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Letters to the Editor
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Homoeopathy
Continuing to champion it
From Mr F. Khan, MRPharmS
I commend The Journal for the comments in this week’s leading
article (PJ, 3 September, p272). The Lancet’s conclusions will
have helped close the minds of many health care practitioners to the
possibility that homoeopathy can be an effective remedy for certain patients,
and not just by a placebo effect. Many, like me, who have studied homoeopathy
and have been successful in using it personally and have used it effectively
on patients, will read comments like James Semple’s in your news
feature (p277) and feel it a shame that his views now will add to the
current indoctrinated scepticism regarding homoeopathy that exists in
the fields of science and medicine.
However, there will always remain the many thousands, if not millions,
of open-minded people who are convinced of homoeopathy’s efficacy
and will continue to champion it, regardless of the “official results”.
Faez Khan
Leeds, West Yorkshire
Not convinced
From Mr J. Sharp, Hon.MRPharmS
In your leading article “Homoeopathy
hubbub” (PJ, 3 September,
p272), as a token of your belief that “journalists, like scientists,
should have open minds”, you state: “There may be no convincing
proof that homoeopathy works, but equally there is no convincing proof
that it does not work.” That, surely, is to take open-mindedness
to an unscientific level. The burden of proof must be with the proponents
of homoeopathy, to present evidence of the truth of their contentions.
This they singularly fail to do.
Using the analogies of “relativity and plate tectonics” is
inappropriate and irrelevant. You say that these were “pooh-poohed
when they were first proposed”. Are you able to quote any references
to the “pooh-poohing” of relativity that have been published
in any reputable journals?
You urge the suspension of “negative attitudes”. The accusation
of “negativity” is the last resort of those attempting to
defend the indefensible. To impute “negative attitudes” to
those who would deny the validity of nonsense is like accusing Copernicus,
Kepler, Galileo and Newton of having “negative attitudes” because
they refused to believe that the planets were pushed around the earth
by harmoniously singing angels.
It is perhaps worth noting that the policy of the Royal Pharmaceutical
Society, as published in the PJ, June 14, 1986 is: “…with
regard to the actual composition of the ‘homoeopathic remedies’,
there is no scientific evidence for their efficacy, only anecdotal and
subjective reports. It is unlikely that the benefits attributed to homoeopathy
could extend to over-the-counter recommendation or self-selection sale.
“The Society’s Council therefore recommends members to inform
any persons seeking advice on homoeopathic products that there is no scientific
evidence for their efficacy beyond that to be expected from a placebo
response.”
I am not aware that there has been any formal amendment to that policy.
In your news
feature (PJ, 3 September, p 277), you quote Christine Glover
as stating that a double-blind randomised controlled trial “…is
not an appropriate paradigm to use for homoeopathy, which is usually
tailored for individual use.” But is it not a fact that the great
majority of homoeopathic “remedies” are sold on a self-service
and self-selection basis where there is no possibility whatsoever of
individual “tailoring”?
John Sharp
Woodley,
Berkshire
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We thank Mr Sharp for drawing attention to the Society’s
policy that pharmacists should mention the lack of scientific evidence
for homoeopathy without condemning it out of hand. This is an excellent
illustration of the open-mindedness advocated in the leading article
— EDITOR
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Forcing a round peg into a square hole
From Mr S. B. Kayne, FRPharmS
One might be forgiven for approaching the latest burst of debate concerning
homoeopathy with a degree of frustration. The results
from Switzerland (PJ, 3 September, p277) add nothing new, for yet again researchers have
tried to force the round peg of homoeopathy into the square hole of randomised
clinical trials. There are always going to be difficulties associated
with analysing data derived from the application of rigid RCT protocols.
Data that, as a result of standardising the populations and dose regimens,
do not reflect the way in which homoeopathy is routinely used in day-to-day
practice.
Why should the RCT be considered the gold standard? Because there is
nothing else? Is it not time we developed a robust patient-oriented outcome
measure that would establish conclusively whether homoeopathy works or
not? Many orthodox interventions are made on the basis of simply responding
to symptoms and could also be assessed using the tool. I suggest that
this approach is preferable to merely stating that 200 years of homoeopathy
has taught us it is a placebo effect. It seems to be a case of petulance — “if
you are not playing my game do not come to the party.”
Steven Kayne
Glasgow
Leave it alone
From Mr K. R. Nathwani, MRPharmS
Here we go again, researchers investigating another negative
hypothesis about homoeopathy (PJ, 3 September, p277). Why is it that it is always
those people commissioned to conduct trials who are not practising homoeopaths,
who make ridiculous claims that homoeopathy is no more effective that
placebo.
I would like to recap that homoeopathy is an art and science of holistic
healing, proven to be successful for over 250 years without any changes
to the philosophy and principles by which homoeopaths prescribe.
I recollect that the PJ some years back said that they would not publish
any more letters regarding homoeopathy because it is an endless debate.
By the same token the PJ should not publish such ridiculous trials which
only serve to infuriate respectable homoeopaths.
It is high time that individuals with limited knowledge of homoeopathy
stopped interfering with this gentle form of healing. Ask the many children
who have been cured by homoeopathy without any adverse effects if their
treatment is a placebo. It is easy for Swiss and UK researchers to quickly
give homoeopathy headlines by their results of their so-called (negative!)
trials.
What about the medicinal drugs such as Vioxx, Celebrex, co-proxamol,
etc, making the headlines? At least the system of healing by homoeopathy
to date has not killed anyone!
Kindly ask those who have been cured for their comments. Remember “trials” are
not holistic, ie, treating the whole person rather than the disease.
The Swiss trial conducted is questionable and baseless, used to undermine
the profession of homoeopathy. These researchers should concentrate in
areas of their expertise and leave homoeopathy alone.
Kamal Nathwani
Hertford
Logical errors
From Mr S. A. Malcolm, MRPharmS
The writer of your leading article on the homoeopathy
debate (PJ, 3
September, p272), in attempting to keep an open mind, has made some logical
errors.
In talking about the dilution process he states, “It may be contrary
to conventional scientific wisdom…but many scientific principles that
are now generally accepted were pooh-poohed when they were first proposed — relativity
and plate tectonics are just two that come to mind.”
There are two problems here; first the dilution process is just that,
a process not a principle. Secondly, relativity and plate tectonics are
theories to explain well-recognised phenomena, whereas it is the very
existence of a homoeopathic effect that is in question. The writer makes
the same error when he states, “…it is only in recent years
that we have even begun to understand the pharmacology of the salicylates
even though, in the form of willow bark, they have been used for some
2,500 years.” Again the benefits of the use of salicylates are
unquestionable. Nobody has ever suggested that treatments that work but
whose mechanisms are unknown should not be used.
Your writer then adds, “Even if we believe that homeopathy is quackery
we need to remember that many people are convinced of its power to heal.
That power may derive from the placebo effect, but what is wrong with
that?” Like religion, homoeopathy depends on faith. In the case
of medicine, placebo effects occur when a patient sincerely believes
that they are receiving a treatment that has been proven to be effective.
But this raises ethical questions. Should treatments that depend on deception
ever receive the endorsement of the medical profession? There are two
reasons why they should not. A deception discovered will result in mistrust
of those providing the false assurance and a disease may worsen if not
properly treated. There may be some rare cases where a placebo rather
than effective medication should be prescribed but the job of the medical
profession is to provide patients with evidence based treatment.
Stewart Malcolm
Bures,
Suffolk
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The
Pharmaceutical Journal