Archive for the ‘Alternative medicine’ Category

Podcast plug – Dr Aust live (ish)

September 30, 2010

In which Dr Aust does some heavy breathing into a headset.

A week or so back, thanks to the wonders of internet-based communication technology (aka Skype) I joined the guys from Greater Manchester Skeptics for their podcast Just Skeptics (Episode 12, apparently). It is now out – if you’re interested, you can listen to it here, or here, or even download it (free, of course) from the iTunes store.

You’ll have to excuse the heavy breathing, which I’m embarrassed to say was me. I’d never used a microphone headset before – I’d only installed Skype a day or two earlier – and I think the microphone distance needs adjusting. Or perhaps I’m just a heavy breather.

Anyway, if you do fancy checking it out, you can first hear us talking about “Charity mugging”, the phenomenon whereby you can’t walk twenty metres in a British town centre in the daytime without being accosted by someone trying to sign you up as a charity (direct debit) donor. Until the podcast I hadn’t heard that these “Chuggers” are often out-of-work actors.

We also discuss mad chemists, that hardy stereotype of the man in the white coat with the mad staring eyes. This was inspired by the UK Government’s “Crazy Chemist” anti-drug campaign – the one that got the Royal Society of Chemistry so hot under the collar.

And finally, at 24 minutes in, you can hear me having my “Soapbox” where I poke fun at Alternative Medicine. It’s not terribly original stuff, and will probably be fairly familiar to regular readers, but hopefully you might find some of it amusing.  This segment is followed by a discussion of similar themes, which runs for most of the rest of the podcast. It  concludes with the Richard Feynman reflexology story that you may remember from here.

Anyway, let me know what you think, especially if you stick it out all the way through.

PS Listening to the podcast I now notice a couple of minor factual inaccuracies on my part, notably giving the wrong name for something… ah well. Shows that talking off the cuff is not as easy as one might think. Try to spot the slip(s), if you like.

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Feynman on foot fondling

June 10, 2010

In which Dr Aust muses on foot flim-flam.

The night before last I went along to a rather good Skeptics in the Pub talk by the excellent Simon Perry.

As Simon was going through the ways he had got interested in debunking preposterous claims by Alt therapists, he mentioned Reflexology as being one of the first Alt.Therapies that had caught his eye.

Reflexology, for anyone that doesn’t know, is one of the more laughably daft quackeries, especially popular with New Age types. It is based on the idea – needless to say, an idea with no kind of basis in anatomy, or anything else – that a “map” of the body’s areas can be found on the sole of the foot, and that massaging these areas can help with the “mapped” bit of you.

Ref;exp;pgy foot chart, with "zones" supposed to correspond to body parts colour-coded

Like many a choice quackery, reflexology in the form we now have it is a surprisingly recent invention. As the Wikipedia page on reflexology explains, it dates from around the time of the First World War, and was then elaborated and codified in the 30s and 40s. It gained greatly in popularity  during the 60s and 70s, when Woo became fashionable along with other kinds of mysticism and “stoned thinking”. I am in two minds whether to blame Marin County or the Glastonbury Festival.

Less surprisingly, reflexologists like to claim that reflexology is based on “Ancient Healing Wisdom”.

Now…. where have I heard that before? Oh yes, for just about every piece of Alt.Therapy  quackery you can possibly think of.

The Association of Reflexologists – yes, I’m afraid they have an association – tells us:

“The art of reflexology dates back to Ancient Egypt, India and China”

Fancy, just like chiropractic. Now who’d have thought it?

Now, I don’t know if the reflexologists have followed the chiropractors in being miraculously able to detect the practice of their Nonsense of Choice“Art” back to before there were actual written records – remarkable how they manage to do that – but I wouldn’t be terribly surprised. It is amazing just how ancient that ol’ wisdom becomes when you are trying to sell it to folks. Just sayin’.

When the topic of reflexology comes up, as it did in conversation with one of my Nursing degree student groups the other day, I am given to referring to it as:

“A pricey foot massage with added Mumbo-Jumbo.”

– a description I like to think even my friend  David Colquhoun might approve of, since it is shorter than the potted summary of reflexology in his Patients’ Guide to Magic Medicine.


There’s no Woo too far…

Now,  it is a measure of just how much mainstream medicine currently bends over backwards to be respectful of complementary medicine (CAM) – and quite contrary, by the way, to what the CAM advocates, who always complain they are not taken seriously enough, would have you believe – that there have been quite a number of randomised controlled trials of reflexology. I shit you not.  Indeed, there is  a recent Systematic Review of them by the ever-punctilious Edzard Ernst:

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Med J Aust. 2009 Sep 7;191(5):263-6.
Is reflexology an effective intervention? A systematic review of randomised controlled trials.
Ernst E.

Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, United Kingdom. Edzard.Ernst@pms.ac.uk

Abstract

OBJECTIVE: To evaluate the evidence for and against the effectiveness of reflexology for treating any medical condition. DATA SOURCES: Six electronic databases were searched from their inception to February 2009 to identify all relevant randomised controlled trials (RCTs). No language restrictions were applied. STUDY SELECTION AND DATA EXTRACTION: RCTs of reflexology delivered by trained reflexologists to patients with specific medical conditions. Condition studied, study design and controls, primary outcome measures, follow-up, and main results were extracted. DATA SYNTHESIS: 18 RCTs met all the inclusion criteria. The studies examined a range of conditions: anovulation, asthma, back pain, dementia, diabetes, cancer, foot oedema in pregnancy, headache, irritable bowel syndrome, menopause, multiple sclerosis, the postoperative state and premenstrual syndrome. There were > 1 studies for asthma, the postoperative state, cancer palliation and multiple sclerosis. Five RCTs yielded positive results. Methodological quality was evaluated using the Jadad scale. The methodological quality was often poor, and sample sizes were generally low. Most higher-quality trials did not generate positive findings. CONCLUSION: The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition.

PMID: 19740047

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Good Old Edzard. How he keeps a straight face whilst reviewing this kind of ridiculous “Prior Probability Zero” nonsense I really don’t know. I am damn sure I wouldn’t be able to.

[An aside to  explain why not: a decade or so ago I turned down a final interview for a rather better paid job (better paid than being a junior academic) as a mid-level administrator for a Large and Important Medical Charity. A big part of my decision was that it was clear that an atmosphere of High and Hushed Seriousness was a major part of their Headquarters House Style. It was clear to me that High Seriousness was not something I would be able to stick to for that long, being a person naturally given to Low and Childish Mockery.]

Anyway, getting back to the estimable Professor Ernst, he is a treasure, partly because he is able to do what he does with complete seriousness and great thoroughness. I suggest we should have a slogan for him:

“Prof Edzard Ernst: rigorously appraising Alt.Med research, so that you don’t have to.

– and, indeed, long may he continue to do so.

Finally – Feynman on Foot Flim-Flam

Anyway, the point of this post, before it got sidetracked, was to say

(i) that Simon Perry gives an excellent talk, and

(ii) that reflexology is (to use a piece of British vernacular) “Bollocks”.

And finally, to re-tell a story.

I happened to ask Simon Perry if he had heard Richard Feynman’s reflexology story. He hadn’t, which makes me think it is not as well known as it could be. So I will reproduce it here. It comes from one of my favourite pieces of Feynman’s debunking work, his famous talk on “Cargo Cult Science”. The talk was given originally in 1974, at the Caltech (California Institute of Technology) Commencement Address, but thirty-six years later it remains just as apposite.

I shall leave the rest to the master:

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“During the Middle Ages there were all kinds of crazy ideas, such as that a piece of rhinoceros horn would increase potency. Then a method was discovered for separating the ideas–which was to try one to see if it worked, and if it didn’t work, to eliminate it. This method became organized, of course, into science. And it developed very well, so that we are now in the scientific age. It is such a scientific age, in fact, that we have difficulty in understanding how witch doctors could ever have existed, when nothing that they proposed ever really worked–or very little of it did.

But even today I meet lots of people who sooner or later get me into a conversation about UFOs, or astrology, or some form of mysticism, expanded consciousness, new types of awareness, ESP, and so forth. And I’ve concluded that it’s not a scientific world.

Most people believe so many wonderful things that I decided to investigate why they did. And what has been referred to as my curiosity for investigation has landed me in a difficulty where I found so much junk that I’m overwhelmed. First I started out by investigating various ideas of mysticism and mystic experiences. I went into isolation tanks and got many hours of hallucinations, so I know something about that. Then I went to Esalen, which is a hotbed of this kind of thought (it’s a wonderful place; you should go visit there). Then I became overwhelmed. I didn’t realize how MUCH there was.

At Esalen there are some large baths fed by hot springs situated on a ledge about thirty feet above the ocean. One of my most pleasurable experiences has been to sit in one of those baths and watch the waves crashing onto the rocky slope below, to gaze into the clear blue sky above, and to study a beautiful nude as she quietly appears and settles into the bath with me.

One time I sat down in a bath where there was a beautiful girl sitting with a guy who didn’t seem to know her. Right away I began thinking, “Gee! How am I gonna get started talking to this beautiful nude woman?”

I’m trying to figure out what to say, when the guy says to her, “I’m, uh, studying massage. Could I practice on you?” “Sure,” she says. They get out of the bath and she lies down on a massage table nearby. I think to myself, “What a nifty line! I can never think of anything like that!” He starts to rub her big toe. “I think I feel it,” he says. “I feel a kind of dent–is that the pituitary?” I blurt out, “You’re a helluva long way from the pituitary, man!” They looked at me, horrified–I had blown my cover–and said, “It’s reflexology!”

I quickly closed my eyes and appeared to be meditating.”

Richard P Feynman

Poetry corner – subluxation special

May 15, 2010

In which Dr Aust mourns the loss of an old (imaginary) friend.

Today Zeno’s excellent blog alerts me to the sad loss of the Chiropractic Subluxation, printing an extended and most informative Obituary.

This follows a lengthy investigation by Zeno and other interested parties, notably the Skeptic Barista, into claims that the Subluxation had, in fact, been deceased for many years.

Or, indeed, that it had never existed in the first place – except, perhaps, as a metaphor.

The Chiropractic Subluxation,  you may remember, is the mysterious “functional lesion” (no non-subjective test will actually find it, but chiropractors have insisted it is there) in the vertebral column which chiropractors claim to find, “diagnose” and correct.

Well – they did used to claim this.

That, however,  may be about to change.

The Skeptic Barista informs us that the UK’s General Chiropractic Council has now declared that:

“There is no clinical research base to support claims that the chiropractic vertebral subluxation complex is the cause of disease or health concerns.”

Advice to chiropractors about whether they can continue to make claims for the subluxation complex being:-

“the cause of disease or health concerns”

– and hence, of course, something you should consider paying a chiropractor to correct – is likely to follow shortly.

In the meantime, and following the acclaim for our resident bard’s  recent Memorial Poem on the demise of the Prince’s Foundation for Integrated Health, he has been persuaded to pen something suitable on this new, and solemn, occasion.

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POETRY CORNER

In Memoriam
The Chiropractic Subluxation

So. Farewell
Then. The Chiropractic
Subluxation

A complicated Word
For something that
Does not
Exist.

Or perhaps for what
Was just
A Metaphor.

Or rather –
A Metaphor
Wrapped up inside
An Enigma
Wrapped up inside
A Paradox.
Wrapped up inside
A Huge Invoice.

Which last
Chiropractors have been
Presenting for
At least
A Century

Very Tricky

As a member of
The Public
You would probably
Need X-ray
Vision
to
Get to the
Bottom
Of All This.

Or at least to make
Sure you
Were not being
Manipulated

In memoriam

April 30, 2010

In which Dr Aust gets a bit poetic

Today the Prince of Wales’ Foundation for Integrated Health (FIH) announced that it was to close its doors.

(There is some suggestion that if you look at the logo for long enough the feathers will start to droop.)

The announcement follows recent revelations about the FIH’s finances, sources of income for at least one of their more notorious projects, and the police investigation into allegations of serious fraud at the charity, including the arrest of at least one ex-staffer.

Though the announcement states that the closure of the charity was “already planned”,  it acknowledges that it has been brought forward by the ongoing police investigation.

The story has already attracted coverage in the media – both mainstream and scientific/medical – and on the blogs.  Some links are at the end.

However, as yet, no-one has penned a valedictory poem.

Though I suppose it is possible Poet Laureate Carole Ann Duffy will rise to the challenge in due course, in the meantime I thought I would have a go.

So, with apologies to E.J. Thribb, I give you:

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POETRY CORNER

In Memoriam
Prince of Wales’ Foundation for Integrated Health

So. Farewell
Then. The
Prince of Wales’ Foundation
for Integrated Health

As it so
Happens a
Much disputed term

“Integrated Health”
You said.
“Quack nonsense” said
The scientists.

“Achieve optimal health
and wellbeing”
You said.
“If you buy this Duchy dodgy
Herbal potion
They mocked.

But of course now
That all the
Money has disappeared
It might
Appear rather
Quackademic.

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I have also been trying to come up with a suitable epitaph for the FIH

So far my favourite is:

Requiescat in ridiculo

or perhaps:

Requiescat in ridiculo (a)eterno

Which latter version would have the neat acronym – at least for anyone who has ever studied French at school – RIRE.

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More coverage:

From Pulse (with quotes from FIH’s Dr Micharl Dixon and Edzard Ernst)
From Nature (with comment from Edzard Ernst)
From David Colquhoun’s blog (with updates promised)
Google collection of news stories