A recent article in ‘The Lancet Regional Health‘ emphasized the “need for reimagining India’s health system and the importance of an inclusive approach for Universal Health Coverage” by employing traditional medicine, including homeopathy. This prompted a response by Siddhesh Zadey that I consider worthy of reproducing here in abbreviated form:
… Since the first trial conducted in 1835 that questioned homeopathy’s efficacy, multiple randomized controlled trials (RCTs) and other studies compiled in several systematic reviews and meta-analyses have shown that there is no reliable and clinically significant effect of non-individualized or individualized homeopathic treatments across disease conditions ranging from irritable bowel syndrome in adults to acute respiratory tract infections in children when compared to placebo or other treatments. Even reviews that support homeopathy’s efficacy consistently caution about low quality of evidence and raise questions on its clinical use. The most recent analysis of reporting bias in homeopathic trials depicted problematic trial conduction practices that further obscure reliability and validity of evidence. Homeopathic treatments have also been linked to aggravations and non-fatal and fatal adverse events.
The Lancet has previously published on another kind of harm that uptake of homeopathy encourages in India: delay to evidence-based clinical care that can lead to fatality. Authors have pointed out that evidence for some of the alternative systems of medicine may not come from RCTs. I agree that more appropriate study designs and analytical techniques are needed for carefully studying individualized treatment paradigms. However, the need for agreement on some consistent form of evidence synthesis and empirical testing across diverse disciplines cannot be discounted. Several other disciplines including psychology, economics, community health, implementation science, and public policy have adopted RCTs and related study designs and have passed the empirical tests of efficacy. Moreover, the ideas around mechanism of action in case of homeopathy still remain controversial and lack evidence after over a century. On the contrary, biochemical, molecular, and physiological mechanistic evidence supporting allopathic treatments has grown abundantly in the same period.
Owing to lack of evidence on its efficacy and safety, the World Health Organization had previously warned against the use of homeopathic treatments for severe diseases. Additionally, multiple countries, including Germany where the practice originated, have initiated mechanisms that discourage uptake of homeopathy while others are considering banning it. Homeopathy doesn’t work, could be harmful, and is not a part of Indian traditional medicine. While we should welcome pluralistic approaches towards UHC, we need to drop homeopathy.
(for references, see original text)
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Yes, in the name of progress and in the interest of patients, “we need to drop homeopathy” (not just in India but everywhere). I quite agree!
43 Responses to A ‘letter to the editor’ of The Lancet: we need to drop homeopathy in India
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I remain surprised that India embraced western homeopathy with such enthusiasm, as if there were not enough domestic quackery.
One reason seems to be that, under British rule, Indians were not allowed to train as doctors but were allowed to become homeopaths.
That is one of the cruelest things about colonialism I’ve ever heard. Just appalling.
Cruel but true. In our book (https://www.hive.co.uk/Product/Dr-Dr-Simon-Singh/Trick-or-Treatment–Alternative-Medicine-on-Trial/1382322), we provide further details about this history.
Coming from India, I believe that this is due to the widespread misconception that popular homeopathic treatments have no side-effects and are very inexpensive compared to Western medicine. I come across many common folks and even some allopathic doctors recommending to visit a homeopath for auto-immune disorders and headaches. People whom I know very well claim that it works wonders. The questionable scientific plausibility in its mechanism of action does not bother them as long as they are relieved of their symptoms.
perhaps, but this misconception is universal and not specific to India.
That’s it, Edzard! The fact that Indians were not allowed to be “medical doctors” back in the 1940s but allowed to be “homeopathic doctors” is the complete explanation for why homeopathy is so popular in India 80 years later. And what’s more is that Indians have not adopted any changes in their lives in the past 80 years. They are still driving cars from the 1940s, using typewriters not computers, and even eating the same foods. Obviously, people in India today prefer to live as though this is 1948. OR…maybe these ideas are simply full of shit (they are!).
In fact, according to the Lancet, about 10% of the population of India, approximately 100 million people, depend SOLELY on homeopathy for their health care. Reference: Prasad, R. Homoeopathy Booming in India, Lancet, 370(November 17 2007):1679-80. https://www.thelancet.com/journals/lancet/article/PIIS0140673607617097/fulltext
If YOU or ANYONE else believes that homeopathic medicines are simply placeboes, I challenge ONE doctor anywhere in the world to practice medicine for just ONE week by prescribing just placeboes to every patient. Let’s see how many patients return to this doctor’s practice.
BTW, the reply that you have chosen is hilarious by its cherry-picked “evidence.” However, the author did a piss-poor cherry-picking because many of the citations he provided give powerful support to homeopathy and scientific evidence for it. The author quotes Mathie (2018) in SYSTEMIC REVIEWS, and in this article Mathie notes: “Five systematic reviews have examined the RCT research literature on homeopathy as a whole, including the broad spectrum of medical conditions that have been researched and by all forms of homeopathy: four of these ‘global’ systematic reviews reached the conclusion that, with important caveats, the homeopathic intervention probably differs from placebo.”
And it is so easy to pick apart virtually every paragraph in the Zadeh’s reply…and it is interesting that no one here, despite their seemingly “critical thinking” capacities has chosen to do so. Cognitive dissonance to the rescue!
Hi Dana, Sweaty
“I challenge ONE doctor anywhere in the world to practice medicine for just ONE week by prescribing just placeboes to every patient. Let’s see how many patients return to this doctor’s practice.”
You must know because you’ve done this all your life.
In case you disagree, you ought to go for the half million dollars: https://edzardernst.com/2023/02/who-wants-to-win-half-a-million-dollars/
Thanx for that comment…and in MY experience, a HUGE percent of patients keep coming back to me.
Now, I challenge YOU or ANYONE to prescribe placeboes for a week…and tell me what % of patients return.
Yeah, that’s what I thought.
@Dana Ullman
So what you’re selling them doesn’t actually work? Except of course for the placebo effect that gives them a short-term illusion of efficacy. Why would those people keep coming back if your homeopathic sugar crumbs work so well? Or do these people develop new problems all the time?(*)
What an exceedingly stupid idea – almost as stupid as the concept of ‘proving’. If you want to show that homeopathy is a bogus treatment, you can’t do that by swapping real medicines for placebos (not placeboes btw). The best and simplest way to show this is to swap your specific homeopathic sugar crumbs for blank pellets, or for ‘remedies’ that should have the opposite effect to what is intended – and observe that nothing will change. The treatments will be just as ‘effective’ as before the swap.
*: As your fellow water-shakers would say: this is because you just suppress symptoms instead of treating the root cause – which of course is just another excuse to obfuscate the fact that you people have no knowledge of sickness and health, and your treatments don’t actually do anything.
Dear Mr Ullman,
Such behaviour (“practicing for just one week by prescribing just placebos to every patient”) would be unethical for a medically qualified doctor (registered medical practitioner.)
I’m surprised you recommend such an unethical ‘test’ on any patient – who would have to give fully informed consent.
But perhaps I should not be surprised…?
Ah, Dana. Presumably you have a plausible explanation why the healthcare systems of the rest of the world don’t use homeopathy to the same extent. How strange that, if homeopathy is so wondrous and ubiquitous, only 10% of Indians rely on it. And also how India has a lower life expectancy than comparable nations.
We haven’t picked apart Zadeh’s reply because what he says is correct. You disagree. This is because you are a scientifically ignorant and inconsequential zealot. It is also why nobody outside this blog pays any heed to your words.
Your petulant yammering remains only a source of amusement, Dana.
or perhaps Dana could explain why India suffered so much COVID after adopting homeopathy as a prophylaxis?
https://edzardernst.com/2021/04/homeopathy-covid-india-and-prince-charles-not-a-good-mixture/
Wow…misinforming people again?
There was a very short epidemic of cases in India…though they got OUT of significant problems quickly and then had statistically much better than the USA and Europe, especially the high vaccine countries.
It is almost as though you only read what supports your narrative (“How convenient”)
Oh dear Dana. You and your dislike for facts.
India had the fastest-rising number of cases in the world in 2020 and the healthcare system nearly collapsed in April 2021. What a shame when the truth gets in the way of your fantasies. How inconvenient. What a stupid man you are..
https://www.statista.com/topics/6135/coronavirus-covid-19-outbreak-in-india/
Here’s yet another real survey…with data on what people are actually doing, as compared with the people at THIS website who are armchair philosophers and seem to be anti-scientific in their attitudes because they allow accept data that support their own narrative…and to heck with objectivity:
A survey was conducted in Germany to explore the interest from parents in the medical treatment of their children. This survey was conducted of parents who visited the Pediatric Department of the Elisabeth Hospital, Essen, Germany and the Children’s Hospital St. Marien, Landshut, Germany with their children in 2015 and 2016. Both outpatients and inpatients were interviewed.
A total of 1,323 parents participated in the survey which discovered that 40 % of parents stated that they already use complementary and integrative medicine (CIM) for their children. Homeopathy was the most frequently desired treatment with almost 60 %, followed by osteopathy and phytotherapy. More than 80 % of the participants supported the expansion of the CIM offers in respective hospitals.
40% of the surveyed parents stated that they already use CIM for their children at home. A significant majority (88%) stated that they would be willing to pay extra costs if the therapy is not covered by their insurance.
Anheyer D, Koch AK, Anheyer M, Amarell C, Eckert M, Dobos G, Cramer H. Integrative pediatrics survey: Parents report high demand and willingness to self-pay for complementary and integrative medicine in German hospitals. Complement Ther Med. 2021 Aug;60:102757. doi: 10.1016/j.ctim.2021.102757. Epub 2021 Jul 8. PMID: 34246995. https://pubmed.ncbi.nlm.nih.gov/34246995/
Dana Ullman wrote: “compared with the people at THIS website who are armchair philosophers”
I am not the only person “at THIS website” who has experienced, in depth, homeopathy and a plethora of other branches on the tree of so‑called alternative medicine, for many decades starting from childhood.
So, I do not merely think that homeopathy is ‘rubbish’, I damned well know:
• that it is ‘rubbish’
• how it is ‘rubbish’
• why it is ‘rubbish’.
As I’ve told you previously, Mr Ullman:
Homeopathy is a business model, not a medical model.
https://edzardernst.com/2022/03/the-body-of-evidence-on-homeopathy-is-rotten-to-the-core/#comment-138109
Homeopathy ‘works’ [is effective] as a business model; it does not work as a medical model. Conflating and/or confusing the two is a frequently committed ontological error.
https://edzardernst.com/2021/07/dana-ullman-has-just-published-two-papers-in-real-science-journals/#comment-132376
You wrote:
thereby confirming:
• your success with using homeopathy as a business model;
• homeopathy’s lack of utility as a medical model.
Well done!
Note: Former Chief Medical Officer for England, Professor Dame Sally Davies, has stated that homeopathic preparations are ‘rubbish’ and do not serve as anything more than placebos.
https://web.archive.org/web/20130126102237/http://www.telegraph.co.uk/health/healthnews/9822744/Homeopathy-is-rubbish-says-chief-medical-officer.html
Ok…which homeopath did you see…or did you use your ignorance of homeopathy to treat yourself (in that case, you have a fool for a homeopath and for a patient).
Therefore, I know you’re a fool…it is so obvious.
Several decades ago, how many children, Mr Ullman, treated themselves for serious illnesses using homeopathy. I certainly didn’t.
I sincerely hope that you, Mr Ullman, have enough integrity to always refuse to treat children who have an actual medical condition. Delaying required medical treatment to a child is an unforgivable act.
“Ok…which homeopath did you see”
Over the decades, I lost count, somewhere in the range from twenty to thirty, with many visits to each.
The reason that I remained ill was not because those homeopaths were incompetent — indeed, they were very kind, understanding, compassionate people who did their utmost to help — it was simply because of what they didn’t know back then: homeopathy doesn’t cure any known illness.
Homeopathy does, of course, ‘cure’ a wide range of pseudo-illnesses.
“How convenient!” for you, Mr Ullman.
I shall share a secret with you, Mr Ullman: if you managed to totally discredit me, and Professor Ernst, and you managed to permanently silence each and every critic of homeopathy, it would not change one iota the simple fact that homeopathy is ‘rubbish’.
You wrote: “Therefore, I know you’re a fool…it is so obvious.”
I’m delighted by that, really I am. You are the very antithesis of each and every one of those homeopaths I interacted with. Your words warm my heart, knowing that they are issued by someone who has an alarmingly fragile ego, who uses a radionics machine 🤣, and who’s managed to achieve this spectacular ‘accolade’:
“The Court found Mr. Ullman’s testimony to be not credible.”
https://edzardernst.com/2018/11/why-do-so-many-german-doctors-practise-homeopathy/#comment-109533
And your ad pop fallacy proves exactly what, Dana?
40% of those polled had used homeopathy, therefore homeopathy works?
40% of Americans believe the biblical theory of creation is true. By your logic, the Earth is 4500 years old.
No, the article you cite says that is “according to the Indian government”, which has an entire department devoted to promoting homeopathy along with various indigenous systems (incidentally, what do you think Hahnemann would have thought of these allopathic systems being promoted alongside homeopathy?). And, if you actually read the article you cite, it regards this as a cause for concern rather than celebration.
The Indian government spokesman quoted there says they regard homeopathy as complementary, not alternative, to medicine.
The Lancet article also says that the vast majority of these homeopaths were prescribing pharmaceutical drugs.
that’s naughty! … to take Dana Sweety into the real world [and it will not work!]
The author of the reply to the Lancet’s article is clearly misinforming the reader about homeopathic research, and it is perfectly clear that he is further misinforming the reader on the HISTORY of homeopathic research.
Here are short descriptions of the first several studies on homeopathy…and I encourage people here to make note of the embarrassing “science” that sought to discredit homeopathy:
1834, St. Petersburg, Russia
The first known account of the use of placeboes in homeopathic proving research* occurred in 1834 at the Naval Hospital in St. Petersburg, Russia. This study was a proving of the medicine Carbo vegetabilis (vegetable charcoal). However, an allopathic physician who was very skeptical of homeopathy conducted this study. Also, each subject was given a once daily dose of the remedy for a few days followed by doses of a placebo. Because of this, it is not possible to evaluate the results of this study. Further, this report was written with great sarcasm, and thus, there was no objectivity in this trial.
(*A proving is an experiment in toxicology that is integral to the homeopathic methodology; it is the use of crude OR potentized doses of a substance given in recurrent doses until symptoms of toxicology are experienced)
1834, Paris, France
This observational study described 35 mixed cases from 54 that were admitted to the trial. However, Andral was not a homeopath, and his records show that he prescribed a single dose of a single medicine based on only a single chief symptom. In 1835, he conducted a second trial with 130 to 140 cases. Both trials did not find any benefit to this type of homeopathic prescribing.
1834, Paris, France
Two homeopaths, Leon Simon and P. Curie, prescribed homeopathic medicines in a Parisian hospital called Hotel-Dieu. The director of the hospital asserted that homeopathic treatment was unsuccessful and that the record of these failures was available on demand. The homeopaths demanded these records but never got them. The director claimed that they got lost when he rearranged his library.
The most famous anti-homeopathy book written in the 19th century (initially published in 1842) was by Oliver Wendell (this man was the father of the famous Supreme Court Chief Justice, and instead, he was a MD). Called “Homoeopathy and Its Kindred Delusions,” this book’s strongest evidence against homeopathy was the totally flawed study described above by Andral. Later in his life, Andral himself acknowledged the problems in his study. And further, he had changed his mind about homeopathy and asserted that it deserved the closest examination by every physician.
1835, Nuremberg, Germany
One of the earliest known double-blind studies was conducted as early as 1835, a double-blind proving using potentized doses of Natrum muriaticum in liquid, with distilled water used as a control. A homeopath or an allopath didn’t do this study; a journalist performed it. However, reports about the study suggest that it resembled a séance rather than a sober scientific experiment.
REFERENCE: Dean, Michael Emmans, The Trials of Homeopathy. Essen, Germany: KVC Verlag, 2004.
Once again, Edzard, you and your team have struck out. Down for the count on history and research. Well, there’s always ad hom that you can do instead.
OK, here’s a description of the last one Dana mentions: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1676327/
Dana says that “a journalist performed it”. In fact, it seems that it was conducted by a group of physicians, at the suggestion of a homeopath called Reuter, “supported by” the editor of a newspaper, who also wrote up the report.
Here’s how the article linked above summarises the major features of the trial:
I’m not convinced that séances have ever been conducted like that.
Incidentally, you seem to have missed the 1839-1830 placebo-controlled (but not, as far as I can tell, blinded or randomised) trial conducted at the Regional Military Hospital at St Petersburg, described by Dean here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1484568/
There was a homeopath involved in the trial, and it found that the patients in the placebo arm had better outcomes than those in either the homeopathy or regular medicine arms.
Furthermore, the World Health Organization lists homeopathy as an integral part of “Tradition medicine,” and in this W.H.O. report, homeopathy is referenced over 200 times!
chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://oialliance.org/wp-content/uploads/2019/06/WHO-GLOBAL-REPORT-ON-TRADITIONAL-AND-COMPLEMENTARY-MEDICINE-2019-2.pdf
And…?
Incidentally, the report is about traditional and complementary medicine, not just “Tradition” [sic] medicine. It says that “Member States were asked about whether indigenous TM and other types of T&CM practices are used by people in their country. They were given nine T&CM practices to select from (and an option to select “others” for other forms of practices)”. Homeopathy was one of the nine they were specifically asked about, so it’s unsurprising that it’s frequently mentioned in the report.
The question remains: why do you think it is significant that homeopathy is discussed in a report on CAM?
Mojo…thanx for confirming that you are clueless.
My point is that the WHO recognizes homeopathy as an integral part of traditional medicine. I didn’t even mention CAM…you did.
Daft to the max is not a good strategy…
Dana
Your ongoing gibbering becomes tiresome.
You have repeatedly cited the hapless Jacobs papers which you imagine demonstrate the usefulness of homeopathy to treat childhood diarrhoea.
The WHO expressedly states that homeopathy should NOT be used for such purposes.
https://www.bmj.com/content/339/bmj.b3447.full
The WHO recognises homeopathy to be the nonsense that it is in the same way that we recognise you to be the witless, hapless, egotistical, pompous, and incosequential buffoon that you are.
“The Court found Mr. Ullman’s testimony to be not credible.”
I beg to differ!
Dana’s gibbering is rarely tiresome. It regularly has me in stitches. I often laugh tears about it.
Please Dana, don’t feel deterred by rational thinkers, and don’t ever let the truth get in the way of your comments.
Lenny…WRONG again! The link that you provided did NOT mention the Jacobs studies…and it ONLY makes reference to “serious disease.” There is no reference to “childhood diarrhea” as a “serious disease.”
You also seem to be “unaware” of the fact that a leading member of the WHO was a coauthor of the article in support of use of traditional medicine, including homeopathy (!), in the world.
What a “convenient” oversight on your part.
Oh Dear Dana. You and your reading comprehension. And your being wrong. Again.
“The link that you provided did NOT mention the Jacobs studies”
Where did I say that it did? I said that YOU have cited them. Repeatedly.
” it ONLY makes reference to “serious disease.” There is no reference to “childhood diarrhea””
Which bit of “WHO also said that it does not recommend homoeopathy for treating diarrhoea in infants” didn’t you understand, Dana?
Why are you so proud to repeatedly demonstrate your idiocy? Keep doing it, though. Such public displays of your stupidity only strengthen our case.
You linked to a WHO report on usage of traditional and complementary medicine, which stated that homeopathy was one of nine types of T&CM they specifically asked people about, and got all excited that “homeopathy is referenced over 200 times” in it.
Well, I’m not the one getting excited about homeopathy being mentioned in a study that asked people about homeopathy, am I?
Gad, when the Lancet reported that 100 million people in India rely SOLELY on homeopathic medicines, how do you spin this fact that homeopathy is “complementary” to NOTHING? Curious minds want to know.
The degree of sloppy thinking and spin-control is remarkable…and Mojo has a blackbelt in spin.
Dana
We know how limited your comprehension skills are. Try reading things a few times and trying to understand them before replying. It’ll help to make you look less stupid.
So.
Read Mojo’s post again and try and engage what little intelligence you have to work out what it says and not what you THINK it says.
If you read beyond the introductory sentence of the Lancet article you cited, you will find that these are both statements that it attributes to Indian government sources. Here’s the comment about it being considered complementary:
“OK sir, we have a pretty good idea what’s wrong with you, and it is up to you to choose which treatment you like best. We have two options:
– A gentle treatment involving extensive talks with a homeopath, discussing your life and your medical complaints, followed by taking sugar pellets for several weeks, or
– Major open-heart surgery in order to fix your leaking heart valve, followed by several days ICU stay and at least three months of rehabilitation. Not only will you be pretty miserable for at least a month, but you also have a 1 in 40 chance of not surviving the procedure.”
But the problem is that they don’t really have a choice. The Lancet article that Dana linked to says:
They are using homeopathy not because they prefer it but because real medicine is inaccessible.
@Mojo
Very true, poor people in India have no choice but to rely on ineffective make-believe healthcare, including homeopaths and ayurvedic practitioners. This also correlates with lower life expectancy figures:
https://www.hindustantimes.com/india-news/urbanrural-life-expectancy-gap-widened-slightly-before-pandemic-101654541580728.html
Summarized: people in India’s rural areas have an almost 5 year lower life expectancy than people in urban areas. Of course one can’t claim causality based on just these figures, but there is at least a strong suspicion that the absence of effective medicine plays an important role. Many of the leading causes of death are more or less treatable with real medicine, but not with placebo treatments such as homeopathy:
https://life.futuregenerali.in/life-insurance-made-simple/cancer-heart-critical-illness-insurance/what-is-the-leading-cause-of-death-in-india
As an interesting aside: here in western countries, the exact opposite applies: only the more wealthy people here can afford to pay homeopaths. The reason of course is that at least in most European countries, we have universal healthcare coverage, so that poorer people still have affordable access to real healthcare – and that homeopaths often charge at least twice the fee that a GP takes.
About the ‘choice’ as presented: I knew several people who chose the first option. Yes, past tense, as they usually died within a year of being diagnosed with their heart condition. The ones who chose option 2 survived significantly longer, usually 10 years or more.
Interesting how Dana motors into one stone wall after another in happy ignorance of simple facts.
He decorates his name with “MPH”, which usually means “Master of Public Health”.. Having a masters degree in public health should have bestowed on him enough knowledge to understand that India, where homeopathy is said to be most used of all countries has a life expectancy of 70.15 years, while Japan, where homeopathy is very rarely used (0.1% rspondents in a study I read some time ago had visited a homeopath during a year, if memory serves me) has a life expectancy of 84.62 years. Now what might the relationship, if any, between these statistical facts be? At least we can deduce that if homeopathy works, it sure isn’t doing much to raise the life expectancy of the indian population.
This phenomenon has been documented here:
https://gfycat.com/agedtinyblackfly
Everybody’s criticism of Dana Ullman’s comments as well as of himself personally is perhaps too frank and explicit. Obviously it doesn’t work. It has to be vastly diluted first to the extent that not a jot of criticism remains. Then it may have some effect …?
Dear Mr. Ullman, I do envy your lucrative business. But unfortunatley I’m too honest to practice anything other than scientifically based methods.
I’m making my criticisms of Mr Ullman soooooo much more powerful by not actually explicitly stating them, just occasionally thinking them.