One of the major differences between science-based medicine (SBM) and alternative medicine—or, as they call it these days, "complementary and alternative medicine" (CAM) or "integrative medicine"—is that SBM is always questioning itself, always reevaluating its practices. Related to this difference is that SBM does change its practice, discarding treatments that don't work and incorporating those that do work (or at least work better than older practices). As I've said many times before, the process by which this happens is messy and slower than we might like, and that provides ammunition to CAM practitioners to cast doubt on the scientific basis of medicine. However, when push comes to shove, SBM does evolve in response to science and evidence. In contrast, alternative medicine practices, regardless of whether they stand alone or are "integrated" with SBM (or, as I prefer to call it, they contaminate SBM), remain fixed in a prescientific mindset in which magical energy fields and life forces are manipulated and evil humors cause disease more than microbes. Sure, old concepts are gussied up with "science-y" sounding terms, but the basic concepts remain rooted in long abandoned humoral theory and vitalism.
One example of science-based medicine trying to improve itself is an initiative called Choosing Wisely. Basically, it's the result of a challenge by the ABIM Foundation to professional organizations:
An initiative of the ABIM Foundation, Choosing Wisely is focused on encouraging physicians, patients and other health care stakeholders to think and talk about medical tests and procedures that may be unnecessary, and in some instances can cause harm.
To spark these conversations, leading specialty societies have created lists of “Things Physicians and Patients Should Question” — evidence-based recommendations that should be discussed to help make wise decisions about the most appropriate care based on a patients’ individual situation.
Consumer Reports is developing and disseminating materials for patients through large consumer groups to help patients engage their physicians in these conversations and ask questions about what tests and procedures are right for them.
It's also an initiative that I fully support, so much so that I am involved with a statewide initiative to discourage practices related to breast cancer in Choosing Wisely lists. I've written about before, pointing out some of its prominent recommendations and also noting a couple of areas where it falls short (for instance, routine breast MRI before breast-conserving surgery in the absence of high breast density does not decrease reexcision rates or decrease the mastectomy rate). I've also used it (and a prominent study) to illustrate the key difference between SBM and CAM I alluded to at the beginning of this post.
Now I see that there are new recommendations, and they are of interest to those of us who keep track of CAM practices, in particular practices favored by naturopaths and other quacks who claim that everyone suffers from "heavy metal toxicity" or some variant thereof and recommend various treatments designed to eliminate that "toxicity," such as replacement of amalgam fillings and chelation therapy. It's a rather interesting interface between CAM and conventional medicine. In one way, I see these recommendations as a bit of a cop-out, but on the other hand they can also be viewed as a much-needed calling out of bad actors who profit from quackery and are used by quacks. I'm referring to the recently released Choosing Wisely list from the American College of Medical Toxicology and The American Academy of Clinical Toxicology. Let's take a look at them, shall we?
1. Don’t use homeopathic medications, non-vitamin dietary supplements or herbal supplements as treatments for disease or preventive health measures.
Alternative therapies are often assumed safe and effective just because they are “natural.” There is a lack of stringent quality control of the ingredients present in many herbal and dietary supplements. Reliable evidence that these products are effective is often lacking, but substantial evidence exists that they may produce harm. Indirect health risks also occur when these products delay or replace more effective forms of treatment or when they compromise the efficacy of conventional medicines.
There really isn't much to add to this one. The ACMT and AACT are absolutely right, but they didn't go far enough. They really should have mentioned that homeopathic remedies are so diluted that, most commonly except in the case of the very "weakest" (i.e., least diluted) homeopathic remedies, there is a vanishingly small chance that there is even a single molecule of the original substance left.
The one that's going to leave a mark is #2:
2. Don’t administer a chelating agent prior to testing urine for metals, a practice referred to as “provoked” urine testing.
Metals are ubiquitous in the environment and all individuals are exposed to and store some quantity of metals in the body. These do not necessarily result in illness. Scientific studies demonstrate that administration of a chelating agent leads to increased excretion of various metals into the urine, even in healthy individuals without metal-related disease. These “provoked” or “challenge” tests of urine are not reliable means to diagnose metal poisoning and have been associated with harm.
This is an issue I've written about since near the very beginning of this blog, and it's great to see a mainstream organization to which many of the doctors running the labs that run these medically useless tests belong to. One of these laboratories is particularly notorious for this practice, commonly called the "provoked urine test" for heavy metals. Indeed, this very laboratory is engaging in a bit of legal thuggery, Stephen Barrett of Quackwatch for actually writing about its scientifically unsupported practice. (Personally, I hope that this new Choosing Wisely list provides Dr. Barrett with ammunition for his defense against this frivolous lawsuit.) It's also a favorite test of the mercury militia looking for elevated mercury levels due to exposure to thimerosal in vaccines and elsewhere. (Never mind that thimerosal has been removed from childhood vaccines other than certain flu vaccines, and there are now only trace amounts of thimerosal in some vaccines.) In essence, the chelating agent given before this test elevates the levels of mercury and other heavy metals in the urine, sometimes far beyond normal. The urine is then collected for several hours after the chelator has been administered. That is the “provoked” nature of the urine test. This method is in contrast to the standard manner of measuring these metals in the urine, which involves collecting a 24 hour urine sample, no provocation. Here’s the problem. A provoked urine test, by its very nature, is designed to increase the secretion of heavy metals and thus increase their concentration in the urine. The problem is that there are no standard values for provoked urine tests, although there are reference values for standard, unprovoked, 24 hour urine specimens. Guess what values antivaccine quacks and naturopaths (but I repeat myself) use?
Doing provoked urine testing is a cottage industry among various medical laboratories, and there are labs that should know better that do these tests on the side or wink at the values even though values as high as they get are rare if no chelation agent is administered beforehand.
The next two item on the list is very much related to #2:
3. Don’t order heavy metal screening tests to assess non-specific symptoms in the absence of excessive exposure to metals.
Individuals are constantly exposed to metals in the environment and often have detectable levels without being poisoned. Indiscriminant testing leads to needless concern when a test returns outside of a “normal” range. Diagnosis of any metal poisoning requires an appropriate exposure history and clinical findings consistent with poisoning by that metal. A patient should only undergo specific metal testing if there is concern for a specific poisoning based on history and physical examination findings.
4. Don’t recommend chelation except for documented metal intoxication which has been diagnosed using validated tests in appropriate biological samples.
Chelation does not improve objective outcomes in autism, cardiovascular disease or neurodegenerative conditions like Alzheimer’s disease. Edetate disodium is not FDA-approved for any condition. Even when used for appropriately diagnosed metal intoxication, chelating drugs may have significant side effects, including dehydration, hypocalcemia, kidney injury, liver enzyme elevations, hypotension, allergic reactions and essential mineral deficiencies. Inappropriate chelation, which may cost hundreds to thousands of dollars, risks these harms, as well as neurodevelopmental toxicity, teratogenicity and death.
As I've discussed many times, a catch-all diagnosis from quacks of many varieties, but in particular from naturopaths, is "heavy metal toxicity." It's billed as the cause of autism in children, and diseases in adults as varied as cardiovascular disease and cancer; in particular it is blamed as the cause of common complaints such as fatigue and feeling run down. In addition, chelation therapy is a favorite treatment for "detoxification" by naturopaths and many other varieties of quacks. It is a real treatment for real acute heavy metal poisoning, but real acute heavy metal poisoning is quite uncommon in industrialized nations these days. Unlike the alt-med version of heavy metal "toxicity," real heavy metal poisoning requires a history of exposure plus actual symptoms of toxicity. Those symptoms and the symptoms for which chelation therapy is frequently given are often related to each other only by coincidence.
Worse, chelation therapy is potentially dangerous. The most egregious example of this was a real "clean kill," an unfortunate autistic child named Abubakar Tariq Nadama who was unfortunate enough to be born to parents who brought him to a physician near Pittsburgh who killed him with chelation therapy.
5. Don’t remove mercury-containing dental amalgams.
Mercury-containing dental amalgams release small amounts of mercury. Randomized clinical trials demonstrate that the mercury present in amalgams does not produce illness. Removal of such amalgams is unnecessary, expensive and subjects the individual to absorption of greater doses of mercury than if left in place.
This is what is sometimes called "toxic teeth" quackery. It's so pervasive that Dr. Oz featured it on his show. Sadly, he did so completely credulously and approvingly, but that's par for the course for Dr. Oz. The bottom line is that quacks frequently tell people to have their amalgam fillings removed and replaced as part of their "detoxification" regimen. Sometimes, when it's part of cancer quackery, removing fillings and replacing them is just one more thing making the patient suffer before the end.
As I mentioned at the beginning of this article, I'm a bit conflicted about this list. The purpose of Choosing Wisely is to point out commonly performed medical practices and procedures that are either unnecessary, ineffective, or even harmful. This is a very good thing indeed. If I didn't think so, I wouldn't be involved in promoting the initiative with respect to breast cancer. However, the purpose of the Choosing Wisely initiative struck me as being to promote the questioning of conventional medical treatments that don't have a good evidence base for them. This entire list is basically calling out quackery. Then it occurred to me. The ACMT states that its primary mission is to serve physicians who are medical toxicologists, defined as treating "drug overdose, acute drug abuse problems, chemical exposures, and envenomations." The AACT describes its mission as uniting "into one group scientists and clinicians whose research, clinical, and academic experience focus on clinical toxicology."
On the other hand, the Choosing Wisely challenge specifically was that "national organizations representing medical specialists have been asked to 'choose wisely' by identifying five tests or procedures commonly used in their field, whose necessity should be questioned and discussed." The choice of these five items by the AACT and ACMT implies that these five practices, which, let's face it, are all sheer quackery, are commonly used in its field. If that's true, it's very sad, but it is very good that the AACT and ACMT are finally calling the quacks out.
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I wonder if this will extend to cover the barrage of unnecessary screening tests, given the well documented risks of false positives?
I've had a lot of dental work done in the last few years, including replacement of some amalgam fillings, but it was for purely dental reasons (the very old amalgams were causing cracks in the tooth structure, if I recall). A distant relative is a dentistry professor -- he once told me that he considers replacing amalgam fillings to avoid toxicity to be malpractice.
Based on what I see at the choosingwisely.org web site, that certainly seems like a major focus.
Re: Dental amalgams. The effect of mercury-containing dental amalgams on child behavior was examined in the New England Children's Amalgam Trial:
No effects of mercury-containing amalgam was observed. However, an interesting effect was noticed. Children who had one type of dental composite actually had a low but detectible increase in adverse psychosocial function as compared to other composites or amalgam:
Thus if one had chosen to use this type of composite instead of amalgam in the belief that it might be less deleterious, that would have been a mistake.
I think those provoked heavy urine heavy metal tests are the medical equivalent of the con artist who knocks a few roof tiles off someone's house and then calls round to point out the missing tiles and offers to replace them, for a fee. I'm glad the ABIM Foundation are drawing people's attention to it.
That is what a lot of these are about. They're also about not routinely doing unnecessary pretreatment tests (like advanced imaging such as CT scans and bone scans before treating early stage breast cancer). Peruse the lists at the Choosing Wisely website.
Krebiozen -- I'm reminded of the high-pressure tire salesman in "The Simpsons"?
"Yeah. Legally, I can't even let you drive outta here on
I propose an experiment.
Fill two swimming pools with water. Treat one with the recommended dose of chlorine. Let a homeopath add whatever he considers beneficial to the other (it will be potentiated in the process). Fill pool with children for a week.
Let homeopath decide which one to use.
Sometimes you read these lists and go "well, duh, no kidding.", and then you wonder which of your colleagues might actually be practicing medicine so off-base that this list was needed.
I don't think the outcome for either pool would be good, unless you have a secondary goal of producing a large number of plump, swollen raisin-children.
If homeopathic chlorine worked, it would bankrupt the pool care industry.
As I’ve discussed many times, a catch-all diagnosis from quacks of many varieties, but in particular from naturopaths, is “heavy metal toxicity.” I don't know where you're getting this information, but you seem to lack first-hand experience. I have seen several Naturopaths at the Canadian Naturopathic College of Medicine and none have ever suggested chelation therapy or any of the other crap you ascribe. I think you are stereotyping.
What crap have they suggested instead--homeopathy, perhaps?
@Curious I have seen several Naturopaths at the Canadian Naturopathic College of Medicine and none have ever suggested chelation therapy or any of the other crap you ascribe. I think you are stereotyping.
Where does Orac say that all naturopaths suggest chelation therapy?
Ah, the "no true Scotsman" fallacy. Seriously, dude. You need to get out more. Just Google "naturopath" and "chelation" and you'll find tones of naturopaths who do, yes, chelation therapy for "detoxification." For example:
I could go on and on, but it's easier just to say you're uninformed. Chelation therapy is a very common "detoxification" treatment in naturopathy, and a lot of naturopaths offer it.
I don’t know where you’re getting this information, but you seem to lack first-hand experience. I have seen several Naturopaths at the Canadian Naturopathic College of Medicine and none have ever suggested chelation therapy or any of the other crap you ascribe. I think you are stereotyping.
Ah, the “no true Scotsman” fallacy. Seriously, dude. You need to get out more. Just Google “naturopath” and “chelation” and you’ll find tones of naturopaths who do, yes, chelation therapy for “detoxification.” For example:
I could go on and on, but it’s easier just to say you’re uninformed. Chelation therapy is a very common “detoxification” treatment in naturopathy, and a lot of naturopaths offer it.
Like I said, you don't seem to have any first-hand experience, but I agree that "detoxification", except where medically necessary, is quackery.
Skepticalslug - it is implied
JGC - no homeopathy, accupuncture which helped my tendonitis and a tincture of botanicals to aid sleep.
I can't tell you how many times I've seen folks suggest bathing in bentonite clay to 'detox' heavy metals from bone.
I'm convinced these folks failed high school biology.
I'm convinced these people failed high school.
OK, maybe not. Even if someone had a pretty good grounding in science at school, it's easy to forget so much detail after a decade or two of adult life. I know I've forgotten a lot. It's the way you choose to live your life which determines whether you're happy to forget or are willing to re-learn.
Unfortunately there are too many external negative factors regarding "choose to live your life".
Omg, now you are supposed to drink unpasteurized milk instead of taking Tylenol? Where do they come up with this stuff?
Works best for those sporting an exoskeleton...
I've been hearing lately ( @ PRN) that those who lose weight must be VERY careful and should take up a regime of de-toxifocation because all of the toxins currently being stored in their fat will now be LIBERATED and will POISON them.
Fortunately, their chief honcho sells green vegetable powders which serve as chelators.
"Omg, now you are supposed to drink unpasteurized milk instead of taking Tylenol? Where do they come up with this stuff?
I'm surprised Healthy Home Economist hasn't been brought up in these blogs, the woman is, to put it delicately, a dangerous moron. I try to read it for a laugh but it always makes me sad and frightened. Why do people slavishly follow her?
@Mu and Chris Hickie
It wouldn't be homeopathic chlorine. It would be homeopathic e.coli and salmonella.
@TwistBarbie, one of my high school 'friends' posted this. I was laughing until the end of the article when it advised you TO KILL YOUR CHILDREN by drinking unpasteurized milk. I don't know why people follow her. Denice can answer better than me :)
I recall reading a case report of (IIRC) a gentleman that underwent a gastric bypass and lost over 100 pounds rather rapidly - and had some toxicity effects. Can't remember if it was mercury or what. I'll have to go looking for it.
drinking unpasteurised milk is hardly like drinking cyanide. It depends on the health of your cows. Pasteurisation was brought in to keep milk fresh longer, not (at least initially) as any kind of health measure.
Darwy @ 26:
In 1990-91 Iost close to 100 pounds in about five months (no bypass or anything, just finally got motivated) and I wouldn't be surprised if some of the effects I ran into weren't attributable to something like that, but what are you going to do? I'm still glad I did it.
Insert this I where needed.
Interesting. I lost almost 98 lbs in a year a few years ago....had I known how dangerous it was, and that I'm now riddled with the toxins trapped in my shed adipose tissue, I would have never done it!
In case anyone missed it, *SARCASM*
Did you read all the comments on the HHE article you cited? I found it especially revealing when a real MD (as opposed to chiros, naturopaths, homeopaths, etc.) chimed in and debunked the survey, all the while respectfully and politely explaining why it's a weak study and providing real evidence.
The Home Economist immediately resorted to insults and denialism aimed at the MD. At least a few other commenters supported the doctor and said they'd never read her blog again.
I'm surprised she didn't just delete the doctor's comments.
@ Scared Momma:
re why people follow woo-casters...
Denialism allows them to thumb their noses at reality and the vicissitudes of life, including illness.... disability... and death.
They can talk themselves into believing that they are indeed exceptions to the rule and that by simply eating correctly, exercising and taking supplements they will be spared. Yes, right, everything's under control or so they think. I hear this incessantly at PRN and NN.
They also share in the dim-witted belief that they are ahead of science and soon will be riding the crest of the wave of Paradigm Shift, tsunamically washing SBM away, leaving only them and their cherished notions intact, triumphant.
some people ingest contaminated food or drink and become very, very ill- there is no supplement that will protect you from this. Being a vegan or eating only raw food** or exercising aerobically for an hour a day won't help either.. if the bacteria are there and you ingest them...oh, guess what.. the bacteria doesn't care if you live healthily.
My friend visited India and lost 30 lbs because of bacteria.
People may get away with believing in personal invulnerability as long as they don't get really sick. Or they may play around with the notion of personal controi of illness- someone with asthma only takes the inhaler when having obvious symptoms ( not using 2 meds as directed) or one with depression only takes meds when absolutely necessary ( not as prescribed)*** It's a way to feel control.
Every now and then though, reality throws a gallon of ice water upon your pleasant dreams and you learn that you have a ONS meningioma and it has to come out- or else you'll go blind in a few months ( a cousin learned this on Tuesday).
Of couse, woo-meisters will say that the examples I gave are NOT people who live a healthy lifestyle****..in other words, they BROUGHT IT ON THEMSELVES. Similarly if one of their vict...um,,,er, CLIENTS, doesn't improve or experience a cure, he or she obviously did something wrong. It's his or her own fault.
I would venture that alt med proselytisers may also be believers in their own message, perhaps having had developed it as a reaction to witnessing illness and death in their own families and feeling helpless and afraid of the future . So perhaps they believe their own press and mis-information as self-protection but I think think that relying solely on psychological defence mechanisms should not serve as a living plan .
In reality, we all postpone and push away reality to a limited degree BUT at some point, we do have to call it pathological.
** lettuce might even MAKE you ill as we've learned.
*** true examples- welcome to MY world
**** and they know me, what would you expect?
No, I didn't cite it myself, I was replying to Scared Momma who did, so I didn't read that particular article, but sounds typical of her response to anyone who doesn't agree with her. I'm glad the brave MD who decided to wade into that quagmire of BS managed to sway some people.
If you want to see some real crazy nonsense read her article about how she cured her sons dental caries (which she repeatedly refers to as a "tooth hole") using fermented butter capsules or some goofy crap like that. She gets a thorough bashing in the comments by several dentists.
TwistBarbie @33 -- Dental caries are one of the few instances in which Sarah Palin's moronic slogan is actually appropriate:
Scientology has a quacky detox program called the Purification Rundown consisting of massive doses of niacin and B vitamins, running and hours and hours in a sauna. It's supposed to release all the drugs you've ever taken and environmental toxins trapped in your fat. Tom Cruise tried to get the FDNY to send all their 9/11 first responders to do this. There were the usual tales of purple goo coming out of people's skin and miraculous recoveries. It's very expensive, useless and dangerous, just like the rest of Scientology.
Denise, as usual, you hit the nail directly on the head. We are fragile monkeys in the big scheme of things.
#33 Oh... gosh. That poor child. That would be so incredibly painful. I'm surprised the child's screams of pain didn't alert her that was a bad idea.
Holy sh*t, I actually went to that demented home economist's site. I need a shower and some brain floss to get that crap out. I don't know how that doctor kept his cool. And that super quacky "doctor" grobbling on about "energy" and lungs and the like. What was all that about?
Geez, that "home moronist" is scary. I wouldn't be surprised if she recommended trepanation for headaches.
I just spent a couple of hours perusing the comments on the "self-healing tooth hole" story on the HHE site. Up until now, I really thought there were paranoid, deluded fools posting comments on Natural News and InfoWars, but the comments on that one story beat anything I've ever read on Adams's and Jones's sites. And the Economist's responses to some voices of reason are among the rudest, most hateful and ignorant comments I've ever encountered.
I don't know why comments like those make me so angry and feel so discouraged with mankind but they do. Those people really do believe that every medical professional is motivated and controlled by conspiracy, greed, corruption, deliberate malpractice, incompetence, "the banksters" and and an underlying drive to maim and kill their patients.
It's flu vaccine time, and I'm seeing an increase in anti-vaccine woo on social media feeds. Any suggestions?
@ Khani: Dr. Mark Crislip, an infectious diseases specialist, has posted his annual seasonal influenza vaccine article on the SBM blog. It's loaded with excellent links that you can use, when you encounter anti-vaccine woo on social media feeds.
Pareidolius and Dr. Hickie,
Kudos for being brave enough to wade into the cesspool of the HHE site and posting comments. That quacky energy "doctor" John Foley isn't an MD; he's a chiropractor and "nutritionist" who embraces homeopathy (natch), is an EMF scaremonger and touts all sorts of "bio-energy" woo. You should check out his website if you want to see pseudoscience in action.
Q: You are known far and wide as an expert on Environmental Toxicity. What does that mean, exactly, and how do you help people?
We are assailed by toxins on a daily basis and, sadly, most of us aren't even aware of it. Our air is toxic, our water is polluted, and our food is depleted of nutrients and packed with chemicals and hormones. It has now gotten to the point where babies are born toxic due to the toxic load of their mothers. A 2004 study by the Environmental Working Group (EWG) found that blood samples from newborns contained an average of 287 toxins, including mercury, fire retardants, pesticides and Teflon chemicals. The complex health problems of the 21st century are not only related to diet and lifestyle, but caused by the buildup of toxic chemicals and metals that have overwhelmed the body's vital organs and systems. I always find toxicity to be the major cause of all hormone imbalances, Autism, ADHD, Chronic Fatigue, Fibromyalgia, Cancer, heart disease, digestive disorders, skin problems, anxiety, depression, headaches, asthma, allergies, infertility, autoimmune disease, and much more. Much of the pain and suffering caused by our toxic lifestyle can be avoided and even reversed. The body is perfectly designed to heal and repair itself when given the correct nutritional regimen, and the toxic buildup can be identified and removed with precision. I am a Master Clinician of several 21st century cutting edge Bio-energetic testing systems that are clinically proven to determine the exact cause of ill or non-optimal health.
Q: Tell us how you help families dealing with Autism and ADHD.
Since starting out in cellular biology and research 16 years ago, I have been searching for the cause of these childhood epidemics. Our medical establishment overlooks the adverse effects of low-level, chronic heavy metal exposure. Aside from treating symptoms, our current health care system does not offer much hope for these children. After helping over a thousand children with Autism and ADHD from all over the country, I can confidently state that there is genuine hope, and the chances for complete recovery have never been greater. I use the extraordinary properties of the human cells and tissues to bring about healing and health changes exactly as nature intended. The power of the body to heal itself is truly awesome in every one of these children, once the toxic buildup is removed from the brain and body. I'm an expert at scanning the brain and other organs for dozens of toxic metals and chemicals that we are all constantly exposed to (mercury, lead, aluminum, arsenic, formaldehyde, etc). Food allergies typically show up in the presence of these toxins and they are treated, along with nutritional deficiencies, for optimal healing. Due to the dramatic clinical improvements and complete recovery that often occurs in these children, many parents have encouraged me to write a book and create a documentary film.
Q: What is your training?
I am an established Clinical Researcher and Nutritionist, specializing in advanced Bio-energetic technology. I have extensive experience and expertise in the fields of environmental medicine, detoxification, pediatric neurology, functional endocrinology, homeopathy, herbal medicine, naturopathy, anti-aging and weight management. I am also a Board Certified Chiropractic Physician and Physiotherapist.
Sorry to leave you out. Kudos to you too. You all need decontamination showers now.
I had to look up trepanation. In the process, I found a website that promotes the practice. Note the "controversy" page; as if there are two sides to the story:
This reminds me of a low-budget horror film I saw a few years ago where a father and son hillbilly team capture victims and drill holes in their skulls to, er, shall we say, pleasure themselves. I forget the title, but believe me, you don't want to see the movie.
"Known far and wide as an expert on Environmental Toxicity"
My @ss he is.
Did she ever specify whether curing the "tooth hole" was that it was a baby tooth that merely rotted and fell out, leaving no lasting damage aside from what must be some scarring memories?
@Woo Fighter and Dr. Hickie,
That trepanation "controversy" is so upsetting it's funny... Brain doctors seem to view this invasion of the cranium's hallowed realm as a violation of some universal taboo. Yeah, how about the taboo of not going into my sterile neural space outside of an operating room setting with a highly-trained "brain doctor" in meticulously clean settings for a specific medical indication? I need to look into this, I had no idea this was coming back into vogue. My degrees are in physical anthropology and paleopathology...there were many who survived--at least long enough for bone to start to heal--but a lot more who didn't.
There is an extensive scientific literature on trepanation both in medicine and anthropology. The risk to benefit ratio would have to have been very favorable for the practice to have been so widely practiced but official investigators haven't been able to see that there is a both a rationale and a benefit to this procedure.
Risk-benefit ratio in a time when simple cut could be a death sentence? Or when mental illness was understood to be demonic possession? I don't know if looking at risk-benefit ratios for medical procedures in antiquity is always a good idea, the risks were generally so high (whether due to real or imaginary afflictions) for the original condition that yeah, last ditch, why not?
Read what lilady posted! Hilarious and informative. We've started our vaccination-declination period in accordance with hospital policy and NYS law, some of the stuff we are getting is downright hilarious. It is every year, but it seems worse now that the state is in on it. It's pretty well established amongst IPs in NY that this is probably the first step on the road to absolute mandate (outside of real medical contraindications) and the employees declining know that too. One told me she would quit...really? You're gonna give up a state retirement (this chick is my age, retirements aren't common in the under-30-crowd) when it's mandated? Ok then. Another told me the CDC should stop focusing on the flu and start working on a West Nile Virus vaccine because it's a much higher risk than influenza. What? Not to belittle WNV, but seriously? We also apparently have an incredibly high rate of people with a history Guillain-Barre...someone really needs to study why we're so much higher than the baseline *eye roll* Someone once came in to fight the policy in general last year, screaming she doesn't like when patients ask her why she's masked. It's a "scarlet letter." Yes, that is part of the point. We know the evidence for mask-protection is spotty...we want you to be uncomfortable and stand out if you are endangering patients. It's coercion and the next best thing to vaccination save you no longer working here! And I absolutely love hearing that the patients know to question it and say something. But my blood pressure skyrockets this time of year.
Oh, sorry for not closing the italics on the quote, everyone. Ouch, that makes my brain hurt. Maybe I should get trepanned.
re : flu vaccine time
Today Dan Olmsted doesn't disappoint us with his initiative to boycott a large retailer who advertises flu shots AND ( horrors of horrors) donates free vaccines to poorer countries. The advert video is voiced by a friendly-sounding actor and children in ( probably) south Asia and Africa are shown.
Dan tells his readers to boycott the store and readers chime in voicing their alarm that this is NOT the only store that is distributing the deadly jab. They're SURROUNDED!
I and my family drank unpasteurised milk for fifteen years or so and never had any health problems that could be traced to it. Then the law was changed so that our milkman couldn't sell it any more, so we switched to the pasteurised stuff. There was no change at all, we couldn't even taste the difference.
Unpasteurised milk is simply milk that hasn't been heat-treated. It doesn't have any health benefits, but it's NOT poison. If the cows are healthy and TB-tested, and the milking equipment has been thoroughly sterilised, there won't be a problem.
I again thank you for your kind words: where should I send the money?
re Sarah, the HHE
Although a quick perusal of her work does reveal *beaucoup de woo*, she is not any more looned out than many of those I survey or their adamant followers. For example, she writes about methods to *overcome* the effects of antibiotics whereas I've heard about total avoidance of anti-biotics more often than not . How about natural remedies for MRSA? ( yep, @ Talkback @ PRN).
If you want to read some truly lunatic posts, I suggest Gaia Health or Green Med Info for smaller venues and of course,
Natural News or PRN, for ridiculous advice on a grander scale, naturally.
BUT then, I am so de-sensitivised and aclimmated to pseudo-science, it takes a lot for my Signal detector to scream out, 'DANGER"
sophia8 - what you say is correct. However, there are substantial opportunities for raw milk to become contaminated at various points in the route from udder to carton, and these are what pasteurization helps protect against. If your dairy and farmer are highly vigilant, and the cows don't get infected without being noticed, then the risk is likely relatively small for an individual.
Given that many homeopathic remedies have been found to contain significant and even harmful levels of the substances, I think it might actually be better that they left it the way they did. Many doctors don't mind if their patients take homeopathic remedies on the basis that it's just a harmless affectation -- basically a placebo. So I'd rather they if they did add detail, it would be to remind that even homeopathic remedies can be contaminated or not what it says on the bottle.
But preserving freshness *is* a health measure! One of the major reasons people want fresh milk is because going "off" is a sign it may not be safe to drink, unless you've introduced a known bacterial culture to produce yogurt or buttermilk or whatnot.
Yes, pasteurization was widely adopted to keep milk fresh longer. But ask yourself why people *wanted* fresher milk.
I'd also want the cows vaccinated against rabies. There was a bovine rabies case at a raw milk dairy a few years ago, and rabies is still endemic in most of the US. In England, you'd be pretty safe from that -- they have extirpated rabies. But as there was a bovine rabies case associated with a raw milk dairy in the US just a few years ago, I'd want some assurance that the cattle had been vaccinated. (And before you ask, yes you can get rabies by drinking the milk of a rabid cow. This is a documented mode of transmission.)
Regarding trepanation: having dealt with severe headaches from time to time, I can totally understand why this became widespread. And I know mine are not the worst ones that people can get. As it is, if I thought amputating a limb would forever cure me of it, I'd try it. Seriously. Go back a thousand years, and the idea of drilling a hole in the skull doesn't seem quite as crazy, and given that some people have headaches bad enough that they contemplate suicide, trepanation probably seemed reasonable.
And sometimes it would work! If you've had a head injury, it can prevent brain damage due to swelling, and modern surgeons will remove part of the skull for this purpose sometimes. The occasional times that people did this and survived would have encouraged ancient doctors to keep trying.
@ Calli Arcale
why people wanted fresher milk was because they started living further away from cows, in cities. it was not, and never had been about health. It was about getting milk that didnt become yoghurt before it hit the coffee. And the bacteria that commonly cause milk to go off are generally pretty similar to the ones in yoghurt....which many choose to eat. Granted there are others too but there you go. Unpasteurised milk is only a risk where the cows are unhealthy- as you mention rabies and TB....its not just England you know. Unpasteurised milk is available and drunk commonly in most european countries. It is more common in rural areas because of the shelf life but I live and work in Zurich and our main source of milk here is unpasteurised. The simple fact is that the US is out of step with most developed nations and has spread fear around unpasteurised milk for two reasons. Firstly the appalling (to europeans) low standards of animal husbandry and inspection tolerated by US producers and secondly (this one admittedly may simply be prejudice) in order to defend the alleged US cheese industry from having to compete with well made cheese.\
Instead of implementing farm inspection and animal husbandry controls which eradicated TB transmission via the bovine route in Europe the US chose to simply accept diseased cows and treat the milk. Wierd huh?
You are right it isnt a cure for anything- its just milk. but its also not any more dangerous than, say, eating steak. rare.
#46 West Nile is horrible and like shingles, can cause lasting nerve pain and weakness. I've heard it described as "It felt like my core was on fire."
It'd be great to have a West Nile virus vaccine, and I have been told researchers are working on one. But there's no reason we shouldn't work on the flu vaccine too. They're both horrible.
Honestly, if I were in the hospital and had a nurse with a mask, and found out the nurse was not vaccinated, I would ask for a different nurse. I prefer science-based care for my loved ones.
#53 Of course, TB is not the only thing you can get that way...
Besides pasteurization another thing these folk are against is homogenization. They say the fat globules are so small they go directly into the bloodstream and clog the arteries or something .
incitatus,The correct analogy would be eating raw hamburger. In a typical steak any contamination would be on the outside, which would be sanitized by the cooking process. Milk is a liquid; any contamination or infection would be mixed with the entire batch. This is similar to hamburger, where anything on the outside of the muscle is well blended to the entire batch.
Fortunately, nobody has ever suffered health affects from drinking contaminated raw milk or contaminated raw hamburger.
no but all the others also get dealt with the same way...minimum standards of husbandry and inspection.
The bans on unpasteurised milk products i think feed into the woomongers hands- it becomes the government banning a good/natural thing. its much harder for them to argue with hygeine and husbandry measures given the propaganda they already use. Homogenisation is another thing- that was (in europe anyway) only ever about supermarkets making money. one wonders if the woosters have ever looked at the range of particles and globules in natural milk- its not like the small stuff isnt there.
I didnt claim it was risk free. and ok shall we say steak tartare?
the point is that provided you treat the cows well and milk in a hygeinic way the risk from unpasteurised milk itself is pretty low. Certainly lower than some other food risks which are tolerated even in the US. The bans on unpasteurised milk products are something that are hard to understand from teh point of view of, well, anywhere with decent inspection routines. or even france. If dirty, disease ridden, backward countries like Switzerland allow this filth then certainly it should be banned. after all the Swiss have a huge rate of vicious milk carried disease sweeping the nation.......
the point is that something that in the US, due to laxity in US farming and dairy practice, is seen as a dangerous health risky item is actually a normal part of the diet in many developed nations and is seen as a very low and acceptable risk. Less of a risk, in fact, than say sushi, or supemarket salad bars or many other items of a westernised diet. Its only seen as a problem on your side of the pond and the evidence for it being a danger in areas with good husbandry standards is not obvious.
Thing is I know that most of you guys are coming from a situation where unpasteurised milk is seen as abnormal/dangerous. but you need to recognise that this makes little sense from other countries where unpasteurised milk and milk products are a big part of the diet with little apparent downside. And that this difference is due in part to historical choices on the best way to tackle milk related health problems.
As this review puts it:
Most commercial milk is contaminated with cow feces to some extent which is one reason I am happy that the milk I drink is pasteurized. I drank unpasteurized milk as a child and it did me no obvious harm, but then I had influenza, measles, mumps and chicken pox too.
Why take the risk when there is no benefit to unpasteurized milk and many risks?
Quite honestly, you guys also don't vaccinate against chicken pox, either, so I'm not sure that "x doesn't see it as a problem, it's only a problem in filthy America" is a good argument, I guess.
Most commercial milk is contaminated with cow feces to some extent
You really have to grow up on a dairy farm to realise what filthy animals cows are.
A drive through Texas on a superhighway ~ 15 years ago, abutting cattle meat processing plants, convinced me. I think the noxious fumes took the paint off our rental car.
Information from the CDC about drinking raw milk/milk products:
I assume that was meant sarcastically, but the Swiss have had at least one epidemic of listeriosis associated with consumption of unpasteurized dairy products in the recent past, with at least 18 deaths.
I lived on a pig farm for a while, but not a dairy farm. Nevertheless I have seen quite enough cow feces being sprayed around to have become extremely skeptical that none of it ends up in the milk being extracted from udders at the same end of the animal. Feces from herbivores may not be as bad as that from carnivores, but can and often does contain some nasty human pathogens.
Well that spark of curiosity led me to some grim reading. I found that Campylobacter infection from unpasteurized milk is thought to be a major cause of Guillain Barre. I learned about an outbreak of Streptococcus equisimilis in the UK in 1984 that killed 7 people and that was spread by unpasteurized milk. I also learned that In the U.S., a strain of E. Coli (EHEC O157:H7) causes approximately 73,000 illnesses, 2,000 hospitalizations, and 50-60 deaths each year, and similar misery and death in other countries:
I think I'll stick with pasteurized* milk and cheese, well-done burgers and I'll pass on the steak tartar. I'm safe with UK sausages as they contain so little meat.
* To be honest I don't care if it only comes up to my chest - an obscure reference for a Saturday night.
@ #54 Khani,
That was exactly my point. She was using a lack of a WNV vaccine as an argument against the importance of the flu vaccine...a terrible, zoonotic disease in which a majority of cases are subclinical and it isn't transferred from human to human vs. a bad, TRANSMISSIBLE respiratory virus that has a symptom-free infectious period of up to 48 hours and causes 1000s of deaths. In a cancer hospital. From an infection prevention standpoint, shingles is worse than WNV...if you lost your immunity (or never had any to begin with) you could catch chicken pox from active shingles. That's why, in my mind, WNV isn't as high risk as the others, especially for a health-care worker. The comparison was nonsensical in my mind. But you're right...why does one negate the importance of the other? It always baffles me what some people choose to fear. And I would too, just based on principle. You won't accept a shot, but you're going to treat me? No thanks.
Re: raw milk, I've had it, I don't notice a difference in taste...pasteurized milk from my local Wegman's is cheaper so that's the way I go. I do eat cheese made from raw milk, which I've rationalized to being like eating my steak or duck rare (and my hamburgers medium-rare, I grew up in a family that only cooks its meat because it's not socially acceptable not to) just because I like it. I know the risks for myself with that but...yeah, I really have no defense for myself. But I would tell anyone compromised to avoid it, and we don't allow it in our patients' diets. An interesting exercise would to be ask all those denying a flu shot due to a risk of GBS what their feelings on raw milk are...as one of the most common contaminate of raw milk is campylobacter...which has been readily associated with an increased risk of GBS.
Denice, I'm pretty sure more than one retailer is doing the donation-thing, and if they are simply refusing to go anywhere advertising the shot, well, they're going to be living without a lot of stuff for a long few months. Although I'm sure many of them shop at the Huggy Lovey Hippie Patchouli Shop anyway. Target is even doing a promotion where if you get the shot you get a coupon for 5% off your entire purchase that day. Even if I wasn't so passionate about vaccination, I'd get a shot just for a coupon! They must be getting beaucoup Pharma bucks to offset that promotion. *eye roll*
I take it you have never lived or been in Iowa. I have lived in Iowa for much of my childhood, and let me tell you, pig farms stink to high heaven. They're worse than cattle farms. Once you make the mistake of driving past a pig farm with the windows down, you never make that mistake again.
About cows, one really only has to look at them to realize the problem -- the udder is directly below the rectum. It would require a minor miracle for it to never be contaminated. Washing the teats certainly helps tremendously, but it's never going to stop all of it. And it won't do a damn thing against rabies or listeria, which are systemic infections.
Incitatus -- spoiled milk and yogurt are definitely NOT the same thing. It depends on what organisms you have in there. E. coli isn't helpful at making yogurt, for instance.
@ #32 "I would venture that alt med proselytisers may also be believers in their own message, perhaps having had developed it as a reaction to witnessing illness and death in their own families and feeling helpless and afraid of the future."
That sounds very common. There's also others that got interested in health through some sort of woo, and they probably jumped into it without having much (or any) scientific literacy or critical thinking skills, basically not questioning any of the info.
Sadly they may also fall for the conspiratorial talk, parroting the same combination of prejudice, disinformation, logical fallacies and unscientific statements. It's not unheard of that certain quacks preach oversimplified answers and sensationalism and a level of spin that defies the laws of physics (like that piece of sh*t "Health" Ranger).
In grad school I helped a classmate drive out to a slaughterhouse west of Houston to collect bovine tracheas, which they used in their lab to isolate a Na-Cl transporter protein that was similar to the CFTR protein that is defective in people with cystic fibrosis.
Anyhow, I had never seen how meat processing works, and it was at one level impressive (how quickly after killing the cow they could skin/drain/dissect it), but at another level, the smell of the place was something I couldn't shake for a few days and I didn't want a burger for about a week. It didn't change me into a vegetarian, but it did convince that meat really needs to be cooked well.
Also, regarding milk--brucellosis is an infection one can get from drinking unpasteurized milk. I believe it is more common with goat milk (which people seem to want to give to their babies here) than cow milk. I think it is one of those "uh-oh...someone didn't clean that udder" infections. I've never actually seen a case of brucellosis, but I have seen infants on goats milk with allergic enterocolitis because their intestines weren't ready for another specie's milk yet.
brucellosis is an infection one can get from drinking unpasteurized milk
The name itself is a source of amusement here, being naturally enough an occupational hazard for dairy farmers, who are always called Bruce (or Trev) according to the stereotypes.
I have never had the pleasure of visiting Iowa, but I was raised in East Anglia in the UK which has plenty of pig farms, and I lived on one for almost a year*. They do indeed smell far worse than dairy farms but you do get used to it quite quickly. There was, still is, a pork factory next to the village I lived in as a child which smelled terrible. A few miles in the other direction was a flavors and fragrances factory which emitted an odor that was a combination of cheap perfumes and food flavorings. It depended which way the wind blew which we were treated to. On balance I think I preferred the pig factory smell. However, I think silage is probably even worse than either.
These days I'm anosmic, my sense of smell having been completely destroyed by a chronic infection, so I am weirdly nostalgic even for foul smells.
* Feeding the runts by bottle in the kitchen was fun, the rest not so much.
#67 Mosquitos are extremely prevalent in the Midwest, so I think WNV is pretty scary, myself.
You don't think about dying horribly after five months in a hospital while you're playing on the swings on a sunny day with your kid, but one mosquito bite later...
Unpasteurized milk also spreads tuberculosis: this is not a major health problem in the developed world because most of the milk is pasteurized. Not because British and other European cattle are somehow magically TB-free. They're not.
hdb: "The name itself is a source of amusement here, being naturally enough an occupational hazard for dairy farmers, who are always called Bruce (or Trev) according to the stereotypes"
It is also called undulant fever. My step-mother had a graphic description of her suffering with it as a teenager in the early 1940s in Wisconsin, right there in America's Dairyland.
@ Woo Fighter...
"You all need decontamination showers now."
Only if Ursula Andress joins me.
@ herr doktor bimler:
Just for the record, I have never milked a cow in my life.
Please don't tell me that "T" stands for Trevor
We recently had an cluster of listeria cases in western Canada with one or two fatalities as result of raw milk cheese from a source in British Columbia.
How useful! Thank you Orac, I found some interesting advice on my migraine :)
Heh. It turns out that Heartbeat in the Brain is not completely lost, having been screened in London in 2011. This really needs to make it to DVD. Somebody get Criterion on the blower.
It's been a while since I've surveyed this stuff, but I'm pretty sure that there's a photo gallery of a more recent self-trepanation out there.
^ (Or, perhaps, one Eli Kabillio. There's a dandy double feature here just waiting to happen.)
Oh, wait, scratch that. I have a terrible habit of mixing up the titles of the original and the later film, sorry. The urine one still might be promising.
Apologies if anyone else has already posted this. It's not exactly on topic but is still quackery!http://www.stuff.co.nz/world/australia/9223578/Chiropractor-breaks-baby…
Well that's reassuring:
"Chiropractic care can be remarkably gentle,"
Peter Bowditch, among other sceptics, has done a great job covering this story. He has reprinted a news release the Chiropractors' Association of Australia issued today demanding a retraction.
Just scroll down a bit here:
I wonder how many consumers of woo (woosumers?) know how much radiation they absorb on the plane out to the natural-healing sweat lodge retreat in Arizona, or from the granite facings on the walls of their naturopath's office building. Or whether they're inhaling pyrobenzene and other nasties when they get moxibustion, or in that sweat lodge session. Does the ink their favorite natural health publications are printed with contain harmful levels of selenium that will have to be chelated out of them by their favorite quacktitioner (I doubt that one, since they all take megadoses of selenium anyway.)?
By the by, just now my spellcheck suggested "megadeaths" instead of "megadoses". Firefox seems to have a sense of humor.
The chlorine challenge reminds of the famous duel between the 19th Century pathologist Rudolf Virchow and Otto von Bismarck. Virchow sat in the Prussian parliament and pushed a pork inspection law that the Iron Chancellor opposed. He challenged Bismarck to a duel: they would choose blindly from two pork sausage sandwiches, one made with pork inspected for trichinosis and one not. Bismarck declined and Virchow got his law passed. At least that is the story as I learned it.
It may be why the quote "Laws are like sausages, it is better not to see them being made." is (wrongly) attributed to Bismarck.
@Kelly M. Bray:
"“You all need decontamination showers now.”
Only if Ursula Andress joins me."
She's 77 years old and the famous white bikini was sold at auction years ago. Have fun.
Thanks Woo-Fighter, I see he has too. I often don't get my Ratbags update alert email until a couple of days after he posts new things!
@Narad - The "star" of Heartbeat In the Brain, Amanda Feilding, is currently a writer for......wait for it......The Huffington Post!
Oddly enough, her Huffpo bio leaves out the little detail that she DRILLED A HOLE IN HER SKULL!
"We recently had an cluster of listeria cases in western Canada with one or two fatalities as result of raw milk cheese from a source in British Columbia."
I'd be curious to know the details. My impression was that the aging process for raw milk cheese, when sufficient, eliminates listeria. That and/or the salt/moisture content.
The BC cases were quite recent and were caused by E coli O157, not Listeria. There was one death suspected to be caused by this infection and several other documented illnesses as a result.
It would have worked if you hadn't stopped me.
"I found that Campylobacter infection from unpasteurized milk is thought to be a major cause of Guillain Barre. "
It reminds me the way antivaccinationists argue that polio vaccine is a cause of cancer, after picking up a citation in pubmed. Comparison of Guillain Barre incidence in France and US is sufficient to disprove this statement.
Actually, there is no doubt that unpasteurized milk can cause several deaths a year in the world, but how doest it compare to "legal" tobacco?
@ Daniel Corcos:
“I found that Campylobacter infection from unpasteurized milk is thought to be a major cause of Guillain Barre."
Perhaps Krebiozen should have phrased his statement in two parts, i.e.
"I found that Campylobacter is a major cause of food-borne illness after consuming raw milk http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6234a4.htm
and a recent C. jejuni infection is a major cause of Guillain Barre Syndrome at its subtypes".
GBS is a postinfectious, immune-mediated disease. Cellular and humoral immune mechanisms probably play a role in its development. Most patients report an infectious illness in the weeks prior to the onset of GBS. Many of the identified infectious agents are thought to induce production of antibodies that cross-react with specific gangliosides and glycolipids, such as GM1 and GD1b, that are distributed throughout the myelin in the peripheral nervous system.
The pathophysiologic mechanism of an antecedent illness and of GBS can be typified by Campylobacter jejuni infections.[4, 5] The virulence of C jejuni is thought to be based on the presence of specific antigens in its capsule that are shared with nerves.
Immune responses directed against lipopolysaccharide antigens in the capsule of C jejuni result in antibodies that cross-react with ganglioside GM1 in myelin, resulting in the immunologic damage to the peripheral nervous system. This process has been termed molecular mimicry.[6, 7]
Pathologic findings in GBS include lymphocytic infiltration of spinal roots and peripheral nerves (cranial nerves may be involved as well), followed by macrophage-mediated, multifocal stripping of myelin. This phenomenon results in defects in the propagation of electrical nerve impulses, with eventual absence or profound delay in conduction, causing flaccid paralysis. Recovery is typically associated with remyelination.
In some patients with severe disease, a secondary consequence of the severe inflammation is axonal disruption and loss. A subgroup of patients may have a primary immune attack directly against nerve axons, with sparing of myelin. The clinical presentation in these patients is similar to that of the principal type.
Acute inflammatory demyelinating polyneuropathy
The acute inflammatory demyelinating polyneuropathy (AIDP) subtype is the most commonly identified form in the United States. It is generally preceded by a bacterial or viral infection. Nearly 40% of patients are seropositive for C jejuni. Lymphocytic infiltration and macrophage-mediated peripheral nerve demyelination is present. Symptoms generally resolve with remyelination.
Acute motor axonal neuropathy
The acute motor axonal neuropathy (AMAN) subtype is a purely motor disorder that is more prevalent in pediatric age groups. AMAN is generally characterized by rapidly progressive symmetric weakness and ensuing respiratory failure.
Nearly 70-75% of patients are seropositive for Campylobacter. Patients typically have high titers of antibodies to gangliosides (ie, GM1, GD1a, GD1b). Inflammation of the spinal anterior roots may lead to disruption of the blood-CNS barrier. Biopsies show wallerianlike degeneration without significant lymphocytic inflammation....."
P.S. Daniel Corcos:
I don't recall Krebiozen, or any other poster on this thread, comparing deaths from unpasteurized milk and deaths from tobacco use.
"Perhaps Krebiozen should have phrased his statement in two parts"
Yes, and perhaps the antivaccinationist should have phrased: "SV40 can cause cancer" and "SV40 was present in polio vaccine" ;-)
'I don’t recall Krebiozen, or any other poster on this thread, comparing deaths from unpasteurized milk and deaths from tobacco use.'
That is precisely the problem.
Um, nope. The scientific research does not support the finding of SV-40 causing cancer in human beings, in spite of that virus being found in certain lots of polio vaccines, years ago. Orac's friend recently wrote about that bogus anti-vaccine theme that gets new play every few years:
If you want to discuss the proven links between tobacco use and cancers, perhaps you ought to discuss that topic on your own blog...rather than derailing the thread on this blog.
P.S. If you insist, I can locate disease-causing C. jenuni contamination in raw milk and in soft cheeses produced from that raw milk produced in France....as well as cases of Guillain Barre Syndrome associated with a recent infection caused by that C. Jejuni bacteriosis.
And then you will sue french cheese makers for any disease you would get in France.
You are incorrect in your comparison. There is compelling evidence that the polio vaccine and SV40 does not cause cancer in humans. There is also compelling evidence that Campylobacter does trigger GBS and that consumption of unpasteurized milk is a major source of Campylobacter infection. Are you seriously suggesting that I am unjustified in connecting these two facts?
BTW, I did more than pick up a single citation in PubMed, I browsed through several papers including the review I cited above (published in a reputable journal) which concludes:
There doesn't seem to be much, if any, doubt about this.
Citation? My reading suggests that GBS incidence is similar worldwide, but I couldn't find any incidence figures for France. This study examined stool samples in GBS patients in France and concluded:
Campylobacter does appear to be a serious problem in France, with widespread infection of cattle and concerns about the development of antibiotic resistant strains.
Favorably, no doubt; I try to persuade people to stop smoking tobacco too. Unpasteurized milk kills far more people than SSPE which is also preventable. I don't see your point. Which preventable deaths should we attempt to prevent, and when should we just shrug our shoulders?
Not all cheese is aged. Hard cheeses, yes, that will eliminate listeria. You can chow down on raw-milk Reggiano. But raw-milk Camembert is not recommended for pregnant women because of the small risk of listeria.
I think it's a case of "well, that's SUPPOSED to be poisonous", sort of like alcoholic beverages. Not that anyone generally wants to admit that they're recreationally consuming a poison. ;-) But that is how people are. If you took the nicotine out, nobody'd start smoking. And although grape juice is perfectly fine on its own, people actually enjoy the buzz they get from the fermented version.
But that's the point -- they *know* it's dangerous, and the dangerous part is actually relevant to why they're consuming it. Nobody drinks raw milk because they want listeria or campylobacter or rabies. They drink it because they think it will make them healthier. Since the evidence actually points the other way, this is pretty foolish. Some drink it because they believe it tastes better, although it's arguable whether this is any different from how expensive wines taste better than cheap wines, even if they are in fact the exact same wine in two different bottles. Anyway, if you don't want it cooked, we could just introduce irradiation; you get all the health benefits of pasteurization without cooking the milk.
May be improper conduct? Hello!!!!
In France, we prefer "camembert au lait cru", not because we believe it is good for health, but because the taste is much better. You must try to know. in the US you really miss something. And prevalence of C. Jejuni is lower In France than in England.
The Choosing Wisely campaign - which actually represents evidence-based medicine, not Science-based medicine - asks professional associations to flag needless or harmful practices that their own members may engage in. The idea is that it's harder to reflexively defend overtesting and overtreating when the criticism comes not from "outsiders" but from your colleagues. It would indeed be nice to see something similar from naturopathy groups. However, these folks you quote are recommending against practices used by people with competing professions or ideologies.
That might not create such an appearance of bias if they had limited themselves to the second through fifth recommendations you quote. Those are sensible. But the first really blows the deal. Never use any botanical for anything?? Really??? First, this is the exact equivalent of "Never use any allopathic single-compound drug to treat or prevent any disease", which I'm sure you can see to be so general and poorly supported a recommendation as to be totally worthless. A one-sentence statement of pure ideology regarding the worthlessness and yet potent toxicity of, apparently, the plant kingdom in general should cause us to discard the results of not just millennia of experience, but many hundreds of clinical trials? If this is not just grossly unscientific protectionism, it is the sort of scientism that demands that we ignore the results of actual published science.
Even the lay person who does not read clinical trials and reviews knows that many of the evil botanicals in those evil supplements are also common foods and beverages. Ginger, garlic, peppermint, elderberry and chamomile are conventional foods, as are prune juice, coffee, and many other substances that have been adequately demonstrated to be bioactive. They are safe. Even us peasants know that they do not magically become poisonous when used with an expectation of benefit. The attempt to create evidence-free FUD about all of them as a group looks very much like it is motivated more by a desire to keep the sheep in the pen and regularly sheared than by a desire to see us maximize our health or happiness.
That's some straw man you've built there, jane.
How does this remotely equate to "the worthlessness and yet potent toxicity of, apparently, the plant kingdom in general"?
Do you agree that there is "a lack of stringent quality control of the ingredients present in many herbal and dietary supplements"?
Daniel -- when I've been to France, I have enjoyed the real stuff. It is indeed much superior to what comes out of Wisconsin with the misleading label of "Camembert". ;-) Flavor as a reason I can get behind. It's taking a calculated risk, as with steak tartare and sashimi and pretty much any buffet line anywhere.
It would only be "an exact equivalent" if there were Phase I, II and III clinical trials demonstrating the safety and efficacy of those botanical solutions, sufficient for them to receive FDA or EMEA approval..
It is a calculated risk, indeed. But, except for pregnant women, the risk with the "camembert au lair cru" is very low as compared to risky behaviors like driving a car, swimming in the sea, or having sex with only one condom.
Are you sure about that?
With a population of around 60 million that's an isolation rate of around 1 per 1,000 or 0.01 per 100,000.
That makes Campylobacter some 300 times more common in France than in England and Wales.
The "recent study" mentioned (PMID: 16156703) reports 10,200-17,800 hospitalizations due to contaminated food each year in France with around 3,000 of these due to Campylobacter.
French cheeses are often delicious, I agree, but it seems there may be a price to pay.
Most of the cases in England and Wales are due to undercooked meat and poultry, which is also something to avoid.
that’s an isolation rate of around 1 per 1,000 or 0.01 per 100,000.
You may need more coffee, Krebiozen. Surely 58,000 per 60 million -> 100 per 100,000.
Yes, actually "camembert au lait cru' does protect against C. Jejuni. This is the french paradox. Maybe listeria? What do you think?
Dammit, you're right. How did I make a stupid blunder like that? Apologies Daniel, it appears you were quite right about the relative incidence of campylobacter in France and England.
Still, I stand by my argument that campylobacter from unpasteurized dairy products is a major cause of GBS. Just because in England people contract campylobacter more from undercooked meats than from unpasteurized dairy products doesn't make consuming either a good idea, especially by those with immune system impairment.
To be honest I'm not sure this will stop me from eating French cheeses. My local supermarket sells a Brie de Meaux that is very hard to resist, but I'm not sure if it is pasteurized or not.
Krebs: (or shall I call you "Ernie"?*), Brie de Meaux is an AOC cheese, which means that to use that name, the cheese must be made according to certain criteria. One of them is that it must be made from unpasteurised milk.
*carrying on an obscure reference from Krebs above.
I cannot even imagine english people eating uncooked meat :-). In any case, if you have immunodeficiency, you must avoid raw milk and raw meat. For the Brie de Meaux, maybe I'm wrong but I have always thought that cheese made from unpasteurized milk was forbidden in the US.
Daniel Corcos - You may not have noticed that Krebiozen lives in the UK and thus may be able to buy things that he might not in the US.
It's my understanding that different states have different regulations and restrictions on unpasteurized dairy products.
The other day I was in a posh, huge food market/ garden store in the country and they presented a great variety of cheese - from top flight French to local - 'Janie's Hippie Farm Down the Road' brands ( lots of that) : because we often discuss raw milk and other health issues @ RI, I was surprised how much labels varied- some proudly proclaimed "raw milk" - others were unclear but I imagine in this trendy area, raw/ unpasteurised might be a sales advantage.
So I was very careful and advised my companion to READ the labels before he bought an exotic, creatively-named product.
-btw- there were some blue cheeses ( a Stilton/ something Danish) that looked like they had seen better days or were just dug up from someone's basement. I like cheese but these were frightening. I can understand why a Chinese writer said her mother thought that cheese was "rotting milk" when she first encountered it.
Glad you got the reference - my ghostly (pasteurized) gold-tops are a rattlin' in their crates ;-) I'm sure you're right about the Brie de Meaux; it is an authentic French cheese and is truly delicious, so I'm sure it is unpasteurized. Now I have a yearning for it, while feeling simultaneously suspicious about the infection risk.
I am English, and my compatriots do tend to either over or under-cook everything (not in a "bloody as hell or burned to a crisp" way sadly). I am, of course, an excellent chef and do neither ;-)
We are allowed unpasteurized soft cheese here, as M.O'B. correctly stated, and I think farms still sell unpasteurized milk direct to the consumer. They certainly did when I was a kid.
It's a bit sad that you Americans are denied the joys of a good unpasteurized Brie or Camembert, while you can take all the same risks by consuming unpasteurized milk. A foolish consistency and all that I suppose...
My American wife considers my Brie de Meaux an abomination, and insists I store it in a hermetically sealed container in the fridge, by the way.
I should mention- before anyone gets the wrong idea- that I love cheese - esp blue cheeses, Brie, Camembert- always. I can't understand vegans.
BUT those two just looked awful. Really crappy and not cheap. Maybe it's fashionable to put something truly disgusting on a plate next to over fruity wine or suchlike.
From my two years in England, I keep the memory of overcooked steaks and undercooked vegetables.
You're right in saying that drinking unpasteurized milk and not eating raw milk cheese is stupid. Unpasteurized milk doesn't taste better.
That comes from the different jurisdictions involved. The federal government sets down the regulations for import and for interstate commerce. The states regulate intra-state commerce. If a state permits raw milk sales (particularly direct from farmer) or unpasteurized cheese sales within the state, then you can get any of those you want as long as it doesn't cross state lines.
Naturally, none of them will be Brie or Camembert (which is French for, "Come on, Bert!") as those are from particular regions in France. I suppose, though, that someone could create a domestic cheese in the Brie (wait, I met a Brie once. She was a stripper from Kansas City) or Camembert styles using raw milk.
Your description of those artisanal cheeses reminded me of an experiment of mine that went terribly wrong. An unopened bottle of milk had gone sour in the fridge, so I strained it through a piece of muslin, mashed it up with salt and garlic and ate it on crackers. It didn't taste quite right, but after all that effort I persevered. I was lucky that I wasn't sicker, and that the gastroenteritis cleared up after only 24 hours...
The moral of my tale? Many bacteria can sour milk, some of them are human pathogens. If you want to make a quick cream cheese like this, use lemon juice.
I'm surprised that there weren't any closely-guarded cultures brought to the New World by immigrants from Europe in the 18th and 19th centuries. Other foods came across with migrants, surely cheese must have been among them. There must be traditional French-style cheese made somewhere in the US, or in Canada? Or maybe they did, but conditions weren't conducive, day-to-day survival took precedence, or the cheese got eaten...
I just came across this, which made me laugh:
What a terrible waste of good cheese.
Krebiozen - I know that people are making North American versions of various French cheeses, even the really stinky ones (though likely not the mite-infested ones). I'd have thought they couldn't get away with using the French names for it without the EU getting upset. http://minnesota.publicradio.org/display/web/2011/09/22/dara-moskowitz-…
As long as they're not trying to sell them in the EU, the EU has no jurisdiction. That's why they can get away with it. For instance, you can get away with calling cheese "parmasan" in America, even if it's from a dairy in Madison, Wisconsin, though in Europe it would actually have to come from Parma, Italy. I believe the city of Parma was successful in getting trade protection on the word "parmigianno" though (uh, I have probably butchered the spelling), which is of course what Parmasan is an anglicization of.
I think "camembert" has to be lower-case in the US unless it's from Camembert. Same with cheddar, brie, and other regional cheeses.
Winemakers were more successful in getting trade protection, though California vinters have fought back by seriously pushing the concept of "varietal" wine as a fashionable choice that isn't region-dependent. A California wine cannot be sold as a burgundy in the US; only a wine from Burgogne, France can. And a sparkling wine can be sold as "methode champagnoise" but not as Champagne, unless it actually comes from Champagne, France.
The Korbel company get around that by calling their product 'California Champagne' ( korbel.com) but they do refer to their 'champagnes'.
I think they are only able to get away with that by limiting the distribution area, though it's also possible they managed to get the rules overturned at long last. I stopped following it a while ago. (No particular reason. Just lost interest.)
Ok I didn't read all the comments yet but as an epidemiologist I had to weigh in on the raw milk comments. Raw milk is inherently dangerous. I don't care how happy your cows are, how 'clean' and 'sterilized' your equipment is there will be dangerous pathogens. Period. Cow naturally carry pathogenic (to humans) bacteria in their intestines. They are not ill or affected in any way. They shed these pathogens. Do you know where a cow's teats are located? There is no way to ensure that every bit of feces is eliminated. Hence pasteurization to kill off the pathogens and stop them from replicating. Milk contaminated at even a low level without being pasteurized will quickly lead to growth of pathogenic organisms. Raw milk has become a major health fad and a major pain in the posterior for those of us in public health. Since a lot of this milk is sold quasi-legally (or illegally depending on where you live) and the customers are sold on all of the 'benefits' most people are deeply unwilling to give up their sources even when their children end up with Campylobacter, Salmonella, and/or E. coli. Drinking raw milk is playing Russian Roulette with your children's lives. There is a reason we started pasteurizing milk, it kills dangerous pathogens. Anyone playing games with their children's health by providing them raw milk should be slapped IMHO. Too many dangerous nuts are promoting dubious or debunked benefits of raw milk while completely ignoring the ever mounting epidemiological evidence that the increase in raw milk is fueling a dramatic increase in outbreaks linked to milk. It's only a matter of time until another child dies because of this.
On cheese, the FDA allows sale of raw milk cheese that has been aged 60 days. That rule was put in place after some study that the aging process resulted in log reduction of pathogenic bacteria in the cheese. That being said, there have been recent high profile outbreaks linked to the sale of raw milk cheese that had purportedly been aged 60 days. (and some cheese which could not be verified to have met that standard due to extremely poor record keeping by the manufacturer) Additional research is now showing that this rather arbitrary limit may not provide as much reduction of pathogens as thought, particularly if the milk was highly contaminated to begin with. I would view raw cheese with suspicion and avoid particularly if you are high risk (immunocompromised or pregnant) due the high risk of death or fetal loss if you are unfortunate enough to contract Listeria.