More Fun with Homeopath Dana Ullman, MPH(!)

[manioberoi]

Financing and organising long series of homeopathic trials

I see ... you have now moved on to the "defence by conspiracy theory" approach.

You are implying that "published materia medica" has deliberately with-held "all" studies that use accepted protocols and conclusively prove that homoeopathy works ... that is such obvious b@ll@cks of a smokescreen that I hope you are already embarassed by it - Did I denounce your long-winded and pathetic list because of where its contents were published? NO - I denounced the lack of proper protocols in those studies.

We have already described simple ways that you could convince us - these involve proper controls, not just rambling anecdotes. Homoeopaths are free to publish the results of properly controlled studies in the homoeopathic literature - yet no-one has done so ... I think even you can make the next logical step ...

You don't appear to be listening to, or understanding, the points being made to you by posters on this board ... if homoeopathy works - great - lets prove it and all move on to bigger and better things ... otherwise ...

Your latest invented obstacle .. the conspriacy theory ... should be consigned to the dustbin without further ado. I know you'll have another excuse coming ... shall we move on to it?

You have not considered the fact that in conventional medicine, the drug companies research the new drug and independent doctors at research facilities carry out the trials (in the ideal world the drug companies carry no influence on the trial even if they pay for them) with proper double blind controls & c.

Who pays for the trials - the drug companies - who then recover the cost (and more) from the sale of the drug.

As for homeopathic remedies the proving is done by any homeopath or homeopathic organisation.

Manufacture of homeopathic remedies is a relatively routine process requiring no excessive costs of safety trials & c. Once the proving is done no homeopath feels the necessity to carry out trials of effectiveness of the remedy. Even if he were to feel like carrying out a trial, such as has been suggested here the costs(in the region of 5 to 10 million dollars) would dissuade the richest homeopath from attempting this.

No homeopathic remedy manufacturer would agree to bear the cost since all single homeopathic remedies are FREE to manufacture and there are over 1000 manufacturers of homeopathic remedies worldwide.

So if this forum were to be serious about a long series of homeopathic trials, a little thought needs to be given on how to share out the costs among all the homeopaths and all the homeopathic remedy manufacturers worldwide - and set up an organisation to carry out such a series of trials.

 

[manioberoi]

Nobody (apart from you in your attempt to introduce this strawman) has suggested "chemically testing" the remedy. You claim that the remedy has an effect; it has been suggested that the remedy should be tested by trying to detect this effect.

In other words, people have been known to improve after taking it.

Some people are intolerant to lactose.

At 12C???

 

[krazyKemist]

Not at all - I was fully aware of non acceptance of ALL of the published materia medica and ALL of the homeopathic trials published in any journal except those which subscribe to the viewpoint (of the drug majors?) :

"that homeopathy is placebo and can never be proven to work and hence does not work and is a fraud."

Caution: that's conspiracy theory, that is. Remember ? "good journals are controlled by big bad pharmas ?"

If we start in this direction, we'll have to move this thread, you know.

the Kemist

 

[manioberoi]

Not if he actually CURED them.

The law will act EVEN IF he cured them.

Just as the law would act if it is proved that last month the 15 year old son of a surgeon in India (succesfully )operated a patient (who is not complaining) without the presence of an anaesthetist.

 

[krazyKemist]

You have not considered the fact that in conventional medicine, the drug companies research the new drug and independent doctors at research facilities carry out the trials (in the ideal world the drug companies carry no influence on the trial even if they pay for them) with proper double blind controls & c.

Who pays for the trials - the drug companies - who then recover the cost (and more) from the sale of the drug.

As for homeopathic remedies the proving is done by any homeopath or homeopathic organisation.

Yep. Definitely delving into conspiracy theory . That is a more than a little disappointing.

As we're speaking of monetary interest, do you think homeopaths would benefit if homeopathy is once and for all proven to be only placebo ?

the Kemist

 

[Badly Shaved Monkey]

I can undertand your frustration.

The conventional medicines are tagged with severe side effects and each causes some new disease, cancer, genetic damage, liver dysfunction, blood disorders, immue suppression and the like. EVERY prescription has a high cost of cure - one that the patient bears for the rest of her life.

However, applying the standards of proof that you use, we see that homeopathy can be fatal;

http://www.internationalskeptics.com/forums/showthread.php?t=85560

What do you say to that?

 

[fls]

Nevermind.

 

[Mongrel]

Manufacture of homeopathic remedies is a relatively routine process requiring no excessive costs of safety trials & c. Once the proving is done no homeopath feels the necessity to carry out trials of effectiveness of the remedy. Even if he were to feel like carrying out a trial, such as has been suggested here the costs(in the region of 5 to 10 million dollars) would dissuade the richest homeopath from attempting this.

Clinical trials for homeopathic remedies would be a lot cheaper. A read through of "An introduction to clinical trials". For the Phase II trials they sum it up as "the experimental study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety." (my bold). Repeat a couple of times to ensure the results are correct and you'll still have change from half a million, and given how much profit the manufacturers and manufacturers do make a year there must be a reason why the excuses get dragged out every time.

 

[Professor Yaffle]

I'm sorry, you can't use the excuse "we can't afford to do trials". Many trials HAVE been done. They have either been of low quality, had negative results, or been one of the few flukes to show positive results.

 

[Gord_in_Toronto]

The law will act EVEN IF he cured them.
<SNIP>

Where is this true? In Canada there have been a number of deaths of people (including fairly high profile people) who rejected real medicine to get treated by quacks. No one is charged. A person is seen as responsible for his/her own decisions.

Jehova Witnesses run out of blood all the time.

 

[SYLVESTER1592]

To the risk of repeating myself (and other people here), there is no need for a chemical analysis at this time. If you can prove that it works, using a double blind experiment with a placebo, then we can begin to work on what could be happening physically in the dilution ! Working the other way around is a loss of time and money, especially as we would have to look at an unknown piece of physics/chemistry !

An acceptable placebo would have to be unidentifiable by both the tester and patient as such. Plain, double-distilled, or reverse-osmosed water, the very same that is used for the dilutions without succussion, would be all right for me. Would it be for you ?

the Kemist

Where is this true? In Canada there have been a number of deaths of people (including fairly high profile people) who rejected real medicine to get treated by quacks. No one is charged. A person is seen as responsible for his/her own decisions.

Jehova Witnesses run out of blood all the time.

In the Netherlands. 3 doctors have recently been suspended for life, they didn't cure their patient and did not offer the conventional treatment but agreed to let the patient get the alternative treatment elsewhere instead. The patient died. The civil suit is still pending. If there will be a criminal suit is not clear.

I highly object to experimenting on patients without proper argumentation and supporting basic research. Our patients are not labrats. There are reasons why we make our clinical trials follow the phase I step first. You do not want to expose patients to something that is potentially harmful or has no effect. Placing it at an equal standard to conventional effective drugs will give doctors the opportunity or even the obligation to consider this unproven drug or treatment above other treatments and thereby denies the patient the proven cure.

Observation in clinical cases that show an effect, may lead to further investigation. This is how sometimes unproven drugs are rolled into a medical experiment anyway to confirm the effects. If they succeed in repeating the effects, further research is done to identify why it works. If the effects are not repeated, the treatment is rejected, end of story. To get it back of the ground again, you have to start at the basis and show how it could work, a probable mechanism and go through the phase I trial after doing all the basic science leg work. If patients choose to use a drug or it's used in experimental conditions overlooked and approved by the ethics committee with proper medical evaluation and back-up care to step in if the trial goes wrong, then maybe this is something that can be discussed. There has to be a reason to try it first.

I don't want to step on anyone's toes, but the question: "can the effects of homeopathy be tested or not?", still stands.

SYL

 

[Chris Haynes]

...I don't want to step on anyone's toes, but the question: "can the effects of homoeopathy be tested or not?", still stands.

SYL

Especially since Dana Ullman claims that homeopathy is a viable treatment for HIV/AIDS:
Controlled clinical trials evaluating the homeopathic treatment of people with human immunodeficiency virus or acquired immune deficiency syndrome.

He really needs to answer to this claim!

 

[Mojo]

Incidentally even Sac lac (the homeopathic equivalent of placebo has been known to cure - and I personally know a lady who gets the most terrible aggravation from Sac lac.

So I would take care to see that only water potencies (prepared from globules and not alcohol - as that could be smelt by the homeopath) are given in any trial and the placebo given to the control would be pure water(reverse osmosis purified) if I were to design any kind of homeopathic trial as is being suggested by this forum.

Some people are intolerant to lactose.

At 12C???

No, the lactose in the sugar pills. You were using this as a reason for using liquid preparations rather than pills, remember.

Incidentally, your objection to the use of alcohol in the preparation doesn't stand: as long as the placebo was made from the same solvent as the remedy, it would smell the same as the remedy.

 

[Mojo]

However, applying the standards of proof that you use, we see that homeopathy can be fatal;

http://www.internationalskeptics.com/forums/showthread.php?t=85560

Applying the standards of proof that homoeopathy uses, we've established that it's fatal in this very thread!

Post hoc ergo propter hoc.

 

[Badly Shaved Monkey]

Applying the standards of proof that homoeopathy uses, we've established that it's fatal in this very thread!

Post hoc ergo propter hoc.

Dammit, you're right. Regular users of homeopathy all die (eventually). There should be an enquiry.

 

[SYLVESTER1592]

Manioberoi, I have a tangent question:

Have there ever been tests between homeopaths to see which ones do best. Which individual homeopaths have the best track record? I know they give out prizes, but these don't say much about the results a homeopath achieves, but more about his/her popularity.

Could it be taught to a nurse or someone with a basic understanding of human physiology and disease? Or maybe to someone with very little knowledge of these?

What would you say is the basic skill of a homeopath?

I would also like to restate a question posted earlier but which did not recieve a reply:

Some homeopathic pharmacies enjoy higher reputations than others. Sometimes accidental exposure to sunlight / radiation may cause problems. Also there are more than one protocols / methods in use and full standardisation has not been achieved so far.

To get round this problem if a remedy is rightly selected and does not act as expected either another batch is used or a different (better?) manufacturer is used.

This is kind of like playing craps. You change the enchantment on the dice, ... You just keep throwing the dice 'till you get a seven. When you do... the therapy worked. When the patient gets impatient or starts to doubt the "therapy", you get rid of them by sending them to us. Is this how it works? Just curious...
If this still is a personalized optimalization of the remedy... Have there been tests of the difference in effect of the manufacturer or the batch used?

SYL

I can undertand your frustration.

The conventional medicines are tagged with severe side effects and each causes some new disease, cancer, genetic damage, liver dysfunction, blood disorders, immue suppression and the like. EVERY prescription has a high cost of cure - one that the patient bears for the rest of her life.

In homeopathy, provided a lower 'balancing' potency in the range of 6X to 6C (water) is used the effects are slow in coming up (for the first month) but the cure thereafter is increasingly perceptible and entirely without the kind of side effects stated above.

So even if the homeopath throws the dice successfully the seventh time (most good homeopaths manage it on the first or second throw) the patient will still be benefited more by homeopathy than by conventional medicne in a chronic disease.

"If this still is a personalized optimalization of the remedy... Have there been tests of the difference in effect of the manufacturer or the batch used?"

SYL

 

[krazyKemist]

In the Netherlands. 3 doctors have recently been suspended for life, they didn't cure their patient and did not offer the conventional treatment but agreed to let the patient get the alternative treatment elsewhere instead. The patient died. The civil suit is still pending. If there will be a criminal suit is not clear.

I highly object to experimenting on patients without proper argumentation and supporting basic research. Our patients are not labrats. There are reasons why we make our clinical trials follow the phase I step first. You do not want to expose patients to something that is potentially harmful or has no effect. Placing it at an equal standard to conventional effective drugs will give doctors the opportunity or even the obligation to consider this unproven drug or treatment above other treatments and thereby denies the patient the proven cure.

Observation in clinical cases that show an effect, may lead to further investigation. This is how sometimes unproven drugs are rolled into a medical experiment anyway to confirm the effects. If they succeed in repeating the effects, further research is done to identify why it works. If the effects are not repeated, the treatment is rejected, end of story. To get it back of the ground again, you have to start at the basis and show how it could work, a probable mechanism and go through the phase I trial after doing all the basic science leg work. If patients choose to use a drug or it's used in experimental conditions overlooked and approved by the ethics committee with proper medical evaluation and back-up care to step in if the trial goes wrong, then maybe this is something that can be discussed. There has to be a reason to try it first.

I don't want to step on anyone's toes, but the question: "can the effects of homeopathy be tested or not?", still stands.

SYL

True. You can't ethically test homeopathic remedies on patients whose life would be endangered by a delay in proper medication (ex.: cancer). However there is an exception in the law (in US at least) that permits it in terminal patients: compassionate use. It's been used before to allow testing on laetrile/amygdalin.

But barring that, the testing could be done on more bening illnesses, ex.: flu. I still can't see no reason testing couldn't be done. A 6 months test, as was proposed earlier, is not unusual for drugs. Testing costs would be greatly diminished if you consider that toxicity testing is not necessary, you don't need pharmacokinetics (nothing to measure there), AUC, ect. Basically, you remove all the costier lab work. What's left is writing a decent protocol for remedy/placebo preparation and tracking.

As to the funding matter, I'm not sure homeopathic remedy manufacturers are as poor as they would like us believe... I don't know how such things cost in India, but here in north america they're sold at a similar price to real medicine, and sometimes more !

the Kemist

 

[Gord_in_Toronto]

In the Netherlands. 3 doctors have recently been suspended for life, they didn't cure their patient and did not offer the conventional treatment but agreed to let the patient get the alternative treatment elsewhere instead. The patient died. The civil suit is still pending. If there will be a criminal suit is not clear.

I highly object to experimenting on patients without proper argumentation and supporting basic research. Our patients are not labrats. There are reasons why we make our clinical trials follow the phase I step first. You do not want to expose patients to something that is potentially harmful or has no effect. Placing it at an equal standard to conventional effective drugs will give doctors the opportunity or even the obligation to consider this unproven drug or treatment above other treatments and thereby denies the patient the proven cure.

Observation in clinical cases that show an effect, may lead to further investigation. This is how sometimes unproven drugs are rolled into a medical experiment anyway to confirm the effects. If they succeed in repeating the effects, further research is done to identify why it works. If the effects are not repeated, the treatment is rejected, end of story. To get it back of the ground again, you have to start at the basis and show how it could work, a probable mechanism and go through the phase I trial after doing all the basic science leg work. If patients choose to use a drug or it's used in experimental conditions overlooked and approved by the ethics committee with proper medical evaluation and back-up care to step in if the trial goes wrong, then maybe this is something that can be discussed. There has to be a reason to try it first.

I don't want to step on anyone's toes, but the question: "can the effects of homeopathy be tested or not?", still stands.

SYL

True. You can't ethically test homeopathic remedies on patients whose life would be endangered by a delay in proper medication (ex.: cancer). However there is an exception in the law (in US at least) that permits it in terminal patients: compassionate use. It's been used before to allow testing on laetrile/amygdalin.

But barring that, the testing could be done on more bening illnesses, ex.: flu. I still can't see no reason testing couldn't be done. A 6 months test, as was proposed earlier, is not unusual for drugs. Testing costs would be greatly diminished if you consider that toxicity testing is not necessary, you don't need pharmacokinetics (nothing to measure there), AUC, ect. Basically, you remove all the costier lab work. What's left is writing a decent protocol for remedy/placebo preparation and tracking.

As to the funding matter, I'm not sure homeopathic remedy manufacturers are as poor as they would like us believe... I don't know how such things cost in India, but here in north america they're sold at a similar price to real medicine, and sometimes more !

the Kemist

Adult, mentally compeptent patients always have the right to accept or reject treatment. Jehova's Witnesses regularly refuse blood transfusion. No one gets sued. Though, in the Dutch case, the issue seems to be that doctors were, err, mistaken about the efficacy about the "alternative" treatment they recommended.

Patients very often reject real medicine and stagger off to woo frauds to get phoney treatment. Where are the current users of homeopathy that have been cured of syphilis? If the quacks kept proper records, the proof would be available (or not, as the case may be). As it would be for any of the "alternative" cancer cures.

 

[SYLVESTER1592]

True. You can't ethically test homeopathic remedies on patients whose life would be endangered by a delay in proper medication (ex.: cancer). However there is an exception in the law (in US at least) that permits it in terminal patients: compassionate use. It's been used before to allow testing on laetrile/amygdalin.

In the Netherlands it is largely frowned upon in palliative care, but a trial as complementary treatment could be conceivable. As an alternative treatment, replacing pain medication, it is hardly ethical, so that in my opinion is a definite No No. I don't know how things works in the US and Canada, but I imagine the sentiment would be the same. Homeopaths in the Netherlands have told some of their patients after they had already left the hospital that paracetamol is enough to kill the pain in combination with the homeopathic treatment. To say this to a slowly dying terminal patient in severe pain... Well, I think you can imagine what I what I would like to do (and I'm not just talking about the patient).

But baring that, the testing could be done on more bening illnesses, ex.: flu. I still can't see no reason testing couldn't be done. A 6 months test, as was proposed earlier, is not unusual for drugs. Testing costs would be greatly diminished if you consider that toxicity testing is not necessary, you don't need pharmacokinetics (nothing to measure there), AUC, ect. Basically, you remove all the costier lab work. What's left is writing a decent protocol for remedy/placebo preparation and tracking.

Actually, you just mentioned an illness that will clear up by itself and for which there is no treatment of the cause but only supportive treatment. So test away...
The timeline of the test needs argumentation, as would the reason to treat a patient.
The argument is, you need to show that there is a reason to test a drug on a patient. The reason (most often) could be that laboratory test showed a promising effect of the drug on animals or cell culture. Another reason could be that the drug was designed for another illness but has shown a promising effect that had not been recognized before. Yet another reason could be that many case reports led to a small patient group presenting beneficial effects of an formerly unknown substance. This has happened in the case of homeopathy, but the following trials failed to show a conclusive or even promising result under careful scrutiny by peers in the medical world. This normally means further research is shelved. But you don't start testing on patients first and analyze later. That is something you do in the lab on animals or cell culture. Even if the new drug is only a derivative of a already known drug, testing normally starts in the lab. I understand very well that you believe it is all bunk and they are only getting water anyway, so there would be no problem. But by subjecting patients to a trial, they have to follow the trial protocol. This means the patients are subjected to tests and a regimen that is often an infringement on the normal care given by their physician. For a benign problem (something you would encounter in a General Practitioner's office on a Monday morning) this can probably be done and the burden of the trial can be minimized. For more serious disease it becomes another story and I would have serious problems with the reasons for such a trial.

In general: A drug that does not work in the lab, does not make it to the patient.

( On a side note: I think some of the few exceptions where shortcuts were taken and testing in humans started long before labtests were finished were trials done by Bayer in WWII and more recently trials done on HIV patients in Africa, but I think we can agree this should not be considered normal )

SYL

 

[SYLVESTER1592]

Adult, mentally compeptent patients always have the right to accept or reject treatment. Jehova's Witnesses regularly refuse blood transfusion. No one gets sued. Though, in the Dutch case, the issue seems to be that doctors were, err, mistaken about the efficacy about the "alternative" treatment they recommended.

True. I think you are right about that.

However, we also have the WGBO, this is a law that regulates the agreement between patients and doctors about their treatment. It has a lot of duties for doctors, but one right. The right to determine the treatment for the patient. If the doctor decides to give blood anyway in case of emergency, he can't be touched. In general any doctor will do everything to keep their word to their patient. The Jehova's in the Netherlands have already stated that if the doctor makes this decision against their wishes they will accept it, but they can not accept it in advance, willingly. Doctors try to take other precautions to avoid giving blood and choose conditions that will avoid the necessity of supplementing blood. If he refuses to give blood because of the patient's religion this needs to be recorded, argumented and defended. He can still be judged by his peers.

SYL