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The article reads as follows:

Complementary medicines are useless and dangerous, says Britain's foremost expert

Useless. Dangerous. Even crooked. The brutal verdict on our most popular complementary cures - by Britain's foremost expert:

A lot of complementary medicine is ineffective, and some positively dangerous. Meanwhile, alternative treatments that promise to cure cancer 'are downright irresponsible, if not criminal'.

These are the views not of an old-school doctor dismissive of alternative therapies, but of Professor Edzard Ernst, Britain's first professor of complementary medicine and, you would have assumed, its greatest champion.

There is a booming market for complementary medicine, and it's not only the public who are turning to alternative remedies. Last week it was revealed that 60 per cent of Scottish doctors prescribe their patients homeopathic or herbal remedies.

Professor Ernst is not yet convinced by homeopathy, either. Its effectiveness has neither been proved, nor ruled out, he says.

'Miracle' cures and 'anecdotal' evidence mean nothing to him. But if a therapy passes scientific muster - which usually means it has been shown to be effective in a double-blind placebo-controlled study - he gives it the thumbs up.

Acupuncture gets the thumbs up. It's good for pain, particularly back pain, though it has nothing to do with mysterious energy flows, as many therapists claim. 'Acupuncture works in a physical way: it's nothing to do with yin and yang,' he says.

Massage, too, gets the Ernst thumbs up. It has 'considerable potential' for treating conditions such as constipation, back pain, anxiety, depression and stress.

Herbal medicines - though not all of them - also pass muster because their success in treating a number of specific conditions has been demonstrated.

But most therapies don't come up to scientific scratch. In a series of articles for the trade publication Independent Nurse, reprinted on the publishers' website, he gives most the thumbs down.

These include spinal manipulation, particularly chiropractic. He says there is little evidence that spinal manipulation, practised by osteopaths and chiropractors, is any more effective than other remedies, such as exercise, and indeed it carries the risk of dangerous side-effects, including strokes.

Nor is there any reliable evidence that flower remedies (which are made from extracts of plants and flowers) generate clinical effects that differ from placebo - or a dummy remedy - says Ernst. And the same goes for reflexology, which he says shouldn't be used to diagnose illness.

Hardly surprising, then, to discover that Professor Ernst is the most vilified player in the complementary world. Mention his name in a room full of practitioners

Nand you can feel the mercury plummet. Ron Bishop, chair of the British Acupuncture Council, concedes that Ernst is unpopular with his members because he produces results with which they don't agree.

'He did a trial and found that acupuncture didn't help people stop smoking. If you're an acupuncturist working with people trying to stop smoking, every day you get good results and help people stop smoking. We think that's a bit unfair on what our members do.'

Nor do they like the professor's view that complementary medicine could be dangerous. He was the first to draw attention to Chinese herbs mixed with dangerous substances, the potential danger of 'high velocity' thrusting in spinal manipulation and ill-placed acupuncture needles.

'A lot of interest groups were very puzzled because, surely, complementary medicine was, by and large, very safe, and mainstream medicine was where you had side-effects,' says Ernst, who is professor of complementary medicine at the Peninsula Medical School at the universities of Exeter and Plymouth.

'But when we did our research we found a lot of surprises - and since we started our work 13 years ago, various things have been banned from the market because they are so unsafe.'

Practitioners argue his time could be better spent campaigning for regulation in complementary medicine to drive out the charlatans.

On paper, Professor Ernst, now 58, looked the perfect candidate for the first professorial post in complementary medicine.

He previously held the chair of physical and rehabilitation medicine at the Medical Faculty of Vienna - a high-status position with 120 people under him and a salary to match - and as well as his medical qualifications, he is a trained homeopath, acupuncturist, massage therapist and spinal manipulator.

But in 1993 Ernst turned his back on status and cash to take up the Exeter post. It has, he says, taken him over 'body and soul'.

Since then, his department has published well over 1,000 research papers and tested a hugely diverse number of therapies, making it the most productive research unit in the world in this field.

Professor Ernst and his colleagues have produced the weighty Desktop Guide To Complementary And Alternative Medicine: An Evidence Based Approach - the second edition was published in June.

'Putting science into complementary medicine is like mixing fire and water,' he acknowledges.

'But it is the only way ahead. Complementary medicine has always come and gone in waves, so historically, you need science to establish an evidence base, because if you have that, it won't go away.

'If you don't have that base, it may flourish under Prince Charles, but it will be short-lived. So in a way, I think I am the biggest champion of complementary medicine.'

Others might argue that the Prince of Wales deserves that mantle. But, says Prof Ernst, Prince Charles is 'amazingly resistant to the scientific approach - and if he keeps rejecting the scientific testing of complementary medicine, then the therapies he has spent much of his life championing could disappear under his reign'.

Practitioners accuse Professor Ernst of trying to shoehorn therapies which are individually tailored to the patient into the straitjacket of a double-blind randomised placebo-controlled trial - the gold standard for conventional medicine.

In such a trial, a drug and a placebo pill are distributed at random to selected patients. Neither patient nor scientist knows who gets what. The code is broken only at the end and the results analysed.

Practitioners question how a treatment such as homeopathy or acupuncture, which treats the 'whole' person not just the symptom, can be subjected to such a study.

Ernst concedes that the 'bog-standard' randomised clinical trial is sometimes not completely suited to a number of treatments, but says he and his team work hard to find new ways of testing different therapies.

'There are ways of doing clinical trials,' he says, 'where you can have the full spectrum of individualisation, holism and so on. You need to think a bit more - it's a challenge.'


ANH Comment


What can we say? This is at the same time almost unbelievable - yet also typical form for Prof Ernst. The most staggering thing about these sorts of attacks is that they lack scientific objectivity. They fail to address the inherent weaknesses of the scientific methodologies that these narrow-minded scientists hold in such high esteem. 


The concept of orthodox medicine relying on the evidence-based gold standard of the randomized controlled trial (RCT) is now wearing thin when it comes to understanding the relevance of this methodology to many forms of alternative medicine.


Let's take nutrition - is it really scientifically valid to condemn the potential role of supplementary nutrients like vitamin E and carotenoids which have failed to generate strong beneficial effects in RCTs aiming to investigate their role in reducing chronic diseases like cancer and heart disease? Is it fair when copious evidence shows that epidemiological and observational studies - which are less free from bias and confounding factors - have consistently demonstrated very strong associations. We think not - and so do many other scientists.


Natural products work within the human body in a different manner to pharmacologically active drugs. They often work in complex mixtures and interact with each other synergistically or they interact with factors in the diet. All these sorts of variables are ommitted from the pharma-friendly gold standard that Ernst and his cronies seem to worship as if it were the holy grail.


We have no issue with using the evidence base - but we have a big problem with how selective you are being when you view the available evidence.


Wake up, Prof Ernst...can you smell the coffee? Oh...and are you really as independent as you and some of the other scientists you are increasingly associating yourself with like to think you are - such Prof Michael Baum and Jonathan Waxman?