Respectful Insolence

i-07d0cd8a1bd48b3c93ef58e81c7edc6c-newavengers_28.jpgIt would appear that I must respectfully disagree (or be Respectfully Insolent, if you will) with fellow comic fan Scott over at Polite Dissent.

Two of my all-time favorite comics are Fantastic Four and (believe it or not, given my present day disdain for woo) Doctor Strange. Doctor Stephen Strange, for those of you not familiar with him, started out as an incredibly arrogant and greedy neurosurgeon who was involved in an auto accident in which he suffered nerve damage to his hands that impaired the fine motor control to the point where, while he could function normally in every day life, he could no longer operate. This led to his downfall as he searched the world for someone who could repair the nerves in his injured hands. Just as he hit rock bottom, though, he managed to make his way to Tibet, where he found the Ancient One, a mystical wise man who, it was said, could cure anything. Ultimately, through a confrontation with the Ancient One’s disciple at the time, Mordo, Strange rediscovered the goodness in his nature and became the Ancient One’s disciple himself, ultimately becoming his successor as Sorcerer Supreme, the title given to the one sorcerer sworn to protect Earth and its universe against mystic threats such as the Dread Dormammu.

Scott objected to Dr. Strange’s use of the term “homeopathic” in an appearance by Dr. Strange in The New Avengers #28, as illustrated in the panel to the right, stating:

This is yet another example of the word homeopathic being used as a buzzword in a situation where it makes no sense…

Medically, Homeopathy is nonsense and bunk. Logically, it makes no sense, and multiple rigorous scientific studies have confirmed that it works no better than placebo. I’ll grant you that there are no side effects — but that’s just because the treatment is simply water. But let’s assume for a minute that Homeopathy does work — and even then Dr. Strange’s statements make no sense. Is he casting a spell that actually worsens her vital signs, but “diluting” the magic? Casting a placebo spell?

I beg to differ (not with Scott’s contention that homeopathy is bunk, I hasten to add).

In reality, this context is the perfect use of the word “homeopathic” and the only situation (i.e., a fictional situation using magic) in which the use of homeopathy makes sense. Although Scott is certainly correct that, scientifically speaking, homeopathy is utter bunk, at the very core of homeopathy is a concept that can only be considered to be magic. In homeopathy, the main principles are that “like heals like” and that dilution increases potency. Thus, in homeopathy, to cure an illness, you pick something that causes symptoms similar to those of that illness and then dilute it from 30C to 40C, where each “C” represents a 1:100 dilution. Given that such levels of dilution exceed Avagaddro’s number by many orders of magnitude, even if any sort of active medicine was used, there is no active ingredient left after homeopathic dilution. This was known as far back as the mid-1800’s. Of course, this doesn’t stop homeopaths, who argue that water somehow retains the “essence” of whatever homeopathic remedy it has been in contact with, and that’s how homeopathy “works.”

A better example of magical thinking is hard to come by. Indeed, homeopathy can best be described as a spell being cast. Indeed, it’s been pointed out that homeopathy’s Principle of Similarities (“like cures like”) actually resembles Frazer’s Law of Similarity from the Golden Bough, one of the implicit principles of magic:

IF we analyse the principles of thought on which magic is based, they will probably be found to resolve themselves into two: first, that like produces like, or that an effect resembles its cause; and, second, that things which have once been in contact with each other continue to act on each other at a distance after the physical contact has been severed. The former principle may be called the Law of Similarity, the latter the Law of Contact or Contagion. From the first of these principles, namely the Law of Similarity, the magician infers that he can produce any effect he desires merely by imitating it: from the second he infers that whatever he does to a material object will affect equally the person with whom the object was once in contact, whether it formed part of his body or not. Charms based on the Law of Similarity may be called Homoeopathic or Imitative Magic. Charms based on the Law of Contact or Contagion may be called Contagious Magic.

Actually, come to think of it, homeopathy seems to use both principles, the Law of Similarity, and the Law of Contagion, given that it postulates that water somehow remains influenced by substances that it’s been in contact with even after that substance has been diluted away to not a single molecule. It just reverses the concept that “like produces like” (the Law of Similars”) to “like heals like” (or “like reverses like”). Given that homeopathy is magic, what better person to actually make a “homeopathic” spell work than the Sorcerer Supreme?

In fact, Dr. Strange appears to be taking homeopathy to a whole new level. Notice how he’s eliminated even the use of water. Instead, he’s just using the symbol (language) that represents the “cure” to take care of the problem. Why bother with all that silliness regarding water somehow retaining “memory” of homeopathic cures when you can just eliminate the water?

Yes, this is the only place where the use of homeopathic spells (which is, in essence, what all homeopathy is) might be appropriate: By a fictional character who is a sorcerer!

Comments

  1. #1 jufulu
    May 20, 2007

    What I’m trying to figure out is; is he trying to cast cure serious spells or cure criticals? I don’t remember an enhance vital signs spell. Restoring mana doesn’t seem applicable here.

  2. #2 Bronze Dog
    May 20, 2007

    Well, I think there are some spells designed for the purpose of stabilizing a dying (at -1 to -9 hp) character. I may have to rifle though my Spell Compendium to find them.

    They tend to be low-level spells, and supposing that Dr. Strange is an arcane spellcaster, it’d make sense that he couldn’t simply heal his subject into positive hp, since the cure series isn’t on the sor/wiz list.

    But I never read Dr. Strange, so he might have some divine caster levels thrown in there.

  3. #3 Lynet
    May 20, 2007

    Homeopathy reminds me of an old mathematical joke: did you hear about the epsilon that’s so small that when you divide it in half you get a negative number?

    It’s a cute joke for those who know that, by convention, epsilon usually represents a very (occasionally inifinitesimally) small positive number. But that’s actually the principle on which homeopathy works: divide it enough times and you’ll get a negative version!

  4. #4 Feral Kitten
    May 20, 2007

    he suffered nerve damage to his hands that impaired the fine motor control to the point where … he could no longer operate.

    Wouldn’t this also affect his ability to cast spells with somatic components?

  5. #5 Thony C.
    May 20, 2007

    Your supposition actually has a historical origin in the Renaissance. The homeopathic principle of like healing like was first expounded by Paracelsus, although Hahnemann always denied any connection, claiming to have discovered the principle for himself. Paracelsus, as is well known, also believed in and practiced “sympathetic magic” as part of his medical philosophy. So Stephan Strange’s homeopathic magic is totally plausible

  6. #6 daedalus2u
    May 20, 2007

    Orac, homeopathy is one of the major principles of neoconservative thought. If something by itself is good enough for them, then diluting that thing 10^60 or 10^80 times makes it “better”, and good enough for everyone else.

    This is what Bush and Gonzoles are doing to the rights in the Constitution, diluting them by many orders of magnitude to make them “better”. Diluting EPA regulations to make them “stronger”. Diluting “truth” to make it better.

  7. #7 Badger3k
    May 20, 2007

    What’s with this d20 stuff. Real players go to the original – http://www.heroplay.com/features/rules/marvel.php

  8. #8 Kapitano
    May 20, 2007

    I suspect the thinking behind homeopathy originally looked something like this:

    1) Arsenic (for instance) kills in large doses.
    2) In smaller doses it doesn’t kill, but induces illness. So the “bad” effect is lessened by dilution.
    3) In smaller doses still, it can be a treatment for angina, and indeed impotence. So now the bad has flipped over into the good.
    4) So therefore if you continue to dilute the doses, the good effects will be further magnified.

    (3) is obviously an error, though an understandable one. (4) is a second, seperate error.

    One issue is that there are actually two incompatible versions of homeopathy. One uses thinking like that above. The other, which I think derives from misunderstanding the first, and is in a distinct minority, is that the effect of the substance is not reversed but simply increased by dilution.

    The first will use caffine as a sedative. The second will use a very small dose of a sedative…as a strong sedative. The second is the one “verified” by the Bienvenu’s “Memory of Water” experiments.

    However, I think the situation is even more complicated than that, because a lot of fans of homeopathy have such a vague understanding of its principles that they can flip-flop between the two different homeopathies.

  9. #9 Alan Kellogg
    May 21, 2007

    Feral Kitten

    Presumably casting does not require the fine motor control neuro-surgery does. Or, Doctor Strange uses a style of casting that uses broader gestures than other styles. It would appear that for the Sorcerer Supreme magic is as much a performance art as a way of shaping the universe.

  10. #10 Melissa G
    May 21, 2007

    By the Moons of Munnopor!!! I see it all clearly now! Homeopathy was bequeathed unto Doctor Strange by the mighty Vishanti themselves! Only HE can use it to keep the Mindless Ones at bay!!! (Instead of, y’know, attracting more mindless ones to the use of homeopathy.)

  11. #11 Alan Kellogg
    May 21, 2007

    Mellissa G,

    Nah, Homeopathic Healing Medical Dweomers has Doctor Strange under a multi-year contract. He has to use their castings for healing instead of those designed by anthore at other spell coding companies.

  12. #12 AgnosticOracle
    May 21, 2007

    I’ve been going through the archives of Irregular Webcomic over the last week or so. I bumped into this one that gives a much more educational take on homeopathy.

    http://www.irregularwebcomic.net/675.html

  13. #13 Iskra
    May 21, 2007

    Pfft, homeopathy still doesn’t make sense. What is he going to do, cast a very small magic missile?

  14. #14 Dana Ullman, MPH
    May 21, 2007

    It is EASY to assume that homeopathic medicines are akin to placebos if one has a superficial understanding of what homeopathy is and what good research has been conducted to evaluate it.

    I actually think that skeptics of alternative medicine can and should separately understand and evaluate homeopathy if you wish to honor good scientific thinking. Mixing various subjects together is just sloppy, and I know that skeptics don’t like or honor such undisciplined thinking.

    Further, it is necessary for skeptics of homeopathy to do their homework on the subject. I am amazed to have debated skeptics of homeopathy who know virtually nothing about it and have only a very superficial knowledge of the basic science and clinical science research on the subject. Such sloppiness is common amongst people who think of themselves as defenders of “science.” There is more than a tad amount of irony here. The references to the 200+ clinical studies and the several hundred basic science studies are at my website (www.homeopathic.com) and in the ebook that I’ve written…as well as some of the high quality books on homeopathic research that we sell (i.e. one by Drs. Bellavite and Signorini as well as Dr. Michael Dean are good examples).

    If you don’t want to spend a dime, you can read the article at my website called “Why Homeopathy Makes Sense and Works” (www.homeopathic.com). I will be curious if those of you who choose to be skeptical of homeopathy even know much about what it is.

    Some new research on the silicates in water provide some very provocative possibilities on how the structure in water can change and how these nano-sized “silica chips” and the nano-bubbles can influence the water. I can tell you that later this week a new study on homeopathy and water will be published by two internationally respected professors of material sciences: Rustum Roy, PhD (of Penn State University) and Bill Tiller, PhD (former head of material sciences at Stanford). If any of your fellow skeptics can claim greater understanding of water than these two gentlemen, please publish your work.

    I will be the first to acknowledge that not all of homeopathic research has positive results, though most meta-analyses show that there is more evidence that the “placebo explanation” for homeopathy is inadequate. Please also know that the 2005 comparison of homeopathic and conventional studies that was published in the Lancet was embarrassingly bad science. Here’s a short review/critique of it:
    In 2005, the representatives of World Health Organization (WHO) were working on a report on homeopathic medicine, and one of the skeptics of homeopathy who was asked to review this report for comment complained bitterly about it because it was too “positive” towards homeopathy. He then leaked it to other skeptics and to the Lancet, a usually highly respected medical journal. In response to the potentially positive report on homeopathy from WHO, the Lancet published an article attacking this “report” that had not even been completed or published (Critics, 2005), and further, the Lancet rushed to publication a “study” that compared homeopathic and conventional medical treatment (Shang, et al, 2005).

    The idea for comparing clinical studies of homeopathic and conventional medicine is certainly a good one, but actually doing so in a fair and accurate way is more challenging than it may seem. The lead author of this comparative study, however, was not the ideal physician or scientist to evaluate homeopathy objectively. Dr. M. Egger is a Swiss physician who is notoriously and actively anti-homeopathy. Before he completed his study, he informed the editors at the Lancet that he had planned to submit his study to them and that he fully expected the results to show that homeopathic medicines didn’t work.

    Egger and his team first found 110 placebo-controlled trials evaluating the efficacy of homeopathic medicine. Next, they selected 110 “matched” placebo-controlled trials. Finding “matched” trials usually means finding experiments that sought to treat people with a similar disease, in a similar population, and who were treated for a similar period of time, but the researchers never explained how or why they included or excluded any of the conventional medical trials. And needless to say, finding matched experiments is much more difficult than it sounds. Although it is easy to question if these researchers found matched experiments or not, let’s give them the benefit of the doubt and say that they were successful in doing so.
    Next, the researchers choose to evaluate the “quality of research design” and how each trial was conducted. The researchers determined that only 21 of the homeopathic studies were of a “high quality,” and yet, ironically, they found only 9 (!) of the conventional medical studies to be of a similar high quality.[1] Then, without adequate explanation, the researchers decided to only evaluate those studies that were both “high quality” and had large numbers of patients in each trial. The researchers found 8 homeopathic studies that fit these characteristics and only 6 conventional medical studies. Only two of the eight homeopathic studies used homeopathic medicines that were individualized to each patient, with the remaining studies giving the same medicine to everyone (this method may make research easier, but it is not necessarily a good test of the homeopathic methodology).

    Of the remaining 8 homeopathic studies and 6 conventional medical studies, the studies were not matched in any way. How or why the researchers would or could claim that these studies were comparable requires “creative thinking” and logic (or illogic). Further, the researchers never provided the analysis of the results of the 21 “high quality” homeopathic studies as compared with the 9 conventional studies.

    What is also interesting is the fact that the researchers acknowledged that they found eight homeopathic studies in the treatment of people with acute respiratory tract infections and that these studies found “substantial beneficial effect” and that this effect was “robust.” However, without adequate evidence or explanation, the researchers asserted that these studies could not be “trusted” and that eight trials is simply not enough to provide an adequate analysis. And yet, these same researchers evaluated 8 other homeopathic trials and concluded that they showed no obvious better treatment than the 6 conventional studies.

    If the above concerns were not enough to lead readers to the conclusion that this is “garbage in, garbage out” type of comparative research, there are still even more concerns about this study. For instance, the researchers did not even reveal which studies were selected until many months later. And when the studies were finally announced, it was shocking to note that they had selected a study testing a single homeopathic medicine in the treatment of “weight-loss” (this study bordered on the preposterous because homeopaths assert that there is no one single remedy to augment weight-loss), another study evaluated the use of a homeopathic formula in the prevention of influenza (while there have been at least three large studies verifying the efficacy of homeopathic medicines in the treatment of influenza, only one of these three large studies was selected, while the study that evaluated its prevention was selected even though it was simply an exploratory investigation, not one that homeopaths necessarily expected to have a positive outcome).

    As for some good studies in homeopathy…
    COPD (chronic obstructive pulmonary disease) is the #4 reason that people in the US die. A study conducted at the University of Vienna Hospital found “substantially significant” results from a double-blind placebo-controlled trial using homeopathic doses of potassium dichromate. This study was published in the most respected journal in medical respiratory health, CHEST.
    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed

    50% (!) of people in hospitals who experience severe sepsis die, and yet, the below study found that there was a 50% reduction in these deaths in those people with severe sepsis who were individually prescribed homeopathic medicines, as compared with those patients who underwent the same homeopathic interview process but who were given a placebo. There study was also double-blind, placebo controlled and randomized: Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit.

    When skeptics of homeopathy assert that there is “nothing” in homeopathic medicines, they seem to
    assume that they know everything there is to know about the physics of water. I want to remind skeptics that good and serious scientists maintain a high level of HUMILITY about what they know and what they don’t know. I am proud of my humility of what I know and what I don’t know.

    I am perfectly familiar with Mr. Randi’s silly offer. He was involved in the intellectually dishonest study conducted by ABC’s 20/20 program. If Randi was serious about science, he would have supported my critique of Mr. Stossel’s junk science. For details about this junk journalism/science, go to:
    http://homeopathic.com/articles/media/index.php

    I honor conventional medicine for its integrity to consistently and repeatedly disprove itself. What treatments have lasted 50 or more years? That’s consistency! Homeopaths have expanded considerably its use of various medicines, but we have maintained the use of our past medicines too because 200 years of clinical experience has verified it.

    Dana Ullman, MPH

  15. #15 Jody
    May 21, 2007

    Forget the magic missle. Doctor Strange practices -real- fake magic as opposed to that fake fake magic that D&D uses.

    It’s all about Dormammu, baby.

  16. #16 Brian Thompson
    May 21, 2007

    So to cure a gunshot wound, I should dip a bullet in water, take the bullet out (diluting it), then drink the water?

    Amazing, it really works!!! First hand testimony here folks!

  17. #17 Lucas McCarty
    May 21, 2007

    Dana Ullman’s post only confirmed one well-known and well-supported theory of psychology: fanatics don’t have a fully developed sense of humour.

    I need to find my 20-sided die and make an Initiative roll. That’ll show ‘em!

  18. #18 Bronze Dog
    May 21, 2007

    Homeopaths have expanded considerably its use of various medicines, but we have maintained the use of our past medicines too because 200 years of clinical experience has verified it.

    Can you name one homeopathic product that has double-blind clinical studies that show it works better than placebo?

    Please cite your sources.

  19. #19 Jon H
    May 21, 2007

    “Wouldn’t this also affect his ability to cast spells with somatic components?”

    Pretty much the only component seems to be making devil horns with his fingers or ‘ok’ signs, etc. Nothing very precise.

    ..

    My favorite gag from MST3K was from a fantasy flick they were skewering. The hero falls into a pit, and one of the guys yells “Ow! I landed on my 8-sided die!”

  20. #20 Alan Kellogg
    May 21, 2007

    Even with blunted points d4s hurt a lot worse than d8s.

  21. #21 Alan Kellogg
    May 22, 2007

    Dana Ullman,

    If homeopathic medicine worked as it’s said to, then we would have healing magics of other kinds in use in emergency rooms. That’s all homeopathy is, magic. Magic dressed up in a poor imitation of science, but magic in the traditional sense. If homeopathy worked as it is said to, then conjuration would be taught in high school, and evocation in college.

    You wish to persuade me that magic works, then you’ll need to show that it has a physical effect on the world that cannot be duplicated by any other means. Then show me how this ability to shape the world physically through will has affected our world in a substantial way. Because any such ability would be used, and used extensively. It could not help but change the world in substantial and long acting ways.

    Wanting something to be true does not make it true. A thing is regardless of our desires.

  22. #22 Dana Ullman, MPH
    May 22, 2007

    It is more than a tad ironic that people who think of themselves as “defenders of science” tend to have such unscientific attitudes towards subjects that don’t fit within their limited paradigm.

    “Bronze dog” asked me which homeopathic medicine has undergone double-blind trials, but it seems that s/he didn’t even read my post above. Homeopathic potassium dichromate (known as “Kali bic” in Latin) has found effective in treating COPD (the #4 reason for mortality in the US!). As for emergency rooms, as Allan Kellogg queried, my initial post noted a double-blind trial (also conducted at the famed University of Vienna Hospital!) in the treatment of “severe sepsis” (which has a 50% mortality rate in hospitals…except when homeopathic treatment is provided, when it is only 25%).

    As for replication trials, homeopathic Oscillococcinum has been found to be effective in treating the flu in FOUR large (300+ patient) trials.

    If you wish to attack homeopathy, please do so, but please do so with intelligence…and after you’ve done some homework on the subject (isn’t that the scientific way?). Unless you just wish to shuck and jive and think you’re funny.

    As for humor, you’re right…my post was serious, as were the sharp words against homeopathy.

  23. #23 HCN
    May 22, 2007

    It would help your case, Mr. Ullman, if you had provided the link to the actual paper instead of just the search page:
    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed

    Which showed up just as empty as a homeopathic remedy.

    Because when I do a search for the the paper I get a paper from the “Influence of potassium dichromate on tracheal secretions in critically ill patients.Frass M, Dielacher C, Linkesch M, Endler C, Muchitsch I, Schuster E, Kaye A.
    Ludwig Boltzmann Institute for Homeopathy, Duerergasse 4, A 8010 Graz, Austria. michael.frass@kabsi.at

    Note that it is from an Institute for HOMEOPATHY… not exactly an unbiased source.

    What I really got when I first searched for the paper was this comment in the same journal:
    1: Chest. 2007 Feb;131(2):635-6; author reply 636. Links
    Comment on:
    Chest. 2005 Mar;127(3):936-41.
    Treating critically ill patients with sugar pills.Colquhoun D.
    PMID: 17296675 [PubMed – indexed for MEDLINE]
    ….

    Unfortunately I cannot get the full letter. It should be interesting.

    Also, be spedific on the age group when pronouncing such plunkers “as 4th leading cause of death”. In reality it depends on age. Because according to http://www.disastercenter.com/cdc/ , chronic obstructive pulmonary disease is the 4th leading reason persons over the age of 65 die.

    Now, here are some my own questions:

    1) One of the “miasms” Hahnemann was claiming to cure was syphilis. What was his success in curing syphilis two hundred years ago? What is the standard of care for treating the actual bacterial disease known as syphilis? How effective would modern homeopathy be with actual syphilis?

    2) Cardiac conditions are another big killer of Americans… so your magic potions should work great for them also. My oldest son as a genetic condition known as hypertrophic cardiomyopathy with obstruction. He presently takes the beta-blockers (Atenolol) to reduce the pressure on his already damaged mitral valve. My question is how would your homeopathic treatment be better for him than Atenolol?

    3) Also, how does your Masters in Public Health (MPH) give any credibility? Does this mean you have actually learned the value of sewage disposal, clean water supplies, pest control in food preparation areas, and vaccines? Are you the one who shows up in a disaster area (flood, hurricane, earthquake, etc) giving out homeopathic remedies instead of clean water, toilet facilities and vaccines for tetanus?

  24. #24 HCN
    May 22, 2007

    A comment on the article that was posted in Chest, http://www.chestjournal.org/cgi/content/full/131/2/635 , by a professor of pharmacology:
    Begin Quote
    It surprises me that CHEST would publish an article (March 2005)127 on the effect of a therapeutic agent when in fact the patients received none of the agent mentioned in the title of the article. [T]he “potassium dichromate” was a homeopathic C30 dilution. That is a dilution by a factor of 1060 [which] means there would be one molecule in a sphere with a diameter of approximately 1.46 × 1011 m….To describe this as “diluted and well shaken,” as the authors do, is the understatement of the century. The fact of the matter is that the medicine contained no medicine.

    The authors…will doubtless claim some magic effect of shaking that causes the water to remember…The memory of water has been studied quite a lot. The estimate of the duration of this memory has been revised…downwards…to approximately 50 femtoseconds…That is not a very good shelf life.

    It is one thing to tolerate homeopathy as a harmless 19th century eccentricity for its placebo effect in minor self-limiting conditions like colds. It is quite another to have it recommended for seriously ill patients. That is downright dangerous.
    End Quote

    Mr. Ullman… you were shown to be dishonest on WHO did the study that the above letter is crititizing. It was NOT the University of Vienna, but instead the “Ludwig Boltzmann Institute for Homeopathy”. Indeed, you did not even provide the Pubmed link, nor even the TITLE of the paper.

    Then you say “As for replication trials, homeopathic Oscillococcinum has been found to be effective in treating the flu in FOUR large (300+ patient) trials. ”

    Ummm, where are those papers for us to see? Because when I put the word “Oscillococcinum” into the PubMed search window I get a grand total of 6 (six) hits.

    The most recent one is:
    1: Cochrane Database Syst Rev. 2006 Jul 19;3:CD001957. Links
    Update of:
    Cochrane Database Syst Rev. 2004;(1):CD001957.
    Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes.Vickers AJ, Smith C.
    … AUTHORS’ CONCLUSIONS: Though promising, the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes. Further research is warranted but the required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.

    The second one is: 1: Respir Med. 2005 Nov;99(11):1341-9. Epub 2005 Aug 19. Links
    Preventing influenza: an overview of systematic reviews.van der Wouden JC, Bueving HJ, Poole P.
    …. The popularity of homoeopathic Oscillococcinum, especially in France, is not supported by current evidence….

    The third one is: 1: Cochrane Database Syst Rev. 2004;(1):CD001957. Links
    Update in:
    Cochrane Database Syst Rev. 2006;3:CD001957.
    Update of:
    Cochrane Database Syst Rev. 2000;(2):CD001957.
    Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes.Vickers AJ, Smith C.
    Integrative Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York, 10021, USA.
    …. REVIEWER’S CONCLUSIONS: Though promising, the data are not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndrome. Further research is warranted but required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.

    The fourth one is: Prim Care. 2002 Jun;29(2):231-61. Links
    Respiratory and allergic diseases: from upper respiratory tract infections to asthma.Jaber R.
    …. Homeopathic remedies based on extreme dilutions of the allergen may be beneficial in allergic rhinitis but require collaboration with an experienced homeopath. There are no research data on constitutional homeopathic approaches to asthma and allergic rhinitis. …

    The fifth one was: 1: BMC Complement Altern Med. 2001;1:4. Epub 2001 Jul 20. Links
    Systematic reviews of complementary therapies – an annotated bibliography. Part 3: homeopathy.Linde K, Hondras M, Vickers A, ter Riet G, Melchart D.
    ….The majority of available trials seem to report positive results but the evidence is not convincing. For isopathic nosodes for allergic conditions, oscillococcinum for influenza-like syndromes and galphimia for pollinosis the evidence is promising while in other areas reviewed the results are equivocal. INTERPRETATION: Reviews on homeopathy often address general questions. While the evidence is promising for some topics the findings of the available reviews are unlikely to end the controversy on this therapy.

    The sixth and LAST hit was just the original of the first and third, Cochrane Database stuff.

    Where are those replicating studies again? Do they actually exist? Did you mix up the “Oscillococcinum” with some other remedy? How exactly is duck liver supposed to help even in concentrations that may actually include, well… uh actual duck bits? It is a bit of a canard, isn’t it? http://www.homeowatch.org/history/oscillo.html

  25. #25 HCN
    May 23, 2007

    Dana, Dana, Dana… where are you? Can’t you answer my simple questions?

    Here, let me try another question: Which is more effective for influenza — prevention with a flu vaccine or very very diluted duck bits (Oscillococcinum)?

  26. #26 Sophist, FCD
    May 23, 2007

    If you want to prove how well homeopathy works, I have an experiment for you to run.

    1. Find two comparable cities.
    2. Grind up one (1) sleeping pill and introduce it into the drinking water reservoir of one city.
    3. See cases on insomnia skyrocket relative to the control city as residents consume large quantities of the powerful stimulent that the city water supply has become.

    Go ahead, try it out. I’ll wait here.

  27. #27 Dana Ullman, MPH
    May 23, 2007

    If you want to dialogue, let’s do so in a rational way. It seems that most skeptics simply want to do name-calling and superficial analysis of homeopathy. This is not evidence of a scientific attitude.

    I said that the CHEST study was conducted at the Unviersity of Vienna Hospital, and it was. Why anyone suggests that I “lied” here is wrong.

    One person said that using homeopathy for people with COPD is “dangerous.” Please refer me to a study that shows this. I have referred you to a study that showed SUBSTANTIALLY significant clinical benefits without any harm.

    I have never said that homeopathic Oscillococcinum is effective in the “prevention” of the flu (in fact, there is no evidence that it is), but instead, I referred you to several studies that showed it was effective in the TREATMENT of the flu. I also gave you some rationale for its ingredient: it is made from the heart & liver of a duck (homeopaths have been familiar with avian sources of flu viruses since 1926).

    There are many many other good studies on homeopathy, but I don’t wish to spend my time quoting them, especially when I’ve written a good short review of research at my website called Why Homeopathy Makes Sense and Works (http://homeopathic.com/articles/homeopathy_works.php). I have also written an eBook which references 200+ clinical studies (the great thing about writing an eBook is that I can update it regularly!).

    If you’re serious about critiquing homeopathy, please do so with knowledge rather than without it.

  28. #28 Sophist, FCD
    May 23, 2007

    It is important to note that immunizations and allergy treatments are two of the very few applications in modern medicine today that actually stimulate the body’s own defenses in the prevention or treatment of specific diseases, and it is NOT simply a coincidence that both of these treatments are derived from the homeopathic principle of similars.

    No. Just…no. Neither of these are derived from, or make use of, the homeopathic principle of similars. Only the most superficial understanding of how they work could lead you to believe that.

  29. #29 HCN
    May 24, 2007

    But, Dana, Dana, Dana… which is really BETTER… prevention of influenza with a vaccine (which is really NOT homeopathic) or treating it with duck bits? You do understand the use of the phrase “more effective” (hint it means “better”)?

    Also, what is the standard of care for syphilis? Remember one of the miasms is syphilis as noted by Hahnemann, so is his treatment used for sysphilis in 2007?

    How does homeopathy really help hypertrophic cardiomyopathy? Would it really be better than beta-blockers?

    Oh, and I stand corrected on the Chest study. Someone kindly sent me the actual paper (the abstract only listed the Institute of Homeopathy in Graz, which from personal experience is not even close to Vienna). I now know where you got the stupid statistic that COPD is the 4th leading cause of death in the USA… which pretty much shows the level of quality of the entire paper. By the way, as a former engineer who used statistics in random vibration analysis… you have a funny concept of “significant”. (by the way, searching PubMed for COPD brings up over 30000 hits, if you add the word homeopathy you come up with the study by the guys at the Institute of Homeopathy in Graz done in Vienna, and the caustic letter to the editor I quoted… a total of 2 (two) hits! So I am pretty sure that not many hospitals let homeopaths in their intensive care units).

    I apologize for saying you “lied”… misinterpreted or were ignorant of the actual results is a more accurate description. This is evident in your ability, or lack thereof, to cite actual studies or list the link to the actual PubMed page, as opposed to its search page.

    Another question: How can you have a “rational discussion” on a concept of super-uber dilution that is beyond reason? Remember a 30C is equivalent of 1/2 teaspoon of stuff, like duck bits, in the total amount of water of several planets!?

  30. #30 HCN
    May 24, 2007

    I really do want to know about influenza: vaccine versus homeopathy. You did know that some practicioners of homeopathy offer homeopathic vaccines? Check out these “vaccines” for Hepatitis B, influenza and Meningococcal disease: http://www.ratbags.com/rsoles/comment/homeopathy2.htm

    As I have mentioned before, my oldest son has hypertrophic cardiomyopathy with obstruction. He gets a flu vaccine each fall. Should I skip that and give him some solution that at one time or another was in the same vat as some duck bits? How about his daily Atenolol? Since it lowers his blood pressure (and hence the pressure across his already damaged mitral valve) should he be given Nat Mur instead? The thinking being that since salt raises blood pressure, a solution that contains the ratio of about a half teaspoon of salt to the amount of water that is greater than the amount on this planet would be just the ticket. Is that right?

    I do know how well homeopathy works for bipolar disease. It is worthless. In my spouse’s extended family someone left the psych ward after six weeks of therapy and real medication doing better than she had done in years (her mother called the police when she had a psychotic episode). Only she decided the naturapath was better than the psychiatrist, and dropped the real meds for the homeopathic remedies prescribed by the dingbat naturapath. Hmmm… even she realized it didn’t work when she found herself swinging between mania and depression.

  31. #31 Dana Ullman, MPH
    May 24, 2007

    It is NOT a question of “better!” Both prevention AND treatment have their place.

    Skeptics refuse to look at or accept the many good scientific studies, and when they are shown them, the skeptics then ask “where is the research on some other disease?”

    I can’t waste my time here. Do some homework on homeopathy. My website (www.homeopathic.com) has some articles, though you are better off getting some real books or (better) the eBook on research that I’ve written (though I predict that you are not really interested in research).

    Homeopathy is nanopharmacology at its best; it is biomimicry with cell-signaling and immuno-augmentation capabilities. Investigate it and learn.

  32. #32 HCN
    May 24, 2007

    But I have done my homework on homeopathy, I have even read parts of the Organon… and hence the question about syphilis. One of the many questions you have refused to answer. I bet any clinic that treats syphilis the same way that Hahnemann did will have the same results as the homeopaths who were steering folks in the UK away from the NHS prevention methods… Many of those folks became seriously ill: http://www.senseaboutscience.org.uk/index.php/site/project/71/

    Like which “good scientific studies”?… You haven’t listed any. Not by title, author, journal or date… not even by a decent link. I’ve listed more than you have, and they do not show homeopathy in the best of light.

    I’m not going to click on your webpage because I think it is as well thought out and clear as your postings here. The postings that do not clearly state the titles of the studies, lists a webpage as the link to the abstract when it is actually the PubMed search page and your lack actually answering direct questions (hint the COPD study is not as significant as you claim it to be). You mention a study of sepsis and say “the study below”, but do not even list the study… uh, where is it? By the way it is: Homeopathy (2005) 94, 75-80
    Adjunctive homeopathic treatment patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit by M Frass et al. Institute for Homeopathy, Graz, Austria
    … let it be known that the patients were not denied anitbiotics, the sepsis was treated conventially also. In this small study of a total of 70 severely ill patients 75% of the patients on homoepathic meds survived after 180 days versus 50% of the patients on “placebo”… when you consider that the “placebo” patients were on the average OLDER than the others, it is not that all significant a difference. It really is not an iron-clad argument for homeopathy.

    It pretty much reflect much of the “scientific research” favoring homeopathy… poorly designed studies with barely any perceptible significant difference, and what there is blown up out of proportion by ignoring glaring errors of critical thinking. Like this classic where they walked around a homeopathic hospital asking if the patients felt better: Assessing Homeopathic Proving Using Questionnaire Methodology: Consideration and Implications for Future Studies
    S. Brien; G. Lewith
    University of Southampton, Hampshire, Great Britain
    Forsch Komplementärmed Klass Naturheilkd 2005;12:152-158
    (DOI: 10.1159/000084837)

    So what place do tiny duck buts have in influenza? Influenza is a viral infection. There are very few anti-viral medications so basically the patient’s immune system is doing all the work. Water or sugar pills that may at one time been near itty bitty duck bits will need a whole lot more proof.

    Also, don’t get bent out of shape about the question which is better — prevention with vaccine or insy bitsy teeny weeny duck bits… because the title of the Cochrane Database report I listed above is “Homoeopathic Oscillococcinum for *P_R_E_V_E_N_T_I_N_G* and treating influenza and influenza-like syndromes.” Did you not notice that, or did you choose to ignore that? Just like you ignored its conclusion “Though promising, the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes. Further research is warranted but the required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.”

    Yeah, I know you won’t answer me… Sir Dana. You are bravely running away because you have no answers.

  33. #33 HCN
    May 24, 2007

    But I have done my homework on homeopathy, I have even read parts of the Organon… and hence the question about syphilis (there are interesting references to psoras, syphilis and gonnorhea in a couple of chapters). One of the many questions you have refused to answer.

    I bet any clinic that treats syphilis the same way that Hahnemann did will have the same results as the homeopaths who were steering folks in the UK away from the NHS prevention methods… Many of those folks became seriously ill: http://www.senseaboutscience.org.uk/index.php/site/project/71/

    Like which “good scientific studies”?… You haven’t listed any. Not by title, author, journal or date… not even by a decent link. I’ve listed more than you have, and they do not show homeopathy in the best of light.

    I’m not going to click on your webpage because I think it is as well thought out and clear as your postings here. The postings that do not clearly state the titles of the studies, lists a webpage as the link to the abstract when it is actually the PubMed search page and your lack actually answering direct questions (hint the COPD study is not as significant as you claim it to be). You mention a study of sepsis and say “the study below”, but do not even list the study… uh, where is it? By the way it is: Homeopathy (2005) 94, 75-80
    Adjunctive homeopathic treatment patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit by M Frass et al. Institute for Homeopathy, Graz, Austria
    … let it be known that the patients were not denied anitbiotics, the sepsis was treated conventially also. In this small study of a total of 70 severely ill patients 75% of the patients on homoepathic meds survived after 180 days versus 50% of the patients on “placebo”… when you consider that the “placebo” patients were on the average OLDER than the others, it is not that all significant a difference. It really is not an iron-clad argument for homeopathy.

    It pretty much reflect much of the “scientific research” favoring homeopathy… poorly designed studies with barely any perceptible significant difference, and what there is blown up out of proportion by ignoring glaring errors of critical thinking. Like this classic where they walked around a homeopathic hospital asking if the patients felt better: Assessing Homeopathic Proving Using Questionnaire Methodology: Consideration and Implications for Future Studies
    S. Brien; G. Lewith
    University of Southampton, Hampshire, Great Britain
    Forsch Komplementärmed Klass Naturheilkd 2005;12:152-158
    (DOI: 10.1159/000084837)

    So what place do tiny duck buts have in influenza? Influenza is a viral infection. There are very few anti-viral medications so basically the patient’s immune system is doing all the work. Water or sugar pills that may at one time been near itty bitty duck bits will need a whole lot more proof.

    Also, don’t get bent out of shape about the question which is better — prevention with vaccine or insy bitsy teeny weeny duck bits… because the title of the Cochrane Database report I listed above is “Homoeopathic Oscillococcinum for *P_R_E_V_E_N_T_I_N_G* and treating influenza and influenza-like syndromes.” Did you not notice that, or did you choose to ignore that? Just like you ignored its conclusion “Though promising, the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes. Further research is warranted but the required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.”

    Yeah, I know you won’t answer me… Sir Dana. You are bravely running away because you have no answers.

  34. #34 HCN
    May 24, 2007

    Sorry for the double post, I got an internal server error.

    But I’ll take this opportunity to add the interesting bits from the Organon on syphilis. From http://www.homeopathyhome.com/reference/organon/51.html:

    “If such infection have previously occurred, this must also be borne in mind in the treatment of those cases in which psora is present, because in them the latter is complicated with the former, as is always the case when the symptoms are not those of pure syphilis; for when the physician thinks he has a case of old venereal disease before him, he has always, or almost always, to treat a syphilitic affection accompanied mostly by (complicated with) psora, for the internal itch dyscrasia (the psora) is far the most frequent (most certain) fundamental cause of chronic diseases, either united (complicated) with syphilis (or with sycosis), if the latter infections have avowedly occurred; or, as is much more frequently the case, psora is the sole fundamental cause of all other chronic maladies, whatever names they may bear, which are, moreover, so often bungled, increased and disfigured to a monstrous extent by allopathic unskillfulness.”

    With a footnote: “1 In investigations of this nature we must not allow ourselves to be deceived by the assertions of the patients of their friends, who frequently assign as the cause of chronic, even of the severest and most inveterate diseases, either a cold caught (a thorough wetting, drinking cold water after being heated) many years ago, or a former fright, a sprain, a vexation (sometimes even a bewitchment), etc. ”

    Yeah, it continues on like that.

  35. #35 HCN
    May 25, 2007

    Brave Sir Dana said “Homeopathy is nanopharmacology at its best; it is biomimicry with cell-signaling and immuno-augmentation capabilities. Investigate it and learn.”

    Actually the only homoepathy that is “nanopharmacology” are 9X and something between 4C and 5C. Why is that you may ask? Because “nano” is a real term, not one you can make up terms for to make your magic solutions more “scientific”:
    http://en.wikipedia.org/wiki/Nano

    By the way, I know one researcher in nanotechnology that has told me about some of the medical applications that his colleagues are working on… none of it is homeopathic. See http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17489016#id2534040 for an example. Several universities are doing research in medical nanotechnology… so be careful how much you make yourself look foolish when you use the term “nanopharmacology”.

  36. #36 HCN
    May 26, 2007

    Oh, good grief! I put the search terms “dana ullman idiot” into Google.com and got over 17000 hits!!!

  37. #37 Dana Ullman
    May 26, 2007

    You can call names…do you really think that this improves your argument? Let’s go beyond name-calling (neither are adolescents, I hope).

    Please do not call yourself knowledgeable of homeopathy just because you’ve “read parts of Hahnemann’s Organon.” Just because I’ve read parts of Harvey’s original work doesn’t make me knowledge of cardiology. And no, I’m not interested in talking with you about syphilis.

    You can say that you like Salzburg more than Vienna (so do I),though you have ignored any adequate critique of that study on COPD at the University of Vienna. And strangely enough, you seem confused why the use of Oscilloccinum (made from the “heart and liver of a duck”) can have any effect. I thought you believed in double-blind and placebo-controlled trials? Three large trials have shown efficacy in the treatment of the flu. When you consider that ducks are known to have numerous influenza viruses in their digestive tracts, it seems that homeopathic doses of duck organs convey immunlogical benefits to patients who take them. I guess science is getting in the way of your anti-homeopathic viewpoints.

    As for understanding why homeopathic medicines are different than “plain water,” I suggest that you visit the website of Rustum Roy, PhD. He’s had over a dozen articles published in NATURE, though they refuse to publish his research on homeopathy. The ISI rated his laboratory as the best material sciences lab in the world. A 2005 article is at: http://www.rustumroy.com/Roy_Structure%20of%20Water.pdf
    Another article will be published in July, 2007.

    Many skeptics say that homeopathic medicines “cannot” work, but they remain ill-informed about the physics of water. Dr. Roy’s work may be helpful to those of you who are really scientifically-minded.

    As for “nanopharmacology,” the origin of the word nano is “dwarf” or extremely small. It does not just mean one-billionth. No one is calling Steve Jobs names just because he called his music device the NANO. Let’s talk substance.

    Yes…nanomedicine will be BIG. In addition to homeopathic medicine, the field of HORMESIS and its IMMENSE body of research is worthy of exploration…or you can continue to stick your head in a hole and continue to use your rotary phone and typewriter.

  38. #38 Orac
    May 27, 2007

    Roy lost me pretty fast in the fourth paragraph of th article when he stated:

    The burden of proof on critics of homeopathy is to establish that the structure of the processed remedy is not different from the original solvent.

    Wrong. Given the scientific implausibility of homeopathy, the burden of proof is on advocates of homeopathy to show that the structure of the processed remedy is different from the original solvent, not on critics who point out how utterly implausible the principle behind homeopathy is.

  39. #39 Dana Ullman
    May 27, 2007

    After you’ve gotten a dozen plus articles published in NATURE (as Rustum Roy has), you are start giving a reasonable critique of his work (or at least stop just taking something out of context and stop being lazy enough to read only 4 paragraphs). Please respond to his information on the structure of water. Do you mean to say that you know more about water than Dr. Roy? If so, get it published and stop wasting everyone’s time here.

  40. #40 Orac
    May 27, 2007

    If Roy’s water stuff is so great, then why can’t he get it published in Nature, too?

    Oh, and I did read the whole paper. It didn’t take long. It says some interesting things but also some woo-ey things as well. In fact, deconstructing it might make a good topic for a future post sometime next week if I have time. I don’t usually waste such material as a deconstruction of a paper in the comments of a post, where I’d be writing a fairly long post that far fewer people would read than if I turned it into a formal post.

    In any case, you are only arguing from authority, anyway, which Roy may or may not still have. After all, Roy wouldn’t be the first eminent scientist to turn into a crank. A fair number of Nobel Laureates have fallen prey to pseudoscience in their later years, Linus Pauling being the most prominent example and Louis Ignarro being the most recent. So, just because Rustum Roy has a long and distinguished career in materials science does not mean that he hasn’t devolved into crankery.

    The efficacy (or lack thereof) of homeopathy must turn on clinical evidence, not any sort of theories of water “memory.” Pointing out the scientific implausibility of water “memory” or homeopathy merely serves to point out that the evidence from clinical studies would have to be very convincing indeed to make us rewrite our chemistry and physics textbooks. So far, no evidence for homeopathy that compelling exists, including the papers you cited.

  41. #41 daedalus2u
    May 27, 2007

    Orac, actually, Ignarro is correct about increasing NO preventing and curing heart disease, he is incorrect that dietary arginine will do so. Arginine is the substrate for nitric oxide synthase. Nitric oxide synthase is used to generate NO in signaling pathways, not to generate the basal level of NO. When arginine is increased there is compensatory increase of asymetric dimethylarginines (NOS inhibitors), and upregulation of arginase which cleaves arginine to ornithine plus urea. The urea is then excreted in sweat where “my” bacteria (if present) will convert it into NO and nitrite and so increase basal NO levels.

    It has been pretty well established that arginine can increase NO in the short term, but not in the long term.

    The “classic” symptoms of low NO (to me) are increased excretion of ammonia (as in hepatic encephalopathy, kidney failure, cachexia) and adrenergic sweating (particularly on the scalp). Some cachexia is due to insufficient mitochondria biogenesis in the liver, which results in not enough mitochondria to run gluconeogenesis and the urea cycle. “Normally” the ammonia then increases NO and nitrite on the skin which increases mitochondria biogenesis, but without “my” bacteria, it is just excreted. I think this is the most common cause of cachexia, including from cancer, heart disease, liver failure, kidney failure, HIV (HAART inhibits mitochondria biogenesis) and even sepsis and ARDS. In sepsis and ARDS the inhibition of liver mitochondria can be transient (if the patient survives). A “classic” sign of insufficient liver mitochondria is elevated lactate. The hypermetabolic state of these diseases is due to insufficient mitochondria. Fewer mitochondria can produce the same ATP only by operating at a higher potential, where the conversion of substrate into ATP isn’t as efficient. It takes more substrate to make the same ATP.

  42. #42 HCN
    May 28, 2007

    Oh good grief… I go away to chaperone a band camp on a weekend and Brave Sir Dana responds… weakly, very weakly.

    You still have not answered the bulk of my questions on syphilis, hypertrophic cardiomyopathy and how itsty biysy teeny tiny bits of duck parts help influenza.

    Brave Sir Dana… how about you explain EXACTLY how the very poorly designed and written paper on COPD proves anything. First of all, you failed to even cite it properly. You may think they were double blind and placebo controlled trials… but you fail to understand that STANDARD MEDICAL PRACTICES WERE NOT DISCARDED!!! Oh, and that the differences were not that statistically relevant given the teeny tiny study size.

    You really need a remedial lesson in statistics… oh, and please ANSWER my questions:

    1) One of the “miasms” Hahnemann was claiming to cure was syphilis. What was his success in curing syphilis two hundred years ago? What is the standard of care for treating the actual bacterial disease known as syphilis? How effective would modern homeopathy be with actual syphilis?

    2) Cardiac conditions are another big killer of Americans… so your magic potions should work great for them also. My oldest son as a genetic condition known as hypertrophic cardiomyopathy with obstruction. He presently takes the beta-blockers (Atenolol) to reduce the pressure on his already damaged mitral valve. My question is how would your homeopathic treatment be better for him than Atenolol?

    3) Also, how does your Masters in Public Health (MPH) give any credibility? Does this mean you have actually learned the value of sewage disposal, clean water supplies, pest control in food preparation areas, and vaccines? Are you the one who shows up in a disaster area (flood, hurricane, earthquake, etc) giving out homeopathic remedies instead of clean water, toilet facilities and vaccines for tetanus?

    4) (a new question) What exactly is the mechanism in itsy bitsy teeny tiny not perceptible with standard scientific equipment on this planet at this time duck bits have to alleviate any part of influenza (which is caused a virus)?

  43. #43 daedalus2u
    May 28, 2007

    Actually HCN, hypertrophic cardiomyopathy is due (in part) to insufficient basal nitric oxide, which reduces mitochondria biogenesis. The reason that long duration pressure overload produces it, is that to generate the increased ATP that is needed, mitochondria increase their potential, which increases superoxide production, which pulls down NO levels which disinhibits cytochrome c oxidase, which pulls down O2 levels at the mitochondria, so the gradient in O2 between the vessel and the mitochondria increases, so that more O2 can diffuse there and be consumed. When that goes on for “too long” (longer than the lifetime of mitochondria), then there is low NO during periods of mitochondria biogenesis which results in too few mitochondria being generated. The system evolves to a new steady state operating point, with fewer mitochondria operating at a higher potential. There are some more complicated effects too, relating to capillary spacing and some other things.

    A potential “solution”, (in your son’s case), would be to increase basal NO levels (while maintaining low blood pressure via betablockers or other methods) until mitochondria levels go up and the hypertrophy is repaired. How long this would take is unknown, I would expect no less than a few months, perhaps a couple of years. There should be steady progress if it is “working”.

  44. #44 Dana Ullman
    May 28, 2007

    I have no interest in talking/writing about syphilis nor hypertrophic cardiomyopathy.

    People on this list questioned whether homeopathic doses can have any effect and seemed unfamiliar with any studies. The COPD study is but one of several hundred. You questioned its design, and yet, you provided NO adequate critique (if you want to be a good skeptic, be a good scientist). Although both the homeopathic treated patients AND those given a placebo were also given allopathic drugs, ONLY those who were given a homeopathic medicine experienced substantial health improvements (remember, this was a double-blind, placebo controlled trial). This study strongly suggested a benefit from the homeopathic medicine (if you believe in double-blind and placebo controlled research…if you don’t, please say so!).

    As for the flu trials, they too were double-blind and placebo controlled…and all 3 trials found statistically significant results. Do you believe in scientific research or not. These studies were shown replicability.

    There are various theories about how homeopathic medicines work, but it was not until somewhat recently that scientists figured out how aspirin worked…and I do not know a single MD (or not) who didn’t use aspirin just because we didn’t know how it worked.

    The MPH is no big thing, especially compared with other work that I’ve done over the years. I was more honored when UC Berkeley’s alumni magazine honored me with a 5 page interview (February 1999). I’ve written chapters in medical textbooks in pain management–published by the leading pain management organization in the US, and oncology (published by Oxford University Press).

  45. #45 HCN
    May 28, 2007

    There is a structural anomaly associated with the disorder, which is clearly visible in an echocardiogram. In our case it is a genetic condition that caused the death of one of my aunts when she was an infant. If the NO levels can be adjusted to reduce the size of the muscle, you are going to have to use actual medical literature to prove it.

    How about you try telling these guys your theory:
    http://www.4hcm.org/WCMS/index.php

  46. #46 daedalus2u
    May 28, 2007

    If there is a structural abnormality, that will trump most everything else. The “problem” isn’t so much the size of the muscle, it is with the “effectiveness” of the muscle after it is remodeled. The heart is the one thing that can never “rest”. The mitochondria turnover has to occur while the heart is still active (unlike most everything else). What makes a muscle stronger isn’t “exercise” per se, it is the remodeling that happens during rest after exercise where the damage is repaired plus some more to make it stronger. The level of NO during that rest is one of the things that sets the magnitude of the repair and increased capacity.

    What sets the spacing between capillaries is not just hypoxia, but also NO. Hemoglobin is the sink for NO, and the source of O2. The vasculature is “well formed”, that is “not enough” capillaries are fixed by angiogenesis, and “too many” capillaries are fixed by capillary ablation. Low O2 could be enough to fix “not enough”, but high O2 will not work to measure “too many”. With O2 and NO having very similar diffusion properties, if a region is “diffusively close enough” to hemoglobin can be determined either by high O2, or low NO. The NO signal works to measure both “not enough” (high NO), and “too many” (low NO). A lot of this signaling is mediated through HIFa. The O2 signal isn’t really necessary. In fact, O2 isn’t going to work in utero because the O2 levels are so much lower. NO works both in utero and while breathing air.

    Low NO is what causes the capillary rarefaction observed in a lot of conditions. The “chronic inflammation” is (I think) due to the cells “too far” from a capillary dying of hypoxia one cell at a time. The cells get replaced, but with capillary rarefaction there isn’t enough vasculature to support them, so the space has to fill up with something, fibrotic tissue. In the heart, the muscle gets bigger but weaker and stiffer.

    I will check out the HCM site, thanks.

  47. #47 HCN
    May 28, 2007

    Daedalus: At least the homeopaths I have posed that question to at least looked up the disorder before responding. Of course, they never responded with anything useful, but at least they tried to find out FIRST what the condition involved.

    In the future when you impose your “NO theory on absolutely everything” look up the condition FIRST!

  48. #48 Dana Ullman
    May 30, 2007

    Your silence speaks for itself. You attack without knowledge and yet have the chutzpah to think of yourself as a “defender of science.” You even had the audacity to brag how “Dana Ullman was lacking answers” at randi.org. I am truly honored that you call me “annoying.” I bet that you hate it when people show you research that shakes your believes. You seem more religious than scientific.

    I am still waiting for your critique of the COPD study or the four studies by David Reilly on allergic disorders…or the 2005 study in West Bengal on people who were exposed to arsenic (that is, IF you still believe in double-blind and placebo controlled research)…published by Oxford University Press.

    I bet you even believe that the Iraqis do have WMDs and that they created 9/11. You seem to like to rant and still to your guns no matter what. Peace out…

  49. #49 Dana Ullman
    May 31, 2007

    To make your life a little easier, here’s the URL for that arsenic study:

    http://ecam.oxfordjournals.org/cgi/content/abstract/2/4/537

    Oh…and this research found specific liver enzyme changes too (but only in the homeopathic treated group):

    http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16550230

    Oh…and this group of researchers has a variety of other well-controlled studies published in peer-review journals:

    http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=search&db=pubmed&term=Khuda-Bukhsh%20AR%5Bau%5D&dispmax=50

    And while you’re at it, please review the 1,000+ studies on HORMESIS…a veritable treasuretrove of good research showing the power of nanopharmacology. I bet you join us shortly and will be ranting with us rather than against us.

    PS Sorry for the misspelling of “beliefs” in the above email.

  50. #50 HCN
    May 31, 2007

    Well, I have yet to see an answer to my questions.

    But I will say this: In the COPD study they did not really deny standard treatment.

    Also, when examined most of the homeopathic studies you seem to favor fall apart in the details. The throwing a whole bunch more does not really help your case… especially when you have not answered even a teeny tiny bit of my questions.

    Why don’t you sign up to debate on the JREF forums?

  51. #51 HCN
    May 31, 2007

    Here is another question that you will not answer:

    Please list the complete list of ingredients with their amounts in percentages for the type Oscillococcinum you commonally prescribe.

  52. #52 Joe
    May 31, 2007

    I noted that Sir Dana is referring to quack literature, not medical lit. When one is a quack, one’s “peer” reviewers are quacks, and the result is a suspect publication. Can Sir Dana offer any citations to medical literature.

    Yes some of this stuff is indexed by PubMed; unfortunately- they (PubMed) are forced to index a lot of junk. But that doesn’t make junk legit. Have you ever heard the expression “don’t pee on my leg and tell me it’s raining”?

  53. #53 Dana Ullman, MPH
    May 31, 2007

    Excuse me…but there is but one more example of you not doing your homework. Why, oh why, do you consider the journal CHEST to be “quack literature.” It is considered to be one of the best medical journals in internal medicine.
    Or…how about RHEUMATOLOGY, the journal of the British Rheumatological Society…search for a clinical trial by Iris Bell, MD, PhD, showing clinical effects AND objective changes in EEG readings in only those patients given a homeopathic medicine (not the placebo group)…but are you really interested in research or just ranting?

    But heck, if you want hard science, listen to a webinar with Rustum Roy, PhD (professor of material sciences at Penn State University, author of 793 papers, including 13 articles in NATURE!) and Iris Bell, MD, PhD at:
    http://www.infiniteconferencing.com/Events/nch/051607nch/recording-playback.html.

    As for Oscillococcinum, it is the 200C potency of the heart and liver of a duck (because ducks are known to be resevoirs of flu viruses…and 3 large clinical trials have confirmed its efficacy).

    I wish someone (!) on this list would do some homework and would stand up for research rather than rants.

    And yes…I will some time soon go to randi.org because you folks don’t do real science and don’t seem to know it either.

  54. #54 daedalus2u
    May 31, 2007

    HCN, There are multiple causes for dilative cardiomyopathy. Structural abnormality is only one of them. Until you mentioned that was the cause of your son’s DCM, I didn’t know the specific mechanism in your son’s case. All of causes are ultimately mediated through NO. It is the remodeling of the heart muscle under conditions of low NO that causes the dilatation and fibrotic degradation of the heart. That effect is mediated through the cross-talk between the NO and superoxide signaling systems. An imbalance in that system leads to the damage observed.
    Multiple factors can lead to the mechanical unbalancing of the heart. Including pressure overload via obstruction, pacing overload, inhibition of nitric oxide synthase, oxidative stress produced via viral infection, oxidative stress from diabetes, oxidative stress from inflammation. What ever starts the heart on the path to dilative cardiomyopathy, it is low NO that causes it to progress.

  55. #55 Joe
    June 2, 2007

    Dana, Dana, Dana; your most-recent, three citations were to quack lit. As I recall, you made an incomplete or dead-end reference to Chest a while ago. How about some complete citations.

    While you are at it, why not give full citations to your own, claimed, publications? One would think that would be easy.

  56. #56 Dana Ullman
    June 3, 2007

    Here’s the link to the CHEST article. My apologies if I incorrectly assumed that you could google it yourself.

    http://www.chestjournal.org/cgi/content/abstract/127/3/936

    As for the other trial on severe sepsis also conducted at the University of Vienna Hospital, ALL patients were given antibiotics, though those given a homeopathic medicine had a mortality rate of 25%, while those patients given a placebo had a 50% mortality. I bet that some of you would prefer to die than simply try homeopathy…and ironically, you think of yourself as “defenders of science” even though you ignore good research, you call any journal that publishes research on homeopathy as “quack literature,” and you don’t even do some simply homework (such as reading the scientific literature).

    For the record, the severe sepsis study is at:
    http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=15892486&dopt=Abstract

    Interesting…you’ve called the journal, “RHEUMATOLOGY,” as “quack literature.” Hmmmm.

    The journal in which this latter study was published, “Homeopathy,” is published by Elsevier, that same publisher that publishes another “quack journal” called “The Lancet” (by YOUR definition, any journal that publishes such studies is quackish).

    Some of the smarter ones of you who read this will be intrigued by homeopathy and will not be close-minded and scientifically thinking. Quit the rants and consider being real scientists.

  57. #57 Dana Ullman, MPH
    June 5, 2007

    Wow…this SILENCE is so loud. It is time to LEARN from homeopathy and be a real scientist.

    Read this impressive article published in the MEDICAL SCIENCE MONITOR by an Italian MD and senior research scientist at the University of Siena:
    http://www.medscimonit.com/pub/vol_13/no_1/9827.pdf

    Your bubble is about the pop. Enjoy it.

  58. #58 Orac
    June 5, 2007

    Dana,

    I’ve read some of the studies that you’ve presented. Quite frankly, I’m unimpressed. I just haven’t blogged about them yet because I’ve had other topics that have interested me a lot more than homeopathy lately.

    However, be careful what you ask for when trying to taunt me. You just might get it…

  59. #59 HCN
    June 5, 2007

    Just noticed this… I have not bothered looking on anything past the main page for over a week. Brave Sir Dana is now posting on JREF as Steve Gilley.

    By the way, Daedalus… hypertrophic cardiomyopathy is NOT dilative cardiomyopathy. As I said before, have the courtesy of actually looking up the disorder before pronouncing anything about it. HCM is an inherited disorder.

  60. #60 HCN
    June 5, 2007

    AAAGH… he is posting as JamesGulley:
    http://forums.randi.org/showthread.php?p=2665313#post2665313

    See, I told you I needed to log off my computer over an hour ago!

  61. #61 Joe
    June 6, 2007

    Did somebody mention the rag “Homeopathy” which is published by the printing-press whore, Elsevier? I once helped a retarded boy with a high-school science project that was more sophisticated than their articles.

  62. #62 drrandy
    June 7, 2007

    This is my first post in this interesting blog, which I first happened upon today. I thought I might share some perspectives by an MD who practices homeopathy.

    I consider myself a scientist. On the one hand, it is unclear exactly how homeopthy works, and thus it is dismissed out of hand by many simply because they have prejudged that it can not possible work. Certainly, the mechanisms are difficult to explain from the perspective of Newtonian physics, but there are many things that make no sense from a Newtonian perspective that are true from the perspective of quantum physics. I am no expert in quantum physics, but my point is that the fact that the mechanism is not yet elucidated does not mean that it should be rejected out of hand- as has been mentioned, aspirin was used by many generations of physicians before its mechanism of action was known, but that did not prevent its being used or being useful.

    I am a supporter of Evidence-Based Medicine, and double-blind controlled studies are the gold standard of EBM. There are numerous double-blind controlled studies published in mainstream peer-reviewed journals demonstrating homeopathic medicines to be effective in treating a wide range of conditions, from sepsis (as mentioned above) to childhood diarrhea to arthritis. Meta-analyses published in the Lancet and British Medical Journal have found that, while many studies on homeopathy were flawed (just as many allopathic studies are flawed), there were several that held up to rigorous scrutiny and showed efficacy (I refer you to Dana Ullman’s website for links to these studies). Skeptics and allopaths tend to ignore these studies. However, it seems to me that these studies either prove that homeopathy works better than palcebo or that the whole foundation of EBM, the double-blind controlled study, is an invalid scientific tool. You can’t have it both ways.

    However, the most significant point I wish to make is that the most convincing evidence for homeopathy is not in controlled studies but in the individual cases one encounters in clinical practice. Homeopaths learn homeopathy by going to homepathic colleges (after completing my residency in Family Pracitce at the University of Michigan, where I also received my medical degree after obtaining my BS in biology at Stanford, I attended a four-year part time postgraduate program in homeopathy, the Hahmemann College of Homeopathy) and attending conferences and seminars. The typical teaching method in these settings is to show a video of the patient at their initial consultation, so the students can observe the patient and hear their symptoms first-hand. Then, typically, the students are shown videos of the same patient 1 month, 6 months, a year etc. following treatment. What we are able to witness directly is not only incredible cures of a wide variety of illnesses considered incurable by conventional medicine, but profound personal transformations, people who have been emotionally tormented their whole lives finding inner peace and happiness, a sense of purpose where they were previously confused. Such changes are difficult to quantify in graphs and charts, but powerfully evident to those who observe. And, after witnessing these cases of our teachers, homeopaths are eventually priveleged to see similar results in their practices (it should be noted that of all the forms of healing I have studied, homeopathy is the most subtle and challenging. There are thousands of medicines used in homeopathy,and at any given time there is one that is the best fit; finding that remedy is easier said than done, and even the best homeopaths don’t always get it right, but when the optimal remedy is found the results are often remarkable).

    Perhaps these results are due to a placebo effect, but if so, homeopathy is the best placebo I have found. I have no doubt that many of the benefits of allopathic medicine are also due to placebo effect (such as when someone’s viral respiratory infection improves with an antibiotic) but at least homeopathy has no toxicity (however, some patients can experience severe “aggravations” secondary to homeopathic medicine- but those who see it as just a placebo can point to the high incidence of side effects experienced by placebo groups in contolled studies).

    But if homepathy is purely a placebo, it is difficult to explain the good results homeopaths routinely experience with babies and animals (more than once, I have seen an infant screaming in pain from an ear infection fall asleep within moments of receiving a remedy, and having no apparent pain thereafter- and, no, it was not due to the eardrum suddenly rupturing by coincidence just after receiving the remedy).

    Another point that is difficult to convey is the extreme intelligence and the level of intellectual sophisitcation and subtle nuance that is displayed at homeopathic conferences. Having studied at Stanford and the U. of Michigan, I encountered many brilliant professors, but some of the most impressive intellects and finest minds I have met are the master homeopaths .It is hard for me to believe that people so brilliant would be spending their careers on something that is as nonsensical as the skeptics believe.

  63. #63 Cain
    June 7, 2007

    I consider myself a scientist. On the one hand, it is unclear exactly how homeopthy works, and thus it is dismissed out of hand by many simply because they have prejudged that it can not possible work

    This is a lie and you know it. There have been countless trials of homeopathy, and it’s never been shown to work better than a placebo. That’s why it’s dismissed.

  64. #64 Joe
    June 7, 2007

    Not a lie, I think. Rather- uninformed, uncritical and self-deluded. See:
    http://www.skepdic.com/homeo.html
    http://www.homeowatch.org/news/baum.html
    http://www.homeowatch.org/

    The first link can also lead one to a book on critical thinking. There are other good books such as “How We Know What Isn’t So.”

    As for using poorly understood drugs, the mechanism of action is less inportant than proper clinical proof. Note that homeo research has a greater duty to prove efficacy- it must be conducted under conditions that independently confirm no cheating occured. manufacturers have added clinically effective amounts of drugs to their preps in order to assure activity.

    Finally, drrandy, have any remedies been removed from the pharmacopeia for lack of efficacy?

  65. #65 drrandy
    June 7, 2007

    With all due respect, Cain, your post is proveably false (countless times over) and a perfect example of the “head in the sand” attitude homepaths face. Since you (and others inthis forum) seem too lazy to visit Dana Ullman’s excellent website, I will provide a quote from one of his articles:

    “People are often confused by research, not only because it can be overly technical but because some studies show that a therapy works and other studies shows that it doesn’t. To solve this problem, a recent development in research is used, called a “meta-analysis,” which is a systematic review of a body of research that evaluates the overall results of experiments.

    In 1991, three professors of medicine from the Netherlands, none of them homeopaths, performed a meta-analysis of 25 years of clinical studies using homeopathic medicines and published their results in the British Medical Journal.4 This meta-analysis covered 107 controlled trials, of which 81 showed that homeopathic medicines were effective, 24 showed they were ineffective, and 2 were inconclusive.

    The professors concluded, “The amount of positive results came as a surprise to us.” Specifically, they found that:

    13 of 19 trials showed successful treatment of respiratory infections,
    6 of 7 trials showed positive results in treating other infections,
    5 of 7 trials showed improvement in diseases of the digestive system,
    5 of 5 showed successful treatment of hay fever,
    5 of 7 showed faster recovery after abdominal surgery,
    4 of 6 promoted healing in treating rheumatological disease,
    18 of 20 showed benefit in addressing pain or trauma,
    8 of 10 showed positive results in relieving mental or psychological problems, and
    13 of 15 showed benefit from miscellaneous diagnoses.

    Despite the high percentage of studies that provided evidence of success with homeopathic medicine, most of these studies were flawed in some way or another. Still, the researchers found 22 high-caliber studies, 15 of which showed that homeopathic medicines were effective. Of further interest, they found that 11 of the best 15 studies showed efficacy of these natural medicines, suggesting that the better designed and performed the studies were, the higher the likelihood that the medicines were found to be effective. Although people unfamiliar with research may be surprised to learn that most of the studies on homeopathy were flawed in one significant way or another,5 research in conventional medicine during the past 25 years has had a similar percentage of flawed studies.

    With this knowledge, the researchers of the meta-analysis on homeopathy concluded, “The evidence presented in this review would probably be sufficient for establishing homeopathy as a regular treatment for certain indications.”

    There are different types of homeopathic clinical research, some of which provide individualization of remedies; which is the hallmark of the homeopathic methodology; some of which give a commonly prescribed remedy to all people with a similar ailment, and some of which give a combination of homeopathic medicines to people with a similar condition. While one can perform good research using any of these methods, there are certain issues that researchers have to be aware of and sensitive to in order to obtain the best objective results.

    For instance, if a study does not individualize a homeopathic medicine to people suffering from a specific ailment and the results of the study show that there was no difference between those given this remedy and those given a placebo, the study does not disprove homeopathy; it simply proves that this one remedy is not effective in treating every person suffering from that ailment, each of whom may have a unique pattern of symptoms that requires an individual prescription.

    In describing specifics of the following studies using homeopathic medicines, differentiation has been made between studies that allowed for individualization of medicines and those that did not.

    Clinical Research with Individualized Care

    Some people incorrectly assume that research using homeopathic medicines is impossibly complicated because each medicine must be individualized to the patient. The following studies disprove this simplistic belief.

    A recent clinical trial evaluating homeopathic medicine was a unique study of the treatment of asthma.6 Researchers at the University of Glasgow used conventional allergy testing to discover which substances these asthma patients were most allergic to. Once this was determined, the subjects were randomized into treatment and placebo groups. Those patients chosen for treatment were given the 30c potency of the substance to which they were most allergic (the most common substance was house dust mite). The researchers called this unique method of individualizing remedies “homeopathic immunotherapy” (homeopathic medicines are usually prescribed based on the patient’s idiosyncratic symptoms, not on laboratory analysis or diagnostic categories). Subjects in this experiment were evaluated by both homeopathic and conventional physicians.

    This study showed that 82% of the patients given a homeopathic medicine improved, while only 38% of patients given a placebo experienced a similar degree of relief. When asked if they felt the patient received the homeopathic medicine or the placebo, both the patients and the doctors tended to guess correctly.

    The experiment was relatively small, with only 24 patients. As noted, for statistically significant results, small experiments must show a large difference between those treated with a medicine and those given a placebo. Such was the case in this study.

    Along with this recent asthma study, the authors performed a meta-analysis, reviewing all the data from three studies they performed on allergic conditions, which totaled 202 subjects. The researchers found a similar pattern in the three studies. Improvement began within the first week and continued through to the end of the trial four weeks later. The results of this meta-analysis were so substantial (P=0.0004) that the authors concluded that either homeopathic medicines work or controlled clinical trials do not. Because modern science is based on controlled clinical trials, it is a more likely conclusion that homeopathic medicines are effective.

    Another recent study, published in the American journal Pediatrics, tested homeopathic medicine for the treatment of a condition recognized to be the most serious public health problem today, childhood diarrhea.7 Over 5 million children die each year as the result of diarrhea, mostly in nonindustrialized countries. Conventional physicians prescribe oral rehydration therapy (ORT, a salt solution that helps children maintain fluid balance), but this treatment does not fight the infection that underlies the diarrhea.

    Conducted in Nicaragua in association with the University of Washington and the University of Guadalajara, this randomized double-blind, placebo-controlled study of 81 children showed that an individually chosen remedy provided statistically significant improvement of the children’s diarrhea as compared to those given a placebo. Children given the homeopathic remedy were cured of their infection 20% faster than those given a placebo, and the sicker children responded most dramatically to the homeopathic treatment. A total of 18 different remedies were used in this trial, individually chosen based on each child’s symptoms.

    A study of the homeopathic treatment of migraine headache was conducted in Italy.8 Sixty patients were randomized and entered into a double-blind, placebo-controlled trial. Patients regularly filled out a questionnaire on the frequency, intensity, and characteristics of their head pain. They were prescribed a single dose of a 30c remedy at four separate times over two-week intervals. Eight remedies were considered, and prescribers were allowed to use any two with a patient. While only 17% of patients given a placebo experienced relief of their migraine pain, an impressive 93% of patients given an individualized homeopathic medicine experienced good results.”

    Please go to http://www.homeopathic.com/articles/research/scienti.php to read more and see his citations.

    A quote from another article there is:

    “The Lancet published the most significant and comprehensive review of homeopathic research ever published in its September 20, 1997, issue. This article was a meta-analysis of 89 blinded, randomized, placebo-controlled clinical trials. The authors conclude that the clinical effects of homeopathic medicines are not simply the results of placebo.

    The researchers uncovered 186 studies, 119 of which were double-blind and/or randomized placebo-control trials, and 89 of which met pre-defined criteria for inclusion into a pooled meta-analysis. The reseachers found that by pooling the 89 trials together that homeopathic medicines had a 2.45 times greater effect than placebo.”

    As I said, the only reasonable conclusion is that homeopathy has been proven (time and time again) to work better than placebo or that the foundation of evidence-based medicine, double-blind controlle studies, is invalid.

  66. #66 drrandy
    June 7, 2007

    I apologize for the typo in the last line above (should read “controlled”)- my 2 young daughters were requesting my attention, so I finished the post in haste.

    I would add that it is fascinating to observe how those who claim to worship at the altar of science can simply and conveniently ignore well-designed research that flies in the face of their preconceived notions.

  67. #67 HCN
    June 7, 2007

    What do homeopaths (or Dana Ullman, since this guy is referencing Ullman’s webpage, he could just be another Ullman sockpuppet) have against actually citing the PubMed reference? Not even the decency to give the name of the resercher so it can be verified. Is there some kind problem with the paper that you are making it hard to look? How do we know you are not just making it up?

    But never mind, 1991 is a pretty old reference. Here is a more recent one from the respected Mayo Clinic:
    1: Mayo Clin Proc. 2007 Jan;82(1):69-75.Links
    Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials.Altunç U, Pittler MH, Ernst E.
    Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, United Kingdom.

    Which concludes: CONCLUSION: The evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition.

    PMID: 17285788 [PubMed – indexed for MEDLINE]

  68. #68 Mojo
    June 7, 2007

    The 1991 meta-analysis referred to looks to be this one (it’s currently cited on the homoeopathy page of Wikipedia): Kleijnen, Knipschild, and ter Riet: Clinical trials of homoeopathy, BMJ. 1991 Feb 9;302(6772):316-23

    http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=1825800

    “CONCLUSIONS–At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials.”

    The results of more recent meta-analysis papers (such as the one cited above) suggest that “further evaluation by means of well controlled trials” hasn’t been particularly positive for homoeopathy.

  69. #69 Mojo
    June 7, 2007

    Oh, and the 1997 Lancet study cited is Linde, I think:

    http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=9310601

    “INTERPRETATION: The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition. Further research on homeopathy is warranted provided it is rigorous and systematic.”

    This seems to be SOP: studies are touted as proving that homoeopathy works despite appearing inconclusive. Is that as good as meta-analysis gets for homoeopathy?

    Seems to answer HCN’s question about the reluctance to provide reference or authors’ names, anyway.

  70. #70 HCN
    June 7, 2007

    Oooooh… you definitely have good Mojo! I did look, but couldn’t find them. Which seems was a definite goal in the oblique way that Ullman/drrandy/jamesgully references them!

    I did find a bunch of stuff by L. Milgrom, but I figured that was the same guy who didn’t notice Ben Goldacre sitting next to Dr. Peter Fisher here:
    http://www.badscience.net/?p=341

  71. #71 Orac
    June 7, 2007

    You mean this Lionel Milgrom? ;-)

    But you guys are right; homeopathy boosters love the 1991 meta-analysis (which doesn’t really show much of anything anyway), but somehow conveniently forget that it rated the studies that it examined to be of low methodological quality and that there are multiple meta-analyses that are much more recent and failed to find any effect of homeopathy in any condition.

  72. #72 HCN
    June 8, 2007

    Oh, yes… THAT Lionel Milgrom!

    By the way, Mojo said “This seems to be SOP: studies are touted as proving that homoeopathy works despite appearing inconclusive. Is that as good as meta-analysis gets for homoeopathy?

    “Seems to answer HCN’s question about the reluctance to provide reference or authors’ names, anyway.”

    So Ullman/drrandy/JamesGully actually KNOWS that the studies he cites aren’t worth much, and don’t really say what he says they do. He is hoping that his oblique references would flummox some readers enough so that they would click onto his website and buy his books.

    Of course, only the most gullible would do that (like my niece!). Mr. Ullman has not yet figured out how to calculate percentages, or what “nano” actually means (and it is NOT 200C!), so why should we trust his interpretation of science?

  73. #73 HCN
    June 8, 2007

    By the way, the 1991 study that Ullman/drrandy/JamesGully was reluctant to actually name so that it could be checked is fully available online:
    http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=1825800

    Be sure to also click on the “corrections” and “letter” links which are also availableon PubMedCentral.

  74. #74 Orac
    June 8, 2007

    Heh.

    One notes that Dana and Dr. Randy don’t generally provide links to the studies that they reference. Indeed, early on Dana didn’t even really give full references.

  75. #75 Dana Ullman
    June 12, 2007

    It is rarely hard to find references that I have provided as long as you use google. Please don’t expect me to hold your hand. Anyway, most online references are only to abstracts. Good scientists have to do more than abstract reading, right?

    As for the 1997 metaanlysis in the LANCET, Mojo has seemingly not read the abstract, nor the full article, nor does Mojo understood it (ironically, in the defense of science, Mojo doesn’t practice it). Mojo quoted the absract:
    “INTERPRETATION: The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition. Further research on homeopathy is warranted provided it is rigorous and systematic.”

    Please note that the authors of this metaanlysis defined “efficaciousness” as having at least THREE independent replications of a trial in the treatment of a specific disease. Shortly after publication of this review, the THIRD independent clinical trial in the treatment of influenza with Oscillococcinum was published.

    The researchers found that according to their review of 89 double-blind studies, the patients given a homeopathic medicine had a 2.45 times greater chance of experiencing a therapeutic benefit than those people given a placebo. This is why the authors asserted that the placebo explanation is still inadequate for explaining all that homeopathic medicines offer.

    For these and other references to homeopathic literature, see my article “Why Homeopathy Makes Sense and Works” at http://homeopathic.com/articles/homeopathy_works.php.

    However, it seems that the hyper-skeptics on this list don’t do their homework, spout personal attacks on homeopaths, do name-calling, or rarely engage in real dialogue. I’m trying to talk to you, but read and re-read this dialogue, and people pick out one thing that I write and attack it (usually with only partial knowledge), but then ignore the other important references to research. It is not hard to see what you do to keep your worldview intact, despite its many cracks.

  76. #76 Orac
    June 12, 2007

    Oh, please, don’t give me that “I won’t hold your hand” BS. That’s a crock. It’s simply common courtesy when citing studies to provide either the PubMed link, a link to the article at the journal’s website, or, at the very least, a complete citation. Failure to do so is, as far as I’m concerned, due to either laziness, carelessness, or intentionally wanting to make it difficult for the reader to find the study.

    The bottom line is that, the better quality the study, in terms of numbers and rigorous experimental design, the less of a purported “effect” from homeopathy above placebo is seen. It’s quite clear that whatever “effect” homeopathy may have is almost certainly due to placebo effect. As for meta-analyses, the old computer term comes into play here: GIGO (or, “garbage in, garbage out”). If the studies used for the meta-analysis are weak and of poor design then the conclusions of the meta-analysis will be dubious. This is particularly true of the 1991 meta-analysis that homeopaths love to cite, as if no further work has been done in the intervening 16 years.

    Oh, by the way, you may be interested in my latest post on the topic.

  77. #77 Dana Ullman, MPH
    June 12, 2007

    “Common courtesy”? That’s a good one from you, especially since your hyper-condescending attitude towards me and anyone who disagrees with you.

    And once again, you show how little homework you do. First, the 1991 meta-analysis showed that the higher quality studies had better results! This is an extremely rare tendency in research, and homeopaths have not been able to sustain these results, due in part to higher quality research done by allopaths who set up experiments so that homeopathy will fail (you can create a seemingly good double-blind trial that doesn’t have honor the homeopathic method even though the design used homeopathic medicines (yeah…the anti-homeopaths are clever in this way).

    Secondly, the Lancet in 1997 published a state-of-the-art meta-analysis that evaluated 89 DBPC trials, with a 2.45 greater chance for homeopathic subjects to experience a therapeutically beneficial result than those given a placebo.

    There has also been good meta-analyses on allergies/asthma and on childhood diarrhea (a leading public health ailment internationally).

    You won’t find research unless you choose to look.

    Join in the discussion the randi list. You might learn something.

  78. #78 Mojo
    June 12, 2007

    “Secondly, the Lancet in 1997 published a state-of-the-art meta-analysis that evaluated 89 DBPC trials, with a 2.45 greater chance for homeopathic subjects to experience a therapeutically beneficial result than those given a placebo.”

    A meta-analysis that concluded (much as the 1991 on did) that further research was warranted provided it was rigorous and systematic, not that homoeopathy worked. The “state of the art” doesn’t seem to have advanced mush in those 6 years. Has it advanced since?

    “There has also been good meta-analyses on allergies/asthma”

    Yes, there has. White et al, Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised placebo controlled trial: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12668794
    “CONCLUSIONS: This study provides no evidence that adjunctive homeopathic remedies, as prescribed by experienced homeopathic practitioners, are superior to placebo in improving the quality of life of children with mild to moderate asthma in addition to conventional treatment in primary care.”

  79. #79 Dana Ullman
    June 13, 2007

    Mojo…you do not seem to know what a meta-analysis is. Whoops. The above study that you cite is a single study, while the below study is a new study…plus a meta-analysis of a total of four DBPC trials.

    Taylor, MA, Reilly, D, Llewellyn-Jones, RH, et al., Randomised Controlled Trial of Homoeopathy versus Placebo in Perennial Allergic Rhinitis with Overview of Four Trial Series, BMJ (August 19, 2000)321:471-476.
    http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10948025&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

    And by the way, if you read the asthma study that you reference above (and not just the abstract), you will see that the homeopathic treated group experienced different patterns of relief than are normally expected from placebo and/or non-treatment groups. Read the study…

  80. #80 Orac
    June 13, 2007

    Join in the discussion the randi list. You might learn something.

    You mean this discussion?

    It is indeed very enlightening, but you do not appear to be acquitting yourself very well at all.

  81. #81 Mojo
    June 13, 2007

    “Mojo…you do not seem to know what a meta-analysis is. Whoops.”

    Yeah, my mistake, I misread your post. I guess that’s what comes of posting after midnight.

    Mind you, if you’d actually said what study you were referring to in the first place, or linked to it, I might have noticed my mistake when I read the abstract. It’s all very well to smugly say “you won’t find research unless you choose to look” but if you don’t have the courtesy to say what you’ve found yourself…

    “The above study that you cite is a single study, while the below study is a new study…plus a meta-analysis of a total of four DBPC trials.”

    A meta-analysis of four trials by the same team.
    Can you cite any meta-analysis that looks a bit more widely at the research?

    I can’t see any recent meta-analysis that is particularly supportive of homoeopathy on Pubmed. Maybe you can find one from the “Cochrane Commission” you referred to here: http://secularstudentslb.wordpress.com/2007/02/

    “…but you probably don’t even know who or what the Cochrane Commission is. Whooops again.”

  82. #82 jeremy
    July 10, 2007

    As a practising Intensive Care physician I thought I might comment on the sepsis paper (Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit, Frass et al, Homeopathy
    Volume 94, Issue 2, April 2005, Pages 75-80).
    Firstly, the numbers are small; 33 patients in the treatment arm, 34 in the placebo. Thats especially a problem in sepsis, as its such a heterogenous disease. For example, sepsis of urinary origin tends to have a better outcome than say abdominal sepsis, although the APACHE scores (measurements of illness severity) may be similar. The authors do not provide enough information in the demographics table to accurately determine the site of sepsis in the patients – 40 of the 70 enrolled patients have their reason for admission as simply “sepsis” (all the patients have sepsis by definition) with the remainder given as either respiratory insufficiency or “other”.
    However having said that the groups do appear reasonabely well matched at baseline. The placebo group does have a higher mean heart rate, but thats probably not a big deal. I think the main issue is in the results themselves. Comments such as

    “ALL patients were given antibiotics, though those given a homeopathic medicine had a mortality rate of 25%, while those patients given a placebo had a 50% mortality. I bet that some of you would prefer to die than simply try homeopathy”

    I think are disingenous. At 30 days mortality in the treated group was 81.8% and in the control group was 67.7%. P value of 0.19, not significant. At 180 days a significant result is demonstrated, 75.8% vs 50.0%, p 0.043. The question is why should there not be an effect at 30 days, but one at 180? In general terms sepsis is an acute disease. Mortality is usually determined within a few weeks and epidemiological studies show that mortality data further out from 28 days do not tend to change (I apologise as I don’t have the references to hand). Most large scale sepsis studies use a 28 day mortality as a cut off, and don’t provide long term outcome data. In the current study, no data is provided on length of stay in ICU (the treatment was discontinued on discharge to the medical ward) or any other secondary outcome measures such as time on ventilation or duration of inotrope therapy. Without this its impossible to really comment on whether that 180 day result is valid – if all the patients had been discharged by that time , for example, its difficult to attribute the effect to the intervention.

    In summary my impression is that is a small scale study, with an equivocal result. The paper does not provide the sort of detail that is required in work of this nature, and on the basis of these results I would not prescribe any intervention, homeopathic or not, to my patients.

    Worth a repeat though,

  83. #83 adjn
    July 20, 2007

    i can’t say that homeopathy has helped with everything and i do use other forms of healing and will use allopathic meds when necessary, but here’s my true life story.

    homeopathy helped to save my dog’s life. for 5 days he vomited and had smelly bms. he was losing weight and went from 9 lbs to about 7 lbs. his ribs were showing and he looked as if were dying. he was just wasting away. after a few tries with different remedies, i finally found that arsenicum worked. from 5 days of vomiting and smelly diarrhea , he started to run a bit within one hour and all vomiting & smelly bms stopped. the next day, he was jumping on my bed again and eating.

    my mother had a stroke and is 1/2 paralyzed. i gave her arnica. after a few weeks, she still couldn’t talk. i gave her more arnica and she started to talk and can now eat smooth foods and drink thickened fluids. she’s still paralyzed and is still dying slowly, but it’s been the closest i’ve ever been to her and i owe it to arnica and her near death experience for prolonging her life and improving it just a bit so that we could talk. it healed her large bed sores too.

    my daughter always caught the flu from school and kept getting 5-6 days of fever. tylenol did nothing to stop the fever. on two occassions (not all times did it work) by the 4th day I finally gave her eupertorium perf. The fever broke. On one of those days, within 20 seconds of receiving just one dose, she started to sneeze repetitively, then asked to eat! After 4 days of not eating, this was the best words I heard from her.

    i used to have severe, breaking back pains. a few doses of phosphorus cured it permanently. I also had convulsive limbs b4 going to bed and a few doses of ignatia cured that too. i do have other medical issues and don’t know if i’ll get cured of it homeopathically, but i could tell you that my doctors did absolutely nothing and found nothing wrong with me when i got checked in their office or in the hospital. i guess i’ll leave the hospital for emergencies only and will go to the doctor for antibiotics, or in the future, insulin and blood pressure meds.

    mock my testimony all you want, but i’m glad i had time w/ my mom, my dog is alive, my daughter is feeling better and my convulsive limbs and severe back pain is gone. like i said, it doesn’t always work, but when it does, it’s wonderful.

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