Homöopathie: Es gibt nichts in ihm

It’s admittedly and regretfully rather rare that we at the Merseyside Skeptics Society cover stories of a non-English language nature. That’s entirely mea culpa, malheureusement my non-English language abilities are limited at ‘meilleur’. Still, it would be ridiculous of us not to mention the Wünderbar developments coming out of Germany, where top magazine Der Spiegel ran with the cover story:

Homoöpathie: Die groβe Illusion (‘Homeopathy: The grand illusion’) – Source: Der Spiegel

This, of course, is HUGE. Not least because Germany is oft-cited as a prime example of a healthcare system in which homeopathy is given the ‘respect’ it deserves (I’d argue 10:23 actually gave the respect homeopathy REALLY deserves), but also because Germany is the home of homoeopathy and Hahnemann – all of which making the prospect of the magic water getting ‘Das Boot’ from the German equivalent of the NHS an incredibly sweet pill to swallow.

Far be it from me to wallow in all of the delicious, delicious developments too much, but here’s a glimpse at the online version of the Der Spiegel article, for any of our Deutsch companions out there. What’s that at the bottom? Why, that would be the 10:23 Campaign, cited as an influence! Needless to say (although I will anyway), our collective bosoms swell with pride here at 10:23 HQ. My aforementioned linguistic limitations prevent me from doing it justice in the original German, and the Google translate is admirable if patchy (“Many patients believe the cash to pay only that which helps also detectable. Ennoble why the health insurance with their approach to homeopathy.” – I swear Google hires Master Yoda to do their translating…). With that in mind, allow me to quote from the English version of Deutsche World:

The 200-year-old dubious medical treatment may soon be dropped from German medical insurance providers as a cost-saving measure. The the United Kingdom may also do the same.

Too right we might.

In recent days, the over-two-centuries-old practice of homeopathy has come under fire in Germany.

Dr. Karl Lauterbach, the chair of the parliamentary health committee, recently called for public health insurers to stop funding the practice, which typically involves solutions of small amounts of herbs or other medicines heavily diluted with water and then shaken or stirred to “add energy” to the solution.

According to its proponents, homeopathy can heal patients as well – if not better – than conventional medicine, while its detractors, including nearly all medical doctors and scientists, say that it is no more powerful than a placebo.

What’s more:

“If everybody pays for his beer, then he can pay for his homeopathy,” said Dr. Kay Brune, a professor in the Department of Experimental and Clinical Pharmacology and Toxicology at Friedrich-Alexander University Erlangen-Nuernberg, in southern Germany.

Brune added that there is no scientific evidence to suggest that homeopathy actually causes any meaningful and healing bio-chemical reactions in patients, but that doesn’t stop people from believing in a practice that has been so deeply ingrained into the German psyche.

“Homeopathy has a very long tradition in Germany,” he added in an interview with Deutsche Welle. “The founder, Hahnemann was a brilliant physician. But at that time doing nothing was helpful to the patient. In 200 years, the pseudo-science has not taken any steps forward.”

Now, of course, we aren’t arrogant enough for one second to think that we had a huge part to play in this – but if the actions of the 10:23 Campaign and our amazing support (not least the hundreds of national and international ‘overdoses’ who joined in back in January) had even a small effect on this development, I safely speak for everyone at 10:23 and the MSS in saying how immensely proud we are to have been involved.

What’s been staggering over the last 6 months, and in fact back to October when we started letting the 10:23 cat a little out of the bag, is the phenomenal response we’ve had from ordinary people – not just doctors and working scientists. We’ve been blown away by the level of involvement support, coverage and interest 10:23 has had so far, and as we’re starting to see the homeopathic dominoes tumbling here in the UK – and in Germany too, now – the level of interest continues to amaze me. On our side we have the science, we have the support, and we have the momentum.

Homeopathy: There’s nothing in it / Es gibt nichts in ihm

Here’s one of my recent favourites, with my response. I hope you enjoy it as much as I did (for full clarity, I’ve not corrected any grammar, presentational issues, and to be clear I’ve not missed a word of what I received):

Why the “fight against Homeopathy” if you think it doesnt work? Homeopathy is safe, and inexpensive.It is in the interests of multi-national drug companies to suppress homeopathy because it is effective and doesnt have side-effects. Check out France and Germany. Also check out the history books where you will find “witch-hunt” and  “witchcraft” referring to suppression of Americans in the 1950′s.Read Doctorow’s “The book of Daniel” :Berthold Brecht and Arthur Millers  “Crucible” .

Your campaign is targeting  well-trained practitioners who are unable to make a living, largely because of adverse publicity.I am wondering about  the business interests of Simon and other leaders of your campaign, and whether there may be involvment with any drug companies.If so I would politely ask any of you to declare this, please.Last week the World Health Organisation were exposed:-members of the committee who upped the status of swine flu to pandemic, were found to have business interests with the multi -national pharmaceutical company who produced the vaccine.The bill for vaccine cost Great Britain £1.2 Billion, and most of it was refused and unused.There has been no pandemic. Magdalena Whitehouse BA RGN  PCH  RShom.

Pick your way through that one, if you will! Well, I did, and here’s my response:

Hi Magdalena

I’ve stated many times, and will continue to do so – there has been NO funding for the whole campaign, at any point. We paid for our own domain name, all work has been done on a voluntary basis, and we’ve never even accepted donations to help with running costs. The Merseyside Skeptics Society is a non-profit organisation, and we’ve never taken money from anyone in the pharmaceutical industry.  Also, to be clear – Simon (I presume you mean Simon Singh?) is not involved in the running of the 10:23 Campaign, or indeed the Merseyside Skeptics Society, he instead is a valued supporter and has been a wonderful champion of our cause.

More to the point – why would the pharmaceutical industry try and ban homeopathy? If it actually worked, they’d sell it – it’s so much cheaper to produce than real medicine, and needs no expensive research to create new remedies. If it worked, they’d sell it in an instant.

Could you please provide proof that homeopathy works, or a clear and referenced description of exactly how it works? In my many months of investigation, the closest I’ve found has involved vague invocations of quantum theory, entanglement, fuzzy ‘energy’ speak and some hand-waving regarding it being natural. To be clear, describing something as natural doesn’t in any way explain how it works. What’s more, diluting a substance, succussing it and then saying it’s stronger – which natural law does this adhere to? I don’t mean Hahnemann’s laws, which he appears to have called ‘laws’ to excuse the fact that they are not actually laws, or indeed real.

Interesting that your defence of homeopathy is to ask me to read Miller’s ‘The Crucible’ – I’ve read the play many times, it’s a great book. In it people’s paranoia about an evil, organised attack by Satan leads them to see the shadowy hand of Big Devil in the actions of everyone they disagree with. Perhaps this sounds familiar to you. Or perhaps that’s just my ‘Big Pharma’ backers speaking…?

That the campaign is preventing practitioners from making a living is kinda the point – as it has been proven not to work, it’s good that they are prevented from selling it! I’ve seen homeopaths claiming to cure cancer, going to third world disaster areas to attempt emergency treatment, and advising people not to rely on medicine to prevent malaria infection or to prevent their child dying of measles. Until homeopathy can prove that taking their sugar pills is better than innoculating against deadly diseases, they should not be selling the pills.

I really like your point about Swine Flu – I’m sure if millions of people had died from the pandemic, you’d be telling me that medicine shouldn’t be trusted because it failed to prevent millions of deaths.

Thanks for taking the time to respond, and happy to have your interest in our campaign. I look forward to your response. For full discolsure – as you have politely asked me to declare any financial interests – I’ve published your request for information and my response to it on the Merseyside Skeptics Society website. I’d hate for other people to feel I hadn’t answered your request in full.

Thanks very much
Michael Marshall – BA MSS 10:23 BS SSC (Silver Swimming Certificate) CPB (Cycling Proficiency Badge)

I’ll keep you posted on other feedback I receive, of if indeed Magdelan responds to me with the ground-breaking, nobel-prize-winning response she’d need to give me to prove homeopathy actually works.

However, there are still significant challenges ahead – not least in the form of David Tredinnick MP, recently appointed to the Health Select Committee despite his beliefs that astrology has a role to play in healthcare, and that surgeons won’t operate under a full moon as the lunar cycle has an effect on the clotting of blood. Both of which are, of course, untrue. This isn’t the extent of Mr Tredinnick’s misunderstanding of health advice – he recently tabled 4 Early Day Motions, urging MPs to support homeopathy and to ignore the findings of the Science and Technology Select Committee. These EDMs are based on flawed science and false assertion, and should not be supported by your local MP.

Fortunately, Julian Huppert MP has tabled amendments to each of Mr Tredinnick’s motions, in order to correct the inaccuracies, misunderstandings and misguided support for homeopathy. These amendments are based on clear reviews of the studies in question, and are backed by scientists and experts in the fields – as such, they also have the backing of the Merseyside Skeptics Society, and the 10:23 Campaign.

At the moment, many MPs may not know much about homeopathy, and may not know it is based on quackery and magical thinking; most crucially, they may not know how important an issue it is to you. With this in mind, we urge you to write to your MP to let them know how strongly you feel. The website Write To Them (http://www.writetothem.com/) makes writing to your MP very easy, and for your convenience you can find below a standard letter to copy and paste into the body of your letter.

Please, take 2 minutes to let your MP know that homeopathy is not an effective healthcare option, does not offer value for taxpayer money, and should not be supported. Ask your MP to sign EDM amendments 284A1, 285A1, 286A1 and 287A1. Ask your friends to do the same. Spread the word – together, we can make a difference.

Visit http://www.writetothem.com/ and paste the following into the body of your letter – as Write To Them blocks identical letters, please adjust the wording in the letter as you see fit, to best express your views:

Dear <your MP>

I am writing to you to alert you to an important issue you might not be aware of – while the role of an MP is doubtlessly a busy one, and the challenge to keep on top of all of the various issues put to you is likely significant, I can appreciate that you may not have been made aware of the ongoing debate regarding government funding for homeopathy on the NHS.

At a time when cuts are increasingly likely, it was refreshing to see the Science and Technology Select Committee advise the cutting of homeopathy – a 200-year-old pseudoscience – from NHS funding. I applaud the committee, and their reliance on evidence to come to a solid conclusion. It is, therefore, disappointing in the extreme to see the Early Day Motions EDM284 [Bma Annual Representative Meeting Motions On Homeopathy], EDM285 [Effect Of Homeopathic Remedies On Breast Cancer Cells], EDM286 [Homeopathic Medicines In The Treatment Of Moderate To Severe Depression] and EDM287 [Homeopathy And Chronic Primary Insomnia] call for support for this disproven quackery.

Indeed, it’s further distressing that, upon examination, the studies cited as proof of the effect of homeopathic treatments in EDM284, EDM285 and EDM286 are in fact riddled with deep and significant flaws. Given that EDM285 applauds the use of homeopathic substances to treat breast cancer – a claim which would be illegal if made by a UK practitioner – it’s clear to see how support for this motion could lead to real and significant harm.

I applaud the actions of Julian Huppert MP – who has tabled clear and reasonable amendments to these misguided motions, amendments which correct their inaccuracies and redirect them back in line with real science and evidence. These amendments are titled as follows: EDM284A1 [Bma Annual Representative Meeting Motions On Homeopathy], EDM285A1 [Effect Of Homeopathic Remedies On Breast Cancer Cells], EDM286A1 [Homeopathic Medicines In The Treatment Of Moderate To Severe Depression] and EDM287A1 [Homeopathy And Chronic Primary Insomnia].

I therefore urge you to consider the issues and the serious ramifications to both the taxpayer in funding disproven treatments on the NHS, and to the overall health of the nation in recommending pseudo-medicine for such serious issues as severe depression and breast cancer. If you agree that cancer, depression and other illnesses should only be treated with modalities that have been proven to work, I urge you to sign EDM284A1, EDM285A1, EDM286A1 and EDM287A1.

Thank you for your time

In a recent Pulse magazine article professor of complementary medicine Edzard Ernst praised the founder of homeopathy, Samuel Hahnemann.

“In my view, Samuel Hahnemann, the German doctor who invented homeopathy about 200 years ago, is a man who should be celebrated.”

Can this be true? Surely one of the most respected proponents of evidence based medicine cannot be advocating homeopathy as a treatment.

In his article he cites the hammering homeopathy has received over the last year including the House of Commons select committee’s damning report, the BMA describing homeopathy as “witchcraft”, and my particular favourite – comedians taking the “homeopathic mickey” (sadly 10.23′s not insignificant role doesn’t get a mention).

Fortunately normal service resumes further in the article – to quote Prof Ernst:

“His primary achievement is not to have developed homeopathy. His true achievement is that, in the course of doing this, he has shown us how important non-specific effects – often also called the ‘art’ of medicine – are in terms of getting patients better. To put it bluntly, Hahnemann has taught us that patients can improve even when we give them nothing but placebos.”

This somewhat conciliatory line is admirable, but I think also provides the crack which has allowed homeopathy to be practiced for so many years as an NHS treatment. Most doctors either haven’t been aware of the implausibility of homeopathy, or have been happy for other practitioners to provide placebos to patients, in the knowledge that there is some perceived benefit. Homeopathy is often given for intractable problems, where EBM doesn’t always provide sufficient benefit. As Prof Ernst says, the act of being empathic and providing sufficient time is often enough to make the patient feel better.

I agree with the professor on the benefits of offering empathy and time, but I don’t believe this is the entirety of what homeopathy offers. Firstly it requires a degree of dishonesty on the part of the clinician who either is consciously giving a placebo treatment, or is deluding himself that there is efficacy in the homeopathic treatment. There is also a degree of collusion between practitioner and patient, where both may be aware of the lie, but have to go through the ritual, in order for the placebo effect to work. This ritual extends to the ridiculous dilution and succussion process.

The degree of self delusion is apparent in the responses to Prof Ernst’s post. One homeopath writes:

“a medical system that has spread to all continents of the world through little more than word of mouth- ie the recommendation of satisfied patients- to the point where it is now the second most widely used medical system in the world’ I think these … qualifications speak for themselves for it is a ludicrous supposition that homoeopathy could have gained such widespread approval on the strength of nothing more than the placebo effect.”

No need for evidence here then, just lay on the self delusion with a trowel. Further on he states:

“I believe it is part of the code of ethics of doctors in this country that they do not publicly decry fellow professionals. The fact that some junior members of the BMA broke their own code in order to criticise fellow doctors who have undergone full professional training then undertaken further training in order to become members of the Faculty of Homoeopaths should be deplored and is certainly evidence of a lowering of professional standards.”

This last point is especially sad, as the junior doctors were not criticising specific homeopathic doctors, but the entire implausible tenet that they depend on.

Hats off then to Hahnemann for helping to expose the placebo effect, which through double blinded placebo controlled trials can be dialled out of the equation. The short term gains achieved by being dishonest with patients cannot be helpful in the long run. Despite time constraints, I would hope that doctors would always provide empathy and sufficient time required to deal with their patients. Providing an explanation of their condition, and being honest about what can (or cannot) be done to help them is much more laudable, empowering and ultimately more beneficial.