We all have gaps in our knowledge. The trick is not letting on about the gaps, by not mouthing off when we don't know. Emma Mitchell is a natural health therapist. Naturally, her ‘Ask Emma’ column is the first section of the Guardian I turn to as I settle down to morning coffee of a Saturday. Mostly it's harmless stuff, full of boosting immune systems and eliminating toxins for people with intolerable itching and unbearable weariness. The lotions and potions she proposes don't seem too expensive, and I don't suppose their GPs could do any better. But every now and again our Emma shows just how little she really knows.
Her correspondent had ‘a history of digestive problems’ — the sort of history, I am certain, that makes me glad I am an anaesthetist not a GP. Her worry was that she had been diagnosed with benign liver cysts. I can see what happened. After normal barium meal, barium enema, and liver function tests, the digestive problems were still there. Someone ordered an MRI, and whose liver, by the time they are middle aged, does not contain a cyst or two? As we age, so everything gets a bit lumpy. Skin tags and age spots we can see; little lumps in the liver or lung need expensive equipment, but are as medically irrelevant.
Emma started off well, saying that a cyst was an abnormal fluid-filled swelling. She was probably wrong when she thought the previous digestive problems a factor. After which it was time for serious nonsense. Citing a Dr Howard Hay (‘famous for his theories on food combining’), she advised alkalisation, via large quantities of vegetables and reduced meat intake, to prevent further growths. Because, Dr Hay had found, people with a blood pH lower than 7 were more likely to have health problems. On that point, both Dr Hay and Emma are incontrovertibly correct. However, our ICU — which is where patients with such pH's are likely to be found — does not use large quantities of vegetables.
pH more often appears in adverts for shampoo and skin products, although then nirvana is a neutral pH. I don't expect Emma to know that pH is the negative logarithm of the hydrogen ion concentration, but her understanding of simple physiology and homeostasis is woeful. Even drinking sodium citrate in cystitis won't alkalise the blood, although if it doesn't make you vomit it will alkalise the urine. There have been calls for the alternative health sector to be regulated, but how can you regulate things that are just plain wrong?
- © British Journal of General Practice, 2005.
