CHEM 183 Lecture 11 - David Harpp PDF

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David Harpp...

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Lecture #11 Alternative Medicine What is alternative medicine? Not a simple answer -> whatever is not taught in medical school  Not enough evidence to allow it to be taught to medical students, not because it may not work Anton Mesmer (1734-1815)  Graduated from medical school  Became interested in loadstones (naturally occurring magnets) o Began to show that magnets could pull disease out of the body by getting patients to hold onto metal rods -> about 30-40% of the time the patients started to feel better  This is the common statistic for the placebo effect o None of this sounded good to King Louis XVI -> constructed a community to examine "mesmerism"  This community consisted of: Benjamin Franklin (US ambassador to France at the time), Joseph-Ignace Guillotin (did not invent the guillotine but did suggest its use during the French revolution), and Anton Lavoisier (leading French chemist at the time)  They examined Mesmer's work and came up with a report -> stated that a lot of the time Mesmer was able to cure people, but they dismissed this b/c they claimed "the healing was all in the imagination" Acupuncture:  Some studies that show it works for some patients, exactly why it works is up in the air, however the placebo effect undoubtedly has some effect on this Cupping:  Small glass containers heated up, creates a vacuum and skin gets sucked up into the cup & unknown toxins apparently get sucked out of the body  The only thing you're really left with is the mark of the cup, sometimes it is hardly noticeable, but when you leave it on too long then your blood vessels can burst and leave you with what looks like terrible burns Pigeon therapy:  Originated in the middle ages  Patient complaining of abdominal pain, then the therapist comes and takes a pigeon and puts it on the abdomen… then all of a sudden the birds head falls over and dies… the death of the bird symbolizes that the disease has been passed to the pigeon o If the patient says they do not feel better, then the pigeon is discarded and a second live pigeon is used… if that feels then a third pigeon is used… by that time the patient usually says they feel better  This is still used today, but the therapist is actually killing the bird (snaps its neck)

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Placebo effect yet again

Urine therapy:  "Urine is a magic elixir" -> benefits of drinking urine, usually drink their own urine (not dangerous to do)  World conferences held on this, instead of a coffee break they have a urine break -> no evidence that they get sick from this, no reason to think there's any kind of benefit (except in placebo effect cases) Ear candling:  Hollow wax candles that are supposed to draw disease out of the body  Put it in your ear, light one air, supposed to create suction and draws ear wax out of your ear o Once the candle burns down, they take the remnant and cut it open to show you the ear wax that was "sucked out of your ear" (but, its really the wax from the candle that hardens and cools at the bottom, not ear wax) o Many people still felt better because of the placebo effect What links everything together is the lack of evidence of efficacy  Alternative becomes conventional with evidence  It is up to people who make a claim to show that it can happen  Best example: treatment of ulcers o Dr. Barry Marshall (Perth, Australia 1983) -> suggested that ulcers were caused by bacteria, lots of people thought he was crazy  Proved his point by swallowing helicobacter pylori, developing an ulcer, and then curing it with antibiotics  It was clearly shown that helicobacter pylori were responsible for about 80% of ulcers Need to make sure alternative medicine is science based  Experience, peer review, plausibility, and critical thinking are all necessary Why do patients use alternative medicine?  Dissatisfaction with the efficacy of conventional medicine o It can't cure everything  Dissatisfaction with the "hurried" approach of conventional physicians o Average time that a physician sees a patient in Canada is 7 minutes o Not enough time being spent with patients  Distrust of "big pharma" o Make too much money selling their ineffective drugs  Belief that "natural" healing methods are superior  Annually, there are more visits to alternative practitioners than to conventional physicians o The keys to alternative medicine are the charisma of the providers and the faith of the patient  Ex. Dr. Andrew Weil -> Harvard trained physician, but spends a lot of time with herbalism, the mind overcoming ailments, etc. The Dr. Oz Show

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Properly trained physician, not everything is nonsense "Miracle of the day" -> miracle pill, palm oil, no exercise or effort, green coffee bean extract, etc. o The miracle of each day obviously isn't that effective since there's a new one claiming to do the same thing each day o There is not a single study in humans that shows any weight loss with raspberry ketone Gotten a lot of criticism for "promoting quack treatments" o Has become an "actor playing the role of Dr. Oz", not possible for someone being trained the way he was to buy into any of this o Just wants to be famous

Alternative medicine concerns:  Misrepresentation of conventional medicine  Introduction of pseudoscientific ideas  Misrepresentation of efficacy and safety of treatment  Steering patients away from possibly effective treatments Why the belief in alternative medicine?  Frustration with conventional medicine  Lack of understanding of the nature of disease  Lack of understanding of cause and effect  Lack of understanding of the placebo effect  Lack of realization that therapists will say things that simply are not true  Lack of understanding of anecdotal evidence Naturopathy Nature provides a cure for everything  A naturopath is a health practitioner who avoids the use of drugs or surgery in favour of "natural" therapies that include fasting, nutrition adjustments, homeopathy, acupuncture, and herbal medicine, as well as the use of modern methods like bio-resonance, ozone-therapy, and colon hydrotherapy. o They do learn some things, but nowhere near what a trained physician would learn o What they have that doctors don’t have is time -> they will spend a lot of time with a patient and ask tons of questions, so then the patient feels like the naturopath is really listening to them and caring for them  Most of the time they're treating diseases that would go away on their own anyway  At a time when modern technology, environmental pollution, poor diet, and stress play a significant role in the degradation of health, a naturopath's ability to apply natural methods of healing is of considerable importance. "Applied Kinesiology" Not the same as kinesiology at all  Magnetic bracelets, healing bracelets, healing patch, etc. is what they use in applied kinesiology  They do not apply the same force at both tests

Applied kinesiology is a technique that claims to be able to diagnose illness or choose treatment by testing muscles for strength and weaknesses Homeopathy What ISN'T it?  Not an overarching term for every type of alternative medicine  Many times things are mislabeled as homeopathic Definition: a therapeutic system of "medicine" that is based on the hypothesis of "like cures like", which means that a substance that can cause certain symptoms in a healthy person can cure similar symptoms unhealthy person  Homeopathic medicines are derived from a variety of plants, animal materials, and minerals. o They are prescribed to fit each individual's needs, given in much smaller and less toxic doses than traditional medications, and are used for both prevention and treatment Invented by Samuel Hahnemann (1755-1843)  A physician trained in the practices of the time (such as using a lancet and leeches for bloodletting, purging, etc.) o Some of the treatments studied then actually worked, such as cinchona  Became known as Peruvian bark and would reduce fever  But, never knew how much to give a patient… what was an unsafe amount to give? He started to test this on himself  Began to do "provings", tested cinchona bark and realized in a diluted sense it may work to cure malaria  BUT, in 1991 Professor W. H. Hopff found that cinchona did not trigger malaria symptoms, so it was a total coincidence -> original concept of homeopathy was based on a fallacy  He "proved" that a diluted solution of arsenic could be used to cure food poisoning (gastric pain, vomiting, diarrhea)  Investigated "Spanish Fly" which would be the treatment for urinary problems  With all of his provings he documented all of the "like cures like" in a journal type thing o Law of Infinitesimals -> didn't realize that once he diluted it a bunch that the final solution actually didn't contain anything o Principle of succussion -> need to bang the solution into a leather pillow a hundred times in order to potentiate the non-existent molecules in that solution  By the time you get to a 12C dilution, there isn't a single molecule of the original left  Usually they (homeopaths) recommend a 30C dilution, but at this point it doesn't even contain any water molecules that had come into contact with the original substance A large range of homeopathic remedies are sold  "Homeopathic drugs act like vaccines by stimulating the immune system" -> interesting b/c most homeopaths are actually anti-vax  No risks associated b/c it contains nothing, but it won't protect people when they think that it might (so the claims may be dangerous)

We dismiss homeopathy b/c there is no evidence behind it, not because it is also implausible  Conclusion that the effects from homeopathy are actually the placebo effect  In Canada homeopathy is approved, and has a DIN-HM (drug identifying number - homeopathy) -> this does not say that it is effective though o Have no banned them, but have made them put "this product is not intended to be a substitute for vaccination" if sold in stores Why does homeopathy persist?  The placebo effect  Regression to the mean: suggests that symptoms may be excessively severe one week, but less severe the next simply by random fluctuations. If treatment is only sought when these symptoms are at their worst, there will almost always be a coincidental recovery. o This appears even if the treatment has no effectiveness whatsoever  Standard treatments are also being used  Lifestyle changes recommended by homeopath  Fear of conventional treatments Therapeutic Touch Therapeutic touch:  Touching the body in a specific way in order to 'heal' it  Human body is surrounded by some sort of energy field, which you can massage back into its proper orientation Can sense when the body's energy field is out of balance 10-year-old girl did a science project on this, to see if therapeutic touch practitioners could feel the energy field, etc.  Were right 50% of the time (total guess work), b/c you can't feel the body's "energy field" Ex. Reiki Tapping solution: "a combination of ancient Chinese acupressure and modern psychology"  It is said to be useful in relieving such conditions as migraines, fibromyalgia, phobias, body aches, etc.  Tapping certain parts of the body with two fingers...