Articles

Smallpox and Pseudomedicine

A good case of smallpox may rid the system of more scrofulous, tubercular, syphilitic and other poisons than could otherwise be eliminated in a lifetime. Therefore, smallpox is certainly to be preferred to vaccination. The one means elimination of chronic disease, the other the making of it.

Naturopaths do not believe in artificial immunization . . .

—Harry Riley Spitler, Basic Naturopathy: a textbook (American Naturopathic Association, Inc., 1948). Quoted here.

Here’s what a good case of smallpox will do for you:

If you’re lucky enough to beat the reaper (20-60%; 80% or higher in infants) or blindness (up to 30%), those blisters will leave you scarred for life. Oh, and the next time a good smallpox epidemic comes around, your children born since the last one will catch it and contribute their fair share to the death rate. But not you because you’ll be immune, so you’ll have the “preferred” experience of watching your children die well before you do.

(more…)

Posted in: Chiropractic, Epidemiology, Health Fraud, History, Homeopathy, Naturopathy, Public Health, Vaccines

Leave a Comment (71) →

Oil of Oregano

Paradoxically, the less evidence that exists to support the use of of a treatment, the more passionate its supporters seem to be. I learned this early in my career as a pharmacist. One pharmacy I worked at did a steady business in essential oils. And king of the oils was oil of oregano. Not only were there several different brands of the basic oil, they were different forms, including capsules, creams and even nasal sprays. Not aware of any therapeutic benefits, I would ask customers what they were using it for. I rarely heard the same condition described: skin infections, athlete’s foot, head lice, colds, sore throats, “parasites”, “yeasts”, diabetes, allergies and ringworm were apparently no match against the judicious use of oregano oil. Intrigued, I took a closer look.

Long before our scientific understanding of bacteria and antimicrobials, infected wounds were packed with different products in an attempt to minimize the odour, and hopefully speed healing. It’s likely that someone happened upon a fragrant herb and discovered that it seemed to help treat wounds (or at least, cover some of the smell). Given there have been some amazing drugs with powerful effects that have emerged from natural products, it’s certainly plausible that oil of oregano could have biological and therapeutic effects. Oregano (Origanum vulgare) leaves contain a wide variety of chemical compounds, including leanolic acids, ursolic acids, and phenolic glycosides. Phenolic compounds make up to 71% of the oil. Carvacrol, thymol, cymene, and terpinine and are found in oregano leaves and do appear to have biological effects. It’s these chemicals that are proposed to be the parts with beneficial effects.

The claims made by one manufacturer are unambiguous:

Oreganol P73 is the most powerful germ killer with scientifically proven results against almost every virus, bacteria, parasite, and fungi. The complexity of the phytochemical matrix in Oreganol P73 possesses a broad spectrum of antimicrobial properties that are safe for prolonged use. The oil can be used topically and internally. Oreganol P73 is the medicine chest in a bottle, especially since it is proven never to harm the internal organs, even when used daily for health maintenance.

So if we accept the manufacturer’s claims at face value, there should be evidence demonstrating oregano oil is both safe and effective when used internally and externally. There is apparently also adequate long-term safety data to demonstrate that it can be safely used on a daily basis.
(more…)

Posted in: Herbs & Supplements

Leave a Comment (30) →

SBM at TAM9

This year The Amazing Meeting 9 (designated TAM9 From Outer Space) will be held in Las Vegas from July 14-17. If you have not registered, do it fast – this year the conference will likely sell out.

Among the many incredible speakers and events at TAM9 there will be a Science-Based Medicine workshop and an SBM panel discussion. The prominence of SBM at TAM9 partly reflects the new collaboration between SBM and the James Randi Educational Foundation (JREF), who organizes TAM.

The SBM website is now a joint project of the New England Skeptical Society (who founded SBM) and the JREF – two non-profit educational organizations dedicated to promoting the public understanding of science. I am delighted that the JREF is making SBM a priority, and we all look forward to working closely with them in promoting high standards of science in medicine and improved public understanding of the relationship between science and the practice of medicine.

As part of this new relationship I have accepted a position at the JREF of Senior Fellow and Director of their Science-Based Medicine project.

(more…)

Posted in: Announcements

Leave a Comment (10) →

How to Build a Bridge

People tend to limit their reading to sources that agree with their beliefs. We find ourselves mostly preaching to the choir; our message usually doesn’t reach those who most need to hear it. I recently received an inquiry from a science-based medical doctor asking how to approach others in building a bridge to clarify so much misinformation.

My first thought was that you can build a bridge but the real challenge is persuading people to cross that bridge. Like leading a horse to water…

How to approach others? That’s a tough question. The best approach varies with the individual and with where he is in his journey. Confrontation seldom works: it just makes people angry. It is counterproductive: it only serves to make them invent more rationalizations to defend their beliefs. Although sometimes anger can be a good thing. I got an e-mail from an acupuncturist who was incensed by an article I wrote saying that acupuncture was not based on good evidence. He set out to prove me wrong by looking up the evidence behind what he had been taught by his teachers about acupuncture’s efficacy for specific conditions, and when he couldn’t find any, he realized that his teachers and his textbooks had misled him with lies. He gave up acupuncture and went back to school to learn a science-based health profession. (more…)

Posted in: Science and the Media

Leave a Comment (80) →

Fashionably toxic

It’s the toxins.

Toujours les toxines.

How many times have I read or heard from believers in “alternative” medicine that some disease or other is caused by “toxins”? I honestly can’t remember, but in alt-world, no matter what the disease or condition under discussion is, there’s a good chance that sooner or later it will be linked to “toxins.” It doesn’t matter if it’s cancer, autism, heart disease, diabetes, hypertension, or that general malaise that comes over people who, as British comedians Mitchell and Webb put it, have more money than sense; somehow, some way, someone will invoke “toxins.”

I was reminded of this obsession among believers in unscientific medicine last Friday when I came across an article by Guy Trebay in the New York Times entitled The Age of Purification. The article appeared, appropriately enough, in the Fashion section and was festooned with photos of cupping, surely one of the silliest of the many “detoxification” modalities that alternative medicine practitioners use to claim to draw the “toxins” out of their clients through the application of, well, cups or various other containers in which the air had been heated in order to generate negative pressure when sealed to the skin and presumably thus bring them to a greater level of purification and health. Indeed, the only “detoxification” rituals sillier than cupping that I can think of off the top of my head are detoxifying footpads and “detox foot baths.”

Oh, wait. Scratch that. I forgot about ear candling, which must surely be the undisputed silliest “detox” treatment of all time—until someone thinks of an even sillier one. Or not. There are just so many silly “detox” procedures that it’s hard to select a “winner.”

Be that as it may, Trebay mixes sarcasm with exposition throughout his article in a rather amusing way that’s worth quoting:

My friend, like everyone else around, seemed to believe that mysterious, amorphous sludge had lodged in the anatomical crannies of half the local adult population. Unseen toxins were lurking, like Communists during the Red Scare.

The “toxins” required elimination, somehow, and thus at lunches, at cocktails, at dinner parties, normal conversations turned abruptly from the day’s news to progress reports on juice fasts, energy alignments, radical purging. From painful sessions with traditional healers to toxin-leaching treatments designed, it might seem, to clean out not just body but wallet, a surprising number of New Yorkers (not all of them well-to-do neurotics) are caught up in a new New Age, the Age of Purification.

How had it happened, I wondered, that so many otherwise sensible, urban people found themselves in the grip of a dreadful feeling that systems are down? “I just bought five pounds of carrots, ginger and kale and put it all in my Breville juicer and pounded that all day,” said a corporate adviser of my acquaintance, far from a credulous woo-woo type.

Of course, as we have noted so many times before, hard-nosed skepticism in one area of one’s life does not necessarily translate to other areas. Many are the people who would never ever fall prey to scams in business, for example, but happily fork over money for scams such as “detox footpads”—or fall for anti-vaccine quackery, like J.B. Handley. Whatever the case, why this fascination with “detoxification” in alternative medicine? Why do so many of its treatments, be they dietary, chelation therapy, purges, colon cleanses, or whatever, claim to eliminate “toxins”? Why is it that, if you Google “alternative medicine” and “detoxification,” you find so many references, some of which claim external toxins need to be eliminated, some of which claim that internal toxins need to be purged, and still more of which blame various “parasites” for all manner of health distress? In this post, I’ll try to explain, but first a little history—self-history that is.
(more…)

Posted in: Naturopathy, Science and the Media, Vaccines

Leave a Comment (82) →

Raw Milk in Modern Times

It is hard to get infected. The immune system is robust and has a multitude of interlinking defenses that are extremely efficient in beating off most pathogens. Most of the time.

Fortunately, it is a minority of microbes that have evolved to be virulent in humans. Bacteremia is common with our own microbiome. When you brush or floss, bacteria leak into the blood stream:

We identified oral bacterial species in blood cultures following single-tooth extraction and tooth brushing. Sequence analysis of 16S rRNA genes identified 98 different bacterial species recovered from 151 bacteremic subjects. Of interest, 48 of the isolates represented 19 novel species of Prevotella, Fusobacterium, Streptococcus, Actinomyces, Capnocytophaga, Selenomonas, and Veillonella.

but with a good immune system, low virulence bacteria and no place to go, unfortunately the bacteria rarely cause infections.

Even heroin users rarely get infection. Heroin is a rich melange of  with bacteria and, on occasion, yeasts (I hate to say contaminated, since avoiding microbes is hardly a worry of heroin manufacturers), and the water used for injection is rarely sterile, yet infections are relatively rare despite the filth in which many heroin users exist.

I used to be somewhat fatalistic about hospital acquired infections. However, as the institutions in which I have worked have proven, almost all infections in the hospital are preventable if the institutions aggressively pursue high standards of care.

There are many systems in place in society to prevent infections: flush toilets, good nutrition, public health, vaccines, antibiotics, good hygiene, and an understanding of disease epidemiology, and I suspect people forget there are bugs out there that are pathogenic, just waiting to sicken and kill us. At least a couple of times a year I see patients come into the hospital, previously healthy, who rapidly die of acute infections.  But for most people, most of the time,  it takes a lot of effort to get an infection.

From my perspective we are Charlie Chaplain on skates , mostly unaware of the infections that awaits us if we do something silly, or even when we act with the best intentions to avoid illness. The odds are small we will get a life threatening or serious infection in the US, just as the odds are small we will drown or be killed in a car accident. The germs are there, waiting, and in the end, no matter what we do, we will be consumed by the microbial world. (more…)

Posted in: Nutrition, Science and Medicine

Leave a Comment (74) →

The Top Ten Pet Supplements: Do They Work?

An Embarrassment of Riches?

Much has been written here about the dietary supplement business, a multibillion dollar industry with powerful political connections, and about the woeful inadequacy of regulation which allows widespread marketing of supplements without a solid basis in science or scientific evidence. 

The veterinary supplement market is a pittance compared to the human market, but still a billion-dollar pittance that is growing rapidly. Unfortunately, the resources available for good quality research in veterinary healthcare are also a pittance, and it is not at all unusual for our pets to suffer, or even be euthanized, as a result of treatable diseases for want of money to pay for needed care. So $1 billion a year spent on nutritional supplements may not be such a good deal if these products don’t effectively prevent or treat disease. 

The variety of supplements available is staggering. Many proprietary concoctions of vitamins, minerals, herbs, and other ingredients are marketed for health maintenance, “boosting the immune system,” retarding aging, or treating specific diseases. A comprehensive review of this multitude of moving targets is impossible. But the lion’s share of the pet supplement market goes to a few specific compounds, so I will focus on these. Most of these ingredients are also among the most popular supplements for humans, so there will be substantial overlap with previous discussions of the plausibility and evidence for many of these substances. (more…)

Posted in: Herbs & Supplements, Veterinary medicine

Leave a Comment (26) →

Delusional Parasitosis

A new study looks into the disorder known as delusional parasitosis, which many dermatologists believe is the true diagnosis behind the controversial disorder called Morgellon’s disease. Morgellons is a controversial disorder because many patients with symptoms believe they are being infected by an unusual organism, causing excessive itching, but no offending organism has been found. Some patients claim they have strange fibers exuding from the sores in their skin.

The term “Morgellons” was coined in 2002 by Mary Leitao, who was trying to find a diagnosis for her son who was suffering from skin lesions. Since then it has become a grassroots diagnosis – used by some patients to describe themselves but not accepted by the medical community.

Most dermatologists, rather, feel that the disorder is actually a manifestation of delusional parasitosis – a mental disorder. This has set up an unnecessarily confrontational situation. And of course, some charlatans are exploiting the situation by taking the side of the patients and offering them their nostrums as a cure.

(more…)

Posted in: Neuroscience/Mental Health

Leave a Comment (47) →

Pragmatic Studies and Cinderella Medicine

Explanatory studies are done under controlled conditions to determine whether a treatment has any efficacy compared to a placebo. Pragmatic studies are designed to assess how the intervention performs in everyday real world practice. Pragmatic studies measure practical success but don’t determine actual efficacy: that requires a proper randomized controlled trial (RCT) with an appropriate control. Pragmatic studies have their place, but they can sometimes make an ineffective treatment look good: a phenomenon I have christened Cinderella Medicine.

(more…)

Posted in: Acupuncture, Clinical Trials

Leave a Comment (36) →

Surprise, surprise! Dr. Andrew Weil doesn’t like evidence-based medicine

ResearchBlogging.orgDr. Andrew Weil is a rock star in the “complementary and alternative medicine” (CAM) and “integrative medicine” (IM) movement. Indeed, it can be persuasively argued that he is one of its founders, at least a founder of the its most modern iteration, and I am hard-pressed to think of anyone who did more in the early days of the CAM/IM movement, back before it ever managed to achieve a modicum of unearned respectability, to popularize CAM. In fact, no physician that I can think of has over the course of his lifetime done more to promote the rise of quackademic medicine than Dr. Weil. The only forces greater than Dr. Weil in promoting the infiltration of pseudoscience into academic medicine have been the Bravewell Collaborative and the National Center for Complementary and Alternative Medicine (NCCAM). Before there was Dr. Mehmet Oz, Dr. Dean Ornish, Dr. Mark Hyman, or any of the other promoters of IM, there was Dr. Weil.

And why not? Dr. Weil looks like an aging 1960s rock star, and, operating from his redoubt at the University of Arizona, is quite charismatic. For all the world he has the appearance of a kindly, benevolent Arizona desert Santa Claus, an ex-hippie turned respectable dispensing advice about “natural” medicines, writing books, and making himself ubiquitous on television and radio whenever the topic of alternative medicine comes up. Before Dr. Oz told Steve Novella that “Western” science and medicine can’t study woo like acupuncture, Dr. Weil was there, paving the way for such arguments, previously considered ludicrous, to achieve a patina of respectability.

In fact, he’s still at it, doing it far better and far more subtly than the ham-handed Dr. Oz. Unfortunately, it’s the same anti-science message and the same appeal to other ways of knowing built upon tearing down straw men versions of evidence-based medicine (EBM) with gusto. This was brought home last week when Dr. Weil co-authored an opinion piece with Drs. Scott Shannon and Bonnie J. Kaplan for the journal Alternative and Complementary Therapies entitled Safety and Patient Preferences, Not Just Effectiveness, Should Guide Medical Treatment Decisions, an article that was noted at the blog Booster Shots in a credulous, fawning post entitled Dr. Weil says there’s a better approach to evaluating clinical drug trials. In contast, Steve Novella put it far more succinctly (and accurately) in the title of his post: Andrew Weil Attacks EBM. That’s exactly what Weil and company did in this article.

While Steve is absolutely correct, I also see it more as Dr. Weil demonstrating once again that, upstarts like Dr. Oz aside, he is still the master of CAM/IM apologia, much as, even though both were Sith Lords, Emperor Palpatine remained master over Darth Vader until just before the end. You’ll see why in terms of the arguments, both subtle and not-so-subtle, that Dr. Weil and his acolytes make. Moreover, even though his disciple Shannon is granted the coveted first author position, the arguments presented leave little doubt that it’s Weil who’s driving the bus.
(more…)

Posted in: Clinical Trials, Medical Academia

Leave a Comment (24) →
Page 152 of 266 «...120130140150151152153154...»