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Archive for the ‘Homeopathy’ Category

Closure threat

Wednesday, March 21st, 2007

“First they ignore you, then they laugh at you, then they fight you, then you win.”
Mahatma Gandhi

The Royal London Homeopathic Hospital is being threatened with closure. This appears to have very little to do with any falls in underlying patient demand or levels of satisfaction with the services offered by the hospital and rather more to do with politically-motivated agendas to undermine complementary therapies and restrict patient choice.

More details from Dr Peter Fisher, Clinical Director of the RLHH (and homeopath to the Queen) can be found here.

If you’d like to register your support for the hospital, there is a petition online at Number 10 Downing Street’s website … “We the undersigned petition the Prime Minister to honour Parliament’s committment to patient choice by preserving the Royal London Homeopathic Hospital and the service it provides as an integral part of the NHS.” This petition can only be signed by UK residents. If you’re from overseas, you can join the campaign to save the RLHH by contacting them directly. The address is available at the end of this article.



The studiously unstudied

Thursday, December 7th, 2006

“Nothing exists except atoms and empty space; everything else is opinion.”
Democritus of Abdera

They’re at it again. Yet another medical academic hits the headlines with a denouncement of homeopathy, yet again attempting to scare people away, this time by targeting children. Glasgow’s The Herald put the story on its front page on Monday under the headline “Homeopathic medicines ‘not good for children’” (article now only available by pay per view or subscription to the archives).

The study by Aberdeen University analysed the records of nearly two million patients in 323 practices from 2003-4, and revealed that 60% of GP practices in Scotland make homeopathic and herbal medical prescriptions. Dr James McLay, a clinical pharmacologist and ‘leading child health care expert’ according to The Herald, said “There is a real drive to use rational and proven medication and the whole thing about homeopathy is it is totally unproven and totally irrational as well.” He goes on to say, “It is difficult to know why children are being prescribed homeopathy. If one assumes homeopathy works because of the placebo effect, and I personally do believe that, you can’t do that with children under one year old.”

Yet another beautiful example of mistaking the map for the territory; of extrapolating apparent “sense” from a set of questionable presumptions. At least Dr McLay is to be congratulated for stating this clearly (“if one assumes …”, “I personally do believe …” ) rather than attempting to pass his opinions off as incontrovertible “fact” as so many others have done. I wonder if the fact that people using homeopathy for babies to the extent they do has ever caused him to question his assumptions?

There is enormous irony in so many academics denouncing something they have never taken the time to study in depth. After all, academics are supposed to be people that devote their lives to studying things. Perhaps they have just become altogether too enamoured of their theories and separated from the day-to-day reality of treating people who are sick? Funnily enough, this was the principle complaint of Dr Samuel Hahnemann, the founder of homeopathy, and is what led him to develop his therapy. Meanwhile, 60% of those at the coal face of modern medicine in Scotland are making use of a 250 year-old therapy that only four decades ago was practiced by just a handful of stalwarts and which hardly anybody had ever heard of. Do all these academic scientists imagine that homeopathy would have survived the test of time and risen to its current prominence unless there was a good body of evidence and experience amongst those that have tried it to suggest that it actually does work?

More than a few who practice the therapy, and the vast majority of their patients, don’t actually care that we don’t have a theoretical framework to explain how it works. They’re just glad that it does. It seems that the ones who are squealing the loudest are the ones being brought to confront the possibility that their theoretical frameworks might just require some dismantling and rebuilding.

Or perhaps also those who see their vast and unreasonable profiteering at the expense of suffering humanity under threat by a therapy who’s remedies are absurdly cheap to produce and which can’t be patented? On that subject, the extraordinary course of events surrounding the Swiss PEK study – a spin-off of which was the much-publicised Shang et al meta-analysis published in the Lancet in August 2005 proclaiming ‘the end of homeopathy’ – provide some very interesting reading. Consider the repeated assertions that homeopathy is “unproven” against this background, and a quite different picture emerges.



Can we afford to be so superficial?

Monday, November 13th, 2006
George Vithoulkas

George Vithoulkas

“I know that most men, including those at ease with problems of greatest complexity, can seldom accept even the simplest and most obvious truth if it would be such as oblige them to admit the falsity of conclusions which they have delighted in explaining to colleagues, which they have proudly taught to others, and which they have woven, thread by thread, into the fabric of their lives.”
Leo Tolstoy

In a piece on his website under the title “Can we afford to be so superficial?“, Prof George Vithoulkas writes in highly condemnatory terms about a proving of Thiosinamine he’s received from Manchester’s North West College of Homeopathy. The target of his derision is the assertion in the proving documentation that people involved with the proving, but who had not actually taken the remedy themselves, produced symptoms of the remedy.

He writes, “It is unbelievable that in our times due to the new ideas by new teachers people have come to believe such trash.” And goes on to say, “It is really pathetic that somebody managed to persuade quite a few of the poor novices in homeopathy that the symptoms of those with placebo can belong also to the proving of the remedy through a metaphysical medium!”

Yet when we are dealing with a form of medicine which has no properties pertaining to physical substance, when it is – according to Hahnemann himself – immaterial substance, then what we are dealing with is, by definition, a metaphysical medium!

The assertion in the North West College’s proving documentation is a phenomenon that’s repeatedly observed and well documented in provings from Jeremy Sherr onward. It’s got nothing whatsoever to do with new teachers beguiling their students, but with solid, replicable and demonstrable evidence, discovered and experienced again and again by students, qualified homeopaths, and homeopathic pharmacists alike who are involved with provings. Such observations require proper investigation, and if that means questioning and reassessing our foundational assumptions in the light of new evidence, then that’s what’s required. That’s the cornerstone of the scientific method after all. The map is not the territory. It’s only a map. And if the map proves deficient, then it needs to be redrawn. This is how Hahnemann discovered homeopathy in the first place.

Vithoulkas’s argument rests on the differentiation between remedy and placebo, viz “In a proving you have the same or similar symptoms of those with verum with those with placebo, the logical conclusion should be that such symptoms do not belong to the remedy but rather to the environmental or circumstantial or to psychological conditions (hysteria, ecstasy, fear, anxiety etc.) but surely not to the remedy!”

Hahnemann’s original provings did not feature placebo controls, so there really is little established precedent for their use in homeopathy. They are a modern transplantation from the biomedical model, based on the assumptions of materialist science and, as is now being found repeatedly, are of marginal – if any – use in homeopathic provings. (See Walach, H, Sherr, J, et al, Homeopathic proving symptoms: result of a local, non-local, or placebo process? A blinded,placebo-controlled pilot study. Homeopathy (2004) 93, 179–185.) Moreover, to base our materia medica on an assumption so recently grafted onto homeopathy seems somewhat inconsistent with Prof Vithoulkas’s avowed classical affiliations.

Prof Vithoulkas’s enormous contributions to homeopathy are not in doubt, but since his language here betrays an emotional, rather than rational, basis for his argument (a well-reasoned and supported argument has no need of words like “trash” and “pathetic”), perhaps we should reflect the question back to the man who posed it and ask “can we afford to be so superficial?” as to put the interests of pursuing scientific principles in homeopathy in second place to one man’s desire for mainstream acceptance?



Evidence? What evidence?

Tuesday, May 23rd, 2006

“I know that most men, including those at ease with problems of greatest complexity, can seldom accept even the simplest and most obvious truth if it would be such as oblige them to admit the falsity of conclusions which they have delighted in explaining to colleagues, which they have proudly taught to others, and which they have woven, thread by thread, into the fabric of their lives.”
Leo Tolstoy

And so it goes on …

It really is extraordinary to what lengths people will go to try to keep the world within their comfort zones. Whatever happened to the concepts of open mindedness and free choice?

Today we have Michael Baum, emeritus professor of surgery at University College London, along with 12 other doctors, writing to 476 primary care trusts urging them to discontinue the funding of complementary therapies. Never mind that an estimated 50% of GPs recommend their patients for complementary treatment, these 13 people clearly believe they have the right to dictate national policy on the matter. Signatories to the letter include Nobel Prize-winner Sir James Black, Sir Keith Peters, president of the Academy of Medical Science, and Edzard Ernst, the UK’s first “professor” of complementary medicine. The letter describes homeopathy as an “implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness”.

Seems these august gentlemen have got their facts just a little bit wrong here, which ought to royally backfire on them, but probably won’t because so few people bother to read beyond the sensationalist headlines and examine the data on which the conclusions are based. For example, linked from this article on the BBC’s website, is one from November last yearpublicising the Bristol Homeopathic Hospital study in which 70% of 6,500 patients reported positive health changes with homeopathic treatment. The article mentions last year’s Lancet meta-analysis, saying:

“The Swiss-UK review of 110 trials found no convincing evidence the treatment worked any better than a placebo.”

Again, factually incorrect. The review gathered a total of 220 trials for examination, but its conclusions were based solely on a comparison of just 8 homeopathic trials (selected from a total of 110) with 6 conventional medical trials (out of a total of 110). 8 undisclosed trials at that, making it impossible to determine whether what was being measured even falls within an acceptable definition of “homeopathy”. Further, the authors of the study declared their bias from the outset. They believed homeopathy to be placebo and there appeared to be no attempt to do any more than support that opinion. The quality of this study has been so widely condemned by serious academic scientists that it prompted the following comments from Mikel Aickin PhD, Research Professor at the University of Arizona:

“The Lancet article appears to be part of a recent trend, in which medical journals are publishing articles of exceedingly low quality to justify attacks on controversial therapies.”
[...]
“There is unsettling evidence that we are now in the midst of a methodological degeneration in biomedical science. This appears to be occurring in, of all places, our fundamental approach to inference – using observation and evidence to decide how to act or believe. That it might be happening in medical research makes it of more than just academic interest.”
(Aickin, Mikel. The End of Biomedical Journals: There Is Madness in Their Methods. Journal of Alternative and Complementary Medicine Oct 2005, Vol. 11, No. 5: 755-757)

(For a more detailed exposé of the Lancet study and the wider context in which it was produced see my post from March 18 and Myths and Misconceptions about homeopathy, both on this site.)

Edzard Ernst is quoted in the BBC article as saying, “I believe we need one single standard in medicine and that is the standard of evidence based medicine.” Indeed. Couldn’t agree more. Perhaps these 13 devotees of evidence-based medicine should take a closer look at their “evidence” before pontificating so loudly and publicly? If we’re to take their conclusions as representative of the quality and rigour of scientific investigation found in the upper echelons of the medical elite then biomedical science is, as Mikel Aickin suggests, in very deep doodoo.

Several news websites are conducting polls based on this letter. If you would like to take part, try:
BBC
Sky News
Daily Mail



Classical clashes

Saturday, April 22nd, 2006

“We have actually touched the Borderland where Matter and Force seem to merge into one another, the shadowy realm between the Known and Unknown … I venture to think that the greatest scientific problems of the future will find their solution in this Borderland, and even beyond; here, it seems to me, lie Ultimate Realities, subtle, far-reaching, wonderful.”
Sir William Crookes, 1879

This one’s for homeopaths …

Dr Luc de Schepper puts his finger on a fascinating and frustrating phenomenon in this month’s edition of the energetic e-zine Homeopathy 4 Everyone. He says, “After many years of experience I now know that it is extremely difficult to discuss true classical homeopathy at public meetings or seminars. There are so many misconceptions of the matter, so many prejudices against the latest Hahnemann views, that it is almost impossible to reach mutual understanding in a public discussion. Yet, a question that I heard with increasing desperation among homeopathic students and practitioners alike is, “Why is it that there are so many different opinions regarding the practice of homeopathy?” It indeed must look as a dark, obstructing evil to the student when he is confronted with so many contradictory opinions where Hahnemann has supplied us with so many clear and logical instructions.”

He goes on to say “It is my firm conviction that no one is competent to form an opinion on the matter of homeopathy until he has studied the basic writings of the homeopathic school. Only then, will we see that these endless fights among homeopaths, which are the sole cause of non-progression of homeopathy, are absolutely unnecessary.”

The first point – “that no one is competent to form an opinion on the matter of homeopathy until he has studied the basic writings of the homeopathic school” – is sound common sense (although it unfortunately doesn’t seem to prevent countless “authoritative” pronouncements on the subject by people who have never given the Organon of Medicine so much as the time of day). The second point, while at first glance appearing equally sensible, isn’t.

This seems to be one of the thorniest problems presented to us as we step out of the conventional model of health and disease and into the homeopathic one. The very clarity of Hahnemann’s writings are in some ways their own undoing. His exposition of the homeopathic system is so clear, so sensible, so accessible, that it becomes relatively easy for anyone not completely welded to a materialistic conception of existence to take his perspective on board. It all rings so true.

Yet homeopathy also comes packaged as a system in itself. It’s apparent completeness can lull both the student and the experienced practitioner into thinking that it can be seen in relative isolation and that all they need to do is master the basic tenets, and they have found the one true answer to all the world’s ills. This tends to encourage the mere exchange of one medical system for another without considering that the underlying mechanisms at work in homeopathy would appear to lie more in the realms of quantum mechanics and chaos theory than they do in the Newtonian paradigm which still governs much of our prevailing rationalisations about how the world works.

We really do need to get it into our heads that deterministic predictability is largely illusory. Physics taught us that nearly a century ago now, yet so far it’s a fact that’s failed miserably to find its way into our daily lives to any significant degree. And the fact that it patently does not obtain in any kind of generalised fashion in the real world of homeopathic practice should perhaps alert us to an error in an assumption somewhere, but instead the prevailing rationalisation seems to be that the failure of homeopaths to agree on the nature of the one true way must come down to a failure to grasp the “true” nature of what Hahnemann was on about. Of course, it goes without saying that those who favour such opinions are usually also of the opinion that they themselves have grasped the essential Hahnemann. And no doubt the phenomenon of sympathetic resonance, like resonating with like, has more than a passing role to play in the confrontational, irascible and self-righteous qualities evident in many of these debates.

This whole phenomenon seems to hinge on our interpretation of the feeling that there is indeed “one true way”. Feelings themselves are always valid, but are frequently misattributed, misplaced or misinterpreted. All the evidence, not to mention the fundamental individualisation inherent in the therapy, suggests that a one-size-fits-all approach is simply untenable. Yet equally well it’s clear that there is only one simillimum in each case. This would seem to suggest that the “one true way” we’re driven to seek is the one true way for each of us as individuals; ie. the individual way that is true to ourselves. In the same way that each and every one of us represents an ultimately unique expression of the fundamental principles of existence, so too each and every homeopath evolves a unique expression of the fundamental principles described in Hahnemann’s work. And just as each of us are valid as living beings, each of us discovers a valid interpretation of the Organon that works for us in practice.

James Tyler Kent is a case in point. Kent believed fervently, and taught, that his own perspective on the Organon was exactly where Hahnemann was coming from. His methods have thoroughly infused the revival of homeopathy in the English-speaking world to such an extent that a large number of homeopaths don’t even realise they’re reading the Organon with Kentian spectacles on. But what appears to be an identical fit is not necessarily what is one. It’s extraordinary just how many ways there are to read and interpret even the clearest of guidelines – see the discussion of Kent’s methods and assumptions in the article Bringing Back the Baron – because it all hinges on what underlying assumptions you personally bring to your reading of those guidelines. It’s what’s implicit rather than explicit that makes the difference. Yet Kent’s version of homeopathy has proved time and again that it’s valid and successful, as have the methods of others who’ve evolved their own vision of the Organon to varying degrees. Whether the method relates clearly and closely to the Organon or whether it appears to play fast and loose with Hahnemann’s principles, all methods appear to work for some of the people some of the time, and not one of us has a 100% success rate or even anywhere close. What seems to distinguish the more successful practitioners is the fact that they have honed their practice until it becomes a true expression of their own individuality. It is how the Organon rings true for them.

The mistake we appear to make is in assuming that what works for one individual – whether Hahnemann, von Bönninghausen, Kent, Vithoulkas, Sankaran, Sherr, Mangialavori, Klein, Scholten, whoever – will work for every other homeopath; that any of these unique perspectives on Hahnemann’s principles is somehow the only “true” one. The fact that this assumption is patently contrary to the principles of homeopathy somehow entirely escapes us. Yet to the extent that each teacher of method discovers something that throws more light on the fundamental principles, and attracts students of similar resonance to him/herself, there is validity and value in passing on perspectives and techniques. However, so much emphasis on the method itself seems misplaced. Few students find they have as much success with someone else’s method as the method’s originator, and again the prevailing assumption seems to be that they’ve somehow “failed” to fully grasp it or have otherwise got it “wrong”. That rationale is rather unsatisfactory. It doesn’t seem to fit what actually happens very well. What seems far more likely is that each of these homeopaths have not yet discovered their own unique homeopathic voice. It’s been said by others of a similar viewpoint that it generally takes around a decade of practice for that voice to emerge, which seems about right.

This is where our cherished notions about deterministic predictability fit in. It does indeed exist to some extent, but it’s relative, subjective, and contingent. It is not objective and absolute. (See the essay Holed in One for more on this subject.)

The widespread idea too that “success” or “failure” hinges purely on a combination of a deterministically predictable methodology and a proven materia medica that includes the “right” remedy seems to be guilty of leaving almost as much out of the equation as conventional approaches do, as well as being hidebound by the same Newtonian/Laplacian mindset. There is far more than just the methodology at work. Luc de Schepper draws attention to the practitioner’s own condition which is certainly part of the equation, but still falls prey to the assumption that deterministic predictability is valid on a generalised basis.

It seems to me that this continual castigation of each other for our collective “failures” to understand what Hahnemann was teaching really amounts to little more than an expression of “my way is the only way”, which in turn is a sophisticated abstraction of primate-ive and testosterone-fueled tribe-forming behaviour by dominant males. The fact that it’s behaviour that’s almost exclusively evident in the male members of the profession, Hahnemann included, speaks for itself. If we really care about healing people with homeopathy, we might be better putting our energies into exploring our very diversity and by so doing, draw some understanding of what’s really going on in the healing interaction.

“Let us admit what all idealists admit – the hallucinatory nature of the world. Let us do what no idealist has done – let us search for unrealities that confirm that nature. I believe we shall find them in the antinomies of Kant and in the dialectic of Zeno . . . ‘The greatest wizard (Novalis writes memorably) would be the one who bewitched himself to the point of accepting his own phantasmagorias as autonomous apparitions. Wouldn’t that be our case.’ I surmise it is so. We (that indivisible divinity that operates in us) have dreamed the world. We have dreamed it as enduring, mysterious, visible, omnipresent in space and stable in time; but we have consented to tenuous and eternal intervals of illogicalness in its architecture that we might know it is false.”
Jorge Luis Borges, ‘Other Inquisitions’



DISCLAIMER
Thanks to the current insanity revolving around homeopathy in this country, in both media and blogosphere, it's become necessary to insult your intelligence by explicitly drawing your attention to the obvious fact that any views or advice in this weblog/website are, unless stated otherwise, the opinions of the author alone and should not be taken as a substitute for medical advice or treatment. If you choose to take anything from here that might be construed as advice, you do so entirely under your own recognisance and responsibility.

smeddum.net - Blog: Confessions of a Serial Prover. Weblog on homeopathy, health and related subjects by homeopathic practitioner Wendy Howard