Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
CAM
Two more high quality trials have failed to show any benefit from alternative medicine.
Acupuncture no help for knee osteoarthritis
This trial is particularly interesting because osteoarthritis of the knee is the one thing that is always cited as a triumph for acupuncture. It is common to hear people talk about acupuncture as though it were the acceptable, or even accepted, face of alternative medicine. Perhaps that is because it is not so obviously preposterous as homeopathy. Sticking a needle into you obviously produces a signal in the brain. That is just sensory physiology. But the evidence that this produces any real benefit for patients is, in fact, almost thin as for homeopathy. This paper seems to have been done very well. It is another nail in the coffin of needle quacks.
Osteoarthritis of the knee is what was cited by the Prince of Wales in his speech to WHO. In that speech he stuck to things that he thought were safe, in contrast to the far more barmy claims on his own web site.
The paper is “Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: randomised controlled trial”, Foster et al. (BMJ 2007;335;436), and the British Medical Journal has made it available freely: read it here..
Patients were allocated randomly to one of three groups
- Advice and exercise (112 patients)
- Advice, exercise, and true acupuncture (112 patients)
- Advice, exercise, and non-penetrating acupuncture (115 patients)
The question of controls is crucial. In this trial, “non-penetrating acupuncture” was done with ‘stage dagger’ needles: blunt needles that retract into the handle, without actually penetrating the skin at all, but which create an illusion of insertion.
Patients were told that they would receive physiotherapy advice and exercise and “may receive acupuncture, using one of two different types of acupuncture needle”, but were not told that one type of needle would not penetrate the skin.
The bottom line
“Our trial failed to show that acupuncture is a useful adjunct to a course of individualised, exercise based physiotherapy for older adults with knee osteoarthritis.”
| Conclusions Our trial addressed the three important questions recommended by the House of Lords report on complementary and alternative medicine in 2000.
|
Acupuncture delivered by physiotherapists as part of an integrated package of health care with advice and exercise, for older adults with osteoarthritis of the knee, provided no additional improvement in pain scores compared with advice and exercise alone measured on the Western Ontario and McMaster Universities osteoarthritis index at six and 12 months. Small benefits were shown for pain intensity and unpleasantness but these effects were greater and sustained for longer in the group receiving non-penetrating acupuncture than in the group receiving true acupuncture. This finding makes it unlikely that the observed effects were due to needling effects of needle penetration, manual stimulation throughout treatment, and elicitation of the de qi sensation.
We have shown that there are no differences when a credible, non-penetrating acupuncture treatment, delivered under strict participant blinded conditions, and true acupuncture, involving needle penetration, manual stimulation, and elicitation of the de qi sensation are added to a course of advice and exercise. Indeed patient satisfaction, credibility of intervention at six weeks, and reduction in pain intensity and unpleasantness were significantly greater for the advice and exercise plus non-penetrating acupuncture group than for the advice and exercise group but not for the advice and exercise plus true acupuncture group.
Vitamins C and E and Beta Carotene fail again
The anti-oxidant myth is already well-documented. A recent report even suggested that beta carotene, vitamin A, and vitamin E
might do harm rather than good.
Another good trial has confirmed the uselessness of these “supplements” (other than for making a great deal of money for supplement hucksters).
“A Randomized Factorial Trial of Vitamins C and E and Beta Carotene in the Secondary Prevention of Cardiovascular Events in Women” Cook et al. Arch Intern Med. 2007;167:1610-1618. [Download the paper here].
Here is the summary taken from the invaluable Consumer Health Digest (a free weekly e-mail newsletter edited by Stephen Barrett, M.D., and cosponsored by NCAHF and Quackwatch), 16-08-07
| Antioxidants for cardiovascular disease flunk another test. A 10-year double-blind, placebo-controlled study has found that women at high risk for cardiovascular disease derived no benefit from taking vitamin C (500 mg/day), vitamin E (600 international units every other day), or beta carotene (50 mg every other day). The researchers looked at the incidence of myocardial infarction, stroke, coronary artery surgery, and cardiovascular disease death among 8171 female health professionals, 40 years or older, with a history of cardiovascular disease or 3 or more cardiovascular disease risk factors. |
There was some surprise when the University of Teesside recently appointed as a visiting professor, Patrick Holford, the “media nutritionist” and supplement salesman. This has elicited some indignation from within Teesside as well as without.
The CV that was submitted to the University of Teesside in support of his appointment at Teesside included the following glowing endorsement from “Dr John Marks, Life Fellow and former Director of Medical Studies, Cambridge University.”
“There have been dramatic changes over the past decade in our views about healthcare and Patrick Holford has been right at the forefront of many of these changes, particularly with our revised appreciation of nutrition. The road to bad medicine and bad health is built on the foundation of dogma. It is refreshing to have this dogma subjected to fresh examination.”
Dr John Marks, Life Fellow and former Director of Medical Studies, Cambridge University
Download the CV that was submitted.
The same endorsement appears in the CV on Holford’s web site.
Dr Marks is also cited prominently as a reviewer of Holford’s book, “The H factor” (2003 edition), thus.
“This book covers the exciting developments of the story of homocysteine in current clinical nutrition and medicine. The authors have examined with commendable clarity the controversy which inevitably surrounds any such cutting-edge subject.”
Dr John Marks, former Director of Medical Studies at Girton College, University of Cambridge
And this is the top of the back cover of Holford’s book, “Optimum Nutrition for the Mind (2003 edition)”, as it appears on the Amazon
web site
Dr Marks appears again in a 2004 press release at on Holford’s site.
“Monday 25 October 2004
OPTIMUM NUTRITION UK SURVEY
Britain’s Largest – Ever Health and Diet Survey
. . . .
“Scientific advisors to the survey include Professor Helga Refsum, Professor Jeff Holly, Professor Jane Plant, Professor Andre Tylee, Dr John Marks and Dr Derek Shrimpton. “
Who is Dr Marks?
It turns out that he is now long-retired from his job as Director of Medical Studies at Girton College. Clearly, and very understandably, Dr Marks would now much rather tend his garden than get involved in this sort of unpleasantness. When I drew his attention to the way his name was being used. he said “I agree that he must be stopped but not by running myself into yet more difficulties I want to reduce difficulties for myself having reached middle age (83).”.
Nevertheless, as a public service, he has kindly given me permission to reproduce his initial response.
| Dear Professor Colquhoun Oh dear, my foolishness of youth has come home to haunt me, luckily too late to hurt me. Way back in, I would guess, the late 1970s or early 1980s I was doing some writing on the vitamins. Essentially my contention was that because of inappropriate eating patterns, it was not possible to say that “a normal mixed diet (as consumed today) provided all the nutrients that are needed”. I used the term “optimum nutrition” to indicate one which did precisely that. Some of this was at least reasonable given the understanding of the day. I know that much of it is no longer accepted (certainly by me), but I have a suspicion that we have swung probably a little too far the other way recently. At that stage Patrick Holford wrote an article or a book on “optimal nutrition” quoting me, inter alia. I did write at his request some comments which were broadly favourable about it, though the text that you quote does not look like mine. Thereafter he has hounded me with pre-publication copies of books etc, each of which has been more exaggerated and less scientific. I was also involved with him at the start of his work on nutritional standards in ordinary members of the public, but it soon became obvious that the whole study was unsupportable and I withdrew completely from it. I also challenged one of his books but got nowhere, even though I suggested that it be not published until he had confirmed some of his ‘observations’. Shortly after that I wrote to him to say that I was not prepared any longer to support his work or views in any way and to please stop using my name as a supporter of his work, and stop writing to me. I had thought and hoped that the whole sad story of my early support for him had died a death, but from what you tell me it seems not. I have to admit that I have not wasted time and effort reading any of his recent work. In fact I should have difficulty doing so since I am effectively blind. I hope that this puts you in the picture. I hope that the wording you quote was from his first book, but even that wording does not look what I might have written even in my foolish youth. Thank you for drawing my attention to the situation but I shall not waste my time issuing denials. It is too late now. With my thanks and best wishes John Marks |
” to say that I was not prepared any longer to support his work or views in any way and to please stop using my name as a supporter of his work and stop writing to me.”
Dr Marks has now written to Holford to ask for the source of these quotations, having destroyed all his own records that relate to Holford some time ago. If and when he gets a reply it will be posted here.
It is for you, and the luminaries of the University of Teesside, to decide whether or not this amounts to falsification of the CV that Holford submitted in support of his appointment as a visiting professor.
It isn’t just Marks
According to some investigation by HolfordWatch, it seems the Prof Andree Tylee has suffered a similar fate to that of Dr Marks. Tylee is Professor of Primary Care Mental Health, at the Institute of Psychiatry, Holford has been citing him too, contrary to his wishes.
A recent post, Homeopathic “cures” for malaria: a wicked scam, revealed two more cases of claims to cure malaria with homeopathic funny water.
One was the claim of Kate Birch, the vice president of the North American Society of Homeopaths, that “Homeopathy is more effective that any western medication”
for treatment of malaria.
This is so dangerous that some action was needed.
The other was a claim by a UK company that claims for Demal 200 (which contains nothing but 15% alcohol)
“Demal 200 is highly effective in treating all types of Malaria even the strains that have developed a resistance to chemical based drugs”
But on checking the web site in 28 Aug, 18 days after the original post, guess what? Demal 200 has vanished. I wonder who told them to do that? The advert was still in the Google cache, and you can download it here, as it appeared on 10th August. Don’t worry though, 20 seconds with Google shows that there are plenty of other people willing to sell this expensive hooch. For example ‘Blueturtle Remedial Sciences’. They give a lot of email addresses to which you can write for further information.
I made a lot of complaints about these wickedly dangerous claims. So far, the result is close to zero.
The Society of Homeopaths, both UK and USA, refuse point blank to give any opinion about the ability of homeopaths to cure malaria.
The Society of Homeopaths is also making its contribution to deaths in Africa by its utterly delusional attitude to AIDS.
They do nothing to stop their many members who do make such claims from killing people. As regulatory organisations, they are just a sick joke.
The Advertising Standards Authority and the Trading Standards people disclaim any responsibility, as does the Center for Disease Control (USA). The FDA and the MHRA have yet to reply, but they did very little after the revelation that homeopaths claimed to be able to prevent malaria.
Nobody seems willing to do anything at all.
But is characteristic of quasi-religious organisations that they split in to warring sects. The Faculty of Homeopaths (UK), in stark contrast to the Society of Homeopaths,
” . . . does not promote the use of homeopathy for the prevention of malaria.
It also supports steps to inform the public of the dangers of malaria and the need to follow government guidance. Last year the Faculty worked with the Health Protection Agency (HPA) on a statement for the HPA website: http://www.hpa.org.uk/infections/topics_az/malaria/homeopathic_statement_260705.htm “
All that can be said for the malaria scandal is that it has revealed that the curious world of homeopathy is in in chaos when it comes to serious diseases. And it shows very starkly how utterly meaningless self-regulation of homeopathy is, and how government agencies disclaim responsibility
There is lots more about this wickedness on the web: try The Gentle Art of Homeopathic Killing.
Here are some of the results of complaints.
Society of Homeopaths (SoH) (UK)
I wrote (13 Aug) to the Society of Homeopaths (SoH) to ask about the use of the initials RSHom and RSHom (NA), and to ask about their attitude to the claims made for Demal 200.”Please could you tell me the opinion of the Society of Homeopaths about someone describing herself as RSHom behaving in this way, and also about Demal 200.”
I had a very quick reply from Paula Ross, chief executive of the SoH. She said
“There is no connection between The Society of Homeopaths (whose registered members use the designation ‘RSHom’) and the North American Society of Homeopaths (whose registered members use the designation ‘RSHom NA’).”
But she ignored the second question.
| My other question was about whether SoH would like to comment on Demal 200.A company called giftofafrica says of its homeopathic malaria treatment. “Demal 200 is highly effective in treating all types of Malaria even the strains that have developed a resistance to chemical based drugs.†The company selling this is based in Wolverhampton, UK. and their claim seems to contradict directly your statement at http://www.homeopathy-soh.org/whats-new/patientinfo.aspxBest regardsDavid Colquhoun |
Paula Ross. However a correspondent sent a similar enquiry to the Society of Homeopaths, asking of Demal 200
“Would you recommend this product for use in Malaria regions or are the claims bogus?”
This was the ‘response’.
| Dear ***, Thank you for your email.May I suggest you contact one of the Homeopathic manufacturers who will be able to advise you and give you more information regarding Demal 200.For our list of Pharmacies please visit our website www.homeopathy-soh.org Regards Melissa Wootton Office Administrator The Society of Homeopaths. 11 Brookfield, Duncan Close, Moulton Park, Northampton NN3 6WL Website: www.homeopathy-soh.org |
13 Aug 2007
Recently the Society of Homeopaths (UK) issued a statement that read thus I can see no such statement on the NASH web site. In fact there are some things that seem to suggest that NASH approves of homeopathic treatment of infectious diseases (not least Kate Birch’s book), despite the fact that your Standards of Practice Guidelines says “Do not claim that you can treat any disease, condition or ailment or imply that you can do so. Please could you give me a clear statement of your policy concerning homeopathic treatment of malaria, AIDS, cholera, typhoid fever, yellow fever and tuberculosis. Best regards David Colquhoun |
| Dear Mr. Colquhoun, Thank you for your inquiry of 8/13/07. NASH does not have a policy on the treatment of any disease category, in accordance with the tenet that homeopathy treats the whole person based on characteristic symptoms rather than a diagnosis. Sincerely, Liz Bonfig NASH Administrator============================== The NORTH AMERICAN SOCIETY OF HOMEOPATHS PO BOX 450039, Sunrise, FL 33345-0039, USA ~ Tel: 206-720-7000 ~ Fax: 208-248-1942 343 Carrville Road, Richmond Hill, ONT L4C 6E4, CANADA ~ Tel: 905-886-1060 ~ Fax: 905-886-1418 |
| X-UCL-MailScanner-From: katebhom@hotmail.commy final statement to you is: The personal response that was solicited from me on my private e-mail does not represent the views of the North American Society of Homeopaths. |
| It has come to my attention that a Ms Kate Birch (vice chair of the North American Society of Homeopaths), is advocating homeopathic treatment of malaria and also yellow fever, typhoid, dengue fever and cholera. She does this through her book and also in emails to potential customers.This seems to me to be very dangerous, so I have asembled some of the relevant evidence at http://dcscience.net/?p=24Please can you tell me if it is legal in the USA to claim to cure serious diseases like these with “remedies” that contain nothing but water and alcohol? |
| Dear Mr. Colquhoun,I forwarded your email to one of our staff scientists; his response was as follows:—–Original Message—–FDA regulates medicines, vaccines, and drugs. States regulate the practice of medicine.Charlatans and quacks can be reported to these regulatory agencies.However, the Constitution guarantees freedom of the press and authors can write all kinds of wacky stuff that is bad for your health.
Thank you for your inquiry. Internet Response Team National Center for Infectious Diseases Centers for Disease Control and Prevention |
Demal 200 UK
This UK company makes the outrageuous claim that their 15% alcohol “”Demal 200 is highly effective in treating all types of Malaria even the strains that have developed a resistance to chemical based drugs”
A complaint about this to the Advertising Standards Authority about this mendacious
advertisement produced a quick reply which said it did not come under their remit,
They suggested trying the Trading Standards people. The Trading Standards Authority replied on 28 Aug 07 (Adrian Winter).
” . . . this is not a matter that falls under the jurisdiction of
Trading Standards. The Medicines and HeathcareProducts Regulatory Agency (MHRA) is the appropriate body in this instance.”
I’d already written to the MHRA (13 Aug 2007) thus,
A company called giftofafrica says of its homeopathic malaria treatment:
This direct claim of effectiveness seems to me to be mind-bogglingly irresponsible. The company selling this stuff is based in Wolverhampton, UK. It costs £31.99 (or $56.40) for 30 ml of 15% alcohol (and 200C homeopathic dilutions, .i.e., nothing) Please can you tell me about the legal position concerning claims to be able to cure infectious diseases, and whether or not the MHRA has any responsibility in cases like this. Best regards David Colquhoun |
On 21 August 2007, the Taxpayers’ Alliance produced a report that
“compiled Britain’s first ever list of university ‘non-courses’; university degrees that lend the respectability of scholarly qualifications to non-academic subjects and calculated their annual cost to students and taxpayers.”
In this they list 400 degree course, at 91 institutions in the UK, which they describe as “non-courses”. They claim that these courses cost the taxpayer £40 million per year.
At the top of their list they place a BA (Hons) degree in Outdoor Adventure and Philosophy, at Marjon College in Plymouth. They include also in their list 60 different courses in alternative medicine.
I don’t agree entirely with the Alliance. They fail, I think, to make a vital distinction, between things that are untrue, and things that a merely not a great intellectual challenge. In “Science degrees in anti-science” I said
“What matters here is that degrees in things such as golf-course management are honest. They do what it says on the label. That is quite different from awarding BSc degrees in subjects that are not science at all, but are positively anti-science.”
Nevertheless the 400 “non-courses” include 60 in alternative medicine, and they are quite unacceptable.
So how does Universities UK (UUK) react? (They are the folks who used to have the sensibly self-explanatory title “Committee of Vice-Chancellors and Principals”, before they had their Consignia moment). Nothing short of a blanket defence, according to the BBC News
But Universities UK said the alliance had failed to understand developments in higher education or the labour market.
“Had they done a little more research, they would have found that these so-called ‘non-courses’ are in fact based on demand from employers and developed in association with them,”
“Graduates on these courses are in demand from employers who are looking for people with specific skills alongside the general skills acquired during a degree such as critical thinking, team-working, time management and IT skills – a point lost on the authors of this rag-bag of prehudices and outdated assumptions.”
All courses were checked rigorously to ensure they met appropriate standards. “This is academic snobbery, as predictable as it is unfounded.”
Does UUK really think that that is a sufficient justification for BSc degrees in homeopathy?
Does UUK really think that degrees in homeopathy teach “critical thinking”?
Does UUK really think that “rigorous checking” of a degree in homeopathy is possible?
If so, the endarkenment has certainly reached high places.
Postcript
An email from the president of UUK, Rick Trainor says that
“. . . degree courses change over time, are independently assessed for academic rigour and quality and provide a wider education than the simple description of the course might suggest”
Professor Trainor, Principal of King’s College London, is a social historian, not a scientist. But you don’t have to be a scientist to understand that it is simply preposterous to think that the smaller the dose the bigger the effect. The defence of such ideas on the basis that they have been “independently assessed for academic rigour” (assessed, of course, by fellow believers in magic) is equally preposterous.
SO I wrote again to explain the difference between honest and dishonest vocational degrees. It reall isn’t very difficult to grasp. This time all I got was
| Dear David Thank you very much for your comments, which I have read with interest. Best wishes Rick Trainor |
There is no nutrional “therapist” whose doings have been the butt of more attention on the web. Ben Goldacre has been through his writings in meticulous detail. “Patrick Holford – “Food Is Better Than Medicine” South Africa Tour Blighted By HIV Claim” is particularly rivetting. The Holfordwatch web site is a mine of carefully-researched information.
It is bad enough that the University of Bedfordshire (in its previous incarnation as the University of Luton) accredited a Foundation Degree course in ‘nutritional therapy’, at`his Institute of Optimum Nutrition (IoN).
That saga was discussed in “Science in an age of endarkenment” as an example of how university accreditation committees can produce long pompous official reports that fail to discuss anything that matters (like ‘is it true?’).
Then came the even more mind-boggling news that Patrick Holford had been made a visiting professor at the University of Teesside. What on earth can be the university’s criteria be for awarding the title of professor? Download them and find out.
One criterion is “their contribution by research to the furtherance of knowledge”. Well it’s obviously not that one.
Another criterion is
“the application of knowledge in a systematic and original manner, designed to enhance wealth creation and/or the quality of life”
Well he has certainly created a lot of wealth for himself. The “application of knowledge” bit is just a little worrisome though.
Case for Patrick Holford as a Visiting Professor is a university document, obtained under the Freedom of Information Act (download the whole document). The opening words are “Patrick Holford has an international reputation in terms of nutrition and mental health.”
I guess he has an international reputation. But to find what sort of reputation, just check the references at the top of this post. Unfortunately the document is anonymous. I guess that makes it safe to say that whoever wrote it must be a scientific ignoramus.
The case for Holford mentions the possibility of starting a northern Brain Bio centre. If you want to know more about that wheeze, check Holfordwatch. And now Holfordwatch has done a nice analysis of the whole document
Teesside’s Assistant Dean Research, Dr Barry Doyle sent an email to his vice chancellor, Graham Henderson, with this case document and “curriculum vitae, with extensive personal commentary” (missing -I’ve asked for it) (download the email).
It did the trick.
An “Extract from minutes of University of Teesside Professorial Conferment Committee, 25/06/2007” (download it) recorded the conferment of title. If there was any real discussion it has been cut out (I’ve asked for more). Or perhaps there was no discussion. It seems to be just another example of the box-ticking mentality that has become so prominent as universities succumb to the cult of managerialism. Those present were
Professor G Henderson, Vice-Chancellor (Chair)
Professor A Unsworth, University of Durham
Professor C Hardcastle, Deputy-VC (Research & Enterprise)
Professor E E Green, School of Social Sciences & Law
Professor F Nabhani, School of Science & Technology
Professor M Rampley, School of Arts & Media
How is it that the combined intellect of these luminaries seemed to be incapable of finding out about the candidate the facts that any teenager could unearth on five minutes with Google?
One despairs
Postscript
It seems that some of the staff at Teesside are not at all happy about the appointment either. On 24th August, this email arrived.
| Colleagues I wish to confirm that Professor Patrick Holford has been Conferred with the title of Visiting Professor at the University of Teesside through the School of Social Sciences and Law.He has not been Conferred with the title of Visiting Professor in Nutrition. He has no association with the School of Health & Social Care and in particular, the Institute of Health Sciences and Social Care Research which is led by Professor Carolyn Summerbell, Professor in Nutrition and Assistant Dean for Research.PaulProfessor Paul Keane, Dean School of Health & Social Care Centuria Building University of Teesside |
Some more information
In response to a Freedom of Information act request, sent on 7 December 2007, the University of Teesside has been quite forthcoming in providing documents that relate to Holford’s appointment. It is pretty clear that the whole episode has been a bit of an embarrassment to them. As a result of internal dissension within Teesside, Holford was banned from using the title “Visiting Professor” or “Visiting Professor in mental health and/or nutrition” but to use only “Visiting Professor in the School of Social Sciences”.
Download all the documents. (zip file, i.5 Mb)
There are comments on some of these documents here.
How irrational thinking in government and universities has led to the rise of new-age nonsense in the name of science.
This article appeared on 15th August 2007, on the Guardian Science web site.
The Guardian made very few cuts to the original version, but removed a lot of the links. If you want to have references to some of the claims that are made, try the original, which I reproduce here. [Download this as pdf]
The Guardian Science site also has a piece on this topic by Alok Jha: Reigniting the enlightenment How do we win back our civilisation from the jaws of darkness?
Comments can be left there too.
A German translation of this piece has been posted at the Mental health blog.
A Russian translation (draft version) has appeared here . There is also a Russian translation of How to Get Good Science which can be found here.
Etymological note. The word endarkenment has been used by several people as an antonym for the enlightenment, but the first time it caught my eye was in an article in 2005 by Gerald Weissman, The facts of evolution: fighting the Endarkenment. The article opens thus.
“Those of us who practice experimental science are living in the best of times and the worst of times, and I’m not talking about A Tale of Two Cities, but a tale of two cultures.”
Science in an Age of Endarkenment
“Education: Elitist activity. Cost ineffective. Unpopular with Grey Suits. Now largely replaced by Training.” Michael O’Donnell, in A Sceptic’s Medical Dictionary (BMJ publishing, 1997).
The enlightenment was a beautiful thing. People cast aside dogma and authority. They started to think for themselves. Natural science flourished. Understanding of the real world increased. The hegemony of religion slowly declined. Real universities were created and eventually democracy took hold. The modern world was born. Until recently we were making good progress. So what went wrong?
The past 30 years or so have been an age of endarkenment. It has been a period in which truth ceased to matter very much, and dogma and irrationality became once more respectable.
This matters when people delude themselves into believing that we could be endangered at 45 minute’s notice by non-existent weapons of mass destruction.It matters when reputable accountants delude themselves into thinking that Enron-style accounting is acceptable.
It matters when people are deluded into thinking that they will be rewarded in paradise for killing themselves and others.
It matters when bishops attribute floods to a deity whose evident vengefulness and malevolence leave one reeling. And it matters when science teachers start to believe that the earth was created 6000 years ago.
These are serious examples of the endarkenment mentality, but I’ll stick with my day job and consider what this mentality is doing to science.
One minor aspect of the endarkenment has been a resurgence in magical and superstitious ideas about medicine. The existence of homeopaths on the High Street won’t usually do too much harm. Their sugar pills contain nothing. They won’t poison your body; the greater danger is that they poison your mind.
It is true that consulting a homeopath could endanger your health if it delays proper diagnosis, or if they recommend sugar pills to prevent malaria, but the real objection is cultural. Homeopaths are a manifestation of a society in which wishful thinking matters more than truth; a society where what I say three times is true and never mind the facts.
If this attitude were restricted to half-educated herbalists and crackpot crystal gazers, perhaps one could shrug it off. But it isn’t restricted to them. The endarkenment extends to the highest reaches of the media, government and universities. And it corrupts science itself.
Even respectable newspapers still run nonsensical astrology columns. Respected members of parliament seem quite unaware of what constitutes evidence. Peter Hain (Lab., Neath) set back medicine in Northern Ireland. David Tredinnick (Cons., Bosworth) advocated homeopathic treatment of foot and mouth disease. Caroline Flint condoned homeopathy, and Lord Hunt referred to ‘psychic surgery’ as a “profession” in a letter written in response to question by a clinical scientist
Under the influence of the Department of Health, normally sane pharmacologists on the Medicines and Health Regulatory Authority, which is meant to “ensure the medicines work”, changed the rules to allow homeopathic and herbal products to be labelled, misleadingly, with “traditional” uses, while requiring no evidence to be produced that they work.
Tony Blair himself created religiously-divided schools at a time when that has never been more obviously foolish, and he defended in the House of Commons, schools run by ‘young-earth creationists‘, the lunatic fringe of religious zealots. The ex-Head Science teacher at Emmanuel College said
“Note every occasion when an evolutionary/old-earth paradigm . . . is explicitly mentioned . . . we must give the alternative (always better) Biblical explanation of the same dataâ€:
That is not from the fundamentalists of the southern USA, but from Gateshead, UK.
The Blairs’ fascination with pendulum wavers, crystals and other new age nonsense is well known. When their elders set examples like that, is it any surprise that over 30% of students in the UK now say they believe in creationism and “intelligent design”? As Steve Jones has pointed out so trenchantly, this makes it hard to teach them science at all. Welcome back, Cardinal Bellarmine.
Homeopaths and herbalists may be anti-science but they are not nearly as worrying as the university vice-chancellors who try to justify the giving of bachelor of science degrees in subjects that are anti-science to their core. How, one may well ask, have universities got into the embarrassing position of having to answer questions like that?
Here are a couple of examples of how. The University of Bedfordshire (in its previous incarnation as the University of Luton) accredited a Foundation Degree course in ‘nutritional therapy’, at`the Institute of Optimum Nutrition (IoN). The give-away is the term Nutritional Therapy . They are the folks who claim, with next to no evidence, that changing your diet, and buying from them a lot of expensive ‘supplements’, will cure almost any disease (even AIDS and cancer).
The IoN is run by Patrick Holford, whose only qualification in nutrition is a diploma awarded to himself by his own Institute. His advocacy of vitamin C as better than conventional drugs to treat AIDS is truly scary. His pretensions have been analysed effectively by Ben Goldacre, and by Holfordwatch.. See the toe-curling details on badscience.net .
The documents that relate to this accreditation are mind-boggling. One of the recommended books for the course, on “Energy Medicine” (a subject that is pure fantasy) has been reviewed thus.
“This book masquerades as science, but it amounts to little more than speculation and polemic in support of a preconceived belief.”.
The report of Luton’s Teaching Quality and Enhancement Committee (May 24th 2004) looks terribly official, with at least three “quality assurance” people in attendance. But the minutes show that they discussed almost everything about the course apart from the one thing that really matters, the truth of what was being taught. The accreditation was granted. It’s true that the QAA criticised Luton for this, but only because they failed to tick a box, not because of the content of the course.
The University of Central Lancashire ‘s justification for its BSc in Homeopathic Medicine consists of 49 pages of what the late, great Ted Wragg might have called “world-class meaningless bollocks”. All the buzzwords are there “multi-disciplinary delivery”, “formative and summative assessment”, log books and schedules. But not a single word about the fact that the course is devoted to a totally discredited early 19th century view of medicine. Not a single word about truth and falsehood. Has it become politically incorrect to ask questions like that? The box-ticking mentality is just another manifestation of the endarkenment thought. If you tick a box to say that you are fully-qualified at laying-on-of-hands, that is good enough. You have done the course, and it is irrelevant whether the course teaches rubbish.
These examples, and many like them, result, I believe from the bureaucratisation and corporatisation of science and education. Power has gradually ebbed away from the people who do the research and teaching, and become centralised in the hands of people who do neither.
The sad thing is that the intentions are good. Taxpayers have every right to expect that their money is well spent, and students have every right to expect that a university will teach them well. How, then, have we ended up with attempts to deliver these things that do more harm than good?
One reason is that the bureaucrats who impose these schemes have no interest in data. They don’t do randomised tests, or even run pilot schemes, on their educational or management theories because, like and old-fashioned clinician, they just know they are right. Enormous harm has been done to science by valuing quantity over quality, short-termism over originality and, at the extremes, fraud over honesty. Spoofs about the pretentiousness and dishonesty of some science, like that published in The New York Times last year, are too close to the truth to be very funny now.
Science, left to itself, and run by scientists, has created much of the world we live in. It has self-correcting mechanisms built in, so that mistakes, and the occasional bit of fraud, are soon eliminated. Corporatisation has meant that, increasingly, you are not responsible to your conscience, just to your line manager. The result of this, I fear, is a decrease in honesty, and in the long run inevitably a decrease in quality and originality too.
If all we had to worry about was a few potty homeopaths and astrologers, it might be better to shrug, and get on with trying to find some truths about the world. But now the endarkenment extends to parliament, universities and schools, it is far too dangerous to ignore.
Homeopathy doesn’t poison your body, it poisons your mind
Often that is true. Not always though. Homeopathy is worse than just a cultural poison if you die of malaria as a result of advice from a homeopath.
The Newsnight TV programme exposed the fact that many UK homeopaths advise homeopathic pills for prevention of malaria. This strikes me as nothing short of criminal, and it was condemned roundly by more responsible homeopaths like Peter Fisher.
Bur a correspondent has pointed out that there are even more dangerous fantasies around. Direct claims to cure malaria with homeopathic ‘funny water’. [See postscript for some of the US rules.]
He spotted an entry in Facebook that is nothing more than an advertisement for a book, by a Kate Birch.
Kate Birch and malaria treatment
The book being advertised is called Vaccine Free – Prevention and Treatment of Infectious Contagious Diseases with homeopathy. This prompted my correspondent to write to Kate Birch, thus.
| 3 August 2007 Kate I am planning to work in Nigeria (rather I’m returning to work in Nigeria). I am not keen on subjecting myself once again to anti malarial drugs. I have looked at your facebook page and I am curious as to what Homeopathic remedy would be suitable for Nigeria. I know that Dr Peter Fisher of the University College Homeopathic Hospital states that Homeopathy is not suitable for prevention or treatment of Malaria. You obviously disagree, and I would like to follow your approach. Can you advise me please. |
| “Thank you for your inquiry. There is a complete chapter on malaria in my book. and Homeopathy is more effective that any western medication.There is a protocol to follow. I have attached it below. however if you need more information I would recommend the book as it goes ointo more detail on the specific remedies and also deals with Yellow fever, dengue, hep A, typhoid etc. just in case. a small remedy kit can get you very far with many of these conditions. check out Washington homeopathics for their travel kits or 50 C potency kit. just watch that the remedies don’t go through the x-ray at the airport or sustain too much heat. both will ruin the remedies. Not only can you help your self but once you get used to understanding the remedies you can help many people.There is a clininc in Tanzania that treats 35,000 people a year with homeopathy. most of their caes are malaria and they have tremendous success rate. get the book and tell your doctor that his information is incomplete.Good luck, Happy travels, Kate |
“Miasmatic influences can accumulate in an individual or in select populations based on their exposure to pathological agents and the ability of the individual to develop immunity. There is a pre-miasmatic state that exists prior to incarnation. It is described as a state of bliss and connection to the universe.”
Who is it who is giving this dangerous and irresponsible advice? Kate Birch is not a back-street quack. ” Since 1990 Kate has over 1900 hours in homeopathic and clinical education”. She is vice president of the North American Society of Homeopaths (NASH). The mind boggles.
Legal and ethical stuff
The North American Society of Homeopaths (NASH) has a code of ethics. It includes this.
“3.01 Where the homeopath considers that the treatment is beyond his/her capacity or skill, the patient with the homeopath’s consent shall refer to or consult with a homeopathic colleague or appropriate health care practitioner.”
and their Standards of Practice Guidelines say
“Do not claim that you can treat any disease, condition or ailment or imply that you can do so.
Be extremely careful when speaking or writing about the treatment of particular diseases or conditions (and never offer or claim to help anybody). “
If you consider that Ms Birch is “acting beyond her capacity” in recommending treatment for malaria, contact NASH at NashInfo@homeopathy.org
The UK Society of Homeopaths made the following statement, after the Newsnight TV programme.
| The Society of Homeopaths, the UK’s largest register of professional homeopaths, acknowledges that malaria is a serious and life-threatening condition and that there is currently no peer reviewed research to support the use of homeopathy as an anti-malarial treatment. |
The North American Society seems to take a very different view.
“Remember, although homeopathy has been shown to treat symptoms of infectious and epidemic diseases, Federal law prohibits the sale of products for these symptoms as OTC products. Accordingly, the AAHP makes clear its position that websites and marketers selling homeopathic medicines as OTC products for epidemic and infectious diseases may be in violation of Federal law.”
Question for US readers. Does this mean Ms Birch is breaking the law?
Kate Birch replies
Soon after posting this, I got this email from Kate Birch, vice president of the North American Society of Homeopaths. She has also posted a comment below.
Believe it or not, I don’t really like the ad hominem stuff at all.
But there are limits, and one limit is when people are given advice that is likely to kill them.
| Thanks for all the publicity. I hope books sales will go through the roof now seeing as every homeopath around the world is following what you are up to. We know what we are doing even if you don’t understand it. You must be really bored, preoccupied, or need attention in order to spend your time instigating controversy, hype, and slander.What you resist will persist. Kate Birch PS I didn’t appreciate being set up for your antics. And it is a good thing you didn’t post the excerpt from my book or you would be liable for copy write infringement. And FYI the letter you posted (as below) isn’t the letter I received. The doctor was never named in the letter I received. You could be liable for fraud too as this is not the letter I responded to. Therefore my comments were taken out of context and made to look like I was disagreeing with Dr Peter Fisher. “I know that Dr Peter Fisher of the University College Homeopathic Hospital states that Homeopathy is not suitable for prevention or treatment of Malaria. You obviously disagree,” This sentence was not in the original letter and has been added in your blog to inflame the situation. get your facts strait before you go making such accusations. |
Peter Fisher, as I imagine you know, is clinical director of the Royal London Homeooathic Hospital (which will probably close soon), and homeopathic physician to the Queen (our royal family, I fear, is better at pageantry than intellect). On the occasion when it was revealed that London homeopaths were recommending homeopathic pills for prevention (not even cure) of malaria, Fisher’s words were
You can read this on the BBC report. At least it seems that there is very radical disagreement between one homeopath and another. |
Sham cures in Africa
Use Google to search for ‘homeopathic malaria Tanzania’ and you will get an astonishing number of direct claims to cure malaria with sugar pills. Claims are all you will get though, no evidence that any of them work.
For example, The Abha Light College in Nairobi, Kenya, refers to a report about homeopathic malaria prevention in 152 Tanzanian patients. This “study” had no control group with which to compare the effects of homeopathic neem leaves, and comments “Considering the exploratory nature of the study, no statistical significance testing was planned”.
It is not worth the paper it’s written on.
The same “study” is cited by the Global Resource Alliance, Inc., based in California. This seems to be a well-meaning organisation which, through its devotion to quackery, is helping to spread malaria in Africa.
Demal 200
A company called giftofafrica says of its homeopathic malaria treatment.
This direct claim of effectiveness is mind-bogglingly irresponsible. This “remedy” contains nothing whatsoever apart from 15% alcohol, It is a 200C homeopathic preparation. That is a dilution if 1 part in 10 to the power 400. There would not be a single molecule in a volume vastly larger than that of all the water on the earth (a mere 13 times 10 to the power 21 litres). |
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There is, of course, the usual small print at the bottom of the page, that contradicts the claims in large print.
*Malaria is a serious and sometimes fatal disease. Any form of self-treatment or alternative health program necessarily must involve an individual’s acceptance of some risk. It is advised that you consult your doctor before making any health decision. Demal 200 is primarily sold as a malaria treatment, it’s prophylactic qualities are secondary to it’s intended use which is to treat chronic or acute malaria.
. . .
Because Demal 200 has not yet been conclusively scientifically tested, it is not licensed for medical use in European Union; North America and Australasia. Please note: The staff of Shoponlion Ltd and their families have successfully used Demal 200 as a prophylactic but are not in a position to guarantee the efficacy of this medicine.
The company selling this stuff is based in Wolverhampton, UK. It costs £31.99 (or $56.40) for 30 ml of 15% alcohol. That is an £1066 per litre: expensive way to get drunk (which is all this stuff will do for you).
Unbelievable.
Of course no evidence at all is offered that it works. Just the usual list of testimonials from people who didn’t happen to get malaria.
If you like anecdotes, you can read here the stories of some people who were less lucky.
Postscript
“Quackery hinders AIDS treatment efforts” is the title of an article in Science in Africa.
And let’s not forget the efforts of Patrick Holford for health in Africa.
FDA rules about homeopathy
The FDA’s rules include the following statement.
7. Health Fraud: The deceptive promotion, advertisement, distribution or sale of articles, intended for human or animal use, that are represented as being effective to diagnose, prevent, cure, treat, or mitigate disease (or other conditions), or provide a beneficial effect on health, but which have not been scientifically proven safe and effective for such purposes. Such practices may be deliberate, or done without adequate knowledge or understanding of the article.*
Federal Trade Commission
The FTC is running Operation Cure All. This encourages reporting of health scams
Unfortunately, consumers spend millions of dollars every year on unproven – and often useless – health products and services. Health fraud trades on false hope. It promises quick cures for dozens of medical conditions – from arthritis and obesity to osteoporosis, cancer and AIDS.
. . .
The Federal Trade Commission is targeting false and unsubstantiated health claims on the Internet through Operation Cure.All – a law enforcement and consumer education campaign.
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For once, the Advertising Standards Authority (ASA) has done a good job. Legal loopholes prevent them from doing much about fraudulent advertisements for homeopathy, but they have upheld complaints about the Body Detox Clinic in Newcastle upon Tyne.
The ASA
“. . .considered that, because the substantiation supplied was anecdotal in nature, it was not robust enough to support the implication that colonic irrigation could relieve the symptoms of: diarrhoea; bloating; haemorrhoids; I.B.S.; colitis; flatulence; bad breath; body odour; headaches; fatigue; M.E.; eczema; psoriasis; dandruff; acne; joint pain; P.M.T; and water retention. Because of that, we concluded that the ad breached the Code.”
“Detoxification” is, of course a bit of meaningless mumbo jumbo that is widely used in the healhfraud industry (see, for example, here and here).
If the ASA can do this, why do they do nothing at all about the mountain of mendacious advertisements for “supplements”and cosmetics?
Channel 4 TV, Monday 13 August, 8.00 pm in the UK
The Enemies of Reason: new age therapies cause ‘retreat from reason’
The Sunday Telegraph (5 August 2007) gave a bit of advance publicity for “The Enemies of Reason”.
Prof Dawkins says that alternative remedies constitute little more than a “money-spinning, multi-million pound industry that impoverishes our culture and throws up new age gurus who exhort us to run away from reality”.
The first episode can be seen at http://video.google.co.uk/videoplay?docid=8669488783707640763
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The Daily Mail has always been notorious for its stories that advocate unproven and disproved treatments, but are they now getting converted to reason?
Recently the Daily Mail published an excellent piece based on comments by Michael Baum. “Homeopathy is worse than witchcraft (1st May 2007). Continue reading
Sigh! The Times Higher Education Supplement (27 July 2007) reports an 31.5% increase in applications for ‘university’ courses in complementary medicine.
Compare this with 19 per cent fall in applications for places on anatomy, physiology and pathology courses, and a relatively low 6 per cent rise in applications for pharmacology, toxicology and pharmacy. Continue reading
After the fuss about the BBC Alternative Medicine series (see next item), it was good to see the excellent report on the news last night (16th July 2007) about the appearence of the notorious Andrew Wakefield to face charges of professional misconduct. They showed graphs of the increase in
the incidence of measles which has followed the fall in MMR vaccination. They reported on the many studies that have shown no link between MMR and autism. And most fascinatingly, they showed a movie of Wakefield’s speech at the Mind Institute.
Remember that BBC2 series on Alternative Medicine, shown in February 2006?
Given the superb standards of many BBC science programmes, this series was certainly very disappointing, for the reasons, for the reasons listed in detail here. At the time, my own complaints to the BBC got nowhere at all. The series producer came to see me, but remained adamant that the presentation of evidence had been fair.
| Simon Singh’s excellent critiques in the Telegraph and the Guardian got some good publicity, but no retraction from the BBC. On the contrary, a letter was sent to the Guardian, apparently signed by scientists who were involved in making the programme. I discovered that this letter had been written by the BBC itself, and had not even been seen by some of the people whose names appeared at the bottom. |  |
Simon Singh also lodged a complaint to the BBC, which was rejected. But he is made of sterner stuff than most people. He appealed, but again the complaint was rejected. Singh then appealed to the highest level (Board of Trustees) and at last the complaint was upheld. At least two of the most serious complaints were upheld.
Singh says
“First, the BBC agreed that the acupuncture open heart surgery sequence “could have misled the audience”. Second, the BBC agreed that their attempts to discredit my criticism of the series “was a breach of trust with the audience” because the BBC had not disclosed its role in organising critical letters.”
This is good news and we should all be grateful to Simon Singh for his persistence. Two of his three serious complaints were upheld, though seven “less serious” ones were not (but should have been).
Read the full judgement of the BBC Trustees.
Let’s hope lessons have been learned.
The Westminster Diet and Health Forum “aims to provide the premier environment where parliamentarians, senior policy advisors, regulators and other decision makers can discuss critical issues, and exchange ideas and information with leaders from industry, responsible interest groups, analysts, academics, journalists and others”.
Their meeting on Thursday 5 July 2007 had the title “Integrating Complementary and Conventional Approaches to Health Care”. Despite some good contributions by Edzard Ernst and Simon Singh, the meeting failed to live up to the aims of the forum, partly because the representatives from the Department of Health failed to turn up (because of the changes following the accession of Gordon Brown), and partly because of the choice of speakers. For a start the audience consisted almost entirely of advocates of various forms of alternative medicine. And the meeting was chaired by David Tredinnick MP (Cons, Bosworth). This is what the BBC News profile says about him.
| David Tredinnick is an old style Conservative MP, being an Eton-educated former Guards officer, who has sat in the Commons since 1987.However, his ambition for high office was thwarted by his role in one of the sleaze stories which helped to sink the Major government.He accepted £1,000 from an undercover reporter to ask parliamentary questions about a fictitious drug.He was obliged to resign from his role as a PPS and was suspended from the Commons for 20 sitting days. He has not sat on the frontbench since.He is an orthodox Conservative loyalist, though he is more supportive of the European Union than many of his colleagues.He has, however, carved himself a niche as the Commons’ most enthusiastic supporter of complementary medicine.He has wearied successive health secretaries with his persistent advocacy of any and all homeopathic remedies.He has also supported their use in prisons and even suggested them as an aid in alleviating the foot and mouth crisis. |
The chairmanship was punctuated by party political speeches, and, more remarkably, by the apparently serious assertion that he was aware of a psychiatric hospital that doubled its staff at full moon (this is an old urban myth, and is, of course, quite untrue). His advocacy of homeopathic borax as a way to control the 2001 epidemic of foot and mouth diease can be read here.
Picture of David Tredinnick MP from the Conservative Party |
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Kim Lavely, chief executive of the Prince’s Foundation for Integrated Health (FIH), was chosen as the keynote speaker. She made (several times) the quite remarkable assertion that Prince’s Foundation did not advocate complementary medicine. That’s not quite the impression given by their web site, and I have to say I find the dissimulation of speeches like this hard to take. Just as with her boss, the Prince of Wales, the message seems to be tailored to the audience.Kim Lavely, and Boo Armstrong (of GetWell UK), tried to persuade me that the ‘audit’ of the effects of Pater Hain’s infliction of privatised alternative medicine in Northern Ireland would tell us something useful.Of course it won’t provide any useful information. The efforts of Ben Goldacre to explain to the public what constitutes a trial and what doesn’t have not made much progress here. Edzard Ernst’s request for an example of a treatment that could not be tested in a randomised controlled trial produced no response.
Regulation of complementary medicine is the topic that occupied much of the time. The obvious question is ‘how can one have a professional body for a therapy that doesn’t work?’. This crucial question was consistently ignored. Alternative medicine advocates are mostly desparate to gain respectability by becoming regulated professionals, though only, of course, as along as the regulations do not require them to demonstrate that they can actually benefit patients (see letter to The Times).
The Council for Healthcare Regulatory Excellence (CHRE) is yet another quango. I was unaware of its existence until their “head of Fitness to practice” gave a talk. This organisation gets over £2 million per year of taxpayer’s money. What does it do? Well “CHRE is a statutory overarching body, covering all of the United Kingdom and separate from Government, established from April 2003. It promotes best practice and consistency in the regulation of healthcare professionals by the following nine regulatory bodies”. But these bodies include not only the General Medical Council and the General Dental Council, but also the two forms of alternative medicine that have so far succeeded in getting ‘regulated’ status, the General Chiropractic Council and the General Osteopathic Council (for information on Chiropractic see below and here).
H.L. Mencken (1924) on chiropractic
“This preposterous quackery flourishes lushly in the back reaches of the Republic, and begins to conquer the less civilized folk of the big cities.” (source)
I asked the CHRE representative, Mike Andrews, what would happen if a question of fitness to practice in medicine arose that involved inappropriate use of form of alternative medicine that was also represented by CHRE, but of course I got no answer. Such cases have happened in the UK, for example Dr Marisa Viegas was suspended by the GMC advising a patient to stop heart medication which led to her death. And a Dutch doctor was struck off the register after the death of Sylvia Millecam.
The CHRE seems to be yet another expensive form of ‘box-ticking’ bureaucratic regulation that ends up doing more harm than good. We have become very familiar with such things in universities, where “quality assurance regulators” approve people like Patrick Holford, and pursue policies that end up harming good science, not helping it.
The saga of the excommunication of this page, and its de-excommunication, is described here, and here, and here.
I am supposed to be on holiday, but the Red Lion in Grasmere has a wireless network, and this is just too good not to post at once. So, after a distinctly moist walk over Loughrigg Fell, and an excellent dinner, here goes.
Panorama from half way up Loughrigg Fell, with Grasmere on left and Rydal Water on write, taken just before the downpour started.
Loughrigg Fell and Rydal Water on left. Grasmere Lake above and Grasmere village (right) with GPS track.
The main trigger for the allegations of defamation seems to have been the fact that I said (and still say), apropos of Dr Ann Walker’s description of red clover, “What on earth is a “blood cleanser” or a “cleanser of the lymphatic system”. This is so much meaningless gobbledygook”.
This set me wondering about the origin of the term “blood cleanser”, and who better to ask than the erudite Micheal Quinion of the wonderful World Wide Words site. His weekly newsletter is invariably fascinating. And buy his books.
Michael Quinion has kindly given permission for me to reproduce his “non-definitive” investigation into the use of the term “blood cleanser”. It seems to have been a favourite of snake oil salesmen in thw 19th century. Of course, none of them defined what it means. You are just meant to know that it’s something good.
Quinion on “Blood Cleanser”“The exact phrase “blood cleanser” is known no later than the nineteenth century. The earliest I’ve found is from an advertisement in the Ohio Democrat for 30 June 1871 (it ran regularly from then on) “D.B. FAHRNEY’S Blood Cleanser or Panacea, for sale by Miller & O’Donnel, is becoming a popular family medicine.” There was also Prof. Chapins’ Blood Cleanser, advertised the following year. But the concept of cleansing the blood is very much older, of course. I have found another advertisement, in the Milwaukee Evening Courier of Wisconsin, dated 22 March 1847: “As a SPRING and FALL PURIFIER it cannot be surpassed, working its way through the system with a silent and effective force,–Cleansing the BLOOD; Removing DYSPEPTIC INFLUENCES; Variations on the phrase also occur several times in Culpeper’s Herbal (1653 edition) in the section on hops: “In cleansing the blood they help to cure the French diseases, and all manner of scabs, itch, and other breakings-out of the body; as also all tetters, ringworms, and spreading sores, the morphew and all discolouring of the skin.” Another example is: “The roots of this Bastard Rhubarb are used in opening and purging diet- #drinks, with other things, to open the liver, and to cleanse and cool the blood.” It also appears earlier still in The Anatomy of Melancholy by Richard Burton (1621): “And because the spleen and blood are often misaffected in melancholy, I may not omit endive, succory, dandelion, fumitory, &c., which cleanse the blood, Scolopendria, cuscuta, ceterache, mugwort, liverwort, ash, tamarisk, genist, maidenhair, &c., which must help and ease the spleen.” No doubt a more thorough search will turn up still earlier examples. (My sources are poor before the eighteenth century.)” |