♘امیرحسین♞
♘ مدیریت انجمن اسب ایران ♞
In the children's story "The Boy who Cried Wolf," a young shepherd amuses himself by crying "Wolf!" and enticing villagers to run to help him save his flock. After a time, when there were never any wolves, no one paid attention to the cries.
As it is with sheep, so it also is with unproven treatments. Veterinarians have heard of "promising" claims of "complementary" or "alternative" veterinary medicine (CAVM) for at least three decades. Countless articles, books, and reports of successes have appeared, mostly in the popular press. Appeals have been made to the putative popularity of such therapies, the purported antiquity of some, or their almost miraculous nature, supposedly both less toxic and more effective and more "natural" than the complicated and difficult real medicine practiced by the vast majority of veterinarians. The only thing that's not been forthcoming is good evidence of effectiveness.
Scientists have looked for decades, but so far when they've looked, like the young boy in another children's story, they've found that the emperor of "alternative" veterinary medicine has no clothes. In human medicine, where "alternative" medicine has been widely studied, convincing evidence of effectiveness has failed to materialize for the use of acupuncture, chiropractic, homeopathy, magnets, lasers, etc. (Herbs are a special case, and while they are mostly ineffective, for a variety of reasons, they are merely crude, uncontrolled drugs.) The only review of acupuncture in horses did not support its use. No good studies of veterinary chiropractic have been published in any major veterinary publication. Good studies in veterinary homeopathy have been uniformly negative.
But it's not just the lack of evidence, it's also the claims, ranging from the sublime to the ridiculous. The claim that acupuncture was practiced on animals 4,000 years ago is absurd. Serious historians have found that the current practice has been tried only for the last 50 years or so, and that it originates mostly from France, not China. Acupuncture points have never been demonstrated. "Auricular acupuncture" developed in the mid-1950s in France is based on the supposition that the human ear looks like an upside-down fetus (how's that supposed to relate to animals?). Chiropractic "subluxations" have never been demonstrated in any species. "Specific" adjustments, forces precisely directed at a point on the spine, have been shown to be impossible. And so it goes.
Given the dearth of good supporting evidence, and the many false--and in some cases ludicrous--claims, at some point the glowing pronouncements about "alternative" approaches to medicine have to be viewed for what they really are: Propaganda. So, instead of presenting rational evidence-based argument, reason, and logic, proponents of CAVM play on the hopes, desires, and fears of concerned horse owners. For example, CAVM practitioners may call themselves "holistic," but ignore the fact that, as the 2001 American Veterinary Medical Association's (AVMA) guidelines on CAVM note, all good veterinary medicine is holistic. They use glowing, broad, virtuous linguistic strokes, trying to encourage people to rush to judgment without examining the evidence. They state that CAVM practitioners offer "the best of both worlds" and thereby imply that other veterinarians may not. In fact, there's only one kind of medicine: Effective.
The veterinary community is noticing. No one wants to deny animals useful treatments, but there's no point in wasting time or money on ineffective ones. So, in 2001, the AVMA's guidelines on CAVM noted that "Recognition of a veterinary specialty organization by the AVMA requires demonstration of a substantial body of scientific knowledge. The AVMA encourages CAVM organizations to demonstrate such a body of knowledge." In April 2005, the European Board of Veterinary Surgeons unanimously agreed to recognize only "scientific, evidence-based veterinary medicine." Furthermore, they stated: "Specialists or colleges who use or support implausible treatment modalities with no proof of effectiveness run the risk of withdrawal of their specialist status. No credit points can be granted for education or training in these so-called supplementary, complementary, and alternative treatment modalities." In June, 2005, the Swiss interior minister announced that five types of "alternative" medicine, including homeopathy, herbal medicine, and "traditional Chinese medicine," would no longer be covered by basic human health insurance. Swedish veterinarians are not allowed to practice homeopathy, and the Dutch are likely to withdraw official recognition of veterinary homeopaths in the near future.
The cries to use CAVM are merely a smokescreen: Loud, perhaps sincere, cries of "Wolf!" CAVM is a term invented by proponents to excuse themselves from the burden of providing scientific evidence. After decades, assuming the therapies work, that evidence should be compelling. It isn't.
As it is with sheep, so it also is with unproven treatments. Veterinarians have heard of "promising" claims of "complementary" or "alternative" veterinary medicine (CAVM) for at least three decades. Countless articles, books, and reports of successes have appeared, mostly in the popular press. Appeals have been made to the putative popularity of such therapies, the purported antiquity of some, or their almost miraculous nature, supposedly both less toxic and more effective and more "natural" than the complicated and difficult real medicine practiced by the vast majority of veterinarians. The only thing that's not been forthcoming is good evidence of effectiveness.
Scientists have looked for decades, but so far when they've looked, like the young boy in another children's story, they've found that the emperor of "alternative" veterinary medicine has no clothes. In human medicine, where "alternative" medicine has been widely studied, convincing evidence of effectiveness has failed to materialize for the use of acupuncture, chiropractic, homeopathy, magnets, lasers, etc. (Herbs are a special case, and while they are mostly ineffective, for a variety of reasons, they are merely crude, uncontrolled drugs.) The only review of acupuncture in horses did not support its use. No good studies of veterinary chiropractic have been published in any major veterinary publication. Good studies in veterinary homeopathy have been uniformly negative.
But it's not just the lack of evidence, it's also the claims, ranging from the sublime to the ridiculous. The claim that acupuncture was practiced on animals 4,000 years ago is absurd. Serious historians have found that the current practice has been tried only for the last 50 years or so, and that it originates mostly from France, not China. Acupuncture points have never been demonstrated. "Auricular acupuncture" developed in the mid-1950s in France is based on the supposition that the human ear looks like an upside-down fetus (how's that supposed to relate to animals?). Chiropractic "subluxations" have never been demonstrated in any species. "Specific" adjustments, forces precisely directed at a point on the spine, have been shown to be impossible. And so it goes.
Given the dearth of good supporting evidence, and the many false--and in some cases ludicrous--claims, at some point the glowing pronouncements about "alternative" approaches to medicine have to be viewed for what they really are: Propaganda. So, instead of presenting rational evidence-based argument, reason, and logic, proponents of CAVM play on the hopes, desires, and fears of concerned horse owners. For example, CAVM practitioners may call themselves "holistic," but ignore the fact that, as the 2001 American Veterinary Medical Association's (AVMA) guidelines on CAVM note, all good veterinary medicine is holistic. They use glowing, broad, virtuous linguistic strokes, trying to encourage people to rush to judgment without examining the evidence. They state that CAVM practitioners offer "the best of both worlds" and thereby imply that other veterinarians may not. In fact, there's only one kind of medicine: Effective.
The veterinary community is noticing. No one wants to deny animals useful treatments, but there's no point in wasting time or money on ineffective ones. So, in 2001, the AVMA's guidelines on CAVM noted that "Recognition of a veterinary specialty organization by the AVMA requires demonstration of a substantial body of scientific knowledge. The AVMA encourages CAVM organizations to demonstrate such a body of knowledge." In April 2005, the European Board of Veterinary Surgeons unanimously agreed to recognize only "scientific, evidence-based veterinary medicine." Furthermore, they stated: "Specialists or colleges who use or support implausible treatment modalities with no proof of effectiveness run the risk of withdrawal of their specialist status. No credit points can be granted for education or training in these so-called supplementary, complementary, and alternative treatment modalities." In June, 2005, the Swiss interior minister announced that five types of "alternative" medicine, including homeopathy, herbal medicine, and "traditional Chinese medicine," would no longer be covered by basic human health insurance. Swedish veterinarians are not allowed to practice homeopathy, and the Dutch are likely to withdraw official recognition of veterinary homeopaths in the near future.
The cries to use CAVM are merely a smokescreen: Loud, perhaps sincere, cries of "Wolf!" CAVM is a term invented by proponents to excuse themselves from the burden of providing scientific evidence. After decades, assuming the therapies work, that evidence should be compelling. It isn't.