Monthly Archives: June 2019
The fact that homeopathy is under siege in France, has been discussed before. Now even the international media have picked up the story. Here are some excerpts from an interesting article in Bloomberg:
… The looming brawl gets to the heart of conflicting visions of the state’s involvement in the country’s health system at a time of eroding quality and services. Jobs are also at stake: France is home to Boiron SA, the leader in a global homeopathy market estimated at more than $30 billion.
Boiron’s pills and tinctures have long coexisted with conventional care in France, prescribed by regular doctors and dispensed in almost every pharmacy. Ending public support for the remedies would discredit homeopathy and “send a shock wave” through the industry worldwide, says Boiron’s chief executive officer, Valerie Poinsot. “We’ve been caught in this storm for the past year,” Poinsot says. “Why the hostility, when we contribute to caring for patients?”
Facing a possible backlash, Boiron, based in Lyon, teamed with rivals Weleda AG of Switzerland and closely held family group Lehning to fund a campaign called MyHomeoMyChoice. The push has garnered just over 1 million signatures in an online petition and placed bright-colored posters framed with the recognizable little white pills at pharmacies across the country. “Homeopathy has treated generations of French patients,” says one slogan. “Why deprive future generations?”
For now, French people can walk into any pharmacy and buy a tube of Arnica granules — recommended for shocks and bruises — or roughly a thousand other similar remedies for 1.6 euros ($1.80) with a prescription, because the state health system shoulders about 30% of its cost. In some cases, private insurers cover the remainder and patients pay nothing. That may all soon change. A science agency is wrapping up a study of the relative benefits of alternative medicine that will inform the government’s position: Keep the funding, trim it or scrap it altogether.
If the government cuts funding, Boiron would instantly feel the pain. Poinsot estimates that sales of reimbursed treatments could plummet by 50% in France, where the company brings in almost half its revenue. The company’s stock price has lost about 13% since May 15, when a French newspaper wrote that the panel reviewing homeopathy funding would probably rule against it…
In France, the controversy first erupted last year when the influential Le Figaro newspaper published a letter from a doctor’s collective called FakeMed lambasting alternative medicines. The authors called for ending support of “irrational and dangerous” therapies with “no scientific foundation.” The ensuing debate prompted Health Minister Agnes Buzyn to place funding under review and ask the country’s High Authority for Health to rule on homeopathy’s scientific merits…
New evidence on adverse effects of manual therapy comes from an unexpected source. Here is the abstract of the paper:
The aim of this study was to investigate if mild or moderate adverse events after manual therapy has an impact on the chance to recover from back/neck pain in men and women. A prospective cohort study of 771 patients with at least three treatment sessions in a randomized controlled trial performed in January 2010 – December 2013. Adverse events within 24 h after each treatment were measured with questionnaires and categorized as: no, mild or moderate, based on bothersomeness. Outcome measure was the perceived recovery at seven weeks and at three months follow-up. Odds Ratios (OR) and 95% confidence intervals (CI) were calculated by Logistic regression to investigate the associations between the exposure and outcome, and to test and adjust for potential confounding. There were no statistically significant associations observed between the experience of mild or moderate adverse events and being recovered at the seven weeks follow-up. The only statistically significant association observed at the three months follow-up was for mild adverse events in men with an OR of 2.44, 95% CI: 1.24–4.80 in comparison to men with no adverse events. This study indicates that mild adverse events after manual therapy may be related to a better chance to recover in men.
In my view this is a rather boring analysis of a bizarre hypothesis … were it not for a result that cropped up almost unintendedly: AE were reported in 81% of women and 66% of men. No severe irreversible AE were reported, but 178 AEs were rated as moderate to severe. As only symptoms within 24 h after the first three treatment session were reported, the true figures might even be larger.
These figures are considerably higher than previously reported. Our own systematic review of prospective studies suggested that AEs occur in approximately half of all patients receiving spinal manipulation. It follows, I think, that we have to discuss the question about risk versus benefit of manual treatments (such as spinal manipulations) even more critically than before.
I have become used to lamentably poor research in the realm of SCAM, particularly homeopathy. Thus, there is little that can amaze me these days; at least this is what I had thought. But this paper is an exception. The new trial is entitled ‘ETHICAL CLINICAL TRIAL OF LESSER KNOWN HOMEOPATHIC REMEDIES IN INFERTILITY IN FEMALES’, and it is truly outstanding. Here is the abstract:
Background & Objective: Homoeopathy with time honoured results, has a great number of cured cases of infertility, but without much evidence. So, it is imperative to show scientifically the scope of homoeopathy in treating infertility cases. Materials and Methodology: 7 lesser known medicines (Alteris farinosa, Janosia Ashoka, Viburnum opulus, Euphonium, Ustilago, Bacillus sycocuss, Bacillus morgan) were prescribed to the sample size (n=23), at the project site O.P.D/I.P.D. of Homoeopathy university, Saipura, Jaipur and Dr Madan Pratap Khunteta Homoeopathic Medical College, Hospital & Research Centre, Station Road, Jaipur & its extension O.P.D.’s. for study within 12 months. Result-In the present study 7 (30.43%) patients were prescribed Janosia Ashoka amongst whom 2(28.57%) showed marked improvement, while 5(71.43%) remained in the state of status quo. Conclusion- Study has shown encouraging and effective treatment in infertility in females.
It does not tell us much; therefore, let me copy several crucial passages from the paper itself:
Objectives of the study-
- To study the efficacy of homoeopathic medicines in the treatment of infertility in females.
- To enhance the knowledge of materia medica in cases of infertility in females.
Material and Methodology-
The study was conducted at O.P.D./I.P.D.of Homoeopathy University, Saipura, Sanganer and Dr M.P.K. Homoeopathic Medical College &Research Centre, Station Road, Jaipur from 2010 to 2013 for a total period of 3 Years. A sample size of n=23 and 7 lesser known remedies were selected for the studies.
Inferences- Based on clinical symptoms and pathological investigations. It was inferred that out of 23 patients taken for study, 2 (8.69%) patients showed marked improvement, while 21 (91.31%) patients remained in the state of status quo.
No, I am not kidding you. There is no further relevant information about the trial methodology nor about the results. Therefore, I feel unable to even criticise this study; it is even too awful for a critique.
And all this could be quite funny – except, of course, some nutter will undoubtedly use this paper for claiming that there is evidence for homeopathy to efficiently treat female infertility.
You have to be a homeopath to call this an ethical trial!
I have recently given interviews to German, Austrian, French and Canadian journalists. They all had different perspectives, but they all had one question in common:
YOU ARE RETIRED AND COULD BE ENJOYING LIFE, WHY DO YOU CARRY ON WORKING?
And every time I was asked this question, I was surprised. To me, it seems perfectly natural to carry on. But having been asked several times, I did ponder: why do I do it? Here are some answers found through this exercise of introspection.
First let me list three reasons that my detractors regularly imply which, however, are all false:
- I do not do it for the money. In fact, I earn nothing from writing this blog and even have to pay for the pleasure.
- I do not do it because of a bad personal experience; such an event does simply not exist.
- I do not do it because I want to be famous.
So, why then?
The best reason I can give is that I feel a responsibility to do what I do. I am perhaps the only person on the planet who has studied so-called alternative medicine (SCAM) extensively and who, at the same time, has been critical about it. Practically all other full-time SCAM researchers are demonstrably less than critical about their subject (in case you know someone who isn’t, please tell me). And other SCAM critics are often (rightly or wrongly) dismissed by SCAM enthusiasts because they have never done original research on the subject. This does not easily work in my case.
The responsibility I feel relates to the abominable amount of false or unreliable information that is being published every day about SCAM. In my view, it harms and even endangers the life of many consumers and patients (see, for instance, this recent case). Confronted with this endless flow of seriously misleading information, I feel unable not to do anything about it. I thus see my work since retirement as an attempt to counter-balance this danger and to make a small contribution to progress.
If I am honest, I also have to admit that I am enjoying what I do. Thus the question ‘why don’t you enjoy life…?’ entirely misses the point. I have enough time to pursue my hobbies and, when I work on SCAM, I usually have plenty of fun.
In conclusion, I am retired and I enjoy life!
My friend and colleague Willem Betz has died on 8 June 2019. He was a physician and professor emeritus at the Belgian university Vrije Universiteit Brussel. Willem was a leading sceptic and a founding member of the Belgian sceptic organization SKEPP.
After having worked 20 years as a general practitioner, he made a career change and became a teacher of general practice and a researcher. As a clinician, he received training in several alternative therapies and practiced them of a short while. Soon, he started questioning the validity of these methods and thus became a dedicated sceptic. He served SKEPP as vice-president and as president and became a fellow of the Committee for Scientific Inquiry.
His last paper was published less than a year ago. Here is its abstract:
Conventional treatment of multiple sclerosis (MS) is often disappointing. As a result, some of these patients seek salvation in traditional and complementary medicine (T&CM). The aim of this study is to describe how many patients with MS use T&CM and what their motives and expectations are in doing so. Methods. Ninety-nine patients with diagnosed MS, attending the service of ambulatory revalidation of the National Clinic for Multiple Sclerosis in Melsbroek (Belgium) were included in February 2004 in this retrospective study. All patients had MS resulting in motoric or psychosocial symptoms. The disability was not quantified for this study. Participants were interviewed by means of a structured questionnaire on their current treatment of MS including T&CM. Results. In total 44% of the participants had experiences with T&CM. The most frequently used T&CM were homeopathy and acupuncture. Participants using conventional treatment were more satisfied with the support (p=0.006) and the treatment outcome (0.018) than T&CM users. The use of T&CM was not related to gender, education, living conditions, causal treatment such as disease modifying-therapy (DMT), grade of disability or subtype of the disease. Conclusion. Patients diagnosed with MS seek hope in T&CM such as homeopathy or acupuncture. The results of this study suggest that MS patients need more professional support in their personal search for alternative therapies. Key point. 50% of patients diagnosed with multiple sclerosis search relief in traditional and complementary medicine such as homeopathy or acupuncture. These patients often feel compelled to try every opportunity to heal, often stimulated or urged on by friends or relatives. Multiple sclerosis patients are more satisfied with their conventional treatment than with the traditional and complementary medicine.
Through his personality, enthusiasm, analytical mind, humour and dedication, Willem has inspired an entire generation of sceptics. We will miss you Willem.
In 1995, the Church of Scientology attempted to suppress the Fishman Affidavit which contained Church-copyrighted versions of Operating Thetan levels I-VII. This promptly resulted in hundreds of copies being circulated around the world.
In 2003, Barbra Streisand’s lawyers sent a cease and desist letter to the California Coastal Records Project about the inclusion of a photo of her Malibu beach house on their website. When the website operators rejected the demand, Streisand sued. Subsequently, the Los Angeles Superior Court dismissed the case and the worlds attention focussed on her villa (see below).
Today, there are numerous further cases where someone has tried to censor another party and the attempt spectacularly backfired thus resulting in the opposite effect. Ever since the events surrounding the Streisand affair, the phenomenon has been called the ‘Streisand Effect‘. But recently, German sceptics have proposed to re-name it in
THE ‘HEVERT EFFECT’.
The reason is that a firm producing homeopathic remedies in Germany, Hevert, sent a desist letter to German critics of homeopathy demanding they stop stating that homeopathy is not effective beyond placebo (I did mention the story in a previous post).
I do get the impression that Hevert are not very lucky with their PR. On their website, they claim that homeopathy activates the body’s own self-healing powers. I fear this is much more wishful thinking than fact; at least I know of no sound evidence that would prove this statement to be correct. They also claim that homeopathy is a naturopathic treatment method that was developed at the beginning of the 19th century by German physician and pharmacist Samuel Hahnemann (1755-1843). This does not seem correct either; homeopathy does not fall under the umbrella of naturopathic medicine, not least because it includes plenty of remedies as unnatural as the Berlin Wall. The Hevert website furthermore states that Hahnemann discovered that, with many substances, the healing powers are only released by potentization. He also discovered that toxic substances became valuable medicines when potentized. I fear that this is wrong too; in fact, Hahnemann discovered nothing of the sort – he merely postulated stuff that evidently turned out to be untrue.
Anyway, one of the recipients of the above mentioned desist letters, Natalie Grams, decided not to comply and rather risk the penalty of Euro 5 100. This news then resulted in a storm of angry protests. Germans do not like to be told what to say, and freedom of speech is valued highly these days. Numerous newspapers, magazines, radio broadcasts, blogs and tweets thus sided firmly with Dr Grams.
This week, even a prominent and rather excellent German TV satirical programme aired a long film mercilessly mocking Hevert and homeopathy (no, nothing to do with me!). It is is, in my view, the best critique of homeopathy ever broadcast on German TV. Even if you do not understand the language , it is worth watching, if only for the musical finale:
One theme that occurs repeatedly in the film is the concept of ‘the three pillars of homeopathy’:
- waffle BS (the German original is even less polite [‘Scheisse labern’]).
The ‘three pillars’ have become an instant hit on twitter, with bloggers and elsewhere. They look destined to become the future hallmark of homeopathy. Hevert will now be asking themselves whether the thing with the desist letters was such a brilliant idea.
I suspect it wasn’t – perhaps only trumped by the idea to sell homeopathic remedies?
A few days ago, I received this email:
Dear Dr. Edzard Ernst,
I am xxyy*, Editorial assistant from xxxzzz* Publishing Group Ltd. contacting you with the reference from our editorial department. Basing on your outstanding contribution to the scientific community, we would like to write a book for you.
Researchers like you are adding so much value to the scientific community, yet you are not getting enough exposure. No matter how many papers you publish in famous journals, you will be still unknown to common people. To solve this problem, we came up with this unique solution.
With our book writing service, we will write your research contributions in common man’s language. We will also include all your published papers into this book in a way that a common man can understand it. And then, we will publish your book with our publishing group. Before, publication, we will send the draft to you for scientific accuracy, once you approve our draft, we then proceed for publication. You will get all the rights of your book, and all the sales generated from your book will be credited to you.
Your book will then be listed on famous websites like Amazon, eBay, Goodreads, and many other popular book websites. As a result, you will get good credit and people will recognize your hard work and your scientific contributions.
Last but not least, after the publication of your book, it will be published in Google News, Yahoo, and other major news channels. What more can you ask for?
All we need is your book writing contract, and you will get all the rights for your book.
Will be waiting to hear from you.
Amazed and curious, I replied:
that sounds interesting; please let me know what costs are involved.
The answer came a few days later. Here is the passage that addressed my question:
Usually, Researchers want their articles converted into common man’s language and make them into a book. But if you have a special requirement, then please let us know, so that our writers can write according to your needs. And once the drafting has finished, we will send it for your review for scientific accuracy. This includes book cover & page design, ISBN (International Standard Book Number) for your book, proofreading service and publication fee. And Our service fee for this is $1895. And it will take around 1 month to complete your project. Last but not least, once your book is published, we will write a news article about you and your book and will publish it in major newspapers to get proper publicity.
I have to admit, I am still amazed! The price seems not high (though, judging from the quality of their English, the price/value balance might still be doubtful). Whenever I write a book, it takes me the best part of a year. Once I calculate a realistic $-figure for this effort, it would surely be more than one dimension higher.
So, am I going to have my next book ghost-written by this or any other service?
(*Yes, I deleted the names)
The question whether chiropractic spinal manipulations are an effective treatment of infantile colic has been raging ever since the BCA sued Simon Singh over it (and lost). On this blog, I have discussed the evidence several times (see here, here, here and here). Now a new paper has emerged with the title ‘MEDICAL MANAGEMENT OF INFANTILE COLIC AND OTHER CONDITIONS WITH SPINAL MANIPULATION: A NARRATIVE REVIEW OF THE EUROPEAN MEDICAL LITERATURE’. As it was published on a journal not listed in Medline (J Contemporary Chiropr 2019;2:60-75), I will quote more extensively from it than I do normally. Here is the abstract in its original form:
Objective: Strong evidence is found for European medical management of ‘infantile colic’ by spinal manipulation. This paper identiﬁes and describes this body of evidence. We apply the social research method of document analysis to the European medical literature and report the medical practices regarding the management of infantile colic by manual means including manipulation.
Data Sources: Primary data sources were Medline, accessed via PubMed, and the Index to Chiropractic Literature (ICL). Secondary material was sourced from the private collections of the authors. Acceptability criterion included a report of the medical management of infantile colic.
Data Synthesis: A range of languages were accepted and either translated or interpreted by clinicians known to the authors. Each retrieved paper was then hand-searched to identify additional citations which were also collected. A total of 69 papers met the acceptance criteria. The statements accepted for appraisal were those of methods descriptive of the clinical assessment and management of patients classiﬁed by the practitioner as a child with infantile colic.
Results: The medical management of infantile colic by spinal manipulation is well reported in the European medical literature. Triangulation also identiﬁed reports of medical management of a range of pediatric nonneuromusculoskeletal conditions. European medical papers report a number of positive outcomes for infantile colic with care broadly considered to be manipulative care. These outcomes parallel those known to be widely reported in the chiropractic literature.
Conclusion: We report strong evidence from the European medical literature related to the management by manipulation of infants with infantile colic and other conditions.
In the article proper, the authors conclusions are more detailed and very much longer:
It is difﬁcult to reconcile the positive evidence for manipulative management of infantile colic recorded in
the European medical literature and the known safety of chiropractic management with the need for the 2019 Safer Care Victoria inquiry into Chiropractic manipulation of infants. We consider there is no reasonable evidential basis for this inquiry.
The evidence is that “Infantile colic is an easily identiﬁed childhood entity that has no clear treatment guidelines. The management of infantile colic varies among physicians, and families are often frustrated by the medical community’s inability to prescribe a cure for colic.” (163)
Infantile colic remains a medical enigma with no evidence of safety for medical management, in fact the determination of terminology for reporting such adverse events is relatively new. (164) On the other hand the remarkable safety of chiropractic management is known and the ﬁnding that European medical literature strongly indicates manipulative management of infantile colic as a safe and effective practice, places conventional chiropractic as a safe evidence-based choice to meet parental demand.
Alcantara et al (165) show support for this position by stating “chiropractic care is a viable alternative to the care of infantile colic and congruent with evidence-based practice, particularly when one considers that medical care options are no better than placebo or have associated adverse events.”
In the absence of consistently effective management options, accepting the evidence of the European medical literature shows the beneﬁt of manipulative care for infantile colicky patients and the wider collateral beneﬁcial effect on parents. (166,167)
We consider it important to report the uncertainty of medical management of infantile colic and to recognize manual therapy as a legitimate management option as actively utilized by mostly European medical doctors. Multiple case reports document the efﬁcacy of manual therapy of infants. There is a distinct absence of original evidence contradicting the efﬁcacy of spinal manipulative management of infantile colic and an absence of evidential contraindications for its implementation.
This paper reports considerable material in the European medical literature on the manipulative management of infants, particularly infantile colic. Although supportive in safety (150,158) and efﬁcacy (145), the chiropractic literature on these topics was not the primary focus at this time. However in relation to safety, Funabashi and colleagues noted providers of spinal manipulation have similar or better dimension scores compared to the 2016 medical data base of the Agency for Healthcare Research and Quality. (158)
On balance we can state with conﬁdence that the published, indexed evidence places conventional chiropractic management of infantile colic as safe and effective in the manner clearly documented as clinical methods in the European Medical literature.
I find it hard to decide where to begin. The problem is that there is almost nothing right with this review.
Let’s start with the title, ‘MEDICAL MANAGEMENT OF INFANTILE COLIC AND OTHER CONDITIONS WITH SPINAL MANIPULATION: A NARRATIVE REVIEW OF THE EUROPEAN MEDICAL LITERATURE’. What do they mean with ‘other conditions’? As the review does, in fact, include plenty of non-European papers, this title is simply nonsensical.
Next is the objective: it states that there is good evidence for spinal manipulation as a treatment of infantile colic. The authors thus managed to disclose their bias in the very first sentence of their paper.
The rest of the abstract is similarly incompetent. Crucially, we do not learn what inclusion/exclusion criteria the authors applied and how they evaluated the methodological quality of the included studies. Remarkably, this information is also not provided anywhere else in the paper. Thus, this article lacks all the essential elements of a scientific review and turns out to be little more than a highly biased opinion piece. In fact, it is worse; the introduction, for instance, begins with what I can only call a rant: Within Australia there is a government-manufactured controversy regarding the management of infants by chiropractors…
The results section is equally remarkable. Here are a few direct quotes to give you a flavour:
Forty-ﬁve papers were accepted as valid clinical reports of the management of infantile colic by medical manipulation (Table 1). There are over 60 papers relating to infantile colic on ICL; we do not report these. The Chiropractic Resource Organisation (CRO) website essentially carries the same papers as ICL. Many of these listings are case reports and outcome-based studies. (33, 34) Reference lists were also obtained from indexed papers as well a range of medical and chiropractic textbooks. (35 – 37)
The truth is that the 45 papers are not ‘valid clinical reports’ but a mixture of comments, case reports, opinion pieces, observational studies and a few clinical trials. The latter are identical with those discussed in proper systematic reviews of the subject. There is thus no reason for arriving at different conclusions than these reviews. But, of course, the authors do exactly that, and they do not explain why. They claim that European doctors use spinal manipulation routinely for colicky babies; this is not true (I am a European doctor and have never seen this happening). They claim that unearthing the European literature revealed more positive evidence; this is also not true: this literature was not hidden but it simply does not measure up to the standard required for evidence and was thus not included in previous reviews.
The authors could not identify any original research study report that rejected spinal manipulation of infants for colic on the grounds of being unsafe or with negative clinical outcomes.
As the authors did cite a few (by no means all) review papers that clearly showed the risks of spinal manipulation, one must ask what this statement was intended for. Was it to give the false impression that chiropractic spinal manipulations are safe?
The criticism of commentators seems to be that chiropractic care for infantile colic is no better than a placebo (147), the same ﬁnding for a common colic medication. (148) In other words, chiropractic care is equal to or just as effective as placebo and medication and therefore becomes the preferred clinical option on
the basis of safety and the absence of potential adverse effects. (63,149-151)
I fail to understand the logic behind this argument. The authors seem to admit that chiropractic care is a placebo therapy. To any reasonable person, this means that any benign and cost-free intervention (such as a gentle massage or cuddle by a parent) is preferable to an expensive and potentially harmful chiropractic treatment.
Chiropractic has been examined with rigour and found safe. Our interpretation of this evidence is that there is virtually no danger to infants from carefully applied manual methods by qualiﬁed providers and perhaps the best of both worlds is concomitant care among chiropractors and medical practitioners.
This conclusion is not supported by the evidence presented, and the authors do not explain how they arrived at it.
In addition to such irrational passages, we find plenty of nonsensical or factually incorrect statements in the authors’ pseudo-review. Here are a few examples that I found amusing:
Spinal manipulation as it is known today was brought to European medical doctors by chiropractors and osteopaths, (105) and since then it has become an entrenched medical practice in most European countries, particularly Germany. In Europe, the use of spinal manipulation within the medical profession for the management of infantile colic has been a well-recognised procedure for some decades. (38,43,63,106)
The chiropractic vertebral subluxation is recognised in the medical literature (107) contrary to unsupported claims that it cannot be identiﬁed. It is this type of mechanical spinal lesion that has been identiﬁed to address as a vertebrogenic factor under this model.
However, my favourite bit is this direct quote:
The evidence is that “Infantile colic is an easily identiﬁed childhood entity that has no clear treatment guidelines. The management of infantile colic varies among physicians, and families are often frustrated by the medical community’s inability to prescribe a cure for colic.”
The authors quote here from my own review, and remarkably it is the only quote from it. The authors otherwise ignore it completely and, crucially, they do also not list it as one of the 45 included papers. Why? To answer this question, we need to see what my review says. Here is its very short abstract:
Some chiropractors claim that spinal manipulation is an effective treatment for infant colic. This systematic review was aimed at evaluating the evidence for this claim. Four databases were searched and three randomised clinical trials met all the inclusion criteria. The totality of this evidence fails to demonstrate the effectiveness of this treatment. It is concluded that the above claim is not based on convincing data from rigorous clinical trials.
Call me biased, but I do believe that this is much closer to the truth than the lengthy pseudo-review above.
Let me finish this post by revealing who its authors are.
- Peter Rome, Chiropractor, retired
- John Waterhouse, Private practice of chiropractic
- Glenn Maginness, Private practice of chiropractic
- Phillip Ebrall, Tokyo College of Chiropractic
No funding was received for this study.
No author declared a conﬂict of interest (at least, this is what they claim).
No further contact details were provided.
My conclusion of all this:
We have to search long and far before we find a SCAM article that is more misleading and less competent than this one.
You might remember my post from last October:
On Twitter and elsewhere, homeopaths have been celebrating: FINALLY A PROOF OF HOMEOPATHY HAS BEEN PUBLISHED IN A TOP SCIENCE JOURNAL!!!
Here is just one example:
#homeopathy under threat because of lack of peer reviewed studies in respectable journals? Think again. Study published in the most prestigious journal Nature shows efficacy of rhus tox in pain control in rats.
But what exactly does this study show (btw, it was not published in ‘Nature’)?
The authors of the paper in question evaluated antinociceptive efficacy of Rhus Tox in the neuropathic pain and delineated its underlying mechanism. Initially, in-vitro assay using LPS-mediated ROS-induced U-87 glioblastoma cells was performed to study the effect of Rhus Tox on reactive oxygen species (ROS), anti-oxidant status and cytokine profile. Rhus Tox decreased oxidative stress and cytokine release with restoration of anti-oxidant systems. Chronic treatment with Rhus Tox ultra dilutions for 14 days ameliorated neuropathic pain revealed as inhibition of cold, warm and mechanical allodynia along with improved motor nerve conduction velocity (MNCV) in constricted nerve. Rhus Tox decreased the oxidative and nitrosative stress by reducing malondialdehyde (MDA) and nitric oxide (NO) content, respectively along with up regulated glutathione (GSH), superoxide dismutase (SOD) and catalase activity in sciatic nerve of rats. Notably, Rhus Tox treatment caused significant reductions in the levels of tumor necrosis factor (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) as compared with CCI-control group. Protective effect of Rhus Tox against CCI-induced sciatic nerve injury in histopathology study was exhibited through maintenance of normal nerve architecture and inhibition of inflammatory changes. Overall, neuroprotective effect of Rhus Tox in CCI-induced neuropathic pain suggests the involvement of anti-oxidative and anti-inflammatory mechanisms.
END OF QUOTE
I am utterly under-whelmed by in-vitro experiments (which are prone to artefacts) and animal studies (especially those with a sample size of 8!) of homeopathy. I think they have very little relevance to the question whether homeopathy works.
But there is more, much more!
It has been pointed out that there are several oddities in this paper which are highly suspicious of scientific misconduct or fraud. It has been noted that the study used duplicated data figures that claimed to show different experimental results, inconsistently reported data and results for various treatment dilutions in the text and figures, contained suspiciously identical data points throughout a series of figures that were reported to represent different experimental results, and hinged on subjective, non-blinded data from a pain experiment involving just eight rats.
Lastly, others pointed out that even if the data is somehow accurate, the experiment is unconvincing. The fast timing differences of paw withdraw is subjective. It’s also prone to bias because the researchers were not blinded to the rats’ treatments (meaning they could have known which animals were given the control drug or the homeopathic dilution). Moreover, eight animals in each group is not a large enough number from which to draw firm conclusions, they argue.
As one consequence of these suspicions, the journal has recently added the following footnote to the publication:
10/1/2018 Editors’ Note: Readers are alerted that the conclusions of this paper are subject to criticisms that are being considered by the editors. Appropriate editorial action will be taken once this matter is resolved.
Well, it took a while, but now there is some news about this case:
‘Science Reports’, just published a retraction note:
Retraction of: Scientific Reports https://doi.org/10.1038/s41598-018-31971-9, published online 10 September 2018
Following publication, the journal received criticisms regarding the rationale of this study and the plausibility of its central conclusions. Expert advice was obtained, and the following issues were determined to undermine confidence in the reliability of the study.
The in vitro model does not support the main conclusion of the paper that Rhus Tox reduces pain. The qualitative and quantitative composition of the Rhus Tox extract is unknown. Figures 1G and 1H are duplicates; and figures 1I and 1J are duplicates. The majority of experimental points reported in figure 3 panel A are duplicated in figure 3 panel B. The collection, description, analysis and presentation of the behavioural data in Figure 3 is inadequate and cannot be relied upon.
As a result the editors are retracting the Article. The authors do not agree with the retraction.
Does that mean the suspect paper has been declared fraudulent?
I think so.
In any case: another victory of reason over unreason!
This is from the ‘Association to Protect the Sick from Pseudoscientific Therapies’ in Spain. I have the permission to post it here without comment.
Let’s be clear: pseudoscience kills. And they are being employed with total impunity thanks to European laws that protect them.
They kill thousands of people, with names and family. People such as Francesco Bonifaz, a 7-year-old boy whose doctor prescribed homeopathy instead of antibiotics. He died in Italy . People like Mario Rodríguez, who was 21 years old and was told to use vitamins to treat his cancer. He died in Spain . People like Jacqueline Alderslade, a 55-year-old woman whose homeopath told her to stop taking her asthma medication. She died in Ireland . People like Cameron Ayres, a 6-month-old baby, whose parents did not want to give their child “scientific medicine” . He died in England. People like Victoria Waymouth, a 57-year-old woman who was prescribed a homeopathic medication to treat her heart problem. She died in France . People like Sofia Balyaykina, a 25-year-old woman, who had a cancer that was curable with chemotherapy but was recommended an “alternative treatment”, a mosquito bite treatment. She died in Russia . People like Erling Møllehave, a 71-year-old man whose acupuncturist pierced and damaged his lung with a needle. He died in Denmark . People like Michaela Jakubczyk-Eckert, a 40-year-old-woman whose therapist recommended the German New Medicine to treat her breast cancer. She died in Germany . People like Sylvia Millecam, a 45-year-old woman whose New Age healer promised to cure her cancer. She died in Netherlands .
European directive 2001/83/CE has made –and still makes— possible the daily deceiving of thousands of hundreds of European citizens . Influential lobbies have been given the opportunity to redefine what a medicine is, and now they are selling sugar to sick people and making them believe it can cure them or improve their health. This has caused deaths and will continue to do so until Europe admits an undeniable truth: scientific knowledge cannot yield under economic interests, especially when it means deceiving patients and violating their rights.
Europe is facing very serious problems regarding public health. Over-medicalization, multiresistant bacteria or the financial issues of the public systems are already grave enough, and there is no need to add to that gurus, fake doctors or even qualified doctors who claim they can cure any disease by manipulating chakras, making people eat sugar or employing “quantic frequencies”. Europe must not only stop the promotion of homeopathy but also actively fight to eradicate public health scams, which implicate more than 150 pseudo-therapies in our territory. Thousands of citizens lives depend on that. In fact, according to recent research, 25.9 % of Europeans have used pseudo-therapies last year. In other words, 192 million patients have been deceived .
Some believe there is a conflict between freedom of choice for a treatment and the removal of pseudo-therapies, but this is not true. According to article 25 of the Universal Declaration of Human Rights, every person has a right to medical care. Lying to patients in order to sell them useless products that could kill them breaks the right to true information about their health. This way, even if a citizen has a right to refuse medical treatment when properly informed, it is also true that nobody has the right to lie to obtain profit at the expense of someone else’s life. Only in a world in which lying to a sick person would be considered ethical, could we allow homeopathy—or any other pseudo-therapy—to continue to be sold to citizens.
Effective treatments being replaced by false ones is not the only danger of pseudo-therapies. Obvious delays in therapeutic care occur when a person gets false products instead of medication at the early stages of a disease. Many times, it is already too late by the time they get treated with proper medicine. Moreover, several of these practices have serious effects on their own and may cause damage or even death because of their side effects.
Many pseudo-therapists argue that “the other medicine” comes with side effects as well, which is true indeed. However, the difference resides in that pseudo-therapies cannot cure a disease or improve your health, and because of that patients assume risks in exchange of promises that are a scam, according to the full weight of the scientific evidence available. Lying to a sick person is not another type of medicine, it is simply lying to a sick person.
Every country has to face the issue with pseudo-therapies in its own ways. Yet it is not acceptable that European laws protect the distortion of scientific facts so that thousands of citizens can be deceived or even lead to their deaths.
We, the signatories of this manifest, therefore declare that:
- Scientific knowledge is incompatible with what pseudo-therapies postulate, as in the case of homeopathy.
- European laws that protect homeopathy are not admissible in a scientific and technological society that respects the right of the patients not to be deceived.
- Homeopathy is the most known pseudo-therapy, but it is not the only one nor the most dangerous one. Others, such as acupuncture, reiki, German New Medicine, iridology, biomagnetism, orthomolecular therapy and many more, are gaining ground and causing victims.
- Measures must be taken to stop pseudo-therapies, since they are not harmless and result in thousands of people affected.
- Europe needs to work towards creating legislation that will help stop this problem.
Europe being concerned about the misinformation phenomena but at the same time protecting one the most dangerous types of it, health misinformation, is just not coherent. This is why the people signing this manifesto urge the governments of European countries to end a problem in which the name of science is being used falsely and has already costed the life of too many.
References: Homeopathy boy died of encephalitis. Redazione ANSA, 2017.http://www.ansa.it/english/news/general_news/2017/05/29/homeopathy-boy-died-of-encephalitis-3_13e02493-4e62-4787-9162-12d831121ef6.html  Grieving dad sues over ‘cure cancer with vitamins’ therapy, The local. Emma Anderson, 2016. http://news.bbc.co.uk/2/hi/uk_news/england/london/6255356.stm  Футболист рассказал трагичную историю жены. Она умерла от рака в 25 лет. Sport24, 2018. https://scienceblogs.com/insolence/2012/08/30/the-price-of-refusing-science-based-medical-and-surgical-therapy-in-breast-cancer  Psychic ‘misled actress to hopeless cancer death’. Expatica. 2004