Faith Healing and Alternative Therapies

4.1: Isn't western medicine reductionistic and alternatives holistic?

Practitioners of alternative therapies often put forward the idea that modern scientific medicine is reductionistic: it concentrates on those parts of the body that are not working properly, and in so doing it reduces the patient to a collection of organs. Alternative therapies try to consider the patient as a whole (a holistic approach).

This is a fine piece of rhetoric, but it's wrong. It is true that modern medicine looks at the details of diseases, trying to find out exactly what is going wrong and what is causing it. But it also looks at the life of the patient, and tries to understand how the patient interacts with his/her environment and how this interaction can be improved. For instance, smoking is known to cause a wide variety of medical problems. Hence doctors advise patients to give up smoking as well as treating the individual illnesses that it causes. When a patient presents with an illness then the doctor will not only treat the illness but also try to understand how this illness was caused in order to avoid a recurrence.

4.2: What is a double-blind trial? What is a placebo?

A double-blind trial is the standard method for deciding whether or not a treatment has any "real" effect.

A placebo is a "treatment" that has no effect except through the mind of the patient. The usual form is a pill containing a little lactose (milk-sugar), although a bitter-tasting liquid or injections of 1cc saline can be used instead.

The "placebo effect" is the observed tendency for patients to display the symptoms they are told to expect.

The problem is that the state of mind of a patient is often a significant factor in the effect of a course of treatment. All doctors know this; it is why "bedside manner" is considered so important. In statistical tests of new treatments it is even more important, since even a small effect from the state of mind of a small fraction of the patients in the trial can have a significant effect on the results. Hence new medicines are tested against a placebo. The patients in the trial are randomly divided into two groups. One of these groups is given the real medicine, the other is given the placebo. Neither group knows which they have been given. Hence the state of mind for both groups will be similar, and any difference between the two groups must be due to the drug. This is a blind trial.

It has been found that patients can be unconsciously affected by the attitude and expectations of the doctor supplying the drug, even if the doctor does not explicitly tell them what to expect. Hence it is usual for the doctor to be equally unaware which group is which. This is a "double blind" trial. The job of remembering which group is which is given to some administrative person who does not normally come into contact with patients.

This causes problems for many alternative therapies because they do something to the patient which is difficult to do in a placebo-like manner. For instance, a treatment involving the laying-on of hands cannot be done in such a way that both patient and practitioner are unaware as to whether a "real" laying on of hands has taken place. There are partial solutions to this. For instance one study employed a three-way test of drug placebo, counseling and alternative therapy.

4.3: Why should scientific criteria apply to alternative therapies?

So that we can tell if they work or not. If you take a patient and give them treatment then one of three things will happen: the patient will get better, will get worse, or will not change. And this is true whether the treatment is a course of drugs chosen by a doctor, an alternative therapy, or just counting to ten.

Many alternative therapies depend on "anecdotal evidence" where particular cases got better after the therapy was applied. Almost any therapy will have some such cases, even if it actually harms the patients. And so anecdotal evidence of Mrs. X who was cured of cancer by this wonderful new treatment is not useful in deciding whether the treatment is any good.

The only way to tell for sure whether or not an alternative treatment works is to use a double-blind trial, or as near to it as you can get. See the previous question.

4.4: What is homeopathy?

Homeopathy is sometimes confused with herbalism. A herbalist prescribes herbs with known medicinal effects. Two well known examples are foxglove flowers (which contain digitalin) and willow bark (which contains aspirin). Folk remedies are now being studied extensively in order to winnow the wheat from the chaff.

Homeopathists believe that if a drug produces symptoms similar to certain disease then a highly diluted form of the same drug will cure the disease. The greater the dilution, the stronger this curative effect will be (this is known as the law of Arndt-Schulz). Great importance is also attached to the way in which the diluted solution is shaken during the dilution.

People are skeptical about homeopathy because:

1. There is no known mechanism by which it can work. Many homeopathic treatments are so diluted that not one molecule of the original substance is contained in the final dose.

2. The indicator symptoms are highly subjective. Some substances have hundreds of trivial indicators.

3. Almost no clinical tests have been done.

4. It is not clear why trace impurities in the dilutants are not also fortified by the dilution mechanism.

Reports of one scientific trial that seemed to provide evidence for homeopathy until a double-blind trial was set up can be found in Nature vol 333, p.816 and further, and the few issues of Nature following that, about until November of that year (1988).

SI ran a good article on the origins and claims of homeopathy: Stephen Barrett, M.D., "Homeopathy: Is It Medicine?", SI, vol. 12, no. 1, Fall 1987, pp. 56-62.

4.5: What is aromatherapy?

A belief that the essential oils of various flowers have therapeutic effects. These effects are psychological rather than physical, and so its a bit difficult to define what we mean by a statement that "it works". After all, if people do it and feel better then that is a real effect, whether it occurred because of suggestion or because the flowers contain a powerful psychoactive drug.

4.6: What is reflexology? What is iridology?

Reflexology is an alternative therapy based on massage of the feet. The idea is that parts of the body can be mapped onto areas of the feet. There is no known mechanism by which massaging the feet can affect other parts of the body (other than the simple soothing and relaxing effect that any massage gives) and no evidence that it actually works.

Iridology is a remarkably similar notion. Diseases are detected and diagnosed by examining the iris of the eye. A good critique of iridology: Russell S. Worrall, "Iridology: Diagnosis or Delusion?", SI, vol. 7 no. 3, pp. 23-35.

4.7: Does acupuncture work?

There is evidence that acupuncture treatment has an analgesic ("pain killing") effect. The mechanism seems to involve the endogenous opiate system (at least in part), but the exact mechanism by which endogenous opiates are released by acupuncture skin stimulation is not yet known. It does not appear that the effect can be explained simply by pain caused by the needles. However it is possible to achieve similar effects by suggestion alone, suggesting that acupuncture is no more than a placebo.

There have been reports of measurable physiological effects, apparently via local changes in the activity of the sympathetic and parasympathetic nervous systems. While much more detail remains to be elucidated, this is at least a testable hypothesis which brings acupuncture within the realm of science.

This suggests that acupuncture might be a useful tool in pain management, but that it is unlikely to be of value in curing the underlying cause of the pain.

The traditional theory of acupuncture involves balancing the yin and yang (male and female principles) which flow in pathways through the body. Nothing bearing any resemblance to this has been found by medical researchers.

References:

Skrabanek, Petr: Acupuncture: Past, Present and Future. In: Examining Holistic Medicine by Stalker D & Glymour G (eds), Prometheus Books, NY

Skrabanek, Petr: Acupuncture and Endorphins. Lancet 1984;i:220

Skrabanek, Petr: Acupuncture and the Age of Unreason. Lancet 1984;i:1169-1171

Skrabanek, Petr: Acupuncture-Needless Needles. Irish Medical Journal 1986;79:334-335

A 1977 study, Stern, Brown, Ulett, and Sletten, 'A comparison of hypnosis, acupuncture, morphine, Valium, aspirin, and placebo in the management of experimentally induced pain,' Annals of the New York Academy of Sciences, 296, 175-193, found that acupuncture, morphine, and hypnostic analgesia all produced significantly reduced pain ratings for cold pressor and ischemic pain.

Mayer,Price, Raffi, 1977, "Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone," Brain Research, 121, 368-372.

Sjolund, Terenius, Erikson, 1977, "Increased cerebrospinal fluid levels of endorphins after electroacupuncture," Acta Physiologica Scandinavica, 100, 382-384.

"Practical application of acupuncture analgesia" and it's by Cheng, SB (1973 Apr 27), Nature 242(5400): 559-60.

"Electrophysiological measures during acupuncture-induced surgical analgesia" by Starr A (1989 Sep) Arch Neurol 46(9): 1010-12.

4.8: What about psychic surgery?

Psychic surgeons have claimed to be able to make magical incisions, remove cancers and perform other miracles. To date, no investigation of a psychic surgeon has ever found real paranormal ability. Instead they have found one of two things:

1. Simple conjuring tricks. The "surgeons" in these cases are confidence tricksters who prey on the desperate and the foolish.

2. Delusions of grandeur. These people are even more dangerous than the first category, as their treatments may actually cause harm in addition to whatever was wrong with the patient in the first place.

4.9: What is Crystal Healing?

The belief that carrying a small quartz crystal will make you a healthier person. People selling these crystals use phrases like "the body's natural energy fields" and "tuning into the right vibrational frequencies". All this sounds vaguely scientific but means absolutely nothing. Crystal Healing is mostly a New Age idea. See the section on the New Age below for more information.

4.10: Does religious healing work?

Miraculous healing is often put forward as a proof of the existence and approval of God. The Catholic and Christian Scientist churches in particular often claim that believers have been healed, but none of these healings have stood up to careful scrutiny. However it should be noted that the Catholic church does investigate alleged miracles.

One famous "healing" which has been carefully investigated is the case of Mrs. Jean Neil. Many people have seen the video of her getting out of a wheel-chair and running around the stadium at meeting led by the German evangelist Reinhard Bonnke. This was investigated by Dr. Peter May, a GP and member of the General Synod of the Church of England. His findings were reported in the Skeptic (organ of the UK Skeptics). Here is a summary of the report. [Any errors are mine. PAJ].

May found that Mrs. Neil was helpful and enthusiastic when he contacted her, and there is little doubt that her quality of life has improved greatly since the "healing". However May was unable to find any physical changes. His report lists each of the illnesses claimed by Mrs. Neil, and he found that they were either not recorded by doctors previous to the healing or that no physical change had taken place. It seems that the only change in Mrs. Neil was in her mental state. Before the healing she was depressed and introverted. Afterwards she became happy and outgoing.

A more sinister aspect of the story is the presentation of the Neil case in a video promoted by CfaN Productions. This represented Mrs. Neil before the healing as a "hopeless case", implied that she had a single serious illness rather than a series of less major ones, and included the false statement that she had been confined to a wheelchair for 25 years (in fact Mrs. Neil had used a wheelchair for about 15 months and could still walk, although with great difficulty). A report on her spine was carefully edited to include statements about her new pain-free movement but to exclude the statement that there was no evidence of physical changes.

For the full report, see The Skeptic p9, vol. 5, no. 5, Sept. 91. Back issues are available from The Skeptic (Dept. B), P.O. Box 475, Manchester, M60 2TH, U.K. Price UKL 2.10 for UK, UKL 2.70 elsewhere.

The video is entitled "Something to Shout About --- The Documentation of a Miracle". Presumably "CfaN Productions" is part of Bonke's organisation "Church for all Nations" [does anyone have an address?]

Of course, this does not disprove the existence of miraculous healing. Even Mrs. Neil's improvement could have been due to divine intervention rather than a sub-conscious decision to get better (as most skeptics would conclude, although the May report carefully refrains from doing so). I include this summary here because the Neil case is often cited by evangelical Christians as an undeniable miracle. In fact the case demonstrates that even such dramatic events as a cripple getting up and running may not be so very inexplicable.

For more general coverage of this topic, see James Randi's book The Faith Healers. Free Inquiry magazine has also run exposes on fraudulent faith healers like Peter Popoff and W.V. Grant.

4.11: What harm does it do anyway?

People have died when alternative practitioners told them to stop taking conventional treatment. Children have died when their parents refused to give them conventional treatment. These issues matter.

Most alternative treatments are harmless, so the "complementary medicine" approach where conventional and alternative therapies proceed in parallel will not hurt anyone physically (although it is a waste of time and money).