Die spanische Online-Zeitung eldiario.es über Homöopathiekritik in Deutschland

Ein Gespräch mit Dr. Natalie Grams

Spanien eilt uns davon in Sachen Homöopathie im Gesundheitssystem, England ist noch weiter, Frankreich ist bald gleichauf – und Deutschland? Nun ja… nähere Ausführungen an dieser Stelle erübrigen sich wohl.

Wir freuen uns angesichts dessen sehr über das Interesse von eldiario.es an der Situation in Deutschland und den Beitrag über das Gespräch mit Dr. Natalie Grams, den wir nachfolgend übersetzt wiedergeben:


Natalie Grams, die Wissenschaftlerin, die Deutschland vom Einfluss der homöopathischen Lobby “befreien” will.

    • Die Aktivistin, die sich der Verbreitung der Wissenschaft verschrieben hat, stellt sich der Aufgabe, in Deutschland, dem gesellschaftlichen Einfluss der Homöopathie entgegen zu treten – in dem Land, in dem die Homöopathie erfunden wurde.
    • Die homöopathische Industrie hat 2018 in Deutschland 670 Millionen Euro umgesetzt; ihre Produkte gehören zu den Leistungskatalogen vieler gesetzlicher Krankenversicherungen.

Von Aldo Mas – 02/11/2019 – 20:45h

Screenshot der Titelzeile aus der Online-Veröffentlichung von eldiatio.es

Natalie Grams ist Ärztin und hatte sich früher auf den Einsatz von Homöopathie spezialisiert. Sie ist jedoch längst zu einer der prominentesten Stimmen im Chor derer geworden, die sich in Deutschland gegen die Behauptung zur Wehr setzen, Homöopathika seien wirksame Arzneimittel. Grams hat bereits mehrere homöopathiekritische Bücher verfasst und ist nutzt auch öffentliche Auftritte, um die Thesen, die sie selbst einmal verteidigt hat, zu entkräften.

Deutschland ist das Land der Homöopathie, in der sie im 18. Jahrhundert erfunden wurde: “Viele sehen die Homöopathie als eine Art Kulturgut. Eine Tradition, die als etwas Effektives, Althergebrachtes verkauft wird, das den Menschen besser gerecht werde als “böse und kalte Schulmedizin”, sagt Grams. “Aber selbst unter den Nationalsozialisten wurde die Homöopathie untersucht und keine Belege dafür gefunden, dass sie funktioniert”.

Porträtfoto von Dr. Natalie Grams
Dr. Natalie Grams

Sie kennt das “Denkschema” der Homöopathie und ihrer Fürsprecher sehr gut, so dass sie für die Gesellschaft zur wissenschaftlichen Untersuchung von Parawissenschaften (GWUP), eine Organisation zur Förderung von Wissenschaft und wissenschaftlichem Denken, als Referentin zu diesem Thema tätig geworden ist. “Homöopathie ist keine Medizin. Wenn jemand sagt: ‚Ich nehme es, weil ich mich einfach gut dabei fühle, ich nehme es, weil ich vom Placebo-Effekt profitiere‘, oder wenn es jemand mit einem Husten oder einer Erkältung nimmt, also bei Erkrankungen der Art, die von allein wieder vergehen, dann hat die Homöopathie eine Berechtigung”, erklärt Grams gegenüber eldiario.es. “Aber in Deutschland wird die Homöopathie weithin immer noch als etwas angesehen, das der wissenschaftlichen Medizin gleichwertig ist, ja, als die bessere Medizin, ohne Nebenwirkungen. Und das sind falsche Attribute”, sagt sie.

„Nebenwirkungen“ haben jedoch Grams‘ Diskurs und ihr Auftreten gegen die Vorstellung, dass Homöopathie Medizin sei. Im vergangenen Frühjahr erhielt Grams eine E-Mail von einem Hersteller homöopathischer Produkte mit der Aufforderung, nicht mehr – wie sie es in einem deutschen Presseinterview getan hatte – öffentlich zu äußern, dass homöopathische Produkte “nicht über den Placebo-Effekt hinaus“ wirken. Das sind per Definition diejenigen Substanzen, denen es an spezifischer therapeutischer Wirkung mangelt, die aber bei Patienten dann zu einer gewissen Verbesserung führen, wenn sie überzeugt sind, dass diese Substanzen imstande sind, ihnen zu helfen.

Das fragliche Unternehmen, Hevert, forderte von Grams eine schriftliche Verpflichtung, künftig keine kritischen Aussagen gegen die Homöopathie (im beschriebenen Sinne) mehr zu tätigen. Sonst müsse sie dem Unternehmen für jede weitere entsprechende Äußerung 5.100 Euro zahlen. “Ich werde dieses Dokument nicht unterschreiben. Wenn es nötig ist, werde ich damit vor Gericht gehen. Was ich tue, ist einfach, zu verbreiten, was die Wissenschaft heute über die Homöopathie sagt”, erklärt Grams.

In den sozialen Netzwerken twitterte Grams an Hevert: “Was sagen wir, wenn die Homöopathie-Pharma versucht, uns mundtot zu machen? Not today.“ „Viele Menschen denken, dass die Homöopathie eine irgendwie “gute” Medizin ist, bei der alles anders funktioniert als bei der Pharmaindustrie. Aber in der Homöopathie greifen die gleichen Mechanismen wie in der Pharmaindustrie”, erklärt Grams. “Marketing und Werbung werden genauso eingesetzt, und das Ziel ist in erster Linie Gewinnorientierung und nicht, dass Patienten die bestmögliche Medizin erhalten”, fügt sie hinzu.

Ein 670 Millionen-Euro-Geschäft

Die Homöopathie ist ein Millionengeschäft. Nach Angaben des Zentralvereins der homöopathischen Ärzte (DZVhÄ) hat die Homöopathie im Land von Angela Merkel 2018 einen Umsatz von 670 Millionen Euro erzielt. Im deutschen Gesundheitswesen ist in der Regel jeder Bürger Beitragszahler in der gesetzlichen Krankenversicherung. Es gibt gut 100 Krankenkassen, die die gesetzliche Versicherung anbieten und dafür einstehen, dass die dem Patienten verordneten Medikamente ganz oder teilweise bezahlt werden. Es ist der Normalfall, dass die Krankenkassen homöopathische Mittel in ihre Erstattungskataloge aufgenommen haben, obwohl es, wie Grams betont, “keinen wissenschaftlichen Beweis dafür gibt, dass sie wirken”.

“Den Versicherern steht es frei, dies zu tun, und über die Homöopathie betreiben sie viel Marketing, indem sie für Produkte bezahlen, die besonders gutsituierte jüngere Menschen als Mitglieder anziehen. Und dabei ist die Homöopathie ein ‚Bestseller‘”, sagt Grams. Sie gehört zu denen, die es für vernünftig halten, dass homöopathische Mittel nicht in die Liste der erstattungsfähigen Mittel bei gesetzlichen Krankenkassen aufgenommen werden. “Wir wollen nicht, dass die Homöopathie verboten wird. Aber wir hätten uns gewünscht, dass mit Gesundheitsminister Jens Spahn diese Situation ein Ende gefunden hätte”, sagt die GWUP-Expertin.

Grams bezieht sich auf den konservativen Minister Jens Spahn, mit dessen Haus sie bereits mehr als ein Gespräch zum Thema Homöopathie geführt hat. Offensichtlich konnte Grams Spahn und sein Ministerium bislang nicht davon überzeugen, dass es sinnvoll ist, den Umgang des deutschen Gesundheitssystems mit homöopathischen Produkten zu ändern. Und das, obwohl Spahn schon 2010 zur Homöopathie sagte: “Wann immer die SPD es will, können wir sie streichen, da es keinen wissenschaftlichen Beweis für ihre Wirksamkeit gibt.“

Eine Lobby mit mehr als „homöopathischen Effekten“

Spahn machte diese Aussagen, bevor er Gesundheitsminister im Kabinett der Großen Koalition von Bundeskanzlerin Angela Merkel wurde, eine Position, die er seit Anfang letzten Jahres innehat. Angesichts seines Etats sagte Spahn im vergangenen September, dass das System “ok” sei. “Ich habe entschieden, dass es okay so ist, wie es ist”, sagte Spahn. Sein Argument scheint wie folgt zu sein: Im Gesundheitswesen zahlen die gesetzlichen Kassen für Behandlungen in einer Größenordnung von 40 Milliarden Euro pro Jahr, die 20 Millionen, die sie für homöopathische Arzneimittel zahlen, sind nicht so wichtig. “Aber wichtig ist nicht das Geld, viel wichtiger ist das Prinzip”, beschwert sich Grams.

Sie sagt, sie sei “überrascht”, wie “gut vernetzt” die homöopathische Lobby mit der Politik sei. “Die Politik hat offenbar wirklich Angst vor diesen Unternehmen. Politiker lassen häufig erkennen, dass sie gegen diese Lobby nicht initiativ werden“, sagt sie. Ein radikal entgegengesetztes Beispiel ist das der französischen Position. In Frankreich kündigte Gesundheitsministerin Agnès Buzyn in diesem Sommer an, dass die gesetzliche Krankenversicherung bis 2021 die Zahlung für homöopathische Arzneimittel einstellen werde.

Die französische Entscheidung fiel zu einem Zeitpunkt, als sich die öffentliche Debatte über die Homöopathie auf deutschem Boden intensivierte. In diesem Zusammenhang erregte der Moderator Jan Böhmermann, verantwortlich für die satirische und sehr populäre öffentlich-rechtliche Sendung „Neo Magazin Royale“, Aufmerksamkeit damit, dass er mit Hunderten der typischen homöopathischen weißen Globuli in seiner Sendung in einer Art Demonstration zeigte, dass homöopathische Mittel nicht mehr Folgen haben als die, die sich aus dem Placebo-Effekt ergeben.

Die Debatte in Deutschland scheint mit dem jüngsten “ok” von Merkels Gesundheitsminister derzeit abgeschlossen zu sein, ein Vorgang, den Grams bedauert. Aber diese Widrigkeiten werden sie sicherlich nicht in ihrem Engagement bremsen. Sie wird weiter Öffentlichkeitsarbeit für die Wissenschaft betreiben, wird erklären, was wissenschaftsbasierte Medizin ist und was nicht. Sie weiß natürlich – zu ihrem Bedauern -, dass es genug derer gibt, die bereitstehen, “die Aufklärung der Öffentlichkeit zu attackieren”.  Nämlich unter anderem eine Homöopathie-Lobby, deren Druck sich durchaus über den Placebo-Effekt hinaus bemerkbar macht.


Originaltext: https://www.eldiario.es/sociedad/cientifica-quiere-liberar-Alemania-homeopatico_0_957855206.html
(unter Lizenz CC-BY-SA)


Bildnachweise: Screenshot eldiario.es / Dorothee Pirouelle

The INH on its own account – Notes to the public discourse

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.

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

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!


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?

The picture shows a pharmacist in Homoeopathic pharmacy Varanasi Benares India
Pharmacist in Homoeopathic pharmacy Varanasi Benares India

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

Portrait of Samuel Hahnemann, inventor of homeopathiy
Samuel Hahnemann

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.

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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.

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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.

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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?

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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.”

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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.


FURTHER READING

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/

Happy Birthday, Samuel Hahnemann!

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

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

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

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

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

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

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


Picture: Wikimedia commons

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

Naturalness reconsidered – Why babies don’t need globules

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”.

Homeopathy as “refugee aid” – a medical and ethical problem!

Under the flag “Homeopathy for refugees in Germany” the “Homeopaths Without Borders” together with the initiative “Homeopathy in Action” advertise a nationwide network of homeopathy offers for the “treatment of refugees”. Again and again, related “offers” appear in refugee aid associations which – obviously in complete ignorance of the relevant connections – misinterpret and gladly accept such things as meaningful offers of help.

So one can read for example in an announcement of such an association:

… “Unfortunately, tablets are far too often desired and used to alleviate the symptoms. There are far too few therapy places for psychotherapeutic treatments. In the second part of the evening, we would like to present two free therapy offers from the field of natural medicine.
Dr. med. … and Mrs. …, alternative practitioner, will present the project “Homeopathy for refugees in Germany”.
Every Friday doctors and non-medical practitioners offer homeopathic treatments in the rooms of … as a holistic treatment method for physical and mental problems, if necessary also with the support of interpreters.
… The treatment leads to a reduction of stress and stress symptoms and has a balancing, relaxing effect, so that many people can cope better with stress and thoughts of trauma afterwards.

The activities of the “homoeopaths without borders” (a name trying to benefit from the good name of the “doctors without borders”) were not so long ago criticized in West Africa. There they were consistently rejected with their request to treat Ebola with homeopathy. Apparently, offers under the flag of humanitarian aid is part of the business model of the Homeopaths without Borders. The Süddeutsche Zeitung also reported on corresponding activities in the Munich area.

Quite apart from the therapeutic worthlessness of these “measures”, the question arises whether there is a particular ethical problem besides the medical one.

The fact is: People in need of help from a foreign culture, who as a rule cannot be regarded as “responsible and informed patients” in the sense of our health system, are literally recruited for homeopathic “methods”. People who have to deal with severe traumas – which is explicitly the “goal” of the actions of homeopaths without borders. There is no question about it: providing all these people with psychologically and psychotherapeutically professional care is an almost unsolvable task. But the offer of a sham therapy can’t be a solution! With traumatized people, often children?

Certainly one or the other superficial “success” will occur, precisely because of the psychologically occupied overall situation. But an improper treatment of mental disorders does not solve the problem. Neither is there a careful differential diagnosis (“trauma” is not a diagnosis), nor is anything lastingly done for the patient, nor does one gain knowledge about possible external or self-endangerment due to a psychological disorder. In the age group mainly affected here, one may have to reckon with borderline disorders, whose treatment with sham drugs is hair-raising. We do not like to remember the treatment of the assassin of Ansbach (German small city, where it came to a crime with causing death) with a completely inadequate “therapy” – here by a non-medical practitioner, with a devastating result.

In our opinion, the unspecific “treatment” of severe mental illnesses with homeopathic placebos instead of guideline-oriented drugs goes beyond any tolerable framework. Especially in cases of severe depression, the absence of a specific effective treatment can even be fatal in the worst case because of possible suicide risk. It is not unusual for a traumatised or severely depressed person to be able to undergo therapy at all only with the help of preliminary medication treatment individually adjusted by a specialist.

Even the aspect of the placebo effect must be viewed critically in this context. The language barrier and the origin from a different culture, also and especially in connection with psychological problems, make it seem largely unpredictable whether and how a placebo effect will occur. Since the patients, in this case, might even perceive the “treatment” as overly invasive or authoritarian, even a nocebo effect is conceivable.

Is it really so impossible to provide low-threshold help offers (skills) for those affected instead of idly watching how not only ineffective, but dangerous illusory therapies are offered here? And shouldn’t it be possible – as it happens also for German-speaking patients particularly in emergency situations or in “waiting position” – to publish information brochures in the appropriate languages and age-appropriately, which can help concerning first of all to understand one’s experience and to see that also other humans experience similar after comparable experiences?

Our opinion:

Here the consequence of the social reputation and political “ennobling” of homeopathy becomes visible in a devastating way. Under the guise of helpfulness and support for refugee initiatives, the “Homeopaths without Borders” spread their propaganda for ineffective treatment methods. In this particular case extremely irresponsible. The credulous refugee aid associations, which serve here as vehicles for the transport of the “message homeopathy”, cannot estimate the consequences of these “offers of help” at all and rely on the “good reputation” of homeopathy and the willingness to help shown. There is probably no legal means to prevent this. As always, this is rooted by the fact that homeopathy is anchored in the public health system.
Which indeed sets us apart from the states of West Africa.
Shouldn’t this finally be revised in view of such excesses?


Authors: Monika Kreusel, Udo Endruscheit


Picture: Fotolia_106344027_XS1

Conversation in medicine

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)

What does “proved” mean?

Evidence in Natural Science

Eine Ansammlung von Fragezeichen, die die im Beitrag beschriebene Erkenntnisproblematik symbolisiert“Scientifically proven” or “scientifically refuted” are statements that are often heard, but they are not precise. More correct would be the formulation “according to previous knowledge” – or more extensively “according to previous knowledge gained with scientific methods, which have proven themselves because of their extraordinarily high explanatory potential”. (1).

Statements such as “homeopathic effects can be proven” or “homeopathic effects can be refuted” cannot be decided purely logically (like a mathematical task), i.e. not by disregarding all observations. Neither can one decide purely formallogically whether our observations are correct. Statements about correctness are always tainted with the flaw that we cannot get one hundred percent certainty. Errors can never be excluded. Also an inner consistency is no guarantee for correctness (“truth”). This is the Critical rationalism, Karl Popper’s theory of science, which is generally accepted and practiced today and uses the method of falsification, the “false proof” (testing the validity of a theory by trying to debunk it).

The practice, however, is that apart from the contradiction-free system of the laws of nature – so far considered valid (strictly speaking “provisionally”) – we do not know a second contradiction-free system of laws of nature – and we cannot even imagine it! And that the laws of nature considered valid so far have the highest explanatory potential that we know. The physicists still have a lot of unexplained phenomena on their “to-do-list”, but they obviously have no need (again: until now) for further “tools” – no physicist seems to miss a fifth basic force. Even if not everything is explained yet, the explanatory potential of the scientific findings (important: they are “our” findings) is extraordinarily high. Until today, there has not been a single reason to explain the natural with the supernatural. Even if this cannot be “safely” ruled out for the future: If one excludes it “because of experience”, then that is completely sufficient. We can live well with the residual error: It is extremely small.

We don’t need more than our carefully gained experience either (however, this does not mean personal individual experience, but the portfolio of all scientifically obtained observation data). We have to find our way in our cosmos. And we brilliantly complete this task with our “set of insights”. In this cosmos no living being needs a “feeling” (possibility of recognition) for a 4th or 5th dimension. We can survive with our cognitive ability for a maximum of 3 dimensions. Measured against this goal, one may claim: Evolution, which allows us to recognize “only” three dimensions, has obviously not done much wrong.

Homeopathy and “Proof”

Homeopathy is not a glass bead game. It is not a question of certifying or denying a theoretically possible validity of homeopathy or other therapies with formal-logical and “hair-splitting” methods, of arguing it into a formally existing “knowledge gap”. Homoeopathy cannot be formally declared invalid “a priori” (although the statement is legitimate that because of the incompatibility of its premises with sound knowledge the probability of its validity is conceivably low) – accuracy freaks may enjoy this and be satisfied with it. For the important questions of practical application in daily practice, it is sufficient if homeopathy is declared invalid “a posteriori”, i.e. “in the aftermath”, measured against its actual effects: There are no demonstrable phenomena of efficacy beyond the placebo effect (failure due to empiricism). And homoeopathy violates our previously valid and proven findings (lack of external consistency).

Anyone who wants to rely on the expectation that a new, contradiction-free system of knowledge will someday ensure that homeopathy will still be possible in the future – because it will fit into the new system – can trust with equal justification that a new system will also be found for gravity. He can then already jump from Empire-State-Building in confidence in these future insights (oh what, a 10-m-tower is quite enough). We do not participate in these speculations and prefer to stay on the ground until gravity actually has repulsive instead of attractive forces …

We hold it there with Prof. Otto Prokop, a decisive and convincingly arguing homeopathy critic who wrote aptly in the middle of the last century:

“What is considered true in natural science is what fits harmoniously into the overall system of knowledge. (…) A hypothesis, if it is to satisfy, must be able to be brought into meaningful connection with all associated facts. (…) The limits within which there is objectification are the limits of the real world.” (2)

And what does philosophy say?

We can willingly concede to the philosophers (science theorists, epistemologists) that there is a difference between “security – in philosophical and formal-logical rigour” and “security – in everyday language use”. But: “Security – in philosophical and formallogical strictness” is an unattainable goal for everything. The term cannot be used outside formal logic: There is nothing that could fulfill this claim. With strict philosophical and formal-logical certainty, one cannot exclude neither yetis, fairies, elves, leprechauns … nor Sir Bertrand Russell’s teapot circling around Jupiter, which he used to illustrate this statement.

It is interesting, however, that precisely those who are philosophically strict in “not being able to exclude” and who demand this strictness are absolutely negligent in the popular conclusion derived from it, “Everything whose existence cannot be excluded is existent”. This conclusion is philosophically untenable and simply wrong – it is the aforementioned attempt to take advantage of an apparent “gap” in the system of evidence.

If such a conclusion were correct, then thinking would be an “act of creation”: I imagine something. No one can prove the non-existence of the imagined. So the imagined is existent and real. Wrong! For the term “security – in philosophical strictness” one can’t “buy anything”, so to speak. The term merely floats as such, as an mere idea in the spiritual heights – outside the “boundaries of the real world”. As valuable for decision-making in everyday life it correspondents to assets deposited on a planet in the Andromeda Nebula.

When we say that homeopathy has been refuted, we mean the “weak” refutation in everyday language – and we are more than extremely sure not to make a relevant mistake thereby. To limit ourselves to the “accuracy of everyday language” when the higher-quality “philosophically rigorous accuracy” is in principle – without exception – unattainable: this is not reprehensible. On the contrary, it is a necessary condition for us to be able to communicate about anything at all. If we wanted to wait for one hundred percent certainty, then we would have to remain in eternal inaction.

Author: Dr. med. Wolfgang Vahle


(1) Remark: Proofs in mathematics are created according to strict logical rules, rules that may not automatically being transferred to the “real world”. The mathematical proof e.g. that there are infinitely many prime numbers is of a completely different caliber than “proofs” in the natural sciences. The demands that mathematics makes on proofs cannot be met by the natural sciences.

Mathematicians do not even agree whether mathematics is immanently anchored in nature or whether it is a human invention that is only – completely inexplicably – capable of precisely describing natural phenomena. Mathematics itself belongs to the STEM disciplines, but it is probably not a natural science in the proper sense.

And although mathematics can prove much more by purely logical conclusions than the natural sciences by observation with theoretical reappraisal, it is also not possible for mathematics to achieve “truth” (= “correctness of assumptions”) and “logical consistency” simultaneously within an axiom system. This has been shown by the logician Kurt Gödel in his “incompleteness theorems“. Strictly formallogically true statements do not exist within a system, but only from the outside, from “higher points of view” so to speak.

And what if one is already at the “highest observer level”? Then, unfortunately, one must be content with the fact that the truth of a statement cannot be proved strictly logically. This also applies to the statements “homeopathic effects can be proven” or “homeopathic effects can be refuted”: strictly formallogically this is not possible.

(2) O.u.L. Prokop, Homeopathy and Science, Stuttgart 1957 (S. 2, 31)


Learn more about the empirical knowledge situation on homeopathy: “Criticism on criticism on homeopathy #3 – “Homeopathy is impossible”


Picture credits: Gerd Altmann on Pixabay

On the developments in the USA and the demands of the FTC

Typical brown glass bottle with the well-known homeopathic remedy 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:

Screenshot: Expert circles of the DHU on their website
Image 1: Expert circles of the DHU on their website
Extract from the range of specialist midwifery services with additional information on homeopathy for children
Image 2: Extract from the range of specialist midwifery services

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..:

Screenshot: Events offered and promoted by the DHU for individuals
Image 3: Events offered and promoted by the DHU for individuals

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:

Screenshot: Sponsored guide page
Image 4: Sponsored guide page

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

Offener Brief des INH und des Wissenschaftsrats der GWUP zur “Ringvorlesung Homöopathie” der LMU München

In einer aktuellen Veröffentlichung bewirbt die Ludwig-Maximilians-Universität München eine Veranstaltungsreihe (Ringvorlesung) im Wintersemester 2016/17 zum Thema “Homöopathie: Von der Theorie zur Praxis – Mit Praxisbeispielen und Patientenvorstellungen”. Dabei handelt es sich, wie ein Blick in die Ankündigung zeigt, um eine Reihe von Vorträgen, die den “homöopathischen Ansatz” bei unterschiedlichsten Krankheitsbildern vorstellen will.

Wir halten es für verfehlt, durch eine solche Veranstaltung der homöopathischen Methode zu akademischem Ansehen zu verhelfen, nachdem dies eigentlich längst als obsolet angesehen werden müsste:

  • 1939: Die von August Bier, einem seinerzeit führenden Homöopathen, durchgesetzte Einrichtung einer homöopathischen Fakultät an der Universität Berlin wird rückgängig gemacht – ausdrücklich wegen “Ergebnislosigkeit”.
  • 1958: Die gleiche Universität wehrt sich mit deutlichen Worten gegen den Versuch, diesen Lehrstuhl wieder aufleben zu lassen.
  • 1992: Die medizinische Fakultät der Universität Marburg weist in einer deutlichen Erklärung jede Relevanz der Homöopathie für den Wissenschaftsbetrieb zurück und verwahrt sich gegen ministerielle Bemühungen, Homöopathie in die Lehre einzubeziehen.

Vor diesem Hintergrund ist es mehr als befremdlich, dass die LMU den Lobbyisten vom Deutschen Zentralverein homöopathischer Ärzte eine Plattform bietet, zumal diese mit Lehre und Forschung, den Grundaufgaben jeder Universität, offenbar wenig bis nichts zu tun hat. Leider. Denn wir sind durchaus der Ansicht, dass richtig verstandene Lehre auch in Bezug auf die Homöopathie an einer Universität Platz finden könnte, ja sogar müsste.
Lehren! Das würde für die Homöopathie bedeuten, sie im medizinhistorischen Kontext zu vermitteln, ihre Widersprüchlichkeiten und Unverträglichkeiten mit naturgesetzlichen Gegebenheiten zu erörtern und den fehlenden Wirkungsnachweis und die sogenannte Grundlagenforschung zur Homöopathie vorzustellen und zu diskutieren. Das wäre im Hinblick darauf zu begrüßen, dass angehende Mediziner dann auch auf diesem Gebiet mit solidem Wissen und nicht mit einem Bündel von nicht hinterfragten Vorurteilen ins Berufsleben starten.

Davon ist in der Ankündigung der LMU allerdings nichts zu finden. Stattdessen besteht die Ringvorlesung aus einer Abfolge von Veranstaltungen, in denen die “homöopathischen Ansätze” bei unterschiedlichsten Krankheitsbildern präsentiert werden. Dabei reicht die Palette von einfachen selbstlimitierenden Erkrankungen wie Sinusitis bis hin zu schwersten Erkrankungen, sogar bis in den palliativmedizinischen Bereich. Die angekündigte Eingangsvorlesung “Geschichte und Philosophie der Medizin: Samuel Hahnemanns Begründung einer rationalen Heilkunde” wird wohl auch kaum zu einer methodenkritischen Einführung in die nachfolgenden Vorlesungen gedacht sein. So sind die angekündigten “Praxisbeispiele und Patientenvorstellungen” kein positives Merkmal, sondern bieten nur wieder die Möglichkeit, Homöopathie als “Erfahrungsmedizin” darzustellen.

Wir meinen:

  • Diese unkritische Behandlung der Homöopathie hat an einer wissenschaftlichen Fakultät nichts zu suchen.
  • Es ist mit dem Auftrag zu Forschung und Lehre unvereinbar, einer von der überwältigenden Mehrheit der weltweiten Forschungsgemeinde als spezifisch arzneilich unwirksam eingestuften Methode eine oberflächlich-werbende Darstellung zu geben.
  • Es wäre allenfalls geboten, die Homöopathie gut wissenschaftlich im Sinne einer Erörterung und Falsifikation ihrer Annahmen zu behandeln.
  • Das aktuelle Vorgehen entspricht nicht der Verantwortung der Hochschule gegenüber Studierenden und Patienten.

Unterzeichner:

Für das INH

Dr. Norbert Aust
Udo Endruscheit (Verfasser)
Prof. em. Dr. Edzard Ernst
Dr. Natalie Grams
Amardeo Sarma
Prof. Dr. Norbert Schmacke

Für den Wissenschaftsrat der GWUP

Prof. Dr. Michael Bach
Prof. Dr. Dr. Ulrich Berger
Lydia Benecke
Prof. Dr. Peter Brugger
Prof. em. Dr. Edzard Ernst
Prof. Dr. Dittmar Graf
Dr. Natalie Grams
Prof. Dr. Wolfgang Hell
Prof. Dr. Dieter B. Herrmann
Prof. Dr. Johannes Köbberling
Prof. Dr. Walter Krämer
Prof. Dr. Martin Lambeck
Dr. Rainer Rosenzweig
Prof. Dr. Dr. Gerhard Vollmer
Dr. Barbro Walker
Dr. Christian Weymayr
Dr. habil. Rainer Wolf


Weitere aktuelle Stellungnahmen:

Blogbeitrag bei Edzard Ernst (auf Englisch) hier

Kritischer Kommentar von Wissenschaftsjournalist Werner Bartens in der Südeutschen Zeitung hier

Interessanter älterer Beitrag zur Homöopathie an der LMU auch im Laborjournal hier


Bildnachweis: Fotolia_90994398_XS

What about Schuessler Salts?

Are Schuessler Salts Homeopathy?

The photo shows tree packages for Schuessler Salts: No. 4 Kalium chloratum, No. 3 Ferrum phosporicum and No. 17 Manganum sulfuricum

The so-called “Schuessler salts” are often equated or confused with homeopathy. However, they do not go back to Hahnemann, but to the Oldenburg physician Wilhelm Heinrich Schüßler (1821 to 1898).

Biographical

Schüßler can easily be described as a “dazzling figure” of his time. Actually a secretary by profession, from 1849 he taught foreign languages. Although he had not passed his high school diploma, he had the opportunity to begin medical studies in Paris, which he continued in Berlin and Giessen. His doctorate was also somewhat unusual. Since he pretended to be called up shortly as a military doctor, the university did without a dissertation and only held an examination interview and (after all, one was in Prussia) the examination fees were charged.

Only when Schüßler wanted to take the medical state examination, which was a prerequisite for the granting of the regular license to practise medicine, the lack of the Abitur became a problem. The administrative authority did not accept this any longer and demanded that the examination had to made up for. It was at first in 1857 that he was able to take the medical state examination. This examination was a somewhat mediocre success for him, but he passed and was able to settle as a doctor in his home town of Oldenburg in January 1858. For this, however, he needed a municipal concession, which he received only because he undertook to work exclusively as a homeopathic physician.

He had some success with the practice, probably due to the fact that he demanded very low fees. In other sources it is said that he had given away the required homeopathic remedies free of charge. Three years after his establishment, in 1861, he joined the “Centralverein homöopathischer Ärzte” (Central Association of Homeopathic Doctors).

Schüßler’s “Biochemical Healing Method”

In the first 15 years of his practice he developed a shortened form of homeopathy, which he presented in 1873 in the memorandum “Eine abgekürzte Therapie gegründet auf Histologie und Cellularpathologie” (“An abbreviated therapy based on histology and cellular pathology”). He called his form of therapy the “Biochemical Healing Method”. The basic assumption of this therapy is that diseases are caused solely by disturbances of the mineral balance in the body cells and thus disturb the entire metabolism. The salts were potentiated as in homeopathy, because Schüßler meant that only in this way could the “ions” penetrate directly into the interior of the cell. This should be supplemented by a special diet to eliminate the mineral deficiencies outside the cell in order to establish the balance between the cell’s interior and exterior. Schüßler believed that a pathogenic stimulus would stimulate the individual cells so massive that the defence reaction would be so energy-intensive that the cell would deplete its mineral reserves.

Schüßler reduced the more than thousand homeopathic remedies known at the time to 12 functional remedies. In his opinion, this should be the mineral salts that would remain when a human body is burned.

These means were:

Calcium fluoratum D12 (calcium fluoride)
Calcium phosphoricum D6 (calcium phosphate)
Ferrum phosphoricum D12 (iron phosphate)
Potassium chloratum D6 (potassium chlorite)
Potassium phosphoricum D6 (potassium phosphate)
Potassium sulfuricum D6 (potassium sulfate)
Magnesium phosphoricum D6 (magnesium hydrogen phosphate)
Sodium chloratum D6 (sodium chloride)
Sodium phosphoricum D6 (sodium phosphate)
Sodium sulfuricum D6 (sodium sulfate)
Silicea D12 (silicic acid)
Calcium sulfuricum D6 (calcium sulfate)

Whereby Schüßler himself removed the calcium sulphate from the list in 1895. In its place sodium phosphate and Silicea should be used.
At the beginning of the 20th century, Schüßler’s exegetes added 15 supplements to these original 11 (resp. 12) salts, and later seven “biochemical agents”.

Although Schüßler produced his salts by potentiation, he strongly distinguished himself from homeopathy, as he rejected Samuel Hahnemann’s principle of similarity for his “biochemical healing method” in favour of physiological-chemical processes in the body (this idea was indeed a step away from Hahnemann’s vitalist-esoteric assumptions of a “deranged vital force” in the direction of natural science, but pure speculation and a complete misinterpretation of cellular processes and their participation in disease processes). On this basis he denied the effectiveness of potentiated means propagated by Hahnemann. These statements were the basis for a long dispute with other homeopaths, which led to Schüßler’s resignation from the “Centralverein homöopathischer Ärzte” in 1876.

Wilhelm Schüßler based his diagnoses on the so-called “facial diagnosis”. He thus claimed that one could recognize the respective mineral deficiency by different signs in the face of a person. (A procedure that of course lacks any scientific basis – then as now.)

This “facial diagnosis” was further developed by Kurt Hickethier, a layman interested in alternative medicine, under the name “Sonnerschau” and is still used by alternative practitioners today.

The effectiveness of the Schuessler Salts was examined several times, however, no pharmacological effect could be determined. What had been expectable. The Stiftung Warentest (a German consumer protection organisation) comes to the following conclusion in its publication “The other Medicine”: “Schüßler’s biochemistry is not suitable for the treatment of diseases”.


More about Schüßler also on our Homöopedia (in German)

Authors: Dr. Natalie Grams and Michael Scholz

Picture by A_Different_Perspective on Pixabay

What are Bach Flower Remedies anyway?

About the inventor

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

The photo shows a number of Bach Flower Remedies in their typical Stock Bottles of brown glass.
Bach Flower Remedies in the typical “Stock Bottles”

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

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

About the system

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

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

About the production

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

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

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

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

About the application

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

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

About the effectiveness

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

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

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



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


Picture credits: Pixabay License CC0

Hahnemann’s Organon – Fundamental Work of Homeopathy

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

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

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

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

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

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

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

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

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

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


Picture: Andreas Weimann for the INH

How homeopathy overrides common sense

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

Miasms in homeopathy –

Psora + Sykose + ererbte Sykose + Tuberkulinie + Lepröses Miasma+Syphilis + Akutes Miasma + Typhus + Ringwurm + Spiegelmiasma + Skrophulose + Egolyse + Miasmensplitting + Egotropie + primäre Psora + Überfunktion+Pseudopsora+Haltepunkt + Krätze + Carcinogenie  –
Miasmatische Begrifflichkeiten von damals bis heute

Der Begriff Miasma kommt aus dem Griechischen und bedeutet “Befleckung” (oder “Verunreinigung”)

In der klassischen Medizin, lange bevor man über Viren und andere Mikrooganismen als Krankheitserreger Bescheid wusste, verstand man darunter Ausdünstungen und üble Gerüche, die als Ursache für Krankheiten angesehen wurden. Diese Lehre gilt heute als überholt, sie hat aber durchaus zu richtigen Schlussfolgerungen geführt. Das Trockenlegen von Sümpfen, um den Gestank der Faulgase zu unterbinden, hat auch den Mücken als Krankheitserreger die Brutgebiete entzogen. Das Absondern der übel riechenden Pestkranken hat auch das Risiko der weiteren Ausbreitung gemindert.

Bei Hahnemann, dem Begründer der Homöopathie, hatte jedoch der Begriff des Miasmas eine ganz andere Bedeutung. Er verstand hierunter die tieferen Ursachen für chronische Krankheiten, die er mit seinem normalen Verfahren der Homöopathie nicht heilen konnte. Als Ursache für das Versagen nahm Hahnemann an, dass es tiefer sitzende Überbleibsel älterer nicht ausgeheilter ‘Urübel’ gab, eben die Miasmen, die sich nicht durch die äußere Symptomatik erkennen ließen. Diese hielt er sogar für vererbbar.

“Obwohl (…) heutigen Homöopathen der derzeitige wissenschaftliche Stand der Medizin bekannt ist, sprechen (sie) heute noch von “Miasmen”, wenn (sie) bestimmte Phänomene meinen, die in der homöopathischen Praxis beobachtet werden. Homöopathen, die das Werkzeug “Miasmatik” in ihrem Werkzeugkasten haben, sehen, dass viele Beschwerden auf eine oder mehrere andere verborgene Ursachen zurückgeführt werden müssen.” (Quelle)

Was stimmt an dieser Aussage der Homöopathie?

Der Fehler begann als gute Idee bei Hahnemann

Beginnen wir bei Hahnemann. Seine letzte wichtige Veröffentlichung, “Die chronischen Krankheiten”, wirkt auf den ersten Blick wie das Spätwerk eines mittlerweile verbitterten Greises. Dieses Bild verflüchtigt sich aber, wenn man sich näher mit dem Text beschäftigt. Man kann darin ein Paradebeispiel dafür sehen, dass man trotz einigermaßen folgerichtiger Ideen und Überlegungen zu falschen Schlussfolgerungen gelangen kann. Für seine Zeit waren die Erkenntnisse Hahnemanns beachtlich und innovativ! Auch stand er mit seiner Sichtweise der chronischen Krankheiten der modernen Medizin und Naturwissenschaft wesentlich näher, als seine heutigen Nachfolger, welche die Lehre von den chronischen Krankheiten “weiterentwickelt” haben und immer noch nutzen (trotz besseren Wissens).
Hahnemann war bekannt, dass viele Krankheiten “durch etwas” übertragen werden, also z.B. durch den Kontakt oder die Nähe zu einem Erkrankten oder einer anderen Infektionsquelle, einem tollwütigen Hund zum Beispiel. Er konnte also durchaus feststellen, dass eine – mit seinen Mitteln – nicht mehr feststellbare winzige Menge eines unbekannten Giftes zu erheblichen Beeinträchtigungen und Krankheitserscheinungen führen kann. Warum sollen dann nicht winzigste Mengen eines Heilmittels ebenfalls umfassende Wirkung zeigen können? Die Genese einer Infektionskrankheit, die Vermehrung der Erreger im Körper des Betroffenen, blieben ihm ja mangels Mikroskop verborgen. Hahnemanns Forderung, seine Medikamente in möglichst kleinen Gaben zu verabreichen, ist daher nicht so abstrus, wie es uns heute zunächst erscheint.
Hahnemann hatte durchaus richtig beobachtet, dass es Beschwerden gab, die sich oberflächlich durch Symptome auf der Hautoberfläche äußerten, aber nicht durch ein Behandeln dieser Symptome heilbar waren. Das ist das Bild, das wir auch heute von einigen Infektionskrankheiten haben, wie z. B. Masern, Windpocken etc.
Hahnemann tat das, was ein Wissenschaftler zu seiner Zeit machen musste: Er beobachtete “die Natur” und leitete daraus seine Erkenntnisse ab. Er beobachtete also tatsächlich Phänomene – und erklärte sie im Rahmen seiner Möglichkeiten. So weit, so gut. Doch er machte einen Fehler.

Ende der Homöopathie bei chronischen Krankheiten fehlgedeutet

Zunächst ist zu bedenken, dass Hahnemann unter einer “chronischen Krankheit” sicher nicht das Gleiche verstand wie wir heute, sondern es sich einfach um Symptome handelte, die er mit seiner normalen Vorgehensweise nicht erfolgreich behandeln konnte. Chronische Krankheiten waren also alle diejenigen, die sich der Homöopathie widersetzten.
Er sah an diesem Punkt aber nicht etwa, dass seine Homöopathie wohl nicht wirklich heilen konnte, sondern entspann eine Theorie: wonach etwas die Wirkung verhindern würde!
Im Kernpunkt führt er die chronischen Erkrankungen des Menschen, und zwar alle, ohne Ausnahme, auf drei Urübel zurück: Die Syphilis (Geschlechtskrankheit), die Sykosis (“Feigwarze”, ebenfalls sexuell übertragbare Krankheit) und die Psora (“Krätze”).
Aus seinen Beobachtungen leitete Hahnemann das Vorgehen bei der Behandlung dahingehend ab, dass bei der “miasmatischen Behandlung” zunächst die Natur der inneren verborgenen Krankheit in Erfahrung gebracht werden müsse, also im Anamnesegespräch frühere Infektionen herausgearbeitet werden müssen. Die homöopathische Behandlung muss sich zunächst auf diese innere Krankheit beschränken. Das vorzeitige Beseitigen der äußeren Hautbeschwerden nähme der inneren Krankheit nur das Ventil, woraufhin sich diese noch viel grässlicherer Ausdrucksmittel bedienen würde. Wenn man unter Hahnemanns Miasma eine unbehandelte Infektionskrankheit versteht, dann klingt die obige Behandlungsvorschrift auch aus heutiger Sicht gar nicht so unsinnig. Hätte er anstelle seiner Kügelchen Antibiotika verwendet – die gab es aber erst ein paar Dutzend Jahre später – wäre die Vorgehensweise durchaus erfolgsversprechend.
Hahnemann hatte aber nun mal nur seine Homöopathie eingesetzt. Unwahrscheinlich, dass er damit tatsächlich eine Syphilis-Infektion erfolgreich behandelt haben könnte. Das hatte ihn aber nicht von seinen Vorstellungen abgebracht, denn er nahm gleichzeitig an, dass eine Krankheit um so schwieriger zu behandeln sei, je länger sie bereits andauerte. Und eine zwanzig oder dreißig Jahre alte Infektion zu beseitigen, muss daher fast unmöglich gewesen sein, insbesondere, wenn der Patient durch Fehlbehandlungen seitens der Allopathen “verpfuscht” worden war. Wenn also eine Heilung einer miasmatischen Erkrankung nicht gelang, dann lag das an der Hartnäckigkeit der Krankheit, nicht an den Mängeln der Therapie. So weit verfügte Hahnemann aus seiner Sicht über ein durchaus stimmiges Weltbild, das in manchen Aspekten erstaunlich gut mit dem heutigen Kenntnisstand über Infektionen übereinstimmt.
Hahnemann hatte also aus seinen Beobachtungen durchaus eine folgerichtige Induktion aufgebaut – und sich dennoch geirrt. Es ist einfach nicht zutreffend, dass alle Beschwerden, die sich nicht auf Anhieb mit der Homöopathie behandeln lassen, auf drei Haut- und Geschlechtskrankheiten zurückzuführen sind. Auch wenn man unterstellt, dass die Abgrenzung zu anderen Krankheitsbildern mit ähnlicher Symptomatik nicht unbedingt klar und deutlich war.

Wie hätte man diesen Irrtum feststellen können?

In der Wissenschaft ist die Induktion, also die Schlussfolgerung von Beobachtungen auf vermutete Gesetzmäßigkeiten, ein wichtiger Schritt. Aber wie man sieht, man kann da auch in die Irre gehen, wenn man die Zusammenhänge falsch einschätzt. Daher ist es wichtig – und heute üblich -, die abgeleiteten Gesetzmäßigkeiten in einem zweiten Schritt zu überprüfen und das Ergebnis später zu veröffentlichen und so der wissenschaftlichen Gemeinschaft zur Diskussion zu stellen.
Die Aussage, dass die chronischen Beschwerden von den drei betrachteten Krankheiten verursacht werden, kann auf zwei Weisen falsifiziert werden:

  • Treten chronische Beschwerden auch bei Menschen auf, die keine entsprechende Krankengeschichte aufweisen?
    Damit hätte man herausfinden können, dass es auch chronische Krankheiten gibt, die eine andere Ursache haben und hätte daraufhin die Ursachenforschung erweitern können.
  • Treten in allen Fällen, in denen eine der als Ursache angenommenen Infektionen nur äußerlich behandelt wurde, die chronischen Beschwerden auf?
    Dies hätte die Behandlungsstrategie verbessern können. Beispielsweise hätte sich gezeigt, dass die Krätze tatsächlich nur eine durch Milben verursachte, auf die Haut beschränkte, Erscheinung ist.

Lassen wir dabei einmal außer Acht, dass ein Studiendesign, das dieses untersuchen könnte und dabei gleichzeitig mit ethischen Gesichtspunkten vereinbar wäre, nur schwierig zu realisieren sein dürfte. Hier geht es lediglich darum, aufzuzeigen, wie die Wissenschaft sicherstellt, dass Fehlschlüsse, wie sie hier Hahnemann unterlaufen sind, ausgeschlossen werden. Wie man sieht, versucht man die gefundene Regel zu widerlegen, indem man untersucht, ob das Gegenteil zutreffend sein könnte. Widersprüche führen zu einer Überprüfung der Regel. Hier hätte sich ein weites Feld aufgetan, aber dieses Vorgehen war nicht üblich.

Die miasmatische Behandlung heute

Es scheint gerechtfertigt, die Miasmen Hahnemanns als eine Bezeichnung für das im Inneren des Körpers ablaufende Geschehen bei einer unbehandelten und fortbestehenden Infektion zu verstehen. Dann wäre diese Vokabel mit den zunehmenden Kenntnissen über virale und bakterielle Infektionskrankheiten in der Vergangenheit überflüssig geworden. Auch sind heute viele chronische Krankheiten zumindest so weit bekannt, dass sie ihre Ursache nicht in früheren Infektionen haben (Rheuma, Diabetes, COPD etc.). Dennoch lebt das Miasma und seine Behandlung in der homöopathischen Literatur fort und wird quasi, wie im Eingangszitat erwähnt, als Parallelwissen zum heutigen Kenntnisstand gehandelt.

Es gibt jedoch bis heute keine einheitliche Definition von Miasmen oder eine allgemein gültige/akzeptierte Einteilung. Miasmen gibt es nach Hahnemann, Gienow, Sankaran, Scholten, Masi-Elizalde, Sanchez-Ortega, Burnett, Allen, Sonnenschmidt, Laborde, Vijayakar, Banergea, Banerjee und vielen anderen mehr. Dabei werden zwischen 3 und 12 Miasmen unterschieden. Gewisse Miasmen selbst scheinen vollständig in das Reich der Esoterik abgedriftet zu sein. Bei den Homöopathen sind also vielerlei unterschiedliche Verfahren als “miasmatische Behandlung” bekannt. Zu stören scheint das nicht. Alle beobachten natürlich “Phänomene” und alle berichten von Heilerfolgen – aber nicht von eklatanten Widersprüchen.

Damals interessant – heute falsch und dogmatisch

Man kann Hahnemann zugestehen, in der Natur zumindest einiger chronischer Beschwerden gar nicht so falsch gelegen zu haben und nur durch die beschränkten Möglichkeiten seiner Zeit zwangsläufig in seinen Irrtümern gefangen geblieben zu sein. Also in seinem Erkenntnisprozess durchaus einen richtigen Weg eingeschlagen zu haben, dabei allerdings in einem frühen Stadium verblieben zu sein.
Für seine Nachfolger, insbesondere die modernen, die Miasmentheorie bearbeitenden Homöopathen wie Masi-Elizalde (1933-2003), Sankaran (* 1960) oder Gienow (*1960), gilt diese wohlwollende Betrachtung ausdrücklich nicht. Sie könnten besser wissen, dass 1. die Miasmentheorie widerlegt und durch besseres Wissen ersetzt ist und dass wir 2. alle möglichen Phänomene nach Art einer self-fulfilling-prophecy irgendwie erklärbar machen können. Nur, im Gegensatz zu Hahnemann, haben wir heute Möglichkeiten mit Hilfe der Wissenschaft, dabei Fehler und Fehlwahrnehmungen aufzuspüren und zu korrigieren. Diesem Vorgehen verweigern sich Homöopathen jedoch konsequent und bleiben lieber in ihrer Luftblase aus Ideen von vor 200 Jahren gefangen. Der Wissenschaft allerdings werfen sie vor, sie möge doch auch “endlich mal über ihren Tellerrand hinaus schauen”.


(Autoren: Dr. Norbert Aust, Dr. med. Natalie Grams)

Mehr zum Thema Miasmen und zur Sicht der homöopathischen Szene auf die Miasmenlehre auch hier.

Foto: Wikipedia Commons The Yorck Project/Directmedia Publishing GmbH (Gemälde: Pietro Longhi)

Homeopathy is esotericism

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

 

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