Sunday, May 25, 2014

House of Commons Report on Homeopathy


Science and Technology Committee - Fourth Report
Evidence Check 2: Homeopathy


http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/4502.htm


With acknowledgements to the House of Commons Technology Committee

Extracts from the report (I have added italics and underlined text)

4. This inquiry was an examination of the evidence behind government policies on homeopathy, not an inquiry into homeopathy. We do not challenge the intentions of those homeopaths who strive to cure patients, nor do we question that many people feel they have benefited from it. Our task was to determine whether scientific evidence supports government policies that allow the funding and provision of homeopathy through the NHS and the licensing of homeopathic products by the MHRA.


* The the intentions of those that provided the 'evidence' for the committee is not questioned but the best intentions do not make the evidence, constructed on false premises, and conclusions to be valid. 


* The disbursement of state resources is the key concern, not the effectiveness of homeopathy which the Committee attributes to the placebo effect.


8. This report is in two parts. Chapter 2 addresses the evidence base for the provision of homeopathy on the NHS. Chapter 3 examines the evidence base for the MHRA's licensing regime for homeopathic products. In each chapter we have adopted the approach we followed in the first Evidence Check inquiry: we have outlined the Government's policy, summarised what we would expect of a good evidence base and then evaluated whether the Government's policy is sufficiently evidence-based (the Evidence Check).

What is homeopathy?
9. Homeopathy is a 200-year old system of medicine that seeks to treat patients with highly diluted substances that are administered orally. Homeopathy is based on two principles: "like-cures-like" whereby a substance that causes a symptom is used in diluted form to treat the same symptom in illness and "ultra-dilution" whereby the more dilute a substance the more potent it is (this is aided by a specific method of shaking the solutions, termed "succussion"). It is claimed that homeopathy works by stimulating the body's self-healing mechanisms.

* Homeopathic medicines can also be administered via skin and olfactory routes.
* Substances used as medicines in homeopathy are actually more potent when they are used in undiluted form, for example, Arsenicum Album can kill a human being if the dosage is sufficient. Dilution of substances DOES NOT MAKE THEM MORE POTENT but rather it enables some remedies to resonate with the emotional and mental planes of the organism. In some cases, dilution of substances transforms an inert substance into a remedy, for example Lycopodium Clavatum. In all cases of sufficiently diluted substances the toxicity is removed. For example, Arsenicum Album 30 cannot poison a human being.


10. Homeopathic products should not be confused with herbal remedies. Some homeopathic products are derived from herbal active ingredients, but the important distinction is that homeopathic products are extremely diluted and administered according to specific principles.

* A homeopathic remedy is one that is prescribed on the basis of the law of similars. Homeopathy is the treatment of a disease with a substance that produces similar symptoms; the principle of dilution and ultra- dilution of substances is a completely separate matter to consider. The reason that Hahnemann decided to dilute substances was based on the idea that this would reduce the aggravation to the disease that was manifested following the administration of undiluted homeopathic remedies. Hahnemann continued the process of diluting medicines and found to his astonishment that the substances continued to act and that the higher dilutions of the remedies released hitherto unknown powers of the substances to act medicinally.


Our expectation of an explanation for a mechanism of action is that it is both scientifically plausible and demonstrable. We should, however, add that, while we comment on explanations for how homeopathy works, it is not a key part of our Evidence Check. Historically, some medical interventions were demonstrably effective before anyone understood their modes of action. For example, after 150 years of use, there is still debate about precisely how anaesthetics work. It is more important to know whether a treatment works—its efficacy—than how it works.

19. Randomised Controlled Trials (RCTs) are the best way of determining whether a cause-effect relationship exists between a treatment and an outcome. Well designed RCTs have the following important features:

  • randomisation: patients should be randomly allocated to placebo (dummy treatment) or treatment groups—this ensures that there are no systematic differences between patient groups that may affect the outcome;
  • controlled conditions: aside from the treatment given, all patients should be treated identically, whether in placebo or treatment groups—this excludes other factors from influencing the outcome;
  • intention to treat analysis: patients are analysed within their allocated group even if they did not experience the intervention—this maintains the advantages of randomisation which may be lost if patients withdraw or fail to comply;
  • double blinding: patients and clinicians should remain unaware of which patients received placebo or treatment until the study is completed—this eliminates the possibility of preconceived views of patients and clinicians affecting the outcome; and
  • placebo controlled: if there is no appropriate alternative treatment against which to compare the test treatment, the intervention under consideration is tested against a dummy treatment to see if the intervention has any benefit or side effects.
20. In clinical research, it is widely accepted that RCTs are the best way to evaluate the efficacy of different treatments and distinguish them from placebos. However, some supporters of homeopathy claim that RCTs are not an appropriate way to test homeopathy because "they are far less suitable when studying the overall effects of a holistic therapy in a complex organism with multiple problems". We do not agree. If homeopathic products—or any medicinal product—are more than placebos, and all other elements of the "holistic" care package are the same (controlled), it should be possible to see differential results between the test substance and the placebo. We consider that conclusions about the evidence on the efficacy of homeopathy should be derived from well designed and rigorous randomised controlled trials (RCTs).
39. We have set out the issue of efficacy and effectiveness at some length to illustrate that a non-efficacious medicine might, in some situations, be effective (patients feel better) because of the placebo effect. That is why we put more weight on evidence of efficacy than of effectiveness.
43. Another example of how patient satisfaction may not correlate to the medical intervention might be if a patient seeks treatment for a common cold. The patient's perception of the quality of the consultation and whether a course of treatment has been prescribed may contribute to patient satisfaction, irrespective of whether the treatment itself is effective; the patient would have become better anyway. The House of Lords Committee concluded:
patient satisfaction has its place as part of the evidence base for CAM but its position is complicated, as Sir Michael Rawlins [Chairman of NICE], explained: "The difficulty, of course, is that very often the anecdotal evidence relates to conditions where there is fluctuation in the clinical course and people who start an intervention at a time when there is a natural resolution of the disease, very understandably, are likely to attribute cause and effect when it may not be. But, on the other hand, there are some anecdotes that are quite clearly important." Therefore, ideally studies should include patient satisfaction as one of a number of measures in evaluating a treatment, but it alone cannot be taken as a proof or otherwise of a treatment's efficacy or as evidence to justify provision.

The report of the Select Committee on Homeopathy is the judgment made according to the world view of the panel that the RCT method to determine the efficacy or non/efficacy of a treatment is the best method. If the genetic constitutions of all human beings were exactly the same, I suppose then they could all be treated exactly the same. Evidence does suggest that although human beings are all very similar in genetic make-up, the little differences between each organism are what makes each person unique. This is the reason that the RCT method will fail with homeopathy because if we had, for example, 10 patients with the same generic disease name, the process of their homeopathic treatment will not be the same. Assume only 10 remedies are relevant to the particular disease and applied only to a group of 10 patients:
Order of prescription:
Patient A: 3/5/1/7 cured
Patient B: 9/ 5 / 10/ 1 cured
Etc.
The RCT method of testing will be ‘game over’ at stage 1, at stage 2 the process will fail at the very outset.

Like-cures-like principle
50. The principle of like-cures-like was described by Dr Peter Fisher as analogous to the principle of toxicology hormesis. Professor Edward Calabrese, a toxicology expert from the University of Massachusetts, has described hormesis as "a dose-response relationship phenomenon characterized by low-dose stimulation and high-dose inhibition". In other words, the impact of toxins on physiology depends on dose: substances that are toxic in high doses may be beneficial in low doses. For example, "as the dose of a carcinogen decreases, it reaches a point where the agent actually may reduce the risk of cancer below that of the control group". And this has been likened to the like-cures-like principle central to homeopathy, whereby a substance that causes a particular symptom will cure that symptom if administered at a low dose.
51. There are two aspects of the argument that the like-cures-like principle is based on hormesis that concern us.
a)  Over-extrapolation: it is not good scientific practice to conclude that because some substances are harmful at high doses and beneficial at low doses, that all substances behave in the same way; and

*Homeopathy does not advocate that all substances behave in the same way.
Of the millions of chemical, plant and animal substances on the planet, the number of these substances used in homeopathy is a small fraction. The majority of substances on the planet do not have energetic correspondence to disease manifestations in human beings and other animals.

b)  Provings using ultra-dilutions: the similarity with hormesis breaks down further if provings are carried out using ultra-dilutions. Hormesis is a dose-response: it provides no rationale for expecting an ultra-dilution to cause symptoms in "healthy" people and the same ultra-dilution to cure those symptoms in "unwell" people.

Etc
NO further comment required for this ‘Report’

Conclusion
In my opinion, despite the honourable intentions of the Honourable Members of the House of Commons to establish ‘the truth’ about homeopathy’s lack of scientific proof of ‘efficacy’ and thereby justify eliminating it from receiving ‘scarce’ State funds, the House of Commons Science and Technology Committee Evidence Check 2: Homeopathy, Fourth Report of Session 2009–10 is not exactly ‘rubbish’. There are some points to consider but the level of the analysis of homeopathy is at GCSE level and, in my opinion, basic errors of analysis of homeopathy render the report ‘worthless’ as a document to guide state policy in regard to the provision of homeopathy in the UK.

 RCT / Case studies
To claim that the only or the best method for testing medicines is the RCT method is rejected here. For homeopathic RCTs to be effective in determining efficacy the selection of the control group would be a herculean effort to ensure that the subjects of the trial are actually all susceptible to the remedy being tested. For example, for 'hyperactivity' in children a number of remedies may be helpful in different phases for each individual. Some of the more frequently occurring remedies that have some similarity with this condition are Anac, Cham,Hyos, Lyc, Med, Nux-V, Stram, Sul, Tarent Hispanica and Tub. How is a RCT going to test for effectiveness in the treatment of hyperactivity? The hyperactive child would have to be in the state of the remedy being tested at the time of testing in order to reflect a fair outcome to the trial. In case studies, a child diagnosed and certified as 'hyperactive' can go through individualised treatment and if their hyperactivity magically resolves then the case is evidence towards positive case outcomes. Possibly, the most appropriate method for testing homeopathic treatment outcomes would be to use rigorously controlled case studies in which individualised treatments (including placebo, Mr Ernst) are carried out for a particular disease or condition. In homeopathy, there are very few remedies that are specific to one particular disease and therefore cannot be verified as effective against a particular disease. In homeopathy, the name of the remedy IS the name of the disease.


Thursday, July 18, 2013

Homeopathy of Hahnemann

Hahnemann states in the Organon:
  • that there is 'nothing morbid that is curable' which is not revealed by 'morbid signs and symptoms'. (para 14)
  • that 'we have only to rely on the morbid phenomena which medicines produce in the healthy body as the sole possible revelation of their in-dwelling curative power'. (para 21)
  • 'owing to the moderate number of medicines yet known with respect to their true, pure action, that but a portion of the symptoms of the disease under treatment are to be met with in the list of symptoms of the most appropriate medicine, consequently this imperfect medicinal morbific agent must be employed for lack of a more perfect one.' (para 162, italics in the original)
  • In chronic diseases ('that arise from psora'), 'we often require, in order to effect a cure, to give several antipsoric remedies in succession, every successive one being homeopathically chosen in consonance with a group of symptoms remaining after the expiry of the action of the previous remedy.' (para 171)
(In acute diseases, the situation is similar, the resolution frequently requires a series of remedies)

In my opinion, the admission of and recourse to the 'imperfect similimum' points the way for each practitioner to engage with their patient in a unique process that would not be replicated if the patient went through the process with a different practitioner. This is the basis of the blending of the 'art' and 'science' of the homeopathy of Hahnemann in which the 'management' of the case by the homeopathic practitioner varies according to the knowledge&personality of the practitioner and the unique discourse between practitioner and patient that arises from this relationship.

Paragraph 162 of the Organon is possibly one of Hahnemann's most important statements on homeopathy. He clearly perceived the partial similarity of symptoms of a remedy within the total picture of an individual illness. This point of view is devastating to the adherents of the 'totality of symptoms' single remedy approach and even more problematic for the adherents of the constitutional typology approach that asserts that individuals have a basic constitution, for example, that the basic constitution of an individual is Calcarea Carbonica. Instead, human beings are unique and complex organisms that embody unique combinations of elements, as revealed in symptoms of remedies. Once this is seen, an approach to addressing these combinations of elements can be determined, whether by using a one remedy at a time approach or by using a combination of remedies approach that is suitable for an individual in a given moment.

Reference
Hahnemann, S. Organon of Medicine, 5th & 6th edition, translated by R.E. Dudgeon and W. Boericke

Friday, April 12, 2013

3 fundamental principles of homeopathy

The theory and practice of homeopathy is set out by Hahnemann in the Organon; the 3 principles that I list below are those that I consider to be keys to knowledge of homeopathy.

1. Provings - the effect or action of a substance on the human body is determined by the administration of a substance to healthy human beings. The more perfect the state of health of the prover, the more perfect the elicitation of pure symptoms of the substance will be.

2. Similimum - in order for a dose of the proved substance to elicit a therapeutic response from the human being who is in a state of sickness, the matching of the symptoms of the remedy to the symptoms of the sick person must be precise. Hahnemann often used the words to the effect that 'no other remedy can do what this one does'.

3. Outcome - the administration of a similimum to a sick patient does not necessarily result in the diseased state of the body returning to a state of health. There are 12 possible outcomes to the administration of a similimum to a sick person, these range from extremely positive (quick cure) to extremely negative (incurability of the disease), see:
Kent, J. Lectures on Homeopathic Philosophy (read online - Google Books)
http://archive.org/stream/lecturesonhomoe00kentgoog#page/n9/mode/2up

The 3 principles above may enable one to see through the un-wiseness of most of the critiques of homeopathy. Although many critics have attempted to make fun of and/or attempted a critique of homeopathy, no 'theoretical discourse' to date has and never will be able to disprove 'similia similibus curentur', infinite dilution of matter/energy, and the existence of 'vital force'.

A note on dosage
Please see: Kent's method in his biography by Sue Young
http://sueyounghistories.com/archives/2008/03/28/james-tyler-kent-and-homeopathy/

In the videos below, a modern master homeopath provides clarifications to reflect on before you choose to swallow straw man critiques of homeopathy.

George Vithoulkas, On Benveniste's experiment
https://www.youtube.com/watch?v=lzcpOa4rl78

George Vithoulkas, Homeopathic Prophylaxis, Vaccinations, AIDS, Provings parts 1 - 3
https://www.youtube.com/watch?v=S3aGFBxV6Uc

George Vithoulkas, Imagination
https://www.youtube.com/watch?v=Fb0iF8pbtOM

George Vithoulkas, Definition of Health
https://www.youtube.com/watch?v=6MobgeT1W1E
(This video may present a double shock for critics like Dawkins. God and Homeopathy presented together in one lecture.)

George Vithoulkas, Secrets of taking a homeopathic case
https://www.youtube.com/watch?v=OJgsAoYknyo

George Vithoulkas, Materia Medica: Phosphorus
https://www.youtube.com/watch?v=3hDmA-5Rz10

Sunday, March 31, 2013

Materia Medica Pura by Dr. Samuel Hahnemann



Available from Google Books Search in collaboration with Open Library
Read Vol. 1 online 


Available from Google Books Search in collaboration with Open Library
Read Vol. 2 online 


Comment on Homeopathic Materia Medica (Insight provided by Frans Vermeulen who wrote an excellent essay on this topic).
Materia Medica: Standing on Shifting Sands

To improve the reliability of Homeopathic Materia Medica, research and re-proving remedies using today's scientific standards would be a good thing to do. 
Some of the issues are that:
  • Anecdotal evidence and 'clinical observations' have been incorporated into Materia Medica. Some of this evidence may be 'good' but scientific verification is required.
  • The sample of profiles of the provers used in the earlier provings were limited. (Vermuelen's example of Mrs Hahnemann being the subject responsible for a significant portion of the symptoms in one of the provings is comical.)
  • Provings conducted in different potencies may yield different symptom complexes.

The Chronic Diseases by Dr. Samuel Hahnemann




Available from Google Books Search in collaboration with Open Library
Read the book online 

Tuesday, March 26, 2013

Homeopathy - The Test, BBC Horizon production


http://www.youtube.com/watch?v=vcBHKMJDHaU

An excellent BBC production that seeks to answer the question whether 'water has memory'. 

My comments on Homeopathy - The Test

1. The theme of 'memory of water' is an absurd approach to examining how potentisation of matter is achieved through the homeopathic method of serial dilutions as the process of potentisation can be done with pure water or ethanol or lactose or a combination of water and ethanol.

* The 'key to the mystery' of potentised substances is not in the 'memory of water'.

2. The experiments conducted in the film are rigorous and the outcome of the investigation conducted by the Royal Society strongly indicates that homeopathic remedies do not work by activating cell responses. This conclusion resulting from the investigation is logical - there are no molecules of the original substance in remedies potentised beyond 12CH and therefore no correlation is found between 'potentised water' and cell reaction.

* This suggests that the science of high potency remedies is beyond the molecular paradigm; Hahnemann did not postulate homeopathy in terms of cell responses so this finding does not contradict Hahnemann. Hahnemann postulated homeopathy in terms of the theory of 'vital force' immanent within the human being and it is to this that all classical homeopaths direct their observation and attention.

3. If the molecular scientific paradigm cannot explain homeopathy then how can the homeopathy hypothesis (the theory of the vital force) be 'proved'?

* Key point - note that the method of science is supposed to be to replicate the method used to establish the initial hypothesis and test the hypothesis. One thing that is singularly noteworthy of Hahnemann's critics from the very beginning is that this basic tenet of science has not been followed in testing Hahnemann's hypothesis.


Page updated: 13-05-2013

Monday, March 25, 2013

Tuesday, March 19, 2013

Richard Dawkins and the 30 CH potency



Homeopathic Dilution 'explained' by Richard Dawkins
http://www.youtube.com/watch?v=eN6U6cpGzss

The amount of water in the oceans of the world is estimated to be: 166 451 618 047 000 000 000 000 litres 
How much water is in the oceans
http://oceanservice.noaa.gov/facts/oceanwater.html


One litre is 1000 ml and 1 ml contains approximately 20 drops of liquid.
Therefore, number of drops of water in the ocean is approximately:166 451 618 047 000 000 000 000 X 1000 X 20= 3 329 032 360 940 000 000 000 000 000
Therefore, 1 drop in the oceans of the world is approximately 14 CH 
Therefore, 1 drop in 2 x oceans of the world is approximately 30 CH. Richard Dawkins says it is impossible for something so diluted as 1 drop in the oceans to have any effect on the body; impossible, so it can't be true. Richard Dawkins does not give Hahnemann any credit and if Dawkins has actually read Hahnemann's books then he would know that Hahnemann discussed the 'mystery' of dilution in the year 1827 when he published How Can Small Doses of Such Very Attenuated Medicine As Homeopathy Employs Still Possess Great Power? In this article, Hahnemann used Lake Geneva as an example of a quantity of water to which one drop is added to make a remedy. ‘Of course this is ridiculous’, Hahnemann wrote:
'The answer to this is, that in the preparation of the homeopathic medicinal attenuations, a small portion of medicine is not merely added to an enormous quantity of non-medicinal fluid, or only slightly mingled with it, as in the above comparison, which has been devised in order to pour ridicule upon the affair, but, by the prolonged succussion or trituration, there ensues not only the most intimate mixture, but at the same time - and this is the most important circumstance - there ensues such a great, and hitherto unknown and undreamt of change, by the development and liberation of the dynamic powers of the medicinal substance so treated, as to excite astonishment.'

To make a 30 CH potency of a medicine only requires:
 1 drop of the pure substance + 150 ml of diluting substance (distilled water, alcohol or lactose) 

not 1 drop of the pure substance + 2 X the oceans of the world. 
In each stage of the dilutions to make a 30 CH potency, 1 drop is diluted in 5ml of liquid. 
The process of diluting and shaking 1 drop of substance in 5ml of liquid is done 30 times.
 In the first dilution, 1 drop of the pure substance is diluted in 5ml of liquid = 1CH potency.
 1 drop of the 1 CH potency is diluted in 5ml of liquid and becomes = 2 CH potency.
 Dilution and succussion repeated 30 times = 30 CH potency.

The Dawkins metaphor of the one drop of a substance in the ocean contrasted with the homeopathic method of 30 serial dilutions shows that these are completely different conceptions. The contact volume of 1 drop in the ocean is vastly different from the contact volume in the process of producing a 30 CH potency - a mere 150ml of liquid is used in the homeopathic preparation of the 30th potency, compared to the trillions of litres in the oceans in the 'Dawkins explanation'. 

Page updated: 07-08-2016

Saturday, March 16, 2013

Homeopathy as placebo - a critique of Edzard Ernst


The comments made by Professor Dame Sally Davies to the House of Commons Select Committee on Science and Technology continues the trumpeting of the same old stories about homeopathy that surfaced at the time Hahnemann began to publish his works. Dame Davies just says straight out that homeopaths are "peddlers" and that homeopathy is "rubbish", scary stuff coming from the Chief.


Mr. Ernst, Why I changed my mind about homeopathy, delivers a more thoughtful consideration - homeopathy is placebo.

Edzard Ernst provides a concise of the homeopathy as placebo thesis.  Strangely, as an ex-homeopath, Edzard does not discuss the process of 'proving' remedies and I find it 'telling' when a partial critique of a subject is delivered from someone who ought to know better.

In Why I changed my mind about homeopathy, Edzard Ernst commenced:


'Homeopathy has intrigued me for many years; in a way, I grew up with it. Our family doctor was a homeopath, and my very first job as a junior doctor, was in a German homeopathic hospital. For the last two decades, I have investigated homeopathy scientifically. During this period, the evidence has become more and more negative, and it is now quite clear that highly diluted homeopathic remedies are pure placebos.’

Mr Ernst concluded his article:

‘My personal journey in and out of homeopathy might be convoluted. I always knew that the homeopathic principles fly in the face of science. Yet I did see positive results and thought maybe there was some fundamental phenomenon to discover. What I did discover was perhaps not fundamental but nevertheless important: patients can experience significant improvement from non-specific effects. This is why they get better after seeing a homeopath – but this has nothing to do with the homeopathic sugar pills.’

With acknowledgements to Mr Ernst and The Guardian

Mr Ernst makes no mention of the homeopathic provings of remedies. So, I wonder, how does he think Samuel Hahnemann determined the thousands of symptoms of all the remedies that he published in Materia Medica Pura and Chronic Diseases?

I shall return, later, to discuss other parts of Mr Ernst's article but in the meantime he ought to know that this is nothing personal, just academic business. That his name is in my blog discussion is pure random chance, I could have chosen any of thousands of other past and current aspirant critics of homeopathy. One thing that does interest me about Mr Ernst's statements is that while he was carrying out his 20 years of scientific investigation of homeopathy while knowing all along that its principles fly in the face of science, I wonder if Mr Ernst had a homeopathic practice during this time and conducted these experiments on his patients or if he did not have a homeopathic practice then how exactly did he carry out the 20 year scientific investigation? Did he have his scientific papers peer reviewed and, if so, by whom? 

Mr Ernst, I am interested to read the findings of your 20 year investigation, please would you comment on this blog and state the source where your scientific papers may be obtained.

The Edzard Ernst papers on homeopathy (based on his 20 years of scientific investigation):

1. Ernst, E. 2002. A systematic review of systematic reviews of homeopathy, BJCP 54 (6)

Additional papers related to Edzard Ernst's 20 year scientific investigation of homeopathy will be added to the Edzard Ernst papers on homeopathy section, as soon as they are uncovered. The systematic review of systematic reviews is a good introduction to understanding the Edzard Ernst approach to scientific investigation.

09-04-2013
Unfortunately, I feel that it is not worthwhile adding more here regarding Professor Ernst's 20 year scientific investigation into homeopathy as a little research led to the article by Susanna Rustin regarding Edzard's labelling HRH Prince of Wales as a "snake oil salesman" due to the Prince's involvement in a company that sells herbal products and donates its profits to charity. 

Susanna Rustin, Edzard Ernst: the professor at war with the prince

Readers interested in reading more of Professor Ernst’s insights into homeopathy can find these on his website:

http://edzardernst.com/category/homeopathy/

Provings
Many years ago, I challenged a pharmacist to put his skepticism of homeopathy to the test by undergoing a remedy proving. I offered to select a remedy and write the name of the remedy on a paper and seal it in an envelope. The pharmacist would then take the remedy until it commenced to induce symptoms and then he would record these symptoms. We would then check the symptoms of his 'proving' of the remedy with those recorded in Hahnemann's Materia Medica Pura. The pharmacist declined the offer even though the remedy was, in the view of skeptics, 'purely nothing', just sugar pills.

Edzard Ernst, The four types of homeopaths: would Hahnemann approve?

A fifth type of homeopath: would Edzard Ernst approve? (Inspired by George Vithoulkas, Secrets of taking a homeopathic case)
One who spent many years unsuccessfully treating patients using the 'classical approach'. Various methods of treatment were tried but the results obtained not satisfactory. Instead of the realisation dawning that they are not good homeopaths or that they are a person that chose the wrong profession and just moving on, their next mission is to prove that the science of homeopathy was at fault all along and it is their duty to inform others so that they are not duped as they were. A single sad event thereby becomes a double sad event. 

Edzard Ernst: My double life as a homeopath

Updated 07/08/2016

1MCH - the optimal high potency of homeopathic remedies?

A note on potency:

1CH

1:100

30CH

1:1000000000000000000000000000000000000000000000000000000000000

200CH

1:10000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000

1MCH

1:100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000

Compare 10MCH below with 1MCH

1:1000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000


In homeopathy, one may get an impression of caution/concern expressed by some homeopaths to prescribing potencies higher than 10 M (the magic potency for some) but, looking at the numbers objectively, the potencies from 1MCH to MM represent a 100% increase in potency.

10MCH is 1% higher in potency than 1MCH.
100 MCH (CM) is 10% higher in potency than 1MCH.
1000 MCH (MM) is double the potency of a 1MCH; the number of serial dilutions has increased from  1000 times to 2000 times.

Based on these figures, my conclusion is that the 1 MCH potency is the optimal high potency.

If evidence can be produced that the MCH potency induces a drug effect then this poses a serious question for physics to examine rather than simply dismissing it out of hand.

Tuesday, February 12, 2013

Professor Dame Sally Davies says that Homeopathy "is rubbish", reply by Dr. Lionel Milgrom



Dr Lionel Milgrom's letters to Professor Dame Sally Davies and the Rt. Hon Jeremy Hunt MP, Secretary of State for Health

Professor Dame Sally Davies
Chief Medical Officer
Department of Health
Richmond House
79, Whitehall
London SW1A 2NS
29th January 2013
Dear Professor Davies,
Your recent pejorative remarks about homeopathy made to the House of Commons Select Committee on Science and Technology were inaccurate, misleading, and I have to say not worthy of someone charged with the role of Chief Medical Officer. Frankly, your comments fall far short of the objectivity and gravitas required of someone in your position.
This is why your comments were misleading. As CMO, you will no doubt be aware that, according to the BMJ [1], over 50% ofconventional medical procedures funded by the National Health Service (NHS) have little or no basis in science. So, funding these procedures must be even more stupid than funding homeopathy, especially as they are much more expensive!
But it gets worse. Much is made of the millions spent on homeopathy by the NHS. This too is utterly misleading. Again as CMO, you will be aware that in 2010, the NHS’s drug bill was a staggering £10.2 billion, £2 billion of which was spent dealing with these drugs’ side effects. NHS spending on homeopathy (including infrastructure) was just £12 million – a mere 0.011% of the total £110 billion NHS budget – of which only a miniscule amount, £152,000, was spent on side-effect-free homeopathic medicines [2-4].
Given this vast disparity, why should the NHS stop funding an incredibly cheap therapeutic modality used and trusted by millions of people throughout the United Kingdom, and half a billion people around the world? Oh yes, I remember: it’s all about the science, isn’t it?  Well, let’s examine that.
It is disappointing that again as CMO you accept so uncritically the spurious claims of so-called ‘sceptics’ and campaigning organisations, that there is no scientific basis for homeopathy. I wonder whether you have ever bothered to seriously investigate this for yourself? If you had, then you would know that, by end of 2010, 156 Randomised Controlled Trials (RCTs) of homeopathy (on 75 different medical conditions) had been published in peer-reviewed journals. Of these, 41% had a balance of positive evidence, 7% had a balance of negative evidence, and for 52% no conclusions could be drawn either way [5].
A cursory glance at these statistics might cause supporters of homeopathy to rejoice because the ratio of positive to negative trials is clearly in homeopathy’s favour. However, the really interesting statistic here is the number of trials for which no conclusions can be drawn; greater than 50%. Because when you then look at similar statistics for RCTs of conventional medicine, something odd appears.
So, data obtained from an analysis of 1016 systematic reviews of RCTs of conventional medicine, indicate that 44% of the reviews concluded the interventions studied were likely to be beneficial (positive), 7% concluded that the interventions were likely to be harmful (negative), and 49% reported that the evidence did not support either benefit or harm (non-conclusive) [6].

Please take careful note of this, Professor Davies, because obtaining such a similar spread of statistics regardless of the therapeutic modality would suggest:
  • Homeopathy fares no better or worse in RCTs than conventional medicine. Therefore, rejecting homeopathy on RCT data is false and biased, as many conventional drugs/procedures should on that basis be similarly rejected but are not.
  • There is something fundamentally wrong with the RCT (and those who claim it to be a ‘gold standard’), when around 50% of all RCTs fail to deliver a clear result [6]. So all that the available scientific evidence suggests is at the very least, there is disagreement over the effects of homeopathic medicines and how ultra-high dilutions work.
Thus, a less emotive, more objective CMO, would no doubt have concluded, not that homeopathy “is rubbish” but that as with many conventional medical proceduresthe scientific evidence so far can only indicate homeopathy is of uncertain efficacy. And even if homeopaths were just ‘peddlers’ of placebos (you are by no means the first, nor unfortunately will you be the last to make such a scurrilous, unfounded accusation), homeopathy would still be far cheaper than Prozac, currently favoured by the NHS and, as I am sure you are well aware, recently shown to be no better than placebo [7]!
Add this to the now well-known systemic, systematic fraud perpetrated by the pharmaceutical industry (e.g. the real peddling of unlicensed anti-depressants to minors by GSK last year [8]), and the long-term abuse of science that has been going on in medical and pharmacological research [9-11], you could have reported these concerns soberly and with gravitas to the Science and Technology Committee. Instead (dire warnings of an approaching antibiotic ‘apocalypse’ aside), it is disappointing and intellectually moribund you have now joined the ranks of those unobjective ‘cheerleaders’, so-called sceptics who protesteth too much over homeopathy.
Scientists, probably with good reason, worry that the government ignores them. In his recent Dimbleby Lecture, Sir Paul Nurse enjoined scientists to speak truth to power, and engage more with the public [12]. As a scientist, I have to agree with him, but with the proviso that it is truth we speak, not the tired shibboleths of well-funded campaigning organisations, or the ersatz invective of facile media commentators who use homeopathy as a whipping boy [13]. In the eyes of the public, that simply demeans us.
For history shows time and again that the truths of science are relative not absolute, but when believed absolutely (aka. scientism, especially when over-enthusiastically applied in medicine [14-20]), science descends into a bullying quasi-religious dogma [21], ably assisted by lucrative commercial considerations). In a liberal democracy beset by the growing demands of globalised capital, that should worry us all [22], Professor Davies, and as CMO, particularly you.
Your Sincerely,
Dr. Lionel R Milgrom BSc, MSc, CChem, FRSC, LCH, MARH, RHom.
17, Skardu Road
London NW2 3ES

References:
2. Call to curb the rising NHS drug bill, 3.04.2008. http://news.bbc.co.uk/2/hi/health/7190267.stm.
3. Boseley S: Adverse drug reactions cost NHS £2 billion. The Guardian, 03.04.2008.http://www.guardian.co.uk/society/2008/apr/03/nhs.drugsandalcohol
4. Mr O’Brien, response to Q244, House of Commons Science and Technology Committee, Evidence Check 2: Homeopathy (London: The Stationery Office Limited 2010) p Ev73.
5. The Evidence for Homeopathy. British Homeopathic Association. www.britishhomeopathic.org.
6. El Dib RP, Atallah AN, Andriolo RB: Mapping the Cochrane evidence for decision making in health care. J Eval Clin Pract2007;13:689–692. Cartwright N, and Munro E. The limitations of randomized controlled trials in predicting effectiveness J Eval Clin Pract 2010;16:260-266.
7. Kirsch I, et al.: Initial severity and anti-depressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med 2008; 5:e45.
8. GlaxoSmithKline to pay $3bn in US drug fraud scandal. BBC News On-line, 2nd July 2012.
9. Titus SL, Wells JA, Rhoades LJ: Repairing research integrity. Nature 2008;453:980–982.
10. Fanelli D: How many scientists fabricate and falsify research? A systematic review and meta-analysis of survey data. PLoS One 2009;4:e5738.
11. Naish J: Faking it. Prospect August 2009:63.
13. Liddle R: Homeopathy? Let’s save £4 million and hire a witch doctor instead. London, Sunday Times, 25.03.2012. Aaronovitch D. Enough placebo politics. Vote for the geeks. The Times
14. Sackett DL, et al.: Evidence based medicine: what it is and what it isn’t. BMJ 1996;13:71–72.
15. Leggett JM: Medical scientism: good practice or fatal error? J R Soc Med 1997;90:97–101.
16. Sikora K: Complementary medicine does help patients. Times Online, 3.02.2009.
17. Smith GCS, Pell JP: Parachute use to prevent death and major trauma related to gravitational challenge. Systematic review of RCTs. BMJ 2003;327:1459–1461.
18. Holmes D, et al.: Deconstructing the evidence-based discourse in health sciences: truth, power, and fascism. Int J Evid Based Healthc 2006;4:180.
19. Devisch I, Murray SJ: ‘We hold these truths to be self-evident’: deconstructing ‘evidence-based’ medical practice. J Eval Clin Pract 2009;15:950–954.
20. Rawlins M: De Testimonio: Harveian Oration Delivered to the Royal College of Physicians, Lancet 2008;372:2152–2161.
21. Baum M, Ernst E: Should we maintain an open mind about homeopathy? Am J Med 2009;122:973. Smith K: Against Homeopathy: A Utilitarian Perspective. Bioethics 2011; doi:10.1111/j.1467-8519. 2010.01876.x. Milgrom LR, Chatfield KC: Is homeopathy really ‘morally and ethically unacceptable’? A critique of pure scientism. Bioethics 2012; doi: 16.1111/j.1467-8519.2012.01948.x. Milgrom LR: Homeopathy and the New Fundamentalism: a critique of the critics. J Altern Complement Med2008;14:589–594.
22. Ryder M: Scientism. Entry in the Encyclopaedia of Science, Technology, and Ethics. Toronto, ON, Macmillan, 2008. Feyerabend P: Science in a Free Society. London, Routledge, 1979.
 ___________________________________________________________________________
Letter to the Rt. Hon Jeremy Hunt MP, Secretary of State for Health.
Dear Mr Hunt,
I am not one of your constituents. I am writing to you in your capacity as Secretary of State at the Department of Health.
I read with dismay Prof. Sally Davies' comments to the House of Commons Science and Technology Committee, that homeopathy was "rubbish" and its practitioners were "peddlers".
While I would defend Prof. Davies' right to her private opinion, I do not think it is part of the remit of the Chief Medical Officer for the United Kingdom to insult the health choices of the millions of people in this country who partake of homeopathy, especially those who do so courtesy of our NHS, nor to insult the dedicated doctors and health professionals who have trained long and hard to be able to practice homeopathy, and to do so as if her statements about homeopathy were matters of public fact. They most certainly are not, as I hope the enclosed letter I have written to her at the DoH makes abundantly clear.
While I am acutely aware that there are various individuals and campaigning organisations whose views are congruent with those expressed by the Chief Medical Officer, I would sincerely hope that Prof. Davies is not using her position to promulgate them. Therefore, If it is at all possible, I would hope that Prof. Davies be asked to explain her outrageous statements and apologise to those millions who use homeopathy and those doctors and health practitioners who practise it.
Yours sincerely,
Dr Lionel R Milgrom BSc, MSc, PhD, CChem, FRSC, LCH, MARH, RHom

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Many thanks to Dr Lionel Milgrom for defending the all the people devoted to using homeopathy to help others.

In our society, we are entitled have have divergent and opposing views; it is good that we do as it stimulates debate that produces greater good. May I suggest though that those people who are vehemently opposed to homeopathy have a look at the list of people compiled by Sue Young. Is it reasonable to think of them as 'quacks' who advocated and dispensed 'rubbish' homeopathy?

http://sueyounghistories.com/archives/2009/11/18/homeopathy-a-–-l/

http://sueyounghistories.com/archives/2009/09/13/homeopathy-m-z/

With many thanks to Sue Young for her research that will be the undoing of any sceptic that dares to open her pages. Amongst those associated with homeopathy or offering sage advice, we find people like Goethe, Jung, Blake.

In 10, 50 or 100 years time, who will remember a homeopathic critic like Edzard Ernst?