use in China, and the plethora of verbiage and publications that ensued. If the story of the Tooth of Gold is comical, colorful and amusing, its applicability to acupuncture is not.

In 1593, the rumor ran that a seven year old in Silesia grew a tooth of gold in place of one of the cheek tooth he lost. Horatius, professor of medicine at the University of Helmstad, wrote a history of this tooth in 1595 and alleged that it was partially natural, partially miraculous, and that it was sent by God to this child to console the Christians that were oppressed by the Turks. Just imagine what consolation and what concern this tooth might bring to the Christians or to the Turks. For this tooth not to lack historians, Rullandus rewrote its history in the same year. Two years later, Ingolsteterus, another learned man, wrote against the views of Rullandus on the tooth of gold; to which Rullandus immediately wrote a fine and wise reply. Another great man named Libavius gathered all that had been written on this tooth and added his own views. Nothing lacked to these many fine books, other than the tooth were truly of gold. When the goldsmith examined it, he found that it was made of a leaf of gold skillfully applied to the tooth; but they began by writing books and then they consulted the goldsmith.1

Translated from French by the author

Besides the glut of popular publications on Chinese acupuncture and medicine by wishful authors without any training in biomedical sciences and healthcare, the NIH, the NCCAM, and some of our most prodigious medical universities also have official and academic publications on the subject that too well resemble the fine and wise publications of Horatius and his contemporaries. They also began by writing books and articles on the theories that could explain the purported indications of acupuncture, and then they assessed the veracity these indications in clinical trials and according to the principles of evidence-based medicine.
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Posted in: Acupuncture, History, Science and the Media

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Acupuncture is astrology with needles

EDITOR’S NOTE: Because, for the first time in a year and a half, both professional and personal responsibilities precluded my producing a post for Science-Based Medicine, today is the perfect time to present a guest post by Ben Kavoussi. Ben is a medical informatician with an interest in the scientific evaluation of CAM, as well as a Captain in the Army Medical Service Corps. He also studied to become an acupuncturist himself, and his article is a fascinating look at some little known history behind acupuncture that strongly suggests that it is more akin to astrology than you may be aware of. Certainly I had been unaware of it, and I bet most of our readers are unaware of it, too.

Enjoy!

I’ll be back with a post here next week at the latest.

Acupuncture is astrology with needles

by Ben Kavoussi, MS, MSOM, LAc

The following is an excerpt of an upcoming article called “The Untold Story of Acupuncture.” It is scheduled to be published in December 2009 in Focus in Alternative and Complementary Therapies (FACT), a review journal that presents the evidence on alternative medicine in an analytic and impartial manner. It argues that if the effects of “real” and “sham” acupuncture do not significantly differ in well-conducted trials, it is because traditional theories for selecting points and means of stimulation are not based on an empirical rationale, but on ancient cosmology, astrology and mythology. These theories significantly resemble those that underlined European and Islamic astrological medicine and bloodletting in the Middle-Ages. In addition, the alleged predominance of acupuncture amongst the scholarly medical traditions of China is not supported by evidence, given that for most of China’s long medical history, needling, bloodletting and cautery were largely practiced by itinerant and illiterate folk-healers, and frowned upon by the learned physicians who favored the use of pharmacopoeia.

Heaven is covered with constellations, Earth with waterways, and man with channels.

Yellow Emperor’s Canon of Medicine (黄帝内经, huang di nei jing)1

Acupuncture is presumed to have its origins in blood ritual, magic tattooing and body piercing associated with Neolithic healing practices.2,3 The Neolithic origin hypothesis is supported by the presence of nonfigurative tattoos on the Tyrolean Ice Man–an inhabitant of the Oetztal Alps in Europe–whose naturally preserved 5,200-year-old body displays a set of small cross-shaped tattoos that are located significantly proximal to classical acupuncture points. Medical imaging shows that the middle-aged man suffered from lumbar arthrosis and the cross-shaped tattoos are located at points traditionally indicated for this condition.4,5 Similar nonfigurative tattoos and evidence of therapeutic tattooing, lancing and blood ritual have been found throughout the Ancient world, including the Americas.6,7,8 Health-related tattoos are still prevalent in Tibet, where specific points on the body are needled with a blend of medicinal herbs in the dyes. These practices appear to be largely intended to maintain balance with the natural and spiritual worlds, and also to protect against demonic infestation and malevolence. Seemingly, this Neolithic and Bronze Age lancing heritage, which was intertwined with magic and animism, has evolved in various cultures into codified systems of lancing and venesection for assuring good health and longevity. In addition to treating the impurity or superabundance of blood, in various cultures lancing was also believed to affect the flow of a numinous life-force that is, for instance, called qi (or chi, 氣, pronounced “chee”) in Chinese, prāna (प्राण) in Sanskrit, pneuma (πνεύμα) in Greek, etc.9 In many instances, elements of metaphysics, mythology, mysticism, magic, shamanism, exorcism, astrology and empirical medicine intimately intertwined, making it difficult for modern scholars to interpret them as mutually exclusive categories.
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Posted in: Acupuncture, History

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Plus ça change, plus c’est la même chose

The more things change, the more they stay the same.

Not every post will be an in-depth, authoritative review of a topic like yesterday’s on Dr. Sears.  A change of pace can be nice, and I have always liked history.

JAMA likes to run articles called “JAMA 100 YEARS AGO” and the reprint from the July 24, 1909 issue is interesting. It is called  BUTTERMILK THERAPY.  They liked all caps at the turn of the century.

1909 was at the very beginning of the biologic sciences and the understanding of disease pathophysiology. Physicians had almost no useful, or more importantly, rigorously tested therapeutic interventions for diseases. So they relied on traditional method of determining what worked: expert opinion and anecdote. And that lead to buttermilk.

“Metchnikoff, Massol and several other authors have recommended fermented sour milk as prepared in Bulgaria, or a similar product, prepared according to Metchnikoff’s method from pure cultures of bacteria, as a panacea for many ills.”

Metchnikoff was a Russian microbiologist who won a Nobel prize in 1908 for discovering phagocytosis and was responsible for many early discoveries in the immune system and in host-bacterial interactions.  As a preeminent scientist of the time, his word was respected and carried weight.  As a side note, when he tried to commit suicide he did  so in a manner that would benefit science: he injected himself with the relapsing fever organisms and proved it could be blood borne, and while he evidently became very ill in the process, it failed to kill him.
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Posted in: History, Science and Medicine

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