By Martin Watt

Mainly UK but can apply to other countries.

A letter (May 2006) from Professor Michael Baum and other leading doctors in
the UK, suggested that complementary therapies should not be used by our
health service. Their reasoning was that there was little evidence that these
therapies were effective. This call was (they claim) partly because cash for
effective conventional treatments was limited.

While some of their comments I am in broad agreement with, I do not believe
that they should throw out all therapies without further investigation.
Therefore, here I will present some facts from an inside but critical view of
Complementary medicine.

What are Complementary therapies?

This is an abused terminology. Medical and scientific people side step the fact
that many mainstream medical treatments grew from traditional medicine.
Examples:
Physiotherapy developed from a background of traditional manipulative
body treatments.

Pharmaceutical drugs are still made from plant extracts or are synthesised
to emulate potent natural drugs. Some of our most powerful drugs in the
future are likely to be based on naturally occurring substances in man, plants
and various creatures.

Wound care is thousands of years old and some of the Ancient treatments
have only become recognised and used again in recent years. So could the use
of leeches and maggots to deal with wounds NOW in hospitals be considered
"Complementary" treatment? Could the use of strips to join wound edges
instead of sewing be considered "Complementary"? That was exactly the
method used by Ancient physicians BCE.

These advocates of "tested" conventional medicine also side step the fact that
numerous nursing techniques, older medicines and even surgical techniques
have often never undergone any kind of formal evaluation. It is simply
accepted by the medical profession that experience shows they work. Non-
evaluated "experience" is something I have long castigated in aromatherapy,
yet the same lack of evaluation certainly holds good for many medical
practices.

What is the difference between main and complementary medicine?

The main difference is this thorny question of sound clinical trials. All modern
drugs have to undergo extensive testing, however, despite their tests, many
dangerous drugs have been withdrawn from use. This question of trials is
where there is a vast gap between conventional and complementary
treatments. The International medicines organisations do have reporting
systems in place to monitor adverse effects from drugs. When such effects are
proven, then the drug can be ordered off the market or changes made to the
way it is used. This is the one big factor that does not apply with most
Complementary therapies. Any adverse effect reporting is ad hoc and rarely
are any substances found to represent health risks banned by the plethora of
largely incompetent complementary therapies organisations.

In practice, herbal medicine tends to be the closest to the pharmaceutical
monitoring systems. If certain herbs prove to have significant dangers this gets
reported in the International phytochemical journals and National authorities
will act to restrict the availability of the herb. In some cases the herb is
banned, in others its use is restricted to herbal practitioners. Therein lies
another minefield as standards of practitioner training and competency around
the world are very much open to question. With other therapies such as
aromatherapy, the thousands of incompetent teachers continue advocating the
use of dangerous extracts despite these dangers being known.

Training and quality control of complementary practitioners.

In many cases this is a complete mess. Whereas herbal practitioners have
been around for millennia with a vast knowledge base to draw on, as have
some of the body manipulation therapies, some of the more modern therapies
are commercial inventions without any traditional background. Many can be
tracked back to one individual who created a "new" therapy in order to sell the
idea and make cash. An Internet search can find numerous quack medicine
therapies with thousands of web sites promoting them. Hundreds of thousands
of web sites have sprung up where the owner has no formal training on the
substances they sell and indeed many are simply clever confidence tricksters.
This is a very serious situation for Complementary medicine world-wide, yet no
organisation has has attempted to do anything about it.

The fact that therapies such as herbal medicine have such an Ancient
background does not mean their treatments do not need evaluation in the light
of modern knowledge. For example, some herbalists still use some of the
sensitising resins despite it being known they can cause problems. If someone
is in the jungle and gets a wound, and no modern medicines are around, then
fine use the traditional treatment as a side effect may be better than
gangrene. However, to use such a hazardous material when safer
pharmaceutical treatments are available is foolish and I believe disreputable.
Yet it is common to see such traditional treatments promoted on Internet
newsgroups. I have also come across many flashy looking websites selling such
traditional products and masquerading as "helping native populations" by
selling the stuff.

What are the problems using Complementary therapies
in health services?

The authors of the above report are correct in that there is insufficient
evidence that many therapies are effective. We then have to consider what
they mean by effective. For example, if a physical effect is claimed but cannot
be proven, then perhaps that claim is baseless. On the other hand, many
complementary therapies are used by people simply because it makes them
feel better. There is now some evidence that just feeling better does improve
immune function and therefore one has to take this factor into account. In my
opinion, the placebo effect is initiated far better by several Complementary
therapies than by conventional medicine, and the placebo effect is a REAL
healing effect.

In reality the above is no different from the use of conventional drugs, many of
which act as placebos. In addition, after long term use, some drugs no longer
have the expected effect, yet the medical profession continue prescribing them
without a second thought. So questioning the effectiveness of treatments
works for all, not just Complementary therapies.

We do need much better evaluation of the effectiveness of Complementary
therapies, yet many of our trade associations have failed miserably for over 20
years to address this issue. Several of the older therapies have had training
clinics for years where no real attempts were made to ascertain the treatments
that worked best. The real facts are that most Complementary medicine
associations are there simply as a method to gain insurance for their
members; to put the leading lights onto advisory committees, and to put them
into positions where the public are fooled that any books they write must be
the real deal. Member apathy is rampant and therefore disreputable figures
easily gain control of the organisations and use them for self promotion and
financial gain. Hence the reason we have some real con artists on the advisory
committees, particularly in aromatherapy although doubtless in others.

Does the above differ from the medical and scientific establishment? No, some
of those people are just as much con artists as in our sector. We have
numerous University Professors appointed to advisory committees who then
pontificate on subjects they have no expedience or training in. These "experts"
often are there simply to obtain Government funding to keep their Universities
in business. We have had numerous examples of supposed experts causing
unnecessarily economic damage as the result of their lack of real expertise. I
give as but one example the mad rush to build up stocks of medicines against
bird flu. On the advice of supposed experts, yet based on theoretical
considerations not real evidence. Millions have been spent on an exercise
which may end up being a huge waste of resources, resources that could have
been put into the health services. So do the doctors who wrote this letter
consider that the facts behind this huge International effort on bird flu are
based on good evidence?

Conclusion

There is clear research evidence that certain herbal medicines are effective for
certain health problems. Also evidence that essential oils can be effective as
antimicrobial agents and that massage helps certain conditions. These doctors
who call for restrictions would serve their patients far better by calling for
adequate research funding for extensive clinical trials. That way at least we will
know for sure what is cost effective and what not. Until so-called
complementary therapies are given some decent funding then things can only
continue in the current haphazard fashion. One plea I have though is that
Prince Charles needs to take his head out of the arse of University trained
academics and instead support real therapists. In the last 10 or so years the
academics who have elbowed their way into Complementary therapy
organisations have contributed very little to the advancement of the effective
therapies, and done nothing at all to inhibit the useless therapies. Come back
Henry the 8th who intelligently realised the academics of the time were
useless-little changes!!
 

Qualified Medical Herbalist, but never joined the TRADE associations and
therefore soon may no longer call himself a "Medical Herbalist"

 

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