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[Editor’s note: Today is a holiday in the US, and your humble managing editor spent much of it working on a grant, a book chapter, and, all day yesterday in Toledo on family business. As a result, I didn’t have time to produce one of my usual 5,000-word epics. I do, however, have a post that some of you might have seen before (and many probably have not) from my not-so-secret other blog, modified and repurposed for SBM. I’ll be back next week as usual. In the meantime, I’ll be holed up working on a grant and book chapter in my air-conditioned office, given that it’s supposed to go up to 96° F here in my neck of the woods. That’s too much heat for me to venture outside without a damned good reason.]

We here at SBM write about naturopathy a lot because, almost alone among alternative medicine “specialties,” naturopaths think of themselves as real physicians. They aren’t, of course. They are basically cosplaying real physicians, but they really do think that their education, training, and methodology are equal to that of MDs (and, in the US, DOs), even though it’s been discussed many times here and elsewhere why they are not, why naturopathic “accreditation” is a joke, and just how low standards are in naturopathic “medical” schools. I personally have discussed many incidents of naturopathic quackery that are, as much as naturopaths deny it, well within the accepted practice of naturopaths. I’m referring, of course, to treatments like the use of saliva from a rabid dog as an “approved” remedy to treat a variety of conditions, how naturopaths can make even Epsom salts fatal, the horror of what happens when a naturopath tries to treat pertussis “naturally,” or, thanks to lax regulations on compounding pharmacies, a clean kill by a naturopathic quack injecting curcumin intravenously. This latter incident, in particular, resulted not in naturopaths in California trying to clean up their acts but rather in their circling the wagons to defend their profession. It was also a very good illustration of why naturopathic licensure doesn’t protect patients from bad naturopaths because naturopathy is quackery by its very nature. “Licensed naturopaths” are no safer than any other naturopath.

Don’t even get me started on “stuff” naturopaths say when they think no non-naturopaths are listening, or the antivaccine quackery that is at the heart of naturopathy, such that the vast majority of naturopaths being antivaccine. Yes, I know that there are a few who are not (although I point out that even some of those, when tweaked, reveal antivaccine tendencies), but they are vastly outnumbered by the majority who range from moderately antivaccine to rabidly antivaccine. (Maybe that could be treated with a bit of homeopathic Lyssinum)

Given that naturopaths are making yet another effort to achieve licensure in my state of Michigan (and, sadly, having some success at it), I’m likely to be writing more than usual about naturopathic quackery (but I repeat myself) more than usual, the better to build an armamentarium of examples of why naturopathy is not medicine and why it endangers patients. So, when several people Tweeted this story at me, I took interest. So did Jann, who wrote about this legislative alchemy last week, but, since I live in the state, I figured it wouldn’t hurt to add my take on the story:

The College of Naturopathic Physicians is investigating a complaint launched against three B.C. practioners.

The registered naturopaths are said to be offering a treatment known as “CEASE” – Complete Elimination of Autism Spectrum Expression. The idea is largely based on the unscientific claim that Autism is caused primarily by vaccines.

In the treatment, children are “detoxified” using a highly diluted version of the causative agent, or toxin, in order to “purify” the body.

Who are the three naturopaths? Another news story reveals their names:

B.C. naturopaths Anke Zimmermann, Janice Potter and Margret Holland are all certified CEASE practitioners, and the college has acknowledged it is investigating the public complaint against them.

Anke Zimmerman? Hmmm. Where have we heard that name before? Oh, yes, I remember. She’s the naturopath who loves to use homeopathy about whose use of a homeopathic remedy supposedly derived from the saliva of a rabid dog to treat a boy with behavioral issues I wrote about last month. She also uses a homeopathic remedy supposedly derived from gonorrhea. (I swear, you can’t make stuff like this up. At least, I can’t.)

So what is CEASE therapy?

First, for those not familiar with homeopathy, I do need to do a little primer again. (I know, I know, there probably aren’t that many readers not familiar with The One Quackery To Rule Them All, but I do occasionally get new readers, and I don’t want to force them to click a link to learn what homeopathy is.) As I like to say, homeopathy doesn’t really qualify even as pseudoscience given that there’s nothing scientific about it and that in reality it shows far more similarity to sympathetic magic than anything else. In other words, there isn’t even enough of patina of science slathered over the quackery to qualify as pseudoscience. It’s magical thinking, pure and simple, in which homeopaths believe that diluting a remedy makes it stronger, but only if it is shaken vigorously (succussed) between each serial dilution step. Even more magically, they believe that it is possible for a compound that has been diluted many orders of magnitude more than Avagadro’s number, such that it’s exceedingly unlikely that even a single molecule of active substance remains, to have a therapeutic effect. They justify this by claiming that water has “memory” and retains some sort of “imprint” of the substance that it’s been in contact with. Never mind that there’s no evidence that water has “memory” beyond an extraordinarily brief period of time. Homeopaths are impervious to reason.

So CEASE therapy involves homeopathy, which is more than enough to make it quackery. That’s not all, though. It also involves the belief that vaccines are the cause of autism, which they are not. So let’s take a look at CEASE therapy again. It’s an invention/delusion of an actual MD (unfortunately) named Tinus Smits, who “discovered” CEASE:

Dr. Smits discovered in his practice with over 300 cases the foundation of CEASE therapy and came to his hypothisis [sic] of what causes autism. In his experience autism is an accumulation of different causes and about 70% is due to vaccines, 25% to toxic medication and other toxic substances, 5% to some diseases. With isotherapy (see below), a form of homeopathy using the causative substances themselves in homeopathic preparation, the toxic imprints can be erased.

He continues:

The treatment of autistic children and even adults has matured through 300 cases over the last three years and is called CEASE Therapy, which stands for Complete Elimination of Autistic Spectrum Expression. Step by step all asumed [sic] causative factors (vaccines, regular medication, environmental toxic exposures, effects of illness, etc.) are detoxified with the homeopathically prepared, that is diluted and potentized substances that were administered prior to the onset of autism. Currently we use the 30C, 200C, 1M and 10M potencies to clear out the energetic field of the patient from the imprint of toxic substances or diseases.

Of course, a 30C dilution means 30 serial 100-fold dilutions, or a 1060-fold dilution. A 200C dilution means 200 serial 100-fold dilutions, or a 10400-fold dilution. 1M means 1,000C, or a 102,000-fold dilution. You get the idea. Indeed, one can’t help in these situations to point out that Avagadro’s number is approximately 6 x 1023. That means if you dilute a one molar solution of something by approximately 12C (1024), then the solution is highly unlikely to have more than one or two molecules of the substance left. Take the dilution up to 30C, 100C, and beyond, and the odds rapidly become vanishingly small that a single molecule will remain. How small? Well, for a comparison that I frequently use when I’m giving talks that include a section on homeopathy, there are only estimated to be approximately 1080 atoms in the observable universe. Also remember, when Smits says that he’s using these different potencies, what he’s doing is increasing the “potency” at each step by using a more diluted remedy:

The duration of a remedy course depends on the severity of the problems and the reactions of the patient and can vary from 2 weeks to 2 months. Potencies should be repeated until no further improvement is seen before passsing [sic] to the next poetency [sic]. After each course a 1 or 2 week break is applied. The administration is carried out by letting 2 granules melt in the mouth.

So basically Smits is deluded into thinking that he’s using increasingly strong medicine to treat his patients.

What, however, is “isotherapy”? Smits is happy to explain:

Using the causative substances as a homeopathic remedy, their profound toxic effects can be witnessed as the children begin to react to the remedies. The reactions on the isopathic remedies are so characteristic, that there can be no doubt about the existence of a link between the toxins as the cause and the development of Autism as its effects although this is not considered as scientific proof. In this way Dr. Smits discovered, step by step, why autism and other behavioral problems, with their specific developmental problems, have so dramatically increased over the last ten to twenty years. It also became clear that autistic children do not suffer from one single cause but from an accumulation of different causes.

Do tell. So it sounds as though Smits uses vaccines and other “toxins” as the basis for his homeopathic “detoxification.” Of course, inquiring minds want to know: How much of each vaccine is in the starting material? Does he replicate the CDC vaccination schedule and then use some of that as his starting tincture for his homeopathic dilutions? This is about as close to an explanation as Smits comes:

The homeopathic method as applied in the treatment of vaccination damage consists of administering four successive remedies of the suspected vaccine.

I’m guessing Smits must use a lot of MMR. Actually, no he doesn’t. After all, if he’s making such diluted solutions of vaccine he could buy one vial and then use it for decades. Later, he claims:

All autistic children should be detoxified using the homeopathically diluted remedies of the vaccines that have been administered to the child.

And:

Autistic children should never again be vaccinated!

One more time. Vaccines do not, as far as science has been able to tell, cause autism. Many have been the epidemiological studies, and none of the large, well-designed ones have found a hint of a whisper of an association between vaccination and an increased risk of autism. By urging that autistic children never be vaccinated again, he is placing them in danger of infectious disease and turning them into vectors to spread infection.

Of course, homeopathy isn’t the only quackery in CEASE. As any good quack is, Dr. Smits is very much into high dose vitamin C, claiming that it “seems to play an essential role in protecting children against the adverse effects of vaccinations or other stress inducing events.” Whether vitamin C plays a role in protecting against stress-inducing events is still up for discussion, but it surely doesn’t prevent, treat, or cure autism.

Let’s conclude by getting to training. The three naturopaths being investigated are listed as being “certified CEASE practitioners.” Apparently, it means undergoing “training” by one of a few CEASE practitioners who appear to be acolytes of Dr. Smits, such as Kim Kalina. There’s a CEASE Facebook page showing various training sessions, such as:

You get the idea. Show up at a CEASE course, and get a certificate that’s not worth the paper it’s printed on. But what do these courses cover? Here’s one by Kim Kalina herself given last summer:

The course will cover

  • how to individualise, evaluate the need for and accurately apply each of the core components of CEASE – Isotherapy Remedies, Orthomolecular Supplements and the ‘Saturday’ Remedies
  • how to recognise which cases are best suited to CEASE vs Classical Homeopathy
  • the additional case-taking skills, questions and information needed in a CEASE case
  • the key ‘ Saturday’ remedies, potencies and posology indicated in autism cases, as well as other frequently indicated remedies in general CEASE cases – including specific Inspiring Homeopathy, Matridonal and Sarcode remedies.
  • the key Orthomolecular supports needed to support cellular detoxification in various types of CEASE cases, including supplements, vitamins, baths, etc.
  • how to apply and adjust the Isotherapy components of CEASE, including resources for info about drugs, vaccines etc. and extensive vaccine charts Kim has personally developed to enable practitioners to quickly identify which vaccine may need to be cleared based on unique characteristic symptoms of each
  • how to manage CEASE cases – this is perhaps the single most important aspect of the training, and Kim uses several of her own cases (not just autism cases), as well as FAQ’s from clients and practitioners, to take participants through many follow-ups, crises, etc. so that practitioners can learn how to handle the many case management issues that can arise and how to correctly interpret and manage each one
  • how to manage herxheimer reactions – don’t know what these are? This is essential info if you want to use CEASE safely and appropriately!
  • other supports and therapies that are very beneficial in CEASE cases, particularly in the management of these complex cases – specific cell salts, bowel nosodes, flower essences and additional therapies to consider that can help the healing process to unfold much more gently and easily

Such a lot of quackery. I note that, elsewhere, it is revealed that Smits died in 2010 and Kalina is carrying on his “legacy,” such as it is. She is also described as “one of the five approved instructors for the CEASE Organization (the others being in the Netherlands, Germany and Sweden), and brings extensive experience in both teaching and clinical case management to the CEASE community.” Kalina also misuses the concept of the Herxheimer reaction, which is sometimes seen after the initiation of antibacterials for tick-borne relapsing fever due to the release of endotoxin-like products by microorganisms as they die off during antibiotic treatment. It was first described as a reaction to the treatment of syphilis with penicillin and is also seen after treatment of other diseases caused by spirochetes, such as Lyme disease and leptospirosis. Yes, basically, Kalina is claiming that CEASE therapy can cause a “healing crisis” in which the patient gets worse before getting better. This is a common claim among quacks.

So what will happen? It’s noted in one story:

College bylaws prohibit false and misleading advertising, including marketing “likely to create in the mind of the recipient or intended recipient an unjustified expectation about the results which the registrant can achieve.”

The college also forbids naturopaths from advising against vaccination unless there is a “sound, and properly documented, medical rationale for doing so.”

I expect that nothing will come of this complaint against these three naturopaths. After all, if any “board” of naturopathy were actually to enforce standards like the ones above, it would have to take away the license of pretty much every naturopath under its regulatory authority.

Michigan legislators, take note. This is what naturopaths want for Michigan, and, if you pass a naturopathic licensure bill into law, this is what they will get.

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Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.