Friday, December 2, 2011

Like Water for Lockjaw

The last Quacktion Figure™ gives me a good excuse to talk about a news item that popped up in my inbox the other day. Well, not so much a news item as someone's notion of a "brilliant" treatment for tetanus. You see, I have some alerts set up looking for vaccine preventable diseases. I take a quick glance at most of the stories and either do a quick tweet or simply archive it for background material for possible future posts. Every now and then, however, there will be something that catches my eye. Some combination of words in the headline or brief blurb snags my attention.

That's what happened with one such alert notification on tetanus. While perusing my inbox, what to my wandering eyes should appear but a story titled "Homeopathic Ledum for Tetanus".

Uh oh.

I haven't exactly been very coy with my thoughts on homeopathy. A lot of commercial products aren't even homeopathic, and when that happens, the consequences can be potentially deadly. I really have a problem when it comes to using homeopathy on kids; it is, in my opinion, grossly unethical. Since homeopathy is basically nothing but water and sugar pills, using them to treat anything more serious than a self-limiting or subjective condition is not simply careless, but willfully reckless. That's why I had something of a sinking feeling when I saw that e-mail.

Before I get into a discussion on the article itself, a little translation is in order. Homeopaths have this frankly bizarre need to invent new science-y sounding names for things or use their Latin, rather than common, names. It makes them sound smart and means the mark patient has little clue what the substance actually is. For example, "arnica" is arsenic.

So what the heck is "ledum"?

Photo by: Sten Porse
The article discusses the use of Ledum palustre. This is a variety of rhododendron, also known as Labrador tea or wild/marsh rosemary. In North America, it grows in northern latitudes, preferring arctic and subarctic climates. In small amounts, it can serve to season your food, but in large doses, it can cause some undesirable side effects, like stomach or intestinal irritation, kidney damage, seizures, increased menstrual flow or even abortions.

The author of the homeopathy article, Josephine, is certainly a fan of magic water. She also seems to be of the belief that homeopathy is a valid substitution for vaccination, though she doesn't seem like she's completely against vaccines (at least not yet). That belief, that homeopathy is just as good as (if not better than) vaccination is a rather dangerous one.

You see tetanus (PDF) is not what one would call a happy, fun time. The bacterium that causes the disease is found just about everywhere in the world. It lives in dirt and feces, doesn't care much for oxygen-rich environments and wreaks havoc on one's nervous system using its lovely toxin, tetanospasmin. Even with treatment, it has a death rate of about 11%. It causes your muscles to spasm, potentially breaking bones and halting your ability to breathe. One of the most important muscles in your body, your heart, is not immune, either; the toxin can cause irregular rhythms. And then there's the lovely secondary infections that take advantage of tetanus' work, causing pneumonia or even sepsis.

What does this ledum stuff have to do with tetanus?

According to homeopaths, if you give large doses of a substance to a healthy individual and it causes certain symptoms, then when you give highly diluted preparations of the same substance to people suffering those symptoms, the preparation will lessen or even cure the symptoms. Using this reasoning, since ledum in large enough doses causes muscle spasms, stiffness and joint pain, then it must be good for treating tetanus!

There's just one problem. It doesn't. At least, I couldn't find a single study on PubMed looking at ledum palustre use for the treatment of tetanus. No studies looking at whether or not it had any effect. No studies even showing whether or not the substance is safe! I also searched some of the PLoS journals. Nada. Medscape? No luck. There wasn't even any information available from the National Center for Complementary and Alternative Medicine.

You see, the way tetanus works, there is only one way to treat an infection. First, you need to kill any bacteria that are circulating in the body. Since they are the critters that produce the tetanospasmin, they'll just keep pumping it out into your body until they're dead. Unfortunately, the antibiotics used to kill the bacteria will have no effect at all on the toxins already circulating through your system. That requires the administration of tetanus immune globulin, which neutralizes any freely circulating tetanospasmin. But we're still not done. Since TIG can only neutralize free toxins, any of the toxin that has already bonded to your nerves will continue to cause problems. To prevent serious injuries or death that might result from the muscle spasms these toxins cause, other drugs may be used to sedate you, relaxing your muscles and stopping the convulsions until your body is able to finish off the last of the toxins on its own.

Because treating tetanus is so involved, costly and time-dependent, and because it doesn't necessarily lead to full recovery, I can understand the desire to find something that is cheaper and likely will have fewer side effects. A magic bullet, as it were, can be very appealing. Unfortunately for people like Josephine, trying to treat an actual (as opposed to suspected) tetanus infection with homeopathy rather than real treatment gives you nothing but a 1 in 4 chance of death.

Josephine ends her article by stating:
Ledum is brilliant homeopathic remedy for Tetanus, but as always, please get homeopathic advise first.
Frankly, Josephine, that is dangerous and irresponsible advice.

My advice, talk to a real doctor. Stay up to date on your tetanus shots and seek real medical help if you get infected.

6 comments:

  1. I had a similar horrified reaction when I saw that Indian homeopaths are starting to tout sugar pills as an effective treatment for TB. To be frank, I am slightly too drunk to find the link again right now, but I'll look tomorrow.

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  2. Update: Lizditz and Blue_wode just tweeted it: http://www.hindustantimes.com/India-news/NewDelhi/Homoeopathy-an-alternative-to-treat-TB/Article1-777165.aspx

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  3. Yeah, I saw that link earlier. If a person wants to take a tic tac for their seasonal cold, fine. It's their money wasted. But for anyone to sell sugar pills to treat serious illnesses? That is unconscionable.

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  4. Kim Stagliano once tweeted to one of the pathogens that she got her tetanus vaccine after a cut or scrape or something... I'd need to go dig through their twitter streams. Anyway, she continued by saying that she took some sort of remedy to rid her body of the toxins in the tetanus vaccine.

    My head exploded when I read that.

    Seriously, your head could explode: http://www.sleepassociation.org/index.php?p=explodingheadsyndrome

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  5. And the AIDS woo makes me ca-razy.

    Maun Homeopathy for AIDS (including getting people of antivirals)
    http://www.homeopathybotswana.com/

    http://hpathy.com/homeopathy-papers/a-homeopathic-perspective-on-aids/

    and etc.

    garrrrr.

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  6. "...I couldn't find a single study on PubMed looking at ledum palustre use for the treatment of tetanus."

    Uh, no. That's because it would be hideously unethical to do such a study (as you well know).

    Along the way, I've come to realise that there are two varieties of "alternative" (i.e. fantasy-based) medical practitioners: "self-aware" and "non-self-aware".

    Most "alternative" medical practitioners are, fortunately, of the "self-aware" variety - they are at least subconsciously aware that their fantasy-based "therapies" don't do anything (apart from enriching the practitioner) and will instinctively avoid using them on patients who have medical problems that can lead to death or serious injury. One possible exception to this are patients with terminal cancer, who are already expected to die of their illness, so the "alternative" practitioner can't be blamed for their death.

    The "non-self-aware" practitioners are more rare, but they are responsible for a disproportionate amount of the morbidity and mortality of "alternative" medicine. These are the folks who might actually try using homeopathic Ledum on a patient with a tetanus-prone injury. Most of the time - since tetanus wasn't all that common even before the vaccine - they will be spared by random chance, but every once in a while....boom!, the roulette wheel comes up zero and everybody loses.

    Historically, as real medicine has advanced, "alternative" or fantasy-based medicine has been forced into the progressively smaller areas where real medicine has little or nothing to offer. Fortunately for the "alternative" practitioners, there will always be the "worried well" and people with imaginary illnesses to....heal (usually accompanied by a significant reduction in wallet mass).

    Prometheus

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