Baptist Vine

A few people from this board responded to my homeopathy posts when I made them on the BB, but nobody could refer me to any studies until I noticed the post from Olon on this board.

General response from the BB folks regarding homeopathy was skeptical.

Regarding studies, I have heard of the infamous Benviniste "study" out of NSERM, and the popular books that you can find in Chapters etc describe some trials in Africa (forget the specific country) that deal with childhood diarrhea and allegedly provide some justification for favouring a homeopathic remedy over placebo.

The African diarrhea example always seemed weak to me, after all, isn't the treatment for diarrhea simply to replace fluid and electrolytes? And even a homeopathic 'remedy' would have this to some degree.

I had no problem disbelieving the Benviniste 'study', but one aspect that made me wonder was the alleged replication by respectable universities, including participation by at least one prof here at the University of Toronto who is also into some studies of acupuncture and pain management. Benviniste might have been deluded, but several others as well seems to demand a closer look.

I've talked with my brother, a toxicologist at one of the pharaceuticals here, about the 'alleged' replication of Benviniste, published in what was probably one of the most controversial issues of 'Nature' ever. He speculates that if there is any legitimacy at all to the alleged replication, then this might indicate that some other kind of unknown phenomenon is occurring, but this would be a small effect and likely not at all what the homeopaths ascribe to their system. I'd like to find more about this alleged replication.

Most of the Christians I know wouldn't dispute the biological aspect of drug addiction - it's too fierce and real, although they would very likely describe those certain situations where an individuals pain is masked by behaviours that lead to addiction as primarily emotional and spiritual dilemmas. Methodone may be necessary to deal with the biological re-wiring that occurs in heroin addicts for example, but I think it's clear that other issues have to be dealt with as well.

[ June 13, 2002: Message edited by: Baptist Vine ]

[ June 13, 2002: Message edited by: Baptist Vine ]

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LeftCoast

Huh?

Care to try and make sense?

Ovazor

Homeopathy cannot be _disproven_. To do this would require homeopathy to be tested against every known medical condition, and I think new disorders are being discovered faster than this kind of testing could be done even if somebody found the time and resources do it. The question is rather, is there any point in continuing pouring resources into research which has continued for more than 200 years and still hasn't produced any definite positive results.

<a href="http://www.phys.hawaii.edu/vjs/www/med/homeop.html" target="_blank">Here</a> is list several studies in the references list.

<a href="http://www.thelancet.com" target="_blank">The Lancet</a> has some articles online for free, but you need to register. Try Linde, K., et al. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controled trials. The Lancet 1997; 350: 834-843 and be sure to read the comments to the article in Volume 351 Issue 9099 Page 365

The problem with homeopathy is, that despite two hundred years and hundreds of studies, no single medical condition to which homeopathy have been shown to be an effective treatment. Many individual studies, like the ones you provided link to, show positive results, but unfortunately the positive results tend to disappear if the quality of research work goes up. Also, the good-quality studies with positive results haven't been repeated with similar results. Therefore it is correct to say that there is no scientific evidence that homeopathy works, even if some studies suggest that it might.

It must be remembered, that research producing negative results are less likely to be published in high-profile journals which end into MEDLINE.

Ovazor

There has been several good-quality studies producing negative results. But the results of each is more or less: "Homeopathic remedy Y used for treating X did not cause effects significantly different from plasebo". I cannot even imagine a study which you could show and say "see, homeopathy is crap."

Of course. And if urine-drinking didn't work nobody would do it. There is the placebo-effect, which makes the users think the treatment worked, i.e. feel better. This doesn't mean that it actually has any effect to the disease.

So...If chiropract if effective for some special conditions (but not altogether safe), what does this tell about completely unrelated homeopathy? Precisely nothing. Besides, liquid homeopathic remedy would propable be effective against dehydration if taken in sufficiently large quantities.

Such study is not possible. This doesn't mean that homeopathy wasn't complete bunk. Here we have a "treatment" which
<ol type="A">[*]Despite more than two centuries of research still lacks a single condition against which it has been shown to be effective.[*]The claimed mechanism of which goes against the known laws of nature. [/list=a]

This leaves very little reason to suppose there's anything to it.

[ June 14, 2002: Message edited by: Ovazor ]

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acampbell

I was a consultant physician for 24 years at The Royal London Homeopathic Hospital, which is one of 5 homeopathic hospitals in the British National Health Service. In spite of, or because of, this background, I share a good deal of the skepticism voiced here; but the real truth about homeopathy is more complex than most people realize. For example, some recent research carried out at Belfast university and other centres seems to confirm some of the much-derided Benveniste results.

For anyone interested in reading the real inner story of homeopathy, which is significantly different from that believed by most critics and enthusiasts alike, I have an electronic book called "Homeopathy in Perspective" on my website:
<a href="http://www.acampbell.org.uk/homeopathy/" target="_blank">http://www.acampbell.org.uk/homeopathy/</a>

Oolon Colluphid

Many thanks to all for the excellent links and discussion!

acampbell, very interesting book. I’ll try to read it thoroughly. From a browse through though, you seem to be saying that:

(a) parts of homeopathy may have a small real effect. Are those the phytotherapy-overlap bits, or the more ‘normal’ dilute-it-out-of-existence homeopathic remedies?

(b) the rest of the effect is due to the psychotherapy aspect. I’m curious as to how this ‘more talking than my GP has time for’ psychotherapy differs from placebo. Isn’t the essence of a placebo that it works if the patient thinks it will? Surely this psycho-homeopathy has nothnig to do with the ‘medicine’ itself at all -- it’s working because of the social interactions, not because the medicine does anything?

Maybe I need to read your book properly, but it looks like traditional homeopathy still doesn’t actually work (ie as a medicine)...?

Cheers, Oolon

acampbell

Essentially, I am saying what you have understood from my book. There is probably more evidence for phytotherapy preparations, but some also exists for certain purely homeopathic medications, mainly however for isotherapy rather than pure homeopathy (a somewhat theological distinction). There has been a trend recently for research studies to blur all these distinctions, with remedies being applied externally as tinctures or even injected. It seems to me that this stretches the definition of homeopathy to breaking point or beyond.

In summary, I'd say there is some evidence to show that "homeopathy works" in the broadest sense, but the effect is small and not of great practical importance. (Possibly of some theoretical importance. however, if there really is a potency phenomenon.)

As for the placebo question: it really depends on whether you think that psychotherapy depends on the placebo effect. Actually this begs the question of what the placebo effect is anyway. For reasons I explain in another article on my site (Cartesian Dualism and the Concept of Medical Placebos), I should say it is a neurophysiological phenomenon (indeed, what else could it be?). I'd suggest that it is probably mediated by the limbic system.

It is too simple to say that the placebo effect is
just a matter of belief. A very interesting study was carried out in New York many years ago in which people were *told* that the medication they were receiving was a placebo, yet many of them had a therapeutic response! (Sorry, I don't have the reference to hand.)

[ June 18, 2002: Message edited by: acampbell ]

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Arrowman

Oolon: In response to the person who wants you to show "studies which disprove homeopathy", I'd say this: (and in response to Veil of Fire also):

1. The burden of proof is on the person making the claim. Can they show studies (published, peer-reviewed etc) that show the efficacy of homeopathy?

2. Even if such studies can be cited, they would demonstrate an effect of a particular remedy on a particular condition (which is always possible). What they do not do, is prove the effectiveness of homeopathy in general - which can only be done by proving the supposed scientific principles on which it is based.

"Conventional" medicine (I hate that qualification - it's medicine - but that's another story) can be said to be "generally effective" because it is based on known scientific principles (biochemistry etc) - whether or not any individual treatment is effective, needs to be subject of research. Homeopathy is not starting from the same point.

3. As a general critique of homeopathy in lay terms - Any medical treatment for which research is worthwhile needs imho to be either
(a) an extrapolation of a known scientific principle
- eg "we know that dihydroxyflugelmush dissolves Trebaxian molecules; let us examine whether it would be effective to inject it into patients with Trebaxian Fever..."
(b) an investigation of an observed but not fully understood effect
- eg "we have observed that Trebaxian Fever patients seem to recover faster when they spend time in the presence of Labrador Retrievers - coincidence? Or is there a hitherto unknown mechanism at work here? Let's find out."

Homeopathy is neither of these. It is not based on a known scientific principle, and there are no studies showing its effectiveness. (with apologies to acampbell - I have not yet read your paper and you may have a point...)

4. As others have said, studies "disproving homeopathy" are likely to be few and far between because (a) people have better things to spend time and money on, and (b) when it comes to publication, I'd expect that the journals are more likely to give space to articles which (a) propose, with support, new theories, or (b) criticise, with support, currently accepted theories over those which debunk assertions which have never been accepted or supported in the first place.

acampbell

You are correct in saying that one cannot prove homeopathy in general but only the efficacy or otherwise of individual treatments. This is because homeopathy actually contains two logically separate elements: the similia principle and the potency theory.

The potency theory can be tested scientifically, since it makes testable predictions, viz. that a potentized solution will produce measurable effects in vitro or in vivo. Experiments of this kind have been done, for example by members of the international research society called GIRI. There is no doubt room for argument about the interpretation of the results, and a major difficulty is that of trying to provide a plausible explanation for how ultramolecular dilutions might work.

The similia principle cannot, in my view, be tested scientifically. This is because similarity is a subjective assessment; similarity, like beauty, is in the eye of the beholder. Historically it is a heuristic principle which has been applied in many different ways. As I said previously, there is a tendency today for "homeopathy" to be interpreted very loosely and a number of recent clinical trials have used preparations which could hardly claim to be homeopathic at all.

We need to remember that homeopathy is not a unitary theory and in fact I doubt if it is possible to present a definition of homeopathy that would be accepted by all its practitioners. For example, "classical" homeopathy uses single doses of high potencies, whereas "complex" homeopathy uses mixtures of low potencies.