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What does the German “internal consensus” mean?

This text describes the topic “Homoeopathy in German Pharmaceutical Law”.

The picture symbolizes the In 1976, consultations began on a fundamental reorganisation of German pharmaceutical law. By and large, the state’s involvement in the pharmaceutical industry previously consisted of little more than a “registration” of drugs placed on the market under the responsibility of pharmaceutical manufacturers.

It had taken a long time for the legislature to consider its own responsibility in the field of drug supply. A trigger for this was the thalidomide scandal of the 1960s. This terrible process, in which neither the manufacturer nor the state authorities presented a particularly happy picture, gradually led to a growing awareness of the need for action – yet it still took 17 years before a fundamental reorganisation took place.

The basic approach of the new Medicines Act was to replace the mere registration with an “approval procedure” for pharmaceutical medicinal products and to link this to scientifically substantiated evidence of efficacy and side effects. The parliamentary and extra-parliamentary discussion dragged on for more than two years – in the end, the “Medicines Act 1978” (Arzneimittelgesetz) was passed. This marked a move away from a largely individual-empirical based therapy towards a drug therapy on as objective a basis as possible. All old remedies already registered at that time were subjected to a subsequent approval procedure, and many were no longer approved – often to the chagrin of doctors who had been using these remedies for a long time for “empirical medicine”. Even the pharmaceuticals marketed in the former GDR at the time of reunification were subject to such a subsequent approval procedure.

So far, so remarkable. So are all available medicines based on scientifically proven efficacy?

Not at all.

A very active parliamentary and also extra-parliamentary lobby succeeded in obtaining special rights for the “Erfahrungsheilkunde” ( experience medicine), to which apart from homeopathy anthroposophy and herbal medicine were added (how these three are connected is a story in itself). At that time it could be suggested to the parliamentarians in the context of the upcoming “innovations” that the “empirical medicine” of these directions pursues a completely different “approach” and that the principle of scientific proof, so to speak, bypasses the “peculiarities” of these directions. The parliamentary paper at that time speaks volumes and is quite interesting to read. [1]

Many parliamentarians may have been aware that the demand for proven effective drugs has nothing to do with “pluralism in science” and “a fundamentally different approach”, but represents nothing more than a self-evident basic consensus for health care. On the other hand, the representatives of the homeopathic and anthroposophical lobby will have been fully aware that the demand for scientific proof of efficacy would have meant the end for their remedies on the pharmaceutical market. Which, incidentally, was basically an admission that the homeopaths’ claims about the efficacy of their remedies and their great benefit to the patient were not substantially. So it was about something.

And so it came to a complete break with what had actually been the intention of the new law, in favour of what at that time was called “empirical medicine” and understood itself to be a kind of “separate medicine”. Special rules in the AMG established homeopathy, anthroposophy and phytotherapy (herbal medicine) as “special therapeutic directions” and granted them special rights. The proof of efficacy according to recognized scientific methods, actually the purpose and intention of the law for everything that wanted to trade as a drug, was waived on for these remedies.

In order to preserve the appearance of state regulation, it was decided that special commissions were to be set up at the Federal Institute for Drugs and Medical Devices (which at the time was still called differently) for the “special therapeutic directions”. For homeopathics, this is still Commission D today.

The old instrument of simple “registration” was retained for the medicinal products of these “directions”, as long as they were not to be marketed and advertised with a medical indication – as a purely administrative procedure in Division 4 of the BfArM. This department decides whether a remedy is homeopathic at all (of course the simple registration is extraordinarily “popular”) and, according to its own statements, makes this dependent on the “manufacturing process”, i.e. on the application of the principle of potentiated basic substance. In addition, safety and compliance with best practice rules during production are checked.

Those manufacturers who wish to advertise with an indication, i.e. information on areas of application, can submit an “application for approval”. The Commission D has to decide on this application. It bases its decision on “homeopathic knowledge material”, the evaluation of which is reserved for the “experts in the therapeutic direction” within Commission D. The Commission is therefore not responsible for the objective scientific evaluation of this material. On the contrary, such is suspended in favour of an “internal”, i.e. always subjective, expert assessment. In this way the “special therapeutic directions” are namely protected from the requirements of objective science, but at the same time, they also lack any possibility of invoking on this.

To clarify once again: the task of Commission D (and the commissions for the other special therapeutic directions) is not the evaluation of the approved applications of efficacy according to objective scientific criteria, as is the case for normal pharmaceuticals. No, the internal group of “experts” who have the “medical expertise in the therapeutic direction” will decide on the approval and thus the market access of homeopathic medicinal products with indications. Among themselves. In a joint consensus. According to personal perception, opinion or “experience”, according to “internal evidence” instead of intersubjective, generally valid criteria. This situation has remained unchanged since 1978 – on the homepage of Department 4 of the BfArM there is still talk of the relic of “scientific pluralism in the field of drug therapy”, which the legislation (40 years ago) had expressly provided for. Already at that time an anachronism that should not have been followed. [2]

This is the so often invoked “internal consensus” which still privileges homeopathy (and the other “special directions”) in an unacceptable way, even erecting a real protective fence around it. From the legal point of view – and in the general public’s perception – the remedies of the “special therapeutic directions” are just as much “drugs” as any pharmaceutical product that has undergone a testing and approval process that often takes years (only about eight per cent of all new developments in the pharmaceutical industry make it to approval in the first place). Homeopathy – and anthroposophy – are obviously doing their utmost to maintain this special legal regulation. This is because of their integration into the health care system and social security law depends directly on it.

There is nothing in German pharmaceutical law that is more in need of reform.

Edit: Specified and extended on 5 July 2019

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Happy Birthday, Samuel Hahnemann!

Samuel Hahnemann, the inventor of homeopathy, would have turned 264 today.
A retrospective by Dr. Natalie Grams

When I first heard a sentence from Samuel Hahnemann, the founder of homeopathy, I was a young medical student – and totally excited: “The highest ideal of cure is rapid, gentle and permanent restoration of health, or removal and annihilation of the disease in its whole extent, in the shortest, most reliable, and most harmless way, on clearly comprehensible principles.” (Organon, 6th edition). Whoa! That was exactly what I wanted to achieve as a prospective doctor: to understand, to really understand what made my patients ill and to help them to achieve improvement in the gentlest and yet best possible way. In short: I found this ideal great.

At my university I found like-minded people during my studies and learned homeopathy there in student circles and in courses and weekend seminars. I read the texts by Hahnemann, in particular his basic works “The Organon of Medicine” and “The Chronic Diseases” and really had the feeling that I had found a particularly healthening form of medicine. Later I opened a private practice for homeopathy, treated my own family and patients mainly homeopathically and was happy about the success. Although I heard here and there about the criticism of homeopathy, I dismissed it as unfounded – without looking into it any further – and swore by Hahnemann. I was fascinated by his idea that illness only arose because the immaterial life force in humans was disturbed and this in turn could only be brought into an even flow by immaterial healing force in drugs. The successes, which I also saw in practice and in my circle of acquaintances, convinced me that this concept simply had to have something to do with this. I could have imagined keeping this work and this medicine up to the end of my life. Hahnemann appeared to me as a genius, a great thinker and pioneer of his time.

In order to really understand homeopathy and its founder, however, we must keep in mind the time Hahnemann lived at and how he came up with his ideas and the development of his own “medicine”. Especially in the last 200 years, medicine and science made an enormously progress. Hahnemann had no idea of bacteria, infection pathways, the immune system in all its complexity and how we could influence it. His ideas, as innovative as they were at that time, have become untenable regarding to the background of today’s knowledge. Moreover, he had succumbed to a thinking error from the very beginning. The well-known chinona bark self-experiment, with which he believed to have found the similarity principle of homeopathy, could never be reproduced after all.

Homeopathy may have been a blessing as an alternative to the medicine of that time, but today it is no longer the case (neither alternative nor blessing). By turning away from the then usual rough methods such as bloodletting or vomiting cures, Hahnemann certainly contributed to a better medicine. This is still his merit and legacy. Today, however, knowledge in physics and chemistry is completely sufficient to be able to say that nothing else happens during the production of homeopathic remedies than a very, very heavy dilution, which leads to the fact that usually no active substance is present at all and no energy is produced. After all, the globules cannot do any direct harm, but they don’t really work either. This does not make homeopathy completely ineffective and this explains the successes that I have also noticed: A so-called “sham therapy” does not mean that nothing happens. Only the thought and the hope that someone treats us well can lead to physical improvements in us humans. It’s called the placebo effect. That is not nothing, but it is also certainly not a medication therapy – and it does not replace such if you are really ill. Hahnemann himself could not know this, because he had neither the knowledge of today’s natural sciences, nor the statistical possibilities, the theory of science, and our complex methods (“clinical studies”) today to test the efficacy of drugs and methods in medicine. So we can’t blame him! But anyone who still believes one to one in his statements today is wrong together with Hahnemann who deceased 176 years ago. Where there is nothing, nothing can work – except good faith and understandable hope.

Even today, when I have distanced myself far from homeopathy and criticize it in many places, I believe that Hahnemann was a mastermind of his time. However, someone who has been refuted in many of his thoughts over the course of time. But it is not a sign of tolerance to hold on to what has been refuted. Let us thank him for what he did well in his time and let us remain realistic: Even 264 years after Hahnemann’s birth, healing does not come from nothing. And as beautiful as the sentence of gentle and comprehensive permanent healing sounds for us, as little has been proven in almost 200 years of research that it is also true when homeopathy is used as a medication therapy. And didn’t Hahnemann himself demand “clearly comprehensible principles”?

Today, I find it important to be honest with patients and not to keep them from really effective therapy with deceptive promises of salvation – even if this may consist in waiting patiently (this will be the case often more than expected). If there is one thing that I have taken with me from my time in homeopathy, it is that our body is surprisingly often healed all by itself and with the help of its inherent self-healing capacities. And that really is the gentlest and most natural way of healing.

Picture: Wikimedia commons

This article was published originally in German on the blog “deiks.de” on Wednesday, 10-04-2019

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Homeopathic preparations also don’t act through nanoparticles

Representatives of homeopathy often claim that nanoparticles of the mother tincture are the carriers of the effectiveness of homeopathic preparations. That this is not possible at all can be seen after quite simple considerations:

The image shows nanoparticles in an electron microscope image with a size scale in nanometers.
Nanoparticles in an electron microscope image

Nanoparticles are particles that consist of comparatively few atoms or molecules and are therefore very small. The size is measured according to “nanometres”, which is the millionth part of a millimetre. Because of their small size, nanoparticles have astonishing properties; they can penetrate cell membranes, for example, are very reactive and much more.

If homeopathy with nanoparticles is to work, such particles would have to be present in the finished preparation the patient is taking. These are particles from the mother tincture, the original substance with which the production of the homeopathic remedy began. And that is the key with which this assertion can quite simply be reduced to absurdity.

Potentiation is also dilution. This means that the more often you potentiate, the less of the starting material is present in the solution. And already from very early potencies the quantity of these atoms or molecules is no longer sufficient to form nanoparticles in appreciable numbers.

No problem, say the homeopaths, these nanoparticles are certainly somehow passed from one potency to the next quite completely. But nobody can explain how this is supposed to happen, how to make sure that the particles are also noticed if only one tenth or even one hundredth of the solution is removed in order to then potentiate them further. Nor what the point of this undertaking would be if it were successful. If the nanoparticles remain the same as before, what will change in the efficacy that is to be increased by potentiation?

Yes, homoeopaths say again, perhaps the particles will become smaller through the subsequent shaking and thus more reactive and thus more effective? Good answer, but why do we have to keep on diluting? Why can’t we just prepare the solution once, say one gram of primary substance to one litre of water or a mixture of water and alcohol, and then simply shake until the desired strength is reached? No more answer.

There is also no answer to the objection that in order to be effective via nanoparticles, the original substance itself must first form nanoparticles in the solution. This is precisely what substances that are soluble in solvents do not do. Just some of the most universally applicable homeopathic remedies, sodium chloratum, potassium carbonicum and arsenic album, are salts that form differently electrically charged particles (“ions”) in the solution, but no nanoparticles.

Now, however, nanoparticles have been found in sodium chloratum, even at highest potencies, there is even research on it? Yes, you did – but how? One has examined highly potentiated solution of sodium chloratum with an electron microscope for nanoparticles. The only problem is that the sample, i.e. the drop to be examined, has to be dried. The impurities contained in the solvent – 10 milligrams per cubic centimeter – remain and form crystals. And this is what can be found under the microscope: Crystals of impurities, the most common of which is the ubiquitous table salt, i.e. sodium chloratum. Of course, these crystals can also be found on the globules, theoretically at least, but when the patient takes them, the salt dissolves again in the saliva – and the nanoparticles observed are gone.

That should be enough. Let us spare ourselves the thought of how nanoparticles would actually have to be imagined if primordial substances from the animal and plant kingdoms were used. What do the nanoparticles contain in these cases? Which of the many thousands of different substances that make up an animal or a plant are combined to form nanoparticles? Or is the nanoparticle an extremely miniaturised image of the original organism that contains everything? If not, how is the right component selected? And what do the nanoparticles look like when non-material primary substances are used? Light, electricity or vacuum?

As you can see: The concept of nanoparticles as carriers of the effectiveness of homeopathic remedies generates more questions than answers and is absolutely not suitable to explain the effectiveness of homeopathic remedies.

Author: Dr. Norbert Aust

Further information:

Nanoparticles and homeopathy – how is that possible?

Picture credits: Wikimedia Commons; Lmackenzie89 – Own work, CC BY-SA 4.0,
https://commons.wikimedia.org/w/index.php?curid=56937308

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Can’t homeopathy not be a “placebo” because often the first given remedy does not work?

What happens after ingesting a homeopathic remedy – according to the homeopathic build of thought?

Occasionally one is confronted with the argument that the effect of homeopathic remedies cannot be based on a placebo effect because often the first homeopathic remedy did not “heal” at all, but only the second, third, fourth or fifth …

In fact, at first glance this argument seems to have something for itself. A closer look, however, shows that it is not in favour of homeopathy, but against it.

Behind this argument, however, lies a confusion of terms.

It is not only about “placebo”

On the one hand, there is the established term “placebo effect”, which refers to the reactions that can also trigger empty forms of medication in the body. This actual placebo effect is not a constant quantity. It depends on the disease and is highly individual and unpredictable in its time of onset, strength and duration. But it also depends on the properties of the placebo: It is known that more expensive placebos have a stronger effect than cheap ones and red placebos have a stronger effect than green ones. The placebo effect cannot be calculated or controlled. It cannot be demanded by nature in such a way that it corresponds to its cliché.

However, this placebo effect (in the narrower sense) is not the only reason why the administration of homeopathic remedies can lead to a feeling of improvement or healing. Other important reasons are:

  • Spontaneous course of the disease. Many (most) diseases heal spontaneously. Many other diseases, especially chronic ones, have a wave-like course, so that “bad times” are spontaneously followed by “good times” (“regression to the middle”).
  • “Confirmation error” and “selective perception”. Small positive experiences are evaluated as therapy success, but negative developments are not attributed to the therapy.
  • “Post-hoc-ergo-propter-hoc” error. All changes after ingestion are causally attributed to ingestion, although causality is not given, but only a simple temporal relationship.
  • Expectational pressure and expectations.

May be continued …

If not the first homoeopathic is regarded as effective, but only a second, third, further one, then several points come together. On the one hand, one sees nothing else in these courses than the spontaneous course of the disease. Homeopathic medicine has nothing at all to do with “healing”. The improvement is simply attributed to the last homeopathic used. Also, with every further administration of homeopathic remedies, the therapist’s pressure of expectation as well as the patient’s attitude of expectation increases, which can feign fictitious success. Also, the term “success” or “healing” is not defined in an objective-medical sense; usually the patients only report their subjective feelings. But also deteriorations are often called “success”: The term “initial aggravation” indicates that aggravations are seen as proving the right choice of means.

Can a homeopathic remedy be “ineffective”?

The approach of homeopaths to give other remedies until finally something desired happens at some point shows not only the therapeutic helplessness of homeopathy and the misinterpretation of chance or completely natural processes as “success” – it also stands in stark contradiction to Hahnemann’s teaching.

Hahnemann justifies his principle of similarity with the postulate that a body cannot have two similar diseases at the same time – it must then separate from one, namely the weaker one. In “drug tests” – on healthy people! – homeopathic remedies are examined for “drug pictures” allegedly produced by them. If a patient shows symptoms similar to those of a drug picture, then the right remedy has been found. The correct selection of “potency” is then intended to ensure that the homeopathic remedy is stronger in nature but weaker in symptoms than the disease (whatever one might imagine it to be). Because of this, the body should separate from the “right” of the two diseases (the comparatively weaker original disease), but not suffer (because of the comparatively weaker symptoms of the art disease).

If the recovery is not complete, the logic of homeopathy leads to certain conclusions, especially that the previous remedy was not “ineffective”. What does this mean?

According to the homeopathic doctrine, if the “right” remedy is chosen, “healing success” should occur quickly and completely:

“… fast, gentle, permanent restoration of health, or lifting and destruction of the disease in its entirety by the shortest, most reliable, most unholy means …”. (§ 2 Organon)

If there is a change instead of a complete recovery, the homeopathic remedy – mind you: in the imaginary world of homeopathy – has changed some of the symptoms and thus the symptom picture. Even if the homeopathic remedy was completely ineffective with regard to the disease, at least a “drug test on healthy persons” has taken place:

According to the rules of homeopathy, a homeopathic remedy cannot have “no effect” – not even a “wrong” remedy. Homeopathic remedies (from a homeopathic point of view) have an effect on symptoms: If symptoms are present in the clinical picture which are also contained in the drug picture of the homeopathic remedy, they are “extinguished”. If symptoms are present in the clinical picture which are not contained in the drug picture of the homeopathic remedy, they remain unchanged. If, however, symptoms are present in the drug picture but not in the clinical picture, then they are produced in the patient – who is considered “partially healthy” with regard to the non-existent symptoms – in the same way as in a normal drug test on a completely healthy person.

In any case – according to homeopathic doctrine – the administration of a homeopathic remedy causes changes which lead to a change in the symptoms. Either it has an effect on the “disease” or in the sense of “homeopathic drug testing” by causing symptoms. Thus the repeated administration of the same medicine (i.e. with an unchanged drug picture) is in any case a “mistake”, against which Hahnemann has already acted sharply in his time:

If a different remedy is “tried out” with every new therapy attempt, the consequence is that a correct selection (“repertorization”) is no longer possible with any further homeopathic remedy: The superimposition of the complete or partial symptom pictures from all earlier remedies makes a correct choice of remedy – according to homeopathic criteria – impossible.

The bad habit of treating patients after “trial and error” therefore does not speak at all for the effectiveness of homeopathic remedies. On the contrary, this practice once again deprives Hahnemann’s homeopathic thought structure of decisive ground. It is the desperate attempt of the homeopaths to be perceived “sometime” and “somehow” as “successful”. Such a procedure provokes a considerable delay of important treatment measures and accepts them cheaply, which can lead to serious damages. There can be no question of “proof of the effectiveness of homeopathy” if one produces random events until a – not causal – desired event occurs.

Author: Dr. med. Wolfgang Vahle

Picture credits: Pixabay, license CC0

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Homeopathy isn’t a “stimulus-regulation therapy”

Homeopathy is occasionally referred to as “stimulus-regulation therapy”, which assumes the existence of a corresponding explanatory model. The reader (or listener) is left alone with this term – there is no precise explanation of how homeopathy could work as stimulus-regulation therapy.

What does “regulation” actually mean?

The term “stimulus-regulation therapy” contains the word “regulation”. In technology and in nature many variables (properties, parameters) are “regulated”, i.e. they are kept constant by a “control loop”.

As a symbolic illustration of the article theme, the picture shows part of a technical control loop system.
Part of a technical control loop

A well-known example from technology is the regulation of room temperature. In the room there is a sensor for the temperature (“thermometer”), there is a device (“actuator”) that can change the room temperature (“heating” or “cooling unit”) and there is a circuit that uses the measured values from the thermometer to influence the actuator so that the temperature remains constant. The thermometer with built-in circuit keeps the temperature constant (static) by activating the actuators, therefore it is also called “thermostat”. When the room temperature drops, more heat is emitted from the heating. When the room temperature rises, excess heat is dissipated via the cooling unit.

There are also many parameters in our body that have to be kept constant. The range of permitted fluctuations is usually very small; excessively large deviations are not compatible with life. The principle is called “homeostasis”. Although this word is similar to the word “homeopathy”, it means something completely different. The prefix “homoeo” means – in both cases – “the same” and “-stase” describes that a state is “standing”, “static” or constant. (The word “homeopathy” actually means that a disease is to be cured with a “same” disease – and is thus wrongly chosen, because in homeopathy not the “principle of equality” applies, but the “principle of similarity” Hahnemann attached great importance to this distinction).

Some examples of homeostasis in the body are given below:

  • The oxygen saturation in the blood. If the measured value drops, respiration is forced.
  • Associated with this is the carbon dioxide content in the blood. If the measured value increases, respiration is forced.
  • The salt content in the blood. If it rises, one gets thirsty and drinks water for dilution and the kidney excretes more salt. If it sinks, you get an appetite for saltiness and the kidney excretes more water.
  • The blood sugar level. If it rises, more insulin is released. If it sinks, you get a ravenous appetite for sweets.
  • The body temperature. If it sinks, the muscles begin to tremble (“freeze”) and try to generate movement heat, it rises, sweat is excreted to cool the body by evaporative cooling.

The list is of course far from complete, but these examples will suffice for your understanding.

Control loops follow the allopathic, not the homeopathic principle.

What you can see in all these examples: The control has the opposite effect on the disturbing change in order to cancel it out in this way. If the blood pressure rises, it is lowered. If the blood glucose level rises, it is lowered. If the body temperature rises, it is lowered. If the acid content in the blood rises, it is lowered. This principle corresponds to what Hahnemann contemptuously called “allopathy”. Even today it is still called “symptom suppression” by homeopaths.

The principle of homeopathy, however, is – in disregard of the wrongly chosen term “homeopathic” – to eliminate a disturbance by a similar disturbance. What should one imagine – with regard to the term “stimulus-regulation therapy”? Should, for example, an increased salt content in the blood be corrected by “even more salt” (possibly of a different type)? This would additionally burden the homeostasis, even if the amount of salt added is small. In addition, it is not necessary to “push” the control loop; the control loops are basic life functions. In the case of kidney damage, for example, the control sensor correctly measures the high salt content – it is the diseased kidney that cannot excrete the excess salt. There can be no stimulus regulation under the premise of the principle of similarity.

Hahnemann does not, however, explain homeopathy by any means via “stimulus regulation”. Hahnemann assumes that a body can never have two similar diseases at the same time. In such a case, he would have to separate from one of the two diseases: the weaker one. The aim of homeopathy is therefore to provide a diseased body with a second disease (“artificial disease”, triggered by the homeopathic remedy, which has a similar “drug picture” to the “symptom picture” of the disease). This second disease must be stronger in nature (it is supposed to drive away the original disease, which must be weaker), but weaker in symptoms (otherwise no one would want to be treated if the treatment produces more complaints than the disease). The term “stimulus regulation” does not fit into Hahnemann’s explanatory model.

Wrong labels

We observe in homeopathy that Hahnemann’s pre-scientific explanations are to be explained with modern scientific terms, “subsequently interpreted”, but this is not possible. Hahnemann’s doctrine of diseases from pre-scientific times does not know today’s terms such as “cellular pathology”, “physiology”, “biochemistry”, “biomechanics”, “microbiology”. The similarity principle of homeopathy and the homeostasis of body sizes are mutually exclusive. If one wants to regulate stimuli, one needs the “allopathy principle”. If one wants to adhere to the “homeopathy principle”, the term “stimulus regulation” remains empty.

Author: Dr. med. Wolfgang Vahle

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Arnica for minor injuries

A popular remedy – a closer look

The picture shows a injuried girl on the playground with her worried mother

Minor injuries with swelling (“bumps”) are often treated with arnica (e.g. in small children after they have fallen and a “bruise” forms, sometimes even prophylactically in athletes). The rapid decrease in swelling is considered to be evidence of the medicinal effect of homeopathic medication.

There are two different types of application:

1. Arnica as a herbal medicinal product, mostly administered in the form of ointments. The quantity of medicinal substances is sufficiently high so that an efficacy of the plant ingredients cannot be ruled out at all.

2. Arnica as a homeopathic remedy, mostly administered in the form of globules. The amount of medicinal substances is reduced by the dilution process during potentiation to such an extent that the effectiveness of the herbal ingredients is excluded.

From the point of view of homeopathy, both types of application contradict each other. The similarity principle of homeopathy means that medicines are applied to sick people which produce the symptoms of the disease in healthy people. When homeopaths use arnica as a homeopathic remedy for swelling, they must assume that a higher dose of arnica causes swelling.

However, this is not possible, because a higher dosage of arnica is not used to cause swelling, but to treat it. If arnica reduces swelling in higher doses, it cannot be used as a homeopathic remedy for this indication. If arnica as a homeopathic remedy is effective against swelling, it should not be used in higher doses against swelling, because arnica would lead to an increase in swelling in this case.

Both application types are mutually exclusive. Arnica cannot be a homeopathic remedy if it is used as an “allopathic remedy” (a term used by Samuel Hahnemann to derogate medicine).

In case reports it is repeatedly pointed out that swelling disappears more quickly under arnica globules therapy than without.

It has to be said that a comparison between both versions – swelling with arnica globules compared to swelling without arnica globules – is not possible without large case numbers (studies): A patient cannot be treated with the same swelling with and without arnica at the same time. The recovery time is normally only an estimated value: usually the time is not determined by a stopwatch. The assertion that swelling would disappear more slowly if you don’t take arnica is nothing more than an assumption. In surgical outpatient departments, it is regularly observed that swelling decreases rapidly at all and that there are no differences between patients – regardless of whether or not arnica globules were administered.

What happens medically with a minor injury? In the first phase, substances are released into the tissue that lead to swelling. Blood vessels can also be injured so that blood escapes (“bruise”, “haematoma”). But already after a short time other substances (e.g. “histamine”) are released which lead to a vasodilatation. More liquid is then transported away via the more distant vessels in a shorter time and the swelling decreases again.

Conclusion: Arnica as a homeopathic remedy for minor injuries is ineffective.

1. The principle of similarity – one of the essential foundations of homeopathy – cannot be effective because higher doses of arnica are not used to create swelling but to treat it.

2. The exorbitant dilution during potentizing causes all ingredients necessary for the treatment to disappear: There are no active substances in the globules.

Comparisons between treatments “with” and “without” arnica globules cannot be performed on the same patient. Thus, it is not possible to determine whether the swelling with arnica globules has decreased more compared to the swelling without arnica globules: A patient cannot be treated with and without arnica for the same swelling. Here it is important that it is one and the same swelling – otherwise no comparison can be made.

4. the high rate of regression of swellings during treatment with arnica beads is only an estimated size, which is also very strongly dependent on wishful thinking and selective perception.

It is often not known that swelling quickly disappears even without treatment with arnica globules, but this can be explained very well from a medical point of view. You can trust it.

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Nocebo – what’s that again?

A medical capsule shows two colours in two halves - red and green - and is labeled

On this page you will find various information about the placebo effect, which explain that it is effective with any kind of attention – and therefore, of course, even more so with medical interventions. Furthermore, it is explained that homeopathy, like other pseudomedical procedures, sucks its honey partly from this effect instead of showing an own specific effect. Which – contrary to many a claim – not does help her to a place in scientific medicine.

This must be supplemented by a few remarks on the Nocebo effect. What does this mean?

There is a “counterpart” to the placebo effect: the nocebo effect. Placebo researchers even occasionally talk about the “side effect” of the placebo effect, but this does not quite hit the nail on the head. The mechanisms are the same, yes, placebo and nocebo are a sole phenomena. Only the effects of Nocebo are, so to speak, the “dark side” of the placebo effect, the negative mirror image. The differentiation between placebo and nocebo is thus only due to human perception and evaluation (similar to effects vs. side effects of drugs, which also is an evaluation system based purely on the utility or harm value in humans).

It is obvious that negative expectations can lead to a worsening of the patient’s condition – in the sense of a placebo effect with a negative sign. A good physician should take this into account in the same way as the placebo effect. Who does not know the “fear of the package insert”, which unfortunately causes a basic distrust of the prescribed medication in many people and thus often noticeably impairs its effect? The same applies in hospital if – what should not happen! – the patient is simply presented with his pill glass without being told what it is all about – the nocebo effect lurks. Especially if someone is already conditioned by pseudomedical “wisdom” to reservations about “conventional medicine”, which can very well have a negative effect on the effect of a finally inevitable medical treatment. It has also been proven many times that such an attitude leads to a lack of compliance – basically nothing more than an effect of Nocebo.

One of the most impressive examples of a nocebo effect is a study that was conducted with considerable effort and methodically correct in the USA a few years ago: The question was whether prayers can help in the recovery process. Patients who had undergone bypass surgery were divided into groups, one of whom knew that they were being prayed for and the other did not. This study showed a clear result: the group that knew they were prayed for clearly showed more complications and worse outcomes during convalescence. Quite obviously a Nocebo effect, which was certainly due to the – conscious or unconscious – assumption of the patients that it must be quite bad for them if they are prayed for …

Conclusion: placebo and nocebo effects are both important aspects that the responsible physician must always take into account. However, they are not a cheap alibi for the “effectiveness” of pseudomedical methods that cannot offer their own specific effects.

When trying to justify “placebo” as an independent medical intervention, it is repeatedly forgotten that placebo is neither predictable nor targeted. Main thing: placebo! Would the advocates of this view see it the same way when expecting nocebo effects? Especially since it depends on the situation and the patient whether a certain intervention has placebo or nocebo effects.

Author: Udo Endruscheit

Picture: Fotolia_84526053_XS

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What is the Placebo effect and what are Context effects?

Red-white medical capsules filled with a white substance spread on a table

Let us first clarify what is meant by the term “placebo”. Here we would like to limit ourselves to placebos as drugs (yes, there are a lot of placebos that have nothing to do with drugs). Let us stick to the drugs: Then a placebo is a drug that is actually not a drug at all. It does not contain any medicinal substance. It looks and feels like an effective drug (or what you think it is) – but it doesn’t contain any active ingredients.

Nevertheless, such placebo drugs can cause something in the patient: the “placebo effect”. Not only does one feel better, but physical changes can also occur that can actually be detected. However, these are not caused by medicinal agents. Rather, they are caused by the fact that patients think they are receiving an effective drug and they have repeatedly experienced that treatment improves their symptoms. This is a complicated connection with psycho-physical effects, which has been well researched, but by no means completely, but which can be described quite simply for our consideration:

  • If a patient is convinced that a treatment will help him, he loses, at least for a while, his fears and worries. He can relax much better, and his self-healing powers can become more effective. This is the actual placebo effect.

But now we have to bear in mind that it is not only the pharmacological effect of a drug and this placebo effect that make the patient feel better after a certain time. There are other things that make this possible to a considerable extent – this “bundle” of causes is referred to as “context effects” (including the placebo effect), i.e. the sum of effects that are not triggered by a specifically effective medical intervention:

  • The natural course of the disease: In this case, the complaints go back by themselves, without any need to do anything about it. Let us think, for example, of mild colds, sprains, harmless superficial injuries, bruises in children, etc. These are all trifles that the body overcomes by itself – and not just these.
  • The regression to the middle: This is the effect that extreme situations in nature are rarely maintained for long. In terms of disease, this means that either the symptoms become worse and worse and possibly even tragic – or they go back to mediocrity. If you only start treatment when the situation is already difficult to bear (which is very often the case), you often have most of it behind you. The situation for the patient would also improve now without further external intervention.
  • Accompanying therapies or measures: When we humans feel ill, the time has often come for us to listen to good advice. That we, for example, pay attention to a healthy diet, take walks, replace alcohol and coffee with water and avoid cigarettes, move more or even spare ourselves if we have put up with too much. These seem to be trivialities – but they can achieve a lot.
    Perhaps we also had accompanying therapies that do their work, such as physiotherapy, massages and the like. But also the improvement of the personal life situation or psychological help by a qualified therapist fall into this category.
  • Indirect effects: Perhaps we had also chosen a therapy that was not sensible and possibly even had side effects. By starting the new therapy, a previous one may be terminated, and the healing is a consequence of the now no longer occurring side effects of the old therapy, which did us no good. Or the patient is removed from the disease-causing influences, for example, he no longer goes to work because of his complaints or is no longer exposed to other disease-causing conditions due to a change of location. There are many possibilities here.
  • Getting used: The patient gets used to the situation, learns to deal with it and then does not feel his condition as unpleasant as it initially seemed to him.
  • Unknown causes: Ultimately, the healing can also come from things or circumstances that are not associated with it, either because they are overlooked or because the influence on the condition is not known and nobody pays attention to these things.

This should suffice here as an overview, which could certainly be supplemented further. All these effects can occur with any therapy – but they do not belong to the specific effect of the drug, because they are independent of what the patient is taking. This also applies to placebo.

Learn more:

https://de.wikipedia.org/wiki/Placebo

http://www.homöopedia.eu/index.php/Artikel:Oft_gehörte_Argumente_-_Verbreitete_Vorstellungen_über_den_Placebo-Effekt (in German)

http://placeboforschung.de/de/mechanisms underlying placebo effects

On this website about Nocebo: Nocebo – What’s that again?

Picture credits: Ewa Urban on Pixabay

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What are Bach Flower Remedies anyway?

About the inventor

Edward Bach was a doctor from Birmingham, England, who studied medicine at the University College Hospital in London and graduated from Cambridge. Before he began his studies, however, he worked in the family brass foundry. Bach saw the source of diseases mainly in psychological causes or in the intestines.

After leaving some real clinical positions behind, he worked from 1918 at the London Homeopathic Hospital, which he left again in 1920 in favour of a private practice. One of his main areas in the Homeopathic Hospital was the extraction of so-called “nosodes”, which are homeopathic remedies obtained from pathological endogenous substances such as blood or pus.

In 1930, however, he closed his practice again in order to devote himself to observing nature and herbal medicine in Wales. Here his principle that illnesses are only the expression of a conflict between soul and mind became firmly established. On 27 November 1936 Bach, just 50 years old, died of heart failure.

About the system

The system Bach came up with is relatively simple. He took a mental misfeeling, such as “mental stress and tension” and assigned him a plant essence. This plant essence in turn should harmonize the vibrations of the patient with the cosmic energy field through its vibrations and thus heal the disease. Bach put together a total of 37 flower essences as well as an essence from rock spring water and a combination of five essences, which is probably the best known product under the term “Rescue remedy”.

The selection of plants for the negative mental states was purely intuitive, with Bach assuming that a divine inspiration guided him in his selection. However, the main criterion for selection was that the plants correspond with the concept of archetypes in the sense of Carl Gustav Jung. The flower essences still bear English names today, as a kind of homage to their inventor.

About the production

At the beginning of the production of its essences Bach used only the dew that was on the flowers of each plant at sunrise. The morning sun, which shone through dew and blossom, was to enrich the water with the vibrations of the plant. Thus, as in homeopathy, the assumed healing power is based on the non-existent water memory. As his flower essences became more and more successful, Bach was no longer able to meet the demand with dew drops alone and devised two other ways of preparing the essences.

The first of these is the so-called “sun method”, in which the freshly picked flowers are placed in about half a litre of water and stand in the blazing sun for three to four hours. In Bach’s imagination the vibrations of the plants are transferred to the water as healing energy. This part of the production is strongly ritualized by Bach’s regulations. So the plants have to be collected before nine o’clock in the morning on a sunny and cloudless day. The places where the plants have to be picked are also specified.

After these three to four hours the treated water is diluted 1:1 with 40% alcohol (formerly brandy or cognac). This is for conservation purposes. This mixture is now the mother tincture, which must be diluted again in the ratio 1:240 with alcohol in order to produce the “effective” essences. The end user must dilute the essence again in water in order to take it.

The second method is the so-called “cooking method”, in which the plants do not stand in the sun but emit their vibrations during a 30-minute cooking process. The further treatment is then the same. This method is usually only used for very woody plants or for autumn and winter bloomers.

About the application

Bach flowers are not only available as drops, but also as ointments, sweets, chewing gums, globules, teas, sprays, etc. There are also Bach flowers for animals. The classic dosage form, however, is that of the “stockbottles” with a content of 10 ml.

The “right” essence can be found by going to a Bach flower consultant or a non-medical practitioner, swinging out the essences yourself, using a guidebook or selecting the plants purely intuitively on the basis of their appearance.

About the effectiveness

Bach died in 1936 and his doctrine was forgotten. It was not until the great esoteric wave of the 1970s that it became known again. Since then, several clinical studies have been carried out, but none of them have shown any effect.

Today, flower mixtures are also offered which are outside the canon of Edward Bach. Special attention was given, for example, to an essence that should be used in the case of child abuse. After strong protests, this essence was taken off the market. With homeopathy they have only the magic thinking in common – but they are often confused or equated with it and are considered “particularly natural or vegetable”. Especially esoteric would be more appropriate.

We find it particularly problematic that Bach’s remedies are mainly used for psychological complaints (e.g. anxiety, loneliness, panic attacks, examination anxiety, trauma, depression, weariness, thoughts of death) and can thus delay or even prevent necessary psychological or psychiatric therapies. Moreover, their widespread and uncritical use conveys that for such serious diagnoses it is sufficient to take “a few little blossoms” and everything is fine again.

More about this on our Homöopedia: http://www.homöopedia.eu/index.php/Artikel:Edward_Bach

Picture credits: Sylvia Stang for the INH

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Objection: Globules are much better than antibiotics anyway!

Antibiotika vs. Globules – really?

“Antibiotics versus globules – really?

“I’d rather take globules than antibiotics.”

“Doctors prescribe way too much antibiotics randomly.”

“If I take too much of it, I’ll be resistant in later diseases.”

These sentences can be heard very often in this or similar form. But all three sentences are wrong. Let’s look at them one by one:

1.  I’d rather take globules than antibiotics.

Taking globules rather than antibiotics is an understandable wish. But it’s a false comparison. If it were up to me: For example, I’d rather win the lottery than take antibiotics.

Antibiotics are highly effective drugs that are able to kill certain pathogens (bacteria) or prevent their multiplication. Although “anti bios” has the meaning “directed against life”, antibiotics are not effective against all life: parasites and viruses cannot be treated with antibiotics. Nor do we have to fear that humans and animals will be killed by antibiotics. Also not all antibiotics are effective against all bacteria. Bacteria can be “sensitive” or “resistant” (insensitive) to antibiotics.

There are many antibiotic groups whose representatives are not chemically related to each other. They have no common “roots”, but a common goal: the reduction of the number of pathogenic germs in the host organism; the “reduction of the germ load”. For each antibiotic it is possible to indicate which bacteria are sensitive or resistant to this antibiotic. And for each bacterium one can indicate which antibiotics it is sensitive or resistant to. With regard to pathogenic germs, every antibiotic has a “spectrum of action”.

In principle, the use of antibiotics only makes sense if the disease is caused by germs that also lie within the spectrum of action of an antibiotic. If one uses an antibiotic that is effective against pathogenic germs, the germ load in the host organism is reduced. The immune system of the host organism can bring about healing under these improved conditions. The strengthening of the immune system is only induced by the reduction of the germ load itself. A non-specific strengthening of the immune system by foreign substances has not been proven – neither for preparations such as “Echinacin” nor for globules. An undirected use of antibiotics – even of ineffective ones in the case of resistant germs or viruses – cannot lead to a reduction in the germ load and therefore cannot support the immune system.

Occasionally there are studies that show that antibiotics do not work better than homeopathic remedies. To prove this false assertion, antibiotics are then used in the comparison group for diseases that do not respond to antibiotics. So it is not surprising that antibiotics do poorly in these studies. However, this does not mean that globules are preferable to antibiotics, but only that the study design was poor.

However, every use of antibiotics has a second component: under the influence of antibiotics and the resulting increased “selection pressure”, sensitive bacteria can become resistant or more quickly resistant. This accelerated development of resistance also affects germs that are not – not yet! – are pathogenic and can only become dangerous through their antibiotic-induced resistance. The use of antibiotics in viral diseases is therefore not only nonsensical because it is ineffective, but also harmful because it promotes resistance. Medicine as science knows this and teaches it. For this reason, antibiotics are available only on prescription. If there are doctors in individual cases who do not adhere to the guidelines of medicine, then this is a failure of the doctor and not a failure of medicine. In the event of legal proceedings in this regard, medicine would act as a witness against the doctor.

2. Doctors prescribe way too much antibiotics randomly? Why one does think that?

Because doctors are informed about the advantages and disadvantages of antibiotics, they use these drugs only – according to their knowledge and conscience – specifically.

In the case of some infectious diseases, the bacterial cause can be quickly identified without great effort. Other infectious diseases require complex diagnostics. If there is a bacterial infection, antibiotics are justified – even if the path to diagnosis was short: even short routes can be targeted. If the application is incorrectly unintended, the risk of developing resistance to previously sensitive germs increases. The more resistant germs there are, the greater the general health risk to the population. Therefore, germs that are resistant to one antibiotic must be killed by another antibiotic as soon as possible: Dead bacteria cannot pass on their resistances to the next generation of bacteria.

Particularly in mixed infections with a group of different pathogenic germs, even a “broad-spectrum antibiotic” may not be effective for all germs. In this case, several different antibiotics have to be taken one after the other (simultaneous taking is usually problematic because the different chemical mechanisms of action of antibiotics hinder rather than promote each other). Also a change of antibiotics to avoid the formation of resistance is by no means unintended, even if the necessity is not apparent to all patients. And in case of doubt, pathogens and their resistance are determined in the laboratory.

The latest developments, however, give us hope that in the future it will be possible to determine germs quickly and easily in the doctor’s practice and thus drastically reduce “misprescriptions” of antibiotics.

3  If I take too much of it, then I will be resistant in later diseases.

The term resistance refers only to pathogenic germs, not to the host organism (the human body) from which these germs are to be eliminated. The host organisms are “naturally” resistant to antibiotics. This means that only a chemical substance to which host organisms are resistant can be tested for possible antibiotic efficacy. Substances such as “cyanide” or “mercury” may have good ability to kill pathogenic germs. The use of these substances as “antibiotics” is out of the question: humans and animals are not resistant to cyanide or mercury. For humans and animals are cyanide or mercury poisons. It goes without saying that the antibiotics used in medicine must not be toxic to humans or animals, so that humans and animals are resistant to the antibiotics used is not a disadvantage but, on the contrary, a prerequisite for the use of antibiotics. Let us assume – in a game of thought – that people could become resistant to mercury, for example: then we would not have any disadvantage, but only another therapeutic option for infectious diseases caused by mercury-sensitive germs.

Conclusion: I’d rather take globules than antibiotics?

Globules are “homeopathic remedies”. The doctrine of homeopathy knows no germs, so for homeopathy the use of antibiotics is simply absurd. And that is why, conversely, the administration of globules to infectious diseases is no less nonsensical from the point of view of scientific medicine, because homeopathy categorically ignores precisely the actual causes of infectious diseases and the only effective remedies against them.

Antibiotic treatment of infectious diseases – especially severe infectious diseases – is by no means a purely symptomatic therapy, but a causal therapy (“treatment of causes”) that can save lives. A renouncement of a necessary antibiotic therapy can result in serious health damages – by omission.

Harmless diseases, on the other hand, require neither antibiotics nor globules. Homeopathic remedies are ineffective and superfluous for all diseases.

Further information can be found in the article Antibiotics on Homöopedia (in German)

Further information about the immune system on our family site (in German)

Picture credits: INH

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Globules are natural and plant-based – really?

Another common misconception about homeopathy

Many people assume that homeopathic remedies are made from herbal substances. But if you look at the long “drug lists” of homeopathic manufacturers, it quickly becomes clear that homeopathy and phytotherapy are two completely different things.

In herbal (phytotherapeutic) drugs the ingredients are present in medically effective concentrations, in modern herbal medicine the cause-effect relationship is investigated using scientific methods and in pharmaceutical processing, for example, unwanted by-products are removed and it is ensured that an exact dosage is possible (standardization).

In homeopathy, however, only some of the basic substances used are of a herbal nature and even among these there are some that can be hazardous to health even in small doses, such as the arrow poison curare, the fly agaric or hemlock.

One can be glad that by the high degree dilution in the used remedies nothing or at least no effective concentration of the raw materials is more present.

This is emphasized even by the authors of drug lists (1).

In the lists of ingredients there are also things of completely non-plant origin like polio viruses (“sterilized”), “humming crop circles”, aluminum, mercury and all other metals, chlorine, the magnetic North Pole, meteor dust from Arizona, microwaves, plutonium, Gonorrhea and syphilis pathogens, even smallpox and plague pathogens (Yersinia pestis), optionally the Berlin Wall or the Great Wall of China – and last but not least sugar, which is – diluted millions or billions of times – sprayed onto globules (which themselves consist only of sugar). But since homeopathic remedies with their Latin or occasionally at least English names are on the market, very few people know what is hidden behind the scientifically sounding names. Who realizes that Cimex lectularius is the common bed bug, Porcellanum misniense Meissen porcelain, Gunpowder comp. pure gunpowder or Excrementum caninum nothing else but dog excrement?

Many of the original materials were unknown at Hahnemann’s time. In the last edition of the ‘Reine Arzneimittellehre’ ( in 1833, he himself described as many as 70 substances which he used for his preparations. Even then, these were not only vegetable raw materials, but also mercury, gold, silver, tin and bismuth, sulphur, phosphoric acid or charcoal. The systematics of the ingredients are at least in part still based on the views of nature as they were common in Hahnemann’s time, but also incorporates modern taxonomies.

A distinction is made between the authors of the drug lists:

Animated kingdoms of nature:
  • animals
  • plants
    mushrooms
  • Protists (all unicellular organisms that do not belong to any other empire)
  • bacteria
Uninhabited kingdoms of nature:
  • viruses
  • Minerals (all chemical elements, but with homoeopathic abbreviations)
  • Energy fields (physical radiation such as the light of the polar star, energy fields of places)

How do the manufacturers of globules and the “inventors” of new formulations come up with the possible substances when they launch new products on the market? After all, there are now over 7,000 ingredients that are used for homeopathic preparations.

The choice of what things are used to make new homeopathic remedies is completely arbitrary and emerges from the developers intuition. It is based on the theory of signatures, which originated in antiquity and was widely used in Europe in the late Middle Ages. She assumes that similarities of characteristics of natural objects indicate inner connections between them and the sphere of human being. These characteristics can be any property imaginable: Form, colour, behaviour, character, smell, taste, location, date of origin, colours, astrological classifications – every aspect you want to read into something.

A popular example is the walnut, whose shape is reminiscent of the human brain and is therefore used in brain diseases, or the bean, which is supposed to help with kidney diseases due to its kidney-like shape. But there are also homeopathic remedies such as “Terra” (normal earth, diluted 1 : 10^30), which is used by expellees, but also by other “uprooted” people such as divorcees.

That these phenomenological similarities have nothing to do with structural, functional or physical connections and correspond to a pre-scientific world model should be clear even to elementary school pupils.

Even completely individual-subjective observations from everyday life can be used for the selection of the basic substance if, for example, the supposedly increased need for chocolate during menstruation is concluded to be related to circulation and the hormone system (of course without having any empirical evidence for this).

Conclusion: The selection of homoeopathic basic substances is random, subjective, purely intuitive and not proven by any logic, research or scientific derivation. The understanding of cause-effect relationships is at best unscientific and often corresponds to magical thinking.

The conclusions follow an inductive logic in which feelings, individual observations or esoteric hypotheses are used to infer regularities without these being able to be empirically proven in any way.

No, globules are not “natural and vegetable” in the sense that the consumer always imagines when he makes such a statement or asks a question.

(1) “Poisons, medicines or pathogens mentioned in the list of homeopathic remedies are to be understood only in the sense of a remedy potentiated according to homeopathic rules, i.e. the homeopathic remedies offered by the aforementioned manufacturers and discussed in tests for medicinal products or articles do not contain the aforementioned substances (poisons, medicines, pathogens) in the chemical or biological sense if the potency level is C12, D24 or higher“. (Source)

Author: Dr. Susanne Kretschmann (Certified Psychologist)

Picture credits: Fotolia 47049734 Auremar

 

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Objection: Theoretically bumble bees can’t fly either!

“According to the known laws of aerodynamics, a bumblebee cannot fly. The bumblebee knows nothing about aerodynamics – and still flies”…

…and therefore, as the argument is intended to express, science is also not suited to judge whether homeopathic remedies can work. Finally, as this example clearly shows, science refuses to take note of the obvious and dogmatically insists on her apparently false laws of nature. Really?

The picture shows a bumblebee sitting on a thistle blossom. With regard to the title of the article, the caption ironically asks how it might have got there.
Bumblebee on a blossom – how might she have got there?

The bumblebee can fly of course and has (probably) no idea of aerodynamics, so far this is true, but the claim is wrong that the first would contradict the laws of aerodynamics.

What would happen if the statement were true? If knowledge of physics at this point would be wrong or coarse incomplete? If such an obvious phenomenon could not be explained?

Quite simply: There would be a huge challenge as to which physicist would be the first to unveil the secrets of the bumble-bee flight and who the first to be able to correctly describe the causes of the phenomenon. That’s what every scientist strives for: To be the first to break new ground, to connect his name forever with a new knowledge. That’s what Nobel Prizes are for. This achieves reputation, which represents the market value of the researcher.

The fact that this race does not take place is because it is simply not true that the “laws of aerodynamics” contradict the bumblebee flight. It goes too far here to explain the principles of wing theory at comparatively low Reynold’s Numbers (that is, at small dimensions and low speeds), but there is nothing mysterious about it. The bumblebee flaps its wings and can continuously change the shape of the wings in such a way that it sets air in motion in a certain direction, which creates a force on the bumblebee in the opposite direction. You can watch it in high speed slow motion (video YouTube from min 1:30). (These are bees, but wings of bumble bees and bees are not very different).

The basis for the sentence, which is also often used by motivational trainers, is obviously a small, in itself insignificant incident, which would have been forgotten had it not developed into a student eulogy in Göttingen in the 1930s. At that time, the Aerodynamische Versuchsanstalt (AVA) in Göttingen was one of the world’s leading research institutes, which gave it a certain significance.

The starting point is supposed to have been a meeting of a biologist and an aerodynamicist in a restaurant. The biologist used the example of the bumblebee to get to know how flying works. The aerodynamicist made a short rough calculation on a napkin or a beer mat. He (obviously) calculated that the wings (area 0.7 cm²) would not develop enough lift at the airspeed (10 km/h) to support the weight of the bumblebee (1.2 g). The aerodynamicist made the mistake of using equations that apply in the case that the wings act like rigid aerofoils that are incidently flown in by the airstream. It is easy to imagine that the biologist took this opportunity to talk about nature’s superiority over human technology. When the aerodynamicist noticed and corrected his mistake, it was of course less spectacular and caused much less sensation. (source)

That is the background for this false argument: an error of a single person eating in a pub. It is not known what role wine and beer played in this. There is by no means a whole scientific discipline involved, no physicist has ever claimed that the flight of a bumblebee is impossible.

The argument that the bumble-bee flight contradicts physical laws rather testifies to the lack of expertise of the one who uses this argument, both in terms of physics and aerodynamics, as well as how science works. A probability for the “functioning” of homeopathy is not inherent in this “argument” in the least.

Picture credits:  Rudy and Peter Skitterians on Pixabay

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Objection: Mobile phones also function immaterially during data transmission!

Homeopathic remedies in medium and high potencies do not contain any or no significant amounts of the remedy indicated on the packaging. Some advocates of homeopathy say that it is an antiquated view of the world that a specific effect is linked to the existence of matter. See the mobile phone, which obviously reproduces the words of the interlocutor without the effect of matter.

There is no doubt that there is no direct effect of other parts on the mobile phone, e.g. via a wire connection. However, the underlying idea that matter can only be effective in direct contact with other matter is erroneous. In fact, matter can also work over great distances, just think of gravity, which holds together not only our solar system but whole galaxies over huge distances.

The same applies to electromagnetic distant effects when a transmitter emits electromagnetic waves that can be detected by a receiver. This, too, is an effect based on matter, of which one can easily convince oneself in a small experiment with an older functional mobile phone:

Take the mobile phone apart, remove the antenna and reassemble it. If the effect were actually not bound to matter, the cell phone would still have to function without the antenna, i.e. you would have to be able to make a call with it.

We will see how much the function of the mobile phone is linked to the presence of matter in the form of the required components and that it is therefore erroneous to see an immaterial effect in it. By the way, one will search in vain for an example of an immaterial effect – such phenomena are unknown in natural science. And also for homeopathy the claim of an immaterial effect is wrong. So the “argument” is none.

Picture: Wikimedia, Author: Martingrina

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Objection: CDs also store information!

Does storing music on a CD really have anything to do with homeopathy?

Proponents of homeopathy often point out that chemical analysis cannot determine whether a CD is recorded or not, or what is stored on it.

This comparison is intended to refute an essential reservation of critics of homeopathy. Although homeopaths do not deny that the solution does not contain any active ingredient even at a comparatively low potentiation when diluted and shaken, the comparison with the CD allegedly shows that this chemical examination is obviously not sufficient to understand the whole process.

It is undoubtedly true that a chemical analysis cannot distinguish a recorded CD from an unrecorded one. The reason for this is that an essential part is missing from the analysis, namely the structure of the surface which is applied when the CD is burned and in which the contained information is stored. Just as the burning of the information on the CD is obviously independent of its chemical composition, this should also be possible in the solvent if the active ingredient has disappeared from it due to dilution.

This analogy is based on the assumption that water has similar properties to the CD and can also store information in its structure in some way. However, the analogy is no proof that this is really the case. In fact, the opposite is the case: while a CD as a solid can easily store an imprinted structure over a very long period of time even with a certain resistance to destruction, this property of a liquid is completely absent. Try to write something with any pen on the surface of liquid water. What is easily achieved with a CD with a suitable pen proves to be impossible with a liquid. The structures (water clusters) that water actually forms are of such an extremely short lifespan that it is impossible to store information even for the tiniest fractions of a second.

Quintessence: The statement that a chemical analysis cannot tell whether data is stored on a CD is correct, but the implicit assertion that the conditions in the water are similar is wrong. The CD is a completely unsuitable model to illustrate the processes of potentiation and therefore does not function as a “proof” for homeopathy.

-> More about this on our Homöopedia Website.

Picture credits: Andreas Weimann for INH

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Hahnemann’s Organon – Fundamental Work of Homeopathy

A book from the beginning of the 19th century – a Bible of today’s “medicine”?

The picture shows a memorial plaque to Hahnemann's tomb in Paris with key sentences from the Organon
Memorial plaque to Hahnemann’s tomb in Paris with key sentences from the Organon

The Organon can justifiably be called the Bible of homeopaths. It was first published in 1810 by the inventor of homeopathy, the Saxon physician Samuel Hahnemann, and received a total of five revisions and six editions from his hand.

The term organon comes from ancient Greek and means as much as tool, and Hahnemann has seen it as such. The organon should be the tool for healing the patients. His book was therefore aimed not only at doctors, but also at patients. Hahnemann also partly gave away his organon to his own patients.

While the book also contained reasonable suggestions for personal hygiene or lifestyle in case of illness, it also contains abstruse explanations as to why homeopathy cannot work, for example, because one wore underwear made of sheep’s wool or had unchaste thoughts.

Of course, a good part of the organon takes up the explanation of the basic homeopathic principle that similar things are cured with similar things. The same applies to the instructions for potentiation, i.e. the dilution of the active substances. In his teaching, Hahnemann assumed that the dilution would not weaken the effect, but even increase it.

You can’t blame Hahnemann here, though. At the time when he wrote his Organon, the basics of pharmaceutical mechanisms of action were not yet known, neither were viruses or bacteria (germs) as pathogens, since science-oriented medicine was still in its infancy. Therefore, the Organon and its origin must always be seen in its historical context.
What Samuel Hahnemann insists on in his Organon, however, is the compilation of a comprehensive diagnosis, which is today referred to as the “first conversation”. Only through this diagnostic interview can the “symptom picture” of the patient be determined, which is then a prerequisite for finding the “only right” remedy and thus for a comprehensive and lasting cure.  – On the side: If you read this paragraph in the Organon, the question arises: And how should animal homeopathy work? A diagnostic interview with a dog or horse might be a bit difficult.

Another interesting point is that Hahnemann assumes that there is always only one disease in the human body that can do its mischief, which can only be treated with one active ingredient. Today’s “homeopathic tri-complexes”, which we know from advertising, completely contradict Hahnemann’s basic idea in Organon. And these are not marginalities, but core principles of homeopathy. At Hahnemann it is clear: one disease, one active substance, one recovery.

That Samuel Hahnemann already felt harsh headwinds in the first years after the publication of his new doctrine of faith in the Organon, can be noticed at the latest from the fifth edition of the Organon. In this edition he insults his opponents violently and “renegade homoeopaths” massively. The renegade homoeopaths even more violently than the opponents, so there is to read from “mongrel homeopaths” and more. By this he means above all those who deviated from his teachings and created their own “variations” (of which there is a huge amount today that contradict both the Organon and among each other, sometimes massively).

It is also interesting to note that nothing has changed in the organon, and thus in the homeopathic core doctrine, in the last 200 years. Especially the medical homoeopathy usually refers to representing the “classical” (strongly based on Hahnemann) or the “genuine” (Hahnemann literally taking) homoeopathy. Although medical knowledge has multiplied extremely in this long time, no paragraph of this book has been revised or replaced. Nevertheless, this book from the early 19th century is the basis of the homoeopathic education and training – also the “official” based on the training regulations of the German Medical Association for the acquisition of the “additional medical designation homoeopathy”.

Picture: Andreas Weimann for the INH

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Why people like to believe in homeopathy

“We all don’t process information as carefully and reflectively as we think we do.”

Fast thinking versus slow thinking

People use two different ways of thinking. Normally we judge intuitively, without reflection and according to learned, generalized and often irrational rules that are not consciously perceived and questioned. Such intuitive rules are for example: “Loss of something is worse than an equal loss of profit” – “When one event occurs after another, it is caused by the first” – “My view on a subject corresponds to the opinion of the majority” – “chemical is bad, of natural origin is good” or also “scientific explanations are only one of several equivalent views”. This system has its advantages, it is fast and mostly effective for everyday decisions in a stable environment. It’s also called thinking fast.

System two, which is called slow thinking, is the logical and systematic thinking, the weighing of different alternatives according to rational points of view. It is slow, but leads to more reliable results, especially under uncertain conditions or when making important decisions. Economists in particular, with their model of “homo oeconomicus”, are of the (often erroneous) opinion that people always behave rationally.

The slow rational system must first be consciously activated, while the intuitive one is permanently “in operation”. This means that it not always come to fruition, even in the case of important and momentous decisions. So we do not weigh up the important arguments, but are often influenced in our intuitive way of thinking by completely unimportant criteria. Studies have shown that judges’ judgments after eating were milder than before – blood glucose had influenced the decision, not just the rational balance.

Homeopathy “feeds” fast thinking

The more central a conviction is for one’s own value system, the more powerful the intuitive level is. For example, in a consolidated belief in the effectiveness of homeopathy, it is of little use to refute individual points because they are supported by others – doubts would question one’s own self-image! Experiences, which contradict the firm belief (a remedy does not work), do not question the remedy or homeopathy as such, but are explained within the system (wrong application, wrong boundary conditions, wrong homeopath). As a rule of thumb can be considered: The less comprehensive an intuitive control system is or the less central a rule such as “chemical vs. biological” is in the value system, the less immune they are to irritations such as logical refutation. In this case, the rational debate can be set in motion by questioning intuition, by letting the rule “stumble”, so to speak: “Why should something work that does not contain any active ingredient?” Someone for whom homeopathy is not central will think about the argument and perhaps come to their own conclusions. A convinced homeopathic practitioner will change the level of argumentation and bring the supposed water memory into play.

Our judgements and behaviour are usually determined more by the intuitive level than by the rational level. The world is too complex to process every input in detail and to judge it rationally. So we use cognitive heuristics that give us quick orientation and guidance. One of these heuristics is, for example, the intuitive judgment of a text according to the connotations of the words used, i.e. the emotional meanings that the terms have subjectively. When fast reactions are required – and they are usually in everyday life (for example: Is this product interesting for me? Am I going to read this text? Does this information correspond to my opinion?) -, we usually let ourselves be guided by this first subjective impression and not by rational reflection.

How to convince homeopathy advocates?

By rational arguments rather not, because the rational thinking is largely “switched off” in the evaluation of the beloved healing method. The choice of terms when communicating with believers in alternative medicine is nevertheless important for the acceptance of the arguments. The term “not complicated” in a product description leaves a more negative feeling than the term “simple”, although both have the same meaning. We will tend not to buy the product or to accept communicated information. This effect generally occurs in negative statements, especially in written communication: the negative connotation and not the objective content is permanently remembered.

The phenomenon of reaction to connotations instead of content can be easily verified: How does an opponent of alternative medicine spontaneously perceive a text and evaluate it, which contains some of the following words, possibly already in the heading: Mindfulness – gentle – natural – subtle – quantum healing – energetic – healer? How long will she be reading? Will she buy a book advertised with such terms?

For this reason, terms should also be avoided that have already acquired their own meaning in relevant discussions and have been appropriated by one side, i.e. are stored in an intuitive rule. They automatically generate ideas that obstruct or make impossible the goal of communication – namely an objective examination of the topic and the information conveyed – from the outset. Examples of such contaminated terms are “chemical” vs. “biological”, “esoteric”, “science”, “pharmaceutical industry” or “sugar pellets”.

On the other hand, as a homoeopathic practitioner one intuitively grasps the associations of homoeopathy such as “natural”, “gentle” or “no side effects” and tends to do so emotionally quickly – often without further questioning these associations. Perhaps, however, it will be possible with previous advocates to flip the switch from fast to slow thinking and to sensitize them for new arguments against their previous faith by using the right choice of words – INH is also committed to this.

Author: Dr. Susanne Kretschmann is a graduate psychologist specializing in cognitive and environmental psychology

Read more:

Daniel Kahneman: Thinking, Fast and Slow; Penguin Pocketbook, 512 pages (2016)

“How homeopathy overrides common sense”

Photo: Shutterstock 41183275 Sebastian Kaulitzki

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Homeopathy is esotericism

This true without lying, certain and most true.
That which is below is like that which is above and that which is above is like that which is below to do the miracles of one only thing.

(Tabula Smaragdina – Emerald Tablet – of Hermes Trismegistos, translated by Sir Isaac Newton)

The picture shows as an allegory on the article theme esotericism the magical endowed Medea on a painting by John William Waterhouse
Medea – painting by John William Waterhouse

The term esotericism originates from the ancient Greek “ἐσωτερικός”, which means as much as “directed inwards”. Esotericism was once regarded as a secret doctrine, but today it can be found everywhere in the alternative faith scene and has long been accessible to the general public.

Nowadays, esotericism is understood to mean practically any discipline that is neither empirically nor rationally verifiable and therefore does not agree with scientific findings – and to a large extent contradicts them – and deals with mythical and spiritual topics. Esotericism and occultism (lat. “occultus” = hidden, mysterious, dark) are closely related. Occultism is usually defined as the more practical part of the same worldview. Meanwhile, there is an increasing mixture of esotericism with ancient wisdom teachings of various cultures and predominantly Far Eastern religions.

Many ideas of the archaic world view can be found in “alternative medicine”. Esoterics of all fractions represent ancient ideas, which contradict all today known scientific knowledge and allegedly go back to Hermes Trismegistos. Hermes Trismegistos was (possibly) a priest who lived in the third century BC. Some speak of a deity, a syncretic fusion (i.e. a mixture of religious ideas into a new world view) of the gods Hermes and Thot. Esotericists repeatedly quote the hermetic philosophy, i.e. the fifteen sentences Trismegistos supposedly wrote down on emerald tablets. Esotericists believe that in these sentences “all knowledge of mankind is summarized”, whereby the second and central sentence is: “What is below is equal to what is above”.

The core of the esoteric world view is the assignment of the ten eternally existing primordial principles. These embody for symbolic astrology the basic building blocks of all life in the universe – to the “ten planets” (the “heavenly representatives” sun, moon, Venus, Mercury, Mars, Jupiter, Saturn, Uranus, Neptune, Pluto) and the four, respectively five elements. Accordingly, in the understanding of symbolic astrology, the world is constructed from ten eternally existing, divine primeval principles (archetypes), which can be found in hierarchies in all layers of being – from the macrocosm to the microcosm, from top to bottom and from inside to outside.

The well-known Austrian homeopath Clemens Fischmeister argued the same way in his article “Wie denkt ein klassischer Homöopath? (How does a classic homeopath think? – published in “Facharzt” 2002). There he writes: “The healing takes place in hierarchies, from top to bottom … from the most important to the less important organ” (Hering´s rule), whereby he described (completely unchallenged) the skin as the “most unimportant organ of man”!

Another basis of homeopathy is the “principle of similarity” (Similia similibus curentur). This is associated with the imaginative idea that it is possible to eliminate symptoms of disease by diluting and potentiating primal substances – e.g. arsenic – which in healthy test subjects trigger symptoms similar to those shown by the patient. This “principle of similarity”, which does not play the slightest role in modern medicine, is based on the medieval “theory of signatures”, which is closely linked to the analogous thinking of all esotericists. It is the doctrine of the “signs in nature” that supposedly point to inner connections and similarities within the framework of the entire divine creation. These signatures are thus a work of God which man only has to recognize. Accordingly, there are analogies between form, colour, smell, location and astrological classifications. In the logic of the faithful, above all the similarities are of great importance. For example, the kidney-shaped bean with the kidney, the brain-shaped walnut with the brain, heart-shaped leaves of the melissa with the heart, the mistletoe as a semi-parasite with cancer, the lady’s mantle with female organs and lungwort with the lungs are said to be related. Bitter-tasting plants are said to have a relationship to the “element” fire, which is related to the sun, and thus stimulate metabolic processes.

This ancient, imaginative and completely unscientific doctrine, which in its concrete formulation goes back to Paracelsus and the Neapolitan doctor and alchemist Giambattista della Porta, also conveys the belief that the colour of medicinal products gives an indication of the diseases for which they are intended to be used. The colour red, for example, for heart diseases, blue for reducing restlessness. The doctrine of the “divine signatures” is also part of many esoteric treatment methods such as Ayurveda medicine, traditional Chinese medicine and, last but not least, homeopathy.

Like many astrologers and homoeopaths today, the vitalist Hahnemann believed in the “spiritual essence of the primordial substance” – which unfolds more and more strongly through the process of potentizing (diluting and shaking towards the center of the earth) and acts most strongly as high potency -, in the “cosmic primordial force” and in the “primordial idea that permeates all levels from top to bottom”. In the vertical world view of astrology, for example, the original principle of Mars (“the god of war and ruler over the wild aries”) is analogous to aggression and ferocity, to certain organs and body parts such as blood, head, teeth, nails, gall, striated muscles, the “element” fire, to the red colour of the blood and to certain Martian plants.

In homeopathy, therefore, the often prickly “Martian plants” of astrologers are associated with certain human organs (blood vessels, gallbladder, muscles and head), the colour red and the element fire. This is why homeopaths prescribe the original substances Aconitum, Allium cepa and Belladonna – all “Martian plants” – for severe, feverish, fiery inflammations, for gallstones as well as for bright red head, bleeding and blood congestion. Exactly such nonsensical recommendations for the treatment of severe febrile diseases with the Mars plant Belladonna can be found again and again in various magazines and online.

Other planets and their earthly plants and metals also play an important role in the thinking of homeopaths. In astrology, the planet Saturn is always associated with the colour lead grey, the metal lead, with lime deposits, reduction and stone ailments. In addition, astromedics see a connection between the primordial principle of Saturn and the skeleton, kidney, gall bladder and spleen. It is therefore not surprising that the “original substance” lycopodium (a “Saturn plant”) and the metallic lead of homeopaths are used in patients with reduced general condition, dirty grey skin colour and “hardening” caused by gout, arteriosclerosis, diseases of bile, kidney (nephrosclerosis) and skeleton. The planet Uranus is connected to varicose veins, nerves and the sexual urge in the vertical world view of astrology. Consequently, the most important “uranium plant” in astrology – hamamelis – is used by homeopaths to treat symptoms caused by varicose veins, venous bleeding, nerve inflammation and testicular diseases.

Other examples are also included: Following closely astrological (pseudomedical) ideas, homeopaths prescribe the Venus metal copper for cramps of all kinds and disorders of the nervous system; the sun metal gold for cardiovascular disorders, increased blood pressure and depression; the Jupiter metal tin for nervous exhaustion, neuralgia and liver pain; or the moon metal silver for restlessness and neurasthenia.

Remarkably also the common “holy” numbers of all esotericists: The 12 stands in some schools of homeopathy for the modalities (12 environmental influences), in other esoteric pseudosciences for zodiac signs and houses in astrology, the 12 disciples and 12 senses of Rudolf Steiner. In homeopathy the 10 often stands for organ and emotional hierarchies, otherwise for heavenly tribes, number of perfection and regional centers of anthroposophy, the 10 commandments and 10 planets (incl. moon and sun). The number 5 is the often recommended dosage unit for taking globules, it also stands for the pentagram, the 5 elements, 5 seasons and 5 organs of Chinese medicine. In homeopathy, the number 4 partly stands for the 4 constitutions (corresponding to the four-juice doctrine of Hippocrates) and the 4 basic qualities; in other esotericism it stands for the quadrants in the horoscope, the 4 Vedas of Ayurveda, the 4 members of Anthroposophy, the 4 Gospels and Archangels.

Anyone who thinks that homeopathy has nothing to do with esotericism (Kabbalah, numerology, astrology, Ayurveda or anthroposophy etc.) is mistaken.

(Author: Dr. Theodor Much is the author of Der große Bluff: Irrwege und Lügen in der Alternativmedizin – The Great Bluff: Wrong ways and lies in alternative medicine; Goldegg Verlag, 2013)