Dave, Aysha, and Lisa attended with a group of approximately twelve sceptics, many of whom were from CFI and Skeptic North. Apparently before we even stepped foot into the Convention Centre there was some controversy over at Skeptic North. Some of the organizers of the expo, along with some other folks associated with it, were engaged in a back-and-forth with the blog’s authors in the comments section (some of it was genial and some of it was nasty). So the organizers knew at least that some members of Skeptic North would be in attendance, and they were ready for them.

Lisa’s immediate response to the expo was revulsion at having to give propagators of woo and pseudoscience her $8 admission fee. She would much rather have donated the money to some sort of charity than to fork it over to them. So she felt a little better when Sunday turned out to be two-for-one admission.

Once inside the expo, the group naturally split off into sub-groups, with a plan to meet at the exit at 12:30pm. Somehow Aysha and Lisa managed to stick together and experienced most of the expo as a pair, going undetected as skeptics and experiencing no drama. Not so for some of the other attendees. Approximately 20 minutes into their foray, Lisa and Aysha heard an announcement over the loud speaker warning vendors that “four members of Skeptics North” were in attendance and may “attempt to record and/or photograph” vendors without authorization. The announcement also mentioned that the skeptics appeared to be dressed in black. It was an odd statement given that probably three-quarters of the people in the room were wearing black. At the moment the announcement came, Aysha and Lisa were discussing Omega Alpha’s products with the vendor, who then said, “You’re wearing black. Are you a skeptic?” To which Lisa responded, “Everyone here is wearing black. You’re wearing black!” It was light-hearted and they all went back to discussing Omega Alpha’s vast array of natural health products including their robust pet line (OptiPet Multi, E-Z Rest, GlucosaPet, Kidney Tone, and Liver Tone, to name a few).

Dave Bailey was prepared to go either way at the expo, but any notion of innocently engaging people went out the window when the organisers made their announcement. At that point his dander was raised and plan ‘B’ went into action. The previous evening Dave had downloaded a picture from Hell’s News Stand and ironed it onto a t-shirt — a cross-section of a toilet with the slogan, “If water has a memory then homeopathy is full of crap.” He took off his jacket to reveal his shirt and waited for reactions. For better or worse, none of the organisers or participants chose to take up the obvious challenge, although Dave did have a pleasant conversation with a couple of elderly ladies who seemed both amused and bemused. Later as Dave was being ‘followed’ out of the hall, a man walking in stopped to read it, chuckled, showed it to his wife, and then gave Dave a thumbs up and said he loved it. What he was doing there with that attitude was anyone’s guess — perhaps he wanted to have some past-life regression therapy to find out why homeopathy had failed to save him in a previous existence.

Dave was intrigued that some of the exhibitors seemed to be lowering themselves by appearing in such an environment when their presence at a genuine health expo would not have been out of place. He was particularly struck by the hemp booth, which didn’t seem to be touting any miracle cures, just promoting a product that is provably a resource with good sustainability and one that could be of much benefit to the agricultural community. Dave wonders if such vendors can’t afford to turn down any opportunity for publicity. (He highly recommends the hemp substitute for peanut butter — a free sample was eagerly devoured!)

This was Aysha’s first time attending the Whole Life Expo, or anything like it, so she was pretty excited to learn about which alternative products are popular right now. The one she was most baffled by was a homeopathic detox kit. Drops of the remedy had to be added to a 1.5 litres of water, shaken, and consumed daily for a few weeks. Aysha felt that simply filling a bottle with tap water at home would have been a more cost-effective and sensible option.

It was Lisa’s first natural health expo as well. She had no idea what to expect, but found herself constantly exclaiming about how unbelievable it all was. As Dave noted, there were some ‘legitimate’ vendors, but they were few and far between. The vast majority of them stretched the boundaries of science, and many of them were ethically questionable. It seemed as though Lisa’s incredulity grew greater with each booth she visited.

First there was Asea, the “scientific breakthrough that was thought to be impossible.” This was a particularly interesting experience because in trying explain how the product works, the vendor just got more and more twisted up. For the record, the front of the pamphlet explains that Asea is “NOT a vitamin or mineral supplement, NOT made from sea vegetables, NOT a [sic] herbal formula, NOT an exotic fruit or berry energy juice, NOT an over hyped antioxidant formula, NOT a novel delivery system.” So what is it? Lisa wondered as she excitedly opened the pamphlet to find out. Well, it doesn’t actually say. The brochure explains what Asea does for you (“boosting the cell’s communication allowing it to protect, repairing [sic], and replacing cells efficiently”). It explains the “science” of it (some stuff about reactive molecules, ATP, antioxidants, free radicals, oxidative stress, and redox signalling). According to the fine people at Asea, their product is “highly patented” (Lisa didn’t know there were high and low stages of patents) and is the only product that has stabilized the native cell molecules. Okay!

Aysha tried a sample of Asea while Lisa asked the vendor what Aysha might expect to feel from it. They were told that in about 15 minutes Aysha would feel a boost of energy. Lisa kept checking in, but Aysha reported no increased energy.

Lisa’s incredulity grows over at the Biotronix Research Instruments booth. Apparently these products heal with “electro-medicine.” This information packet is almost too brilliant to ever be thrown out and must be excerpted here, in its original form — all spelling and capitalization is in the original:

Every Cell In The Body Is Designed To Run At A Voltage Of 70-90 Millivolts. We Heal By Making New Cells ! For The Body To Make These New Cells Requires 70-90 Millivolts. We Get Sick When Our Voltage Drops Below The Operating Voltage of 20 MIllivolts. Thus, All Chronic Disease is Defined by Having Low Voltage.

However, If You Run Out of Voltage Before Finishing Making Enough New Cells To Replace Those That Are Damaged, Voltage Will Drop Even Lower And Now You Are Stuck With CHRONIC DISEASE. A Drop In Voltage Causes A Drop In OXYGEN!!! [—.] The Only Way You Can Get Well Is To Increase Voltage. This, Can Be Assisted By Using ELECTROMAGNETIC DEVICES. [—.] INTRODUCING: – A NEW INSTRUMENT ‘LYMEAID GENERATOR’

And it goes on—for SIX PAGES!!!

But the expo got even better. (Worse?)

Aysha and Lisa caught about 10 minutes of a talk/demonstration by Nicholas Ashfield. The presentation platform happened to be right near the washrooms, and when Lisa saw the device on the table, she couldn’t resist finding out what it did. The device looked like something that would be used in a low-budget 1970s sci-fi movie to appear “science-y” — it had knobs and a meter. Ashfield’s field of expertise (over 30 years of practice) is Radionics: “vibrational healing that clears past traumas, restoring attunement [sic] with life.” According to his flyer, Radionics is “gentle, fascinating, and effective.” While not a particularly great speaker, Ashfield did have a few choice bon mots that Lisa just had to jot down. When it came time to demonstrate his product, Ashfield asked for a volunteer, and one bald gentleman in a black shirt (perhaps a skeptic??) raised his hand a little too eagerly. Then a bunch of other people raised their hands, including Lisa. Ashfield said he couldn’t just choose someone, that he had to let the “source” choose for him and he used “internal dowsing” to eliminate everyone in the crowd except for—bald-black-shirt guy! Ashfield referred to this “source” over and over again, but never explained what it was. Apparently it was some sort of supernatural entity that guided him. It was the “source” that allowed Ashfield to use Radionics to “clear” the plant—ahem, uh—volunteer from a distance — he didn’t have to be hooked up to the machine or even be near it; it works long distance. Ashfield informed us that in physics it’s known as an “index.” Ah. So long-distance, via Radionics, Ashfield managed to tune into the plant/volunteer’s “energetic e-mail address.” And then he told his fortune. Aysha commented that it was like he was reading the guy’s horoscope out of the paper. Indeed. After a relatively racist comment (about how Native people have been using this technique for a long time because they have a connection to nature that modern, “civilized” people didn’t have), Aysha and Lisa had had enough of the Radionics guy and moved on.

(Side note: It was just before Ashfield’s talk that the second announcement about ‘skeptics in our midst’ came over the loud speaker. Ashfield said he didn’t mind if skeptics were in attendance because he, too, used to be a skeptic — before he tried Radionics.)

Lisa really wanted to have a “Bio-ENERGY & KARMA DIAGNOSIS” and even filled out the form to have it done, but alas the line was too long. Instead she had her posture checked. There were maybe five or six chiropractic-type people there all with the same tools for checking posture, so Lisa had it done twice. The first gentleman told her that her head was too far forward while pointing to a photo of a spine with scoliosis in a subluxation text book. He really wanted her to sign up that day for treatment at a discounted rate. He even took credit cards!

Despite all of these experiences, not every vendor was sketchy. Or, at least, some provided pleasant surprises. One vendor spent a great deal of time discussing her product for digestive problems. Aysha and Lisa maintained a credulous, curious demeanour throughout the expo, asking questions with keen interest. When Lisa asked this vendor, “Should I take this pill if I don’t have digestive problems?” it is to the vendor’s credit that she said no. She instead suggested foisting it upon grandma at Christmas dinner. Nonetheless, the question was meant as a set-up to see if the vendor would recommend her ‘remedy’ even in light of a lack of symptoms, and she passed the test.

Aysha also found herself impressed by a vendor’s candor. She had a great conversation with a vendor about a “chakra reading” being offered at one of the other booths. The vendor had a ‘reading’ done the day before and seemed a little skeptical of what she was told. She mentioned that a lot of what the ‘reader’ told her was very general and could have applied to anyone, but that a couple of major things were going on in her life that the ‘reader’ did not mention; the vendor really felt that the ‘reader’ should have picked up on those things. Aysha told the vendor that she agreed and that she wishes people would talk more about the misses that they experience when they have a ‘reading’ done. Aysha was impressed with vendor’s critical reflection on her experience.

Dave was surprised to learn (and later confirmed through independent online research) that what he has been using as cinnamon for years is actually not true cinnamon, but cassia, a related plant that is usually substituted. The true cinnamon is much less woody than cassia, thin and brittle in texture, but with a very similar if not identical aroma. The genuine article may soon be appearing on his spice rack. Knowledge worth the $4 admission fee?

What shocked Lisa most about the expo overall was what seemed to be the absolute lack of effort on the part of the vendors and manufacturers to pass their products off as scientific. It seems that just saying something is science and having a few pseudoscientific words and phrases at the ready is all these vendors generally need to fob their wares off on unsuspecting consumers. But when pushed even a little to get into the nitty gritty by people with some scientific knowledge, the vendors tripped over themselves in a befuddled mass of confusion and ignorance. When the Asea vendor was going on about redox signalling and mitochondria, Aysha asked for more specifics about how it worked. The woman then pulled out a lovely colour photo of a cell, when she didn’t identify as a blood cell until Lisa pointed it out to her. “Oh yes,” she said, laughing, “thank you for pointing that out!”

Another vendor had a few products, one of which was a plate that allegedly leeches bad chemicals from your food. Simply place your grocery bag on this plate and it will remove all harmful chemicals from your food. Lisa asked how it works. The vendor explained that it uses a “process” by which the “bonds” between the chemicals are “broken down.” When Lisa pushed further — microwaves? what? — the vendor replied, “It’s proprietary.” Lisa didn’t leave it there. “Well, what about the good things in food, like the vitamins and minerals? Does it break those down too?” The response was “no.” Magic!

Aysha and Lisa visited a booth promoting “polarity therapy” workshops. This was something neither of them had heard of before and they were ever so curious! The pamphlet explains polarity therapy as “the art and science of balancing the subtle, natural electromagnetic energy that creates and maintains our physical, mental, emotional and spiritual selves.” When prompted, the vendor had an extremely difficult time explaining what it was, highlighting instead that we could learn all about it through the workshops. She pointed to a couple of books there and then said that it takes years to learn.

Aysha and Lisa still don’t know what polarity therapy is.

For the most part, the members of Association for Science and Reason had a fine time at the expo until Dave Bailey ran into a little trouble at the end for taking photographs. While there was apparently a sign indicating that photography was not allowed inside the expo hall, Dave went outside of the expo hall to a balcony above it and took photos from there. He was approached by security and someone who seemed to be one of the organizers or associated with the organizers. Members of CFI and Skeptic North were treated antagonistically, and you can read their respective reports via the links below.

CFI’s account:
Skeptic North’s account, 1:

Skeptic North’s account, 2:

Then she discovered Judy suffered from osteo-arthritis, mild scoliosis (curvature of the spine), pronounced asymmetry and multiple subluxations that could lead to serious health problems. The cost of chiropractic therapy to deal with these problems, she was told, would be approximately $5,000.

However, Judy’s mother did not panic and pull out her check book. In fact, she was not alarmed at all, unlike most parents upon hearing such news. For she had taken her daughter to five chiropractors as part of an undercover investigation by a team of Toronto journalists.

Judy Matthews (a pseudonym to protect the youngster’s identity) was further examined by Dr. John Wedge, chief of surgery for Toronto’s famed Hospital for Sick Children, and found to be a “perfectly healthy girl” who needed no immediate or ongoing treatment.

Yet four out of five chiropractors in the Toronto area had found “serious” problems with Judy’s spine — specifically subluxations that needed chiropractic treatment.

Judy’s experience with chiropractors was part of the research undertaken by a team of journalists, headed by veteran reporters Paul Benedetti and Wayne MacPhail, to investigate pediatric chiropractic. Their investigation, which concluded that most chiropractic treatment of infants and children is “quackery”, was reported in a week-long series in Canada’s Sun Media newspapers and on the CANOE.CA news Web site in March 2001.

Among their findings were that as many as half the chiropractors in Canada may be using illegal tools for diagnosis, chiropractors often use scare tactics on parents of young children to build their practices, and more than 70 percent of Toronto-area chiropractors contacted in a random phone survey claim to be able to treat ear infections with chiropractic adjustments. Some chiropractors were found to claim they could treat attention-deficit disorder, hyperactivity, asthma, learning disabilities and even autism.

More damning, the journalists could find no evidence that subluxations even exist or that the treatments cured the problems said to be caused by subluxations.

The cost to Canadian taxpayers through medical insurance plans and user fees for pediatric chiropractic was estimated at $40 million a year (much of which is covered by government-funded medicare in Canada).

Not all chiropractors were found wanting however. The articles noted that not all chiropractors treat infants and children and that some restrict their practices to musculoskeletal problems.

In recognition of their work, Benedetti and MacPhail received on March 28, 2001 the Ontario Skeptics’ first Award for Critical Media Reporting, “exemplifying the skeptical ideals of open-minded investigation, critical thinking, and alerting the public to the dangers of pseudoscience”.

The Ontario Skeptics also wrote the Ontario minister of health and other government officials to demand an investigation of pediatric chiropractic and to “put an end to the tragic waste of taxpayers’ dollars which are urgently needed for established treatments for actual medical conditions”. The government has not responded.

This article is based on an article that first appeared in Skeptical Inquirer.

Some might be surprised he is even alive—a week after publicly downing the entire contents of three containers of homeopathic remedies, including a supposed arsenic alum.

McMillan took the massive overdoses as part of an event to launch the organization’s year-long campaign on Complementary and Alternative Medicine (CAM). The meeting featured York University professor Michael De Robertis presenting the history and research into homeopathy, as well as award-winning journalists Paul Benedetti and Wayne MacPhail reporting on their investigations into chiropractic and other alternative medical treatments.

The audience gasped as halfway through the meeting McMillan displayed three homeopathic products, opened the packages and tilted the contents of all—including a bottle of liquid, a dispenser of granules and three tubes of caplets— into his mouth, adding only a little water to help him swallow them.

“I wanted to dramatically demonstrate the ineffectiveness of these so-called remedies,” he said afterwards.

According to homeopathic theory and practice, the effective agents in the remedies are diluted by their makers to the point that it is unlikely that even a molecule remains, but “water memory” is supposed to help the diluted substance retain its curative properties.

Despite warnings from the products’ manufacturers about overdosing, the three selected for the demonstration contained no active ingredients, McMillan said.

“I was told that if they were effective, I would start feeling ill within one to two hours.” However, he completed hosting the meeting. And seven days later he reports no ill effects at all. “Not even a twinge.”

However, McMillan does not recommend anyone else try this experiment on their own.

“We researched the products beforehand and I consulted with a pharmacist about the particular ingredients in the three I decided to take,” he said. “Even if the advertised active ingredients are not actually present in mixtures, homeopathic products are often filled out with other substances that I understand may cause a reaction if taken in large doses.”

He also experimented with other samples of the products earlier to ensure he would not have an allergic or other reaction to the ingredients at the meeting.

Nor was the demonstration offered as a controlled, scientific experiment examining the effectiveness of homeopathic products in preventing or curing disease, he said.

“Skeptics Canada is calling for all such products to be tested for efficacy, with scientific evaluation meeting the same empirical standards that all medical remedies should meet,” said the chairperson.

“This was just a little dramatization to bring home the lack of understanding about these products.”

As most skeptics will realize, the claim that solutions can retain their effect when diluted many times, and indeed that the effect increases with dilution, is one of the fundamental tenets of the fringe medicine of homeopathy, but runs contrary to current knowledge in chemistry and biology. The results of this experiment, if validated, would therefore have lent credence to the claims of homeopaths.

However, additional information has come to light which forces us to reassess this research and its publication.

The initial report appeared in the June 30, 1988 issue of the British journal Nature, Vol. 333. Its results were sufficiently unusual that the editor of Nature began that issue with an editorial titled, “When to believe the unbelievable”. It is worth quoting extensively from that editorial:

Inexplicable observations are not always signs of the supernatural. That is what readers of the remarkable article on page 816 should keep in mind. They should also remember that Avogadro’s number, the number of molecules in a gram molecule of material is roughly UR1021, which naturally implies that most of the experiments with antibody solution reported by Professor Benveniste and his colleagues have been carried out in the literal absence of antibody molecules. For what the article shows is that it is possible to dilute an aqueous solution of an antibody virtually indefinitely without the solution losing its biological activity. Or rather, there is a surprising rhythmic fluctuation in the activity of the solution. At some dilutions, the activity falls off; on further dilution, it is restored.

There is no objective explanation of these observations. Nor is there much comfort for anybody in the explanation offered at the end of the article that antibody molecules once embodied in water leave their internal marks, as ghosts of a kind, on its molecular structure for there is no evidence of any other kind to suggest that such behaviour may be within the bounds of possibility….

Certainly there can be no justification, at this stage, for an attempt to use Benveniste’s conclusions for the malign purposes to which they might be put. There are some obvious dangers. In homeopathic medicine, for example, which works on the principle that very small concentrations of appropriate products may have consequences that far outweigh those expected of them, there will be a natural inclination to welcome Benveniste’s article as aid and comfort, but that would be premature, probably mistaken.

Nature also appended the following to the end of Benveniste’s article:

Editorial Reservation:

Readers of this article may share the incredulity of the many referees who have commented on several versions of it during the past several months. The essence of the result is that an aqueous solution of an antibody retains its ability to evoke a biological response even when diluted to such an extent that there is a negligible chance of there being a single molecule in any sample. There is no physical basis for such an activity. With the kind collaboration of Professor Benveniste, Nature has therefore arranged for independent investigators to observe repetitions of the experiments. A report of this investigation will appear shortly.

Apparently, the editors of Nature were sufficiently uncomfortable with Benveniste’s article that, after several revisions, they agreed to publish the article only if the researchers would permit their laboratory to be visited and their results investigated, by a team selected by Nature.

This team consisted of John Maddox, a journalist with a background in theoretical physics; Walter W. Stewart, a specialist in studies of errors and inconsistencies in the scientific literature and in the subject of misconduct in science, and James “The Amazing” Randi, whose name should be familiar to readers as a magician and skilled debunker of the paranormal and who was included on the team “in case the remarkable results reported had been produced by trickery”. After their investigation, the team published their findings in the July 28 issue of Nature, Vol. 334. They found in essence that the results were wholly erroneous.

Erroneous results found

Before their findings can be properly understood, it is necessary to understand the design of the original experiment. In the bloodstream is a variety of types of white blood cell, which perform various functions. This experiment focused on a particular type known as a basophil, so named because it contains granules which are selectively stained by basic (alkaline) dyes. Basophils carry on their surface a type of antibody called IgE (Immunoglobulin type E). If this antibody binds to a foreign substance for which it is specific, it causes the basophil to release its granules, which contain histamine and a variety of other substances responsible for the clinical signs of allergic reactions. The same result can be elicited by exposing the basophils to an antibody which binds to IgE, referred to as antiIgE.

In their experiment, Benveniste’s team began with a standard solution of anti IgE and repeatedly diluted it by 1:10. Each dilution was then added to a suspension of white cells, and the number of intact basophils was counted. (Basophils which have lost their granules do not pick up the specific stain and are therefore not readily distinguishable from certain other types of white cells.) This was done by placing a measured amount of the suspension in a counting chamber, a glass slide with a grid precisely etched on its surface, and counting the basophils under a microscope. The amount of degranulation was calculated by noting the difference in the number of basophils between test and control samples, expressed as a percentage.

Under the eyes of the investigative team, Denveniste’s researchers repeated their experiment seven times: three times using their normal procedure, once “blind” (that is, reading the dilutions in random order without knowing which ones they were), and three strict “double blind” experiments, in which no one present knew which samples corresponded to which dilutions until after they had been read. The “normal” runs produced the results that had been reported in the original paper. The fourth run produced very high peaks even at high dilutions, an effect comparable to the undiluted original sample. The three double blind runs produced the result that conventional science would have expected: a high initial peak, which drops off to a minimum when diluted.

Experiments don’t always “work”

The investigation team found the following flaws in the experiment:

1) The experiments do not always “work”. There are periods during which high dilutions produce the negative results that current science would expect, and these periods last for up to several months. These negative results were not reported.

2) The experimenters are far from unbiased. Two of the coauthors of the article receive salaries under a contract with a supplier of homeopathic medicines. This alone, of course, does not invalidate the experiment; most researchers expect to get some particular result when they run an experiment. It does, however, explain why the researchers, even now, refuse to admit that their results have been refuted. The investigators stated in their report that “the climate of the laboratory is inimical to an objective evaluation of the exceptional data”.

3) The peaks seen at high dilution, and described by Benveniste as “periodic” occur in fact at rather irregular intervals. Furthermore, Benveniste’s notebooks showed that the peaks do not occur at the same dilutions on successive runs. This alone suggests that the results reported are a random phenomenon, and not the positive result claimed.

4) There is a problem in experimental procedures of this type called “sampling error”. In essence, when a sample of blood is placed in the counting chamber, and the number of basophils is counted, the result will not be the same each time, but will vary randomly to either side of the true proportion. The branch of mathematics known as statistics provides formulas for calculating how much variation of this type can be expected for a given experimental setup. In the investigators’ report. they state:

At INSERM 200 [Benveniste's lab], there seems to have gown up a less formal way of dealing with problems of this kind: When the reading of a diluted sample is greater than the control counts, the experimenter often counts the control sample again, on the grounds that the first reading “must have been wrong ….”

This procedure exaggerates to some extent the amount of basophil degranulation measured with reagents at high dilution. The practice makes the control values unreliable, and is a significant pointer to the laboratory’s disregard of statistical principles.

To someone with no training in statistics, this procedure might seem reasonable, or unimportant. In fact, it alone is sufficient to invalidate the results. Recounting only those control values which are “too low” has the effect of artificially inflating the control values, and thereby creating a purely artifactual difference between the control and sample values.

The investigators summarized their findings by stating, “We conclude that there is no substantial basis for the claim that antiIgE at high dilution (by factors as great as 10¹²⁰ retains its biological effectiveness, and that the hypothesis that water can be imprinted with the memory of past solutes is as unnecessary as it is fanciful.”

Dr. Scrimgeour is a veterinarian with Agriculture Canada’s Meat Hygiene Division and was a member of the executive of Ontario Skeptics when this article was written.

Naturopathy and its associated practices are well known to skeptics, and little description is needed here, but for those who are interested in an in-depth analysis, try www.naturowatch.org/general/beyerstein.html by the late Dr. Barry Beyerstein, a skeptic and biopsychologist at Simon Fraser University.

In general, naturopathy eschews conventional scientific ideas about medicine and lifestyles in favour of a “natural” approach to treatment. I’m sure that we can all agree that “natural” is fine, up to a point—arsenic and poison ivy are natural, too. Furthermore, since the panoply of modern medicines and surgical techniques are outgrowths of our natural intellect, can’t they also be classified as natural? Not good enough, say the practitioners of naturopathy; they want nothing to do with what most of us would look for from a doctor or pharmacist.

But it seems that they often want it both ways. While they extol the very “naturalness” of natural medicines, they are all too eager to try to impress the public with laboratory studies and claims that naturopathy is “evidence based”. They are quick to latch on to any scientific discoveries that they can use to make naturopathic claims sound impressive, even if such discoveries, such as quantum mechanics, have little or no relevance to medical practices.

Beneath the façade is a simplistic approach with very little science involved, an approach in which observations and evidence are gathered and applied using flawed premises and mystical assumptions of “energy fields”, water with a memory, and unobservable “vibrations”. Some common themes can be found in alt-med proponents, one of which is that these therapies have been used for thousands of years. True, many have, but for all those thousands of years only the hardiest people lived much beyond the age of thirty, and human life expectancy grew dramatically only once science-based medicine became widespread.

Naturopathic practitioners often accuse conventional medicine of being all about money. There is money to be made for sure, and drug companies have occasionally been involved in scandals by skewing their test results. But for the most part, they are more concerned with turning out something that truly works, because it is those pharmaceuticals which will return their investments in research and bring them the best public image; after all, nothing succeeds like success. Nor are the naturopaths, for all their spiritual interests, noted for altruism. Americans spend over $5 billion per year on alternative medicines. There is surely serious profit involved. If drug companies were interested only in money, wouldn’t they want a piece of that action? Don’t bother spending money on tests and production facilities, just pick it at the roadside, wash the coyote pee off it, and stick it in a bottle! What could be simpler?

A perusal of web sites dedicated to alt-med shows indulgence in one of the oldest logical fallacies. Naturopaths will often point out real or perceived failures of conventional medicine as if it somehow strengthens their position. At the site named enerchihealth.com ( I think “chi” is a bit of a giveaway) we find the statement, “In 1971 President Richard Nixon declared ‘war on cancer’ and scientists were optimistic there would be a cure in 5–10 years. Today there is still no cure for cancer.” Let’s have a look at that. Who were these scientists, how many were there, and what were their areas of expertise? One thing we can be sure of is that they were human, with all the hopes, dreams, and foibles we are all subject to. Just because some may have beaten the drum and been overly optimistic doesn’t mean that a program has been a failure and should be replaced with another method.

And while we may not have what can be truly described as a “cure” for cancer, present science-based treatments are far in advance of what was available in 1971, with survival rates much higher.

Meanwhile various naturopathic treatments show no advancement in survival rates, and practitioners will cringe and run when the name Steve McQueen is mentioned.

Where does the blogisphere stand on this? Google the phrase “naturopathic medicine” and you get 742,000 returns, which should provide plenty of fodder for those who would expose it. But try a search on “naturopathic medicine” + “pseudoscience” and you get only 2,180.

There may be lots of us fighting for reason and against pseudoscience, but it appears that we are severely outnumbered.

Iridology was developed by the Hungarian Ignatz von Peczely, who at the age of ten had the bad—or good—luck to accidentally break an owl’s leg. What happened then is told with many small variations, but here is the version given on the website of The Canadian Institute of Iridology : “… the two glared into each other’s eyes and he noticed a black streak instantaneously appear at 6 o’clock in the owl’s iris. He nursed the owl back to health and observed that the streak had changed over time to a crooked white line. When von Peczely became a doctor, he remembered this incident while examining a patient with a broken leg. To his amazement, Dr. von Peczely saw the same crooked white line at 6 o’clock in this patient’s iris … he realized [it was] an indication of scar tissue in the leg.”

Dr. von Peczely went on to chart the correspondence he saw between each organ of the body to a particular location on each iris. The iris is mapped as if it were a clock. Diagnosis is made simply from the texture of the iris and the location of pigment flecks in the eye. Problems with the thyroid gland, for example, should show up in the iris of the right eye at 2:30, and the iris of the left eye at 9:30.

Does a PhD study conducted in Sweden, claiming to definitely link the appearance of the iris of the eye to certain personality traits, provide a scientific basis for the tenets of Iridology? The study, led by postgraduate student Mats Larrson, examined the irises of 428 people who had already provided personality data about themselves through a personality inventory. (You may read about the study in detail at www.oru.se/templates/oruExt Normal_24994.aspx .) The conclusion was that people with more “crypts”, or pits, in their irises tended be warm, sympathetic and trusting. People with more “contraction furrows”, or lines curving around the pupil’s outer edge, rated themselves as more impulsive and neurotic, and likely to give in to cravings. Pigment dots, on the other hand, were not found to be linked to any personality traits. This is reassuring, I think, because it proves the researchers’ bias was not completely controlling their reading of the evidence.

At first glance, this claim brings to mind the pseudoscience of phrenology (now no longer rearing its ugly head). Phrenology claimed the pattern of bumps on the skull revealed an individual’s personality. It has become a historical joke. The practice of iridology, however, is alive and well. You may visit an iridologist today if you like; there are several practising in every major city in Canada. The Canadian Institute of Iridology, based in Toronto, will give you the opportunity to become a Registered Iridologist entirely by correspondence. Think about that for a while, but not for too long. The good part of visiting an iridologist is that there is no need to change into one of those embarrassing paper gowns. The bad part is iridology doesn’t work. Tests repeated in various countries over the years have proven that iridologists cannot correctly identify the sick from the well simply by looking at pictures of irises—and often even disagreed with each other’s diagnoses.

In any case, how could iridology work? According to Dr. Steven Novella, the author of an excellent skeptical website, NeuroLogica Blog (www.theness.com/neurologicablog) there is no known pathway through which any organ in the body can express its aches and pains (or joys and thrills) to a specific location in the iris.

Which brings us back to the question: can the iris reveal personality traits? Dr. Novella thinks it is quite possible. He explains that the PAX6 gene, (at the centre of Larsson’s study), is known to control the development of the iris, and also plays a role in the development of the frontal lobes of the brain. A correlation between the iris and personality could exist.

That large bump over your right ear doesn’t prove you are greedy, and that black spot at 3 o’clock in your right iris is probably a flake of mascara, rather than a sign of kidney disease, but if you often find yourself craving excitement and impulsively driving to the casino in the middle of the night, you might want to take a good look in the mirror.

North Americans spend over $30 billion annually on Complementary and Alternative Medicine (CAM) – from acupuncture to therapeutic touch. More than one-third of adults now use at least one form of “alternative” health care each year (where “alternative” is loosely defined as those practices which aren’t generally taught in medical schools or offered at most hospitals).¹

The most frequent health problems treated by alternative practitioners are chronic pain, anxiety or chronic fatigue syndrome, sprains/muscle strains, addictive problems, arthritis, and headaches.

The most frequently cited benefits of CAM by patients are: partial relief from symptoms/pain; the treatment works better than standard medicine’s; and the treatment promotes health rather than just focusing on illness.

Users of CAM are on average more educated and believe they’re in poorer health. (More educated people are exposed to non-traditional forms of health care through reading and are more likely to question conventional authority.) Many of these are the “worried well”; people who experience and report symptoms that have no physiological explanation.²

Why is CAM now so popular? According to a recent survey:

1. patients are dissatisfied with conventional treatments because they are ineffective, produce adverse effects, or are “impersonal, too technologically oriented, and/or too costly”;
2. patients seek greater “personal control” or “empowerment” over their health-care decisions;
3. alternative medicine is more compatible with patients’ worldview, values or spiritual/religious philosophy.

It should be of great concern that the last reason turns out to be the most important of all because it is not congruent with a rational, efficient and effective health-care policy.⁴

Unlike conventional medicine, the majority of alternative therapies have not been scientifically tested. Many of its advocates even deny the need for or applicability of clinical testing, relying instead on anecdotes, “natural” remedies, or ancient theories for justification.

Most CAMs adopt a form of vitalism; the notion that the human body contains an “energy field” (e.g., chi, ki, prana, orgone, life force, aura…) whose disturbance leads to pain and dis-ease. This view is rejected by modern medicine. In the same way, CAM practitioners emphasize terms like “wellness” and “natural” that convey little meaning. Moreover, they incorrectly maintain that CAM treats the cause of disease, while conventional medicine merely treats symptoms.

Biomedicine has remained relatively silent during the CAM explosion of the past generation. This is a serious mistake according to a recent editorial:⁵

“It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments.”

And finally, it is a popular misperception that alternative therapies are harmless, even if they are no better than a placebo (“sugar pill”) because:

1. Money spent on CAM could be better spent on scientific research for serious ailments.
2. In rare instances, the delay resulting from not seeking conventional therapy could have dramatic consequences for a patient with a serious condition.
3. Tacit support of CAM by governments legitimizes anti- and pseudoscientific health-care practices.

References

¹ Eisenberg DM et al. Unconventional medicine in the United States: prevalence, costs, and patterns of use. N Engl J Med. 1993;328:246-252. http://content.nejm.org/cgi/content/abstract/328/4/246
² Barsky AJ, Borus JF. Somatization: and medicalization in the era of managed care. JAMA. 1995;274:1931-1934.
³ Astin JA. Why Patients Use Alternative Medicine. JAMA. 1998;279:1548-1553. http://jama.ama-assn.org/issues/v279n19/rfull/joc71141.html
⁴ http://www.crhp.net/ Canadians for Rational Health Policy.
⁵ Angell M, Kassirer JP. Alternative Medicine – The Risks of Untested and Unregulated Remedies. N Engl J Med. 1998;339:839.

Lewis had been treated for migraine headaches by chiropractor Philip Emanuele. After her final visit she complained about the manner in which her neck had been manipulated and the intense pain which ensued. A couple of days after this visit, Lewis suffered a stroke. This was followed a few days later by a second stroke, which resulted in her death.

Dr. John Deck, neuropathologist from the Office of the Chief Coroner, Toronto, blamed the death on chiropractic manipulation. Deck said that there was no significant doubt in his mind that the chiropractic manipulation was the cause of the fatal stroke. His findings were certified by Dr. Robert Huxter, Regional Coroner for Ontario and by another Ontario coroner, Dr. Murray Naiberg.

An inquest was held into the death and ran from 2002 to 2004. At the inquest the Lewis family was represented by lawyers Amani and Neil Oakley. The Oakley’s previous cases had usually involved medical malpractice or human rights. Prior to taking on the Lewis case, they knew very little about chiropractic. They thought that it was used only for back pain, but further research showed that some chiropractors claimed they could treat a wide range of ailments, including allergies and cancer.

As the Oakleys delved deeper, they were shocked to learn how little evidence exists to back up the claims of chiropractors. While chiropractic uses a lot of jargon which sounds scientific, it is based on an untested hypothesis. Spinal manipulation is supposed to correct “subluxations” that interfere with the flow of innate energy through the body. According to chiropractic, this energy will flow properly only if the neck and spine are lined up properly.

The technique that chiropractors use for neck manipulation is quite different from that used by other health practitioners such as physiotherapists. Apparently it can make alarmingly loud crunching and cracking noises.

Chiropractors claim that everyone can benefit from their treatment. This includes healthy children, who they say may be suffering from subluxations caused by birth or normal childhood activities. They also claim that the risks of chiropractic treatment are small, and that the probability of a bad outcome is small. Amani Oakley however, whose firm now deals with many cases involving chirorparactic, counters that claim with a question: if a treatment has no benefit, then is any risk acceptable?

In a typical medical malpractice suit, the Oakleys generally argue that the treatment was not appropriate or was administered improperly. But it comes to chiropractic, they now take the position that someone coming in for maintenance care has no condition to be treated. If a specific ailment is being addressed, they argue there is insufficient evidence that the treatment accomplishes more than a placebo. In both cases, then, it seems inappropriate to take on any level of risk.

Before becoming lawyers, both Amani and Neil Oakley had obtained science degrees and had worked in the field. This helped them realize, after they started to delve into the inquest’s issues, that chiropractic has no solid science to support it. During the inquest they drew on their research to discredit the witnesses called to support neck manipulations and they laid out before the jury the evidence that such adjustments were dangerous.

Relying on arguments based on hard science, Amani was able to convince the jury in the Lewis case to return a verdict favourable to the family’s claims, even though she had to wrestle with countless procedural oddities. (For example, the counsel for the defence received three times as much time for its concluding statements since they had three sets of lawyers who represented the chiropractor, the chiropractic college, the chiropractors’ association and the chiropractors’ insurers.)

The victory in the Lana Dale Lewis case cast a harsh light on chiropractic and raised the public’s awareness of the risks of treatment. According to Amani, more people who go to chiropractors now tell them, “Don’t touch my neck.”

With these words in the Senate of York University on April 26th, 2001, the proposal for an affiliation with the Canadian Memorial Chiropractic College (CMCC) expired without so much as a whimper. The six-year nightmare was over.

This was in stark contrast to the divisive and often bitter struggle waged by faculty members concerned about the academic integrity of York University over the past few years. The consensus seems to be that without the intervention of Professors Alcock, Böhme, Jeffers and the author—dubbed the “gang of four”—CMCC would have finally succeeded in securing the academic legitimacy the worldwide chiropractic community has desperately craved over the past century.

Now is the time for post mortems. The most common question people ask at this point is, what finally turned the tide, given that only three years ago this initiative was regarded as a fait accompli?

I wish I could write that senators and faculty at York were swayed by compelling arguments involving scientific and ethical integrity.¹ But conversations with a number of professors tell a different story. Each seems to have his or her own reasons for rejecting the association, reasons that are often more political than scientific, even among scientists.

Equally frustrating was the almost complete lack of public support by academics who knew better. Dozens of prominent faculty expressed outrage at York’s chiropractic dalliance in private, condemning the administration for its anti-science initiative and wishing us “all the best.” But when it came to joining the public campaign, the silence was deafening.²

It may come as a shock that there were actually several scientists, largely biologists, who not only approved of the proposal, but also likely counselled and even encouraged the administration to proceed with the affiliation.³ While the biology department would have benefited tangibly from the merger, one might have expected scientists to unanimously disapprove of a proposal so scientifically flawed. Perhaps this illustrates that scientists are as susceptible as anyone else to the temptations of politics.

There is no question that this proposal was first and foremost politically driven. As Canada’s third largest university, York is anomalous in not having a medical school or large-scale health program. In my view, the senior administration at York University in 1994 regarded an affiliation with CMCC as an opportunity to become a “player” in health studies and health policy overnight, particularly since the prospects for securing a medical school were remote. In fact the Associate VP Research was quoted in an international publication as saying that the affiliation was intended more for social scientists than scientists.

When controversy first erupted over this initiative in 1998, proponents of the proposal were forced to defend it publicly, citing the following justifications on various occasions:

a) chiropractic is a licensed, regulated profession in Ontario and as such there could be no question of its legitimacy as a university discipline.

b) chiropractic lacks research maturity because the hegemonous medical establishment has marginalized it for years. Chiropractic today finds itself in an analogous position to conventional medicine a century ago.

c) chiropractic certainly needs reforming, and the best way to do so—and the most socially responsible way—is to bring it into a university environment.

d) chiropractic works.

e) the “buy-in” price of twenty-five million dollars.

Each of these is easily refutable: (a) has nothing to do with scientific legitimacy or the ability to establish a research culture which are essential. For example, massage therapy is licensed and regulated, but no one is suggesting York offer a degree in it (I hope!); (b) is simply inaccurate, though it may sound convincing to some academics for whom everything is political. (c) is entirely irresponsible until chiropractic renounces its anti-scientific practices and attitudes of its own volition; (d) there are no compelling studies that show that chiropractic therapies are safe and effective; (e) since when is academic integrity for sale?

As the gang of four began to draw attention to specific issues of biomedical concern in campus publications and private letters, the administration and senate became strangely silent. Not once did a York official address a single biomedical concern in a public forum. And right to the end, the Senate was adamant that the process had always been open and fair, even though it consistently refused to solicit information from the biomedical community (or from its Faculty of Science for that matter).

York had, however, solicited advice extensively from alternative medicine practitioners! Very curious behaviour from an institution committed to a search for truth in an open and rigorous manner. From the perspective of scientists, perhaps the most troubling aspect of the chiropractic experience was the magnitude of the ignorance of and antagonism toward science. One of York’s most senior administrators and a regular chiropractic patient approved of the proposal because chiropractic “works for me.”

Senior senators renounced Science’s objections to the proposal, accusing scientists of being “unwilling to admit there are other truths,” of failing to recognize that “alternative medicine is the way of the future and we should be leaders,” etc. York’s senior administration also ignored a petition signed by many well-known academics, including two Nobel Laureates in Medicine, asking York to reconsider its actions.

What does the future hold? If the past is any guide, CMCC will seek a partnership with yet another Ontario or Canadian university in a couple of years.⁴ The “gang” intends to document fully our story so that these institutions can benefit from our experiences.

Finally, it is important to note that while this marks the end of the York chiropractic campaign, a much larger and more important battle lies ahead, a battle in which we are all called to participate. Can there be any doubt that cash-strapped, post-secondary institutions will be wooed in the near future by major alternative medicine colleges—homeopathic, naturopathic, acupuncture, holistic, shiatsu, and chiropractic? “Have money, seek legitimacy. Are you for sale?”

And the moment the first university succumbs to this temptation, society will have taken a fork in the road that leads away from enlightenment.

Footnotes

¹ For example, chiropractic continues to lean heavily on its vitalistic roots. Until the community rejects these in favour of standard biomedical paradigms, it should not be offered a place at any research-based institution. And the burgeoning field of pediatric chiropractic is regarded by the Canadian Pediatric Society as entirely unnecessary and ineffective.

² This was in contrast to the many skeptics who courageously wrote York’s administration to express their concerns. These letters almost certainly had a positive effect.

³ There cannot be much doubt that this support prolonged the nightmare until two independent Faculties, Science (1998) and Atkinson College (2001), unconditionally rejected the affiliation

⁴ CMCC has been involved in over a dozen (unsuccessful) affiliation attempts with Canadian universities