conflict of interest
Exploring preventive therapeutic measures has been among the biggest challenges during the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A team of Indian and US researchers explored the feasibility and methods of recruitment, retention, and potential signal of efficacy, of selected homeopathic medicines as a preventive measure for developing COVID-19 in a multi-group study.
A six-group, randomized, double-blind, placebo-controlled prophylaxis study was conducted in a COVID-19 exposed population in a quarantine facility in Mumbai, India. Each group received one of the following:
- Arsenicum album 30c,
- Bryonia alba 30c,
- Arsenicum album 30c, Bryonia alba 30c, Gelsemium sempervirens 30c, and Influenzinum 30c
- coronavirus nosode CVN01 30c,
- Camphora 1M,
- placebo.
Six pills twice a day were administered for 3 days. The primary outcome measure used was testing recruitment and retention in this quarantined setting. Secondary outcomes were numbers testing positive for COVID-19 after developing symptoms of illness, the number of subjects hospitalized, and days to recovery.
Good rates of recruitment and retention were achieved. Of 4,497 quarantined individuals, 2,343 sought enrollment, with 2,294 enrolled and 2,233 completing the trial (49.7% recruitment, 97.3% retention). Subjects who were randomized to either Bryonia alba (group 2) or to the CVN01 nosode (group 4) signaled a numerically lower incidence of laboratory-confirmed COVID-19 and a shorter period of illness, with evidence of fewer hospitalizations than those taking placebo. The three other groups did not show signals of efficacy.
The authors concluded that this pilot study supports the feasibility of a larger randomized, double-blind, placebo-controlled trial. Bryonia alba 30c and CVN01 30c should both be explored in disease prevention or shortening the course of disease symptomatology in a COVID-19-exposed population.
Signals of efficacy?
Are they kidding us?
The results failed to be statistically significant!
Hence the conclusions should be rewritten as follows:
This pilot study supports the feasibility of a larger trial in India where people have been told by an irresponsible government to believe in homeopathy. None of the 5 homeopathic treatments generated encouraging findings and none should be explored further. Studies of this nature must be discouraged firstly because homeopaths would not accept the findings of a trial of non-individualized homeopathy, and secondly because such trials will further confuse the public who might think that homeopathy is worth trying.
Traditional European Medicine (TEM) is an increasingly popular yet ill-defined term. Like Traditional Chinese Medicine (TCM), it encompasses all the traditional therapies from the respective region. One website describes it with this very odd graph:
On Medline, I found only very few papers on TEM. One article reported about a congress based on the concept of TEM but confusingly called it ‘European Traditional Medicine (ETM). Here are a few excerpts:
… the aim of this congress is to explore and survey, very old and modern traditional based therapies and treatments curing the principles of scientific medicine (1). Discussions of the links between ETM and other traditional medicines therefore are mandatory, particularly when considering the importance of traditionally based therapies that are still a source of primary health care to about 70 percent of the world’s population. Connections between traditional medicine and human health have been addressed and commented upon by many national and international political and sanitary bodies because: a) the good health of populations requires enlightened management of our social resources, economic relations, and of the natural world, and b) that many of today’s public-health issues have their roots in lack of scientifically sustainable holistic approach to the patient c) many socioeconomic inequalities and irrational consumption patterns that jeopardize the future economic sustainability of health.
In the same context the conventional biomedical approach to health is based on methods of diagnosing and treating specific pathologies: one pathogen = one disease, an approach that does not take into account connections between diseases, humanity, and some psychological aspects of suffering, and other socioeconomic factors such as poverty and education, and even the connections between disease and the environment in which sick people lives (2,3).
Other authors, like the one on this website, are much more concrete. Again, a few excerpts must suffice:
Bloodletting
When bloodletting according to Hildegard von Bingen max. 150 ml of blood taken. It is one of the most valuable and fastest detoxification options in TEM. In some people, no blood comes, because the body has no need to excrete something. For others, the doctor may say a lot about human health after the blood has been left for about 2 hours. If the serum is yellowish or whitish, this indicates excess fats. If certain threads form, they are signs of inflammation. Then the doctor gives recommendations for certain herbs and applications.
Wraps and packs
Whether neck wrap or hay flower sack. In TEM, there are many natural remedies made from natural materials (clay, pots) and herbs that support the body’s self-healing powers.
Wyda instead of yoga
Wyda is a holistic philosophy that is about getting in touch with yourself. In doing so, one can relax through flowing exercises and energy sounds, strengthen one’s mind or stimulate the metabolism. The exercises are similar in some ways to yoga. Here you can learn more about European yoga!
Which archetype are you?
In Traditional European Medicine (TEM), the archetype of a human is first determined so that the TEM doctor can coordinate the treatments. There are 4 temperatures:
Sanguine: He is active, open-hearted, energetic and mostly optimistic and cheerful. He is not resentful and does what he enjoys.
Suitable use: cool applications such as chest and liver wrap, whole body rubbings with grape seed and lemon balm oils.
Abandonment: too much sweet and fat, animal foods, sweet alcohol.
Choleric: He has a hot temper, shows leadership qualities, is prone to hyperbole, emotional and outbursts of anger, is extroverted, but often uncontrolled. Suitable application: cooling and calming applications. Massages with thistle, almond and lavender oils.
Avoidance of: too much animal protein, alcohol, hot spices and fatty foods.
Phlegmatic: enjoyment is important to him. He is reliable, can accomplish things, but seldom initiate. To get going causes him problems when he “runs”, then persistently and with energy.
Suitable application: warming and drying applications, warm chest wraps. Abdominal massages with camelina oil, marigold ointment.
Abandonment: too much sweets, milk, whole grains, tropical fruits, pork, too many carbohydrates.
Melancholic: He is an admonisher and a thinker, appreciates beauty and intelligence, is more introverted. He tends to ponder and pessimism, struggling for an activity.
Suitable use: warm applications such as warm chest wraps and liver wrap. Clay in water in the morning relieves gastrointestinal discomfort. Massages with strengthening cedar nut oil.
No: Frozen food, raw food, hard to digest, too much salt and sugar.
Yes, much of this is dangerous nostalgic nonsense that would lead us straight back into the dark ages.
Do we need more of this in so-called alternative medicine (SCAM)?
Definitely not!
TCM was created by Mao as a substitute for real medicine, at a time when China was desperately short of medicine. The creators of TEM have no such reason or motivation. So, why do they do it?
Search me!
I have repeatedly likened so-called alternative medicine (SCAM) to a cult – not a religious cult, of course, but to a ‘health cult’. A health cult is defined as a system for the cure of disease based on dogma set forth by its promulgator. So, are you a member of a health cult?
In case you are a proponent of SCAM, you might be in danger. Here are a few questions you should ask yourself:
- Is your SCAM based on dogma, such as ‘LIKE CURES LIKE’ or ‘SUBLUXATIONS ARE THE CAUSE OF DISEASE?
- Does the cult demand you accept its dogma or doctrine as truth?
- Is it set forth by a single guru or promulgator?
- Is your SCAM supposed to cure all ills?
- Is belief used by proponents of your SCAM as a substitute for evidence?
- Does the SCAM determine your diet and/or lifestyle?
- Does the SCAM exploit you financially?
- Does your SCAM impose rigid rules and regulations?
- Does your SCAM practice deception?
- Does your SCAM have its own sources of information/propaganda?
- Does your SCAM cultivate its own lingo?
- Does your SCAM discourage or inhibit critical thinking?
- Are questions about the values of your SCAM discouraged or forbidden?
- Do the proponents of your SCAM reduce complexities into platitudinous buzz words?
- Do they assume that health problems are the result of not adhering to the dogma?
- Does your SCAM instill fear into members who consider leaving?
- Do the proponents of your SCAM depict conventional medicine as ineffective or harmful?
- Are you asked to recruit new members to your SCAM?
Please try to answer these questions honestly and self-critically.
If more than a handful turn out to be positive, you have, in my view, a reason to be concerned. In this case, I would recommend you go to a library and start reading a few books that provide critical analyses of SCAM.
I was alerted to an interesting article about homeopathy in Switzerland. Its author points out that homeopathy is paid for by health insurance in Switzerland because of anything remotely related to evidence but because of a referendum in 2009. At the time, one of the arguments of the proponents was that health care costs would tend to decrease if more so-called alternative medicine (SCAM) would be paid for by the public purse. This is what Jacques de Haller, the president of the medical association, claimed: because SCAM is comparatively cheap and helps to prevent more expensive consultations, the total cost of health care would decrease.
This rather naive assumption was also one made in 2005 by the ‘Smallwood-Report’, commissioned by Charles and paid for by Dame Shirley Porter, specifically to inform health ministers. It stated that up to 480 million pounds could be saved if one in 10 family doctors offered homeopathy as an alternative to standard drugs. Savings of up to 3.5 billion pounds could be achieved by offering spinal manipulation rather than drugs to people with back pain. (Because I had commented on this report, Prince Charles’ first private secretary asked the vice-chancellor of Exeter University, Steve Smith, to investigate. Even though I was found to be not guilty of any wrongdoing, specifically of violating confidentiality, all local support stopped which led to my decision to retire early.)
In Switzerland, the assumption that SCAM saves money was refuted in 2019 by the Swiss health insurance association Santésuisse in a proper cost analysis. According to this analysis, doctors who also prescribed homeopathy caused 22% more costs per patient than those practicing conventional medicine. As it turned out, SCAM would be charged in addition to existing conventional medical services. Consequently, from a point of view of health economics, SCAM should not be called “alternative”, but rather “additive”, Santésuisse wrote at the time.
More evidence comes from a German study (authored by proponents of homeopathy!) that confirms these findings. Integrated care contracts for homeopathy by German health insurers were shown to result in higher costs across all diagnoses.
The recognition that homeopathy lacks sound evidence has already led to an end of reimbursement in the UK and France. Both in Germany and Switzerland, strong pro-homeopathy lobbies have so far succeeded in preventing similar actions. Yet, there is no doubt that, in these and other countries, the writing is on the wall.
Past life regression therapy (PLRT) is, according to one practitioner, a therapeutic technique for accessing and re-experiencing your past lives directly. A branch of hypnotherapy, past life regression therapy has grown over the last 50 years to be an important addition to the healing arts. This website also informs us that:
Past life regression is an amazing, full-sensory experience. You might experience the memory as a vivid movie, or see only vague flashes of images that prompt the narrative. You might hear gunshots or explosions on a battlefield, or music at a dance. It is possible to recall smells too: smoke from a fire, leather from a saddle, or the sweat of a dirty body.
As the story unfolds, you feel real emotions appropriate to the story. You may cry when you re-experience deep sadness at the death of a beloved child, feel despair in the pit of your stomach as you witness a massacre, or elation at a long-awaited homecoming from war. And just as you can recall strong emotions, you feel the pain of an arrow piercing your body as you are dying, or the heaviness of a load you’re carrying on your back. These physical sensations and emotions are very real in the moment, but pass quickly as you move through the past life story and death.
PLRT is used by some clinicians for anxiety disorders, mood disorders, gender dysphoria, and other conditions. One survey suggested that 22% of European cancer patients use PLRT as a so-called alternative medicine (SCAM) to treat their illness. Some proponents argue that, since the exploration of the event/memory is actually helping the client resolve the challenge, the overall process can have immense therapeutic benefit, provided it is done responsibly and effectively.
So, it is effective because it is effective??? Such assurances make my alarm bells ring loud and clear. And I am not alone. It has been argued that PLRT is unethical:
- First, it is not evidence-based. Past life regression is based on the reincarnation hypothesis, but this hypothesis is not supported by evidence, and in fact, it faces some insurmountable conceptual problems. If patients are not fully informed about these problems, they cannot provide informed consent, and hence, the principle of autonomy is violated.
- Second, past life regression therapy has the great risk of implanting false memories in patients, and thus, causing significant harm. This is a violation of the principle of non-malfeasance, which is surely the most important principle in medical ethics.
I was unable to find convincing evidence that PLRT is effective. Furthermore, PLRT is by no means cheap; a typical session lasts two hours and costs $350. This suggests that PLRT is
- unproven,
- expensive,
- and unsafe.
In other words, it is not a therapeutic option that I would recommend to anyone for any condition.
This shocking paper presents 5 cases of patients with moderate to severe COVID-19 infections, 2 of them hospitalized in the intensive care unit, who were successfully treated with homeopathy. All 5 patients responded to homeopathic treatment in an unexpectedly short time span (in fact, it took up to 8 days), improving both physically and mentally.
The authors concluded that the present case series emphasizes the rapidity of response among moderate to severely ill patients to homeopathic treatment, when conventional medical options have been unable to relieve or shorten the disease. The observations described should encourage use of homeopathy in treating patients with COVID-19 during the acute phase of the disease.
If I hear about patients suffering from a cold, or tennis elbow, or otitis, or back pain, or allergy who responded to homeopathic treatment in an unexpectedly short time span, I tend to giggle and usually consider it a waste of time to explain that the observed outcome most likely is not a RESPONSE to homeopathic treatment but a non-causally related by-product. Correlation is not causation! What caused the outcome was, in fact, the natural history of the condition which would have improved even without homeopathy. To make this even clearer, I sometimes ask the homeopath: HOW DO YOU KNOW THAT THE PATIENT WOULD NOT HAVE IMPROVED EVEN FASTER IF YOU HAD NOT GIVEN HIM THE HOMEOPATHIC REMEDY? This question sometimes (sadly not always) leads to the realization that homeopathy may not have caused the outcome.
But when, in the middle of a pandemic during which millions of people died and continue to die, someone writes in a medical journal that 5 COVID patients responded to homeopathic treatment in an unexpectedly short time span, I feel compelled to disclose the statement as pure, unethical, irresponsible, and dangerous quackery.
The 5 patients with COVID-19 were hospitalized at a tertiary medical center in Jerusalem for moderate to severe
COVID-19-related symptoms. Each of them requested homeopathic treatment in addition to conventional therapy from the hospital’s ‘Center for Integrative Complementary Medicine’. All 5 patients were over 18 years old and had confirmed COVID-19 infection at the time of admission. They received their homeopathic medications as small round pills (globules); no further information about the homeopathic treatment was provided. Similarly, we also do not learn whether some patients who did not receive homeopathy recovered just as quickly (I am sure that worldwide thousands did), or whether some patients who did get homeopathic remedies failed to recover.
To make matters worse, the authors of this paper state this:
Several conclusions are evident from the cases presented:
1 homeopathy’s effect may be expected within minutes or, at most, hours;
2 contrary to classical homeopathic consultations, which may extend over an hour, correct medications for patients with acute COVID-19 symptoms may be determined in minutes;
3 there were no observable adverse effects to homeopathic treatment of COVID-19;
4 therapy can be administered via telehealth services, increasing safety of treating patients with active infection;
5 patient satisfaction was high; scoring their experience of homeopathic therapy on a 7-point scale, ranging
from “It greatly improved my condition” to “It greatly aggravated my condition,” all 5 patients indicated it
had greatly improved their condition.
The possibility that the outcomes are not causally related to the homeopathic treatment seems to have escaped the authors. The harm that can be done by such an article seems obvious: fans of homeopathy might be misled into assuming that homeopathy is an effective therapy for COVID infections and other serious conditions. It is not hard to imagine that this error would cost many lives.
The authors state in their article that, to the best of their knowledge, this is the first time that a tertiary medical center has permitted homeopathic therapy of patients under treatment for COVID-19-related illness.
I sincerely hope that it is also the last time!
They say, one has to try everything at least once – except line-dancing and incest. So, when I was invited to co-organize a petition, I considered it and thought: WHY NOT?
Here is the text (as translated by myself) of our petition to the German Medical Association:
Dear President Dr Reinhardt,
Dear Ms Lundershausen,
Mrs Held,
Dear Ms Johna,
We, the undersigned doctors, would like to draw your attention to the insistence of individual state medical associations on preserving “homeopathy” as a component of continuing medical education. We hope that you, by virtue of your office, will ensure a nationwide regulation so that this form of sham treatment [1], as has already happened in other European countries, can no longer call itself part of medicine.
We justify our request by the following facts:
- After the landmark vote in Bremen in September 2019 to remove “homeopathy” from the medical training regulations, 10 other state medical associations have so far followed Bremen’s example. For reasons of credibility and transparency, it would be desirable if the main features of the training content taught were not coordinated locally in the future, but centrally and uniformly across the country so that there is no “training tourism”. Because changes to a state’s own regulations of postgraduate training are only binding for the examination committee of the respective state, this does not affect national regulations but is reduced to only a symbolic character without sufficient effects on the portfolio of medical education nationwide.
- Medicine always works through the combination of a specifically effective part and non-specific placebo effects. By insisting on a pseudo-medical methodology – as is “homeopathy” represents in our opinion – patients are deprived of the specific effective part and often unnecessarily deprived of therapy appropriate to the indication. Tragically, it happens again and again that the “therapeutic window of opportunity” for an appropriate therapy is missed, tumors can grow to inoperable size, etc.
- Due to the insistence of individual state medical associations on the “homeopathic doctrine of healing” as part of the medical profession, we are increasingly exposed to the blanket accusation that, by tolerating this doctrine, we are supporting and promoting ways of thinking and world views that are detached from science. This is a dangerous situation, which in times of a pandemic manifests itself in misguided aggression reflected not just in vaccination skepticism and vaccination refusal, but also in unacceptable personal attacks and assaults on vaccinating colleagues in private practice.
Responsible:
Dr. med. Dent. Hans-Werner Bertelsen
Prof. Dr. med. Edzard Ernst
George A. Rausche
You can sign the petition here:
I was alerted to this announcement by the Faculty of Homeopathy:
Faculty of Homeopathy Accredited Education
The role of Dentistry in Integrative Medicine and Homeopathy
Dentistry appears to be the Cinderella of healthcare and the importance of good oral health is hugely underestimated. The mouth is the portal into the rest of our bodies. There is increasing evidence proving that health of the oral cavity has strong links with the health of the rest of the body especially increasing risk of heart disease, low birth weight babies and type 2 diabetes. The aim of this webinar is to highlight the vital importance of dentistry and oral health in integrative medicine and why healthcare professionals need to work closely with dentists. It will also cover how, as homeopaths, we can appreciate symptoms in the mouth as indications of general health or disease and manage dental conditions.
THE TICKETS FOR THIS WEBINAR ARE LIMITED THEREFORE, PLEASE REGISTER NOW TO ENSURE ACCESS.
Some splendid platitudes there:
- the Cinderella of healthcare
- The mouth is the portal into the rest of our bodies
- health of the oral cavity has strong links with the health of the rest of the body…
But what about the importance of dentistry in integrative medicine? The importance of dentistry in medicine is fairly clear to me. However, what is the importance of dentistry in integrative medicine?
Even more puzzling seems the ‘role of dentistry in homeopathy’? What on earth do they mean by that? Perhaps they meant the ‘role of homeopathy in dentistry’?
And what is the role of homeopathy in dentistry? The British Homeopathic Dental Association should know, shouldn’t they? On their website, they explain that they are a group of dentists and dental care professionals that have an interest in using homeopathy alongside our dentistry.
On the basis of what evidence, you ask? They kindly provide an answer to that question:
In dentistry there is limited research though studies have shown improved bone healing around implants with Symphytum and reduced discomfort and improved healing time with ulcers and beneficial in oral lichen planus. These studies have small numbers and are not generally acepted as stong evidence.
Are they trying to tell us that there is no good evidence? Looks like it, doesn’t it? In this case, the above Webinar seems rather superfluous.
For those of you who want to save the money for the tickets, here is a full and evidence-based summary of all the conditions where homeopathy might be helpful in dentistry:
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THE END
Cannabis seems often to be an emotional subject where more heat than light is generated. Does it work for chronic pain? This cannot be such a difficult question to answer definitively. Yet, systematic reviews have provided conflicting results due, in part, to limitations of analytical approaches and interpretation of findings.
A new systematic review is therefore both necessary and welcome. It aimed at determining the benefits and harms of medical cannabis and cannabinoids for chronic pain. Included were all randomised clinical trials of medical cannabis or cannabinoids versus any non-cannabis control for chronic pain at ≥1-month follow-up.
A total of 32 trials with 5174 adult patients were included, 29 of which compared medical cannabis or cannabinoids with placebo. Medical cannabis was administered orally (n=30) or topically (n=2). Clinical populations included chronic non-cancer pain (n=28) and cancer-related pain (n=4). Length of follow-up ranged from 1 to 5.5 months.
Compared with placebo, non-inhaled medical cannabis probably results in a small increase in the proportion of patients experiencing at least the minimally important difference (MID) of 1 cm (on a 10 cm visual analogue scale (VAS)) in pain relief (modelled risk difference (RD) of 10% (95% confidence interval 5% to 15%), based on a weighted mean difference (WMD) of −0.50 cm (95% CI −0.75 to −0.25 cm, moderate certainty)). Medical cannabis taken orally results in a very small improvement in physical functioning (4% modelled RD (0.1% to 8%) for achieving at least the MID of 10 points on the 100-point SF-36 physical functioning scale, WMD of 1.67 points (0.03 to 3.31, high certainty)), and a small improvement in sleep quality (6% modelled RD (2% to 9%) for achieving at least the MID of 1 cm on a 10 cm VAS, WMD of −0.35 cm (−0.55 to −0.14 cm, high certainty)). Medical cannabis taken orally does not improve emotional, role, or social functioning (high certainty). Moderate certainty evidence shows that medical cannabis taken orally probably results in a small increased risk of transient cognitive impairment (RD 2% (0.1% to 6%)), vomiting (RD 3% (0.4% to 6%)), drowsiness (RD 5% (2% to 8%)), impaired attention (RD 3% (1% to 8%)), and nausea (RD 5% (2% to 8%)), but not diarrhoea; while high certainty evidence shows greater increased risk of dizziness (RD 9% (5% to 14%)) for trials with <3 months follow-up versus RD 28% (18% to 43%) for trials with ≥3 months follow-up; interaction test P=0.003; moderate credibility of subgroup effect).
The authors concluded that moderate to high certainty evidence shows that non-inhaled medical cannabis or cannabinoids results in a small to very small improvement in pain relief, physical functioning, and sleep quality among patients with chronic pain, along with several transient adverse side effects, compared with placebo.
This is a high-quality review. Its findings will disappoint the many advocates of cannabis as a therapy for chronic pain management. The bottom line, I think, seems to be that cannabis works but the effect is not very powerful, while we have treatments for managing chronic pain that are both more effective and arguably less risky. So, its place in clinical routine is debatable.
PS
Cannabis is, of course, a herbal remedy and therefore belongs to so-called alternative medicine (SCAM). Yet, I am aware that the medical cannabis preparations used in most studies are based on single cannabinoids which makes them conventional medicines.
The General Chiropractic Council (GCC) regulates chiropractors in the UK, Isle of Man, and Gibraltar to ensure the safety of patients undergoing chiropractic treatment. The GCC sets the standards of chiropractic practice and professional conduct that all chiropractors must meet.
By providing a lengthy ruling in the case of the late John Lawler and his chiropractor, Arlene Scholten, the GCC has recently established new standards for chiropractors working in the UK, Isle of Man, and Gibraltar (see also today’s article in The Daily Mail). If I interpret the GCC’s ruling correctly, a UK chiropractor is henceforth allowed to do all of the following things without fearing to get reprimanded, as long as he or she produces evidence that the deeds were done not with malicious intentions but in a state of confusion and panic:
- Treat a patient with treatments that are contraindicated.
- Fail to obtain informed consent.
- Pose as a real doctor without informing the patient that the practitioner is just a chiropractor who has never been near a medical school.
- Cause the death of a patient by treatment to the neck.
- Administer first aid in a way that makes matters worse.
- Tell lies to the ambulance men who consequently failed to employ a method of transport that would save the patient’s life.
- Keep inaccurate patient records that conceal what treatments were administered.
In previous years, the job of a chiropractor had turned out to be demanding, difficult, and stressful. This was due not least to the GCC’s professional standards which UK chiropractors were obliged to observe. The code of the GCC stated prominently that “our overall purpose is to protect the public.”
All this is now a thing of the past.
The new ruling changed everything. Now, UK chiropractors can relax and can happily pursue their true devotion, namely to keep their bank manager happy, while not worrying too much about the welfare and health of their patients.
In the name of all UK chiropractors, I herewith express my thanks to the GCC for unashamedly protecting first and foremost the interests of their members, while tacitly discarding medical ethics and evidently not protecting the public.
MAKE CHIROPRACTIC GREAT AGAIN!
