Placebo Medicine

Placebo Medicine



Introduction by Abram Hoffer, M.D., Ph.D.:

Since performing the very first double-blind controlled therapeutic trials in psychiatry, I have followed with interest the history of this type of experimental research. I was never convinced it was the best way or the only way. In 1952, we did the first experiments double-blind because that was the condition to obtain a research grant for testing vitamin B-3 as a treatment for schizophrenia. Since then, I have become disillusioned with this type of trial. I do agree that controlled trials are needed, but not necessarily double blind ones. The New England Journal of Medicine (344, 1594-1602, 2001) carried a report by Hrobjartsson and Gotzsche which questioned whether the placebo was in fact as powerful as everyone thought it was. An inert pill has little influence and might as well not be used. But the drug companies have always claimed that such trials, which were forced on them by the FDA, are the only scientific way. In this article on placebo medicine, Dr. Saul shows how any experiment can be biased in any direction if you have the will and the money. And yet even after the billions of dollars of pharmaceutical-based research conducted over decades, there is little to show for it. In my opinion, no toximolecular substance will ever be a cure for anything. Natural means have been almost totally ignored. The body is composed of innumerable molecules developed over the past billions of years by the toughest test of all, survival. We are finely tuned organisms, with so many different compounds and reactions and inter-reactions. Even after over 50 years of medical practice, it still surprises me that everything functions so well. So to think that one can insert a strange molecule that has never been there before, and hope to correct some malfunction, is the height of folly. The only molecules that are therapeutic are orthomolecular, that is molecules that are normally present and with which the body is familiar. The only compounds that have been used successfully in chronic ailments are the nutrients, vitamins, minerals, amino acids, essential fatty acids, and hormones. And when one tries to replace natural substances with compounds that are slightly different in order to have patent protection, the results are dismal. The following article makes my point. - A. Hoffer.)




by Andrew W. Saul


Ever since I first watched comedian Steve Martin do a stand-up routine about being "high on a new drug called Pla-cee-bo," I've questioned the scientific method a lot more often. The great majority of all illnesses are self limiting. About eighty percent of all sick people will either get better anyway or die anyway, no matter what the doctor does. So why have doctors? For the twenty percent who need intervention, common sense would tell us. Just how much bias enters into medical practice? In so-called double blind studies, where neither experimenter nor subject know who got the active medicine and who got the sugar pill, there can be little doubt.  Yet only about twenty percent of all medical and surgical procedures have ever been double-blind, placebo tested. Let's see if we've got this straight:  Only twenty percent can be helped, and only twenty percent of what will be tried is known to help. I haltingly say that twenty percent of twenty percent is..., ah, is... is a small number.

 And then there is the opportunity for bias in the interpretation of what results you do obtain. Example: as a student at the Canberra Hospital in Australia, I attended a physician's seminar on a new treatment for migraine headache. The seminar was paid for by the drug company that, surprise surprise, made the very drug being reported on. Research on this particular medicine showed that it worked better than placebo. About 55 to 65% of patients taking it had relief, whereas only about 45% taking the placebo had relief. Consider the wonder of the real difference: 45 of one hundred had relief from thinking that they might possibly be taking an effective medication, whereas only 20 out of a hundred more actually got relief from definitely ingesting the active chemical. When we do placebo controlled, double blind studies, the pony to bet on is the sugar pill: it will be infinitely safer, unbelievably cheaper, and damn near as effective as the drug du jour. Why, then don't we just go whole hog and just use placebos?

 Well, we have.  In a little-publicized (and downright embarrassing) chapter of 19th century medical history, there was a movement among some physicians who had good reason to believe that the cures of the day were worse than the diseases.  he very term "quack" was in fact first applied to medical doctors who gave their drug of choice, mercury, for almost anything. They were called "quicks," actually, for using "quicksilver," mercury's nickname. Some doctors rebelled against what we today would consider to be bona fide medical barbarism, such as bleeding by the pint, uterus removals for female hysteria, lower rib removals in woman so they could fit into corsets better, arsenic treatments for syphilis, and so forth.

 So along come some dissident doctors who choose to give no medicines at all, just placebos. Their cure rate was very high, their death rate very low, their popularity with patients very strong, their names today very much unsung. Just try to find information about them at you local medical library or museum.

 On the other hand, it would take no effort at all to hear our doctor-loving press promptly preach that today this has all changed. Surely modern medicine has progressed so far as to become so safe, so scientific and so successful!

 So sorry: it hasn't. The war on cancer has been a 50-year flop. The medical-pharmaceutical wars on AIDS, the common cold, and even the number one killer, cardiovascular disease, have all been defeats. They continue, like all badly managed campaigns, wars or businesses, only because of a huge influx of funding. 

 To go point by point: 

Cancer: over the past four decades, five-year survival rates are virtually unchanged for the cancers that kill the most people.  

AIDS: according to a recent international AIDS conference in Belgium, people on AZT actually develop full-blown AIDS sooner than controls given nothing.  

Colds: any physician will tell you that there simply is no "cure" for the common cold.  

Heart disease: if there were a cure for cardiovascular disease, you would have heard about it. What progress has been made against heart disease is primarily due to advances in nutritional knowledge of fats, fiber, vitamins and minerals.  

 There is not one successful example of the "one drug, one disease" dogma among these illnesses. Modern medicine is merely the warmed-up leftovers of the bad old days of polypharmacy, heroic (read "expensive") measures, and monolithic thinking. The poverty of philosophy in medical schools is appalling. Anarchy among physicians, and nurses, and patients is inevitable if word of this gets out.  There are leaks, from time to time. The medical cartel calls these informants "quacks."

 Talk about the pot calling the kettle black. Well, the best defense is a good offense, and institutionalized medicine is about as offensive as it gets. A single example is adequate to prove this: What is the biggest spending professional special-interest lobby in the USA?  The American Medical Association.  By far. If they are so good, why do they have to pay so much for influence in Washington?

 What's worse, the medical profession reviles emerging nutrition-therapy doctors, eating its own like some demented hamster. I had two colleagues, both New York State licensed MDs, who lived near Buffalo. Each was a good doctor, with decades of experience and a busy practice, and good sense. Each directed his patients to change their diets, emphasized fiber, and prescribed vitamins instead of drugs to get the same, or better, results than anybody else I knew. Each was well and rightly known for his good sense. Both were targeted as medical renegades. The one retired before he could be silenced. The other was railroaded out of the state by the medical practice board in Albany. He called me up shortly before he left for Nevada, where he told me he would be able to continue as a homeopathic physician.

 I was stunned.  "Why you?” I asked.  “I've seen patients of yours, along with your written instructions for their meal planning and supplementation.  You are helping everybody and killing nobody!"

 "Helping people is not what medical practice is about now," he told me calmly. He sounded just like the perfect doctor you dream of  reaching with a 3 AM emergency: confident, capable, friendly, relaxed, assured. "The insurance companies run things now.  You can only prescribe a vitamin for its approved purpose, which to them, is simple deficiency. Physicians are simply not allowed to cure illness with supplements. I tried, somebody complained, and that was the end."

 Here is an exact transcript of what this dangerous man directed his patients to do:

SUGARS:  Avoid all sugars, white or brown.  Use concentrated apple juice or barley malt extract.  Honey can be introduced after one month.  If tolerated use sparingly. (Note: Molasses & honey when used in baking seem to be well tolerated in general.)

FLOURS:  Avoid all refined white flour including unbleached white flour. Permitted are whole wheat, soy, gluten, oat, rye, and Jerusalem Artichoke flours. Recommended whole wheat breads brands include "Arnolds," "Pepperidge Farm,"  "Monks'  Bread" (Please note that the term "Wheat Flour" simply means :refined white flour.  Label must read "whole wheat" flour.) Avoid commercial "rye" breads... they all contain white flour.

VEGETABLES: All vegetables permitted. except possibly corn. Corn (with caution) after months.  If tolerated, use in moderation.

FRUITS: All fruits permitted except excesses of dried fruits.

MEATS: All meats permitted except pork.  Avoid bacon and commercial cold cuts. (Cold cuts permitted if made without fillers.

DAIRY PRODUCTS: All dairy products permitted (except those containing sugars). Avoid processed or cheese spreads, ice cream, flavored yogurt, etc. (Cream cheese is OK)

BEVERAGES: Permitted are tea, decaffeinated coffee, herb teas, unsweetened fruit and vegetable juices.  Bottled or distilled water preferable to tap water. 

SMOKING: Don't smoke. All American tobacco is sugar cured.

ALCOHOL: Avoid drinking beer, liquor, or wine.

SEA FOODS: All sea foods are permitted.

CEREALS: Permitted are oatmeal, shredded wheat, millet, buckwheat, natural grain
cereals, "Grape nuts," "Nutri-Grain."

MISCELLANEOUS: Permitted are all soy products, nuts, seeds, whole grains, carob,  and tofu.

You should not be hungry. when first going on a diet.  If you are, increase your carbohydrate intake (i.e., up to six slices whole grain bread and up to three medium
sized potatoes a day.

Remember to read all the labels!!

Add vitamin supplements, and that was his protocol.

 I couldn't believe that a fully qualified MD could be called on the carpet for this, or if he were, that it could possibly be made to stick. To me, the medicos had always been the top bananas in health care. Doctors like him were not in the same class as self-styled nature-cure quacks like me, working out of my basement, ineligible for third-party insurance coverage. I sincerely regretted his leaving the area, told him so, and wished him well.  Always the gentleman, he paid me a compliment and that was the last I ever heard from him.

 And then it happened again. Another acquaintance of mine, a board-certified with at least 20 years in his specialty, was kicked out of one of his two insurance companies. Since he was my primary care doctor at the time, I was mostly naked, wearing a light blue faded paper gown and in the midst of a physical when he told me.

 "I've made too many enemies," he said. "I tell patients to take a lot of vitamins. I prescribe herbs.  I've told other doctors at the local medical society that they didn't know what they were doing.  Big surprise that they got me, eh?"

 Not long after that, he voluntarily left his other insurance company. "They were going to drop me anyway.  I just beat 'em to it."

 If medical doctors will not listen to their own, or to Nobel Prize winners like Linus Pauling, they are certainly not going to listen to an outsider like me. To try to influence the medicos would be a lot like speaking in a large auditorium, with nobody there, and the microphone off. And if the room were full, they wouldn't hear anyway. And if the mike were on, they wouldn't listen. And if they actually heard you, they'd leave.

 I've got another for you. Back in the 1970s, Dr. Benjamin Feingold, an allergist, noticed that some children seemed to be noticeably sensitive to artificial colors and other food additives. He worked primarily with hyperactive kids, had their parents clean up their diets and go chemical-free, and the hyperactive behavior stopped. From this came a classic book, Why Your Child Is Hyperactive.

 Feingold was an MD. He was credentialed in every way and then some. I posses correspondence from him and you should see just the letterhead.  Feingold's diet was so effective that Feingold Associations, grass roots groups of parents, sprung up across the nation.  Basically all they did was keep painted foods out of their children's stomachs.

 The food industry's response was predictable. Study after study has been bankrolled to show that food additives, and sugar, for that matter, have no negative effect on children's behavior. Yeah, right!  Been to a kid's birthday party lately? Ever taught school during the week following Halloween? Ever tried to nap a toddler full of M&M's? Most importantly, did you ever read Feingold's book?  This man knows what he is talking about and got good results. 

 As long as we let kids eat chemically dyed "foods" and "drinks," we might just as well give them a can of Sherwin-Williams housepaint and a spoon.

 The worst that can be said about the Feingold approach is that it doesn't work for all children. Somewhere around 45% to 50% of kids will improve on his program. Maybe it is no more than a placebo effect.  But it may still be worth a try because there is no harm to it. Doctors give chemotherapy with a success rate of under 30%, and chemo has serious side effects. What is the down side of not feeding kids food paint?  How can it possibly hurt to try avoidance of unneeded chemicals? What really rankles you is that allergists have made a subculture out of avoiding various molds, pollens, hairs and foods... all substances that we have had millions of years of evolutionary exposure to.  Allergists will be quick to tell you that your child is allergic... but not, of course, to an industrial synthetic chemical dye. For it would somehow seem to them that only substances found in nature can produce an authentic allergy. Factory foods and artificial colors bearing molecular names a yard long cannot cause hyperactivity. But corn can.

 Logic like that does not even pass the straight-faced test.

Copyright  C  2004, 2003 and prior years Andrew W. Saul. 

Andrew Saul is the author of the books FIRE YOUR DOCTOR! How to be Independently Healthy (reader reviews at ) and DOCTOR YOURSELF: Natural Healing that Works. (reviewed at )

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Andrew W. Saul


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