George Lewith, who is an advocate of CAM research, appears to have rather different standards in his private clinic.
Some interesting emails have come into my possession recently. They concern the Centre for Complementary and Integrated Medicine, which gives its address as Harley House, Brunswick Place (Formerly Upper Harley St.), London NW1 4PR (don’t you just love “formerly Upper Harley Street”?).
This centre lists its doctors as Dr Nick Avery, Dr Mike Clark and Professor George Lewith.
Their web site claims “There are several approaches that we use in complementary medicine that may be of help to people with fibromyalgia. There is at least one positive clinical trial that indicates that homeopathy can help this condition.”
An enquiry was sent to the clinic, as follows.
|My GP diagnosed my pain as fibromyalgia almost 2 years ago, but I have not had much relief from the treatment I’ve had so far. I have never tried alternative treatments, but I have looked at your web site and I see that you say “There is at least one positive clinical trial that indicates that homeopathy can help this condition”.
I wonder if you could give me some more details about that before I commit myself to trying it?
After some delay, a polite response came from Dr Avery.
|We treat an enormous number of patients with fibromyalgia and there are many things that can help. In practise [sic] we tend to use combinations of diet, nutrition, homeopathy and acupuncture.In my experience fibromyalgia patients are almost all suffering from magnesium deficiency which, once corrected, can have an enormous impact on symptoms. If this is not corrected, then conventional treatment cannot help.
Homeopathy seems to be a fundamental part of treating the (whole person) and it is the combination that seems to be so helpful.If you would like to come and see me then please ring my receptionists
But no mention there of a trial. A second enquiry gave a fascinating
|I am forwarding you the information you requested about the clinical trial for homeopathy used in helping with Fibromyalgia. I will pass Dr. Lewith’s reply to Dr. Avery who will be able to write to you with more detail when he’s at the clinic this Thursday.
—– Original Message —–
From: “Lewith G.” < firstname.lastname@example.org>
To: “CCIM” < email@example.com >; < firstname.lastname@example.org>
Sent: Friday, May 26, 2006 10:50 PM
Subject: RE: Message from Dr Avery
Its a BMJ paper in the late 1980’s by Peter Fisher. He used Rhus Tox 6C and it was a small positive trial.He will have it.
This paper must be the one that I was asked to check by the producer of a television programme (QED), (Fisher, P., Greenwood, A., Huskisson, E. C., Turner, P., & Belon, P. (1989). Effect of homoeopathic treatment on fibrositis (primary fibromyalgia) British Medical Journal 299, 365-366.).
But surely some mistake here? The problems with this paper have already been here. Fisher et al. had made a naive mistake in their statistical analysis, and in fact the homeopathic treatment had no demonstrable effect whatsoever, a result that was published soon after in the Lancet: Colquhoun, D. (1990), Reanalysis of a clinical trial of a homoeopathic treatment of fibrositis. Lancet 336, 441-442.). [Get the pdf]
So why does Professor Lewith cite the Fisher paper without mentioning that it provides no evidence at all? Professor Lewith says that he was unaware of this history. That does seem odd for someone who is devoted to assessment of CAM (all you have to do is search for ‘fibromyalgia and homeopathy’ in Medline). Very baffling.
Despite these puzzles, when I showed a draft for this site to Prof Lewith he said “Nick [Avery] and I have thought very carefully about the responses and we are very happy with them”.
|There are now more papers on the treatment of fibromyalgia, as Prof Lewith has pointed out to me. They are all from the University of Arizona, and all appear to refer to the same set of patients. One of these suggests that homeopathic treatment is effective (Bell IR; Lewis DA; Brooks AJ; Schwartz GE; Lewis SE; Walsh BT; Baldwin CM, Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology. 2004; 43: 77-582).
But a second paper about the same patients seems much less sure. The trial was organised as an ‘optional crossover trial’, and there was no significant difference between the proportion of patients who opted to swap treatments between those who were initially on placebo and those who were initially on homeopathy. Evidently they couldn’t tell the difference! (Bell et al., 2004, J. Alt Comp Med, 10, 269 383).
Both of these papers, incidentally, have as a co-author the famous (or perhaps infamous) Gary Schwartz, of the “Centre for Frontier Medicine in Biofield Science”, which is, believe it or not, part of the University of Arizona, and which, even more incredibly, gets NIH funding. He “photographs” non-existent “energy fields” and claims to be able to communicate with the dead (critique here).Well I guess the immortality is an even better seller than homeopathy. The picture on the right is what the “Biofield science” centre uses on its web site.
The AMI test and the Vega test
Dr Avery also sent “our information leaflet on Fibromyalgia”. This document was rather interesting.
|We find that a lot of patients with this condition suffer from food intolerance, which can be identified and treated. . . .Other measurements using the “AMI” which measures imbalances in the body can also indicate the whereabouts of the most significant internal dysfunction.Dietary and nutritional approaches can be enhanced by using acupuncture, classical and, in particular, complex homeopathy. Remedies can be identified using the Vega test, which measures energetic imbalances in the body, helping the practitioner to target the most appropriate areas in each individual patient.
What are these tests? The Vega test is one of the older con tricks. Dr Avery seems to be misinformed. The Vega test does not measure “energetic imbalances” (whatever that means), it measures skin conductance. So it resembles the infamous lie detector (perhaps it should be tried on its advocates). It has been the subject of several legal actions (listed here, by the Quackwatch site). Here are three of many examples.
- In 1985, the FDA notified a distributor that Vegatest devices could not be marketed as a medical devices without FDA approval (which they do not have).
- In 1990, the New Zealand Medical Journal described how a homeopathic physician had used a Vega device to diagnose allergies in three infants. In each case, the device was applied to the mother with the child on the mother’s lap or roaming about the examining room. The doctor also diagnosed “miasms,” which, if not removed, would prove fatal later in life. The Medical Practitioners Disciplinary Committee ordered that he be censured, pay a penalty of NZ$900 plus NZ$25,000 for costs and expenses, and follow certain standards of care for three years
- In 2002, the British Advertising Standards Agency concluded that a leaflet offering Vega testing as a “complete test for hidden problems” was misleading and advised the advertiser to withdraw it .
In 2003, the BBC did its own investigation.
“We sent Inside Out’s Chris Packham to three Holland and Barrett stores across the South to find out more.
Chris took the Vega test in Newbury, Chichester and Farnborough, only to discover that his allergy results differed from store to store.
In total, Chris was sensitive to over 33 different foods, including staples like wheat, potatoes, milk, tomatoes, tea and coffee. But out of the 33 products, there was only two that all three testers agreed on – cheese and chocolate.
Chris was also advised by Holland and Barrett staff to take a total of 20 different vitamins and minerals. But again, the testers can’t seem to agree and all three testers advised different supplements.
It seems your allergies may not be determined by food alone, but also your location.
Professor Lewith told me, when I asked about the Vega test,
“I use it to help with homeopathic diagnoses, your next question of course is why on earth would you want to make an irrational diagnosis about a completely irrational subject.”
Yes, indeed it is! But that question has not been answered.
To make matters still odder, Professor Lewith has himself published a paper showing that the Vega test does not work. Why, then, does he use it in his private clinic? The paper in question is in British Medical Journal, 2001;322:131-4. It concludes “Electrodermal testing cannot be used to diagnose environmental allergies.”
Despite his own conclusion in the BMJ, the homeopathy page of the Rosedale Clinic concludes
The Vega offers one of the most exciting advances in modern medicine to appear in recent years, an accurate method of non-invasive deep physiological investigation
I would like to dedicate this section to Dr’s LEWITH, KENYON and SCHIMMEL for their tuition and helpful guidance with the Vega technique.
The AMI machine is much less well-known. It presumably refers to “Apparatus for Measuring the Functions Of the Meridians and Corresponding Internal Organ”. Again it is said the the mysterious and undefined “imbalances”. The most likely interpretation seems to be that it just another galvanometer.
For a sane description of bizarre ‘allergy tests’, look here.