Sunday 13 June: from 3 pm at Cafetopia, 1 Hackett Place, Hackett.

Cafetopia is an intellectual café run by Julia McCarron-Benson who was president of Canberra Skeptics for some years.

Pizza only $5 per head if you wish to bring your own wine. Gold coin donation for the "extras".

Fri 25th June, 7.30pm. Dr Jill Gordon: "A sceptical view of psychotherapy" Canberra Bridge Club, 60 Duff Place, Deakin (behind the Deakin Shops). Some members will be dining at a local restaurant before the talk; for information contact Vicki or Pete on 6296 4555.

Thur 8th July, 7.30pm. Lynne Kelly: "Science and the paranormal − a writer's perspective". RSL, Civic.

Fri 13th Aug, 7.30pm. Social evening at the Wig and Pen, Civic.

Sat 21st Aug, 1.00pm. Forum on Global Warming. CSIRO Discovery Centre

Sat 21st Aug, 7.00pm. Dinner and Debate "This house believes global warming is a Good Thing"

Sun 22nd Aug, 10.30am. Ride for the Planet. Hall to Parliament House.

International Skeptics conference will be held in Italy, at Padua (which is 30 mins drive from Venice) from October 8-10, 2004.

Our website has been updated by Jim Foley (thanx Jim!) and may be accessed (for those willing to search for it) via a link at www.skeptics.com.au. A quicker alternative is to log into http://finch.customer.netspace.net.au/skeptics/ As the Argos will in future be posted on this site, anyone wishing to be deleted from our direct emailing list should let me know − that will save us both some megabytes.

Canberra Skeptics needs the use of a power-point light projector for the talks on Friday 25 June and Thursday 8 July. Also a reasonably sized screen: the Bridge Club doesn't have one, and, while the RSL has three, all were broken for Alan Wade's talk on 13th May. If anyone has either we could use on these occasions, please contact Vicki Moss on 6296 4555.

Alan Wade's talk on Thur 13th May, ("Fire and water − a virtual reality") at the RSL, Civic was attended by close to 20 who were entertained with a fascinating account of how the fires in 2003 affected Canberra's water catchment and what has happened to it since. And if you think another dam is the answer to the ACT's future water needs, you should have been there.

From the Committee. Information about the August Forum and Ride for the Planet is available on the web site mentioned above. This info will also be in the June issue of The Skeptic. In the meantime, if you wish to register for the Forum and/or Dinner-Debate, keep an eye on the website and, when we get the registration form on it, print one off and follow the mailing instructions.

New Members. A warm welcome to six new members who joined at Alan's talk: Paul Wilkinson, Stephen Wilks, Dierk von Behrens, Nick Lhuede, Jim Watson, and Eva Papp.

As a child, like most small boys, from time to time I suffered from warts. Apart from an ingrowing (plantar) one on the sole of my foot − which had to be removed surgically − these were more a cosmetic nuisance than a pain. Except that is, until they were treated. In those days they were burnt off with dry ice, presumably because it was quick and cheap, and the carbon dioxide would supposedly have local anaesthetic properties; my memory was that it didn't, cos it hurt like hell. A less painful method is to have them charmed away: I speak from experience, of which more anon.

Now having a painful method of removing warts from little boys might have been deliberate. If the time between a decision being made to go to the clinic and actually turning up is a couple of weeks or three, and the child is warned how painful the visit will be, not infrequently the warts just disappear. How so? Another successful method is sham X-ray treatment (Dermatology. 2002; 204:287-289). How does this work? And Dr Greene (http://www.drgreene.com/21_567.html) reports, "'Charming warts' is particularly effective with children, and is discussed in leading medical textbooks. I've had success with dabbing warts with paint and letting children watch them glow under a black light! For added impact, I've sometimes pressed a painted wart onto a piece of filter paper to make a spot, and then burned the paper. I tell the child it will fall off in two weeks - and it does!" How come? Well a little bit of wart biology might help to answer these questions.

Warts are benign tumours (generally) of body surfaces (skin, mucosa) and are caused by viruses of the Papilloma group. A virus can only replicate (grow) inside living cells. Human wart viruses only infect humans, and only one cell type. Skin cells called keratinocytes (which eventually become the surface skin scales) in the dermis, if exposed to virus by minor trauma, may become infected. Each infected cell nucleus contains new virus DNA (about 50 copies of the original infecting DNA) behaving like mini-chromosomes. This DNA generates proteins, which interfere with the control of expression of surface receptors on the cell and its division, as do a variety of factors produced normally by the body to maintain the skin and effect wound repair. Growth factors derived from cells involved in production of new skin (complete with blood and nerve supply) interact with the infected keratinocytes and a skin nodule − a wart − is formed. But it is only when infected cells move closer to the skin surface and start to change to hardened skin scales do thousands of copies of the DNA (and then infectious wart virus particles) appear within them. In this way the virus produces a launching pad to infect the next victim, and evades circulating antibody and white blood cells, which is why these have been shown to be rather ineffective in eliminating warts. Stimulation of the immune response to warts to get rid of them (so popular with naturopaths and even physicians) is thus probably not the whole story − as we will see.

Warts vary in size, shape, texture and location depending on which of the over 100 known types of human wart virus is involved. They can persist for months or years, or life. Some types of wart virus have the potential to insert their DNA into the DNA of their host cell chromosomes, and as a result, these invaded cells sometimes become malignant. A co-carcinogen is probably involved. For example, in Queensland, skin containing wart virus around the eye of the non-pigmented (white) side of the face of Hereford cattle can become malignant under the influence of the sun's ultraviolet light; this rarely occurs where the skin is black. And there is good evidence squamous cell skin cancer in humans has a similar basis, especially in aging − or otherwise immunodepressed (including AIDS cases) − fair skinned Celts.

There is also a clear association of particular wart virus types with cervical, vulval, penile, rectal and laryngeal cancer in humans. For cancer to develop various co-carcinogens (such as herpes simplex virus, cigarette smoke, ultraviolet light, X-rays), hormonal changes (contraceptive pill, pregnancy) or dietary deficiency (e.g. folate) are believed to be involved. [Compared with non-smoking controls, the urine of smokers is loaded with carcinogens. A wag in one of my lectures, in answer to my question what the moral of this observation was, responded "Don't drink piss!"]. Cervical cancer is the sixth most common cancer worldwide and the most common in parts of the developing world; world wide, in women (naturally), it is the second most common cause of death from cancer (http://www.emedicine.com/MED/topic1037.htm).

Warts regress spontaneously for reasons not well understood. Immune suppression allows wart development, so it is currently believed the immune system is responsible for containing warts − and for their regression. It may well be, in part, but in my opinion other factors might be as important. For years, human wart virus couldn't be grown in cultured cells in the laboratory (though bovine ones could). Cell culture mostly uses bovine serum as part of the growth medium. When human growth factors were added to the medium, human keratinocytes could grow in culture and with them the wart virus. Now these growth factors − epidermal growth factor (EPG) and transforming growth factor alpha − are released by various cells involved in wound repair. Their role is to increase keratinocyte migration and multiplication. They can be released in response to external stimuli − so if you spend your days wielding an axe you'll develop calluses on the palms. Or if you cut yourself, the wound will heal. But can the brain control release of these factors via nerve endings in the skin? Well, maybe.

There is increasing evidence that keratinocytes, using chemical messages, have two-way communication with both the immune and nervous systems. Keratinocytes have receptors to various neurotransmitters (e.g. neurotensin, neurotrophin 3, mu-opiate, beta-endorphin, dopamine, beta-2-adrenergic, calcitonin-gene-related-peptide, substance P) and in themselves secrete substances such as nerve growth factor. I chanced upon one paper (Chin J Traumatol.(2002) 5(3):176-9) which described how nerve endings in skin wounds release substance P. Compared with controls (wounds with nerve endings treated with capsaicin to block substance P release) − the level of both EPG in wounded skin and EPG-receptors on its keratinocytes was raised significantly by substance P.

I heard somewhere once that nuns can develop a ridge of skin simulating a wedding ring on their ring finger through a desire to be wedded to Jesus. Whether this is a result of rubbing the spot continuously or through higher centre activity was not reported. The brain must certainly be involved in the terrified little boys losing their warts as mentioned above. But what about hypnosis? There are reports of warts being induced under hypnosis, and loads of reports of them being cured by hypnosis, or even autosuggestion. The latter happened to me.

My parents took the family camping in Cornwall for 3 or 4 weeks in 1948, when I was age six and a half. Each Sunday we had a cooked midday meal at the "Pig and Whistle" in the nearby village. I sported a large wart on the knuckle of my right middle digit, and the landlord's old mother noted this. She said for me to come back at noon on the day of the full moon and she would cast a magic spell and make the wart disappear. On the appointed day I was taken down into a basement kitchen where, I recall, there was a very large scrubbed wooden table. The old lady produced a venomous looking knife with which, dear readers, she did not attack the offending wart as you might surmise, but used it to cut up a raw tomato. Then, while chanting some spell in ancient Cornish, she rubbed the wart with a bit of the tomato: after this she informed me, in English, that as long as I believed the spell had worked, the wart would go. Being young I took this to heart, and so believed and, yes folks, the wart started to regress. But even at that tender age I was a skeptic. To test the spell I ceased to believe in its magic. And yes folks, the wart stopped regressing. Or maybe the tomato was the wrong variety, or over ripe, or the kitchen clock was fast.

Well as we know, alt med is replete with anecdotes such as this. So I might as well add another. In the 1980s, my 11-year-old niece was visiting from Scotland. We were spending Easter at a ski lodge at Falls Creek. Naturally there is always a full moon at Easter, and my niece was sporting a splendid wart on one finger. What a chance to test my white magic skills! So I charmed her wart away using the same routine as the old Cornish woman − with one exception. The ancient Cornish "spell" I chanted was actually a fair imitation of Spike Milligan gibberish. I instructed my niece to believe in the spell and she departed soon after for Scotland. A few weeks later I received a letter reporting the wart had gone and a request to write down the ancient Cornish spell for her. I sent her a Goon Show tape instead.

So, my sceptical friends, your reaction is, quite naturally, that these are mere coincidences − warts regress spontaneously, so where's the double blind, placebo-controlled, cross-over clinical trial? Well, many years ago I was told the medical literature had reported on 12 patients with warts all over the body − too many to treat surgically. Under hypnosis the patients were told the warts would disappear on the right side of the body only − the left side was to retain its warts as a control. With 11 of the patients the warts indeed disappeared from their right side; with the twelfth the warts disappeared only on the left side of the body. So hypnosis can work, and can depend on what side you believe is right or left − or maybe the erring patient was just contra suggestive.

OK, you say, it's just an urban myth − give us the reference. A Google on "warts hypnosis" − obviously a popular subject − resulted in 9370 hits (on 26 May 2004). Skimming through the first 100 revealed a great variety of folk remedies involving rubbing the wart (plus or minus accompanying incantations and/or sundry mystic activities) with things such as a piece of garlic (of course), onion, chalk, peas, beans, raw potato or apple, wild turnip or horse's milk; with oil of vitamins E or A or D, white cedar, neem tree, Tangantangan plant, cinnamon, clove, cashew, butter, pork or bacon rind; or with the juice of aloe Vera, milkweed, sow's thistle plant, dandelion, marigold, greater celandine, blood flower, common teasel, great chelidonium, brucea fruit, unripe figs, cashew fruit, papaya leaf, trumpet tree, Euphorbia helisscopia or a grasshopper. Plus the usual variety of alt med herbal and homoeopathic concoctions e.g. a lotion made by boiling a pint each of plantain leaves and cream, or sallow bark or celandine in vinegar, or onion in water: an aqueous extract of baked beans as a wart lotion has even been recently patented in the USA.

There was also advice on ingesting garlic capsules, zinc supplements, colostrum tablets, and/or fish oil, painting the wart with nail varnish, or contact glue, or sticking ducting tape on it, or taping to it a banana skin, a garlic clove, castor oil (neat, or as a paste with sodium bicarbonate), table salt, a fresh pepper pod, or fresh basil leaves. Or stroke the wart with a black snail and impale the latter on a thorn tree. I will not dwell on the use of cats, or urine, or the sweat from a corpse (or a horse) together with certain activities at the cross roads (or wherever) at midnight other than to quote Mark Twain "Why, you take your cat and go and get in the graveyard 'long about midnight when somebody that was wicked has been buried; and when it's midnight a devil will come, or maybe two or three, but you can't see 'em, you can only hear something like the wind, or maybe hear 'em talk; and when they're taking that feller away, you heave your cat after 'em and say, 'Devil follow corpse, cat follow devil, warts follow cat, I'm done with ye!' That'll fetch any wart." - Adventures of Tom Sawyer.

Number 41 of the Google gave me the reference I was after, the name of the second author of which − in view of the subject of these ramblings − is most appropriate (Sinclair-Gieben AHC, Chalmers D "Evaluation of treatment of warts by hypnosis" The Lancet ii: 480-482, 1959). The study actually involved 14 patients with multiple warts. Under hypnosis it was suggested to the patients that the side of their body the worse for warts would be cleared. Five were excluded as not adequately hypnotised since they failed the post-hypnotic suggestion that they would open the door when the clinician blew his nose; no change in their wart load was observed. The other nine patients were assessed over the next 5 -13 weeks. On the relevant side only, seven were totally cured and two, apart from one large fading wart, virtually cured: the other (control) side was unchanged in eight patients and cured in only one. If immune system activation alone was responsible for the warts regressing, it's difficult to explain the selective nature of the observed response.

Now that you know that folk remedies aim at inducing autosuggestion, you may feel that the cure for your warts is at hand. Unfortunately self-hypnosis has a poor record for curing warts, presumably because the rational mind overrules the subconscious one. And this might be why spells work best with children − at least up to the age they stop believing in fairies. A third party may be needed. I used to suffer from a stress-related muscle tic in my left eyelid, which for years I could will away by focussing on it − until a few years ago it just persisted. As an alternative to having the nerve to the eyelid cut, my GP in Melbourne talked me into trying hypnosis. I went under and am unaware what he said while I slept. On coming round I was instructed to clench my left fist tightly by my side whenever the tic started and it would stop. This I now do, and it does. Since nerves are responsible for twitching muscles, the hypnosis had presumably activated (and/or set up new) neural networks in my brain − networks able to inhibit release of neurotransmitters at the nerve endings serving my eyelid muscle.

Tinkering with the brain and immune responses has been around for many years. Following Pavlov's classical experiments with bells and salivating dogs, in the 1920s (with follow up in the 1950s) the Russians applied the classical conditioning experiments to immune responses. Robert Ader et al in the USA resurrected this research in the 1970s. These American workers fed rats with saccharin at the same time as injecting them with a toxic immunosuppressive drug (cyclophosphamide). Subsequently these conditioned rats showed marked immune suppression following re-feeding with saccharine alone [Psychosom Med 37:333(1975)]. A new discipline – psychoimmunology – was born. Much work since clearly demonstrates the higher centres can modulate immune responses. And not just to eliminate benign tumours like warts.

So has the 1959 report in The Lancet been repeated? Ewin (Am J Clin Hypn.(1992) 35(1):1-10) reviewed 41 cases of hypnotherapy of warts and concluded "Published, controlled studies of the use of hypnosis to cure warts are confined to using direct suggestion in hypnosis (DSIH), with cure rates of 27% to 55%. Prepubertal children respond to DSIH almost without exception, but adults often do not. Clinically, many adults who fail to respond to DSIH will heal with individual hypnoanalytic techniques that cannot be tested against controls. By using hypnoanalysis on those who failed to respond to DSIH, 33 of 41 (80%) consecutive patients were cured, two were lost to follow-up, and six did not respond to treatment. Self-hypnosis was not used."

But what if hypnosis fails? What about "proven" treatments for warts? Application of dyes such as neutral red (a known carcinogen!) was once used; methylene blue (with vigorous incantation) still is. I was alarmed to discover the old neutral red method has been recently resurrected (US Patent 6,368,637) – exposing warts to UV light after painting on neutral red is asking for cancer! And how it could be patented is a mystery to me, since this knowledge is in the public domain. Apart from burning or cutting warts off, caustic chemical treatments (not recommended for genital warts – ouch!!) seem to work. Such involve regular application of salicylic acid (aspirin, a close relative of phenol), lactic acid, acetic acid, trichloroacetic acid, ascorbic acid (crushed vitamin C tablet in water), 34% hydrogen peroxide, tea tree oil (a good solvent for plastic Petri dishes; see Argos 8 ), spirits of camphor, or concentrated nitric acid (or a safer version – silver nitrate tincture; since protein in the skin complexes the silver, the nitrate is left as nitric acid).

In a review of 51 trials of applying things to warts, Gibbs and colleagues (The Cochrane Library, Issue 2, 2004) concluded "There is a considerable lack of evidence on which to base the rational use of the local treatments for common warts. The reviewed trials are highly variable in method and quality. Cure rates with placebo preparations are variable but nevertheless considerable." Their view was that the application of salicylate appeared to be the best, though not universally effective.

But what about prescription medications? These are mostly used for warts of the mucosa, and include cell-killing agents (such as bleomycin, 5-fluorouracil, podofilox or podophyllin resin – derived from the Mayapple or Junipers) or immune stimulants (such as interferon, imiquimod; killed cells of the bacterium involved in acne - US Patent: 6,726,913). Gibbs et al conclude "The benefits and risks of 5-fluorouracil, bleomycin, interferons and photodynamic therapy remain to be determined". High doses of the antihistamine Tagamet over several weeks are supposed to work. But I reckon some of the natural product irritants would be just as effective in stimulating a local inflammatory reaction and would be a lot cheaper.

Use of raw tomato for warts yielded no Google hits. But what about capsaicin? After all, as reported above, it blocks nerve-induced elevation of tissue EGF and EGF receptors on keratinocytes in abraded skin. Capsaicin is the fiery alkaloid in Chile peppers. You would certainly know about its inflammatory potential if careless where you put your fingers after handling peppers. A lengthy search of the internet uncovered "The Healing Powers of Peppers: With Chile Pepper Recipes and Folk Remedies for Better Health and Living" by Dave Hewitt et al.; it did not list warts in its index. But I did score one hit, which trumpeted "Hillary's Diet Sauce -- A real man's sauce; use with caution! This ain't no wimp's sauce. Also useful in removing warts." (http://www.salsaplace.com/combos/). A Chile pepper costs a few cents in Coles. Any folks out there prepared to try it on their warts? But be very careful if they are in a secret place – something milder might be wise. Anyone need the juice of dandelion? Despite the drought, our lawn is full of them. Or maybe you should just try hypnosis.

Pete Griffith

9th June 2004