The Quackometer

Last night, a friend who I have not seen for a little while, asked me an important question. She was well aware of my blogging activities as my blog rss feed pipes through delicious and then twitter and onto my facebook account, or something. Why my fascination with criticising alternative medicine? A difficult question – and after a few pints and the energy for a one word answer, I responded “sport”.

Fortunately, a journalism student asked me some interview questions that allowed me the indulgence of providing a little more depth to my reasoning. I repost them here for the record after bashing them out whilst also trying to cook a mushroom stroganoff. The strog was a success. I hope these answers are also digestible.

Is there any evidence that alternative medicines work?

That depends on which alternative medicine you mean and what condition you want it to work for. It also depends on what you mean by 'work'. A complex question. What we do know is that most alternative medicines are essentially inert - they have no specific effects. Homeopathy uses medicines so dilute that no medicine remains. Reiki is just a form of faith healing. Acupuncture is just sticking pins in your body at arbitrary points. Reflexology is just a foot massage. Bach Remedies are just dilute brandy. Practitioners may claim specific effects due to 'quantum theory' or Chinese Meridians and Qi, but these are just pseudoscientific explanations with no basis of evidence or rationality. Some therapies may have specific effects such as chiropractic, but the evidence suggest that this is only effective for lower back pain and then pain killers may be just as good, and much cheaper. A few herbs have been shown to have specific effects, but patients have no way of telling if their herbs contain the right amount of active ingredient and are not contaminated with other compounds.

Do you think there is any merit in using alternative medicines and
therapies or is it more of a danger to health?

Even though specific effects may be non-existent, or at best unpredictable, alternative medicines may well give non-specific effects and these may indeed have positive effects. The use of alternative medicine may well give a sense of empowerment and control, lift the mood, reduce anxiety and make pain more bearable. Together, these effects tend to be clumped under 'the Placebo Effect'. In itself, this is not harmful and it is clear to see why patients like to take alternative medicines. The dangers are wider though. Firstly, in order to gain a good placebo effect, you have to believe that the therapy will work. The therapist then has to be a liar or deluded about their own powers. Trust in medicine is pretty important and it can be argued that the mild benefits of placebo do not outweigh the loss of integrity in delivering a placebo. Also, placebo effects are not magic. They have effects concerning beliefs but do not generally alter the course of the illness. With serious illnesses, people taking alternative medicine may delay or avoid treatment with proven beneficial and necessary effects. Practitioners too fail to limit their claims to what can be expected from a placebo treatment as they often do not realise this is what they are doing. Therein lies the danger of alternative medicine.

Should more alternative medicine be integrated into the health system?

I see little problem with integrating alternative therapies that are not based on pseudo-science into mainstream practice when there are evidenced benefits to be gained. People with terminal illnesses, or those undergoing difficult treatments, may well benefit from such things as massage, music therapy and other anxiety reducers. However, I see little evidence amongst the champions of 'Integrated Medicine' that they worry about what works and what does not. The Princes Foundation for Integrated Health advocates all sorts of disproven and nonsensical therapies that may well do more harm than good. Such bodies never rule out any therapy - they have no standards by which they can judge their 'integration' effective. As such integrative medicine is just a back door attempt to gain public funding of quackery and it is a massive distraction from researching and funding genuine complementary therapies that people may well gain real benefits from.

Why choose conventional scientifically-tested medicines over alternative
therapies and medicines?

Patient choice is an important concept in health care thinking and rightly so. However, proponents of alternative medicine use the ideal of patient choice as a way of justifying quackery within the healthcare system. Choice is only really empowering when it is informed. That is, choice works when patients have available to them all the relevant information in a way that is not distorted by false or unproven claims and where the benefits and side effects can be compared on equal terms. For doctors, giving choice to the patient is vital, but they should not feel forced to provide treatments in the name of 'patient choice' when it is against their clinical judgement and the available evidence. People in all sorts of situations make difficult choices on the available evidence. We do not buy a second hand car on the word of the salesman. We seek independent and impartial evidence that the car is sound, not stolen and right for me. We would definitely feel we did not have a genuine choice of car if all we had was misinformation and raw salesmanship to hand. Why we are less diligent in our health choices is a fascinating question.

Is there anything you would like to add?

I believe the study of health beliefs and alternative medicine gives a fascinating insight into what it means to be human and how we form our opinions and views of the world. Human beings existed for most of their history with little more than familial care and plenty of ritual in the face of illness. For that reason, attempts to ban alternative medicine will be futile. It appears to fulfil some sort of deep need that mainstream medicine fails at. We are part of the first few generations that can begin to understand the true nature of disease and use technology to alter the course of illness. We may be becoming more technically adept at reducing suffering and early death, but we may be missing out on the human needs of such a process. But also, modern medicine can be pretty brutal in the face of deadly disease. Risks are taken to save lives and much discomfort is endured on the path to recovery. The tension that exists is between allowing alternative medicine to provide the ritual of healing that may be missing without allowing it to appear to provide alluring and easy answers to suffering that do not really exist. What is so disappointing is that the practitioners of alternative medicine do not want to take part in that debate but instead want to cling to their nonsensical beliefs and unevidenced practices. And it is on that point that real conflict exists between mainstream and alternative medicine. 

 

Tonight, on BBC2, we were treated to Professor Regan’s Medicine Cabinet, where we were walked through the vast amount of quackery that we can find in a high street pharmacists.

Homeopathy was given a thorough kicking and straightforwardly shown to be utter nonsense. I did love the Ainsworth’s Pharmacist trying to defend his batshit robotic dilution apparatus, the The Pinkus Potentizer, that produced dilutions of 100 to the power of 100,000 – a truly barking level of dilution that would leave one molecule in a hundred squillion visible universes.

Happily, we were also shown some of his minions in the background preparing remedies in the more traditional manner of banging the vials against a leather Bible whilst looking slightly possessed. And then we were told by the Ainsworth chap, Mr. Tony Pinkus, Homeopathic Pharmacist,  that modern science had not yet caught up with the wonders of homeopathy. Yes, I am sure.

My position has always been that homeopathy’s biggest threat is for people to find out what it is. It is not herbalism, it is modern day witchcraft wearing the white coat of a scientist. This programme will have done wonders for the demise of this shabby trade.

You can watch the programme on the fabulous BBC iPlayer. Unless you live outside of the UK, in such a place as America, and have rejected the rule of our sovereign Queen and  have chosen not to pay the BBC licence fee. I suggest you get straight on an aircraft to Heathrow now, or use some techie proxy server thingy to get round the BBC rules.

Enjoy.

Labels: homeopathy

 

The stillborn homeopathy campaign, Homeopathy Worked for Me, that attempted to collect 250,000 signatures but managed just a few percent of that, has now resorted to producing a laughably daft critique of Ernst & Singh’s Trick or Treatment.

William Alderson, a homeopath, has produced a 142 page response to the book that attempts to show that the book has “has no validity as a scientific examination of alternative medicine”. Entitled, Halloween Science, the critique is a collection of misunderstandings, quibbles, strawmen and just plain daftness.

The approach that Alderson is taking here is to produce so many half baked critiques that to debunk the whole work would take 500 pages or more. Even if I was to show that the first few pages contained nothing but nonsense, the charge could be made that the rest of the book must contain some well targeted criticism. The whole book is destined to become an exemplar of the Dunning-Kruger effect.

Nonetheless, given that I have a life, I have no choice but to pick out a few examples and display their total inadequacy to you. The rest I shall leave as an exercise to the reader. No doubt, as with any work, there may well be weaknesses in Trick or Treatment and Alderson may well stumble over a few of them. Whether this undermines the main argument of the book though is a different matter. In that regard, Alderson fails to plant any fatal punches.

For the easily bored, or for those with delicate foreheads (for you will be sure to be banging yours on the desk if you attempt to read the full tome), Alderson gracefully produces a précis of his magnum opus.

So, a quick example: early on in Trick or Treatment, Ernst and Singh show how early versions of clinical trials established effective treatments for sailors’ scurvy. By trialling different proposed remedies and comparing outcomes, the British Navy was able to eradicate the curse of scurvy by allowing sailors access to lemons and oranges, a good source of vitamin C.

Alderson contends that in doing so the authors are “confusing two types of intervention”.

In fact, we need to be clear that the condition which lemons, oranges or vitamin C are actually curing is the absence of vitamin C in the diet. In other words the treatment in this case is actually the ending of a harmful intervention (deprivation of vitamin C), and this harmful intervention is the one and only cause of the illness. In this respect dietary deficiency diseases and poisonings are totally different from infections or chronic diseases, where there are multiple causes. The point can be illustrated by reference to another of Ernst and Singh’s examples: loss of blood as a result of bloodletting simply requires one to stop depriving the patient of blood, whereas a haemorrhage requires an active intervention to be initiated to solve the problem. Nobody would call the former action a ‘cure’, yet that is precisely what Ernst and Singh are doing in the case of scurvy.

You might want to read that again, because, yes Alderson is really saying what you thought he did.

Before I highlight his error here, it is worth noting Alderson’s misplaced obsession with theory in medical treatments. He claims that Ernst and Singh ignore theory when they say that “by experimenting and observing, [we] can determine whether or not a particular therapy is effective.” Alderson contends that “Ernst and Singh [believe] the scientific method is about “experimenting and observing”, not about experimenting, observing and theory.” The observant might notice the Alderson is attacking an argument that the authors do not make. Ernst and Singh do not attempt to define science as being about “experimenting and observing” but that we can determine what facts are true about the world by such processes. We can understand if an intervention has an effect on a disease without having a theoretical understanding of the diseases nature. That may well come later.

Alderson obsesses about theory because, like a lot of homeopaths, he delights that homeopathy provides a theory of disease – imbalances in vital forces (or something) and a theory of cure – ‘like cures like’. Like all homeopaths, he does not understand that you cannot have a theory until you have a set of observations that need explaining by a theory. No such observations exist for homeopathy. In two hundred years, homeopaths have failed to produce a similar demonstration of efficacy as this primitive trial with lemons.

So, back to our scurvy problem. What Alderson is missing is that when citrus fruits were proposed as a cure for scurvy, that this was not based on any theory of disease. Indeed, it was completely unknown what caused the terrible disease amongst sailors. It could have been an infection or diet; some though the disease was caused by sailor’s laziness and so made sick sailors work harder. Physicians at the time had no knowledge of vitamins and the book makes this clear. The sailors’ trials tried different suggested remedies including cider, sulphuric acid, vinegar, sea water, garlic paste and, of course, oranges and lemons on twelve afflicted patients. The two given fruit recovered very quickly, the cider drinkers somewhat and the rest made no progress. As trials go, it is pretty primitive, but understandably compelling.

Even with this result, it would take a long time to establish that that the reason lemons worked was because of a dietary deficiency. Alderson is quite wrong to suggest that somehow the trial only worked because of the nature of the cause. In fact, the nature of the trial makes no assumptions about the cause of the illness; it merely seeks to determine what intervention has an effect on the illness. The trial has about as much need of theory as a ruler does of General Relativity. Alderson fails to state why this so called failure or ‘confusion’ had any bearing on this or any other trial.

The rest of Halloween Science is riddled with the same error and similar misunderstandings. What is unforgivable is that that Ernst and Singh go to some six pages explaining very carefully the same point I have made above. William Alderson does not, or chooses not to, understand.

Of course, the whole Alderson book is a mere fig-leaf. Its clumsy rhetoric and lengthy nitpicking is a disguise of the embarrassment that homeopaths have over the fact that they cannot produce any reliable evidence for the efficacy of their treatments and the validity of their hypotheses (not theories). This pamphlet may well please the homeopaths who continue to avoid acknowledging the genuine and urgent criticisms of their shabby trade (such as their refusal to condemn the practices of their colleagues who dish out sugar pills in Africa in order to 'prevent’ malaria or treat HIV infection). More competent readers will not be impressed.

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UPDATE

It is probably worth mentioning the section in Halloween Science that discusses the attempts by the Society Homeopaths to sue my internet service provider when I dared to criticise them.

William Alderson, a member of that society continues to misrepresent what happened in the most shocking way.

Ernst and Singh said in their book,

Worse still, when the Society of Homeopaths, based in Britain, was criticized for not taking a firm stand against inappropriate use of homeopathy, it decided to suppress criticism rather than to address the central issue. Andy Lewis, who runs a sceptical and satirical website (www.quackometer.net), had written about the Society and the issue of homeopathic malaria treatments, which resulted in the Society asking the company that hosts his website to remove the offending page. In our opinion, the Society needs to improve in three ways. First, it ought to police its practitioners more thoroughly. Second, it ought to act publicly and promptly when serious complaints are made. Third, it should listen to its critics rather than silence them.

You can read my criticism here. It is harsh – but the issue was very important.

At its most basic level, the Society fail to uphold their own code of conduct, never censor anyone for clear breaches and allow their members to offer dangerously misleading advice to the public. (Example here)Those charges demand a serious response. The Society have never done so.

Alderson responds to this rather serious charge by just quoting the Society asserting what good eggs they are. He then repeats the lie that the Society could not take action against any members as no information had been given to them. This is simple untrue as you can read here. To say that the society had nothing to “police” is an utter distortion. The Society is riddled with members who either support or who actively engage in immoral and dangerous uses of homeopathy on Africans with malaria or AIDS.

Alderson then claims that the Society was justified in calling in their lawyers because my remarks were not criticism but defamatory. I wrote to Paula Ross asking for an explanation. None was ever forthcoming. They simply wanted to silence me.

And the Society and their members made no meaningful attempt to stamp out dangerous practices. Indeed, they went on to host a conference on treating AIDS with sugar pills and have been financially supporting members experimenting on Africans with AIDS. Let me now defame them: despicable scum.

Labels: edzard ernst, homeopathy, Simon Singh

 

Nutritional Therapists have a ‘professional body’ called BANT, the British Association for Applied Nutrition and Nutritional Therapy. BANT appear to back the formation of a unified regulator and have issued the following statement:

So, how come so few nutritional therapists have joined? Let’s have a look at the governing council of BANT and the members who are qualified and working in some professional capacity as a nurtritional therapist:

Running each of these names through the CNHC register uncovers that not one of these people has bothered to register themselves with the new regulator. It would look as if BANT is not fully behind this enterprise.

BANT is not the only body representing nutritionists. The Nutritional Therapy Council claims to be the current regulator and, according the Princes’ Foundation for Integrated Health, is “transferring the administration of its practitioner register” to the CNHC. How many of the senior nutritionists at the NTC have joined Ofquack? Well, in a display of superb openness and transparency, the NTC do not list their officers and so we cannot find out who their leaders are.

However, we can guess that not too many have rushed to join the register. For despite early signs of eagerness to join this state sponsored enterprise, the NTC issued the following statement last  February,

So, the NTC have for some reason seen fit not to transfer their powers away. Why, we do not know.

What of other senior figures in the world of Nutritional Therapy. Well, the most obvious figure is Patrick Holford, the founder of the Institute of Optimum Nutrition that has trained a significant fraction of the UK’s nutritionists. Well, obviously, Patrick has not seen fit to register himself, despite his claims to be at the forefront of  patient research. What of his various organisations that he has involvement with, like ION and the Brain Bio Institute? Well, the ION runs patient clinics. We can see a list of nutrionists who work with the public,

No. Not a single registration.

Are their education team setting an example to their students?

So, our tax money has funded the registration of quacks with the CNHC to the sum of about £4,000 per quack. It is not clear where they are going to get the money they need to keep going. The registration fees they have so far collected would keep them going for about a week. Other professions are supposed to be joining soon. Will they be forthcoming? So far only the massage therapists have been in any way compliant. And then only a couple of hundred of them.

Things must be getting pretty frantic. If Ofquack cannot get the nutritionists to play ball then the whole project must be over now. How much more money will they waste before the inevitable happens?

It is about time the government took a fresh look at this whole issue. The current situation has arisen after a House of Lords report in 2000 recommended a unified register for a wide range of alternative medicine practitioners. The governments big mistake was to put the process of setting this up in the hands of Prince Charles. Nothing sensible was ever going to be forthcoming. the farce was was predictable. It has happened.

Labels: CNHC, Complementary and Natural Healthcare Council

 

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* I have since found out that two of the homeopathic treatments reviewed were atypical homeopathic remedies and were undiluted. These were the two that have shown preliminary and tentative positive results. Do these treatments then really work? Well, at least they have some plausibility – but as the reviewers state, the positive results from these small studies need to be independently replicated. What is the betting that they will not but homeopaths will take this as all the evidence they need?

** Here is the Cochrane review...

http://www3.interscience.wiley.com/homepages/106568753/CD004845.pdf

PPS It has also just been pointed out to me that the paper on the topical cream dos not even mention the word homeopathy in it.

http://jco.ascopubs.org/cgi/content/full/22/8/1447

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Follow Up.

This is how the completely batshit site What Doctor's Don't Tell You said about the review:

Homeopathy relieves side effects of cancer therapies

15 April 2009

Homeopathy isn’t quite the quack medicine its critics claim.  It can help relieve some of the side effects of cancer therapy, the prestigious Cochrane Collaboration has discovered.

Calendula ointment eases skin irritations after radiotherapy, and Traumeel, a combination of 14 homeopathic medicines, helps relieve mouth sores caused by chemotherapy.

The Cochrane researchers found eight studies, involving 664 participants, which produced valid results.

Don't say I didn't warn you.

Labels: cochrane, homeopathy

 

Some of the quackometer functionality has not been working too well over the past few months. The Am I a Quack or Not? function was very poorly and only working for a few searches per day. The reason being that the operation depended on some very old and unsupported Google technology that was about to be unplugged. So, I have now done the work to convert over to Yahoo search.

For the interested, I am now using Yahoo Pipes where I do about five simultaneous different Yahoo searches, based on the name entered, for different aspects of quackery and then merge, sort and filter the results to produce three pages that may be utter quackery. I then run each page through the Quackometer engine to see if the pages really are quackery or not. The resulting average of the quack scores gives a score for the name you entered. You can then check out the pages yourself to see if the Quackometer got it right.

So, it is working again (I hope). Other fun things to do are to install the Quackometer Toolbar Button. This allows you to highlight a name in a web page, click the button and find out if someone might be a quack. You can also use it to test the current page you are on for quackery, or search for information on a subject from reliable sources. What fun.

Labels: quackometer

 

The pharmaceuticals are deliberately included to make it work. People think they are getting something completely herbal but it contains up to four times the dose of pharmaceuticals found in legally prescribed medicinal products. Often, such marketing claims about the supposed natural ingredients in these unlicensed products are simply an attempt to divert the consumer's attention away from very low manufacturing and ethical standards.

It might be tempting to dismiss this as an exceptional case where the herbal product required adulteration in order for it to rise to the occasion. However, some independent research has been done into measuring the levels and frequency of adulteration in herbal medicines and the results are rather startling. Bandolier, the Oxford evidence based healthcare information journal, reports that a literature survey would suggest that adulteration was widespread and that “Chinese herbal medicines may work because of the adulterants.” Surveys reported conflicting levels of adulteration, from US reports of 7% to reports showing nearly all samples containing adulterants. Bandolier conclude that  “in the absence of better information, we should assume that Chinese medicines are adulterated.” A review by Edzard Ernst concluded, “that adulteration of CHMs [Chinese herbal medicines] with synthetic drugs is a potentially serious problem which needs to be addressed by adequate regulatory measures.”

Alarming stuff. And of course, if your are lucky enough to have got from your Chinese herbalist some unadulterated herbs, then you are still left with the problem that you are about to take an unquantified amount of probably pharmacological active ingredient, mixed in with many other compounds that may or not be good for you, in a way that has not been tested for safety or efficacy and without any recourse should the herb not work or even harm you. And at the same time, your condition and herb taking is not being monitored by a qualified health worker.

Fraud in Chinese Medicine does not appear to be restricted to herbalism. It is not just adulteration that distorts our view of Chinese Medicine. Claims of efficacy can also be subject to fraud. One interesting review is by Kevin W Chen, Ph.D., M.P.H. of the University of Medicine and Dentistry of New Jersey. The review is into a branch of TCM called QiGong. Qi is the mysterious life-force that binds together so much of so called Traditional Chinese Medicine. QiGong was really invented in the last fifty years, but it has spawned a lot of research in China. Despite Kevin Chen being a True Believer, his review is interesting because it paints a fascinating picture of the nature of research in China into TCM. 

The review (An Analytic Review of Studies on Measuring Effects of External Qi in China) describes the various methods used to research Qi. However, the author notes that there are few randomised controlled studies and the field does not tend to replicate any results. As you might expect, there is complete publication bias with no negative results being considered worthy of publication.  Thus, any spurious results stand without independent confirmation. The reasons for this are interesting. Chen describes the “deliberate deception by qigong healers and in the research conducted by special interest groups that are determined to find positive outcomes”. There is a complete lack of discussion of “potential covariates that may affect the results”: positive results are assumed to be due to Qi.

Rivalry between different research teams drove bias,

Few double-blind randomization methods were used in these exploratory studies, which may greatly discount the results or conclusions, because experimenter effect and measurement bias might all become part of the observed results, especially when the specific qigong schools sponsored the research and tried to prove their own styles of qigong to be most effective.

Ten years ago, a review by Vickers et al looked at the question “Do Certain Countries Produce Only Positive Results? A Systematic Review of Controlled Trials”. They looked specifically at thousands of acupuncture trials and noted that “No trial published in China or Russia/USSR found a test treatment to be ineffective.” Even in England, “75% gave the test treatment as superior to control.” Not publishing negative results massively distorts our view of the efficacy of treatments; it can make ineffective treatments look effective, and that is not good. Pharmaceutical companies are guilty of publication bias too, but not on the scale of Chinese researchers.

Tang, Zhan and Ernst (1999) wrote a paper on “Review of randomised controlled trials of traditional Chinese medicine”. They saw a list of similar problems over all TCM. They concluded that “the quality of trials of traditional Chinese medicine must be improved urgently.”

Misleading people about acupuncture has a long history. Since, the first diplomatic contacts with communist China with Nixon, reports emerged of major operations being undertaken with acupuncture being used as an anaesthetic. What was not reported was the massive levels of patient sedation and local anaesthetic. Even the BBC were fooled and, in turn, fooled their audience when Kathy Sykes broadcast her programme, Alternative Medicine, that claimed to show that “acupuncture was used instead of a general anaesthetic during open heart surgery in China”. After a complaint and an appeal to the BBC, it finally admitted that it had misled the audience over acupuncture.

Why should Chinese Medicine be associated with so much fraud? I find this alarming. For the best part, I believe that most people working in alternative medicine are simply naive and deluded, and only harm people through omission and a negligence in not doing enough due diligence over their own beliefs. The examples I report here go somewhat further than this. China, being a nationalistic and totalitarian regime, will not produce the strongest incentives to produce honest and open research and industrial methods. Accountability will be low and  the rewards for producing ‘success’ high. Examining the research and claims of Chinese medicine in the UK is naturally made more difficult by language.

But what is more alarming is that there are signs we are approaching the regulation of much of Chinese Alternative Medicine in the belief that we simply need to uphold standards of training and ensure that traders are of ‘good character’. This will do little to stop adulterated products arriving in the UK or false and misleading claims being made by practitioners. Even unadulterated products present significant risks to customers. At the heart of the regulatory problem is a double standard. Real medicine is tightly regulated. Only a few qualified people can prescribe and dispense. There are professional regulators with teeth and drug companies are not allowed to advertise to the public and make misleading claims in their literature. Somehow, we allow herbalists to imply all sorts of unproven claims. They do not have to provide proof of efficacy or safety. There is no follow up and monitoring of side effects. We do this under the mistaken belief that Chinese Medicine is “traditional, natural and safe”. None of this is true. It is a business based on fraud, misleading claims and dangerous practices. I rarely say this sort of thing, but there is a strong case to be made to make the dispensing of herbal medicines illegal.

Labels: regulation, Traditional Chinese Medicine

 

I was going to call this post “The Failure of IT at Ofquack”, but I think the failure is a little deeper than computers. The Complementary and Natural Healthcare Council have recently put the following announcement up on their web site:

Website Hackers

We are extremely disappointed to have to share with you that we have had a number of unprecedented attempts by hackers to disable our website. We are currently taking IT and legal advice on how to resolve these issues.

Meanwhile we have reduced some aspects of the register’s functionality in order to ensure the security of personal details of applicants and registrants on the CNHC register.

If you have any difficulty in accessing any part of the CNHC website or retrieving information please call CNHC on 020 3178 2199 or e-mail info@cnhc.org.uk and we will assist you with your enquiries.

Added: 01-04-2009

This sounds quite serious. Unprecedented attempts by hackers to disable their website? I am not so sure it is as simple as that. Firstly, a number of people have noticed that the CNHC were listing their members’ full personal details. Search for a name by putting in an initial letter and all quacks that had joined were listed along with all their details. It was easy to do so. The search functionality allowed you to enter simple wildcards and the results would list everyone on their register. Not only names, but home addresses and telephone numbers.

Their own privacy policy states,

The Published Register
CNHC will make part of your register entry available to any enquirer as part of the published register.

The public can inspect the following information on the online register:

• Your full name
• Your profession or practice discipline
• Your approximate work location
• Your registration number
• Any restrictions imposed on your registration

Your home address, contact details, date of birth and other data are not available to the public.

In publishing their registrant personal contact details, the CNHC were in quite a serious breach of trust. The legality of publishing the details is dubious too, since the Data Protection Act insists data is only used for stated purposes.

In the last few days, it is no longer possible to gain these details on the CNHC web site. Far from them “reducing some aspects of the register’s functionality” because of “hackers”, the CNHC have finally stopped dishing out their members private data to all and sundry. Hackers have nothing to do with the “loss of functionality” – they were managing to cause privacy leaks all on their own.

But did some malicious person try to disable their web site? Well, last week I twittered that the CNHC web site was down. Well, it was not quite down, but the content management system was spewing out an error. What was quite remarkable was that a complete dump of debugging information was being returned to my browser. This information was giving me lots of information about the nature of their server and he code they were using to run the web site. In web site security rulebooks, this is a number one no no. “If an error is encountered, do not return technical error information to the user”. Such information is invaluable to a real hacker. Even if a hacker does compromise your server, you do not return more fuel for them to use. There is only really one conclusion I can make – Ofquack’s IT team are utterly incompetent. I can well believe that the CNHC management were told “it woz hackerz wot dun it” when the web site crashed.

So, it would look like the CNHC IT system is not fit for purpose. Not only was there a failure to describe proper functional requirements for the web site, including what data should be displayed, it would also look like it has been coded in a compromisingly amateurish way. I would not want my own data on the site.

I have no idea if hackers really did have a go at their site. And I would not condone such silliness. But the CNHC would appear to have been negligent in not anticipating problems and in not protecting their data. The web is a wild place and there are people out there who like attacking naive web sites just for the hell of it. You need to be prepared. You do not leave your front door open just because you live in a nice village of homeopaths and nutritionists.

But the bigger issue is that Ofquack is not being entirely open. There may well be people who want to see a list of registered members for perfectly legitimate reasons. The CNHC are providing a public service and have been funded by public money. We deserve some transparency in what they are doing, especially given that they have been so heavily criticised. They claim in their statement of values to be “open and transparent in our business”. I see little evidence of this.

My main criticism of the CNHC is that they have failed to answer the single most important question about themselves. Given that their “key purpose” is to “protect the public by means of regulating practitioners” they have not said how this is possible when they will not take into account if any of the alternative medicine techniques they claim to regulate are actually effective. If their members are making false, delusional or even fraudulent claims to the public, how do the CNHC claim to protect the public if they are not concerned about the truth of their members’ claims? There has been no “open and transparent” response to this concern.

Their website claims that “in order to meet our commitment to transparency, CNHC will make the minutes of its Board Meetings available.” They have failed to do this. Worse, they had published some minutes but have since removed them from public scrutiny.

I can speculate why this must be. In my last blog post on Ofquack, I noted that they had only managed to attract about 150 members. Given that they need 10,000 members to break even, they have managed to acquire independent funding to keep them afloat for a week. They have achieved less than 2% of their required income levels. Maybe they are hoping that by starting to regulate more forms of quackery later this year, they will make up the missing 98%. I would suggest, like all quackery, they are indulging in wishful thinking.

So, panic must be setting in. The main aspect of their register's functionality they have removed is the ability to easily see how many members they have attracted. I would suggest that this is not the result of ‘hackers’, but an attempt to keep under wraps the increasing failure of this folly.

Labels: CNHC, Complementary and Natural Healthcare Council, ofquack

 

My automated scans of the internet for all things about quackery have thrown up some interesting news today. The German newspaper Bild is reporting that an academic homeopathy journal is about to publish the discovery of fragments of a new edition of Hahnemann’s Organon. (translation here from "Die Entdeckung einer verlorenen siebte Auflage des Organon?") For those not familiar with the origins of homeopathy, its inventor, a German doctor, wrote about all his discoveries and musings in a big book called the Organon. During his lifetime, he published five editions of his great work. Finding a new, previously unknown, version of his manuscript is not without precedent. The sixth edition of the Organan was discovered after his death and was finally published in 1921, some 80 years posthumously.

What makes this quite interesting is that the Organon is treated like holy scripture to homeopaths. If a homeopath wants to know what is the correct way to prescribe their sugar pills, they are told to consult the Great Book. But like all scripture, disputes can break out over interpretation. Disagreements persist about how many pills to give a patient, whether homeopathic vaccines work, wether like-cures-like is always true, and if same-cures-same (isopathy) is also viable. Wilder homeopaths dabble with homeopathic electronic remedy machines and magic MP3 files. All can find justification in the Organon (or at least one edition of it.) Scientific experiments are not done to resolve disputes because they tend to show that no alternative interpretation is viable. Something has to give – and it is the scientific method in favour of the Organon Scripture. So, will the new Seventh Edition of the Organon create havoc? Is this the quackery version of the dead sea scrolls?

It would appear that Hahnemann was not beyond dabbling in wild speculation about homeopathy. Undoubtedly, if he was alive today, he too would be downloading curative homeopathic MP3 files. The newspaper article is not long and does not give too much detail, but (forgive my minor German)  appears to suggest that the ‘Seventh Organon’ delves off into “Animal Magnetism and Homeopathic Mesmerism”. Remarkable.

The newspaper claims that (translation) “It would appear that the doctor had continued his work on replacing dilutions with mesmerism and had completed experiments on the resuscitation of dead dogs. He died shortly afterwards.”

Could this be true? Well, it does indeed follow on from work he did in the Sixth edition. We are told,

I find it necessary to allude here to animal magnetism, as it is termed, or rather mesmerism (as it should be called, out of gratitude to Mesmer, its first founder), which differs so much in its nature from all other therapeutic agents. This curative power, often so stupidly denied, which streams upon a patient by the contact of a well-intentioned person powerfully exerting his will, either acts homœopathically, by the production of symptoms similar to those of the diseased state to be cured; and for this purpose a single pass made, without much exertion of the will, with the palms of the hands not too slowly from the top of the head downwards over the body to the tips of the toes,¹ is serviceable in, for instance, uterine haemorrhages, even in the last stage when death seems approaching; or it is useful by distributing the vital force uniformly throughout the organism, when it is in abnormal excess in one part and deficient in other parts, for example, in rush of blood to the head and sleepless, anxious restlessness of weakly persons, etc., by means of a similar, single, but somewhat stronger pass; or for the immediate communication and restoration of the vital force to some one weakened part or to the whole organism, - an object that cannot be attained so certainly and with so little interference with the other medicinal treatment by any other agent besides mesmerism. If it is wished to supply a particular part with the vital force, this is effected by concentrating a very powerful and well-intentioned will for the purpose, and placing the hands or tips of the fingers on the chronically weakened parts, whither an internal chronic dyscrasia has transferred its important local symptom, as, for example, in the case of old ulcers, amaurosis, paralysis of certain limbs, etc.

Pause for breath. He did go on, didn’t he?

But, blimey. It does indeed look like he had invented Reiki.

Hahnemann goes on some more:

Many rapid apparent cures performed in all ages, by mesmerizers endowed with great natural power, belong to this class. The effect of communicated human power upon the whole human organism was most brilliantly shown, in the resuscitation of persons who had lain some time apparently dead, by the most powerful sympathetic will of a man in full vigor of vital force, and of this kind of resurrection history records many undeniable examples.

Wow. Hahnemann believes that his homeopathic mesmerism can bring the dead back from life. Did he really spend the last years of his life experimenting with dead animals and seeing of they can be bought back to life? Did he really abandon his beloved dilutions in favour of the more fashionable mesmerism? Fascinating stuff.

If this true, it does look like Hahnemann spent his last years in Paris as some sort of role model for Mary Shelley. What monster did he create? Without access to the published ‘new’ seventh edition, we do not know yet. One hint comes from a rather strange source: Charles Dickens. He wrote about homeopathy in his rather obscure novel The Mudfog Papers. In this novel, published in 1837 at roughly the time these exeriments in re-animation were taking place, he introduces us to a character called Sir William Courtenay who believed that homeopathy can raise the dead.

MR. PIPKIN (M.R.C.S.) read a short but most interesting communication in which he sought to prove the complete belief of Sir William Courtenay, otherwise Thorn, recently shot at Canterbury, in the homoeopathic system. The section would bear in mind that one of the Homoeopathic doctrines was, that infinitesimal doses of any medicine which would occasion the disease under which the patient laboured, supposing him to be in a healthy state, would cure it. Now, it was a remarkable circumstance--proved in the evidence--that the deceased Thorn employed a woman to follow him about all day with a pail of water, assuring her that one drop (a purely homoeopathic remedy, the section would observe), placed upon his tongue, after death, would restore him.

Did Dickens know of Hahnemann’s last works?

We shall see. Maybe some homeopaths will not want to dabble in mesmerism and call it all a heresy. Maybe others will embrace the chance to raise the dead back to life. I, for one, would like to see what Prince Charles will do with this new knowledge. Will we see his Duchy Originals creating a “Dead Dog Revival Tincture” and the Foundation for Integrated Health create a “Universal Lazarus Potion” for the NHS?

Unfortunately, the world of homeopathy is beyond satire. I try my best.