The media announced that the NIH had given its blessing to acupuncture following the Nov.3-5 NIH Consensus Conference. Some sources reported this story as "NIH approval of acupuncture." To properly interpret this event one must first appreciate the nature of an NIH consensus statement. According to NIH, consensus statements are prepared by a nonadvocate, non-Federal panel of experts based upon presentations and discussion at the conference. Such statements are NOT policy statements of the NIH or the Federal Government. "Consensus," on any topic, represents a pooling of opinion. Expert opinion is always a combination of experience, interpretation, and ignorance. A new sound scientific study can cause sudden dramatic shifts in consensus.
NCAHF's review of the consensus panel does not give us confidence in the idea that it substantially consisted of nonadvocates, but even if it were, the conference presentations were clearly unbalanced. When NCAHF reviewed the literature on acupuncture up to 1989, it found a predominance of negative findings. Two major meta-analyses by Riet, et al, [Riet, et al. "Meta-analysis; acupuncture on addiction," Brit J Gen Pract 1990;40:379+; Riet el al. "Meta-analysis; acupuncture and pain," J Clin Epi 1990;43:1191+) that covered the same time period found the same predominance of negative outcomes. The 1993 FDA review of acupuncture was also consistent with the negative findings. (Lytle CD. An Overview of Acupuncture. USDHHS, Public Health Service, FDA Center for Devices & Radiological Health, May, 1993.) We are not aware of any major scientific findings since then that would change the view that acupuncture is mostly a powerful placebo and/or a psychological aid for use in managing behavioral disorders. The presentations at the conference only strengthened this view.
Most outstanding to us was the absence of negative reports. A balanced program would have contained a representative proportion of negative studies. An objective consensus panel functions much like a jury at a court trial. It bases its verdict upon the evidence that was presented. If one side fails to enter significant adverse data into evidence, the jury cannot be blamed for an erroneous conclusion. To us, the consensus conference appeared strongly biased toward putting the best face possible on acupuncture. The data suggest that acupuncture use by the public is diminishing. Was this a public relations event aimed at marketing acupuncture? The good name of NIH seems to be being abused more and more often to sell the public on the value of scientifically impoverished methods of health care.
Two recent useful articles on acupuncture appeared in Priorities 1997;9(3): "Not all acupuncture is quackupuncture," by George Ulett, MD, PhD, and "A bird's eye view of Chinese medicine," by Jack Raso. Also, Jane Brody's coverage of the conference was commendable [NY Times, Health, 11/1897].
NCAHF's William Jarvis says that misinformation and misbelief underlie most nutrition-related quackery. Therefore, monographs that deal with these aspects of the problem are useful to anyone who is trying to cope with dietary quackery on a practical level.
Drs. Barry and Seymour Mishkin, who are, respectively an internist and gastroenterologist, discuss nutritional self-help literature that is directed at the public. Writers, some of whom are physicians or people with credentials in nutrition, of popular nutrition literature avoid scientific and medical review as they propound crackpot notions about diet and health. The authors discuss popular misconceptions regarding food allergies, table sugar, food combining, the alleged "French paradox," and dietary supplements. The authors analyze how popular nutrition writers utilize the "sound bite" to capitalize upon nutrition misinformation and misbelief. They even give credit for some of the positive effects that may come from recommendations that cause people to take in more fruits, vegetables, nuts, and seeds, but advise the public to be alert and skeptical about popular self-help nutrition books.
Most useful is the authors' recommendations on what doctors should tell their patients about alternative medical practices related to diet. They provide an analysis of key differences between standard medical practitioners and food faddists, and lists of reliable sources of nutrition information, including information on inflammatory bowel disease, for doctors and patients.
(Mishkin B, Mishkin S. "Dietary fads and gut mysteries vs nutrition with a grain of common sense," Canadian J Gastroenterology, 1997;11:371-5).
The Philadelphia-based Vegan Resistance Liberation circulated a news release claiming that it had contaminated thousands of supermarket turkeys with a lethal substance prior to Thanksgiving. This terrorist tactic has been used in both the USA and Canada for several years. A curious aspect of this matter is that one of vegetarianism's traditional arguments has been that eating meat makes people blood-thirsty and more warlike, and that conversely, vegetarianism "cools the animal passions." The animal rights activists are vegetarians, but this apparently hasn't quelled their appetite for the blood of people who do not share their ideology. Animal rights zealots are deserving of the label "Vege-Nazis" because of their willingness to engage in mind-control, coercion, and violence to achieve their ideological ends.
In June, 1997, LLU Medical Center surgeon, Dr. Leonard Bailey, revealed on ABC's television show Turning Point that the reason that he discontinued his productive research into using baboon hearts to save the lives of infants born with heart defects was due to the death threats he and his family members received from animal rights terrorists. Bailey said that for more than a year following the Baby Fae experiment the police had opened his mail to protect him from letter bombs. He said that living with the constant threat of mayhem by animal rights terrorists was an unacceptable way to live for a clinical researcher.
Ginkgo biloba may benefit Alzheimer's patients, but its anticoagulating effect may cause bleeding in patients also taking aspirin, vitamin E, or garlic.
Ginseng may benefit diabetics but also can cancel the effects of warfarin.[Am J Health Syst Pharm 1997; 54:692-3]
St. John's wort is an antidepressant; do not mix its use with other such drugs.
Want to know more about possible drug-herb interactions?
The publishers of Pharmacist's Letter and Prescriber's Letter have developed a chart with information about over 50 common herbs, including their possible interactions with conventional drugs, and they have agreed to provide a complimentary copy to members or subscribers to the NCAHF Newsletter. If you are interested in obtaining a free copy of this chart, contact Pharmacist's Letter or Prescriber's Letter at P.O. Box 8190, Stockton, CA 95208; telephone: 209-472-2240; fax: 209-472-2249, and identify yourself as a reader of the NCAHF Newsletter.
In late 1997, researchers at the Baylor College of Medicine reported on a double-blind, placebo controlled study in which a device delivering static magnetic fields of 300-500 Gaus over a pain trigger point resulted in significant, prompt relief of pain in patients with chronic post-polio pain. Interestingly, the patients treated by placebo devices experienced statistically significant pain relief (p<.005), but the magnet-treated patients experienced still significantly greater relief (p<.0001). (A magnetic field of one gauss is about twice the magnetic field at the earth's surface. 300-500 is a weak field. Refrigerator magnets run from 80-100 gauss, and Magnetic Resonance Imaging is done in a field of 10,000 gauss.)
Chief researcher, Carlos Vallbona, MD, told NCAHF president William Jarvis that their results only can be generalized to post-polio pain patients because the mechanism--which is unknown--may involve neurological factors unique to that condition. However, in a Nov. 13 telephone conversation, Dr. Vallbona speculated that other types of pain may eventually be shown to respond.
[Vallbona C, Hazlewood CG, Jurida G. "Response of pain to static magnet fields in post-polio patients: a double-blind pilot study," Arch Phys Med & Rehab, Nov, 1997, pp.1200-03]
The $12 million spent on the NIH Office of Alternative Medicine doesn't sound like much considering the entire NIH budget, but the folly of spending money on unpromising alternative medicine just because some politicians fancy it, came home to us at Loma Linda University when President Clinton used the line-item veto to kill a $4 million research project that would have tested the effectiveness of the LLU medical centers' proton beam accelerator on breast cancer. The proton device delivers narrowly targeted beams of radiation to moderate-sized solid tumors. It's only when real world projects such as this get set aside that one begins to appreciate the impact of diverting even a few million dollars to dubious projects.
[The Sun (San Bernardino); Press-Enterprise (Riverside) 10/15/97]
Authors of a meta-analysis of placebo-controlled homeopathic trials concluded that the clinical effects of homeopathy appear to be more than merely placebo effects, but that there was insufficient evidence that homeopathy is clearly efficacious for any single clinical condition. The authors stated that "further research on homeopathy is warranted provided it is rigorous and systematic."
[Linde, et al. "Are the clinical effects of homeopathy placebo effects? a meta-analysis of placebo-controlled trials," The Lancet, 1997;350:834-43.]
Comment: The authors did not consider the possibility that homeopathic remedies could have been adulterated, or may have contained effective amounts of standard ingredients. Homeopathic remedies are described in terms of their number of dilutions rather than by quantitative analysis. No test of homeopathy can be fully understood without quantitative analysis by an independent laboratory. The sectarian nature of homeopathy raises serious questions about the trustworthiness of homeopathic researchers. Scofield appropriately stated: "It is hardly surprising in view of the quality of much of the experimental work as well as its philosophical framework, that this system of medicine is not accepted by the medical and scientific community at large."
Because homeopathy's "laws" contradict with the basic laws of physics, chemistry, and pharmacology, a caveat laid down by Thomas Paine is appropriate. Paine warned, "is it easier to believe that nature has gone out of her course, or that a man would tell a lie?" Two guiding rules required by skeptics of paranormal research should be applied to homeopathic research, to wit: (1) extraordinary claims demand extraordinary evidence; and, (2) it is not necessary to prove fraud, rather, the research must be done in such a manner that fraud is not possible. A homeopathic study that does not include independent monitoring and quantitative analysis of the remedy is inadequate and must be suspect. Further, a reverse dose-response curve would have to be demonstrated as well to validate homeopathic thinking.
Manassas, VA, physician, Donald L. MacNay's license was suspended by the Virginia Board of Medicine following the investigations of three of his patients who he had treated with an aloe vera substance intravenously. All were cancer patients from outside Virginia. A Maryland woman says that her husband also died following MacNay's treatment. MacNay charged $12,000 for the treatment which is not FDA approved, nor deemed worthy of use by the NCI.
[American Medical News, 10/13/97:10]
Julian Whitaker, MD, of Newport Beach, CA, publishes a variety of health tabloids, magazines and newsletters in which he modestly bills himself as "America's #1 health advocate," "America's #1 health champion," and "the physician America trusts." Whitaker said in 1993 that his Health & Healing newsletter had 475,000 paid subscribers.
Doctor-Bashing, Anti-Government Rhetoric
Whitaker's publications regularly bash standard medicine and the government regulators. Headlines cry out: "Forbidden Cures!"; "Censored Cures!...treatments organized medicine doesn't want you to know about"; "Miracles of healing censored by the medical establishment"; "cures that greedy drug companies and FDA bureaucrats don't want you to have." One Wellness Today cover picture shows Uncle Sam holding his hands over the eyes of a female who is holding a prescription container in her hands. The "cures" often turn out to be dietary supplements that Whitaker sells.
Champion of Maverick Medicine
Whitaker has taken up the causes of others in legal or ethical difficulty. In 1995, he viciously attacked the American Dietetic Association for its attempt to discipline Shari Lieberman for violating the ADA code of ethics. (See Raso "Progressive or renegade? Shari Lieberman up-close," Nutrition Forum, 1994;11:9-15.)
More recently, he took up the cause of Stanislaw Burzynski, MD, who was on trial for violating a court injunction against the interstate distribution of his unapproved cancer remedy. Whitaker offers his personal inspection of Burzynski's facility as proof of its validity. Whitaker is Past President of the American Preventive Medical Association (APMA). (Ms. Lieberman a APMA board member.) APMA is largely made up of chelation therapy practitioners who lobby for laws that would strip medical licensing boards of their power to discipline maverick doctors who use chelation therapy for questionable, unapproved purposes.
Such is done under the guise of patient freedom of choice, but, in actuality, would excuse dubious doctors from accountability. Whitaker writes pro-chelation therapy articles such as "why angioplasty and bypass surgery won't work," and books such as, Is Heart Surgery Necessary?
Whitaker is also heavily involved in an anti-aging scheme. According to the Wall Street Journal (1/10/96) Whitaker is part of Howard Turney's U.S. network that supplies aging men with human growth hormone (HGH). (Turney heads a clinic in Cancun, Mexico that dispenses a 90-day personal supply of HGH to clients, and a Houston based company, El Dorado Rejuvenation & Longevity Institute which gives physicians exclusive rights to treat patients in a geographic region.) An article entitled "A Hunger to be Younger" (Jane Haas, The Register [Palm Springs area], 8/11/96) says that Whitaker takes HGH himself. HGH is not snake oil. Its a prescription drug marketed by Genentech and the Eli Lilly company--pharmaceutical companies like those that Whitaker condemns. The EDTA used by chelationists is also a standard drug product for treating lead poisoning. Even vitamins, which Whitaker fondly promotes, are manufactured by drug companies. The logic that drug companies would somehow want to suppress the use of these items escapes me.
Why Whitaker Attacks NCAHF
Whitaker began attacking NCAHF after I had security officers escort him from the room as a result of his attempt to take over my presentation on cancer quackery on April 7 at Loma Linda University (LLU). I am one of several LLU faculty members who lecture for the LLU Medical Center's Cancer Institute series. The program, "Cancer quackery: what you should know," was advertised throughout southern California. Several days before the event, Whitaker telephoned Jimmie Loder, the program coordinator, and asked for equal time to make a presentation on the Burzynski case. She denied his request.
Whitaker then telephoned me personally and asked if I was going to discuss Dr. Burzynski. I told him that I did not intend to discuss Burzynski in any detail, but that his name would probably come up because of the publicity being given his trial. Whitaker suggested that I discard my presentation and substitute a debate between him and me over the Burzynski case. I declined stating that this would not suit my audience which had little interest in the matter. He asked if he could be given equal time to rebut my presentation. I said, no, because neither time limitations nor the situation would make such appropriate.
He then asked if he could make a brief presentation on the Burzynski case. Again, I said, no, and reiterated that such would be inappropriate since the Burzynski case was not of particular interest to the audience, nor was it to be the focus of my presentation. He then asked if he could attend the meeting. I said yes, that it was open to the public. Lastly, he asked if he could ask a question. I told him that time would be made for the audience to ask questions, and he could do so.
Contrary to Whitaker's assertion, I did not engage in the character assassination of Dr. Burzynski or anyone else during my presentation. My only mention of Burzynski was when I introduced the 48 Hours video as a current example of an unapproved cancer remedy that had taken on the proportions of a social movement. I presented it as evidence for the need of a more accessible, and highly visible, method for testing unusual cancer remedies before they grow to become crusades. This can be verified because my entire presentation was video-taped. I define what quackery is, and take an "if the shoe fits..." attitude.
I do not even bash individuals who traffic in unapproved cancer care, nor do I accuse cancer patients who use nonstandard therapies of gullibility or folly. I focus, rather, on how honest, intelligent, well-meaning practitioners can be fooled into believing in worthless cancer remedies by a failure to use randomized, double-blind clinical trials. Subjective clinical observations are deceiving because cancer is a silent disease for most of its natural history. This allows both patients and practitioners to misperceive reality. Also, it is impossible to predict outcomes for any individual. The predominant factor that confuses both cancer patients and the purveyors of questionable cancer treatments is that many patients outlive their physicians' estimates of how much time they have left to live. I show that the survival curve for cancer patients is skewed, and that the median survival time is relatively short for the first half of a patient population, but extends much farther for the remainder.
This means that any practitioner who sees a large number of cancer patients will attend many of the longer term survivors. Clinical illusions, such as brain tumors that have a tendency to form cysts that drain on their own thus producing rapid shrinking, can also distort the picture of what is happening. When this is combined with the fact that an unorthodox doctor must justify promoting an unapproved procedure, the illusions can be overwhelming. Burzynski argues that he has more apparent successes than spontaneous remission could explain, but longterm survivors are not limited to those experiencing spontaneous remission.
History has taught that even under normal conditions doctors, like the title of an old song, "accentuate the positive, eliminate the negative, latch on to the affirmative, and don't mess with Mr. In-between," notice affirming more than disconfirming evidence. This is why "double-blind" clinical trials evolved. Someone with strong beliefs who is caught in the ego-trap of promoting an off-beat procedure is more likely to misperceive clinical results, and to work at converting patients to their ways of thinking. Patients who have come to believe that they owe their lives to the maverick doctor can hardly be blamed for rallying to his defense, and the public cannot be blamed its sympathy with desperate cancer patients. I also present the findings of studies done at unorthodox cancer clinics where the staffs believed patients were doing better than those treated by standard methods, but where researchers found just the opposite.
Whitaker and his entourage of supporters arrived about 2/3s of the way through the presentation so they missed most of its content. Supporters skillfully spread throughout the audience so they could protest from various points rather than from a single gallery. Several were the same people who had appeared on the 48 Hours video as pickets at the Burzynski trial. The video provided a complete explanation of Burzynski's theory and practices. Its coverage was fair and balanced, and showed that Burzynski had won his case by jury nullification. Whitaker would have added little, if any, substance to its coverage.)At the beginning of the question and answer period, Dr. Whitaker stepped to a microphone and introduced himself. He then proceeded to do exactly what he had been denied on the telephone--make a speech on the Burzynski case. It was clear at this point that he meant to bully his way to imposing his own agenda upon the meeting.
After giving him enough time for the audience to sense his intentions, I interrupted. I informed the audience that Dr. Whitaker was attempting to give a commercial for Dr. Burzynski after having been told by Jimmie Loder and me that he would not be allowed to do so. Whitaker ignored my words and proceeded with his speech. When it became clear that he would not be dissuaded, I asked for the security officers to escort him from the room.
Whitaker's supporters began yelling "censorship!" and "freedom of speech!" They seemed unaware that the First Amendment does not permit the disruption of a meeting on private property. One attempted to also make a pro-Burzynski speech instead of asking a relevant question. When he refused to desist, he too was escorted by Security from the room at my request. Following that, the meeting proceeded in an orderly fashion. Other members of the audience began to ask relevant questions and tell of their experiences with cancer quackery (one man had lost both parents to cancer quacks!).
One member of the Whitaker entourage identified herself as a physician who had worked with Dr. Burzynski. She believed that his methods may have value, asked an appropriate question. Her demeanor, comments, and question were welcomed, and I commended her on her civil behavior. Dr. Whitaker could have done the same if he had wished. It was clear that he had come to the meeting to force his agenda on an unwilling audience. In addition to a video of the entire event, the audience's written evaluations of the event expressed strong support for my actions. They clearly did not appreciate Whitaker's disruption. A retired LLU president who was at the meeting telephoned me at home later that evening. He commended me and stated that I had done precisely the right thing by having Whitaker removed before the meeting had become completely disrupted. I took no pleasure in the experience but felt that it was my duty to maintain order in the meeting.
Seething with anger because of having embarrassed himself at Loma Linda, Whitaker went on the attack. I judge that his massive ego has led him to exceed the bounds of both civility and truth. In the July, 1997, issue of the Townsend Letter (TL), a publication favorable to "medical alternatives," Whitaker presented his version of what happened at LLU. He addressed his article to LLU President Lyn Behrens and headed it with the charge that NCAHF had "posted" a list of 2,500 doctors who it views as quacks. Presumably, this was to stir up the readers of the TL so they would write nasty letters to the LLU administration.
The fact is that NCAHF has never posted any such list. The only list I am aware of that resembles what Whitaker ranted about is The NCAHF Players Program (NPP). NPP is an encyclopedic listing of individuals who have been victims or perpetrators of quackery that was prepared for internal use as an efficient referral source. NPP merely contains descriptive information, quotations, and substantive facts which are referenced. A copy of the NPP was stolen some years back from Dr. Renner by a disgruntled employee, and Whitaker has somehow come into possession of this stolen property. I have no knowledge of it ever having been used as a posted blacklist as suggested by Whitaker. In the October, 1997, Health & Healing, Whitaker restated his distorted version of what happened at LLU, and accused NCAHF of being on "a witch hunt" for quacks. He also compared NCAHF's anti-quackery efforts to the crusade of the late Sen. Joseph McCarthy who searched for Communists imagined to have infiltrated American government.
Which Hunt is Witch?
These are curious charges by someone who advances the sinister idea that organized medicine, drug companies, and the Federal Government censor and suppress cures that would benefit the public. Whitaker's assertions seem to be more like witch-hunting and McCarthyism than NCAHF's consumer protection activities. Further, Whitaker's tactic of bringing emotionally-involved patients along to demonstrate on his behalf also smacks of witch-hunting hysteria (NCAHF doesn't attempt to disrupt Whitaker's seminars). Whitaker's characterizations of NCAHF do not square with reality. He simply has chosen to use negative buzz words as weapons to smear NCAHF in his efforts to advance the cause of maverick medicine.