“Time to say good-bye? Homeopathy, skeptics and thoughts on how to proceed” is the title of an article by two Swiss homeopaths which is almost touchingly naive. Here is its abstract:
Although homeopathy is frequently used by many health professionals, there are ongoing debates concerning its effectiveness. Currently no unifying explanation how homeopathy works exists. Homeopaths are frequently challenged by skeptics, and in public opinion, the swan song for homeopathy is frequently sung.
Content: Regarding the efficacy of homeopathy, several well-designed RCTs, observational studies, case studies, and case reports, have been published, demonstrating its clinical efficacy. Regarding its mode of action, the discovery of the working principle of homeopathy would be a major advance towards a thorough scientific recognition of homeopathy. Basic research has already discovered some milestones, e.g., significant and reproducible effects of homeopathic preparations in plants.
Summary: To overcome the distrust of skeptics and public opinion, the support of basic research is indispensable. Second, homeopaths should continue to design prospective randomized clinical studies in order to create robust clinical evidence for the efficacy of homeopathy. Third, they should continue to publish their treatment outcomes, as these publications document clinical effectiveness beyond doubts about its mode of action.
Outlook: These measures will not only support homeopaths in continuing their clinical work, but may lead to a better recognition of this treatment in both the scientific world and the public.
To this, I might add the following comments:
- “ongoing debates concerning its effectiveness”: this debate has been ongoing for 200 years but it has now come to a conclusion, namely that homeopathy is a placebo therapy.
- “no unifying explanation how homeopathy works exists”: we do know, however, that the laws of nature, as we understand them today, must be wrong if homeopathy did work.
- “Homeopaths are frequently challenged by skeptics”: the main challenges currently come not from skeptics but from health experts who rightly insist on sound evidence.
- “several well-designed RCTs, observational studies, case studies, and case reports, have been published, demonstrating its clinical efficacy”: arguably, this might be correct but misses the crucial point that the totality of the reliable evidence fails to show that homeopathy is efficacious for any condition of humans or animals.
- “the discovery of the working principle of homeopathy would be a major advance”: yes, so much so that it would require rewriting whole sections of the textbooks of physics and chemistry.
- “Basic research has already discovered some milestones”: these ‘milestones’ are so imposing that nobody outside the realm of homeopathy has ever recognized them.
- “the support of basic research is indispensable”: not so much indispensable as non-existent, I would say.
- “design prospective randomized clinical studies in order to create robust clinical evidence for the efficacy of homeopathy”: homeopaths believe research to be a tool for creating evidence that supports their creed; I have often tried to remind them that it is a tool for testing hypotheses – to no avail, it seems.
- “publish their treatment outcomes, as these publications document clinical effectiveness”: I have also often tried to explain to them that treatment outcomes can be due to many factors other than the specific effect of the applied therapy – again to no avail.
- “These measures will not only support homeopaths in continuing their clinical work, but may lead to a better recognition of this treatment in both the scientific world and the public”: these measures, if applied rigorously, will merely confirm what we already know, namely that homeopathy does not work beyond placebo.
25 Responses to Time to say good-bye? Homeopathy, skeptics and thoughts on how to proceed
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My absolute favourite here: “We need to design studies to create robust clinical evidence”
This almost deserves to be printed in nice big curly type and framed behind glass, to adorn the wall of homeopaths’ offices.
Now, where did I leave that homeopathic headache remedy I had lying around (Malleus maximus cranialis 30C – not to be confused with the real Malleus) …. I could really use some of that after a dozen facepalms in a row.
I can’t wait to see some basic research in homeopathy. We might find out the water does have a memory for the matter that was used to make the remedy. I can’t wait to see how the research can used Quantum Theory to see how the particles manage to find and use the ‘memory’ it the remedy.
Obviously, this will not happen! If we were to do basic research we would find that there is nothing to cure anything! Of course, new physics might be found but I bet this is never tried.
I wonder what explanation of how homeopathy works we are going to be told next…
Neither can I. I repeatedly asked homeopaths and proponents of homeopathy to link to even the tiniest shred of research showing the existence of or even a remotely plausible mechanism for
– the similia principle, i.e. ‘Like cures Like’,
– the law of infenitesimals, i.e. that diluting homeopathic preparations makes them more instead of less potent,
– the viability ofprovings, i.e. that homeopaths (or preferably: anyone) can blindly identify a homeopathic preparation by the symptoms it supposedly to evokes. Or even that a symptom-‘matched’ preparation produces better health outcomes in patients than a preparation that should have the opposite effect.
And each and every time, total silence ensues. No homeopath has ever come up with even the tiniest bit of evidence for the existence or viability of any of these core principles of homeopathy. Neither are there experiments or procedures by which an arbitrary scientist can verify the existence of these things.
Let’s not forget there are even believers in “paper homeopathy”. In this alternate universe you simply write the “ cure” on paper and either put it in the persons pocket etc. Or stand a glass of water on the paper and it transfers its mystical powers to the water, by some unexplained mechanism.
Mad enough, but I have never heard a homeopath criticise this concept, they either don’t reply or ignore the question. One might consider this is an indication of the fact it’s a faith based concept and they can’t criticise anyone who agrees with even a part of their fairy story, or the whole house of cards may tumble.
Advocates of homeopathy formerly rather active on this blog in relation to the putative prophylactic benefits of homeopathic ‘medicines’ distributed in India to prevent Coronavirus infection, have fallen strangely silent…..
And what is that evidence? Your biased reviews? The fraudulent second Australian report? The EASAC report and the Russian report based on that second Australian report?
What laws of nature? You’re saying there’s nothing to discover in science anymore?
“Sound” science is the same thing that the tobacco industry was asking for to quell criticism. Strange that you use that term. But I’m not surprised if you’re a lobbyist with the American Council on Science and Health “Science 2.0”, Do You Know Your Friend Hank Campbell?
So you don’t deny that there are good quality clinical trials that have been shown that homeopathy has a better effect than placebo, but rather you hide in a myth invented by you that “all the reliable evidence fails.”
Guess, science always changes and sometimes what was once considered impossible becomes possible when evidence accumulates!
Well, well, you’ve forgotten that a fact is objective regardless of who believes in it.
Remember; if you make a claim in a comment, support it with evidence!
A few years ago you yourself encouraged homeopaths to do scientific research, but when you see that they do it you retract.
If you had only read the article you would have noticed that the authors do not exclude that placebo is a factor in patient improvement, but the placebo hypothesis is not the only explanation and does not rule out specific effects anymore when the base evidence supports it.
If this were true there were no researchers trying to clear double standards (NHRMC; Shang, Ernst, among others) to alter the conclusions and creating a false negative!
Oooh look at those little hands flapping!
Dodge, obfuscate, bluff, bluster. Same as ever. I won’t bother with a point-by-point refutation but will pass comment on the poster’s first observation – namely the “fraudulent” second NHMRC report.
On what grounds has it been shown to be fraudulent, Zhan? The homeopaths have whinged and whined about it. They claim to have raised objections with the ombudsman.
The report stands. The complaints have either been ignored or rejected. It is fraudulent in the same way that homeopathy is effective – i.e. only in the deluded imaginations of quacks.
And it’s strange how Zhan is happy to post a load of high-handed pompous windbaggery but for some reason fails to post links to the evidence which unequivocally demonstrates the effectiveness of homeopathy. The knock-down studies. The unarguable proofs which will end the argument.
i know why Zhan hasn’t done this
Because there aren’t any.
Carry on, Zhan. You’re just another one of the hapless fools who periodically crops up on this blog flogging their dead horse in public. It’s always fun to watch the ongoing exercises in self-delusion. We’ve seen it all before and we’ll see it all again.
The law of nature that says that a particular substance cannot have an effect when it is completely absent.
Oh, there is enough to discover in science. But homeopathy is not science. Homeopathy is a long-discredited and obsolete form of medicine, and is nowadays best described as a system of belief.
In 200 years, no progress whatsoever has been made in homeopathy – quite the contrary: it was already scientifically discredited at the beginning of the 19th century, when scientists took a closer look at it. Even its core principles and practices have never been confirmed experimentally in any credible manner, also see my comment above.
If you think differently, simply provide links to or descriptions of proper scientific experiments or procedures by which these principles can be observed by an arbitrary scientist, and not just by homeopaths.
or the 2nd law of thermodynamics.
Discredited by who? for you and your band? the nineteenth century? you mean those pamphlets written by people like Oliver W. Holmes that lack the slightest rigor and contain numerous errors about Hahnemann’s system? Do you need to add a tag like “proper” to always move the goal posts?
You and Ernst are the laughingstock, there’s no law of nature that says that. There are phenomena that do not follow linear and directly proportional responses, your friend Ernst should know, hormesis is a typical effect that this” law ” of proportionality is not always fulfilled. Ernst is ignorant of the branches of physics, the second law of thermodynamics has limitations and is very good at describing equilibrium systems, not open systems.
I’m not going to respond to useless people like Leny.
are you feeling alright?
you write a bit like a loon, if I may say so.
I realize at last that your Ernst answers are mere direct attacks on the mental health of your opponents, poor old man, it must be horrible to know that your book “Undilitued facts” is a cherry picking fraud very easy to refute. And so you say you are the “world reference of the fight against homeopathy”?
In hormesis, Zhan, am I not correct in understanding that the active substance is present, not absent?
Exactly. Hormesis describes the phenomenon where a small (but perfectly measurable) dose of a substance has the opposite effect of a larger dose. There are quite a few substances that are beneficial or even essential at relatively low doses or concentrations, but harmful in higher doses. Vitamins A and D are well-known examples.
However, there exists no substance that still has a measurable effect after diluting the last molecule into oblivion.
Hormesis is a general biological rule, similia similibus curentur is only a special case. Many homeopathics have substances like those potencies up to 4C, even Ernst himself recognizes and knows it. Nothing prevents that if a potentized substante up to 30C has effect can exert a hormetic effect, there is research on that correlating the effects of change with hormesis and they are consistent.
Wrong. Hormesis is not a universal phenomenon, as there are countless substances that do not sway from one particular effect to the opposite when the dose is increased. Heavy metals are examples of these.
Wrong. The similia principle has nothing to do with hormesis, as it makes claims about the nature of effects, if any, not about the dose at which they occur. It literally says: “the same that causes [symptoms of] disease shall also cure the [symptoms of] a similar disease”. (Which of course is nonsense for which there no shred of evidence.) Nowhere does it say anything about dosage.
When starting out with a 100 grams of the base material, a 4C dilution means that you end up with 1 microgram of it in your dilution. Even though this means that there is a measurable amount present, there are only very few substances that still have an effect in dosages like this – I can only think of botulin toxin and its cousins such as tetanospasmin, and perhaps a few psychotropic substances. Those 4C homeopathic preparations will very likely have no effect whatsoever(*).
Sorry, this sentence is unintelligible. 30C dilutions cannot possibly have an effect, and there are no repeatable experiments that show any such effects. And if you refer to research to prove your point, please provide links to that research – carried out by real scientists and peer-reviewed if possible, because homeopaths have been found to first and foremost ‘potentize’ scientific rigour in their experiments.
*: And this is also why these preparations don’t have to comply with medicinal regulations with regard to efficacy and safety: they don’t do anything, which means that they also can’t be harmful.
Says who, you? Richard Rasker? Are you an authority on toxicology? Oh, no, you’re not. Dr. Calabresse, the highest authority on the study of hormesis, says that this is a universal rule. If you think otherwise, I’ll be waiting for your great scientific publications.
Another comment that you don’t support more than what you read out there somewhere. Let me tell you that your friend Ernst should know the work of Dr. F. A. Wiegand and Dr. Van Wijk on hormesis and homeopathy, to mention one example.
We are progressing, you have already admitted that in a 4C there may be substance.
It definitely only has word without substance or content, at all times you add adjectives like “real” scientists, so you can always move the goal posts. I guess your thing is called sealoening. Nothing in physics prevents a 30C power from having an effect, if you believe otherwise you must prove it mathematically and with experimental evidence.
THE EARTH IS NOT FLAT
Says who, you? Richard Rasker?
@Edzard
I think this latest blog item by Steven Novella is an appropriate final comment on the endless drivel from ‘Zhan’: https://theness.com/neurologicablog/index.php/bullshit-and-intelligence/
By scientists of course. Not one scientist has succeeded in reliably showing the claimed effects of homeopathy – and not for lack of trying. One such experiment dates back to as early as 1835 – and one of the reasons that this test was performed was because the majority of doctors had failed to replicate Hahnemann’s findings, and saw that simply administering plain water instead of a homeopathic ‘remedy’ worked just as well.
And oh, in spite of this utter failure, Natrium Muriaticum is still prescribed by homeopaths today – which of course is madness: every one of us has some 200 grams of table salt in our body. Yet homeopaths are insane enough to firmly believe that water from which most(*) salt has been diluted away still has a huge number of effects in the human body.
*: It is in fact almost impossible to get rid of all the sodium and chlorine ions in water, as even the purest water will always have numerous contaminants. This also means that approximately 10C is the highest practical dilution achievable for homeopathic preparations. Beyond that, the composition of the water is almost fully dictated by contaminants which are present in more or less constant concentrations. Yet those silly homeopaths keep on diluting and diluting and diluting …
Ah, the characteristic colossal arrogance of the homeopath …
Now, this may come as a bit of a shock to you, but Prof. Dr. Ernst and the handful of other people here (including me) are not the only ones to think differently. In all, there are approximately 15 million doctors and 7 million scientists in the world, and they virtually ALL agree that homeopathy is nonsense, and that homeopaths are self-deluded fools who had better stop messing with people’s health – simply because telling lies to people is not good, and because people can (and do) die if they are sold magical water drops and fairy sugar crumbs by medically incompetent practitioners instead of getting proper healthcare.
The 1835 experiment was a very low quality and unreliable proving conducted by a fanatical German priest who was against homeopathy. The only valuable thing about that experiment is the attempt to use statistics comparing to a group, but it is an experiment that has many methodological flaws, including attrition bias, which Harald Walach himself has corrected and improved over the years. I’m not surprised you don’t mention the other multicenter provings made in the United States, and with thousands of people taking into account objective physiological measurements, but I see that doesn’t suit the narrative of your colleagues.
This is a radical change, in many books that attack Hahnemann they say that no one ever tried to replicate his experiment, but here you say the opposite. Leaving aside this obvious contradiction, I must assume that you are referring to the experiments which Holmes mentions in his pamphlet. As always, you are another misinformed trickster who believes everything they tell him, those “experiments” that Holmes mentions were not even true replications of the proving, already at the time several homeopaths and historians exposed the errors and failures of those attempts of replication. Not to mention the confusion Gabriel Andral and his friend.
If world experience, provings, TEM experiments and others indicate that potentized NaCL has effects, it would be arrogant to dismiss them with nonsense based on mere comments from a man named Richard Rasker, who not appear be a scientist.
Precisely if you recognize that NaCl dissociates, its effects will be different than simply taking salt, is exactly what Hahnemann says in his book: the effects of potentized substances do not necessarily have to be identical. And on contaminants is the same” argument ” spent, if you do an experiment with TEM and you consistently find that there are Na and Cl ions in potentized substances like a 30C, however much contaminants like ClO2 or silicates you find these are not salt ions from NaCl.
Remember, if you make a claim in a comment, support it with evidence! Even if you do you have other problems, those supposedly “15 million” of people may be wrong and you are surely deceiving yourself. At first glance although you repeat that homeopathy is used less than conventional medicine, not at all insinuating that the number of people who use it continues to increase and that even doctors, nurses and pharmacists admit to using it. Yes, there are others who oppose on social networks, but when you get to make a historic ten or twenty years, you will realize that many of those opposed to homeopathy ignore the research, they are arrogant people do not recognize the evidence and believe that they know more than a Nobel as Luc Montagnier, although they are no more than hicks that live tweeting 12 hours on twitter, some are “researchers” who believe in their fantasies censoring homeopathy some day.
As you appear to be either a troll or a seriously unhinged homeopathy adherent, I shall not address each and every detail of the above. I think the following will suffice:
Sorry, but this once again tells us that you know nothing about either homeopathy or chemistry.
All Na+ (sodium) ions are 100% identical on the most fundamental level, as are all Cl- (chlorine) ions (disregarding weight differences of different isotopes). There is fundamentally no difference whatsoever between the ions present in the body, those entering the body through food and drink, and those leaving the body through our urine and feces. And no, those few remaining sodium and chlorine ions in homeopathic preparations don’t do anything special either, nor does removing ions from a solution by diluting it and discarding 99% at each dilution step. Those diluted-away ions are simply gone, they can’t and don’t have any persistent effects in the solution whatsoever(*).
Hahnemann thought he was on to something, and for a while it appeared that he might be right, as patients fared better when receiving homeopathic treatment instead of the ‘standard of care’ of those days – but it eventually turned out that homeopathy only got good results because it boiled down to simply doing nothing, instead of killing patients by all sorts of well-meant but quite harmful interventions such as bloodletting and manure-laden wound dressings. This was a valuable lesson of homeopathy. But another valuable lesson of homeopathy is that it is VERY easy to fool yourself and your patients into believing that something works, simply because people get better after a treatment. And you appear to ignore both lessons.
Anyway, I shall heed this topic’s headline: it is time to say goodbye to homeopathy, or at the very least to you. You can’t show us any evidence for the viability of homeopathy, and instead resort to ad-hominems, untruths, gibberish and almost every fallacy under the sun. Which I have seen already ad nauseam. So have a nice life.
*: This reminds me of a joke I once read:
A man enters a London courier’s office, almost bent double under the weight of a huge package apparently containing bricks, with a few already poking through the cardboard. With his last efforts, he dumps the package on the counter, and, quite out of breath, asks the clerk
“OK, I want to send this package to Palmerston North, New Zealand, by plane. Hoe much is that?”
The clerk manoeuvres the package on their biggest scales, and types in the destination.
“That’ll be £850 for normal service”
“OK, and with express service?”
“That’ll be another £220”
“OK, and with the fastest local overnight delivery service?”
“Um, that’ll add another £180 …”
The customer does some calculations under his breath, and then turns to the clerk:
“OK, here’s the deal: I do NOT send this package to Palmerston North, New Zealand by plane, express service and overnight delivery. So this means you now owe me £1250.”
Who knew, all those who disagree with you or your beloved leader Ernst are “trolls”or ” adherents”.
Another comment without substance from you. Is it normal for you to invent things that no one has told you? It’s just that nowhere have I said that sodium and chlorine ions are different, I’ve told you that the effect is not the same if you have sodium chloride as if you have the ions of that molecule separately, that’s basic chemistry. Even an Electromedical technician should know.
You’re not telling me anything here, and you’re not responding to my comment.
I get it, you don’t like to be questioned and you’re just looking to use a censorship method. For you will have to desire it and repeat it many times because there are no signs that homeopathy is about to disappear, Oliver Wendell Holmes ardently desired and predicted that homeopathy would disappear in a few years, it did not happen, and many authors of the same type said it over 200 years and none of that happened. Much of the evidence has even been presented by Ernst on his blog, evidence that he only disqualifies with comments that reflect his complete ignorance. I don’t think it’s necessary to mention Frass’s review in which he systematically refutes all the overall negative reviews that had come to negative conclusions. But no way, respectable journals like The Oncologist have already accepted homeopathy trials, and you?
What did you expect to accomplish with that? being funny? Is that your “evidence”? I didn’t expect you to be on the same level as troll Lenny. By the way, I know it hurts him a lot to be ignored.
Namecalling, Zhan. That’s all you’ve got.
I repeat:
Oh dear.
I know why Zhan hasn’t done this
Because there aren’t any.
Proving my point most eloquently, Zhan. You won’t respond because you can’t. Because to do so would be to acknowledge the house of cards that is your argument.
Dodge, obfuscate, bluff, bluster. You, Dana, Lollypop, Sandra, Benneth, Pinkus and all the rest. All the same. You’ve got nothing beyond your empty, boastful, witless hubris.
Pathetic. Truly pathetic.
“I’m not going to respond to useless people like Leny (sic)”
Oh dear.
Proving my point most eloquently, Zhan. You won’t respond because you can’t. Because to do so would be to acknowledge the house of cards that is your argument.
Dodge, obfuscate, bluff, bluster. You, Dana, Lollypop, Sandra, Benneth, Pinkus and all the rest. All the same. You’ve got nothing beyond your empty, boastful, witless hubris.
Pathetic. Truly pathetic.