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Wednesday, March 24, 2021

Quackery

From Wikipedia, the free encyclopedia
 
WPA poster, 1936–38

Quackery, often synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, qualification or credentials they do not possess; a charlatan or snake oil salesman". The term quack is a clipped form of the archaic term quacksalver, from Dutch: kwakzalver a "hawker of salve". In the Middle Ages the term quack meant "shouting". The quacksalvers sold their wares on the market shouting in a loud voice.

Common elements of general quackery include questionable diagnoses using questionable diagnostic tests, as well as untested or refuted treatments, especially for serious diseases such as cancer. Quackery is often described as "health fraud" with the salient characteristic of aggressive promotion.

Definition

William Hogarth's The Inspection, the third canvas in his Marriage à-la-mode (The Visit to the Quack Doctor)

Since it is difficult to distinguish between those who knowingly promote unproven medical therapies and those who are mistaken as to their effectiveness, United States courts have ruled in defamation cases that accusing someone of quackery or calling a practitioner a quack is not equivalent to accusing that person of committing medical fraud. To be both quackery and fraud, the quack must know they are misrepresenting the benefits and risks of the medical services offered (instead of, for example, promoting an ineffective product they honestly believe is effective).

In addition to the ethical problems of promising benefits that can not reasonably be expected to occur, quackery also includes the risk that patients may choose to forego treatments that are more likely to help them, in favor of ineffective treatments given by the "quack".

Stephen Barrett of Quackwatch defines quackery "as the promotion of unsubstantiated methods that lack a scientifically plausible rationale" and more broadly as:

Pietro Longhi's The Charlatan (1757)

"anything involving overpromotion in the field of health." This definition would include questionable ideas as well as questionable products and services, regardless of the sincerity of their promoters. In line with this definition, the word "fraud" would be reserved only for situations in which deliberate deception is involved.

Paul Offit has proposed four ways in which alternative medicine "becomes quackery":

  1. "...by recommending against conventional therapies that are helpful."
  2. "...by promoting potentially harmful therapies without adequate warning."
  3. "...by draining patients' bank accounts,..."
  4. "...by promoting magical thinking,..."

Quacksalver

Unproven, usually ineffective, and sometimes dangerous medicines and treatments have been peddled throughout human history. Theatrical performances were sometimes given to enhance the credibility of purported medicines. Grandiose claims were made for what could be humble materials indeed: for example, in the mid-19th century revalenta arabica was advertised as having extraordinary restorative virtues as an empirical diet for invalids; despite its impressive name and many glowing testimonials it was in truth only ordinary lentil flour, sold to the gullible at many times the true cost.

Even where no fraud was intended, quack remedies often contained no effective ingredients whatsoever. Some remedies contained substances such as opium, alcohol and honey, which would have given symptomatic relief but had no curative properties. Some would have addictive qualities to entice the buyer to return. The few effective remedies sold by quacks included emetics, laxatives and diuretics. Some ingredients did have medicinal effects: mercury, silver and arsenic compounds may have helped some infections and infestations; willow bark contained salicylic acid, chemically closely related to aspirin; and the quinine contained in Jesuit's bark was an effective treatment for malaria and other fevers. However, knowledge of appropriate uses and dosages was limited.

Criticism of quackery in academia

The science-based medicine community has criticized the infiltration of alternative medicine into mainstream academic medicine, education, and publications, accusing institutions of "diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology." R.W. Donnell coined the phrase "quackademic medicine" to describe this attention given to alternative medicine by academia. Referring to the Flexner Report, he said that medical education "needs a good Flexnerian housecleaning."

For example, David Gorski criticized Brian M. Berman, founder of the University of Maryland Center for Integrative Medicine, for writing that "There [is] evidence that both real acupuncture and sham acupuncture [are] more effective than no treatment and that acupuncture can be a useful supplement to other forms of conventional therapy for low back pain." He also castigated editors and peer reviewers at the New England Journal of Medicine for allowing it to be published, since it effectively recommended deliberately misleading patients in order to achieve a known placebo effect.

History in Europe and the United States

The Extraction of the Stone of Madness by Jan Sanders van Hemessen, c. 1550

With little understanding of the causes and mechanisms of illnesses, widely marketed "cures" (as opposed to locally produced and locally used remedies), often referred to as patent medicines, first came to prominence during the 17th and 18th centuries in Britain and the British colonies, including those in North America. Daffy's Elixir and Turlington's Balsam were among the first products that used branding (e.g. using highly distinctive containers) and mass marketing to create and maintain markets. A similar process occurred in other countries of Europe around the same time, for example with the marketing of Eau de Cologne as a cure-all medicine by Johann Maria Farina and his imitators. Patent medicines often contained alcohol or opium, which, while presumably not curing the diseases for which they were sold as a remedy, did make the imbibers feel better and confusedly appreciative of the product.

The number of internationally marketed quack medicines increased in the later 18th century; the majority of them originated in Britain and were exported throughout the British Empire. By 1830, British parliamentary records list over 1,300 different "proprietary medicines", the majority of which were "quack" cures by modern standards.

A Dutch organisation that opposes quackery, Vereniging tegen de Kwakzalverij (VtdK) was founded in 1881, making it the oldest organisation of this kind in the world. It has published its magazine Nederlands Tijdschrift tegen de Kwakzalverij (Dutch Magazine against Quackery) ever since. In these early years the VtdK played a part in the professionalisation of medicine. Its efforts in the public debate helped to make the Netherlands one of the first countries with governmental drug regulation.

Dalby's Carminative, Daffy's Elixir and Turlington's Balsam of Life bottles dating to the late 18th and early 19th centuries. These "typical" patent or quack medicines were marketed in very different, and highly distinctive, bottles. Each brand retained the same basic appearance for more than 100 years.

In 1909, in an attempt to stop the sale of quack medicines, the British Medical Association published Secret Remedies, What They Cost And What They Contain. This publication was originally a series of articles published in the British Medical Journal between 1904 and 1909. The publication was composed of 20 chapters, organising the work by sections according to the ailments the medicines claimed to treat. Each remedy was tested thoroughly, the preface stated: "Of the accuracy of the analytical data there can be no question; the investigation has been carried out with great care by a skilled analytical chemist." The book did lead to the end of some of the quack cures, but some survived the book by several decades. For example, Beecham's Pills, which according to the British Medical Association contained in 1909 only aloes, ginger and soap, but claimed to cure 31 medical conditions, were sold until 1998.

British patent medicines lost their dominance in the United States when they were denied access to the Thirteen Colonies markets during the American Revolution, and lost further ground for the same reason during the War of 1812. From the early 19th century "home-grown" American brands started to fill the gap, reaching their peak in the years after the American Civil War. British medicines never regained their previous dominance in North America, and the subsequent era of mass marketing of American patent medicines is usually considered to have been a "golden age" of quackery in the United States. This was mirrored by similar growth in marketing of quack medicines elsewhere in the world.

Clark Stanley's Snake Oil

In the United States, false medicines in this era were often denoted by the slang term snake oil, a reference to sales pitches for the false medicines that claimed exotic ingredients provided the supposed benefits. Those who sold them were called "snake oil salesmen", and usually sold their medicines with a fervent pitch similar to a fire and brimstone religious sermon. They often accompanied other theatrical and entertainment productions that traveled as a road show from town to town, leaving quickly before the falseness of their medicine was discovered. Not all quacks were restricted to such small-time businesses however, and a number, especially in the United States, became enormously wealthy through national and international sales of their products.

In 1875, the Pacific Medical and Surgical Journal complained:

If Satan has ever succeeded in compressing a greater amount of concentrated mendacity into one set of human bodies above every other description, it is in the advertising quacks. The coolness and deliberation with which they announce the most glaring falsehoods are really appalling. A recent arrival in San Francisco, whose name might indicate that he had his origin in the Pontine marshes of Europe, announces himself as the "Late examining physician of the Massachusetts Infirmary, Boston." This fellow has the impudence to publish that his charge to physicians in their own cases is $5.00! Another genius in Philadelphia, of the bogus diploma breed, who claims to have founded a new system of practice and who calls himself a "Professor," advertises two elixers of his own make, one of which is for "all male diseases" and the other for "all female diseases"! In the list of preparations which this wretch advertises for sale as the result of his own labors and discoveries, is ozone!

One among many examples is William Radam, a German immigrant to the US, who, in the 1880s, started to sell his "Microbe Killer" throughout the United States and, soon afterwards, in Britain and throughout the British colonies. His concoction was widely advertised as being able to "cure all diseases", and this phrase was even embossed on the glass bottles the medicine was sold in. In fact, Radam's medicine was a therapeutically useless (and in large quantities actively poisonous) dilute solution of sulfuric acid, coloured with a little red wine. Radam's publicity material, particularly his books, provide an insight into the role that pseudoscience played in the development and marketing of "quack" medicines towards the end of the 19th century.

Cartoon depicting a quack doctor using hypnotism (1780, France)

Similar advertising claims to those of Radam can be found throughout the 18th, 19th, 20th and 21st centuries. "Dr." Sibley, an English patent medicine seller of the late 18th and early 19th centuries, even went so far as to claim that his Reanimating Solar Tincture would, as the name implies, "restore life in the event of sudden death". Another English quack, "Dr. Solomon" claimed that his Cordial Balm of Gilead cured almost anything, but was particularly effective against all venereal complaints, from gonorrhoea to onanism. Although it was basically just brandy flavoured with herbs, the price of a bottle was a half guinea (£sd system) in 1800, equivalent to over £38 ($49) in 2014.

Not all patent medicines were without merit. Turlingtons Balsam of Life, first marketed in the mid-18th century, did have genuinely beneficial properties. This medicine continued to be sold under the original name into the early 20th century, and can still be found in the British and American pharmacopoeias as "Compound tincture of benzoin". In these cases, the treatments likely lacked empirical support when they were introduced to the market, and their benefits were simply a convenient coincidence discovered after the fact.

The end of the road for the quack medicines now considered grossly fraudulent in the nations of North America and Europe came in the early 20th century. 21 February 1906 saw the passage into law of the Pure Food and Drug Act in the United States. This was the result of decades of campaigning by both government departments and the medical establishment, supported by a number of publishers and journalists (one of the most effective was Samuel Hopkins Adams, who wrote "The Great American Fraud" series in Collier's in 1905). This American Act was followed three years later by similar legislation in Britain and in other European nations. Between them, these laws began to remove the more outrageously dangerous contents from patent and proprietary medicines, and to force quack medicine proprietors to stop making some of their more blatantly dishonest claims. The Act, however, left advertising and claims of effectiveness unregulated as the Supreme Court interpreted it to mean only that ingredients on labels had to be accurate. Language in the 1912 Sherley Amendment, meant to close this loophole, was limited to regulating claims that were false and fraudulent, creating the need to show intent. Throughout the early 20th century, the American Medical Association collected material on medical quackery, and one of their members and medical editors in particular, Arthur J. Cramp, devoted his career to criticizing such products. The AMA's Department of Investigation closed in 1975, but their only archive open to non-members remains, the American Medical Association Health Fraud and Alternative Medicine Collection.

"Medical quackery and promotion of nostrums and worthless drugs were among the most prominent abuses that led to formal self-regulation in business and, in turn, to the creation of the" Better Business Bureau.

Contemporary culture

Electro-metabograph machine on display in the "Quackery Hall of Fame" in the Science Museum of Minnesota, St. Paul, Minnesota, US

"Quackery is the promotion of false and unproven health schemes for a profit. It is rooted in the traditions of the marketplace", with "commercialism overwhelming professionalism in the marketing of alternative medicine". Quackery is most often used to denote the peddling of the "cure-alls" described above. Quackery continues even today; it can be found in any culture and in every medical tradition. Unlike other advertising mediums, rapid advancements in communication through the Internet have opened doors for an unregulated market of quack cures and marketing campaigns rivaling the early 20th century. Most people with an e-mail account have experienced the marketing tactics of spamming – in which modern forms of quackery are touted as miraculous remedies for "weight loss" and "sexual enhancement", as well as outlets for medicines of unknown quality.

United States

"Tho-radia powder" box, an example of radioactive quackery

While quackery is often aimed at the aged or chronically ill, it can be aimed at all age groups, including teens, and the FDA has mentioned some areas where potential quackery may be a problem: breast developers, weight loss, steroids and growth hormones, tanning and tanning pills, hair removal and growth, and look-alike drugs.

In 1992, the president of The National Council Against Health Fraud, William T. Jarvis, wrote in Clinical Chemistry that:

The U.S. Congress determined quackery to be the most harmful consumer fraud against elderly people. Americans waste $27 billion annually on questionable health care, exceeding the amount spent on biomedical research. Quackery is characterized by the promotion of false and unproven health schemes for profit and does not necessarily involve imposture, fraud, or greed. The real issues in the war against quackery are the principles, including scientific rationale, encoded into consumer protection laws, primarily the U.S. Food, Drug, and Cosmetic Act. More such laws are badly needed. Regulators are failing the public by enforcing laws inadequately, applying double standards, and accrediting pseudomedicine. Non-scientific health care (e.g., acupuncture, ayurvedic medicine, chiropractic, homeopathy, naturopathy) is licensed by individual states. Practitioners use unscientific practices and deception on a public who, lacking complex health-care knowledge, must rely upon the trustworthiness of providers. Quackery not only harms people, it undermines the scientific enterprise and should be actively opposed by every scientist.

Scientology's E-Meter, a quack device for measuring 'engrams'

For those in the practice of any medicine, to allege quackery is to level a serious objection to a particular form of practice. Most developed countries have a governmental agency, such as the Food and Drug Administration (FDA) in the US, whose purpose is to monitor and regulate the safety of medications as well as the claims made by the manufacturers of new and existing products, including drugs and nutritional supplements or vitamins. The Federal Trade Commission (FTC) participates in some of these efforts. To better address less regulated products, in 2000, US President Clinton signed Executive Order 13147 that created the White House Commission on Complementary and Alternative Medicine. In 2002, the commission's final report made several suggestions regarding education, research, implementation, and reimbursement as ways to evaluate the risks and benefits of each. As a direct result, more public dollars have been allocated for research into some of these methods.

The 1929 Revigator (sometimes misspelled Revigorator) was a pottery crock lined with radioactive ore that emitted radon.

Individuals and non-governmental agencies are active in attempts to expose quackery. According to John C. Norcross et al. less is consensus about ineffective "compared to effective procedures" but identifying both "pseudoscientific, unvalidated, or 'quack' psychotherapies" and "assessment measures of questionable validity on psycho-metric grounds" was pursued by various authors. The evidence-based practice (EBP) movement in mental health emphasizes the consensus in psychology that psychological practice should rely on empirical research. There are also "anti-quackery" websites, such as Quackwatch, that help consumers evaluate claims. Quackwatch's information is relevant to both consumers and medical professionals.

China

Zhang Wuben, a quack who posed as skilled in traditional Chinese medicine in the People's Republic of China, based his operation on representations that raw eggplant and mung beans were a general cure-all. Zhang, who has escaped legal liability as he portrayed himself as a nutritionist, not a doctor, appeared on television in China and authored a best-selling book, Eat Away the Diseases You Get from Eating. Zhang, who charged the equivalent of $450 for a 10-minute examination, had a two-year waiting list when he was exposed. Investigations launched after a run on mung beans revealed that contrary to his representations, he did not come from a family of accomplished traditional practitioners (中医世家) and never had the medical degree from Beijing Medical University he claimed to have. His only education was a brief correspondence or night school course, completed after he was laid off from a textile factory. Zhang, despite negative publicity on the national level, continues to practice but has committed himself to finding a cheaper cure-all than mung beans. His clinic, Wuben Hall, adjacent to Beijing National Stadium, was torn down as an illegal structure. Much of Zhang Wuben's success was due to the efforts of Chinese entrepreneurs, including one government-owned company, who promoted him.

Hu Wanlin, who did hold himself out as a doctor, was exposed in 2000 and sentenced to 15 years in prison. He adulterated his concoctions with sodium sulfate, Glauber's salt, a poison in large doses. That case resulted in creating a system of licensing medical doctors in China.

In 1992, Li Hongzhi, a former grain clerk from Jilin introduced a new version of Falun Gong exercises which soon turned into a cult with a mass following. One of its controversial tenets was its quack belief that its followers need not take any medicines for any diseases and illnesses. As a number of followers began to refuse medical treatment, fall ill and die, the government began to pay more attention to it. Falun Gong was banned in China, but Li escaped to the United States, with his followers. Falun Gong continued to thrive in the United States as an alternative therapy.

Presence and acceptance

The pee looker (Piskijker), David Teniers the Younger (1660)
 
A quack selling cards with a verse from the Quran which is supposed to protect the wearer from snakebites. Tabant, Aït Bouguemez valley, Central Morocco (2009).
 
The Quack Doctor, Jan Victors (c. 1635)

There have been several suggested reasons why quackery is accepted by patients in spite of its lack of effectiveness:

  • Ignorance: Those who perpetuate quackery may do so to take advantage of ignorance about conventional medical treatments versus alternative treatments, or may themselves be ignorant regarding their own claims. Mainstream medicine has produced many remarkable advances, so people may tend to also believe groundless claims.
  • Placebo effect: Medicines or treatments known to have no pharmacological effect on a disease can still affect a person's perception of their illness, and this belief in its turn does indeed sometimes have a therapeutic effect, causing the patient's condition to improve. This is not to say that no real cure of biological illness is effected – "though we might describe a placebo effect as being 'all in the mind', we now know that there is a genuine neurobiological basis to this phenomenon." People report reduced pain, increased well-being, improvement, or even total alleviation of symptoms. For some, the presence of a caring practitioner and the dispensation of medicine is curative in itself.
  • Regression fallacy: Lack of understanding that health conditions change with no treatment and attributing changes in ailments to a given therapy.
  • Confirmation bias: The tendency to search for, interpret, or prioritize information in a way that confirms one's beliefs or hypotheses. It is a type of cognitive bias and a systematic error of inductive reasoning.
  • Distrust of conventional medicine: Many people, for various reasons, have a distrust of conventional medicine, or of the regulating organizations such as the FDA, or the major drug corporations. For example, "CAM may represent a response to disenfranchisement [discrimination] in conventional medical settings and resulting distrust".
  • Conspiracy theories: Anti-quackery activists ("quackbusters") are often falsely accused of being part of a huge "conspiracy" to suppress "unconventional" and/or "natural" therapies, as well as those who promote them. It is alleged that this conspiracy is backed and funded by the pharmaceutical industry and the established medical care system – represented by the AMA, FDA, ADA, CDC, WHO, etc. – for the purpose of preserving their power and increasing their profits. This idea is often held by people with Antiscience views.
  • Fear of side effects: A great variety of pharmaceutical medications can have very distressing side effects, and many people fear surgery and its consequences, so they may opt to shy away from these mainstream treatments.
  • Cost: There are some people who simply cannot afford conventional treatment, and seek out a cheaper alternative. Nonconventional practitioners can often dispense treatment at a much lower cost. This is compounded by reduced access to healthcare.
  • Desperation: People with a serious or terminal disease, or who have been told by their practitioner that their condition is "untreatable", may react by seeking out treatment, disregarding the lack of scientific proof for its effectiveness, or even the existence of evidence that the method is ineffective or even dangerous. Despair may be exacerbated by the lack of palliative non-curative end-of-life care. Between 2012 and 2018 appeals on UK crowdfunding sites for cancer treatment with an alternative health element have raised £8 million. This is described as "a new and lucrative revenue stream for cranks, charlatans, and conmen who prey on the vulnerable."
  • Pride: Once people have endorsed or defended a cure, or invested time and money in it, they may be reluctant or embarrassed to admit its ineffectiveness and therefore recommend a treatment that does not work.
  • Fraud: Some practitioners, fully aware of the ineffectiveness of their medicine, may intentionally produce fraudulent scientific studies and medical test results, thereby confusing any potential consumers as to the effectiveness of the medical treatment.

Persons accused of quackery

Deceased

  • Thomas Allinson (1858–1918), founder of naturopathy. His views often brought him into conflict with the Royal College of Physicians of Edinburgh and the General Medical Council, particularly his opposition to doctors' frequent use of drugs, his opposition to vaccination and his self-promotion in the press. His views and publication of them led to him being labeled a quack and being struck off by the General Medical Council for infamous conduct in a professional respect.
  • Lovisa Åhrberg (1801–1881), the first Swedish female doctor. Åhrberg was met with strong resistance from male doctors and was accused of quackery. During the formal examination she was acquitted of all charges and allowed to practice medicine in Stockholm even though it was forbidden for women in the 1820s. She later received a medal for her work.
  • Johanna Brandt (1876–1964), a South African naturopath who advocated the "Grape Cure" as a cure for cancer.
  • John R. Brinkley (1885–1942), a nonphysician and xenotransplant specialist in Kansas, US, who claimed to have discovered a method of effectively transplanting the testicles of goats into aging men. After state authorities took steps to shut down his practice, he retaliated by entering politics in 1930 and running for the office of Governor of Kansas.
  • Hulda Regehr Clark (1928–2009), was a controversial naturopath, author, and practitioner of alternative medicine who claimed to be able to cure all diseases and advocated methods that have no scientific validity.
  • Max Gerson (1881–1959), was a German-born American physician who developed a dietary-based alternative cancer treatment that he claimed could cure cancer and most chronic, degenerative diseases. His treatment was called The Gerson Therapy. Most notably, Gerson Therapy was used, unsuccessfully, to treat Jessica Ainscough. According to Quackwatch, Gerson Institute claims of cure are based not on actual documentation of survival, but on "a combination of the doctor's estimate that the departing patient has a 'reasonable chance of surviving', plus feelings that the Institute staff have about the status of people who call in". The American Cancer Society reports that "[t]here is no reliable scientific evidence that Gerson therapy is effective..."
The quack, Jan Steen (c. 1650–60)
  • Samuel Hahnemann (1755–1843), founder of homeopathy. Hahnemann believed that all diseases were caused by "miasms", which he defined as irregularities in the patient's vital force. He also said that illnesses could be treated by substances that in a healthy person produced similar symptoms to the illness, in extremely low concentrations, with the therapeutic effect increasing with dilution and repeated shaking.
  • Lawrence B. Hamlin (in 1916), was fined under the 1906 US Pure Food and Drug Act for advertising that his Wizard Oil could kill cancer.
  • L. Ron Hubbard (1911–1986), was the founder of the Church of Scientology. He was an American science fiction writer, former US Navy officer, and creator of Dianetics. He has been commonly called a quack and a con man by both critics of Scientology and by many psychiatric organizations in part for his often extreme anti-psychiatric beliefs.
  • Linda Hazzard, (1867–1938), was a self-declared doctor and fasting specialist, which she advertised as a panacea for every medical ailment. Up to 40 patients may have died of starvation in her "sanitarium" in Olalla, Washington, US. Imprisoned for one death in 1912, Hazzard was paroled in 1915 and continued to practice medicine without a license in New Zealand (1915–1920) and Washington, US (1920–1935). Died in 1938 while attempting a fasting to cure herself.
  • William Donald Kelley, (1925–2005), was an orthodontist and a follower of Max Gerson who developed his own alternative cancer treatment called Nonspecific Metabolic Therapy. This treatment is based on the unsubstantiated belief that "wrong foods [cause] malignancy to grow, while proper foods [allow] natural body defenses to work". It involves, specifically, treatment with pancreatic enzymes, 50 daily vitamins and minerals (including laetrile), frequent body shampoos, coffee enemas, and a specific diet. According to Quackwatch, "not only is his therapy ineffective, but people with cancer who take it die more quickly and have a worse quality of life than those having standard treatment, and can suffer serious or fatal side-effects. Kelley's most famous patient was actor Steve McQueen.
  • John Harvey Kellogg (1852–1943), was a medical doctor in Battle Creek, Michigan, US, who ran a sanitarium using holistic methods, with a particular focus on nutrition, enemas and exercise. Kellogg was an advocate of vegetarianism and invented the corn flake breakfast cereal with his brother, Will Keith Kellogg.
  • John St. John Long (1798–1834) was an Irish artist who claimed to be able to cure tuberculosis by causing a sore or wound on the back of the patient, out of which the disease would exit. He was tried twice for manslaughter of his patients who died under this treatment.
  • Franz Anton Mesmer (1734–1815), was a German physician and astrologist, who invented what he called magnétisme animal.
  • Theodor Morell (1886–1948), a German physician best known as Adolf Hitler's personal doctor. Morell administered approximately 74 substances, in 28 different mixtures to Hitler, including heroin, cocaine, Doktor Koster's Antigaspills, potassium bromide, papaverine, testosterone, vitamins and animal enzymes. Despite Hitler's dependence on Morell, and his recommendations of him to other Nazi leaders, Hermann Göring, Heinrich Himmler, Albert Speer and others quietly dismissed Morell as a quack.
  • Daniel David Palmer (1845–1913), was a grocery store owner that claimed to have healed a janitor of deafness after adjusting the alignment of his back. He founded the field of chiropractic based on the principle that all disease and ailments could be fixed by adjusting the alignment of someone's back. His hypothesis was disregarded by medical professionals at the time and despite a considerable following has yet to be scientifically proven. Palmer established a magnetic healing facility in Davenport, Iowa, styling himself 'doctor'. Not everyone was convinced, as a local paper in 1894 wrote about him: "A crank on magnetism has a crazy notion that he can cure the sick and crippled with his magnetic hands. His victims are the weak-minded, ignorant and superstitious, those foolish people who have been sick for years and have become tired of the regular physician and want health by the short-cut method…he has certainly profited by the ignorance of his victims…His increase in business shows what can be done in Davenport, even by a quack."
  • Louis Pasteur (1822–1895), was a French chemist best known for his remarkable breakthroughs in microbiology. His experiments confirmed the germ theory of disease, also reducing mortality from puerperal fever (childbed), and he created the first vaccine for rabies. He is best known to the general public for showing how to stop milk and wine from going sour – this process came to be called pasteurization. His hypotheses initially met with much hostility, and he was accused of quackery on multiple occasions. However, he is now regarded as one of the three main founders of microbiology, together with Ferdinand Cohn and Robert Koch.
  • Linus Pauling (1901–1994), a Nobel Prize winner in chemistry, Pauling spent much of his later career arguing for the treatment of somatic and psychological diseases with orthomolecular medicine. Among his claims were that the common cold could be cured with massive doses of vitamin C. Together with Ewan Cameron he wrote the 1979 book Cancer and Vitamin C, which was again more popular with the public than the medical profession, which continued to regard claims about the effectiveness of vitamin C in treating or preventing cancer as quackery. A biographer has discussed how controversial his views on megadoses of Vitamin C have been and that he was "still being called a 'fraud' and a 'quack' by opponents of his 'orthomolecular medicine'".
  • Doctor John Henry Pinkard (1866–1934) was a Roanoke, Virginia businessman and "Yarb Doctor" or "Herb Doctor" who concocted quack medicines that he sold and distributed in violation of the Food and Drugs Act and the earlier Pure Food and Drug Act. He was also known as a "...clairvoyant, herb doctor and spiritualist." Some of Pinkard's Sanguinaria Compound, made from bloodroot or bloodwort, was seized by federal officials in 1931. "Analysis by this department of a sample of the article showed that it consisted essentially of extracts of plant drugs including sanguinaria, sugar, alcohol, and water. It was alleged in the information that the article was misbranded in that certain statements, designs, and devices regarding the therapeutic and curative effects of the article, appearing on the bottle label, falsely and fraudulently represented that it would be effective as a treatment, remedy, and cure for pneumonia, coughs, weak lungs, asthma, kidney, liver, bladder, or any stomach troubles, and effective as a great blood and nerve tonic." He pleaded guilty and was fined.
  • Wilhelm Reich (1897–1957), Austrian-American Psychoanalyst. Claimed that he had discovered a primordial cosmic energy called Orgone. He developed several devices, including the Cloudbuster and the Orgone Accumulator, that he believed could use orgone to manipulate the weather, battle space aliens and cure diseases, including cancer. After an investigation, the US Food and Drug Administration concluded that they were dealing with a "fraud of the first magnitude". On 10 February 1954, the US Attorney for Maine filed a complaint seeking a permanent injunction under Sections 301 and 302 of the Federal Food, Drug, and Cosmetic Act, to prevent interstate shipment of orgone accumulators and to ban some of Reich's writing promoting and advertising the devices. Reich refused to appear in court, arguing that no court was in a position to evaluate his work. Reich was arrested for contempt of court, and convicted to two years in jail, a US$10,000 fine, and his Orgone Accumulators and work on Orgone were ordered to be destroyed. On 23 August 1956, six tons of his books, journals, and papers were burned in the 25th Street public incinerator in New York. On 12 March 1957 he was sent to Danbury Federal Prison, where Richard C. Hubbard, a psychiatrist who admired Reich, examined him, recording paranoia manifested by delusions of grandiosity, persecution, and ideas of reference. On 18 November 1957 Reich died of a heart attack nine months later while he was in the federal penitentiary in Lewisburg, Pennsylvania.
  • William Herbert Sheldon (1898–1977), who created the theory of somatotypes corresponding to intelligence.

Living

  • Stanislaw Burzynski conducts experimental research on and administers antineoplastons to cancer patients, which are ineffective and dangerous. Burzynski operates the Burzynski Clinic in Houston, Texas, US. He has been involved in numerous lawsuits and the subject of US Food and Drug Administration warnings. Aided through aggressive legal threats to critics and an active group of patient-supporters, Burzynski continues practicing cancer quackery.
  • Peter Duesberg (born 1936) is a German American molecular biologist and a professor of molecular and cell biology at the University of California, Berkeley known for his early research into the genetic aspects of cancer. He is a proponent of the claim that HIV does not cause AIDS. Duesberg began to gain public notoriety with a March 1987 article in Cancer Research entitled "Retroviruses as Carcinogens and Pathogens: Expectations and Reality".Duesberg has proposed that AIDS is caused by long-term consumption of recreational drugs or antiretroviral drugs, and that HIV is a harmless passenger virus. In contrast, the scientific consensus is that HIV infection causes AIDS and Duesberg's HIV/AIDS claims have been rejected as erroneous by the scientific community. Reviews of his opinions in Nature and Science asserted that they were unpersuasive and based on selective reading of the literature.
  • Vernon Coleman (born 1946) is a former GP who claims COVID-19 is a hoax and AIDS cannot infect heterosexuals. An advertisement by Coleman which claimed doctors were "the person most likely to kill you" was banned by the Advertising Standards Authority.
  • Belle Gibson (born 1991) falsely claimed that she had brain cancer which was cured by alternative therapies and nutrition as outlined in her book The Whole Pantry. She was convicted of misleading and deceptive conduct by Consumer Affairs Victoria, Australia. She was ordered to pay a fine of A$410,000.
  • Ann Louise Gittleman (born 1949) published a series of fad diet books that promote pseudoscientific ideas about weight loss, "detoxification" and electromagnetic radiation. She received a PhD from the now-defunct Clayton College of Natural Health, which is known as a diploma mill that gave degrees to a number of individuals who went on to be accused of quackery.
  • Mehmet Oz (born 1960), as host of The Dr. Oz Show, has promoted pseudoscientific health treatments and supplements and faced a hearing at the United States Senate for helping companies sell fraudulent medicine.
  • Tullio Simoncini (born 1951) has claimed that cancer is caused by, and in fact is, the yeast Candida albicans, and that it can be cured with an injection of sodium bicarbonate. He was convicted in 2006 of manslaughter due to the death of one of his patients and came under fire again in 2012 after attempting to promote his treatment in Totnes, UK in violation of the Cancer Act 1939.
  • Kevin Trudeau (born 1963) published several books about cures relating to maladies, weight loss and debt. He was imprisoned in Alabama, US for failing to pay a US$37.6 million fine that he incurred as a result of claims he made in his book about weight loss cures.
  • Andrew Wakefield (born 1957) published a fraudulent study in The Lancet in 1998 claiming that the MMR vaccine increases the chance of autism. His research has been described as "an elaborate fraud". None of his results could be reproduced by other researchers. The study claimed the combined MMR vaccine increased the risk of autism, while Wakefield had just applied for patent on separate vaccines for the three diseases, and therefore the study, if accepted, would have generated a large profit for Wakefield. The UK General Medical Council subsequently struck Wakefield off its register.


Information Age quackery

A form of quackery common in the 21st Century is laypeople using online sites, such as WebMD to find diagnoses. The best way to avoid falling victim to this is to make an appointment with a certified physician at a local hospital. Writing in The New York Times Magazine, Virginia Heffernan criticized WebMD for biasing readers toward drugs that are sold by the site's pharmaceutical sponsors, even when they are unnecessary. She wrote that WebMD "has become permeated with pseudomedicine and subtle misinformation."

Paradigm shift

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Paradigm_shift

A paradigm shift, a concept identified by the American physicist and philosopher Thomas Kuhn, is a fundamental change in the basic concepts and experimental practices of a scientific discipline. Even though Kuhn restricted the use of the term to the natural sciences, the concept of a paradigm shift has also been used in numerous non-scientific contexts to describe a profound change in a fundamental model or perception of events.

Kuhn presented his notion of a paradigm shift in his influential book The Structure of Scientific Revolutions (1962).

Kuhn contrasts paradigm shifts, which characterize a scientific revolution, to the activity of normal science, which he describes as scientific work done within a prevailing framework or paradigm. Paradigm shifts arise when the dominant paradigm under which normal science operates is rendered incompatible with new phenomena, facilitating the adoption of a new theory or paradigm.

As one commentator summarizes:

Kuhn acknowledges having used the term "paradigm" in two different meanings. In the first one, "paradigm" designates what the members of a certain scientific community have in common, that is to say, the whole of techniques, patents and values shared by the members of the community. In the second sense, the paradigm is a single element of a whole, say for instance Newton’s Principia, which, acting as a common model or an example... stands for the explicit rules and thus defines a coherent tradition of investigation. Thus the question is for Kuhn to investigate by means of the paradigm what makes possible the constitution of what he calls "normal science". That is to say, the science which can decide if a certain problem will be considered scientific or not. Normal science does not mean at all a science guided by a coherent system of rules, on the contrary, the rules can be derived from the paradigms, but the paradigms can guide the investigation also in the absence of rules. This is precisely the second meaning of the term "paradigm", which Kuhn considered the most new and profound, though it is in truth the oldest.

History

The nature of scientific revolutions has been studied by modern philosophy since Immanuel Kant used the phrase in the preface to the second edition of his Critique of Pure Reason (1787). Kant used the phrase "revolution of the way of thinking" (Revolution der Denkart) to refer to Greek mathematics and Newtonian physics. In the 20th century, new developments in the basic concepts of mathematics, physics, and biology revitalized interest in the question among scholars.

Original usage

Kuhn used the duck-rabbit optical illusion, made famous by Wittgenstein, to demonstrate the way in which a paradigm shift could cause one to see the same information in an entirely different way.

In his 1962 book The Structure of Scientific Revolutions, Kuhn explains the development of paradigm shifts in science into four stages:

  • Normal science – In this stage, which Kuhn sees as most prominent in science, a dominant paradigm is active. This paradigm is characterized by a set of theories and ideas that define what is possible and rational to do, giving scientists a clear set of tools to approach certain problems. Some examples of dominant paradigms that Kuhn gives are: Newtonian physics, caloric theory, and the theory of electromagnetism. Insofar as paradigms are useful, they expand both the scope and the tools with which scientists do research. Kuhn stresses that, rather than being monolithic, the paradigms that define normal science can be particular to different people. A chemist and a physicist might operate with different paradigms of what a helium atom is. Under normal science, scientists encounter anomalies that cannot be explained by the universally accepted paradigm within which scientific progress has thereto been made.
  • Extraordinary research – When enough significant anomalies have accrued against a current paradigm, the scientific discipline is thrown into a state of crisis. To address the crisis, scientists push the boundaries of normal science in what Kuhn calls “extraordinary research”, which is characterized by its exploratory nature. Without the structures of the dominant paradigm to depend on, scientists engaging in extraordinary research must produce new theories, thought experiments, and experiments to explain the anomalies. Kuhn sees the practice of this stage – “the proliferation of competing articulations, the willingness to try anything, the expression of explicit discontent, the recourse to philosophy and to debate over fundamentals” – as even more important to science than paradigm shifts.
  • Adoption of a new paradigm – Eventually a new paradigm is formed, which gains its own new followers. For Kuhn, this stage entails both resistance to the new paradigm, and reasons for why individual scientists adopt it. According to Max Planck, "a new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it." Because scientists are committed to the dominant paradigm, and paradigm shifts involve gestalt-like changes, Kuhn stresses that paradigms are difficult to change. However, paradigms can gain influence by explaining or predicting phenomena much better than before (i.e., Bohr's model of the atom) or by being more subjectively pleasing. During this phase, proponents for competing paradigms address what Kuhn considers the core of a paradigm debate: whether a given paradigm will be a good guide for future problems – things that neither the proposed paradigm nor the dominant paradigm are capable of solving currently.
  • Aftermath of the scientific revolution – In the long run, the new paradigm becomes institutionalized as the dominant one. Textbooks are written, obscuring the revolutionary process.

Features

Paradigm shifts and progress

A common misinterpretation of paradigms is the belief that the discovery of paradigm shifts and the dynamic nature of science (with its many opportunities for subjective judgments by scientists) are a case for relativism, the view that all kinds of belief systems are equal. Kuhn vehemently denies this interpretation and states that when a scientific paradigm is replaced by a new one, albeit through a complex social process, the new one is always better, not just different.

Incommensurability

These claims of relativism are, however, tied to another claim that Kuhn does at least somewhat endorse: that the language and theories of different paradigms cannot be translated into one another or rationally evaluated against one another—that they are incommensurable. This gave rise to much talk of different peoples and cultures having radically different worldviews or conceptual schemes—so different that whether or not one was better, they could not be understood by one another. However, the philosopher Donald Davidson published the highly regarded essay "On the Very Idea of a Conceptual Scheme" (Proceedings and Addresses of the American Philosophical Association, Vol. 47, (1973–1974), pp. 5–20) in 1974 arguing that the notion that any languages or theories could be incommensurable with one another was itself incoherent. If this is correct, Kuhn's claims must be taken in a weaker sense than they often are. Furthermore, the hold of the Kuhnian analysis on social science has long been tenuous, with the wide application of multi-paradigmatic approaches in order to understand complex human behaviour (see for example John Hassard, Sociology and Organization Theory: Positivism, Paradigm and Postmodernity. Cambridge University Press, 1993, ISBN 0521350344).

Gradualism vs. sudden change

Paradigm shifts tend to be most dramatic in sciences that appear to be stable and mature, as in physics at the end of the 19th century. At that time, physics seemed to be a discipline filling in the last few details of a largely worked-out system.

In The Structure of Scientific Revolutions, Kuhn wrote, "Successive transition from one paradigm to another via revolution is the usual developmental pattern of mature science" (p. 12). Kuhn's idea was itself revolutionary in its time as it caused a major change in the way that academics talk about science. Thus, it could be argued that it caused or was itself part of a "paradigm shift" in the history and sociology of science. However, Kuhn would not recognise such a paradigm shift. In the social sciences, people can still use earlier ideas to discuss the history of science.

Philosophers and historians of science, including Kuhn himself, ultimately accepted a modified version of Kuhn's model, which synthesizes his original view with the gradualist model that preceded it.[citation needed]

Examples

Natural sciences

Some of the "classical cases" of Kuhnian paradigm shifts in science are:

Social sciences

In Kuhn's view, the existence of a single reigning paradigm is characteristic of the natural sciences, while philosophy and much of social science were characterized by a "tradition of claims, counterclaims, and debates over fundamentals." Others have applied Kuhn's concept of paradigm shift to the social sciences.

  • The movement known as the cognitive revolution moved away from behaviourist approaches to psychological study and the acceptance of cognition as central to studying human behaviour.
  • The Keynesian revolution is typically viewed as a major shift in macroeconomics. According to John Kenneth Galbraith, Say's Law dominated economic thought prior to Keynes for over a century, and the shift to Keynesianism was difficult. Economists who contradicted the law, which implied that underemployment and underinvestment (coupled with oversaving) were virtually impossible, risked losing their careers. In his magnum opus, Keynes cited one of his predecessors, John A. Hobson, who was repeatedly denied positions at universities for his heretical theory.
  • Later, the movement for monetarism over Keynesianism marked a second divisive shift. Monetarists held that fiscal policy was not effective for stabilizing inflation, that it was solely a monetary phenomenon, in contrast to the Keynesian view of the time was that both fiscal and monetary policy were important. Keynesians later adopted much of the monetarists' view of the quantity theory of money and shifting Phillips curve, theories they initially rejected.
  • First proposed by Ferdinand de Saussure in 1879, the laryngeal theory in Indo-European linguistics postulated the existence of "laryngeal" consonants in the Proto-Indo-European language (PIE), a theory that was confirmed by the discovery of the Hittite language in the early 20th century. The theory has since been accepted by the vast majority of linguists, paving the way for the internal reconstruction of the syntax and grammatical rules of PIE and is considered one of the most significant developments in linguistics since the initial discovery of the Indo-European language family.
  • The adoption of radiocarbon dating by archaeologists has been proposed as a paradigm shift because of how it greatly increased the time depth the archaeologists could reliably date objects from. Similarly the use of LIDAR for remote geospatial imaging of cultural landscapes, and the shift from processual to post-processual archaeology have both been claimed as paradigm shifts by archaeologists.

Applied sciences

More recently, paradigm shifts are also recognisable in applied sciences:

  • In medicine, the transition from "clinical judgment" to evidence-based medicine
  • In software engineering, the transition from the Rational Paradigm to the Empirical Paradigm

Other uses

The term "paradigm shift" has found uses in other contexts, representing the notion of a major change in a certain thought pattern—a radical change in personal beliefs, complex systems or organizations, replacing the former way of thinking or organizing with a radically different way of thinking or organizing:

  • M. L. Handa, a professor of sociology in education at O.I.S.E. University of Toronto, Canada, developed the concept of a paradigm within the context of social sciences. He defines what he means by "paradigm" and introduces the idea of a "social paradigm". In addition, he identifies the basic component of any social paradigm. Like Kuhn, he addresses the issue of changing paradigms, the process popularly known as "paradigm shift". In this respect, he focuses on the social circumstances that precipitate such a shift. Relatedly, he addresses how that shift affects social institutions, including the institution of education.
  • The concept has been developed for technology and economics in the identification of new techno-economic paradigms as changes in technological systems that have a major influence on the behaviour of the entire economy (Carlota Perez; earlier work only on technological paradigms by Giovanni Dosi). This concept is linked to Joseph Schumpeter's idea of creative destruction. Examples include the move to mass production and the introduction of microelectronics.
  • Two photographs of the Earth from space, "Earthrise" (1968) and "The Blue Marble" (1972), are thought to have helped to usher in the environmentalist movement, which gained great prominence in the years immediately following distribution of those images.
  • Hans Küng applies Thomas Kuhn's theory of paradigm change to the entire history of Christian thought and theology. He identifies six historical "macromodels": 1) the apocalyptic paradigm of primitive Christianity, 2) the Hellenistic paradigm of the patristic period, 3) the medieval Roman Catholic paradigm, 4) the Protestant (Reformation) paradigm, 5) the modern Enlightenment paradigm, and 6) the emerging ecumenical paradigm. He also discusses five analogies between natural science and theology in relation to paradigm shifts. Küng addresses paradigm change in his books, Paradigm Change in Theology and Theology for the Third Millennium: An Ecumenical View.
  • In the later part of the 1990s, 'paradigm shift' emerged as a buzzword, popularized as marketing speak and appearing more frequently in print and publication. In his book Mind The Gaffe, author Larry Trask advises readers to refrain from using it, and to use caution when reading anything that contains the phrase. It is referred to in several articles and books as abused and overused to the point of becoming meaningless.
  • The concept of technological paradigms has been advanced, particularly by Giovanni Dosi.

Criticism

In a 2015 retrospective on Kuhn, the philosopher Martin Cohen describes the notion of the paradigm shift as a kind of intellectual virus – spreading from hard science to social science and on to the arts and even everyday political rhetoric today. Cohen claims that Kuhn had only a very hazy idea of what it might mean and, in line with the American philosopher of science Paul Feyerabend, accuses Kuhn of retreating from the more radical implications of his theory, which are that scientific facts are never really more than opinions whose popularity is transitory and far from conclusive. Cohen says scientific knowledge is less certain than it is usually portrayed, and that science and knowledge generally is not the 'very sensible and reassuringly solid sort of affair' that Kuhn describes, in which progress involves periodic paradigm shifts in which much of the old certainties are abandoned in order to open up new approaches to understanding that scientists would never have considered valid before. He argues that information cascades can distort rational, scientific debate. He has focused on health issues, including the example of highly mediatised 'pandemic' alarms, and why they have turned out eventually to be little more than scares.

United States labor law

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