The mood in New South Wales State Supreme Court was somber that early June day in 2009. Seven years earlier a little girl of nine-months from Earlwood, Sydney, had died under tragic circumstances, and in the dock for medical negligence were her Indian immigrant parents, Mrs. Manju and Thomas Sam. The jury heard, from experts and other witnesses, how baby Gloria Thomas suffered from significant malnutrition early in her short life, which compromised her immunity; how she was diagnosed with eczema at four months, and through her broken skin, disease-causing bacteria entered her bloodstream, attacking her lungs and one eye; and how throughout the entire, extremely painful ordeal, her father—a homeopath—steadfastly, repeatedly refused medical care, electing instead to treat her with one homeopathic remedy after another, until she passed away. The jury returned a verdict of manslaughter, and the judge sentenced the couple to up to 8 years in prison.
This morning, I was alerted to the latest homeopathy shenanigan via the Forbes column of Dr. Steven Salzberg. (COI statement: I don’t know Dr. Salzberg personally, but I follow his columns, and he is a faculty member at my institution—albeit in a discipline not directly related to mine.) At the heart of it is yet another bog-standard ridiculous “study” purporting to show “clinical effect” of homeopathy, despite the preponderant evidence that homeopathy does not work. What makes this instance special enough for me to take time out from my over-burdened work schedule? The fact that it was published in Scientific Reports from the—wait for it!—Nature Publishing Group. Yes, THAT Nature.
It has been a while since I last posted on homeopathy. Frankly speaking, having written about it quite a bit, I have grown kinda tired of the utterly unscientific, nonsensical nature of homeopathy, and foolishness of its relentless proponents. However, a few days ago on Twitter, my attention was brought to a whole new level of ridiculousness in this quackery modality, and I found it concerning anew because of what it implies for the hapless, gullible and vulnerable patients desperately seeking medical care. Today’s short post touches on this.
A physician friend alerted me the other day about a strange new official proclamation from the Government of India (GoI). With a long history of uncritical friendliness (as well as State-sponsorship) towards various alternative medicine modalities, GoI —specifically, the ministry in charge of altmed, the Ministry of AYUSH (Ayurveda, Yoga, Unani, Siddha & Homeopathy) in this case— announced that a “high level committee” has been set up to “deal with issues” related to “false propaganda against homeopathy”.
A paper published last month in PLOS One by a group of investigators from the University of Verona in Italy states that Arnica montana Stimulates Extracellular Matrix Gene Expression in a Macrophage Cell Line Differentiated to Wound-Healing Phenotype. Given my abiding interest in pharmacognosy and ethnobotany, I was suitably intrigued because the extract derived from Arnica montana, a European flowering plant of the sunflower family, is likely to be biologically active due to the presence of certain sesquiterpene lactones (same class of substances as present in the plant-derived anti-malarial Artemisinin), the plant metabolite flavonoids (substances with some in vitro anti-oxidant and anti-inflammatory activity), and derivatives of thymol (phenolic substance with antimicrobial action). Like many bioactive phytopharmaceutical substances, Helenalins, the sesquiterpene lactones and their fatty acyl esters in Arnica montana, are toxic in high concentrations, but have anti-inflammatory properties via its inhibition of the transcription factor NFkB.
Science communicators are no strangers to spin in the reporting of scientific studies, especially in Press Releases. This is a favorite tactic of aficionados and researchers alike in the so-called ‘complementary and alternative medicine’ (CAM), which includes acupuncture — a pre-scientific therapeutic modality originating in ancient China with roots in medical astrology and ignorance of human anatomy and physiology. I have earlier written several times on an issue that I continue to find rather perplexing: when it comes to publishing studies on CAM research, the usually-high publication standards of the premier open access journal PLOS ONE appear to be ignored, in the context of both primary research and systemic, quantitative and analytical reviews.
Last month, PLOS One published a study which held significant interest for me; as a long time sufferer from acid reflux (which is currently reasonably controlled by regular use of a PPI – Proton-pump inhibitor – class of prescription antacid), I was curious to dive into this Randomized Controlled Trial (RCT) study from Beth Israel Deaconess in Boston, in which the investigators observed that Patient-Provider Interactions Affect Symptoms in Gastroesophageal Reflux Disease (GERD) as well as dyspepsia and other acid-reflux related issues, which affect 2-4 out of every 10 people in Western world (similar statistics were observed in the Northern part of India). The name of the study medication, Acidil, wasn’t immediately familiar to me, but it turned out to be a ‘homeopathic preparation’, which – along with the placebo-controlled designed – piqued my interest further. Although the severity of GERD symptoms may fluctuate due to different reasons, it is usually not one of those self-correcting conditions in which homeopaths often claim beneficial effect. So, sufficiently interested, I delved deeper.
The world of alternative medicine – nowadays more fashionably known as complementary and integrative medicine (CIM), replacing the erstwhile CAM (A = alternative) – encompasses a wide range of practices. Some of these practices involve physical motion of parts or whole of the body, such as massage, Yoga, and Tai Chi; if one subtracts the dollops of mysticism, especially of Eastern origin, that have come to be associated with these practices, one finds that they perform much of the same functions as any other regular exercise regimen, providing similar benefits. A few practices employ dietary supplements (vitamins, minerals, various salts, et cetera) and folk-remedies based on herbal medicine (Traditional Chinese Medicine/TCM, Ayurveda, Siddha, Unani, Amachi, and so forth) – some of which may and do contain biologically active substances, but the evidence for those being functional, safe, and effective therapeutic modalities in actual clinical situations is extremely scant, and the wide-ranging claims made by the practitioners are mostly never backed up by solid, scientific empirical methods. (Further reading: 1. Veteran ScienceBlogger Orac explains how the multi-billion dollar Supplements Industry takes their adoring clients for a ride; 2. I argue how the recent accolades for work stemming from the use of herbal medicine as a resource is not a context-less validation that herbalism works.)
Yesterday, on October 5, 2015, one half of the Nobel Prize in Physiology or Medicine was awarded to scientist and pharmaceutical chemist Tu Youyou (alternatively, Tu Yo Yo, 屠呦呦 in Chinese), for her discovery of the anti-malarial Artemisinin. (The other half went jointly to William C. Campbell and Satoshi Ōmura, for their discovery of a novel therapy for roundworm infection.)
PLOS One seems to have done it again! I wrote a few days ago about how the peer review system at PLOS One seemed to give a free pass to acupuncture studies, when it came to seeking rigorous experimental evidence in support of the claims presented in the paper. I had shared the post via Twitter, and in response, someone from PLOS One had replied: