Quacks in a Potassium Solution

(in Dutch)
Cees Renckens

Reviewed by Mira de Vries

Once again the books I had ordered at the university library were not on the shelf when I came to pick them up. As I was starting to go into literary withdrawal symptoms, I hastened to the nearby discount bookstore. I assure you, I don’t only read books about medicine and healing, but I was in a terrible rush, and the section on medicine happened to be exactly to the left of the store entrance.

It became immediately evident that the store’s ideas about medicine are not the same as mine. There were all sorts of books about dieting, exercise, herbs, ortho-this and manual-that, and other forms of “alternative medicine,” but books that are based on sources of information that I trust were not among them. Then I spotted “Quacks in a Potassium Solution” by Cees Renckens, chairman of the Association Against Quackery (AAQ). It was published in 2000. After a brief pause at the cash register to pay for it, I rushed to my appointment where I now had something to read in the waiting room.

You know that in my way I am constantly battling against quackery. I expected to have found an ally in Cees Renckens. He is a physician (gynecologist) and would be able to arm me with irrefutable arguments. Alas…

Legitimate arguments I did not find anywhere in the whole book – nearly 300 pages of tiny type.

Renckens repeatedly describes non-physicians as “people who are not used to thinking scientifically.” But his description of practitioners of alternative medicine – he calls them “alterns” – don’t sound in the least scientific. “Quacks reside according to Dante in the deepest regions of Hell,” {pp 25-26} says Renckens, “should be brewed in their own contaminated stew,” {p46} “[are] rude apes,” {p128} “remind us of a rare group of scum, {p133} “[are] bone-heads,” {p150} “[are] scatterbrained or  … criminals,” {p151} and “ [are] medical juvenile delinquents,” {p222}. 

Their publications “should be sent along with the trash man … Some book burnings deserve everyone’s approval,” {p122} and “He who reads said publications aloud longer than ten minutes will get stinky breath,” {p282}.

Renckens reserves his deepest hatred for licensed physicians who do alternative healing on the side. They have “delusions of grandeur, excessive drive to distinction, and other character neuroses, and even more gross psychiatric problems,” {p 155}. When the reumatologist, professor Rasker, cooperates with scientifically set up research on an alternative medicine – which leads to the conclusion that it is indeed a quack remedy – you’d think Renckens would shout “hooray.” But no, he insults the professor, the professor’s father, and the university that employs the professor {p259}.

Why is Renckens not happy when proof of his position is provided? After all, repeatedly in his book he posits that alternative treatments should meet the same criteria as conventional treatments. Why, then, does he repeatedly say in the same book, that alternative treatments should not be investigated at all? Does he fear that such an investigation might turn out favorably for the alternative treatment?

Renckens himself explains it this way, “A positive outcome must be considered an industrial accident,” {p197}. Research on homeopathy is not dependable, says Renckens, because “negative research results will not be readily published,” {p213}. The research with which Rasker cooperated, and which exposed the investigated product as not more effective than a placebo, was in part sponsored by the manufacturer. Try and find publication of such a result at one of the pharmaceutical giants! When they reach a positive result, is that also “an industrial accident”?

Renckens doesn’t want us to investigate alternative treatments at all. That only extends honor to the alterns. We also shouldn’t bother to read their explanations, nor should we believe statistics {p34&196}, but we should believe statistics when they regard conventional treatments. We are to blindly reject the alterns and to trust Renckens when he says that they are quacks “because not a single theoretical explanation can be conjured up” {p34 et al}. So what should we believe in? “[T]ruly effective medicines, such as … tranquilizers [in English]” {p38}.

I almost agreed with Renckens when I read, “That category causes psychogenic problems to be medicalized. It causes somatic fixation and a relationship of dependence with the therapist. It impedes a more sensible approach, as the patient is presented an absurd explanation for his symptomatology.” {pp 40-41}. Too bad, Renckens is referring to acupuncture, and that “more sensible approach” is, according to him … psychiatry!

Surely the reader will join me in suspecting that something other than scientific objections is bugging Renckens. He says it best himself: “Could it be that conventional physicians fear competition?” {p73}. After all, Renckens admits, before ratification of the Thorbecke law [establishing state regulated medicine] in 1865 “the difference between quackery and officially sanctioned therapy … was based more on differences in training and recognition of authority (the guilds) than on any important differences in medical achievement,” {pp 58-59}. In other words, in those days, it was all quackery. The Thorbecke law replaced the guilds with state licensing. Renckens extols the Thorbecke law that established the “physicians’ monopoly” according to him, “not to protect the position of the physicians, but solely to protect the position of the patient,” {p127}. Yet this law was drafted due to “strong lobbying” by the physicians’ professional organization {p145} which defends physicians’ interests {p207}. Why was it necessary to found the AAQ in 1881, if the physicians had already won their place in government? Because the demand for non-conventional treatments remains until today unabated, in spite of the Thorbecke law.

Repeatedly throughout the book Renckens calls on the government to deny (tax)money, subsidy, semi-government support, and recognition to alterns. At the same time, he urges government to expand rather than cut funds to “professional brothers” {term p173}. Renckens would like to see alternative therapies “totally annihilated.” The impression remains that the AAQ, founded before there were any “scientifically thinking people,” then and now simply tries to discredit the competitor.

Why? On page 73 Renckens doesn’t mind so much that someone spends his own money on alterns, seeing as how much money is spent in the Netherlands every year on prostitution, fireworks, and cosmetic treatments – even though on page 72 he calls someone who spends his money on an altern a “victim.” No, his objection is that alternative treatments:
  • encourage medicalization and somatic fixation. Huh? Which treatments do that???
  • isolate the patient. Because, you see, if he is prescribed a diet by the altern, then the patient will no longer be able to accept dinner invitations!
  • present the patient with an absurd image of anatomy physiology, and therapy.
But Renckens’ first objection, every doctor’s trump card, is that alternative medicine:
  • can …kill {p74}.
This may ring familiar to those who are familiar with the Bible: Whoever is unfaithful to the One and Only True Healer, will be punished by death. Renckens in his conceit positions himself and his “professional brothers” above “normal people” and alongside the Almighty.

To defend his position, he tells two anecdotes. The first is related without source reference. Renckens claims to have heard from someone else about a toddler with an infection of the valve at the top of the esophagus who supposedly nearly died in emergency room because the parents wished to try an alternative treatment first {p55}. Noteworthy about this unlikely story (because the parents would not have brought the child to the emergency room if they did not seek emergency conventional treatment) is that on page 33 Renckens warns us precisely against belief in this type of unconfirmable anecdote, which is likely to have burgeoned into a life of its own. It will be clear by now that Renckens, who accuses others of hypocrisy {p222}, is guilty of it himself. The other incident regards Flora, a woman with cervical cancer who “evaded” (as though she didn’t have the right!) gynecology, preferring an alternative treatment. This time Renckens quotes a source: The Dutch newspaper Trouw. The case of Sylvia Millecam had apparently not yet transpired when “Quacks in a Potassium Solution” went to press. [She was a well-known TV actress who died of breast cancer after having lived in her alternative therapist’s home during her last months.]

Renckens overlooks the fact that, as he himself admits elsewhere in the book, most people by far who turn to alterns do so with annoying but not terminal conditions such as itching or pain for which conventional medicine has not been able to provide relief; or with terminal illnesses that cannot be cured by conventional medicine either; or with conditions that are not at all somatic. Cases such as Flora and Sylvia are extremely rare, which is exactly why they hit the headlines. In addition, there is no indication that if the government had succeeded in annihilating alternative treatments, Flora en Sylvia would have agreed to submit themselves to Renckens and his “professional brothers.” On the other hand, it is no longer a secret that most mastectomies and hysterectomies are unnecessary because more conservative treatment suffices but is not offered. Oh, how the professional brothers enjoy chopping off female body parts!

That sounds nothing like the “loving care, sympathy, aid, and support of the family” {p185} and “virtues” {p50} that Renckens ascribes to himself and his kind, but claims we cannot receive from the alterns. Have you ever noticed any of it? In addition, conventional physicians offer “assistance in dying” {p185}. But when euthanasia upon request is provided by a licensed physician who also happens to be an altern, Renckens calls it “murder” {p221}. Hypocrisy, again.

Only in one place, on pages 171-172, does Renckens entertain some mitigating comments. He quotes the physician Knipschild: “The way medicines work isn’t relevant. Conventional doctors also don’t know how aspirin works!” and “There are only effective and ineffective treatments, and that differentiation runs straight through both conventional and alternative medicine.” I read on in suspense. What will Renckens reply to these arguments? He doesn’t, anywhere, in the 297 pages.

By now we know what Renckens thinks of alternative therapists. What does he think of you and me? For us, there is “no greater disaster than two physicians who give conflicting advice” {p47} or “contradict each other” {p74}. We are “in general equipped with little ability to discern” {p 121}. And we allow ourselves to be “seduced by all sorts of irrelevant ‘attractions’ such as the right to a second opinion.” {p121}. “A male physician with an earring or a tattoo will not soon win the trust of his patient,” {p50} which is a calamity for Renckens and his kind, as in the absence of scientific arguments, loving care, or positive results, they have nothing but their aura of authority with which to snare us.

If we believe in the alterns, we are “medical bulk users” who also bother many conventional physicians with our hypochondria {p135}. If we “advocate some well set up trials [English] testing the efficacy of homeopathy” then we are “a clown” {p 217}.

It is clear that Renckens opposes medical and therapeutic self-determination as well as thoroug information for patients. We are to obey him. Period. For our own good.

Not unjustly Renckens fears the fading away of the boundary between conventional and alternative medicine. What would happen if that boundary disappeared? Then both forms of medicine might be judged by the same criteria (as he sometimes advocates himself). Let’s turn it around. Not the alterns have to meet the same criteria as the conventionals, but on the contrary, we test the conventionals by the same criteria that ordinarily are applied to the alterns. How would Renckens and his colleague physicians do?

Instead of asking, “Is the treatment legal? Has it been approved by a medical-ethical committee? Is it the standard treatment that every physician would apply?” we ask “Is it effective? Is it safe? Is the client satisfied?” It could well turn out that in Renckens’ practice, next to a minority of sensible treatments, quackery prevails.

On the side, I first heard of the AAQ when my son was studying pharmacochemistry at the Free University (not really free) under professor Timmerman, whom he deeply respects. Timmerman is also an active member of the AAQ and is mentioned by Renckens several times in the book. A pharmacochemist, contrary to most physicians, really understands drugs.
At the time I visited the AAQ web site and was surprised to see that there are also psychiatrists among the members. I contacted one of those psychiatrists. Unfortunately, I’ve forgotten his name. He phoned me, and at his own expense, talked to me at length about the AAQ. He was most friendly. I did not tell him who I am and what I stand for, or the conversation might have been much shorter!

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