LOB-vs
Download Lectures on Biostatistics (1971).
Corrected and searchable version of Google books edition

Download review of Lectures on Biostatistics (THES, 1973).

Latest Tweets
Categories
Archives

quacks

In 2009 I asked Napier University Edinburgh for details of what was taught on its herbal medicine "BSc" course. At first it was refused, but then (as often seems to happen when threatened with exposure) the course was closed, and Napier sent what I’d asked for without waiting for the judgement from the Scottish Information Commissioner,

napier-logo

Some samples of the dangerous nonsense that used to be taught on Napier’s herbal medicine course (now closed) have been exposed in “Hot and cold herbal nonsense from Napier University Edinburgh: another course shuts“.

That sadly doesn’t mean that Napier has stopped teaching nonsense. It offers a 3 year Honours BA degree in "reflexology" (the only other place in UCAS is the University of Wales Institute, Cardiff (UWIC), which offers a “BSc(Hons)”, though nine other places offer foundation degrees or HND)

Napier also offers a BA (Hons) in Aromatherapy, according to UCAS

Clearly quackademia has not died entirely yet, though it is on its way. It has closed down entirely at the University of Salford and the University of Central Lancashire. And when I wrote about quackademia in Nature in 2007 there were five "BSc" degrees in homeopathy. Now UCAS does not list a single one. It has even vanished in the home of woo, the University of Westminster.

When I asked Napier for teaching materials used in reflexology and aromatherapy, the request was, as usual. refused. In a letter dated 20 August 2010, David Cloy, Head of Governance & Management Services, wrote that disclosure of the materials “. , would be substantially prejudicial to the Universitys [sic] commercial interests”.

Scotland has its own Freedom of Information (Scotland) Act, and its own Information Commissioner, so it wasn’t possible to rely on the win that I had with the Information Commission (England and Wales). An Appeal was duly lodged on September 3rd 2010. They were a lot faster than before and their decision, dated 9 December 2010, was again almost completely in my favour [download the whole decision]. The decision ended thus.

The Commissioner finds that Edinburgh Napier University (the University) failed to comply with Part 1 of the Freedom of Information (Scotland) Act 2002 (FOISA) in responding to the information request made by Professor Colquhoun. The University wrongly withheld information under section 33(1)(b) of FOISA, and thereby failed to comply with section 1(1) of FOISA. It also failed to provide Professor Colquhoun with notice that certain of the information he had requested was not held, as required by section 17(1) of FOISA. The University also failed to provide Professor Colquhoun with reasonable advice and assistance in relation to his information request, as required by section 15(1) of FOISA.

The Commissioner therefore requires the University to provide the withheld information, and the advice detailed in paragraph 16 of this decision notice, by 27 January 2011.

There is quite a lot of material, so I’ll restrict myself to a few quotations.

Therapeutic Touch

This makes an interesting example because it is so obviously fraudulent. It is particularly interesting because of a famous paper published in 1996, in the Journal of the American Medical Association (read the paper) by Emily Rosa aged 9. She devised a simple experiment that showed convincingly that healers could not do what they claimed. Nobody has ever detected the magic rays that are said to emanate from the hands of the ‘healer’/confidence trickster. It is all pure make-believe. Like so many things of its sort, there is no ancient wisdom involved. It was invented in 1977 by a nurse. Watch the video of the test on YouTube, or the less reverent version by Penn and Teller. Also worth reading is Why Therapeutic Touch Should Be Considered Quackery.

I was sent a set if slides that are used for teaching students at Edinburgh Napier University about "Therapeutic Touch" (part of course CPT08104 “Pathophysiology Insights to Practice”)..

When reading these, remember that this is not a course on cultural history, or a course about the pre-scientific beliefs of primitive tribes as in anthropology. It is taught to students to enable them to charge money to sick and desperate people.

Rogerian Perspectives on Therapeutic Touch

– seen as a knowledgeable and purposive patterning of patient-environment energy field process in which (the nurse) assumes a meditative form of awareness and uses her/his hands as a focus for the patterning of the mutual patient-environment energy field process”.

Four Principal (Conceptual ) Building Blocks.

Energy Fields.

The fundamental unit of the living and the non living” (Rogers 1986).

This field is considered to be irreducible – not comprehensible in terms of a simple list of component parts.

Openness

  • The human field is integral with the environmental field
  • Reflects a continuous and open movement/interchange between the human and environmental fields.  Considered to be a process of evolution and ongoing re-fashioning..

 

Pattern – the distinguishing characteristic of the energy field.

A very useful concept – it helps with understanding the uniqueness of the individual – human existence and movement of energy.

Patterns of relating – responding 

  • Patterns of thinking 
  • Patterns of behaving 
  • Wave-like activity of energy fields 
  • Patterns of expansion/contraction 
  • Patterns of responding to environmental phenomena – lunar cycles – seasonal cycles. 

Pan-dimensionality – a non-linear domain without special / temporal attributes

  • Different and relative to our everyday 3-d world.
  • Involves different means of knowing/understanding

Rogers model also has 3 cardinal principles.

Three Principles of Homeodynamics:

  • Integrality – refers to continuity and integrality of human and environmental fields. 
  • Helicy – relates to openness and pattern.  Basically asserts that movement within fields is generally in the direction of greater complexity and diversity. ( true in health and disrupted health)
  • Resonancy – related to helicy – refers to the tendency for energy/living processes to move from low frequency/long wave patterns towards high frequency/short wave patterns

 

Teilhardt de Chardin  (Essay on Human Spirituality)

A comparative Explanation of Rogers’ laws of Homeodynamics )

  1. Life is not a partial limited property of matter – analogous to some vibratory or molecular effect:  it is rather a sort of inverse of everything that habitually serves us as a definition of matter”.
  2. The Cosmos could not possibly be explained as a dust of unconscious elements on which life, for some incomprehensible reason burst into flower – as an accident or as a mould.  But it is fundamentally and primarily living and its complete history nothing but an immense psychic exercise”. e.g. a movement from matter to spirit e.g. from primal reproductive sexual energy to love
  3. “Not only a unique and periodic attraction for the purposes of material fertility ….. but an unbanded and continuous possibility of contact between minds rather than bodies.  The play of countless subtle antennae seeking one another in the light and darkness of the soul.

All of this is so many meaningless words. It has the vaguely sciencey sound beloved of quacks (and post-modernists), but it is a million miles from science.

Empirically it just doesn’t work.

Sadly the slides from Napier did not include any helpful illustrations, but these two, from a similar lecture given at the University of Westminster should make it all clear.

wmin-1

wmin-2

Aromatherapy

There’s some perfectly sensible stuff about the chemistry of essential oils. It’s when it comes to what they are good for that things rapidly come unstuck. Table 17 (extracted from a handout on essential oil chemistry) has all sorts of suggested uses

Energising
Essential oils can correct deficits or blockages in energy
Difficult to back up with scientific research, but nevertheless an important property in aromatherapy
Synergistic blending using the energetic approaches

So it is "important" but there is no evidence for it. The Table is prefaced by a disclaimer of sorts.

There is a body of anecdotal information concerning the potential therapeutic actions of essential oils, such as their anti-inflammatory, sedative and analgesic effects (Bowles 2003).

Despite some of the potential uses of essential oils contained in Table 17, it is not the role of the aromatherapist to treat specific conditions such as infections. However, the therapist can include appropriate oils in a holistic context, and can offer aromatherapy support preparations for home use.

At this point the handout does give quite strong hints that there is no good evidence that any of it works. In that case, why are they doing a three year degree in it?

Then of course we get on to the 19th century vitalism (being taught in the 21st century) and the usual ‘energy’ nonsense. For example

Holmes (1997) proposed that the nature of a fragrance can bring about specific psychotherapeutic effects. Using three fragrance parameters – tone (odour quality), intensity and note (evaporation rate), with tone being the most significant, and six fragrance categories – spicy, sweet, lemony, green, woody and rooty. He proposes that the nature of a fragrance will bring about specific psychotherapeutic effects. The following is a summary of his suggestions.

‘High/Top tone’ oils such as those from the citrus group, the Myrtaceae family and also ylang ylang extra and 1, lavender and mimosa abs. will have a stimulating, uplifting effect.

‘Low/Base tone’ oils including vetivert, patchouli, sandalwood and also tuberose, hay and oakmoss abs., will have a depressing, sedating effect.

Gabriel Mojay is quoted as saying

“Fragrance is the primary effective quality of essential oils. By this we mean their most immediate and generalised effect on the body and mind. This effect is first and foremost an energetic effect – as it is the vital energy of the human organism that first responds to an essential oil and its fragrance.”

These are just more empty words, woolly thoughts about long-discredited ideas of vitalism. They are presented entirely uncritically.

Reflexology

Reflexology is based on the utterly barmy proposition that "… reflexologists claim to be a system of zones and reflex areas that they say reflect an image of the body on the feet and hands, with the premise that such work effects a physical change to the body".

Regardless of its absurd premises, it just doesn’t work. A review by Ernst (2009) concludes

"The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition."

It is simply a foot massage, There’s nothing wrong with that, if you like that kind of thing, but please don’t pretend it is anything more

One handout lists, under the treatments for Migraines and Headaches

  • Homeopathy (applying the principle of similimum)
  • Herbal
  • Massage for relaxation
  • Reflexology (addressing reflexes relating to head, neck, solar plexus, spine, pituitary & digestive systems).
  • Nutritional therapy
  • Accupressure.[sic]
  • Bach Flowers may be useful

No evidence is cited for any of them, not doubt because next-to-none exists.

A three year degree in rubbing feet is just an absurdity.

The material that was sent about reflexology was very thin. I’ve asked for more, but in a sense it doesn’t matter, because all one has to do is look at a standard reflexology diagram to see what a load of unmitigated nonsense it is. There isn’t the slightest reason to think that an area on your big toe is ‘connected’ in some unspecified sense, to you nose, It is just preposterous made-up junk.

reflexology diagram
Diagram from Scienceblogs

Who is responsible?

I’m quite happy to believe that the people who teach this new-age nonsense actually believe it.

What I would like to know is whether the Principal and Vice-Chancellor of Edinburgh Napier University believes it. She is Professor Dame Joan K. Stringer DBE, BA (Hons) CertEd PhD CCMI FRSA FRSE.

That’s an impressive string of initials for somebody who seems to defend 19th century vitalism as a suitable subject for an honours degree. I could ask her, but such letters rarely get a response.

Follow-up

Jump to follow-up

Alfred Joseph Clark FRS held the established chair of Pharmacology at UCL from 1919 to 1926, when he left for Edinburgh.  In the 1920s and 30s, Clark was a great pioneer in the application of quantitative physical ideas to pharmacology.   As well as his classic scientific works, like The Mode of Action of Drugs on Cells (1933) he wrote, and felt strongly, about the fraud perpetrated on the public by patent medicine salesmen.  In 1938 (while in Edinburgh) he published a slim volume called Patent Medicines.  The parallels with today are astonishing.


Alfred Joseph Clark FRS (1885 – 1941)

I was lucky to be given a copy of this book by David Clark, A.J. Clark’s eldest son, who is now 88. I visited him in Cambridge on 17 September 2008, because he thought that, as holder of the A.J. Clark chair at UCL from 1985 to 2004, I’d be a good person to look after this and several other books from his father’s library. They would have gone to the Department of Pharmacology if we still had one, but that has been swept away by mindless administrators with little understanding of how to get good science.

Quotations from the book are in italic, and are interspersed with comments from me.

The book starts with a quotation from the House of Commons Select Committee report on Patent Medicines. The report was submitted to the House on 4 August 1914, so there is no need to explain why it had little effect. The report differs from recent ones in that it is not stifled by the sort of political correctness that makes politicians refer to fraudsters as “professions”.


The problem

“2.2 The situation, therefore, as regards the sale and advertisement of proprietary medicines and articles may be summarised as follows:

For all practical purposes British law is powerless to prevent any person from procuring any drug, or making any mixture, whether patent or without any therapeutical activity whatever (as long as it does not contain a scheduled poison), advertising it in any decent terms as a cure for any disease or ailment, recommending it by bogus testimonials and the invented opinions and facsimile signatures of fictitious physicians, and selling it under any name he chooses, on payment of a small stamp duty. For any price he can persuade a credulous public to pay.”

Select Committee on Patent Medicines. 1914

“The writer has endeavoured in the present article to analyse the reasons for the amazing immunity of patent medicines form all attempts to curb their activity, to estimate the results and to suggest the obvious measures of reform that are needed.”

Clark, writing in 1938, was surprised that so little had changed since 1914.  What would he have thought if he had known that now, almost 100 years after the 1914 report, the fraudsters are still getting away with it?


Chapter 2 starts thus.

THE LAW

The Select Committee appointed by the House of Commons in 1914 ‘to consider and inquire into the question of the sale of Patent and Proprietary Medicines’ stated its opinion in 28 pages of terse and uncompromising invective. Its general conclusions were as follows:

That the trade in secret remedies constituted a grave and widespread public evil.

That the existing law was chaotic and had proved inoperative and that consequently the traffic in secret remedies was practically uncontrolled.

In particular it concluded ‘”that this is an intolerable state of things and that new legislation to deal with it, rather than merely the amendment of existing laws, is urgently needed in the public interest.”

The “widespread public evil”continues almost unabated, and rather than introduce sensible legislation to cope with it, the government has instead given a stamp of approval for quackery by introducing utterly ineffective voluntary “self-regulation”.

Another Bill to deal with patent medicines was introduced in 1931, without success, and finally in 1936, a Medical and Surgical Appliances (Advertisement) Bill was introduced. This Bill had a very limited scope. Its purpose was to alleviate some of the worst abuses of the quack medicine trade by prohibiting the advertisement of cures for certain diseases such as blindness, Bright’s disease [nephritis] , cancer, consumption [tuberculosis], epilepsy, fits, locomotor ataxy, fits, lupus or paralysis.

The agreement of many interests was secured for this measure. The president of the Advertising Association stated that the proposed Bill would not affect adversely any legitimate trade interest. Opposition to the Bill was, however, whipped up amongst psychic healers, anti-vivisectionists and other opponents of medicine and at the second reading in March 1936, the Bill was opposed and the House was counted out during the ensuing debate. The immediate reason for this fate was that the Bill came up for second reading on the day of the Grand National! This is only one example of the remarkable luck that has attended the patent medicine vendors.
(Page 14).

The “remarkable luck” of patent medicine vendors continues to this day, Although, in principle, advertisement of cures for venereal diseases was banned in 1917, and for cancer in 1939, it takes only a few minutes with Google to find that these laws are regularly flouted by quacks,  In practice quacks get away with selling vitamin pills for AIDS, sugar pills for malaria and homeopathic pills for rabies, polio anthrax and just about anything else you can think of.  Most of these advertisements are contrary to the published codes of ethics of the organisations to which the quack in question belongs but nothing ever happens.
Self-regulation simply does not work, and there is still no effective enforcement even of existing laws..

“It has already been stated that British law allows the advertiser of a secret remedy to tell any lie or make any claim that he fancies will sell his goods and the completeness of this licence is best illustrated by the consideration of a few specific points.

Advertisements for secret remedies very frequently contain a list of testimonials from medical men, which usually are in an anonymous form, stating that ………….. M.D., F.R.C.S., has found the remedy infallible. Occasionally, however, the name and address of a doctor is given and anyone unaware of the vagaries of English law would imagine that such use of a doctor’s name and professional reputation could not be made with impunity without his consent. In 1899, however, the Sallyco Mineral Water Company advertised that ‘Dr. Morgan Dochrill, physician to St. John’s Hospital, London and many of the leading physicians are presenting ‘Sallyco’ as an habitual drink. Dr. Dochrill says nothing has done his gout so much good.
Dr. Dochrill, whose name and title were correctly stated above, sued the company but failed in his case. ”

“The statement that the law does not prevent the recommending of a secret remedy by the use of bogus testimonials and facsimile signatures of fictitious physicians is obviously an understatement since it is doubtful how far it interferes with the use of bogus testimonials from real physicians.”

Dodgy testimonials are still a mainstay of dodgy salesman.  One is reminded of the unauthorised citation of testimonials from Dr John Marks and Professor Jonathan Waxman by Patrick Holford to aid his sales of unnecessary vitamin supplements. There is more on this at Holfordwatch.

The man in the street knows that the merits of any article are usually exaggerated in advertisements and is in the habit of discounting a large proportion of such claims, but, outside the realm of secret remedies, the law is fairly strict as regards definite misstatements concerning goods offered for sale and hence the everyday experience of the man in the street does not prepare him for dealing with advertisements which are not merely exaggerations but plain straightforward lies from beginning to end.

Scientific training is undoubtedly a handicap in estimating popular gullibility as regards nostrums. One imagines that no one today would be willing to spend money on pills guaranteed to prevent earthquakes but yet the claims of many of the remedies offered appear equally absurd to anyone with an elementary
knowledge of physiology or even of chemistry. A study of the successes and failures suggests that success depends chiefly on not over-rating the public intelligence. (Page 34)

This may have changed a bit since A.J. Clark was writing in 1938. Now the main clients of quacks seem to be the well-off “worried-well”. But it remains as true as ever that “Scientific training is undoubtedly a handicap in estimating popular gullibility as regards nostrums.” In 2008, it is perhaps more a problem of Ben Goldacre’s dictum ““My basic hypothesis is this: the people who run the media are humanities graduates with little understanding of science, who wear their ignorance as a badge of honour.”

Clark refers (page 36) to a successful conviction for fraud in the USA in 1917.  The subject was a widely advertised ‘get fat quick’ pill that contained lecithin, proteins and sugar.  The BMA analysis (in 1912)
suggested that the cost of the ingredients in a box of 30 tablets sold for 4/6 was 1 1/4 d. [4/6 meant 4 shillings and six pence, or 22.5 pence since 1971, and 1 1/4 old pence, a penny farthing, is 0.52 new pence]. He comments thus.

The trial revealed many interesting facts. The formula was devised after a short consultation with the expert of one of the largest drug manufacturers in the U.S.A. This firm manufactured the tablets and sold them to the proprietary medicine company at about 3/- per 1000, whilst they were retailed to the public at the rate of £7 10s. per 1000. The firm is estimated to have made a profit of about $3,000,000.

These trials in the U.S.A. revealed the fact that in a considerable proportion of cases the ‘private formula’ department of the large and well known drug firm already mentioned had first provided the formula for the nostrum and subsequently had prepared it wholesale.

Nothing much has changed here either. The alternative medicine industry (and it is a very big industry) is fond of denouncing the evils of the pharmaceutical industry, and sadly, occasionally they are right.  One of the less honest practices of the pharmaceutical industry (though one never mentioned by quacks) is buying heavily into alternative medicine. Goldacre points out

“there is little difference between the vitamin and pharmaceutical industries. Key players in both include multinationals such as Roche and Aventis; BioCare, the vitamin pill producer that media nutritionist Patrick Holford works for, is part-owned by Elder Pharmaceuticals.”

And then. of course, there is the deeply dishonest promotion by Boots the Chemists of homeopathic miseducation, of vitamins and of CoQ10 supplements.

The manner in which secret remedies can survive repeated exposure is shown by the following summary of the life history of a vendor of a consumption [tuberculosis] cure.

1904, 1906: Convicted of violating the law in South Africa.

1908:            Exposed in British Medical Association report and also attacked by Truth.

1910:            Sued by a widow. The judge stated: ‘I think this is an intentional and well-considered fraud. It is a scandalous thing that poor people should be imposed upon and led to part with their money, and to hope that those dear to them would be cured by those  processes which were nothing but quack remedies and had not the slightest value of any kind.’

1914:             A libel action against the British Medical Association was lost.

1915              The cure was introduced into the United States.

1919               The cure was sold in Canada.

1924                Articles by men with medical qualifications appeared in the Swiss medical journal boosting
the cure.

Secret remedies have a vitality that resembles that of the more noxious weeds and the examples mentioned suggest that nothing can do them any serious harm.

Most of the time, quacks get away with claims every bit as outrageous today.   But Clark does give one example of a successful prosecution.  It resulted from an exposé in the newspapers -wait for it -in the Daily Mail.

There is, however, one example which proves that a proprietary remedy can be squashed by exposure if this is accompanied by adequate publicity.

The preparation Yadil was introduced as an antiseptic and was at first advertised to the medical profession. The proprietor claimed that the remedy was not secret and that the active principle was ‘tri-methenal allylic carbide’. The drug acquired popularity in the influenza epidemic of 1918 and the proprietor became more and more ambitious in his therapeutic claims. The special virtue claimed for Yadil was that it would kill any harmful organism that had invaded the body. A more specific claim was that consumption in the first stage was cured with two or three pints whilst advanced cases might require a little more.  Other advertisements suggested that it was a cure for most known diseases from cancer downwards.

These claims were supported by an extraordinarily intense advertising campaign.  Most papers, and even magazines circulating amongst the wealthier classes,  carried full page and even double page advertisements. The Daily Mail refused these advertisements and in 1924 published a three column article by Sir William Pope, professor of Chemistry in the University of Cambridge. He stated that
the name ‘tri-methenal allylic carbide’ was meaningless gibberish and was not the chemical definition of any known substance. He concluded that Yadil consisted of :

‘About one per cent of the chemical compound formaldehyde.

About four per cent of glycerine.

About ninety-five per cent of water and, lastly, a smell.

He calculated that the materials contained in a gallon cost about 1/6, whilst the mixture was sold at £4 10s. per gallon.

This exposure was completely successful and the matter is of historic interest in that it is the only example of the career of a proprietary medicine being arrested by the action of the Press.

Clark goes on to talk of the law of libel.


“On the other hand the quack medicine vendor can pursue his advertising campaigns in the happy assurance that, whatever lies he tells, he need fear nothing from the interference of British law. The law does much to protect the quack medicine vendor because the laws of slander and libel are so severe.”

The law of libel to this day remains a serious risk to freedom of speech of both individuals and the media. Its use by rogues to suppress fair comment is routine.  My first encounter was when a couple of herbalists
threatened to sue UCL
because I said that the term ‘blood cleanser’ is gobbledygook.  The fact that the statement was obviously true didn’t deter them for a moment.  The herbalists were bluffing no doubt, but they caused enough nuisance that I was asked to take my pages off UCL’s server.  A week later I was invited back but by then I’d set up a much better blog and the publicity resulted in an enormous increase in readership, so the outcome was good for me (but bad for herbalists).

It was also good in the end for Andy Lewis when his immortal page “The gentle art of homoeopathic killing” (about the great malaria scandal) was suppressed.   The Society of Homeopaths’ lawyers didn’t go for him personally but for his ISP who gave in shamefully and removed the page.  As a result the missing page reappeared in dozens of web sites round the world and shot to the top in a Google search.

Chiropractors are perhaps the group most likely to try to suppress contrary opinions by law not argument.  The only lawyers’ letter that has been sent to me personally, alleged defamation in an editorial that I wrote for the New Zealand Medical Journal.  That was a little scary, but the journal stuck up for its right to speak and the threat went away after  chiropractors were allowed right of reply (but we got the last word).

Simon Singh, one of the best science communicators we have, has not been so lucky. He is going to have to defend in court an action brought by the British Chiropractic Association because of innocent opinions expressed in the Guardian.

Chapter 6 is about “The harm done by patent medicines”. It starts thus.

“The trade in secret remedies obviously represents a ridiculous waste of money but some may argue that, since we are a free country and it pleases people to waste their money in this particular way, there is no call for any legislative interference. The trade in quack medicines cannot, however, be regarded as a harmless one. The Poisons Acts fortunately prevent the sale of a large number of dangerous drugs, but there are numerous other ways in which injury can be produced by these remedies.”

The most serious harm, he thought, resulted from self-medication, and he doesn’t mince his words.

“The most serious objection to quack medicines is however that their advertisements encourage self-medication as a substitute for adequate treatment and they probably do more harm in this than in any other manner.

The nature of the problem can best be illustrated by considering a simple example such as diabetes. In this case no actual cure is known to medicine but, on the other hand, if a patient is treated adequately by insulin combined with appropriate diet, he can be maintained in practically normal health, in spite of his disability, for an indefinite period. The expectation of life of the majority of intelligent diabetics, who make no mistakes in their regime, is not much less than that of normal persons. The regime is both irksome and unpleasant, but anyone who persuades diabetics to abandon it, is committing manslaughter as certainly as if he fired a machine gun into a crowded street.

As regards serious chronic disease the influence of secret remedies may be said to range from murderous to merely harmful.

‘Cures’ for consumption, cancer and diabetes may fairly be classed as murderous, since they are likely to cause the death of anyone who is unfortunate enough to believe in their efficacy and thus delay adequate treatment until too late.

The phrase “‘Cures for consumption, cancer and diabetes may fairly be classed as murderous” made Clark himself the victim of suppression of freedom of speech by lawyers. His son, David Clark, wrote of his father in “Alfred Joseph Clark, A Memoir” (C. & J. Clark Ltd 1985 ISBN 0-9510401-0-3)

“Although tolerant of many human foibles, A. J. had always disapproved fiercely of quacks, particularly the charlatans who sold fraudulent medicines.  During his visits to London he met Raymond Postgate, then a crusading left wing journalist, who persuaded A.J. to write a pamphlet which was published in an ephemeral series called ‘Fact‘ in March 1938. It was a lively polemical piece. . To A.J.’s surprise and dismay he was sued for libel by a notorious
rogue who peddled a quack cure for for tuberculosis. This man said that A.J.’s remarks (such as “‘Cures’ for consumption, cancer and diabetes may fairly be classed as murderous”) were libellous and would damage his business.  A.J. was determined to fight, and he and Trixie decided to put their savings at stake if necessary. The B.M.A. and the Medical Defence Union agreed to support him and they all went to lawyers. He was shocked when they advised him that he would be bound to lose for he had damaged the man’s livelihood!   Finally, after much heart searching, he made an apology, saying that he had not meant that particular man’s nostrum”

Talk about déjà vu!

On page 68 there is another very familiar story. It could have been written today.

“The fact that the public is acquiring more knowledge of health matters and is becoming more suspicious of the cruder forms of lies is also helping to weed out the worst types of patent medicine advertisements. For example, in 1751 a bottle of oil was advertised as a cure for scurvy, leprosy and consumption but today such claims would not be effective in promoting the sale of a remedy. The modern advertiser would probably claim that the oil was rich in all the vitamins and the elements essential for life and would confine his claims to a statement that it would alleviate all minor forms of physical or mental ill-health.

The average patent medicine advertised today makes plausible rather than absurd claims and in general the advertisements have changed to conform with a change in the level of the public’s knowledge.

It is somewhat misleading, however, to speak of this as an improvement, since the law has not altered and hence the change only means that the public is being swindled in a somewhat more skilful manner.

The ideal method of obtaining an adequate vitamin supply is to select a diet containing an abundant supply of fresh foods, but unfortunately the populace is accustomed to live very largely on preserved or partially purified food stuffs and such processes usually remove most of the vitamins.”

The first part of the passage above is reminiscent of something that A.J Clark wrote in  the BMJ in 1927.  Nowadays it is almost unquotable and I was told by a journal editor that it was unacceptable even with asterisks.  That seems to me a bit silly. Words had different connotations in 1927.

“The less intelligent revert to the oldest form of belief and seek someone who will make strong magic for them and defeat the evil spirits by some potent charm. This is the feeling to which the quack appeals; he claims to be above the laws of science and to possess some charm for defeating disease of any variety.

The nature of the charm changes with the growth of education. A naked n****r howling to the beat of a tom-tom does not impress a European, and most modern Europeans would be either amused or disgusted by the Black mass that was popular in the seventeenth century. Today some travesty of physical science appears to be the most popular form of incantation.”

A.J. Clark (1927) The historical aspect of quackery, BMJ October 1st 1927

Apart from some of the vocabulary, what better description could one have of the tendency of homeopaths to harp on meaninglessly about quantum theory or the “scienciness” and “referenciness” of
modern books on nutritional therapy?

So has anything changed?

Thus far, the outcome might be thought gloomy. Judging by Clark’s account, remarkably little has changed since 1938, or even since 1914. The libel law in the UK is as bad now as it was then. Recently the United Nations Human Rights Committee said UK laws block matters of public interest and encourage libel tourism (report here, see also here).   It is unfit for a free society and it should be changed.

But there are positive sides too. Firstly the advent of scientific bloggers has begun to have some real influence. People are no longer reliant on journalists to interpret (or, often, misinterpret) results for them. They can now get real experts and links to original sources.  Just one of these, Ben Goldacre’s badscience.net, and his weekly column in the Guardian has worked wonders in educating the public and improving journalism.  Young people can, and do, contribute to the debate because they can blog anonymously if they are frightened that their employer might object.

Perhaps still more important, the law changed this year. Now, at last, it may be possible to prosecute successfully those who make fraudulent health claims. Sad to say, this was not an initiative of the UK government, which remains as devoted as ever to supporting quacks.  Remember that, quite  shamefully, the only reason given by the Medicines and Health Regulatory Authority (MHRA) gave for allowing false labelling of homeopathic pills was to support the “homeopathic industry”. They suggested (falsely) that the EU required them to take this irresponsible step, which was condemned by just about every scientific organisation. But the new unfair trading regulations did come from the EU. After almost 100 years since the 1914 report, we have at last some decent legislation. Let’s hope it’s enforced.

Postcript

The back cover of the series of ‘Fact‘ books in which A.J. Clark’s article appeared is reproduced below, simply because of the historical portrait of the 1930s that it gives.


Follow-up

This post got a lot of hits from Ben Goldacre’s miniblog which read

Recent Comments