Remedies guide confuses science and anecdote. . - book review

The Natural Physician's Healing Therapies. By Mark Stengler, N.D. Prentice Hall, 2001. ISBN 0-73520250-8. 562 pp. $30, hardcover.

This book is no doubt a boon to humankind. For those of you who are ill, chronically or acutely, this book will provide cures, yes cures, is the word author Stengler uses. It is a self-help book that advertises "proven remedies that medical doctors don't know." Here is a wonderland of solutions for your aches, disabilities, distressed mental states, and what-not. Stengler describes a multitude of illnesses which herbs, chemicals, homeopathic nostrums, acupuncture, etc. will fix. Stengler does not argue that sufferers should avoid seeing physicians (oops, that is ambiguous because he and others of his ilk are equally physicians, their degrees in naturopathic medicine), because his "cures" are complementary to standard medical practice. And, while one might disagree with my characterization of his remedies as cures, in the section entitled: "Quick Cure Finder: An A to Z Guide to Health Conditions and Therapies," he offers cures for 372 (more or less--you get the idea) health conditions. And each of the condit ions usually has several treatments. Back pain can be "cured" with horse chestnut and nux vomica. Breast cancer is preventable with flaxseed and phytonutrients. Bronchitis has seven cures (astragalus; bromelain; cell salts; food sensitivity therapy; hydrotherapy; ipecacuanha; pulsatilla), and cancer has fourteen. Any sufferer would find great hope in his recommendations.

Well, perhaps although he boldly uses the word "cure" he means the word only in a manner of speaking. Surely, he does not mean to cure cancer, or macular degeneration, or anorexia, or colitis, or the multitude of "health conditions" with which we humans struggle. Perhaps he only means "feel better." We shall see.

Stengler has a distinguished history in the healing arts, with the doctorate in naturopathy (N.D.) and a certificate in homeopathic medicine, both from the National College of Naturopathic Medicine. He has trained as a general family practitioner and has "expertise" in nutrition, nutritional supplements, herbal therapy, and "many other modalities." Of great interest (though perhaps perplexing) is his membership on Yale University's Complementary Medicine Outcomes Research Project. He has achieved distinction as a writer and as a talk show host, and that he trademarked his self-chosen title, The Natural Physician, lends a sense of confidence to his pronouncements.

Clearly, this is a man of many parts who, by resume alone, we surely must take seriously. When he says in the body of this book that there is research that backs up an anecdote, we must accept that, although frequently he offers no reference. Homeopathic treatments are to be accepted on his say-so. He offers many anecdotes about how the treatments cured him and his patients, all with an aura of verisimilitude. Once he noted (in himself) the onset of the flu accompanied by a strong sense of fear. Deciding that anxiety is one symptom of the flu, he concluded that homeopathic aconite would cure the illness. Five minutes after ingesting the substance, he felt calmer and within a half-hour the other symptoms significantly diminished. At the end of the day, he was...cured. Yes, we should take him seriously.

Or should we? A boast of this book is that he provides references for the variety of treatments he recommends. That impresses, and I eagerly searched out the proper section. Sure enough, there are forty pages of professional references, but upon examination, doubts emerge. For example, he suggests ginger root for arthritis, bloating and flatulence, cardiovascular disease, diarrhea, high cholesterol, morning sickness, motion sickness, nausea, and vomiting. For all these conditions, there are only four references, one from Chinese herbal medicine and the other three from standard medical journals. But those three deal with the same topic: the reduction of nausea. While ginger, he explains, reduces cholesterol in rats, it does not do the same for humans. But he does not mind recommending it; he says that if you take it for some other reason, who knows, it might help with cholesterol. Parting company with many of his herbalist colleagues, he does not believe that ginger can help arthritis, but also says, "It can be helpful to some people as part of a comprehensive herbal formula ..." So, whatever the outcome, he is right.

About 28 percent of the references are from 1997 or later (my arbitrary cutoff for currency)--the rest are earlier than 1997, the oldest dating back to 1935. That means about 70 percent of the references are old without any suggestion of ongoing investigation. Some of the references have no citation, and some with citations have no year reported. Many of the journals cited are devoted to Chinese medicine or naturopathic medicine and many are from Europe. And many simply indicate that a study was done. For example: "One of the few studies on arsenicum album was done on rats that were given arsenic," or, "A study was done with forty people with chronic venous insufficiency ...," or "Researchers examined twenty-nine overweight individuals who also had a family history of diabetes." There are many such notes, giving the aura of research success but not providing even a hint of the findings. Many of the citations start with the line: "One study has shown..." Stengler does not inform the reader that basing a cure or treatment on one study is shaky. Positive findings have frequently failed upon replication, and sometimes there is a seesaw effect, so that to rely heavily on one study seems inappropriate. We have no way of knowing how many similar studies failed. One positive study amid several failures provides no useful information, no matter how provocative.