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It all came to a head last week when his anti-vaccine “rants” were covered by our national media when The Australian newspaper and Radio National both took him to task over his public anti-vaccine lectures. The stories came after Australian Doctor published the audio of his talk online, against his wishes but in what they say was in the public interest.

Why is it in the public interest? Because Weiner gives talks to parents, pregnant mothers and young mums and effectively scares them into not vaccinating. Also, he’s the Vice President of the Chiropractors Association of Australia (CAA) NSW branch of whom Australian Doctor have previously accused of “fundamentalist ideologies” and “pseudoscientific dogma”. He’s also on the board of the Australian Spinal Research Foundation where he contributes content for the newsletter. So effectively, he’s a high profile chiropractor.

But leading up to the bad news week for Weiner was a heck of a lot of work behind the scenes. I thought it might be interesting to track the chronology of events which resulted in him getting pwned all over the media. Hopefully, it will give readers an understanding of the value of grass roots scepticism and how a little bit of investigation, like asking questions at the Mind Body Wallet Festival or spending two hours in a chiropractors clinic can result in exposing dangerous quackery. And anti-vaccine quackery is particularly dangerous.

Let’s begin.

November 14th, 2010. My mate Richard Saunders came across this flyer at the Newtown Festival last year where Newtown Community Chiropractic had a stall. He twitpicked it and we decided to go along (Richard didn’t end up going – we can’t remember why).

November 25th, 2010. Meryl Dorey sends out warning to chiropractors as part of her newsletter

December 4th, 2010. I attended the 2 hr free seminar with a friend and blogged it here the same day. Or watch it on the YouTube (thanks to the kind soul who made it).

March 8th 2011. A journalist from Australian Doctor contacted me as part of researching a feature on CAM published as Exploring the Alternatives (I eventually wrote a guest editorial). He was curious about chiropractors and their views on vaccination and knew I had been to listen to Weiner. He booked to go along to the seminar in March. He recorded the seminar, identified himself as from Australian Doctor and asked Weiner if he could post it on-line. Weiner declined.

(Note: according to the Australian Doctor article – which is paywalled – Weiner claims he’s done five years of a medical degree. I was unable to confirm this).

Literature handed out at Nimrod Weiner's December 2010 seminar

To provide you with some context for what happened next, chiropractors were copping it around this time for treating babies.

March 18th 2011. The first stories about a chiropractic clinic at a Victorian University treating babies and kids appears in national newspaper The Australian. Spearheaded by Loretta Marron, academics and health professionals including Simon Singh and Edzard Ernst petition the government to close the clinic down.

March 28th 2011. The British medical journal covers the story

April 27th 2011. Australian Doctor are the first to link chiropractors with the anti-vaccine group the AVN revealing that 130 of professional members of the AVN are chiropractors. This includes clinics run by the CAA president Simon Floreani, the association’s treasurer Taylor Vagg and board member Anthony Croke.

“Mr Floreani….insisted AVN was a valuable resource for patients: “For me it’s about critical thinking. You are only going to get one biased side of the debate from the medical profession. Can you trust the claims that the vaccines are safe when one-fifth of all deaths are related to medical error?

“The AVN has links and resources to an enormous amount of information that you don’t find elsewhere. As a registered health professional, your role is to help patients. I don’t think [of the AVN] as anti-vaccination. It is more pro-choice.”

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May 28th 2011. More bad publicity for baby-cracking chiros, where Marron says, “I would not have written a submission if the chiropractors were treating adults for lower back pain,” she says. “Pediatric chiropractic is a form of faith healing and it should be in theology, not health science.”

July 2nd 2011. A feature story on chiros treating kids appears in The Australian with another “pro-choice” chiropractor, Warren Sipser. (note: this the same one who commented in an article which Meryl Dorey went onto refer to as “vaccination is akin to rape with full penetration.”

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The decision sparked a reaction from the anti-immunisation movement in Australia, with one sceptic, paediatric chiropractor Dr Warren Sipser, saying the judgment was “dangerous” and some children could have severe reactions.

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18 reasons to not vaccinate. Literature from December 2010 seminar

July 11th 2011. The CAA sent a media alert out to their members about damage control, directing their members to send all media enquiries to a PR firm.

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“We wish to alert you to an article that may be appearing in this weekend’s edition of The Weekend Australian…..As always, we continue to make every effort to mitigate negative press that at times is being played out in the media, as well as our attempts to generate positive media..”

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July 23rd, 2011. A bunch of concerned citizens and some members of SAVN attended Weiner’s talk. They were “…criticised by the audience for doing such dreadful things as pointing out errors made by the speaker.”

July 24th 2011. I received a call from a journo who was investigating how widespread anti-vaccine beliefs were amongst chiropractors. The story was published a few days later.

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“Of the (AVN) network’s 198 professional members, 128 are registered chiropractors. Many are members of the professional body the Chiropractor’s Association of Australia, or CAA.”

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August 8th 2011. After obtaining legal advice, Australian Doctor posts the audio of Weiner’s talk online with commentary, even though Weiner did not agree to it. They state; “… we believe it is in the public interest, particularly given Mr Weiner’s profile within the chiropractic profession.”

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We…reported on accusations against the Chiropractors Association of Australia – the profession’s peak body – that it has turned its back on science to peddle “fundamentalist ideologies” and “pseudoscientific dogma”. The CAA has strenuously denied the claims.

On the issue of vaccination, it says the profession’s role is to educate the public on health issues – the risks and benefits of vaccinations is just one of those issues. So here we offer a talk on vaccinations given to members of the public by Nimrod Weiner…..vice-president of the NSW Chiropractors Association of Australia and ..on the board of the Australia Spinal Research Foundation, a self-styled scientific research body.

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August 15th 2011. Another journo, again from The Australian newspaper emailed to ask me about the Australian Doctor audio, since he knew I had blogged about the talk. A story entitled “Call to probe anti-vax rant” was published on August 17th (seen by approximately 128,985 people) where Weiner’s comments were described as “outrageous” by the Australian Medical Association who called on the CAA to intervene.

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Mr Weiner declined to comment, referring questions from The Australian to a PR company, which said the Chiropractors Association of Australia (NSW) had no position on vaccination and “any comments that Nimrod Weiner may have made would be his private opinions, not those of the association”.

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August 18th 2011. The following day, the story appeared on Radio National on the back of Australian Doctor audio and The Australian newspaper article.

August 19th 2011. Another critical article appeared in the press

Interestingly, shortly after these national stories broke, a link on Weiner’s website to his vaccine talks was showing a 404 but it could be found in Google cache. Today, as I was researching to write this article I again found the page, but it appears an attempt to hide it has been made, as indicated by the “_offline” text at the end of the url. You can still get the page though if you do some digging, but it has been moved thus breaking all previous links.

I guess the question now is will Weiner continue to give these seminars. According to this screenshot he has previously charged for the seminars.

UPDATE: Another critical article appeared in Australian Doctor today, where the Chiropractic Board of Australia is calling on people to complain about Weiner;

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The chair of the chiropractic board is urging people to make a formal complaint about high-profile chiropractor Nimrod Weiner over his public seminar on the alleged dangers of vaccines.

Phillip Donato stressed that chiropractors had a duty under the profession’s code of conduct to provide up-to-date, evidence-based information. He said: “It appeared at the very least he is misinformed and may be providing misleading information to the public. We would encourage notifications so that we can have a look at the case properly.” Australian Doctor understands that notifications have already been made.

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Indeed a complaint made to AHPRA then passed onto the Chiropractic Council of NSW was dismissed in June this year. The complainant flagged anti-vaccination material on Weiner’s website as being in breach of section 10.2 of the Code of Conduct for Chiropractors, which states; “good practice involves: c) understanding the principles of immunisation against communicable diseases.”

The complaint was dismissed on the grounds that “The Council considered that Dr Weiner was entitled to put his opinion forward and that this did was not in breach of the Code.”

I don’t think we’ve seen the end of this saga. I’ll be sure to keep you posted.

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The backlash from the BCA decision to sue Simon Singh back in 2009 resulted in a huge Streisand Effect for the profession. Attempting to silence Singh with legal chill had many knock-on effects including one in every four chiropractors in the UK being investigated for making false claims in their advertising. To avoid prosecution, the McTimoney chiropractors emailed all their members and instructed them to take down their websites and “remove information leaflets that state you treat whiplash, colic or other childhood problems in your clinic..”.

Here in Australia we haven’t seen anything as hysterical as this, but our paranoid friends over at the AVN were clearly worried, issuing a warning in their Nov 2010 newsletter that sceptics were posing as clients and reporting chiros to the authorities.

To me, this seems like a silly way to go about reporting chiros – paying them. It’s much simpler to just take a look at their websites or promotional material. Just like the anti-vax handouts I was given by Nimrod “I’m not anti-vaccine, i just don’t recommend it” Weiner, whom I’ve blogged about previously.

Of course, none of this would be a problem if they simply operated within their code of conduct and stuck to cracking backs.

So I suppose I shouldn’t have been surprised to see this claim in a leaflet sent to me by a friend earlier today:

The text says; IQ – A study demonstrated an increase in visual perception, motivation, performance and 100% of the sample group showed an increase in IQ.

One hundred percent of the sample group showed an increase in IQ? Wow, what an extraordinary claim! You’ll note there is no reference provide for this “study”, but if you want one, why not contact them through their website. (The page above is taken from a newsletter from October 2007).

As @cactopos suggested on Twitter; “I guess you could argue that alternative medicine increases everyone else’s IQ thru a process of natural selection?”. Touche Cactopos.

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Hello friends! long time no bloggy-blog etc. Apologies, but there was this small thing called #TAMOz. Dunno if you’ve heard of it, but it completely took up my life for the last six months so everything else had to take a back seat. I apologise, I hope you’ll forgive me, etc etc.

Let’s move on.

So now I’m back in investigative sceptic mode, I will tell you what I did on this fine Saturday afternoon. I attended a seminar from Pediatric Chiropractor, Nimrod Weiner, at Newtown Community Chiropractic entitled Vaccinations: Make an Informed Decision. Sounds like a loaded title doesn’t it? And it was, as you’re about to find out.

To set the scene, the audience consisted of about 20 people, mostly women (several pregnant) and assorted couples with very young babies (< 2 years old) gurgling in the background. Then there was me and my mate Frode (I don’t think he is pregnant).

Nimrod started by saying he was going to provide us with both sides of the story to vaccination. He acknowledged that vaccination is an emotive issue, but he asked that we do not let our emotions get in the way. He was happy for dissenting views to be aired and he would respect people for their views.

He also said (and I think I recall this correctly) that he had been called anti-vaccination after giving some of his lectures, but that he was no such thing. I settled a little lower in my seat when I heard this.

After detailing his qualifications (which include a masters in Chiro with units of peadiatric chiropractic) Nimrod emphasised he would stick to the science about vaccinations in an effort to arm parents with the ability to ask the right questions and weigh up the evidence from both sides. He said he approached the research from a logical and rational point of view and his aim was to “empower parents to make a good decision” (does this sound like someone else we know?).

He was also going to explain to us “how safe the diseases (we vaccinate against) are” and thereby allow us to make “an informed decision based on science”. So far this is sounding pretty anti-vaccine to me. I had so many flags up already it felt like a flag festival (or something) and we were only 5 minutes in.

After a brief explanation of what chiropractic is – chiros keep the nervous system healthy – stressors can “imprint on the nervous system” and cause decay, a healthy body heals itself – Nimrod attempted to explain the immune system to a room full of lay people. He used the rather unusual analogy of “Avatar” (the movie) and the reactions of the female versus male population of the fictional planet to invaders, to describe that Th1 cells are the warriors (they go in fighting without much thought, like the males in “Avatar”) and the Th2 cells maintain a memory and “learn” from the invaders (there were the female characters in “Avatar”).

I guess if you’ve seen Avatar this might work ( I haven’t) , but for me, it was a long-winded and not very effective approach. Further, I don’t think a lay audience needs to know the ins-and-outs of the immune system, especially since he hardly referred to Th1/Th2 later.

Finally we got on to vaccines, however the talk was still peppered with phrases such as “leave out emotions and propaganda”, “respect critical thinking and analysis” but immediately followed with “information about vaccines is laden with propaganda”. Nimrod continued to emphasise that his information is based on current research and science and further, he has spent more than 100 hours on “this topic alone”.

I reckon if you can count the number of hours you have spent on a topic, then you haven’t spent nearly enough. Also, it doesn’t matter if you’ve spent more than 100 hours, if you’ve read the wrong information from the likes of Mercola*, Mike Adams or the AVN, then you’re not going to glean anything based on research and science by the time you finish.

Nimrod then proposed, “no criticisms are allowed (from the audience) without an accompanying suggestion for improvement”. We’ll get to that later.

It was here that I began to tally the number of times he said, or referred to vaccines as “injected into the blood”. Granted, the first time he mentioned it, he did say “straight into the blood or a muscle….”.

But, I ticked off at least 6 mentions of INJECTED INTO THE BLOOD. Anti-vaxers love to do this – it sounds so SCARY and EBIL. He did follow this up with by saying that some vaccines can be inhaled but they are not as effective.

Which is interesting, because his whole explanation about the immune system being like “Avatar” was designed to illustrate that vaccines by-pass the “first line of defence” (being the skin and mucous membranes) therefore can never be as effective as natural infections. Yet vaccines that are inhaled are not very effective? Does not compute.

He also said that injecting a vaccine DIRECTLY INTO THE BLOOD means the immune system can’t respond as effectively. Which made me wonder, what happens when I cut myself and germs get in? Isn’t my immune system able to cope just as well in this instance, compared to when I breathe in a virus or bacteria?

So then we got the old antivax canards:
1) Non-one knows how long vaccines last
2) No guarantee of their effectiveness
3) Antibodies have no role in immunity
4) These diseases are designed to come into our bodies when we are kids
6) Vaccines have never been tested

Nimrod then went onto to talk about lots of pseudoscience, lack of ethics and negligence associated with vaccine manufacturers and government health bodies. Some of his points were quite valid, such as Big Pharma test the vaccines they make hence there is propensity to bias, some government advisors have links to Big Pharma suggesting a conflict of interest, and the TGA doesn’t independently test drugs.

But then he went and undid all his good work by saying something like:

No lot of vaccines have ever been recalled for increased adverse reactions, lots that may have caused harm in children, they have never been taken off the shelf. In the “whole history of the world” this has never happened.

Oh, except in WA with the recent fluvax reactions scare.

So he scares parents into thinking that vaccines batches that may be faulty and cause increased adverse reactions are ever recalled EXCEPT that time when they were.

He also claimed that parents are not told what to expect after a vaccination. I’m pretty sure everyone is told what to expect and even made to wait for at least 15 minutes in case of an immediate adverse event.

He then cited deaths from vaccine preventable diseases in the last decade (cited as sourced from Immunise Australia) and proposed reasons for the cause of death, since vaccine preventable illnesses are not so bad. Really.

He suggested that since vaccination status was unknown, these people may have had other illnesses, they may have been Aboriginal (a population which suffers a greater incidence of disease that the rest of the country), they may have lived in unsanitary conditions and perhaps they were in refugee camps. So in other words, any number of explanations – including they were somehow in squalid refugee camps – could explain their death from vaccine preventable disease. Cause it sure as hell wasn’t the disease.

As we moved onto vaccine ingredients, I felt as if I was reading the AVN’s page or something from Joseph Mercola as he listed all the SCARY CHEMICALS in vaccines.

There was no acknowledgment of the “poison is in the dose”, or that there are 2 types of mercury, the one in some vaccines being much less SCARY. All the usual suspects got a mention including ABORTED HUMAN FOETUS, thimerosal, aluminium, bacteria, formaldehyde, and anti-freeze.

We were also reminded that scientists say that vaccines are safe but what about ASBESTOS AND CIGARETTES AND THALIDIMIDE!!!!1!!eleventy11 – they said they were safe too.

As expected, the old “vaccines cause autism” show boat was rolled out several times. When myself and Frode politely pointed out that Nimrod should probably not be using Wakefield’s Lancet (since retracted) paper as evidence for such – if, as he claims he was basing his research on good science – he insisted that the science was still valid. According to him, Wakefield was only in trouble for 2 things in regards to that paper – he didn’t have ethics for the birthday party blood taking and he paid the parents – otherwise it was solid science. When Frode gently pointed out that you generally have to do more than that to get struck off the medical register, Nimrod said it was political.

During this discussion Nimrod also stated he had read The Lancet paper. I propose he didn’t read it properly, because in his summary he wrote it showed a link between MMR and autism. But The Lancet paper doesn’t address a connection between MMR and autism, this was suggested at a press conference after the paper was published.

When both Frode and I informed him that Wakefield was paid by lawyers to show a link between MMR and autism and had a patent pending on a single measles vaccine, he again claimed to not know anything about this. So he was quite happy to throw mud at Big Pharma for bias, pseudoscience and vested interests, but these same rules do not apply to Wakefield.

In fact, the Wakefield-in-the-room was addressed several times, once by a lady inquiring about the Swedish study (actual it’s Danish) of all children born in Denmark from January 1991 through December 1998 which provided strong evidence against the hypothesis that MMR vaccination causes autism. Nimrod said he had not heard of that study either but he would like to see a copy.

There was more vaccines cause autism to come, with evidence in the form of a American Dental Association video showing a neurone dying in culture when incubated with mercury. The dose of mercury was not specified, how a cell in a dish is relevant to a child’s brain was not discussed, and fortunately for us the video stopped working half way through.

We were then told that vaccines are associated with shaken baby syndrome, SIDS, ADD, asthma, MS, suppress the immune system and “shift the balance for life”. We were told that polio has not been eradicated in many countries, but has simply been renamed (in an attempt to hide the ineffectiveness of the vaccine I presume) by Big Pharma, as flaccid aseptic meningitis or aseptic meningitis. We were also told that one in two people now have a chronic disease, herd immunity doesn’t work, and most childhood illnesses are self limiting, rarely dangerous and have few serious consequences (except the ones that kill you).

Nimrod ended by saying he treats babies as young as one day old and if your baby is sick get it to a pediatric chiropractor for treatment as soon as you can. Thanks, but I’ll go to a real doctor.

So after listening to this propaganda for two hrs and asking a few polite questions here and there, I decided to offer “criticism….with an accompanying suggestion for improvement”.

I asked Nimrod why he didn’t tell us from the very beginning that he was against vaccination. Recall that he told us at the beginning of the lecture that some people come away from his seminars thinking he is anti-vaccine, (he didn’t like me reminding him of this btw, and mumbled something about “not my words”). I suggested that he had not shown anything about the risk/benefit ratio of vaccination – that is, the risk of getting an adverse reaction to a vaccine is tiny compared to the risks associated with the disease. He said he was not anti-vax, but admitted that he would not choose to vaccinate, but it is the choice of the parents. My suggestion for improvement was therefore that he inform people from the very beginning that he is against vaccination.

I’m not anti-vaccination, I just don’t recommend it. Although we were told this was not an anti-vax seminar, this was the literature handed out at the end.

My second criticism was that nowhere in his seminar had he addressed the issue of the seriousness of childhood diseases and that as a pediatric chiropractor, it was irresponsible not to inform a room full of mums holding babies and pregnant women that there is currently an epidemic of pertussis and pertussis kills babies. I suggested to him that he had glossed over the seriousness of this disease (and others) and that whilst he spent a lot of time talking about vaccine reactions, he didn’t even mention that in babies under the age of two years, pertussis can be fatal at the worst, and at the best have complications such as broken ribs, hernias, vomiting after coughing episodes, pneumonia etc. My suggestion for improvement was that when there is an epidemic of a vaccine preventable disease in our community, he might remind parents that they should vaccinate their kids and get their own booster shot to protect theirs and other babies.

My final criticism was he said that vaccines don’t work because I can still get the disease even if I am vaccinated. My suggestion for improvement was that although a vaccine is not a force field, it can significantly reduce the severity of the disease. So kids who have had two or three shots for pertussis can still get the disease, but they have a reduced risk of getting complications and suffering long term effects.

It was at this point that a discussion ensued around the room in which one pregnant lady asked Nimrod if there was a cure for whooping cough. She looked over to me and I shook my head and Nimrod confirmed this. She then asked Nimrod which vaccines were important and which you could skip. As she listed them off, she said one thing that made me pause. She said something like, “Obviously I can’t skip the pertussis vaccine, that disease sounds really bad”.

So maybe we achieved something today.

Yet, sadly, she included chicken pox in her list of “not so bad childhood diseases”. It was on my tongue to remind her of the death of a seven year old from chicken pox recently, but by this stage I was tired and also losing my temper.

For a pediatric chiropractor I couldn’t be more disappointed in Nimrod Weiner. He’s a smart man who has studied extensively, but he sat in a room filled almost exclusively with pregnant women and parents with babies and scared them into not vaccinating. He told them never to get vaccinated if they are pregnant “no matter what they tell you”. He cited studies that have been struck from the literature because they were found to be fraudulent and he defended them when questioned. In the middle of a pertussis epidemic in which at least three babies have died, he told parents that childhood diseases are self limiting and not very harmful.

But worst of all, as we were gathering our stuff and about to leave, someone asked him a question about homeopathic vaccination. He said although he wasn’t a homeopath, he understood it worked like vaccines, in that it had contained small amount of the infectious material, but was safer because it didn’t have the toxic chemicals that vaccines have.

Ironic really, when he had just stood in front of us for two hours, spouting misinformation about vaccines and never once did he say he was not an immunologist or a medical doctor. He gave medical advice to pregnant women and parents for two hours and much of it was wrong.

I guess all we can hope is that Frode and I planted a seed in some people’s minds today. Also thanks to the lady who cited the Danish study (woo hoo!). As for us, We didnt give up on the Wakefield stuff. We didn’t let it go when Nimrod kept saying it was “good science”. He told us he updates his slides every time he gives a talk, to which I suggested next time you do that, remove the Wakefield one.

Who knows if he will. At least he was willing to listen to our criticisms. Unlike some, he didn’t have us ejected from the room as soon as we started to ask questions. But when someone who calls themselves a pediatric chiropractor and says homeopathic vaccination works and “That Lancet Paper” is valid, well it’s time to notify the relevant authorities.

Especially when kids’ lives are at risk.

* To his credit, Nimrod did end by saying he reads Mercola “with a grain of salt” and that his website does have some strange ideas about medicine, but if this is the case why mention him at all?

The edited version has the libelous sentence removed, but is reproduced to allow the public at large to understand the intentions of Simon’s original post. Given the current legal action currently in progress by the British Chiropractic Association against Simon, this provides insight into the claims for all to see.

Spearheaded by Sense about Science, the intention of campaign is to alert the public to the potential implications  of libel or defamation as it pertains to free speech and journalism, not only in the UK but also across the globe.

Below is the article produced in full, as approved by Simon and Sense about Science.
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Beware the spinal trap

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

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Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

The story was broken by Andy Lewis from Quackometer, who published the letter in full on his website. An article, written by Chris French, detailing the events, was published today in the Guardian. You can read the full article here, but, briefly it says;

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On May 20, 2009, the Advertising Standards Authority (ASA) published its adjudication on whether chiropractors Dr Carl Irwin and Associates “could substantiate the implied claim that their therapies could successfully treat some of the conditions mentioned, in particular IBS, colic and learning difficulties”. The relevant part of the adjudication reads as follows:

We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties.

On these points the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.1 (Health and Beauty Products and Therapies).

Simon Perry, the founder of Skeptics in the Pub, Leicester, was so incensed by the British Chiropractic Association’s libel case against Simon Singh, he decided to do something about making sure this legislation was enforced. He searched chiropractic websites, collating those that claimed to treat colic or else implied that chiropractic was an effective treatment for this condition and reported 174 for breaching the advertising standards code. In response, the MCA sent a letter to their members advising them to do the following;

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“If you have a website, take it down NOW. REMOVE all the blue MCA patient information leaflets, or any patient information leaflets of your own that state you treat whiplash, colic or other childhood problems in your clinic”

“If you use business cards or other stationery using the ‘doctor’ title and it does not clearly state that you are a doctor of chiropractic or that you are not a registered medical practitioner, STOP USING THEM immediately.

“Be wary of ‘mystery shopper’ phone calls and ‘drop ins’ to your practice, especially if they start asking about your care of children, or whiplash, or your evidence base for practices.

“Finally, we strongly suggest you do NOT discuss this with others, especially patients, Firstly it would not be ethical to burden patients with this, though if they ask we hope you now have information with which you can respond.

Most importantly, this email and all correspondence from the MCA is confidential advice to MCA members alone, and should not be shared with anyone else.”

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One would have thought it would be more responsible to advise members to simply not use therapies for which there is no evidence, particularly when it comes to treating children. But then quacks will be quacks…

And now it appears we have the same problem in Australia. The article below appeared in a regional newspaper this week and was sent to me by a reader;

(emphasis is from reader).

The text says;
“Chiropractic treatment has also been shown to provide significant benefits for the treatment of colic. Research from the University of Southern Denmark found that spinal manipulation is effective in relieving infantile colic. Chiropractors use safe and gentle procedures to correct spinal misalignments affecting the nervous system. Chiropractors believe that trauma during the birth process can be a factor in the development of colic”.

I don’t know the laws in Australia regarding this, but given the smackdown the Arnica Montana website received this week from the Complaints Resolution Panel, this looks like a potential breach of the code.

In any case I plan to write a letter to the editior about this, citing the fact that there is no evidence for chiropractic being beneficial in colic. You should too; letters should be less than 250 words. Name, address, and phone number is required (can be withheld on request). Email editor@surfcoasttimes.com.au, snail mail, PO Box 714 Torquay VIC 3228, fax 5264 8413.

Thanks @eemyoo for the tip-off.

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UPDATE: Thanks to eemyoo for sourcing the CHIROPRACTORS REGISTRATION BOARD OF VICTORIA             STANDARDS OF PRACTICE GUIDELINES for ADVERTISING.

The sections this advertorial appear to breach appear below;

For the purpose of these Guidelines, advertising…..includes situations where practitioners make themselves available for, or provide information to, media reports, magazine articles or advertorials.

Advertising general guidelines; Chiropractors must be certain that they can substantiate any claims made in advertising material, particularly in relation to outcomes of treatment, whether implied or explicitly stated.

5.2 What is unacceptable advertising? a) create or be likely to create unwarranted and unrealistic expectations about the effectiveness of the chiropractic services to be provided

For many years, unregistered practitioners such as naturopaths, acupuncturists, reiki practitioners, massage therapists, iridologists and the like, have been without any accountability for selling bogus or dangerous products or services.

In Australia, we have the federally controlled Therapeutic Goods Administration (TGA) which is responsible for “safeguarding public health and safety in Australia by regulating medicines, medical devices, blood and tissues”. But this does not include unregistered and alternative health practitioners. In NSW, a Code of Conduct for Unregistered Practitioners was released on August 1st, 2008. The code consists of 17 sections, covering such matters as;

practitioners are to provide services in a safe and ethical manner, are not to financially exploit clients and practitioners are required to have a clinical basis for their treatment”.

The code is designed to fill a loophole for the regulation of health providers who are not covered by a registration body, meaning that although the public could lodge a complaint about a practitioner, the regulatory bodies could do little more than slap them on the wrist. Whereas this new legislation means they can be banned from practicing either for a specific period or permanently. The code is administered by the Health Care Complaints Commission (HCCC) and if breached,

the Commission has the power to impose a prohibition order and/or issue a public warning about the practitioner and their services. A prohibition order bans a practitioner from providing health services, or places conditions on their provision of health services, for a specified period or permanently. It is a criminal offence to breach the order”.

But not every state in Australia has such a code for alternative health practitioners. (One wonders if Queensland is exempt since there seems to be so much woo in this state). For example South Australia (SA) does not, but a parliamentary inquiry is currently underway which plans to change this. Labour MP Trish White set-up a Social Development Committee inquiry in 2007. Its brief was to investigate “bogus, unregistered and deregistered health practitioners” and to develop a way to regulate the growing number of people making false claims about their ability to cure. White hopes the inquiry will expose the charlatans and work out ways to stop them popping up again under different names.

The current inquiry is spearheaded by the state head of the Australian Medical Association (AMA), Dr Peter Ford, the proposal is modelled on the NSW code. The impetus for the introduction of such a code came from Dr Ford as a mechanism for regulating quacks. Dr Ford told the inquiry that the unregulated practitioners are a “relative risk to patient health and have enjoyed immunity and lack of scrutiny from the legal and regulatory authorities which apply to the medical profession”.

In his submission about “bogus” doctors, he highlights colonic irrigation, thermography, subluxation and cancer cures as some of the more dangerous alternative medicine treatments. AS previously mentioned on Dr Rachie Reports, colonic irrigation can result in tearing of the colon and septicemia, or chronic depletion of electrolytes and death.

Thermography is a tool promoted as a way to detect breast cancer, but the AMA says it is unreliable, missing known cancers and diagnosing non-existent cancers – and further it is expensive. Chiropractic subluxations or spinal problems, can lead to other health complaints. The AMA is concerned about children being subjected to unnecessary X-rays for what is a controversial diagnosis and treatment (see here for more information). Regular listeners to Dr Rachie will remember that chiropractic manipulation has lead to death from tearing of arteries in the neck.

Dr Ford also cites fanciful claims of cancer cures as particularly insidious. And as is evidenced by some of the complaints currently being heard as part of the inquiry, it seems this is an urgent inclusion. He also cited other therapies, such as alternative massage therapies, Vega testing and coffee or chamomile enemas are “untested and potentially harmful”. Vega testing is as food allergy test, reminscent of alternative hair analysis, which claims to identify different food allergies and then prescribes you a special diet.

QuackWatch describes the Vega test as “…used to diagnose nonexistent health problems, select inappropriate treatment, and defraud insurance companies. The practitioners who use them are either delusional, dishonest, or both. These devices should be confiscated and the practitioners who use them should be prosecuted”.

Recently an article appeared in the local Adelaide press about a health practitioner treating cancer sufferers with massage, home-made remedies, and Kentucky Fried Chicken (KFC). The Favira Clinic, run by “miracle worker” Elvira Brunt uses a type of massage to change the way blood flows through the body, and this is supposed to cure terminal illnesses. Her supporters call her a gifted healer who can cure cancer. Her detractors have told a parliamentary committee that she takes money from vulnerable people, charging hundreds of dollars for a few precious minutes, paid in cash, with no receipt.

The AMA claims that she tried to convince the parents of a young leukemia victim to delay giving her treatment. The girls’ GP eventually told the committee the delays had a devastating effect;

….the interventions by the bogus practitioner served only to reduce the opportunity of giving the girl the best chance of a cure…..and when the cure could not be achieved she was deprived of optimal palliative care”.

Even more bizarre, Brunt apparently advised the girl’s father to give her the aforementioned KFC to get her kidneys functioning properly. The girl has since died. Her GP said; “People battling serious or terminal illnesses can be desperate and will sometimes hand over large amounts of money for quite useless treatments. We would like to think that the public is protected from such charlatans”.

Also reported to the inquiry is a man known as Lubo Bitelco who is alleged to have promised a woman a “50 percent” cure for cancer through a technique known as vaginal blowing, during which she had to move up and down on the bed saying “oh boy!”

In NSW, making claims of curing cancer or other terminal illnesses was outlawed in August 2008 with the introduction of the code. According to section 5, part 1 of the code; “A health practitioner must not hold himself or herself out as qualified, able or willing to cure cancer and other terminal illnesses”.

Also according to section 17 of the Code, Health Practitioners (with some exceptions such as the ambulance service and private hospitals) must display the Code and information about the way in which clients may make a complaint to the HCCC if necessary. These documents are available as easily downloadable pdfs from the Department of Health and the HCCC websites.

I am currently making enquiries as to whether it is an offence if the code is not displayed. If this is the case, it should make for an interesting visit to the Mind body Wallet festival at the end of this month, where all manner of fantastical woo is on display, with only the NSW department of health and the TGA are conspicuous by their absence.

I am personally very pleased to see the code introduced and hope that SA expect something similar. One expects Dr Peter Ford is not going to let these “wide-ranging ratbags” get off the hook that easily. He is a very active campaigner for science based medicine and features regularly on local ABC radio in SA.

What interested me most about the code is how it will be implemented. For example, can I dob in a website that claims to treat cancer with oxygen, water, sunlight and sleep? In accordance with Section 5,

health practitioners are not to make claims to cure serious illnesses”

including cancer, but do they actually have to state the word “cure” in their promotional material? What if they just infer they can cure an illness?

I was particularly interested in Section 12 which states that health practitioners are not to misinform their clients. Part 2 states that a health practitioner must provide truthful information to his or her qualifications, training or professional affiliations if asked. So, does this mean the end for people posing as doctors with bogus or on-line PhDs? One can only hope.

Section 3 is also interesting and has potentially far reaching consequences.

A health practitioner must not make claims about the efficacy of treatment or services if the claims cannot be substantiated”.

Sounds like curtains for KFC and “water can cure incurable diseases”. I will be very interested to see what impact the code has on alternative and unregistered practitioners in NSW.

Mind Body Spirit happens every 6 months in Sydney and the description on the website is as follows; “…Australia’s largest event for personal growth, natural therapies, alternative healing, self development, spiritual awareness and much more. See, try and buy hundreds of products and services for your total wellbeing: physical, mental and spiritual”.

This is a woo festival on a huge scale! With over 190 exhibitors, spiritual cinema, free seminars, free performance stage, free positive thinking a meditation centre, and of course it wouldn’t be the same without the psychics and clairvoyants. Accordingly, there is a psychic reading room with over 60 of the best clairvoyants, who will sting you $40 for a 25 min reading or $80 for 50 mins. This room is always packed and you are advised to book ahead. Back in May, this room was constantly buzzing. This year there are several seminars from the psychics featured on “The One” but before I delve into that, I want to bring to your attention, some of the more weird and wonderful exhibitors.

Weird

Ouch!

Noseworks are suppliers of a product known as Neti Pot (also known as Nasal Cleansing Pot or Jala Neti). This thing looks like a tea pot with an inverted spout. According to an instructional video on the website, you fill it with warm salty water and then flush your sinuses by pouring it up your nose!

And another website proclaims this process to be a “….simple solution to asthma, sinusitis, snoring, hay fever, blocked noses, sneezing, sinus headaches”. And even better, “It has a cooling and soothing effect on the brain and is therefore beneficial for headaches, migraine and general mental tension”. What? How does it get into your brain???

And there’s more… “Regular cleansing helps the eyes, ears and mind become clearer” and “It helps clear the mind giving you a sense of lightness and clarity which aids better concentration”

Go ahead and shove this thing up your nose if you wish. I know one thing, you will most certainly look silly, but as for the rest of the claims? Dubious to say the least. And the part about clearing your mind and cooling your brain? There is no basis in science for this. But wait, why listen to me? Apparently this thing has featured on Oprah, but then so has Tom Cruise and Jenny Macarthy…..

More weirdness

Nana Mays Magic Hands and Tea Cup Readings with Betty? Doesn’t this sound like a lovely old lady, straight out of the 1950s who makes you a “nice cuppa tea” and reads your leaves? I thought this stuff went out of fashion years ago. Hasn’t Betty heard of the “Coffee Oracle” by Stacey Demarco? We’ve gone espresso now my dear…As for Nana Mays Magic hands? No idea but I’ll be certain to check this one out.

[youtube=http://au.youtube.com/watch?v=BwMI9wOLrZ4]

Wrong

All across the festival there are stalls and seminars espousing the benefits of drinking “alkaline water”. One is entitled “How water can cure incurable diseases” (grrr, misleading in the extreme), but when I did some further digging it’s just alkaline water again. And another; “Food intolerances, digestive enzymes and alkalisation”, which apparently will report on two new digestive enzymes that will greatly boost your digestive power? Digestive power? Sounds like a washing powder to me.

Proponents of this stuff claim;

Looks just like water to me

“The negative ions in alkaline water are a rich source of electrons that can be donated to …free radicals in the body, neutralising them and stopping them from damaging healthy tissues”.

Nonsense, when you drink alkaline water, its alkalinity is quickly removed by the highly acidic gastric fluid in the stomach. And the body regulates it’s pH by buffering with bicarbonate ions and breathing off CO2. This is pure pseudoscience nonsense

Supernatural

Of course it wouldn’t be MB$ without the usual collection of psychics and this year there is a contingent from “The One – the search for Australia’s most gifted psychic” giving seminars such as, “Connecting with Spirit”, “Messages from Beyond” and “You too can be The One – how to develop your own psychic gifts”. These sounds decidedly normal stacked up against “Sonic re-birthing through sound therapy”, “The Atlantian pathway to Isis” and “Psychic spoon bending and Egyptian Alchemy”.

And folks, this is just the beginning of four days of the strange, the supernatural and the silly. Combined with the usual suspects, being the iridologists, chiropractors, Chinese medicine, reflexologists, aura capturers, angels, orb spotters, ear candles, etc. we are certainly in for an interesting experience.

I have an accompanying blog about MB$ on scepticsbook.com. Thanks to everyone who has been emailing me, I appreciate your feedback, comments and suggestions.