Spence sides with the charlatans who are either lying to their patients or are fools beyond belief, and against honest hard working doctors. He rightly criticises the excesses of "big pharma" but at least the pharmaceutical industry has produced most of the active medicines that we use. Homeopathic medicines are surprisingly expensive since all that diluting and shaking takes time. Homeopathic practitioners rarely restrict themselves to homeopathy but embrace the whole world of alternative medicine and this is a multi-million pound business, which has never done anyone any good, apart from making profits for unscrupulous individuals. The most charitable view of this article is that Spence is suffering from commentator fatigue and resorting to babbling dangerous nonsense just to fill up the page. The BMJ should not publish articles that are clearly nonsensical, and not just not evidence based but actually opposed to the use of evidence, just because it will stimulate debate.

Competing interests: None declared