The Evidence
Rational Veterinary Medicine:
Papers, listed by lead author: R-
R
Ramey, D.W. (2000) ‘The Scientific Evidence on Homeopathy’, American Council on Science and Health
Introduction: The scientific investigations of homeopathy that have been completed and published are sufficient for drawing reliable conclusions about this counterscientific approach to medicine. These studies have generated widely assorted positive, negative, and neutral conclusions. Therefore, it is not difficult, especially if one does not consider the quality of the evidence, to find published conclusions compatible with, or pervertible to, a particular bias. But parading pieces of evidence thus culled does the public little or no good.
Links: none currently available
Ramey, D. et al and Hektoen, L. (2005) ‘Homeopathic veterinary medicine’ (letter+author’s response), Veterinary Record, vol. 157, pp 390-
(A reply to Hektoen, 2005)
Ramey, D. (2010) ‘Acupuncture and history: The “ancient” therapy that’s been around for several decades’ (blog entry), Science Based Medicine, October 18 (also attributed to Kavoussi, B.)
Links: [full text]
“Acupuncture proponents may assert... that acupuncture is “4,000 years old.” While the assertion isn’t true, it’s also ridiculous, since the Chinese hadn’t invented writing 4,000 years ago. Even if the assertion were true, there would be no way to possibly know about it, since no one could have written anything down about the practice.
... it can be stated that Chinese veterinary medicine isn’t unique, and it isn’t even particularly Chinese. That is, what is presented to the eager public as the essence of Chinese thought and practice is, in fact, just an adaptation of contemporaneous practices in Greece and the Middle East. In fact, most Chinese practices, such as bleeding, and burning at points, appear in Greek, Egyptian, and Arabic sources long before they were ever mentioned in China. Such practices first appear in China during a period of maximal western influence on China, corresponding with regular traffic on the Silk Road (during Han times, approx. 200 BCE – 200 AD), as well as with the coming of Buddhism, which brought in influences from Indian traditions.
... there is no reference to what can even be remotely considered as modern acupuncture in any of the pre-
Rao, M.L., Roy, R., Bell, I.R. and Hoover, R. (2007) ‘The defining role of structure (including epitaxy) in the plausibility of homeopathy’, Homeopathy, vol. 96, no. 3, pp. 175-
This paper attempts to prove that liquids have a memory based on structural differences between different type of homeopathically diluted solutions of (in this case) ethanol. The authors claim that this memory can be demonstrated by spectroscopic analysis of the different solutions.
It was thoroughly debunked by a group of authors in a letter to the journal which is reproduced in full in the Bad Science Journal Club (link below).
In a nutshell the paper is riddled with problems which render the conclusion "Preliminary data... illustrate the ability to distinguish two different homeopathic medicines... from one another and to differentiate, within a given medicine, the 6c, 12c, and 30c potencies" completely unjustified. The journal Homeopathy is a subscription only publication with the abstract being the only section publicly available. Rather disingenuously, although the authors mention the word "water" twice in the abstract and one of the phrases in the key words is "structure of water", at no point do they mention that the paper itself concerns ethanol (i.e. alcohol), not water -
The authors claim in the abstract "The key stumbling block to serious consideration of homeopathy is the presumed “implausibility” of biological activity for homeopathic medicines in which the source material is diluted past Avogadro's number of molecules". This is just nonsense -
The letter of refutation (the reference to a copy in the Bad Science comments section is given below but it was actually accepted for publication in the journal itself) is well worth a read as a masterclass in how to interpret a scientific paper. Its authors point out a myriad of fatal flaws in the original paper, not least the fact that the samples of ethanol used for comparison seemed to be from different sources with different levels of contaminants, and none of them were of a grade pure enough to perform reliable spectroscopy on anyway. Also the paper's authors appear to have got two of their graphs mixed up by mistake. Their key claim that the various remedies were spectroscopically different by virtue of their supposed homeopathic properties is incorrect, any differences infact being due either to faulty presentation of the data or to the presence of contaminants. Furthermore the lack of data and statistical analyses presented preclude any independent verification of the figures.
All in all this is just more homeopathic bluster, badly done and claiming to prove something that it doesn't.
Links: [abstract -
Responses: [JREF forum]:[JREF, incorrect UV spectroscopy]:[press release -
Ratajczak, H.V. (2011) ‘Theoretical aspects of autism: Causes -
Links: [abstract pubmed]:[abstract, informahealthcare]:[full text, cogforlife, pdf]:[full text, rescuepost, pdf]
Responses: [mercola]:[JREF forum]:[CBS news]:[skepdic.com]:[respectful insolence]
Reilly, D.T. and Taylor, M.A. (1985) ‘Potent placebo or potency? A proposed study model with initial findings using homoeopathically prepared pollens in hay fever’, British Homoeopathic Journal, vol. 74, pp. 65-
Links: none online
Remarks: [RationalVetMed -
Reilly, D.T., Taylor, M.A., McSharry, C. and Aitchison, T. (1986) ‘Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hayfever as model’, Lancet, vol. 2, pp. 881-
Links: [abstract pubmed]
Remarks: [RationalVetMed -
Reilly, D., Taylor, M.A., Beattie, N.G., Campbell, J.H., McSharry, C., Aitchison, T.C., Carter, R. and Stevenson, R.D. (1994) ‘Is evidence for homeopathy reproducible?’, Lancet, vol. 344, no. 1, pp. 601-
A meta-
Links: [abstract -
Responses: [JREF thread]:[RationalVetMed -
Rosa, L., Rosa, E., Sarner, L. and Barrett, S. (1998) ‘A Close Look at Therapeutic Touch’, Journal of the American Medical Association, vol. 279, no. 13, pp. 1005-
Links: [abstract, JAMA]:[full text, html, JAMA]:[full text, pdf, JAMA]
Responses: [Committee for Skeptical Enquiry]:[wikipedia]
Roy, R., Tiller, W.A., Bell, I. and Hoover, M.R. (2005) ‘The structure of liquid water; novel insights from materials research; potential relevance to homeopathy’’, Materials research innovations, online 9-
“This paper does not deal in any way with, and has no bearing whatsoever on, the clinical efficacy of any homeopathic remedy.”
Fair enough, pray continue…
“However, it does definitively demolish the objection against homeopathy, when such is based on the wholly incorrect claim that since there is no difference in composition between a remedy and the pure water used, there can be no differences at all between them…”
Nope, sorry, this article, effectively self published, doesn’t demolish anything. And even if anyone did manage, contrary to all scientific evidence, to show that homeopathic remedies were any more than water or sugar, that still wouldn’t validate homeopathy -
Links: [Researchgate -
Responses: [JREF thread]
Rutten, A.L.B., and Stolper, C.F. (2008) ‘The 2005 meta-
"their entire paper is an exercise in post-
Links: [abstract, science direct]:[abstract, pub-
Responses: [Wilson, 2008 -
S
Sainte-
Links: [abstract, pubmed]
Responses: [JREF post]
Sampson, W. and London, W. (1995) ‘Analysis of Homeopathic Treatment of Childhood Diarrhea’, Pediatrics, vol. 96, no. 5, pp. 961-
Links: [abstract, Pediatrics]
Schmidt, K., Pittler, M.H. and Ernst, E. (2001a) ‘A profile of journals of complementary and alternative medicine’, Swiss Medical Weekly, vol. 131, pp. 588-
“The number of original articles [in CAM journals] increased from a total of 61 in 1995 to 97 in 2000... the number of papers reporting clinical trials decreased by 4% between 1995 and 2000, and the number of surveys increased more than six times... The majority of articles published in 1995 suggested positive treatment effects, a phenomenon that was still present in 2000 albeit less strong. CAM journals, and most likely CAM itself, are associated with a lack of clinical trials and a bias in favour of positive conclusions.”
Journals written by practitioners of alternative medicine about alternative medicine seem reluctant to publish negative results -
Links: [full text, pdf]:[abstract pubmed]
Responses: [Schmidt et al 2001]
Schmidt, K., Pittler, M.H. and Ernst, E. (2001b) ‘Bias in alternative medicine is still rife but is diminishing’, British Medical Journal, vol. 323, no. 7320, p. 1071.
“In 1995, journals of alternative medicine published virtually no studies with negative results, which suggests that the literature was far from objective”
This is a letter to the BMJ from the authors of Schmidt et al 2001 following the publication of their paper in Swiss Medical Weekly (above).
Links: [abstract, pub med]:[full text, pdf (see p8), pub med]
Schmidt, K. and Ernst, E. (2003) ‘MMR vaccination advice over the internet’, Vaccine, vol. 21, pp. 1044-
A letter from a fictitious patient asking for advice about the MMR vaccine was emailed to homeopaths, chiropracters and GPs. After the reply was received the recipients were told of the purpose of the project at which point over a quarter of the CAM practitioners withdrew. Final response rates were: homeopaths -
Links: [Abstract, science direct]:[Full text, DCScience, pdf, OA]
Schoen, A.M. (2000) ‘Results of a survey on educational and research programs in complementary and alternative veterinary medicine at veterinary medical schools in the United States’, Journal of American Veterinary Medical Association, vol. 216, pp. 502–509.
“Currently, few veterinary schools offer educational or research programs in CAVM. Veterinary schools are aware of the interest in CAVM and acknowledge a lack of educational and research programs in these areas. More veterinary schools are in the process of developing educational and research programs in various aspects of CAVM."
Links:[abstract -
Schott, H.C. (2002) ‘Pituitary pars intermedia dysfunction: equine Cushing’s disease’, Veterinary Clinincs Equine Practice, vol. 18, pp. 237–270.
A study of equine Cushing’s syndrome which is of great interest and mentions several possible ways of testing to both confirm a clinical diagnosis and to objectively monitor response to treatment. Strangely “looking at it and thinking it might be a wee bit better” doesn’t figure as a reliable diagnostic test. Which is a shame for Mark Elliott because that’s pretty much all he relies on when it comes to assessing his patients’ so-
“Assessment of the efficacy of nutritional supplements and alternative therapies... is hampered by the same limitations as reports describing clinical response to medications. Specifically, most previous reports fail to include a comparison group or a nontreated control group to evaluate the effect of the intervention more objectively. Although this is an inherent ethical dilemma when studies are performed on client-
Links: [science direct]
Scott, D.W., Miller, W.H., Senter, D.A., et al. (2002) ‘Treatment of canine atopic dermatitis with a commercial homeopathic remedy: a single-
Danny Scott is an engaging and charismatic speaker who sports a long silver-
“A commercial homeopathic remedy and a placebo were administered orally as individual agents to 18 dogs with atopic dermatitis. The pruritus was reduced by less than 50% in only 2/18 dogs; 1 of these dogs was receiving the homeopathic remedy, the other was receiving the placebo. One dog vomited after administration of the homeopathic remedy.”
Yet again, no evidence that homeopathy works.
Links: [abstract -
Seeley, B.M., Denton, A.B., Min, S., Ahn, M.S., Corey S. and Maas, C.S. (2006) ‘Effect of Homeopathic Arnica montana on Bruising in Face-
Links: [full text JAMA]:[full text JAMA pdf]:[abstract PubMed]
Comments: [Ingraham, P. -
“Subjective evaluation
“Of the 29 patients enrolled in the study, 26 completed the Visual Analog Score (VAS)... Patients in both groups followed a trend of steady recovery starting at post-
“All 29 patients were subjectively evaluated by a registered nurse or a physician on a separate VAS... Data for this VAS were obtained only on PODs 1, 5, 7, and 10; a general trend in resolution of ecchymosis was seen throughout this period. In contrast to the data obtained from the patients, the A montana group did better than the control group at all time points, but again these differences were minimal and the variability was high; therefore, no statistically significant difference (P#.05 at all data points) was noted. Finally, when asked to note the day when they felt comfortable going out to dinner, the patients in the control group reported a mean±SD of 10.6±3.9 days, while those in the A montana group reported a mean±SD of 11.2±3.8 days. The difference was not statistically significant.
“Objective evaluation
“… Patients in the A montana group showed more discoloration on POD 1, with a mean score of 46.41, and then showed steady improvement, with subsequent scores of 40.39, 32.71, and 24.78. Using the t test, these differences were not statistically significant at any time point. With respect to area, patients in the A montana group showed less ecchymosis at all time points, with these data being statistically significant (P#.05, t test) only on PODs 1 and 7.
In this trial, at every stage of the evaluation, the patients, according to their own scoring, did slightly worse in the homeopathic arm, including taking a bit longer before feeling confident enough to appear in public. When assessed by health-
When comparing photographs (objective evaluation), the overall colour change in the homeopathic group was slightly worse than the placebo but not significantly so. When comparing blood spots (ecchymosis) at the surgical site, the homeopathic group did slightly better than the placebo group though only statistically so at two of the four time points (and still, there is a one in twenty chance that even this was, to quote Professor McGonagall “pure dumb luck”).
So, in other words, some days the placebo group did slightly better, other days the arnica group did slightly better and the differences were always minimal and highly variable. The fact that, at two of the many data points looked at, the results from the homeopathic arm just scraped past the placebo is hardly a triumph for the pro-
Paul Ingraham, at PainScience.com (link above) describes this paper as “tiny and sloppy”, with “Key data… omitted from the conclusion”. He points out the alleged improvement in bruising which was claimed was so trivial “it could only be detected by instrumentation”.
And it bears repeating -
Sehon, S. and Stanley, D. (2010) ‘Evidence and simplicity: why we should reject homeopathy’, Journal of Evaluation in Clinical Practice, vol. 16, no. 2, pp 276-
Philosophical objections to homeopathy are not simply due to stubbornness or prejudice but because of a general epistemological principle known as the 'principle of simplicity'. This concept, which has profound relevance not just to science but to every day experience, is described most eloquently the above paper. Put briefly, the authors state that "given two theories, it is unreasonable to believe the one that leaves significantly more unexplained mysteries". If anyone is interested in a serious consideration of the reasons science is so far unable to take homeopathy seriously then a careful reading of this paper will serve as an excellent starting point.
Links: [abstract -
Sehon, S. and Stanley, D. (2010) ‘Applying the simplicity principle to homeopathy: what remains?’ Focus on Alternative and Complementary Therapies, vol. 15, no. 1, pp. 8-
"Homeopathy is one of the more controversial types of alternative medicine. Millions of consumers swear by it and there are many practitioners who are quite convinced of its efficacy. The debate can be heated, with each regarding the other as biased or even irrational. We hope to illuminate this debate by making explicit an underlying philosophical principle that plays a key, but often tacit, role in the debate. By making the principle explicit, we can show why mainstream medicine views homeopathy so sceptically, and why such scepticism is justified."
A simplified version of Sehon and Stanley (2010) (above).
Links: [full text, html, FACT]
Shang, A., Huwiler-
“Biases are present in placebo-
This is the sort of paper that homeopaths absolutely hate; a well conducted metanalysis with good, pre-
One of the criticisms (Bell 2005) contains the memorable complaint that Shang (2005) was unfair because it lumped together a "heterogenous" group of conditions which were treated with different homeopathic remedies in the homeopathic group of papers -
Links: [abstract -
Responses: [authors' reply to criticism -
Shang, A., Jüni, P., Sterne, J.A.C., Huwiler-
Links: [full text, Lancet]
“Our study showed... based on more than 200 placebo-
“We agree with Dantas that we need to compare homoeopathy and allopathy: this was the aim of our study. We also need to be prepared to accept the results of well designed studies, even if they challenge our own fervently held beliefs.”
Shaw, D. (2011) ‘Homeopathy and medical ethics’, Focus on Alternative and Complementary Therapies, vol. 16, no. 1, pp. 17-
"This paper examines homeopathy from the perspective of medical ethics. It emerges that homeopathic practice is likely to breach basic tenets of medical ethics, even if homeopathic practitioners are well-
Links: [full text, html, FACT]
Shekelle, P.G., Morton, S.C., Suttorp, M.J., Buscemi, N. and Friesen, C. (2005) ‘Challenges in Systematic Reviews of Complementary and Alternative Medicine’, Topics Annals of Internal Medicine, vol. 142, no. 12, Part 2 pp 1042-
“The many biases in the publication and indexing of CAM research pose a challenge for locating literature. Publication bias refers to the tendency of investigators, reviewers, and editors to submit or accept manuscripts on the basis of the strength or direction of the findings. While publication bias is a concern in conventional medical research, in CAM research the issue is particularly complicated. Most studies published in leading CAM journals have positive results. Some countries, such as China, Japan, Russia, and Taiwan, publish more studies with positive results than studies with negative results; this imbalance may reflect publication bias”
To quote Richard Dawkins, "Either it is true that a medicine works or it isn't. It cannot be false in the ordinary sense but true in some 'alternative' sense". CAM practitioners who promote watered down trials as described in this paper, for instance “pragmatic” trials, observational studies and postmarketing surveillance are fully aware that when subject to real science CAM is always found lacking so, instead of being honest with themselves and us, they prefer to change the way the trials are done until they get the results they want.
Links: [abstract, AIM]:[full text, html, AIM]:[full text, pdf]
Smith, S.A., Baker, A.E. and Williams, J.H. (2002) ‘Effective treatment of seborrhoeic dermatitis using a low dose, oral homeopathic medication consisting of potassium bromide, sodium bromide, nickel sulfate, and sodium chloride in a double-
A paper which gets trotted out every time there is an inquiry into the usefulness of homeopathy, this is an excellent illustration of the sort of thing homeopaths regard as some of the best evidence that homeopathy works but is actually nothing of the sort. In short this paper tells us more about homeopaths’ self-
Firstly, the conclusions about homeopathy are nul and void for the simple reason the compound under test (Loma Lux Psoriasis™ -
That means it has active ingredients, and that's not what homeopathy is about. True homeopathic remedies (certainly those the homeopaths claim are the most powerful ones) are ultra-
Secondly, the paper was conducted by the very individuals who make and profit from sales of the medication under test. Can you imagine the cries of bias and vested interest if the sole basis for believing, say a new antibiotic worked was one paper carried out by the pharmaceutical company who made it? Well homeopathy is no different, it doesn’t get a free ride by virtue of being all alternative and new-
If you have any lingering doubts as to the imparitality of the authors just read these quotes, from the website of lead author Dr. Steven A. Smith M.D., President of Loma Lux Laboratories and inventor of Loma Lux Psoriasis™, who seems to think a series of before and after photographs, gushing testimonials and a bit of scare-
"At Last, an Effective Remedy for Psoriasis Without Any Known Side Effects...", "By a combination of scientific investigations and divine intervention, Dr. Smith has discovered Lomalux Psoriasis... ", "This Miracle Product...", "Psoriasis Can Be Serious. You Can Die From This Disease!" "Satisfaction Guaranteed or Money Back" "Retail Price: $29.95 plus $7.00 shipping and handling [for an 8oz bottle]" And finally, just to confirm it's not even homeopathy -
Divinely inspired it may be; disinterested it is not!
And it's not just Dr Smith who profits by increased sales of Loma Lux™, the other two authors of this study – Ardith E. Baker, MS, Professor and clinical statistician, Tulsa, OK and John H. Williams Jr., MS, Consultant with expertise in clinical studies, Tulsa, OK – were both in the pay of Loma Lux Laboratories at time of the study.
Yet despite all this homeopaths, who would have apoplexy if a pharmaceutical was launched on such flimsy grounds, still insist this is high class evidence in their favour and get all huffy and upset when anyone suggests otherwise.
Links: [Full text, researchgate]:[Abstract, wikigenes]:[Abstract pubmed]:[Full text alt med rev]
Responses: [psorosite]
Smith, K.R. and Sampson, W. (2008) ‘Word use and semantics in alternative medicine’, Medscape News today -
"Proponents of altmed have encountered major difficulties in achieving acceptance of their methods by the medical community. Such difficulties remain pervasive because many rationales, bases, and claims for alternative approaches conflict with the logicoscientific foundations of medicine. Faced with this fundamental problem, a tempting solution for proponents of altmed is one of semantics: alter the words but not the substance...
"Some altmed advocates have proposed using language change as a tool for swaying public opinion, with the intent of changing laws, presumably to legalize methods and practices now or previously considered illegal"
If proof were needed of the devious tactics employed by CAM profiteers then this is it. Unable to prove their case logically or by scientific means they employ linguistic tricks instead to gain acceptance. They don’t care whether what they do really works according to any real sense of the word, this is pure politics, a power play intended to make this dangerous nonsense acceptable by making it sound all touchy feely, empathic and (inevitably) natural. This is simply the cynical exploitation of vulnerable people who deserve better -
Link: [full text, html Medscape]
Spence, D., Thompson, E. and Barron, S. (2005) ‘Homeopathic treatment for chronic disease: a 6-
This paper is nothing more than a customer satisfaction survey where patients who had used homeopathy (so hardly an unbiased sample) said they thought it was great stuff. This was then passed off as evidence that “homeopathic treatment is a valuable intervention”. No controls, no blinding, nothing that would be required in the protocol of a rigorous trial. A complete waste of time and public money.
David Colquhoun (link below) isn’t pulling any punches, “Papers like this do not add to human knowledge, they detract from it. By reverting to pre-
“What on earth is a respectable hospital and medical school, like those in Bristol, wasting money with this sort of mediaeval hindrance to medical knowledge? We are truly living in an age of delusions”
Nicely put Prof.!
Links: [Full text, pdf, DCscience]:[full text pdf, britishhomeopathic.org]:[full text, pdf, UCL.ac.uk]
Responses: [DC’s improbable science]:[Ben Goldacre, Bad Science]
Spencer, W. (1997) ‘Homoeopathy’, Skeptical Intelligencer, vol. 2, no. 2.
This article is reproduced here by kind permission of Mike Heap of the Skeptical Intelligencer magazine, the journal of the Association of Skeptical Enquiry (ASKE).
Links: [full text, RationalVetMed]
Stevinson, C., Devaraj, V.S., Fountain-
“... The results of this trial do not suggest that homeopathic arnica has an advantage over placebo in reducing postoperative pain, bruising and swelling in patients undergoing elective hand surgery”
...Homeopathy = sugar tablets.
Links: [abstract]:[full text -
Szeto, A.L., Rollwagen, F. and Jonas, W.B. (2004) ‘Rapid induction of protective tolerance to potential terrorist agents: a systematic review of low-
“Weaponised anthrax!?” -
Links: [abstract]
