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

Monthly Archives: January 2024

After the nationwide huha created by the BBC’s promotion of auriculotherapy and AcuSeeds, it comes as a surprise to learn that, in Kent (UK), the NHS seems to advocate and provide this form of quackery. Here is the text of the patient leaflet:

Kent Community Health, NHS Foundation Trust

Auriculotherapy

This section provides information to patients who might benefit from auriculotherapy, to complement their acupuncture treatment, as part of their chronic pain management plan.

What is auriculotherapy?

In traditional Chinese medicine, the ear is seen as a microsystem representing the entire body. Auricular acupuncture focuses on ear points that may help a wide variety of conditions including pain. Acupuncture points on the ear are stimulated with fine needles or with earseeds and massage (acupressure).

How does it work?

Recent research has shown that auriculotherapy stimulates the release of natural endorphins, the body’s own feel good chemicals, which may help some patients as part of their chronic pain management plan.

What are earseeds?

Earseeds are traditionally small seeds from the Vaccaria plant, but they can also be made from different types of metal or ceramic. Vaccaria earseeds are held in place over auricular points by a small piece of adhesive tape, or plaster. Applying these small and barely noticeable earseeds between acupuncture treatments allows for patient massage of the auricular points. Earseeds may be left in place for up to a week.

Who can use earseeds?

Earseeds are sometimes used by our Chronic Pain Service to prolong the effects of standard acupuncture treatments and may help some patients to self manage their chronic pain.

How can I get the most out my treatment with earseeds?

It is recommended that the earseeds are massaged two to three times a day or when symptoms occur by applying gentle pressure to the earseeds and massaging in small circles.

Will using earseeds cure my chronic pain?

As with any treatment, earseeds are not a cure but they can reduce pain levels for some patients as part of their chronic pain management programme.

________________________

What the authors of the leaflet forgot to tell the reader is this:

  • Auriculotherapy is based on ideas that fly in the face of science.
  • The evidence that auriculotherapy works is flimsy, to say the least.
  • The evidence earseeds work is even worse.
  • To arrive at a positive recommendation, the NHS had to heavily indulge in the pseudo-scientific art of cherry-picking.
  • The positive experience that some patients report is due to a placebo response.
  • For whichever condition auriculotherapy is used, there are treatments that are much more adequate.
  • Advocating auriculotherapy is therefore not in the best interest of the patient.
  • Arguably, it is unethical.
  • Definitely, it is not what the NHS should be doing.
The objective of this study is to evaluate the efficacy of an OMT intervention for reducing pain and disability in patients with chronic low back pain (LBP). It was designed as a single-blinded, crossover, randomized trial (RCT) and conducted at a university-based health system. Participants were adults, 21–65 years old, with non-specific LBP. Eligible participants (n=80) were randomized to two trial arms:
  • an immediate osteopathic manipulative therapy (OMT) intervention group,
  • a delayed OMT (waiting period) group.

The intervention consisted of three to four OMT sessions over 4–6 weeks, after which the participants switched (crossed-over) groups. The OMT techniques included a mandatory HVLA thrust technique to the lumbar spine region and any (or none) combination of the following four techniques: (i) soft tissue, (ii) muscle energy, (iii) myofascial, and (iv) articulatory. For patients who could not tolerate the HVLA treatment, a physician had to attempt this technique, minimally by attempting to place the patient in the position to perform this maneuver.

The primary clinical outcomes were average pain, current pain, Patient-Reported Outcomes Measurement Information System (PROMIS) 29 v1.0 pain interference and physical function, and modified Oswestry Disability Index (ODI). Secondary outcomes included the remaining PROMIS health domains and the Fear Avoidance Beliefs Questionnaire (FABQ). These measures were taken at baseline (T0), after one OMT session (T1), at the crossover point (T2), and at the end of the trial (T3). Due to the carryover effects of OMT intervention, only the outcomes obtained prior to T2 were evaluated utilizing mixed-effects models and after adjusting for baseline values.

Totals of 35 and 36 participants with chronic LBP were available for the analysis at T1 in the immediate OMT and waiting period groups, respectively, whereas 31 and 33 participants were available for the analysis at T2 in the immediate OMT and waiting period groups, respectively.
After one session of OMT (T1), the analysis showed a significant reduction in the secondary outcomes of sleep disturbance and anxiety compared to the waiting period group. Following the entire intervention period (T2), the immediate OMT group demonstrated a significantly better average pain outcome. The effect size was a 0.8 standard deviation (SD), rendering the reduction in pain clinically significant. Further, the improvement in anxiety remained statistically significant. No study-related serious adverse events (AEs) were reported.
The authors concluded that OMT intervention is safe and effective in reducing pain along with improving sleep and anxiety profiles in patients with chronic LBP.The authors stared their abstract by stating that “the evidence for the efficacy of osteopathic manipulative treatment (OMT) in the management of low back pain (LBP) is considered weak … because it is generally based on low-quality studies.” This is undoubtedly true – but why then did they add one more low-quality study?, I ask myself. To mention just some of the most obvious flaws:

  • This study is far too small to allow conclusions about safety.
  • The trial compared OMT with no therapy; it is likely that the observed outcomes have little to do with OMT but are due to a placebo response.
  • The primary outcome measure showed no effect which essentially means that the study finding was that OMT is ineffective.

My conclusion:

a poor study conducted by wishful thinkers.

 

The so-called ‘Miracle Mineral Solution’ (MMS) – bleach for you and me – is a SCAM that keeps on giving. On this blog, we have featured MMS several times before, e.g.:

Now,it has been reported that a New Zealand anti-vaxxer has been jailed for selling more than $100,000 worth of an industrial bleach as a “miracle” cure for Covid-19. Roger Blake, who describes himself as a “human man”, was sentenced to just over 10 months’ imprisonment after being found guilty at trial of 29 charges in the Hamilton District Court.

Blake advertised and sold MMS products, claiming it could treat, prevent and cure coronavirus. However, New Zealand’s Ministry of Health had not approved the product, and detailed that when ingested became chlorine dioxide – a bleach commonly used for water treatment, bleaching textiles and paper.

The court heard Blake had marketed the product as a cure in New Zealand from the start of the pandemic between December 2019 and December 2020. Medsafe, the health ministry’s safety authority, said Blake’s company had sales of NZ$160,000 in that period – with sales spiking in March when the country was placed in lockdown.

Judge Brett Crowley said Blake’s behaviour had been “utterly disgraceful”. He added that Blake had “seized upon the tragedy” of the pandemic for financial gain. Before selling MMS as a “cure” for the coronavirus, Blake had marketed the product as a preventive of other diseases and illnesses such as cancer, Alzheimer’s, diabetes and HIV.

Medsafe prosecuted him under the Medicines Act, with compliance manager Derek Fitzgerald saying the “fake cure” Blake spruiked presented a “significant public health risk”. “He targeted the vulnerable, preyed on public fears and exposed people to harm”, he said. “This decision sends a strong message that people who engage in selling so called ‘miracle cures’ will be held to account and face fines or imprisonment.”

The website which sold MMS in New Zealand was registered to US-based Mark Grenon, who set up the “Genesis II Church of Health and Healing”. As reported previously, Grenon and his three sons were jailed in October for several years in the US for selling more than US$1m of the product. Michael Homer, an assistant US lawyer who prosecuted the case, said at the time the family targeted people suffering from life-threatening illnesses. The Grenons poisoned thousands of people with their bogus miracle cure, which was nothing more than industrial bleach,” he said.

Medsafe warns: “Drinking MMS is the same as drinking bleach and can cause dangerous side effects, including severe vomiting, diarrhoea, and life-threatening low blood pressure. We strongly encourage people to only go to trusted sources, such as your doctor, to get reliable information”.

Medsafe received three reports of people requiring hospitalizations after drinking MMS. “His conduct presented a significant risk to public health, and that is why Medsafe acted. His actions were in stark contrast to the requirements of the Medicines Act 1981, which is public welfare legislation designed to protect the public” said Mr Fitzgerald.

This review aimed to investigate and categorize the causes and consequences of ‘quack medicine’ in the healthcare.

A scoping review, using the 5 stages of Arksey and O’Malley’s framework, was conducted to retrieve and analyze the literature. International databases including the PubMed, Scopus, Embase and Web of Science and also national Iranian databases were searched to find peer reviewed published literature in English and Persian languages. Grey literature was also included. Meta-Synthesis was applied to analyze the findings through an inductive approach.

Out of 3794 initially identified studies, 30 were selected for this review. Based on the findings of this research, the causes of quackery in the health were divided into six categories:

  • political,
  • economic,
  • socio-cultural,
  • technical-organizational,
  • legal,
  • and psychological.

Additionally, the consequences of this issue were classified into three categories:

  • health,
  • economic,
  • and social.

Economic and social factors were found to have the most significant impact on the prevalence of quackery in the health sector. Legal and technical-organizational factors played a crucial role in facilitating fraudulent practices, resulting in severe health consequences.

The authors concluded that it is evident that governing bodies and health systems must prioritize addressing economic and social factors in combating quackery in the health sector. Special attention should be paid to the issue of cultural development and community education to strengthen the mechanisms that lead to the society access to standard affordable services. Efforts should be made also to improve the efficiency of legislation, implementation and evaluation systems to effectively tackle this issue.

The authors point out that, in the health systems, particularly those of developing countries, a phenomenon known as “Quack Medicine” has been a persistent problem, causing harm in various branches of health care services. They define quackery as unproven or fraudulent medical practices that have no scientifically plausible rationale behind them. Someone who does not have professional qualification, formal registration from a legitimated institution, or required knowledge of a particular branch of medicine but practices in the field of medicine, is a quack, according to the authors’ definition. Finally, they define quack medicine as a fraudulent practice of quacks claiming to possess the ability and experience to diagnose and treat diseases, and pretending that the medicine or treatment they provide are effective, generally for personal and financial gain.

The authors rightly point out that, in some countries, there may be a lack of willpower, determination and effort among political leaders to deal with and prevent fraud and charlatanism in various fields, especially in the health system. This can be due to conflict of interests, corruption network, or insufficient infrastructure and resources, such as financial capacity and human resources. In some cases, they stress, policy makers may choose to tolerate small levels of unproven medical practices if the cost of prosecuting and correcting the situation outweigh the financial benefits. This can lead to a cycle of continued fraud and a lack of effective interventions to address the issue. In many countries laws against quack medicine do exist. However, their effectiveness depends on proper and strict implementation. More efforts and measures must be taken to implement the existing laws. Inadequate enforcement of laws and approval of pseudo-medicine can result in people receiving improper care.

The authors recommend that the healthcare systems, prioritize addressing economic and sociocultural factors in order to effectively combat this issue. In developing solutions, attention must be given to cultural development and community education, and efforts should be made to strengthen mechanisms that provide access to affordable, standard healthcare services for all. Lastly, it is crucial to enhance the performance of systems responsible for legislation, implementation and evaluation of laws and regulations related to quack medicine.

Guest post by Udo Endruscheit

Switzerland is probably the European country with the strangest complementary and alternative medicine (CAM) regulations in the health insurance system. A total of five different CAM methods have been included in the benefits catalogue of basic insurance for several years. However, this is subject to a strange proviso. How did this come about?

As almost everywhere in Europe, there was a desire in Switzerland in the 1990s to include CAM in the public healthcare system, with homeopathy naturally once again taking pole position. Initially, the urge to include five CAM modalities in basic care was granted, but only provisionally. A major project called the “Complementary Medicine Evaluation Programme” (PEK) was launched in 1999 to evaluate the procedures. Even back then, the criteria of efficacy, appropriateness and cost-effectiveness were prerequisites for reimbursement in health insurance. PEK was intended to create clarity here.

One part of PEK has been the well-known Shang/Egger (2005) study on homeopathy “Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy”, which was to become a bone of contention without precedent. However, this did not change the negative result for homeopathy.

In any case, clear conclusions were drawn in Switzerland not only from this study, but also from the results of the other evaluations: the provisional inclusion of the methods in statutory basic insurance was terminated.

This in turn enraged the supporters of CAM methods, who thought they had already reached their goal with the provisional decision in their favour. Apparently, they had not even considered the possibility that scientific evaluations could actually lead to a sudden end to their wishes, which they believed had already been fulfilled.

In fact, in 2009, the friends of ineffective methods succeeded in bringing about one of the referendums for which Switzerland is known under the catchphrase “direct democracy”. And they prevailed – around two thirds of the votes cast were in favour of CAM and its inclusion in the Swiss Federal Constitution. However, it should be borne in mind that the two-thirds figure is put into perspective if the approval, including the low voter turnout, is converted to the proportion of the total electorate. This leaves just 17 per cent who voted for the CAM. And a closer look at the issue of the constitution also reveals that no unconditional protection space has been created for CAM. This is more or less a kind of good behaviour clause for CAM methods, but not rules that could render laws null and void.

The Swiss government was faced with the question of how to avoid simply ignoring the result of the referendum, while at the same time complying with the still valid requirements for reimbursement in basic insurance. So the representatives of the five CAM directions were actually asked to come to the Federal Office of Public Health with their proof of efficacy and economic efficiency. This was done in 2011.

Of course, this was a little bizarre at this stage – and of course nothing came of it. Or actually it did: once again, no proof could be provided. Meanwhile, a lot of time had passed again and a new Federal Council was forced to take up the matter.

The latter, Alain Berset, came up with the plan that the necessary proof of efficacy could actually be postponed until after the methods had been included in the catalogue of basic insurance benefits. In other words, he gave the methods a governmental leap of faith (which, in view of the long-year history of the case, meant closing several eyes) and postulated that this should be the matter until someone applied for an evaluation of one of the methods.

This is what happened in the year of our Lord 2017. Apparently everyone was able to make their peace with it, which is hardly surprising after ten years of moving around and around. Only the umbrella organisation of health insurers, Santesuisse, grumbled about it and predicted that the announced cost neutrality of such a measure could hardly be expected. Which Santesuisse did indeed prove in a dossier two years later.

The exhausted Swiss have so far left it at that. Homeopathy remained untouched. This was also unfortunate for the reason that the fairy tale of the clever and innovative Switzerland, which knew how important the wishes and preferences of its patients were, was propagated in Germany. The rather strange result of more than ten years of struggle was even passed around by German homeopaths under the name “Swiss model”. Even the leading Swiss press was embarrassed by this and published a clarifying article. And unfortunately, the Swiss began to get used to the existence of hocus-pocus in their basic insurance and to take it for granted.

Until now. Even in Switzerland, the fact that homeopathy is coming under increasing criticism everywhere has probably not gone unnoticed. And the Swiss are actually a rather critical and resistant people. And so it happened that a single brave inhabitant of the country recently decided to exercise his right to demand a new evaluation of homeopathy. The Federal Office of Public Health must have been surprised – or perhaps they were desperately waiting for it? Perhaps. In any case, the application was accepted without hesitation. Meanwhile, a notification has been issued that the hearing procedure for the evaluation has been initiated. The representatives of homeopathy (the service providers), the representatives of the Swiss medical profession and the representatives of the health insurance companies – the aforementioned Santesuisse – will be heard. The final decision will then be made by the Swiss government’s Department of Home Affairs.

How many attempts at an evaluation has this actually been – the third? The fourth? We can’t keep up … We have seen the consequences of scientific questions being decided by majorities. It is to be hoped that Switzerland will not add another chapter to the drama that has been going on since 2005. Mr Berset’s successor, who has been in office since the beginning of the year, should only be given a brief reminder: in Switzerland, too, homeopathy has no effect beyond contextual effects. And that is not enough to prove efficacy, appropriateness and cost-effectiveness.

But cheers to the courageous descendant of William Tell, who is about to single-handedly bring down homeopathy in the Swiss healthcare system!

The Austrian ‘Initiative für Wissenschaftliche Medizin‘ (Initiative for Scientific Medicine) did a great job by summarizing the non-scientific training events dedicated to pseudomedicine organized, supported or promoted by the ‘Österreichische Akademie der Ärzte‘ (Austrian Academy of Physicians), a partner of the Austrian Medical Association. They sorted them by date in descending order, listing the DFP points (points required for postgraduate education) awarded and the link to each specific event. The content of the programme of such events, if available, is also often “interesting”. The pseudomedicine methods are provided with links to psiram.com, where these methods are described in more detail.

So, restricting ourselves to the period of 20 years (2003-2023) and merely looking at a selection of all possible so-called alternative medicine (SCAM), we find in this treasure trove of quackery the following:

  • Anthroposophic medicine – 218 events
  • Homeopathy – 1 708 events
  • Orthomolecular medicine – 645 events
  • Neural therapy – 864 events
  • TCM diagnostics – 1214 events

In total, thousands SCAM events were organized, supported or promoted by the Academy, and I am not aware of any national physicians’ organization that has done anywhere near as much for quackery.

On their website, the Austrian Academy of Physicians state that they were founded by the Austrian Medical Association as a non-profit organisation with the aim of promoting and further developing medical education in Austria… The aim is to lead the way in medical education issues in order to achieve continuous improvement in the medical profession. For the Academy, continuing medical education is an essential component of medical quality improvement…

This may sound alright but, in my view, it raises several questions, e,g,:

  • Does the Academy believe that continuous improvement in the medical profession can be achieved by promoting, organizing or conducting such a huge amount of courses in quackery?
  • Do they not know that this is the exact opposite of medical quality improvement?
  • Are they aware of their ethical responsibility?
  • Do they know that the promotion of quackery puts patients at risk?
  • Have they heard of evidence-based education?

It is easy to criticize but less obvious to improve. In case the people responsible for postgraduate education at the Academy want to discuss these issues with me, I would therefore be delighted to do so, for instance, via a series of evidence-based lectures on SCAM.

 

 

If you live in the UK, it was impossible during the last week or so to escape the news that our King is going into hospital for a ‘corrective procedure’ on his benign prostate problem. Apparently, he is keen to share his diagnosis with the public to encourage other men who may be experiencing symptoms to get checked. “In common with thousands of men each year, the King has sought treatment for an enlarged prostate,” the official statement said.

According to the NHS website, the King should make lifestyle changes, such as:

  • drinking less alcohol, caffeine and fizzy drinks
  • limiting your intake of artificial sweeteners
  • exercising regularly
  • drinking less in the evening

Medicine to reduce the size of the prostate and relax your bladder may be recommended to treat moderate to severe symptoms of an enlarged prostate. Surgery is usually only recommended for moderate to severe symptoms that have not responded to medicine.

It is said that Charles had symptoms since Christmas. So, being the most outspoken fan of so-called alternative medicine (SCAM), why has he not tried SCAM? Has he, for example, tried any of these treatments that have reported at least in one or more studies some promise?:

  • Camelia sinensis (green or black tea),
  • Solanum lycopersicum (common tomato),
  • Punica granatum (pomegranate),
  • Glycine max (common soy),
  • Linum usitatissimum (linen),
  • Ellagic acid,
  • Saw palmetto,
  • Pumpkin seed,
  • Willow herb,
  • Maritime pine bark,
  • Pygeum africanum bark,
  • Rye pollen,
  • Nettle root,
  • Dozens of Chinese herbs,
  • Acupuncture,
  • Homeopathy.

It seems not!

But why not?

Why does the world’s greatest SCAM enthusiast not go for his beloved natural cures and ancient wisdom?

Has Charles been advised that the studies are flimsy and the evidence is unconvincing (in that case, well-done Michael!)? I might have given the same advice. Yet, this begs the question, why are he and his head of the royal medical household, Dr Michael Dixon, fiercely in favor of SCAM? Is the evidence for other conditions any better?

Michael, in case you read this: it is nottrust me, I have studied the subject for >30 years.

Anyway, I would probably have consulted a surgeon too, if I had Charles’ problem. Yet, there is an important difference: I (in common with thousands of men) have to join the UK waiting list which currently stands at around 8 000 000.

Yes, I do try to understand that the King is the King and that I am far less of a priority.

The King is special!

The King deserves special, non-NHS treatment!

But scientific evidence is the scientific evidence, no matter whether it relates to SCAM or surgery. So, why does the King (and Dixon) promote SCAM when he himself does evidently not trust it?

It has been reported that the New York State Department of Health has issued a $300,000 penalty as part of a Stipulation and Order signed by a Nassau County midwife who created false immunization records. Roughly 1,500 school-aged children from throughout the State are affected by the vaccine scheme, which has resulted in their immunization records being voided. All affected children must be fully up to date with all age-appropriate immunizations, or be in the process of receiving their missing vaccinations, before they can return to school.

“Misrepresenting or falsifying vaccine records puts lives in jeopardy and undermines the system that exists to protect public health,” State Health Commissioner Dr. James McDonald said. “Let it be clear, the New York State Department of Health takes this issue seriously and will investigate and use all enforcement tools at its disposal against those who have been found to have committed such violations.” State Education Commissioner Betty A. Rosa said: “By intentionally falsifying immunization records for students, this licensed health care professional not only endangered the health and safety of our school communities but also undermined public trust. We are pleased to have worked with our partners in government to bring this wrongdoer to justice. We remain committed to upholding the highest standards of health and well-being within our educational institutions.”

The vaccination scheme began at the start of the 2019-2020 school year, just three months after the June 2019 elimination of non-medical exemptions for required school immunizations. Breen supplied patients with the “Real Immunity Homeoprophylaxis Program,” a series of oral pellets marketed by an out-of-state homeopath as an alternative to vaccination. The homeopathic pellets are not authorized by the U.S. Food and Drug Administration (FDA) nor approved by the Centers for Disease Control and Prevention (CDC) or the Department as an immunizing agent against any disease.

Breen was found to have administered 12,449 fake ‘homeopathic’ immunizations to roughly 1,500 school-aged patients as pretext for submitting false information to the New York State Immunization Information System (NYSIIS). The agreed-upon settlement reached between the Department and Breen is the first of its kind addressing a scheme to create false immunization records. It includes a $300,000 monetary penalty and requires that Breen never again administer a vaccination that must be reported to NYSIIS. In addition, Breen is permanently excluded from accessing NYSIIS under any circumstances.

____________________________

We have discussed the absurd and dangerous idea of homeoparophylaxis several times before, e.g.:

Suffice to stress just this:

Homeoprophylaxis is a criminally stupid way to endanger lives!

Motor aphasia is common among patients with stroke. Acupuncture is recommended by TCM enthusiasts as a so-called alternative medicine (SCAM) for poststroke aphasia, but its efficacy remains uncertain.

JAMA just published a study that investigated the effects of acupuncture on language function, neurological function, and quality of life in patients with poststroke motor aphasia.
The study was designed as a multicenter, sham-controlled, randomized clinical trial. It was conducted in 3 tertiary hospitals in China from October 21, 2019, to November 13, 2021. Adult patients with poststroke motor aphasia were enrolled. Data analysis was performed from February to April 2023.

Eligible participants were randomly allocated (1:1) to manual acupuncture (MA) or sham acupuncture (SA) groups. Both groups underwent language training and conventional treatments.
The primary outcomes were the aphasia quotient (AQ) of the Western Aphasia Battery (WAB) and scores on the Chinese Functional Communication Profile (CFCP) at 6 weeks. Secondary outcomes included WAB subitems, Boston Diagnostic Aphasia Examination, National Institutes of Health Stroke Scale, Stroke-Specific Quality of Life Scale, Stroke and Aphasia Quality of Life Scale–39, and Health Scale of Traditional Chinese Medicine scores at 6 weeks and 6 months after onset. All statistical analyses were performed according to the intention-to-treat principle.

Among 252 randomized patients (198 men [78.6%]; mean [SD] age, 60.7 [7.5] years), 231 were included in the modified intention-to-treat analysis (115 in the MA group and 116 in the SA group). Compared with the SA group, the MA group had significant increases in AQ (difference, 7.99 points; 95% CI, 3.42-12.55 points; P = .001) and CFCP (difference, 23.51 points; 95% CI, 11.10-35.93 points; P < .001) scores at week 6 and showed significant improvements in AQ (difference, 10.34; 95% CI, 5.75-14.93; P < .001) and CFCP (difference, 27.43; 95% CI, 14.75-40.10; P < .001) scores at the end of follow-up.

The authors concluded that in this randomized clinical trial, patients with poststroke motor
aphasia who received 6 weeks of MA compared with those who received SA demonstrated
statistically significant improvements in language function, quality of life, and neurological
impairment from week 6 of treatment to the end of follow-up at 6 months after onset.

I was asked by the SCIENCE MEDIC CENTRE to provide a short comment. This is what I stated:

Superficially, this looks like a rigorous trial. We should remember, however, that several groups, including mine, have shown that very nearly all Chinese acupuncture studies report positive results. This suggests that the reliability of these trials is less than encouraging. Moreover, the authors state that real acupuncture induced ‘de chi’, while sham acupuncture did not. This shows that the patients were not blinded and the outcomes might easily be due to a placebo response.

Here, I’d like to add two further points:

A we have heard from our homeopathic friend, Dana Ullaman, homeopathy works well for plants. Unfortunatley, he was unable to provide any good evidence for his claim. To show what a nice guy I am, I herewith help him out and present a recent study on the subject:

Given the seasonal climatic characteristics, forest fires in “cerrado” areas in Central Brazil are not infrequently, with permanent damage. Due to its physicochemical qualities acting in biological regulation processes, water has been considered the primary vehicle for propagating signals from homeopathic ingredients, as suggested by previous studies carried out with solvatochromic dyes. Therefore, such inputs could, in theory, be inserted into watercourses to stimulate the regeneration of the biome destroyed by fire. This hypothesis motivated this case study.

A slow dispersion device was developed aiming at promoting continuous environmental regeneration, containing hydrocolloid and calcium carbonate as a solid base soaked in a homeopathic complex specifically designed for this purpose, composed of Arsenicum albumArnica montanaStaphysagriaIgnatia amara, and Phosphorus, all at 30cH. The case occurred in Nascentes do Rio Taquari Park, between Mato Grosso and Mato Grosso do Sul state, Brazil. It is a “cerrado” area, with multiple springs that feed the Paraguay River, occupying an area of 26,849 hectares over the Guarani and Bauru aquifers.

After the fire in early September 2020, the devices were fixed at 9 strategic points in the park (P1 to P9) over 10 days, between September 29, and October 11, 2020, in water courses close to the main springs. To assess the restoration signs of the post-fire environment, the technicians responsible for monitoring the park made observations of flora and fauna recomposition in different locations close to four device-insertion points (P3, P5, P7, P8).

Signs of recovery were observed 40 days after the fire was over. A rapid pioneer plant restructuring was noted, with a significant regrowth of grass, herbaceous and shrub species, such as Mutamba (Guazuma ulmifolia), Murici (Byrsonima spp.), Inga (Inga sp.), Brachiaria (Brachiaria sp.), Jaraguá grass (Hyparrhenia rufa), Colonião grass (Panicum maximum), Gabiroba (Campomanesia sp.), and Pixirica (Miconia sp.). Some species, such as Mimosa (Mimosa sp.), Colonião grass (Panicum maximum), and Jaraguá grass (Hyparrhenia rufa), were not detected in the area before the fire, probably by the seed bank stimulation caused by the heat. There was rapid forest regeneration (4 months after the fire) and restoration of most of the burned trees, both for resisting the fire and for being free of invasive species highly aggressive to native plants, which were controlled by the action of fire. Concerning the fauna, a vast animal population was detected, especially birds, highlighting the “Tuiuiú” (Jabiru mycteria) and “Socó” (Tigrisoma lineatum) close to a water body with a waterfall area (P3). Both species belong to the “Pantanal” biome close to the park. Such species began to frequent the park’s lakes, being observed until February 2023 (the last survey date). The park’s inventory of lichens and fungi showed an unusual tolerance to fire in species that adhered to burned trees and remained active.

In this way, it is suggested that installing slow dispersion devices in watercourses can contribute to the regeneration of other “cerrado” biome areas subjected to fire, protecting the local biodiversity. More studies of this nature are needed to know the real impact of this method on the recovery of different biomes.

Convinced?

I suspect Dana might be (he seems to be particularly prone to confirmation bias) – but rational thinkers do probably have questions; let me just mention two:

  • Was there a control area with which the findings were compared?
  • Was the outcome measure objective?

As the answers are NO and NO, I fear that we need to disappoint Dana yet again:

homeopathy is a placebo treatment no matter whether we apply it to humans, animals or plants.

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