alternative health practices.

"How do homeopaths explain this supposed potency of infinitesimal doses, even when the dilution removes all molecules of a drug? They invoke mysterious vibrations, resonances, force fields, or radiations totally unknown to science."
--- Martin Gardner

Yet, homeopathic advocates give ardent testimonials to the curative powers of their remedies. How can so many case histories be dismissed? Easily: the "cures" are probably the result of spontaneous remission or the placebo effect and the testimonials are of no empirical value as evidence.

massage

It doesn't take a miracle-worker to make a person feel good by the "laying on of hands." Most of us know from experience how just the touch of another person can be soothing, comforting and spirit-enhancing: healing, if you will. Anyone who has ever had a massage knows how good it feels, but most of us could not explain the physical and physiological mechanisms causing the relaxation and pleasure. Most of us probably suspect it has something to do with being touched and with the physical movement of muscles and other body parts. But then, maybe we haven't been introduced to the New Age explanations, none of which has to do with muscles being relaxed or blood being circulated.

An article in my local newspaper features local "massage therapist" (not `masseuse') Karen Khamashta using Ortho-Bionomy, Reflexology, and Polarity.[note 1]

Ortho-Bionomy works by contacting the body's "trigger points." When a trigger point is contacted, you "immediately relieve pain and restore the body's natural balance and rhythm."

Reflexology works by unblocking the 7,200 nerve endings in each foot so that they [the nerve endings] can respond to all of the glands, organs and other parts of the body and improve the blood supply as well. This helps the body "reach a balanced state."

Polarity therapy is based on "balancing the life energy that moves through every part of the body...and...moves in currents, or channels within and around the body." Polarity therapy "attempts to eliminate blockages in these channels which can cause imbalance and illness." The theory is that "if the body's currents are balanced, the person relaxes and is able to heal more efficiently."

Another massage therapist, Christy Freidrich says "A lot of what I do is to try to help people with their structural balance. Over a period of time, people end up learning more about structure and how it works."

There is undoubtedly something to all this talk about trigger points, unblocked nerve endings, improved blood circulation and relief of pain. And the truth is, if I have to listen to you babble about balanced states and structural balance in order to get a massage, I'll do it. You might think you're enhancing my spiritual self-realization and bringing my life-force into harmony, structure and balance, but I'm just enjoying the massage. You probably won't get too many complaints, even from skeptics about such parapsychobabble because, as one therapist put it, "there are not very many people who don't like to get a massage."

reader comments

11 Sep 1996
Your definition of Ortho-Bionomy is not even close. It has almost nothing to do with contacting trigger points (we prefer to use the word "indicator points").

reply: I agree, "indicator points" is much preferable to "trigger points." It's much more precise and scientific and not as likely to be confused with Roy Rogers.

It has to do with facilitating self-correcting reflexes though positioning, facilitated movement, isometrics, and other methods.
Richard Valasek, Advanced Instructor, Honoululu

reply: Well, I am glad someone is facilitating those self-correcting reflexes or else they might stop self-correcting and begin rebelling or opening their own ortho-bionomy clinics. I will notify Karen Khamashta, our local massage therapist who is spreading these vicious lies about your field, that she is wrong, wrong, wrong. And I will print your letter so the world will know that ortho-bionomy has to do with positioning, facilitated movement and isometrics, not contacting trigger points.

8 Dec 1996
I am a registered massage therapist in Texas. I do a combination of Swedish massage (mainly for relaxation) and Neuromuscular Therapy (NMT - for pain relief). I agree with you (surprise!). Touch and soft tissue manipulation are soothing, relaxing, pleasurable, stress relieving, pain relieving, etc. It is physical, not magical .I think it does the massage profession a disservice when some practitioners go overboard on what I call voodoo. It scares away many average folks who could benefit from the positive effects of massage.

Of course, I do have some clients who espouse ther own New Age beliefs, and I do not try to dissuade them. My main concern in the area of New Age massage are techniques designed to evoke an emotional response which is supposed to be healing. This type of therapy may be useful with a highly trained psychotherapist in attendance to handle disturbing images that surface, but I personally know no massage therapists who have any training in this regard. My massage training focused on anatomy, physiology, and massage technique and I think we should stick with what we know. After all, massage is already a wonderful thing. Relax & enjoy!

Philippa Dodson

The main reason people seek alternative health care, however, is probably because it "works." That is, they feel better, healthier, more vital, etc., after the treatment. In many cases, a person's condition would have improved had he or she done nothing at all, but the improvement came after the treatment so it must have been caused by the treatment (post hoc fallacy). In many cases, the successful treatment may be due to nothing more than the placebo effect. It is also possible that in some cases treatment by traditional medicine causes more harm than good and the improvement one feels is due to stopping the traditional treatment rather than to starting the alternative one. (One reason spiritual healers in pre-modern medicine times may have had better success rates on the battlefield than traditional healers is due to the fact that traditional healers often harmed their patients: e.g., infecting them while treating them. Spritual healers, who did nothing to the wound, didn't infect the patient, who often healed thanks to the body's own internal healing mechanisms!)

Also, alternative health care is often sanctioned by state governments which license and regulate their practice and even protect alternative practitioners from attack by the medical establishment. Chiropractors, for example, won a major restraint-of-trade lawsuit against the American Medical Association in 1987. A federal judge permanently barred the AMA from "hindering the practice of chiropractic." So the fact that there is little if any scientific evidence that alternative health care is based on sound theory does not deter millions of people from seeking the services of quacks. The quacks are state approved, so they can't be that bad. Right?

A few years ago, a woman who taught at the same college I teach at sought the help of a holistic practitioner who treated her with herbs. She avoided drugs and surgery, which would have been the treatment she would have received had she gone to a physician. She had a very treatable from of cancer, discovered after she died. Her name was Carol Frasinetti.

In the fall of 1992, physicians treated a five-year-old boy and his four-year-old sister for mastoiditis. The boy's infection had invaded his skull; the girl's was so severe that part of her face was paralyzed and pus was pressing against her brain. The children's parents were using a chiropractor as their primary care doctor. The doctor of chiropractic correctly diagnosed the ear infections and tried to cure the children by manipulating the bones of their spines. Because they were not treated with antibiotics, the girl is now deaf in one ear and the boy is still under observation for neurological damage.[note 2] The article notes that chiropractic colleges are accredited and their services are covered by Medicare, Medicaid and some private insurance plans. This gives chiropractic an "authoritative resonance" which other non- traditional treatments do not have. The same article in the Wall Street Journal which describes these children gives an account of children with cancer who have been treated by chiropractors who made inappropriate diagnoses which "resulted in delay of correct medical diagnoses and treatment."

I think Dr. John Bolton, a San Francisco pediatrician, put it best when he said "It's criminal to tell kids not to get immunizations because somehow cracking their backs can prevent infectious disease. It's not reportable as child abuse, although it's certainly abusive." And it's state approved child abuse!

Dr. Jennifer Peet thinks differently. She and her husband founded The Baby Adjusters in 1992, a chiropractic clinic mainly for children. She says her clinic adjusts the spines of 150-200 people a day, most of them children and some of them infants. "We check them when they're 24 hours old. Very gently, it's almost just a tapping, we push the bone back into alignment." She claims she's cured infections, asthma and allergies. She's written a book, has a newsletter, pamphlets and posters, gives lectures and sells audiotapes. Next she hopes to start a magazine. Soon, no doubt she'll be on the talk shows. She'll be recognized as an "expert" and quoted by others like her who will also write books and quote each other and reinforce their non-sense until it all has the ring of verisimilitude about it.

Nevertheless, it should not be assumed that because most alternative medicine is quackery, traditional or mainstream medicine is without fault. Most of American mainstream medicine can be reduced to two types of treatment: drugs and surgery. Fear of, or lack of confidence in, the harmful consequences of both forms of treatment drive many people to seek alternatives. This fear and skepticism regarding drug treatment and surgery is not without foundation. We've all heard of cases where surgeons have amputated the wrong limb. The latest I've read about is that of Willie King, a 51 year old man who went into University Community Hospital in Tampa, Florida, to have his right foot amputated but got his left foot amputated instead. (Of course, you can't believe everything you read in the newspapers or hear on the national news. Mr. King's lawyer is quoted as saying that his client "never had any serious problem with his left leg." The hospital claims their patient was going to lose both legs and the only mix-up was in the order of amputation.)

We've all heard of cases where a patient goes in for "routine" surgery but dies. It is difficult to say what is meant by the claim that "no surgery is without risk of death." But to some people the warning entails the notion that sometimes the surgeon will kill you by accident, though the report will refer to something like a "therapeutic misadventure of very high magnitude." Such accidents can happen in the best hospitals performed by the best surgeons. Often, however, when a patient dies unexpectedly during or shortly after surgery, the spouse, parent or child of the deceased is never told the reason for the death. This may because the doctors really do not have a clue as to what happened. It may be because they want to avoid lawsuits, tarnishing their reputations, and all the negative consequences that should follow from failure due to accident, mistake or incompetence in the operating room. Sandra M. Gilbert, spouse of Elliot Gilbert, former English Department Chairman at the University of California at Davis, has written a book called Wrongful Death (Norton, 1995) in which she details her husband's "successful" prostate surgery, his death in the recovery room shortly thereafter, and her years of frustration at trying to find out what went wrong. The surgery took place in 1991 at the University Medical Center and was performed by Dr. Ralph W. deVere White, a nationally recognized expert on prostate cancer with years of success as a surgeon and an impeccable record.

The Gilbert case is at least matched, if not topped, in the history of modern medical failure by the case of Betsy Lehman. She was the Boston Globe's health columnist who was killed by her health care providers at the Dana-Farber Cancer Institute. Lehman was 39 years old, a mother of two, being treated for breast cancer with chemotherapy at one of the best hospitals in the world. Her heart failed after she was given four times the maximum safe dosage of cyclophosphamide, a highly toxic drug. Her husband is a scientist at Dana-Farber. He is quoted as saying: "The whole lining of her gut from one end to the other was shedding. She was vomiting sheets of tissue. They said this was the worst case they'd every seen. But the doctors said this was all normal." She died Dec. 3, 1994. Two days earlier at the same treatment center a 52-year old woman was a victim of the same mistake. She remains hospitalized with serious heart damage. In June, 1995, a neurosurgeon at the Memorial Sloan-Kettering Cancer Center mistakenly operated on the healthy part of a cancer patient's brain after pulling pictures of the wrong person's skull. Dr. Joseph Simone, Sloan-Kettering's physician-in-chief, said: "We have acknowledged that a mistake was made, and we have extended a heartfelt apology to the patient's family."

Are these "therapeutic misadventures" rare? Perhaps. As far as I know, there has never been a national study of the issue. There was a study done in New York in 1991 (The Harvard Medical Practice Study) which found that nearly 4 percent of patients were harmed in the hospital and 14 percent of these died, presumably of their hospital-inflicted injuries. Lucian L. Leape, a Boston physician, extrapolated from this data that as many as 180,000 Americans may be dying each year of medical injuries suffered at the hands of medical care providers. He notes, for dramatic effect, that this is the equivalent of three jumbo-jet crashes every two days. ("Truth about human error in hospitals," Abigail Trafford, editor of the Washington Post's health section, printed in the Sacramento Bee, March 21, 1995, p. B7.) Is the situation really that bad? I don't know but I think it is safe to say that "further studies are needed!"

Given the risks and dangers of being harmed by practitioners of traditional medicine no doubt contributes to the popularity of alternative health practices. It is true that the risks of being positively harmed by a homeopath are negligible when compared to the risks of being harmed by a traditional physician dispensing powerful drugs and performing risky surgeries. This is because a homeopath is not intervening in any significant way. The doses they give are not likely to have any effect on anyone. So a homeopath is not likely to ever kill a patient by mistake. The danger from alternative medical treatments which are essentially non-interventionist is negative, not positive. The harm to the patient comes not from positive intervention but from not getting treatment (drugs or surgery) which would improve their health and increase their lifespan. While it is true that traditional medicine is not without its risks and dangers, even fatal risks, it is unreasonable to reject it altogether on these grounds. Reasonable people can't ignore the diabetics now alive and well thanks to their drugs or the millions of people who owe their lives to vaccinations against lethal or crippling diseases. We can't ignore the millions whose pain is gone thanks to surgery, or who owe their continuing existence to successful medical treatment involving both drugs and surgery.

It seems to me that a reasonable response to the very real risks of treatment by traditional health care providers is to take greater responsibility for one's treatment. A reasonable patient cannot have blind faith in his or her physician, no matter how godlike the doctor may seem or try to present himself. (A very dear friend of mine who lived to be 80 thanks to pills and surgery, found great humor in telling her physicians she knew M.D. stands for "medical divinity.") We have to become more knowledgeable of the drugs prescribed to us. We have to participate more in our own treatment which means we have to ask lots of questions and assume nothing. We can't assume that the drug the nurse wants us to swallow is the one our physician has prescribed. (Just ask, "What's this pill?" You should know whether you're supposed to take it or not.) We need to seek second and third opinions, which doesn't necessarily mean look for another doctor who will tell you what you want to hear. It means do research. Read about your illness and the prescribed treatment for it. We can never eliminate risk altogether when we must depend on human beings, fallible and imperfect as we are. But we can reduce our risk by being more responsible for our health care and being less passive. Some faith in the competence of our health care providers is necessary, but it need not be blind faith. You may have to have surgery to have a limb removed, but you may need to make sure that the surgeon ready to operate doesn't think he's supposed to remove your gall bladder. The young boy who was to have a leg amputated and had written in large ink letters on his good leg "NOT THIS ONE" may have gotten a laugh from the hospital personnel. We can admire the boy's humor, but it is his lack of blind faith that is most admirable to a skeptic.

See entries for acupuncture, chiropractic, Edgar Cayce, chelation therapy and communal reinforcement, the placebo effect , testimonials and therapeutic touch.

reader comments

24 Sep 1996
Interesting stuff. As a fully paid up skeptic/cynic from my early teens, I found some of the stuff very interesting indeed. Not that I agree with all of your comments. I found your article on Chiropractic rather extreme - and noted the many responses from those who benefit temporarily from the "realignment'. I visit a chiropractor from time to time, and believe me, the temporary relief is worth the cost (no more expensive than the painkillers the regular medics would prescribe). I don't think its any more bizarre to believe in the therapeutic effects of chiropractic than the therapeutic effects of regular exercise.

reply: I discuss only alternative medicine because of its general pseudoscientific or unscientific approach. Alternative medicine is generally based upon untested claims and is mainly appealing to desperate people. A dying person is easy prey for charlatans, not that there are not charlatans in traditional medicine. In fact, many of those offering miracle cures for cancer are physicians who were trained in traditional medicine. I don't discuss alternative medicine because the field is dominated by charlatans. It is because their cures are based more on hope than on evidence, that I discuss alternative medicine. Of course, treatment with chemotherapy involves hope on the part of both patient and physician. But, anyone who expects traditional medicine to stop people from dying will be disappointed. I don't criticize alternative medicine because it is fallible and imperfect. I, too, have lost some loved ones to cancer. Chemotherapy did not help them. Would they be alive today if they had taken shark cartilage and coffee enemas? There is no way to know, but I doubt it. However, your characterization of chemotherapy to bloodletting is unfair. I wouldn't even compare coffee enemas (an alternative medicine therapy for cancer) to bloodletting. I understand your implication that traditional medicine sometimes recommends therapies that turn out to be useless or harmful. I do not agree, however, that that fact puts traditional medicine in the same class as alternative medicine.

Finally, I discuss only alternative medicine because its very nature encourages people to experiment on themselves with either no theoretical guidance or with faith in the guidance of untested and purely speculative notions. If people want to do this to themselves, that is their business. And it is not difficult to see why a dying person would seek out any therapy, no matter how ridiculous it might seem. At death's door, you and I might be tempted to wear a pyramid hat and let cats rub our bellies, if someone told us that it might help us survive a little longer. We might also be tempted to continue with chemotherapy, even though the prospects are not promising. That fact does not put chemotherapy in the same class as wearing a pyramid hat.

further reading

The National Council Against Health Fraud

Skeptic's Sanctuary, by Brian Wall

Mystical Medical Alternativism

On Naturopathy from Jim Thomas's The World of Science

Homeopathy - a position statement by the National Council Against Health Fraud

"Is Evidence for Homeopathy Reproducible?" The Lancet

Barrett, Stephen and William T. Jarvis. eds. The Health Robbers: A Close Look at Quackery in America, (Amherst, N.Y.: Prometheus Books, 1993).

Barrett, Stephen. "Homeopathy: Is It Medicine?," in The Hundredth Monkey and Other Paradigms of the Paranormal - A Skeptical Inquirer Collection, ed. Kendrick Frazier (Buffalo, N.Y.: Prometheus Books, 1991), pp. 271-277.

Gardner, Martin. Fads and Fallacies in the Name of Science (New York: Dover Publications, Inc., 1957), ch. 16.

Gardner, Martin. "Water With Memory? The Dilution Affair," in The Hundredth Monkey, ed. Kendrick Frazier (Buffalo, N.Y.: Prometheus Books, 1991), pp. 364-371.

Glymour, Clark and Douglas Stalker, eds. Examining Holistic Medicine, (Buffalo, N.Y.: Prometheus, 1985).

Jarvis, William. "Chiropractic: A Skeptical View," in The Hundredth Monkey, ed. Kendrick Frazier (Buffalo, N.Y.: Prometheus Books, 1991), pp. 262-270.

Smith, Ralph. At Your Own Risk: The Case Against Chiropractors, (New York: Simon and Shuster, 1984).

Raso, Jack. "Mystical Medical Alternativism," Skeptical Inquirer, Sept/Oct 1995.

Notes

1. The Davis Enterprise, January 10, 1993, p. C-1 and C-3.

2. The Wall Street Journal, March 18, 1993, p. A4. "Chiropractors Seeking to Expand Practices Take Aim at Children," by Timothy K. Smith. The author reports on the systematic efforts of chiropractors to recruit children as patients. One company, Peter Pan Potential, holds seminars for chiropractors to teach them how to get more children as patients. Their advertisements for chiropractors in trade magazines tell the chiropractors to "Do your part to change the perception of chiropractic with patients who aren't negative or skeptical--they're children!"

The American Chiropractic Association (ACA) responded with a full page ad in The Wall Street Journal (March 22, 1993, p. A11). The ACA ad stated that "It deeply regrets and condemns the unfortunate, although, isolated, conduct reported by The Wall Street Journal." To its credit, the ACA didn't deny that some chiropractors are dangerous quacks. The ad further stated that "Chiropractic manipulation is not a substitute for routine vaccinations, and our Association considers any contrary suggestion to be unethical, unprofessional and wrong." The ad made no comment on the practice of treating day old babies for spinal misalignment.