TRIO DELIRIUM ,,, #STRAMONIUM,,Stramonium belongs to the botanical family Solanaceae, the nightshade family. It is found world-wide, although it is believed it originated in the area around the Caspian Sea. It is reputed that gypsies spread the seeds. Dracula is helped throughout the book by Szygany, Eastern European gypsies.
Some of the Solanaceae are beneficial to man, like potato, tomato, aubergine, and capsicum pepper. Others are deadly poisons, such as Belladonna, Stramonium and Hyoscymus. Their toxicity is related to the presence of atropine and related compounds which have a powerful effect on the nervous system, blocking the actions of the neurotransmitters (chemicals which allow for nerve transmission).
The effect of stramonium is that one becomes “as blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone”2 – all signs of an adrenaline rush that may occur with terror or violent anger.
Despite this, stramonium has medicinal uses. The refined chemicals are still used today in orthodox medicine to dilate pupils for eye examinations and operations, to prevent vomiting following opiate painkillers and chemotherapy, to stimulate the heart, and to treat sarin and nerve gas poisoning. In the past it was also used for asthma.
The concentration of the chemicals varies considerably – the plants are more potent in the night, hence Dracula’s nocturnal existence, and in cloudy, dark autumnal weather, again perfect vampire conditions. The white trumpet shaped flowers open in the twilight, hence the nickname Moonflower. The term lunatic is derived from the belief that insanity was associated with the moon.,,,VIOLENCE AND AGGRESSIVENESS– 1,Stramonium is like an earthquake in violence. They simply switch from rage mode to normal mode, as if nothing happened. They are very controlled and very nice and can be very sweet when they are in consultation room. But then they will say from time to time or when time comes, the fit comes, the anger comes, the violence comes and violence is hitting, striking, killing. It is not the desire to kill, they kill. They have to complete the action of violence. They go ahead and detonate their anger by doing something very violent. They will really take knife and there will be aggression. They hit children, their mother, their father. They will attack, they are tremendously aggressive and violent in their fit of anger.
There is no holding back when Sramonium “loses it.” The rage is quite insane, and accompanied by definite desire to kill. The Stramonium people were not angry most of the time. Rather they would suddenly be prone to bouts of rage with which they would struggle for few hours, and then they will be calm again, or enter a different emotion, such as lust or terror.
Stramonium is the violence of the mental state. It is very active, agitated, driven state. The person is out of control, destructive, even malicious in behaviour. It is destructiveness of all kinds- against other persons or oneself. Striking, biting, tearing, shrieking, cursing- but most specially smashing things. Such a state may erupt rather suddenly, then subside after a while, but the person is not free of it. Typically it is the chronic mania or relapsing frequently over a period of time, rather than just a simple paroxysm of rage.
It might be indicated in mass killer who suddenly begins killing many people indiscriminately. Stramonium would have to be at least thought of in such cases.
2) FEAR OF DARKNESS– stramonium individuals are subject to all manner of terrors, delusions and hallucinations and they usually dread the night, because it is that they become haunted by the horrors of their own subconscious mind. They will tell you that they hate sunset, because it heralds the beginning of the dark time.
If you have Stramonium and you sleep in dormitory and you switch off the light in night, even if he is asleep he will awake in terror and will jump to on the lights.
They sleep with lights on, and if they awake in darkened room, they will see monsters in dark and will scream long after their parents have arrived and tried to soothe them.
KENT: HE SEES ANIMALS, GHOSTS, ANGELS, DEPARTED SPIRITS.
3) WILDNESS, DESTRUCTIVENESS, STRIKING– there is wildness in delirium, they will be more furious and more like a wild animal. It will go to that point. His whole situation including his ailments frighten him so much that he doesn’t want it to ever surface again. He wants to finish it off, to eradicate, to destroy, and exterminate it. His problems trouble and scare him and he wants to finish them. His actions are always total.
4) HALLUCINATIONS– they will have a lot of hallucinations and are usually related to frightful things such as animals. They will see dogs, wolves, etc. but they see animals wanting to see them. Usually delusion is related to something dangerous, especially animals, dark or black things. They imagine dark, black things, black ghosts. One of the characteristic fear and delusion is – “always worse on waking.” (Whereas belladonna is usually worse before going to bed.) Stramonium has great fear of darkness and being alone.
5) FEAR OF SHINNING OBJECTS– Stramonium patients will report that they feel panicky in a moving car if sunlight is flickering in between a row of trees, or through a fence. One woman said she hated to look at sunlight upon water. When I asked why? She said – she said it was “one of those horrible shiny things.”
6) DESIRE TO KILL– It is not the desire to kill, they kill. They have to complete the action of violence. Stramonium will really take a knife and will charge and will charge and hit and then you see the aggression. They hit children, the mother, the father. They will attack, they are tremendously aggressive and violent in their fit of anger.
Children usually that develop Stramonium symptoms have been terrified by parents. There is a little one here, 5 year old and he plays, he does this, they say, “shut up.” He continues. The father grasp him and goes to balcony and says, “I am going to throw you down. So you shall stop. Yes or no?” great fright and then slowly that child develops symptoms of aggression. Eventually you enter the house it does not matter who you are, he looks at you and goes and hits you.
7) FEAR OF BEING INJURED– it is very interesting that this violent remedy, which is so violent that it can kill, they themselves are afraid of injured. Either the same person has both the violence.
8) MANIA– the mental symptoms are as follows. The mania or delirium is of wild character, the face being of bright red, the eyes have wild and suffused look, although they are not so thoroughly congested as under belladonna. The hallucinations terrify the patient, he sees objects springing up from every corner, animals of every kind and grotesque creatures arise and terrify him. The patient, if child, cries out for his mother even when she is near. The eyes are open and the pupils widely dilated. If an adult, he is decidedly loquacious in his delirium. At times he manifests a merry mood in his loquacity, and at others he has horrors. At one moment he will be laughing, singing, and making faces, and at another moment praying, crying for help etc. he often has photomania or desire for light. The mania assumes a silly character. The loquacity differs from Lachesis. In Stramonium the loquacity consists of a simple garrulity, whereas in Lachesis it is jumping from one subject to another. During delirium of Stramonium, as under many narcotics the patient frequently attempts to escape.
Cerebral anemia usually refers to brain ischemia. Brain ischemia, also known as cerebral ischemia, is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. This leads to poor oxygen supply or cerebral hypoxia and thus to the death of brain tissue or cerebral infarction / ischemic stroke. It is a sub-type of stroke along with subarachnoid hemorrhage and intracerebral hemorrhage. Ischemia leads to alterations in brain metabolism, reduction in metabolic rates, and energy crisis.
There are two types of ischemia: focal ischemia, which is confined to a specific region of the brain; and global ischemia, which encompasses wide areas of brain tissue. The main symptoms involve impairments in vision, body movement, and speaking. The causes of cerebral ischemia vary from sickle cell anemia to congenital heart defects. Symptoms of cerebral ischemia can include unconsciousness, blindness, problems with coordination, and weakness in the body. Other effects that may result from cerebral ischemia are stroke, cardiorespiratory arrest, and irreversible brain damage.
Other Cerebral conditions
Cerebral congestion usually refers to heat stroke.
Cerebral Irritation has therefore come to be a term used to describe extreme “perceived” pain that a child experiences which is of unknown origin and where all other obvious causes of pain have been treated or ruled out. Meningeal irritation caused by a pain-reflex muscle contraction.
Cerebral softening (encephalomalacia) is a localized softening of the brain substance, due to hemorrhage or inflammation.
Cerebral Ischemia and Cerebral Congestion: Homeopathic Remedies & Homeopathy Treatment
Aconite suits active cerebral congestion from heat of the sun or due to sudden emotional excitement. It suits the first stage of idiopathic inflammation of the brain,thirst,delirium and vertigo point to it. Any noise or light will aggravate the condition,and the eyes feel as if starting from their sockets.
This remedy has congestion and cerebral irritation with hot head, cold feet,throbbing carotids and headache. There are sharp, shooting pains in the head,which make the patient cringe. These pains are stabbing, come suddenly last indefinitely and cease suddenly, and they may be accompanied with vomiting. It is the prime remedy in the cerebral congestions of childhood. The child will bore the head into the pillow, have strabismus and convulsions. There is also a stupor out of the which the patient can hardly be aroused, and when aroused is very violent and delirious. Glonoine is very similar; it has a great rush of blood to the head and a sensation as if the head were enormously large and crowded with blood. It is aggravated by bending backward, relieved by motion and uncovering the head, while Belladonna is relieved by bending backward and by covering the head and is aggravated by motion.
Hyoscyamus is suitable for cerebral inflammation with pulsating waves through the head, relieved by shaking the head or sitting with the head bent forward, which is the opposite of Belladonna. Kali bromatum. This remedy has numb sensations in the head brought on by overwork.
This remedy suits inflammatory conditions of the brain with violent delirium or epileptiform seizures. Vertigo is a prominent symptom and also a transient blindness. It is especially useful in brain involvement in epilepsy. Veratrum viride suites the active form of cerebral hyperaemia. There is a full bounding pulse and symptoms of mania and convulsions
A most valuable remedy for cerebral ischemia. There is disposition to faint, ischemic murmurs in the vessels in the neck; there is an appearance of full bloodedness, but the flesh is flabby and soft, and the patients are really very weak and anaemic. Arsenicum is especially indicated in cerebral ischemia due to malaria or as a result of excessive use of quinine. There is great depression of the vital forces, nausea, bloating of the hands, feet and face and other Arsenicum symptoms. Cinchona. Anemia (cerebral ischemia) due to long-continued drains on the system indicate this remedy.
#Nux vomica [Nux-v]
Nux suits ischemia of the brain brought on by a long-continuous over- stimulation caused by spirituous liquors, mental overwork and dissipation in general. It suits also softening of the brain due to sedentary habits and intemperance. The headache characteristic of the drug is present, the gastric symptoms, the unsteady gait, and the vertigo. The memory is weakened, the patient is sleepless. Anacardium. This drug is especially to be thought of in loss memory. Opium. This remedy suits a passive cerebral congestion with great heaviness of the head and vertigo on rising. It produces a continual sopor, even insensibility, with dark redness of the face and coldness and paleness of the rest of the body. The pulse is slow and the breathing is stertorous; it suits hyperaemia of the brain dependent upon sedentary life.
Phosphorus suits cerebral ischemia, the result of mental work or incident to the development of tuberculosis. It also suits softening of the brain with persistent headache, vertigo, formication and numbness in the limbs; the patients are weak, tired and have a great difficulty in walking. Jahr speaks warmly of its power in this affection. Baryta carbonica corresponds to premature loss of memory and childishness in old people, to sclerotic condition of the brain with excessive irritation of all the nerves; tumors in the brain may cause symptoms corresponding to Baryta.
A useful remedy in old chronic cases of cerebral ischemia, especially if brought about by the excessive use of the bromide of potassium. It is also a useful remedy for brain affection in the course of scarlet fever or summer complaints. Paralytic condition from cerebral softening may need Zincum. Rhus corresponds to senile changes in the brain. There is a swashing sensation in the brain when moving the head. It also suits paralytic troubles from brain diseases.
It is okay for the home prescriber to treat an acute post-traumatic reaction, but serious and/or chronic cases should be treated by a professional. Here are some of the most commonly-indicated homeopathic remedies for Post-Traumatic Stress Disorder (PTSD). Remember, there are many other remedies that might be chosen to help a patient with PTSD, so if one of the remedies below doesn’t fit the situation, do some more research or seek professional help.
Aconite:extreme fear, frequently accompanied by an unexplainable, vivid sense—even certainty—of imminent death, along with restlessness and agitation. The victim looks scared and has very small pupils. Most helpful during the first hours after a traumatic event (especially disasters), it might also be helpful many years later.
Arnica:for people who suffer from PTSD as a result of a terrible car or motorcycle accident. They may be morbidly afraid to ride a bike or drive a car.
Arsenicum album:victims are anxious, restless, and fidgety. They constantly call for help, need to be reassured, and crave company. They may become chilly and may feel much worse after midnight. They’re unable to sleep and may develop diarrhea from severe anxiety. They’re also thirsty for small amounts of cold drinks.
Stramonium:for people with nightmares (when a child wakes up terrified and remembers the dream) and night terrors (when a child wakes up morbidly frightened but doesn’t remember the dream). Some children develop violent behavior after a terrorizing experience. This violence seems to come in outbursts, without any apparent premeditation. They may become afraid of the dark, of dogs or other animals, and of water. Some children begin to stammer; others may exhibit various grimaces and twitches.
Homoeopathic Medicines substantially reduced the need for clotting factor concentrates in haemophilia patients; results of a blinded, placebo controlled cross over trial.
This was a single blind placebo trial in 28 persons with severe (24) and moderately severe (4) patients of haemophilia. This study was conducted over a period of two years. During the firstyear,patients were given placebo and during the second year, acute medication was prescribed as and when the need arose, and also a deeper constitutional remedy was simultaneously administered. If the patient did not respond in the first six hours of medication, they were given factor concentrates.
During the first year there were a total of 203 bleeding episodes in 28 patients. This had come down to a phenomenal 28 bleeding episodes in the second year of observation with homeopathic remedies. The pain score and behavioural scores improved significantly and so did the need for analgesics. No patient developed inhibitors!
Arnica, Ledum pal, Mag phos and Hypericum were most useful for pain while Arnica Hamamelis andMillefolium were of use in acute bleeding. Calc flour was of great help with haemophilic synovitis. Millefolium proved its worth in the acute phase. Causticum, Calcarea carb, Heparsulph and Lachesis were the deep acting remedies that suited 16/28 patients.
Thesecond research publicationwas in 2015 in theJournal of Traditional Medicine & Clinical Naturopathywhich reads:
Management of Acute Bleeding in Severe Haemophilia using Homoeopathic Medicines: a Multicentric Case Series
The analysis of this paper was done from 2007 till 2014 involving 494 patients with ages between 9-51 years. Of 578 bleeding episodes, a staggering 91%of them responded successfully with homeopathic medicines, while 3.1% did not and factor substitutes had to be given. Patients who had inhibitors also responded 65% of the time. Pain was relieved in 83% of the cases.
The 636 bleeding episodes in the seven years of study included, epistaxis, bleeding from the gums, haematuria and miscellaneous bleeding. Hamamelis Q was found effective for open bleeding and was applied over the area for about 15-20 minutes. Arnica 30, Ledum pal 30 or Rhus tox 30 were the frequently used medicines apart from Merc sol, Calc carb, Sepia, Sulphur, Silicea, Veratrum alb, Tuberculinum, Medorrhinum, Lachesis, Lycopodium, Phosphorus, Pulsatilla etc. as and when the symptoms corresponded. These were given every half an hour and when there was no response in a fourhour period, factor precipitates were resorted to, to achieve haemostasis.
It was found that most of the cases responded with stoppage of bleeding within half an hour and pain was relieved within a two hour period.
Standard biochemical, haematological, grouping, cross matching and coagulation work up was done as per the clinical requirement and situation. Dr.Kanjaksha Ghosh(Director, National Institute of Haematology), Surgeon-Dr.Sudhir Kulkarni and Dr.Ranjana Kulkarni clinically evaluated the effects of homeopathic medicine single-blinded, and provided factor concentrates whenever possible. Apart from Dr.Tapas Kundu, Dr.Afroz Shaikh, Dr.Priyanka Singh andDr.Afiya Shaikh were the prescribing homeopathic physicians.
The third research study was published in Journal of Evidence-Based Complementary & Alternative Medicine in 2017and is available as reprint in sagepub.com. The title of the paper is:
An Exploratory Study of Autonomic Function Investigations in Haemophiliacs on Homeopathy Medications Using Impedance Plethysmography
A medical analyzer system helps in finding the heart rate variability (HRV) and blood flow variability (BFV). It has been found that the autonomic nervous system has an impact on homoeostasis. This is measured by the medical analyzer system produced by the Bhabha Atomic Research Centre. It has been proven that HRV and BFV arefound more often in haemophiliacs than in the normal population.
A total of 80 subjects were studied amongst which were 18 healthy controls and 62 were severe haemophiliacs where Factor VIII was less than one percent. Heart rate and peripheral blood flow were recorded over one hour in all the subjects.
Amongst the 62 haemophiliacs, 49 were on individualized homoeopathic medicines and 13 were not on individualized medicines. Amongst the 49 haemophiliacs, 34 were feeling better symptomatically while 12 were not better. Three patients were not recorded due to technical limitations.
It was found that there was a decrease in parasympathetic activity in haemophiliac patients taking homoeopathic medicines, which suggests that the BFV is impacted by reducing vagal input to the heart, allowing the sympathetic system to respond to stress and haemostasis.
The fourth research study was published inComplementary Medicine Research in May 2018, titled:
Homoeopathic Medicine Reduces Pain and Haemarthrosis in Moderate and Severe Haemophilia: A Multicentric study
This study was done over a period between 2007 and March 2014 with 1679 episodes of haemarthrosis in 343 patients with haemophilia. This study included the knee joints, shoulder joints, elbows, ankles and the wrists. This also included patients who had already developed inhibitors but still responded to homeopathic medication.
In 23 patients, 99 episodes could not be managed with homeopathic medicines and required factor concentrate infusion. But a staggering 1550 plus episodes of pain in the joints due to haemarthrosis responded to homeopathic medication. The progression of improvement was seen in six hours. It was studied as reduction in the joint swelling, reduction of joint girth and relief of pain.
If the improvement did not occur in 24 hours they were told to resort to factor concentrates. The following remedies were prescribed on symptom similarity in lower trituritions. Arsenic alb, Belladonna, Apismellifica, Calc carb, Calc flour, Bryonia, Rhus tox, Sepia, Sulphur, Silicea, Veratrum album, Tuberculinum, Medorrhinum, Thuja, Sticta, Stellaria media, Ledum pal, Lachesis, Lycopodium, Phosphorus and Pulsatilla. If the change did not happen in two hours of starting the medicines, they were re-assessed and changed, which accounted for 497 episodes of the total 2173 occasions.
This study was helpful as homeopathic remedies have been able to arrest bleeding apart from providing significant pain relief, and they reduced the long-term tendency of frequent joint bleeds in a significant number of patients.
As always, observation was done by seasoned allopathic doctors who were unaware of the nature of the homoeopathic medicines given.
The fifth research publication was published inEuropean Journal of Biomedical and Pharmaceutical Sciences in April 2018, titled:
Effective Management of Haemophilia patients with a combined therapy to reduce cost: A New Approach
This study measured the work done by the centres of Dr.Tapas Kundu and was accepted for publication. This showed that the periodic medical camps at different cities treating haemophilia patients with homoeopathic remedies have met with remarkable success in reducing the clotting times and gaps between hospital visits for transfusion concentrates, causing improvement in general health, a feeling of well-being and considerably bringing down the cost of overall management of haemophilia. All of this brings a ray of hope to the poor patients.
<a href="https://www.ncbi.nlm.nih.gov/pubmed/12561803" data-href="https://www.ncbi.nlm.nih.gov/pubmed/12561803" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>in chief of the NEJM said this in 2002
“The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research. The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. I think it’s disgraceful”
The people in charge of the system — the editors of the most important medical journals in the world, gradually learn over a few decades that their life’s work is being slowly and steadily corrupted. Physicians and universities have allowed themselves to be bribed.
The examples in medicine are everywhere. Research is almost always paid for by pharmaceutical companies. But studies done by industry are<a href="https://www.ncbi.nlm.nih.gov/pubmed/20679560" data-href="https://www.ncbi.nlm.nih.gov/pubmed/20679560" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>well known to have positive results far more frequently. Trials run by industry are 70% more likely than government funded trials to show a positive result. Think about that for a second. If EBM says that 2+2 = 5 is correct 70% of the time, would you trust this sort of ‘science’?
Selective Publication— Negative trials (those that show no benefit for the drugs) are likely to be suppressed. For example,<a href="http://www.nejm.org/doi/full/10.1056/NEJMsa065779#t=abstract" data-href="http://www.nejm.org/doi/full/10.1056/NEJMsa065779#t=abstract" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>in the case of antidepressants, 36/37studies that were favourable to drugs were published. But of the studies not favorable to drugs, a paltry 3/36 were published. Selective publication of positive (for the drug company) results means that a review of the literature would suggest that 94% of studies favor drugs where in truth, only 51% were actually positive. Suppose you know that your stockbroker publishes all his winning trades, but suppresses all his losing trades. Would you trust him with your money? But yet, we trust EBM with our lives, even though the same thing is happening.
Let’s look at the following graph of the number of trials completed versus those that were published. In 2008, the company Sanofi completed 92 studies but only a piddly 14 were published. Who gets to decide which gets published and which does not? Right. Sanofi. Which ones do you think will be published? The ones that favor its drugs, or the ones that prove their drugs do not work? Right. Keep in mind that this is the only rational course of action for Sanofi, or any other company to pursue. It’s idiotic to publish data that harms yourself. It’s financial suicide. So this sort of rational behavior will happen now, and it will not stop in the future. But knowing this, why do we still believe the evidence based medicine, when the evidence base is completely biased? An outside observer, only looking at all published data, will conclude that the drugs are far, far more effective than they are in reality. Yet, if you point this out in academic circles, people label you a quack, who does not ‘believe the evidence’.
Rigging of Outcomes— Or consider the example of registration of primary outcomes. Prior to year 2000, companies doing trials did not need to declare what end points they measured. So they measure many different endpoints and simply figured out which one looked best and then declared the trial a success. Kind of like tossing a coin, looking at which one come up more, and saying that they were backing the winning side. If you measured enough outcomes, something was bound to come up positive.
In 2000, the government moved to stop these shenanigans. They required companies to register what they were measuring ahead of time. Prior to 2000, 57% of trials showed a positive result. After 2000, a paltry 8% showed good results. More evidence of the evidence base being completely corrupted by commercial interest, and the academic physicians who were getting rich on it tacitly allowing corruption because they know that you don’t bite the hand that feeds you
‘Advertorials’— Or this example of a r<a href="http://www.nejm.org/doi/pdf/10.1056/NEJMoa1001086" data-href="http://www.nejm.org/doi/pdf/10.1056/NEJMoa1001086" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>eview paper in the NEJMthat fracture rates caused by the lucrative bisphosphonate drugs were “very rare”. Not only did the drug companies pay lots of consulting fees to the doctors, three of the authors of this review were full time employees! To allow an advertorial to be published as the best scientific fact is scandalous. Doctors, trusting the NEJM to publish quality, unbiased advice have no idea that this review article is pure advertising. Yet, we still consider the NEJM to be the very pinnacle of evidence based medicine. Instead, as all the editors of the journals sadly recognize, it has become lucre-based publishing. Mo money = better results.
Money from Reprints— The<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964337/" data-href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964337/" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>reasons for this problem is obvious to all— it’s insanely profitable for journals to take money from Big Pharma. Journals want to be read. So they all try to get a high Impact Factor (IF). To do this, you need to get cited by other authors. And nothing boosts ratings like a blockbuster produced by Big Pharma. They have the contacts and the sales force to make any study a landmark. A less obvious benefit is the fees that are generated by Big Pharma purchasing articles for reprint. If a company publishes an article in the NEJM, they may order several hundred thousand copies of the article to be distributed to unsuspecting doctors everywhere. These fees are not trivial. The NEJM publisher Massachusetts Medical Society gets 23% of its income from reprints. The Lancet — 41%. The American Medical Association — a gut busting 53%. No wonder these journals are ready to sell their readers (ordinary physicians) down the river. It pays. Who needs journalistic ethics when there’s a Mercedes in the driveway? Mo money, baby. Mo money.
Bribery of Journal Editors— A<a href="http://www.bmj.com/content/359/bmj.j4619" data-href="http://www.bmj.com/content/359/bmj.j4619" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>recent study by Liu et al in the BMJshed more light on the problem of crooked journals. Crooked journal editors. Editors play a crucial role in determining the scientific dialogue by deciding which manuscripts are published. They determine who the peer reviewers are. Using the Open Payments database, they looked at how much money the editors of the most influential journals in the world were taking from industry sources. This includes ‘research’ payments, which are largely unregulated. As mention previously, much ‘research’ consists of going to meetings in exotic locale. It funny how many conferences are held in beautiful European cities like Barcelona, and how few are done in brutally cold Quebec City.
Of all journal editors that could be assessed, 50.6% were on the take. The average payment in 2014 was $27,564. Each. This does not include an average $37, 330 given for ‘research’ payments. Other particularly corrupt journals include:
This is slightly horrifying. Each editor of the Journal of the American College of Cardiology received, on average $475 072 personally and another $119 407 for ‘research’. With 35 editors, that’s about $15 million in bribes to doctors. No wonder the JACC loves drugs and devices. It pays the private school bills. Mo money = we’ll publish your crooked studies for you. Mo money, baby, mo money.
Publication Bias —The evidence base that EBM depends upon is completely biased. Some people think I’m really anti-Pharma, but this is not really true. Big Pharma companies have a duty to their shareholders to make money. They have no duty to patients. On the other hand, doctors have a duty to patients. Universities have a duty to remain unbiased.
It is the failure of doctors and universities to keep their greedy paws out of the corrupting influence of Big Pharma money that is the problem. If Big Pharma is allowed to spend lots of $$$ paying off doctors and universities and professors, then it should do so to maximize profits. That is their mission statement. Doctors love to blame Big Pharma companies because it takes peoples gaze off the real problem — lots of doctors taking $$$ from anybody who will pay. The pharma industry is not the problem.Bribery of university doctorsis the problem — one that is easily fixed if the political will exists.
Consider<a href="http://onlinelibrary.wiley.com/doi/10.1111/ene.13336/pdf" data-href="http://onlinelibrary.wiley.com/doi/10.1111/ene.13336/pdf" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>this study. Looking at studies in the field of neurodegenerative disease, researchers looked at all the studies that were started but never finished or never published. Approximately 28% of studies never made it to the finish line. That’s a problem. If all the studies that don’t look promising for drug candidates are not published, then it appears that the drugs are way way more effective than they really are. But the published ‘evidence base’ would falsely support the drug. Indeed, Pharma sponsored trials were5 times more likelyto be unpublished.
Imagine you have a coin flipping contest. Suppose a player call ‘Big Pharma” chooses heads, and also pays the coin flipper. Every time the coin flipper pulls up tails, the results don’t count. Every time it comes up heads, it counts. This happens 28% of the time. Now, instead of a 50/50 split of heads and tails, it’s more like a 66/34 split of heads/tails. So the ‘evidence based medicine’ lover claims that heads is far more likely to come up than tails, and castigates people who don’t believe the results as ‘anti-science’.
Evidence based medicine depends entirely upon having a reliable base of evidence (studies). If the evidence base is tampered with, and paid for, then EBM as a science is completely useless. Indeed, the very editors whose entire careers have been EBM have now discovered it to be worthless. Does the CEO of Phillip Morris (maker of Marlboro cigarettes) smoke? That tells you all you need to know about the health risks. Do the editors of the NEJM and the Lancet believe EBM anymore? Not at all. So neither should we. We can’t believe evidence based medicine until the evidence has been cleaned up from the corrupting influence of commercial interests.
Financial conflicts of interest (COI), also known as gifts to doctors, is a well accepted practice. A national survey in the<a href="http://www.nejm.org/doi/pdf/10.1056/NEJMsa064508" data-href="http://www.nejm.org/doi/pdf/10.1056/NEJMsa064508" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>New England Journal of Medicine in 2007shows that 94% of physicians had ties to the pharmaceutical industry. This gravy train only rides in one direction. From Big Pharma to the wallets of doctors. Sure Big Pharma can simply pay doctors directly, and it does plenty of that. It’s no surprise that<a href="https://www.ncbi.nlm.nih.gov/pubmed/20672554" data-href="https://www.ncbi.nlm.nih.gov/pubmed/20672554" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>medical students with more exposure to pharmaceutical reps developa more positive attitude towards them. Many medical schools have limited exposure of medical students in response, but declined to get off the gravy train themselves. There is a simple relationship between how prominent a physician is (more articles published — almost always academic doctors and professors) and how much money they take from Big Pharma.Mo prominent = mo money. Further, there is a<a href="https://www.ncbi.nlm.nih.gov/pubmed/20299696" data-href="https://www.ncbi.nlm.nih.gov/pubmed/20299696" class="markup–anchor markup–p-anchor" rel="nofollow noopener" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>‘clear and strong link’ between taking industry money and minimizing the risk of side effects of medications. What, you thought people teach at prestigious institutions like universities for the good of mankind? Maybe that’s why they went there, but that’s not why they stay. They came for the science. They stayed for the money.
So here’s a damning list of all the problems of EBM
Bribery of Journal Editors
Financial Conflicts of Interests
When the evidence base of medicine is bought and paid for, people die. That is how doctors have created this opioid crisis that kills thousands of people. Pharmaceutical companieswantto pay off doctors, just as drug lord want to pay off judges and police officers. Doctors, being human, should put safeguards against this temptation. Unfortunately, doctors and universities have been willing participants in this<a href="https://www.facebook.com/NathanGillOfficial/videos/2134121280141545/" data-href="https://www.facebook.com/NathanGillOfficial/videos/2134121280141545/" class="markup–anchor markup–p-anchor" rel="noopener nofollow" target="_blank" style="background-color: transparent; color: inherit; text-decoration: none; -webkit-tap-highlight-color: rgba(0, 0, 0, 0.541176); background-image: url("data:image/svg+xml; utf8, “); background-size: 1px 1px; background-position: 0px calc(1em + 1px); background-repeat: repeat no-repeat”>game of killing for profit. We need to end it now. End the corruption of the universities. Stop the bribery of doctors.