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Alternative Medical Treatments

Topics - Altmedicine(2002), Alternative Medicine(2004), Homoeopathy, Iridology,
Cures for Cancer - Apricot Kernels

There have been many discussions of non-conventional medical treatments on the Science Matters list.  This is an attempt to put some of the more recent ones into a common area.  They  are guarrenteed to polarise the contributors, and frequetly spark robust discussion.

On 21/12/2002, Podargus wrote:

Talking about committees as we were, I notice that the NSW Minister for Health, Craig Knowles, has set up a committee to look at the more outrageous claims of the so called alternative medicine money making machine.  A good start in making them justify their treatments and potions.

Charles deG responded:

I believe that "scientific"Medicine is not capable of Diagnosis in many cases.An example,1 of my Nephews is allergic to Nuts and it was a Naturopath that found this out not a Convential Medico.As far as Doctors are concerned,he ISNT allergic to Nuts.And it took doctors 48 yrs to discover i have Diabetes,{i'm 48 and was diagnosed in the last 5 weeks].In a way,so much for "scientific" Medicine.

Gerald Cairns commented:

I just want to say a few words on this topic which I have omitted to do at various times in the past.

Medicine is based a lot of diverse science and I believe can claim to be scientific discipline which I have noted claims to the contrary in the past. The point is that in many disciplines there is also a large measure of "Art" in the practise and that special skill is commonly what differentiates good practitioners from mediocre ones.

My activities are heavily involved with chemical formulations which ICI claims is highly dependent on the "ART" of the formulator.

What evidence do you have that he is allergic to nuts?  Does his throat swell up and give him trouble brathing?  What exactly?  Are you sure it is an alergy to 'nuts' and not something that is some foods particularly nuts?  are you sure that it is an allergy, or may it be that they just don't agree with him?

For one thing, you didn't havediabetes 48 years ago.  You have achieved it over that period of time.  I'm not making excuses for doctors but only you know what your circumstances were and whether or not you should have been tested.   I should have been tested far earlier but didn't get sent for one until I asked despite a long history of complaints associated with diabetes.

Mostly doctors don't seem start thinking about type II diabetes until you are approaching 50.

Greald Cairns wrote:

While we try to be scientific and purely objective this in reality an idealistic view of scientific endeavour. I have been trying to find the quote from a senior chemist with ICI but seem to have misplaced it however he basically summarised it when he said when referring to formulators, something like,  " you cannot, must not ever underestimate the formulator's art because it is in large measure the innovative application of fundamental chemistry through formulation which creates the business.."  A formulator is just a chemist or an amateur who gives effect to the final form of mixtures of chemicals to achieve particular properties rather than one who works on the manufacture if the basic raw materials themselves and it is this aspect which I was comparing with a good doctor who in reality may not know more of the detail of his profession than another but he will be exceptional at interpreting the symptoms and anticipating the course of action required. We cannot all necessarily reach the same levels of skill.

I am constantly surprised by what we don't know about some very common chemicals which are thought to have been thoroughly investigated that there is little liklihood of discovering anything new about them but suddenly you can be confronted with a new behaviour in a different setting. An example which I remember was an aqueous emulsion I was preparing, a mixture of some species which were intensely hydrophobic and physically incompatible with each other. There are formulae which apply to adjustment of surfactant systems or aid in the choice thereof but none of this was of any use. I also exhausted the knowledge of a couple of very experienced surfactant chemists in the exercise to no avail. Contemplating the problem laterally I added a third highly hydrophobic species which was incompatible with one of the other two species and anticipated a wholly unmanageable mess but without disclosing some confidential details, Lo and behold as they say in the good Book, the entire system immediately emulsified perfectly. You cannot ever assume that you have exhausted all possibilities and it is worth "turning the principles on their heads" to see if the known wisdom still holds, often enough in my experience it does not. "All dogs are animals but not all animals are dogs", a quote whose author escapes me. While I believe I know the reasons for this valuable effect I no longer have the lab resources to investigate it formally.

On the basis of this last discovery I lay claim to the Chair and Title "Master Empiricist and Chief Alchemist", now for my next Project Lead to ...........G? :-))

Chris Lawson responded:

Look, Charles, I'm not about to take on the entire alternative health scene, but I would like to ask a few questions before we get any further.

1. How do you define "allergy"? (Remember, this is a *scientific* term, not one that came out of naturopathy.)

2. What symptoms demonstrate that your nephew has an allergy?

3. How do you know it's nuts? Has he done an exclusion diet followed by re-challenge? (Remember, food allergies are just about the most over-diagnosed condition in alternative medicine, after 'liver toxicity".) And why do the doctors believe he isn't allergic to nuts? Do they have good reasons? Have you asked? And which nuts? Peanuts? Brazil nuts? Macadamias?

4. What makes you think you had undetected diabetes for your entire life? People with juvenile diabetes who are not diagnosed and treated, they die. Every single one of them. How long do you *really* think you had diabetes before it was detected?

5. Even if the doctors were slow to pick up your diabetes, why is this the fault of scientific medicine, as opposed to a lapse in the application of scientific knowledge? If you think scientific medicine should be treated so dismissively for not being perfect, how do you feel about chiropractors who cause spinal injuries, acupuncturists who cause pneumothorax, naturopaths who tell people not to get their children immunised, homeopaths who tell people not to have their melanomas removed, and herbalists who put heavy metals in their concoctions?

Eremia answered:

G'day Charles,
Your comments disturbed me!
I can understand your disquietude. However your position reinforces many social myths and nurtures many of the "litigation" problems today. "We" as health consumers must remember that Medical Doctors are "not Gods". "We" as health consumers have created the problem by believing they are. Medical Doctors are not omnipotent and omniscient. They are human beings; doing a "human" job. They use the tools available to them, and for the most part use "the scientific method " wisely. They, like us, make mistakes. By virtue of our humanness we are fallible. No individual can know "everything".

Furthermore, the human body is so complex than many things can disguise what may seemingly be a simple diagnoses. Medical doctors, like nurses do all the same things that non-medical people do. We have our virtues and our vices. This is where I think once again "RESPONSIBILITY comes into focus.  We must take RESPONSIBILITY for not only our actions, our motives and the consequences but furthermore our health and the direction of our lives. It is so easy to "blame" the medical profession when something goes wrong. Most of our medical problems are "life style" problems. There is substantial evidence for this.

Once again I think the genesis of this problem lies in our inability to accept our finiteness. There is "no exit" so to speak , only through death. We are always looking for a "pill" to fix our problems and if the doctor does not provide one he/she is not a "good doctor". Herbalist and so forth are also human. They also make mistakes

Charles deG replied:

Yes,it's definatly Nuts that cause his allergy and his mother had him checked out by a doctor after his allergy was discovered. And as with you it took a long time for Doctors to discover i have Diabetes,despite i too had a  history of similar complaints like u as well.

Zero sum wrote:

If you accept me to accept that, you are 'definately nuts'.

You get asked for more information/evidence and just repeat the same story.  The assmumption will be that you have don't have that information and that your original complaint was made in ignorance.

On 11/6/2004, Daya Papalkar wrote:

In a book about Mark Twain (reviewed in NEJM), the author makes the point that there is "no such thing as alternative medicine" - only medicine with and without scientific evidence to support it. This was a view also put forward recently by Prof John Dwyer in an SBS Insight show - emphasising the point that "alternative medicine" may have something to offer, but it should be subjected to the usual process of investigation, and if it is actually shown to work, then it can be incorporated into standard medical care.

Any thoughts?

Kurt Alexander replied:

some 'alternative' medical practices may not stand up to the rigors of 'scientific investigation'

I have used and had success with Bach Flower remedies with humans and with animals the latter supposedly less inclined to respond 'psychologically' to placebo's

The fact that animals did respond to Bach Flower remedies seemed for me the most compelling evidence of an 'alternative' medicines efficacy however over time I found some failure of the said remedies in both animals and humans

If you examine the history and understand the principles of use of the BFR's then you will appreciate that this therapy is aimed at the psychological states said to be the root cause of an otherwise physiologically manifest 'disease'

I would thus venture to say that failures then in my use of BFR's were quite likely to be in my diagnosis of the underlying psychological state and/or a psychologically negative response in the person and yes, I am inclined to say by experience now a negative response in the animal psychologically also (viz resistance to being treated by Dr X)

the number of times I have seen animals manifest disease concurrent and more often than not symptomatically parallel to their owners illness makes it for me no longer extraordinary as to suggest they can be 'sold' a placebo

the crux however of what I am saying is that IF a disease state has psychological antecedents and IF the practitioner can identify these so that IF they use the right BFR then I believe emphatically that the right BFR
will go a long way to resolving the disease state especially where persistent mainstream medical therapy seems to fail in the face of what may seem a straight forward case

there are a lot of if's in this equation and why I both understand and empathize come conditionally agree on the use of antidepressants and other prescribed psycho actives when I know that effective identification and psychotherapy of the root cause would be better and ultimately for that persons long term health and happiness the most efficacious

all I can say that I may not have intimated above regards the complexity and accuracy of 'testing' psychological responses to alternative medicines to underpin the usefulness of these 'medicines' is my 'companies' drug suppliers WADS (WestAustralian Drug Supplies) product list includes all the Bach Flower remedies both singularly and boxed in sets at a very un alternative competitive pricing which suggests for many Veterinarians BFR's are now mainstream practice

You could however argue that this is so because of public demand being met by equally enterprising Veterinarians

IOW the proof of alternative medicines efficacy/failure in the light of scientific investigation is necessarily fraught with psychological and diagnostic confounds

Ray commented:

Some alternative medicine defies scientific investigation, either by being too difficult to investigate or by having scientific investigation utterly ignored by devotees (eg; Raki {sic} in the former instance and Homoeopathy in the latter).

There is also the little problem of the great unknowns in science.  For example, how and why placebo effect works at all even if in some instances it seems to.  Then there are other limitations in the field of science, such as (not being able to think of a better example) our limited identification of neurotransmitters, where we only know the ID of about 10 of them whilst it is reasonable to presume that there are hundreds of them.

Daya, this is only the beginning of scientific enlightenment, and questions such as these ought to be reserved for 3004AD. (if not 7004AD, should we survive so long :)

Daya Papalkar answered:

The point being made was that "treatments" that show promise should be subjected to randomised controlled double-blind trials, and investigated for an effect. I was mainly referring to traditional medicine or herbal medicine that may contain an active pharmacological agent. It's not *necessary* to understand the mechanism of action to provide evidence (one way or another) for an effect. Effective treatments are often found before the mechanism of action is understood. Validly quantifying the psychological effects of medication is possible, but admittedly introduces some subjectivity.

Treatments that suggest a non-biologically plausible mechanism of action should probably only be investigated if there is preliminary evidence that it has a strong effect. Otherwise, scientific investigation is useful to stop people wasting their money on bunkum. The homeopathic concept of diluting something to provide a stronger effect is the antithesis of pharmacology and common sense. Is it any surprise that homeopaths are not interested in scientific investigation?

10 neurotransmitters? There are many more known amongst just the tachykinins...

http://www.montegen.com/Montegen/Nature_of_Business/The_Library/RecommendedReading/TheTachykininPeptideFamily.pdf

I disagree. If we have a scientific method and the means to measure the effects we propose to measure, then we are able to answer the question: Does this treatment actually work?
If it actually works, then further investigation could determine *how* it works. Why wait 1000 years? Besides, given the relative recency of the discovery of DNA, who knows how far biomedical science will have progressed in 1000 years. It is probably beyond the scope of our imagination.

Ray responded:

OK Daya, but the problem will always be that scientific investigation will only be 'selling ice to Eskimo' because devotees will believe in spite of any evidence suggested to the contrary.  Unless it is vaguely supportive evidence in its favour.

Also, the problem I think, with many herbal remedies is in the isolation of the particular functional chemicals (if any) or if said chemicals act alone or in combination with other components within the herbal medicine or in addition to it. (like, say, being a vegan?)

Difficult, but probably not impossible.

Daya Papalkar replied:

That's probably true. But maybe science will help improve government regulation of alternative medicine practitioners, who are largely unregulated at the moment (and some of them are frankly dangerous).

See Barry Williams' article here:
http://www.control.com.au/bi2004/254Skeptic.pdf

Australian skeptics article:
http://www.skeptics.com.au/features/weird/media/mw-natbaby.htm

Naturopath in court after baby dies
The Age, Melbourne Australia
Sat, 08-Mar-2003
The parents of a critically ill baby boy were told his heart "could stop" and required urgent surgery, a court was told yesterday.

But the parents of baby Mitchell James Little cancelled surgery in the belief that he had been cured by naturopathy, cardiologist Dr Garry Warner told the NSW Supreme Court. He said that he was "stunned" to learn the parents, Michael and Elizabeth Little, cancelled after a second opinion from a naturopath.

Mitchell was diagnosed with aortic stenosis, a congenital heart disease, and died before surgery could be done. Naturopath Reginald Harold Fenn, 74, has pleaded not guilty to manslaughter between September 15 and 25, 1999, at Raymond Terrace, near Newcastle.

Dr Warner said he had explained more than once to the parents that "there was no way in the world that a naturopath could fix a structural problem" and that the baby could die. He rang Fenn, who told him that he had found a different heart condition and cured it, as well as the aortic stenosis.
[ends]
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It is ironic that the media (in general) paid this case and others relatively little attention (compared to regular front page news about hospital errors). Perhaps it reflects a community expectation that nothing is really expected of alternative medicine (and serious adverse outcomes are not a major concern if caused by an alternative health practitioner?). The community has real expectations of hospitals but maybe not of "quacks", but why not expose them? Perhaps the death of a baby is the only way to get the some media to report on these people.

Why did Fenn (the naturopath involved) seek medical attention for his cancer instead of prescribing himself "jojoba" drops or going to a naturopath???

An older article about the case:
http://www.heraldsun.news.com.au/footy/common/story_page/0,8033,6074703%255E1702,00.html

Dead-baby mum granted immunity AAP

"...Baby Mitchell James Little was born on September 7, 1999, and within three days was diagnosed with a congenital heart disease which required surgery to fix.  His parents sought treatment from naturopath Reginald Harold Fenn, who prescribed jojoba drops and treated the baby with a machine that measures energy levels.  He also urged the parents not to have the operation, it was alleged in court.  Fenn, 74, is standing trial for unlawfully killing the baby between September 17 and 25, 1999.  He has pleaded not guilty..."
[ends]
 

Ronald Lewis Tuckwell posted:

If there is inadequate testing, what is your evidence for "frankly dangerous"?

Ray commented:

At risk of appearing heartless and callous Daya, in terms of the instances you provided where alternative medicine has proved fatal (and I don't know whether there are more or less in this area than there are in standard medicine?), it might be an opportunity to allocate Darwin Awards to the parents.

This, given media taste of the masses, would probably have more educational weight than years of clinical research.  :)