PS1620 Lecture 6: Alternative Medicine

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PS1620 Lecture 6 Alternative Medicine

• Mike Eslea
• 11 March 2005
• www.uclan.ac.uk/psychology/bully

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Outline

• Herbalism
• Oriental Medicine
• Acupuncture
• Gimmicks Gadgets
• Magnets
• Water
• Homeopathy

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Aims Objectives

• To examine some of the most popular forms of CAM
• To consider the evidence for/against the
  effectiveness of CAM therapies
• To consider the reasons people believe in
  unproven therapies

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Herbalism

• Herbalism involves the medical use of plant
  compounds
• Traditional Many have been used for hundreds
  (thousands?) of years
• Natural
• Is herbalism paranormal?
• Not really of course, there are plenty of ways
  that plant extracts can affect the human body

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St Johns Wort

• St Johns Wort is a very widely used
  anti-depressant, similar in many ways to Prozac
• It has been tested in double-blind controlled
  trials, and shown to be effective

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Problems With Herbalism

• Lack of proper testing
• Effectiveness St Johns Wort is unusual in
  having been tested. Most herbal remedies (85)
  have never been properly evaluated against
  placebos or mainstream alternatives
• Safety Few (11) have even been tested for
  safety
• Lack of testing is, in effect, the definition of
  a CAM
• Compare with dowsers and psychic detectives (last
  week)

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Problems With Herbalism 2

• Interactions with other medicines
• Sellers users are often ignorant of recommended
  uses precautions
• Perhaps because people forget natural
  substances are still medicines, they often forget
  to mention them to their doctors
• Lack of standardisation (compare aspirin)
• Active ingredient Varies wildly
• Contaminants Unknown unpredictable
• Pan Pharma

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Herbalism Conclusions

• Sensible use of herbal medicine may be effective,
  but you should be cautious

Slightly Barmy
Mad As A Lorry
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Oriental Medicine

• A set of ancient mystical beliefs, centered
  around an energy known as chi or qi
• Flows through channels known as meridians,
  between organs known as Zang Fu
• Often needs unblocking or balancing via
  acupuncture, reiki, therapeutic touch
• Oriental medicine also features a great deal of
  sympathetic magic
• Rhino horn or tiger penis makes you potent

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Contrast With Scientific Medicine

• Not compatible with modern knowledge of
  physiology, biochemistry, nutrition, anatomy,
  cell chemistry, blood circulation, nerve
  function, hormones, disease pathology
• Virtually untested (lots of studies, but of very
  poor quality)
• Losing popularity in China
• Medicine of the poor
• Spread of scientific medicine has coincided with
  massive increase in life expectancy

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Acupuncture

• Is acupuncture paranormal?
• Not really Sticking needles in people may well
  have SOME effect
• Does it work?
• There is some weak evidence that acupuncture is
  effective against pain and nausea
• BUT It is very difficult to have a convincing
  placebo group

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Acupuncture Tests

• New placebo needles offer a useful method
• Have been used in controlled studies of post-op
  nausea
• No significant benefit
• Surveys have revealed some quite nasty side
  effects errors, but (as long as the equipment
  is sterile) it looks like acupuncture is pretty
  safe overall

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Acupuncture Conclusion

• It seems unlikely that acupuncture will ever be
  shown to be effective
• Some argue that it may work via endorphin
  stimulation
• Jalapenos have the same effect!

Slightly Barmy
Mad As A Lorry
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Gimmicks Gadgets

• Approx 1 billion is spent on magnetic therapy
  devices each year, worldwide
• Mostly used for pain relief
• Also, golf
• Despite costing hundreds,most medical magnets
  arebasically the same as theones on your fridge

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Magnetism

• Some sellers claim that magnets work on the iron
  in the human body
• In fact, the water in the human body is so weakly
  diamagnetic, it would need a vast magnet to have
  any effect

To see the levitating frog, go to www.hfml.science
.ru.nl/levitation-movies.html
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Water Quackeries

• Billions more are spent on water and
  water-treating devices
• Energizing, Balancing, Oxygenating,
  Clustering, Magnetizing etc etc...
• Most are indistinguishable from tap water
• Because they ARE tap water!
• There is no evidence of any benefit from any of
  these water quackeries

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Magnets Waters Conclusion

• These gimmicks are largely harmless to health
• Except when real ailments go untreated
• But they are severely harmful to wealth, so...

Slightly Barmy
Mad As A Lorry
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Homeopathy

• Similar in many ways to herbalism
• Uses many of the same compounds, as treatment for
  the same ailments
• Based on the law of similars (sympathetic
  magic)
• Compare with allopathy
• BUT In homeopathy, the remedies are extremely
  diluted
• The law of infinitesimals
• Compare with dose-response

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Dilution

• Homeopathic remedies are classed according to the
  levels of dilution
• X means diluted to 10
• C means diluted to 1
• Between dilutions, the solution is succussed
• 10X means the 10 dilution is repeated 10 times
• 30C means the 1 dilution is repeated 30 times
• Some remedies are 200C!

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Dilution 2

• A typical homeopathic dilution is 30C (or 1E60)
• How much water would we need to produce a 30C
  dilution with one single molecule of the active
  ingredient in?
• One mole of water occupies 18.02cc. A mole
  contains 6.02E23 molecules (Avogadro) so one cc
  contains 3.34E22 molecules.
• Therefore, 1E60 molecules would occupy 2.99E38cc.
  
• The volume of a sphere is 4/3 ?r³, and the radius
  of Earth is 6.37E8cm, so the volume of Earth is
  (approximately) 1.08E27cc.
• This gives 2.76E10, or nearly 30 billion earths!

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Can Something Diluted So Much Still Have An
Effect?

• YES! (Say the homeopaths)
• A small number of tests have found some effect of
  homeopathic medicines
• But meta-analysis suggests this is mostly due to
  poor study design

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Homeopathy Conclusion

• There is no evidence to suggest that homeopathy
  is better than placebo for any condition
• Walach calls it a magical effect
• Yet it is a vast industry, including NHS
  hospitals, scientific journals etc, so...

Slightly Barmy
Mad As A Lorry
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Why Do People Believe In Nonsense Remedies?

• People get better, naturally, when a disease has
  run its course
• Diseases often have ups and downs
• Placebo effect (compare with nocebo effect)
• People are selective in the way they give credit
  for any improvement
• Maybe the diagnosis was wrong
• Maybe the patients mood has improved
• Psychological investment influences perceptions

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Conclusions

• CAMs range from the slightly daft to the
  completely barking.
• Many rely upon paranormal forms of energy that
  have never been detected scientifically
• Like the applied paranormalists lasts week, many
  CAM enthusiasts either
• Refuse to be tested
• Submit happily to testing, but reject negative
  results
• The vast CAM industry is just a house of cards...