MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Dengue is a viral infection spread by mosquitoes; it is common in many parts of the world. The symptoms include fever, headache, muscle/joint pain and a red rash. The infection is usually mild and lasts about a week. In rare cases it can be more serious and even life threatening. There’s no specific treatment – except for homeopathy; at least this is what many homeopaths want us to believe.

And, of course, we don’t want to listen to just any odd homeopath, we want true experts to tell us the truth – for instance, experts like Dr. R.K. Manchanda, Deputy Director(Homoeopathy), Directorate of ISM & Homoeopathy, Govt. of NCT of Delhi and Dr. Surinder Verma, Assistant Director (Homoeopathy), Directorate of ISM & Homoeopathy, Govt. of NCT of Delhi. They authored an article which states the following:

There are about 25 homoeopathic drugs available for the treatment of dengue fever. These are Aconite., Arnica, Arsenic-alb., Arum-tri., Baptisia., Belladonna., Bryonia., Cantharis., China officinalis Colocynthis., Eupatorium perfoliatum., Ferrum metallicum., Gelsemium., Hamamelis., Ipecac., Lachesis, Merc-sol, Nux vomica., Podophyllum., Rhus toxicodendron., Rhus-venenata., Sanicula., Secale cornutum and Sul-acidum. These drugs had been successfully used by various homeopaths across the globe for its treatment and management. In 1996 during the epidemic of dengue in Delhi Eupatorium perfoliatum was found most effective.

Sadly, the article does not provide any evidence. A quick Medline search located one (!) single trial on the subject. Here is the abstract:

A double-blind, placebo-controlled randomized trial of a homeopathic combination medication for dengue fever was carried out in municipal health clinics in Honduras. Sixty patients who met the case definition of dengue (fever plus two ancillary symptoms) were randomized to receive the homeopathic medication or placebo for 1 week, along with standard conventional analgesic treatment for dengue. The results showed no difference in outcomes between the two groups, including the number of days of fever and pain as well as analgesic use and complication rates. Only three subjects had laboratory confirmed dengue. An interesting sinusoidal curve in reported pain scores was seen in the verum group that might suggest a homeopathic aggravation or a proving. The small sample size makes conclusions difficult, but the results of this study do not suggest that this combination homeopathic remedy is effective for the symptoms that are characteristic of dengue fever.

This is a 2007 study by a well-known US homeopath. Its results fail to confirm that homeopathy is effective for Dengue. So, surely the homeopathic community has since stopped claiming that homeopathy is an option for this infection!

No, you guessed correctly, they continue claiming that homeopathy works for Dengue. Currently, there are about half a million websites doing exactly that. An example is this article published YESTERDAY (!):

Alopathy is no more the only solution for Dengue these days. Especially in a place like Bengaluru where doctors and medicines are both expensive, residents have now turned to a cheaper and an effective alternative-Homeopathy to combat Dengue.People have been milling Homeopathy clinics and hospitals for an antidote. Dr Sudhir Babu of Javaji Advanced Homeopathy said, “People ask for some cure to keep the disease at bay. We do in fact have medicines to help build immunity against the ailment.”The dosage is for four or five days and is taken daily. Homeopathy has now become a trusted alternative in the field of medicine, especially because of its easy acceptibility among children and adults. According to a survey by IMRB, 100% people know about this form of medicine and 92% perceive it as a reputed form of treatment. The medicines that are administered depending on the symmptoms of Dengue Fever are Aconitum Napellus, Arsenicum Album, Belladonna, Bryonia Alba, Cantharis, Cinchona Officinalis, Eupatorium Perfoliatum, Gelsemium, Ipecacuanha, Nux Vomica, Rhus Toxicodendron and Rhus Venenata.

What I found particularly impressive here is the way popularity has been used to replace evidence. This, I think, begs several questions:

  • How long will homeopaths continue treating self-limiting conditions to claim success based no nothing but their natural history?
  • How long will they continue to lie to the public?
  • How long will they refuse to learn from the evidence?
  • How long will they ignore even the most fundamental rules of medical ethics?
  • How long will we let them get away with all this?

33 Responses to Homeopathy = a dangerous and unethical branch of pseudo-medicine that is impervious to progress

  • The cited paper on the RCT in Honduras alone is worth a separate blog entry. My favorites are:

    “Despite this misdiagnosis, from a homeopathic standpoint, these patients with pain and fever should theoretically respond to this combination of remedies, well known in the homeopathic literature for their use in flu-like syndromes. The fact that they did not is troubling, suggesting that further studies of this combination may not be indicated. However, there are several factors that could have contributed to this outcome.”

    this:

    “It is also possible that the repeated doses of the 12C potency caused a proving or aggravation in those taking verum, whereby the symptoms got worse temporarily after taking the doses each day. Of interest is the sinusoidal curve in the mean pain scores of those taking verum (Fig. 1) compared to placebo. Since medicines were taken uniformly at 8 a.m., 12 p.m., 4 p.m., and 8 p.m. and symptom scores were recorded in the morning (7–9 a.m.) and evening (7–9 p.m.), the higher scores at 36, 60, and 84 h would have coincided with the evening recording, after 3–4 doses of the medication had been taken. Conversely, the morning report would have reflected 12 h without medication. Considering this possibility, perhaps a lower potency combination, lesser dosages per day, or both, should be considered in future protocols.”

    They completely overlook the fact that the placebo group had a similar sinusoid, although a bit belayed and not as visible.

    and finally the cherry on the cake:

    “Finally, one must address the now popular ‘entanglement’ theory.13 This theory borrows from quantum physics and posits that the homeopathic interview along with the intention to heal from the homeopathic provider have a positive effect on the outcome of treatment. If this is correct, one would expect that a combination remedy given to all subjects without the involvement of the patient–physician relationship would fail. ”

    In other words, patients get well because the doctor wants it.

    In summary, their attempts to expain away their own negative findings is hilarious.

  • Right on Edzard…. Keep up the great work!

  • Global warming is moving the mosquito vector north. Many areas of America and Europe will see Dengu, malaria, chikunguyna etc. cases go up exponentially.
    http://www.scientificamerican.com/article/mosquito-borne-diseases-on-the-uptick-thanks-to-global-warming/

    I am sure you will be the first one to dig out these very references and update your homeopathy knowledge to select the right medicine. Remember G Subramanian: She converted to homeopathy altogether and ran a heated discussion for homeopathy after spending years of studying the Scientific Medical syste,

    “In rare cases it can be more serious and even life threatening.” You should define “rare” for a population that has no earlier exposure to this vector.

    • @Iqbal Krishna

      If there is one area of medicine where homeopathy clearly fails it’s with infectious diseases. You can usually measure the extent of infection not just by symptoms but by demonstrating the causative virus or bug is there or not: independent biomarkers such as the presence of microbial antigens or microbe-specific antibodies tell the story even in cases where isolating or visualizing the microbe is difficult. Advocating homeopathic medicine water or sugar pills for treatment of any infectious disease is criminally irresponsible. Homeopathist lunatics who, like yourself and those mentioned in this blog post, think any homeopathic remedy is appropriate for management of dengue deserve nothing but extremes of scorn, disdain and contempt for their failure of ethical responsibility. Semantic tricks such as focussing on ‘treating the symptoms of a potentially fatal infectious disease are the tricks of the nursery.

      For goodness’ sake, Iqbal, even the article (it’s from the partisan journal Homeopathy) was forced to conclude “…the results of this study do not suggest that this combination homeopathic remedy is effective for the symptoms that are characteristic of dengue fever.” I presume the authors are already aware that homeopathy has zero antimicrobial potential.

  • @ Frank Odds

    “…the results of this study do not suggest that THIS COMBINATION homeopathic remedy is effective for the symptoms that are characteristic of dengue fever.”

    You should read carefully. Things change, if the right combination is used.

    http://www.bioline.org.br/pdf?pr13095

    • yes, of course!
      and until we have evidence to the contrary, all other homeopathic remedies are not supported by anything but opinion.

      • “If there is one area of medicine where homeopathy clearly fails it’s with infectious diseases.”

        Read comments of 2 doctors from Michigen, during the same period.

        http://www.pbs.org/wgbh/americanexperience/features/biography/influenza-victor-vaughan/
        https://www.ecampnd.com/homeopathy/A_Chorus_of_Fifty_in_Harmony.pdf

        You believe, the ex AMA president would have allowed the homeopath to get away with the report, unless it was true?

        • why don’t you read up on what is evidence and what isn’t?
          here is a blog post that might help http://edzardernst.com/2012/11/what-is-and-what-isnt-clinical-evidence-and-why-is-the-distinction-important/

          • Ernst, your post is a opinion piece, not a peer review clinical trial.

          • After reading Dr. Hahn’s comments about you, I refuse to accept your analysis.

            I would rather you clear up the allegations of “ideological bias leading to tampering with data.”

        • “You believe, the ex AMA president would have allowed the homeopath to get away with the report, unless it was true?” You’re now reduced to citing books published in 1921 in support of your preposterous claims?! OK, try Dan King’s Quackery Unmasked from 1858. He nails the stupidity of homeopathy in more or less the same terms as you find posted on this blog. But, like unsinkable bath toys, homeopathists keep popping up for more. You, Iqbal, are a shining gem among the unsinkable bath toys.

          Your point about the ex-AMA president is pure argument from authority. What about all those other MDs quoted in your link: don’t you want to add them as authorities? Take Laura A. Hurd, M.D., San Francisco: “In Hahnemann Hospital of San Francisco, homeopathic remedies acted in a curative way while, with some other forms of treatment, the result was only palliative.” Well now, who could possibly argue with that?

          Or G.H. Wright, M.D., Forest Glen, Md.: “I attended over one hundred cases without any fatalities. I never deviated from the homeopathic remedy. I never gave aspirin. One case that was loaded with Aspirin before I saw him, referred to me from an old school physician, died. This epidemic should encourage us to renewed faith in homeopathy.” Or how about C.J. Loizeaux, M.D., Des Moines, Iowa: “The German Aspirin has killed more people than the German bullets killed.” What marvellous testaments to clinical quality and intellect.

          For readers of this comment who can’t be bothered to read Iqbal’s link, it’s a long series of testimonials by qualified medics to the terrible, mortal risks of aspirin, whereas homeopathy cures influenza. The terrible risks of aspirin don’t stack up at all with today’s evidence concerning aspirin, and influenza is, in most cases, a self-limiting disease, so it responds to homeopathy in exactly the same way as it would to teaspoonfuls of water.

          The one statement that may be accurate comes from G.B. Stearns, M.D., New York: “Through the International Hahnemann Association I have collected over 17,000 cases of influenza with a mortality of 4%.” That rings true for 1921: the 1918 pandemic had a 2.5–10% mortality, depending on which source you look at.

          Iqbal, I’m afraid your concepts of evidence are risible. Remember: when you think you’re good, you’re probably comparing yourself with the wrong people.

          • “The one statement that may be accurate comes from G.B. Stearns, M.D., New York: “Through the International Hahnemann Association I have collected over 17,000 cases of influenza with a mortality of 4%.”

            The 1918 flu pandemic (January 1918 – December 1920) was an unusually deadly influenza pandemic, the first of the two pandemics involving H1N1 influenza virus. It infected 500 million people across the world, including remote Pacific islands and the Arctic, and resulted in the deaths of 50 to 100 million (three to five percent of the world’s population, making it one of the deadliest natural disasters in human history.

            It killed between 10%-20% (50m-100m/500m) of the INFECTED. Over all it killed 3%-5% of the population. Wikipedia.

          • Iqbal, you’re a treasure of cerebration failure. The Wikipedia article says “The unusually severe disease killed up to 20% of those infected, as opposed to the usual flu epidemic mortality rate of 0.1%.” That’s up to 20%, not “10–20%”. There are plenty of sources that give lower estimates, e.g. https://virus.stanford.edu/uda/ says 2.5% for the USA. http://www.history.com/topics/1918-flu-pandemic estimates 500 million people infected worldwide of whom 20–50 million died. That’s 4–10%.

            The fact is, nobody knows the mortality rate for sure. We have absolutely no idea what global distribution of patients Dr Stearns of New York had among his 17,000 cases. All I said was his 4% mortality looked appropriate.

            More to the point of this discussion: the Wikipedia article estimates the normal epidemic mortality rate as only 0.1%. Most of the deaths occur among the elderly. Small wonder that patients receiving homeopathy didn’t die, as your 1921 piece, comprising uncontrolled data quotes from homeopaths, already shows. For most people, influenza is a self-limiting disease. That’s what homeopathy successfully treats, isn’t it? Self-limiting diseases that get better anyway or whose symptoms at least regress to the mean.

          • @ Frank Odds

            Specific details do not jell with you. “Dean WA Pearson of Philadelphia collected 26,795 cases of influenza case treated by homeopathic physicians with a mortality of 1.05% while the old school mortality is 30%”.

            ” The terrible risks of aspirin don’t stack up at all with today’s evidence concerning aspirin, and influenza is, in most cases, a self-limiting disease… ”
            Deaths calculated at 50 m -100 m are due to self limiting spanish influenza.

            Would you take an aspirin if you had flu? Or will your doctor insist for paracetamol? For your information both are equally bad. Bringing down fever has no scientific rationale. The increase in body temperature is the body’s immune response to the virus attack, which these drugs interfere with.

            For Aspirin, the doctor wrote: In all cases, it masks the symptoms, and renders immeasurably more difficult the selection of the curative remedy. Apparently, Aspirin bears no curative relation to any disease and it ought to be prohibited.” Valid even today.

          • @Thiqbal

            “Specific details do not jell with you.” You’re right: I’m not prepared to spend my time reading all the rubbish in your link. I cherry picked the Stearn example from a quick skim as one of the few that makes sense. Pearson’s quote makes no sense at all.

            Please reread my last comment in its entirety. Ask a friend to help you with the words you don’t understand. I fully acknowledge the ‘Spanish ‘flu’ pandemic wiped out lots of people. I even quote the Wikipedia article to say so. Then I go on to cite the datum that the normal mortality rate even in epidemics is only 0.1%. Let me expand on this. People with ‘flu-like symptoms, even those who seek medical attention, may not actually have influenza. Because it is normally a self-limiting disease in otherwise healthy people, proper virological diagnoses are seldom undertaken.

            If a person with ‘flu-like symptoms visits a homeopath they appear to recover because the condition is self-limiting. What does a homeopath do to diagnose the presence of influenza virus? Dowse with a pendulum? Use an ouija board?

            You wrote “Would you take an aspirin if you had flu? Or will your doctor insist for paracetamol? For your information both are equally bad. Bringing down fever has no scientific rationale. The increase in body temperature is the body’s immune response to the virus attack, which these drugs interfere with.” I most certainly would take an antipyretic for ‘flu-like symptoms. Your knowledge of the immune response is below playground level.

            You wrote: “For Aspirin, the doctor wrote: In all cases, it masks the symptoms, and renders immeasurably more difficult the selection of the curative remedy. Apparently, Aspirin bears no curative relation to any disease and it ought to be prohibited.” Valid even today.” Any sane person reading this will realize these words characterize you as an idiot or a troll. I’ve decided I no longer feed trolls: this blog attracts too many of them.

          • Frank Odds on Thursday 18 August 2016 at 20:26

            “If a person with ‘flu-like symptoms visits a homeopath they appear to recover because the condition is self-limiting. What does a homeopath do to diagnose the presence of influenza virus? Dowse with a pendulum? Use an ouija board?”

            The patients with spanish flu in 1918 went to orthodox doctors, took aspirin and died.
            http://cid.oxfordjournals.org/content/49/9/1405.full.pdf+html

            The patients in 1918, who had flu like symptoms, went to homeopaths and lived. Great understanding.

            “I most certainly would take an antipyretic for ‘flu-like symptoms. Your knowledge of the immune response is below playground level.”

            Refresh your playground level knowledge.

            http://www.who.int/bulletin/volumes/81/5/Russell0503.pdf

    • Well, Iqbal, nice study you have posted, it has one severe drawback. counts – as a discrete parameter are not to be tested with a t-test which requires (a) continuous parameters and (b) a gaussian distribution. Counts, especially close to zero, violate *both* conditions. So this study is worthless.

      • @Iqbal
        If you fill a statistics program with data on the amount of money left by the Tooth-fairy in different situations and run a t-test (or any other test for that matter), SPSS will produce a result that may well look impressive to those who do not understand what prior plausibility means.
        But that result will not make the Tooth-fairy appear 😀

        • The proper test in your “study” would have been a mixed model ANOVA based on non-paramteric tests and the appropriate post-tests between treatments

        • Iqbal, you are truly hilarious. First, you do not know who you are dealing with. I am a scientist in computational biology with 25+ years experience. I KNOW how a t-test is made and – more importantly – when it is appropriate. In the study you posted it is not. Any reviewer with minimal statistical knowlegde would have thrown the study out.

          Second, the link to pubmed links to a drug use study and has nothing whatsoever to do with the question here. However, if you want to come up with the argument people use it therefore it must be effective, in the 19th century belladonna was a very popular homeopathic remedy to prevent scarlet fever, and praised highly by even the best clinicians of the time. That is until a british doctor looked at a very hard measure, that is the mortality. (available here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2789015/) Quote: “Vaccination in its effects made itself at once recognized, and the contrast between the ravages of small-pox at the commencement of this century, and the almost entire immunity from that disease in an epidemic form, which now prevails, are facts so plainly recognizable, and so appreciable, as in the instance of that disease entirely to remove the difficulty referred to. It is altogether otherwise with scarlatina; notwithstanding the introduction of belladonna, and its extensive employment, both in this country and abroad, as a prophylactic against scarlet fever, we are not aware that the mortality in either has been reduced; a circumstance which itself militates very strongly both against the prophylactic and the remedial efficacy of belladonna.” Now guess who is still using belladonna against scarlet fever, despite this damning conclusion (more than 100 years old) ? Correct, homeopaths. This is a prime example that popularity does not mean effectiveness.

          • @Thomas Mohr

            “First, you do not know who you are dealing with. I am a scientist in computational biology with 25+ years experience. ”

            So why are you stuck in the first year of the 25 years? Did not someone tell you to reconfirm data from 2 or 3 possible sources?
            The trial that you refer is done in 1848. This idiot has caught on to one statement ” Belladona for Scarlet fever” by Hahnemann. He did not check for later version? Did you?

            http://www.ijrh.org/article.asp?issn=0974-7168;year=2014;volume=8;issue=3;spage=160;epage=165;aulast=Janardanan

            Read this carefully. Reference 4 & 9. “Organon of Medicine (§241) as “…each single epidemic is of a peculiar, uniform character common to all the individuals attacked, and when this character is found in the totality of the symptoms common to all, it guides us to the discovery of homoeopathic (specific) remedy suitable for all the cases.” In 1808, Aconite N was the medicine for Scarlet fever. If the idiot had read the update, he would not have wasted time for this study with Belladona and made you look xxxx. You would had tearnt in your 25 years that virus mutates? Yes?

            Now you know why vaccine for flu does not work most of the time. Hahnemann observed this phenomena 208 years ago.

            http://treatment.hpathy.com/homeo-medicine/homeopathy-scarlet-fever/

          • Pure comedy Iqbal, your fellow homeopaths look intelligent in comparison.

          • @Bjorn. Hear! Hear! I no longer plan to respond to Thiqbal.

      • You’re making a fool of yorself again Iqbal. Your first link demonstrates that Thomas Mohr is right, the second that there are more people who need to learn how to use statistics.

        • Björn, Iqbal’s link to the Excel Easy website tutorial demonstrates just how intellectually lazy it has become for everyone to discover *how* to perform a statistical analysis (using a spreadsheet) without bothering to firstly answer the fundamental information-gathering questions: What?; Who?; When?; Where?; and Why?

          The website entry for the t-Test states:

          To perform a t-Test, execute the following steps.
          1. First, perform an F-Test to determine if the variances of the two populations are equal.

          Wrong! The first essential test is to determine whether or not the probability mass function of the data closely matches the probability density function of the proposed hypothesis, its null hypothesis, and that of its alternative hypotheses.

          As the number of samples reduces below thirty, statistics become increasingly meaningless. The number of samples used in the tutorial were 7 and 6. Nowhere within the tutorial does it inform the reader that the worked example has produced meaningless results. Instead, it lists the results of the t-Test to a measurement resolution of 9 decimal places 🙂

        • Björn Geir on Saturday 20 August 2016 at 08:49

          As I wrote earlier: The cowboy had a name for the likes of you: YELLOW.

          • Iqbal, I will not comment on the study you posted since it is statistically (at least from the M&Ms) a bit flawed, therefore the p-values are likely too low, aside that you should enlighten yourself about the prior probability and it’s effects. As we say in Austria, one swallow doesn’t make a summer, and with a highly improbable model as homeopathics is, one p-value does not make a significant effect.

            As for the flu pandemic, Aspirin poisoning was a major contributing factor to the mortality rate. Aside that your posts contain a fatal flaw. You tek the overall mortality rate, but overlook that it made a HUGE difference if you got the flu in war torn Austria (with a bad medical service) or the USA which was not affected by the war. In that light homeopathy

          • Björn Geir on Saturday 20 August 2016 at 08:49

            Regret error. The correct phrase was “yellow belly”.

            Take a wager and then wiggle out!

          • Yellow, Wager… What on earth is the person babbling about??

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