In medical school, or so we're told, aspiring young doctors are taught the fundamentals of medicine. What we science-based physicians usually mean by "fundamentals" includes the basic science necessary to understand human health and disease, the mechanism by which human disease develops, and the basics of how to treat it. We also learn a way of thinking about diagnosis and treatment, a systematic approach to differential diagnosis and how to hone in on a diagnosis based on history, physical findings, and imaging and laboratory tests. Fundamentals are important in any profession. Being a baseball fan, I can't resist making the comparison to baseball, where no matter how fantastic a player you are you still need to keep working on the fundamentals. Miguel Cabrera, for instance, does not eschew batting practice because he's such an awesome hitter. One of the reasons why he's such an awesome hitter is because he is obsessive about batting practice.

If there's one thing I've learned about quacks, however, it's that they have an entirely different idea of what constitutes the "fundamentals" of medicine, or, as I've heard it called, "fundamental medicine." I just caught an example of this the other day from our old friend "Dr." Sircus, whom we've met before a couple of times around here. In case you don't remember, Sircus is an acupuncturist, practitioner of traditional Chinese medicine, and the director of the International Medical Veritas Association (IMVA), an organization that's about as pro-quackery as you can get: antivaccine, pro-cancer quackery, anti-science. He's also a guy who once advocated killing CDC scientists in a post charmingly titled String the Bastards Up. This time around, he's trying to tell doctors how to practice by opining that smart doctors understand fundamental medicine.

Believe it or not, I'd actually agree. The problem is that what Sircus considers "fundamental medicine" and what science-based practitioners consider fundamental medicine are related only by coincidence and then only occasionally. Even then, if you were to construct a Venn diagram of what Sircus considers fundamental medicine and what real doctors consider fundamental medicine, the area of overlap would be distorted beyond recognition, as though Sircus sees reality through a warped magnifying glass after dropping a whole lot of acid. He begins by citing someone named Dr. Jerry Tennant:

Smart doctors like Dr. Jerry Tennant say, “We do not treat cancer. We do support patients with cancer to help get their nutrition, minerals, acid-base balance, etc. in as good a condition as possible.” Oncologists certainly don’t cure cancer since it’s illegal to even speak about curing cancer and since most of their patients die no matter what the doctors say or do. What they are doing is using toxic substances and radiation for diagnosis and treatments, substances and procedures that cause cancer. Chemo and radiation kill both cancer and human cells and both increase instead of decreasing the chances of further reoccurrence of cancer. A safer way to do the same is with light and heat via far infrared rays whose intense internally generated heat will kill cancer cells before too much heat kills the host. Human cells are much more resistant to heat extremes than cancer cells.

Ah, yes. The same old tropes, so perfunctorily dropped into the blog post like so many duck turds quacking up the place. Of course, it's not at all true that "most patients die no matter what doctors say or do." Nor is it "illegal" to speak about curing cancer, a quack claim so simultaneously untrue and silly that I don't know whether to be outraged or to laugh whenever I see it. I talk to patients about curing their breast cancer all the time, although I'm nuanced enough that I usually point out that what doctors mean by "cures" for cancer is long term survival. After all, surgery cures breast cancer quite frequently; indeed, when breast cancer is cured it's almost always the surgery that does it. Ditto for most other solid tumors. What Tennant is referring to, of course, is the FDA not taking kindly to claims for cancer cures that aren't backed by data. When I say that surgery has about a 90% chance of "curing" (i.e., producing ten year survival) of an early stage cancer, I have the data to back it up. Does Tennant? Probably not, given that he's the author of a book called Healing Is Voltage.

No, he's into pH woo with a twist:

Each cellular biology book gave passing notice to the fact that cells require a narrow range of pH, but little more was discussed on the subject. He began to look at pH and discovered that it is a measurement of the voltage in a solution. It is measured with a sophisticated voltmeter. If the solution is an electron donor, a minus sign is placed in front of the voltage. If the solution is an electron stealer, a plus sign is placed in front of the voltage. The measured voltage is then converted to a logarithmic scale from 0-14 with zero corresponding to +400 millivolts of electron stealer to -400 millivolts corresponding to a pH of 14. Cells are designed to run at about -20 millivolts (pH 7.35). Dr. Tennant began to understand that cells must have enough voltage to work and that chronic disease was associated with loss of voltage. Next he had to find out how to measure the voltage and then how to correct it. This is how he was able to heal himself.

Uh, not exactly. Cells do function quite well at pH 7.35, and the normal pH of the blood tends to run between 7.35 and 7.45, with homeostatic mechanisms keeping it in a very tight range. Tennant is also wrong when he says that cells are designed to run at -20 mV. The usual membrane potential (the electrochemical gradient across the cell membrane) is usually between -40 and -80 mV, negative in the cell interior relative to the exterior. This electrochemical gradient is used for many purposes, from the firing of nerve cells to proliferation, to a number of other functions. The voltage gradient is maintained by utilizing chemical energy in the form of ATP to pump ions against their concentration gradient. I've dealt with this sort of "electrochemical woo" before. It's the same nonsense that is used as the justification for the cancer quackery known as Cantron. In any case, it looks to me as though Tennant is confusing how a pH meter works with the voltage that really matters in biology: Namely the membrane potential.

It goes even beyond that, though. Sircus brags about how he's about to publish a book called Conquering Cancer, which apparently will be 3,000 pages worth of Sircus' writings on cancer. (Oh, goody.) Apparently, he intends it as a one-stop shop for cancer patients to learn cancer quackery. Obviously he didn't say it that way, but given the scientifically ignorant beliefs Sircus holds about human biology and disease, that's what it is certain to be. For instance, he has has his own version of Tullio Simoncini and Robert O. Young's belief that alkalinization is the cure for everything, be it cancer or influenza. Given his truly atrocious understanding of cancer, it's no surprise.

In any case, we know Sircus believes in a whole lot of pseudoscience with respect to medicine; so it's also no surprise that Sircus is quite enamored of Tennant's explanation for disease and inflammation:

Some doctors like Dr. Tennant understand the principles of health and healing. He says, “The voltage in my thumb is -25 millivolts. Now I hit it with a hammer. The voltage immediately goes to -50 millivolts so it has enough power to replace the cells I damaged with the hammer. At -50 millivolts, we have the signs familiar as inflammation: throbbing pain, swelling, redness, and heat as well as decreased function. When tissue is at -50 millivolts and healing is occurring, two things are possible. It can have enough electrons to heal the damaged cells, and it returns to normal at -25 millivolts. The other possibility is that it runs out of voltage before the damaged cells are replaced. It then drops to a voltage lower than -25 millivolts. Now we have all the signs of degeneration. The pain changes from throbbing to a constant ache, the swelling may or may not be present, redness turns to paleness, and heat disappears as circulation diminishes.” “Every cell in the body is designed to run at -20 to -25 millivolts. To heal, we must make new cells. To make a new cell requires -50 millivolts. Chronic disease occurs when voltage drops below -20 and/or you cannot achieve -50 millivolts to make new cells,” says Tennant. Thus chronic disease can almost always be defined by having low voltage, low body temperature, low pH occurring in conjunction with low CO2 and O2 levels. Tennant himself is a medical genius telling us that cell voltage and cell pH is running down the same railroad tracks together.

Any docs out there want to take a crack at this silliness? I was particularly amused that Sircus is so impressed as to call Tennant a "medical genius" because he supposedly figured out something that physiologists have known for decades and then put a pseudoscientific gloss on it. For one thing, the voltage gradient across the cell membrane is caused primarily differences in cation concentrations across the cell membrane, not differences in electrons. As for what happens when cell voltage drops below -20 mV, well, it does that a lot in a lot of cell types, particularly neurons. It's called depolarization. Do you know, however, what you call a cell that chronically and consistently has a voltage much below -20 mV? Dead. That's what you call it: A dead cell. I suppose that would be bad in a trivial sense.

Sircus, of course, advocates dubious devices such as the Breathslim device and—my favorite!—the infrared Biomat. It's basically an infrared mat that, or so its manufacturers claim, kills cancer cells, improves immune function, and in general fix anything that ails you. Not mentioned are some of Tennant's dubious devices. My favorite is the Tennant Biomodulator. When you boil it down, it appears to be basically some sort of variant of a transcutaneous electrical nerve stimulation (TENS) device, tarted up with claims that it can increase pH and voltage. Of course, TENS units cause nerves to depolarize, actually temporarily decreasing their voltage before the cells can recover and repolarize. So I'm not sure how running electricity through nerves would do all the things Tennant claims for it.

Reading the "fundamentals" as described by Sircus and Tennant is look at a parody of science-based medicine in which basic physiology is often twisted and distorted into an unrecognizable form and then used to justify all manner of quackery. Fundamentals indeed. The fundamentals of quackery would be more like it.