Prince Charles’s ideas about medicine may seriously harm your health

We tend to think of alternative medicine as a colourful array of therapeutic methods. However, this ignores the fact that alternative practitioners also use a range of diagnostic tools which would bewilder every conventional physician. These alternative diagnostic methods have grown out of the different traditions of alternative medicine and are therefore are extremely diverse. Yet they have in common that they have either not been validated or, in case they have been tested, they have been found to be invalid.

Non-validated diagnostic methods run an unacceptably high risk of producing false positive or false negative diagnoses; with invalid methods, the risk turns into certainty. A false positive diagnosis is a diagnosis that the patient in question is, in fact, not suffering from. Such a scenario is, of course, a most welcome ‘carte blanche’ for every charlatan; it enables him or her to cash in on treating something that is not even there. A false negative diagnosis is much more dangerous; it means missing an existing disease, and that might even threaten the patient’s life.

In addition to false positive and false negative diagnoses, we also encounter invented diagnoses. By this term I mean conditions that are pure fantasy and have been invented by practitioners mostly in order to keep the cash flowing into their bank accounts. Chiropractors, for instance, go on about ‘subluxations’ which are a complete myth, and acupuncturists speak of yin or yang deficiencies which have no basis in reality.

More than 20 years ago, I published a review evaluating the evidence for or against alternative diagnostic techniques entitled ‘Which craft is witchcraft?’. Its conclusions are as true today as they were then: ‘…alternative’ diagnostic methods may seriously threaten the safety and health of patients submitted to them. Orthodox doctors should be aware of the problem and inform their patients accordingly.

Fifteen years after the publication of my paper, Prince Charles published his book Harmony: A New Way of Looking at Our World. It covers, among many other topics, the subject of alternative diagnostic techniques. This is what His Royal Highness tells us about them:

I have also learnt from leading experts how we can understand a great deal about the causes of ill health through more traditional methods of diagnosis — for example, through examination of the iris, ears, tongue, feet and pulse, very much the basis of the Indian Ayurvedic system.

This is not to say that modern diagnostic techniques do not have a role, but let us not forget what we can gain by using the knowledge and wisdom accumulated over thousands of years by pioneers who did not have access to today’s technology. In fact, an over-reliance can often mean that the subtle signs of imbalance revealed by the examination of the eyes, pulse and tongue are totally missed.

Including the fruits of such knowledge, gleaned over 8,000 years of studying the relationship of the human body to the rest of Nature and to the Universe, can but only provide an extra, valuable resource to doctors as they seek to make a full diagnosis. Why persist in denying the immense value of such accumulated wisdom when it can tell us so much about the whole person — mind, body and spirit? Employing the best of the ancient and modern in a truly integrated way is another example of harmony and balance at work.

When he talks about ‘the subtle signs of imbalance revealed by the examination of the eyes’, Charles is referring to iridology, of course. Iridologists diagnose diseases or susceptibility to diseases by analysing the colour pattern of a patient’s iris. This method has repeatedly been put to the test, and, in 1999, I published a systematic review of the evidence which concluded that ‘the validity of iridology as a diagnostic tool is not supported by scientific evaluations. Patients and therapists should be discouraged from using this method.’

And when Charles talks about ‘the subtle signs of imbalance revealed by the examination of the feet’, he might think of the diagnostic technique some reflexologists employ when palpating the feet of their patients to draw conclusions about inner organs. In 2000, we put this method to the test. Eighteen adults with one or more of six specified conditions were identified from primary care records. Two reflexologists, blinded to the patients’ conditions, examined each patient’s feet and rated the probability of each of the six conditions being present. The results revealed that reflexology is no good at distinguishing between the presence and absence of any of the six conditions. Inter-rater reliability scores were very low and provided no evidence of agreement between the examiners. We concluded that, ‘despite certain limitations to the data provided by this study, the results do not suggest that reflexology techniques are a valid method of diagnosis’.

Given that the evidence for alternative diagnostic techniques is either negative or absent, why does the heir to the throne advocate using them? He must be aware that he has considerable influence; in fact, it would not be unreasonable to assume that this is precisely why he goes to the trouble of writing a book. So, does he not know that publishing nonsense about medicine endangers the health of those who believe him? Why does he call disproven diagnostic tools ‘valuable’? The answer, I assume, is that he does not know better.

There would be nothing wrong with Charles’s ignorance, of course. He is not a medic — if he were, this quackery might get him struck off the medical register. He does not need to know such things. But, if he is ignorant about certain technicalities, should he write about them? At the very least, when giving such concrete medical advice about diagnostic methods, should he not recruit the expertise of people who do know about such matters?

In Charles’s defence, I should mention that he did ask several physicians for help with his book. In the above-cited paragraph, he even stated that he ‘learnt from leading experts’. Two of those whose assistance he acknowledged in his book Harmony are Mosaraf Ali and Michael Dixon. I cannot help feeling that this reflects poorly on all three individuals: Ali and Dixon for not advising Charles more responsibly. And Charles for not recruiting better advisors.

Anyway, Charles is, of course, entitled to find new ways of looking at our world — with or without ‘leading experts’. But personally I would prefer it if he could look at diagnostics (and other medical issues) in a way that does not endanger the health of his subjects.

Edzard Ernst, emeritus professor at the University of Exeter, is the author of A Scientist in Wonderland and the awardee of the John Maddox Prize 2015 for standing up for science. He blogs at edzardernst.com.


  • John Traynor

    Priince Charles’ parents are related.

    • Jenny H

      Everybody’s parents are related.

  • mel

    Edzard Ernst has some gall to call himself a scientist and then to publish an article referring to an experiment with only 18 participants and 2 reflexologists as a method of putting the practice of reflexology “to the test” and to claim on that basis that “reflexology is no good…”. And why blast Charles for a book that was published years ago, has fantastic reviews and is simply an alternative opinion? Only because Edzard wants to use the name to get more hits on his overly sensationalised and one sided article.

    • Perhaps you have some good evidence that reflexology is effective?

      • mel

        The excerpt above from Charles’ book does not suggest using reflexology as a diagnostic tool in isolation; it is suggested as a way to help understand the causes of ill health and to be used as an “extra” tool alongside modern medicine. I’m not here to argue whether reflexology is effective as a diagnostic tool, but what I am saying is that the author of this article should not be so arrogant to say such methods have no basis in reality and cite just one small study that really has no basis for forming any scientific opinion, either yay or nay. On this basis, he goes on to call this a “disproven diagnostic tool” yet considers himself the scientist. His logic is too black and white, too overly simplistic. His take away from the excerpt is incorrect and his reaction, overly accusatory.

        From what I can tell, research does provide reflexology a degree of credibility as a discipline that supports orthodox care, but more research is needed to determine its role as a diagnostic tool. A scientific mind would take a more balanced and nuanced view.

        • “to be used as an “extra” tool alongside modern medicine”

          But if there’s no credible evidence it serves any use (the research you claim exists isn’t credible, but please do share it in case I’ve missed any) and if there is positive evidence that it is useless, then using it it just wasting time and money and is potentially misleading and therefore dangerous. That’s the problem.

          Here, also from Ernst, who has demonstrably studied this more than you have: “The
          best evidence available to date does not demonstrate convincingly
          that reflexology is an effective treatment for any medical condition.”
          https://www.ncbi.nlm.nih.gov/pubmed/19740047

          If reflexology (a) isn’t observed to work reliably if at all and (b) is potentially dangerous due to its ability to mislead, what other logical decision could be made? How is that “too black and white”? “Balance” does not mean giving equal weight to every idea: that is called “false balance”.

          Personally, I’m all for a little complementary therapy for really life-threatening diseases like cancer. Done right, it can help raise spirits and give hope in a world filled with fear. But I’m thinking more of light exercise and talking therapy than having your feet tickled…

        • Ieva Zagante

          Then why reflexdology and not sheep entrails? After all this had been used as tool to predict future, so let’s research, whether it is possible to find out the fate of particular patient!~
          There cannot be anything in between in diagnostics: either the method works or it does not. And if there are methods that work, the new ones should either work better or be easier to use, but work as well as the existing one. Reflexology has not proven it is either.

        • Ieva Zagante

          By the way, if reflexology is of any value, what about people with foot deformations then? Is their health totally ruined? Or somewhat wrong? And what happens after deformation is surgically corrected? Do you really believe that you can e.g. treat muscular atrophy by operating cavoid feet?

          • kfunk937

            Then the reflexologist just uses the ear (more specifically, the auricle / pinna). Because they needed backup plans for amputees and such.

            If there are no external ears, I ‘spose there’s always the tongue…

        • mel said:

          “From what I can tell, research does provide reflexology a degree of credibility as a discipline that supports orthodox care”

          What research?

          • kfunk937

            What degree of credibility? Are we looking at a range, say from 0 to something? Inclusive of zed, I’ll concede the point.

    • weather_nerd

      Do you hear yourself? For something so ridiculous as feet indicating the health of one’s organs, why even bother with such a method in the first place? We already have many others which are proven to be effective.

    • Edzard Ernst deserves a public apology from prince Charles and from the University of Exeter for their money grubbing quack-cure supporting harassment of sound academic clinical and evaluation scholarship.
      Moreover, Ernst deserves a knighthood for the good scientific work he has done for humanity.

    • Acleron

      Unlike the pseudoscientists and quacks, Ernst mentioned the limitations of that experiment. Where is the evidence from those making these claims that their frankly ludicrous diagnostic techniques work?

  • In America they were compelled to lock-away Typhoid Mary because she was a public health threat. It seems to me that Prince Charles – in misleading the public regarding his promotion of clinically debunked quack cures and other “dark-ages” wishful thinking delusional nonsense – is a threat to the health of all those members of the public who know no better than to listen to him. And there are lots of them it seems.

    We have the Tower of London. I propose we use it for the benefit of the nation by creating a “Right Royal Charlie” public health educational attraction. A robotic manikin of Charles, a hologram projection, or a character actor would serve as well as the genuine Right Royal Charlie menace himself. All the proposed attraction need do is spout some of Charles ludicrously uninformed and dangerous claptrap about “alternative therapies” etc . Imagine the lives that would be saved.

  • Tarek

    Unusually balanced and non-emotive for a change. I’m sure the fact that it was about HRH the Prince of Wales is just mere coincidence

  • figs

    He’s never been the sharpest pencil in the drawer.

  • Jenny H

    Poor Charles. on the other hand some people can be intuitive about problems without actually understanding what has caused them to make that diagnosis.
    But it is the arrogance of ‘alternative medicine practitioners’ that gravely concerns me. I would suggest that anybody who thinks they are ‘reliable’ to go to a few different practitioners without letting on they are already seen someone else. They are all most unlikely to guess the same thing.
    (It is also not a bad idea to get second opinions from mainstream medical practitioners too.)