The #1 bogus argument that quacks and the government use to promote pseudoscience

This does not reduce pain.

Chairman Mao would be delighted, if he were alive to see it. He now has the U.S. government buying into arguments that he used to hoodwink his own people, decades ago. Never mind that the arguments are all bogus.

This morning, the front page of The Baltimore Sun describes how the U.S. Veterans Administration is using acupuncture to treat chronic pain in veterans. The VA especially likes something called "ear acupuncture," the creation (out of thin air) of a VA doctor who claims that a few needles inserted in your ear will cure pain anywhere in your body. The VA also calls this "battlefield acupuncture," and it is not only fake but also dangerous, so much so that in 2011 I labelled it the worst quackery of the year.

And yet it hasn't gone away, as the Baltimore Sun reports. The VA uses acupuncture "across the country," offering it to veterans who have little choice about their health care provider. A few years ago, the VA argued this could help veterans manage chronic pain from war injuries. Now they're claiming that acupuncture will help solve the opioid epidemic. Whether it works or not seems beside the point: a VA doctor quoted in the story argues that "if patients believe that it’s helping their pain, then it is." Unfortunately for her patients, she seems unaware that science has shown that acupuncture does not work–for anything (as Yale neurologist Steven Novella succinctly put it).

Why is the VA offering quack treatments to veterans? One reason is that these treatments are popular. The same argument appears in countless forms, but it boils down to: "the people want this, so we should give it to them."

I get it: popularity is good news if you're an actor, or a writer, or a singer, or an athlete, or especially a politician. But it means nothing when we're trying to decide if a medical practice is effective. Doctors in medieval Europe used to bleed their patients, often killing them, in the belief that sickness was caused by "ill humors" in the blood. Bleeding was popular, but it was a very bad idea.

It's not just the VA. This past fall, two Colorado Congressmen, Jared Polis (D) and Mike Coffman, (R) announced the creation of a bipartisan Integrative Health and Wellness Caucus, explaining that:

"While at least a third of Americans use complementary or alternative medicines, access is often inconsistent."

It's not surprising that Polis and Coffman believe that we should give people whatever treatments they ask for. Neither of them is a scientist, so they live in a world (politics) where popularity counts for a lot. How ironic that, in the hyper-partisan U.S. political scene today, the parties have come together to support something that is flat-out wrong.

Just stop it already. Stop arguing that just because something is popular, it must be true, or at least worth investigating (at taxpayer expense). For centuries, most humans believed the Earth was flat, but that didn't turn out to be true, though it was popular. We figured it out and moved on.

Today's versions of medieval bleeding include acupuncture, homeopathy, naturopathy, chiropractic, reiki, Ayurveda, healing touch, various "detox" treatments, and more. Science has figured out that all of these are nonsense, and moved on. (And by calling them "nonsense," I am being generous. Some of them are dangerous.) But people who make money off these practices have been waging a decades-long campaign to keep them going.

Acupuncture is a scam foisted on the Chinese people by Mao Tse-Tung, whose country was too poor to provide real medicine to its population. Instead, Chairman Mao launched a marketing campaign to convince them that the old, traditional medicine was just as good. Kimball Atwood wrote a 4-part history of these events; in part 3 he reveals this gem, from Mao's personal physician:

"Publicly, the Chairman was the leading advocate of traditional medicine, but he refused to use it himself."

And now the U.S. government has fallen for the same scam.

Universities are prey to this as well. This fall, we saw the University of California at Irvine announce a $200 million gift to create a new medical center dedicated to integrative medicine, a disturbing intrusion of junk science into the academic mission of the university. One of the donors, Susan Samueli, argued that "The public is not only interested [in integrative medicine], but they are clamoring for it.”

There it is again–the argument from popularity. And even though this might be privately funded, it is based at a public, state-funded university.

One might hope that the NIH would help set things straight. Think again. Here's an example from NIH's National Center for Complementary and Integrative Health (NCCIH:

"Many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches developed outside of mainstream Western, or conventional, medicine."

NCCIH's website is careful not to state explicitly that popularity is equivalent to evidence. But then what are they saying? That NIH thinks that 30% of Americans are wrong? (By the way, that 30% number is highly dubious. It includes a wide array of practices, some reasonable and others wacky.)

Why do we even have an NIH center devoted to integrative medicine? It's not because there's any science behind it. On the contrary, NCCIH is a monument to a deep misunderstanding on the part of former Senator Tom Harkin, who created it back in 1991. For an excellent summary of NCCIH's history, see this short video from Reason TV:

or my own talk from a 2015 conference, here. Harkin earmarked a few million dollars to create a small Office of Alternative Medicine in 1991, and with his help it grew over the years into a large, money-wasting administrative behemoth.

NCCIH's website is replete with misleading statements. After pointing out that "millions of Americans use complementary health approaches" (there's that popularity argument again), they offer this sage advice:

"Choose a complementary health practitioner, such as an acupuncturist, as carefully as you would choose a conventional health care provider."

Face, meet palm. No one shouldn't be choosing a "complementary" health provider in the first place, and NIH shouldn't be telling people to do it carefully, whatever the heck that means.

Yes, this stuff is popular. And its popularity has enriched the numerous practitioners of bad medicine, many (most?) of whom may genuinely believe that their snake oil works. But popularity doesn't make something true. Or maybe it does–I hear that the tooth fairy is very popular.

NIH distorts report showing risk of stroke after chiropractic

Why would an NIH center try to mislead the public about a newly published study that it funded? Last month NIH’s alternative medicine center, NCCIH, highlighted one of its studies with this headline: “Low risk of stroke after chiropractic spinal manipulation in older patients with neck pain, study finds.” 

This sounds reassuring, unless you read the study. It turns out that the risk of stroke was 10% higher in patients who saw a chiropractor compared to those who saw a regular doctor. Yet NIH wants us to believe that the study found no serious risk.

Why ask this question? Because earlier studies showed a small but frightening risk of stroke in younger people (45 and below) after chiropractic, caused by dissection of the vertebral artery. Strokes caused by a tear in this artery are extremely rare, but even a tiny possibility of a fatal stroke after a chiropractic manipulation is alarming. As Forbes writer Larry Husten reported last August, the American Heart Association and the American Stroke Association issued a statement warning that chiropractic neck adjustments might cause strokes. The AHA stated:

• "Manipulating the neck has been associated with cervical dissection, a type of arterial tear that can lead to stroke.
• Although a direct cause-and-effect link has not been established between neck manipulation and the risk of stroke, healthcare providers should inform patients of the association before they undergo neck manipulation."

I’ve written about this as well, both at Forbes and in The Atlantic Monthly. The risk is small but the consequences can be extremely serious.

So what's in this new study? The study, led by chiropractor James Whedon at Dartmouth College, was a large-scale survey of Medicare claims involving people aged 66 to 99. Its aim was to answer this question: "what is the probability of stroke following chiropractic spinal manipulation, as compared to a control group of subjects evaluated for neck pain by a primary care physician?" Key findings from the study included these (all from Table 2):

                     Hazard ratio for stroke at 30 days

All patients         1.10 (10% increase)

Patients aged 75-79  1.93 (93% increase)

Patients aged 80-84  2.50 (2.5 times more likely)

Patients over 85     3.59 (over 3.5 times more likely)

This looks bad: for all patients, the risk of stroke was 10% higher if they'd seen a chiropractor versus a regular doctor. In the older patients, the risk of stroke after 30 days was 1.9 to 3.6 times higher than for patients aged 66-69. (All four of these results were reported as statistically significant.) Yet the conclusions of the study–and the NIH press release–make no mention of these findings. The study itself concludes only that 

“Among Medicare B beneficiaries aged 66 to 99 years with neck pain, incidence of vertebrobasilar stroke was extremely low. Small differences in risk between patients who saw a chiropractor and those who saw a primary care physician are probably not clinically significant.”

Talk about spin! The study provides no support for the dismissive statement that the increase in risk of stroke after chiropractic is "not clinically significant"; it seems they are trying to downplay their own finding of a statistically significant increase in risk. The NIH’s press release is just as bad: it merely parrots the study's conclusions, opening with the statement that “cervical spine manipulation is unlikely to cause a stroke,” and never mentioning the statistically significant 10% increase in risk or that the study was led by a chiropractor.

Despite the misleading press release, this new study adds to the evidence that chiropractic carries an increased risk of stroke, especially for older patients. As the American Heart Association recommends, patients should be informed of this risk before submitting themselves to a possibly dangerous neck manipulation. And NIH press officers should read the study before issuing a press release.

Internet quack Joe Mercola is worried. Dr. Oz to the rescue!

Dr. Oz interviews Joe Mercola on his show.

After a series of studies showing that vitamins and supplements are usually a waste of money, including my recent article on the top 6 vitamins you shouldn’t take, internet supplement salesman Joe Mercola is worried.  He should be: his Internet-driven empire is largely based on sales of vitamins and supplements, for which his claims range from merely implausible to dangerously untrue, including:

• Himalayan salt is far better for you than regular salt. Coincidentally, Mercola sells the good salt.
• Vitamin D is "the new silver bullet for cancer." No, it's not.  Not even a little bit.
• Homeopathy cured a boy of autism. Of course Mercola doesn't provide any proof of this, only a testimonial.  This is not even remotely plausible, since homeopathic preparations are just sugar pills.

I could provide many more examples, but this should be enough to demonstrate that I'm not making this stuff up.

Mercola is also one of the loudest voices and worst offenders in the anti-vaccine movement. Among other misinformation, he claims that the hepatitis vaccine causes autism, and his website urges people to use his supplements instead of getting vaccinated.

So how do I know Mercola is worried? He's appearing on the Dr. Oz Show on Monday, February 10 (the day after I'm writing this) to talk about multivitamins. Apparently his 10 minute segment wasn't enough, so he posted an article on his website with the "Information I couldn't share" on Dr. Oz's show.

Does the article explain why multivitamins are actually good for you?  Well, no. Most of the article is a big red herring, in which he argues that supplements should not be regulated as drugs, because "we have all the regulations we need." Then he contradicts himself and says that the FDA already regulates supplements. (It doesn't - or to be more precise, the FDA does not require supplement makers to prove their products work. It can only step in if the products start to kill people. This is what Mercola calls regulation.) Besides, he says, supplements are harmless. As evidence, he cites a press release from a pseudoscientific organization that claims "no deaths from supplements in 27 years."

Not surprisingly, Mercola doesn't cite any actual science to support his claims. In contrast, several very large studies in major medical journals, cited in my own columns last month and last October, show that routine supplementation with multivitamins, especially with the megadoses that many people take, can indeed cause genuine harm. Those same studies showed that if you don't have a deficiency, there's simply no benefit to taking most vitamins.  Mercola's response is to cite opinion pieces from his own website that simply assert, without any evidence, that the studies are wrong.

In other words, Mercola's response is "Oh yeah?" He then goes off on a tangent and launches an irrelevant ad hominem attack on noted vaccine expert Dr. Paul Offit.

Why has Dr. Oz repeatedly had Joe Mercola on his show? This is a tough one. Does Oz believe that autism is caused by vaccines, something Mercola has claimed repeatedly over the years?  Does he understand that Mercola's anti-vaccination campaign leads to genuine harm? Does he know that the FDA has repeatedly issued warnings to Mercola to demand that he stop making false claims about his vitamins and supplements, as Chicago Magazine reported?

Or does Dr. Oz keep inviting Mercola back because he knows Mercola has a big audience that will increase his own viewership?

Despite my past criticism of Dr. Oz, I still think he has a better grasp of science than Joe Mercola. He also reassures viewers constantly that he doesn't sell the products that appear on his show. And yet Oz is giving a platform to someone who makes huge profits selling products based on unproven claims. By having Mercola on his show, Oz is giving him free publicity and helping him sell those same products. And whether or not Oz agrees with Mercola, he is helping to give credibility to Mercola's wildly inaccurate and dangerous anti-vaccine claims.

Alternative medicine quacks show their greedy side

Congress is on holiday this month, but the lobbyists are baiting their hooks, planning their strategies for how to get more money for themselves.

A growing lobby is Complementary and Alternative Medicine (CAM) providers, who have discovered a new opportunity to extract even more money from patients than they do already. They want the government to force insurance providers to pay for quack treatments, regardless of whether or not the treatments work. Any attempt to require evidence, they argue, amounts to discrimination.

Discrimination? Yes! We must not allow the government to exclude health care providers just because those providers don't cure anything.  The CAMmers argument boils down to this: we have patients who want our services.  The patients like us. In some cases, thanks to lobbying at the state level, we even have state-approved licenses. Therefore insurance companies must pay for our services.

Neat.

To be specific, the CAMmers are lobbying furiously to try to protect a special clause in the Affordable Care Act (Obamacare) that promises them a fertile new ground for making money from vulnerable patients.

The strategy is simple: require the government to fund any treatment that a patient wants, and dress this up as "patient choice."  Then if insurance companies resist paying for ineffective treatments, accuse them of discriminating against the poor, hapless "integrative medicine" providers.

Thus through a diabolical twist of illogic, if Obamacare doesn't cover homeopathy, or naturopathy, or acupuncture, or magnetic energy healing, or any other so-called alternative therapy, it's discrimination.

The mind boggles.

Why is this an issue now?  Because, unbeknownst to most people outside the Washington beltway, two pro-CAM lobbying groups slipped a clause into the ACA, section 2706, that attempts to force insurance providers to cover a wide range of quack practices.  This section requires that insurers

"shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable state law."

Sounds harmless, right?  Well, no.  This language was added to the ACA by Senator Tom Harkin, after heavy lobbying by the American Chiropractic Association and the Integrative Healthcare Policy Consortium.  In fact, it is virtually certain that lobbyists wrote the section, and Harkin simply inserted it into the law. The IHPC is a lobbying group dedicated to obtaining more government money for homeopathy, naturopathy, chiropractic, acupuncture, and a raft of other ineffective medical practices.

Section 2706 opens the door to anyone who provides what they claim is health care - no matter how ridiculous the claim - to file a lawsuit claiming discrimination if an insurance company won't pay for their services.  You could start offering dried bird poop for arthritis, call it "avian nature therapy," and if an insurer won't pay for it, you can sue.

Some in Congress have realized how truly bad an idea this is, and just a few weeks ago, a new bill was introduced to get rid of it, HR 2817.  The American Medical Association supports the new bill. This has some CAM proponents alarmed.

Over at the Huffington Post, John Weeks, an outspoken apologist for questionable medical practices, offers the predictable, whining claim that this is all about "discrimination" by legitimate health care providers (the big, bad AMA) against poor, defenseless integrative medicine providers.

Make no mistake: this is all about greed.  The CAM industry sees Obamacare as a chance to reap huge profits, by forcing insurance companies to pay for ineffective treatments, including many that are wildly implausible.

Homeopaths, naturopaths, acupuncturists, reiki practitioners, energy healers, and other CAM practitioners don't want to subject their methods to rigorous tests of effectiveness.  They know that their methods have failed scientific scrutiny, time and time again.  So now they want to force health care providers to pay for anything the patient wants. "Our patients believe us," they argue, "so pay us."

Forcing health care providers to pay for anything a patient wants, even if it doesn't work, is guaranteed to drive up costs, without any benefit to patients.  Let's ditch this bogus "discrimination" clause in the ACA, and insist that all medical care be held to the same high, scientifically rigorous standards.

Naturopathic shenanigans in the Maryland state legislature

Quacks never give up.  In their never-ending quest to make money from bogus treatments, they try all kinds of strategies to convince people that what they're selling really, really works, despite the evidence to the contrary.

One strategy is creating a legal licensing system.  If the government licenses your profession, it must be legitimate, right?  Legislators wouldn't approve a licensing system for nonsense, would they?  Of course not!

So it's strange that the Maryland legislature is considering a bill in its upcoming session to allow naturopaths to practice medicine in the state of Maryland.  

Some of you might be wondering, what the heck is a naturopath?  As Peter Lipson explained recently in his Forbes column, naturopaths are little more than fake doctors, whose practices are a modern-day version of folk medicine.  When naturopaths got licensed in Minnesota, PZ Myers suggested they be called "witch doctors."  Too harsh?  Well, one thing is clear: naturopaths are trying to get licensed in multiple states (Lipson described their efforts in Michigan) as a route towards legitimacy.

There's an easy way to become legitimate: practice science-based medicine.  This would be awfully difficult for naturopaths, whose practices include homeopathy, colloidal silver treatments, and chelation therapy, to name but a few.

When the naturopaths tried this in Massachusetts 10 years ago, my colleague Kimball Atwood put together detailed testimony describing many of the unscientific and downright dangerous practices of naturopaths.  I encourage anyone to read his full testimony or his series of blog articles.  Here, though, is a brief sample of the erroneous claims made by naturopaths, courtesy of Dr. Atwood:

• "... that hydrogen peroxide dissolved in a bath can provide vital oxygen through the skin of a patient suffering from an acute asthma attack [5]; 
• that balloons inflated inside the nose can cure learning disorders [8];
• that strokes in progress can be reversed by cold compresses applied over the carotid arteries [9]; 
• that vitamin C is an effective treatment for approximately 100 conditions, including glaucoma, male infertility, and AIDS [12]; 
• that high blood pressure and coronary heart disease should be treated with unproven herbs and chelation therapy [17]."

The numbers refer to citations that Dr. Atwood provides for each of his points.

Among other things, the proposed new law (House bill 1029 and its companion Senate bill 783) specifically authorizes hydrotherapy, stating: 

"A license authorizes a licensee to ... administer or perform hot or cold hydrotherapy, naturopathic physical therapy, electromagnetic energy, colon hydrotherapy ... for the purpose of providing basic therapeutic care."

[Aside: I have no idea what it means to "administer electromagnetic energy"; perhaps you simply shine a light on the patient?  I suspect the legislators who are sponsoring this bill haven't a clue either.]

Hydrotherapy doesn't sound so bad until you learn what naturopaths do with it.  According to the naturopathic organization's own experts, 

"One technique is to lower your body temperature, with a cold bath for example, as much as possible without inducing shivering as soon as possible after a stroke has occurred, or is suspected to have occured.... Another hydrotherapy technique with a similar rationale is to soak the feet in a hot foot bath, as soon as possible after the stroke has occurred, while applying a cold compress to the neck, face and scalp. If this technique can be applied as a stroke is happening, it may even abort the stroke."

Again, quoting Dr. Atwood: "All strokes are potentially life-threatening, and are considered to be medical emergencies that require prompt and expert evaluation and supportive care. The treatments described above will do nothing to improve the outcomes of strokes, but are certain to delay competent diagnosis and treatment. 

Most disturbing, perhaps, is that the new Maryland bill would require physicians to violate medical ethics.  The AMA code of ethics states that

"It is unethical to engage in or to aid and abet in treatment which has no scientific basis and is dangerous, is calculated to deceive the patient by giving false hope, or which may cause the patient to delay in seeking proper care."

By adding a naturopath to the Maryland State Board of Physicians, and by requiring them to license naturopaths to practice medicine, the legislature is forcing physicians to act unethically.

So if you live in Maryland, take a few minutes and write to your state representative telling him or her not to support this quack bill.  Heck, contact them even if you don't live in Maryland, and tell them you were thinking of moving but now you want to move to Virginia instead. 

Bad medicine infiltrates M.D. Anderson Cancer Center

M.D. Anderson Cancer Center in Texas is usually considered one of the country's top cancer centers, but that hasn't stopped it from promoting bad science.   In Friday's Huffington Post, Dr. Lorenzo Cohen, Director of MD Anderson's Integrative Medicine program, writes that it is "time for acupuncture to become part of standard care" for cancer.  He claims that acupuncture is "an appropriate treatment alongside conventional care for chemotherapy-induced nausea/vomiting."

As evidence, Dr. Cohen cites a newly published review article.  There are many problems with Cohen's arguments. Let's start with what he fails to tell us.

First, he states that he is reporting on the results of "a recent systematic review conducted by researchers in the Integrative Medicine Program at the MD Anderson Cancer center."  He conveniently neglects to say that he is the senior author of that review!  He should have made it clear that he's writing about his own report.  Unless his readers look up the original article, they may not realize that he is is merely promoting his own work, in a highly biased way.  He also fails to point out that his article doesn't provide any new evidence itself; it only reviews other, earlier studies.

Second, Cohen tells us that his group found 41 studies evaluating the use of acupuncture for treating the symptoms of cancer therapy.  (To be precise, he writes that "41 studies were found," still disguising the fact that he's the one who found them.)  He neglects to mention that out of 41 studies, all but one were highly biased, by his own review's judgment (and therefore scientifically worthless).  Rather than concluding that "it's time for acupuncture to become part of standard care," Cohen should be lamenting the fact that nearly all studies of acupuncture are badly done.

Third, Cohen does mention that his review article considered 8 symptoms of cancer treatment: pain, nausea, hot flashes, fatigue, dry mouth, constipation, anxiety, and sleep disturbance, but he doesn't explain that the only study out of 41 that wasn't excessively biased (according to his own criteria) looked at nausea.  Thus Cohen should have told us that acupuncture is not effective for any of these other conditions.  At best, if he insists on putting a positive spin on it, he should have explained that the evidence is insufficient to recommend acupuncture for any of these symptoms.

Let's look at that one positive study, published in 2000 by Joannie Shen and colleagues.  It's a small study, with about 33 patients in each of 3 groups, where the treatment group got electroacupuncture, which means an electric current is run through the needles.  This isn't the same as traditional acupuncture, and the study didn't compare identical groups with and without the electrical stimulation.  So we can't know whether the electrical current was the real reason the treatment showed a benefit.  The study also failed (and this is a huge problem) to "blind" either the patients or those providing treatment: obviously the patients knew they were getting electroacupuncture.  Despite this, Cohen claimed in his review article that the 12-year-old study had a low risk of bias for blinding.

The patients that received electrical stimulation plus acupuncture had fewer episodes of vomiting.  This suggests that something in the treatment - maybe the acupuncture, maybe the electricity - somehow reduced this particular symptom.  Or maybe not: the study had a possibly serious flaw in the assignment of patients to groups: in the electroacupuncture group, only 51% had vomited during previous chemotherapy sessions, significantly fewer than in the other two groups.

Despite the methodological flaws, if acupuncture works, surely that 12-year-old study would be replicated by now, yes?  Well, no.  Cohen neglects to mention a much more recent study on acupuncture for nausea, published just last year, which his own reviewed graded as unbiased for 5 out of 6 criteria, including blinding.  That study was negative: acupuncture was no better than sham acupuncture.  When a small, problematic study fails to replicate, good scientists conclude that the treatment simply doesn't work.  Cohen, though, ignores this larger (twice as many patients), better-done study in his HuffPo piece.

So based on one mediocre study from 12 years ago, involving only a small number of patients, for only one condition, Cohen is calling for acupuncture to become standard treatment for all cancer patients.  Could this be because he is currently running his own clinical trial on acupuncture for the treatment of cancer patients?  Could he be biased by the $777,886 he is currently receiving from NIH to study acupuncture?

Given that Cohen is its Director of Integrative Medicine, it's not surprising that MD Anderson has been using acupuncture on its patients since 2003:  they even list a fee schedule, $80 on the first visit and $65 for each follow-up, and they recommend at least 8-10 treatments.  MD Anderson's website offers up this gem of an explanation:

"A block in the meridians can deny the muscles and surrounding tissues of Qi, creating an imbalance of health. However, the flow of Qi can be restored by inserting needles at specific acupuncture points."  

This pseudoscientific babble does not belong in one the nation's best cancer centers.  What's worse is that MD Anderson is offering ineffective treatments to cancer patients - a highly vulnerable population - accompanied by claims that they should know are false.  This is inexcusable.

MD Anderson's many outstanding scientists surely know that acupuncture is wildly implausible, and many of them (although not Dr. Cohen) must know that it has repeatedly failed to stand up to scientific scrutiny.  US News ranks MD Anderson as the country's top cancer hospital, followed by Memorial Sloan-Kettering and Johns Hopkins Hospital. After reading Dr. Cohen's article, and looking at MD Anderson's promotion of unproven pseudoscientific treatments, I would argue that MD Anderson should be dropped many, many notches down in those rankings.

Questionable for-profit cancer center profits from alternative therapies

It sounds like a crazy conspiracy theory: a secretive businessman founds a for-profit medical center to treat cancer.  His hospitals offer conventional treatments but also sell highly questionable, unscientific treatments to vulnerable patients. These treatments help to increase profits.  The businessman uses the profits from his cancer hospitals to support his favorite right-wing causes.  Patients have no idea that the fees they pay for treatment help support these causes.

It may sound unbelievable, but it's true.  Most of this story was described in a lengthy exposé just published in the Washington Post on Christmas day.  The Post revealed that Richard Stephenson, the founder of a large for-profit cancer center, is also one of the primary funding sources for Freedom Works, a right-wing Tea Party organization that played a major role in the 2012 elections.  As the Post story described him:

[Stephenson is] "a reclusive Illinois millionaire who has exerted increasing control over one of Washington’s most influential conservative grass-roots organizations."

Among other examples, the Post describes how

"more than $12 million in donations was funneled through two Tennessee corporations to the FreedomWorks super PAC after negotiations with Stephenson over a preelection gift of the same size....  The origin of the money has not previously been reported."

What the Post story didn't explain was the source of Stephenson's millions: Cancer Treatment Centers of America (CTCA), a private, for-profit company with five cancer hospitals scattered around the U.S.  Stephenson is the founder and chairman of CTCA.

For-profit hospitals present a big ethical problem, even when they provide proper care.  The problem is that motivation to increase profits may work against the interest of patients.  I don't want to debate that here, because CTCA has another, more serious problem.  Alongside standard, science-based cancer therapies, CTCA also offers an array of questionable, unscientific therapies, which it proudly labels as part of its "integrative cancer treatment."  CTCA advertises many such treatments, including:

• Acupuncture
• Acupressure
• Chiropractic
• Naturopathy 
• Homeopathy
• Mind-Body medicine (including Reiki and Qi Gong)

None of the treatments in this list has any scientific support showing that they provide a benefit to cancer patients.  Some of them carry a real risk of harm, as I've written about previously.  Acupuncture carries a risk of infection and chiropractic treatment has a risk of stroke - very small risks, admittedly, but no risk is acceptable when the benefit is nonexistent.  (See Science-Based Medicine for a summary of the science behind these and other alternative therapies.)

CTCA makes multiple unsupported, unscientific claims for its alternative treatments, such as:

• "Naturopathic medicine can help reduce these [cancer-related] symptoms, strengthen the immune system and support the healing process throughout your brain cancer treatment." 
• "Acupuncture may help to alleviate [cancer] treatment-related side effects, such as nausea and vomiting." 
• "When used during your leukemia treatment, our chiropractic care services can help correct bone, muscle and joint problems and restore nerve function." 

These are just a few examples. These claims, and CTCA's marketing of the therapies involved, present a huge ethical problem.  Cancer patients are facing some of the most difficult decisions in their lives, often while suffering through painful treatments, not to mention the fear that their cancer will kill them.  When a cancer hospital offers an "integrative" treatment with the promise that it may help, the patient is highly likely to try it, regardless of the cost.  These are extremely vulnerable patients, and CTCA is taking advantage of them to sell ineffective therapies.  CTCA and its owners, including Richard Stephenson, are profiting from their unsuspecting patients.

Offering treatments that are little more than snake oil to cancer patients is ethically indefensible.  Believers in acupuncture, naturopathy, Reiki, and homeopathy will argue that they are not unethical, because the treatments work.  This argument, though, flies in the face of overwhelming evidence to the contrary.  Those who argue that these therapies really work only demonstrate that they are unqualified to offer medical care.

Cancer Treatment Centers of America presents a very welcoming, positive picture of itself through its website, and much of what it describes is accurate.  However, its errors of omission are huge: nowhere does its website say that CTCA is a for-profit center, nor does it tell you that its founder is a major donor to right-wing political organizations.  And most critically for patients, CTCA offers a palette of pseudoscientific treatments, making medical claims that are not supported by any evidence and that in some cases violate basic principles of physiology and biology - although the website claims that its integrative treatments are "scientifically-based supportive therapies."

Let's put aside the right-wing propensities of its owners and simply focus on the science and the ethics of CTCA's "integrative" therapies.  Even if the treatments were free, there is no justification for offering treatments based on pseudoscience.  In the context of a for-profit hospital, where every treatment provided adds to the bottom line, the practice of pushing illegitimate treatments onto cancer patients is even more reprehensible.

[Note: the publisher of Forbes magazine, Steve Forbes, is a board member for Freedom Works.  In case it's not obvious, I don't speak for Forbes and they don't endorse the content of my blog, which appears both here and on the Forbes site.]

[Note 2: for a more detailed, critical look at some of CTCA's offerings and its claims, see this post by Orac at Respectful Insolence from mid-2010.]

Stabbing kids with needles: malpractice, or just a very bad idea?

Yesterday's Washington Post featured a terribly researched article titled "Kids and needles is sometimes a good match: Acupuncture can help with pain."

Imagine: a one-year-old boy arrives at an emergency room in New York at 3 a.m. with an asthma attack.  He is slow to respond to a nebulizer treatment.  Enter Dr. Stephen Cowan, who decides to use acupuncture.  That's right, he stabs a one-year-old baby with multiple needles to treat asthma.  According to Dr. Cowan, the boy "reacted calmly" and improved.  The article doesn't provide any more details.

This is appalling.  Sticking needles into a baby has never been shown to have any effectiveness at treating asthma, and we do have treatments that work.  In all likelihood, the nebulizer did work, in the case that Dr. Cowan related to the reporter, but Dr. Cowan mistakenly credits his acupuncture treatment.

Stephen Cowan is a aggressively self-promoting doctor, who claims on his website that he can treat both autism and ADHD with acupuncture and other forms of Chinese Medicine.  He also describes how he convinces children to let him stick needles into them.  He states his belief in mystical "vital energy" or qi, one of the wacky pseudoscientific notions at the core of acupuncture beliefs.  His claims are little more than a modern, mystical version of the claims made by 19th-century snake oil salesman.

The Washington Post story also revealed that Children's National Medical Center in Washington, D.C. recently treated a 17-year-old girl with pancreatitis by stabbing needles into her stomach and other places.  There is no evidence that this works, but the girl's doctor believes it does.  The girl reportedly wasn't harmed, fortunately.

The doctor at Children's Hospital, Jennifer Anderson, is an anesthesiologist who is also an acupuncturist.  In the story, she said "I often treat patients with chronic issues" with acupuncture.  This is frightening: a doctor at a major medical center is telling children, most of whom are too young to even think of questioning the wisdom of a doctor, that sticking them with needles will help their pain.  Dr. Anderson admitted that "she often does two to three treatments a week at first on a child."  So she admits to stabbing many sharp needles into children and telling them that the treatments will help their pain.  She argues that the children report that this is "helpful."

This is perilously close to child abuse.  Children want to please adults, and if an adult tells them something is good for them, especially if an authority figure tells them, they are extremely unlikely to disagree. They'll just swallow the medicine, or endure the treatment, and then tell the adult what she wants to hear.  Dr. Anderson seems unaware of this.  And Children's National Medical Center, a generally outstanding hospital, should be seriously concerned that one of its anesthesiologists is practicing quack medicine on children, who are perhaps the most vulnerable of all patients.

Let's be clear: acupuncture is based on nonsense.  Scientists have gone to great pains to study it, and the conclusion can be stated simply: acupuncture does not work.  (And yes, I know about the latest meta-analysis claiming that acupuncture works.  Dr. Steven Novella has already explained why that analysis is "completely useless.")  If acupuncture were a drug being tested by a pharmaceutical company, it would have been abandoned long ago.  Its proponents are no better than any big pharma company that pushes a drug that it knows to be ineffective.

Acupuncture is worse than ineffective: because it's an invasive procedure, there is a small but real risk of harm.  As I wrote last year in The Atlantic, acupuncturist sometimes cause infections, which can lead to rare but serious complications.  Acupuncturists protest (often) that they use sterile needles, but this very protest reveals their ignorance: most infections are caused by bacteria already present on the skin, which enter through the puncture wound.

Parents: don't let an acupuncturist stick needles into your kids.  Read the science first, and avoid - no, run screaming from - any practitioner who claims that he can adjust the "qi" in your child.

British Health Minister believes in magic water

Well, this is one way to save money on health care.  The new British Minister of Health, Jeremy Hunt, is a firm believer in homeopathy, which treats disease using magic water solutions that contain - well, only water.

Just a few days ago, British prime minister David Cameron shuffled his cabinet, moving Hunt from Minister of Culture to his new position in charge of health.  Within hours, Tom Chivers, a science editor at the Telegraph, reported on Hunt's belief in homeopathy:

"The man put in charge of the nation's health policy is on record as supporting spending public money on magic water to cure disease." 

He went on to add:

"This is not unlike putting someone who thinks the Second World War began in 1986 in charge of the Department of Education."

Not surprisingly, Chivers' blog post was flooded with hundreds of comments, many of them from upset defenders of homeopathy.  Most of their arguments boiled down to "I think it works for me, so there."

Homeopathy is one of the most absurd, wildly implausible forms of quack medicine. I've written about it many times (for example, about the bogus flu pills sold as oscillococcinum,
about NCCAM's embarrassing funding of studies of homeopathy, and about how homeopaths offer strychnine to cure children's colds), so I'll try not to repeat myself.  Homeopathy is founded on two basic notinos, both of them dead wrong:

1. Infinitely diluted substances are more potent than substances at higher concentrations, and
2. "Like cures like," meaning that if a substance causes a symptom, you can use that substance to cure the symptom.  

Thus caffeine can be used to help you sleep, and poison ivy can cure itching.  No, I'm not making this up; homeopaths really believe this stuff.

Homeopathy is simply magical thinking.  There has never been a shred of scientific evidence to support it, and the British Medical Association declared in 2010 that homeopathy is witchcraft.  After pressure from science bloggers, NIH's NCCAM has corrected its website to state that

"it is not possible to explain in scientific terms how a remedy containing little or no active ingredient can have any effect."

But homeopaths make a lot of money selling homeopathic potions, and through clever marketing they keep themselves in business.  Now they have a new ally, the UK Minister of Health. Andy Coghlan, writing in The New Scientist, called him "the new minister for magic."  Brilliant!  As Coghlan pointed out, magic is much cheaper than real medicine:

"Think of the savings if all those expensive proven treatments and drugs are phased out, and patients are offered cheap little vials of water instead."

We're desperately looking for ways to control health care costs here in the U.S. as well.  The UK Minister of Magic may have a solution for us.  I wonder, though, if it works for muggles?

Government subsidies for chiropractic education

Source: daryl-cunningham.blogspot.com

The U.S. is having a political debate about college tuition loans.  Everyone seems to be in favor of keeping the loan rates low, but politicians disagree about how to pay for the subsidized rates.  (The interest rate on government-guaranteed loans will double this July, from 3.4% to 6.8%, unless Congress takes action.)

Lost in this fight is any discussion at all about which students - and which colleges - get these subsidies.  Right now, the subsidized loans are available to almost any institution that calls itself a college or university.

But what about institutions that provide a substandard education?  Or worse, what about institutions that educate people in quackery and pseudoscience?  Subsidies to these institutions are worse than useless.  These so-called colleges spread misinformation that will require much more investment to correct, if it is even possible.  Why, to be specific, is the U.S. government subsidizing students to attend chiropractic colleges?

Chiropractic colleges are a relatively new invention, as is the entire profession.  Chiropractic was invented out of whole cloth by D.D. Palmer in the 1890s.  He mistakenly believed that misalignments of the spine, which he called subluxations, caused a vast range of health problems, even infectious diseases.  Over a century later, chiropractic colleges continue to preach this nonsense; here is what Palmer College of Chiropractic says:

"Improper function of the spine due to slight misalignments—called subluxations—can cause poor health or function, even in areas far removed from the spine and spinal cord itself."

Subluxations have never been shown to cause disease. In fact, subluxations of the spine have not even been shown to exist.  Despite the thorough lack of evidence, chiropractors appear to be quite skilled at keeping patients returning for "adjustments" to maintain good health.  I wonder how much time is spent in chiropractic colleges teaching students about the need for regular spinal adjustments? As retired chiropractor Sam Homola wrote recently:

"The only thing unique about chiropractic is its basic definition as a method of adjusting vertebral subluxations to restore and maintain health....  The subluxation theory has been the chiropractic profession’s only reason for existence since its inception in 1895."

I wonder, too, if chiropractic colleges educate their students about the risk of stroke from their treatments. The rapid head-twisting move that many chiropractors use, which produces a startling cracking sound in the neck, also carries a small but real (and frightening) risk of tearing one of the arteries in the neck.  Chiropractors dispute this claim, but studies have shown that patients with vertebral tears are much more likely to have recently visited a chiropractor.  A systematic review of the evidence in 2010 concluded

"Numerous deaths have occurred after chiropractic manipulations. The risks of this treatment by far outweigh its benefit."

On top of their dubious educational programs, chiropractic colleges pay their presidents astonishingly high salaries, as documented recently in the Chronicle of Higher Education, which pointed out that

"the presidents of chiro­practic colleges are taking in some of the biggest paychecks in higher education." 

For example, the president of Logan College of Chiropractic, which has a budget of $24.5 million, earned $791,418 in 2009.  That's the same salary earned by the president of CalTech, which has a budget 100 times larger.

Low-cost student loans provide a benefit to many students and their universities.  But we don't need to subsidize erroneous and misguided colleges that teach their students nonsense.  If Congress is going to extend the student loan program, they should take this chance to make the program far more selective.  Helping students get a good education helps the country.  Lending students money to learn pseudoscience does just the opposite.

Nobel laureate joins the autism cranks at AutismOne conference

If you're reading this from anywhere but Chicago, you just missed the Autism One conference, which ends today.  This conference, run by Jenny McCarthy and Generation Rescue, purports to tell parents "the truth" about autism.

The conference is a veritable festival of unproven claims, offering a powerful but false message of hope to parents who are desperately searching for new treatments for their children.  It's also a nexus for anti-vaccinationists, who run special seminars educating parents about how to get vaccine exemptions so that they can enroll their unvaccinated children in public schools.

A look at the presentations reveals that rather than presenting "the truth," one speaker after another is making unsupported, unscientific claims and then offering their own special therapy.  The one thing that most of these presentations have in common is that the speaker is making money from selling their so-called treatments.  For example, Anat Baniel offers her self-named "Anat Baniel method" and is promoting it through ads in the conference program.  Other speakers are offering special diets, hyperbaric oxygen therapy, and in perhaps the most damaging treatment, Mark and David Geier's chemical castration therapy.  Mark Blaxill is there, still pushing the thoroughly disproven link between mercury and autism, and hawking his book on the topic.

The other major theme of the conference is conspiracies: how the government, big pharma, and the scientific establishment are all conspiring to hide "the truth" about autism, which the speaker will reveal to the audience. Coincidentally, many of the speakers also offer treatments, for a fee.

This year's speakers include Jenny McCarthy and Andrew Wakefield, as usual, but also a new entry: Luc Montagnier.

Jenny McCarthy has been a leader of the anti-vaccine movement for over a decade.  She's a former Playboy playmate and MTV host, with no medical qualifications whatsoever, who is convinced that vaccines caused her son's autism.  She's been spreading her anti-vaccine message very effectively, with particular help from Oprah Winfrey and Larry King, who gave her prime television exposure countless times.  Oprah even offered McCarthy her own show, until McCarthy ditched Oprah for NBC.

Andrew Wakefield, the thoroughly discredited doctor who falsified data in order to push his false hypothesis that autism is caused by the MMR vaccine - whose medical license was revoked in the UK, and whose famous 1998 paper on autism and vaccines was retracted after it was shown to be fraudulent - claims that his talk "offers solutions [that] will be ignored by those in power and the more dire of its predictions will result."  Too bad I missed that one.

It's no surprise that Jenny McCarthy and Andrew Wakefield, leaders of the anti-vaccine movement, are speaking at AutismOne.  Much more surprising is the presence of Nobel laureate Luc Montagnier, co-discoverer of the link between the HIV virus and AIDS.  What is he doing at this festival of pseudoscience?

Well, apparently Montagnier has gone off the deep end into pseudoscience himself.  He claims that his new group, Chronimed, has discovered in autistic children

"DNA sequences that emit, in certain conditions, electromagnetic waves.  The analysis by molecular biology techniques allows us to identify these electromagnetic waves as coming from … bacterial species."

What the heck?  In what seems to be a desperate effort to stay relevant, Montagnier is promoting wild theories with little scientific basis, and now he is taking advantage of vulnerable parents (see his appeal here) to push a therapy of long-term antibiotic treatment for autistic children.

This is truly a wacky theory.  Montagnier hasn't been able to publish this in a proper journal, for a very good reason: it's nonsense.   He claims that quantum field theory - an area of physics in which he has no qualifications - explains how electromagnetic waves emanating from DNA can explain not only autism, but also Alzheimer's disease, Parkinson's disease, multiple sclerosis, Lyme disease, and rheumatoid arthritis.  Montagnier makes these claims and more in a self-published paper that he posted on arXiv.

This isn't Montagnier's first crazy idea: just a year ago, he claimed that DNA molecules can teleport between test tubes, also based on some kind of quantum hocus pocus.  This crackpot claim should have been ignored, and it would have been, if not for the fact that Montagnier is a Nobel laureate.  He's also endorsed homeopathy, another quack treatment.

This is a sad coda to a brilliant medical career.  Not only is Montagnier espousing junk science and tarnishing his own reputation, but he is lending credibility to the AutismOne conference, which is a festival of hucksters and snake-oil salesman, offering unproven, ineffective, and even harmful treatments to vulnerable children and their parents.

Autism is a complex, difficult disease.  Thousands of researchers are pouring their hearts and souls into understanding the disease and developing new treatments.  AutismOne does a terrible disservice to autistic children by siphoning away time, energy, and money that could instead go into real science.  We can only hope that it will fade away.

Zinc still doesn't work very well for colds

Cold cure manufacturers continue to push zinc as a cure, despite the lack of evidence.  Today, the Washington Post reported, not for the first time, that taking zinc will shorten the duration a cold by three days in adults.  Sounds pretty good!  Only it's wrong.

The Post reporter apparently didn't really get past the abstract for the new study, which isn't actually a study at all, but just a review of 17 other studies.  The review appeared on May 8 in the Canadian Medical Association Journal.

ALL of the studies were funded by the companies that make zinc supplements, mostly large pharmaceutical companies.  (Big Pharma or Big Supp, they are often the same companies.)  Here's a partial list of the sponsors: Warner Lambert, McNeil Consumer Products, Weider Nutrition, Truett Laboratories, Bristol Myers, Berko Ilac, and Quigley.  Not that there's anything wrong with that!

One problem with the Washington Post summary is that the benefit wasn't really three days, even if you believe the results.  Although the study looked at 17 trials, the core analysis only used eight of them, all of which used patients with naturally acquired colds.  The average benefit was 1.6 days, not 3 days, and it was highly variable.  Reuters and Fox reported the story more accurately as "one and a half days" and pointed out that the effect was just over two and a half days in adults.

Somehow, though, the benefit disappeared in children.  Could this be because children don't care so much about telling the investigators what they want to hear?

And what about those trials that didn't use naturally occurring colds.  As I pointed out in a recent blog post, if you look at only the studies where the researchers intentionally gave people a cold, the effect vanishes.

"The more rigorously scientific studies, where you took a group of people and gave half of them zinc and half a placebo and inoculated their nose with a cold virus, found there were no differences," said Terence Davidson, director of the UC San Diego Nasal Dysfunction Clinic in a February interview.

None of this stops ProPhase (NasdaqGM: PRPH), maker of ColdEeze zinc products, from making this claim on their website:

"Cold-EEZE® has been clinically proven to shorten the duration of the common cold by nearly half."  

As evidence, their website points to three studies from 10-20 years ago.  They conveniently ignore the more recent studies that showed far less (possibly no) benefit.

The authors of the latest review article graded the quality of evidence for five different outcomes.  Their report card on these studies has one "Moderate" and four "Low" grades.  Moderate means "further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.  Most of the grades were "low," which means

"further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate."  

So the authors themselves don't really trust their own study!  In the end, they conclude that "there is only a weak rationale" to recommend zinc.  And previous studies, not funded by supplement manufacturers, showed no benefit.  Who are you going to believe?

Save your money and use it to buy chicken soup instead.*

*The author receives no financial backing from the makers of chicken soup, although he does like it and would appreciate a free sample.

The worst quackery of 2011: battlefield acupuncture

Pseudoscience continued to thrive in 2011, making my choice for the worst quackery of the year a difficult one.  So much nonsense!  Promoters of both new age and old-time hocus pocus continued to sell their unscientific therapies, as they have for decades (or centuries), including homeopathy, Ayurveda, acupuncture, qigong, reiki, magnet therapy, and a cornucopia of special "super foods", all guaranteed to cure whatever ails you.  These various alternatives to medicine are just as ridiculous today as when they were invented, decades or centuries ago.

How can anyone choose the worst practice among so many false claims?  Well, those that cause real harm to patients are worse than those that are merely useless.  I also decided to give extra weight to newer forms of mumbo jumbo.  But I could have chosen differently, and I encourage readers to nominate their own favorites in the Comments section.

And the 2011 winner of the worst quackery award is: battlefield acupuncture.  This particular bizarre medical practice offers a trifecta of ills:

1. It offers no medical benefit and carries a real risk of harm for some patients.
2. The U.S. government is wasting tens of millions of dollars per year on it, and plans to increase its spending next year.
3. The patients are wounded combat veterans who have no choice about where to get treatment.

Battlefield acupuncture has a growing number of supporters in the U.S. Defense Department (especially Richard Niemtzow, its proud inventor), who are determined to see it delivered to as many troops as possible.  I've written about this before, but it's in the news again this month, in Wired magazine.  In battlefield acupuncture, the "doctor" (no competent doctor would do this) sticks needles into the patient's ear to relieve pain.  Yes, that's right: needles in the ear.

Battlefield acupuncture was invented out of whole cloth by military doctor Richard Niemtzow, who runs an acupuncture clinic out of Andrews Air Force Base in Maryland.  Niemtzow appears to be the leading advocate for the use of acupuncture on wounded soldiers, and he has been disturbingly effective.  The military publication Stars and Stripes reported in August that the Air Force has

"launched a program to train more than 30 military doctors to use acupuncture in the war zone and at their base clinics. The program will be expanded next year with the Air Force, Army and Navy combining funds for two courses to certify 60 active-duty physicians as medical acupuncturists."

Multiple scientific studies have shown clearly that acupuncture doesn't work. The benefit is the same no matter where you place the needles, or even if you use toothpicks that don't pierce the skin.  (See a summary here, with multiple references.)  Acupuncture points and "meridians" - the pathways that acupuncturists claim to manipulate with their needles - don't even exist.

Acupuncture carries a real risk of harm, too, primarily from infection.  Acupuncturists don't practice sterile procedure, as I've pointed out before.  They claim that they do, because they think that using sterilized needles is sufficient.  Wrong again.  Sterile procedure requires that every site of needle insertion be properly sterilized, because most infections are caused by bacteria already present on the skin.  As reported last year in BMJ:

"Although most patients recovered, 5-10% died of the infections and at least another 10% had serious consequences such as joint destruction, paraplegia, necrotising fasciitis, and multiorgan failure."  

Pretty serious harm from a procedure with no real benefit.

The evidence for "auricular acupuncture" - sticking needles in the ear - is less than zero.  This shouldn't be surprising, since Neimtzow just pulled this wacky theory out of thin air - but he and his converts have repeatedly asserted that it works, although they offer nothing more than anecdotes.  Niemtzow has even claimed that 18th-century pirates pierced their ears to improve their night vision.  Yes, really.  Now he's piercing the ears of wounded soldiers.

A big part of the Wired story is how the billionaire founders of the Samueli Institute, an institute dedicated to pseudoscience, have used their political muscle to obtain millions of dollars in Defense Department earmarks to support acupuncture research.  ($7.6 million in 2010, for example.)  Make no mistake, there's plenty of money in acupuncture, as in the rest of the alt-med industry.

But the real harm is in treating wounded soldiers by sticking needles in their ears, instead of offering real treatments.  To their credit, some soldiers are not fooled by Niemtzow's claims.  As a veteran over at Military.com said,

"In civilian medicine, this [battlefield acupuncture] would be called malpractice. This smacks of using military personnel in the field as guinea pigs. That's a dangerous game. If the pain of severe trauma isn't treated effectively in a timely manner, shock and even death can follow."

That discussion appeared in 2008, but three years later, Andrews Air Force Base has a full-time acupuncture clinic, and the military is training more doctors in this dangerous, ineffective, and highly unethical practice.  For this, battlefield acupuncture gets my award for the worst quackery of 2011.

(For further reading, see David Gorski's excellent takedown of battlefield acupuncture from 2008.)

Kill the tigers

Here's a choice: save the last remaining tigers on the planet, or kill them, chop them into pieces, and eat them in the mistaken belief that tiger parts can be used as medicine.

Sounds like an easy choice, no? Unfortunately, humans have already decided to kill the tigers rather than saving them. Fewer than 4,000 wild tigers survive on the planet. As journalist Caroline Alexander wrote in a compelling article in the December issue of National Geographic, "tigers in the wild face the black abyss of annihilation." And their greatest threat, she writes, is "the brutal Chinese black market for tiger parts."

Traditional Chinese Medicine (TCM) practitioners claim that tiger parts can be used to treat a wide variety of ailments, including malaria, bacterial infections, bad skin, ulcers, leprosy, and impotence. There is not a whit of scientific evidence to support any of these claims; they are nothing more than folk medicine, based on primitive beliefs dating from a pre-scientific era, when it was believed you could acquire the properties of an animal by eating it. Unfortunately, these beliefs have driven the mightiest of the big cats to the brink of extinction.

The World Federation of Chinese Medicine Societies asked its members to stop using tiger bones last year, but their action is far too little, too late. The New York Times reported around the same time that tiger-based "medicines" are widely available in China.

Proponents of Traditional Chinese Medicine claim that it is beneficial, but they have no science to back them up. NIH's National Center for Complementary and Alternative Medicine (NCCAM), an apologist for all sorts of quack medical practices, explains that

"In the TCM view, a vital energy or life force called qi circulates in the body through a system of pathways called meridians. Health is an ongoing process of maintaining balance and harmony in the circulation of qi."

This is little more than fantasy. Too bad NCCAM's leaders seem to have forgotten whatever they knew about human physiology. They might just as well explain that midi-chlorians circulating in the blood are the source of the Force. (Actually, there are midichlorians in nature now, in a species of tick.  Really.)

Some forms of "alternative medicine" are ineffective but mostly harmless (think homeopathy, which is just water and sugar pills), while others can be harmful to the patients who use them (think acupuncture, with its risk of infection, or ayurveda, which uses toxic chemicals). TCM is doubly harmful: it doesn't benefit patients, and it is the single greatest threat to the world's tigers. I hope people come to their senses before the last tiger is gone.

The Baltimore Sun dives into the anti-vaccination pool

In recent weeks, the Baltimore Sun, once an excellent newspaper, has dived headfirst into the pool of anti-vaccination pseudoscience. With two prominent opinion pieces, the Sun has given a platform to the anti-vaccine movement that they probably didn't expect, and that they certainly didn't deserve. The puzzle is, why? Who on the Sun's editorial board decided to offer their pages to the voices of fear and unreason?

First, on June 16, the Sun printed an Opinion article by Mark Geier, where he argued that his unfounded theories about the causes of autism make it okay for him to chemically castrate young boys. (I know this sounds shocking, but it's all too true.) I wrote about Geier two years ago: he and his son David administer what they called the "Lupron protocol" to autistic boys. They charge $5000-$6000 per month for their treatment, which is based on their belief that autism is caused by an excess of testosterone. Lupron, the drug they give to children, is a testosterone-suppressing drug that is the chemical equivalent of castration. It is a harsh treatment used to treat advanced prostate cancer. There is no evidence that it helps autistic boys. When the Chicago Tribune interviewed Simon Baron-Cohen, a professor and director of the Autism Research Center at Cambridge University, here was his reaction:

"The idea of using it [Lupron] with vulnerable children with autism, who do not have a life-threatening disease and pose no danger to anyone, without a careful trial to determine the unwanted side effects or indeed any benefits, fills me with horror."

Finally, after Geier had spent many years of selling his quack treatment to vulnerable families, the state of Maryland suspected his medical license suspected in April. Now, for reasons I cannot fathom, the Baltimore Sun has given him a huge billboard to ask for his license back so he can resume his discredited Lupron protocol.

(Geier also claims that mercury in vaccines causes the rise in testosterone levels that he claims to treat. He ignores the overwhelming evidence, re-affirmed again last year, that there is no link between mercury-containing vaccines and autism.)

This wasn't enough bad science for the Sun, which just a few weeks later published another Opinion piece, this one by anti-vaccine activist Margaret Dunkle. In her article, Dunkle claims that the vaccine schedule includes too many doses, and she further claims that these are harmful to children. This "too many, too soon" argumen is a constant refrain of the anti-vax movement (particularly Jenny McCarthy), despite the lack of science to support it. The evidence on her side: a new study published by Gayle Delong, claiming that autism rates and vaccination rates are linked. Who is Gayle Delong? It turns out she is an economist, not a scientist, and she's a board member of SafeMinds, a well-known anti-vaccination group. Delong's study has already been thoroughly debunked by Neuroskeptic, Sullivan, Liz Ditz, and others, who pointed out its deeply flawed statistics and other problems. Dunkle, though, was happy to jump on this junk science and ignore the real science.

The real science tells just the opposite tale. For example, a thorough review published in Pediatrics in 2002 showed that infants today are exposed to fewer antigens than they were 40 years ago, due to better vaccine formulations. It also found that vaccines "prevent the weakening of the immune system." Countless other articles have shown the efficacy of vaccines; the Immunize for Good site is a good source for a realistic picture of the risks versus the benefits.

Is the Baltimore Sun responsible for the anti-vaccination stories appearing on its Opinion pages? I can imagine their response: "we're just presenting both sides," they might argue. Debates are just fine when political opinions are concerned, but you don't get to argue about facts. Scientific facts are not debated from "both sides" - for example, we don't waste time arguing that diseases are caused by "miasmas" as was once believed. And when the subject is vaccines, presenting the anti-science, anti-vaccine argument has real, and harmful, consequences.

The science is clear: vaccines have been the single greatest boon to public health in the history of mankind. Vaccines have saved millions of lives, and allowed parents to live without the fear that their children will sicken and die. Here are some facts: pre-vaccination, whooping cough caused 9000 deaths per year in the U.S. Post-vaccine, this has dropped to 20 deaths per year. Pre-vaccination, there were 350,000 polio cases worldwide in 1988. In 2009, there were just 1,604, and there's a chance we can eliminate polio entirely. Back in 1921, diptheria caused 206,000 cases in the U.S. alone. In 2001, there were just 2 cases.

If we stop vaccinating, these diseases will return. And make no mistake about it: if measles, whooping cough, polio, and other vaccine-preventable diseases return, children will die. I'm sure that the editors of the Baltimore Sun don't want this to happen. But through their ignorance of the science around vaccines, they have allowed their newspaper to become a voice for a dangerously misinformed group of activists whose main goal is to stop vaccines.

How to correct the damage? Well, the Sun could publish multiple articles on their Opinion pages explaining how many lives vaccines have saved. They could help to re-educate parents about how valuable these medicines are, so they will demand them for their children, rather than refusing them as some parents now do. I have only a faint hope that the Sun's editors will take such action, but I'm calling for it anyway. They owe it to the public.