The last rites for alternative medicine?

By Damian Thompson

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Few experiences are more disorientating than the erosion of faith. I have seen it many times in my encounters with religious believers: the fixed smile contradicted by a flicker of doubt in the eyes; the desperate appeal to half-remembered scriptures. And then the confession: "I've been doing some... questioning." Michael Bywater reviews Counterknowledge by Damian Thompson Damian Thompson: Another serving of episcopal waffle Recently, I've heard these words many times. Troubled believers, their tongues loosened by a few glasses of Chablis, admit to what Catholics used to call "doubts". advertisement Interestingly, many of them are women. The faith in question is the system of belief built around Complementary and Alternative Medicine. Women have always been attracted to alternative remedies. Now that faith is crumbling. People still fill their bathroom cabinets with herbal cold remedies and nod respectfully at the words "rich in antioxidants". But, like Mediterranean peasants who still make the sign of the cross but have lost all confidence in the Church, growing numbers no longer subscribe to the doctrines of alternative medicine. These are difficult times for CAM. For the past 15 years, a multi-billion pound industry has fed off the claims of media nutritionists, barefoot doctors, Native American shamans and homeopaths. Suddenly, it finds itself threatened by the economic downturn: forced to choose between pricey detox courses and mortgage payments, customers have decided to put up with their toxins. But CAM's real problem is not shortage of money; it is shortage of proof. The information technology brilliantly exploited by unorthodox therapies is now being harnessed to spread the inconvenient truth that most of them don't work. Sceptics in the blogosphere have assembled a global daisy-chain of links exposing the falsehoods of alternative practitioners. The BBC, which used to be strongly biased in favour of CAM, had these headlines on its website recently: "University professor criticises guides on alternative medicine backed by Prince Charles"; "Complementary therapy hampers IVF"; "Concern over HIV homeopathy role". When did the tide begin to turn? I reckon the consumers of CAM got the shock of their lives when the case against MMR - in which they had invested so heavily, not to say hysterically - collapsed. Dr Andrew Wakefield's theory that the injection triggered autism tied together a whole bundle of anxieties: about "Big Pharma", synthetic drugs, a blinkered medical establishment, lying politicians and autism, one of the least understood but most widely misdiagnosed child disorders of our age. Plus, Dr Wakefield's campaign made such a good story. His claims felt right. But they were wrong, it turned out - completely unsupported by large-scale studies. They were, however, supported by the nutritionist high priests of CAM such as Patrick Holford, who carried on lobbying for Wakefield even after the latter had been accused of serious professional misconduct by the General Medical Council. The media nutritionists have also contributed to the erosion of faith in CAM. For years, they had the lucrative field to themselves. No breakfast television sofa was complete without a "food doctor" making wild claims for berries and herbs through a rictus grin. The most familiar was Gillian McKeith, a bossy Scottish nutritionist who called herself "Dr McKeith". And she might have got away with it if it wasn't for that pesky kid, Dr Ben Goldacre, youthful author of the "Bad Science" blog, who discovered that her doctorate came from a correspondence college. A website called Holfordwatch then started looking at the CV of Patrick Holford, who was recently made a professor of nutrition by Teesside University, despite the fact that his only academic qualification is a 30-year-old BSc in psychology. Growing scepticism about alternative medicine has emboldened opponents of homeopathy. This 200-year-old quackery is available on the NHS - but that may change, as financial pressures mount, and as "respectable" British homeopaths continue to turn a blind eye to the prescription of lethal homeopathic Aids treatment by their maverick colleagues. This month saw the publication of Trick or Treatment? Alternative Medicine on Trial, co-authored by Edzard Ernst, Britain's first professor of complementary medicine. He found that Britain spends £500 million a year on unproved or disproved therapies. Compared to that figure, even Scientology is value for money. No one is saying that orthodox medicine is a complete body of knowledge, that Big Pharma is not capable of gross ethical lapses, or that strange or traditional treatments do not sometimes work. But we should welcome the fact that healthy scepticism is finally being extended to CAM. Instead of requests to share their wisdom, alternative practitioners are being asked to produce double-blind randomised tests to support their claims. They try to shrug off the demands - but, if you look closely, you can see their ayurvedic auras vanishing into thin air. Damian Thompson is the author of 'Counterknowledge: How we surrendered to conspiracy theories, quack medicine, bogus science and fake history' (Atlantic Books).

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Related articles 24 April 2008: Alternative medical degrees 'harm' universities

A great article and a great analogy to start with. Any activity not based upon evidence is based upon faith.

Not so long ago people believed that performing rituals in mid winter caused the sun to return. The shamen probably asserted that as summer reliably followed winter their rituals the dances obviously worked.

Its the same with all the people claiming to be cured by CAM - they would have got better anyway.

That includes the person with Alopecia. How do you know that the Chinese treatment 'works' at all? A lot of the time the condition gets better on its own. You could just be wasting your money.


Posted by woodchopper on April 27, 2008 11:38 AM
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It is always the same people who write comments in articles against alternative medicine. Are they paid to watch out for any and every article that appears in the press, so they can weigh in with their tired and worn out comments? The public see through these articles and they don't care what they say anymore. They will continue to use what works.
Posted by Louise Mikula on April 27, 2008 1:24 AM
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Flummery, bunkum and snake oil should not be available on the NHS. If you're stupid enough to want to pay for "potentised" tap water, do it with your own money thank you very much. Every time I hear an "NHS" homeptahic or alternative hospital is in financial woes I rasie a small cheer to both Conservatives and Labour who introduced Payment by Results for the Health Service!
Posted by Phil on April 26, 2008 11:48 PM
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Fear, ignorance, and BS.

That sums up most of the posts here.

First, the fact that homoepathy etc is not explicbale in "scientific" terms means nothing.

Second, homoeopathy, herbalism etc WORKS - cheaply, effectively, and without side effects.

So for goodness sake stop talking prejudiced nonsense.

Posted by Joe on April 26, 2008 11:31 PM
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Further to the comments by Mary Walker and pv about individualisation and double blind RCTs:

There is no reason that double blind RCTs cannot be used to test individualised treatments such as homoeopathy. The homoeopath can give their usual consultation and prescribe a remedy; at that point either the prescribed remedy or a placebo can be given to the patient, without patient or homoeopath being told which it is. In fact, precisely this type of trial has been carried out. See, for example, White et al: Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised placebo controlled trial, Thorax. 2003 Apr;58(4):317-21

link
Posted by Mojo on April 26, 2008 11:04 PM
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What on earth does Wakefield have to do with
alternative medicine? The now-notorious paper
he co-authored some ten years ago suggested
further in-depth scientific research was
necessary, and in a press conference he said
separating the three vaccines might not be a
bad idea, --both expressions of scientific and
medical conservatism, if anything. Somebody
has indeed gone off the track here, but it's not
Wakefield, it's self-promoters like Damian
Thompson, who has a book to sell, just as Pig
Pharma has some drugs to sell.
Posted by Anne Van R on April 26, 2008 7:48 PM
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Thomas- I have contacted Mind myself about some of my concerns. I was surprised to hear that Mind are affiliated to Patrick Holford's Food for the Brain organisation, given that - aside from the lack of decent evidence for many of the interventions recommended by Food for the Brain - Holford uses unusual diagnostic terms such as ‘crazy’ for people with mental health problems. To the best of my knowledge, Mind have chosen to maintain this affiliation -- some details at this link link
Posted by HolfordWatch on April 26, 2008 7:02 PM
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Well, I have contacted MIND 4 times in the last week regarding 2 items on their site - "Making sense of Homeopathy" and "Making sense of Traditional Chinese Medicine", which I see as misleading and possibly dangerous.

Their response? "Thanks for your comments on both booklets. We will consider your opinion when we next update our booklets.

That's alright, then.
Posted by Thomas Roberts on April 26, 2008 6:25 PM
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Sorry, link didn't work. See here for details on Wakefield's 'ethics' - link
Posted by HolfordWatch on April 26, 2008 5:31 PM
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Ralf Jeutter- you say that "it appears that Wakefield is clar [sic] on charges of consent/ethics and conflict of interest." However, Wakefield himself has apparently admitted">link that his understanding of ethics "was wrong". Given the accusations against Wakefield - including paying children for their blood at a birthday party - I really don't think that this puts him in the clear.
Posted by HolfordWatch on April 26, 2008 4:58 PM
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It's amazing how homeopaths want the world to believe their chosen quackery cannot be tested by double blind RCTs, because it is individualised. This is either ignorant or deliberately misleading rot.
The pathogens that cause disease aren't individualised any more than the mechanisms by which they work. Anyway, if homeopathic preparations are "individualised", how come most preparations are bought from high street chemists. Hardly individual, methinks.
The thing is homeopathy has never been demonstrated to cure a single case of a non-self-limiting ailment. After 200 years of meticulous record keeping and extravagabt claims not even one incontrovertible example has been forthcoming - merely a lot of hot air and sales pitch. All the other things that homeopathy is supposed to cure are self-limiting and would (in fact, do) get better without intervention of any kind.
Homeopathy has no medical ingredient and no physical effect that isn't attributable to a psychological cause. Furthermore, the manufacturers of homeopathic preparations and the practitioners should be prosecuted for medical fraud.
Posted by pv on April 26, 2008 4:32 PM
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Double blind testing is not the only route to proof of efficacy. Homeopathic treatment is individualized, useless in double blind testing, and the research is assembled differently. There is a considerable amount available, and worth investigating.
Posted by Mary Walker on April 26, 2008 3:55 PM
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To Richard Avon: h

ey, if you say that you got better from Reiki then obviously it works! This is the best evidence! If only science worked that way, you know?

And then you move on to show that you just do not get it: if someone in the 18th century said those things about the moon and the television then he would indeed be insane! Regardless of the fact that later on those things would happen, you cannot just go on and say whatever it comes in your head and expect people to believe you!!

Further, you may not be able to measure something directly but you can measure its effects. If it has physical effects, we measure it and study it. If there are no physical effects (e.g. Homeopathy, Reiki) then we might as well say that it doesn't exist.

Finally, regarding close mindedness: show some evidence. If there are no evidence to back up claims, then there is no point wasting precious resources in the claim for the sake of being "open-minded". Bad ideas have to make way for the good ones. And your brains must not be so open as to accept any crap idea everyone tells you.
Posted by stavros on April 26, 2008 3:26 PM
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Terryeo - by "some alternatives" are you suggesting Scientology?
Posted by R. L. on April 26, 2008 3:09 PM
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I found it rather disorientating that at the other end of the link embedded in the text, "growing numbers no longer subscribe to the doctrines of alternative medicine", is an article reporting that "a growing number of universities are offering "bogus" degrees in alternative and complementary medicine".

Is that just a mistake or is it a subtle joke alluding to the CAM/woo blogger habit of indiscriminate link bombing - often even to material which refutes their absurd claims? ;-)
Posted by phayes on April 26, 2008 2:58 PM
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Six months of pain from a twisted knee which my GP said would require surgery with a six month waiting list was 80% better after one visit to a Reiki Master and 100% better after the second visit two days later.

SO! My wife and I decided to become attuned to Reiki ourselves. On the second morning of our Reiki II training, a Sunday, I awoke with ghastly toothache in my right lower jaw. I told our Reiki Master that I would try and complete the day but that I would be having the tooth out the next day. She asked the location of the tooth and then said 'You have a communication problem with another male' 'No,' I said 'I have a bad tooth!' She just smiled.

During the course of the day I realised who she meant! I made a phone call in the evening and sorted it out. I then applied some self healing Reiki. The pain disappeared totally after about thirty minutes. By chance I had my six month dental checkup on the t Thursday. When I told the dentist what had happened she had a look at the tooth and said that she thought it should come out soon. That was nearly two years ago and I still have the tooth and a lot of other benefits from Reiki.

I happen to know quite a few Alternative Health practitioners of various disciplines and many of them have been in business for over twenty years with full lists of patients. People aren't stupid and they won't continue paying for treatments that don't work!

The argument that scientists can't measure the results and prove them scientifically is pretty stupid. After all scientists don't yet understand Gravity and if you were a scientist in the 18th century and someone said that in the 20th Century a man would stand on the Moon AND you would be able to see it happening in real time by looking at a glass screen in your living room, I guarantee you, with your scientific training leading to a closed mind about anything you couldn't measure at that time, would have declared the person insane!

An what about EFT? Emotional Freedom Technique? No one yet knows how this works but it is becoming so effective, all round the world, that even enlightened Doctors and Physicians are beginning to use it. You can't measure it but it just WORKS!
Posted by Richard Avon on April 26, 2008 2:54 PM
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Oh dear, the pro-homeopaths are out: "don't knock it because you don't know how it works". No, no, no, homeopathy, the pinnacle of the quackery manure pile, does NOT work. No more than the horseshoe nailed to my gatepost keeps elephants away.

Bill is confused too in thinking that evidence-based medicine rejects all non-traditional or non-Western medicines: clearly many herbs have active ingredients, and many modern medicines (e.g. aspirin) are derived from herbal remedies. The focus of complaints about "complementary medicine" (which is actually neither complementary nor medicine!) is about pure quackery.

Interesting that a recent trial found that sham acupuncture was more effective than real acupuncture!
Posted by Sam Centipedro on April 26, 2008 2:08 PM
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M.C. wrote ".... anything seriously wrong"...

Y'mean like that Russian guy who had a flock of
UCLH high tech professors unable to discover what
was wrong with him for weeks until he died, and
only then did a technician discover that the body
was highly radio-active
Posted by Jack on April 26, 2008 1:30 PM
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While we are on an anti-alternative medicine line, isn't it about time all these health food shops are examined with a little more scrutiny?

Just because something is "natural" doesn't make it unsafe. Digitalis (Foxglove) being a typical example of a natural substance used in heart operations, but more than the tiniest amount will kill you stone dead.

One can overdose on all vitamins (with serious effects in some cases), and there are many more examples. Pharmaceutical companies spend millions testing their products due to stringent legislation, so why do the wierdy-beardies with their snake-oil remedies and "organic" cures not have to be subjected to both safety and efficacy tests?
Posted by Rob Neal on April 26, 2008 1:29 PM
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Hmm, I've been experiencing alopeacia on my legs now for a few years. A well respected dermatologist has told me that there is nothing that can be done. I went to the local Chinese doctor who has been treating me with acupuncture, massage, tablets and lotion. Well, you'll never guess, but this so-called 'rubbish' medicine is working a treat. Hair is coming back where it wasn't for the past two years.

Just because the medical community doesn't know how something works, doesn't mean it doesn't. After all, no one really has any idea how anesthetics work, but we know they certainly do.

I'm certainly not anti-medicine, but I find that vitamin therapy (which is used extensively in veterinarian medicine to great effect) works wonders for most people.
Posted by Bill on April 26, 2008 1:28 PM
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Massage does make sense for things that are
related to stress and tight muscles -- it may not
cure serious ailments, but then I have never met
a serious practitioner who made that claim. I'd
therefore put massage in the same category with
yoga and taking brisk walks, generally desirable
for staying well but not sufficient for curing
serious diseases.

Same with nutrition. Eating green stuff, berries
and so on is a good thing to do. It won't help if
you need an appendectomy, but there's no good
reason not to do it. Or to stress out if you skip a
week when work is stressful. Actual deficiency
diseases are rare in developed countries, but
people with limited diets (those obsessed with
weight?) can usually benefit from paying
attention to the nutritional quality of food.

There seem to be a few herbs that work, too, but
again mostly on fairly routine and low-level
complaints.

As for the rest, if anything is REALLY wrong with
me, I'll go with regular western medicine every
time. The imaging technology alone is better
than anything else that has ever existed.
Posted by M.C. on April 26, 2008 1:05 PM
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There have been trials of placebo effect, typified
by the well known one that involved delivering
fake but effective surgery to an experienced GP,
who when told afterwards that it was fake,
continued to be pain free.
As for research, Zubieta et al. 2005, in
"Endogenous Opiates and the Placebo Effect"
pub. The journal of neuroscience vol.25 no.34,
showed that belief in the placebo treatment,
causes opioid release in the brain, which
operates in an analogous way to externally
administered morphine.

Posted by Jack on April 26, 2008 1:03 PM
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My link didn't work, here it is.
link
Posted by gimpy on April 26, 2008 12:49 PM
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There is no justification, in age of tired and busy
GPs and serious conflicts of interest as a
characteristic of consultants, from denying patients
access to a splendid and far more cost effective
than 'conventional' quackery, placebo. Placebo is at
its most effective and cost-effective when the
patient is throroughly convinced that it is not a
placebo. That means dressing it appropriately.
Posted by Jack on April 26, 2008 12:44 PM
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An interesting article and one whose opinions I largely agree with and have often argued myself. However one area which I feel that Mr Thompson has neglected to mention is the largely succesful attempts of vitamin pill manufacturers and other commercial concerns to infiltrate and even organise so-called regulatory bodies for CAM. There is a recent example on my blog here">link. Where BANT, an organisation purported to set standards for nutrionists, altered its Code of Ethics in response to commercial concerns. I believe this sort of duplicity and lack of independence is utterly rife within CAM and needs to be expose.

Posted by gimpy on April 26, 2008 12:40 PM
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The reason believers faith collapses is because few have ever studied anuthing. For instance many yeaqrsago when an eminant Historian announced with great flourish in head lines reserrved for the Second Coming, the Bible was wrong because there was no such Empire as the Hittite Empire, Many accepted it astruth. Yet five years later when that Empire and its extensive power was finnalt found little was said. So today many who thought the Bible was wrong do not know its been proven right At the same time an eminent archeologist got world head lines when she said the bible was wrong because the walls of Jerico fell 400 years before the date in the bible. Yet wuithin a year another archeologist proved she was digging in the wrong spot and with ease proved the Bible was once again right but no head lines. Few know of the subsequent retraction. Time after time I see this assasination of the bible even when the facts are to hand probving the Bible. But then again the aqssasins today have the floor. There is a conspiracy to destroy the bible and no one gets to produce the actuall proof. Do not believe the experts, they are wrong, bnot believers and are paid by evolutionists a truly failed concept religion.
Posted by Jas on April 26, 2008 12:40 PM
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Ralph - I'm going to leave your comments on MMR, because if you're going to ignore the several extremely large and well-run studies showing no link between the vaccine and autism, I won't be able to change your mind.

However re homeopathy - what is it that makes it untestable by science? A suitable trial is obvious - put the patient through the consultation, let the practitioner decide on the suitable remedy, and after that either give them the remedy or a placebo, randomised and double-blind. Compare outcomes between the placebo and remedy groups.

This has been done several times and homeopathy invariably performs as well as, but no better than, placebo. What extra "complexity" is missing there?
Posted by Tom C on April 26, 2008 12:33 PM
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Not a timely article, a least a decade late, but better late than never.

There may be some difficult pills for the British to swallow. Amongst others: end all free standing counselling, psychotherapy and listening services. Counselling combined with, for example, nicotine replacement therapy, may have some value, but on its own psychotherapy is a waste.

Hopefully the listening service of The Samaritans will soon receive its last pound of public money. Many make extravagant claims for The Samaritans, but the evidence shows their listening service has no long term value of any kind at all.

Give up the campaign against Cannabis. Not only is it impossible for Cannabis to cause Schizophrenia, but the active ingredient of Cannabis is a mild anti-psychotic.

Hyperactivity, identified by Dr. Dennis Hill at the Maudsley Hospital in 1944, does exist and Ritalin does treat its symptoms.

Teachers are worse than useless at spotting developmental disorders in their pupils. The evidence, a matter of observation alone, is that if a teacher suggests a pupil does have X and does not have Y, the pupil is more likely to have Y and not X.

But this is evidence drawn from observation: it does not say why, and it does place any blame on anyone.

Posted by Liisa Stenfors on April 26, 2008 12:24 PM
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You people are so smugly ignorant. It gets on my nerves. AM is not based on "faith", and this stupid remark sums up my response:

"A typical homeopathic dilution is unlikely to contain a single molecule of the "active" ingredient."

Indeed - that's the way it works. Conventional science does not recognise how it works. Try reading Samuel Hahneman's writings if you want to find out about it.

Scientology? - what the hell's that got to with this?? And since when has the church of "science" been an ultimate source of knowledge? You're just selling your book Thompson, which looks about as interesting and informed as daytime TV.

Posted by Joe on April 26, 2008 12:23 PM
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James Randi will be pleased!

Danny

You said "your dilutions in homeopathy are wrong, as the liquids would in fact contain medicine". That is not true. A typical homeopathic dilution is unlikely to contain a single molecule of the "active" ingredient.
Posted by Richard on April 26, 2008 11:39 AM
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The Wakefield hearing is ongoing. For the first time in 4 years we have the chance to hear the side of the defence. This has largely been underreported in the British press. So far it appears that Wakefield is clar on charges of consent/ethics and conflict of interest. His Lancet article has aain been described as good science. Equally undererported in the British press is the ongoing MMR debate, which rages at the moment in the States. see for more information link That MMR causes no harm is based on epidiomeliogical studies, which cannot answer the question whether x causes y in a specific individual, and are therfore of not much use to investigate whether MMR causes damage to individuals or not. Damian Thompson, please ask Ernst to tell you how many conventional medical interventions are unproven according to his model. You will be surprised about the answer. Ernst operates with a model of evidence which favours particular types of medical interventions, but is not well suited to complex interventions like homeopathy. His science is biased not disppassionate.
Posted by Ralf Jeutter on April 26, 2008 11:29 AM
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I'd venture the real poodle fakers and quacks doing serious damage in this world are not those of "Complementary and Alternative Medicine" - but those of "non-Complementary and no-Alternative Faiths"
Posted by simon coulter on April 26, 2008 11:20 AM
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Surely, the sales of CAM are hugely encouraged
by the duplicity and downright dishonesty of Big
Pharma. e.g. Their well-funded and orchestrated
fight against the simple cure for Helicobacter
pylori, which threatened their multi-billion dollar
sales of antacid stomach pills.

Add to this the tragedies which have been
caused by such drugs as thalidomide and you
can well understand the attraction of CAM.

Big Pharma is not in business to cure people; it
is in business to make money, which it does in
huge amounts.
Posted by Mark on April 26, 2008 11:15 AM
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I hope you are right, but I suspect it won't be long before the media - Telegraph included - are back to running CAM-friendly health articles in which the "wisdom" of McKeith, Holford etc. is regurgitated as though it is factual rather than just the wacky opinions of some very dubious characters making lots of money out of the gullible.

Posted by Chris K on April 26, 2008 10:55 AM
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The conundrum is that the placebo effect is genuine and is probably how CAM works, when it does. But how do you enlist it whilst also promoting evidence-based practice and openness with patients?

Back to 'doctor knows best'? Difficult to put the genie back into the bottle.
Posted by Phil Cowburn on April 26, 2008 9:32 AM
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I read your book, and thoroughly commend it, together with The March of Unreason (Taverne). Just one small point, your dilutions in homeopathy are wrong, as the liquids would in fact contain medicine.
I was present when Wakefield made his first presentation, and it was parents, some from his original 12, who later did not believe his evidence was accurate. Particularly as many parents had two children with ASD one who had been MMR vaccinated and one without!
The attraction of CAM lies in part with the large numbers of people who are seen to die while exposed to drugs modern medicine and hospitals. Calling practitioners quacks and insulting them (and by inference their clientele) has only increased attendances. Attention to careful explanation and limitation of therapy claims and licensing will be helpful, but you cannot force people to take up a medication choice by regulation entirely.
Posted by Danny on April 26, 2008 9:30 AM
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I'm always amazed that Damian Thompson who is obviusly intelligent, and is rightly the scourge of therapies that don't work, and other irrationalities ...
Beleives in RC christianity, a collection of raving irrationalities, if ever there was one.
I have yet to get an explanation.
Posted by G. Tingey on April 26, 2008 9:12 AM
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Not so sure about this. Enthusiasm for alternative medicine will only stop when women stop being hysterical and irrational.
Not much chance of that, is there?
Posted by B Grant on April 26, 2008 6:33 AM
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Alternative medicine is successful at treating patients' symptoms that are purely psychosomatic, and hence appeal to anxious obsessed people . All sorts of non illness, fatigue syndrome, fibromyalgia, aches and pains etc respond well to listening and kindness, and gentle stimulation with potions , needles . massage etc etc. That alternative practitioners are basically quacks , and their bogus theories are without foundation, has been known since the birth of scientific medicine. My frustration has always been why it has had government backing for so long , with many courses taught at the new " unis", and homeopathy embraced by the NHS. Its basically a soft left thing, coupled with a dislike for the medical profession- which is often seen as right in politics , and possibly too hard and logical about real illness. The irony is that in the new labour NHS , there is no time for talking to patients - and indeed listening - there are targets to meet!
Posted by Andrew on April 26, 2008 6:25 AM
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The author present that alternative medicine is poor medicine. On the other hand give some alternatives. Today psychotropic drugs are handed out like candy to children while the government pays for most of that, and that produces suicide and worse. not 100%, but neither does alternative medicine claim 100%. How about some alternatives instead of a pile of criticism?
Posted by Terryeo on April 26, 2008 6:21 AM
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