MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

quackery

So-called alternative medicine (SCAM) interventions are often being discussed as possible treatments for long COVID symptoms. However, comprehensive analysis of current evidence in this setting is still lacking. This review aims to review existing published studies on the use of SCAM interventions for patients experiencing long COVID through a systematic review.

A comprehensive electronic literature search was performed in multiple databases and clinical trial registries from September 2019 to January 2023. RCTs evaluating efficacy and safety of SCAM for long COVID were included. Methodological quality of each included trial was appraised with the Cochrane ‘risk of bias’ tool. A qualitative analysis was conducted due to heterogeneity of included studies.

A total of 14 RCTs with 1195 participants were included in this review. Study findings demonstrated that SCAM interventions could benefit patients with long COVID, especially those suffering from neuropsychiatric disorders, olfactory dysfunction, cognitive impairment, fatigue, breathlessness, and mild-to-moderate lung fibrosis. The main interventions reported were self-administered transcutaneous auricular vagus nerve stimulation, neuro-meditation, dietary supplements, olfactory training, aromatherapy, inspiratory muscle training, concurrent training, and an online breathing and well-being program.

The authors concluded that SCAM interventions may be effective, safe, and acceptable to patients with symptoms of long COVID. However, the findings from this systematic review should be interpreted with caution due to various methodological limitations. More rigorous trials focused on SCAM for long COVID are warranted in the future.

The review’s aim is, in my view, nonsense. SCAM is a diverse field which means that the review must capture a wide range of therapies each represented by just one or two primary studies. In turn, this means that general conclusions across all SCAM will be highly questionable, if not misleading.

Furthermore, I find these conclusions odd and irresponsibly misleading. My main reason for this is the poor methodological quality of the primary studies:

  • Four trials were considered to have unknown bias risk for generating the random sequence due to insufficient information about the specific method of randomization used.
  • Only 5 of the trials provided appropriate random allocation concealment.
  • Only 5 trials were blinded to both participants and personnel.
  •  Three trials were rated as unknown risk of bias since insufficient information was provided.
  • Four trials failed to performed outcome assessment blinding.
  • One trial did not report detailed information about drop-out cases and was defined as high risk of bias. 
  • Three study protocols were unavailable and had relevant outcomes that were not reported in the pre-specified way.

Moreover, safety cannot possibly be reliably estimated on the basis of the data. And finally, the statement that SCAM interventions may be effective, as the authors put it, is in my view not a valid conclusion but a silly platitude.

I therefore suggest to re-formulate the conclusion of this review as follows:

At present there is no sound evidence to assume that any SCAM intervention is effective in the management of long COVID.

I was alerted to the updated and strengthened guidance to ensure safer practice by chiropractors who treat children under the age of 12 years that has recently been published by the Chiropractic Board of Australia after considering the recommendations made by the Safer Care Victoria independent review. The Board also considered community needs and expectations, and specifically the strong support for consumer choice voiced in the public consultation of the independent review.

The Board examined how common themes in the independent review’s recommendations align with its existing regulatory guidance, and used these insights to inform a risk-based approach to updating its Statement on paediatric care. This includes updated advice reinforcing the need to ensure that parents or guardians fully understand their rights and the evidence before treatment is provided to children. ‘Public safety is our priority, and especially so when we consider the care of children’, Board Chair Dr Wayne Minter said.

According to the statement, the Board expects chiropractors to various things, including the following [the numbers in the following passage were added by me and refer to my brief comments below]:

  • inform the patient and their parent/guardian about the quality of the acceptable evidence and explain the basis for the proposed treatment [1]
  • provide the patient and their parent/guardian with information about the risks and benefits of the proposed treatment and the risks of receiving no treatment [2]
  • appropriately document consent, including considering the need for written consent for high-risk procedures [3]
  • refer patients when they have conditions or symptoms outside a chiropractor’s area of competence, for example ‘red flags’ such as the presence of possible serious pathology that requires urgent medical referral to the care of other registered health practitioners [4]

______________________________

  1. I know what is meant by the ‘quality of the evidence’ but am not sure what to make of the ‘quality of the acceptable evidence]. Acceptable by whom? In any case, who checks whether this information is being provided?
  2. Imagine the scenatio following this guidance: Chiro informs that there is a serious risk and no proven benefit – which parent would then procede with the treatment? In any case, the informed consent is incomplete because it also requires information as to which conventional treatment is effective for the condition at had [information that chiros are not competent to provide].
  3. Who checks whether this is done properly?
  4. Arguably, all pediatric conditions or symptoms are outside a chiropractor’s area of competence!

In view of these points, I fear that the updated guidance is a transparent attempt of window dressing, yet unfit for purpose. Most certainly, it does not ensure safer practice by chiropractors who treat children under the age of 12 years.

A case report of a U-type sacral fracture, or spinopelvic dissociation, resulting from chiropractic manipulation has recently been published. It presents the case of a 74-year-old male patient who sustained a U-type sacral fracture after drop-table chiropractic manipulation.

The drop table chiropractic technique is claimed by chiropractors to involve lesser brute force for spinal manipulation than traditional chiropractic care. It involves low-velocity movement and less spinal manoeuvring on the specific area of injury. It is said to be particularly beneficial for adjusting the pelvis or sacroiliac joints. Furthermore, this is, according to chiros, one of the only methods that can adjust spondylolisthesis. In fact, the evidence that it is effective for anything other that boosting the chiros’ income is more than thin, while there is at least one tragic report that it can be lethal.

The recent case of a spinopelvic dissociation demonstrates that chiropractic manipulative therapy involving the commonly used drop-table can cause severe injury. The patient’s course was complicated by a delay in diagnosis and a prolonged hospital stay. Orthopaedic surgeons should have a high degree of suspicion for spinopelvic dissociation in the setting of bilateral sacral fractures. One year after injury, with conservative management, the patient returned to baseline function with mild residual neuropathy.

Spinopelvic dissociation is a rare injury associated with 2% to 3% of transverse sacral fractures and 3% of sacral fractures associated with pelvic ring injuries. When spinopelvic dissociation is expediently identified and treated appropriately, patient outcomes can be maximized, highlighting the importance of early diagnosis and treatment. Because of its rarity and complexity, there remains a paucity of high-level evidence-based guidance on treating this complex issue.  Most cases are caused by a fall from heights, followed by road accidents. Many patients show neurologic impairment at initial presentation, which often improves after surgery, the treatment of choice.

 

That proponents of anthroposophic medicine have strange attitudes towards established and effective immunizations is hardly a secret. The authors of this review defined anthroposophic communities as people following some/certain views more or less loosely connected to the philosophies of anthroposophy. Their systematic review firstly collated evidence documenting outbreaks linked to anthroposophic communities.

A total of 18 measles outbreaks occurred between 1997 and 2011 in European countries. Eight out of 18 measles outbreaks started at Waldorf schools throughout Germany, Switzerland, Austria, Netherlands, and the UK. Although data from community reporting was limited, the measles cases at Waldorf schools were predominantly higher than in mainstream private or state schools across the five countries. Offering measles vaccination catch-ups by public health authorities (which is an effective way to manage a measles outbreak) was described in several articles but was largely refused by both parents and Waldorf schools. The most effective outbreak control strategy was the immediate closure of the Waldorf school and strict rules regarding entry to the school upon reopening.

Secondly, the review summarized the literature on vaccination coverage in anthroposophic communities. Six articles described vaccine coverage in anthroposophic communities, and one article described the personal belief exception (PBE) rate at Waldorf school in the USA. The papers focussed predominantly on diphtheria, pertussis, tetanus and poliomyelitis (DPTP), and mumps, measles and rubella (MMR) vaccines. Two studies studying the vaccination coverage at Waldorf pre-schools/schools, demonstrated overall low immunization coverage at those schools. One article focusing on PBE rates demonstrated a proportionally high rate at Waldorf schools in California. Three studies from the Netherlands measure vaccination coverage in general and focussed specifically on whether there were special groups that showed specifically low coverage. In these studies, anthroposophic communities were identified as showing low coverage. However, one study suggested that anthroposophic communities are not as significant in terms of low coverage as low-income groups. One paper described rates of vaccination refusal in Switzerland. It showed that complementary alternative medicine users, including people who draw on anthroposophic medicine, are more likely to refuse vaccination. However, the paper also shows that this group was more likely to vaccinate against tick-borne diseases and encephalitis than the general population.

Thirdly, the review discussed the literature that summarized theories and factors influencing vaccine decision-making in anthroposophic communities. Eight articles examining factors and theories influencing vaccine decision-making in anthroposophic communities were included. Five articles focused on parents of children attending Waldorf schools or who considered themselves part of an anthroposophic community. Three articles focused on the perspectives of anthroposophic healthcare providers, although two of those articles mixed and compared views with other alternative/complementary providers or allopathic health providers. Of the eight articles, two were quantitative and did not provide an in-depth discussion. The qualitative findings from six articles were summarized in-depth and revealed four themes.

The authors concluded that this systematic review showed that there have been several measles outbreaks linked to anthroposophic communities in Europe. Although studies on vaccination coverage in anthroposophic communities are limited, it appears that coverage is lower than in the general population. Monitoring outbreak numbers and vaccination coverage could be important. Popular beliefs about the anthroposophic communities’ vaccination beliefs are challenged in this review. As the evidence shows the communities are not categorically against vaccines. Moreover, there are a myriad of factors that influence vaccine decision-making of parents belonging to an anthroposophic community. The importance of experiencing childhood illnesses and concerns over long-term side effects were mentioned. Moreover, parents want to be able to individually select vaccines for their children. They consider themselves actively engaged in vaccine decision-making and well-informed. Stigma regarding vaccine choices was mentioned repeatedly mostly by people outside of the anthroposophic community but also by people within the community. This review calls for a better understanding of vaccine choices and beliefs for vaccines beyond MMR, in particular HPV vaccines. The review also highlights a potentially important research gap, which constitutes understanding not only a belief system but the role that stigma may play in making decisions about vaccines.

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If you ask where this strange anti-vaccination stance of anthroposophic medicine comes from, you don’t need to look far:

“In the future, we will eliminate the soul with medicine.

Under the pretext of a ‘healthy point of view’, there will be a vaccine by which the human body will be treated as soon as possible directly at birth,
(1) so that the human being cannot develop the thought of the existence of soul and Spirit.

To materialistic doctors, will be entrusted with the task of removing the soul of humanity.

As today, people are vaccinated against this disease or disease, so in the future, children will
(2) be vaccinated with a substance that can be produced precisely in such a way that people, thanks to this vaccination, will be immune to being subjected to the “madness” of spiritual life.

He would be extremely smart, but he would not develop a conscience, and that is the
(3) true goal of some materialistic circles.

With such a vaccine, you can easily make the etheric body loose in the physical body.
Once the etheric body is detached, the relationship between the universe and the etheric body would become extremely unstable, and man would become
(4) an automaton, for the physical body of man must be polished on this Earth by spiritual will.

So, the vaccine becomes a kind of arymanique [Ahrimanic] force; man can no longer get rid of a given materialistic feeling.
(5) He becomes materialistic of constitution and can no longer rise to the spiritual “.

Rudolf Steiner 

Despite effective vaccines, there is still a need for effective treatments for COVID, especially for people in the community. Dietary supplements have long been used to treat respiratory infections, and preliminary evidence indicates some may be effective in people with COVID-19. This study tested whether a combination of vitamin C, vitamin D3, vitamin K2 and zinc would improve overall health and decrease symptom burden in outpatients diagnosed with COVID-19.

Participants were randomised to receive either vitamin C (6 g), vitamin D3 (1000 units), vitamin K2 (240 μg) and zinc acetate (75 mg) or placebo daily for 21 days and were followed for 12 weeks. An additional loading dose of 50 000 units vitamin D3 (or placebo) was given on day one. The primary outcome was participant-reported overall health using the EuroQol Visual Assessment Scale summed over 21 days. Secondary outcomes included health status, symptom severity, symptom duration, delayed return to usual health, frequency of hospitalisation and mortality.

A total of 90 patients (46 control, 44 treatment) were randomised. The study was stopped prematurely due to insufficient capacity for recruitment. The mean difference (control-treatment) in cumulative overall health was -37.4 (95% CI -157.2 to 82.3), p=0.53 on a scale of 0-2100. No clinically or statistically significant differences were seen in any secondary outcomes.

The authors concluded that, in this double-blind, placebo-controlled, randomised trial of outpatients diagnosed with COVID-19, the dietary supplements vitamin C, vitamin D3, vitamin K2 and zinc acetate showed no clinically or statistically significant effects on the documented measures of health compared with a placebo when given for 21 days. Termination due to feasibility limited our ability to demonstrate the efficacy of these supplements for COVID-19. Further research is needed to determine clinical utility.

In several ways I am puzzled by this study. On the other hand, I should congratulate the naturopathic authors for honestly reporting such a squarely negative result. One could, of course, argue that the study was under-powered and that thus the findings are not conclusive. However, the actual survival curve depicting the results show clearly that there was not even the tiniest trend for the supplement to show any effect. In other words, a larger sample would have most likely yielded the same result.

Participants randomised to the treatment arm received:

  1. Vitamin D3 50 000 units orally once on day 1 of the study (capsule).
  2. Vitamin K2/D3 120 μg/500 units orally two times per day for 21 days (liquid).
  3. Vitamin C/Zinc acetate 2 g/25 mg orally three times daily for 21 days (capsule).

I fail to understand why the researchers might have conceived the hypothesis that such a mixture would be effective. Only 90 of a planned 200 participants were enrolled in this study which ran between September 2021 and April 2022. I fail to understand why recruitment was so poor that the study eventually had to be aborted. My speculation is that the naturopaths in charge of running the trial were too inexperienced in conducting such research to make it a success.

The study was supported by the Ottawa Integrative Cancer Centre Foundation and by Mavis and Martin Sacher. All investigational products for this study were provided in-kind by New Roots Herbal. Perhaps in future these sponsors should think again before they support amateurs pretending to be scientists?

Several newspapers have reported that, in the Paris region and in the Alpes-Maritimes, France, some 175 police officers were mobilized yesterday to arrest of Gregorian Bivolaru, 71, the Romanian guru and founder of the Movement for Spiritual Integration Towards the Absolute (Misa), which became the ‘Atman Yoga Federation’ when it expanded outside Romania.

Bivolaru had already been convicted in Romania of rape of a minor and is wanted by Interpol for trafficking women. He has also been the subject of a judicial investigation in France since July 2023 for “human trafficking, “organized gang confinement”, “rape” and “organized gang abuse”. He presents himself as the “spiritual leader” of the Atman yoga federation, which has branches in some 30 countries. Under the guise of teaching tantric yoga, this sect conditions its female followers to accept sexual relations eliminating any notion of consent. The victims were encouraged to accept sexual relations with the group’s leader and to engage in pornographic practices for a fee in France and abroad.

Twenty-six women were released during the police operation. Gregorian Bivolaru was arrested in a house in Ivry-sur-Seine where he used to receive his followers for tantric yoga “sexual initiations”. A dozen women were also held for days in the Paris region, to be handed over to the guru.

Gregorian Bivolaru’s career began in 1990 in Romania, where he first founded Misa. Accused of human trafficking and tax evasion in his home country, he moved to Sweden, where he was granted political asylum in 2005, along with a new identity. A conspiracy theorist, he has always maintained that the proceedings against him were political and that the Romanian legal system was against him.

In 2016, Gregorian Bivolaru was sentenced to six years’ imprisonment in Romania for raping a minor and extradited from France. He remained in custody for just one year. New charges were brought against him in Finland after six women, members of the Atman yoga federation, filed a complaint for “human trafficking”. This led Helsinki to issue an international wanted notice by Interpol, in 2017.

Subsequently, the sect continued to exist, still under the control of Gregorian Bivolaru, based in the Paris region. Former followers claimed that the man financed his activities by forcing his victims to submit to various forms of prostitution in strip clubs and massage parlors, or by forcing them to take part in pornographic films in Romania, Hungary and the Czech Republic.

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The International Federation of Yoga and Meditation, ATMAN, claims on its website that it is a non-profit organisation and the majority of its members are committed to a non-profit and charitable orientation. ATMAN is providing a basis for communication and cooperation between various traditional yoga schools and genuine spiritual paths worldwide, promoting true spiritual values for the benefit of mankind.

________________________

A website for Tara Yoga states that Gregorian Bivolaru, nicknamed ‘Grieg’, “is the author of the yoga course taught in Tara and our sister schools in the ATMAN Federation. Having dedicated his entire life towards helping people awaken to that which is divine, Grieg is recognised by many as having a high level of enlightenment and spiritual power, and as belonging to the highest category of spiritual guides, bodhaka.”

_______________________

Tara is one of the ten Maha Vidyas or goddesses of the Tantric pantheon. She is the embodiment of knowledge, grace and compassion. Tara is the guiding star of all spiritual seekers, helping aspirants at any moment as they navigate ‘samsara’, the ocean of illusion, on the path to self-knowledge.

 

According to chiropractic belief, vertebral subluxation (VS) is a clinical entity defined as a misalignment of the spine affecting biomechanical and neurological function. The identification and correction of VS is the primary focus of the chiropractic profession. The purpose of this study was to estimate VS prevalence using a sample of individuals presenting for chiropractic care and explore the preventative public health implications of VS through the promotion of overall health and function.

A brief review of the literature was conducted to support an operational definition for VS that incorporated neurologic and kinesiologic exam components. A retrospective, quantitative analysis of a multi-clinic dataset was then performed using this operational definition.

The operational definition used in this study included:

  • (1) inflammation of the C2 (second cervical vertebra) DRG,
  • (2) leg length inequality,
  • (3) tautness of the erector spinae muscles,
  • (4) upper extremity muscle weakness,
  • (5) Fakuda Step test,
  • radiographic analysis based on the (6) frontal atlas cranium line and (7) horizontal atlas cranium line.

Descriptive statistics on patient demographic data included age, gender, and past health history characteristics. In addition to calculating estimates of the overall prevalence of VS, age- and gender-stratified estimates in the different clinics were calculated to allow for potential variations.

A total of 1,851 patient records from seven chiropractic clinics in four states were obtained. The mean age of patients was 43.48 (SD = 16.8, range = 18-91 years). There were more females (n = 927, 64.6%) than males who presented for chiropractic care. Patients reported various reasons for seeking chiropractic care, including, spinal or extremity pain, numbness, or tingling; headaches; ear, nose, and throat-related issues; or visceral issues. Mental health concerns, neurocognitive issues, and concerns about general health were also noted as reasons for care. The overall prevalence of VS was 78.55% (95% CI = 76.68-80.42). Female and male prevalence of VS was 77.17% and 80.15%, respectively; notably, all per-clinic, age, or gender-stratified prevalences were ≥50%.

The authors concluded that the results of this study suggest a high rate of prevalence of VS in a sample of individuals who sought chiropractic care. Concerns about general health and wellness were represented in the sample and suggest chiropractic may serve a primary prevention function in the absence of disease or injury. Further investigation into the epidemiology of VS and its role in health promotion and prevention is recommended.

This is one of the most hilarious pieces of ‘research’ that I have recently encountered. The strategy is siarmingly simple:

  • invent a ficticious pathology (VS) that will earn you plently of money;
  • develop criteria that allow you to diagnose this pathology in the maximum amount of consumers;
  • show gullible consumers that they are afflicted by this pathology;
  • use scare mongering tactics to convince consumers that the pathology needs treating;
  • offer a treatment that, after a series of expensive sessions, will address the pathology;
  • cash in regularly while this goes on;
  • when the consumer has paid enough, declare that your fabulous treatment has done the trick and the consumer is again healthy.

The strategy is well known amongst practitioners of so-called alternative medicine (SCAM), e.g.:

  • Traditional acupuncturists diagnose a ficticious imbalance of yin and yang only to normalise it with numerous acupuncture sessions.
  • Naturopaths diagnose ficticious intoxications and treat it with various detox measures.
  • Iridologists diagnose ficticious abnormalities of the iris that allegedly indicate organ disstress and treat it with whatever SCAM they can offer.

As they say:

No disease can be more surely, effectively, and profitably treated than a condition that the unsuspecting customer did not have in the first place!

 

PS

Sadly, such behavior exists in convertional medicine occasionally too, but SCAM relies almost entirely on it.

This study was aimed at evaluating the effectiveness of osteopathic visceral manipulation (OVM) combined with physical therapy in pain, depression, and functional impairment in patients with chronic mechanical low back pain (LBP).
A total of 118 patients with chronic mechanical LBP were assessed, and 86 who met the inclusion criteria were included in the randomized clinical trial (RCT). The patients were randomized to either:

  • Group 1 (n=43), who underwent physical therapy (5 days/week, for a total of 15 sessions) combined with OVM (2 days/week with three-day intervals),
  • or Group 2 (n=43), which underwent physical therapy (5 days/week, for a total of 15 sessions) combined with sham OVM (2 days/week with three-day intervals).

Both groups were assessed before and after treatment and at the fourth week post-treatment.

Seven patients were lost to follow-up, and the study was completed with 79 patients. Pain, depression, and functional impairment scores were all improved in both groups (p=0.001 for all). This improvement was sustained at week four after the end of treatment. However, improvement in the pain, depression, and functional impairment scores was significantly higher in Group 1 than in Group 2 (p=0.001 for all).

The authors concluded that the results suggest that OVM combined with physical therapy is useful to improve pain, depression, and functional impairment in patients with chronic mechanical low back pain. We believe that OVM techniques should be combined with other physical therapy modalities in this patient population.

OVM was invented by the French osteopath, Jean-Piere Barral. In the 1980s, he stated that through his clinical work with thousands of patients, he discovered that many health issues were caused by our inner organs being entrapped and immobile. According to its proponents, OVM is based on the specific placement of soft manual forces that encourage the normal mobility, tone and function of our inner organs and their surrounding tissues. In this way, the structural integrity of the entire body is allegedly restored.

I am not aware of good evidence to show that OVM is effective – and this, sadly, includes the study above.

In my view, the most plausible explanation for its findings have little to do with OVM itself: sham OVM was applied “by performing light pressure and touches with the palm of the hand on the selected points for OVM without the intention of treating the patient”. This means that most likely patients were able to tell OVM from sham OVM and thus de-blinded. In other words, their expectation of receiving an effective therapy (and not the OVM per se) determined the outcome.

 

I was alerted to this message on ‘reddit’:

I went in to a chiropractor for a sports injury which was completely unrelated to my neck (wrist). While I was there, the chiropractor insisted on also doing a neck adjustment. To make a very long story short, this adjustment caused a vertebral artery dissection. The injury has left me with lifelong symptoms that I won’t get into here.>Because of tort reform law in Texas, and the $250k cap, I had a very difficult time finding any attorney to represent me even though there’s a mountain of evidence in my favor. My time to file a lawsuit has almost run out (statute of limitations).

Out of principle I want to hold this person accountable. How would I go about at least filing my lawsuit so that I get in within the statute of limitations which is very quickly approaching?

My thought is if I do sue this person within the two year timeframe then I can either self represent, have the option of withdrawing my case, or maybe in the meantime find an attorney to represent me for if/when we go to trial.

Any other advice or things that I should be considering? What would you do?

Thank you

____________________

If anyone can help this person, please do so. I have acted as an expert witness in several such cases and would be happy to do so also in this instance.

Chiropractors will, of course, say that this message is not a proper case report and cannot therefore count as evidence against the safety of chiropractic. I agree that it does not in itself amount to compelling evidence. But I would like to remind the chiros that it is up to them to establish a proper surveillance system for such tragic events which seem to occur far more often than they want us to believe (as discussed ad nauseam on this blog).

I was alerted to a new book entitled “Handbook of Space Pharmaceuticals“. It contains a chapter on “Homeopathy as a Therapeutic Option in Space” (yes, I am not kidding!). Here is its abstract (the numbers were inserted by me and refer to the short comments below):

Homeopathy is one of the largest used unorthodox medicinal systems having a wide number of principles and logic to treat and cure various diseases [1]. Many successful concepts like severe dilution to high agitation have been applied in the homeopathic system [2]. Though many concepts like different treatment for same diseases and many more are contradictory to the allopathic system [3], homeopathy has proved its worth in decreasing drug-related side effects in many arenas [4]. Various treatments and researches are carried out on various diseases; mostly homeopathic treatment is used in joint diseases, respiratory diseases, cancer, and gastrointestinal tract diseases [5]. In this chapter, readers will have a brief idea about many meta-analysis results of most common respiratory diseases, i.e., asthma, incurable hypertension condition, rheumatoid arthritis, and diarrhea and a megareview of all the diseases to see their unwanted effects, uses of drugs, concepts, and issues related to homeopathy [6]. Various limitations of homeopathic treatments are also highlighted which can give a clear idea about the future scope of research [7]. Overall, it can be concluded that placebo and homeopathic treatments give almost the same effect [8], but the less severe side effects of homeopathic drugs in comparison to all other treatment groups catch great attention [9].

Apart from the very poor English of the text and the fact that it has as good as nothing to do with the subject of ‘Homeopathy as a Therapeutic Option in Space’, I have the following brief comments:

  1. I did not know that homeopathy has ‘a wide number of logic’ and had alwas assumed that there is only one logic.
  2. Successful concepts? Really?
  3. So, homeopaths believe that the ‘allopathic system’ treats the same diseases uniformly? In this case, they should perhaps read up what conventional medicine really does.
  4. I am not aware of good evidence showing that homeopathy reduces drug related adverse effects.
  5. No, homeopathy is used for all symptoms – Hahnemann did not believe in treating disease entities – and mostly for those that are self-limiting.
  6. I love the term ‘incurable hypertension condition’; can somebody please explain what it is?
  7. The main limitation is that homeopathy is nonsense and, as such, does not really require further research.
  8. Not ‘almost’ but ‘exactly’! But thanks for pointing it out.
  9. Wishful thinking and not true. Firstly, the author forgot about ‘homeopathic aggravations’ in which homeopaths so strongly believe. Secondly, I know of many non-homeopathic treatments that are free of adverse effects when done properly.

Altogether, I am as disappointed by this article as you must be: we were probably all hoping to hear about the discovery showing that homeopathy works splendidly in space – not least because we have known for a while that homeopaths seem to be from a different planet.

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