MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Surely, homeopathy must be free of adverse-effects! The typically highly diluted remedies contain no active molecules and therefore they cannot possibly cause any harm whatsoever. One could even go one step further and argue that the generally acknowledged absence of side-effects made homeopathy as popular as it is today. Why then did we just publish a systematic review of adverse effects of homeopathy?

We conducted searches in 5 electronic databases and also looked through our own, extensive files on homeopathy. This resulted in 38 primary reports of adverse effects associated with the use of homeopathy. The total number of patients thus affected was not small: 1159; 4 fatalities were also reported. Our conclusion was that “homeopathy has the potential to harm patients in both direct and indirect ways”.

I already hear homeopaths shouting at me: “but this is nothing compare to the millions of patients who suffer side-effects of conventional drugs!” I don’t doubt this for a second; our aim was not to show that homeopathy is less safe than mainstream medicine, we merely wanted to test the hypothesis that numerous adverse-effects are on record.

So, how can a therapy that usually relies on nothing more than placebos cause harm? Many of the patients that experienced harm did so because the use of homeopathy meant that effective treatments were given too late or not at all. In our book TRICK OR TREATMENT, we describe the case of a homeopath who collaborated with my research team while conducting a clinical trial of homeopathy; before the trial had been completed, she died of cancer simply because she self-treated it with homeopathy and thus lost valuable time for proper therapy which might have saved her life. I have said it often and I say it again: if used as an alternative to an effective cure, even the most “harmless” treatment can become life-threatening.

In other cases, adverse effects can occur when remedies are not highly diluted. Most but not all homeopathic remedies are devoid of active molecules. Homeopaths prescribe treatments like arsenic and other highly poisonous substances; if such a remedy is not administered in a much diluted form, it can easily kill whoever is unfortunate enough to take it.

The reactions (letters yet to be published in the journal) by proponents of homeopathy to our article was predictable: they claimed we contradicted our published statements that homeopathy was without any effect at all, they tried to find mistakes in our analysis, they claimed that we had a track record of publishing sloppy research, and they even asked the editor to withdraw our paper [I am pleased to report that he resisted this invitation]. Our response to these comments and allegations pointed out that ad hominem attacks are transparent attempts to get rid of unwanted truths – in fact, they are not just transparent but also never successful in suppressing the evidence and, in the final analysis, they merely disclose the fallacies of the opponent.

63 Responses to The risks of homeopathy?

  • Magufo says:

    This study I read last week. It strikes me that focuses on the collateral damage to patients and has the same agenda as the site holds Whats the harm?. (Coincidence? I think not).
    On the other hand, as you refer to low dilutions, it is clear that his article (though we already know homeopaths) shows that the 10:23 campaign is irrational and was a lie. Remember their slogan still says “no cure, no nothing” or “Homeopathy: Water and sugar.”
    Powers as a 6X if ingested, if they can cause damage. So the “skeptics” were very selective with suicide only as a 30CH remedies and no less.

      • Magufo says:

        That things, the question is for Dr. Edzard …. for now … ¡Quackometer pseudo skeptics appear here!
        This site had already read and does not handle, in essence, no different from the other sites pseudo skeptics:

        http://discoverhomeopathy.co.uk/

        It is curious that the victims managed only 9 cases! Of those nine, only one is “fully” documented. The other eight are either poor quality websites and in your case is an excellent double standard in the “skeptical scientists” that, according to the input rciente Edzard, they “ask evidence”, but it seems that when you are ask for evidence they give “evidence” of poor quality.
        The site has the same rhetoric propaganda Whats the harm and the use of ad-terror fallacy and ad-populum (although ad-populum based on a false consensus).

        Now if we go to site What the harm? Interestingly they claim:

        “Here are 437 people who Were harmed by someone not thinking Critically.”

        So why not died critial thinkers “? Go, then how will thinking critically die? Outside the jokes, this is advertising . Easily could have since died by falling into a charlatan or something manosde similar, missing only, to put killed for not having read Carl Sagan?

        Skeptikcat Sorry, what I ofrces are anecdotes. And according to you, that’s not true.

        • Skepticat_UK says:

          Hey, Magufo,

          I asked you to clarify what you meant by something you said. I wonder why you are ducking the question.

          “Only 9 cases”? You’re surprised the number is so small when there have undoubtedly been many thousands of ‘deaths by homeopathy’ over the years? I mean, I personally know of two more cases and we know from reports like this one from the National Cancer Institute, Karachi, that some women delay seeking medical advice for breast cancer because they choose to rely on homeopathy and by the time they present, it’s too late to save them.

          The problem is, how do we prove it unless (a) there is an inquest at which it is stated that the victim had rejected or delayed medical help in favour of homeopathy and (b) there is an online report in English of what was said at the inquest?

          “Of those nine, only one is “fully” documented. The other eight are either poor quality websites,”

          The quality of the websites is irrelevant. The point is that all of them contain reports of coroners verdicts or criminal trials. And when an anecdote is confirmed by a coroner’s report, it stops being an anecdote and becomes data.

          “and in your case is an excellent double standard in the “skeptical scientists” that, according to the input rciente (sic) Edzard, they “ask evidence”, but it seems that when you are ask for evidence they give “evidence” of poor quality.”

          There is no double standard. Homeopaths rely primarily on anecdote unconfirmed by independent evidence and when they do claim the support of clinical trials, these invariably turn out to be rubbish quality. (I do hope you understand the need to, as far as possible, eliminate bias and how best to do this.) In a nutshell, the totality of evidence available to us indicates that homeopathy is a crock. End of story.

          • Magufo says:

            Can you show all these reports? Until it does are simple anecdotes:

            “I mean, I personally know of two more cases and we know from reports like this one from the National Cancer Institute, Karachi, That some women delay seeking medical advice for breast cancer They choose to rely Because on homeopathy and by the They present time, it’s too late to save them. “

            Thousands of deaths? Come on man more people die from other more serious things: murders, car accidents or laorales, malnutrition, assaults, iatrogenic, poverty, poor working conditions and / or health …. These deaths if they are fairly documented.

            So if you validate all cases in homeopathy. I know I’ve read and fully documented clinical cases where the patient has been cured with homeopathy. These are valid? According your logic: yes.

            he quality of the sites is not irrelevant. Whats the harm if Dingle says died “for not thinking critically.” You believe that? If the same site says there are hundreds of deaths, and when you see every link you find that some of them are broken, or even some of them do not mention homeopathy … You will believe them? There any reliable statistics on Whats the harm? Apparently they care more to worry about selling books, over show fully documented cases.

            Indeed, I have pointed out that the case of Dingle is the only one who could legitimately claim it says. But it is still a sign very, very small. I think most of the data of poisoning by low and high dilutions, than Whats the harm? or postean place.

            If there is a double standard, thus if you claim that “there are hundreds of deaths by homeopathy” then I have every right to demand in full the hundreds of well-documented cases, and I suppose also validated by the Crown or any examiner.

            In clinical trials, it is curious that the study by Rutten gave false that these trials were all of “low quality”, which shows is that these studies have even better quality than conventional medicine (I’m not discrediting the conventional medicine).

            Of course not, “the totality of the evidence”? The Cochrane reviews are generally more ambiguous and require further studies. The review of Linde (1999), Linde & Jonas (2001) also do. Shang (2005) (if it is bad science), Cucherat (2001) requires more evidence …..A new meta-analysis with statistics show that homeopathy is superior to placebo, pity it was not published in a magazine because the test data were taken until 2005
            Ernst?? I have already indicated that revisions are fully Ernst narratives. NO is an ad-hominem, is that they are of poor quality.

    • Mojo says:

      @Magufo

      It strikes me that focuses on the collateral damage to patients and has the same agenda as the site holds Whats the harm?. (Coincidence? I think not).

      Here’s another study that focuses on adverse events in homoeopathy, and found that “remedy reactions are common in clinical practice; some patients experience them as adverse events. ” Do you think its authors also share the same agenda?

        • Magufo says:

          And …

          Seudoskeptiks law: Any study that says being positive must have “poor methodology” to be funded by Boiron-Heel-Weleda, or make use of “bad statistics” have biases.

          Ernst-Park law: Homeopathy is “implausible” that “contradicts everything we know about physics, chemistry, and toxicology”

          • Skepticat_UK says:

            Magufo

            You’re failing to grasp something very essential here:

            When quacks say critics are stooges of Big Pharma, they are simply speculating. They have no evidence.

            When critics say trials showing a positive benefit for quackery are of poor quality, the evidence is there for everyone to examine. You can check the numbers, the methodology, blinding, randomisation and come to your own conclusion.

            When I was provided with a list of four references for meta-analyses or systematic reviews that were supposedly positive for homeopathy, I checked them out and found that the authors themselves had all commented on the poor quality of most trials. Here’s an example:

            “There is some evidence that homeopathic treatments are more effective than placebo; however, the strength of this evidence is low because of the low methodological quality of the trials. Studies of high methodological quality were more likely to be negative than the lower quality studies. Further high quality studies are needed to confirm these results.” ( Cucherat et al 2000)

            Homeopaths claim this as positive evidence for homeopathy. They obviously only read the first half of the first sentence and pretend the rest of the conclusion doesn’t exist.

            See here for further examples: http://discoverhomeopathy.co.uk/?page_id=2

          • Mojo says:

            @Skepticat

            They obviously only read the first half of the first sentence and pretend the rest of the conclusion doesn’t exist.

            I notice that the page you link to cites the House of Commons Science and Tecnology Select Committee’s “Evidence Check” on homoeopathy, which also said, “We regret that advocates of homeopathy, including in their submissions to our inquiry, choose to rely on, and promulgate, selective approaches to the treatment of the evidence base as this risks confusing or misleading the public, the media and policy-makers.”

      • Magufo says:

        It has taken my quote out of context. The study you mention I’ve noticed, and in any case is not anything new. In fact Hahnemann had reported adverse effects. To which I refer, reads well, is that the study of Edzard is propaganda that ensures that adverse effects are inattention of conventional medicine, which follows exactly the same propaganda Whats the harm and step of the Center for Inquiry.
        When the 10:23 campaign as homeopathy say “only water” and say things like “low dilutions are herbal” is that or are misinformed, or / and are lying. Although I’ve done some interviews “skeptical” of my country, I have noticed that many of them if they were aware that there are low doses. Even some of them are “committed suicide” with sedafit PC with low dilution as 4Ch although in his blog said that “homeopathy has nothing” and just took a box of Sedafit PC. Others, however ingested higher amounts but only with dilutions above or equal to 30CH.

        • Mojo says:

          It has taken my quote out of context.

          Your quotation has not been taken out of context. Anyone reading this page can see its context. The sentence I quoted implies that Professor Ernst has a particular agenda because his study looks at adverse events associated with homoeopathy. The rest of your post makes a different point about dilutions and the 1023 campaign and is therefore not relevant to this point.

          You are still making the same claim, now using the word “propaganda”. You have provided nothing to back up this claim other than your allegation that because Ernst has looked at adverse effects he must share a particular agenda. Did Hahnemann share the same agenda as “What’s The Harm”? Do the team from the Bristol Homeopathic Hospital share the same agenda? You are relying on the fact that Ernst has reported on adverse events to back up your claim of his sharing this agenda; why do you not draw the same inference from the fact that they have also reported on adverse events?

          • Magufo says:

            Okay … not out of context …
            The 10:23 campaign is relevant. Even if your dating a study of Homeopathy (2004) is more than enough to see the trap of pseudo skeptics and GWUP own agenda and Sense About Science.
              Precisely that Hahanmenann and Bristol have reported hospital adverse events, in those days when the pseudo skeptics said that “no cure or anything”, in the context of the report of the committee and UK campaigns astrotufting 10:23, is a good example to show that lie.

            What really catches my attention is the cherry picking, because you quote a study in the journal Homeopathy and only those who bear him to his point. But I have noticed that both their interests in Quackometer ScienceBasedMedicine and say that this magazine is a “pseudo journal”. Do you have something to say?

          • Mojo says:

            my agenda? it has always been to research the efficacy and safety of alternative medicine

            See? You’re obviously biased against therapies that don’t work.

          • Magufo says:

            I think not. Because you take so long to claim the figure of pseudo skepticism in Nature in 2010? When for over 10 years you were an undeclared anti homeopathy!
            Interestingly, the year 2010 is a special date: Sense About Science (who was already riding operations since 2004?) And Comitté meddling in science and technology, fraud astrotufting 10:23 campaign, his statements in Nature , Samuele allegations Rivva, James Randi and his ofrecimiciento million dollar again, Darryl Cunningham and inaccurate information from your comic …
            All this can not be mere coincidence.

            It is a political agenda, not scientific. Skepticism “scientific” is an unscientific political philosophy.

        • Darron Wolf says:

          Magufo, please, your command of English is so poor as to make your points on this matter almost indecipherable. With all sympathy to your level of communication skills (but absolutely none to your support for pseudo-scientific nonsense), please seek out some formal training & education in English. (This is not designed to be an ad-hominem attack but rather some sound advice for those planning to enter the field of public discourse.)

  • edzard says:

    A review of side-effects has to focus on side-effects! Isn’t that rather obvious? The 10:23 action used those remedies available OTC, and they are all highly diluted and devoid of any effects. But this does not mean that homeopathy is harmless – and that was one of the points we tried to make with our paper.

  • Martin B. says:

    Dear Dr Ernst,

    I read the article a few days ago, and a quite snarky comment of Harald Walach.

    On his blog, Harald Walach is criticizing the inclusion of case report of a heart problem and bladder cancer Geukens (2000?), where the patient was given a C1000-”potentiated” remedy. You or your coworkers classified both conditions as direct AE of the placebo treatment. The original case report by Geukens is a total mess and I’m still not sure if his patient had homeopathic treatment all along and thus delayed proper medication/therapy.

    But even if I assume this has been the case – how is that a “direct AE”? Wouldn’t every “direct” effect be a toxicological one from low potencies, like e.g. allergic reactions to mycotoxins? Wouldn’t “received proper treatment too late” a indirect effect?

    Regards
    Martin B.

  • Paul Posadzki says:

    @ Martin B

    The case of bladder cancer was judged as ‘direct AE’ of homeopathy based on the following sentence/quote: “(…) the patient developed cancer of the bladder, that occurrence suggesting that even after a correct homeopathic remedy has been prescribed, a patient may subsequently contract a cancerous condition” Geukens (2001).
    >

  • Tim says:

    Dr. Ernst I think it is good idea that scientists attempt to investigate all claims with the best tools they consider available. So congratulations on your work and thank you for attempting to investigate the matter.

    According to homeopaths mild AE or aggravation of old symptoms are common and it is a sign that the human organism responds to the homeopathic treatment especially when the remedies prescribed are higher than 6x.

    If this study ( Mojo referred to ) is valid – as it is supposed to be – then it is reasonable for homeopaths to say that it is strong evidence that high dilutions have a biologic effect on the human organism. Isn’t that correct ?

    Since homeopathy is not everywhere regulated warning that not all products who someone prescribes them as homeopathic is a good thing to do.

    The problem here is that the typical homeopath mainly in the western world will not prescribe lower dilutions (less than 6x) to patients. And the pharmacies sell these products 6x or higher (more diluted remedies typically – without a prescription.

    I don’t have access to your study so I m assuming that all AE are linked with lower dilutions less than 6x? or with higher dilutions?

    Homeopaths would argue : isn’t not kind of misleading to imply that typical use of homeopathy (since it typically involves higher than 6x dilutions – I mean more diluted “remedies”) is dangerous at least in terms of AE ?

    I know that you want to point out that patients may avoid having a medical diagnosis but at least in Europe and US even a trained homeopath typically would have the skills to refer to an MD if needed.

    Finally how the case of bladder cancer was judged as ‘direct AE’ of homeopathy? This is completely irrational . I would understand if it were an indirect effect. But how can you justify that? If someone reads only this example from your study, s/he would start thinking that something is wrong with the criteria you used.
    Best regards

  • MarGal says:

    If high dilutions have non specific biological effects that can worsen the situation of a patient (think of worsening heart attack aka known as death) and low dilutions still contain toxic compounds would this not be a good reason for banning homeopathy?

    • Tim says:

      This might be misleading: high dilutions do not cause anything, according to Dr. Ernts review(s). Not receiving appropriate care for a life threatening condition might cause death and this is an indirect AE, not a direct AE.

      The questions I asked are :

      1. Mojo, discussing with Dr Ernst about AE, referred to a study showing that homeopathic “remedies” have adverse effects. Dr. Ernst did not seem to object, he only commented that everybody who writes something negative about homeopathy is attacked.
      if one accepts the validity of the study Mojo referred to, is reasonable to say that the same study is evidence that high dilutions have an biologic effect on the human organism.

      2. Why the case of bladder cancer was judged as ‘direct AE’ of homeopathy? This seems completely irrational . I would understand it, if was classified as an indirect effect. But how can you justify it? Higher or lower dilutions did not cause this condition.

      • Vicky says:

        There are several ways in which highly diluted “remedies” can have adverse effects. Off the top of my head:
        1. Nocebo-effects
        2. Allergic reaction/intolerance reaction to carrier substance (lactose intolerance comes to mind, but also allergic reactions to preservatives in eyedrops)
        3. A recent study suggests that high dilutions of metals do still contain starting material; if the metal itself is harmless (like gold, for example, which acts inert), that’s not a problem, but it may be a problem if you use a “remedy” maed from metallic lead (or other toxic metals).
        The package inserts of “conventional” medications have to list all adverse effects that were observed (in this case, as a safety measure, post hoc, ergo propter hoc is assumed), so it’s only fair if the same standard is applied to homeopathic “remedies”.

        Your question regarding bladder cancer was already answered above by the review’s primary author, Paul Posadzki.

  • MarGal says:

    My point of view is: 1) we have no effect so indirect harm (because no intervention) and fraud or 2) we have toxic effect because of known toxicity of used compounds => potential direct harm and fraud (because no curative effect). Homeopaths point out that if you say 1 you cannot say 2, but in fact both are true, 1 for high dilutions, 2 for low ones, no matter what the discussion is about. There are crank parents who test low potencies on their children with the purpose to cause toxic effect so they can choose the right “remedy”. There are no toxicity studies of this hidden practice and I wonder how many disorders are in fact caused by homeopaths and naturopaths giving toxic compounds or other preparations with unknown toxicity to their customers.

  • Tim says:

    Vicky

    1. According to the study Mojo referred to http://www.ncbi.nlm.nih.gov/pubmed/15532700 the specific Adverse effects were caused by homeopathic high dilutions known as “remedies” which are typically prescribed to patients. If the study is valid then homeopathic high dilutions have measurable effects on human organism as homeopaths claim. Is this correct?

    2. Can you explain in your own words how is it possible high dilutions to cause a cancerous condition? If this is conclusion from Dr. Ernsrt study is valid, then someone should get the Nobel prize! I think it must be a mistake and Dr Ernst quickly will correct but if you know something I do not know, please explain.

  • Vicky says:

    Re. #1
    Well, I took a look at it now, and I’m really unimpressed – patients were asked if/how their symptoms changed and homeopaths ascribed these changes to the “remedies” the patients were given (post hoc ergo propter hoc). No, that’s not evidence for a specific effect of high dilutions, that’s evidence of homeopaths believing in homeopathic principles.
    “Why did some patients’ symptoms become worse then?” you might ask. “Because they were given sugar pills or alcohol drops instead of effective medicine”, I’d answer.
    “Why did some patients experience new symptoms then?” you might ask. “Because they were given sugar pills or alcohol drops instead of effective medicine”, I’d answer.
    “Why did some patients experience recurrence of old symptoms then?” you might ask. “Because they were given sugar pills or alcohol drops instead of effective medicine”, I’d answer.
    “Why did some patients experience adverse effects then?” you might ask. “I explained the ‘adverse effects’ bit above”, I’d answer.

    Re. #2
    I was under the impression that the conclusion was the homeopath’s, not the review’s authors’. What made the homeopath think that the homeopathic remedy caused cancer? I don’t know, nor do I need to.

  • Tim says:

    Vicky ,

    I did not refer to this study http://www.ncbi.nlm.nih.gov/pubmed/15532700 and i have no pinion about it. Mojo did, as an example, discussing with Dr. Ernst about other researchers looking into adverse effects of homeopathic remedies or “remedies”
    I just said that one cannot count these effects as direct effects of homeopathy unless s/he believes that homeopathic high dilution have an effect on patients ( excluding the reaction to carrier substance lactose intolerance (not a case in this study) and high dilution of metals contain starting material which are not used typically in homeopathy anyway.)

    The reason is that direct effect in science means a causal effect. In our discussion it means that a specific substance actually triggers a series of events. An indirect effect might mean that absence of proper treatment;l It is not the cause of a condition but it triggers a deterioration of a condition.

    So the worse that can be said about AE of homeopathy is that one can delay a proper treatment in a serious condition – an indirect effect- and not that homeopathy can trigger or cause a series of events.

    All the other conclusions, for example, that cancer might be a direct effect of homeopathic remedies are logical fallacies. I think, Paul said that The case of bladder cancer was judged as ‘direct AE’ of homeopathy based on the following sentence/quote: “(…) the patient developed cancer of the bladder, that occurrence suggesting that even after a correct homeopathic remedy has been prescribed, a patient may subsequently contract a cancerous condition” Geukens (2001). This conclusion belongs to the reviewers – they classified the effect as direct -which is again a logical fallacy. ( the homeopaths can claim whatever they want.)

  • Vicky says:

    You did not refer to the study, yet you linked to it,…
    And now you’re shifting the goalposts by excluding my points as if you’d acknowledged them from the beginning. Cute.

    I do (did from the start) understand what you wanted me to say, but, as we Germans use to say, das Leben ist kein Wunschkonzert.
    You asked how supposedly inert treatments can have any effect, and I gave an answer – take it or leave it.

    • Tim says:

      Oh I did not see that – I did not exclude your points ; they were not relevant to homeopathic dilutions besides lactose intolerance – which was not the issue in these studies.

  • Mojo says:

    I brought the study up in response to Magufo’s ad hominem argument that Professor Ernst has an anti-homoeopathy agenda because he has published a study of adverse effects of homoeopathy. Its results and their possible interpretations don’t matter as far as my argument is concerned. Personally, I don’t think that there is anything happening there beyond an application of the post hoc ergo propter hoc fallacy. Homoeopaths may disagree.

  • Tim says:

    Vicky

    (You did not read carefully – you were under the impression that the conclusion was the homeopath’s, not the review’s authors’ which is wrong – the reviewers concluded that – not the homeopaths. ) And I did not link the study – Mojo did. )

    I dont think you addressed the specific issues but you don’t have to.

    For example, my objection to this study ( even though I praised different parts of it ) was that: the conclusion that cancer could be a direct or adverse effect of homeopathic higher dilutions is a logical fallacy no matter the method one used or the claims of homeopaths were.

    I would be open to read and consider any rational answer, if anyone is interested, of course, in providing one.

  • Vicky says:

    Tim,
    the review (linked in the blog post above) states that “[c]ausality was estimated based on the description provided by the authors of the primary articles.”

    And I did not link the study – Mojo did.

    Are you kidding? Here, let me refresh your memory:

    Vicky

    1. According to the study Mojo referred to http://www.ncbi.nlm.nih.gov/pubmed/15532700 the specific Adverse effects were caused by homeopathic high dilutions known as “remedies” which are typically prescribed to patients. If the study is valid then homeopathic high dilutions have measurable effects on human organism as homeopaths claim. Is this correct?

    You asked me about this specific study. You linked to it twice. It was clear from the context in which it was originally linked that the point was not that the study showed real effects, but that one doesn’t need to be an opponent of homeopathy to look at adverse effects; if there was any doubt left about this intention, Mojo explained that above. You asked a question based on assumptions (adverse effects were specific, high dilutions were used -> occurence of adverse effects means measureable effects of high dilutions). I told you that assumption #1 was incorrect – adverse effects needn’t be because of the non-existent ingredient (they can be caused by “inert” ingredients), or even due to an ingredient at all (they can due to a nocebo effect).

    I dont think you addressed the specific issues but you don’t have to.

    I know I’m repeating myself, but: I answered your question. Not the way you obviously wanted it answered, but that’s life.

    my objection to this study ( even though I praised different parts of it ) was that: the conclusion that cancer could be a direct or adverse effect of homeopathic higher dilutions is a logical fallacy no matter the method one used or the claims of homeopaths were.

    No, that’s not what you did, at least not in your first comment. You assumed “that all AE are linked with lower dilutions less than 6x”, but called it “completely irrational” that “the case of bladder cancer was judged as ‘direct AE’ of homeopathy”. Where material doses are used, it is not a logical fallacy to assume a direct adverse reaction. In your second comment, you claimed that “higher or lower dilutions did not cause this condition.”, ruling out that lower dilutions can cause cancer. It’s only now, in your latest comments that you claim only high dilutions were used and that because of that it’s impossible these were direct results, but the review doesn’t give the dilution for every remedy the patient took, so it’s still only assumptions. You’ve shifted the goalposts gradually, but it hasn’t gone unnoticed. I wish you better luck next time.

    I would be open to read and consider any rational answer, if anyone is interested, of course, in providing one.

    You won’t get better answers than those given by the authors of the review.

  • Tim says:

    Vicky

    Mojo initially referred to and linked the study and I copied the link from him – I did not bring the study in the discussion I just commented on it – look at his first comment click ( it seems a kindergarden issue at this point .)

    Paul said:
    The case of bladder cancer was judged as ‘direct AE’ of homeopathy based on the following sentence/quote: “(…) the patient developed cancer of the bladder, that occurrence suggesting that even after a correct homeopathic remedy has been prescribed, a patient may subsequently contract a cancerous condition” Geukens (2001).

    That was his reasoning. He did not say that a lower dilution might be the reason.

    “[c]ausality was estimated based on the description provided by the authors of the primary articles.” means that the reviewers estimated the cause. I have to assume that the reviewers critically summarize the original reports and they don’t arrive to absurd conclusions that homeopathic dilutions even lower ones – (unless it is Polonium or something else) …may be the cause …..of a cancerous condition. It is their responsibility to describe it critically.

    It is like writing a systematic review on the efficacy of prayer ( or……. fairies ) and if they find a case that the person praying got cancer while the priest had promised that s/he will be always… healthy you arrive to the conclusion that one AE of prayer might be…… cancer.

    How can someone be a scientist and think like that? Do you realize that it is really absurd for a systematic review to arrive to such a conclusion that Homeopathy or….. fairies can be ……the cause of a cancerous condition?

    • Vicky says:

      Mojo initially referred to and linked the study and I copied the link from him

      You asked me to comment on it.

      I did not bring the study in the discussion I just commented on it

      No, you asked me to comment on it.

      ( it seems a kindergarden issue at this point .)

      That’s because you’re acting like a kindergardner.

      He did not say that a lower dilution might be the reason.

      (kindergarden mode)Well, he did not say that it didn’t!(/kindergarden mode)
      You were already sure it couldn’t be because of homeopathy of whatever dilution before you entered the discussion, as is clearly visible from your comments.

      “[c]ausality was estimated based on the description provided by the authors of the primary articles.” means that the reviewers estimated the cause.

      Based on the information the case studies provide. Do you think they would have concluded the treatment could have caused cancer if the cancer hadn’t played a huge role in the case study? Homeopaths can either be taken seriously with all consequences or not.

      I have to assume that the reviewers critically summarize the original reports and they don’t arrive to absurd conclusions that homeopathic dilutions even lower ones – (unless it is Polonium or something else) …may be the cause …..of a cancerous condition. It is their responsibility to describe it critically.

      Again: your concluded it was impossible before even knowing any details (unless you were lying about being unable to read the review), and this was obvious from the beginning.

      It is like writing a systematic review on the efficacy of prayer ( or……. fairies ) and if they find a case that the person praying got cancer while the priest had promised that s/he will be always… healthy you arrive to the conclusion that one AE of prayer might be…… cancer.

      First of all, both prayer and fairies are immaterial, homeopathic remedies aren’t. Giving someone pills, drops, tablets, suppositories, creams, … can have a direct, physiological effect on them, prayer, good/bad wishes and fairies can’t. Second, except for some obscure sects, nobody claims that prayer can treat anything. Homeopathy, on the other hand, is often paid for by national health care systems and studies on it have been conducted using public funding. This is used by proponents as evidence for legitimacy and efficacy of this treatment, yet it’s unthinkable that there might also be unwanted effects?

      How can someone be a scientist and think like that? Do you realize that it is really absurd for a systematic review to arrive to such a conclusion that Homeopathy or….. fairies can be ……the cause of a cancerous condition?

      And this is the answer you wanted to hear: no true scotsman scientist can find that homeopathic treatment of any kind can ever cause cancer. Except that there are ways it might cause cancer (see above).

      Just so we’re clear: I don’t think that anything that has been diluted out of existence can cause cancer. If all the ‘remedies’ used were highly dilute, didn’t contain a cancer causing excipient, were prepared properly and were unadulterated, I think it would be more likely that the cancer was caused by the radiation due to the telephone call to make the appointment with the homeopath than by the ‘remedies’ (which would be tremendously unlikely).
      But I understand that if these conditions aren’t met, any of them can cause a seemingly safe preparation to be actively harmful and even cancer-causing. You understand this, too, but you’re unwilling to let it get in the way of your “Ernst is no true scotsman scientist admit it already” frenzy.

  • Tim says:

    Vicky your response is more emotional and less rational; this mode of thinking does not promote logical conclusions.

    Unless a carcinogenic lower dilution ( or a not imperfect higher dilution) is the cause of a cancerous condition then the entire hypothesis is pointless. I am not excluding that.

    But Paul did not say that the dilution was the possible cause. My objection is based on the reasoning Paul gave:

    The case of bladder cancer was judged as ‘direct AE’ of homeopathy based on the following sentence/quote: “(…) the patient developed cancer of the bladder, that occurrence suggesting that even after a correct homeopathic remedy has been prescribed, a patient may subsequently contract a cancerous condition” Geukens (2001).

    He based his judgment that cancer was a direct effect of homeopathic treatment on the “homeopath” ‘s claim – NOT on the possibility that a cancerous dilution might have been prescribed. This is Dr. Ernst review.

    Thats way I refer to the the efficacy of prayer example – If someone claims that your wishes can cure you and you get sick it , are the wishes that caused the condition? Is it a valid conclusion?

    It is a metaphysical conclusion and you are free to adopt it – just don’t pretend it is science.

    • Vicky says:

      Emotional? Hardly, unless you count amusement. You can ignore it all you like, but your comment history shows that your opoinion on this matter was set before you started commenting here. You’re also asking questions that I already answered – please read more carefully.

      Let’s say this case was wrongly attributed to the homeopathic treatment – does that invalidate the entire review, or is it possible that the other 29 case reports/series that showed direct harm are strong enough to still conclude that homeopathic treatment does in fact have the potential to harm a patient?

  • Tim says:

    You did not sound amused thought. Any how to answer your question it does not invalidate the study no -I was the first to praise it – look at my first comment., However including cases like that weakens its value.

    • Vicky says:

      I’m not responsible for your intonation – if it doesn’t sound amused you’re reading it wrong.
      I don’t doubt that you think you’ve praised the review, but I’ve already hinted at why this “praise” is quite meaningless. It seems you don’t really understand what I’ve been saying – you’re just too confident with your conclusions – so I’ll try to explain it with an anology.

      Let’s say a well known director made an adaptation of Dickens’ David Copperfield and blogged about it. We could certainly assume that he’s very pleased with his own work and his blogging reflects that.
      Now someone appears in the comments section and says that while he thinks it’s a great idea to make this film, how could the director ever even think of making that kid who played Harry Potter his Uriah Heep? He says that he didn’t see the film (because nobody will take him and he himself can’t afford going to the cinema), and he might have understood it if the director had picked that bloke who played Ron Weasley, but Potter as Uriah? Nobody in their right mind would think that’s great cinema!
      Someone else says there are many possible reasons for why the actor was picked, but the other commentator ignores them and continues to insist that it can’t be a good film, pointing out that the director said he picked the actor because of how good he was in the casting, and if any of the other reasons had been important the director surely would have mentioned it?
      When asked if the film with that many roles (after all David Copperfield meets many people who are at least as important for the story as Uriah Heep) could still be great even if one actor wasn’t the best pick, the commentator responds that yes, the film may still be good and he even praised it but picking the Potter actor weakens it.

      Yes, that’s what you’ve been doing – criticising a review you didn’t read because it included a conclusion you didn’t like – and that was painfully obvious from the beginning. The praise you gave was not praise of the review, but some empty verbiage; that was obvious, too.
      Have you had the chance to read the review yet? I don’t know if this is a limited offer, but it’s available for free right now (you just need to follow the link Edzard Ernst provided).
      Seriously, there is nothing but amusement I feel at this point, and every new comment you post adds to it, so keep them coming.

  • Tim says:

    Empty verbiage? What I should do, to send flowers?

    I praised the effort and I asked 2 questions. I was not involved in any original research so I did not arrive to any conclusions.

    The first was the bladder case which is a logical fallacy and you saw it yourself – we discuss it.

    and the second was if these practices Dr. Ernst described represent the typical homeopathic practice. My first impression is that they don’t, since typical homeopathy does not use lower dilutions below 6x and they typically use “remedies” safely prepared from big companies like boiron. But I will look more carefully.

    I m looking for the pdf file not only the abstract which I once had found but I cannot find it now – If you have the link please provide it.

  • Vicky says:

    Empty verbiage? What I should do, to send flowers?

    You reviewed a film you didn’t watch. What do you think you should do (or rather should have done)?

    …which is a logical fallacy and you saw it yourself – we discuss it.

    Nope, I said that under very specific circumstances I’d find it unlikely.

    and the second was if these practices Dr. Ernst described represent the typical homeopathic practice. My first impression is that they don’t, since typical homeopathy does not use lower dilutions below 6x and they typically use “remedies” safely prepared from big companies like boiron.

    Your first impression is wrong. There is no “typical homeopathic practice” in this regard. Some homeopaths only prescribe “high potencies”, some prescribe only “low potencies”, some prescribe both. You don’t need to trust me on this, homeopaths publish papers about that. (Usually I wouldn’t find it necessary to point out that I have linked to this only as evidence for the use of both high and low dilutions, but hey, it’s Tim I’m conversing with – I only provide this link to demonstrate that both high and low dilutions are used. I don’t agree with the authors’ claim that these dilutions have shown effectiveness in clinical trials, so there’s no point in trying to bring this up for discussion.)

    I m looking for the pdf file not only the abstract which I once had found but I cannot find it now – If you have the link please provide it.

    Have you clicked the “Get PDF” link on the page Edzard Ernst linked to? If I were you I’d try that.

  • Tim says:

    Oh dear, oh dear

    I point out the bladder case which is obviously wrong and you said “Let’s say this case was wrongly attributed to the homeopathic treatment” – It does not look good on you to deny that. Let me remind you that your little crusade against my argument was based on your misconception of the bladder case.

    Regarding the lower potencies I will read and will reply – I dont have a preconceived idea about these things and I do like to revise my views if a rational argument is presented.

    It is a good idea – and promotes logical conclusions.

    • Vicky says:

      Tim, I usually get paid for tutoring but since you’ve made me laugh so much I’ll make an exception for you.

      I point out the bladder case which is obviously wrong and you said “Let’s say this case was wrongly attributed to the homeopathic treatment”

      obviously = plainly evident, without any doubt
      Anything that needs to be based on assumptions isn’t obvious. You’re convinced it’s wrong, but that’s different from being obviously wrong.

      Let’s say = let us pretend, let us do as if
      This phrase does not imply agreement. It’s an invtiation to a thought experiment: what would it mean if assumption X was correct?

      In this case: not very much – there are 29 more reports of direct adverse effects and 8 reports of indirect harm from homeopathic treatment. Even if the bladder cancer case was completely omitted, the overall conclusion – homeopathic treatment is potentially harmful – would still be justified.

      Let me remind you that your little crusade against my argument was based on your misconception of the bladder case

      If you think I’m “cursading” against your “argument” you’re wildly overrating both yourself and the strength of your arguments. What I said was independent of who judged the case a ‘direct effect’ of homeopathy, so I don’t see where I based anything on a misconception (not that I agree there was a real misconception). Anyway, I realise that my efforts are futile – whatever I say, it won’t make you question your beliefs, it’ll only be more “proof” for a “crusade” against your “argument”.

      Regarding the lower potencies I will read and will reply – I dont have a preconceived idea about these things and I do like to revise my views if a rational argument is presented.

      I don’t really see the point (unless you’re planning to use the “no true scotsman” again).

  • Tim says:

    Oh thanks for the tutoring Vicky.You are so kind and you seem to know everything. ! i would give you something though. Don’t tutor me for free.

    No. the fallacy of the bladder case is so obvious – I repeat the word – to anyone not matter to what you believe for homeopathy.
    I explained it ; You had nothing else to say at the end besides : “Let’s say this case was wrongly attributed to the homeopathic treatment” and that was really good for you – for a second you did seem to understand what a logical fallacy means.

    The conclusion is really……… metaphysical and I cannot argue against faith. If you believe that Dr. Ernst has some kind of Papal infallibility then your are correct – and he cannot be wrong.

    Denying the logical fallacy of the bladder case makes you seem much less “intelligent” than you pretend to be.

    Furthermore, this arrogant editing style – a funny combination of pretentiousness and self confidence makes things worse for the impression you want to give about your real intelligence besides the fact that you are arguing – arguing so to speak – for something so ridiculous.

    And you think that no one would check the facts and the arguments.

    • Vicky says:

      [...] You had nothing else to say at the end besides [...]

      I’ve said it before and I’ll say it again: I know what you want me to say. But you don’t get to choose the answers you’re given.

      for a second you did seem to understand what a logical fallacy means.

      People who live in glass houses…

      If you believe that Dr. Ernst has some kind of Papal infallibility then your are correct – and he cannot be wrong.

      I never said that nor do I believe it. On the contrary, I believe that as long as we live we’re bound to make mistakes. I also believe that Edzard Ernst himself would happily admit that he’s not infallible, so please stop building straw men.

      And you think that no one would check the facts and the arguments.

      So you’ve had the chance to actually read the review now? What do you think, is the conclusion justified?

  • Tim says:

    OK. Let ‘s suppose ( just for fun ) that cancer might a direct effect of a broken promise (!) of an X homeopath as the review states.

    Now let me ask. I m reading the review – there are about 8 -9 cases we don’t know the remedies. The review writes unknown. How do we know that the “homeopaths” prescribed homeopathic “remedies” and not something else? This is a good faith question and not a criticism ( as the bladder case ).

  • Paul Posadzki says:

    Tim,

    I think, it does not really matter whether the bladder cancer patient should be labeled as direct or indirect as long as it actually happened. In other words, for the patient with bladder cancer, it did not really matter whether we would judge his case as direct or indirect- he had the disease! Maybe, if we had created a third category of cases, let’s say ‘unlabeled/unknown attribution’ (in addition to direct and indirect ones) would you be happy? No, I am definitely not the Alpha and Omega, I admitted making mistakes in our review (see our response to the Letter to the Editor in the current issue of IJCP). Also, the Geukens case was marked as ‘unclear’ simply because we did not know what could be the possible explanation for the disease. Finally, whether this case is a ‘logical fallacy’ or not also does not matter as long as Geukens himself believed that homeopathic remedy was to blame. Thanks

    • John says:

      I think John means that one should be approaching primary and secondary studies critically ; and avoid adopting uncritically whatever information serves her or his current bias — pro or anti homeopathy.

      If Geukens himself believes that homeopathic remedy was to blame for bladder cancer and you adopt this as truth ( maintaining the same time the position that homeopathy cannot have any effect because it is water ) shows a very strong bias which is unscientific. This is a logical fallacy and unfortunately or fortunately we communicate with logical arguments – at least in the medical field and other sciences. If you don’t comply with logic whatever arguments are useful only in religion and the arts – this is correct and I agree with the previous comments.

      Regarding the rest of the evidence : why do you bother publishing such a study when you don’t have all the evidence???
      – for many cases even the remedies or whatever were used were not known. We don’t know if homeopathic remedies were used……….

      • Pete 628 says:

        I’m totally confused. What do you mean by “I think John means that one should be approaching…”? You are the only person named John who has commented on this article.

  • Mojo says:

    For some reason the title of Walach, Lewith and Jonas’s reply (“Can you kill your enemy by giving homeopathy?”) made me think of all those homoeopaths who have threatened to make skeptics really ill by giving them homoeopathic remedies.

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