Lesson 1: Homeopathy is NOT herbal medicine (repost)

This article yesterday in the Wall Street Journal has led me to revisit and repost an old essay I had at the old place on 6 January 2006. The article addresses Oscillococcinum, an extract of the liver and heart of the Muscovy duck that is diluted so many times that, thankfully, it contains no duck organs but only water, and is then packaged into degradable beads. This product is sold by the French company, Boiron, to prevent colds and flu and you can find this stuff sold at Whole Foods and other "health" stores. There is even a children's product by the same name but I have no idea how one makes a different "strength" of nonexistent molecules.

As you'll read the repost below, homeopathy requires that you suspend belief in all concepts and principles of physics, pharmacology, and medicine. While the occasional paper will report a positive effect of homeopathy, all systematic reviews of the homeopathy literature suggest that these "remedies" are no more than expensive placebos. In the Laura Johannes article, we learn that even high-ranking physicians can fall prey to credulous thinking:

"If you take it when you begin to feel ill it really makes a difference," says Robert Schiller, chairman of family medicine at Beth Israel Medical Center in New York. He recommends the homeopathic remedy to many of his patients, but still prescribes antivirals, particularly to patients at high risk for complications from the flu.

This gives me agita.

Here's my repost:


I love Ode Magazine - much, much more often than not.

Today, I have a bone to pick.

In the aftermath of the 2004 US presidential election, I had to cancel my subscription to The Nation just because I got so depressed about negative news coming into every conduit of my house.

Ode is a Dutch-based mag that offers original and reprinted stories describing where people and ideas are working around the world to create positive change. From their mission statement: "We publish stories that bridge the gap between thinking and doing, between rage and hope, and the painful gap between the rich and the poor. By doing so we build peace and sustainability."

Cool. A breath of fresh air when everyone is screaming at one another. And, largely, Ode succeeds. Until this issue, when I ran screaming from my mailbox like Steve Martin in The Jerk.

In the January 2006 issue, Kim Ridley offers an overview of homeopathy as "a healing idea whose time has come - again?" The article does wisely posit, "Is homeopathy a 200-year-old hoax, or a powerful paradigm for healing?" But the cover statement (above) that homeopathic remedies produced much higher survival rates than conventional medicine during the 1918 influenza pandemic is poorly substantiated in a related article. More disturbingly, an Indian homeopath who uses these remedies to treat cancer is quoted as saying, "The only things I don't approve of are chemo and radiation."

Together with surgery, I know of no two other modalities that HAVE been shown conclusively to produce long-term cancer remissions (I hate to use the word 'cure'). Yet the article irresponsibly provides further details on how to seek this 'healer' who claims to have cured 80 percent of cancers over the last 10 years.

Homeopathy is a late 1700s/early 1800s practice of using extremely dilute preparations, largely of plant extracts and toxic metals, to treat diseases based upon the so-called 'law of similars'. The philosophy that 'like cures like' was first espoused by a German physician named Samuel Hahnemann who took high, conventional doses of plant medicines, observed the symptoms produced, and then used extremely dilute versions of the same plant to treat diseases that produced similar symptoms. For example, the vomit-inducing syrup of ipecac is offered in an extremely dilute form as a homeopathic treatment for any disorder where the patient is experiencing vomiting.

Where homeopathy is most controversial is in the claim that a remedy becomes more potent as it is diluted. Even experts quoted cannot account for how this is scientifically possible, although some invoke a sort of "quantum physics" change in the structure of water. Hmmm.

More erudite fellow bloggers have already commented more concisely on the implausibility of homeopathy. Even the British journal The Lancet, one of the most alternative medicine-friendly among high-impact conventional medical journals, published results last year of a meta-analysis demonstrating that homeopathy is no better than placebo.

But where I object further is when photographs of herbal medicines are placed within an article on homeopathy as is done throughout this issue of Ode.

Herbal medicine is NOT homeopathy.

Herbal medicine and the use of pure chemical constituents from plants still subscribe to dose-response pharmacology: that the biological response varies in direct proportion to the dose or concentration of the remedy. While some medicinal plants are used as a source for homeopathic treatments, the rationale for dosing in medicine vs. homeopathy are diametrically opposed. Lumping together herbal medicine with homeopathy gives the former practice the same air of impossibility and detracts from the demonstrated benefits and future promise of using plants as a source of novel therapeutic molecules.

Many would love to see homeopathy proven as an effective medical practice. What's not to like: non-existent doses of a remedy that cure diseases without any side effects.

Anecdotes abound. Show me the data. Until then, I find homeopathy difficult to swallow.

More like this

Homeopathy during a pandemic when hospitals are overrun has come up a few times. Even the use of CPR for older adults has been questioned as there may not be any EMTs or hospitals. Midwifery is another hot topic.

Free pandemic update webcast today by US Dept of Health and Human services today at 2pm Eastern time

http://www.pandemicflu.gov/news/panflu_webinar.html

You can email your questions beforehand or during the hour long webcast.

Discussion at:
http://www.newfluwiki2.com/showDiary.do?diaryId=2962
Answers and blogs at: http://www.newfluwiki2.com

Be prepared - not scared. If you think you can do something about global warming, which we have, know you can do more about this.

Regards,
Kobie

AP: Right on!
Kobie: What?

By Sven DiMilo (not verified) on 28 Jan 2009 #permalink

"Robert Schiller, chairman of family medicine at Beth Israel Medical Center in New York"

My god that's depressing. I may have just flipped the bozo bit on all of Beth Israel. Great flying spaghetti monster that's a terrible sign.

By Ancient Sumerian (not verified) on 28 Jan 2009 #permalink

Homeopathy has had hundreds of years to prove its effectiveness. Chinese traditional medicine has had thousands. Herbalism has had thousands/hundreds and has seen some remedies show their effectiveness in scientific studies and become incorporated into science-based medicine. Meanwhile, science-based medicine has, in the last few hundred years, extended our lifespans dramatically, cut deaths in childbirth, and conquered smallpox. If those "cures" of the ancients worked, why did lifespans only start to shoot up since the advent of science-based medicine? How's that for some meta-analysis?

Whenever someone points to the age of some of the alternative medicines, they don't realize that they just damned them as showing they are ineffective in practice.

You know, I have cured so many of my own illnesses with homeopathy (and acupuncture, for that matter) that I frankly don't care what you have to say about it. If it's a placebo effect, that's fine with me. I'd rather have a placebo effect that consistently makes me better than a healthy skepticism that leaves me sick.

By shannon Murphy (not verified) on 28 Jan 2009 #permalink

If you are interested in further reading about alternative medicine, the new book "Trick or Treatment: The Undeniable Facts About Alternative Medicine" by Simon Singh and Edzard Ernst is highly recommendable. It deals with homeopathy, acupuncture, herbal medicine, and other things by presenting the available evidence. It also addresses Shannon Murphy's comment about placebo: Is it ok to treat with placebo if it works? It's an interesting discussion ... and I don't agree with Shannon.

If you are interested in further reading about alternative medicine, the new book "Trick or Treatment: The Undeniable Facts About Alternative Medicine" by Simon Singh and Edzard Ernst is highly recommendable. It deals with homeopathy, acupuncture, herbal medicine, and other things by presenting the available evidence. It also addresses Shannon Murphy's comment about placebo: Is it ok to treat with placebo if it works? It's an interesting discussion ... and I don't agree with Shannon.

As Tim Minchin so gracefully put it:

"You know what they call Alternative Medicine that works?

... MEDICINE!"

By UrbanWildCat (not verified) on 28 Jan 2009 #permalink

While in some cases, modern drugs have done wonders to help cure disease and infections, the idea that modern drugs have extended the average human life span is preposterous. I think clean water and food along with our improved understanding about how to live a healthier lifestyle would have more to do with it.

In China, where Traditional Chinese Medicine, developed and practiced for more than a thousand years is the norm, the average life span there is not lower than in the United States, it's higher.

The problem with modern drugs, is what they have become. Consider the fiasco with Vicodin and most recently Children's Cough and Cold medicines? "Modern - homeopathic medicines, developed in compliance with the HPUS and FDA, provide a safe alternative for more "self-limiting" conditions and should not be tossed out with the bathwater.

In China, where Traditional Chinese Medicine, developed and practiced for more than a thousand years is the norm, the average life span there is not lower than in the United States, it's higher.

This is entirely incorrect. TCM as understood by the majority of people today is a fabrication and reinvention popularized by the Chinese Communist Party. Today, most Chinese citizens who can afford it use the same drugs and other interventions as their counterparts in "the west." While it's certain that the ancient Chinese had their own form of "medicine" as well, the practices that are described as "traditional Chinese medicine" now bear largely no resemblance to them.

If there's anything to credit for the lifespans of the Chinese it's modern science, not "ancient" suppositions about ki and meridians.

If TCM worked so well, then lifespans in China should not have increased since the introduction of western-based medicine, right?

So what was the average lifespan in China 1000 years ago, and what is it now?

||If it's a placebo effect, that's fine with me. I'd rather have a placebo effect that consistently makes me better than a healthy skepticism that leaves me sick.||

Shannon your argument is a false dichotomy. You can be both skeptical of ineffective and costly treatments and enjoy the healthy positive effects that are at the root of placebo treatment. Instead of paying to visit a kindly homeopath who will listen to your problems and then prescribe an ineffective medication, pay to take your niece or nephew out to a movie, go walk your dog in the park, etc.

||The problem with modern drugs, is what they have become. Consider the fiasco with Vicodin and most recently Children's Cough and Cold medicines? "Modern - homeopathic medicines, developed in compliance with the HPUS and FDA, provide a safe alternative for more "self-limiting" conditions and should not be tossed out with the bathwater.||

Why not just give them the bathwater? It's cheaper and as effective. Since it's self limiting (runs its course for 7 days without homeopathic treatment or a week with homeopathic treatment), why not just advise do nothing?

And the reason you can say "the problem with modern drugs" is because drug companies have to collect follow up data and the medical literature is self policing. Nothing is perfect, of course, but I wonder if homeopaths ever publish negative studies or publish studies that homeopathic malaria pills are not only ineffective but actually dangerous as they provide a person with a false sense of security?

Yes, if you give people water, you won't kill them. But you won't save them. If you're aware of any homeopathic remedies for rabies, I'd like to see the research. If you give people drugs, you will save their lives. But there are also risks. If you think the risks far, far outweigh the benefits, then again, I'd like to see your data.

And the reason you can say "the problem with modern drugs" is because drug companies have to collect follow up data and the medical literature is self policing. Nothing is perfect, of course, but I wonder if homeopaths ever publish negative studies or publish studies that homeopathic malaria pills are not only ineffective but actually dangerous as they provide a person with a false sense of security

[ignoring the ignorant] I've said it before, probably even here. There is a large segment of the woo community, that wants desperately to equate notions like homeopathy and qui, with herbal medicines, many of which actually contain compounds that are medicinal. Efficacy by association.

And of course they are all about throwing treatments into the mix that are FDA approved for certain conditions. They may not use them for the conditions they're actually approved for, but what the hell, it's "real" medicine. [/ignoring the ingnorant]

shannon -

And if you should, gods forbid, get cancer? Please tell me that you would get legitimate help.

This is the problem I have with this stuff. People like you and even myself become convinced that the "medicines" we are taking actually work. For my own part it was made worse by the fact that I mainly used herbal medicines. The thing is, a lot of them were actually fairly effective for the things I used them for. Pain relief, insomnia - no problem. Except it was a problem, because some of the plants I used, while effective for what ailed me, also cause undue damage to the kidneys. Thankfully I probably didn't cause much damage, but these are not things to be toyed with.

But then there was other woo to be had. Like homeopathic remedies, which were explained rather badly to me, in a way that made them sound rather reasonable. And cleanses, because what I really needed to be healthy, was to take expensive systems to help me poo. While I do prefer to stay regular, I have found that oatmeal is just as effective as forty to sixty dollar cleansing regimens.

Edward -

Why hurt my head further?

Google Traditional Chinese Medicines and heavy metals. I think even Abel's posted on this topic. Heavy metals, they're not just for Ayurvedic "medicine" anymore.

I am always surprised when people say or assume that there is no research on homeopathy or that the "nano" doses used make no sense. We don't think of the atomic bomb as a "small" dose of a bomb, and likewise, homeopathic medicines are not just diluted, but there is vigorous shaking in-between each dose. Physicists and chemists have noted "nano-bubbles" that influence water structure. For these other more technical issues, see the site of Professor Martin Chaplin, a world renowned expert on water: http://www.lsbu.ac.uk/water/homeop.html and http://www.lsbu.ac.uk/water/memory.html

As for research, see:
WB Jonas, TJ Kaptchuk, K Linde, A Critical Overview of Homeopathy, Annals in Internal Medicine, March 4, 2003:138:393-399. Although this is not a meta-analysis, it is still a very good review of the clinical literature in homeopathy.

Vickers AJ. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza ‐ like syndromes. Cochrane Reviews. 2007. http://www.medscape.com/viewarticle/485935. Four treatment trials (N=1,194) found âpromisingâ results from Oscillococcinum in the treatment of influenza or influenza-like syndrome. Three prevention trials (N=2,265) did not find efficacy of Oscillococcinum in the prevention of these conditions.

J. Jacobs, WB Jonas, M Jimenez-Perez, D Crothers, Homeopathy for Childhood Diarrhea: Combined Results and Metaanalysis from Three Randomized, Controlled Clinical Trials, Pediatr Infect Dis J, 2003;22:229-34. This metaanalysis of 242 children showed a highly significant result in the duration of childhood diarrhea (P=0.008).

Frass, M, Dielacher, C, Linkesch, M, Endler, C, Muchitsch, I, Schuster, E, Kaye, A. Influence of potassium dichromate on tracheal secretions in critically ill patients, Chest, March, 2005;127:936-941. (Research conducted at the University of Vienna on people with chronic obstructive pulmonary disease)

Bell IR, Lewis II DA, Brooks AJ, et al. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo, Rheumatology. 2004:1111-5. Participants on active treatment showed significantly greater improvements in tender point count and tender point pain, quality of life, global health and a trend toward less depression compared with those on placebo. People on homeopathic treatment also experienced changes in EEG readings. âHelpfulness from treatmentâ in homeopathic patients was very significant (P=.004).

Belon P, Banerjee P, Choudhury SC, Banerjee A., Can administration of potentized homeopathic remedy, Arsenicum album, alter antinuclear antibody (ANA) titer in people living in high-risk arsenic contaminated areas? I. A correlation with certain hematological parameters. Evid Based Complement Alternat Med. 2006 Mar;3(1):99-107.

And there have been good basic science studies too:

Sunila ES, Kuttan R, Preethi KC, and Kuttan G. Dynamized Preparations in Cell Culture, eCAM. October 3, 2007; doi:10.1093/ecam/nem082

Complement Ther Med. 2007 Jun;15(2):128-38. Epub 2007 Mar 28. The in vitro evidence for an effect of high homeopathic potenciesâa systematic review of the literature.
Witt CM, Bluth M, Albrecht H, Weisshuhn TE, Baumgartner S, Willich SN. From 75 publications, 67 experiments (1/3 of them replications) were evaluated. Nearly 3/4 of them found a high potency effect, and 2/3 of those 18 that scored 6 points or more and controlled contamination. Nearly 3/4 of all replications were positive.

Banerjee, P.; Biswas, S. J.; Belon, P.; Khuda-Bukhsh, A. R. A Potentized Homeopathic Drug, Arsenicum Album 200, Can Ameliorate Genotoxicity Induced by Repeated Injections of Arsenic Trioxide in Mice. Journal of Veterinary Medicine, Series A, Volume 54, Number 7, September 2007 , pp. 370-376(7). DOI: 10.1111/j.1439-0442.2007.00945.x

Elia, V, and Niccoli, M. Thermodynamics of Extremely Diluted Aqueous Solutions, Annals of the New York Academy of Sciences, 879, 1999:241-248.

Rey, L. Thermoluminescence of Ultra-High Dilutions of Lithium Chloride and Sodium Chloride. Physica A, 323(2003)67-74.

For more...go to http://www.homeopathic.com

Dana,

"Nano" that's a new one I've not heard applied to homeopathy. Are you saying homeopathy preparations also include water that still has detectable amounts of the active substance?

Your atomic bomb comparison is a non sequitur. Nuclear weapons have quite a lot of plutonium. I don't see how that rescues your position.

Karl, Dana Ullman has been told that "nano" has a specific meaning several times (10^-9), yet he still thinks he can redefine it to whatever he wants.

Now from:
http://www.sciencebasedmedicine.org/?p=355#comment-12570

"Itâs high time to invoke a new, utterly ad hominem rule similar to Scopieâs Law (see: http://rationalwiki.com/wiki/Scopie%27s_Law)

It will be called the âDull-Man Law.â It reads:

âIn any discussion involving science or medicine, being Dana Ullman loses you the argument immediatelyâ¦and gets you laughed out of the room.â "

Look further down that same thread and there is another more general proposed "Law":

âPerhaps their homeopathic philosophy suggests to them that any arguments are made more potent if they are greatly diluted with tens of thousands of meaningless words.â

âjaycueaitch

HCN -

âPerhaps their homeopathic philosophy suggests to them that any arguments are made more potent if they are greatly diluted with tens of thousands of meaningless words.â

âjaycueaitch

After a really intense session with my therapist, I needed that laugh. I realize that you didn't originate it, but thanks so much for posting it.

HCN is of the belief that if HE says it, it must be true.

The origin of the word "nano" is dwarf or very small. It also has a meaning as one-billionth, but this is not its only meaning. I assume that HCN will now fight with Steve Jobs about his product, the Nano.

I encourage people to explore the silica hypothesis and the influence of nano-bubbles and how both of these factors influence the structure of water. And in addition to these influences, simply follow the good research that has both internal AND external validity.

A well-design trial that has no external validity is like throwing out all antibiotics just because they don't cure viral disease. Get a clue, in homeopathic or any dose...

And here's another clue for you all...google "Canova" and homeopathy...and find a treasure...Gimpy has been silenced from it...

And yet there is absolutely no proof that homeopathy has cured a non-self limiting disease. Still waiting for the evidence that it works better than standard treatment for rabies, which is what Andre Saine claims.

Just a reminder, Dana, "nano" has a specific meaning in science (which has been explained to you in detail several times), despite how someone uses it in marketing a product.

Though you may think it is a cute way to describe the unnatural dilutions that you promote, your use makes you look as silly as anyone else. And yes, even Steve Jobs looks stupid using it as a marketing tool (and really, I did not know he used it, nor do I care).

Just like you look really idiotic with this statement: "A well-design trial that has no external validity is like throwing out all antibiotics just because they don't cure viral disease."

Just show us the actual factual evidence that homeopathy has actually cured ONE non-limiting disease. There is a lone list: syphilis, AIDS, rabies and even bacterial infections like strep throat.

You been asked for that data for well over a year, and yet the only thing you have responded with is bleating on bad studies with either bad sampling or subjective criteria in third rate journals!

I finally realized why you have now changed your question from ANY clinical evidence to now just FOUR different diseases: these are diseases from which you suffer! You are rabid. You are syphilitic (read about the effects of syphilis on the brain, and it is a perfect description of your personality...or is it just a coincidence?).

You can continue to change the goal posts, but your syphilitic blindness won't allow you to see the results. What a pity...

And heck, I previously referred to you evidence of malignant cancer...but THAT wasn't good enough when you change the goal posts (again)...

Your idiocy is showing.

That was not moving the goalposts, that was a list of suggestions that were included in Badly Shaved Monkey, Rolfe and others on JREF over the past couple of years. You only need to provide one case:
http://forums.randi.org/showthread.php?t=119159 (and other threads there, plus postings on Quackometer blog, and elsewhere)

I have used syphilis because it is one of the miasms that Hahnemann invented (and claiming I have syphilis while missing the connection to the Organon is good proof that you are completely clueless), and also rabies because of the Andre Saine's claim. Rolfe has included Addison's , and BSM is appalled at the claims of homeopaths to cure AIDS in Africa recently.

Your lack of an answer is quite telling.

Wow... no wonder you got annoyed with me when I mentioned Airborne! Actually, your article was interesting. Apparently I didn't know the real definition of homeopathic medicine and the difference between herbal medicine. I was confused by the "Throat Health" tea in your office the other day but now it all makes sense!

I have previously reported evidence of cure of serious non-self-limiting disease, as long as malignant cancers count. If so, read this from ONCOLOGY REPORT (2008):
http://209.85.173.132/search?q=cache:q0SPoyu9P8oJ:www.ayudacancer.com/f…

Wilsontown and Oracâs previous âanalysisâ of the study on COPD in âCHESTâ is an embarrassment to scientifically-minded people (and I assume the readers here would like to think of themselves as such). I therefore challenge Wilsontown or Orac or any of your to simply take out the THREE best-responding patients from the homeopathic treatment group and tell me what results remain. (The number 3 is chosen here due to this being the difference in the moderate to severe COPD). We all eagerly await your answer.

This study in CHEST did not seek to evaluate a âcureâ for COPD, but hospitalization stay was cut in HALF (!) and reintubation was not needed in the homeopathic treatment group. Is someone out there going to tell a COPD patient that THESE results are not important? Come on, say it!

Okay, so the Chest article was a statistical fluke. Look at the other citations Dana provides. Discard those that are not clinical, and those in quack magazines. What is left?

An inconclusive Cochrane Review.

An article in Rheumatology that is too small to be definitive.

Ditto the paper in Ped. Inf. Dis.

An opinion piece in AIM.

Of all the tens of thousands of claims made by homeopaths over 200+ years, this is the best evidence. No, master Dull Man, you owe us citations of thousands of high-quality articles.

I see that for the most part, when Dana Ullman goes to the trouble of listing research, you then find it necessary to attack him or to engage in semantics on the word "nano", or to make shifitng contextual references rather than discuss the research. One of the researchers listed, for example, Dr. Iris Bell MD, PhD, is a genuine scientists and her presentation in a debate on Homeopathy, which can be found on YouTube, is quite enlightening and interesting, I believe especially to those sceptical.

In each of these instances, those of you engaging in these diversions avoids the main issue, that the research DOES exist, is done by qualified and fully credentialed scientists. and is indicative that it is worthwhile to continue researching and analyzing Homeopathy.

Those of you who take this very anti-intellectual denialism are in fact cutting yourselves off from science and, I believe, allying yourselves unintentionally with political and special interests which have much to lose (VERY much) as utilization of Complementary and Alternative medicine increase.

On all fronts the science is continuing to support Homeopathy and to attempt to pretend otherwise and to make personal attacks against anyone pointing this out is surely not in the spirit of rational discussion.

For example, a famous Lancet 2005 meta analysis wrongly claiming to "prove" that Homeopathy was no better than placebo has been convincingly re-examined and found to be worthless in a recent Journal of Clinical Epidemiology article.

Likewise, experiments by M. Ennis clearly indicative of biological activity being stimulated by high dilution solutions, solutions which no longer contain molecules of the stimulant, have been published (Inflammation Research vol 53, p181) and these experiments have been repeated successfully numerous times, most recently in 2007 and 2008 by Sainte-Laudy. (A 2001 BBC Horizon documentary purported to show her experiment produced negative results but after some effort in questiong them by Ennis, the producers sheepishly addmited that they never intended to repeat her experiment and their researcher indicated that he had used a chemical which killed the cells under test.)

People in discussion groups such as this one continue to uphold a contradiction - they insist they are supportive of genuine scientific research but then attempt to characterize ALL scientific researchers in Homeopathy as quacks and to completely ignore ALL the research. This contradiction, coupled with attacks on people clearly showing that valid research on Homeopathy, by bona fide scientists does exist,
indicates the most serious anti-intellectual and irrational bases lie at the heart of the anti-Homeopathy position - a position of scientific elitism and denialism in which the research supporting only one philoophy and one point of view is allowed and the research which indicates the slightest possibility of major scientific paradigm shifts is denounced, ignored or otherwise hysterically and irrationally attacked with innuendo.

For those interested in getting to the truth, a quick search turns up Dana Ullman's superb web site listing numerous books and articles, the wonderful blog by laughingmysocksoff in which the anti-Homeopathists are engaged in a friendly, relaxed and non-insulting manner and the limitations and fallacies of their pseudo scepticism can clearly be seen and their are numerous other sites, for example that of the New Zealand Homeopathic Society, which are suggested to those who really want to know what it is all about or really want to engage in a real debate rather than chidlish name calling innuendo.

By James Pannozzi (not verified) on 02 Feb 2009 #permalink

Dear Mr Pannozzi, if I may be clear on my perspective and respectful of your position:

1. No scientific basis exists to support any biological of physiological action of true homeopathic medicines (not ultra-dilute).

2. Any evidence for positive efficacy of a homeopathic remedy over that of placebo has thus far been attributed only to statistical chance (p < 0.05 means roughly that we accept the risk that 5% of positive trials are false negatives; publications reporting negative results are far less likely to appear in the peer-reviewed literature for any drug or practice). Hence, no single study conclusively proves or disproves the efficacy of a remedy.

I submit that my position remains one of openmindedness. My position is neither elitist nor denialist. I have made a conclusion about the lack of homeopathic efficacy based on facts alone.

@James Pannozzi | February 2, 2009 11:39 AM wrote "People in discussion groups such as this one ... insist they are supportive of genuine scientific research but then attempt to characterize ALL scientific researchers in Homeopathy as quacks and to completely ignore ALL the research."

I did not do that, I addressed the articles presented. Non-clinical studies are not acceptable (e.g., Ennis). There are quack magazines (Homeopathy, eCAM, etc.) that are not properly peer-reviewed; they can be ignored. I have looked at many such magazines, I even had a note published in Homeopathy a while back in response to a particularly incompetent article by Rustum Roy. I no longer waste my time with those magazines.

There are no persuasive clinical studies that conclusively support any homeopathic remedies. Yes, research exists, it is just not good. Your complaints are unfounded.

@Abel, it looks like part of your post was truncated (perhaps by the HTML demons). You were noting that apparent success in homeopathy may be a statistical fluke. There is something else we (as scientists) do not often consider, and my old habits got the better of me and I omitted to mention (above) the fact that many, positive AltMed studies are marred by fraud. In both homeopathy and "supplements" there is always the possibility that clinically effective drugs are present in the preps.

On another forum, someone reported attending a talk by Arthur Grollman (Stony Brook) who analyzed a lot of OTC homeopathic preps and found 1/3 were adulterated (most commonly with caffeine or OTC analgesics). I looked at his web-site and saw no indication of that work. It would be a great project for high school or undergrad-college students who can do (at least) TLC.

The FDA often reports that "natural Viagra" is spiked with the unnatural sort.

The blame for this always lies with the entity that made the prep. It can be difficult to know if the clinical researcher, not using home-made preps, knows about it. Fraud is really hard to catch if the researchers are in on it because they can always give me an un-adulterated sample if I want to check it.

@Abel Pharmboy
Your item 1 is, I believe, quite correct to distinguish the two things and Ennis' experiments by no means prove Homeopathy but are merely suggestive that research continue. I believe she remains sceptical of Homeopathy to this day. No quackery there, just science and scientists doing their work. I would like to make note that her results have no explanation in known science.

Your item 2 invites comment from Dana Ullman and the generalization made presupposes that you have surveyed ALL such tests and ALL the literature with no mention of your exclusionary criteria as to what consitutes acceptable tests. I'm well aware of crap research tests in CAM, but do not dismiss ALL the testing because of this nor demean ALL the researchers and ALL the journals.

Lastly with regards to item number 2, I will point out, in my opinion, that the body of knowledge in standard medicine, now wrongly (I believe) called "evidence" based medicine implying scientfically exact mathematical evidence, does NOT rely in its totality on double blinded placebo controlled testing for the bulk of its knowledge, but rather, in my opinion, on the accumulated clinical and case "evidence" (evidence of quite a different type) history as published by practicing MD's, surgeons and other standard medicine professionals over a long period of time.

There are NO double blinded randomized placebo controlled studies for heart surgeries, knee replacement operations, chemotherapy on humans for obvious ethical reasons and so that body of knowledge is clinical in nature, EXACTLY as is the case in Homeopathy. When THAT is factored in to the evaulative criteria, rather than relying exclusively on testing methods more germane to pharmaceutical drug testing, the picture changes and BOTH in standard medicine and in Homeopathy, treatments can be seen to be efficacious here, adquate there and sometimes, as in, for exmaple, lung or pancreatic cancers of certain types, totally insufficient across all systems of medicine.

Thanks for hearing me out, I've talked too much and will shut up now.

By James Pannozzi (not verified) on 02 Feb 2009 #permalink

James Pannozzi -

Please, by all means don't feel the need to shut up. You're polite and bring up important points about evidence based medicine. The reason that Dana Ullman has been treated the way he has, is that he is not making points that are anything new to the people hearing them and has often resorted to mockery and rudeness when they have been thoroughly debunked.

I would like to relate a little more of my experience, because I think it will better illustrate the logical fallicies that are all too often prevalent in this discussion. I am what I like to describe as pathologically credulous, much like Mr Ullman. More importantly, I was victim to the phenom I describe in the comment I made above, the idea of efficacy by association.

For many years I lived without access to reasonable health care. In order to get some of the medications that I need, I found herbals that could provide similar benefits to some pharmaceuticals. Along the way I got caught up in seemingly reasonable ideas, such as the notion that the plants might be preferable to their synthesized pharmaceutical counterparts. That there was probably something in many of the plants that would actually aleviate some of the side effects caused by many pharmaceuticals. It wasn't until I was able to learn more, from people who have been involved in research, that some of the plants that I was using actually have very nasty side effects of their own.

My introduction to homeopathic remedies, was through Oscicillium (sp?). A friend convinced me to try it, when I started getting the symptoms that were leading many of the people around me into a really nasty bout of the flu. I took the Oscio and low, I just had a low grade cough and general funk, but never got the flu - even after my partner, the women I slept next to every night and my son got the actual flu. It was easy for me to attribute it to the oscio and soon I made sure we had it on hand during flu season. I also expanded our selection of homeopathic remedies, to include some for anxiety and pain - though it didn't work all that well for either. But I thought it seemed to help a little and look how well the Oscio worked.

It wasn't until I had the intersect of discovering the Seed science blogs and had a fortuitous discussion with one of my brothers that it all made more sense. The science bloggers (Might even have been Abel) were writing about Oscio and the multi-million dollar goose. I got into a defense of it with one of my brothers, who just thought he'd remind me that when we were growing up, I rarely got the flu, even if he and the other brother still at home at the time did. The year before I discovered Oscio, I happened to have a run in with the flu, that kind of through me. Because while I rarely come down with a full on flu, on the occasions I do, I get really damned sick. Spewing out both ends, wish I would just die sort of sick.

What had sold me on homeopathy, was my own selective memory and the fact that it was being encouraged by someone who had quite often helped me find herbal medicines that actually work (unfortunately a couple of them also have some nasty effects on the liver and kidneys) for the symptoms I was trying to alleviate.

If it were just a matter of taking something that won't do you any good, but won't harm you, I honestly wouldn't have a problem in the world with homeopathy. The problem is that there are those who want to claim it as a functional cure for malaria, HIV/AIDS, some cancers and a host of other lifethreatening illnesses. People actually die because of this bullshit. And that's the problem. It's being pushed to replace necessary, lifesaving treatments.

Hey Sloppy Joe,

You said that the study in the Pediatrics Infectious Disease Journal was "too small." Ha! Really!? Is 292 children in a study too small?

With such "defenders of science" as you, you give science a bad name.

And strangely enough, you are one of the few who doesn't resort to personal attacks. So, with the "substantative" attacks against homeopathy stand on jello and simple sloppiness.

Please give us a reference to a good randomized double-blind trials on heart surgery or knee replacements, OR please start called cardiologists and rheumatologists "quacks." Come on...

And that study published in RHEUMATOLOGY also found significant differences in EEG readings. What a coincidence!

As for the Oscillococcinum trials, there are now 4 large trials, each with 300 patients. There's another coincidence.

And David Reilly and colleagues at the University of Glasgow conducted FOUR trials, 2 in the LANCET and 1 in the BMJ...and together, found a p-value of P<0.0007. What a coincidence!

Oh...the Shang "analysis" neglected to include any of Reilly's studies without any explanation. Those coincidences keep on happening...

Yes, Dana (MPH!!), 292 subjects is interesting, not compelling. Also, as I wrote (above), we need strong evidence the homeopathic preps were not adulterated with known drugs.

Actually, there was an RCT on heart surgery many decades ago. However, your question is a red herring. There is no reason not to do RCTs on homeopathy; except, they are never convincing. If you had better studies to cite, you would have done so.

In the text of the Shang study, it explains the selection criteria. You have had this explained to you.

Well, Ms. Malik, ignoring the fact that there is no such thing as "allopathic medicine," what evidence do you have for homeopathic cures? Brave sir Dana (MPH!!) doesn't have any reliable evidence, this is an opportunity for you to shine.

||There are NO double blinded randomized placebo controlled studies for heart surgeries, knee replacement operations, chemotherapy on humans for obvious ethical reasons and so that body of knowledge is clinical in nature, EXACTLY as is the case in Homeopathy.||

And yet one can ethically design double blinded randomized placebo controlled studies for a broad range of homeopathic claims. But so few are done. Odd that.

@ "There are NO double blinded randomized placebo controlled studies for heart surgeries ..."

Actually, there were at least two. They were done long ago. There have also been placebo controlled studies of knee surgery and brain surgery. I wish I could remember the sources.

Aspirin (acetylsalicylic acid), histamine dihydrochloride, metals such as silver, zinc, copper, other plant extracts such as beladona, and many many other active ingredients are found in the Homeopathic Pharmacopoeia of the US. These are all effective homeopathic actives of traditional homeopathic medicine AND modern medicines, including Rx, that have proven their effectiveness. Homeopathy is no more voodoo/witch craft than many of the modern modified protein drugs, psych drugs, etc that are terribly dangerous. If you ever get pink eye try Similasan brand homeopathic Pink Eye Relief - works faster than prescription products...

By Thor Henry (not verified) on 07 Feb 2009 #permalink

@Thor Henry,

The Homeopathic Pharmacopoeia is not backed by any facts. It is the result of legislation by an ignorant US Congress.

||Aspirin (acetylsalicylic acid)...many many other active ingredients are found in the Homeopathic Pharmacopoeia of the US. These are all effective homeopathic actives of traditional homeopathic medicine AND modern medicines...||

I'm not sure what your point is. Homeopaths use ASA? The issue is the water memory claim. Psychics use pens. Pens have been demonstrated to work. Therefore this is good evidence psychic claims should be accorded plausibility. Is that what you're trying to argue?

||Homeopathy is no more voodoo/witch craft than many of the modern modified protein drugs, psych drugs, etc that are terribly dangerous. ||

A "you did it too" fallacy? Because some drugs are later discovered to be placebos, therefore your placebo is okay too?

||If you ever get pink eye try Similasan brand homeopathic Pink Eye Relief - works faster than prescription products...||

A claim supported by?

If something works for me, you call it anecdotal evidence and discount it...why? Is not the evidence of personal experience good enough? It is my personal opinion (and oh because I'm not a scientist that has no real veracity, or value, right?) What total arrogance the so called "scientific community" has!

For those of you who are short on memory might I remind you that the "science" of chemistry evolved from alchemy. The rest of the so called sciences evolved from Botany, Horticulture, Animal Husbandry and yes, folk medicine, which included what is now looked down upon as "alternative medicine".

I personally don't care what "modern science" says or what the FDA in its short sighted ignorance says is ok. I neither need nor want them telling me what I can or cannot take to treat myself and family nor do I trust their judgment. I trust my own experience and the tried and true methods which have worked for hundreds/thousands of years before "science" or the FDA were ever around to decide for me what was safe and effective.

My experience with the "medical community" have taught me that doctors today are a corrupted lot out for a buck who either can't or won't read and don't have a clue in most cases what is wrong with patients or how to treat the real cause of an illness or disease.

They only deal in symptoms and are in the business of keeping people sick so they don't run out of customers. The whole thing is an awful fraud from the FDA to the AMA.

Thank you, I don't need a double blind placebo controlled study to tell me whether something makes me better or worse. I can find that out for myself through experience which is a much more reliable measurement of efficacy and safety than some "scientific study" which is funded by pharmaceutical companies and interpreted by statisticians paid by pharmaceutical companies with a view toward selling their drugs.

The real issue is not whether "alternative medicine or homeopathy" is safe and effective. That's already been proven by many years of safe effective use by hundreds of thousands of people across cultures for ages of time. The issue is competition for market share.

The pharmaceutical industry doesn't want the competition for consumer dollars. It has nothing to do with real science or pseudo science. "Scientists" are elitist, myopic and biased in their ignorance and arrogance.

Pharmaceutical companies originally made life saving drugs (back when they were honest) from natural substances. That means herbs, roots, berries and barks. The same thing used in "alternative medicine".

I'd rather have my medicine natural than chemically and genetically altered by people I don't know or trust.

I have used "alternative or natural medicine" all
my life, my mother, grandmother and great grandmother were all "alternative medical practitioners".

Their code of ethics was stringent and demanding. "Do NO HARM!!" and they lived up to it.

Can "modern medical science", or pharmaceutical companies claim as much when they are irresponsibly, shamefully and without compunction killing thousands of people every day? I think not!!

||If something works for me, you call it anecdotal evidence and discount it...why? Is not the evidence of personal experience good enough? It is my personal opinion (and oh because I'm not a scientist that has no real veracity, or value, right?) What total arrogance the so called "scientific community" has!||

If something works for you, great. If you want to bottle it, sell it, and advise people it is safe and effective and should be used over another treatment then we would call that anecdotal evidence and NOT discount it but challenge you to establish it is safe and effective. It's that simple.

||Their code of ethics was stringent and demanding. "Do NO HARM!!" and they lived up to it. ||

And yet when homeopaths advise people their water can protect them from malaria and it doesn't they are doing harm. No?

||My experience with the "medical community" have taught me that doctors today are a corrupted lot out for a buck who either can't or won't read and don't have a clue in most cases what is wrong with patients or how to treat the real cause of an illness or disease.||

My experience is the polar opposite of yours. Either you're unlucky picking good doctors or I'm lucky at picking good doctors. Huh.

Ms. Malik,

You are the Energizer Bunny of homeopathetic. You never stop, you just wander aimlessly.

Homeopathy is non-toxic system of medical science originated in Germany by Dr. Friedrich Samuel Hahnemann (1755-1843) (the founder and father of homeopathy). He was M.D. in conventional medicine. The term âhomoeopathyâ was coined in 1807.

The four fundamental principles of Homeopathy are: -

1. Law of similars/Like cures like (1796): Disease can be cured by a medicinal substance given in micro doses that produces similar symptoms in health people when given in large doses.

2. Law of minimum dose (1801): Since the homoeopathic medicines act at a dynamic level, only a minute quantity of the medicine is administered which is enough/sufficient to stimulate the dynamically deranged vital force/innate healing powers to bring about the necessary curative change in a patient

3. Law of simplex (1810): At any given time, only one remedy can be the exact similar to the presenting disease condition of the patient. So a single remedy (one remedy at a time) is given based upon their constitution/totality of the symptoms which includes physical, mental, and emotional aspects/symptoms.

4. Heringâs law of five directions of cure (1845): Cure progresses from above downwards, from within outwards, center to periphery, from more important organ to less important one, in reverse order of coming of the symptoms