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Treating The Common Cold

For the last week I have had a cold. I usually get one each winter. I have two kids in school and they bring home a lot of viruses. I also work in a hospital, which tends (for some reason) to have lots of sick people. Although this year I think I caught my cold while traveling.  I’m almost over it now, but it’s certainly a miserable interlude to my normal routine.

One thing we can say for certain about the common cold — it’s common. It is therefore no surprise that there are lots of cold remedies, folk remedies, pharmaceuticals, and “alternative” treatments. Finding a “cure for the common cold” has also become a journalistic cliche — reporters will jump on any chance to claim that some new research may one day lead to a cure for the common cold. Just about any research into viruses, no matter how basic or preliminary, seems to get tagged with this headline. (It’s right up there with every fossil being a “missing link.”)

But despite the commonality of the cold, the overall success of modern medicine, and the many attempts to treat or prevent the cold — there are very few treatments that are actually of any benefit. The only certain treatment is tincture of time. Most colds will get better on their own in about a week. This also creates the impression that any treatment works — no matter what you do, your symptoms are likely to improve. It is also very common to get a mild cold that lasts just a day or so. Many people my feel a cold “coming on” but then it never manifests. This is likely because there was already some partial immunity, so the infection was wiped out quickly by the immune system. But this can also create the impression that whatever treatment was taken at the onset of symptoms worked really well, and even prevented the cold altogether.

What Works

There is a short list of treatments that do seem to have some benefit. Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen, and naproxen, can reduce many of the symptoms of a cold – sore throat, inflamed mucosa, aches, and fever. Acetaminophen may help with the pain and fever, but it is not anti-inflammatory and so will not work as well. NSAIDs basically take the edge off, and may make it easier to sleep. Read more »

*This blog post was originally published at Science-Based Medicine*

Vaginal Steam Baths: A Medical Opinion

A spa in California is offering vaginal steam baths, in which spa-goers squat or sit on open stools over a tub of hot steam, as a cure-all for menstrual, digestion, and mood disorders:

The V-Steam: Inspired by an ancient ritual practiced for many years in Korea. The steam from the herbal tea rises and absorbs into your skin & orifice. This steaming treatment stimulates the production of hormones to maintain uterine health, aids regular menstrual cycles, helps correct digestive disorders while soothing the nervous system. The natural antibiotic and anti-fungal properties are said to help maintain internal health as well as keeping your skin looking young. (30 min: $50. Series of 6: $180.)

It’s a douche, folks. A $50 douche made with mugwort and 13 other herbs and having a fancy Korean name: Chai-Yok. True, the water gets up there as steam, and if you don’t squat just right over the steam bath, I imagine it may not get up there at all. But in the end, it’s a douche.

We docs strongly advise against douching since we know that women who do it have higher rates of vaginal and pelvic infections. Not to mention that the vaginal mucosa is highly-absorptive surface, meaning anything you put in there is likely to end up in the rest of your body. And so I ask: What herbs are they using, at what doses, and what side effects might they have? Not to mention what might be growing in those wooden tubs they have you squatting over? Read more »

*This blog post was originally published at tbtam*

Unscientific Medicine: What’s The Harm?

Any promoter of science-based medicine often faces the question: “What’s the harm?” What is the harm if people try treatment modalities that are not based upon good science, that are anecdotal, or provide only a placebo benefit? There are generally two premises to this question. The first is that most “alternative” placebo interventions are directly harmless. The second is that direct harm is the only type worth considering. Both of these premises are wrong.

The pages of Science Based Medicine (SBM) are filled with accounts of direct harm from unscientific treatments: Argyria from colloidal silver, death from chelation therapy, infection or other complications from acupuncture, burns from ear candleing, stroke from chiropractic neck manipulation — the list goes on. You can read anecdotal accounts of such harm on the website,

Of course, as we often point out, harm and risk is only one end of the equation — one must also consider benefit. It is the risk-benefit ratio of an intervention that is important. But generally we are talking about interventions that lack any evidence for benefit, and therefore any risk of harm is arguably unacceptable. Read more »

*This blog post was originally published at Science-Based Medicine*

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