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Schadenfreude and the Harsh Light of Day

February 5, 2010

Vaccines do not cause autism. Homeopathy does not do anything. Chiropractic does not cure disease.  Any controversy about this has long been buried under meticulously-gathered evidence.  

If modern medicine has tought us anything, it is that careful study must precede claims that particular treatments are indicated and effective in given situations.  Another well-established medical truth is that there is no panacea.  Diseases, disorders, and injuries originate in diverse ways, and it’s prima facie nonsense to claim that any single product can meaningfully address every malady. 

Mark Twain certainly understood this when he received a letter from a patent medicine vendor who claimed to have the Elixir of Life, as answer to all sickness (including diphtheria and meningitis, diseases responsible for the deaths of two of Twain’s children.)  Twain’s withering response:

Nov. 20. 1905

J. H. Todd
1212 Webster St.
San Francisco, Cal.

Dear Sir,

Your letter is an insoluble puzzle to me. The handwriting is good and exhibits considerable character, and there are even traces of intelligence in what you say, yet the letter and the accompanying advertisements profess to be the work of the same hand. The person who wrote the advertisements is without doubt the most ignorant person now alive on the planet; also without doubt he is an idiot, an idiot of the 33rd degree, and scion of an ancestral procession of idiots stretching back to the Missing Link. It puzzles me to make out how the same hand could have constructed your letter and your advertisements. Puzzles fret me, puzzles annoy me, puzzles exasperate me; and always, for a moment, they arouse in me an unkind state of mind toward the person who has puzzled me. A few moments from now my resentment will have faded and passed and I shall probably even be praying for you; but while there is yet time I hasten to wish that you may take a dose of your own poison by mistake, and enter swiftly into the damnation which you and all other patent medicine assassins have so remorselessly earned and do so richly deserve.

Adieu, adieu, adieu!

Mark Twain

Though not as sharp, witty, or articulate, an equally damning reaction to snake oil came on the TV show Dragons’ Den. I have never seen the show before, but apparently would-be entrepeneurs pitch their ideas to potential investors. Here, a guy tells some savvy businessfolk that his unique water cures everything from cancer to prostrate (sic).  Bad idea:

I first saw the Twain letter on Steven “Gnar” Novella’s NeuroLogica; the Dragon clip comes via Phil “Also Gnar” Plait’s Bad Astronomy.

4 Comments leave one →
  1. Aaron permalink
    February 6, 2010 6:54 pm

    My new favorite insult… “an idiot of the 33rd degree, and scion of an ancestral procession of idiots stretching back to the Missing Link.” Well done Mr. Clemens!

    I agree with the spirit of your argument here, but would caution that perhaps we don’t have all the data yet. 50 years ago acupuncture would have been dismissed as Oriental mumbo jumbo. Today it’s recognized as an often vital component of treatment for chronic pain and neuromuscular conditions.

    Dog said Oriental.

    • Barry permalink*
      February 6, 2010 7:14 pm

      As far as acupuncture goes, I think we do have all the data at this point. There have been innumerable studies, and the better controlled the study, the less pronounced the effect becomes.

      While acupuncture has been shown to be more effective than no treatment at all, that is not saying much; after all, this is what the placebo effect is. In fact, by-the-book acupuncture has been shown to be no more effective than sham acupuncture – that is to say just poking people in random places with toothpicks *without even breaking the skin*.

      In other words, no matter what kind of poking the practitioner does (heh, heh), the results are about equally effective. This has been carefully studied. The thing about so-called alternative medicine that is so important to keep in mind is that if a particular intervention can be shown to be relatively safe and effective, it will be subsumed within regular old medicine.

      I didn’t mention acupuncture in the original post, so I am not sure if there is one of the things I mentioned that you are compelled by, but the premise is similar for the three things I began the post with. For example, homeopathy simply can’t work. The idea thst as an ingredient’s concentration goes down its potency goes up is obviously false to anyone who has ever experienced the strength of Bacardi 151 as compared to the 80-proof stuff. Similarly, manipulation of the back – in chiropractic – cannot cure an ear infection, as some chiropractors claim.

      These modalities are often practiced in the same or a substantially similar way as when they were founded, showing a refusal to seriously consider evidence. That alone is a damning failure.

  2. Aaron permalink
    February 6, 2010 7:22 pm

    I want to check out these studies. That said, acupuncture has been “subsumed within regular old medicine” to a degree. It’s often prescribed in tandem with orthopeodic and osteopathic treatment and is generally covered by insurers.

    Also, it works.

    • Barry permalink*
      February 6, 2010 7:42 pm

      Take a look, and let me know what you think.

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