With thanks to the Deccan Chronicle 29.6.11:

The rivalry between allopathy and homeopathy has now assumed a filmy turn. A registered pharmacist has filed a public interest litigation in the Kerala High Court seeking to ban Malayalam movie Kana Kombathu saying it was creating an unnecessary scare about allopathy medicines. The petitioner, Mr Karakkad Rajasekharan Nair, said the film created the impression that even popping a paracetamol pill will give you deadly diseases in the long run.

“Its dialogues are aimed at portraying modern medical science as a demonic phenomenon and pharmacists and doctors as agents of imperialism,” he said. “The film says that allopaths are out to kill people.” Mr T.M. Subasah, the petitioner’s advocate, said the film, scripted by Madhu Muttom of Manichaitrathazhu fame, ended with the heroes triggering an explosion destroying a pharmaceutical factory. “The character played by Manoj K. Jayan then says that our society does not need allopathy and can survive with traditional medicines,” said Mr Subash.

The advocate added that on inquiry, he found that Kana Kombathu was produced by a homeopathy doctor who was also involved in running a homeo medicine firm. Mr Subhash said that the PIL had been filed before the HC Chief Justice citing section 5 of the 1952 Cinematography Act relating to defamation. The film, directed by newcomer Mahadevan, stars Mythili, Biju Menon, Nedumudi Venu, Suraj Venjarammoodu and cricketer Sreesanth’s brother Deepu along with newcomers.

The NHS is right to fund homoeopathy. S Clare Stanford, reader in experimental psychopharmacology, Department of Neuroscience, Physiology, and Pharmacology, University College London. c.stanford@ucl.ac.uk. BMJ 2011; 342:d2642 doi: 10.1136/bmj.d2642 (Published 4 May 2011)

The campaign to expel homeopathy from the NHS continues unabated despite a position statement from the Department of Health: “We believe in patients being able to make informed choices about their treatment, and in a clinician being able to prescribe the treatment they feel most appropriate … which includes … homeopathy.”

To put this skirmish into perspective, the NHS spends about £4m (€4.5m; $6.6m) a year on homeopathic prescriptions, which is peanuts. Even if subsidiary costs are rolled in, this battle is clearly more about winning a scientific argument, and protecting patients from themselves, than preserving NHS coffers.

To avoid being misrepresented, let me be clear that I am not pro-homeopathy. I would not use homeopathic preparations myself, and I do not believe that they have actions that can be measured in vitro.

So should homeopathy be available on the NHS? Absolutely. That is not to say that all alternative treatments should be funded by the state. Homeopathy within the NHS is an historical accident. By analogy, most people can live with the fact that nicotine and alcohol are exempt from the Misuse of Drugs Act.

I agree that the scientific explanation for homeopathy is implausible. However, I note that the Nobel laureate, Luc Montagnier, is open minded on the issue and is being pilloried as a consequence. He must feel like Galileo.

To condemn a treatment because the proposed mechanism of action does not fit scientific dogma has a rather Soviet feel to it.

In any case, the mechanism is a red herring: we do not need to understand how drugs work before prescribing them, which is just as well.

The main argument against the NHS funding homeopathy is that “patient satisfaction can occur through a placebo effect alone and therefore does not prove the efficacy of homeopathic interventions,” according to the fourth report of the House of Commons Science and Technology Committee.

In short, the NHS should not pander to patients’ irrational beliefs, with an acknowledgment that homeopathy triggers a placebo response that can be beneficial. To infer that these treatments lack efficacy, they would have to offer less “satisfaction” than placebo. I am not aware of any evidence to support that claim, with the possible exception of a dubious study carried out on wounded soldiers in St Petersburg in 1829.

Given that patients’ treatment response is influenced by their expectations, homeopathy can be regarded as a so called thinking therapy at the least. In other contexts, cognitive therapies are championed for their apparent efficacy without any drugs at all. In fact, some of the same campaigners who deride homeopathy as a placebo response also assert that a placebo response accounts for the therapeutic effects of antidepressant drugs.

This contradiction exposes a double standard in the interpretation of evidence, propped up by prejudice.

Clearly, there is a need for more stringent criteria for comparisons of efficacy.

If homoeopathy is a hoax then patients who believe it is beneficial must be deluded. It follows that their medical complaints are also an illusion or resolve spontaneously. These patients will not take kindly to being told that there is nothing wrong with them.

Prescribing homeopathic treatments in such cases would be a problem if they were potentially toxic. Thanks to a recent experiment, in which campaigners consumed industrial quantities of homeopathic preparations, we can be confident that these treatments are harmless—at least in the short term.

If they were banned from the NHS, an obvious alternative would be to prescribe conventional drugs. These will be more expensive and have real side effects, some of them potentially harmful.

This is not desirable when clinicians are already accused of playing fast and loose with prescription drugs and of medicalising problems that do not need treating.

Another complaint is that homeopathy is used when patients need conventional drugs. Such medical neglect will not be resolved by homeopathy’s expulsion from the NHS. The current position optimises opportunities for responsible practitioners to refer patients for more appropriate treatment, if necessary. A good example of that practice is the (former) Royal London Homeopathic Hospital, which was cowed into changing its name after relentless battering from campaigners. A seamless switch to conventional medicine will be impossible if homeopathic treatments are available only on the high street.

All this will enrage homeopaths, who assure us that they do not deceive their patients and agree that prescription of any old thing is unethical. Both they and their critics are ignoring the difference between homeopathy and the intentional administration of an inert pill. Only in the former case do patients and practitioners believe that the treatment works. This paired belief will influence clinical outcome, which is precisely why we need double blind clinical trials.

Even if homeopathy does trigger merely a placebo response, its provision by the NHS still makes sense on grounds of safety, tolerability, efficacy, and cost. I am convinced that the National Institute for Health and Clinical Excellence would have concluded that it is thoroughly good value for money.

The New Coalition Government rejects the petition to implement the Science and Technology Commission on Homeopathy Fourth Report of Session 2009-2010 on 18.2.11:

The new Government considered the findings and recommendations of the House of Commons Science and Technology Committee and has published a full response.

The Department of Health will not be withdrawing funding for homeopathy on the NHS, nor will the licensing of homeopathic products be stopped.  Decisions on the provision and funding of any treatment will remain the responsibility of the NHS locally.

A patient who wants homeopathic treatment on the NHS should speak to his or her GP.  If the GP is satisfied this would be the most appropriate and effective treatment then, subject to any local commissioning policies, he or she can refer them to a practitioner or one of the NHS homeopathic hospitals.

In deciding whether homeopathy is appropriate for a patient, the treating clinician would be expected to take into account safety, clinical and cost-effectiveness as well as the availability of suitably qualified and regulated practitioners.  The Department of Health would not intervene in such decisions.

The Department’s response to the Science and Technology Committee report explains the reasons behind its decisions in more detail.  The response can be found on clicking on the following link:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4006368

See The Government defends the right to homeopathy on the NHS

See If you love homeopathy don’t vote Liberal Democrat

See Homeopathy: British Justice or British Bullying?

With thanks to Jenny Hope at the Mail Online 29.10.10:

Homeopathy really does work and doctors should recognise its healing effects, say researchers. A study found that allergy sufferers who were given homeopathic treatment were ten times more likely to be cured than those given a dummy pill instead.

Doctors should be more positive about the alternative medicine, which is the only complementary therapy available on the NHS, the researchers said.

Their study attempts to settle the controversy over homeopathic treatment, which critics say is not effective because of the tiny level of active substance used in most remedies.

It works on the principle that a substance which in large doses will cause the symptoms of an illness can be used in minute doses to relieve the same symptoms.

Critics argue that the active substance is so diluted that homeopathic remedies have no more effect than placebo or dummy treatment.

The study put homeopathy to the test in 50 patients suffering from nasal allergies. They were given either a homeopathic preparation or a placebo.

Each day for four weeks patients recruited from general practices and a hospital in London measured their nasal air flow and recorded symptoms such as blocked, runny or itchy nose, sneezing or eye irritation.

Both groups reported that they got better – but on average patients who received homeopathy had a 28 per cent improvement in nasal air flow compared with 3 per cent among those in the placebo group.

The study was carried out by doctors in Glasgow, led by Dr David Reilly of the Glasgow Homeopathic Hospital, one of five specialist hospitals in Britain. He said the difference in results from the two treatments was statistically significant.

Dr Reilly said this was the fourth trial carried out by his hospital, all with similar results. In addition, there were positive findings in 70 per cent of a further 180 clinical trials.

‘I hope this will encourage doctors to examine the volume of evidence supporting homeopathy – they might be quite surprised at the positive outcome in many trials,’ he said.

He added that it would take consistent scientific investigation to persuade some doctors, but attitudes were changing. About 20 per cent of doctors in Scotland have basic homeopathic training compared with one per cent 15 years ago.

‘It isn’t just about the remedies, which can be put to the test in trials, but about a greater holistic approach in encouraging self-healing and self-recovery.’

Dr Bob Leckridge, president of the Faculty of Homeopathy – the body for doctors, vets, nurses and other health professionals – said: ‘This latest research builds on existing evidence that homeopathy works, something that hundreds of doctors and their patients have known for 200 years.’

With thanks to Dana Ullman, MPH, here is another of his striking articles written to protest about spin, bias and yellow journalism:

Medical Fundamentalists Prove (again) How They Misinform the Public about Homeopathy… by Dana Ullman:

The medical fundamentalists (the “denialists”) have again shown their strong propensity to spread misinformation about homeopathy and homeopaths.

On September 7, 2010, Andy Lewis (who arrogantly enough calls himself the “Quackometer”) declared in a headline for his blog: An Obituary: Royal London Homeopathic Hospital, 1849-2010.

Another denier of homeopathy, appropriately called “Gimpy,” provided a little more accuracy in his headline, Farewell to the RLHH, hello to the RLHIM.

However, both “reporters” provided a highly selective interpretation and significantly biased analysis of the re-naming of the Royal London Homeopathic Hospital to become the Royal London Hospital for Integrative Medicine.

This misinformation is akin to creating an obituary for a caterpillar, even though it did not die but simply evolved into a butterfly.

Rather than mourn the death of a caterpillar, we should all be CELEBRATING the birth of a caterpillar, and likewise, we can (and are) celebrating the birth of the Royal London Hospital for Integrative Medicine, which is the new name for this important hospital.

Sadly (and strangely), the medical fundamentalists love to mis-characterize homeopathy and homeopaths. They often purposefully over-simplify what homeopathy is and isn’t, and they love to spin any potentially positive report on homeopathy in negative ways.

This form of yellow journalism is typical of the reporting on homeopathy by this group of denialists. The fact of the matter is that a large number of homeopaths integrate various natural therapies into their practices, and it is therefore not surprising and disconcerting at all that the Royal London Homeopathic Hospital would evolve into an integrative medical hospital. In fact, one could even assume that this evolution, like most evolutionary trends, was predictable.

Also typical of the medical fundamentalists are their mis-use of science and statistics. For instance, these medical fundamentalists were behind the recent report on homeopathy issued by the House of Commons’ Science and Technology Committee. This report had the sheer audacity and the paucity of medical and scientific integrity to suggest that there is no research to show that homeopathic medicines have a beneficial effect beyond that of a placebo. This ilk of deniers find that by repeating a lie often enough, they and others will actually believe them (as is commonly observed on certain American television news channels).

It is not surprising that the leading organization that worked to support and popularize the Science and Technology Committee’s report on homeopathy was the infamous organization Sense About Science, a non-profit organization whose funding primarily comes from Big Pharma. The fact that the leader of this organization previously worked for a leading public relations company that represented Big Pharma interests seems to be lost by the skeptics of homeopathy (and by most of the media).

The medical fundamentalists commonly brag about the fact that this Science and Technology Committee’s report “proved” that there was no evidence that supports any specific benefits of homeopathic treatment beyond the placebo effect.  And yet, none of these fundamentalists acknowledge that this Committee consisted of 14 members, 10 of whom did not consider this issue worthy of voting.

Ultimately, a “majority” of only THREE members voted for this anti-homeopathy report.  Of these 3 votes, two members were so new to the Committee that they did not attend a single hearing on the subject of homeopathy.  The third vote for the “report” came from Evan Harris, a vitriolic antagonist to homeopathy who was not re-elected this year, losing to a 20-something year old political neophyte.  Obviously, the British people wanted anyone but Evan Harris and his partisan science.

It seems that these medical fundamentalists not only have questionable ethics, but they seem conveniently ignorance of medical history. Therefore, it is appropriate to be reminded of an important story from medical history that might help shed light on the recent attacks against homeopathy…

In 1854, Sir Benjamin Hall, a member of Englands Parliament, administered the the government’s General Board of Health, and his first act was to set up a General Medical Council of clinicians to conduct a major epidemiological survey of the cholera epidemic, a serious public health problem in that year.

The Councils report showed that 51.9 percent of patients treated for cholera as in-patients or out-patients in London hospitals had died and that all types of treatment were deemed useless.

The London Homeopathic Hospital in Golden Square had just established a charitable foundation in 1849 and opened its doors in 1850. During the 1854 cholera epidemic, the thirty-bed hospital was devoted to the treatment of the indigent poor of the area. The homeopathic hospital, like all other hospitals in London, submitted its records to the council for its report on cholera treatment, but the homeopathic mortality statistics were not listed in the report. The homeopathic hospital experienced a mortality rate of only 16.4 percent of patients.

When Hall asked the council to explain this omission, the reply was: “That by introducing the returns of homeopathic practitioners, they would not only compromise the value and utility of their averages of cure, as deduced from the operation of known remedies, but they would give an unjustifiable sanction to an empirical practice alike opposed to the maintenance of truth and to the progress of science.” (Nichols, 1988, 145146)

In other words, the statistics from the homeopathic hospital were not listed because their listing would suggest that homeopathic medicines provide a superior treatment for cholera.

Skeptics may wonder how valid the homeopathic hospitals statistics were. It is therefore important to note that the inspector appointed to the district of London refused to visit the homeopathic hospital, so another inspector reluctantly agreed to do so.

In a letter to the Homeopathic Hospital on February 22, 1855, he wrote: “You are aware that I went to your hospital prepossessed against the homeopathic system; that you had in me, in your camp, an enemy rather than a friend, and that I must therefore have seen some cogent reason there, the first day I went, to come away so favourably disposed as to advise a friend to send a subscription to your charitable fund. (Dean, 2004, 127)

In 1858, the conventional physicians sought to have homeopathic practice outlawed. Despite some vitriolic lobbying, this law was not passed, in part because of the evidence of homeopathys successes in treating the recent cholera epidemic. Still, the British Medical Association passed internal rules that forbade their members from practicing homeopathy or even consulting with a homeopath in the care of any patient.

The British doctors even required medical students to sign a pledge that they would never become a
homeopath, and they actually failed any student who refused to sign this pledge (Baumann, 1857).

Homeopaths in England continued to seek comparative trials but were always turned down. Even an offer of 5,000 pounds (the equivalent to 1 million pounds today or $2 million!) was offered by Major Vaughan Morgan in the 1860s to establish a homeopathic ward in a conventional London hospital, and this offer was turned down by every hospital in London due to the real fear that involvement with homeopathy or homeopaths in any way would cause orthodox physicians to leave the hospital and never refer patients there.

If these actions against homeopathy and homeopaths were not enough, the conventional physicians also sought manslaughter charges against homeopaths if and when any patients died under their care. All doctors have some patients who pass away, but the conventional physicians did all they could to make practicing homeopathy difficult or impossible.[i] Despite the much more frequent deaths that occurred under the care of conventional physicians, there is no similar pattern of manslaughter charges against them by homeopaths.

Appropriately, the British government decided to ignore the advice from the report on homeopathy issued by the Science and Technology Committee. And likewise, the evolution of the Royal London Homeopathic Hospital to become the Royal London Hospital for Integrative Medicine is not an obituary but a “birth announcement.”

REFERENCES:

Baumann, J. The Old and New Therapy with/of Medicine According to the Writings of
Others and According to Personal Experience for the Thinking Public. Remmingen:
Oscar Belsenfelder. 1857.

Dean, M. E., The Trials of Homeopathy. Essen, Germany: KVC, 2004. (This book is a
truly excellent book on the history of scientific studies testing homeopathic medicines.
Readers will be impressed to learn that some of the earliest double-blind and placebo-
controlled trials were in the testing of homeopathic medicines.)

Nichols, P. A. Homeopathy and the Medical Profession. London: Croom Helm, 1988.

Treuherz, F. The Origins of Kent’s Homeopathy, Journal of the American Institute of
Homeopathy, December 1984, 77(4):130–149.

[i] In 1850 James Epps, a British homeopathic pharmacist, produced a comprehensive
justification of homeopathy for the lay and medical public. Fully one-fourth of the
320 pages are devoted to an examination of coroners inquests, including details of a
manslaughter trial of 1840, and analysis of medical and other witnesses evidence, and
press comment (Treuherz, 1984).