Greg Kochanski

Question

I am the volunteer administrator for the ZZZ and Black Cohosh Information Center, ... and how to effectively ease its symptoms. In our efforts to promote awareness about ZZZ, we have been looking for websites to exchange links with. ...

If you will link to "The ZZZ and Black Cohosh Information Center", located at ZZZ and send me an email listing where the link can be found on your site, I will add your reciprocal link to our site within 24 hours.

Answer

Dear Ms. Whitley,

I really can't endorse Black Cohosh for much of anything unless I see some proper studies that prove it works.

It's a matter of professional standards and personal ethics.

Many people believe that a few individual testimonials are a good enough reason to try something or recommend it, but that's not so. Let me give you a story.

Imagine that (I'm sure it's not so!) half of the people who use Black Cohosh get better, and half die within a week. Will you still get testimonials? You betcha! The recovered ones will burble away, and the dead ones will be quite quiet. Even an opinion poll of users will indicate that 100% of the respondents are happy with the stuff.

So, you have to be careful. Nature is not malicious, but nature is sometimes rather complex and confusing.

The techniques for being careful are really the core of medical science that we've learned over the last few hundred years. In a proper study, you

1. Follow all the patients as well as you can (to make sure the dead ones don't lie silently).
2. Always compare people getting the treatment against a similar group of people who don't get the treatment. This is called a "control group". People sometimes feel better without any help, all by themselves, and you have to find out how many will get better without Black Cohosh.

• If possible, you don't tell the patients if they are getting Black Cohosh or not. Why? Because we've learned that some people feel better if they believe in a treatment. Any treatment.
• This is called the placebo effect. (See the ONION for a humorous look at the placebo effect.) It seems that giving a person a pill filled with sugar, or a shot of pure distilled water will (if they believe it is a real treatment), often make people feel much better. The placebo effect is a bit mysterious! Still, unless Black Cohosh does better than a sugar pill (or a little lump of bread, or some other cheap, safe, and known harmless placebo) why use it? Unless the stuff works better than chocolate, why not give them chocolate?
• If possible, don't even tell the people doing the experiment. We've learned not to trust ourselves completely, either. Doctors and scientists have hopes and beliefs, and if they believe that the patient should be getting better, we will often believe that the patient really is getting better.
• But, it's a cruel hoax to let your hopes and emotions influence the study. Ultimately, what counts is whether the patients get better, not what the doctors feel. So, good experimenters will do what is called a 'double-blind' experiment. No one, not the patients, not the doctor knows who is getting what until it's all written down on paper. Only then do you open the envelope and see who got what.

So, I'd love to exchange links, but only if you have something that really works.