vendredi 28 septembre 2007

Atomul de rata



Vine toamna, miroase a struguri copti si a dulceata de gutui dar apar si ploile si frigul si , inevitabil, reincep discutiile despre remediul miracol care ne apara de raceli: atomul de rata vandut de laboratoarele Boiron sub numele de Oscillococcinum. Pe forumuri se face schimb de "scheme de tratament" si au loc discutii aprinse despre cate graunte trebuie sa inghita un copil de 12 luni cumparativ cu unul care a implinit 2 anisori. Se acorda cu generozitate sfaturi care mai de care mai absurde "sa nu se atinga granulele cu mana ca li se ia din 'energie'", "sa fie tinute sub limba ca sa treaca direct in sange" (?!!?), "sa nu ne spalam pe dinti inainte si nici dupa", "sa avem stomacul gol si capul descoperit" ... sa ne dam de trei ori peste cap si sa recitam catelus cu parul cret stand intr-un picior in timp ce inghitim pilulele (pe astea doua le-am inventat dar se incadreaza perfect in stilul discutiei)

Ce este de fapt Oscillococcinumul sau cum a reusit monsieur Boiron sa vanda o biata rata cu 20 de milioane de euro?!
'Remediul' a fost intradevar inventat pe la inceputul secolului 20, inventatorul lui, francezul Joseph Roy (1891-1978), credea ca ficatul de rata ar contine o bacterie, Oscillococcus, care ar provoca gripa (spaniola la vremea aia ca era la 'moda' pe atunci). Tot el credea ca bacteria asta mai provoaca printre altele si reumatism, tuberculoza, eczema, rujeola si cancer. Probabil omul o banuia responsabila si de inceperea primului razboi mondial si de faptul ca il insala nevasta. Nimic din toate acestea nu a fost dovedit ulterior, bacteria respectiva nu exista, s-a dovedit ca gripa e provocata de fapt de virusi, despre cauzele celorlalte boli mentionate nici nu poate fi vorba.
Iata si procedeul de fabricatie al Oscillococcinumului de azi, edificator pentru 'eficacitatea' acestui remediu:
1) un flacon steril de 1l e umplut cu un amestec de suc pancreatic si glucoza
2) se adauga 25g ficat de rata si 15g inima de rata
3)flaconul se pastreaza timp de 40 de zile timp in care ficatul si inima se descompun
4) acest preparat e plasat intr-un recipient. recipientul este golit, apoi umplut cu apa ultrafiltrata si scuturat. Se obtine astfel dilutia (korsakoviana) 1K
5) operatiile de mai sus (se goleste recipientul, se umple cu apa, se scutura) sunt repetate de 200 de ori pentru a obtine dilutia de 200K

Asta inseamna ca flaconul in care s-a aflat preparatul initial este clatit de 200 de ori cu apa chioara, iar apa de la ultima clatire se foloseste pentru a impregna granulele de lactoza care se vand apoi sub numele de oscillococcinum. Adica un fel de spalatura de vase amestecata cu lactoza, asta e tot ce contine medicamentul 'miracol' destinat sa "previna starile gripale"
Se poate calcula ca intr-un tub de 1 g se afla mai putin de un atom din ratza initiala...asta da rentabilitate!

In "Guide Giroud-H agége de tous les médicaments" (un fel de DEX al tuturor medicamentelor existente pe piata franceza) singura remarca pentru medicamentele homeopate este: "Indicatii ne-admisibile". Numai Oscillococcinum face exceptie, in dreptul lui scrie: "Sfatul nostru este sa inlocuiti acest produs cu o friptura de rata, va fi tot la fel de eficace contra gripei. In acelasi timp rugam laboratoarele Boiron sa mai lase ratele in pace."

20 commentaires:

Anonyme a dit…

Superb pamflet si trebuie tratat ca atare.
Nimic medical, nimic stiintific. Doar vorbe "preluate' de la "babe".
Azi avem pretentii. Sau ne place sa credem ca avem.
Oscillococcinum are "proba timpului" similara cu a aspirinei. Si nici despre aspirina nu s-a stiut mai nimic stiintific timp de 60 de ani. Dar clinic a fost utila si a fost utilizata. Vreme indelungata a fost blamata.In ultima perioada este adulata - salveaza vieti. Prelungeste vieti. Oare trebuie sa asteptam 60 de ani ca sa incepem sa intelegem ca nu stim tot? Ca nu stapanim tot? Ca nu putem controla tot? Ca suntem uneori incapabili sa intelegem tot? Oare "minima moralia" medicala si stiintifica nu ne indeamna sa ne indoim de tot si toate? Oare ai dreptate? Argumentele sunt "subtiri". Neconvingatoare stiintific.
Oricum, ca si pamflet, este un articol frumos si arata ca ai suficient talent. Felicitari. Continua.
Dr.Cadar Sorin Dan
medic primar ORL

Alexandra a dit…

Din pacate nu este un pamflet, este modul de preparare si istoria Oscillococcinumului, afirmatiile pot fi verificate foarte usor (citind prospectul "medicamentului" de ex sau cautand ce spun insisi homeopatii:
- aici sau aici. )

Insa e adevarat ca pare o gluma proasta a dlui Boiron la adresa milioanelor de pacaliti care se reped in fiecare an sa cumpere cate un atom de ficat de rata sperand ca acesta ii va feri de "starile gripale" (ce or mai si fi alea? nu se stie exact da' suna bine muritorului de rand consumator de ficat de rata)

Aspirina n-are nimic de a face cu extractele de ficat de rata, in primul rand pentru ca in fiertura de salcie a lui Hippocrate chiar se afla o substanta activa (acidul salicilic) chiar daca el a fost extras si caracterizat mult mai tarziu. Care e "substanta minune" care se afla in ficatul de rata? Ca osciloccocusul s-a dovedit a fi doar o fantezie a dlui doctor Roy. Si poate doar in ficatul lui Donald Duck sa mai existe vreo substanta necunoscuta si necaracterizata de catre stiinta de azi.

In al doilea rand chiar presupunand ca in ficatul de rata se afla o substanta inca necunoscuta si misterioasa (?) care ne-ar proteja de gripa (desi nici un astfel de efect nu a fost dovedit si desi inventatorul ei credea ca vindeca... cancerul!!).... ce efect poate avea o substanta (oricare ar fi aceea) diluata intr-un volum de apa egal cu talia a 3 Universuri? (asta inseamna dilutia de 200K. Un singur atom diluat intr-un volum de apa de talia Universului n-ar da decat marunta dilutie 40CH)

In al treilea dar nu in ultimul rand nici un studiu facut dupa regulile stiintifice nu a demonstrat vreo eficacitate a acestui remediu mai mare decat a efectului placebo.

Daca acestea le considerati "argumente subtiri" va astept cu "argumentul decisiv" in favoarea consumului ficatului de rata sub forma de spalatura de vase homeopatica in locul celui la gratar.

Pana atunci publicitatea si vanzarea Oscillococcinum in farmacii ramane o mare sarlatanie la fel cu homeopatia

Anonyme a dit…

In fiertura de salcie a lui Hippocrate ( = extract apos )chiar se afla o substanta activa (acidul salicilic) chiar daca el a fost extras si caracterizat mult mai tarziu. Oare nu poate fi valabil acelasi traseu si pentru extractul de focat de rata? Acum, din punct de vedere tehnologic nu este posibil!! Tehnologic. Nici Hipocrate nu a avut atunci tehnologia. Nici noi acum. Este vina noastra a medicilor sau a fizicienilor care nu au capacitatea actuala de a pune la dispozitie tehnologia de laborator necesara?
Se doresc studii? Da-ti-ne tehnologia si o vom face.
Cu respect
Dr.Cadar Sorin

Alexandra a dit…

Nu ati citit tot mesajul meu inainte de a raspunde, spuneam acolo ca nu e vorba doar de substanta "nedescoperita inca" existenta doar in ficatul de rata desi e foarte greu de crezut ca mai exista o molecula necunoscuta care se plimba nevazuta pe acolo (ba mai mult ca aceasta molecula ar da simptome asemanatoare cu ale gripei!)
Era vorba si de faptul ca aceasta misterioasa molecula e diluata intr-un volum de apa care depaseste de cateva milioane de ori distanta de la pamant la luna!(ca si cum am dilua o picatura de extract de ficat de rata intr-un vas cu diametrul de... 48 de ani lumina!) Prin urmare, oricare ar fi "substanta" necunoscuta ea oricum nu se mai regaseste demult in produsul vandut in farmacii el fiind doar o simpla biluta de zahar colorat.

Ca sa fie mai simplu de inteles, haideti sa facem calculul invers:
- medicul recomanda 3 pilule de aspirina de 1g /zi dar farmacistul nu are decat pilule de 500mg => cate pilule trebuie sa iau ca sa respect doza?
- in acelasi mod homeopatul recomanda 3 bilute de ficat de rata (pardon, Anas Barbariae) in dilutia de 20CH dar farmacistul nu are decat bilute de 30CH => cate bilute trebuie sa iau ca sa respect indicatia?
Va astept cu calculele.

In al treilea rand, asteptam degeaba 'noile tehnologii' care sa sondeze ficatii de rata, oricum acestea vor fi inutile pentru ca
1) principiul similitudinii nu exista
2) Osciloccocinumul (ca toate celelalte "remedii") nu are si nu a avut niciodata un efect superior placebo.

Anonyme a dit…

Am citit cu mare atentie. Boala pacientilor precum si a farmacistilor este sa "adapteze" recomandarea medicala data de medic. Deci aici s-a ajuns. Adaptam!? Nu, respectam.
De ce nu exista principiul similitudinii? Scoatem cuvantul din dictionar? Etichete, etichete, etichete. Este clar. Renunt sa mai fiu in situatia de a face un schimb de idei medicale cu cineva care nu detine nici cele mai mici notiuni de fiziologie, fiziopatologie, histologie, semiologie, farmacologie, farmacochinetica, etc, etc, etc. Despre principiul similitudinii medicii invata la facultate in anul 2 de studii. In toata lumea, la toate facultatile de medicina din lume. Deci...sunt nedrept. Nu am cum sa inteleg ceea ce nu am studiat. Este valabil pentru toti!!! Astfel incat ma voi intoarce la site-urile mele medicale unde interlocutori sunt medici sau au habar de asta. Macar ei nu sunt fanatici sau absolutisti. La cate vede un medic in activitate...are bunul simt sa se indoiasca de tot si de toate si sa nu fie absolutist.
Placebo este un mod de tratament. In cazul in care nu acceptam asta...desfiintam psihologia. Tot cercetatorii au stabilit si efectul placebo al Xanax, Seroxat etc. Si totusi de producatorii acestor medicamente nu se leaga nimeni. De ce? Pai...Pfizzer? Glaxo? etc? Nu te poti opune unor giganti financiari atata timp cat au bugetul de publicitate pe 1 an cat beneficiul Boiron pe 20 de ani. Dar asta nu se pune. Eu sunt in sistem si stiu cum functioneaza. Crede-ti-ma. Siko = vizionati documentarul. Este real. Omul s-a prins. A inteles.
Nu fiti fanatici, nu este bine. Valabil pentru toata lumea.
La revedere
Dr.Cadar Sorin Dan
dr.cadar@homeopatie.ro

Alexandra a dit…

>>Boala pacientilor precum si a farmacistilor este sa "adapteze" recomandarea medicala data de medic.

Era doar o propunere de exercitiu teoretic ca sa intelegem si noi mai bine analogia cu aspirina. Apreciez insa modul in care ati eschivat raspunsul:) Calculul era totusi extrem de simplu: 3 bilute 20CH contin tot atata... nimic, ca si 3 bilute 30CH. Pentru simplul fapt ca legile chimiei (alea care se invata in liceu) ne spun ca incepand de la dilutia 12CH "remediile" nu mai contin nici macar un singur atom de substanta activa (cf numarului lui Avogadro)

>>>Despre principiul similitudinii medicii invata la facultate in anul 2 de studii. In toata lumea, la toate facultatile de medicina din lume.<<

La ce materie? Istoria samanismului? Biochimia farmecelor?:) Cel care se declara "autorul" acestui principiu este neamtul "parinte al homeopatiei".. si nu prea vad ce ar putea invata medicii de la dansul

>>>Placebo este un mod de tratament. In cazul in care nu acceptam asta...desfiintam psihologia. <<<

Cu asta sunt de acord, homeopatia este placebo, nimeni nu a sustinut altceva. Iar din DEX aflam ca:

PLACÉBO s.n. (Farm.) Medicament (sau preparat) INACTIV prescris fie pentru a-i face plăcere pacientului, fie în scopuri experimentale, pentru a studia efectele farmaceutice ale medicamentului şi reacţiile psihice ale pacientului.

E normal insa sa vindem apa chioara (sau ficati de rata) in farmacii sub pretext ca actioneaza ca...placebo?
In rest, dvs stiti foarte bine ca toate medicamentele au efect placebo. Ba chiar o simpla vizita la medic are acest efect, un "pupa mama si trece" are efectul asta. De aceea medicamentele sunt testate in dublu orb (nici pacientul nici medicul nu stiu daca au primit/prescris apa chioara sau substanta activa) tocmai ca sa se poata determina eficacitatea medicamentului dincolo de actiunea acestui efect. La aceste teste homeopatia a esuat lamentabil, nu s-a aratat niciodata superioara placebo. Cu adevaratele medicamente lucrurile stau exact invers.

Sa nu-l plangem pe dl Boiron, este unul din cei mai bogati oameni din fr. Nici nu-i de mirare daca vinde un ficat de rata cu cateva milioane de euro:)
Cifrele de afaceri ale Boiron nu sunt deloc neglijabile iar in ceea ce priveste publicitatea... vedem mult mai des pe ecrane reclame la ficatul de ratusca contra "starilor gripale" decat reclama la Viagra:)

Insa dvs cunoasteti foarte bine toate aceste lucruri insa incercati sa va aparati "afacerea" in fata eventualilor cititori utilizatori de homeopatie:)

Anonyme a dit…

Homeopathy in Sweden
Professor George Wahlenberg of Uppsala did not practice but knew Stapf in Germany. He discussed homeopathy with several others, including Peter Jacob Leidbeck of Stockholm who began practice and visited Hahnemann in 1832.
A journal was published in Stockholm in 1855-56. The first Organon in Swedish was translated by Liedbeck in 1835.
The practice of homeopathy was "almost unknown in 1902." There was one pharmacy with low potencies in the country. There were eight homeopaths listed in 1911.
In 1907, a journal called Homoeopatiens Seger (The Victory of Homeopathy) was published, under editor Dr. Helledag. It lasted five years. In 1909 the first homeopathic association was established-Hahnemann-föreningen- in Göteborg. Its aim was to start a free clinic for poor people, and also to start a homeopathic hospital. However, for different reasons, it was never really maintained.
In 1912 Svenska homeopatiska Läkarföreningen (Swedish Homeopathic Society for Physicians) was started by Dr. Gröndal and Dr. Helledag. All practicing homeopathic doctors were members. In 1912 the faculty of four medical schools refused to recognize homeopathy as a legitimate practice. Said the 1911 Directory: "Many allopaths use homeopathy on themselves and their families, but are afraid, due to inexperience, to try it on their patients."
During this time there were also conflicts between medical doctors practicing homeopathy and several practicing homeopaths who were not licensed physicians, and whose skill level was sorely questioned. In 1915 Svenska föreningen for Vetenskaplig Homeopati (Swedish Association for Scientific Homeopathy) was established. The main aim was to make homeopathy reach the same status as allopathy. The association published a journal, called Sigyn. In 1919 the name was changed into Homoeopatiens Seger and the editor, once again, was Dr. Helledag, The association still exists and its journal today is called Tidskrift för Homeopati (Journal of Homeopathy).
In 1919, the Government decided homeopathic remedies could be sold freely, without a prescription. In 1928 an association for non-medical homeopathic practitioners, Svenska Homeopaters Riksförbund, was established. Its name today is Svenska Homeopraktikers Riksförbund (SHR). Three times- in 1944, 1952 and 1955- the Government attempted to ban the sale of homeopathic medicines, but all efforts to do so failed. In 1941 and 1950 there were attempts to forbid lay homeopaths from practicing, but these also failed.
In January 1961 the prevaling law concerning the practice of homeopathy came into force. Even though there are limitations on practicing homeopathy, it was a victory for the homeopathic community. One of the laws forbids homeopaths (and other alternative practitioners) treating patients under eight years old.
Harald Ramme, wrote several short materia medicas based on his own experiences. In 1971 he founded the first school in Sweden, Arcanum in Göteborg, which is now run by his son. The school also runs a publishing enterprise, and has translated some homeopathic books into Swedish. The elder Ramme also started producing homeopathic remedies. The pharmacy is called DCG Farmaceutiska AB, and it is the main supplier of homeopathic remedies in Scandinavia.
In 1985 Svenska Akademin för Klassisk Homeopati (SAKH) was established with 15 members, growing to about 90 during its 13 years of existence. Today, practicing homeopaths in Sweden can belong to the SAKH, the SHR, and the Hahnemann Collegium (HC), founded in 1988. Two organizations whose members use different therapies including homeopathy are Svenska Naturmedicinska Sällskapet (SNS) and Svenska Naturläkarförbundet (SNLF).
The total membership in the three homeopathic organizations is about 250 (some are members of two organizations). In Stockholm (one million population) 40 homeopaths are in the yellow pages. Medicina Futura (MF), started in 1995, teaches from the ECCH guide lines. The homeopathic part of the school is a three year, part-time course.
Nordiska Akademi för Klassisk Homeopati (NAKH), is a three year part time school of homeopathy. Students have to have a nurse's level of medical training to be accepted. It started teaching in 1986. Naturmedicinska Fackskolan (NMF), is a five year part-time, or two year, full-time, school of medicine homeopathy and other alternative methods. It started in 1975. Nordiska Hahnemann Institutet (NHI), provides a course of homeopathy, and is associated with a school for medical studies.
Practical training for graduate homeopaths is a problem in Sweden, since there are few well-trained homeopaths with experience. There are eight pharmacies, several of them making their own remedies. The country is represented in the LMHI.
Sorry - the things are changing step by step.

Anonyme a dit…

http://www.webhomeopath.com/uk/aboutus.php

Anonyme a dit…

In the August 27 issue, The Lancet published an article titled “Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy”. It was based on a metaanalysis done by Aijing Shang, Karin Huwiler-Müntener, Linda Nartey, Peter Jüni, Stephan Dörig, Jonathan A C Sterne, Daniel Pewsner, and Matthias Egger (of Switzerland’s University of Berne).

The Method Used

Placebo-controlled trials of homoeopathy were identified by a comprehensive literature search, which covered 19 electronic databases, reference lists of relevant papers, and contacts with experts. Trials in conventional medicine matched to homoeopathy trials for disorder and type of outcome were randomly selected from the Cochrane Controlled Trials Register (issue 1, 2003). Data were extracted in duplicate and outcomes coded so that odds ratios below 1 indicated benefit. Trials described as double-blind, with adequate randomization, were assumed to be of higher methodological quality. Bias effects were examined in funnel plots and meta-regression models.

Findings of the meta-analysis

110 homoeopathy trials and 110 matched conventional-medicine trials were analyzed. The median study size was 65 participants (range ten to 1573). 21 homoeopathy trials (19%) and nine (8%) conventional-medicine trials were of higher quality. In both groups, smaller trials and those of lower quality showed more beneficial treatment effects than larger and higher-quality trials. When the analysis was restricted to large trials of higher quality, the odds ratio was 0·88 (95% CI 0·65–1·19) for homoeopathy (eight trials) and 0·58 (0·39–0·85) for conventional medicine (six trials).

Interpretation

Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, 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.

What did the Lancet editorial say?

The editorial was titled ‘The End of Homeopathy’ and it basically says that homeopathy is nothing but placebo and the doctors should be ‘bold and honest’ to tell this truth about homeopathy to their patients. It also says that the lack of ‘personalized care’ also drives people towards alternative means like homeopathy.

Some more facts about the analysis.

Out of the total 110 studies used, the percentage of studies as per clinical topics was as follows:

Respiratory-tract infections 21 (19%)
Pollinosis and asthma 16 (15%)
Gynaecology and obstetrics 14 (13%)
Surgery and anaesthetics 12 (11%)
Gastroenterology 12 (11%)
Musculoskeletal disorders 11 (10%)
Neurology 10 (9%)
Other 14 (13%)

Among homoeopathy trials 48 (44%) concerned clinical homoeopathy, 35 (32%) complex homoeopathy, 18 (16%) classical homoeopathy, and eight (7%) isopathy. On page two (p. 727), researchers, led by Aijing Shang, PhD, of the University of Berne, described the four types of homeopathy studies they included in their meta-analysis:

* Studies using "clinical homeopathy". Patients did not receive a comprehensive homeopathic history and all patients received a single, identical remedy. This accounted for 48, or 44% of the homeopathy studies analyzed in the Lancet meta-analysis.
* Studies using "complex homeopathy". Patients did not receive a comprehensive homeopathic history and all patients received a mixture of different commonly used homeopathic remedies. This accounted for 35, or 32% of the homeopathy studies analyzed.
* Studies using "classical homeopathy". Patients were given a comprehensive patient history and received a single, individualized remedy. This accounted for 18, or 16% of the homeopathy studies analyzed.
* Studies using "isopathy". Patients did not receive a comprehensive homeopathic history and all patients received a diluted substance that was believed to be the cause of the disorder (e.g. pollen in seasonal allergies). This accounted for 8, or 7% of the homeopathy studies analyzed.

What are the salient points – in simple words?

The study says that there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions.

The studies which were larger and of higher quality showed that homeopathy is no different than placebo, whereas smaller studies show significant results in favor of homeopathy. But publication bias and other factors may account for it. Here is a quote (page 7 of the paper) from the authors:

For example, for the eight trials of homoeopathic remedies in acute infections

of the upper respiratory tract that were included in our sample, the pooled effect indicated a substantial beneficial effect (odds ratio 0·36 [95% CI 0·26–0·50]) and there was neither convincing evidence of funnel-plot asymmetry nor evidence that the effect differed between the trial classified as of higher reported quality and the remaining trials. Such sensitivity analyses might suggest that there is robust evidence that the treatment under investigation works. However, the biases that are prevalent in these publications, as shown by our study, might promote the conclusion that the results cannot be trusted.

What is the uproar about?

Homeopaths believe that homeopathy works. They are not ready to accept the findings of this meta-analysis. They consider the methodology used has many flaws. They also find the title of the editorial ‘The End of Homeopathy’ ridiculous!

What are the flaws then?

Statistically – there are no flaws in the study. The people have done their math right! But then statistics depend upon the numbers from which they are crunched. So the next question is - were the numbers right? For most part, yes! The people have taken due care in finding the placebo-controlled studies, matching the numbers of homeopathic and conventional medicine studies, their clinical types, relevance and every other statistical aspect. They have even tried to find difference between various ‘types’ pf homeopathy but the statistical difference was not significant.

What’s wrong then?

The premise, the methodology and the trials covered. The premise is that the same methodology can be applied to homeopathy and allopathy. The motive is to compare ‘specific effects’ of homeopathic remedies with conventional medicine. This premise itself is flawed.

* Homeopathic medicines do not show ‘specific effect’. They show ‘individualized’ effect. What this means is that in homeopathy there are no medicines that can be given to take care of the ‘fever’ or the ‘headache’. The symptoms of the medicine have to match closely with the symptoms of the patient. There are hundreds of medicines in homeopathy that may be used for ‘headache’ depending upon the exact symptoms. If you give a particular remedy (known to cure headache, like Belladona) to 100 people for ‘headache’, without due individualization, you are going to fail in more than 80% of the cases. The cause, the signs, symptoms, modalities and accessory symptoms of the patient should match with the symptom-picture of Belladona. Otherwise, failure is natural.
* The skeptics counter this statement by saying that if there are no ‘specifics’ in homeopathy, then why do you suggest ‘Arnica’ for every injury? Again this is a misconception. Arnica will only work if the symptom picture that arises after injury matches that of Arnica. Otherwise some other remedy like Rhus-tox, Ruta, Symphytum, Calc-flour, Aconite, Bellis-p, Calendula, Camphora, Causticum, Cicuta, Conium, Hammamelis, Hypericum, Ledum, Plantago, Pulsatilla, Staph etc may come into play. There are actually more than 217 homeopathic remedies listed for injuries! Still, it is true that homeopaths often suggest arnica in cases of injuries but then conscientious homeopaths also know that in large number of cases such a prescription does not work. This does not show that anything is wrong with the system or the law. It just reflects the personal deficiency of a homeopath.
* People can also counter the first statement by saying that in this meta-analysis, there was no significant statistical difference between individualized and non-individualized trials. But look at the numbers again. Only 18 studies, out of the total 110 have been classified as ‘classical’. There has been no reference as to how many of these ‘classical’ trials were of ‘high-quality’. If you consider the sample size of these trials and filter only the ‘high-quality’ trials, on which most of the assumptions of this meta-analysis are based, the remaining sample size will itself become statistically insufficient to draw conclusions or to compare it with conventional medicine trials.
* The measure of benefit is also controversial. During a correct homeopathic treatment, symptoms are often (not always) known to aggravate initially for a short period. An objective scale measurement and short-term follow-up may show negative results even if the treatment is appropriate. I will clarify this further with an example. Suppose a patient of atopic dermatitis (eczema) comes to a homeopath. After administration of correct homeopathic medicines, the patients’ sense of well-being will improve but there may (not necessarily) be a transient worsening in the symptoms of eczema. This period of aggravation (called homeopathic aggravation) can vary from a few hours to a few months. If an assessment is made during this period on an objective scale based on signs and symptoms of the disease, the results are not going to be in favor of homeopathy. But homeopaths know that such an occurrence is good for the patient and once the short aggravation subsides, there will be full recovery.
* Another point of divergence in approach is the homeopathic concept of ‘return of old symptoms’ or ‘Hering’s Law of Cure’. This law states that symptoms disappear in the reverse order of their appearance. Even the conventional medicine knows that when eczema patients are treated with corticosteroids, the rate of development of asthma is very high and that patients of asthma often develop hypertension (approximately three-fourths of children with atopic dermatitis go on to develop hay fever or asthma). But conventional medicine can not make much sense of it. Homeopaths do not consider disease as an ‘entity’. Instead they consider every disease as a ‘process’. For an allopath the dermatitis, the asthma and the hypertension are separate entities that need different experts and different medication. For a homeopath, this is just one process and the progression of disease from one plane to other is often due to suppression with conventional medicines.

The eczema results due to ‘hypersensitivity’. The symptoms on the skin (inflammation, itching, burning, oozing) are just manifestation of that hypersensitivity. The homeopath asks why this person has developed ‘hypersensitivity’ and tries to treat the ‘cause’ not the eczema. Homeopathy believes if there is no cause for hypersensitivity, there will be no eczema and hence it treats accordingly. The conventional medicine focuses all its force on the ‘local symptoms’ of that hypersensitivity without actually bothering with why the person has developed this hypersensitivity and what will happen to the ‘internal-process’ once the ‘external manifestations’ are removed (suppressed). Homeopaths know that the ‘process’ continues and manifests on some other organ – most commonly lungs – and develops asthma – which is again a hypersensitivity disorder.

Homeopaths know that such suppressed symptoms can reappear for some time during the process of cure – as disease again moves from more vital organs to less important ones. The understanding and the approach to disease is so diametrically opposite in homeopathy and allopathy that trying to measure and compare their effects on the same scale is nothing but foolishness!

* We have already discussed the flaws within the so-called ‘clinical’ homeopathy. Another point of contention is the mixing of ‘complex homeopathy’ and ‘classical homeopathy’. The medicines used in ‘complex’ homeopathy are often a combination of ‘low-potency’ homeopathic medicines with some therapeutic affinity for a disease or an organ. The problem is that these ‘complexes’ often have and rely on the physiological effect of the drugs substance they contain. They are more like herbal extracts and in principle; they have nothing to do with homeopathy, except that the source of drugs are common. ‘Classical’ homeopaths on the other hand, usually prescribe remedies with no physiological quantity of drug. Mixing these two approaches in itself is a fundamental flaw in this meta-analysis.


The Hidden Questions

The meta-analysis and its publication in Lancet raises many questions. Why homeopathy was chosen as the test subject in comparison with conventional medicine? Why not Chinese Medicine, Ayuerveda, Yoga, Aromatherapy or something else? There are more than 300 alternative systems of medicine!

Is this meta-analysis planned and targeted against homeopathy? Could be! But why? Homeopathy has now come to a stage where it might have started to threaten the conventional medical structure. The number of homeopaths is around half a million now. The number of patients – hundreds of millions. (A recent paper titled ‘Cost effectiveness and efficacy of homoeopathy in primary health care units of government of Delhi’ by Dr Manchanda and Dr Kulashreshtha says: "The average annual patient turnover in an allopathic clinic as against a homoeopathic one was 27,508 patients and 24,943 respectively." – Not much difference there!). In Britain alone, sales of homeopathic medicines have grown by a third in the last five years to 32 million pounds in 2004. Groups like Boiron have annual sales of 300-400 million euros and the sale is growing exponentially throughout the world for all homeopathic pharmaceutical companies.

Although the figures are still very small compared to the conventional medical structure, still the growth has defied the logic of most. The editorial of The Lancet rightly said – “The more dilute the evidence for homoeopathy becomes, the greater seems its popularity.” Is someone trying to nip us in the bud?? People should think about it.

Another question is that should we at all give so much weight to the article because it has been published in The Lancet. I don’t think so. All this article has done is that it has renewed the interest of the scientific community in homeopathy, which should work in our favor in the long run!

What to do now?

Nothing special! Just keep curing the patients. The proof of the pudding lies in its eating. So we should bring these ‘theoretical scientists’ to India and keep them in a zoo. Eh...sorry, I meant to say that we should show them some real good pathological cures of dermatitis, tonsillitis, sinusitis, fibroadenomas, ovarian cysts, hypothyroidism, sciatica, alopecia areata, migraine, otitis media, renal stones, chronic laryngitis, pneumonia, peptic ulcers, chronic fatigue syndrome, ADD/ADHD etc., which they will find difficult to attribute to any ‘placebo’!!

But hopefully, this controversy will also help in starting more research for homeopathy.

This is the beginning of homeopathy, not its end!

The Feedback ..or the Fight Back!

From various corners of earth, people have given comments against this meta-analysis. We have gathered some interesting ones below:

"Furthermore, a single remedy selection for a given conventionally-diagnosed condition is not homeopathy, yet there are numerous conventionally-judged high quality studies that were so designed. The analogy would be to test the effects of penicillin for all patients with symptoms of an apparent infection. The quality of the studies would otherwise be excellent in design. However, penicillin will not work for patients with viral infections or bacterial infections resistant to its effects or for persons with fevers from other non-infectious causes - and it thus might show benefit only for a subset of patients with symptoms of infections, i.e., the ones with true penicillin-sensitive infections. How would penicillin fare in a meta-analysis of studies designed to ignore the intrinsic nature of penicillin in benefiting patients?" said Iris Bell, M.D., Ph.D.

Joyce Frye DO, MBA commented that the study's authors seemed to begin their work with a bias. "While their analysis clearly showed effects of homeopathic treatment - they found ways to disregard those. Out of the millions of trials in conventional medicine, their primary outcome relied on the comparison of ridiculously small numbers--8 trials of homeopathy and 6 trials of conventional medicine. They began their work with the assumption 'that the effects observed in placebo-controlled trials of homoeopathy could be explained by a combination of methodological deficiencies and biased reporting'. Sound research is not conducted from this starting position."

Among other topics, the Lancet challenges the plausibility of homeopathic effects given that homeopathic remedies are often administered in dilutions in excess of Avogadro's number. Dr. Rustum Roy, Ph.D. distinguished material scientist from Penn State University commented that the chemistry argument made in this study and by conventional medicine in general is false science. "The underpinning of the editorial content of the Lancet as it relates to homeopathy relies on a quaint old idea from the nineteenth century that the ONLY way that the property of water can be affected or changed is by incorporating foreign molecules. This is the Avogadro-limit high-school level chemistry argument. To a materials scientist this notion is absurd, since the fundamental paradigm of materials-science is that the structure-property relationship is the basic determinant of everything. It is a fact that the structure of water and therefore the informational content of water can be altered in infinite ways"

Another fundamental concern is that the paper gives no clue about the nature of the 14 trials selected for the key analysis: whether they were mainly therapeutic or prophylactic, for example, and whether the homeopathic interventions were classical, ‘clinical’ or complex homeopathy, or isopathy. Knowledge of these would potentially make a great difference to the inferences that should be drawn. Given the heterogeneity of homeopathy trials, it seems unlikely that the design and methods of just 8 can be representative of 110. Nor are we offered proper summary data on the odds ratios for effectiveness in the two sets of 110 trials overall; without such information, it is impossible to gauge the impact of having narrowed the analysis to just 8+6 trials.

There are other bizarre features of this paper. On reading its text, it seems that only the literature between 1995 and January 2003 was included in the analysis. This would have built on a previous major meta-analysis of homeopathy trials (3). However, on examination of the web-table that lists all the references, it becomes apparent that 62 of the papers analyzed were actually published before 1995. The remaining papers analyzed were published from that year onwards, but some of the main articles during that time have not been included. Inexplicably too, a substantial number of the papers reviewed in the previous meta-analysis are absent from the new one.

Robert Mathie, Research Development Adviser of the BHA and Faculty of Homeopathy

However, the Lancet also reports that a draft report on homeopathy by the World Health Organization says the majority of peer-reviewed scientific papers published over the past 40 years have demonstrated that homeopathy is superior to placebo in placebo-controlled trials. – BBC

It is wonderful that homeopathy has stimulated such an emotional and viperous response from the editors of Lancet. I classify the editorial response as a case of delusional self importance based on weird science and pre-judgment. The response is similar to the Catholic Church’s response to Galileo’s assertion that the earth revolves around the sun and not the other way around. In spite of Lancet’s assertion that the body is a sum of chemical processes and measured only by double blind studies, there is a new more profoundly modern view of the human body based on quantum physics and other advances in science, which is encompassed in homeopathic methodology and preparation.

The world’s survival does not revolve around modern medicine’s older Newtonian beliefs or Lancet. In spite of the enormous amount of resources that modern medicine has consumed and continues to consume and profit from, chronic and acute disease continues to advance at a phenomenal pace. It also means that the structure of medicine is finally straining to a point of collapse. This can only be a demonstration that the fragile underpinnings of modern medicine are crumbling. A simultaneous patient revolt and serious iatrogenic effect with the resultant publicity this has engendered has created the spectacle of medical editors making pathetic emotional pleas.

In all of this, what is clear is that homeopathy will survive. It is not the end but an auspicious beginning

Harold Bothrops, Practitioner

Dear Sirs,
I totally disagree with your article against homeopathy. I am the father of a baby boy aged of 6 months. Since his birth, my wife and I have treated ALL his discomforts with the help of homeopathy and he's ALLWAYS been fine the days after the beginning of the treatment. My point is that you can't explain to a baby the nature of what you are giving him as a treatment or its effects. So you can tell that homeopathy DOES work and is not as good as a placebo. Otherwise and following your article, my wife and I possess mental powers and we should be able to treat our baby with them!
Once again homeopathy is a scapegoat responsible for the economic decline of the medical industry... Trillet

The present debate illustrates the chronic scarcity of viable homeopathic research. This scarcity plagues understanding the true nature of homeopathic science. While it is true that some relatively few quality studies showing results have put homeopathy on the scientific map, no serious researcher would claim that homeopathy has proven its claims completely and beyond doubt. As long as there are very few good studies, the successful treatment outcome which homeopaths and their patients have become accustomed to will not likely be reflected in the statistical data. We still have a long road ahead in substantiating our therapeutic approach, and the current debate will undoubtedly prove a healthy development for our profession.

Liz Bonfig, Administrator, NASH.
Manfred Mueller, NASH President

Summary

All’s Well That Ends Well!

References:

1. thelancet.com
2. http://www.niams.nih.gov/hi/topics/dermatitis/#link_d
3. http://news.bbc.co.uk/1/hi/health/4183916.stm
4. http://www.delhihomeo.com/paperberlin.html
Si iata ca unii chiar muncesc sa "inteleaga" si sa "arate" iar altii "ucid" si "ascund" ceea ce nu inteleg sau nu stiu. Ignoranta medicala nu este o scuza !!!

Alexandra a dit…

Articolele citate mai sus nu fac decat sa confirme ceea ce spun eu, dvs insa va bazati pe faptul ca inecati informatia adevarata intr-o mare de amanunte si de citate complet inutile. Insa nu v-ati gasit partenerul de discutie pe care sa-l pacaliti tot asa de usor ca pe pacientii homeopatiei:))

Sa analizam de ex articolul despre legislatia din Suedia:

In primul rand articolul -preluat de pe un site homeopat, cum altfel?- o ia de la 1848 toamna si ajunge in zilele noastre cand zice ca:

"One of the laws forbids homeopaths (and other alternative practitioners) treating patients under eight years old."

Ups!! sa traduc? Zice acolo ca o lege INTERZICE homeopatilor sa trateze copiii sub 8 ani. Adica exact ceea ce spuneam mai sus. Poate explicati dvs si DE CE?

- In 1985 Svenska Akademin för Klassisk Homeopati (SAKH) was established with 15 members. (!!!) growing to about 90 during its 13 years of existence.

De la 15 membrii la 90, numarul de homeopati suedezi e direct proportional cu dilutiile :)))

- articolul se fereste sa spuna direct cati dintre acesti cativa membrii sunt...medici!! Insa noi stim: NICI UNUL! Zice acolo ca la scoala de homeopatie se "accepta" doar cei care au oareace nivel de studii de asistenti medicali dar acestia NU SUNT medici:

The homeopathic part of the school is a three year, part-time course
Nordiska Akademi för Klassisk Homeopati (NAKH), is a three year part time school of homeopathy. Students have to have a nurse's level of medical training to be accepted.

Si mai zice acolo ca au existat conflicte intre medici si "practicienii homeopati care NU SUNT medici licentiati":

During this time there were also conflicts between medical doctors practicing homeopathy and several practicing homeopaths who WERE NOT LICENSED PHYSICIANS, and whose skill level was sorely questioned.

In total in Suedia sunt 8 (OPT!!) farmacii:

There are eight pharmacies, several of them making their own remedies.

etc

Edificator, intradevar! Merci pentru acest articol care confirma direct de la sursa ceea ce sustineam mai sus:))

Alexandra a dit…

@Anonyme a citat urmatorul articol:

>> In the August 27 issue, The Lancet published an article titled “Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy”.
[...]<<

...caruia insa nu i-a comunicat sursa. Nu e greu de ghicit de ce, pentru simplul fapt ca e o sursa homeopata deci departe de a fi obiectiva.
Articolul e de fapt un 'raspuns' la metaanaliza din revista The Lancet. Autorul lui este directorul unei reviste homeopatice (Homeopathic Research), un indian (??) numit Manish Bhatia

Dupa ce dl homeopat delireaza spunand ca "beneficiile homeopatiei nu se pot masura" (??) ajunge si la intrebarea cheie:

The meta-analysis and its publication in Lancet raises many questions. Why homeopathy was chosen as the test subject in comparison with conventional medicine? Why not Chinese Medicine, Ayuerveda, Yoga, Aromatherapy or something else? There are more than 300 alternative systems of medicine!

Adica se intreaba nedumerit dl homeopat de ce oare se se leaga lumea stiintei de homeopatie si nu de Ayuerveda, Yoga, aromaterapie sau alte sarlatanii?
:)))
Prin urmare recunoaste dansul ca homeopatia e un fel de Yoga adica tot un fel de religie care pretinde ca "ajuta" daca pacientii merg in maini cu picioarele pe dupa cap:))
Pai exact asta tot zic si eu aici, ca homeopatia e un fel de secta! Merci inca odata pentru confirmare:)

In plus, motivatia analizei din Lancet e evidenta: nu e vorba de nici o conspiratie mondiala ci doar de banii publici cheltuiti aiurea pe sarlatanii homeopatice inactive. Ia sa incerce cineva sa ceara asigurarilor sociale sa-i plateasca sedintele de yoga, ce ar zice atunci platitorul de taxe si impozite?

Apoi dl homeopat indian se scarpina in cap si se intreaba "ce sa faca":

What to do now?

Nothing special! Just keep curing the patients. The proof of the pudding lies in its eating. So we should bring these 'theoretical scientists' to India and keep them in a zoo.


Ne sugereaza deci dansul sa bagam stiinta la zdup si sa ne tratam cu totii la vracii indieni. Din fericire a trecut vremea inchizitiei...

Urmeaza bineinteles comentariile "oamenilor de bine" care ridica in slavi homeopatia pe motiv de 'martori oculari ai vindecarilor'. Insa doar la cateva clickuri pe net putem gasi inca si mai multi martori care:
- au vazut fantome
- au fost rapiti de extraterestrii
- au avut diverse experiente in vrajitorie, astrologie, feng shui, telepatie etc
Urmand logica homeopata toate acestea sunt adevaruri incontestabile din moment ce sunt sustinute de un mare numar de indivizi. (de fapt argumentul popularitatii este o eroare de rationament cunoscuta in logica sub numele de Argumentum ad Populum)

Daca mai aveti si alte articole de acest gen chiar va rog sa le publicati (eventual un link e de ajuns) ma distreaza teribil elucubratiile de acest gen si in plus, confirma cum nu se poate mai bine ceea ce incerc eu sa spun aici:)

Armand K. a dit…

Că o fi spus-o într-adevăr sau i-a fost doar atribuit citatul, mare dreptate avea Einstein cand zicea: "Doar două lucruri sunt infinite, universul şi prostia omenească; şi nu sunt foarte sigur de primul."

Mi-e milă de medicul care susţine că ceva poate avea vreo influenţă la o "diluţie homeopatică" (sau care-o fi denumirea exactă folosită) de 200K (sau chiar şi numai 100K) sau alte aberaţii similare. Ştiam că pentru admiterea la medicină se cere şi chimia -- iar la chimie se învaţă câte ceva despre diluţie chiar şi în liceu.

Titlul e foarte potrivit, dar nu e exact: faţă de o diluţie 200K, ai mai multe probabilităţi de a găsi urme de raţă într-un pahar de apă luat dintr-un lac în care a înotat odată o raţă decât ai să găseşti într-o capsulă de cum-se-cheamă.

cristian baltatescu a dit…

Domnul doctor ORL foarte fervent, dar care numeste pe altii fanatici (cum poti fi fanatic al normalitatii ???) ocoleste toate raspunsurile la obiect. Nu raspunde nici la problema dilutiei si nu vede nici eroarea din rationamentul vis-a-vis de placebo, argument pe care il serveste singur, intreband de ce mai exista psihologie.
Exact. Efectul, daca e sa fie unul, e numai acolo.Ok, de neglijat, demonstrat si eficient. Dar e psihologic, nu chimic.
Domnul doctor, caruia cu greu ma abtin sa nu-i scriu personal e demonstratia unui fapt trist.
Ni se pare perfect normal sa existe ingineri prosti (ma rog, sa zicem prost pregatiti), avocati slabi, invatatori fara vocatie, chiar si preoti adulteri si betivi.
Insa meseria de medic e inca una invaluita in fabulos, in mitic, aproape il vedem pe Hipocrat cu mantie pe umar cand intram in cabinet.
Au facut 6 ani de facultate, care e altfel fata de celelelalte facultati, lumesti, civile, nu-i asa?
Ei bine nu. Mi-e clar de acum ca si la medici e fix la fel. Si ce daca a facut chimie din generala si pana in facultate. Si ce daca ar trebui sa fi si inteles ce a tocit pentru facultate si ce a tocit IN facultate (nu e vina lor ca au de invatat 100 de pagini de la o zi la alta)?
Se abereaza la fel ca orice electronist slab care nu a inteles niciodata pana la capat magia semiconductorului, asa ca elaboreaza in capul lui de geniu ne inteles teorii ale campului unificat bazate pe spritism.
Cam asa si cu medicii astia.
Stiu personal medici psihiatri care te analizeaza cu ansa. Nu va obositi sa va intrebati ce e aia ansa, daca nu stiti, va e de ajuns sa intelegeti ca si ei sunt oameni si deci, in aceste vremuri de restriste cand mai toti se intorc superficial la religie si paranormal, si ei se pot ticni.
Sa ne fie mila si gata.

Si domnul doctor, daca mai sunteti pe frecventa astrala corespunzatoare, inteleg ca nu stiti chimie, dar cu limba romana ce aveti? "Da-ti-ne" pace sa fim noi fanatici.

Armand K. a dit…

De acord că meseria de medic nu are nimic fabulos şi aşa mai departe. Există însă un lucru fundamental care diferenţiază profesia de medic, alături de alte câteva, de majoritatea celorlalte: lucrează direct şi nemediat cu viaţa şi sănătatea omului.

Este normal (în sensul de "obişnuit") să existe profesionişti slabi pregătiţi în toate domeniile. Dar este cel puţin deplorabil ca un medic să apeleze la gândirea magică, punându-i eticheta de "fapt ştiinţific", într-un ambalaj drăguţ de termeni tehnici (ceea ce americanii numesc technobabble). Similitudinea (sic!) e perfectă cu astrologia, unde ţi se livrează o cantitate impresionantă de inepţii despre psihologia individului, condimentate cu argumentaţii alambicate în jargon astronomico-matematic.

elisa a dit…

Buna treaba, chiar am inghitit un astfel de... ce-o fi el, nu ma mai doare nimic(nici nu m-a durut ceva inainte de administrare, faceam un test), ca asa m-a lasat Dumnezeu, rezistenta, dar imi vine greata de modul in care unii se imbogatesc pe spinarea unor fraieri amarasteni care si-ar da si ultimul banut sa-si vada copilul sanatos... Pentru copil am incercat porcaria asta, e sensibil la raceala, dar ajung sa cred ca... asa l-a lasat Diumnezeu, mai sensibil. Nu-i voi da niciodata apa de ploaie pe bani, ca, deocamdata, aia care cade din cer e gratis...
Felicitari si tot respectul meu, doamna!

Anonyme a dit…

Multumesc pentru articol. Chiar voiam sa aflu mai multe despre remediile homeopate, pt ca intr-o luna, mi s-au prescris deja 2 medicamente homeopate, pt fetita mea de 7 luni. Am vazut ca sunt homeopate abia dupa ce le-am cumparat. Daca stiam dinainte nu le luam.
Intotdeauna am avut indoieli cu privire la homeopatie, dar nu stiam unde sa caut informatii despre ce inseamna ea cu adevarat.
Chiar mi-ai fost de mare ajutor, Alexandra.

Anonyme a dit…

Medicamentele homeopate sunt excelente si sunt o alternativa salvatoare. Nu faceti nimanui bine cu lupta asta anti homeopatie. Copiilor mei le-a salvat viata.
A.M

Alexandra a dit…

imi pare rau ca ati avut copiii bolnavi, sunt sigura insa ca nu i-ati pus in pericol si ca ati folosit in primul rand medicamentele adevarate iar bilutele au fost doar "tratament" complementar. Nu vreau sa cred ca in secolul 21 vrun homeopat iresponsabil trateaza copiii de boli GRAVE cu atomi de rata si solutii cu nimic!

Homeopatele singure nu au cum sa salveze viata cuiva, nu au cum sa vindece nici macar o boala usoara darmite una serioasa pentru simplul motiv ca sunt doar bilute cu zaharel descantate, nimic altceva...

mihaizzz a dit…

asta ultimul cu " bilute cu zaharel descantate,", a fost cel mai tare comentariu!

se pare ca "nenea" doctorul homeopat a renuntat pana la urma !

una peste alta, reclama face totul legat de bilute; recunosc ca pana sa aflu despre ce este vorba le-am cumparat si eu!

numai bine.

Anonyme a dit…

When Boiron's spokeswoman Gina Casey was asked if a product made from the heart and liver of a duck was safe, she replied: "Of course it is safe. There's nothing in it." (Wikipedia)