A real death by homeopathy

For those who argue that homeopathy is harmless, here's a story that shows what can happen when faith in quackery results in parents eschewing effective evdience-based medicine:

NINE-MONTH-OLD Gloria Thomas was in such distress that her crying alarmed some passengers on a plane trip from India to Sydney.

She had been overseas for two months receiving medical treatment, and homeopathic medication from an uncle for severe eczema.

But in that time she missed two appointments which separate doctors had made for her at specialist dermatologists.

In May 2002, less than 10 days after her return, she was admitted to the Children's Hospital at Randwick severely malnourished and with infections to the skin and eyes.

She had died within three days of sepsis (bacterial infections) which had caused bleeding in her lungs and airways.

The reason for the baby's death:

Her father, Thomas Sam, who practised and taught homeopathy, had applied homeopathic remedies to try to cure Gloria's eczema since she was diagnosed with it when aged about four months, he said.

The inquest, which will examine the role of nutrition in her death, will also examine the actions of her father and mother, Manju Samuel, and advice they received from doctors and homeopaths. Mr Hoy said the inquest would reveal if homeopathy should be better regulated or scrutinised.

A forensic pathologist, Ella Sugo, told the court a micro-organism which was commonly found in broken skin, was isolated in Gloria's blood, urine, skin and eyes. She had abnormally pale skin and hair. Dr Sugo found her immune system was weakened. Her thymus gland, a part of the immune system, had shrunk after originally being in good condition.

So much for homeopathy "strengthening the immune system."

Although it's possible that modern medicine might have been able to prevent this death, one thing's for sure: Treating the baby with water, which is all that homeopathic remedies really are, rather than effective medicine certainly didn't make it more likely that this baby would survive. Worse, the baby almost certainly suffered far more than she should have.

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Sad Story. When the child's father develops some serious illness, I want to be there to feed him tiny little bottles of water and sugar pills.
Homeopathy belongs in the rubbish bin of wrong ideas, along with the four humors, phrenology and other such complete utter nonsense.

First, it's the first time I comment here so please forgive me if everything is not done in the rule. (also english is not my mothertongue :-))

So to the point, I just want to share something that may become as tragic in my family, my sister-in-law has just been diagnosed with Crohn's disease after finally have gone to a real doctor instead of her usual homeopath.

After the diagnosis, the doctor prescribed her some medication to "control" the disease and then she gets back to her homeopath who told her to throw it away as "it is bad".

The only positive point about this story, is that my wife who were trying for a long time to use homeopathy for our children (because everybody tell her it "works" and because it's not "harmful") as finally understood one of the reason I'm against it ...

What a sad story! I'm sure many homeopaths are cynical exploiters of their victims but I have to assume that this one was genuinely deluded into believing he was doing the right thing. He deserves some pity, but the law should have the power to prevent him killing anybody else.

many woo-meisters believe their own woo...but that doesn't relieve society of the responsibility to regulate/hobble them.

Orac, I have to say I'm a little disappointed. Your post title suggested that you'd found a case where the homeopathic "treatment" itself was the cause of death, something like what chelation "therapy" can do. But this appears to be no more than a run-of-the-mill case wherein the victim actually died of something else, and the only role that homeopathy played was in the way that the parents used it instead of real medical treatment.

It's certainly one more piece of evidence that homeopathic remedies are worthless and should be avoided. But it's no more than that. Is it?

By wolfwalker (not verified) on 06 Nov 2007 #permalink

This is a straw man argument against homeopathy because the same argument can be made against placebo treatment, or the option called "no treatment" when the patient actually has a treatable life threatening disease.

In the above case it was probably strep cellulitis rather than eczema. Acute cellulitis can be life threatening if the infection goes to hematogenous spread. While confined to the skin in its early stages, the infection is exquisitely sensitive to penicillin, one of the great triumphs of modern medicine.

Homeopathic remedies are not antibiotics and are not recommended for acute life threatening infections such as pneumococcal pneumonia, strep cellulitis or pulmonary TB, or an acute STD for example. However, homeopathy can safely be tried on the common scenario of cases of chronic infection on and off multiple antibiotics that aren't working, as well as other similar chronic medical problems. In this setting, hemeopathic remedies do no harm and can actually be associated with improved outcome.

By ductofsantorini (not verified) on 06 Nov 2007 #permalink

Your post title suggested that you'd found a case where the homeopathic "treatment" itself was the cause of death, something like what chelation "therapy" can do.

Given that homeopathy is notable for having no actual effect whatsoever, that would be a fairly stupid reading on your part.

This is a straw man argument against homeopathy because the same argument can be made against placebo treatment, or the option called "no treatment" when the patient actually has a treatable life threatening disease.

The difference being that no one ever claimed that placebo works better than placebo.

In this setting, hemeopathic remedies...can actually be associated with improved outcome.

And yet, unsurprisingly, you cite no evidence whatsoever to support this.

On a positive note. There are too many people in the world right now, to eliminate the child of a stupid man is, perhaps, desirable

By Eric Bloodaxe (not verified) on 06 Nov 2007 #permalink

"The difference being that no one ever claimed that placebo works better than placebo." That beautiful, one of the most quotable things I have seen.

In homeopathy what does the use of a number followed by an X mean. I have a buddy recommending this homeopathic cream for pain. The knee pain is less but as you can guess no clinical trials are available and it is probably placebo. They list the homeopathic ingredients with a number followed by an X (6X, 8X etc.) but not the carrier agent.

There are too many people in the world right now, to eliminate the child of a stupid man is, perhaps, desirable

I'll take the child of a stupid man over someone who thinks the death of a child desirable any day.

In homeopathy what does the use of a number followed by an X mean.

That tells you how much the original solution has been diluted. 'X' means it's been diluted by a factor of ten each time, and the number tells you how many times - so 6X means diluted by a factor of ten, six times. 'C' means diluted by a factor of 100 each time.

The thing is, the dad will probably swear up and down that his child didn't die because of his having used homeopathy instead of real medical treatment - it'll be because he didn't dilute it enough, or used eye of newt instead of frankincense, or whatever - anything to avoid admitting to himself that he is to blame for his own child's death.

And yet, unsurprisingly, you cite no evidence whatsoever to support this.

Güthlin C, Lange O and Walach H. Measuring the effects of acupuncture and homoeopathy in general practice: An uncontrolled prospective documentation approach. BMC Public Health 2004, 4:6.

By squeakywheel (not verified) on 06 Nov 2007 #permalink

Ok I'm no medic so I may be missing something, but does the paper cited by Squeakywheel really pass as a good study? I don't see any control group who received no treatment, so it doesn't show any improvement over doing nothing. Additionally there's no placebo group in the trial. Also wouldn't another group, people receiving orthodox treatments, be another suitable comparison?

For all I know that paper could just be showing that homeopathy can clear up a cold in seven days, while without treatment it'll hang around for week.

the only role that homeopathy played was in the way that the parents used it instead of real medical treatment.

Homeopathy is not just a pseudo-medical practice: it is an ideology which rejects the use of real medical treatment and has to be seen as at the root of the neglect and abuse which resulted in death.

If homeopathy was presented as supplemental it might be relatively harmless. Might.

Homeopathic remedies are not antibiotics and are not recommended for acute life threatening infections such as:

pneumococcal pneumonia

http://www.hpathy.com/diseases/pneumonia1-symptoms-treatment-cure.asp

strep cellulitis

http://www.hpathy.com/diseases/erysipelas-symptoms-treatment-cure.asp

pulmonary TB, or an

http://www.specialityhomeopathy.com/treatment/MDR_Tuberculosis.htm

acute STD for example.

http://www.hpathy.com/diseases/genital-herpes-symptoms-treatment-cure.a…

(Sorry, had to guess what you meant by 'acute' here)

Obviously people recommend Homeopathy for exactly what you list.

By Brendan S (not verified) on 06 Nov 2007 #permalink

duct:

My original comment with direct links is held for moderation, but:

http://www.hpathy.com/

Lists EVERY disease you mention.

Please don't pretend like Homeopathy isn't recommended for every ailment under the sun by people wanting to sell other people fancy water.

By Brendan S (not verified) on 06 Nov 2007 #permalink

Squeakywheel and ductofsantorini:
Here, try this.
Properly administered, it will help your condition.
If it doesn't work the first time, read it again.

Vlad:

In homeopathy what does the use of a number followed by an X mean. I have a buddy recommending this homeopathic cream for pain. The knee pain is less but as you can guess no clinical trials are available and it is probably placebo.
I seem to remember a paper recently that showed that simply the action of rubbing can help reduce pain, which may mean that applying a homeopathic cream could genuinely reduce pain above placebo (even though the cream itself is only a placebo).

I'm afraid I don't have the reference, but maybe someone else will remember it.

The difference being that no one ever claimed that placebo works better than placebo.

That's because they haven't tried my new water-energized placebo! It's based on magnetic water energetic technology derived from faeces equinum extract!!

Roflmao ... "Properly administered, it will help your condition. If it doesn't work the first time, read it again."

Here is the blame the patient for not doing it right excuse.

And by the way, "reading" it a second time won't help anything.

Her thymus gland, a part of the immune system, had shrunk after originally being in good condition.

Two questions: When and why was her thymus checked and found to be in good condition, and what sort of common microrganism causes the thymus to shrink like this?

Is there more to the story or have I missed something?

By notmercury (not verified) on 06 Nov 2007 #permalink

That poor baby.

I watch friends do homeopathy, and swear by it, and yet...they don't get better. In fact, they get worse.

One friend tried to control her diabetes by diet, and while it helped, it wasn't enough, and her GP told her it was time to consider insulin.

Instead, she started a whole food diet, which isn't bad at all actually, except she isn't getting enough protein. She can't stand dried beans, and tofu is upsetting her GI.system. She's upset she isn't getting better, and is blaming herself. She started taking more homeopathy "things," and it's not working either. She has been playing this game for years, and all to avoid the side effects of DRUGS.

But why subject a baby to such an awful death when there was something that would work, and work fairly quickly? Why, why, why? And for the baby to have low levels of protein? Was she not being fed properly as well? There's more to this tale than has been revealed, and it will be interesting to see how this tale unfolds.

The x is a dilution factor. The idea is that you take a tincture of the medicine prepared according to the founding texts on homeopathy.

You put one drop of that in a quantity of either water or alcohol depending on solubility. As it was explained to me by a manufacturer of homeopathic remedies several years ago, I think the ratio is 1000 to 1.

That's 1X. Then you take one drop of that and put it in a similar quantity of the water or alcohol at 1000 to 1 again.
That's 2X

Do that again - that's 3X. . . etc.

And here's the kicker. 8X is marketed as a way more effective medicine than say 3X or 4X and at a higher price. It's basically a way to sell water or alcohol at many times their cost to the manufacturer.

But, you get plug into some serious woo - and I guess that's worth something.

By Pelican's Point (not verified) on 06 Nov 2007 #permalink

For years acupuncture was considered quackery and now its in every GP's office.

Homeopathy will probably go the same route.

It is econoimically viable and when used with in proper medical settings causes no harm and may actually benefit the patient. Whether the benefit is from placebo effect or not doesnt matter. The drug industry has been selling the placebo effect for years.

Sure you can call Homeopathy deadly if it is used in the wrong setting. Any modality including most drugs are also deadly when used in the wrong setting, medical condition or wrong dosage. Actually a case can be made that most drugs are more dangerous than homeopathic liquids which are so benign, they can be swallowed with no adverse side effects.

This brings us to the real reason why homepathy MUST BE STAMPED OUT. It will cut into drug company sales and profits.

By squeakywheel (not verified) on 06 Nov 2007 #permalink

I'm happy to stand corrected, Squeakywheel, but I thought one of the reasons Homeopaths argued that testing was too expensive for them was that Drug companies could afford to test their products against a placebo, a placebo being a treatment with no biological effect. If this isn't the case and orthodox drugs are largely placeboes, then why are their results much stronger than those for homeopathy?

Also wouldn't the fact that drugs have side effects suggest that they are biologically active and there's a lot more going on than a placebo effect?

I can see how you might want to argue that orthodox drugs are placeboes, or how orthodox drugs have dangerous side effects. I can't logically see how you can argue for both. Could you explain how this works?

I think you might also want to ponder the meaning of the term economically viable. I'm sure it's economically viable to leave a road accident victim to die, but I don't think that anyone would argue that's a Good Thing to do.

Finally, when you talk about sales and profits is the motivation to profit only on the side of Big Pharma? Are professional homeopaths and the companies which sell homeopathic products non-profit making?

This brings us to the real reason why homepathy MUST BE STAMPED OUT. It will cut into drug company sales and profits.

When I hear someone say something like that about their favored woo, I know that they're such deluded True Believers that there's little point in dealing with them further.

I note that "squeaky wheel" still hasn't produced any positive evidence that homeopathy is anything other than a fancy placebo. No doubt his/her/its response now will either be to bloviate and dodge or to post some of the usual poor quality studies that homeopaths like to cite.

For years acupuncture was considered quackery and now its in every GP's office.

Well, no. Acupuncture is claimed to be effective for a vast range of conditions; for almost all of these, it's still considered quackery, on the rather simple basis that there's no evidence whatsoever of any benefit. The claimed underlying mechanism of acupuncture is still considered quackery, on the rather simple basis that there's no evidence whatsoever to support it.

Homeopathy will probably go the same route.

And your evidence for this is...?

Actually a case can be made that most drugs are more dangerous than homeopathic liquids which are so benign, they can be swallowed with no adverse side effects.

Well, yes. It's one of the common characteristics of liquids containing no active ingredients that they tend not to have any effects, 'side' or otherwise.

This brings us to the real reason why homepathy MUST BE STAMPED OUT. It will cut into drug company sales and profits.

Idiot! Do you have any idea how many medical researchers there are in the US alone? How many you need to dismiss as dishonest, ignorant or incompetent to explain the dearth of support for your quackery of choice? If the only way you can defend your position is by slandering people who, by and large, are doing their bit to improve humanity's lot, then it would behoove you to consider the possibility that your position is utterly bereft of merit.

Idiot! Do you have any idea how many medical researchers there are in the US alone? How many you need to dismiss as dishonest, ignorant or incompetent to explain the dearth of support for your quackery of choice? If the only way you can defend your position is by slandering people who, by and large, are doing their bit to improve humanity's lot, then it would behoove you to consider the possibility that your position is utterly bereft of merit.

Hey, no slander there, just economic reality. Medical practice is dominated by the drug industry, this is just a fact of life. Anything that is bad for drug sales is shall we say, "discouraged".

When drug companies do a study showing that placebo beats their drug, they just hide the study in the file cabinet, do more studies until they get the "right" results, then ghost write it into a major journal, get FDA approval, and PRESTO, all the GP's are pushing placebos on the population.

Works for the drug companies, and it works for homeopathy only cheaper.

By squeakywheel (not verified) on 07 Nov 2007 #permalink

Hey, no slander there, just economic reality. Medical practice is dominated by the drug industry, this is just a fact of life. Anything that is bad for drug sales is shall we say, "discouraged".

HOW? Do they bribe or threaten every medical student in universities, all the doctors who just want to help people, yadda yadda yadda? That's a LOT of people all over the world. It'd be almost utterly impossible to prevent a leak.

When drug companies do a study showing that placebo beats their drug, they just hide the study in the file cabinet, do more studies until they get the "right" results, then ghost write it into a major journal, get FDA approval, and PRESTO, all the GP's are pushing placebos on the population.

Seems quacks of all stripes try to do that. It'd also require silencing all the people involved in the negative studies. Again, that's a lot of people, all over the world.

Works for the drug companies, and it works for homeopathy only cheaper.

That's the problem: It doesn't work. Homeopaths can't get away with their consistent failure. They can't even get the balls to take on James Randi for a million dollars to do something even less of what we demand of drug companies.

HOW? Do they bribe or threaten every medical student in universities, all the doctors who just want to help people, yadda yadda yadda? That's a LOT of people all over the world. It'd be almost utterly impossible to prevent a leak.

take a look at the leaked Zyprexa documents for an inside look at the "HOW"

And you've just proven my point: If the drug companies do something dishonest, there will be a leak. You're asking me to believe that they can operate routinely without any leaks.

A single drug company wouldn't be able to 'stamp out' homeopathy on its own. Even if there were a conspiracy between all drug companies, and even if every single person involved was corrupt, dishonest, or for some other reason unwilling to leak, that would still leave academia. After all, it's not like it's the drug companies which are saying that homeopathy doesn't work. It's the general consensus of the medical community as a whole. That's a lot of people who have to be dishonest, corrupt, ignorant, blackmailed, or whatever.

So yes, the idea that the medical community rejects homeopathy not on its merits but for economic reasons is indeed slander on a grand scale.

Pelican's Point said "The x is a dilution factor. The idea is that you take a tincture of the medicine prepared according to the founding texts on homeopathy.

You put one drop of that in a quantity of either water or alcohol depending on solubility. As it was explained to me by a manufacturer of homeopathic remedies several years ago, I think the ratio is 1000 to 1. "

Close, but not quite. The "X" is a 1 in 10 dilution (X = 10), so any dilution between 1X to about 23X would actually have molucules of the particular remedy in the solution.

The 1 in 100 dilution factor is "C", so any dilution between 1C and 12C would have a molecule of the remedy in the solution. A very common homeopathic dilution is "30C", which is a solution that would require the oceans of several Earth-like planets to prepare in order to have one molecule of the remedy. On Usenet there is a "recipe" for 30C Nat Mur (salt diluted to 1/1000000000000000000000000000000000000000000000000000000000000 ratio):
http://groups.google.com/group/misc.health.alternative/msg/8e13fd1b374c…

The 1 in 1000 dilution factor is noted with "M". That is not seen often.

Hey, Squeakywheel... I have a kid with hypertrophic cardiomyopathy who takes generic Atenolol every day (about $4/month) to reduce the pressure across his already damaged mitral valve. What homeopathic preparation would be just as effective and cheaper to deal with that genetic heart anomaly (which is one of the more common of about a half dozen reasons that adolescents sometimes suffer from "sudden cardiac death")?

Many years ago I used to think there was something to homeopathy; I thought it was traditional herbal remedies.

When I read what it actually was (water memory!?) I realized I could reasonably dismiss it all as pure crap.

BTW how do you get water to only remember one of all the substances it has been exposed to?

Squeakywheel, if proving that a medicine works is simply a matter of cycling the tests until a result beats the placebo then are you saying this is how homeopaths get their positive results too? Is it possible you may have misunderstood what a placebo is?

I ask as the documents you link to would suggest that Zyprexa has a biological effect, which would also indicate it's not a placebo. I'm still confused as to how a placebo could be biologically active. If the drugs were as ineffectual as you claim surely there wouldn't be side-effects?

Her thymus gland, a part of the immune system, had shrunk after originally being in good condition.
Two questions: When and why was her thymus checked and found to be in good condition, and what sort of common microrganism causes the thymus to shrink like this?
Is there more to the story or have I missed something?

Notmercury--the pathologist looked at the thymus gland and saw stress involution. A response of a functioning gland that was presented with a severe stressor (such as sepsis) and was unable to cope. It's "burned out" in the lingo, trying to keep up with the overwhelming infection.

Any bacterial sepsis can have this effect. H. flu, Staph. aureus, P. pneumioniae, Streptococci, you name it. You can tell in the post-mortem examination. BTW, I've done around 1,300 pms, and approximately 10% were infants.

Thank you William the Coroner.

By notmercury (not verified) on 07 Nov 2007 #permalink

[irony]I highly recommend this video of James Randi explaining the magic of homeopathy.[/irony]

By Robster, FCD (not verified) on 07 Nov 2007 #permalink

SqueekyWheel,

The problem with the medical field in this country is not the drug companies...

It's the insurance companies. Have you seen the returns for those investments?

Metta.

Sure homepathy is the wrong treatment for this unfortunate kid who died of septicemia. Digitalis for pulmonary edema when its not pulmonary edema (actually pneumonia) on the chest film is also the wrong treatment which can kill from dig toxicity and untreated rampaging pneumonia. So, does that mean allopathic medicine should be banned and "laws passed " to protect the public from docs who mistake pulmonary edema for pneumonia? No, of course not. We have other ways of dealing with it.

By Limpi-Tor (not verified) on 07 Nov 2007 #permalink

Here is the blame the patient for not doing it right excuse.

And by the way, "reading" it a second time won't help anything.

Hee, hee! Actually, Patrick, I agree. My comment was intended only to provide a useful link to the Lancet survey of homeopathy studies. The accompanying remark was intended only in jest. Belief in homeopathy is a condition for which there is no known cure.

Limpi-Tor, can you explain what homeopathy is the RIGHT treatment for anything that is not self-limiting?

Really, check out the video posted by Robster just a couple posts above yours.

The classic homeopathic tale:

"Homeopathy can treat serious conditions like diseasonitis!"

Kid treated for diseasonitis with homeopathy dies horribly.

"No one anywhere ever said that homeopathy was of any use for diseasonitis! It's only good for small stuff that goes away on it's own! Homeopathy can't treat anything life-threatening!"

Next week: "Homeopathy can treat serious conditions like diseasonitis!"

Possible side events: Skeptical blogger gets censored by a bunch of Society of Homeopath thugs for suggesting that homeopaths enforce codes of conduct against claiming cures when one of their own violates the code of conduct.

Meanwhile, homeopaths have yet to prove they can tell the difference between a homeopathically treated pill and one sham-treated with normal water/alcohol/whatever. Still other homeopaths talk about the dangers of overdosing on their sleep remedies while skeptics can publicly guzzle them down in large quantities without fear.

Oh Squeakywheel, why won't you answer my question?

What magical power does homeopathy have for hypertrophic cardiomyopathy?

This also goes for Mr/Ms Limpi-Tor. Where was pulmonary edema or pnuemonia ever mentioned in this case?

Where is homeopathy ever the preferred treatment for a NON-self-limiting condition ever preferred?

I mean what homeopathic treatment is better for hypertrophic cardiomyopathy? Or for strep throat? Or for bacterial pneumonia? Or for tuberculosis? Or for Haemophilus influenzae type b bacteria? Or for Bordetella pertussis? Or for cholera? (wait, unfair... cholera can actually be treated with plenty of fluids, something homeopathy does not lack!) Or for syphilis? Or for Pasteurella pestis (bubonic plague)? Or for hypertension? Or for lymphoma?

Come on! Give us the answers!

Alun asked:

Ok I'm no medic so I may be missing something, but does the paper cited by Squeakywheel really pass as a good study?

No. Not even close.

squeakywheel wrote:

When drug companies do a study showing that placebo beats their drug, they just hide the study in the file cabinet, do more studies until they get the "right" results, then ghost write it into a major journal, get FDA approval, and PRESTO, all the GP's are pushing placebos on the population.

How much do you know about the IND process? Are you aware that you are required by law to submit an Investigational New Drug (IND) application to the FDA before you begin testing a new drug in people in the US? Are you also aware that you are required to inform the FDA of every clinical study you do on that drug? Every single one?

In fact, you have to submit a detailed written protocol for every clinical study, covering pretty much everything you plan to do in that study. And if you change the protocol, you have to submit the changes to FDA. And you have to send them annual reports, telling them how many people you've treated in every single study that year, and summarizing what you found. And then later, when you ask them to approve your new drug, they expect you to provide a very detailed report of all the results of every one of those clinical studies (not to mention all the animal studies, etc.).

So, do you think the drug companies are hiding these studies from FDA as well? How do they do that? Do they do all the studies first, decide which ones are good, and then pretend to do them all over again? Because FDA really doesn't like it if you tell them "Hey, here are the results of a bunch of clinical studies we did over the past 3-5 years. We neglected to mention any of them before, but the results are really good, so can you please approve our drug now?" Remember, FDA wants you to tell them about each study before you start it. But you can't do that if you don't know in advance which ones you need to hide from them.

Unless, of course, FDA is in on this vast conspiracy. But if that's the case, why would Pharma do all these studies at all? They could just fabricate some imaginary clinical data, tuck a nice fat envelope of cash between pages 200-201, submit the 'data' to FDA with a wink, get a guaranteed approval, and start raking in profits.

take a look at the leaked Zyprexa documents for an inside look at the "HOW"

There must be 300 document links on that site. Any chance you could narrow it down a bit? Tell me which one or two or even ten are the most incriminating. Otherwise, it's a bit like me telling you to read the US Code of Federal Regulations if you don't believe my statements about INDs and FDA. (Except that, unlike your site, the CFR has nice descriptive titles and is searchable.)

If the FDA was in on it, there'd be no need for the song and dance except to type up fake studies: They could operate just like any profitable altie company. They'd just have government approval, and the savings from not having to do tests would be a nice bonus.

Alun, about your question: "Are the companies which sell homeopathic products non-profit making?" Here in Europe some are listed, see for instance Laboratoires Boiron
http://fr.wikipedia.org/wiki/Boiron
Sales keep growing, net results went down in recent years during a buying spree and new ventures abroad. Debt fully repaid in 2006, record profit expected for 2007.
Not in the Big Pharma league, but a "multinationale" all the same and doing quite nicely
sylvie c.

789,936 real deaths per year by medicine:

http://www.lef.org/magazine/mag2004/mar2004_awsi_death_01.htm

Not familiar with the magazine (I just googled leading causes of death) but the references at the end are from well respected, peer reviewed medical journals.

Poor judgement and mistakes are part of life does this make medicine quackery?

I referred to the references and not the article itself.
Here are some original articles published in well respected, peer reviewed medical journals:

1. Barbara Starfield. Is US Health Really the Best in the World? JAMA. 2000;284:483-485.

2. Phillips D, Christenfeld N, Glynn L. Increase in US medication-error deaths between 1983 and 1993. Lancet. 1998;351:643-644.

3. Lazarou J, Pomeranz B, Corey P. Incidence of adverse drug reactions in hospitalized patients. JAMA. 1998;279:1200-1205.

[2] and [3] are available free on-line, I believe. I quote from [1]:

>>
12,000 deaths/year from unnecessary surgery
7,000 deaths/year from medication errors in hospitals
20,000 deaths/year from other errors in hospitals
80,000 deaths/year from nosocomical infections in hospitals
106,000 deaths/year from non-error, adverse effects of medications
<<

The numbers, esp. the last one, are still pretty mind-numbing.

Hope this clarifies my earlier posting.

Those mostly have to do with Adverse Drug Reactions, which means that people do have problems with real drugs that have real biological effects on people.

What does that have to do with homeopathy?

Are you saying that homeopathy is safer because it is impossible for homeopathic remedies to have any kind of biological effect? Is homeopathy safer because it does nothing?

I can get some of the studies of Adverse Drug Effects may be problems with antibiotics because of allergies, stomach problems, yeast growth and other things (the IV giving my newborn antibiotics had to be moved every day because it irritated the area it was in, fortunately after being put in both legs and arms, he was removed from IV antibiotics before they had to put on the top of his head). Would a person infected with a bacterial infection be better off with homeopathy than antibiotics?

Can you give us the studies that show specifically how much better homeopathy is for strep, staph, or other bacterial infections like syphilis (which is something Hahnemann claimed to be able to cure)?

As noted by William the Coroner's message, http://scienceblogs.com/insolence/2007/11/a_real_death_by_homeopathy.ph… , there is a high probability the child had sepsis. So your answer on how homeopathy is a better treatment for bacterial infections is very pertinent to this discussion.

Vanodorf:

Is your point simply that conventional drugs and medical practices have risks? Granted.

Or is your point that conventional drugs and medical practices have risks, therefore homeopathy has merit? In that case, please brush up on your logic.

Surprise surprise, the studies that find positive outcomes for homeopathic remedies are commonly done by committed homeopaths, and funded by homeopathy companies.

But... isn't this exactly the same "funder bias" they routinely flay mainstream medicine and science for? It is? Fascinating... But... don't the homeopathy companies have to submit their trial data to an independent regulator to get approval for the drug before selling it? They don't? Not at all? Seriously? No oversight? You mean... they can just publish in a dyed-on-the-wool journal of alternative medicine, where the data is "peer reviewed" by other people who explicitly believe homeopathy works? Doesn't that mean the homeopaths don't have to do any of the controls sceptical mainstream scientist reviewers would ask for? It does mean that? Right.

Yep. Sounds like a nice racket.

Or Alternative-Illuminati Conspiracy. Take your pick.

By the way, following on from Sylvie Coyaud's link to the French "Homeopathic Pharmaceutical" company Boiron, it is worth mentioning that Boiron has had a hand in several of the most high profile "proof that homeopathy works" stories. Phillipe Belon, who was one of the co-authors on the original (infamous?) Jacques Benveniste 1988 homeopathy paper in Nature, later became research director of Boiron. Belon is also an author on the work of Madeleine Ennis and co-authors that is regularly cited by homeopaths as "proof that ultra-high dilutions have biological effects".

Incidentally, one of the things that doomed Benveniste (in addition to the shoddy procedures in his lab, debunked by Nature editor John Maddox, Walter Stewart of the NIH and James Randi) was the discovery that two of the key members of his group were enthusiastic believers in homeopathy whose salaries were funded (unacknowledged in the original paper) by..... Boiron.

Errm... you mean there was hidden conflict of interest? But ... isn't that just what the Alties always accuse mainstream medicine of...? (etc etc)

Boiron makes the laughable (though highly profitable) "20 million dollar duck" homeopathic cold remedy Oscillococcinum. Oscillococcinum is made from extract of the liver of one unlucky duck, diluted 100 to the power of thirty times (sic). Thats diluted by a factor of one in 10^60. Count the molecules of solvent... but you may run out of universe first.

I guess it's a smart way to keep the cost of raw materials and R&D down. Boiron may only have 2% of the global sales of a big pharma like AstraZeneca, but that still means they sell 600 million ish dollars worth of product a year. Ker-chingg.

There are well-recognised issues of over-prescribing certain drugs for certain things for certain patient groups - e.g. it can be argued that elderly people get a lot of GI bleeding problems from non-steroidal anti-inflammatories that they might not have needed to take - but antibiotics for a serious systemic infection is surely one of medicine's most complete no-brainers.

Should say that I am a bioscience PhD, not an MD (that's my wife's paying gig) but it seems pretty likely that the kid in the story had nasty eczema that got infected, which then proceeded to systemic infection and then to sepsis and organ failure that killed her. A very avoidable tragedy if they had gone to a conventional doctor, or certainly to a dermatologist who would likely have recognised the problem easily and treated the infected eczema with antibiotics.

BTW, I know a young adult who got hospitalised aged 20ish by systemic consequences of untreated infected eczema. Luckily she got appropriate treatment (prompt antibiotics and inpatient care), and following her recovery a referral to a dermatologist specialising in eczema who taught her how to manage her eczema properly.

In addition to the inherent risks in doing anything medical that have been pointed out, it should be noted that absolute numbers are large because lots of people use real medicine.

But real medicine at least has a favorable risk/benefit ratio. Homeopathy has no detectable benefit, and it comes with the various risks of inaction. Homeopathy is doing nothing. That's what they want us to do: Nothing.

Real medicine risks lives, but it saves so many more who could not survive on their own. We're doing everything we can to cut down on the risks, but homeopaths would rather we just give up and go to 3rd world status, rather than engage in a risk.

So, do you think the drug companies are hiding these studies from FDA as well?

No, they just hide them from the American public, until forced out in the open by litigation.

What magical power does homeopathy have for hypertrophic cardiomyopathy?

None that I know of, on the other hand beta blockers don't have any magical powers to change the underlying defect which is a mutation in one of four genes that encode proteins of the cardiac sarcomere: the β-myosin heavy-chain, cardiac troponin T, α-tropomyosin, and myosin-binding protein C genes.

Since there are 50 different genetic variations, drug treatment is empiric. Some drugs help, some don't. Only way to find out is to try them. This is also true for homeopathy.

There is no evidence that either beta-blockers or verapamil protects patients with hypertrophic cardiomyopathy from sudden death. This is the same for homeopathy, no evidence homeopathy pretects from sudden death, either.

By squeakywheel (not verified) on 08 Nov 2007 #permalink

Squeakywheel said "There is no evidence that either beta-blockers or verapamil protects patients with hypertrophic cardiomyopathy from sudden death."

It reduces the pressure across the mitral valve, this is evidenced by the the every 6 month appointment for monitoring by the cardiologist. There is an avoidence of high heart rates in exercising because that could cause obstruction of the mitral valve.

Do you have any evidence to back up your assertion? It looks that you actually looked at the data (but fluxed up the conclusions).

Something like:
http://circ.ahajournals.org/cgi/content/full/92/7/1680? which says "In obstructive HCM, negative inotropic agents (Ã-blockers,154 155 156 157 158 159 160 161 162 calcium antagonists,49 50 163 164 165 166 167 168 and disopyramide8 169 170 171 172 ) have been used to decrease the degree of outflow obstruction. In our experience, Ã-blockers are especially effective in latent obstruction and to some extent in mild resting obstruction but tend to be less effective in the more severe degrees of obstruction,8 159 although others have reported more favorable results.154 155 156 158 160"

and http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_ui…
(there are more recent papers that seem to show other medications, and that there is still sudden death, but not as much as before)

And the question was how is homeopathy BETTER than atenolol. You seem to have conceded that homeopathy would not be at all effective. But you decided to try to poison the well by claiming conventional medicine is also not effective. Which was just silly.

I was just trying to place "a" death from homeopathy in the context of 106,000 deaths from adverse drug reactions.

Now that I have been "outed" as a homeopathic sympathizer here are the facts as I know them:

1.Nobody knows how homeopathy works. Worse, it goes against current understandings of physics and biology. This is, unquestionably, the biggest obstacle in gaining wider acceptance. It won't be the first time something works before the underlying principle is discovered though. The Wright brothers managed to fly their airplanes with no knowledge of the Bernoulli principle, the connection was not made until 30 years later.
2.Like everything else, there is good homeopathy and bad homeopathy (and many bad homeopaths). Still in the fringes, it tends to attract a good following of quacks and "homeopathic fundamentalists"
3.A good homeopathic prescription is individualized to the patient (not the diagnosis) so it works quite different from traditional medicine. Medical studies, structured around the diagnosis and broad action of traditional medicines, have for that reason difficulty capturing its curative effects. I believe, however, that it's matter of time before a properly structured, rigorous study will be able to demonstrate its effectiveness.
4.Good homeopathy is very difficult to practice and the truly good homeopaths are few. There are over 1500 homeopathic medicines available and often a successful prescription can take several attempts at finding the right one.

I have personally experienced the success of homeopathy in our family, horse farm and small pets for over twenty years. In the case of one of the children, the success came after a week of hospitalization and batteries of tests. With no diagnosis and a rapidly advancing paralysis of the lower limbs we resorted to a (good) homeopath. The improvement started almost immediately and within a week the cure was complete. Placebo? We routinely treat colic, a rapidly advancing and life threatening condition, in our horses. Sometimes it takes a few attempts to refine the prescription and bring about relief. And we always keep the local vet's number handy. Coincidence? Spontaneous remission? After personally witnessing the cause-and-effect too many times to make it statistically plausible one has to look beyond.

Not a scientific proof but a personal experience that as an honest observer I cannot deny even as I cannot explain ...

I feel that because Vanodorf and squeakywheel find that real medicine has risks, and sometimes does not work and is in general not perfect that they would be perfectly happy to have us forego anything but homeopathy.

Basically getting us back to the "good ol' days" of 1830 in terms of medical care. Just treat the symptoms with magic water, and ignore finding out what is actually wrong.

This is how Baby Gloria was treated, and we all know how well that worked.

Oh, must point out this bit of Vanadorf sillyness "The Wright brothers managed to fly their airplanes with no knowledge of the Bernoulli principle, the connection was not made until 30 years later."

That is a bunch of bullocks. The Bernoulli book "Hydrodynamica" was published in the mid 1700s (predating even Hahnemann's magic water). The Wright brothers built and used a wind tunnel to test their wing sections. They conducted experiments, read aeronautical papers and even wrote several. Here is one of those papers that they presented: http://www.wright-house.com/wright-brothers/Aeronautical.html

1. Nobody knows how homeopathy works. Worse, it goes against current understandings of physics and biology. This is, unquestionably, the biggest obstacle in gaining wider acceptance.

WRONG! The biggest obstacle to acceptability is that you haven't been able to prove that it works under unbiased, controlled conditions. That's why we push for double-blind clinical studies. They're designed to remove biases and other distorting factors.

Note on personal experience: How the hell do you eliminate bias in such uncontrolled conditions? All sorts of alternate explanations can creep in under sloppy conditions. Placebo effect, self-limiting nature of disease, regressive fallacy, confirmation bias, cherrypicking, subjective validation, and so on and so forth. Living creatures don't just sit idle when they're faced with problems so that you can conveniently nail it down to your pet hypothesis. Life is a noisy procedure, and we have to limit that noise.

The easiest person to fool is yourself. That's why you have to undergo heavy bias-removal in the form of clinical trials. With personal experience, you have a habit to assume you're typical when you could be lucky.

You're thinking like the centuries-old allopaths, Vanodorf. Mankind largely abandoned allopathy for many of the same reasons we currently reject homeopathy. Bleeding, leeching, etcetera persisted because some lucky individuals survived to give good testimonials, and they had some simple, elegant (and, of course, wrong) principles that sound good to laymen.

Just like homeopathy. The only difference is that homeopathy is nearly incapable of direct harm, only the indirect harm associated with inaction.

That's why we push for double-blind clinical studies. They're designed to remove biases and other distorting factors.

Where is the initial double blind placebo controlled study that showed arthroscopy is beneficial for osteoarthrits before the tens of thousands of procedures that were done? Some brave soul revealed the truth that arthroscopy for osteoparthitis is a sham, mainly benefical for the operators bank account. How many other accepted procedures are being done today without DBPC studies, and how many of these will be revealed as shams? You name the number.

By squeakywheel (not verified) on 08 Nov 2007 #permalink

How can you do double blind placebo studies on surgical procedures? Do you knock out the patient, wake them up and tell them that they have had surgery, but with invisible stitches?

That "brave soul" was an insurance company. Big whoop. A check on their website shows the same thing for homeopathy. Another public health insurance entity has also put the brakes on cranial sacral therapy: http://www.chspr.ubc.ca/node/391

And what does that have to do with homeopathy?

You seem to think that finding flaws in real medicine that somehow exonerates homeopathy. Sorry, it does not work that way. What you have to do is actually show homeopathy works.

Here is an idea, show that you can differentiate between 30C Nat Mur and 30C Nux Vomica that are in identical unmarked bottles (maybe marked "a" and "b"), and then you might have something.

squeakywheel:

So, do you think the drug companies are hiding these studies from FDA as well?

No, they just hide them from the American public, until forced out in the open by litigation.

So let's be clear. You're saying the FDA knowingly conspires with industry to commit fraud. FDA intentionally conceals large numbers of studies showing that drugs don't work, in favor of the occasional study that appears positive just by chance.

Fine. So, which of those 300 Zyprexa documents should I read to be convinced of that?

Note: I don't claim FDA is never biased, or that pharma never lies, cheats, or tries to play down bad data. But if you honestly think pharma routinely does 20 studies, hides the 19 with p > 0.05, and only discloses the 1 with p < 0.05, AND that FDA knowingly goes along with it, you're nutty.

Maybe you should increase the dilution factor on your homeopathic anti-paranoia preparation. The potency is clearly too low.

That should be:

"But if you honestly think pharma routinely does 20 studies, hides the 19 with p > 0.05, and only discloses the 1 with p less than 0.05, you're nutty."

I guess using a 'less than' sign is a no-no.

Note: I don't claim FDA is never biased, or that pharma never lies, cheats, or tries to play down bad data.

Correct, the FDA is biased, and pharma lies, cheats, and tries to play down bad data. This is all true. Are you allowed to openly say this here?

By squeakywheel (not verified) on 08 Nov 2007 #permalink

squeakywheel ranted "Correct, the FDA is biased, and pharma lies, cheats, and tries to play down bad data. This is all true. Are you allowed to openly say this here?"

Yes, of course you can say that here. Except, you will be thought of as a paranoid loon unless you can prove it.

Prove it.

(Orac has only banned one person, and well that was because he was abusive. You are safe because you are actually amusing in a silly kind of way)

squeakywheel:

Are you allowed to openly say this here?

Oh sure! We may be conspirators, but lucky for you, we're incompetent conspirators. That's why we do 20 clinical trials to get one good result, and then bribe FDA to help us cover up the other 19.

If we were competent conspirators, we'd save our money and just make up whatever data we wanted. But we're not; we're incompetent.

Which means you don't really have to worry about our black helicopters. Sure, we'll send them after you. But they'll just blow up houses at random, hoping that eventually, by chance, they'll blow up yours. It's a strategy that's served us well, why change now?

I never said or implied that "I would be perfectly happy to have us forego anything but homeopathy". In the ordeal I described with our son's lower limb paralysis, we took him to the hospital first and only after one week of all traditional approaches failing we resorted to homeopathy. Certainly not an attempt to "forgo anything but homeopathy".

"That is a bunch of bullocks..." getting off topic here, but not so: Bernoulli's book was published in the 1700s but the connection between the principle and flying was not made until 1920 and the Wright brothers were not aware of it:

http://www.etsu.edu/math/gardner/wright-brothers/huffaker.htm

"The easiest person to fool is yourself" Well, when the horse is writhing in pain from colic and, time after time, gets relief within sometimes minutes of the homeopathic prescription how am I fooling myself?

When our son after a week of conventional treatments at the hospital continues to get worse and then shows improvement within hours of the homeopathic treatment where am I fooling myself?

I do not claim scientific proof here just very compelling evidence. Mounting evidence is bound to eventually lead to convincing scientific studies. It's work in progress. Some are already available:

Bell IR, Lewis DA, 2nd, Lewis SE et al. EEG alpha sensitization in individualized homeopathic treatment of fibromyalgia. International Journal of Neuroscience 2004c; 114 (9):1195-220.

Chapman EH, Weintraub RJ, Milburn MA et al. Homeopathic treatment of mild traumatic brain injury: A randomized, double-blind, placebo-controlled clinical trial. Journal of Head Trauma Rehabilitation 1999; 14 (6):521-42

"Here is an idea, show that you can differentiate between 30C Nat Mur and 30C Nux Vomica ..."

Clear reference to the recent Rustum Roy paper. Again, just because the mechanism is not well understood doesn't preclude it from working. These comments on Randi's site by the way, geez, I forgot how petty and childish scientists can be, glad I moved on to the business world ...

Regards ...

Again, just because the
mechanism is not well understood doesn't preclude it from working.

Define "working." How do we know it's "working"?

As for your references, I'd be willing to bet that they're no better than this one or this one. Inevitably, the better the study of homeopathy, the less the effect, which fades into nonexistence in the best studies.

Who cares about the mechanism? Prove that it works under controlled conditions engineered for the purpose of eliminating extraneous effects, and then we can worry about the mechanism.

"Does it work?" is a more fundamental question than "How does it work?"

Why doesn't it work with higher quality studies? The only difference is that increase in quality reduces outside noise from non-homeopathic causes.

Oh, and about censorship, it's more likely for the Society of Homeopaths to sweep in with frivolous lawsuits and Thought Police to silence us. They did it to Le Canard Noir at the Quackometer blog.

Woos are such hypocrites. They talk about open-mindedness, yet they do everything they can to distract and silence the key parts of the debate.

Vanodorf, your Huffaker link is pitiful. Check out the link I included where the Wrights actually measured the pressures along the wing sections.

Be advised that I spent my 50th birthday wandering around an airplane museum, with a whole room devoted to the Wright brothers.

Better links: http://www.wrightflyer.org/WindTunnel/testing1.html
and from http://www.pbs.org/wgbh/nova/transcripts/3015_wright.html, "This concept, known as Bernoulli's theorem, had been understood for 160 years, but Wilbur Wright quickly discovered there was little agreement on what the proper shape of a wing should be."

Still, this does not explain your devotion to super diluted remedies. There is no reason why anything without ANY active ingredients should have an effect on human biology.

HCN:
I'm just trying to convey positive experiences that I have had with homeopathy on myself, our children and animals repeatable over many years (pse refer to my earlier posting).

I have no other way of explaning these than to concede that super-diluted remedies work, just nobody knows how yet. It's not devotion, just wonder and amazement that it is actually possible. It doesn't always have to start with science, humans breathed long time before Lavoisier discovered oxygen!

BTW I enjoy the Wright Patt museum too!

Recipe for "Homeopathic Thick Chocolate Shake":

Dump 1 sampler scoop (1/2 teaspoon) premium chocolate ice cream into 1 cup of distilled water. Stir vigorously until uniform. This is the 1C dillution. From this mixture, take 1/2 teaspoon and stir into a fresh cup of distilled water, and discard the original batch. This is the 2C dillution. Repeat this process until you have a 30C dillution.

Though the water will be crystal clear, it really does taste so creamy and delicious, and leaves a chocolate "mustache", too! Enjoy!

Vanodorf -

I'm slightly confused. First, you claim that the remidies need to be tailored to the patient.. then that you may have to try several in succession.

Now, to a natural cynic such as myself, this looks very much like you try one rememdy after another until the condition spontaneously resolves. For instance, the paralysis you talk about could have been (for instance) just bruising squeezing a nerve, which would indeed have resolved in a week or so with no intervention.

By Andrew Dodds (not verified) on 08 Nov 2007 #permalink

prove it

Its already been proven ad nauseum:

The Truth About the Drug Companies: How They Deceive Us and What to Do About It Marcia Angell

Inside the FDA: The Business and Politics Behind the Drugs We Take and the Food We Eat by Fran Hawthorne

A few interesting facts about the drug industry we can't mention here:

1.Preventive medicine, including vaccines, decrease the pharmaceutical sales and are not in the interest of this industry. However, lately the new vaccines haven't been so great.

2.Most drugs are symptom oriented and dont address the cause of disease.

3.Profits are not linked to fighting disease, but to patent royalties of newly synthesized molecules that dont appear in nature or humans.

4.Most drugs are toxic to the human body and frequently cause serious adverse side effects, like a long painful death.

5.Pharmaceutical industry spends more money on advertising and lobbying than on drug research.

6.Vitamins and other natural health therapies like homeopathy threaten the pharmaceuticals because they preventive or treat the cause of the disease, are not patentable and not as profitable.

7.Natural health therapies like homeopathy are incompatible with the drug industry and cannot exist together.

8.Long-term success of the pharmaceutical industry requires getting rid of all natural natural therapies (including homeopathy).

9. The Orac blog, like the mass media, is a sockpuppet for the pharmaceutical industry, so the above goals are reflected in arguments and debates here.

10. If you havent noticed, our health care system is sick and the drug industry shares a large part of the blame.

By squeakywheel (not verified) on 09 Nov 2007 #permalink

The Orac blog, like the mass media, is a sockpuppet for the pharmaceutical industry, so the above goals are reflected in arguments and debates here.

Ah, the pharma shill gambit. Very amusing.

And soooo predictable.

Hey, no slander there, just economic reality. Medical practice is dominated by the drug industry, this is just a fact of life. Anything that is bad for drug sales is shall we say, "discouraged".

And you know this, because you are an insider... right?

When drug companies do a study showing that placebo beats their drug, they just hide the study in the file cabinet, do more studies until they get the "right" results

The fact that you suggest it is possible to get the "right" result just be repeating a study shows you are a postmodernist who doesn't want to accept the existence of reality. You should be very ashamed.

And you've just proven my point: If the drug companies do something dishonest, there will be a leak. You're asking me to believe that they can operate routinely without any leaks.

"The complete lack of evidence is a sure sign the conspiracy is working."

The problem with the medical field in this country is not the drug companies...

It's the insurance companies.

Which mostly don't exist outside the USA.

Pasteurella pestis (bubonic plague)

No longer Yersinia?

Incidentally, one of the things that doomed Benveniste (in addition to the shoddy procedures in his lab, debunked by Nature editor John Maddox, Walter Stewart of the NIH and James Randi)

And being the only person who ever got two IgNobel Prizes.

No, they just hide them from the American public

Which, as everyone knows, is the only public in the world.

I guess using a 'less than' sign is a no-no.

Use the HTML entity instead: &lt;

Most drugs are symptom oriented and dont address the cause of disease.

That's what homeopaths like saying, but it's projection. It's homeopathy that looks at the symptoms and then prescribes a dilution of something that induces the same symptoms in a healthy subject (similia similibus curentur). Evidence-based medicine looks for the cause -- such as the bacterium or virus -- and tries to eliminate it.

Most drugs are toxic to the human body and frequently cause serious adverse side effects, like a long painful death.

"Most drugs"... "frequently"... you don't believe that yourself.

Vitamins and other natural health therapies like homeopathy

What, pray tell, is more natural in any of that than in penicillin?

Long-term success of the pharmaceutical industry requires getting rid of all natural natural therapies (including homeopathy).

Untrue. The pharma companies already are rich. They have long-term success.

If you havent noticed, our health care system is sick

The US healthcare system, or lack thereof, is indeed sick. It's just not the only one that exists in the world.

By David MarjanoviÄ (not verified) on 09 Nov 2007 #permalink

Preventive medicine, including vaccines, decrease the pharmaceutical sales and are not in the interest of this industry.

So why does the industry produce vaccines, then? Why research preventatives at all?

Most drugs are symptom oriented and dont address the cause of disease.

Is there something wrong with treating symptoms?

Profits are not linked to fighting disease, but to patent royalties of newly synthesized molecules that dont appear in nature or humans.

Patents don't mean a damn if you can't sell your product. You can't sell drugs in the US without FDA approval. FDA approval requires proven efficacy...

Most drugs are toxic to the human body and frequently cause serious adverse side effects, like a long painful death.

...and safety.

Of course, none of this matters a damn anyway. What matters is what works. You've been utterly unable to provide a single shred of reliable evidence to show that homeopathy works, which is why you're left with no choice but to spin, dissemble and slander. When you can't support your position with evidence, the honest thing to do is consider the possibility that your position is simply wrong.

How can you do double blind placebo studies on surgical procedures? Do you knock out the patient, wake them up and tell them that they have had surgery, but with invisible stitches?

No, actual incisions with actual stitches.

Which is part of why so few surgical interventions have been properly studied.

By Caledonian (not verified) on 09 Nov 2007 #permalink

Indeed. It's not like comparing two drugs, where in comparison it's relatively easy to blind the physicians and patients to drug versus placebo. (Actually, even with drugs, blinding is a nontrivial consideration, particularly if the drug has a certain odor or taste or if it has certain physical characteristics that are hard to mimic.)

For most surgical procedures, it's impossible, for one thing, ever to blind the surgeons as to what was done. Also, doing sham "placebo" surgery on patients as a part of a study raises grave ethical issues. Even so, there are a few randomized double-blinded studies in surgery. One involved the injection of stem cells into the the brains of patients with Parkinson's disease, which required a surgical incision to approach the correct area to inject. Basically, all the patients got a surgical procedure and the surgeons doing the procedures never knew whether they had injected stem cells or not. (It was a negative study, as I recall. I may have to go and look it up, as it was a fascinating paper.)

Be that as it may, the ethical and logistical difficulties involved in doing surgical procedures often mean that surgeons have to rely on retrospective studies, prospective unblinded studies, etc.. This makes it more difficult, but it doesn't mean that surgery is not evidence-based.

Andrew Dodds -
I understand the confusion; the homeopathic model is rather different from the established medical model. I'll try to explain:

There are over 1500 homeopathic preparations available and the homeopath has to select the one that presents a profile that best fits the patient's symptom set. This task is made particularly difficult by the fact that often, subsets of remedies (say 3 or 4 remedies in a patient's case) may present profiles very close to the patient's symptoms. It's the selection from this sub-set that may require the refinement of the prescription to be made by trial and error. More experienced homeopaths have better success in selecting the correct remedy first shot. Interestingly, in my opinion, this also weakens the placebo argument: While one or two of the remedies have no effect at all on the patient, when the correct one is selected the results can be quite remarkable and, to the honest observer, unmistakably linked by cause and effect to the prescription. Hope this helps.

Re your "natural cynic" comment, yes, the squeezing of a nerve is a reasonable "remote diagnosis" although the doctors at the hospital, who carried out a wide range of tests, did not find anything of that sort. Further, there was no indication at that point that things were starting to improve, quite the opposite. The trend was a steady advancement of the paralysis up both limbs. It was then we decided to consult the homeopath. No diagnosis was made in the end since the condition improved rapidly following the homeopathic prescription. Personally, if I were to choose between a diagnosis and a cure I'll take the cure again.

Ho hum, the Pharma Shill gambit again.

I must be doing something wrong. In over twenty years in biomedical science research I have scored an amazing DOZEN or so free lunches off the Pharma Industry - so approx. 0.5 lunches / yr. Most of these were a free sandwich, and the most lavish was lunch (no wine or beer) in a PharmaCo's in-house restaurant. It's reassuring to know that we college professor types can be corrupted and brainwashed at such economic rates.

Like many others here, I guess, I never cease to be amazed by the Conspiracy Craziness of significant parts of the human race when it comes to anything related to (alternative) health.

As someone else wrote on the original Pharma Shill thread, I would be rather happy if some industry would pay me a handy salary to write blog posts about anything I fancied whilst generally explaining that mainstream science and medicine are based on evidence, and do mostly good things.

Unfortunately, I'm still waiting for the job offer.

Vanodorf,

You are pushing baloney. How does water act as a cure?

You keep saying that it "works," but with no presentation of evidence. Thats the pragmatic fallacy. It won't pass muster here.

If your claims were correct, a good homeopath (if such a person exists) could demonstrate their prowess via a well designed trial. They can't, but offer up excuses of having to try more preparations until they get it right. More likely, the patient just gets better or decides to quit coming back to the con artist.

You also claim that you have had success with homeopathy. Anecdotal evidence won't cut it either.

Homeopathy is sympathetic magic. Just hocus pocus. No more, no less.

By Robster, FCD (not verified) on 09 Nov 2007 #permalink

Robster, FCD -
"... with no presentation of evidence ..." " ...demonstrate their prowess via a well designed trial" . Here are the two published papers I referenced earlier:

Bell IR, Lewis DA, 2nd, Lewis SE et al. EEG alpha sensitization in individualized homeopathic treatment of fibromyalgia. International Journal of Neuroscience 2004c; 114 (9):1195-220.

Chapman EH, Weintraub RJ, Milburn MA et al. Homeopathic treatment of mild traumatic brain injury: A randomized, double-blind, placebo-controlled clinical trial. Journal of Head Trauma Rehabilitation 1999; 14 (6):521-42

" ... offer up excuses of having to try more preparations ..." What I said was that a homeopath sometimes needs to try 2-3 prescriptions until the correct one is found. Nothing unusual here, doctors practicing traditional medicine routinely do the same thing, say, when they are trying to selsct the right antibiotic.

" ... Anecdotal evidence won't cut it either..." I gave examples both of published studies (above) as well as anecdotal evidence from first hand personal experience. Yes, my son's rapid and complete homeopathic cure (please read my earlier posting) is not a repeatable trial. That takes nothing away from the fact that he recovered his health and has remained healthy since.

Be very, very careful. You might interest me enough to look at the two papers you referenced. I've deconstructed lame papers trying to show the efficacy of homeopathy before, as I mentioned in an earlier comment. One of the two papers I looked at was routinely cited as being particularly strong evidence of homeopathy.

It wasn't.

Perhaps these papers that you cite are different, but the odds are against it. I suppose we could find out, couldn't we?

Orac -

Here is a radical suggestion:

Buy a vile of Arnica 200C from your local health food store (it will set you back maybe $10). It works well for injuries to muscles. Keep it until you or someone around you has a small accident, a bruise or a fall and just try it and observe, see what happens...

/// anticipating heaps of scorn ...

Regards

By Vandodorf (not verified) on 09 Nov 2007 #permalink

Actually, Vanodorf (or Vandodorf), that is not a "radical" suggestion. That is the "you don't know until you try gambit". It is usually thrown out before the "pharma shill" gambit is used, and after the "you don't know what you are talking about" gambit.

How about you save us the time and trouble, go to your medicine cabinet, get your vile of the stuff and post the list of ingredients on the label. More often than not, there is actually a bio-active ingredient listed that is not under the "active ingredient" list. (the "Head-On" stuff is one of those, it is a supposedly homeopathic nostrum in a menthol cream, guess what... the menthol actually has an effect!).

Then while you are at it, explain why Arnica Montana with a ratio of 1 part to 10000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 (yes, that is 400 zeros!) is supposed to have any effect.

It was a very judicious use of ctrl-c and ctrl-v !

Here is a radical suggestion:

Buy a vile of Arnica 200C from your local health food store (it will set you back maybe $10). It works well for injuries to muscles. Keep it until you or someone around you has a small accident, a bruise or a fall and just try it and observe, see what happens...

Why bother, when:

a) it wouldn't actually tell us anything about whether the remedy had any effect (because of the lack of a control), and

b) a proper study of homoeopathic arnica for bruising has already been carried out:

http://www.jrsm.org/cgi/content/abstract/96/2/60

You can keep your vile arnica.

HCN,

So thats what is in headon. Figures. Its also illegal to sell homeopathic "remedies" with unlisted actives. More ethics issues for homeoscamartists.

By Robster, FCD (not verified) on 10 Nov 2007 #permalink

You've been utterly unable to provide a single shred of reliable evidence to show that homeopathy works

The final obvious proof that anything works is that the test of time. For modern medicine its been about 60 years (since end of WW-II), and for homeopathy its been more like 210 years (1782).

Based on the amount of time, homeopathy clearly is the winner.

210 years is mighty strong medicine (as Big Cheif say).

If Homeopathy didn't work, nobody would be using it now. If acupuncture didnt work for the past 2000 years, nobody would be using that either. Otherwise they both would have gone the way of vioxx (5 billion for the victims), zelnorm and baychol, the three great pillars of modern medicine which ended up in the garbage can. In the case of Vioxx, an expensive garbage can.

And yes everything stated above about the control of medicine by the drug industry is correct, and no they dont even have to buy you lunch. They just have to buy lunch for the guy who leads you. Its an old technique but always works, especially for docile, easily intimidated ones who have surrendered critical thinking ability.

By oil-the-squeak… (not verified) on 10 Nov 2007 #permalink

Squeak,

The final proof is proof, not more of the pragmatic fallacy.

Evidence. Either you have it or you don't.

By Robster, FCD (not verified) on 10 Nov 2007 #permalink

The final obvious proof that anything works is that the test of time. For modern medicine its been about 60 years (since end of WW-II), and for homeopathy its been more like 210 years (1782).

People have believed in ghosts for thousands of years. How long people have believed in something has little correlation to its truth.

I believe squeakywheel, van(d)odorf, and oil-the-squeaky-wheel are fools. I guess the longer I believe it, the truer it gets.

The test of time would only be meaningful if people were always rational.

Homeopathy still can't pass a single test that real medicine is expected to, several times before approval. Homeopathy's only survived because people are capable of irrational forgiveness for sloppiness, short memories, and so on. If homeopathy had any effects, they'd be dancing their way out of a million Vioxx-equivalent scandals, given the way they work. Especially when you've got some of them, like the Society of Homeopaths playing Thought Police. It's easier for them, since their record-keeping demands are typically a lot more lax.

But, thankfully, homeopathy amounts to nothing more dangerous than inaction most of the time.

My favourite author (a fantasy and fiction novellist) has recently aquired a livejournal, which I follow. I was dismayed to see that she's apparently a big fan of homeopathy. Dismayed because one more person believes that utter shit. I've found I like her less and respect her less--even though her field and the things I liked her for in the first place have nothing to do with medicine--because she believes utter crap.

Hmm, Patience, now you know how I felt about my last Prime Minister, "Saint" Tony (lecturing-soon-at-a-US-campus-near-you) Blair.

At least fantasy novelists just invent worlds for a living, instead of trying to re-draft real ones according to their mystic-babble-clouded worldview.

Some new names joined the thread so I thought I'd summarize what I tried to say:

- I picked up this thread trying to balance the discussion on "A death from Homeopathy" (as sad as it is) by placing it in the context of the 106,000 annual deaths from non-error medical prescriptions [1].

- I referred to two scientific studies published in peer review journals demonstrating the efficacy of homeopathy [2], [3]

- I provided a faithful account of our personal experience with our son's hospitalization and following breakthrough recovery using homeopathy. I also referred to the numerous successes we have had with our show horses (placebo on horses?)

- Someone mentioned surgery as a good example of a well accepted procedure that is not well suited to double-blind studies. In surgery, there is a clear cause-and-effect (surgery -> cure) with a clear mechanistic link between the two (bone repaired -> patient gets better). No one is asking for double blind studies to legitimize surgery. Homeopathy also has a cause-and-effect link ([2], [3]) and scores of well documented, in paper and video, cured cases. The stumble, I still believe, is the mechanism (the number of zeros ...)

- Nobody understands how homeopathy works, at least at this time, but given the strong evidence, one should be intrigued and motivated to pursue further. Maybe even (now I'm going to hear it...) consult with a good homeopath about this stubborn hay fever you've had for years.

I would also like to add to oil-the-squeaky-wheel's insightful comment re the time test of homeopathy (and getzal's "I believe squeakywheel, vanodorf, and oil-the-squeaky-wheel are fools" comment. Some good homeopaths these days have 1 to 2 year waiting lists and patients often pay fees not covered by their insurance for treatment. This recognition of homeopathy by "popular vote" so to speak, shouldn't be dismissed as "collective delusion" as some would like it. Many institutions in our society work rather well this way, effectively by popular vote [4]. Google's search engine is an interesting example of that.

I tried to be rigorous by providing credible references and argued my case in good faith. I know, I know, I won't convince anyone (not on this blog!) and who's got time to check all the references and read the postings carefully. But hey, everyone likes a good spar.

References
[1] Barbara Starfield. Is US Health Really the Best in the World? JAMA. 2000;284:483-485.
[2] Bell IR, Lewis DA, 2nd, Lewis SE et al. EEG alpha sensitization in individualized homeopathic treatment of fibromyalgia. International Journal of Neuroscience 2004c; 114 (9):1195-220.
[3] Chapman EH, Weintraub RJ, Milburn MA et al. Homeopathic treatment of mild traumatic brain injury: A randomized, double-blind, placebo-controlled clinical trial. Journal of Head Trauma Rehabilitation 1999; 14 (6):521-42
[4] "The Wisdom of Crowds", James Surowiecki. A good read even if you don't care about my arguments here.

I squeaked long enough.
Cheers and good health to all (however you get there ...)

Van, Nobody understands how homeopathy works is a misstatement, especially with a lack of solid evidence that it does actually work (2 positives out of piles of negative results is not a good record). A more accurate statement would be, "Nobody understand how homeopathy could possibly work."

I would appreciate it if Orac would take a look at the two pro homeopathy articles, with apologies for the headaches to ensue. I have a feeling that it would be... illuminating.

By Robster, FCD (not verified) on 11 Nov 2007 #permalink

People have believed in ghosts for thousands of years. How long people have believed in something has little correlation to its truth.

This is a common misconception that "belief" is required for something to work. Do I have to believe in aspirin for it to relieve my headache. No of course not. Same for homepathy. It either works or it doesn't.

Does the horse believe in the homepathic treatment that is effective as Van Dorf mentions? No horses dont do that.

On the other hand, for a placebo effect to work for humans, there is obviously a mental component. But this is a belief at one moment in one instance of a treatment modality. This is a different thing from oracs' concept of historical belief, or an overall belief that something works.

There are many examples of historical belief in modern medicine.

For example, in patients with known heart disease (secondary prevention), statin anticholesterol drugs are of benefit and decrease the mortality rate.

However, is is also commonly believed that statin drugs prolong life for patients with elevated cholesterol and no pre-existing heart disease (this is called primary prevention).

However, there is no scientific data to prove primary prevention with statins prolongs life. The data shows the opposite. Actually, mortality in the placebo group was lower in many statin drug trials in patients with no known heart disease.

Thats because satan drugs are carcinogenic, impair mental function and a host of other nasty side effects. Yet doctors and patients alike believe that everybody in the population with an elevated cholesterol above 200 should be on the satan drugs.

That is believing in a ghost that pulls in 20 billion globally. Now if you made that much wouldnt you also believe in the ghost?

By doctordebunker (not verified) on 12 Nov 2007 #permalink

Does the horse believe in the homepathic treatment that is effective as Van Dorf mentions? No horses dont do that.

The horse isn't evaluating and reporting on its own condition.

Ah! Yet another in the recent plethora of rabid anti-Homeopathy articles which has appeared recently.

I have neither tried Homeopathy nor know if it "works" but I DO know that the of NUMEROUS SUCCESFFUL such Homeopathic tests reported in their journals, the endless distortions, misrepresentations, assertions that there has NEVER been a successful double blind placebo test of ANY Homeopathic remedy and the like indicate an apparent level of desperation among supposedly "scientific" people which I find rather curious.

Nor am I impressed with that favorite "refutation" of those anti-Homeopathists who have attained a level of knowledge at the level of High School chemistry who mention that the high dilution Homeopathic remedies could not possibly have an atom of the original substance left in it.

This would be a good argument if we somehow had dynamic knowledge of the BILLIONS of quantum states and atomic interactions occuring in a thimblefull of water every nanosecond... but we DO NOT.

If Homeopathy were the inept, worthless and trivial bit of nonsense that the rabid anti-Homeopathists make it out to be, then people would have quietly stopped using it long ago.
Please don't offer that "placebo" nonsense because there are some very satisfied babies out there whose negative colic experiences have quieted them and who most certainly are not subject, at their young age to the placebo effect.

Likewise, if the anti-Homeopathists really believed their own quackery nonsense they would NEVER bother to mount a campaign against such an absurd and obviously inept medical modality as Homeopathy -> but they do and its viciousness goes right up to well educated rabid anti-Homeopathists, such as Ben Goldarcre, who mounts a very impressive bit of "debunking" against a scientifically untrained woman author who dared mention a successful experience she had with one homeopathic remedy.

Mr. Goldacre, as with all scientific bullies, disappears into the woodwork, rather quickly when confronted with serious challenges to his clever misdirections, misrepresentations of homepathic research and even omissions of successful results from some of the very studies that he mentioned.

http://www.guardian.co.uk/comment/story/0,,2224877,00.html

Which tells me in a very "unscientific" way, that if standard medicine is afraid enough of Homeopathy to have to misrepresent their successes, then there may be something to this
after all.

By James Pannozzi (not verified) on 15 Dec 2007 #permalink

James Pannozzi wrote "Ah! Yet another in the recent plethora of rabid anti-Homeopathy articles which has appeared recently."

Orac wrote this almost six week ago. What is you definition of "recent"

He continues, "This would be a good argument if we somehow had dynamic knowledge of the BILLIONS of quantum states and atomic interactions occuring in a thimblefull of water every nanosecond... but we DO NOT."

Well, why don't you tell us all about it then. While you are at it please answer this question that no homeopath seems to want to answer: How many sodium and chlorine atoms are in one cubic centimeter of Nat Mur 30C ?

He continues: "If Homeopathy were the inept, worthless and trivial bit of nonsense that the rabid anti-Homeopathists make it out to be, then people would have quietly stopped using it long ago."

Uh, right... then why do people still try to sell laetrile when it was proven quite well to do nothing for cancer and actually caused cyanide poisoning in the 1970s? Just because people use it, doesn't mean a thing.

And he continues: "Mr. Goldacre, as with all scientific bullies, disappears into the woodwork, rather quickly when confronted with serious challenges to his clever misdirections, misrepresentations of homepathic research and even omissions of successful results from some of the very studies that he mentioned."

... and lists a silly reader article, which had some very amusing comments... do you defend the right to believe in fairies also?

Dr. Goldacre is still very much around and active here:
http://www.badscience.net/

You might want to catch up to some more recent postings on this blog, Gimpy's blog, the Quackometer's blog and elsewhere.

I suspect I am almost alone in the "sceptical" community in being able to see a role for homeopathy in clinical practice, for all of the reasons i outlined in my piece

http://www.badscience.net/?p=578

However, it is cases like this which exemplify the extremes of what is unacceptable about the culture of homeopathy, and specifically the total lack of critical appraisal from within of the problems in its practice, and the infantile and melodramatic conspiratorial rejection of medical treatment.

There has been no criticism from homeopaths of the role of homeopathy in the death of this child. This is the best illustration of the problems with homeopathy: a total failure of critical self appraisal from within. This problem is most chillingly expressed in this discussion, where vaccine are blamed for the tragic death of this child:

http://www.hpathy.com/homeopathyforums/forum_posts.asp?TID=6923

In contrast, critical self appraisal is deeply ingrained in the practice and culture of medicine.

The BMJ recently announced the three most popular research papers from its archive, according to an audit which assessed their use by readers, the number of times they were referenced by other academic papers, and so on.

http://www.bmj.com/cgi/content/full/334/7593/554-a

Every single one of these papers was highly critical of either a drug, a drug company, or a medical activity, as its most central theme.

The top scoring paper was a case-control study which showed that patients had a higher risk of heart attack if they were taking the painkillers rofecoxib (Vioxx), diclofenac, or ibuprofen. Vioxx of course was at the heart of a major scandal. At number 2 was a large meta-analysis of drug company data, which showed no evidence that SSRI antidepressants increase the risk of suicide, but did find weak evidence for an increased risk of deliberate self harm, which is worth keeping an eye on. And in third place was a systematic review which showed an association between suicide attempts and the use of SSRI's, and highlighted - very critically - some of the inadequacies around the reporting of suicides in clinical trials.

This is critical appraisal of new ideas. This is open discussion of real problems in clinical practice. This is kind of appraisal is completely absent from the homeopathic literature, in which simplistic fantasies reign supreme: that is attractive PR, but it is not how ideas move forwards in the real world of health care.