Alternative Facts On Alternative Medicine
Regarding Rabbi Yair Hoffman’s review of Alternative Medicine in Halachah by Rabbi Rephoel Szmerla (“Medicine and Mysticism,” JulyÂ 7) and his article about applied kinesiology (“Moving Away from Kinesiology,” JulyÂ 14):
Rabbi Hoffman writes, “Rabbi Szmerla dismisses the view of Rav Dovid Morgenstern, shlita, Rav Elyashiv, zt’l, and Rav Nissim Karelitz, shlita, regarding the definition of what would constitute a refuah bedukah–a tested and certain cure.” Nothing could be further from the truth. Rav Szmerla clearly shows (see ×¢×ž×³ ×§×¡×-×§×¡×“) how his understanding in this matter coincides with everything Rav Elyashiv wrote on the subject, as well as with what all Acharonim and poskim wrote, except for Rav Morgenstern (see ×¢×ž×³ ×§×¡×–-×§×¢). And he also states that anyone who will review Rav Morgenstern’s sources will realize that they are totally inadequate, nothing but misquotes.
Additionally, to claim that one needs scientific studies and elaborate statistics to establish a therapy as refuah bedukah is ludicrous, as Chazal in the Gemara clearly classified various remedies as refuah bedukah without the existence of double-blind studies or statistics. The Gemara and Shulchan Aruch are quite explicit that three consecutive positive results suffice to consider a remedy as refuah bedukah. This does not mean that Chazal were ignorant of the placebo effect or dismissed it. Chazal were aware of it (as mentioned in Meiri), but they knew that only 20 to 30 percent of positive results may be attributed to it. And they understood statistics. They knew that the chances of experiencing three consecutive positive results due solely to a placebo effect are 1/5 Ã— 1/5 Ã—1/5. Less than 1%. Meaning, there is a 99% chance that such therapy is having a real beneficial effect and not just placebo. And they considered 99% enough proof to classify something as refuah bedukah and be mechalel Shabbos for it.
Rabbi Hoffman also writes, “The American Cancer Society has remarked, ‘Available scientific evidence does not support any claims that TT [therapeutic touch] can cure cancer or other diseases.’” A truly laughable statement. It’s like trying to disprove the pharmaceutical value of aspirin by asserting that “available scientific evidence does not support any claims that aspirin can cure cancer.” No one ever claimed that therapeutic touch alone can cure cancer!
Lastly, Rabbi Hoffman complains that Rav Szmerla claims many worthless therapies are effective, without bothering to justify his position. In truth, it is quite obvious that Rav Szmerla wrote his sefer for the benefit of the practitioners and patients who are convinced of these therapies’ effectiveness but want to know which of them are permitted and which are not. He never meant it for the skeptics such as Rabbi Hoffman, and that’s probably why he didn’t bother trying to prove his position. And anyway, for the skeptics bent on conventional medicine only, even scientific studies proving the validity of applied kinesiology, therapeutic touch, etc. (and there are many such studies) will not convince them.
As a clinician in practice for almost 40 years, I treat a hospital department chairman, a neuroradiologist, surgeons, internists, psychologist[s], and psychiatrist[s]. These traditionally trained medical professionals come for care along with their families specifically because I use applied kinesiology (AK), not health kinesiology (HK), and other noninvasive procedures.
The governing body for applied kinesiology, known as the International College of Applied Kinesiology, has over 1,000 professional members, with the great majority being medical doctors. So for Rabbi Hoffman to spew rhetoric that does not reflect a view from the international governing body but from a few non-professionals taking weekend courses, and then dispense this information, shows a lack of honesty. He knows not of what he speaks. Rabbi Hoffman, as a non-clinician, presents his perspective without even interviewing a single doctor that practices in this manner.
In his latest article, the definition of AK does not discuss “energy.” It does, however, discuss “manual muscle testing,” a standard in the medical profession, and “other conventional diagnostic methods.” Perhaps he has issues with clinical nutrition or meridian therapy or cranial or spinal manipulation. One needs to recognize his strong bias that does not hold up under scrutiny.
Jeffrey E. Weber, DC, DCBCN
Rabbi Hoffman responds:
Thank you for taking the time to respond to the important series of articles on various forms of fraud in the world of alternative medicine, particularly the form known as applied kinesiology. As you well know, virtually every established hospital, medical school, and insurance company believes that there is no statistical validity to such forms of therapy and diagnosis, despite the attempts to obscure these facts. Kinesiology is a legitimate study in medical schools; applied kinesiology is not. In an attempt to gain legitimacy, practitioners of AK often blur the lines between these two.
Since this is an important issue, I will take the time to address your response, paragraph by paragraph.
In paragraph number two, you describe Rav Morgenstern’s sources as totally inadequate and nothing but misquotes. Rav Morgenstern was one of Rav Elyashiv’s closest talmidim. He is well-respected throughout the world and especially among world-class poskim. Rav Elyashiv trusted him implicitly. Rabbi Szmerla may be a talmid chacham, but he is in no position to state that his position “coincides with everything Rav Elyashiv wrote on the subject.” Rav Elyashiv held that Rav Morgenstern knows kol haTorah kulah. He did not freely give out such descriptions. One can ask the family members of Rav Elyashiv to see how much Rav Elyashiv trusted Rav Morgenstern. Rav Morgenstern was meshamesh Rav Elyashiv for three decades. To have a sefer that dismisses the statements of a talmid muvhak because of a few minutes of conversation is the height of chutzpah.
Next, you create a straw man to attack. I pointed out that Rav Morgenstern writes that a cure must be statistically valid. You, on the other hand, describe it as “elaborate statistics.” No, sir. The alternative to statistically valid is statistically invalid. Let us realize that many illnesses resolve naturally, many were psychosomatic in the first place. Kamiyas have a different halachic status, as seen in their intricate halachos. Then you describe as “ludicrous” the statement of the American Cancer Society. Specifically, it was made in the American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies (2nd ed.) in the section on applied kinesiology (pp. 160—164). The American Cancer Society has been at the forefront of supporting the funding of cancer researchers. It is a venerable organization that has been instrumental in curing cancer for millions of people.
So you have demeaned one of the most trusted rabbanim in Yerushalayim, as well as an organization that has saved millions of lives. For what purpose? To defend the practices of “alternative healers”–which most doctors in this country have described as quackery and theft. Imagine for a moment if someone were to diagnose and repair cars using these techniques, using jewelry or gems to diagnose why the “check engine” light went on. It would be preposterous.
In paragraph five, you say that Rabbi Szmerla need not prove his claims that these therapies are effective because he was only writing for believers. This is disingenuous; he is attempting to prove that it is halachically permitted because they are effective through teva, nature. And yet he does not prove that assertion. The main objection is that he fails to cite any of the studies in legitimate medical journals that prove these therapies to be statistically invalid.
Paragraph six is disingenuous as well because you write how you treat all of these medical personnel while skirting around the issue that hospitals don’t grant medical privileges to AK practitioners as AK practitioners.
In paragraph seven, you say that the ICAK “has over 1,000 professional members, with the great majority being medical doctors.” I don’t believe that at all. I don’t think there are 500 medical doctors in that organization. Unless, of course, you are redefining what “medical doctor” means. Rather than “medical doctor,” ICAK’s website uses the term “doctor member,” which they define as “any health professional who has completed professional postgraduate education with a minimum of 3,500 hours and received a degree such as DC, DDS, DMD, DO, DPM, MD, ND, PhD in Psychology, with a license to diagnose if available under his/her local law.”
Lastly, you claim that I have biases that do not hold up to scrutiny. Readers may scrutinize the science-based articles listed below, among others.
There are plenty of people that charge significant sums of money for therapies that have been disproven, and that includes applied kinesiology.
Baggoley C (2015). “Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance.” Australian Government Department of Health. Gavura, S.: Australian review finds no benefit to 17 natural therapies. Science-Based Medicine (19 November 2015).
Russell J, Rovere A, eds. (2009). “Applied Kinesiology.” American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies (2nd ed.). American Cancer Society. pp. 160—164. ISBN 9780944235713.
Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R, et al. (2008). “Allergy diagnostic testing: an updated practice parameter.” Ann Allergy Asthma Immunol. 100 (3 Suppl 3): S1—148.
Haas, Mitchell; Robert Cooperstein; David Peterson (August 2007). “Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review.” Chiropractic & Osteopathy 15 (1): 11.
Cuthbert, S C; Goodheart, G J (March 2007). “On the reliability and validity of manual muscle testing: a literature review.” Chiropractic & Osteopathy 2007 15 (1): 4.
I did not appreciate Yair Hoffman’s negative review of R’Â Szmerla’s sefer. The way he put down holistic healing shows his lack of knowledge in this area and I have to question what his motives for this article are. I am part of many holistic groups of hundreds of mothers who are healing their children through homeopathy, essential oils, nutrition, chiropractic, and so many other modalities. I don’t need science to tell me whether it works or not–because I personally see the results with my own children.
And if you think it’s all “placebo” based, let me tell you a story.
My daughter was suffering from red, itchy eyes this past winter. I thought she had pinkeye, so I used colloidal silver and tea bags to help cure her infection. For the first time ever, it didn’t clear up her eyes! I was using every remedy in the book and nothing was working. Then someone mentioned that because of the unusually warm weather (it was February), people were exhibiting seasonal allergies. My daughter suffers terribly from seasonal allergies! It clicked in my head that I need to treat her for allergies, and so I gave her a spoon of raw, local honey. Within 2 minutes, her symptoms went away. Now, had this all been a placebo effect, all in her head, she would have been cured with the first remedy. Hashem created a wonderful world of cures growing in our own backyards. And they don’t need a patent to work!
There happens to be plenty of scientific research on natural remedies, but the media which is bought out by the medical industry doesn’t give it the publicity it deserves.
Editorial response: This letter raises several issues that those who would provide medical care for their children or for themselves ought to be concerned with:
- “Natural” does not equal safe or effective. Arsenic, lead, and cobra venom are just as “natural” as silver and honey. The fact that some ingredients found in nature have the potency to cure illness is itself an indication that they can also be dangerous if misused. This is especially true when they are provided in concentrated forms that do not exist in ordinary foods and drinks but only in commercially available supplements. Such products may be produced with minimal government regulation and oversight and with little proper quality control.
- Those who are not trained to tell the difference between an allergic reaction and an eye infection may wish to enlist the aid of a licensed medical professional who can do so and who can recommend steps to prevent spreading a contagious condition to others, such as by prescribing antibiotics if warranted.
- Regarding colloidal silver, WebMD reports that “colloidal silver products were once available as over-the-counter drug products, but in 1999, the U.S. Food and Drug Administration (FDA) ruled that these colloidal silver products were not considered safe or effective.” The site further states, “Colloidal silver is likely unsafe when taken by mouth, applied to the skin, or injected intravenously (by IV). The silver in colloidal silver products gets deposited in vital organs such as the skin, liver, spleen, kidney, muscle, and brain. This can lead to an irreversible bluish skin discoloration that first appears in the gums. It can also stimulate melanin production in skin, and areas exposed to the sun will become increasingly discolored.”
- When dealing with a medical condition whose cause is unknown and that has not been properly diagnosed, it is probably not a very good idea to use “every remedy in the book,” natural or otherwise.
- Any benefits to allergy sufferers from ingesting raw honey are presumably due to traces of pollen in the honey, so the potential may exist for an adverse allergic reaction as well.
- The “natural supplements” industry is a multibillion-dollar industry in its own right. Treatments and remedies should be chosen based on the best medical information available, not on how much publicity they receive in the media or which industries they are promoted by.
Nutraceuticals (dietary supplements, vitamins, minerals, herbals, etc.) are products that come from food sources and are advertised as providing extra health benefits. There is certainly no question that the human body requires vitamins and minerals. However, nutraceuticals are marketed to treat diseases such as cancer, arthritis, ADHD, and mental-health disorders, among others, for which there is little, if any, data proving benefit. Note that ads for nutraceuticals are required by law to carry a disclaimer: “These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, prevent, or cure any disease.” In fact, when subjected to rigorous scientific study, many of these products have been shown to be of absolutely no benefit.
Even more important than the fact that most supplements do not provide their advertised benefit, they can actually cause patients harm. This is due to their unregulated nature and the fact that people use them to self-medicate rather than on the advice of a physician. I would like to cite a few facts on this topic from the Merck Manual (Consumer Version), the oldest continuously published medical textbook and the world’s best-selling medical textbook:
- Although dietary supplements must have a history of safety, their manufacturers are not required to prove their safety and effectiveness.
- Only a relatively small number of supplements have been studied rigorously, and most of these studies have not been designed well enough to provide clear, reliable answers.
- Supplements, unlike pharmaceutical drugs, are not regulated to ensure that they are pure or that they contain the ingredients or the amount of active ingredient they claim to contain. As a result, the supplement may contain other substances, including, in some cases, prescription or nonprescription drugs and even dangerous substances such as mercury.
- The amount of active ingredient in a dose of a supplement may vary, especially when whole herbs are ground or made into extracts to produce a tablet, capsule, or solution.
- Most herbal products are mixtures of several substances, and which ingredient is the most active is not always known. Therefore, determining which ingredient or ingredients should be considered active and thus subject to standardization can be difficult.
- Supplements can interact with both prescription and nonprescription drugs. Such interactions may intensify or reduce the effectiveness of a drug or cause a serious side effect.
- In contrast, both prescription and nonprescription (over-the-counter) drugs have been extensively and systematically studied by researchers and reviewed for safety and effectiveness by the FDA. These studies include those in animals to detect the development of cancer and organ damage and those in humans to detect any signs of toxicity.
In conclusion, I would strongly encourage consumers to defer to their physicians on the safety and efficacy of any supplements they are considering. Taking this step could potentially save them and their loved ones from harm either directly associated with the supplement or from not following a treatment plan that would effectively treat the condition.
Binyomin Greenberg, MD, FAAP
I read your publication each week and find it refreshing and open-minded. That is why I was so surprised and dismayed to read the article by Yair Hoffman where he puts down an entire well-researched book by the esteemed Rav Szmerla. This does not appear to be an objective article. He basically delegitimizes every kind of alternative-medicine approach. Furthermore, he appears to have an agenda in striking fear or bullying those that don’t solely ascribe to Western medicine. It is so important to have honest journalism. This is not.
I concur with Rabbi Hoffman (“Moving Away from Kinesiology,” July 14) that kinesiology has its limitations viz. divination like asking about the compatibility of a potential shidduch, as he mentioned in his article. However, where I disagree with Rabbi Hoffman is that he categorically discounts any permitted use of kinesiology according to halachah. In his recent book, Alternative Medicine in Halachah, Rabbi Szmerla writes about the very letter authored by Rabbi Elyashiv mentioned in Rabbi Hoffman’s article which forbids the use of kinesiology; however, this sefer further states that Rabbi Elyashiv did permit kinesiology in a later teshuvah.
Rabbi Szmerla’s book comprehensively covers the subject of kinesiology and other alternative modalities like the aura, homeopathy, brain gym, remote testing, and others. This sefer is approximately 200 pages in length of text and about another 200 in notes and references.
The bottom line about kinesiology is this: It is permissible to use it for physical and mental health because it does not use outside means nor does it foretell the future. It is neither kishuf nor kosem because it is using the body’s intelligence to access information for healing.
While one must be careful to acknowledge the Ultimate Healer, misuse of kinesiology by having the wrong intentions doesn’t discount any good or permitted use of this modality for people’s good and improved health. One is obligated to guard his health–v’nishmartem me’od l’nafshoteichem–and should use any permissible means to do so. I encourage the rabbi and others to read this sefer.
Note: Rabbi Hoffman reviewed Rabbi Szmerla’s sefer in the JulyÂ 7 issue (“Medicine and Mysticism,” Page 1).
Rabbi Hoffman paints a picture of negative practices and halachic violations of kinesiology practitioners. While a kinesiologist who is inconsiderate of their client’s time is no different than a doctor or any other service provider who has poor office management, the one-sided picture he paints of halachic pitfalls of kinesiology omits vital information.
Rabbi Rephoel Szmerla of Lakewood has written a balanced, well researched and documented sefer about all facets of alternative medicine. It has 15 haskamos, including such major authorities as Rabbi Shmuel Kamenetsky (Rosh Yeshiva of Talmudical Yeshiva of Philadelphia), Dayan Gavriel Krausz (Rosh Beth Din, Manchester), Rabbi Moshe Sternbuch (Chief Rabbi of Orthodox Rabbinical Courts in Yerushalayim).
Rabbi Szmerla carefully delineates what may and may not be done vis-Ã -vis kinesiology, and clearly states that asking about life decisions and about the future is prohibited. He also states and supports what may be done al pi din–not only regarding kinesiology, but the whole spectrum of what is termed alternative medicine.
While Rabbi Hoffman may be sincere in his desire to prevent people from unknowingly violating halachah, chas v’shalom, he “throws out the baby” with the proverbial bathwater, and this is misleading.
Kinesiology is the scientific method taught and used by professionals such as OTs, PTs, and osteopathic doctors, to name a few. It is covered by insurance in many cases. So it is medically sound and should not be relegated to the “trash heap” as having no basis in fact.
Respectfully, it is hoped that Rabbi Hoffman will have a more informed and balanced presentation if he deals with this subject in the future.
Thank you so much [to Rabbi Hoffman] for your fiery protests against using alternate medicine. The frum world has an obsession with not using medicines, [and that] can be fatal. Keep it up!
I would just like to express my disappointment that the 5TJT has provided a platform for Rabbi Yair Hoffman to degrade R’Â Szmerla, a well-known and respected talmid chacham.
Rabbi Hoffman does not seem to like alternative medicine, and if that’s the case he can stick to the conventional approach. However, I cannot understand why he feels the need to spread sinas chinam and degrade anyone who takes another approach. Even more baffling is the fact that the 5TJT has become a platform for this. I think someone in the public eye should not use their position to put down those who they do not agree with.
As far as his article about kinesiology: In any profession, there are good practitioners, bad ones, those who take theirÂ skills out of context. And again, if kinesiology is not his flavor, then don’t have it!
Rabbi Hoffman responds:
Thank you for taking the time to write.
There is a vast difference between a legitimate profession where there are good practitioners, bad ones, and those who take their skills out of context and a profession whose entire nature is fraudulent at its very core.
You would be quite correct if my articles were attacking such fields as cardiology, hematology, or endocrinology. But the articles I wrote were attacking the field of applied kinesiology–a field I would invite you to look up in the sources that are accepted as authoritative in medical schools.
The Torah teaches us to speak the truth–even when vested interests such as hucksters, snake-oil salesmen, and AK practitioners would try to suppress it. Furthermore, the Torah commands us not to put a stumbling block before the blind. Supporting or advising others to take up therapies that have been empirically proven ineffective and false is a clear violation of “Lifnei iver.” This is not a matter that should be taken lightly. There are over one million registered doctors of medicine in the United States. Each one of them, Jew or gentile, would tell you that applied kinesiology is quackery. It is thus a clear violation of Lifnei iver.
There is a reason why no hospital, no legitimate medical doctor, and no insurance company lends support or credence to therapies such as these. The reason is that they do not work beyond the placebo effect and they are a complete waste of money. If these therapies did work, do you think that the insurance companies wouldn’t jump on it to save themselves millions of dollars? You can theorize Big Pharma conspiracy theories all day; the fact of the matter is that insurance companies are interested in only one thing: to save themselves money. If AK really worked, don’t you think that they would jump on it?
There is no legitimate response to this point. There is also no legitimate response to the fact that all the statistical data from legitimate researchers demonstrates that this is a false therapy.
We must realize that just as it is forbidden for Jews to eat treif and such tamei items as lobster and pork, it is likewise forbidden for Jews to engage in or to support fraud.
We have here an unfortunate case where a brilliant and profound talmid chacham has erred grievously in his support of therapies and methods of diagnosis that are fraudulent at their very core. This can only be, of course, because while his knowledge of Torah is indisputably vast and deep, he clearly does not have the ability to differentiate between statistically valid studies and those that are statistically invalid. He also does not have the life experience to realize that double-blind studies are a virtual necessity in analyzing medical data, particularly when lives are at stake.
It is this world of rigorous analysis of medical data that has given us the life-saving medical advances of the polio vaccine and so many others. These life-saving vaccines have come from Hashem, of course, but He enabled them to be found through rigorous statistical analysis. Not the pseudoscientific data that AK practitioners hale before everyone they wish to convince. Chazal tell us, “Chochmah ba’goyim ta’amin.” That chochmah has given us the MRI, the CT scan, the PET scan, and a whole slew of life-saving medicines and vaccines.
We live in a malchus shel chessed, where safety is a prime concern. If there is a fire, chalilah, there is an investigation. Statistics are used to make sure that a Ford Pinto is not produced again where the gas tank can explode when it is rear-ended. Alternative medicine and the ever-growing scourge of the anti-vaccination movement are telling us the exact opposite, countering the words of Chazal.
Practitioners and those who promote such falsehoods must rethink their way of life, because they are misleading the masses. There are other ways to make a living, where one does not have to resort to chicanery and quackery.
Hashem wants us to engage in an honest way of living. Deep down, every AK practitioner knows that he or she is engaging in dishonesty and is misleading his or her clientele.
It is time for people to realize that we need to stand up for emes. We waited far too long to stop the Shabtai Tzvi movement and other movements that are antithetical to our Torah values. Why are we waiting so long to stand up to a movement which is antithetical to emes?
Emes is the signet ring of HaKadosh Baruch Hu. It is time that we stood up for emes and denounce the Lifnei iver violations that are constantly occurring in our midst when anyone recommends applied kinesiology or to evade immunizing our children.
How To Avoid
Future Chillul Hashem
Thank you so much for your wonderful publication. I remember when I was studying in Yeshiva Shaar HaTorah in Queens and someone approached our esteemed rosh yeshiva, Rabbi Kalman Epstein, and asked him about the halachic grounds for paying taxes. From what I remember, R’Â Kalman responded, “You pay taxes because that is the law and we are all bound by the law.” No lamdus, no pilpulim, no l’chatchilah, and no b’di’eved. You keep the law because it is the law.
This was not just a onetime response of his or the approach of his father R’Â Zelik Epstein, zt’l. They both instilled in their students a strong sense of honesty and commitment to be honest and law-abiding bnei Torah. Students or members of the community who went to work, in any kind of job, were valued and respected for working hard and earning an honest living. It was far more chashuv to be an honest, hardworking talmid than engaging in legally questionable behavior.
Following the immeasurable and colossal chillul Hashem which took place in Lakewood over the past few weeks, which may continue into this week, it is essential that all roshei yeshiva, rabbanim, and community members emphasize this lesson to avoid such horrible occurrences in the future: you keep the law no matter what, with no room for excuses, and we highly value hardworking members of our community, in whatever job they are doing to earn an honest living.
Rabbi Elchanan Poupko
I read your article (“Kaddish Coordinates,” July 14) with great interest as we are learning these halachos of “kedimah” in Kitzur Shulchan Aruch. One thing you didn’t mention is something that some shuls are noheig: all the people saying Kaddish gather around the bima. In this way, it is easier to adjust the speed and cadence. When attending a shul for the first time, one should ask if that is the minhag of the shul.