Hokum Locum

It's beginning! I have long wondered when our health system would give in to public demands for fringe medicine, and I see that the West Auckland Health District has appointed a part-time naturopath offering alternative or complementary methods for the treatment of smoking, alcohol misuse and high blood pressure and including nutritional advice. This at a time when the Board's own nutrition services are struggling for funding.

We are told that the naturopath's appointment followed an "extensive consultative process" between the West Auckland District Health Committee and the local community. This raises the interesting question of how far do we have to respond to community pressure for the employment of unproven techniques? Current medical practice has a scientific basis and any proposed additional treatment systems such as naturopathy, should have to come up to the same exacting scientific standards.

New Zealand General Practice 26/3/91

In an article in NZ Women's Day, Annie Whittle claimed that "she has no doubts" that her rheumatic symptoms are "triggered by increasing electro-magnetic radiation (EMR)" from a local TV and radio transmitter. The article goes on to implicate EMR as a cause of cancer and having "an inhibiting effect on the immune system". Two cases of melanoma and one of hypertension are alleged to "have been made worse or accelerated by the EMR"1.

This is another good example of the eternal quest of all of us to find some cause or explanation for ill-health or feeling unwell. EMR is given out by nearly every electrical household appliance and these sources are far more important than distant aerials. Ultraviolet radiation (UV) is a far more important health problem in Australasia and is the risk factor for melanoma, not EMR.

Some 85% of all hypertension (raised blood pressure) arises de novo and has no known cause so it is frivolous to attempt an implausible link with EMR. A recent Australian study2 found that any effect of EMR "would be very slight" and another one of people exposed to radiation from radio, television, satellite and microwave transmission towers showed no evidence of genetic damage3.

However, a book reviewed recently in New Scientist makes the sensational claim that a conspiracy exists to cover up the threat to health from EMR given off by power lines, computer screens (I'm doomed already!!) electric blankets, radar and other military devices'. Very little hard evidence is provided and it has become fashionable for fanatics to dream up conspiracy allegations to explain why nobody takes much notice of their excessive claims.

1. Annie Whittle's Fight for Life. Woman's Day June 20 1990, p8-9
2. Powerline Argument remains unresolved. NZ Doctor 15 April 1991
3. High-frequency radio towers cause no genetic damage. Marlborough Express 16/8/90
4. Book review. New Scientist 23 June 1990 p45.

In Issue 16, I mentioned the absurd osteopathic technique of cranial manipulation. Readers of a recent article in the NZ Women's Weekly will be interested to know that their jigsaw of 29 skull bones are pulsating at a rate of 12-14 times a minute but that "this movement is very tiny and can be felt only by trained (not skeptical!) hands". An osteopath can detect an imbalance in these movements and by massaging the skull can re-establish a "normal cranial rhythm".

The most incredible statement in this farrago of nonsense is that the cerebrospinal fluid (CSF) is "thought to be pumped up and down the spine by the contractions of the skull". The circulation of the CSF has been extensively studied by physiologists and has nothing to do with pulsations of the skull bones which exist only in the fevered imagination of self-deluded osteopaths. If this is the best that the NZ Women's Weekly can come up with we will have to make them a permanent award for gullible journalism. Their pages will, however, continue to provide rich resource material for psychologists.

Danielle transformed by cranial osteopathy. NZ Women's Weekly Sept 17, 1990.

The latest quack fad is the obsession that mercury leaking from dental amalgam is causing illness ranging from multiple sclerosis, arthritis, and chronic fatigue syndrome, to Meniere's disease (a disorder of balance).

This belief can be traced to a study reported in The Economist1 and again in The Press2 where a deterioration in the renal function of sheep was reported after their teeth were filled with 12 amalgam fillings. My dentist tells me that he would never do more than 3 fillings in one session and I intend to duplicate the sheep study by comparing renal function before and after this number of amalgam fillings in young people.

Amalgam is a complex alloy containing mercury, tin and silver. Since its introduction by the Chinese in 659 AD it has been extensively studied and dentists in NZ would fit about 4 million such fillings per year. Small quantities of mercury are released from fillings but the amounts are small compared with dietary sources and are far less than the amounts required to produce toxicity. Many reviews have confirmed the safety of amalgam fillings3,4.

In Tauranga, a Dr Godfrey claims, however, that "many illnesses can be attributed to the amount and condition of mercury contained in amalgam fillings" and quotes examples such as chronic fatigue, myalgic pains, immune suppressive states, coldness, short term memory loss, food allergies and paresthesia. In fact, none of these illnesses are diagnoses but are subjective complaints only.

Dr Godfrey rejects research to the contrary as "anecdotal" but I note he goes on to "quote many of his own case studies to support his theories" and asserts "we are living in a toxic soup". Dr Godfrey continues in much the same vein in a letter to the NZMF where he criticises skeptical thinking, invokes the familiar conspiracy theory and says "we might do well to consider that approximately 50% of French doctors...have homeopathic qualifications" and "over 30% of German general practitioners use EAV and homeopathy". So what! All that tells me is that these countries have a lot of self-deluded doctors.

Dr Godfrey runs a chelation clinic and has been treating patients with Dimaval (2,3-

dimercaptopropan-1-sulphonate), a mercury chelating agent. The diagnosis of "mercury poisoning" is made on history and clinical presentation (both highly subjective), hair analysis (mercury levels can be either high or low!) and measurement of dental galvanic current by a specially designed. dental ammeter. These have actually been tested and readers will be interested in the following reference4:

When two of these machines, one from a medical practitioner and one from a dentist, were used independently to measure 37 restorations (ie fillings), it was found that there was no correlation between the instruments' readings. Furthermore, readings could be altered 100% by the presence or absence of cavity varnish, and were also dependent on the prior DH history of the mouth. Large negative readings were also obtained on teeth with no restorations. Whatever these instruments are reading, it is certainly not an index of mercury poisoning.

Anyone treating patients with drugs for mercury "poisoning" that doesn't exist is running a risk of a charge of malpractice. The use of dental "amalgameters" is a scientific absurdity and the NZ Medical Council should prohibit the use of these, Vega testing machines, EAV

machines and anything else which is operator-dependent and without scientific basis. Likewise, any dentist who removes amalgam fillings for mercury "poisoning" should be professionally disciplined.

1. Mercury in teeth. No silver linings. The Economist Feb 2 1991
2. Safety of mercury fillings questioned. Christchurch Press 22/2/91
3. Safety of dental amalgam: an update. Journal of the American Dental Association. Vol 119, July 1989 p204
4. Why Amalgam? NZ Dental Journal, Vol 87, Number 388 April 1991.
5. Doctor joins controversy over amalgam fillings. NZ Doctor 2 April 1991

Dr John Welch is a medical officer with the RNZAF.