Since it was first published, the “Swiss government report” on homeopathy has been celebrated as the most convincing proof so far that homeopathy works. On the back of this news, all sorts of strange stories have emerged. Their aim seems to be that consumers become convinced that homeopathy is based on compelling evidence.
Readers of this blog might therefore benefit from a brief and critical evaluation of this “evidence” in support of homeopathy. Recently, not one, two, three but four independent critiques of this document have become available.
Collectively, these articles [only one of which is mine] suggest that the “Swiss report” is hardly worth the paper it was written on; one of the critiques published in the Swiss Medical Weekly even stated that it amounted to “research misconduct”! Compared to such outspoken language, my own paper concluded much more conservatively: “this report [is] methodologically flawed, inaccurate and biased”.
So what is wrong with it? Why is this document not an accurate summary of the existing evidence? I said this would be a brief post, so I will only mention some of the most striking flaws.
The report is not, as often claimed, a product by the Swiss government; in fact, it was produced by 13 authors who have no connection to any government and who are known proponents of homeopathy. For some unimaginable reason, they decided to invent their very own criteria for what constitutes evidence. For instance, they included case-reports and case-series, re-defined what is meant by effectiveness, were highly selective in choosing the articles they happened to like [presumably because of the direction of the result] while omitting lots of data that did not seem to confirm their prior belief, and assessed only a very narrow range of indications.
The report quotes several of my own reviews of homeopathy but, intriguingly, it omitted others for no conceivable reason. I was baffled to realise that the authors reported my conclusions differently from the original published text in my articles. If this had occurred once or twice, it might have been a forgivable error – but this happened in 10 of 22 instances.
Negative conclusions in my original reviews were thus repeatedly turned into positive verdicts, and evidence against homeopathy suddenly appeared to support it. This is, of course, a serious problem: if someone is too busy to look up my original articles, she is very unlikely to notice this extraordinary attempt to cheat.
To me, this approach seems similar to that of an accountant who produces a balance sheet where debts appear as credits. It is a simple yet dishonest way to generate a positive result where there is none!
The final straw for me came when I realised that the authors of this dubious report had declared that they were free of conflicts of interest. This notion is demonstrably wrong; several of them earn their living through homeopathy!
Knowing all this, sceptics might take any future praise of this “Swiss government report” with more than just a pinch of salt. Once we are aware of the full, embarrassing details, it is not difficult to understand how the final verdict turned out to be in favour of homeopathy: if we convert much of the negative data on any subject into positive evidence, any rubbish will come out smelling of roses – even homeopathy.
Edzard Ernst wrote: “Recently, not one, two, three but four independent critiques of this document have become available.”
Here’s a fifth:
“The Swiss report on homeopathy represents an embarrassing failure for the Swiss government. They should suspend any decisions based upon this report and put together an new scientific panel to perform a fresh and legitimate review of homeopathy. Or, they don’t have to reinvent the wheel – they can just review the UKs thorough and rigorous report and adopt its findings. Homeopathy is witchcraft and deserves no government support of any kind.”
study it, and watch a homeopaths patient outcomes. see the cures come in thick and fast for yourself. Then say its witchcraft. (Witchcraft by the way is wise craft…a healing and natural lifestyle… and not hollywood madness or a thing to be seen as derrogatory.)
lol thats funny coming from you prof ernst.
“were highly selective in choosing the articles they happened to like [presumably because of the direction of the result] while omitting lots of data that did not seem to confirm their prior belief, and assessed only a very narrow range of indications.”
“it was produced by 13 authors” 12 more than most of your work.
“this report [is] methodologically flawed, inaccurate and biased”.
Sounds like the pot calling the kettle to me.
In which scientific publication – not blog, twitter etc – did I do all these things that you accuse me of?
Come on, fed up, you’ve had two days to substantiate your accusation. If you can’t be specific you get dismissed as just another embittered quack troll.
The Swiss people wanted to continue using Homeopathy and having it available as a part of their national health insurance.
The report was part of this process. The result shows people can still have their own opinion which trounces the posturings of those who would tell them what they must think.
Why do patients not respond to scientifically effective treatments, old friend?
Or rather the Swiss homeopathy industry lobbied for a referendum and the authors of the supposedly neutral report orchestrated a campaign for a yes vote, which covered many forms of alternative-to-medicine.
But Andrew, popularity is not the same thing as validity. It really isn’t. Look at the number of doctors who are pestered for antibiotics by people with viruses.
Guy Chapman’s funny. Because you do not say anything about the British report where the pressure was for the Sense About Science?
Andrew, you are surpassing yourself! The Swiss had a referendum on this, and the dodgy report which my post is about had nothing to do with this. The Swiss government had to abide by the result of the vote not because but despite the report, so they decided to pay for homeopathy for a short trial period and then re-visit the scientific data.
Yeah…that “short” trial period is FIVE years…but spin away and make believe that there is no research confirming the efficacy of homeopathy and no evidence that patient satisfaction with homeopathy is significant (heck, the fact that 2/3 of the Swiss population wanted to include homeopathy in their national health insurance means “nothing” to you…but it means a lot to others!).
And the fact is that dozens (!) of surveys consistently confirm that people who use homeopathic medicines are more educated than those who don’t.
But worst of all, your arrogance embodies an anti-scientific attitude.
I do not think that telling the truth is arrogant. telling lies about the “Swiss report” is also not arrogant, it is dishonest.
There are plenty of surveys, you are right, but they tell us NOTHING about efficacy. There are also some positive trials, and cherry-picking will thus generate a positive picture about efficacy. But that’s cheating as well: the totality of the evidence fails to be positive.
Please try to get your facts right. It was two-thirds of those who voted in the referendum who wanted homeopathy reimbursed by the Swiss government, not two-thirds of the Swiss population.
It is not a ‘trial’ period, it is a temporary period of reimbursement. Do you understand why the period is temporary and not permanent? If so, please tell us what homeopaths have to do by 2015 to achieve permanent inclusion and what progress they are making towards that.
Dana, a scientific attitude requires that hypotheses are tested, rather than experiments designed which can only confirm them.
Please cite the peer-reviewed and replicated experiments that test the so-called “law of similars” and establish it as a general principle. I am not aware of any such research.
Then, please document the peer-reviewed and replicated experiments which show that potency increases with dilution. Don’t try to smokescreen with hormesis, as that effect is found only for a few substances in a narrow band and dies off rapidly as dilution increases.
Then, please document the peer-reviewed and replicated experiments which demonstrate the mechanisms by which dilutions past the point of non-existence can deliver a therapeutic effect.
Then, please document the findings from independent research in other areas science that corroborate these experiments.
I think you will find it difficult to provide any of this. I am not aware of anyone finding a homeopathy effect who was not actively looking for one (and scientists all know, from the n-ray debacle, that you simply must not do that).
There are many, many broken links in the evidential chain that would be required to establish homeopathy as valid. Every single homeopath with whom I have discussed this shows themselves either not to understand the scientific method, or to fall back on “but it works!”, without acknowledging that this result is also consistent with the null hypothesis of placebo effect, natural history of disease, cognitive bias and other things which (unlike homeopathy) can be independently proven to exist.
The scientific method is absolutely the heart of this. I have never seen a study supportive of homeopathy that did not consciously set out to deliver a supportive result.
Dr Andrew Sikorski said:
As Edzard said, the HTA had nothing to do with the Swiss Government’s decision to allow a second period of temporary reimbursement for homeopathy; it was simply the outcome of the referendum after a campaign by Ja zur Komplementärmedizin. Do you know what will happen in 2017?
It’s also notable that the authors of the purportedly neutral “Swizz report” orchestrated that campaign, and were doing so during the period of preparation of the revised version of the report which is, in translation, the version most of us will have seen.
Indeed. Many homeopaths still seem unable to grasp that the English published version was not the HTA submitted to the PEK, but was added to and amended by homeopaths.
Andrew knew all this, I suspect. Do all homeopaths deliberately mislead the public? Is the term “mislead” perhaps to kind a word for this?
All would be too general, but certainly most of the leading lights.
It was illuminating how hard a certain homeopath tried to prevent the fact that most homeopathic preparations contain nothing but sugar, water and alcohol from appearing in Wikipedia.
There’s an extended debunking at http://rationalwiki.org/wiki/Homeopathy_in_Healthcare:_Effectiveness,_Appropriateness,_Safety,_Costs which also addresses some of the bogus claims made about the report by the likes of Dana Ullman. Of course Dullman continues to make these claims even though the errors have been pointed out to him.
Dullman, Sikorski etc – I seriously wonder why they keep on preaching lies. They are like fanatical evangelists, blind to the truth.
Why do patients not respond to scientifically effective treatments, old friend?
Andrew, you should seriously consider stopping to make a fool out of yourself!
My dear Edzard,
If you had any serious knowledge of homeopathy and had prescribed the remedies accurately for yourself or others, you would have seen that it works. You would not be out here trashing a science that millions of other people ( including thousands of physicians around the world have seen to be highly effective.
So, if you still say it doesn’t work, then you either you never used homeopathy, or you lacked the skill to use it properly, or you have some other agenda. Many of us in the community believe that you are too literate to have missed homeopathy’s value and so believe you are a shill for pharma. Or maybe you are bitter because homeopathy failed to save someone close to you. Whatever the reason, you seem to have chosen the dark side.
Mr Schmulker, do you know what a “delusion” is?
Consider the late Prof. Richard Feynman’s assertion that the easiest person to fool is yourself. You won’t consider it for sure, but if you believe a fraction of what you type then you are a perfect example of what Feynman meant.
There is no science in homeopathy apart from the empirical fact that it is nonsense. The effect of dilution isn’t to make anything more potent, rather the contrary. The miasma theory of disease has been long discredited.
As for facts being decided by popularity, it wasn’t so long ago (only a few centuries) that you could find any number of highly authoritative people to assert in no uncertain terms that the Earth is flat. If you had any serious knowledge of the Earth you would know what these ancient wise others knew… that the Earth is incontrovertibly flat.
Lastly, if I may ask you for a favour, could you please provide one evidenced and documented case study showing homeopathy incontrovertibly curing anything at all in the last 200+ years. You should have no trouble providing millions of case studies, but one example showing an incontrovertible cure will do. Many thanks.
“my dear edzard” … “my old friend”… Is patronising BS endemic in homeopathy? do you know how pathetic you really are?
A bit like consistently and persistently spelling someone’s name wrong even when it is spelt out in bold above their postings 🙂
So why do patients not respond to scientifically effective treatments, old friend?
An individual may not (for some unknown reason) but a sufficiently large afflicted group will have a statistically measurable response compared to a similar control group. That is the definition of a scientifically effective treatment.
I gave homeopathy a whole chapter in my book Deceived Wisdom. Of course, I could have abbreviated said chapter significantly: BS
Alan: your suspicion that I am a bitter, disappointed homeopath who became a pharma shill is great – pure comic gold!
Why shouldn’t a scientist not be interested in researching an ‘unknown reason’ for something?
Isn’t the epitome of science to explore events which happen ‘for some unknown reason’ exactly in order to scientifically deduce that reason!?
Kasilas’ statement scientifically indicates where kasila#s#’s brain is resident?
Oh Edzard, old friend, Alan is certainly unlikely to consider you to be a homeopath as you only ‘had exposure’ to homeopathy.
“Isn’t the epitome of science to explore events which happen ‘for some unknown reason’ exactly in order to scientifically deduce that reason!?”
How disingenuous you are.
The first scientific thing to do is determine whether what is reported to have happened actually has happened. Only then can one investigate why. Since it is easy to establish (and it has been incontrovertibly established) that homeopathy itself does nothing, there is nothing in that regard left to investigate. There is no “why” to investigate. The psychology of it is another matter, but that is irrelevant to your spurious, patronising nonsense.
If what you assert is really true then once again I ask for a single documented, evidenced case study showing homeopathy incontrovertibly curing anything at all, ever. What could be simpler for you than to enlighten an ignoramus such as me with a case study.
I cannot understand why no homeopath can produce a single case study showing a cure that can incontrovertibly be attributed to homeopathy. According to the never ending supply of incontrovertible claims for efficacy there should by now (after 200+ years) be hundreds of millions of such case studies, all documented, evidenced and filed away. But not a single such case study has ever been produced.
In the real world, if you assert the existence of unicorns it would be reasonable for me to ask you to produce a live one to show me. I wouldn’t expect you to respond with a pile of bullshit telling me why they exist and and that millions of other people believe in their existence, and not show me an actual example.
Yet this is exactly what people like you do repeatedly, ad nauseum, which suggests either you are hiding something (a scam or deception, maybe) or you are completely and utterly deluded.
I think “completely and utterly deluded” captures the situation quite well.
Andrew: you take a heavy weight off my shoulder – I would not want to be considered a homeopath by anyone, particularly not Alan.
It is so so interesting that Ernst condemns the Swiss report on homeopathy and ANY report on homeopathy that has a positive evaluation on the subject, but then, he goes deaf, dumb (really dumb) and blind (really really blind) whenever a study or meta-analysis has a negative evaluation on the subject.
The classic example of the latter is the questionable meta-analysis conducted by Shang, et al (2005) in the Lancet.and the really stupid (and severely limited) review UK Science and Technology Report.
I have no interest in providing here and now my own detailed critique of these two junk science reports (I have provided such critique elsewhere, as have many others).but my comments about Ernst’s criticisms of the Shang and UK S&T reports are NOT TO BE FOUND anywhere, while he takes out his razor blades to any and all positive reports on homeopathy. And it is interesting to note that Ernst also ignores the previous biases by the various authors of these reports (is anyone really to believe that Shang, Egger (!!!!), and this team are not strongly biased against homeopathy?).
If Ernst used the same degree of analysis and critique of the negative studies on homeopathy as he does the positive studies, he would have some modicum of integrity, but this is clearly not the case.
Do you know what homeopaths have to do by 2015 to achieve permanent inclusion in the Swiss reimbursement scheme and do you know what progress they are making towards that.
..no modicum of integrity? really dumb? really really blind?
is there not a homeopathic remedy against foaming from the mouth?
Apologies for some typos in my above statement. I mis-wrote: “… but my comments about Ernst’s criticisms of the Shang and UK S&T reports are NOT TO BE FOUND anywhere, while he takes out his razor blades to any and all positive reports on homeopathy.”
But I meant to say: “but Ernst’s criticisms of the Shang and UK S&T reports are NOT TO BE FOUND anywhere, while he takes out his razor blades to any and all positive reports on homeopathy.”
I challenge Ernst to provide the same level of critique that he gives to homeopathic studies/reviews that have a positive result as those that have a negative result…
And the difference between the newer Swiss Report and the Shang review is that the Shang review is only a very small part of a much larger review of research on homeopathy, and further, Shang chose specially (and with bias) to throw out many high quality studies (even by Shang’s own definition of “high quality”) just so that he can lie with statistics. This evidence has been published in high impact journals: — Lüdtke R, Rutten ALB. The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. Journal of Clinical Epidemiology. October 2008. doi: 10.1016/j.jclinepi.2008.06/015. Slam dunk.
Dana: you are about to comprehend the concept of a systematic review, namely to critically analyse the data irrespective of the direction of the result. For your challenge, can I direct you to my published systematic reviews? There are about 200 of them, so take your pick.
In due respect, you go out of your way to sharply criticize virtually every major study published on homeopathy that has had a positive result, and yet, you go equally out of your way to AVOID providing critique of the various studies that have had a negative result. For instance, please provide a reference to your critique of the Shang study. You certainly do not believe that it is not without serious flaws.
No, I do not sharply criticise every major study!!! If I did, this blog would have hundreds of posts on homeopathy and I would be doing nothing else. What I try to do is instill some critical thinking into CAM, and you show me almost on a daily basis how urgent this task is. And I go not out of my way either: in fact, I could hardly ignore that the authors of the “Swiss” report were misreporting my very own publications in a blatant case of science misconduct, nor that you kept on telling lies about the nature and background of this document even after you have been told the truth several times.
As to the Shang Lancet paper, if I remember correctly, its authors have responded to the criticism and deflated it. In any case, I know that a perfect piece of reseach does probably not exist. Therefore, I do not make too much of one single paper either way. I find it more important that all systematic reviews [well over a dozen], including Linde’s re-analysis of his false positive Lancet paper, fail to show that homeopathy is effective for any condition. I am sure you know my systematic review of systematic reviews, if not, here it is http://www.ncbi.nlm.nih.gov/pubmed/12492603 Do you find any evidence of bias or cherry-picking in there?
No, the studies were excluded because that’s what the predetermined design of the analysis required; see Edzard’s comment about analysing the data irrespective of the direction of the result. To include studies that the analysis design excluded simply because you happen to like the results would introduce bias. It looks very much as if your objection to the Shang paper is that it is not biased enough for your liking.
As for the impact of the Ludtke and Rutten paper on the Shang analysis, well, perhaps that wasn’t as much of a slam-dunk as you think; see also here.
All this has been explained to you before, of course, but you still don’t get it.
That defense of Shang was extremely weak. Just answer 2 questions:
— It was interesting to note that Shang excluded Wiesenauer’s chronic polyarthritis study (N=176) because no matching trial could be found (Linde, 1997, defined this study as “high quality” and so did Shang). Shang actually assumed that there have NEVER been a controlled and blinded trial using any conventional drug in patients with polyarthritis. My simple question is: do you believe that this is true?
And still, whether you believe this is true or not, because none of the trials (!) in the final evaluation matched each other in any way, omitting inclusion of this study was the result of bias from the authors.
— Next, Shang simply chose to not compare ALL of the “high quality” trials between homeopathic and allopathic treatments. What result would he have found if he did so? (We both know that this comparison would find that homeopathic medicines are effective as compared with placebo.)
Slam dunk, indeed.
“that defese”??? what defense? I am not aware defending Shang; what I did say was that there will never be a totally perfect analysis of this material[articles are written by imperfect humans, you know] and that it is better to minimise random and selection biases by looking at the totality of the SRs. AND THE TOTALITY OF THE EVIDENCE ON HOMEOPATHY FAILS TO BE POSITIVE – twist and turn it as you want!
Do not ask me to defend Shang [I do not claim to be an expert on their methodology etc], ask the authors or read what they have written in this context.
Much more importantly, you did not respond to being told that you repeatedly told lies about the “Swiss” report.This is, after all, the topic of this post, isn’t it? Personally, I would prefer to be an author of a flawed paper [not that I am convinced that the Shang-paper is all that flawed] than a habitual liar.
Dana Ullman said:
Demolishing Shang et al. seems to be very important to you and other homeopaths. What have homeopaths done to carry out the comparison you suggest? And when it’s done, will it be passed to the Swiss Government?
What makes you so certain?
Weak? That wasn’t weak! If you want weak, there’s some abysmal idiot who wrote a book in which he claims that Charles Darwin was a supporter of homeopathy even though Darwin’s letters are scathingly contemptuous of it!
Edzard, You go out of your way to provide critique of the Swiss Report, but have never provided any similar critique of the Shang study. Likewise, you never uttered a peep of critique of the really stupid Science and Technology Report on homeopathy. I personally do not understand how or why a serious scientist can lend any credibility to these biased and limited reviews of research. Didn’t you think it a tad weird that Shang, et al. never provided any results that compared the “high quality” (by THEIR OWN definition of these terms) homeopathic and allopathic studies (instead, Shang chose to throw out a large number of the high quality studies in order to prove their biases hypothesis).
And Guy, my book and articles about Darwin and homeopathy give details about Darwin’s skepticism about homeopathy, but my question is: what RESULTS did Darwin get from Dr. Gully, Darwin’s homeopathic doctor who prescribed homeopathic medicines and hydrotherapy for Darwin. Tell us all what RESULTS he got…and the best part of THIS story is that a placebo response is quite unlikely in this case, especially due to Darwin’s skepticism! Thanx Guy for helping proving my point.
Do you agree with these criticisms of the Swiss HTA?
A critique of the Swiss report Homeopathy in Healthcare
The Swiss report on homeopathy – a case study of research misconduct
If not, why not?
And, again, do you know what homeopaths have to do by 2015?
What results did Darwin get from Gully? Pretty much the same results he got when he sought treatment from his father, an “orthodox” doctor, in 1840; the symptoms of his chronic condition receded temporarily, and then returned. The claim that “a placebo response is quite unlikely in this case, especially due to Darwin’s skepticism” is irrelevant; the usual progress of Darwin’s condition (whatever it was), and the fact that he had a changed diet, rest, and regular exercise, is quite sufficient to explain his improvement while under Gully’s care.
And as for calling Gully “Darwin’s homeopathic doctor”…
Gully was a Hydropath. He is on record as stating that he “never much cared for the doctrine of “like curing like””. The book Darwin read which led him to consult Gully was titled The Water Cure in Chronic Disease, and barely mentioned homoeopathy, withmention of it confined to a single footnote. Here is Darwin’s description of Gully’s regime:
The homoeopathy would appear to be a very small component of this. How does it differ from the person who you objected to being described as a homoeopath here?
All you have in the case of Darwin is a temporary reduction in his symptoms. You don’t know what condition Darwin was suffering from; you don’t know whether the reduction was caused by any of Gully’s many treatments or would have happened anyway; even if it was Gully’s treatments that caused the improvement you can have no idea whether it was the hydrotherapy, the change of diet, the exercise, the time out from Darwin’s work, the reduction of Darwin’s snuff intake to six pinches a week, the homoeopathic remedies, or any other part of Gully’s rigmarole that caused it. You have no idea what homoeopathic remedies Gully prescribed, or even of Gully’s rationale for prescribing them. Given his statement the he “never much cared for the doctrine of like cures like” it is entirely possible that he was just handing them out like sugar pills.
Darwin’s experiences can tell us nothing about homoeopathy.
Its even more interesting that Dana hasn’t realised that the Shang et al meta-analysis has as much right to be called “the Swiss report” as the Bornhoft et al HTA, since both were commissioned as part of the same evaluation process. An evaluation process that led to the Swiss government withdrawing funding from homoeopathy and four other alternative therapies.
…and we’ve seen those “detailed critiques” demolished elsewhere, for example on the Hawk/Handsaw blog.
Well, that’s your problem, isnt it? It isn’t as if you don’t have a website you could publish them on.
Thanx Mojo for verifying your “bad faith” in scholarship. You have acknowledged many times that you’ve read my articles about Darwin and his homeopathic doctor, and in my eCAM peer-reviewed article. Your ability to cherry-pick information is transparent (and ineffective). Those of you who have a serious interest in this subject would benefit from reading my article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816387/pdf/nep168.pdf
Quoting from it, it is worthy to take note of the following:
“…by 1848, Dr Gully became a formal member of the British Society of Homeopathy (6), and he maintained his membership through at least 1871 (7). In subsequent editions of his book, his favorable experiences with homeopathy led him to change his writings on the subject. In the 5th edition of this book (1856), for instance, he writes that distinct from the use of conventional medicines in the treatment of chronic constipation where drugs do not cure and lead to relapse, it is significantly different with homeopathic care: ‘In fact, cases abound in which homeopathic treatment alone has effectually and permanently cure habitual costiveness’ (p. 48).
To actually say that Darwin’s symptoms disappeared under his father’s care is not true. In fact, in 1849, he wrote that he was dying, that he was unable to work 1 in 3 days, and that he was having fainting spells and spots in front of his eyes, along with constant nausea, body-wide boils, heart palpitations, and general fatigue. He had most of these symptoms for 12 years…until he saw a homeopath/hydrotherapist.
This quote is also intriguing:
And even though Darwin was extremely skeptical of water-cure and homeopathic medicine, just two days
later (March 30, 1849) Darwin acknowledged, ‘I have already received so much benefit that I really hope my
health will be much renovated’ (8). After 8 days a skin eruption broke out all over Darwin’s legs, and he was
actually pleased to experience this problem because he had previously observed that his physical and mental
health improved noticeably after having skin eruptions. He went a month without vomiting, a very rare experience
for him, and even gained some weight. One day he surprised himself by being able to walk 7 miles. He wrote
to a friend, ‘I am turning into a mere walking & eating machine’ (9).
Once again, I want to acknowledge my mis-writing above. I meant to assert that Ernst has NEVER written a single bit of criticism of the Shang “review.” Speaking of Shang, Mojo is wrong (again) in saying that Shang could be consider the “Swiss Report” because the real Swiss Report was much much more comprehensive than Shang (Shang’s work was but a small part of it, and Shang over-extending himself by providing biased commentary and statistical trickery. Shang’s decision to throw out a LARGE portion of his own defined “high quality” studies PROVES that they were shaving the data to fit their personal point of view. Transparent.
It is perhaps time to make something clear to those who are a bit slow to grasp the obvious:
I have conducted plenty of research into homeopathy and evaluated the studies of other investigators [in total about 100 peer-reviewed publications on the subject]. I even conducted a systematic review of systematic reviews [see above]. None of this work generated the slightest proof that homeopathy is effective. The inescapable conclusion emerged that homeopathic remedies are pure placebos.
Why then should I bother to criticise analyses like Shang et al which confirm this well-established, evidence-based conclusion? The Shang-paper may have some weaknesses [I don’t know, because I never looked closely at its methodology] but its conclusion is in accordance with all the reliable data on the subject. So why waste time on an attempt to question a correct conclusion? There are more urgent things to do.
On the other hand, when an article emerges that contradicts the accepted wisdom, it is in my view necessary to investigate why this might be so. Chances are that we learn something new! As it turns out, we merely learn that biased studies generate false positives.
SO MR ULLMAN ET AL, PLEASE, PLEASE, PLEASE THINK ABOUT THIS AND STOP GOING IN CIRCLES – THIS IS NOT PRODUCTIVE AND MAKES FOOLS OF YOU.
Yes, I’ve read your article (or as you referred to it on the Quackometer blog, your “****ing article”). But I’ve also followed up and looked at the sources you cite in it; they have a remarkable tendency not to support your claims.
For example, the last portion of your article is headed “Darwin’s Admiration of Another Homeopath”, and is based on what you claim was “an August 20, 1862, letter to Asa Gray”, about a book that Darwin had read. The passage you quote from Francis Darwin’s Life and Letters of Charles Darwin clearly identifies it as a comment on “an example of the odd letters he received”. Tracking down the original source for this, a postscript to a January 16, 1862 letter to Joseph Hooker, makes this even more obvious:
You claim that Darwin “asserted that this writing by a homeopathic doctor is similar to his own but ‘goes much deeper’.” This is clearly not the case; he is reporting the homoeopath’s assertions about his book in “the letter with curious address”. Darwin evidently considers the idea of translating and publishing the book to be ridiculous (see that “&c &c?!” at the end of the postscript?). There is no evidence here that Darwin ever saw a copy of the book, much less read it, and there isn’t any sign of admiration for the author of the “odd letter”.
Again, you cite Darwin’s Insectivorous Plants as the source for your claim that Darwin experimented with “homeopathic doses” of ammonia (You also, rather oddly, cite reference (11), a “Letter of September 4, 1850”, as the source for comments Darwin wrote in a letter to F. C. Donders on July 7, 1874). The link provided in the references to your article (reference 21) doesn’t seem to work, but the full text of the book is freely available on the Darwin Online website. The relevant experiments are described in Chapter 7 (pp.136-173).
There is no mention of serial dilution or succussion being used in the preparation of the solutions Darwin used. You have in the past been highy indignant if anyone mentioned the low concentrations of homoeopathic remedies without also mentioning succussion. Are you now claiming that serial dilution with succussion is not a necessary part of the preparation of homoeopathic remedies?
Darwin established an orthodox dose-response curve, with the effect becoming weaker and more difficult to observe with reducing concentration (note for example the comment on p.171 that “It is to be especially observed that the experiments with the weaker solutions ought to be tried after several days of very warm weather. Those with the weakest solutions should be made on plants which have been kept for a considerable time in a warm greenhouse, or cool hothouse; but this is by no means necessary for trials with solutions of moderate strength”) and a limit beyond which no response was observed. Note also p.170, with the footnote in which Darwin notes that in the detection of dilute substances “the spectroscope has altogether beaten Drosera.”
Your article claims that Darwin experimented on Drosera with “homoeopathic doses”, and implies that Darwin was reluctant to publish his results because of this connection with homoeopathy, but there is no suggestion of any connection with homoeopathy in any of the sources you reference. I posted this on the quackometer blog in response to your request that I “give us dem quotes and references…or STFU.” When I requested that you do the same you took the latter option.
By the way, if Darwin’s Drosera experiments were using homoeopathic remedies, they showed that the remedies ceased to have any effect way before the “Avogadro limit”.
I don’t deny that Gully had an interest in homoeopathy, just as he had an interest in Mesmerism, clairvoyance, and spiritualism. The gullible Dr. Gully seems to have taken an interest in a wide variety of fashionable nonsenses of the victorian era, and made a good deal of money by doing so.
But he was known as a hydropath. The books he wrote to advertise his practice were about hydropathy, and even the footnote about homoeopathy to which you keep referring says that he had to “speak of the whole subject [of homoeopathy] with diffidence, my experience being as yet limited”. When Gully needed a homoeopath, he brought one in (see for example your quotation from the September 4, 1850 letter to William Darwin Fox: “he had a clairvoyant girl to report on internal changes, a mesmerist to put her to sleep, an homeopathist, viz. Dr. —, and himself as hydropathist”). Gully even stated that he had “never much cared for the doctrine of like curing like”. Are you now claiming that “like cures like”, like serial dilution and succussion, is not an essential pert of homoeopathy? There doesn’t seem to be much of homoeopathy left.
Every reliable source describes Gully as a hydropath, not a homoeopath. And yet you continue to insist that it is the rest of the world, not you, that is out of step.
Yes, that’s in the same footnote I’ve already mentioned, which he evidently thought was as much mention as homoeopathy merited.
I didn’t say that Darwin’s symptoms disappeared under his father’s care; I said that they receded, and then returned. This is also what happened when he consulted Gully. Darwin had some sort of chronic condition that waxed and waned. He would seek treatment when his condition was particularly bad; it would then, naturally, tend to improve.
Gully’s treatments didn’t cure Darwin any more than Darwin’s father’s treatments did. Around fifteen years after Darwin was treated by Gully, he reported that he was still suffering the same symptoms that he had suffered for the last 25 years:
So in fact I was wrong when I said that Darwin’s experiences can tell us nothing about homoeopathy. What they can tell us is that homoeopathic remedies, as administered by Dr. Gully, most certainly did not cure Charles Darwin.
My apologies to Professor Ernst for straying so far from the topic of his blog post.
Please provide me with proof of no effect of homeopathic medicine- I’d really like you to make my job simpler. You are all so bright, witty and intelligent.
There’s a video of James Randi taking lethal dose of homeopathic medicine on the TED website, if you’d care to check that out. He’s still alive and kicking, I believe. QED.
I love it when people are stupid enough to bring up this Randi story because it assumes that REAL medicines must be able to kill you…or they are not real. Ya gotta love how daft skeptics are! Thanx.
Anyway, Randi is a master of deception and misdirection. Those skeptics are daft enough to be fooled so easily. And finally, who is the real James Randi? It seems that he and people close to him are having identity crises!
It is we who should be thanking you, Dana, for that wonderful illustration of flawed thinking.
It’s not just Randi – hundreds of us have now taken overdoses of homeopathic ‘remedies’ with no ill effects. Thus we have the “proof of no effect of homeopathic medicine” that Andrew demands. The assumption about real medicines is that they have active ingredients which can be beneficial if correctly prescribed but in overdose they will be harmful. If a remedy has no active ingredients – as is typically the case with homeopathy – they can be neither helpful nor harmful.
Got it now?
And you are transparently disingenuous and intellectually dishonest. Don’t be so juvenile.
Homeopathy has never incontrovertibly cured anyone of anything. Not ever. And I suspect you know this only too well. There isn’t a single documented verifiable case study in existence, never mind one that stands up to the slightest scrutiny.
I’d like you to provide evidence of the non-existence of unicorns. You can’t do that, and you know perfectly well why you cant do it. But you certainly won’t explain here why you can’t do it. By the same token you can’t provide a single documented case study of homeopathy incontrovertibly curing anything, ever. You know perfectly well why you cant do that and, just as with your non-evidence for the non-existence of unicorns, you will refuse to explain why you can’t.
Please provide me with proof that life on earth did not arise through the act of a deity. You can’t, can you? But that doesn’t undermine the fact that it arose through a process of evolution, any more than the inability to conclusively prove a negative undermines the fact that homeopathy lacks any basis in fact.
You know the problems with homeopathy. You know there is no reason to suppose it should work, because the so-called law of similars is simply wrong. You know there is no way it can work without violating the laws of physics that underpin much of modern technology. And you know there is no good evidence it does work beyond placebo.
You also know that the burden of proof is firmly on the homeopaths to prove their case, not on skeptics to disprove it, as is the case for every other medical claim. The fact that this argument even exists is proof positive that they have yet to do so. They have had over 200 years, they really ought to roll their sleeves up and get cracking on that.
You really should learn about logical fallacies and burden of proof. It might stop you making yourself look quite as silly.
The Null Hypothesis is a perfectly valid starting point for Homeopathy, as its an inert intervention. Arguing against this is simply an attempt to reverse the burden of proof.
Bearing in mind how effective and repeatable Homeopaths claim it is, finding good robust unambiguous evidence of efficacy even under controlled conditions should be an absolute doozie. Yet it eludes Homeopaths.
You might want to consider why.
Andrew, oh dear oh dear!
There never ever was even a single proof that homeopathy works. Homeopathy is insane bullshit, based on religious egomanic insanity.
I do wish people would stop asking for “one example” of homeopathy having an effect.
Even if it had no healing properties at all you would expect a p<0.05 "false positive" in 1 out of 20 studies.
Set the bar higher: demand RCT results which were independantly reproduced.
I think a single documented case study of an incontrovertible cure is already setting the bar too high. You do know what a case study is? You do know what “incontrovertible” means?
The point is, if homeopathy ever worked at all case studies should crawling out of the woodwork, as it were. They would ubiquitous, everywhere. Homeopaths would be flinging them around like confetti. They would be irrefutable as evidence.
Homeopaths have had 200 years to produce not even a single documented verifiable case study.
Only one is required because, like unicorns, none exist. None exist because homeopathy has never cured anything.
At this point in the 21st century the accumulated sum of human knowledge incontrovertibly points to homeopaths either being irredeemably ignorant and deluded, or deliberate liars. There is no other choice.
If homeopathy doesn’t work, then please tell me why there are 500,000 homeopathic doctors in India with 20,000 newly registered every year!!! Or do you think they are all delusional as well as their millions of patients?!
I think it might be something to do with India being a developing country. It’s easier for quacks to make a living from people who can’t access proper healthcare.
i enjoy seeing my clients get well when i treat them. You lot are beyond words.
homeopathic Jayne said:
What makes them get well?
Perhaps you’d like to tell us what you believe are the right answers to your questions?
Nobody said they are all delusional., just that they are in all probabilities wrong about why they got better.
Please don’t built emotive strawmen arguments to avoid the central point which is there are a variety or reasons why people can get better without any intervention and that to properly test efficacy you must design your trial to exclude these.
In this case tell me why blood-letting was used for hundreds of years and killed thousands of patients without anyone suspecting that it was ineffective. The argumentum ad populum is a classical fallacy.
Louise, the answer to your question was provided in the 19th Century, possibly by Joe Bessimer, but more usually credited to P. T. Barnum: there’s a sucker born every minute.
I wonder how people can even dare to write against a science (worlds second popular medicine,homoeopathy)which they’ve hardly understood.It seems they dont care to go through the trials conduted all over which have given sufficient evidence or probably they’ve simply failed to comprehend it.
so what do we call them??EDUCATED IGNORANTS???
Gayatri: to go through the trials, one has to conduct a SYSTEMATIC REVIEW. About 20 such projects have been published, and collectively they fail to provide good evidence for the efficacy of homeopathic remedies http://www.ncbi.nlm.nih.gov/pubmed/17658121 . Who then is ignorant????
And here is what a Swiss government official has published about the history and nature of the REPORT http://www.ncbi.nlm.nih.gov/pubmed/23255156 :
“As far as homeopathy is concerned, two literature reviews were commissioned: A meta-analysis on homeopathy trials and of matched trials in conventional medicine , and a broad analysis of the literature incorporating publications and unpublished reports on studies of various methodologies (randomised and non-randomised trials, case series, experimental studies). This review was declared to be an HTA by the authors (the final PEK  report does not classify the literature reviews as HTA reports) and published later as a book  under their responsibility without any consent of the Swiss government or administration. The book by Bonhöft and Matthiessen was later translated into English and published in 2012 .
The decision to end coverage for homeopathy and other CAM methods in 2005 was strongly criticised by large parts of the population even beyond the (according to the Swiss Health Survey 2002 ) 11% CAM users, and by many politicians. The decision also led to a referendum aiming at promoting CAM in general. The intention behind the referendum was to reinstall coverage by the mandatory health insurance. A moderate form of the referendum was accepted by three-quarters of the population during a popular vote in 2009. As a result, the medical associations in 5 CAM methods submitted documented requests for re-installing coverage again in 2010, using the systematic application forms introduced by the Federal Office of Public Health in 2008 . The book on homeopathy mentioned above was part of the submission on homeopathy.
In December 2010 the advisory commission again came to the conclusion that for all five CAM methods, the proof of efficacy, effectiveness, appropriateness and cost impact was not convincing enough . One month later, the minister of home affairs made the decision to re-install coverage from 2012 onwards under roughly the same conditions as during the period from 1999 to 2005 (physicians certified in CAM methods, coverage in evaluation) . This decision took both the negative verdict of the advising commission as well as the will of the population, expressed in the popular vote in 2009, into account. However, one main difference must be taken notice of: During the first evaluation period all evaluation projects were conducted in one single evaluation programme under a mixed steering committee; the responsibility in future for evaluation will be divided between the providers (focus on utilisation and cost impact) and the administration (HTAs to be commissioned internationally). This approach should lead to methodologically correct evaluation projects”.
I think this statement should lay to rest all the falsehoods that have been claimed by Ulmann and other homeopaths.
try to make some sense, please
I deleted it. It was just another spam comment advertising an online pharmacy.