Alternative medicine doesn't exist and acupuncture is useless

31/08/06 18:18

HEALTHY DOUBTS, Wallace Sampson - While his views may not be popular in Northern California, Wallace Sampson, clinical professor emeritus of medicine at Stanford University and editor in chief of the Scientific Review of Alternative Medicine, is frank about his thoughts about alternative medicine. "It doesn't exist," he says. "We've looked into most of the practices and, biochemically or physically, their supposed effects lie somewhere between highly improbable and impossible."

Sampson has been invited by the Commonwealth Club to hold forth on one of the most popular alternative medical practices, acupuncture.

There are two major misconceptions about acupuncture, Sampson says, and both contribute to the misunderstanding of its worth as medical treatment. First, most people assume that it's an ancient Chinese cure that has existed, unchanging, for centuries. Not so, says Sampson, noting that "acupuncture was formalized in a complex way over the past 100 years, mostly in Europe and France and after the Communist takeover in China. Before that time there was no consistent formalization of acupuncture points or what each place was supposed to do. It was largely regional, and the thinking varied from city to city."

The other mistake people make about acupuncture, Sampson says, is that it offers specific cures. "It is nonspecific," Sampson says. "If it has the effect of, say, releasing endorphins through the application of needles, well, many things release endorphins -- a walk in the woods, a 5-mile run, a pinch on the butt."

Clinically, it has been shown that acupuncture can have counter-irritative effects. The basis for this is simple: If you have a headache and someone applies pressure through needles to your arms and neck, you get distracted from your headache. "It has no effect on disease process," Sampson says, "but it can affect perception of symptoms through these nonspecific devices, such as attention diversion or the desire of the patient to please the treater and feel benefits."

Sampson doesn't actually find acupuncture to be a very dangerous procedure -- although it is invasive, most people seek acupuncture for a known, nonserious disorder -- but he does say it's useless.

"I look at it this way: what if acupuncture didn't exist?" he says. "Would medicine or society be any worse off? If no one knew about it, nothing would change. You would still have ways to apply counter-irritation, through massage or rubbing."

But there are more dangerous aspects to the world of alternative medicine, Sampson says, starting with the wildly popular practice of chiropractics. In general, he says, one of the biggest problems with the whole notion of "ancient Chinese medicine" is that it falsely pits itself against "Western medicine." Sampson says these distinctions are useless; a more apt comparison, he says, would be ancient Chinese medicine to ancient European medicine, which share many similarities in their fundamental notions about how the body works. Western medicine, on the other hand, has grown up as the world rejected those ancient notions.

Sampson points to the Western ideal of "first do no harm" as a major difference in the approaches. "Some find Western medicine to be cold because there's no laying of hands on the body unless it's absolutely necessary," says Sampson. "But we took an oath. Physicians should not lay on hands or do something that doesn't accomplish its goal. Cracking a neck or a back, for instance, can do much more harm than good. You have to draw the line somewhere. "

On l'aura compris: malgré les gesticulations médiatiques d'AMESSI, les remèdes qu'ils proposent, en contradiction avec la "médecine officielle", n'ont aucune efficacité et peuvent même être dangereux par eux-mêmes, en plus de retarder la véritable prise en charge médicale.

Doctors attack 'bogus' therapies

23/05/06 08:59

Some of Britain's leading doctors have urged NHS trusts to stop using complementary therapies and to pay only for medicine "based on solid evidence".

In a letter, reproduced in the Times, they raised concern the NHS is backing "unproven or disproved treatments", like homeopathy and acupuncture.

One doctor said the NHS was funding "bogus" therapies when patients struggled to get drugs like Herceptin.

Prince Charles is to make a speech in Geneva backing complementary therapies.

He will put forward the case for alternative medicine in the fight against serious disease, in a speech to the World Health Assembly.

'Implausible treatment'

The letter, on behalf of 13 people and sent to 476 acute and primary care trusts, is being seen as a direct challenge to the prince's campaign.

Organised by Michael Baum, emeritus professor of surgery at University College London, the letter said he and fellow doctors believed alternative medicine was being promoted despite a lack of evidence and "at a time when the NHS is under intense pressure".

It criticised two initiatives - a government-funded guide on homeopathy for patients, and the Smallwood report, commissioned by Prince Charles, which suggested greater access to complementary therapies in the NHS might lead to widespread benefits.

The letter described homeopathy as an "implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness".

The doctors say while "medical practice must remain open to new discoveries", it would "be highly irresponsible to embrace any medicine as though it were a matter of principle".

The letter continues: "The public and the NHS are best served by using the available funds for treatments that are based on solid evidence."

Signatories on the letter include Nobel Prize-winner Sir James Black and Sir Keith Peters, president of the Academy of Medical Science.

But 93-year-old Jane Gilchrist, who uses homeopathic therapies, said she had had "great benefit" from it.

"It has been in the NHS since 1948. It's the best kept secret in Britain," she told BBC Radio 4's Today programme.

She said it was difficult to collect data because it was hard to prove the effectiveness of a therapy "based on people, not on symptoms".

'Needs evidence'

One signatory to the letter, consultant clinical scientist Leslie Rose, said its purpose was to instil equal vigour in gathering evidence for every treatment prescribed to NHS patients.

"The NHS should not be spending money where the evidence base is much weaker than it is for conventional treatments," he told BBC Breakfast.

He said a business plan for the refurbishment of the Royal London Homeopathic Hospital - which cost £20m to set up - did not put any emphasis on evidence.

Complementary therapies also include reflexology, aromatherapy and a range of massage techniques such as reiki and shiatsu.

Prince Charles first advocated the use of complementary medicines more than 20 years ago.

He has since established the Prince's Foundation for Integrated Health (FIH), which encourages the development of complementary medicines and integrated healthcare.

On Monday the prince had a lesson in crystal therapy while visiting a hospital in Merthyr Tydfil, to see how complementary therapies are helping older people with Alzheimer's and other mental illnesses.

A spokeswoman for the Department of Health (DoH) said it was up to clinicians and trusts to decide on the best treatment for a patient.

"We know it is important that as more people turn to these therapies a solid evidence base is developed," she said.

"Patients rightly expect to have clear information about the range of treatments that are available to them, including complementary therapies."

The department said it did not have figures on the amount spend by the NHS on complementary medicines because decisions were taken locally.

About half of GPs are thought to refer patients to alternative therapists.

On comprend la compassion des médecins qui envoient leurs patients ailleurs lorsque tous leurs efforts ont échoué. L'espoir généré par un changement de traitement est un placebo intéressant, pendant un certain temps On comprend moins pourquoi on enverrait ces patients vers des charlatans avérés, qui vendent leurs prestations-placebo à un tarif inacceptable, surtout si ces prestations sont remboursées, même très partiellement. Le code de déontologie médicale oblige les médecins à ne prescrire que des traitements reconnus scientifiquement comme efficaces.