A Beginner’s Guide To Homeopathy

December 5, 2009 at 3:52 pm (Beginner's Guides, Homeopathy) (, , , , , , , , , , , , , )

The latest in an occasional series looks at homeopathy.

What is homeopathy?

It is a system of medicine based on the principle that ‘like cures like’. The German physician Samuel Hahnemann founded homeopathy in the 18th century after hearing claims that cinchona could cure malaria. Hahnemann took cinchona bark and decided that the symptoms he noted in the following weeks were similar to those associated with malaria.

He concluded that “that which can produce a set of symptoms in a healthy individual, can treat a sick individual who is manifesting a similar set of symptoms.” The principle of like curing like, and the discipline of homeopathy, came into being based on this conclusion. The ideas of Succussion and High Dilutions of remedies followed.

What are these high dilutions?

Homeopathic remedies are diluted in stages by a factor of 10 or 100. Remedies above 24X or 12C are unlikely to contain a single molecule of the active ingredient. While some homeopaths tend to prescribe so-called ‘lower potency’ remedies that are at or below 24X or 12C and may therefore contain a trace of the original active ingredient, others claim that higher dilutions are more potent – despite them not containing any trace of the active ingredient. To back up this claim, they invoke ‘the memory of water’.

What does the memory of water mean?

It has been claimed that the water in homeopathic remedies is somehow able to retain a memory of the original active ingredient that has been diluted out of existence. In the 1990s an experiment (using antibodies that were then diluted out of existence) was reported to have found that water had a ‘memory’ – but only when the experimenters were aware of which test tubes originally contained the antibodies and which did not. When the experiment was repeated with blinding, the results could not be replicated.

In 2005, researchers found that “liquid water essentially loses the memory of persistent correlations in its structure within 50 fs.” 50 fs means 50 femtoseconds – and a femtosecond is one thousandth of one billionth of one second one thousandth of one trillionth (or one millionth of one billionth) of a second*. This is rather less time than would be needed to take a homeopathic remedy after its manufacture.

Is homeopathy explained by quantum physics?

I doubt it. Some advocates have claimed that they can explain how homeopathy works using quantum theory. However, several bloggers have taken a closer look at some of those making these claims and examined the basis for the claims. Here, it is noted of a paper on homeopathy and quantum theory that “Having misunderstood and misrepresented quantum theory, Milgrom now goes on to do the same for weak quantum theory (WQT).”

Does homeopathy work?

No. There are several ways in which we can try to judge whether a treatment works. Prof Ernst described these methods in a talk he gave on alternative medicine. Ernst highlighted four ways of attempting to find out if something works: plausibility; the test of time; ask the patient; do the research.

Plausibility is a poor guide to the efficacy of a medical treatment. Blood-letting was (in its time) seen as a plausible treatment because of the belief that health was affected by the status of the four humours, yet it did not work**. Homeopathy is implausible (some would argue that efficacy in terms of the higher dilutions, which contain not a single molecule of the original ingredient, is impossible rather than implausible), but the implausibility of homeopathy is not the final nail in its coffin.

The test of time is also a poor guide – blood-letting was used for hundreds, if not thousands of years despite being ineffective. An appeal to tradition is a logical fallacy – there is nothing inherently good about an idea simply because it has been held for some time. Old ideas can be bad ideas and the longevity of an idea, whether old or new, gives us no clue as to its truth. That homeopathy has lasted for some time should not lead us to assume that it may be of use in treating patients.

Asking the patient is an unreliable way to discover the truth about a treatment. What Ernst refers to as the perceived therapeutic effect covers: the specific effect of therapy; true placebo-effect; clinician-patient interaction; the natural history of the condition; regression towards the mean; social desirability (e.g., the desire to please the person treating you may make you more inclined to claim a treatment worked); concomittent therapies; other context effects. While homeopathy may lack the first factor – a specific beneficial effect on the patient – some or all of the other factors will be present and will influence the patient’s view of the treatment.

We are then left with research. Homeopaths claim that their remedies will make you better. This is something that can be tested. Not only is it possible to conduct a double-blind, randomised, placebo-controlled trial on homeopathic remedies, it is possible to conduct such a trial on individualised homeopathy. There are some trials that show that homeopathy has an effect above placebo, but these tend not to be as well-designed as those that show no effect over placebo. Anyone can cherry-pick a single trial with a result that suits their argument, but if you look at the available literature and pick out the best-quality trials you will have a more reliable view of the evidence.

Fortunately, I don’t have to do this. Some scientists are willing to spend their time trawling through all the research into homeopathy and producing a systematic review of the literature. One such paper (Shang et al) can be found here.

Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects. [My bold.]

There have been some criticisms of the Shang paper, but these have tended to be insubstantial and have been dealt with by several people. An example of the criticisms and the way they have been dealt with is available here.

Another review, by Linde and Melchart, seemed more positive:

The results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. The evidence, however, is not convincing because of methodological shortcomings and inconsistencies.***

However, the same author (Linde, this time with other colleagues) later noted that:

Studies that were explicitly randomized and were double-blind as well as studies scoring above the cut-points yielded significantly less positive results than studies not meeting the criteria. In the cumulative meta-analyses, there was a trend for increasing effect sizes when more studies with lower-quality scores were added.

In other words: the poorer the quality of the trial, the better homeopathy looks. Design rigorous trials that eliminate bias, and the effects of homeopathy begin to disappear. If you want to show an effect of homeopathy, your best bet is to include the poorest-quality trials – those most likely to yield spurious results due to biases that have not been eliminated.

Believe it or not, there is actually a systematic review of systematic reviews of homeopathy:

Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.

OK – even if homeopathy is implausible, is not explained by quantum physics, and has not been shown to work better than placebo, shouldn’t we harness the power of the placebo effect by using homeopathy?

In my opinion, we should not. While we may all derive some benefit from something that is comforting (for example, a nice warm blanket or a mug of tea), prescribing pills and potions that have no beneficial effect for pretty much anything other than pain is in my view unethical – and any hope provided by homeopathy is a false hope.

Here, I looked at the case for the “powerful placebo” and found no good evidence that there was such a thing as the ‘powerful placebo effect’ – as Hróbjartsson and Gøtzsche put it in their Cochrane Review:

We found no evidence that placebo interventions in general have clinically important effects. A possible moderate effect on patient-reported continuous outcomes, especially pain, could not be clearly distinguished from reporting bias and other biases. We suggest that placebo interventions should not be used outside clinical trials, also for ethical reasons, as the use of placebo often involves deception.

Note that even in pain (the area where a claim for a powerful placebo effect is most plausible), the authors state that, far from being powerful, there is only a possible moderate effect. This moderate effect cannot be clearly distinguished from reporting bias and other biases and is therefore in doubt.

As to the ethics of prescribing alternative medicine such as homeopathy for its placebo effect, here, David Colquhoun writes that: “The whole trend in medicine has been to be more open with the patient and to tell them the truth. To maximise the benefit of alternative medicine, it is necessary to lie to the patient as much as possible.”

More

A video of Ben Goldacre explaining homeopathy. And an article of the same.

With regard to ethics and homeopathy, Gimpy has detailed examples of the issues.

A little light relief: a video of James Randi discussing homeopathy here. And here, Crispian Jago with a blog post ‘inspired’ by Monty Python.

*Correction: I made an error in describing a femtosecond as one thousandth of one billionth. Thanks are due to Col for pointing this out in the comments section.

**Correction: bloodletting is effective for haemochromatosis and therefore is probably more useful than the entire discipline of homeopathy. Thanks to Jo Brodie for pointing this out in the comments.

***Correction: it is worth noting that the authors also state that “when the analysis was restricted to the methodologically best trials no significant effect was seen”. Thanks to Mojo for pointing this out in the comments below.

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92 Comments

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  2. draust said,

    Nice summary jdc.

    Also in the “homeopathic light relief” category, could I offer (a blatant plug for my) “Super Calibrated Shaking” song?

  3. col said,

    Hate to split hairs, but a femtosecond is one millionth of one billionth of a second, not one thousandth of a billionth.

    Granted, this makes the “memory of water” even less plausible…

  4. jdc325 said,

    Thank you col – I meant to write “one thousandth of one trillionth” rather than “one thousandth of one billionth” of one second. I will fix my post shortly. Corrections and criticism are always welcomed on this blog, so please feel free to “split hairs” any time.

  5. Mojo said,

    The Linde and Melchart review might have stated in the “conclusion” section of its abstract that the “results of the available randomized trials suggest that individualized homeopathy has an effect over placebo”, but the “results” section says that (my emphasis):

    “In the 19 placebo-controlled trials providing sufficient data for meta-analysis, individualized homeopathy was significantly more effective than placebo (pooled rate ratio 1.62, 95% confidence interval 1.17 to 2.23), but when the analysis was restricted to the methodologically best trials no significant effect was seen.”

    This finding is made particularly clear by the “blobbogram” included in the paper (p.383), and is of course entirely consistent with the findings of the Shang paper.

    Homoeopaths rarely, if ever, cite this review (the ones they tend to cite are Kleijnen 1991, Boissel 1996, Linde 1997 and Cucherat 2000). I can’t figure out whether this is because of its results (which are pretty similar to the ones they like to cite) or simply because they like to deny that RCTs of individualised homoeopathy are even possible.

  6. AndyD said,

    What I find intriguing about homeopathy is that the water only ever remembers “beneficial” properties of the active ingredient. So it won’t remember the toxic qualities of arsenic, even when highly potentised but will, supposedly, remember the thing which, supposedly, makes arsenic a cure for something.

    Homeopathic water only has happy memories.

  7. Mojo said,

    @AndyD

    The thing is that the symptoms that homoeopaths want their remedies to cause are all the symptoms, whether apparently beneficial or otherwise. The perfectly matched remedy will be one that produces all, and only, the symptoms that the patient reports, so there is no distinction in homoeopathy between beneficial and toxic effects of remedies.

    “Provings” of remedies are these days carried out using the potentised remedies (as prescribed by Hahnemann in the 5th and 6th editions of The Organon) rather than the crude remedy substance. He considered that remedies would only exhibit “full amount of the powers that lie hidden in them”, hence the “law of infinitesimals” in which it is considered that the symptoms caused by remedies become more powerful and profound the more the remedy is diluted.

    This doesn’t appear to be consistent with the toxic effects of substances being eliminated by the dilutions, of course. As symptoms go, death is about as powerful and profound as it gets.

  8. Lindy said,

    Great post!

    One of the anomalies about this dilute nonsense is that the homeopathic health practitioners, or whatever they call themselves to try to sound real, is that they make all these rollocks claims about being holistic and ‘treating the whole person’ and then give them sugar pills that are supposed to relate to the symptoms. Can’t get my head round that, any more than I can round the notion of nothingness to cure illness (or wellness com to that).

    And if you want a laugh look at the helios website (my homeopathic favourite when I can be bothered)

    http://www.helios.co.uk/cgi-bin/store.cgi?action=list_remedies

    to see some of the remedies you can buy. They don’t make parrot droppings any more, but……………

  9. jdc325 said,

    Thanks Lindy – I think dog poo and the Berlin Wall are among my favourite homeopathic remedies. There really are some barmy remedies out there.

  10. jdc325 said,

    Thanks for commenting Mojo, AndyD.

  11. Jo Brodie said,

    Hello :)

    Bloodletting is actually a fairly effective treatment for something called haemochromatosis – this is an iron storage disorder in which too much iron is stored / retained by the body. The bloodletting helps to keep this at bay and needs to be done regularly, ie not a one-off treatment unfortunately.

    I only heard about this because one of the many organs that can be affected is the pancreas – in this case the person may develop a form of secondary diabetes called bronze diabetes. I think the bronze part refers to a colour change of the skin but if I remember correctly this is partly due to changes in melanin content rather than just iron.

    There may be other conditions in which ‘therapeutic venesection’ is recommended – I think it’s pretty much the same as donating blood.

    Anyway, enjoyed the post.

  12. jdc325 said,

    *Shamefaced*

    I can’t believe that this is the second time I have mentioned bloodletting on my blog and I have again forgotten to mention haemochromatosis. Damn my unreliable memory.

  13. warhelmet said,

    Hmm. I think that it is important to remember that homeopathy’s rather strange ideas about how to treat illness pale into insignificance compared to homeopathic ideas about the nature of “dis-ease” and the origins of “dis-ease”. Perhaps some homeopaths now accept germ theory but I’ve certain come across those that don’t. And many prominent homeopaths still burble on about “miasmatic influence” and stuff like that.

  14. In Defence Of Bloodletting « Stuff And Nonsense said,

    [...] that we once thought plausible, but now view as ridiculous. It is compared with chiropractic, homeopathy, and other “Alternative Medicine” disciplines in order to ridicule them. However, we [...]

  15. Nancy said,

  16. jdc325 said,

    Still ducking the Think Humanism challenge Nancy?

  17. Oliver Dowding said,

    Sorry, cynics and blind ones. Homoeopathy does work, and animals prove it time after time. Like hundreds of thousands of times each year. ooohhh, how painful you must find that – maybe take some Aconite for the shock of learning this?

    You may also like to contemplate how many 100′s of millions of pounds European Governments, including ours, are spending on the Large Hadron Collider, seeking to try and find out something nobody to date has proven therefore does not exist and is a phoney theory. If these Governments invested similar sums in homoeopthic research they might actually be investing wisely for the people.

    But I can safely say the cynics won’t agree. More power to the drug industry they will say. Bring on more drugs, more multiple dosing and ill people as a consequence. Etc etc etc…..

  18. jdc325 said,

    “Homoeopathy does work, and animals prove it time after time. Like hundreds of thousands of times each year.”
    Evidence, please.

    I quite often see the claim that placebo effects don’t apply to children or animals. It is possible, though, for an ineffective treatment to appear to benefit children and/or animals – firstly because there may be an expectation on the part of the owner or medical practitioner that the treatment will be beneficial and secondly because there may be a conditioning effect on the animal being treated.

    If homeopathy really did work in children or animals then this would be easily tested in trials designed to reduce bias.

    All you have to do, then, is post convincing evidence that homeopathy has an effect beyond placebo in animals. A systematic review that shows that the best available evidence supports the use of homeopathy in animals would be a good start.

    If no well-designed studies have been conducted then one would have to ask why on earth homeopaths are claiming the therapy works in animals in the absence of decent evidence.

    You claim hundreds of thousands of animals each year are successfully treated by homeopathy – but can you back up this claim?

  19. jdc325 said,

    “You may also like to contemplate how many 100’s of millions of pounds European Governments, including ours, are spending on the Large Hadron Collider, seeking to try and find out something nobody to date has proven therefore does not exist and is a phoney theory. If these Governments invested similar sums in homoeopthic research they might actually be investing wisely for the people.”

    Researchers are trying to recreate conditions a fraction of a second after the big bang in order to see if they can work out what happened. The creation of the Higgs boson is just one of the rare events that the researchers in question are looking for. We don’t know what they will find until they look.

    With regards homeopathic research, this has already been done (there is extensive research in humans) and has shown time-after-time that in the best-conducted studies homeopathy has no effect beyond placebo – what makes you think that more research into a therapy we already have rather a lot of information on (and is not only implausible but has been consistently shown to have effects comparable to placebo) is a wiser investment than the LHC?

  20. Oliver Dowding said,

    There are none so blind as those who won’t look.

    You know the evidence is there, trials have been written up – I am not a scientist and so won’t be doing so myself as unfunded.

    There are results if you cared to look – see The Veterinary Record March 3rd 1984

    Alternatively see http://www.alternativevet.org/research.htm

    However, I have every confidence you will use your best nit-picking endeavours to ridicule this research.

    Just as I doubt you will have any problem with wrongly conventionally diagnosed conditions, wrongly prescribed “drugs” and further illnesses caused by these and or death, and none of which will be recorded.

    With regard the Higgs Boson research, I accept what you say about it. It may show benefit to human kind, who knows. But the money if spent on homoeopathy, with properly designed trials, would show what it can do for sick people, and much sooner.

    Lastly, I would remind you that you did not comment on this point – I don’t wonder why. If, as you are so cocksure, the animals got better “anyway” as what we did to them acted merely as a placebo, then surely you ought to advocate this method of treatment for the millions of other animals currently subjected to anitbiotic and other “drug” treatments? Think how much the animal keepers could save, reduced the risk of resistance, and the impact on the animals that will get better all by themselves courtesy of a placebo.

    I’m pleased to comment in my own name, and find it sad to have to guess who jdc really is.

  21. jdc325 said,

    There are none so blind as those who won’t look.

    You know the evidence is there, trials have been written up – I am not a scientist and so won’t be doing so myself as unfunded.

    There are results if you cared to look – see The Veterinary Record March 3rd 1984

    Alternatively see http://www.alternativevet.org/research.htm

    OK, let’s take a look. The link provided gives six links to research. Two of these links are to trials of homeopathy for mastitis in dairy cows. I’ve found another trial of the same that was not linked to. Why? Perhaps because the results didn’t suit the authors of the website you link to. This is known as cherry-picking. The reason I suggested that a systematic review would be a good place to start is because (if the review is well-conducted) the authors will have searched for each paper in the field and used pre-defined criteria for inclusion in the review – giving an accurate overview of the state of the evidence.

    The first study I looked at from the link you provided stated that they tried and failed to replicate their work. The second study stated in the discussion that “it is not possible to determine for certain, whether the effect is from the intervention or from some other ‘unknown’ factor.” So you can see, far from your prediction that I would “use [my] best nit-picking endeavours to ridicule this research”, the authors have themselves pointed out the flaws and difficulties with their research. Here’s a paper I found: “There were no significant
    differences between the SCC of the two groups on any sample day, but there were significant variations between the SCC on different days (P=0·003) in both groups.” PDF.

    Just as I doubt you will have any problem with wrongly conventionally diagnosed conditions, wrongly prescribed “drugs” and further illnesses caused by these and or death, and none of which will be recorded.

    You may doubt that I have a problem with misdiagnosis, but there is absolutely no basis whatsoever for this “doubt” and I can assure you that you are entirely wrong. You are also wrong that adverse events that may (or may not) be caused by drugs will all go unrecorded – I suggest you look up the Yellow Card Scheme.

    With regard the Higgs Boson research, I accept what you say about it. It may show benefit to human kind, who knows. But the money if spent on homoeopathy, with properly designed trials, would show what it can do for sick people, and much sooner.

    We’ve already got the results of many properly designed trials into homeopathy, the results of systematic reviews of these trials, and even a systematic review of systematic reviews of these trials – they show that homeopathy provides no benefit beyond placebo effect. Quite frankly, conducting further research into homeopathy would be flogging a dead horse. However, if you are so convinced that further research is needed you might perhaps ask the homeopathy industry to fund it? When I criticised Big Pharma (for being ‘pill pushers’ and spending twice as much on promotion as they do on R&D), Gimpy pointed out that Boiron spend ~18.5 times as much on advertising as they do on research.

    Lastly, I would remind you that you did not comment on this point – I don’t wonder why. If, as you are so cocksure, the animals got better “anyway” as what we did to them acted merely as a placebo, then surely you ought to advocate this method of treatment for the millions of other animals currently subjected to anitbiotic and other “drug” treatments? Think how much the animal keepers could save, reduced the risk of resistance, and the impact on the animals that will get better all by themselves courtesy of a placebo.

    I made clear in my post why I thought that we shouldn’t harness the power of the placebo effect by using homeopathy – perhaps you would like to re-read that section? I don’t think that effective treatment should be witheld from animals in favour of homeopathy and I don’t think money should be wasted purchasing homeopathic remedies to use alongside effective medication. Where treatment would be inappropriate, none should be given – conventional or homeopathic.

    I’m pleased to comment in my own name, and find it sad to have to guess who jdc really is.

    Well, guess no longer – my full name, email address, and competing interests are all listed in the “About” page for this blog (linked to in the sidebar). I don’t think that you need to know anything about me in order to judge the views I express, but the information is but a click away should you feel otherwise.

  22. Dr*T said,

    “There are none so blind as those who won’t look”

    e.g., looking up the vast number of good quality trials that demonstrate that homeopathy is no better than placebo?

    None so blind, indeed.

  23. Chris said,

    I’ve seen homeopathy work on animals and babies many, many times, I’ve also seen it not work. For someone who purports to have a significant interest in the subject of homeopathy, I wonder how you come to fall entirely on one side of the discussion. Is this because there is *nothing* whatsoever in homeopathy being effective? Clearly, this is not the case as so many people have actually seen it work – there must be something in it.

    To deny this puts you on the ‘flat earth’ side of scientific enquiry: “If I can’t see it, it can’t be true!”. No ability to hear what people say, what other people have seen, and repeatedly trotting out the same one sided arguments, and no discussion or real scientific enquiry. Your mind appears to be closed, (blind – as was said above) just as it is in others who grip tightly to such an absolute one sided perspective.

    To call this “A Beginner’s Guide To Homeopathy” is misguided, and misleading. You don’t actually offer a guide to homeopathy in any normal sense, just a one sided ‘critique’ on it.

    You have a right to your views, of course. But there is a reason why you hold them so rigidly tight. Maybe you don’t know why, or maybe you can illuminate us.

  24. jdc325 said,

    “…so many people have actually seen it work – there must be something in it.”
    Really? Before I respond to your comment, I’d like to ask you one or two questions. Do you understand anything about cognitive biases or evidence-based medicine Chris?

  25. Oliver Dowding said,

    “Do you understand anything about cognitive biases or evidence-based medicine Chris?”

    I am sure that Chris will reply his own time, let me say that yes, I do understand about cognitive bias.

    Unfortunately, the thousands of cows, calves and other animals that I and my herdsmen treated over 15 years did not. They weren’t interested in cynics, or naysayers.

    The same is true for the tens of thousands and more animals which are treated routinely by homoeopathic vets, and farmers up and down the country. They are not interested in mind games. I don’t know whether the earth is flat all round, and they don’t care.

    I appreciate that this is the hardest argument for those such as jdc to accept. Because you think, you now know all there is to know about molecules, atoms and particulate sizes smaller than that, you judge all reactions and responses upon that knowledge alone and make no allowance for there being something you don’t know. In other words, you appear to have a closed mind, which is not what I thought, a scientist had.

    I am not a scientist, but surely, just because I don’t have fancy letters after my name it doesn’t invalidate experience? Surely it doesn’t stop me from using my eyes.

    Before I first began using homoeopathy on livestock, I had for 15 years used very conventional veterinary intervention, and the concept of homoeopathy seemed as alien and unlikely to me then, as it does to the naysayers now. However, fortunately, that didn’t stop me enquiring further and learning from practical experience and observation. In making the change, I forgot to tell the cows. Oooopps. Had I explained to them, I’m sure they would have resisted and refused to get better, letting their cognitive function overtake their bodily reaction.

    So, you can ask Chris whether he understands about cognitive bias or evidence-based medicine. You can’t ask animals. And once again, I’ll suggest, to which you’ll brush over and ignore the remark, but if you think the animal would have got better anyway, why don’t you recommend to livestock farmers that they stopped using modern veterinary drugs? It would appear that you think that their animals will get better anyway, that they won’t have any animal welfare suffering to contend with. Reality of course would be very different. You won’t find any conventional veterinary colleagues, who will recommend this course of action either.

  26. Oliver Dowding said,

    As a follow-up, where I said “I don’t know whether the earth is flat all round, and they don’t care.”, I meant to say “They don’t know whether the earth is flat all round, and they don’t care.

  27. jdc325 said,

    “I am sure that Chris will reply his own time, let me say that yes, I do understand about cognitive bias.

    Unfortunately, the thousands of cows, calves and other animals that I and my herdsmen treated over 15 years did not. They weren’t interested in cynics, or naysayers.”

    Unfortunately, the owners of these animals and those treating them have cognitive biases. This is something you appear either not to recognise or not to have considered.

  28. jdc325 said,

    “I appreciate that this is the hardest argument for those such as jdc to accept. Because you think, you now know all there is to know about molecules, atoms and particulate sizes smaller than that, you judge all reactions and responses upon that knowledge alone and make no allowance for there being something you don’t know. In other words, you appear to have a closed mind, which is not what I thought, a scientist had.”
    Funnily enough, you don’t need to know about “molecules, atoms and particulate sizes smaller than that” to judge whether or not homeopathy works – you can simply test it in controlled trials (or read the published results of those who have done so). That homeopathy defies the laws of physics merely makes it an implausible treatment, that homeopathy consistently fails controlled trials designed to test its efficacy makes it a useless therapy.

  29. Oliver Dowding said,

    You said “you don’t need to know about “molecules, atoms and particulate sizes smaller than that” to judge whether or not homeopathy works”

    Perhaps you don’t need to know. Tens of thousands of animals getting better after having homoeopathic remedies administered don’t need to know either.

    Because you refuse to accept the concept, and like to fall back on your knowledge of the laws of physics to therefore describe it as implausible, does not in itself mean that it is not efficacious. Anyone who has understood the modus operandi of prescribing and selecting homoeopathic remedies would understand that trials in the commonly understood sense, as used on pharmaceutical drugs are not a valid way of testing homoeopathic treatment.

    When you say that “Unfortunately, the owners of these animals and those treating them have cognitive biases. This is something you appear either not to recognise or not to have considered” you are sadly mistaken. You also didn’t read my post thoroughly. If you did you’d have understood that I’ve treated animals using both forms of medication, came to homoeopathy with a very dubious mind that had the evidence presented to me by truthful animals. The herdsmen who looked after them were predominantly not highly educated, but excellent stockmen, and held no brief for either code of treatment.

    So, with regard to your your statement that “you don’t need to know about “molecules, atoms and particulate sizes smaller than that” to judge whether or not homeopathy works”, maybe I could agree with you, because I don’t know, the animals don’t know, and yet miraculously they get better.

  30. jdc325 said,

    “Because you refuse to accept the concept, and like to fall back on your knowledge of the laws of physics to therefore describe it as implausible, does not in itself mean that it is not efficacious.”
    You seem to be simply repeating my point here – I noted that homeopathy is implausible due to it defying the laws of physics. I noted that homeopathy is a useless therapy because it fails tests. It is not the implausibility that makes me believe that homeopathy is not efficacious, it is the consistent failing of well-designed tests.

    “Anyone who has understood the modus operandi of prescribing and selecting homoeopathic remedies would understand that trials in the commonly understood sense, as used on pharmaceutical drugs are not a valid way of testing homoeopathic treatment.”
    In response to this point, I think perhaps I should simply quote this:

    Here is a model trial for homeopathy. You take, say, 200 people, and divide them at random into two groups of 100. All of the patients visit their homeopath, they all get a homeopathic prescription at the end (because homeopaths love to prescribe pills even more than doctors) for whatever it is that the homeopath wants to prescribe, and all the patients take their prescription to the homeopathic pharmacy. Every patient can be prescribed something completely different, an “individualised” prescription – it doesn’t matter.

    Now here is the twist: one group gets the real homeopathy pills they were prescribed (whatever they were), and the patients in the other group are given fake sugar pills. Crucially, neither the patients, nor the people who meet them in the trial, know who is getting which treatment.

    This trial has been done, time and time again, with homeopathy, and when you do a trial like this, you find, overall, that the people getting the placebo sugar pills do just as well as those getting the real, posh, expensive, technical, magical homeopathy pills.

  31. Neuroskeptic said,

    “Tens of thousands of animals getting better after having homoeopathic remedies administered don’t need to know either.”

    Animals are quite clever in their own way you know: they have immune systems, and they use them to get better from illness! Indeed unlike humans, they don’t automatically ascribe their improvement to the treatments they received beforehand, which is rather a plus. My cat, for example, is a veritable medical genius – he has never claimed to cure anyone by CAM.

  32. Oliver Dowding said,

    “I noted that homeopathy is a useless therapy because it fails tests. It is not the implausibility that makes me believe that homeopathy is not efficacious, it is the consistent failing of well-designed tests.”
    If you really believe this, then what explanation to you give for the “well designed (by nature/evolution)” animals recovery? And we should note that some of the conditions being treated are not simple, but complex.

    “This trial has been done, time and time again, with homeopathy, and when you do a trial like this, you find, overall, that the people getting the placebo sugar pills do just as well as those getting the real, posh, expensive, technical, magical homeopathy pills.”
    Once again, I hear your comments…..”people”. So what of animals who cannot speak no evil, hear no evil nor (except in a few monkey’s cases) do no evil? What of the fact that tens of thousands – perhaps millions – of animals have been treated individually – ah, not the sort of trial you want, how inconvenient – and responded positively……unless you think they are liars, deceivers, or would have just got better anyway. Of course, anyone who has kept animals on a farm-scale will know that all three scenarios are false.

    For what its worth, I was not using “sugar pills” but liquid solution – alcohol, distilled water and the remedy.

  33. Oliver Dowding said,

    Neuroskeptic, your cat is not a trial of one.

    Don’t patronise me or anyone treating animals homoeopathic link by suggesting I don’t know about animals and their immune systems. Its just that those immune systems don’t stop them getting mastitis, metritis, having calving problems, having difficulty with fertility and many many other illnesses or conditions. I wish.

    Furthermore they don’t know that they are getting any treatment, they don’t know they are ill, necessarily, and they certainly don’t know what the illness is that they are expected to recover from. They don’t know what the remedy is. They don’t know the strength of the remedy. Also, they can’t write.

    The sheer numbers of positive responses to homoeopathy by animals, mining and those of other people, suggests to me that it’s something better than chance or cunning animal behaviour that leads to success. It’s very unfortunate for those who like to deny, and insist that they just got better just because they did. Sounds a bit like a grumpy parent responding to a persistent child’s valid enquiry for which the parent has no ready answer but resorts to the retort “you do it because I say so”.

    As an added bonus, the animals didn’t get treated with antibiotics, and therefore increase the risk of resistance to the antibiotics becoming a problem, which it increasingly is these days.

  34. jdc325 said,

    “I noted that homeopathy is a useless therapy because it fails tests. It is not the implausibility that makes me believe that homeopathy is not efficacious, it is the consistent failing of well-designed tests.”
    If you really believe this, then what explanation to you give for the “well designed (by nature/evolution)” animals recovery? And we should note that some of the conditions being treated are not simple, but complex.

    Why would we see signs of recovery in sick animals treated with homeopathy? Here’s a partial list of possible reasons: spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment.

  35. jdc325 said,

    “This trial has been done, time and time again, with homeopathy, and when you do a trial like this, you find, overall, that the people getting the placebo sugar pills do just as well as those getting the real, posh, expensive, technical, magical homeopathy pills.”
    Once again, I hear your comments…..”people”. So what of animals who cannot speak no evil, hear no evil nor (except in a few monkey’s cases) do no evil?

    Sorry – I should have pointed out that trials of homeopathy in animals have also been conducted. Would you like to discuss the available evidence relating to homeopathy in animals?

  36. Oliver Dowding said,

    “Why would we see signs of recovery in sick animals treated with homeopathy? Here’s a partial list of possible reasons: spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment.”
    if you truly believe that this is the possible list of explanations, when you write a letter in Farmers Weekly, or the Veterinary Record, and explain that you see these as possible ways that animals recover from illness, and that farmers therefore need not bother to give them the more normal drug treatments that they administer. Explain to them that they can just sit and watch their cows and other livestock quietly recover. That was a partial list, then goodness knows what other nonsense, you got put on the full list. the animals that I am talking about, which we treated did not get additional treatment, only homoeopathic remedies. I’ll have to leave you to carry on in your denialist mode.

    You then asked “Sorry – I should have pointed out that trials of homeopathy in animals have also been conducted. Would you like to discuss the available evidence relating to homeopathy in animals?” I’m well aware that many trials have been conducted, not least because you’ve pointed them out to me before. I’ve also read them from other sources. I’ve also seen the results of each individual trial, much more relevant and appertaining to homoeopathy, undertaken with each individual animal on my farm. it seems you’re doing everything you possibly can to avoid facing up to the facts of how my animals, remember that 500 kept on the farm every year for 15 years, responded to homoeopathy in their own individual way, within individual remedies selected for an individual complaint. That is what medicines should be all about, treating the individual and observing the reaction and responses. Whether you choose to do it with groups and try to conduct what you call a trial is up to you. If that’s the only kind of research or trial that you’re prepared to either undertake, or accept the results of, then that’s an unfortunately narrow-minded approach, but one which I suggest suits those who wish to deny the efficacy of the treatments administered on an individual basis to an individual animal, which does not know how to lie or deny. Not forgetting, of course, that this is just about what happened on my farm, or what happens on farms in this country, but about what happens on many farms the world over. As I’ve said before, it looks to me you see this as an inconvenient obstruction to attempts to close minds, be that yours or other people’s, and deny reality.

    As I’ve also said before, I am happy to have medicine of many different sorts, and rule out nothing as being potentially efficacious in dealing with the condition that I, people I know, people I don’t know, animals I keep, animals I don’t keep may be suffering from.

  37. Michael said,

    Oliver’s used the “the sheer number of…” gambit several times now, so it’s probably time to address it.
    Nobody’s contesting the fact that you’ve seen lots of cows get better after you’ve treated them.
    What folks are questioning is you using this to leap to the conclusion that they got better because of the homeopathy.
    This is because you a) ignore the number of cows that didn’t get better and b) fail to see the number of cows that get better of their own accord.
    The “sheer number” is irrelevant without this information.
    It’s like saying “I tossed a coin 100 times a day every day for a year. The sheer number of heads I got (over 15000!) means if I bet on heads, I’d almost certainly win!”

  38. Oliver Dowding said,

    “What folks are questioning is you using this to leap to the conclusion that they got better because of the homeopathy.”
    Thank you for raising this.
    I don’t consider that I leapt to any conclusions. What I did do was to speak with the herdsman, on a daily basis, who were administering the remedies, see their results noted in their notebooks, and appreciate what 95% success rates looked like. Of course, these records were very much ad hoc and for our own use, and not recorded in a way that constituted a trial or would stand up to your idea of commonly understood scientific rigour.
    I’m pleased to be able to tell you that we most certainly didn’t ignore the number of cows that didn’t get better. Those animals for either reassessed, given the different remedy or a different potency of the same remedy, or maybe even a conventional medication to ensure that we were not any point compromising their welfare, for which our regular veterinary surgeon visit on a weekly basis would have been quick to pick up.
    However, Michael, if you want to be so flippant (!!) as to suggest that the responses were nothing more than equivalent to tossing/flipping a coin, then I’ll have to leave you to reside within the irrelevance of your opinion, because that is what it is if you’re determined to assume the application of homoeopathy within the animal kingdom is nothing more than a result of chance.
    As I’ve already said on several occasions, chances are that the animals haven’t learnt to be cynical, lie or deceive. Thank goodness I trusted their integrity!

  39. Chris said,

    You do take the biscuit mate :)

    “….that homeopathy consistently fails controlled trials designed to test its efficacy makes it a useless therapy.”

    No, it makes it a therapy not recognised as being effective by those people who choose to only judge efficacy within certain parameters. You may be a disciple of double blind trials, but you aren’t appreciative of logic. This does lend towards validating my point of you having a closed mind, or tunnel vision.

    To go back to your point of cognitive bias; for sure this is important. I have seen it operate in various scientific studies. Indeed more than cognitive bias, there is the issue of trials that are paid for by the drug companies that are having there wares tested. Trials that are designed to sit within a paradigm that only test specific effects. Eg a drug is tested for its effect on depression. The results are pushed out to the medical community in a certain way that means doctors will prescribe that drug to patients where harm comes to them. No harmful intention from the doctors, ignorance maybe, but harmful intent from the drug company who have had their drug tested within certain constraints? Maybe. Certainly greed is an issue there. We can look at the prozacs of this world to see such a process.

    And then there’s the long term effects of these medicines. There’s the effects of anti-biotics on possibly causing type 1 diabetes by toxicity in the pancreas. Etc etc…..

    Medicine is one of the least scientific areas there is. You should know that, and am sure you could offer me many examples. But you choose to rubbish a system of medicine that is far more difficult to prove in the type of trial you suggest above. If money were available, I’d be more than happy to design a trial that would prove homeopathy. But, there isn’t the money from drug companies or the government to do this. Meanwhile, there is the evidence from people such as Oliver here, who is patiently taking time to point you towards something that contains at least a ray of light. Are you spectacles really that jaded that you can’t see that?

    Meanwhile, I can assure you that people and animals are getting better every day through the use of homeopathy. One day, you may well have an ailment that can benefit from seeing a homeopath. But from what I read here, you’d rather trust in medicine that has many many faults in its trials, and has been shown to cause harm in itself. Who is the loser?

  40. jdc325 said,

    “…a therapy not recognised as being effective by those people who choose to only judge efficacy within certain parameters”
    I would prefer to judge efficacy based on fair tests. How would you judge efficacy?

  41. Oliver Dowding said,

    The circle is narrowing!

    I was always very happy for 15 years to leave the animals to judge its efficacy, and although you might think they’re biased, or that I had a preconception as to whether they got better or not, or was simply confused, I found them to be fairly trustworthy, having no commercial venture to promote etc. I’ve always found every animal very fair in their dealings with me, and therefore conclude that the test they were undergoing by using homoeopathy was also fair.

    The simple answer to your question, of course, is that efficacy is judged by response to treatment. See my several previous posts, the previous paragraph on this one, and there you have the answer you’ve been looking for.

  42. Homeopathic Confusion « Stuff And Nonsense said,

    [...] post on 10:23 and Boots. A beginners guide to homeopathy that I [...]

  43. jdc325 said,

    Oliver – I think you may have missed the point of my earlier comments. You write that:

    I was always very happy for 15 years to leave the animals to judge its efficacy, and although you might think they’re biased, or that I had a preconception as to whether they got better or not, or was simply confused, I found them to be fairly trustworthy, having no commercial venture to promote etc. I’ve always found every animal very fair in their dealings with me, and therefore conclude that the test they were undergoing by using homoeopathy was also fair.

    I’m talking about cognitive biases that affect the owners and those treating the animals, not a potential conflict of interest affecting the animals themselves. I’m not claiming that the animals being treated are confused or have biases or preconceptions that make your observations invalid. I am pointing out that your observations are subject to your own cognitive biases.

  44. Oliver Dowding said,

    Well, I accept that one cannot 100% rule out cognitive bias.

    However, on the sample size, and over the period. I think that highly unlikely, particularly given that there were multiple people (herdsmen/vets/researchers et al) observing the same positive responses. Furthermore, let’s not forget the thousands of vets, large numbers of whom have been conventionally trained in veterinary science, practice homoeopathic treatment of animals all over the world, and of whom there are significant numbers in this country. They wouldn’t continue to practice homoeopathy if they hadn’t noted positive results.

    Furthermore, if people are perhaps guilty of cognitive bias with homoeopathic remedies, why does the rule not equally applied to pharmaceutical drugs?

    Will you and everybody else seems who think homoeopathy consider a trial with Lachesis 6c? If you genuinely believe that there is nothing in the pills, you will feel convinced by your own arguments and be happy to take the Lachesis. I look forward to your response as to why you won’t, if that’s the case. After all, you probably want to dismiss it as something that would be ineffective, just sugar pills, so what’s the risk to you? Please be advised that the last person I heard of who did this developed long term paralysis in his arm. Maybe it was a coindicence? So if all the naysayers to dismiss homoeopathy and its potential to affect bodily change, all to the same remedy, for the same length of time, wouldn’t this be an excellent trial?

  45. jdc325 said,

    I’m not impressed by the number of people who have “researched” homeopathy in animals or the number of animals that are claimed to have been cured. Quality of research is more important than quantity in determining the efficacy of a treatment. If these “multiple people” or “thousands of vets” were taking part in properly controlled trials with randomisation and blinding then their “results” might be worth taking note of. Instead, all you can offer are anecdotes and the plural of anecdote is not data.

    Will you and everybody else seems who think homoeopathy consider a trial with Lachesis 6c? If you genuinely believe that there is nothing in the pills, you will feel convinced by your own arguments and be happy to take the Lachesis.

    Funnily enough, there are plans for sceptics to take homeopathic remedies in a few days time: link. Although it seems that this is a publicity stunt designed to raise awareness rather than a serious attempt to “test” homeopathy. You don’t test a treatment by asking a healthy person to take it and asking them what they feel. You design an appropriate trial. If I took Lachesis and nothing happened, what would it prove? Nothing. If I took it and something happened what would it prove? Again, nothing. You can’t rely on anecdotes.

  46. Oliver Dowding said,

    Well, I accept that one cannot 100% rule out cognitive bias. You’ll be pleased with that!

    However, on the sample size, and over the period. I think that highly unlikely, particularly given that there were multiple people (herdsmen/vets/researchers et al) observing the same positive responses. Furthermore, let’s not forget the thousands of vets, large numbers of whom have been conventionally trained in veterinary science, practice homoeopathic treatment of animals all over the world, and of whom there are significant numbers in this country. They wouldn’t continue to practice homoeopathy if they hadn’t noted positive results. You try to dismiss animals as though mine were the only ones on which it has been used!

    Furthermore, if people are perhaps guilty of cognitive bias with homoeopathic remedies, why does the rule not equally applied to pharmaceutical drugs? Not to forget the many side effects mentioned by others and ignored by the sceptics.

    Will you and everybody else who seems to think homoeopathy consider a trial with Lachesis 6c? If you genuinely believe that there is nothing in the pills, you will feel convinced by your own arguments and be happy to take the Lachesis. But….not just as a stunt outside Boots, but for a week. Extra dosing won’t matter – its only sugar after all, and you can exert mind over matter too.

    I look forward to your response as to why you won’t, if that’s the case. After all, you probably want to dismiss it as something that would be ineffective, just sugar pills, so what’s the risk to you? Please be advised that the last person I heard of who did this developed long term paralysis in his arm. Maybe it was a coincidence? So if all the naysayers who dismiss homoeopathy and its potential to affect bodily change, all take the same remedy, for the same length of time, wouldn’t this be an excellent trial?

  47. jdc325 said,

    “You try to dismiss animals as though mine were the only ones on which it has been used!”
    I think not. As I wrote earlier – “I’m not impressed by the number of people who have “researched” homeopathy in animals or the number of animals that are claimed to have been cured. Quality of research is more important than quantity in determining the efficacy of a treatment.”

    “Furthermore, if people are perhaps guilty of cognitive bias with homoeopathic remedies, why does the rule not equally applied to pharmaceutical drugs?”
    It does – which is why we expect pharmaceutical drugs to be tested in properly controlled trials.

    You seem not to believe that there can be any element of placebo effect in animals. One element of the placebo effect is conditioning – and we know that animals are susceptible to this e.g. Clever Hans, Pavlov’s Dog, etc etc.

  48. Oliver Dowding said,

    Re. your thoughts on animals treated and restored to full health by homoeopathy:

    If the kind of numbers that homoeopaths have treated and which have responded positively don’t impress you, then it’s safe to say that nothing is likely to impress you. You would appear to be prepared to believe that there’s an awful lot of animals out there that will respond in a placebo fashion to something that they don’t understand, do not know they are being treated with, a disease they didn’t understand, and probably didn’t know they’d got. If you’re going to stick to your guns, and continue to believe that they would have got better anyway, then presumably you will be campaigning for the majority of animals to be treated with nothing, because they too will get better. I’ve made this point before, but I don’t think you’ve responded to it, perhaps not surprisingly. Naturally, there won’t be any farmers who are prepared to take part in such trial, nor private pet owners etc. If they do, they’ll be up on animal cruelty charges before you can say knife.

    Re: cognitive bias with homoeopathic remedies and my asking “why does the rule not equally applied to pharmaceutical drugs?” and your saying “It does – which is why we expect pharmaceutical drugs to be tested in properly controlled trials.”

    I suppose that is a concession in that you only think that people may “perhaps” be guilty of cognitive bias. When something happens that challenges one’s natural belief system, then it’s relatively easy to dismiss it. When it happens time and again, it becomes harder. And when that becomes even more prevalent, it’s impossible, other than to the one whose eyes are totally closed, and mind made up to oppose reality. Furthermore, before you say, I can confirm that I’m quite happy to change my belief system, but unfortunately fee you and your fellow travellers, all I’ve seen with homoeopathy is results that enhance my belief system.

    You say “You seem not to believe that there can be any element of placebo effect in animals. One element of the placebo effect is conditioning – and we know that animals are susceptible to this e.g. Clever Hans, Pavlov’s Dog, etc etc.”

    I say in response….please see the above piece about animals.

  49. Oliver Dowding said,

    One other phone, giving a moment’s thought to conventional medication.
    Seroxat.
    maybe you’d like to have a read through the resume on Paul Flynn’s website, and MP taking a real interest in real people, and the problems they have gained courtesy of pharmaceutical products allegedly certified as safe and efficacious. I didn’t particularly mean to broaden the subject beyond homoeopathy, which is what we are discussing, but frankly, if you’re going to rely so heavily on the certainty that everything conventionally approved is safe, and that that’s the way we’re going to do science, then how on earth did a product like this ever get onto the market, and how on earth have scientists failed to admit they got it wrong. Unfortunately, this is not the only product were disasters have befallen mankind, courtesy of the laboratory and apparent safety testing.

    Here is the link http://www.paulflynnmp.co.uk/seroxat04.htm
    It is also somewhat disconcerting when one sees the pedigree of the people in charge of the MHRA.

  50. jdc325 said,

    “If the kind of numbers that homoeopaths have treated and which have responded positively don’t impress you, then it’s safe to say that nothing is likely to impress you. ”
    That’s untrue and unfair. I have repeatedly stated that good quality evidence is important – more important than the number of vets/owners using homeopathy. Yet again, you have completely missed the point.

    Quality – not quantity. Don’t try to impress me with anecdotes, however many of them you have. Try good quality evidence instead – RCTs, systematic reviews etc.

  51. jdc325 said,

    You would appear to be prepared to believe that there’s an awful lot of animals out there that will respond in a placebo fashion to something that they don’t understand, do not know they are being treated with, a disease they didn’t understand, and probably didn’t know they’d got. If you’re going to stick to your guns, and continue to believe that they would have got better anyway, then presumably you will be campaigning for the majority of animals to be treated with nothing, because they too will get better. I’ve made this point before, but I don’t think you’ve responded to it, perhaps not surprisingly. Naturally, there won’t be any farmers who are prepared to take part in such trial, nor private pet owners etc. If they do, they’ll be up on animal cruelty charges before you can say knife.

    No, I would not argue that animals should be given “nothing” as a treatment – which is precisely why I do not advocate homeopathy.

    I would argue that where there is evidence a treatment will help, it should be given. Where there is no evidence that something works, then why on earth would you use such a treatment?

    If one uses inert treatments with effects no greater than placebo (such as homeopathy) instead of evidence-based treatments then one is neglecting the animal. If one uses such inert treatments as well as evidence-based medicine, then one is simply wasting money.

    Use of homeopathy as a ‘complementary’ treatment is a waste of money. Use of homeopathy as an ‘alternative’ treatment instead of EBM is actively dangerous.

  52. Oliver Dowding said,

    “Where there is no evidence that something works, then why on earth would you use such a treatment?”

    The answer: because I know it works, because thousands of others do, etc.

    I’m clearly not going to convince you and you’re clearly not going to convince me. Enjoy your chemical potions, and I’ll enjoy my natural ones. I’ll also be able to rely on synthetic medication from time to time.

    Where you say “inert treatments with effects no greater than placebo (such as homeopathy)”, I take it that you’re not going to accept the Lachesis challenge. Remember, in your own words, it’s inert. If you want to reply, I’ll look forward to your reasons on why you won’t accept this challenge.

  53. jdc325 said,

    “Where there is no evidence that something works, then why on earth would you use such a treatment?”

    The answer: because I know it works, because thousands of others do, etc.

    But without evidence, you cannot have any degree of certainty as to whether it works or not. Without evidence, the correct answer to the question “does it work” is “I don’t know”.

    I’m clearly not going to convince you and you’re clearly not going to convince me. Enjoy your chemical potions, and I’ll enjoy my natural ones. I’ll also be able to rely on synthetic medication from time to time.

    You seem to be under the misapprehension that skeptics spend their time necking pharmaceutical medicines. I take medicine only when necessary. I can’t remember the last time I took any kind of medicine whether conventional or ‘alternative’. Luckily, I have managed to stay (fairly) fit and healthy without recourse to pills and potions of any sort except on very rare occasions when I contract an illness that requires medical attention.

    Where you say “inert treatments with effects no greater than placebo (such as homeopathy)”, I take it that you’re not going to accept the Lachesis challenge. Remember, in your own words, it’s inert. If you want to reply, I’ll look forward to your reasons on why you won’t accept this challenge.

    Frankly, I am not really inclined to waste time and money on a pointless ‘test’ of a homeopathic medicine that can tell neither of us anything about homeopathy (although I will not rule it out entirely). Should I choose to take up your rather pointless challenge, what would I need to do? Do I need to simply purchase a bottle of sugar pills / water and post you a copy of the receipt or something more elaborate? I don’t have access to a video camera, so cannot film myself taking the pills and post proof. If I provided proof of purchase would that be enough for you or would you demand a higher level of proof?

  54. brainduck said,

    Oliver, see http://www.1023.org.uk/the-1023-overdose-event.php
    I’m planning to buy and take a bottle of 30c arsenic outside Boots in Leeds on Saturday. You can come and watch if you’d like. If you’re picky about the specific remedy, I’ll take a bottle of 6c lachesis (whatever that is) too. No problem.

  55. lesmondine said,

    Duck: It’s from the venom of a bushmaster snake.

    I’ll take the Lachesis if you want. £5.25 a bottle. Duly purchased from here: http://www.healthstore.uk.com/p151418/weleda-lachesis-6c-125-tablets.html

    I guess if I come to harm we can write off that stuff about homeopathy never causing illness or nasty side effects, can’t we?

  56. Ed B said,

    All this back and forth about trials — rather tiresome. And extremely hard to be conclusive – there’s always another study that might be replicated one of these days. Even scientists of the calibre of Ennis agree that more trials sounds like a good idea (famously, when analysing attempts to replicate Beneveniste’s work).

    Let’s forget experimentation and evidence for a second. Let’s turn to that other great pillar of Science (other than experimentation and simulation). Let’s consider theory and method.

    For I think it would be more impressive if homeopaths actually had a decent scientific method to back up claims about evidence. Other way around sounds a bit cart before horse to me. After all, we wouldn’t be interested in RCT for witchcraft, would we? Why? Because we simply can’t agree that the method could possibly work.

    But we do seem to think that homeopaths have a sound method. Well, let’s ask Chris and Oliver to “show their working”, so to speak.

    Here are 3 fields of interest for Chris and Oliver to chew over:

    1. SUCUSSION. What reasons led homeopathy to substitute automated succussion for, if you will excuse the expression, “banging on a big leather book”? Has research been conducted in this field as to the differences this has or has not made? If so, what were the results? If not, why not?

    2. POTENTISATION. If remedies are potentised, how long does this potentisation last? That is: do homeopathic remedies have such a thing as a “sell-by date”? If not, why not? If so, how is this determined? Research? Bonus “paradox” question: what happens to potentised remedies that enter the water supply — as they indeed must if taken by healthy people (since we have homeopaths on record as stating that remedies have no effect on healthy people)?

    3. PROVINGS. Lastly, what is the procedure for designing remedies to match illnesses or conditions? We are aware of the “provings” aspect, which this addresses. Yet how does this work with new illnesses (such as new strains of flu), new conditions (e.g. RSI, which was perhaps less widespread before computers) or rare (genetic) disorders? Is the system standardised? If not, why not? If so, how?

    I’m happy for you to take part of one area or all three.

    As far as I know there are no industry-standard, research-based answers to any of the above. (And yes, I have posted this on other places on the internet and no, I have not had any answers yet.)

    Thank you.

    (Oh, and by the way, my name is Ed and I live here: http://www.twitter.com/edbradburn. As you can see, I think homeopathy is about as well-founded scientifically as the laying on of hands.)

  57. Oliver Dowding said,

    For Brainduck (!!) and Lesmondine…….

    You can buy as many bottles of as many remedies as you choose, and on the assumption that they are off the 30c potency or less, then as far as I know (and please note that I’m not qualified homoeopath) then few if any will have any impact. Remedial benefits are gained, generally, from taking the remedy over a specified period of time at specified regular intervals. There should be no surprise in this to you, because as you will recall from any time in the past when you be given medicine by your doctor, they’ve always specified the same thing, and more importantly, they’ve always reminding you to finish the course of medication. If you were taking antibiotics to deal with an infection, one antibiotic pill would be unlikely to create resolution of the infection.

    Should any of you really want to do the Lachesis experiment with Homoeopathy, then for it to be a worthwhile experiment, you will need to undertake it in this manner: take 1 homoeopathic dose (1 pill) of Lachesis 6c every hour, for a week…… and then say that it doesn’t work. Please be advised that I read that the last person who did this developed long term paralysis in his arm. As Lesmondine noted, the remedy is derived from the bushmaster snake’s venom, which poison works by paralysing the central nervous system. You should understand that if you only take one pill, once, I have no idea whether there will be any effect, but it will prove absolutely nothing. The same is true, for whatever remedy the crazy stunt participants decide to trial on Saturday.

    For Ed Bradburn’s benefit, I did not and am not saying that it is poisonous, as a remedy. So your silly twitter was completely misinterpreting what was being said. You might like to correct it? Ha, some chance. What I’m saying, and in the previous paragraph, is that the remedy, if taken as above, will create the symptoms of poisoning, but not be poisonous in itself. I imagine, you can see the difference between these two things. This is precisely how homoeopathy works, and the principle of like cures like. What makes you ill can also be what makes you well. I don’t have space here to educate you on the whole principal operation of homoeopathy, I’m not a trained homoeopath, I’m not a trained teacher, I’m not selling any homoeopathic product, I’m just engaged in a debate about its efficacy.

    With regard to your three points, I’ll take them in turn.

    Succussion: I don’t know. Others have done all this work, and I’m simply reaping the benefits of their research and endeavour. I choose to believe the efficacy of the process, having witnessed the benefit from the product. You can be sure that succussion is done in a different way today. As I’ve said previously, I don’t know exactly how everything I use on a day-to-day basis works, but I’m content that other people have trialled them adequately and develop them for my benefit, and therefore I’m happy to put my faith in their engineering or whatever other skills were deployed. This ranges from my computer, vehicles I use, etc.

    Potentisation: I again don’t know how this works. Again, it has no difference whether I do or I don’t understand the mechanics, but I do understand the difference in application. With regard suggesting that the remedy if found in the water supply could be impacting on normal healthy people, it would depend entirely on how much was in the water, and how often the drinker was exposed to it. To my knowledge, there won’t ever be any in general water supply, so therefore is a hypothetical scenario alone. This not least since the general water supply is laced with chlorine, which generally renders homoeopathic remedies ineffective. And no, I don’t know why that is either, just that it does.

    Provings: I refer to my answers above, I was not involved in the mechanics involved in this process, and have never undertaken anything like this myself.

    I’m sorry, Ed, if my answers aren’t terribly helpful, but may I suggest that you ask them of an homoeopath or an homoeopathic organisation. You ask a lot of questions, which the dancers could often be that it is “received wisdom.” I confidently anticipate that is not a basis upon which you would accept efficacy. I wonder if you asked all the same questions every single time your parents explained something to you? That is not to say that one should have blind faith in absolutely everything that somebody else tells you.

  58. jdc325 said,

    “Should any of you really want to do the Lachesis experiment with Homoeopathy, then for it to be a worthwhile experiment, you will need to undertake it in this manner: take 1 homoeopathic dose (1 pill) of Lachesis 6c every hour, for a week…… and then say that it doesn’t work.”
    No – for it to be a worthwhile experiment, you would need more subjects, a control group, blinding, and randomization.

    Can I ask, just out of interest – is the subject of the trial allowed to sleep or is the “every hour” part of the protocol literally “every hour”? I only ask because if I had to take a pill literally every hour of the day I think the sleep deprivation would cause me quite some discomfort.

  59. Ed B said,

    Hi Oliver,

    First off, many thanks for taking the time to reply. While it’s easy to Twitter, it’s nice to engage in a proper “full-length” discussion.

    Here are a few thoughts in return.

    “Should any of you really want to do the Lachesis experiment with Homoeopathy … Please be advised that I read that the last person who did this developed long term paralysis in his arm … For Ed Bradburn’s benefit, I did not and am not saying that it is poisonous, as a remedy. So your silly twitter was completely misinterpreting what was being said. You might like to correct it? Ha, some chance.”

    Not sure I understand you here. The remedy, if taken as you suggest, may lead to paralysis – but this is not to be regarded as poisonous? I am quite happy to retract an incorrect statement, but if something leads to paralysis as you suggest then I would hardly call it safe. Should I correct “poisonous” to “can cause long-term paralysis”?

    “What I’m saying, and in the previous paragraph, is that the remedy, if taken as above, will create the symptoms of poisoning, but not be poisonous in itself. I imagine, you can see the difference between these two things.”

    No, I do not see the difference between “causing long-term paralysis” and “causing the symptoms of long-term paralysis”. Paralysis is a condition: you are either paralyzed or you are not.

    “This is precisely how homoeopathy works, and the principle of like cures like. What makes you ill can also be what makes you well. I don’t have space here to educate you on the whole principal operation of homoeopathy, I’m not a trained homoeopath, I’m not a trained teacher, I’m not selling any homoeopathic product, I’m just engaged in a debate about its efficacy.”

    Ah, I was not aware you are not a trained homeopath. Much of the debate on 10:23 has been “interested lay public” vs. “trained homeopaths” so you’ll have to excuse my misapprehension there. That said, let’s continue as “lay public” vs. “lay public” :=) I have quoted you in brief to save space, not to “misquote” you – but feel free to comment if you feel my edits are untoward.

    Your comments about succussion, i.e.

    “Succussion: I don’t know. Others have done all this work, and I’m simply reaping the benefits of their research and endeavour … I’m happy to put my faith in their engineering or whatever other skills were deployed. This ranges from my computer, vehicles I use, etc.”

    OK, jury’s out on that one then. That agrees with my experience so far. I agree one can’t know everything about all aspects of modern technology. See however my last comment below.

    Potentisation:

    “With regard suggesting that the remedy if found in the water supply could be impacting on normal healthy people, it would depend entirely on how much was in the water, and how often the drinker was exposed to it. To my knowledge, there won’t ever be any in general water supply, so therefore is a hypothetical scenario alone. This not least since the general water supply is laced with chlorine, which generally renders homoeopathic remedies ineffective. And no, I don’t know why that is either, just that it does.”

    Interesting: I didn’t realize that chlorine treatment renders homeopathic remedies inactive. I have read that the treatment used in drinking water is hypochlorous acid, which has a pH of about 7.5. That’s odd, because these remedies will have survived stomach acid at a pH of 1 – 2. I’d been interested on seeing the data on this.

    Provings and conclusion:

    “Provings: I refer to my answers above, I was not involved in the mechanics involved in this process, and have never undertaken anything like this myself … You ask a lot of questions, which the dancers could often be that it is “received wisdom.” I confidently anticipate that is not a basis upon which you would accept efficacy. I wonder if you asked all the same questions every single time your parents explained something to you?”

    You make an interesting point about handed-down parental wisdom, Chris, but I think your previous point covers it well enough, about not knowing how everything works – especially as technology grows more complex. My problem with homeopathy is twofold in relation to this. First, while I do not know how a combustion engine works well enough to, say, teach someone how to build one, I do know that there are people who know this and can explain it to the last detail. With homeopathy, however, it’s not merely the lay public who cannot explain it – no trained homeopath can, either. Especially surprising, given that the discipline is over 200 years old, is that it is cutting-edge science that is often brought to bear on the problem. It seems an odd match and I can’t think of a similar field, anywhere in science, that shares this quality. I may of course be simply ignorant.

    So, faced with this situation, my reaction is to investigate the subject as best I can, and that does not mean trawling through random controlled trials and so forth, since I am not a research scientist. Which is why I asked the questions above, and will continue to ask them until I get satisfactory answers. As a member of the lay public, I consider manufacturing practice (succussion), shelf life/the environment (potentisation) and product development to be areas I can understand.

    Yet clearly my questions are harder to answer than I thought.

    Finally, our mutual friend Lesmondine has another article up today, which you may have seen linked on Twitter: http://lesmondine.wordpress.com/2010/01/28/homeopathy-theres-something-in-it/. For me, this clinches the argument concerning dilution, since if this post is correct then homeopathic dilutions above even 4C are to all intents and purposes impossible in the real world (even if possible in theory).

    Cheers,

    Ed

  60. lesmondine said,

    You got any links to the story of this man with a paralysed arm?
    Of course, 6C remedies may contain a tiny, tiny amount of the active ingredient (in the case of stuff like snake venom) but snake venom is usually ineffective when taken orally.

  61. Chris said,

    jdc said “If one uses inert treatments with effects no greater than placebo (such as homeopathy) instead of evidence-based treatments then one is neglecting the animal. If one uses such inert treatments as well as evidence-based medicine, then one is simply wasting money.

    Use of homeopathy as a ‘complementary’ treatment is a waste of money. Use of homeopathy as an ‘alternative’ treatment instead of EBM is actively dangerous.”

    I think if you examine your conclusions, you can see it is not fact, but in your opinion. I find it hard to understand how someone with such a purported interest in science, research and fact so easily falls to opinionations.

    Prove to me how homeopathy is dangerous. Prove to me how it’s a waste of money. Prove to me that it is inert. Any evidence in your answers most welcome.

  62. jdc325 said,

    “Prove to me how homeopathy is dangerous. Prove to me how it’s a waste of money. Prove to me that it is inert. Any evidence in your answers most welcome.”

    I stated that use of homeoapthy as an alternative to EBM was dangerous. Anecdotal evidence: http://whatstheharm.net/homeopathy.html

    I stated that use of homeopathy as a complementary treatment is a waste of money. Evidence: the evidence that shows this use of homeopathy is the same as that which shows that homeopathy provides no benefit beyond placebo. If it doesn’t work, then any expenditure on a treatment is money wasted.

    I stated that homeopathy is an inert treatment. There are two forms of evidence here. One is that which makes clear that higher dilutions contain no active ingredient (this is the very definition of an inert medicine). The other is the evidence in the shape of randomised controlled trials and systematic reviews. The best available evidence shows that homeopathy provides no benefit beyond placebo. For example: http://www.ncbi.nlm.nih.gov/pubmed/16125589

  63. Ed B said,

    Chris,

    While jdc is off getting that proof, have you got an answer to the water dilution problem?

    I have asked this about a half-dozen times on various blogs and no homeopath (lay or not) can answer it.

    The problem, in three simple statements, is as follows:

    1. Even if you use lab-quality water, a solution cannot be diluted past about 5C, since after this, there is a background level of pollutants that cannot be removed (at about 10 ppb or thereabouts).

    2. This is not scientific, but common knowledge, accessible to anyone who wants to look up the website of a manufacturer of lab water.

    3. Given that this is common knowledge, why do homeopaths persist in asserting that their dilutions can “go further”?

    Any answers very welcome indeed.

  64. Ed B said,

    Sorry, I just thought of an important and lengthy postscript to my last comment.

    An important conclusion to be drawn is that if you cannot dilute any further, then why bother? You might as well just “succuss” the water you have, since if you dilute the water to the point where pollutants outnumber the original substance (in no matter how small a quantity) you will be succussing the pollutants, not the original substance.

    Unless you mean to tell me that at the crossover point — say, 6C — the succussion process suddenly “knows” it must succuss the water and not the pollutants (which are now more numerous than the original substance). Any theories about the mechanism by which this happens would be very interesting to hear.

    I think this is a hugely more important point than the “Avogadro” problem, where the original substance disappears at about 12C. The pollutant/dilution problem is much harder to get around, since water is simply not as pure as would have to be BEFORE you got to 12C.

    Moreover, the assumption that pure water is pure enough is very much a product of the time Hahnemann lived in.

    I very much doubt whether the water he used for his original remedies would pass our modern tap water quality tests, let alone tests for water used in medicinal products.

  65. Chris said,

    Ed said
    “1. SUCUSSION. What reasons led homeopathy to substitute automated succussion for, if you will excuse the expression, “banging on a big leather book”? Has research been conducted in this field as to the differences this has or has not made? If so, what were the results? If not, why not?”

    Sucussion started out as “banging on a book”. As higher potencies were used, producing them automatically made more sense time wise. In India you can get potencies up to 1M made by hand, possibly higher. So, it was the other way round. Differences – not really been noted as anything significant, and no one I know feels any need for research to show any exact difference as it all seems to work well as it is.

    “2. POTENTISATION. If remedies are potentised, how long does this potentisation last? That is: do homeopathic remedies have such a thing as a “sell-by date”? If not, why not? If so, how is this determined? Research? Bonus “paradox” question: what happens to potentised remedies that enter the water supply — as they indeed must if taken by healthy people (since we have homeopaths on record as stating that remedies have no effect on healthy people)?”

    I have some remedies made nearly a hundred years ago. They work fine. I have heard that remedies made back in Hahnemanns day still work. Some people claim remedies may lose potency in going through airport security, some say they lose potency if left very nearby electrical equipment – TV’s etc. Some say they lose potency if left in direct sunlight or are exposed to strong oils, especially camphor. It is likely that all these things have some degree of effect on “wearing out” the potency of a medicine. I try to minimise these effects on the remedies I store. None of my remedies seem to have lost their effectiveness over the 25 years I’ve had them. ie there isn’t a problem, so no need for research. Same goes for all homeopaths I know.

    Remedies entering the water supply are not potentised, so would be diluted beyond effectiveness. I use remedies in the pill form. Occasionally I will prescribe them to be taken in water with minimal sucussion, or sometimes none at all. Then non at all would be a diluted remedy, and tends not to act so strongly – usually prescribed for someone sensitive who tends to react too much to remedies.

    “3. PROVINGS. Lastly, what is the procedure for designing remedies to match illnesses or conditions? We are aware of the “provings” aspect, which this addresses. Yet how does this work with new illnesses (such as new strains of flu), new conditions (e.g. RSI, which was perhaps less widespread before computers) or rare (genetic) disorders? Is the system standardised? If not, why not? If so, how?”

    Remedies have symptoms which come out in the provings that are as they are, not necessarily related directly to a named illness. As such, these symptoms are able to match conditions not named, and match conditions that are named in the future. Not sure really what your full question is here, but the system of matching a remedy to a person is what is the major part of what is learned in the three or four or more years training a homeopath undertakes, and is learned onwards from there. I’m sure you can google up a remedy proving somewhere and look through the symptoms produced and see how some may remind you of named illnesses.

  66. Chris said,

    jd said “I stated that use of homeoapthy as an alternative to EBM was dangerous. Anecdotal evidence: http://whatstheharm.net/homeopathy.html

    I stated that use of homeopathy as a complementary treatment is a waste of money. Evidence: the evidence that shows this use of homeopathy is the same as that which shows that homeopathy provides no benefit beyond placebo. If it doesn’t work, then any expenditure on a treatment is money wasted.”

    So, you’re now using anecdotal evidence?!

    “If it doesn’t work” you say. Indeed, “IF”.

    So, no evidence there then to back up your previous presumptions.

  67. Chris said,

    Ed asked about –
    “1. Even if you use lab-quality water, a solution cannot be diluted past about 5C, since after this, there is a background level of pollutants that cannot be removed (at about 10 ppb or thereabouts).

    2. This is not scientific, but common knowledge, accessible to anyone who wants to look up the website of a manufacturer of lab water.

    3. Given that this is common knowledge, why do homeopaths persist in asserting that their dilutions can “go further”?”

    Agreed, thats why there are many remedies made from various waters. Remedies are diluted and sucussed using alcohol, or even ethanol I think. In the past brandy was used. The evidence of the provings seems to suggest that the effect of the brandy being potentised didn’t come through. There is a remedy made from alcohol. Now there is the source of a question for you :) The point is, there are other questions that are important to answer, this one isn’t as it in no way effects what we as homeopaths do.

    The remedies are diluted and sucussed, not just diluted. They go as far as MM, as you probably know. The 30c, 200c, 1m, LM etcremedies work, homeopaths use them successfully in their practices. Babies get better, vets and owners help animals get better. Open your eyes, its a wonderful and fascinating world out there :)

  68. Chris said,

    Ed said, in his part two ” An important conclusion to be drawn is that if you cannot dilute any further, then why bother? You might as well just “succuss” the water you have, since if you dilute the water to the point where pollutants outnumber the original substance (in no matter how small a quantity) you will be succussing the pollutants, not the original substance.”

    Evidence proves otherwise – see the results of provings which have different syptoms from different substances. The effect you describe doesn’t happen. It is evidently clear to homeopaths that a remedy that is sucussed without dilution isn’t as potent. Potent there being used in the homeopathic manner of course.

    “Unless you mean to tell me that at the crossover point — say, 6C — the succussion process suddenly “knows” it must succuss the water and not the pollutants (which are now more numerous than the original substance). Any theories about the mechanism by which this happens would be very interesting to hear.”

    Its just evident from how remedies are more potent, and still distinct, in fact more so, the more the sucussion AND dilution is repeated.

    “I think this is a hugely more important point than the “Avogadro” problem, where the original substance disappears at about 12C. The pollutant/dilution problem is much harder to get around, since water is simply not as pure as would have to be BEFORE you got to 12C.”

    It makes no difference to potentised remedies.

    “Moreover, the assumption that pure water is pure enough is very much a product of the time Hahnemann lived in.

    I very much doubt whether the water he used for his original remedies would pass our modern tap water quality tests, let alone tests for water used in medicinal products.”

    As said earlier, he used Brandy. And it has no bearing on anything in practice, which is what counts.

  69. Ed B said,

    Chris,

    Thanks for the answer, but you clearly haven’t understood the impact of my question on the dilution issue.

    I’ll put it more simply: the dilution problem as I understand it means you cannot dilute anything in water more than 5 or 6 homeopathic “rounds”.

    Period. Impurities will always be there, and at 6C they rear their ugly heads.

    In a nutshell:

    I’m not interested in any evidence that 30C remedies work.

    I’m interested in why you are using the label “30C”.

    Unless you can answer the dilution problem, your 30C consists of 6C succussed substance (in varying quantities down to 10 ppb) and 24C succussed pollutants (at a fairly steady concentration of 10 ppb).

    Do you see my point?

  70. Ed B said,

    Chris,

    OK, I think we might be getting nowhere here.

    You seem to be suggesting that homeopathy is 100% practice and 0% theory. That fits, from what I have heard of it. And it makes homeopathy a pseudo-science.

    I’ll quote you Leonardo da Vinci (you can quote Kant back), and wait for you to tackle my actual questions:

    “He who loves practice without theory is like the sailor who boards ship without a rudder and compass and never knows where he may cast.”

  71. jdc325 said,

    “If it doesn’t work” you say. Indeed, “IF”.

    So, no evidence there then to back up your previous presumptions.

    You seem to have missed the bit where I provided an example of the evidence – the Shang et al systematic review.

    So, you’re now using anecdotal evidence?!

    To illustrate the harm caused by eschewing evidence-based medicine for homeopathy? Yes, yes I am. It would be ridiculous to suggest that an RCT of homeopathy versus conventional medicine should be conducted for people who need (for example) asthma or epilepsy medication or malaria prophylaxis. Case studies such as those listed on the What’s The Harm site are all we have and I think they are sufficient. Refusing evidence-based medicine in favour of magic sugar pills is clearly harmful.

  72. Ed B said,

    “Refusing evidence-based medicine in favour of magic sugar pills is clearly harmful.”

    In the well-publicised case of Gloria Sam, it resulted in her death.

    The girl was the daughter of a practising homeopath, who did just what jdc has stated: he refused to treat his daughter using medicine, and insisted on giving her magic sugar pills:

    http://www.dailytelegraph.com.au/news/homeopath-thomas-sam-guilty-of-daughter-glorias-death/story-e6freuy9-1225723018271

    She died an agonizing death from treatable eczema.

    Quite apart from the tragedy of her unnecessary death, it also raises the question of why homeopathy cannot treat eczema.

    It is after all, a relatively common disease.

  73. Chris said,

    72.
    Hmmm… you give one example, which actually suggests that in one case, someone used homeopathy in what seems like an inappropriate situation. There may be a few more. On that basis I wouldn’t be so far from matching it by putting Harold Shipman forward as a reason not to go to GP’s – which of course I don’t. Your argument is equally inappropriate. Ezcema has disappeared in many thousands of people under homeopathic treatment. All homeopaths I know will judge a situation as to what is appropriate treatment. Also, they would not tell anyone not to take treatment from doctors. They may point them towards looking at the issues of choice in the matter. Homeopathy dangerous? I think you need more evidence than that. And the bottom line here is that you argue potentised remedies have no effect, so how can someone prescribing a potentised remedy have any effect?

    How many people have died of inappropriate drug treatment from doctors? How many people have died from accidental wrong drug treatment from doctors? How many people have died from the side effects of drug treatment? etc etc. There is no comparison. The only issue for homeopaths is that they undergo proper training, follow a clear code of ethics and procedures, all of which is in place. Unfortunately, some people, and I include all health professionals in this, make poor judgements.

    71.
    Shang et al “When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies” ie weak, but acknowledged.

    If you accept those case studies, then there are numerous case studies of homeopathic successes.

    70.
    All qualified homeopaths study the theory. Its widely available for you to read. We practice using that theory as our guide. It is very specific. It forms a guideline for our practice. I’ve no idea what your problem is there. Please be specific and refer to anything that you have a problem with.

    69.
    One fact you missed is that remedies are not made up in water. Another fact is that remedies made from different substances have different results when potentised, in both provings and treatment.

    Another fact is that remedies are not always used in high potencies. They can be used in the material dose, or in low decimal potencies.

    Anyway, to cut to where I guess you are intending to go, the theories of why potentised remedies work in these ways are explanations of a phenomena. Potentised remedies were developed because there was a problem with the toxicity of material doses in some cases, and with the intensity of the effect. Hahnemann’s genius was to not only dilute the remedies but to sucuss them. Dilution alone will still have an effect, but as you go further with the dilution, that effect will disappear. Succuss as well as dilute and the effect is in the same direction, if you like, but not toxic. We are talking here about science before modern day developments, and indeed a science, alchemy, where many modern day developments originated from – eg the discovery of many of the chemical elements. Hahnemann was a doctor, and observed his patients improving more so than when he used the old methods. Other doctors found the same happened. As did the dieases they suffered from.

  74. Ed B said,

    Chris,

    You state:

    “One fact you missed is that remedies are not made up in water.”

    OK.

    What are they made up in, then?

  75. Ed B said,

    Chris,

    You state:

    “Please be specific and refer to anything that you have a problem with.”

    OK.

    Please show me where your theory states why you dilute and succuss mother tincture to produce remedies.

  76. Ed B said,

    Chris,

    Lastly (I’m keeping these separate since your referencing of posts with numbers was a good idea):

    You state:

    “Ezcema has disappeared in many thousands of people under homeopathic treatment.”

    There is no evidence for this.

  77. Oliver Dowding said,

    Just thought I’d help Chris out a little…………

    “Ezcema has disappeared in many thousands of people under homeopathic treatment.”

    I’m sure that this won’t satisfy, because it doesn’t conform to your holy Grail, called RCT, but these are some fairly impressive cases, which I don’t suppose for a moment you consider to be evidence.

    Here is what this person said: “I suffered miserably for 49 years from this horrible disease which totally debilitated me. No creams, potions, salves, cortisone or anything else cured my condition. It wasn’t until I turned 50 that I finally discovered how to heal my skin by igniting my own internal healing force. Ironically in the process of curing my eczema my overall health and vitality improved dramatically. If you expect to find a magic bullet cure here, you’ll be disapointed. In a nutshell, I credit my healing to a combination of approach: homeopathy, natural rawfood diet and juice, special oils and tea, uropathy, and herbal remedies.”

    http://www.shirleys-wellness-cafe.com/eczema.htm

    Perhaps you’d like to contact her and tell her she’s got a vivid imagination, and that for 49 year she wasn’t really suffering and that since then she’s not really got better from any alternative medicine, north from changing their diet, and it’s mostly about wishful thinking.

    Then there is this one http://health.hpathy.com/eczema-symptoms-treatment-cure.asp on which I offer no commentary other than that you can read it yourself as well as I.

    Then you could try this one http://ezinearticles.com/?Eczema—Homeopathic-Remedies-That-Work&id=1644252

    http://homeopathyplus.com.au/hplus/treatment-room/eczema-homeopathic-help-for-sore-and-itchy-skin.html

    http://www.vitalitymagazine.com/node/1201 which I fully understand to be a magazine article and not a scientific paper. Indeed, not many of the others would be what many people would consider a scientific paper

    Admin Edit: this comment was trapped in the spam filter due to the number of links. Apologies for the 3 hour delay in retrieval – I have only just logged on.

  78. Chris said,

    74
    Already explained this twice – in alcohol. For an eg see http://www.helios.co.uk/technical.html

    75
    The above link covers this too. But I explained it anyway.

    76
    Seek and you shall find. Maybe not on your specific terms, though as I said, how come there is so much damage caused by pharmacueticals “proved” in your terms? Doesn’t seem to be a fool proof system you have there. It will pass in time, like so many others have. Interestingto note how homeopathy has remained fundamentally constant for two hundred years – if it aint bust, don’t fix it. If it fails, change it – which is the story of modern medicine.

    One of the first patients I saw came to me with eczema all over her arms and legs. Not extreme, but widespread. This had been with her consistantly for over ten years. One pill of sulphur 200 and all clear within a couple of weeks. No other changes. Saw her a year and half later and had been totally clear till a few months before, when it began to come back, not as severe. Remedy repeated and clear again as before. What is also interesting, she looked so much healthier in general, had gradually lost excess weight, was more focused. These characteristics changed after the eczema went in the first place.

    So, why did this happen? The remedy was spot on for her. It stimulated her body to begin a process of change that involved an increasing vitality whereby her bodys need to produce eczema wasn’t there anymore. She was less stressed, more focused, and dealing with life in a healthy way. He digestion had also improved. You could say her energy was balanced, you could say her body was functioning far more healthily, you could say she was more fully connected in her life in a positive way hence not stressed or irritated by things as significantly. Indeed all these fit with how she changed and how she was. She was very happy.

    Compare this with putting steroid cream on the eczema as was the case in the past. In this situation there was no change in her whole system, she wasn’t any healthier – eg her digestion was still poor. She was stressed by many things, always irritable and edgy. She wasn’t able to focus efficiently. All her observations. There was a change though from the steroid cream – the eczema was up to 50% better, and her skin was gradually thining, most notably on her hands.

    Which of the two treatments appear to be more successful? The one that has been “proved” effective, or the one that was effective? And, which was the safest? Which was was the cheapest? Its a no brainer.

    I see it all the time, sometimes as clear as this, sometimes less clear. Thousands of other homeopaths and hundreds of thousands of patients have seen the same. And the occasional farmer! That you two haven’t seen this suggests to me that there’s some eye opening needs to be done :) If you have any real interest in this, you would seek. If you are neutral, you would be able to see at least that there is something in it, even if you don’t understand it.

    The biggest stumbling block you have I think is that evidence based medicine is a noble aim. However, it clearly hasn’t got all the answers or drugs currently making people ill – and thats a very big list – wouldn’t be used. Evidence based medicine is the thing of the moment, and like all such things, it will be gone when the new kid comes on the block. Thats history.

  79. Chris said,

    re the helios link, you will notice they use highly purified water in the machine version for the higher potencies. It has no adverse effect on how the remedies work, experience is clear regarding this or they wouldn’t be selling them. And before you say, potentised remedies of the level of 1m and above will work when they are accurately prescribed, and won’t if they are not. Positive effects of homeopathy are not placebo. I see placebo effects, and they are not the same as when the remedy is accurately prescribed, unfortunately for my workload!

  80. Ed B said,

    Hi Chris,

    Thanks for your replies. Let’s take water vs. alcohol first.

    For normal potencies, Helios seem to use 90% alcohol. Meaning 90% alcohol and 10% water.

    That’s pretty high quality alcohol.

    And for higher potencies, lo and behold, they use “highly purified water”.

    Why? Why does it have to be highly purified?

    Surely if remedies simply work when prescribed or not, then tap water would do. Or beer.

    And no, I’m not being facetious. I just wonder why the manufacture of homeopathic remedies involves such a lot of fiddling about when it’s the prescription that counts, not the remedy (as you have just stated).

    I’m willing to bet that if you made homeopathic remedies at home using normal, clean water, you’d get just as good results.

    So all this stuff about pure water and 90% alcohol is all a bit silly, isn’t it?

  81. Ed B said,

    Chris,

    Point #2. What I would like is an exact reference (i.e. web link) to the theory you are talking about.

    If that’s possible.

  82. Ed B said,

    Chris,

    Last point: eczema.

    Um, by “evidence” I didn’t mean a first-hand narrative. I could just as easily post the same, but denying any efficacy for remedies.

    What I meant was clinical trials. Yes, I have been trying to avoid this subject, but I have to admit that your eczema claim was too much to take after the Gloria Sam story.

    You claim that thousands have been cured of eczema by homeopathic remedies.

    Let’s call it 1,000 people. Can you back up that claim with evidence? All your claims of hundreds here, thousands here — anyone can say the same in the negative.

    After a brief search, the only clinical trial I actually found for homeopathic treatment of eczema had been conducted on dogs. http://www.bristol.ac.uk/news/2009/6274.html. The sample size was, er, four (that is, the RCT sample size).

    One last point. By anyone’s standards, claiming you can cure a chronic, common skin condition like eczema with a single pill is an astonishing claim. Lets say you it is 100% true. Yet even it its true, it is a pretty empty claim if you cannot repeat it. Maybe you just got lucky.

    So: can you repeat it?

  83. Ed B said,

    Oliver.

    Oh come on, quit with the holy grails and lackey of Big Science rubbish. If you must know, my doctorate is in medieval Scots literature for Pete’s sake.

    You want to support the claim that thousands have been healed, you post links for a thousand people.

    Come on guys, I’m not making the claims, I’m just trying to put yours in perspective!

  84. Oliver Dowding said,

    I’m not the one slavishly following RCT’s as the only source of evidence……I’m content to understand that for any one condition or illness there can be many different remedies for homoeopaths to use, individually assessed and individually selected, and the likely all different. I’m not worried about what your doctor might be in.

    For your information, I’m not a homoeopathic, I’m not a scientist, I’m not a researcher, and I don’t have the time in my life to go hunting about for thousands of references. However, I do read, I do talk to people, I do listen to people, and I do understand when somebody explains to me that after many years of neglect and suffering at the hand of conventional medicine, they turn to homoeopathy or some other alternative option, and find a resolution to their health problem. As I said before, they are often the dustbin cases failed by the conventional system. It’s especially powerful when the report comes from a conventionally trained doctor, who understands how conventional research operates, understands the need for probity, but is also prepared to accept that there is another way to approach illness and healing then the one in which he/she was initially trained.

    I’m sorry if this isn’t quite the perspective that you wanted, Ed. As I say, there’s more than one way to approach most things.

  85. Ed B said,

    Oliver,

    It’s not a question of anyone slavishly following anything. If homeopathy wants to go toe-to-toe with modern medicine, then RCTs are the standard. If it doesn’t, then it doesn’t need to. But it shouldn’t then want the same status.

    I agree with you, there’s certainly more than one way to approach everything in life.

    Yet, even after two hundred years of trying, homeopathy and its adherents don’t seem to be able to decide which one they want.

    Boots and OTC remedies sold as if they are the same as aspirin? Clinical trials, the same as are used for modern pharmaceuticals? Homeopathic remedies on the NHS, same as for other “allopathic” treatments?

    Homeopathy seems to want to stay “alternative” while actively pursuing integration into mainstream medicine.

    It shouldn’t then be surprised if mainstream medicine turns around and asks it to play by the mainstream rules.

    Especially if homeopathy makes claims that do not merely position it as a potential equal to mainstream medicine, but in fact as the superior discipline.

  86. jdc325 said,

    “I’m not the one slavishly following RCT’s as the only source of evidence…”
    No-one is doing this. There are many forms of evidence – there is a hierarchy of evidence in EBM and RCTs are considered more reliable than, say, observational studies. This paper discusses the role of observational studies and the abstract includes the following:

    Although randomized controlled designs are considered the so-called gold standard in medical trials and sit atop the hierarchy of evidence in evidence-based medicine, there are situations in which they are impractical or unethical to undertake, especially in surgical trials. Then, observational studies often provide the best source of information.

    As homeopathy can be studied using RCTs there seems to be no good reason that I can think of not to use them.

    You go on to write that you are “content to understand that for any one condition or illness there can be many different remedies for homoeopaths to use, individually assessed and individually selected, and the likely all different.” This focus on individual assessment and remedy selection as a counter to RCTs seems to ignore the point I made earlier – that randomised controlled trials of individualised homeopathy have already been conducted.

  87. jdc325 said,

    If you are interested in Evidence-Based Medicine, you might like this: Sackett.

    Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.

    By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centred clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer.

    Evidence based medicine is not restricted to randomised trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions.

    Because the randomised trial, and especially the systematic review of several randomised trials, is so much more likely to inform us and so much less likely to mislead us, it has become the “gold standard” for judging whether a treatment does more good than harm. However, some questions about therapy do not require randomised trials (successful interventions for otherwise fatal conditions) or cannot wait for the trials to be conducted. And if no randomised trial has been carried out for our patient’s predicament, we must follow the trail to the next best external evidence and work from there.

  88. jdc325 said,

    A couple of sceptic blog posts that discuss evidence and CAM: 21st Floor and …and your electron microscope.

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