Bach flower remedies and the problem of quackery

This is an ad that appeared in the Hindu on the 16th of November, 2015:

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Bach Flower anxiety

[Update] Another one in the same newspaper on the 30th of November, 2015:

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The “divine” cure (Re: The cornerstone of quackery)

Among other very interesting things (like “Medical Astrologer”), what caught my eye was “Bach Flower Remedies”. Apparently a solution for your anxiety and stress. I thought I had heard about it earlier, so I decided to take a closer look.

Bach flower remedies were divined by Edward Bach, a British practitioner of homeopathy in the first half of the 20th century. A bit of background check on sites encomiating him reveals that as a young man he had served as a medical aid provider to soldiers during the World War I. Claims are made that he “recovered completely” from some severe medical condition, varying in different accounts from malignant tumors to hemorrhage in the stomach, even though he was only given three months to live. He trained as an immunologist, and became unhappy with conventional medicine, because he was

dissatisfied with the way doctors were expected to concentrate on diseases and ignore the whole person. He aspired to a more holistic approach to medicine. Perhaps this explains why, not being a homoeopath, he took the offer of a post at the Royal London Homoeopathic Hospital.

He noticed the similarities between vaccines and the homeopathic treatment philosophy of “like cures like”. He developed homeopathic”nosodes”, or doses prepared from body waste containing the products of disease, based on these observations. But he was still not satisfied. He wanted to find remedies that would be “purer and less reliant on the products of disease” than vaccines or anything of the like.

He began collecting plants and in particular flowers – the most highly-developed part of a plant – in the hope of replacing the nosodes with a series of gentler remedies.

By 1930 he was so enthused by the direction his work was taking that he gave up his lucrative Harley Street practice and left London, determined to devote the rest of his life to the new system of medicine that he was sure could be found in nature. He took with him as his assistant a radiographer called Nora Weeks.

Just as he had abandoned his home, office and work, Dr Bach began to abandon the scientific method and its reliance on laboratories and reductionism. He fell back instead on his natural gifts as a healer, and more and more allowed his intuition to guide him to the right plants.

And so Bach Flower Remedies were born. There are 38 different remedies for a range of “energy blockages”, supposedly caused by conflicts between “purposes of the soul and one’s personality and actions”. These 38 different remedies are derived from 38 different flower materials, as mentioned earlier, and then diluted to homeopathic levels using 1:1 brandy-water solution. These solutions are known as “mother tincture”.

These prepared Bach solutions are prescribed by “Bach medical practitioners” or naturopaths after establishing a detailed physical and emotional profile of the patient.

So, how well do these remedies work?

A 1995 study on flower remedies by alternative medicine researcher and critic Edzard Ernst had this to conclude about the efficacy of Bach flower remedies:

Collectively they fail to produce convincing evidence to suggest that flower remedies are associated with clinical effects that differ from those of placebo.

In most countries, flower remedies are marketed not as medicines but as food supplements. Therefore there is no legal requirement to demonstrate efficacy and no health claims are permitted. Yet there is an abundance of literature on flower remedies which does make such claims. Customers are thus attracted to flower remedies with certain expectations, and the question arises whether this has the potential for causing harm to patients. Due to their highly dilute nature, flower remedies are devoid of toxicology. However, flower remedies may be used in cases of severe illness as an “alternative” to effective therapy. In such a scenario, the use of flower remedies could become life-threatening ….

When professional flower remedy organisations were asked for which indications they would recommend flower remedies […], they named the following conditions: anxiety/stress, depression, general mental stress, lack of confidence, trauma (emotional and physical), cancer and HIV/AIDS. This systematic review shows that these claims are not based on evidence. Others have stressed that “the basic principles of Bach’s theory are settled on ungrounded, deeply intuitive hypotheses, belong to magical thinking, and do promote philosophical approaches that weaken patients-consumers, particularly with regard to sectarian trends” […]. The implication from the negative clinical evidence and the lack of biological plausibility might be that further research in this area is not warranted.

In conclusion, the most reliable clinical trials of flower remedies available to date fail to show efficacy.

Here is what another randomized control study has to say:

We conclude that Bach-flower remedies are an effective placebo for test anxiety and do not have a specific effect.

Therefore, these treatment regimes do nothing better than placebo, which is merely a subjective perception of well-being. For subjective problems like anxiety, headaches, mild muscular pain and itching, placebo treatment with basically harmless nostrums might give someone an illusion of well-being. In layperson’s terms then, Bach flower remedies is quackery, very much like its ancestor, homeopathy. Quackwatch gives us a brief insight:

These are homeopathically prepared (highly dilute) products said to have been developed during the 1930s by Edward Bach, a British bacteriologist and homeopath [….]. Ellon USA, Inc., of Lynbrook, New York, states that Bach “believed that the only way to cure illness was to address the underlying emotional causes of disease.” This company markets an “emergency rescue formula” for “calming and stabilizing emotions” and a line of 38 “flower remedies” said to alleviate negative emotions. The Rescue Remdy is also said to be “of great benefit to all animals, no matter how large or small” and “useful in easing the trauma of transplanted plants, falling flowers, or injured trees.” […] The various remedies can be selected using Ellon’s 116-item “self-help questionnaire.” Someone who feels overwhelmed with work, for example, is advised to take the product called Elm, whereas someone who has strong opinions and is easily incensed by injustices is advised to use Vervain. An Ellon competitor describes its Rescue Remedy as “the one product you need to take care of all kinds of emergency emotional stress.” This company’s catalog states that this product “helps center the emotions until the crisis is past” and depicts it as useful for: (a) a woman under stress because her computer “froze,” (b) a mother coping with a cranky toddler, (c) the partner of a doubles tennis player who missed a few shots, (d) participants in a minor auto accident, and (e) a man racing to board a plane who suddenly realizes he forgot to pack his suit and left his keys and ticket at home. A few companies market additional products they say are based on Bach’s principles.

Flower remedies are also promoted through books, seminars, private practitioners, and telephone consultations. Some proponents state that the remedies can “balance out the body’s subtle energy fields” and “prevent disease before physical symptoms develop.” Of course, neither the theories nor the products make any sense.

For further reading, consult Dr Harriet Hall, popularly known as SkepDoc, here. It’s interesting to read how even the alternative medicine fraternity has excommunicated BFR.

Coming back to the newspaper ad, I was wondering what “medical astrologer” could conceivably mean. I never thought “medicine” and “astrology” could come together. I mean how could you have a combination of pseudoscience with science? So I decided to take a sneak peek into the world of “medical astrology”. Now, we all know about astrology. Successful astrologers, in India at least, are some of the wealthiest and most celebrated charlatans on the planet. Needless to say, their predictions about specific events are always wrong, just as you would expect any specific prediction about something uncertain to be. So, astrology is all about stars, planets and the mystical, right? This is how medical astrology relates to human beings physically:

Depending upon the relative position of the sun and the other heavenly bodies in the solar system in the zodiac circular band, ailments are prognosticated in the light of the astrological connection of the organs with each specific sector of the zodiac. The relationship of various heavenly bodies upon the organs is listed below.

1. Sun-entrails/abdomen
2. Moon-heart
3. Mars-head
4. Jupiter-thighs
5. Venus-face
6. Saturn-knees
7. Evil satellite (Rahu)-feet

Wait, what? “Evil satellite”? The moon has already been mentioned on that list, and as far as is known to science and ordinary perception, the moon is the only satellite that the Earth has. Is there a celestial Jekyll/Hyde game that is taking place unbeknownst to us and to science? I do know of this wacky ancient fable about “Rahu” consuming the sun during solar eclipses. But I didn’t know it was an evil satellite, much less know that it is supposed to affect a person’s feet. Sigh. Anyway, moving on:

A gifted astrologist (sic) can succinctly predict, what disease is going to affect a person at what point of time and the season of the year when it happens if at all. That is, the planets have a relationship with the seasons of the year in so far as pathology goes.

Saturn – winter
Venus – spring
Mars and the sun – summer
Moon – Rainy season
Mercury – autumn
Jupiter – early winter

There you go. So medical astrologers are nothing but astrologers. It’s not any kind of specialization, but rebranding of quackery. Or should I say, reentry of astrology into the quack domain. Also, you can’t miss the religious aspect of this stuff:

In the minute analyses of hysteria, astrology has very astral and delicate analytical tools. Generally the causes provoking madness by the excitement of each of the three troubles separately (respiratory-vatha, digestive-pitha and muscular-kaffa) and the synergy of the simultaneous occurrence of all the three, are classified into seven groups which are as follows:-

1. Over happiness
2. Greed
3. Sudden fear
4. Deep sorrow and inky melancholia.
5. Trouble emanating from contradictory food.
6. Wrath of the guru (master).
7. Retribution of god.

The diagnostic symptoms mentioned above, result from the trouble trio, curses of elders or guru, or parents or evil magic or karma and culminate in lunacy.

You can never have just enough of danger in the world. These astroquacks and god (complete with the retributive avatar) are our only saviours. Move over, medical science. Usher in the dark ages.

What bothers me is that newspapers like the Hindu, which are often responsible, balanced and objective, promote such fraud. If the editors of the newspaper are responsible for the advertisements in them and their PR, then this is a disgrace for a bunch of journalists who pride themselves on plying their trade responsibly. Such ads are a misrepresentation of objective journalists who are supposedly committed to practising, if not promoting, scientific temper. Purveyors of these nostrums have governmental backing and their practice is legally protected. Taxpayer’s money is used to fund these quacks. But the greatest harm is being done to those whose unquestioning faith and belief in the mystical/supernatural are being exploited. It doesn’t help that in India, religious tradition permits quackery like ayurveda and naturopathy , because of which mostly religious people tend to believe in them. Even people who are educated tend to be drawn to alternative medicine because of how exotic and holistic it seems. They are basically drawn to its fantastic and false promises and claims (such as “95 percent success rate with cancer” etc). As a result, alternative medicine has a booming trade in India, as it does in many other parts of the world.

The surprising thing is, while medical drugs go through a rigorous battery of tests, all of which they have to pass in order to be released into the market for large scale production, all these “drugs” are tested for is their side-effects. And of course there are usually very few, especially with homeopathic solutions, so they keep getting approval despite repeated research studies showing them to be ineffective. A combination of a lack of public awareness about the inefficacy of alternative medicine and encouragement and funding from the government has led to these industries thriving. This is an insult to reason and indeed, human dignity.

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