Dr. Brian Kaplan Articles

New Website and Blog launched

2009-03-10T20:39:00.003Z

My new website and blog has now launched, and I look forward to your visit.

Many thanks
Dr. Brian Kaplan
London

PS: This Blog will not be updated in future.

Some thoughts on staying well

2008-11-23T17:52:00.004Z

The poet Longfellow writes:

Joy, temperance, and repose, slam the door on the doctor's nose.

And ‘slamming the door on the doctor’s nose’ can simply be translated into practising effective personal preventative medicine. Personally, I’d add exercise to the list but that would spoil the metre – so let’s look at the 3 qualities espoused by Longfellow.

JOY: No doubt about it: Love, happiness and laughter are good for your physical health. A pity doctors don’t try to prescribe these much – even though pioneers like Patch Adams, MD have been promoting this sort of ‘medicine’ for some time now.

TEMPERANCE: Doctors have no problem in prescribing this. The problem is more about how to get patients to ‘take the medicine.’ Personally I feel that patients don’t often appreciate direct and unoriginal advice which they can experience as patronising and condescending. Thus they need another way of being persuaded to live healthier lives. More about this in a future post…

REPOSE: Ah, this is the one. How do we rest? How do we release stress? How do we stop being stressed in the first place? All doctors, especially GPs, know that a huge amount of the patients seeing them are suffering from problems either caused or at least exacerbated by stress. But what can they do about it? Tell patients to take it easy? Think that will work?

Fortunately there is something doctors can do about this. Autogenic Therapy is a marvellously effective method of reducing stress. It takes a bit of dedication by the patient but is easy to learn. Just look at what Prof. Edzard Ernst (a man with whom I totally disagree with on so many things, not least homeopathy being available on the NHS) has to say about it in this article written some years ago. I totally agree with every word he writes here. It is a huge pity that he has become well known for trying to ‘debunk’ various forms of holistic medicine and being part of the movement to thwart Britain's GPs from being able to send patients to NHS homeopathic clinics than for his open endorsement of Autogenic Therapy.

Anyway you can get an excellent eight session course in Autogenic Therapy on the NHS at the Royal London Homeopathic Hospital (See Prof. Ernst, where else would you get Autogenic Therapy on the NHS if it were not for the RLHH? Can this possibly be a hospital you would like to have removed from the NHS?). To get Autogenic Therapy on the NHS you will need a referral from your GP, but even without that, you can still attend a course there privately at a hugely discounted rate compared to private practice.

I really must lighten up

2008-11-16T21:06:00.006Z

Prof. Colquhoun has noticed my last post and accused homeopaths of being ‘deluded’ and concluded that my ‘paranoid tone’ is an indication that they (presumably those whom I’ve dubbed The Disciples of Scientism) are ‘winning’. Reading this I realised that ‘losing’ is far less of a problem for me than forgetting to take my anti-psychotic medication!

He also accused me of getting my facts wrong about that letter to Directors of Commissioning which I apparently incorrectly alleged was on NHS paper. I don’t have the stomach to discuss this anymore. I got my information here on the website of the Department of Health. They believe in an ‘evidence-based’ society so they should have ‘evidence’ to justify sending out such a message. The Department of Health uses the word ‘inappropriate’ about the use of the NHS logo so I suggest he take up the argument with them and not me.

Finally he denies accusing homeopaths of lying to their patients. But he has posted:

This suggests that, in order to maximise the placebo effect, it will be important to lie to the patient as much as possible, and certainly to disguise from them the fact that, for example, their homeopathic pill contains nothing but lactose.

Okay, maybe somehow that can be read in a way that doesn’t accuse homeopaths of routinely lying to their patients – but it’s not easy to avoid being left with that impression.

He also accuses me of posting ‘splenetic comments’. Now this observation really hit home. Maybe I can’t do much about my ‘paranoid tone’ and being ‘deluded’ because these may be symptoms of a previously undiagnosed medical condition.

Now sing Sondheim’s lyrics to the music of Leonard Bernstein from the wondrous musical, West Side Story:

Right! Officer Krupke, you're really a square
This boy don't need a judge, he needs an analyst's care
It's just his neurosis, that oughta be curbed
He's psychologically disturbed

However for venting spleen even on one occasion, I must be contrite; there is quite enough splenetic expression in the world without me adding to it. So please forgive me that dear reader. I will endeavour to be light and breezy from hereon out.

Life is far too important a thing ever to talk seriously about it. (Oscar Wilde)

So I’ll try not to be too serious either. They say that if you take life too seriously you may end up with a serious dis-ease and I’m not keen on that either.

Actually this may be a very good time to start to talk about other aspects of whole person medicine. So in a non-splenetic spirit of reconciliation and tender feelings between members of the medical profession, in my next post I will write about a form of whole person medicine that is far from well-known (I’m not talking about something we would obviously agree on such as treating syphilis with Penicillin here*), extremely effective and enthusiastically endorsed by both myself and none other than the very doctor I challenged to a duel on a point of honour, Prof. Edzard Ernst!

* Here is a joke by my friend, the Scottish comedian, Arnold Brown that goes something like this: ‘Whenever I hear someone criticise Scots for being hard-drinking, uncouth Rab C. Nesbitt type characters, I say: “Thank Heavens Alexander Fleming sobered up long enough to discover Penicillin"

That Letter of the Disciples of Scientism

2008-11-09T13:20:00.010Z

Dr. David Colquhoun writes about me and that UCL debate in his rather sneering blog in which he accuses anyone using alternative medicine of lying to their patients. This is a blatant and untrue insult which he arrives at via an illogical and irrational cascade of argument. Suffice to say that I've yet to meet a doctor using homeopathy who does not believe his or her homeopathic prescriptions have an effect independent of the placebo effect. Prof. Colquhoun might not think that homeopathic remedies have a physiological effect but homeopathic doctors using them certainly do. Anyway this is what he has to say about the UCL debate and myself:

Dr Brian Kaplan was there. He had given the meeting some publicity, in a web posting that also kindly gave publicity to our 2006 letter to the Times. He didn’t like the letter, which is unsurprising given that it turned out to be more effective than we could ever have hoped.

For once I agree with everything Prof. Colquhoun says here.

I was at the meeting and was happy to give it advance publicity.

I was also more than happy to give publicity to the letter that Colquhoun et al, a group of doctors and scientists, I have called Physicians of the Utmost Fame (apologies to Hilaire Belloc) wrote to NHS Directors of Commissioning. More than anything else, this letter was a slap in the face for Britain’s 40 000 GPs as it sought to go above their heads and thwart any of them that would like to send a patient for NHS homeopathic treatment.

Colquhoun is also right in saying that I did not like the letter. Here are my reasons:

It was inappropriately and highly misleadingly written on paper that had an NHS letterhead. This is what the Department of Health thinks of that:

A document entitled “Homoeopathic Services” which was distributed to Directors of Commissioning earlier this year has caused some confusion because it carried the NHS logo.
We would like to clarify that this document was not issued with the knowledge or approval of the Department of Health and that the use of the National Health Service logo was inappropriate in this instance.
The document does not represent any central policy on the commissioning of homoeopathy and PCTs continue to be responsible for making the decisions on what services or treatments to commission to meet their community’s health needs.

But of course this ‘correction’ was almost invisible after chief executives of 476 NHS Trusts had read this highly personal and opinionated viewpoint of the The Disciples of Scientism – on NHS paper! So yes I do agree it was effective. Expedient, opportunistic, misleadingly written on NHS paper, patronising and condescending to GPs – but effective, yes. And thus I must conclude that Prof. Colquhoun thinks that the end justifies the means. There are two possible reasons for this:

1. The people of the UK are too stupid or too uneducated to choose the sort of doctors they want and must be forced to have only medicine approved of by the Disciples of Scientism.

2. The General Practitioners of Britain cannot be trusted not to refer patients for ‘implausible’ forms of medicine such as homeopathy. This is my main point and has been for some time. Homeopathy is not and never was available on demand to the British public. You had to get your GP to refer you to an NHS clinic to get homeopathic medicine. Thus an honourable course of action by the Physicians of the Utmost Fame would have been to write their letter to a journal widely read by GPs such as the British Medical Journal. But GPs might have not appreciated the condescending and patronising tone of the letter and reserved the right to choose to refer to whatever NHS clinics they liked. Knowing this, the professors chose to go over the heads of GPs and write a letter (totally inappropriately on NHS paper) to chief executives of 476 NHS Trusts with the power to thwart GPs who wanted to send patients for NHS homeopathy!

Do I like that? No, Prof. Coquohoun I don’t. Bullying Britain’s GPs, leaving the utterly spurious impression that conventional medicine is based on solid evidence while homeopathy isn’t, writing to non-medical bureaucrats utterly inappropriately on NHS paper thus giving the false impression that your pompous letter was somehow an NHS document (a ‘technicality’ that would have your entire case for a reform in NHS policy unceremoniously thrown out in a British court of law), is definitely not to my taste. Perhaps I should wake up, abandon conscience, read The Prince, and fully understand that the end always justifies the means.

Professor David Coquhoun, I’m happy to debate this with you. Feel free to be assisted by the jeering journalist, Simon Singh or preferably the medically trained journalist, Ben Goldacre. Bring along the man who also nastily accused homeopaths of ‘lying’ to their patients, Prof. Edzard Ernst. I tried to defend honour in traditional British manner by challenging him to a duel – but alas no reply. Whatever happened to chivalry? In fact bring any of your fellow Physicians of the Utmost Fame or any of the other 13 Disciples of Scientism who co-signed that letter. Your case is so weak it has been transferred to the Intensive Care Unit.

Anywhere, any time, on any media, in front of any audience. I’m ready…

The Tide is Turning!

2008-11-03T11:45:00.007Z

Good news friends. The tide is starting to turn… Homeopathy is starting to defend itself in earnest against biased attacks in the medical literature and media in general.

A press release by the Faculty of Homeopathy today shows that the ‘conclusions’ of a paper in the Lancet entitled ‘The End of Homeopathy’ have been called into serious doubt. As Dr Peter Fisher puts it: they cast ‘serious doubts on the review, showing that it was based on a series of hidden judgments unfavourable to homeopathy’ No space for the detail but here are the references:

Lüdtke R, Rutten ALB. The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. J Clin Epidemiol 2008. doi:10.1016/j.jclinepi.2008.06.015

Rutten ALB, Stolper CF. The 2005 meta-analysis of homeopathy: the importance of post-publication data. Homeopathy 2008. doi:10.1016/j.homp.2008.09.008.

More amusing and therefore much more appealing to me was an amazing article in the New York Times (you might need to register to read it but free registration to the NYT is not a bad idea) citing a study that shows half of US doctors prescribe 'placebos', but they are not really placebos like homeopathy (please pronounce with a sneering tone) because they have active ingredients that are known to have adverse effects. Thus I conclude that from the point of view of Scientism it is better to prescribe a placebo that may well cause harm to a patient than to give patients homeopathic (have you perfected that sneer yet?) medicines that nobody accuses of having side effects. And if you have any doubts about the sheer scale of adverse effects that orthodox drugs can produce just read this recent article. It is clearly better to give a medicine that can have a bad effect than one that can’t have any effect. That way at least the doctors that prescribe them don’t look stupid. Primum non nocere (‘First do no harm’) said Hippocrates but what did he know? Or for that matter what did any of the Greek philosophers know? They can go and jump in the River of Elitism as far as Scientism and The Dumbed Down Society are concerned. We have the ‘philosophy’ of Naïve Realism to explain everything these days. And we have journalists like Ben Goldacre (medical doctor) and Simon Singh (not a doctor) to jeer at anyone who subscribes to inane concepts such as holism, vitalism and whole person medicine. And if they are not considered sufficiently qualified there is always the greatest exponent of Scientism on the planet (besides the magician, James Randi) Professor Richard Dawkins to call upon to prove that homeopathy is nonsense. After thousands of years of unsuccessful efforts, this man has finally disproved the existence of God so what chance has homeopathy got against him? We, homeopaths lie vanquished in the gutter next to God licking our wounds. What can we possible say except that at least we are in good company?

And never, never forget the main message of this post: Medical doctors retain the inalienable right to prescribe placebos as long as those placebos can be shown unequivocally to have an effect on patients. Whether that effect is positive or negative seems to be besides the point!

That Debate at UCL

2008-10-31T09:12:00.006Z

This House would no longer make homeopathic treatment available on the NHS:

For: 65
Against: 53
In abstention: 37
The motion was therefore carried.

You can see Prof. Colquhoun's comments and hopefully my reply on the UCL debate website.

No count (as is done by Intelligence Squared debates) was taken before the debate but clearly most people had come with their minds made up.

Peter Fisher gave a good account of homeopathy and he and his colleague easily won the rational debate.

Prof. Colquhoun made the astonishing claim to the effect that the great majority of orthodox interventions ARE in the sector of evidence based medicine. Astonishing because he offered NO PROOF and NO EVIDENCE for this. Clearly the same rules do not apply to homeopathic doctors and Professors of orthodox medicine! I would love to debate this with him.

The jeering journalist, Simon Singh, had much to say. Memorable was his referring to homeopathy as a 'spherical bastard' by which he means that which ever way you look at it, it's a 'bastard'. Obviously he does not care to look at it from the point of view of the over 90% of patients who visit the Royal London Hospital being very satisfied with the service. (Note added on 25/11/2008: Simon Singh has been in contact with me since the debate and has made it very clear that although he did talk about 'spherical bastards' in his allotted time during the debate, this was before he actually began to speak about homeopathy and that consquently I misunderstood what was simply him quoting a joke by the astrophysicist, Fritz Zwicky. He has made it clear that it was not his intention in any way for anyone to think that he was referring to homeopathy as an example of a 'spherical bastard') He also cited his vile 'study' showing that homeopaths supported giving homeopathic prevention for malaria. 'Ten out of ten homeopaths' phoned apparently were happy to do so. I KNOW this is false (and I wrote about this at the time) because I was phoned up and made it clear in no uncertain terms that people should take orthodox malaria preventative medicine and anyone advising any alternative is giving criminally negligent advice.

But overall I expected no better from Singh and Colquhoun. My great disappointment was with the students. They missed the point of the debate which was not whether homeopathy is plausible or 'scientific'. It was about whether it should be allowed on the NHS - an issue of civil liberty in many ways. The point that Colquhoun and his cronies sought to go over the heads of GPs to prevent rather than dissuade (which would have been at least an honourable course of action) by writing to PCTs asking them to disallow GP referrals to homeopathy in their areas was never discussed. These physicians of the utmost fame also sent this letter containing their private opinion on paper with an NHS logo! It's not just me that thinks that this was inappropriate at best and highly expedient at worst. Just look at what the Department of Health thought about it here. But of course the letter is famous/infamous and this rebuke from the Department of Health is invisible to most people. Perhaps these eminent doctors think the end justifies the means when it comes to clamping down on GPs who would like to refer patients to other doctors who use homeopathy.

That Colquhoun, Ernst and co. are using the nanny state to further their cause is understandable from their point of view but to see young students inadvertently voting for 'tighter controls', a more regulated society and more of the nanny state, was rather sad. My view is that the whole campaign to stop the provision of homeopathy on the NHS (and remember YOU CANNOT GET NHS HOMEOPATHY WITHOUT YOUR GP REFERRING YOU)by attempting to restrict the referring rights of GPs in this way is a condescending and patronising slap in the face for Britain's 36 000 GPs.

But my friends, the tide is turning. In my next post I will cite many articles in which the Disciples of Scientism come under heavy attack for their 'philosophy' (Naive Realism in my opinion) and their attempts at achieving hegemony in medicine. Thank heavens for this. Natural, whole person orientated medicine (to complement conventional, more mechanistic medicine) will never die. Fresh ways of presenting it will appear in response to the Naive Realism of The Disciples of Scientism and you will see some of them in my next post.

As Hopkins put it:
'And for all this, nature is never spent;
There lives the dearest freshness deep down things'

Homeopathy on Trial: The Debate and The Letter

2008-10-18T15:05:00.013+01:00

On Monday night, the 20th October 2008, I will attend a debate at University College London at 7.00 pm. The motion is: 'This House believes homeopathy should not be available on the NHS’ The debate is free and open to all and this is how you get there.

Speaking against the motion: Dr Peter Fisher - doctor, specialist physician,chief consultant at the Royal London Homeopathic Hospital and homeopathic physician to the Royal Family.

Speaking for the motion: Simon Singh - author, journalist and TV producer

But fear not for the intrepid Singh! It is he who has home ground advantage for UCL is the spiritual home (okay really sorry to use that word to describe disciples of Scientism - but you know what I mean) of four of the authors of a famous/notorious letter attacking the provision of homeopathy on the NHS, Professor David Colquhoun, Professor Lewis Wolpert, Professor Michael Baum and Professor Peter Dawson.

I have referred to this letter before in these pages and accused it of trying to thwart the wishes of Britain's GPs. Homeopathy is only available on the NHS if your GP refers you to an NHS homeopathic clinic. But Coquhoun, Wolpert, Baum, Ernst and co. (see below) did not address this letter to GPs; they wrote to Patient Care Trusts (PCTs) essentially appealing to them to prevent GPs in their areas from sending patients to NHS hospitals. Although some would describe such an action as patronising and condescending to GPs, they were quite successful with some PCTs banning GPs from referring patients for homeopathy! GPs are quite at liberty to send patients for all sorts of unproved orthodox interventions of course. Anyone reading these notes knows that huge swathes of conventional medicine are far from being evidence based. I've used a pie from the BMJ's Handbook of Clinical Medicine many times to illustrate this.

Their letter was an open one so I thought it opportune to re-publish it here and annotate it.

We are a group of physicians and scientists who are concerned about ways in which unproven or disproved treatments are being encouraged for general use in the NHS. We would ask you to review practices in your own trust, and to join us in representing our concerns to the Department of Health because we want patients to benefit from the best treatments available.

As a physician myself, I wholeheartedly concur with this opening statement. We need to have a way of accurately assessing whether a treatment is proven or unproven. May I suggest this immaculately constructed diagram that appears in the British Medical Journal’s Handbook of Clinical Evidence as a guide to making such assessments.

This will enable us to categorize any form of medical intervention in terms of how well it has been proven. I feel confident that learned physicians such as yourselves will agree that assessing any intervention ‘alternative’ or ‘orthodox’ needs just such an objective assessment of its proven efficacy.

There are two particular developments to which we would like to draw your attention. First, there is now overt promotion of homeopathy in parts of the NHS (including the NHS Direct website). It is an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness. Despite this, a recently-published patient guide, promoting use of homeopathy without making the lack of proven efficacy clear to patients, is being made available through government funding. Further suggestions about benefits of homeopathy in the treatment of asthma have been made in the ‘Smallwood Report’ and in another publication by the Department of Health designed to give primary care groups “a basic source of reference on complementary and alternative therapies.” A Cochrane review of all relevant studies, however, failed to confirm any benefits for asthma treatment.

Fellow physicians, I do not think it becoming of us to focus on or attack any one form of intervention in isolation as this may invite criticisms of inherent bias. It is incumbent upon us to agree on standards of proven efficacy and then objectively rate each intervention. The BMJ’s pie cited above, could be used until the appearance of a better objective methodology of assessment. May I respectfully suggest that our opinions (necessarily subjective) of what is ‘implausible’ are somewhat less important than objective assessment.

Secondly, as you may know, there has been a concerted campaign to promote complementary and alternative medicine as a component of healthcare provision. Treatments covered by this definition include some which have not been tested as pharmaceutical products, but which are known to cause adverse effects, and others that have no demonstrable benefits. While medical practice must remain open to new discoveries for which there is convincing evidence, including any branded as ‘alternative’, it would be highly irresponsible to embrace any medicine as though it were a matter of principle.

I absolutely agree that adverse effects of any medical intervention are a major concern for us all. Thus surely any form of treatment that is included in the repertoire of NHS doctors should not only be given its rightful place in the pie diagram but also be included in another diagram constructed to show all documented risks and side effects. In this way physicians and patients will be able to make accurate efficacy versus risk assessments on any treatment in any condition. Obviously the same criteria should be used objectively for all forms of interventions otherwise we risk being seen as biased in favour of treatments that we subjectively consider ‘plausible’.

At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence. Furthermore, as someone in a position of accountability for resource distribution, you will be familiar with just how publicly emotive the decisions concerning which therapies to provide under the NHS can be; our ability to explain and justify to patients the selection of treatments, and to account for expenditure on them more widely, is compromised if we abandon our reference to evidence. We are sensitive to the needs of patients for complementary care to enhance well-being and for spiritual support to deal with the fear of death at a time of critical illness, all of which can be supported through services already available within the NHS without resorting to false claims.

I agree that funds should only be automatically available for treatments based on ‘solid evidence’. I take it that you would agree that only the sector of the BMJ’s pie representing the 13% of orthodox interventions that have been proved to be beneficial, qualify for automatic funding by the NHS. It is vital that funding for anything lying outside this segment be decided by objective assessment on a level playing field and not ‘plausibility’ which is highly subjective. Some may suggest that the medically uneducated general public should have a say about which – if any – of the treatments (both orthodox and alternative that do not have ‘solid evidence’ behind them) should be funded by their taxes. This would be consistent with the current zeitgeist where the people are promised ‘choice’ in their lives. So perhaps we could have a ‘People’s Choice’ segment of the pie representing funding. Or perhaps the power of decision should always remain with physicians who are better qualified to speak about the health and taxes of the people than they are themselves.

May I also respectfully suggest that the term ‘spiritual support’ is unbecoming of gentlemen of your standing in the medico-scientific community, has none of Popper’s falsifiability and therefore should be considered somewhat less than scientific. Therefore it is my humble opinion that it should not be used in discussions of this kind. Even if (in a bad case scenario for medical science), ‘spiritual support’ was shown to be evidence based medicine, surely we physicians are at least as capable of administering it as uneducated ‘alternative’ or ‘complementary’ practitioners?

These are not trivial matters. We urge you to take an early opportunity to review practice in your own trust with a view to ensuring that patients do not receive misleading information about the effectiveness of alternative medicines. We would also ask you to write to the Department of Health requesting evidence-based information for trusts and for patients with respect to alternative medicine.

Gentlemen physicians, I could not agree more that these matters are not trivial. But may I respectfully request more respect for our colleagues on the coalface of primary medical care – our NHS general practitioners. I accept that until we have constructed a new pie showing which treatments not in the crucial 13% segment of the BMJ pie, should be funded for various reasons such as patient demand (however irrational that can be at times) we leave such decisions to our hardworking GPs and not to non-medically qualified people in administration who may not find it easy to make objective assessments about complicated but profound medical issues. In addition our noblest efforts on behalf of the public risk being seen as patronizing and condescending by our tireless GPs who will soon be consulting on weekends.

Primum non nocere.

Your colleague,
Dr Brian Kaplan

Finally for the record, these are the doctors that signed the open letter to Patient Care Trusts (PCTs - which comprise mainly non-medical people) in order to persuaded them to thwart GPs in their areas from referring patients to NHS homeopathic physicians.

Yours sincerely

* Professor Michael Baum, Emeritus Professor of Surgery, University College London
* Professor Frances Ashcroft FRS, University Laboratory of Physiology, Oxford
* Professor Sir Colin Berry, Emeritus Professor of Pathology, Queen Mary, London
* Professor Gustav Born FRS, Emeritus Professor of Pharmacology, Kings College London
* Professor Sir James Black FRS, Kings College London
* Professor David Colquhoun FRS, University College London
* Professor Peter Dawson. Clinical Director of Imaging, University College London
* Professor Edzard Ernst, Peninsula Medical School, Exeter
* Professor John Garrow, Emeritus Professor of Human Nutrition, London
* Professor Sir Keith Peters FRS, President, The Academy of Medical Sciences
* Mr Leslie Rose, Consultant Clinical Scientist
* Professor Raymond Tallis, Emeritus Professor of Geriatric Medicine, University of Manchester
* Professor Lewis Wolpert CBE FRS. University College London

The BMJ Pie that doth mislead us all

2008-10-12T12:07:00.003+01:00

Maybe I should give up talking about how homeopathy has served this country well for nearly 200 years. I thought I presented a convincing expose of the apparent ‘evidence basis’ of orthodox medicine using a pie published by that well-known supporter of all things alternative, wacky and charlatan – The British Medical Journal’s Handbook of Clinical Evidence.

I thought that the pie showed that only 13-15% of conventional techniques were purely evidence based and another 44% were of probable benefit but did not have the evidence basis demanded of homeopathic doctors for their art. I thought I was being generous in ‘giving’ orthodox medicine the whole 44 + 15 = 59% as ‘more or less evidence based’ even though my colleagues told me that such generosity had no chance of being reciprocated. But further discussions on this forum (please read the important views of this learned forum on the site of the man I like to call King of Scientism and Magician Extraordinaire, James Randi) have now convinced me otherwise.
Finally I see that this pie is profoundly misleading because as one of the above mentioned Disciples of Scientism has correctly pointed out, it somehow does not consider the frequency of use of recognised orthodox interventions.

THUS WITH DEEP REGRET I MUST CONCLUDE: The publication of such a dangerously misleading pie (and no parallel diagram to take into consideration frequency of use of interventions) is an act of profound medical irresponsibility inexplicably uncharacteristic of a publication by (until now) one of the world’s top five medical journals. British medicine simply isn’t what it used to be and from now on I will look exclusively trans-Atlantically for truth, elegance and beauty in medicine.

Doctors and Scientists in Glass Houses

2008-10-01T13:26:00.005+01:00

It seems that my last post has made things just a little less than comfortable for stone throwers living in glass houses. (aka as critics of homeopathy who assume that most of conventional medicine is clearly ‘evidence-based’.) Some are even desperately appealing to colleagues for reinforcement. Unfortunately for them it’s not easy to sell houses these days – especially glass ones.

I really had a few good laughs while browsing at one of the internet homes of the disciples of scientism as they squirmed to defend the fact that orthodox medicine can hardly claim to be evidence based – as is clearly illustrated in the pie baked by the BMJ’s handbook of clinical evidence.

Let’s look at a one attempt at refutation and riposte to me simply drawing to attention the fact that huge swathes of orthodox medicine are simply not evidence based.

Brian Kaplan on Homeopathy and evidence based medicine

I have been wearily arguing with a couple of homeopaths on another forum for a couple of weeks now but today one has posted this link to a blog by Brian Kaplan
http://drkaplanarticles.blogspot.com/
in which Kaplan moans about the medical establishment attacking "homeopathy for not being evidence-based, the obvious implication is that orthodox, conventional medicine is indeed based on reliable evidence."

He has found this from the BMJ
http://www.clinicalevidence.com/cewe.../knowledge.jsp
a pie chart showing the current knowledge about treatments that work.

He obviously thinks this trumps all arguments (as will the homeopaths I am talking to) because "only 15% of orthodox interventions are definitely evidence based."

I think he is being ridiculous because 44% of treatments are beneficail, likely to be beneficial or a trade of between benefits and harms (which sounds pretty good to me), whereas homeopathy has little proof of benefit at all. Plus, at least medicine is looking at its faults and addressing them.

But I would be really interested to know what people cleverer than me make of this - and grateful for any points to further my side of the argument. Thoughts anyone?

Here are some thoughts for you, your colleagues and your allies:
Okay, out of generosity of spirit I’ll give you that 44% (even though the BMJ would definitely not) So – for the sake of discussion - now you have 59% that is more or less ‘evidence-based’. So let’s discuss the remaining 41%, shall we? That is almost 50% - or half of 'orthodox' practice. So what you are admitting is that almost half of what is considered as scientific medicine is actually equivalent to garbage. Rather than attack homeopathy first (and there are legitimate areas of weakness but we have never made any claim that homeopathy is such a broad spectrum panacea as the worshippers at the orthodox medical temple insist we have), why don't you focus on the at least 41% of ‘scientific medicine’ that clearly does no good at all – but is not even politely accused of ‘not being based on evidence’?

Once that is cleared up, feel free to throw stones at the houses of homeopathic doctors and other people against whom you clearly are impressively biased.

Since I am a qualified medical doctor and an idealistic one to boot, please understand that nothing of what I say of this arises from envy or a campaign to 'push' homeopathy, but rather a desire for conventional medicine to come clean and admit that until the almost 50% detritus is unclogged from the orthodox system, you have no right to assail any alternatives (such as homeopathy) that are known at least to cause no harm. (Primum non nocere – Remember that one?) The latter assumption is from my perspective, since I am fully prepared to use any orthodox intervention that I see fit and appropriate in any clinical situation. In other words while you irrationally attack what I do, I will feel free to pick and choose only the best of scientific medicine for my patients and ignore big chunks of it that are not evidence based and may well cause harm to patients. Homeopaths who ignore the hard core 15% should not be defended but I don’t know any homeopathic doctors who do this.

It might be a good idea now to calculate the cost in pounds as well as morbidity/mortality of the (at least) 41% of non-evidence based conventional medicine. I predict it will be deeply shocking. Would you like to do it, or would you like it done for you by an impartial economist who will undoubtedly make your numbers look like child's play. Why? Because they will include all sorts of measurements such as quality of life impairment, productivity losses, impact on the national budget and taxes, etc.

That 41% (at least) out there is a festering wound that you seem intent on defending or hiding with bandages. As far as I am concerned it is an 800-pound gorilla sitting in your surgeries and scientific laboratories. So why not declare a bust on ~50% of your temple now and avoid more pain down the road – it really will be to the benefit of the public at large.

Okay I’ve agreed that 15% (sometimes it’s given as 13% but I’ll give you 15%) of orthodox medicine is hard-core evidence based and homeopaths should never ignore this – and the ones I know certainly do not. Thus, any homeopath who attacks the entire edifice of medicine is almost as guilty as you so called ‘100% orthodox practitioners’ who ‘apparently’ exclusively use evidence based medicine. 'Almost', since the ~40-50% of unproven medicine you use poses dangers that would likely not otherwise be broached in a more benign, more whole patient oriented medical practice.

For the time being I’ll choose to watch your activities through the glass walls of your houses but really hope to see you cleaning up some of the rubbish (at least 41% of the contents, remember?). And if you have a hard time getting rid of some of the grime, I’m always available to help you steam-clean, hoover and de-louse your house in general. This is not a time for us to be uncharitable to our neighbours. In the end it is the health of the people that matters and as doctors we should all still put our patients first.

Note: May I be absolutely clear that all my comments are directed only at those critics of homeopathy who have used ‘lack of scientific evidence’ as a reason to attack, abuse and insult a system of therapeutics that whole person orientated medical doctors have used alongside orthodox medicine to serve the British public well for nearly 200 years.

Let critics of homeopathy eat humble pie

2008-09-11T12:21:00.011+01:00

I promised to use a pie to put everything into perspective and here it is - a pie baked by the highly reputable British Medical Journal’s Handbook of Clinical Evidence.

The Background: Prof. Edzard Ernst and others have repeatedly attacked homeopathy on the basis that there is no evidence to suggest that it works. Ernst even went as far as to claim that homeopaths were lying to their patients – a claim to which I took the strongest possible objection: I challenged him to a duel albeit with merely words as weapons.

In the ongoing debate there is something that never seems to be sufficiently discussed. When Ernst and company viciously attack homeopathy for not being evidence-based, the obvious implication is that orthodox, conventional medicine is indeed based on reliable evidence. There is just one little problem with this implication: It is simply not true. And here is the pie that proves this. Now please know that this is not a pie baked in my kitchen. The source of this pie is the British Medical Journal of Clinical Evidence, as respectable source of information on scientific medicine as can be found on the planet. Okay, eat, swallow, digest and assimilate this pie and then we will discuss. This pie represents the proven effectiveness of modern medical interventions or treatments.

Now let’s take a deep breath, put aside all prejudices, sit back and look at the pie again and agree on 3 facts:

1. A mere 13% of medical interventions are proven to be beneficial – ie. evidence based. I suspect that’s a lot less than you thought and hardly powerful ammunition for people like Ernst and his henchmen to use against homeopathy and alternative medicine. 13% that’s thirteen per cent.

2. 21% of interventions are ‘likely to be beneficial’. That means they are likely to help but there is no hard evidence to prove this. Hmmm, that reminds me of the many thousands of patients who say they have been helped by visits to homeopathic hospitals in England.

3. We simply don’t know if 47% of interventions are of any use at all! And we are talking about drugs and surgery here – not eating an apple a day or doing 20 minutes meditation twice a day or taking a few pills that homeopathy’s detractors describe as pure placebo.
And side effects obviously occur more frequently with orthodox drugs than they do with homeopathic medicines – a fact Ernst and co. cannot deny since they think homeopathic remedies simply cannot have any effect independent of a placebo response!

So what does this say about all the attacks on homeopathy for not being evidence based and on homeopaths for lying to their patients. Now I’m going to make some strong statements here because I believe that homeopathy’s detractors have got away with murder and this really does need to be redressed:

Ernst accused homeopaths of lying ( interview in The New Scientist on the 28th April 2008) to their patients because of lack of evidence that homeopathy works. Yet only 13% of orthodox interventions are definitely evidence based. Did he accuse orthodox doctors of lying to their patients about 87% of their treatments? Did he allow the public to assume that just about all of orthodox medicine is evidence based? Did he use evidence based medicine as a club to bash homeopathy exclusively when only 13 (sic) % of orthodox interventions are definitely evidence based. Is this unequivocally honest? Is this what we expect from a Professor of Complementary Medicine? Does this reek of bias against homeopathy? Is this in the public interest?

1. If most of medicine is not evidence based and many drugs (by their manufacturers’ admission) are capable of causing side effects, this actually means that most of orthodox medicine not only lacks evidence of its efficacy but actually can do harm. And certainly more harm than homeopathy! I find this quite stunning because it means that doctors like Ernst should be telling their patients: ‘Orthodox medicine is superior to homeopathy because homeopathy is not evidence based and at least 13 (thirteen!)% of conventional medicine is! And before you make your choice let me warn you that side effects are much more common with orthodox drugs!’ Do they do this? Do politicians ever admit mistakes? Does anybody actually say ‘Fair cop guv’?

2. Homeopathic doctors do use orthodox medicines on occasion, usually when there is an excellent indication for their use in a specific clinical condition ie. strong evidence. Could this mean that homeopathic doctors tend mainly to use the orthodox interventions that comprise the 13% of the pie that represents evidence based medicine?
So is it just possible that homeopathic doctors use only the best 13% of orthodox medicine and homeopathy for everything else? You know something – this could really be close to the truth. I don’t know of a homeopathic doctor who wouldn’t treat syphilis with penicillin or appendicitis with surgery. We do use orthodox medicine when it really does work. And we do consider orthodox medicines which may be of benefit – when homeopathy doesn’t do the trick. What we don’t do is use medicines that could do a lot of harm when there is no evidence for their use. This we leave to the huge majority of orthodox doctors some of whom (such as Ernst, Baum and co.) have the audacity to criticise us!

I suggest therefore that homeopathic doctors that are respectful of the best of orthodox medicine might just be the most efficient users of evidence based medicine. This may be true simply because orthodox doctors feel obliged to use sectors of the pie (ie 87% of it) that are not evidence based simply because they feel that they must try something. Homeopathic doctors however can use their homeopathic remedies safely instead of using drugs and surgery in situations where their efficacy has not been proved and even carries the risk of doing harm. So exactly who do the general public need protection from?

Needless to say, the attacks on homeopathy will continue. I suggest to all defenders of homeopathy that citing the pie above is the best possible defence of our art. Show it to our detractors, let them taste it and if they still refuse to eat humble pie – well then be courteous and only throw it into their faces very, very gently.

Source of the pie: BMJ Clinical Evidence Handbook, Summer 2007, Figure 1, page 4 http://www.clinicalevidence.com/ceweb/about/knowledge.jsp

Hypocrisy of attacks on homeopathy to be exposed soon

2008-08-10T12:15:00.004+01:00

Followers of this blog are familiar with my position with regard to the relentless attacks on homeopathy by the likes of Prof. Edzard Ernst and others who use evidence based medicine as a club with which to attempt to batter homeopaths into submission. Over and over they repeat that there is no valid evidence to support the view that homeopathy works.

Supporters of homeopathy claim otherwise. We say that scientific trials of homeopathy generally show a positive effect. We say that the fact that many thousands of patients with difficult to treat conditions claiming to have been helped at NHS homeopathic hospitals for the past 200 years is also ‘evidence’ of efficacy as is the fact that homeopathy has survived this long while many other forms of therapy have come and gone.

Ernst, Baum and a group of physicians then managed to persuade PCTs (patient care trusts) to prevent GPs in many areas from sending patients for homeopathy on the NHS, a tactic that for this author implies that they think both patients and GPs are too ignorant or stupid to realise they are being duped and need to be protected from themselves. The nanny state agreed in many (but by no means all) areas and many GPs who wanted to send patients from getting homeopathic treatment on the NHS were prevented from doing so by people (in the PCTs) who are not doctors!

I’ve written about this many times and when Ernst accused homeopaths of lying to their patients I challenged him to a duel on this blog. Well a duel of words, but unsurprisingly I never heard from him. I simply read of him calling for ‘tighter controls’ on alternative medicine. Obviously he continues in his quest to protect the gullible British public (and GPs!) from their own ignorance. But in a society that seems to welcome and bleatingly acquiesce to more and more regulations, Ernst has perhaps found his time and place in the world while more libertarian people like myself blog on in the hope that people will wake up and say they are not stupid and don’t need nannies like Ernst protecting them from their own ignorance.

My next blog will be a final word on this. There is a limit to how much time I am prepared to read, think and talk about those who wish to control and coerce people whom they think are unable to think for themselves. In that blog, which will appear within a week, I will expose the incredible hypocrisy of the attacks on homeopathy using a simple pie diagram. After that, this voice will address other important medical issues of the day. However the challenge of a duel still stand, Prof. Ernst...

Medical Debate Tonight

2008-06-26T10:21:00.002+01:00

Medical Debate Tonight

Tonight there will be a debate on the ‘Best of Medicine’ at the Welcome Collection. Homeopathy, initially nominated for the ‘Worst of Medicine’ debate scheduled for 17th July has been nominated for tonight’s debate and Dr Sara Eames of the Royal London Homeopathic Hospital will speak in favour. Should be interesting…

I won’t be there tonight but have booked my place for the 17th of July, assuming homeopathy is still nominated.

My personal opinions of the Best and Worst of Medicine:

Worst Medicine: When doctors out of fear, think of themselves first instead of their patients. Stringent regulation, box ticking and increasing fear of litigation make this more likely. Far from benefiting patients it makes them feel like they are being regarded as robots by doctors following rigid criteria about how diseases (as opposed to patients) should be treated.

Best Medicine: Well-educated doctors, instead of acting out of fear, making decisions based on knowledge, experience, wisdom and importantly, personal conscience.

Debating the 'Worst of Medicine'

2008-06-12T10:28:00.006+01:00

On the 17th of July the Welcome Institute is hosting a discussion/debate on the 'Worst of Medicine'

The following subjects have been nominated as candidates for the Worst of Medicine.

1. The BMI farce
nominated by Patrick Basham & John Luik
The Body Mass Index is an inaccurate measurement of people's healthiness, yet it is used to scare and hector the population.

2. Epidemiology: medicine gone wrong?
nominated by Rob Lyons
In today's frantic search for the origins of disease in our lifestyles and environment, the value of epidemiology has been greatly overstated.

3. The homeopathy hoax
nominated by Baum and Ernst
All serious thinkers should have a closed mind on the question of homeopathy: it is anti-scientific and simply does not work.

4. Healthy living is a sickness
nominated by Dr Michael Fitzpatrick (GP & a speaker at the live debate with William Schabas, Director, Irish Centre for Human Rights & David Wootton, Professor of History, author of 'Bad Medicine')
GP and author Dr Michael Fitzpatrick says the injunction to be super-fit and super-healthy is ruining our quality of life.

Let's look a little closer at these:
1. BMI: Of course this is not a totally accurate measurement of 'health'. Who says it is? It does give useful information as does an 'apple-shaped' body. There is no way this can 'win' the title of Worst Medicine and it seems that it's just being nominated to give someone a chance to voice an opinion on its limited usefulness in medicine.
2. Epidemiology: The worst of medicine? That's ridiculous too. It may have its limitations, it may indeed have been overstated but it's always been a valid science and useful it its place. Another ridiculous nomination.
3.Healthy Living is a sickness - Yeah, sure and life is a terminal, sexually transmitted disease. A really insightful observation.
4.Which leaves Homeopathy is a Hoax - clearly set up not only to lose but to be trashed in public.

I think I've made the point several times that homeopathy is not a hoax which would imply that homeopaths know that they are deceiving their patients. I challenged Edzard Ernst to a duel for accusing homeopaths of lying to their patients. I chose words as weapons but to date have received no answer - which does not surprise me. A challenge to a duel was considered an honorable response to the slur of an accusation of lying in this country 150 years ago so I've done my job in defending the honour of homeopathy. Ernst and others may believe that what homeopaths tell their patients is untrue but that does not mean they are lying. Richard (The God Delusion) Dawkins and Christopher (God is not Great) Hitchens are obviously no great fans of the Almighty and clearly do not agree with what the Pope or any other religious leaders say but as far as I know, they are not accusing these leaders of lying.

Ernst has accused homeopaths of lying. Ernst and Baum are accusing homeopaths of perpetrating a hoax (in this discussion)
I've had enough insults from these eminent professors. I don't know if they will attend the debate on the 17th of July but I'll be there. So dear reader, why not come along to a free debate in central London and give your view.

Homeopathy:The Public are being misled by Omission

2008-05-29T11:09:00.003+01:00

To be honest dear reader, I am getting rather bored with discussing the irrational attacks on homeopathy in the media and prefer to read more positive literature rather than read the biased, self-righteous and insulting comments made about homeopaths and homeopathic doctors by doctors such as Edzard Ernst and journalists such as Simon Singh and Ben Goldacre whose lack of medical education doesn’t seem to deter from writing articles and books with strongly-held opinions. I’d love to know who buys these books and why.

Anyway let’s wrap up a few points.

1. The Duel: I challenged Prof. Ernst to a duel (with only words as weapons) for accusing homeopathic doctors of lying to their patients. Guess what? No reply. The age of chivalry, ladies and gentlemen is dead – but at least I tried.

2. Attack on Homeopathy is pernicious: I must justify that and I will. The club used to try to beat homeopathy into submission is that it is not evidence based. Now to look at all health interventions on this basis would be fair and consistent. If something has the requisite quality of evidenced you put a tick next to it if it does not you put a cross but it’s only fair to look at all medical interventions this way.

Ernst, Singh, Goldacre, Baum et al have conveniently allowed the public to believe that conventional medical interventions are all evidence based and homeopathy is rubbish because it is not. Both statements are patently untrue. Interpretation of trials of homeopathy is controversial to say the least and but I won’t get into that here other than to say it is not at all ‘well established’ that the trials show that homeopathy is no better than placebo. In fact most trials in my opinion seem to show that it does have a clinical effect independent of placebo.

My first accusation is more serious – that the public are being misled by omission. These eminent doctors are conveniently not telling the public something very, very important and that is this (please forgive the capitals but if I could make light shine out of the screen though the letters in the next sentence I would) MANY, MANY INTERVENTIONS IN ORTHODOX MEDICINE ARE NOT EVIDENCE-BASED. And although these are used in serious conditions such as coronary heart disease, depression (to the tune of hundreds of millions of NHS pounds) and back pain – there is no attack on them by those that attack homeopathy and CAM. I’ve listed these before but let me say once again to Ernst et al who selectively attack homeopathy and CAM for not being evidence based.

Surgery: Show me the evidence base for spinal fusion for chronic back pain.
Paediatrics: Show me the evidence base for the use of drugs such as Prozac and Ritalin in ADHD
Cardiology: Show me the evidence for angioplasty and stents in coronary heart disease.
Psychiatry: Show me the evidence for the use of SSRI anti-depressants for depression.

and there are many, many more but I don't want to bore you with long lists.

And if you can’t… Let me say this:

You accuse homeopaths of only getting results by the placebo effect with no evidence. And if you are right (and I certainly DO NOT think you are) you should applaud rather than attack homeopaths for getting results with what you think is merely placebo. Why do I say this?

Because surely it’s better and safer to get results with what you think are just pills of sugar of milk than to get results with unproven interventions which use chemicals and even scalpels on patients?

Double standards? You bet!

Medicine, Honesty and Duplicity: The disgrace of the recent attacks on homeopathy

2008-05-22T10:59:00.004+01:00

Today I am in a very serious mood and on this occasion will choose to ignore Oscar Wilde’s aphorism: ‘Life is far too important ever to talk seriously about it’

In my last article I challenged Professor Edzard Ernst to a duel (okay - with only words as weapons) for accusing homeopaths of lying to their patients. For centuries in this country the slur of being accused of lying was considered one of the main reasons for challenging someone to a duel. It was actually considered the gallant thing to do in the circumstances - otherwise the accusation of lying would leave a stain on your character. Of course I have not been accused personally of lying – but as a doctor who does use homeopathy – I certainly object to being generically accused of lying. This was an insulting, wrong and vicious thing to say. The slur can be ameliorated if Ernst admits that it is simply a matter of his English not being up to scratch on that occasion and that what he meant to say was that homeopaths were saying things to their patients that he, Ernst, considered to be untrue. Lying is a different matter and as I’ve said I have never met a homeopathic doctor whom I thought was lying to his patients and I’ve met hundreds of them.

I regret to inform you that no answer to my challenge of a duel has been received. Perhaps Ernst prefers to confer with journalists than doctors. He has received far too much publicity already in my opinion. I don’t know what his qualifications or motives are other than the smearing of homeopathy and complementary medicine in this country. The paradox of this is that he claims to have been a homeopath and is apparently still a professor of complementary medicine! I don’t want to give the ghastly negative book he wrote with Simon Singh any more publicity than it has received – but feel the need to reiterate what I consider the hypocrisy and duplicity that is at its core.

The basic claim is that most of CAM and especially homeopathy are not ‘evidence based’ (This morning on Radio 4’s Today programme, I heard someone say that we live in an ‘evidentially-based’ society. Holy Jupiter! Must we have our language as well as our society totally deconstructed and then destroyed?) My answer to this was simple: Ernst knows that much of conventional medicine (eg spinal fusion, use of drugs for ADHD in children, angioplasty and stents and many many more examples) is not evidence based. How can he then selectively use ‘evidence based medicine’ as a club to bash homeopathy? Surely he should use it as a weapon to attack any form of medical intervention that lacks the requisite trials and results? Nobody addresses this point and people like Simon Singh and Edzard Ernst outrageously get away with an approach that reeks of double standards. In fact Dr Damien Downing has written an excellent piece on Ernst and his approach in the journal of the Alliance for Natural Health which articulately points out how much of what Ernst says applies far more to himself than to those he attacks.

So in bullet form:

1. Much of CAM is not evidence based. (fact)
2. Much of conventional medicine is not evidence based. (fact)
3. Therefore it is two-faced and hypocritical to use evidence based medicine as a weapon to attack CAM and homeopathy.

It could be used to attack any medical intervention that is not evidence based. That would be consistent but I would still be against attacking interventions that are not evidence based. We should allow doctors to practise the art of medicine as well as the science. This means they are allowed to use interventions that have worked for them or their colleagues and mentors and that suit their style of medicine and personality. Of course in critical situations if they ignore the evidence-based recommended approach to the detriment of their patients they will be called to account.

It’s all quite simple really. What is amazing is the amount of publicity this duplicitous, hypocritical and negative campaign has achieved with the result that quangos such as PCTs (Patient Care Trusts comprising mainly non-medical people) are able to threaten NHS homeopathic hospitals with closure by preventing doctors in their areas from choosing to refer patients to homeopathic hospitals! Yes you heard me correctly. Unelected committees consisting mainly of non-medically qualified people have exercised their power under the present system of financing healthcare on the NHS, to prevent GP’s from choosing to send selected patients to other doctors (homeopathic consultants) at homeopathic hospitals! And this has occurred because people like Ernst, Baum and others have misled the media and public by giving them the impression that orthodox medicine is all evidence based (it certainly is not) and that homeopathy and CAM are not (studies of multiple trials do not clearly demonstrate that homeopathy is no better than placebo - as Dr Downing clearly points out in his excellent article).

I plead ignorance of their true motives but the fact that so far they have been allowed to get away with this heist and get huge exposure on all the media for their propaganda with the result that many GPs have been prevented from referring patients to specialist homeopathic doctors is not merely tragic for decency and honesty in medicine; it is no less than an embarrassment for liberal democracy in this country.

Orthodox Medicine, Homeopathic Medicine and 'Evidence'

2008-05-15T10:57:00.011+01:00

Before I write more about homeopathy and evidence based medicine I feel the need to declare who I am and what sort of doctor I am. Other bloggers have described me as ‘a homeopath’ and although technically true, that is not how I would choose to position myself in medicine.

WHO AM I?
I am a medical doctor who uses a whole person orientated approach which comprises everything conventional medicine has to offer and some methodologies which it does not offer. These include Homeopathy but also Autogenic Therapy (now there is something both Prof. Ernst and I agree is an excellent adjunct to orthodox medicine) and Provocative Therapy which is the clinical application of reverse psychology in medicine and psychotherapy. Patients consult me because they know I will try to choose from these, the sort of medicine that is most appropriate for their particular situation. This could be a combination of any of the above or it might involve referral to a conventional specialist or to a member of a group of holistic physicians that I meet with on a weekly basis.

MY MENTOR: I was fortunate to have a mentor, E.K. Ledermann, a medical philosopher, psychiatrist and physician who also used homeopathy in his 70 years of holistic practice in London. He impressed on me both the importance of the mechanistic approach of orthodox scientific medicine when appropriate and the need for a holistic general practitioner to have knowledge of psychotherapy as well as some whole person orientated medical tools at his or her disposal. I see homeopathy (alongside other methods such as traditional Chinese medicine) as a powerful example of such a tool.

HOMEOPATHY: Thus homeopathy is an holistic tool that a doctor can use – but only when it is appropriate to do so. In no way does it ‘replace’ conventional medicine. In no way should it ever be used in situations where there is a risk of morbidity or mortality. In many other situations it can be used (in our opinion) to stimulate the inherent regenerative power of the body. If it fails to do the job, we homeopathic physicians are ethically obliged to use conventional medicine to do whatever it can for the patient.

It is my belief that doctors using homeopathy in their practices have served the people of Britain well (including every monarch since the early 19th century) and I am proud to be a fellow of the Faculty of Homeopathy.

Having declared who I am let me now restate what I think of the recent attacks on homeopathy on the basis that it is not scientific and particularly that it is not evidence-based medicine.

HOMEOPATHY, CONVENTIONAL MEDICINE AND ‘EVIDENCE’: Recently homeopathy has coming under stinging attacks for not being ‘evidence based’. By far the most significant of these attacks was an open letter to Patient Care Trusts by a group of British professors including Michael Baum and Edzard Ernst among others. The idea appeared to be to persuade these trusts not to allow GPs in their areas to refer patients to NHS homeopathic hospitals because homeopathy was not evidence based. Ernst went on to write a book with a journalist Simon Singh continuing these attacks and in interview also allegedly accused homeopaths of lying to their patients – an accusation that I felt morally obliged to respond to and did. Other journalists such as Ben Goldacre then joined the lynch mob and everyone continued to use evidence based medicine as the club with which to bash homeopathy.

Along the way a few lone voices occasionally cried out: ‘Hey, not all orthodox medicine is evidence based is it?’ But all the attacks on homeopathy by Ernst, Baum, Singh, Goldacre and others are based on homeopathy apparently not being evidence based which implies that orthodox medicine is evidence based. Otherwise these learned men of medicine and journalism should simply attack ALL medicine that is not evidence based, unless of course there is another agenda here.

Well I started to look at the evidence base treatments in common usage in orthodox medicine. And what did I find? A HUGE number of treatments in frequent usage and generating huge revenue for doctors and pharamaceutical companies simply cannot claim to be evidence based. A good place to prove this is the British Medical Journal of Clinical Evidence. A short time spent there will show you what I say to be true. How dare these people attack homeopathy for lacking an evidence base and by their attitude allow the public to assume that orthodox medicine is all evidence based? It’s an absolute disgrace and I’d like anyone who disagrees to tell me why.

Just for starters here is a short personal list I have of orthodox treatments that are not evidence based. If anyone thinks they are please send me the evidence and I’ll remove that item from the list. And this list is just a sample for starters. It will certainly be continued.

1. The use of drugs such as antidepressants and others for Attention Deficit Hyperactivity Disorder in children.

2. The surgical procedure of spinal fusion for many forms of back pain.

3. The use of SSRIs for depression – a treatment that costs the NHS hundreds of millions of pounds a year and yet a recent study by a highly respectable group of researchers concluded that these drugs are no better than placebo!

4. Antibiotics to prevent endocarditis
In this weeks 'placebo' issue of the BMJ there was a letter by Neil Herring and David Sprigings that expressed worry over the fact that guidelines on antibiotic prophylaxis in structural heart disease for preventing infective endocarditis have now been changed by NICE because they have found no evidence base forits effectiveness. There have been no(sic) RCTs on this subject.

5. Steroids for prevention of ARDS In the Research section there is also a paper 'Corticosteroids in the prevention and treatment of ARDS in adults; a meta-analysis' by Peter, John, Graham, Moran,George and Bersten that showed no convincing treatment effect of steroids in the condition. However the authors also state that 'meta analysis based on a small number of trials with sparse data must be cognisant of limitations in estimation of treatment effects'. You don't see people saying that about trials of homeopathic medicines do you? I wonder why not.

FINALLY:
I must state that I don’t believe that doctors should be coerced into EXCLUSIVELY using approaches which are evidence-based. I didn’t go to medical school to become a robot. Successful medical practice is an art in which the practitioner uses the tools that suit his or her particular talents and personality. Of course in life threatening situations or where there is risk of morbidity, the standard proven protocols MUST be used. Doctors must be free to practice the art of medicine according to their own consciences. Of course if patients come to grief because of this the doctors can and will be held to account. But selectively to attack and insult a group of doctors (in this case those that use homeopathy in their practices both privately and on the NHS) on the basis that homeopathy is not evidence based while knowing full well that much of conventional medicine similarly lacks the type of evidence base they self righteously scream for in homoepathy, is in my opinion both duplicitous and pernicious.

Evidence-based Medicine: To be applied across the board or just used as a stick with which to beat homeopathy and CAM?

2008-05-08T12:13:00.007+01:00

Okay, so far no reply to my challenge of a duel of words with Professor Ernst. There has also been no reply to my alternative suggestion that he withdraw his accusation that homeopaths lie to their patients.

If he is unaware of my challenge then hopefully it will not escape his attention for long. If he is ignoring it then I say: Qui tacet, consentit and will assume that his silence gives consent to what I’ve said.

I’d like to make the following very straightforward points to clarify where I stand on this issue and why I felt so insulted by Ernst’s accusation of lying.

HISTORICAL:
1. May 25, 2006. Thirteen eminent British scientists and physicians including Edzard Ernst and Michael Baum write an open letter to Primary Care Trusts in which they express concern about ‘ways in which unproven or disproved treatments are being encouraged for general use in the NHS’ and go on to say: ‘At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence.’ They particularly attacked homeopathy because of its availability on the NHS.

2. Consequences of this letter:

a) Many Primary Care Trusts responded by preventing GPs in their areas from referring patients to medical qualified homeopathic consultants at NHS homeopathic hospitals. This appalling distrust in GPs ability to make coherent clinical decisions about what is good for their own patients not only deprived patients of homeopathy but also threatened to close down NHS hospitals. This was because under the present system the funding of these hospitals depends on funds generated by GPs referring patients to these hospitals. Thus PCTs comprising many non-medically qualified people have been given the power to deprive patients from receiving homeopathy on the NHS as well as preventing GPs from sending patients to the consultants of their choice.

b) The letter generated a media firestorm with medical journalists such as Ben Goldacre and Simon Singh wading in with highly opinionated but poorly informed opinions on the subject. These and other journalists conveniently label homeopathy as not having scientific evidence for its use – as opposed to orthodox medicine which by implication they believe is always evidence based. This implication is by no means true. Heartened by the media interest in the subject Singh and apparently Goldacre too, have written books on the subject.

I don’t think there can be much dispute about the above so let me give my reaction:

Ernst, Baum and Co. express concern in their influential letter about NHS funds being exclusively for ‘treatments that are based on solid evidence’. Okay fair enough – it’s a valid opinion even though it tends to be exclusively from the Scientism School of Naïve Realism but that is another issue altogether. Let’s just say for now it’s a reasonable viewpoint. What I want to ask them is this:

Why do you not attack all forms of medical intervention that are not ‘based on solid evidence’ ? Or did you not know that many, many orthodox medical interventions have no ‘solid evidence’ to back them up.

Want some examples? With pleasure… Show me the ‘solid evidence’ for the following:

1. The use of drugs such as Prozac and Ritalin for Attention Deficit Disorder (ADD)
2. The surgical procedure of spinal fusion for many forms of back pain. (Critics of any medical intervention that is not evidence-based may meditate on the fact that at least homeopathic doctors are not wielding scalpels without evidence based studies to back them up)
3. The use of SSRIs for depression – a treatment that costs the NHS hundreds of millions of pounds a year and yet a recent study by a highly respectable group of researchers concluded that these drugs are no better than placebo! Wow, and the attack on homeopathy not being based on evidence goes on and this is seldom mentioned?

And those three are just for starters… I will be more than happy to give more examples here in the future.

I end with the following apologies:

1. To GPs: I am so sorry to see your autonomy and clinical judgment eroded like this.
2. To Ernst, Baum and Co: I am sorry if I appear to criticise you of being prejudiced against homeopathy. I just don’t understand why you don’t attack all medical interventions that are not ‘based on solid evidence’ such as the 3 examples I’ve given above. I really would appreciate an explanation.
3. To journalists Singh and Goldacre: I believe in freedom of the press and am proud that it was established in the UK. You are not in the same boat as Ernst, Baum and Co. because you are not medically trained. However you could have a field day by attacking all forms of medicine that are not evidence based. In exclusively attacking CAM and not orthodox interventions (some of them multi million pound industries in themselves) you might be depriving yourselves, your papers and your readers of vital information and for this I’m really sorry.
4. To the significant proportion of the British public who have trusted homeopathy since it’s inception in the early 19th century and who funded the building of the UK’s homeopathic hospitals which were invited to become part of the NHS in 1948: I’m sorry that you as a significant minority are being bullied in this way by Big Nanny. We can but hope that things will change soon.

Lying? Who exactly is lying?

2008-05-01T13:46:00.005+01:00

Okay I take back my 'surrender'. I don’t surrender to the ‘logic’ of Ernst and Singh anymore and vow to fight them on the beaches if necessary. Why this turnaround? Because I read an interview with the Professor Ernst in The New Scientist on the 28th April 2008 that irritated me – to put it euphemistically.

When asked to explain the ‘huge popularity’ of alternative medicine: Ernst replied: ‘…people are being lied to. Practitioners of complementary and alternative medicine (CAM) often fail to explain what the evidence shows and does not show. It is the triumph of advertising over rationality:’ Okay Prof – you’ve indirectly accused me of lying and if theres is one thing I cannot abide it's being accused of lying. By all means call me ignorant, naïve, gullible, stupid, ‘new age’, complementary, alternative, homeopathic, idealistic or weird – but how dare you accuse me of lying?

I have met hundreds if not thousands of homeopaths in my career. Some have indeed believed in some strange things, some have been very naive indeed in my opinion, but I have never met a homeopath whom I thought was lying to his/her patients. They may have said things to patients that Ernst thinks is untrue but that is very different from lying which is the deliberately not telling the truth. If it is just a matter of your English not being up to scratch, Prof Ernst, just let me know and I'll take back what I say here.

TO: ‘often fail to explain what the evidence shows and does not show’
I SAY: How often does any doctor spontaneously and without being asked ‘explain’ the evidence behind any course of action? Ernst is fully aware that many drugs and even surgical techniques in orthodox medicine are not evidence based. Doctors (unlike lawyers) don’t discuss ‘evidence’ with patients unless specifically asked. To use this to support an accusation of lying is disingenuous to say the least.

TO: ‘the triumph of advertising over rationality’
I SAY: This clumsy rephrasing of Oscar Wilde’s witty description of second marriages as the ‘triumph of hope over experience’ is as ridiculous and unfair criticism of alternative medicine as I have ever seen in print because:

Advertising of CAM is mild and reasonable compared to advertising of orthodox drugs. Has Ernst ever seen how drugs are advertised on TV and in newspapers or magazines? Apparently he hasn’t seen the idiotic green arrows showing how apparently drugs reach the throat, head etc. not to mention other puerile and anatomically incorrect graphic representations of how drugs apparently work. Which of course bears no resemblance to what they actually do physiologically. To accuse CAM practitioners of using advertising to ‘triumph over rationality’ is not even worthy of being called a sick joke.

Homeopathy, one of Ernst and Singh’s least favourite forms of CAM has been attacked and insulted since its inception in the UK in the early 19th century. Frederick Foster Hervey Quin, the man who brought homeopathy to England, became the first of a sequence of Royal homeopathic physicians persisting to the present day and built the Royal London Homeopathic Hospital, once applied to join the Athenaeum Club. When his nomination was considered a certain Dr. Paris, president of the Royal College of Surgeons said: “A pretty pass we have come to when quacks and adventurers are proposed as members of this club.” The following day, the good Dr Paris was challenged either to retract his comments in writing or justify his language with pistols at 12 paces. He wrote the apology.

Now I think being accused of lying is even worse than being called an ‘adventurer’ or ‘quack’ so I hereby challenge Professor Ernst to a duel, albeit with words rather than pistols - but that is only for legal reasons ;-) where he can attempt to justify calling homeopathic doctors liars. Alternatively he can retract this outrageous slur. Otherwise - bring it on!

Unconditional Surrender to Singh and Ernst

2008-04-20T13:56:00.010+01:00

Okay, finally I give up. It’s Unconditional Surrender for me. I will not harp on anymore about: the dangers of separating the practitioner from his tools; self-induced healing; the art of medicine, the use of the self in therapy and the healing qualities of holistic doctors that cannot simply be emulated by purely scientific doctors not trained in any particular holistic tool. Why do I give up now?

Because a book has just been published that has forced me to lay down all arms, abandon my holistic principles and worship exclusively at the philanthropic Church of Big Pharma and the philosophical school of Naive Realism.

This book is called Trick or treatment? Alternative Medicine on Trial by Simon Singh and Edzard Ernst. For a mere £16.99 you can have any illusions you once had about holistic medicine kicked into touch by a journalist and doctor who totally have your interests at heart and conduct a Kafkaesque trial of Altenative Medicine on behalf of the public good. Although many other doctors have tried to disparage homeopathy and holistic medicine in the pasts, these two have put themselves at a much higher level to reveal the truth, the absolute truth and nothing but the truth and therefore are justified in putting the boot into anything Big Pharma (and shareholders of course) would not approve of. This is not to say they work for Big Pharma in any way. I really and sincerly don't think they do. BUT the pharmaceutical industry must be earnestly praising Ernst and singing the praises of Singh on a daily basis. In their view far too much money (that rightfully belongs to them and their shareholders) has been squandered on useless treatments that the public only thinks were useful.

When, as a young doctor, I first began to study homeopathy in 1982 at the Royal London Homeopathic Hospital I was deeply moved by the humane and kindly doctors working there and the many patients who had tried everything before coming there and now had finally benefited from homeopathic treatment. Now Singh and Ernst have convinced me that we were all deluded. Me, the patients and the homeopathic doctors. All improvements were imagined… But I really was inspired and thought it true at the time. Why was I so gullible?

I do take issue with one thing though. Singh and Ernst are quoted in The Times as saying: ‘In fact the best way to exploit the placebo effect is to lie excessively to make the pill seem extra-special, by using statements such as “this remedy has been imported from Timbuktu etc.”’ This is simply wrong. I have met hundreds of homeopathic doctors and heard many say many strange things – but never have I thought they were lying. The best way to get patients better with medicines that Ernst and Singh think are placebo is for the gullible, inane and misguided prescribers like myself earnestly to BELIEVE that these useless remedies actually help their patients. Faith, belief and confidence in what you are doing are much more effective at getting results than lying. I am not a liar but maybe this book will convince me that I have been wrong all these years about homeopathy – so I will now make a formal statement on behalf of myself and all homeopaths who think along similar lines to me.

I hereby state that Edzard Ernst and Simon Singh are honorable men and have convinced me to make the following statement:

1. Homeopathy is worthless because even though patients do remarkably well after consulting us homeopathic doctors, scientific studies have convinced authorities that these improvements are not happening because of the remedies taken. Any other possible reason for the patients' improvement is not scientific and must also therefore be rejected.

2. The people of Britain are ignorant of medical science and obviously cannot be trusted to make a decision about whether homeopathy should retain the small place it has in the NHS. Referendums on this issue would be pointless. As Winston Churchill correctly pointed out: 'The greatest argument against democracy is a five minute conversation with the average voter'.

3. In this era of what has rudely, ignorantly and unfairly pejoratively been termed 'The Nanny State', informed authorities, be they qualified in medicine or not, will decide whether we the gullible public who pay for the NHS get homeopathy on our democratic NHS - or not. This is common sense and those that unpatriotically refer to it as 'Stalinism' should have severe action taken against them - including detention without trial.

4. Trials showing that homeopathy works on animals should be discounted because animals don't respond to placebo and Ernst, Singh and other members of the Naive Realism school of philosophy of science can see no other way in which homeopathy could have a clinical effect.

5. In the footsteps of Galileo, we retract whatever statements we have previously and erroneously stated about homeopathy being a useful medical adjunct to conventional medicine and apologise unequivocally for any inconvenience to the State, the public and especially to school of Naive Realism for our previous actions.

DEMOCRACY, HOMEOPATHY AND THE PLACEBO EFFECT

2008-04-13T13:11:00.002+01:00

Okay, let’s get a few things straight about so called ‘alternative’ holistic medical approaches that are now being vilified because scientific trials have apparently finally shown that they are no better than placebo.

The first therapy seemingly chosen to be wiped out for the good of the public in the killing fields of apparently rational scientific evidence-based medicine is Homeopathy.

Homeopathy, because of the mystery about how it works is a natural target for those who want to destroy anything that doesn’t fit into their paradigm. Well okay not destroy, but make it unavailable on the NHS. Apparently only rational, proven, and evidence-based systems should be funded by the tax payer – like the Royal Family for example. Now don’t get me wrong – I am a royalist but I am also a medical doctor who uses homeopathy in his practice.

Personally I don’t think that democracy should only fund things that are strictly scientific. If the people want a Royal Family and Homeopathy – then that’s good enough for me. A recent survey clearly shows that huge swathes of the international public trust and want homeopathy. But in England we have senior medical figures who are intent and working hard to make sure that the public do not get what they want. They must only get what these doctors think they should get. In other words the public is too stupid or too ill-informed to choose for itself when it comes to health and doctors. Democracy or nanny state? You tell me.

Okay let’s look at the issue from the side of the sceptics.

THE SCEPTICS SAY:
1. Multiple studies of trials of homeopathy show it to be no better at helping people than placebo.

2. Although the amount of money spent by the NHS on homeopathic hospitals is small it should be removed and those wanting homeopathy should pay for it themselves – because homeopathy has not passed the test of science.

3. Abolishing homeopathy on the NHS would make a little money available for other treatments and better still we can use the Royal London Hospital for ‘real medicine’.

ANSWERING THE SCEPTICS:
1. Homeopathic doctors dispute the ‘fact’ that homeopathy has been found to be no better than placebo and interpret the analysis of studies as being positive for homeopathy.

2. The amount of money spent on homeopathy on the NHS is miniscule and offers good value for the NHS as homeopathic NHS doctors often see and help the most difficult cases including many cases that have been told that they cannot be helped by orthodox medicine.

4. Pushing homeopathy out of the homeopathic hospitals of the UK is an act of grand larceny in my opinion. These hospitals were funded and built by benefactors of homeopathy. At the advent of the NHS they were invited to become part of the NHS and did so obviously on the understanding that they would remain homeopathic hospitals.

I opine simply that if the public wants homeopathy it should have it. And there is good reason for this: It does not matter how homeopathy works only that it works. I believe that it works completely independent of the placebo effect but let me for a moment ‘assume’ the opponents of homeopathy are correct and that it only works by placebo effect.

Remember I said ‘assume’. This is not what I believe but I want to make the case that even if they think their belief system is the absolute truth, the opponents of homeopathy are doing the British public a terrible disservice.

SO THE CRITICS OF HOMEOPATHY SAY:
1. Homeopathy works no better than placebo
2. Therefore it should not be available on the NHS.

AND I ANSWER:
1. I don’t agree but let’s ‘assume’ this to be true.
2. No! no! no! this would be a terrible thing to do even if 1. is proved a million times to be true.

WHY WOULD THIS BE A TERRIBLE THING?
Because people with very hard-to-treat problems are benefiting from seeing homeopathic doctors at NHS homeopathic hospitals. It does not matter how they are being helped, whether it by homeopathic medicine, hypnosis, suggestion or love. The fact is that they are being helped and they want homeopathic medicine to be available on the NHS. That is democracy.

AND FINALLY…
The crucial point is that if homeopathy is removed from the NHS what will take it’s place to help the difficult cases who were only helped by homeopaths because of the ‘placebo effect’, self-induced healing, hypnosis, suggestion or call it what you want. The answer: Nothing. Ernst and his anti-homeopathic gang sometimes pay lip service to the ‘bedside manner’ of homeopaths and say that NHS doctor could ‘learn something’ from homeopathic doctors – and what a pity that NHS GPs don’t have time to do this. What? - no time to get patients better by talking and being kind to them? That’s a pity isn’t it?

The fact is that they will neither ‘learn’ anything from homeopaths nor ever learn any method of helping people actually get better from illnesses by just talking to them. This is because of a simple fact which is the main point of today’s blog.

I believe that homeopathy works independent of the placebo effect. However IF a doctor using homeopathy or any form of ‘alternative medicine’ accused of only working by suggestion, does not himself or herself believe that it works in its own right, then that system becomes a con and a hoax in the hands of that practitioner. And most patients can smell the insincerity of a hoax or a con – whatever the condescending (to the public who want homeopathy) and patronising academic opponents of homeopathy think. The fact is that the majority of patients sense their homeopaths to be kind people who really believe in what they are doing.

So Homeopathy should not be removed from the NHS even if it is thought only to work through the placebo effect. Those who would remove it have no plans for replacing it with anything else that will initiate self-induced healing. In striving to remove Homeopathy from the NHS it is not the British public they are thinking of protecting – it is their arrogantly held sense of knowing that only their medical paradigm is valid. The fact that eminent philosopher/doctors such as Karl Jaspers and E.K. Ledermann described quite different holistic paradigms of medical approach is of no interest to them. Lederman correctly describes their limited and limiting philosophy of medicine as one of naïve realism.

Let the people of Britain, not experts of any kind, decide what types of medical care they get. That would be democracy.

Alternative Therapies: Meditation

2008-04-01T12:23:00.003+01:00

Last night Kathy Sykes explored the ‘alternative therapy’ meditation. Just to categorise this ancient psychological and physiological techniqe as ‘alternative’ seem somewhat ridiculous to me. Still, Kathy Sykes, somewhat straitjacketed by her self-applied label as 'scientist' admitted that regularly sitting quietly and doing nothing except observe her breathing benefited her whole day including her capacity to love. That she knew this before making the programme didn’t deter her from making expensive journeys around the world in search of proof.

The facts regarding meditation and health are simple.

1. Up to 50% of patients consulting a GP in England are suffering from conditions either caused or made worse by stress – FACT.
2. Meditation and relaxation techniques are good for reducing stress and preventing stress from building up in the first place – FACT.
3. Therefore meditation is a useful treatment for many patients with many problems – LOGICAL CONCLUSION.

But the scientific Ms. Sykes needs scientific proof and for that we must be taken around the world for her to interview meditators, the ‘happiest man in the world’, see machines that show brain changes due to meditation etc. And finally she concluded that it would be wonderful if meditation could be shown to make people happier.

But everyone knows that meditation and relaxation makes people happier and very probably much healthier. As the 19th century poet Longfellow put it:

Joy, temperance, and repose,
Slam the door on the doctor's nose.

I don’t know if it’s merely a symptom of the general dumbing down of our society and particularly that of the BBC, but I found Kathy Sykes’s tone throughout this series very much like that of a primary school teacher slowly and carefully explaining things to her 10 and 11 year old pupils. Of course these explanations were totally from a deterministic, mechanistic view of medicine and the universe. Philosophy of medicine is not quite as simple as that as pioneers of holistic philosophy in medicine such as Dr. E.K.Ledermann, have pointed out.

We live in a world where NAIVE REALISM RULES! and no it's not okay. This series on alternative medicine taught me very little except remind me to do my Autogenic Therapy meditation regularly.

Reflexology on BBC2 last night

2008-03-25T11:33:00.002Z

Alternative Therapies BBC2 Monday 24/3/2008

In an appallingly crafted hour of 'investigation' into whether reflexology works Professor Kathy Sykes interviews various reflexologists, their patients and eminent scientists. This was very bad TV because you could see the bias from the beginning and the conclusion is telescoped well in advance.

Of course an anatomist was wheeled out to show everyone what they already knew: there is no anatomical connection between the soles of the feet and specific areas parts of those soles are connected to according to reflexology. No mention was made of parallels with acupuncture and it's subtle meridians - not fully accepted by medical science but used by the Chinese for a mere 5000 years or so. These meridians are the most plausible explanation for the reflexology effect.

Trials showing that reflexology did indeed make patients feel better but no more so than head massage were described to show that it basically is all in the patients' minds. It's okay for others to feel better by being duped but this is not for people like Prof Sykes who think their highly personal mechanistic and deterministic view of the universe is common sense and people who disagree are deluding themselves.

I'm used to this low brow fare from the BBC these days - so why am I discussing this?
Because this programme by implication expressed a very damaging view of what has been called the 'placebo effect' And as in previous blogs - I have said that it is terribly poorly understood. And so it proved to be last night by the prof.

Kathy Sykes came to the conclusion (which we saw coming all through the programme) that it was the ambience, the kindness and most of all the touch that did the healing - not the reflexology. Something was said about touch alleviating the 'emotional burden' of the illness and about GP's not having enough time to do this.
Not enough time? She might have added not enough inclination and not enough training but more important than this is a simple point: These holistic/alternative approaches do not work if the practitioner does not believe in what s/he is doing. A GP who touches his patient on the shoulder reassuringly will get better results than one who doesn't but he won't get better results from this than a reflexologist who sincerely believes that what he is doing works beyond the healing effect of touch.

Personally I believe there is more to reflexology than just touch. I believe it works in its own right but also because of the whole healing set up - which would not be there if the reflexologist did not believe in the healing effect of the work. There are other systems of medicine where one part of the body has a map on it that represents other parts. These include auricular acupuncture and iridology both of whom have many adherents including medical doctors. Almost every cell in the body has the DNA to clone the whole body again. Thus it's not surprising to me that one part of the body could have some subtle knowledge about another part. No mention of this of course.

The only part of the programme of value was watching Prof Sykes admitting that going to a 'cuddle club' in LA really moved her and made her feel better. Interestingly as she said this, she was unable to look at the camera. Heaven help her if the viewer saw tears in the scientist's eyes as she felt better for reasons her central nervous system could not fathom.

This was a programme that probably hurt some people who have benefited from reflexology whatever its operating mechanism. It certainly wasn't good for reflexologists who in my opinion do a lot of good and many of my patients have reported very good results from going to see them. And there is the rub. If patients feel that reflexology does them good then so be it. Let them see reflexologists. But no - in an age of ugly scientism we have people like Prof Sykes on TV there to rid us all of our 'illusions'. No surprise to see 'quackbuster' Raymond Tallis on the programme but no doctor who advocates an holistic approach in medicine. Boy do I love paying the license fee!

Science Rules okay? No it's not okay. Medicine is an art as well as a science as every doctor knows. And reflexologists practise the true art of healing a lot better than most doctors, not that I'd go to one if I had appendicitis of course. We doctors can learn from this and what we should learn is something about the art of medicine - not condescendingly diminish people who are genuinely helping others, say it's all in the mind and oh what a pity that NHS GPs don't have the time to get people better using touch, care and love.

Placebos, self-induced healing, Homeopathy and Anti-depressants

2008-03-03T12:05:00.005Z

Placebos, self-induced healing, Homeopathy and Anti-depressants

Declaration of Interest: I am a medical doctor who has used homeopathic medicine for over 25 years and believe that homeopathy has a clinical effect independent of the placebo effect.

As the world of psychiatric medicine squirms uncomfortably with the publication of a significant meta-analysis showing that anti-depressants are unlikely to work better than placebo, it is perhaps time to consider the profound implications of this study. We are not simply talking about a single drug that has been found not to work, we are talking about an industry that gratefully accepts an estimated £380 million pounds of tax payers’ money through the NHS per year in the UK alone. This is an amount that makes the highly contraversial cost of NHS homeopathy look exceedingly trivial.

£380 million a year for drugs that ‘don’t work’? Well that is not quite true. The study did not show that the anti-depressants don’t help the people that take them; it showed that that people taking anti-depressants did not do any better than people who thought they were taking drugs for depression and in this there is a world of difference. Stated simply: Patients taking anti-depressants and patients taking dummy tablets both felt better.

To me it is clear that both sets of patients got better for one simple reason. They both thought that the drugs would to them good. Why did they think this? Because in the consultation with the doctor or psychiatrist who prescribed the drugs they were convinced that the pills would help them. This was made possible by the fact that the doctors prescribing the anti-depressants were convinced that they would help their patients and this conviction was passed on to the patients resulting in the so-called ‘placebo effect’. I don’t like the term ‘placebo effect’ which feels contemptuous and patronising to patients. It is fairer to say that these patients healed themselves because they had confidence in their medication. I don’t believe that they were conned at all. Their doctors believed the drugs would work and certainly were not ‘conning’ anyone. If there is any con here it can only be that the doctors were conned somewhere along the line – whether this be by over-enthusiastic advertising by Big Pharma, or that Big Pharma failed to publish unfavourable data. The drugs and placebo would not have had such a good clinical effect if doctors knew they were giving physiologically ineffective placebos to their patients. Inauthentic doctoring has a bad smell easily detected by patients and tends to be anti-therapeutic. Thus the big question is why did so many depressed patients feel better on placebo or ineffective medications?

The answer is surely in the body-mind connection which holistic practitioners have been ‘going on’ about for decades, if not centuries. There is art in medicine and this art is in the consultation. The findings of this study show just how clinically powerful the consultation can be – even in the long term.

In the light of this, let us revisit the controversy surrounding patients receiving homeopathic medicine on the NHS. As I have stated the amount of money this costs the tax payer is trivial compared to the costs of the anti-depressants apparently now shown to be no better than placebo but such financial considerations are not my main point. Homeopathic medicine has been attacked by a group of doctors who say that it should not be funded by the NHS because although it clearly helps patients, it performs no better than placebo. I disagree with this as stated clearly in my declaration of interest at the start of this essay. However let me pretend for a moment that these expert doctors are correct and that homeopathic doctors are only getting results because of their bedside manner and the belief of both them and their patients that homeopathy has a clinical effect. The idea that homeopathy is a ‘con’ is ridiculous if you at least accept that homeopathic doctors believe that their medicines have a clinical effect – a necessary condition to provide an atmosphere of authenticity in the consulting room which is essential for getting results through ‘suggestion’.

If we compare homeopathy to these anti-depressants (again as viewed by those who believe that homeopathy only works through suggestion) we see two groups of patients both getting better due to the ‘placebo effect’ or self-induced healing. However the homeopathic patients apparently received placebo while the other group definitely receive drugs that act on the chemistry of the brain. Yet it is only the prescribers of the non-chemical so-called placebos who are being told that they should not be allowed to treat patients on the NHS. This is clearly a travesty.

As stated above, I believe that homeopathy works beyond the placebo effect but I say this to those who ridicule it because they believe it is ‘no better than placebo’: Homeopathy is not a ‘con’ because the thousands of medically qualified doctors practising it do believe that it is clinically effective and would not get results or bother to spend many years studying it if they did not believe in its clinically efficacity. I believe my patients get better because homeopathic medication works. To those who think that is only because I believe this that my patients get better I would say the following: How do you suggest that doctors get their patients better by getting them to believe that their health will improve? Prof. Ernst, one of homeopathy’s most vociferous detractors has stated:

If certain practitioners such as homeopaths are good at maximising placebo effects, why not learn how to do it? Why not maximise placebo effects when prescribing genuinely effective treatments? If we start systematically investigating how to achieve this, we are likely to rediscover the value of good bedside manners, good therapeutic relationships and of seeing patients as whole individuals.Then patients might no longer feel the need to consult homeopaths in the first place.

I find this statement incredible and naive. When will this ‘systematic investigation’ begin? And much more importantly – why try to prevent patients getting this sort of healing before doctors are educated in some sort of new paradigm of medicine at which he vaguely hints. I find it deeply disturbing that Ernst and his colleagues would choose to attack homeopathy instead of working very hard indeed on this ‘systematic investigation’ in search of what they clearly believe is the healing power of the homeopathic consultation alone and then finding a way of teaching doctors to utilise it. Until then would it not be more logical to avoid attacking homeopathic doctors and campaigning against NHS homeopathy? When a new paradigm of medicine emerges and patients are helped to heal themselves by some new system of applying mind-body medicine, that would be a logical time for them (if not me) to revisit the necessity of homeopathy. Attacks on homeopathic medicine before that time can be considered hypocritical, disingenuous and clearly not in the interest of any patients whatsoever.

A Witchhunt on Homeopathy

2007-12-16T15:51:00.000Z

THE HOMEOPATHIC WITCHUNT

Attacks on Homeopathy

Ever since it inception in 1810, homeopathic medicine has endured periods where it has been ridiculed, insulted and generally lambasted. Such periods tend to alternate with times in which it enjoys widespread support. At the moment it is enduring a sustained attack in the media generally supported by eminent scientists whose rhetoric treats homeopathy’s practitioners and supporters with total contempt. The question that needs to be asked is:Why is this happening now?

Determinism, Mechanism, Dawkins and God

This is no place to have a discussion about philosophy of science. Suffice to say that we (in the West) live in a time of determinism, mechanistic thinking and naïve realism in which anything intangible or occult, those things that cannot be touched or seen, are said not to exist. Those who believe in such phenomena are fair game for attack. Richard Dawkins, author of The God Delusion is one of the attackers. What is remarkable about Dawkins is simply why he thinks he is saying anything new. Believers in things that cannot be grasped by the senses have always been attacked – at least going back to the Enlightenment. Having pronounced his judgment on God, Dawkins goes on to attack homeopathy. As a homeopathic physician, all I can say is that at least we are in good company!

The Enlightenment and its Critics

In my view the Enlightenment was enlightening but not that enlightening. Criticism of many aspects of it appears in many parts of Jonathan Swift’s Gulliver’s Travels. People like Dawkins would have found themselves satirically attacked by Swift. Alas we have no Swift today, no John Kennedy Toole, no Bill Hicks and particularly no Lenny Bruce to say that everywhere ‘people are leaving the temples and returning to God’.

The Professors that hit below the belt

So in this time of naïve realism, a gang of mainly retired doctors have decided to mount a new form of attack on homeopathy. In a letter to Patient Care Trusts (PCTs) they pompously dismissed homeopathy and urged all PCTs to prevent GPs in their areas from referring patients to medical qualified homeopathic doctors working at NHS homeopathic hospitals. In other words they urged bureaucratic non-doctors in positions of power to prevent doctors referring patients to other doctors! This is the pernicious point that none of the media coverage picked up on. Baum, Ernst, Tallis and fellow enlightened luminaries are entitled to their opinion. They are entitled to form an organisation to perpetrate their view. But in my opinion to seek to influence non-medical bureaucracy to prevent doctors referring patients to other doctors is a cynical, pernicious and underhand exploitation of one of the worst aspects of the ‘nanny state.’ This position taken by these eminent professors generated a media storm in which newspapers such as The Guardian (in particular articles by the ranting radical rationalist, Ben Goldacre) seemed to delight in giving space to. But why do I use the word pernicious? Because there was an honourable course of action that could have been taken by these professorial doctors and scientists that would have been more academically honest. They could have written to every GP in the country and exhorted them not to support homeopathy in any way. The could have written a joint article in the British Medical Journal or any journal read by doctors with the same message. But I think they feared that doctors would still ‘irrationally’ support homeopathy by sending patients to other homeopathic doctors. So they had to go above the heads of GPs and try to win the battle at a bureaucratic level instead. This in my view was underhand and pernicious and nobody seems to have picked up on this.

The Truth about Homeopathy and NHS Homeopathic Hospitals

The simple fact is that since 1948 when homeopathic hospitals in London, Liverpool, Manchester, Tonbridge Wells and Bristol chose to become part of the NHS, hundreds of thousands of patients have been help by going to those hospitals. Many of these patients are ‘difficult cases’ that have not been able to be helped by conventional medicine. How exactly they were helped may or may not be a moot point, but to claim as the government ‘advisor’ Sir David King claimed that homeopathy was of no medical use whatsoever and that it even put lives at risk. Such a comment of complete balderdash is unworthy of a knight, never mind a top scientist. Even homeopathy’s worst enemies do not claim that it is completely ineffective. They claim that it works by the placebo effect or suggestion, that homeopathic doctors get results because of their superior bedside manner or that they give patients more time. Why non-homeopathic doctors are unable to get similar results simply by ‘talking to patients’ remains a mystery. And if they say they haven’t got time to talk to patients and help them get better by doing so – then this is a tragedy for both patients and doctors. Analyses of trials of homeopathic medicines remain controversial. My personal opinion is that most meta-analyses show that homeopathic medicines do work over and above the placebo effect but nobody can doubt that patients benefit from seeing homeopathic doctors.

A significant minority of taxpayers want homeopathy to be available on the NHS. Over 200 MPs have signed an early day motion on their behalf. But the witchhunt continues. Let us hope that good old British common sense prevails here and homeopathy remains available on the NHS for those who want it. Patients who feel better after receiving homeopathic treatment are like any other patients who feel better after medical attention. Whether Sir David King or any of the enlightened professors who wrote to every PCT in the country understand exactly how these patients got better is simply not the point.

# 106: On its way to England: The 1420 Calorie Hamburger! • Careful with Vitamin E • But eat plenty of Porridge • Oscillococcinum

2004-11-30T08:32:00.000Z

On its way to England: The 1420 Calorie Hamburger!
Yes, dear readers, it's here - the meal, called by a nutritionist 'a heart attack in a bun'. Hardees, the fast food chain in the US who have created this 107g of fat in a sandwich known as a 'Monster Thickburger' make no apologies for the health effects of this £3 hamburger comprising two big chunks of processed beef, four rashers of bacon and plenty of cheese and mayonnaise. A spokesman for the company, describing this mass of saturated animal fat as a 'monument to decadence', made the insightful comment that this was no 'burger for tree-huggers'. The Centre for Science in the Public Interest was less complimentary, saying: 'If the old Thickburger was food porn' the Monster Thickburger is the fast-food equivalent of a snuff-movie.' [sic]. Go on then - supersize me. French fries and a chocolate malted milkshake on the side. You only live once, you know.

Careful with Vitamin E
A lot of people take supplements of Vitamin E in high doses for various reasons including menopausal symptoms and raising you libido. Actually the vitamin was shown to raise the sex drive of rats but never proved to have the same effect on humans. This hasn't deterred some people - after all we are living in a rat race aren't we? Anyway, the men in white coats at the prestigious Johns Hopkin University School of Medicine have conducted a study that showed that taking too much of this vitamin can increase your risk of an early death by as much as 10%. Let's be clear about this vitamin then. The daily requirement is 10 iu (international units). Multivitamin tablets contain up to 60 iu and are completely safe. However pure Vitamin E supplement typically contain 400, 800 or even more iu and its these high dose supplements of the vitamin that are being questioned with regard to their health value, especially in the over 60s. As always I recommend one multivitamin a day. If you think you should be taking more than that you should discuss it with your doctor.

But eat plenty of Porridge:
The Daily Mail extolled the benefits of porridge giving 6 reasons to start winter days with a steaming bowl of oats.

It helps hangovers by absorbing toxins, neutralising acid and keeping the bowels moving.
It fights heart disease. Porridge contains avenanthramides that act against fat being laid down in the arteries.
It boosts energy by releasing sugar gradually until lunch.
It helps depression due to a high content of Vitamin B6 which boots our serotonin levels. In this way it acts as a 'natural Prozac' (Exercise does exactly the same thing and much more intensely.)
It's high fibre content may help prevent cancer especially bowel cancer.
It is rich in zinc (needed for a healthy immune system) and manganese which is good for the bones.

Homeopathic Tip of the Week: Oscillococcinum

As winter approaches, the papers and magazines are full of articles on how to treat and prevent colds and 'flu. I will have more to say about this in future columns but for today let me mention the most famous French homeopathic remedy for viral infections. It's called Oscillococcinum and it is prescribed and used very frequently in France usually in strength 200K. This is an homeopathic remedy easily available over the counter at most French chemists. It's available over the counter here too, but you will need to buy or order it from a specialist homeopathic pharmacy.

# 105: More good news for chocoholics • Yes, but... • Homeopathic Tip of the Week: Cravings for sweet things

2004-11-23T08:32:00.000Z

More good news for chocoholics

The Daily Mirror had some very good news for chocoholics. The popular paper reported on the latest health benefit of chocolate - apparently it's good for coughs!

Cocoa, the principle ingredient of chocolate contains a chemical called theobromine which the men in white coats are saying is a third better for coughs than codeine which is one of the most commonly used drugs for suppressing coughs. The Mirror then goes on to list another 15 benefits of eating chocolate and I can resist listing them here:

1.Cocoa beans contain polyphenols which may help to prevent heart disease

2.Chocolate is high in anti-oxidants which may help prevent cancer.

3. It has high levels of Calcium which is good for your bones.

4. It can release endomorphins, the 'feel good' chemicals in the body.

5. It can lower blood pressure (according to some research by the men in white coats at Harvard Medical School) as well as increase blood flow to the brain.

6.It has high levels of fluoride, which is good for your teeth.

7.It may make us feel more alert due to high levels of phenylethylamine.

8.It's a 'better break' than coffee due to lower levels of caffeine.

9.It's better for you than sweets as it is less damaging to your teeth than sugar.

10.It contains copper which is needed by the body for various functions.

11.It may reduce blood clotting (according to the men in white coats at the University of California. This may help prevent heart attacks in much the same way as small doses of aspirin.

12. It gives you energy without causing a surge in your blood sugar.

13.It doesn't raise your cholesterol to the same degree as other saturated fats.

14.It contains iron and zinc, essential metals for the body and its immune system.

15.It contains valeric acid which has a natural tranquillising effect.

Yes, but
Chocolate is good for you but chocolate is not chocolate is not chocolate. Some chocolate bars are much better for you than others. In short dark chocolate is the best, mainly because it contains more chocolate and less sugar than milk chocolate. However researchers at Glasgow University have found that the milk in milk chocolate can inhibit healthy anti-oxidants in chocolate from being absorbed by the body. Also eating a lot of chocolate isn't a good idea because it contains fat and sugar neither of which is particularly good for any of us. Bottom line: Small quantities of chocolate are good for you especially black chocolate.

Homeopathic Tip of the Week: Cravings for sweet things

For people with too much of a sweet tooth. You can consider the following homeopathic remedies with a good reputation for helping people with a craving for sweet things.

Sulphur: Itchy skin rashes, untidy people, intolerant of heat, argumentative.

Argentum nitricum: Fear of heights, always rushing, desires salt and sweets, very fearful in anticipation of important events like exams.

Calcarea carbonica: tend to be overweight people, a bit slow but very reliable, sweat at the back of the neck at night.

Carbo vegetabilis: lots of wind, also like salt, digestive problems, must have fresh air.

Any of these can be tried in a 6c potency, twice a day for a couple of weeks but on the whole it's better to consult an homeopathic doctor.

--

# 104: Smoking Kills 5 million a year • Is smoking addiction in our genes • Babies love curry • Homeopathic Tip: Babies

2004-11-15T08:32:00.000Z

Smoking Kills 5 million a year

The Journal Tobacco Control reported the results of a survey of smoking related deaths in the year 2000. Smoking accounted for nearly 5 million deaths worldwide that year, with three times as many men as women succumbing to the deadly effects of the most addictive weed on the planet.
The main smoking related disease was coronary artery disease which accounted for a million deaths in the industrialised world and 670 000 in the developing countries. Then came lung cancer and chronic obstructive airways diseases such as bronchitis and emphysema. More than half of all these deaths occurred between the ages of 30 and 69.

But is smoking addiction in our genes?

The same journal had an interesting article on a Canadian study of the genetic profiles of 228 students who 'smoked but were not addicted'. The Canadian men in white coats monitored these students for two years after which it was established that 69 of them became addicted to nicotine. However the researchers made an interesting finding: The young people with inactive variants of the CYP2A6 gene were nearly three times likely to become addicted to nicotine. Apparently this is because people with an inactive version of this gene clear nicotine more slowly from their systems. Thus the nicotine remains in the blood longer and makes you crave the next cigarette more.

What this means is that although tobacco is highly addictive to all, it may be more addictive to some than others. How does that help us? Not very much is the answer. My view is that the physical addiction to nicotine, although pretty strong, can be beaten in three weeks. The psychological addiction is somewhat harder to beat, but many have been successful there too. I recommend Allen Carr's Easyway® which he has described in a couple of books and CD's as it addresses the psychological addiction to smoking very well indeed.

Babies love Curry
It's not only adults that like a good Chicken Korma these days, it's children and babies too. We like to think of babies preferring mashed banana to curry but according to the great medical research centre, Sainsbury's supermarket, this is not true anymore. Sainsbury's did their own research over 10 years and found that the top selling baby foods were pretty exotic. For the record here are Sainsbury's Top 10 selling baby foods: potato and lamb moussaka; vegetable, chicken and coconut korma; pasta stars and parmesan,; sweet potato, carrots and beef; rigatoni Napoli; vegetable noodle and chicken; lamb risotto and Hawaiin Chicken; spaghetti, tomatoes and mozzarella; banoffee pie and crème caramel. Favourite places for babies to eat out in London were The Savoy Grill and Claridges. (Just joking on the last point, but the rest of it is true ;-)

Homeopathic Tip of the Week: Babies

One of the best homeopathic remedies for babies, according to the Greek master homeopath, George Vithoulkas, is Calcarea carbonica. He reckons that many babies with various problems can be helped with a few doses of this remedy - no matter what the problems are. On the whole it is indicated in sweat babies who are rather plump and whose milestones are marginally late. It's always best to consult a homeopathic doctor and this is especially true when it comes to treating children and babies.

# 103: Tea Too is Good for Your Memory • Tea Too is Good for Your Memory • Obesity in Pets • Tip of the Week: Colds & Flu, continued...

2004-11-08T20:15:00.000Z

Tea Too is Good for Your Memory

The Science correspondent of The Times reports that drinking tea regularly can help prevent the distressful memory losing illness, Alzheimer's Disease.
According to research carried out by the men in white coats at Newcastle Universities Medicinal Plant Research Centre, tea acts against the certain enzymes in the brain helping it to ward off dementia or Alzheimer's Disease. This could lead to new drugs being developed from tea to help treat this severe disease that affects about 10 million people internationally. The effects of coffee on Alzheimer's were also examined and it was found that coffee has no effect on Alzheimer's.

And so too is a drink or two

Reuters online reports the results of some interesting research on 'older women' who have a couple of alcoholic drinks a day. This time it was the men in white coats at the University of Texas that did the research. This was a serious five year study conducted by Dr. Graham McDougall, associate professor of nursing (sic) at the university. The study examined various factors in both men and women with an average age of 75.One of the factors tested was the ability of the women to remember where things were left as well as story lines and random associations of numbers and letters. The study showed clearly that the women senior citizens who drank regularly performed better in the memory tests than those who did not drink at all. In addition these ladies had more confidence and showed greater versatility in working out strategies to help them remember things. They also performed everyday tasks better and reported less depression and better health in general.

Many articles have appeared in the media extolling the benefits of a couple of drinks a night. Of course the medical profession has to be very cautious about promoting the use of alcohol based on the various studies that show that moderate consumption is good for your health. This is because even small amounts of alcohol do impair one's ability do drive and large amounts make all motorists a menace to others on the road as well as causing many severe physical and mental problems. But it really does seem that one or two drinks in the comfort of your home with nowhere to drive thereafter, are indeed good for your health.

Obesity in Pets

We have discussed obesity, weight loss and diets in detail in this column but only with regard to human beings! The Times reports that obesity and lack of exercise has become a big problem for dogs making them more prone to strokes, injuries and depression. So make sure your dogs eat moderately and get plenty of exercise. Otherwise a 'dog's life' will no longer have such a good reputation.

Homeopathic Tip of the Week: Colds & Flu, continued...

A few tips on treating and preventing colds and 'flu.

At the first definite sign of a cold, a tickle at the back of the throats or a chill, take homeopathic Aconite 6c every hour for five or six doses.
For chills, fever and weakness in a confirmed case of 'flu, use homeopathic Gelsemium 6c every hour for a day or two.
For that lingering cough after colds and 'flu, use Bryonia 6c twice a day for a week.

# 102: The Diet for Chocoholics? • Dr. Kaplan's Ultimate Diet • To Stretch or not to Stretch • Tip of the Week: Overdoing exercise

2004-10-27T20:11:00.000+01:00

The Diet for Chocoholics?

The Daily Express is not a newspaper I usually read but when I saw a front page headline that said: 'The New diet that can end your sugar cravings' I just had to buy an issue.

Well it's all about yet another new diet book. This one is called 'Why do you overeat?' by Zoe Harcombe who has apparently spent 20 years researching nutrition after suffering from various eating disorders herself. The story is about one woman who wanted to lose her cravings for chocolate, sugar, tea, coffee and alcohol.

The diet is a three phase plan:

Phase I: 5 days of meat, fish, eggs, vegetables, rice and salad, yogurt, decaf tea and coffee, water.
Phase II: you keep this up for as long as you want to keep losing weight. Add to Phase I, tofu, dairy, baked potatoes and beans, pulses and wholemeal bread.
Phase III: you remain on this 'for the rest of your life' Now you can eat anything you like. At this point you should have lost all your cravings and can enjoy sweet things occasionally.

My verdict on this diet (as expressed by the Express): Yes, I agree that if you cut out something you are addicted to, the craving for this substance gets less with time. This applies not only to sugar and chocolate, but also to alcohol, caffeine, recreational drugs and nicotine. So what's new pussycat? Another diet book hits the shelves. Well Atkins hasn't been in the news for a while so luckily for Zoe Harcombe there was some column space for her book. We wish her well. Nothing dangerous or radical about her sensible suggestions but is this as the Express asks the 'Ultimate Diet' I doubt it. There is a new 'Ultimate Diet' every few months these days.

So may I remind you of my own 'Ultimate Diet'...

Dr. Kaplan's Ultimate Diet:

Follow these rules to achieve you 'ultimate' weight.

Only ever eat when you feel hungry.
Ideally stop eating when still a little hungry. This feeling will pass soon as you digest and absorb what you have already eaten.
Eat a combination of healthy foods and foods you really enjoy.
Avoid foods to which you are definitely allergic.

That's it. The 'Ultimate Diet' of all time and it's only 53 words long. Feel free to send it to your friends and print it out. It's free and it really works. Trust me; I'm a doctor.

To Stretch or not to Stretch:
To my surprise, the rest of the health section in the Express was pretty decent. There was a good article on why stretching before exercising can actually make you more prone to injuries. There are exceptions made for rugby and football players because there is a great deal of stretching in these games. But for the rest of us, stretching before exercise is not recommended. However it's a good idea to warm up for approximately 10 minutes before doing the full exercise regimen.

For Gym trainers: the rowing machine and cross-trainer are recommended.
For runners: a brisk walk, then a jog, then run is the way to do it.

So remember: No need to stretch before exercise unless you do a sport in which this is specifically recommended. However stretching after exercising is an excellent idea and a good stretching session should take you about 10 minutes.

Homeopathic Tip of the Week: Overdoing exercise

Everyone overdoes their exercising every now and then (except for my wife). When you feel a bit bruised after a particularly hard session or a long run, take a single dose of the homeopathic remedy, Arnica 30c. It's the most famous remedy for injuries but is also great for when you feel you have overdone things.

# 101: Woman about to overtake Men?? • Tip of the Day: Colds & Flu

2004-10-20T20:09:00.000+01:00

Woman about to overtake Men??

For those of us who like to watch the Olympic Games there was an interesting little article in The Week. The men in white coats at no less than Oxford University have been comparing the performances of men and women on the track. Now, everybody knows that men are faster and stronger than women, but what few people know is that women are catching up at quite an alarming rate. So fast is this advance in women's fitness, that the leader of the study, Dr. Andrew Tatem, has mooted the possibility of women becoming the superior athletes!

Taking the 100m sprint as an example. In 1928 the men's winning time was a full 1.4 seconds less than that of the women. However in 1952, although both genders have improved their time, the gap was reduced to 1.1 seconds. In 2000 it was down to less than a second. So the good scientist used these figures to make a guesstimate of what the figures might just be in the 2156 Games. This is what he came up with:

Men: 8.098 seconds
Women: 8.079 seconds

Well we will believe that when we see it. In the meantime, Dr. Tatam's, projections have been hotly disputed. They say it's all about testosterone. Testosterone gives muscle power and allows us to use oxygen more effectively thus helping athletic performance. Both men and women have this hormone, but men have more of it, giving them the advantage in all physical activity. Sorry about this girls, but I guess you knew it all along. But what about Dr Tatam's prediction that it will be girls taking the lead in a mere 150 years time. Watch this column in 2156!

So it probably still makes sense that men and women compete in separate races in athletics. But what about chess? Yes, chess. Believe it or not, there is a men's world champion and a women's world champion. Of course women can compete in all men's events but men are not allowed to compete in womens' chess tournaments! This is ludicrous! Testosterone does not help the brain! Bridge players know this and all their tournaments are unisex. The division of men and women chess players in this way is an insult to women and the strongest women player of all time, Judit Polgar knows this very well. Sensibly she refuses to enter in events exclusively for women. She has done very well against the men and is among the 30 best chess players of today. Good for you Judit!

Homeopathic Tip of the Day: Colds & Flu

Winter approaches and with it the dreaded lurgies of colds and 'flu. I recommend:

1. 500mg of Vitamin C a day, preferably in a slow release tablet.
2. At first sign of a cold, take homeopathic Aconite 6c one tablet hourly for 5 or 6 hours.
3. When everyone is coughing and sneezing around you, try boosting your immune system with Echinacea, a herb that has a good reputation for boosting your resistance to colds and 'flu. It's available in liquid or tablet form with appropriate instructions on the bottle.

# 100: Medicine, Philosophy and 'Alternative Medicine' •

2004-10-13T20:06:00.000+01:00

Medicine, Philosophy and 'Alternative Medicine'

Last week I recommended a book, Hippocratic Oaths: Medicine and its Discontents by Raymond Tallis (Publisher: Atlantic Books, 2004) The author, a doctor and a philosopher, makes a scathing attack on the nanny state interfering with NHS medicine, spending vast quantities on 'improvements' that do not stand up to examination in the light of day. He correctly points out that each successive government feels honour-bound to introduce improvements which just disrupt things and lower the quality of medical care. With all this I concur and applaud loudly.

Unfortunately the good doctor then goes on to trash alternative and traditional medicine. He does so in the predictable formulaic way that I have encountered over the last two decades. Let's look at some of this criticisms. We welcome criticism because by answering criticism we can know ourselves better and improve.

Criticism 1 : Tallis makes the point that there is no convincing scientific evidence that alternative medicine actually works better than suggestion.
My response: What Tallis should be asking is not what works better than suggestion but why it works at all. In particular if suggestion is so powerful, how should scientific doctors utilise it? If alternative therapies work better than orthodox ones in some cases and 'suggestion' is the key, doctors better learn how to use 'suggestion' creatively and they had better learn it quickly.

Criticism 2: Alternative medicine spuriously offers 'personal significance' as an important part of the way it views medicine.
My response: It's not only alternative practitioners who have recognised the importance of personal differences in the way we deal with diseases. It's scientific geneticists who have also recognised that different diseases may need different treatments in different type of people because each person has a different genome.

Criticism 3: Homeopathy has neither biological basis nor physical basis for its action
My response: Why then do eminent physicists such as Capra (The Turning Point) devote large segments of their books to homeopathic medicine?

Criticism 4: Alternative Medicine relies on anecdotal evidence (stories of successfully treated cases) to further its cause. Tallis compares this to the marketing technique of a snake-oil selling 'huckster'.
My response: While not wishing to accuse my eminent colleague of hypocrisy, I would like to draw his attention to some of his own writing. While deploring the use of anecdotal evidence by practitioners of alternative medicine himself, he is not averse to using some personal anecdotes taken from his time as a young doctor in Nigeria. He uses these anecdotal descriptions of the horror of what can happen when one eschews scientific medicine for 'traditional medicine'. I have no problem with this as these anecdotes make a valid point. I do have a problem with him reserving the right to use anecdotes himself but denying this right to others.

Tallis also makes the point of how ignoring sage medical advice can be disastrous for a whole country. His attack on the South African government's attitude to the catastrophic spread of AIDS in that country is totally justified. When a powerful body such as a government ignores science and scientifically proven treatment and favours obscure and highly controversial views about a major illness, they deserve all the criticism they get. His attitude to the MMR inoculation and how its 'dangers' were hyped by the media at huge financial cost to us all, is also appropriate.

Conclusion: Orthodox scientific, 'alternative' and 'traditional' medicine all have their place. In life-threatening conditions (or conditions where there is a risk of irreversible damage) only conventional scientific medicine should be used. In many other conditions however, holistic alternatives can be tried in conjunction with orthodox tests and monitoring procedures. This is why alternative medicine is best practised by fully qualified doctors. Even 'traditional medicine' has its place but it is best used for psychological and psychosomatic problems rather than in the treatment of life-threatening infections such as HIV/AIDS where the advocation of its use by irresponsible governments has had disastrous results.

# 99: Medicine, Philosophy and the NHS •

2004-09-27T20:03:00.000+01:00

Medicine, Philosophy and the NHS

A book by a doctor and philosopher has caught my attention. It's called Hippocratic Oaths: Medicine and its Discontents by Raymond Tallis The Times printed several large extracts from the book. In the first extract, provocatively entitled 'How Patient Power Could Kill The NHS' the 'eminent consultant and noted philosopher' (the words of The Times, not mine) makes a good case to show how consumer rights and 'patient power' is making us lose respect for doctors and undermining the profession in a way that will inevitably lead to lowering of medical standards.

The way this happens is simple. The patient becomes more of a 'client', 'customer' or 'consumer' as the special qualities of the doctor-patient relationship are stripped away by people who know next to nothing about medicine. Doctors then have to focus on one thing. Self protection. In short we will become well-paid automatons who deliver service with a smile - albeit a smile that is somewhat less than authentic. Tallis correctly alerts us to the danger of this, saying that when 'disrespect for the profession' is combined with an 'attitude of hostility towards their physicians, it will further reduce the goodwill of doctors' and 'make them less willing, perhaps, to go the extra mile'. This is a huge point and I totally endorse it. Medicine should never be allowed to be degraded in this way. We, doctors, should always have to answer to our conscience as well as to the guidelines of well-meaning and wise authorities, such as Hippocrates, for example. When the demands of our consciences become totally subservient to the needs, financial and others of 'higher authorities' this profession will be in very serious trouble, to the detriment of those we were honour-bound to put first - our patients.

Tallis makes his point in spades when he compares the health advances made by doctors in the last 50 years to those made by government. Both are vitally important, of course but here is the comparison.

Doctor-led advances in Medicine: (and this is only a sample from Tallis's list)

Surgery: joint replacements, bypass ops, transplants and fertility treatments
Drugs: to treat: hypertension, killer infections, high cholesterol, stomach ulcers and cancer.
Other Treatments: Dialysis and machines that break up kidney stones.
Tests to Diagnose: Among many others, MRI scans, ultrasound and cardiac catheterization (a method of getting detailed information about what's going on with your hearet)
Medical Services: Appointment times, admission wards, day surgeries and home-based hospital care

Government led Innovations:

Expensive reorginasation of the whole service by each new government. The huge cost and effort do not justify the small improvements and there has been much deterioration as well.
Fewer hospital beds and longer waiting lists for 'non-urgent' treatment.
Target setting for waiting lists while simultaneously restricting resources including available beds.

This is a timely publication and the good doctor has much wisdom to share about the crisis in health care in this country.

Recommended reading even though he attacks alternative medicine - somewhat irrationally in my opinion. (See next week's article)

Title: Hippocratic Oaths: Medicine and its Discontents by Raymond Tallis
Publisher: Atlantic Books
Price: �19.99

# 98: Homeopathy Special

2004-09-20T20:01:00.000+01:00

HOMEOPATHY SPECIAL

The Times devoted a whole page to homeopathy in France. For many years France has afforded homeopathy great respect. Visitors to Paris will not have failed to notice that every pharmacy advertises that it carries homeopathic remedies on the front window, something unheard of on these shores.

Now homeopathy is being threatened by proposed new governmental laws. Ever since Samuel Hahnemann, the German founder of homeopathy, died in Paris in 1856, homeopathy has been well-thought of and respected in France. Now it is being challenged by the establishment. The French medical academy, known there as Academie Nationale de Medecine want to end the government subsidy of 35% of the cost of homeopathic prescriptions made by doctors for the French people. In France, 70% of general practitioners at least occasionally prescribe homeopathic medicines. And every time they do, it saves the government money because homeopathic medicines are invariably cheaper than orthodox drugs. It's a long battle that's been going on for some time, and not only in France.

Supporters and users of homeopathy include: the Queen, the Prince of Wales and other Royals. In fact the Royal Family have been supporters ever since the great homeopathic physician, Frederick Foster Hervey Quin brought homeopathy to this country. If anyone is very rude about homoeopathy I love watching their face when I tell them this. You really shouldn't be rude about the monarch, should you. Bill Clinton and David Beckham also use homeopathy. Interestingly the right of the British people to receive professional homeopathic treatment is protected by a by-law and Britain has several NHS homeopathic hospitals in London, Glasgow, Manchester, Bristol, Liverpool and Tonbridge Wells. The Royal London Homeopathic Hospital is being completely refurbished and the much-awaited re-opening should happen early next year. Homeopathy continues to flourish in this country because the people believe in it and want it. 'Should alternative medicine be banned?' asks The Times and invites you to reply to debate@thetimes.co.uk. Do so and tell The Times what you think of the 'nanny state'.

Hopefully we will keep our common sense on this side of the channel. Otherwise we should ban everything that the experts think are duping us. Ready for the chop would be: all advertisements, tobacco, fatty foods (especially fish and chips) and sex on television. Actually let's ban television completely. People who don't exercise should pay higher income tax as should obese people. Let's make freedom of choice a thing of the past - not.

The people want homeopathy and clearly benefit from it. We don't know how it works but no charlatanism in medicine tends to be short-lived. Homeopathy has been around for nearly 200 years. Scientific studies have been done and on the whole they tend to find that it does actually work. We homeopaths treat people rather than just diseases and this can make studies difficult to do. Nevertheless, a scientific enquiry into homeopathy is possible. Good studies do tend to be expensive though and homeopathic institutions and medicine makers are not super-rich like the pharmaceutical giants who have no interest in spending money on finding out whether homeopathy, a cost-effective humane form of medicine actually works. This is a big issue involving science, governments and big money. Let's all hope that what we the people actually want, however stupid the men in white coats think we are, prevails in the end.

# 97: To be a REAL MAN, don't smoke and drink

2004-09-13T19:58:00.000+01:00

For once the Atkins diet was not in the news this week. Small wonder considering the devastating blow it received from Denmark. (See Newsletter no 96 for the Danish study showing that Atkins dieters do lose more weight than other dieters - but only for the first 6 months.

To be a REAL MAN, don't smoke and drink

Unhealthy semen was in the medical news this week. Apparently if you both smoke and drink alcohol, the quality of your sperm and semen goes downhill. Now just listen to what the men in white coats from Argentina have found when they compared the semen of men who neither smoke or drink to those who do both. The drinkers and smokers' semen had a lower volume, lower concentration of spermatozoa and less active sperm than those who abstained.

Interestingly this only applied to men who both smoke and drank alcohol. Those who only used one of the two vices were apparently fine. Dr. Marta Fiol de Cuneo, a medical researcher from Universidad Nacional de Cordoba (the first time this Argentinian institution has been mentioned in this column.) said that although the deterioration in semen quality were not bad enough to reduce fertility, 'in conjunction with another deleterious factors they would diminish male fertility'. Diminish? Reduce? But to what extent? And what is an example of a 'deliterious factor'? According to Reuters, the good doctor and her colleagues asked almost 4,000 men between the ages of 29 and 36 about their smoking and drinking habits, and tested their semen. Now for that I must take my hat off to Argentinian medicine. I wonder how they recruited 4000 volunteers to produce those samples. It's not easy you know; just ask any male who has had to produce a sample on demand in some laboratory.

Anyway the study, published in the journal, Fertility and Sterility, concludes with the advice: 'Men who wish to procreate should be specifically warned of this matter' Yes, good advice doc! I can just see the different reactions of men to this piece of wonderful news.
1. Laugh it off: Result: Most of you will still be fine as far as fertility goes, although the cigarettes will still take you out.
2. Worry about it and stop drinking and smoking: Result: You should be fine as long as you can still produce a 'sample'.
3. Worry about it and stop drinking but continue smoking: Result: Make an appointment to see a psychiatrist, now!
4. Quit smoking, drink between 2 and 4 units a night and thank Argentinian medicine for giving you yet another reason to give up tobacco. Result: Sanity and a longer life.

Homeopathic Tip of the Week

The Times ran an interesting story about homeopathy in France this week. More about it next week, but this is what really fascinated me. The Times had Van Gogh's famous portrait of his doctor, the kind doctor who gave the penniless Vincent, a place to stay in France. Well guess what - he was a homeopathic doctor. Which just goes to show that homeopaths have good taste ;-)

# 96: Adkins: Does it work in the long term? • Tip of the Week: Bad Breath

2004-09-04T19:55:00.000+01:00

THE ATKINS DIET: Does it work in the LONG TERM?

The book called itself 'revolutionary'. It sold more than 45 million copies making it one of the biggest selling books in history. Its message was simple: Carbohydrates are the enemy and must largely be avoided. Protein and fat are fine and you can more or less eat as much of them as you like. It gave biochemical 'reasons' why such a diet made you lose weight, but these explanations have been largely discounted and certainly have never been proved. It was accused of raising people's cholesterol to dangerously high levels - but this could not be proved in clinical trials.

Slimmers all over the globe flocked to buy the book. Stories of miracle weight losses flashed across the globe. Butchers, especially those hard hit by the Mad Cow Disease fiasco, must have thought that Robert Atkins was a gift from the Almighty himself when the sales of meat went through the roof and sales of other foods went down. The level of anxiety among cows, sheep, pigs and chickens went up but nobody seemed to notice this. Even fish became disconcerted. Man had always been a carnivore but never such a voracious carnivore!

I watched these 'miracles' on television and read about them in almost every magazine available. There was some bad publicity and talk of dangers of the diet, but even bad publicity tends to sell books. As the publishers must have said to themselves: 'Good publicity, bad publicity as long as they spell Atkins correctly'. Then on Friday 3rd September, 2004 the bubble might just have burst.

The men in white coats at RVA University in Copenhagen, Denmark revealed the results of an interesting study that compared the effects on obese people of a low carbohydrate diet (eg. the Atkins Diet) and a low fat and carbohydrate diet (almost any other diet other than Atkins). They wanted to see who was doing better in the relative short term (6 months after starting) and the relative long term (12 months after starting).

The results were fascinating indeed. After 6 months the Atkins-like diet did indeed produce real weight loss and outperformed the low carbohydrate diets that people have used since the mid-19th century. In this period there were no adverse effects on the body such as raised cholesterol levels. It doesn't say anything about the notorious 'Atkins breath' a sign of ketosis in the body.(See my previous articles on the Atkins diet)

However after 12 months things were not so good for the Atkins dieters. A review in The Lancet, one of the most respected medical journals in the world, examined the results of THREE studies of the long term effects of the Atkins diet. After 6 months the dieters started to put on weight and after a year they had lost no more weight than people using old-fashioned diets that were low carbohydrate, low fat and did not produce the 'Atkins breath'. But there was more disconcerting news. Professor Arne Astrup of RVA University in Copenhagen found that the Atkins groupies started to suffer from 'headaches, muscle weakness, cramps and diarrhea', which Astrup said could be explained by the reduced levels of fruits, vegetables and whole-grain cereals and bread that are eaten by Atkins people.

So slimmers beware of people promising miracles. Until it is proven otherwise, a moderate diet including lots of fresh fruit and vegetables remains a sensible way to lose weight. And did I forget to mention it - lots of exercise!

Homeopathic Tip of the Week: Bad Breath

Talking of bad breath in general, the most famous homeopathic remedy for bad breath is Merc. sol. If you have bad breath not due to the Atkins diet or any medical cause, you could try some Merc. sol. 6c one twice a day for two weeks and see what happens. Of course it's better to consult a professional homeopathic doctor but Merc. sol 6 for 14 days is safe and sold over the counter at most chemists in the UK.

# 95: Let the Diet Wars begin! • GREED IS THE ENEMY! • Fines for missed GP appointments• Tip of the Week: Sunburn

2004-08-28T19:47:00.000+01:00

Let the Diet Wars begin!

After two successive columns devoted to the redoubtable Atkin's diet it would have been time to move on. Except I couldn't resist telling you about an article in Tuesday's Times which put the diet in the ring against that old workhorse of a diet or slimming plan - Weightwatchers!

Under a full page headline, 'Weightwatchers shape up to Atkins and challenge from low-carb diets' the paper describes how Weightwatchers have been more or less forced to revamp their famous low calorie diet simply to compete with the hordes swarming towards the Atkins system of eating. (which is a high protein and fat diet with low carbohydrates) No wonder the Weightwatching people are scared. Apparently 1.4 billion Americans who used to attend Weightwatchers meetings in America have given the diet and the meetings up and turned to the Atkins Revolution for salvation. This is not merely a matter of fat, it's a matter of the fat of the land. And in the 'land of the fat' that means megabucks! Billions and billions of dollars.

Meat farmers, whom I now understand include the name of Robert Atkins in the daily prayers are watching anxiously. A comeback by Weightwatchers could dent their profits significantly if the recent epidemic of Atkins-inspired carnivore-mania is curbed in the USA.

So Weightwatchers has introduced a new improved system. Not that there was anything wrong with the old system. As a diet, it was as good or bad as any other diet - regular readers know what I think of diets in general. What it had going for it was psychological support and group determination, much like AA and NA. Loving support for your efforts always works and this was a strong contributing factor to the success of Weightwatchers. Still, loving support is hard to market, so Weightwatchers have introduced a new 'Core' System to replace the tried and tested Points System. Why? Because in order to compete with Atkins which allows you to eat as much protein as you want, Weightwatchers also needed to introduce a new diet that allows you to eat until 'comfortable' Thus the new diet is full of food that is high in volume but low in calories. It fills you up without making you fat. Congratulations to them for thinking up such an ingenious strategy - eating foods that fill you up.

Obviously diets are here to stay whatever I think. But if you want a system that always works, why not try the Dr Brian Kaplan's 4 WORD DIET. It only costs �4. (Special offer in USA $4!!!) and it really works. If you want it read on�

Okay here it is!

GREED IS THE ENEMY!

Think about it, digest it, assimilate it, send me �4 and you will surely lose weight. And remember this, it doesn't work if you don't pay. You will then feel guilty and then you will eat to ameliorate your guilt. Then you will be fat again.

Fines for missed GP appointments:

The Times reports that two thirds of British GP's want to fine patients who miss appointments without cancellation. Such considerate behaviour only costs the NHS approximately �162 million a year. That's what it costs the government for the 9 million missed appointments. Outrage is what I say! It's our civil right to have free medicine and our right to miss a GP appointment if we get better while we are waiting for our appointments. And if we have something better to do? What do they expect? I thought doctors in this country were always complaining that they have too many patients! They should be happy that some don't show up.
Don't let them take away our rights!

Not.

Homeopathic Tip of the Week: Sunburn

Here is a homeopathic medicine for sunburn. Yes I know there hasn't been any sun this summer but the sun still shines in Greece, Spain, France, Mallorca etc.

For a hot, red painful skin: Belladonna 6c one every 2 hours. Belladonna is one of the first homeopathic remedies and has had a good reputation for treating various forms of inflammation for nearly two hundred years. Any part of the body that's red, hot and painful may need it, although consulting a doctor for such symptoms is always a good idea as well!

Have a nice long weekend.

# 94: The Atkins Diet: Part II • Tip of the Week: Toxic or overeaten?

2004-08-23T19:06:00.000+01:00

The Atkins Diet: Part II

In my last column I reviewed the Horizon programme on the Atkins Diet. Although the programme clearly showed that people on the diet do indeed lose weight, (by simply consuming less calories) it was not able to give answers to some important questions: Is the diet good for you? What are the health effects in the long term? What about consuming all those fats that doctors say are bad for you?

Why do people lose weight on the Atkins Diet?

The Horizon programme broke new ground by finally demonstrating why people on the diet lose weight. Although they are permitted to eat as much protein as they wish, a study showed that they do not choose to do this. But why don't they? That is the crucial question. In order to attempt to answer this question we need to look at an important process going on in the bodies of people on the Atkins diet. This process is called ketosis..

Ketosis

To produce usable energy the body prefers carbohydrates. It utilizes insulin to convert them quickly into energy. However if you deprive your body of carbohydrates or reduce them radically as you are requested to do on the Atkins diet, the body can still produce energy. It can do this but with far from the ease it can utilize carbohydrates for the same purpose. It can convert protein and fat into energy by breaking down ketones in both of these foodstuffs. The process of producing energy in this way is called ketosis. Ketones can be found in the urine of some people on the Atkins diet (as demonstrated on Horizon) and is responsible for the notorious 'Atkins breath.' Opponents of the diet reckon that when the body has to break protein for energy in this way, it will also digest muscle (composed mainly of protein) and this is very unhealthy.

So why do we eat less on the Atkins diet?

This is the question nobody can answer! People on the diet consume less calories. Here is my personal theory why. When ketosis occurs in your body, it suppresses appetite. This may occur because you feel slightly toxic inside. When you feel ill or toxic your appetite is suppressed. I think people on the Atkins diet may be losing weight for this reason.

Why we need unrefined carbohydrates

All athletes understand the importance of getting energy from carbohydrates. That's why they eat bananas or glucose drinks during a sporting contest and not sirloin steak - which would surely slow them down. However, and here is the rub, you do need to use the energy provided by the carbohydrates otherwise they will be stored as fat. In my opinion unrefined carbohydrates are a vital ingredient of our diet as long as we do moderate exercise. The emergence of a diet like the Atkins may have everything to do with our lack of physical activity. If we exercise we need energy and carbohydrates are ace at providing it.

So how should we eat?

A balance of carbohydrates fats and protein is the ideal. And exercise!

Homeopathic Tip of the Week: Toxic or overeaten?

When you feel toxic or have overeaten try a few doses of homeopathic Nux vomica 6. It is also the homeopathic remedy for a hangover.

# 93: The Atkins Diet: Part I • That Horizon Programme • Tip of the Week: Mosquito bites

2004-08-14T19:04:00.000+01:00

The Atkins Diet: Part I

That Horizon Programme
Well the health news item of the week just has to be BBC2's Horizon programme on Thursday night. It was all about that most fashionable of diets, The Atkins Diet.

It was one of the most interesting and well-made television programmes on a health issue that I've ever seen. That it was all about one of the most fashionable and controversial diets in history made it all that more fascinating and worthy of devoting at least two columns to.

Let's begin by looking the Atkins Diet. Dr Robert Atkins, a cardiologist, introduced the world to a very interesting way of eating that would allow you to eat as much as you want without putting on weight. You would also lose weight if you stopped your normal way of eating and switched over to the Atkins way of eating.

Basically the diet encouraged you to eat as much protein and fat as you want but to decrease drastically the amount of carbohydrates in your daily diet. 'Carbohydrates are the enemy' was the aphorism on everybody's lips. Many doctors were appalled by the recommended high fat diet as it would increase everyone's cholesterol levels. Studies showed that it did not and they also showed that people put on a high protein diet definitely did lose weight. People trying to prove the diet didn't work were confounded with the results of their own studies that showed it did. But how did it work?

Meat and fat certainly contain calories - but Dr Atkins said that we could eat more or less as much as we want. So what happens to the calories? Some thought that the body had to 'work harder' to digest protein and used up calories. Some thought we were losing more calories in our urine. We do lose a few more but not nearly enough to explain the weight loss of people on this diet. So how on earth does it work?

How it works
Finally the men in white coats came up with a very clever study. They got large sets of volunteers to get free food at a specially-designed supermarket for a few months. One group got a normal diet with foods such as fruit, bread and other prohibited 'inimical' carbohydrates. And the other group got a very high protein diet. Guess who lost weight? The people on the high protein diet. But why? These guys in white coats were clever. They measured the calorific content of all the food consumed and came up with the simple answer that the people on the Atkins-like diet consumed LESS calories. The people eating the high protein diet simply consumed less food.

What does this mean?
A very high protein diet changes our metabolism in a big way and makes us feel less hungry. Therefore we consume fewer calories and lose weight. The huge misunderstanding about the diet is that we assumed that when it said 'as much as you like' in relation to protein foods we automatically assumed that people would gorge themselves. In fact they ate less. Why they did so and continue to do so remains a mystery - but one which is likely to be solved soon.

So do I recommend the Atkins Diet. No, I don't and I'll give my reasons next week. Be sure to read Part II next week.

Homeopathic Tip of the Week: Mosquito bites
Getting bitten by mosquitoes? Leaving beautiful England for a holiday in some place with insects that are after your blood? Well if you have to, at least take some homeopathic Ledum 6c with you. Take a dose twice a day for a few days for insect bites. You can also get a tincture of this medicine to put directly on the skin.

# 92: Healthy Snacking • Fruit • Tip of the Week: Digestion

2004-07-29T19:00:00.000+01:00

Healthy Snacking - Around the world

The BBC has a plethora of information on health issues on the health area of its website (http://www.bbc.co.uk/health) which is well worth a look at. There is a useful article on how to snack without putting on weight. The piece makes the point that snacking is not necessarily unhealthy. It all depends on how many calories you are getting from your normal meals.

For some people like diabetics and sufferers of hypoglycaemia (low blood sugar) regular small snacks are preferable to large meals at any time. For the rest of us, healthy snacks are a good way of eating as long as we don't overeat at our regular meals - which alas most of us do. So if you are going to snack, what should you eat?

Well the BBC website makes the point that crisps have become the most popular savoury snack and of course we spend hundreds of millions of pounds on chocolate. Both of these contain loads of empty calories, fat and sometimes a lot of salt as well. In other words they are pretty unhealthy foods on which to snack. Of course the healthy snack foods are fruit, vegetables with a healthy dip, some nuts, unsweetened yogurt etc. Popcorn (unsalted and unsweetened) may not be particularly unhealthy but it doesn't contain much fat or calories if you make it in a popcorn machine that doesn't use fat. Of course I'm not recommending some sort of faddish 'popcorn diet' but it's quite nice to nibble in front of the television at times. The BBC site makes the point that popcorn was discovered by the Incas in 300 CE! That probably makes it one of the world's oldest manufactured snacks. I'm pretty sure fruit and nuts are the worlds oldest snacks and not only for the human species.

The website gives some useful information about how people of various cultures snack.

For example:
The Caribbean - Possibly the worlds healthiest snackers, they get a lot of their daily snacks straight of trees! These include melon, passion fruit, papaya, mango, figs and coconut all of which are a healthy source of unrefined carbohydrates, minerals and vitamins
Nepal - A famous snack here is 'uncooked rice, soaked, beaten and roasted, then served with yogurt' Sounds very good.
Japan
Chicken kebabs dipped in sauce and grilled = Yakitori
Fresh sliced raw fish = sashimi
Mmmmmm! You can get these here but they tend to be a bit expensive.

And the winner is!

So I hope the BBC and I have convinced you that crisps and chocolate are not the only way to snack. In my experience, fruit is the creme de la creme of snacks. It's fresh, healthy, easy to carry and available everywhere. An apple a day keeps the doctor away. Well we doctors do need to make a living, so I can't agree with that. Still, two or three pieces of fruit consumed by everyone every day and hey we doctors could be out of pocket.

The best time to eat Fruit

It's interesting to note that snacking is possibly the best way to eat fruit. The thing about fruit is that it's digested very quickly. If you eat a dessert of fruit salad after a normal meal, the fruit is digested quickly and catches up with the rest of the meal in the bowel. It then gets 'blocked' by the other food and starts to ferment, causing wind and discomfort. Thus it is much better to eat fruit as a starter than as a dessert and this is one of the reasons it makes such a health snack.

Homeopathic Tip of the Week: Digestion

Well, remember not to eat fruit after a full meal and you might find your digestion improves a great deal. To take things further you might like to try the food combining diet on this website. (Basically you don't combine carbohydrates and proteins in the same meal and you keep fruit separate as I have already suggested. If you still have a lot of problems with wind and bloating you should obviously see your doctor. If you get a diagnosis of 'Irritable Bowel Syndrome' you could try some homeopathy.

For bloating and discomfort NOT relieved by passing wind you could try Carbo vegetabilis 6c one three times a day for a couple of weeks.

If it is relieved by passing wind - try Lycopodium 6c one three times a day for a couple of weeks.
If you know the bloating is due to psychological stress and pressure and you are of a nervous disposition, try Argentum nitricum 6c one three times a day for a couple of weeks.

Jul29, 2004

# 91: Fertility and the Atkins Diet • Dr Kaplan’s Rules of Rational Eating • Hay fever •

2004-07-22T18:41:00.000+01:00

Fertility and the Atkins Diet

So many people are on the Atkins diet that Britain's butchers are on a high. But how healthy is this popular diet that calls carbohydrates 'the enemy'. Various studies have allegedly linked it to sugar diabetes, depression, osteoporosis and breast cancer, but none of these links has been substantially proved. Now comes another study that links it to decreasing a female's chance of having healthy offspring. But the three million Britons on this diet need not be too concerned yet, the study was done on female mice, not humans.

The men in white coats at Colorado Center for Reproductive Medicine, according to the Daily Telegraph, took a bunch of mice and put half of them on a high protein, low carbohydrate diet similar to the Atkins diet. The other half were given a normal diet - for mice. The half that didn't eat the Atkins-style diet produced much healthier embryos. So much so that the scientist conducting the study actually recommended that women trying to conceive should probably avoid high protein diets such as the Atkins diet. But what goes for mice does not always go for men - or women. As I've often stated in this column, I do not believe in any form of dieting, although I do recommend certain principles in:

Dr Kaplan's Rules of Rational Eating:

To maintain a healthy weight only eat when you feel hungry and stop eating while still a little hungry.
To lose weight, wait a while before immediately appeasing your hunger (except if you are a diabetic or told by a doctor to eat regular small snacks) When you feel hungry and delay eating, you lose weight.
Eat a mixture of healthy foods such as fruit and vegetables and foods you really enjoy. No food is the enemy. Greed is the enemy.

Exercise is a vital part of any weight-reducing campaign. Walking, weight training, running, yoga, tai chi and many sports are all excellent thought activities such as yoga and weight training require expert supervision.

Who exercises?
According to The Week, a recent government survey reported the following:
40% of those interviewed had taken no exercise for a month.
Many of the other 60% had hardly exercised but merely gone for a short walk.

Hay Fever: A new cure?

About one in six Britons suffer from this annoying problem making us the worst hit country in Europe. But fear not, hope is at hand according to the Daily Telegraph. A drug called for now, R112 is being researched in California that could have a big impact on hay fever. It comes in the form of a nasal spray that inhibits all the chemicals (eg. histamine) that cause sneezing and watery eyes within 15 seconds! The makers have described the results of initial tests (on humans not mice) as 'spectacular'. The bad news is that it will not become available for prescription until much more comprehensive trials confirm its efficacy and show that it does not have any unacceptable side effects - and that could take up to five years. Watch this space�

Homeopathic tip of the week: Hay fever

Homeopaths do treat hay fever and it's best to consult a homeopath in person to have the best remedy prescribed. Still here are a couple of safe options for you to try.

For hayfever that mainly affects the eyes, Euphrasia 6c one tablet three times a day when your eyes are watering and itchy.

For hayfever that is definitely worse when the pollen count is high, you can try Mixed Grasses and Pollens 30c, one tablet twice a day for a week.

For the long-term treatment of chronic hay fever I recommend a visit to a qualified homeopathic practitioner.

# 90: The Nation's Health • Safe Sex: Prostitution: To legalise or not to • Homeopathic Tip: Warts

2004-07-16T18:38:00.000+01:00

The Nation's Health

As I write this newsletter I'm looking at an A3 poster sent to me by a company called NatCen (The National Centre for Social Research). Apparently they work 'on behalf' of the Department of Health.

NatCen have done a big health survey of England. The study used a sample of 20 000 adults and children and this is a statistically significant sample of the nation. The stated aim of the survey was to:

1. Help plan NHS services
2. Look at ways of improving people's health.
3. Look at changes in the nation's health over time

I suppose NatCen would like me to put this rather ugly poster in red, white and black on one of the walls in my surgery. Forgive me NatCen but I prefer art that helps my patients relax. Still I thought I'd share some of the interesting statistics on your poster with my readers. Here they are:

Smoking: The percentage of the adult population that smokes is 25%

My advice: The recommended amount of cigarettes to smoke a day is 0.

Weight: 40% of all adults are overweight (overweight is generally considered to be between 10% and 20% over your ideal weight.

20% of adult Britons is obese (obesity is more than 20% over your ideal weight)

My advice: Eat 'rationally' and exercise regularly. Do not diet. There are new diets every year because no diet works in the long term.

Fruit and Vegetables: 10% of children in Britain don't eat vegetables on any given day.

My advice: If all else fails, bribe your kids to eat fruit and vegetables ;-)

Alcohol: 40% of young men and 33% of young women binge drink on a regular basis.

My advice: Alcohol in moderation can even be good for your health.

For men: no more than 3-4 units a day

For women: no more than 2-3 units a day.

'Binge drinking' is defined as consuming double the recommended limit.

Safe Sex: Prostitution: To legalise or not to...

This was not in NatCen's poster but was on the front page of Friday's Evening Standard. Apparently the government is seriously thinking of bringing brothels into the public domain where they could perform regular health checks and protect prostitutes (actually 'sex workers' is the politically correct term) from violence. I think this is a very good idea. The oldest profession will never go away. Wherever it is made illegal, it simply goes underground or brothels call themselves 'massage parlours' or 'unisex saunas' where there are no health checks and prostitutes are often at the mercy of ruthless pimps. I think the situation in Holland where prostitution is out in the open and subject to medical supervision is a much healthier way of dealing with the issue than putting our heads in the sand and pretending that it isn't there. The latter is dangerous indeed to the nation's health. Sex workers sitting in windows may not be to everybody's taste, but this can be overcome by allowing this only in designated areas of each town and city. If you don't like it, you don't have to go there.

Homeopathic tip of the week: Warts

For warts on any part of the body take a dose of the remedy Thuja 30 once a day for a week. You can also buy some Thuja mother tincture and put some on the actual wart for a few weeks. Many warts respond to this most famous homeopathic remedy for warts and verrucae.

# 89: To smack or not to smack • Good news for milk drinkers • Jogging • Homeopathic Tip: Bruises & grazes that redden the skin

2004-07-10T18:35:00.000+01:00

To smack or not to smack, that is the question

So how does this controversial debate in the House of Lords become a medical issue? Let me explain. They want to make a law that says you should not smack your kids but if you do smack them, you shouldn't smack them too hard. So that leaves the question: When is a smack too hard? And they have an answer to this: When it reddens the skin. Ah, reddening of the skin that sounds medical doesn't it?

The inanity of this method of calibrating the severity of a smack becomes self-evident when we begin with the fact that human beings have very different colours of skin. A Swedish Caucasian is likely to have much whiter skin that will 'redden' a lot more easily than the dark skin of an indigenous Nigerian. That's bad news for Nigerian, other Africans, South Americans and other people with dark skins which will take a more severe smacking to 'redden'. Who will assess reddened skin? A doctor, a colour therapist or a specially trained policeman? Should we install CCTV cameras in every home that can zoom in on reddened skin? The nanny state must decide.

Good news for milk drinkers

Milk is a strange food. Was it meant for human consumption or was it designed for baby cows? Are we humans the only species that routinely drinks the mother's milk of another species? Anyway, drink it we do in millions of litres a day. Now the men in white coats at no less an institution than Harvard medical school, have found that milk with its high calcium content, gives 12% protection against bowel cancer, which is one of the most common cancers these days. The study looked at 500 000 people of whom 5000 eventually developed cancer of the colon. Those who drank milk every day were definitely given some protection from this severe disease. If you do drink milk every day, I definitely recommend the skimmed version. It is probably the calcium content rather that the percentage of fat that is doing the good work here.

Jogging: Good for the body, good for the mind and good for your career

Now everyone knows that jogging is good for the body and good for keeping trim. Joggers know how good it is for the mind and can even become quite depressed from the withdrawal symptoms if they cannot jog for any reason.

What is new is that jogging can expedite your rise up the corporate ladder!

According to Metro, jogging has 'become part of British corporate culture' with a quarter of all employees pounding the pavements. 40% of lawyers apparently have been offered a job while jogging with another lawyer, and one fifth of all accountants jog. Recruitment consultants praised jogging, saying that it helped them work better by increasing confidence and self esteem. As for doctors, this one jogs regularly on the athletic track at Regents Park. If you see a tall, fit, incredibly good-looking man there, he might well be me ;-).

Homeopathic tip of the week: Bruises & grazes that redden the skin

Going back to that 'reddening of the skin' issue. What can we do about genuine bruises and grazes that redden the skin. Orthodox medicine does not have much to offer but homeopathy has some useful remedies in this regard.

Arnica: Very useful for any type of injury and the top homeopathic remedy for bruising. Small bruises should not be treated with anything but when you are a bit 'black and blue' from a fall or any other cause, Arnica 30 three times a day is recommended by homeopaths all over the world.

Calendula cream: This is the homeopathic treatment of choice for all grazes. Just smear some of this wonderful cream on the graze twice a day and watch it heal.

# 88: When will your biological clock begin to tick? • Homeopathic Tip: Premenstrual TensionWhen will your biological clock begin to tick?

2004-07-01T18:33:00.000+01:00

When will your biological clock begin to tick?

This is a question that millions of childless women ask themselves. In today's society women are having babies later and later and some manage to leave it too late. It brings to mind a cartoon I once saw of a smartly-dressed, obviously successful woman throwing up her hands in shock and saying:
"Oh no! I forgot to have children!" So when exactly does this moment arrive?

Well fertility in women definitely decreases with age and it can be quite difficult for some women who are experiencing normal menstruation, to get pregnant. When periods cease for good, women experience the menopause, which is confirmation of the end of fertility. Thus it would be very useful if the busy women of the Western world in the 21st century would know when menopause will happen in their lives. The age of menopause varies between 45 and 55 but the syndrome of 'early menopause' is also possible. The good news is that according to The Guardian the men and women in white coats have come up with a method of working out exactly when your biological clock will start ticking towards the menopause.

This is how it works: Unlike men, who go on producing spermatozoa until they are old and grey, women are born with a set number of ova and do not manufacture any new ones throughout the duration of their lives. At birth there are approximately five million eggs in her ovaries but by age 37 there are only 25 000 left. Now the loss of eggs begins to get much faster until there are only 1000 eggs left and the beginning of the menopause. As I've said this normally happens between ages 45 and 55 but for some unfortunate women it can happen much earlier. Until now the only warning sign for this is to have a mother or close relative who suffered from 'early menopause'. Now the scientists have devised and very clever method for predicting the time of the menopause. Using a sensitive ultrasound machine, they are able to measure the ovaries and guesstimates the number of eggs remaining in them. They then feed this to a computer which uses a sophisticated formula to calculate the number of fertile years remaining.

Thus most women having this very simple, non-invasive test, will be told that fertility will end for them at around 50. However, an unfortunate few will be told that it might happen significantly earlier than that. These women will then be given the chance to start a family much earlier than they would have initially chosen. The test should be easily affordable, pain-free and quick. This is a significant medical advance. However all women should remember that although fertility ends with the menopause it decreases with age from their early twenties onwards. So when you put that ad in the lonely hearts column, be sure to add "Time-wasters need not apply!"

Homeopathic tip of the week: Premenstrual Tension

Staying with the theme of female fertility and menstruation, here is a tip for women who suffer from severe premenstrual tension. Supplement you diet with evening primrose oil (1g -2g a day) a good vitamin B complex tablet and a tablet combining Calcium, magnesium and zinc.

If your symptoms always disappear the moment menstruation begins, try taking the homeopathic remedy Lachesis 30, but only three doses after one period. Do not repeat. If you get a good result but the PMS returns after a few months, don't take the remedy again but consult a homeopathic doctor who might choose to give you the remedy in a higher potency.

# 87: Dr No-Smoke • Food: The Good, the Bad and the Ugly • Happy women are Healthy women • Homeopathic Tip: Football fever

2004-06-25T18:30:00.000+01:00

Dr No-Smoke:

This week I went to the popular press for health news. Starting with England's best-selling newspaper, The Sun, I was impressed to see that Sir Richard Doll was mentioned. Now Dr Doll together with a Dr Hill actually were the first to prove that smoking causes lung cancer. They did this some 40 years ago and this changed the image of the smoker forever.
Now Dr Doll had some more interesting and more optimistic news for smokers and ex-smokers. If you give up smoking at age 30, you can return to having the same risk of serious disease as a non-smoker. If you give up at 50 you can reduce your risk of illness by half. So whatever your age, it's always worth giving up. Thanks Dr Doll, for furnishing us with proof of this. Good to see you in the news again.

Food: The Good, the Bad and the Ugly:

Next I turned to one of the most popular monthly magazines of all time, The Readers Digest. On the front cover was emblazoned 'Foods That Harm. Foods That Heal'. I turned to page for inspiration only to find that the whole article (and therefore the cover story itself) was no more than an advertisement for a Readers Digest book by that very name. It's available from Readers Digest for �28.95 and will not be reviewed in this column. Anyway the Digest was generous enough to give a few healing and harming foods away in the current addition.

So, Reader's Digest foods that Heal include: Asparagus, chilies, grapefruit, Kiwi fruit and mushrooms and sweet potatoes.

Foods that you should consume only in moderation include: Pickled food, mayonnaise and smoked meats.

Happy women are Healthy women:

Now here is some really good news for happily married women: You have stronger hearts than your lonely and unhappy sisters. Yahoo news reports a very interesting study conducted by the men and women in white coats in Sweden. They took 600 women aged 30 to 65 and studied the health of their hearts over a ten-year period. They found that women under stress in their marriages had more arteriosclerosis and narrowing of the coronary arteries than women who were happily married. The study also found that the women who were socially isolated were more likely to suffer from diabetes and obesity. So listen to me all you beautiful young things: being happily married seems to be one of the best things you can do for your health.

How does one stay happily married though. No space for the answer to that one. Until next week then�

Homeopathic tip of the week: Football fever

Last night England played Portugal in the quarter finals of Euro 2004. I guess you know the result by now.

If you are an England supporter:

Ignatia: If you are tearful and a bit hysterical about the result. And especially indicated if you are sighing a lot!
Natrum muriaticum: If you are very sad but keeping your grief and disappointment to yourself.
Nux vomica: If you've just had an awful night drowning your sorrows.

If you are a Portugal supporter:

Coffea: the remedy for 'ailments from excessive joy'. But how can joy make you sick. Well it can and sometimes it does. If you were overcome with joy last night and now feel a bit under the weather for no reason (if you are hung over, then Nux vomica is your remedy) you should try a few doses of Coffea. If you can't sleep because you are so happy, Coffea, is very much the homeopathic remedy of choice.

Dosage: All the homeopathic remedies above should be taken in strength 6c, one pill three to four times a day.

# 86: Diets: Yo-yo is a no-no • But Exercise is a yes-yes! • Echinacea: No good proof that it works • Homeopathic Tip: Colds

2004-06-17T18:27:00.000+01:00

Diets: Yo-yo is a no-no

Everybody knows that people whose diets result in their weights yo-yoing up and down tend to end up with the yo-yo at the top rather than the bottom. However yo-yoing your weight may have more unpleasant effects than simple obesity.

In an article in the Times this week it was claimed that fluctuating your weight can actually weaken your immune system making you more vulnerable to all sorts of diseases. In a study conducted by the men and women in white coats at the University of Washington, it was found that women who had gone on diet and succeeded in losing ten pounds on two or more occasions in the last 20 years had weaker immunity than those who had not dieted in this way. Immunity was measured objectively by counting the number of natural killer cells in the blood. Natural killer cells (or NK cells) are the soldiers of the body who fight bacteria, viruses and other dangerous substances in the body. A lower NK cell response has purportedly been linked to a higher risk of cancer as well.

British nutritionists tended to agree with the general idea of the findings of their colleagues across the Atlantic. Said Sarah Schenker of the British Nutrition Foundation: 'It is far healthier to lose weight gradually by reducing food intake gradually (that's two 'graduallys' in once sentence, Sarah) and becoming more physically active. We agree.

But Exercise is a yes-yes!

All indications are that exercise strengthens the immune system. Californian researchers have shown the exercise increases immunity and this can be proved by showing an increase in not only NK cells but also killer T-lymphocytes and antibody-producing B-cells all signs of a healthy, active immune system. So listen here all fatties: Forget the crash diets but keep on that treadmill!

And that means you too, girls!

It seems that teenage girls have slightly more to gain from regular exercise than the rest of us. The Times, quoting the medical journal, Pediatrics, mentions a study that shows that girls who do regular exercise during puberty end up having higher bone density and therefore stronger bones than girls who prefer more leisurely activities during their spare time. So it seems the jolly hockey sticks were right and will end up with less osteoporosis in later life than their more sedentary colleagues.

Echinacea: No good proof that it works

For some time now, the herb, Echinacea, has been marketed as a booster of the immune system in general and a herb that helps keeps colds at bay. American researchers, according to the Evening Standard, seem to suggest that there may be little proof that it is capable of doing this. In an interesting study, 48 volunteers were given (unbeknownst to them) either Echinacea or a placebo and then exposed to a cold virus. Ninety per cent of both groups came down with bad colds showing that the herb gave no protection against catching colds and viruses - at least in that sample of people. My only comment is that I hope that those volunteers were well paid. A bad cold is no joke. So until next week - ATISHOOOOOO!

Homeopathic tip of the week: Colds

Staying with the subject of colds, it's well worth trying homeopathy when hit by the dreaded lurgy.

1. At the very start of a cold, when you can just feel that familiar tingle in the back of your throat, start taking Aconite 6c every hour for the day. This is your best chance of warding the cold off, but you must use it early.
2. When you are really feeling down with a cold, with shivers down your spine, a fever and very sore throat, use Gelsemium 6c hourly.
3. Towards the end of a cold, when that dry cough just won't go away, use Bryonia 6c three times a day until it does, but no longer than two weeks after which you should have a doctor listen to your chest.

# 85: Diet? Exercise? Viva la creme! • More benefits of exercise • Homeopathic Tip: Nerves before Exams?

2004-05-24T18:17:00.000+01:00

Diet? Exercise? Viva la creme

Well this is the slimming tip that takes the cake - or should I say the cream? Yes ladies and gentleman, 'they' are saying that you can use a cream on your skin to lose weight now. I'd thought I'd heard it all but the French magazine, 60 Million de Consommateurs (quoted by The Week) has seemingly endorsed the use of slimming creams by quoting a study showing that slimming creams are more effective at getting you to lose weight than dummy creams or placebos.

This is what the men in white coats (admittedly men in white coats at the magazine rather than at a French hospital) did. They got 40 or so volunteers to rub cream into their thighs. (Where else? This is France you know.) Half were given a dummy cream and the other half 2 different slimming creams. After two weeks, it is alleged that the ones ('dummies'?) using the slimming creams lost 2cm off their thigh measurements. Eureka! The wonders of 'medical' research leave me dumbfounded again. By all means get your partners to massage cream into your thighs but Vaseline or aqueous cream should be less expensive. However it is entirely possible that this process could lead to another activity that definitely helps you blow off some calories.

More benefits of exercise

Meanwhile back in Britain the Government was extolling the virtues of plain old exercise. The Independent reported further benefits of exercise including reduced breast and colon cancer and osteoporosis. Overall 30 minutes of exercise five times a week can reduce the risk of an early death by 30%. According to the Government however, it's not necessary to join a gym; cycling to work can do the trick. They don't say anything about riding through red traffic lights or treating one way signs with contempt but as a medical doctor I can tell you that these activities are not particularly helpful in staving off an early death.

From personal experience, I think getting some training in a gym is most useful. A good quality gym offers motivation and correct instruction on strengthening all groups of muscles. But by all means walk. Apparently two thirds of us are not taking enough exercise and according to a French psychiatrists this also makes us less happy! In a new book, called Healing without Freud or Prozac, Dr. Servan-Shreiber advocates exercise as a treatment for depression. The book is a bestseller in France and an English edition will be available next month. Watch out for the following bestsellers from this columnist: Help yourself to health by drinking more water; Vegetables, the mystery health foods and Think positive - for a happier day!

Homeopathic Tip of the Week: Nerves before Exams?

Getting nervous before some big exams? Homeopathy has a good reputation for treating apprehension before important events.

The following medicines can be used in a 6c strength three times a day on the following indications:

Gelsemium: For when you get all shaky, want to pass urine a lot and even may have some nervous diarrhoea.

Lycopodium: For those who get terribly nervous before the event, but inevitably do well at the time.

Argentum nitricum: For those who get trembly and nervous before and during important occasions.

# 84: How to grow new teeth • Vitamins may be bad for your heart • Homeopathic Tip: Dental

2004-05-11T18:24:00.000+01:00

How to grow new teeth

I had heard of tooth implants but never of actually growing new teeth. Not until I read the Sunday Times that is! Their science correspondent, Mark Henderson, reports that dentures could become a thing of the past and a process of regenerating teeth (= growing new teeth) could become a standard process in only five years. Wow! This is no joke however and to prove this, let me inform you what is actually going on.

Apparently the man at the centre of all this is Paul Sharpe of the Dental Institute of King's College London, a reputable centre of dental excellence if ever there was one. Professor Sharpe has found a way of using stem cells to grow teeth. Well, not in humans yet, but he had managed to grow a healthy tooth in a mouse using rudimentary tooth tissue taken from the embryo of another mouse. And as we all know, mice are not that different from men and women. As the old saying goes: Are you a man or a mouse? Squeak up! Anyway trials of growing teeth in humans could begin in only two years time. Still don't believe it? Well listen to this: Apparently Professor Sharpe has a company called Odontis which is developing this project and they have just been awarded �100, 000 by the National Endowment for Science, Technology and the Arts. So start believing that grown up humans may soon be able to grow new teeth!

Vitamins may be bad for your heart

Well many of us thought that vitamins were good for you, or at least could do you no harm. Then there were some warnings about taking too many vitamin supplements. Some believed that certain vitamins, such as vitamins C and E as well as Beta Carotene were good for the immune system and the heart. Now the news is that the opposite may be true. Instead of boosting the immune system of the body, as many thought, they may actually slow it down. It's all to do with free radicals, the liver and the wrong sort of cholesterol and this time it's the men in white coats at New York University School of Medicine who are doing the research. It's all very complicated but columnist, Dr Thomas Stuttaford puts it into context in an article in the Sunday Times. He correctly makes the point that a balanced diet is all we need to keep healthy - as far as what we put in our mouths is concerned of course. (Nobody could have missed the media's obsession with obesity and exercise in recent months. We should have seen it coming. This sort of 'revelation' always hits these shores about 6 months after it's big news on the other side of the Atlantic.) Anyway the problem with a 'balanced diet' is that it's quite hard to do unless you live on an organic farm and grow your own. The fruit and vegetables on the shelves of the supermarkets are depeleted of many minerals and vitamins and that's the case for taking supplements!

In the final analysis, moderation may be the key. The jury is still out on big doses of vitamins and mineral supplements. But one good multivitamin a day could still 'fill in the gaps' of some of the things our bodies require but are not getting with our daily diets. That has been the recommendation of this columnist for some time and I stand by it.

Homeopathic Tip of the Week: Dental

Having some dental work done? And I don't mean growing new teeth! My homeopathic teacher, Dr. Donald Foubister used to say having a filling is a bit like a hammer and chisel job on the head. In other words it's a little trauma. And the great homeopathic remedy for all types of trauma is Arnica. Take Arnica 30c three times a day for two days starting immediately after dental treatment. I took it after having four wisdom teeth out under local anaesthetic at the same time (not generally recommended as it's a bit 'traumatic'). I took lots of Arnica, had a bruised mouth for one night but was amazed at how much better I felt the very next morning. From where I sit, no family should be without this most famous of homeopathic remedies, good for bad bruising, sports injuries and after dental treatment.

# 83: Hay fever Season * Homeopathic Tip: Hayfever

2004-05-04T18:11:00.000+01:00

Hay fever Season:

The Evening Standard's Health&Fitness section led with a full page article entitled 'At last, I don't cry when the sun comes out' which was all about the trials, tribulations and treatment of hay fever sufferer, James Delingpole. James had suffered for many years from very severe hay fever symptoms which lasted from May to September causing him untold misery.

He describes how he tried everything from the orthodox treatments of antihistamines, nasal inhalers, eye drops and disposable tissues to naturopathic treatments like dairy free diets - but without significant relief. He was skeptical about homeopathy, having watched a very anti-homeopathy programme on television last year. The programme did not show any ill effects of homeopathic treatment, merely that a laboratory trial didn't show a difference between the effects of water with a homeopathic remedy in it on live cells in a test tube and water without a homeopathic remedy in it. It wasn't a clinical trial (when you test the effects on live human beings, known as 'patients' in my profession). Studies of clinical trials, known as meta-analyses actually show that patients do tend to be helped by homeopathic remedies.

Nevertheless this programme put some people off homeopathy and Jamie was one of them. In desperation, he went to see a homeopath anyway and to his astonishment, his hay fever has improved dramatically. The crowning glory of his successful treatment was that he was able to attend the Glastonbury music festival last year (outdoors in the country in case anybody didn't know) with hardly any symptoms at all. Having tried so many treatments without a result, Jamie is convinced that it was homeopathy that finally did the trick for him.

Homeopathic Tip of the Week: Hayfever

Hay fever can be tough to treat but homeopathy is well worth a try. It doesn't have the side effects of orthodox treatment and many thousands of people resort to it at this time of the year. As always it's best to see an homeopathic doctor who can individualise your remedy. Still here are some basic guidelines for OTC (over the counter) homeopathic remedies:

1. Allium cepa: You can try this remedy if your hay fever mainly affects your nose. Your eyes may water, but you are constantly sneezing and the discharge from your nose is acrid, burns the skin and causes redness under your nose. Use strength 6c four times a day.

2. Euphrasia: This is the remedy when it's the eyes that are most affected. This time the discharge from the eyes burns and makes the eyes look red. You may also have a nasal discharge, but it's likely to be bland and non-irritating. Use strength 6c four times a day.

3. Mixed Grasses and Pollens: (This is the remedy that played a part in Jamie's treatment in the story above.) The idea of this remedy is to try to 'desensitise' you to the very things that hay fever sufferers are allergic to. There was a time that orthodox doctors used small but very tangible doses of these same pollens to desensitise patients against the allergens. It worked in some cases, but in a significant few, produced a dangerous allergic reaction which caused it to be more or less abandoned by the medical profession. In a homeopathic potency however (extremely dilute - 10-60 for the mathematically inclined) there is no such risk.

This is the one to try when your hay fever definitely gets worse when the pollen count goes up. It can be used in conjunction with one of the remedies mentioned above where it can safely be taken in strength 30c one dose a week. Again supervision by a homeopathic doctor is always preferable.

# 82: Caesarian Sections: A Kinder Cut or a Waste of Money? • Homeopathic Tip: Childbirth

2004-04-29T08:11:00.000+01:00

Caesarian Sections: A Kinder Cut or a Waste of Money?

The issue of elective Caesarian section was all over the media this week. Among a lot of absolute rubbish written about this important issue were a few interesting points. First let us be clear what an 'elective' Caesarian section actually is.

If a pregnant woman goes into labour and at some stage all is not going well her obstetrician may strongly recommend an emergency 'Caesar'. There is no controversy about this and it happens every day in every O&G ward in the world. However there are reasons for electing to do a Caesarian section and dispense with the process of labour altogether. These reasons fall into two categories.

1. Medical Reasons: Good examples:

If the baby is in a breech position and is very large. One can attempt a normal labour but a Caesarian section is often recommended as being much safer.
Placenta previa: the placenta is in a position that makes it vulnerable to the process of labour. Labour becomes potentially dangerous for the mother and a Caesar is highly recommended.

2. Cultural and Cosmetic Reasons:

Some women quite capable of having a normal vaginal delivery may prefer to choose to have a Caesarian section. There may be many reasons for this choice. It avoids vaginal tearing and stretching, it ensures that no episiotomy is done, and it prevents the occasional urinary problems that can follow labour. It also avoids the pain of childbirth and the fear of that pain. Thus we can see why some women would prefer a Caesar to natural childbirth.

Problems with Caesarian Sections:

The truth is that having a section is not a simple matter; it's actually quite a big operation. There are occasionally problems with anaesthesia and it takes about 6 weeks to get over the op. In addition it can sometimes reduce chances of further pregnancies. However all these risks are very, very small.

The Real Controversy about Caesarians:

It's about money. A section costs a lot more than a natural childbirth. Few obstetricians in private practice would absolutely refuse to do a Caesarian section on a women who really, really insists on one even though her reasons for having one are personal rather than medical. Thus the government and the NHS would lose millions of pounds every year if sections suddenly became very trendy. The ethics of the situation are not difficult to weigh. In a country that is apparently pro-Choice as far as elective abortion goes (118 000 a year in Britain) it is ridiculous to say that women should not be allowed to choose an elective Caesarian. The only rational question to be asked is: "Who should pay for it?" And the same question should be asked of elective abortions.

But let me end on a lighter note. Some psychologists have said that it's better for a child to be born by normal vaginal delivery. Apparently the struggle of the journey prepares us all for the struggles that lie ahead. The comedian Stephen Wright, perhaps the greatest proponent of the one-liner in comedy today, had this to say about it all: "I was Caesarian-born. You can't really tell, except sometimes when I leave my house, I go out through the window."

Homeopathic Tip of the Week: Childbirth

There are two great remedies to use after childbirth. Arnica and Bellis perennis and they are usually prescribed in 30c potency two or three times for a few days, starting immediately after giving birth. For Caesarian sections, and episiotomies, use Arnica and Staphisagria 30 also two to three times a day.

# 81: Thinness takes off in Zululand • Bad News for Pancake eaters • How to deal with Childhood Obesity • Homeopathic Tip: Sulphur

2004-04-24T08:08:00.000+01:00

Thinness takes off in Zululand.
Zululand in South Africa is one of the most beautiful places on the planet. It is an exquisite sub-tropical, picturesque land that has been through a terrible political struggle and cycle of violence in the last two decades.

The Zulus are an incredibly proud, warrior-like nation whose great leaders, Chaka and Dingaan are still studied in military academies all over the world.

For many years, a full rounded figure was the desired body shape for Zulu woman as it was equated with health and fertility. No more. The men in white coats at the University of Zululand conducted a study of young female students at the university in which they examined their attitudes to body shape, weight and food habits. The results were alarming; 45% of these women suffered from some sort of eating disorder such as bulimia, anorexia or indulging in fasts in order to lose weight. In a comparative study at Northumbria University 25% of the women interviewed suffered from similar problems.

So why do the Zulu women torture themselves like this? Apparently they, just like their Western sisters, think that they must achieve the body shape that most men apparently desire. How do they know what this shape is? From those great trendsetters in the international society of course - the television and the magazine. They, like women all over the world, have bought the myth - as the July Seed, the person who conducted the study, so aptly puts it - 'that thinness is progress'. It seems that our obsession with extremes has reached every corner of the globe now. We must be either dangerously fat or dangerously thin it seems. Anyone for a healthy average weight? Anyone?

Bad News for Pancake eaters
In a report on CNN this week, refined foods such as corn syrup got some sticky publicity. Apparently it is highly likely that the increase in adult-onset diabetes (Type II) is due to a huge increase in the number of calories people now consume in America. Type II diabetes is suffered by 16 million Americans which makes it the sixth biggest killer disease in the USA. Dr. Lee Gross, a family physician involved in this study, said that he was not "picking on the corn syrup industry," but added, "It is hard to ignore the fact that 20 percent of our carbohydrates are coming from corn syrup -- 10 percent of our total calories."

Anyone for organic muesli? A piece of fruit? C'mon force yourself!

How to deal with Childhood Obesity

This week I bought a copy of the magazine Men's Health and was pleasantly surprised by the quality of journalism. It encouraged the consumption of fruit and healthy foods by kids along the following lines:

Breakfast: Low sugar unrefined cereals are recommended. Many 'healthy' breakfast cereals contain so much sugar, there have been campaigns to have them put in the confectionary section of the supermarket!

Lunch: Invite your child to help you prepare a fruit salad. Getting the child involved in making it is vital as they are then highly likely to eat it.

Afternoon snack: Yogurt, stewed fruit, almonds and honey are recommended.

Homeopathic Tip of the Week: Sulphur

For children who have an incredible craving for sweets, tend to be on the plump side and who have a tendency to get itchy rashes, the homeopathic remedy, Sulphur, is often useful. For this type of child, you could try Sulphur 6c (available over-the-counter at most chemists) one pill daily for a week. Of course it's much better to have homeopathic remedies prescribed by a professional homeopathic doctor, but using a 6c strength for a week or under is generally considered safe by most homeopaths.

# 80: Sleeping well? • Homeopathic Tip of the Week: Insomnia

2004-04-17T21:45:00.000+01:00

Sleeping well?

We are such stuff as dreams are made on, and our little life is rounded with a sleep. (Shakespeare: The Tempest)

Thus spake the bard in his last play. Prospero was probably the wisest and most evolved of all Shakespeare's characters. A scholar, magician and healer, he saw the foolishness of the human race and dreaded returning to society.

Life does indeed end with a sleep but so does every day, if we are lucky that is. What of the millions who cannot get to sleep every night? Where is respite for them? Is there anything that can be done for the one in three of us who will suffer from insomnia sooner or later?

The Week quoted some useful tips from a new book called The Insomniac's Best Friend by Lynda Brown (Harper Collins 2004, £9.99) She emphasizes the importance of learning how to relax but let's have a look at some of her advice...

Don't set targets of how many hours to sleep, don't take insomnia seriously, feel happy if you get a little sleep every night.
Have a warm (not hot) bath every night before going to sleep
Repeat the 'sleep mantra' Tonight I'm going to sleep for (however many) hours... over and over.
Do not try to work through any problems in bed at night.
Recommended aromatherapy oils: Sandalwood and sweet marjoram
On waking up in the middle of the night, put you hands on your tummy and concentrate on its rise as you breath in and its fall as you breath out.
Become aware of each muscle group in the body and tense and release it.

Okay, some good practical advice there. In my experience as a medical doctor I can say that the last piece of advice is by far the most important. Learn a form of deep relaxation. However I do think this process is greatly facilitated by being taught properly and supervised, so let us look at some of the methods of deep relaxation.

1. Jacobson's Progressive Relaxation: Perhaps the most widely-practised form of deep relaxation although it is seldom attributed to it's founder. It involves becoming conscious of your toes, tensing them to an inbreath and then releasing them to an outbreath. Then your feet, your shins and working all the way up to your head. Simple and effective, it has been used for decades.

2. Meditation: The most well-known meditation is perhaps TM or Transcendental Meditation, but many forms of meditation can be learned. Most involve the silent repeating of a mantra (sacred sound).

3. Biofeedback: This technique involves connecting you to machines that show your brainwaves. When you see them slow down, you try to do whatever you were doing to get them that way.

4. Autogenic Training: This is my personal recommendation for effective deep relaxation. It is a very efficiently-taught system of deep relaxation involving the muscles, heart, breathing and much more. It has no religious connotations. In my experience, most insomniacs who learn Autogenic Training, eventually learn to sleep well.

(See www. autogenictherapy.org for more information)

Homeopathic Tip of the Week: Insomnia

The most famous homeopathic remedy for insomnia is Coffea cruda. Yes indeed, it is made from coffee! This shows the paradoxical nature of homeopathy. A stimulating substance like coffee can have the opposite effect when given in homeopathic potency (dilution). There is no harm in using a dose of Coffea 6c to help you sleep now and then but I wouldn't rely on any form of medication, orthodox, herbal or homeopathic to help you sleep. Best results come from deep relaxation methods and my personal choice of these is Autogenic Training

# 79: Male Baldness: German men are 'wiser' than us; or are they? • Homeopathic Tip: Prostate problems

2004-04-12T08:03:00.000+01:00

MALE BALDNESS:
German men are 'wiser' than us; or are they?

The Times chose to give their medical correspondent, Dr Thomas Stuttaford a whole page to write an article which he called 'The Bald Truth about Hair Loss'. As I 'suffer' from a receding hairline myself, I started to read it with interest but soon my interest turned to boredom and finally amazement.

Dr. Stuttaford addresses the problem of baldness in men or 'male pattern alopecia' as it's known in the trade. He starts the article by discussing the relationship between baldness and levels of testosterone. He initially states correctly that baldness is due to higher levels of dihydrotestosterone but then incorrectly gives the reader the impression that baldness occurs in men with higher testosterone levels. The first part of the article therefore propogates the myth that bald men are sexier because of higher testosterone levels. In truth they probably only have higher dihydrotestosterone levels and it's testosterone that increases libido in men and women.

I shouldn't be complaining as I like the myth that bald men are sexier - but the truth is the truth. Anyway the good doctor goes on to give some hair-raising statistics about baldness in Europe. One in two British men suffer from baldness before the age of 50 (yes I'm one of them). He goes on to reveal that a survey of several European countries showed Britain to be the worst hit by this baldness epidemic. That means we have higher sex drives than the Europeans - not. He goes on to make an amazing statement which I will quote in full: "The Germans are almost as severely affected - but there is a difference ; nine out of ten British men accept a receding hair line in their early forties as an act of God, or a downside of their masculinity. They generally do no more than to try to disguise it than having their hair cut very short, whereas the Germans try to do something about it. They have the wiser approach."

Wiser? Is the good Dr. Stuttaford serious? Vainer, more arrogant or more neurotic but wiser? Okay maybe it was just an unfortunate choice of word so let's look at what 'do something about it means'.

Dr Stuttaford mentions two treatments for male pattern baldness.
1. Finasteride (Proscar) also a treatment for enlarged prostate taken as an oral tablet may help baldness a little, but no doctor I know would seriously advocate its use to treat baldness in men without prostate problems.
2. Minoxidil (Regaine in the UK and Rogaine in the USA) This drug was initially used to treat high blood pressure and then someone found that it inhibited hair loss in these patients so they made a topical hair lotion out of it. It may work in some cases, at best it only prevents further hair loss and you have to keep using it more or less forever just as is the case with finasteride.

So is it wise to take medication for a harmless condition like baldness? Well it all depends on who you want to believe. I think we should believe what women think about this issue. What do women advise men with receding hairlines to do? The great majority of women (about 70%) say 'don't worry about it'. Most of the rest say 'shave it'. Not even 1% say take drugs for it, have hair transplants, wear wigs or employ a psychotherapist to deal with the trauma of going bald. So should we emulate German men who are apparently 'wiser' than us or should we listen to what women say about the issue? Perhaps we should all just grow long strands of hair on one side and comb it over our heads. It may not be good on a windy day, but it fools everyone doesn't it?

Homeopathic Tip of the Week: Prostate problems

I've mentioned prostate problems and they are very common as men get older. The most common of these is BPH or benign prostate hypertrophy which just means 'enlarged prostate'. This can eventually cause urinary problems and is highly treatable by drugs such as finasteride (mentioned above) and/or surgery. However homeopaths have been using a natural medicine called Sabal serulata (known as Saw palmetto to herbalists) for many decades. More recently it has become quite popular as a treatment for enlarged prostate and in one study showed itself to be at least as effective as finasteride. It's safe and may well be trying in this very common complaint

# 78: The Zero-Effort Way to lose weight • Homeopathic Tip of the Week: Water

2004-04-03T16:45:00.000+01:00

The Zero-Effort Way to lose weight

The issue of obesity will not go away. It's there in every branch of the media: newspapers, magazines (for men and women), radio and of course, television. Switching on the television in the morning is a risk business these days. It's good news if there is an absence of an atrocity somewhere in the world. On Thursday morning however, one of the breakfast channels interviewed a lean- looking family tucking into a fried breakfast in Yorkshire. This family had apparently invented the simplest and easiest way of losing weight ever.

The family explained joyously as they tucked into their fried breakfast. It's all about a totally new form of water that helps you lose weight. Called 'Yorkshire Water' you can get it plumbed into your house. Now ordinary tap water contains zero calories - everyone knows that. But wait for it, Yorkshire Water contains something never before heard of in medicine - negative or minus calories! Amazing, the more you drink the more fat you lose. But how? Another of this family of innovators and cholesterol-packed breakfast warmly explains. Apparently the water is 'treated' and receives a 'negative charge' This negative charge apparently attracts the fat cells and when you excrete the excess water in your system (munch, munch on another forkful of tasty buttered toast) you also lose the fat cells! It's pure magic from Yorkshire folks and you read it here first. No need to diet, no need to exercise, no need to limit your greed, not need to indulge in what my friend Arnold Brown, calls 'pleasure-free foods' ('if you enjoy them you get your money back') Just plumb Yorkshire Water into your homes and kiss the fat family members goodbye.

So what can a medical doctor like myself say in the face of such underwhelmingly convincing anecdotal evidence. Ask to see tests that show the urine of Yorkshire Water drinkers contains more fat than the rest of us who have to put up with Thames Water or some other inferior zero calorie water? Suggest that Yorkshire Water start doing some very simple trials? They could choose 10 families of fatties (FACT: 20% of Britons are 'officially obese') Each family gets water plumbed in. Half get Yorkshire water and half get local tap water but nobody knows what they are getting. Everybody eats what they want; English fried breakfasts are allowed. New exercise regimens are forbidden. Everyone must drink plenty of water. Now after 6 months we can see which families lose weight. Then we could check to see if those families are the ones drinking Yorkshire water. This is how modern medicine and science work. But who needs medicine, science and eggheads in white coats? That family on TV said they lost stones and stones of weight. Cancel your gym membership, enjoy proper food with high calories and high fat content. All will be well as long as you drink water with 'negative calories'.

Homeopathic Tip of the Week: Water

Let's talk about water. Water is essential for our health and it comprises 70% of our bodies. When you drink a lot of water, your blood volume increases and the body needs to keep the blood volume constant. So you urinate more; but you don't just urinate pure water, you also expel waste material. So your body flushes itself out. However if you deprive yourself of water, the body has to hang on to all fluid in order to keep the blood volume normal. So it can't afford to flush the system. Waste material accumulate and remain in the body. So do drink water; any water!

# 77: Death McChocolate! • But Scotland is truly a great country • Homeopathic Tip: Glasgow Homeopathic Hospital

2004-03-27T16:40:00.000Z

Death McChocolate!
Obesity continues to dominate the international media. Even presidents and prime ministers are talking about the problem. George W. Bush has urged Americans to slim down and exercise. Tony Blair apparently works out at a gym and he certainly doesn't look like a slouch. England won the Word Cup at rugby not least because they were the fittest team in the tournament - as an excellent documentary on BBC I on Wednesday night pointed out.
So the message is clear. Slim down, keep active and don't even think about smoking!

So it came as some surprise to hear about a new contribution to society from Scotland. Yes, the land that gave us haggis, smoked salmon, television and penicillin has now presented us with one of its greatest culinary masterpieces - The deep-fried chocolate sandwich [sic] This delicacy was released to the world this week by Ramada Jarvis, according to ABC News online who reports that this masterpiece of a dessert has become the fastest-selling dessert on its menu! I decided to research the dish ABC has started to call the 'Brits' nouveau cuisine'. Well can't they leave the credit where it belongs - in Scotland. They do have their own parliament these days, you know.

Yes, the people who brought us that other great contribution to the poshest tables in the land, the deep-fried Mars bar have revealed how their latest contribution is made.

Take two pieces of white (wholemeal is too healthy, contains too much fibre and really should only be consumed by animals) bread. Smother in chocolate sauce. Deep-fry the sandwich. Now sprinkle with sugar and add more chocolate sauce. Yes, more chocolate sauce. When it comes to chocolate sauce, the Scots do not want to appear mean. Serve with ice-cream and hey presto you have a new dessert. Eat your heart out France! You may have beaten Scotland 33-0 at Murrayfield, but your croissants, your crème broule and your crepe suzettes are nothing compared to this latest Scottish contribution to the recipe books. And listen ladies, at 1000 calories a sandwich you only need to eat two of these a day to get your total calorie allocation for the day!

But Scotland is truly a great country!
Now just in case anyone thinks I'm being a bit unkind to the Scots, let me make it perfectly clear that I recognise the enormous contributions Scotland has made to the world and especially the world of medicine. My good friend, the Scottish Jewish comedian (as he says 'that's two racial stereotypes for the price of one!') always has an amusing anecdote for people who dare to make critical comments about the Scots especially when it comes to the Rab C. Nesbitt stereotype of a drunken loutish Scot. 'Isn't it fortunate' he muses, that Alexander Fleming sobered up long enough to discover penicillin?' Arnold will be performing at the Edinburgh Festival (The Fringe) as will the greatest comedy talents from all over the world. Be there if you love comedy or deep-fried chocolate sandwiches.

Homeopathic Tip of the Week: Glasgow Homeopathic Hospital

I thought I'd stay with Scotland and mention that Glasgow has one of the finest homeopathic hospitals in the world. The Glasgow Homeopathic Hospital (at 1000 Great Western Road, Glasgow) like the Royal London Homeopathic Hospital, is an NHS hospital. Did you know that there is a parliamentary bylaw that guarantees the right of the British people to homeopathic medicine on the NHS? No other form of complementary medicine has been honoured in this way. Homeopathy is 194 years old this year and it retains a fine tradition in Britain with royal patronage and a bylaw insuring it remains available to all the people.

# 76: Punch your way to happiness • Packaged Foods: The Bad and the Ugly • Homeopathic Tip: Contact Sports

2004-03-20T16:31:00.000Z

Punch your way to happiness:
This week I turned to London's only evening newspaper, the Evening Standard for inspiration and health news. The Standard is no heavyweight newspaper, but when I got to the Health & Fitness section I found myself reading and readingŠ

The leading article in the section was by the novelist, Santa Montifiore. Her body, somewhat battered and bruised by having 2 children, she came across a boxing instructor. In a very short period, she had 'fought her way to fitness'. But not only fitness; she found that she had become more confident, opinionated and assertive. She writes: 'Boxing is a return to the primitive, the cure to modernism. That's just what Mohamed Ali was thinking when he recovered the heavyweight crown by knocking out George Foreman in The Rumble in the Jungle: ' I've just cured modernism!'

Anyway this woman has certainly benefited from learning to box. And there's also that advertisement with Ali and his daughter on the television that seems to be all for women getting in the ring and laying into each other. There's a lot to be angry about these days and boxing seems to be a safe and healthy way to let out all that aggression and get fit in the process. Seconds out, round number one!

Packaged Foods: The Bad and the Ugly
If I was somewhat taken back by that article, I was really impressed by the one on the next page of Tuesday's Evening Standard. The paper investigated packaged foods and was shocked with what it found. Conscious of the present obsession with the 'obesity crisis', the paper employed nutritionist Natalie Savona (author of The Kitchen Shrink) to compile a list of foods that 'should carry health warnings on their content label'. With food companies under pressure to reduce fat, sugar and salt in their products the Standard had the guts to publish the names of 30 foods with unacceptably high levels of some or all of these three. The article correctly points out that fat is what really gives food flavour. If you cut down on that, you need to add salt or sugar to make the food tasty. Anyway in case you missed this hit list, here are the 'dirty thirty':

Pot Noodle Fun Pots;
Melton Mowbray Pork Pie;
Dairylea Lunchables;
Sunny D;
Tamar Foods' Deep Filled Cornish Pie;
Coca Cola (the normal non-diet type);
Ribena (apparently only 6% blackcurrant juice);
Kellogg's Pop Tarts;
Kellog's Ricicles;
Nestles Cookie Crisp cereal;
Bernard Matthews Dinosaur-shaped turkey nuggets;
Fruit Winders;
Muller Yogz;
Screamin' fruit spurters;
Cheestrings;
Tweenies pasta;
Hellema's Chocolate Peanut Cookies;
McCoy's crisps;
Jumbo sausage roll;
Cocktail sausages;
Jordan' Muesli Break;
Nesquik Cereal Bar;
Milky Way spread;
Sainsbury's Deep and Loaded pepperoni pizza;
Vodka Caramel Mudshake;
Weightwatchers Chocolate Brownies;
School Bars;
King-sized Snickers bar;
Heinz Cream of Tomato Soup in microwaveable cup;
McVities "Go Ahead" Crispy apple & sultana slices.

So before you buy any of the above, or any other packaged food for that matter, remember to check the content of FAT, SUGAR and SALT. The recommended daily intake of these for adults is:

Fat: Men- 95g Women-70g
Salt: 6g (one heaped teaspoon)
Sugar: no specific guidelines, it does depend on how physically active you are. Best to take your sugar as part of unrefined carbohydrates such as fruit rather than as added sugar or in the form of confectionary which is nothing more than empty calories.

My recommendation: The best snack in the world is fruit. An apple is perfectly balanced in carbohydrates, vitamins and minerals as is most fruit. In addition it contains live plant enzymes that help us digest it. Why we need to buy garbage in packages instead of fruit is one of life's mysteries.

Homeopathic Tip of the Week: Contact Sports

For people that get involved in contact sports such as boxing and rugby, homeopathic Arnica, is a great medicine. It's worthwhile having it in tablet form (I recommend strength 30c) and cream. If you come off the pitch a little more bruised than usual or take a few good shots in the ring, take a single dose of Arnica 30c and rub some cream into the area that hurts - you might just be surprised at how quickly you recover.

# 75: Serial Killer Number One under Serious Challenge • A Good Week for T'ai Chi • Homeopathic Tip: Pain after an injection

2004-03-13T09:22:00.000Z

Serial Killer Number One under Serious Challenge
Cigarettes, those white cancer sticks have long been considered one of the public's greatest enemies. Especially toxic to Americans, they have been outlawed in most public places in most states. They produce heart attacks, strokes, emphysema and a host of terrible cancers. No wonder, they are attacked by all and sundry.

All this might lead you to think that smoking is the most dangerous lifestyle choice you can make. (Well, heroin addiction is a lot worse actually, but it's not a legal or sane 'lifestyle choice') The truth is that obesity is gaining ground on smoking as a public killer at an alarming rate, especially in the USA.

Let's look at some of the figures which were recently published (Reuters online)
Deaths in USA due to smoking in 2000: 435 000 (18% of all deaths)
Deaths in USA due to obesity/inactivity in 2000 400 000 (16, 6% of all deaths)
Number of Americans overweight: 129.6 million (64% of the population)

Medical surveys like this take a long time to prepare: that is why we are only getting the figures from 2000 now. The alarming thing about these statistics is that they suggest that obesity may already be the biggest threat to health in the Western World or at least in America.

It seems absolutely clear now that malnutrition is the greatest cause of death to humans. In undeveloped countries, people starve or suffer the horrors of nutritional diseases like kwashiorkor and marasmus. In the more privileged West we continue to dig our graves with our teeth, waddle around in oversized clothes and consume junk. We sit more than walk, amble rather than jog, and only ever run when our life is at stake.

You don't find many state leaders who smoke these days (well at least not in public) but plenty of them obviously buy their clothes from outsize shops! How do they get away with this? At least in the USA the president is in good shape and I don't give any obese person the slightest chance of being elected. In Europe we still elect fat people to office. Perhaps political candidates should be forced to put their BMI (body mass index) on the ballot paper. After all, obesity is becoming public enemy number one. Politicians should decide whether they are part of the problem or part of the solution.

A Good Week for T'ai Chi
Practitioners of T'ai Chi and yoga have long claimed superb health benefits for these activities. Claims are one thing but proof is another. Proper scientific proof has been lacking, until now that is. The men in white coats at Tufts-New England Medical Center in Boston (publishing in the journal, Archives of Internal Medicine) have proved that t'ai chi, practised long-term is beneficial to 'balance control, flexibility, cardiovascular fitness and reduces the risks of falling in the elderly'. These conclusions come out of a meta-analysis conducted by these researchers. A meta-analysis is reliable because it is a synthesis of the findings of several other studies. In this meta-analysis 47 studies of the health benefits of t'ai chi were reviewed. This is excellent news for this increasingly popular discipline; there are approximately 100 000 people who practice t'ai chi in Britain. Incidentally the boffins have no idea about why it is so beneficial to our health even though it has been practised a mere 2000 years!

Homeopathic Tip of the Week: Pain after an injection
Had an injection that's still painful at the place the needle went in? Try homeopathic Hypericum 30. One pill 4x a day for 2 days. Hypericum is also useful for any type of nerve injury, such as getting your fingers crushed in the car door.

# 74: MMR back in the News • More fishy news • Dairy dreams • Homeopathy & Vaccination

2004-03-06T09:18:00.000Z

MMR back in the News:

That most famous of triple vaccines was back in the news this week. MMR is a combined vaccine against the childhood illnesses of Measles, Mumps and Rubella. It has been alleged to have been associated with both autism and Crohn's disease but neither of these allegations, based on actual medical research, has stood up to further rigorous research. Nevertheless the allegations have made big news over the past few years.

This week the man responsible for the linkage (in the public eye at least) of MMR and autism, Dr Andrew Wakefield came under fire because he apparently did not declare that he was being paid by the Legal Aid Board to determine whether parents of children allegedly adversely affected by the vaccine had a case. This is suggestive of him having a vested interest in the result which lessens the researcher's objectivity. Being objective is critical in science so this news was the medical controversy of the week with a heavy attack on the scientist and the whole MMR issue being labelled as a 'phoney scare'. To Dr. Wakefield's defence sprang the Daily Mail which correctly pointed out that much medical research is undertaken by people with a vested interest in the outcome. The government's vaccine safety bodies are funded by pharmaceutical companies who clearly would love to prove beyond any doubt whatsoever that vaccines are safe. Still the Lancet described Wakefield's original study as 'entirely flawed' and as far as I know that most prestigious of medical journals is not funded by anyone with a vested interest in the matter.

More fishy news

Autism was also in the news this week when the men in white coats in Columbia University warned that pregnant women who eat a lot of tuna might have a higher chance of producing autistic children. Apparently tuna and swordfish can have high levels of mercury and as the developing brain is highly sensitive to mercury poisoning it might be damaged in utero. A proper study will now be conducted on 100 000 Norwegian children to test this hypothesis. If it's true, it will be ground-breaking medical news. For the moment though, I still enjoy my tuna mayonnaise sandwich. Still if I were a pregnant woman, I might not eat huge quantities of fish that might have a high mercury content.

With salmon getting some bad press last month, fish have had a rough time in the news this year. A few years ago it was British meat that was getting the knife thrust into it. Maybe the vegetarians are right after all...Nobody accuses organic vegetables of causing serious diseases after all.

Dairy Dreams

Finally some good news. Melatonin is a hormone that helps us sleep by keeping our serotonin levels down at night. It has been claimed that the highest levels of melatonin are found in young cows milked at dawn. Sainsbury's jumped on the bandwagon and are selling these cows milk as Night Time Milk at 89p a pint! I'd like to see some research that shows that Night Time Milk gives better sleep than other milk. Still our grandmothers used to prescribe a cup of warm milk at night to help us sleep. I wonder if heating up the milk makes the melatonin more effective ;-)

Homeopathic Tip of the Week: Homeopathy & Vaccination

There is no such thing as an 'homeopathic vaccination'. Homeopathic remedies can be made from orthodox vaccinations but there is no proof that they actually give any protection against any diseases. Patients frequently ask me for natural alternatives to vaccinations but I have to tell them that they do not officially exist. If a patient has a bad reaction to an ordinary vaccine, homeopathy can be useful in treating this. The most famous homeopathic remedy for treating the 'never well since vaccination' syndrome, is Thuja. Sometimes a homeopathic remedy made from the vaccine that apparently caused a reaction, can be described. It is wishful thinking however (and neither science nor true homeopathy) to use these homeopathic remedies as 'vaccines'.

# 73: Britain is getting fatter by the day • Cod liver oil

2004-02-28T13:02:00.000Z

Britain is getting fatter by the day

George W. Bush is apparently the fittest president of the United States in recent history. A few months ago he personally advised the nation to slim down and avoid obesity. It seems that on this side of the Atlantic we have a similar problem with the bulge. All the papers focused on how fat we have become as a nation.

The Daily Express hit us with the happy news that one in three of us looks destined to be obese by the year 2020. In the past two decades, obesity has become four times more common in men and three times more common in women and children. Why is this so? It certainly isn’t due to better television. Or maybe the dumbing down of our national pastime has actually turned more people into snack-munching couch potatoes.

Let us be clear about this word ‘obesity’. The most reliable indicator of your ideal weight is your body mass index or BMI. This is calculated by dividing your mass in kg by the square of your height in metres.

Thus BMI = kg/m²

Okay, I know it’s a hassle to calculate and you also need to factor in your age. Fortunately there is a website that makes this all incredibly simple.

Go to http://www.halls.md/body-mass-index/av.htm and simply put in your weight, height and age in pounds, kilograms, metres or inches and it will calculate your BMI. Then you will know just how fat/thin/normal you are.

If you are 1 – 10% heavier than you should be, call yourself ‘slightly overweight’

If you are 10 – 20% heavier than you should be, call yourself ‘overweight’.

If you are 20% heavier than you should be you are officially obese.

Regular readers of this column will know how much I dislike and distrust ‘diets’ of all kinds. Every year some new diet guru becomes a multi-millionaire by duping people into believing his or her particular fad diet is the answer. Thin people eat what they like but only when hungry. They also tend to exercise. If you are overweight and want to lose weight you are going to have to endure being hungry for a while and you are going to have to do some exercise. When you feel hungry and you don’t immediately gratify that hunger, you lose weight. On reaching your ideal weight, you only eat when hungry and you try to make healthy foods the mainstay of your eating habits. Simple isn’t it? Don’t take my word for it; ask any slim person.

Homeopathic Tip of the Week: Cod Liver Oil

Cod liver oil really is good for you. Our grandparents used to recommend it for everything but nothing was proved. Now the men in white coats at Cardiff University have proved that cod liver oil helps keep cartilage healthy. This is very important as cartilage protects the ends of bones in our joints. Unhealthy cartilage predisposes us to osteoarthritis, the arthritis of ‘wear and tear’. Apparently cod liver oil reduces the level the enzyme that causes cartilage damage and this was proved in clinical trial in which patients getting 2g of cod liver oil (that’s 2 big capsules, much less than our grandparents’ recommended tablespoon!) had much less cartilage damage than the patients in the trial receiving a placebo. And we know that fish oils are also good for lowering our cholesterol. So next time you visit your granny, be sure to listen to her advice.

# 72: The Ultimate American Diet: The ‘McDonalds Diet’ • Dr. Kaplan’s weight loss tips •

2004-02-15T11:58:00.000Z

The Ultimate American Diet: The ‘McDonalds Diet’

The media love new diets and plans to lose weight. Dispensers of spam love them and it’s obvious that the public is obsessed with losing weight. Of course everybody knows that all you need to do to become your ideal weight is to eat sensibly and exercise in the right way. Still this doesn’t stop authors publishers, newspaper barons and spam-makers, from cashing in big time by ‘introducing’ the public to the latest fad in slimming.

The sick joke is that all these new diets work and all of them don’t work. They work for a while because you deprive yourself of some fattening foods that are forbidden on your new slimming plan. Eventually the diet becomes too boring or too socially restrictive and you go back to your old eating patterns and old body shape and size. As a medical doctor I’ve seen this over and over again over the last 25 years. It’s amazing how easily the general public are duped.

Still, even I was surprised by a diet tried out by one Morgan Spurlock, a New York film maker. Spurlock had noticed a newspaper article in which it was reported that 2 girls were suing McDonalds ‘for making them obese’. (This reminds me of the Jackie Mason joke in which he suggests that people who hurt themselves by jumping out of windows, should sue the window company) Anyway in the name of personal research for a documentary movie, Spurlock decided to put himself on a diet which restricted him to food prepared by the well-known fast food chain. In an article in The Week, it is reported that his health took a dive in the first week. Besides putting on 2 stone and significantly raising his blood cholesterol, he lost his sex drive and became depressed. He also suffered from headaches and vomiting. Besides that he was very well – you might say ;-).

Now this dietary adventurer got what he deserved. Not even McDonald’s biggest shareholder would recommend a McDonalds-only diet. Fruit is probably one of the healthiest foods around yet if you eat fruit exclusively, you risk damaging your health severely. Therefore in defence of McDonalds I must say that I sympathise. Anything in moderation is fine – even an occasional McDonalds. I’ve seen many a happy (and non-obese) family in McDonalds enjoying an outing they could never afford in a fancy restaurant.

Dr. Kaplan’s weight loss tips:
Here are some excellent tips for losing weight. They may not make me as famous as Dr. Atkins, but they do work.

Only ever eat when you feel hungry.
Finish eating while still feeling that you could eat a bit more.
Do not ever feel embarrassed about leaving food on your plate. (Notice how most thin people do this all the time)
If you eat a big meal on a special occasion, compensate by eating very little at the next meal, eg. a couple of pieces of fruit.
Embark on an exercise programme that involves ‘cardio-work’ as well as muscle-building (such as the Bodydoctor Programme featured on this website). It is now pretty clear that the best way to lose weight with exercise is to build muscle as well as get fit. The bigger muscles need food and drive your metabolism, making you lose weight.

Okay, if you take my advice and lose weight, feel free to donate £100 to a charity of your choice.

Homeopathic Tip of the Week

If you feel that you have always been overweight (and I mean since infancy) and you find it incredibly difficult to lose weight you could try the following. First contact your doctor and make sure you don’t have any hormonal problem such as a low thyroid hormone level. When you have the ‘all clear’ from your doctor, consider consulting a homeopath. There are a number of homeopathic remedies aimed at helping people with fat ‘constitutions’. For example the remedy, Calcarea carbonica is indicated in people who are fair, fat, flabby with pale skin and a propensity to sweat on the back of their necks. Best to leave the choice of remedy to a qualified homeopathic doctor who will also help you with a diet and exercise programme.

# 71: Back in the news: Back Pain • Exercise and strengthen those abs!

2004-02-08T11:52:00.000Z

Back in the news: Back Pain

Take it from me, back pain is one of the most debilitating, depressing and difficult to treat of all medical conditions. The Times’ excellent body&soul supplement (comes with the Times on Saturday), devoted a full ten pages to this common cause of pain, misery and loss of working hours. It’s a drain on the NHS, industry and obviously the sufferers and their families. Worst of all, it’s notoriously difficult to treat.

GP’s are apparently pretty in the dark about how to treat back pain. Bed rest is frequently prescribed but guidelines available since 1996 have specifically stated that ‘bed rest should not be considered as a treatment’. All in all patients with back problems are often considered as ‘heart sink’ patients and dreaded by GP’s, mainly because they are very hard to treat. The fact that we doctors know next to nothing about back pain is epitomised in the phrase, ‘bad back’. What other condition in medicine is described like this? If you have constant headaches you are not said to have a ‘bad head’. We simply don’t know what the cause of many ‘bad backs’ are. So doctors tend to prescribe anti-inflammatory drugs and pain-killers, which obviously do not address the cause of the problem.

So many patients with ‘bad backs’ end up with alternative practitioners. Many get considerable benefit from doing so and many general practices are even employing osteopaths in their practices to help their patients with back problems. So let’s have a look at some of the things that may be helpful to patients with back pain.

Orthodox Medicine: is essential to make the diagnosis. Your back pain may be due to a problem that requires surgery and for this you need to be examined by a doctor. Just because a cause is not found for many back problems does not mean that there is no point in going to a doctor. Sometimes back pain can be due to a very specific cause which needs a proper medical examination (and perhaps some investigations) to identify.

Osteopathy: Back pain is probably the most common reason for visiting an osteopath. It is my belief that osteopaths often get very good results when adopting an holistic approach to the back and rest of the body. Choose an osteopath with a good reputation in your area. It’s a hands on technique with a few manipulations but a good osteopath will also give you some exercises or stretches to do at home, specially chosen for your particular type of back pain.

Chiropractic: Very similar to osteopathy. They may rely a little more on X-rays than osteopaths and in my experience, they seem to spend less time with you than osteopaths. Again, choose one with a good reputation.

The difference between osteopathy and chiropractic?
“About £30 an hour” (joke by my friend, the comedian, Arnold Brown)

Alexander Technique
This focuses on how we use our bodies. Or more commonly misuse them. Lessons are aimed at replacing bad habits with good ones. It’s wonderful stuff but be warned: you need a lot of lessons and a lot of home practice to get the benefit. Think in terms of 20 to 30 lessons for starters.

Dr Kaplan’s personal advice: Exercise and strengthen those abs!

Here is the best free advice I can give anyone with back pain. Learn how to safely strengthen and build up your abdominal muscles. You will need two things:
1. An abdominal rocker/cruncher: (no more than £20 to £40)
2. Two or three lessons from someone who really knows how to do sit ups to supervise that you are using it correctly.
So why does this work? Building up a strong frontal structural support system, helps hold up the whole body. This takes some of the pressure and responsibility for doing this off the back. Simple and it really works. In my opinion, every GP should know how to teach his or her patients to do situps safely (ie. slowly and without straining the neck).

Homeopathic Tip of the Week

If your back pain is worse in cold, damp weather there are two easily available homeopathic remedies you can try together with any of the methods described above. They are Ruta and Rhus tox. Try one first, taking one tablet three times a day for two weeks. Use strength 6c, which is the usual strength kept by most chemists.

# 70: Smoking less helps a bit • The Grapefruit Diet • Body&Soul • Consulting a homeopath

2004-02-07T10:54:00.000Z

Smoking less helps a bit

Of course everyone knows the health risks of smoking these days. It was not always so. It was only in the 1950’s that smoking was proven to be bad for your health. Of course many people had spoken against it but the proof was missing until 1954 when doctors Hill and Bell published a study that proved that lung cancer was linked to smoking.

Quitting is best of course, but many smokers these days have decided to ‘cut down’ instead. Now the men in white coats at Minnesota University have done a study to calculate how beneficial this is to your health. The news isn’t great. Carcinogens (substances that encourage cancer) do not drop proportionally to the amount you cut down. Smokers who cut their smoking by 90% only cut down their intake of carcinogens by 46%. In a study published in the Journal of National Cancer Institute, it was also shown that smokers who ‘cut down’ tend to ‘drag harder and longer’ on every cigarette.
The point of all this: The rewards for quitting are far better value for the effort than those for cutting down.

The Grapefruit Diet

Now here is some interesting news for slimmers. A study in San Diego has shown that grapefruit helps you lose weight. Grapefruit apparently contains a chemical that works on the insulin-glucose metabolism in the body and this ‘allows the body to process food more efficiently for use as energy’ enabling weight loss. The 12-week study at the Metabolic Research Center in San Diego, California, on 100 men and women showed that the ones who ate the grapefruit lost 3.6 pounds. Doesn’t seem like a lot to me. And guess how much grapefruit they had to eat? Half a grapefruit with every meal!

body&soul

The two stories above were first noticed by me in the excellent health supplement body&soul to the Times (on Saturday). This is a little newspaper in itself, packed with useful, well-written information. I highly recommend it. It is not without humour as a recent article on ‘Saddam Sympathy Syndrome’ shows. In an article by a psychoanalyst, Darren Leader, it was pointed out that many people felt sorry for the captured dictator being forced to open his mouth and be examined by a medic. Actually it hadn’t occurred to me that this particular medical investigation was painful or humiliating but apparently the public, or some of the public, felt that it was wrong to ‘invade his space in this way’. Well perhaps invasion of personal space is a lesser sin than the hostile invasion other countries. Still we do need more compassion in this world.

body&soul also give out some interesting health awards. Some examples:
The most spurious attempt to generate publicity award: To the Priory Clinic for discovering a new psychiatric condition called ‘compulsive text messaging’. Apparently some people obsessively spend 7 hours a day texting and need treatment for this. Y? ;-)

Homeopathic Tip of the Week

If you are interested in being treated homeopathically, you don’t have to be ill at all to consult a homeopath. A homeopathic doctor will spend about an hour learning all about you and your health. S/he may then decide to give you what we call a ‘constitutional prescription’ which simply acts as a general tonic to your health. In addition s/he will have your case on record and if you get an acute illness, this background information will prove to be very useful in helping her/him make an accurate prescription.

# 69: ‘Fat Baby Syndrome’ • Homeopathic Tip of the Week: Glue ear

2004-01-31T10:50:00.000Z

‘Fat Baby Syndrome’

We know that far too many adults are unhealthily overweight. We have read about the problem of obesity in children and the role that junk food may have to play in this problem. But have you heard about the problem of obese toddlers?

The Daily Mail ran an alarming story about British toddlers becoming seriously and unhealthily overweight. The Week shows a most disturbing photograph of an American 4 year-old who weighs 8 stone and looks like a Sumo wrestler. In the past, fat children were rarer than fat adults and this was widely believed to be due to the fact that they were much more physically active than their parents. When you are active, run, swim and kick a ball around, you burn calories and build muscle. As we slacken off such activities (but still eat as much as ever) we put on weight.

According to the men in white coats at Glasgow University, three to five year-old children are no more active than the average office worker! Children of this age need an hour’s physical activity a day and they are simply not getting it – much to the detriment of their health.

As they grow older some play sport but I fear more acquire a taste for my least favourite childrens’ toy, the ‘playstation’. The technology is wonderful, the simulation of footballers’ turns amazing. Fantastic stuff until you see that glazed look in the child’s eyes, that ghostly look in the face reflecting the light of the monitor, the irritability when interrupted. And only the fingers moving.
My six year old son enjoyed playing on one of these at a friend’s house and expressed interest in our family acquiring a playstation. I patiently explained that a playstation only exercises your thumbs while almost any sport exercises the whole body. He thought for a while and then said: ‘But my thumbs are very weak, you know.’

Make sure you exercise yourself and get your children to exercise too. Playstations (aka ‘electronic nannies’) are a good way to keep kids occupied when you have other priorities but as a doctor I think that the only good they can do for kids is improve some basic reflexes and that just isn’t good enough.

Homeopathic Tip of the Week: Glue ear

‘Glue ear’ is a common condition in children caused by repeated ear infections. Viscous fluid builds up in the inner and middle ear leading to decreased hearing ability and a feeling of muzziness in the ear. Sometimes the condition is picked up at school where the child is simply unable to hear the teacher’s voice. This condition can be difficult to treat with orthodox medicine alone. Grommets have been the mainstay treatment for many years but recent studies show their use to be controversial and the medical profession is far from certain about how useful they are.

In the Winter edition of the British Homeopathic Association’s (www.trusthomeopathy.org) excellent journal for the public, Health & Homeopathy, Dr Bob Leckridge, mentions the homeopathic remedy Pulsatilla as ‘great medicine’ for this condition. As usual I recommend it to be taken in the 6c strength which is easily available. I also totally endorse Dr Leckridge's opinion that it’s best to consult a trained homeopathic doctor if you have a child with this condition.

# 68: Plastic Surgery is all the rage • Aspirin: a small blow to the magic drug • Homeopathic Tip of the Week: Painful Injuries

2004-01-24T10:46:00.000Z

Plastic Surgery is all the rage

Plastic surgery, in its purest form, is a noble art. Most plastic surgeons have trained in general surgery initially and specialised in ‘plastics’. People all over the world are deeply traumatised when their looks are radically changed by accidents, war and disease. It’s the plastic surgeon who can sculpt a new face, repair a damaged breast or remove an unsightly scar. The work is intricate and requires the most delicate of touches. These surgeons are the ‘boys and girls with the golden hands’. Now within plastic surgery there exists a slightly different discipline, called cosmetic surgery. And plastic surgeons doing cosmetic surgery seem to be all over the media at the moment. There is TV programme called Nip/Tuck that is very popular, but I seem to be seeing cosmetic surgery on almost every channel these days. Even I find I have to turn the telly off when watching some of this stuff. It seems that the public’s appetite for medical voyeurism knows no bounds. What is interesting is that cosmetic surgery seems to have become much more acceptable than before. People used to keep it to themselves and hide it, in much the same way as President Berlusconi is alleged to have done. But so many others are more than happy to parade in front of the public, not only the results of cosmetic surgery, but also the actual scalpel action! In one case on television a young man had an excellent looking stomach with strong abdominals. However he had a small ring of fat around his waist that just would not respond to diet and endless sit-ups. So he resorted to cosmetic surgery. Shloop and the fat ring was liposuctioned and hey presto he had his ideal abdomen! No embarrassment about it. Cosmetic surgery has become something that people talk openly about now. Is this good news? For cosmetic surgeons, a resounding ‘Yes!’.

Aspirin: a small blow to the magic drug

I’ve often praised aspirin in these pages. It has relieved pain for many decades now and when prescribed in low dosage (75 mg a day) for people at risk from heart attacks, has been proved to be effective. It has potential side effects, some serious, but these are relatively rare. Most people have taken this drug at some time in their lives and benefited from it. However this week the men/women in white coats in the hallowed corridors of no lesser institution than Harvard Medical School have linked regular aspirin consumption with an increased risk of pancreatic cancer in women. (Actually the study was conducted on 86 000 female nurses so we don’t know if it applies to men or not.) The study showed that the women taking aspirin on a regular basis for a long time were 86% more likely to suffer from this very serious disease. This is not about people taking occasional aspirin for a headache. The people at risk were those taking more than 14 tablets for over 20 years. And these are the normal 300mg tablets, not the 75 mg tablets taken once a day for people relatively at risk for a heart attack. So this is not worrying news. In fact we have known for some time that to take two normal size aspirin tablets for that length of time is never a good idea and can be bad for the kidneys as well. Overall aspirin looks well set to survive this blip in its fortunes and remain a powerful, useful and cost-effective drug. If there is a moral to the story, it is to know that pain should not be treated blindly with pain killers. Long-lasting pain should be investigated by a doctor and even if pain killers are prescribed long term, the patient and his/her drug management should be monitored regularly.

Homeopathic Tip of the Week: Painful Injuries

Some useful first aid homeopathic remedies for painful injuries. All of these can be taken in 6c strength, one three times a day for a few days.

A painful bruise: Arnica
Crushed tips of fingers in door: Hypericum
A piercing injury with something sharp like a needle: Hypericum
A painful graze: Calendula cream
A painful burn: Apis or Combudoron cream

# 67: Salt of the Earth • New responsibility for sperm donors • Natrum muriaticum

2004-01-17T10:43:00.000Z

Salt of the Earth

“Pass the salt, dear” is almost a cliché. Salt is on almost every kitchen and dinner table in the land. It’s in most breads we buy, most canned food, most prepared food and certainly most junk food. We have known for some time that salt can raise your blood pressure and have advised people with hypertension to cut down on their salt intake. Now the British Journal of Cancer tells of a study in Japan which seems to show that stomach cancer is more common in people with a higher salt intake. For the record a ‘low salt intake’ is considered 4 to 6 grams a day. The present daily average intake of salt per person in Britain is 9g. The Week says the government is attempting to reduce this but I haven’t seen much about reducing one’s salt intake in the media. One fish and chips with uh, just vinegar please.

New responsibility for sperm donors

Last week I wrote about the serious issue of the falling male sperm count. Spermatazoa were right back in the news this week, but in a completely different way. For many decades the donation of sperm has been a fairly straightforward matter. Healthy males donate or paid for healthy sperm. For best results they need to abstain from any sexual activity for a day or two before donating. Everything was done anonymously and the system worked well and without contraversy. Until now that is… The Times on Saturday had a front page headline about new government plans to change this completely. Apparently the Public Health Minister, Melanie Johnson, will unveil plans to remove the anonymity of sperm donors. This will allow future children of women who have conceived with donated sperm to track down their biological fathers. There are some biological advantages to this. The 1000 babies born in Britain every year by this method will be able to learn more about their genetic predispositions and this can sometimes be very important. However there is a big downside to this new law. The truth of the matter is that Britain is already short of sperm donors; we actually have been importing sperm from Denmark for some time now. This new legislation can hardly encourage new sperm donors, which means we will have to import even more sperm. Okay, so there will be more Danish genes in the British population. Maybe that’s not a bad thing, but children conceived by donated sperm, who insist on knowing exactly where there genes came from, may have to travel to Copenhagen to meet their biological fathers.

Homeopathic Tip of the Week
As salt was in the news this week, I thought I’d tell you about one of the most famous homeopathic remedies, Natrum muriaticum which is actually made from tiny quantities of common salt.

The uses of this remedy are many but it is most famous for people who get stuck in grief, bottle their emotions up, are unable to cry themselves but are always available to help others with difficult emotional problems. It’s also used a lot for cold sores on the lips and is often indicated in people who actually crave common salt or those who put salt on their food without tasting it. If you recognise yourself here, you could consider trying Natrum muriaticum 6c one twice a day for a week to 10 days and see how you feel. Homeopathic medicines are the safest of over-the-counter (OTC) medications, but it is still much better to have them prescribed for you personally by a qualified homeopathic doctor.

# 66: Salmon is back in the news • And more bad news for male fertility • Homeopathic Tip of the Week: Dental issues

2004-01-11T10:40:00.000Z

Salmon back in the News

Well it was bad news again for salmon at the start of 2004. Or at least bad news for those who love salmon. All the newspapers featured a report that many types of farm salmon contain chemicals that may make us more likely to get cancer. The incriminated chemicals: dioxins, DDT and polychlorinated biphenyls (PCBs), are all organochlorines, which are linked to cancer and birth defects. The bad news for salmon farmers on this side of the Atlantic is that salmon farmed in Scotland, Denmark and the Faroe Islands had much higher levels of these chemicals than those farmed in the USA. Some scientists recommended that it was safe to eat only one portion of European salmon every 2 months. North American salmon could safely be eaten twice a month and the cleanest and safest salmon of all, wild salmon could be eaten up to eight times a month without ill effect.

The news rocked the industry as salmon lovers in Britain spend around £700 million a year on farmed salmon. Now they might be tempted to look at where the salmon was farmed. So my New Year’s advice to salmon lovers is: Buy a boat, learn how to fish, row out to sea and catch your own wild salmon. You can then enjoy salmon twice a week without fear. Otherwise you might need to add salmon to the long list of foods that are now considered slightly risky to consume.

The reason that farmed salmon is more polluted than wild salmon has been mooted to be that the farmed variety is fed a more fatty diet than is consumed by their wild brothers and sisters. This means they accumulate more fat in their bodies and it is in this fatty tissue that the incriminated organochlorines are apparently stored, waiting to be consumed by lovers of smoked salmon bagels with cream cheese, pepper and lemon juice. With cream cheese high in cholesterol it seems another fast food favourite has taken a bit of a beating.

And more bad news for male fertility

We have known for a few decades now that the male sperm count is falling. However a recent study of sperm counts over the last decade confirms that the situation is indeed worrying. It was the most comprehensive study of sperm counts ever done with the semen of 7500 men monitored between 1989 and 2002. The alarming results showed that the average sperm count had fallen from 87 million sperm per ml of semen to 62 million. Now, a man with a 60 million sperm count is still pretty fertile. The problem is that the study shows that the sperm count is continuing to drop at an alarming rate. If this continues, most men born in the middle of the next century could actually be infertile. Now this may not be a problem for anyone alive at the moment (sigh of relief) but for the future of the human race, it’s a terrible prediction. A new society may emerge where there are infertile males and fertile alpha-males who will be much in demand.

The real problem is: Nobody really knows the cause of the problem. The men in white coats think that sperm count is determined while men are babies in utero and think that environmental factors such as pesticides may be to blame. But nobody is sure at all. For those concerned about the future of the human race, it’s worrying news.

Homeopathic Tip of the Week: Dental issues

Having some dental work soon? When a dentist drills into your teeth, it’s a bit of a shock to the body according to the homeopathic point of view. That great homeopathic remedy for shock and trauma, Arnica, is the remedy to think of. So next time you have a filling or root canal or any other dental process besides dental hygiene, consider taking Arnica 6c, one pill three times a day for two days, starting immediately after dental treatment.

# 65: Science, ‘Bad Science’ and Alternative Medicine • Who can ‘bear’ such food? • Hangovers

2003-12-23T10:29:00.000Z

Science, ‘Bad Science’ and Alternative Medicine

Last week I discovered a columnist that I’d never read before. He is Ben Goldacre who writes a column called ‘Bad Science’ in the Guardian. Apparently Mr. Goldacre has a mission to expose fraudulent or pseudoscientific data wherever it appears. For example he criticises the Science Museum for advertising in its gift catalogue, a ‘salt crystal lamp’ which ‘cleanses the air by absorbing humidity’. This is fair enough; the Science Museum should know better than to publish such unproved nonsense. He goes on to attack the Daily Express for ‘raving’ about a magnetic coaster that apparently improves water by making it more likely to ‘flush away toxins’. Okay, once again Mr. Goldacre has a point.

Then this truth-seeking columnist expresses horror at how a patient with pancreatic cancer (a particular deadly form of tumour) was duped by an alternative practitioner who treated him with a ‘high frequency therapy’ machine. Unsurprisingly this did not work and the patient died. Again Mr. Goldacre is entitled to be galled. However he then goes on to use this case to make a wildly unfounded attack on all alternative medicine. He writes: ‘Alternative medicine is defined by being a set of practices that cannot be tested, refuse to be tested, or have consistently failed tests.’ This is a ridiculous statement worthy of the contempt that Mr. Goldacre himself has for magic coasters and air-cleansing crystals. Whose definition of alternative medicine is this? Who says that alternative medicine cannot be tested? There are many trials of homeopathic medicine, some positive and some not. There is a department of Complimentary Medicine at Exeter University that is consistently doing trials of alternative approaches such as acupuncture and osteopathy. Can Mr. Goldacre substantiate the part of his definition that says that alternative medicine ‘refuses to be tested’? I doubt it. My experience in the world of alternative medicine is that most practitioners would be quite happy for their work to be tested. Trials of all medicines are very, very expensive however and guess who can really afford such trials. Yes, the pharmaceutical companies…

Who can ‘bear’ such food?

Finally a story worthy of this time of the year comes from the USA. Apparently bears are rather partial to junk food, well junk food leftovers to be precise. The Independent reported that bears along the Nevada-California border have started to stroll into urban areas and eat leftover hamburgers out of rubbish bins. It’s apparently a lot easier than hunting and foraging. So much so that these bears are 30% fatter than their health-food eating brethren, which is tantamount to clinical obesity in humans. It’s nice to know that another species shares one of our commonest health problems!

Homeopathic Tip of the Week: Hangovers

At this time of the year everyone starts talking about the way of treating a hangover. The fact that there is no absolute wonder cure for a hangover makes it open season for the most ridiculous suggestions. Perhaps a book should be written about all the hangover cures ever described. A useful conclusion can be drawn from this: When there are hundreds of different ‘cures’ for any problem, you can be sure that none have been proven. There is only one cure for acute appendicitis and that is surgery. It works, it’s reliable and there is not an alternative. With hangovers there is no such magic bullet, but here are some suggestion that are often helpful.

Keep hydrated: Prevention is better than cure. With each drink you have, ask for a glass of water as well. Much of the discomfort of a hangover is due to dehydration and this is easily prevented by this suggestion and by drinking a beer mug full of water before you go to sleep. Yes, it’s a lot of fluid, but you weren’t complaining about that when it was full of beer!

Homeopathy: If you would like avoid any drugs and take something completely safe and natural, the homeopathic remedy Nux vomica has a very good reputation in treating hangovers. Take Nux vomica 6c (available from most chemists), one dose before going to sleep and the next morning one pill every two hours until you start feeling better.

Aspirin: If you know you can tolerate Aspirin well and are definitely not allergic to it, you could take one 300mg tablet of Aspirin) with your beer mug of water before you go to sleep.

So in summary, Dr. Kaplan’s hangover cure:
While drinking: Drink plenty of water as well.
Before sleeping: Take one 300mg tablet of Aspirin (if you can tolerate Aspirin) + one tablet of Nux vomica 6c + 500-750ml of water.
Next morning: Nux vomica 6c tablets: one every 2 hours until feeling better.

Seasonal Greetings to you all and see you next year!

# 64: ‘Quads’ might be dangerous • Pharmaceuticals: Sometimes they works and sometimes they don’t • Runners take note •

2003-12-19T10:24:00.000Z

‘Quads’ might be dangerous:

News of Ozzy Osbourne’s crash on a quad bike was all over the media in the last ten days. Personally I’d never heard of a ‘quad bike’ until this story hit the news. However, the Royal Society for the Prevention of Accidents had certainly heard of this ‘bike’ (a contradiction in terms as the ‘bi’ of bike implies two wheels, not four.) The Times on Saturday quoted Roger Vincent of this well-meaning society who made the point that the number of accidents on these strange vehicles went up from 1200 in 1998 to 4200 in 2002. Once used only by farmers, they have become the ‘playthings of fun-seekers’. So, fellow fun-seekers, if you want to have fun on a ‘quad’ be sure to wear a crash helmet.

Pharmaceuticals: Sometimes they works and sometimes they don’t

The big news was that the pharmaceutical industry admitted that 90% of drugs work for only 30% to 50% of us. And amazingly this piece of news came from the industry itself in the name of Dr Allen Roses of GlaxoSmithKline, a pharmaceutical giant if ever there was one. Some drugs work better than others. Painkillers work in 80% of us while anti-cancer drugs tend to help only 25% of us.

The media gleefully quoted a song by the Verve that goes: ‘The drugs don’t work, they just make you worse’ etc. Of course the good band were singing about the use of recreational drugs but the quote was just too good to ignore ;-). Actually doctors have known for some time that different people react differently to different medicines for no obvious reason. Sometimes an anti-hypertensive drug will effectively lower the blood pressure of one patient while having little effect on another. The pharmaceutical industry is gradually beginning to come to the conclusion that doctors may need to individualise drugs. That means certain people with a particular genetic predisposition may require specific medicines. Such research is in its infancy however. So in the meantime my advice is to keep taking the tablets…

Runners take note:
Wherever I go these days, I see determined runners pounding the pavements. London seems determined to stay fit. But is it a good idea simply to buy a pair of running shoes and hit the streets? A few years ago I did this and ran to the shop to buy milk. This resulted in a strained Achilles tendon and a quick end to my running career. A year later I started going to the Bodydoctor studio and learned to train properly with loose weights and machines. After 8 months of this, I decided to try running again. Over the past few months, I have been able to run further and faster with no strained ligaments, muscles or tendons. On looking at the December 2003 edition of Running Fitness, I read an article strongly advocating that runners do some sensible training with weights so I can personally endorse that advice.

In the same edition of Running Fitness there is also an excellent article on stretching for runners with a free stretching poster. I’ll try these out and report back in the New Year.

Homeopathic Tip of the Week
Staying with the theme of running and training, let’s look at injuries. Unfortunately, just about everyone who works out, eventually gets at least a minor injury. When this happens, be sure to suspend exercise until the pain is 90% better. You could also try the following homeopathic remedies: (the recommended strength is 6c twice a day)

Arnica: for all injuries especially those where there is some bruising. A great medicine for just generally overdoing it.

Rhus tox: For strains and sprains especially those that seem to be worse in cold and damp weather.

Calendula cream: Marvelous for grazes. Keep some in the house; you never know when you might need it.

# 63: Could a total ban on smoking work? • Unhealthiest children ever? • Homeopathic Tip of the Week: Colds & Flu

2003-12-12T01:00:00.000Z

Could a total ban on smoking work?

At medical school there were three medical journals that were held in the highest esteem. Two were British and one American: The British Medical Journal, The Lancet and the New England Journal of Medicine. Last week’s edition of The Lancet had an astounding article in which the authors called for a total ban on smoking; making tobacco illegal. I have to admit that I was stunned…

That smoking is bad for your health is irrefutable. The list of diseases including many cancers it can cause is too long to be included here. However making cigarettes illegal is one of the silliest suggestions I’ve heard for some time. Of course doctors are very intelligent people so perhaps the article is a bit tongue in cheek although it’s not written that way and The Lancet is no light-hearted comic. Banning cigarettes anywhere will only do one thing and that is produce a whole new generation of violent criminals, the tobacco smugglers. I cannot think of any form of contraband more attractive to criminals than tobacco, a highly addictive substance, much in demand by a significant segment of the population. In prisons cigarettes are often currency. Even now there is a market for blackmarket cigarettes simply because they are cheaper. Yes banning tobacco could make it harder to get hold of. But it will create violent crime and very rich cartels of criminals who will inherit the billions of pounds that the government earns from taxing tobacco to the hilt.

Unhealthiest children ever?

Our children came in for heavy censoring this week in all the papers. Apparently they are the fattest, most drug-craven and infertile youngsters in history. This does not auger well for English sport. Who is responsible for this sorry state of affairs? It’s difficult to say because there are so many potential factors involved: Easy availability of drugs; modern food containing many additives and preservatives; computer games becoming more popular than outdoor sport and a creeping nihilism in youth culture. What is to be done about this? Perhaps the decline of institutionalised religion has something to do with this. Kids need something to believe in. God, love, a political position, physical health, the environment even Arsenal football club…anything! A huge deficit in childhood ideals has now resulted in a severe decline in our children’s health. What to do about it? I don’t know; talk to your children and see if you can find out.

Homeopathic Tip of the Week

A lot of people seem to have colds and flu at the moment so here are some useful first aid remedies.

All the following remedies should be used in 6c potency which is the one most chemists keep in stock.

Aconite: Use this when you feel yourself actually catch a chill. Once the cold starts it’s too late for this remedy, but if you get in really early just as that tingle at the back of your throat is starting, you may well stave off a few colds. (Take a 6c every hour for a few hours)

Gelsemium: An excellent remedy for those awful flu symptoms of terrible fatigue, chills going up and down the spine, drowsiness and especially if you do not feel thirsty.

Pulsatilla: For any cold that produces green mucus, this is your remedy of choice (one pill three times a day).

Bryonia: For that dry cough that lingers after a cold, use this remedy three times a day for a week or so.

In addition you should drink a great deal of water. Water encourages the filtering of your blood by your kidneys. When your system is invaded by a virus it produces a lot of by-products and debris that need to be flushed out of your system through the urinary tract. However your body will not form urine if it lacks fluid. Hence the advice to drink plenty of water when you are ill.

# 62: Future Pill: A tablet a day keeps obesity away… • Irritable Bowel Syndrome: Do we need more bacteria? • But Worms as medicine? • IBS

2003-12-06T10:01:00.000Z

Future Pill: A tablet a day keeps obesity away…

The Daily Mail is not a newspaper I normally read. However many people had told me that the health section was rather good so I dutifully bought The Mail on Tuesday, the day they give a lot of inches to health issues.

To my surprise, I found the health section remarkably informative, helpful and pleasant to read. One of the articles was entitled ‘Magic’ pill to treat obesity. Ever thought it would be nice to lose weight without dieting or regular exercise. Apparently the men in white coats at Aston University in Birmingham, have discovered that there is a protein in the body called zinc alpha 2 glycoprotein (also known as ZAG). Now this protein promotes weight loss independent of your diet, exercise or lack thereof! ZAG can apparently also lower blood sugar levels which could make it a useful treatment in diabetes. Don’t rush to the chemist just yet though. The scientists still have to figure a way of putting ZAG into a pill; but they are apparently hard at work…

Irritable Bowel Syndrome: Do we need more bacteria?

This extremely common condition which causes misery for hundreds of thousands of people by causing bloating, indigestion constipation, diarrhoea, abdominal pain is also known as IBS. (which is why IDS is such a funny acronym for Iain Duncan Smith ;-) Once again it’s Birmingham scientists that are at the forefront. According to The Mail, doctors at Selly Oak Hospital are using bacteria to treat IBS. This sounds like an interesting idea as the large bowel or colon needs to be colonised by healthy bacteria which form a stable community. This community of bacteria prevent newcomers in the form of unhealthy bacteria and fungi from settling it. The doctors also think that the new healthy bacteria may also reduce inflammation and even ‘boost the immune system’.

Interestingly this is why it’s not a great idea to take too many antibiotics. Most antibiotics wipe out the healthy bacteria all over the body, allowing opportunistic infections with unhealthy bacteria and fungi.

But Worms as medicine?

This week I watched a television programme on parasites. There is a doctor in the United States that gives his patients worms! Sounds crazy but there is method in the madness. The good doctor has been treating ulcerative colitis, a potentially very serious condition (and certainly not to be confused with IBS) that often needs to be treated with steroids and even surgery. Thus any new treatment for this debilitating condition is deserving of attention – even worms. Apparently the worms in the gut produce chemicals that reduce the inflammation produced by the disease. So far 125 patients have been treated but the results of the study have yet to be published. Until worms become an officially recognised treatment for ulcerative colitis, my advice to you is not to try this treatment at home.

Homeopathic Tip of the Week
Okay let’s stay with IBS as it’s such a common condition. In my experience there is much you can do with natural medicine for IBS. I recommend a three-pronged approach.
1. Stress Reduction: There is no doubt that IBS is a stress-related condition. Therefore regular deep relaxation, meditation and stress management can make a big difference.
2. Diet: Sometimes a new diet can make a big difference. Avoiding the combination of carbohydrates and proteins in the same meal can sometimes be highly effective
3. Homeopathy: Can be very useful. It’s best to have a remedy chosen for you by a professional homeopath. However if you have IBS, love sweets, are of a nervous disposition and tend to be rushed and stressed, you could try the homeopathic remedy Argentum nitricum 6 twice a day for a few weeks.

# 61: How to snack and not put on weight • But our kids are getting fat • Homeopathic Tip of the Week: What to do after overindulging

2003-12-01T23:51:00.000Z

How to snack and not put on weight
A useful source of health information can be found at http://health.yahoo.com

This week, in their nutritional and fitness tip of the week they have some suggestions about what to eat when you feel inclined to snack. Recommended are foods that are low in fat, high in fibre and relatively low in calories. Some of the more innovative snacks recommended included frozen grapes and frozen bananas. Yahoo don't tell you how to freeze a banana or a grape though. I've never frozen grapes but frozen bananas are absolutely delicious. This is how you make one: Peel the banana, wrap it in silver foil freeze it and there is a healthy delicious snack waiting for you in the freezer.

Yahoo go on to recommend popcorn. Obviously you should make your own and not add sugar! Raw vegetables dipped in low-fat dressing or hummus is mentioned and there is an innovative snack recipe for those with a sweet tooth. "Try low-fat, high-calcium "Pudding Kisses" -- drop level teaspoons of chocolate pudding (made with nonfat milk) onto wax paper, freeze and enjoy!" Well that sounds like a real treat! If you enjoy it, be sure to send a thank you email to Yahoo.

But our kids are getting fat

This is a fact. Childhood obesity is such a problem that it made the headlines on the front page of the Guardian on Monday. Apparently it's now become a serious epidemic. The suggested remedy - stop advertisements for junk foods. That's what some 'experts' are suggesting - not the author of this column. The American comedian Dick Cavett once made the point that just because there is a lot of comedy on TV does not mean there is a lot of comedy on the streets. I find it hard to believe the advertisements for fast food is the cause of childhood obesity. There are many people, including children, who enjoy fast foods without becoming clinically obese. In addition children have always had tuck shops to tempt them with all sorts of unhealthy foods containing empty calories. Some behaved like Billy Bunter; most did not. Children do not naturally overeat. Many obese children eat because they are lonely, worried or sad. They need to be helped to balance things in their lives including what they eat. To play the Blame Game and point a finger at the manufacturers of fast foods is ridiculous. Overweight kids need a little help and if the whole family is overweight, then family therapy should be considered. Good organizations, like the British Heart Foundation (www.bhf.org.uk) constantly offer good advice on healthy eating. That's all we need. A nannyish attitude that bans advertising 'unhealthy food' risks giving fast food a cult status. Much better to advocate moderation in fast foods as we would for sugar, salt, fats etc. etc.

Homeopathic Tip of the Week

Well what do you do after overindulging in fast foods and feeling slightly sick and guilty. Well you could take the homeopathic remedy, Nux vomica 6c (one dose) or you can do something brave and simply have fruit for your next meal. This is called 'compensation' and is an important principle to understand for those who want to keep slim. Instead of giving up your program after a lapse in your healthy eating, you simply compensate at the next meal and eat a very light meal. More on this next time...

# 60: You, your health, your time and the Internet • Exercise and Cholesterol • Useful Health Sites

2003-11-21T23:26:00.000Z

You, your health, your time and the Internet

Okay a doctor had to say it sooner or later. The internet has irrevocably changed the doctor-patient relationship all over the world. Well maybe not for people who have no access to the internet, but everyone else.

These days, I'm not at all surprised when a patient knows more about his or her disease than I do! All they have to do is type the name of their illness once and Dr Google will provide an almost infinite amount of information for them. This is the way people become experts on their own illness in general. And there is the rub 'in general'. That means they can learn a lot about the illness itself but not about how exactly it should be treated in their case. Patients often misdiagnose themselves as they are not aware of what we call the 'differential diagnosis', the other illnesses whose symptoms are somewhat similar to what the patient thinks they have.

Personally, I am grateful when a patient brings in information about their illness from the internet. It's easier than researching it myself! Some patients bring in large books about their illness and this is less useful as many of these books are written by fanatics with axes to grind and are often incredibly badly written to boot. They always remind me of a huge doorstep of a blockbuster novel which received the following literary review: 'My first advice to you is not to read this book. My second is that if you do, don't drop it on your foot!'

Useful websites on the Internet

www.healthfinder.gov ( a site associated with the American government, this is an excellent place to type in any illness and get it explained to you in simple non-jargon.

www.medscape.com (this is the site that I use to do research on the internet. This is a site for the professional - professional doctor, professional patient or professional researcher. Superb, nobody can criticise the internet after seeing this.

www.health.yahoo.com (a superbly comprehensive, up-to-the-minute site on health and medicine)

Exercise and Cholesterol

And straight from the www.health.yahoo.com is an article on whether regular exercise can decrease your cholesterol level. All forms of exercise including gardening and cleaning can lower your cholesterol and help your heart in the following ways
1. Exercise increases the 'healthy cholesterol' (HDL) and lowers the dangerous cholesterol (LDL).
2. Exercise helps you lose weight which is good news for your coronary arteries.
3. Exercise tones and strengthens your heart.
4. Exercise improves and energises the circulation in general which helps sweep away any early clots that develop in the blood vessels.

Homeopathic Tip of the Week

Some excellent homeopathic sites on the internet.

www.trusthomeopathy.org (The site of the Faculty of Homeopathy and the British Homeopathic Association) The main site for medical homeopathy in Britain. They can supply you with all sorts of leaflets and information on homeopathy and will give you a list of medical doctors trained in homeopathy in your part of the country. An excellent site

www.hptg.org (The site of the Homeopathic Physician's Teaching Group. One of the main organization that teaches doctors homeopathic medicine)

www.drkaplan.co.uk (my personal website, with information about my book, The Homeopathic Conversation (Natural Medicine Press, 2001)

www.drlockie.com (excellent site of the author of the best-selling The Family Guide to Homeopathy)

www.homeopathic.com (homeopathic educational service for pharmacies and suppliers of nutritional supplements)

www.homeoopathyhome.com (excellent site for all sorts of information on homeopathy)

www.hom-Inform.org (highly informative website of the Glasgow Homeopathic Hospital)

# 59: Joy to the fishes in the deep blue sea... but is there joy for you and me? • Cheer up and WALK! • Pregnant women shouldn't eat shark

2003-11-15T23:26:00.000Z

The issue is fish, mercury and your health. After years of advocating fish as one of the finest foods for man (and sharks), medical doctors suddenly had mercury to contend with. Fish were found to contain mercury and some had levels that were simply unacceptable for human consumption. This has been in the news for some months now, but the November issue of Readers Digest promoted it to the front cover.

The Digest draws our attention to the fact that last year for the first time ever, the FSA (Food Standards Agency) warned fish-eating Britons that some fish might contain unacceptable levels of mercury. Now I don't want to go into gruesome details of mercury poisoning. Suffice to say it's capable of damaging babies in utero and can cause neurological disease. On the positive side it served doctors very well in thermometers and blood pressure machines, but the digital age is starting to replace those too. But take it from me, mercury is not good for you. So here is the low down; what you need to know. Which fish have the mercury?

Well, according the Digest the following fish are 'safe to eat': Cod, haddock, salmon, sardines, sole, halibut, monkfish, sea bass, sea bream, trout, prawns, crab, scallops and oyster.

The following fish should be limited in our diet, as follows:

Tuna: no more than two sandwiches a day - hey, that sounds pretty reasonable
If you are pregnant or planning a pregnancy, two medium sized tins or one fresh steak a week is enough.

Shark, swordfish and marlin:
The Digest recommends that people under 16, pregnant women and women who are breastfeeding should avoid these fishes all together. For the rest of us, one portion a week is the recommended limit.

Cheer up and WALK!

Now some good news. An early morning walk can cure the 'blues'. This time it was a lady in a white coat that brought us the good news. The Week reports that according to Professor Marie-Annette Brown, one of the reasons for this is that our bodies really need light to boost our serotonin levels. The other is that moderate exercise invigorates the circulation thereby sending more blood to the brain which helps it feel better about things. How long and how often to walk? Twenty minutes five times a week. They used to call such walks 'constitutionals'. They were right; now we know why. Other forms of exercise are also good, but the point made by the good professor is that activity outdoors is especially good for us.

Homeopathic Tip of the Week: pregnant women shouldn't eat shark

Okay so pregnant women shouldn't eat shark. Perhaps sharks shouldn't eat pregnant women but sharks are not gender conscious when it comes to food. Pregnant women should be happy and looked after and kept away from sharks as well as 'sharks'. After labour they should be treated with a lot of tender loving care and given one or both of the following two homeopathic remedies.

Arnica 6: one three times a day.

Bellis perennis 6: one three times a day.
Both of these famous homeopathic remedies has a good reputation for treating bruises - which are inevitable in normal labour.

# 58: To microwave or not to... • Men: Be thin and fertile... • Tip of the Week: Computers & useful information

2003-11-07T19:49:00.000Z

To microwave or not to...

With the advent of the microwave oven, society changed forever. The magic oven was suddenly in nearly every restaurant and every home. They even entered the hallowed territory of contemporary popular music. As Dire Straits sang: "We've got to move these microwave ovens, we've got to move these colour TV's..."

Some hailed the microwave as manna from the scientists. A life-easing machine of the highest order; an object of desire; a popcorn maker of impeccable credentials. Then there were those who simply refused to 'nuke' their food, as they put it. They didn't know what they were talking about but they knew they didn't trust those little white boxes to cook their food. It now seems that they intuition had some substance to it.

The men in white coats at Spain claim that microwave ovens really hit green vegetable where it hurts, right in the bioflavinoids! The scientists compared broccoli which had been microwaved to broccoli which had simply been steamed. The microwaved broccoli lost 97% of it's bioflavinoids whereas the steamed broccoli only lost 11%. Now these bioflavinoids are important nutritionally because they are anti-oxidants which take care of unhealthy free radicals in the body. It seems that microwaves generate more heat than other forms of cooking and this wipes out the friendly flavinoids. Steaming is best with pressure cooking and boiling still a lot better than microwaving.
For making popcorn, microwaves are still very good indeed...

Men: Be thin and fertile...

One of the most worrying pieces of medical news in the last few decades has been the falling sperm count in men. The average sperm count of European men has dropped by 25% in the last quarter of a century and over 25,000 British couples seek infertility treatment every year. Male infertility is the cause of about half of these infertility problems. A drop of 25% in 25 years is hugely significant considering the many thousands of years we have been on the planet. Nobody knows the cause of this. Tight nappies when a baby, iodine poisoning, bad nutrition, residues of the contraceptive pill in tap water, pesticides, inoculations and modern pharmaceuticals have all been blamed but nothing proved.

Now New Scientist has found another possible cause - obesity. 52 men were weighed and had their semen analysed. The men with a healthy body weight (or BMI, body mass index) had an average of 18 million spermatozoa in their sample but the 'overweight' had only 3.6 million; the really fat ('obese') had a mere 0.7 million. The fatter men not only had less sperm than the thin ones, they also had less healthy sperm, according to Dr. Roudebush, the scientist who carried out this ingenious, but relatively simple study. He thinks that obesity may be 'partly to blame' for the mysterious decrease in sperm count over the past 25 years. So now you have yet another reason to get into shape, guys.

Homeopathy Tip of the Week:
Computers are now very big time in homoeopathy. When you see your homeopath look at his/her laptop, understand that the pc contain many libraries of useful homeopathic books. When I first studied homeopathy, 21 years ago, I slowly started building a library of homeopathic books. Now you can get ALL the books in one piece of software. So, although homoeopathy is natural, it is not old-fashioned and modern technology is able to top it up with diesel as far as giving homeopaths instant access to all the literature.

For more on the state of homeopathy in the UK, have a look at