MD, PhD, FMedSci, FSB, FRCP, FRCPEd

conflict of interest

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Some osteopaths – similar to their chiropractic, naturopathic, homeopathic, etc. colleagues – claim they can treat almost any condition under the sun. Even gynaecological ones? Sure! But is the claim true? Let’s find out.

The aim of this recent review was to evaluate the effects of the osteopathic manipulative treatment (OMT) on women with gynaecological and obstetric disorders. An extensive search from inception to April 2014 was conducted on MEDLINE, Embase, the Cochrane library using MeSH and free terms. Clinical studies investigating the effect of OMT in gynaecologic and obstetric conditions were included as well as unpublished works. Reviews and personal contributions were excluded. Studies were screened for population, outcome, results and adverse effects by two independent reviewers using an ad-hoc data extraction form. The high heterogeneity of the studies led to a narrative review.

In total, 24 studies were included. They addressed the following conditions: back pain and low back functioning in pregnancy, pain and drug use during labor and delivery, infertility and subfertility, dysmenorrhea, symptoms of (peri)menopause and pelvic pain. Overall, OMT was considered to be effective for pregnancy related back pain. For all other gynaecological and obstetrical conditions the evidence was considered to be uncertain. Only three studies mentioned adverse events after OMT.

The authors concluded that, although positive effects were found, the heterogeneity of study designs, the low number of studies and the high risk of bias of included trials prevented any indication on the effect of osteopathic care. Further investigation with more pragmatic methodology, better and detailed description of interventions and systematic reporting of adverse events are recommended in order to obtain solid and generalizable results.

Given the fact that the lead authors of this review come from the “Accademia Italiana Osteopatia Tradizionale, Pescara, Italy, we can probably answer the question in the title of this blog with a straight NO. I see no reason why OMT should work for gynaecological conditions, and I am not in the least surprised to read that there is no clinical evidence for this notion. Sadly, this is unlikely to stop osteopaths to claim otherwise and continue to prey on the desperate and the gullible.

One might thus say that this review is totally unremarkable – but I would beg to differ: it highlights yet again one very important finding, namely the fact that trials of alternative therapies far too often fail to report adverse effects. I have stated this often already, but I will say it again: THIS OMISSION IS A VIOLATION OF RESEARCH ETHICS WHICH GIVES US A FALSE POSITIVE OVERALL PICTURE OF THE RISKS ASSOCIATED WITH ALTERNATIVE MEDICINE.

According to Wikipedia, Swiss state insurance funding of homeopathy and four other alternative therapies had been withdrawn after a review in 2005, and a 2009 referendum vote called for state backed health insurance to once more pay for these therapies. In 2012 the Swiss government reinstated them for a trial period until 2017, pending an independent investigation of the efficacy and cost-effectiveness of the therapies. The rules for the registration of homeopathic remedies without a concrete field of application are more liberal in Switzerland than they are in member countries of the EU. For homeopathic medicines based on well-known low-risk substances, Swissmedic, the regulatory authority, offers inexpensive registration by means of a simplified electronic registration procedure.

Several weeks ago, I have commented on the remarkable position of alternative medicine in Switzerland. Now this website offers further information specifically on homeopathy in Switzerland:

According to a report jointly issued by the Swiss Federal Health Office and the Swiss State Secretariat for Economic Affairs (SECO), the annual expenses for homeopathic treatments and medications in Switzerland amount to roughly CHF 50 million and CHF 31 million, respectively. These numbers seem impressive, particularly if we consider how little each homeopathic remedy costs and how ineffective it is.

But the argument that homeopathy somehow defies scientific testing does not seem to die. For instance, SantéSuisse, the umbrella organisation of health insurers, argues that standardised methods used to test conventional treatments cannot be applied to homeopathy. “It would be unfair to homeopathy if we borrowed the methodologies from conventional therapeutic options when evaluating its effectiveness. The potential risk is that these systematic and internationally accepted methods of biomedical science go against the underlying principles of homeopathy,” said SantéSuisse spokesman Christophe Kämpf. I am afraid, he is talking complete tosh – and he should, of course, know better.

The Swiss Federal Health Office admitted in its press release at the end of March that “no evidence has so far been found to prove that complementary and alternative therapies”, including homeopathy, meet the standard criteria for “effectiveness, appropriateness, and costs.” And a Swiss health office spokesman, Daniel Dauwalder, explained that the decision “reflected the will of the people” in a 2009 referendum. “The health insurance system will cover the cost of alternative therapies according to the principle of trust,” Dauwalder explained. He added that, if the standards of effectiveness, suitability and economy are called into question, SantéSuisse have the right to deny payment.

The core of the issue centres on the questions

  • How to ensure that the physical conditions of patients will not be compromised by unqualified, self-proclaimed clinicians?
  • How can health insurers deal with the potential challenges?

The truth is, alternative treatments will not be unconditionally covered by the basic insurance policies which every Swiss resident must have. Only the costs of treatments administered by certified medical doctors will be considered. Otherwise, the costs incurred can only be reimbursed, if the person insured has purchased supplementary health coverage.

END OF QUOTE

That, however, does not mean that only doctors can practice homeopathy in Switzerland. Lay-homeopaths do exist in the form of Heilpraktiker. While it is true that the national health insurance only covers the treatment by medical doctors, some private health insurances also cover homeopathy by Heilpraktiker.

All this is very different from what some enthusiasts report about homeopathy in Switzerland. Probably the best example for someone obscuring the truth is (yet again) Dana Ullman who stated that “the Swiss government has determined that the very small doses commonly used in homeopathic medicine are both effective and cost-effective.” Little wonder, I might add, because Dana Ullman also keeps on referring to “a remarkable report on homeopathic medicine conducted by and for the government of Switzerland”. He does so despite having been told over and over again that the report in question is firstly utterly unreliable and secondly not by the Swiss government.

Why this odd insistence on disseminating wrong information? Is it because it is good for business, or because homeopaths are not capable of learning (otherwise they would not be homeopaths), or both?

This is your occasion to meet some of the most influential and progressive people in health care today! An occasion too good to be missed! The future of medicine is integrated – we all know that, of course. Here you can learn some of the key messages and techniques from the horses’ mouths. Book now before the last places have gone; at £300, this is a bargain!!!

The COLLEGE OF MEDICINE announced the event with the following words:

This two-day course led by Professor David Peters and Dr Michael Dixon will provide an introduction to integrated health and care.  It is open to all clinicians but should be particularly helpful for GPs and nurses, who are interested in looking beyond the conventional biomedical box.  

The course will include sessions on lifestyle approaches, social prescribing, mind/body therapies and cover most mainstream complementary therapies.  

The aim of the course will be to demonstrate our healing potential beyond prescribing and referral, to provide information that will be useful in discussing non-conventional treatment options with patients and to teach some basic skills that can be used in clinical practice.  The latter will include breathing techniques, basic manipulation and acupuncture, mind/body therapies including self-hypnosis and a limited range of herbal remedies.  There will also be an opportunity to discuss how those attending might begin to integrate their everyday clinical practice.  

The course will qualify for Continuing Professional Development hours and can provide a first stage towards a Fellowship of the College.

Both Dixon and Peters have been featured on this blog before. I have also commented regularly on the wonders of integrated (or was it integrative?) medicine. And I have even blogged about the College of Medicine and what it stands for. So readers of this blog know about the players as well as the issues for this event. Now it surely must be time to learn more from those who are much better placed than I to teach about bogus claims, phoney theories and unethical practices.

What are you waiting for? Book now – they would love to have a few rationalists in the audience, I am sure.

At first, I thought this survey would be yet another of those useless and boring articles that currently seem to litter the literature of alternative medicine. It’s abstract seemed to confirm my suspicion: “Fifty-two chiropractors in Victoria, Australia, provided information for up to 100 consecutive encounters. If patients attended more than once during the 100 encounters, only data from their first encounter were included in this study. Where possible patient characteristics were compared with the general Australian population…” But then I saw that the chiropractors were also asked to record their patients’ main complaints. That, I thought, was much more interesting, and I decided to do a post that focusses on this particular point.

The article informs us that 72 chiropractors agreed to participate (46 % response rate of eligible chiropractors approached). During the study, 20 (28 %) of these chiropractors withdrew and did not provide any data. Fifty two chiropractors (72 % of those enrolled) completed the study, providing information for 4464 chiropractor-patient encounters. Of these, 1123 (25 %) encounters were identified as repeat patient encounters during the recording period and were removed from further analyses, leaving 3287 unique patients.

The results that I want to focus on indicated that chiropractors give the following reasons for treating patients:

  • maintenance: 39%
  • spinal problems: 33%
  • neck problems: 18%
  • shoulder problems: 6%
  • headache: 6%
  • hip problems: 3%
  • leg problems: 3%
  • muscle problems: 3%
  • knee problems: 2%

(the percentage figures refer to the percentages of patients with the indicated problem)

Yes, I know, there is lots to be criticised about the methodology used for this survey. But let’s forget about this for the moment and focus on the list of reasons or indications which these chiropractors give for treating patients. For which of these is there enough evidence to justify this decision and the fees asked for the interventions? Here is my very quick run-down of the evidence:

  • maintenance: no good evidence.
  • spinal problems: if they mean back pain by this nebulous term, an optimist might grant that there is some promising but by no means conclusive evidence.
  • neck problems: again some promising but by no means conclusive evidence.
  • shoulder problems: no good evidence.
  • headache: again some promising but by no means conclusive evidence
  • hip problems: no good evidence.
  • leg problems: no good evidence.
  • muscle problems: no good evidence.
  • knee problems: no good evidence.

As I said, this is merely a very quick assessment. I imagine that many chiropractors will disagree with it – and I invite them to present their evidence in the comments section below. However, if I am correct (or at least not totally off the mark), this new survey seems to show that most of the things these chiropractors do is not supported by good evidence. One could be more blunt and phrase this differently:

  • these chiropractors are misleading their patients;
  • they are not behaving ethically;
  • they are not adhering to EBP.

Yes, we (I mean rationalists who know about EBM) did suspect this all along – but now we can back it up with quite nice data from a recent survey done by chiropractors themselves.

I have moaned about the JACM several times on this blog (for instance here). It is a very poor journal, in my view, but it nevertheless is important because it is the one with the highest impact factor in this field. Despite all this I missed something important that recently happened to the JACM: a few months ago, it got a new editor in chief: John Weeks.

Had I been more attentive, I would have known this already in May when Weeks wrote in the HuffPo this: “I was asked a month ago, out of the blue, if I would like to become editor-in-chief of the first peer-reviewed, indexed journal in what is now the “integrative health and medicine” field. The journal was born 20 years ago when — as my father would have put it — “integrative medicine” was hardly a gleam in anyone’s eye. The publication is the Journal of Alternative and Complementary Medicine.”

I have a vague memory of meeting him once at a conference and sitting next to him during a dinner. For those who haven’t heard of him, here is how he once described himself:

I have been involved as an organizer-writer in the emerging fields of complementary, alternative and integrative medicine since 1983. Happily, I have learned some things. I was once called an “expert in alternative medicine” by Medical Economics and later an “alternative care (integration) expert” by Modern Healthcare. The name-calling was proud-making, even if I was so-dubbed by reporters who were on their first forays into the field.

Both anointed me before I went on sabbatical in Costa Rica and later Nicaragua with my family in 2002. Part of the reason for sabbatical was that whatever expertise I may have developed often ran frustratingly short of being able to offer robust, successful business models with readers and clients. More than once I counseled people against the initiatives they planned. Trends taught me to recognize the invisible handwriting of a sure failure event behind the bubbling enthusiasm of an initiate. I needed a break from the work. My family and I took it!

I was away from the United States for three years. I had my hand back in things for the last 2.5 years. I assisted a philanthropist on her integrative medicine investments in community clinics, CAM schools and academic health centers. From early 2004 forward, and out of home offices in Monteverde, Costa Rica, and then Granada, Nicaragua, I helped organize and direct the National Education Dialogue to Advance Integrated Health Care: Creating Common Ground

END OF QUOTE

Is Weeks going to be a good editor who throws out all the trash that JACM has been publishing on a far too regular basis? Well, the good news, I suppose, is that he cannot possibly be worse than his predecessor. Perhaps we should see for ourselves what the new man thinks and writes. Here is an excerpt from his recent editorial on the question of medical errors in conventional medicine and the role of integrative medicine in this difficult issue:

[A] whole-system solution to medical errors suggests many roles for traditional, alternative, complementary, and integrative approaches and practices. First, better use of these new therapies and provider types expands the tools and strategies for keeping the locus of care out in communities instead of in the problematic hospital environment. One of the commentators at Medscape for instance pointed out that when it comes to “errors” that lead to death, the most significant culprits are the errors individuals make in living the standard U.S. life-style. A starting place in limiting medical deaths is for us to take better care of ourselves. We’ll be less likely to need treatment or to be admitted if we do. The across-the-board engagement by multiple integrative and traditional medicine practitioners with life-style medicine, there are clearly important roles for integrative and traditional practices and practitioners.

More evidence that integrative practice keeps people healthy and out of hospitals would be useful. Our research needs to capture these life-changing outcomes better. The values movement is toward primary care and community medicine. Outpatient care offers a home-field advantage for traditional medical systems and licensed integrative health practitioners, from yoga and massage therapists to acupuncture and Oriental medicine specialists and integrative, chiropractic, and naturopathic doctors. And when people are admitted to hospitals, broader integrative teams need to be available to catch, hold, and treat the whole person and help keep them from being biomedically reduced. Such efforts would be served by research data that measure quadruple-aim outcomes. Think patient experience, enhancing life-style skills, faster healing times, diminished hospital stays, and more pleasure of practitioners in their caregiving. Some have begun gathering these outcomes. We need bushels more. We’ll also have a growing need for reports that delineate processes and obstacles overcome in highly functioning integrative care teams.

The whole-system response to medical deaths is opening minds and doors to integrative practices and to leadership from the integrative community. In one remarkable example, the state of Oregon is seeking to reduce the morbidity and mortality associated with opioids through prioritizing the care of chiropractors, acupuncturists, and massage and yoga therapists. To maximize our effectiveness as agents of change in helping create health in those we serve, more of us need to study up on the emerging language, goals, and methods of the value-based movement, then match up to these aims in our study designs and selections of outcomes. Advancing whole-person care and linking to the emerging values appear to be our best opportunities to help shape the path away from death and toward safety and health.

END OF QUOTE

Impressed? Me neither!

In my view, this reads like an accumulation of platitudes, wishful thinking and uncritical waffling. The passage that I found positively worrying was this one: More evidence that integrative practice keeps people healthy and out of hospitals would be useful. Our research needs to capture these life-changing outcomes better. The editor of a medical journal should, I think, know that research is not for confirming beliefs but for testing hypotheses. In all this verbose rambling, I really cannot find a good reason why integrative medicine might have a role in reducing medical errors. More worrying still, I cannot find a trace of critical thinking.

As I was writing this, I remembered more about the only personal encounter I had with Weeks years ago. For some reason we talked about THE ‘textbook’ of naturopaths, entitled THE TEXTBOOK OF NATURAL MEDICINE. I remember explaining to Weeks that it contained a lot of factual errors and outright nonsense. He very much disputed my view, seemed to take it personally, and even got quite stroppy. In the end, we agreed to disagree.

Neither this episode nor indeed the editorial are all that important – we will simply have to wait and see how the JACM does under its new editor.

Since several years, there has been an increasingly vociferous movement within the chiropractic profession to obtain limited prescription rights, that is the right to prescribe drugs for musculoskeletal problems. A recent article by Canadian and Swiss chiropractors is an attempt to sum up the arguments for and against this notion. Here I have tried to distil the essence of the pros and contras into short sentences.

 1) Arguments in favour of prescription rights for chiropractors

1.1 Such privileges would be in line with current evidence-based practice. Currently, most international guidelines recommend, alongside prescription medication, a course of manual therapy and/or exercise as well as education and reassurance as part of a multi-modal approach to managing various spine-related and other MSK conditions.

1.2 Limited medication prescription privileges would be consistent with chiropractors’ general experience and practice behaviour. Many clinicians tend to recommend OTC medications to their patients in practice.

1.3 A more comprehensive treatment approach offered by chiropractors could potentially lead to a reduction in healthcare costs by providing additional specialized health care options for the treatment of MSK conditions. Namely, if patients consult one central practitioner who can effectively address and provide a range of treatment modalities for MSK pain-related matters, the number of visits to providers might be reduced, thereby resulting in better resource allocation.

1.4 Limited medication prescription rights could lead to improved cultural authority for chiropractors and better integration within the healthcare system.

1.5 With these privileges, chiropractors could have a positive influence on public health. For instance, analgesics and NSAIDs are widely used and potentially misused by the general public, and users are often unaware of the potential side effects that such medication may cause.

2) Arguments against prescription rights for chiropractors

2.1 Chiropractors and their governing bodies would start reaching out to politicians and third-party payers to promote the benefits of making such changes to the existing healthcare system.

2.2 Additional research may be needed to better understand the consequences of such changes and provide leverage for discussions with healthcare stakeholders.

2.3 Existing healthcare legislation needs to be amended in order to regulate medication prescription by chiropractors.

2.4 There is a need to focus on the curriculum of chiropractors. Inadequate knowledge and competence can result in harm to patients; therefore, appropriate and robust continuing education and training would be an absolute requirement.

2.5 Another important issue to consider relates to the divisiveness around this topic within the profession. In fact, some have argued that the right to prescribe medication in chiropractic practice is the profession’s most divisive issue. Some have argued that further incorporation of prescription rights into the chiropractic scope of practice will negatively impact the distinct professional brand and identity of chiropractic.

2.6 Such privileges would increase chiropractors’ professional responsibilities. For example, if given limited prescriptive authority, chiropractors would be required to recognize and monitor medication side effects in their patients.

2.7 Prior to medication prescription rights being incorporated into the chiropractic scope of practice worldwide, further discussions need to take place around the breadth of such privileges for the chiropractic profession.

In my view, some of these arguments are clearly spurious, particularly those in favour of prescription rights. Moreover, the list of arguments against this notion seems a little incomplete. Here are a few additional ones that came to my mind:

  • Patients might be put at risk by chiropractors who are less than competent in prescribing medicines.
  • More unnecessary NAISDs would be prescribed.
  • The vast majority of the drugs in question is already available OTC.
  • Healthcare costs would increase (just as plausible as the opposite argument made above, I think).
  • Prescribing rights would give more legitimacy to a profession that arguably does not deserve it.
  • Chiropractors would then continue their lobby work and soon demand the prescription rights to be extended to other classes of drugs.

I am sure there are plenty of further arguments both pro and contra – and I would be keen to hear them; so please post yours in the comments section below.

In alternative medicine, good evidence is like gold dust and good evidence showing that alternative therapies are efficacious is even rarer. Therefore, I was delighted to come across a brand-new article from an institution that should stand for reliable information: the NIH, no less.

According to its authors, this new article “examines the clinical trial evidence for the efficacy and safety of several specific approaches—acupuncture, manipulation, massage therapy, relaxation techniques including meditation, selected natural product supplements (chondroitin, glucosamine, methylsulfonylmethane, S-adenosylmethionine), tai chi, and yoga—as used to manage chronic pain and related disability associated with back pain, fibromyalgia, osteoarthritis, neck pain, and severe headaches or migraines.”

The results of this huge undertaking are complex, of course, but in a nutshell they are at least partly positive for alternative medicine. Specifically, the authors state that “based on a preponderance of positive trials vs negative trials, current evidence suggests that the following complementary approaches may help some patients manage their painful health conditions: acupuncture and yoga for back pain; acupuncture and tai chi for OA of the knee; massage therapy for neck pain with adequate doses and for short-term benefit; and relaxation techniques for severe headaches and migraine. Weaker evidence suggests that massage therapy, SM, and osteopathic manipulation might also be of some benefit to those with back pain, and relaxation approaches and tai chi might help those with fibromyalgia.”

This is excellent news! Finally, we have data from an authoritative source showing that some alternative treatments can be recommended for common pain conditions.

Hold on, not so fast! Yes, the NIH is a most respectable organisation, but we must not blindly accept anything of importance just because it appears to come form a reputable source. Let’s look a bit closer at the actual evidence provided by the authors of this paper.

Reading the article carefully, it is impossible not to get troubled. Here are a few points that concern me most:

  • the safety of a therapy cannot be evaluated on the basis of data from RCTs (particularly as it has been shown repeatedly that trials of alternative therapies often fail to report adverse effects); much larger samples are needed for that; any statements about safety in the aims of the paper are therefore misplaced;
  • the authors talk about efficacy but seem to mean effectiveness;
  • the authors only included RCTs from the US which must result in a skewed and incomplete picture;
  • the article is from the National Center for Complementary and Integrative Health which is part of the NIH but which has been criticised repeatedly for being biased in favour of alternative medicine;
  • not all of the authors seem to be NIH staff, and I cannot find a declaration of conflicts of interest;
  • the discussion of the paper totally lacks any critical thinking;
  • there is no assessment of the quality of the trials included in this review.

My last point is by far the most important. A summary of this nature that fails to take into account the numerous limitations of the primary data is, I think, as good as worthless. As I know most of the RCTs included in the analyses, I predict that the overall picture generated by this review would have changed substantially, if the risks of bias in the primary studies had been accounted for.

Personally, I find it lamentable that such a potentially worthy exercise ended up employing such lousy methodology. Perhaps even more lamentable is the fact that the NIH (or one of its Centers) can descend that low; to mislead the public in this way borders on scientific misconduct and is, in my view, unethical and unacceptable.

Did you know that:

  • All diseases are really just psychological conflicts.
  • Conventional medicine is a conspiracy of Jews to decimate the non-Jewish population.
  • Microbes do not cause diseases.
  • AIDS is just a normal allergy.
  • Cancer is the result of a mental shock.

These are just some of the theories of RG Hamer realized in his Germanic (or German) New Medicine.

Hamer once had a medical licence; it was revoked after he was found guilty of malpractice. Subsequently, he continued treating patients as a ‘Heilpraktiker‘. He has been in court many times, sentenced repeatedly and imprisoned at least twice. There is an abundance of information about Hamer available on the Internet (for instance here), and I am therefore not attempting to repeat it here. Yet to give a quick impression of Hamer’s mind-set, I translate what he is quoted stating: ” … I do not even believe in the holocaust…I also do not believe that man was on the moon and, much worse, that the Twin Towers were brought down by Arabs, but hardly anybody believes that today…”

Hamer’s treatments have been associated with several deaths. The most recent case has only just been reported in this article from the Austrian newspaper ‘Der Standard’. As it is in German, I will summarize the essence here:

An Italian couple apparently had refused to let her daughter’s leukaemia be treated with conventional medicine (which usually is life-saving in this condition) but insisted that she receives Hamer’s methods of cancer therapy (which are not evidence-based). They therefore took her to a Swiss clinic where she apparently received cortisol and vitamins. After the interventions of Italian doctors, the parents were forbidden to take charge of their daughter’s care. Meanwhile, however, the daughter, Eleonora Bottaro from Padova, had reached the age of 18 and was therefore legally allowed to decide about her treatments. She opted to continue the treatment in the Swiss clinic and died of her leukaemia in mid August.

Some aspects of this new case are reminiscent of the one of the Austrian, Olivia Pilhar. In 1995, this girl, then aged 6, was diagnosed with a Wilms’ tumour. The parents withheld conventional treatments from her and opted for Hamer’s methods as an alternative. When the authorities intervened, the parents took their child to Malaga where she was treated according to Hamer’s weird ideas. Following a court order, the child eventually did receive proper medical treatment and survived her disease. Her parents received a suspended prison sentence of 8 months in Austria.

Sadly, alternative medicine hosts many miracle healers like Hamer. They have in common that

  • they create their own bizarre ideas about healthcare which are neither plausible nor evidence-based;
  • they mix them with a rich dose of conspiracy theory;
  • they tend to sue those who expose them for what they are;
  • they manage to amass a sizeable following of often quite fanatical believers;
  • they exploit them by selling false hope;
  • they manage to create some sort of cult;
  • they do financially very well with their quackery;
  • they endanger the health of consumers and patients who have the misfortune to come into contact with them;
  • they are undeterred by medical ethics, the law or the authorities.

These people disgust me beyond words. Yet, even in this company of rogues, Hamer is special  – not least because of his rampant racism. He claims, for instance, that conventional medicine is guilty of the “most hideous crime in the whole history of mankind” and alleges that Jews have killed around two billion people with morphine, chemotherapy and radiation.

Highly diluted homeopathic remedies are pure placebos; that statement is by no means new and has been discussed here so many times that it hardly needs repeating. It follows that those who, in the face of overwhelming evidence, claim that such remedies are efficacious for any condition or symptom are misleading the public.

What, in the realm of homeopathy, could be worse?

The answer is fairly clear, I think: those who promote homeopathy for immunizations; i.e. those ‘experts’ who advocate HOMEOPROPHYLAXIS; they are clearly worse, much worse.

On this blog, I have repeatedly warned consumers of this nonsense (see for instance here, here, here, here and here), yet the Internet remains full of promotion of this dangerous quackery. Few charlatans are as despicable as the author of this recent article:

…Energy medicine is becoming more sought after and used. Homeopathy is one such form of energy medicine used by over 500 million people worldwide. Within homeopathy is the practice of a safe and natural disease prevention method called homeoprophylaxis, or “HP.”

HP involves the safe use of either diluted and potentized disease products or materials from animal, mineral, or vegetable sources to elicit an immune response in order to educate the immune system before encountering a disease. Due to the ultra-high dilution, the final product contains no molecules of the original source, rendering it completely harmless. It is energetic instead of material and operates by way of its frequency.

Energetic Medicine

This energetic frequency “educates” the immune system to recognize a disease when met in the environment and effectively mount an immune response in the most natural way. As Albert Einstein once said, “Everything is energy and that’s all there is to it. This is not philosophy. This is physics.”

Just like cell phones receive a radio frequency, interpret it, and deliver it to the user in a form that can be understood, HP delivers the energetic spectrum of a targeted disease. The human body, just like the phone, is able to receive and respond to the energetic signature and produce a beneficial response.

This signature is delivered on tiny sugar pellets, by mouth, one disease at a time, and is devoid of adjuvents, preservatives, or antibiotics of any kind. It is not grown on foreign mediums, but contains only the frequency of the disease.

This is how illness occurs in nature. Pure and simple. The developing immune system contracts a disease, mounts an immune response, resolves the illness, and is left with lifelong immunity to a specific virus. No chemicals, no confusion, no system overload! HP confers all of the benefits with none of the risks…

Is HP for Me?

With any aspect of your health, or the health of your children, it’s essential to do your homework and carefully gather all the information you can before making choices. HP is not a “replacement” for vaccination. It is a conscious method to enhance immunity that employs energetic principles. Applications for epidemics and childhood diseases are based upon sound homeopathic principles and common sense. It is utilized and appreciated by many people around the world and shown to be safe and effective…

The time will come when we recognize that trying to eliminate disease is an infantile attempt to declare superiority over other lifeforms. The human body is 9/10ths bacteria, viruses, and other organisms that live symbiotically within us. Living in harmony with these organisms is the only answer to the survival of our species. HP honours this relationship. More people are finding it as they seek a better way…

END OF QUOTE

And here are the facts about HP:

  • there is no reason why it should work; it is not biological plausible,
  • there is no clinical evidence that it does work,
  • the stories HP-fans tell us about epidemics where HP has been employed successfully are unconvincing nonsense,
  • this means that HP is not evidence-based,
  • to mislead people into thinking otherwise is criminally irresponsible, in my view,
  • such bogus claims could cost the lives of millions, if HP truly became wide-spread.

I cannot think of anything in the realm of homeopathy that is more irresponsible than the promotion of HP.

The ‘Deutsche Apotheker Zeitung’, a paper for German pharmacists, rarely is the most humorous of publications. However, recently they reported on a battle between the EU and the European producers of homeopathic remedies – a battle over mercury which has, I think, hints of Monty Python and the Flying Circus.

The EU already has strict regulations on the use of mercury, for obvious reasons, they apply particularly to medicines. The law in this area is now 8 years old and is about to be replaced by a new one which is even stricter. A draft has been recently published here.

The new law would prohibit all mercury in medicinal products, except for some used in dentistry. For the homeopathic and anthroposophic manufacturers, this is not good news because they have many remedies on the market that have the word ‘mercury’ on the label. Consequently, they fear that the sale of these products might be impeded or even become impossible in the EU.

„Quecksilber und Quecksilberverbindungen stellen für manche homöopathische und andere traditionelle Arzneimittel einen unverzichtbaren Bestandteil dar“ (Mercury and mercury compounds are an essential ingredient of some homeopathic and other traditional medicines) .. “Es steht keine Quecksilber-freie Alternative zur Verfügung, die als aktiver Bestandteil in der Therapie mit homöopathischen oder anderen traditionellen Arzneimitteln verwendet werden könnte“ (There is no mercury-free alternative that could be used in these medications”) wrote the Dachverband der Arzneimittelhersteller im Bereich der Selbstmedikation (AESGP) (a lobby group of the homeopathic manufacturers) in a comment adding that „Diese Produkte sind seit Dekaden auf dem europäischen Markt und gehören zum Arzneimittel-Werkzeugkoffer” (these products are on the market since decades and belong to the medical tool-kit)… and that these products contain merely tiny amounts of mercury – even the largest manufacturers of these remedies only require a few milligrams for their production.

The plea of the manufacturers therefore is for an exemption from the new law which would allow the trade of mercury-containing remedies in future. They even have the support of some health politicians; for instance Peter Liese CDU favours an exemption for homeopathic medicines. The next meeting of the EU committee on public health will vote on the matter.

Personally, I can imagine the following dialogue between the EU officials (EU) and the lobbyists of the homeopathic industry (LOHI):

EU: We are very sorry but, because of the toxicity of mercury, we will not allow any of it in medicines.

LOHI: But we have always used it and nobody has come to harm.

EU: We don’t know that, and we have to be strict.

LOHI: We appreciate your concern, but we use only very, very tiny amounts; they cannot cause harm.

EU: The law is the law!

LOHI: Actually, the vast majority of our products are so dilute that they do not contain a single molecule of the ingredient on the bottle.

EU: That’s interesting! In this case, they are not medicines and we will have to ban them.

LOHI: NO, no, no – you don’t understand. We potentise our medicines; this means that the ingredient that they no longer contain gets more and more powerful.

EU: Are you sure?

LOHI: Absolutely!

EU: In this case, we will ban not just your mercury products but all your phony remedies. Because either science is right and they are fraudulent, or you are correct and they are dangerous.

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