study design
When a top journal like PNAS (Procedings of the Nationsl Academy of Science) publishes an article entitled “What’s the science behind acupuncture?“, I must take notice. Here is my take on the (sadly disappointing) effort:
My very short summary of the paper (I do encourange my readers to read it in full)
The article starts from the premise that acupuncture is proven to work, an assumption that – as we will see in a minute – is not based on sound evidence. It describes the evolution of acupuncture from a traditional practice rooted in ancient concepts like “qi” and “meridians” to a modern medical treatment increasingly validated by science. It argues that practitioners like Min Chen are today able to provide evidence-based explanations for their work. While early clinical trials were plagued by the “sham” acupuncture paradox, the text argues that more recent, rigorous studies and technological projects are bridging the gap between Eastern philosophy and evidence-based medicine, suggesting that acupuncture’s effects are physiological realities rather than mere placebo.
My concerns of the paper
The article attempts to bridge the gap between Traditional Chinese Medicine (TCM) and conventional medicine suggesting that several anatomical discoveries “correspond” to ancient meridians. This, however, is a post hoc ergo propter hoc fallacy. Finding a morphological structure (e.g. fascia) and claiming it represents the meridian system ignores that meridians were conceptualized as functional energetic conduits, not anatomical vessels. Citing an 80% overlap between acupoints and connective tissue planes lacks specificity. Given the ubiquity of connective tissue in the human frame, any randomized point on the body would likely “overlap” with a tissue plane, rendering the “meridian” map a possible exercise in pattern-seeking rather than anatomical discovery.
The paper acknowledges the “most puzzling” finding that sham acupuncture often produces results comparable to “true” acupuncture. This, it would seem to me, invalidates the foundational TCM theory of specific “acupoints” and “meridians” is invalidated. Yet, the article suggests that sham acupuncture is “not a true placebo” because it also triggers biological pathways. If needling anywhere produces an effect, acupuncture is merely a generalized, non-specific neuro-modulatory stimulus.
The article quotes Chen on “harmonizing organ functions” and “regulating qi” as well as researchers referring to “fibroblast activation” and “vagus nerve stimulation”. The author seems to consider both to be true; yet they seem mutually exclusive. Translating metaphysical concepts into physical phenomena does not “validate” the original theory but merely replaces it.
The article employs the opioid crisis to justify the rise of acupuncture. Yes, the need for non-pharmacological pain management is urgent, but clinical necessity does not equate to scientific validity. The text quotes the “lasting benefits” observed in some meta-analyses without discussing the often fatal flaws in these papers. Furthermore, it fails to cite the substantial body of evidence suggesting that acupuncture is not effective. Moreover, it hardly mentions the small effect sizes and hence limited clinical usefulness found in the positive studies.
The final section of the paper essentially rebrands acupuncture as “bioelectronic medicine”. If its mechanism of action is purely the electrical stimulation of the vagus nerve or the release of endogenous opioids, then the TCM concepts are all but superfluous. If a cheap and wearable TENS unit is more or less equivalent, the “meridian” and “qi” myths are obsolete.
In summary, the paper reads, I fear, only marginally better than a Chinese government promotional text – most disappointing for an article published in a journal of high standing. It attempts to preserve the cultural prestige of TCM while stripping it of its internal logic in order to make it compatible with science. For acupuncture to gain a true “scientific footing”, research must, in my view, move beyond finding “tantalizing” correlations. It should address fundamental problems, e.g.:
- As long as we have no convincing proof that acupuncture works beyond placebo, discussions about its mechanisms are futile.
- If qi, acupoints and meridians are illusions and irrelevant for the clinical outcome, then the science is not validating acupuncture but merely re-discovering a well-known non-specific form of peripheral nerve stimulation.
The defence of anthroposophical medicine – or of any other unproven modality – as articulated, for example, by figures like Weleda CEO Tina Müller, presents a vision of patient-centred care and economic pragmatism. However, when held against the light of current clinical standards and the principles of evidence-based medicine (EBM), it reveals significant cracks.
The most profound problem lies in the definition of scientific evidence. Proponents often point to decades of “positive experience” and high patient satisfaction as proof of effectiveness. Yet, in the hierarchy of science, anecdotal success sits at the very bottom. Anthroposophical treatments lack biological plausibility. Their perceived benefits are largely indistinguishable from context effects (such as placebo). Anthroposophical medicine might provide more time, empathy, and personal attention – factors that undoubtedly improve a patient’s well-being but do not validate the effectiveness of the specific remedies used. When independent bodies subject these treatments to rigorous, high-quality trials, the purported effects usually vanishe.
Anthroposophical medicine represents merely a tiny percentage of our healthcare expenditures. Therefore, proponents argue, little money would be saved by getting rid of it. This argument is a calculated distraction from the ethical core of the issue. While the fiscal burden may be marginal, the scientific cost is immense. A statutory health insurance system is built on a social contract of solidarity; it functions under the premise that public funds are reserved for treatments of proven value and effectiveness. To fund therapies that lack plausibility as well as reproducible results is to erode the credibility of medicine and rational thought. It is not a question of the amount of money, but the principle of integrity: every Euro, £ and $ spent on unproven treatments is a euro, £, and $ diverted from underfunded and often life-saving healthcare.
The regularly made appeal to the Swiss Model as a beacon of success also requires a more critical reading. The integration of so-called alternative medicine (SCAM) in Switzerland was, at its heart, a result of direct democracy rather than evidence. While the Swiss public voted for inclusion, the majority of the medical community remains deeply sceptical. To cite Switzerland as “proof” that anthroposophical medicine has fulfilled the criteria of EBM is to conflate political popularity with scientific validation. Democracy can decide how a nation spends its money, but it cannot vote a reliable evidence-base into existence.
Finally, we must consider the human risk of legitimizing non-evidenced-based practices. When a state-sanctioned insurance system places such therapies on the same pedestal as EBM, it risks misleading vulnerable individuals. For patients facing chronic or life-threatening illnesses, the “integrative” path can lead to a dangerous delay in seeking conventional, life-saving interventions. By treating subjective belief and peer-reviewed science as equal peers, we risk entering a “post-truth” medical era where the desire for a “natural” or “holistic” experience outweighs the necessity for proof.
In conclusion, while the call for a more “human” and “holistic” medical system might be noble, it must not come at the expense of scientific rigor. It is deeply misleading to imply that this is an ‘either or’; good medicine will always be based on both. A healthcare system that prioritizes popularity over proof risks becoming a system of expensive comfort rather than one of effective healing. True patient appreciation lies not in offering unproven choices, but in ensuring that every treatment covered by the public purse is supported by sound evidence. Not following this strategy is a disservice to patients and to progress.
So, the next time you hear people defending anthroposophical medicine or any other unproven modality, please look behind the smoke screen and find out why they do it. More often than not, you will then identify a massive conflict of interest. My advice is to listen to independent experts and to dismiss the people with an axe to grind.
Tonsillitis is a common condition predominantly affecting children and adolescents, presenting as acute, recurrent, or chronic infection. This review evaluated the effectiveness of homeopathy for clinical improvement and recurrence prevention across all tonsillitis presentations.
A team of scientists searched nine databases and four trial registries for randomised controlled trials (RCTs) and non-randomised controlled trials (nRCTs) involving patients of all ages with diagnosed tonsillitis. Studies examining individualised homeopathy (IH) and non-individualised homeopathy (non-IH) were included, compared with an inactive or active control group. Primary outcomes were clinical improvement (symptoms and signs) and recurrence. Secondary outcomes were antibiotic consumption, healthcare utilisation, quality of life, costs, and adverse events. Data extraction, Risk of Bias assessment, and certainty of evidence evaluation (GRADE) followed established methodology.
Five RCTs compared homeopathy with placebo (n=4) or standard care (n=1): one used IH, one used both IH and non-IH, and three used non-IH. Two RCTs examined acute tonsillitis, two examined recurrent tonsillitis, and one examined chronic tonsillitis. Three trials enrolled children, one enrolled adults, and one enrolled a mixed population. Sample sizes ranged from 30 to 256. Substantial heterogeneity across populations, interventions, and outcomes precluded meta-analysis. Individual RCTs showed that, in acute tonsillitis, non-IH achieved short-term symptom improvement. In recurrent tonsillitis, both IH and non-IH were associated with reduced infection recurrence, lower antibiotic consumption, and improved quality of life, with the strongest evidence for a standardised non-IH complex (SilAtro-5-90). In chronic tonsillitis, IH showed delayed but consistent improvements in symptoms, recurrence, healthcare utilisation, and quality of life by 2–3 months, with early outcomes favouring placebo. The certainty of evidence for all outcomes was low. No serious adverse events were reported.
The authors concluded that the evidence from individual trials suggests that both individualised and non-individualised homeopathy may benefit clinical improvement, reduce infection recurrence, reduce antibiotic use, and enhance quality of life in tonsillitis, with no safety concerns reported. However, substantial heterogeneity across studies and methodological limitations restrict the ability to draw definitive conclusions about homeopathy’s effectiveness in patients with tonsillitis. Further well-designed, adequately-powered trials with standardised outcomes and consistent methodological approaches are needed to strengthen the evidence base and enable more robust conclusions.
My critical evaluation of this paper is impeded by the fact that two of its authors were once members of my own team. On the one hand, this might assure me that their review is of a high standard, on the other hand it hinders me to voice harsh criticism. Fortunately, they include their own valid criticism of their project:
One study was a pilot study and therefore not appropriately powered [36] and one was published by a single researcher not following a formal publication protocol or underwent a formal peer-review process [34]. One study used an add-on design [31] which is a recognised methodology in clinical research, not unique to homeopathy, and their limitations regarding attribution of effect are well understood and acknowledged. We do acknowledge the possibility of publication bias and the limitations of a small evidence base. We also note there are issues arising from numerous outcomes, subscales, and repeated time-point analyses, which substantially increases the likelihood of false-positive findings.
Further variability was introduced by unclear definitions of some secondary outcomes and by differences in definitions across studies. Two of the five studies reported on their funding body. One did not receive funding [37] and Palm et al., 2017 [31] was sponsored by Deutsche Homoopathie-Union, DHU-Arzneimittel GmbH & Co. Germany.
They also are open about the funding of their work:
Existing funds held by Homeopathy Research Institute (HRI) – donated by Manchester Homeopathic Clinic Charitable Trust – were donated to University of Bristol to conduct the systematic review. The funders had no involvement in the study design; in the collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication.
So, what should we make of their effort? Let me just state this:
If I had to advise them on how to improve their review substantially, I would have suggested they re-phrase their conclusion. I am sure that something like this would have been much more adequate:
Most of the included trials were positive yet, because of substantial heterogeneity and methodological limitations of the primary studies, the evidence collectively fails to show that individualised or non-individualised homeopathy are effective treatments for tonsillitis.
- IHMPs (verum; n = 67),
- or identical-looking placebos (control; n = 67)
Both treatments were administered alongside standard concomitant care including sitz baths, pelvic floor exercises, and dietary advice.
- Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, Kolkata, India.
- East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, under Department of Health & Family Welfare, Government of West Bengal, Parganas, India.
- Department of Pathology & Microbiology, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, Kolkata, India.
- Department of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, Kolkata, India.
- Department of Materia Medica, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, Kolkata, India.
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Ministry of AYUSH, Government of India, Salt Lake, Kolkata, India.
- Department of Community Medicine, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, Tangra, India.
This list does not inspire me with confidence that this study is reliable.
Next I looked around for further trials of homeopathy for hemorrhoids – and I found another study by the same authors published 2 years earlier in the same dodgy journal:
Objectives: To investigate the efficacy and safety of individualized homeopathic medicines (IHMs) in treating hemorrhoids compared with placebo. Design: This is a double-blind, randomized (1:1), two parallel arms, placebo-controlled trial. Setting: The trial was conducted at the surgery outpatient department of the State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh, India. Subjects: Patients were 140 women and men, aged between 18 and 65 years, with a diagnosis of primary hemorrhoids grades I-III for at least 3 months. Excluded were the patients with grade IV hemorrhoids, anal fissure, and fistula, hypertrophic anal papillae, inflammatory bowel disease, coagulation disorders, rectal malignancies, obstructed portal circulation, patients requiring immediate surgical intervention, and vulnerable samples. Interventions: Patients were randomized to Group 1 (n = 70; IHMs plus concomitant care; verum) and Group 2 (n = 70; placebos plus concomitant care; control). Outcome measures: Primary-the anorectal symptom severity and quality-of-life (ARSSQoL) questionnaire, and secondary-the EuroQol 5-dimensions 5-levels (EQ-5D-5L) questionnaire and EQ visual analogue scale (VAS); all of them were measured at baseline, and every month, up to 3 months. Results: Out of the 140 randomized patients, 122 were protocol compliant. Intention-to-treat sample (n = 140) was analyzed. The level of significance was set at p < 0.05 two tailed. Statistically significant between-group differences were elicited in the ARSSQoL total (Mann-Whitney U [MWU]: 1227.0, p < 0.001) and EQ-5D-5L VAS (MWU: 1228.0, p = 0.001) favoring homeopathy against placebos. Sulfur was the most frequently prescribed medicine. No harm or serious adverse events were reported from either of the groups. Conclusions: IHMs demonstrated superior results over placebo in the short-term treatment of hemorrhoids of grades I-III. The findings are promising, but need to be substantiated by further phase 3 trials.
Are we to believe that the authors were able to pull off 2 large almost identical studies within just 2 years?
Pull the other one!
The Spanish Agency for Medicines and Medical Products (AEMPS) has just published a comprehensive technical report entitled “Homeopathy and Homeopathic Products: Evaluation of Evidence on Their Efficacy and Safety”, which categorically concludes that there is no scientific evidence supporting the efficacy of homeopathy as a therapeutic tool. After a systematic review of scientific literature and evaluations by state agencies internationally, the report states that the observed effects are comparable to placebo.
The report, which analyzed 64 systematic reviews published since 2009, highlights that most studies suggesting benefits from homeopathy have low methodological quality, often invalidated by small samples, short follow-up periods, or biases in randomization. Furthermore, it notes that as the quality and rigor of clinical trials increase, the supposed effect of homeopathy diminishes until it disappears entirely.
From a scientific standpoint, the principles of homeopathy clash with the laws of physics and current pharmacology. In typical dilutions like 12 CH—where one part of the original substance is mixed with 100 parts of solvent twelve times consecutively—it is mathematically impossible for a single molecule of the original ingredient to remain in the preparation, breaking any cause-and-effect relationship between the product and the therapeutic effect.
To illustrate this disproportion, the report points out that a dilution of just 6 CH (far less extreme than 12 CH) equates to dissolving a packet of sugar in the entire Mediterranean Sea. For this reason, the AEMPS classifies theories like “water memory”—the belief that the liquid retains the properties of a substance even without its molecules—as empirically baseless postulates that challenge scientific and rational thinking.
In compliance with European and national regulations, the AEMPS has completed a regularization process that has resulted in the market withdrawal of numerous products. As of the report’s publication date, no homeopathic product with authorized therapeutic indications exists in Spain. The 976 that remain registered did so via a simplified procedure, based on extreme dilutions ensuring the preparation’s innocuousness, which does not require proof of therapeutic effect and legally prohibits any therapeutic claims on labeling.
Spain aligns with a global trend of health institutions adopting critical stances:
- United Kingdom: The Science and Technology Committee recommended halting public funding and requiring labeling warnings about lack of efficacy.
- Australia: The National Health and Medical Research Council concluded that homeopathy should not be used for chronic or serious diseases.
- France: The Haute Autorité de Santé eliminated public reimbursement for these products in 2021 due to lack of demonstrated efficacy.
- Germany: Approval is expected in 2026 for the definitive removal of homeopathy coverage from statutory health insurance.
- United States: The Food and Drug Administration (FDA) considers these products “unapproved new drugs,” and the Federal Trade Commission requires warnings that there is no scientific evidence of their functioning.
Although there is a popular belief that these preparations are innocuous because they are “natural,” serious adverse reactions have been reported, including poisonings from poor dosing and infant deaths linked to teething products in other countries.
However, the AEMPS warns that the main associated risk is the abandonment or delay of proven effective medical treatments. Citizens opting for homeopathy to treat serious or chronic conditions may endanger their health by replacing evidence-based therapies with products lacking such evidence.
The AEMPS report reaffirms the Ministry’s commitment to public health protection and evidence-based medicine. In line with other international agencies, it emphasizes the need for transparent information so citizens can make safe health decisions. The conclusion of the report is firm:
Given the lack of evidence of efficacy, homeopathy cannot be considered a valid therapeutic alternative, and its use must not lead to delaying or abandoning treatments proven to be effective.
The suppression of scientific data within US federal agencies represents a fundamental tension between independent public health expertise and political ideology. This conflict seems to have now reached a boiling point at the ‘Centers for Disease Control and Prevention’ (CDC), where the Trump administration’s political leadership has indefinitely delayed the publication of an important report demonstrating the continued benefits of the COVID-19 vaccine. This action marks a pivotal shift in how the US manages public health information, signalling an era where data is scrutinized not just for its accuracy, but for its alignment with a specific political narrative.
The controversy centres on a study conducted by career scientists within the CDC’s ‘National Center for Immunization and Respiratory Diseases’. It analyzed data from the winter of 2025 and showed that COVID-19 vaccinations reduced the risk of hospitalization by 55% and emergency room visits by 50% among healthy adults. These figures provide a compelling argument for the vaccine’s role in mitigating the burden on the US healthcare system. However, despite being scheduled for release in the agency’s Morbidity and Mortality Weekly Report (MMWR) in mid-March, the study remains unpublished.
The primary figure behind this delay is the Acting CDC Director, Dr. Jay Bhattacharya. Appointed by the Trump administration and a vocal advocate for the “Great Barrington Declaration,” Bhattacharya has challenged the report’s methodology, specifically the “test-negative design”. This is an observational study design often used to estimate vaccine effectiveness. It compares people who seek care and are test-positive for the target infection with similar people who seek care but are test-negative. The key idea is simple:
- Recruit people with similar symptoms who come for testing.
- Split them into cases, who test positive, and controls, who test negative.
- Compare the odds of prior vaccination or another exposure between the two groups.
If vaccinated people are less common among the test-positive group than among the test-negative group, that suggests the vaccine is effective. This design is efficient because both cases and controls come from the same care-seeking population which reduces confounding. It is also practical during outbreaks, since cases and controls can be identified quickly from testing records.
While Bhattacharya frames his criticism as a commitment to rigorous quality control, the scientific community begs to differ and stress that the test-negative design has been the gold standard for assessing vaccine effectiveness for over twenty years. Indeed, a flu vaccine study using the exact same methodology was approved for publication by the same leadership just days prior, suggesting a double standard applied specifically to COVID-19 data.
This scandalous incident does not exist in a vacuum; it is a manifestation of a broader overhaul of US public health spearheaded by Health Secretary Robert F. Kennedy Jr. Under this leadership, the administration has sought to deprioritize standard immunization schedules and has integrated vaccine skeptics into the Advisory Committee on Immunization Practices (ACIP). By suppressing data that proves vaccine efficacy, the administration creates a vacuum of information that can be filled by more skeptical, politically convenient narratives.
The consequences of all this are profound. When political appointees act as gatekeepers for scientific data, it erodes the public’s trust in the CDC as a neutral, evidence-based institution. High-profile resignations, such as that of Dr. Fiona Havers, suggest a demoralized workforce of career scientists who feel their objective research is being censored. Furthermore, by withholding data that quantifies the protection offered by vaccines, the government limits the ability of healthcare providers and citizens to make informed decisions about their own health risks.
In conclusion, the suppression of the 2026 CDC vaccine report is a watershed moment for scientific integrity in government. It illustrates the danger of a system where data is viewed through a lens of political utility rather than public safety. As the administration continues to reshape federal health policy, the ongoing struggle between career researchers and political leadership will likely define the future of public health transparency in the US. The losers, no doubt, will be the people – primarily in the US but likely also globally.
The Indian Ministry of Ayush was established in 2014 with a vision of reviving the profound knowledge of India’s ancient systems of medicine and ensuring the optimal development and propagation of the Ayush systems of healthcare. Earlier, the Department of Indian System of Medicine and Homoeopathy (ISM&H) formed in 1995, was responsible for the development of these systems. It was then renamed as the Department of Ayurveda, Yoga, and Naturopathy, Unani, Siddha and Homoeopathy (Ayush) in November 2003 with focused attention towards education and research in these therapies.
In the global landscape of public health, India’s Ministry of AYUSH stands as a profound anomaly. While most middle‑ and high‑income countries have converged around evidence‑based, scientifically grounded medicine, India has instead expanded this large, state‑run administrative apparatus where cultural nationalism and traditionalist narratives dominates over clinical efficacy and scientific rigor. The Ministry’s current trajectory reveals a troubling pattern: the systematic promotion of unproven therapies, flawed research, and notorious breaches of ethical principles, particularly with respect to the treatment of India’s most vulnerable populations.
The Homeopathy Anomaly
The most glaring anomaly must be the Ministry’s continued, high‑level support for homoeopathy. India is currently the only country in the world that maintains a dedicated national ministry and a statutory regulatory framework – via the National Commission for Homoeopathy – specifically to promote a system widely regarded as implausible, ineffective and harmful. Global assessments, including those by no less than 28 independent organisations worldwide, have concluded that there is no reliable evidence that homeopathic remedies work beyond placebo. Yet the AYUSH Ministry funds and publicizes a central research council (the Central Council for Research in Homoeopathy, CCRH) as well as a network of homoeopathic hospitals and teaching institutions, with annual budget allocations now exceeding ₹4,400 crore (roughly 470–480 million US dollars at current exchange rates). By directing substantial taxpayer funds to homoeopathic research and infrastructure, the state effectively endorses a “placebo‑as‑medicine” model, elevating it to the status of a national health strategy. This is not merely an academic dispute; it is a policy outlier that places India’s healthcare posture at odds with well‑established chemical and physical principles, as well as with the recommendations of leading international scientific bodies.
The Facade of Rigor
The Ministry tends to defend its approach by claiming a pivot toward “evidence‑based” or “scientific” AYUSH medicine, but an examination of its research output suggests a facade of rigor rather than its substance. Much of the work produced by bodies such as the Central Council for Research in Ayurveda (CCRA) and their counterparts in Unani and Siddha consists of investigations that are methodologically weak and wide open to bias. Key methodological flaws recur:
- Small sample sizes: Many trials involve fewer than 50–100 participants, rendering them statistically underpowered.
- Lack of blinding: A large proportion of studies is open‑label, where both clinicians and patients know the assigned intervention, amplifying placebo effects and observational bias.
- Selective reporting and publication bias: Negative findings – where AYUSH interventions fail to demonstrate benefit – are rarely published.
By branding such useless studies as “scientific proof,” the Ministry engages in a form of “science‑washing.” This practice misleads the public, uncritical clinicians, and policymakers into believing that AYUSH therapies have undergone the same rigorous, independent scrutiny as conventional therapies.
The Ethical Violations
In my view, the most serious concern is ethical. Under the banner of “Self‑Reliant India” (Atmanirbhar Bharat), the Ministry has aggressively promoted AYUSH products, for instance, during the COVID‑19 pandemic. This push could be viewed as an exercise in cultural pride and national self‑reliance but, in fact, it carries serious risks.
Medical ethics rely on two core principles: informed consent and non‑maleficence. When a state body, backed by cabinet‑level authority, “flogs” unproven and potentially dangerous treatments to a largely rural population with limited health literacy, it undermines both. Many patients are not able to distinguish between an ancient tradition and a clinically validated drug, yet they may be led by government‑sponsored messaging to defer or abandon evidence‑based treatments.
This is particularly dangerous in chronic conditions such as diabetes mellitus and hypertension, where effective pharmacological control and regular monitoring are both available and potentially life‑saving. If patients substitute proven allopathic regimens with state‑endorsed AYUSH alternatives of uncertain efficacy, the consequences can be dire. They include uncontrolled blood glucose, stroke‑risk elevation, organ damage, and avoidable mortality. The Ministry’s conduct, in effect, offloads these risks onto the most vulnerable while shielding itself behind appeals to tradition and national identity.
Conclusion
The Ministry of AYUSH has become the institutional vehicle for a “pluralistic” health model that, in practice, functions as a state‑funded rejection of the scientific method. This constitutes a regression in public‑health governance rather than a progressive pluralism. Until the Ministry subjects its therapies to the same scrutiny as any other medicine, and until it accepts transparent, independent evaluations without recourse to political or cultural vindication, it will remain less a health body and more a department of cultural preservation and doctrine.
Aaron Siri is an American lawyer and anti‑vaccine activist. He has become a key figure in contemporary US vaccine‑policy debates, largely through his legal challenges and close ties to health‑policy critics such as Robert F. Kennedy Jr. His following five central claims about vaccines are a mix of selective quoting, misrepresentation of studies, and appeal to legal‑style rhetoric:
- Vaccines cause chronic illness
Siri’s central “smoking‑gun” claim rests on an unpublished Henry Ford Health‑system analysis allegedly showing that vaccinated children have far higher rates of chronic illness than unvaccinated children. Vaccinated children in this dataset had far more health‑care visits than unvaccinated children, so more conditions were diagnosed in them regardless of whether vaccines caused them. This is a textbook example of detection bias, but not evidence of causation. Moreover, the study has not passed peer review; its reported disease prevalences are inconsistent with known epidemiology. It is therefore widely seen as methodologically unsound.
- Vaccines were never properly tested against proper controls
Siri argues that many childhood vaccines have not been tested in inadequately-powered, placebo‑controlled trials. When an effective vaccine exists, medical ethics oppose using placebos in new trials, as that would deny protection to a control group. Moreover, his claim that older vaccines (e.g., tetanus–diphtheria–pertussis) “lack adequate controlled trials” is misleading because earlier trials were designed for different standards and later observational data, post‑licensure surveillance, and large‑scale cohort studies have filled the gaps. In other words, he exploits technical‑sounding language to imply a hiatus of evidence, when in reality the evidence base is broader and more heterogeneous than he portrays.
- The CDC/WHO inflates how many lives vaccines have saved
Siri has attacked the WHO’s estimate that vaccines have saved around 154 million lives, calling it “corruption of science”. The 154‑million figure comes from a modelling exercise [like most “lives‑saved” statements in public health]. It depends on assumptions but is based on vaccine‑coverage and mortality‑trend data, but it is not fabricated. Siri’s rebuttals focus on rhetorically dismissing the exercise as “advertising” rather than engaging its assumptions or proposing alternative, better‑validated models. His claim that this number is “corrupt” thus rests polemic than but not on a coherent technical critique of the underlying epidemiological models.
- Exploiting the 1986 Vaccine Injury Act and “lack of liability”
Siri blames the 1986 National Childhood Vaccine Injury Act for reducing oversight and downplaying risk, arguing that liability protection “corrupts” safety monitoring. Yet the law was designed to protect manufacturers from financially ruinous litigation and to create a dedicated federal compensation program for proven injuries, not to forbid safety monitoring. The US has multiple surveillance systems (VAERS, VSD, CISA) and expert advisory bodies (ACIP, NVAC) that continuously review vaccine safety. Siri’s critique thus conflates legal strategy with scientific oversight, implying that the absence of mass torts proves lax monitoring.
In conclusion, Siri’s vaccine claims are mostly built on:
- one deeply flawed, unpublished observational study,
- selective readings of older vaccine‑trial designs,
- unwarranted dismissal of WHO‑level modelling, and
- a legal framing that conflates liability shields with absence of safety science.
Epidemiologists, infectious‑disease specialists and other experts rightly regard Siri’s arguments as misrepresenting or misapplying biostatistics and failing to meet standards for causal inference. It would be a serious mistake to follow them!
Some papers on so-called alternative medicine (SCAM) are such that I am almost lost for words. Here is the abstract of such an article:
Background: Autism Spectrum Disorder is a complex neurodevelopmental condition with characteristic
challenges like persistent deficits in social communication, restricted and repetitive behaviors, sensory
processing anomalies. Defined by DSM-5criteria, it affects about 1in 100 children globally and 1in 36 in
united states and poses a significant burden for families and healthcare systems. Research on homoeopathy
and Bach flower Remedies as adjunctive or primary therapies has often explored by families and clinical
interest in complementary and alternative medicine for additional support.
Materials and Methods: A comprehensive study of related review articles, related different components
of Autism spectrum disorder treated with homeopathy treatment, Bach Flower Remedies and
complementary medicine in children were search out. Databases search is PubMed, Google Scholar,
ResearchGate and Web of Science, Scopus and Homoeopathic journal.
Result: Reviewed evidence indicates that no systematic studies have been done to manage autism
spectrum disorder with Bach flower Remedies as an adjuvant or primary treatment along with
homoeopathy. Although individualized homoeopathic treatment has promising results in reducing core
and associated symptoms in children including improvement in social interaction, hyperactivity,
communication and behavioral regulation. Although there is less data available thorough trails, Bach
Flower Remedies especially Rescue remedy that have help in treating the emotional dysregulations and
anxiety that are frequently connected with autism spectrum condition.
Conclusion: The available clinical data on autism spectrum with homoeopathy and Bach flower remedies
is not enough to provide new and sufficient evidence. To overcome this more well-designed study of RCT
and larger sample with standardized procedures will be able to help to this rising burden of autism
spectrum disorder.
In the article itself, the authors state the following: “This review article indicates that both homoeopathy and Bach Flower Remedies are promising adjunct intervention in treatment of Autism spectrum disorder in children especially marked improvement in social interaction, communication, behavioural rigidity, emotional dysregulation and sensory processing. Based on the reviewed data from case series, controlled clinical trials and systematic reviews it can be state that individualized homeopathic treatment leads to clinically relevant improvement in core and associated symptoms of autism spectrum disorder.
Studies on Bach flower remedies specifically in autism spectrum disorder are very less but it suggests that Bach flower remedies offer practically accessible intervention for emotional and behavioural dimension mostly in anxiety, emotional dysregulation, sensory hyperactivity and resistance to change. Evidence from controlled trials and clinical studies shows a statistical and significant in symptom.
Homoeopathy and Bach flower remedies should not replace evidence-based behavioural and development intervention for autism spectrum disorder, but rather be investigation as complementary modalities within an integrative care framework. Despite of growing clinical observations, the field of homoeopathy and Batch Flower remedies in autism spectrum disorder is characterised by substantial and identifiable research gaps that limit the formulation of evidence-based clinical guidelines and urgent research priorities include the multicentric, double-blind RCTs with standardised diagnostic criteria and validated core outcome sets; longitudinal follow-up.”
Bearing in mind that this comes from the “Head of the Department, Department of Practice of Medicine, Bharati Vidyapeeth (Deemed to beUniversity), Homoeopathic Medical College”, this is remarkably embarrassing!
Why?
The review is badly written and poorly done. More importantly, according to the data provided by the authors, there is only one rigorous RCT. Here is its abstract:
Objective: To evaluate the effectiveness of Bach flower remedies in the treatment of children with attention deficit hyperactivity disorder (ADHD), in a double blind prospective controlled study.
Methods: Fourty Children with ADHD, aged 7-11 years, diagnosed according to the DSM criteria, were randomised to Bach flower remedies or placebo treatments for a period of 3 months. Children’s performance was evaluated by the teacher before commencement of treatment and subsequently each month during the study period.
Results: Bach flower remedies have no statistically significant effect when compared to placebo in the treatment of children with ADHD. There was a significant correlation between treatment duration’s and improvement of performance, with no difference between the treatment group compared to the placebo.
Conclusions: There is no statistically significant difference between the effects of Bach flower remedies compared with placebo in the treatment of children with ADHD.
If a head of department nonetheless concludes that “both homoeopathy and Bach Flower Remedies are promising adjunct intervention in treatment of Autism spectrum disorder in children especially marked improvement in social interaction, communication, behavioural rigidity, emotional dysregulation and sensory processing”, it is, I fear, high time to replace him.
I am sure that many of my readers have no idea what ‘Slinding Cupping Therapy’ is. It is a TCM therapy that, according to the authors of this paper, receives much appreciation for treating plaque psoriasis. This study was designed to test the hypothesis that sliding cupping therapy is non-inferior to narrowband ultraviolet B (NBUVB) therapy in improving disease severity in patients with plaque psoriasis.
This prospective trial recruited 60 patients with plaque psoriasis who were randomized to receive either sliding cupping intervention or NBUVB treatment. The cup was moved 30 times for each skin lesion until the target skin area turned purple. The initial dose (mJ/cm2) of ultraviolet radiation b (UVB) was determined based on sun-reactive skin types I through VI, which ranged from 300 mJ/cm2 to 800 mJ/cm2. Both treatments were performed 3 times per week for 8 weeks. The primary endpoint was the percentage reduction in Psoriasis Area and Severity Index (PASI) score at week 8, with secondary endpoints, including Physician’s Global Assessment (PGA), body surface area, visual analogue scale scores, and quality of life measures.
The total response rates were 69% (18/26) and 79% (19/24) for patients receiving sliding cupping intervention and those receiving NBUVB treatment, respectively, which showed no significant difference (P = .526). The PASI scores, body surface area, and PGA were reduced in patients with plaque psoriasis at W0, W4 and W8 after either sliding cupping intervention or NBUVB treatment (P <.001), and these reductions were not significantly different between the patients receiving sliding cupping intervention and those receiving NBUVB treatment at W0, W4, W8, and W12. At W8, the mean percentage reduction in PASI was 62.4% (95% CI, 54.9–69.8) in the sliding cupping group and 66.9% (95% CI, 59.6–74.2) in the NBUVB group, with no significant difference between groups. The total response rates were 69.23% (18/26) and 79.17% (19/24), respectively (P = .526). Patients receiving sliding cupping intervention and those receiving NBUVB treatment did not show statistically significant differences in these outcomes at W0, W4, W8, and W12 (P >.05).
The authors concluded that the overall results suggest that sliding cupping therapy exhibits statistically similar efficacy and safety profiles as NBUVB treatment, especially at 8 weeks after treatment.
Sliding cupping therapy is a form of cupping in which cups producing mild suction are placed on oiled skin and then moved along the body surface, generating a “reverse massage” that lifts rather than compresses the subcutaneous tissues. The negative pressure is thought to increase local blood flow and lymphatic drainage, reduce perceived muscle tension, and temporarily improve range of motion, though high‑quality clinical evidence for most claimed benefits remains limited.
The treatment is used mainly by massage therapists, physiotherapists, and TCM practitioners in musculoskeletal and sports‑rehab settings, as well as in wellness and spa‑oriented clinics; it is commonly applied to the back, shoulders, neck, limbs, and along fascial lines or acupuncture meridians, often for pain, stiffness, “trigger‑point”‑type tension, and post‑exercise recovery. The popularity of this therapy is best characterised as a niche within broader cupping and fascial‑release practice rather than a mainstream standard treatment.
The new study is a text-book example of how to mislead people with seemingly reliable research. The fact that it was grossly under-powered – and not the effectiveness of the sliding cupping therapy – is obviously the cause of the lack of a difference between the effective therapy (NBUVB) and the sliding quackery.
Let me give you an example: say, we compare antibiotics (A) to homeopathy (H) as treatments for bacterial pneumonia. We treat 10 patientsin each group, and 8 of them recover in group A within a week, while in the H-group the amount is 6 (many patients recover even without an effective treatment). We run statistical tests which tell us that the difference is not significant. Thus we falsely conclude that homeopathy is as effective as antibiotics in the treatment of pneumonia. The 2 treatments were, in fact, not equal but the lack of power of the small study failed to detect the existing difference.
It seems rather obvious to me that a similar thing has happened with the above study. Its authors are to be congratulated for cheating so slyly that neither the editors nor the reviewers of the journal ‘Medicine’ managed to see through their simple litte trick.
