Avoiding scientific delusions

In all my blogging about altie claims and the alleged (and most likely nonexistent) link between mercury exposure from thimerosal in childhood vaccines and autism, I've been consistent in one thing. I try as much as possible to champion evidence-based medicine. I insist on evidence-based medicine because, with good reason, I believe it to be superior to testimonial-based medicine, which is what practitioners like Dr. Rashid Buttar, who cannot demonstrate that his "transdermal cream" even gets his chelating agent into the bloodstream at concentrations that will chelate anything, much less mercury, much less that it can improve the functional level of autistics in controlled randomized trials, do. (On a side note, I've also learned that Dr. Buttar also doesn't like me very much for saying that, much to my amusement. If this, this, or this inspired him to mention me in the same sentence as "stupidity" or a "brick wall," he really should check out Kev's fantastically sarcastic letter to him or this broadside against chelation therapy for autism. Or better yet, he should read Peter Bowditch's take on the matter. That ought to raise his blood pressure. Then he could chelate himself to get it back down.) I also try to insist on evidence-based medicine because lack of evidence is what quacks like Hulda Clark prey upon in selling their worthless "cures" for diseases like cancer. However, contrary to what some alties will claim, I do not limit my insistence on evidence-based medicine to various alternative treatments. I insist on uniform scientific standards for evaluating the biological mechanism of disease and potential treatments, whether the treatment be "alternative" or "conventional."

Alties are frequently unhappy about medicine's growing insistence on well-designed clinical trials to test their claims, considering it evidence of the "elitism" that they despise in "conventional" medicine. What they don't understand is that the reason that the scientific method and clinical trials are so important is not because scientists and "conventional" doctors are any wiser than "alternative" practitioners or even the general population at large. They most certainly are not; they are just more highly educated and trained. The reason the scientific methods and clinical trials are so important in developing and evaluating new therapies is because doctors are human and therefore just as prone to bias and wishful thinking as the worst pseudoscientist or quack. They are just as prone to falling victim to the trap of wanting so badly to believe that an experimental result is valid or that a treatment is effective that they fool themselves into believing it or to resisting change because "always done it this way." (Altie practitioners tend to be prone to a different kind of self-deception, namely the Galileo gambit, in which they believe themselves akin to Galileo, persecuted because they are so far ahead of their time.)

Last Sunday's New York Times had a very good example of a "conventional" treatment that demonstrates why clinical trials are so important. The treatment is vertebroplasty using spinal cement to treat vertebral fractures due to osteoporosis:
No one is sure why it helps, or even if it does. The hot cement may be shoring up the spine or merely destroying the nerve endings that transmit pain. Or the procedure may simply have a placebo effect.

And some research hints that the procedure may be harmful in the long run, because when one vertebra is shored up, adjacent ones may be more likely to break.

But vertebroplasty and a similar procedure, kyphoplasty, are fast becoming the treatments of choice for patients with bones so weak their vertebrae break.

The two procedures are so common, said Dr. Ethel Siris, an osteoporosis researcher at Columbia University, that "if you have osteoporosis and come into an emergency room with back pain from a fractured vertebra, you are unlikely to leave without it." She said she was concerned about the procedures' widespread and largely uncritical acceptance.
Sound familiar? If not, consider this quote:
"I struggle with this," said Dr. Joshua A. Hirsch, director of interventional neuroradiology at Massachusetts General Hospital in Boston. He believes in clinical trials, he said, but when it comes to vertebroplasty and kyphoplasty, "I truly believe these procedures work."

"I adore my patients," Dr. Hirsch added, "and it hurts me that they suffer, to the point that I come in on my days off to do these procedures."

Dr. Hirsch apparently started with the noblest of motives, wanting to relieve his patients' unremitting pain from spinal metastases due to cancer or fractures due to osteoporosis. He still believes he is helping; otherwise he would probably abandon vertebroplasty. Many altie practitioners start out similarly, no doubt. They come up with a method or a treatment, see what appears to be a good result, become convinced that it works, and thus become true believers. The difference is that, unlike Dr. Buttar, as an academician Dr. Hirsch at least still feels uneasy about advocating this therapy without adequate research or strong objective evidence to show that it really works better than a sham procedure, because doing so goes against his academic training. (Quacks like Dr. Kerry have no such qualms, even though he was educated at the University of Pittsburgh.) Nonetheless, Dr. Hirsch appears to have convinced himself by personal observation and small pilot studies that the procedure works. That the the Director of Interventional Neuroradiology at Massachusetts General Hospital can convince himself that an unproven treatment works on the basis of personal observation and small pilot studies simply shows how easy it is to persuade oneself to believe what one wants to believe. He may or may not be correct in his belief, but we have no way of knowing.

Unfortunately, personal observation is prone to far too many biases, the worst of which is selective thinking or confirmation bias. In short, we remember successes (or seeming successes) and observations that confirm our expectations, and tend to forget or discount failures and observations that do not confirm our expectations. Small pilot studies are also prone to bias and confounding factors, which is why they are generally good only as a means of determining if a treatment shows an inkling of effectiveness worth following up with a larger trial. As the claim spreads, it can then become accepted through communal reinforcement, regardless of the poor quality of the initial data. Apparently this is happening now with vertebroplasty.

In studies of pain relief treatments or procedures, one particularly nasty bias that cannot be eliminated without good placebo controls is regression to the mean:
For example, he said, patients come in crying for relief when their pain is at its apogee. By chance, it is likely to regress whether or not they are treated. That phenomenon, regression to the mean, has foiled researchers time and time again.
Although there was one uncontrolled pilot study that reported 26/29 patients showing pain relief after the procedure, a followup study with placebo control, although quite small, cast doubt on the effectiveness of the procedure:
But Dr. David F. Kallmes, one of her partners, wanted a rigorous test. He began a pilot study, randomly assigning participants to vertebroplasty or placebo. To make it more appealing, he told patients that 10 days later they could get whichever treatment they had failed to get the first time.

It was hard to find subjects, and Dr. Kallmes ended up with only five. For the sham procedure, he pressed on the patient's back as if injecting cement, injected a local anesthetic, opened a container of polymethylmethacrylate so the distinctive nail-polish-remover smell would waft through the air and banged on a bowl so it sounded like he was mixing cement.

In 2002, he reported his results: three patients initially had vertebroplasty and two had the sham. But there was no difference in pain relief. All the patients thought they had gotten the placebo, and all wanted the other treatment after 10 days. One patient who had vertebroplasty followed in 10 days by the sham said the second procedure - the sham - relieved his pain.
In other words, none of the patients got any relief when they thought that they might be getting a placebo the first time around and thus wanted the "real thing." This implies that the pain relief due to the treatment may well be due to a placebo effect. Remember, placebo effects are often more potent the more elaborate or invasive the treatment is, and thus harder to control for. This is one of many reasons that trials for surgical or invasive procedures to relieve chronic pain are often so hard to do. Sadly, Dr. Kallmes trial was so small that we cannot make any definitive conclusions from it, although there is also an Australian trial that found that pain relief at six weeks in the vertebroplasty group was no better than the control group, bringing the long-term effectiveness of the technique into doubt.

It turns out that the bulk of the evidence that is being used to argue that vertebroplasty is effective are in essence testimonials, rather uncomfortably like the "evidence" being used to promote Dr. Buttar's "transdermal chelation" therapy and other altie treatments. We have no idea whether vertebroplasty actually works, for which patients it does and doesn't work, what the long term results are in terms of durable pain relief, whether it increases the risk of additional fractures, or what the potential complications are. To find that out would require clinical trials, and, barring such trials, we can never be certain whether vertebroplasty or kyphoplasty are anything superior to elaborate placebos. The difference, of course, is that at least vertebroplasty has a biologically and anatomically plausible rationale to lead us to think that it might work. The same most definitely does not apply to Dr. Buttar's treatment. Read this and tell me that this story of a doctor giving a talk about vertebroplasty to a skeptical audience of doctors doesn't sound familiar:

"I could tell by looking at the audience that no one believed me," she said. When she finished, no one even asked questions.

Finally, a woman in back raised her hand. Her father, she told the group, had severe osteoporosis and had fractured a vertebra. The pain was so severe he needed morphine; that made him demented, landing him in a nursing home.

Then he had vertebroplasty. It had a real Lazarus effect, the woman said: the pain disappeared, the narcotics stopped, and her father could go home.

"That was all it took," Dr. Jensen said. "Suddenly, people were asking questions. 'How do we get started?' "

Can you picture this sort of scene in an infomercial for an herbal remedy? I can.

So what's wrong with testimonials? Well, as I like to say, the plural of "anecdote" is not "data," and testimonials usually don't even rise to the level of anecdotes. Testimonials are often highly subjective, and, of course, practitioners can and do pick which testimonials they present. Even in the case of cancer "cure rates," testimonials often mean little because they are given for diseases that surgery alone "cured." (Also, dead patients don't provide good testimonials.) Worse, testimonial-based practice tends to preclude the detailed observation and long-term followup necessary to identify which patients benefit from treatments and which do not, complication types and rates, or long-term results of the treatment. Anecdotes are really good for only one thing, and that's developing hypotheses to test with basic scientific experimentation and then clinical trials. Vertebroplasty may indeed be very effective at pain relief with a low risk of complications. Or it may not. We simply don't have the data to know one way or the other, and now we may never have it. What is odd is that Medicare and insurance companies are usually pretty firm about not paying for an experimental procedure (which is what vertebroplasty should be considered), yet somehow third party payers have been persuaded to pay for this procedure.

Science itself and randomized clinical trials are designed to combat such biases. In preclinical studies, the scientific method uses the careful formulation of hypotheses and testing of those hypotheses with experiments that can either confirm or falsify the hypothesis, experiments that include appropriate control groups to rule out results due to factors other than what the researcher is studying. The scientific method, rigidly adhered to, helps investigators protect themselves from their own tendency to see what they want to see, to correct mistaken results, and recover from stupidity faster. The same is true of randomized clinical trials, which accomplish this in much the same way by using four factors: strict inclusion criteria, so that only patients with the disease being studied are admitted; close measurement of endpoints that are as objectively and reproducibly measured as possible; careful, statistically valid randomization, so that the control group and experimental groups resemble each other as closely as possible; and a placebo control (or a comparison against the standard of care treatment for disease in which a placebo control would be unethical, as in cancer trials). Whenever possible, double blinding is advisable, so that neither the patients nor the doctors know which patient is getting which treatment, so that doctors don't treat patients in either group differently or look more closely for (and therefore find) treatment effects in the experimental group and so that patients don't pick up cues from the doctors' interaction with them. This maximizes objectivity and minimizes bias.

It should also be remembered that one study is not enough, either. Single studies can be wrong one-third or even one-half of the time. I've often joked that, if you look hard enough, you can almost always find a study that supports whatever conclusion about a clinical question that you want to make. Alties don't understand this and will cite one or two carefully selected reports that seem to support their claims, ignoring the many that do not. Illustrating this example is chelation therapy for another disease, namely athersclerotic vascular disease, for which chelationists will cite old papers with inadequate controls that seemed to show a benefit. For example, there was one randomized study in 1990 that appeared to show a benefit for chelation therapy over placebo, but this was a study that looked at only 10 patients. Multiple much larger randomized studies have been done since then, such as this one, and none of them has shown a benefit. Guess which studies alties like to cite? (Hint: It isn't any study newer than 1991 or so.) Hopefully an ongoing NCCAM study will resolve the study once and for all, although there is little doubt in my mind that chelationists will not believe the study if, as is likely, it fails to find a beneficial treatment effect.

What really needs to be considered in clinical decision-making is the totality of data from well-designed clinical studies, something the Cochrane Collaboration tries to facilitate by evaluating the literature concerning important clinical questions and synthesizing it into recommendations and a summary of the quality of available evidence to support their recommendations (or the lack thereof). The bottom line is that evidence-based medicine, far from being a way for "conventional" doctors to assert their superiority over "alternative medicine," is a in actuality means for doctors to try to avoid medical and scientific self-delusion about the effectiveness of a favorite treatment. Just because the medical profession all too often doesn't do a good job of practicing evidence-based medicine is not a reason to throw these scientific standards out in favor of fluffy, feel-good, testimonial-based treatments like Dr. Buttar's or to give advocates of such treatments a pass in terms of supporting their claims. Rather, it is a strong reason to strive to do a better job at improving the science behind our treatments and the scientific rigor of our clinical trials. Evidence-based medicine may not be without problems itself (and perhaps I shall try to address some of its shortcomings in future posts). However, it is far better than the alternative.


  1. It's a shame that doctors fall for this. One would think that doctors would have a better appreciation for the scienfic method. But I suppose it's a symptom of two things: a general ignorance of the scientific method, and human nature. After all, there are some very respected scientists who have fallen for quackery or other superstitions outside of their own field of speciality.

  2. Excellent post, very well argued. Unfortunately, the history of medicine shows that doctors are just as vunerable to the pull of tradition, anecdote, and wishful thinking as anyone else.

    One comment on the issue of anecdote, though: as you said, the plural of "anecdote" is not "data". However, anecdotal observations can be useful for getting hints about possible correlations that might be useful to study further. For example, a phase I study of chemotherapy is designed to show toxicity, not efficacy. However, if, say, 5 patients with pancreatic cancer were put on one particular trial and three of them showed a response, that might suggest that a phase II trial of the drug in question might be warrented. Of course, most of those correlations are going to disappear in phase II and III trials and one certainly wouldn't want to declare a new standard of care based on the phase I findings, but they can be useful if treated with proper skepticism.

  3. Orac,

    I read Buttar's pseudo-rebuttal and was intrigued by his "appeal to authority" when he cited the response of his colleague Dr. Steve Coles - who Buttar referred to as "a UCLA doc".

    Well, I checked the faculty directory of UCLA and guess what? They don't have a Steve Coles on their faculty - they don't even anyone with the last name of "Coles" on their faculty. Perhaps Buttar meant that the estimable Dr. Coles had attended UCLA.

    Big deal - they graduate over a hundred doctors a year and , unfortunately, some of their graduates succumb to the siren call of "alternative" medicine. There are bad apples in every barrel.

    Every time he opens his mouth, Rashid Buttar puts his foot in it - it's a wonder he hasn't choked to death by now.


  4. Buttar is wonderful, he's just too busy to cite even other people's research, and we know he's far too busy to see what he's actually doing to children's health.

  5. It pains me greatly to have to come to the defense of someone like Buttar but I am afraid that in this case he is right and Prometheus is wrong- Steve Coles does indeed seem to be a member of the UCLA faculty.

  6. That's Steve Cole at UCLA (notice not: Coles)

    Did Prometheus make a spelling mistake or did Buttar, or is this Cole guy another guy entirely.

    I'm sure Prometheus is preparing to fall on his sword if it's his spelling error.

    DON'T DO IT Prometheus! :-)

    Do we even know if either Cole or Coles said what Buttar is attributing to him?

    I notice this Cole has an email address there. :-D We could ask him.

  7. My mistake! Sorry! When I searched the UCLA site for "coles," it turned up that innocent Cole fellow because "coles" is part of his email address.
    When you search the web for variations of Stephen Coles and UCLA you'll find plenty of references indicating that the gentleman is affiliated with UCLA and is involved in quack-ish sounding projects to prolong human life to ridiculous lengths.
    However- after nearly five minutes of dilligent, wearying searching- I could find only one reference to him on the UCLA site. (It's the fifth item down- and it identifies him as being an "assistant researcher")

  8. TO: Kevin Greenlee - I am willing to admit that I was wrong about Steve Coles. As for falling on my sword, how about if I fall on my butter knife and we call it even?


  9. "Assistant researcher"? Well, that means he's almost certainly not faculty. The lowest faculty title is usually "Instructor."

  10. ....I believe that if every American took IP-6 (Inositol Hexaphosphate) our cancer rate would drop dramatically says Dr. L. Stephen Coles...

  11. Great post --- and thanks for being honest enough to point out that we in organized medicine have our own issues with treating anecdotal data as "real" data. Unfortunately, it is all too easy to fall into the trap of treating patients based upon what appears to provide benefit, without an adequate trial. The kyphoplasty procedure is one that is tailor made for a good study....but it appears that one will not be done any time soon.

  12. First of all, you guys are UNBELIEVABLE at getting off-topic and picking out what is totally irrelevant. SO FRUSTRATING!

    "Concerned," I went back to the email that Dr. Buttar forwarded me. It turns out that I did copy and paste correctly and I'm pretty sure "Steve Coles" didn't type his own damn name wrong.

    So then Kevin Greenlee contradicts Prometheus, who almost gracefully conceeds that he was wrong (a first for this blog?) and falls on his butter knife, with the following description listed on the UCLA Surgery page:

    "...Dr. L. Stephen Coles, M.D., Ph.D., assistant researcher in the Department of Surgery..."

    And Orac has the audacity to say that assitant researcher is not faculty position. SERIOUSLY??

    Hmm...let's see here. Dr. Coles, MD and PHD? Do you have both an MD and PHD Orac?

    Maybe Dr. Coles is just a lowly "assistant researcher" because he's too busy actually making things happen rather than spending his life debating and conjecturing over how things happen and putting down those people that can actually get results.

    For my next comment...

    - Patrick Sullivan Jr.

  13. Orac, my apologies if you think this is rude of me to repost my same comment here as I just did here. But you're lambasting Dr. Buttar in this post for the same exact things as the comments in the last post and therefore, the comment is relevant here as well.

    (And the disk space is on Google's nickel anyways.)

    There is just one comment that I would add here. In your bloviating explanation about medical studies, boring as they are, you fail to mention even ONCE the word "empirical."

    Do a search everyone. The hotkey is Ctrl + F. The first time it's used is in my comments.

    Is empirical evidence just not useful in science?

    If so, somebody better call Webster:

    em·pir·i·cal ( P ) Pronunciation Key (m-pîr-kl) adj.

    a. Relying on or derived from observation or experiment: empirical results that supported the hypothesis.
    b. Verifiable or provable by means of observation or experiment: empirical laws
    2. Guided by practical experience and not theory, especially in medicine.

    And all of us alties are the ones ignoring science?

    Honestly, are you even really a surgeon? I think I've earned the right to know.

    As hard as you try to pull off a "I'm skeptical for the public good" visage, it's just turning you into one of those people who sit back all day and figure out why/what/how.

    But you don't want anyone to actually DO anything.

    It's the Dr. Buttar's that are the pioneers -- the mavericks -- that say, "I've seen this work enough times with my own eyes...let's keep doing it!"

    Or maybe you just lack the confidence to make a decision?

    Twenty-five years from now, Buttar will be the Semmelweis of his day. You'll be the, well...actually no one is going to remember you. Not even the LA Times.

    - Patrick Sullivan Jr.

  14. Orac, you said, "Pat, Pat, Pat, so like your dad."

    Guilty as charged -- and proud of it! I'm proud of my dad. I'm proud of the fact that he is a hard-working, humorous, generous, honest, God-fearing man. Being able to launch Jigsaw Health with him has been one of the most challenging and rewarding things of my life.

    My Dad was born and raised in East St. Louis, Illinois. The high school he went to, Assumption Catholic High School, is now the Southwestern Illinois Correctional Center (state prison). (Of course, he jokes that all the kids thought it was a prison back then and the only thing that really changed in 1994 was the name! ;-)

    My Dad worked his ass off to become successful. When he started ACT! in 1986, his only goal was to make enough money to feed his wife, son and three daughters. And if you read his book -- send me an email and I'll send you a FREE copy Orac -- you'll find out that that while trying to feed his family and build a company, he was silently struggling with recurrent bouts of insomnia, fatigue, anxiety, diarrhea, etc. all of which he has concluded stemmed from poor diet and overuse of broad-spectrum antibiotics which impaired digestion (leading to Leaky Gut Syndrome) AND the 8 grams of mercury in his mouth from his 14 "silver fillings." He had those removed in 1987 and experienced significant improvements right away. But subsequent provocation tests have continued to show high levels of mercury since then. Therefore, he has been trying to find an effective detoxifier/chelator ever since. In his own experience, TD-DMPS has been the most effective by far!

    Why the heck am I writing all that? For sympathy? For praise? For self-promotion? Absolutely not!

    To show my/our true colors? Absolutely!

    And most of you can't even show your real names. HCN, you think "Pat Sullivan" is an common name? Come on guys, we're not in an AOL chatroom circa 1994. (Btw, Hello from "bluerolo42" to anyone who remembers me.) The blogosphere today REQUIRES disclosure or you risk the loss of credibility. As far as I'm concerned, Orac's explanation for his anonymity should only apply to him, unless everyone else in here is a doctor...

    So Orac, whether or not your comparison of me to my Dad is meant to be an insult, I wear it as a badge of honor!

    Now, Orac I halfway accept your claim of "There's nothing "intellectually dishonest" at all." That's because I thought you had a valid question. And after hearing it on an endless loop I started to think, "Yeah Dr. Buttar! Why not just do a stupid blood test and prove whether or not TD-DMPS gets through the skin?"

    So I exchanged several emails back and forth with Dr. Buttar late Tuesday night and into early Wednesday morning. Having no scientific background myself (other than my Bachelor of Science in Marketing), he had to explain himself a couple of times for me to finally "get it."

    But I can assure you in all honesty, with my real name and reputation on the line, knowing I had to come back here and face the music regardless of his answer, I was going to make SURE he explained it to me until I absolutely understood him and his position.

    I was not going to follow him blindly. His explanation absolutely had to make sense and appeal to my own logic. I refuse to be the mouthpiece for a liar or a con man! If I concluded, or even suspected, after our email exchange that he was lying, I would have come right back here and fessed up to it.

    So here is our email conversation. I gave my word to Dr. Buttar that he could read my transcription before I posted it. He sent me a reply email saying "go for it" on 8/31/05 at 11:31pm EST.

    Patrick Jr. (8/30/05 11:40pm EST): ...I think there may be a flaw in your "thimerosal challenge" if you choose to use DMPS in TD and IV for chelating out the thimerosal. One of the biggest, most common complaints from your critics is that there is no proof that DMPS is even being absorbed. If you use IV DMPS alongside TD-DMPS, you'll leave them a hole big enough to drive a truck through.

    Dr. Buttar (8/31/05 1:06am EST): For acute mercury toxicity, TD-DMPS is not sufficient...for chronic mercury toxicity where mercury absorbed into the the tissues, etc....it is the best. I will be taking a bolus of thimerosal.....I will take the bolus antidote. I don't care about the critics or what they say. We don't know how aspirin works but the entire world uses it anyway! A neurosurgeon friend, and father of a child I am treating, will be writing about this issue anyway...

    My purpose is not to prove that TD-DMPS is getting through the skin Patrick. I don't care if it is a placebo, which obviously it isn't....and our lancet paper
    [based upon the results of my own empirical observation] will show that the more you use the TD-DMPS, the more mercury is coming out. My purpose [for the thimerosal challenge] is different...I want to show that thimerosal is dangerous, and I will take DMPS intravenously to show how safe it is.

    It is a "SAFETY" issue I'm talking about....I don't care to prove a damn thing to those people that you have been dueling it out with. The NIH has said our treatment and DMPS specifically is DANGEROUS....so I will take DMPS intravenously to show that it is NOT dangerous. That's why I want the media....to show the world how safe DMPS is. And if it's safe to take intravenously, then it's OBVIOUSLY safer to take it transdermally.

    Patrick Jr. (8/31/05 1:49am EST): Dr. Buttar, please forgive me, but I didn't realize that showing the safety of DMPS was your true motivation. Frankly, I thought this was already well established? Isn't it readily used overseas?

    And yes, chelation therapy for mercury is coming under fire because of Tariq's death, but I believe that to be a knee-jerk reaction. The data of tens of thousands of parents who have already safely used chelation therapies (like what GenerationRescue reports) will eventually change that mindset.

    I assumed your motivation would be to prove that TD-DMPS ("expensive hand lotion" as your critics like to call it!) actually WORKS and to absolutely prove once and for all that it is in fact absorbed into the bloodstream. Otherwise, how could you have cured your son? How could my Dad's last TD-DMPS provocation test show elevated levels of heavy metals? etc. etc. etc.

    Honestly, unless DMPS is NOT recognized as a powerful heavy metal chelator (which would be shocking news to me!), I'm confused why you would personally risk death to prove its efficacy in IV form for acute exposure. I believe that a (simple?) test proving that DMPS and GSH do in fact enter the bloodstream transdermally would be BIG TIME ammo for you! It probably won't shut up the Orac's of the world, but it will certainly help to convince parents on the fence who are worried about it's efficacy. Let time and the numbers take care of proving it's safety.

    Of course, the upcoming Lancet article will surely make for great ammo as well.

    Dr. Buttar, my apologies in advance for asking you to explain this to me and for challenging you on this. Please know that I do it with only the best of intentions!

    Dr. Buttar (8/31/05 2:32am EST): Patrick,

    First, there is no need to apologize to me. Your intent is clear. This letter that the neurosurgeon friend of mine will write talks about the effectiveness issue from a conventional medicine side of the house.

    You see, first, you would have to actually have to have some type of test developed to actually detect the DMPS in it's altered form as it is absorbed. That takes money, effort and time. As my friend says, why do it? Let someone who wants to establish biokenetics and half life do that. It is not necessary to do this from a clinical efficacy standpoint. It would be nice to know how it works, but it is irrelevant. It works based on empirical evidence.

    So it's absorption is not an issue for me or for anyone who is a true scientist because the empirical evidence is abundant. Only a pseduo scientist is going to get caught up with levels in serum, which it may not even show, since DMPS is highly neurophillic and may be possibly taken up by the nerves or distributed through the lymphatics...I don't know and I frankly don't care since it has no relevance to the clinical side of the house. But you see how absurd it is to simply assume it has to get into the serum? It most likely does, but it may not. The point is, it gets in and it works....and it works better than anything else out there.

    Patrick Jr. (8/31/05 3:11am EST): Ok, it IS clear to me now! You have me convinced, and fired up about it actually!


    PS - I'm glad my true intention is coming through clearly. I know you are busy and that I am taking up much of your time, but I believe it is time well invested.

    PATRICK JR. (8/31/05 12:04pm EST)...I emailed him again before I received a reply back: Dr. Buttar, I had an epiphany this morning and I think I finally get it!! It all boils down to EMPIRICAL EVIDENCE -- your son and 20+ others have been cured from the symptoms of autism following the TD-DMPS protocol. It just works! We don't know *exactly* how it works, and we don't really care because the reward FAR exceeds any alleged risk of DMPS.

    Arguing absorption rates, etc. is complete folly b/c no matter what, no one can explain this empirical evidence away!!

    I feel a little moronic that I've had to go around in circles with you only to come back to what I now remember was the most convincing aspect of your testimony to Congress when I first read it 10 months ago -- the stuff just works!


    And that is the best way to finish this post. Our entire argument really all comes down to one, and one thing only -- EMPIRICAL EVIDENCE. You can certainly try to pretend it doesn't exist, but not a single one of you can explain away the fact that chelation therapy has worked to abate and cure the symptoms of autism. And you never will.

    - Patrick Sullivan Jr.

  15. Game. Set. Match.

  16. Game, set, match, but the winner isn't Dr. Buttar.

    Let's see. Lots and lots of verbiage, but no evidence that Dr. Buttar's cream actually gets absorbed through the skin, chelates mercury, or improves autism symptoms. In other words, a lot of sound and fury, signifying nothing--as usual.

    You can pull the Galileo gambit with Dr. Buttar all you want, but Dr. Buttar's no Galileo.

    And his rationalizations for not doing the blood and urine tests are LAME in the extreme. He claims he doesn't have to prove it gets in the serum, but he's claiming his treatment works by chelating mercury? That's bullshit, pure and simple (pardon my French). If he's claiming he's chelating mercury, then he has to prove that he's actually chelating mercury.

    When this is pointed out to him, he then waves his hands and says we don't have to "prove" that it gets into the blood and chelates mercury because we have "empirical" evidence that it works. Only we don't have "empirical evidence that it works," just testimonials and Dr. Buttar's word.

    You've obviously missed the point of my post. My post describes the deficiencies of such evidence and why it's so easy to delude oneself into thinking a treatment "works" with little or no evidence, and Dr. Buttar is example #1 of this. We have no randomized controlled studies. Given that the mechanism of Dr. Buttar's concoction is very implausible, it's very highly unlikely that it "works" at alleviating the symptoms of autism.

  17. As Dr. Buttar says:

    You see, first, you would have to actually have to have some type of test developed to actually detect the DMPS in it's altered form as it is absorbed. That takes money, effort and time. As my friend says, why do it? Let someone who wants to establish biokenetics and half life do that. It is not necessary to do this from a clinical efficacy standpoint. It would be nice to know how it works, but it is irrelevant. It works based on empirical evidence.

    No, Dr. Buttar, what IS important from a clinical efficacy standpoint is to determine whether TD-DMPS is more effective than a placebo or other "standards of care" (whatever the case may be) with regards to treating autism. By his own admission, he hasn't done that yet touts it as a cure for autism.

    But Dr. Buttar's prior statement is even more oustanding:

    We don't know how aspirin works but the entire world uses it anyway!

    If that's true (and I doubt it) cinical trials proved that low-dose aspirin, for example, is heart protective. It wasn't done using "empirical evidence", it was done using the rigor of actual studies that determined aspirin was better than a placebo.

    Again, I don't buy the "we can't do real trials of these therapies to see if they work" if tens of thousands of kids are already using said therapy. Even if the therapy IS safe (and with chelation that's not always a given) there's good reason to know that is truly is effective.

    How many parents of autistic children who tried chelation - at substantial cost? I've heard estimates where biomedical treatments can cost up to $100,000 per year, and I'd bet not a whole lot of that is covered by insurance. I wonder how many would be angry if it turned out that the gains their children made during these therapies would've happened anyway?

  18. Since PS Jr seems so keen on full disclosure, it behooves him to post the correct and proper contact information for Rashid Buttar, D.O. - so that those who want to submit to his challenge may reach him straight-away. Is Buttar already in possession of the prepared paper work necessary to proceed with his challenge? Please post his cell phone number or a "hotline" number so he may be easily reached, or YOU lose YOUR "credibility", Patrick.

  19. "'We don't know how aspirin works but the entire world uses it anyway!'

    "If that's true (and I doubt it) cinical trials proved that low-dose aspirin, for example, is heart protective"

    It's not true. We know that aspirin works through inhibition of prostacyclin which in turn inhibits platelet aggregation. We know this because of meticulous and carefully documented research by researchers who were willing to put their egos on the line by actually testing their hypotheses instead of just trying to BS their way through. We also know that aspirin is clinically efficacious through multiple large scale, double blinded placebo controlled clinical trials. Multicenter, double blinded placebo controlled trials are the gold standard of proof of efficacy of any therapy. Anything less is too open to error to be considered definitive. (Of course, even large and well done studies can be wrong, which is why repetition of the studies is important.)

  20. Orac, I have been following your site lately, and I am really impressed by your thorough detail. Maybe one day you'll reveal yourself, because you sound like an interesting person. I have so many questions, and I hope you can address these in future posts. If you have addressed these, please refer me to a link. 1) How does chelation relate to amalgam fillings? Pat Sullivan is using transdermal therapy to chelate mercury due to his fillings. So what are your thoughts on the ADA's position of amalgam (that it's safe????) All of this autism stuff reminds me of "Lorenzo's Oil." For those who haven't seen it, rent it. 2) Orac, what are your thoughts about perseverent parents who actually find medical solutions, despite scientific protests? One thing that bugs me about your site is that you and your blog followers appear to be condescending and downright nasty at times. Is this really the purpose of your site? For everyone to slam each other? I have a bachelor of arts degree, and hopefully you won't dismiss my comments because you are the almighty Orac, and I am just too "artsy" for you to take me seriously. Like you, I'm choosing to be annonymous, so I won't be too affected when I get slammed by you and your blog followers!

  21. P.S. Orac, hopefully, you will actually address my questions, because I am genuinuely interested on your thoughts about amalgam. Also, have you ever had any patients whose health outcome defied all scientific study or logical explanation? Do you acknowledge any level of "mysticism" in medicine? (Mysticism defined as "A belief in the existence of realities beyond perceptual or intellectual apprehension that are central to being and directly accessible by subjective experience.") And you can call me a fool. I'm still anonymous.

  22. Anon said "All of this autism stuff reminds me of "Lorenzo's Oil." For those who haven't seen it, rent it. "

    One should not really get medical information from a movie. It is better to register for free in www.medscape.com and read:

    Also, many of us know who Orac is, but there are very serious reasons for being anonymous. See:
    http://oracknows.blogspot.com/2005/06/la-times-on-medblogging.html and
    http://neurodiversity.com/weblog/article/15/st-paul-saga and

    Also, this is not about amalgam fillings. But about how to differentiate from testimonials versus actual scientific observation in medicine. Even with an example from what may actually be a REAL treatment, but has not yet been qualified as such in reality.

  23. Thanks for the links. I'm shot down every time I post to this blog no matter what I say, so I'm out. No more almighty Orac for me.

  24. Thanks, Kev; with the visuals you provided now I think I finally understand this saying we have here in the U.S. -- "With whom would you rather have a beer?"

  25. But Kev, I love fish and chips. Ah, well. Still, I do love a good English brew, such as Boddington's, Bass Ale, Newcastle Brown, or (of course) Guinness every now and then; so I'd gladly lift a pint (or two or three) with you if I ever make it back to the U.K. and your neck of the woods. I've been meaning to get back to London someday; it's been 26 years since the one and only time I've been there, and I was too young to appreciate it properly back then.

  26. Though I do love a good Newcastle or Guinness, I have to say you guys make me sick.

    HCN: Anonymous wasn’t saying, “get your medical information from a movie.” That aside was simply a matter of opinion. Obviously, Anon just enjoyed "Lorenzo’s Oil." (As did I BTW! It’s a fantastic movie! And though it IS based on a true story, it’s still just a movie...not a double-blind, placebo-controlled, and peer-reviewed study confirming that such things CAN actually happen. So would-be renters, BEWARE.)

    HCN, either you’re an idiot for not recognizing that, or you’re deliberately misconstruing Anon’s words to deride the entirety of the post. (Not a very intelligent maneuver (or a humane one)...but I’m getting used to seeing that on this blog.)

    Clearly, Anon was just throwing "L’s Oil" out there to introduce one of her 2 questions.

    "2) Orac, what are your thoughts about perseverant parents who actually find medical solutions, despite scientific protests?"

    A valid and interesting question! Far more interesting than some of the recent blather that’s come out of YOU and other arrogant a**holes here!

    Secondly, HCN, obviously TO YOU this is not about amalgams, but since the topic in question here IS mercury, it seems odd that you’d criticize Anon for asking ORAC a question about them (and yet another valid one at that). I would be very interested to hear Orac’s response to this question as well. Especially if it’s true that "72 TONS of mercury is placed in the mouths of over 100 million Americans every single year!" (http://www.patsullivan.com/blog/2005/05/follow_the_mone.html) A frightening fact, if amalgams are harmful as many believe!

    Orac, I do hope at some point to hear your opinion on the American Dental Association as well as the potential connection of mercury amalgams to the dramatic rise in the number of neuro-degenerative diseases (i.e. Alzheimer’s, etc.) and chronic illnesses that are becoming epidemic in our country right alongside autism.

    Anon, apparently disclaimers on this site are just as futile as trying to raise good questions. Either way you get ripped to shreds. Such a shame. Hope you at least stick around long enough to see if there’s EVER a true answer from Orac instead of the nonsense from these clowns.

  27. "We don't know how aspirin works but the entire world uses it anyway! A neurosurgeon friend, and father of a child I am treating, will be writing about this issue anyway..."

    #1 "we" do know how aspirin works, someone just explained that, and
    #2 it does work better than placebo, that too was shown scientifically.
    #3 What do you bet his neurosurgeon friend doesn't even exist. Can we contact him? If you post his name I'll contact him with my real email address and everything.

    The man can't open his mouth without prevaricating.

    I think he's mercury toxic.

    What is he charging per hour this week in Texas? Still $800? You like this man Pat Jr? Why?


  28. If you had read the Medscape link you would have seen that there was some real science validating Lorenzo's oil for reducing (not curing) the progression of a particular disease.

    I still no reason why amalgams need to be discussed. The subject is NOT mercury... but how to evaluate studies and treatments. How even a trained physician can be swayed by his own pre-conceived notions.

  29. Kristi,

    HCN's point was that there were published studies that showed Lorenzo's Oil actually made a difference. No such studies exist for things like Buttar's TD-DMPS. It's really just a clever version of the "Galileo gambit".

    As others have mentioned, the issue here is not amalgams or mercury, or whether they have links to neurodegenerative disorders. It's about the belief that a medical treatment works in the face of hard evidence that it doesn't. (or at the very least, a lack of evidence that it does)

    As to what I (can't speak for Orac) think of perseverant parents who actually find medical solutions, despite scientific protests - I think they're great. And at the end of the day, if treatments like chelation or vitamin supplementation or gold salts end up being a cure for autism, it will be because good scientific study proved it to be so. My objection has never been that one shouldn't pursue those avenues - it's that the claims of success and marketing of such treatments exceeds the current state of the science that supports them.

  30. The mercury parents would love to cast themselves as characters in a "lorenzo's oil" film.

    Lorenzo's parents were #1 using real science not quackery. They knew actual stuff about the action of the fatty acids on the hormones or whatever is involved there. I don't know what they found exactly.
    #2 There's pretty much no way any child could have been harmed by what they were proposing it's a fraction of Canola oil and olive oil or something. Maybe they could have accidently got something that would encourage blood not to clot or something... but it's not likely they could harm a child with oil. They weren't ever going to administer it IV.

    The mercury parents are in way over their heads and talking about methylation and stuff they don't even understand. The parrot spoken by quacks like Buttar.
    "you don't lay carpeting in a burning house, first you stop the fire".... with my $200 an ounce hand lotion that isn't proven to do a thing.

    These parents are suckers for questionable labs. Go look at their home cooked research and see how often "Doctor's Data" lab shows up as their source for lab results.

    These parents are so ignorant they think they can just make a statement like, "well, if the kids don't have mercury in their hair then they must not be able to EXCRETE IT!" They all look knowingly and nod, 'YESSSS, that's it. They CAN'T EXCRETE IT." Never mind that such a problem doesn't exist because mercury is never "excreted" in hair.

    These parents are so ignorant even Buttar can fool them, and that's pretty ignorant. By the way, he says thousands of children are being chelated. Who says? How do they support such a number, and which ones are getting just oral chelation? How many are only doing TD-dmps? Enough to make Buttar wealthy, no doubt, but HOW many? Buttar is also seeing cancer patients, so we know his schedule must not be totally filled with autistic children. We also have been told that he's doing IV chelation on children...anyone know if that's true? Pat, wanna ask him?

    By trying to put the mercury moms and Blaxill in the same category as Lorenzo's parents you despicably insult Lorenzo's parents, though I'm sure that's hard for you to believe, dianne. See: A perfect example of how not to do a study part I"
    and part II




    For the record, I have amalgam fillings and they aren't getting pulled out because some quack says they should be.

    These parents are injecting their kids with methyl b12 based on a tiny study that ended up recommending more research into the use of b12 on 'regressed autistic' children ONLY. That's about 25% of all autistic children. What do you bet that non-regressed autistic children are being injected with b12 just for the heck of it? The original study was very weak and yet it was enough to start an industry of selling b12 injections to parents of autistic kids.

    What will happen if it turns out that it's no better than placebo? Most likely this bunch will continue to use it.

    Just like their friends continued to use secretin when it was shown not to be better than placebo.

    What a waste!

  31. My apologies for being oblique. Today I just have fleeting chances to read and post while dealing with real life... including in an hour finding out the implications of having a child in a high school marching band, and then we are missing most of the band booster picnic! (one reason to object to the mercury subject).

  32. I'll answer your question about amalgams first because I can do so briefly. Also, I've dealt extensively with the whole mercury-amalgam thing on the Usenet newsgroup misc.health.alternative before over the last five years or so before I started blogging, after which I became much less of a regular there. I'm guessing that you're not going to like my answer, though. It may even piss you off.

    Anti-amalgam dentists are quacks, pure and simple. There is no good evidence that amalgams cause any of the problems attributed to them, and lots of quacks are making lots of money scaring people into having their fillings replaced.







    As for parents who "persevere" and a find a medical treatment going against, I have no problem with them and wish them the best of luck. However, it is exactly these parents looking outside "conventional" medicine who are most vulnerable to the siren call of quackery. It is exactly these parents upon whom quacks like Dr. Kerry are most likely to prey. I rather suspect that, of the parents who represent themselves or are represented as having found an effective medical treatment outside of mainstream medicine, at best 1/100 (if even 1/1000) are true "Lorenzo's Oil" stories. The rest are following the siren call of quackery.

    As for my seeming condescending, well it's easy for that to happen in online discussions, where no body language or voice inflections are possible. Also, my frustration at having to refute the same nonsense over and over and over sometimes gets the better of me (not to mention that some of the quackery and pseudoscience I encounter is so ridiculous that it deserves to be mocked). Finally, I think it's a huge exaggeration to refer to folks who post here and happen to agree with me as "followers." "Fans," maybe (a humbling thought to have even a handful of fans), but definitely not followers.

  33. "By trying to put the mercury moms and Blaxill in the same category as Lorenzo's parents you despicably insult Lorenzo's parents, though I'm sure that's hard for you to believe, dianne."

    (Scratching my head in puzzlement about how my comments could have elicited this response since I never talked about Lorenzo one way or another.)

  34. I shall attempt brevity!

    * JP, your argument is wrong. The rest is conjecture. (ie. "I've heard estimates where biomedical treatments can cost up to $100,000 per year, and I'd bet not a whole lot of that is covered by insurance.") Your license to blogpost should be revoked for arguing that as your point.

    * Disclosure Anonymous, you said, "Since PS Jr seems so keen on full disclosure, it behooves him to post the correct and proper contact information for Rashid Buttar, D.O."

    Rashid A. Buttar, DO, FAAPM, FACAM, FAAIM

    Medical Director, Advanced Concepts in Medicine
    The Center for Advanced Medicine
    20721 Torrence Chapel Road, # 101-103
    Cornelius, NC 28031
    704-895-WELL (9355)

    That exact information has been posted numerous times now. Google is free. Use it.

    You also said, "Please post his cell phone number or a "hotline" number so he may be easily reached, or YOU lose YOUR "credibility", Patrick."

    Give out his cell number or email? How naive do you think I am?

    If you're really serious, call his office or write him a letter. I *highly* doubt that my credibility would be at stake in the eyes of Orac's readers -- even the ones that despise me -- for failing to meet your demands M. Anonymous...

    * Dianne, thanks for the education about Aspirin. Quite honestly, it went right over my head though. I mean, I tried to read it but I don't know half those words. And why should I, I'm got my degree in marketing!

    But by NO means did it help explain away empirical evidence.

    PS - "Painkillers cause fatal stomach bleeding"

    TO: Orac
    SENT: 5 minutes after I posted this
    SUBJECT: Haha!

    There goes that idiot altie citing just ONE medical study.

    Btw, will you be at the polo grounds this weekend?



    * Anonymous with question about mercury amalgams, HCN is right. This is not the forum for discussion about mercury amalgams, but only because Orac is the LAST PERSON in the world you should be talking to. Start with www.IAOMT.org instead.

    Or go visit Pat Sullivan Blog since he writes about "silver fillings" on a regular basis.

    * HCN, Kristi is spot on -- do you really need to make fun of Anon for talking about a movie? Anon had a good point since autism is mercury poisoning.

    And everyone here already knows how you feel on that issue, so please spare us your reply composed of something as stupid as everything else you have written so far. You are adding nothing!

    If you wish to debate, the only thing OPEN for debate right now empirical evidence.

    Except for the fact it is actually CLOSED for debate. Source: Every one of my dozen bloviating posts to the Rude/Insolent Blog. (hey, I'm getting sick of writing all this down over and over again!)

    * Kev, while I don't agree with your positions, I genuinely appreciate your attempt to keep things cordial (most of the time ;-) here and on Pat Sullivan Blog. You're a fine bloke. God love the British. (And God help us with comment formatting! ;-)

    * Alfalfamoo, see comment to Dianne RE: aspirin.

    And Dr. Coles does exist.

    (Btw, the handle selection on this blog is awesome. Everyone on Orac's "team" gives me the visual picture of a bunch of anti-anti-mercury super-heroes! LOL ;-)

    So why do I like Dr. Buttar? Fair question. I like him because he is a maverick and he doesn't give a F*** what any of you caped anti-crusaders think.

    That takes character. That takes backbone.

    I'm proud to defend him because as you can so painfully see through my THOUSANDS of words (wasted?) on Orac's blog, I have made the man explain himself to me so that I would "get it!"

    * JP, Because of your last paragraph to Kristi, where for the first time in the history of this blog, a point was conceded by someone other than me (ie. "good for parents who are finding that chelation works"), I re-invoke your blogpost license. ;-)

    * i2bpacific, you said, "with my $200 an ounce hand lotion that isn't proven to do a thing.

    AGAIN, read EVERYTHING I've written here about EMPIRICAL EVIDENCE. No one but Orac has even attempted to touch this. And Orac failed miserably by trying to argue the same points about absorbability et al. which I had already TAKEN from him.

    The only logical position you are left with is, "let's see the kids."

    You want some parents to drive some of their cured kids over to your house?????

    You want the 6NEWS Investigators to film it?

    Then post your address. Setup a hotline so they can schedule visits.

    You guys are just jerks!

    Lastly, I ask that the "jury of readers" compare your non-scientifically based analysis of "homecooked labs from Doctor's Data" versus the fact that on paper, in living color, when the test shows metals coming out, symptoms abate.


    i2bpacific, you label these parents as ignorant rather quickly. A look in the mirror might be called for.

    You say, "...he says thousands of children are being chelated. (snip) Pat, wanna ask him?"

    I already have.

    I got the answer at 9/1/05 9:01am EST. For brevity sake (which is a joke at this point), here is the paraphrase of 4 rounds of emails:

    Patrick Jr.: Dr. Buttar, for supporting the "empirical evidence" argument, it would be really helpful to know how many patients have had symptoms improve or disappear under your protocol (both you and the other docs practicing).

    Dr. Buttar: I have treated over 180 myself....and a number of doctors have over a 100 patients each. I would estimate the number up to at least a 1000 or more that have been treated.

    Answering how many have had symptoms improve is more difficult given that the process usually takes 18 months to slowly and safely chelate out metals and continually replenish minerals....but I think it would be VERY safe to say that most have had significant improvement, to the point that SOME parents have stated if they see no further improvements, they would be satisfied with the result attained thus far.

    What is significant? Well, if you have a child that's 8 years old in diapers, and becomes potty trained in 4 months after starting TD-DMPS, I consider that HIGHLY significant.

    Percentage response would be like giving you windage....I have no idea but I would certainly say it should be greater than 50% improvement to date if averaged among all of them.


    It should be noted that Dr. Buttar's testimony to Congress was on May 4, 2004 -- 485 days ago from today. 485 days is roughly 16 months.

    Still want to continue bloviating about lack of clinical studies and ignoring the empirical proof?

    ***TO ALL ORAC-ITES***
    I'm exhausted from writing long posts and making astoundingly good arguments on the Insolent blog, only to come back to see that 99% of my arguments are totally ignored by you. Instead, you use google to see if Dr. Coles really does teach at UCLA. (Thanks to Kevin Greenlee, who doesn't even like Dr. Buttar, we learn that Dr. Coles does in fact work at UCLA.)

    Orac, you are proving to your 994 average daily readers that you really cannot debate the facts that I am bringing to the table. And we have seen that none of you can. That may sound haughty, but it really has NOTHING to do with me: an empirical fact is non-debatable, period.



    Yet you still will refuse, as if I had been "talking to walls" this whole time.

    And you'll all continue to scream at Buttar, "SHOW ME THE MONEY, er...kids!! No, crap, uhh...show me both you greedy bastard!!"

    And speaking of movies, I feel like I'm having an "Old School" moment with the collective bunch of you embodied in the character of James Carville during which he tries to think of a rebuttal to Will Ferrell's argument during the collegiate debate.

    Carville: "Umm...well...we have nothing left to say...That answer was perfect."

    Cue: Roar of crowd!

    Orac, you said, "Game, set, match, but the winner isn't Dr. Buttar."

    This match is between you and me "pal." WE are the ones who are volleying.

    My "racquet" is Dr. Buttar. Yours is HCN. (Or Autism Diva, or whoever.)

    You should remember that the players themselves don't ever judge the match.

    Could Orac is the metaphorical Andy Rodick?

    I must admit that it has been tiring, but fun as hell to have been the "Cinderella story," coming out of nowhere, upsetting the #1 seed on his home court.

    Cue: Roar of Crowd!

    - Patrick Sullivan Jr., "Giant" Killer

  35. So much for brevity.

    Btw, I won't be coming back to this God-forsaken post -- I don't need to.

    - Patrick Sullivan, Jr.

  36. "Giant killer"?


    Ah yes, declare victory and leave. Why am I not surprised. That's lame, even by your standards. (Oh, and the problems with aspirin causing bleeding are well known. If you actually read the scientific papers about it, you would know that any long term use of aspirin for chemoprevention is a risk-benefit analysis to determine if the benefits in terms of cancer and heart disease balance out with the risk of GI bleeding.)

    And my "match" was with Dr. Buttar, not you, given that you were just regurgitating your e-mail exchange with Dr. Buttar anyway. You keep crowing about "empirical evidence." That's exactly what I'm asking for and not getting from you! Where is the "empiric evidence" that Buttar's cream results in any improvement in autism? Where is the "empiric" evidence that it gets through the skin and chelates mercury, as Buttar claims?

    Neither you nor he has presented any. Just testimonials. And I've already demonstrated why testimonials do not constitute reliable evidence, particularly in a condition like autism, where waxing and waning of the condition routinely occurs.

  37. I'm sorry Dianne. I'm going off now to fall on my sword, crosswise, so that I can come back.

    I was trying to answer anonymous, who I thought had signed "dianne", it was a really stupid mistake.


  38. Laughing...

    Pat is such a cute little thing, especially when he's flustered.

    Let's see I, Alfalfamoo, aka Alf Alpha Mu, mentioned the supposed _neurosurgeon_ friend who is a father of a patient of Buttar and who is unnamed by the all wise Buttar, does not exist.

    And Pat Jr. says, "Dr Coles does exist"

    so Dr. Coles is the 'neurosurgeon friend'?

    I don't think so:
    L. Stephen Coles, M.D., Ph.D., Co-Founder
    Los Angeles Gerontology Research Group
    URL: http://www.grg.org

    this page calls him a gerontologist and stem cell researcher

    Try to follow the arguments Pat.

    I know it's hard, especially when you are playing the dummy to Buttar's ventriloquist.

    It's nice to think of Buttar's fans sending him cakes once he gets to the big house.

  39. Pat Jr.'s rant would be an excellent addition to Peter B.'s "Full Canvas Jacket" (if it was still being updated):


  40. See above. I2bpacific is acknowleging a mistake and has apologized.

    I did not mean to make anyone feel bad about stating that movies are not a good source for science information. If it was taken that way, then I am sorry. But, I still feel that those people who make movies tend to play fast and loose with facts... so it pays to actually look further with real research tools (starting from well researched and documented sources). Let it be said that many people with degrees in art (including a lawyer friend) do UNDERSTAND science and science methodology. They often do learn how to look at all angles, sides and insides (like anatomy). Many have the training to see the reasons, the why and most importantly to OBSERVE. Like my mother. She was a visual artist (paint, fabric and some carpentry)... and she was my FIRST science teacher. As a little kid she showed me how interesting it was to observe the things around me (like what happens when you drop a pebble in a puddle).

    Now we have this little drama from PS, which is one reason why I avoided responding to him:

    TO: Orac
    SENT: 5 minutes after I posted this
    SUBJECT: Haha!

    There goes that idiot altie citing just ONE medical study.

    Btw, will you be at the polo grounds this weekend?


    WHAT is that??? Some kind of projection?

    Note: Orac and I are on opposite coasts. I am also allergic to horses... and if you had read my last note you would have known that I was going to a band booster picnic (and we WERE over an hour late, but there were some cookies left --- and we found the we parents get to fund raise to replace the 18 year old uniforms... woo hoo). I'm back now, and soon I have to take out the garbage and recycling.

    By the way, autism is NOT mercury poisoning. It has been shown over and over again in several countries that it has no connection with vaccines that come with or without thimerosal... or even with the MMR vaccine.

    So you do not win a debate by pretending people say something when they did not. You do not win a debate by making statements with proof or evidence that is NOT verifiable. Finally, you do not win a debate by declaring yourself the winner.

  41. Boy, this was really the "Patrick Sullivan, Jr. Show", wasn't it? Now that he's gone (wanna bet?), I'd like to squeeze in a quick point.

    Dr. Buttar claimed (in one of PS, Jr's posts) that he didn't test for DMPS in the urine because he didn't have the time and money (or expertise, I might add) to develop a test. But there already are tests for DMPS. From MedLine:

    [1] Gein LG, Kotliachkova AI. [Titrometric determination of unithiol using copper sulfate] Farmatsiia. 1975 Jul-Aug;24(4):69-70. Russian.

    [2] Maiorino RM, Weber GL, Aposhian HV. Fluorometric determination of 2,3-dimercaptopropane-1-sulfonic acid and other dithiols by precolumn derivatization with bromobimane and column liquid chromatography. J Chromatogr. 1986 Jan 24;374 (2):297-310.

    [3] Maiorino RM, Barry TJ, Aposhian HV. Determination and metabolism of dithiol-chelating agents: electrolytic and chemical reduction of oxidized dithiols in urine. Anal Biochem. 1987 Jan;160(1):217-26.

    Yet another of the good doctor's excuses shot down in the dust.

    Let's face it - Buttar is never going to test for DMPS in the urine of the children he's treating. If he did, he might have to admit that he was wrong. And it would be hard - not to mention potentially dangerous - to tell all those parents that he charged them $150 an ounce (is it up to $200 an ounce?) for smelly skin lotion.

    Unlike some, I persist in my belief (unsupported by any data) that Buttar and most of his ilk truly believe that they are helping these kids. And their entire belief structure would come crashing down if they ever listened to that small, quiet voice of doubt that says, "How do you know that you're right?"

    I hear that voice all the time - it has saved my professional bacon on more than a few occasions. All scientists learn to heed that voice or they soon become "ex-scientists" (e.g. Fleischman and Pons, of "cold fusion" fame).

    Professional "saviours" - like Dr. Buttar - cannot afford the luxury of doubt. Doubt would prevent them from projecting an aura of supreme confidence - and that is what these parents are buying, not the skin lotion. They want to believe that someone can make their children better - and that's what Buttar is selling.


  42. What is really a wonderful thing to think about is:
    One of these days, maybe tomorrow, someone is going to do that simple test to see if the TDDMPS lotion is really TD.

    And if or rather, when, they find out that it isn't chelating anything, the Buttar and his colleagues who presecribe or compound Buttar's lotion and similar DMPS lotions will have shown the unusual nature of autistic children or the unusual nature of their parents, or both.

    If there are thousands of children who got better when their parents ONLY used DMPS and didn't use any other therapies, that will show that kids can get better if there parents merely have hope for them that wasn't there before.

    Otherwise, if the parents are doing speech therapy and other things along side of the "chelation", then we will have to ask what it was about the sham chelation that made the parents credit IT with the change.

    I think the key will be the hope that someone like the charming (but slimy) Buttar can engender plus the contact on the internet with other parents who reinforce the hopefulness.

    It will be interesting to gather the parents for whom it didn't "work" and see if they felt like they were left behind by all the parents who had success that they attributed to the lotion. We can ask them, how did you feel? How much did you spend before you gave up? Did they tell you you didn't do it right?

    You can see Buttar doing his guilt trip thing on the vidoe that is on autismmedia.org. He says that the parents who stopped because their kids were acting horrible are at fault for not continuing the treatment, because those kids who were acting really horribly according to his description, were having a healing crisis or something which means that though they seemed to be hurting or something was making them act out, they were actually become less autistic, it just didn't show yet - or something.

    I'm sorry, but that is pure slime.

    That is psychological torture and manipulation.

    But...once he is deposed and exposed there will be at least a few ill-tempered lawyers out there who will make sure he pays - if what I think is true is true.

    If you have been a patient of Dr. Buttar's and have a complaint you can email it to the NC Medical board, but you have to include your name and address and the doctor gets a copy.

    Buttar , Rashid Ali DO
    Cornelius, NC License # 9500528

    North Carolina Medical Board
    Contacting the Board
    Address and Telephone

    Physical Address:
    North Carolina Medical Board
    1203 Front Street
    Raleigh, NC 27609-7533

    Mailing Address:
    North Carolina Medical Board
    PO Box 20007
    Raleigh, NC 27619-0007

    Telephone: (919) 326-1100 or (919) 326-1109
    Toll-free number (800) 253-9653
    Fax: (919) 326-1130 or (919) 326-1131

    The Board's general purpose e-mail address is info@ncmedboard.org . Please include your full name and postal address in any e-mail sent to the Board. (Please type "NCMB Question" in the subject line)

    Ten Things Physicians, Physician Assistants, and Nurse Practitioners Can Do That Will Get Them in Trouble with the North Carolina Medical Board

    Reader Friendly

    Among the things that get physicians, physician assistants, and nurse practitioners in trouble with the North Carolina Medical Board, which licenses and disciplines those health care providers, the following ten are particularly common. Any one of them can lead to serious disciplinary action against the practitioner involved. They are not listed here in any order of importance. The Board considers all violations of the law it enforces, the North Carolina Medical Practice Act, to be important. These, however, tend to be the most frequently seen violations.

    The Board's attention will focus on any physician, physician assistant, or nurse practitioner it learns may have...

    abused alcohol or controlled substances, or used illegal drugs;
    prescribed medications inappropriately;
    violated the boundary between patient and practitioner by sexual exploitation or other means;
    practiced incompetently or provided care below acceptable standards;
    behaved disruptively or unprofessionally;
    exploited patients for financial gain;
    abused patient rights (which are well described in the American Medical Association's Code of Medical Ethics--see Patient Rights statement below);
    improperly supervised physician assistants or nurse practitioners (in the case of a physician);
    practiced or behaved in a manner that brought about a restriction or revocation of his or her privileges by a hospital, HMO, or other medical institution or organization; or
    failed to respond in a timely manner to a request from the North Carolina Medical Board for information or for cooperation with the Board.
    When these or other violations are proved or admitted, either in a formal hearing or in an agreement (Consent Order) between the Board and the practitioner, the Board can take one or more of a variety of actions. The severity of the action will depend on the nature and seriousness of the violation. Among other things, the Board can go so far as to revoke or suspend the practitioner's license, pulling him or her out of practice. It can also restrict his or her license in various ways. The licensee may also be ordered to undergo physical or mental examination, enter an impairment program, pursue added education, or take other steps to assure he or she is capable of practicing with reasonable skill and safety. In some instances, when a practitioner has not actually violated the law, the Board may still be concerned about some aspect of his or her practice or behavior that could eventually lead to trouble. In that case, a letter of advice or guidance will be sent to the practitioner. This approach to encouraging change, though not part of the public record, is a serious part of the Board's effort to prevent future problems.

    Patient Rights

    The American Medical Association, in the Fundamental Elements of the Patient-Physician Relationship section of its Council on Ethical and Judicial Affairs Code of Medical Ethics, outlines its views on the rights of patients. Briefly summarized, these include the patient's right:

    to get information and guidance from the physician on the benefits, risks, and costs of appropriate treatment alternatives;
    to obtain copies or summaries of his or her medical record and have questions answered;
    to be made aware of potential conflicts of interest that his or her physician might have;
    to make decisions about health care recommendations by the physician, accepting or refusing those recommendations;
    to be treated with courtesy and respect and to receive timely attention to needs;
    to confidentiality, except when the law provides otherwise;
    to continuity of health care, the physician not discontinuing treatment when treatment is indicated without giving the patient sufficient opportunity to make other arrangements for care;
    to availability of adequate health care, a goal toward which physicians and society should strive.
    (For more detail, see the AMA's Council on Ethical and Judicial Affairs Code of Medical Ethics: Current Opinions with Annotations, 1996-97 edition.)

    The Better Business Bureau for the area where Buttar lives.
    A list of agencies who want to hear about health fraud including, but not limited to the Federal Trade Commission and the FDA .

  43. Even Junior Boyd Handley didn't trust the Buttair creme enough to rely on it as monotherapy. One news story complete with exploitave pictures of the Handley lab rat child, showed a virtual apothecary of RNA drops and other scam medicine. He says they started the diet around the same time as the magic potions and other supplements, but of course it's the TD-BS creme. JB also stood by the fake RNA drops as if they were the cure but we don't hear about that much these days. One year into autism and he is the expert on all things autism. God bless his child.

  44. i2b: The apology is appreciated, but falling on your sword, even a rhetorical one, seems excessive for a simple mistake that anyone could make.

    Rambling off on the issue of mistakes...One difference, it seems to me, between science and religion is that in science you are allowed to admit you made a mistake or change your opinion based on new evidence, whereas in religion or pseudoscience you are expected to have faith and maintain your original belief whatever the evidence. Whatever that means.

  45. Wow, I thought I wouldn't come back here because I didn't think the almighty Orac would even consider responding to me. Ha! I am surprised. The Orac appears to have a heart! First of all, let's start with your first response "....This will probably piss you off..." I get your viewpoint, that "a hope, a testimonial, a weird unexpected result, a medical oddity" is not scientific fact, or maybe not even safe.
    The point is:
    Orac, I wanted your opinion on amalgam, because I VALUE your opinion. No, I'm not pissed off! although your site seems to incite a lot of anger, which feeds and keeps this blog going. In fact, allowing us to tap into "the brain" of a surgeon and a scientist on a blog is actually incredibly cool and I'm glad you're doing it, to help people understand!
    The last time I asked an M.D. (NOT AN ALTIE!!! for Christ's sake!), she said that the risks of removing them are more harmful than the risks of having them in, but she acknowledged that they're probably not a good idea to put in your mouth. So, would I put amalgam in my son's mouth? NOT! (I'm looking for alternative cavity fillers for him). Should I ignore my gut feeling about this, and put amalgam in my son's mouth because the ADA says so, because they can't prove a link to human health? Can they sufficiently disprove a link to human health? For the blog followers' criticisms about me being relevant: Pat Sullivan Sr. (according to Pat Jr.) is using transdermal chelation for what he believes is mercury poisoning, which is what parents of autism are talking about! Mercury poisoning! In fact, parents are saying that "autism" doesn't exist, but that it's mercury poisoning. So I diverted from the topic a bit, but I'm still talking about mercury poisoning and I'm still talking about testimonials vs. scientific evidence. Oh my, like straying from Orac's original premise hasn't been done on this site before???

  46. Point 2: Lorenzo's oil I thank everyone who responded positively to my comment about this. I get it! I'm not saying that I get my medical facts from a movie. It's a concept about parents who persevere to find solutions for a suffering child--from an emotional center--and sometimes they come across things that work. Parents are just trying things, because they (their loved ones) are suffering with a disabling, chronic disease, which is difficult for anyone to handle! It's hard to stomach the posts of all the insults hurled at parents. Parents of autistic children do extensive "research," so I wouldn't call them blind idiots following a "lunatic" predator altie! A couple of problems surface:
    1. The Internet has created a nightmarish web of lies about health, which most parents use as their basis for seeking care. Just look at the stats; health is the number-one researched topic on the Internet.
    2. Traditional docs are doing a horrendous job of explaining the scientific facts to patients, so that they don't leave the medical office in frustration, looking on the Internet for "answers" and finding people like Buttar, who will LISTEN to them! We know that scientists/traditional docs lack people skills! Almighty Orac, defender of scientific truth, please continue to inform us on this blog!

  47. Anon said " Traditional docs are doing a horrendous job of explaining the scientific facts to patients, "

    Use the resources at www.medlineplus.gov

    and "finding people like Buttar, who will LISTEN to them!"... In our experience the the neurologist and cardiologist BOTH listen to our concerns. And if I took their hourly rate and added them up it would STILL be less than $700/hour! Also, we have a very good family doc who has been very good all along in referring us to very competent specialists. He did NOT do the normal bit 15 years ago of saying "let's wait and see" when my oldest was not tallking, so my son got good early intervention.

  48. There is a level of understanding that can be put across in 5 or 10 minutes, say on "what is cancer" or "how is food digested" or "what is depression".

    But you can not take a person with a high school biology level education and really explain serotonin or peristalsis or the difference between different kinds of cancer. The doctors are using a level of information that is mind numbingly deep and complex.

    I know a little about "the serotinin system" and I can tell you a little about "g proteins" and what they do in neurons and the difference between an agonist and antagonist. But what a neurologist knows would blow me out of the water like I was a kindergartner.

    Some of these quacky PhDs will make presentations on "methylation" and sort of mystify the parents with mumbo jumbo that sounds plausible and might be 99% true, but if they leave out one fact that totally dismantles their version .... say "Give the child methyl b12 injections and then after 15 chemical transformations with this donating that "methyl group" ... BINGO the kid isn't autistic any more!!!" Yay!!!!

    People who aren't educated in neurology can't find the flaw in what is being said, and yet they feel sooo good that the PhD took the time to teach them all about methylation, and they feel so educated and informed, blah blah. They walk away with some buzz words, most of them, and they can work "glutathione" into a conversation just as David Kirby does, but they don't know what they are talking about. They'd have to go to school to begin to get it.

    They've just been bamboozled. The PhD "teaching them" might have a plausible schtick and might believe it but it won't pass the muster with other PhD's who work in that area.

    Just like PhDs looked at the Hornig study and said, "what the hey??" "This means nothing!", but the parents say, "Mady Hornig made autistic mice with thimerosal."

    Just like parents point to the "Calgary video" and say, "See! mercury destroys neurons therefore, mercury causes autism." And worse, Boyd Hayley PhD (classic case of PhD syndrome) encourages it.

    You can't trust your neighbor who went to a seminar on back pain to do your back surgery. You shouldn't take your child to an otolaryngologist to get chelated for autism. At some point you just have to take the doctor's word for it when he says, "Look, vitamin C is NOT going to cure your athlete's foot."

  49. Zaffran - absolutely!

    I get so steamed when I hear folks like Haley, Buttar and the rest talking scientific-sounding prattle while people (like the inevitable Patrick Sullivan, Jr [PS2]) who don't know an ion from an ion channel nod their heads and say, "Boy! That makes sense!"

    I know that it's not politically correct to say this, but the average person can't tell real science from "Star Trek" science. And that's what people like Buttar are counting on.

    They're betting that nobody in their audience will realize that even though they sound scientific, they have no science behind them at all.

    The people in the audience - for the most part - are thinking, "It's great that this doctor/scientist is willing to take the time to explain it to us." The folks at the podium, however, are saying the equivalent of, "The square root of orange is blue. And since the sky is blue, that is why sunsets are orange." It sounds scientific, but it isn't. Not really.

    I have people ask me at least once a week, "How do you know that's not true?" Well folks, the answer to that is simple: I've studied the sciences (especially biology) a long, long time and I know when someone is "talking trash".

    In much the same way, someone who knows cars (which I do not!) can tell when the auto mechanic is feeding them a line of baloney. They know how cars work and they know what is and is not possible. And what is and is not likely.

    PS2 has, by his own admission, zero knowledge about science and how it works. He has proudly announced that on at least one occasion on this very blog. Yet he is certain that Dr. Buttar is absolutely right. Because...? He just knows it!

    The other thing PS2 is certain about is that studies that fail to find what the autism-mercury movement knows for certain is true (i.e. that mercury causes autism) are biased. And he knows they are biased because...? Well, because they didn't come up with the right results. Nice and circular, eh?

    If PS2 can come up with something more concrete than that - and I don't mean character assassination, innuendo and unsubstantiated conspiracy theories - then I'm all ears. But, since we haven't seen anything more concrete than six quotes taken out of context from a 286-page transcript, I'm not going to be holding my breath while I wait.


  50. I agree with you Prometheus! I can't make heads or tails of the field of medicine, and I don't want to (or maybe I don't even have the capacity to do so). But there's a problem: an American mistrust of physicians. We've been hearing over and over again about the FDA, FTC, NIH, ADA, Big Pharma conspiracies (throw in whatever acronym you want here!). The bureaucracy of healthcare is causing people to mistrust anyone in the healthcare industry. This is like New Orleans, where people are now saying they're better off fending for themselves than relying on an inept, bureaucratic government emergency crisis system. I remember as a kid going to the local family pediatrician, who my mother trusted wholeheartedly to take care of her children! So much so, that she called him regularly for medical concerns and consultations, even after we left New Jersey. We trusted him! Back then there was no such thing as HMOs, pre-existing conditions, insurance rules, regulations, crazy paperwork, outrageously expensive prescriptions, and all the nonsense. Personally, I'm sick of it. I think good doctors are victims of a failed, crazy healthcare bureaucracy and people are saying, "No more BS" but it's misdirected anger. True physicians are caught in the middle. And people like Kevin Trudeau (and we could probably throw in the name Buttar) are taking advantage of the public's dissatisfaction with the healthcare industry. But this has NOTHING to do with competent physicians. But things are changing. My own doc won't even take health insurance and makes me pay up front. I applaud him, because he's following his own ethical standards, and getting back to what medicine should be, which is taking care of people, and building patient trust. Personally, I'm sick of it all, but I don't blame the docs. The docs need to get paid, so they have to follow the crazy antics of America's healthcare bureaucracy.

  51. Prometheus,

    Buttar and Haley have forgotten more science than you know. What arrogance you and Orac's ilk have!

    I bet that Orac does not expose his real name because he is not even a practicing doctor. Perhaps lost his license. Lots of malpractice suits? Maybe has never even been a doctor. Surgeons I know don't have time to publish the crap he does here!

    Let him PROVE he is who he says he is! At least we know who Haley and Buttar are! We KNOW that they have a PhD and an MD! Usually people who get these degrees are not terribly stupid as most of you wannabees are!

    With Buttar's background I am sure he would love to beat the crap out of all of you and could do so you mealy mouthed little asshole wimps!

    You people are deranged!

  52. Buttar and Haley have forgotten more science than you know"?

    In Buttar's case, your remark is unintentionally hilarious, given that Buttar can't produce a single bit of convincing science to show that his chelation agent is absorbed through the skin and chelates mercury, never mind the more complex question of whether it does any good for autism. When this is pointed out to him, he then waves his hands and says that we don't need to know how his cream "works" because he has "empiric" evidence that it does. Too bad he never presents that "empiric" evidence.

    In Haley's case that's the very problem. His infatuation with mercury has apparently led him to forget that inconvenient stuff about the scientific method that he learned in graduate school and that got him so far as a chemist before he discovered mercury.

    As for arrogance, you appear to have missed the point of this post, which is that "conventional" doctors are just as prone to self-delusion about a treatment as doctors like Dr. Buttar. That's why the scientific method and clinical trials are necessary!

  53. Orac,

    And you seem to have missed the purpose of Anon's post... To throw your silly crap right back in your face! You continue to make judgemental and confident assertions about people you don't even know. What an ass you are!

    Anon knows rightly that you are not even a doctor but you WILL NOT deal with this question because you cannot! You are just an arrogant wannabee who loves to tear down people who have the gall to suggest that the evidence leads away from mainstream thinking.

    You ignore ANY indication of truth by hiding behind the statement, "There have not been any clinical studies!" all the while knowing that getting a peer reviewed clinical study of any consequence done and published is rather difficult to do. You have never had anything published peer reviewed so how would you really know anything about it!

    One would have to WANT to do it, be financially able to do it, and get the mainstream protectors to allow them to publish it in a respectable journal before you are willing to acknowledge that they just might be smart people! What a crock!

    When someone is unable or unwilling to fulfill these criteria then in your view they are stupid charlatans who should not dare to propose where the evidence leads.

    You merely sit in your easy chair pontificating about people and ideas you really know little about.

  54. One of these days, maybe tomorrow, someone is going to do that simple test to see if the TDDMPS lotion is really TD.

    HV Aposhian (from the urine test links upthread) is at the U of Arizona. I have no standing to do this, but perhaps someone could write and ask whether he'd offer to test urine from Buttar's patients (or know someone who would). Buttar would doubtless decline, but the patient's parents might be interested in doing the study.

  55. And if someone did, you would castigate them regardless! It could not possibly be done in a way that would satisfy your arrogant closed minds! If you really need or want further proof, do it yourselves you lazy, arrogant asses.

  56. I can't speak for other arrogant closed minds, but if the urine of patients treated only with the cream contains DMPS or a metabolite thereof, I will concede that DMPS can be absorbed transdermally. There appears to be a good test available for this purpose.

    There is also evidence that DMPS is a useful way to mobilize mercury in humans, so if the cream is an effective route of administration one would expect to be able to measure increased excretion of mercury in treated patients.

    At that point, it still remains to be seen what levels of mercury Buttar's patients are excreting (and when they stop, that is, run out of mercury). He talks about the therapy requiring 12-18 months, but I would expect the mercury to be gone long before that sort of time frame. (Additionally, DMPS challenge is a one-time exposure, and I have seen no information on the safety of long-term DMPS use.)

    None of the above speaks at all to whether mercury has anything to do with autism or whether DMPS therapy (by any route) results in any real improvement in autistic patients.

    I look forward to the Lancet paper mentioned upthread.

  57. Hey, Orac, can you at least tell us whether you're male or female?

  58. Geez. This whole post is about how we "conventional" scientists can be just as prone to the same self-delusion about the effectiveness of our favored treatments as any altie (which is the very reason we've come to learn to insist on good scientific methodology and well-designed clinical trials), and I get accused of arrogance for saying that. I tell ya, ya just can't win with these guys. Would it help if I mentioned that, like all good scientists, I live in fear that one day my pet hypothesis will be shown to be completely wrong, either by myself or (worse) by someone else?

    As for my gender, I would have thought that would be obvious from the content of the blog...

  59. It is terribly amusing that "anonymous" is so eager to discover the identities of Orac and myself all the while hiding behind an anonymous post. Unintentional irony is truly the best!

    As for anonymity, besides the obvious effect of protecting myself from the unwanted attentions of the disgruntled, disturbed and deranged, it also has the effect of removing the temptation to say:

    "Believe me! I am the great and powerful Dr. Oz! I have forgotten more science than you have ever known!"

    In other words, I cannot use the self-referential "appeal to authority" fallacy, because you have no idea who I am and therefore no reason to believe me based on who I am. My arguments must stand or fall by their own merit.

    You can choose to believe that I am who I say I am - a biologist at a medium-sized university - or you can, if you like, imagine that I am a spotty 13-year-old boy tweaking my elders for amusement. Either way, my arguments speak for themselves. Refute them if you can.

    The argument that my anonymity invalidates my arguments is not just a fallacy - it is ridiculous. Quite the opposite is true - if my identity swayed you to believe of not believe my arguments, that be invalid.

    Prometheus. Anonymous and proud of it!

  60. Orac,

    And how do we know you are "like all good scientists?" What a nice thing to say about yourself. Don't break your arm patting yourself on the back!

    What peer reviewed scientific studies have you ever published? Please list them for us! None? Geez indeed!!

    You insist on proof from everybody else but provide none yourself other than your unproven rantings and diatribes running down people who actually are doctors and PhD scientists!

    You question the motives of everyone you don't agree with as if you have some awesome powers discerning the motives of people you don't even know! Give them and us a break!

  61. If you want to know who Orac is go hang out with the wackiest of the alties,... it's not that hard to find out... he or she is just trying to slow down the uber wackos.

    I happen to think that Prometheus is a very bright twelve year old girl form Athens ... Georgia.

    But I could be wrong. In this case we are all peers of Prometheus and Orac, and we can all do the checking on their facts... isn't that just nice? If you don't know enough biology to check their facts, email a professor or Marilyn vos Savant... ask a pharmacist at the local drug store... e-mail a real toxicologist.

    I also notice that you, anonymous don't find any fault with Orac's points, you are just hung up on the fact that you don't know who he or she is....

    on the internet no one knows if you are on'y a mouse

  62. Anonymous (not an ony mouse),

    Believe what you like about me. I really don't care enough anymore whether someone who is even more anonymous than me believes I am who I say I am to spar with you about this issue (other than this one last message, of course). I never even really made an issue of who I am. You are the one making the issue of it.

    Let me ask you: If I could provide you incontrovertible proof that I am who I say I am (and I could easily provide that if I were so inclined), would it change one iota the violence of your disagreement with me? Would it make you any more likely to accept my arguments? Would it make you any less angry at me for what I have written?

    I doubt it. So why should I bother?

    Finally, would I be showing poor judgment to let an anonymous someone who is so clearly angry and hostile to me know my identity?

    Yes, absolutely.

    Besides, your fixation on this issue is nothing more than a convenient excuse for you not to address the substance of what I've written. Read Prometheus' comment a couple of comments above this. I agree with him wholeheartedly. One advantage of anonymity is that my arguments have to stand or fall on their own merits (or lack thereof). If you want to believe I'm a college kid, a disgraced doctor who has been sued multiple times, unemployed, or whatever, knock yourself out!

    It wouldn't change the validity (or lack thereof) of my comments.

  63. Anon has had the effect that anon was trying to have. I did exactly what you all do regularly.

    Anon could care less who you are!

    Anon ignored the substance of your arguments and attacked you instead at your weakest point. And predictably Anon elicited the same response from you that you do from those who seek to argue the other side here on this Blog. Frustration!

    It wasn't "unintentional" Prometheus, that Anon chose to be anon! I did it to see if I could get someone like you to say exactly what you said.

    My point is that you all have a double standard on this and many issues! You attack the person instead of the person's arguments. You attacked Anon for being Anon, all the while that you are anon!

    You require of those you disagree with, ala Buttar and Haley etc., double blind studies to back up everything that they hypothesize. But you require of yourselves nothing to back most of your statements and opinions. You regularly attack and castigate people you don't even know!

    You slander people who are legitimate scientists and doctors, ASSUMING the absolute worse about them all the while defending the ADA and vaccine manufacturers who have been making HUGE PROFITS while using a KNOWN and PROVEN highly toxic substance when they have produced NO toxicity studies EVER!!!

    Where are your demands for Real Scientific Studies proving the use of mercury is SAFE? You have a double standard! Instead you want everyone to prove it ISN'T safe which you know scientifically this difficult if not impossible to do!

    You demand peer reviewed studies from Buttar when you know that this is NOT easy to do even when a doc or scientist WANTS to do the study!

    You ignore ANY positive evidence that there just might be something to mercury being a causative agent in MANY diseases for which ALL "MAINSTREAM" scientists today are offering NO solutions to. Could it be that they are striking out because they are ignoring mercury as a causative agent? And they are doing so because it is a politically and financially incorrect cause?

    You assume Big Pharma, the FDA and ADA have practiced
    "science", while assuming that people like Haley and Buttar are charlatans, stupid and evil! You have a double standard! You strain out a gnat in your opponents all the while swallowing a camel.

    You wan't Buttar to run tests to show that DMPS is absorbed when it is only logical that if he legitamately sees patients getting well, AND he sees pre and post provoked tests showing high amounts of metals being excreted, AND it is well known that the skin readily absorbs, AND it is known that compounding pharmacies like AMT (the makers of TD DMPS) commonly use "carriers" proven to deliver substances through the skin, AND numerous parents testify that they have seen amazing results AND evidence from the use of TD DMPS and other forms of chelation, THEN you should at least grant Buttar and these people the benefit of the doubt for the "evidence" that they have instead of ATTACKING them as EVIL and STUPID people! But that is exactly what you do here all the time! Guilty until proven innocent!

    You regularly ignore the arguments of opponents here and instead attack the person! It is amusing Orac, that this is what you take exception with Anon for doing! Anon only did what you and your minions do regularly. Anon attacked YOU instead of your arguments and illicited from you exactly the same frustration that you get from your opponents!

    Turnabout is fair play! LOL

  64. Orac,

    Anon makes one final point. You said, "I never even really made an issue of who I am." Wrong!

    Read you own description of yourself on the Blog. "ramblings of a surgeon/scientist on medicine and pseudomedicine."

    Seems a VERY legitimate question to ask you to prove this statement especially since you are Blogging all the time when you should be operating on people saving them from their illnesses!

    Given your supposed logical ATTACKS on your opponents persons; your assuming the absolute worst that you can about all who oppose your arguments, it would be fair to do the same to you!

    Funny that you would feel the same as they!

  65. Anon is YELLING! That is what caps are for.

  66. Also Nancy, once again you take the same approach of most of the commentators on this blog; ignore what is being said and attack the commentator. "What anon is saying can't be valid because anon is YELLING." Geez!

  67. To Anon;

    I've gone back through your posts and I still can't see what your point is.

    I can't recall anybody on this blog saying that mercury was safe, only that it hadn't been shown to cause autism. There is a difference.

    It seems that you bring up a number of straw men (like the inimitable PS2) and procede to rip them up, oblivious to the fact that nobody ever made those claims.

    This has certainly led to a bit of frustration, but only because I've been foolish enough to actually read your posts. I guess I'm the eternal optimist.

    After you get over smirking about how incisively witty you have been, perhaps you could get to your point.

    You think that Dr. Buttar and others like him should be exempted from having to show that their new remedies are safe and effective. Why?

    And pointing to FDA-approved drugs that have been found to have problems after release isn't the same as showing why Buttar's TD-DPMS should be exempt. He is doing just fine peddling his cream without FDA approval.

    Why should we accept what he says without some data?

    Finally, I keep wondering what sort of a raw nerve we've touched in poor Anon that he/she/it keeps coming back, day after day, to shout down the skeptics. After all, if we're so "pathetic", why do the alties feel so threatened by us?


  68. "You demand peer reviewed studies from Buttar when you know that this is NOT easy to do even when a doc or scientist WANTS to do the study! "

    No we demand a study. Peer reviewed and published would be even better, and he could do that in Medical Hypotheses or Medical Veritas...

    He's already done the research... all he has to do is put it in writing so it can be checked by other people.

    He won't do that. Ever, because he has nothing. That's the obvious assumption. He's published something, if only on the Internet about his Trans D Tropin or whatever it is... that cures aging.

    Have you seen it "anonymous with the all caps"? There is a link somewhere here on Orac's blog...

    It has little figures and everything. See another scientist could take that and try to replicate it, because there are actual numbers and everything.

    Buttar should be able to do ONE case study, I mean he sees these kids getting cured before his very eyes, how about his son. See he could explain how his son got diagnosed and everthing and we could actually have reason to trust him.

    As it stands - he just ratchets up the psycho tricks, referring to unnamed friends who are writing papers that might get published, blah blah.

    He hasn't even applied for an institutional review board permission to put dmps on kids to see what it does. His first thing was using patches and kids had rashes so without further ado he switched to lotion. If his big results were with patches, maybe the lotion works differently?

    Is that stuff really microencapsulated? If so should it be odorless, or odorless until it's rubbed in?

    What's this thing with getting a "feeling" if you put 300 drops on. Did Buttar say this, or is it just a JB Handley thing?

    Concerns that won't be answered by Buttar's research any time soon
    Does the glutathione in Buttar's recipe cause problems for some kids? Is it even necessary to add amino acids and glutathione?
    "> We concluded that the DMPS had produced real >changes but the glutathione had caused temporary >problems (this happens to a lot of people with TD >glutathione)


    Nice detective work!

    Even though Stevens-Johnson Syndrome is supposed to be rare, it seems like people on the list see at least the beginnings of it with oral DMPS not all that rarely. Is my memory right -- don't reports of S-JS symptoms seem more frequent than say, low neutrophils from DMSA? Do you know if S-JS is less likely to occur with TD-DMPS, or does the administration not make any difference?

    I have been sticking with oral ALA and DMSA since it's been working well, but now that school has started the 3-hr dosing is much harder to get in, so I'm thinking of finally giving TD-DMPS a try. Does anyone know of a source in the States for TD-DMPS with no additives?

    Thanks, Steve. Great that you're seeing such positives."

    Stevens-Johnson syndrome is ugly and they are talking about how their kids are getting it for what? Because of unreliable consumer lab tests and stupid mercury hysteria?

    Sick business.

  69. Prometheus,

    You don't get my point? You are not really trying it seems to me.

    My point: (I will go slowly here so you don't miss it) -you, Orac and others are very quick to label people like Buttar and Haley "quacks", "charlatans", "alties" awful, terrible, evil people etc. but you give a pass to the ADA and the pharmaceutical companies who have made $$billions$$ while very possibly having poisoned a few generations; hundreds of millions of people. And they have done this without having done ANY toxicity studies whatsoever! None. Zero. Zilch.

    Don't you see the problem? You go after a single guy like Buttar who perhaps has treated a few hundred kids/people with something that you all surmise (perhaps rightly) does NOT even do anything at all. And yet there is NO call for "Evidence Based Medicine" for organizations that have treated hundreds of millions of people in the US and billions worldwide with something that is well known to be highly toxic and IS proven to be absorbed unlike Buttar's TD!

    Don't you see the absurdity of attacking Buttar when millions of people are getting a very real dose of a very real poison every single day from the mercury placed in their mouths by an organization that has NEVER done a single safety study??

    Forget Buttar, lets demand studies from the ADA because THAT really matters! Let's demand studies from the "money grubbing" vaccine manufacturers who have injected hundreds of millions of our kids with a known toxin without EVER proving that it is SAFE! Screw Buttar! I want evidence based studies from groups that really matter.

    Forgive my repetitiveness but I want to make sure you get my point since I seem to have done such a bad job before.

    Orac said above, "Anti-amalgam dentists are quacks, pure and simple. There is no good evidence that amalgams cause any of the problems attributed to them, and lots of quacks are making lots of money scaring people into having their fillings replaced."

    This statement ignores the facts that 1.) it is proven that amalgams regularly leach mercury in significant quantities according to EPA and FDA standards 2.) there are thousands of studies that show the health dangers of mercury even in very small quantities 3.) there have NEVER been studies done to prove the safety of amalgams or Thimerasol. Duh!!

    Anon is trying to point out the absurdity of this blogs attack on Buttar while you all readily accept and even defend putting mercury into the mouths of hundreds of millions of people. Worse, you accept the safety of injecting large amounts of mercury into developing babies without ANY scientific evidence that it is safe!

    The best that you can say for the ADA and vaccine makers is that they have "anecdotal/testimonial"data to show it is safe. I totally agree with Orac that this is NOT acceptable science!

    For Orac to attack every dentist who is anti-amalgam as ABSOLUTELY A QUACK is blatant arrogance bordering on pure stupidity! His all knowing certainty that they are quacks when he has no evidence based scientific data supporting his statement, is bad science at best, arrogant stupidity at worst.

    These men/women risk their licenses because they are APPALLED at the lack of science supporting the use of this terribly dangerous, toxic metal. They have concluded at the risk of their livelihood, they WILL NOT use this highly toxic metal anymore. And you call these credentialed, educated people quacks. To assume that they are not at least as thoughtful and reasoned in their decisions as the Oracites is just pure arrogance and illogical.

    To assume they do it for money is not logical. They risk their very careers! One could readily argue that those dentists who continue to put mercury into the mouths of millions only do it for money since they absolutely know that mercury contracts and expands, cracking people's teeth and creating lifelong customers! Buttar is likely an angel compared to them!

    To me, Orac's attack on these people is not logical and it is not science! It is character assassination. It is why I unfairly attempted to assassinate Orac's character on no basis whatsoever. What goes around...

    The ADA and Vaccine manufacturers get a free pass for their total lack of science but these Dentists, Buttar etc. get trashed. That is my point! It is a double standard of massive proportions.

    I am not even saying that Buttar et al, are even right! They might be but who cares??!? They pale in significance for not practicing evidence based medicine.

    I AM saying that just the suspicion alone that mercury could be a causative factor in Autism and many other diseases that remain unsolved, should be enough to stop using it.

    You require absolute PROOF that it is dangerous and harmful BEFORE you would stop using it! I would require absolute scientific PROOF that it IS safe before it could continue to be used. Better yet before it was EVER used as good medicine should require as Orac rightly points out above.

    These things should never have been allowed without studies. Particularly true of Thimerasol. Amalgams have been around for 150+ years but even at their beginning there were people calling for proof that they were safe but they were run over in the mad dash to make money! Were these early amalgam dentists Buttars? Rushing to make money without ANY proof that their new magic amalgams worked and were safe? Let's castigate them for their lack of evidentiary medicine!

    Why not an outrage about this instead of attacking a relatively insignificant thing like the use of TD DMPS? Who gives a flip about Buttar when a known dangerous substance IS being absorbed and can be measured in the bodies of hundreds of millions with no scientific proof that this is safe?

    (I truly am sorry for my repetitive and long post but I wanted to be sure my point was not missed.)

    And again, so you won't miss it, I agree with Orac! I just am totally dumbfounded that we don't apply his "evidence based medicine" to groups that really matter!

    Hopefully, anon has now made a point that at least can be discerned by smart people. If not, anon will disappear to Diva's blog where speaking of oneself in the third person is appreciated! Thanks.

  70. Thimerosal and other forms of mercury were grandfathered in on the basis that it didn't do any harm to the great numbers of people who had been exposed to it (in merthiolate for instance).

    The rest of the world is not freaking out about mercury at the levels that were in vaccines in the US and are now in some vaccines being used elsewhere.

    The anti amalgam dentists make money off of terrorizing people into fearing mercury.

    Autism Diva's autistic child needs to have several cavities filled, with NO!!! SAY IT ISN'T SO!!! amalgam fillings. And that child will get those fillings.


    You know that website where some guy threatened to kill a bunny if people didn't pay him so much money? Autism Diva thinks she ought to put a PayPal button on her website to see if the mercury parents are freaked out enough to pay money for the autistic offspring to get ceramic fillings...

    Nah, that would be too much like something a quack would do.

    Autism Diva speaks in the third person because its funny, it's her schtick, and because speaking in the third person is a trait of autistic people.

    Please - Anonymous -keep your wacky mercury phobia away from the Diva blog. Go start a new anti-amalgam website or something.

  71. Diva,

    Anon is LOL! Too funny.

    To each their own.

    All the best.


  72. "No we demand a study. Peer reviewed and published would be even better, and he could do that in Medical Hypotheses or Medical Veritas..."

    Miranda, I agree with muchof what you say, except for one thing. Those journals wouldn't be good enough. Medical Hypotheses is a journal that is devoted mainly to essays and review articles, not primary research. Also, it's the type of journal that encourages speculative thinking and, well, medical hypotheses to test. It's meant more as a vehicle to encourage creative thinking than as a vehicle to disseminate research findings.

  73. Kev,

    Anon has resisted for days to say anything but now has succumbed because yours is such a stupid argument!

    You know that this is not at all what I am saying.

    If you cannot see the weight of difference in the two issues you do not want to see. You are correct, "WE JUST KNOW" that you are not very bright!

    It would be nice if you all could produce the names of the studies that the ADA did and the vaccine manufacturers did to prove the safety of their products. There are none.

    Hence, you can only make another stupid argument.

    Have a nice day.


  74. It seems Mr/Ms Anon only looks at data that fits into his/her already set dataset of opinion. A search of the medical journals through www.pubmed.gov with the search words "vaccine safety" brings up almost 5000 hits.

    And the American Dental Association has nothing to do with vaccines, so that is a non-issue.

  75. Anonymous is arguing from ignorance. As HCN says, there are many studies on vaccine safety. Does "anonymous" realize just how much data it takes to get a new vaccine approved?


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