The Quacktitioner Royal

Among our ancient mountains,
And from our lovely vales,
Oh! let the pray'r re-echo,
"God bless the Prince of Wales!"

(sing along here)

It is distressing to find the Prince of Wales has turned his attention from architecture to medicine. He has now had the temerity to address the World Health Organisation on the value of alternative medicine.

There is no such thing as alternative medicine. There is only medicine. There is good medicine and bad medicine. There are doctors and there are quacks.

All medical treatment that has a rational scientific basis is used by doctors. The rest is humbug.

Medical science is not omnipotent. There are illness, some life-threatening, that we cannot cure. There are many non-life threatening illnesses that we cannot help.

Ancient man invented God to fill in and explain the gaps in his knowledge. Why did the sun rise? Why does the moon go round the earth? And so on. As science advanced and the gaps became smaller, the need for God, or gods, diminished.

Two hundred years ago patients suffering from myxoedema died. There are graphic descriptions of the descent into myxoedematous madness and death. Then we synthesised thyroxine and a fatal condition became so easy to treat that it is now regarded as trivial. The advances in the treatment of leukaemia, particularly the childhood leukawmias, over the last fifty years, have been staggering. Antibiotics. Coronary artery replacement. Kidney dialysis and transplants. Science marches on. The remaining gaps are small but there has been a corresponding increase in expectation. As medicine has not been able to satisfy these expectations, people turn to quackery to fill the gaps.

If medical science cannot solve a problem, for the “alties” that is the fault of the blinkered and ignorant doctors who will not take the quackery on board. What is an "altie"?

Read ORACs many excellent posts on alternative medicine and, in particular, his entertaining article on “What is an ‘altie”

“That term is term is an "altie" and has a meaning similar to the term "woo-woo," in that it describes people who are so militantly pro-alternative medicine and so distrustful of conventional medicine that they will never admit when conventional medicine is effective and refuse ever to concede that any alternative medical practitioner might, just might, possibly be a quack. Part and parcel of being an altie is an anti-intellectual and antiscientific attitude that does not allow a little thing like evidence to sway one from one's belief in the power of alternative medicine."

The believers in "alternative medicine" never produce evidence. They produce anecdotes. They believe that the plural of "anecdote" is "evidence". It is not. It is "anecdotes".

Let us consider one common medical condition. Simple back strain. Every day in the UK thirty thousand family doctors have a heart sink experience as patients present with acute mechanical back pain. There is nothing you can offer except painkillers most of which could be bought over the counter. Ninety five percent of the suffers will be better in six weeks whatever they do, with or without treatment. This is not good enough. Patients demand more. Doctors are honest. They have nothing more to offer. So the “rubbing” therapists step in to offer a "solution". The private physiotherapists, the chiropractors, the osteopaths, the acupuncturists, the list is endless, will all take your money for their spurious treatment. And when, a few weeks later, you are better, they will take the credit, and you will want them to because they have your money.

Fraud and dishonesty abound in quack medicine. Ignore the Prince of Wales. You would be safer listening to his views on architecture and marriage guidance.

Considerations of space make it impossible to go through the whole lunatic fringe of quackery but Dr Crippen would like to mention a few that cause him particular concern.

Chinese Medicine : there is nothing wrong with Chinese medicine as practised by the many fine Chinese doctors in China. But the little old ladies who sell brown paper bags full of bird seed out of the back door of Chinese Restaurants have nothing to do with medicine.

The “rubbers” - osteopaths, chiropractors and private physiotherapists : they have little to offer suffers for mechanical back pain. Take some aspirin, have a long soak in a hot bath and save your money.

Homeopathy : much favoured by the Royal Family. Utter, incomprehensible nonsense. Dangerous if used as a substitute for medical treatment.

Herbal medicine: well, it depends what you mean. Some of the finest drugs known to medicine have “natural” origins. The Foxglove. Aspirin. Cyclosporin. But, as well as having “natural” origins, all these drugs have been extensively tested by scientists. Patients occasionally say to me when I prescripe something, “Is it natural?” My standard reply is, “You mean like cow-dung and Deadly Nightshade?” People want to take St John’s Wort, because it is “natural”. It contains hypericum, which is a chemical anti-depressant. Why not get a real anti-depessant, which has been tried and tested, from your doctor? The saddest thing about St John’s Wort is that it can interfere with the contraceptive pill. Unwanted pregnancies do not help depression.

Acupuncture: has a real role in providing pain relief provided the needles are sterile. Not much good for anything else. More Chinese hocus-pocus.

Reflexology : nonsense
Radionics : nonsense
Cranial osteopathy: nonsense
Watsu: these practitioners float their patients in water so that they can better relate to them. No, really, they do!

I leave until last the quacks I hate most. The “cancer” practitioners. They hold out the possibiltity of a “cure” when conventional medicine has failed. Sometimes they offer their treatment instead of conventional medicine. These people are criminals. They need locking up. They will sell you vitamins and things like laetrile. I am not going to refer to any of their sites.

As and when Dr Crippen gets an incurable cancer, he will research everything that is available, believe me. If if he finds anything that has a scientific evidence base, he will be after it. As yet, there is nothing with a scientific base that medicine cannot already provide.

Anyone who has cancer and is considering alternative therapy, should read Snake Oil by Jon Diamond, written whilst he was suffering from cancer, and also metastases, written by a breast cancer suffer.

And the Prince of Wales? I wish him well. I wish also he would stick to doing something he understands.

Whatever that maybe.