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

homeopathy

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I have to admit that I do not regularly read the DMZ, a German paper. In fact, until a minute ago, I did not know it existed. Nor do I know Anton Aeberhard. I saw his DMZ homeopathy article on the Internet and find it excellent; so much so that I translated parts of it for you:

… Because this pseudoscience is considered by some people to be an effective alternative to conventional medicine, it is important to understand the potential dangers and risks of homeopathy…

Homeopathy is based on the principle of the rule of similars and extreme dilution of substances. However, there is no scientific evidence that homeopathic remedies have any therapeutic effect beyond the placebo effect. Most studies that purport to show efficacy are methodologically flawed. Homeopathy contradicts fundamental principles of biology, chemistry, and physics. It is therefore irresponsible to consider this practice a legitimate medical treatment.

One of the greatest and real dangers of homeopathy is that it can cause people to refuse or delay effective medical treatments. By believing in homeopathic remedies, life-threatening conditions such as cancer, heart disease, or infections may not be treated appropriately. This can lead to worsening health conditions and increase the risk of complications or even death…

Conclusion I

Homeopathy is a pseudoscientific practice based on outdated principles and a lack of scientific evidence. The dangers of this practice should not be underestimated. It can cause people to reject or delay effective medical treatments, which can endanger their health and lives. It is important to make informed decisions about health care and to rely on evidence-based medicine to provide the best possible treatment and care.

Conclusion II.

Homeopathy is a joke.

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Thank you Anton Aeberhard!

It is not often that we find a journalist who has the courage to defy the demand for ‘balance’. In the case of clear nonsensical issues, this demand becomes a demand for misleading people, a demand for FALSE balance!

When a journalist writes about the planet, he does not require a representative of the FLAT EARTH SOCIETY to add his views. Similarly, when someone writes about homeopathy, there is no need to interview the chair of a homeopaths’ association saying: “But we have 200 years of experience and we therefore know it works…”

Psoriasis is a chronic inflammatory skin disorder, affecting the trunk and extensor surfaces of limbs and scalp predominantly. Its prevalence ranges between 0.1 and 11.4% and in India between 0.4 and 2.8%.  Psoriasis remains a frequently encountered condition in homeopathy practice, but there is a dearth of evidence supporting its use.

This 6-month, double-blind, randomized trial was conducted on 51 patients suffering from psoriasis at the National Institute of Homoeopathy, India. Patients were randomized to receive either individualized homeopathic medicines (IHMs; n = 25) in LM potencies or identical-looking placebos (n=26). Psoriasis area and severity index (PASI; primary), psoriasis disability index (PDI), and dermatological life quality index (DLQI; secondary) were measured at baseline, and every 2 months, up to 6 months. The intention-to-treat sample was analyzed using a two-way repeated measure analysis of variance.

Although intra-group changes were significant in both groups, improvements were significantly greater in the IHMs group than in the placebo group regarding the PASI scores after 6 months (F1, 49 = 10.448, P = 0.002). DLQI daily activity subscale scores also yielded similar significant results favoring IHMs against placebos after 6 months (F1, 49 = 5.480, P = 0.023). Improvement in PDI total (F1, 49 = 0.063, P = 0.803), DLQI total (F1, 49 = 1.371, P = 0.247), and all remaining subscales were higher in the IHMs group than placebos after 6 months, but non-significant statistically. Calcarea carbonica, Mercurius solubilis, Arsenicum album, and Petroleum were the most frequently prescribed medicines.

The authors concluded that IHMs exhibited better results than placebos in the treatment of psoriasis. Further research is warranted.

I am unable to access the full text of this paper [in case someone can, please send it to me for further scrutiny]. Judging from just the abstract, I see the following problems with this trial:

  • Psoriasis is a genetically determined condition, and I find it hard to believe that homeopathy can change its natural history.
  • The symptoms of psoriasis fluctuate and can be influenced by a range of factors, including stress.
  • We learn nothing about any concomitant interventions which are always necessary, e.g. creams, or compliance with them.
  • It is conceivable that patients in the verum group received inadvertent reassurance which, in turn, reduced stress and improved compliance with external treatments.
  • It is unclear whether patients were successfully blinded or whether inadvertent de-blinding occurred.

In any case, I would caution that this trial needs independent replications before we can take its findings seriously.

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Thanks to several readers, I now have the full text and can add the following points:

  • The authors report adverse events as follows: ” No adverse events were reported during the treatment period from either group that could be attributed causally to either IHMs or placebos. Some minor events unrelated to study medications, like common cold and injury occurring in both groups were treated with acute homeopathic medicines irrespective of allocated codes, and once those acute phases were over, the patients were returned to originally allocated groups again.” This is odd because homeopaths would expect aggravations in a high percentage of cases.
  • I am not sure that I understand the blinding procedure; it is described as follows: “Double-blinding method was adopted by masking the trial participants, investigators, outcome assessors, pharmacists, and data entry operators throughout the trial. Identical-looking vials were coded as either “1” or “2” and contained either medicines or placebos. The codes remained the same for all the randomized participants. Codes were assigned randomly and confidentially by another independent third party. Both medicines and placebos were repacked in identical glass bottles and labeled with code, name of medicine, and potency, and were dispensed according to the random number list. The vials were destined for each patient by the random number chart. The participants got the medicines dispensed personally at the hospital pharmacy. Codes were broken at the end of the trial after the dataset was frozen.”
  • The affiliations of the authors are interesting:1 Dept. of Materia Medica, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Block GE, Sector 3, Salt Lake, Kolkata 700106, West Bengal, India; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
    2 Dept. of Repertory, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Block GE,
    Sector 3, Salt Lake, Kolkata 700106, West Bengal, India; affiliated to The West Bengal University of
    Health Sciences, Govt. of West Bengal, India 3 Dept. of Repertory, The Calcutta Homoeopathic Medical College and Hospital, Govt. of West Bengal, 265, 266, Acharya Prafulla Chandra Road, Kolkata 700009, West Bengal; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
    4 East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre,
    Village and Post Office: Dakshin Gouripur, Police Station Bishnupur, South 24 Parganas 743503, West
    Bengal, under Department of Health & Family Welfare, Govt. of West Bengal, India 5 Dept. of Repertory, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal; affiliated to The West Bengal University
    of Health Sciences, Govt. of West Bengal, India.

I think it is safe to repeat that independent replications would be essential.

Menopausal symptoms are systemic symptoms that are associated with estrogen deficiency after menopause. Although widely practiced, homeopathy remains under-researched in menopausal syndrome in terms of quality evidence, especially in randomized trials. The efficacy of individualized homeopathic medicines (IHMs) was evaluated in this double-blind, randomized, placebo-controlled trial in the treatment of the menopausal syndrome.

Group 1 (n = 30) received IHMs plus concomitant care, while group 2 (n = 30) had placebos plus concomitant care. The primary outcome measures were the Greene Climacteric Scale (GCS) total score and the menopause rating scale (MRS) total score. The secondary endpoint was the Utian quality of life (UQOL) total score. Measurements were taken at baseline and every month up to 3 months.

Intention-to-treat sample (n = 60) was analyzed. Group differences were examined by two-way (split-half) repeated-measure analysis of variance, primarily taking into account all the estimates measured at monthly intervals, and secondarily, by unpaired t-tests comparing the estimates obtained individually every month. The level of significance was set at p < 0.025 two-tailed. Between-group differences were nonsignificant statistically—GCS total score (F1, 58 = 1.372, p = 0.246), MRS total score (F1, 58 = 0.720, p = 0.4), and UQOL total scores (F1, 58 = 2.903, p = 0.094). Some of the subscales preferred IHMs significantly against placebos—for example, MRS somatic subscale (F1, 56 = 0.466, p < 0.001), UQOL occupational subscale (F1, 58 = 4.865, p = 0.031), and UQOL health subscale (F1, 58 = 4.971, p = 0.030). Sulfur and Sepia succus were the most frequently prescribed medicines. No harm or serious adverse events were reported from either group.

The authors concluded that, although the primary analysis failed to demonstrate clearly that the treatment was effective beyond placebo, some significant benefits of IHMs over placebo could still be detected in some of the subscales in the secondary analysis.

The article was published in the recently re-named JICM, a journal that, when it was still called JCAM, featured regularly on this blog. As such, the paper is remarkable: who would have thought that this journal might publish a trial of homeopathy with a squarely negative result?

Yes, I know, the surprise is tempered by the fact that the authors make much in the conclusions of their article about the significant findings related to secondary analyses. Should we tell them that these results are all but irrelevant?

Better not!

The decline of homeopathy, the ‘medicine’ that doesn’t cure anything” is the title of a remarkable article in EL PAIS of which I take the liberty of showing you a few key passages:

In the more than 200 years that have passed since its invention, no one has been able to prove that homeopathy is actually capable of curing anything with its alleged medicines that have no active ingredients…

…EL PAÍS reached out to some of its main promoters, such as the pharmaceutical company Boiron, leader in the sector; the Spanish Association of Homeopathy Pharmacists and the Spanish Society of Homeopathic Doctors. In the absence of a response from all three, the explanations are given by experts who are more critical of the discipline.

Many people who used to consume homeopathy were not even aware that this was the case. Fernando Frías, one of the activists who worked to undermine the discipline’s remaining prestige, recalls that people did not believe them when they were told that compounds with diluted Berlin Wall were sold to overcome the feelings of oppression and anxiety. This was actually commercialized under the premise that “like cures like”: if the Berlin Wall oppressed, a piece of it diluted in water should remedy it. “Many were under the impression that it was just a natural therapy and that we were making things up to attack it,” says Frías…

… There has been a lot of debate about how to regulate an alleged drug whose only effect is, in truth, the placebo effect. In 2001, the European Parliament issued a directive that covered its use in countries with a homeopathic tradition; sources explain that this happened due to the pressure exerted by both the industries and the governments of countries where pseudoscience is deep-rooted, such as France (where Boiron is headquartered) or Germany, where its consumption is much higher than in others, such as Spain.

“Having regard to the particular characteristics of these homeopathic medicinal products, such as the very low level of active principles they contain and the difficulty of applying to them the conventional statistical methods relating to clinical trials, it is desirable to provide a special, simplified registration procedure for those homeopathic medicinal products which are placed on the market without therapeutic indications in a pharmaceutical form and dosage which do not present a risk for the patient,” states the directive.

In its more than two centuries of history, this is not the first time that homeopathy loses ground. Still, Frías warns, it cannot be ruled out that at some point something will come up that will make it fashionable again. “Look at the example of chemtrails [the condensation trails left by airplanes that some conspiracy theorists believe are a way of poisoning the population from the air]. It seemed that no one remembered them anymore, but now they’re back,” he says. Frías cites the astrophysicist and disseminator Javier Armentia, who states that beliefs are like a rubber duck: no matter how much they sink, they always resurface. “Especially if there is money behind,” he adds.

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As reported previously, homeopathy and other forms of so-called alternative medicine (SCAM) have come under fire in Spain. In 2017, ‘HOMEOPATHY PLUS‘ reported that “in a reversal of the 2015 Royal Legislative Decree, the Minister of Health has withdrawn homeopathic remedies and outlawed the practice in Spain’s national health services.” In 2018, more than 400 people signed an open letter triggered by the case of a cancer patient who died after preferring homeopathy to regular treatment. “Let’s be clear: pseudoscience kills,” begins the letter. Since then, the struggle of Spanish rational thinkers to stop misleading information about SCAM in general and homeopathy, in particular, has only intensified.

Spain is thus joining other European countries in opposing misinformation about homeopathy. Contrary to what some have claimed (for instance, in the comments section of this blog), most of the opponents do not want to restrict the public’s choice. People who wish to use homeopathy should be able to do so (but should pay for it themselves). However, the choice must be based on evidence-based information.

It has been reported, at the German Medical Congress (DÄT) a year ago, that it was decided to delete the additional title of homeopathy from the model further training regulations of the German Medical Association. And Federal Health Minister Karl Lauterbach (SPD) tweeted applause: “Homeopathy has no place in modern medicine.”

Now the ‘ Bundesverband der Pharmaziestudierenden in Deutschland’ (BPhD), the German Pharmacists Organization, even goes a few steps further. The position paper distinguishes between evidence-based medicine (EBM) and unproven therapeutic methods. According to the BPhD, these include homeopathy, but also anthroposophy, traditional Chinese medicine, and traditional medicines.

Among other things, the BPhD is disturbed by the way homeopathy presents itself as an alternative, because an alternative means “a choice between two equally suitable possibilities” to achieve a goal, and this is not the case. Compared to evidence-based medicine (EBM), homeopathy is a “constructed, illusory concept” and “the principles of homeopathic teachings and principles” are to be rejected as “unscientific”. According to the BPhD, a designation as “alternative” for advertising purposes should no longer be allowed.

They would also like to see a demarcation from naturopathy; the clear distinction between homeopathy and phytopharmacy has been lacking up to now. The advertising attribute “natural” should therefore also be banned in order to prevent equalization in advertising, the position paper states.

Like doctors, pharmacy students point to the lack of proof of efficacy beyond the placebo effect. According to the BPhD, the dogma WER HEILT HAT RECHT, “he who heals is right” would “disregard all processes that work towards healing and glorify the result”. The “gold standard” of EBM – randomized, double-blind studies with placebo control – should in future also have to be fulfilled by homeopathic medicines, experience reports are not sufficient, it continues.

Homeopathic medicines are only registered as medicinal products without indication, which requires neither proof of efficacy nor clinical studies. The BPhD, therefore, demands that a warning be placed on the preparations that they have “no proven efficacy beyond the placebo effect”. Up to now, without this warning, patients have been “deceived about the efficacy”, and there is an “urgent need for detailed public information and counseling on homeopathy since its unjustified reputation poses a danger of not seeking treatment”. The BPhD also demands that the status of homeopathic medicines is withdrawn and that the pharmacy obligation for the preparations is abolished…

“In the health professions, no trivialization of unproven therapeutic procedures should be tolerated, as inadequate counseling or ignorance poses a danger to patients,” the BPhD said.

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When I first read this article – I translated and shortened it for those who cannot read German- I was truly dazzled. These are the suggestions that I have been making for around 20 years now, not specifically for Germany but for pharmacists in general. For many years, the Germans seemed the least likely to agree with me. But now they seem to be ahead of everyone else in Europe!

How come?

I suspect and hope that our recent initiative might have something to do with it.

Let’s hope that the pharmacists of other countries follow the German example.

A team of French researchers assessed whether a conflict of interest (COI) might be associated with the direction of the results of meta-analyses of homoeopathy trials. Their analysis (published as a ‘letter to the editor) is complex, therefore, I present here only their main finding.

The team conducted a literature search until July 2022 on PubMed and Embase to identify meta-analyses of randomized clinical trials assessing the efficacy of homoeopathy. They then assessed the existence of potential COI, defined by the presence of at least one of the following criteria:

  • affiliation of one or more authors to an academic homoeopathy research or care facility, or to the homoeopathy industry;
  • research sponsored or funded by the homoeopathy industry;
  • COI declared by the authors.

The researchers also evaluated and classified any spin in meta-analyses conclusions into three categories (misleading reporting, misleading interpretation and inappropriate extrapolation). Two reviewers assessed the quality of meta-analyses and the risk of bias based. Publication bias was evaluated by the funnel plot method. For all the studies included in these meta-analyses, the researchers checked whether they reported a statistically significant result in favour of homoeopathy. Further details about the methods are provided on OSF (https://osf.io/nqw7r/) and in the preregistered protocol (CRD42020206242).

Twenty meta-analyses were included in the analysis (list of references available at https://osf.io/nqw7r/).

  • Among the 13 meta-analyses with COI, a significantly positive effect of homoeopathy emerged (OR=0.60 (95% CI 0.50 to 0.70)).
  • There was no such effect for meta-analyses without COI (OR=0.96 (95% CI 0.75 to 1.23)).

The authors concluded that in the presence of COI, meta-analyses of homoeopathy trials are more likely
to have favourable results. This is consistent with recent research suggesting that systematic reviews with financial COI are associated with more positive outcomes.

Meta-analyses are systematic reviews (critical assessments of the totality of the available evidence) where the data from the included studies are pooled. For a range of reasons, this may not always be possible. Therefore the number of meta-analyses (20) is substantially lower than that of the existing systematic reviews (>50).

Both systematic reviews and meta-analyses are theoretically the most reliable evidence regarding the value of any intervention. I said ‘theoretically’ because, like any human endeavour, they need to be done in an unbiased fashion to produce reliable results. People with a conflict of interest by definition struggle to be free of bias. As we have seen many times, this would include homoeopaths.

This new analysis confirms what many of us have feared. If proponents of homeopathy with an overt conflict of interest conduct a meta-analysis of studies of homeopathy, the results tend to be more positive than when independent researchers do it. The question that emerges from this is the following:

Are the findings of those researchers who have an interest in producing a positive result closer to the truth than the findings of researchers who have no such conflict?

I let you decide.

In response to yesterday’s post, I received a lengthy comment from ‘Stan’. Several readers have already commented on it. Therefore, I can make my arguments short. In this post, will repeat Stan’s points each followed by my comments (in bold). Here we go:

Seven Reasons Homœopathy is Not Placebo Effect

Sorry, Stan, but your heading is not proper English; I have therefore changed it for the title of this post.

1. Homeopathic remedies work on babies, animals, plants and people in a coma. Biodynamic farmers use homeopathic remedies to repel pests and treat plant diseases. Some organic ranchers rely on homeopathic remedies to treat their herds. Some “placebo by proxy” effect has been shown for children but its doubtful that it could be shown for a herd of cattle or crops in a field. Farmers can’t rely on wishful thinking to stay in business.

As discussed ad nauseam on this blog, homeopathic remedies do not work on babies or animals better than placebos. I don’t know of any studies with “people in a coma” (if you do, Stan, please let me know). The fact that ranchers rely on homeopathy is hilarious but does not prove anything.

2. The correct curative remedy will initially cause a worsening of the condition being cured if it is given in too strong (i.e. too dilute) a dose. A placebo might only cause a temporary improvement of the condition being treated; certainly not an aggravation.

The ‘homeopathic aggravation’ is a myth created by homeopaths. It disappears if we try to systematically research it; see here, for instance.

3. One can do a “proving” of an unknown homeopathic remedy by taking it repeatedly over several days and it will temporarily cause symptoms that one has never experienced previously – symptoms it will cure in a sick person. This is a repeatable scientific experiment used to determine the scope of a new remedy, or confirm the effects of an already proven remedy. A placebo might possibly have an effect if the individual taking it has been “prepared” by being told what they are taking but it likely wouldnt match previously recorded symptoms in the literature.

Homeopathic provings are rubbish and not reproducible when done rigorously; see here.

4. One can treat simple acute (self-limiting) conditions (e.g. minor burns, minor injuries, insect bites, etc.) and see unusually rapid cures with homeopathic remedies. A placebo might only cause a temporary improvement of the condition being treated while taken. Placebos have been found mostly effective in conditions with a strong psychological component like pain.

You mean like using Arnica for cuts and bruises? Sadly, it does not work.

5. One can get homeopathic treatment for long term chronic (non self-limiting) conditions and see a deep lasting cure, as has been documented clinically for a couple centuries. A placebo might only cause a temporary partial improvement of the condition being treated while the placebo is being taken.

You mean like asthma, eczema, or insomnia?

6. There is over 200 years worth of extensive documentation from around the world, of the clinical successes of homeopathy for both acute and chronic conditions of all types. As Dr Hahn has said you have throw out 90% of the evidence to conclude that homeopathy doesnt work. The Sheng et al meta-analysis in 2005 Lancet that was supposedly the death knell of homeopathy used only 8 studies, excluding hundreds of others. Unsurprisingly homeopathy was found wanting. So-called Skeptics see what they want to see in the science. There is relatively little documentation of placebo usage. A few recent studies have been done showing the limited temporary benefits of placebos.

What Hahn wrote is understandably liked by homeopaths but it nevertheless is BS. If you don’t trust me, please rely on independent bodies from across the world.

7. Homeopathic remedies have been shown to have a very weak electromagnetic signature and contain some nano-particles. Some believe this explains their mechanism. An exciting new potential field of research is the subtle cell signalling that has been found to direct the development of stem cells. Scientists have created double-headed planeria worms and this trait has been found to be inherited by their offspring without any change in the genes or epigenetics. Until now we had no idea how a single fertilized ovum could evolve into a complex creature that is bilateral and has multiple cell types. It is possible that the very subtle electromagnetic signature or some other unknown effect of homeopathic remedies is effecting this subtle cell signalling.

The homeopathic nano-myth is nonsense. And so is the rest of your assumptions.

Every conventional drug has “side effects” that match the symptoms for which it is indicated! Aspirin can cause headaches and fever, ritalin can cause hyperactive effects, radiation can cause cancer. Conventional doctors are just practicing bad homeopathy. They are prescribing Partially similar medicines. If their drugs were homeopathic (i.e. similar) to the patients symptoms on all levels they would be curative. Radiation sometimes does cure cancer instead of just suppressing it per usual.

Even if this were true, what would it prove? Certainly not that homeopathy works!

Dr Hahneman did forbid mixing homeopathy and conventional medicine. In his day doctors commonly used extensive blood letting and extreme doses of mercury. Its not Quite as bad now.

You evidently did not read Hahnemann’s writings.

Just because we dont know how extremely dilute homeopathic remedies work, doesn’t discount that they Do work. Homeopathy seems to fly in the face of Known science. In no way is it irrational or unscientific. There are lots of phenomena in the universe that cant be explained yet, like dark energy and dark matter effects and even consciousness!

Not knowing how a treatment works has not stopped science to test whether it works (e.g. Aspirin). In the case of homeopathy, the results of these endeavors were not positive.

The assumption that the moon is made of cheese also flies in the face of science; do you perhaps think that this makes it true?

The actions of homeopathy can and have been well-explained: they are due to placebo effects.

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Stan, thank you for this entertaining exercise. But, next time, please remember to supply evidence for your statements.

After all these years, I am still fascinated by what proponents of homeopathy try to tell others about their trade. Recently I found a long article in this vein. It is aimed at an audience of HEILPRAKTIKER and their patients. It should therefore be responsible, thorough, and evidence-based (yes, I am an optimist).

“With this article”, the authors state, “we aim to provide a comprehensive overview of homeopathy and help people make informed decisions about their health. Whether you already have experience with homeopathy or simply want to inform yourself, we hope that this article will provide you with valuable insights and information” (my translation).

Here I present to you just the relatively short section dedicated to the ‘pros and cons’ of homeopathy. Here we go:

Advantages of homeopathy:

  1. Holistic approach: homeopathy considers the human being as a whole and takes into account both physical and emotional aspects. It aims to support individual balance and the body’s self-healing powers.
  2. Gentle and non-invasive treatment: Homeopathic remedies are usually taken as globules, drops, or tablets and are therefore easy and convenient to use. They rarely cause side effects and are generally well tolerated.
  3. Individualized treatment: In homeopathy, each patient is considered unique and treatment is based on individual symptoms and characteristics. There is no “one-size-fits-all” solution, but a personalized approach.
  4. Support for chronic diseases: Homeopathy can be an alternative or complementary treatment for chronic conditions where conventional medicines offer limited relief. It can help improve quality of life and promote overall well-being.

Limitations of homeopathy:

  1. Placebo effect: Much of the effect of homeopathy is attributed to the placebo effect. It is argued that the improvements patients experience occur because of belief in the efficacy of the remedies and positive expectations, rather than due to a specific effect of the diluted substances.
  2. Lack of scientific evidence: The scientific evidence for the efficacy of homeopathy is limited and controversial. Many studies have failed to demonstrate benefits beyond the placebo effect. There is a lack of well-conducted randomized controlled trials that clearly show the effectiveness of homeopathy.
  3. Delay or rejection of conventional treatments: In some cases, the choice of homeopathy as the sole method of treatment may lead to delays in the diagnosis and timely treatment of serious or acute illnesses. It is important that serious illnesses are examined by a doctor and treated appropriately.
  4. Difficulties in standardization: Homeopathy involves a variety of remedies used in different potencies and dilutions. This makes standardization and the conduct of reproducible studies difficult. There are also controversial debates about whether the dilutions go beyond the extent to which molecules of the original substance are still present.

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I am sure that you have heard the BS about the alleged advantages of homeopathy often enough. Therefore, I will here not bother to comment on them again. More interesting, in my view, are the limitations of homeopathy, as seen by its proponents. Please allow me, therefore, to discuss them briefly.

  1. The authors state that “it is argued that the improvements patients experience occur because of belief in the efficacy of the remedies and positive expectations”. This sounds as though this is a mere aberrant opinion or at least an ongoing debate amongst scientists. In fact, it is the scientific consensus supported by tons of evidence.
  2. This is the same point expressed differently.
  3. The admission that “the choice of homeopathy as the sole method of treatment may lead to delays in the diagnosis and timely treatment” is yet another way of stating that homeopathy is not effective. What is, however, not expressed clearly enough, in my view, is the fact that homeopathic treatment usually amounts to medical neglect which is unethical and can cause serious harm, in extreme cases even death.
  4. It is not true that the range of potencies renders “the conduct of reproducible studies difficult”. There are plenty of examples to demonstrate this, for instance, this study. “There are also controversial debates about whether the dilutions go beyond the extent to which molecules of the original substance are still present.” Yes, I did translate this correctly. I am sorry to say that this sentence does make no sense in German or in English.

What I find particularly interesting is that the authors do not mention disadvantages that non-homeopaths would rate as quite important, e.g.:

  • The assumptions of homeopathy fly in the face of science.
  • Hahnemann strictly forbade homeopathy to be combined with ‘allopathy’ (yet proponents now claim this option to be an advantage).
  • Treating a patient with homeopathy violates even the most basic rules of medical ethics.
  • Homeopaths have no choice but to lie to their patients on a daily basis.
  • Many homeopaths have the nasty habit of advising their patients against using effective treatments, e.g. vaccinations.
  • Homeopathy undermines rational thinking in a general way.

In summary, the authors’ “aim to provide a comprehensive overview of homeopathy and help people make informed decisions about their health” has not been reached.

Last September, THE GUARDIAN published an article about the HEAD OF THE ROYAL MEDICAL HOUSEHOLD. I did not know much about this position, so I informed myself:

The royal household has its own team of medics, who are on call 24 hours a day. They are led by Prof Sir Huw Thomas (a consultant at King Edward VII’s hospital [the private hospital in Marylebone often used by members of the royal family, including the late Prince Philip] and St Mary’s hospital in Paddington, and professor of gastrointestinal genetics at Imperial College London), head of the medical household and physician to the Queen – a title dating back to 1557. Thomas has been part of the team of royal physicians for 16 years and became the Queen’s personal physician in 2014. The role is not full-time and does not have fixed hours or sessions but Thomas is available whenever he is needed. Thomas received a knighthood in the 2021 new year honours, and was made Knight Commander of the Royal Victorian Order (KCVO) – a personal gift of the monarch. At the time of the honour, in an interview with Imperial College London, he said it had been a “busy couple of years in this role,” adding that he felt “very grateful to have been recognised for my service to date”. Thomas added that being the Queen’s personal physician was a “great honour” and “a very enjoyable and rewarding role”. He said: “The nature of the work is interesting because you see how a whole different organisation, the royal household, operates. You very much become part of that organisation and become the personal doctor to the principal people in it, who are patients just like other patients.” …

In previous generations the royal doctor has caused controversy. When the Queen’s grandfather King George V was in his final hours, Lord Dawson, the royal doctor with personal responsibility for the 70-year-old monarch issued a bulletin, declaring: “The King’s life is moving peacefully towards its close.”

In 1986, four decades after Lord Dawson’s death, his diaries were made public – revealing that he had administered a lethal dose of morphine and cocaine to relieve the King’s pain, but also to ensure that the death could be announced in the morning edition of the Times, rather than “less appropriate evening journals”.

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During the last few days, it was difficult to escape all the hoo-hah related to the coronation, and I wondered whether Charles has replaced Prof Thomas in his role as HEAD OF THE ROYAL MEDICAL HOUSEHOLD. It did not take long to find out. There even is a Wiki page on the subject! It provides a list of the recent heads:

List of Heads of the Medical Household

The Head of the Medical Household was first appointed in 1973.

Yes, Michael Dixon! I am sure this will be of interest. Michael Dixon used to be a friend and an occasional collaborator of mine. He has featured prominently in my memoir as well as in my biography of Charles. In addition, he has been the subject of numerous blog posts, e.g.:

I am sure that many of my readers would like to join me in wishing both Michael and Charles all the best in their new roles.

 

Assigning shelf life for homeopathic medicine is – according to the authors of this new, ground-breaking study – an important yet debatable issue. Therefore, the present article is aimed at investigating the problem from a Quantum Electrodynamics point of view and suggests ten years to be a moderate estimate of shelf life.

Data were obtained by the following methods:

  • dynamic light scattering,
  • atomic force microscopy,
  • anomalous dielectric dispersion,
  • UV,
  • electron spin resonance spectrometry.

The results show the formation of nanosized molecular assemblies.  These water clusters containing millions to billions of water molecules, which are created by repeated dilution of aqueous solutions, have been photographed.

The authors draw the following conclusions:

  • Ultra-high dilutions (UHD) contain dissipative structures.
  • These structures are solute specific
  • These structures are tremendously persistent
  • Therapeutic values of UHDs are found to continue for a very long time (20-25 years)

Summarizing, we can say that the solute, which in this case is the starting material of homeopathic medicine, leaves its highly stable foot prints in the dissipative structure formed in the UHD solution of polar solvent. Unfortunately, no targeted experiments are done yet to find the exact shelf life. Hence, we wish to suggest that as the shelf life (with proper precautionary measures) of the homeopathic medicine are theoretically expected to be very prolonged and supported by clinical experience, let it be accepted as ten years till future targeted experiments give the exact value, which is expected to be higher than this suggested value.

Were these sensational findings published in a journal like NATURE or SCIENCE? No, they emerged in ‘HPATHY‘ (“the World’s No. 1 Homeopathy Website: Since 2001”). That is a great shame, I think, because they might thus not be awarded the Noble Prize that they clearly deserve.

________________

Joking apart, the self life issue is evidently of some concern to homeopaths. Take this ‘study‘, for instance:

Background: Assignment of expiry date to homeopathic medicines is a subject of important concern to its pharmacists and practitioners. This study compares the regulatory framework for the expiry of homeopathic medicines in four countries: Brazil, Germany, India and the United States.

Findings: Different or no expiry periods are variously followed. Whereas Germany, with some exceptions, employs a maximum expiry of 5 years for both potencies and finished products, Brazil adopts a 5-year expiry for finished products only, potencies used in manufacture being exempted from an assigned expiry date. In India, all homeopathic medicines except dilutions and back potencies have a maximum of 5 years’ shelf-life, including those supplied to consumers. In the United States, homeopathic medicines are exempted from expiry dates.

Comments: There is neither a rational basis nor scientific evidence for assigning a short (3-5 years) expiry period for homeopathic medicines as followed in some of the countries, particularly in light of the fact that some studies have shown homeopathic medications to be effective even after 25 years. Homeopathic ultra-dilutions seem to contain non-material activity that is maintained over time and, since these exhibit different chemical properties compared to the original starting material, it is quite possible they possess properties of longer activity than conventional medicines. Regulators should acknowledge this feature and differentiate expiry of homeopathic medicinal products from that of conventional drugs.

____________________

For once, I almost agree with my homeopathic colleagues:

The activity of homeopathic ultra-dilutions is maintained over time.

However, we need to add just a little explanation to this statement:

This activity is zero.

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