Essay:A Critique of Alternative Medicine
This essay is an original work by User:Krej. The original author has freed it for editing by other editors.
This essay has been released into the public domain by its author(s) with the Creative Commons CC0 license.
We are constantly bombarded with stories of people miraculously being cured from diseases such as asthma and cancer by "natural, safe, and gentle" treatments. The general public and the media, for the most part, seem to uncritically accept these anecdotes as convincing evidence, and many journalists become crusaders against science-based medicine, frequently accepting all non-mainstream treatments — even ones that are completely contradictory.
But if it's natural, safe, and gentle, why doesn't everybody use alternative medicine (also known as "complementary and alternative medicine", or "CAM")? These anecdotes and testimonials seem like definite proof that alternative medicine can cure uncurable conditions. Why are skeptics so hateful towards something that works for so many people?
Most diseases come and go – even cancer can go into spontaneous remission –, but whether a treatment makes them go away in a particular case is generally not knowable.
The popularity of CAM is entirely due to the many (supposedly miraculous) anecdotes and testimonials floating around. Barry Beyerstein's article Why Bogus Therapies Seem to Work covers many ways in which anecdotes can be misleading, but I'd like to list a few more:
 The alternative treament works, but for reasons other than expected
Sometimes homeopathic remedies, for example, can have effects beyond those of a placebo, but not for the reasons you might think. Imagine the following scenario: Two parents are raising a baby. The baby is teething, and the parents haven't had any sleep for days. They're tearing their hair out, trying to make the baby stop crying. They've tried everything, and in desperation, they buy homeopathic teething tablets. When they give them to the baby, it stops crying. Immediately. My God! How can this be? Homeopathy is the greatest thing since sliced bread!
But wait a minute. The tablets are solid. How can they be homeopathic?
Homeopathic teething tablets are generally made of sucrose and lactose. In other words, sugar and milk. The companies that manufacture these tablets get to call them homeopathic and charge exorbitant prices for them because during the manufacturing process, they add a drop of homeopathic water to them. When the frustrated parents give their baby a tablet and it stops crying, they assume the improvement is due to the water, when it is in fact because of the milk and sugar in the tablets.
Similarly, other homeopathic remedies that are creams or solid are made of a base to which homeopathic water is added. This base can (and usually does) consist of active compounds, so a homeopathic cream for acne may contain potent anti-microbial substances. This is one of the ways in which homeopathy can appear to be effective.
 Selection bias/Not all information is included in anecdote
There is no guarantee that any particular anecdote is complete. Anecdotes are told from a subjective point of view, and people who tell them may want the therapy to be true, and selectively remember parts of their experience which support that hypothesis, while leaving out other factors which may have caused the improvement in their condition, such as science-based therapies they used in conjunction with the alternative treatment.
Sometimes, peddlers of CAM therapies claim they have cured a disease, while ignoring all their unsuccessful cases (this is known as publication bias). They may go on television shows claiming their treatment cures cancer; they may have brought one of their patients on the show as an example of a "cured" case. For example, Robert O. Young went on Oprah with Kim Tinkham, a patient of his, to promote his alkaline diet, and claimed it cured her cancer. Kim died three years later of the cancer of which Young supposedly "cured" her. When this happened, The Oprah Show didn't tell their viewers. Stanisław Burzyński also makes claims of having cured cancer patients, but the said patients tend to die afterwards.
While it is true that no treatment is 100% effective, and that people can die despite using an effective treatment, anecdotes are not reliable for determining whether or not a treatment is effective – especially not those of people who clearly have a vested interest in selling their products.
No decent scientist would bypass peer-reviewed journals and promote a treatment directly to the public on a talk show.
Kevin Trudeau's motives for promoting CAM are quite dubious. He has a history of larceny and fraud: He deposited $80,000 in false checks at a bank, while posing as a doctor to appear more credible, and he defrauded American Express out of $122,735.68. The title of his book Natural Cures "They" Don't Want You To Know About suggests that it includes some herbs or other alternative things that supposedly cure diseases, but it doesn't, and only refers his readers to his site. Not only are there no cures on it, but for access to the site he charges a monthly fee of $9.95, or $999.00 for a lifetime membership. It also includes many conspiracy theories about how drug companies and the government are trying to hide the truth about all-natural cures because they can't make money off of natural cures. The problem with this is obvious: Why would the government want to pay more on health care? And what about insurance companies? They surely have an interest in keeping their clients healthy.
Trudeau had infomercials in which he spouted false claims and more conspiracy theories. He frequently had Bob Barefoot on his show to promote his special brand of coral calcium, which was claimed to be a panacea. Regular coral calcium wasn't good enough, apparently, so you had to buy his special, more expensive, brand. Anecdotes told by Trudeau or Barefoot may not necessarily be true.
 Clinical trials
The reason anecdotes are not reliable is that when evaluating the efficacy of a treatment, you need to be sure that the improvement was caused by that specific treatment, and not by other factors such as chance, the placebo effect, or misdiagnosis. If the cure really was due to the particular treatment, then clinical trials will detect that. Treatments cannot somehow work when experienced by single people, but then magically decide not to when being objectically observed en masse.
In addition, the idea that anecdotes are superior and more reliable than clinical trials is contradicted by the fact that if they really were superior, governments and pharmaceutical companies worldwide wouldn't be spending millions of dollars on medical research. What reason could governments possibly have for rejecting anecdotes other than the fact that they are worthless?
 Alternative medicine
Medicine is an ancient practice, which has existed for millennia. But pre-scientific medicine was quite crude, primitive, and did more harm than good, because it used anecdotal evidence. For example, pre-scientific physicians used bloodletting, trepanning and tobacco for precisely the reason that their anecdotal experience told them they worked. Tobacco was used for many illnesses and considered to be a panacea, even being called "the holy herb", and bloodletting use only declined with the advent of statistics-based medicine. Even now, general-purpose bloodletting is still used in alternative medicine in Unani, Ayurveda, and traditional Chinese medicine, simply because practitioners of these systems believe in medical anecdotes and reject evidence-based medicine. Anecdotal evidence is incapable of detecting long-term side effects (which, contrary to what many people believe, do exist in alternative medicine) -- for example, besides the aforementioned bloodletting, traditional medicine can (and does) use hepatotoxic and carcinogenic plants (such as tobacco and birthwort) for centuries or millenia without ever catching on to their adverse effects. These herbs' side effects are known now only because of modern clinical trials and adverse event reporting systems; without them, the carcinogenic and other dangerous properties of these plants would be completely unknown. This isn't to say that pharmaceutical drugs don't have side effects, but their risks are, at least, well known.
 Herbal medicine
Some like to say that people used plants to treat themselves for millennia, so they must be good (the so-called appeal to antiquity). Besides the already mentioned problem of undetected side effects, the fact is that medicine used plants because molecules had not been discovered yet, so herbs and animal parts were the best options available. With the advent of chemistry, the use of plants as medicine became obsolete because it became possible to use pure substances.
Herbs present an interesting example of possibly effective alternative medicine. Medicine uses pure compounds instead of herbs because herbs contain variable and unknown amounts of active compound(s), which may or may not counteract each other, and because herbs may have many compounds that are useless or harmful. If a beneficial herb contains substances that have no beneficial effect and are only carcinogenic or hepatotoxic, the beneficial compounds can be extracted and used as drugs, while leaving the useless/harmful ones behind.
The amount of active compound(s) varies, even between individuals of a single species. For example, one digitalis individual may be an effective treatment for heart disease, another individual may be ineffective, and another may be lethal. Just as no two humans (not even twin babies) are exactly alike, no two herbs have the same chemical makeup. There are many factors which could influence their contents, such as genetics, composition of the soil, and amount of water/sun received. Even food can vary dangerously in its contents. Potatoes contain a poison called solanine, but usually not enough of it to kill a person. However, there have been cases of potato poisoning, such as one in which 78 boys became ill from eating potatoes particularly high in solanine; 17 of the boys were hospitalized.
 Herbs and food
It is sometimes claimed that because food and medicinal herbs are both plants (usually), herbs must be as safe as food. This is false. Food is consumed for its nutritional compounds, which are needed for the body to function. Medicinal herbs, on the other hand, are ingested for their medicinal compounds – that is, those compounds which change the body to correct the body's malfunctioning. These medicinal compounds are more dangerous than nutritional ones because of their role in actively changing the body (yes, that's right, herbs change the body.) Humans evolved taste as a heuristic: Sweetness usually indicates that something provides more energy; saltiness usually indicates the presence of electrolyes; sourness usually indicates acidity; and finally, (and most importantly), bitterness usually indicates the presence of toxins. Medicinal herbs are usually quite bitter, and this indicates that they have more toxic (i.e. medicinal) compounds.
To summarize: Nutrients (i.e., most food compounds) are compounds which provide energy, while drugs (i.e., most herbal compounds) are compounds which change the human body.
 Herbs vs. drugs
Are herbs safer than pure drugs derived from them? In theory, yes. This is because a given quantity of drug will have more active ingredient than a herb. One gram of a drug will have just that: One gram of pure active ingredient. One gram of ground-up plant, on the other hand, will contain many chemicals, of which only one or a few may actually be useful for medicinal purposes, and which may or may not counteract each other. Willow bark, for example, may be anywhere from 0.08% to 12.6% salicin.
Drugs generally have large lists of side effects because they have been extensively studied; if a side effect occurs even 0.0001% of the time, it will be included. Herbs, on the other hand, are not generally thoroughly studied, and any side effects they may have will not be displayed, because they are unknown. If a herb has no list of side effects, that doesn't mean it has no side effects; it just means insufficient research has been done on its effects or that the supplement company is withholding them (thanks to deregulation). Any substance (or group of substances) will be shown to have side effects with enough study – even food.
Herbs are sometimes topically applied to wounds as substitutes for antibiotics. Some plants do have antimicrobial properties; they contain antibiotics, but the herbs are usually much weaker than antibiotic drugs because the amounts of antibiotics in plants are smaller than the therapeutic doses in which antibacterial drugs are used. Antibiotic resistance occurs when an antibiotic kills all non-resistant bacteria, leaving behind the ones that are resistant. The resistant bacteria were always there, but because the non-resistant ones have been killed, the resistant bacteria are able to divide, multiply, and become the entire colony. When weaker antibacterial herbs are used, non-resistant bacteria remain, and the colony is not as resistant as it would be if antibiotics had been. This why you never hear about "herb-resistant" bacteria. Herbs do cause selection pressure, but not enough to create completely resistant colonies of bacteria.
Supplements are not usually regulated very strictly, and there is no guarantee that the herb the company claims to be selling is actually in the bottle or in the amounts listed, nor that it is free of contamination, nor that the herb is actually used in traditional medicine for that purpose. Traditional Chinese medicine and Ayurvedic remedies sold in the U.S. can (and frequently do) contain dangerous amounts of heavy metals such as lead, mercury and arsenic. In addition, about 20% of Ayurvedic herbs sold on the Internet (by both Indian and American companies) contain dangerous amounts of these toxins.
Even if we assume that the labels of supplements bottles reflect their contents, there are thousands of different herbs sold as supplements, some of which may contain compounds useful for some types of cancer, and which may contain enough of said compounds to be effective (maybe some pills in a bottle do and some don't), and which may contain compounds already used in modern medicine for chemotherapy (in which case, why use the herb?) Whether any of these are true for a particular supplement is usually not known. The supplement may be contaminated with heavy metals or adulterated, and there is always the possibility that the supplement company is lying about the contents.
In scientific medicine, drugs used for treating cancer have been extensively tested for their effect on certain types of cancer, and the amount of drug to be used has been determined so that no one overdoses on them -- the drug is used in very precise doses, unlike supplements, which cannot have precise doses of compounds. Using unproven supplements to treat something can be like buying a lottery ticket and expecting to win millions of dollars.
 Natural medicine is environmentally unsound
Extracting substances from plants instead of instead of synthesizing them can have devastating environmental consequences. The anti-cancer medicine taxol (or paclitaxel) was originally produced from the Pacific Yew (Taxus brevifolia), but the amounts of tree needed to produce even a small amount of the drug were enormous; dependence on the tree was eliminated when chemists discovered a way of synthesizing taxol without Yew bark. Producing aspirin "naturally" is likewise unsustainable. If all drugs derived frcm plants were extracted instead of synthesized, the toll on the environment would be enormous. And the resulting medicines would be exactly the same as, chemically indistinguishable from, and no better than the synthesized versions. All that work, for no benefit whatsoever. Lest you object that the whole plant should be used, and not single substances, I'd like to point out that the supplement industry and many, if not all, alternative medicine promoters sell products such as vitamins, raspberry ketone, allicin, and other single chemicals quite successfully. Granted, supplement companies are not obliged to obtain them from natural sources, and synthesizing is frequently cheaper, so these products are very often synthetic (though they come in appealing, green, pseudo-ecological packaging). But even so, a number of medicinal herbs sold as herbal supplements (such as goldenseal, echinacea, and eyebright) are at risk because of overcultivation. These plants haven't even been shown to be good for anything, and yet people splurge on what most likely are placebos, while, at the same time, encouraging the overharvesting of endangered species. Of course, there are some sellers who obtain these plants from sustainable sources (if you're willing to go out of your way to buy from only those), but every acre of land used for echinacea is an acre of land not used for food or ecological/municipal growth. If these herbs really do contain useful active ingredients, then they can be isolated and synthesized, without the need for environmentally risky practices.
And it's not just plants: Poachers kill endangered species such as rhinos, sharks, seahorses, manta rays, and tigers and sell their body parts to traditional Chinese medicine users; rhino horns are considered panaceas that can cure everything from arthritis to cancer. Needless to say, these remedies are useless, but in alternative medicine, anything goes. Species are being driven to extinction just for the sake of some ineffective treatments. Natural medicines are much less environmentally friendly (to use a clichéd phrase) than synthetic ones, and much less effective (if at all).
 What is natural?
There is a general fear of things thought to be "chemicals", and a tendency to prefer to be in contact with "natural" things – the so-called naturalistic fallacy. The solanine mentioned previously was all-natural, but toxic nevertheless, and tobacco is natural, and also toxic. A number of entirely natural substances are actually lethal to humans, such as hemlock, curare and ricin.
Let's examine what the word "natural" means. Because of the Law of Conservation of Mass, no new particles can be created, so everything in the Universe is part of Nature and is natural. All atoms, photons, and quarks are part of the Universe's repository of particles.
But usually, the word "natural" is used by alternative practitioners to refer to a substance formed from chemical reactions caused by human intervention. This would include drugs, yes. During the infancy of chemistry, substances were taken from nature, and combined to create products (in the chemical sense). These would also be considered synthetic. But the water and carbon dioxide obtained from the reaction of sodium bicarbonate and vinegar or lemon juice would also be synthetic, according to this logic. All drugs and synthesized compounds have their origins in nature. If a human happened to combine the reactants, why should that make any difference? If the water obtained from the reaction above isn't synthetic, then what if that water were used for a different reaction? Would the resulting product be synthetic? At what point does a molecule cease to be "natural"?If the substances happened to be combined by some random force, would the product would be natural? Apparently, yes. Why? Why, out of the vast infinity of the Universe, are some substances "synthetic" and therefore inferior, simply because a sentient being combined the reactants leading to its formation? If reactants are brought together by a human as opposed to by the random forces of nature or by some animal other than homo sapiens, why should that somehow modify the nature of the particles? Do humans have some negative aura that influences substances from a distance? Why is a product formed from the combination of reactants by a human more dangerous than one formed from the combination of reactants by random forces such as wind or gravity? And why doesn't this apply to homeopathy, which claims man-made homeopathic water is better than natural water?
One alternative medicine company (one that actually did believe in the naturalistic fallacy) wanted to sell only "natural" raspberry ketone, and for that reason set out to find a way to chemically distinguish between natural and synthesized raspberry ketone. When they found that the two were exactly the same, they refused to admit they were the same because of their ideology, and decided not to sell the substance at all, so they wouldn't risk selling inferior, "bad", synthetic raspberry ketone (at least they, unlike many other supplement companies, put their money where their mouth was). Even people who desperately wanted natural things to be better and set out to prove this could find no confirmation. In the face of objective evidence, their beliefs remained unshaken (much like many people believe the Earth is 6000 years old). To paraphrase one anonymous Internet commentator, they "looked reality right in the eye and said, 'Nope, we're not buying it.'"
At the end of the day, the CAM definition of a "natural" substance is arbitrary, useless, and certainly not based on any objective molecular facts.
 Unscientific "theories"
A unifying theme common to many CAM treatments is their adherence to disproven, obsolete theories of disease. For the CAM user, it makes no difference whether these theories are coherent or have any basis in reality. You say disease is caused by humoral imbalance? Great, better go to a Unani or Ayurvedic bloodletter. Disease is caused by energy imbalance, and germs are only symptoms? I should go to a homeopathist/use Reiki. Disease is caused by germs, and can only be cured by buying supplements and vitamins? I should go do that. The fact that all these theories are contradictory that makes no difference. (Samuel Hahnemann was adamant that homeopathy was the only true medical system, and that using homeopathy together with non-homeopathic treatments (which is what herbs are) was blasphemy.)
One argument advanced by CAM is: "Who cares how it works? It just does". This is reasonable, as treatments can work even if the mechanism of action is unknown, but if many well designed trials have not found that a therapy is effective (in other words, disproven it), there is no point in indefinitely prolonging its demise by cries of "It does work! More studies are needed!" CAM users usually very strongly reject any possibility of the improvement being due to the placebo effect or non-CAM causes.
Before the germ theory of disease was formulated, people had no idea what caused illness. Various hypotheses were floating around, one of which was formulated by Samuel Hahnemann, creator of homeopathy. He thought that disease was caused by "miasms" which disrupted a person's vital force which could be corrected with remedies following the "like cures like" rule used by homeopathy. But if homeopathy were true, all water (tap, stream, and ocean) would be homeopathic because it would have memories of almost everything, so there would be no need to buy homeopathic remedies.
Homeopathists like to point out that in the homeopathy did better than mainstream medicine in the Asiatic Cholera Epidemic of 1830. Before the introduction of science into medicine, medicine used unscientific therapies such as bloodletting and mostly random substances, and as such, homeopathic remedies did better because they did no harm – they were just watery placebos! As science progressed, we invented double-blind, placebo-contrlled clinical trials to see what treatments worked, and what side effects they had, and medicine became actually effective.
"But they also laughed at Galileo/Darwin/Ignaz Semmelweis!" They also laughed at many people who were wrong. Besides, Semmelweis used statistics to show that hygiene was beneficial – but CAM practitioners don't like statistics. Homeopaths hand-wave studies which disprove homeopathy, just like the 19th century's medical establishment hand-waved away Semmelweiss' statistics proving hygiene's effectiveness. Quoting an article about Semmelweis:
|At the time, diseases were attributed to many different and unrelated causes. Each case was considered unique, just like a human person is unique.
Semmelweis' hypothesis, that there was only one cause, that all that mattered was cleanliness, was extreme at the time, and was largely ignored, rejected or ridiculed. He was dismissed from his hospital and had difficulty finding employment as a medical doctor.
The medical establishment clung to their millenia of anecdotes and humoristic tradition and rejected Semmelweis' science. Indeed, around roughly the same time, the establishment defended bloodletting, also on holistic grounds, because "results obtained by analyses of large groups of patients were not universally applicable to the single individual presenting in their examining room" – a glaringly naturopathic defence. It is perhaps unsurprising that the Textbook of Natural Medicine lists Unani as an acceptable system of naturopathic medicine.
Bloodletting was demonstrated to be ineffective through, among other things, the pioneering statistical methods of Pierre Charles Alexandre Louis[wp], which were met with considerable resistance from anecdotally-minded doctors; this resembles the way homeopaths react when statistics show homeopathy to be no more than a placebo. The physician Benjamin Rush (who preferred personal observations) believed that he could effectively fight a yellow fever pandemic in 1793 by a kind of bloodletting that removed 75% of the person's blood. To prove it, he treated himself this way and survived (which is, again, a glaringly naturopathic approach). One source says:
|Powell describes Rush as "a ready victim of every trap self-discretion could lay" who found security in the good opinion of others. He kept his theory of treatment and ignored the facts. "He recognized no error except in others."|
Homeopaths still recommend homeopathic remedies for malaria prevention to replace effective prophylactics on the same shaky basis. If Rush were alive today, he would undoubtedly be an alternative practitioner. If it weren't for the advent of the statistical approach to medicine, bloodletting would still be widespread.
In the 19th century there were doctors who used traditional, unscientific therapies, were hostile to scientific evidence disproving them, believed in anecdotes, and rejected advances in medical science when it suited them, even to the point of germ theory denialism. By contrast, in the 21st century, there are naturopaths who use traditional, unscientific therapies, are hostile to scientific evidence disproving them, believe in anecdotes, and reject advances in medical science when it suits them, even to the point of germ theory denialism. Semmelweis was a fighter against the backwards logic that pervades CAM thought.
If a scientist has a hypotheses, he tests it to see if the evidence will support it. If an alternative practitioner has a hypotheses, he tests it until the evidence supports it. Why walk on a bridge built by a holistic engineer who thinks gravity and the laws of physics are myths and prefers using philosophy to build structures?
Proponents of CAM may also resort to special pleading, such as the following: "Homeopathy cannot be tested by science because remedies must be individualized". Studies of homeopathy can indeed be blinded; see this article. And why are so many homeopathic remedies for specific conditions sold in stores directly to customers, if remedies have to be individualized?
Acupuncture is another therapy based on an obsolete theory. It claims the body has "energy" called chi which flows in the body in channels called meridians, and that diseases are caused by imbalances of the body's chi, which can be fixed by inserting needles into specific points on the body. This chi has not been scientifically found to exist.
One acupuncture site says: "The modern scientific explanation is that needling the acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain. These chemicals will either change the experience of pain, or they will trigger the release of other chemicals and hormones which influence the body's own internal regulating system." This is simply a description of the placebo effect!
A study found that sham acupuncture (in which needles are placed on random spots on the body) has just as much of an effect as regular acupuncture. In other words, it's not the chi that makes you feel better, but the body's placebo response.
 Double standards
Imagine, if you will, the following situation: Pharmaceutical companies (affectionately nicknamed "Big Pharma") unhappy with the exorbitant costs of developing drugs, lobby the government to lower the bar for approval. They succeed, and the bar is lowered so much, that they can sell whatever random substance they want, with no testing whatsoever. There is now a huge uproar. Now, replace the word "pharmaceutical" with "supplement" (affectionately nicknamed "Big Placebo"), and you have the current situation in the U.S – except for the uproar part. Why the double standards?
CAM supporters may go on passionate diatribes against the evils of drugs and modern medicine, while claiming, that clinical trials, no matter how large or well designed, are rubbish, and, at the same time, that anecdotes are perfectly acceptable evidence for alternative medicine. When people die from overdosing on a drug, CAM users will point to that as proof that it's an evil pharmaceutical. If people die from overdosing on a herb (or even from using normal doses), CAM users will just handwave the deaths away because the cognitive dissonance would be too much to bear.
Drugs are defined as "A substance used to treat an illness, relieve a symptom, or modify a chemical process in the body for a specific purpose." This accurately describes herbal active ingredients. One site astutely observes that herbal medicine is "giving patients an unknown dose of an ill-defined drug, of unknown effectiveness and unknown safety." Herbs are drugs (or, more accurately, contain drugs), but any attempt to regulate herbs will be met with strong opposition from CAM supporters because of their double standards.
Naturopaths, and CAM supporters in general, tend to ignore or reject scientific evidence. If they had been around during the time tobacco was being shown to be harmful, they would certainly have ignored any and all scientific evidence showing its adverse effects and fervently lobbied against tobacco regulation. Given tobacco's history of traditional medical use, it definitely would have been sold by CAM practitioners. This isn't to say all herbal supplements are as bad as tobacco – but you can't know for sure whether a given supplement isn't harmful using only anecdotal experience. Nowadays, if a harmful (even lethal) supplement is banned, CAM practitioners publish ignorant articles expressing outrage – how could their favorite gentle, natural, herbal remedy (such as ephedra) be banned?
Supplement and pharmaceutical companies are both run by greedy people who will do anything to make a buck. The only difference is that supplement companies have successfully lobbied to be held completely unaccountable (and, besides that, sell the results of tradition), while pharmaceutical companies are held in check by government regulation (and sell the results of science). Supplement companies just take random herbs, slap some claims and an FDA disclaimer on the bottles, and sell them with absolutely no testing required. The contents aren't even guaranteed to be the herb being advertised on the bottle, and the possibility that there's lead or mercury in it can't be ruled out. It would be totally inacceptable for food, medicine, or motor vehicles to be so unregulated. Yet, here are the supplement companies, peddling their possibly contaminated random plants and animal genitals.
 Naturopathic practice
Naturopaths frequently claim they "treat the cause, not the symptoms" because they act nice (thus helping with stress) and give nutritional advice, implying that physicians only treat symptoms. This is not true, because stress and inadequate diets are not the causes of all diseases, and because naturopaths prescribe, in most cases, completely unproven supplements – or homeopathic remedies. Naturopathy has no standards; it's a loose hodge-podge of whatever New Age things the individual naturopath happens to believe in.
What would happen if naturopathy were society's main healthcare system? Demand for naturopaths would be very high, and they would be just as busy as doctors are now. Naturopaths would have two choices: 1) to continue treating patients holistically, thus neglecting the majority of their patients, or 2) to try to help as many as possible, and become, in effect, cold and heartless – in other words, like regular doctors. The holistic health model can only function when a minority of people use it. Either there would be huge waiting lists for medical treatment, or the holistic model would be abandoned.
Hospitals would still be packed with ill people, and many homeopaths are germ theory denialists, so the sanitation in some (if not most) of these hospitals would be severly lacking. To make up for it, hospitals would be designed to maximize the flow of feng shui.
People involved in accidents would be brought into the emergency room, treated with whatever the practitioner happens to believe in, like various herbs or methods of faith healing, reflexology, maybe some acupuncture -- perhaps exorcism or bloodletting. Nothing's too unscientific to be used. Those horrible, toxic, synthetic drugs, on the other hand, would be gone, of course. Poof! Measles, mumps, rubeola, and other diseases (and related deaths) would be rampant, because vaccines are just too evil to be used; they do save millions of lives, but that's nothing compared to the harm done by pharmaceuticals.
Naturopathic practice being based on ideology, as opposed to science, practitioners could do whatever they wanted, from urine/crystal/magnet therapy, to prescribing ineffective and carcinogenic herbs. Psychics would be hired in some cases to determine a patient's prognosis. Naturopaths base their practice not on science, but on whatever unscientific therapies they personally believe in.
After a few hundred years of naturopathic care, when all traces of science have been completely eradicated from medicine, the social taboos brought about by science on bloodletting and medicinal tobacco use (the "holy herb" of indigenous medicine) would disappear. Tobacco would be sold in naturopaths' stores as supplements, after heavy lobbying succeeded in deregulating it. It would be advertised with ads such as this one. The claims of the ads on that page are indistinguishable to those made by supplement companies; one ad claims to sell cigarettes that can cure asthma. Denying that clinical trials are evidence means denying that tobacco is unhealthy. In fact, there are some CAM practitioners who do just that.
This is the naturopathic utopia.
 Modern medicine
Modern medicine is a science that tries to make people live as long as possible. It tries to figure out what causes a disease and to fix the problem. (Treating the cause, in other words.) If something is found to be wrong with an aspect of medicine, debate is encouraged.
Alternative medicine is a stagnant Holy Tradition, not subject to change. Any criticism is ignored or (in the case of website comments) suppressed, because CAM is already perfect.
If science had left CAM alone, we'd all be smoking medicinal tobacco.
 What has modern medicine ever accomplished?
Well, for starters, the eradication of smallpox and the elimination of rabies in many countries. Conditions which were formerly uniformly (or almost) fatal are now treatable: To wit, appendicitis, diabetes, some types of cancer (testicular cancer in particular has a remission rate of over 90% when treated with modern medicine). Other illnesses which have not been eradicated but significantly reduced (thanks to vaccines, antibiotics, and drugs) include polio, diphtheria, chicken pox, tuberculosis, and yellow fever, among others. Traditional medicine had thousands of years to treat these illnesses and failed miserably.
 Hygiene would have eradicated diseases anyway
It is true that hygiene is useful in preventing infectious diseases, but the argument is otherwise obviously false, because if hygiene were sufficient, the developed world should be free of things such as influenza, the common cold, and chickenpox. As this graph clearly shows, the incidence of measles significantly dropped only after the start of measles vaccination. It is not even possible to avoid infecting people; people can spread a flu or cold even if they have no symptoms. The only sure way to avoid getting infected using only hygiene is to live in a sterile bubble. How did partial rabies eradication come about, given the fact that wild animals cannot be hygenic?
 But more people are dying of cancer than ever before!
When one fatal disease is cured or becomes treatable, the people who would have died of that disease go on to live longer and die of something else. People who would have died of diabetes went on to continue living until they died of tuberculosis; people who would have died of tuberculosis went on to continue living until they died of smallpox; and so on. The percent of people who will die is always 100%; there cannot be any percent of people who don't die. When the number of deaths from diseases like the ones previously mentioned became small or non-existant, the number of deaths from other diseases, such as cancer or heart disease, became larger.
Consider the first chart on the right: You can see that in the year 1900 there were almost twice as many deaths as in 2000, and that the number of diseases on the 2000 side is much smaller. Tuberculosis, pneumonia, and other diseases, which used to cause almost half of all deaths in 1900, are completely (or almost) absent in 2000, but the number of deaths from cancer is higher in 2000 than in 1900. The second image shows how deaths from circulatory diseases in Norway dramatically dropped during World War II. Does this mean World War II is good for you? Of course not. When medical science cures cancer (as it inevitably will), there will simply be an increase in deaths from other diseases.
Year-by-year statistics paint the same picture: pneumonia, tuberculosis, and influenza were, at first, the top causes of death in the U.S, but as the incidence of these gradually decreased, heart disease and cancer rose in the ranks, eventually becoming the most common causes of death. With the advent of antibacterials, infant mortality dropped 52% from 1930 to 1950.
Sometimes people using this claim may say that animals or some isolated ethnic groups don't get cancer or heart failure, or some other illness, implying that these groups don't get these diseases because they live more naturally and aren't exposed to synthetic chemicals, like we are. Animals get killed and eaten before they even get a chance to develop either cancer or heart failure; exposure to chemicals has nothing to do with it. Isolated ethnic groups, likewise, can have smaller lifespans, because they don't have any concept of hygiene or access to modern medicine, and thus don't have much of a risk of developing cancer. (Though there can be a few long-lived exceptions, as there have been throughout history.)
The main risk factors for cancer are tobacco use or exposure, alcohol, obesity, radiation (such as from overexposure to the sun), heredity, stress, and pollutants. These factors (with the exception of the pollutants and the addition of infections) are estimated to be the cause of about 90% of all cancer deaths, and they're all completely natural. If elderly people of an isolated ethnic group don't generally get cancer, it is probably because they don't have any of these risk factors except for radiation from the sun and heredity. Now, pollutants, such as those from motor vehicles and factories, and other results of the Industrial Revolution do contribute to cancer rates, but assuming that they're the only or by far the most important causes is naive, at best.
The main reason for the prevalence of cancer now is not that persons in developed countries live unnaturally and are exposed to horrible synthetic compounds, but because they actually live long enough to get it.
Every single compound can be lethal, from dihydrogen monoxide, to salt, to the solanine in potatoes. Every single substance is toxic if taken in large enough quantities. In other words, "the dose makes the poison." Consider acetic acid. Pure acetic acid can burn through latex gloves and skin. And yet we ingest it all the time in a solution of 95% water in the form of vinegar.
Every substance in the universe is a "chemical". I wonder what the writer's reaction would be if salt were labeled "sodium chloride" and vitamin C "ascorbic acid". I mean, come on, just look at them: They're chlorine (like bleach) and acid, for cripes sake!
Here's a list of other "dangerous" chemicals: "Stearic acid; tannins; cyanocobalamin; linoleic acid; dihydrogen monoxide". Tannins are carcinogens; cyanocobalamin releases cyanide into the body when ingested; linoleic acid is released by cockroaches when they die in order to prevent other cockroaches from getting near it; dihydrogen monoxide can kill quickly when inhaled, and all people exposed to it will die.
Tannins also happen to be in cocoa, tea, and other foods; cyanocobalamin is better known by the name Vitamin B12; linoleic acid is a fatty acid and a major component of most edible vegetable oils, and dihydrogen monoxide is water. Cocoa doesn't cause cancer because it doesn't contain enough tannic acid to be dangerous; vitamin B12 doesn't kill you because only very small amounts of cyanide are released; and water can only be lethal when taken in large quantities. Anything can be made to seem dangerous by cherry picking a few scary-sounding facts.
I'd like to point out that foods containing carcinogenic compounds include, but are not limited to, cocoa, celery, cinnamon, parsley, carrots, peaches, pineapples, mushrooms, turnips, and even broccoli. Why are we constantly being told that these foods are good for us and prevent cancer? The carcinogenic chemicals (food is made of chemicals, you know) don't occur in sufficient quantities to cause cancer in humans. Likewise, foods containing solanine (the toxin implicated in cases of potato poisoning), like tomatoes, paprika, eggplants, peppers, blueberries, apples, cherries, sugar beets, huckleberries, okra and artichokes don't make us drop dead because they don't have enough solanine in them. (That they usually don't is attributable to government regulation.) We ingest lots of natural poisons all the time, every day. There is no compound which is so dangerous that only one molecule can kill you. What about two? No. A thousand? Nope. How about a billion molecules? Still no. There is a safe level for everything.
 Iatrogenic deaths
One statistic frequently pointed to by CAM supporters says that about 100,000 deaths occur each year in the United States because of iatrogenic (physician-caused) problems. CAM supporters interpret it to mean that the patients would have lived longer had they not been treated by allopathy. But consider this: If somebody died during surgery for appendicitis, that would undoubtedly be a mistake included in the statistic, but without the surgery, the patient would still have died. While it is certainly true that some people die unnecessarily because of physicians' mistakes, it does not follow that medicine is bad and people should stop using it. For example, if someone with a terminal illness is informed that they can try a drug, but that it might kill them, and they then take the drug and die, the death would be included in the statistic, despite the fact that the patient would have died anyway.
Nobody can deny that food, water, and kitchen knives cause many deaths every year worldwide, but it would be absurd to suggest that they should be banned. When analyzing the risks of something, the benefits also have to be taken into account. Medical practitioners do, sometimes, cause unnecessary deaths. But if there were no food, water, or science-based medicine, we'd be much worse off. When considering the deaths caused by a treatment, the number of people saved by that treatment must also be taken into account.
Not to mention that if CAM were mainstream, the deaths caused directly by it would soar, because it would have many more users. Modern medicine has more iatrogenic deaths than CAM simply because more people use it.
What about Vioxx? It is true that Vioxx was an example of a failure of the regulatory system, but modern medicine at least has a regulatory system, and the drug was taken off the market after a few years; alternative medicine, on the other hand, is practically unregulated. Its harmful remedies (like birthwort) are banned only after thousands of years (and then only thanks to science). (See Big Placebo) There could be (and probably are) plenty of dangerous supplements on the market right now with serious adverse effects that haven't been discovered. In fact, unproven herbs known to be carcinogenic, such as madder root and betelnuts, are currently being sold on the Internet for medicinal purposes.
 Doctors are rich, cold, and heartless
In Canada, general practitioners and family physicians earn from $22 to $156.65 an hour, while naturopaths, according to the Canadian Association of Naturopathic Doctors (CAND), earn from $125 to $180 an hour. The Association of Accredited Naturopathic Medical Colleges, a U.S. organization, advises naturopaths to use the CAND guidelines when charging clients. The same organization (AANMC) suggests selling vitamins and supplements as a way for naturopaths to add to their income (no conflict of interest there at all).
So not only are naturopaths paid more than doctors, but they also sell their "medicines" at a profit. Imagine what would happen if a doctor tried selling drugs.
Statistics for hourly and annual salaries of naturopaths in the U.S. aren't available, so let's compare the annual wages of U.S. family physicians with naturopaths: Family physicians have a average yearly salary of $164.952, while naturopaths earn an average of $80.000 to $90.000, with the highest salaries in the $200.000 range, and 20-30K range early in their careers. Since naturopaths earn more or less the same hourly wage as doctors, one reason for the discrepancy of the hourly and yearly salaries could be that naturopaths don't work as much. (This is why they can be sympathetic).
So, no, doctors do not have it better than naturopaths.
Doctors in hospitals generally have many, many patients, and can't spend much time with each individual one, but at the end they give them some effective medicine. They can be callous, insensitive, and even cruelly indifferent. But they at least can save your life. Naturopaths, on the other hand, sit comfortably in their offices, selecting their clients, talking to them for hours, and being all rainbows and sunshine – and then they give the patients some magic water for their cancer (while also telling them not to undergo chemotherapy).
CAM practitioners don't sell medicine; they peddle sympathy, placebos, and false hope. Which would be fine, if they didn't also spread their harmful anti-science ideology and discourage people with life-threatening illnesses from seeking real medical care.
The insensitivity of allopaths is a result of the high demand and low supply of healthcare. If naturopathy replaced allopathy as the mainstream healthcare system, naturopaths would become just as insensitive for two reasons: 1) naturopaths would start having to deal with huge workloads, and 2) all sorts of persons would go to naturopath school, and not just the idealists that make up the majority of CAM practitioners today.
 "They" [doctors] don't want you to find out about natural cure X because it would cut into their profits
Ah, yes. A favorite conspiracy theory and marketing tactic of certain well known charlatans and CAM-peddlers of all sorts. It assumes that every one of the millions of doctors in the world – every single one – is a horrible, selfish person, who is just greedy for more money and patients, while the person(s) selling the treatment (naturopaths, private individuals, etc.) is perfectly selfless and not in it for the money. At all. Never mind that somebody who proved something to be a cure would instantly become famous, a hero, and probably be awarded a Nobel prize (which has a hefty cash prize, by the way).
Doctors have no lack of patients. They are the mainstream healthcare providers, their services being covered by insurance in most places, and their waiting lists are huge. They only see patients for a few minutes because they have so many. A few less patients won't make much of a difference. If they are cured and leave, that just means a shorter waiting list. Besides, they'll be back. Nobody stays healthy their entire lives unless they die in an accident or kill themselves.
Naturopaths make roughly as much as, or more than, doctors, per hour. But they have a much smaller customer base, one that pays out-of-pocket. If a patient is cured and leaves, it would have more of an effect on a naturopath's ability to make a living than it would on a doctor's. There is no reason why a doctor would be more likely to withhold a "cure" than a naturopath, and besides, something can only be shown to be a cure, generally, by clinical studies, which necessarily involve several people.
 Allopathy only cares about drugs and not about nutrition or lifestyle choices
This claim has absolutely no basis in reality. Nutrition is an integral part of medical science. Ever seen all those articles in newspapers about some study that shows a food is good or bad? That's allopathy. Science-based nutritional counselors are called dietitians (not to be confused with nutritionists.) It is the dreaded allopathy that created the field of nutrition in the first place, and without science-based medicine, we'd be blissfully unaware of the dangers of a high-sugar diet, not exercising, alcohol, and tobacco.
Drugs are to be used when lifestyle and dietary changes are not enough (excepting drugs for symptomatic relief). Statin drugs are to be used if changing one's diet is not enough to lower cholesterol.
This is what The Medical Letter has to say about drugs (emphasis added):
“”Supplements are necessary to assure adequate intake of folic acid in young women and possibly of vitamins D and B12 in the elderly. There is no convincing evidence that taking supplements of vitamin C prevents any disease except scurvy. Women should not take vitamin A supplements during pregnancy or after menopause. No one should take high dose beta carotene supplements. A balanced diet rich in fruits and vegetables may be safer than taking vitamin supplements. No biologically active substance taken for a long term can be assumed to be free of risk.
The phrase "biologically active substances" applies to drugs, as well as herbal supplements and vitamins. Supplements are not necessarily food (and, indeed, in the case of herbal supplements, usually aren't.)
For preventing prostate cancer, the science-based (or allopathic) Mayo Clinic suggests eating a healthy diet, exercising, and drinking green tea. An article by a Canadian naturopath writing for a newspaper only suggests taking some supplements and vitamins, some for "eliminating toxins". In her other articles for the newspaper, she occasionally recommends dietary changes, but in most cases, her advice consists of telling the reader to take various supplements.
This is possibly unrepresentative of naturopathy; there could be a significant number of naturopaths that prefer dietary changes to supplements (though that's really not likely). The fact remains that prevention by nutrition is an integral part of modern medicine.
 What is wrong with modern medicine?
Now, all that said, there are very important problems with modern medicine, such as the greed of pharmaceutical corporations (although Big Placebo certainly isn't blameless, either) and unnecessary deaths caused by medical mistakes. Michael Specter says it best:
We hate Big Pharma. We hate big government. We don’t trust The Man. And we shouldn’t. Our health care system sucks. It’s cruel to millions of people. It’s absolutely astonishingly cold and soul-bending to those of us who can even afford it. So we run away from it, and where do we run? We leap into the arms of Big Placebo.
For all its flaws, modern medicine is the best we have. Alternative medicine has not proven to be a viable alternative.
At the end of the day, alternative medicine is simply anything that's unproven or disproven. Alternative medicine that's been shown to work becomes regular medicine. Using CAM, to the rejection of all or part of modern medicine, is unreasonable and rationally unjustifiable.
- ↑ Kim Tinkham, the woman whom Oprah made famous, dead at 53, DigitalJournal.com, Dec 8, 2010.
- ↑ The OTHER Burzynski Patient Group.
- ↑ Why Bogus Therapies Often Seem to Work, Barry L. Beyerstein, Ph.D. Quackwatch.
- ↑ The False Hope of the Burzynski Clinic, Quackometer, November 21, 2011.
- ↑ 5.0 5.1 Kevin Trudeau, SkepDic.
- ↑ Exposing Natural Cures, 'They' Don't Want You to Know About by Author Kevin Trudeau, Anna Swan, Yahoo! Contributor Network May 1, 2006.
- ↑ Analysis of Kevin Trudeau's "Natural Cures" Infomercial, Stephen Barrett, M.D.
- ↑ A Critical Look at Robert Barefoot and Coral Calcium, Stephen Barrett, M.D.
- ↑ Medicinal uses of tobacco in history, Anne Charlton, J R Soc Med. 2004 June; 97(6): 292–296. PMCID: PMC1079499.
- ↑ Unani System of Medicine Practice, Globinmed.com.
- ↑ Naturopathy embraces the four humors, Jann Bellamy, Science-Based Medicine, December 27, 2012.
- ↑ An outbreak of suspected solanine poisoning in schoolboys: Examinations of criteria of solanine poisoning. McMillan M, Thompson JC. Q J Med. 1979 Apr;48(190):227-43.
- ↑ Physiology of Taste, R. Bowen.
- ↑ The Science of Taste.
- ↑ 15.0 15.1 Selling supplements, Steven Novella.
- ↑ Willow bark, University of Maryland Medical Center
- ↑ 29 Side Effects of Food
- ↑ Contaminated Herbal Medicine Products, Lead Poisoning Prevention Program, New York City Department of Health and Mental Hygiene.
- ↑ Folk Medicine, Sources of Lead, Centers for Disease Control and Prevention
- ↑ Study finds toxins in some herbal medicines, Liz Szabo, USAToday.
- ↑ 21.0 21.1 A Tale of Taxol, Frank Stephenson.
- ↑ L’utilité de la chimie de synthèse : l’exemple de l’aspirine, Anton Suwalki.
- ↑ Endangered Medicinal Plants: List of Plants at Risk, Terrie Schultz, BrightHub.
- ↑ Species At-Risk, United Plant Savers.
- ↑ Chinese Medicine Driving Rhinos to Extinction, Yahoo! News.
- ↑ Alternative Medicine Threatans Beasts with Extinction, LiveScience.
- ↑ Unproven Chinese Medicine Killing Manta Rays, Discovery News.
- ↑ The word "natural" is also frequently used to refer to techniques such as chiropractic and acupuncture to imply that their mainstream equivalent, physiotherapy, somehow isn't – but these therapies are all essentially physical manipulation; chiropractic and acupuncture are not somehow more natural just because their users said so.
- ↑ Why no Raspberry Ketones at NOW Foods?, The Herbal Insider.
- ↑ Miasms in Case Management hpathy.com
- ↑ Death and Numbers: Semmelweis the Statistician, Herbert F. Spirer, Ph.D., Louise Spirer.
- ↑ Famous doctors: Ignaz Semmelweis
- ↑ Bloodletting and the management of localized prostate cancer, J. Curtis Nickel, Can Urol Assoc J. 2011 June; 5(3): 159–160. doi: 10.5489/cuaj.11076 PMCID: PMC3114022.
- ↑ Pierre Charles Alexandre Louis, Red Gold, PBS.
- ↑ Pierre-Charles-Alexandre Louis and the evaluation of bloodletting, Alfredo Morabia, J R Soc Med. 2006 March; 99(3): 158–160. PMCID: PMC1383766.
- ↑ 36.0 36.1 Pierre Charles Alexandre Louis: Master of the spirit of mathematical clinical science, Qual Saf Health Care 2005;14:462-464 doi:10.1136/qshc.2005.016816.
- ↑ See Science vs Creationism.
- ↑ Refutation courtesy of Heathen Mike.
- ↑ Acupuncture, Cathy Wong. About.com
- ↑ Doctor, What's This Acupuncture All About? American Academy of Medical Acupuncture.
- ↑ A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Cherkin DC, Sherman KJ, Avins AL, Erro JH, Ichikawa L, Barlow WE, Delaney K, Hawkes R, Hamilton L, Pressman A, Khalsa PS, Deyo RA. Arch Intern Med. 2009 May 11;169(9):858-66. doi: 10.1001/archinternmed.2009.65.
- ↑ drug, Wiktionary.
- ↑ Patients’ guide to Magic medicine, DC's Improbable Science.
- ↑ Eumel Bull Power Potency Booster
- ↑ "For your health" Cigarette Ads, Stanford Research into the Impact of Tobacco Advertising.
- ↑ This article isn't related to the image, but interesting nevertheless: “Divine Stramonium”: The Rise and Fall of Smoking for Asthma, Mark Jackson. Med Hist. 2010 April; 54(2): 171–194. PMCID: PMC2844275.
- ↑ Survival rates for testicular cancer, American Cancer Society.
- ↑ Testicular Cancer, MedlinePlus Medical Encyclopedia.
- ↑ http://health.howstuffworks.com/diseases-conditions/rare/12-deadly-diseases-cured-in-the-20th-century.htm, HowStuffWorks.
- ↑ Common Cold: OSH Answers, Canadian Centre for Occupational Health and Safety.
- ↑ Asymptomatic rhinovirus infection outnumbers symptomatic infection 4 to 1 among university students, American Society for Microbiology, 19-Jun-2012.
- ↑ Clinical Signs and Symptoms of Influenza, Centers for Disease Control and Prevention.
- ↑ http://www.nejm.org/action/showImage?doi=10.1056%2FNEJMp1113569&iid=f02
- ↑ Leading Causes of Death, 1900-1998
- ↑ Achievements in Public Health, 1900-1999: Healthier Mothers and Babies
- ↑ 
- ↑ Natural Carcinogens in Food, Bernadene Magnuson, Ph.D.
- ↑ Man-made and Natural Carcinogens -- Putting the Risks in Perspective, Eugene Garfield. Veterinary and Human Toxicology, 31 (6) p.589-590, 1989.
- ↑ Killer Tomatoes and Poisonous Potatoes? Dr. Harriet Hall MD, Science-Based Medicine.
- ↑ Quack Word #20: ‘Iatrogenic’, Andy Lewis, The Quackometer, July 3, 2007.
- ↑ General Practitioner and Family Physician Salary Canada, Living in Canada.
- ↑ Questions: Naturopathic Visits, Canadian Association of Naturopathic Doctors.
- ↑ 63.0 63.1 63.2 Your Questions Answered, Association of Accredited Naturopathic Medical Colleges.
- ↑ What About Physician Salaries?, Physicians for a National Health Program.
- ↑ Andrew Weil's Seasonal Supplements
- ↑ Preventative measures may lessen chances of developing prostate cancer, The Guardian, November 20, 2012.
- ↑ Prostate cancer prevention: Ways to reduce your risk, Mayo Clinic, Sept. 23, 2011.
- ↑ Articles by her for The Guardian.
- ↑ Michael Specter, The danger of science denial, TED Talks.