An Alternative Recipe

In a recent comment on Sunrise Rounds, a reader noted that I was opposed to “Alternative Medicine.”  Actually, I do not oppose any idea that has a chance of helping, especially to fight a disease as vile as cancer.  I do strongly oppose treatment without evidence or research.  However, today a patient asked me about an Alternative method, which I must say was so unique that it might make me change my mind … yes, if this is where Alternative Medicine is headed, I may decide that I am opposed to all of it.

My patient has a blood disorder, which requires regular intravenous therapy.  The condition is well described in thousands of published papers and the medicine he is receiving has been proven in hundreds of randomized trials to successfully treat and often cure this disease.  While I can add that my partners and I have seen this therapy work in hundreds of patients, it is not necessary, as every major hematologic authority in the world supports what we are doing.

However, after getting three “second” opinions from other hematologists, all of whom supported and recommended the same treatment, the patient and family sought an “Alternative” opinion, this time from a Naturopathic Doctor.  The recommendation from this clinician is enlightening.

Naturopathy, a more than 150-year-old system of care, is based on the concept of “vitalism,” the idea that energy forces, not biologic systems, control the body’s organs.  There is no objective scientific evidence to support this idea. Naturopathy tends to focus on wellness and lifestyle changes that attempt to support the body’s “innate healing potential,” taking a holistic approach to care.  While traditional medical authorities, such as the American Cancer Society and National Cancer Institute, do not recognize any health benefit for Naturopathy and worry it may distract patients from getting real care, some of the simple interventions which are used, such as exercise, manipulation, balanced nutrition, meditation and avoiding alcohol, may complement oncologic care.  However, the advice given to my patient makes my head spin.

My patient was told that he did not have a primary problem with his blood.  Rather he had “radiation poisoning” and this was causing a breakdown in his body.  How this toxicity was detected, as no tests were performed, was not clear. In addition, how he would have become contaminated with radioactive material was not obvious; he lives in non radioactive Central New Jersey, has never been to a nuclear power plant, has done nothing for which the Russian secret service would want to poison him with polonium -210 and has not taken to digging for or eating uranium.  Nonetheless, radiation poisoning was the diagnosis and “fortunately” there was a cure.

The patient was told, on a daily basis, to soak in a hot bath of water.  Into the water, he should place several quarts of apple cider vinegar and a prodigious quantity of sea salt.  He was to lie in the water until it cooled.  The heat would cause the radiation to move to the skin and the brine mixture would draw it out by “osmosis.”  The cure was just a supermarket away.

Now wait a moment.  Let us talk biology and physics 101.  First, radiation is called that because it radiates… it is like light, in a second, it is 186,000 miles away.  It does not stay in a person’s body.  The only way to stay radioactive is to eat something radioactive … i.e. swallow radioactive dust or rock.  While it is clear that my patient did not do this, it is even more ridiculous to think that heat and a salt-vinegar soup could make a radioactive substance migrate through the body and “out the pores.”   Osmosis is the movement of fluid, not radioactive metal, and fluid movement by osmosis is absolutely blocked by the outside layer of our skin; if not we would dry up like a raisin when we swim in the ocean.  This “diagnosis” and “treatment” is patently ridiculous.

I was more balanced in my answer to our patient.  I emphasized to him the importance of continuing his traditional hematologic therapy, as it is very likely to help.  I told him that I doubted he had radiation poisoning, as there was no evidence of that horrible condition in our extensive blood testing.  Nonetheless, I told him that if he wished it would be OK to take the salt and vinegar hot baths.  I doubt it could cause harm. I suggest, however, that perhaps it would be better used for making pickles.


  • Nice touch at the end :)
  • kmogle
    I do hope your patient follows through with your treatment. It is heartbreaking when someone does not, and a real cure is in sight. The larger question may be why is there so much magical thinking in our culture, and when did we go off the rails in the scientific and medical world (or in education?) so that we lost the trust of people who seemed at one time to accept the role of experts? Or is there just a percentage of the population that can't grasp any uncertainly at all (inherent in honest science and medicine) and leaps at what seems like a guarantee (and one with a villain in the story to blame for their sickness, rather than just random chance)? Your story is distressing on many levels and I wish you and your patient all the best.
    • James Salwitz, MD
      Thanks for your comment. I tend to believe that the wide use of unproven health care methods is a mixture of lack of trust or understanding in science, failure to build a solid relationship with a physician, overwhelming/confusing information, a desire to leave no stone unturned and the drive to maintain control. Sometimes it is just that a vulnerable frightened population is a good target for those of less honest motives. jcs
  • Stacy Snyder
    This opinion was from a dangerous crank not a Naturopathic doctor who completed a four year medical education at an accredited college . Licensed Natropathic Doctor are licensed as primary care providers and prescribe drugs as needed, in many states.
    • James Salwitz, MD
      Thanks, important point. While not recognized by any conventional medical board, society or authority, sixteen states in the US and five Canadian provinces do allow graduate naturopathic doctors to hang out a shingle as a "ND" or "NMD." Each state has very different regulations on what services they are allowed to provide. Most naturopaths have not graduated from any organized training program and practice what is referred to as "traditional naturopathy." jcs
  • gopja
    It never ceases to amaze me that patients will throw exhaustive medical research out the window in lieu of alternative and unproven therapies. I see it as the ultimate form of denial. I hope and pray your patient sees the 'light'.
    • Stacy Snyder
      Some "exhaustive medical research" is fraudulent with important critical information redacted. Many published pre-clinical cancer studies that drove research decisions had outcomes that could NOT be replicated. This isn't serving anyone. The clinical expertise of oncologists in practice is essential to guide patients through this morass of questionable research and treatment choices.
      • gopja
      • James Salwitz, MD
        Absolutely true and a critical comment. No matter how good is the "research" it requires the experience and training of a physician. "Watson" will never replace the doc at the bedside. jcs
  • Amy S. Miller
    Traditional medicine with a well trained specialize in his/her field that includes knowledge of medical scientifically proven research, by no question is a positive way to follow. Lets not leave out the overall picture of the healing process. I feel a combination of traditinal and complimentary medicine(change the verbage from alternative) works hand and hand to heal the body, mind, and soul. There are a lot of great complimentary medicines that is supported by research to support the healing process of many diseases. With technology increasing daily, we need to use all of the resources out there to solve all the different types of medical issues. ASM, LMT
    • James Salwitz, MD
      Beautifully said. Thank you. jcs

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