Two items appear below:

The Australian Skeptics' Guide to

(Investigator 70,2001 January)

Qakatak is dedicated to getting some control over "alternative" medicine and educating the public over the difference between medicine and pseudo-medicine.

Part of that strategy is to force the labeling and advertising of all products or procedures that infer therapeutic claims to declare whether or not they can repeatedly demonstrate efficacy in controlled, double-blind scientific tests. It is not the role of Australian skeptics to tell the public what they can and can't do, but merely to supply accurate information so the buying public can make individual, informed decisions.

The history of Europe for much of the last 2000 years has been dominated by the Church. People who propose alternatives to the teachings of the Church were burned as heretics. Copernicus, Galileo, Bruno and other changed the things so that scientists such as Newton could hypothesise. Medicine began to try new things and search in new directions. Arsenic became a cure-all and blood letting was a common remedy with death from septicemia a common result.

Samuel Hahnemann observed that many of the people who came in contact with such medicine either got worse, or died. He came up with two hypotheses. One was that "like cures like" and the other was that the more dilute the solution, the more powerful the effect. He called his system homeopathy. By diluting the original substance down trillions of times, his patients were taking water and so suffered no ill effects.

Smallpox had been a major killer for centuries. All that could be done was to take the pus someone with a mild case of smallpox and use it to vaccinate children, hoping that they would also get a mild case. Most of those children got severe smallpox and apart from the two per cent who died, many of the rest were badly disfigured with pockmarks. Clearly, a better method was needed.

Around the same time as Hahnemann was developing homeopathy, folk tales claimed that milkmaids who had suffered cowpox did not get smallpox. Physician Edward Jenner's hypotheses was that if he injected people with pus from a cowpox sore, he could prevent them getting smallpox. In 1796, he injected cowpox pus into 8-year-old James Phipps who developed cowpox. Several weeks later, Jenner injected smallpox pus into him, but it had no effect. The experiment was duplicated on many others and the hypothesis was proven. Smallpox had been one of the greatest scourges of mankind for thousands of years, but with the use of science, in just 181 years it was totally eradicated. In a few years time, the defeat of polio will have been even quicker.

What is the difference between conmen and alternative medicine practitioners? Conmen set up some deception or scam then gain people's confidence. People willingly part with their money and are said to have been conned.

Alternative medicine practitioners make claims of medical knowledge and ways of treating and preventing ailments that cannot be backed up by science. They call themselves health professionals to gain people's confidence who then willingly hand over their money.

When asked for scientific testing, they nearly always refuse. On the few occasions that they have been tested, their claims are shown to be false. When a new medical hypothesis is proposed, it remains a hypothesis until proven by the scientific method. If it works, then it is adopted by medicine. If it doesn't then it is either discarded as useless or called alternative medicine.

It has often been said that only a small percentage of medical procedures have been properly tested. A double blind randomized trial on immunization would require a large group of people, say 1000, to be immunized against a disease. Another 1000 people would receive a harmless substance as a placebo and the third 1000, the control group, would receive nothing. All 3000 people would then be subjected to the disease in question and the results would be recorded. Obviously, many people would die, so it would never be done. Chemotherapy would be the same and so would removal of an appendix.

Therefore, it is true that  most medical procedures have not been properly tested, but if my sister hadn't had her appendix removed when she was a child, she would have died. My sister-in-law had chemotherapy after a mastectomy. Neither of those procedures has been subjected to a double blind, randomised trial for the reasons given above. However, without both procedures, she would be dead.

There is statistical evidence that surgery, chemotherapy and mouth-to-mouth resuscitation work. That makes it medicine according to the dictionary.

What will keep us all happy? It can cost tens of thousands of dollars to test some products and techniques, and the profits aren't necessarily at the end of the rainbow, so they may not be presented for testing nor even come into the market, denying consumers any benefit because there is not enough profit for sponsors. It can also take years to do such tests. While the bureaucrats argue, the suffering consumers could be using the products or techniques.

I turn to my Macquarie dictionary, which has seven definitions for medicine.

The first is Medicine — any substance or substances used in treating disease; a medicament; a remedy.

Obviously, Band-Aids have no medical effect, but we will never stop parents putting Band-Aids on children to cure them of all sorts of ailments form bumps on the head to tummy aches. If the vendors of products such as Echinacea and Evening Primrose Oil make therapeutic claims but cannot prove efficacy, let all such products be labeled pseudo-medicine. If it treats disease, it is medicine. Not orthodox, mainstream or anything else. Medicine, just as the dictionary says.

If it claims to treat disease but can't demonstrate that claim, then it is pseudo-medicine. But it is not alternative, complementary, holistic or anything else. It is just pseudo-medicine and if it were labeled so, the consumers could make informed choices.

On the label of products making therapeutic claims, you will usually find either Aust R or Aust L followed by a number in very small print. Aust R means that the product has been independently tested and found to be efficacious, ie, it works. Aust L means no testing has been done, and the people selling the product can tell any lies they want, take your money, and nobody will stop them. You will not always find an Aust L number because nobody polices the law and the Therapeutic Goods Administration has never prosecuted anyone for not labeling their goods correctly.

There are good and bad bus drivers, plumbers and medical practitioners. Australian Skeptics does not concern itself with quality control, leaving that to organizations such as Australian Consumers' Association. Quacks are pretenders to medical knowledge. If medical practitioners abandon science and make pseudo-scientific claims, they become quacks and Qakatak — Australian Skeptics — will get involved.

When people travel by plane, they don't have to concern themselves with whether or not the captain can fly. When they go to the top of a multi-storey building, they can take it on faith that the builders did a proper job. When people get sick, why is it that they are expected to sift the wheat from the chaff on who has and has not been trained in scientific medicine?

John Foley

The Case for Alternative Medicine

Harry Edwards

(From: Investigator No. 73 2000 July)

The editor has drawn attention to the fact that true believers in religion, the supernatural and the paranormal are backward in coming forward. As a consequence, statements are made, opinions aired, views expressed and claims made, most of which go unchallenged. Take for example John Foley's article on alternative medicine, Qakatak, in issue #70. John left himself wide open and any self-respecting alternative practitioner would have commented along the following lines.

John is strong on rhetoric, his case relying on generalities. His argument lacks any kind of supporting evidence and leaves much to be desired if he wishes to persuade the consumer that alternative medicine should be shunned. If the article is supposed to be informative then I for one am left completely in the dark.

We are told by the writer that Australian Skeptics is "dedicated to getting some 'control' over 'alternative' medicine" and will provide accurate information to enable the buying public to make informed decisions. 'Control' means the power to direct or to regulate. Why do the Australian Skeptics presume they should be the ultimate arbiter of what health services are suitable for your particular needs? Because of the opinion of a biased GP on the committee? Because of the advice of other committee members no more qualified than those they seek to advise?

To my knowledge, the only attempt to 'educate' the consumer was my recent book Alternative, Complementary, Holistic and Spiritual Healing, in which I highlight the dangers of relying on some, but not all, types of alternative health practices. Despite the book receiving excellent reviews in medical journals Australian Skeptics withdrew the book from sale thus cutting a primary conduit to the consumer.

Addressing the main points raised by John. He implies that there is no difference between conmen and alternative medical practitioners. I doubt very much that anyone who has spent five years in college studying homoeopathy, naturopathy or chiropractic would take kindly to that label, particularly as some of them are also science-based medical practitioners.

The popularity of alternative healing can be gauged by a perusal of the Sydney telephone directory's Yellow Pages. There are 9 columns listing Alternative Health Services and 156 columns of those practitioners specialising in services such as chiropractic, naturopathy and homoeopathy. Are they are all conmen?

Over $600,000,000 is spent on these services each year. Isn't this an indication that the services are patronised by those who are satisfied with them? Or does it indicate that half the population in Australia is composed of uninformed ignoramuses who should consult Australian Skeptics before making a health decision.

John further states that alternative practitioners claim to be medical practitioners. This of course is not true unless they also have an orthodox medical qualification. To do otherwise would invite serious legal consequences.

In any case, having a medical qualification doesn't necessarily confer sainthood nor infallibility. Currently there are 543 law suits for medical negligence facing the NSW Public Health System and more than 3% of doctors in NSW are facing legal action for negligence. In 1999, the United States Institute of Medicine found that drugs and medical devices had led to the deaths of 98,000 Americans each year as well as countless non-fatal accidents.

From the service point of view too there is much to be desired. In New South Wales there are over 55,000 people waiting for operations.

A major point, and the only one with any validity raised by John, is the question of testing products and therapies for their efficacy. He argues, quite correctly, that research is often prohibitively expensive and few of the alternative methods have been scientifically tested. In his opinion therefore, they remain hypotheses rather than proven by scientific method. He then admits that only a small percentage of orthodox medical procedures have also been properly tested, quoting immunisation, chemotherapy and appendectomy as examples. But, he adds — they work.

Now let's test John's criteria by looking at one of the principal alternatives — Traditional Chinese herbal medicine (TCM). Prior to the development of the scientific methods of clinical trials and double-blind tests, the beneficial or deleterious effects of herb ingestion could only be discovered by trial and error and by observing the effects on birds and animals. The cost in human life must have been enormous before it was finally determined what was and what was not safe to ingest.

While there is no empirical evidence available prior to the invention of written languages, evidence has come down to us in the form of clay tablets written in cuneiform from Sumerian times, in Egyptian papyri and Chinese materia medica. The Chinese Shen Nun Ben Tsao published in 659 AD, listed more than 300 medicines. A similar compilation is attributed to India whose pharmacopoeia lists 2000 plants which form the basis of ayurvedic medicine. Many of the herbal extracts have been adopted or synthesised and in many cases are pharmaceutical products used in one form or another by the orthodox medical profession. These medicines therefore meet John's criteria. They have been tested for hundreds — in some instances thousands of years on control groups of millions — vastly larger than those available for any scientific project. The demand and their longevity is an indication that they have proven their efficaciousness and worth. Many are now recommended and prescribed by orthodox medical practitioners embracing alternative therapies as well as science-based medicine in their practices. What right then has an organisation such as the Australian Skeptics to decide that time and money should now be wasted on proving what has already been proven?

Regarding John's final point — the claims made by promoters of therapeutic goods and the labeling of those items. Anyone making false claims is liable to prosecution under the Therapeutic Goods Act, and if they are not prosecuted it is the fault of those charged with implementing the legislation. If the Australian Skeptics have an axe to grind then it is to the legislators they should turn.

For some years now complementary health sciences have been finding their way into university curricula and research charters. Lismore's Southern Cross University has a degree-level course in naturopathy. The University of Western Australia a Bachelor of Applied Sciences (Osteopathy) and the University of Western Sydney, Macarthur, a Bachelor of Applied Sciences (Chinese Medicine). In July 1997, the University of Sydney opened Australia's first Herbal Medicines Research and Education Centre (HMREC) a branch of the Department of Pharmacy. It offers education on the safety, quality and efficacy of herbal and complementary medicines. Post-graduate degrees, certificates, diplomas and masters are now provided.

It would seem that the medical establishment's antipathy towards many "alternative" health therapies is mellowing. Many respectable institutions are now prepared to give accreditation to what many medicos formally considered to be "dubious practices."

Perhaps John Foley and the Australian Skeptics are a little too sceptical.