A common criticism aimed at those of us who are highly critical of various alternative medicine treatments and, in particular, of the "integration" of such treatments into conventional medical treatment is: What's the harm? What, they ask, is the harm of homeopathy, acupuncture, iridology, or traditional Chinese medicine? They argue that it's pretty much harmless, or, to quote Douglas Adam's The Hitchhiker's Guide to the Galaxy about earth, harmless. Of course, fans of the novels know that Ford Prefect, a contributor to the guide, reacting to Earthling Arthur Dent's outrage that the entry for the planet earth consisted of only one word, assured him that in the next edition the entry would be expanded to read "mostly harmless." An analogy to this sort of quackery could be made, except that it is anything but "mostly harmless." It can—and is—often harmful to individual patients, not to mention the corrosive effect integrating pseudoscience into conventional medicine has in general.

I've documented various examples over the years, examples such as Madeleine Neumann, a 11-year-old diabetic girl who died of diabetic ketoacidosis when her parents relied on prayer instead of medicine to treat her diabetes. Then there have been children like Daniel Hauser, Katie Wernecke, Abraham Cherrix, Jacob Stieler, an Amish girl named Sarah Hershberger, Cassandra C, and, most recently, two aboriginal girls from Canada, Makayla Sault (who died) and JJ (who will, hopefully, live, although her chances of ultimately surviving were greatly compromised by her mother's insistence on pursuing a Florida quack's medicine instead of chemotherapy). These were all children or teens with cancer whose parents chose (or supported their choice) not to undergo chemotherapy and to pursue quackery instead. Then there was Mazeratti Mitchell, who suffered a spinal cord injury while wrestling, whose mother wanted to rely on a naturopathic quack instead of surgery to fuse his spine. The list goes on and on and on; depressingly so, in fact.

I'm sighing with sadness as I add another one to the list: Aidan Fenton of Sydney, Australia, a seven-year old boy with type I diabetes who died undergoing quack treatments associated with using traditional Chinese medicine:

A Chinese healer, who slaps patients until they produce dark bruising and is now under investigation over the death of a Sydney boy, had brought his treatments to Perth. Self-proclaimed healer Hongchi Xiao was using slapping therapy on seven-year-old Aidan Fenton to treat type 1 diabetes when the boy died in Hurstville New South Wales on Monday evening. Mr Xiao brought his traditional Chinese medical treatments to Perth in 2013 and was sponsored by Perth traditional medicine practitioner Chai Chua. Mr Chua told 6PR Mornings on Friday that anyone, especially children, undergoing Chinese therapy for serious health conditions should be supported by conventional medical advice.

It sounds to me as though Mr. Chua is trying to cover his proverbial posterior here. Basically, Aidan Fenton was taking part in a seven day workshop in Huntsville when his parents found him dead in their hotel room:

Police and paramedics were called to the Ritz Hotel in Hurstville about 9pm on Monday to reports that the boy had collapsed and was not breathing. His parents' screams alerted staff at the hotel, who called triple zero. A NSW Police spokesman said the boy died at the scene. It is believed Aidan, from Prospect, had type 1 diabetes, and police are investigating whether he was no longer taking insulin before his death. Mr Xiao's week-long Sydney workshop cost $1800 for participants to attend, and was held at the Pan Health Medical Centre.

This Australian news story includes a video of the sort of "therapy" that Hongchi Xia teaches. I encourage you to watch the brief clip. It shows people undergoing Paida, or "slapping therapy," during which they are seen slapping themselves on the legs, body, face and other locations until the skin was turning black and blue with some rather impressive bruising, and I call this bruising impressive as a surgeon who's seen a lot of trauma in his residency and, for a few years after, covered trauma call as an attending. Included with the news story is a photo from Xia's website showing a man with bruising on his abdomen that wouldn't have been out of place in a trauma patient pulled from a crashed car.

I perused Xia's website, PaidaLajin Self-Healing and it's a frightening place on the Internet. Right on the English home page, it advertises Paida as "DIY," effective, simple, low cost, safe, and universally applicable, as in "effective on about all diseases" (an exact quote). Elsewhere, we learn that Paida means to "pat and slap external skin areas to expel poisonous waste (in the form of Sha) and to restore health by facilitating the smooth flow of Qi throughout the meridians (energy channels in the body). ." (Detoxification. Of course it had to be "detoxification," complete with acupuncture meridians.) Xia tells us that he uses disease categories "for convenience only," and "to self heal and to help others regain health, you are advised to 'forget the disease name.'" What is the rationale for this treatment? Vitalistic, prescientific nonsense, of course:

Paida /Inducing Sha = Elimination of the toxic waste in the body Our skin is closely related to meridians (energy channels in the body), limbs, five internal organs, six entrails and nine apertures (including the eyes, ears, nostrils, mouth, urethra and anus). Paida enhances one’s faith and power of the heart, stimulates and cleanses relevant meridians to facilitate the Qi flow. Smooth Qi flow will in turn help the circulation of blood. Clearing meridians could cure diseases. The patted and slapped parts of the body will automatically gather Qi and blood, which then facilitates their circulation. As a toxin-sweeper, the enhanced Qi automatically scans the body to locate and cleanse the blocked meridians. As a result, toxic waste, illnesses and even tumors can be cleared. From the perspective of Western medicine, Paida is a "proactive sabotage technique" that stimulates the central nervous system, which then activates energy and blood flow, secretions, and the lymphatic, nervous and immune systems to help repair the damaged parts. This is a process of self-healing and rehabilitation, and enhances the body’s immune functions.

Supposedly, you can even tell what sort of effect the Paida is having by the Sha it produces, which supposedly appears only where diseases are present. in this way of thinking, the amount of Sha indicates the severity of disease and the intensity of the Sha color correlates with the amount of "toxic qi" in the body, with darker colors corresponding to more "toxins":

According to the position of Sha, one can tell the illness (or potential illness) of the corresponding organs and the Sha itself also shows the body has started the reduction of body endotoxin and the treatment. The Sha will come out in a minute after Paida with those who suffer from obstructed blood circulation and their Sha comes faster and the color of the Sha is darker than usual. Some people will have red Sha first, and after more Paida, the color will turn dark purple or even into dark masses.

Yes, it's called bruising. It's what happens when the skin is traumatized sufficiently. First it turns red with inflammation, and then the breakage of small blood vessels under the skin leads to bleeding under the skin; i.e., bruises (or, to use the medically fancy term, ecchymoses). Then, as the bruises resolve, as virtually every human being knows, having experienced at least small bruises in his or her lifetime, such bruises turn all sorts of lovely colors from purple to green to yellow, before fading away. Xia notes that sometimes "people will have Sha the first time they have Paida and don’t have Sha afterwards and may have Sha again later, which means their body and mood are undergoing some changes." No, what it means is that they probably didn't hit themselves hard enough to cause immediate bruising the first time around and the bruises are showing up later, as they often do with lesser injuries. I know TCM has some really dumb ideas at its heart, such as a concept that links various organs to regions on the tongue, much as reflexology links them to parts of the palms of the hand and soles of the feet, but somehow I had gone all these years without having ever encountered Paida before. This is even dumber than Tong Ren, because at least in Tong Ren the person is hitting a doll instead of himself.

So how, specifically, is Paida done? Xia's website describes that the proper sequence is to start hitting yourself from the "top down"; i.e., starting at the head and working your way down to the feet until, apparently, you've beat your entire body to a bruised pulp. Xia helpfully notes that if you feel the pain of slapping then "you are on the right way" and recommends that you chant mantras while patting or slapping for better results. He even recommends "Paida with your mind," observing that "when slapping the skin, you can imagine that you are injecting fresh Qi into the body and bringing out the dirty Qi." You know, it occurs to me that Dirty Qi would be a totally awesome name for a rock band. For a rationale for slapping yourself silly to bring out the "toxins" and treat disease? Not so much.

In fairness, we don't know yet whether Aidan Fenton died of Paida, whether he had stopped his insulin, or whether he died of something else. However, as noted in Doubtful News, the circumstances look very, very suspicious. It's also been reported in The Daily Telegraph that Fenton had been made to fast before slapping therapy and that he vomited and died:

It is understood Mr Xiao has claimed participants in the seminar were asked to fast for three days and to undertake the slapping and stretching exercises that can prompt vomiting and dizzy spells, known as a “healing crisis”. Aidan was among those vomiting during the seminar. Mr Xiao said Aidan looked well during the seminar and had eaten rice but became ill on Monday evening after Mr Xiao had gone to dinner. Police and paramedics were called to the nearby Hurstville Ritz Hotel where the Year 1 student had been staying with his parents after the little boy was found unconscious at 9pm. Hotel staff said they rushed to the family’s aid after hearing screams coming from their room. Aidan was found in bed. His heart stopped beating on the way to the hospital. Police are now investigating if the “healer” advised his parents to take Aidan off insulin and instead encouraged alternative therapies to treat him, including massages and slapping.

Consider the pain and fear of a seven year old. He's made to fast, and doesn't understand why. He's made to slap himself all over until he's bruised, which is painful, and he doesn't understand why. Why, he wonders, why are you doing this to me, Mommy and Daddy? If Aidan underwent Paida as it's described on Xia's website, it's hard not to conclude that he was tortured, either by Xia or his parents. That's why reading quotes like this drives me crazy:

Neighbours of the Fenton family described Aidan as a “beautiful, really good boy” and said his parents had been too traumatised to speak about the incident. “All we can hear is them crying, all the time,” said a neighbour, whose daughter was the same age as Aidan and played with him over the school holidays. “They were such good parents, it is really hard to understand why it happened and how it happened.”

Yes, it is hard to understand how this happened—very hard—if you're a rational, science-baed person. There is no physiologic rationale why raising welts and bruises would have therapeutic effect for diabetes or any other serious diesease and lots of reasons for it to be harmful. If, as is alleged, Aidan was forced to fast before, then it might actually be even worse if he had still been taking his insulin, because, as all type I diabetics know, taking the same dose of insulin if you haven't eaten can lead to dangerously low blood sugar. Be that as it may, I must strenuously disagree with the next part. While I have no doubt that they both loved Aidan and are, as described, completely traumatized by his death and suffering profound grief at his lost, it must be said that Aidan's parents were most definitely not good parents if, as it appears, they took their seven-year-old diabetic child to a week-long session with a quack who advocates beating the "toxins" out of people until they're bruised all over their body. To subject a diabetic child to such torture—yes, torture—is unconscionable and unquestionably in my mind child abuse, regardless of the parents' love or good intentions in doing it. Even if Aidan is found to have died of something else, it would still be child abuse in my mind.

What's the harm? Sadly, Aidan Fenton appears to have learned the answer to that question.

ADDENDUM: Here is a video of Hongchi Xia speaking about his Paida method. Wow, the quackery is thick here.