Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
Thames Valley University is one of those shameful institutions that offer Bachelor of Science degrees in homeopathy. They don’t stop there though. They’ll teach you several other forms of make-believe medicine. Among these is “nutritional medicine”. This is taught at the Plaskett Nutritional Medicine College which is now part of Thames Valley University.
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Everyone is for good nutrition of course, but ‘nutritional medicine’, or ‘nutritional therapy’ pretends to be able to cure all sorts of diseases by changes in diet or by buying expensive nutritional supplement pills. It has no perceptible relationship to the very important subjects of ‘nutrition’ or ‘dietetics’. Nutritional therapy is very firmly part of alternative medicine, in other words it is largely quackery. If you don’t believe that, read on.
The subject of nutritional therapy was in the news recently because of Matthias Rath. He is the person who is reponsible for the death of many Africans because of his advocacy of vitamin pills for the treatment of HIV/AIDS. He didn’t just (mis)treat people, but also played a role in persuading the recently departed Thabo Mbeki, and his health minister (“Mrs Beetroot”) to abandon effective therapies for AIDS sufferers. See reports in The Guardian, by Ben Goldacre, and here,
I’ve written a lot about the penetration of quackery into universities, and I thought I’d seen the worst with ‘amethysts emit high yin energy‘. But, as Goldacre said, let me tell you how bad things have become. .
Recently I came into possession of a lengthy set of notes for a first year course on “The Holistic Model of Healthcare”. The notes are from the 2005 course at Thames Valley University, They are not signed, but appear to have been written by Dr Lawrence Plaskett himself. . You can download the whole set of notes here.
Here are a few choice quotations. The basis of them is pure vitalism. They read like a throwback to the dark ages. Little comment is needed. They speak for themselves.
1.3 What do Orthodox Dieticians know about Food and Health?
Dieticians working in the National Health Service and private clinics and hospitals are usually well trained in the basics of the subject, though they too have an entirely orthodox slant. By and large they seem to accept the general view of most of the medical profession that nutrition does not affect illness much. Hence, they restrict themselves to designing diets required by the doctors for whom they work – usually for specified narrow purposes, such as low fat diets, low sodium diets etc. Such diets are, indeed, important in the hospital management of certain diseases (once these have become established) but they represent extremely limited horizons. Much that is in the basic and essential training of alternative nutritional practitioners is missing from the training of dieticians. As a result, most hospital diets are not very good for health judging from the parameters that will be set down in the following Sessions
Well, it is true that real dietitians prefer not to base their practice on mediaeval vitalism. That is what marks them out as professionals.
1.4 Relationship to Science and the Limitations of Orthodox Methods
However, the subject of Wholistic Nutrition transcends the area of human understanding for which science, alone, is appropriate. The reason is that it is ‘vitalistic’. It recognises the presence in all life forms including the human body, of subtle (or ‘etheric’) energy forces not easily measurable by the physicist’s equipment. It shares that position with the ‘energy medicine’ disciplines such as homoeopathy, traditional acupuncture and spiritual healing. It follows an approach to those subtle energies that is embodied in the discipline and philosophy of naturopathy.
Vitalism is the notion that life in living organisms is sustained by a vital principle that cannot be explained in terms of physics and chemistry. This vital principle, often called “the life force”, is something quite distinct from the physical body and is responsible for much that happens in health and disease.
Naturopathy is a relatively modem term for an ancient concept (dating back to 400 BC). This concept embraces the notion that the body is inherently self-healing and that it is the practitioner’s job to stimulate and support this process. Each patient is recognised as having a unique life experience and a unique genetic inheritance. All diseases are seen as one and as attempts by the body to purify itself of toxins. Treatment focuses on causes rather than on symptoms and always addresses the whole person. The wise words of Hippocrates (often called the Father of Medicine) express some of the main tenants of naturopathic thought. He said:
- It is only nature that heals and wherever and whenever possible nature should be given the opportunity to do so.
- Disease is only an expression of purification.
- All disease is one.
- Let food be your medicine and medicine be your food.”
Hence, most ‘alternative’ nutritionists see conventional nutrition. as being rather rigid and unmoving. Hence, they also see it as very limited. This happens because orthodox nutritionists tend to be locked into science alone. They fail to grasp the significance (or the reality of) the subtle energies and they reject the philosophy of vitalism. It is generally the view of ‘alternative’ nutritionists that understanding these things is a major step to healing the patient.
“Understanding” vitalism sounds more like a way of harming patients than healing patients.
1.5 The Pressure of the Orthodox model
Almost everyone who takes steps towards ‘alternative’ medicine experiences a backlash from others around them who have not been able to make the same conceptual change. Patients wanting to settle into an ‘alternative’ approach can be subject to negativity from their doctors (and as a result many patients do not ask the doctor’s opinion). But students and practitioners alike are frequently subject to negative expressions and even frank hostility from relatives
who can understand only orthodox, symptomatic treatment. It is therefore best to be forewarned that your adherence to ‘alternative’ principles will be tested in these ways.
The “Life Force” gets capital letters, like God, But what is it? Pure fantasy.
2 THE LIFE FORCE
2.1 What does our Energy Consist of?
At the root of most hoIistic therapies lies the belief that all life is animated by a subtle force. We call this the Life Force. You either believe it or you do not. It cannot exactly be proved at the moment and the belief is not in accord with the yardsticks that we call ‘scientific’, The belief is a little akin to the belief in God or in spirits or ghosts, and yet at the same time it is not,
because the Life Force is by no means so remote from us. It is not necessarily difficult for an agnostic to accept the Life Force. The writer was once asked for a definition of the Life Force and wrote:” The Life Force is that non-material. non-physical force that animates all life forms and distinguishes them from non-living matter. It Is seen as a determining Force, not as a mere accompaniment to the phenomenon of Life. That is, it determines whether Life can exist or not. It determines the physical form that a life form takes: by its quality and its strength it determines the health, vigour and vitality of the life form. Hence it determines our freedom from, or our susceptibility to illnesses, and our general ability to come through and to recover from Life’s stresses and traumas.”
A bit later it gets even better, when we get to astral travel and even survival after death. Truly bonkers.
The postulate of a subtle Life Force makes a natural connection with such topics as out of body experiences, astral travel and even survival after death. This happens because the subtle Life Force appears by its very nature to be “life within a different medium” and if life can exist in
a different medium, then why should it not exist quite independently of the physical body?
So what’s the evidence?
2.2 Evidence Concerning the Life Force
Since our ‘usual’ human senses only work through the medium of the human body we can only expect to detect the Life Force or other subtle forces, through their interactions with matter. It is clear that these interactions are themselves subtle and sensitive because one level or state is impinging upon another. It is postulated that they are not entirely of our world, not physical, only detectable with physical apparatus under special conditions.
Often they are described as “that which science cannot see”. Not surprisingly, therefore, when investigators come forward convinced that they have a phenomenon that demonstrates the Life Force. the physicists, looking at it with a steely scientific eye, are not usually ready to accept the conclusions claimed. Hence, we have several delicate phenomena that are often claimed to be manifestations of the Life Force, yet not accepted as such scientifically.• The experiments done by Harold Saxton Burr on the “Fields of Life”.
• The experimen1s performed on detecting and measuring “Electrodynamic fields”
• The phenomenon of “Capillary dynamolysis”
• Homoeopathic effects.
• The Chinese ‘energy pulses’ at the human wrists.
From experience it is clear that many students will simply accept the Life Force as ‘obvious’. Some will say they have always known about it. Others are able to accept the concept now as a reasonable principle. Others perhaps (though we have rarely come across it) will never accept the Life Force. If that occurs, it seems a shame, for it removes some of the excitement from wholistic nutrition, . . .
What’s said about the homeopathic evidence?
2.6 Homoeopathic Effects
It is not until Nutritional Medicine students have qualified and got into practice that they usually employ any homoeopathy as an adjunct to their therapy in anything other than a first-aid role. That is because homoeopathy is a complex training in its own right and a quite separate discipline. However, any demonstration of the effectiveness of homoeopathic medicines at potencies higher than 12C is evidence for the existence of the subtle etheric energies. Such remedies have been diluted beyond the point at which the last traces of material substance derived from the Mother tincture, have been removed, leaving only the residual energy associated with the original material.
Of course the notes go on to misrepresent the clinical trials which actually show that homeopathy is mere placebo.
2.9 Toxic Effects upon the Life Force
The Life Force is generally seen as an abundant ebullient and beautiful manifestation of Nature’s energy. Although some forms of acupuncture take in the concept of a form of polluted Life Force called Aggressive Energy”, that idea is not shared much by other whoIistic disciplines. We are left for the most part with the idea of a rather perfect form of energy.
In Western Naturopathic thought, the enemy of the Life Force is toxicity. The Life Force inhabits a potentially perfect physical body. The main threat to the integrity of that body consists of the body’s own metabolic wastes, if they are not properly cleared out. Plus environmental toxins that gain access to the body from outside, or that are generated in the bowel. In that way the bowel gains a high level of importance in Naturopathy and ‘”Nature Cure”.
The Life Force, then, with its almost holy purity, is in danger of being inhibited, dampened down and threatened by what amounts to some entirely physical dirt that gains access to that temple of the soul the human body. Whilst in Traditional Chinese Medicine impurities in the mind, emotions or spirit are just as important as physical impurity, it is naturopathy that focuses upon the actual physical sewers of the body.
Aha, that’s it. Holy water.
The inability of naturopaths in the past to identify specific toxins or to point with sufficient exactitude to the ways in which they can be removed, has been the Achilles Heel of the naturopaths in trying to represent their views in the past to orthodox doctors or medical scientists.
And it still is. The alleged toxins have never been identified, still less removed. Detoxification is a myth of downmarket women’s magazines and profiteering spas. And, of course, of some Bachelor of Science degrees.
2.10 Nutritional Effects upon the Life Force
2.10.1 Bulk nutrients
Next comes the consideration of the bulk nutrients – the protein, carbohydrate and fat. These are our source of biochemical energy and we obviously starve without them. Their purity is crucial. If they have been chemically modified or damaged by toxic interactions, then they will entrain toxicity and also be hard to break down. Even at best, their digestion and assimilation costs energy, which may well be both biochemical and subtle.
What “toxic interactions”? This is all sheer fantasy.
2.10.3 The micronutrients
When you practice [sic] nutritional therapy in a naturopathic setting, being aware at the same time of the on-going biochemistry, you become critically aware of the role of the micronutrients in a way that the classical naturopaths were not.
Biochemical reactions will flow better when they are present in the correct balance. Therefore the minerals have a key interaction with the Life Force. Without the right minerals the Life Force can be conceived of as pushing forward to achieve high activity in the body, yet being blocked through the chemical composition not being correct. If you apply the minerals in this situation, there may, indeed. be a surge forward of the energy.
Whatever that may mean.
3 THE EBULLIENCE OF THE LIFE FORCE: STOPPING THE ROT AND STARTING TO RECOVER
3.1 The Horror of Deterioration: The Chronic State
All that has gone before has already shown that the grassroots of deterioration in the physical body are:
- Weakened Life Force
- Nutritional Deficiency and Imbalance
- Toxic Attack
If nutritional error or deprivation are the more strongly implicated primary cause, then the Life Force struggles with an unbalanced physical body, getting the tissue biochemistry to work at full integrity is impossible; hence. the body’s detoxification system becomes incompetent and the body’s toxic burden may rise steeply. At the same time the Life Force ails.
So, focusing as we do now upon elimination of toxins (the very nub of classical naturopathy), we perceive that it is a process that depends upon a good strong Life Force and also upon adequate nutrient intake. Therapies that directly stimulate the Life Force (homoeopathy, acupuncture and spiritual healing) therefore make an indirect, though real, contribution to toxic elimination through increasing the Life Force or otherwise improving its health and balance.
So according to this, all CAM is much the same. That idea will provoke bitter internecine warfare.
3.5 The Law of Cure
We have above depicted the move from relative health to chronic illness as a downward path. Equally, the route back from the edge of the abyss of chronic illness is one of revitalisation and detoxification. The idea of the ‘route back’ was spotted years ago by the homoeopath, Constantine Hering, and has become known as ‘Hering’s Law of Cure’.
The Law further embodies the notion that toxins, and therefore symptoms, tend to move outward from within as recovery or cleansing occurs. This is fully in accord with the classical naturopath’s idea. Toxins close to the surface of the body are conceived to be most likely on their way out. The skin is an eliminatory organ and toxins at or near the skin level are not so much of a threat to well being. Naturally, the patient may well be horrified at the disfiguring
rash that may be seen by all. Nonetheless, the patient is seen to be far better off than when having these toxins deep within the body, held, perhaps within essential organs that are becoming progressively damaged.
This sounds increasingly like a ‘do-nothing’ approach (much like homeopathy then).
3.6 Suppression
Boils used to swell up into a red sore and then burst. Very bad ones, or carbuncles, might be lanced to cause the pus (morbid matter) to run out. These days, boils and carbuncles tend to occur much less than formerly, presumably because of the lower Life Force of the population and the generally suppressive medical culture. The chances are that they get treated with an antibiotic long before they get a chance to come to a head and burst. Such treatment is suppressive in the strictly naturopathic sense of the word. The same is absolutely true with regard to bringing down artificially the temperature during a fever, whereas ‘sweating it out’ is the natural thing to do.
More of the do-nothing approach.
4.2 How lridology Helps us to See Toxic Foci
As mentioned above, toxic foci (deposits) in the body show up in the iris of the eye. The iris is arranged so as to encompass a complete ‘map’ of the body. with all the organs and systems laid out upon it. Hence the location of a toxic deposit in the iris shows the iridologist its position within the body. The toxins may appear as colours, spots. blobs and smears in particular
places in the iris, or as darkened areas.
Now iridology, another sort of fantasy medicine, creeps in.
5.5 What Place for Immunisations?
Here we shall restrict ourselves to saying as little as possible. We shall. indeed, make no recommendations. However. the classical naturopaths and homoeopaths have all been of one voice in condemning the use of morbid diseased matter for injection into the human body to prevent disease. It was not, they said, a proper procedure. There has also been much disagreement about how effective such measures are. Of course, whenever there is danger of infection. it is wrong to do nothing. At least you should use the homoeopathic equivalent treatment. As to the effectiveness of those methods, that is beyond the scope of this course.
As to the personal view of the writer, it is that the natural therapists who have declared thernselves on this topic in the past are probably right. They have maintained that immunisation is just another form of toxin and an especially potent one capable, on its own, of sparking a downward spiral into ill health in susceptible people. As to what extent that effect might be balanced by benefit, that is an unresolved argument. The writer does not use immunisations himself.
Well there is a surprise. Just like almost every other quack, the writer would endanger the whole population by opposing immunisation.
The quiz
The notes contain a number of questions, and, more interestingly, model answers are given at the end. Here is one example.
Question. Why do some patients respond well to very little treatment?
Answer. The size of the toxic burden, the strength of the Life Force and micro nutrient status strongly influence a person’s response to treatment. Therefore a person with a low toxic burden, high micro nutrient status and strong life force should respond well to very little treatment.
Or, to put it differently, echinacea cures your cold in seven days, when otherwise it would have taken a week.
Conclusion
We’ll always have crackpot ideas about medicine, at least until real medicine gets much more effective than it is now. For example, in low back pain, the cause is usually not known, the treatments are only palliative, and it isn’t very effective palliation either. The big difference between real medicine and crackpot medicine, is that in real medicine you aren’t allowed to invent the answer when you don’t know it.
No doubt the author of these fantasy notes was entirely sincere in his delusions. But how can any self-respecting vice-chancellor tolerate having this sort of stuff as part of a Bachelor of Science degree? Professor Peter John, vice-chancellor of Thames Valley University is not a scientist. His background is in education. But you don’t need to be a scientist to see what nonsense is being taught as science in his university.
Perhaps he didn’t know what is going on. Well, he does now.
Follow-up
Thanks to Ben Goldacre for the link from his miniblog.?
Thames Valley University and their degree in “Nutritional Medicine”
Why? Why do they pretend it’s science? Why don’t they just call it “some stuff we made up”
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Just how bad is all this going to get?
Once again it is not just harmless meanderings. The implied recommendation of not ‘artificially bringing down the temperature’ during fever is dangerous. The logic is flawed too: if it is wrong to reduce temperature, why not let nature take its course for all disease? Then these quacks might go away.
On immunisation, if the use of ‘morbid diseased matter’ involves toxins, how come it is OK to use homeopathy, with its mercury, snake oil (oh no, sorry that should be venom) and worse. (As a reminder the most mind-blowing list is at http://www.helios.co.uk/ ).
Following the link to Dr Lawrence Plaskett , as usual the most telling thing is the revelation that he has ‘designed a range of nutritional supplement products’ and that he has ‘US and UK patent applications’. Combine this with the stated objective of one quack ‘discipline’ (won’t say which) and the aims of the fervent founder of the Bravewell Foundation in the US ( who, it seems, is on a crusade and will not rest until ‘integrated’ quackery is ubiquitous in health systems world-wide – http://www.bravewell.org/ ) and the benign, holisticker-than-thou, holier-than-thou, pompous, pious, greed…. – mustn’t get carried away – integrated bollocks people are simply onto a huge money-making venture.
As you say DC, this doesn’t have any place in BSc degrees, but really should it have any place in higher education at all?
This is astonishing, these notes are complete bullshit. Surely teaching students ‘truths’ that are demonstrably, completely and unarguably wrong as part of a science course must breach some legislation or charter that TVU is bound by? If not, it should.
[…] David Colquhoun’s blog [ http://dcscience.net/?p=260 ] to read for yourself. Here’s a small taster of what students were being taught (poor things): […]
Good Grief!
Capillary dynamolysis – Nothing more than Rorschach shapes and fractals.
Hering’s Law of Cure:
From above downwards.
From within outwards.
From a more important organ to a less important one.
In the reverse order of their coming.
Just meaningless bad poetry.
Boils, fevers and immunisations.
This is more dangerous stuff.
We need to cherish or lost boils and carbuncles and live through every fever and febrile convulsion we are unlucky enough to suffer. Oh and bring back smallpox and polio too.
No thanks; I think I’ll stick with an occasional antibiotic rather than bursting my pustules and the odd paracetamol to stop those pesky though thoroughly health-giving febrile convulsions.
Give me suppression and toxic vaccines rather than sweating, fevered, convulsions, boils and carbuncles requiring lancing, and the crippling effects of polio.
Keep up the fabulous exposure work David. It will always be required and you do it excellently.
“Toxins close to the surface of the body are conceived to be most likely on their way out. The skin is an eliminatory organ and toxins at or near the skin level are not so much of a threat to well being. Naturally, the patient may well be horrified at the disfiguring
rash that may be seen by all. Nonetheless, the patient is seen to be far better off than when having these toxins deep within the body, held, perhaps within essential organs that are becoming progressively damaged.
”
Really? So ignore that rash then?
Lindy noted “Following the link to Dr Lawrence Plaskett , as usual the most telling thing is the revelation that he has ‘designed a range of nutritional supplement products’ and that he has ‘US and UK patent applications’”.
Naturally we are led to believe that the patent applications are for nutritional supplements. A search on the service of the European Patent Office reveals two patents in the name of Lawrence G Plaskett (He may have other applications as yet unpublished).
US4125634/GB1579823 describes: Coagulation and flavoring of spun protein fibers (TVP for synthetic meats); and
GB1209055 which describes “Instant Tea Composition and Process for the Preparation Thereof
All natural of course!
As Claire has pointed out with the above example, some of this information is not just wrong – it is dangerous.
The “Do nothing” approach and advice to avoid vaccination is so dangerously wrong that I think TVU need to look at what they are promoting.
My jaw is on the floor. It is going to remain there for the rest of the day. This has to be the biggest display of anti-intellectual garbage taught in a UK university ever. Although, I am not sure I would place a bet on it any more.
I’ve just had a look at the range of courses available at TVU when you search for “Medicine”. It’s stunning: there’s a PhD in Complementary Medicine, for example, and a Postgraduate Diploma in Anti-ageing and Longevity Medicine. Can’t the BMA complain about the misuse of the term “medicine” or something?
The full list is here:
http://courses.tvu.ac.uk/?SearchType=adv&KeyWord=medicine&rptindex=1&isSorted=0&img=img&sortname=null&count=0&PageSize=20&Sub=Select&Mode=Select&Campaign=Select&Quali=Select&Duration=Select&International=&Year=&Month=&Ccode=&txtKeywords=medicine&StudyLeavel=Select&Location=Select
LCN
I don’t wish to sound harsh but if you got off your arse and got the Quackometer working you would have a mechanism for formally quantifying the degree of mumbo-jumbo displayed here vis-a-vis elsewhere.
Hopefull you will be able to add in a parameter which multiplies by two the woo-ness measured IF the woo-vendor has some financial interest to promote (pills, creams, tachyon water blah blah blah blah . . . . . contributor lapses into a coma).
Ah, good old Slough college!
I agree with David Mingay: the BMA should take a much more active stance on such nonsense.
On the other hand, in my experience, the ‘orthodox’ medical profession can sometimes spout unscientific claptrap too.
You might be right HoldThem
But usually orthodox scientists only make fools of themselves when they go outside of their area of expertise. They have too much to lose to act up within their specialities.
I guess a prime example is Fred Hoyle with his nonsensical drivel about evolution being as likely as a tornado blowing through a scrap yard and creating a jumbo jet from the rubbish.
Apart from being a complete misuderstanding of the process of evolution it is difficult to see how an astronomer who could grasp the concept of interstellar distances could not grasp the concept of deep time over which evolution occurs.
Plus his belief that life originated from viruses from space surely only regresses the question of the origin of life.
And he wonders why they passed him over for a Nobel ! (well “wondered” obviously seeing as how he is dead).
Be interesting to see some examples of the orthodoxy spouting claptrap.
Wow! That is some heavy duty woo. I guess the part that worries me most is the anti-vaccination propaganda that is being included in this “healthcare BSc”.
Perhaps it’s time to set up a campaign for science in science education to lobby for minimum (but strict) standards to be met before an institution can award a BSc at the end of a course.
What shameful drivel. How on earth can this be a BSc? Though I did quite like the (limited) comedy value in, “subtle or ‘etheric’ energy forces not easily measurable by the physicist’s equipment”. The use of “easily” for “at all” is such a silly attempt at sleight of hand; particularly when it goes on to say, “Vitalism is the notion that life in living organisms is sustained by a vital principle that cannot be explained in terms of physics and chemistry” and, “You either believe it or you do not.”
Also it’s heavily ironic that content which, “cannot be explained in terms of physics and chemistry” is taught as part of a BSc. It really makes me wonder what the “Sc” is for, “Scam” perhaps?
“Just how bad is all this going to get?” –Lindy
How did it all get even close to as bad as it already is?
“How did it all get even close to as bad as it already is?”
The only reason that I can think of is that universities are no longer run by academics, but by managers whose standards are not those of science, but more like those of accountants, PR people, or even of the folks who gave us Enron and Lehman Bros. Who gives a damn if it’s true, as long as it makes money?
The ludicrous thing is that as the amount of formal quality control has increased, the lower the actual quality has become. The box-ticking formal assessments are what prop up all sorts of outrageous junk, that wouldn’t have survived a glance by any half-competent scientist.
Hear Hear. I wonder what the no doubt multi-page “accreditation document” for this course says? And does the person teaching Vitalism have a Practitioner Certificate in Advanced Imaginary Forces? Or possibly a licence as an ordained Minister of religion?
I’m betting, BTW, that if they have a Reiki teacher she/he will have to have taken a Certificate in Reiki Advanced Practitionership (think acronyms).
OK, I’m a scientist at a low ranking Uni. but I still have pride in the scientific standards and rigor that I (try) and instill in my students I’m only writing this out as I’ve not seen anyone say it outright, but I’m sure we all know it..
The problem is this, the introduction of market economics to the University sector. I know that might seem like a different issue to some, but here’s the rub, and this is a perfect example.
The introduction of market economics has meant that the managers of low ranking Uni’s (like mine) that don’t attract 1% of the research funding of high ranking Universities. (I’m not bemoaning this just stating it as fact…bear with me here!) are looking at their bottom line much more than before. Add to that, that managers have taken over from academics in running Universities and what do you have?
You have a bunch of people in charge who are only interested in student recruitment, and this means running courses that are POPULAR. That is the key, and if popular and scientific rigor collide then rigor looses.
“Sure we could run a demanding degree in mathematical modeling but homeopathy would recruit 10 times the students” That is the mindset we are fighting. It is these people that devised the checklist method of program validation, asking if there are sufficient resources for the students without ever asking if the content is any good. Validation committees may even check that the intended lecturers are proficient in their field…..it simply doesn’t matter if their field is complete make believe. In skeptical terminology most validation events produce a straw man. They say “we have checked these (seemingly) important things and they are all fine”
So that’s my view from the trenches, popular trumps rigor and evidence based and honest. Popular sits on the veneer of respectability over a seat of cash! (quite poetic that might use it again!).
But then what do I know, Im not even in management…
Thanks Nick. I know a lot of very good scientists who work in post-1992 universities. And they are all very embarrassed by what their VCs are doing. I’m supporting them. It is their own managers who are bringing them into disrepute.
Of course, we have never actually had a degree course in Complementary Medicine anywhere which tried to take a properly rigorous science-driven approach (the Comp Med lot claim they do, but wherever it has been looked at it turns out this is crap)… … so we don’t know how such a degree would play.
Put another way, the other thing that goes along with Nick’s market forces / bums-on-seats imperative is “Practitioner Training”. The “B.Sc.” in Homeopathy has to be accredited by the make-believers at the Society of Homeopathy too (and thus has to be full-on make-believe), otherwise it won’t be a “training”, on which the student enrolment presumably depends.
Nutrition is an interesting in-between case since there are places offering “kosher” Nutrition B.Sc.s (leading perhaps to careers in dietetics) and also places offering bogus Holford-y degrees in “nutritional therapy” or “Nutritional Medicine”.
Can I add a comment as a non-academic which will probably not surprise many people here.
I work in IT nowadays and for five years I was involved in the graduate recruitment programme for a well known UK IT services company.
Every year we got truckloads of CVs from aspiring graduates (partly because we offered exceedingly good training and career prospects).
The first pass on the CVs would be to split them up into two categories:
1) In no particular order – Oxbridge, London (depending on college), Durham, Exeter, Edinburgh and so forth.
2) Former colleges and polytechnics like TVU. These were colloquially known as the “University formerly known as Bash Street Poly”.
Only if we could not fill our requirements from Category 1 would we dip into and cherry pick Category 2.
This is brutal, probably unfair, probably elitist and snobby and probably missed out on some good people. However, it is the way of the world (the company I joined after this one used exactly the same filtering method). I would suggest it is endemic.
If I were a student looking for a course I would be remarkably wary of anything woo related as it would effectively cut my career prospects to virtually nothing. (I recognise that university is not meant to be vocational but some sort of job at the end of it is useful).
The reason for this is simple. We looked for analytical, creative thinking people who could demonstrate a degree of objectivity and intellectual rigour in whatever discipline they studied (and we recruited from a broad range of academic disciplines).
What part of B.Sc Homeopathy would fit that description ?
(And I would point out that if that sounds a bit arrogant my wife did a degree in History of Art at Ealing College before it morphed into a uni – because it offered exactly what she wanted)
Yes all of those. I’m rather shocked by the crudeness of the selection that you describe. I have news for you. People leave UCL with 2.1 degrees that I would regard as verging on unemployable (at least as pharmacologists). We now have vast classes, many of whom have little real interest in the subject.
I’d guess that the range of variability within one institution is quite wide compared with that between institutions.
David
I was merely describing the first pass filter on graduate applicants as I know it to apply in a number of IT companies (and I have no doubt it applies in other organisations).
I was not defending it in any way – merely trying to tell it like it is.
It is a crude process. It was not of my invention, I did not particularly endorse it and I felt we should look at general skills rather than what university someone went to.
And there are indeed graduates from “excellent” universities who are to all intents and purposes unemployable. The post filtering interview process sorted them out – CVs and application forms only got them through the door.
There is simply not enough time to review and interview every applicant so crude mechanisms are used to reduce the workload.
Plus this acts as a sort of double filter because the “better” universities will already have done their own filtering on applicants in the first place (presumably).
Maybe it is a reflection of something I posted elsewhere about the transition from personnel to human resources to “Human Capital Management”.
Having said that I personally would never take forward someone who had a B.Sc in some form of hokum like HY, pixy dust nutrition, bio-energetic vitalism and so forth. The CV would go in the bin immediately as I would be unable to work out which part of the Sc bit this drivel fitted into. Even media studies types can probably do something useful like write advertising waffle (OK I retract “useful”).
It is a harsh world and it will only get harsher in the future. Studying mumbo-jumbo (i.e formally declaring you are an idiot) is probably not the best way to survive in it.
If anyone is interested, I have compiled a list of the quack courses offered for 2009 at undergraduate level from the UCAS website:
http://www.thinkhumanism.com/files/UCAS%20Courses%20on%20quackery.xls
There are 60 courses from 31 institutions.
On the list are UCLAN: I thought they had withdrawn their quack courses?
Dr. C.:
Thanks for doing this, from the U.S.A.!
I collect citations of ‘naturopathic vitalism’ over here (see http://thevitalismofnaturopathy.blogspot.com/ ), and this is quite a rich lode!!!
Of course, sadly — shamefully — over here, States [yes, as in government] falls squarely on the side of the woo-miesters, claiming that vitalism quite heartily survives scientific scrutiny
(see http://www.oregon.gov/OBNE/docs/Philosophy.htm ).
-r.c.
…with a few Latin phrases thrown in for good measure and authority!
Alan H, I am afraid that although in the summer UCLAN not only announced the suspension of its ‘BSc’ in homeopathy (see DC’s posting University abandons homeopathy “degree”) but also a review of its plans for increasing the number of fancy bollocks degrees, the homeopathy course is still advertised on its website (http://www.uclan.ac.uk/courses/ug/bsc_homed.htm). What is more, the entry requirements are,
‘200 points* plus GCSE Science grade C ‘.
Now I don’t know what the 200 points would entail, but how many real BScs can be undertaken with simply a GCSE grade C in science? It just emphasises the ludicrous way in which academia is being debased.
Another stupid thing about the woo-mongers is that they bang on about their methods and mumbo jumbo being outside the comprehension of normal science, yet still want to have BScs. Not even a modicum of logical thinking can make its way in. Maybe vitalism replaces the need for working grey matter.
200 points = 2 Bs at A level (although things like a pass at Stage 3 Horse Knowledge & Care from the British Horse Society are worth 35 points. And possibly Stage 3 Horseshit might be worth something in this case). The full list is here: http://www.ucas.com/students/ucas_tariff/tarifftables/
I took a group of year 10 students to TVU for a taster day of careers in health care, with contributions from radiology, physiotherapy, nursing and, guess what, complementary therapy! I sat through a heart breaking hour as the students were ‘taught’ about the benefits of complementary therapy and how traditional medicine is failing patients. I am in total shock. Especially having read articles about TVU’s courses recently here. Keep up the good work – I shall certainly be doing some interesting work after half term concerning ‘complementary medicine’!
My solution would be to place academic research and post-graduate study in a smaller number of combined research centres organised regionally (Oxford/Reading, Cambrdige/UEA, London, the NW, the NE, the SW + Cardiff, Scotland, etc) to perform all major research projects.
Undergrad teaching to continue at university level, but with clear curricula so that if one has any aspiration to study, say, genetics, at one of the research centres one must achieve a minimum grade in that subject.
Smaller universities could stop funding small-scale research and concentrate on quality teaching – taught by academics who do their research in the institutes at 3/4 year level, and non-research active lecturers at the 1/2 year level.
Science_teacher. Thanks very much for your valuable view from the inside. It would be wonderful if you could point out to the vice-chancellor the impression that his policies are making on science teachers. But if that would be hard for you, I expect that somebody else will.
This sort of thing is precisely what I mean by vice-chancellors bringing their own universities into disrepute.
I wish I had taken a dictaphone, or at least taken detailed notes, so I could quote what they were saying to my students. If, and I doubt this will occur, I do return with my students I will take careful notes.
I can’t say enough how shocked I was that this was included in our taster day. Obviously I do not know who organises these days and what their motives are. However, I will take your suggestion and write to the vice-chancellor with my thoughts.
We have to be so careful to educate our children to think for themselves and to detect this kind of pseudoscience. Good science teachers are aware and constantly battling against, mainly media driven, misconceptions in the science classroom.
Hi,
I’ve studied nutritional therapy (at another institution I hasten to add) and my course bears no resemblance to this. The TVU stuff is ancient. It is possible to study nutritional therapy with recourse to science, and I can’t belive that what is presented here could possibly be part of a degree course (or any other course for that matter).
Are we sure this forms part of the course. How can that be verified? Is is not just some historical curiosity studied as background? So far I’ve managed to avoid using concepts like “life force”: there is no need for it. But then I’m a scientist by nature (BSc. Mathematics). My course has a few wooy things, but nothing like this. The modern nutritional books, such as those by Murray & Pizzorno talk in terms of science. You might not agree with them, but at least they are written using terms like blood presure, ateriosclerosis, cholesterol, etc.,
I can’t believe this material is from a TVU course. It’s ridiculous.
Just a comment about a vaccinations. I’m sure they work after I read about the tremendous results in Africa with the measles vaccine. However, when I was a child we all caught measles from other kids to give us lifelong immunity. Although in some circumstanses measles can be life threatening (eg in Africa), well nourished children can survive the disease. So what does vaccination in west give us? A way of avoiding an inconvenience?
No, gonzo – it gives us a way of avoiding deaths and injuries. Surely your (mathematics) education has equipped you with the tools of logic and arithmetic? If so, please do a little googling/wikiing for the death/injury rates from measles in historical and recent outbreaks in the well-nourished west and use them. 🙂
Hi phayes,
I did find the report “Death occurs in 1-2 of every 1,000 reported measles cases in the United States.” But also “At least 127 people in 15 states have come down with the measles, the biggest outbreak in the United States in more than 10 years, Reuters reported. (July 2008)” So if that was the biggest outbreak in 10 years, where did the statistic in the first statement come from? The low rate of infection in the USA is obviously due to the intensive vaccination programme. The high survival rate in infected people in the USA could be down to better nutrition or better post infection health care. But the potential for injury is a more convincing argument for vaccination.
Gonzo. You might try Harrison’s Principles of Internal Medicine (16th Ed, page 713), Then see if how your conscience feels about the near-universal opposition to immunisation on the world of alternative medicine.
Concerning measles in particular, see the Eurosurveillance report, Measles is still a cause of concern in Europe..
Where did it come from? Earlier outbreaks, I’d imagine. See also the recent Netherlands and Irish outbreaks.
As for your rather curious remark about what constitutes a convincing argument: if you were a US politician in a pre-vaccination era America, do you really think that saying something like, “With only a few hundred measles deaths each year, a mass vaccination program would no doubt be considered an unjustifiable imposition by my fellow Americans, but since measles causes a large number of serious injuries too, I think they might be persuaded to put up with the inconvenience.” would’ve been good for your political career?
Yes, I’d never make a politician. But there are other criteria for arguments besides political acceptability. What I meant to say was that even though there may be no deaths, the fact that side effects of measles are severe (alone) justifies vaccination. I’m reversing my stance based on your help. One of the problems with childhood vaccinations has been the thimersol, which although pharma companies say causes no harm, has now been removed. Thus removing objections. I think attitutes to vaccination in alternative medicine are changing.
Gonzo, I sorry to confirm that this apparently ancient material is indeed from the TVU BSc course.
Goinzo. You said
I’ve now taken a look at the bit of this this textbook that can be seen here. Certainly it uses sciencey words, but it doesn’t look like anything that I’d call science because of its cavalier attitude to evidence. The book takes seriously the now utterly discredited mumbo-jumbo of homoeopathy and is equally credulous about meridians and “Qi”.
Most offensively it harps on about how medicine treats symptoms, but naturopaths treat causes. If it had been left to naturopaths and homeopaths we would never know the causes of infectious diseases.
The “enhancement of the immune system” has never been demonstrated. It is simply a mantra, repeated endlessly by quacks.
It is particularly silly of Murray & Pizzorno to pick infectious diseases as a battleground, because it is one of the rather few areas in which diseases can be cured.
It is quite true that for many of the diseases that are now most important, cancer, heart, Alzheimer’s and so on, the causes are not known by anyone in any detail, and the treatments are largely palliative (not even that in the case of Alzheimer’s).
The difference between real medicine and alternative medicine is that we admit that freely. The alternative people, on the other hand just make up the answer. It looks like a classical case of wishful thinking to me, It would be wonderful if we could avoid cancer and Alzheimer’s by changing diet or swallowing vitamin pills or ‘antioxidants (recommended reading: ‘The Antioxidant Myth: a medical fairy tale). But beyond the standard basic advice about diet, there is next to no reason to think that you can. Sad but true.
Murray & Pizzorno are betraying patients by giving false hopes, and betraying science by their bad assessment of evidence. But I expect they are much richer than me.
I hadn’t heard of this book by Murray & Pizzorno before, but the introduction with its ‘old paradigm’ versus ‘new paradigm’ is precisely the sort of cobblers that makes it difficult for me to keep my breakfast down. I am not a great fan of the notion of paradigms anyway, but these persistent mantras implying that proper doctors have no empathy, do not try to get to the root of diseases and that the wonderfully naïve and simple suggestion that a little bit of adjustment to diet and lifestyle and the ‘right’ mental attitude – whatever that is – will make us all healthy is beyond contempt. Also could someone please explain to me precisely what is meant by treating the whole person?
Well, I guess the answers are in the edicts on page 3 of the book. Here we are encouraged to return to a natural way of living, including breathing (jolly good idea), exercising (ditto) and employing various forces to eliminate poisonous things, though who these forces are it does not tell us on this page.
The new principles of living are interesting. Chiropractic (inter alia) is apparently one such principle, another being for us to have mud baths. Blimey, what do they think we are, a bunch of hippos? Spare us please!
Gonzo has told me that his course makes reference to “The wherewithal to detoxify“, by Lawrence Plaskett, putative author of the TVU stuff in this post.
‘Detoxification’ seems to be a favourite myth of nutrition gurus and downmarket women’s magazines. The problem is that we are never told what these toxins might be. The ‘detox’ devices that are sold seem to be frauds.
This article by Plaskett has a lot of perfectly sensible stuff about cytochromes, but fails totally to link it to any human health outcomes. After the sciencey bit all we get is the usual list of unproven supplements.
Buy the pills and all will be well. if only it were that easy.
>>The problem is that we are never told what these toxins might be. <<
Unfortunately there is often a misuse of the word toxin. Toxin refers to a biological product, when in fact the word toxicant should be used for exogenous agents.
Please read “Environmental Toxicants: Human Exposures and Their Health Effects”. Unfortunately, its a bit out of my price range, but one can read a fair bit here.
“Chemical contaminants of every conceivable kind can be found in most types of human food” (page 6)
Sure, we should all be concerned about eating things that might do harm, whether natural in origin, or man made (pesticides, hormones etc). My point is, though, that there isn’t the slightest reason to think that taking the supplements listed by Plaskett will do anything to help. That isn’t the solution but it is sold as such by a lot of nutritional “therapists”.
I was only trying to answer the point. “Where do they come from”. So none of those substances will give any support to the natural “detoxifying” pathways?
loopylou
>>Gonzo, I sorry to confirm that this apparently ancient material is indeed from the TVU BSc course.<<
Don’t be sorry about it. You are only verifying a fact. Thanks.
It is astonishing, truely astonishing, though.
[…] of course, they’ve utterly failed to […]
Dear Dr. Colquhoun and others (particularly Alan Henness),
I very much object to my BSc (Hons) in Herbal Medicine from the Life Sciences Department at Napier University in Edinburgh being referred to as a ‘quack’ course. I think that it is possibly one of the few ‘non-quack’ courses in the UK that is rather unfortunately included in the CAM category. Because we belonged to the Life Sciences Department, the course I took was rigorously scientific, although I would have liked to have seen even more attention to the evidence base. The modules I took included Botany, Plant Chemistry (both at RGBE), Biochemistry, Pharmacology and Toxicology, Genetics, and Molecular Pathology. My Clinical Medicine classes were taught by a GP (retired), and my Clinical Diagnosis classes were practical and included visits to the Edinburgh Uni anatomy labs and practicals at the Western General. My exams for these classes took the OSCE form currently used by medical and nursing courses. I worked in a local hospital as an auxiliary nurse to supplement my training. My final year studies included a paper on anthocyanidin interruption of COX-2 molecular cascades, via MAPK-signalling pathways and the attendent inhibition of NF-B and AP-1, and my dissertation was on modern medical applications for anthocyanidins from a plant-based source. Others on my course worked in the labs looking at specific medical applications for essential oils, interference of herbal medicines and foods with pharmaceuticals, and anti-oxidant profiles for plant medicines. I also wrote an essay supporting vaccination as one of the major medical breakthroughs of the the last century. I would like to suggest that lumping Herbal Medicine in with Homeopathy and ‘naturopathy’ or, even, ‘nutritional studies’ is irresponsible. The evidence-base for herbal medicine is far from complete, but I would like, for instance, someone to give me good evidence for the efficacy of polypharmacy with pharmaceuticals. My patients often take between 5 and 10 pharmaceuticals, none of which have ever been tested together. I would also request that anyone who is willing to give me £60,000 to complete my PhD in Pharmacology, focusing on plant-based materials that kill the Tuberculosis virus, contact me here. Much of the problem with plant pharmacology is that it simply lacks funding. Why? You can’t get any IP on a whole-plant product. Only on a process or a specific molecule that you have produced. When you consider what we are up against, it’s no wonder there isn’t ‘any evidence’. Show me the money, and we can see what we can find.
Finally, the WHO states that 25% of pharmaceuticals are still made from plant products and that 80% of peoples world-wide still rely on the plant-based medicines of their cultures. Although we cannot know which of these are efficacious, only money and exploration will show us the truth.
At a conference on immune disease at the Royal Society in Edinburgh last year, an eminent consultant referred back to a 19th century Materia Medica in which women’s menstrual bleeding had been treated with Glycyrrhiza glabra. There is currently a strong suggestion (money for a trial, please?) that Glycyrrhenetic acid and the aglycone of Glycyrrhizin alter the way that steroidal hormones are metabolized. How is this quack science?
Physicians in Britain used plant medicines for centuries, and having studied many of the old materia medicae, I think we should be less sceptical about the past and more curious about plant medicines than we currently are. Does anybody know when botany was officially phased out in the medical programme at Edinburgh? I think it was in the 1950s or 1960s….
All the best.
Gonzo – the book you recommend by Murray & Pizzorno is equivalent to a Readers Digest book on healing foods, or – dare I say it – remarkably similar to Holford & Burnes recent foray into the same subject.
From a dietetic point of view, these books are akin to the quality of medical rigour equivalent to the Daily Mail vs the BMJ.
Of course, theres nothing wrong with being a ‘lifestyle’ therapist, dispensing ‘drink your water and eat 8 a day F+V for good health’ style advice to people who need a bit of ‘me’ time. It’s the dabbling in health issues you don’t understand and the attendant inaccurate and potentially harmful advice dispensed…
In ‘practicing’ your version of ‘nutrition-lite’ therapy you undermine the rigour and knowledge of dietitians versed in medical, nutritional and sociological knowledge, and able to put this into context for the individual. I’ve lost count of the number of times individuals have spouted some ridiculously incorrect perception about what a dietitian does on the basis of contact with self-styled nutritionists, later to qualify their comments with an apology for failing to appreciate our differences.
Hopefully the HPC ruling will create a more level playing field for qualified therapists to access clients directly.
Notawitchdoctor – I sympathise your position of herbal medicine being undermined as a treatment modality. However, like the Nutrition Society, there are many members of the NIMH happy to claim responses beyond the evidence. Its surely time to reclaim the subject as a botanical equivalent to pharmacy.
You mention use of licorice compounds as potential treatment for menorrhagia – fine as long as you watch for hypokalaemic arrhythmias and CCF and other side effects, particularly in those on diuretics, corticosteroids, digoxin, oestrogens and warfarin.
@UKdietitian
Of course it’s time for us to reclaim botanicals as a complement to certain aspects of pharmaceutical treatment. Pharmaceutical treatment arises, in part, from physicians’ use of botanicals before modern chemistry and pharmacology even existed.
I am well trained in the interactions of the herbs I use. Much more so than many of the doctors I encounter, many of whom presume botanicals to be harmless. I even know which ones interact with each other. Funny, that.
The National Institute of Medical Herbalists is a body made up of many different practitioners from different backgrounds. I do not agree with many of my colleagues on any number of subjects.
What you just took from a book displays how herbal medicine is very misunderstood and must be restricted, in practice, to qualified and registered medical herbalists. From my experience, hypokalaemic arrythmias are extremely rare at therapeutic doses. Glycyrrhiza glabra is also indicated in the British National Pharmacopoeia for treatment for adrenocortical insufficiency (such as that created by long-term ingestion of corticosteroids). You should also point out that it’s not simple diuretics that are the problem, but loop-diuretics. Large doses (outwith the therapeutic range) deplete potassium levels in the body over time. I would rather that people taking beta-blockers, hypotensive medications like atenolol and enalapril not take Glycyrrhiza, as it increases blood pressure in high doses.
Please don’t treat people with herbal medicines unless you understand what they do.
All the best.
notawitchdoctor is clearly at the well educated end of the spectrum of herbalists. I agree totally with the final plea.
But since the vast majority of herbal medicines have never been tested properly, nobody “understands what they do”. And worse, since no herbal medicines are standardised nobody even knows what dose is being given. To give an unknown dose of something that may or may not work seems a bit irresponsible to me.
These indubitable facts seem to me to lead us straight back to the view that if a herb works then is just pharmacology (and it must either be purified or standardised so you know the dose). If it doesn’t work then you shouldn’t be using it.
Dr Colquhoun,
you come to the critical question about herbalism. Obviously, as a herbalist, I cannot completely agree, because the therapeutic doses we use are not those used by physicians in the past. Of, course these herbs work, so we need more research about what they do pharmacologically.
However, you have never answered my question about the lack of evidence regarding polypharmacy in pharmaceutical medicine. Nor have you addressed iatrogenic illness in the general population. Pharmaceutical medicine is much more ‘dangerous’ than herbal medicine exactly because the medicines are standardised and contain isolated molecules that have the capability to damage organs, as a result.
I think we are all talking at cross-purposes. I would like to see more transparency in orthodox medicine AND phytotherapy. The nurses I worked with in hospital looked up doses from a book before they dispensed, and many had no idea what the drugs they were administering were going to do to their patients. I also witnessed incompatible drugs being administered by Foundation doctors and patients being very very ill from taking medicines that should not have been prescribed together. Surely the public deserve better on all counts?
All the best.
There is no “of course” about it! I’m sorry, but if that is really your attitude to evidence, I don’t really see how we can have a very useful dialogue, Your arguments seem to at the same level that allowed blood letting to persist for centuries. The most obvious characteristic of ‘ancient wisdom’ is that it was mostly wrong, That is what the enlightenment was about.
If you look at this blog you will see a great deal of criticism of conventional pharmacology and of the drug industry, But at least we try to be rational, and at least some of it works.
Dr. Colquhoun,
May I be so bold as to ask if you are saying plant-based medicines don’t work? If they don’t work, then what is the issue?
I think you are letting your desire to raise ‘evidence’ above all else, to obscure what you know to be true about pharmacology. There is plenty of animal and cellular research to support the efficacy of herbal medicine. What we need are sound, double-blind RCT clinical trials on humans. Since these are not being done on any reasonable scale, and are not likely to be done, on the basis that herbal medicine stands to make little money for the pharmaceutical industry, you should admit the weaknesses in the system. I know that herbal medicines work anecdotally because my patients (physicians among them) improve on the herbal medicines I dispense. I agree about standardisation, I would like to see it happen, but it doesn’t look like it is going to any time soon.
I refer back to Ernst’s book Herbal Medicine: A Concise Overview for Professionals (Butterworth-Heinemann, 2000). From the essay on synergy by E.M Williamson: ‘Many traditional prescriptions are historical combinations, and evidence as to the importance of their exact constitution is lacking, although their efficacy is not in question’ (p.51). And, ‘We are now realizing that these empirically derived mixtures often have efficacy as yet unexplained, since the dose levels of the component herbs often seem too low to have a therapeutic effect’ (p.53). This is a book edited and supported by Ernst. All of the contributors are pharmacologists or physicans.
I’m always glad to see proper scientific criticism of any discipline. But that means examining your own position with the same microscope. Do you care to address any of the points I made earlier?
And as for the blood-letting comment, herbalists never did that. Physicians did. It’s a bit desperate grasping onto such a thing as your position for why I might not support evidence-based phytotherapy. I support it whole-heartedly. There is simply no money in the research, and so it is not being done. Neither is the research into pharmaceutical co-prescription.
Dialogue means listening to others; not dismissing them forthwith because their position challenges yours. I am effectively, on your side as regards many arguments about ‘alternative medicine’. I ask for you to be reasonable about the shortcomings of the evidence-base in phytotherapy and orthodox medicine.
Science (as Thomas Kuhn pointed out in his wonderful book The Structure of Scientific Revolutions) is constantly undergoing change. I am very glad to be a witness to this process.
All the best.
“What we need are sound, double-blind RCT clinical trials on humans.”
Yes exactly. That is all I was saying. When they appear, I’ll believe they work. Until that time I won’t. Anecdote is simply not reliable as history has shown time and time again. Any manufacturer wants to sell a herbal medicine should have to show it works, just like any other medicine It really is that simple.
The obvious answer to ‘validating’ the instructors for such courses will soon be solved. After all what other use is a BSc in woo other than certifying your competence to teach woo to others?
IOW it is too late, the box tickers will be able to list the formal degree qualifications of the proposed staff and how petty and ‘uncollegial’ will we look trying to decry those ‘qualificiations’?
AS DC rightly points out NAWD is clearly at the top of the tree in terms of his approach and education and is probably miles apart from the usual woo merchant.
However, he is wrong about pharmcos not being interested because of IP issues. They are extremely interested and have been ever since Bayer patented aspirin and heroin – clearly plant extracts originally but codified and formulated into medicines (not too successfully in the latter case).
Pharmcos are asset stripping (bark-stripping, leaf-stripping ??) the third world for natural and herbal based remedies which they can patent.
Nobody doubts the efficaciousness of herbal remedies – clearly some of them (belladonna perhaps) have profound medical effects.
So we know plant based stuff works. We just want to know why, in what dose, with what side effects etc etc. All that sciencey stuff that enabled the vaccines DC lists in the table above (the one that shows scores of millions of saved lives !)
What people doubt is the proliferation of herbalists, natural remedies etc and the spread of Chinese herbal outlets selling a range of pot-pourri designed to clear up all the illnesses known to man (with zero research to prove any of it).
NAWD faces an uphill struggle I think but does at least seem to be approaching it from the right direction.
@Notawitchdoctor,
Forgive my cynicism, but doesn’t the fact that you are doing a PhD on the “Tuberculosis virus” have more than a passing relevance to the question about science and pseudoscience?
Best laugh of the day (once I checked it was actually a bacterium – I ain’t a medico).
Hoist by his own petard I think.
Please delete all benefit of the doubt previously afforded to said herbalist.
Indeed, i would have thought that someone investigating the possible therapeutic herbal/pharmacological interventions would at least start out with a basic understanding of the replication steps of the organism and which processes were vulnerable enzyme inhibition.
An apt analogy would be the mechanic who insists he is going to carry out a comprehensive MOT on your “Boeing motorcycle”
I would like to thank those who pointed out my error, here. Indeed, the bacillus that causes tuberculosis is a mycobacterium. I am a human and in the heat of a discussion, I make mistakes. This doesn’t discount my background as a plant pharmacologist. My humble apologies for my mistake, in the first instance.
@John Hooper: That would be HER own petard. Your smugness at my mistake only hardens my opinion, that, in so many ways, science has lost its way. Why did you assume I was a man? Because only men study at university? Or study biochemistry? Such sexism is rampant in academic circles, but some of the finest biochemists I have met have been women. Are you a throwback to the days when women were considered to be better off at home? Many women have made outstanding contributions to science. Marie Curie and (the much maligned) Rosalind Franklin come to mind, as do many of my fine professors in molecular pathology, pharmacology, and clinical medicine . You are also wrong on the subject of IP. Salicylic acid and diamorphine are both plant-based, but fall under IP rules exactly because they are modified from the original plant product. It is not possible to secure IP on a whole-plant product under current legislation.
As I pointed out in my last post, the history of science is punctuated by changes in the scientific paradigm. The current paradigm that places emphasis on evidence, has its uses, but does not account for the place of innovation in science. The 19th-century surgeons who pioneered heart surgery had no evidence that it would work. Yet, their persistence led to the modern surgical techniques that saves tens of thousands of lives every year. Ditto those who pioneered inoculation which has led to the modern vaccinations that have saved so many lives, worldwide. By reducing modern science to a competition as to who can produce statistical significance in an experiment, reduces science to being a branch of statistics. Innovation and experimentation are at the heart of scientific investigation. ORAC, FRAP, and PCR are amongst the modern techniques that have given us tools to examine anti-oxidant activity and DNA, for example. These techniques did not exist until relatively recently. Supercritical C02 as an extraction method for plant-based compounds is also a new method by which we may be able to find new insights into botanicals. I have hope that the future is bright for botanical medicines.
Whilst you may laugh at the lack of ‘evidence’ for the efficacy of plant extracts, I notice NO ONE has responded to my multiple comments that pharmaceutical co-prescription is untested and, by your own admission, unsafe? Why the silence?
I note, with interest, the JAMA article on pharmaceuticals from October 1st, last month. That study, which looked at media reportage of pharmaceuticals, found that 42% of media articles did not report that the original research on a medicine had received funding from the company that discovered it. If the companies that have a vested interest in promoting a medicine for the purpose of paying shareholders dividends are not admitting their conflict of interest, where do modern pharmaceuticals stand? If you are going to place such restrictive qualifications on the use of botanicals, I would request you apply the same principles to pharmaceutical companies who are withholding ‘evidence’ from trials in order to sell a product (Vioxx and Seroxat come to mind).
Science must, eventually, have a just view of both pharmaceuticals and botanicals. Health-care is not a competition between companies or individuals, but a search for effective health-care for people who are ill. I would very much like for my discipline to be able to answer many of the questions you all ask, but it is simply impossible at this time. I still find that, anecdotally, my patients improve through treatment with botanicals.
It’s a sad state of affairs when someone from my background who is genuinely interested in the potentials of plant-based medicines is treated with the kind of disrespect I have witnessed, here. I am one of a small group of herbalists who genuinely loves pharmacology and is interested in the study of plant medicines in a laboratory. Shame on those of you who cast derision, when you should encourage dialogue.
Incidently, the person who supervised my BSc (Hons) dissertation was on the research team that discovered ranitidine, and my co-reader is a PhD in Biochemistry from Edinburgh University. They both felt that my dissertation was First-class and I received an award for innovation on my project. I am not particularly impressed with the level of thoughtful critique I have experienced, here.
Kind Regards.
And DeeTee
I’m not doing a PhD currently. I would like to very much do a PhD in Pharmacology. I have an interest in many subjects, one of which is a promising plant-product that has been shown to kill the Tuberculosis bacillum in vitro. Whether this might come to anything is the subject of 3 or 4 years’ study. Read more carefully.
I would also rather repair your Indian motorcycle. As I understand it, Boeing makes airplanes.
Kind regards.
Calm down folks, Nobody is insulting NAWD, and I really don’t think anyone is being sexist. I for one quite accept NAWD’s genuine interest in pharmacology, and genuine wish to obtain evidence. What I can’t understand is why she thinks it proper to treat people before that evidence is available.
The undisputed fact that regular pharmacology is imperfect, as I said above and often blog about, doesn’t really bear at all on whether herbal medicines work.
Sometimes you sound like a scientist, but then you say things like
The emphasis on evidence is what the enlightenment was about. It hasn’t changed and is the basis of the modern world.
The fact that good chemical methods can be used to examine antioxidant activity is not really relevant unless it is established that antioxidants are good for you. That was never more than a plausible guess and the evidence is now pretty clear that it was a bad guess.
Oh, and I hate to nit-pick again, but I think you’ll find that salicylic acid is the naturally-occurring. It is acetylsalicylic acid (aspirin) that is the synthetic derivative.
I wish you luck in getting a PhD in a good lab. If you do, I suspect that they’ll take a dim view of the idea that the need for evidence is merely the “current paradigm”.
Dear Dr. Colquhoun,
Obviously, I am wrong again. Being patronised by someone I admire, has reduced my desire to engage with science, somewhat. Many apologies for my ignorance. I never meant to appear so ignorant without purpose. I believed that my position held merit. Obviously, to you, it didn’t.
If my studies of the history of science offend you, I apologise. I thought science was subject to change because scientists had new ideas and wanted to explore them. Obviously I was wrong. Science has clearly been the same for hundreds of years, and I didn’t know this. I didn’t realise that science was static, my apologies.
I suddenly find that I am required to adhere to the current dogma and give up a career that I felt was particularly promising because I wanted to be innovative. Since innovation and thinking creatively are not scientific, I will give up on that.
Well done. You have succeeded in undermining my desire to study pharmacology. I hope that you feel vindicated by that.
Is that a victory on your behalf?
All the best,
H.
It is a comman mantra of altie types that conventional science doesn’t think outside the box and doesn’t innovate, but really this wrong.
For instance herbalists believe in the healing powers of plants, but don’t look at non-plant based sources and will discard ingredients that are not fresh. Which is why it wasn’t a herbalist that discovered Penicillin (a completely natural product).
When Fleming discovered it, he was looking for something else entirely, but he had the wit to investigate something that he was not looking for.
Fleming was not convinced that it was safe to use pencillin in the body, but because his work was published and peer reviewed others took up from where he left off and eventually it was successfully developed into a useful drug.
One of the early barriers to mass production was finding a suitalbe strain and a moldy cantaloupe in a Peoria, Illinois market in 1943 was found to contain the best and highest-quality penicillin after a world-wide search. Would herbalists have looked here? I really don’t think so.
If you don’t like anti-biotics, then there are Bacteriophages. Again a natural solution. But of course, sourcing these can involve looking through very unwholesome substances.
Alternative medicine simultaneouly appeals to antiquity whilst claiming to be modern. In reality it is a dead end. The paradigm that Alt-med is in is unoriginal, blinkered, self-contridictory and hollow.
NAWD
The last thing I want to do us undermine your interest in pharmacology.
Perhaps I didn’t express myself well. What I meant was that the scientific method has not changed greatly. That method, which cast aside dogma, authority and myth, had its roots in the age of enlightenment. It ensured that knowledge of the natural world increased and changed continuously. It is that method that took us out of the dark ages. I think it was rather beautiful.
@NAWD,
Sorry if I was unecessarily facetious – I realise you know what you are talking about and your “Tuberculosis virus” was just a brain slippage.
Apologies to NAWD for the unintended sexist slight. Maybe I assumed a female would be too intelligent and meticulous in attention to detail to confuse a virus and bacteria.
I don’t really need to respond to your comments as I don’t feel the need to defend myself. In any case my partner said I was in no way sexist (after I let her out of the kitchen – admittedly only to iron my shirts and polish my shoes).
Perhaps you should have followed Dr Austs lead. He refers to his wife as Mrs Dr Aust so perhaps you should have changed your name to mrs/miss/msnotawitchdoctor or notawitchdoctoress.
However, you are absolutely right and I should not have made a rash assumption.
I would always admit to the possibility of being wrong – it is one of the things people like me do rather than rely utterly on unjustified and unproven claims and assertions.
I am not sure that I am wrong about the IP though. I work in IT and my clients include GSK, Pfizer, Wyeth and a few other pharmas. I do not speak for them nor any of the other pharmas, nor would I defend many of their business practices (John Le Carre can crucify them far more effectively than me) but I can assure you they are indeed roaming the world looking for plant extracts that they can make a buck on.
If they have to tweak a molecule here and there to get IP then so be it.
If they can find some herb or plant which has a genuine and provable effect on some illness they will isolate the active ingredient and patent all possible variants of it or patent the process for extracting it.
Or they will just hide the whole thing behind an impenetrable wall of commercial confidence and secrecy.
And they have remarkably effective lawyers.
If the remarkably gentle comments of DC have dented your confidence and faith I would suggest that this herbal emperor had no clothes in the first place. Had you posted your comments on some of the other anti-woo sites you would have been eviscerated.
I wish you every success and as ever hope you never have to travel on a non-evidence based or culturally relative aeroplane.
I would like to thank you all for your very useful comments and for making me realise that, although I had pretentions that botanical medicines might eventually be brought, kicking-and-screaming into the 21st century, this is obviously not the case. I worked so very hard at my degree, and the research design I did for Molecular Pathology was so elegant, I lulled myself into believing I was something I was not. Many apologies. Obviously, I’m a ‘quack’ and a practitioner of ‘woo’.
I shall slope back to my kitchen and place something foul I picked from the hedgerow into a pot and brew it up in non-GMP conditions as a prescription for some poor soul who came to me because they wanted some snake oil. Oh, and while I’m at it, I’ll prescribe them some co-enzyme Q-10. (That’s a joke).
Incidently, will someone please enlighten me as to the evidence base for the safety and efficacy of prescribing multiple pharmaceuticals, the evidence base for therapeutic dosing of children and the elderly with all of the pharmaceuticals in the BNF, and the evidence base for the Higgs Bosun (seeing that the Large Hadron Collider doesn’t work, wouldn’t it have been more interesting to spend that money on something useful)?
all the best to you
Is “co-enzyme Q-10” some sort of piss take or is it just another bunch of woo.
It apparently cures all illnesses known to man which immediately makes me suspicious.
Plus it is sold in capsule form by Holland and Barrett which make me suspiciouser.
It reminds me of the great “Dihydrogen monoxide” joke.
Apologies to Mr Higgs, I believe I meant ‘boson’. *Whistling the Sailor’s Hornpipe*
@John Hooper
I agree with you wholeheartedly. That’s why it was a joke! 🙂
As I have pointed out in a conversation with Dr Colquhoun, I dislike ‘supplementation’ as much as I dislike Gillian McKeith and Patrick Holford. At least botanicals have an in vivo and in vitro body of research to suggest they are efficacious. We simply need the clinical evidence to clarify which botanicals work. I look forward to the day…. Anybody willing to volunteer to be in a trial? 🙂
Speaking of water, my husband pointed out a ‘recession-busting’ tip given by the hilarious Tim Dowling in today’s Grauniad: “Stop wasting money on expensive proprietary medicines. You can make your own homeopathic remedies at home using distilled water- and that’s it!”
I’m still giggling!
I would love to mount a “Shut down Holland and Barratt’ campaign.
And ‘suspiciouser’ is pushing it a bit, linguistically……. 😉
All the best to you.
For coQ10 you could start at http://dcscience.net/?p=223
The claims made by Boots are ridiculous. The ASA upheld a complaint http://dcscience.net/?p=232
As NAWD has said, it isn’t herbalism, just woo.
Irrelevant note. I used to prop up the bar with Peter Higgs in the Edinburgh Staff Club when he was a young lecturer and I was a PhD student. He had this wonderful new theory. Now he’s retired and we still don’t know if he was right about that boson. I hope so. He is a lovely modest man.
@John Hooper
Also, Dr Colquhoun wrote about Co-enzyme Q-10 in one of his blogs. I’m sure it’s here on this site.
Click on the ‘herbalism’ tab on the left-hand side of the homepage. I’ve already complained to Dr Colquhoun that supplementation with vitamins, etc etc is not herbalism. Or at least not herbalism as I would practice it.
NAWD
I know ’suspiciouser’ is pushing it a bit linguistically but I can get my comparatives and superlatives correct should I wish to.
I was alluding to Alice and “curiouser and curiouser” – after all we are living in a wonderland of mumbo-jumbo and hokum.
I think (based on Post 72) you might be getting the hang of this thing.
But do try to keep up. The Canard pointed out the Guardian HY thing this morning and I posted it on Becky’s anti-jabbophobe site.
@ Dr. Colquhoun
What a nice ancedote. Was the staff pub in Teviot? Envy is too mild a word….
I watched the live feed for the whole day when they fired up the LHC. I can’t believe it’s not working, and Higgs’ moment of glory is still on hold. Here’s to being brave enough and clever enough to create beautiful scientific theories when most people don’t even understand your mathmatics.
I should be so lucky just to stand on the shoulders of such giants. Much less have mind-power enough to be one.
@John Hooper
You’ll, of course, explain how plant extracts are mumbo-jumbo? In the meantime, may I offer you a drink? Fresh Conium maculatum juiced fresh from the hedgerow by myself this afternoon…… 😉
More irrelevant anecdotes. The staff club was in Chambers Street. It was a wonderful place to meet people, and learn new things. It has now been abolished, no doubt by managers who don’t understand the importance of that sort of interaction for the progress of knowledge.
NAWD
Oddly enough the mumbo-jumbo comment was not actually aimed at you. It was more aimed at the general zeitgeist of mumbo-jumbo and bullshit engulfing the western world.
You occupy a zone somewhere in the margin between this wonderland of hokum and the real world.
And I suppose I now have to use the Miasmic Herald to work out whether a serving of Conium maculatum is a draft of hemlock or a glass of elderberry wine.
In any case I explained in a previous post (based on DC explaining to me in an even previouser post) why plant extracts are hokum. It is not because they are harmless and useless pixy dust like HY or magic crystals but precisely because they are potentially dangerous and are not codified in the same way medicines are.
Looks like my first guess above was correct. Nice to be elevated to the level of Socrates. My old Phiosophy of Science lecturer will be turning in his grave with envy (assuming he is dead).
In fact you highlight one of the issues you and your ilk face. How would you know how much to poison me with ? I might have done a Livia and inured myself to it. Then I could have done what she did – drank from the cup and then offered it to you in all innocence.
Make sure you clean the juicer thoroughly !
And before you start on my English again I know philosophy has an “L” in it. And mathematics has an “E” in it by the way.
@John Hooper,
What a pleasure to spar with you, sir.
Plant medicines ARE codified under section 12(1) of the Medicines act of 1968. This is currently under review as part of the statutory regulation of herbalists and has been under signifcant scrutiny because EU regulation of herbal medicine is kicking in by 2011.
As for how much Hemlock I would have to poison you with, I am no longer allowed to use Conium internally. Externally a 7% solution is allowed, but I have never met any herbalist who used Conium in practice. I was joking (in case you didn’t guess).
We know how much to dose with in the case of potentially toxic herbs because these doses are stipulated in the 1968 Medicines Act, section 12(1). There are a few herbs that I am allowed to use that you would not be allowed to use. I rarely use them, but on occasion, they come in handy. I was trained to use them in my course (woo!).
Slouching away to work on the lastest issue of the ‘miasmic herald’………
LOL.
@ Dr. Colquhoun
Subject: Irrelevant anecdotes
In the past, coffeehouses and public houses often served as places where men (!) could meet to discuss and debate academic points. This tradition has not ended with the abolition of the staff pub on Chambers Street (although I’m SO curious where it was). The Doctor’s is still full of medical students on a Friday night, and I have had more than one excellent conversation with fellow scientists, there. Teviot is a bit down-scale these days.
Edinburgh remains the most beautiful (IMHO) campus in the UK. I loved spending time in the stacks at the Erskine before they moved all of the medical books to the main library 2 years ago. I have many happy memories of looking out the window at the sunshine on the Meadows with a huge pile of bound journals and text books piled up in front of me.
The musty smell of the stacks and the allure of new information to be absorbed made those days some of the happiest in my life.
*sigh*
Oh, Arse. My mistake, the Erskine looked over the square (all the closer to the Starbucks at Bristo Square). After the books were moved to the main library (4th floor), I sat and stared out at The Meadows in between taking notes.
I still have very happy memories of spending time amongst all of those wonderful medical texts.
The historical texts in the collections are almost as wonderful as the materia medicae at the RGBE.
NAWD you seem to be ignoring or eliding the fact that the problem with botanicals is that the active ingredients/potency can vary enormously from plant to plant, from different parts of the plant and year to year. In cases in medicine where extracts from life are/were used there was an in vitro/in vivo way of quantifying activity. Which is why things like heparin are given in units, not mg/ml.
When herbalists can do the same with the same degree of accuracy i might pay attention. But then there is the other problems with botanicals, which is all the other things you get with the active ingredients.
These and other reasons are of course the main reason why few botanicals (St. John’s Wort being one) are suitable for clinical trials. Without proper clinical trials you cannot adequately prove efficacy. From your comments i doubt you would take a pharmaceutical that had not been properly tested, why should I take a risk with a ‘botanical’?
NAWD
I cannot really let this one go but I hope you do not make the same mistake with your plant extracts that you make with your spatial awareness.
I assume by Materia Medicae you are referring to the repository of proper medical knowledge and not the Homeopathic Materia Medica.
Test for rejecting piss take.
Well it wasn’t that David !
Having let Mrs John out of the kitchen once again (well my shoes WERE muddy and I needed some clean shirts) she promptly pointed out in a remarkably derisory tone that I had (to quote the ham/cowboy president who paved the way for so much irrationality) “misspoke myself”.
My memory of I CLAVDIVS was faulty when I said (in post 79) that Livia inured herself to poison.
She didn’t (although I obviously thought she did). She just rubbed poison on the figs Augustus picked himself to prevent being poisoned. Nice wife – hopefully not a model for Mrs John.
It was Mithridates who gradually inured himself to poison, not Augustus. Bit ironic then that he could not poison himself when the Romans captured him.
Arts graduates. Who needs them.
Happy to admit (on sufferance and under duress from the threat of no shirts, clean shoes or food) that I was totally wrong.
I blame time, senility and alcohol.
@Muscleman and John Hooper: Materia Medicae means ‘the ingredients used to make medicines’. I am no fan of homeopathy, I find it doesn’t work at all, even on my cat or my child. I did try… what a load of complete tosh. Complete rubbish. You can quote me.
I spent most of the four years I studied, either in the Erskine Library (University of Edinburgh’s medical library), or in the equivalent stacks on level four of the main library (University of Edinburgh) enjoying the time to think, read, and enjoy medical research. We have come so far in the last 100 years, that I can’t help but be proud of our endeavors. I mean science, not alternative medicine, of course.
I should perhaps use the term pharmacopoeia, rather than materia medicae. It’s closer to how I view my work, and perhaps more reasonable.
@Muscleman, particularly, you are completely right!!! My research has shown that plant medicines vary according to soil conditions, weather, pollination, and any number of variables along this line of discussion. It doesn’t mean that plant medicines don’t work, but that we must study how constituents arise very seriously. Botanicals work, but we must discover exactly how they work, and how the plants work, too. This is one of my pharmacological loves and one of the reasons I love plants as much as I do.
@ John Hooper: Obviously late nights don’t suit you. What were you saying?????? 😉
All this talk of doing PhDs reminded me that the School of Pharmacy at the University of London did research into phytopharmacology. Although the research seems to have been merged into the theme of drug discovery it seems to be still continuing.
http://www.pharmacy.ac.uk/ddisc.html
Yes, but that is chemistry (and some in vitro function). Not herbalism at all.
NAWD
Not sure where the late nights comment come from !
If you are referring to posts 86 and 87 (which may appear slightly cryptic) they were posted at 1.55pm which scientifically is post meridian i.e. in the early afternoon.
Some posts went missing and we thought it was either because there were unacceptable words in them (i.e piss-take) or excessive URLs.
Clearly it wasn’t the former. Which is just as well.
UK dietitian post 50
>>In ‘practicing’ your version of ‘nutrition-lite’ therapy you undermine the rigour and knowledge of dietitians versed in medical, nutritional and sociological knowledge, and able to put this into context for the individual. I’ve lost count of the number of times individuals have spouted some ridiculously incorrect perception about what a dietitian does on the basis of contact with self-styled nutritionists, later to qualify their comments with an apology for failing to appreciate our differences.<<
Pray tell me how do you know what “my version” of therapy is? How do you know my level or depth of knowledge?
I really woul like to know what it is that a dietitian does. But so far, no-one has enlightened me. Sure, dietitian’s are always telling me that their knowledge is far superior and anyone who has not done an orthodox course knows nothing. So tell me where I can find an indepth critical appraisal of what a dietitian actually does. I would not like to misinform anyone.
Rgds
[…] Notes from Thames Valley University’s homeopathic degree program: At the root of most holistic therapies lies the belief that all life is animated by a subtle force. We call this the Life Force. You either believe it or you do not. It cannot exactly be proved at the moment and the belief is not in accord with the yardsticks that we call ’scientific.’ […]
[…] Vote Nutritional Fairy Tales from Thames Valley University […]
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I see TVU are in the spotlight again:
http://www.timesonline.co.uk/tol/life_and_style/education/article5847914.ece
I commented (awaiting moderation):
“TVU still offer courses in quack pseudo science:
Comp Approaches to Health (Massage & Reflex) Fdg FdSc
Complementary Medicine in Healthcare Hon BSc
Perhaps they should concentrate on real subjects.”