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EDITOR'S CHOICE: Fiona Godlee Simple problems please, and one at a time BMJ 2005; 330: 0-g [Full text]

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The gap between words and facts!

Sergio Stagnaro   (20 May 2005)

Acupuncture and psychotherapy - complex interventions for multiple causes

Ellen C G Grant   (25 May 2005)

The gap between words and facts! 20 May 2005
Sergio Stagnaro, Specialist in Blood, Gastrointestinal, and Metabolic Diseases. Researcher in Biophysical Semeiotics. Via Erasmo Piaggio 23/8. 16037 Riva Trigoso (Genoa) Italy. Send response to journal: Re: The gap between words and facts!	Sirs, In my opinion all doctors must agree with such as statement: "Great is our desire as doctors to identify a single simple problem that has a single simple solution". I suggest, however, one paramount problem, among numerous others, that can be solved easily because "ab esse ad posse valet illatio", according to E. Kant. Here is the problem: "Since not all individuals are affected by, and die from, cancer, who is predisposed to malignancy?" If we are able to ascertain that in a clinical way, cancer primary prevention is going to be realized on very large scale in individuals rationally selected (1). As a consequence there will be less expense of money by NHSs, as well as of patient's anxiety. 1)Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Travel Factory SRL., Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm Competing interests: None declared
Acupuncture and psychotherapy - complex interventions for multiple causes 25 May 2005
Ellen C G Grant, physician Kingston-upon-Thames, KT2 7JU, UK Send response to journal: Re: Acupuncture and psychotherapy - complex interventions for multiple causes	BMJ Editor Fiona Godlee writes that complex interventions, such as acupuncture and psychotherapy are interwoven with so called non-specific factors, such as talking and listening, which are in fact part of the therapeutic relationship. The process of diagnosis, she writes, is also hard to separate from the therapy, emerging as it does throughout treatment rather than being an isolated preceding event. Therein lies the confusion between lack of evidence of benefit in trials and claims of 95% benefit from practitioners of acupuncture.1 What are the reasons patients ask to be treated by acupuncture? Are the patients’ symptoms due to addiction, smoking, alcohol, hormone use or due to side-effects from regular medications? Are their symptoms due to nutritional deficiencies, toxic metal overload, food and chemical allergies or intestinal dysbiosis? No intervention, other than removal of the basic causes of symptoms, resulted in 100% of migraine patients having fewer headaches, with 85% having no further headaches over the follow-up period. 2,3 Clearly any trial of acupuncture, which gives such basic health advice to both treated and untreated patients, would struggle to prove any further benefit. 1 Godlee F. Simple problems please, and one at a time BMJ 2005; 330: 0-g 2 Grant ECG. Food allergies and migraine. Lancet 1979; 1: 966-69. 3 Grant ECG. Food allergy and migraine. Lancet 1979; 2: 358-59. Competing interests: None declared