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62A Review of the SRAM Conference in Philadelphia

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  • Eric Krieg
    Mar 5, 1999

      A Review of the SRAM Conference in Philadelphia -
      By Hunter R. Gordon

      On Saturday, February 27 and Sunday, February 28, the Skeptical Inquirer and
      The Scientific Review of
      Alternative Medicine held a conference entitled "Science Meets Alternative
      Medicine" at the Warwick Hotel in
      Philadelphia. The Scientific Review of Alternative Medicine (SRAM), which is
      sponsored by the Council for
      Scientific Medicine, is a peer-reviewed medical journal dedicated to providing
      scientific, rational evaluations
      of unconventional health claims. The purpose of the conference was,
      ostensibly, to ask the questions: How strong
      (or weak) is the evidence? What's the impact on doctors and patients? What are
      the implications for medical
      ethics, government, and the media? Over the two days of sessions, attendees
      heard stimulating discussions of
      topics ranging from acupuncture, antineoplastons and argyria to
      (non)therapeutic (non)touch, Vitalism, and
      Andrew Weil. Keynote addresses were provided by two luminaries in medical
      journalism: Marcia Angell, M.D.,
      Editor of the New England Journal of Medicine; and George D. Lundberg, M.D.,
      former editor of the Journal of the
      American Medical Association. PhACT provided assistance to the conference
      organizers, giving local media
      contacts and helping with the general operations of running the conference.
      Most attendees were from the
      medical/health professions, with perhaps 60% being licensed practitioners.

      The conference was opened by Paul Kurtz, founder and chairman of CSICOP and
      publisher of SRAM, who stated the
      purpose of the Committee for the Scientific Investigation of Claims of the
      Paranormal (CSICOP) and stressed the
      importance of bringing its investigative focus to the field of health and
      medicine. After describing how folk
      medicine was based on religious beliefs and traditions, he listed a number of
      the many contributions that
      science has made in the field of medicine. He then stated the central theme of
      the conference, that the medical
      community should apply the same scientific, peer review process to
      complementary and alternative medicine (CAM).
      In particular, he said that CAM practices should have a valid therapeutic
      theory, be replicable, and should
      undergo the rigorous testing found in properly randomized, placebo controlled,
      double-blind clinical trials. Mr.
      Kurtz did point out that the Council for Scientific Medicine is not trying to
      defend the medical profession per
      se. He told the audience that they should be open to new claims if they were
      responsibly claimed and testable.
      And he stated what was obvious to the attendees, that medical science is not
      infallible, but added that the
      medical community has failed to properly communicate this to the public.

      Wallace Sampson, M.D., Clinical Professor of Medicine at Stanford University
      and editor of SRAM, continued the
      opening address by describing postmodernism and deconstructivism and how those
      movements have attacked science,
      and thus standard medicine, because it is a scientific construct. He then
      asked the question: Why now? The
      causes he listed were many. They included various anti-authority feelings
      against regulation, physicians and
      technology. He cited the influence of money, both from large foundations and
      from commercial interests such as
      occupational guilds and the supplement industry. Some of the ideological
      imperatives attacking scientific
      medicine include cultural relativism, postmodernism. Dr. Sampson also
      described how public opinion is directed
      by propaganda terms, language distortion and medical myths. He explained how
      the purpose of SRAM is to review
      and comment on the misrepresentations and misinterpretations that are so
      prevalent today, stating that "The
      public are not stupid, they're gullible." Dr. Sampson listed a number of books
      that have been influential in the
      movements that are attacking scientific medicine and promoting CAM. They
      include T. Kuhn's "The Structure of
      Scientific Revolution," A. Weil's "The Natural Mind" and M. Furgeson's "The
      Aquarian Conspiracy." He concluded
      by saying that the assaults on scientific medicine have been going on for most
      of a century, but that now the
      movement is within government and is credentialed, making it more influential.

      The Saturday morning plenary sessions were on the topic of Science and AM:
      Exploring Points of Conflict. It
      started with a talk by Robert Park, Ph.D., Executive Director of the American
      Physical Society, entitled
      "Physics, Scientific Law and Homeopathy." In his talk, Dr. Park went through a
      few current CAM theories and
      showed how knowledge of physics can help evaluate the theories underlying the
      claims. The first treatment method
      he analyzed was magnetic therapy. Dr. Park described the state of iron in
      blood, the diamagnetic nature of the
      human body and also went into considerable detail on how multipolar magnets
      are currently manufactured. (An
      excellent article thoroughly evaluated this topic in the July, 1998 issue of
      Skeptical Inquirer and can be found
      in its entirety at:

      Dr. Park also discussed vitamin O (salt water) and homeopathy. As to the
      latter, he discussed the practical
      implications of dilutions in light of Avogadro's number. (Dr. Park authored an
      article on this subject in the
      September/October issue of Skeptical Inquirer, which can be found at
      One startling calculation of Dr. Park's is that in a common homeopathic
      dilution of 30x, a person would need to
      drink 865,000 gallons to get one molecule of the "active" substance. He also
      pointed out that in some cases
      where the substance used is one we would normally avoid, such as poison ivy
      (used for diaper rash) or arsenic
      (used for diarrhea), we should be thankful that Hahneman discovered his "law
      of infinitesimals."

      Dr. Park concluded by conjecturing that modern science's amazing discoveries
      and counter-intuitive theories, in
      particular: relativity, chaos theory and quantum mechanics, have lead the
      public to feel that science says that
      anything is possible. And this sentiment leaves the door open for the
      acceptance of other weird theories, such
      as those found in many CAM therapies.

      Dr. Park was followed by Saul Green, Ph.D., emeritus Professor of Biochemistry
      at Memorial-Sloan-Kettering
      Cancer Institute. He spoke on biochemistry and cancer. He described his search
      for "a diamond in the rough" in
      CAM, the database his search produced and the trouble he had trying to get it
      accepted by the National Cancer
      Institute. Dr. Green also discussed, in some detail, Stanislaw Burzynski's
      antineoplaston theory, which uses
      peptides from human urine to "normalize" cancer cells. Much of this discussion
      would have been familiar to PhACT
      members who attended Dr. Green's talk at the Bensalem library on March 21,
      1998. Dr. Green concluded by saying
      that patients who visit CAM practitioners should ask: Why should I believe
      you? and: What responsibility will
      you take if the treatment doesn't work or causes harm?

      Next to speak was William Jarvis, M.D., Executive Director of the National
      Council Against Health Fraud, on the
      topic of Biology and "Life Forces." He expressed the idea that belief in a
      "Life Force" drives alternative
      medicine. He began by describing some of the forms of this type of belief in
      health care, including: Mesmer and
      his theory of "animal magnetism"; vitalism; Hahneman, the founder of
      homeopathy, who believed that material
      became spirit with dilution; aurvedic medicine; and even chiropractic, whose
      founder, Daniel David Palmer,
      appreciated the working of "Universal Intelligence" (God) and had an interest
      in metaphysical health

      Dr. Jarvis cited the statistic that 40% of cancer patients who use both
      traditional medicine and CAM abandon
      traditional medicine. He stated the opinion that CAM does a better sales job.
      It's basis in theories of "life
      forces" gives it a belief system that is impervious to evidence. Dr. Jarvis
      compared vitalism to materialism and
      showed how alternativism has captured the language and the high ground.
      Calling scientific medicine
      "traditional" turns the world upside-down, because scientific medicine
      includes the most innovative techniques,
      while CAM includes therapies that are thousands of years old and have long
      traditions. He concluded by saying
      that alternativism asks, "What has science done for us lately?" He expressed
      the opinion that they are asking
      this because science-based medicine is reaching the limits of the human

      Timothy Gorski, M.D., chairman of the Dallas/Fort Worth Council Against Health
      Fraud, spoke on Clinical Errors
      in Alternative Medicine. Most of his talk focused on the now famous 1993 New
      England Journal of Medicine article
      by David M. Eisenberg that concluded that the frequency and use of
      unconventional therapies in the United States
      is far higher than previously reported. Dr. Gorski showed many weaknesses in
      the Eisenberg study that put into
      question the statistical result and thus its conclusion. For example, the
      survey included therapies that could
      also be used in legitimate or conventional practices, such as relaxation
      therapy, biofeedback and hypnotism.
      Also, the some conventional practices were not included, such as OB/GYN and
      psychotherapy. An amusing quirk was
      that the study showed that the percentage of people claimed to have used
      acupuncture or chiropractic within the
      last 12 months was higher than the percentage who claimed to have visited an
      acupuncturist or chiropractor in
      the same time period. Were there people who practiced acupuncture on

      Dr. Gorski also reviewed a study by J. Jacobs published in Pediatrics in May
      of 1994 that purported to show that
      a homeopathic remedy was effective in treating acute childhood diarrhea. Dr.
      Gorski reviewed some of the
      problems with the statistical analysis of the study. These included putting
      many different homeopathic remedies,
      individualized for each patient, together as a single type of treatment. It
      also included the fact that the
      study only found statistical significance in one of five different intervals,
      and thus chose that specific
      interval as the one to cite as relevant. Dr. Gorski concluded by talking about
      the difference between
      statistical significance (P-value < .05) and the general conception of
      "significance" and how this affects the
      media's reporting of health studies such as the Jacobs study.

      In the question and answer session that followed, Marcia Angell, M.D., Editor
      of the New England Journal of
      Medicine, defended the publishing of the Eisenberg study. While she stated
      that she disagreed with the
      conclusions of the study, she defended it by saying that it was thorough and
      well laid out with sufficient
      information for others to see how the conclusions were reached. Another
      questioner asked what term the panel
      preferred to use in place of "traditional" medicine. The answer given was that
      "standard" medicine is preferred,
      even to "scientific."

      George D. Lundberg, M.D., former editor of the Journal of the American Medical
      Association, gave the keynote
      address. He started by making two disclaimers. He said that before he was
      fired from his position at JAMA he
      always stated that he was not speaking for the AMA, and mentioned that that
      disclaimer is beneficial to both
      parties. He also said that he would not speak on, or entertain any questions
      on, the controversy surrounding his
      recent dismissal. He then listed three types of medicine: 1) Medicine that has
      been tested scientifically and
      shown to work; 2) Medicine that has been tested scientifically and shown not
      to work, and; 3) Medicine that has
      not been tested but shows some promise and should be tested scientifically. He
      went on to talk about the peer
      review process and its role in medicine, because physicians will only change
      their behavior when the physician
      "thought leaders" form some consensus.

      Dr. Lundberg went on to give the audience a view of medical publishing from
      the editor's perspective. He stated
      his personal view that a journal should publish articles that help patients.
      He described his conversion from
      thinking that authors' financial disclosures were not necessary to his current
      view that they are important. And
      he described what he called the "editor's test" when reviewing an article: Ask
      two questions - "So what?" and
      "Who cares?" Dr. Lundberg showed slides of JAMA covers and asked the audience
      if they could tell what subject
      was featured in an issue by its cover art. For instance, JAMA used the
      painting "Absinth" by Edgar Degas on the
      cover of the issue that dealt with alcoholism. Dr. Lundberg concluded by
      saying that he agreed with Wallace
      Sampson on why CAM has become as popular as it is now, namely,
      deconstructivism. He listed 10 additional
      reasons, which included that the placebo effect is real and that science
      doesn't have all the answers.

      The afternoon session was entitled "AM and the Psychology of Belief." The
      first speaker was James Alcock, Ph.D.,
      of the Department of Psychology at Glendon College, which is part of York
      University. He started by asking for
      audience members, if they felt so inclined, to write to York University in
      protest of its announcement to
      affiliate with the Canadian Memorial Chiropractic College. Dr. Alcock's talk
      on the psychology of belief dealt
      mostly with why people believe that CAM treatments work. He discussed how the
      brain uses two systems to make
      sense of things, one experiential and other intellectual, and how those two
      systems are sometimes in conflict.
      He pointed out that intermittent experiential reinforcement is very powerful
      and difficult to counter by reason.
      If people who feel ill start feeling better after trying a CAM treatment, they
      will often credit the treatment,
      even though they may intellectually realize that the treatment doesn't make
      sense. Dr. Alcock also pointed out
      that most beliefs that people hold actually come from authority. So it is easy
      to see how belief in CAM
      treatments increases when an authority figure, say, an M.D. trained at
      Harvard, states that a particular
      treatment works. He also stressed that feelings are important, both in
      standard medicine and CAM. If a doctor
      tells a person that they have hypertension, but that person feels all right,
      they may not be sufficiently
      inclined to take their medication regularly. On the other hand, if a CAM
      treatment makes a person feel better,
      they will be inclined to stick with it.

      Barry Beyerstein, Ph.D., from the Department of Psychology of Simon Fraser
      University in British Columbia, then
      gave a talk on Why Worthless Therapies Seem To Work. He pointed out that the
      average purveyor and purchaser of
      unfounded therapies is insufficiently knowledgeable about the criteria for
      evidence. This is easily seen in the
      use of anecdotal testimonials for CAM treatments. Dr. Beyerstein cited the
      fallacy of "post hoc, ergo propter
      hoc," under which people believe correlation implies causation. He went on to
      discuss a number of reasons why
      people can think that a bogus treatment worked. The list included the fact
      that diseases, especially those that
      are cyclical, may have run their course at the time of treatment. He also
      discussed the causes of psychological
      distortion of reality such as the norm of reciprocity, cognitive dissonance
      and self-serving biases. He
      concluded with a call for randomized, placebo-controlled, double-blind
      clinical trials with proper statistical
      analysis, long term follow-up and replication by independent researchers. (An
      excellent article of his that
      closely matches his talk appeared in the September/October, 1997 issue of
      Skeptical Inquirer and can be found in
      its entirety at:

      John Renner, M.D., Clinical Professor of Family Medicine at the University of
      Missouri in Kansas City, talked
      about Personal "Conversions" to AM Therapies. He started by saying that the
      medical community does not give
      enough credit to the sales ability of some of these CAM "perpetrators." He
      described how they get into church
      groups and schools and how they influence family members. He stated three
      important harms caused by CAM: 1)
      Delay of standard treatments; 2) Potential economic impact that we can not
      currently ascertain, and; 3)
      Anti-public health activity. Dr. Renner went on to tell a number of true
      stories, some quite alarming, about
      people's use of CAM. He talked about a nurse who injected a concentrated salt
      solution directly into tumors. She
      did it on her husband and was planning to drill a hole in the skull of a child
      in order to inject it into a
      brain tumor. Another involved people who only consumed one food a day in a 31
      day rotation. While having dinner
      with the family he discovered that they also use colonic irrigation. He
      concluded by stating that we need to
      evaluate the long-term harm of some of these treatments, noting that they have
      profound implications.

      Steve Novella, M.D., Assistant Professor of Neurology at Yale University
      School of Medicine, next discussed
      conspiracy theories in alternative medicine and the theory of "Hidden Cures."
      He detailed how CAM replaces
      scientific thinking with psychological appeal and how conspiracy theories can
      enhance this approach. He
      described the structure and psychological appeal of conspiracies and then
      pointed out an important fallacy of
      conspiracies. The alleged existence of a conspiracy can be invoked to explain
      a lack of evidence, a surfeit of
      counter-evidence, and the existence of opponents. Dr. Novella showed how
      conspiracy theories are used in CAM,
      both by the patients, who use them to maintain belief in a hidden cure, and by
      practitioners, who use it to
      explain why treatments haven't been shown to work. He stressed the
      psychological relevance by pointing out that
      if a person has an incurable illness, it is more comforting for them to
      believe in a hidden cure than it is to
      accept their condition. He cited the Galileo Complex, saying that if anyone
      compares themselves to Galileo due
      to their persecution, then they are most likely a quack. Dr. Novella also
      described how as you tear down the
      conspiracy, the conspiracy expands.

      At the Saturday night banquet Robert McCoy, proprietor of The Museum of
      Questionable Medical Devices in
      Minneapolis gave an entertaining presentation on Quack
      Medical Devices. He showed a large assortment of the medical devices from the
      museum including: a prostate gland
      warmer, used to treat the "abdominal brain"; a Specto-Chrome, which claimed to
      cure everything, including
      cancer, with colored lights; a Nose Shaper that you strap on your face and
      tighten tiny bolts to push your nose
      into position; and a foot operated breast enlarger pump. In addition to the
      actual devices, Mr. McCoy has an
      encyclopedic knowledge of some of the stories of famous quacks, such as John
      Harvey Kellogg. He even had
      personal tales, such as one where a man who had sold a bogus weight loss
      device called the Roll-A-Ray admitted
      to Mr. McCoy that he knew the device was bogus. After twenty years of selling
      it, his conscience got to him and
      he quit the business. He's now retired, living in Florida. (Ah, the wages of
      sin...) His web page is at:

      A highlight of the show was when Mr. McCoy convinced Paul Kurtz to sit on the
      Psychograph to have his head
      examined. The Psychograph, patented in 1905, is an antique phrenology machine
      that claims to read the bumps on a
      person's head and then prints out an assessment of that person's personality.
      Mr. McCoy lowered the
      Psychograph's metal basket onto Mr. Kurtz's head. He flipped a lever. A blue
      light went on and the machine
      proceeded to make noise and print out a list of personality traits, which Mr.
      McCoy read to the audience.
      According to the machine, Mr. Kurtz is difficult to collaborate with, is
      strongly oversexed, tends to begin new
      undertakings without sufficient planning and has difficulty with religion.

      Sunday morning's plenary session was entitled Scientific Critiques of AM
      Therapies and Theories. The first
      presenter was Willem Betz, M.D., Prof. Academish Centrum voor
      Huisartsgeneeskunde VUB in Belgium, who spoke on
      The Crisis of Herbal Cures in Europe. In 1991, in Brussels, a pathologist, who
      had been examining biopsies from
      kidneys, found an epidemic of approximately 100 young women who lost their
      kidneys. It turned out that doctors
      in weight loss clinics were prescribing a concoction that included among other
      things, amphetamines,
      fenfluramine, belladonna extract, and two Chinese herbs. One of the herbs was
      listed as Hang Fang Ji. Further
      investigation determined that instead of Hang Fang Ji, the concoctions
      contained Guang Fang Ji, also known as
      aristolochia, which is known to be toxic and very carcinogenic. The response
      from Traditional Chinese Medicine
      (TCM) practitioners varied widely. Some claimed that you can not mix TCM with
      Western medicine. Others claimed
      that you need the whole plant. Still others claimed that aristolochia is not
      toxic when combined with other
      herbs. Dr. Betz's conclusion is that not only should aristolochia not be given
      to patients, but also that TCM
      experts do not know what they are talking about.

      Next, Dr. Jarvis spoke on acupuncture. He outlined three faces of acupuncture.
      First is the TCM face. He quoted
      Dr. Felix Mann who said: "Acupuncture points and meridians do not exist. There
      are so many acupuncture points
      that there is no skin left which is not an acupuncture point." The second face
      is the one they show the
      consumer, making claims that are not supported. The third face is the medical
      face. But, Dr. Jarvis pointed out,
      they are "single modality practitioners." Dr. Jarvis talked about one study
      that, after 250 controlled trials,
      only found support for one acupuncture point, related to nausea and vomiting.
      But he compared this with another
      study on the adverse effects of acupuncture. One of the prominent adverse
      effects was nausea and vomiting.
      Although acupuncture does have hazards, including local hematoma, pneumothorax
      and nerve damage, Dr. Jarvis
      pointed out that we still don't know what hazards to look for. He also
      described electroacupuncture, which uses
      a galvanic meter probe and is easily affected by pressure and moisture.

      Steven Barrett, M.D., Board Chairman of Quackwatch, Inc. and Board Member of
      the National Council Against Health
      Fraud, spoke on chiropractic. Dr. Barrett, who has been studying the
      chiropractic marketplace since 1968,
      explained that there is no single theory behind chiropractic, but rather a mix
      of a large number of different
      things. Some techniques that are used by a majority of chiropractors are
      pseudo-scientific, such as that
      subluxations cause disease. Dr. Barrett told the audience about some of his
      investigations into the field of
      chiropractic, including sending three children and five adults on undercover
      investigations to more than 80
      chiropractors. Visits by a single patient to multiple chiropractors invariably
      resulted in completely different
      diagnoses. Dr. Barrett did tell what chiropractors can do that is good,
      namely, they can relieve some types of
      back and neck pain and other conditions related to tightness and loss of
      mobility, such as tension headache or
      aching in muscles and joints. And he stated that there are some very good
      chiropractors. But he also listed some
      of the harm that chiropractic can do. The harms include anti-immunization and
      anti-fluoridation attitudes and
      the taking of excessive x-rays. Other harms arise when chiropractors claim to
      treat other illnesses,
      particularly pediatric illnesses such as ear infections. Dr. Barrett even
      mentioned the case of a woman who died
      after neck manipulation split the inside walls of both of her vertebral
      arteries. Quackwatch, Dr. Barrett's
      excellent website is at: http://www.quackwatch.com/
      It has a link to his chiropractic website, chirobase:

      The next speaker was Dr. Beyerstein who spoke about Naturopathy. He started by
      describing how difficult it is to
      define naturopathy because there is practically nothing that all naturopathy
      practitioners believe and there are
      no core diagnostic or therapeutic methods. They do some things that are
      already accepted, some that are doubtful
      or unsupported and some that are absurd. Generally, naturopaths exhibit a
      penchant for magical thinking, a weak
      grasp of science and an inordinate faith in the power of diet to cure, among
      other things. And they are bound
      together by the belief in the beneficence of an animistically conceived,
      anthropocentric concept of nature. Dr.
      Beyerstein described the spiritual component of naturopathy and compared it to
      Qi Gong. He stated that to
      naturopaths, illness is like a sin, a straying from the dictates of nature.
      The causes of disease are
      devitalized foods, autointoxication and metabolic imbalances, to name a few.
      Naturopaths diagnose these
      conditions through a long list of varied and questionable practices, including
      applied kinesiology, iridology
      and kirlian photography. And the remedies require cleansing, balancing and
      detoxifying the whole person. Dr.
      Beyerstein mentioned that there are naturopathic colleges, including one at a
      fully accredited school, the
      University of Bridgeport, which is owned by the Rev Sun Myung Moon's
      Unification Church.

      Dr. Sampson then talked about Mind/Body Therapies. While noting that the
      connection of the mind to the body is
      obvious, he stated that there have been few studies on the relationship of the
      mind to healing, and that the
      studies that do exist have shown had mixed results. He said that the best
      evidence of this relationship is in
      stress' effect on wound healing. But studies, at least the good ones, don't
      show a relationship between stress
      and cancer recovery rates. Dr. Sampson detailed many of the studies and
      surveys that have been published and
      stated why some have conclusions that are not compelling. He warned against
      putting too much reliance on single
      case reports and studies with no replication. The studies he cited included
      two from JAMA, one linking the
      susceptibility to the common cold to social connections, printed in 1997, and
      another that discussed the
      postponement of death until after the Chinese Harvest Moon Festival, printed
      in 1990. His conclusion is that
      there have only been bits and pieces that show only minor effects. In the
      question and answer session that
      followed the talk, one audience member approached the microphone and stated
      that she was studying to be a
      naturopath. In relation to the mind/body connection she asked, "So you're
      telling me I've wasted four years
      studying something that doesn't exist?" Dr. Sampson reiterated that it is
      obvious that the connection does
      exist, but warned her to critically examine the studies that purport to show a
      relationship between the mind and

      Rebecca Long, President of Georgia Skeptics, described a study she had done
      investigating the perception of
      subtle cues in therapeutic touch (TT). She conducted tests of
      non-practitioners of TT that were similar to the
      one conducted by Emily Rosa, where a subject behind a barrier attempts to
      determine if there is a hand over his
      or her left or right hand. Ms. Long's tests found that individuals could
      detect a variety of very subtle cues
      including: body heat; the direction of vocalizations ("Okay"); creating or
      blocking air flow; and table leaning.
      In her study she found ways of blocking these cues and also tested negative
      cueing. Note by Eric - I provide
      more TT information at:

      Rosemary Jacobs then took the floor and described her own personal case study.
      Ms. Jacobs has argyria, a
      permanent skin discoloration that makes a person's skin gray. This condition
      is caused by ingesting too much
      silver. In the 1950's, Ms. Jacobs was given colloidal silver nose drops by a
      doctor to combat allergies. In her
      research, she discovered that medical literature in the 1930's had warned that
      colloidal silver had no evidence
      for its effectiveness, and was known to cause argyria. But her doctor listened
      to the advertisements, not the
      medical literature. Ms. Jacobs was alarmed to learn that there has been a
      resurgence of AM promotion of
      colloidal silver. It is readily availability for purchase at health-food
      stores and on the internet, accompanied
      again by unsubstantiated claims of its curative power. In the question and
      answer session that followed, a
      doctor linked the topic to the Philadelphia area. He indicated that Dr. Albert
      C. Barnes, who established the
      Barnes Foundation, one of the finest private collections of early French
      modern and post-impressionist paintings
      in the world, located in suburban Philadelphia, made his fortune by selling a
      patent medicine called Argyrol.
      Ms. Jacob's story can be found at her web site:

      The keynote address for the day was given by Marcia Angell, M.D., Editor of
      the New England Journal of Medicine.
      The title of her talk was "Why Everyone Loves Alternative Medicine." In her
      talk, Dr. Angell addressed three
      questions: 1) What is alternative medicine (AM)?; 2) Why is it sweeping the
      country now?, and; 3) Why is there
      so little resistance from the medical community? As to the first question, Dr.
      Angell pointed out some of the
      difficulties in defining AM. She went on to list some of the general qualities
      of AM such as its resistance to
      scientific testing, its celebration of nature and tradition and its tendency
      to attribute authenticity to the

      As to the second question, Dr. Angell talked about the current antipathy
      towards the medical establishment, some
      of which is deserved. And she contrasted standard medicine doctors with AM
      practitioners who are "user
      friendly." She also talked about the users of AM and how most of them are
      relatively young, more affluent and
      well educated, and fall into the category of the "worried well." But she
      echoed Dr. Jarvis when she said that
      the most important reason why people use AM is spiritual. She compared AM to
      religions but pointed out that most
      religions have an ethical content, while AM is narcissistic.

      As to the third question, Dr. Angell pointed out that doctors are not
      scientists, but rather clinicians skilled
      in a specific area. She outlined the economic realities of the medical market,
      where third-party payers have a
      buyers market and how this affects doctors' practices. And she pointed out
      that HMO's and hospitals use AM to
      create a niche market.

      Dr. Angell concluded by saying that AM is a cultural/religious movement in the
      guise of a medical movement, and
      that its main danger is to cause a retreat from rationality towards claptrap.
      And this, she said, will spread
      outside medicine. The audience indicated their agreement by giving her a
      standing ovation.

      The rest of the day was filled with concurrent sessions on AM and Medical
      Ethics; AM, Government and the Law,
      and; Educating Physicians and Consumers. At the government session, Dr.
      Barrett discussed the three primary
      federal agencies that have jurisdiction: The U.S. Postal Service; the FDA,
      and; the FTC. He described how each
      operates under powerful laws, but generally lacks the resources to handle the
      number of cases it encounters. The
      Postal Service has jurisdiction over those who make false representations on a
      product sent through the mail,
      but only handles a small number of health-related cases each year. The FDA,
      which became very effective under
      the leadership of David Kessler, was severely hampered in its efforts to
      regulate products the industry calls
      "dietary supplements" by the passage of the Dietary Supplement Health and
      Education Act of 1993.

      Of the three agencies, the FTC seems to be the most effective now. It has
      primary jurisdiction over the
      advertising of foods, nonprescription drugs, cosmetics, devices, and services
      that are marketed in interstate
      commerce. During the Reagan administration they were not very active,
      averaging 5 health-related cases per year.
      But they have been much more vigilant since that time. During 1997 they
      completed 31 cases. And they have
      implemented new tactics, including setting up false web sites that appear to
      sell AM products, but eventually
      warn the potential buyer that they should be wary of such sites. And they now
      have "surf days" when they
      actively warn web sites that sell products using unsubstantiated claims. The
      lesson seems to be that if you have
      a complaint, take it to the FTC.

      ============ end of post by Hunter ==========
      This report is found at:

      Eric Krieg eric@...