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Thursday, 15 September 2011

The Disinformation Campaign Against Homeopathy

Homeopathic medicine is at present one of the leading alternative therapies practiced by physicians in Europe (particularly France, Germany, UK and Italy) and Asia, especially on the Indian subcontinent (EU Commission, 1997; Prasad, 2007). Since homeopathy's development as a medical specialty in the early 1800s, it has been a leading alternative to orthodox medicine internationally, and it has posed an ongoing threat to the scientific, philosophical and economics of conventional medical care.
The homeopathic approach to healing maintains a deep respect for symptoms of illness as important defenses of a person's immune and defense system. While conventional medicine often tends to assume that symptoms are something "wrong" with the person that need to be treated, inhibited, suppressed or biochemically manipulated, homeopaths tend to assume that symptoms are important defenses of the organism that are most effectively resolved when treatments nurture, nourish or mimic the symptoms in order to initiate a healing process. Ultimately, these two different approaches to healing people have led to various conflicts.
It is common, for instance, for homeopaths to question the alleged "scientific" studies that conventional drugs are "effective" as treatments because of concern that many of these treatments tend to suppress symptoms or disrupt the complex inner ecology of the body and create much more serious illness. Just as opiate drugs of the 19th century gave the guise of healing, homeopaths contend that many modern-day drugs provide blessed short-term relief but create immune dysfunction, mental illness and other chronic disease processes in its wake. Further, the fact that most people today are prescribed multiple drugs concurrently, despite the fact that clinical research is rarely conducted showing the safety or efficacy of such practices, forces us all to question how scientific modern medicine truly is.
Homeopaths contend that increased rates of cancer, heart disease, chronic fatigue and various chronic diseases for increasingly younger people may result from conventional medicine's suppression of symptoms and disease processes. It is therefore no surprise that conventional physicians and Big Pharma have a long and dark history of working together to attack homeopathy and homeopaths.
The antagonism against homeopathy began when the highly-respected Saxon physician Samuel Hahnemann, M.D., first developed the system in the early 1800s. Hahnemann was a translator of leading medical and pharmacology texts and the author of the leading textbook used by pharmacists of his day.
Despite Hahnemann's high stature in medicine, pharmacology and chemistry, his strong critique of conventional medicine led to personal attacks against him by orthodox physicians as well as by the apothecaries (the drug makers of that time) who were philosophically and economically threatened by Hahnemann's work. When homeopathy arrived in America in 1825, it grew rapidly due to its widely-recognized success in treating infectious disease epidemics that raged in the early and mid-1800s. Then, when the American Institute of Homeopathy became the first national medical organization in 1844, a rival organization developed that proposed to stop the growth of homeopathy (Rothstein, 1985, p. 232). That organization called itself the American Medical Association, and this organization worked relentlessly to diminish the popularity and influence of this natural medicine.
Paul Starr's Pulitzer Prize-winning book, "The Social Transformation of American Medicine," acknowledged the stature that homeopathy achieved in America in the mid-and later 19th century:
"Because homeopathy was simultaneously philosophical and experimental, it seemed to many people to be more rather than less scientific than orthodox medicine" (p. 97).
U.S. President William McKinley even dedicated a special monument to Dr. Hahnemann in Washington, D.C., in 1900, which still stands today as the only monument in America's capital to the deeds of a physician.
However, because of the economic, philosophical and scientific threat that the paradigm and practice of homeopathy represents, the vitriol and antagonism still exists. It is therefore enlightening to expose the disinformation that is spread about homeopathy and then understand who is leading this disinformation campaign (the second part of this article will name names and discuss two individuals, one from the U.S. and one from the UK, who are presently leaders in the campaign against homeopathy).
The Myths Spread about Homeopathy
Like other propagandists, the homeopathy deniers seek to create disinformation by using three straightforward techniques. First, the homeopathy deniers make a simple false accusation, a lie, and repeat it constantly and consistently in an attempt to make it a new "truth." Second, this repetition is then done within the context of some legitimizing element. In the case of the homeopathy deniers, that element is a corruption of normal science, an analysis of scientific evidence that creates reasons (excuses) to exclude high-quality studies that show positive results (even those studies that have been published in leading conventional medical journals), and a mis-use of the concept of skepticism. The homeopathy deniers ignore or downplay the substantial body of evidence from basic science and clinical research, from outcome studies, from cost-effectiveness studies and from epidemiological evidence, and only quote from those studies that verify their own point of view, rather than reviewing the entire body of evidence.
The third component of the technique is to sell the lie to a vulnerable population in an attempt to have repetition from that group. In the case of the homeopathy deniers, the vulnerable groups are often young students of science who are enamored with the language and elitism of their newly-learned craft, but who lack the deep understanding and experience to realize that they are being "used" by the deniers. The homeopathy deniers also play on the fears of those older and established scientists and physicians and who are led to believe that "if homeopathy is true, then everything about modern medicine and science is false." This over-simplification of reality is commonly repeated.
However, just as quantum physics does not "disprove" all of physics -- but, rather,extends our capability to understand and predict events on extremely small and extremely large systems -- likewise, homeopathy does not disprove all of modern pharmacology but extends our understanding of the use of extremely small doses of medicinal agents to elicit healing responses.
History is replete with orthodox medicine and science being steadfastly resistant to different systems of medicine and paradigms of healing. Although, the average physician and scientist tends to be threatened by new ideas, a common attribute of leading physicians and scientists is a certain openness and humility due to the common and even expected evolution of knowledge.
It should be acknowledged upfront that homeopathic practitioners, patients and users of these natural medicines are often surprised and amazed at the results they experience in the treatment of themselves, children, infants, animals and even plants. In my observations over the past 40 years, most people are skeptical about homeopathy until they try it and see for themselves ... and there are then good reasons that tens of millions of people all over the world use and rely upon these natural medicines for a wide range of acute and chronic ailments. That said, the challenge is not just trying homeopathy, but first learning something about it so you can use it correctly and effectively.
Sadly, however, the homeopathy deniers tend to spread disinformation about homeopathy, including the following myths:
Myth #1: "There is no research that shows that homeopathic medicines work."
Such statements are a creative use of statistics, or what might be called "lies, damn lies and statistics." Actually, most clinical research studies conducted with homeopathic medicines show a positive outcome. However, if "creative statisticians" evaluate only the smaller number of large studies, a positive result is less likely, not because homeopathy doesn't work, but because these larger studies tend to dispense only one homeopathic medicine for everyone in the study, without any degree of individualized treatment that is typical of the homeopathic method (1). To claim that homeopathic medicines do not work using only these studies is as illogical as to say that antibiotics are ineffective just because they do not cure for every viral, fungal or bacterial infection.

Myth #2:
"The research studies showing that homeopathic medicines work are 'poorly conducted studies.'"
Wrong! Studies showing the efficacy of homeopathic medicines have been published in the Lancet, the British Medical Journal, Pediatrics, Pediatric Infectious Disease Journal, Cochrane Reports, Chest (the publication of the British Society of Rheumatology), Cancer (the journal of the American Cancer Society), Journal of Clinical Oncology (journal of the Society of Clinical Oncology), Human Toxicology, European Journal of Pediatrics, Archives in Facial Plastic Surgery, Archives of Otolaryngology -- Head and Neck Surgery, Journal of Clinical Psychiatry and many more (2). All of these studies were randomized, double-blind and placebo controlled. Further, because of bias against homeopathy, these studies have been scrutinized rigorously, perhaps even more rigorously than is usual.
The weak response from the homeopathy deniers is that the above studies are "cherry-picked." Well, it seems that there are a lot of "cherries" (clinical studies that verify the efficacy of homeopathic medicines). Also, numerous of the above leading medical journals have published meta-analyzes of clinical trials on specific diseases and have shown that homeopathic medicines have significantly more benefits than does a placebo. And further, the deniers erroneously equate the "negative" studies as evidence that the whole system of homeopathy does not work when, in fact, these studies are usually of a preliminary nature that explored the use of one or a small handful of remedies for a specific condition.
Ironically, the one review of research that the homeopathic deniers most commonly assert as strong evidence that there's no difference between homeopathic medicines and placebo (Shang et al, 2005) has been shown to be bad or certainly inadequate science (Walach, et al, 2005; Fisher, 2006; Rutten, 2009, Rutten and Stolper, 2008; Lüdtke and Rutten, 2008).

Myth #3:
"12C is like one drop in the entire Atlantic Ocean."
Pure fantasy (and fuzzy math)! In fact, the 12C dose requires 12 test tubes, and 1 percent of the solution is drawn from each of the 12 test tubes. It is also very typical for the "deniers" of homeopathy to assert with a straight face that the making of a single homeopathic medicine requires more water than exists on the planet. It seems that the skeptics are so fundamentalist in their point of view that they consciously or unconsciously mis-assume that the dilutions used in homeopathy grow proportionately with each dilution; they assume that each dilution requires 10 or 100 times more water with each dilution -- which they don't, and even the most elementary articles and books on homeopathy affirm this fact. Sadly (and strangely), most of the skeptics of homeopathy seem to read each other's misinformation on homeopathy and have a propensity to spin the reality of what homeopathy is in ways that misconstrue it.
Myth #4: "There is nothing in a homeopathic medicine. It is just water."
Ignorance and direct disinformation. First, a large number of homeopathic medicines that are sold in health food stores and pharmacies are what are called "low potencies," that is, small or very small doses of medicines, most of which are in a similar dose to which certain powerful hormones and immune cells circulate in our body. Second, using samples of six different medicines made from minerals, scientists at the Department of Engineering at the Indian Institute of Technology have consistently confirmed that the starting substance is still present in the form of nanoparticles of the starting minerals even when the medicine has undergone hundreds of serial dilutions -- with vigorous shaking in between each dilution, as per the homeopathic method (Chikramane, Suresh, Bellare, 2010) (3). Further, leading chemistry and physics journals have published other research to confirm that there are differences between water and "homeopathic water" (Elia and Niccoli, 1999; Elia, Napoli, Niccoli, et al, 2008; Rey, 2003)
Myth #5: "If we do not presently understand how homeopathic medicines work, then, they cannot work. It's witchcraft."
Lame on face value. How many more times in history do scientists and others need before they realize that we do not understand a lot of nature's mysteries, but our lack of understanding does not mean that the mysteries are not real. Calling homeopathy "witchcraft" clearly is someone's fear of what they do not know or understand, and a common observation from history is that whenever one goes on a witchhunt, a witch is found (one way or another). The fact that there is a small but significant body of basic sciences research that has shown physical and biological effects from homeopathic medicines tends to be ignored (Endler, Thieves, Reich, et al 2010; Witt, Bluth, Albrecht, et al, 2007). To publish in peer-reviewed scientific journals is not a common practice from witches (or warlocks).
Dr. Karol Sikora is a respected oncologist and dean of the University of Buckingham medical school in England. Sikora has expressed serious concern about the "Stalinist repression" that certain skeptics of homeopathic and alternative medicines engage (Sikora, 2009). Sikora has harshly criticized "armchair physicians" and others who seem to have little or no experience in using these treatments with real patients.
One other critical piece of evidence to show and even prove the unscientific attitude of the homeopathy deniers is that they now wish to close off all discussion of the efficacy of homeopathic medicines (Baum and Ernst, 2009). These medical fundamentalists actually discourage keeping an open mind about homeopathy. One must question this unscientific attitude that select antagonists to homeopathy embody, and one must even wonder why they maintain such a position.
The second part of this article will provide further specific evidence of the unscientific attitude and actions from those individuals and organizations who are leading the campaign against homeopathy. A leading antagonist to homeopathy from the U.S. and another from the UK will be discussed in order to shed light on this important debate in health care. Stay tuned to find out who they are and why they maintain their point of view.

FOOTNOTES:

(1) Although individualization of treatment is one of the hallmarks of the homeopathic method, there are exceptions to this common rule. For instance, there have been four large randomized, double-blind and placebo-controlled studies that have shown that homeopathic Oscillococcinum is effective in treating people with influenza or influenza-like syndrome (Vickers and Smith, 2006).

(2) References to these and other studies can be found in the following article: The Case FOR Homeopathic Medicine: Historical and Scientific Evidence -- http://www.huffingtonpost.com/dana-ullman/the-case-for-homeopathic_b_451187.html
(3) Transmission Electron Microscopy (TEM), electron diffraction by Selected Area Electron Diffraction (SAED), and chemical analysis by Inductively Coupled Plasma-Atomic Emission Spectroscopy.
REFERENCES:

Baum M, Ernst E. Should we maintain an open mind about homeopathy? American Journal of Medicine. 122,11: November 2009. doi:10.1016/j.amjmed.2009/03.038. http://www.amjmed.com/article/S0002-9343(09)00533-6/fulltext
Chikramane PS, Suresh AK, Bellare JR, and Govind S. Extreme homeopathic dilutions retain starting materials: A nanoparticulate perspective. Homeopathy. Volume 99, Issue 4, October 2010, 231-242. http://www.homeopathy.org/files/HomeopathyandNanoparticle.pdf

Elia V, and Niccoli M. Thermodynamics of Extremely Diluted Aqueous Solutions, Annals of the New York Academy of Sciences, 879, 1999:241-248. http://www.ncbi.nlm.nih.gov/pubmed/10415834/
Elia V, Napoli E, Niccoli M, Marchettini N, Tiezzi E(2008). New Physico-Chemical Properties of Extremely Dilute Solutions. A Conductivity Study at 25 °C in Relation to Ageing. Journal of Solution Chemistry, 37:85-96. http://www.springerlink.com/content/v27884306836g251/
Endler PC, Thieves K, Reich C, Matthiessen P, Bonamin L, Scherr C, Baumgartner S. Repetitions of fundamental research models for homeopathically prepared dilutions beyond 10-23: a bibliometric study. Homeopathy, 2010; 99: 25-36. http://www.similima.com/homeopathyresearch/thesis108.pdf
EU Commission report evaluating implementation of Homeopathy Directives 92/73 EEC and 92/74/EEC, 1997.
Fisher P, 2006. Evid Based Complement Alternat Med. 2006 March; 3(1): 145-147.
Published online 2006 January 26. doi: 10.1093/ecam/nek007 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375230/
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Prasad R. Homoeopathy booming in India. Lancet, 370:November 17, 2007,1679-80. http://www.ncbi.nlm.nih.gov/pubmed/18035598
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Rutten L, 2009. http://www.dokterrutten.nl/collega/Liga09.pdf
Rutten ALB, Stolper CF, The 2005 meta-analysis of homeopathy: The importance of post-publication data. Homeopathy. October 2008, doi:10.1016/j.homp.2008.09/008. http://www.ncbi.nlm.nih.gov/pubmed/19371564
Shang A, Huwiler-Müntener K, Nartey L, Jüni P, Dörig S, Sterne JA, Pewsner D, Egger M. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. The Lancet. 366,9487, 27 August 2005:726-732. http://www.ncbi.nlm.nih.gov/pubmed/16125589
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Vickers A, Smith C. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD001957. DOI: 10.1002/14651858.CD001957.pub3. http://www.ncbi.nlm.nih.gov/pubmed/14973976
Walach H, Jonas W, Lewith G. Are the clinical effects of homoeopathy placebo effects? Lancet. 2005 Dec 17;366(9503):2081; author reply 2083-6. http://www.ncbi.nlm.nih.gov/pubmed/16360778
Witt CM, Bluth M, Albrecht H, Weisshuhn TE, Baumgartner S, Willich SN. The in vitro evidence for an effect of high homeopathic potencies--a systematic review of the literature. Complement Ther Med. 2007 Jun;15(2):128-38. Epub 2007 Mar 28. From 75 publications, 67 experiments (1/3 of them replications) were evaluated. Nearly 3/4 of them found a high potency effect, and nearly 3/4 of all replications were positive. http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=17544864&cmd=showdetailview&indexed=google

Courtesy:
Dana Ullman
Evidence based Homeopath

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