Consumer Advocate Stephen Barrett, MD has redesigned NCAHF's website to provide easy access to available information. Using the Glimpse search engine, visitors can find all pages on the Web site containing a word or string of words typed in. Visitors can also sign up to receive Consumer Health Digest, a free, weekly e-mail newsletter edited by Dr. Barrett and co-sponsored by NCAHF and Quackwatch. The Digest will include summaries of scientific reports; legislative developments; enforcement actions; other news items; Web site evaluations; recommended and nonrecommended books; research tips; and other information relevant to consumer protection and consumer decision-making. The Council will continue to publish a printed newsletter for subscribers and council members. Look for a new name and design layout for the printed newsletter beginning with the January/February 2001 issue.
A 55-year old man with maxillary sinus carcinoma died of hepatorenal failure after taking, for the first four months following diagnosis, hydrazine sulfate according a regimen recommended on the Kathy Keeton website. He had previously declined standard therapies. A report of the case was published in the Annals of Internal Medicine (133:877-880;2000). The authors noted that analogues of hydrazine sulfate were previously established as toxic to the liver.
Hydrazine sulfate is an unapproved cancer treatment that has been popularized by the Syracuse Cancer Research Institute. On December 14th, nine days following the publication date of the case report, the Institute's website continued to claim: "Hydrazine sulfate has been demonstrated to produce only few and transient side effects."
Kathy Keeton was vice-chairman and chief operating officer of Penthouse magazine, which has promoted hydrazine sulfate and other dubious cancer treatments. Appearing on The Montel Williams Show, Keeton attributed her survival beyond six weeks after receiving a diagnosis of metastatic breast cancer to taking hydrazine sulfate. Several months later, on September 19, 1997 she died during surgery to remove tumors from her upper digestive system. See: <http://www.acsh.org/publications/priorities/1004/hydrazine.html>.
Although it is the only public health measure routinely subjected to voter referenda, community water fluoridation was adopted successfully in a number of American cities during the November 2000 general election. In spite of intense opposition by small groups of local antifluoride zealots, cities approving fluoridation included San Antonio, Texas; Las Vegas-Clark County, Nevada; Salt Lake City-County, Utah; Abilene Texas; Davis County, Utah; Sunnyvale, California; Gilbert, Arizona; Leavenworth, Kansas; and North Attleboro, Massachusetts. The total population that will be served by fluoridated water systems as a result of the election is estimated to be 3,957,079.
Despite the significant efforts of health professionals, pubic health officials, and community groups, fluoridation efforts were temporarily stymied by election losses in Spokane, Washington, and 13 other smaller communities. The total population that will be denied the benefits of fluoridation because of the election losses is estimated to be 366,347.
Community water fluoridation was recently featured in the Surgeon General's Report on Oral Health in America as the safest, most effective, and most cost-effective public health measure to prevent dental decay in all Americans and to reduce the oral health disparities experienced by some segments of American society. In addition, it recently was termed one of the Ten Greatest Public Health Achievements in the Twentieth Century by the U.S. Centers for Disease Control & Prevention.
A special double issue (Nov. 1-Dec. 1, 2000) of PROBE, veteran science writer David Zimmerman's monthly newsletter on science, media, policy and health, focuses primarily on Nicholas James Gonzalez, MD, who promotes dubious methods of cancer management including the use of a radionics device for hair testing, animal gland extracts, coffee enemas, diet, and dietary supplements. PROBE discusses findings about Dr. Gonzalez by the Office of Professional Medical Conduct of the New York State Department of Health, successful plaintiffs against Dr. Gonzalez in lawsuits, assessments of his methods, his supporters, and National Cancer Institute funding to study his methods. To order a copy send a check for $10 payable to: The PROBE Newsletter Inc., Box 1321, Cathedral Station, New York, NY 10025-1321.
In a study by the American Council on Science and Health, each of 97 obtainable transcripts of health stories that aired from 1978 to 1995 on CBS Television's 60 Minutes was reviewed and evaluated for accuracy of reporting by three or more experts. Errors of inattention to evidence and of imprudence were common. Reporting accuracy was judged only fair, on average. Among the segments receiving the best evaluation scores were: a 1994 segment that debunked "facilitated communication" for autism; a 1991 segment that refuted Scientology's objections to Prozac; reports about pharmaceutical companies mishandling information about adverse effects of drugs in 1982 (Selacryn) and 1983 (Oraflex); and a 1978 segment that exposed a dubious cancer clinic in Murietta Hot Springs, California. Poor scores were given to segments that promoted: removal of mercury-amalgam fillings (1990); "immunoaugmentative therapy" against cancer (1980); "Doc Willard's Wonder Water" (1981); tinted lenses to treat dyslexia (1989); positive outlook and visualization to cure cancer (1987); "shark cartilage" against cancer (1993); DMSO-dimethyl sulfoxide-for pain relief (1980); and "cell therapy," deprenyl, and human growth hormone for longevity (1993). [London WM et al. Expert reviews of health reports on CBS Television's 60 Minutes, 1978-1995. Technology 7:539-552;2000.]
Writing in the August/September 2000 issue of Policy Review (pp. 15-25), Hoover Institution fellow Henry I. Miller, M.D. and freelance writer David Longtin make a strong case in their paper "Death by Dietary Supplement" that in the U.S. "[r]egulation of the herbal supplement industry is so lax, and some of the products so dangerous, that a public health catastrophe seems inevitable."
The Dietary Supplement and Health Education Act of 1994 virtually exempted herbal remedies from government oversight. Although FDA can restrict the sale of an herbal product when it receives well-documented reports of health problems associated with it, the congressional General Accounting Office has found inadequacy in the FDA's monitoring system and adverse reaction reports. While manufacturers of drug products are required to report side effects, the makers of herbal products make adverse reaction reports voluntarily. "This is rather like the IRS asking taxpayers to voluntarily provide information on their own underreporting of income" explain Miller and Longtin.
While critical of the current laissez-faire regulatory model of herbal products sold as supplements in the U.S., the authors are also critical of FDA having "an absolute monopoly over regulation, a situation that can produce delays, increased expense, and inefficiency." Dr. Miller, who was an FDA official from 1979 to 1994, has an insider's view of how "[g]overnment monopolies can foster abuses by bureaucrats." Thus, Miller and Longtin examine other models of regulation: (1) a private monopoly organization to review and certify new products; (2) supplement manufacturers contracting with competing private entities to perform certifications; (3) voluntary contracting with a not-for-profit organization similar to Underwriter's Laboratories (UL) and its competitors which certify more than 16,500 types of products, many of which, like mechanical parts, present inherent hazards; (4) a nonprofit organization modeled after the California Crop Improvement Association which provides a voluntary quality assurance program for plant seeds sold to agricultural producers or growers; (5) the European Union model of medical device regulation which relies on competing private entities to perform certifications and which has resulted in approval of devices that "takes perhaps half as long as it does in the United Statesapparently without compromising safety;"
Miller & Longtin suggest that voluntary, extragovernmental regulation can give consumers informed choice among competing products and give makers of herbal products who participate protection against liability. Miller discusses the UL model applied to additional products regulated by FDA in his book To America's Health: A Proposal to Reform the Food and Drug Administration (Stanford CA: Hoover Institution Press, 2000.)
Comment: Dr. Miller told NCAHF President William M. London that in proposing extragovernmental regulation based on the UL model, he calls for higher standards of product quality than the model proposed in NCAHF's 1995 Position Paper on Herbal Remedies.
Based on responses by eleven hundred medical and nonmedical practitioners of Traditional Chinese Medicine in Australia to a survey mailed by the Health Insurance Commission of the Australian Federal Government, a team of researchers led by Alan Bensoussan of the Research Unit for Complementary Medicine at the University of Western Sydney estimated that "approximately 1 adverse occurred for every 8 to 9 months of full-time [TCM] practice, or for every 633 consultations." Most (79%) adverse events reported were attributable to acupuncture. The most common adverse events associated with acupuncture were fainting during treatment, increased pain, nausea/vomiting. Less common were pneumothorax and convulsions.
Adverse events attributed to Chinese Herbal Medicine, possibly interacting with pharmaceutical drugs, included 19 deaths reported by practitioners. More common were gastrointestinal symptoms, fainting and dizziness, significant skin reactions, central nervous system effects, liver toxicity, and kidney toxicity.
The 30% response rate of medical practitioners and 50% response rate for nonmedical practitioners sent surveys are limitations of the study. The authors acknowledge that practitioners may have underreported adverse events. [Risks associated with the practice of Traditional Chinese Medicine, Archives of Family Medicine 9:1071-1078;2000.]
Comment: The authors "hypothesize that TCM causes significantly fewer adverse reactions than does Western medicine [pharmaceuticals]." The hypothesis may be reasonable, but it is problematic in this paper because the authors did not attempt to weigh potential for harm against potential for benefit from different types of treatments or consider possible differences in severity of medical problems of patients with different medical conditions. In a recent review of acupuncture studies on pain, which is the major complaint of U.S. consumers who seek acupuncture, researchers from the Complementary Medicine Program at the University of Maryland School of Medicine concluded that "there is limited evidence that acupuncture is more effective than no treatment for chronic pain; and inconclusive evidence that acupuncture is more effective than placebo, sham acupuncture or standard care." [Berman EJ, Hadhazy VA, Jadad AR et al. Is acupuncture effective for the treatment of chronic pain? A systematic areview. Pain 86(3):217-225;2000.]
Christian Brothers Contracting Corporation of Whitestone, New York and its president, Jason Vale, signed a consent decree entered in November 2000 to stop manufacturing, processing, and distributing its amygdalin products referred to as Laetrile, Vitamin B-17, or apricot kernels. The company's Web site had made unsubstantiated claims for the products in curing, mitigating, treating, and preventing cancer. (See FDA Talk Paper T00-62, November 17, 2000). In 1999 a US magistrate found that Christian Brothers and Vale unlawfully used America Online's network and trademark in sending unsolicited bulk e-mails promoting sales of apple and apricot seeds as anticancer agents. The ruling entitled AOL to recover damages of $631,585. [See 98 Civ 8959 (DAB)(HPB) at http://www.nylj.com/links/aol.html.]
Most readers will immediately recognize the name of Bob McCoy, curator of the Museum of Questionable Medical Devices which is located in Minneapolis, Minnesota. McCoy, a natural-born story teller, has combined his extensive historical knowledge of medical devices with his pleasing narrative style and has written the best book I have ever seen on the fascinating field of black box quackery. The book contains numerous reprints of original advertisements for the devices, plus current photos posed by McCoy and his helpers--as McCoy states on the cover, it is "Profusely Illustrated" (an example of McCoy's penchant for showmanship).
McCoy's book both entertains and educates its readers as it provides insight into the nature of quackery itself and then explores different kinds of devices: mechanical, magnetic, electrical, radionic, radium, rays, psychological, sensory, for beauty and for sexual enhancement. Reading about quack devices historically has the disarming quality of making the quackery seem blatantly obvious and the people involved seem silly, when it was not so easy for many people to tell the difference at the time the events were taking place. The reality that people can still be fooled by the seeming logic and rationale that attends the promotion of black box devices is attested to by the fact that many of the theories behind the old time devices have been revived in the name of alternative medicine and similar devices are being sold today. For instance, I regularly see ads for an electro-muscle stimulator (EMS) device on television that promises great "abs" and shows a model hooked up to electrodes and her tummy muscles twitching with each electrical jolt. As McCoy reports, EMS devices have been prosecuted by the FDA as recently as in 1999, yet the ads continue.
EMS devices are not the only quack devices to have a contemporary manifestation. Other dubious devices that flourish today include magnets for health purposes, radionics devices, lights that allege to benefit health, violet ray producers, negative ion generators, penis enlargers, and many more. Readers with common sense abilities should learn how to spot a contemporary quack device as they learn how people have been fooled in the past--and recognize that the same promotions are being aimed at the same human vulnerabilities today. One of quackery's age-old ploys is to encourage "open-mindedness" toward off-beat ideas. My retort has long been to warn of "empty-mindedness"--which means to have failed to learn from history. McCoy's book provides the substance that people need to fill the mental voids to which quacks continue to appeal. This splendid book belongs in the library of every health-conscious consumer.
The largest network of Complementary and Alternative Medicine practitioners in America announces they have formed a strategic association with the newly formed International Union for the Natural Health, Complementary & Alternative Medicine Professions (IUNH). The 20,000 members of The National Complementary & Alternative Medicine Network (N-CAM) will be encouraged to support the goals and mission of IUNH. N-CAM has contracts with a wide range of practitioners. These practitioners contract with N-CAM to provide reduced fees for their clients. These consist of large organizations that want to offer alternative benefits to their employees or members. In return IUNH will encourage union members to support the practices of N-CAM members. It will also give IUNH members access to N-CAM's provider network. "Associate memberships" will be offered to N-CAM. IUNH previously announced their agreement with the International Massage Association in June and the creation of the IUNH Look for the Union Doctor (TM) program in July. (International Union for the Natural Health. This story appeared on http://www.individual.com August 10, 2000)
Cornelis Moerman (1893-1988), who invented an anti-cancer diet based on experiments with carrier-pigeons, heads the list of the twenty biggest quacks of the twentieth century announced by C. N. M. Renckens, the chair of VtdK, the Dutch Union Against Quackery at an antiquackery symposium in Utrecht on October 14th. The names on Renckens's list are familiar to Dutch people, but are not well known in the United States. See: http://www.dds.nl/~antikwak/.
The Moerman diet consisted of fresh fruits, fresh vegetables, non-refined cereals, leguminous plants and dairy-products. Moerman also recommended supplemental vitamins and minerals. Forbidden were meat, fish, fowl, coffee, tea and water. Moerman, a doctor who practiced nearly 50 years, was very aggressive against his colleagues. He organized support in the parliament. The late Linus Pauling praised him.
Moerman received 30 out of a maximum 37 points in the scoring system Dr. Renckens used for rating quackiness. The scoring system illustrates the complexity of quackery as societal and public health problem.
Criteria and Scoring Used by Dr. Renckens (Slightly Modified)
A. Level of education
B. Character of the therapy
C. Inflicted damage
D. Aggression against regular medicine
E. Duration of career
F. Material gains
H. Indications for swindling
K. Support from politicians
L. Degree of impudence of the claims
Comments by Dr. Renckens
Some of the second thoughts others and I had were as follows.