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Bioterrorism and the NCCAM: The selling of 'Complementary and Alternative Medicine' - Special Reports - National Center for Complementary and Alternative Medicine
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The recent bioterrorism threat has attracted renewed attention to the myriad pseudoscientific claims that permeate "complementary and alternative medicine." Past history predicts that there will be continued pressure for the National Center for Complementary and Alternative Medicine (NCCAM) to fund studies of claims that can already be dismissed on the basis of established knowledge.

Thanks to the threat of bioterrorism, Dr. Stephen E. Straus, director of the National Center for Complementary and Alternative Medicine (NCCAM), may be on the verge of shedding his naivete about the real purpose of the organization that he runs. At a hearing of the House Government Reform Committee on November 10, 2001, Dr. Straus warned against the use of "alternative" remedies for the prevention or treatment of anthrax or other diseases of bioterrorism. He pointed out that there is no evidence supporting the use of such remedies, and that they may interfere with the effectiveness of proven measures (Associated Press 2001). Dr. Straus is a virologist, and his statements were consistent with the views of any reasonable, scientifically trained physician.

What Dr. Straus may not have appreciated is that the chairman of the committee to which he addressed his remarks is not pleased by rational evaluations of "alternative medicine." Republican Dan Burton battled to legalize the dangerous quack cancer "cure" laetrile in his home state of Indiana in the 1970s. He is called "quackery's best friend in Congress" by Stephen Barrett, M.D., the creator of the award-winning Quackwatch Web site and the vice-president of the National Council Against Health Fraud (NCAHF). Although laetrile remained oudawed in the U.S., Rep. Burton has continued to support other dangerous and absurd cancer treatments, such as the "anti-neoplastons" of Stanislaw Burzynski and the regimen of coffee enemas, hundreds of daily "dietary supplement" pills, and hair analyses of Nicholas Gonzalez. Burton also supports passage of the Access to Medical Treatment Act, an annually defeated bill that would permit quacks to prey upon unsuspecting consumers without having to worry about legal interference. Most recently Rep. Burton showed how rabid his intentions are by falsely accusing another NCAHF board member, Dr. Tim Gorski, of having misrepresented his credentials following Dr. Gorski's incisive testimony at the Senate Hearing on Anti-Aging Quackery on September 10. The details of that event are available at the Quackwatch Web site (Barrett 2001a; Burton 2001; Gorski 2001).

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Rep. Burton was disturbed, at the bioterrorism hearing, to learn that neither the NCCAM nor the FDA is testing "alternative" remedies for anthrax and smallpox. According to the AP report quoted on CNN.com, Rep. Burton opined that since there are only 15 million doses of smallpox vaccine available, the government should be pursuing "alternative" remedies. "We're facing a terrorism threat now," he said.

Rep. Burton suggested that the lack of government interest in "alternative" proposals might be due to a conspiracy between the FDA and the pharmaceutical industry. Queried Burton, "unless it's brought to you by a pharmaceutical company, you don't take action?" A representative of the FDA replied that anyone may apply for drug approval, but that no applications for "alternative" substances had been made. Dr. Straus, for his part, said that he would be "open" to funding research on "natural remedies" for the agents of bioterrorism. He would be wise to do just that if he hopes to keep his job; but should he?

The OAM Legacy

Straus began his tenure as the sixth (but only third full-time) director of the NCCAM two years ago, when the name of the organization had just changed from the "Office of Alternative Medicine." The OAM had been established in 1991 not because of any scientific or medical need, but because of the sectarian leanings of Iowa Senator Tom Harkin, who was convinced that his hay fever had been cured by bee pollen. The first full-time director was Joseph Jacobs, M.D., like Straus a nonideologue with an ingenuous enthusiasm for "alternative medicine." Jacobs's tenure was short precisely for that reason. As reported in Science magazine in 1994, Senator Harkin drummed Jacobs out of the office after only a year, once it became clear that Jacobs felt that the role of the GAM was to subject aberrant methods to rational scrutiny (Marshall 1994). Harkin would apparently have preferred that these methods simply be declared valid and integrated into common practice. In an article in The New Republic in 1996, Dr. Jacobs was qu oted as saying, "it's pathetic. They were so naive about science. I wouldn't trust anything coming out of the OAM as long as the Harkinites are micromanaging it" (Satel and Taranto 1996).

The next full-time director of the OAM was Wayne Jonas, M.D., a believer in homeopathy, an absurd eighteenth century "healing system" that has been known to be at odds with the fundamentals of chemistry and biology since shortly after its introduction. Homeopaths maintain that "like cures like" (hence the name): thus the "cure" for a disease is a substance that produces similar symptoms when given to a healthy person. An example is the use of onion for the common cold. Medical historians, anthropologists, and psychologists recognize this as a variation of the "doctrine of signatures," a prescientific myth common to the folklore of many cultures. Homeopathy doesn't leave it at that, however. The curative agent must be "potentized" by a series of dilutions and "succussions," such that not even a molecule of the original substance remains in the "remedy." Thus the patient is given a sugar pill, or possibly a small quantity of water or alcohol.

Homeopathy offers the very sort of "alternative remedy" that Rep. Burton might imagine could solve the bioterrorism problem. Zealous homeopath Dana Ullman, quoted in a recent article for Utne Reader Online, recommends homeopathic "nosodes" to prevent anthrax (Garsombke 2001). These consist of farm animals infected with anthrax, ground up, and diluted in alcohol to well beyond the point at which any trace of the original preparation remains. According to the article this works like a vaccine and is utterly safe. Nevertheless, Ullman recommends that its use be limited to high-risk persons such as postal workers.

Ullman is well known and respected in CAM circles. According to the Web site Integrative Medicine: the Worldwide Authority on Integrative Care, "Mr. Ullman is a member of the advisory council of the Alternative Medicine Center at Columbia University's College of Physicians and Surgeons [and] a former consultant to the World Health Organization" (Integrative Medicine 2001). A visit to the Web site of Columbia's Rosenthal Center for Complementary and Alternative Medicine confirms that Ullman's Web site, Homeopathic Educational Services, is recommended, as is another link in which "[d]ozens of full-text articles and excerpts from hooks by Dana Ullman are available" (Rosenthal Center 2001). Such is the topsy-turvy world of pseudomedicine and its startling patrons.

NCCAM and Advisors

Dr. Straus can assume that there will be pressure for the NCCAM to investigate Ullman's ridiculous claim. In addition to the advocacy of legislators such as Harkin and Burton and the legacy of Dr. Jonas, there are several influential NCCAM advisors who can be expected to agree with Ullman. On the National Advisory Council, for example, are three "naturopathic doctors." Naturopathy is an eclectic assortment of implausible "alternative" claims, one of which is homeopathy. Homeopathy is taught, uncritically, in all four naturopathic schools. Ullman's Web site is listed as a "recommended Web site" by the National College of Naturopathic Medicine in Portland, Oregon (NCNM 2001). Homeopathy is promoted in the Textbook of Natural Medicine (Pizzorno and Murray 1999), the only general textbook of the field of naturopathy, and is recommended in virtually every naturopathic treatise. The 1994 edition of the Journal of Naturopathic Medicine (the "official publication of the American Association of Naturopathic Physicians "), as reviewed by Stephen Barrett, promotes homeopathic "nosodes" as safer and more effective than real vaccines (Barrett 2001b). Many naturopaths consider themselves to be "specialists" in homeopathy.

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