I appreciate your genuine concern for my homeopathic soul. I guess I will have to keep living in my alternate reality, helping people not helped by those living in your vastly superior one (I love to catch all of those regressions to the mean just in time; evidently the medical community has less talent in this game).

You have still not given me the incontrovertible criteria that you so adamantly demand. Evidently they cannot be produced, and it is therefore not surprising that in all your years of demanding them they haven’t been satisfied, as they couldn’t be even if homeopathy were real.

As far as I can tell, you don’t seem to have, in all your years of evaluating homeopathy, spent appreciable time in a clinical setting with a senior homeopath and engaged in long-term observation of chronic cases — as I said this is the only way that a die-hard skeptic would potentially be able to gather the necessary evidence to perturb one’s conviction. Then you might have remained skeptical, but you would have had other, far more concrete and convincing reasons on which to base your case, as opposed to the theoretical dismissals that you keep offering.

Regarding studies, your confident pronouncements (whereby you parse studies for quality by their conclusions) are simply ludicrous. They are nothing more than a personal reading in the spirit of Shang et al.: “I will assume that all positive results could be explained as [insert criticism here]“. You are obviously not open to a chain of reasoning in which the consequence is yet-undetermined, as yours is predetermined.

I will end my participation in this thread here; feel free to add a coup de grace.

3. I have not dismissed articles in mainstream journal without proper argument. Give me one example, where you have read the full-text and are prepared to defend it and I will go through that paper with you, but bear in mind that the lesson of the meta-analyses has been that there exist no homeopathic papers showing positive results for homeopathy which can bear proper scrutiny or are anything other than statistical anomalies. But, please feel free to look for one.

1. We know the homeopathic literature is untrustworthy, but I don’t expect it contains many outright lies. If you can come up with a properly documented case record of the type I have described then it would be interesting. So far you have not even made the attempt.

2. I dismiss your first hand evidence as unimpressive because it is unimpressive and conforms to a standard pattern: the homeopath one is talking to only has rather feeble cases available, but they’re sure they’ve heard of someone or read something once that should a really dramatic cure of cancer/rabies/AIDS (delete as appropriate).

3. I have not dismissed articles in mainstream journal without proper argument. Give me one example, where you have read the full-text and are prepared to defend it and I will go through that paper with you, but bear in mind that the lesson of the meta-analyses has been that no homeopathic papers exist which can bear proper scrutiny or are anything other than statistical anomalies. But, please feel free to look for one.

4. This point requires an understanding of the statistics at play in these papers. The point I was making, however is that homeopathy claims strong reliable real effects in patients. The mere fact of having to hunt for tiny effects in the statistical noise disproves the main claims of homeopathy. For instance, one of the papers of Oscillococcinum did manage to find a p value of “So, I see no reason not to present you with a requirement to come up with a homeopathic cure for something like cirrhosis of the liver. After all, in Hahnemann’s day that would have been a patient suffering dropsy, lethargy and fatty pallid stools.
Or how about AIDS. Homeopathy has no place for the germ-theory of infection, so it makes no difference to you whether we can measure HIV in the bloodstream and monitor CD4 cell counts, you just have a fevered patient losing weight with a mysterious red skin rash to deal with. How many of those has homeopathy fixed?
Or breast cancer with spread to lymph nodes.
Or macular degeneration.
Or Type 1 diabetes.
If you are going to start placing limitations on what homeopathy says it can cure then you’re going to have to reject an awful lot of your historical literature.”

I will repeat again that it is only since the advent of modern medicine that the clinical syndromes and symptom-pictures with which such patients present would lead to an untreatable conventional diagnosis. Patients always had these diseases we just didn’t have the means to apply the current set of labels to them. Throughout homeopathy’s history these patients would simply have received remedies targeted at the symptoms. So, I specifically do not allow you to shy away from diseases that conventional medicine calls ‘untreatable’. Homeopaths pretend to treat AIDS and cancer, it would be futile for you to deny this. So, please come up with a properly documented case, or learn something from your inability to do so.

David, I have spent years honestly evaluating the evidence advanced by homeopaths. All I have found have been misrepresentations, lies, confusion and mainly badly designed studies. I have found some good studies: these are negative. There have been a number of attempted provings done under properly controlled conditions rather than the joke protocols that homeopaths usually call controlled. These have been done by homeopaths. Look these up. They have all been failures. Why? Because homeopathic “provings” are works of the imagination not recordings of genuine facts.

Here’s a short list. All done by homeopaths. The failures by Harald Walach seem to have driven him to declaring that homeopathy works by magic at which point homeopathy and reality finally part company for the last time.

Brien et al Ultramolecular homeopathy has no observable clinical effects. A randomized, double-blind, placebo-controlled proving trial of Belladonna 30C B J C Pharm, 56, 562-568. (2003)

Walach et al The effects of homeopathic belladonna 30CH in healthy volunteers – a randomized, double-blind experiment. J Psychosom Res 50 155-160. (2001)

Vickers et al Can homeopathically prepared mercury cause symptoms in healthy volunteers? A randomized, double-blind placebo-controlled trial. J Alt Comp Med. 7 141-8. (2001)

Goodyear et al Randomized double-blind placebo-controlled trial of homoeopathic ‘proving’ for Belladonna C30. J R Soc Med 91 579-82. (1998)

Walach Does a highly diluted homeopathic drug act as a placebo in healthy volunteers? Experimental study of Belladonna 30C in a double blind crossover design – a pilot study. J Psychosom Res 37 851-860. (1993)

This is your literature, David, you should have been familiar with it.

You are a young man with a long career ahead of you. Go and do something useful with your life instead of wasting it on the pack of lies that is homeopathy. It’s a big interesting world out there. All homeopathy does is force you to view it through distorting lenses. That is not healthy and it is a sad waste of one’s life, which may be why we see such desperation when it is challenged.

Your disingenuousness and dogmatism are transparent:

1) You have already concluded that the homeopathic literature is untrustworthy, yet ask for documented cases as evidence that you will consider.

2) Given (1), you nevertheless dismiss first-hand evidence I provide as unimpressive, without justification. (You don’t want untrustworthy case records; you don’t want me to refer you to other living authorities; and you dogmatically assert that my first-hand evidence is irrelevant, leaving my reply to your reasoning unanswered.)

3) You likewise dismiss studies published in your own prestigious journals without proper argument (I guess this implies you mistrust the peer review process; fine, but be consistent and reject all clinical research published in those journals).

4) You privately misinterpret weak positive evidence as negative evidence (“all effects are lost in teh statistical noise” — no, it’s precisely the point that despite statistical noise all effects are not lost!). You are freely applying the Shang et al. attitude, all the while refusing to provide your defense of this paper against my charge of data-dredging — yet you continue to apply the dogma perpetuated by that very trial in your own argument (if I may dignify it thus).

5) You repeatedly ignore my request to provide a full specification of the criteria to be fulfilled by incontroverible clinical evidence.

So, until you are able to provide me with “just one incontrovertible example of a set of criteria that will oblige you to accept evidence in case they were fulfilled”, please do not ask me for any evidence. Until you are willing to honestly evaluate studies on both sides of the debate, please do not ask for such evidence, either.

If you want peer reviewed studies, I reference four in comment #26 above, which I was a little disappointed that no-one responded to.

Which werel;

RCTs I’ve read that show efficacy for homeopathy include:
Jacobs et al, “Treatment of Acute Childhood Diarrhea with Homeopathic Medicine: A Randomized Clinical Trial in Nicaragua,” Pediatrics, Volume 93, Number 5, pp. 714-725 (May 1994)
Jacobs et al., “Homeopathic Treatment of Acute Childhood Diarrhea: Results from a Clinical Trial in Nepal,” Journal of Alternative and Complementary Medicine, Volume 6, pp. 131-139 (2000)
Gibson et al., “Homoeopathic Therapy in Rheumatoid Arthritis: Evaluation by Double-Blind Clinical Therapeutic Trial,” British Journal of Clinical Pharmacology, 9, pp. 453-459 (1980)
Taylor et al., “Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series,” British Medical Journal, 321, pp. 471-476 (19 August 2000)

All rubbish. Badly defined end-points. Badly designed controls. All the usual things.

Now, I’m perfectly willing to believe that homeopathy is complete hogwash, and stick to remedies like pharmaceuticals, nutritional advice, botanical medicine, counseling, etc.

I think you mean imperfectly.

Linde revised his findings, but the homeopaths only quote the 1997 version with flawed results not the revision. Both Linde and Kleijnen at best offer very weak support for homeopathy which basically says any effects are lost in the statistical noise and this is what we would expect for a placebo not what we would expect for this allegedly all-conquering therapeutic system.

If you want individual cases, come on, don’t ask for cures of type I diabetes or end stage renal failure.

I think you have just disqualified yourself from comment. Let me remind you that homeopathy originated in a world in which no such diagnoses could have been made. All the homeopath would have would be the symptoms the patient told him about. So, we now might be able to determine that the patient has cirrhosis, but the homeopath would only have seen ‘dropsy’ and ‘jaundice’. As I said to David previously, you as a homeopath are disallowed modern medical diagnostic methods. If you insist on acting in accordance with modern diagnoses then you must reject as utter fiction the vast bulk of your historical case records. Why? Because historical homeopaths were treating just these end-stage patients that modern medicine can accurately describe but reporting alleged successes regardless. This, if any more was needed, should tell you that the homeopathic literature is just a work of the human imagination, having no more bearing on real medicine than astrology.

I would remind you that homeopathy is supposed to be a “complete system of medicine” not a system restricted to dealing in trivia.

As of right now, I imagine that when I graduate, I’ll be inclined to try homeopathy when my patients are kids with diarrhea, or arthritis or rhinitis sufferers. Or, for that matter, kids with otitis media, which I hear I’ll probably see a lot.

So no danger of having your prejudices and preconceptions challenged. That’s just hopeless.

So, you’ll take money for treating self-limiting conditions that fluctuate or resolve spontaneously. Very honourable. Not.

David said;

Yes, there is a small number of cures of rabies in the homeopathic literature, which are available to all for inspection

OK, then cite one properly documented case. Unless you can do that I shall file this along with the other Big Fat Lies that have to be told to keep homeopathy’s show on the road.

Your point about pathology being produced in provings shows that you are ignorant of the fact that the remedy picture is not merely made up of the proving (again, this is the “consumer’s guide” first-approximation explanation), but also on toxiocological data where available, and also on cured cases thereafter.

Forgive me, but that is just utter bollocks. Even if it were not close to being a literal untruth, it would still be bollocks, because accumulating ‘cured cases’ in the completely non-systematic way of homeopaths is no evidence of anything. This is your whole problem. You think you have this marvellous secure evidence base but are so blinkered in your belief that you cannot see it has been knitted from fog.

Where is the toxicological data for “Light of Venus” or “Peregrine Falcon”? Pull the other one, it has bells on it- being an attractive English idiomatic phrase expressingly cynical disbelief.

Your point about pathology being produced in provings shows that you are ignorant of the fact that the remedy picture is not merely made up of the proving (again, this is the “consumer’s guide” first-approximation explanation), but also on toxiocological data where available, and also on cured cases thereafter.

I’ve earlier given examples of what should be considered impressive results, which you dismissed without providing the criteria on which you based your dismissal. Another reader provided examples that were likewise dismissed by someone else.

Yes, there is a small number of cures of rabies in the homeopathic literature, which are available to all for inspection. I don’t, however, see the point of presenting them to you only for them to be dismissed as fraudulent, misdiagnoses, etc.

As I’ve mentioned above, you already know the truth even though you are obviously ignorant of the clinical reality of homeopathy, and so there is no point in furthering our debate.

As I have just pointed out to David, no one is claiming that the effects of homeopathy are all placebo. There is probably a modest placebo effect in some illnesses but not in the majority of significant physical medical conditions. The idea that it is all placebo effect is merely a cover to allow you to hide the real mendacity of the homeopathic community. No, the real processes behind most homeopathic tales of successes are simply lies or misunderstanding of the natural history of disease so that coincidental changes are reported as success for homeopathy or real outcomes are concealed or justified by one of the set of excuses that homeopathy provides.

If you are a homeopath, will you have the honesty to tell us whether you have ever cured a major physical disease or whether you piddle around with trivial lifestyle conditions like most homeopaths and/or piggyback your practice on the expectation that asthma or eczema or irritable bowel syndrome will fluctuate into improvement phases for which you an claim credit?

“For you to suggest that I have no right to refer to pathology is therefore ridiculous.”

I’m afraid the subtlety of the point was lost on you.

Perhaps you might like to produce me an example of a proving in which histologically confirmed end-stage renal fibrosis was produced by the remedy until consideration. Once you have done that then I will accept your point that conventional pathological descriptions of disease can have some meaningful part to play in your interventions.

I’m afraid you have fallen into the trap along with all other homeopaths of apeing the mannerisms of conventional medicine in order to appear credible but without understanding that you cannot logically apply it by your own rules.

That homeopaths do not understand their own philosophy and express mutually contradictory and internally contradictory versions of it is something I have seen time and again. The reason for this is that all of you are basically trading in fictions that do not intersect with the real world and can say anything you like without fear of contradiction because your approach to medical cases renders you incapable of forming valid judgements. Remember, homeopathy is just a set of excuses not a system of medicine.

“You coudn’t ever convince me homeopathy has no effect as I have personally witnessed dramatic, immediate effects after giving homeopathic remedies, including on animals and babies, where placebo cannot possibly be an explanation.”
You keep repeating this strawman. Please understand this once and for all. I think the place for placebo in most of homeopathic practice is vanishingly small. Most reported improvements are either coincidental or misrepresentations of the truth.

The idea that the placebo effect may be important is a sop thrown to homeopaths to allow them to leave the field with a little dignity intact. If you had real effects then you would find it very easy to answer the question;

GIVE ONE, YOU ONLY NEED ONE, INCONTROVERTIBLE EXAMPLE, WITH REFERENCES, OF HOMEOPATHY CURING A NON-SELF-LIMITING CONDITION.

The fact that you can’t even come up with a half answer should tell you something.

But if you’d like a specific example to narrow the field, show me a cure of AIDS or metastatic melanoma or end-stage renal failure or Type 1 diabetes or Addison’s disease or rabies.

How do you conclude I have a closed mind? I am a doctor of philosophy, and will reconsider my opinion based on the evidence. You state that nothing could change your mind – is that the very definition of a closed mind?

Also, why do you use the word allopathy? Doesn’t this show an inherent bias?

I’m afraid your experience counts for nothing unless you have scientifically documented it and carried out properly conducted scientific studies.

You have added nothing new to this debate and repeated the worn clichés that have already been addressed many times here and elsewhere.

Why, if it so miraculous, does homeopathy score no better than placebo in all well conducted scientific studies? (Please don’t use quantum theory to support your arguments.)

Well, it doesn’t surprise me to hear you say that, however BSM asked for an individual example and that is what i gave. Obviously, no single case in either homeopathy or allopathy could offer *incontrovertible* proof. It would seem rather futile to debate with someone who already has a closed mind, but i’m not sure what ‘reasons discussed above’ you are referring to…. unless you mean David’s comment to BSM: ‘Your contempt for everything homeopathic precludes you from impartially investigating the issue.’

You coudn’t ever convince me homeopathy has no effect as I have personally witnessed dramatic, immediate effects after giving homeopathic remedies, including on animals and babies, where placebo cannot possibly be an explanation.

In fact, regards the much touted theory that homeopathy is nothing but placebo, I have always wondered why patients who have been failed by allopathic medicine, and who have tried other alternatives before they finally get to homeopathy, suddenly report feeling better. If they are so prone to suggestion, why didn’t they get better after allopathic treatment or the previous therapies they tried? Do they get to the homepath’s consulting room and suddenly come over all gullible?

I have patients who, after years of psychotherapy, make huge progress very quickly after beginning homeopathic treatment. If it was just an effect of counselling, why didn’t years of psychotherapy cure them? (Incidentally, in my experience homeopaths do not counsel – they just listen to the patient’s story and record their symptoms.)

Like, David says, I don’t blame people for being skeptical – I used to work in conventional medicine myself -but when you have seen such miracles occurring ‘coincidentally’after homeopathic treatment time after time, you really have to start believing in it.

What would it take to convince you homeopathy has no effect?

i know you only asked for one, but i’m in a good mood, so here are 2 cured cases i found after a 2 minute google:

graves disease:
http://www.hpathy.com/casesnew/schepper-lachesis.asp
.asp

chronic pancreatitis (80% reduced function)
http://www.hpathy.com/casesnew/barvalia-kali-iod.asp

you’ll generally find the indian homeopaths have more cases of serious pathology than homeopaths in the uk (for obvious reasons).

if you’d like more, there are plenty on the site above, plus i suggest you refer to the spring 07 edition of ‘The Homeopath’ (25:4) particulary Banerjea, ‘Pathology & Homeopathy’ pp122-125, which includes cases of cerebral atrophy & abdo tumour.

Very well written and you make excellent points.

Thanks!

While pathology is not an important diagnostic factor — most of the time other, more specific symptoms will trump it in the hierarchy of important symptoms to consider — it is a crucially important prognostically, as the same symptom may be curable or not depending on pathological basis. In contemporary homeopathic practice the vast majority of patients have ben diagnosed and rediagnosed before ever arriving at homeopathy, whereas historically many homeopaths were MDs versed in the diagnostic tools of their day. For you to suggest that I have no right to refer to pathology is therefore ridiculous.

Your claims about the AS and MS examples being easily explicable by other factors is baseless: I recognize that my case descriptions were brief, but they were enough to suggest that these were fairly severe cases. The AS patient was in a wheelchair and remained so for the first 2 years of treatment. The MS patient was also in a wheelchair with complete lower-body paralysis (not just weakness or spasticity) and her breathing was beginning to be compromised as the diaphragm was being threatened with paralysis — this is by any measure a severe case. Please provide case examples of remissions from these states rather than claim that they could easily happen. Likewise please provide examples of medical treatment leading to remission and decalcificaiton of a fused spine. The requirement for providing evidence falls on both parties.

Given your craftiness, it is perfectly reasonable for me to request specific requirements for the sort of evidence you would like me to profer. It is interesting, for example, that you consider AIDS a non-self-limiting pathology but the cases I described are. Where do you get this division from? Do refer me to an evidence base.

Anyway, my impression is that you are not in the business of “inference to the best explanation” but, just like Shang et al., are doing “inference to the best explanation of the phenomenon that excludes homeopathy”, which means you are not open to the possibility that the best explanation includes homeopathy as you consider it prima facie out-of-the-question. I therefore suggest that we end it here, unless I see an indication that you are willing actually to enter into a debate which you haven’t, thus far, entered.

I would also say David, that having debated homeopaths of a number of years, I will commend you on at least making an effort and accepting the responsibility for trying to make your case.