It shouldn't surprise anyone: Phelps won a Bent Spoon Award in 2008 from the Australian Skeptics.
http://www.skeptics.com.au/features/bent-spoon/
Phelps turned her back on science many years ago.

Tim, I think you will find that Dr Phelps, like many of the public, turned her focus to natural and complementary medicine after a life threatening adverse reaction to medication. Yes, nothing like a near brush with death to sharpen the mind to other options.

I think you will find that turning your back on science is folly.

This is also nothing more than a red herring. It doesn't matter that Phelps had an adverse reaction to medicine, the fact is medicine actually works. It isn't an option to take 'not-medicine', because 'not-medicine' doesn't actually do anything.

What's a little death between friends so long as it's scientifically proven? So what if you are now healthy - I can't find a journal article that supports it? All of you mustn't have been sick in the first place (even though scientifically trained doctors said you were) or you are just weak minded and that's why you got better.

I guess this is why scientists are not as highly respected as they used to be. Common sense has clearly left the building.

"Professor Myers said that complementary medicine was a broad field that could not be described with generalisations. It was important, he added, to distinguish the major professional and university-based disciplines of traditional Chinese medicine, chiropractic, osteopathy and naturopathy from “fringe practices, and the actions of rogue or unqualified practitioners”.

What part of this comment from the article do you not understand?

The UK Science and Technology Committee's report was underwritten by 3 individuals out of 17... what happened to the other 14 members?
The UK Government did not implement its recommendations.
This "Committee" was a knee-jerk reaction to a leaked WHO Report recommending the implementation of Homeopathy as a cost-effective alternative to pharmaceuticals in Third World countries. Very transparent.
Homeopathy is now being used in Cuba as prevention for annual outbreaks of Leptospirosis, in Brazil for Dengue Fever, and in India for Malaria. It is the second largest system of medicine used worldwide.
The homeopathic Banerji Protocol is used at Texas Anderson MD Cancer Centre.
Much to FOSiM's chagrin, Homeopathy is growing at a rate of 20-30% worldwide and hardly because it relies on a blind adherence to the genius of Samuel Hahnemann. A present line of research shows that homeopathic remedies work through the Rebound Effect, which is very much substantiated in medical studies.

Laurie Willberg - India has now celebrated a year without new cases of polio due to vaccination. Are they also celebrating the end of malaria due to homeopathy? I haven't heard that news - surely it would be widely celebrated?

I don't understand "to distinguish the major professional and university-based disciplines of traditional Chinese medicine, chiropractic, osteopathy and naturopathy from “fringe practices,"

TCM, chiropractic and naturopathy ARE fringe practices. In the UK the evidence for chiropractic was destroyed when the British Chiropractic Association tried to sue Simon Singh for defamation, after he described most of their treatments as "bogus" and "without a jot of evidence". The BCA not only lost the legal case, but also lost all credibility

And it's hard to get much more fringe than naturopathy.

Simon Singh was rightly sued by the BCA. He lost the case and just managed to squeak by on an appeal. This hardly means the BCA "lost all credibility".
The case for the validity of Chiropractic took place in the U.S. about 30 years ago http://www.familychiropractic.org/propaganda.htm
You seem to like to twist facts to suit your opinion.
Naturopathy is hardly "fringe". In many jurisdictions it's a registered health profession.... you know, like nurses, dental technicians, physiotherapists and of course, MDs.
I suppose that since "pharmacology" is threatened by the natural health products industry any sort of mudslinging can be justified in your mind in order to protect your job.
Posturing that anything that isn't underwritten by the drug companies is "pseudoscientific" or "fringe" is not even being bought by the majority of mainstream health care practitioners -- they're going to alternative health care practitioners for their own needs.
What patients would like to see are comparative studies of treatment outcomes so that they can decide for themselves. Unfortunately people like you want to censor their options with a Big Brother facade.

The cases of polio you are referring to were caused by the vaccine -- or did you miss that part?
The mass Homeopathic treatment of malaria in India started last week. It's too soon to tell... But I'm sure when the positive results are in, the pseudo-skeptic crowd will be in the usual state of pathological denial.

You obviously do not understand enough Homeopathic theory or practise to be qualified enough to comment. No one has "debunked" the Banerji Protocol -- perhaps you should consult with the Texas Anderson MD Cancer Centre instead of posting silly opinions as fact.
"Science blogs" are not reliable sources of information, regardless of how arrogant their posturing is.

Anybody who treats malaria with pills that contain nothing should be in jail (at least two are).

Fantasies about sugar pills do little harm in the case of minor self-limiting conditions, For the treatment of malaria, cholera and AIDS, it is simply homicide. You should be deeply ashamed of yourself.

It really isn't much use citing 30 year-old references. And it's plain silly to say Simon Singh "squeaked by". His final appeal was heard by three of the most senior judges in the country, and they judged in his favour.

When, after a long delay, the BCA finally produced its "plethora of evidence" for chiropractic, the papers they cited were demolished within 24 hours. They were truly pathetic.

Pharmacology, as i say repeatedly, has failed to solve many important problems. But CAM has done even worse. There is scarcely any CAM treatment for which the evidence is strong just check the NCCAM site if you doubt it). But there is a lot of money in CAM, so it isn't surprising that the industry is as corrupt as Big Pharma has become.

At least a few things produced by Big Pharma work quite well. May I presume that when you have a tooth pulled, you refuse a local anaesthetic on the grounds that they are produced by big pharma? Would you prefer to have your appendix removed with acupuncture alone as anaesthetic? If you were unfortunate enough to get septicaemia. would you refuse to take antibiotics?

As for naturopathy, there are no BSc degrees left in the UK. The revelation of the nonsense taught on the courses shamed even vice-chancellors into shutting them down -e.g http://www.dcscience.net/?p=1812

Laurie, Simon Singh was sued by the BCA because they suffered from hubris and he called them out for selling snake oil and putting lives at risk. In fact the appeal found the first judge had made an erroneous finding and overturned the initial decision three nil, as I recall they were also critical of the first judge's decision.

Naturopathy along with homoeopathy, chiropractic and the other SCAM's should face the same tests for efficacy as Western medicine must undergo.

I think it's you who is twisting facts to suit your own opinion. Your tendency to resort to conspiracy theories doesn't help your argument.

What's to understand about homoeopathy? It's nonsense dressed up as medicine and defies everything we know about physics and chemistry.

My understanding David is that the court found that Simon Singh was entitled to his opinion and he could use this as a defense (fair comment). In fact, in order for Simon to win the appeal, he had to plead with the court that what he said was not fact, but merely his opinion based on his interpretation of the evidence.

The court made no judgement on the level of evidence for chiropractic and in fact stated that it was not there role. So to insinuate (if that's what you are doing) that the courts in the UK agreed that there was not a jot of evidence for chiropractic treatment of children is not correct.

Jerry, the judge in the initial case focused on Simon Singh's use of the word "bogus" and effectively ruled that he had slandered chiropractors. Simon understandably appealed the decision and the three judges in the appeal overturned the initial decision and criticised the judge.

The BCA also fell foul of advertising guidelines and many enterprising UK sceptics took screenshots of the chiropractors advertising online and reported their false advertising and claims to the appropriate advertising body. From memory about one in four chiropractors were breaking advertising guidelines.

The whole saga was covered very well by the Merseyside skeptics on their blog and podcast, "skeptics with a K"

All up it looks like being a win all-round, the BCA has effectively destroyed itself and chiropractic has lost almost all credibility, many dodgy chiropractors have gone out of business and probably best of all, libel laws in the UK are being reformed. Thanks BCA.

"Science blogs" are not reliable sources of information,"

But the link you posted to chiropractic "propaganda" in response to another post is?

If you want to discuss reliable information that's great, that's what scientifically literate people do. We can talk all day about evidence and facts and all that. But if scientific discourse is what you want why then would you resort to the special pleadings fallacy of accusing people of being not qualified to comment?

Yes Blair you are correct that the case was overturned. My reading is that the original judge based his decision on a few things. Bogus being one, but also "not a jot of evidence' and 'happily promotes' were the others. It seems somewhat ironic that Simon himself seemed to be pleading that his comments were not meant to be read as fact, but merely his opinion based on the evidence. Obviously I am not judge, but in reading his article it certainly seemed to me that he was stating his points as a fact.

For the record, I believe that over 91% of chiropractors had the allegations dismissed as not proven.

@jerry sprom

You are right that the GCC rejected most of the complaints. but that's because they function as a sort of trade union for chiropractors, rather than as an effective regulator.

The GCC was in a tricky position because it had been endorsing evidence-free treatments itself. In the end, though, they were forced to admit that the mythical "subluxations" were no more than a "historical concept", thus removing the only thing that distinguishes chiropractic from other sorts of manipulation.

There is no need to debunk individual homeopathic protocols as the underlying concept of homeopathy has been falsified.

It seems that homeopathy is of enough interest to Nobel Prize winner Professor Luc Montagnier to warrant further investigation.

Quote from the Huffington Post: "Montagnier, who is also founder and president of the World Foundation for AIDS Research and Prevention, asserted, "I can't say that homeopathy is right in everything. What I can say now is that the high dilutions (used in homeopathy) are right. High dilutions of something are not nothing. They are water structures which mimic the original molecules."
Here, Montagnier is making reference to his experimental research that confirms one of the controversial features of homeopathic medicine that uses doses of substances that undergo sequential dilution with vigorous shaking in-between each dilution. Although it is common for modern-day scientists to assume that none of the original molecules remain in solution, Montagnier's research (and other of many of his colleagues) has verified that electromagnetic signals of the original medicine remains in the water and has dramatic biological effects."

Of course, given he has received the highest award in science, I'm sure you'll just say he's turned his back on science. Sheldon Cooper lives in many of the scientists I have met.

Given the number of deaths and injuries related to correctly administered medications, perhaps the FSM would be better to tighten up the quality of evidence in their own back yard instead of relying on recalls to protect the public from their own "scientifically based" treatments. Vioxx, anyone?

You have to remember that a substantial number of Nobel prizewinners go a bit bats after getting the big prize (though not any of the four I know personally). There is another Nobel winner, Brian Joseph in Cambridge who claims to believe in homeopathy (and you can't get much battier than that).

More seriously, Montagnier's has been thoroughly debunked (I'm sure you can find it if you want). His experiments were just (poor) physical chemistry and certainly didn't show "dramatic biological effects"., or any biological effects at all, speaking from memory.

"Western medicine" is hardly the paragon of effectiveness you would like (mostly unsophisticated consumers) to buy into. No "conpiracy theories" here. Patients who are prescribed drugs are advised to come back in a couple of weeks to report (this is anecdotal) on how the drugs are doing -- as if they have sophisticated lab equipment to report on the differences before and after in terms of their own physiology.
Wow, is this scientific or what?

What you are belabouring are RCTs that are supposed to indicate what can be expected with drugs that are suppressive of symptoms. When the system of medicine, like Homeopathy or TCM, does not rely on symptom suppression, RCTs are irrelevant because they were never designed to test effects other than symptom suppression. Hope this sorts out your confusion. Simple as that.

Nobody has "debunked" Montagnier's research, however it's telling that he had to go to China to continue his research to evade persecution from arrogant nobodies who have achieved nothing. I believe he referred to people like you as "intellectual terrorists".
Please let us know when you have been even nominated for a Nobel Prize so we can consider you in the same league as previous winners.
It must be frustrating to just be another runofthemill lecturer in pharmacology, but until you have some critical insight into some research discipline or another that's going to be your lot in life.

You have opined that what you disagree with is a "special pleading"? Cute. The Wilks case in the U.S. settled the issue about Chiropractic effectiveness. The fact that you either didn't know about it or selectively choose to ignore it removes you from the arena of people who have enough knowledge to comment from an educated point of view.
How have you missed the fact that a BSc is required for entrance to a Chiropractic College -- same as an MD? How have you missed the reams of studies that show muskuloskeletal injuries can't be fixed with pain medications?
You are not as "scientifically literate" as you would like others to believe, and in any event, health care technology is not science. You are not a clinical practitioner, and psychology (your specialty) has nothing to do with anything but statistics.

The "underlying concept of homeopathy" has hardly been "falsified".

One of the problems with the treatment of malaria with pharma drugs was the "watering down" of those drugs by unscupulous pharmacists. In a lowered dose, those drugs alllowed malarial mosquitoes to develop a tolerance to anti-malarial drugs, as if they had been vaccinated against them. There are similar events recorded in the early prescription of anti-biotics where smaller doses were given in cases of drug shortage -- the recipients of the smaller doses developed the bacterial infections the antibiotics were supposed to eliminate and died.
The fact that the Cuban government is using Homeopathy for the control of Leptospirosis, Brazil the control of Dengue Fever, and India the control of malaria, makes your posts a testament to your ignorance.

Just looked up some of the details of the Wilks case, rather than just relying on memory as I did for my post about about its dates. Justice Getzendanner said "This finding is not and should not be construed as a judicial endorsement of chiropractic". Laurie said " The Wilks case in the U.S.settled the issue about Chiropractic effectiveness"??? Hardly! And, again, I note, in any case, courts are not where scientific questions are determined.

The "underlying concept of homeopathy" was discredited in the 19th century by Oliver Wendell Holmes, in his essay Homeopathy and Kindred Delusions, The fact that it's had a bit of a resurgence in that last 30 years doesn't change that. I guess it got sort of fashionable to believe things that aren't true (like WMD and homeopathy), but that era is coming to an end. You've been rumbled (yet again).

I suspect that Hahnemann himself would have renounced his 30C dilutions if he'd known the value of Avodadro's number. Sadly that was not discovered until 22 years after he died. See "Hahnemann would have thought modern homeopaths were barmy" http://bit.ly/MdT9e6

Perhaps the most important reason that conventional physicians disliked homeopathy and homeopaths was well expressed at an A.M.A. meeting by one of the more respected orthodox physicians who said, "We must admit that we never fought the homeopath on matters of principles; we fought him because he came into the community and got the business."
Martin Kaufman, Homeopathy in America. Baltimore: Johns Hopkins 1971, 53

Oliver Wendell Holmes? Really? You have to do better than that. Sir William Osler, the "father of modern medicine" stated "No individual ahs done more good to the medical profession than Samuel Hahnemann" in 1919.

You are circulating nothing more than nasty opinions, David.

You'll notice the courts don't provide any endorsement of any form of medicine... you're just playing semantics boys.

I see no point in continuing this discussion. Nobody but a few homeopaths is willing to defend homeopathy now. No doubt remnants of it will hang on in the High Street, and that is fine as long as they refrain from making false claims. The UK Advertising Standards Authority has made it clear that homeopaths can't claim to treat any named disease. As far as serious medicine goes it's essentially dead. It really isn't worth wasting breath on it any longer.

I'm sorry if this affects your income, but you lost.

There is plenty of evidence that TCM and acupuncture work well for some conditions, the problem is that the evidence is never enough for those who have a philosophical prejudice for anything that falls outside of their materialist and mechanistic worldview. Many people like myself have a different view of the universe and what it means to be human, the nature of consciousness etc. this is why a large portion of society continue to seek out alternative healing practices. And this is what is meant by the authors 'dystopia' comment. Science has given us much over the last couple of hundred years, but for some it is inadequate at answering many of the big questions, the nature of consciousness for example or morphogenesis. The probability is that the answers to these questions exist outside the current materialist paradigm, but limiting discourse to that which only confirms to this worldview would most definitely - for me anyway - be extremely dystopic.

Anecdotes and un- or poorly blinded trails are not evidence.

Acupuncture may have some efficacy as a pain relief, however as the trials achieve better blinding the efficacy decreases.

That is what the evidence says, but that is not what is taught in acupuncture courses. Students like yourself are being paying good money to be lied to.

The plural of "anecdote" is DATA.

Wake up Joel, the dystopia is already here. A large amount of clinical trial evidence support St Johns Wort for depression. Why is not first line treatment in this country like in many European countries?

Oh dear, please try to get the evidence right.

The evidence says that St John's Wort has similar effectiveness to SSRIs. Sadly, the evidence also says that SSRIs are essentially placebos for mild and moderate depression. That emerged from the analysis by Kirsch et al 2008, when all the negative data that had (wickedly) been suppressed by GSK were included in the analysis.

The corollary is that St John's Wort doesn't work either. It seems that the pharmacological treatment of depression just doesn't work. That's sad but it doesn't help anyone to pretend otherwise.

Science indeed can't answer questions like the nature of consciousness. Possible it never will.

But the answer to that problem is to say "we don't know". The answer is not to believe fairy stories, and still less is it acceptable to inflict fairy stories on patients.

"It seems that the pharmacological treatment of depression just doesn't work."

Then why are these drugs still being prescribed for the treatment of depression?

I suppose that the answer to that is that they continue to be prescribed because of ignorance about the evidence, and because of desperation.

In other words, they continue to be prescribed for much the same reasons as ineffective herbal treatments continue to be prescribed.

It's also true that commercial interests distort judgements. That is true not only of GSK and other big pharma companies who have suppressed data. It is also true of the huge alternative medicine industry (some of which is owned by big pharma), which has exploited ruthlessly the waek standards of evidence that prevail in CAM to make huge profits.

I'll get the evidence right if you do also.

http://www.ncbi.nlm.nih.gov/pubmed/20708905

Now I'm just a Artisan, so one of the actual medical scientist here might need to correct me here...

St. Johns Wort is no more efficacious then pharmaceutical medication, has more side effects and has more adverse reactions with other prescription drugs particularly with HIV and cancer medications then the currently used anti-depressants.

Ignorance about the evidence is an understatement. You don't read the Cochrane Collaboration summaries Prof Colquhuon? I'd say the evidence points to anti-cam skeptics having sadly distorted judgement. http://summaries.cochrane.org/CD000448/st.-johns-wort-for-treating-depression.

Oh dear, you are making it much too easy for me.

The Cochrane review to which you refer says that St John's Wort was "similarly effective as standard antidepressants", which is precisely what I said. Since it is now known that SSRIs are not effective for mild/moderate depression, that leaves St John's Wort as being equally ineffective.

May i suggest that you read references more carefully before you cite them.

Your inability to accurately analyse a most basic research summary is concerning. But thank you. You're poverty of analysis is on the record. Not only do anti-cam skeptics have sadly distorted judgement, your last response is evidence that some of them lack even basic comprehension skills.

I think perhaps you should read my statistics textbook before you accuse me of being unable to read Cochrane reviews. You can download it (now free) from http://www.dcscience.net/

Your anger is very obvious but your grasp of statistics seems to be slim. I guess that sort of thing wasn't taught on your naturopathy course. That's one thing that's wrong with them.

I think perhaps you should read the course overview of what the naturopathy course at SCU actually entails. Woops, looks like there are couple of subjects covering statistics available http://www.scu.edu.au/coursesin2013/?action=matrix&command=matrix_temp_load&spk_no=301766#award-rules-hdr

Hi David, sorry to jump a little off topic here. Just in regards to your statement that it seems that the pharmacological treatment of depression just doesn't work, what you say may be 100% accurate or it may not be a slight overstatement. I haven’t really looked at all the available evidence.

However it might be prudent to refer those readers who may be thinking about stopping their medications to first consult with their doctor. He or she may discuss other alternatives such as “cognitive behavioural therapy” which has shown great promise in this area. For many people suffering with depression their medication may be an important part of just getting through each day. To take that away would be akin to removing a life jacket from someone already treading water.

Another valuable resource for those suffering with depression is “beyond blue”.
http://www.beyondblue.org.au

Your reference says this:
"However, since the constituents of Hypericum extract differ between the individual manufacturers, the efficacy cannot be extrapolated from one extract to another."

Once you take a therapeutic substance, purify and standardise it, you have.....a pharmaceutical.

It often seems important to remind people, because they seem to forget that... IF St John's Wort does have some efficacy in the treatment of depression, which maybe it may but I'm not convinced it does, then it does NOT have this efficacy because it's a plant that contains some sort of "natural organic happy plant energy field", or something.

If that efficacy exists, then St. John's Wort has that efficacy because the plant contains a CHEMICAL (or several) that gets into your brain and interferes with the serotonin transporter, and/or the reuptake of the other monoamine neurotransmitters.

"It seems that the pharmacological treatment of depression just doesn't work."

To state these research findings more accurately, it seems that SSRIs *alone* are no more effective than placebos *alone* for the treatment of *mild* depression.

(And of course some non-standardised flower containing some sort of ill-characterised and less effective, less selective SSRI or non-selective neurotransmitter reuptake inhibitor or modulator is even less effective.)

For the treatment of moderate to severe depression, we know that SSRIs are valuable and useful.

What is the optimal course of treatment for mild to moderate depression?

Not SSRIs alone, but how about the appropriate combination of consultation with a qualified psychiatrist/psychologist over a period of time, SSRIs, cognitive behavioural therapy with a qualified practitioner, and those sorts of things together?

Well, perhaps for severe anyway.

I don't envy the doctor who has to deal with a desperate patient, for whom he can do little. There are many cases where this is true, specially for CNS conditions, and low back pain etc.

If, heaven forbid, I were in this situation, I guess I'd have to say "try this, some people find it helpful" but it would be old-fashioned and paternalistic to lie to patient about efficacy of treatments.

No doubt some people like to have their feet rubbed, but to call it reflexology (with it's absurd made-up diagram of make-believe connections) may fool some people, but it's grossly offensive to others. My wife was recently offered some such nonsense after she'd had a mastectomy. It harmed her wellbeing (and can't have done much for the person who offered it who was told to take her nonsense somewhere else).

I don't know who you've been talking to Luke, but as a university qualified naturopath, we have been aware of multiple mechanisms of action for SJW since 2003. Check it out http://www.ncbi.nlm.nih.gov/pubmed/12775192

Exactly, Luke. The reason herbs or plants can have both a therapeutic and a toxic effect is that they contain a range of chemicals. The Castor Bean plant, for example, contains the poison Ricin, as well as "castor oil"(not that that is therapeutic!). Teenagers use plants to induce hallucinations - like Angel's Trumpet, which can have toxic levels of Atropine, as does Belladonna. Anticholinergics have both therapeutic and toxic effects.

The problems with using unprocessed plant materials include extreme variability in the desired chemical content as well as the mixture of inhibitory and/or toxic substances.

That's why people take a standard dose of Digoxin instead of eating or brewing foxglove.

You describe an interesting irony, David.

Our community has encouraged doctors to become better communicators and behave in a less paternalistic way, respecting their patients as partners in the process, and promoting overall well-being.

At some level, though, many of us crave the simple, directed advice that saves us having to wade through lots of complex evidence or make difficult decisions while we are stressed or sick. We want someone to decide for us, and take it out of our hands, but we don't want to support paternalistic style in medical practice (though, to be honest, some people still prefer that).

So, what do we do? We go to a non-science based practitioner, a good communicator, who says "you have X, take this, come back and see me next week, but makes you feel like you made a choice. This is what I call "the new paternalism". These people don't express doubt, don't send you for a second opinion, don't tell you that you can do OK without therapy - they are always sure of what is wrong and what will work. But if that remedy doesnt work, we'll change it when I see you next week.

Poster says "we have been aware of multiple mechanisms of action for SJW since 2003."

but her reference says:

"Although St John's wort has been subjected to extensive scientific studies in the last decade, there are still many open questions about its pharmacology and mechanism of action."

When the active ingredients are found, it would make sense to purify and standardise them. And voila' - a pharmaceutical antidepressant!

Most herbs do not contain cardiac glycosides like foxglove or atropine like belladonna that have very narrow therapeutic windows of use. Most medicinal herbs contain potentially hundreds of active constituents that when used as whole plant extracts generally do not have the litany of side effects that pharmaceutical drugs have due to isolating, concentrating and manipulating single active constituents.

Joel - you never seem to see them calling out their own - and yet providers like homeopaths will never let you leave the room without selling something. ANd then come back and see me next week. And if that didn't work, I'll sell you this.

Big Tincture makes enormous profits by selling infinitely diluted little bottles of water and/or alcohol at substantial profit. This puts the profit-margin of any pharmaceutical company in the shade.

There is only one way to win an argument with someone with a closed mind

http://www.xkcd.org/1081/

Really Sue? Perhaps you can supply some evidence for your statement. See if you can find a homeopathic company that has a bigger profit margin than GlaxoSmithKlein? Even after their recent 3 billion dollar fraud payout they still should have a a couple of billion in after tax profits.

Really, Angela Duncan - look up the financial statements of the multinational homeopathic manufacturer Boiron - you can see how little they spend on R&D in comparison to pharmaceutical companies.

It is easy to see how huge the profit margins in the homeopathic-industrial compelx are. You can buy a bottle of Mother Tincture wholesale for a few dollars, dilute it infinitely, and sell little bottles of the resulting water and/or alcohol at essentially infinite profit. I'm not making this up - I've looked up the cost of "Mother Tincture", little dropper bottles, little "pillules" of lactose or sucrose - you can wholesale all that stuff in bulk and dilute away forever.

Sure GSK is a big profitable company - but at least they are making and selling pharmaceuticals that contain active ingredients, and that are based on scientific research. Their profit margin is massively reduced by the high cost of their R&D, as opposed to drops of water, which need essentially no R&D.

That's what I call fraud.

Time to actually look at the NCCAM results David. http://nccam.nih.gov/research/results

I have looked. Please point out to me any useful treatments that have emerged from the $2 bn spent by NCCAM. All they have done is to show that a variety of implausible treatments don't work.

That has some value of course, but it doesn't do much for naturopaths, and other folk who don't really care about evidence. I suppose that's natural, because caring about evidence could seriously affect your income.

I don't really blame you, but I do blame SCU for giving you a poor education.

It is comments such as this that give science and scientists a bad name, the absolute arrogance is astounding. Sitting up there in your ivory tower smoking your pipe and throwing insults at the ignorant peasants, you should be ashamed. Is it little wonder that there is a major move away from your 'scientific' medicine with know it all doctors like you!

Shame!

I asked for evidence. you reply with abuse. I guess that says it all.

If the shoe fits..

You see professor the only insults and abuse so far has been directed at alt med practitioners like me, so far just on this page we have been labeled quacks, charlatans, practicing voo doo, gullible and desperate and thats just off the top of my head. This site is supposed to be about having a conversation, all views should be welcome, but when ever this topic comes up it's the usual tirade from the same old tired bunch slinging the same old insults, without a care for the opinions or feelings of other who hold a different viewpoint. Like I said, shame!

As an evidence based naturopath I'll just ask you to just actually look at the evidence, again, because for anyone who actually bothers, there are multiple examples of successful evidence for CAM at the NCCAM website http://nccam.nih.gov/research/results

Sadly, your grasp on the CAM evidence base is as lacking as your knowledge of SCU training in naturopathy.

It is really very easy. You produce evidence and we'll believe it.
Science isn't about "viewpoint". it's about data.

I agree that the term charlatan is often not appropriate because it implies intentional dishonesty. I have the impression that many practitioners of evidence-free medicine are really convinced by anecdotes and are entirely honest in their beliefs.

It was in Australia that two homeopaths were jailed for manslaughter (of their own daughter) and perhaps that should happen more often. However honestly they believed that pills which contain nothing would cure their daughter, they were culpable.

If anyone deserves the description of charlatan, it isn't (usually anyway) the practitioners. It is the vice-chancellors of the universities who are happy to make money selling BSc degrees in things that are not science, and which often are often actively anti-science.

I went to the NCCAM site referenced by Angela Doolan and started reading reviews - I didn't get to any that found any good evidence for the "therapies" being examined.

I guess that's why an "evidence based naturopath" would have to go and study law...

"Chinese medicine in particular does immense damage to efforts to save endangered species by promoting the use of animal parts purely for the doubtful benefit of deflated male egos."

Please provide evidence of any TCM practitioner in this country who promotes or uses parts of animals from endangered species as medicine..

Jamie, I didn't specify practitioners in this country but in any case, can you prove they don't use animal parts?

You made the claim, prove it yourself..

I think importation is reasonable evidence that there are some practitioners in Australia who use TCM products containing endangered species.

https://theconversation.edu.au/are-traditional-chinese-medicines-safe-and-legal-6373

IIRC there was also a conviction in Sydney around 2006

BTW Blair should we also move on from modern biomedicine because of organ harvesting in the third world, or to rid the world from disgusting practices such as this?

http://www.theage.com.au/opinion/political-news/human-corpses-harvested-in-multimilliondollar-trade-20120717-2278v.html

You see my point here, tarring a whole system of medicine because of the unscrupulous practices of a few. China has a population of over a billion people, by those odds there a bound to be many that operate outside of the limits of what we in society generally consider acceptable. I personally find it offensive that you would have me or my collegues in this country associated with such practices..

Wow, you pull me apart on the evidence regarding RCT's on acupuncture, yet you pull out this bullshit piece of evidence to demonstrate that TCM practitioners here are using products containing endangered species.. Anything to support and maintain your worldview, hey Joel..?

Are you really claiming the TCM products seized and analysed in that paper were not for use? Remember I'm not say that the practice is wide spread or common, but at least one TCM practitioner tried to import Saiga Antelope horn powder.

And here is the CDPP Annual Report which details the 2006 conviction.

http://www.cdpp.gov.au/Publications/AnnualReports/CDPP-AnnualReport-2006-2007.pdf

Are you really claiming the TCM products seized and analysed in that paper were not for use?

It's up to you to provide the evidence that they were to be used in commercial practice, that is an assumption you are making. Many Chinese self medicate using traditional medicines, this is the most likely reason for there importation.

Hi Michael, thanks for your reply, products sourced from China can be a problem because you don't always know what you are getting. I'm not a herbalist so I'm no expert, but most practitioners I know source their herbs from Taiwan which are supposed to be better quality and free from impurities. I also believe that many herb gardens are being set up in Australia now, but these will take some time to be established but it is something to look forward to.

I think it is important to keep in mind what Professor Myers states in the article, that is not to confuse 'mainstream CAM' with rogue practices or practitioners.

Jaime, recent research shows that many TCMs imported into Australia contain endangered species: http://media.murdoch.edu.au/illegal-ingredients-found-in-traditional-chinese-medicines This is happening even when these ingredients aren't labeled as being included.

I was at the zoo yesterday with my kids looking at the amazing rhinos thinking what a shame it was the western black rhino has recently disappeared due to TCM. Rhino horn is basically just hair and it doesn't even treat baldness!

Guy I find the use of endagered species as medicine as abhorrent as you do, but this has nothing to do with mainstream TCM as it is practiced in the west. With national registration now under way nationally for TCM any practitioner found prescribing illegal products would rightly be thrown out of the profession and probably prosecuted.

Banning TCM will not solve the problem of endangered species being killed for medicine, this is something that is done by criminals and needs to by addressed as such. Tarring a whole system of medicine because of the acts of criminals is unfair, and a low blow in this debate..

Jaime,
I was replying to your request for evidence that endangered species had been used in TCM in Australia. From there you go on to extrapolate from nothing that I have said TCM should be banned in Australia and that this was a low blow. Try reading my post again.

"If you can prove in properly conducted double blind trials that a medicine or treatment works better than the current treatments then it becomes science and should be taught in a university science faculty"

Here you go.. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057684/

Acupuncture for chronic low back pain..
both acupuncture and placebo acupuncture were statistically and clinically superior to mainstream care that included physiotherapy, exercises and non-steroidal anti-inflammatory drugs (p<0.001).

Some comments on that paper, They base their claim of efficacy on two meta-analysis one of which concludes acupuncture is no better then placebo, the other is a deeply flawed study.

Before I can accept the conclusion of the paper you have provided, can you please give reason why the authors ignored the following flaws in the GERAC study.

You can find the full text of the GERAC study here:
http://www.essl-perl.at/fileadmin/downloads/misc/Study_back_pain.pdf

The sham acupuncture did just as well as real acupuncture, i.e. acupuncture did not perform better then placebo.

Looking at table 3 it appears nearly 1/3 of the acupuncture or placebo acupuncture subjects were unblinded during the trial, this can lead to bias.

The conventional treatment group (group 3) where not given consistent treatment, the paper lists 8 different treatments for group 3 not all of which were given to every patient, I don't see how it is possible to compare outcomes between groups of patients receiving a consistent schedule of treatments, and a group of patients who's treatment chops and changes through out the trial.

The American College of Physicians, The National Institute for Health and Clinical Excellence (NICE) in Britain and the German Federal Committee of Physicians and Health Insurers seemed to agree the the results were valid enough to recommend acupunture for treatment of chronic low back pain.

As for the GERAC study placebo or not, acupuncture outperformed conventional care by a country mile. Should the conventional care be dropped because it can't even compete with a placebo? BTW the Chinese have known about the placebo effect for over two thousand years, it is discussed in the Huang Di Nei Jing and has been utilized with great effect by physicians for millenia..

Did you not read my comment?

"The conventional treatment group (group 3) where not given consistent treatment, the paper lists 8 different treatments for group 3 not all of which were given to every patient, I don't see how it is possible to compare outcomes between groups of patients receiving a consistent schedule of treatments, and a group of patients who's treatment chops and changes through out the trial."

Until you can explain this flaw in the study it is not good evidence to backup your statement.

Well if it pleases you ignore the German study and go with the American one which replicated the results..

From that study..

Usual Care Comparison Group: Participants in the usual care group received no study-related care—just the care, if any, they and their physicians chose (mostly medications, primary care, and physical therapy visits).

The point is that conventional medicine doesn't deal well with chronic low back pain, acupuncture does. This is the whole crux of these studies which address this issue of pragmatism as well as efficacy. From a pragmatic POV acupuncture should be considered as an alternative therapy for this condition as it is 1. cheaper and 2. more effective than what conventional care can currently offer..

You are again describing a paper where the "conventional therapy" group has an inconsistent treatment regime, without addressing the concern I outline above.

That is because there is no consistant treatment regime for cLBP in conventional med, that is the point there is no one size fits all treatment for this condition. In the verum acupuncture group each patient was also individually diagnosed and treated according to the principle of TCM. As I stated the significance of these papers is their pragmatism, acupuncture may not have demonstarted efficacy, but it did demonstrate it's relative effectiveness over current mainstream care.

Jamie - how do you interpret the fact that acupuncture was equally effective with placebo acupuncture? Doesn't that make them both placebo?

Jamie - you say that "each patient was also individually diagnosed and treated according to the principle of TCM" - but then the carefully-honed TCM was only as effective as the sham needling - so what does the individualisation do?

Refer to the pdf I posted..

I'm not denying that the placebo effect or I prefer the meaning response plays a significant role in an acupuncture treatment. But from my experience there are also effects that cannot be purley explained by the meaning response, but thats too much to go into here. But what seems to be missed is that acupuncture is only one tool that we as practitioners use, we also counsel on diet, lifestyle, exercise (Tai Chi/Qi Gong), meditation, herbs.. TCM is a whole system of medicine, and one that originally evolved to work best as a preventitive medicine..

All that aside though, if this treatment can help people suffering from cLBP (which you must admit is a difficult condition to treat effectively) reasonably cheaply and without the use of drugs shouldn't it be considered as an alternative?

You say
"TCM is a whole system of medicine, and one that originally evolved to work best as a preventitive [sic] medicine"

I would prefer to say that it is a system of medicine that evolved in a pre-scientific age, before anything was known about physiology and before anything was know about how to conduct fair tests.

Thats not entirely true David, basic functions of the Zang Fu (internal) organs is described fairly acurately in ancient texts written over two thousand years ago. The only mistake they made was confusing the role of the Pancreas with the Spleen. On top of that in the Nei Jing, written in the Han Dynasty (300 BCE) is described for the first time the continuous circulation of the Blood through the body, something that wasn't discovered in the the west until 2,000 years later. As well as over two thousand years of clinical observation and meticulous record taking, it is not to be dismissed as lightly. I'm sure being a pharmacologist you will recognise that many pharmaceuticals were derived from Chinese herbs, ephidrene from má huáng, Tamiflu from Star Anise..

Jamie - the main difference between the various forms of traditional medicine - whether Chinese, Greek or herbal - is that they are systems based on observation and theories that evolved without technology. In other words, they had macroscopic/real life observation, perahps long-term but in a limited population.

The evolution of more and more sophisticated technology - both laboratory and imaging, has added exponentially to our understanding of how the body works.

Hippocrates and the ancient Chinese could only theorise about basic particles - now we have electron microscopy to show the structure of sub-cellular organelles. We ahve the scienc eof microbiology to identify and type infective micro-organisms. We have spectrophotometry to display the various serum proteins, including antibodies. We have ordinary microscopes to count cells and cell types in the blood and tissues. In imaging, we have ultrasound, CT, MRI - we can see structures, bleeding, perfusion.

I suggest to you that the ancients - whether Persian, Greek or Chinese, did not ignore whatever evidence was available in their time. Why would we prefer their explanations for things, lacking access to the evidence we npw have.

I suspect Hippocrates would be turning in his grave if he thought we clung onto ancient pre-evidence principels when we have so much evidence before our eyes now. What is the purpose of pretending it is not there?

The CHinese don't ignore modern evidence - people in CHina who have access to modern medicine use it and excel in its practice.

"I suspect Hippocrates would be turning in his grave if he thought we clung onto ancient pre-evidence principels when we have so much evidence before our eyes now."

Hippocrates also laid out in his Hippocratic oath "Primum non nocere", so he's probably already turning in his grave considering that we now know, in the U.S. at least medicine is now annually the third leading cause of death.

I'm not stating this fact to try to get one up on you, but to highlight that modern scientific medicine has its own problems. Sue do you have any understanding of Eastern philosophy? By breaking Chinese medicine up into parts to try to find out what works and what doesn't you lose the integrity of the whole, it is opposed to Asian thought and I am reminded of this quote by the eminent Sinologist Paul Unschuld, it goes like this..

"The western preference for thought systems that are free of internal contradictions and that constitute truth until a new truth provides better explanations with fewer contradictions is diametrically opposed to an East Asian tradition that judges thought systems by how well they prove themselves to be in practice rather than by how true they are... "

Molecular biology hasn't supplied us with all the answers we were hoping for, the human genome project has been a real let down, especially after it was discovered that the simple rice plant contains more genes than a human. No new major discoveries in health have been made for a couple of decades, drug companies are just rebranding old drugs when the patents run out and then try to find new diseases to use them for. Medicine has also become prohibitably expensive and is almost at crisis levels.

So what to do? Shutting down opposing voices is not the answer, we need to rethink healthcare, we need to keep the dialogue open and not howl down the 'heretics'. Anyway, I thank you for at least being respectful in your reply to me which was well considered and has given me some food for thought..

I reckon this address says it all really. http://www.who.int/dg/speeches/2008/20081107/en/index.html

Jamie - I know enough of "Eastern philosophy" to know that there is no such entity....The Eastern hemisphere contains a multitude of communities, nations, religions and cultures. Are you referring to Sri Lankan Buddhism, Southern Indian Catholicism, Chinese confucianism, the Islam of the Uyghurs?

Traditional Chinese medicine has not served its community well, nor has homeopathy in India. Chinese and Indians who have the means get access to effective medicine, and practice it.

You say "No new major discoveries in health have been made for a couple of decades"...on what basis do you make that claim? Read Chris Semsarian's post on "energy drinks" to learn about molecular cardiology. We now also know more about the acute pathological process of coronary artery occlusion (heart attack), the nature of unstable plaque, and the role of inflammation. Children with Type 1 diabetes are now using insulin pumps. In my own ED, we diagnosed a life-threatening condition with bedside ultrasound yesterday and a life was saved in a way that would not have been possible ten years ago.

I am not interested in shutting down voices purely for the sake of silencing "opposition" - but I am interested in saving vulnerable people from being sold "remedies" that don't work.

I know that the evidence shows that chiropractic manipulation has objective benefit for low back pain - that makes sense. I also know that chiropractic manipulation does not have the organ-system effects it was previously claimed to have.

I also believe that some therapists benefit people by being empathetic listeners and perhaps good counsellors, but I can't accept that they sell these same vulnerable people "remedies" that are inert, and at enormous mark-up.

I know that effective medicine has side-effects and complications - that is because it has an effect on the body.

So what to do? COntinue to support people in good lifestyle choices, and back them up with effective medicine when it is needed. Stop being so risk-averse and expecting medicine to solve every anxiety. Stop prolonging the process of death in the very elderly who are at the end of life. Teach the community to be resilient and not reach for a remedy or go to a therapist any time they have a midl illness. COntinue to use science to test the effect of therapeutic substances.

Hi Sue, I was refering to East Asian philosophy, Daoism and Buddhism mostly.

"So what to do? COntinue to support people in good lifestyle choices, and back them up with effective medicine when it is needed. Stop being so risk-averse and expecting medicine to solve every anxiety. Stop prolonging the process of death in the very elderly who are at the end of life. Teach the community to be resilient and not reach for a remedy or go to a therapist any time they have a midl illness. COntinue to use science to test the effect of therapeutic substances."

Well I agree with you, so there! My question on Eastern philosophy was pertinent because although the ancients may not have known about the Krebs cycle or the electron transport chain they new much about the human condition and the mind. Thousands of years ago the effect of the emotions on health was well understood, living in accordance to the seasons and what is known as living in the Dao, in harmony with nature. We have move so far from this now and the consequences on our physical/emotional and environmental health are clear.

The heart of Chinese or I prefer Oriental medicine is the prevention of illness through the teaching of this philosophy and it is one that I follow, for me it is my spiritual path. Part of this path for me will be to set up a community centre where people can pop in for cheap treatment if needed, talk about their health and other problems, learn meditation techniques, take Tai Chi classes and meet other like minded souls. This model is called community acupuncture and is a movement that is growing worldwide. I believe this has a place in our healthcare system, especially for education and prevention. It also has the ability to take some stress of our already over burdened health system..

Over to you..

Some background on Community Acupuncture.. http://www.youtube.com/watch?v=r9F5dtcN380