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Nov Dec**_SI new design masters 9/27/12 10:57 AM Page 43 The Pseudoscience of Live Blood Cell Analysis Of the many aspects of alternative medicine, one of the most bizarre is live blood cell analysis. This unapproved blood test supposedly identifies nutritional deficiencies and other nebulous conditions. THOMAS PATTERSON connected to the microscope and feeds a ake a simple scientific fact or term, build an elaborate video monitor so that the enlarged image fantasy on top of it, promote it, and you have pseudo- is visible on the screen. For a fee, the Tscience. Live blood cell analysis by darkfield mi- practitioner will offer the test to a patient croscopy is an example. It sounds like a legitimate and valu- or attendee at a health fair. The customers may be asked to prick able evidence-based diagnostic procedure; it is not. their own fingers with a sterile lancet to Darkfield microscopy is a microscopic darkfield is by definition dark, most of obtain blood. It is illegal in some states technique in which light strikes the ob- the detail that is apparent in brightfield for an alternative medicine practitioner served material from the side rather than examination is invisible. The use of dark- to perform any invasive procedure on the from underneath and through the mate- field techniques in examining live blood public. In these states, the customers rial. The background is dark with the ob- for cellular shape and detail is suspect must perform the invasive procedure by served material highlighted by the lateral and is not offered by most reputable collecting their own blood samples. light source. In normal brightfield mi- medical laboratories because it has little After a drop of blood oozes to the croscopy, the background is white or very diagnostic value. surface of the skin, the practitioner will light and the material is usually darkly That fact has not deterred some alter- dab it onto a glass cover slip and place stained to bring out fine details and col- native medicine practitioners from pro- the slip on a glass slide for observation ors not normally visible. viding live blood cell analysis (darkfield under the darkfield microscope. The In medicine, the most common use of blood analysis) to the unsuspecting pub- practitioner will then scan the slide and brightfield microscopy is in diagnostic lic. In a typical scenario, the alternative point out various features of the sample applications. The commonly or dered medicine practitioner will have the dark- as the customer observes the screen in complete blood count (CBC) is often field microscope set up at a health fair or confused wonderment. partly done with stained smears of the in his or her office. A video camera is The problem is that most of these patient’s blood observed under bright- field microscopy. With this technique, the clinical laboratory scientist can ob- serve very fine details about the size and shape of the red blood cells; the shape, size, and relative numbers of the white blood cells; and the presence or absence of platelets, those small cell fragments that cause blood to clot. Darkfield microscopy is useful in the medical laboratory for identifying living spirochetes collected from an infected patient. These are corkscrew-shaped bac- teria that can be seen wiggling and corkscrewing their way through the liq- uid or material in which they are sus- pended. However, the use of darkfield microscopy as part of a CBC or analysis of live blood is questionable. Because Skeptical Inquirer | November/December 2012 43 Nov Dec**_SI new design masters 9/27/12 10:57 AM Page 44 practitioners are not trained medical pro- The rouleaux observed by alternative level of slight alkalinity; blood is never fessionals and are not qualified to exam- medicine practitioners are almost always acidic unless the person is very ill. ine a blood sample. Microscopes and artifacts due to the slight drying of the Rouleaux are not caused by acidic video set-ups are available for purchase blood sample around the edges of the blood, and people who are actually in by anyone for $3,500 to $6,000. With coverslip or due to clumping in areas of severe acidosis would certainly not be the purchase of the set-up, a two- or the slide where there is a large concen- well enough to be wandering around an three-day training course is offered. No tration of red cells. In micro scopy, an ar- alternative medicine health fair. Curi- one can be adequately trained in a couple tifact is something that looks abnormal ously, other practitioners will state that of days to properly evaluate a blood sam- or odd but is actually insignificant and is rouleaux are actually caused by a slug- ple. Laboratory professionals and pathol- ignored by a trained professional. Blood gish or weak pancreas that is not digest- ogists must take years of training through cells will normally start to clot and stack ing protein properly. accredited educational programs before upon coming in contact with glass. Alternative medicine practitioners they can competently perform a micro- Observa tion of red cell rouleaux on a often demonstrate a complete lack of scopic examination of blood cells. darkfield microscope from a finger-stick knowledge concerning basic biology— not to mention pathology or medicine. They will comment that the red cells are beginning to bud off bacteria from the edge of the red cell membrane. These A high school biology student would know that small artifacts near the cell membrane one form of life cannot instantly transform are interpreted as bacteria being born. A high school biology student would into another; it’s completely implausible. know that this idea is implausible. One form of life cannot instantly transform into another. It is a biological impossi- bility for a red blood cell to transform into a bacterium. Each biological organ- ism, from a blue whale to a Vidalia Businesses that provide these micro- sample obtained from a customer or pa- onion to a coliform bacterium, has a scope/video set-ups are careful in de - tient is diagnostic of nothing. completely different genome or set of scribing the purpose of their product. If the slide is observed near the cen- DNA that makes the organism unique. Most will say that their equipment is to ter of the coverslip, rouleaux are rarely If the practitioner could actually identify be used for educational purposes only. seen. The red cells are free floating and bacteria in the blood, the customer is in Customers will supposedly be moti- are not attached to each other. The danger and should request immediate vated to improve their lifestyles after practitioner will often identify these red transfer to the nearest emergency room seeing their blood on the video screen. cells as “healthy.” The customer can be to be treated for septicemia, a poten- The product is not to be used to diag- misled by the practitioner moving the tially life-threatening infection of the nose, evaluate, or treat any disease or slide near the edge of the coverslip bloodstream. disorder. Undoubtedly, the purpose of where false rouleaux are common or Some artifacts are mistakenly iden- this disclaimer is to prevent legal entan- showing the field near the center where tified by the practitioner as yeast cells, glements. Providing an unlicensed, non- rouleaux are rarely seen. The practi- one of the most common “findings” by validated test to diagnose disease or ill- tioner can show the customer whatever alternative practitioners. Yeast cells can- ness is unprofessional if not illegal. he or she wants the customer to see by not be seen in the blood of a healthy However, in actual practice, most al- selecting a specific area of the slide. person for the simple reason that they ternative practitioners will come close to According to some alternative prac- are not there. An actual fungus (yeast) a diagnosis as they review the blood sam- titioners, rouleaux are indicative of acid in the blood is seen in patients who are ple. While reviewing the sample with the in the blood. Anyone who has taken a critically ill with some type of severe customer the practitioner will often ob- real anatomy and physiology course immune system deficiency. These indi- serve “rouleau” formations of the red cells. knows that blood is not acidic unless viduals also will not be well enough to Rouleaux occur when the red cells stack the person is acutely ill with respiratory be wandering about at a health fair. on top of one another and appear like or metabolic acidosis, conditions that Often a microscopic shard of glass stacks of coins. True rouleaux can be seen are life-threatening. The kidneys will from the slide will be present in the mi- in patients with plasma protein abnor- normally excrete excess metabolic acid croscopic field. These tiny shards are malities like multiple mye loma, but this into the urine while the lungs continu- present on most slides unless the slide is is rare. Myeloma is a life threatening con- ally rid the body of excess carbon diox- carefully cleaned before use. The alterna- dition and requires medical attention. ide to keep the blood at the normal tive practitioner will usually identify 44 Volume 36 Issue 6 | Skeptical Inquirer Nov Dec**_SI new design masters 9/27/12 10:57 AM Page 45 these glass shards as uric acid crystals or influence after eating a doughnut. The formed by qualified personnel and that cholesterol plaques, which are simply not light spots are actually artifacts and are all laboratory tests offered must be con- visible in a blood sample.

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