In an interview with Pharma Relations, Mathias Hevert, Managing Director of Hevert Arzneimittel, accused the “skeptics” of taking a “clearly biased stance towards homeopathy”, of neither wanting to inform nor being willing to discuss.

We do not know who the “skeptics” are supposed to be here. We regret, however, that Mr. Hevert obviously did not inform himself in any way about the aims and contents of the INH – for example on this page – and instead makes such statements.

Mr. Hevert has today received the INH letter published below with reference to these statements:

Mr. Mathias Hevert
Management Hevert Arzneimittel
by e-mail info@hevert.de
July 2, 2019

July 2, 2019.

Your interview on Pharma-Relations

Dear Mr. Hevert,

With this letter we refer to your interview, which was published on 01.07.2019 on Pharma-Relations (Link). In particular, we’d like to address the accusation having a “clearly biased attitude towards homeopathy” and the claim that we wouldn’t be open to discussion. You, on the other hand, would welcome a scientifically based and fact-oriented discussion at any time.

We would like to convince you that our attitude is not based on an unreflected bias, but is rather the result of a long and intense occupation of the doctrine of homeopathy. We have looked at homeopathy from different angles and come to the same conclusion in different ways: from our point of view homeopathy does not work beyond placebo. Homeopathic preparations are in higher as well as in lower potency unsuitable to bring about specific effects, especially not those which are supposed to unfold according to the homeopahtic doctrine. There is no scientifically valid evidence for an effect beyond placebo.

On the other hand, we as skeptics are of course open to your arguments as to why our point of view should be wrong. With the exception of Prof. Frass, formerly of Med-Uni Vienna, our previous offers for a discussion with representatives of homeopathy have not yet been taken up. We are therefore pleased that you welcome a scientifically sound and fact-based discussion at any time, and would like to enter into a corresponding dialogue with you. After all, we consider the same facts, but come to different conclusions, which at least in principle could be dispelled in a discussion.

One could imagine different procedures, from a moderated discussion in a smaller circle to a public panel discussion. Perhaps a moderator of a TV talk show could also be inspired by this topic. Of course, we assume that as a business economist you will be supported by experts from inside or outside your company or association.

As minimum result it could result from this discussion that you would learn more and better know about the motives and arguments of the skeptics, the GWUP and the INH and wouldn’t have to make further wrong statements about the relevant persons from ignorance.

We look forward to your answer with interest.

Dr. – Ing. Norbert Aust – Dr. med. Christian Luebbers

We are curious.

The INH is pleased to note that the critical debate on homeopathy is gaining in breadth. But now, criticism of homeopathy is increasingly expressed in a form that we cannot approve of, because it exceeds the limits of legitimate intensification, irony or satire.

The INH therefore sees reason to refer to principles for the discourse on homeopathy which are part of its self-understanding:

• Our criticism is directed at the doctrine of homeopathy and the institutions that represent it, but not at the patients and users applying homeopathy. Obviously, it is apparently unavoidable that there are people who perceive the fact-based dispute with homeopathy as a personal attack. However, this is by no means our intention.
• Our criticism also goes to the public health institutions, which are supposed to protect patients from quackery and ineffective therapies, but obviously fail in the case of homeopathy.
• We strictly reject any form of attack on persons. In particular, derogatory and insulting statements are not a means of pertinent discussion for us.
• We treat all discussion partners with due respect and keep a polite tone, even if the other side is lacking in this.
• We consider homeopathy to be a false doctrine that currently occupies an unjustified special position in public health. But we accept that it is possible to take a different position, without that in any way would devalue the person who advocates this.
• We reject statements which place homeopathy and its users close to crimes or offenders, which in any other way merely express an aggressive attitude or which, without any factual connections, are merely intended to provocatively heat up the mood.
  

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Introduction

Again and again we hear of India as the “promised land” of homeopathy. Again and again the critics are reproached of India as a shining example when it comes to constructing a “proof” of its validity through the widespread spread of homeopathy.

All the more we are pleased to be able to present here today a guest contribution of an Indian author who grew up with homeopathy there and has nevertheless found a critical and negative attitude. The following article first appeared on his blog (berationable,com, and also The Rationable Podcast).

We can only speculate here about the reasons for the widespread spread of homeopathy in India. Therefore we find the message of our guest author highly interesting that the reputation of homeopathy in India is largely based on the fact that it comes from Germany – one cannot imagine there that something wrong or nonsense (“bogus”) would come from Germany. On the one hand this is astonishing and on the other hand it unmasks the reference of the local homeopaths to the popularity in India as a circular conclusion.

We consider this contribution to be an extremely important document from a part of the world where critical-rational thinking is only slowly beginning to spread. We have great respect for our guest author, who has found such a critical attitude in his completely different socio-cultural environment that it hits the heart of the matter.

We are very happy about the possibility of the publication and would like to thank our guest author!

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Does homeopathy work?
A guest contribution by Abhijit Chanda (berationable.com)

Homoeopathy, especially in India, is a treatment method in which a lot of people believe. In fact, India is one of the biggest markets for homoeopathic medicine, if not the largest. Plus, it’s getting support from the government through the AYUSH initiative. My parents gave me homoeopathic treatments as a child, and they swear by it. In fact, most people do. There are college degrees for it, doctors prescribe it, and infants and animals are said to benefit from it too! But does homoeopathy really work? As I found out, it kind of does, but not in the way you think.

Disclaimer: This is going to be a long article, so bear with me. If you can’t here’s a TL;DR version. But I recommend you go through this to get the nuances, and my side of the story.

TL;DR

1. Homoeopathy is an ancient practice created in the 1700s as a counter treatment to bloodletting and other rather horrific medical practices

2. Homoeopathy is a process of diluting a small amount substance in more water than the whole earth can contain to treat your ailment

3. There has been no evidence to show that it works any better than a placebo, even after hundreds of clinical trials have been conducted.

MY STORY

For most of my life, I have taken it for granted that homoeopathy worked. I didn’t know how or why, I just knew that my parents and most other people swore by it, so there had to be something to it. I was treated with homoeopathy several times. In one case, it actually made things worse. The homoeopathic doctor responded with, “Things sometimes have to get worse before they get better.” I have to admit, as much as I wasn’t impressed with that answer, I liked the taste of the medicines. Always sugary and sweet or even with that little bit of alcohol. What more does a kid need in his life than to eat something sugary sweet for medicine!

It was only when I started becoming more of a science enthusiast, did I realise that the rest of the scientific world didn’t think that homoeopathy worked. Richard Dawkins and James Randi were the first people I encountered who had publicly ridiculed homoeopathy. I couldn’t believe what I was seeing! How could this form of treatment be so ineffective and yet have millions of followers?

HOW HOMOEOPATHY WAS BORN

It took me a while to get to the root of the question – does homoeopathy work at all? I think the most comprehensive and interestingly told account was on a podcast called Skeptoid by Brian Dunning. It’s an excellent collection of everything you need to know about Homeopathy in just around 15 minutes. You should certainly check it out.

So here’s what I found out about how homoeopathy came into existence.

Back in the 1700s, the prevalent medical treatments of the time involved balancing the four humours: blood, phlegm, black bile and yellow bile. The prevailing theory was that sickness was caused by an imbalance of these “humours”, which wasn’t at all funny because the way to balance them was primarily through bloodletting, leeching, or purging. If you’re wondering if these words mean what you think, they do. They were all about somehow getting rid of some of the fluids to blame for the disease, whether it was the blood by opening a vein and letting it flow out of the victim or more slowly by using a leach. Enemas, vomiting and sweating were other ways of getting rid of these diseases. Of course, these did work some of the time if the patient had a condition that called for such treatment. However, many ended up dying due to malnutrition, dehydration or loss of blood. Or all of the above.

Out of these archaic so-called medical practices, a German physician called Samuel Hahnemann found a treatment that didn’t at all affect his patients adversely. He called it Homoeopathy. The theory was published in 1807 and was governed by a couple of laws:

1. Law of similars: which basically states that like cures like. He claimed that if you use a toxin that causes certain effects on a person, that same toxin can be used to alleviate those symptoms, but only if it was diluted very thoroughly

2. The Law of Infinitesimals: The more dilute the solution was, the more profound would be its ability to balance the humours.

So, as you can see, this does sound somewhat similar to how vaccines work – where a weaker version of a virus is injected into a person to teach the immune system to fight the disease. And vaccines work brilliantly!

HOW HOMOEOPATHIC REMEDIES ARE MADE

However, homoeopathy is different in a fundamental way. The solutions are so dilute, there’s almost no chance that even a molecule of the original toxin remains in the final product. How? To show you how this works, I’ll quote Brian Dunning from Skeptoid.com, who explains it particularly well:

Dilutions of homoeopathic products that are sold today usually range from 6X to 30X. This is homoeopathy’s system for measuring the dilution, and it doesn’t mean 1 part in 6 or 1 part in 30. X represents the roman numeral 10. A 6X dilution means one part in 106 or one in one million. A 30X dilution means one part in 10³⁰ or one followed by 30 zeros. A few products are even marketed using the C scale, Roman numeral 100. 30C is 100³⁰. That’s a staggering number; it’s 1 followed by 60 zeros, about the number of atoms in our galaxy. In 1807, they knew more about mathematics and chemistry than they did about medicine, and it was known that there is a maximum dilution possible in chemistry. Some decades later it was learned that this proportion is related to Avogadro’s constant, about 6 × 10²³. Beyond this limit, where many of Hahnemann’s dilutions lay, they are in fact no longer dilutions but are chemically considered to be pure water. So Hahnemann designed a workaround. Hahnemann thought that if a solution was agitated enough, the water would retain a spiritual imprint of the original substance, and could then be diluted without limit. The water is often added to sugar pills for remedies designed to be taken in a pill form. So when you buy homoeopathic pills sold today, you’re actually buying sugar, water, or alcohol that’s “channelling” (for lack of a better term) some described substance. The substance itself no longer remains, except for a few millionth-part molecules in the lowest dilutions.

Let’s look again at Avogadro’s number. 6 × 1023 atoms are called a mole, a term any chemistry student is familiar with. How big is that number? Well, if you had 500 sheets of paper, you’d have a stack about two and a half inches high, like a ream that you’d buy at the stationery store. If you had 6 × 1023 sheets of paper, your stack would reach all the way from the Earth to the Sun. And not only that: it would reach that distance four hundred million times. Think about that for a moment. One sheet of paper, in a stack that’s 400,000,000 times the distance from the Earth to the Sun. That’s a typical homoeopathic dilution. Sounds pretty potent, doesn’t it?

Brian Dunning from Homeopathy: Pure Water or Pure Nonsense

Quackwatch has another way of putting it. Here’s an excerpt from their article, Homeopathy: The Ultimate Fake by Stephen Barrett MD:

Robert L Park, Ph.D., a prominent physicist who is executive director of The American Physical Society, has noted that since the least amount of a substance in a solution is one molecule, a 30C solution would have to have at least one molecule of the original substance dissolved in a minimum of 1,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000 molecules of water. This would require a container more than 30,000,000,000 times the size of the Earth.

That’s really hard to wrap your head around, isn’t it? To put it in simpler terms, the amount of dilution any substance goes through in homoeopathy makes it almost impossible to find even a single molecule of the original material in the final product. Simpler still, none of the original substance will find its way into your regime of treatments.

HOW DO THE TREATMENTS WORK THEN?

According to Hahnemann, the process of diluting and shaking the concoction (potentization) imprints the essence of the substance onto the water molecules, which then interacts with the body’s “vital force”.

It does seem a bit spiritual, doesn’t it? So is homoeopathy a spiritual medicine? It certainly seems so, even though I don’t think many people would believe that. However, there is another explanation that I’ve heard.

WATER HAS MEMORY

Apparently, water can “remember”, or retain the spiritual imprint of the substance that has been in it, and that is what helps treat you.

A French scientist by the name of Jacques Benveniste published a study in the science journal Nature in 1988. This caused quite a ruckus in the scientific community as it didn’t seem plausible. But as the study methodology seemed sound, the journal had published it. But it did come with a note from the editor, John Maddox, asking people to “suspend judgement” until the study was replicated.

In brief, the study took human antibodies, put them a test tube, shook it thoroughly and then diluted it to a point where not even a molecule of the first sample would be present. The team reported that when human basophils were exposed to this water, they reacted as if there was an allergic reaction.

When the time came, John Maddox along with magician and paranormal researcher, James ‘The Amazing’ Randi, and Walter W Stewart, a chemist, set up the study. They noticed that Benveniste‘s team knew where the vials with the first solutions were. Therefore, they decided to make the study double-blinded – meaning none of the researchers, or the team from Nature, would possibly know which test tube or vial was which, and went to elaborate lengths to ensure there was no cheating.

Long story short, the study came out negative, showing no effects at all. Benveniste‘s study had been debunked.

THE EVIDENCE

There have been literally hundreds of studies done to test homoeopathy. Every single meta-analysis and systematic review of the research published has come back with results claiming homoeopathy works no better than a placebo. There were quite a few studies that showed homoeopathy is better than placebo, but after analysing them, it was found that either their sample sizes were tiny or their methods were questionable.

There are way too many studies and reviews to go into each of them or even describe them in brief. However, the entry in Wikipedia has an excellent overview of the evidence along with all the links to the studies, if you want to dig deeper.

SO WHY DO SO MANY PEOPLE SWEAR BY HOMOEOPATHY?

This is probably the most critical question here. After my faith in homoeopathy had been shaken, I shared what I had found, hoping my friends would see that they had been fooled just like I had been. I wasn’t ready for their responses. They defended homoeopathy quite aggressively. It felt like I had offended them by saying their beloved alternative medicine didn’t have any evidence behind it.

However, I want nothing more than to share what I’ve found and ask you to consider the evidence. So, if I’ve angered and offended you in some way, and you think homoeopathy does indeed work, let’s have a civil discussion about where you think I’ve gone wrong.

Still, let’s try and figure out why it seems to work so well:

• Natural healing: More often than not, our immune systems and other healing processes in our bodies heal many disorders naturally. If one takes homoeopathy and the body heals itself in the meanwhile, of course, the former gets all the praise. One way you can observe this is when a homoeopathic doctor or follower says something like, “It’s only effective if you take it for over a long period”. For many conditions, this gives the body enough time to heal by itself, but homoeopathy gets the credit. Unfortunately, this doesn’t happen for chronic or serious diseases.

• The placebo effect: This is a very profound and still slightly mysterious phenomenon. The placebo effect is when a sick person feels better when they have been given a fake treatment. A few examples of this are sugar pills, saline drips or injections, or even sham surgeries. It has been found that these treatments really do help patients feel better. The more severe the intervention, the more profound the effect. However, it’s essential to remember that the effects are temporary. If a patient has a chronic condition or a severe disease that isn’t going away, the sickness will return eventually. And not everyone feels the effect of the placebo. That’s why medicines are tested in Randomized Controlled Trials (RCT) – Randomized meaning there is a random selection of people participating in the test; Controlled meaning people are assigned to get either the placebo or the real medicine in such a way that neither the testers nor the people in the trial know which one they are getting. Then, the scientists unveil the results and see which people got the placebo and which didn’t. If the group who got the real medicine show marked improvement, the medicine being tested is a success. If not, it’s deemed only as effective as the placebo and rejected. (Of course, these trials have to be done multiple times by independent groups on different populations over a long period before the medicine is allowed to come to the market). The high-quality studies that tested homoeopathy in RCTs found they were no better than placebo, which means they don’t really have any significant effect at all.

• Regression towards the mean: We sometimes suffer from conditions that may not have a cause. They come, and they go. For example, headaches, allergies, rashes or itches etc. These are usually the natural process and reactions of the body, and they tend to go away. If you have a sudden, acute response, it could get aggressive and then subside and disappear. If you have a chronic condition that lasts for a long time, there will be times when it gets better and then becomes worse. Regression towards the mean is what this natural variation is called. If you have a homoeopathic remedy and your symptoms subside, it could either be the placebo effect or merely a regression towards the mean.

• Confirmation bias: When I was biased about the Ketogenic Diet, it seemed that, everywhere I looked, I found evidence that confirmed my beliefs that keto worked. When one is convinced about an idea, the mind selectively finds reasons to reinforce it. Similarly, it’s likely that firm believers in homoeopathy would count all the times the treatments made them feel better but subconsciously forget the times it didn’t.

• Misdiagnosis: It’s also possible that a misdiagnosed condition could make it seem more severe than it is. And then, when you got better, you gave homoeopathy the credit.

• Standard medicine: Many people take conventional medicine along with homoeopathy if they believe in it. Doctors are reluctant to stop them from taking it because, if it makes their patients feel better, even if it’s due to the placebo effect, it’s worth it because it could help them stick to their prescriptions. Of course, when they get cured, chances are they’ll give homoeopathy credit rather than the medication.

• Stopping an unpleasant treatment: Sometimes treatments for specific diseases can have unpleasant side-effects. If someone ends that treatment and uses homoeopathy instead, the side-effects will wear off. And, as homoeopathy has no known side-effects, it will get the credit in making them feel better.

HOMOEOPATHIC HEALING OF INFANTS AND PETS

Some have said that homoeopathy treated an infant or a pet. After all, since they don’t know what homoeopathy is, how can they possibly be susceptible to the placebo effect?

They do seem to have a point. But since we have established that homoeopathy doesn’t work, there must be something else at play here. The placebo effect and confirmation bias work here too, just as they do in adult humans. When a child or a pet is given homoeopathic remedies, the way they are treated by the parent or the master could also affect how they feel. Especially when they are cuddled or cared for more, they would feel better. Animals and children can also recover naturally from mild infections and transient conditions like rashes given enough time.

Another critical factor is the parents’/owners’ confirmation bias. If they are sure the remedy is helping, chances are they’ll see an improvement in their child’s or pet’s condition even if there isn’t one. Plus, the other factors I mentioned earlier also play parts here, and none of those is dependent on the child or pet’s awareness of the medicine.

HOLISTIC TREATMENT VS SYMPTOMATIC TREATMENT

Homoeopathy is said to be a holistic form of treatment, where the patients, body, mind and spirit are taken into account. Even their daily routine, diet, work life and other factors are considered when consulting a homoeopath.

On the other hand, proponents of homoeopathy and other alternative medicines say that modern medicine treats only the symptoms and not the root cause of the disease.

I feel many people take this idea for granted without really thinking about it. Modern medicine is a systematic process where a patient is asked questions about their conditions and how long they have persisted. Based on this, the patient may need to get some tests done to confirm or deny the doctor’s suspicions. These tests can reveal the root cause, and the treatment will be prescribed accordingly. For example, if you go to a doctor with a fever, he or she will ask you about it, and based on your other symptoms like maybe a cough or a cold, or an upset stomach, get in the ballpark of what kind of an infection you have. If it’s a bacterial infection, they’ll give you an antibiotic to kill the germs. If it’s a viral without any known treatment like the flu, they will probably treat it symptomatically to make sure the fever stays down. If you have something more extreme, like cancer, they might recommend surgery to get the cancerous cells out of you or to kill it with chemotherapy or radiation. That’s going down to the root cause.

On the other hand, the homoeopath will have an in-depth consultation, but the treatments they give have been formulated based only on the symptoms. They will find a toxin that causes similar symptoms and then dilute it down to nothingness before they give it to you. From whatever I’ve read, there seems to be little or no regard for specific germs, cancers, viruses or any other root causes for diseases taken into consideration. In fact, the germ theory of disease hadn’t even been formulated back when homoeopathy was first thought up by Hahnemann. How can they possibly claim to get to the root cause of any disease?

MODERN MEDICINE HAS SIDE-EFFECTS

Yes, they do. There’s no denying it. All medicines have side effects. If you look at the little leaflet inside the box or even look it up online, any drug you search for will have a list of side effects – some short, some long. And they will be divided by how common they are, as well as advice to see your physician if you experience any of these.

You see, every medicine goes through a long process of RCTs to uncover their effects and side effects in Petri dishes in the lab, to animal studies and human studies, which are conducted on a large population. This is to figure out what the effects and side effects are. A medicine that goes on the shelf is usually one that has the lowest side effects versus the most potent effects. Even if you look at chemotherapy, a treatment we all know to be harrowing for the patient, the sickness, hair falling out, loss of appetite and so on, are all preferable to dying. People go through chemotherapy to kill cancer in the most effective ways possible while still giving the patient a fighting chance to survive.

On the other hand, paracetamol, or Crocin as you might know it, are pretty safe, or so we think. We pop them without a thought if we have a headache or a fever. But they do have side effects. Here’s what I found on Drugs.com:

Rare (Side effects)

• Bloody or black, tarry stools
• bloody or cloudy urine
• fever with or without chills (not present before treatment and not caused by the condition being treated)
• pain in the lower back and/or side (severe and/or sharp)
• pinpoint red spots on the skin
• skin rash, hives, or itching
• sore throat (not present before treatment and not caused by the condition being treated)
• sores, ulcers, or white spots on the lips or in the mouth
• sudden decrease in the amount of urine
• unusual bleeding or bruising
• unusual tiredness or weakness
• yellow eyes or skin

As you can see, these are pretty rare and most people won’t be affected by any of it. But it’s important to know about these, just in case you’re the one in a million who does. Dr Shantanu Abhyankar, a renowned, practising Obstetrician and Gynaecologist based in Wai, Maharashtra, talked about this in his TEDxPICT talk:

“In fact, modern medicine has devised methods to document, study and, as far as possible, mitigate these side effects. We are open, we are frank. Which is not the case with many other “pathies”. And come to think of it, side effects need to be compared with what you are going to use that particular product for. Oral contraceptive pills have side effects, but then you have to compare the side effects of oral contraceptive pills with the side effects of not using oral contraceptive pills. If you use oral contraceptive pills, you get contraceptive action and a few side effects. But if you don’t use them, then maybe you’re faced with an unwanted pregnancy. You have to undergo the trouble of eliminating that unwanted pregnancy or add in the socio-economic burden of continuing an unplanned pregnancy. Finally, not all side-effects are bad. Take the same example of oral contraceptive pills. Women who take oral contraceptive pills are protected against endometrial cancer, ovarian cancer and so many other disorders. Women who take oral contraceptive pills have less menstrual blood flow, which is a boon to already anaemic Indian women. So, it’s not that all side effects are bad. In fact, when somebody claims that a “pathy” [referring to forms of medicine like allopathy, naturopathy or homoeopathy] doesn’t have any side effects, it probably means that there is no effect at all. Or it probably means that there is no drug at all.”

BIG PHARMA

The Big Pharma conspiracy theories are at another level. According to some, modern medicine is just a profit-centred industry bent on keeping you sick. Alternative therapies like homoeopathy are nobler and want the best for you, and not for their pockets.

However, there are massive, multi-national, profit-led homoeopathic companies as well, and they get their merchandise stocked in major pharmacies worldwide. In India, the market for homoeopathy, according to one source, is Rs. 2,758 crores and predicted to grow 30% each year! Sure, it’s nowhere close to mainstream pharmaceuticals, but that seems to be changing. They don’t sound like the underdog to me, especially when they are being promoted by the government so aggressively through the AYUSH initiative.

ALLOPATHY

You may have noticed how I’m avoided using the word “Allopathy” in this article. The term is used to describe mainstream medicine now. Dr Shantanu Abhyankar described the origins of the word first coined by Samuel Hahnemann:

“He coined [allopathy] as a derogatory word to describe the practices that were prevalent then. And the practices were very bad. Allopathy means the hodgepodge mixtures being administered to cure whatever conditions came your way [sic]. Usually, bloodletting was very common and was offered for every disorder. But then, over the years, keeping in step with the science, allopathy has completely changed, and what allopathy was described for the practices then prevalent is totally misfit today [sic]. Today’s allopathy is no allopathy at all.”

Modern medicine has come so far from its archaic practices. This is because, in the pursuit of finding the secrets of human health, medicine has used science to ascertain what works and what doesn’t. In this process, our life-expectancy has soared and infant deaths have been minimised. Many diseases have even been considered eradicated! Now, AIDS is no longer a death sentence, and neither is cancer. This is all because of scientific progress and the evolution of evidence-based medicine.

CONCLUSION

Here I am, a decade later, seeing homoeopathy from a completely different perspective than what I used to. It’s probably one of the most profound discoveries in my life and has been one of the factors that have led me to question everything, including, most importantly, myself.

Now, homoeopathy has become one of the most studied fields in the world, with an impenetrable mountain of evidence that has piled up against its claims. These studies have been done by many independent teams and analysed and reviewed by some of the most reliable scientific organisations in the world. There’s just no denying it. There is no evidence for it working…ever. Why? Because it’s just water. And if it’s brought into contact with sugar, it somehow transfers its memories to it. The more I think about it, the more implausible it sounds.

And it’s not just me. Many governmental bodies like UK’s National Health Service (NHS), The American Medical Association, the FASEB and National Health and Medical Research Council of Australia, have stated that there is no evidence to support the use of homoeopathic treatments. Even representatives of the WHO have said that homoeopathic remedies should not be used to treat tuberculosis or diarrhoea.

So, what do you think? Is it worth your time and money to buy water and sugar pills that have shown no evidence of working, or would you instead go to a regular doctor and get real medication that has a good chance of treating you? I, for one, will be going to the latter.

CRITICAL TOOLS

• Reliable sources: The most critical tools I used to get to the bottom of this topic was to find as many reliable sources that I could find who spoke about homoeopathy. They are all linked to relevant sections in the article. What makes them reliable? They consistently interpret real scientific evidence to support their statements and reviews.

• Independent sources: I also look for sources that are not associated with one another so there is little to no chance of this information being propaganda.

• Conflicting Sources: I’ve also tried to find sources that at pro-homoeopathic so that I can see if their evidence is any more compelling than the other side. This adds a level of falsifiability to the claims and simultaneously challenges my beliefs.

Tell me what you think in the comments.

Until next time, I wish you good health and rationable thoughts.

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FURTHER READING

• https://www.theguardian.com/science/blog/2012/apr/03/homeopathy-why-i-changed-my-mind

• https://skeptoid.com/blog/2011/09/18/homeopathy-a-drop-in-10-billion-oceans/

• https://nccih.nih.gov/health/homeopathy

• https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/complementary-alternative-therapies/individual-therapies/homeopathy

• https://www.livescience.com/31977-homeopathy.html

• https://www.nhs.uk/conditions/homeopathy/

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Picture credits:

Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Samuel Christian Friedrich Hahnemann. Line engraving by L. Beyer after J. Schoppe, senior, 1831. By: J. Schoppeafter: L. BeyerPublished: – Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

Yesterday, on 13.06.2019, German TV satirist Jan Böhmermann so satirically as accurately analysed homeopathy in his programme “Neo Magazin Royale” and thus articulated in his special way the – in our opinion –  widespreaded displeasure about the role of the sham method homeopathy in public health care.

We regard the time as appropriate to turn now with our core concern to the Federal Minister for health. Today he received the following open letter from the INH:

Information Network Homeopathy
We explain – you have the choice

14 June 2019

Mr
Federal Minister for Health
Jens Spahn
by e-mail

Dear Federal Minister Spahn,

As Information Network Homeopathy, we have been contributing to the public education about the background of homeopathy since 2016 and have also focused on the so-called “internal consensus” of the German Medicines Act.

Yesterday evening, we were able to experience on German television how homeopathy became the subject of prominent satire. For more than 20 minutes Jan Böhmermann burned down a fireworks on homeopathy in his “Neo Magazin Royale”, which – like all good satire – presented nothing but the facts. We regard this as a clear sign that the public reputation of homeopathy, not least supported for decades by the internal consensus, is eroding massively. More and more people see the fact that homeopathy is spent on an effective medical method as an unreasonable anachronism, as science-medical as well as intellectual impertinences.

The construction of the so-called internal consensus in Paragraph 38 of the AMG represents nothing less than the partial reversal of the meaning of the AMG into its complete opposite: Instead of applying intersubjective scientific standards to everything that “pharmaceuticals” want to be, it creates an incomprehensible protective space for remedies of “special therapeutic directions” – a “black hole” in pharmaceutical law – by expressly dispensing with evidence of efficacy.

The lack of intersubjectivity in it is obvious: no one can comprehend the healing promises of homeopathy (or anthroposophy) according to objective standards. After more than 200 years, it remains with claims that could never be verified in any way according to intersubjective criteria. This is the undeniable state of the art of science, which the legal situation nonsensically contradicts – and this contradictions serve the interested circles as a false justification for their untenable positions.

It is time that the legislator no longer provides an apparent legitimation for this and revises the internal consensus of the AMG. In the right understanding, there is only one medicine: the one that works. The one that can scientifically answer the question “Where is the proof?”. In addition, there is no need and no place for somewhat “alternative”, “complementary” or “integrative” in medicine. The dividing line between medicine and non-medicine is the proven effectiveness according to scientific standards. Homeopathy has remained beyond this boundary for over 200 years and cannot invoke more than a legal fiction.

We have no doubt about your personal attitude to the problem and are convinced that our concern is in good hands with you, given the energy you have shown in your office so far. In view of the circumstances described and current developments, give up the political restraint that has so far left the internal consensus untouched! Take the initiative to put an end to the unspeakable anachronism of the internal consensus and to subject to the same rules all remedies that strive access to the market as a pharmaceutical. A factually untenable legal fiction should no longer be the basis for errors and misinformation about homeopathy and should no longer serve to discredit the state of science and those who publicly represent it. Particular interests casted in legal structures should be a thing of the past, especially if they contradict the facts.

We are at your disposal at any time with our expertise in any form you like.

Respectfully

For the Homeopathy Information Network

Dr. med. Natalie Grams (Head / Spokeswoman)
Dr. med. Christian W. Lübbers (Spokesman)
Dr. Ing. Norbert Aust (Spokesman)

On several occasions we have reported on the progress of the critical debate on the role of homeopathy in the French health system. In almost breathtaking speed, a protest article of the group #NoFakeMed in Le Figaro has developed into a debate, which in the meantime has yielded statements of the supreme French Medical Association as well as the Academies of the Sciences of Medicine and Pharmacy (in a joint statement), all of which clearly position themselves against the role of homeopathy in the health care system and which have not been lacking in clarity about the unscientificness, ineffectiveness and possibly dangerousness of homeopathy.

The official statements had been requested by the French Minister of Health, Agnés Buzyn, who at the beginning of the debate had expressed herself somewhat nonchalantly ignorant about homeopathy (“if it helps to avoid toxic medicines…”). But then she had promised to follow the final statements of the chambers and academies and above all the recommendation of the highest French health authority, the HAS (Haute autorité de santé) in her final decision. Of course, Mrs. Buzyn played for time, involving all the authorities that could be found in France. But that didn’t quite work out. After little more than a year after the article in Le Figaro, the final opinion of the HAS is now available –  LeMonde reports..

And it’s devastating for homeopathy. Although the HAS speaks of a “disputed” effect of homeopathy, which is not comprehensible according to the statements of the two academies – but that may already be a politically shaded formula. However, the recommendation to Mrs Buzyn is clear: No more refunds for homeopathy in public health.

And the key sentence is unmistakable:

“No studies have demonstrated the superiority of the homeopathic approach in terms of efficacy (…) over conventional treatments or placebo.”

Mrs Buzyn’s decision will be made in June. Before that, the three major homeopathy producers in France, Boiron, Weleda and the lesser-known Lehning, still have the opportunity to bring counter-arguments. Lo and behold – the nagging has already begun. Boiron “beckons” with the loss of 1,000 jobs and the “marginal” costs – in the French cash register system recently 130 million euros annually – would not be of any significance in view of the fact that there are proper placebo effects for it after all… so at least franceinfo. We remind ourselves that nowhere was the cost factor decisive where homeopathy was given its farewell. Besides, we know The body itself can heal in many cases, the natural course of the disease usually also brings healing, placebo may have only a small part in all this, does not heal diseases – and is everywhere, where there is care and attention, completely free to have.

We do not believe that Boiron will be on the verge of ruin only because of the abolition of reimbursement by the social security system.

Be that as it may – it’s going to be exciting and the matter is just before the finish line in France. Let’s simply note that the 200-year-old business model of homeopathy is now falling victim to science and honesty, as it looks. After all, the facts are as indisputable as the existence of the phases of the moon.

Picture credits: Screenshot franceinfo, 15.5.2019

The Brussels Times reports under this title on 15 May 2019 and quotes Simon November, spokesman for the consumer protection organisation “Test Achats”:

“The requirements of effectiveness, safety and quality to bring a product to market and be allowed to use the name of medication are sadly not the same for all products,” commented Simon November, spokesperson for Test-Achats. “Homeopathic products are required to be accompanied by a minimum of documentation, and the working of the product barely has to be proven. And that, while classic medications have to go through an entire process of trials and study panels. We simply cannot accept that difference.”

The Brussels Times continues: “The organisation (Test Achats) describes homoeopathy as ‘quack medicine’, which would be bad enough if it only robbed the patient of money.  But there are conditions where the patient really has no time to lose on products whose effectiveness has not been demonstrated. People who are suffering from very real heart and vascular conditions should immediately seek treatment by a doctor, and with truly effective medication.”

Tell me about it. We also think that the criticism may have to focus even more on the danger potential of homeopathy. They are real dangers – but they rarely become visible and are therefore “out of mind”. The consequences and delays caused by homeopathic “therapies” are not recorded anywhere and ultimately virtually all end up in the case statistics – and deaths – of scientific medicine. There are very few reports about it. And in the famous case reports of the homoeopaths, with which they want to prove “evidence”, such cases are of course not to be found – only those are presented there that have recovered thanks to their self-healing powers and the natural course of the disease.

What is the general situation in Belgium, by the way?

The Federaal Kenniscentrum voor de Gezondheidszorg, the official health information service, has already stated in 2011 in a paper “State of affairs on Homeopathy in Belgium “ (Stand van zaken van de homeopathie in België):

“From a purely clinical point of view, there is no valid empirical evidence for the efficacy of homeopathy beyond the placebo effect.”

The Belgian skeptics “skepp” reported in detail on their website about this statement under the title “Homeopathy: geen bewijs dat het werkt en toch veel gebruikt” (“Homeopathy: No proof of an effect and still much used”).

It is up to the health insurance funds in Belgium (similar to the “statutory benefits” in Germany) whether they reimburse homeopathy or not. As you would expect, practically everyone does, with a view to the competition, which you just don’t want to give a marketing advantage to. However, there was a collapse of this front in Belgium last year: one of the major insurers announced that it would no longer cover homeopathy reimbursements.

For some time now, the therapeutic use of homeopathy in Belgium has only been reserved for “qualified” people. In 1999, homeopathy, acupuncture, chiropractic and osteopathy were considerably regulated by the so-called “Colla Law”. One may argue, however, whether it is the right way to persuade the therapists of these directions to found professional associations and to believe that this would suffice an already dubious quality aspect. But the actual aim was to prevent the practice of these forms of therapy by non-physician therapists. In fact, in 2014, a royal decree was added and the end of the non-medical practice of these therapies was sealed. The decree regulated

1. homeopathic therapists must be licensed doctors, dentists or midwives.

2. they must have a degree in homeopathy from an (official) university or college.

3. doctors, dentists and midwives may only use homeopathy for evidence-based indications.

Well, yeah. Let’s disregard the last point, which should actually mean the end of homeopathy, if you take it as it stands. Of course nobody does. (This does not mean, of course, that the indications must be evidence-based, but rather the therapies for the indications. But it is exactly written so in the original text.) Well-intentioned, but actually more than half-hearted, sometimes even nothing more than a appreciation of the sugar ball method – if such a regulation came into force in Germany, the Central Association of Homeopathic Physicians would probably celebrate longer…

No, a prerogative for physicians in homeopathy is not a solution at all. Such regulations arise from the illusion that there exists a “qualified” homeopathic therapy. The lever does not have to be applied to the group of persons exercising the method, but to the method itself, as is currently the case in Spain and France. And that is why we would like to thank the Belgian consumer protectors, who have taken just this approach with their recently published statement. Let us hope that in Belgium, too, there will be realised that homeopathy – no matter who is practising it – has no place in the qualified health care of the population.

And German health policy? Instead of attentively reflecting on developments in Europe – and worldwide – and questioning one’s own position, policy continues to hide behind the popularity-“argument”. However, we do not want to accuse health policymakers of not knowing that “popularity” is not a criterion for the validity of medical means and methods. But we criticize them for pretending to be. Belgium may be half-hearted as far as the official attitude to homeopathy is concerned, but Germany is at best chicken-hearted, if at all.

Picture credits: Screenshot Brussels Times 15.05.2019

This year’s Homeopathic Medical Congress of the Central Association of Homeopathic Physicians will take place in Stralsund from 29 May to 1 June 2019. As usual with such meetings, the DZVhÄ assured itself also this time again of the support in the policy, by offering  the patronage over the meeting to the Prime Minister of the country Mecklenburg-Western Pomerania. Of course there is also a well-meaning greeting connected with it.
In (bad) tradition, the Prime Minister followed this wish. The greeting was published on the website of the medical congress.

The INH feels compelled to send the following open letter to Prime Minister Mrs. Schwesig:

To the

Minister President of the State of Mecklenburg-Western Pomerania
Mrs. Manuela Schwesig
– State Chancellery –
Schloßstr. 2-4
19053 Schwerin

Dear Prime Minister,

From various sources we could see that you have taken over the patronage of the Homeopathic Medical Congress of the German Central Association of Homeopathic Physicians taking place in May 2019 in Stralsund. We are also familiar with your greeting to the Congress.

We have a critial view on both the assumption of patronage and the greeting to the congress. Allow us to explain the reasons for this below. We consider it important to make representatives of politics familiar with our concern, an enlightened approach to the subject of homeopathy, and to explain our motives.

Since 2016, we, the Information Network Homeopathy, its members and supporters, have been explaining that homeopathy is a sham therapy that has neither ever been able to provide valid proof of its effectiveness nor to eliminate the incompatibility of its basic assumptions with scientifically proven principles. There is a consensus on this among almost the entire world’s scientific community. To illustrate this, we refer as one voice among many to the 2017 judgement on homeopathy by EASAC, the Advisory Council of the Association of European Academies of Science:

“Scientific mechanisms of action—where we conclude that the claims for
homeopathy are implausible and inconsistent with established scientific concepts.
Clinical efficacy—we acknowledge that a placebo effect may appear in individual patients but we agree with previous extensive evaluations concluding that there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect. ”

As a consequence, in more and more countries homeopathy no longer finds a place within scientifically based medicine and public health systems. In this connection, reference is made to the end of the prescribability of homeopathic remedies in England, which is now followed by the inclusion of homeopathic remedies in the blacklist of the British Ministry of Health, so that they can no longer be registered as medicines.

In particular, we draw attention to current developments in France and Spain. In both countries, the professional associations and scientific academies of both medicine and pharmacy have clearly distanced themselves from homeopathy and demanded that it no longer be given a place in the public health system. In Spain, the current government has already taken concrete measures to remove homeopathy from therapeutic practice. In France the political decision on this is currently pending, the recommendations of the chambers and the academies of science leave nothing to be desired in terms of clarity: homeopathy is medically worthless to potentially harmful.

In the USA, the Food and Drug Administration, in consultation with the FTC, is in the process of creating an increasingly stringent regulatory framework for homeopathic medicines. Consumer protection organisations are currently suing distributors of homeopathic medicines for fraud. In Australia, the possibility of covering homeopathy through private supplementary insurance was even abolished by law in 2017. In Austria, the compulsory elective subject homeopathy at the MedUni Vienna was recently cancelled without replacement, the “Homeopathic Emergency Outpatient Clinic” was closed and the accumulated research work in these areas was rejected by the Scientific Council of the MedUni as “unscientific”.

Many other political and scientific organizations in other countries have also positioned themselves against homeopathy as part of medicine and health care.

The extraordinarily effective homeopathic lobby in Germany has apparently succeeded in keeping such developments at bay. The danger of isolation of German health policy in the circle of EU partner countries in particular can no longer be dismissed here.

The efforts of the relevant lobby to present homeopathy as a proven form of therapy essentially equivalent to scientific medicine are manifold and extensive. This alone does not change the facts, the broad scientific consensus that considers homeopathy only as a relic of medical history and not as a justified part of modern health care.

Here now the circle closes for the occasion of this writing. The Central Association of Homeopathic Physicians is one of the pillars of homeopathic advocacy in Germany. He is very interested in public reputation. Of course, in view of the massively dwindling importance of the pre-scientific homeopathic method in Europe and worldwide, it is of great importance to obtain the patronage of high-ranking political representatives for the homeopathic congresses, for example.

However, this only strengthens the public reputation of homeopathy, which is scientifically and, in our opinion, unacceptable from the point of view of health policy, and leads to a consolidation of the already all too widespread assumption among the population that homeopathy is a recognised form of therapy, which should at any rate be regarded as equivalent to scientific medicine.

That is why the core concern of the homeopathy information network is that homeopathy should no longer be given public credibility or a place in the public health system – especially with regard to the good treatment of children to which you referred. We do not consider the current situation to be scientifically or ethically justifiable. A “therapy” that does not have more to show than the contextual effects (especially placebo) that occur with any kind of attention – even non-medical – cannot be justified as a medical therapy. It should also not be allowed to hide the fact that homeopathy is incorrectly offered and advertised by its representatives as specifically effective drug therapy.

Medicine today defines itself as that which can prove specific effects beyond the “background noise” of the always present placebo effect. Contrary to the perpetuated claims of the homeopathic interest groups and their self-referring events such as the “Homeopathic Medical Congress”, homeopathy cannot do this – and is therefore not a factor for the goal of a generally more human approach to patients in medicine, which we consider to be very desirable.

We would be pleased if we had opened a perhaps not so familiar view on the topic of homeopathy for you. The fact is that the general perception of homeopathy is currently characterised by decades of unchallenged influence by interested circles. Homeopathic criticism is as old as the method itself. However, it was not until 2016 that the Homeopathy Information Network was established as the first independent association of interests, whose members pursue the common goal of educating the general public about homeopathy on the basis of scientific facts.

It is clear to us that as a high state representative you must do justice to a broad pluralistic spectrum of social groups. We, the undersigned, would, however, ask you to refrain in the future from giving additional nourishment to the false and inappropriate public image of homeopathy through – undoubtedly well-meaning – commitment.

Scientifically founded as well as generally understandable sources of information for the classification of homeopathy as a disproved method from pre-scientific times are extensively available. We would also like to draw your attention to the information provided on the website of the Homeopathy Information Network. If you wish, representatives of the information network would also be happy to meet you in person.

Yours sincerely

For the Homeopathy Information Network

Dr. Natalie Grams.
Dr. Norbert Aust
Dr. Christian W. Lübbers

Picture credits: Private / own picture

More than a year ago, the discussion about homeopathy in health care in France began, triggered by the merger of 124 doctors (the #NoFakeMed initiative), who made a clear statement to the public. The waves went up quickly, the public debate flared up, #NoFakeMed members were even sued before the Medical Association – and probably also before the ordinary courts – for the insubordination to stand up against unscientific and specifically ineffective homeopathy. The French health policy, in the person of Health Minister Buzyn, was initially rather cautious (“does no harm, may be useful even if it avoids ‘poisonous’ medicines”), but then came under pressure when the central French Medical Association took a stand against homeopathy. Ms. Buzyn played for time by requesting an expertise from the French Medical Science Academy. We reported here and here.

This expertise has been available since yesterday (25 March 2019). And more: There was a joint communiqué from the medical and pharmaceutical academies. Le Figaro reports.

In a joint declaration (addressed to the government), the boards (of the academies) called for an end to the reimbursement of homeopathy (within the framework of public health) and an end to their teaching at the Faculties of Medicine and Pharmacy.

“End the reimbursement of homeopathy by statutory social security. Note that it is a placebo and inform patients accordingly; indicate on the packaging that there is no scientific evidence of efficacy; no longer accredit a university degree (in homeopathy) in a medical faculty or certificates and diplomas in pharmacy or veterinary education. More than a year after the publication of the Forum (#NoFakeMed) in Le Figaro Santé by 124 doctors, which relaunched a debate as old as the therapy itself, the Medical Academy voted 58 votes in favour (16 against, 8 abstentions) this Tuesday afternoon for a communiqué signed jointly with the Pharmaceutical Academy to reaffirm its positions on homeopathy.

What the Medical Academy had already made clear in 1984, 1987 and 2004 and then via its participation in the Scientific Advisory Board of the Academies of European Sciences 2017 (EASAC), was repeated in the press release adopted on Tuesday: “The state of scientific data does not permit verification of one of the principles of homeopathy (similarity and high dilutions)” (meaning that these principles have unscientific bases), and “meta-analyses could not prove the effectiveness of homeopathic preparations”.

According to Le Figaro, the working group of the Medical Academy takes care not to refer to homeopathy as “medicine” at any point in its text. Yes, she does not even want to accept the term “alternative medicine” (quite rightly, as we find). The working group acknowledges that, according to surveys, the French “believe” in homeopathy and apply it, doctors prescribe it, hospitals integrate it into their range of services. “Social data”, which the two academies “cannot ignore” – but “which can be explained by a lack of knowledge and/or underestimation of the placebo effect with the expectation of an effect – the only possible, but also sufficient explanation for the effects of homeopathy according to the state of the art”. Homoeopathy is therefore at most “initial” for the placebo effect and a conditioning of the patient (after apparent previous successes), but the patient has a right to receive clear and verifiable information.

“We are pleased that both academies are clearly positioned. It is time for government and administrative authorities to take note of this,” says Dr Jérémy Descoux, cardiologist and president of the Fakemed collective, which emerged from the #NoFakeMed forum, which was launched last March. Descoux himself would have liked an even more concise discourse that would have placed the ethical implications of homeopathic prescriptions more at the centre of attention. “To prescribe and deliver homeopathy is to ultimately accept the premises of homeopathy; and when we offer homeopathy to a patient, we are at least ambiguous in our medical ethos towards him,” he says.

Some members of the Academy declared that they had voted against the communiqué – but not out of disagreement on the matter, but out of concern for a text that is still “ambiguous, given our duty to inform the authorities clearly and decisively”.

Well, do we still have to comment on this with regard to German health policy, including the fact that neither the organised medical profession nor other large organisations of the health care system have positioned themselves in a similar way? We are grateful for a multitude of individual voices from these circles who share our criticism of homeopathy, but “officially” we still state a vacuum. The homeopathy lobby uses this vacuum to gain political credit with its unproven claims about the effectiveness of the method and its meaningless appeals to the “popularity” in the general public. The latest activity is even a petition for the – purely insurance and legal – abolition of homeopathy tariffs at some insurance companies, which still affects 562 people throughout Germany. With this grotesque (you can’t call it any other way) about 77,000 signers have already been reached. It is doubtful that the majority of them can see through the background of this propagandistic effort. Will the addressees do it? We very much hope so. And we hope for more – for the return of reason and honesty in matters of homeopathy and health care.

Our appreciation and thanks go to the French skeptics, the small NoFakeMed community, who gave the impetus to the development in their country and helped the facts to victory despite violent hostilities. Let us now hope for the insight of German health policy before Germany makes a fool of itself as a country of homeopathy with eternal status!

A guest contribution by Dr. phil. Susanne Dietz

There are existing, unfortunately, the Jakeszs, Hubers, Broers, Burkarts, Dahlkes, etc. of this world, who spread esoterically and spiritually veiled beliefs (in addition to the occasionally available professional competence in their field) and earn money with them.

Since I myself have been active in the academic sector and know that there is a very special commitment to knowledge, for a long time it has been an absurdity for me to experience how some intellectually crashed “scientists” or physicians consciously inflict damage on their field and mislead other people – against better knowledge and thus assumingly with lack of conscience.

The attitude of integer scientists to such revelation oaths of scientific ethos still consists too frequently in declining and saying: “I have better things to do than to deal with something like this. It’s clearly obvious that xy is off track.”

Sorry, but no, it is not obvious, not clearly recognizable for many. The average citizen recognizes only that here someone “of the discipline” confirms his world of faith and cites this again and again as testimonial for the conservation of his view of a “spiritual/esoteric world”. But he does not recognize (or is not willing to recognize) that this is only a fact-negative interpretation of reality. A reality which – in light of a research which hat advanced far in the 21st century – has little or nothing to do with esotericism, but with rules and laws which we often do not suit and are partly difficult to understand because they run contrary to our everyday thought structures and processes.

Such an indifferent attitude on the part of scientists of integrity makes it possible for laypersons to engage in pseudo-scientific cherry-picking for more or less base motives, and thus to give themselves a scientific touch that is de facto none. And to improve oneself pecuniarily with it – not exactly seldom.

Our world, our existence, our finiteness is not easy to understand and also not easy to accept. It is understandable to me that many therefore gather a view of the world that gives them pseudo security and well-being. But I cannot agree with that.
Because it doesn’t change anything that faith and knowledge are two pairs of boots and at the end of the day that what we know is preferable to what we believe – simply because it is KNOWLEDGE. And the nature of secure knowledge – such as the ineffectiveness of homeopathy beyond placebo – is its non-negotiability.

If, then, the scientific community does not publicly clearly reject and clarifies postulates from doctors like R. Jakesz, or J. Huber (by the way: these are doctors and by no means scientists) or D. Broers (whose imaginative academic career is more than questionable) and other esoterically inclined “colleagues” or hypotheses from pre-scientific times like those of Samuel Hahnemann, they commit in my eyes a sin of omission that damages the status and reputation of science.

I would wish therefore more and more people and committees from the scientific / academic field to take a clearer stand against such currents, just as the Münsteraner Kreis (German transdisciplinary scientific network against pseudomedicine in medical and non-medical practice) does against homeopathy.

We have the opportunity to obtain specific information: There are Cochrane, Higgs (Swiss scientific portal), Information Network Homeopathy, GWUP (German skeptics association), MaiLab (very popular scientific video blog), MedWatch (investigative project of misleading medical advertisement and information), and bloggers like Dr. Natalie Grams, Dr. Florian Aigner, Dr. Norbert Aust and many, many more. So there would be offers for every social and intellectual group to protect themselves against esotericism and pseudomedicine, their false assertions and manipulations – and thus to protect their own purses and health.

However, getting this information is a commitment to themselves – and is not always lived, not even by academics. What does that tell us? That the personal feeling of well-being counts more for some people than the awareness of the limits of the possible that indeed goes hand in hand with knowledge implying some inconveniences and imponderables that have to be endured in the real world. Even some students prefer to believe and repress, although they know better. And that’s where the fun ends.

Because academics know one thing:

Conspiracy theories of all kinds are lived errors of thought, which are clearly recognizable as such and can be named – and must also be named, so that the manifold damages, which can emanate from esoteric influences of all kinds, are contained. The responsibility lies with the scientific community of the 21st century, simply because it has the ability to do – and knows better.

Ergo: If academics, some doctors and some scientists make use of esotericism, this has a clear proximity to wilful intent and has to do with self-interest and manipulation of others. Consequently, I cannot resist assuming that it is fraud. The sentence: “They don’t know what they’re doing” doesn’t work.

At this point it is no longer a matter of desire – I EXPECT from academics to differentiate, clear conclusions (i.e. not to base them on simplistic cause-effect thinking) and to position themselves clearly against esotericism. No academic can tell me that he doesn’t know better – or at least could know better – if he did what he learned: research cleanly.

And why did I write this? I did my doctorate and the title is not just an academic achievement to me. Above all, I associate it with a clear academic ethos: I feel committed to interdisciplinary, clean, development-oriented acquisition of knowledge, preservation of knowledge in line with reality, and a faithful transfer of knowledge.

Dr. phil. Susanne Dietz

The above article first appeared in the blog “Draufgeschaut” by Dr. Susanne Dietz and is published here with the kind permission of the author.
Original article at http://dietz-trainings.com/#4#blog#30

Picture credits: Pixabay CC0

On 13 December 2018, the CSU parliamentary group in the Bavarian state parliament published a press release entitled “Naturopathy should be more firmly anchored at Bavarian universities”. This corresponded both with a similar parliamentary motion from the middle of the year and without doubt with the decision of the state government of Baden-Württemberg to establish a chair for “Naturopathy and Integrative Medicine” in Tübingen.

The press release makes it clear that it was much more about homeopathy than about naturopathy – the well-known misinterpretation of both terms was the basis for the whole meeting. Two representatives of homeopathy – the chairwoman of the Hahnemann Society and a clinical pratician from an institution of the LMU Munich who was co-financed by the Foundation for Nature and Medicine (formerly Carstens Foundation) – had spoken to the parliamentary group and apparently found an open ear for their lobbying for homeopathy (“so popular with people”). The Bavarian Minister of State for Health, Mrs. Melanie Huml, was also present.

This procedure caused the science advice of the GWUP and the INH to send the Minister of State and the parliamentary groups in the Bavarian federal state parliament the following open letter:

Mrs. Minister of State
Melanie Huml
Bavarian State Ministry of Health and Care
Haidenauplatz 1
81667 Munich, Germany

E-mail: poststelle@stmgp.bayern.de

(For information to the health policy spokespersons of all fractions and as an open letter on www.netzwerk-homoeopathie.info)

Homoeopathy in Health Care and Universities – CSU Group Press Release 13.12.2018

Dear Mrs. Minister of State,

From the above-mentioned press release of the CSU parliamentary group in the Bavarian state parliament we can see that there – in your presence – representatives of the pseudomethode “homoeopathy” have made representations in order to take representatives of Bavarian state politics for a promotion of their method with the aim of a stronger anchoring in health and higher education policy.

We, the science advice of the society for the scientific investigation of Parawissenschaften (GWUP), hold the goal direction conceived there into the eye both health and universitypolitically for missed.

The Hom?opathie is after world-wide scientific consensus a sham therapy, which could furnish neither ever a valid proof of efficacy, nor the incompatibility of its basic assumptions with scientifically in the best way occupied bases clear out. It is therefore our concern that homeopathy should no longer be given public credibility or a place in the public health system and that it should only be given a place in the medical-historical part of the curricula at universities.

A “therapy” that does not have more to show than the contextual effects (especially placebo) that occur with any kind of attention – even non-medical – cannot be justified as a medical therapy. It should also not be allowed to hide the fact that homeopathy is incorrectly offered and advertised by its representatives as specifically effective drug therapy.

To illustrate this internationally widely recognised position, we refer to the 2017 decision on homeopathy by EASAC, the advisory board of the Association of European Academies of Science:

“(We conclude from our research) that the claims on homeopathy are implausible and contrary to established scientific principles.
We acknowledge that a placebo effect may occur in individual patients, but we agree with earlier detailed studies and conclude that there are no known diseases for which there is robust and replicable evidence that homeopathy is effective beyond this placebo effect.

The international study situation is clear. In the meantime, ten systematic reviews, including those of homeopathy representatives, have shown that there is no evidence for any single indication of homeopathy. How could it be any different for a method that partly violates natural laws?

Even false arguments such as those repeatedly put forward in favour of homeopathy cannot change this. Neither is a “popularity” of homeopathy in the population a justification for unscientific and specifically ineffective methods in health care and university curricula, nor can the method be attributed to naturopathy. The latter is a downright “urban legend” that has been propagated by interested parties for decades.

This is probably the most deeply rooted error about homeopathy in the public. Homoeopathy is a conceivably “artificial” thought construct, which is based among other things on the esoteric ideas of the effect of “spiritual forces”. It thus contradicts the basic idea of naturopathy, which assumes a real effect of natural entities (light, air, sun, herbal extracts…).

We therefore feel compelled to raise our voices against any influence that could strengthen the position of homeopathy in public and political perception due to such misinformation, as the establishment of a chair would undoubtedly be. Rather, we are of the opinion that both a sustainable health system and the future higher education of physicians are dependent on the principles of evidence-based medicine and not to promote unscientific methods. Anything else would be a step backwards, a waste of resources and the opposite of a health policy that sees itself as modern.

Medicine is pragmatic and open to new findings, like any good science. This leads to – and has always led to – that methods, regardless of their origin or age, are included in the canon of medicine if they can prove a specific effectiveness according to scientific criteria. If they cannot do this, they are not entitled to the predicate “medicine” even with the attributes “alternative”, “complementary” or “integrative”. Furthermore, it should be warned against equating “naturopathy” with these terms.

In this context, the experience at the Medical University of Vienna, which had introduced homeopathy as a subject in order to teach a critical approach to the method, seems important to us. This has not proved successful, but has even turned into the opposite. The appearance of representatives of homeopathy as lecturers (and allegedly “experts”) led to the fact that in teaching the concrete application of the method instead of the scientific-critical view came to the fore. From our point of view a critical examination of the teachings of “alternative medicine” would be quite sufficient if one shows in the basic subjects to what extent such doctrines of salvation contradict the critical-rational scientific view inherent in the higher education system.

We point out that the MedUni Vienna recently drew the consequences from this and cancelled the homoeopathy lectures. University Rector Markus Meier distanced himself in this context from unscientific procedures and charlatanry. This is just one example – there is an increasingly critical approach to homeopathy internationally on a broad front, also and above all in EU partner countries.

From this point of view, in our opinion, the idea should also be seen that a chair is explicitly required for “integrative” or “complementary” medicine, as articulated in the motion for a resolution to the Bavarian Parliament of 10.07.2018 (Bill to Bavarian parliament 17/23310).

We would like to sensitize you as the minister of the Free State of Bavaria responsible for health policy to this topic. The intensified – in particular political – activities of the homoeopathic lobby, which obviously go back to the increasing, justified criticism of the homeopathic method, causes us concern. In our view, it would be fatal to hold on to, or even further strengthen, the pseudo-method of homeopathy, both in terms of good general health care and in terms of strengthening the population’s competence in health issues, which undoubtedly need to a great extent.

Thank you for your attention.

Yours sincerely,
the Science Council of the Society for the Scientific Investigation of Parasciences and the Information Network Homeopathy

Dr.-Ing. Norbert Aust
Prof. Dr. Michael Bach
Lydia Benecke
Prof. Dr. Dr. Ulrich Berger
Prof. Dr. Peter Brugger
Udo Endruscheit
Prof. Dr. Edzard Ernst
Thomas Fraps
Prof. Dr. Dittmar Graf
Dr. Natalie Grams.
Prof. Dr. Wolfgang Hell
Prof. Dr. Dieter B. Herrmann
Prof. Dr. Johannes Köbberling
Prof. Dr. Martin Lambeck
Dr. Nikil Mukerji
Dr. Rainer Rosenzweig
Prof. Dr. Dr. Gerhard Vollmer
Prof. Dr. Barbro Walker
Dr. Christian Weymayr
Dr. habil. Rainer Wolf

We had reported that on 22 June this year, the Madrid Medical Association, de facto the supreme medical association of Spain, issued a very clear declaration against the use of homeopathy in medical practice and referred to the medical obligations in the Code of Ethics of the Spanish Medical Profession.

Now this position is also government official: The Spanish health minister María Luisa Carcedo is quoted by the portal La Vanguardia: ” I will fight the pseudoscience, and homeopathy belongs to it.“

The decisive part of the interview with Minister Carcedo at La Vanguardia translated:

“Q: What about the healers, charlatans and miracle sellers?

A: We will take it up. We’ve had the prosecution take up the use of chlorine bleach as a cure for autism, and we will continue to do so with other things. As soon as we identify a situation that could pose a threat to public health, we will report it. It is our duty as health authorities to take action against those who want to do business at the expense of naivety or by exploiting the faith of part of the population.

Q: Do you include homeopathy in the pseudosciences?

A: Homeopathy is an “alternative therapy” that is not scientifically proven.

Q: More than 600 health professionals have appealed to you to respect their right (within the framework of freedom of therapy) to use homeopathy.

A: Health facilities have a duty to use products with proven efficacy, i.e. medicines that have undergone rigorous clinical trials and criteria. When homeopathic medicinal products provide scientific evidence, they are considered as such. This is not the case at present.

Q: Will you remove homeopathy from pharmacies, propose an increase in VAT … ? What are you going to do?

A: We are working with the Ministry of Science on a strategy to combat pseudosciences. Once this strategy is in place, we will present measures on individual methods/means, but it is clear that it is urgent to raise public awareness and show which products are useful and which are not, and to explain the damage that the decision for an alternative therapy can do.

Most remarkable. Even more noteworthy is a message from the French news channel Franceinfo (in France the discussion about homeopathy in health care is also intensively underway) on its homepage:

“The Spanish Ministry of Health has asked manufacturers (of homeopathic remedies) to subject their products to the same efficacy tests as other medicines.

The debate on homeopathy is cross-border. This is confirmed by Spain’s recent decision. The Spanish Ministry of Health now requires homeopathic manufacturers to subject their products to the same authorisation procedure as conventional medicines so that they can be indicated. If manufacturers refuse, they must indicate on the packaging that the therapeutic effect of the treatment has not been demonstrated. This is an opportunity for homeopathy to have its efficacy recognised. (sic!)”

So, words are very quickly followed by deeds.

In Germany, too, an indication may only be advertised in the case of a marketing authorisation, not a simple registration. However, the Spanish regulation still goes further: The “authorisation procedure” of Commission D at the German BfArM does not necessarily require a science-based authorisation procedure as with “normal” pharmaceutical medicinal products, but also makes an “authorisation” possible in an “internal consensus”. In addition, the positive labelling obligation as a therapeutically unproven means would clearly go beyond the German regulations. The Spanish rules are roughly equivalent to the stricter regulations of the FTC (the consumer protection authority) in the USA since 2017. Approvals based on scientifically valid proof of efficacy are unlikely. One considers: The demand for scientifically proven proofs of efficacy would – transferred to Germany – be tantamount to a lifting of the internal consensus and would make the reimbursability by statutory health insurance funds de facto invalid via the social code!

All we have left is our usual “Ceterum censeo”:

Where is the reaction of the German health system, politics, the medical profession and the other players in self-administration in the health system? To say it once again emphatically: The (scientific) debate about homeopathy is over! And it should be added: The health-political probably also soon – with exception of Germany?!?

Picture credits: La Vanguardia

The homoeopaths have long since discovered the title of Michael Ende’s well-known work “Die unendliche Geschichte” (“The Infinite Story”) as a quiet motto for themselves, as their constantly repeated “arguments” in favour of homeopathy prove. In a special context, they once again prove impressively that they are not about more than a constant warming up of the familiar on the hearth of rumours and half-truths.

In an article on “Nature and Medicine” Jens Behnke tries to keep the “serious accusations” against the review of the Australian health authority NHMRC, which have been floating freely in the homeopathic universe for more than two years, at operating temperature.

Let us remember that the Australian Health Authority’s review, conducted in rare cases with transparency and explicit involvement of the homeopathic side, is considered to be the most comprehensive study of the effectiveness of homeopathy ever. What was extremely badly received in some circles: Some time after the review was published in 2015, the information circulated that three homeopathic organisations from Australia had lodged a complaint against the NHMRC with Her Majesty’s Ombudsman (the “grievance box” for citizens’ concerns), complaining of “serious shortcomings” in the review. Significantly, the first news of this in Europe appeared in April 2016 (about eight months after the complaint had been lodged) in an institution that – quoting Prof. Ernst – had “often been at war with the truth”. The German Central Association of Homeopathic Physicians immediately circulated this report (original link expired, wording here) and, in particular, coined the word of “deception of the public” which has been recurring ever since.

The British Homeopathy Research Institute picked up this story in Europe, made itself, so to speak, the advocate of the matter and, according to its own statements, also prepared a “paper of evidence”. Since then, the ominous “deficiencies” of the review have been haunting the homoeopathic scene time and again and serve as arguments “against” the criticism of homoeopathy – now, once again, on “Nature and Medicine”.

Which is remarkable:

• The text of the complaint was never made public,
• the three complainants in Australia refuse to provide any information upon request (and have since erased any reference to the input from their websites),
• the Ombudsman does not appear to be moving (a decision normally takes a maximum of three months, the filing date is August 2016 – which is only worth Mr Behnke a succinct final sentence on an alleged “ongoing procedure”) and
• what has become known about the alleged “shortcomings” of the review has long since been invalidated.

Furthermore it was and is not recognizable in the least, what the known “complaints” are supposed to change in the result of the review – which in the end is no different than all other homeopathy reviews since 1991. Especially not different than the meanwhile three reviews of Robert H. Mathie, his sign employee of the British HRI. Just like the NHMRC, Mathie comes to the conclusion that there is no reliable evidence for homeopathic treatments.

We reported several times, contentwise here and here, to the history here, in detail in the Homöopedia. Compared to the status of these contributions, nothing has simply changed in the matter. Nevertheless, Mr. Behnke considers it necessary to remind the homeopathic fan community once again of the alleged “scandal” about the NHMRC review, which is slowly reminding us of a tabloid report.

In all this, the question is allowed: What is all this about? What is the point of reheating this rumour conglomerate, which has been kept warm on the stove of rumours for far too long? The intention to keep a “never ending story” alive here at the expense of critical voices is obvious. Recently, the – unexplained – fate of the complaint to the Australian Ombudsman has even been joined by a “petition” for “disclosure” of an alleged “first version” of the NHMRC review.

Incidentally, where does the homeopathic faction get its “findings” from on a “first version” of the review – a point apparently perceived as central – and what are the conclusions drawn from it? With the best will in the world, we do not know. In view of the “criticism” on this point, can we perhaps hope in the future for a section under “Nature and Medicine” in which all draft stages of Mr. Behnke’s articles will be published without interruption?

We find this – amazing. Because in the end all this shows a complete lack of interest in a real dissolution of the node protected by the homeopaths. Since when has a complaint to Her Majesty’s citizens’ grief box or a petition based on completely unproven rumours been a form of scientific debate?

Credits: Pixabay Creative Commons Lizenz CC0

Scientific Reports, quite a medical journal of good reputation, published on 10.09.2018 a paper entitled “Ultra-diluted Toxicodendron pubescens attenuates pro-inflammatory cytokines and ROS- mediated neuropathic pain [1] in rats“. The paper concludes that homeopathic high potencies based on Rhus toxicondendron (poison ivy, a traditional homeopathic remedy for pain symptoms) are at least as effective as Gabapentin in reducing pain and its molecular correlates (i.e. changes in the cellular signalling pathway), both in cell experiments (in vitro) and in animal experiments with rats.

Once again, parts of the homeopathic scene (associated with the exaggeration that the article appeared directly in “Nature“) announced the ultimate breakthrough in the effort to prove homeopathy “scientifically”. The Italian daily La Repubblica drew more attention to the matter with an article that was entranced by the statement:

“The studies published in Scientific Reports confirm the effectiveness of homeopathic ultra-thin dilutions: Homeopathic medicine works and has statistically significant biological effects in alleviating neuropathic pain in rats. The effect of the dynamised dilutions was similar to that of Gabapentin […]”.

Note the lack of subjunctive, also the uncritical use of the term “statistically significant”, which as a statistical probability value does not allow conclusions to be drawn about the actual effect size, but which is suggested by the formulation. No reproach against a daily newspaper, but a suggestion for the public that is welcome in homeopathy and never corrected.

Proof of the efficacy of homeopathic high potencies – a bold statement, which must be considered in view of the contradiction to the homeopathic study situation according to the postulate “extraordinary claims require extraordinary proof”.

First of all, it is a completely unscientific conclusion that the paper “confirms the effectiveness of homeopathic ultra-thin dilutions”. A single study has no evidential value, but at most an indicative value, especially if it produces a highly unlikely result. Such a result must be replicated independently – preferably several times – before the described effect can be assumed with sufficient probability to be actually present and further scientific discussion can be initiated. All this is missing here.

A first glance shows that the in vivo tests on rats involved a total of 40 animals, which were divided into five test groups (n=8). This is astonishing with regard to the small number of test subjects. Should the “groundbreaking” result of the study be seriously based on the data of a verum group of eight animals? It can’t be inferred from the study that case number planning was carried out, highly required for intervention studies and representing a factor for the validity of the later results. Above all, if differences – as here – are to be determined in five differently parameterized groups (not only verum versus placebo or standard means), the careful determination of a sufficient and meaningful number of test objects is anything but trivial.

The publication also shows relatively easily identifiable uncleanliness / abnormalities, which the portal RESIS – Research Integrity Solutions – explains in a contribution by Enrico Bucci from Temple University in Philadelphia.

This starts with the fact that graphical representations of the in vitro results are partly incorrectly labeled, partly the same graphics were published for different parameters. Even more important is the fact that different effect/time diagrams (one for a cold test, one for a heat test in animal experiments) in all (!) displayed data points (“every experimental point”) correspond 1 : 1 (which is not immediately visible due to the differently selected axis sizes), so that RESIS draws the conclusion that something elementary cannot be correct here – random chance excluded. The raw data are not published – of course not. RESIS states: If there are really two different experiments, the shown coincidence of the data is simply impossible.

RESIS points out that these are not the only statistical-numerological inconsistencies and rightly believes that this is enough to discredit the validity of the study. Other portals and forums have also already taken a critical look at the work, e.g. PubPeer, where the panelists go into even more critical detail.

A particularly strange circumstance, in which journals usually tend to react very sensitively, is added. One of the authors of the Indian research group names a mail address that was demonstrably used in another work by an author of another name. This is not only completely unusual, but also doesn’t correspond in any way to good practice and integrity in publishing.

The pharmacology professor Silvio Garattini, who has discovered further methodological shortcomings on the sanita24 portal, concludes: “Homeopathy remains a method without scientific proof, and there is no change of that because of the alleged efficacy claimed by the studies published in Scientific Reports”.

We agree – and ask ourselves together with RESIS, how such a work can survive a peer review for a journal, also in view of the responsibility a journal has towards the scientific community and the public. This does not mean, however, that there can be no mistakes in scientific publishing, not at all. However, one can rely on the self-control of the scientific community, as in this case.

After all, the publication of Scientific Reports now carries an editor’s note that refers to the objections against the work and announces “appropriate editorial measures” “as soon as this matter has been clarified”. The quick-shot statement of the authors of the study that this may be all, but does not change the result seems to no longer satisfy the editors of Scientific Reports.

Supplement, 11.10.2018, 15:00 o’clock:

In the meantime, “Nature”, the “mother journal” of Scientific Reports, also reports on the matter. They are striving for neutrality, but with a rather critical undertone.

Supplement, 11.06.2019:

As Retraction Watch reports, the study has just been retracted by Scientific Reports. Scientific Reports published a comprehensive retraction note today (11.06.2019). It says:

“Following publication, the journal received criticisms regarding the rationale of this study and the plausibility of its central conclusions. Expert advice was obtained, and the following issues were determined to undermine confidence in the reliability of the study.

The in vitro model does not support the main conclusion of the paper that Rhus Tox reduces pain. The qualitative and quantitative composition of the Rhus Tox extract is unknown. Figures 1G and 1H are duplicates; and figures 1I and 1J are duplicates. The majority of experimental points reported in figure 3 panel A are duplicated in figure 3 panel B. The collection, description, analysis and presentation of the behavioural data in Figure 3 is inadequate and cannot be relied upon.

As a result the editors are retracting the Article. The authors do not agree with the retraction.“

In other words, everything that was already the main object of criticism eight months ago bears out. Nature resp. Scientific Reports must not be criticized for the period of time that has elapsed until the retraction, here is carefully examined and external neutral expert knowledge is used. All the more important is a complete retract. It is noteworthy that the main author of the study does not agree at all with the withdrawal and repeats his indications that it is a matter of “typos” and perhaps a little laxity in the publication. This can probably be seen as a mixture between massive confirmation bias and defensive strategy. More interesting, the question remains how such a work could “slip” through the peer review of a highly respected scientific publication.

Our conclusion:

Another case from the colourful wreath of the famous “many studies” that “undoubtedly prove the effectiveness of homeopathy”, as it is heard every day. The special thing about this case compared to many others is its deep fall: After all, it was loudly exclaimed as the ultimate proof of the “efficacy of homeopathic ultra-dilutions” and thus settled even a few floors above the well-known “results” of Jacques Benveniste and Luc Montagnier – these two had “only” postulated that they had found “differences” between pure solvent and homeopathic high potencies, not more. Here in the case of the “rat study” it was even up to “efficacy of homeopathy”…

Failed, once more. The lack of evidence of homeopathy is a fact; it has not been able to prove such evidence either for individual indications or as a method. With studies such as this, she at least continues to contribute to its discrediting. We rest our case.

1] ROS: Reactive Oxygene Species, known as “free radicals”. A mediating role of ROS in intra- and intercellular signalling processes is considered to be assured

Picture credits: Screenshot Scientific Reports online

The discussion about alternative medical methods in the health system, especially homeopathy, has quickly and apparently sustaining gained momentum in France.

We reported on the request of the National Council of the Medical Chamber of 22 March this year that the National Academy of Medical Sciences and the Ministry of Health should decide on the scientific relevance of “alternative and complementary methods, namely homeopathy”. This was flanked by the #FakeMed medical initiative, which strongly opposed pseudomedicine and all forms of its direct and indirect acceptance and promotion in health care.

The public discussion – also in the media – was intensively taken up afterwards. Health Minister Buzyn, who had expressed herself somewhat indifferently in public after the National Council of the Medical Chamber’s call, came under fire. But even the dissenting votes were not long in coming: The homeopathy lobby in France began to target the physicians’ association #FakeMed as the supposedly weakest link in the chain of critics and to try to shift the matter to both a professional and a legal level. The press, including leading newspapers such as Libération, Le Monde and Le Figaro, reported in part extensively.

Le Monde stated on 25 May 2018 that on 18 May the Academy of Medical Sciences, referring to its earlier opinion of 2004, described homeopathy as “a method developed two centuries ago on the basis of a priori concepts without any scientific basis”. This is not a direct verdict, but at least a very strong position setting, especially as an answer to the initiative of the Supreme Medical Chamber. Le Monde leaves no doubt that this verdict is tantamount to classifying homeopathy as “unscientific”. It might only be a side note that the Association of French Homeopathic Physicians, on the other hand, refers the EPI3 study financed by Boiron, on which we have already made comments here (a detailed discussion on EPI3 worth reading by Dr. Norbert Aust here).  Le Monde refers to this without digression as a “bad study” and quotes the pharmacology professor François Chast: “We are in the world of faith”.

Now Le Figaro reports that the National Council of the Medical Association has for the first time positioned itself – with a new version of a part of the medical code of honour of the chambers, which – as Le Figaro finds – “does not completely close the door for homeopathy”, probably because of the concessions in complementary measures (which we consider problematic). But pseudomedical means and methods are distinguished from scientific medicine here with unprecedented clarity. The text leaves no doubt that the Chamber does not place it at the discretion of doctors to use unproven methods instead of scientifically proven therapies. This Decision is given below in translated form:

Updating of the generally binding ethical framework by the National Council of the French Medical Chambers:

“The medial use of the terms “alternative and complementary medicine”, in particular with regard to homeopathy, maintains an ambiguity which leads to confusion and interpretation disputes.

“Without questioning the freedom of critical or divergent opinions of each individual in the public sphere, the National Council of the Medical Association demands that the Medical Association should be able to take a more pro-active approach to the issue:

• that the term ‘medicine’ as a prerequisite for any therapeutic procedure first includes a medical process of clinical diagnosis, which may be supplemented by additional examinations with the involvement of competent third parties;
• that every physician must practice medicine according to scientifically gained knowledge and data both in the making of the diagnosis and in the therapy proposal;
• that, since the data derived from science are essentially based on continuous development, controversy over a particular method of treatment, whether medical or not, must lead to an up-to-date, impartial and rigorous assessment of the medical service provided by the medical and scientific community.

The National Council therefore affirms that the medical care of a patient must meet the requirements of quality, safety and urgency of care.

A medically recommended treatment can in no case be an alternative to the knowledge gained from science and the state of the art, but it may include an adjuvant or complementary, medical or other prescription, which the doctor will decide to the best of his knowledge and belief in the individual situation after giving the patient fair, clear and appropriate information.

However, the National Council recalls that the Code of Medical Ethics prohibits the presentation of unattended treatment or therapy as safe and therapeutic effective.

This is the ethical framework that applies to the entire medical profession.

Text adopted by the plenary session of the National Council of the Medical Association on 14 June 2018 (original here)”

Despite the reviving resistance of the lobby, it will probably soon become densely for homeopathy in the French health care system. The polite and unmistakable positions of the highest medical association and the highest scientific authority give a “broad hint” in the direction of the Ministry of Health to draw the political consequences from this joint positioning of practical and research medicine.

We take note that the French medical profession represented by its supreme body has taken the initiative to distance itself from pseudomedical methods, in particular homeopathy. And the highest medical scientific authority in the country follows. And that, since in our country the Medical Association did not even consider it necessary to even debate or even vote on the previously intensively discussed abolition of the “additional medical designation of homeopathy”.

Once again we ask: What’s about us in Germany?

Picture credits: Pixabay Creative Commons License

A clear message from the French medical profession

On Thursday 12 April 2018, French Health Minister Agnès Buzyn made a brief statement on French television on the question of the reimbursement of homeopathy costs by public health care.

She is ” in favour of maintaining the reimbursement of homeopathy, a medicine that probably has a placebo effect but does no harm. There is an ongoing evaluation of what we call complementary medicine. (…) If they (the methods of “complementary medicine”) continue to be useful (?) without being harmful, they will continue to be reimbursed by social security. (…) The French are attached to homeopathy, it probably (!) has a placebo effect. If she can prevent the use of toxic drugs (she obviously means pharmaceutical drugs…), I think that’s a gain for the general public, it doesn’t hurt”.

A remarkable statement for an oncologist, we note.

But what – at least in Germany – had not become quite so clear anywhere, that is the reason for this statement by Mrs. Buzyn – and we consider that far more significant than the statement itself.

She reacted to an intervention by the National Council of the Medical Chamber on 22 March this year, in which the latter called on the scientific (National Academy of Medical Sciences) and political institutions (Ministry of Health) to decide on the scientific relevance of “alternative and complementary methods, namely homeopathy” – with explicit reference to the statement of the EASAC of September 2017.

In this context, there is the activity of a group of doctors called “#FakeMed”, which entered public with a press release of 28 March 2018, which leaves nothing to be desired in terms of clarity on the subject of pseudomedicine, especially homeopathy, and makes a number of very concrete demands on the Medical Association. We note with great interest and agreement that forces are forming in our neighbouring country which no longer want to accept the continuing and expanding legitimacy of sham therapies, especially homeopathy, unchallenged.

Because of the importance of the declaration from France, we give a translation here in a slightly abbreviated form:

Press Release 28 March 2018:
Fierce debate on alternative practices
The collective #FakeMed proposes:

The Hippocratic Oath is one of the oldest known ethical obligations. He demands a doctor who cares for his patients just as honestly as he does in the best possible way.

These two obligations require a doctor to constantly improve his (medical) knowledge and to inform his patients about what he can reasonably offer and which treatments are unnecessary or contraindicated.

It is not a great art – and usually rewarding – to demonstrate one’s knowledge. But it is much more difficult to recognize and accept one’s limits. One can therefore easily be tempted to offer medical care without a scientific basis. This temptation has always been there. It was and is nourished by charlatans of all kinds who use the moral credit of their qualification and reputation to promote illusory therapies with illusory efficacy.

The commitment to honesty is enshrined in the ethical codes of the medical professions and in the French Health Code. These rules prohibit charlatanry and deception, they require the prescription and execution of treatments for which efficacy has been established. They prohibit the use of obscure products or products whose ingredients are not clearly declared. The National Council of the Medical Association is responsible for ensuring that its members do not promote practices for which there is no scientific proof of benefit or which may even be dangerous. The Council must ensure that doctors do not become commercial agents of unscrupulous industries. It must sanction those who have lost sight of the ethical requirements of their profession. Nevertheless, even in 2018, the Medical Association continues to tolerate practices that contradict its own code of ethics; public institutions promote such practices or even contribute to their funding.

We are now forced to respond clearly and forcefully to the spread of these esoteric practices and the growing public distrust of evidence-based medicine.

Homeopathy, like other so-called “alternative medicine”, is by no means scientific. Their methods are based on beliefs that promise a “wonderful, gentle and safe recovery”. In September 2017, the Scientific Council of the Academies of European Sciences (EASAC) published a report confirming the lack of effectiveness of homeopathy. In most developed countries, doctors are prohibited from prescribing homeopathic medicines.

The so-called “alternative” therapies are ineffective beyond the placebo effect and can even prove to be dangerous. They can be dangerous, because they treat irrelevant symptoms, over-medicate the population (conditioning for ingestion, treatment of pure disorders and mild illnesses not requiring treatment) and create the illusion that any situation can be solved with one of their “treatments”. They can be dangerous because they are based on a fundamental distrust of conventional medicine, as the unjustified polemic about vaccines shows. Finally, they can be dangerous because their application delays necessary diagnoses and treatments, which sometimes leads to dramatic consequences, especially in the treatment of serious diseases such as cancer.

These practices are also costly for the public purse. Training for such practices takes place in publicly funded structures. “Alternative” consultation hours are opened in hospitals at the expense of other medical services. Some of these treatments are reimbursed by the (loss-making) French health insurance. In France, 30 % of homeopathic medicinal products can be reimbursed (up to 90 % in the Alsace-Moselle region) and enjoy an exceptional status exempting them from proof of efficacy. This will finance a wealthy industry whose representatives have no hesitation in massively insulting those who criticise it (“There is a Ku Klux Klan against homeopathy,” said Christian Boiron, president of the world’s leading company in the industry, in the July 15, 2016 newspaper “Le Progrès”) or simply putting aside the undeniable scientific evidence requirements.

We want to distance ourselves comprehensively from these practices, which are neither scientific nor ethical, but irrational and dangerous.

We call on the French Medical Association and the French authorities to do everything in their power to implement these demands:

Doctors or health professionals are no longer allowed to further promote these “alternative medical” practices with their professional qualifications.
Homeopathy, mesotherapy or acupuncture diplomas are no longer recognised as medical degrees or qualifications.
It must be ensured that medical faculties or institutes providing health training may no longer issue diplomas for medical practice concerning methods without scientific proof of effectiveness.
No more reimbursement for health care, medications or treatments from disciplines that refuse a rigorous scientific assessment.
Promote initiatives aimed at providing information on the nature of alternative therapies, their harmful effects and their real efficacy.
All health professionals must abide by the ethical consequences associated with their profession, which necessarily result from the ineffectiveness and irrationality of pseudomedical methods, by refusing to carry out useless or ineffective treatments. Instead, they must offer treatments according to the recommendations of scientific societies and the latest scientific findings, demonstrate sincerity and honesty to their patients and offer empathetic listening instead of “alternative methods”.

End of quote.

We are very pleased that well-founded and decisive criticism of pseudomedicine, first and foremost of its “driving force” homeopathy, is now growing together into an international activity. For Germany, this means, as we have already stated on several occasions, increased pressure to act if we do not want to fall into a health policy offside internationally and, above all, within the EU.

German health policy, German Medical Association, medical profession: We’re waiting!

Read more on “Respectful Insolence”: https://respectfulinsolence.com/2018/04/13/fake-medicine-science-based-medicine-versus-homeopathy-france/

Picture credits: Screenshot fakemedecine.org

English version will appear soon.

English version will appear soon.

In the context of the discussion on the reimbursement of homeopathy by statutory health insurance funds, the CEO of SBK drew attention to himself on Twitter with the “argument” that the small amount spent on homeopathy in his company was ultimately irrelevant “from an insurance point of view”. After this position had been contradicted on Twitter, SBK published a “Background Information: Homeopathy at the SBK” on its website and explicitly referred to this as part of the debate.

The Information Network Homeopathy feels compelled to comment on this publication with an open letter to SBK, which is given below:

To the
Siemens Company Health Insurance Fund (SBK)

By e-mail (info@sbk.org)

09.01.2018

Open letter of the information network Homöopathie on the publication of the SBK “Background information: Homeopathy at the Siemens company health insurance fund”

Ladies and Gentlemen,

your institution is one of the many health insurance companies that reimburse the costs of homeopathic treatment, which has been under discussion for some time. On Twitter, your CEO drew additional attention by putting forward the “peanuts” argument, i.e. the opinion that the low expenditure on homeopathy was not a significant part of the total expenditure anyway. This has already been contradicted on Twitter to the extent that this is not the only, not even a priority aspect in the demand that homeopathy no longer be reimbursed by health insurance funds.

Thereafter, you have clarified your point of view on homeopathic reimbursement (https://www.sbk.org/themen-standpunkte/hintergrundinformation-homoeopathie/ ), for which we would like to thank you first of all, because this enables a discourse. In the following we therefore deal with what you state in your clarification and orient ourselves on the headings of the various points as used in your publication:

1. To what extent does the Siemens Company Health Insurance Fund (SBK) cover treatment by homeopaths?

At this point, you inform us that you offer a separate optional tariff for homeopathic services (“pharmaceutical tariff”), which is actuarially self-supporting (i.e. the area of statutory services “for all” is not affected).

However, this information is incomplete.

According to the information on the SBK website, this only applies to the drug part, i.e. the globules; the medical treatment part of homeopathy is covered by a selective contract with the management company of the Central Association of Homeopathic Physicians as part of the statutory benefits, as is the case also with other health insurance funds, and thus also affects all insured persons who have no “interest” in homeopathy.

Even in the case that homeopathy would be a complete part of an optional tariff offer: The health insurance funds, especially the statutory ones, are important players in the health care system. We can certainly see that the legislator – unlike in the vast majority of industrialised countries – has not (yet) consistently implemented the orientation of public health towards evidence-based medicines and methods. Unfortunately, indeed. However, it cannot then be the task of the health insurance funds to undermine the confidence of their policyholders in rational medicine by offering a “vendor’s tray” of unscientific and ineffective methods, not even within the framework of a “voluntary tariff”, and thereby make a not insignificant contribution to the irrationality and hostility towards science that unfortunately prevails anyway. Apart from the fact that such offers, understood correctly, should actually be an ethical problem for health insurance companies.

One should bear in mind that the offer of unscientific methods with the authority of a statutory health insurance directly threatens the necessary further development of the health system in terms of performance, effectiveness and sustainability. Homeopathy is the “entry point” for the acceptance of further pseudomedical methods and often correlates with things like vaccination “skepticism” (perhaps less in the medical profession, but basically very well). Thus homeopathy is the dividing line beyond which there is a danger of further attention by patients to more dangerous pseudomedical methods. The responsibility of the statutory health insurance funds here is considerable. They should send a clear signal against such tendencies.

2. To what extent has the effectiveness of homeopathy been proven and what is SBK’s opinion of studies which consider homeopathic treatment to be free of effects?

“It is true that there are no scientific studies which clearly prove the efficacy of homeopathic medicinal products, but this does not mean that they couldn’t be effective.” This sentence in your publication opens the door to any arbitrariness and has nothing to do with a scientific-rational view on the problem. As the INH has just stated in its article “Scientists claim that homeopathy is impossible“, the “reverse conclusion” quoted by you is an absolute empty statement – simply because the ineffectiveness (impossibility) of something can in principle not be proved. Homoeopathy, however, has the scientifically conceivably highest improbability against itself that it could ever succeed in proving its effectiveness, let alone in explaining a mechanism of action that is compatible with the state of scientific knowledge. It is highly implausible, contradicts everyday experiences and is also incompatible with natural laws. Any explanatory model of homeopathy would require a massive revision of the valid and proven scientific view of the world. One cannot therefore – especially not as a health insurance company that should position itself credibly and seriously towards its policyholders – retreat to the Hamlet argument of “There is between heaven and earth…”.

In response, it should be sufficient to quote once again the summary of EASAC, the Advisory Board of the European Academies of Science:

“[We conclude]  that the claims for homeopathy are implausible and inconsistent with established scientific concepts.
We acknowledge that a placebo effect may appear in individual
patients but we agree with previous extensive evaluations concluding that there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect.”

We conclude from our research that the claims about homeopathy are implausible and contrary to established scientific principles.
We recognize that individual patients may have a placebo effect, but we agree with previous detailed studies and conclude that there is no known disease for which there is robust and replicable evidence that homeopathy is effective beyond this placebo effect.”

This is the valid statement of the scientific world on homeopathy. The position you have formulated is thus untenable according to generally valid rational standards.

3. Why is it not a problem for the SBK to pay for an unprovable form of treatment (= homeopathy), while this is not possible with glasses, for example?

In fact, the statutory health insurance funds are not allowed under German social insurance law to replace homeopathy reimbursements with benefits for spectacles and higher grants for dental prostheses. This is well known to the Homeopathy Information Network and has been explained in detail in an article on its website. Nevertheless, we understand that this is often mentioned as a wish by policyholders who reject homeopathy.

Here, too, we encounter a fundamental misunderstanding in your argumentation when you refer to the possibility granted by law to include homeopathy in the catalogue of statuory benefits. As also mentioned in the article from the INH website quoted above, no health insurance company is forced to do so. You yourself write that reimbursement of the special therapeutic directions is “not excluded” – but that brings your consideration to an end. However, the Federal Social Court has already decided several times that the same criteria of “necessity, economic efficiency and expediency” must be applied to the means of special therapeutic directions (homeopathy, anthroposophy, phytotherapy) as to all other drugs. A relevant social-legal commentary states in agreement: “An advantage of drugs of the special therapy directions with the consequence that quality and effectiveness of the achievements do not correspond to the generally recognized conditions of the medical realizations … contradicts … the legal defaults”.

Already in point 2 it was stated that homeopathy, according to worldwide scientific judgement, contradicts established scientific principles and that there is no reliable and reproducible evidence of specific efficacy for any disease. Such a method can never meet the social security reimbursement requirements of “necessity, cost-effectiveness and expediency” – in our opinion, any health insurance fund that reimburses homeopathy by way of statutory benefits is moving on very thin ice under the current legal situation. In this context, we see interest in the fact that you describe homeopathy as an “unprovable form of treatment” in your statement.

One more word on the objection that even in the field of “normal” medicine, ineffective drugs and methods are paid for: A health insurance company shouldn’t do that either. However, the legal situation here is different: every statutory health insurance fund is for “normal” pharmaceutical drugs and therapeutic methods bound by the approval decisions of the Federal Joint Committee for Drugs and Medicines: What the Federal Joint Committee allows in this area is by law standard benefit of the statutory health insurance funds. It is inconclusive and unreasonable to play this fact off against the reimbursement of homeopathy, for which or against which each statuary insurance fund can decide for itself.

4. What are the annual costs of homeopathic treatments for the contributor?

Here we come to the initial argument, which has led users on Twitter to criticize the statement made by your CEO in this regard. It should suffice to point out that the exclusion of homeopathy from the British public health system was associated with the explicit statement of the NHS (National Health Service) that it was not – not even secondary – a matter of cost savings, but rather of “lack of clinical efficacy” and the resulting “low cost-effectiveness”, i.e. the non-existent cost-benefit ratio. Because: Nothing is always too expensive. From the statements of the other government agencies that removed homeopathy from their health systems in 2017 (Australia and Russia), we also couldn’t find that costs played a role, let alone a decisive one. The same shall apply to the statement of the Scientific Advisory Board of the European Academies of Sciences (EASAC) quoted above. Once more, it is about honesty and probity towards patients, credibility and the best possible care within the healthcare system. The statutory health insurance funds should play a pioneering role in this and not focus on the “wishes” of the insured, but on objectifiable standards. Nihil nocere – above all, do not harm, this old Hippocratic principle also applies here. And damage is – as explained – produced in many ways when statutory health insurers handle homeopathy with their authority as a proven effective method.

5. Why does the SBK not rather reduce the additional contribution (above regular taxes) for policyholders instead of further paying for homeopathic treatments?

The comments made under point 4 make it unnecessary to comment on this matter. Of course, we do not wish to endorse the ‘peanuts’ argument that EUR 1.1 million would not ultimately be important. Every euro of contributions from insured people must be used with due care in the interests of honesty towards the members. For example, the money would be very well spent on voluntary therapies for very rare diseases or similar cases. But this doesn’t affect our core concern.

Concluding remark

In principle, we oppose a strategy of health insurance companies to drive on a “competition” that has gone out of control with a “magic shop” full of things that are ineffective, but are “desired” by a certain clientele. The original idea of health policy, to initiate competition within the statuary insurance system via rationalisation effects and the level of contributions, has – as the merger of many health insurance funds makes clear – certainly had its results. However, we consider it fundamentally wrong to extend this to “competition for benefits” as a means of “catching customers”. We also consider it completely out of the question that ineffective and potentially dangerous methods such as homeopathy should be used for this purpose.

Yours sincerely

Information Network Homeopathy

Dr. Natalie Grams.
Dr. Norbert Aust
Dr. Christian Lübbers
Udo Endruscheit

“There is no scientific evidence that homeopathy works.”

“There’s nothing in it – They’re just sugar pills!”

… is the next thesis from homeopathic criticism to which the Homeopathy Research Institute dedicates the fourth part of its thirteen-part series in order to refute it. The HRI refers to the alleged evidence from “basic research on homeopathy” that globules are “more” than “sugar balls”.

To anticipate the conclusion – the globules are and remain sugar globules on closer inspection. While it is more correct to say that the globules contain “nothing effective” (and “more sugar in sugar” does not work from a certain point), it is explained below that the term “sugar balls” nevertheless hits the nail on the head.

“Laboratory experiments have shown that homeopathic remedies are not just sugar beads.”… this is what the HRI tells us. But what are they instead – and above all, what does this have to do with any proof of the validity of homeopathy? What is the statement when the HRI tells us: “The test results show that homeopathic remedies cannot be pure water or pure sugar. “Because that’s obviously the case, homeopathic remedies can be effective.” That’s a logical circular reasoning, but no proof.

This can be noted first: The attempt to prove physical-chemical changes in high potencies in any way has nothing to do with a proof of the correctness of Hahnemann’s homeopathy – independent of possible results – mainly because there is no idea how this could be causally related to a medicinal effect of homeopathy in the human body. Such a thing is rather a seemingly rational attempt to save the homeopathic building, since the concept of a “mental vital force” can no longer be conveyed in a scientific context – and rightly so.

In addition, the works quoted do not stand up to critical scrutiny neither in the interpretation nor of the results or in terms of design and implementation. They are either very controversial (antibodies to white blood cells, apparently this is the well-known work of Benveniste [1] – keyword water memory [2]) or only of very small effect strength and even contradict the homoeopathic doctrine (Endler); more about the latter can be found in the detailed article on the topic on Dr. Norbert Aust’s blog “Taking of Evidence in Homeopathy”[3] [4].

The fact that these two works are presented by the HRI as the top results in basic homeopathic research speaks for itself.

The following excursus shows how far away homeopathic basic research and the defence of HRI are from homeopathy in another respect:

One should also be aware that Hahnemann’s closed concept of homeopathy is not compatible with the search for or the proof of a “material”, i.e. with physical-chemical methods detectable effects in high potency drugs. Hahnemann constituted the “spiritual life force” (vis vitalis) as the supporting pillar of his homeopathy and the “spiritual medicinal power” in the remedy as the counterpart.

“Our vital force, as a spirit-like dynamis, cannot be attacked and affected by injurious influences on the healthy organism caused by the external inimical forces that disturb the harmonious play of life, otherwise than in a spirit-like (dynamic) way, and in like manner, all such morbid derangements (diseases) cannot be removed from it by the physician in any other way than by the spirit-like (dynamic1, virtual) alterative powers of the serviceable medicines acting upon our spirit-like vital force, which perceives them through the medium of the sentient faculty of the nerves everywhere present in the organism, so that it is only by their dynamic action on the vital force that remedies are able to re-establish and do actually re-establish health and vital harmony, after the changes in the health of the patient cognizable by our senses (the totality of the symptoms) have revealed the disease to the carefully observing and investigating physician as fully as was requisite in order to enable him to cure it.” (§ 16 Organon, 6th edition, trans. Boericke)

He vehemently condemned the “atomists” and “materialists”, who already at his time insisted that a mechanism of action could only be assumed if it was based on material interactions. He believed that he had found the “proof” for his concept of a non-material medicinal power in the use of magnetism as a homeopathic remedy (he deals with this in detail in the 6th edition of his “Organon”). This is not at all consistent with the research conducted by the HRI on the material verifiable and measurable effects of high potencies:

“How can they finally rhyme with their atomistic, material concepts of the effects of medicines that a well-prepared magnetic steel rod, […], can produce such a tremendous change of mood in our condition that we suffer severe pathological complaints from it, or, to such an extent that a magnetic rod can heal quickly and permanently the most violent evils to which it is appropriate as a medicine, conceals them in the above way, approaches them to the body, even approaches them only for a short time? Atomist! atomist! you for wisely in your limitation seeming atomist! say, what weighable magnetic heal penetrated there into the body to make those, often tremendous changes in his condition? Isn’t a centillion part of a grain (a fracture that has 600 digits to denominator) still infinitely heavy for the very imponderable part, for the kind of spirit that flowed from the magnetic rod into this living body? …” (Hahnemann, Reine Arzneimittellehre, 2nd edition, II. part, p. 212).

More than diluting?

The nevertheless very “materialistic” view of “basic research” is often presented as “progressiveness” or “further development”. The fact that these are unsuitable attempts at rationalisation is, however, clearly shown elsewhere: Hahnemann’s dogma that the shaking transfers “information” (the “spiritual medicinal power”) to the solvent and thus represents more than an increasing dilution of the original substance (up to the point where only solvent is shaken with solvent) is held unswervingly by the homeopaths. Quote HRI:

“The physical and chemical changes caused by shaking, and how they enable water to absorb the information of the substances diluted in it, are the big questions that researchers are trying to answer.”

It is probably more the case that no answer can be found here, because false and nonsensical questions are assumed. It would be correct to ask whether such phenomena exist, only then does it make sense to ask how this happens. However, this question already contains the premise, the unproven assumption, that there are actually effects in high potency dilutions (“possibility of water to absorb information about substances diluted therein”), which “only” require research.

This is the inadmissible argumentation with the “false premise”, which one “smuggles” into a discussion as given, in order to be able to lead a sham debate based on it. The premise at issue here, that water is capable of absorbing information by homeopathic potentiation, is unproven, there is no evidence for this, not even plausibility. Thus an argument based on this is invalid from the outset. However, there are the physical-chemical principles that have proven themselves in everyday life and technology, which tell us that a dilution is and remains a dilution and does not mutate into an ominous “transfer of information” because a homeopathic mother substance is involved. A specific effect that could transfer “information”, “vibrations”, “frequencies” or “energies” to the water is not known. [5]

In this respect, one must regard the HRI’s reference to the efforts of the “researchers” as a rhetorical-argumentative trick, with which an unproven and implausible premise is imposed on the debate. In practice – what are we talking about at all? In addition to these fundamental considerations, one should bear in mind what actually are the real orders of magnitude to which the attempt of homeopathic basic research to prove specific effects leads. Even if you are familiar with the system of homeopathic potentiation, you might be surprised if you consider the practical question of which product quantities can be produced with which potentiation.

During potentiation, the concentration of the drug decreases rapidly. As already mentioned, even low potencies show concentrations of active substances which are not sufficient for physiological reactions. Even a low potency of D6 contains more unavoidable impurities of the carrier substance (even at the highest purity level available) than the original substance. 100 kg 6X globules (purity 99.6 %) contain 400 g of random impurities and 0.001 g (!) mother tincture active ingredient.

Let us continue with a simple rule of three. One gram of mother tincture can be used to make 100 tons of Globuli 6X. You need five articulated lorries, each with a lifting capacity of 20 tons, to transport this quantity.

12X produces so many globules from one gram of mother tincture that 1,250 bulk carriers of the PANAMAX class (each with a capacity of 80,000 tons) can just load them – all together with an active substance content corresponding to one third of a piece of sugar cube.

And here we have by no means arrived at what homeopaths in the true sense call “high potencies”, which generally means potentizations from 30C onwards.

Summary

Indeed, globules D6 and higher are pure sugars, in the sense that the impurities always present in the material are much higher than the content of what is supposed to be present as a homoeopathically specific substance. This already applies to potencies far below the range which is described by homeopathy as high potency. No basic research on homeopathy has so far produced a result which disproves this point of view. Even if one were to regard the results presented as correct, they do not constitute a basis for proving the effectiveness or a mechanism of action of homeopathy – there is no even plausible idea of causality.more than 20 years of intensive research in several institutions, with the express aim of “proving” homeopathy (“confirmatory research”), – without anything having been found so far which could somehow be regarded as the cause of the allegedly radical effectiveness of homeopathy? This should not be presented in a positive way.

[1] https://de.wikipedia.org/wiki/Jacques_Benveniste

[2] Refutation in: Memory in water revisited, Nature (1994), Abstract: https://www.ncbi.nlm.nih.gov/pubmed/8255290?dopt=Abstract

3] http://www.beweisaufnahme-homoeopathie.de/?p=2093

[4] http://www.beweisaufnahme-homoeopathie.de/?p=2131

[5] For detailed information on shaking / potentiation in the Homöopedia (in German): http://www.homöopedia.eu/index.php/Artikel:Schütteln

A detailed article on the HRI thesis discussed here has been published on the blog “Beweisaufnahme in Sachen Homöopathie” (“Taking of Evidence in Homeopathy”) by Dr. Norbert Aust.

Previously published by INH in the series “Criticism on criticism on homeopathy”:

Part I – Scientific evidence
Part II – “Positive studies missing”
Part III – “Scientists say homeopathy is not possible”

Picture credits: Fotolia_130625327_XS /
Wikimedia Commons: (C) CostaPPPR / (C) Konrad Kaufmann / (C) Daizotec, Hanoi, Vietnam

English version will appear soon.

English version will appear soon.

Happy without globules! – A guest contribution by Miriam Weissberg, Midwife

Dear becoming and become parents!
I am a midwife with heart and soul, deeply convinced that homeopathy has no use whatsoever that would make it worthwhile to spend money on it, even though it is recommended by many colleagues. That’s why I’m turning to you today.

Many of you may have had the idea of using a homeopathic for the first time during pregnancy or after your baby has just hatched, because you expected it to gently improve an unpleasant condition without having to accept the possible risks and side effects of a “normal” medication.

Homeopathy – many people associate it with naturalness, the healing power of the plant kingdom. In fact, however, globules and co. (Bach flowers, Schüssler salts, homeopathic mixed preparations) are no closer to nature than analogue cheese and plastic flowers. Since they contain – depending on the degree of dilution or potentiation – only very few to no active substance molecules, their efficacy can never be greater than the placebo effect, as numerous scientific studies have clearly shown in the meantime.

Placebo is Latin and means “I will please”. The placebo effect thus means a subjective healing or mitigation of a pathological condition in the patient produced by a sham drug free of active substances, presumably triggered by stimulation of physiological self-healing processes or changes in self-perception.
So if homeopathic remedies are proven to have no specific medical benefit, what are they good for?

One could argue that placebos have their justification in paediatrics, where non-treatable disorders such as unspecific abdominal pain, restlessness and minor injuries (e.g. due to falls while learning to walk) are the order of the day. Why not give globules to the child in such situations when they support the self-healing powers via the placebo effect?
At this point I would like to hook in with my conviction that globules and co. are the wrong way to deal with illness and mood disorders, even if their administration can achieve an – often only apparent – improvement in condition.

For me, to reconsider naturalness means to ask myself what the child could need in the respective situation, what activates its self-healing powers without the use of sham drugs, and to give it THIS:

If it has fallen and injured itself, it needs loving comfort, a plaster and possibly a cool pack. If it is very over-excited and restless, a round of cuddling and reading aloud on the sofa might help. If it has unspecific abdominal pain, carrying it around, a hot-water bottle, or hold it face-down in your lap may be useful.

Whoever gives globules to his child in these and similar situations will ultimately only give him the impression that any physical complaints require medical intervention – in my opinion a very questionable message.
For me, however, reconsidering naturalness also means observing the child’s well-being and developing a feeling for when a visit to the paediatrician is necessary:

A child who has fallen could, for example, have a concussion in addition to the injury to the knee. Nonspecific abdominal pain could conceal inflammation of the middle ear or bladder. Restlessness or apathy could mark the beginning of a serious infection.
Those who first give their child globules in such situations and wait for the effects to unfold, could unfortunately also let unnecessary time pass, which prolongs the suffering of the child or complicates its medical treatment.

Those who love their children understandably want to protect them from discomfort and suffering or end such conditions as quickly as possible. Unfortunately, there is not a quick remedy for every condition in the form of a bead or a tablet – this realization often hits young parents hard for the first time when they experience helplessly how their baby bends in front of abdominal pain and nothing really helps against it.

From my point of view as a midwife I would like to encourage you in this context either to accept that this crisis cannot be ended immediately, but that it becomes easier through care and attention for the child. Or seek medical advice, even if you are afraid of being ridiculed for your supposed overconfidence. In my experience, paediatricians always understand insecure parents and are happy to advise them.

In this spirit I wish you and your children all the best and a wonderful time.

Picture: Provided for the INH (private)

This post first appeared on the Facebook page of “Susannchen braucht keine Globuli”.

The good conversation between patient and doctor is an essential part of the anamnesis, diagnostics and above all the therapy. Mutual trust between patient and doctor is of decisive importance.

Often one hears of a general patients’ unsatisfaction regarding the therapy conversation. It is almost always complained that these conversations are too short, because the doctor has too little time. This general unsatisfactoriness with the medical conversations is mentioned as an important – perhaps even the most important – reason why patients visit a non-medical practitioner or homeopath because he is said to be better trained for the conversation than the doctor and takes more time for the conversation (which is unfortunately a false assumption: non-medical practitioners have no training in conversation and above all no experience with patients if they have passed their exam). Many patients acknowledge that the remuneration of physicians does not normally allow long therapy sessions, but they also know that the remuneration of the physician’s consultations is not the responsibility of the patients. It is obviously the law of the market that you pick up the minutes for conversation where you get them, even if you have to pay for the time yourself.

Doctors who are confronted with criticism of the “inadequate” conversation situation in practices and clinics often find this criticism justified. At the same time, the poor remuneration is cited as the reason for this unsatisfactory situation. Patients and doctors can jointly blame third parties for the precarious situation: politicians and health insurance companies.

Patients, physicians and pseudomedical practitioners largely agree in public that there are deficits in medicine in the area of therapy conversations, which can even excuse and justify a change from medicine to pseudomedicine.

However, this argumentation usually remains general and nebulous. Concrete deficits are not mentioned.

However, a large discrepancy is noticeable: On the one hand the culture of conversation in the medical business is criticized and considered “bad”, on the other hand the patients are very satisfied with their own doctors. – Of course, we cannot and will not deny that there are also doctors who do not comply with medical standards and who rightly offer cause for criticism. However, this is not about the individual doctor with human and professional weaknesses, but about the “medicine” par excellence. It is “medicine” that uncovers and names errors in diagnosis and treatment. The “medicine” is to name the violations of their standards without regard to the person of the doctor as what they are: malpractice.

A study on patient satisfaction is presented in an older, but still valid article in the German Medical Journal (Deutsches Ärzteblatt) from 2005. There it says (quote):

“The key to dissatisfaction is the lack of a culture of speech. The weak point in the German healthcare system was indentified in the communication between doctors and patients, because 61 percent stated that they were not always informed by their doctors about treatment alternatives and asked about their opinions. (1)

The generally high level of patient satisfaction cannot be reconciled with this study result. In a press release of the service “Jameda” it says (quote):

“3-year trend: overall satisfaction in the practices remains at a high level. Overall satisfaction, which also includes the category “relationship of trust”, was stable with Germany’s doctors. As in the previous years 2013 and 2014, overall satisfaction in 2015 will remain at a good level of 1.87.” (2)

Perhaps this discrepancy can be better explained by going into a little more detail and becoming more concrete.

In the case of mental illness, patients are treated by psychiatrists or psychotherapists. These specialists have excellent training in medical conversation skills. Homeopaths and non-medical practitioners are far from having such a qualification in conducting conversations as the doctors in this specialist group have.

But how does it look in the field of somatic medicine? Are their specialists well trained for interviews?

The big question is, which topics should specialists discuss with their patients? What questions should they answer their patients? What do patients want to know? A few exemplary situations will be presented.

From internal medicine:
What does a patient who has just been diagnosed with diabetes mellitus want to know?

He wants to know why he got sick. How’s his life changing? Does he have to give up cake for life? What are bread units? What is insulin? What is the difference between the different types of insulin? Do I have to check my blood sugar daily? How can I protect my blood vessels?

An internist – in this case an endocrinologist – can provide excellent answers to these questions because he is trained to answer them. However, training in psychotherapeutic conversation is not required to answer these questions. Diabetologists even offer complete training courses to answer these questions in particular.

Other examples from internal medicine: hypertension (high blood pressure), asthma, COPD. All patients with these diseases have questions about their lifestyle, about the risks of possible non-treatment, about the risks of therapy. Internists and general practitioners can provide excellent answers to these questions – they know these diseases in all their facets.

Neurologists answer questions on multiple sclerosis, epilepsy, migraine, Parkinson’s disease …

Surgeons answer questions about the risks of any operation in informed consent discussions …

Anaesthetists answer questions about the risks of anaesthesia in the premedication consultation …

The list is not complete. She doesn’t have to be either: All specialists are excellently trained to answer all questions on the diseases of their specialty competently and comprehensively – and family doctors no less. And the cooperation between general practitioner and specialist must not be forgotten or underestimated. And in principle, § 8 of the German professional code of conduct stipulates that doctors must inform their patients about all alternatives before diagnostic and therapeutic interventions.

Do the attending physicians also take enough time to answer the patient’s questions?

It may be that not all questions are answered immediately during the first conversation. But that is not necessary either – yes, it does not even make sense. The length of the discussions must also depend on the nature of the disease and the receptiveness of the patients. Many questions come later. But all patients with such incisive diagnoses come to the practices for checks over and over again. At the second, third or each later consultation, there is also the possibility for the patient and the doctor to discuss open questions. Every time you pick up a repeat prescription, it can be used for a conversation – and it doesn’t even have to be long. Even short conversations can be long enough. The duration of a single conversation is not as decisive as the overall medical care. And with an overall grade of “better than good”, one can assume that the overall medical care is obviously better in each concrete case than its reputation in the undifferentiated general.

As one can see from the text, the accusation related to the lack of information about “treatment alternatives”. Among other things, patients also complain that doctors speak in a scientific language they cannot understand. However, in one study 29% of the patients could not remember it after an informative talk. (3)

The question remains why so many patients (61% in 2005 – see above) did not feel sufficiently enlightened.

I think we should differentiate here too. Every surgeon will inform his patients not only about the operation, but also about the treatment alternative “no operation”. In the case of tumour patients, a whole treatment team consisting of surgeons, internists (chemotherapists) and radiation therapists is discussing the best treatment alternative – one could say ” struggling for it”. Orthopaedists will certainly promote physiotherapy or simply “more sport in everyday life” as an alternative to surgical therapy. Cardiologists also recommend a “cardio sports group” as a supplement to drug therapy – in the best case, sport can replace drugs.

In a study, the authors Bahrs and Dingelstedt came to the conclusion that around 80% of those questioned judged the duration of the conversation with the doctor to be “exactly right”. It was necessary to distinguish between “experienced time” and “calendar time”. The greatest need for discussion exists in medically undetermined or non-clarifiable situations. (4)

How can it be explained that about 80% of patients are satisfied with the duration of the conversation, but 61% do not feel sufficiently informed about treatment alternatives?

If patients do not feel sufficiently enlightened about treatment alternatives, then in many cases they mean “treatment alternatives” from the field of pseudomedicine – in any case, medical treatment alternatives belong to the standard program of every medical consultation.

However, “treatment alternatives” from the field of pseudomedicine are not equivalent to medical treatment including all medical treatment alternatives. The main difference is that “treatment alternatives” from the field of pseudomedicine are ineffective. The desire for as many effective treatment alternatives as possible is quite understandable and comprehensible. But a desire for efficacy does not generate efficacy. No “therapist” can force succeed of his method. Effective treatment methods can only be detected – they cannot be invented. We can be happy and thankful that we found some at all. For it is by no means self-evident that there are any treatment methods at all for sick living beings in our world – the only one we have.

In a specific treatment situation, the patient must learn a lot from the doctor. This does not include detailed information on ineffective treatment procedures: Time can and must be used more sensibly. In view of the large number of ineffective pseudomedical procedures, it is not possible anyway to provide sufficient information about all of them. In this respect, homeopathy is the most important, but by no means the only pseudomedical “alternative”, which is no alternative at all due to its proven ineffectiveness. If one has to spend the same length of time for information about homeopathy, Bach flowers, Schüssler salts, bioresonance, Reiki, spiritual healing, New Germanic Medicine – the list is far from complete and it gets longer practically every day – as for an effective medical treatment method, then no patient is helped with it. The opposite is the case: valuable time for real advice is sacrificed to procedures that should be excluded from the outset because of proven ineffectiveness. In the case of serious illnesses, it must be made clear to patients that wishful thinking does not help. – One may and can talk about a good feeling during the treatment and about the “wellness factor” – there is talk about it! – but as a doctor one must leave no doubt that the effective treatment is in the foreground and “wellness” has a secondary priority. The desire for a “nice way to health” is an understandable wish that is certainly fulfilled wherever such a possibility exists. But even if there’s no nice way to health: The important thing is that there is a way to health at all. – Unfortunately, it happens often enough that there is no way to health at all. In such cases a “nice way” is very important, even if it does not lead to health. But even in such cases, modern palliative medicine certainly offers better methods than all pseudomedical procedures.

Patients’ dissatisfaction with the alleged lack of information about “treatment alternatives” is apparently a problem between “reality” and “perception of reality”. Doctors are aware of this problem. And they know that the pretence of supposed “treatment alternatives” must catch the eye sooner or later than what it is: an empty promise. And doctors also know that empty promises are ethically problematic. Sacrificing time for ethically problematic empty promises when time is scarce does not defuse the ethical problem at all.

The information about the ineffectiveness of – often desired – “treatment alternatives” only belongs to a small part into the medical practice or into the clinics. Basic information should be an essential part of general health education. It belongs in schools and universities. And because there are undeniable deficits there, there is us: the Information Network Homeopathy (INH).

We, the INH, feel obliged to provide correct information about pseudomedicine – mainly in the form of homeopathy.

Medical information about treatment procedures and effective treatment alternatives within medicine is provided by doctors – despite scarce remuneration. Every doctor knows that patients must bring a willingness to cooperate – compliance – because otherwise every therapy is doomed to failure. Correct information is not only in the interest of the patient – it is also in the very interest of the treating physicians.

With a patient satisfaction of “better than good”, one can and must confidently assume that the criticism of the quality and quantity of medical consultations is based more on a deception of perception than on a real deficit.

Author: Dr. med. Wolfgang Vahle

Credits: Fotolia_54048950_XS.jpg

(1) Source: Dtsch Ärztebl 2005; 102(49): A-3389 / B-2865 / C-2683)
(Link: http://www.aerzteblatt.de/archiv/49427)

(2) Source: Note 18.05.2015 by Elke Ruppert)
(Link: https://www.jameda.de/presse/pressemeldungen/?meldung=128)

(3) Source: Gesundheitsmonitor 2014 – Was hindert und was fördert die Teilnahme an Krebsfrüherkennungsuntersuchungen? – (Health Monitor 2014 – What prevents and what promotes the participation in cancer screening programs?)
(Link: http://gesundheitsmonitor.de/uploads/tx_itaoarticles/2014-02-Beitrag.pdf

(4) Source: Gesundheitsmonitor 2009 – Otmar Bahrs und André Dingelstedt: „Auf der Suche nach der verlorenen Zeit: Zur angemessenen Dauer des hausärztlichen Gesprächs aus Sicht der Versicherten“ (“In search of lost time – About the appropriate duration of consultations in general practice from the patients’ point of view”)
(Link: http://gesundheitsmonitor.de/studien/detail/?tx_itaoarticles_pi1%5Barticle%5D=179&tx_itaoarticles_pi1%5Baction%5D=show&tx_itaoarticles_pi1%5Bcontroller%5D=Article&cHash=765eb0849f364edad0039f499bd2dc73)

Malpractice or systemic risk?

In Italy, a child died recently because his parents and the doctor who treated him only relied on homeopathy. The German Central Association of Homeopathic Physicians sees here a “medical malpractice”, thus the “famous” regrettable individual case, but no responsibility of homeopathy as such.

What is a “malpractice” in the medical profession? The correct legal term is “medical error”. It means that a medical treatment is not carried out according to the existing, generally (i.e. according to scientific principles) recognized standards. That homoeopathy does not belong to these generally accepted medical standards is a fact that is testified by the worldwide scientific community. The reason why the Central Association refers to evidence-based medical guidelines in this context is confusing anyway. To whom or what does the homeopathic medical profession feel obliged? The guidelines – or a claim of homeopathy, as the chairwoman claims it on her own homepage? (1) Neither is possible at the same time.

It seems somewhat presumptuous that the Zentralverein speaks here of a “malpractice” – this is why, according to the standards explained above, any treatment carried out by a doctor on a homeopathic basis would be a “malpractice” because it deviates from the generally accepted standards. At least as long as he carries out an homeopathic treatment exclusively, as in the present case.

It should only be mentioned in passing that these considerations have no relevance for non-physician homeopathic practitioners anyway, who, however, in many cases also have no problem wanting to use homeopathy to cure illnesses in which the self-healing powers fail.

In principle, homoeopaths, including the Central Association and above all the chairwoman herself (e.g. on her homepage (1)), are fuelling the hope that homoeopathy can help precisely in such and many other cases. This does not fit in with the relativizing withdrawal in the Central Association’s statement on this case.

In the decision for a homeopathic treatment instead of scientific medicine, the damage potential is already inherent in the core. The potential risk of such incidents exists in principle and from the outset when deciding on homeopathic treatment. In other words, incidents such as the one in question are not unexpected in the sense of a “production fault” or a similar incident in everyday life. They are inherent in the method, systemic, they are manifestations of an unnecessarily high risk level from the outset, since homeopathy cannot offer any specific medicinal effect. When a (no longer) self-limiting disease coincides with the erroneous assumption that it can be combated or even cured with homeopathy, this risk potential is inevitably realized, of course not very frequently, even to the point of death (which, however, has definitely occurred).

It is not for nothing that the main criticism of homeopathy is that it can prevent or delay effective medical treatments. This warning has been given often enough. Even complementary (accompanying) treatment with pseudomedical means or methods impairs the treatment success of well-founded therapies, e.g. due to a lack of compliance (2). For this reason alone it is mistaken to speak of a “malpractice”, a human error in individual cases.

Here the Central Association fails to recognize the reality in which patients rely on an actual and medically equivalent medicinal effect of homeopathic remedies – not least because (not only) repeatedly propagating such an effect itself.

It is not unusual for homeopathy supporters to completely turn away from medicine, to regard it as “poison”, “chemistry” and “harmful” and to reject antibiotic therapy in particular. This effect alone, without reference to a specific treatment case, gives rise to a systemic risk for supporters of the method, which is why the question is once again raised: Is it responsible for the political actors in the health care system to continue exposing consumers or patients to this potential danger by de facto equating homeopathy with evidence-based medicine? And to let people believe and trust that homeopathy is – even legally legitimized – a specifically effective medication therapy?

The explanation as “malpractice” – in the sense of the infamous “regrettable individual case” – we therefore do not want left unchallenged. Rather, we believe that in this case the systemic risk potentially present in any ineffective “alternative” therapy has manifested itself in a particularly tragic way.

We see here rather the “tip of the iceberg” than a “single malpractice”. There’s certainly a dark figure that we all don’t know. And: This boy died in a “normal” clinic. How often will a homeopathic pretreatment with its consequences not become known when it leads to a case of scientific medicine and is recorded with all possible consequences up to death in its statistics?

The special thing about this case is that it has received publicity. The next “individual case” is already waiting. Hopefully it won’t be another death. Seeing the error here not systemically in homeopathy clearly points in the wrong direction.

Supplement, 09 June 2019

The parents of the deceased boy have now given a suspended sentence of three months on probation for culpable manslaughter, according to the Independent.

As always, it is very difficult to decide on individual guilt in such a case. The parents deserve great respect for the fact that they spontaneously decided to release an organ transplant. It is also reported that the parents were not at all against scientific medicine in principle, but were worried because their boy had already received “a lot” of antibiotics in the past. Now these are fundamentally legitimate and understandable concerns of medical laypersons. The basic error, however, was to rely on homeopathy in this initial situation instead of consulting a competent doctor. And this apparently once again due to the conditioning through earlier “healing successes”. Things we’re all too familiar with.

The matter is not made any easier by the fact that, according to the information that has become known so far (source: Corriere della sera), the “therapist” is said to be a man who was temporarily excluded from the Medical Association and during this time was engaged in a wide variety of activities. When the Pesaro Medical Association enquired about the start of his homeopathic activity, he was said to have replied that he had no interest in an answer. What weighs heavily is that he had probably actively advised the parents not to take the boy to a clinic – with horror stories about what he would be administered there. The trial against him is scheduled for September 24.

Once again we see one of the key points of our criticism confirmed: Despite all the lack of understanding for how one can entrust oneself to such a “therapist”: It is not justifiable to leave homeopathy in its positive public reputation or even to confirm that it is a proven, demonstrably effective method that is ultimately equivalent to scientific medicine. In Germany, this misperception is also massively promoted by the legal privilege of internal consensus and the reimbursement practice of health insurance funds. The fact that every “non-treatment” such as homeopathy has inherent risks, which cannot be compared with a risk-benefit evaluation of a scientifically based treatment, must force a rethink.

This is precisely what fundamentally promotes such individual mistakes as in this case. And we believe that this is no longer justifiable – more than that, it never has been. Politicians and health insurance companies are urgently called upon to do their bit here.

(1) Quote: “I have been working classically homeopathically in my own practice since 1997. This method not only allows acute diseases such as flu, cough, gastrointestinal infections, middle ear infections, etc… to be healed quickly and gently, but is also a way to treat severe chronic diseases such as asthma, rheumatism, neurodermatitis, hypertension, etc…. With the help of the homeopathic anamnesis, the symptoms of the disease are worked out and then the appropriate homeopathic medication is administered. It leads to a retuning therapy with benefit for the organism.” (Called on 1 June 2017)

(2) Skyler B. Johnson, MD; Henry S. Park, MD, MPH; Cary P. Gross, MD; et al; Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers; JAMA Oncol. Published online July 19, 2018. doi:10.1001/jamaoncol.2018.2487

More on antibiotics and homeopathy here.

More about this case at “Die Ausrufer” LMHI – Antibiotika und tote Kinder and at DAZonline (in German).

Authors: Dr. Natalie Grams, Dr. Norbert Aust, Udo Endruscheit

Picture credits: Fotolia 145924672_5

English version will appear soon.

English version will appear soon.

A bad day for homeopathy: On November 15, 2016, the U.S. Federal Trade Commission (FTC) issued its statement that in future, over-the-counter homeopathic remedies will have to be labelled as the product’s efficacy is not proven – unless, of course, the manufacturer can provide such evidence. As expected, the German homeopathy associations reacted immediately by pointing out that this demand could not be transferred to Germany. This wouldn’t also be necessary, as the German Medicines Act already would have stricter requirements than those resulting from the requirements of the FTC in the USA.

Requirements of the FTC

The FTC considers it necessary that manufacturers of products should only be allowed to claim that their products are suitable for the treatment of certain health conditions if they have an appropriate basis for doing so. This applies to over-the-counter (OTC) medicines, dietary supplements or food, including homeopathic preparations for self-medication of complaints that would also disappear on their own (“self-limiting”, e.g. a cold – only such can be sold freely in the USA). It was further concluded that health claims for homeopathic products are generally not based on modern scientific methods. For giving health, safety or efficacy claims, manufacturers need proper and reliable evidence, which in the case of medicinal products require well-done human clinical trials. However, these requirements are not met by the vast majority of OTC homoeopathic medicinal products, which is why corresponding claims of efficacy are misleading.

This misleading of customers can be remedied by the fact that manufacturers state the following in their marketing materials:
1. “There is no scientific evidence that the product works.”
2. “The products claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts.”)

It is expressly pointed out that it is not permissible to compensate the reference to the lack of evidence by other claims or references. Since the indication of a field of application and the simultaneous reference to the lack of evidence could also be confusing, the manufacturers would have to check by means of surveys whether the information was understood by the customers.

Comments of the German Homeopathy Associations

The Verband der klassischen Homöopathen Deutschlands (Association of Classic Homeopaths – VKHD) and the Deutsche Zentralverein homöopathischer Ärzte (Central Association of Homeopathic Practicioners – DZVhÄ) are in agreement that the situation in the USA cannot be transferred to Germany. In Germany, homeopathic medicinal products are subject to pharmacy duty and, as registered medicinal products, are not sold under indication. As a result, they claim that there are already now stricter requirements than those resulting from an implementation of the FTC requirements in the USA.

We will not go into the usual misinformation that can be found on the homoeopath websites, such as that there is sufficient evidence or that homoeopathy is subject to examination. Simply for space reasons.

Comment of the INH

In principle, VKHD and DZVhÄ are certainly right: The situation in the USA is not directly comparable with the situation in Germany in detail – but is the matter settled? Certainly not.

The aim of the FTC is to ensure fair competition, which in the case of pharmaceuticals in particular means that customers are not misled as to the nature of what they are purchasing.

It is true that in Germany not the same methods are used as in the USA – but aren’t consumers also deceived about the nature of homeopathic remedies? Shouldn’t measures also be taken in Germany to prevent this deception? These may be different from those in the USA – but the claim that there are no explanatory models or evidence for a mode of action is certainly also necessary in Germany. Currently such is nowhere to be found.

Unlike in the USA, no indication is given for registered homeopathics in Germany. But does not the mere statement that the product sold is a medicinal product in the first place and, unlike in the USA, may only be sold in a pharmacy, lead much more astray than a manufacturer’s statement on a product in a supermarket could ever do?

Even if they do not specify any indications, the manufacturers in Germany have nevertheless found sufficient ways to overturn the ban on advertising with indications for registered homeopathic remedies. Simply stating that the product is a pharmacy-only product will raise the question in the patient as to what it can be used for or against. And the manufacturers will certainly be happy to help finding an answer. Doctors, pharmacists, non-medical practitioners, midwives are trained there:

Pharmacies then logically advertise in their displays with the information on homeopathics, which the manufacturers are not allowed to name directly. One sponsors relevant lectures by pharmacists, doctors, alternative practitioners on the application of homeopathy in the spring, in the flu season, in old age, on journeys etc..:

The number of guidebooks on self-medication is immense, divided into all possible fields of application for humans, animals and plants. On the Internet, relevant websites are promoted by means of advertisements:

Summary

Wee see, it is no need at all that an indication appears on the package insert. This “knowledge” is widespread and freely available – and this is increased by the manufacturers to the best of their ability. All this is presented to the customer as true and justified by the statement ‘Homeopathic medicine – pharmacy compulsory’ – even though it’s sugar only.

The requirements in Germany are not stricter than in the USA; on the contrary, the misleading of the consumer in Germany is much stronger than it was ever the case in the USA considering the overall system. There it was a pure manufacturer’s statement for which a homeopathic remedy can be used, and at least skeptical consumers will have been just as suspicious of such statements in the advertising country USA as they were of the praises of other products, which are supposed to make slim, eternally young, beautiful and of course healthy.

However, the situation in Germany is that pharmaceutical law encourages quackery in homeopathy by promoting what makes a remedy appear to be an effective medicine – pharmacy duty – but at the same time refrains from demanding what makes a remedy a remedy at all, namely demonstrable efficacy. The fact that universities, medical chambers and health insurance companies additionally strengthen this impression by dealing with homeopathy has a much greater potential for deception than manufacturers statements in the USA ever had.

In Germany, in view of this, even more far-reaching demands must be made in order to eliminate the deception of the consumer:

• Marking of packages with the clear name of the product
• Specification of the quantity of ingredients in an absolute unit of mass
• Disclaimer that the efficacy of the product has not been demonstrated and that an efficacy would be contrary to scientific knowledge
• Identical warning notices in the self help literature, “Quickfinders” and in relevant Internet pages as well as at lecture events
• Elimination of the waiver of a proof of efficacy for homeopathies in pharmaceutical law
• Abolition of the pharmacy obligation for homeopathic remedies for which there is no proof of efficacy according to recognised scientific standards
• Elimination of the ‘additional designation homeopathy’ and further training offers for doctors
• Elimination of the reimbursement for homeopathic therapies within the statutory health insurance
• Elimination of homeopathy courses in the licensing regulations and in the curricula of the universities

Only when these points have been implemented will we have a situation like that which is now to be achieved in the USA through the FTC demands.

Author: Dr. Norbert Aust

Supplement, 07.07.2019

The implementation of the FTC’s demands is sluggish in the USA, to put it mildly. In contrast to decisions of the Food and Drug Administration (FDA), the publications of the FTC are not directly legally binding. As expected, this leads to a high degree of ignorance among most manufacturers.

However, the FDA confirms that it is preparing a basic regulation with legal force for homeopathics and related products that will probably include the demands of the FTC. We will report in due course.

Picture credits: Screenshots, Photo: Wikipedia Commons Bhavesh Chauhan

English version will appear soon.

English version will appear soon.

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English version will appear soon.

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Samuel Hahnemann was born on 10 April 1755

Placebo and nocebo effects are not only found in medicine. These effects accompany us in daily life always and everywhere and are not bad in themselves. The ambience of a restaurant makes the schnitzel taste better and if “coffee” and not “café” is on the drinks menu, the taste will be judged more critically. The tricky thing about placebo/nocebo effects is that they are not subjective “imaginations” or apparent effects, but objectively measurable or observable changes. The effect is real. The particular malice of these effects in medicine lies in the fact that they occur in medicine and pseudomedicine both effectively positive and negative.

However, the placebo and nocebo effects are not based on specific individual causes. There is no causal “physical-chemical” relationship. It doesn’t matter with which acting or method one works. The placebo and nocebo effects are neither specifically causal, nor can they be realized at will by certain events or actions. The positive placebo and “vice versa” negative Nocebo effects result from the whole spectrum of expectations, desires and hopes of each individual against the background of his religious and ideological views, its education including its completely subjective life and illness experiences. All this is conditioning. Placebo and nocebo effects can literally be caused by anything, as long as it is “psychologically” significant for the individual, or – to put it casually – corresponds to gut feeling.

Whether we like it or not, we consciously and unconsciously attach highly personal “meanings” to the entire process, the various drugs, the therapeutic spectacle, the people involved, the environment, in short all things and events, whether we like it or not, and contribute to placebo or nocebo effects in this way. These assigned meanings are subjective and prejudices. One orients oneself to this and of course these can also become effective in the sense of placebo and nocebo and this sometimes happens very spectacularly. And this is exactly where “advertising” comes in. Professional advertising psychologists know exactly how and with which images they can reach and influence their target audience. And that happens daily throughout the media.

The placebo effect is one of the main pivotal points in discussions about pseudomedicine. The placebo effect also meets the effect of homeopathy as the best-known pseudomedicine. The lack of causality based on natural science is replaced by fashionable pseudo-scientific swirling and, depending on the clientele, also by angels and the like, if one includes the feel-good and life-support area as a peripheral area of medicine.

Now the placebo effect is being discovered as a hope for legitimazion of pseudomedicine and is being given a completely erroneous meaning. One does not dizzy any longer over this effect, but markets thereby purposefully pseudomedicine and also homeopathy. Placebo is like a drug, but is gentle and free of side effects. To put it simply, one only has to swallow a placebo tablet or apply homeopathy. A naive and unattainable wishful thinking. If an application is very widespread, often used and the field of application concerns mainly harmless, temporary and self-healing complaints, then there will be accordingly many and also sensational “successes”. But however impressive, they are placebo effects and the effects are correspondingly limited.

The discovery of the placebo effect

Franz Anton Mesmer propagated “animalic magnetism” towards the end of the 18th century. His treatments were spectacular, “mesmerism” was booming. Benjamin Franklin, however, was able to demonstrate in 1784 as a member of the royal commission of inquiry in Paris that these “treatment successes” occurred when and only when the subjects knew that they were actually “mesmerized”. If the “healing” spectacle was hidden with the magnets, i.e. performed as blinded or omitted, the sensational effects were over. Benjamin Franklin succeeded, so to speak, in the first documented proof of the placebo effect. Benjamin Franklin showed that the success of medical actions was based on two chains of causes. The effect can lie in the belief in the therapist or his therapeutic spectacle, his method and his remedy as well as in the method and the remedy itself, if a physically causally conditioned effect of the last exists at all.

Evidence versus eminence and pseudomedicine

Since then, a distinction has been made between “physical” and “psychological” causes of action. Until then, the question of a causal effect had not arisen. All you could see was that it worked, and that was enough. From now on, scientific medicine developed. Remedies or therapies were only considered “properly” effective when it could be shown that their effect was independent of the expectations and beliefs of patients and doctors. To work or heal through mere “imagination” was already suspect at that time.

This unmasking of the therapeutic spectacle or the “actor physician” as an effective component of the phenomenon then referred to as hysteria was, however, also a confirmation of the ineffectiveness or effect of “transcendental” healing powers in medicine.

It must be remembered that for thousands of years in healing, the imploring of heavenly goodwill has been an indispensable part of medicine. A remedy alone could not work properly if it was not used with appropriate therapeutic evocation. Healing has always been an extensive ritual that reached into the beyond. The doctor or his art of healing could not heal alone, they could only contribute a part to the healing. Franz Anton Mesmer did not claim to possess supernatural abilities, but his therapeutic spectacle was as effective or ineffective as a heavenly spectacle. The charisma of the healer only had to be just as impressive as the miraculous relic in a pilgrimage cathedral.

This insight changed the development of medicine in the long term. Since that time, a distinction has been made in medicine between evidence and eminence. For a long time, what eminences thought was right and applied that. Today, evidence-based medicine is the standard. It is based on scientifically proven findings. Experience has shown that a personal observation simply does not suffice as proof in order to be able to claim a causal effect or a causal connection.

Today it is no longer part of medicine or the medical art of healing to call upon supernatural heavenly powers. No doctor will forbid his patient to pray, but he will certainly not prescribe the praying of three “Our Fathers” or even propose an exorcism, which is still practiced by the Catholic Church. And just as a heavenly spectacle cannot replace a specifically effective medicine, neither can a therapeutic spectacle do. And spiritual powers in drugs, as Hahnemann still thought, do not exist.

But the medicine based only on “eminence”, whose effectiveness is based on the good reputation, did not disappear. On the contrary, it lives on to this day in alternative, complementary and so-called holistic medicine. Here one justifies oneself still exclusively with the subjective observations and statements of eminences, the treating physicians and healed ones. The anecdotes as eminence-based testimonials are legally safeguarded with the indication that the effectiveness is not scientifically proven. The healing anecdotes correspond to the votive tablets in pilgrimage churches. And an evidently proven effect is still not a prerequisite for legal admissibility.

For the sick hoping for healing this is of no importance. They trust in eminence, they succumb to reputation. For them, individually reported healings or the reputation of the participants are proving enough. The importance attached to doctors, media personalities and stories of spectacular healings weighs more heavily than scientifically based assessments. The therapeutic spectacle, the special care, the recommendation and last but not least the reputation to be without technology, without chemistry, biological, natural etc. count more and act as a placebo.

The doctor or guru convinced of his method sees the success with his patients and clients. These in turn strengthen their practitioners in their belief that they recognize causally effectiveness in their treatment. The technical term for this is “performative deception”. The self-deception of patients and doctors reinforces each other. And a good doctor will give his patients hope. He has no choice: in the patients’ eyes he must appear as guarantor of effective treatment. However, it is only a small step from giving hope to the patient to believing that his treatment will actually have an effect even on life-threatening diseases. The best-known example of such “medicine” is homeopathy. The performative deception is the basis and characteristic of homeopathy. The homeopathic way of working, its setting favours self-deception. The effective therapeutic spectacle begins with the anamnesis. Every little ailment is recorded and treated and, contrary to all assurances, homeopathy is also recommended for life-threatening diseases instead of proven effective medical treatment. In the end, the “homeopaths without borders” “heal” Ebola with sugar beads in Africa.

To date, there is no valid proof of efficacy.

Yes, and there is no evidence of the phenomenon of homeopathy itself. The legendary Nuremberg salt experiment of 1835 and the numerous metastudies to date are clearly negative. The quality of positive studies is usually doubtful and negative study results are negated by homeopaths or highly professionally reinterpreted with idiosyncratic statistics. It is rounded off with allegedly “scientific” explanations of the effects of homeopathy. These are nonsense from a scientific point of view. Nothing but a science fiction effect is explained here.
Such means and methods cannot be objectified. The placebo effect is also and especially founded in eminence-based medicine and is therefore the link between medicine and pseudomedicine. In medicine, successes and failures are investigated and explained. This leads to new insights. In the always dogmatic pseudomedicine there is nothing to clarify. It has therefore also contributed nothing to our current tried and tested state of knowledge. The contribution of “alternative” medicine to progress of knowledge is zero.

The magic wand “Eminence” of yore is still working

Franz Anton Mesmer continued to do good business at that time. His patients remained loyal to him. Nothing has changed in this scenario to date. Therapies and remedies have taken all possible and impossible forms over time. Magnets and high-voltage sparks have been replaced by information, bioresonances, quanta, and much more bywords misusing physical terms. The evidence for the effect is missing. The postulated mechanisms of action contradict all proven and tested scientific findings and many of these universal remedies are also occasionally harmful to acutely life-threatening. The spectrum ranges from ineffective energetic cures to, for example, “Germanic New Medicine”. The last pages of free newspapers and local papers are full of advertisements using these bywords. Einstein’s just good enough for gravitational wave therapy.

For a myriad of newer means and methods, effect is generated with illustrious personalities and impressive advertising, without being able to present any valid evidence of efficacy beyond placebo. Nearly the entire alternative, complementary and holistic medicine still relies exclusively on the unique inspiration of its founders and the positive reports of its practitioners and patients. Charismatic personalities appear regularly in appropriate broadcast formats such as documentaries, health contributions etc. and promise to be able to heal everything or to have been healed with always amazingly simple therapies or means. Criticism is not much in demand. It usually serves only as a fig leaf for the semblance of critical and objective reporting.
The homeopathy of the Mesmer contemporary Hahnemann survived until today. And anyone who wants to, can put the label “homeopathy” on his pseudomedical hustle and bustle. Meanwhile also animals, plants and whole oceans are homoeopathically treated. And also well-known homoeopaths have nothing against it. You heal – and rest the case.

Realism as an opportunity?

The chances are bad. Everything, no matter how absurd, can and will be certified as a medical device. This only means that binding rules are laid down according to which production and applying are carried out. The lawyers are not bothered whether medical products or methods, which come on the market, correspond to our proven and tested scientific state of knowledge as well as are demonstrably effective and reasonable. They may not be “harmful” and may only be sold or used by officially authorized persons. The difference of a non-medical practitioner against an African shaman lies mainly in the possession of a cash register and her membership in the Chamber of Commerce. Many licensed doctors are certified homeopaths. The basics of pseudomedicine homeopathy, however, are as nonsensical as the basics of energetics. But the doctors are members of the Medical Chamber and non-medical practicioners of the Chamber of Commerce – this difference is much more serious than the first-mentioned above.

All the facts speak against homeopathy. It is pseudomedicine, superstition and big business in the health sector. Homeopathy is a lucrative health lottery. There’s only little placebos to win. Many people and especially young mothers and midwives associate homeopathy with biological, gentle, natural and see it as a complement and also an alternative to medicine. Psychologists can explain this phenomenon and advertising experts can be paid for using it. The lucrative gut feeling doesn’t fall from the sky.

The enlightened society must once again decide what kind of treatment is permitted and what kind of protection is appropriate for patients in a civilised society. Evidence, eminence and even pseudo are not clearly distinguishable for laymen. Do we want effective drugs or therapies with verifiable effects or is it also right to offer requisites for a folk-medical superstition and pseudomedicine in ordinations and pharmacies?

Hahnemann died on 2 July 1843 in Paris.

The author Dr. Edmund Berndt is a retired pharmacist and author of the book “Der Pillendreh. Ein Apotheker packt aus” (Rotating Pills – A pharmacist uncovers), Edition Vabene, 2009

Photo: Susanne Aust

English version will appear soon!

English version will appear soon.

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What makes common sense?

As a university teacher, I try to teach my students one thing above all else: common sense. By this I mean the willingness and ability to adhere to simple reasoning principles when thinking, e.g. the principle of not only considering the pro-arguments for a position, but also the contra-arguments. Each of my students accepts these principles of reason – mostly immediately and without contradiction. Everybody! For they are so plausible that our own reason forces us to accept them.

Students often ask me why I spend so much time explaining things that every child should understand. The reason for this is simple: common sense is child’s play – until it is no longer. When we think about questions to which we have no emotional connection, we are sober, serene, reasonable. Our common sense works. However, this has an end as soon as it comes to things that are close to our hearts. Every means is right for us here to support the position that is most sympathetic to us. We then search for evidence for our point of view and ignore everything that speaks against it. Psychologists speak of “confirmation bias” or “disconfirmation bias” in this context. A research team around the American psychologist Dan Kahan has even found out that trial participants literally let five be straight when it comes to their own political views. They accepted arguments for their position even when they obviously violated basic rules of calculation (Kahan et al. 2013).

Homeopathy is a good example of a bad example

Common sense cannot be overridden only by our political orientations. In my courses I often use the topic “homeopathy” to demonstrate how easily intelligent people get stuck in outrageous theses. I choose this topic for two reasons:

• Everything indicates that homeopathy is completely untrue. Their scientific initial plausibility goes towards zero.
• Methodologically flawless empirical studies generate roughly the data one would expect when comparing one placebo with another.

Common sense therefore requires us to reject homeopathy, but many people, some of them quite intelligent, still believe in homeopathy.

The constellation of 1. and 2. ensures that discussions about the pros and cons of homeopathy are regularly transformed into a logical horror cabinet. Intelligent homeopathy advocates put forward arguments that are obviously far-fetched. They conclude in a way that they themselves would reject in other contexts because they are so blatantly contrary to common sense. To illustrate this, I would just like to add an example from the journalist Jens Jessen – after all, head of the feature section emeritus of the renowned weekly DIE ZEIT. He writes: “From the fact that something cannot be explained or proven with present methods, it does not follow at all that it does not exist. Right, gentlemen of the medical profession? Even strict epistemology does not permit such a conclusion. The same scepticism that speaks against homeopathy can also be used in its favour.”

This argument is a sin against common sense – not a small one. To see this, one only has to replace the word “homeopathy” with the word “yeti”, as the philosopher Norbert Hörster once suggested in another context. The result is: “The same scepticism that speaks against the Yeti can also be used in his favor.”

Anyone who allows such an argument for homeopathy to go through should therefore also believe in all other things for which we have no evidence, e.g. in the yeti. I suspect, however, that Jens Jessen does not believe in the Yeti. Because his common sense would certainly turn back on this subject.

Emotion versus Mind

This is exactly the point: homeopathy has managed to bind many intelligent people emotionally to itself. And they’re sometimes willing to say pretty crazy things to defend them. I want someone to say again that homeopathy is incapable of anything. Even though its medicines have no pharmacological effects, homeopathy is extremely effective in another way: it manages to override common sense. You too?

Author: Nikil Mukerji studied philosophy and economics. Today he is Managing Director of the Executive Program Philosophy Politics Economics (PPW) at the Ludwig-Maximilians-University Munich. He also works as a freelance business and political consultant for the Institut für Argumentation in Munich.
In his new book he explains – vividly and true-to-life – the central rules of rational thinking:  “Die 10 Gebote des gesunden Menschenverstandes” (The 10 Commandments of Common Sense, Springer, 2016)

Read also on our website:  “Why people like to believe in homeopathy“.

Photo: Shutterstock 81762259 Anna Omelchenko

English version will appear soon.

English version will appear soon.