Alternative Medicine Literature?

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Discussion by: Albert_asm

Hello to all!

Im constantly fighting against alternative medicines (homeopathy, bach flowers, acupunture) but other than "Enemies of reason" i need to do more reading. 

Can you help me finding books? readings? web sites?

Thanks!!

19 COMMENTS

  1. What do you mean by “fighting?” I would suggest you tell people to google the information (x amount numbers) to find out exactly what it means. If you have an iphone, do it right there. Explain dilution to them; then offer them two beers – one straight from the bottle or a homeopathic brew.

  2. Definitely read Ben Goldacre’s book Bad Science (and his website).

    Also, check out Edzard Ernst, former Professor of Complementary Medicine at Peninsula Medical School who pissed off a number of people (including the Prince of Wales) simply by doing his job properly in actually scientifically investigating complementary therapies.

    I also enjoy reading Orac at Respectful Insolence – he has much good to say on alternative medical therapies e.g. crazy cures for cancer, autism alt med and antivaccinationism.

  3. I demonstrated the futility of homeopathic “medicine” to my daughter one day in a store. She wanted to buy something for cramping and headed straight for the homeopathy section. A few simple calculations later she realized that to get one molecule of what the product said was the active ingredient she would have to drag home several thousand boxes of the product, and take every pill in those boxes, in the futile hope of finding one molecule. Worse still was the fact that even if that one molecule managed to ease her discomfort she would still have to buy several thousand more boxes, and take all those pills, when the relief wore off. Now I just have to work on her mother and her obsession with Reiki.

  4. You could try these two books which I found both rewarding and very readable:

    “Suckers: How alternative medicine makes fools of us all” by Rose Shapiro

    and

    “Trick or Treatment: alternative medicine on trial” by Simon Singh and Edzard Ernst.

    Also, quackwatch.org is very informative.

  5. Also be aware that the placebo effect is very real, and common in many practices, including acupuncture. It isn’t exactly clear how many treatments work, whether it is placebo, or even doctor care and attention, that provides relief so do some research on placebo for sure.

  6. I’d also recommend “Trick or Treatment” by by Simon Singh and Edzard Ernst. It’s a very balanced, well-argued explanation of the major alternative treatments. Large sections of the book are devoted to acupuncture and homeopathy. Other treatments covered include aromatherapy, reflexology, herbal medicine, and of course chiropractic is given a thorough debunking too. And I love that they dedicated the book to Prince Charles!

  7. It’s a vast field as (from my admittedly rather hostile view as both an atheist and a doctor) there seems to be no end as to the fictions and snake oil medicines used to part the ill and vulnerable from their cash.

    A UK government-linked body, the National Institute for Health and Clinical Excellence (NICE) has reviewed many treatments, including homeopathy – which are referred to from http://www.nhs.uk/Conditions/Homeopathy/Pages/Introduction.aspx.

    Homeopathy is of course but one amongst a legion of ‘alternatives’ and I cannot point to you a definitive, well evidenced assessment of the whole alternative medicine field. But NICE might give you some leads – although they tend to focus on evaluating current and new ‘conventional’ treatments.

    Lack of evidence for a treatment is a start – but what is needed, IMO, is evidence from well conducted clinical trials to show the extent of treatment effect. Safety is a separate matter evidentially, but often people seem drawn to alternatives as much through fear of adverse effects of conventional medicine, rather than clear evidence of alternative treatment effects (sometimes it seems far more evidence is demanded for conventional treatment). One might say that, on whole, effective treatments are more prone to adverse risks – surgery involves cutting, heart pills affect the heart etc, but it is obviously crucial to establish any treatment has benefits as well as not having unacceptable dis-benefits.

    Incidentally, and as you may know already, NICE and other surveys usually search for all conceivably related trials (including unpublished ones, which more often have not shown a treatment effect), assess them for scientific value and then collate the findings of those accepted as of good enough quality – a process called meta-analysis. Quite often conventional but ‘established’ treatments have been found to have no useful effects, and even at times significant adverse effects. Thus, to give two example, routine tonsillectomy as a ‘precaution’ against tonsillitis (which I had a a child) is no longer practiced, as (perhaps unsurprisingly) it has been shown to only help when there are significant problems eg with recurrent tonsillitis. In the field of psychiatry, meta-analyses have led to only a limited number of antidepressants being recommended for young people, due both to concerns about potentially higher risks of suicidal thinking, maybe even actions, with some antidepressants and also the lack of good evidence of benefit in younger people.

    In other words, while conventional treatments can be of great help and are generally safe, they obviously need scrutiny. But as for alternative treatments, as others say here, often they have not been exposed to anything like the same rigour in evaluation.

  8. Hi, I just turned down a year of radiation, chemo and surgery for SCC (which has a very poor 5 year prognosis) because having read the literature, I understood why it would be ineffective. What I found suprised me, that chemo actually provokes the tumours into converting existing machinery into pumps which make them “multiple drug resistant”, and that patients whose cases I looked into who “died from cancer” actually died from infections which a newborn baby could throw off. The culprit was the chemo which wrecked their immune system. Other patients reported that the hospital food was unhealthy, and so boosting the immune was left to “alternative” methods.

    One quote in particular alarmed me: “After analyzing cancer survival statistics for several decades, Dr Hardin Jones, a professor at the University of California, concluded: ‘…patients are as well, or better off, untreated. Jones’s disturbing assessment has never been refuted.’” A survey of doctors showed that nearly all would refuse standard treatment for themselves or their families in cases of cancer based on poor outcomes and severe damage to the patient.

    Accordingly I went “alternative” and am peased to say one tumour has already disappeared, according to the surgeon, after six weeks, and the other, I hope will continue to shrink over the next three months. A colleague who also developed throat cancer (on her vocal cord) was first recommended to have radiation.

    When she went for a subsequent consulation in the same department, she was told that because of her age, radiation would be dangerous because (in their words) “radiation causes cancer”. She found the conflicting advice worrying, and has also started on a natural diet, with various supplements, which you might call an “alternative” choice. To each their own, but don’t die from dogma!

    • In reply to #11 by iain399:
      Very sorry to hear of your SCC and wish you all the best. The large scale studies of cancer treatments (the meta-analyses) do I think show an average benefit over risks, but individuals are not average – so some will have little benefit – and, of course, by the nature of averages, some will benefit rather more. I think it is also fair to point out that, as i am sure you know, there are many kinds of cancer and locations which, despite evidence of some common mechanisms, makes generalisations about cancer treatment rather difficult.

      On the whole, I suspect the internet and other media will tend to carry the unusual experiences, at both the better and worse ends of the spectrum, which in my view adds to the importance of the larger scale studies that include the more usual situations.

      This thread is also showing the range of ‘alternative’ – few if any mainstream doctors would advise against healthy eating, and some of the treatments mentioned seem to link into recognised biology. By contrast, there are some ‘alternatives’ invoking supernatural or highly different notions of the body – aura, life energies in stones etc, which appear to be far more ‘alternative’ than others.

      And, of course, every treatment, even surgery and chemotherapy, was ‘alternative’ once (which as above is not to imply that all new ideas are equally good).

      • Yes, that’s all very true indeed. My surgeon was very supportive. But to cover himself professionally, he took care to have at least one witness (his assistant nurse in one case, a cancer home-visit nurse in the other) to whom he looked for confirmation every time he stressed that after a given period he would still of course offer to treat me but may not be able to offer me a cure.

        I was very grateful for his diagnosis, without which I would have had no idea at all what I was dealing with, and probably would have remained unaware of the primary tumour buried under my tongue. The NHS, despite what anyone says, has superb equipment and staff. The slight delay in moving things around from department to department is a sign that many professionals are involved, and I don’t see how this could ever not be the case. You don’t want hurried, frantic, over-stressed double glazing salesmen intent on getting the next cheque cleared. You want people who focus only on medicine and have the time to consider your case.

        The surgeons do their absolute best, and have the patient’s best interests at heart, but only have certain tools which they can offer: the multi displinary team I was scheduled to discuss my treatment with would have included oncologists, surgeons, chemo and radiation specialists but I doubt it would have had an organic farmer! When I suggested that without treatment, I could be a useful “control group” the consultant looked genuinely distressed – “I don’t want you to be a control group!” These are people who care about what they do.

        For me, the bottom line is this: if someone successfully removed your tumour with a napalm flamethrower, but you eventually perished from burns over 90% of your body, would it be fair to say you’d “died from cancer”? Question everything. Keep your pH high and stay away from cancer! And good health to all

        In reply to #14 by steve_hopker:

        In reply to #11 by iain399:
        Very sorry to hear of your SCC and wish you all the best. The large scale studies of cancer treatments (the meta-analyses) do I think show an average benefit over risks, but individuals are not average – so some will have little benefit – and, of course, by the nature of…

  9. In reply to #11 by iain399:

    One quote in particular alarmed me: “After analyzing cancer survival statistics for several decades, Dr Hardin Jones, a professor at the University of California, concluded: ‘…patients are as well, or better off, untreated.”

    Very sorry about your situation iain399. Would just like to point out that Dr (of physiology) Hardin B Jones was talking about different cancer-types combined, and presented that conclusion in 1956 – nearly 60 years ago.

    …A survey of doctors showed that nearly all would refuse standard treatment for themselves or their families in cases of cancer based on poor outcomes and severe damage to the patient.

    Would you let us know where you found this quote? I suspect this is regarding a specific situation and I’d very much like to look into it.

    Hope all continues to go well for you :)

    • Hi,

      That’s very kind, thanks. I will have to dig up that source – I kept the quote but not where I found it. The biggest single thing which influenced me was probably seeing my father die in 2008. He was a doctor all his life, involved in research, and published in the Lancet in the 1960′s as the first person to spot drug aquired immune deficiency. He told me it was no big deal, he just noticed from samples that all the patients on a certain drug had low counts, and put two and two together.

      But anyway, he was diagnosed with lymphoma in December 2007 and given about two years. He was very stoical about it, after he was over the shock, and declared he’d live life to the full, going to Florida as usual, and playing tennis and so on. He wanted to see more of the grandkids, and maybe even do some painting. That kind of mindset, very positive.

      Then he was offered a new “silver bullet chemo” which he explained to me with great excitement. It offered him an extra two years, and of course, being well into his 70′s, jumped at the chance. I think the first treatments were in February 2008. I watched him grow old before my eyes; within another 3 months the tumours had taken over, even into his eyes, and he was gone.

      I thought about that a lot, and in my own case, of course I panicked when I got the diagnosis, because it was stage III by then, so I spent weeks reading everything I could get my hands on. What I found was MDR arose only after tumours were exposed to chemo. Last year I had the great pleasure of getting David Goodsell (The Machinery of Life – best book you can buy!) to get a hematology-related illustration done, and this year he referred me to some pages he’d worked on about cancer. From there I learned the complexity of the tools which these tumour cells come up with, to deal with chemo, and it was staggering.

      If your immune system is completely razed to the ground, even if the mass of the primary tumour disappears after chemo, these stronger tumour cells can of course travel where the hell they like throughout the blood, or in my father’s case, the lymphatic system. I also found that tumours send out chemical messages which ironically can prevent other tumours from forming, though I can’t tell you the mechanism off the top of my head. But there was a chap in Vietnam, a victim of America’s Agent Orange, who, as a child, developed a tumour on his leg. Before he was operated on in his late 20′s, the tumour had grown to the size of a suitcase and of course he was bedridden.

      But the point is, it did not metastasise, even at that size. It remained localised. It seems to show that you’re very unlikely to die solely from a tumour, unless it is in your lung, your brain, or clogging your digestive tract. The problem is when the tumour’s “evolution” is accelerated by pressure from the chemo, and then we see a very interesting mechanism. The tumours all seem to come up with the same solution, no matter the country, no matter the kind of patient or age, which to me indicates it’s a pre-programmed possibility which the cell takes advantage of, the very kind of “cassette” of tools which Shapiro found in his research.

      What makes it worse is, it seems the DNA designs for the pump are shared between the cells – so now millions of ribosomes in different cells get busy and make endless numbers of these very complex 3-part pumps, and then of course the whole army of them is immune from any kind of chemo, not just Cisplatin or whatever, and using chemo is just a waste of time. It’s at that point many patients are told to go find a hospice, and that’s when some of them turn to alternative therapies.

      I had a choice between having my head cut open from ear to ear, bits of my tongue burned away and spending a year on and off vomiting into a bucket (waiting for, as Hitchens said, “the daily bag of poison”), or, instead of losing my business and traumatising my kids, running around cheerfully with them as normal. Everybody should be free to choose, but I wouldn’t be so down on “alternatives” like Budwig, because I can tell you, they do seem to work. Some of the really abrasive sites like quackwatch put the fear of God into me, but I later found that they are part of the established big Pharma, like the shill sites you see with various political agendas. It’s very frightening to be told by a surgeon on Friday he wants to operate on Monday and take bits out of your tongue, and then see quackwatch and read alternative methods are a road to death. They are not, but I can see why many people read this stuff and give in and go under the knife in fear.

      Eventually I thought, even if I do have to die, it would be better to spend my last years in this state of great health – probably this is the first time in my life I have really eaten properly and been on top form physically!

      I’ll be honest and say at first, knowing nothing, I tried acupuncture and I went through the roof – I hated it, so I can’t vouch for that. The only things I’m on now are things I was able to read research about that showed the molecular science involved. And you’d be amazed how things like humble barley grass (with 1000 enzymes!) accelerate your digestion, clear out your intestines and improve your energy level. This stuff is just unbelievable. Why didn’t I know this before? Other things like Ubiquinol, which help in the mitochondrial electron transport and make you feel like you want to run around the block instead of sleeping, are all available very easily. I believe from what I’ve seen in my own body that cancer is, like scurvy, something that happens when we depart from a natural diet, and it can be reversed. Lind’s cure for scurvy took 70 years to be accepted only because the Admiralty preferred to market quack cures, as it boosted their pensions. And cancer is going the same way. If you’re making $500million from a chemical molecule each year, are you going to spend $80m proving via the FDA that apricot seeds or barley grass help dissolve tumours, by playing on their inescapable traits as high glucose and low oxygen users? Of course not. As soon as you get done blowing a year’s profit, your competitors will all be selling them and even your clients will say thanks and goodbye.

      Anyway, I digress – thanks very much for the good wishes… it’s certainly good to be alive. If you have good health, keep it!

  10. Sometimes fighting for something can be more effective than fighting against something else.

    Quack remedies and pseudoscience will not go away, any more than religion. People are naturally pattern seeking and subject to all the various influences identified by social psychology.

    Depending on nuances of scope and the definition of the referent group a genuine scientific comparison of the performance of alternative medicines compared to mainstream orthodox medicine might not necessarily always come out as favourable to orthodox medicine as could be hoped. At least for many common complaints.

    As an example the most common reason patients visit my local General Practitioner is because they feel chronically tired. He can do nothing for them. The advice that might actually make a difference: eat more fresh and unprocessed food, get more exercise, and watch less TV, get more sleep etc. is not a monopoly treatment exclusive to mainstream medical practice. But that kind of advice is at least equally available from an alternative health practitioner than a regular physician. If only because the alternative end of the market is less regulated, therefore more open and more competitive, and so operates on more normal margins from an economics perspective. (You can’t ever escape that supply of pharmaceuticals is extraordinarily profitable – exactly what also motivates many suppliers of quack remedies. Which can sometimes even be those same pharmaceutical firms.)

    Any comparison of effectiveness needs to be made with actual real medicine, as implemented via real clinical practise in real underfunded and overstressed facilities and often orchestrated by the financially motivated rather than health motivated practitioners and institutions. And keep in mind that acute surgery, what most people think of as modern scientific medicine, is just the tip of the iceberg for overall medical treatment. Comparisons with alternative medicine are not relevant there and this isn’t even contested. You’re really only able to compare more fuzzy situations where the nature of the problem and the solution are less distinct and measurable.

    Also remember that orthodox medicine has not really been scientific for very long. There’s some way to go yet. There’s scope for at least some people to perceive that they have received ‘better’ and more effective treatment from the alternative side of the health industry. If the objective is to enhance human health then it might be better to work towards raising the standards of mainstream clinical practise rather than confronting inevitable irrationality of human irrationality.

    Some recent articles:

    There was a good article posting on this site about acupuncture from Stephen Novella very recently.
    And as many have mentioned: Ben Goldacre is probably the best current writer about pseudo-medical quackery. Martin Gardner has some great stuff from a few decades back – it’s still mostly the same old issues though.

    I’d add Robert Cialdini and Philip Zimbardo. They’re prominent social psychologists who’ve written some good pop science books that explain the influences driving a variety of apparently irrational phenomena.

    It’s also worth getting a feel for the best case that can be made from the other direction. You won’t convince people just by telling them alternative medicine is irrational. Especially when they are convinced that they or someone they know really is benefitting from alternative treatments. So you need to understand the source of potential benefits of alternative medicine.

    Keep in mind that hardly anyone studies science. So arguing that alternative medicines are unscientific isn’t sufficient. The employability outlook for uni graduates who major in science or maths is extremely poor. The world certainly needs many more people trained in maths and science, but the world very much doesn’t actually want such people. And certainly isn’t prepared to pay for them, even if it is prepared to pay lip service by deliberately misleading them into incurring personal debts to pay for very expensive training.

    Just as not all medical practitioners are primarily motivated by enhancing the health of their patients, not all homeopathic practitioners are antagonistic towards conventional medical practice or heavily committed to the bizarre molecular basis of homeopathic remedies. For many of them it’s just mumbo jumbo that helps enable the placebo effect among some clients, which may itself be secondary to avoiding making the problem worse and avoiding aggressive pharmaceuticals by attempting basic first aid. First aid involves simply removing the cause of the problem. Many medical conditions also have ‘causes’ as well as ‘cures’. It would make sense to eliminate the cause, and that is often sufficient. But the economics of treatment depends on the supply of remedies. The concept of opportunity cost is counter-intuitive and human psychology makes it difficult to justify expending resources on ‘not doing something’, without even exploring the implications for industry profitability. Same issue as with insurance – people don’t like paying for insurance unless they get something tangible back. For medical insurance you often see policies that include such tangible things like new pairs of running shoes, discounted gym membership etc. (And even alternative treatment coverage!)

    From the ‘other’ side I’ve read an excellent discussion about the history of the splintering of medical practise into orthodox and heretical alternatives, and the regulatory drivers originally behind the licensing of medical practitioners. In the UK medical industry regulation arose to ensure that medical practice primarily remained the domain of the sons of the aristocracy during the rise of industrialization and the threat presented by the rise of wealthy industrialists. In the USA it was more about establishing monopolies, as only the Americans do best. (The process involves imposing very high and costly entry barriers to an industry rather than directly outlawing competitors.) It has its origins in commercial rivalry among the early days of large pharmaceutical manufacturers in Europe and the USA.

    Economic drivers would probably have favoured the ‘paying for illness’ model anyway, rather than the ‘paying for wellness’ model. The reason is that people who are sick feel they are getting value for money when paying for treatment. Even if that ‘treatment’ is effectively not all that different from burning witches. But people who are already healthy tend to baulk at paying for the equivalent of sacrifices to the invisible gods to keep them healthy.

    It may just be an accident of history that one side or the other style of medical practice became the orthodoxy – though you’d expect that regardless of which rival ideology gained the ascendency the consequences today would be indistinguishable after a couple of hundred years. Simply because both sides were equally unscientific –from our modern perspective. And physicians are now told in medical school that most of what they learn will likely be superseded during their careers.

    It’s easy to forget that orthodox medicine is more of a technology, rather than a science. Much of clinical practise remains driven by legal and historical considerations rather than genuine scientific analysis. It exists because it works, but this ‘working’ is primarily defined in economic terms. (Defined by the suppliers rather than consumers – a situation that is always a consequence of de facto monopoly.)

    Science is becoming much more significant in medicine. But it’s not just new discoveries overturning previous knowledge. Much well-established knowledge is being discovered to either have been less than rigorously validated, or possibly less than fully effectively implemented when it is valid. My favorite example of how things can remain in an unsatisfactory situation, despite well-established scientific knowledge, is the present day extreme difficulty in convincing physicians in major hospitals to routinely wash their hands (except for things like surgery). An issue only now resurfacing owing to the increasing prevalence of low cost security cameras and wireless networks in hospital facilities – originally installed to combat theft by junkies and others.

    Though it’s not just a medical issue. Same issue is prevalent in food halls in major shopping centres. Shopping centres are continually exposed to risk of law suits from professional slippers & trippers, so all potentially ‘wet’ areas near toilets and food or drink outlets are increasingly saturated with covert video surveillance devices – with interesting results regarding toilet hygiene. Minor cases of food poisoning are often indistinguishable from mild flu infections. So if you think you may be getting frequent headaches and feeling a little lethargic it can be worth simply removing this cause – i.e. don’t eat at food halls. Especially ethnic outlets where the vendors tend to employ non-english speakers. More relevantly non-english readers, and more specifically: those who cannot understand the written hygiene procedures or instructions printed on the disinfectant containers. But it’s not just an ethnic migrant issue. Possibly these bad habits are increasingly prevalent owing to being indirectly taught in schools. E.g. NSW public schools do not provide soap or hand towels / driers in student toilets.

    It’s easy to see how someone might indirectly obtain good results from a naturopath who advises they eat wheat germ with everything – it doesn’t matter what the dietary advice is as long it’s not available as fast food!

    There’s an interesting discussion about the origins of homeopathy is in a chapter of ‘The Glycation Factor’ – Greg Ellis. Ellis provides plus some insight into why things like homeopathy can seem to be effective, independent to psychological factors and the placebo effect. (The book as actually about arcane aspects of nutrition and hazards of dieting for weight loss etc. – but also includes a few interesting autobiographical digressions involving motivated reasoning and conspiracy theories.)

    From what I recall from his book the essential issue is that there are ongoing issues with routine clinical practice in aspects of orthodox medicine. Just not doing stupid stuff by displacing it with guaranteed ineffective treatment, while also eliminating the cause, can sometimes be more effective. Ineffective treament can sometimes be better, not by providing better scientific solutions but by avoiding making things worse. Evidence based medicine is an attempt to orient medical practice towards real science. Something that Ben Goldacre discusses. Especially in connection with the pharmaceutical industry.

    Science is only as good as the quality and extent of competent research. Which is very much dependent on who controls funding. Control of funding resources is a political and economic issue, but very much constrains the domain of science, at least in public health matters.

    Here’s couple of good examples of how science might be beginning to catch up on some major public health issues:

    sugar lies

    the science of junk food

  11. For those interested in emerging alternative approaches to cancer treatment here’s an article that might be relevant for at least some particular forms of tumour:

    diet and tumours

    I heard a radio interview on this about a year ago and the impact (presumably on rats) was that keto-adaptation was at least as effective as chemo or radiation. And significantly more than twice as effective in combination.

    I think there may be much more substance to this than other alternative approaches. Reason is that the proposed mechanism is consistent with the glycation theory of aging and disease. Though glycation is mostly being taken seriously by the cosmetics industry at this stage. (Basically glycation is the chronic damage accumulating as a result of continual exposure to a high intake of dietary sugars – especially fructose from sugar, and excessive amounts of glucose from low fat, high protein diets. Suspected to contribute to alzheimers, heart disease etc. But also affects skin condition.)

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