Rapid Responses to:

CLINICAL REVIEW: Andrew Vickers and Catherine Zollman ABC of complementary medicine: Homoeopathy BMJ 1999; 319: 1115-1118 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

many qualified homeopaths are againts vaccinations

Andrea Valeri   (22 October 1999)

Homoeopaths have some explaining to do

Adam Jacobs   (23 October 1999)

bunk, bunk and more bunk

Terry Polevoy   (23 October 1999)

Re: bunk, bunk and more bunk

Andrea Valeri   (26 October 1999)

Re: bunk, bunk and more bunk

Andrew Vickers   (27 October 1999)

Re: bunk, bunk and more bunk

Fazlur Rahman   (27 October 1999)

The ABC of Complementary Medicine is most welcome if it presents an objective account of the issues

Peter G May   (28 October 1999)

Scenario

Michael Foley   (28 October 1999)

What is the cultural background to homeopathy?

Maurizio Castellini   (29 October 1999)

ABC of Complementary Medicine is welcome if it presents objective account of issues

Andrew Vickers   (30 October 1999)

HOMOEOPATHY WORKS

Christos Hadjicostas   (1 November 1999)

Disgraceful

Stephen Barrett   (7 November 1999)

Where''s the evidence?

David W Ramey   (8 November 1999)

Re: Where''s the evidence?

Andrew Vickers   (9 November 1999)

Answer to Dr Barrett

Christos Hadjicostas   (10 November 1999)

A bit more on homeopathic mechanisms

David W Ramey   (12 November 1999)

Re: A bit more on homeopathic mechanisms

Andrew Vickers   (14 November 1999)

Re: Homeopathic mechanisms

T L P Watts   (16 November 1999)

Effectiveness

Muscari Tomajoli Gennaro   (17 November 1999)

we must use what help patients

Andrea Valeri   (20 November 1999)

GREAT ARTICLE

Harry R Huxford   (22 November 1999)

Homeopathy and immunology

Gino Santini   (22 November 1999)

Re: Re: Homeopathic mechanisms

Paul Booyse   (22 November 1999)

Excellent Article

Janice Abbott   (22 November 1999)

Re: Disgraceful

Tim Shannon   (22 November 1999)

BMJ Debates Homeopathy: 1990s or 1840s?

Peter Morrell   (23 November 1999)

Research on efficiency of homeopathy

Seema Gupta   (25 November 1999)

Do you have a better explanation than Placebo?

Phoebe Lo   (25 November 1999)

Complementogenic Disease - the Tip of the Iceberg?

Anne M Pettigrew   (28 November 1999)

Conventional medicine, grow up

Simon Rabinovich   (28 November 1999)

Homoeopathy is a part of MEDICINE

Simon Rabinovich   (28 November 1999)

Any information on homoeopathy in animals?

Fabio Rios   (1 December 1999)

Re: Any information on homoeopathy in animals?

Tony Delamothe   (1 December 1999)

Re: Any information on homoeopathy in animals?

Geir Marcussen   (7 December 1999)

Re: Homoeopathy is a part of MEDICINE

Geir Marcussen   (7 December 1999)

MEDICINE OF THE NEW MILLENNIUM

Jayakumar Pannakkal   (8 December 1999)

Re: Any information on homoeopathy in animals?

Andrew Vickers   (9 December 1999)

Should we think at all?

Kai Ruusuvuori   (6 March 2000)

Re: Should we think at all?

Peter Morrell   (9 March 2000)

Closed Minds and Unpleasant Behaviour

Peter Morrell   (20 April 2000)

more scepticism please

Stephen Park   (24 May 2000)

things that work in Homeopathy's favour.

Stephen Park   (25 May 2000)

Re: things that work in Homeopathy's favour.

Peter Morrell   (26 May 2000)

Re: more scepticism please

Peter Morrell   (26 May 2000)

Re: things that work - Homeopathy's.

John P Heptonstall   (26 May 2000)

Re: more scepticism please

Simon Rabinovich   (28 May 2000)

How Homeopathy reaaly works

Stephen Park   (29 May 2000)

Re: BMJ Debates Homeopathy: 1990s or 1840s?

Stephen park   (4 June 2000)

An open letter to health care professionals (with open minds)

Stephen Park   (4 June 2000)

How Homeopathy really works

Peter Morrell   (6 June 2000)

They are worried

Simon Rabinovich   (7 June 2000)

Homeopathy and the question of integrity

Stephen Park   (10 June 2000)

Re: Homoeopaths have some explaining to do

Jay Prakash   (9 February 2004)

Re: Re: Homoeopaths have some explaining to do

Anne Sash   (18 February 2004)

Re: Re: Re: Homoeopaths have some explaining to do

Niall T Taylor   (19 February 2004)

Updated details for Society of Homeopaths

Mary L English   (18 March 2004)

many qualified homeopaths are againts vaccinations 22 October 1999
Andrea Valeri, teacher,homeopathic medical school of Verona,Italy mirandola (modena) italy Send response to journal: Re: many qualified homeopaths are againts vaccinations	Sir, it's not true that only not qualified homeopaths are against vaccinations. I'm a medical doctor, and i teach with other medical doctors, at homeopathic medical school of Verona (Italy) . As teachers and as homopeopaths, we agree that , in most cases, vaccinations do more harm than good. Indeed, we cure every day childrens who got some damage after vaccinations (eg, asthma ) and we collected hundreds of scientific articles that suggest that the risks of mass vaccination are much more than the benefits. More and more physicians are questioning themselves about this topic . "Homeopathy is only fresh water" : this myth is breaking down; " vaccination are safe and effective " : it's time to discuss this second myth of conventional medicine Andrea Valeri ,homeopath,MD Competing interests: None declared
Homoeopaths have some explaining to do 23 October 1999
Adam Jacobs, Director Dianthus Medical Limited Send response to journal: Re: Homoeopaths have some explaining to do	The laws of chemistry and physics, as we understand them, say that homoeopathy cannot possibly work any better than a placebo if a treatment has been diluted to the point where none of the original molecules remain. That is not in itself reason to dismiss homoeopathy as worthless, as the history of science is full of important discoveries that went against the established wisdom of the day, such as the discovery that the Earth is not flat. However, we should not underestimate the change that would be needed in our understanding of physical laws if any scientific basis were found for homoeopathy. The idea of 'solvent memory' is so completely incompatible with the laws of chemistry and physics as we know them that if any such theory could be justified theoretically and proven experimentally, it would represent the most dramatic discovery since Einstein's theories of relativity. Until then, publication bias and poor design and execution of studies can doubtless explain a lot.
bunk, bunk and more bunk 23 October 1999
Terry Polevoy, Webmaster of HealthWatcher.net Waterloo, Ontario Canada Send response to journal: Re: bunk, bunk and more bunk	The BMJ does a great disservice to the medical profession in this poor excuse of an academic article on homeopathy. The British penchant to believe in homeopathy has more to do with what the Germanic roots of its aristocratic monarch than it does with any science. Hundreds of millions of pounds a year in the U.K. is undoubtedly being wasted by the National Health Service for placebos. Homeopathic medicine is largely quackery, plain and simply bunk. My web site in Canada attempts to expose medical quackery, which includes homeopathy, naturopathy, iridology, and other scams. I do not receive any money from pharmaceutical cartels, the government, or the medical establishment. There are plenty of studies that totally and completely disprove homeopathy and the medical fraud that surrounds it. It is a shame that the BMJ has now allowed more misinformation to fill its scholarly pages. I suggest that your readers tune in our web sites below: Terry Polevoy, MD, FRCP(C) www.healthwatcher.net www.chirowatch.com www.dietfraud.com
Re: bunk, bunk and more bunk 26 October 1999
Andrea Valeri, homeopathic medical school of Verona mirandola (modena) Send response to journal: Re: Re: bunk, bunk and more bunk	Medicine is based on clinical experience integrated with scientific literature. Clinical experience: thousands of homeopaths, in the world, and millions of patients can say that homeopathy is effective, in acute and in chronic diseases . Scientific literature: there is an increasing number of methodologically correct clinical trials that demonstrate that homeopathy is effective. Indeed, both from clinical and from scientific point of view, the statement that homeopathy is only bunk, is unproven: as a consequence, is totally unscientific.
Re: bunk, bunk and more bunk 27 October 1999
Andrew Vickers, Co-author of "ABC of complementary mediicne" Send response to journal: Re: Re: bunk, bunk and more bunk	I find Dr Polevoy's letter offensive, not because he criticises an article of which I am first author, but because I consider myself a sceptic, and Dr Polevoy devalues scepticism. Instead of reasoned argument, Dr Polevoy presents abuse: note his use of words such as "scam", "quackery", "fraud" and "bunk" rather than say, "systematic review" or "statistical analysis". He also replaces critical evaluation with knee-jerk gainsaying by asserting that my article is "misinformation" without explaining why. Dr Polevoy makes reference to research without providing citations. And rather than discernment, Dr Polevoy gives us a simplistic generalisation by lumping homoeopathy with techniques of proven inefficacy such as iridology (see Simon et al. An evaluation of iridology. JAMA. 1979;242:1385-9) in order to describe them all as quackery. Dr Polevoy recommends that readers tune in to his websites. I recommend that they stick, instead, to critical and sceptical debate.
Re: bunk, bunk and more bunk 27 October 1999
Fazlur Rahman, physician chennai Send response to journal: Re: Re: bunk, bunk and more bunk	Conventional science is yet to be born alive due to its conceptual and conception difficulties. Terry Polevoy, M.D., FRCP(C), could not even understand that today's science suffers terrible discomfiture over its inability to conceive commonsense, the base of truth. If he cannot conceive homeopathy, it is because of lack of commonsense that has become uncommon with the conventional scientific therapists. Whereas modern science believes in the mechanical, instrumental, equipment and laborious laboratory methodologies, homeopathy requires acute wisdom of all five special senses to arrive at a diagnosis. We can cite an example in the conventional scientific diagnosis of 'Migraine', which means " terrible incurable headache of unknown origin". Scientific medicine cannot diagnose a high blood pressure. Over 90% of hypertension patients suffer from a 'scientific' diagnosis called Essential hypertension whose actual meaning is high blood pressure due to unknown reason. Further, the modern medical science uses the jargons like 'idiopathic', 'primary' etc.; to hide most of their ill conceived diagnoses. P.U.O. (Pyrexia of Unknown Origin) is the most infamous diagnosis of them all. Pyrexia means fever. Even a fever is unable to be diagnosed by the conventional science. If only scientific medicine replaces its gibberish language with the common language while spelling out diagnoses, its true identity will be conceived by the world.
The ABC of Complementary Medicine is most welcome if it presents an objective account of the issues 28 October 1999
Peter G May Send response to journal: Re: The ABC of Complementary Medicine is most welcome if it presents an objective account of the issues	In the most recent article in the series (1), the authors acknowledge that homeopathy presents an enormous intellectual challenge and that there is currently insufficient evidence of its efficacy for any single clinical condition. They go on to assert that there have been rigorous, replicated, double blind, randomised trials showing significant differences between homeopathic and placebo tablets. In the light of this statement, it is astonishingly that they cite only one published work (2), which to our knowledge has not been replicated. It would require more than the odd paper for homeopathy ever to be taken seriously. Only overwhelming empirical evidence or a new theoretical understanding of how the world works could overcome the intellectual "impasse" to which the authors refer. (1) Vickers A, Zollman C. ABC of complementary medicine: Homeopathy. BMJ 1999; 319: 1115-8. (23rd October.) (2) Reilly D, Taylor MA, Beattie NG, Campbell JH, McSharry C, Aitchison TC, et al. Is evidence for homeopathy reproducible? Lancet 1994;344:1601-6 Peter G. May Robert J. Walton General Practitioners, The Grove Medical Practice, Shirley Health Centre, Grove Road, Southampton SO15 3UA
Scenario 28 October 1999
Michael Foley Send response to journal: Re: Scenario	I will prescribe patients elegantly labelled bottles of water or lactose. The indications for the prescriptions will be minor, self-limiting conditions; or chronic relapsing and remitting conditions; or nebulous conditions only diagnosable by myself. The response of my patients to my treatment may be a little better, or a little worse or statistically the same as to a placebo treatment. I shall insist that my treatments are of benefit to many patients and ascribe their action, in the absence of any active ingredient, to 'molecular memory', a phenomenon unknown to any chemist or physicist. This 'molecular memory' will only extend to the specific substance named on my elegant label and not to any other chemical substance, impurity or toxin to which the water or lactose will have also been exposed. I will be allowed to describe the alleged benefits of my system of treatment in an article published in a renowned medical journal1, in my own terms and with no criticism, implied or otherwise, being published alongside it. It is possible that I might then quote this article at a later date, in defence of my system against criticism by unkind and flinty -hearted skeptics. Like myself, the editor of the BMJ will realise that such a scenario is completely preposterous. References. Vickers A, Zollman C. ABC of complementary medicine. Homeopathy. BMJ 1999;319:1115-1118
What is the cultural background to homeopathy? 29 October 1999
Maurizio Castellini, director, Homeopathic medical school of Verona Verona, Italy Send response to journal: Re: What is the cultural background to homeopathy?	Homeopathy is penalised by a fundamental cultural problem: it seems to be unrelated to any cultural context. This is not true. The principle of similarity is neither the invention of Hahnemann nor the discovery of the Hippocratic school. It is a general principle which has psychological implications in terms of awareness, relationships and behaviour, as well as social, biological and even artistic, religious and therapeutic implications. It is therefore much vaster than pharmacological homeopathic treatment, which is only one of its many applications, even in therapeutic terms. This lack of awareness of the importance of similarity derives from its universal continuity of experience. Through similarity, the individual grows psychologically, because it is the foundation stone of the mechanisms of awareness and experience. Psychology explains how, when faced by any new experience, the search for similarities with existing experience (trans-derivational research) is automatic and immediate, since what is already known helps diminish the insecurity and alarm which accompanies the indefinite. Similarity conditions every kind of behaviour and relationship. Thus, a great deal is accepted from "similar" people whereas communication is rejected from those who are different, who in turn are judged and neutralised. In sociology, so-called tribal behaviour patterns, the distinguishing marks of religion, political party, ethnic origin and the various fashions of the time, equally express the attempt to achieve uniformity by making everything similar. Even "stories" or metaphors, which in terms of importance are the first form of communication, appeal through similarity. Whatever their nature (films, books, tales…), their impact involves the automatic activation of the processes of trans-derivational research. It is only through similarity that we are able to understand other peoples' emotions. We seek for "matches" with emotions we have already experienced ourselves to "feel" what others feel and thus cry with those who are crying and laugh with those who are laughing. The same is also true for art. Artistic creations are metaphors of reality: the attraction among similars enables us to react to them, be they music, which most readily encourages “resonance”, painting, theatre or sculpture - stimulating reactions only if they are able to link with known experience. Similarity is the very "life" of artistic creation. The principle of similarity is also the key to Christianity, wherein God created Man in His "image and likeness". When He took incarnation in Christ, He did not ask for theological or cultural knowledge but the re- instatement of this "likeness" or similarity, to the point of identification with Him, offering especially parables, metaphors and thus similarities as a guide along this path. The powerful attraction between similars gives rise to important effects. When a similar is recognised as such, it recalls other similars which are in turn accentuated. This accentuation creates an "excess", a new level of information, more or less conscious, which generates a reaction of change. Action through similars is ecological because, in respecting what already exists, it allows the passage only of what the similitude itself accepts. It is not an extraneous intervention, there is no obligation or forcing, because everything passes through the filter of the similar. Thus, without us even realising, relationships are continuously established and we are changed "homeopathically". Used in therapy, whether as a therapeutic metaphor or an artistic creation, or empathic discussion with the doctor, or cold which causes cold hands to react by warming them, or an homeopathic medicine, the similar provokes a reaction which brings about changes. The pharmaceutical application of similars is very ancient, but it was only with Hahnemann that it became an experimental method. Having established the toxic capability (= the message) of various substances, studied systematically in the symptoms they provoke at a mental, emotional and physical level, Hahnemann began administering them to patients to depending on their symptoms. He diluted them to eliminate toxicity and thus discovered that in so doing they better transmit their information. Pharmacological homeopathy is therefore a particular utilisation of the general attraction between similars, in which the information in the similar remedy imitates the situation present in the patient, thereby provoking a reaction. The more precise this similarity, the more important the consequent reaction. Homeopathy is therefore essentially this: information which generates a reaction in accordance with the universal model of similars.
ABC of Complementary Medicine is welcome if it presents objective account of issues 30 October 1999
Andrew Vickers, Co-author of the ABC of Complementary Medicine Send response to journal: Re: ABC of Complementary Medicine is welcome if it presents objective account of issues	What we actually said in the paper was: "few of the existing studies of homoeopathy have been independently replicated". In short, we are CRITICISING the lack of independent replcation in homoeopathy. As we stated in the paper, however, there are indeed a few instances of independent replications. One example, examined in a forthcoming Cochrane review, is that of the homoeopathic medicine Oscillococcinum for influenza. The two most recent replications of this research are: Papp R. Schuback G. Beck E. Burkard F. Bengel J. Lehrl S. Belon P. Oscillococcinum in patients with influenza-like syndromes: a placebo- controlled double-blind evaluation. British Homoeopathic Journal 1998;87:69-76 Ferley JP. Zmirou D. D'Adhemar D. Balducci F. A controlled evaluation of a homoeopathic preparation in the treatment of influenza-like syndromes. British Journal of Clinical Pharmacology 1989;27:329-35
HOMOEOPATHY WORKS 1 November 1999
Christos Hadjicostas Send response to journal: Re: HOMOEOPATHY WORKS	I am an MD, GP, graduate of the Athen's Medical School and Medical Homoeopathic Academy. I work in the medical team of Prof. Diamantidis in Greece and Cyprus. We have cured homeopathically up to now thousands of people suffering from various chronic or acute diseases. We have performed up to 60 double blind trials proving the effectiveness of homeopathy. Our Institute invites any University or Institution of Medicine for a serious research in the field of homoeopathy, based on commonly accepted protocols. The answer to if homeopathy is placebo is very simple: then how are infants and children cured, how are patients in a coma cured, how are animals cured and, moreover, how are plants cured with Homoeopathy? I believe that medical science must put a more serious eye on homoeopathy. We must not forget what the founder of Homoeopathy has said: the only mission of the doctor is to cure in a safe, permanent and quick way. The question of how the medicines act is of second importance and it is the job of the biochemist to tell us--the doctors--how they act. The main thing of interest for us is that they work. If humanity and scientists had followed up to now the suggestion of not using something we don't understand then possibly we would be still be in the Stone Age! Do we really understand the nature of magnetism or the real nature of electricity, or the electromagnetic fields! But we use them for our benefit. It is the same with Homeopathy.
Disgraceful 7 November 1999
Stephen Barrett, Board Chairman Quackwatch, Inc. Send response to journal: Re: Disgraceful	Your article on homeopathy is disgraceful. Readers who would like the facts about homeopathy can read them at www.quackwatch.com/01QuackeryRelatedTopics/homeo.html
Where''s the evidence? 8 November 1999
David W Ramey, Private veterinary practice Glendale, CA USA Send response to journal: Re: Where''s the evidence?	Apologists for homeopathy must continue to overlook a mounting tide of evidence that the remedies are not effective. Indeed, there have been at least 13 reviews and meta-analyses conducted since the mid-1980s on various aspects of homeopathy. These reviews have failed to identify a single condition for which the remedies are efficacious, and, more recently, have noted that the best studies show no effect (Linde, K, et al. Impact of study quality on outcome in placebo-controlled trials of homeopathy. J Clin Epidemiol. 1999 Jul;52(7):631-6; Ernst E, et al. Meta -analysis of homoeopathy trials. Lancet. 1998 Jan 31;351(9099):366). Add to the mix the fact that homeopathic remedies are at odds with well- established principles of physics, chemistry and pharmacology and one has ample grounds for sustained skepticism. In my opinion, what is of most concern about the Vickers article is its selective quotation in its discussion. The authors note that "practitioners select a drug that would, if given to a healthy volunteer, cause the presenting symptoms of the patient" but fail to note that blinded studies have shown that such volunteers are unable to distinguish between homeopathic remedies and water (Wallach, H. Does a highly diluted homeopathic drug act as a placebo in healthy volunteers? Experimental study of Belladonna 30C in a double blind crossover design - a pilot study. J Psychosomatic Res 1993; 37(8): 851-860). They note that "There is currently insufficient evidence concerning the relative benefits of the different approaches to treatment," while failing to note that there is no good reason nor evidence to believe that there is benefit to *any* of those approaches. The authors note that "The notorious Benveniste affair, which involved accusations of fraud and scientific misconduct after the publication of an in vitro experiment in Nature, continues to dampen enthusiasm for basic research in homoeopathy" while failing to note that at least three attempts at replication of the experiment, using similar or identical methodology have failed. There are numerous other examples. One wonders at what point the evidence showing that the medications are ineffective and, indeed, cannot be effective will be adequate to convince the true believers in homeopathy. Most likely, it will be never, as evidence does not appear to be able to consistently change belief. Still, for a more dispassionate look at the field, your readers might be interested in looking at www.phys.hawaii.edu/vjs/www/med/homeop.html David Ramey, DVM
Re: Where''s the evidence? 9 November 1999
Andrew Vickers, Co-author of "ABC of complementary medicine" Send response to journal: Re: Re: Where''s the evidence?	1) Ramey should be careful before making personal accusations: I am not an "apologist" for homoeopaths. For example, I have published high quality research on homoeopathy showing that one well-known remedy was ineffective [1,2]. For this research I have been subject to personal criticism from homoeopaths [3]. 2) Ramey says we ignore "A mounting tide of evidence that the remedies are not effective." I find this statement difficult to square with the fact that the two highest quality and best known systematic reviews (references in the original paper) drew broadly positive conclusions. 3) Ramey criticises us for not including details of trials which show that volunteers are unable to distinguish between homeopathic remedies and placebo whilst stating that "practitioners select a drug that would, if given to a healthy volunteer, cause the presenting symptoms of the patient". Though I agree that the "proving" research (as it is known) is largely negative, our statement remains correct: this is what practitioners do. 4) About Benveniste: Ramey is correct to say that a number of subsequent authors have failed to replicate his findings. However, the reality is a little more complicated. The most recently published study, which involved several laboratories working independently under fully blinded conditions, did find differences between homoeopathy and placebo[4]. It is perhaps unfortunate that an "ABC" can only give an introduction to a subject, but there you go. References 1. Vickers AJ, Fisher P, Smith C, Wyllie SE, Rees R. Homeopathic Arnica 30X is ineffective for muscle soreness after long-distance running: a randomized, double-blind, placebo-controlled trial. Clinical Journal of Pain 1998;14:227-31 2. Vickers AJ. Fisher P. Smith C. Wyllie SE. Lewith GT. Homoeopathy for delayed onset muscle soreness: a randomised double blind placebo controlled trial. British Journal of Sports Medicine 1997;31:304-7 3. Dean M. Out of step with the Lancet homoeopathy meta-analysis: more objections than objectivity?. Journal of Alternative and Complementary Medicine 1998;4:389-98 4. Belon P. Cumps J. Ennis M. Mannaioni PF. Sainte-Laudy J. Roberfroid M. Weigant FAC. Inhibition of human basophil degranulation by successive histamine dilutions: results of a European multi-centre trial. Inflammation Research 1999:48(supplement 1):S17-S18
Answer to Dr Barrett 10 November 1999
Christos Hadjicostas Send response to journal: Re: Answer to Dr Barrett	If you have 1000 patients suffering from migraines attacks for years and with a therapeutical method you cure PERMANENTLY without any side effects and without the need of taking continously medicines 850 of them, if you have 1000 patients with ulcerative colitis and with the same therapeutical method you cure PERMANENTLY about 700 of them, if you have 1000 patients suffering from chronic allergic rhinitis or asthma and you cure with the same method PERMANENTLY 860 of them, if you have 1000 patients with psoriasis and you cure permanently 600 of them then please answer: 1) Is the method used scientific? 2) If it is not scientific, then tell me something that is scientific and has better results. 3) Do you have any doubt that the results are not due to placebo effect? 4) If the result were due to placebo effect don't you think that it would be worth enough for all the medical doctors to learn this ''magic'' placebo method, to help their patients more. I believe that many patients would prefer to be cured through a non ''scientific'' way instead of dying gradually in a ''scientific way''. If the researches you have in your hands were done properly it is more than sure they should surely have shown the curable effects of homeopathy. The main reasons for not showing are two: (a) Wrong selection of the proper medication because in homeopathy always you individualize (ie you cannot say that for this disease I use these homeopathic medicines and compare with placebo) (b)Bad planning of the methodology. Of course any kind of metananalyses based on these researches very naturally cannot give positive results. If you are honestly interesting about if homeopathy works you can come here and talk with our patients ALIVE and realize what REALLY happens with homeopathy.
A bit more on homeopathic mechanisms 12 November 1999
David W Ramey Private practice, veterinary Send response to journal: Re: A bit more on homeopathic mechanisms	My apologies to Dr. Vickers for any offense that may have been taken in regards to my initial post. It was not my intent to question his motives, only to discuss the evidence in a contentious field of debate. I am still concerned that Dr. Vickers underestimates the substantial physical and chemical obstacles to the hypothesis that there is a mechanism for the activity of homeopathic remedies beyond placebo. While Dr. Vickers suggests that there may be some interactions between water and the solute molecules that could allow for a "memory" of the original material, such molecules have not been readily detectable. Such an alteration of water structure would need to be extremely stable, not only to exist at room temperature, but also to survive the input of kinetic energy in the succussion process. Indeed, it would need to be more stable than the normal structure of liquid water for the conversion to be thermodynamically favorable. Moreover, there would need to be not just one such structure, but a different one for every one of the 2000 homeopathic remedies. As for the preparations themselves, this proposed structure of the water would somehow have to surive when the water is sprayed onto a lactose tablet, as is the case with some homeopathic remedies. It would also have to survive the acidic conditions in the stomach. How this "memory" crosses numerous cell membranes and gets to wherever it is supposed to act in the body is another great mystery. Are these obstacles insurmountable? Perhaps not. However, it will take very convincing evidence to persuade those of a skeptical persuasion. So far, such evidence has not been forthcoming. David W. Ramey, DVM
Re: A bit more on homeopathic mechanisms 14 November 1999
Andrew Vickers Co-author of "ABC of complementary medicine" Send response to journal: Re: Re: A bit more on homeopathic mechanisms	If homoeopathic medicines are not chemically distinguishable from placebo then they must act, if at all, through a biophysical rather than a biochemical mechanism. One analogy which is often used is that of magnetic information storage(1): a tape cassette of the Bach cello suites is chemically identical to an unrecorded cassette; what differs is the physical orientation of the ferric oxide particles on the tape, something which is stable over many years. Homoeopathic researchers have hypothesised that, similarly, water molecules form stable physical structures during the preparation of homoeopathic medicines. The most coherent description of such a phenomenon relies on 'clathrates', a concept developed in conventional physical chemistry. A clathrate is a structure of water molecules which can form around certain solute molecules and which is held together as a stable entity by hydrogen bonds. Some researchers have theorised that when the central solute molecule is dislodged from the centre of the clathrate, for example, by the vigorous shaking of succussion, it shrinks and forms the template for a second clathrate molecule. As a result, serial dilution and agitation, as used in the preparation of homoeopathic medicines, might result in a solution rich in the clathrates associated with a medicine even if molecules of that medicine are no longer detectable(2). There is some evidence that homoeopathic medicines contain clathrates. Though potentisation was found to have no effect on the velocity of propagation or the absorption of ultrasound in water(3), an effect predicted by the clathrate model, homoeopathically-prepared Silicea was distinguished from water by nuclear magnetic resonance spectroscopy, suggesting interference with hydrogen bonding(4). The most direct evidence for the clathrate model comes from experiments conducted by Anagnostatos and colleagues(2). One of the techniques used is that of measuring 'depolarisation current': a sample is polarised by applying an electric current and then cooled to freeze the polarisation; as the sample is gradually heated in the absence of the current, a depolarisation current is generated. In one experiment, the depolarisation curve of Camomile 30c was found to lie between that of pure water and that of Camomile mother tincture. This suggests that, as predicted by the clathrate molecule, homoeopathic Camomile contains more molecules with restricted motion than pure water (which has none) but less than pure camomile extract (which has many water molecules bound to molecules of camomile constituents). A second series of experiments conducted by the same investigators used differential scanning calorimetry (DSC) to investigate the effects of potentisation on the physical characteristics of solutions. DSC measures the amount of energy which is absorbed or released from a sample during cooling or heating. Measurements were taken on camomile prepared homoeopathically in mother tincture, 1c, 6c, and 30c dilutions. The experiment was then repeated for camomile prepared to the same dilution without succussion, and for deonised, distilled water. The four homoeopathic preparations exhibited four distinct DSC plots, an effect not seen for diluted camomile or water. Moreover, the DSC plots exhibited what Anagnostatos described as a "change of phase": at about 35°C, the shape of the plot shifted from an oscillating curve to a steady line. It was claimed that this corresponded to the destruction of clathrates leading to changes in the hydrogen bonding structure of the water. Such studies are provocative. Nonetheless, the existence of physical differences between homoeopathic preparations and placebos is radically insufficient as a mechanism for homoeopathy. Even were such differences to be confirmed by further research, and the existence of solute-specific clathrates to be accepted as an explanation, there remains no conceptual framework (let alone empirical evidence) as to how the physical structure of homoeopathic medicines leads to clinical change in a patient. I think the correct conclusion to draw about any mechanism for homoeopathic action are: a) there is no understood mechanism for how a medicine chemically indistinguishable from water could have clinically distinguishable effects b) some mechanisms have been proposed but these lack significant experimental evidence BUT: c) the physics of water is such that it is not inconceivable that homoeopathic medicines are physically distinguishable from water. Claims that homoeopathy is "impossible", "has zero Bayesian prior probability" or that "we can't have homoeopathy and modern science too" (5) are premature. 1.Holgate ST. Does homoeopathy work and if so how?. In: Meade T (ed). Science-based complementary medicine. London: Royal College of Physicians (1998) 2. Anagnostatos GS. Pissis P. Viras K. Soutzidou M. Theory and experiments on high dilutions. In: Ernst E and Hahn EG (eds). Homoeopathy: a critical appraisal. Oxford: Butterworth Heinemann (1998) 3. Maranta S. Paparelli A. Ultrasonic study of homoeopathic solutions. British Homoeopathic Journal 1991;79:212-216 4. Demangio JL. Demangeat C. Gries P. Poitevin B. Constantinesco A. Modifications des temps de relaxation RMN a 4 MHz des protons du solvant dans les träs hautes dilutions salines de silice/lactose. J Med Nucl Biophy 1992;162:135-45 5. Vickers AJ. Clinical trials of homoeopathy and placebo: analysis of a scientific debate. Journal of Alternative and Complementary Medicine (accepted for publication)
Re: Homeopathic mechanisms 16 November 1999
T L P Watts, Senior Lecturer and Consultant in Periodontology GKT Dental Institute Send response to journal: Re: Re: Homeopathic mechanisms	There are some points arising from homoeopathic theory which concern me: 1. The sea has probably received a little of all conceivable homoeopathic "remedies", and they must be unbelievably potent because they are incredibly diluted. If I take a drop of sea-water every day (diluted further if necessary), is this virtually the elixir of life? Have I discovered a universal homoeopathic remedy?! If not, why not? And please don't tell me that the sea has impurities which nullify the homoeopathic effects -- any homoeopathic remedy will have impurities at a highly diluted level, which presumably makes them of exceptional strength. 2. Why do some homoeopaths want to use nutrition as well? Surely a disease like scurvy requires something which imitates its symptoms rather than Vitamin C in normal doses? Is there an answer for this perplexing inconsistency? 3. And one broader matter: why do mutually exclusive and contradictory alternative medicine systems (at least as they were founded) apparently join together in harmony? Should I go to the homoeopath or the Chinese herbalist and acupuncturist for treatment for disease 'X'? Or, come to think of it, to the old-style chiropractor or the osteopath (for problems that are not low back pain)? How do you decide? Or is there nothing to choose between them?
Effectiveness 17 November 1999
Muscari Tomajoli Gennaro, Homeopath, MD, Teacher, Homeopathic Medical School of Verona Venice Send response to journal: Re: Effectiveness	Paraphrasing Terry Polevoy ("bunk-bunk"): the BMJ does a great service to the medical profession! Finally an important scientific magazine has published an accurate report on this ancient therapy; it is possible to say that homeopathy, during the last two centuries, has cured millions of patients not only in Europe, but all world over, from the USA to Ukraine and from South America to India. As revealed by Doxa, an Italian Institute for Statistical Research, 80% of the patients cured with homeopathy were satisfied, that is a high percentage. The problem is that often it is not possible to judge the efficacy of the therapy without considering its effectiveness on a daily basis; thus many homeopaths are already conducting observation studies as suggested by Linde in his article published on Lancet (1997 Sep 20; 350(9081): 834-43). For example, I have conducted together with other homeopaths, an open observational study on the effectiveness of homeopathic treatment (not yet completed) on patients affected by chronic headaches. To conduct these studies we have used the SF36 questioner, already recognised in conventional medicine. This research has already been presented and acknowledged by the "National Congress on Headaches", held in Perugia on 22/09/1999" as a significant record of statistical data which shows that homeopathic treatment has a high effectiveness. Gennaro Muscari Tomajoli, homeopath, MD, Venice (Italy) Teacher, Homeopathic Medical School of Verona.
we must use what help patients 20 November 1999
Andrea Valeri, homeopathic medical school of Verona, Italy modena Send response to journal: Re: we must use what help patients	Many critics against homeopathy state that one cannot "believe" in homeopathy because , up to now, we don't have a clear mechanism of action of homeopathic drugs. This argument looks very "scientific". This way, we cannot use medicines if we don't use the exact mechanism . But some problems arises : a big amount of daily used conventional drugs don't have a clear mechanism .For example : haloperidol (Haldol, USA) . Under the section : actions, one can read : " the precise mechanism of action has not been clearly established" (1). According to critics physicians, if one of their patient has some intractable psycotic disorder, they must avoid giving haloperidol for "scientific coherence " ? The examples could continue. It's absolutely clear that, as physicians, we MUST use the best medicine for our patient , even if we don't know the exact mechanism of action . At the same time , we MUST look forward for a better understanding of the action of the drug,meanwhile curing our patients and their sufferings. This task is the same ,for each physician, in each part of the world. As homeopaths, we noticed repeated good results giving homeopathic medicines. We want science: every day we try to study better the mechanism of homeopathy, and many homeopaths are planning clinical studies to provide more quantitative results . But, we are FIRST clinical physicians : we have to follow what helps patients . More and more people , and more and more physicians , agree with this basic point. (1) PDR 1999, pag. 2188
GREAT ARTICLE 22 November 1999
Harry R Huxford, Electrical Engineer(retired) Send response to journal: Re: GREAT ARTICLE	I think this Article was very good and needed in a time when our regular "SCIENTFIC" medical practice is becoming less effective.Is there not enough room for other effective alternatives? It is appearent that some readers have not used Homoeopathy or witnessed the near miracles of homoeopathic medicine. There are many areas of chemistry, physics and other sciences that are not well understood.We do not have to know everything about a subject to use it effectively. I have worked with electricity and electronics for 50 years and no one knows how electricity flows in a simple copper wire, nor the way semiconductors work - they do and we use them but there are many theories not facts. Also, there is Kirlian photography(developed in 1939) that has captured on film the aura of energy that emanates from animals(humans included) and plants and the aura undergoes changes when physiological or emotional changes occur. We have yet to develop sensitive enough instrumentation to measure auras but it is there. It took 300 years to accept the lack of vitamin C as the cause of scurvy.How many time was penicillin discovered before it was used. Homoeopathy is not well understood-now and it may be almost impossible to do double-blind studies the way that the medical establishment wants or requires but homoeopathy has worked in my life for 25 years. It has been around for 200 years and I think it will outlast all of its critics. I am also thankful we have regular Medicine. Remember "the world will always validate what you believe" a quot by Gary Zukov.
Homeopathy and immunology 22 November 1999
Gino Santini, MD ISMO, Istituto di Studi di Medicina Omeopatica, Rome, Italy Send response to journal: Re: Homeopathy and immunology	I want to enter the debate only to underline the importance of a lot of immunological data confirming the effectiveness of homeopathy. Only one example: in 218 patients is possible to obtain the decrease of sintomatology and the antibodies concentration of a Chlamydia infection with a homeopathic remedy (and only with this!) administered ad a very high diluition (030 LM), remedy accurately choosen with Hahnemann's principle of similarity. I perfectly agree with Maurizio Castellini when he says that this principle is "therefore much vaster than pharmacological homeopathic treatment, which is only one of its many applications, even in therapeutic terms". The most important fact is that today, basing the work on immunology studies, we have the possibility to demonstrate this with a great deal of "academic" references. This would be enough for every medical research: anyway the oppositors not only do not considerate it, but even are insisting on in asking us the physycal prove of homeopathy. We are clinicians: we can only produce (yes, a lot of) clinical data obtained following a well-codified method, not physycal models. Of course, I do not say that it is easy to produce academic works on homeopathy, but now it is possible: our institute is travelling the immunology pathway, others probably will doing the same thing along different ways. Actually the problem is not the homeopathy, but the homeopaths themselves: few (comparing with the components of the other "team"), lonely (with a masochistic tendency, almost in Italy, to cultural isolation) and disorganized. But BMJ has just demostrated that times are changing, I hope...
Re: Re: Homeopathic mechanisms 22 November 1999
Paul Booyse, Homoeopath and Pharmacist Private Practice Send response to journal: Re: Re: Re: Homeopathic mechanisms	The discussion of Homoeopathy must examine 2 fundamental concepts. Firstly the law of similars, i.e. that substances which can symptoms in a healthy individual, can be used to treat SIMILAR symptoms in the sick. The second concept is that of potentization. The second concept is an exploration in physics, and often the main reason for suggesting homoeopathy is fraudulent. Perhaps it is a question of science not able to to validate homoeopathy because science is not yet advanced enough. (from Andrew Vickers: c) the physics of water is such that it is not inconceivable that homoeopathic medicines are physically distinguishable from water. Claims that homoeopathy is "impossible", "has zero Bayesian prior probability" or that "we can't have homoeopathy and modern science too" (5) are premature. ) Let us rather examine the first concept, that of "like" treating "like". It would seem to be absurb, but if you examine what we know of medicine so far, you will find that this is indeed a fact. Examine any pharmacological textbook, e.g. Martindale. Look up a drug, say Imigran, used for migraines. One of the side effects listed? - is headaches. Antibiotics are used to treat an infection, yet themselves can cause a superinfection. Anti-hypertensives such as hydrallazine and methyldopa list headaches amongst their side-effects, and it may often occur that a hypertensive patient experiences headaches until the blood pressure is controlled. Look at chlorpromazine, known to have anti-emetic properties, and yet in Martindale a case is listed of hypersentivity, where two patients developed jaundice with "vomiting" etc. It is exactly the right term - "hypersensitivity". This implies that certain individuals are more likely to show this reaction and that is why homoeopathy individualizes the choice of prescription, - to find the remedy to which the patient is sensitive. The experience of the homoeopath, born out in the observation of homoeopathic provings, is that the more potentized the remedy, the broader the pattern of symptoms observed. Search through further medicaments and you will observe that even in allopathic medicine, there is, not by choice but by default, an experience of like treating like. It is however the crude dosages used and lack of potentization that cause the allopathic effects of most medicine to be more pronounced.
Excellent Article 22 November 1999
Janice Abbott, Homeopathic Practitioner Toronto Canada Send response to journal: Re: Excellent Article	People should not critisize what they don't understand. Not all drug actions on the body are understood either but are used none the less.
Re: Disgraceful 22 November 1999
Tim Shannon, Naturopathic Student Send response to journal: Re: Re: Disgraceful	I think the only thing that is truly disgraceful in medicine is a closed mind; there are SO MANY suffering people out there. I am a beginning student of homeopathy and I've been able to substantially help many people with homeopathy, many of these people couldn't get satisfactory help from conventional medicine. What I have seen time and time again from people that say nay about homeopathy is that they have NEVER examined it in the clinic, where it really matters. There is all this discussion about "proof" and gold standards and placebo and trials. To me this is all a smokescreen, because what really matters is whether the patients are getting better or not. There are many trials that "prove" certain medicines are effective, but in the clinic, with real patients the medicines don't work very well. I think it is healthy to be skeptical about something you don't know about. It is another matter to be cynical, or to keep insisting that someone out there convince you with some study, that something is true or not. I also think it is natural for doctors who are so closed minded about other medicines to ignore the junk in there own back yard. What I've witnessed, in the clinic, time and time again is that conventional medicine is ineffective at curing chronic diseases. In some cases, I have seen effective or mediocre "management" of chronic diseases, but VERY rarely are patients relieved of their disease entirely as they are with homeopathy. I have also treated patients who are suffering greatly from both the disease and the side effects of the conventional treatment. These side effects are readily justified by the medical profession and accepted as necessary. There are sufficient studies in medical journals showing the high rate of iatrogenic (doctor caused)mortality, problems with side effects, medicines given with NO idea as to their mechanism of action, etc. Conventional treatments are wonderful at keeping people alive and often supressing symptoms, however often patients with chronic diseases can get much better results with homeopathy. It is clear to me that many of these professional skeptics have no true investment in finding out if this medicine is genuine or not. I know this because they NEVER ask the only people who really matter, our patients. They busy themselves with trying to prove or disprove a phenomena without actually going out there and testing it themselves, without really interacting openly and willingly with the world. This little essay is not written for people who have minds cemented shut, but instead for people who are willing to at least look and see for themselves. I encourage people to use a healty skepticism and talk to patients, get out there in the world and meet people who have had success with homeopathy. Even better, try it yourself and make your own assessment. No clinical trial, no matter how clever, will EVER substitute for your own experience and deciding for yourself.
BMJ Debates Homeopathy: 1990s or 1840s? 23 November 1999
Peter Morrell, Hon. Research Associate History of Medicine Staffordshire University, UK Send response to journal: Re: BMJ Debates Homeopathy: 1990s or 1840s?	The original article [of October 23] should be praised as a fair and carefully-crafted account of homeopathic medicine, but some of the responses to it are far from reasoned or well-crafted. I have made the title of my response a question because there are some striking parallels in relation to the ‘dialogue’ between the medical establishment and ‘evil quackery’, in these two time periods. In both cases, the engagement between them has been vigorous and hostile; various arguments were played out then which are still being repeated today; and, most significantly, alternative systems of healing were booming and diverse then just as they are now. What is depressingly clear today is that there are few signs of much progress in the subject of mutual understanding after the passing of 150 years. How can it be ‘disgraceful’ that the British Medical Journal discusses these matters? Is it too much to ask that any self-respecting clinician should, by happy accident, also be equipped with an open mind? Sheer pressure of public popularity, and thus patient demand, is the driving force behind the growth of alternative medicine, not just in the UK, but around the world. Since the early 1980s it has become something of a phenomenon. How can it therefore be ‘disgraceful’ to examine this phenomenon more closely? A phenomenon which is taking place in every town and city of the world, whether doctors like it or not. It would surely be more disgraceful, not to say foolish, to turn aside and ignore it? Doctors should also seriously question the underlying motives of patients who turn to ‘evil quackery’. They are clearly unhappy in some sense with the conventional treatment they have been offered and unless such fears and disappointments are addressed, then it seems inevitable that more will flock to such therapists. Maybe the ‘safe and gentle’ holistic therapies are unwittingly guilty of offering slender hopes to patients, as many doctors suspect, but patients seem to prefer that to strong drugs, surgery and few significant health gains after years of trying. These are the central criticisms patients repeatedly make of scientific medicine. "Dr Burnett had left University with strictly orthodox medical views, "having been taught by good men and true that Homoeopathy was therapeutic nihilism." This was the current view at the time, often expressed with a great deal more virulence. Homoeopathy in Britain was confined to a more or less persecuted sect, actively ridiculed in the universities and widely despised outside them. Its followers were looked upon as quacks or cranks, its practice had narrowly escaped being declared illegal in the 1850s and the British Medical Association prohibited homoeopaths from joining its ranks. "The professor of anatomy at Glasgow in 1873 had begged his most promising pupil not to throw his life away, for it is true that, as Dr Burnett himself afterwards bitterly put it, 'the social value of [surgery] is a baronetcy. The social value of [homoeopathic remedies] is slander and contempt.' When urged not to abandon orthodox medicine, Dr Burnett had declared that 'he could not buy worldly honours at the cost of his conscience', but one may readily detect behind his conscientious objection an equally keen resentment of received authority. Perhaps because of his early hardships, there was something about social ostracism which suited him. " [J H Clarke, The Life and Times of Dr Burnett, 1902] Burnett, who adopted homeopathy upon graduation, went on to establish not one but two of the largest and most thriving medical practices in London. Are people seriously suggesting that highly- qualified doctors like him were fools, to follow their conscience and adopt homeopathy? The argument is an imprudent and unreasonable interpretation. To become a homeopath was, as stated, simply to follow a suicidal career-path within medicine. What type of doctor would willingly choose such a career path? Repeatedly in the responses to this article, people refer to the clinical unprovability of homeopathy and the ludicrous nature of minimum doses. Because ‘it cannot work’ therefore ‘it does not work’ seems to be the argument. It is just about as stubbornly medieval as that of the Pope saying to Galileo ‘There are no moons of Jupiter, so I will not even look into your telescope!’. This is essentially the same argument presented back in the 1840s. Sir John Forbes, physician to Queen Victoria’s household, called ‘the infinitesimal doses’ of homeopathy ‘an outrage to human reason’. But every argument doctors presented against homeopathy eventually backfired on their own side. One popular argument then, has resurfaced again in this discussion: viz., self-limiting diseases. Very few diseases do spontaneously get better if they are left alone. This plain fact is well-known to all patients, which is why they consult physicians in the first place. Therefore, to claim that homeopathy ‘and its kindred delusions’ works because the diseases it treats ‘would get better anyway’ is a highly dubious contention. It might be a convenient philosophical nicety to argue a case against homeopathy, but it simply does not square with human experience. In the last century this argument became termed ‘therapeutic nihilism’ or more popularly the ‘doctor did nothing’. Doing nothing for ‘self-limiting diseases’ is not the reason homeopathy appears to help patients. Indeed, if it was, then why bother with all the expensive drugs which comprise the armamentarium of modern medicine? We might just as well follow that witty Boston physician, Oliver Wendell Holmes’ advice, and tip all our drugs into the sea: ‘and so much the better for man, and so much the worse for the fishes, if we did’. The real problem with the argument is that medicine has become divided into two poles, both implacably opposed to the viewpoint, knowledge and expertise of the other. The BMJ has in fact acted gracefully by opening up a timely debate between these two divisions within medicine and hopefully allowing some much-needed light to fall into an area of great darkness. I shall now respond to some specific points raised in the article. The authors state that ‘during serial dilution the complex interactions between the solvent [water] molecules are permanently altered to retain a ‘memory’ of the original solute material.’. This is not an accurate account of the theory as I understand it. Fortunately there is a book on this subject which people can read, to make their own minds up on the matter [Rolland Conte, Henri Berliocchi and Yves Lasne, Theory of High Dilutions and Experimental Aspects]. In my opinion, the theory states that water is a very complex substance. Few scientists would dispute that. It does not exist as H2O but a complex ‘soup’ composed of millions of large ionic polymers, which are constantly forming and reforming, and interacting with solute molecules. Thus these large polymers are thought, in the serial dilution process, to become coded in some manner, not permanently, but semi-permanently, to contain the shape of solute molecules which were in the original solution. This is by no means as absurd as it sounds. Very vigorous shaking combined with serial dilution, which is the method of preparation of all homeopathic drugs, could radically affect the shape, size and number of these natural water polymers in the solution, in such a way that they retain a ‘shadow’ of the solute molecules which were intermingled with them in the original solution in crude dose. One version of this theory also contends that such large polymers act like microscopic ice crystals within the water as long as it is kept at normal temperatures and away from strong smelling substances, magnetic fields, X-rays etc - which are precisely the things which ‘denature’ homeopathic remedies. As the authors of this article then point out, some therapeutic impact of such coded polymers on the organism, is then perhaps conceivable. I think any open mind would find this interesting material sitting on the borders of human knowledge, rather than a ‘disgraceful’ matter or as ‘bunk, bunk and more bunk’. Such remarks only serve to widen the distance between the two ‘implacably opposed’ camps. It adds much more heat than light. Hostility, insults and name -calling did not move the argument forward in the 1840s and it won’t today. Unpalatable it may be, but patient-demand for alternative medicine is booming, and no amount of name-calling from the ranks of established scientific medicine can change that simple fact. Clinicians need to explain what is so fundamentally outrageous about a healthy dialogue? The authors point out that the homeopathic consultation is likely to be longer than one of most general practitioners, and that the underlying reason for a long consultation is that a very large amount of patient data is collected during its course. This includes modalities, likes and dislikes and many ancillary aspects about the patient’s sense of well-being, sleep, menstruation, feelings and general state of happiness. In general, homeopaths search for ‘the rare, the startling and the peculiar’ in the patient’s symptomatology, because experience dictates that this more frequently leads them to the right drug. As the authors also, and quite rightly reveal, such material is gathered specifically to match it with the characteristics of homeopathic drugs in order to choose a single drug which matches the totality of the patient’s symptoms. Very patient and painstaking matching of patient symptoms to drugs is certainly the central dominating activity of all homeopaths. A great deal of search and analysis and subtle fine-tuning has to be done, not only to find the correct remedy, but also to maintain any therapeutic progress which is achieved. It is worth stating that patient data is not gathered covertly, in order to please the patient, or to elicit some placebo response by contact with a sympathetic person for an hour, which is a criticism one occasionally encounters. As they also point out later, one drug is not the only approach and it is incorrect to claim that there is a routine or rote-prescribing approach in homeopathy, such as grass pollen for all cases of hayfever. The authors refer to a lack of ‘evidence that homeopathy is clearly efficacious for any single condition’. While this is probably strictly correct it is also somehow misleading. It of course depends on what you define as evidence. While many double blind trials are flawed for research into such therapies, and have been admittedly disappointing thusfar for researchers on both sides, nevertheless the sheer weight of anecdotal evidence should give rise to the common-sense notion that there must be some basis for such therapies by virtue of the fact that they have lasted this long. In the 1850s ‘medical delusions’ like homeopathy were all widely predicted, by clinicians at the time, to fizzle out in a few years. That they have failed to do so, but are now as popular as ever, must surely, to open and reasonable minds, indicate that there simply must be something in them. Here is an account of what might be seen as one of the first double blind trials of homeopathy in 1870s Glasgow: "...Hughes had suggested aconite as a remedy for simple fever and Dr Burnett determined to test the advice on his children's fever ward, dosing all the patients down one side with Fleming's Tincture of Aconite, and treating the others as usual. Within twenty-four hours all the aconite children were cured (save one, who had measles) and smartly discharged, while the rest still languished in hospital. The experiment was repeated with the same startling results until a truculent nurse, impatient of the doctor's hard heart, dosed all the patients indiscriminately from 'Dr Burnett's Fever Bottle' and emptied the ward. "The doctor was 'simply dumbfounded', spent his nights reading homoeopathic literature and, having suffered a conversion which he afterwards compared to St Paul's on the road to Damascus, instantly resolved to 'fight the good fight of homoeopathy with all the power I possess: were I to do less I should be afraid to die.' His MD thesis, submitted when his year's term at Barnhill elapsed, was rejected for heretical, homoeopathic tendencies (a second thesis was accepted in 1876).” [from Clarke’s Life of Dr Burnett] Patients are not fools. They know whether they are getting better or not and they would certainly not pay vast sums if there was no progress being made. The argument that they are that rich and that desperate [or that stupid?] to not bother, while interesting, does not really hold much credence. Indeed, as some correspondents here have said: there is not a lack of evidence but an abundance of evidence that homeopathy works. Such evidence is unfortunately an ‘abundance of the wrong type’ and ‘a lack of the right type’ to impress most openly hostile clinicians, who clearly reserve the right to define what is ‘right’ and ‘wrong’ in such matters. Such minds will probably never be persuaded of the efficacy of anything other than scientific medicine. There is a very engaging story worth telling here about Dr Jonathan Miller [the theatre director and neurologist] in a late-night TV discussion programme in September 1988. When asked why he felt that alternative medicine was of no interest to him, he replied along the lines of saying [not verbatim]: ‘Even if it were clinically proven by numerous studies, I would still not be remotely interested in it. Only science holds the future of medicine and this ‘other stuff’ is happening in an entirely different street. The future of medicine is entirely with science.’ These views were then repeated in an article in The Guardian newspaper some months later. I am sure these perfectly understandable views could be repeated many times throughout the medical community, but it is no use running away from the fact that patients demand holistic therapies. They demand natural and harmless therapies which work, and prefer them to strong drugs and surgery. That is the central and uncomfortable reality which medicine faces today. How it is to be faced and dealt with is the very substance of this discussion. Finally, I would say that the bibliography is seriously deficient in a number of very important books on this subject which have been published in recent years. I would have included the following: Phillip A Nicholls, 1988, Homeopathy and the Medical Profession, Croom Helm London Mike Saks, 1992, Alternative Medicine in Britain, RKP Mike Saks, 1995, Professions and the Public Interest - Altruism and Alternative Medicine, RKP London Ursula Sharma, 1992, Complementary Medicine Today: Patients and Practitioners, RKP Barbara Griggs, 1982, Green Pharmacy A History of Herbal Medicine, Jill Norman and Hobhouse, London Ivan Illich, 1977, Limits To Medicine, Penguin, London And it is also useful to read those old classics by Brian Inglis: Fringe Medicine, 1964, Faber, London, and Natural Medicine, 1979, Collins, London. Time has hardly dated them, both in the factual substance and in the underlying themes he discusses. I would also recommend two other classics in the wider field of medical sociology: Margaret Stacey, The Sociology of Health and Healing and the brilliant Freund & McGuire, 1995, Health, Illness And The Social Body: A Critical Sociology, Prentice Hall, USA Peter Morrell Hon. Research Associate History of Medicine Staffordshire University, UK
Research on efficiency of homeopathy 25 November 1999
Seema Gupta, Doctor&Teacher clinic in bombay& hom.medical hospital Send response to journal: Re: Research on efficiency of homeopathy	I can understand the disbelief in efficiency of homeopathy as I know how the system is undependable.The extreme support homeopathy gets is as harmful as the extreme opposition. I have been working clinically as well as in labs to substantiate a system that undeniably works.The immune response of tumour specifc antibodies in soft tissue Ca's and of neutrophils in chronic otitis media are indicative of the action of the indicated hom.remedy.The lab work has come up with nothing. It would be a shame if we did not get our act together after 250 years and let in some scientific light(with the heat) filter in. As far as vaccinations are concerned , it would be criminal to advise against them in a high endemic country like India.There is NO proof of efficiency of hom.prophylaxis even remotely challenging vaccines.
Do you have a better explanation than Placebo? 25 November 1999
Phoebe Lo, Asian Pacific Homeopathy Association Hong Kong Send response to journal: Re: Do you have a better explanation than Placebo?	If you have seem a 11 months old little girl suffering from 3rd degree burn over 70% of her face cured in 7 days; 10 cm large breast tumor with multiple ulcers on the breast shrunk to 1cm in one month and disappeared after 3 months; post-stroke paralysis, could hardly walk into the doctors office without supports, walked out the doctor's office free from support after the first visit, you will probably think: "That's got to be a miracle." In reality, these are just some of the everyday miracles performed by a very low profile doctor who happened to be my boss, using homeopathy in a very unconventional way. For those of you who are skeptical about the effectiveness of homeopathy, do you have a better explanation to the above phenomenon rather than just placebo? And if it is only placebo, then it must be good placebo, because it is getting people better without any side-effects.
Complementogenic Disease - the Tip of the Iceberg? 28 November 1999
Anne M Pettigrew, General Practitioner Ardgowan Medical Practice, Greenock PA16 8HW Send response to journal: Re: Complementogenic Disease - the Tip of the Iceberg?	Editor, Your recent series ABC of Complementary Medicine is timely. We are aware of more and more problems caused by patient use of Complementary and Alternative Medicines and would advise all doctors to ask patients specifically about usage as it may well be that much NHS time and money is being wasted on "complementogenic" disease. It is only since I qualified as a Homeopath that patients have been open in admitting usage of such medicaments and a recent survey of our large General Practice showed over 50% of women aged 20-60 were consulting or taking supplements/ herbal products. Since discussing the problems at a journal club, other practitioners are surprised at how many symptoms can be attributed to supplements. Certainly a few, such as Kava Kava (rich in coumarins to interfere with warfarin) have merited mention in the BMJ in the last year. Our practice has had a severe dyspepsia caused by Zinc (6X RDA bought after hair analysis by mail order), a difficult to control BP caused by Ginseng, severe headaches on waking caused by Evening Primrose Oil and a myopathy due to creatine to mention a few. These had necessitated an endoscopy, a medical referral, and a CAT scan as well as numerous blood tests. Aetiology was only ascertained by direct questioning. All resolved on cessation of CAM substance. We suspect this is the tip of the iceberg. Caution should be exercised in condoning any supplement/ herbal preparation without checking with a pharmacist or reliable source. Many herbals are dangerous to epileptics, diabetics and those on warfarin as well as having the propensity to cause illness in those otherwise healthy and not on medication. It is to be hoped the House of Lords Scientific Committee looking at CAM will regulate the sale of these products and the practise of those who purvey them, but it is important that we educate ourselves to recognise their problems and acknowledge why our patients seem so keen to consult others than ourselves. Perhaps if more doctors qualified in the therapies known to be superior to placebo, like Homeopathy and Acupuncture, there would be less need for them to do so. Anne M Pettigrew General Practitioner Ardgowan Medical Practice Greenock PA16 8HW annepettigrew@compuserve.com
Conventional medicine, grow up 28 November 1999
Simon Rabinovich, Homeopathic physician, Homeopathic Consulting Toronto, Ontario, Canada Send response to journal: Re: Conventional medicine, grow up	This article is a good yet common explanation of basic principles of homeopathy. It is astounding however, that the voices of conventional "fighters" against the obvious facts of life and medicine's achievements are heard with the same consistency. But frankly speaking, I am not surprised. There are several reasons for the attacks on everything that is not matching their scheme of "how it must be". Some of them have been nourished by giant pharmaceutical companies which see the non- conventional drug industry as a danger to their multi-billion profits. Just imagine such "nice" fact: only ONE tablet of any major cholesterol- lowering drug costs several dollars (the cost of the whole bottle of homeopathic remedy which is sometimes enough for the curing the disease), not to speak about "anti-migraine" drugs where one tablet costs dozen of dollars or more.... (Just notice the word "anti", it will lead you to the further understanding of the strategy of conventional advocates of "chemical health") The another explanation of many of conventional MD's fierce and sometimes pretty ugly opposition to ALL non-conventional methods is the obvious attempt to preserve the field of treatment of peoples'diseases as their sole monopolistic prerequisite. I personally know a number of conventional doctors who come for non-conventional treatment (or bring their reltives) to sources that seem ridiculous even to me, a person with open mind and understanding of the obvious achievements of ALL therapeutic methods. What does it mean? It means that the same ardent "fighters" against "quackery" disbelieve in what they are practicing and BELIEVE in the deepness of their hearts that "charlatans" could provide "miracle" for them..... I feel sorry for them....... ( to be continued)
Homoeopathy is a part of MEDICINE 28 November 1999
Simon Rabinovich, Homeopathic physician, Homeopathic Consulting, private practice Toronto, Ontario, Canada Send response to journal: Re: Homoeopathy is a part of MEDICINE	I don't care about the definitions "conventional" and "non- conventional", "complementary", "alternative" and so on medicine. For me these labels are as useless as diagnosis of disease like "essential hypertension" or "low back pain" or "chronic fatigue syndrome". First and foremost ask yourself: what good do these definitions provide for the patient, a sick, a suffering person? Do they help for better understanding of his PERSONAL problem? Or do they suggest a better, PERSONAL treatment? When patient comes to your office he or she wants you to treat HIM or HER and not the vague "generalized" statistical entity. Homoeopathy provides individual, NON-statistical approach which is welcomed by patient and is very rewarding for the doctor in the case of correct and therefore succesful treatment. And what about "regular" and other sorts of therapeutics? This is very simple: as far as any of these methods come to the PATIENT's benefit - it is part of MEDICINE, a term defining the goals all the health practitioners exist for.
Any information on homoeopathy in animals? 1 December 1999
Fabio Rios Columbia Send response to journal: Re: Any information on homoeopathy in animals?	Does anybody have any information on the effects of homoeopathy on cattle?
Re: Any information on homoeopathy in animals? 1 December 1999
Tony Delamothe, web editor www.bmj.com Send response to journal: Re: Re: Any information on homoeopathy in animals?	Might animals be the ideal participants for recruitment into randomised controlled trials of the efficacy of homoeopathy? So many of the factors that seem to complicate the performance of large RCTs in humans disappear.
Re: Any information on homoeopathy in animals? 7 December 1999
Geir Marcussen Send response to journal: Re: Re: Any information on homoeopathy in animals?	Contact DCG, Sweden, they have material on research done on cattle, that shows effect.
Re: Homoeopathy is a part of MEDICINE 7 December 1999
Geir Marcussen Send response to journal: Re: Re: Homoeopathy is a part of MEDICINE	Homeopathy is not a part of whats known to be medicine, its THE MEDICINE, nothing more, nothing less. AND, it can never be part of whats known as "MEDICINE", IT HAS NEVER BEEN THAT, AND NEVER WILL BE, THAT DO HISTORIE SHOW US! Dont repeat yesterdays mistakes!
MEDICINE OF THE NEW MILLENNIUM 8 December 1999
Jayakumar Pannakkal, HOMOEOPATHIC PHYSICIAN CALICUT,KERALA,INDIA Send response to journal: Re: MEDICINE OF THE NEW MILLENNIUM	DEAR DOCTORS, HOT DISCUSSION IS NOW GOING ON .WITHOUT ANY HOSTILITY ,AS PRACTISING HOMOEOPATH FOR THE LAST 16 YEARS I AM HERE EXPRESSING MY OPINION. AFTER READING ORIGINAL DOCUMENT AND VARIOUS RESPONSES I THINK IT IS GOOD TO DISCLOSE MY MIND. 1.PROBABILY THE YOUNGEST MEDICAL SYSTEM; THE ALLOPATHIC (OR THE MODERN SYSTEM AS NOWADAYS CALLED) SYSTEM IS MORE THAN 2000 YEARS OLD,SO AS THE AYURVEDIC AND ACUPUNCTURE. WHEN COMPARED WITH THE ABOVE SYSTEMS THE 200 YEAR OLD HOMOEOPATHY ,WE CAN CALL IT AS AN INFANT. WITH IN THIS SHORT PERIOD THIS SYSTEM BECOME A SYSTEM TO RECKON WITH, WITHOUT ANY PUBLICITY OR SUPPORT FROM GOVERMENT ITSELF. ITS FAME SPREADS FROM INDIVIDUAL TO INDIVIDUAL BY THE REMARKABLE CURES. 2.SCIENTIFICITY ; HOMOEOPATHY IS BASED ON THE NATURAL LAW OF CURE, "SIMILIA SIMILBUS CURRANTER" MEANS LET LIKES CURED BY LIKES .EVERY DRUG IS PROVED UPON HEALTHY HUMAN BEINGS (ONLY IN HOMOEOPATHY), SO MENTAL AS WELL AS PHYSICAL SYSTEM WE GET. IN ALLOPATHY ONLY PATHOLOGICAL PROVING ON ANIMALS ARE DONE. HERE THE MINUS POINTS ARE A)WILL NOT GET ANY MENTAL SYMPTOMS B)CANNOT GET THE SUBJECTIVE SYMPTOMS OR WHAT THE PATIENT FELT AFTER THE ADMINISTERATION OF THE DRUG, BECAUSE ANIMAL CANNOT SPEAK OR THEY HAVE NOT THE SAME MENTAL STATE .SO IN ALLOPATHY THEY DISCARD TOTALLY THE SUBJECTIVE SYMPTOM OF THE PATIENT. C)BY ITS PECULIER METHOD OF DRUG PREPARATION, HOMOEOPATHIC DRUG CAN ABLE TO REACH DEEPER, AND ON MIND. ACTUALLY HAHNEMANN LIFTS THE MEDICAL SYSTEM TO THE SPIRITUAL LEVEL IN A PRACTICAL WAY. D)NOT THE DISEASE BUT PATIENT -DETAILED CASE TAKING COVERING MENTAL, EMOTIONAL, PHYSICAL STATES IN EVERY CASE IS, AND EVERY INDIVIDUAL IS CONSIDERED AS DIFFERNT IS PECULIARITY OF HOMOEOPATHY ALONE E)NO SIDE EFFECTS AND NO SUPPRESSION PLACEBO ACTION ; SOME DOCTORS HERE BLAMING HOMOEOPATHIC ACTION AS PLACEBO ACTION. PLACEBO MEANS TO PLEASE .THEN HOW CAN YOU EXPLAIN THE CASE OF INFANTS, AND CURING OF CHRONIC CASES LIKE RENAL STONES, OVARIAN CYSTS, NASAL POLYPS, SINUSITIS, MIGRAINE, NON HEALING ULCERS, PEPTIC AND DUODENAL ULCERS, OLIGOSPERMIA, BHP, BHT, SKIN DISEASES, MENSTURAL DISORDERS ETC ETC. IF PLACEBO CAN CURE BETTER THAN DRUGS, WHY NOT YOU TRY IT? ACTION OF HOMOEOPATHIC DRUGS - ACTION CAN MEASURE ONLY BY CURING OR PALLIATING. OR TAKING HIMSELF OR PRESCRIBING TO SOME ONE AND OBSERVE. CAN YOU SEE ELECTRICITY OR MAGNETISM? IT CAN BE UNDERSTOOD ONLY BY ITS EFFECTS. LIKEWISE HOMOEOPATHIC ACTION CAN BE OBSERVED BY ITS ACTION UPON PATIENT. DOUBLE BLIND TRIAL OF DRUGS - THIS METHOD IS NOT APPLICABLE TO HOMOEOPATHY ,BECAUSE WE ARE NOT GIVING DRUGS ACCORDING TO THE DISEASE, BUT FOR THE INDIVIDUAL.SO THAT FOR THE SAME DISEASE ACCORDING TO THE INDIVIDUAL PECULIARITY, MEDICINE WILL DIFFER. SO TRIAL OF DRUGS ARE FUTILE. SUCEPTABILITY AND INDIVIDUALITY- WE KNOW THAT PATHOLOGICAL MICRO ORGANISMS ARE PRESENT EVEN IN HEALTHY CONDITIONS, WITHOUT ANY TROUBLE TO THE HOST. ONLY WHEN THE STATE FOR ITS DEVELOPMENT OR IMMUNITY IS LOWERED IT PRODUCES DISEASES. BY HOMOEOPATHIC PRESCRIPTION WE CAN CHANGE THE SUCEPTBILITY AND INCREASE IMMUNITY, SO DISEASE PROCESS ITSELF DISAPPEAR. PRIMARILY THE STATE OR THE SUCEPTABILITY SHOULD BE THERE, THEN ONLY THE PATHOLOGICAL ORGANISM CAN ACT IN A HARMFUL WAY, OTHERWISE AS COMMENSAL THEY STAY. TRUTH WILL STAND- QUACKERY OR CHEATING CANNOT STAND FOR LONG TIME. EVEN AFTER 200 YEARS, HOMOEOPATHY IS GROWING GLOBALLY WITHOUT ANY PUBLICITY. MODERN FACILITIES -MODERN FACILITIES LIKE COMPUTER, SCANNING, USG, ETC WILL HELP HOMOEOPATHIC DEVELOPMENT. WE CAN PROVE OR SHOW EVIDENCE OF OUR CURES WITH THIS. THERE ARE MORE THAN 3000 DRUGS AND WITH THE HELP OF COMPUTER WE FASTLY FIND THE SIMILIMUM OR THE DRUG. SO MY REQUEST IS FIRST TRY AND THEN COMMENT.
Re: Any information on homoeopathy in animals? 9 December 1999
Andrew Vickers, Co-author of "ABC of complementary medicine" Send response to journal: Re: Re: Any information on homoeopathy in animals?	One of the references in the article is: Linde K, Jonas WB, Melchart D, Worku F, Wagner H, Eitel F. Critical review and meta-analysis of serial agitated dilutions in experimental toxicology. Hum Exp Toxicol 1994;13:481-92 This describes several experiments on animals.
Should we think at all? 6 March 2000
Kai Ruusuvuori Send response to journal: Re: Should we think at all?	So are you saying that we should blindly believe everything we don't understand? Au contraire... Concerning all I'm going to say now, I'd like to apologize for not being able to express myself as well as I'd like to in english. This may result as misunderstandings and inaccurate argumentation. I'm not a doctor nor that well educated, even less so in the field of medicine. I study for the first year at the Helsinki Institute of Physics and that leaves me with somewhat inadequate information concerning molecules and the human body. However, it is clear even to a highschool student that there's no scientifical basis for this "similia similbus curranter" nor for the accusation that a homeopathic medicine of a value D2000 would be more effective than one with a value of D1. If there is nothing left of the substance, that is supposed to have an effect, there can be no effect. This is what common sense tells us. However, I admit that sometimes common sense is not enough (the true nature of an electron, for example). However, medical science and chemistry tend to make sense, whereas homeopathy does not. Even if I would accept that a D2000 could have an effect on a patient, I still would critisize homeopathy for the "similia similbus curranter"-principle as this is not, as some claim, the natural law of cure. It is like drying clothes with water or putting out a flame with fire. The whole "natural law of cure"-concept seems, pardon me, idiotic. There is always a reason for sickness and disease and these are not to be fought with substances that produce similar symptoms, but with subtances that have some kind of an effect on what ever it is that is causing the problem. It may be a virus or a physiological fault. It may even be psychological. Whatever the reason may be, things are not cured just by creating like symptoms. There's more. As everything has been tested on healthy people and as the symptoms the substances have created are based on subjective observations, there is no one medicine for a disease. For instance a substance may have created some 2000 different symptoms in different tests. This means every homeopath gives the medicine more or less randomly as there is no one source of knowledge concerning the workings of homeopathic medicines. They might even give a fever patient the same medicine as a cancer patient. This makes no sense to me. As to the point that someone made concerning the seas and their homeopathic value, I believe that most homeopaths would argue that it's not homeopathic medicine, because it has not been prepared right. In other words nobody has shaken the water properply. And btw, nowadays homeopathic medicine is prepared in a manner that Hahnemann himself would most unlikely approve. The "shaking" should be made personally etc. As this has undoubtetly brought little new to the conversation and as I have presented no references this hardly represents a "good" scientific response. I apologize for that but I felt I had to speak my mind. And who knows, maybe it's good for you "old timers" to hear what a 20-year-old kid has to say. ; ) On the other hand, my young age and lack of expertise might make some people dismiss this as not worth their while...
Re: Should we think at all? 9 March 2000
Peter Morrell, Hon. Research Associate, History fo Medicine Staffordshire University, UK Send response to journal: Re: Re: Should we think at all?	Sir, This young writer has raised a number of important aspects about homeopathy that demand a reply. He shows a more than superficial grasp of the subject, but seems to reject it for several reasons. One, because of its minute doses; two, because it seems illogical and against commonsense; three, because the 'law of similars' is incorrect in his view; four, because the drugs in use were not thoroughly proven; four, because it ignores the causes of an illness; five, because the medicines are not made correctly; six, because patients with different conditions can be given the same drug. The writer seems to have decided it does not work beforehand and not to have tested himself. Most people who use homeopathy have been introduced to it, often in childhood or family and seen it work firsthand. This might sound like a side-issue, but it is, in fact, an important point. Much of the theoretical manoeuvring that goes on about it is done by people who have not tried it. It is like arguing about the menu before you have even tried the meal. On theoretical grounds, how can you convince a starving man to eat? They must just do it. Therefore, I would suggest that any enemy of homeopathy should first try the safe and harmless remedies out for themselves, before making judgemental remarks about it. Talking at a theoretical level is cheap and of little value. To discuss in the depth required how Hahnemann came to devise his system would require a lot of space. In recent years, I have published a good number of articles precisely on this theme and on the background history to the development of homeopathy. All I would say in brief is that, while working as a translator of medical texts, he started in the 1780s by collecting from the literature a large number of observations about the actions of drugs. From this, he then decided that contraries and mixed drugs were bad maxims, and saw abundant good evidence in favour of similars and single drugs; he then focused upon the other main doctrines of Old Physic: signatures and strong doses. He deplored both. In the literature, he again found much evidence for using small doses and for the effects of poisonings as a means of investigating the actions of drugs. From this position, he then launched into experiments throughout the 1790s from which he confirmed all his suspicions and then devised 'provings' [mild self-poisonings] of drugs on healthy volunteers. From this research came the single drugs, the provings and the use of similars as the founding maxims of homeopathy. In the late 1790s, he then started to progressively reduce doses to remove ill-effects. Surprisingly to him, the healing effect was retained, even with high dilutions of drugs. He later devised 'dilution scales' out of his passion for mathematical accuracy. That is how this system arose. Thus, I would say that homeopathy is almost entirely derived from experiments, which are broadly scientific in the modern sense, and by no means is it a theoretical system devised on the cheap overnight, by a charlatan. Hahnemann was in fact a serious and renowned experimental chemist as well as a doctor, before he even devised homeopathy. He was just about as scientific as one could get at that time. Therefore, it is not true that the law of similars or the small doses are unscientific. They are based on experiments and are thus evidence driven. That some of this is evidence science still rejects is a separate issue, a social issue really, as it poses a problem for science to believe it. As for the high dilutions this writer refers to, then again, their use is well established for over 150 years and you either use them, and believe your own eyes, or you rant and rave about them from an entirely theoretical position. The fact that there may well be underlying physiological reasons for the symptoms of a patient is still no reason to invalidate the homeopathic approach. If the most similar drug that fits the patient is given, then it should alleviate or cure the symptoms. This would be the case regardless of the cause; assuming it is a curable case. The approach is largely holistic and avoids explanations and mechanisms. I do not know where the writer has got the impression that the shaking [succussion] of a drug by a person is in some way different from shaking by machines, but I can assure him that this is not the view in homeopathic pharmacy, where very few hand-made remedies are made these days. As regards the alleged subjectivity of the provings, I would merely say that the information in provings is collected from people who know they have been given something, but they do not know what. They merely record changes in their health in minute detail over a month or so. This information is then collated. The fact that such data shows remarkable similarities in many people of different age and sex, might suggest that it is by no means as subjective as he thinks. Thus, what he calls these 'subjective symptoms' are pooled to form what I would term an 'objective database'. Thus, it is in not true to say that, the remedies are matched to patients on the basis of 'random information'. Regarding his comments about the law of similars and water helping to dry washing, I would merely say he has obtained a very imperfect and deeply simplistic version to that which is found in most textbooks on this subject. Regarding the nature of homeopathy, it is true that it is hard to explain. It sits uncomfortably on the borders of science, but that does not exclude the possibility that one day it will be explained. It is unfortunate that many scientists seem to regard it so defensively, and feel that their entire world view is challenged or under attack, by the existence of such phenomena as small doses and similars. I hope my comments have proved helpful to this writer. I would advise more careful study of the subject if he wishes to arrive at a deeper understanding. Yes, we should think, but we should also retain an open mind about possibly real observations, rather than condemn them on sight just because they seem illogical. I have heard it said that Bumble bees cannot fly, according to the physics of the thing, but fly they certainly do. Peter Morrell Sources Morrell, Peter, 1995, Hahnemann As Scientist, The Homeopath, UK, April 1995, and Oct 1996, Similia, Australia Morrell, Peter, 1998, A Guide To Hahnemann’s Translations, www Morrell, Peter, 1998, The Proving, Potentisation and The Law of Similars, Resonance, USA, June 1998 Morrell, Peter, 1998, From Poisonings and Provings to Holism, Similia 11.2, Australia, Dec. 1998 Morrell, Peter, 1999, Hunter, Hahnemann and the Origin of Homeopathy, New England Journal of Homeopathy [NEJH] 8.2, Dec. 1999/Jan 2000, USA, pp.97- 110 Morrell, Peter, 2000, Some Reflections On the Origin of Hahnemann's Ideas, Feb 2000, BHJ or Heilkunst, forthcoming Morrell, Peter, 2000, Single Drugs Small Doses, Similars, NEJH, forthcoming
Closed Minds and Unpleasant Behaviour 20 April 2000
Peter Morrell, Hon Research Associate, History Of Medicine Staffordshire University Send response to journal: Re: Closed Minds and Unpleasant Behaviour	Sir, "I think the only thing that is truly disgraceful in medicine is a closed mind; there are SO MANY suffering people out there." [1] "I also think it is natural for doctors who are so closed minded about other medicines to ignore the junk in their own back yard…" [2] Regarding homeopathy two arguments still tend to dominate its apprehension by physicians: 1. concerns disbelief and prejudice [the closed mind]; 2. regards how homeopaths have been treated. With regard to disbelief, clinicians usually claim it is not based on evidence but on a medical theory: ‘The great central truths of Hahnemann’s teaching up to 1828 were these: the demonstration by reasoning and proof of the truth of the therapeutic rule - let like be treated by likes - the necessity for ascertaining the effects of medicines on the healthy human body; the administration of medicine in disease singly and alone and in the precise form in which they had been proved; the diminution of the dose for the purpose of avoiding its too violent action. There is nothing theoretical here, all these maxims are derived from observation and experience; conjecture and speculation have no part in them. No theory of disease or of medicinal action is involved in the therapeutic rule.’ [3] With regard to the 'treatment' homeopaths have received from their colleagues: ‘What was the position of the homeopathic doctor for 60 or 70 years after the opening of the [London] hospital [in 1850]? He was completely ostracised by the rest of the profession, who looked upon him as a quack and renegade and would refuse to meet him in consultation. Dr Stonham says that in his young days a man needed to be a strong individualist to practise homeopathy alone in a town and face this ostracism. In spite of this, however, men were to be found in towns all over the country - and they flourished. Within a week of publishing an article on homeopathy in its pages, the British and Foreign Medical Review received one thousand four hundred notices from subscribers stopping their subscriptions. That gives one some idea of the feeling against homeopathy in the medical world...’ [4] It is sad that a closed mind is so often what scientists manifest when they disbelieve something, usually based on their own ignorance. Arguably, the behaviour it then inspires is equally reprehensible. To 'not believe' Dr Dudgeon is to not believe the inventor of the first Sphygmograph. To 'not believe' Dr Blackie, is to not believe the Queen's doctor for 20 years. Such closed minds will 'not believe' in homeopathy even if presented with a mountain of evidence, because they do not want to; science has nothing to do with it. Regards Peter Morrell [1]. Tim Shannon, Naturopathic Student, letter 'Re: Disgraceful' 22 Nov 1999 http://www.bmj.com/cgi/eletters/319/7217/1115#EL25 [2] ibid. [3] Dudgeon, Dr Robert E, 1882, Hahnemann The Founder of Scientific Therapeutics, E Gould & Son, London, p.36, quoted by Davies, Dr Anita E, 1976, The Scientific Basis and Practice of Homeopathy, Trans. Med. Soc. London, 92, 1976, pp.86-94, p.91] [4] Blackie, Dr Margery G, 1950, The Place of Homeopathy in Modern Medicine, Br. Homeo. Jnl 39, pp15-23, p.16
more scepticism please 24 May 2000
Stephen Park, non medical lay person home Send response to journal: Re: more scepticism please	As a non medical person I am alarmed that you do not take a more sceptical approach to homeopathy. Where I live alternative practicioners outnumber conventional ones by about 3 to 1 . Homeopathy is the most popular choice. The culture of alternative medicine brings with it a great deal of mumbo jumbo, some of which is harmless (obsession with diet etc) some of it can be cruel and stupid:they express the belief that Cancer is brought on by underlying emotional causes. Without fail they grossly exagerate the dangers of pharmecutical drugs and spin conspiracy theories that are irrisistable to people who feel outside the mainstream of society. I am very worried by peoples credulity. I am also worried by the sloppy thinking and hocus-pocus aspect of alternative heath culture. I know a dozen of them. The twaddle they talk on the subject of health would be funny if people were not paying them for help and relief. I have in front of me an anti-immunization pamphlet entitled "Dispelling Vaccination Myths" which is written by Alan Philips. Amongst the scare mongerings and conspiracy theories are recomendations for the homeopathic alternatives to vaccinations, which it claims are proven to be safe and effective. I suspect this pamphlet is a piece of devious marketing. The data quoted is highly selective and of dubious origin.eg:"Recent epidemiological studies show how homeopathic remedies as equalling or surpassing standard vaccinations in preventing desease. There are reports in which populations that were treated homeopathically after exposure had a 100% success rate- none of the treated caught the desease." There are also reports that Elvis presley is alive and well. To whom do I report dangerous medical misinformation? the Advertising standards authority ? I cannot believe that homeopathy is anything but an expensive waste of time. There is no reason to take it more seriously than (eg) astrology for which one can also find no shortage of advocates and mountains of anecdotal evidence. It's had 200 years to prove itself, any meaningful discovery would have demonstrated its worth beyond any argument. The time has come to dump it.
things that work in Homeopathy's favour. 25 May 2000
Stephen Park, non medical lay person home Send response to journal: Re: things that work in Homeopathy's favour.	Some things that work in Homeopathy’s favour. (Why we are still talking about this) 1. Homeopathy (treating like with like) is an appealing romantic idea. Only a philistine would not want it to be true. 2. The placebo effect may paradoxically work best of all on some sceptical people. This makes zealous converts and excellent testimonials. The gullible are already on side. 3. For certain personality types, the placebo effect (or the relationship with a therapist) is emotionally “addictive”. 4. Homeopaths have made an enormous emotional commitment to Homeopathy and recognise their duty to promote it. Doctors on the other hand are generally just doing their job (and why not). 5. People who don’t believe in the power of homeopathy generally think it’s quite harmless and keep quiet about it. It does not seem worth opposing. Doctors are not usually scientists and are not as dismissive of Homeopathy as they should be (they are satisfied that it is unlikely to cause direct harm). It is impolite to quarrel with someone’s beliefs, especially when they are held passionately like religious beliefs. 6. Many people intuitively feel (rightly of wrongly) that their best interests are unlikely to be served by multi national drug companies. Many people are prone to paranoia and conspiracy theories on this score. The “alternative” is irrationally perceived as safer and not motivated by profit. That Homeopathic producers understand this is obvious from their marketing strategies. Objections to Homeopathy are perceived as suppression by vested interests. 7. The idea that “science doesn’t know how it works” is irresistible to many people who are afraid of science and are comforted that some things remain mysterious, e.g. the spirit. The fact that scientists contest the proclaimed efficacy of Homeopathy is a message that is not getting through. Your article does not help. 8. It is unthinkingly assumed that commonly held ideas and widespread practices must be bases in truth or reason. History repeatedly tells us that this is not the case. However to dismiss Homeopathy completely seems to lay one open to the criticism of being unbalanced in ones view. Actually to hold that Homeopathy is bogus is to take the only balanced view. Homeopathy is a remarkable sociological phenomenon. Its greatest achievement is in becoming the subject of serious articles in serious journals like bmj.
Re: things that work in Homeopathy's favour. 26 May 2000
Peter Morrell, Hon Research Associate, History of Medicine Staffordshire University Send response to journal: Re: Re: things that work in Homeopathy's favour.	Sir, This letter [1] seems to stem entirely from a state of disbelief. Never having used homeopathic remedies, and yet eager to pontificate about it, the writer then weaves one long complex web that leads nowhere. Try it out for yourself before you formulate all these convoluted opinions and crass judgements. Buy a small first-aid set of remedies and use them. Better still, use them with the sole purpose of disproving their efficacy. Give Arnica to someone in shock and see what happens. Give Phleum pratense [Timothy Grass] to someone with Hayfever now [end of May] and watch what happens. You will soon realise that there is no greater emotional commitment to homeopathy than exists in any other form of medicine. It works. Very soon that fact becomes commonplace and no longer so sensational. You cannot argue on this subject with much credibility unless you have used the drugs yourself and found them to be useless. Homeopathic efficacy, therefore, has nothing to do with romance, zealous conversion, belief, paranoia, placebo, emotionality, passionate beliefs, religion, conspiracy theories, intuition, irrationality, marketing strategies, vested interests, irresistibility, mystery, unthinking assumption, balance, or sociological phenomena - as this writer claims. Rather, proclamations about its efficacy rest entirely on using it and observing the action of its drugs in practice. "Homeopathy is a remarkable sociological phenomenon. Its greatest achievement is in becoming the subject of serious articles in serious journals like BMJ." [1] Wrong: its greatest achievement is in curing people. That, and having survived for this long in spite of all the vitriol that has been poured upon it. That truly is a remarkable achievement. If only people would study it and read its vast literature they would see what an impressive clinical track record it has established for itself in only two centuries. Peter Morrell Sources [1] Some things that work in Homeopathy's favour, 25 May 2000, BMJ Letter by Stephen Park.
Re: more scepticism please 26 May 2000
Peter Morrell, Hon Research Associate History of Medicine Staffordshire University Send response to journal: Re: Re: more scepticism please	Sir, "As a non medical person I am alarmed that you do not take a more sceptical approach to homeopathy." [1] Regular medicine takes a very sceptical view of homeopathy, and always has. Indeed, one would be hard pushed to find a more sceptical attitude. More sceptical would mean banning it, which was tried in the last century. It was banned in Austria in the 1830s, much to Hahnemann's outrage. On what grounds could you ban homeopathy in a free society like ours? What harm does it do? Can it be proven as deception or causing more harm than conventional medicine? That is what you would have to prove in order to get it banned. On such a basis, there would not be a single drug on the market. Homeopathic remedies are so dilute that there is nothing in them, so how can you ban such a harmless thing? On what possible basis? "Where I live alternative practitioners outnumber conventional ones by about 3 to 1." [1] This has to be a dubious claim. There are more than 106,000 medical practitioners registered in the UK and at most only 4000 persons practising homeopathy [2]. There are thus at least 25 MDs for every homeopath in the UK. Even including herbalists, osteopaths, acupuncturists, etc, it is hard to imagine they total anything like 30- 40,000 overall, which is still a long way short of the MDs. "It's had 200 years to prove itself, any meaningful discovery would have demonstrated its worth beyond any argument. The time has come to dump it." [1] It has never been accepted, so how can you then dump it? Dump it or dump on it? More likely the latter. It has proved itself, within its own parameters, in 200 years and to many thousands of patients and practitioners, but never to the satisfaction of a hostile and uninterested medical profession. The argument is not about its worth per se, but its acceptability. That it is once more becoming acceptable, or even fashionable, still does not invalidate the immense difficulty in trying to prove a system that does not even recognise single disease states. How can you set up a randomised trial? The participants would not even agree on what they were treating. It treats people, not conditions. It thus lies outside the parameters of such trial procedures. Thus, it remains unproven. With regard to deception and commercial pushing of homeopathy, well, to even mention the word 'profit' is ridiculous. Check out the profits of the drug companies and then look again at homeopathic pharmacies. They equate to something like a gnat on an elephant's behind. Sources [1]. Re ABC of complementary medicine: Homoeopathy; more scepticism please; 24 May 2000; Stephen Park, BMJ Letter. [2] Estimated from the 1991 Medical Register and from various sources for medical and non-medical homeopaths.
Re: things that work - Homeopathy's. 26 May 2000
John P Heptonstall, Director of The Morley Acupuncture Clinic and Complementary Therapy Centre West Yorkshire Send response to journal: Re: Re: things that work - Homeopathy's.	Editor I think Stephen Park's letters are testament to his dogmatism - as opposed to scepticism (which usually requires reading around a subject first) - which in itself can be a useful charactersitic for debate. Some more things that work in homeopathy's favour (why I am willing to talk about this):- 1. Homeopathy is such a good idea that millions of people use it for health problems, and find it improves their health. Hundreds of doctors use it and find it improves their patients' health. Many vets use it and find animals recover their health. I understand a number of phillistines have used it and recovered. 2. Where would we be without placebo? It can mean the difference between life and death and may be at the root of all cures, including homeopathy's, wherever the 'medicine' comes from and whatever model is applied to the patient. 3. The 'addictive' qualities of many homeopaths is well known. 4. Most homeopaths promote homeopathy, strange though it may seem, because they firmly believe both that it works and that their patients are being honest when they return and tell the homeopath that the remedies worked. Doctors do their job. 5. Homeopathy is not a religion, it provides medicines and hence is part of medical science as it has derived its medicines scientifically by collecting evidence of efficacy. 6. People who don't believe in homeopathy have usually not studied the available data or scientific rationale behind it sufficiently well. Some have a strong bias towards certain scientific 'facts' that are actually theory and hypothesis that have gained unreasonable credibility. 7. Many people feel intuitively that their best interests are not going to be served as the priority by multinational pharmaceutical corporations; others have read the horror stories accompanying withdrawal of certain drugs from prescription, and that many drugs have never been tested for either safety or efficacy but are in the public domain and our governments still pay handsomly for these unlicensed, untested drugs. Homeopaths also run businesses where profit is necessary. 8. Some scientists continue to resist the belief that homeopathy works by claiming that their own scientific premise will not allow for it to work, and despite these scientific premise having feet of clay. Any 'scientist' that can insist that 'homeopathy cannot work' is not really practising science, a scientist knows full well that the theories that support homeopathic 'science' are still highly debatable; there is no definitive answer either way. If homeopathy is 'mysterious', that does not automatically make it dubious. 9. To hold a belief in something, without having experience or knowledge of that thing, is similar to religion; most homeopaths and their patients base their actions on having been there, tried it and experienced it working; how many serious critics of homeopathy can say the same? If it works for 15 people out of every 100 it will have the same acknowledged evidence-base as modern medicine (without being the 3rd to 4th biggest killer and maimer of humanity) which modern medicine is currently having to come to terms with. Might is not always right. Kind regards John H.
Re: more scepticism please 28 May 2000
Simon Rabinovich, Homeopathic physician Toronto, Canada Send response to journal: Re: Re: more scepticism please	Dear Editor, I don't think that it was "non medical person". It seems to me that somebody very close to conventional medicine has simply prefered to show this image in order to "prove" the general hostility expressed by society members to homeopathy. Anyway, it happens from time to time. In the country like UK one must come and see the waiting lists of patients at the Royal London Homeopathic Hospital. But there are natural sceptics of course. There are people who tried homeopathy and it did not work for them, or worked not too convincing, or too shortly or something else. I am sure that this "non-medical person" who is in favor of conventional medicine where "doctors simply do their job" can obtain conventional chemical drugs that works miraculously and cure diseases immediately (not to be taken three times a day until the end of patient's life). But it was proven anyway. In a extensive laboratory-clinical trials. And approved by authorities for its safety. Despite the conclusion that it works well and safely enough in only 30-50-60% of cases (usually). What about the rest 70 -50-30% of patients who need that drug desperatly because it was widely promoted as a most effective modern achievement in the applied field? I, as a patient, would also ask my doctor to give me only "modern and recently promoted" drugs, not "obsolete" one..... By the way, is Aspirin a obsolete drug? In fact, the humankind has been using it for about 200 years, almost just like Hahnemannian's homeopathy age. And the undesirable side effects that sometimes raise the questions in medical community: what is better for the patient to die from? his natural disease or side effects of the drug he uses for treatment of that disease?...... No, I am definitely not against regular medicine. Absolutely not. Its great achievements are very well known. I am only in favor of thinking. Of looking for different and, preferably, safe and more effective ways of helping the sick people. Because it is OUR job to help the sick person in the best known way. Regardless of somebody's in charge approval (sometimes). We must do our BEST for the people.
How Homeopathy reaaly works 29 May 2000
Stephen Park, non medical lay person home Send response to journal: Re: How Homeopathy reaaly works	How Homeopathy Really works 1. Homeopathy is a sociological phenomenon, not a biochemical one or (absurdly) a sub atomic one. If this seems unlikely consider for a moment some other undeniably sociological phenomena; the avant-garde art market, disco dancing, the fascist youth movement, yogic flying, train-spotting, body-piercing and bungee jumping, not to mention transvestites, astrologers, stag hunters, Christian scientists etc. you will recognise that we humans are weird and wonderful creatures. Our culture cannot stand a vacuum any more than nature. It would be very odd if bogus therapies did not exist. Consider also how deeply rooted in every culture is the story of the miracle cure and how revered is the role of healer. How strong is the urge (perhaps subconsciously) to make this story more plausible and to own it, to bring it home? Is a scientific worldview an obstacle in this regard? For the sake of argument imagine a highly successful bogus therapy, i.e. one that offers a physical cure but doesn’t deliver it. What factors would determine the survival of this therapy? (Of course it would require faith, dogma, organised persuasion, in addition; see “something’s that work in Homeopathy’s favour”) What would all the participants in this performance get out of it? What would it offer patients in place of effective remedy? (1:a placebo. 2: rights to the anecdote “I was cured but science can’t understand how”. 3: “ Those evil multinational drugs companies wont get me”) etc. What’s in it for the therapist? (How fabulous to be a healer that mere pedantic science cannot get a grip on, though a little inappropriate to blow your own trumpet on these pages) How would it place it self in relation to other treatments on the market? (Fill this one in yourself) How would believers in this therapy respond to refutations and criticism? (See responses to “something’s that work in Homeopathy’s favour”) What makes a good therapist? (One that is convinced and convincing, prepared to write letters, make outrageous claims, reassure etc.) There is much more to say on this subject.
Re: BMJ Debates Homeopathy: 1990s or 1840s? 4 June 2000
Stephen park, non medical lay person home Send response to journal: Re: Re: BMJ Debates Homeopathy: 1990s or 1840s?	· A response to Peter Morrel Debate of the 1840s is revisited “EDITORVickers and Zollman's article on homoeopathy was a balanced account of homoeopathic medicine.” I disagree “ However, the ensuing dialogue between medicine and "evil quackery" shows some parallels with that in the 1840s. In both cases, the engagement has been vigorous and hostile; alternative medical systems were booming then, just as they are today. The pressure of public popularity is driving the worldwide growth of alternative medicine. Clearly patients who turn to alternative medicine are unhappy with some aspect of conventional treatment, and they should reveal their motives to their doctors. Unless their disappointments are addressed, more patients will inevitably flock to such therapists. Holistic treatments may offer slender hope to patients, but they seem to prefer hopes to drugs and surgery.” True. I think there are many complex reasons for this. I think we have a very strong need to make sense of our lives, to have stories that are plausible, so that the frightening random element is diminished. Science based medicine is rightly cautious about supplying these. Quacks are fountains of them, Implicit and explicit. Our bodies are a great vulnerability, but we feel strongly that we are not merely bodies. This illusion of dualism is a very natural and very strong one: For centuries it was believed that physical deformity was a manifestation of moral deformity. Why else would God have made some people deformed? Although I haven’t heard this one from a quack recently their rationale is routed in similarly cosy parallels. Thinking scientifically is likely to lead (perhaps unconsciously) to some unpalatable truths, (come to think of it they hang in the air of every hospital.): Life is short, arbitrary painful and pointless. The good are unlikely to be rewarded. Alternative medicine by contrast paints a view of life in which health and happiness are the only natural consequences of being oneself, its just a question of finding ones true self and restoring the balance with some expensive tincture. Is it ludicrous to suggest that people see their healers instead of going to church? “Many people refer to the unproved efficacy of homoeopathy and the "ludicrous" nature of its minimum doses. The usual argument is that because "it cannot work" therefore "it does not work." If I am not mistaken many aspects of anaesthesia were a complete mystery until very recently; it didn’t stop it being a very useful tool and very central to conventional medicine. “Were homeopathy to prove an effective therapy, it would be irrational for any legitimate medical practitioner to ignore or fail to employ it. Given the apparent lack of adverse effects from high dilution homeopathic remedies, such a therapy should be readily embraced if it were effective. Indeed, open-mindedness is one of the hallmarks of science and the rapid assimilation of new therapies and technologies has been a consistent characteristic of scientific medicine. In fact, studies have shown that practitioners of mainstream medicine are less dogmatic than those of its alternatives. To quote the late Dr. Carl Sagan, "...at the heart of science is an essential balance between two seemingly contradictory attitudes -- an openness to new ideas, no matter how bizarre or counterintuitive, and the most ruthlessly sceptical scrutiny of all ideas, old and new. This is how deep truths are winnowed from deep nonsense."68 From "Homeopathy and science a closer look" David W. Ramey, DVM* Mahlon Wagner, PhD^ Robert H. Imrie, DVM` Victor Stenger, PhD# “In the 1840s, Sir John Forbes, physician to Queen Victoria's household, called "the infinitesimal doses" of homoeopathy "an outrage to human reason." Its successes were written off as "self limiting diseases." But as patients know, few diseases improve when left alone.” I disagree, though it’s certainly true that we like to feel we are doing something other than suffering passively. “ Thus, to claim that homoeopathy works because patients "would get better anyway" does not square with human experience:” Human experience is full of its own illusions; we often see what we are looking for. “ if doing nothing for self limiting diseases is the reason that homoeopathy works, then why should anyone bother giving any drugs at all?” Perhaps very often no drugs would be a good idea. “It is doubtful that patients would pay high fees for treatments of no value.” Is it? Some people do yogic flying, others collect avant-garde art, Chinese women had their feet bound. There is no end to the diversity of culture. Can culture stand a vacuum? It would be very odd if bogus therapies did not exist. Imagine a bogus therapy that has all the qualities to survive and flourish and ask yourself how it differs from homeopathy? A: not much if at all. “The argument that they are rich and desperate (or stupid) enough not to know whether a treatment works seems unconvincing. Vickers and Zollman state that there is a lack of "evidence that homoeopathy is clearly efficacious for any single condition." How does one define "evidence" when homoeopaths deny the existence of single conditions?” Is this really a very robust strategy? “ Trials of homoeopathy have been disappointing, but the weight of anecdotal evidence must count for something.” I was Ill (fill in the details) the doctors and specialist could not help me but the homeopath, asking strange questions and finding my constitutional type has cured me and now I can do x again which I couldn’t do before." This story is: A: easier to tell than a more complex one B: more likely to be told and repeated than a similar one with no positive ending. We may have a culturally embedded need to tell this or similar story. Homeopathy is a process for generating these anecdotes. “In the 1850s it was widely predicted that "medical fads" such as homoeopathy would fizzle out in a few years. That they have failed to do so either indicates that they do work or stands as a testament to human credulity.” The latter. Homeopathy does not stand alone in having fooled people, although its products seem to enjoy a peculiar privilege in that they make outrageous and unsubstantiated claims whilst having no active ingredient. Any natural common sense view of fair trade is being violated. In matters of health surely consumers have an even greater than normal right to protection. “The growing demand for these treatments is a central and uncomfortable reality which medicine must face up to.” Sad but true Stephen Park PS, I have no commercial or professional interest in this subject. I am genuinely curious and therefore never satisfied by mumbo jumbo. (Homeopathy is an endless source of this stuff). Where is the nitty- gritty? Homeopathy is an enormous industry precariously balanced on a stupid falsehood. The prognosis is not good. Any careful reading of these exchanges reveals that insiders in this vain and silly enterprise actually carry this conclusion with them, a gene that must not be let out at any time. I was going to write a book on this subject but I’ve been beaten to it. I can thoroughly recommend: Homeopathy What are we Swallowing? By Steven Ransom. Credence publications. ISBN0-953512-2-1 I think I will work instead on a pamphlet, which might be entitled ”How to give up being a homeopath without feeling gullible and foolish” there only one problem , I simply don’t know where to begin. pps. Closed minds? In my experience an open mind would preclude anyone from a career in alternative medicine.
An open letter to health care professionals (with open minds) 4 June 2000
Stephen Park, non medical lay person home Send response to journal: Re: An open letter to health care professionals (with open minds)	An open letter to health care professionals (with open minds) Dear health care professionals, I understand that there is a growing demand for alternative medicine and that public satisfaction rates are high. I also understand that Doctors are overstretched. They may often be tempted to refer patients to alternative practitioners either because they feel that a harmless placebo is the appropriate treatment, or because they have an “open mind” with regard to the efficacy of alternative treatments. (Of course a truly open mind is not closed to the possibility that a lot of fringe medicine is a Barnum and Bailey style rip-off). The BMA document “Referrals to Complementary therapists” makes it clear that patient safety should be the first priority of doctors. I feel that alternative therapies present costs to society that were not touched upon by the document. The National Health Service has, I’m afraid, a duty to weigh these up against the market pressure for alternative therapies. In my view natural consumer rights are violated by the bogus claims of alternative medicines, especially by Homoeopathic remedies which have no active ingredient. Deception is very seldom ethical. If Homoeopathy is not deception then it comes very close indeed. Its survival certainly depends on the organised spread of misinformation. In matters of health, consumers deserve greater than average protection. I believe it is inappropriate for GPs to refer patients to Homoeopaths, and I was disappointed that the document did not simply state this. The spread of pseudo-science is of deep concern to those of us who have not given up hoping for an educated public, who could discern it from real science and dismiss it accordingly. Even some doctors, sadly, have been fooled by Homoeopathy, though the facts are easily available, and speak for themselves. Doctors are not guardians of truth, however they are in a position of some authority. This authority is as abused if they encourage the absorption untruths are into our minds, just as it would be if they encouraged the inhalation of cigarette smoke into our lungs. The environmental and consumer movements are two very necessary forces in a modern economy with which I am broadly sympathetic. They have both, through ignorance, shamefully, given endorsements to alternative health, or so it seems. I am calling, therefore, on doctors and health care professionals to take the sceptical approach, irrespective of its popularity or the length of the “worried well” queue. Giving credibility to mumbo jumbo is seriously bad for society. I have no commercial or professional interest in health, though I have lived for 6 years in an alternative medicine “hot-spot”. I can assure you that while alternative therapies may seldom actually damage health, I feel sure of the detrimental effect it has on a community’s faculty of reason, encouraged as it is to believe in “wave energy fields”, “meridians”, “constitutional types”, potentization and other phenomena who have as little claim on reality as did ectoplasm, phlogiston or the ether. Very best wishes Stephen Park
How Homeopathy really works 6 June 2000
Peter Morrell, Hon. Research Associate, History of Medicine Staffordshire University Send response to journal: Re: How Homeopathy really works	Sir, In the many critical things Stephen Park says [1], he seems to imply that homeopaths spend so much time with their patients deliberately in order to have a therapeutic impact [placebo] on them. This contention is rooted in ignorance - rather than studying the subject itself first in a neutral manner, he chooses to accept the hateful opinions of others, who in turn, have not studied it either. What value can prudently and sensibly be credited to the views of such a person? If you have not studied this subject deeply, neutrally and over time, with a genuinely open mind, then I’m afraid the opinions you express are pretty worthless. Nevertheless, he raises a few valid points that require a more informed response. Homeopaths do tend to spend a lot of time with their patients. This is true. Historically, it has always been the case. Even today, with the aid of computers, they spend between 40 and 60 minutes with them on average. And this ranges down to 20 minutes and upwards to 3 hours for an initial consultation [2]. I think we can safely to assume that they do this because they feel they have to, not for any disreputable reasons. Consider for a moment the economic implications of this situation: they cannot reasonably see more than 10-12 patients in a working day, which means their fees have to be relatively high to make a decent living. Compared to allopaths, with an 8 minute consultation [or less], it is easy to see how, in a free market, allopathy has an undoubted economic edge. It also means that homeopaths would certainly feel tempted to reduce consultation times and drop their fees whenever they could, and thus see more patients per day, so as to enjoy a better livelihood. The question then becomes: is it reasonable to suppose that homeopaths would forgo the chance to earn more money by idly chatting to their patients, if they thought all they were doing was having a placebo effect? Is this a reasonable portrayal of their work? I shall contend that it is not a reasonable picture at all. Homeopaths need long consultations - not to instil any kind of placebo effect - but to get to know their patients more deeply as human beings. This enables them to prescribe more accurately. All the information they gather from the patient about nausea, emotions, menstruation, sleep, vertigo, hot or cold sensations, food preferences, and other such subtle symptom data, is essential to match the totality of the patient with that of a single drug picture in the homeopathic materia medica of 2000+ drugs. There is no shortcut to this approach, which can make it an easier task, as Mr Park should know. It is the very heart and soul of homeopathy to extract and contemplate this type of subtle symptom data. Without painstaking attention to details of this kind, the wrong drug is likely to be chosen, which will do nothing for the patient - regardless of how much time is spent talking. That is the reality of the situation: 'I have often heard physicians tell me that it was due to suggestion that my medicines acted so well; but my answer to this is, that I suggest just as strongly with my wrong remedy as with the right one, and my patients improve only when they have received the similar or correct remedy.' [3] On quite another tack, it is also true to say, that there do exist today some very talented homeopaths who have developed an ability to prescribe on a quick-fire basis, by only giving the patient a few minutes of their time. These homeopaths have an impressively ‘encyclopaedic’ knowledge of homeopathic drugs, without which they would not be able to spot the subtle differences in symptoms that enable them to quickly appraise every individual case. Such homeopaths, often in teams, work queues of patients and hence treat many hundreds per day in rural clinics, mostly in India, but also in parts of Africa, South America and eastern Europe [4]. They mostly treat acute problems a GP might encounter, whereas the longer consultations are still required for deeper constitutional prescribing. All of this information Mr Park could encounter by studying the subject for himself, before publicly parroting the entirely prejudicial opinions of others about it. It is also true to say that the subtle symptom data of the patient cannot actually be used by a regular clinician, as they do not adopt such a neutral listening approach to the patient, but merely seek to see them as a disease label. And nor does the pharmacopoeia contain that kind of fine-tune symptom data. Let us therefore turn Mr Park’s argument around slightly. Regular physicians might easily be accused of ignoring masses of [real and unique] subtle symptom data in their patients, which they regard, if at all, as so much ‘extraneous baggage’ of no use in making clinical decisions. Some even regard this material as invented or fantasised by the patient. So be it. Moreover, as scientific reductionists, they are content merely to treat the parts and disease labels, blithely ignoring the patient as a whole being. Would that be a reasonably fair account of their approach? I think it would. In which case, critics of ‘alt. med.’ like Mr Park should ask themselves long and hard what type of medical encounter they would actually prefer. Would they wish to feel better in every department of their body and mind through the use of subtle and safe microdoses of drugs proven on the healthy; or the use of acupuncture or nutritional reform [for example]? Alternatively, would they prefer instead, to get a few parts sorted out fleetingly by use of poisonous, unproven drugs? In the latter case, of course, there is no true cure on offer, only palliation and suppression; allopaths seem merely to engage in some temporary re- juggling of symptoms, like an elaborate form of physiological window- dressing. It is fundamentally uncurative, as it does not remove all symptoms from the body and it does not stimulate the body’s own healing powers. It does not create health. Well, these are the views natural therapists consistently hold about allopathy. Like acupuncture, homeopathy does not cure disease; it restores health, which may be defined as the body’s innate healing powers [vis medicatrix naturae], the importance of which has been increasingly ignored by regular medicine for the last two centuries. Bedazzled by 'science', and working purely at a chemical and physiological level, allopathy does not seek to boost this power and probably depletes it. The two medical systems seem to stand poles apart and it is hard to see how anyone could be an advocate or practitioner of both [5]. Try as one might, it us difficult to regard Mr Park’s views as deriving from a thorough study of this subject. They seem imprudent, impatiently dismissive and entirely hostile - they reflect the hateful opinions of those who seek to demolish and badmouth ‘alt. med.’ at every turn. If only people would patiently study these subjects, deeply, neutrally and take time to reach more balanced views - and practice some of the therapies too - before choosing to pontificate in this way, then much blatant misunderstanding could be avoided. Peter Morrell Sources [1] Stephen Park, BMJ letter - More Scepticism Please, 20 May 2000 and further letters 24 May, 25 May, and 4 June 2000. [2] This information derives from as yet unprocessed and unpublished data, collected by the author from surveys during 1998-9 from ~300 worldwide homeopaths [mostly Spanish, Australian, UK, New Zealand and American practitioners]. [3] James Tyler Kent, 1926, New Remedies, Lesser Writings and Aphorisms & Precepts, Chicago, quoted in Francis Treuherz, 1984, Origins of Kent's Homeopathy, JAIH 77.4, 130-49; 140-1. [4] see David Little website: http://www.similimum.com London College http://www.lcch.com/ also Buddhist homeopaths in Africa websites: http://www.anandamarga.org http://home.pacific.net.sg/~rucira/africa [5] see Harris L Coulter, 1973-5, Divided Legacy, 3 volumes, Wehawken Books, Washington, for a deeper study of this schism in medical thought.
They are worried 7 June 2000
Simon Rabinovich, Homeopathic Physiacian Toronto Canada Send response to journal: Re: They are worried	Of course they are worried. The "lay" most probably pharmaceutical (or hardened medical conservative) persons use any forum to bring over their laughable "arguments" against what seems to be revolution in public conscience regarding medicine. I got e-mails from the "lay person" with the claim like "Homeopathy is doomed".. "homeopathy's days are numbered"... Well, could you be more specific and tell us WHEN homeopathy is going to die? More than 200 years is not enough? And speaking about "career in alternative medicine" would the "lay person" disregard such fields like acupuncture, which is officially recognized by most of medical institutions and organizations, without any doubt at all about its effectiveness? If so, what is it, biased opinion based on some very specific grounds? Like endangered profit of pharamceutical giants making billions by feeding people with chemical products, which are much more destructive than diseases that are supposed to be treated by those drugs? Of course homeopathy is not perfect and only treatment. Of course, there is place for many other medical methods INCLUDING conventional medicine. This is what we call an "open mind attitude" to the matter of human sufferings.
Homeopathy and the question of integrity 10 June 2000
Stephen Park, non medical layperson. home Send response to journal: Re: Homeopathy and the question of integrity	Alternative medicine is still associated in the popular mindset with organically grown vegetables, healthy food, fair-trade, compassion for animals, sustainable living etc. In my view these concerns deserve to be taken seriously. If I am right, and alternative medicine is a creation that primarily serves the interests of the producer and practitioner, then the whole of the alternative movement stands to lose a lot of credibility (by association) when the truth comes out. Desperate and persistent attempts to verify an utterly bogus theory will eventually yield some meagre positive results. Is my mood effected by what colour socks I am wearing? etc. Good science should involve (as far as possible) attempts to falsify theories rather than attempts to verify them. This means that an inclusive history of medicine would be littered with unsung heroes. Noble failures who invested time, sometimes a lifetimes work, investigating hypothesise that ultimately turn out to be wrong, however robust the rationale seemed at the time. Without these noble failures science would not be possible. The fact that the culture of Homoeopathy is unable to gracefully accept failure is an insult to the integrity of those that have. Alternative medicine has in a small way infiltrated mainstream practice. Where this has occurred it is trumpeted as if it were a validation of the principals, methodology and efficacy. At the same time any kind of opposition to Alternative medicine will be accused of representing the interests of profit or conservatism over the interest of the patient. Health care professionals who are sceptical of alternative medicine are in a double bind; they may choose to remain silent in case open protest is counter-productive. As an interested outsider, I find it deeply insulting when it is suggested that my motives are not honourable, i.e. the best interest of the patient. Given these tactics it is not surprising that alternative medicine has made some headway. Another strategy of argument that is offensive to sceptics is the suggestion that criticism is motivated by hatred. Of course I am motivated by hatred, though not personal hatred of homoeopaths, just hatred of dishonesty, where I perceive it. The subtler shades of dishonesty (including self deception) are in some ways the most worrying, threatening the erosion of important values. I do not mean to suggest that Integrity is easy. To have integrity one must question oneself and be prepared to accept that decisions one made in the past were the wrong ones. Alternative medicine seems to attract people who I call “ethical” types. These people are basically good. I think it’s a fair criticism of this personality type to say that they are so confident that they are “ethical” to the core that they (perhaps a little smugly) forget to scrutinize their own behaviour. When they are in groups they are very uncomfortable with disagreement, consequently the culture of alternative medicine is, as far as I can see, without self-criticism. (They are also more likely to believe in dowsing and astrology than real doctors.) During any argument it is appallingly patronising to be told to go and do more reading on the subject. This response is designed to make the recipient feel ill equipped to continue the discussion. It is a cheap way to assume an air of expertise. There are a number of important points to raise here. 1. If all their reading has been worthwhile why aren’t we given the salient points? 2. Practitioners of Alternative medicine need constant affirmation; of course there are books to provide this, lots of them, no doubt it’s a lucrative market. 3. A general reader, someone with a rudimentary grip on science has all the tools necessary to understand the following: That if there is a “law of similars” and if “potentization” is a true phenomenon then the laws of chemistry, biochemistry and physics as we know them are all erroneous. Such a person would also see that the methodology of Homoeopathic “provings” is hopelessly flawed. If you think there is something premature about these statements, perhaps you ought to do some more general reading. Two hilarious responses to scepticism: “conventional medicine grow up!” “Of course there is still a place for conventional medicine” This must be very highly potentised preposterousness indeed. Although I am irritated by the bigoted views implicit in astrology (for example), I recognise that thousands of years ago it contained some remarkable assumptions for the time. Astrologers looked out at the sky and did not see chaos; instead they saw patterns and order. They observed and chartered the rotation of the heavens. No mean accomplishment. However we can now see that they were absurdly greedy in their deductions, finding erroneous answers to questions that were quite out of context. The same was true with alchemy. These are extreme examples of “greedy reductionism” (a term I’ve taken from Daniel C Dennet). Even far-reaching and sound theories like Darwin’s theory of evolution are subject to this greed (i.e. when it is used to support racist views or neglect of the needy etc). I believe this framework offers a good light in which to view Homoeopathy and its enduring appeal. Its early success was due to the safety of the remedies compared to the hazardous other treatments of the day. Homoeopathic clinics were also relatively hygienic. Hahnemann took the credit for the bodies ability to heal itself. At the time, who could blame him? Nowadays this practice is shameful. The most disgusting of all are the claims that Homoeopathy is “spiritual”, “holistic” and treats “the whole person”, these claims are preposterously grand, yet conveniently impossible to defend. Indoctrinated Homoeopaths are deeply attached to these groundless notions. One only needs to know of one nearly tragic case where a homoeopath did not properly diagnose a serious infection to see how utterly meaningless these claims really are. In any event the correct action would have been to refer the patient to a proper doctor. JOKE: Q: What happens when a homoeopath is knocked down by a car? A: He gets taken away by an AMBIENCE.
Re: Homoeopaths have some explaining to do 9 February 2004
Jay Prakash, Private practitioner, Homoeopathy Bhopal, INDIA, 462003 Send response to journal: Re: Re: Homoeopaths have some explaining to do	It is true that the science or Hahnemann himself are failed to give a perfect mechanism for how does homoeopathic remedies works? What is the mode of there action? But one cannot conclude that the homoeopathic medicines "...that homoeopathy cannot possibly work any better than a placebo....". Then also one sticks on their statement, must explain the following. 1.Any pathogenic disease can be cured by homoeopathy whenever there is presence of active pathogens, how? Is it placebo effect? 2.Any psychotic disease schizophrenia, madness, phobias & all other can be cured by homoeopathy even in case of the very little aged patients homoeopathy works. Does it placebo effect? 3.If we suppose these all are placebo effects then there is one more critical question that must be answered, why cure is impossible if we neglect the 'similia theory' while treating a patient. Competing interests: None declared
Re: Re: Homoeopaths have some explaining to do 18 February 2004
Anne Sash, Homeopath Melbourne, Australia 3047 Send response to journal: Re: Re: Re: Homoeopaths have some explaining to do	Those of us who use homeopathy regularly over many years are not concerned with the placebo theory because: It can take many years of trial and error in choosing the correct remedy, remembering that they all look and taste the same. When the right remedy is taken, a condition of many years is soon resolved. If the condition is returning after some weeks or months, another dose is taken, with the condition once again receding. My severe allergy has abated in this way over 3 summers, (years ago). I no longer fear suffocation, and I am grateful that I am not on Cortisone. I have had so much experience of homeopathy working in this way, that I am amazed that anyone is still arguing whether homeopathy works at all. The best way to find out is to use it yourself. Better still, participate in a Proving, where you test the remedy for what it causes, by taking it frequently for a couple of weeks. Contact a local college. Let us know how you go! Competing interests: None declared
Re: Re: Re: Homoeopaths have some explaining to do 19 February 2004
Niall T Taylor, Veterinary Surgeon Orchard Veterinary Group, Wirrall Park Rd, Glastonbury, Somerset, BA6 9XE Send response to journal: Re: Re: Re: Re: Homoeopaths have some explaining to do	I am a veterinary surgeon in general practice and have been following this debate and others of a similar nature in the veterinary press with great interest. The remarks of Anne Sash couldn’t have been more timely for me and in some ways mirror my own thoughts on the subject – surely the one way to test whether or not there is anything to homoeopathy is simply to try it and see. The crux of the argument is that from the sceptical point of view since, chemically, homoeopathic remedies are simply either water or sugar they are infact identical to those substances and therefore can exert no genuine effect. Homoeopaths will argue on the other hand that the remedies are indeed different from their base components and actually posess properties beyond pharmacology, chemistry or physics, acting in other, as yet unknown ways. In an attempt to resolve some of these matters I have devised a simple, home grown clinical trial and I would like to appeal for volunteers. The aim of the trial to discover whether it is possible to distinguish between a homoeopathic remedy and a placebo preparation. One of the problems with previous clinical trials carried out on homoeopathic remedies is that not all remedies suit all patients when it comes to the treatment of disease. Remedies have to be “individualised” for each patient and this causes problems with trials which often prefer a “one-size-fits-all” remedy to test. When homoeopathic remedies are being developed, however, they undergo a process called proving where healthy volunteers take the homoeopathic remedy and will as a result experience a set of symptoms which are recorded. Once these are known the remedy in question can be used to treat the same symptoms in unwell patients who exibit them. Nowhere in Hahnemann’s Organon or any other major homoeopathic reference is it suggested that the provers themselves need to be individualised for a particular remedy in the same way that patients do when undergoing homoeopathic treatment since plainly it would be impossible to individualise a remedy prior to its characteristics being known. Thus a test by homoeopathic proving is a good test for homoeopathy with none of the pit falls of the clinical setting where observations can be subjective and patients unpredictible and where poor results are often attributed to problems with individualisation. It occurred to me that those from the sceptic camp could be accused of having a vested interest in a ‘negative’ result and might, subconsciously or otherwise withhold evidence that would support the validity of homoeopathy. So, if the trial is properly randomised and blinded, it would be better to ask people who are convinced by homoeopathy and who would therefore have no interest in witholding ‘positive’ results to act as subjects. The randomisation will be done by tossing a coin to see whether subjects receive remedy or placebo and the blinding will be done by using pre-printed, standardised forms & letters and my having only postal or e-mail contact with subjects. The results will be only in a yes/no/don’t know format, will require no interpretation on anyone’s part and will be published in full. Details of all participants will be treated in strictest confidence. A homoeopathic proving is one suitable method and has the virtue of being a well recognised technique but the test can be done in any way participants choose. Techniques used in previous, similar attempts have included clinical trials on volunteers, dowsing, radionics, crystallographic analysis and spectographic analysis. By default the trial will use 30C Belladonna although participants again will be given opportunity to select any remedy they may prefer or feel is more appropriate for whatever reason. I would like to ask anyone interested in participating in the trial either as a volunteer or with advice to please contact me for further details either by letter at Orchard Veterinary Group or by e-mail. For reasons of economy I have to limit participants to the UK at this stage. I would like to offer my grateful thanks in advance to all participants. Niall Taylor Competing interests: None declared
Updated details for Society of Homeopaths 18 March 2004
Mary L English, Licensed member of The Society of Homeopaths BA2 3LT Send response to journal: Re: Updated details for Society of Homeopaths	Dear Sir/ Madam, Please note The Society of Homeopaths has now dropped the 'o' to make it more 'user-friendly'. Our email and website address is now as follows: info@homeopathy-soh.org http://www.homeopathy-soh.org/ The Society of Homeopaths is the largest organization registering professional homeopaths in the UK. Our Registered Members complete rigorous training (normally 3 years full time or 4 years part time) with one of our recognized course providers, and undergo a further period of clinical supervision before becoming eligible for our public Register. We aim to: *develop and maintain high standards for the practice of homeopathy ,br>*develop and maintain for public use a Register of homeopaths who practise to the standards required by the Society, and abide by the Society's Code of Ethics and Practice *protect the public's freedom to have homeopathic treatment now and in the future *promote public awareness of homeopathy and encourage its responsible use in the home *promote and support the establishment of education and training in homeopathy The Society of Homeopaths, 11 Brookfield, Duncan Close, Moulton Park, Northampton NN3 6WL Tel: 0845 450 6611 Fax: 0845 450 6622 Please also note that Society members: "have been adequately trained in the essential medical sciences and skills and have had suitable clinical training and experience." Yours Faithfully, Mary English DSH Licensed member of The Society of Homeopaths working towards registration. Competing interests: I am a Licensed Homeopath