Visceral Manipulation Embraced by the APTA

Many years ago, when I was a naïve and gullible teenager, I read about a home treatment for constipation that involved rolling a bowling ball around on the abdomen. I was intrigued, thought it sounded reasonable, and might even have tried it myself if I had been constipated or had had a bowling ball to

Lessons Learned

I just returned from a trip to Montreal where I spoke at the Lorne Trottier Public Science Symposium, an annual event that David Gorski spoke at a year ago. My topic was “Puncturing the Acupuncture Myth” and the other speakers were Paul Offit, Edzard Ernst, and Bob Park. I was honored to be in such august

Wishing Away Warts

Common warts (verruca vulgaris) are more of a nuisance than a serious health problem, but they are interesting. There is a whole mythology surrounding their cause (touching toads?) and treatment (everything from banana peels to vitamin C).  Many people believe they can be made to vanish by suggestion or hypnosis. I used to believe that

Belief in Echinacea

Note: The study discussed here has also been covered by Mark Crislip. I wrote this before his article was published, so please forgive any repetition. I approached it from a different angle; and anyway, if something is worth saying once it’s probably worth saying twice. Echinacea purpurea, or purple coneflowers – not a cure for

Cognitive Traps

In my recent review of Peter Palmieri’s book Suffer the Children I said I would later try to cover some of the many other important issues he brings up. One of the themes in the book is the process of critical thinking and the various cognitive traps doctors fall into. I will address some of

The Role of Experience in Science-Based Medicine

Before we had EBM (evidence-based medicine) we had another kind of EBM: experience-based medicine. Mark Crislip has said that the three most dangerous words in medicine are “In my experience.” I agree wholeheartedly. On the other hand, it would be a mistake to discount experience entirely. Dynamite is dangerous too, but when handled with proper

The Meaning of Secondary Prevention

A November letter to the editor in American Family Physician chastises that publication for misusing the term “secondary prevention,” even using it in the title of an article that was actually about tertiary prevention. I am guilty of the same sin. I had been influenced by simplistic explanations that distinguished only two kinds of prevention:

Evidence-Based Medicine, Tooth Fairy Science, and Cinderella Medicine

The term evidence-based medicine (EBM) first appeared in the medical literature in 1992. There were two previous EBMs: Expert-Based Medicine and Experience-Based Medicine. In the 4th century BCE, Aristotle said men have more teeth than women. He was the expert, and for many centuries his error was perpetuated because no one dared question his authority

Alchemy Is Back

Alchemy is alive and well! Yes, that medieval precursor of chemistry, that chimerical search for the philosopher’s stone and the transmutation of lead to gold. Modern alchemists have found the philosopher’s stone and are selling it and teaching people how to make it themselves out of dew and Celtic sea salt. The philosopher’s stone apparently

Metabolic Syndrome: A Useless Construct?

Birds of a feather flock together. As they investigated the risk factors for cardiovascular disease and diabetes, medical detectives observed that the usual suspects liked to hang out together. Obesity, high blood pressure, abnormal blood lipids, and elevated blood sugars regularly appeared together in the same patient. It looked like a syndrome that might boil