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

Monthly Archives: August 2018

This could (and perhaps should) be a very short post:

I HAVE NO QUALIFICATIONS IN HOMEOPATHY!

NONE!!!

[the end]

The reason why it is not quite as short as that lies in the the fact that homeopathy-fans regularly start foaming from the mouth when they state, and re-state, and re-state, and re-state this simple, undeniable fact.

The latest example is by our friend Barry Trestain who recently commented on this blog no less than three times about the issue:

  1. Falsified? You didn’t have any qualifications falsified or otherwise according to this. In quotes as well lol. Perhaps you could enlighten us all on this. Edzard Ernst, Professor of Complementary and Alternative Medicine (CAM) at Exeter University, is the most frequently cited „expert‟ by critics of homeopathy, but a recent interview has revealed the astounding fact that he “never completed any courses” and has no qualifications in homeopathy. What is more his principal experience in the field was when “After my state exam I worked under Dr Zimmermann at the Münchner Krankenhaus für Naturheilweisen” (Munich Hospital for Natural Healing Methods). Asked if it is true that he only worked there “for half a year”, he responded that “I am not sure … it is some time ago”!
  2. I don’t know what you got. I’m only going by your quotes above. You didn’t pass ANY exams. “Never completed any courses and has no qualifications in Homeopathy.” Those aren’t my words.
  3. LOL qualification for their cat? You didn’t even get a psuedo qualification and on top of that you practiced Homeopathy for 20 years eremember. With no qualifications. You are a fumbling and bumbling Proffessor of Cam? LOL. In fact I think I’ll make my cat a proffessor of Cam. Why not? He’ll be as qualified as you.

Often, these foaming (and in their apoplectic fury badly-spelling) defenders of homeopathy state or imply that I lied about all this. Yet, it is they who are lying, if they say so. I never claimed that I got any qualifications in homeopathy; I was trained in homeopathy by doctors of considerable standing in their field just like I was trained in many other clinical skills (what is more, I published a memoir where all this is explained in full detail).

In my bewilderment, I sometimes ask my accusers why they think I should have got a qualification in homeopathy. Sadly, so far, I  have not received a logical answer (most of the time not even an illogical one).

So, today I ask the question again: WHY SHOULD I HAVE NEEDED ANY QUALIFICATION IN HOMEOPATHY?

My answers are here:

  1. I consider such qualifications as laughable.  A proper qualification in nonsense is just nonsense!
  2. For practising homeopathy (which I did for a while), I did not need such qualifications; as a licensed physician, I was at liberty to use the treatments I felt to be adequate.
  3. For researching homeopathy (which I did too and published ~120 Medline-listed papers as a result of it), I do not need them either. Anyone can research homeopathy, and some of the most celebrated heroes of homeopathy research (e. g. Klaus Linde and Robert Mathie) do also have no such qualifications.

I am therefore truly puzzled and write this post to give everyone the chance to name the reasons why they feel I needed qualifications in homeopathy.

Please do tell me!

By guest blogger Hans-Werner Bertelsen

It is possible to have an allergic reaction to the materials used in dentistry. These reactions may be type I reactions (immediate) or type IV reactions (delayed). While type I reactions are characterized by the release of humorally active substances and may lead to asthmatic attacks, mucosal swelling, and the much dreaded anaphylactic shock, type IV reactions are characterized by the formation of incomplete antigens (haptens) that bind to tissue proteins to form complete antigens. According to the relevant medical guidelines, diagnosing an allergy requires that allergy testing is used to confirm any allergy suspected based on clinical symptoms.

In the field of so-called alternative dentistry, testing is by far more extensive. Testing of dental materials is conducted in countless variations, and it also contributes to the marketing efforts in this field.

Moreover, testing is not limited to materials, but extended to teeth that have undergone root canal procedures, and to areas of the jaw bone, in particular the spongiosa. Practitioners will conduct so-called muscle testing and declare teeth with previous root canal procedures or fully healed wounds from previous tooth extractions pathological areas in need of sanitation. Testing is usually done with various devices that are of a dubious, but always impressive nature, and that are referred to by mysterious names. Practitioners use so-called electromedical diagnostic procedures to generate a diagnosis that they will present to the patient as an objectively established fact. A staggering number of electromedical diagnostic procedures is available. As G.-M. Ostendorf reports, “there is a barely manageable variety of these unconventional electromedical methods, which is all the more confusing as publications on these methods are usually not circulated outside interested parties.” (Quote translated from German)

The following list (based on Ostendorf’s work) does not claim to be exhaustive:

* Electroacupuncture according to Voll (EAV)

* Bioelectronic function diagnostics

* Vega testing

* Electrophysical terminal point diagnostics

* Electroneural diagnostics according to Croon

* Mora therapy

* Bioresonance therapy

* Biophysical information therapy

* Mora color therapy

* Multi-resonance therapy

* Metabolism testing and treatment device

* Matrix regeneration therapy

* Decoder dermography

All of these mysterious measuring techniques used in dental material testing are intended to detect incompatible materials used in dental prostheses the patient has previously received. Whenever subjected to closer scrutiny, however, incompatibilities postulated based on electromedical diagnostic procedures are found to be non-existent.

A scientific study has shown that results of the aforementioned electromedical diagnostic and treatment procedures cannot be reproduced and that they do not deliver any diagnostic value that goes beyond that of the use of divining rods. [11]

If you want to believe the apologists of the so-called alternative dentistry, testing of the materials used in dental procedures can also be accomplished entirely without any complicated equipment. According to statements made by the proponents of the so-called “applied kinesiology,” health information and the therapeutic consequences they require, can also be determined simply by getting physically close to the patient. Using this approach, the “therapist” senses a patient’s muscle activity and believes he or she can derive information on the patient’s health from this sensation. However, aside from generating physical closeness, the methods of applied kinesiology have been shown not to have any evidential value, and they have also been shown to be invalid in terms of diagnostics. [12]

Any positive resonance on the patient’s part to treatments following the approach of applied kinesiology is most likely due to the physical closeness between the “therapist” and the patient. This type of placebo effect should not be underestimated, and may lead to positive subjective assessments of the treatment by the patient. The fact that touching the patient during dental treatments can be very effective is readily illustrated using the gag reflex that may be triggered during impression taking: When the dentist hugs the patient this reflex is interrupted immediately. The hugging creates a sudden distraction and stimulus satiation in regions of the brain that are not involved in the gag reflex.

When comprehensive treatments are initiated based on the type of divining-rod-like misdiagnosis described above, dramatic consequences such as mutilations of the jaw bone and severe restrictions of masticatory function can arise [4-6,13].

As early as 1992, forensic medicine professor I. Oepen warned that “Unconventional, i.e. disputed medical methods are offered to many patients. However, the propagated effects of such methods could not be confirmed by controlled studies. So neither any risk taken by the use of these methods, can be justified nor are any costs for treatment vindicated [14].”

When it comes to material testing, laboratory medicine plays a special role, as it uses blood analysis to generate a medical diagnosis. These analytical procedures, e.g., the lymphocyte transformation test (LTT), are often very expensive while of very low specificity, which renders them useless for diagnosing potential allergic reactions to the metals used in the mouth. Due to the limited significance of these test results, testing generates costs without providing any benefit to the affected patients–aside from the potential benefit to the local economy.

In allergy diagnostics, the level of significance and interpretation associated with test results depends on the type of allergy present. On the one side, measuring IgE antibodies to pollen, dust mite, and animal hair antigens is of high diagnostic value. When it comes to variations of type IV allergic reactions, on the other side, the situation is different. These include the so-called contact allergies such as allergic reactions to metals in the mouth. Procedures for diagnosing contact allergies often deliver false-positive results, which makes them useless for diagnosing metal allergies in dentistry, as Harald Renz, director of the Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, of Philipps-Universität Marburg, explained to me:

“Interpreting the results of the LTT and other cellular tests is significantly complicated by the possibility of false-positive and false-negative findings. The LTT is not fully standardized, and it is a complex test that requires not only a lot of experience in conducting the test itself, but also in interpreting the results. Anyone performing this test has to adhere, without fail, to the quality assurance requirements as outlined by the test manufacturer. In addition, the test exhibits large inter-individual variability, and there are no ‘standard’ or ‘reference’ values. The only thing the LTT actually detects is whether the specific immune system has mounted a T-cell response to the metal in question. Positive and negative controls have to be tested as well.

Furthermore, there also are differences in the clinical significance between different metals: While its sensitivity to beryllium and nickel is sufficient, data for other metals are still lacking, and this is true also for metals that are relevant in dental implants and prostheses. What is particularly important: A positive test result on its own is not equivalent to a clinical diagnosis! Any test result needs to be interpreted in conjunction with all clinical findings for the patient in order to reach a meaningful conclusion. Furthermore, a single positive test result does not indicate that the patient is currently and acutely exposed to the metal in question. The exposure may have happened years ago, and may still produce a positive result. This is due to memory cells that may be circulating in the blood stream.”(Translated from German)

When disease is clearly present, it is, therefore, reckless to focus on a possible material intolerance without conducting sound diagnostic testing. Major damages may arise, e.g., because adequate therapy is not sought. To illustrate these types of damages, Ostendorf cites the case of a patient who was suffering from initially undiagnosed sleep apnea. This in turn caused a lack of oxygen and of relaxing periods of deep sleep, which led to daytime fatigue. As a reaction to this situation, the patient developed major mental problems. A physician practicing homeopathy conducted “resonance testing” on this patient, and the results, in conjunction with the physician’s considerable level of ignorance, led to a diagnosis of “exposure to pollutants.” The sheer number and duration of measurements and tests not only prolonged the patient’s suffering, it eventually led to the patient becoming suicidal. [15]

It is obvious that this is not an isolated case, and that similar misdiagnoses will be frequent for mental health issues as well.

An unpleasant diagnosis, such as depression, is often not readily accepted by affected patients, and is likely to be ignored. For these patients, it may be much easier to accept an external cause of their suffering than to face the idea of being mentally ill. Providing them with the false diagnostic pathway of ‘material intolerance’ may be very tempting to them. At one ‘holistically oriented’ dental office, the author experienced first-hand how patients were told that their suffering from depression was a reaction to material intolerance, all with the aim of generating large revenues from prostheses. Instead of suggesting a psychiatric examination in order to find the real reasons of their mental issues, the dentist suggested an external cause. Providing such a false diagnostic path may not only cause significant and sustained damage to the masticatory system, but it may also prevent appropriate and timely treatment. [16,17]

References

11. Ostendorf, G.-M. Spezielle Diagnostik im Überblick Teil 1: Unkonventionelle elektromedizinische Diagnose- und Therapiemethoden im Überblick. In Naturheilverfahren und unkonventionelle medizinische Richtungen, Springer Verlag: 2003.

12. Ernst, E. Komplementärmedizinische Diagnoseverfahren (Diagnostic methods in complementary medicine). Deutsches Ärzteblatt 2005, 102, 3034-3037.

13. Nimtz-Köster, R. Störfelder im Gebiss. Der Spiegel 2002.

14. Oepen, I. Kritische Bewertung unkonventioneller diagnostischer und therapeutischer Methoden in der Zahnheilkunde (Critical evaluation of unconventional diagnostic and therapeutic methods in dentistry). Fortschritte der Kieferorthopädie (Journal of Orofacial Orthopedics) 1992.

15. Ostendorf, G.-M. Elektroakupunktur nach Voll (EAV) – ein kritischer Kommentar. skeptiker 2018, 17-19.

16. Berger, U. Die Praxis der “Alternatvmedizin”: Ein Insider berichtet. In Kritisch gedacht, 2012; Vol. 2018.

17. Prchala, G. Weg mit der Zusatzbezeichnung “Homöopathie”. In zm online, Deutscher Ärzteverlag: 2018.

Central retinal artery occlusion, nystagmus, Wallenberg syndrome, ophthalmoplegia, Horner syndrome, loss of vision,  diplopia, and ptosis are all amongst the eye-related problems that have been associated with chiropractic upper spinal manipulations. Often the damage leaves a permanent deficit – happily, not in this instance.

US ophthalmologists published the case of a 59-year-old Caucasian female who presented with the acute, painless constant appearance of three spots in her vision immediately after a chiropractor performed cervical spinal manipulation using the high-velocity, low-amplitude technique. The patient described the spots as “tadpoles” that were constantly present in her vision. She noted the first spot while driving home immediately following a chiropractor neck adjustment, and became more aware that there were two additional spots the following day.

Slit lamp examination of the right eye demonstrated multiple unilateral pre-retinal haemorrhages with three present inferiorly along with a haemorrhage over the optic nerve and a shallow, incomplete posterior vitreous detachment. Optical Coherence Tomography (OCT) demonstrated the pre-retinal location of the haemorrhage.

These haemorrhages resolved within two months.

The specialists concluded that chiropractor neck manipulation has previously been reported leading to complications related to the carotid artery and arterial plaques. This presents the first case of multiple unilateral pre-retinal haemorrhages immediately following chiropractic neck manipulation. This suggests that chiropractor spinal adjustment can not only affect the carotid artery, but also could lead to pre-retinal haemorrhages.

In the discussion section of their paper, the authors stated: Upper spinal manipulation with the HVLA technique involves high velocity, low-amplitude thrusts on the cervical spine administered posteriorly. No other aetiology of the pre-retinal haemorrhages was found on work-up (no leukemic retinopathy, hypertension, diabetes, or retinal tear). The temporal association immediately while driving home from the chiropractic procedure makes other causes less likely, although we cannot exclude Valsalva retinopathy or progressive posterior vitreous detachment. Given the lack of any retinal vessel abnormalities or plaques along with the temporal association, we postulate that the chiropractor neck manipulation itself induced vitreo-retinal traction that likely led to pre-retinal haemorrhages which were self-limited. It is also possible that the HVLA technique could have mechanically assisted with induction of a posterior vitreous detachment.

If the authors are correct, one has to wonder: how often do such problems occur in patients who simply do not bother to report them, or doctors who do not correctly diagnose them?

By guest blogger Hans-Werner Bertelsen

Holistic ideas are booming, and they do not stop at dental medicine, where procedures and techniques that take an alleged ‘holistic’ approach are becoming more and more popular. Are these procedures and techniques effective, and do they offer a benefit over their conventional counterparts, or is it rather the providers of such procedures and techniques who benefit from a lack of knowledge and understanding in patients who seek out this so-called alternative dentistry? This paper will take a look at three topics—the concept of projections, material testing approaches, amalgam removal—that form the basis for many procedures and techniques in so-called alternative dentistry, to examine whether they offer a sound foundation for said procedures and techniques, or whether they are merely empty promises. Might they be nothing but marketing tricks?

The concept of projections suggests that conventional medicine does look closely enough at the human body, ignoring as of yet undiscovered energy lines and other mysterious linkages. Material testing approaches claim to detect harmful and allergenic components, the removal of which may be beneficial in case of systemic diseases, possibly even curing them. Beginning on July 1, 2018, the use of amalgam will be strongly restricted all throughout Europe. This easy-to-use material has received much attention for decades, as it contains a large proportion of mercury, which is known for its high neurotoxicity, and is, therefore, suspected of causing illness in the long term.

Normally, we think of projections as requiring a screen, onto which something then can be projected. Teeth, however, are also ideally suited as a dumping ground for the underlying causes of somatic and/or mental diseases, from where they can radiate out as so-called projections. Once these are identified as the true cause of disease, other potential causes such as age-related wear and tear, detrimental behaviors, or harmful eating habits can be readily ignored. This concept of projections may have particularly harmful and negative consequences in patients with tumors, as it may cause feelings of guilt, although in many cases no definite cause of tumor development can be discerned. Projected feelings of guilt, in turn, can be a negative influence on a person’s health.

The so-called “system of meridians” assigns relationship qualities to individual teeth, meaning that there are strict relationships of individual teeth to the body’s organs and individual entities. [1]

According to this system, an inflammation of the urinary bladder would be related to the number 1 teeth, the incisors. Rheumatism is linked to the number 8 teeth, the wisdom teeth. In between, there are the teeth of the ordinal numbers 2 to 7, distinguished by their locations on the left or right, in the upper or lower jaw, which offer a wealth of opportunities to assign a “guilty tooth” to clinically common physical complaints. However, this mysterious connection is postulated not only for teeth and major organs, but also for joints, vertebral levels, sensory organs, tonsils, and glands, with the relationships neatly organized in ten groups and subgroups. Multiplied by the number of teeth—eight per each of the four quadrants, 32 in total—these afford the “holistic dentist” 320 opportunities for projecting physical complaints ranging from asthma to zonulitis onto a tooth. Those who believe in this system of projections are not deterred by the fact that there is no scientific proof whatsoever for this odd thesis.

On the other hand, it is basic medical knowledge that pathogens may spread hematogenically and affect remote organs. Seeking adequate specialist counsel when dealing with rheumatic diseases, fevers of unclear etiology, or in conjunction with orthopedic joint surgeries, is, therefore, mandated by guidelines and an obvious standard in the practice of medicine. So-called alternative dentistry makes no particular mention of these general facts, but instead focuses on occult-seeming correlations in order to use a mysterious, almost conspiratorial idea of a disease to legitimize the often invasive treatment options it then recommends. Most patients will not realize that these interpretations often mistake synchronicity for causality. For example, most infections of the urinary bladder will resolve over time, regardless of whether any work was done on the upper incisors or not. However, if during the period of healing one of the incisors was treated by a dentist, it is easy enough to associate this treatment with the resolving bladder infection. From a psychological viewpoint, this constitutes a simple manipulation technique, applied to demonstrate the seemingly superior diagnostics of alternative dentistry: a simple, and easily recognized marketing strategy.

When asked what would happen to these doubtful projections in case of an autologous transplantation during which a tooth would move to another tooth’s original place in the jaw, three leading representatives of the so-called alternative dentistry answered in an evasive and even manipulative manner. [2]

There are reports of invasive therapies, conducted following dubious, often electromedical diagnostic procedures, that not only lead to high costs for the repair of the damage they caused, but also to a lasting mutilation of the patients’ jaws and dentitions. [3-6]

Another supposedly holistic school of thought that is similar to that of the system of meridians exists in some fields of dentistry regarding temporo-mandibular joint dysfunction (TMJD, TMD). These theories suggest that a disbalance in the interaction between jaw bones and masticatory muscles may be responsible for all kinds of diseases. [7]

According to the German self-appointed “TMJD Umbrella Organization” (CMD-Dachverband e. V.), TMJD is a “multifaceted disease.” The claim is that TMJD may not only cause back pain, vertigo, and tinnitus, but also sleep apnea, snoring, neck and shoulder pain, hip and knee pain, headaches, migraines, visual, mood swings, and even depression. However, there is no scientific evidence for any of these claims. [8,9]

Jens C. Türp of the University Center for Dental Medicine Basel’s Department of Oral Health & Medicine, Division Temporomandibular Disorders and Orofacial Pain, has called this standard diagnosis, offered by TMJD diagnosticians whenever a patient shows signs of nocturnal teeth grinding, “nonsense that makes your hair stand on end.”

“For a variety of general symptoms, it is claimed that they are caused by a TMJD: Tinnitus, ocular pressure, differences in the lengths of a person’s legs, back pain, hip pain, and knee pain, balance disorders, tingling in the fingers and many more. ‘A relationship [with TMJD] has never been proven for any of these symptoms’, says Türp. According to him, true TMJD causes problems with chewing and pain. Affected patients have difficulties opening their mouth wide or closing it fully. The “CMD-Arztsuche” (Find a TMJD Specialist) website recommends ‘a lasting correction of a person’s bite’ as treatment. This should be achieved with the help of ceramic inlays, dental crowns, and implants— all of which are expensive and unnecessary measures, in the opinion of Jens Türp. He treats his TMJD patients–almost always successfully, as he says–with occlusal splints, physiotherapy, and relaxation exercises.” (Translated from German [10])

In general, any patient should be advised, therefore, to seek a second opinion whenever confronted with a diagnosis requiring invasive treatments.

References:

1. Madsen, H. Studie zur Kieferorthopädie in der Alternativmedizin: Darstellung der Grundlagen und kritische Bewertung. Doctoral dissertation, Poliklinik für Kieferorthopädie der Universität Würzburg. Würzburg 1994

2. Schulte von Drach, M.C. Wenn Zähne fremdgehen. Süddeutsche Zeitung May 15, 2012.

3. Staehle, H.J. Der Patientin wurde das Gebiss verstümmelt. Zahnärztliche Mitteilungen 2000.

4. Dowideit, A. Wenn nach der “Störfeld-Messung” alle Backenzähne fehlen. Welt June 3, 2017.

5. Bertelsen, H.-W. Die Attraktvität “ganzheitlicher” Zahnmedizin – Teil 1: Bohren ohne Reue. skeptiker 2012, 4.

6. Bertelsen, H.-W. Die Attraktivität “ganzheitlicher” Zahnmedizin – Teil 2: Bohren ohne Reue. skeptiker 2013, 4.

7. CMD Dachverband e. V. Craniomandibuläre Dysfunktion – Ursachen & Symptome. http://www.cmd-dachverband.de/fuer-patienten/ursachen-symptome/ (May 11, 2018),

8. Wolf, T. Die richtige Hilfe bei Kieferbeschwerden. Spiegel Online July 7, 2014, 2014.

9. Türp, J.C.; Schindler, H.-J.; Antes, G. Temporomandibular disorders: Evaluation of the usefulness of a self-test questionnaire. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen 2013, 107, 285-290.

10. Albrecht, B. Teure Tricks der Zahnärzte – so schützen Sie sich vor Überbehandlung. stern February 18, 2016.

 

Bacterial vaginosis is a common condition which is more than a triviality. It can have serious consequences including pelvic inflammatory disease, endometritis, postoperative vaginal cuff infections, preterm labor, premature rupture of membranes, and chorioamnionitis. Therefore, it is important to treat it adequately with antibiotics. But are there other options as well?

There are plenty of alternative or ‘natural’ treatments on offer. But do they work?

This trial was conducted on 127 women with bacterial vaginosis to compare a vaginal suppository of metronidazole with Forzejeh, a vaginal suppository of herbal Persian medicine combination of

  • Tribulus terrestris,
  • Myrtus commuis,
  • Foeniculum vulgare,
  • Tamarindus indica.

The patients (63 in metronidazole group and 64 in Forzejeh group) received the medications for 1 week. Their symptoms including the amount and odour of discharge and cervical pain were assessed using a questionnaire. Cervical inflammation and Amsel criteria (pH of vaginal discharge, whiff test, presence of clue cells and Gram staining) were investigated at the beginning of the study and 14 days after treatment.

The amount and odour of discharge, Amsel criteria, pelvic pain and cervical inflammation significantly decreased in Forzejeh and metronidazole groups (p = <.001). There was no statistically significant difference between the metronidazole and Fozejeh groups with respect to any of the clinical symptoms or the laboratory assessments.

The authors concluded that Forzejeh … has a therapeutic effect the same as metronidazole in bacterial vaginosis.

The plants in Fozejeh are assumed to have antimicrobial activities. Forzejeh has been used in folk medicine for many years but was only recently standardised. According to the authors, this study shows that the therapeutic effects of Forzejeh on bacterial vaginosis is similar to metronidazole.

Yet, I am far less convinced than these Iranian researchers. As this trial compared two active treatments, it was an equivalence study. As such, it requires a different statistical approach and a much larger sample size. The absence of a difference between the two groups is most likely due to the fact that the study was too small to show it.

If I am correct, the present investigation only demonstrates yet again that, with flawed study-designs, it is easy to produce false-positive results.

Did you know that I falsified my qualifications?

Neither did I!

But this is exactly what has been posted on Amazon as a review of my book HOMEOPATHY, THE UNDILUTED FACTS. The Amazon review in question is dated 7 August 2018 and authored by ‘Paul’. As it might not be there for long (because it is clearly abusive) I copied it for you:

Edzard Ernst falsified his qualifications to get a job as a professor. When the university found out they fired him. This book is as false as the Mr Ernst

Over the years, I have received so many insults that I stared to collect them and began to quite like them. I even posted selections on this blog (see for instance here and here). Some are really funny and others are enlightening because they reflect on the mind-set of the authors. All of them show that the author has run out of arguments; thus they really are little tiny victories over unreason, I think.

But, somehow, this new one is different. It is actionable, no doubt, and contains an unusual amount of untruths in so few words.

  • I never falsified anything and certainly not my qualification (which is that of a doctor of medicine). If I had, I would be writing these lines from behind bars.
  • And if I had done such a thing, I would not have done it ‘to get a job as a professor’ – I had twice been appointed to professorships before I came to the UK (Hannover and Vienna).
  • My university did not find out, mainly because there was nothing to find out.
  • They did not fire me, but I went into early retirement. Subsequently, they even re-appointed me for several months.
  • My book is not false; I don’t even know what a ‘false book’ is (is it a book that is not really a book but something else?).
  • And finally, for Paul, I am not Mr Ernst, but Prof Ernst.

I don’t know who Paul is. And I don’t know whether he has even read the book he pretends to be commenting on (from what I see, I think this is very unlikely). I am sure, however, that he did not read my memoir where all these things are explained in full detail. And I certainly do not hope he ever reads it – if he did, he might claim:

This book is as false as the Mr Ernst

The ‘Healing Revolution’ began, according to BIO KING’s website, more than 25 years ago with the establishment of King Bio. Its founder, Dr. Frank King, was inspired to find the root causes of illness and empower the whole person. He cultivated an interest in developing pure water-based homeopathic medicines – a type of natural product that was not, to his knowledge, being produced anywhere else. Committed to researching and developing this new homeopathic medicine, Dr. King moved to Asheville, North Carolina, and opened King Bio in 1989. For more than 25 years, King Bio’s mission has remained true to the empowerment of whole person health, most recently including breakthroughs in whole food dietary supplements. Dr. King’s vision for the company has always centered around three core guiding principles: health, wholeness, and innovation.

On their website, BIO KING also explains: Homeopathy … is energy medicine. Rather than going through digestion, homeopathic remedies deliver their messages almost instantly along the body’s nerve pathways. Like acupuncture, it works bioenergetically (“bio” means “life,” so “bioenergetic” means “life energy”). If the biochemical aspects of the body are like the building blocks of a home, bioenergy is like the invisible electricity that powers it. (A deceased person may have the same biochemical constituents as a living person, but the bioenergy is missing.)

BIO KING is on a mission! To be precise, the mission, as stated on the website, is this:

  • To provide safe, all-natural medicines without harmful side effects.
  • To offer affordable natural medicines that help people overcome common health challenges.
  • To achieve the trust and respect of our customers and uphold the best product quality.
  • To empower people with the most effective ways to achieve abundant health.

Safe medicines?

Without side-effects?

Trust and respect?

Best product quality?

Dr King has been reported to be voluntarily recalling 32 different infant and kids medicines after they tested positive for a microbial contamination. Use of these products could, it is feared, cause life-threatening infections.

Quite a ‘Healing Revolution’!

On this blog, I have ad nauseam discussed the fact that many SCAM-practitioners are advising their patients against vaccinations, e. g.:

The reason why I mention this subject yet again is the alarming news reported in numerous places (for instance in this article) that measles outbreaks are now being reported from most parts of the world.

The number of cases in Europe is at a record high of more than 41,000, the World Health Organization (WHO) warned. Halfway through the year, 2018 is already the worst year on record for measles in Europe in a decade. So far, at least 37 patients have died of the infection in 2018.

“Following the decade’s lowest number of cases in 2016, we are seeing a dramatic increase in infections and extended outbreaks,” Dr. Zsuzsanna Jakab, WHO Regional Director for Europe, said in a statement. “Seven countries in the region have seen over 1,000 infections in children and adults this year (France, Georgia, Greece, Italy, the Russian Federation, Serbia and Ukraine).”

In the U.S., where measles were thought to be eradicated, the Centers for Disease Control and Prevention has reported 107 measles cases as of the middle of July this year. “This partial setback demonstrates that every person who is not immune remains vulnerable no matter where they live, and every country must keep pushing to increase coverage and close immunity gaps,” WHO’s Dr. Nedret Emiroglu said.  95 percent of the population must have received at least two doses of measles vaccine to achive herd immunity and prevent outbreaks. Some parts of Europe have reached that target, while others are even below 70 percent.

And why are many parts below the 95% threshold?

Ask your local SCAM-provider, I suggest.

 

In one of his many comments, our friend Iqbal just linked to an article that unquestionably is interesting. Here is its abstract (the link also provides the full paper):

Objective: The objective was to assess the usefulness of homoeopathic genus epidemicus (Bryonia alba 30C) for the prevention of chikungunya during its epidemic outbreak in the state of Kerala, India.

Materials and Methods: A cluster- randomised, double- blind, placebo -controlled trial was conducted in Kerala for prevention of chikungunya during the epidemic outbreak in August-September 2007 in three panchayats of two districts. Bryonia alba 30C/placebo was randomly administered to 167 clusters (Bryonia alba 30C = 84 clusters; placebo = 83 clusters) out of which data of 158 clusters was analyzed (Bryonia alba 30C = 82 clusters; placebo = 76 clusters) . Healthy participants (absence of fever and arthralgia) were eligible for the study (Bryonia alba 30 C n = 19750; placebo n = 18479). Weekly follow-up was done for 35 days. Infection rate in the study groups was analysed and compared by use of cluster analysis.

Results: The findings showed that 2525 out of 19750 persons of Bryonia alba 30 C group suffered from chikungunya, compared to 2919 out of 18479 in placebo group. Cluster analysis showed significant difference between the two groups [rate ratio = 0.76 (95% CI 0.14 – 5.57), P value = 0.03]. The result reflects a 19.76% relative risk reduction by Bryonia alba 30C as compared to placebo.

Conclusion: Bryonia alba 30C as genus epidemicus was better than placebo in decreasing the incidence of chikungunya in Kerala. The efficacy of genus epidemicus needs to be replicated in different epidemic settings.

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I have often said the notion that homeopathy might prevent epidemics is purely based on observational data. Here I stand corrected. This is an RCT! What is more, it suggests that homeopathy might be effective. As this is an important claim, let me quickly post just 10 comments on this study. I will try to make this short (I only looked at it briefly), hoping that others complete my criticism where I missed important issues:

  1. The paper was published in THE INDIAN JOURNAL OF RESEARCH IN HOMEOPATHY. This is not a publication that could be called a top journal. If this study really shows something as revolutionarily new as its conclusions imply, one must wonder why it was published in an obscure and inaccessible journal.
  2. Several of its authors are homeopaths who unquestionably have an axe to grind, yet they do not declare any conflicts of interest.
  3. The abstract states that the trial was aimed at assessing the usefulness of Bryonia C30, while the paper itself states that it assessed its efficacy. The two are not the same, I think.
  4. The trial was conducted in 2007 and published only 7 years later; why the delay?
  5. The criteria for the main outcome measure were less than clear and had plenty of room for interpretation (“Any participant who suffered from fever and arthralgia (characteristic symptoms of chikungunya) during the follow-up period was considered as a case of chikungunya”).
  6. I fail to follow the logic of the sample size calculation provided by the authors and therefore believe that the trial was woefully underpowered.
  7. As a cluster RCT, its unit of assessment is the cluster. Yet the significant results seem to have been obtained by using single patients as the unit of assessment (“At the end of follow-ups it was observed that 12.78% (2525 out of 19750) healthy individuals, administered with Bryonia alba 30 C, were presented diagnosed as probable case of chikungunya, whereas it was 15.79% (2919 out of 18749) in the placebo group”).
  8. The p-value was set at 0.05. As we have often explained, this is far too low considering that the verum was a C30 dilution with zero prior probability.
  9. Nine clusters were not included in the analysis because of ‘non-compliance’. I doubt whether this was the correct way of dealing with this issue and think that an intention to treat analysis would have been better.
  10. This RCT was published 4 years ago. If true, its findings are nothing short of a sensation. Therefore, one would have expected that, by now, we would see several independent replications. The fact that this is not the case might mean that such RCTs were done but failed to confirm the findings above.

As I said, I would welcome others to have a look and tell us what they think about this potentially important study.

A few days ago, I published an article in the ‘Sueddeutsche Zeitung’ (a truly rare event, as I have never done this before) where I argued that German pharmacists should consider stopping the sale of homeopathic remedies. It violates their ethical code, I suggested.

While this discussion has been going on for a while in the UK (British pharmacists have stopped inviting me to their gatherings because I get on their nerves with banging on about this!), it is relatively novel in Germany.

After I had submitted my copy to the SZ, an article was published which is highly relevant to this subject. Here I first copy an extract of the German original, and below I try to briefly explain its content to those who do not read German.

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In vielen Apotheken werden Kunden nicht hinreichend gut zu Homöopathika beraten. Zu diesem Ergebnis kommt Professor Tilmann Betsch, an der Universität Erfurt Leiter der Professur für Sozial-, Organisations- und Wirtschaftspsychologie, der mit seinem Team 100 zufällig ausgewählte Apotheken in Stuttgart, Erfurt, Leipzig und Frankfurt auf Herz und Nieren geprüft hat. Im Mittelpunkt der Kundengespräche stand eine Beratung zu einem erkälteten Familienmitglied.

“Zum einen zeigen unsere Ergebnisse, dass im Falle eines grippalen Infektes die überwiegende Mehrzahl von ihnen zu schulmedizinischen Präparaten rät, die mit hoher Wahrscheinlichkeit zu einer Linderung der Symptome führen”, erläutert Betsch. Was die Wirkung von Homöopathika betreffe, so zeichne das Untersuchungsergebnis ein eher düsteres Bild, ergänzt er. Denn in nur fünf Prozent aller Beratungsgespräche sei gesagt worden, dass es für die Wirkung von Homöopathie keine wissenschaftlichen Belege gäbe. In 30 Prozent sei dagegen behauptet worden, die Wirkung von Homöopathie sei entweder in Studien nachgewiesen oder ergebe sich aus dem Erfahrungswissen.

“Nach den Leitlinien der Bundesapothekenkammer soll jedoch die Beurteilung der Wirksamkeit von Präparaten nach pharmakologisch-toxikologischen Kriterien erfolgen. Zumindest was die Begründung ihrer Empfehlungen betrifft, folgte die überwiegende Mehrheit der von uns befragten Apotheker diesen Leitlinien nicht”, so Betschs Fazit. Während die Empfehlungen der Apotheker in der Regel nachweislich wirksame Medikamente enthalten hätten, habe sich ihr Wissen über die Wirkung von Homöopathie mehrheitlich nicht von Laien-Meinungen unterschieden.

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Professor Tilmann Betsch has conducted a study showing that German pharmacists fail their customers when advising them on homeopathy. His team went under cover as patients with flue-like symptoms to 100 randomly selected pharmacists. Only 5% of the pharmacists admitted that homeopathics have no proven efficacy, while 30% claimed homeopathics have been proven to work in studies and through experience. This behaviour, Betsch explains, violates the current guidelines for pharmacists.

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I am delighted with these findings; they confirm my arguments perfectly.

Since, in Germany, homeopathics are sold only in pharmacies, German pharmacists have a pivotal role here. They are ethically bound to inform their customers based on the current best evidence. So, in my day-dreams, I imagine a dialogue between a customer and an ethical pharmacist:

CUSTOMER: I have a flu, is there a homeopathic remedy against it?

PHARMACIST: Yes, there is.

CUSTOMER: Can I have it please?

PHARMACIST: If you insist; but I must warn you: it has been shown not to work, and there is absolutely nothing in it that could possibly work.

CUSTOMER: What? Why do you sell it then?

PHARMACIST: Because some people like it.

CUSTOMER: Even though it does not work?

PHARMACIST: Yes.

CUSTOMER: Is it expensive?

PHARMACIST: Yes.

CUSTOMER: And some people still buy it?

PHARMACIST: Yes.

CUSTOMER: Well, not I! I am not a fool. But thank you for your honest information. Can I have something else that alleviates my symptoms?

PHARMACIST: With pleasure!

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The fate of homeopathy in Germany is largely in the hands of pharmacists, it seems.

But, is it in good, ethical hands? Is there hope that progress can be made?

We will see – so far, I have heard of just one!!! pharmacy that has stopped displaying homeopathics on its shelves.

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