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.
A recently published paper, with the outcomes of a collaborative European Randomized Controlled Trial (RCT) undertaken in Germany and Ukraine, is making waves amongst jubilant homeopaths as yet another evidence supporting their long-held belief in the clinical effectiveness of homeopathy. Naturally, this 2016 paper in the Journal Global Pediatric Health by van Haselen et al. piqued my curiosity and I dove in to see what the hullabaloo was all about.
Those who read my regular posts (Yes, that rare breed of people…) are amply aware that I am no fan of pseudoscience and quackery, as well as the relentless invasion of quackery into academia, leading invariably to scientifically implausible, nonsensical “research”, for which Dr. Harriet Hall had aptly coined the term “Tooth Fairy Science” several years ago over at Science Based Medicine.
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.)
Classical homeopathy is scientifically implausible as a therapy, because there is no substance of any medicinal value left in the functionally-infinitely diluted nostrum. Naturally, there is no hard evidence supporting the therapeutic use of homeopathy, in terms of clinical benefit to the patient. Absent such support, homeopathy-peddlers generally push affordability and low cost as homeopathy’s unique selling point (USP). A large retrospective cost-analysis study, based on nearly 45000 individual German patients, gives lie to that myth.