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Homeopathy: The Ultimate Fake
Stephen Barrett, M.D.
Homeopathic "remedies" enjoy a unique status in the health marketplace: They are the only category of quack products legally marketable as drugs. This situation is the result of two circumstances. First, the 1938 Federal Food, Drug, and Cosmetic Act, which was shepherded through Congress by a homeopathic physician who was a senator, recognizes as drugs all substances included in the Homeopathic Pharmacopeia of the United States. Second, the FDA has not held homeopathic products to the same standards as other drugs. Today they are marketed in health-food stores, in pharmacies, in practitioner offices, by multilevel distributors [A], through the mail, and on the Internet.
Basic MisbeliefsSamuel Hahnemann (1755-1843), a German physician, began formulating homeopathy's basic principles in the late 1700s. Hahnemann was justifiably distressed about bloodletting, leeching, purging, and other medical procedures of his day that did far more harm than good. Thinking that these treatments were intended to "balance the body's 'humors' by opposite effects," he developed his "law of similars" -- a notion that symptoms of disease can be cured by extremely small amounts of substances that produce similar symptoms in healthy people when administered in large amounts. The word "homeopathy" is derived from the Greek words homoios (similar) and pathos (suffering or disease).
Hahnemann and his early followers conducted "provings" in which they administered herbs, minerals, and other substances to healthy people, including themselves, and kept detailed records of what they observed. Later these records were compiled into lengthy reference books called materia medica, which are used to match a patient's symptoms with a "corresponding" drug.
Hahnemann declared that diseases represent a disturbance in the body's ability to heal itself and that only a small stimulus is needed to begin the healing process. He also claimed that chronic diseases were manifestations of a suppressed itch (psora), a kind of miasma or evil spirit. At first he used small doses of accepted medications. But later he used enormous dilutions and theorized that the smaller the dose, the more powerful the effect -- a notion commonly referred to as the "law of infinitesimals." That, of course, is just the opposite of the dose-response relationship that pharmacologists have demonstrated.
The basis for inclusion in the Homeopathic Pharmacopeia is not modern scientific testing, but homeopathic "provings" conducted during the 1800s and early 1900s. The current (ninth) edition describes how more than a thousand substances are prepared for homeopathic use. It does not identify the symptoms or diseases for which homeopathic products should be used; that is decided by the practitioner (or manufacturer). The fact that substances listed in the Homeopathic Pharmacopeia are legally recognized as "drugs" does not mean that either the law or the FDA recognizes them as effective.
Because homeopathic remedies were actually less dangerous than those of nineteenth-century medical orthodoxy, many medical practitioners began using them. At the turn of the twentieth century, homeopathy had about 14,000 practitioners and 22 schools in the United States. But as medical science and medical education advanced, homeopathy declined sharply in America, where its schools either closed or converted to modern methods. The last pure homeopathic school in this country closed during the 1920s [1].
Many homeopaths maintain that certain people have a special affinity to a particular remedy (their "constitutional remedy") and will respond to it for a variety of ailments. Such remedies can be prescribed according to the person's "constitutional type" -- named after the corresponding remedy in a manner resembling astrologic typing. The "Ignatia Type," for example, is said to be nervous and often tearful, and to dislike tobacco smoke. The typical "Pulsatilla" is a young woman, with blond or light-brown hair, blue eyes, and a delicate complexion, who is gentle, fearful, romantic, emotional, and friendly but shy. The "Nux Vomica Type" is said to be aggressive, bellicose, ambitious, and hyperactive. The "Sulfur Type" likes to be independent. And so on. Does this sound to you like a rational basis for diagnosis and treatment?
The "Remedies" Are PlacebosHomeopathic products are made from minerals, botanical substances, and several other sources. If the original substance is soluble, one part is diluted with either nine or ninety-nine parts of distilled water and/or alcohol and shaken vigorously (succussed); if insoluble, it is finely ground and pulverized in similar proportions with powdered lactose (milk sugar). One part of the diluted medicine is then further diluted, and the process is repeated until the desired concentration is reached. Dilutions of 1 to 10 are designated by the Roman numeral X (1X = 1/10, 3X = 1/1,000, 6X = 1/1,000,000). Similarly, dilutions of 1 to 100 are designated by the Roman numeral C (1C = 1/100, 3C = 1/1,000,000, and so on). Most remedies today range from 6X to 30X, but products of 30C or more are marketed.
A 30X dilution means that the original substance has been diluted 1,000,000,000,000,000,000,000,000,000,000 times. Assuming that a cubic centimeter of water contains 15 drops, this number is greater than the number of drops of water that would fill a container more than 50 times the size of the Earth. Imagine placing a drop of red dye into such a container so that it disperses evenly. Homeopathy's "law of infinitesimals" is the equivalent of saying that any drop of water subsequently removed from that container will possess an essence of redness. Robert L. Park, Ph.D., a prominent physicist who is executive director of The American Physical Society, has noted that since the least amount of a substance in a solution is one molecule, a 30C solution would have to have at least one molecule of the original substance dissolved in a minimum of 1,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000 molecules of water. This would require a container more than 30,000,000,000 times the size of the Earth.
Oscillococcinum, a 200C product "for the relief of colds and flu-like symptoms," involves "dilutions" that are even more far-fetched. Its "active ingredient" is prepared by incubating small amounts of a freshly killed duck's liver and heart for 40 days. The resultant solution is then filtered, freeze-dried, rehydrated, repeatedly diluted, and impregnated into sugar granules. If a single molecule of the duck's heart or liver were to survive the dilution, its concentration would be 1 in 100200. This huge number, which has 400 zeroes, is vastly greater than the estimated number of molecules in the universe (about one googol, which is a 1 followed by 100 zeroes). In its February 17, 1997, issue, U.S. News & World Report noted that only one duck per year is needed to manufacture the product, which had total sales of $20 million in 1996. The magazine dubbed that unlucky bird "the $20-million duck."
Actually, the laws of chemistry state that there is a limit to the dilution that can be made without losing the original substance altogether. This limit, which is related to Avogadro's number, corresponds to homeopathic potencies of 12C or 24X (1 part in 1024). Hahnemann himself realized that there is virtually no chance that even one molecule of original substance would remain after extreme dilutions. But he believed that the vigorous shaking or pulverizing with each step of dilution leaves behind a "spirit-like" essence -- "no longer perceptible to the senses" -- which cures by reviving the body's "vital force." Modern proponents assert that even when the last molecule is gone, a "memory" of the substance is retained. This notion is unsubstantiated. Moreover, if it were true, every substance encountered by a molecule of water might imprint an "essence" that could exert powerful (and unpredictable) medicinal effects when ingested by a person.
Many proponents claim that homeopathic products resemble vaccines because both provide a small stimulus that triggers an immune response. This comparison is not valid. The amounts of active ingredients in vaccines are much greater and can be measured. Moreover, immunizations produce antibodies whose concentration in the blood can be measured, but high-dilution homeopathic products produce no measurable response. In addition, vaccines are used preventively, not for curing symptoms.
Stan Polanski, a physician assistant working in public health near Asheville, North Carolina, has provided additional insights:
Imagine how many compounds must be present, in quantities of a molecule or more, in every dose of a homeopathic drug. Even under the most scrupulously clean conditions, airborne dust in the manufacturing facility must carry thousands of different molecules of biological origin derived from local sources (bacteria, viruses, fungi, respiratory droplets, sloughed skin cells, insect feces) as well as distant ones (pollens, soil particles, products of combustion), along with mineral particles of terrestrial and even extraterrestrial origin (meteor dust). Similarly, the "inert" diluents used in the process must have their own library of microcontaminants.
The dilution/potentiation process in homeopathy involves a stepwise dilution carried to fantastic extremes, with "succussion" between each dilution. Succussion involves shaking or rapping the container a certain way. During the step-by-step dilution process, how is the emerging drug preparation supposed to know which of the countless substances in the container is the One that means business? How is it that thousands (millions?) of chemical compounds know that they are required to lay low, to just stand around while the Potent One is anointed to the status of Healer? That this scenario could lead to distinct products uniquely suited to treat particular illnesses is beyond implausible.
Thus, until homeopathy's apologists can supply a plausible (nonmagical) mechanism for the "potentiation"-through-dilution of precisely one of the many substances in each of their products, it is impossible to accept that they have correctly identified the active ingredients in their products. Any study claiming to demonstrate effectiveness of a homeopathic medication should be rejected out-of-hand unless it includes a list of all the substances present in concentrations equal to or greater than the purported active ingredient at every stage of the dilution process, along with a rationale for rejecting each of them as a suspect.
The process of "proving" through which homeopaths decided which medicine matches which symptom is no more sensible. Provings involved taking various substances recording every twitch, sneeze, ache or itch that occurred afterward -- often for several days. Homeopathy's followers take for granted that every sensation reported was caused by whatever substance was administered, and that extremely dilute doses of that substance would then be just the right thing to treat anyone with those specific symptoms.
Dr. Park has noted that to expect to get even one molecule of the "medicinal" substance allegedly present in 30X pills, it would be necessary to take some two billion of them, which would total about a thousand tons of lactose plus whatever impurities the lactose contained.Cell Salts
Some homeopathic manufacturers market twelve highly diluted mineral products called "cell salts" or "tissue salts." These are claimed to be effective against a wide variety of diseases, including appendicitis (ruptured or not), baldness, deafness, insomnia, and worms. Their use is based on the notion that mineral deficiency is the basic cause of disease. However, many are so diluted that they could not correct a mineral deficiency even if one were present. Development of this approach is attributed to a nineteenth-century physician named W.H. Schuessler."Electrodiagnosis"
Some physicians, dentists, and chiropractors use "electrodiagnostic" devices to help select the homeopathic remedies they prescribe. These practitioners claim they can determine the cause of any disease by detecting the "energy imbalance" causing the problem. Some also claim that the devices can detect whether someone is allergic or sensitive to foods, vitamins, and/or other substances. The procedure, called electroacupuncture according to Voll (EAV), electrodiagnosis, or electrodermal screening, was begun during the late 1950s by Reinhold Voll, M.D., a West German physician who developed the original device. Subsequent models include the Vega, Dermatron, Accupath 1000, and Interro.
Proponents claim these devices measure disturbances in the flow of "electro-magnetic energy" along the body's "acupuncture meridians." Actually, they are fancy galvanometers that measure electrical resistance of the patient's skin when touched by a probe. Each device contains a low-voltage source. One wire from the device goes to a brass cylinder covered by moist gauze, which the patient holds in one hand. A second wire is connected to a probe, which the operator touches to "acupuncture points" on the patient's foot or other hand. This completes a circuit, and the device registers the flow of current. The information is then relayed to a gauge that provides a numerical readout. The size of the number depends on how hard the probe is pressed against the patient's skin. Recent versions, such as the Interro make sounds and provide the readout on a computer screen. The treatment selected depends on the scope of the practitioner's practice and may include acupuncture, dietary change, and/or vitamin supplements, as well as homeopathic products. Regulatory agencies have seized several types of electroacupuncture devices but have not made a systematic effort to drive them from the marketplace.
For more information about these devices and pictures of some of them, click here. If you encounter such a device, please read this article and report the device to the practitioner's state licensing board, the state attorney general, the Federal Trade Commission, the FBI, the National Fraud Information Center, and any insurance company to which the practitioner submits claims that involve use of the device. For the addresses of these agencies, click here.Unimpressive "Research"
Since many homeopathic remedies contain no detectable amount of active ingredient, it is impossible to test whether they contain what their label says. Unlike most potent drugs, they have not been proven effective against disease by double-blind clinical testing. In fact, the vast majority of homeopathic products have never even been tested.
In 1990, an article in Review of Epidemiology analyzed 40 randomized trials that had compared homeopathic treatment with standard treatment, a placebo, or no treatment. The authors concluded that all but three of the trials had major flaws in their design and that only one of those three had reported a positive result. The authors concluded that there is no evidence that homeopathic treatment has any more value than a placebo [2].
In 1994, the journal Pediatrics published an article claiming that homeopathic treatment had been demonstrated to be effective against mild cases of diarrhea among Nicaraguan children [3]. The claim was based on findings that, on certain days, the "treated" group had fewer loose stools than the placebo group. However, Sampson and London noted: (1) the study used an unreliable and unproved diagnostic and therapeutic scheme, (2) there was no safeguard against product adulteration, (3) treatment selection was arbitrary, (4) the data were oddly grouped and contained errors and inconsistencies, (5) the results had questionable clinical significance, and (6) there was no public health significance because the only remedy needed for mild childhood diarrhea is adequate fluid intake to prevent or correct dehydration [4].
In 1995, Prescrire International, a French journal that evaluates pharmaceutical products, published a literature review that concluded:
As homeopathic treatments are generally used in conditions with variable outcome or showing spontaneous recovery (hence their placebo-responsiveness), these treatments are widely considered to have an effect in some patients. However, despite the large number of comparative trials carried out to date there is no evidence that homeopathy is any more effective than placebo therapy given in identical conditions.
In December 1996, a lengthy report was published by the Homoeopathic Medicine Research Group (HMRG), an expert panel convened by the Commission of the European Communities. The HMRG included homeopathic physician-researchers and experts in clinical research, clinical pharmacology, biostatistics, and clinical epidemiology. Its aim was to evaluate published and unpublished reports of controlled trials of homeopathic treatment. After examining 184 reports, the panelists concluded: (1) only 17 were designed and reported well enough to be worth considering; (2) in some of these trials, homeopathic approaches may have exerted a greater effect than a placebo or no treatment; and (3) the number of participants in these 17 trials was too small to draw any conclusions about the effectiveness of homeopathic treatment for any specific condition [5]. Simply put: Most homeopathic research is worthless, and no homeopathic product has been proven effective for any therapeutic purpose. The National Council Against Health Fraud has warned that "the sectarian nature of homeopathy raises serious questions about the trustworthiness of homeopathic researchers." [6]
In 1997, a London health authority decided to stop paying for homeopathic treatment after concluding that there was not enough evidence to support its use. The Lambeth, Southwark, and Lewisham Health Authority had been referring more than 500 patients per year to the Royal Homoeopathic Hospital in London. Public health doctors at the authority reviewed the published scientific literature as part of a general move toward purchasing only evidence-based treatments. The group concluded that many of the studies were methodologically flawed and that recent research produced by the Royal Homoeopathic Hospital contained no convincing evidence that homeopathy offered clinical benefit [7].
Proponents trumpet the few "positive" studies as proof that "homeopathy works." Even if their results can be consistently reproduced (which seems unlikely), the most that the study of a single remedy for a single disease could prove is that the remedy is effective against that disease. It would not validate homeopathy's basic theories or prove that homeopathic treatment is useful for other diseases.
Placebo effects can be powerful, of course, but the potential benefit of relieving symptoms with placebos should be weighed against the harm that can result from relying upon -- and wasting money on -- ineffective products. Spontaneous remission is also a factor in homeopathy's popularity. I believe that most people who credit a homeopathic product for their recovery would have fared equally well without it.
Homeopaths are working hard to have their services covered under national health insurance. They claim to provide care that is safer, gentler, "natural," and less expensive than conventional care -- and more concerned with prevention. However, homeopathic treatments prevent nothing, and many homeopathic leaders preach against immunization. Equally bad, a report on the National Center for Homeopathy's 1997 Conference described how a homeopathic physician had suggested using homeopathic products to help prevent and treat coronary artery disease. According to the article, the speaker recommended various 30C and 200C products as alternatives to aspirin or cholesterol-lowering drugs, both of which are proven to reduce the incidence of heart attacks and strokes [8].Illegal Marketing
In a survey conducted in 1982, the FDA found some over-the-counter products being marketed for serious illnesses, including heart disease, kidney disorders, and cancer. An extract of tarantula was being purveyed for multiple sclerosis; an extract of cobra venom for cancer.
During 1988, the FDA took action against companies marketing "diet patches" with false claims that they could suppress appetite. The largest such company, Meditrend International, of San Diego, instructed users to place 1 or 2 drops of a "homeopathic appetite control solution" on a patch and wear it all day affixed to an "acupuncture point" on the wrist to "bioelectrically" suppress the appetite control center of the brain.
America's most blatant homeopathic marketer appears to be Biological Homeopathic Industries (BHI) of Albuquerque, New Mexico, which, in 1983, sent a 123-page catalog to 200,000 physicians nationwide. Its products included BHI Anticancer Stimulating, BHI Antivirus, BHI Stroke, and 50 other types of tablets claimed to be effective against serious diseases. In 1984, the FDA forced BHI to stop distributing several of the products and to tone down its claims for others. However, BHI has continued to make illegal claims. Its 1991 Physicians' Reference ("for use only by health care professionals") inappropriately recommended products for heart failure, syphilis, kidney failure, blurred vision, and many other serious conditions. The company's publishing arm issues the quarterly Biological Therapy: Journal of Natural Medicine, which regularly contains articles whose authors make questionable claims. An article in the April 1992 issue, for example, listed "indications" for using BHI and Heel products (distributed by BHI) for more than fifty conditions-including cancer, angina pectoris, and paralysis. And the October 1993 issue, devoted to the homeopathic treatment of children, includes an article recommending products for acute bacterial infections of the ear and tonsils. The article is described as selections from Heel seminars given in several cities by a Nevada homeopath who also served as medical editor of Biological Therapy. In 1993, Heel published a 500-page hardcover book describing how to use its products to treat about 450 conditions [9]. Twelve pages of the book cover "Neoplasia and neoplastic phases of disease." (Neoplasm is a medical term for tumor.) In March 1998, during an osteopathic convention in Las Vegas, Nevada, a Heel exhibitor distributed copies of the book when asked for detailed information on how to use Heel products. A 2000 edition is larger but does not have the neoplasia section [10].
Between October 1993 and September 1994, the FDA issued warning letters to four homeopathic manufacturers:
BHI was ordered to stop making claims that BHI Cold, which contained sulfur and pulsatilla, were effective against mumps, whooping cough, chronic respiratory diseases, herpes zoster, all viral infections, and measles. In addition, when combined with other BHI remedies, it had been illegally claimed to be effective against otitis, pleurisy, bronchitis or pneumonia, conjunctivitis, and tracheitis.
Botanical Laboratories, Inc., which distributed Natra-Bio products, was ordered to stop claiming that BioAllers was a homeopathic remedy for reliving symptoms of allergy due to pollen, animal hair, dander, mold, yeast, and dust. The products were promoted as homeopathic even though some ingredients were not in the Homeopathic Pharmacopeia.
L.B.L.-Bot.Bio.Hom.Corp, of Roosevelt, New York, was ordered to stop making false claims that products could prevent AIDS, reduce cholesterol, cure diabetes and other pancreas disorders, and cancerous blood disorders.
Nutrition Express, of Houston, Texas, was warned that products it was marketing for the temporary relief of infection, minor liver disorders, lymphatic disorders, and menstrual discomforts were misbranded because their labels or labeling included statements that represented that the products were intended to be used for curing or preventing disease. Greater Regulation Is Needed
As far as I can tell, the FDA has never recognized any homeopathic remedy as safe and effecative for any medical purpose. In 1995, I filed a Freedom of Information Act request that stated:
I am interested in learning whether the FDA has: (1) received evidence that any homeopathic remedy, now marketed in this country, is effective against any disease or health problem; (2) concluded that any homeopathic product now marketed in the United States is effective against any health problem or condition; (3) concluded that homeopathic remedies are generally effective; or (4) concluded that homeopathic remedies are generally not effective. Please send me copies of all documents in your possession that pertain to these questions [10].
An official from the FDA Center for Drug Evaluation and Research replied that several dozen homeopathic products were approved many years ago, but these approvals were withdrawn by 1970 [12]. In other words, after 1970, no homeopathic remedy had FDA as "safe and effective" for its intended purpose. As far as I can tell, that statement is still true today.
If the FDA required homeopathic remedies to be proven effective in order to remain marketable -- the standard it applies to other categories of drugs -- homeopathy would face extinction in the United States [13]. However, there is no indication that the agency is considering this. FDA officials regard homeopathy as relatively benign (compared, for example, to unsubstantiated products marketed for cancer and AIDS) and believe that other problems should get enforcement priority. If the FDA attacks homeopathy too vigorously, its proponents might even persuade a lobby-susceptible Congress to rescue them. Regardless of this risk, the FDA should not permit worthless products to be marketed with claims that they are effective. Nor should it continue to tolerate the presence of quack "electrodiagnostic" devices in the marketplace.
In 1994, forty-two prominent critics of quackery and pseudoscience asked the agency to curb the sale of homeopathic products. The petition urges the FDA to initiate a rulemaking procedure to require that all over-the-counter (OTC) homeopathic drugs meet the same standards of safety and effectiveness as nonhomeopathic OTC drugs. It also asks for a public warning that although the FDA has permitted homeopathic remedies to be sold, it does not recognize them as effective. The FDA has not yet responded to the petition. However, on March 3, 1998, at a symposium sponsored by Good Housekeeping magazine, former FDA Commissioner David A. Kessler, M.D., J.D., acknowledged that homeopathic remedies do not work but that he did not attempt to ban them because he felt that Congress would not support a ban [14].
Note: We are interested in filing consumer-protection suits against homeopathic sellers. If you have purchased a homeopathic product within the past year and concluded that the product did not work as represented on packaging or in any advertisement, please contact us.
References
Kaufman M. Homeopathy in America. Baltimore, 1971, The Johns Hopkins University Press.
Hill C, Doyon F. Review of randomized trials of homeopathy. Review of Epidemiology 38:139-142, 1990.
Jacob J and others. Treatment of childhood diarrhea with homeopathic medicine: a randomized clinical trial in Nicaragua. Pediatrics 93:719-725, 1994.
Sampson W, London W. Analysis of homeopathic treatment of childhood diarrhea. Pediatrics 96:961-964, 1995.
Homoeopathic Medicine Research Group. Report. Commission of the European Communities, December 1996.
NCAHF Position Paper on Homeopathy. Loma Linda, CA.: National Council Against Health Fraud, 1994.
Wise, J. Health authority stops buying homoeopathy. British Medical Journal 314:1574, 1997.
Hauck KG. Homeopathy and coronary artery disease. Homeopathy Today 17(8):3, 1997.
Biotherapeutic Index. Baden-Baden, Germany: Biologishe Heilmittel Heel GmbH, 1993.
Biotherapeutic Index, 5th revised English edition. Baden-Baden, Germany: Biologische Heilmittel GmbH, 2000.
Barrett S. Letter to FDA Office of Freedom of Information, Feb 7, 1995.
Davis H. Letter to Stephen Barrett, M.D., April 24, 1995.
Pinco RG. Status of homeopathy in the United States: Important ominous developments. Memo to Williard Eldredge, president, American Association of Homeopathic Pharmacists, Jan 17, 1985.
Kessler DA. Panel discussion on herbal dietary supplements. Consumer Safety Symposium on Dietary Supplements and Herbs, New York City, March 3, 1998. Related Topics
Quack "Electrodiagnostic" Devices Used for Selecting Remedies
FDA Compliance Policy Guide 7132.15 for Homeopathic Products
Homoeopathy and Its Kindred Delusions (Essay by Oliver Wendell Holmes, 1842)
Homeopathy and Science: A Closer Look
Petition to Ban the Marketing of Homeopathic Products
Why Extraordinary Claims Require Extraordinary Proof
Alternative Medicine and the Laws of Physics
Samuel Hahnemann's Book: Organon of Medicine
The Scientific Evaluation of Homeopathy (includes research summary)
Hahnemann's Homeopathy (Five articles debunking homeopathic theory and practice)
Reader Responses
From a Californian who runs seminars teaching people "how
to reduce stress by finding their natural breathing pattern":
I am very open minded. I would use drugs, surgery whatever it takes . . . but I feel homeopathy has value and the word "fake" is counterproductive and judgemental. I feel you have not researched the many scholars around the globe that are researching the quantum biological perspective. A few key biophysicists are gaining knowledge that there are subatomic fields that interpenetrate and structure the molecular level. These fields can directly relate to how homeopathy works. YOU DO NOT NEED ANY MOLECULES OF THE SUBSTANCE IN THE REMEDY TO AFFECT THESE UNDERLYING FIELDS. A SUBATOMIC WAVE FIELD THAT IS CARRYED BY THE WATER OR SUGAR IN THE REMEDY IS INTERACTING WITH THE SUBATOMIC FIELDS UNDERLYING THE PHYSICAL MATTER OF THE PATIENT. The problem is our limited technology can only measure a limited band of the energy spectrum. WE ARE NOT THAT ADVANCED AS A CIVILISATION. JUST WATCH THE NEWS.
From an unidentified homeopathic enthusiast:
Homeopathy works and you simply are too narrow-minded to understand that this world is made up of more than the mere physical and chemical natures. You overlook the spiritual and the energetic. You are the quack
From a retired criminal investigator:
Homeopathic practices tend to be from the biblical roots of good natural medicine. There are millions that will fight any intrusion on homeopathy and its tenets. God have mercy on the persecutors.
From another homeopathic enthusiast:
What a sad sorry piece of shit masquerading as science your article is. Which drug company are you a front for? Do you know how many people die each year as a result of prescribed "scientifically validated" drugs? How many people do you murder (sorry treat) each week? How it must irk you that homeopathy is making a huge resurgence worldwide and safely treating iatrogenic and "incurable" diseases. We must start a web site to encourage people to sue doctors and drug companies for harmful side effects, lying and murder. It will be a huge counter punch to established medical quackery.
P.S. Oh I nearly forgot -- FUCK YOU!!!!
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This page was revised on August 26, 2001.
Homeopathy: The Ultimate Fake
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Homeopathy: The Ultimate Fake
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ABC news John Stossel homeopathy million dollar test
by guest » Sat Jan 31, 2004 5:56 am
http://www.abcnews.go.com/sections/2020 ... 130-1.html
Homeopathy
Can Water Really Remember?
Commentary
By John Stossel
ABC news
Jan. 30 — Americans are spending hundreds of millions of dollars a year on homeopathic remedies believed to relieve the flu, colds, allergies and more, but the effectiveness of many remains debatable.
Lots of people believe in the products. Cher says she used homeopathy. So have Martina Navratilova and actress Jane Seymour (aka "Dr. Quinn, Medicine Woman"). The queen of England has her own homeopathic doctor.
In support of homeopathy, there are clinical studies that have found some of the medicines can help people with various conditions, such as the flu.
"There is a body of evidence to show that homeopathy is effective," author Dana Ullman told ABCNEWS. He's homeopathy's foremost spokesman and has written seven books on the subject.
But I'm skeptical. There are also clinical studies that have found many homeopathic products don't work. In fact, the National Institutes of Health says a number of its key concepts "do not follow the laws of science (particularly chemistry and physics)."
"You can choose to call us suckers," said Ullman. "But we have experience which suggests otherwise."
How It Works
Homeopathic researchers look for substances in nature that mimic the various symptoms of a sick person. It's similar to the theory behind vaccinations. You're given a little bit of the disease to keep you from getting sick. In homeopathy, if you're allergic to cats, they may give you a tiny bit of cat hair that they claim will alleviate your sneezing and itchy eyes.
But many homeopathic products are diluted to such absurd degrees that it defies science and common sense.
"We do this process of serial dilution," explained Ullman. "Diluting it and shaking it, diluting it and shaking it. Diluting and shaking."
To understand the proportions, one drop of medicine in 99 drops of water is referred to as 1 C. Then often, homeopaths just keep diluting it. At 6 C the amount is like one drop of medicine in 50 swimming pools. Taken further, 12 C is like one drop in the entire Atlantic Ocean.
The theory claims the more the medicine is diluted, the stronger it becomes. "Not only does the medicine get stronger, but we need less doses of the medicines," said Ullman.And how far do they go? The Food and Drug Administration says some of these things have no molecules of the medicine left. Ullman says that's true, but maintains even when the molecules are gone their message remains. "The water gets impregnated with the information or memory of the original substance," said Ullman, who asserts the water remembers the information."It's nonsense. Total nonsense. It's mythology," said James Randi, a former magician known as the "Amazing Randi," who now runs a foundation that specializes in debunking what he calls pseudo science."Dilution is a term that they don't know the meaning of," said Randi. He said the process leaves them with "water." "If homeopathy can be shown to work, [I'll give you] a million dollars," said Randi. His foundation offers that sum to anyone who can demonstrate any paranormal or supernatural phenomenon works. He says that includes homeopathy. Putting Homeopathic Dilution to the TestTo take the challenge, we checked with Ullman, who described a scientific process for testing the effectiveness of homeopathy. "One way to test it is by using different homeopathic doses of histamine and seeing its effects on a type of white blood cells," said Ullman."Homeopathic doses of histamine would have a dramatic effect upon the white blood cells — these basophils," said Ullman. "And they would decrease in number." So we set it up, in Europe, where similar published tests claimed to find that kind of effect. Scientists at Guy's Hospital in London prepared samples of the type of histamines that Ullman said would relieve allergy symptoms.
They tested them at the kind of ultra-diluted levels that many homeopathic products use, and that Ullman himself recommended. Would the histamines affect the basophils more than plain water? They'd test 400 samples and see. And if it was shown to work, Randi would cough up a million bucks."You want it personally or should I send it to a relative?" Randi asked. We offered to give it to a charity.And the Results Are …The test took a week. Three homeopaths were there to make sure the dilutions were done properly.When the results came in, the homeopathic preparations had no demonstrable effect. "[There's] no evidence at all that there's any difference between the tubes that started up with histamine and the tubes that started up with water," said Professor J. Martin Bland. "Mr. Stossel can kiss his million dollars goodbye." The results were no surprise to James Randi. In fact, before the test, he predicted the homeopaths would make excuses if the test failed. Dana Ullman tried to get the test called off before it even began, saying it was not an exact replica of earlier tests. He later complained the test wasn't designed or conducted properly. We then consulted leading university scientists who reviewed the test protocols and said they were "technically sound" and "meticulously conducted."Ullman said our one test proves nothing, but I doubt any test would discourage the enthusiastic believers."I recognize that the nano-doses, these extremely small doses that we use at homeopathy at first blush may not make sense," said Ullman. "Well there may not be any molecular dose, but somehow the water does change." The water remembers? Give me a break.
Homeopathy
Can Water Really Remember?
Commentary
By John Stossel
ABC news
Jan. 30 — Americans are spending hundreds of millions of dollars a year on homeopathic remedies believed to relieve the flu, colds, allergies and more, but the effectiveness of many remains debatable.
Lots of people believe in the products. Cher says she used homeopathy. So have Martina Navratilova and actress Jane Seymour (aka "Dr. Quinn, Medicine Woman"). The queen of England has her own homeopathic doctor.
In support of homeopathy, there are clinical studies that have found some of the medicines can help people with various conditions, such as the flu.
"There is a body of evidence to show that homeopathy is effective," author Dana Ullman told ABCNEWS. He's homeopathy's foremost spokesman and has written seven books on the subject.
But I'm skeptical. There are also clinical studies that have found many homeopathic products don't work. In fact, the National Institutes of Health says a number of its key concepts "do not follow the laws of science (particularly chemistry and physics)."
"You can choose to call us suckers," said Ullman. "But we have experience which suggests otherwise."
How It Works
Homeopathic researchers look for substances in nature that mimic the various symptoms of a sick person. It's similar to the theory behind vaccinations. You're given a little bit of the disease to keep you from getting sick. In homeopathy, if you're allergic to cats, they may give you a tiny bit of cat hair that they claim will alleviate your sneezing and itchy eyes.
But many homeopathic products are diluted to such absurd degrees that it defies science and common sense.
"We do this process of serial dilution," explained Ullman. "Diluting it and shaking it, diluting it and shaking it. Diluting and shaking."
To understand the proportions, one drop of medicine in 99 drops of water is referred to as 1 C. Then often, homeopaths just keep diluting it. At 6 C the amount is like one drop of medicine in 50 swimming pools. Taken further, 12 C is like one drop in the entire Atlantic Ocean.
The theory claims the more the medicine is diluted, the stronger it becomes. "Not only does the medicine get stronger, but we need less doses of the medicines," said Ullman.And how far do they go? The Food and Drug Administration says some of these things have no molecules of the medicine left. Ullman says that's true, but maintains even when the molecules are gone their message remains. "The water gets impregnated with the information or memory of the original substance," said Ullman, who asserts the water remembers the information."It's nonsense. Total nonsense. It's mythology," said James Randi, a former magician known as the "Amazing Randi," who now runs a foundation that specializes in debunking what he calls pseudo science."Dilution is a term that they don't know the meaning of," said Randi. He said the process leaves them with "water." "If homeopathy can be shown to work, [I'll give you] a million dollars," said Randi. His foundation offers that sum to anyone who can demonstrate any paranormal or supernatural phenomenon works. He says that includes homeopathy. Putting Homeopathic Dilution to the TestTo take the challenge, we checked with Ullman, who described a scientific process for testing the effectiveness of homeopathy. "One way to test it is by using different homeopathic doses of histamine and seeing its effects on a type of white blood cells," said Ullman."Homeopathic doses of histamine would have a dramatic effect upon the white blood cells — these basophils," said Ullman. "And they would decrease in number." So we set it up, in Europe, where similar published tests claimed to find that kind of effect. Scientists at Guy's Hospital in London prepared samples of the type of histamines that Ullman said would relieve allergy symptoms.
They tested them at the kind of ultra-diluted levels that many homeopathic products use, and that Ullman himself recommended. Would the histamines affect the basophils more than plain water? They'd test 400 samples and see. And if it was shown to work, Randi would cough up a million bucks."You want it personally or should I send it to a relative?" Randi asked. We offered to give it to a charity.And the Results Are …The test took a week. Three homeopaths were there to make sure the dilutions were done properly.When the results came in, the homeopathic preparations had no demonstrable effect. "[There's] no evidence at all that there's any difference between the tubes that started up with histamine and the tubes that started up with water," said Professor J. Martin Bland. "Mr. Stossel can kiss his million dollars goodbye." The results were no surprise to James Randi. In fact, before the test, he predicted the homeopaths would make excuses if the test failed. Dana Ullman tried to get the test called off before it even began, saying it was not an exact replica of earlier tests. He later complained the test wasn't designed or conducted properly. We then consulted leading university scientists who reviewed the test protocols and said they were "technically sound" and "meticulously conducted."Ullman said our one test proves nothing, but I doubt any test would discourage the enthusiastic believers."I recognize that the nano-doses, these extremely small doses that we use at homeopathy at first blush may not make sense," said Ullman. "Well there may not be any molecular dose, but somehow the water does change." The water remembers? Give me a break.
- guest
Treatment methods: traditional and alternative
by guest » Wed Mar 17, 2004 10:48 am
1: Tijdschr Diergeneeskd. 1984 Jan 1;109(1):25-34. Related Articles, Links
[Treatment methods: traditional and alternative]
[Article in Dutch]
Rijnberk A.
When choosing a mode of treatment the clinician should consider the basis upon which effectiveness may be expected: (1) unproven clinical experience, (2) rationale based etiology/pathogenesis, or (3) controlled therapeutic experiments. Many therapies are still based on unproven clinical experience, which may be fallacious because of: (1) insufficient insight into the natural course of the condition, (2) statistical variation, (3) placebo effects and (4) the prejudice or bias of the clinician. Against this background the so-called alternative modes of treatment are discussed with special attention to acupuncture and homeopathy. The literature supports the conclusion that from a scientific point of view there is no place for these modes of treatment in (veterinary) medicine. Suggested explanations for the growth of alternative modes of treatment include the changing relation between veterinarians and patients/clients, the shortcomings and limitations of veterinary medicine, and increased interest in what is happening outside the regular culture pattern. Finally, it is proposed that what sets the art of (veterinary) medicine above ordinary (veterinary) medicine is that which can be achieved by good intellectual and emotional contacts between the veterinarian and the patient/client rather than by false therapies.
PMID: 6691194 [PubMed - indexed for MEDLINE]
[Treatment methods: traditional and alternative]
[Article in Dutch]
Rijnberk A.
When choosing a mode of treatment the clinician should consider the basis upon which effectiveness may be expected: (1) unproven clinical experience, (2) rationale based etiology/pathogenesis, or (3) controlled therapeutic experiments. Many therapies are still based on unproven clinical experience, which may be fallacious because of: (1) insufficient insight into the natural course of the condition, (2) statistical variation, (3) placebo effects and (4) the prejudice or bias of the clinician. Against this background the so-called alternative modes of treatment are discussed with special attention to acupuncture and homeopathy. The literature supports the conclusion that from a scientific point of view there is no place for these modes of treatment in (veterinary) medicine. Suggested explanations for the growth of alternative modes of treatment include the changing relation between veterinarians and patients/clients, the shortcomings and limitations of veterinary medicine, and increased interest in what is happening outside the regular culture pattern. Finally, it is proposed that what sets the art of (veterinary) medicine above ordinary (veterinary) medicine is that which can be achieved by good intellectual and emotional contacts between the veterinarian and the patient/client rather than by false therapies.
PMID: 6691194 [PubMed - indexed for MEDLINE]
- guest
Can homeopathy withstand scientific testing?
by guest » Tue Dec 07, 2004 9:48 am
Can homeopathy withstand scientific testing?
F.J. van Sluijs
Introduction
What is the importance of homeopathy in veterinary practice? The television appearance of E.L. Ellinger (DVM) during the Foot and Mouth (FMD) crisis in 2001 gave an insight into the views held by veterinarians practicing homeopathy. And we can be confident these views were representative because Ellinger is not just anybody; she is an active member of the Group of Homeopathic-practicing Veterinarians of the Royal Dutch Veterinary Society, the Dutch representative for the International Association for Veterinary Homeopathy (IAVH) and, in 2001, she was a guest lecturer at the Faculty of Veterinary Medicine in Utrecht (1) .
It was 4 April 2001 when she was interviewed on the RTL5 television programme '5 in het land'. The FMD crisis was at its peak and there was considerable debate about whether the large-scale slaughter of animals could be prevented by vaccinating those that were susceptible in risk areas. Despite widespread support among Dutch people for this approach, it would have had a devastating effect on the meat export industry and was therefore not an option. Ellinger, however, was offering an alternative: she had prepared a homeopathic remedy that would protect against FMD without the production of antibodies, thus allowing exports to continue. Although she advised this 'homeopathic protection' be given to all animals within a 15 km radius of contaminated areas, her suggestion was not taken up, undoubtedly because of the complete lack of evidence that her remedy protected against FMD.
There are other areas of veterinary medicine in which homeopathy is applied as though it were an accepted form of treatment. But what are the arguments for supporting this? Is there evidence that homeopathy really does work in these cases? To answer these questions, we must first consider the background of homeopathy as well as the commonly accepted methods of argumentation in medical science in general.
Scientific testing of homeopathy
To answer the question whether there is scientific proof that homeopathy is effective, both the basic principles of homeopathy and the practical application of these principles in veterinary practice need to be tested. The principles of homeopathy comprise two elements: the similia principle (similia similibus curentur) and potentiation. For the practical application of the similia principle, the so-called 'drug picture' is essential. This consists of a medical impression based on observations made of a patient that can then be compared, according to scientific norms, with comparable observations in a control group. This point is discussed below.
Potentiation, the second principle of homeopathy, involves the stepwise dilution of the active ingredient in an excess of solvent. According to homeopathy, this increases the curative power of the material. According to science, by contrast, such an extreme degree of dilution is reached that no molecules of the original material remain and thus the solution cannot be effective (2) . Scientific investigation can be used to show whether such a dilute solution brings about effects other than those of the diluent alone and will be discussed later.
The application of the principles in veterinary practice is a subject particularly suitable for testing. Those veterinarians practicing homeopathy do not differ from their 'regular' colleagues as much as one might expect: they, too, make a diagnosis, apply treatment based on their diagnosis and claim the patient is thereby cured. The presence or absence of treatment thus furnishes a measurable difference. I will return to this, but first would like to discuss the basic principles of homeopathy.
The drug picture
Drug pictures form the basis of homeopathy. They are set down in thick tomes, of which the Materia Medica of Hahnemann and the Materia Medica of Kent are the best known, though there are others, such as Clarke's three volume Dictionary of Practical Materia Medica, the Complete Materia Medica of Boericke and Pathak and Tyler's Homeopathic Drug Pictures. The drug pictures described in these books are based on 'provings', but how is a proving derived? In the Materia Medica, Hahnemann gave an example in which he, his family and friends consumed more than 100 substances and carefully recorded the effects they observed (3) . Their descriptions are very detailed, such as 'wanting a snack', 'needing to use more tobacco than usual', 'a child's wish to be picked up by the mother' and 'amorous dreams'. However, we should remember Hahnemann lived in another era, when the romantic was at its high point and Goethe wrote about the suffering of the young Werther. However it is presented, the drug picture remains a collection of observations that can be tested scientifically. But how, with our present knowledge of statistics, should this be done? The observations that form the drug picture must satisfy three criteria: they must be 1) measurable, 2) reproducible, and 3) not based on chance. But, if we apply these criteria to the drug pictures, not much remains standing. Many of the described symptoms are subjective and cannot be quantified; exactly how much more is an increased need for tobacco? The reproducibility of the observations is also indeterminable. Furthermore, it will always remain uncertain whether these subjective observations can be extrapolated to animals. But it is statistical testing with regard to 'chance' that shows the weakest point in the drug picture. It should be remembered, of course, that in Hahnemann's time no one had heard of double-blind controlled studies, but the situation is different now. To determine whether an observed effect is 'real' or the result of chance, a statistical test is applied and the result is generally specified with regard to its 'significance'. A significant abnormality means that the probability the observed effect is based on chance is smaller than a predetermined limit. This is also called the alpha value and is generally set at 5%. But before the significance can be calculated, we must be certain that we have made sufficient observations to confirm a significant effect. The number of observations required depends on the value of the variable to be measured and on the magnitude of the expected deviation. The greater the value of the variable and the greater the difference between the experimental group (receiving the drug in question) and the control group (receiving the placebo), the smaller the number of observations required. But I can tell you from personal experience that within the accepted margins large groups of patients are usually necessary. The margin is known as the beta value and is usually set at 20%. It indicates the probability that an effect will actually be found, assuming that there is one. If the predetermined alpha and beta criteria are not met, no effect whatever is observed. And that is the situation that applies at present to the drug pictures.
Potentiation
Potentiation of the substance to be used in a homeopathic treatment is carried out by serial dilution combined with vigorous shaking. The dilution is usually taken to such an extreme that the chance there are any molecules of the original material still present in the solvent at the end of the procedure is nil. According to scientific veterinary medicine, no effect whatever can then be expected, but homeopathy assumes that during potentiation spiritual healing power of the original material is transferred to the solvent. This effect is even supposed to increase in proportion to the increasing dilution. The notion that something that is no longer present can still exert an effect is at odds with the concepts of the natural sciences. Hence science demands cast iron evidence for this claim, or as James Randi expressed it: 'unusual claims require unusually good proof'. In 1988, it seemed that something might even come of this. The renowned French asthma researcher Jacques Benveniste submitted an extraordinary manuscript to the journal 'Nature', describing an experiment of his in which basophile granulocytes responded to a homeopathic dilution of an allergen. He attributed this to the transfer of a property of the allergen to the solvent and named this 'the memory of water'. Nature's chief editor, John Maddox, did not believe in this but realised the manuscript could unleash a scientific revolution. He accepted the article but with a precondition: identical results had to be attained when the experiment was repeated in Benveniste's laboratory under the observation of a delegation drawn up by Maddox. Benveniste accepted the challenge. The group of observers that came to his lab had an unexpected composition, however. In addition to Maddox himself, the team consisted of Walter Stewart (a respected investigator and adversary of scientific fraud) and James Randi, a 'professional magician' better known as the 'The Amazing Randi'. Maddox's choice of Randi caused some amazement, but he had built up a reputation for exposing those claiming to have paranormal gifts. His role in the team was to ensure that the blinding of the experiment was not violated before all the measurements were carried out. For this purpose he had the windows of the laboratory blacked out with newspaper and the code of the test and control tubes placed in a sealed envelope taped to the ceiling. When the experiment was repeated the activation of basophile granulocytes in tubes treated with 'homeopathic diluted antigen' did not differ from that in the control tubes, which were only treated with the solvent. Later it became clear that the laboratory technicians in the original experiment knew which tubes were treated with 'homeopathic allergen' so that in the interpretation of the results they had let themselves be led astray by their belief in the outcome.
The publication of the results of this repetition of Benveniste's experiment in Nature spelled the end of his reputation as a respected investigator. But Randi went a step further: he offered a reward of one million dollars for anyone providing experimental evidence that homeopathy works. The English science television programme Horizon took up the challenge and gathered a team of investigators to repeat, under controlled conditions, an experiment previously performed by Dr. Madeleine Ennis. The experiment strongly resembled that of Benveniste, but this time the basophile granulocytes were stimulated with homeopathic diluted histamine in place of an allergen. The control was in the hands of two persons: James Randi and Professor John Enderby, vice-president of the Royal Society. Again pains were taken for very stringent blinding of the experiment. When the codes were broken at the end of the experiment, no difference was found between the effects of the homeopathic diluted histamine and the solvent. Once again the evidence for 'the memory of water' was negated. The reward put up by Randi is still on offer, but no new candidates have applied.
Efficacy
There are various ways in which the working or effect of a treatment can be tested: 1) the opinion of experts, 2) retrospective clinical research, 3) prospective randomised double-blind clinical research, and 4) meta-analysis of clinical research. The first method has little evidential value. It is sometimes claimed that the so-called consensus meeting of specialists mainly serves to confirm that about which they disagree. Retrospective clinical research was much used in the past but it is no longer accepted by any scientific journal. Prospective randomised double-blind clinical research is now considered to be the golden standard. But it can also be coloured by such factors as ethnic or cultural differences or an invalid analysis of the results. It can also happen that the results of studies with comparable objectives and design do not agree. In order that the findings can still be interpreted, the investigations are compared in a meta-analysis. It is especially the methodological aspects of the different investigations that are critically analyzed in this analysis. If we wish to draw conclusions about the effectiveness of homeopathy, it is especially the last of these approaches that is important. By now a great deal of clinical research has already been carried out on the effectiveness of homeopathy and this research has been carefully analyzed in several meta-analyses, although they only concern homeopathy in humans and not in animals. The results of these meta-analyses are summarised below.
Jos Kleijnen from Maastricht published the first meta-analysis of clinical research on the effects of homeopathy in 1991. The research concerned 96 publications in which 107 clinical investigations were described. Kleijnen and co-workers concluded that there were indeed indications that homeopathy works, but 'At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias' [4]. By 'publication bias' the author meant that research in which an effect was shown was more likely to be published than that in which no effect was observed. This distorts the picture in favour of an effect. An important technical shortcoming was that the patients were not asked which group they thought they had been placed in. This control of the blinding was not applied in any of the analyzed studies, while the breaking of the code by the patient is sufficient to explain the small positive effects in favour of homeopathy [1].
There was little further interest in this topic until in 1996 the Geneesmiddelenbulletin (Dutch bulletin of drugs and therapeutics) gave attention to homeopathy. The study of van Kleijnen was discussed and extended with a meta-analysis of 11 clinical studies, which 'more or less' fulfilled the criteria for prospective randomized clinical research. The Geneesmiddelenbulletin concluded that 'not one homeopathic remedy has been shown to have a specific effect in double-blind randomized and placebo-controlled research' [2].
In 1997, Klaus Linde (an epidemiologist sympathetic to homeopathy) published a meta-analysis of 98 clinical studies in the Lancet [3]. At first glance his conclusion appears favourable to homeopathy: 'The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo', but Linde immediately qualified this by remarking: 'However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition'. Linde continued working and a year later published a second meta-analysis of 32 clinical studies of homeopathy [4]. The conclusion of this analysis closely resembled that in 1997: 'The results of the available randomized trials suggest that individualized homeopathy has an effect over placebo'. Once again the conclusion was immediately qualified, because methodological shortcomings put a spoke in the wheel: 'The evidence, however, is not convincing because of methodological shortcomings and inconsistencies. When the analysis was restricted to methodologically best trials no significant effect was seen'. Because technical aspects of experiments evidently have a great influence on the results of clinical research in homeopathy, Linde directed his attention especially to this point. In 1999 he published a study of the effects of the quality of clinical research in homeopathy on the results [5]. As the starting point he used the same 89 publications that he had analyzed in the Lancet in 1997. He applied three techniques to these investigations: 1) analysis of the components, 2) a minimum score analysis, and 3) a cumulative meta-analysis. For the component analysis, two groups of investigations were compared with regard to a single criterion (e.g. whether or nor there was an explicit statement about randomization, whether or not there was double-blinding, whether or not there was a complete follow-up). For the minimum score analysis, points were awarded to each investigation on the basis of methodological aspects. Then a limiting value was determined and investigations scoring above and below this were compared with each other. In the cumulative meta-analysis, the individual investigations were added stepwise on the basis of the previously applied quality score. Linde's investigation revealed that especially double-blinding and randomization influenced the results of the examined publications: 'Studies that were explicitly randomized and were double-blind [...] yielded significantly less positive results than studies not meeting the criteria'. In addition, Linde pointed out the previously mentioned publication bias. These observations led him to qualify the conclusions he had made in 1997: 'The evidence of bias weakens our original meta-analysis [from 1997], which overestimated the effects of homeopathic treatments'.
The most recent meta-analysis dates from 2002 and was published by Ezard Ernst, who works in the Department of Complementary Medicine at the University of Exeter in England. Ernst's examination was concerned not with individual investigations but rather with 17 meta-analyses of the effectiveness of homeopathy [6]. Six of these 17 articles were repeat analyses of frequently cited meta-analyses; the other 11 were described as independent systematic analyses. Ernst concluded: 'There was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. [...] There was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo'.
In summary, it can be concluded that there has been a great deal of research on the effectiveness of homeopathy. Much of this research is methodologically weak and justifies no conclusion about the effectiveness of homeopathy. But there has also been good research, from which it is apparent that the effect of homeopathy is no greater than that of placebo.
Conclusion
The test of science is hard and merciless. Many conditions must be satisfied in order to demonstrate therapeutic effectiveness. The golden standard is the prospective randomized double-blind clinical trial. For medicine this is a formidable enough challenge; for homeopathy it appears to be insurmountable. After seven years of investigation costing more than $100 million per year [7], there is still no evidence whatever that extremely diluted solutions of homeopathic substances have any effect. The actual existence of drug pictures has not been confirmed and the application of homeopathic therapy has no more effect than a placebo. With regard to the title of this article, there is but one possible conclusion: homeopathy has not withstood the test of science.
Source: This article was originally published in Tijdschrift voor Diergeneeskunde (129, 259-298).
The author presented the paper on 12 January 2004 at the invitation of the Executive Board of the Royal Dutch Veterinary Society during discussions of the continuation of the group 'Homeopathic-practicing Veterinarians' within the Society.
English translation: B.E. Belshaw
References
1. Kleijen, J., Knipschild, P. and Ter Riet, G. (1991) Clinical trials of homeopathy. Brit. Med. J. 302, 316-323.
2. Geneesmiddelenbulletin (1996) 30, 26-32.
3. Linde, K., Clausius, N., Ramirez, G., Melchart, D., Eitel, F., Hedges, L.V. and Jonas, W.B. (1997) Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled clinical trials. Lancet 350, 834-843.
4. Linde, K. and Melchart, D. (1998) Randomized controlled trials of individualized homeopathy: a state-of-the-art review. J. Altern. Complement Med. 4, 371-388.
5. Linde, K., Scholz, M., Ramirez, G., Clausius, N., Melchart, D., Jonas, W.B. (1999) Impact of study quality on outcome in placebo-controlled trials of homeopathy. J. Clin. Epidemiol. 52, 631-636.
6. Ernst, E. (2002) A systematic review of systematic reviews of homeopathy. Br. J. Clin. Pharmacol. 54, 577-582.
7. National Council for Alternative and Complementary Medicine (USA).
F.J. van Sluijs
Introduction
What is the importance of homeopathy in veterinary practice? The television appearance of E.L. Ellinger (DVM) during the Foot and Mouth (FMD) crisis in 2001 gave an insight into the views held by veterinarians practicing homeopathy. And we can be confident these views were representative because Ellinger is not just anybody; she is an active member of the Group of Homeopathic-practicing Veterinarians of the Royal Dutch Veterinary Society, the Dutch representative for the International Association for Veterinary Homeopathy (IAVH) and, in 2001, she was a guest lecturer at the Faculty of Veterinary Medicine in Utrecht (1) .
It was 4 April 2001 when she was interviewed on the RTL5 television programme '5 in het land'. The FMD crisis was at its peak and there was considerable debate about whether the large-scale slaughter of animals could be prevented by vaccinating those that were susceptible in risk areas. Despite widespread support among Dutch people for this approach, it would have had a devastating effect on the meat export industry and was therefore not an option. Ellinger, however, was offering an alternative: she had prepared a homeopathic remedy that would protect against FMD without the production of antibodies, thus allowing exports to continue. Although she advised this 'homeopathic protection' be given to all animals within a 15 km radius of contaminated areas, her suggestion was not taken up, undoubtedly because of the complete lack of evidence that her remedy protected against FMD.
There are other areas of veterinary medicine in which homeopathy is applied as though it were an accepted form of treatment. But what are the arguments for supporting this? Is there evidence that homeopathy really does work in these cases? To answer these questions, we must first consider the background of homeopathy as well as the commonly accepted methods of argumentation in medical science in general.
Scientific testing of homeopathy
To answer the question whether there is scientific proof that homeopathy is effective, both the basic principles of homeopathy and the practical application of these principles in veterinary practice need to be tested. The principles of homeopathy comprise two elements: the similia principle (similia similibus curentur) and potentiation. For the practical application of the similia principle, the so-called 'drug picture' is essential. This consists of a medical impression based on observations made of a patient that can then be compared, according to scientific norms, with comparable observations in a control group. This point is discussed below.
Potentiation, the second principle of homeopathy, involves the stepwise dilution of the active ingredient in an excess of solvent. According to homeopathy, this increases the curative power of the material. According to science, by contrast, such an extreme degree of dilution is reached that no molecules of the original material remain and thus the solution cannot be effective (2) . Scientific investigation can be used to show whether such a dilute solution brings about effects other than those of the diluent alone and will be discussed later.
The application of the principles in veterinary practice is a subject particularly suitable for testing. Those veterinarians practicing homeopathy do not differ from their 'regular' colleagues as much as one might expect: they, too, make a diagnosis, apply treatment based on their diagnosis and claim the patient is thereby cured. The presence or absence of treatment thus furnishes a measurable difference. I will return to this, but first would like to discuss the basic principles of homeopathy.
The drug picture
Drug pictures form the basis of homeopathy. They are set down in thick tomes, of which the Materia Medica of Hahnemann and the Materia Medica of Kent are the best known, though there are others, such as Clarke's three volume Dictionary of Practical Materia Medica, the Complete Materia Medica of Boericke and Pathak and Tyler's Homeopathic Drug Pictures. The drug pictures described in these books are based on 'provings', but how is a proving derived? In the Materia Medica, Hahnemann gave an example in which he, his family and friends consumed more than 100 substances and carefully recorded the effects they observed (3) . Their descriptions are very detailed, such as 'wanting a snack', 'needing to use more tobacco than usual', 'a child's wish to be picked up by the mother' and 'amorous dreams'. However, we should remember Hahnemann lived in another era, when the romantic was at its high point and Goethe wrote about the suffering of the young Werther. However it is presented, the drug picture remains a collection of observations that can be tested scientifically. But how, with our present knowledge of statistics, should this be done? The observations that form the drug picture must satisfy three criteria: they must be 1) measurable, 2) reproducible, and 3) not based on chance. But, if we apply these criteria to the drug pictures, not much remains standing. Many of the described symptoms are subjective and cannot be quantified; exactly how much more is an increased need for tobacco? The reproducibility of the observations is also indeterminable. Furthermore, it will always remain uncertain whether these subjective observations can be extrapolated to animals. But it is statistical testing with regard to 'chance' that shows the weakest point in the drug picture. It should be remembered, of course, that in Hahnemann's time no one had heard of double-blind controlled studies, but the situation is different now. To determine whether an observed effect is 'real' or the result of chance, a statistical test is applied and the result is generally specified with regard to its 'significance'. A significant abnormality means that the probability the observed effect is based on chance is smaller than a predetermined limit. This is also called the alpha value and is generally set at 5%. But before the significance can be calculated, we must be certain that we have made sufficient observations to confirm a significant effect. The number of observations required depends on the value of the variable to be measured and on the magnitude of the expected deviation. The greater the value of the variable and the greater the difference between the experimental group (receiving the drug in question) and the control group (receiving the placebo), the smaller the number of observations required. But I can tell you from personal experience that within the accepted margins large groups of patients are usually necessary. The margin is known as the beta value and is usually set at 20%. It indicates the probability that an effect will actually be found, assuming that there is one. If the predetermined alpha and beta criteria are not met, no effect whatever is observed. And that is the situation that applies at present to the drug pictures.
Potentiation
Potentiation of the substance to be used in a homeopathic treatment is carried out by serial dilution combined with vigorous shaking. The dilution is usually taken to such an extreme that the chance there are any molecules of the original material still present in the solvent at the end of the procedure is nil. According to scientific veterinary medicine, no effect whatever can then be expected, but homeopathy assumes that during potentiation spiritual healing power of the original material is transferred to the solvent. This effect is even supposed to increase in proportion to the increasing dilution. The notion that something that is no longer present can still exert an effect is at odds with the concepts of the natural sciences. Hence science demands cast iron evidence for this claim, or as James Randi expressed it: 'unusual claims require unusually good proof'. In 1988, it seemed that something might even come of this. The renowned French asthma researcher Jacques Benveniste submitted an extraordinary manuscript to the journal 'Nature', describing an experiment of his in which basophile granulocytes responded to a homeopathic dilution of an allergen. He attributed this to the transfer of a property of the allergen to the solvent and named this 'the memory of water'. Nature's chief editor, John Maddox, did not believe in this but realised the manuscript could unleash a scientific revolution. He accepted the article but with a precondition: identical results had to be attained when the experiment was repeated in Benveniste's laboratory under the observation of a delegation drawn up by Maddox. Benveniste accepted the challenge. The group of observers that came to his lab had an unexpected composition, however. In addition to Maddox himself, the team consisted of Walter Stewart (a respected investigator and adversary of scientific fraud) and James Randi, a 'professional magician' better known as the 'The Amazing Randi'. Maddox's choice of Randi caused some amazement, but he had built up a reputation for exposing those claiming to have paranormal gifts. His role in the team was to ensure that the blinding of the experiment was not violated before all the measurements were carried out. For this purpose he had the windows of the laboratory blacked out with newspaper and the code of the test and control tubes placed in a sealed envelope taped to the ceiling. When the experiment was repeated the activation of basophile granulocytes in tubes treated with 'homeopathic diluted antigen' did not differ from that in the control tubes, which were only treated with the solvent. Later it became clear that the laboratory technicians in the original experiment knew which tubes were treated with 'homeopathic allergen' so that in the interpretation of the results they had let themselves be led astray by their belief in the outcome.
The publication of the results of this repetition of Benveniste's experiment in Nature spelled the end of his reputation as a respected investigator. But Randi went a step further: he offered a reward of one million dollars for anyone providing experimental evidence that homeopathy works. The English science television programme Horizon took up the challenge and gathered a team of investigators to repeat, under controlled conditions, an experiment previously performed by Dr. Madeleine Ennis. The experiment strongly resembled that of Benveniste, but this time the basophile granulocytes were stimulated with homeopathic diluted histamine in place of an allergen. The control was in the hands of two persons: James Randi and Professor John Enderby, vice-president of the Royal Society. Again pains were taken for very stringent blinding of the experiment. When the codes were broken at the end of the experiment, no difference was found between the effects of the homeopathic diluted histamine and the solvent. Once again the evidence for 'the memory of water' was negated. The reward put up by Randi is still on offer, but no new candidates have applied.
Efficacy
There are various ways in which the working or effect of a treatment can be tested: 1) the opinion of experts, 2) retrospective clinical research, 3) prospective randomised double-blind clinical research, and 4) meta-analysis of clinical research. The first method has little evidential value. It is sometimes claimed that the so-called consensus meeting of specialists mainly serves to confirm that about which they disagree. Retrospective clinical research was much used in the past but it is no longer accepted by any scientific journal. Prospective randomised double-blind clinical research is now considered to be the golden standard. But it can also be coloured by such factors as ethnic or cultural differences or an invalid analysis of the results. It can also happen that the results of studies with comparable objectives and design do not agree. In order that the findings can still be interpreted, the investigations are compared in a meta-analysis. It is especially the methodological aspects of the different investigations that are critically analyzed in this analysis. If we wish to draw conclusions about the effectiveness of homeopathy, it is especially the last of these approaches that is important. By now a great deal of clinical research has already been carried out on the effectiveness of homeopathy and this research has been carefully analyzed in several meta-analyses, although they only concern homeopathy in humans and not in animals. The results of these meta-analyses are summarised below.
Jos Kleijnen from Maastricht published the first meta-analysis of clinical research on the effects of homeopathy in 1991. The research concerned 96 publications in which 107 clinical investigations were described. Kleijnen and co-workers concluded that there were indeed indications that homeopathy works, but 'At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias' [4]. By 'publication bias' the author meant that research in which an effect was shown was more likely to be published than that in which no effect was observed. This distorts the picture in favour of an effect. An important technical shortcoming was that the patients were not asked which group they thought they had been placed in. This control of the blinding was not applied in any of the analyzed studies, while the breaking of the code by the patient is sufficient to explain the small positive effects in favour of homeopathy [1].
There was little further interest in this topic until in 1996 the Geneesmiddelenbulletin (Dutch bulletin of drugs and therapeutics) gave attention to homeopathy. The study of van Kleijnen was discussed and extended with a meta-analysis of 11 clinical studies, which 'more or less' fulfilled the criteria for prospective randomized clinical research. The Geneesmiddelenbulletin concluded that 'not one homeopathic remedy has been shown to have a specific effect in double-blind randomized and placebo-controlled research' [2].
In 1997, Klaus Linde (an epidemiologist sympathetic to homeopathy) published a meta-analysis of 98 clinical studies in the Lancet [3]. At first glance his conclusion appears favourable to homeopathy: 'The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo', but Linde immediately qualified this by remarking: 'However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition'. Linde continued working and a year later published a second meta-analysis of 32 clinical studies of homeopathy [4]. The conclusion of this analysis closely resembled that in 1997: 'The results of the available randomized trials suggest that individualized homeopathy has an effect over placebo'. Once again the conclusion was immediately qualified, because methodological shortcomings put a spoke in the wheel: 'The evidence, however, is not convincing because of methodological shortcomings and inconsistencies. When the analysis was restricted to methodologically best trials no significant effect was seen'. Because technical aspects of experiments evidently have a great influence on the results of clinical research in homeopathy, Linde directed his attention especially to this point. In 1999 he published a study of the effects of the quality of clinical research in homeopathy on the results [5]. As the starting point he used the same 89 publications that he had analyzed in the Lancet in 1997. He applied three techniques to these investigations: 1) analysis of the components, 2) a minimum score analysis, and 3) a cumulative meta-analysis. For the component analysis, two groups of investigations were compared with regard to a single criterion (e.g. whether or nor there was an explicit statement about randomization, whether or not there was double-blinding, whether or not there was a complete follow-up). For the minimum score analysis, points were awarded to each investigation on the basis of methodological aspects. Then a limiting value was determined and investigations scoring above and below this were compared with each other. In the cumulative meta-analysis, the individual investigations were added stepwise on the basis of the previously applied quality score. Linde's investigation revealed that especially double-blinding and randomization influenced the results of the examined publications: 'Studies that were explicitly randomized and were double-blind [...] yielded significantly less positive results than studies not meeting the criteria'. In addition, Linde pointed out the previously mentioned publication bias. These observations led him to qualify the conclusions he had made in 1997: 'The evidence of bias weakens our original meta-analysis [from 1997], which overestimated the effects of homeopathic treatments'.
The most recent meta-analysis dates from 2002 and was published by Ezard Ernst, who works in the Department of Complementary Medicine at the University of Exeter in England. Ernst's examination was concerned not with individual investigations but rather with 17 meta-analyses of the effectiveness of homeopathy [6]. Six of these 17 articles were repeat analyses of frequently cited meta-analyses; the other 11 were described as independent systematic analyses. Ernst concluded: 'There was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. [...] There was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo'.
In summary, it can be concluded that there has been a great deal of research on the effectiveness of homeopathy. Much of this research is methodologically weak and justifies no conclusion about the effectiveness of homeopathy. But there has also been good research, from which it is apparent that the effect of homeopathy is no greater than that of placebo.
Conclusion
The test of science is hard and merciless. Many conditions must be satisfied in order to demonstrate therapeutic effectiveness. The golden standard is the prospective randomized double-blind clinical trial. For medicine this is a formidable enough challenge; for homeopathy it appears to be insurmountable. After seven years of investigation costing more than $100 million per year [7], there is still no evidence whatever that extremely diluted solutions of homeopathic substances have any effect. The actual existence of drug pictures has not been confirmed and the application of homeopathic therapy has no more effect than a placebo. With regard to the title of this article, there is but one possible conclusion: homeopathy has not withstood the test of science.
Source: This article was originally published in Tijdschrift voor Diergeneeskunde (129, 259-298).
The author presented the paper on 12 January 2004 at the invitation of the Executive Board of the Royal Dutch Veterinary Society during discussions of the continuation of the group 'Homeopathic-practicing Veterinarians' within the Society.
English translation: B.E. Belshaw
References
1. Kleijen, J., Knipschild, P. and Ter Riet, G. (1991) Clinical trials of homeopathy. Brit. Med. J. 302, 316-323.
2. Geneesmiddelenbulletin (1996) 30, 26-32.
3. Linde, K., Clausius, N., Ramirez, G., Melchart, D., Eitel, F., Hedges, L.V. and Jonas, W.B. (1997) Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled clinical trials. Lancet 350, 834-843.
4. Linde, K. and Melchart, D. (1998) Randomized controlled trials of individualized homeopathy: a state-of-the-art review. J. Altern. Complement Med. 4, 371-388.
5. Linde, K., Scholz, M., Ramirez, G., Clausius, N., Melchart, D., Jonas, W.B. (1999) Impact of study quality on outcome in placebo-controlled trials of homeopathy. J. Clin. Epidemiol. 52, 631-636.
6. Ernst, E. (2002) A systematic review of systematic reviews of homeopathy. Br. J. Clin. Pharmacol. 54, 577-582.
7. National Council for Alternative and Complementary Medicine (USA).
- guest
FDA says stop selling homeopathic vaccine
by guest » Thu Feb 10, 2005 9:09 am
Another homeopathic marketer ordered to stop selling "homeopathic vaccine."
The U.S. Food and Drug Administration has ordered Heel, Inc., of
Albuquerque, New Mexico, to stop claiming that five of its products
are effective in preventing or treating influenza. [Malarkey MA.
Warning letter to Chris Rusnock, Jan 3, 2005] Heel and its parent
company have a long history of making illegal claims for homeopathic
products. [Barrett S. Heel-BHI: The world's most outrageous
homeopathic marketer. Homeowatch, Feb 8, 2005]
http://www.homeowatch.org/reg/BHI/bhi.html
The U.S. Food and Drug Administration has ordered Heel, Inc., of
Albuquerque, New Mexico, to stop claiming that five of its products
are effective in preventing or treating influenza. [Malarkey MA.
Warning letter to Chris Rusnock, Jan 3, 2005] Heel and its parent
company have a long history of making illegal claims for homeopathic
products. [Barrett S. Heel-BHI: The world's most outrageous
homeopathic marketer. Homeowatch, Feb 8, 2005]
http://www.homeowatch.org/reg/BHI/bhi.html
- guest
Homeopathy No Better Than Placebo -- Analysis
by guest » Sun Aug 28, 2005 5:27 am
Homeopathy No Better Than Placebo -- Analysis
Reuters Health
Friday, August 26, 2005
NEW YORK (Reuters Health) - The clinical benefits attributed to
homeopathic treatment are merely placebo effects, according to the
authors of a report in The Lancet medical journal.
Homeopathy is based on the notion that "like cures like," and treatment
involves giving a patient small amounts of drugs that, in larger
quantities, cause symptoms like those suffered by the patient. It also
involves a great deal of interaction between the practitioner and the
patient.
In the current article, Dr. Matthias Egger, from the University of Berne
in Switzerland, and associates searched 19 electronic databases covering
the period from 1995 to 2003 to identify scientific trials of
homeopathy, and matched them with trials in conventional medicine.
The team identified 110 trials each of homeopathy and conventional
medicine, or allopathy. They used sophisticated statistical analysis to
score the results of the studies, with those below 1.0 indicating a
beneficial effect of treatment versus inactive placebo.
Including the largest trials, which were considered the most reliable,
the overall scores were 0.96 for homeopathy and 0.67 for conventional
medicine.
Egger and his colleagues say the results provide "no convincing evidence
that homeopathy was superior to placebo, whereas for conventional
medicine an important effect remained."
The Lancet editors weigh in on this topic, saying, "Surely the time has
passed for selective analyses, biased reports, or further investment in
research to perpetuate the homeopathy versus allopathy debate."
They add: "Now Homeopathy No Better Than Placebo -- Analysis
Reuters Health
Friday, August 26, 2005
NEW YORK (Reuters Health) - The clinical benefits attributed to
homeopathic treatment are merely placebo effects, according to the
authors of a report in The Lancet medical journal.
Homeopathy is based on the notion that "like cures like," and treatment
involves giving a patient small amounts of drugs that, in larger
quantities, cause symptoms like those suffered by the patient. It also
involves a great deal of interaction between the practitioner and the
patient.
In the current article, Dr. Matthias Egger, from the University of Berne
in Switzerland, and associates searched 19 electronic databases covering
the period from 1995 to 2003 to identify scientific trials of
homeopathy, and matched them with trials in conventional medicine.
The team identified 110 trials each of homeopathy and conventional
medicine, or allopathy. They used sophisticated statistical analysis to
score the results of the studies, with those below 1.0 indicating a
beneficial effect of treatment versus inactive placebo.
Including the largest trials, which were considered the most reliable,
the overall scores were 0.96 for homeopathy and 0.67 for conventional
medicine.
Egger and his colleagues say the results provide "no convincing evidence
that homeopathy was superior to placebo, whereas for conventional
medicine an important effect remained."
The Lancet editors weigh in on this topic, saying, "Surely the time has
passed for selective analyses, biased reports, or further investment in
research to perpetuate the homeopathy versus allopathy debate."
They add: "Now doctors need to be bold and honest with their patients
about homeopathy's lack of benefit, and with themselves about the
failings of modern medicine to address patients' needs for personalized
care."
SOURCE: Lancet, August 27, 2005.
Copyright 2005 Reuters. Reuters content is the
with their patients
about homeopathy's lack of benefit, and with themselves about the
failings of modern medicine to address patients' needs for personalized
care."
SOURCE: Lancet, August 27, 2005.
Copyright 2005 Reuters. Reuters content is the
Reuters Health
Friday, August 26, 2005
NEW YORK (Reuters Health) - The clinical benefits attributed to
homeopathic treatment are merely placebo effects, according to the
authors of a report in The Lancet medical journal.
Homeopathy is based on the notion that "like cures like," and treatment
involves giving a patient small amounts of drugs that, in larger
quantities, cause symptoms like those suffered by the patient. It also
involves a great deal of interaction between the practitioner and the
patient.
In the current article, Dr. Matthias Egger, from the University of Berne
in Switzerland, and associates searched 19 electronic databases covering
the period from 1995 to 2003 to identify scientific trials of
homeopathy, and matched them with trials in conventional medicine.
The team identified 110 trials each of homeopathy and conventional
medicine, or allopathy. They used sophisticated statistical analysis to
score the results of the studies, with those below 1.0 indicating a
beneficial effect of treatment versus inactive placebo.
Including the largest trials, which were considered the most reliable,
the overall scores were 0.96 for homeopathy and 0.67 for conventional
medicine.
Egger and his colleagues say the results provide "no convincing evidence
that homeopathy was superior to placebo, whereas for conventional
medicine an important effect remained."
The Lancet editors weigh in on this topic, saying, "Surely the time has
passed for selective analyses, biased reports, or further investment in
research to perpetuate the homeopathy versus allopathy debate."
They add: "Now Homeopathy No Better Than Placebo -- Analysis
Reuters Health
Friday, August 26, 2005
NEW YORK (Reuters Health) - The clinical benefits attributed to
homeopathic treatment are merely placebo effects, according to the
authors of a report in The Lancet medical journal.
Homeopathy is based on the notion that "like cures like," and treatment
involves giving a patient small amounts of drugs that, in larger
quantities, cause symptoms like those suffered by the patient. It also
involves a great deal of interaction between the practitioner and the
patient.
In the current article, Dr. Matthias Egger, from the University of Berne
in Switzerland, and associates searched 19 electronic databases covering
the period from 1995 to 2003 to identify scientific trials of
homeopathy, and matched them with trials in conventional medicine.
The team identified 110 trials each of homeopathy and conventional
medicine, or allopathy. They used sophisticated statistical analysis to
score the results of the studies, with those below 1.0 indicating a
beneficial effect of treatment versus inactive placebo.
Including the largest trials, which were considered the most reliable,
the overall scores were 0.96 for homeopathy and 0.67 for conventional
medicine.
Egger and his colleagues say the results provide "no convincing evidence
that homeopathy was superior to placebo, whereas for conventional
medicine an important effect remained."
The Lancet editors weigh in on this topic, saying, "Surely the time has
passed for selective analyses, biased reports, or further investment in
research to perpetuate the homeopathy versus allopathy debate."
They add: "Now doctors need to be bold and honest with their patients
about homeopathy's lack of benefit, and with themselves about the
failings of modern medicine to address patients' needs for personalized
care."
SOURCE: Lancet, August 27, 2005.
Copyright 2005 Reuters. Reuters content is the
with their patients
about homeopathy's lack of benefit, and with themselves about the
failings of modern medicine to address patients' needs for personalized
care."
SOURCE: Lancet, August 27, 2005.
Copyright 2005 Reuters. Reuters content is the
- guest
Critics seek audit of Arizona homeopathy board
by guest » Sun Oct 09, 2005 3:40 pm
Those who want to write a letter to the editor of the Arizona Republic
on this issue can do it online at:
http://www.azcentral.com/arizonarepubli ... etter.html
On 10/9/05, Dean Hughson <deanhughson@gmail.com> wrote:
> http://www.azcentral.com/arizonarepubli ... ic09.html#
>
> Doctor licensing under scrutiny
>
> Critics seek audit of homeopathy board
>
> Robbie Sherwood
> The Arizona Republic
> Oct. 9, 2005 12:00 AM
>
> A California doctor spent five years in prison for performing
> thousands of unnecessary eye surgeries before being allowed to
> practice homeopathic medicine in Arizona.
>
> A New Mexico doctor illegally borrowed hundreds of thousands of
> dollars from more than 100 of his own patients before becoming a
> homeopathic physician in metropolitan Phoenix, a crime that recently
> resulted in felony convictions.
>
> Over the past five years, the Arizona Board of Homeopathic Medical
> Examiners has licensed four doctors who have been convicted of
> felonies in other states and six others who have lost their licenses
> or been disciplined elsewhere. A review of public records shows that
> homeopathic physicians rarely face sanctions from the board, even in
> instances when prescribed remedies reportedly caused serious harm or,
> in one case, death.
>
> Thousands of patients in Arizona have turned to homeopathy, a
> technique that uses diluted amounts of substances to treat symptoms,
> for an alternative to traditional medicine.
>
> But unlike other Arizona medical boards, the homeopathic board has not
> been audited for 20 years. Some homeopathic physicians and former
> board members are questioning what they consider a lack of proper
> regulation. Carolyn Allen, chairwoman of the state Senate Health
> Committee, called Wednesday for an audit by the state Auditor
> General's Office of the board before it faces a 10-year "sunset
> review" in 2006. The review will determine whether the board will
> continue, be disbanded, or face reforms.
>
> "I absolutely believe that an audit is warranted; 20 years is too
> long," Allen said. "There have been a lot of allegations about this
> board, but the key word is 'allegations.' We need to, hopefully
> through an audit, see if the allegations have any merit. I'm not
> necessarily digging for any unethical behavior, but after 20 years, I
> think we should take a look."
>
> Because the homeopathic board is relatively small, with only 113
> licensees, a state lawmaker has to specifically request such a review
> for it to be carried out. The board passed a 10-year sunset review in
> the mid-1990s without a performance audit.
>
>
> The technique
>
>
> Homeopathy is based on the medicinal value of diluted substances:
> Believers say that if bee venom, for example, can cause pain and
> swelling, then very small amounts of the substance can reverse the
> symptoms. Advocates consider it essential to the well-being of
> patients whose symptoms have not responded to traditional forms of
> medicine. Skeptics say any benefits are the result of a placebo
> effect: Patients feel better simply because they believe the treatment
> will help them.
>
> The technique is not generally covered by insurance in Arizona.
>
> Members of the homeopathic board say they have welcomed doctors to
> Arizona who have been disciplined unfairly in other states and whose
> skills could benefit patients seeking alternative remedies. Until
> recently, a Web page operated by the Arizona Homeopathic and
> Integrative Medical Association urged homeopathic doctors to come to
> Arizona if they have been "oppressed" by medical boards elsewhere.
>
> "There are doctors that have been enlightened as far as natural cures
> that have been around for hundreds of years, and their medical boards
> take them up on charges," said Dr. Bruce Shelton, former Arizona
> homeopathic board chairman. "Those doctors are welcomed here to
> practice integrative medicine."
>
> Critics say board members have acted against the best interest of
> patients in many cases. Those critics include a pair of longtime
> public board members who said their concerns went unheeded because
> they were outvoted by the four licensed homeopaths on the board. The
> six-member board consists of four homeopaths and two members of the
> public.
>
> "There have been doctors that they've licensed that I wouldn't send my
> worst enemy to," said Anna Prassa, who spent six years as a public
> member of the board and who is now one of its sharpest critics. "They
> just want one more boy in the band. They don't care."
>
> Prassa said she believes in homeopathic medicine and still uses it but
> is concerned about the number of troubled doctors licensed by the
> board. Former public board member Joan Heskitt agreed and said the
> board should have more laypeople as members.
>
> Some homeopathic physicians contacted by The Republic said they
> believe the board is doing a good job and does not need to be
> scrutinized. Other practitioners said that while they strongly believe
> in the principles of homeopathic and holistic medicine, they want to
> share their concerns with lawmakers about the board's approach to
> licensing. The doctors include a licensed homeopathic physician and
> the director of a homeopathic school that trained two of the current
> board members.
>
> "I'm very motivated to see the Legislature and the Auditor General's
> Office be fully aware of some of the decisions the board has made and
> some of their methods," said Amanya Jacobs of Chandler, who directs a
> school of homeopathy.
>
>
> The board
>
>
> The Arizona Board of Homeopathic Medical Examiners was created in the
> early 1980s to help ensure that patients seeking alternative cures get
> the best possible treatment. The board is considered necessary in part
> because traditional homeopathy is just a small part of what licensees
> are allowed to do in Arizona. They may prescribe any drugs, do minor
> surgery and practice a wide variety of alternative medical treatments.
> Those include chelation, an intravenous injection of substances
> designed to rid the body of heavy metals such as mercury.
>
> One of those alternative treatments allegedly resulted in the death of
> a New York man whose homeopathic physician in Patagonia injected him
> with adrenal fluids from a cow. The patient's family sued for
> malpractice in 2001, saying the injections resulted in a deadly
> gangrene infection. The doctor denied liability, but the case was
> settled out of court. The homeopathic board later concluded that the
> man died of other causes, and the board rejected a complaint against
> the doctor's license.
>
> To practice homeopathic medicine in Arizona, a licensee must have an
> unrestricted osteopathic or medical license obtained in any state.
> Some of the homeopaths with disciplinary problems in other states
> either had their licenses restored in at least one state or were
> granted their Arizona licenses before their home-state medical board
> took action. Additionally, doctors must pass a 40-hour course in
> homeopathy, or they may have 90 hours of "approved homeopathic
> training." They must pass a written exam and then give an oral case
> history before the homeopathic board. If a doctor has enough
> experience in alternative medicine, the board can waive the written
> exam.
>
> Outside of those who have encountered legal problems, many of the
> licensed homeopaths who have had disciplinary troubles in other states
> were investigated for offering alternative therapies that are legal in
> Arizona, said Board Chairman Charles Schwengel.
>
> "Frequently, when a doctor is under investigation, it's for doing
> things that benefit the patient but are not in the scope of their
> practice," Schwengel said. "For example, giving vitamin B-12 shots."
>
>
> The public records
>
>
> The Arizona Republic examined detailed records of the board's meetings
> and actions over the past five years. The Republic also obtained
> information about licenses that have been revoked since the board was
> created.
>
> While dozens of homeopaths have let their licenses lapse in Arizona,
> the board has revoked only two licenses in its 23-year history. One of
> those stripped belonged to its co-founder and former chairman, Dr.
> Harvey Bigelsen, who held the first homeopathic license ever granted
> in the state.
>
> Bigelsen wrote the law that created the board in 1982 and was
> appointed by Gov. Bruce Babbitt as the first chairman. But 10 years
> later, a federal grand jury indicted him on 63 counts of Medicare
> fraud, 44 counts of mail fraud and eight counts of obstruction. In a
> plea bargain, all but three of the counts were dropped and he was
> sentenced to five years of probation. Bigelsen surrendered both his
> medical and homeopathic licenses and opened a cancer clinic in Mexico.
>
> The board's other co-founder, Dr. Abram Ber of Scottsdale, had one
> disciplinary hearing before the board in a case in which a patient was
> allegedly injured. Ber was brought up two years ago on a complaint
> that his treatment hurt a patient, but it was dismissed with a
> non-disciplinary "letter of concern."
>
> A patient of Ber's who lived in Florida had to have a large part of
> her intestine removed after swallowing an experimental Russian device
> called a "Sputnik" that Ber had prescribed over the telephone to kill
> parasites in her colon.
>
> The board found neither a record of consent from Ber's patient nor a
> record of an examination. The woman needed surgery to remove the
> device.
>
> Ber said that he was wrong to send the Sputnik to the woman with no
> examination and that he thought the warning from the board was the
> appropriate action.
>
> "The point is I admitted I did something wrong, and it was for a
> friend of mine," Ber said. "This board is meticulous. The people on
> this board are the most respected holistic physicians in the U.S., not
> just in Arizona. While it may look lax to you, you are talking about
> an elite group of people. They are doing a great job."
>
>
> Convicted felons
>
>
> Arizona law says medical doctors and homeopathic physicians may have
> their licenses revoked for a felony conviction, but the law does not
> absolutely ban such doctors from practicing in the state.
>
> Those who came to practice homeopathic medicine in Arizona after being
> convicted of crimes include Dr. Jeffrey Rutgard, a once phenomenally
> successful eye surgeon from San Diego. He served five years in prison
> for bilking Medicare by performing thousands of "medically
> unnecessary" procedures on mostly elderly patients in the late 1980s
> and early 1990s. In November 2004, Rutgard applied for and received an
> Arizona homeopathic license.
>
> Attempts to locate Rutgard were unsuccessful. Rutgard is believed to
> be in California and has not yet come to Arizona to practice, although
> he told board members in 2004 that he intended to relocate here.
>
> Other felons licensed by the board include Dr. Rick Shacket of San
> Diego and Dr. Robert Rowen, also of California. Both were convicted in
> tax cases. Dr. Joseph Collins of New Mexico was facing accusations of
> illegally borrowing money from more than 100 patients when licensed in
> Arizona, though the board granted the license during a window when his
> case was temporarily thrown out of court. Prosecutors appealed and
> Collins was convicted earlier this year in New Mexico of multiple
> securities fraud felonies.
>
>
> A loss of inhibition
>
>
> Troubled physicians licensed by the board include Dr. Charles Crosby,
> who obtained his Arizona homeopathic license in May 2004 despite
> revealing to the board that he had been ordered to have counseling for
> a "perceived loss of social inhibition" in his home state of Florida.
> It later became known that Crosby had been accused of fondling
> patients and of having a breast fetish. A report on the case in
> Florida said Crosby had developed "a special technique of manipulating
> women's breasts to treat pain in other areas of their body."
>
> The suspension of Crosby's license in Florida triggered a inquiry
> before the Arizona homeopathic board in July. At the meeting,
> Schwengel, the board president, said he did not find any specific
> examples that showed Crosby had acted unprofessionally, according to
> meeting minutes.
>
> Other members expressed concern about Crosby's behavior, but they did
> not suspend his license, instead giving him until November to undergo
> an independent mental evaluation to determine if he is competent to
> practice here.
>
>
> A second chance
>
>
> Board members said they believe doctors who have gotten in trouble but
> who have "paid their debt to society" deserve a second chance to make
> a living, especially when they may have spent thousands of dollars on
> medical training.
>
> "We can always take a doctor's license, but let's assume that we live
> in a country in which, if you've paid your debt to society, that you
> can be rehabilitated," said longtime board member Dr. Gary Gordon.
>
> The Arizona homeopathic board has worked under the legal guidance of
> the Arizona Attorney General's Office. Veteran board members believe
> they have done an outstanding job of protecting patients and the
> public, as well as promoting the benefits of homeopathy and
> alternative medicine.
>
> "What we look at is, do we want to try and resurrect a troubled
> physician and keep them under control, or do we want to throw them
> away and let them dig ditches?" Gordon said. "Once you take a doctor's
> license away, they don't really have a particular skill that they're
> qualified to do."
>
>
> Dismissed complaints
>
>
> The homeopathic board has dismissed at least five complaints against
> its own members over the past five years, including one in which a
> patient suffered kidney failure after treatment, as well as an alleged
> incidence of sexual harassment.
>
> The complaint involving kidney failure was lodged against board member
> Dr. Annemarie Welch in March 2003. The woman who lodged the complaint
> fell ill after seeking treatment from Welch for an infected blister on
> her toe. Welch treated the infection with "vitamin C therapy,"
> according to board meeting minutes.
>
> After the woman suffered "acute renal failure," she filed a complaint
> against Welch with the Arizona Medical Board, which also licenses
> Welch.
>
> The homeopathic board argued for primary jurisdiction of the Arizona
> Medical Board complaint against Welch, arguing that she had primarily
> used homeopathic procedures. Once the homeopathic board had control of
> the case, it dismissed the complaint.
>
> According to meeting minutes, board members did not believe there was
> a correlation between the vitamin C therapy and the patient's kidney
> failure. They also noted that the patient didn't comply with Welch's
> treatment recommendations. Welch pointed out the Medical Board also
> found no wrongdoing in its investigation.
>
> A Phoenix woman lodged a sexual harassment complaint against board
> member Gordon in May 2001. The woman said he had spontaneously kissed
> her on the mouth after she stopped to speak with him at his booth at a
> medical trade show.
>
> The homeopathic board dismissed the woman's complaint because she did
> not show up to the May 2001 meeting at which her complaint was
> scheduled to be heard. She apparently had a family emergency and wrote
> to the board that she could not make it. Board members questioned
> Gordon about the allegation, which he denied. The woman did show up at
> the next board meeting and asked to refile her complaint, but board
> members voted 2-2 against it.
>
>
> Other boards
>
>
> Other medical boards have faced criticism in recent years for their
> approach to regulating doctors. A March 2004 review by the state
> Auditor General's Office, for example, questioned the dismissal of
> five complaints against traditional doctors by the Arizona Medical
> Board. A similar review of the Board of Osteopathic Examiners in April
> 2001 said that board needs to make improvements to its complaint
> investigation process as well as its record-keeping.
>
> But the homeopathic board has not faced such scrutiny from the Auditor
> General's Office since 1985. Recent questions about the board's
> performance have come from a small group of homeopathic doctors and
> former board members who have expressed concerns about leniency when
> it comes to disciplinary actions. Current board members say that,
> generally, those critics have an ax to grind. One of the doctors, for
> example, had multiple fee complaints before the board.
>
> The homeopathic board's realm is much smaller than the state Medical
> Board. Only about 113 homeopaths are currently licensed in Arizona,
> and 163 licenses have been granted during the board's history,
> compared with more than 16,000 traditional medical doctors. The
> homeopathic board has conducted an average of 15 to 20 investigations
> each year since 2000, compared with about 1,000 a year by the Medical
> Board.
>
> Only two other states, Nevada and Connecticut, license homeopathic
> physicians, but Arizona allows the widest range of alternative medical
> practices. Advocates say doctors and patients alike benefit from
> Arizona's integrative approach. Board members have also begun
> encouraging patients to embark on an aggressive letter-writing
> campaign to lawmakers based, in part, on The Republic's investigation.
>
> Linda Heming of Sun City is one of those patients. She says her life
> literally depends on the Legislature renewing the homeopathic board
> for 10 more years. Heming, 61, is a longtime patient of board
> co-founder Ber. She said he treats her for free because she has gone
> through hard financial times, and she credits him with curing her of
> cancer, congestive heart failure, Lyme disease and a host of other
> ailments when traditional approaches failed. Heming said she has "not
> slept in two weeks" because of worry that recent criticism might
> persuade lawmakers to disband the board and strip homeopathic
> licenses.
>
> "If they take away my right to his treatment, I could die," Heming
> said. "This is very upsetting to people whose lives have been saved by
> alternative medicine."
>
> Without the license, the traditional over-the-counter homeopathic
> remedies would still be available, but other alternative treatments
> would not.
>
>
> More scrutiny
>
>
> Shelton said he expected some scrutiny when the board came up for its
> 10-year sunset review, and he thinks the board will come out looking
> good in the end. It is considered unlikely that legislators would
> disband the board, leaving the state without regulation of homeopaths,
> but reforms are considered a possibility.
>
> "I believe that we meticulously protected the patients and the
> public's rights in all cases," Shelton said. "I used to go home
> feeling like I did the right thing."
>
> Prassa, the public member, said she used to go home from board
> meetings with a very different feeling. "You don't know how many times
> I left that meeting and wanted to call a reporter and say somebody
> needs to look at this," Prassa said. "I don't know why I didn't. I was
> busy with my business, and I didn't want to be a tattletale and cause
> trouble."
>
---------------------------------------------------------------------
email healthfraud-faq@lists.quackwatch.com
on this issue can do it online at:
http://www.azcentral.com/arizonarepubli ... etter.html
On 10/9/05, Dean Hughson <deanhughson@gmail.com> wrote:
> http://www.azcentral.com/arizonarepubli ... ic09.html#
>
> Doctor licensing under scrutiny
>
> Critics seek audit of homeopathy board
>
> Robbie Sherwood
> The Arizona Republic
> Oct. 9, 2005 12:00 AM
>
> A California doctor spent five years in prison for performing
> thousands of unnecessary eye surgeries before being allowed to
> practice homeopathic medicine in Arizona.
>
> A New Mexico doctor illegally borrowed hundreds of thousands of
> dollars from more than 100 of his own patients before becoming a
> homeopathic physician in metropolitan Phoenix, a crime that recently
> resulted in felony convictions.
>
> Over the past five years, the Arizona Board of Homeopathic Medical
> Examiners has licensed four doctors who have been convicted of
> felonies in other states and six others who have lost their licenses
> or been disciplined elsewhere. A review of public records shows that
> homeopathic physicians rarely face sanctions from the board, even in
> instances when prescribed remedies reportedly caused serious harm or,
> in one case, death.
>
> Thousands of patients in Arizona have turned to homeopathy, a
> technique that uses diluted amounts of substances to treat symptoms,
> for an alternative to traditional medicine.
>
> But unlike other Arizona medical boards, the homeopathic board has not
> been audited for 20 years. Some homeopathic physicians and former
> board members are questioning what they consider a lack of proper
> regulation. Carolyn Allen, chairwoman of the state Senate Health
> Committee, called Wednesday for an audit by the state Auditor
> General's Office of the board before it faces a 10-year "sunset
> review" in 2006. The review will determine whether the board will
> continue, be disbanded, or face reforms.
>
> "I absolutely believe that an audit is warranted; 20 years is too
> long," Allen said. "There have been a lot of allegations about this
> board, but the key word is 'allegations.' We need to, hopefully
> through an audit, see if the allegations have any merit. I'm not
> necessarily digging for any unethical behavior, but after 20 years, I
> think we should take a look."
>
> Because the homeopathic board is relatively small, with only 113
> licensees, a state lawmaker has to specifically request such a review
> for it to be carried out. The board passed a 10-year sunset review in
> the mid-1990s without a performance audit.
>
>
> The technique
>
>
> Homeopathy is based on the medicinal value of diluted substances:
> Believers say that if bee venom, for example, can cause pain and
> swelling, then very small amounts of the substance can reverse the
> symptoms. Advocates consider it essential to the well-being of
> patients whose symptoms have not responded to traditional forms of
> medicine. Skeptics say any benefits are the result of a placebo
> effect: Patients feel better simply because they believe the treatment
> will help them.
>
> The technique is not generally covered by insurance in Arizona.
>
> Members of the homeopathic board say they have welcomed doctors to
> Arizona who have been disciplined unfairly in other states and whose
> skills could benefit patients seeking alternative remedies. Until
> recently, a Web page operated by the Arizona Homeopathic and
> Integrative Medical Association urged homeopathic doctors to come to
> Arizona if they have been "oppressed" by medical boards elsewhere.
>
> "There are doctors that have been enlightened as far as natural cures
> that have been around for hundreds of years, and their medical boards
> take them up on charges," said Dr. Bruce Shelton, former Arizona
> homeopathic board chairman. "Those doctors are welcomed here to
> practice integrative medicine."
>
> Critics say board members have acted against the best interest of
> patients in many cases. Those critics include a pair of longtime
> public board members who said their concerns went unheeded because
> they were outvoted by the four licensed homeopaths on the board. The
> six-member board consists of four homeopaths and two members of the
> public.
>
> "There have been doctors that they've licensed that I wouldn't send my
> worst enemy to," said Anna Prassa, who spent six years as a public
> member of the board and who is now one of its sharpest critics. "They
> just want one more boy in the band. They don't care."
>
> Prassa said she believes in homeopathic medicine and still uses it but
> is concerned about the number of troubled doctors licensed by the
> board. Former public board member Joan Heskitt agreed and said the
> board should have more laypeople as members.
>
> Some homeopathic physicians contacted by The Republic said they
> believe the board is doing a good job and does not need to be
> scrutinized. Other practitioners said that while they strongly believe
> in the principles of homeopathic and holistic medicine, they want to
> share their concerns with lawmakers about the board's approach to
> licensing. The doctors include a licensed homeopathic physician and
> the director of a homeopathic school that trained two of the current
> board members.
>
> "I'm very motivated to see the Legislature and the Auditor General's
> Office be fully aware of some of the decisions the board has made and
> some of their methods," said Amanya Jacobs of Chandler, who directs a
> school of homeopathy.
>
>
> The board
>
>
> The Arizona Board of Homeopathic Medical Examiners was created in the
> early 1980s to help ensure that patients seeking alternative cures get
> the best possible treatment. The board is considered necessary in part
> because traditional homeopathy is just a small part of what licensees
> are allowed to do in Arizona. They may prescribe any drugs, do minor
> surgery and practice a wide variety of alternative medical treatments.
> Those include chelation, an intravenous injection of substances
> designed to rid the body of heavy metals such as mercury.
>
> One of those alternative treatments allegedly resulted in the death of
> a New York man whose homeopathic physician in Patagonia injected him
> with adrenal fluids from a cow. The patient's family sued for
> malpractice in 2001, saying the injections resulted in a deadly
> gangrene infection. The doctor denied liability, but the case was
> settled out of court. The homeopathic board later concluded that the
> man died of other causes, and the board rejected a complaint against
> the doctor's license.
>
> To practice homeopathic medicine in Arizona, a licensee must have an
> unrestricted osteopathic or medical license obtained in any state.
> Some of the homeopaths with disciplinary problems in other states
> either had their licenses restored in at least one state or were
> granted their Arizona licenses before their home-state medical board
> took action. Additionally, doctors must pass a 40-hour course in
> homeopathy, or they may have 90 hours of "approved homeopathic
> training." They must pass a written exam and then give an oral case
> history before the homeopathic board. If a doctor has enough
> experience in alternative medicine, the board can waive the written
> exam.
>
> Outside of those who have encountered legal problems, many of the
> licensed homeopaths who have had disciplinary troubles in other states
> were investigated for offering alternative therapies that are legal in
> Arizona, said Board Chairman Charles Schwengel.
>
> "Frequently, when a doctor is under investigation, it's for doing
> things that benefit the patient but are not in the scope of their
> practice," Schwengel said. "For example, giving vitamin B-12 shots."
>
>
> The public records
>
>
> The Arizona Republic examined detailed records of the board's meetings
> and actions over the past five years. The Republic also obtained
> information about licenses that have been revoked since the board was
> created.
>
> While dozens of homeopaths have let their licenses lapse in Arizona,
> the board has revoked only two licenses in its 23-year history. One of
> those stripped belonged to its co-founder and former chairman, Dr.
> Harvey Bigelsen, who held the first homeopathic license ever granted
> in the state.
>
> Bigelsen wrote the law that created the board in 1982 and was
> appointed by Gov. Bruce Babbitt as the first chairman. But 10 years
> later, a federal grand jury indicted him on 63 counts of Medicare
> fraud, 44 counts of mail fraud and eight counts of obstruction. In a
> plea bargain, all but three of the counts were dropped and he was
> sentenced to five years of probation. Bigelsen surrendered both his
> medical and homeopathic licenses and opened a cancer clinic in Mexico.
>
> The board's other co-founder, Dr. Abram Ber of Scottsdale, had one
> disciplinary hearing before the board in a case in which a patient was
> allegedly injured. Ber was brought up two years ago on a complaint
> that his treatment hurt a patient, but it was dismissed with a
> non-disciplinary "letter of concern."
>
> A patient of Ber's who lived in Florida had to have a large part of
> her intestine removed after swallowing an experimental Russian device
> called a "Sputnik" that Ber had prescribed over the telephone to kill
> parasites in her colon.
>
> The board found neither a record of consent from Ber's patient nor a
> record of an examination. The woman needed surgery to remove the
> device.
>
> Ber said that he was wrong to send the Sputnik to the woman with no
> examination and that he thought the warning from the board was the
> appropriate action.
>
> "The point is I admitted I did something wrong, and it was for a
> friend of mine," Ber said. "This board is meticulous. The people on
> this board are the most respected holistic physicians in the U.S., not
> just in Arizona. While it may look lax to you, you are talking about
> an elite group of people. They are doing a great job."
>
>
> Convicted felons
>
>
> Arizona law says medical doctors and homeopathic physicians may have
> their licenses revoked for a felony conviction, but the law does not
> absolutely ban such doctors from practicing in the state.
>
> Those who came to practice homeopathic medicine in Arizona after being
> convicted of crimes include Dr. Jeffrey Rutgard, a once phenomenally
> successful eye surgeon from San Diego. He served five years in prison
> for bilking Medicare by performing thousands of "medically
> unnecessary" procedures on mostly elderly patients in the late 1980s
> and early 1990s. In November 2004, Rutgard applied for and received an
> Arizona homeopathic license.
>
> Attempts to locate Rutgard were unsuccessful. Rutgard is believed to
> be in California and has not yet come to Arizona to practice, although
> he told board members in 2004 that he intended to relocate here.
>
> Other felons licensed by the board include Dr. Rick Shacket of San
> Diego and Dr. Robert Rowen, also of California. Both were convicted in
> tax cases. Dr. Joseph Collins of New Mexico was facing accusations of
> illegally borrowing money from more than 100 patients when licensed in
> Arizona, though the board granted the license during a window when his
> case was temporarily thrown out of court. Prosecutors appealed and
> Collins was convicted earlier this year in New Mexico of multiple
> securities fraud felonies.
>
>
> A loss of inhibition
>
>
> Troubled physicians licensed by the board include Dr. Charles Crosby,
> who obtained his Arizona homeopathic license in May 2004 despite
> revealing to the board that he had been ordered to have counseling for
> a "perceived loss of social inhibition" in his home state of Florida.
> It later became known that Crosby had been accused of fondling
> patients and of having a breast fetish. A report on the case in
> Florida said Crosby had developed "a special technique of manipulating
> women's breasts to treat pain in other areas of their body."
>
> The suspension of Crosby's license in Florida triggered a inquiry
> before the Arizona homeopathic board in July. At the meeting,
> Schwengel, the board president, said he did not find any specific
> examples that showed Crosby had acted unprofessionally, according to
> meeting minutes.
>
> Other members expressed concern about Crosby's behavior, but they did
> not suspend his license, instead giving him until November to undergo
> an independent mental evaluation to determine if he is competent to
> practice here.
>
>
> A second chance
>
>
> Board members said they believe doctors who have gotten in trouble but
> who have "paid their debt to society" deserve a second chance to make
> a living, especially when they may have spent thousands of dollars on
> medical training.
>
> "We can always take a doctor's license, but let's assume that we live
> in a country in which, if you've paid your debt to society, that you
> can be rehabilitated," said longtime board member Dr. Gary Gordon.
>
> The Arizona homeopathic board has worked under the legal guidance of
> the Arizona Attorney General's Office. Veteran board members believe
> they have done an outstanding job of protecting patients and the
> public, as well as promoting the benefits of homeopathy and
> alternative medicine.
>
> "What we look at is, do we want to try and resurrect a troubled
> physician and keep them under control, or do we want to throw them
> away and let them dig ditches?" Gordon said. "Once you take a doctor's
> license away, they don't really have a particular skill that they're
> qualified to do."
>
>
> Dismissed complaints
>
>
> The homeopathic board has dismissed at least five complaints against
> its own members over the past five years, including one in which a
> patient suffered kidney failure after treatment, as well as an alleged
> incidence of sexual harassment.
>
> The complaint involving kidney failure was lodged against board member
> Dr. Annemarie Welch in March 2003. The woman who lodged the complaint
> fell ill after seeking treatment from Welch for an infected blister on
> her toe. Welch treated the infection with "vitamin C therapy,"
> according to board meeting minutes.
>
> After the woman suffered "acute renal failure," she filed a complaint
> against Welch with the Arizona Medical Board, which also licenses
> Welch.
>
> The homeopathic board argued for primary jurisdiction of the Arizona
> Medical Board complaint against Welch, arguing that she had primarily
> used homeopathic procedures. Once the homeopathic board had control of
> the case, it dismissed the complaint.
>
> According to meeting minutes, board members did not believe there was
> a correlation between the vitamin C therapy and the patient's kidney
> failure. They also noted that the patient didn't comply with Welch's
> treatment recommendations. Welch pointed out the Medical Board also
> found no wrongdoing in its investigation.
>
> A Phoenix woman lodged a sexual harassment complaint against board
> member Gordon in May 2001. The woman said he had spontaneously kissed
> her on the mouth after she stopped to speak with him at his booth at a
> medical trade show.
>
> The homeopathic board dismissed the woman's complaint because she did
> not show up to the May 2001 meeting at which her complaint was
> scheduled to be heard. She apparently had a family emergency and wrote
> to the board that she could not make it. Board members questioned
> Gordon about the allegation, which he denied. The woman did show up at
> the next board meeting and asked to refile her complaint, but board
> members voted 2-2 against it.
>
>
> Other boards
>
>
> Other medical boards have faced criticism in recent years for their
> approach to regulating doctors. A March 2004 review by the state
> Auditor General's Office, for example, questioned the dismissal of
> five complaints against traditional doctors by the Arizona Medical
> Board. A similar review of the Board of Osteopathic Examiners in April
> 2001 said that board needs to make improvements to its complaint
> investigation process as well as its record-keeping.
>
> But the homeopathic board has not faced such scrutiny from the Auditor
> General's Office since 1985. Recent questions about the board's
> performance have come from a small group of homeopathic doctors and
> former board members who have expressed concerns about leniency when
> it comes to disciplinary actions. Current board members say that,
> generally, those critics have an ax to grind. One of the doctors, for
> example, had multiple fee complaints before the board.
>
> The homeopathic board's realm is much smaller than the state Medical
> Board. Only about 113 homeopaths are currently licensed in Arizona,
> and 163 licenses have been granted during the board's history,
> compared with more than 16,000 traditional medical doctors. The
> homeopathic board has conducted an average of 15 to 20 investigations
> each year since 2000, compared with about 1,000 a year by the Medical
> Board.
>
> Only two other states, Nevada and Connecticut, license homeopathic
> physicians, but Arizona allows the widest range of alternative medical
> practices. Advocates say doctors and patients alike benefit from
> Arizona's integrative approach. Board members have also begun
> encouraging patients to embark on an aggressive letter-writing
> campaign to lawmakers based, in part, on The Republic's investigation.
>
> Linda Heming of Sun City is one of those patients. She says her life
> literally depends on the Legislature renewing the homeopathic board
> for 10 more years. Heming, 61, is a longtime patient of board
> co-founder Ber. She said he treats her for free because she has gone
> through hard financial times, and she credits him with curing her of
> cancer, congestive heart failure, Lyme disease and a host of other
> ailments when traditional approaches failed. Heming said she has "not
> slept in two weeks" because of worry that recent criticism might
> persuade lawmakers to disband the board and strip homeopathic
> licenses.
>
> "If they take away my right to his treatment, I could die," Heming
> said. "This is very upsetting to people whose lives have been saved by
> alternative medicine."
>
> Without the license, the traditional over-the-counter homeopathic
> remedies would still be available, but other alternative treatments
> would not.
>
>
> More scrutiny
>
>
> Shelton said he expected some scrutiny when the board came up for its
> 10-year sunset review, and he thinks the board will come out looking
> good in the end. It is considered unlikely that legislators would
> disband the board, leaving the state without regulation of homeopaths,
> but reforms are considered a possibility.
>
> "I believe that we meticulously protected the patients and the
> public's rights in all cases," Shelton said. "I used to go home
> feeling like I did the right thing."
>
> Prassa, the public member, said she used to go home from board
> meetings with a very different feeling. "You don't know how many times
> I left that meeting and wanted to call a reporter and say somebody
> needs to look at this," Prassa said. "I don't know why I didn't. I was
> busy with my business, and I didn't want to be a tattletale and cause
> trouble."
>
---------------------------------------------------------------------
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- guest
European veterinary specialists denounce alternative medicin
by guest » Tue Jan 17, 2006 6:06 pm
© Veterinary Sciences Tomorrow - 17 January 2006
European veterinary specialists denounce alternative medicine
Marian C. Horzinek and Anjop Venker-van Haagen
In a review article in Veterinary Sciences Tomorrow (30 November 2004), F.J. van Sluijs, Head of the Department of Clinical Sciences of Companion Animals, Utrecht University, discussed the question whether homeopathy can withstand scientific testing. He concluded that the gold standard for the therapeutic effectiveness of a medication is the outcome of a randomized double-blind clinical trial, and that after 7 years of investigation there is still no evidence whatever that extremely diluted solutions of homeopathic substances have any effect.
What is the attitude of European associations of veterinary practitioners concerning the use of homeopathy in veterinary practice? The New Scientist (10 December 2005, http://press.newscientist.com/data/pdf/ ... 252908.pdf) reported some of their statements. On November 19, the Federation of Veterinarians in Europe (FVE) issued a policy statement urging its 200,000 members "to work only on the basis of scientifically proven and evidence-based methods and to stay away from non-evidence-based methods." The Swedish Veterinary Association banned its members from homeopathic practice decades ago, and its president stated that it is "absolutely unacceptable for vets to work without a scientific basis." UK's Royal College of Veterinary Surgeons (RCVS) rejects any suggestion that it supports homeopathy, but states that it takes a neutral stance. In early September the British Veterinary Association issued a statement attacking plans by the UK Medicines and Healthcare Product Regulatory Agency to license homeopathic medicines without demanding clinical trials. It looks like there is a move, at least by some associations, toward advice to eliminate homeopathy from veterinary practice.
Remarkably more robust is the announcement by the European veterinary specialists. The European Board of Veterinary Specialisation (EBVS), an organization which oversees veterinary specialization, is now officially moving against supplementary, alternative and complimentary medicine. In its meeting on April 16 and 17, 2005, this Board unanimously agreed on incorporation of the following statement into its Policies and Procedures: "The EBVS only recognizes scientific, evidence-based veterinary medicine which complies with animal welfare legislation. Specialists or Colleges who practice or support implausible treatment modalities with no proof of effectiveness run the risk of withdrawal of their specialist status. No credit points can be granted for education or training in these so-called supplementary, complementary and alternative treatment modalities. Failure of a college to comply with any of the Policies and Procedures of the EVBS may lead to the withdrawal of provisional or full recognition." In a comment to the New Scientist (10 December 2005) J.T. Lumeij, EBVS President, said: "The basics of homeopathy are not in agreement with science."
The tough standpoint of the EBVS banning the use of supplementary, complementary and alternative medicine in specialist practices in Europe is a courageous and necessary step and deserves the support of every veterinary scientist. On the other hand: are there not treatments and medications in veterinary medicine whose effectiveness still needs to be proven by evidence-based methods? The finger must be pointed in both directions...
European veterinary specialists denounce alternative medicine
Marian C. Horzinek and Anjop Venker-van Haagen
In a review article in Veterinary Sciences Tomorrow (30 November 2004), F.J. van Sluijs, Head of the Department of Clinical Sciences of Companion Animals, Utrecht University, discussed the question whether homeopathy can withstand scientific testing. He concluded that the gold standard for the therapeutic effectiveness of a medication is the outcome of a randomized double-blind clinical trial, and that after 7 years of investigation there is still no evidence whatever that extremely diluted solutions of homeopathic substances have any effect.
What is the attitude of European associations of veterinary practitioners concerning the use of homeopathy in veterinary practice? The New Scientist (10 December 2005, http://press.newscientist.com/data/pdf/ ... 252908.pdf) reported some of their statements. On November 19, the Federation of Veterinarians in Europe (FVE) issued a policy statement urging its 200,000 members "to work only on the basis of scientifically proven and evidence-based methods and to stay away from non-evidence-based methods." The Swedish Veterinary Association banned its members from homeopathic practice decades ago, and its president stated that it is "absolutely unacceptable for vets to work without a scientific basis." UK's Royal College of Veterinary Surgeons (RCVS) rejects any suggestion that it supports homeopathy, but states that it takes a neutral stance. In early September the British Veterinary Association issued a statement attacking plans by the UK Medicines and Healthcare Product Regulatory Agency to license homeopathic medicines without demanding clinical trials. It looks like there is a move, at least by some associations, toward advice to eliminate homeopathy from veterinary practice.
Remarkably more robust is the announcement by the European veterinary specialists. The European Board of Veterinary Specialisation (EBVS), an organization which oversees veterinary specialization, is now officially moving against supplementary, alternative and complimentary medicine. In its meeting on April 16 and 17, 2005, this Board unanimously agreed on incorporation of the following statement into its Policies and Procedures: "The EBVS only recognizes scientific, evidence-based veterinary medicine which complies with animal welfare legislation. Specialists or Colleges who practice or support implausible treatment modalities with no proof of effectiveness run the risk of withdrawal of their specialist status. No credit points can be granted for education or training in these so-called supplementary, complementary and alternative treatment modalities. Failure of a college to comply with any of the Policies and Procedures of the EVBS may lead to the withdrawal of provisional or full recognition." In a comment to the New Scientist (10 December 2005) J.T. Lumeij, EBVS President, said: "The basics of homeopathy are not in agreement with science."
The tough standpoint of the EBVS banning the use of supplementary, complementary and alternative medicine in specialist practices in Europe is a courageous and necessary step and deserves the support of every veterinary scientist. On the other hand: are there not treatments and medications in veterinary medicine whose effectiveness still needs to be proven by evidence-based methods? The finger must be pointed in both directions...
- guest
veterinary homeopathy
by guest » Mon Jan 23, 2006 1:21 pm
8 | NewScientist | 10 December 2005 www.newscientist.com
ANDY COGHLAN
A SATIRICAL website poking fun
at veterinary homeopathy has
become the unlikely symbol of a
global backlash by conventional
vets against their homeopathic
colleagues.
The “British Veterinary Voodoo
Society” (BVVS) is a parody, but its
creators say they are making a
serious point: that the claimed
effectiveness of homeopathic
veterinary medicine has no more
solid scientific evidence behind it
than voodoo. They object to a
decision by the UK’s Royal College
of Veterinary Surgeons (RCVS)
to publish an official list of
homeopathic vets, which they say
undermines the credibility of
conventional veterinary medicine.
The RCVS disputes this.
It points out that the list carries
a disclaimer declaring that the
college does not recognise the
major British homeopathic
veterinary qualification. This is
awarded by The Faculty of
Homeopathy, a separate body that
also promotes the development
of homeopathy for humans.
Homeopathic vets are not
laughing either. They see the site
as a slur on homeopathic
medicine, and say it brings the
whole veterinary profession into
disrepute. They have lodged a
formal complaint with the RCVS,
which regulates the profession,
asking it to censure the website’s
editors and force them to take
down the site. As New Scientist
went to press, the RCVS was
considering the complaint.
This bizarre episode has
exposed a rift in the profession
that extends far beyond the UK.
Conventional vets and the
organisations they belong to are
fighting back against what they
see as infiltration of their
profession by non-evidence-based
practitioners. The ethics of
complementary medicine for
animals and humans are different,
because animals cannot choose
to have complementary therapies.
This, they say, puts vets under a
moral obligation to provide the
best evidence-based treatment,
and the evidence that homeopathy
actually works is, at best, flimsy
(see “Cure or quackery”, right).
The backlash against
veterinary homeopathy is already
in full swing in other countries.
On 19 November, The Federation
of Veterinarians in Europe (FVE)
issued a policy statement urging
its 200,000 members “to work
only on the basis of scientifically
proven and evidence-based
methods and to stay away from
non-evidence-based methods”.
“The FVE feels it should be clear
to clients that vets work on the
basis of evidence-based science,”
Jan Vaarten, executive director of
the federation, told New Scientist.
“When vets go into homeopathy,
it creates a false impression that
it is also evidence-based.”
In April, the European Board
of Veterinary Specialisation issued
a statement warning that its
members could lose their status
if they offer non-evidence-based
treatments. The organisation
represents and registers the 10 per
cent of vets who go on to specialise
in 20 or so fields, such as radiology.
“The basics of homeopathy are
not in agreement with science,”
says Johannes Lumeij of Utrecht
Veterinary School in the
Netherlands, and EBVS president.
The Swedish Veterinary
Association banned its members
from homeopathic practice
decades ago. Its president, Karin
Ostensson, told New Scientist that
the association takes the view that
“homeopathy does not rely on
evidence-based science, and it is
absolutely unacceptable for vets
to work without a scientific basis”.
In early September, the British
Veterinary Association, which
represents 10,000 vets, issued a
statement attacking plans by the
UK Medicines and Healthcare
Products Regulatory Agency to
license homeopathic medicines
without demanding clinical trials.
“No genuine ‘provings’ of
homeopathic remedies have ever
successfully been performed in
animals,” the statement says.
“There is no evidence whatsoever
of a physiological or therapeutic
effect. Instead, the homeopathic
ritual of case-taking and remedy
matching appears to influence the
owner to perceive the animal’s
condition in a more favourable
light, attributing coincidental
recovery to the remedy and even
imagining improvement where
none is present,” it says.
International news and exclusives
This week–
Homeopathic vets
come under fire
A global backlash against alternative veterinary
medicine is leaving its practitioners marginalised
“When vets go into
homeopathy it creates a
false impression that it is
evidence-based”
JL/SAE/KEYSTONE/REX FEATURES
–Do you do voodoo?–
www.newscientist.com 10 December 2005 | NewScientist | 9
In the US, the American
Veterinary Medical Association
(AVMA) allows its 73,000
members to practise homeopathy
or chiropractic, but keeps such
therapies at arm’s length.
“We encourage those that use
alternatives to help develop the
science showing they work,
particularly through double-blind
placebo-controlled tests, but no
one has done that yet,” says Bonnie
Beaver, who recently stood down
as president of the association.
Members of the AVMA are not
allowed to advertise themselves
as a specialist in alternative
therapies, and Beaver says she
cannot imagine the association
giving the kind of endorsement
that homeopathic vets enjoy in
the UK. “A list would give a certain
recognition level to the public,
so it’s not something that would
happen here.”
The RCVS disputes this view.
“We would argue we’re not
promoting homeopathy, but are
taking a neutral stance,” says
council member Stephen Ware.
He says the list provides a service
by helping clients find qualified
vets capable of doing homeopathy.
John Saxton, ex-president of
the British Association of
Homeopathic Veterinary Surgeons,
says the list is not there to
promote homeopathy. “It’s to say
these guys have this qualification,
and if you have a client who wants
homeopathic treatment, here’s a
list to help you find them.”
But David Ramey, a horse vet
in California, and long-term
sceptic of homeopathy, says that
any blurring of the distinction
between conventional and
complementary vets should be
resisted at all costs. “If you try and
incorporate everything under
veterinary medicine, you start to
erode the standards in practice,”
he says. “I say keep the two apart,
and let the market decide.” ●
In this section
● When is a face transplant the answer? page 10
● Sloppy copying is key to polio’s strength, page 16
● Blocking starlight to see alien planets, page 19
IMAGESOURCE/PHOTOLIBRARY
CURE OR QUACKERY?
Many orthodox vets argue that there
is no genuine scientific evidence that
homeopathy works. Very few reliable
studies have been done on homeopathic
treatments in animals, and of these most
point to them having no more than a
placebo effect.
A few have claimed positive results.
Indian researchers led by Ram Naresh of
the Indian Veterinary Research Institute
in Izzatnagar, Uttar Pradesh, this year
reported that a commercially available
cocktail of homeopathic ingredients,
including belladonna and arnica, was
effective against mastitis in cattle. The
homeopathic remedy healed 87 per cent
of treated udder regions, compared with
59 per cent treated with conventional
antibiotics (Homeopathy, vol 94, p 81).
The trials were not “double blind”,
however, which weakens the result.
In a double-blind trial there is no
possibility of bias because neither the
experimenter nor the patient (or in this
case the farmer or owner) knows until
the results are analysed which of the
subjects received the treatment and
which got the placebo. That way there is
no chance for unconscious bias creeping
in: for example, by cows treated with
the homeopathic remedy being looked
after differently.
An earlier double-blind trial, by
British vet Chris Day in 1986, also claimed
to show that homeopathic remedies
cut the incidence of mastitis in cattle
from 48 to 2.5 per cent. And in 1984,
Day reportedly reduced the incidence of
stillborn piglets with another remedy,
caulophyllum (The Veterinary Record,
vol 114, p 216).
The majority of studies have found
no effect, however. In April, for example,
The Veterinary Record reported results
from a double-blind trial in which
250 cows received either a homeopathic
remedy for mastitis or a placebo (vol 156,
p 565). Milk from cows with mastitis
normally has an elevated level of white
blood cells. But when Mark Holmes at
the University of Cambridge and his team
counted white blood cells in milk before
and after treatment they found minimal
change in either case, suggesting the
homeopathic remedy was no better
than the placebo.
In 2003, Kerstin de Verdier of
the National Veterinary Institute in
Uppsala, Sweden, reported in Acta
Veterinaria Scandinavica (vol 44, p 97)
the failure of the homeopathic remedy
podophyllum for diarrhoea in calves
in a double-blind trial.
Recent reviews of the field – both
animal and human – have also been
negative. In August, Matthias Eggar and
colleagues at the University of Bern
in Switzerland published an analysis
comparing 21 studies of homeopathic
remedies with nine studies of
conventional medicines. They
concluded that “the clinical effects
of homeopathy are placebo effects”
(The Lancet, vol 366, p 726).
And last month in Trends in
Pharmacological Sciences (vol 26, p 548)
Edzard Ernst of the University of Exeter,
UK, concluded that “contrary to many
claims by homeopaths there is no
conclusive evidence that highly dilute
homeopathic remedies are different
from placebos”.
Homeopathic vets admit that
evidence from large, double-blind,
placebo-controlled trials is thin on
the ground. But some argue that this
is beside the point. “There’s a strong
body of anecdotal evidence over
hundreds of years,” says Larry
Bernstein, president of the American
Holistic Veterinary Medical Association.
“The problem is if you try to prove
homeopathy using the scientific
paradigm,” he says. “When you do
double-blind studies, you’re trying
to standardise the therapy, but
homeopathy is individualised to each
patient, so if the remedy works in Andy,
who says it will work in Bill?”
“We encourage those that use
homeopathy to help develop
the science showing it works.
No one has done that yet”
–He can’t choose his treatment
ANDY COGHLAN
A SATIRICAL website poking fun
at veterinary homeopathy has
become the unlikely symbol of a
global backlash by conventional
vets against their homeopathic
colleagues.
The “British Veterinary Voodoo
Society” (BVVS) is a parody, but its
creators say they are making a
serious point: that the claimed
effectiveness of homeopathic
veterinary medicine has no more
solid scientific evidence behind it
than voodoo. They object to a
decision by the UK’s Royal College
of Veterinary Surgeons (RCVS)
to publish an official list of
homeopathic vets, which they say
undermines the credibility of
conventional veterinary medicine.
The RCVS disputes this.
It points out that the list carries
a disclaimer declaring that the
college does not recognise the
major British homeopathic
veterinary qualification. This is
awarded by The Faculty of
Homeopathy, a separate body that
also promotes the development
of homeopathy for humans.
Homeopathic vets are not
laughing either. They see the site
as a slur on homeopathic
medicine, and say it brings the
whole veterinary profession into
disrepute. They have lodged a
formal complaint with the RCVS,
which regulates the profession,
asking it to censure the website’s
editors and force them to take
down the site. As New Scientist
went to press, the RCVS was
considering the complaint.
This bizarre episode has
exposed a rift in the profession
that extends far beyond the UK.
Conventional vets and the
organisations they belong to are
fighting back against what they
see as infiltration of their
profession by non-evidence-based
practitioners. The ethics of
complementary medicine for
animals and humans are different,
because animals cannot choose
to have complementary therapies.
This, they say, puts vets under a
moral obligation to provide the
best evidence-based treatment,
and the evidence that homeopathy
actually works is, at best, flimsy
(see “Cure or quackery”, right).
The backlash against
veterinary homeopathy is already
in full swing in other countries.
On 19 November, The Federation
of Veterinarians in Europe (FVE)
issued a policy statement urging
its 200,000 members “to work
only on the basis of scientifically
proven and evidence-based
methods and to stay away from
non-evidence-based methods”.
“The FVE feels it should be clear
to clients that vets work on the
basis of evidence-based science,”
Jan Vaarten, executive director of
the federation, told New Scientist.
“When vets go into homeopathy,
it creates a false impression that
it is also evidence-based.”
In April, the European Board
of Veterinary Specialisation issued
a statement warning that its
members could lose their status
if they offer non-evidence-based
treatments. The organisation
represents and registers the 10 per
cent of vets who go on to specialise
in 20 or so fields, such as radiology.
“The basics of homeopathy are
not in agreement with science,”
says Johannes Lumeij of Utrecht
Veterinary School in the
Netherlands, and EBVS president.
The Swedish Veterinary
Association banned its members
from homeopathic practice
decades ago. Its president, Karin
Ostensson, told New Scientist that
the association takes the view that
“homeopathy does not rely on
evidence-based science, and it is
absolutely unacceptable for vets
to work without a scientific basis”.
In early September, the British
Veterinary Association, which
represents 10,000 vets, issued a
statement attacking plans by the
UK Medicines and Healthcare
Products Regulatory Agency to
license homeopathic medicines
without demanding clinical trials.
“No genuine ‘provings’ of
homeopathic remedies have ever
successfully been performed in
animals,” the statement says.
“There is no evidence whatsoever
of a physiological or therapeutic
effect. Instead, the homeopathic
ritual of case-taking and remedy
matching appears to influence the
owner to perceive the animal’s
condition in a more favourable
light, attributing coincidental
recovery to the remedy and even
imagining improvement where
none is present,” it says.
International news and exclusives
This week–
Homeopathic vets
come under fire
A global backlash against alternative veterinary
medicine is leaving its practitioners marginalised
“When vets go into
homeopathy it creates a
false impression that it is
evidence-based”
JL/SAE/KEYSTONE/REX FEATURES
–Do you do voodoo?–
www.newscientist.com 10 December 2005 | NewScientist | 9
In the US, the American
Veterinary Medical Association
(AVMA) allows its 73,000
members to practise homeopathy
or chiropractic, but keeps such
therapies at arm’s length.
“We encourage those that use
alternatives to help develop the
science showing they work,
particularly through double-blind
placebo-controlled tests, but no
one has done that yet,” says Bonnie
Beaver, who recently stood down
as president of the association.
Members of the AVMA are not
allowed to advertise themselves
as a specialist in alternative
therapies, and Beaver says she
cannot imagine the association
giving the kind of endorsement
that homeopathic vets enjoy in
the UK. “A list would give a certain
recognition level to the public,
so it’s not something that would
happen here.”
The RCVS disputes this view.
“We would argue we’re not
promoting homeopathy, but are
taking a neutral stance,” says
council member Stephen Ware.
He says the list provides a service
by helping clients find qualified
vets capable of doing homeopathy.
John Saxton, ex-president of
the British Association of
Homeopathic Veterinary Surgeons,
says the list is not there to
promote homeopathy. “It’s to say
these guys have this qualification,
and if you have a client who wants
homeopathic treatment, here’s a
list to help you find them.”
But David Ramey, a horse vet
in California, and long-term
sceptic of homeopathy, says that
any blurring of the distinction
between conventional and
complementary vets should be
resisted at all costs. “If you try and
incorporate everything under
veterinary medicine, you start to
erode the standards in practice,”
he says. “I say keep the two apart,
and let the market decide.” ●
In this section
● When is a face transplant the answer? page 10
● Sloppy copying is key to polio’s strength, page 16
● Blocking starlight to see alien planets, page 19
IMAGESOURCE/PHOTOLIBRARY
CURE OR QUACKERY?
Many orthodox vets argue that there
is no genuine scientific evidence that
homeopathy works. Very few reliable
studies have been done on homeopathic
treatments in animals, and of these most
point to them having no more than a
placebo effect.
A few have claimed positive results.
Indian researchers led by Ram Naresh of
the Indian Veterinary Research Institute
in Izzatnagar, Uttar Pradesh, this year
reported that a commercially available
cocktail of homeopathic ingredients,
including belladonna and arnica, was
effective against mastitis in cattle. The
homeopathic remedy healed 87 per cent
of treated udder regions, compared with
59 per cent treated with conventional
antibiotics (Homeopathy, vol 94, p 81).
The trials were not “double blind”,
however, which weakens the result.
In a double-blind trial there is no
possibility of bias because neither the
experimenter nor the patient (or in this
case the farmer or owner) knows until
the results are analysed which of the
subjects received the treatment and
which got the placebo. That way there is
no chance for unconscious bias creeping
in: for example, by cows treated with
the homeopathic remedy being looked
after differently.
An earlier double-blind trial, by
British vet Chris Day in 1986, also claimed
to show that homeopathic remedies
cut the incidence of mastitis in cattle
from 48 to 2.5 per cent. And in 1984,
Day reportedly reduced the incidence of
stillborn piglets with another remedy,
caulophyllum (The Veterinary Record,
vol 114, p 216).
The majority of studies have found
no effect, however. In April, for example,
The Veterinary Record reported results
from a double-blind trial in which
250 cows received either a homeopathic
remedy for mastitis or a placebo (vol 156,
p 565). Milk from cows with mastitis
normally has an elevated level of white
blood cells. But when Mark Holmes at
the University of Cambridge and his team
counted white blood cells in milk before
and after treatment they found minimal
change in either case, suggesting the
homeopathic remedy was no better
than the placebo.
In 2003, Kerstin de Verdier of
the National Veterinary Institute in
Uppsala, Sweden, reported in Acta
Veterinaria Scandinavica (vol 44, p 97)
the failure of the homeopathic remedy
podophyllum for diarrhoea in calves
in a double-blind trial.
Recent reviews of the field – both
animal and human – have also been
negative. In August, Matthias Eggar and
colleagues at the University of Bern
in Switzerland published an analysis
comparing 21 studies of homeopathic
remedies with nine studies of
conventional medicines. They
concluded that “the clinical effects
of homeopathy are placebo effects”
(The Lancet, vol 366, p 726).
And last month in Trends in
Pharmacological Sciences (vol 26, p 548)
Edzard Ernst of the University of Exeter,
UK, concluded that “contrary to many
claims by homeopaths there is no
conclusive evidence that highly dilute
homeopathic remedies are different
from placebos”.
Homeopathic vets admit that
evidence from large, double-blind,
placebo-controlled trials is thin on
the ground. But some argue that this
is beside the point. “There’s a strong
body of anecdotal evidence over
hundreds of years,” says Larry
Bernstein, president of the American
Holistic Veterinary Medical Association.
“The problem is if you try to prove
homeopathy using the scientific
paradigm,” he says. “When you do
double-blind studies, you’re trying
to standardise the therapy, but
homeopathy is individualised to each
patient, so if the remedy works in Andy,
who says it will work in Bill?”
“We encourage those that use
homeopathy to help develop
the science showing it works.
No one has done that yet”
–He can’t choose his treatment
- guest
oh this is so hilarious....
by Scstables » Mon Sep 04, 2006 1:23 pm
Sorry to say, but if used correctly homeopathy does work.
Let's use me as an example. Summer 2004, I came down with a nasty case of Lyme disease. I had the classic bull's eye and everything to go along with it. Instead of screwing around with antibiotics which sometimes do not work, I went directly to my integrated M.D. He did dx me with Lyme and a few other secondary infections on top of it. He put me on a Lyme nosode (which is homeopathy) and immune stimulator drops for 8 weeks. After on the stuff for a week, I began feeling better. In 2 weeks, I was as good as new. So, don't tell me that this is quakery, I will laugh.
I also was "cured" of fibroid breast lumps by my integrated M.D. using homeopathy and acupuncture. I even have the proof - went back to my breast Dr. who could NOT believe that my fibroids disappeared. He said what ever I am doing to keep doing it.
OH YES - I even reversed hypo thyroidism (I mean my holistic veterinarian) in BOTH of my horses with herbs AND homeopathy.
- Scstables
- Posts: 1
- Joined: Mon Sep 04, 2006 1:16 pm
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