Homeopathic Arnica as effective as the usual post-operative painkiller

Visit Dr Briffa’s blog for a report on recent research on the comparable effectiveness of homeopathic Arnica D4 (4X) post-operatively after bunion removal compared to the usual painkiller (diclofenac). It was decided that giving placebo would not be ethical.  Treatment with Arnica also gave fewer side-effects, greater mobility and was less costly.

References:

Karow J-H, et al. Efficacy of Arnica Montana D4 for healing of wounds after hallux valgus surgery compared to diclofenac. J Altern Comp Med 2008;14(1):17-25

Dr Briffa: ‘Homeopathic arnica found to be an effective post-operative aid’

Random Controlled Trials are the worst of medicine

Over at spiked-online there is a debate on the Best and Worst of Medicine.  Unsurprisingly, skeptics have nominated homeopathy as one of the worst, but the sheer volume of messages of support for homeopathy managed to get a nomination for best as well.

The debate for the worst of medicine is due on the 17th July.  A clinician sums up the current fundamentalist scientistic backlash against CAM with a damning criticism of the RCT and of those who narrowly support it:

Randomised Controlled Trials are the worst 28 May 2008

The worst thing to happen to medicine is undoubtedly the Randomised Clinical Trial (RCT) - not for the information it does and doesn’t give us but for the way it has been used by government and tunnel visioned researchers to qualify some ridiculous practices under the heading “Evidence Based Medicine”.

As clinicians we are ‘encouraged’ (read ‘forced’) to ignore our clinical skills and acumen in favor of flow chart diagnosis and prescribing. It is virtually never mentioned how much morbidity and mortality modern medicine directly causes - recent analysis in the USA places iatrogenic problems as the country’s third biggest killer!

In addition we are using medicines on complicated people, often with multiple diagnoses and on a variety of drugs - RCTs are conducted in strict (non-clinical) settings using young, relatively fit and healthy people. I am always flabbergasted at the conclusions drawn from these to ‘inform’ normal clinic practice - the information is barely ever transferable!

The best thing to happen to modern medicine is the shake-up of the rigid paradigm that is now being forced on the ‘establishment’ by hoards of patients and practitioners giving a huge range of complementary practices their attention and confidence.

The narrow-minded view taken by a radical few is that we don’t know how these modalities work, therefore they can’t work. This attitude clearly needs to be counterbalanced by the many hundreds of thousands of people who use these treatments and (RCT be damned) find that they work!

Scientific curiosity, informed by actually hearing what people are saying, is the only way forward. Retire any ‘scientist’ who is not actively demonstrating a flexible and curious approach to investigating these complementary therapies, suspending thier predjudice and bias - after all, is this not the DEFINITION of a real scientist?

Geoff Woodin, UK

Edzard Ernst, take note.

So much homeopathic research evidence should be made widely available ‘for the sake of scientific progression’

Dr Manjir Samanta-Laughton, author of ‘Punk Science’, attended the Scientific Research in Homeopathy Conference hosted by the Complementary Medical Association, held at the University of Westminster on June 18th 2008.

Here are the Complementary Medical Association’s links (some yet to be activated) to the presentations by Dr Alex Tournier, Karin Mont, Dr Rob Verkerk, Oliver Dowding, Claire Haresnape, Dr Lionel Milgrom and Stephen Gordon.

Dr Samanta-Laughtons response to the conference is on her Amazon blog:

“I got invited to the most amazing conference last week as a VIP guest courtesy of Jayney Goddard and the Complementary Medical Association. Well it threw me for a loop! I had no idea there were so many RCT trials and evidence of homeopathy. Or that there were real scientific investigations into the actual mechanisms of homeopathy as eloquently demonstrated by Dr Lionel Milgrom, a Fellow of the Royal Society of Chemists. As this was the inaugural conference of its kind, I have one question - where have you been all my life? Why has this information been so hard to find? For the sake of scientific progression, this sort of information should be widely available.”

As she says in ‘Punk Science’: “The paradigm of science has come to a grinding halt. Some are complaining that there are no big discoveries to find. Although technology advances at a rapid pace, these are simply improvements on previous discoveries. There have been no radical changes in the way we see the universe for decades…until now!  The time is right for a change in science; for the next big discovery. This revolution will place consciousness at the very heart of an intelligent universe.”

Homeopathy works - more scientific investigation merited

The Daily Mail reports:

“Homeopathy really does work and doctors should recognise its healing effects, say researchers.

A study found that allergy sufferers who were given homeopathic treatment were ten times more likely to be cured than those given a dummy pill instead.

Doctors should be more positive about the alternative medicine, which is the only complementary therapy available on the NHS, the researchers said.

Their study attempts to settle the controversy over homeopathic treatment, which critics say is not effective because of the tiny level of active substance used in most remedies.

It works on the principle that a substance which in large doses will cause the symptoms of an illness can be used in minute doses to relieve the same symptoms.

Critics argue that the active substance is so diluted that homeopathic remedies have no more effect than placebo or dummy treatment.

The study put homeopathy to the test in 50 patients suffering from nasal allergies. They were given either a homeopathic preparation or a placebo.

Each day for four weeks patients recruited from general practices and a hospital in London measured their nasal air flow and recorded symptoms such as blocked, runny or itchy nose, sneezing or eye irritation.

Both groups reported that they got better - but on average patients who received homeopathy had a 28 per cent improvement in nasal air flow compared with 3 per cent among those in the placebo group.

The study was carried out by doctors in Glasgow, led by Dr David Reilly of the Glasgow Homeopathic Hospital, one of five specialist hospitals in Britain. He said the difference in results from the two treatments was statistically significant.

Dr Reilly said this was the fourth trial carried out by his hospital, all with similar results. In addition, there were positive findings in 70 per cent of a further 180 clinical trials.

‘I hope this will encourage doctors to examine the volume of evidence supporting homeopathy - they might be quite surprised at the positive outcome in many trials,’ he said.

He added that it would take consistent scientific investigation to persuade some doctors, but attitudes were changing.

About 20 per cent of doctors in Scotland have basic homeopathic training compared with one per cent 15 years ago.

‘It isn’t just about the remedies, which can be put to the test in trials, but about a greater holistic approach in encouraging self-healing and self-recovery.’”

Dr Bob Leckridge, president of the Faculty of Homeopathy - the body for doctors, vets, nurses and other health professionals - said: ‘This latest research builds on existing evidence that homeopathy works, something that hundreds of doctors and their patients have known for 200 years.’

Edzard Ernst’s uncritical endorsement of EBM is ‘empirical quackery’

Dr Michael Fitzpatrick’s review of the book ’Trick or Treatment’ by Simon Singh and Edzard Ernst at  spiked-online (they say: “an independent online phenomenon dedicated to raising the horizons of humanity by waging a culture war of words against misanthropy, priggishness, prejudice, luddism, illiberalism and irrationalism in all their ancient and modern forms”) makes the following observations and criticisms of interest:

“Despairing of their capacity to engage with serious adversaries or big issues, former left-wingers are inclined to re-fight the battles of the past and to seek out soft targets for their invective: current favourites include neo-fascists, creationists and conservative religionists. Though any small success of these forces is trumpeted as a menace to civilisation, in reality they are as marginal as they have ever been. Exaggerating these threats enables liberals to imagine a return to their glory days, and allows them to evade the real problems of the present.”

“Alternative medicine, the focus of a new critique titled Trick or Treatment? by the science writer Simon Singh and Edzard Ernst, ‘the world’s first professor of complementary medicine’, has become another target of the radical backlash. Following the spectacular success of a series of works promoting militant secularism, a spate of books and blogs now signals a new crusade against alternative medicine.”

“it is light on references”

“My reservations about Trick or Treatment? concern its uncritical endorsement of what the health policy expert Rudolph Klein has characterised as the ‘new scientism’ of ‘evidence-based medicine’ (1), its incoherent advice to doctors on telling the truth and its curiously paternalistic approach towards patients.

According to Singh and Ernst, ‘evidence-based medicine’, a term coined by the epidemiologist David Sackett in 1992, has ‘revolutionised medical practice’. They acknowledge that ‘prior to the development of evidence-based medicine, doctors were spectacularly ineffective’. However, ‘once the medical establishment had adopted such simple ideas as the clinical trial, then progress became swift’. As a result, ‘today’, less than two decades later, according to this remarkable telescoping of the familiar narrative of progress from darkness to enlightenment, ‘the clinical trial is routine in the development of new treatments and medical experts agree that evidence-based medicine is the key to effective health care’.

While it is true that evidence-based medicine (EBM) has made some useful contributions to contemporary medical practice, notably in the systematic use of randomised controlled trials in the study of therapeutic interventions, it is nonsense to claim that it has played a major role in the successes of modern medicine (such as vaccines, antibiotics, steroids, anaesthetics, surgical techniques) which arose from developments in the basic medical sciences.”

“To some of its critics, in its disparagement of theory and its crude number-crunching, EBM marks a return to ‘empiricist quackery’ in medical practice.”

“Why are so many GPs tolerating, promoting or even using bogus treatments?’ is the provocative question posed by Singh and Ernst to my colleagues in primary health care. They consider various possibilities (though they do not seem to apply their commitment to an evidence-based approach to their speculations in this area). Could it be that GPs are simply ignorant of the facts that alternative medicine is useless? They raise the possibility that some GPs may be true believers in alternative therapies, but – understandably – find this too terrifying a subject to investigate further. They believe that many GPs are so inconsiderate towards their patients that this drives them into the sympathetic, empathetic arms of alternative therapists. But for them the most likely explanation is that GPs are simply lazy and respond to their patients’ relentless minor complaints by ‘fobbing them off with placebos’, in the form of ‘bogus remedies’ and referrals to alternative therapists.”

“Singh and Ernst criticise GPs for ‘encouraging patients’ to seek out alternative therapists. In a bizarre parallel with the world of drug addiction, they argue that ‘introducing patients to alternative therapists in relation to a minor condition could act as a gateway to a longer-term reliance’. One taste of a (tasteless) homeopathic pill or twist of an acupuncture needle could lead to a serious habit, and they may end up refusing vaccinations and stopping prescription drugs.

This is getting silly.”

I have received the following further comments from Ralf Jeutter PhD RSHom:

“The quotes from the book presented by Fitzpatrick show how superficial Singh and Ernst’s critique is. It is primarily based on the assumption that EBM is a reliable tool with which to judge treatments, totally ignoring that EBM is far from accepted as that.  Fitzpatrick calls it ‘incoherent advice to doctors’; the ‘founder’ of EBM, Sackett, wrote: ‘EBM … never replaces clinical skills, clinical judgment and clinical experience’, thus refuting in one single sentence everything Ernst claims: that EBM is the most reliable and generally accepted standard for assessing clinical effectiveness.

Ernst is a dramatiser who has lost perspective of real academic/scientific issues when he writes that ‘prior to the development of evidence-based medicine, doctors were spectacularly ineffective.’ If he really means this it is clear that he has an utterly uncritical enthusiasm for what is only the latest fashion in medicine, one that is neither established nor universally accepted. The one appeal it has is its mind numbing simplicity, which totally ignores clinical realities.

The review also highlights how desperate Ernst is to find ANYTHING to discredit CAM: apparently it is habit forming on a par with, well, seriously habit forming things. Rightly Fitzpatrick says: ‘This is silly’.

Ernst loses academic credibility by refusing to acknowledge the real complexity of research into CAM. Moreover he refuses to acknowledge that most conventional treatments and interventions are not evidence based. He has found a way of making headlines by propagating very crude science indeed. His academic status is further undermined by acting much more like a quackbuster of recent years than as somebody who should be encouraging more research (including research methodologies into CAM) to benefit the profession and patients.

It really does not become a Professor of CAM to dismiss such a longstanding and successful practice like homeopathy as ‘bogus’ and ‘nonsense’. As an academic he has had to make a determined effort to ignore the plethora of research which has grown around homeopathy over the last 200 years: pre-clinical fundamental research; fundamental research into physics and chemistry as far as it has a bearing on homeopathy; experiments on plants with ultra-high dilutions; experiments on animals and animal tissue with ultra-high dilutions; in-vitro studies; clinical studies, be they observational or comparative studies; controlled studies of nosological clinical homeopathy to randomised clinical isopathic and epidemiological studies. He has also ignored the dedicated hard work of many researchers into CAM and associated fields: dismissing all of this as useless activity which has yielded nothing and will never yield anything. I think it would suit Prof. Ernst to show more respect to his colleagues and a modicum of modesty.

Ernst has come to the conclusion that homeopathy doesn’t work by cherry-picking what he considers to be state-of-the-art research methodologies, which conflict in many instances with clinical realities.

It appears that it is Ernst’s desire to call a premature end to homeopathy which informs his understanding of ’science’. Homeopathy has survived many fads, fashions and detractors, and will no doubt survive this latest attempt at discrediting it. In my own modest predicition, Ernst, in all likelihood, will become a footnote in the history of homeopathy, like so many before him.  He is an academic who mistakes scientific models with reality.”

‘There is a good and growing body of research showing beyond doubt that homeopathy is better than placebo’

Courtesy of HMC21:

 

There is a good and growing body of research showing beyond doubt that homeopathy is better than placebo; in fact so much, that this leaflet can only provide a minute selection. There is a list of sources of further, detailed information at the end of the summary. Different types of research have been used to study effectiveness of homeopathic remedies, and all have provided positive evidence, although in the case of RCTs not consistently.

 

Laboratory research                                                                         (including tests on animals and plants)

This research is important because there can be no placebo effect, but there are ethical problems when it involves subjecting animals to toxic substances and procedures. We include animal studies here and leave it to you to decide whether you want to use them or not.

·         Belon P, Cumps J, Ennis M, Mannaioni PF, Roberfroid M, Sainte-Laudy J, Wiegant FAC, ‘Histamine dilutions modulate basophil activation’, Inflamm. Res., 2004, 53:181-188. In a study including four research centres in Europe the effect of potentised high dilutions of histamine were confirmed. Researchers were able to document that these dilutions of histamine inhibit basophile degranulation. Results cannot be explained through molecular theories.

·         Brizzi, M. et al., ‘Biostatistical Insight into the As₂O₃ High Dilution Effects on the Rate and Variability of Wheat Seedling Growth’, Forsch Komplementärmed Klass Naturheilkd, 2005,12:277-283. Plant-based bioassays are suitable for basic research - lacking the placebo effect and ensuring large data samples for structured statistical analyses. A team of researchers at the University of Bologna carried out a structured experiment, performed blind over nine weeks, using wheat seeds previously stressed with a sub lethal dose of As₂O₃ (arsenic trioxide). The seeds were then treated with either potentized As₂O₃ (5x, 15x, 25x, 35x, 45x), potentized water (equivalent potencies) or diluted As₂O₃ (10^-5, 10^-15, 10^-25, 10^-35, 10^-45). The working variable was the stem length, measured after 4, 5, 6 and 7 days. Results: Some potencies (As₂O₃ 45x and water 45x) induced a relevant increase in seedling growth and/or a variability decrease. Diluted As₂O₃ did not induce any significant results. Conclusions: Confirmation of a significant stimulating effect on seedling growth and a significant decrease of variability was obtained with ultra-high dilutions at the 45x potency. The model of wheat germination and growth has been confirmed to be a good tool for basic research in homeopathy.

·         J. Bildet, M. Guyot, F. Bonini, et al., ‘Demonstrating the Effects of Apis mellifica and Apium virus Dilutions on Erythema Induced by U.V. Radiation on Guinea Pigs’,  Berlin Journal of Research in Homeopathy, 1990, 1:28. Albino guinea pigs were exposed to small doses of X-ray that cause reddening of the skin. Studies showed that Apis mellifica 7c or 9c had a protective effect and a roughly 50% curative effect on X-ray-induced redness of the skin. Apis mellifica (honeybee) is a homeopathic medicine for redness, swelling, and itching, common symptoms of bee venom.

·         Endler, P.C. et al., ‘The Effect of Highly Diluted Agitated Thyroxine on the Climbing Activity of Frogs’,  Veterinary and Human Toxicology, 1994, 36:56. Thyroxine 30x (thyroid hormone) was placed in the water of tadpoles. When compared to tadpoles who were given a placebo, the study showed morphogenesis of the tadpoles into frogs was slowed for those who were exposed to the homeopathic doses. Thyroid hormone in crude doses is known to speed up morphogenesis; it makes sense from a homeopathic perspective that homeopathic doses would slow it down. See doi:10.1016/j.homp.2007.11.002 at http://dx.doi.org for a further experiment in 2006 which confirmed this research.

 

Meta-analyses                          (the statistical amalgamation, summary, and review of previous quantitative research)

·         Linde, K. et al.,  ‘Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials’, The Lancet, 1997, 350:834-843: Meta-analysis of 89 trials of homeopathic medicine versus placebo. Result: significantly in favour of homeopathy (OR 2,45 (95% CI 2,05-2,93)). This meta-analysis included 186 placebo-controlled studies of homeopathy published until mid-1996, of which data for analysis could be extracted from 89 studies. The main conclusion was that the results “were not compatible with the hypothesis that the effects of homeopathy are completely due to placebo”.

·         Homeopathic Medicine Research Group, Report to the European Commission directorate general XII: science, research and development, vol. 1 (short version), Brussels: European Commission, 1996:16-17. This is an overview of clinical research in homeopathy which identified 184 controlled clinical trials. They selected the highest quality randomized control trials, which included a total of 2617 patients for a meta-analysis. This meta-analysis resulted in a p-value of 0.000036 (which means that results are highly significant) indicating that homeopathy is more effective than placebo. The researchers concluded that the “hypothesis that homeopathy has no effect can be rejected with certainty”.

·         Ullman D, ‘Controlled Clinical Trials Evaluating the Homeopathic Treatment of People with Human Immunodeficiency Virus or Acquired Immune Deficiency Syndrome’, The Journal of Alternative and Complementary Medicine, vol. 9, no. 1, 2003, pp. 133–141. A review of placebo-controlled clinical trials using homeopathic medicines to treat people with AIDS or who are HIV-positive found five controlled clinical trials. Results showed statistically significant results in subjects with stage III AIDS, and specific physical, immunologic, neurologic, metabolic, and quality-of-life benefits, including improvements in lymphocyte counts and functions and reductions in HIV viral loads in patients receiving homeopathic treatment.

 

Randomised Controlled Trials (RCTs)           (where one group of subjects is given the treatment being tested,

                                                                                       while a control group is given either a current treatment or a placebo)

Dozens of individual RCTs have been carried out, sometimes repeatedly, researching the effectiveness of homeopathy for a range of conditions. Many are covered in the meta-analyses discussed above.  See the websites below for details.

 

Non-controlled clinical study             (comparison of new or different types of treatments with current treatments)

·         Witt, C. et al., ‘Outcome and costs of homoeopathic and conventional treatment strategies: A comparative cohort study in patients with chronic disorders’, Complementary Therapies in Medicine, 2005, 13, pp. 79-86. Researchers at the Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Center, Berlin, Germany and the Institute for Statistics and Econometrics, Economics, University of Hamburg, Germany  conducted an evaluation of  the effectiveness of homeopathy versus conventional treatment in routine case. Patients with selected chronic diagnoses received either homeopathy or conventional treatment.  Severity of symptoms was assessed by patients and physicians on a scale of 0 to 10, at baseline, 6 and 12 months; costs were also compared. The analyses of 493 patients (315 adults, 178 children) indicated greater improvement in patients’ assessments after homoeopathic versus conventional treatment (adults: homeopathy from 5.7 to 3.2; conventional from 5.9 to 4.4; p = 0.002; children homeopathy from 5.1 to 2.6; conventional from 4.5 to 3.2). The conclusion was that patients having homeopathic treatment had a better outcome overall compared with patients on conventional treatment, whereas total costs in both groups were similar.

 

Clinical outcome survey              (secondary analysis of data collected routinely by clinical services, in order to

                                                        judge the effectiveness of interventions; allows the study of large databases of patients)

·         Spence DS, Thompson EA, Barron SJ, ‘Homeopathic Treatment for Chronic Disease: A 6-Year, University-Hospital Outpatient Observational Study’, Journal of Alternative and Complementary Medicine, 2005, 11:793-798. In one of the largest studies ever carried out, over 70% of the 6500 patients involved reported significant benefits from homeopathic treatment. The results come from a 6 year study of 6500 consecutive patients seen in the outpatient clinic of the Bristol Homeopathic Hospital in the UK, a UK National Health Service Hospital. Patients with a wide range of conditions such as eczema, asthma, migraine, irritable bowel syndrome, menopause, arthritis, depression and chronic fatigue syndrome were included in the study, all patients having been referred by their General Practitioner or a hospital specialist after unsuccessful conventional treatment.

 

Good Sources of Research Information:

·         Bianci, Prof. Ivo et.al. (2002) Homeopathy: The scientific proofs of its efficacy.  This excellent report has detailed information about many trials and comparative studies, including cost comparisons, and is based on international research. It can be downloaded as an e-book at: http://www.guna.it/eng/ricerca/Homeopathy%20the%20scientific%20proofs%20of%20efficacy.pdf

·         www.homeopathic.com is the website of Dana Ullman’s Homeopathic Educational Services and provides a wealth of good research information.

·         An Overview of Positive Homeopathy Research and Surveys; March 2007. This document has been produced by the European Network of Homeopathy Researchers and can be downloaded from the Research page of the Society of Homeopaths’ website (www.homeopathy-soh.org).

·         www.thehomeopath.org.uk is the website of homeopath Ralf Jeutter PhD RSHom, and has detailed research information.

 

Skeptics are advised to comment on their own blogs. I will accept links. H4H

Homeopathy ‘as effective’ as standard care for eczema

I know it’s been reported on other blogs but I thought I’d include it on mine as well, for completeness sake.

UK GP website Pulse reports:

Homeopathy is as effective as conventional therapy in children with eczema, concludes the first prospective cohort study to compare the treatments.

The German study in 118 children with eczema found conventional treatment by GPs was equally as effective as homeopathic treatment in relieving symptoms and improving quality of life.

Symptom scores, as assessed by patients or their parents at one year, were not significantly different, although physician scores for eczema signs and symptom scores were significantly improved in the homoeopathically treated group.

The authors said this trial in primary care provided good evidence for the use of homeopathy for the treatment of eczema and gave a ‘more realistic picture’ of eczema therapy than that seen in a placebo-controlled randomised controlled trial.”

The research is published in the latest issue of Complementary Therapies in Medicine journal. Which describes itself as:

“Complementary Therapies in Medicine is an international, peer-reviewed journal that has considerable appeal to anyone who seeks objective and critical information on complementary therapies or who wishes to deepen their understanding of these approaches. It will be of particular interest to healthcare practitioners including family practitioners, complementary therapists, nurses, and physiotherapists; to academics including social scientists and CAM researchers; to healthcare managers; and to patients.

Complementary Therapies in Medicine aims to publish valid, relevant and rigorous research and serious discussion articles with the main purpose of improving healthcare. The journal believes that good healthcare needs to be based on clinical judgement and the available evidence on what is safe and effective, integrating conventional and complementary therapies as appropriate.

Complementary Therapies in Medicine publishes a variety of articles including primary research, reviews and opinion pieces. Recognising that some forms of CAM present novel and complex interventions, the journal encourages the exploration of the methodology of research. It believes that researchers should always aim at employing high ethical and methodological standards, and also welcomes small or exploratory studies that make a contribution to the area. Well conducted studies with negative outcomes are also welcome if they inform patient care. The journal welcomes considered opinion pieces that reflect genuine disagreements but remain respectful of the views of others.

Each issue features original, high quality research on complementary medicine, an abstracts sections with details of recently published research of high importance, as well as information and experiences on intregrating complementary medicine into mainstream care.”

Sounds like my kind of journal.

Homoeoprophylaxis – a Proven Alternative to Vaccination by Dr Isaac Golden

Visit Nourishedmagazine for the full report of a doctor’s analysis of data on the use of homeopathic remedies to build up immunity to specific diseases:

By Dr Isaac Golden

“I prepared my first formal program of homoeopathic remedies to prevent infectious diseases in 19861. In the following 20+ years, tens of thousands of Australian children have been immunised homoeopathically – a method called homoeoprophylaxis (HP) – using programs from myself as well as other practitioners across the country. The method itself is over 200 years old, and has considerable clinical and research experience to support its claims.

In 2004, I integrated 18 years of data collection from parents of children using my program with 4 years of doctoral research at Swinburne University in Melbourne. The purpose of this article is to share with you the findings of this and other research into the effectiveness and safety of HP.

He concludes:

The Safety of Homoeoprophylaxis

Homoeopathic medicines are usually prepared using a series of dilutions and succussions (firm striking of the container holding the liquid remedy against a firm surface). The remedies are called “potencies” because at each stage they become energetically stronger. After the 12c potency, no molecules of the original substance remain, yet the remedy is energetically stronger. Pharmaceutical advocates cannot understand this, because their paradigm forces them to believe that as the number of molecules of a substance decreases in a medicine, the medicine becomes weaker. This is true if the kinetic energy of the succussion is not correctly applied, and a simple dilution only is prepared. But we are making much more than a simple dilution.

Doctors agree that homoeopathic potencies cannot be toxic, and so physical safety is not an issue. However, some homoeopaths have expressed concerns over the years as to whether the long-term use of the remedies in my HP program is energetically safe. Many people who are not bound to the pharmaceutical paradigm understand that energy can produce real and tangible effects, and if misused can cause problems. One important part of my research at Swinburne was to check the long-term safety of HP.

This was done by examining 5 markers of overall wellbeing in children aged between 4 and 12 years of age - asthma, eczema, ear/hearing problems, allergies and behavioural problems. These were compared to a range of early childhood markers, including breastfeeding status, birthweight, APGAR scores, as well as to 4 possible immunisation methods – vaccination, HP, general/constitutional prevention, and no prevention at all. That gave 20 (5 x 4) possible combinations of health conditions and immunisation methods. The data was processed using Odds Ratios and Chi Squared Probability tests.

Once again, the full results are reported in detail elsewhere8, but the main findings are as follows:

1. In 19 of the 20 possible measures of health, vaccinated children were less healthy than other children, usually by a significant amount (the 1 measure favouring vaccination was not statistically significant). The most dramatic single finding was that vaccinated children have a 15 times greater chance of becoming asthmatic than children using HP, with P>99%, a highly statistically significant finding.
2. Children using HP were generally at least as healthy (and often more healthy) as children who used constitutional/general immunisation or no immunisation at all. The HP group were not exclusively from people who were extremely health conscious. Regularly, parents using my HP program say that it is their first introduction to homoeopathy and to natural medicine in general.
3. Parental estimates of general wellbeing were very high in the HP group – at least as high as in other groups.
4. Not all HP programs give consistent results. When comparing children using my HP program to those using other HP programs, the levels of both effectiveness and safety were lower in the group using other programs. So it is advisable to check the basis of a HP program before committing to it. Programs using daily doses of low potencies provide less effective long-term prevention than programs using infrequent doses of (appropriately selected) high potencies.

We may conclude from the parts of my data which were statistically significant (P?95%), that HP is associated with an improvement in general health, compared to other immunisation methods (as well as no immunisation at all), and that this figure is significantly better when compared to vaccinated children. Therefore we may conclude that the evidence suggests that the use of an appropriate long-term HP program does not lessen the health of children, and evidence suggests that it may in fact assist the maturation of the immune system by gently challenging the system in the first 5-6 years of life.”

Wholesale scorn on complementary medicine is unscientific.

Madeleine Bunting (at my least favourite newspaper ‘The Guardian’ since ‘I’m a cuddly junior doctor/you’re-making-it-up-psychiatrist’ Ben Goldacre’s devoid of any twisted homeopathic facts propaganda piece) makes some pertinent points about the state of Sceptic-Woo wars in complementary medicine.  I disagree that homeopathy is ‘just placebo’ as the benefits of homeopathic treatment can be much more profound than just ‘feeling better’ or ‘removal of symptoms’ but otherwise I agree with her thinking:

“Suckers: How Alternative Medicine Makes Fools of Us All; Snake Oil Science; and next month sees another, Trick or Treatment: what these new books have in common is varying degrees of frustration at the seemingly inexorable rise of complementary medicine. It seems the aim of some of these authors is to finish off a burgeoning health industry that they believe is based on charlatans and quacks preying on the gullible and desperate.

The books reflect the growing exasperation in some quarters that public opinion is not as amenable to persuasion and scientific evidence as they would hope. The language gets lurid; the mood music to pronouncements on complementary medicine is increasingly alarmist - we are living in dangerous times, an unEnlightenment looms as tides of irrationality threaten to overwhelm the palisades erected by science. “Reason is a precious but fragile thing,” declared Richard Dawkins in his series, The Enemies of Reason, last autumn. “Reason has liberated us from superstition and given us centuries of progress. We abandon it at our peril.”

What so troubles these science warriors is that it is estimated a third of people in the UK now use complementary medicine, at a cost of £1.5bn a year. In the US, the figures are substantially higher; it has been calculated that more visits are made to healing therapists than to doctors. There is an extraordinary paradox here: a half-century of astonishing conventional medical advances has not succeeded in eliminating complementary medicine. Quite the reverse: the breakthroughs in conventional medicine have been accompanied by the proliferation of other forms of healing - many of which have little or no evidence base to prove their efficacy. Indeed, it only takes a short surf on the web to discover that the wilder shores of this burgeoning industry are, well, pretty wild.

To the science warriors, this bizarre state of affairs can only be explained by irrationality. They bemoan the state of science education and lament how, contrary to expectation, literacy and access to information have failed to eradicate superstition. Meanwhile, in this increasingly sharply polarised debate, complementary medicine practitioners are equally exasperated by what they see as blinkered scientific reductionism.

So it takes a brave scientist to launch into this territory and risk getting attacked from both camps by daring to ask a simple question: is there anything science can learn from complementary medicine? That is precisely what Kathy Sykes is doing in her current television series, Alternative Therapies (the second programme is on BBC2 tonight). As Bristol University’s professor of public engagement in science and the director of the Cheltenham Festival of Science, no one can challenge her credentials as a scientist, yet her scrutiny of particular therapies throws up serious challenges to conventional medicine.

Sykes is too good a scientist to give complementary medicine an easy run. Tonight she examines reflexology, and gives it pretty short shrift. There are 30,000 reflexologists working on a million British feet a year. They base their work on a theory that parts of the sole of the foot correlate to organs in the body. The only problem is that Sykes could find no one, reflexologist or scientist, who could explain how these correlations might work. Furthermore, it turned out that this “ancient” healing system seems to have originated with an imaginative American woman in the 1930s. But patients swear by it. One reflexologist points Sykes to her annual garden party full of babies and children as evidence of the success she has had with infertility problems. This is the point where most scientists snort with derision at the use of personal anecdote as evidence, but Sykes presses on and it takes her into two areas of scientific research. First, she digs up new research on the importance of touch, which can have a profound impact on the brain. Even the hand of a stranger reduces anxiety and that of someone with whom one has a close relationship is even more significant. In fact, Sykes finds some scientific underpinning which goes beyond placebo in many of the therapies she looks at. But it is placebo which emerges as a recurrent and crucially important thread in her quest, and it leads her to the work of several American scientists who are trying to identify what placebo is, who it works for, and why it works.

This is one of the most common charges made against complementary medicine - that most of it is no better than placebo. But there is a way of turning that accusation around: perhaps complementary medicine is an effective way to harness placebo as one of the most powerful - and cheapest - of healing processes. Rather than being derogatory about the phenomenon as “just” placebo, perhaps we should see it as one of the most remarkable and little understood aspects of the human body.

That line of inquiry has taken Sykes to the US several times over the course of the two series she has made. There placebo has become a new frontier in medicine. In a range of studies with startling results - even sham knee surgery can be as effective as the real thing - many factors contribute to placebo: the confidence of the doctor; the social, cultural expectations around the procedure; the empathy and warmth of the patient-doctor relationship; the patient’s degree of faith. Get all these right, and the outcome can be remarkable. Harvard professor Ted Kaptchuk is publishing a study this week which shows that placebo is as good as any conventional treatment available for irritable bowel syndrome. Given that the eight most industrialised nations spend $40bn a year on medication for this condition, that’s revolutionary stuff.

This kind of research into placebo gives some insight into why complementary medicine has boomed and why there are so many people who cite their own experience to passionately defend it. The average consultation with a GP is 4.6 minutes, while the complementary therapist can devote an hour to taking detailed personal histories. That time and relationship provide a context and an opportunity for the ritual and recasting of personal experience which Kaptchuk believes are the crucial elements of placebo.

Complementary medicine is most popular where conventional medicine fails, such as with musculoskeletal conditions and mental health - stress, depression, anxiety (the recent revelations about the inefficacy of Prozac were another reminder of how shaky the science is in a large area of conventional medicine). Several complementary therapies are particularly effective at pain relief - you had to see Sykes’s footage of hypnotism helping a woman to have teeth extracted without anaesthetic to believe it. Kaptchuk argues that pain is not a static given but can be experienced dramatically differently.

Conventional medicine prolongs life but is less successful in prolonging good health - we can expect to spend more years of our life in poor health, as a government report showed last week - and in producing wellbeing. So people are voting with their feet, trying to find other ways to fill the gaps left by conventional medicine. We need scientists to help to identify what they are looking for and why, rather than pouring scorn indiscriminately on the whole field and on the relations between belief, mind and body, of which science still has such a fragmentary understanding.”

Flu abating, did homeopathy help you?

I notice that my ‘Treating flu symptoms with homeopathy’ post is not getting as many hits from people searching for ‘flu symptoms’ in the US states and cities mentioned in it, so I hope that the epidemic is abating there and that some of the viewers found the post helpful.  So far it has had 283 views.

Sceptics would like us to believe that it is ‘just placebo’ but has anyone ever tried to treat full blown flu with placebo? References please.