Help a fellow skeptical doctor out

Earlier this week, I did a couple of posts about applying evolutionary principles to the meme of complementary and alternative medicine. In one of them, I mentioned how CAM therapies never seem to "go extinct." They may wax and wane in popularity and "evolve" into other therapies, but they never go extinct. PalMD of Whitecoat Underground has noticed the same thing and has posed a question and a challenge:

So today I issue a challenge to both of my readers. Find me examples of "alternative" medicine that have been abandoned because evidence showed them to be failures. Post away, but please leave evidence, or your comment won't be very useful.

An excellent question. There are many examples of "conventional" medical treatments that have been abandoned in the face of evidence showing that they don't work or may even be harmful. That's not what this question is looking for, though. Thus far, unfortunately, PalMD hasn't gotten much in the way of useful responses. So I thought I'd help a fellow skeptic out and post his challenge here. Please post your examples with evidence either here, at Whitecoat Underground or, even better, at both blogs in order to inspire the most discussion.

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This is a great question. Phrenology may qualify; however, it may still be practiced somewhere. Also, I don't know if it was disproven, or ridiculed out of existence by Mark twain.

I do know that ground, dessicated animal-organ tablets persisted into the age of scientific medicine (Reed and Carnrick Pharmaceuticals, recently defunct). It would take a bit of research to determine if they were ruled-out by clinical trials, or simple implausibility (plus, the advent of effective treatments).

Is Wilhelm Reich's "Orgone Therapy" still around in some form? (If not, it's not necessarily due to negative evidence -- fads whither away for all sorts of reasons).

Trepanning

By PoxyHowzes (not verified) on 15 Nov 2007 #permalink

Cross-posted at Whitecoat Underground:
What about the anaphrodisiac woo of Dr. Kellogg's cereal? Or, for that matter, saltpeter? Neither was, as far as I know, tested systematically and found wanting, but nobody eats their Special K to avoid onanism any more.

For that matter, the whole anaphrodisiac/anti-masturbation woo has fallen by the wayside pretty decisively. That's not to say that people don't still have some very weird ideas about wanking, in that sky-daddy apparently cares a lot what you do with the standard equipment, but the giant constellation of ills attributed to masturbation no longer seems to be the focus that it was for the mid-19th to mid-20th century woo-sanitarians.

Dessicated animal-organ tablets still around? Dang, when I worked at R&C I dumped lots of boxes of them, I could have sold them for a fortune.

I went to post at whitecoat; but there seems to be some confusion about what qualifies as "alternative." Two hundred years ago, a lot of nonsense was considered "medicine" and it competed in the same ignorant contest with other beliefs; today we could call that "medical" nonsense "alternative." Homeopathy was less of a problem than medicine at the time. Neither had (much) curative value; but homeopathy was less disabling.

Various "radium" therapies that were popular before the A-bomb, from harmless to fatal.

I doubt pottery glazed with uranium oxide was harmful, 3g would be one uCi and I doubt much radon would pass thru. I doubt radium hot springs have more radon than well water in these areas.

See Eben Byers in Wikipedia. He consumed hundreds of vials containing a mCi of Radium and suffered a grusome death.

By Eric Gisin (not verified) on 15 Nov 2007 #permalink

blood letting, or is that not woo?

Frontal Lobotomy

By PoxyHowzes (not verified) on 15 Nov 2007 #permalink

Thaks Orac and company. This is getting interesting. I did address lobotomy at my place, but to reiterate:
"frontal lobotomy worked (in its own flawed way) and became mainstream. Once mainstream medicine discovered better alternatives it was abandoned."

So is Orgone Therapy, for that matter.

Perhaps it would be helpful if we could get some kind of meaningful threshold for what constitutes "abandonment".

"Perhaps it would be helpful if we could get some kind of meaningful threshold for what constitutes "abandonment"."

I propose that if a brand of woo still has its very own forum over at CureZone, it cannot be described as "abandoned".

Orgone therapy, therefore, is very much alive. Not as popular as urine drinking or liver flushing, but still around.

http://curezone.com/forums/f.asp?f=487

By Dangerous Bacon (not verified) on 15 Nov 2007 #permalink

Viagra

By PoxyHowzes (not verified) on 15 Nov 2007 #permalink

Re: radium therapies.

There are actually a number of radioactive hot springs in Greece, at least, that are still advertised as healthful. S'posed to be good for rheumatism. The most radioactive are on the island of Ikaria, but there also some on the mainland. I think the springs which give the famous ("300") pass at Thermopylai -- "the hot gates" -- its name are also radioactive, certainly the ones at nearby Kamena Vourla are.

Don't know why the Greeks aren't worried about this radioactivity. It may be because older folks who grew up in rural areas are not really clear on what it is. I remember a shepherd in the early 1990s blaming "Chernobyl" as the cause of a prolonged drought. (On the other hand, I once asked to use a copy machine in a village office where I was doing an archaeological project, and was told I could not use it until the pregnant lady in the room was out to lunch, as the radioactivity would harm her developing fetus.)

Not sure if this is how to do the linky thing, but in the "URL" box I pasted in a link an article discussing potential local health impacts of radioactive springs. You'll also find fun stuff if you Google "greece radioactive springs".

CAM modalities probably have gone extinct, we just need to look at the right selection pressure. Evolution selects for beings who can pass on their genetic code. Medicine chooses the most effective treatments. sCAM artists go for the techniques that are the most profitable.

So, instead of asking "Which CAMs have been abandoned because they were disproved?" how about "Which woo won't make money?"

Why should we expect any woo to be abandoned based on evidence? It's sort of a non-sequitur, since evidence (as you or I understand the term) plays no meaningful role in woo. It's like asking for examples of animals that evolved via inheritance of acquired traits.

I think Orac was correct to ask if woo goes extinct at all, regardless of why. Are there any examples of woo that were once accepted but later rejected by the 'mainstream' woo community?

[Yes, I realize "mainstream woo" is an oxymoron.]

While more of a medicine, than a treatment, Thalidomide could be a good example

By Sigma_Orionis (not verified) on 15 Nov 2007 #permalink

Ooh! Ooh! Sorry to post so soon again, but this is too precious to pass up, and also exonerates the poor Greeks somewhat in their woo-eriffic regard for "hot" hot springs.

Google "Radon Health Mine" to find the Free Enterprise Radon Health Mine of Boulder, Montana. (Caution: their home page contains an embedded video with voiceover, so hit the mute button if you're in the office.)

If you can't visit the mine, you can also buy on the site, for only $14.95, the book Underexposed: What if Radiation is Actually Good For You?

I don't quite understand how this can be legal.

By BronzeAger (not verified) on 15 Nov 2007 #permalink

So, instead of asking "Which CAMs have been abandoned because they were disproved?" how about "Which woo won't make money?"

I don't think anybody has made any money out of urine therapy but it still seems to be flowing freely.

By Chris Noble (not verified) on 15 Nov 2007 #permalink

While more of a medicine, than a treatment, Thalidomide could be a good example

Maybe I'm confused what you mean. When was Thalidomide ever an "alternative" medicine treatment?

I assure you that thalidomide is alive and well; it's just not being prescribed for morning sickness. Thalidomide is still used for the treatment of both leprosy and multiple myeloma.

Thalidomide was mainstream medicine---but failed and was abandoned as a treatment for morning sickness. No "alties" popped up selling it in Tijuana.

Currently, as stated above, it is used in the treatment of multiple myeloma and leprosy, both fully mainstream and well-researched.

Secretin for autism? It was all the rage with some parents in the late 90s, but now even Repligen (the company that was marketing it for autism), seems to given up on it for autism. I haven't seen it mentioned on any of the autism boards for a long time either.

blood letting, or is that not woo?

Blood letting is neither (entirely) abandoned nor (entirely) woo. Phlebotomy is a recognized, studied treatment for hematochromatosis and early P vera.

What about powdered rhinoceros horn for impotence? I've heard that its use at least decreased after the invention of Viagra, though I'm not sure it is entirely abandoned.

At first I though arsenic as medicine sounds good. But no, it's still used to treat certain cancers (leukemia). It's not even altie.

Was mercury actually effective at treating syphillis- or pure woo? It's certainly out of favor now.

Various "tonics"

Dosing kids with narcotics to quiet them. I think it was called "Soothing Syrup."

Iridology is interesting. The practice still goes on, but *individuals* who buy the high tech equipment to practice it realize that it is rubbish, because digital photos and computer measurements make it objective, not subjective.

Darwin's Water Cure (He did not perform it, he swore by it) - it was done by 'Dr' James Gully.

Does Insulin Shock apply here?

Psychoanalysis?

What about powdered rhinoceros horn for impotence?

Unfortunately large numbers of rhinos are still being slaughtered by poachers for exactly that reason.

Unfortunately large numbers of rhinos are still being slaughtered by poachers for exactly that reason.

Damn. You'd think that, given that the woosters usually give at least lip service to respecting nature, they'd jump at a chance to end a behavior that is killing animals, but I guess not.

Insulin shock was not alternative, and was finally abandoned when other forms of therapy (medications and ECT) were developed.

Psychoanalysis, in its most traditional form, is not practiced all that much, but it is practiced. Various types of "talk therapy" have been validated, so, while the most convoluted of details of psychoanalytic theory may be woo-ish, they were the "best model" at the time, and considered mainstream. Now other variations of talk therapy are mainstream.

You should be able to find an extinct medical practice to accompany every extinct religion although modern alternative medicine providers have revived many.

Native American herbal treatemnts, Blood letting, the four Humors of Ancient Rome.

Europeans believed Bed rest was the best treatment for pregnancy.

SO many illegal drugs that we use today were used as medicine in their history.

Fact is most things survive in some form. We just aren't using incense and accupuncture to treat brain tumors or broken legs anymore.

I think a better definition of "Alternative" is required.

To day it means spiritual and Unproven. but in the past many alternative treatments were the mainstream medicines. Scientific testing is why all have moved to "alternative".

Modern medicine has has by definition abandoned all faith based medicinal treatments that were not supported by scientific evidence. So Abandoned=Alternative.

Some have died out from even the alternative scene, but that is not because of evidence, but because they were unpopular.

Phrenology occurred to me, also, but then again, so did craniosacral manipulation, which is currently in vogue. I'm not sure if those two methodologies (for lack of a better term) are similar enough to be considered the same, however.

By jweil_2000 (not verified) on 16 Nov 2007 #permalink

also re: radium - as an alpha emitter, would be an excellent chemotherapy if it could be adequately delivered to the target site. I know of work on a chelator that could be bound to antibody and used to simultaneously treat and image tumor. The alpha particle would devastate the target but leave the surrounding tissue unharmed (its penetration depth is no more than a few cell thicknesses).

what about vinegar?

By melpomene (not verified) on 16 Nov 2007 #permalink

Radium would be a terrible agent for chemotherapy. The decay product of radium is radon, an inert gas. What ever chemical species radium could be sequestered in would be ineffective at sequestering radon (and would be destroyed by the recoil of radium decay anyway).

Ra226 has a half life of 1600 years and is a decay product of U238 so it would be available in large quantities. When it decays, it produces Rn222, Po218, Pb214, Bi214, Po214, Pb210, Bi210, Po210, Pb206 (which is stable). There are some alternate decay pathways, but the net result is that there are about 5 alpha decays in radium daughter products for each radium decay plus a few beta decays. Unless you can get rid of those daughter products, you will get more non-discriminate radiation dose from the daughter products than from the parent radium.

Radium does tend to replace calcium, which is the major component of bone. Once in bone it could stay for a long time, irradiating the bone marrow which is where the stem cells for blood cells hang out.

I don't think anyone is still using Perkins tractors... but I wouldn't be surprised to find out someone has revived them. It's amazing how discredited ideas keep recycling, sometimes with only minor changes or a new name.

By Harriet Hall (not verified) on 17 Nov 2007 #permalink

I think it would be interesting (and informative!) to ask this very question on an alt.med site (CureZone or others). What formerly popular "alternative therapy" turned out to not work after all? Then sit back and either

1.) listen to the crickets chirp
2.) watch the sparks fly
3.) get a meaningful answer from the consensus
4.) Watch the consensus focus on the most meaningful answer being "mainstream/Western/Evidence-Based/Scientific/Allopathic Medicine is the alternative therapy which doesn't work."

Haven't seen any Phrenology consultants of late

On the other hand, as wiki notes, Michigan put a new tax on phrenology services in 2007, suggesting that someone does phrenology there: one doesn't impose taxes unless one expects to get some income from them.