Respectful Insolence

Blogging on Peer-Reviewed ResearchI’m on the record multiple times as saying that I reject the entire concept and nomenclature of “alternative medicine” as being distinct from “conventional” medicine as a false dichotomy, when in reality there should be just “medicine.” Moreover, this “medicine” remaining should, whenever possible, be based on sound scientific and clinical trial evidence. In essence, I advocate treating “alternative” medicine the same as “conventional” medicine subjecting it to the same scientific process to determine whether it has efficacy or not, after which medicine that is effective is retained and used and medicine that fails the test is discarded. Where it comes from, the “alternative” or the “conventional” medical realm, matters little to me. All that matters is that it is based on sound science and that it has been demonstrated to have efficacy significantly greater than that of a placebo.

Given that, you’d think I’d be all in favor of subjecting alternative medicine, be it woo or more credible, to rigorous scientific testing. In most cases, you’d be right. My sole caveat is that, when testing alt-med, priority should be given to modalities that have at least a modicum of scientific plausibility, even if a bit tenuous. Herbal remedies would thus be at the front of my line to be tested, while obvious woo whose core principle on which it is based is so utterly ridiculous and scientifically implausible (like homeopathy, for instance) would be relegated to the back of line, if it’s ever tested at all. More implausible modalities that might work (albeit by a method that has nothing to do with the “life energy” manipulation that is claimed for it) like acupuncture would be somewhere in the middle. It’s a matter of resource prioritization, in which it makes little sense to test blatant woo before more plausible therapies are examined. Finally, regardless of what modality is being tested in scientific and/or clinical trials, it has to be done according to the highest ethical standards, on adults fully cognizant of or able to be taught about the questions being asked, the issues involved, and the potential risks who are thus able to give truly informed consent.

Sadly, none of my principles, which I consider to be reasonable ones, seemed to be in play in this trial of homeopathy published in October last year in The Journal of Alternative and Complementary Medicine:

Homeopathic Combination Remedy in the Treatment of Acute Childhood Diarrhea in Honduras

Jacobs J, Guthrie BL, Montes GA, Jacobs LE, Mickey-Colman N, Wilson AR, DiGiacomo R.
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA.

BACKGROUND: Despite the widespread availability of oral rehydration therapy, diarrheal illness remains a major cause of morbidity and mortality around the world. Previous studies have shown individualized homeopathic therapy to be effective in treating childhood diarrhea, but this approach requires specialized training. OBJECTIVE: A homeopathic combination medicine, if effective, could be used by health personnel on a widespread basis. METHODS: A double-blind randomized controlled trial was conducted in Honduras to evaluate the effectiveness of a homeopathic combination therapy to treat acute diarrhea in children. A total of 292 children with acute diarrhea was recruited; 145 were randomized to the experimental group and 147 to the placebo group. Tablets containing a combined preparation of the five most common single homeopathic remedies used to treat diarrhea or placebo were administered by a parent after each unformed stool. Children were followed up daily for 7 days or until symptoms resolved, whichever occurred first. Time until resolution of symptoms, daily rate of unformed stools, and total number of unformed stools were compared between the two groups. RESULTS: There was no significant difference in the likelihood of resolution of diarrheal symptoms between the treatment and placebo groups (hazard ratio = 1.02, 95% confidence interval: 0.79-1.32), with a median time until resolution of 3 days for both groups. Children in the treatment group had an average of 2.6 unformed stools per day compared to 2.8 among those in the placebo group; this difference was not significant (p = 0.43). The median number of unformed stools was 7 among children in the treatment group and 8 among those in the placebo group (p = 0.41). DISCUSSION: The homeopathic combination therapy tested in this study did not significantly reduce the duration or severity of acute diarrhea in Honduran children. Further study is needed to develop affordable and effective methods of using homeopathy to reduce the global burden of childhood diarrhea.

I will give the Journal props for one thing: It actually published a negative study of homeopathy. If you peruse the archive of its past issues, you will find precious few instances of totally negative studies on favored woo like homeopathy being published. Basically, the study above found that the homeopathic “remedies” used above didn’t do diddly-squat for diarrheal illness in these unfortunate children in Honduras. Of course, given the utter scientifically implausibility of homeopathy, that’s pretty much a “well, duh!” conclusion. Indeed, it would have been far more surprising if the investigators had found a treatment effect due to homeopathy.. Unfortunately, they tried to spin their results showing an utter lack of effect of their homeopathic remedies on diarrhea duration or volume as–well, let them the authors spin it:

Although individually prescribed homeopathic therapy by a trained practitioner reduced the duration and severity of acute diarrhea in three previous studies, the combination homeopathic medicine used in this study showed no evidence of efficacy. There was also no evidence that efficacy differed between subgroups defined by demographic or baseline clinical characteristics or category of pathogenic agent detected.

A number of factors could account for the ineffectiveness of the homeopathic combination therapy. Although the homeopathic remedies included in the combination therapy were those most commonly prescribed in the previous studies, 12-14 it is possible that these remedies would not have been prescribed individually in this population and/or that a different combination medicine would have been more effective. There is also a possibility that the remedies included in the combination therapy counteracted each other in some way, rendering the individual remedies ineffective. Other factors could be that the therapy was not administered correctly by parents in this study, or that it had lost its potency because of improper storage or handling before it was administered.

Orac cannot help but chuckle at that last sentence, regardless of how un-computer-like that might be. How does a placebo whose allegedly active ingredient has been diluted to a homeopathic dilution of 30C, (which is the equivalent of a 1:1060), a point where it is incredibly unlikely that even one molecule of “active ingredient” remains, “lose its potency”? In fact, to find a single molecule of the “active substance” would require a container over 30 billion times the size of the earth. “Lose its potency,” indeed. It never had any potency to begin with. In essence, the author is suggesting that, somehow 87% alcohol could inactivate 87% alcohol or water could inactivate water.

Another possibility is that the pathogens infecting children in this study were less susceptible to homeopathic therapy in general or to this specific combination therapy in particular.

Which begs the question of how any pathogens could be susceptible to homeopathic woo at all.

But as much fun as it is to revel in the spectacle of the study authors trying to explain in one of the woo-iest “scientific” journals there is why they found no treatment effect due to homeopathy without stating the glaringly obvious (that homeopathy is nothing more than an elaborate placebo containing no active ingredient), I’m more interested in the ethics of this study. First off, this study gives off an unpleasant whiff of exploitation. Think about it. Here we have comfortable academics from a wealthy nation heading to a country where diarrheal diseases in children, although still mostly self-limited, still cause considerable morbidity even mortality (world-wide around 1.5 million children die every year of such diseases). True, oral rehydration therapy, which has become more widespread, has greatly decreased the death rate. Nonetheless, in spite of this, these diseases still cause considerable morbidity due to malnutrition, mainly because babies suffering from them are unable to eat properly or absorb the nutrients during the course of the illness in whatever milk, food, or formula that they can manage to eat. In our wealthy nation, we rarely, if ever, see the devastation these diseases routinely wreak in impoverished areas like the ones where the study population lives, as described by the authors:

Subjects were drawn from two municipal clinics in the Metropolitan Health District of Honduras. The clinics serve an impoverished population of approximately 80,000 people, with no municipal water, electric, sewage, or garbage disposal services. Educational opportunities are low and unemployment is common…Among the clinic patients, there was a high incidence of childhood diarrhea; in 2001, there was an estimated incidence of 23 cases of diarrhea per 1000 children 5 years old.

Now, let’s look at the specifics of the homeopathic remedies used:

The homeopathic combination medicine was composed of the five most common single remedies, which were prescribed for the treatment of 80% of cases of childhood diarrhea in previous studies.12,13 These included Arsenicum album, Calcarea carbonica, Chamomilla, Podophyllum, and sulphur. The homeopathic remedies were prepared in the United States using standard methods.18 The combination therapy was prepared by a homeopathic pharmacist by impregnating pellets made of 85% sucrose and 15% lactose with a liquid homeopathic dilution in the 30C potency (the active substances diluted 1:100 in an 87% alcohol solution 30 times for a final concentration of 1 x 10-60). Placebo was prepared in the same manner using 87% alcohol instead of the homeopathic dilution. Treatment and placebo preparations were identical in taste, odor, and appearance.

Arsenic. Podophyllin. I wonder if the IRB knew that these were the ingredients being used. Granted, they are so dilute that there is nothing left, but there was no data presented to show that these components had actually been diluted that much and therefore posed no threat to the study subjects. Think of it this way. If the remedy has any active ingredients, it’s potentially toxic. If it is truly homeopathic, then it’s nothing more than 87% ethanol and sugar. How is it ethical to give this to anyone in a clinical trial, other than in a placebo control arm?

Here’s another consideration. The study subjects were children. The Common Rule that covers all federally funded human subjects research makes it very clear that special care must be taken when vulnerable populations are the subjects of a study. Depending on the age of the child, informed consent must be obtained from the subject himself. If the child is too young, then both parents must assent, unless one is dead or unavailable. In any case, the ethical considerations of research on children are very difficult. Now, in the light of the fact that children are considered vulnerable populations who require special protection above and beyond that given adults and that, more than that, they are not American and live in the slums of a Third World nation, think about how these investigators would have signed up patients in Honduras. It’s obvious from the writing in this paper that they are true believers in homeopathy. They probably told parents that they would be randomized to a placebo or to a remedy that might help their child and weren’t lying when they said it–because they truly believed it. Even so, to sell this trial they would have been spreading misinformation, namely that anyone in the study would receive anything that might actually have a therapeutic benefit.

Finally, given the conditions of the areas in which the study population live, it’s not unreasonable to presume that the people living there are mostly not well educated. This brings up the question of whether the parents were in fact able to give truly informed consent. The answer: Almost certainly not. Now, don’t get me wrong. One ethical principle that would be violated in withholding the benefits of a clinical trial from the poorly educated is that such benefits should not be limited only to the well-off or highly educated. However, communicating the risks and benefits of any trial to uneducated people unsophisticated people takes a special effort. It’s a lot of work. Did the investigators make that effort? Maybe I’m being cynical, but I tend to doubt it. In fact, to do this study in the first place, they would by definition of homeopathy have to be giving the parents of the study subjects misinformation. There’d be no way around it.

How this study ever passed muster at the Institutional Review Board at the University of Washington, the home institution of the investigators, I’ll never know. I may have complained about IRB overreach, but this is a case of IRB underreach. In a way, it’s worse than the way that Mark and David Geier have played fast and loose with a faux IRB that they’ve created to rubberstamp their dubious studies treating autistic children with Lupron. It’s worse because, unlike the Geiers’ sham, the UW IRB is a real IRB, constituted according to the Common Rule. This IRB should have been able to protect these Honduran children from being included in an unethical study that could not possibly do them any good. I’m guessing that the reason for this is that the members of the IRB had no clue about what homeopathy actually is, why it’s so scientifically ridiculous, and why the above study is highly dubious ethically. Indeed, I wonder if it is a general problem with IRBs that few of their members know exactly what it is that is in alternative medicine remedies like homeopathy. I wonder if more such trials will occur.

One other possible reason in this case is that the investigators probably cited a 13-year old study done using essentially the same methodology in Nicaragua and published in Pediatrics in 1994. This study purported to show a treatment effect, although it was small and arguable whether, even if real, it would be clinically significant. It also used a slightly different bunch of homeopathic remedies, one of which included mercury, of all things. In addition, this study was riddled with methodological difficulties, including failure to control for diet (diet can, as you would imagine, have a considerable impact on diarrhea in these illnesses); the level of dehydration (the treatment group where an effect was allegedly observed suffered from milder dehydration); and previous treatment interventions (patients in the treatment group were more than twice as likely to have received treatment before starting homeopathy). Finally, they did not use optimal recommended methods for quantifying diarrhea output

I truly wonder if the UW IRB would have approved this sort of study twice–or even once–if the study population had been American. I’m not sure which would be worse: If it wouldn’t have–or if it would have.

Comments

  1. #1 wolfwalker
    March 13, 2007

    Orac, I have to admit to some confusion on homeopathy. As the word is used in everyday life, it appears to be referring to two sharply different things.

    The first one is the one that you rightly describe as woo: the method of preparing “medicines” by dilution so massive that basically none of the active ingredient(s) is left in any single dose.

    But there seems to be a second meaning, which I can’t quite pin down. It seems to be a cross between real homeopathy and some form of herbalist medicine. I see it more in the context of veterinary medicine. Animal medicine seems more susceptible to woo than human medicine does, but even so, these people seem to be talking about something different from classic homeopathy. It seems as if their “homeopathic remedies” use detectable amounts of active ingredients, but the ingredients used actually have no known medicinal value.

    Are there two meanings of “homeopathy,” or am I mixing it up with something else?

  2. #2 factician
    March 13, 2007

    Wolfwalker,

    I think many of the folks who believe in homeopathy actually think there is an active ingredient in their preparation. When you talk to these people, they talk about “vibrational effects” to the solvent that once carried whatever horrible toxin they’ve been diluting.

    Anyway, to my knowledge, homeopathy always refers to treating diseases with a highly diluted form of something nasty (like 1e-60).

  3. #3 csrster
    March 13, 2007

    “the homeopathic “remedies” used above didn’t do diddly-squat for diarrheal illness”

    I know it’s a serious article, but am I the only one who finds something faintly amusing about the choice of the phrase “diddly-squat” in combination with “diarrheal illness”.

  4. #4 gadgeezer
    March 13, 2007

    Wolfwalker, apparently homeopathy exists in several flavours: even for allergies and allergic diseases there are “local”, “constitutional” or “miasmatic” strategies, not to mention isopathy. In a review that is going in the UK, the ‘defender’ of homeopathy (Ms Chatfield) claimed that the Lancet meta-analysis that found no benefit for homeopathy had in fact looked at trials of isopathy so wasn’t a comment on homeopathy. However, she did admit that there is no clinical evidence that homeopathy is any more effective than isopathy although homeopaths feel that it is.

    I don’t know – but I feel that homeopaths might dodge this study as testing isopathy rather than homeopathy.

    There are some excellent exchanges in the oral session of this review.

    Lord Broers: I have a simple, technical question about homeopathy and drugs. Is it possible to distinguish between homeopathic drugs after they have been diluted? Is there any means of distinguishing one from the other?

    Ms Chatfield: Only by the label.

    There are some lively exchanges about the magic of homeopathy mandating that the textbooks of physics, pharmacology and chemistry should be re-written.

  5. #5 LabCat
    March 13, 2007

    Other factors could be that the therapy was not administered correctly by parents in this study, or that it had lost its potency because of improper storage or handling before it was administered.

    The keywords in that sentence are words I highlighted. It certainly was improperly stored and handled: Diluted so much that no active ingredient was left.

  6. #6 Thony C.
    March 13, 2007

    On the subject of acupuncture, there have been major scientific test carried out by the German health insurance into acupuncture as a method of pain relief. The results were fascinating. It was found that acupuncture is in fact significantly more effective in pain relief than other more conventional methods, however one of the controls in the tests was a form of mock acupuncture in which needles were applied at random and not according to the rules and theory of acupuncture. This “method” proved to be even more effective in pain relief than acupuncture. There are a lot of very confused people in the German health industry trying to work out what the hell to make of these results.

  7. #7 Joshua
    March 13, 2007

    There is also a possibility that the remedies included in the combination therapy counteracted each other in some way…

    “In some way”? Seriously? Not even a wild flying leap of a guess at what “some way” might mean? Christ, that kind of sloppiness would get you failed out of high school chemistry.

  8. #8 Skeptico
    March 13, 2007

    From the study

    RESULTS: There was no significant difference in the likelihood of resolution of diarrheal symptoms between the treatment and placebo groups

    [...]

    Further study is needed to develop affordable and effective methods of using homeopathy to reduce the global burden of childhood diarrhea.

    Why?

    A number of factors could account for the ineffectiveness of the homeopathic combination therapy…

    In the things they listed they missed the obvious one – homeopathy doesn’t work.

    Wolfwalker:

    Homeopathy is not a form of herbalist medicine.

  9. #9 _Arthur
    March 13, 2007

    I see another angle. The money spent on this research, say, $10,000, would have been sufficient to prepare a ton of the very basic sugar+salt mixture that helps in diarrhea cases.

    That would have been sufficient to cover the needs of Honduras children for almost a year.
    Instead they carefully watched those children suffer, and vowed to come up with a better woo; after all homeopatic remedies are cheap, aren’t they ?

  10. #10 Kelly
    March 13, 2007

    It seems unethical to offer only a placebo vs. the homeopathic treatment instead of homeopathic treatment + standard diarrhea treatment (Oral rehydration+altered diet etc) vs just standard diarrhea treatment+placebo. They should have given the children something rather than just a placebo pill or an unproved homeopathic ‘treatment’ (unless they did and just didn’t say it!).

  11. #11 Orac
    March 13, 2007

    Actually, the study children did get rehydration therapy in addition to the homeopathy; the study was trying to determine whether homeopathy would shorten the duration and volume of the diarrhea. So, basically, they all got the minimum standard therapy. However, you do raise a good point that I almost raised in my post. The cost of the study could have prepared a whole boatload of oral rehydration solution that the clinic could have distributed to the babies and children with infectious diarrhea. Instead, it was wasted on woo.

  12. #12 Kelly
    March 13, 2007

    Well, yes, the money could have made the rehydration solution, but then you could use that argument forever on everything…”Instead of studying a new treatment for AIDS in Africa, the study money could have gone to giving proven treatments to X number of poor Africans with AIDS who don’t have access to any treatment” etc etc. “Instead of studying this breast cancer treatment, the money could have funded X number of mammograms for those unable to afford them.”

  13. #13 Orac
    March 13, 2007

    True, but at least those new treatments under study (i.e., a new treatment for AIDS or a new treatment for breast cancer) have the potential to be of value. That means that, depending on the probability that they will result in an improvement in care, they are not a “waste of money.”

    Homeopathy does not and cannot provide such a benefit; consequently, there is no potential benefit to the population being studied.

  14. #14 Kelly
    March 13, 2007

    Obviously, I understand what you’re saying. There are many treatments being tested that aren’t drug-company funded multi-million dollar clinical trials of promising new cancer drugs. In nursing, for example, people study “alternative medicine” all the time. Back in the day on my old blog, I wrote about how my nursing program encouraged nurses (by encouraging us to attend expensive seminars and extra classes) to learn “healing touch” so we could better care for our patients, even though it’s just unproven mysticism and weirdness. We also learned about reflexology and was tested on it. I asked when the phrenology test was and my teacher got pissed. There is plenty of good to be had by disproving odd alternative medicine claims/treatments like homeopathy even though a reasonable person could tell you it won’t work by doing nothing.

  15. #15 Eamon Knight
    March 13, 2007

    FWIW, on the different “modes” of homeopathy:
    Last time I had a cold, I was taking Cold-Eze (an OTC zinc/vitamin C/echinacea lozenge), and noticed in the fine print it described itself as “homeopathic”. Since the stated concentrations of the active ingredients were in all cases rather greater than the reciprocal of Avogadro’s Number, I infer this is not the “diluted into oblivion” variety of homeopathy ;-).

    BTW: yes, I know echinacea has been discredited; dunno about the zinc and C. The lozenges did seem to help, although that might just be the lubricative effect of increased salivation in response to sucking what is, by bulk, essentially a sugar candy.

  16. #16 Maronan
    March 13, 2007

    Orac, why are you so dogmatically biased against treatments that don’t work? You insist on using only “evidence-based medicine” and completely close your mind to the numerous treatments that have never been supported by evidence! How can you consider yourself open-minded if you refuse to accept treatments unless they pass clinical tests? You should put aside your dogmatic evidenceism and accept the use of the many treatments that do nothing but waste money and time.

  17. #17 anonimouse
    March 13, 2007

    Maronan – that was awesome.

  18. #18 Zombie
    March 13, 2007

    Frustrating in several ways.

    I studied at the UW (physics, nothing to do with medicine) and I’m pretty disappointed to see any such nonsense associated with the UW.

    I’ve also found myself debating homeopaths on a forum or two, like the JREF. Unfortunately, many homeopaths will claim that studies that don’t provide individual consultation between patient and homeopath are invalid tests of homeopathy, because apparently according to these flakes, what works for one person might not be exactly the right thing for another person. This, of course, renders the whole program non-falsifiable, since basically the procedure boils down to trying random things until the patient gets better, and then takes credit. Of course, its usually dressed up in a lot of nonsense about intuiting what remedies to try and considering “reactions” and so on. The variety of things homeopaths consider useful remedies is quite shocking; I even found a “proving” for antimatter once! At the same time, you won’t ever catch one of these homeopaths criticizing over-the-counter homeopathic remedies which obviously violate the same principle.

    Re: Eamon, I don’t think homeopathy necessarily requires excessively low concentrations although those are presumed to be the most potent. However, an unfortunate side-effect of the confusion about homeopathy vs. naturopathy vs. herbal medicine of various sorts is that companies selling dodgy remedies will often label them homeopathic whether they’re prepared according to formal homeopathic practice or not. As a result, it cannot be assumed that something labelled homeopathic is safe because you actually have to see if its really diluted, and at the same time, it makes homeopathy seem more common than it actually is.

  19. #19 Sastra
    March 13, 2007

    I’ll second Zombie on homeopathy confusion. In practice, the term is frequently applied to any kind of “natural,” gentle remedy, because the general public doesn’t make a distinction. I suspect that’s partly because the underlying “holistic” philosophy is being used to blur distinctions, and partly because the word “homeopathy” has the word “home” in it.

    You know. Home. Home-like. Remedies grandma would give you, like home-y-o-pathic chicken soup made from scratch. Follow the winding home-y-o-path to the home with the white picket fence and old-fashioned herb garden …

  20. #20 SarahBeth
    March 13, 2007

    Wolfwalker,

    You stole my question! I was at Wal-Mart the other day buying some lip balm and saw a “homeopathic” remedy for cold sores in there. The amounts of the “herbs” being used was way more than what Orac describes when he is talking about homeopathy. They had like 5% of this and one ingredient was Poison Ivy. I wondered who would put poison ivy on a cold sore. But I am also confused as to the two different meaning of homeopathy.

  21. #21 Skeptico
    March 13, 2007

    SarahBeth:

    Quite often some remedies are quoted with homeopathic jargon (1X, 2X etc) so that it can be claimed to be homeopathic. One reason for this is that homeopathic remedies (like most alternative “medicines”), are not required to show that their products are either (1) safe or (2) effective. Zicam do the same thing.

    So it’s marketing – and a way of getting round regulations.

  22. #22 Eamon Knight
    March 13, 2007

    Skeptico: thanks for that link, leading to Randi’s examination of Cold-Eze. Gotta love the irony: “fake” homepathic remedies which might actually work, unlike the “genuine” ones, since the active substance isn’t diluted by an astronomical factor. (Which still leaves open the question of whether zinc and ascorbic acid do anything, of course).

  23. #23 SarahBeth
    March 13, 2007

    Skeptico,

    Thanks for answering my question. I am neither a scientist nor a doctor and sometimes feel a little out of my depth and worry about asking questions for fear of making a fool out of myself. I usually understand what points are being made on the various blogs I visit, but sometimes I just don’t have the knowledge or experience to fully understand a topic. I thank Orac and you and everyone else’s blog I’ve been lurking on for enlightening me.

  24. #24 impatientpatient
    March 13, 2007

    Further study is needed to develop affordable and effective methods of using homeopathy to reduce the global burden of childhood diarrhea.
    *********************

    UFB!!!
    (Un_ F*cking_Believable)

    Further study is needed to find methods of preventing and treating diarrhea in poor kids- not in finding a way to make their own shit not stink.

    And 10,000 bucks- no way- that maybe was the cost of finding someone to do the “afterwork” typing it up and making the pretties. Nothing except for used cars cost ten grand these days.
    That is of course coming from my completely ignorant, but very skeptical POV. Maybe it DID cost ten grand – and I guess you get what you pay for.

    Absolute losers, trying this out on kids and passing it off as a true medical intervention. Did they sacrifice chickens too?

  25. #25 Ahistoricality
    March 14, 2007

    Speaking of IRB slip-ups, how often are remedies tested in combination before they’re tested separately? That “might have acted against each other” excuse is pretty damned convenient, actually…..

  26. #26 Amenhotep
    March 14, 2007

    Folks, I have a sneaking suspicion (no, more than that!) that the authors were taking the piss, and the “Journal” and its “peer reviewers” fell for it hook, line and sinker. The Discussion section of the abstract will become a classic. Three cheers for Jacobs et al.!!

  27. #27 Orac
    March 14, 2007

    You would be wrong, I’m afraid. Peruse the journal online and see the sort of stuff that’s published there if you don’t believe me. I may also post later some of the authors’ responses to the criticism of the 1994 article in Pediatrics, which is a very reputable journal. It’s truly hilarious, but depressing at the same time.

  28. #28 Amenhotep
    March 14, 2007

    Aw crap – you’re right – I clicked Jennifer Jacobs, and turned up more of the same. Irony, irony! I posted this to a UK doctors’ discussion forum, and we’re having great mirth with it right now.

    Is this the article in Pediatrics you’re referring to?:

    Pediatrics. 1994 May;93(5):719-25. Treatment of acute childhood diarrhea with homeopathic medicine: a randomized clinical trial in Nicaragua. Jacobs J, Jimenez LM, Gloyd SS, Gale JL, Crothers D.

    Go on – post it :-)

  29. #29 outeast
    March 19, 2007

    On the subject of Vitawmin C, I like the Czech ‘folk wisdom’ about the use theereof in treating a cold: Without vitamin C, a cold lasts a week; with it, it only lasts 7 days!

  30. #30 Nic Delamare
    April 30, 2007

    Jacobs J, Jonas WB, Jimenez-Perez M, Crothers D. Homeopathy for childhood diarrhea: combined results and metaanalysis from three randomized, controlled clinical trials. Pediatr Infect Dis J 2003 Mar;22(3):229-34.
    BACKGROUND: Previous studies have shown a positive treatment effect of individualized homeopathic treatment for acute childhood diarrhea, but sample sizes were small and results were just at or near the level of statistical significance. Because all three studies followed the same basic study design, the combined data from these three studies were analyzed to obtain greater statistical power. METHODS: Three double blind clinical trials of diarrhea in 242 children ages 6 months to 5 years were analyzed as 1 group. Children were randomized to receive either an individualized homeopathic medicine or placebo to be taken as a single dose after each unformed stool for 5 days. Parents recorded daily stools on diary cards, and health workers made home visits daily to monitor children. The duration of diarrhea was defined as the time until there were less than 3 unformed stools per day for 2 consecutive days. A metaanalysis of the effect-size difference of the three studies was also conducted. RESULTS: Combined analysis shows a duration of diarrhea of 3.3 days in the homeopathy group compared with 4.1 in the placebo group (P = 0.008). The metaanalysis shows a consistent effect-size difference of approximately 0.66 day (P = 0.008). CONCLUSIONS: The results from these studies confirm that individualized homeopathic treatment decreases the duration of acute childhood diarrhea and suggest that larger sample sizes be used in future homeopathic research to ensure adequate statistical power. Homeopathy should be considered for use as an adjunct to oral rehydration for this illness.

  31. #31 Ricky
    May 30, 2007

    I totally agree that Homeopathy is fake and very bad I have found an very interesting thing to prove it (please go through the whole email) .
    I took homeopathy medicine and
    found it always aggravates.
    It never cure disease rather increases problem and brings more problem.
    I had night false problem( my semen used to fall once or twice in a week) I took homeopathy medicine and it aggravated and became 6-7 days in a week and soon i became impotent.
    The doctors gave different medicine like nux Acid phos etc,
    I remained impotent for 4-5 years this is nothing but aggravation.
    I realized homeopathy only increases problem. then i bought a homeopathy book and take a medicine and again found it aggravates then i got an idea if i take any medicine which is forbidden in night false that would work.The book says if you take this medicine this might cause night false. I took the medicine and it stopped my night false I was sure that homeopathy only causes aggravation..( i got the idea One day I had diarrhea I took a homeo medicine which homeopaths use for constipation that stopped my diarrhea it is nothing but aggravation )
    Then i thought homeopathy only increases diseases so i was sure if i take this medicine it will stop night false. and that’s what happened.
    Acid Phos caused problem with my memory made me week so also Nux and other homeopathy medicine.

    My method is anty homeopathy (against the homeopathy)and it worked.
    I start taking homeo medicine Which I thought its aggravation may increase potency(
    I found medicine whose aggravation increases sexual intension)
    After trying for six years i found one medicine whose aggravation increases Male semen retentive Power(I can challenge any one)

    All the medicines that Homeopaths use(Like Nux ,Acid Phos, Conium Titanium all are very bad and makes any Male impotent(does not matter what condition when you take the medicine )

    In the process I have found another medicine which actually incresaes Male human potency(the simen falls vary late)

    Actually taking the medicine prescribed by the renowned homeopathy i became impotent.
    If i masturbate the semen would fall within 1 minute and it remained for 5 years.

    When i applied my method which is actually against the theorem of homeopathy nobody would believe my potency(ability to hold semen) became 30 minutes and I am 100% sure it is aggravation(Like aggravation of of amedicine can cause constipation which can stop diarrhea very simple but still it is aggravation and bad effect of homeopathy medicine) .
    30 times more.
    I am writing not to sell anything . I do not want to earn any money by this.
    My life was spoiled because of homeopathy medicine I had problem with my study because of Acid Phos Nux which homeopaths think very good but I experienced very bad.

    Now i do not have have night false or impotency problem because of the firm belive that homeopathy only creates agravation and which stays for years.

    If anyone has suffered write against homeopathy and save other people.
    I can cure anyone who is impotent.
    I have hidden my name because people will think i am mad.
    But those who suffered from homeopathy aggravation they will think i am right.
    And most important aspect is homepaths say homeopathy increase the spiritual power
    But it is not so easy to get spiritual power this proves homeopathy is wrong.

    Please help the humanity by doing something more against the homeopathy aggravation.
    Eagrly waiting for the reply
    Ricky

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