Sampson Wallace Sampson is the editor of The
Scientific Review of Alternative Medicine
and a member of the Board of Directors of the
National Council Against Health Fraud, Inc. Sampson
has served as Chief of Medical Oncology at the
Santa Clara Valley Medical Center, and is clinical
Professor Emeritus of Medicine at Stanford University
School of Medicine. Sampson studies and teaches
about unscientific medical systems and anomalous
medical claims, and teaches the critical analysis
of alternative medicine claims at Stanford University.
Sampson graduated from the University of California,
Berkeley in 1952 and from the UC San Francisco
School of Medicine in 1955.
links to Wally Sampson's home page and other related
infomation please see our resources
would like to know about Spinology. There are
people working in this field who claim to be able
to lengthen a leg that is a bit shorter than the
other. Does this not have to do with bones in
the leg? I would really like to have some clarification
on this issue. I would also like to know if there
is any scientific evidence that the popular cold
remedies such as zinc and echinacea actually work.
Yes, leg bones determine leg length, not the
spine. Spinal deformities can cause the pelvis
to tilt, making one leg appear to be shorter than
the other, but they are the same. That is due
to a real deformity, not an imaginary one, and
cannot be corrected by manipulation or any other
non-surgical procedure. Most "spinologists" are
chiropractors. "Spinology" is not a recognized
medical area of study (the word was made up.)
Second, zinc is not effective against the common
cold. Neither is Echinacea. The original reports
on both were defective, and subsequent studies
came out negative.
Sullivan, D.O. asks:
is common practice in Medicine to put patients
on combinations of drugs. The vast majority of
these combinations of drugs (especially where
3 or more drugs are involved) have never been
studied at all, let alone in double-blind trials,
yet it is frequent practice to prescribe these
is well-accepted in Pharmacology that it is scientifically
impossible to accurately predict the side effects
or clinical effects of a combination of drugs
without studying that PARTICULAR combination of
drugs in TEST subjects. Knowledge of the pharmacologic
profiles of the individual drugs in question does
not in any way assure accurate prediction of the
side effects of combinations of those drugs, especially
when they have different mechanisms of action,
which is very common because polypharmacy is most
often prescribed to patients with "multiple illnesses".
180,000 patients in this country die from identified
adverse drug reactions; the number who die as
a consequence of polypharmacy is, to my knowledge,
The argument that the prescribing of drugs is
the "Art" of Medicine is not valid in defending
polypharmacy, because drugs are developed (indications,
dose and administration, etc) and approved through
a "scientific" process (double-blind, placebo-controlled
studies). The fact that the medicines are often
prescribed for "different conditions" is irrelevant
(especially to the patient's physiology). The
idea that " we are doing the best we can," a frequent
defense of Polypharmacy, does not in any way uphold
a scientific argument in favor of it. (We are,
indeed, trying the best we can, with tools which
do not improve at the rate we would wish!) The
fact that "there is a limit to how much research
can be done" in no way makes the research unnecessary
in order to predict the side effects of specific
combinations of drugs.
has been said that 30% of medical practice can
claim to be backed by controlled studies. Are
we looking closely enough at our way of practicing
Medicine? Can the use of unstudied polypharmacy
really be considered evidence-based, "scientific"
those of us in conventional medicine looking at
our way of practicing using the same "scrutiny"
with which we often condemn other "alternative"
systems of medicine? Charles Sullivan, D.O. Waterville,
The answer is that multiple conditions require
multiple drugs to treat them. Rarely does one
pharmaceutical treat more than one condition in
a person. An example would be aspirin for pain
in a person with rheumatoid arthritis, but that
is unusual. Same for other cyclo-oxygenase inhibitors.
Heart failure, cancer, and other conditions often
require several different drugs that act in different
ways to optimize effect. Cancer chemotherapy with
multiple drugs can cure leukemias, lymphomas,
testis and ovary cancers, and many others, whereas
single agents cannot. Each combination has been
used in thousands of patients, while physicians
monitor for known side effects (those inconvenient
blood tests and X-rays). Doses are well designed,
then individually tailored for effect and side
effects. In addition, all patients are closely
monitored for unusual and unknown effects, and
these are reported in the medical journals.
to polypharmacy are now only theoretical, and
are not realistic. Do you have an alternative
for the cure and successful treatment of these
diseases? If so, we will stop using multiple drugs
in favor of that method.
excuse for polypharmacy Dr. Sullivan quotes, that
"we are doing the best we can," is not only irrelevant,
it is unnecessary. Of course we always try to
do the best we can, but that is not an excuse,
it is a statement of medical ethics.
Dr. Sullivan then states that less than 30% of
medical practice is supported by controlled studies.
That is a medical urban legend. It is based on
a statement made by epidemiologist Kerr White
at an early meeting of the Cochrane Collaboration,
also quoted from the OTA statement, that came
from a 1962 study of prescribing habits of about
16 general practitioners one Northern English
town. The UK National Health Service was checking
on how much it was really getting for its outlay
for medical care. At that time, controlled trials
were in early methodological development - few
medical scientists even knew how to do them -
and there was a large number of drugs approved
before trials were known, based largely on safety
records and uncontrolled but accurate observations.
NHS found about 20% of prescriptions were proved
by controlled trials, but they also found the
majority of prescriptions written were based on
reliable observations and made physiological sense.
But the punch line here is that in 1995, a report
in the British Medical Journal showed that 83%
of hospital orders written were supported by controlled
trials and another 10-15% were supported by other
reliable pharmacological knowledge. The Scientific
Review of Alternative Medicine last year reported
that some 15 articles now exist showing between
60% and 90% of treatments are supported by controlled
Sullivan then asks if standard medicine is examined
with the same scrutiny as we use for "alternatives?"
The answer is that standard medicine is more closely
scrutinized than sectarian, anomalous medicine.
Even with the disparity in the number of trials.
The reason so many have been done on "alternative"
methods is that not enough of them come out positive.
So they keep on trying.
Mary Praino asks:
78 year old mother underwent colon surgery and
had a malignant tumor removed and a re-section.
The entire tumor was removed, however after testing
24 lymph nodes, they found a mild case of carcinoma
in one of the nodes. She is refusing chemotherapy
and I have been giving her 30 mg. of Q10 enzyme
daily. Will this enzyme aid in discouraging the
growth of this type of cancer? Should I be giving
her any other type of supplement, as well? I am
very concerned about her condition and would appreciate
any advice you could give me.
answer is that there is no medical use for CoQ10.
Nor will any supplement affect colon cancer. Yet,
pharmaceutical drugs (chemotherapy) and other
drugs do affect colon cancer. Fluorouracil will
reduce the chance of recurrence in her case by
about 30%. An investigational approach would be
to use one of the modern anti-inflammatory drugs
such as Celebrex or Vioxx. They cause colon pre-cancerous
polyps to regress and also cause regression of
colon cancer cells.
This is another case of pharmaceutical drugs working,
where "natural" substances do not.
may recall treating me around 1989 for ITP, which
had an onset just after trying an herbal remedy.
While I'm sure this falls into the category of
thinking that the last treatment must have caused
a result that doesn't, in fact, correlate to the
"treatment," I wonder if there have ever been
any studies that show a negative affect to such
(It was great to see you on the show. I'm glad
to see you're doing well, as am I).
answer, Gregg, is the same today as 15 years ago.
ITP (immunologic thrombocytopenic purpura - a
mouthful meaning low blood platelets with small
bleeding spots in the skin and mucous membranes.)
has few known triggers, mostly drugs - quinidine
and quinine, and a few diuretics. ITP is most
often acute (temporary) and full recovery occurs
90% or more of the time. The chronic form is less
dramatic and also usually not fatal or drug associated.
I do not know of any supplement or herb cause.
The herb material could have caused it but as
you stated, one case of two sequential events
does not make a cause and effect. Glad you are
years ago I read a report in our local newspaper
of a breakthrough study that had been performed
by pediatric surgeons at the local teaching hospital.
Apparently, "the experts" had assumed that infants
did not feel, could not recognize, were not adversely
affected by pain since there was no empirical
evidence to the contrary. The study found that
infants that were given anesthesia during surgery
had far better outcomes that those who were not
given anesthesia. As a young parent at the time,
I remember being so shocked and dismayed as to
be speechless. I've never looked at the medical
"profession" quite the same way since. I only
know a little physiology, but doesn't pain (stress,
trauma) initiate a whole cascade of physiological
responses. Does the baby not cry and appear to
be in pain? I couldn't help wondering how many
traumatized infants had become troubled children
and adults as the result of their treatment as
infants, of those who survived, that is.
things are intuitive and just plain common sense.
The moral of this story is, I suppose, that it
is possible that you cannot quantify everything
and the absence of empirical evidence at a given
time does not necessarily mean something is correct
First, Susan, I think there may be something
missing in the report. Either the reporter got
it wrong, or else it was written differently or
perhaps interpreted differently by readers or
your assumptions are incorrect. No one I know
thinks that babies do not feel pain, or ever thought
that they do not feel pain. It sounds like they
wondered how the babies did days later - something
not really measured before.
addition, all major surgery is done under general
anesthesia - no matter at what age, so perhaps
they were talking about some minor surgery such
as circumcision or a laceration repair. In those
cases, administering local anesthesia can be as
painful as the procedure. Sounds strange, but
true in many to most cases. In the past, general
anesthesia was more dangerous than it has been
in the past 20 years.
the question, I recommend tracking down that report,
reading it again, and maybe calling the surgeon,
and making sure the story is right.
was wondering what you might know and or think
about "ultraviolet light blood irradiation." I
know it was popular in the 30's and very effective,
but seemed to die out. I know it is not herbal,
but I would think it would be considered a blend
of traditional and alternative medicines.
is an example of the problem of definitions. Is
this an "alternative"? Alternative to what? For
what is it used? This is not to criticize the
questioner, but to illuminate the hidden questions
behind some simple sounding questions in this
field. In order to be irradiated the blood would
have to be removed, which surely does not make
it "natural" or simple - sterile precautions must
be used, careful handling to avoid contact with
the operator, etc. Ultraviolet light is still
used for some skin conditions so it is not "alternative"
in that sense.
shorter answer is, I don't know.
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