MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

You probably remember: the US Federal Trade Commission’s (FTC) has issued a statement announcing that unsupported claims for homeopathic remedies will be no longer allowed. Specifically, they said that, in future, homeopathic remedies have to be held to the same standard as other medicinal products. In other words, American companies must now have reliable scientific evidence for health-related claims that their products can treat specific conditions and illnesses.

Now the AMERICAN INSTITUTE OF HOMEOPATHY (AIH) has published a rebuttal. It is hilarious and embarrassing in equal measure. Here it is in full (I have only omitted their references – they can be seen in the linked original –  and added footnotes in bold square brackets with my very short comments):

START OF QUOTE

November 30, 2016

The American Institute of Homeopathy applauds the Federal Trade Commission’s (FTC) goal of protecting the American public from false advertising claims, but in a recent circumstance we believe the FTC has overstepped its jurisdictional bounds and promulgated false information in what appears to be a bid to restrict health care choices [1] available to the American public.

In Response to the recent Enforcement Policy Statement1 and a Consumer Information Blog,2 both issued by the FTC on November 15, 2016, the American Institute of Homeopathy registers our strong concern regarding the content of the following inaccurate statements:

  1. “Homeopathy… is based on the view that disease symptoms can be treated by minute doses of substances that produce similar symptoms…”

Homeopathy is not based on a “view” or an opinion. It is based on reliable, reproducible, clinically acquired, empiric evidence [2] gathered through two centuries of corroborated data, assisted by thousands of practitioners worldwide [3], demonstrating the actions of different medicinal substances in living systems, aka: the science of homeopathy. In fact, the homeopathic scientific community were pioneers of the modern scientific method including the widespread adoption of blinded and placebo controlled studies in 1885 [4], decades before conventional medicine.3

Homeopathy is not based on a theory or on conjecture, but on principles that have been confirmed by long-studied clinical data, meticulously gathered and analyzed over many years [5].

  1. “Many homeopathic products are diluted to such an extent that they no longer contain detectable levels of the initial substance.”

While the dilution and succussion process of formulating homeopathic medicines does reduce the concentration (and the toxicity) of the original substances, detectable amounts of these materials remain quantifiable in the form of nanoparticles [6] dispersed throughout.4 Multiple independent laboratories, worldwide have confirmed that these nanoparticles persist,5 and that they are biologically active.6 Many other homeopathic products (particularly those sold OTC and described as “low potency”) have dilute amounts of the original substance [7] that remain chemically detectable by straightforward titration.

  1. “…homeopathic product claims are not based on modern scientific methods…”

This statement is false and misleading. The active ingredients within most OTC homeopathic products have hundreds or thousands of case reports from physicians who have used these medicines [8]. These reports of direct clinical experiences establish a collective, real-world dataset that demonstrates which conditions have been observed to respond to treatment. Such historical data is similar to the types of information used to demonstrate effectiveness for many conventional OTC medicines on the market today [9].

The Homeopathic Pharmacopeia Convention of the United States (HPCUS) maintains a formulary describing the appropriate manufacturing standards for homeopathic medicines [10]. Every homeopathic manufacturer member of the American Association of Homeopathic Pharmacists in good ethical standing complies with both manufacturing and labeling standards set by the HPCUS. Consumers should be cautious when using any products that are not distinguished by conformance with “HPUS” on the label.

  1. “…the case for efficacy is based solely on traditional homeopathic theories…”

This statement is false. Neither homeopathy nor homeopathic efficacy is based on any theories. Efficacy for various homeopathic medicines has been established by scientifically reproducible clinical empiric research evidence [11] and cured patient cases followed over many years [12]. Homeopathy is an evidence-based medical subspecialty rooted in patient care.

  1. “…there are no valid studies using current scientific methods showing the product’s efficacy.”

While this statement may have limited accuracy with respect to some OTC products, it is false and misleading with respect to most homeopathic medicines listed in the Homeopathic Pharmacopeia of the United States. Hundreds of state-of-the-art double-blinded, randomized, placebo-controlled studies, many in peer-reviewed journals, demonstrate the superior efficacy of homeopathic medicines in a wide range of conditions, including asthma,7 depression and anxiety,8 chronic illness,9 allergic rhinitis,10 hypertension,11 headaches/migraines,12 sepsis,13 mild traumatic brain injury,14 otitis media,15 cancer,16 and many other conditions [13]. The American Institute of Homeopathy maintains and continually updates an extensive database, available free to the public, with over 6,000 research articles [14].17

Multiple meta-analyses published in peer reviewed medical journals that conclude that homeopathic medicine effects are superior to placebo [15] and that additional study of this therapeutic system is warranted.18,19,20,21,22,23  To that end, we encourage the National Institutes of Health to reverse their current position of blocking funding for homeopathic trials.24

  1. “…marketing claims that such homeopathic products have a therapeutic effect lack a reasonable basis and are likely misleading…”

The conclusion of whether a product has a “reasonable basis” is entirely irrelevant if that product has demonstrable clinical effectiveness. The important question, when it comes to homeopathy, is whether it is effective in clinical settings, not whether it has a “reasonable basis” for how it works. The mechanism by which homeopathy works differs from conventional medicines [16], but this fact does not make these products “misleading”.

Several recent class-action lawsuits brought against homeopathic manufacturers confirm that marketing practices were neither deceptive nor misleading [17].25

The FTC’s inability to formulate a reasonable basis for why homeopathic medicines work should not enter into any governmental enforcement policy statement. The FTC is not a medical organization, lacks expertise in interpreting scientific research [18], and is not qualified to make any comment on the validity of any field of medicine. To be less misleading, the FTC should exclude opinions from its policy statements.

  1. “Homeopathy: Not backed by modern science”

Homeopathy, as a system of medicine, does not fall under the purview of the FTC. Therefore, the FTC has been reckless in expressing an opinion of this magnitude. In this situation, the FTC’s comments can only be construed as being prejudicially biased and intentionally discriminatory against homeopathy. Such statements cause unwarranted harm to public trust and damage to a respected traditional system of medicine in the United States [19].

The American Institute of Homeopathy strongly objects to the FTC’s characterization of the entire field of homeopathic medicine as being without scientific evidence of efficacy. These comments are unqualified and wholly lacking in merit. The release of this Enforcement Policy Statement serves only to align the FTC with several recently released scientifically fraudulent [20] reports by a variety of pseudoscientists [21] and lowers the credibility of this valued consumer protection agency.

This type of misinformation should be embarrassing to a government organization striving to be nonpartisan and objective. The FTC owes an apology to the American Institute of Homeopathy as well as the many consumer groups that look toward this agency for fair and accurate information.

END OF QUOTE

My comments:

1 In healthcare, choice must be restricted to treatments which demonstrably generate more good than harm.

2 The AIH seems to be unaware of the difference between the nature of evidence, anecdote and experience.

3 Fallacy – appeal to popularity.

4 The first randomized, placebo-controlled study of homeopathy was, in fact, published in 1835 – its results were negative.

5 Fallacy – appeal to tradition.

6 The nano-particle explanation of homeopathy is but a theory (at best).

7 Fallacy – appeal to tradition.

8 Fallacy – appeal to authority.

9 Really? Which ones? Examples would help, but I doubt they exist.

10 The proper manufacturing of nonsense must still result in nonsense.

11 See footnote number 2

12 Fallacy – appeal to tradition.

13 For all of these conditions, the totality of the reliable evidence fails to demonstrate efficacy.

14 In this context, only clinical trials are relevant, and their number is nowhere near 6,000.

15 Most of the independent systematic reviews fail to be positive.

16 The mechanism is well-known and is called ‘placebo-effect’.

17 Many class actions also went against the manufacturers of homeopathic preparations.

18 I assume they ‘bought in’ the necessary expertise.

19 Surely, the damage is only to the cash-flow of firms selling bogus products.

20 Really? Name the report you libel here or be quiet!

21 Name the individuals you attack in this way or be quiet!

I must say, I had fun reading this. In fact, I cannot remember having seen a document by an organisation of healthcare professionals which was so embarrassingly nonsensical that it becomes comedy gold. If one of my PhD students, for instance, had submitted such drivel, I would have had no choice but to fail him or her.

Having said that, I need to stress to the AIH:

FULL MARKS FOR AMUSEMENT!!!

 

56 Responses to The AMERICAN INSTITUTE OF HOMEOPATHY just produced pure comedy gold

  • The AIH should therefore challenge the FTC legally and seek redress through the US courts. Have they the confidence to do that?

  • Wow, thank you for my morning chuckle. That response by AIH can only be described as worst organizational delusion I seen in a while.

    I will say that there are probably a few homeopaths that aren’t going to be happy with it though. It will be amusing using AIH’s words to counter the nonsense Venkatesh & his type spout.

  • And full marks to Professor Ernst for pointing these fallacies out (as he does in his new book: ‘Homeopathy’).

    I have tried to understand why those who start to think ‘there might be something in homeopathy’ do not give up as the truth dawns after initial study. Perhaps they live in a very dark place, but just why is that?

    Even my own book (‘Real Secrets of Alternative Medicine’, Amazon, since you ask) tries, but fails to entirely explain this strange phenomenon.

    Hahnemann had it easy. His medical (non-homeopathic) colleagues really were not doing much good.
    His attempts at ‘proving’ (noted to be a mistranslation in both Edzard’s book and mine) are to be applauded. But not the conclusions he drew.
    And times have changed.
    Why haven’t homeopaths?
    Why cannot they move on?
    Faith?

    • Yes Richard, faith.
      Try convincing the pope he is wrong about “the holy trinity” or any of the other sacred cows of christianity. Same with homeopathy and its delusional disciples.

      • @Geir

        “Faith,” states Geir, like that of the Pope’s views of the Holy Trinity, is a sacred cow of Christianity (in the mind of Geir, who is likely not a biblical hermeneutics scholar).

        Faith is exhibited by those in medicine in the reliability and altruism of studies performed by the pillars of “modern medicine,” drug manufacturers. It appears that one must exhibit significant faith to believe that medical research is authoritative and not profit-driven.

        A major reanalysis just published in The BMJ of tens of thousands of pages of original trial documents from GlaxoSmithKline’s infamous Study 329, has concluded that the antidepressant paroxetine is neither safe nor effective in adolescents with depression. This conclusion, drawn by independent researchers, is in direct contrast to that of the trial’s original journal publication in 2001, which had proclaimed paroxetine “generally well tolerated and effective.”2The new paper, published under the restoring invisible and abandoned trials (RIAT) initiative, has reignited calls for retraction of the original study, putting additional pressure on academic and professional institutions to publicly address the many allegations of wrongdoing.

        Troubled from the start
        Few studies have sustained as much criticism as Study 329, a placebo controlled, randomized trial of paroxetine and imipramine carried out by SmithKline Beecham (which became GlaxoSmithKline (GSK) in 2000). In 2002, a US Food and Drug Administration officer who formally reviewed the trial reported that “on balance, this trial should be considered as a failed trial, in that neither active treatment group showed superiority over placebo by a statistically significant margin. Yet this same year, according to the New York State Attorney General’s office, which sued GSK, over two million prescriptions were written for children and adolescents in the United States, all off-label, after a marketing campaign that characterized Study 329 as demonstrating “REMARKABLE Efficacy and Safety.”

        The disparity between what the manufacturer and study authors claim the trial found and what other parties say the data show was an important element in the US Department of Justice’s criminal charges against GSK. Imagine that….a drug company(pillar of “modern medicine”) failed to disclose pertinent research findings and instead allowed and encouraged physicians to prescribe the “no benefit”(for children) drug to millions of their patients. Paxil has been associated with hundreds, if not thousands, of serious side effects, even death.

        I am dubious that there have been more deaths due to misconduct within homeopathy than there have been within “modern medicine.” Just sayin’………

        Be well

    • Richard Rawlins asks why do those who believe in homeopathy live in a very dark place. An assumptive and erroneous remark as is ‘delusional disciple ‘ proffered by a fellow anti cam poster.

      It is hardly worth the merit of responding, but just to put the record straight for me : there are plenty of dark places (just look at Professor Ernst’s ‘most important paper’), homeopathy, chiropractic, Healing etc are within the realms of light.

      I am not a delusional disciple but have the privilege of benefitting from the above and many more. Religion and vaccination are never mentioned, just good old fashioned efficacious treatment by wonderful practitioners.

      Assumptions by anti cam are plentiful on this blog (yes I do understand it is only about atmed; there is no balanced debate having been told in a previous discourse ‘how can you debate with the equivalent of the tooth fairy’ or something similarly inane.)

      So, may I suggest darkness lies in assumptions, intransigence and intolerance of others’ health choices. And darkness may house many delusional disciples, too. Here is wishing all on the blog love and light.

  • HCPUS? I think they meant HPUS (The Homœopathic Pharmacopœia of the United States):

    What is Homeopathy?
    Homeopathy is the art and the science of healing the sick by using substances capable of causing the same symptoms, syndromes and conditions when administered to healthy people.

    Any substance may be considered a homeopathic medicine if it has known “homeopathic provings” and/or known effects which mimic the symptoms, syndromes or conditions which it is administered to treat, and is manufactured according to the specifications of the Homeopathic Pharmacopoeia of the United States (HPUS). Official homeopathic drugs are those that have been monographed and accepted for inclusion in the HPUS.

    Central to all homeopathy is the determination of the effect of substances on healthy volunteers and the use of the developed “drug picture” by the consumer and/or trained health care practitioners according to the homeopathic principle of similia similibus curentur – Let likes be cured by Likes.

    http://www.hpus.com/what-is-homeopathy.php

    Criteria for Eligibility

    4) that for a medical treatment to be considered homeopathic it must reference, or be referenceable to, the traditionally accepted principles of homeopathy. Such referencing will form the “bridge” that will allow for the scientific evolution of homeopathy. The principles and doctrine of homeopathic practice include, but are not limited to, the following:
    · the Law of Similars
    · traditional homeopathic provings
    · cured symptoms
    · toxicologic data
    · Hering’s direction of cure

    http://www.hpus.com/eligibility.php

    Retrieved 2016-12-04 16:45 UTC

    • Pete Atkins said:

      HCPUS? I think they meant HPUS (The Homœopathic Pharmacopœia of the United States):

      They are actually correct: the Convention is the organisation but the HPUS is the ‘formulary’ they produce.

      Of course, they make a big thing out of the legal status of the HPUS, but it must be borne in mind it’s entirely controlled by homeopaths.

      And it’s not cheap:

      HPRS – 1 Year ($1000)
      HPRS – 30 days ($499)
      HPRS – 1 day ($110)
      Corporate (unlimited users) ($15000)

      • Alan,

        I was attempting to convey my tears of laughter at the double entendre in: The Homeopathic Pharmacopeia Convention of the United States.

        convention [noun]:
        1. a way in which something is usually done;
        2. a large meeting or conference, especially of members of a political party or a particular profession or group.

        🙂

    • I have proved it to be good with no side effects for me and i react to so many drugs that are not natural. Homapathic works with the body synthetic medicine is designed to cause other health problems so the person in yrs to come will never get better and need mord drugs this is a money making racket . That is coning the people who are blinded by the system into thinking the medical service is helping them

  • Struth! Desperate people grovelling for nanograins of self-justification. Hilarious reading for anyone with a knowledge of biomedical science and a penchant for critical thinking.

    I recently came across this publication: a clinical trial on the efficacy of paracetamol, aspirin and caffeine combinations in migraine treatment. For anyone who believes homeopaths when they say their clinical trial literature is no worse than that of conventional medicine, it’s worth a look at the abstract. The design is sound, the number of patients enrolled (1220) is vastly more than we ever see in homeopathy trials, and the results show a clear-cut advantage for the treatment group over placebo, albeit far from a 100% success story.

    I make no apologies for this off-topic link: the publication is the sort of thing a camist can only dream about, and for readers of this blog who think critics like me are too harsh on the exponents of Big Snakeoil it’s a reality check on authentic medical science.

  • Prof. Ernst, I would like to draw your attention to a detail you might have missed, namely the blinded placebo controlled studies. The statement of the AHI suggests that homeopaths where instrumental in developing placebo controlled studies which in turn might lead to the conclusion homeopaths where insturmental in developing tests for efficacy of a drug. However, in homeopathy a placebo controlled study is a proving and NOT a study to prove efficacy. Once this proving is done the treatment stands and even statistics will not alter it, as has been the case with belladonna. This is in no way comparable to modern drug development.

  • Calling something placebo effect is simply a lame excuse to not validate claims and not investigate further. Placebo effects are, by all definitions, real positive effects, with real causes.

    • “…not validate claims and not investigate further…”
      nonsense!
      there are >400 controlled clinical trials of homeopathy. how many more do you want?

      • Show me one that clearly defined ‘placebo effect’ and then clearly demonstrates that a positive effect of any alternative medicine is caused by ‘placebo effect’ as defined. Not possible. Placebo effect is the term used when we do not understand what happened.

        Eg. Webster’s defines placebo effect as: “improvement in the condition of a patient that occurs in response to treatment but cannot be considered due to the specific treatment used.”.

        Therefore: If the homeopathic medicine causes an improvement in the patient condition due to ‘placebo effect’, then it cannot be due to ‘placebo effect’, according to Webster’s definition of placebo effect.

        Blaming placebo effect is irresponsible shirking of the responsibility to once actual cause.

        • unhelpful definition!
          If the homeopathic CONSULTATION causes an improvement in the patient’s condition regardless of whether the patient took a homeopathic remedy or a placebo, it cannot be the remedy that caused the improvement but placebo and possibly other non-specific effects.

          • If the homeopathic consultation causes benefits then we should support homeopaths and study their successes.

            Saying “placebo and possibly other non specific effects” is nonsense, poor use of English (effects are not causes) and a dismissal of the search for real causes, real understanding.

            The fact that we don’t have evidence that the medicines work is irrelevant to the outcome. The consultation and treatments provided benefits. In the interest of science and of better medical practice, we have an obligation to investigate, not to dismiss.

            If we want to understand how benefits arise, we need to study all situations where they arise, not to dismiss some because of our unscientific prejudices.

            Note: absence of evidence is not evidence of absence, much less proof of absence of benefit. Claims of absence of evidence are generally supported by dismissing and ignoring evidence that is contrary to the claim.

          • “If the homeopathic consultation causes benefits then we should support homeopaths and study their successes”
            no, we should maximise these effects in conventional clinical practice; they are not specific to homeopathy.
            “Saying “placebo and possibly other non specific effects” is nonsense, poor use of English (effects are not causes)” – sorry for using the wrong term; replace effects with factors.
            “The fact that we don’t have evidence that the medicines work is irrelevant to the outcome.” I disagree.
            “If we want to understand how benefits arise…” this understanding exists; we need to implement it which is easier said than done in a system where there is so little time for consultations.

          • “If the homeopathic CONSULTATION causes an improvement in the patient’s condition regardless of whether the patient took a homeopathic remedy or a placebo..”

            Consultation acts as placebo and causes improvement. If the doctor consults the patient and informs him that he is good, no requirement for any medicine, the patient should get well: “that caused the improvement but placebo and possibly other non-specific effects.”

            As per you, Homeopaths have been getting away with this policy for 200 years, Why not follow the protocol of sending back first time patient after consultation with positive comment “you are good, no medicine required” to get well from placebo effect. This would save numerous patient’s lives presently dying from ADR and improve outcome ratings.

        • Contrary to many drugs, no homeopathic drug ever has demonstrated any cause – effect relationship in any disease. Further, any improvement due to a treatment is an (additive) combination of placebo and treatment effect. The aim of any cure is to be better than the placebo. Therefore one can distinguish very well if a benefit is caused by placebo alone or by treatment. If you don’t get any better results by just applying a random treatment instead of a targeted treatment your targeted treatment is a placebo.

          Aside this, the reply to the “rebuttal” is simply: Well, if homeopathy is such a well defined science, the drugs should be subjected o the same standards as any other drug. No exemptions.

          • “Contrary to many drugs, no homeopathic drug ever has demonstrated any cause – effect relationship in any disease.” – exaggerated nonsense claim, which cannot be proved, and can only be disproved by science.

            “Further, any improvement due to a treatment is an (additive) combination of placebo and treatment effect.”
            – opinion, belief, not supported by any science or factual analysis. Note placebo effect is poorly defined (if at all) and ‘treatments’ effect’? That would be the effects of the treatment, including the medicine. Duh.

            “The aim of any cure is to be better than the placebo.” Now we are getting very, very sloppy. If it cures, there is no question of efficacy, no need to measure which cure is better. Fact: most illnesses treated by medicines, whether they are homeopathic medicines or conventional medicines, are deemed ‘incureble’. Clinical studies measure ‘benefits’, not cures. Studies comparing homeopathic to conventional medicines are clinical studies measuring “which does not cure better”.

          • OK, Tracy, show me *any* homeopathic drug where the machanism of action is known.

            “– opinion, belief, not supported by any science or factual analysis. Note placebo effect is poorly defined (if at all) and ‘treatments’ effect’? That would be the effects of the treatment, including the medicine. Duh.”

            Nope Tracy, this *is* science. In fact all statistical tests in clinical trials test exactly this assumtion, to be exact they test the hypothesis that there is no difference between placebo and verum treatment. If this hypothesis is rejected, the trial has a positive outcome.

            ““The aim of any cure is to be better than the placebo.” Now we are getting very, very sloppy. If it cures, there is no question of efficacy, no need to measure which cure is better. Fact: most illnesses treated by medicines, whether they are homeopathic medicines or conventional medicines, are deemed ‘incureble’.

            Wrong. Most diseases are tackled with curative intent, Tracy.

          • Thomas.. first, be aware that I have not, in any comment suggested that any specific homeopathic medicine works, or does not work for any disease. I am interested in understanding the science of ‘works’ and a science of ‘cured’ before analyzing any general or specific claims. This post, and many of the comments are simply arguments to support a claim, using and abusing scientific research to support their arguments.

            Clinical trials do not study placebo effect at all. They are carefully and deliberately designed to eliminate placebo effects from results, not to study them. When clinical trials encounter strong placebo effects, it is a failed trial.

            Fundraisers often claim to be searching for cured. Selling the sizzle, not the steak. They know that no one actually checks the facts.

            I’ve surveyed the top 100 best selling medicines for 2011 – 2013, and in every year, less than 5 percent of the top sellers claim – in their documentation, to cure. Further, the only medicines claiming to cure are anti-parasite medicines, antibiotics, antifungals, and anti-viral medicines.

            Cured is not defined for any other illness at present, so no clinical studies can test for cured. Research studies for any illness not caused by a parasite, including many common diseases like diabetes, hypertension, obesity, arthritis, Alzheimer’s, Chron’s, MS, Parkinson’s, and cancer do not define cured, and therefore cannot test or prove any instance of cured.

            For these, for all non-parasitic caused diseases, all medicines – conventional and alternative, are racing to ‘not ‘cure’ better than the others. They measure ‘efficacy’ against symptoms of disease, with no attempt to cure. I have seen at least one clinical study where cures were clearly ignored, and not distinguished from ‘efficacy’ against symptoms. It’s nonsense, but it’s also a fact that is trivial to verify.

            Tracy

          • Tracy, guess who essentially finishes the documentation on a drug ? It is NOT the science department, it is the LEGAL department. If you claim drug xy cures disease z, drug xy has to be extremely effective, otherwise you might get in legal hell.

            Quote: “including many common diseases like diabetes, hypertension, obesity, arthritis, Alzheimer’s, Chron’s, MS, Parkinson’s, and cancer do not define cured, and therefore cannot test or prove any instance of cured.”

            Well, the definition of cured exist for these diseases:

            Diabetes: Blood sugar sober below a threshold for prolonged time
            Hypertension: Blood pressure below a threshold for a prolonged time
            Cancer: cancer free survival for >5 years, in some cases >10 years
            Obesity: a BMI permanently below 30.

            Aside this, all diseases you mention are chronic diseases of which we not know (yet) interventions to reverse the underlying mechanism with the exception of obesity where some dietary regimen work well for some patients.

            In such cases you must go for symptoms. These symptoms are carefully chosen so that they resemble the “normal” state as closely as possible. Pre trial drug development in this area utilizes science based medicine so that mechanisms are known or at least suspected. Especially in the diseases you mentioned placebo effects have the very nasty characteristics to be transient as opposed to real therapeutic effects. Additionally, there is a lot of research going on to prevent or reverse these diseases – which is in stark contrast to homeopathy where no research at all happens(except dubious probings). Would medicine be exclusively homeopathy we would still be at the level of 1810..

          • @Tracy Kolenchuk

            We all suffer from a congenital, terminal illness called ‘life’. Now, what is the cure for that one? Death? Or eternal survival? ‘Cure’ is a semantic minefield. Personally, I’m happy with ‘postponement of death’, which is achieved quite dramatically by modern medical approaches, given the impressive increase in average survival expectations in recent years.

          • @Frank Odds Cure is not a semantic minefield. Or perhaps it is, because we don’t try to cure.

            Actually, there are many diseases we can cure today. There are clearly defined ‘cures’ with medical definitions that describe proving the cure. All of them are cures for parasites. If you have a bacterial infection, and you take an antibiotic, there is a clear documented protocol to prove you have been cured. If you are infected with a tapeworm, there is a clear documented treatment and protocol to prove you have been cured.

            The definition of cure, in these cases, can be generalized into a simple definition of cure, that is not a semantic minefield.

            Cure exists when the cause of the illness has been successfully addressed.

            To use this definition of cure requires some understanding.

            You might get an infection which your body, your health, cures. Often, perhaps in most cases – infections are cured by healthiness, not by medicines. We need to separate the definition of ‘cure’ from medicine.

            It is also possible to get another infection – after a cure. The illness might even make it more likely that you will get a second infection, by damaging your health. How can you tell if it is the same infection, or a new one? By the cure test. Of course the cure test sometimes fails, but most of the time, it works. It was not the definition that failed, it was the individual test.

            We do not ‘cure’ disabilities. Damage might be healed, but disabilities, for the most part, cannot be cured. There are exceptions. Cleft lip, cured by surgery and healing. Once it is cured, it is cured. the cause, the improper growth, has been addressed successfully. It does not return.

            It’s not difficult to develop a science of cure, to test cures and determine if an illness has been cured. Here is a flowchart of cure: http://healthicine.org/wordpress/science-cure-cure-illness/

            Take care – many of today’s diseases are actually multiple illnesses – with multiple causes. It’s not hard to see that even a single infection might be caused by two different types of bacteria, and require two different antibiotics to cure. From a medical perspective, it is one disease, cured with two medicines. From a cure perspective, it is two illnesses, each of which can be cured. The more complex the disease, the more likelihood it actually consists of several illnesses, several causes, each of which must be addressed to cure.

            The problem today is that no-one is working on a science of cures – we’re wasting time arguing about which medicine – homeopathic, alternative, or conventional “does not cure” better. It’s nonsense.

          • @Tracy

            From your link I have clearly stepped into a matter you have thought about a lot, but I remain unconvinced your obvious enthusiasm has reached particularly useful conclusions.

            You state that infections exemplify the only kind of illness where a ‘cure’ can be claimed when the cause of the illness can be successfully addressed. You say: “…there is a clear documented protocol to prove you have been cured” which I presume, in the case of infectious diseases, is evidence (direct or indirect) that the infecting agent has been eliminated.

            But many microbial infections leave behind permanent damage. Infection with Toxocara canis, a common parasitic worm, can cause retinal detachment. Meningitis caused by the bacterium Neisseria meningitidis may lead to permanent hearing loss or, in a few cases, other forms of brain damage. Tuberculosis leaves behind pulmonary cavities after the bacteria are eradicated. Poliovirus infections can result in muscle atrophy and even deformity of the limbs: conditions that persist even when the virus is undetectable. These are all rather dramatic examples of infection sequelae, but many infections leave behind some kind of residual tissue damage.

            Your flowchart (linked to in your comment to me) makes no allowance for this. I think you imagine most infections would run down the chart via ‘Illness noticed’ > ‘is it progressing? > YES > ‘Cause known?’ > YES > ‘Caused by injury or disability?’ > NO > ‘Address cause’ > ‘Cured?’ > YES > ‘DONE’. That’s why you cite infections as the sole instance where a ‘cure’ can be claimed. But you need a link that runs ‘Address cause’ > ‘Cause eradicated’ > YES > ‘All pathology eliminated > YES/NO and ‘NO’ leads back to the right-hand section of the chart starting with ‘Injury or disability’. I maintain that defining the word ‘cure’ is a semantic minefield.

            Thomas Mohr listed definitions of ‘cure’ for a number of diseases: they set out black and white cutoff points on what is essentially a continuum, simply because we need some criteria to measure positive changes in response to treatment of disease. Without some form of measurement of clinical improvement we might as well give up medical research. You and I are on common ground with the conjecture that it’s an unusual disease that is truly ‘cured’ without any evidence of long-term, sustained pathological effects. But I’m happy with the notion that a person who has suffered from, say, river blindness claims they have been ‘cured’ because they have regained their eyesight, even though their visual acuity may be terrible compared with what it was before they were infected.

          • @FrankOdds Thanks for recognizing that I have done my homework on cure. I have studied ‘cure’ and definitions of cure for many years, and have collected and studied dozens of different definitions of cure. I was very surprised to learn, for example, that many current medical dictionaries simply do not contain the words cure, cures, cured and even, in some cases ‘incurable’.
            http://healthicine.org/wordpress/disappearance-cure/

            My definition of cured actually has three parts. First, cured is when the progress of the disease is stopped. I begin with the statement that “every illness can be cured (stopped)”. Medical treatment texts like MERCK, Lange’s, and Harrison’s document a cure protocol for a few specific diseases – all parasites, all treated with medicines. I have found only one single reference to ‘cure’ for a single illness not caused by parasites, even though I have searched some medical reference back to 1950s. I suspect it was an editor’s error. The word ‘curable’ is used for a treatment that is clearly not a cure.

            Of course – as you mention – most, perhaps every illness causes damage or disability. The second type of cure is healing and repairing damage – which is covered in the flowchart, accessed after an illness cure, via ‘partial cure’, which leads back to the top, then down to ‘injury or disability’. Healing is seldom, if ever, perfect. Not all damage can be healed, even if every illness can be cured (stopped).

            The third type of cure, not covered in the diagram, is prevention, as in “I think I’ve finally cured the cat of jumping on the table.” Preventative actions, (preventative cures) contain the most risk, because they are inherently speculative.

            I am currently re-doing the diagram, by going through each cell and writing out a detailed descriptions of each step, numbering each box for clarity, and this is resulting in some changes to the flow as I gain clarity myself. For example, I am removing the box ‘test’ as it is not necessary. The box ‘repair’ needs to go to ‘heal’ so I might place repair above heal on the disability side. I’m not sure on this side – because I’m currently writing text for the other side. Writing it out forces more clarity of thought.

            thanks for taking the time to look at the diagram – feedback is a valuable resource.

          • Tracy,

            Thank you for sharing your research and your thoughts (especially regarding the terms: cure; incurable; illness; and disease).

            Please do not take what I’ve written below as criticism; my intention is to be helpful because you wrote “feedback is a valuable resource” (to which I’ll add: the willingness to accept feedback is the very thing that enables science to be self-correcting!).

            You stated: “every illness can be cured (stopped)”, which links to your article titled “Every Illness Can Be Cured, Q.E.D.” This is your chosen version of the just-world hypothesis[1]: a person is ill because they have been / are doing things that are detrimental (unhealthiness), and/or have not been doing the things that are beneficial (healthiness). The essence of your claim is that those who sufferer declining illness are personally responsible for their decline — aka: blaming the victim for their suffering; victim derogation.
            [1]https://en.wikipedia.org/wiki/Just-world_hypothesis

            It is true that unhealthy lifestyle choices often lead to health problems (illness). Drawing from this the conclusion that “every illness can be cured (stopped)” is committing the formal fallacy: affirming the consequent.
            https://en.wikipedia.org/wiki/Affirming_the_consequent

            Furthermore, just because it is impossible to prove that all illnesses cannot be cured, does not lead to the logical conclusion: “Every Illness Can Be Cured, Q.E.D.” E.g. It is impossible to prove that Thor is not controlling the weather, therefore, Thor is controlling the weather, Q.E.D.

            Your understanding of the following terms — as they apply in the 21st Century — is flawed: illness; disease; medicine; epistemology, especially: logic; logical fallacies; empirical evidence; and the scientific method.

            Your blatant misunderstandings and misrepresentations of the psychological and medical definitions of the term “depression” — presented on Healthicine.org — are not just pitiful, I think that the guidance and advice you have given is dangerous to those who suffer from clinical depression; especially to those who suffer clinical depression as a co-morbid condition.

            You wrote: “There are medical techniques to diagnose depression. But there are no medical techniques to diagnose a ‘depression cured’.” I think that statement best conveys your dire lack of medical knowledge.
            http://healthicine.org/wordpress/two_depressed/

            I feel obligated to inform you that providing medical guidance and/or advice on serious illnesses, without a licence to practise medicine, is a criminal offence under many jurisdictions, including the UK.

            Much of what you’ve written seems to make sense and, despite the above, I generally agree with many of your well-researched and well-thought-out points. I’m wondering if you have not yet grasped the crucially important difference between “normal” and “abnormal”. The guidance and advice required for the maintenance of ‘a healthy normal’ is vastly different from both:
            1. the guidance and advice required for restoring an abnormal condition to ‘a healthy normal’;
            2. the guidance and advice required for managing an abnormal condition that cannot be restored to ‘a healthy normal’.

            Generally speaking, in both veterinary and human medicine many/most conditions are defined as “normal” when the parameters lie within two standard deviations (two sigma) of the mean, and “abnormal” when the parameters lie beyond two sigma. The normal distribution informs us that 95% of a large population fall within two sigma of the mean, and 5% fall beyond two sigma. Service providers are doing a good job if 5% or fewer of their customers complain.

            However, medicine is very different from most service providers because its primary role is providing care services to the minority who are/become seriously ill, not to the vast majority who don’t need medical services on a daily or weekly basis.

            I shall refrain from adding the many other things I would like to add because I’ve already written a very long comment. Instead, I shall close by thanking you very much indeed for your enjoyable communication style. I hope that something I’ve written is useful to you, if not then by all means ignore it.

          • @PeteAttkins. Very interesting. It is useful to see how other people perceive my writing – yes, all feedback is valuable. There are a few items in your reply that I will respond to.

            First: “The just world hypothesis”. I make no such claim. Infections can be caused by bacterial invasion, which might be a result of stepping on a nail, or being shot with a gun, or cut by a surgeon. These are not the ‘fault of the patient’. Scurvy can be caused by a lack of Vitamin C in the patient’s diet. But many people simply do not choose their diet, and cannot be blamed. The “it’s your fault” hypothesis ignores a critical aspect to the hierarchy of healthicine: community. Our community extends to other people, and to other living entities – non-people. Finding the cause of an illness should not be limited to the patient. It is possible for a cause to be largely external, partially external and partially internal, or largely internal. In many cases, it is simply not clear if the cause is internal or external, until the illness has been cured – and even then the proof can be difficult, although it has become irrelevant. From a healthicine perspective, the cause might be an unhealthiness of the patient, of the community, or even of the environment. I extend the model further. It is possible for a community to have an ‘illness’.

            re: Every illness can be cured. I provide the simplest proof possible. If it cannot be cured, I define it as “not an illness”. This might seem like logical trickery, but no, it is simply a tool, a technique to a goal to find cures. We might change the wording to “every curable medical condition can be cured”, and “every incurable medical condition cannot be cured”, but no one is interested in this trivial statement – so no one attempts to identify which medical conditions can be cured, and which cannot. As a result, the word ‘cure’ does not appear in medical reference texts and dictionaries.

            My goal: to ensure that medical conditions that cannot be cured are clearly identified as “cannot be cured”. Thus, if it can be cured, I call it an illness. If it cannot be cured, I call it something else: a medical condition, a disability, a deficit, a handicap, an injury. Sometimes, a ‘non-illness’ might be cured – that action converts it to an illness. Sometimes what is believed to be an illness cannot be cured – that converts it to a non-illness, a disability, etc.

            re: Providing medical guidance or advice. I am not a doctor. I am not interested in being a doctor or in any practice of medicine. I’m not interested in providing medical guidance or advice to anyone. I an not interested in ‘treating’ any person’s illness, I want to ‘cure’ the general mindset that cures are not possible. I am interested in thinking about and providing guidance about healthicine, not about medicine. Illness is often portrayed as the opposite of health, a simple error. Illness is the absence of healthiness, just as darkness is the absence of light.

            re: Two standard deviations is a statistical generalization. It is the use of mathematics to attempt to define ‘normal’ and ‘abnormal’ in general – non specific situations. It is a useful guideline for general analysis. Often right, often wrong in specific situations. Every illness is an individual case and must be examined outside of ‘statistical norms’. Every cure is also an individual case, an anecdote. Using general statistical measures to judge specific cases is useful, but not sufficient.

            I can see that we have very different perspectives on illness, disease, medicine, and most importantly, health. This makes me happy.

            It’s my goal – to adopt a different perspective, to explore that different perspective – based on healthicine, not medicine, and see where it leads me. By your comments, I can see that I have achieved considerable success – so much so that we have difficulty seeing eye to eye. That makes me sad, and happy.

            to your health, tracy

          • Tracy,

            Many thanks for your reply. I’m sure you appreciate that comment threads are not the best medium for conducting in-depth discussions of interesting ideas!

            I particularly like your question: “It is possible for a community to have an ‘illness’.” I have an answer that I think you would find interesting and/or useful, but I’m fairly certain that it would be inappropriate to convey my thoughts via Professor Ernst’s blog. I’m fully aware that my last comment was way off-topic for the subject of the article, and I shall try my best to avoid repeating this behaviour.

            You wrote: “Two standard deviations is a statistical generalization. It is the use of mathematics to attempt to define ‘normal’ and ‘abnormal’ in general – non specific situations. It is a useful guideline for general analysis. Often right, often wrong in specific situations.”

            Very sadly, you have clearly demonstrated your total failure to understand both the core mathematics, and the intended real world implications of, statistical measures. Aggregated statistics never do, never can, and never were intended to, explain one-off (individual) cases/instances.

            I have to repeat, yet again, the very simple fact: As the sample size reduces below thirty, statistics become increasingly meaningless; this is why the plural of “anecdote” is not “data”, it is “anecdotes”.

            I can lead a horse to water, but I cannot make it think.

            You are in the process of writing your third book on your original idea. That speaks volumes 🙂

        • @Tracy Kolenchuk

          You might like to read this: Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial

          Conclusion. Homeopathic consultations but not homeopathic remedies are associated with clinically relevant benefits for patients with active but relatively stable RA.

          • The key words in the stated conclusion are “associated with”(i.e. no cause-effect noted). What this study suggests is that a caring, thorough clinician of likely any(medical, homeopathic, chiropractic, etc.) health profession might benefit a patient sans any prescribed substances. Perhaps just the act of a prolonged and comprehensive consultation/examiniation confers benefits to patients?

  • “detectable amounts of these materials remain quantifiable in the form of nanoparticles ”

    Can someone point me to a definition of “nanoparticle” as it is used in the rebuttal?

    I am a physics researcher, and if by nano particle they mean anything subatomic, than the answer is “No way!” It is an essential pillar of quantum physics that sub-atomic particles — I am talking about fermions (like electrons and protons) and bosons (like photons) — are indistinguishable and have no memory: an electron is an electron is an electron. Change this and all the probability distributions of these subatomic particles change and the universe as we know it no longer exists. So the indistinguishable quality of subatomic particles is built into our universe.

    A different subject is the “quantum state” that these particles are in. If they claim that what is being preserved is a quantum state, that is a whole other level of bollocks that can be also dismantled, but I am not qualified to do it very deeply (my last dealing with mathematical calculations in quantum physics was over 20 years ago).

    Sometimes this seems like the Gish Gallop (“spewing so much bullshit in such a short span on that your opponent can’t address let alone counter all of it”) or a wack-a-fallacy game.

    • In medicine, Nanoparticles are particles of a size between 1µm and roughly 100nm. Quote from one publication: “Homeopathic medicines showed not to be nothing, but exhibited nanoparticles and conglomerates of them, which had crystalline nature and were rich in silicon.” I.o.W. what they are measuring is fine glass dust eroded by the shaking process.

      Homeopathy is NOT nanomedicine. In nanomedicine you use nanoparticles to target diseases. For instance, a nanoparticle might be coated with an antibody against a tumor and a cytostatic drug that is activated upon homing to the tumor cell. That means, systemic you have a low dose, but local you have a high dose, whereas if you swallow some suger pill, I doubt you have any dose at all. Nanomedicine is a highly complex system which can not be done by shaking duck liver.

      • Thanks for all the replies. So nano is still on the atomic/chemical level, not on the quantum level. Thomas, I enjoyed this sentence:
        “That means, systemic you have a low dose, but local you have a high dose, whereas if you swallow some suger pill, I doubt you have any dose at all. ”

        Thank you for that 🙂

    • @Paulo Abreu

      You might derive some entertainment from the ‘science’ in this paper.

    • Paulo – you will find the “basis” for the nonsense on homeopathy as “nanoparticles” in this ridiculous Langmuir paper in this link (sorry for the terrible link)

      http://r.search.yahoo.com/_ylt=A0LEVr0irEVYwpkAieMnnIlQ;_ylu=X3oDMTBzdWd2cWI5BGNvbG8DYmYxBHBvcwMxMAR2dGlkAwRzZWMDc3I-/RV=2/RE=1480989858/RO=10/RU=http%3a%2f%2fwww.homeopathycenter.org%2ffiles%2fChikramaneetal2012LangmuirNPAsymptoticConcentration_0.pdf/RK=0/RS=vD5RLuwILcPDKsgKXA_UKknmj0o-

      Essentially, the paper claims the process used to generate homeopathic remedies yields “nanoparticles” which explains how it can be active at such extreme dilutions. What the paper shows is the researchers don’t have very good lab techniques. They produced contamination & wrote it up as “nanoparticles”. Then the homeopathic community ran with it. Sad tale, but true.

      Still shake my head that Langmuir (ACS) actually published the paper & still hasn’t retracted it.

      • That paper of one of Dana Ullman’s favourites: he frequently refers to is as “research published in the American Chemistry Society’s leading scientific journal, called “Langmuir,” “. He has quite a thing about hanging on the coat-tails of celebrities and the like.

        Of course, the ACS have also published this: Does Homeopathy Work?, but he doesn’t like talking about that other than to dismiss it out of hand because it’s not published in a peer-reviewed ‘journal’.

    • @Paullo

      As you know, quantum mechanics and field theory describe fundamentally all matter of which we are composed. However, nothing we experience or test for in everyday life really requires reconciliation to these fundamental theories. It’s the emergent, coarse-grain theories which supervene the fundamental ones that are applicable in medical research.

  • “18 I assume they ‘bought in’ the necessary expertise.” Don’t you mean “brought” in, as in bringing experts to consult, study, and weigh the evidence for and against a subject of contention?

  • For a long time, homeopaths claimed that water remembered things. That notion has, of course, be the subject of much laughter and derision. Then nanoparticles started to capture the interest of many scientist and engineers – and the popular media. Homeopaths glommed onto the idea of nanoparticles as a potential replacement for their deprecated belief in water’s memory. I’m convinced their adoption of nanoparticle hypothesis was entirely a matter of timing. If there had been a lot of talk of the wonders of reverse spin low density demiphotons at the opportune time, that might have equally readily been taken up as the explanation of the inexplicable.

  • Isn’t “HPCUS” also an abbreviation for “hocuspocus”? 😉

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