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Referring to the Flexner Report, he said that medical education "needs a good Flexnerian housecleaning." For example, David Gorski criticized Brian M.

Berman, founder of the University of Maryland Center for Integrative Medicine, for writing that "There [is] evidence that both real acupuncture and sham acupuncture [are] more effective than no treatment and that acupuncture can be a useful supplement to other forms of conventional therapy for low back pain." He also castigated editors and peer reviewers at the New England Journal of Medicine for allowing it to be published, since it effectively recommended deliberately misleading patients in order to achieve a known placebo effect.

A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or qualifications he or she does not possess; a charlatan or snake oil salesman".

Common elements of general quackery include questionable diagnoses using questionable diagnostic tests, as well as untested or refuted treatments, especially for serious diseases such as cancer.

Unproven, usually ineffective, and sometimes dangerous medicines and treatments have been peddled throughout human history.

Theatrical performances were sometimes given to enhance the credibility of purported medicines.

For example, Beecham's Pills, which according to the British Medical Association contained in 1909 only aloes, ginger and soap, but claimed to cure 31 medical conditions, were sold until 1998.

British patent medicines lost their dominance in the United States when they were denied access to the Thirteen Colonies markets during the American Revolution, and lost further ground for the same reason during the War of 1812.These "typical" patent or quack medicines were marketed in very different, and highly distinctive, bottles.Each brand retained the same basic appearance for more than 100 years.With little understanding of the causes and mechanisms of illnesses, widely marketed "cures" (as opposed to locally produced and locally used remedies), often referred to as patent medicines, first came to prominence during the 17th and 18th centuries in Britain and the British colonies, including those in North America.Daffy's Elixir and Turlington's Balsam were among the first products that used branding (e.g."anything involving overpromotion in the field of health." This definition would include questionable ideas as well as questionable products and services, regardless of the sincerity of their promoters.