Homeopathy4health

5 January 2014

Skeptic persecution via Ben Goldacre BadScience Forum leads to patient suicide and medic perpetrator prosecution. GMC fails to act.

http://childhealthsafety.wordpress.com/2014/01/02/patient-committed-suicide-after-his-doctor-was-hounded-by-dr-ben-goldacres-badscience-forum-internet-bullies-perpetrators-mild-two-year-cautionary-sentence-only-just-ended-december-2013/

Perpetrator: Stuart Jones

Causing a patient to commit suicide by vicious bullying of the patient’s treating doctor specifically to “increase anxiety levels” in the victim doctor’s patients is apparently not a sufficiently serious crime to warrant more than a 2 year “caution” for the Health and Care Professions Council.

Although no charges were brought against the patient’s doctor by the GMC and the doctor was never called before the GMC, aborted investigations in 2006/07 cost the GMC £136,692.12 in solicitors’ fees and disbursements and a possible further £500,000 on internal costs – according to a report on a website set up to support the patient’s doctor by patients and wellwishers.

The GMC is funded by a levy paid by all medical doctors registered in the UK.

It appears also no action has been taken by the GMC regarding Dr Goldacre’s BadScience Forum activities.

The GMC is meant to act on patient complaints.  To complain to the GMC you can contact them on:

Email: gmc@gmc-uk.org.”

17 December 2013

Nightingale Collaboration – a key stakeholder prioritised by the Advertising Standards Authority

Nightingale Collaboration – a key stakeholder prioritised by the Advertising Standards Authority

From Letters to the Islington Tribune, London, UK

‘The Advertising Standards Authority (ASA) is pursuing a single complaint regarding 24 words on the clinic website that state homeopathy “is sanctioned by the UK government and has been an integral part of the National Health Service (NHS) since 1948”.

ASA Ltd, a private organisation, should not be abusing its powers to censor self-employed individuals by questioning factual information that does no harm to anyone.

The ASA, however, has a lobby group called the Nightingale Collaboration (NC) that it considers to be a “key stakeholder” informing its decisions, and with whom it has, in its own words, a “continued dialogue at a high level”. 

But why is the NC, an organisation specifically set up to target complementary health therapists, prioritised by the ASA, over and above patients and users of complementary therapists?

Why have they been given priority over and above patient choice and safety?’

29 June 2013

Why hounding homeopaths is both batty and arrogant.

“Ultimately what Nightingale is attacking is the intelligence and judgement of people who are trying to find an effective way to heal themselves. If homeopathy, which even its most virulent critics cannot claim is remotely likely to be harmful, works for you, then someone needs to combine serious arrogance with real battiness to believe they have the right to stand in the way.”

 Body of Evidence

There is no shortage of villains in the world. Psychopaths – domestic and national – whalers, toxic waste dumpers, global eavesdroppers, billionaire tax avoiders and their army of accountants –  all well worth campaigning against with the aim of getting them banged up or forced to cough up.

There is also an infinite supply of people who are mildly irritating who misplace apostrophes, wear Croc shoes, do crochet, litter their sentences with “you know” and text using their middle finger.

However most of us can tell the difference. In fact mixing the two categories up is a pretty reliable indicator of a serious level of battiness . Picketing shops that sell Crocs or campaigning to forbid the sale of mobiles to clumsy texters puts you firmly in the mild-to-fairly-irritating and definitely-a-bit -potty class.

Step forward the Nightingale Collaboration, earnest and self-styled defender of rationalism, whose seriously potty members have got…

View original post 986 more words

23 July 2010

Observations on Homeopathy Evidence Check

(my emphases)

Observations on the report Evidence Check 2: Homeopathy by the House
of Commons Science and Technology Committee, February 2010

1. Background

1.1. The report Evidence Check 2: Homeopathy was the second to be produced with
the purpose of examining how the UK Government uses evidence to
formulate and review its policies
. It was not an inquiry into homeopathy as
such
. The House of Commons Committee asked two principal questions:
What is the Government’s policy? And on what evidence is that policy
based?
The point was whether the scientific evidence supported the provision
of homeopathy by the NHS and the licensing of homeopathic products
by the MHRA.

1.2. The report received much publicity because of its firm rejection of evidence
for homeopathy’s efficacy on its way to answering these questions. The aim
of this paper is to focus on this one aspect of the Committee’s work, in view of
doubts voiced about the validity of its findings
. Sections 2 – 5 below address
this question.

1.3. The author served on the House of Lords Science and Technology Sub-
Committee which in 1999-2000 inquired into complementary and alternative
medicine (CAM). He was Co-Chairman of what used to be called the Parliamentary
Group for Alternative and Complementary Medicine during the
1990s, and also served on the advisory board to the systematic review of water
fluoridation which was conducted in 1999-2000 by the NHS Centre for
Reviews and Dissemination (CRD) at the University of York. As a user of
homeopathy he has failed to derive much benefit from it, but has supported
its use and development in the UK.

2. The scientific evidence for efficacy

2.1. There have been a number of systematic reviews and meta-analyses in this
field, which as the Committee states are the best sources of evidence. The
most recent review of substance is that by Shang et al in 2005, which it
considered “the most comprehensive to date” and which compared 110
placebo-controlled trials of homoeopathy [authors’ spelling] with 110 trials of
conventional medicine matched for disorder and type of outcome. The
Committee cited a conclusion by the authors [paragraph 69] that “when
analyses were restricted to large trials of higher quality there was no convincing
evidence that homeopathy [sic] was superior to placebo”. They did not
also cite the authors’ interpretation which followed these findings in the
Lancet summary, which stated: “When account was taken for these biases
[common to trials of both homoeopathy and conventional medicine], there
was weak evidence for a specific effect of homoeopathic remedies
, but strong
evidence for specific effects of conventional interventions. This finding is
compatible with the notion that the clinical effects of homoeopathy are
placebo effects.”

2.2. This was no endorsement of homeopathy. But it was some way removed
from the Committee’s conclusion in paragraph 70 of their report, “In our view,
the systematic reviews and meta-analyses conclusively demonstrate that
homeopathic products perform no better than placebos.” It also provides
little support for that part of Professor Ernst’s evidence to the Committee
where he “pointed out that: . . . Shang et al very clearly arrived at a
devastatingly negative overall conclusion
” [67].

2.3. The exaggeration by the Committee of Shang’s conclusions is worrying. It is
difficult to see how a weakly supported positive effect, for which one
explanation (possibly well-founded) is a placebo effect, can be translated into
a conclusive demonstration of this effect, with a “devastatingly” negative
finding
. No such firm claims can be found in Shang, who writes of finding
“no strong” evidence, or “little” evidence, and who ends his paper with
cautions about methodology and about the difficulty of detecting bias in
studies, as well as the role of possible “context effects” in homeopathy.

2.4. The Committee’s overstatement is not helped by claiming Government support
for its interpretation in paragraph 70, based on the Minister’s concession
of no “credible” evidence that homeopathy works beyond placebo. If he
meant persuasive evidence – and his guarded support for further research [75]
supports this – that shows a confusion by the Committee between absence of
evidence and evidence of absence
. If however he was saying that all evidence
was negative, this as Prof. Harper correctly stated [71] runs counter to the
message from most reviews up to and including Shang, which is one of primary
studies of insufficient quantity, rigour, size, homogeneity and power to
give clear-cut answers.

2.5. It is the absence of reliable evidence that remains the problem, and this
includes evidence of an absence of specific effects
(while acknowledging the
problem in proving a negative, an obstacle which did not deflect the
Committee from its conclusive verdict in 70). The Committee itself writes in
69 of no “convincing” evidence from Shang, from higher-quality trials, which
is not consistent with a claim of conclusive (dis)proof. Care with words can
be as important as with figures, and can just as easily mislead.

2.6. In a search for best evidence in the early 2000s this author relied on the bulletin
on homeopathy produced by the NHS CRD at York in 2002, one of an
Effective Health Care series on “the effectiveness of health service
interventions for decision makers”. This bulletin made a systematic
assessment of the evidence to date. It advised “caution” in interpreting this
evidence, and warned that many of the areas researched were “not
representative of the conditions that homeopathic practitioners usually treat”,
and that “the methodological problems of the research” should be considered.
It found “insufficient evidence of effectiveness . . to recommend homeopathy
for any specific condition”. At the same time it could not conclude that
homeopathy performed no better than placebo.

2.7. That was eight years ago. But it is notable that the more recent review by
Shang, on which the Committee relied quite heavily, cited no reference to any
placebo-controlled trial (i.e. of reasonable quality) subsequent to the CRD’s
bulletin, in arriving at a suggestion, but not a conclusion, of a placebo effect.

The House of Commons Committee’s verdict in 70 stands on its own in going
beyond what either review found from the evidence before it.

2.8. In seeking an up-to-date assessment from the NHS CRD, this author was referred
to the German researcher Klaus Linde as among the best of the
objective sources of current evidence on homeopathy. Linde, who was the
lead author of a major review in 1997 cited by the Committee, in turn
recommended the statistician Rainer Lüdtke as an expert with a good
overview of the current literature. Correspondence ensued with both
researchers, who were aware of the Committee’s recent report.

2.9. Both Linde and Lüdtke hold that the Committee’s conclusion in 70 that
reviews “conclusively demonstrate” a placebo effect is overstated and
unsustainable on present evidence. They have further criticisms of the way in
which evidence has been addressed.

2.10. Both are critical of Prof. Ernst’s evidence to the Committee as highlighted in
67. Prof. Linde confirms that his own 1999 re-analysis weakened the findings
of his 1997 review and probably “at least overestimated the effects of
homeopathic treatments”, but that his paper was “not ‘negative’” as stated by
Ernst
. He writes that “A more accurate interpretation is that the ‘re-analyses’
[by himself and 5 others, referred to by Ernst] show that the (positive)
evidence is not fool-proof. This applies still today (for example, to the Shang
analysis)”. Lüdtke draws attention to his own paper in 2002 which criticised
many statistical errors in Ernst’s 2000 re-analysis in the same journal, vitiating
Ernst’s negative conclusion, a published criticism which received no mention
in Ernst’s own evidence to the Committee
. Ernst was correct to state in
evidence elsewhere that the re-analyses of Linde came to a “less than positive”
conclusion, and that further reviews “failed to conclude that homeopathy is
effective”. The Committee, while adopting Ernst’s more absolute
conclusions, has not resolved the contradiction between his statements.

2.11. Lüdtke, like Shang, has also drawn attention to the pitfalls in research into
homeopathy, in a chapter in ‘New directions in homeopathy research’ (Witt C,
Albrecht H, eds.) published in 2009. He counsels against including all types
of homeopathy trials of reasonable quality in one review (such reviews tend to
suggest that homeopathic medicines are not efficacious), since the pooling of
so many different kinds of trial and type of homeopathy makes findings
unreliable
. He advocates restricting systematic reviews to clearly defined
health conditions or to single homeopathic medicines, concluding that “the
heterogeneity of trials is high and the meta-analysis results are not robust
against small changes in study design or statistical analysis”. In a paper
published in 2008 he has argued that Shang’s conclusions do not hold when
slightly different selection criteria are applied, e.g. by redefining how large is a
“large” study, or by including treatment trials but excluding prevention trials.
Size is not the only factor in arriving at robust conclusions.

2.12. Context effects may play a part, according to both Shang and Lüdtke.
Shang’s “powerful alliances” between patient and carer, based on “shared
strong beliefs”, may not be as distinctive or as peculiar to homeopathy as the
nature of the homeopathic consultation, with its wider range of questions than
are addressed in a conventional context, and the lifestyle recommendations
referred to by Lüdtke that often flow from it. There is overlap here with the
placebo effect (see 4 below); but homeopathy as “a complex medical system
of its own” may be responsible for some broader effects.

2.13. Linde writes that the “undecided fraction” to which he belongs is confused by
“the notorious lack of predictable reproducibility” on the one side, and by
“too many anomalous results in high quality studies to rule out a relevant
phenomenon”
on the other.

3. Other evidential considerations

3.1 A conventional argument against CAM treatments is often that they are risky
because they deny or delay a proper diagnosis and the adoption of tried and
tested conventional treatments [105; 108; Ev 26-27]. But this is not an
argument about (as here) homeopathy per se, and its side-effects which at such
high dilutions are as implausible as its efficacy is claimed to be. The potential
for harm however is real enough: but only if patients have not been in contact
with their own doctors, which happens in a minority of cases; if homeopaths
are not adequately trained to recognise ‘red flags’, and give bad advice; and if
conventional treatment is likely to be successful and/or acceptably risk-free in
the particular case, and indeed more successful than a homeopathic approach
.

3.2. The argument for adopting one kind of treatment and not the other relates
therefore to issues of practice, communication and training as well as of
comparative efficacy (for patient choice see 6.1 below). These are highly
important; but it is not legitimate to deploy the argument as the Committee
did as a factor in the intrinsic risk/benefit ratio of a therapy
, which it is not,
adducing it as an additional negative element instead of as part of an efficacy
argument which has already been addressed. (Suppose high-quality trials
establish homeopathy’s superiority over conventional treatment for a
condition: this, with homeopathy’s negligible side-effects, would make the
conventional option the risky one.)

3.3. Nor is the argument even-handed if examination of true side-effects in homeopathic
and conventional treatment is not addressed when discussing the
comparative merits of the two approaches, patient satisfaction, and
government policy. Shang et al gave “the exclusive focus on beneficial effects”
as one of several limitations of their study. The extent of adverse
clinical effects is as much a part of the evidence base as is benefit. If the
Committee had looked at these it might have cast a different light on policy
towards homeopathy in the NHS, and would almost certainly have highlighted
public disquiet about some of the more aggressive conventional treatments
as a reason for many patients preferring a CAM approach. This is a
significant omission.

3.4. There may be no good conventional treatment for a condition. Alternatively,
the standard treatment may be contraindicated. The Committee has not
considered these reasons why some patients may welcome the continued
provision of homeopathy.

4. The placebo effect

4.1. The placebo effect, addressed at some length by the Committee (30–40), is not
in dispute. Yet much about it is unknown
. It may be premature to assume
that patient expectations of modern medicine, with its erudition, structures,
scientific approach and rituals which give it the intellectual and moral high
ground in Western society, are of lesser force than those of a treatment which
is commonly thought of as “implausible”, and not only by scientists. Belief in
white coats is not weak
. Furthermore patients are likely to resort to CAM on
grounds of principle or safety as well as efficacy. The placebo as an
explanation is sometimes reached for too readily off the shelf, when its applicability
to the relevant condition, treatment and patient population is poorly
understood. This gap in argument has not been closed by the Committee.
The placebo effect in homeopathy needs more work before conclusions can be
confidently drawn.

4.2. Empathy in a consultation is more than a matter of time given [81]: it also involves
personality and training. This author has on occasion felt better heard
in a ten-minute GP consultation than in an hour with a CAM therapist,
although the latter have generally shown up well. The better comparator in
CAM situations is probably the specialist consultation, since most patients will
have initially visited their GPs. Nor is it always the fluctuating or selflimiting
conditions [43, 81], as the Committee suggests, that send patients to
unconventional providers; claimed relief from chronic complaints after a long
period of failure with conventional treatment is not uncommon
.

4.3. The surveys of homeopathic patients referred to in 80 suggest that selfreported
benefit was not only at a high level but persisted beyond the limits of
any placebo effect which, as the Committee states, is usually short-lived
.

5. The Committee’s witnesses

5.1. The Committee in two sessions called twelve witnesses to give oral evidence,
all but one with relevant affiliations. Selection of witnesses can affect
outcomes in the same way as selection of written evidence
. It is therefore
legitimate to examine the choices made.

5.2. It is not easy to see why a journalist doctor was invited to appear in preference
to some other non-representative contributors to the inquiry. The written
submission by Dr. Goldacre [Ev. 8] was notably short on supporting evidence,
but contained unqualified statements on the ineffectiveness of homeopathy,
forcefully expressed (“extreme quackery” was mentioned)
. By contrast, the
submission by the Complementary Medicine Research Group from the
Department of Health Sciences at the University of York presented a wellargued
summary with 68 references [Ev. 143]. In this appears the statement
“To date there are eight systematic reviews that provide evidence that the
effects of homeopathy are beyond placebo when used as a treatment for [five
childhood conditions]”
. This claim from a mainstream academic centre, rated
joint first nationally for health services research in the latest Research
Assessment Exercise, stands in stark contradiction to Prof. Ernst’s referenced
claims, noted above, and to Dr. Goldacre’s unreferenced statements
. It would
have been illuminating if the Committee had probed the Group about this,
face to face as a witness, and attempted some resolution before agreeing in
unequivocal terms with the two witnesses who were invited to appear and
were quoted favourably. The Committee criticised the supporters of homeopathy for their “selective
approaches” to evidence [73]. They could fairly be accused of the same.

Unfortunately they did not (presumably) have the scope to solicit the views of
Dr. Linde from Germany, which would have differed from those of Prof. Ernst
with regard to the evidence.

5.3. Only one Primary Care Trust submitted a paper, and it was invited to give
oral evidence on its decision that homeopathy did not provide value for
money. Given the number of PCTs countrywide this is rather surprising. It
might be wondered if some form of publication bias was in play, with the
many PCTs who were happy with provision of homeopathy seeing no need to
defend the status quo
. At least one writer complained of the short timescale
for submissions [Ev. 128]. It would have been interesting to know what steps
the Committee took to obtain a range of views about the evidence
, and
whether West Kent was the only PCT to have done an assessment of the kind
referred to in Ev. 134. Only a negative PCT view was recorded; and despite
the Committee’s unequivocal conclusion even West Kent conceded “limited
evidence in favour of homeopathy”.

6. Societal questions

6.1. Since doctors exist for patients and not the other way round it is not selfevident
that scientific evidence, important as it is, should be the sole
determinant of what is provided to the public.
If the patient is ultimately in
the driving seat (s)he might wish on broader grounds than proven efficacy to
finance this type of treatment rather than that (or in addition to that) from the
public purse. This gives scope for political judgements which can set a
government at odds with its medical advisers. This should be no surprise to
a parliamentary scientific committee which sits at the border of these two
worlds.

6.2. In the purely scientific field it is interesting that the present Committee should
feel “troubled” [71] by two senior government scientists coming to different
conclusions about the weight of homeopathic evidence. Such disagreement
in interpretation is quite common in scientific debate, although life is
undoubtedly easier where there is consensus. Premature consensus,
however, has its own dangers, as is generally recognised. The Committee
appears to require the scientists metaphorically to retire to a jury room and
not come out until they agree [64, 72], presumably with the Committee’s view.
This seems a step too far.

6.3. Pre-existing structures have some de facto claims. It is reasonable to decide
that if something were not in existence one would not call it into being, but if
it is already there one would not abolish it. While theoreticians might debate
this, society as a whole can accept it. It is more easy to accept where the
institution claims a minuscule proportion of the health and research budgets,
which must be the case with homeopathy whatever precise figure the
government comes to at the Committee’s request.

7. Conclusion

7.1. The evidence for homeopathy is not impressive, except possibly in terms of
lack of adverse effects. The Committee however has been less than rigorous
in its approach to this evidence.
Its choice of witnesses favoured a medical
media opponent of homeopathy over a research centre of excellence. It was
unwise to rely heavily on the interpretations of one professor of CAM, some
of whose statements are unsound or in conflict with other statements of his,
and who is not without his critics in the worlds of research and academia
whose views were given less prominence.
The 2005 review by Shang et al has
been inaccurately represented as ruling out specific effects of homeopathy, in
a summary statement by the Committee that goes beyond present evidence.
The Committee’s own statements show confusion between unconvincing
evidence of a specific effect and disproof of it
. The true risk profile of
homeopathy, compared with conventional treatment, was not considered.

7.2. These limitations make the Committee’s report an unreliable source of
evidence about homeopathy.
The jury must still be regarded as out on its
efficacy and risk/ benefit ratio. Whether more research should be done, and
of what kind, is another question. But there can be no ethical objection to it
since the principal questions have not, as the Committee claimed, “been
settled already” [78].

Earl Baldwin of Bewdley.
June 2010.

27 February 2010

Who are the MPs who recommend the end of homeopathy in the NHS?

Voice of (Not So) Young Homeopathy:

“Stop funding NHS Homeopathy, MPs urge”. But who are these MPs?

The Science and Technology Committe report was ‘ratified by THREE MPs: TWO of whom were NOT EVEN PRESENT AT THE COMMITTEE MEETINGS  – and ONE of the two was NOT EVEN A MEMBER OF THE COMMITTEE when the hearings were held, and is due to stand down at the election in May this year.’

‘Evan Harris, associate of Sense About Science and it’s fair to say rabid anti-homeopathy campaigner, 1023 participant and ’senior counsel for the prosecution’.

Ian Cawsey – IT expert, who joined the S and T committee in October 2009, just a month before the meetings and yet chose not to attend the committee’s investigation – in fact was nowhere to be seen until the ratification meeting.

Doug Naysmith – an immunologist – did not join the S and T committee until January 2010 – so was not even on the committee until after all the hearings – yet was present for the ratification of the report.  And he is standing down at the next election.  Surely not?’

10 February 2010

Dr Evan Harris bias and behaviour may lose Liberal Democrat votes

Liberal Democrat spokesperson for science Dr Evan Harris’s bias at the UK Government’s Science and Technology Committee Evidence Check on Homeopathy was further confirmed by his unethical behaviour towards Dr Peter Fisher of the Royal London Homeopathic Hospital at the Merseyside Skeptics Society ‘1023’ ‘homeopathy overdose’ stunt recently.  He may cause the Liberal Democrat party to lose votes from homeopaths, homeopathy users (about 10% of the population have taken homeopathic remedies in the last year) and other practitioners of CAM and their supporters. I have consistently voted Lib Dem until now but am reviewing this policy as a direct result and I am not alone.

Here is a video of Evan Harris’s appearance at the 1023 event: http://www.youtube.com/watch?v=xYuLjl9bgIw

And at the Science and Technology Committee Evidence Check for Homeopathy meetings:

Wednesday 25th November 2009

http://www.parliamentlive.tv/Main/Player.aspx?meetingId=5221

Monday 30th November 2009

http://www.parliamentlive.tv/Main/Player.aspx?meetingId=5257

Dr Harris may be in breach of Articles 46 and 47 of the GMC’s Guidelines for Good Medical Practice:

Article 46. You must treat your colleagues fairly and with respect. You must not bully or harass them, or unfairly discriminate against them by allowing your personal views to affect adversely your professional relationship with them. You should challenge colleagues if their behaviour does not comply with this guidance.

Article 47. You must not make malicious and unfounded criticisms of colleagues that may undermine patients’ trust in the care or treatment they receive, or in the judgement of those treating them.

More at: http://vonsyhomeopathy.wordpress.com/2010/02/10/1023-dr-evan-harris-and-the-evidence-check/

11 February 2009

CAM can provide significant health improvements to NHS patients

Hospital Healthcare Europe reports:

A year-long pilot scheme in Northern Ireland has found that complementary and alternative medicine (CAM) can offer significant health improvements to NHS patients.

Independent analysis of the findings showed:

  • Patients receiving acupuncture treatment reported an average 33% improvement in their health and wellbeing
  • Patients receiving chiropractic and osteopathy treatment reported an average 38% improvement in their health and wellbeing
  • Patients receiving homeopathic treatment reported an average 54% improvement in their health and wellbeing

Founder of Get Well UK, Boo Armstrong, says of the results: “The results from this project speak for themselves – complementary therapies improve health and save money. These findings are consistent with other service evaluation from across the UK. A personalised health service will need protocols to include complementary therapies.”  Full report

7 May 2008

‘Is an alternative just the tonic?’ Northern Ireland’s ‘Get Well UK’ project

Although Homeopathy is under threat on the mainland, BBC Northern Ireland and The Belfast Telegraph  report on succesful homeopathic treatment in a trial of alternative therapies in two Northern Ireland GP clinics (Get Well UK):

BBC Northern Ireland: “Northern Ireland is said to use more prescription drugs than any other UK region. While tablets may alleviate symptoms, they can be addictive and have side effects. A BBC NI documentary looks at the alternatives:

Londonderry woman Frances Gillen was addicted to prescription drugs for more than 20 years. The legacy of the Troubles and raising five children by herself took its toll. After being caught up in gunfire, she slid into depression and refused to leave home for years.

It affected me… I stayed in the house for the guts of three years, or maybe more, without going out. The only place I would have gone to was to go over to the doctors,” she said.  “It got that I would not even wash myself. I got the TV brought up into my room. “I didn’t want to commit suicide but I really didn’t want to go on if this was life, if this was my life… the quicker the better, I could go.

However, her life was turned around when she tried homeopathy as part of a pilot scheme being run in two centres in Northern Ireland.  The Get Well Scheme allowed GPs to refer patients to complementary therapists, with the NHS paying for their treatment.

Within weeks, Frances felt her depression lift and she started to resume normal life; she also came off all prescription medication.

“Now I feel like 16 again… well 30,” she joked.

Belfast Telegraph: “Traditionally Northern Ireland has always used more prescription drugs than anywhere else in the UK. We’re fond of our medicines and we’re fond of going to our doctors. The doctor has always been at the centre of our society. Attitudes, however, are changing and for decades patients are now turning to ancient forms of medicine such as acupuncture and aromatherapy — among other therapies.

In 2006 the government controversially decided to do the same and announced a new initiative — the Get Well Scheme. The trial provided complementary therapies to patients within two health centres in Northern Ireland, the Holywood Arches Health Centre in east Belfast and the Shantallow Health Centre in Londonderry, with the treatment paid for by the NHS.

Its aim was to see if complementary therapies could help the health service be more cost-effective by making patients feel better without the use of expensive prescription drugs.

It was designed to help people with problems such as depression and anxiety.

Then we meet Anne McCloskey, a straight-talking GP from the Shantallow Health Centre whose view on complementary medicine differs but changes over time.

In part, her conversion is due to the case of one remarkable patient featured in the film.

Every GP, Anne McCloskey says, has a set of what is referred to as ‘heart-sink’ patients; those who make the GP’s heart sink as soon as they walk through the door. Some ‘heart-sinks’ will visit their GP as often as every second day and, no matter what the GP does, they continue to decline despite there being no clear cause of sickness.

Dr McCloskey’s ‘heart-sink’ patient was Frances Gillen. For over two decades Frances had been suffering from depression which she says began as a result of ‘Troubles-related’ anxiety coupled by the stress of bringing up a large family.

In the film she recalls an incident in which she was almost hit by gunfire and, as a result, refused to leave the house for a number of years.

Frances became heavily dependent on prescription drugs and was one of the first patients Dr McCloskey referred to the Get Well Scheme and her subsequent story is a success.” 

28 February 2008

History of Homeopathy in Britain

An interesting article on the history of Homeopathy in Britain by the Liga Medicorum Homeopathica Internationalis which also details some of the developments, changes in and disputes over prescribing approaches. Contemporary homeopaths are trained in choosing the appropriate prescribing approach for the patient and their symptoms:

“The Early Years
Homeopathy came to Britain relatively late. Although the Organon was published in 1810 it was not until 1832 that the first full time practitioner established himself in London. During this period many British aristocrats, such as the Marquess of Anglesey, and the Duke of Beaufort crossed the Channel for treatment by Hahnemann. Queen Adelaide, wife of King William IV, was a patient of Dr. Stapf and was visited by him at Windsor Castle. A letter published in the Lancet in 1834 demonstrated the effect of the Queen’s interest upon Sir Henry Halford, President of the Royal College of Physicians and dubbed the ‘eel backed baronet’.

The Duke-Royal Homoeopthicism
Dear Dr. Turner,
I am exceedingly annoyed at the Queen’s not commanding my professional attendance, as it would give me an excellent opportunity of playing an important political game at this crisis. The last accounts I have received from the Pavilion mentions that her Majesty is still persevering in the homoeopathic system and she supposes she has derived advantage from it…
Her Majesty’s confidence in the absurd system arose from one of her maids being put under it when they were in Germany. Her brother, the Duke, sends her these invisible pills from Germany and they are such atoms that a quill filled with them lasts her Majesty a couple of months.
Her Majesty has also an extraordinary bottle which she smells whenever she wants a movement in her royal bowels and my correspondent tells me that the effect of smelling the bottle is so immediate that her Majesty is obliged to leave the room at a moments notice
H.H.”
[Lancet: vol1, 1834-5, p359]

Homoeopathy became increasingly popular among the upper classes and pressure grew for a suitable doctor to be available in London. Dr. Frederic Hervey Foster Quin was practising in Naples when Dr. Neckar in Rome first introduced him to the method. He became physician to Prince Leopold, later King of the Belgians but Quin left his service after two years to study with Hahnemann. His aristocratic friends and patients wrote regularly to him, asking him to move to London, which he finally did in 1832.

Quin’s parentage is unknown but he had the entree to all the great houses and numbered royalty, and aristocrats among his friends and patients, as well as Dickens, Landseer and many others from artistic society. Inevitably his practice was at first restricted to the upper classes. He tried unsuccessfully to open a dispensary for the poor but after that concentrated upon the foundation of a hospital. He formed the British Homeopathic Association, a lay/medical society to collect the necessary funds. The hospital was eventually opened in 1850 in Golden Square, Soho, London.

Opposition to homoeopathy was marked from the moment of Quin’s arrival. The Royal College of Physicians had the ancient power to control all medical practice within seven miles of the City of London, although it had not exercised this right for a century. It called upon Quin, an Edinburgh graduate, to take the college examination. He ignored the summons and eventually the College lost its nerve and desisted. But he was not forgotten. When he was proposed for membership of the Athenaeum, an exclusive gentlemens’ club, the then President of the RCP publicly called him a quack. This slur was only retracted on pain of a duel, but the College still mobilised its supporters to ensure that Quin was blackballed.

In 1844 Quin formed the British Homoeopathic Society, the forerunner of the present Faculty, with the half dozen homoeopathic doctors then in the country. It was this society that was attacked in its turn by the Provincial Medical and Surgical Association, later the BMA. Membership was forbidden to all homoeopathic doctors and members of the PMSA were not to co-operate in any way with homoeopaths.

Unfortunately the homoeopathic profession was not united at that time. Why there was a division is not clear. It may have been due to different attitudes to Hahnemann’s theories but more probably was the result of Quin’s attitude to his colleagues. Certainly his insistence that only members of the British Homoeopathic Society could be appointed to the staff of the hospital in Soho played a part.

In 1835 Mr Leaf, a well to do merchant and supporter of homoeopathy, invited Dr. Paul Curie in 1835 to come from Paris as medical officer to a dispensary, which he founded in Finsbury Square, London. Curie, the grandfather of Pierre Curie of radium fame, was regarded as a brilliant homoeopath and teacher. Unfortunately he had been a follower of Broussais who regarded all disease as deriving from the gastrointestinal system. He believed in strict dieting. A scandal arose when one of Curie’s patients died apparently from starvation. However this did not stop Curie who founded the first school of homoeopathy in Britain. In 1850 several doctors including Curie founded the Hahnemann Hospital in Bloomsbury, London, with its associated medical society the Hahnemann Medical Society and its lay counterpart the English Homoeopathic Association. Unfortunately Curie caught typhus from a patient and died in 1853 and the hospital closed shortly afterwards. This led to the unification of the homoeopathic medical profession.

Cholera
Although the London Homoeopathic Hospital in Golden Square, Soho, was ready for patients in October 1849, this was too late for the cholera epidemic of that year. In 1854, when another epidemic threatened, the Governors of the hospital decided to devote the hospital solely to cholera, for the duration of that epidemic. As a result 90 patients were treated. In addition Camphor was distributed free to the local population with instructions for its use as a prophylactic and as a first stage treatment.

The Board of Health had issued strict instructions for the notification of all cases of cholera and of diarrhoea together with details of treatment and of the outcome. The homoeopathic hospital duly submitted its returns, but to its surprise its results which were far superior to those of conventional hospitals, were omitted from the official report on the epidemic when published in 1855. The area of London where the hospital was situated was one where the epidemic was at its worst. It was the site of Dr. John Snow’s famous efforts to remove the handle of the pump in Broad Street, resulting in an immediate reduction in cases. Patients from this area went to only two hospitals, the Homoeopathic and the Middlesex. For the 90 cases treated at the Homoeopathic Hospital there was a death rate of 19%. [Of the 61 cases, the subject of the complaint to the House of Commons, see below, the rate was even lower at 16.4%.] In contrast the death rate at the Middlesex was 52.35% and elsewhere it was as high as 65%.

The British Homoeopathic Society sought the help of Lord Robert Grosvenor, a Member of Parliament sympathetic to homoeopathy. Following a question asked by him in the House of Commons, the homoeopathic results were published, demonstrating the superiority of the system of treatment.

The Expansion of Homoeopathy
In that same decade pressure mounted for the registration of medical practitioners. Opponents of homoeopathy hoped to preclude its supporters from registering and therefore from practising. The Registration Bill was drafted in such a way that any degree granting body could refuse graduation to anyone whose views it disliked. Dr. Robert Dudgeon discovered this only two days before the bill was to go through its final stages. He was a polymath, editor of the British Journal of Homeopathy and a prolific writer on the subject. Together with Lord Robert Grovesnor, by then Baron Ebury, and another peer, he was able to draft a clause, which limited the power of colleges. This appeared so innocuous that it went through on the nod. Sir James Y Simpson, the Scottish obstetrician who introduced Chloroform, was homoeopathy’s leading opponent at the time; although sitting in the public gallery he was quite unaware of what had happened.

Despite this opposition homoeopathy spread steadily throughout the country. By 1880 every major town had its dispensary while in many there was a hospital. Homoeopathic hospitals varied in size from the ‘cottage’, with 3 or 4 beds, to the major hospital of 100 or more beds and provision for surgery and the other specialities.

Supporters of homoeopathy were originally the aristocracy but later in the 19th century it was the rich upper middle classes who provided the funds and the political support. Some of the larger hospitals were provided by businessmen. Thus, the Liverpool Hahnemann Hospital was built and paid for by Sir Henry Tate, a millionaire sugar importer. The hospital in Bristol owed its existence to the tobacco manufacturers, Wills.

Royal patronage always played a part. Although, as mentioned Queen Adelaide used homoeopathy, neither Queen Victoria nor her son, King Edward VII, favoured it. This is surprising since Frederic Quin was a personal friend of Edward. However the Duchess of Cambridge, sister in law of William IV was converted and employed Quin as physician to her household. Her granddaughter Princess Mary of Teck became Queen Mary, when she married King George V. He appointed Dr. John Weir as royal physician and later knighted him. Thus homoeopathy was passed to the present Royal family.

The ‘Scientific Homoeopaths’
As the century progressed the attitude of British homoeopaths to Hahnemann’s theories changed; they increasingly refused to accept the psora theory and were very suspicious of high potencies. Robert Dudgeon and later Richard Hughes led the profession in low potency prescribing. There were of course exceptions, notably JHC Clarke and Compton Burnett who remained ‘classical’ homoeopaths. But as early as 1853 Dudgeon gave lectures which decried the idea of dynamic increase of power with dilution and succussion. While these doctors had to accept the 30th potency and even the 200th, they regarded as nonsense the M potencies that were being produced in America.

Alternation of potencies became commonplace. In the clinical records of the London Homoeopathic Hospital, which have fortunately been preserved, Bryonia is frequently shown as being alternated with Aconite or Arsenicum in acute cases, usually in the 1x or 3x potency. Quantity also played a part and if a satisfactory action was not obtained with one globule per dose (usually given every 2 or 3 hours) then two or three might be given before a change of remedy was considered.

These doctors wanted to be united with the conventional profession. They were sympathetic to the new scientific developments of the time and made use of pathological advances as they arrived. Many medicines such as Aconite and Belladonna, which they used in potency, were absorbed into the conventional pharmacopoeia. As a consequence some doctors found it avoided trouble if they ceased to call themselves homoeopaths while continuing to use the remedies. Those who remained loyal had no compunction about prescribing conventional medicines such as Morphine and Iron, although in the latter case this might, illogically, be given in low potency for anaemia.

The Arrival of Kentian Philosophy
All this was to change early in the twentieth century with the arrival of the ideas of James Tyler Kent from America. Within little more than a decade there was a complete alteration in prescribing methods. Instead of low potencies, single doses of M potencies were used, after repertorisation; previously the repertory was almost unused. There was less concern for the conventional profession, for pathology and other medical advances. Dr. Richard Hughes, the great man of the late nineteenth century, was dismissed as a ‘pathological prescriber’ unworthy of consideration. Homoeopathy became a small isolated sect cut off from mainstream medicine, and supported in the main by a cadre of ‘homoeopathic families’ who provided both the doctors and the patients.

But the homoeopathic medical profession had to provide a full medical service. For example at the turn of the century tuberculosis was a major fatal disease. James Compton Burnett claimed to have discovered Tuberculinum, as a treatment for it, fifteen years before Koch introduced Tuberculin. Homoeopaths used Tuberculinum in the form of Bacillinum for their cases with limited success. It seemed to work in acute cases but was of little use in caseous lung disease. However it proved successful in associated conditions such as tonsils and adenoids.

Tuberculin was similarly limited in success and, because it was toxic, the dosage was progressively reduced so that eventually it was being utilised in homoeopathic doses. Homoeopaths started to use Tuberculinum first, but if that failed they turned to Tuberculin. It is difficult to make any real estimate of its efficacy because it became superseded by sanatorium treatment. As this happened, fewer and fewer cases were referred to homoeopaths, the patients’ disposal being controlled by the Public Health regulations.

The advent of Kentian ideas can be said to have been almost solely due to Dr. Margaret Tyler. She induced her parents, who served on the committees of the London Homoeopathic Hospital, to provide money for scholarships enabling doctors to study in Chicago under Kent. She qualified in medicine in 1903 at the age of 44 and served on the staff of the hospital until her death forty years later. She specialised in retarded children but her great contribution was teaching. She lectured, she ran a correspondence course, and edited a journal which could be used as a textbook. But she is best known for her ‘Drug Pictures’, which simplified the materia medica for students.

However she did not entirely succeed in keeping British homoeopathy tied to the Swedenborgian mysticism of Kent. C.J.Wheeler and others accepted his method of selection of the remedy while moving away from his philosophy. But the idea of the single constitutional remedy has remained the norm to this day.

The Faculty of Homoeopathy
In 1943 the British Homoeopathic Society reformed as the Faculty of Homoepathy. It developed an academic organisation and started a diploma in homoeopathic medicine. This became the basis of full membership. The examination increased in difficulty so that it became a specialist qualification. It is now forming the basis of a proposed European qualification. More recently, owing much to the work of the Scottish branch of the Faculty, a new qualification has been introduced for GPs who are interested but do not wish to go on to full specialist training.

Within a short time of its formation the Faculty was faced with the question of how homoeopathy, and particularly the homoeopathic hospitals of which five remained in existence, was to be integrated into the new National Health Service. After protracted discussions with the Ministry it was agreed that these hospitals would be treated in the same way as conventional hospitals. Equally important, it was agreed that homoeopathic remedies would be prescribable by all NHS doctors.

Recent Developments
This agreement did not, unfortunately, cause the conventional profession to view expenditure upon homoeopathy as justified. Of the five hospitals, three have been reduced in size. The Royal London Homoeopathic Hospital, which moved to its present site in Great Ormond Street in 1859, was replaced the end of the 19th century with a purpose built hospital with state of the art medical and surgical departments. It survived as an independent hospital in the NHS but was starved of funds for years. It lost its surgical departments and has had to offer other forms of complimentary medicine in addition to homoeopathy. In contrast the Scottish hospital, by a sustained effort of teaching, research and by demonstrating its value for money, has succeeded in obtaining the funds necessary to have a new building constructed.

But another factor has affected the situation. In the last ten years, the demand from the general public for homoeopathy has noticeably increased. In addition the conventional medical profession is taking a much more favourable view. While some managers seek to employ non- medically qualified practitioners, because they are cheaper than doctors, the risks of so doing have been explained to them. (In Britain, anyone without any training whatever can practise medicine provided there is no claim to be a doctor or attempt to prescribe dangerous drugs.). The future for homoeopathy itself seems secure.”

22 December 2007

Fundamentalism – one of the great problems facing the world – leading to extreme scientism?

Homeopaths will recognise some of the themes in Dr Barry Morgan’s speech about how the rise in fundamentalism is polarising the world, in the current negativity about homeopathy from sceptic scientists who claim homeopathy has no scientific proof and should therefore be excluded from the already limited NHS provision despite high levels of reported effectiveness.  Is this homeophobia an indication of how extreme fundamentalist scientism will shape future health care?

http://news.bbc.co.uk/1/hi/wales/7156783.stm

The Archbishop of Wales, Dr Barry Morgan, has described a rise in “fundamentalism” as one of the great problems facing the world.

He focused on what he described as “atheistic fundamentalism”.

He said it led to situations such as councils calling Christmas “Winterval”, schools refusing to put on nativity plays and crosses removed from chapels.

In his Christmas message, he said: “Any kind of fundamentalism, be it Biblical, atheistic or Islamic, is dangerous.”

The archbishop said “atheistic fundamentalism” was a new phenomenon.

He said it advocated that religion in general and Christianity in particular have no substance, and that some view the faith as “superstitious nonsense“.

God is not exclusive, he is on the side of the whole of humanity with all its variety
Archbishop of Wales, Dr Barry Morgan

As well as leading to Christmas being called “Winterval,” the archbishop said “virulent, almost irrational” attacks on Christianity led to hospitals removing all Christian symbols from their chapels, and schools refusing to allow children to send Christmas cards with a Christian message.

He also said it led to things like “airlines refusing staff the freedom to wear a cross round their necks” – a reference to the row in which British Airways (BA) suspended an employee who insisted on wearing a cross necklace.

Dr Morgan said: “All of this is what I would call the new “fundamentalism” of our age. It allows no room for disagreement, for doubt, for debate, for discussion.

Children's nativity play

Only one in five schools perform a traditional nativity, say bishops

“It leads to the language of expulsion and exclusivity, of extremism and polarisation, and the claim that, because God is on our side, he is not on yours.”

He said the nativity story in St Luke’s Gospel, in contrast, had a “message of joy and good news for everyone”.

He said: “God is not exclusive, he is on the side of the whole of humanity with all its variety.”

Dr Morgan said it was “perfectly natural” to have a “coherent and rational debate about the tenets of the Christianity”.

But he said “virulent, almost irrational” attacks on it were “dangerous” because they refused to allow any contrary viewpoint and also affected the public perception of religion.

This month community cohesion minister Parmjit Dhanda said the UK should “celebrate” the role of Christianity in the country’s heritage and culture.

His comments came after Mark Pritchard, Conservative MP for The Wrekin, called a Westminster debate on “Christianophobia“, saying attempts to move Christian traditions to the “margins” of British life had “gone far enough”.

The National Secular Society has said Christians in the UK have “nothing to complain about“.

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