Você conhece a iridologia real ou falsa?

Ignatz von Péczely, a 19th-century Hungarian physician is usually credited with inventing iridology. He got the idea for this novel diagnostic tool when he saw a dark streak in the eyes of a man he was treating for a broken leg and it reminded him of a similar dark streak in the eyes of an owl whose leg he had broken years earlier. Von Péczely then went on to document similarities in eye markings and illnesses in his patients. (According to Wikipedia, von Péczely’s nephew, August von Péczely, dismissed the story about the dark streaks as apocryphal. The Wikipedia article also notes: “Iridology is not supported by any published studies and is considered pseudoscience by most medical practitioners and eye care professionals.” Even if the story is apocryphal, I like it because it illustrates the magical thinking of practitioners and patients.) Others completed the map of the eye. A typical map divides the eye into sections, using the image of a clock face as a base. So, for example, if you want to know the condition of a patient’s thyroid gland, you need not touch the patient to feel for any enlargement of the gland. Nor do you need to do any tests of the gland itself. All you need to do is look in the iris of the right eye at about 2:30 and the iris of the left eye at about 9:30. Discolorations, flecks, streaks, etc. in those parts of the eyes are all you need concern yourself with, if it is the condition of the thyroid you wish to know. For problems with the vagina or penis, look at 5 o’clock in the right eye. And so on. An iridologist can do an examination with nothing more than an iridology map, a magnifying glass, a flashlight, and a vivid imagination.

Se o raciocínio de von Péczely for típico, podemos supor que ele e outros iridologistas se enganaram ao procurar e encontrar correlações entre marcas oculares e doenças (viés de confirmação). Eles estavam trabalhando com noções vagas de “marcações” e “doença.” Diseases may not have been precisely or accurately diagnosed in many cases. They were able to validate iridology by finding many correlations that in fact were not established as causal relationships by rigorously defined controlled studies. Some of their correlations may be accurate, but many are undoubtedly bogus

Você conhece a iridologia real ou falsa?

Estudos Científicos

In 1979 Bernard Jensen and two other proponents failed a scientific test in which they examined photographs of the eyes of 143 persons in an attempt to determine which ones had kidney impairments. (Forty-eight had been diagnosed with a standard kidney function test, and the rest had normal function.) The three iridologists showed no statistically significant ability to detect which patients had kidney disease and which did not. One iridologist, for example, decided that 88% of the normal patients had kidney disease, while another judged that 74% of patients sick enough to need artificial kidney treatment were normal [3]. Click here to see an example of Jensen’s iridology chart.

Em 1980, um experiente iridologista australiano passou por dois testes. Na primeira, ele examinou fotografias de 15 pacientes que haviam sido avaliados clinicamente e apresentavam um total de 33 problemas de saúde. O iridologista não diagnosticou corretamente nenhum desses problemas. Em três casos ele citou uma parte do corpo que teve problemas (por exemplo, ele disse “lesão na região da garganta” para um paciente cujas amígdalas foram removidas durante a infância), mas ele perdeu completamente as outras 30 áreas problemáticas e fez 60 diagnósticos incorretos. No segundo ensaio, quatro pessoas tiveram seus olhos fotografados quando estavam com boa saúde e refotografados quando relataram estar doentes. O iridologista fez um grande número de diagnósticos (incorretos) a partir das fotografias iniciais e não conseguiu identificar com precisão nenhum órgão que sofreu alteração quando surgiu o problema de saúde. Ele também foi solicitado a comparar fotografias da íris de outro indivíduo saudável, tiradas com apenas dois minutos de intervalo. Ele fez cinco diagnósticos incorretos para o primeiro deles e quatro diferentes diagnósticos incorretos para o segundo [4].

No final da década de 1980, cinco importantes iridologistas holandeses foram reprovados em um teste semelhante, no qual foram mostrados slides coloridos em estéreo da íris direita de 78 pessoas, metade das quais sofria de doença da vesícula biliar. Nenhum dos cinco conseguiu distinguir entre os pacientes com doença da vesícula biliar e as pessoas saudáveis. Nem eles concordaram entre si sobre qual era qual [5]. Estes resultados negativos, claro, não são surpreendentes, porque não existe nenhum mecanismo conhecido pelo qual os órgãos do corpo possam ser representados ou transmitir o seu estado de saúde a locais específicos da íris.

In another study, researchers took color photographs of the eyes of 30 patients with ulcerative colitis, 25 with coronary heart disease, 30 with asthma, 30 with psoriasis, and a control group matched for age and gender. The photographs were coded and analyzed by an investigator, both manually and by a computer program according to criteria generated by leading iridologists. Using either method, discrimination between cases and controls was not different from what would be expected by chance. The authors concluded that “diagnosis of these diseases cannot be aided by an iridological-style analysis.” [6]

Em 1998, Eugene Emery, escritor científico do Diário da Providência, tested the ability of two iridologists to assess his health and to match slide he had prepared of the eyes of eight people who had been medically diagnosed. Both iridologists scored very poorly [7].

In 2000, Dr. Edzard Ernst issued a thorough review of published reports up to that time. Noting that none of the “positive” studies had been properly designed, he concluded:

Might iridology be doing any harm? Waste of money and time are two obvious undesired effects. The possibility of false-positive diagnoses, ie, diagnosing—and subsequently treating—conditions that did not exist in the first place, seems more serious. The real problem, however, might be false-negative diagnoses: someone may feel unwell, go to an iridologist, and be given a clean bill of health. Subsequently, this person could be found to have a serious disease. In such cases, valuable time for early treatment (and indeed lives) can be lost through the use of iridology [8].

In another study, three iridologists and ten optometry students were shown color iris slides of 30 people with who had fractured an arm or leg and 30 controls without trauma history. Jensen and several other iridologists were consulted about the study’s design. None of the participants demonstrated significant diagnostic accuracy [9]. Fractures were chosen as the medicalk condition to see whether von Peczely original claim about the owl with a broken leg could be reproduced in humans.

A study published in 2005 tested whether iridology could be useful in diagnosing common forms of cancer. An experienced practitioner examined the eyes of 68 people who had proven cancers of the breast, ovary, uterus, prostate, or colorectum, and 42 for whom there was no medical evidence of cancer. The practitioner, who was unaware of their gender or medical details, was asked to suggest up to five diagnoses for each person and his results were then compared with each subject’s known medical diagnosis. Iridology correctly diagnosed cancer in only 3 of the 68 cases [10].

Worrall has noted the ways iridologists try to excuse their failures:

Proponents . . . use a number of ways to rationalize their inconsistencies. One may claim to make subclinical diagnoses; that is, sometimes years before there are signs or symptoms of disease. Or one may claim to use iridology to rate a subject’s constitution or susceptibility to disease. Another might dispute the medical tests used to confirm a medical diagnosis and 路may contest existence of the disease. Others may diagnose hypothetical and imagined disorders using terms such as toxic settlement, chronic weakness, or underactivity of an organ or system These broad characterizations of a subject’s state of health contrast with the detail contained in iris charts, and they are not easily quantifiable for study [9].

Desilusão

Herbalist Michael Tierra has described how he became disillusioned with iridology. After making various observations, he stopped using it but still hoped that it would turn out to have some value. Then, however:

Um colega mais jovem, totalmente equipado com o mais moderno equipamento especializado em iridologia, apresentou-se e afirmou que queria realizar leituras de iridologia na minha clínica e, ao mesmo tempo, monitorar a evolução dos meus pacientes durante um período de seis meses.

Given the fact that for most of us as well my patients six months is quite a long period, there was ample opportunity for many of these to go through a variety of health-related changes. Some people became well and got sick again with either the same or perhaps a different set of symptoms, others suffered injuries or operations. They all had their irises repeatedly photographed and studied by my colleague and myself. Where was Peczely’s owl or the markings he claimed to observe in patients of the 19th century Hungarian hospital ward? Where were the fine white healing lines that were supposed to knit together the small dark lacunae corresponding to the healing of operations and injuries of different parts of the body?

Our conclusion after six months: my colleague, trying to hold on to the fast disappearing shred of belief in the validity of iridology sheepishly and somewhat guiltily sold his camera to another would-be iridology enthusiast. I buried my official iridology magnifying head band in a box in a dark, hopefully soon forgotten area of my office closet, where I must confess it still remains after over 15 years, unopened [11].

Another former iridologist, Joshua David Mather Sr., has written a detailed account of the origin and termination of his beliefs. He began studying iridology at age nine when his father became a practitioner. He abandoned it at age 25 after examining polaroid films of many patients and finding out that although their symptoms often improved, their eye markings never changed [12].

O resultado final

Iridology makes no anatomic or physiologic sense. It is not merely worthless. Incorrect diagnoses can unnecessarily frighten people, cause them to waste money seeking medical care for nonexistent conditions, or steer them away from necessary medical care when a real problem is overlooked.

Alguns distribuidores multiníveis estão usando a iridologia como base para recomendar suplementos dietéticos e/ou ervas. Qualquer pessoa que faça isso e não seja um profissional de saúde licenciado seria culpada de praticar medicina sem licença, o que é uma violação da lei estadual.

If you encounter anyone practicing iridology, please complain to your state attorney general.

Referências

1. About iris constitutions. Guild of Naturopathic Iridologists International Web site, accessed August 20, 2004.
2. Worrall RS. Iridology: Diagnosis or delusion? Skeptical Inquirer 7(3):23-35, 1983.
3. Mehrotra H and others. Does iris change over time? PLOS One 8(11):e78333, 2013.
4. Simon A and others. An evaluation of iridology. JAMA 242:1385-1387, 1979.
5. Cockburn DM. A study of the validity of iris diagnosis. Australian Journal of Optometry. 64:154-157, 1981.
6. Knipschild P. Looking for gall bladder disease in the patient’s iris. British Medical Journal 297:1578-1581, 1988.
7. Buchanan TJ and others. An investigation of the relationship between anatomical features in the iris and systematic disease with reference to iridology. Complementary Therapies in Medicine 4:98-102, 1996.
8. Emery CE. Iridology: Do the eyes have it? Nutrition Forum 6:5-6, 1989.
9. Ernst E. Iridology: Not useful and potentially harmful. Archives of Ophthalmology 118:120-121, 2000.
10. Worrell R and others. Iridology: Diagnostic validity in orthopedic trauma. The Scientific Review of Alternative Medicine 6:63-67, 2002.
11. Münstedt K and others Can iridology detect susceptibility to cancer? A prospective case-controlled study. Journal of Alternative and Complementary Medicine 11;515-519, 2005.
12. Tierra M. A comparative evaluation of diagnostic systems used in herbal medicine. Accessed Dec 23, 1998.
13. Mather JD. Confessions of a former iridologist. Quackwatch, Sept 10, 2004.

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