From the Vault: Fringe Medicine

Jim Ring - 18 September 2023

The suggestion that fringe medicine is more successful than orthodox medicine (NZ Skeptic 3, editorial) was presumably put forward at challenge). It is a suggestion encountered quite frequently these days but rests on two major fallacies. Firstly, medicine is narrowly described as a cure for disease. Secondly, it is assumed that people who recover have been cured by the treatment received. The success of real medicine is illustrated by a cutting from Scientific American, Oct, 1936. It gives the average life expectancy for white males and females in America. In 1900, it was: males 48, females 51, In 1936; males 59, females 63. Compare these with recent figures, The great successes of orthodox medicine have been in the prevention and eradication of diseases. The list of once threatening diseases in N.Z. includes; tuberculosis, polio, typhoid, diphtheria, cholera and smallpox.

The first steps in elimination and prevention are to understand the nature of the illness, to discover its causative agents, to find how it spreads and its reservoirs of infection. By contrast, holistic medicine is not interested in understanding the nature of the affliction. Indeed, most practitioners despise any attempt to discover a particular causal agent. Instead, they claim to treat the whole person.

The relationship between the attempted cure and its effect is difficult to establish. There is often considerable resistance to the evaluation of medical procedures. This comes from the profession who want the best available treatment for their patients and from the public who, very reasonably, do not want to be treated as guinea-pigs. Now, practitioners of fringe medicine have taken to denying the possibility of evaluation. See the recent correspondence in the New Scientist on clinical trials; in particular, the letter in the issue of 2nd October 1986 from the Co-Director of the Centre for the Study of Alternative Therapies.

Human minds find it difficult to accept the statistical effect of regression to the mean. A patient’s condition fluctuates between extremes of poor and good health. In the absence of any control, the only factor needed to ensure the success of a cure is that it should be applied when the condition is at its worst. The patient starts to improve, therefore the treatment was effective. Hence “I went to doctors and specialists all over the place and they couldn’t do a thing for me. Then I went to this man and he told me to give up eating white food (or wear this copper bracelet, or…). Immediately I started to get better”. Of course improvement does not occur after a visit to the first fringe practitioner but if the patient is persistent (one case quoted in the press took 40 years) the miracle eventually occurs.

Many patients visit their GP not because they need treatment for some physical illness but because they need some kind of counselling. In fact this was the major role of the family doctor. If you find this difficult to accept, read Charles Darwin’s autobiography for his account of his father, or Lewis Thomas’s “Notes of a Medicine Watcher”, Thomas says that when he started, diagnosis and prognosis were the limits of a doctor’s skill, a cure was generally impossible. General Practitioners have now abandoned their old role precisely because orthodox medicine now cures and prevents. This has left a gap to be filled by fringe medicine. Faith healers do what doctors used to do when medicine did not work. Orthodox medicine is criticised because of the high public expectations; some people are outraged that not all diseases can be cured. This seems more than a little unfair.

This leaves the question of consumer protection in the area of fringe medicine. As this now earns billions of dollars per year throughout the Western world, it seems that consumer protection is necessary. The exact form is difficult to specify but certain aims can be established:

Methods and treatments need to be tested to make sure they do no actual harm,
Claims of cures need monitoring to ensure that patients are not deluded into parting with money by claims that can not be substantiated.

Who pays for this service is another matter.