People often remain silent about what they really think  …

Alternative medicine controversies spark intriguing debates and discussions worldwide. I have been studying the lectures and seminars that took place at SupplySide West last month, and I’m particularly interested in the parts that the FDA and the FTC play in the nutritional supplement industry. It seems to me that the following excerpt from Jonathan Dimbleby’s book entitled "The Prince of Wales A Biography” © 1994 Little, Brown & Co., pp. 306-311 is relevant. A structure/function claim is allowable with proper foundation, but a health claim is not under most every situations. There are even lawyers prosecuting class action suits that target companies who advertise supplement products, using questionable language. Strange how people form their beliefs.

“I have often thought that one of the less attractive traits of various

professional bodies and institutions is the deeply engrained suspi-

cion and outright hostility which can exist towards anything

unorthodox or unconventional. I suppose it is inevitable that some-

thing which is different should arouse strong feelings on the part of the

majority whose conventional wisdom is being challenged or, in a

more social sense, whose way of life and customs are being insulted by

something rather alien. I suppose, too, that human nature is such that

we are frequently prevented from seeing that what is today's unortho-

doxy is probably going to be tomorrow's convention. Perhaps we just

have to accept that it is God's will that the unorthodox individual is

doomed to years of frustration, ridicule and failure in order to act out

his role in the scheme of things, until his day arrives and mankind is

ready to receive his message, which he probably finds hard to explain

himself, but which he knows comes from a far deeper source than

conscious thought.

Those were not private reflections but public words addressed by

the Prince of Wales as president of the British Medical Association on

the 150th anniversary of its foundation in December I982. Using his speech

to attack some of the fundamental tenets of a hitherto impregnable pro-

fession. The theme had its source in the Prince's own immersion in the

unconventional values of oriental culture, the writings of Jung, and the

mystical revelations about the natural world he shared with Laurens Van

der Post. But as was often to happen, the particular inspiration came

under the pressure of a deadline. On this occasion, he was at Highgrove

in his study wondering precisely what to say at such an august gathering.

He wandered across to his bookshelf and picked up a book about the

sixteenth-century healer Paracelsus. He read a few pages, and suddenly

a host of ideas and emotions took shape and found their expression in

what the medical profession came to regard as a seminal outburst. No

other hand was involved, neither adviser nor specialist --- but only, as the

Prince would say, 'my intuition'.

The Prince told his audience that the principles upon which

Paracelsus had based his treatment 400 years earlier 'have a message for

our time: a time in which science has tended to become estranged from

Nature'. In particular, he noted, paraphrasing Paracelsus who had been

reviled in his own time, the doctor:

should be intimate with Nature. He must have the intuition which

is necessary to understand the patient, his body, his disease. He must have

the 'feel' and the ‘touch' which makes it possible for him to be in sym-

pathetic communication with the patient's spirits ... the good doctor's

therapeutic success largely depends on his ability to inspire the patient

with confidence and to mobilise his will to health . .

In essence, the Prince was arguing for 'holism'. Closely aligned to the

psychology of Jung and to various reinterpretations of the structure of

the natural world, explored by scientists like James Lovelock, who for-

mulated the Gaia hypothesis, the concept of ‘holism' (a term which

brought a curl to the lips of scientific materialists) invoked the principles

of harmony, balance and the interconnectedness of natural phenomena,

combining them with the search for inner awareness. Though he did not

yet use the term 'holism' himself, the Prince did not shrink from urging

that 'healing' should be reincorporated into the practice of medicine. He

reminded his profoundly sceptical audience that 'through the centuries,

healing has been practised by folk-healers who are guided by traditional

wisdom that sees illness as a disorder of the whole person, involving not

only the patient's body, but his mind, his self-image, his dependence on

the physical and social environment, as well as his relation to the cosmos'.

In a final flourish, while being careful to declare that he was a powerful

supporter of modern methods in medicine', he bemoaned the nation's

‘frightening' dependence on drugs (then costing the National Health

Service more than billion pounds sterling a year) as a ‘universal panacea' and declared

that ‘the whole imposing edifice of modern medicine, for all its breath-

taking successes, is, like the celebrated Tower of Pisa, slightly off balance'.

The vivid imagery and the radical thrust of his words sent a shudder

through the medical establishment, both the practitioners and their sym-

biotic partners in the drugs industry. It was not the first significant speech

the Prince had made, but it was by far the most opinionated and, strik-

ing at the heart of a conventional culture, by far the most controversial.

As he had suspected, it brought down on his head a form of praetorian

wrath not so very different from that which Paracelsus had once endured.

Nor was the royal evangelist at all certain about when or if, 'his day'

would arrive.

The Prince's apostasy was as inspiring to the practitioners of 'alterna-

tive' or ‘complementary' medicine as it was outrageous to conventional

opinion. His intervention sparked off an acrimonious debate in which

the only common ground between the two sides was that the Prince's

devastating intervention had suddenly changed the ground rules for their

internecine combat. It would no longer be so easy for the medical estab-

lishment to dismiss 'alternative' practitioners as a ‘fringe' of quacks and

eccentrics. However reluctantly, they were obliged to participate in the

debate which the Prince had instigated, though they did not suppose for

a moment that it would lead to a process through which, by the end of

the decade, the virtues of ‘complementary' medicine were so widely

acknowledged as to make the original furore seem quite antediluvian.

In June that year, the Prince fanned the flames of the debate by

returning to the theme of his speech in a written message as the out-

going president of the BMA. In July, he heaped fuel on the fire by

accepting an invitation to open the Bristol Cancer Help Centre, which

had been running for three years, offering alternative therapies including

yoga and meditation for its patients, many of whom were terminally ill

and beyond hope of recovery by conventional means. Orthodox spe-

cialists were aghast at his decision to sponsor what one of them, a

prominent Bristol surgeon, Dr Elizabeth Whipp, described as a set-up

which was ‘full of bogus notions' .

Besieged by opposing forces, the Prince decided to intervene again,

but not so publicly. With the help of Lord Kindersley, he arranged a pri-

vate dinner at Kensington Palace in the autumn of 1983 for leading

figures from the opposing sides. Among the guests were a chiropractor,

a herbalist and the presidents of all the leading medical colleges, includ-

ing the president of the Royal Society of Medicine, Sir James Watt,

who was to play a key part in changing the climate of orthodox opinion.

The scene was set for an almighty collision of attitudes. Instead, the pro--

tagonists retreated from one another, the representatives of orthodox

medicine being particularly muted, either too embarrassed or too polite

to challenge their opponents in front of the Prince. According to Lord

Kindersley, the Prince gradually drew them into conversation, breaking

the ice between them with humour and charm. ‘It was' , he remembered,

‘a brilliant Start to what became an unstoppable movement.’ The Prince

began by briefly restating his own position and then went on to suggest

that the provision of health care had become too impersonal and remote,

that patients were ‘whisked off to hospital' for treatment without the per-

sonal consultation for which most individuals longed. He proposed that

the medical profession should re-examine its methods, procedures and

attitudes without prejudice and in a spirit of humility. He then went

round the table asking everyone for a contribution. Only one of the

orthodox practitioners spoke openly against 'alternative' medicine; the

others, whatever their true feelings, were restrained and conciliatory.

According to Sir James Watt, the Prince was so ‘gracious and under-

standing'` that his case for a serious examination of the issues at the

highest level became irresistible. When the Prince asked about the next

step, there was a brief silence until Watt spontaneously decided to offer

the resources of the Royal Society of Medicine to explore the issue fur-

ther, an offer which the Prince at once accepted.

When Watt informed the officers of the RSM of his offer, they were

incredulous at what seemed to them an entirely inappropriate gesture,

view which they were confident would be shared by the great majority

of their 18,O00 members once their opinions had been canvassed,

Despite Watt's plea that it was in the distinguished tradition of the

Society to take up controversial causes, they did not hesitate to warn that

his proposal threatened to bring their august institution into disrepute,

According to Watt, his trump card - without which he would have lost

the argument -- was the Prince of Wales. Reminded forcibly of his con-

cern, the officers finally backed down and eventually agreed, though

with great reluctance, that the RSM should host eight colloquia to

explore the possibilities of collaboration with ‘alternative' therapists.

In parallel, the British Medical Association also felt driven by their

president's valedictory message to set up an internal working party to

examine the role and practice of ‘alternative' therapies. However, by

inviting submissions from all manner of fringe therapists, the working

party alienated the mainstream practitioners of complementary medi-

cine - the qualified osteopaths, chiropractors, naturopaths, herbalists,

homoeopaths and acupuncturists - who, for the most part, chose to

boycott an inquiry which they suspected had only been set up to con-

firm the orthodox prejudices of the ‘trade union' which it represented.

The colloquia organised by the RSM, which began in I984, not only

boasted more distinguished participants, but were much more thorough

in approach. Under the chairmanship of Sir James Watt, they were con-

ducted in camera to protect the participants from the glare of the media.

With the Prince of Wales in attendance at three of the sessions to urge

them on, the protagonists argued from first principles in search of com-

mon ground. The challenge was to overcome mutual suspicion, to

explore the techniques adopted by alternative therapists, to establish a set

of criteria to evaluate them, to identify shared concepts of treatment, to

review the history of research into traditional therapies, and to pioneer

standards of training and practice for complementary therapy that would

meet the exacting demands of a sceptical establishment.

A glimpse of the obstacles in the way of finding a consensus emerged

when a participant in one of the early colloquia took the Prince to task

in the Evening Standard, under the headline ‘With respect Your Highness,

you've got it wrong'. Castigating an ancient philosophical approach that

had ‘remained unchallenged through the Dark Ages and is enjoying its

own Renaissance in the year I984', the Professor of Surgery at King's

College Hospital School of Medicine, Michael Baum, was particularly

scathing about ‘fringe' practitioners who collected only corroborative

data to justify their therapies. Their evidence, he complained, amounted

usually to no more than ‘anecdotal case reports' and formed part of an

historical process which was littered with ‘the tragic consequences of

adopting therapeutic revolutions on the basis of a plausible hypothesis

in advance of its scientific testing' . Although he exempted some of the

alternative therapists at the colloquia from his strictures, he concluded

that others were ‘guilty of the most extreme intellectual arrogance,

or more charitably, of confusing faith with fact'. It was to be a long and

rocky path, only somewhat smoothed by further dinners at Kensington

Palace.

Popular reaction to the Prince's part in the debate was far less scepti-

than he had feared. ‘It was unbelievable’,  he told an interviewer some

months later, ‘I have never, ever had so many letters. I was riveted by this

because while I was pretty sure I was going to stir up a hornet's nest

which I did I think - I also realised there was a great deal more interest

and awareness of this aspect than I'd imagined.' Concluding from this

response that ‘people often remain silent about what they really think  …

they are terrified of saying something in case “everyone” should think

they are mad', he went on, ‘I find I feel this about a lot of things.’ “

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