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The current issue of the British Journal of Clinical Pharmacology has what looks like a good placebo controlled trial of homeopathy from France. “Effect of homeopathy on analgesic intake following knee ligament reconstruction: a phase III monocentre randomized placebo controlled study, Paris et al., 2007″.

Conclusion The complex of homeopathy tested in this study (Arnica montana 5 CH, Bryonia alba 5 CH, Hypericum perforatum 5 CH and Ruta graveolens 3 DH) is not superior to placebo in reducing 24 h morphine consumption after knee ligament reconstruction

Another thing that makes the paper interesting is that one of the authors is Philippe Belon. who is a director of the huge French homeopathic company, Boiron. This is properly declared at the end.

Conflicts of interest: Dr Belon is the head of the clinical research department of Laboratoires Boiron. The Laboratoires Boiron financially supported the study. None of the other investigators had any conflict of interest.

Boiron makes profits from homeopathy of about 20 million euros a year, on net operating revenues of about 300 million euros. It is big business. Philippe Belon has an interesting record.

He was one of the authors of the notorious Benveniste paper(see also here), which lead to Beneveniste’s dismissal from INSERM in disgrace. Benveniste’s results were refuted by, among others, Hirst, Hayes, Burridge, Pearce and Foreman (1993, Nature.366, 525-7.

Belon was also senior author in Fisher, P., Greenwood, A., Huskisson, E. C., Turner, P., & Belon, P. (1989). (Effect of homoeopathic treatment on fibrositis (primary fibromyalgia) British Medical Journal 299, 365-366.). That is the paper which I was asked to check (by a TV programme). After Peter Fisher gave me the raw data I found that a naive mistake had been made in the statistical analyis. There was NO evidence for the effect of the treatment at all, as described here. This correction was published (Colquhoun, D. (1990). Reanalysis of a clinical trial of a homoeopathic treatment of fibrositis. Lancet 336, 441-442.), though the correction is usually ignored by homeopaths (see here). [Get pdf].

The Truth about Homeopathy

This is the title of a commentary on the Paris et al. paper by Edzard Ernst, published in the same issue if British Journal of Clinical Pharmacology.

“Heavens!” I hear the homeopathic fraternity shout. “We need more research!”  But are they correct? How much research is enough to show that any treatment does not work (sorry, is not superior to placebo)? Here we go full circle: should we really spend several lifetimes in order to arrive at a more robust conclusion?”

“Most readers and even many homeopaths will be surprised to learn that that has already happened! During the Third Reich the (mostly pro-homeopathy) Nazi leadership wanted to solve the homeopathy question once and for all. The research programme was carefully planned and rigorously executed. A report was written and it even survived the war. But it disappeared nevertheless – apparently in the hands of German homeopaths. Why? According to a very detailed eye-witness report [9 – 12], they were wholly and devastatingly negative.”

Ernst sums up the situation incisively –download a copy of his paper.

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8 Responses to Another nail in the coffin of homeopathy

  • There is some truth in the homeopaths complaint that no amount of positive evidence will convince a sceptic. The total implausibility of homeopathy requires that any evidence for an effect is overwhelming greater than the probability that the result was due to chance, bad experiment or fraud. The mish mash of silly results in favour, special pleading over negative results and general poor experimental approaches means that sceptics can quite justifiably maintain that there is no evidence for homeopathy.

    To look at it another way: if Hahnemann had never been born and the principles of homeopathy were invented in the early 21st century, there would be no NHS money for the specialist hospitals and no calls for ‘more research’ into treatments. Advocates would be clearly be seen as the bonkers quacks they quite clearly are – even by MPs.

  • I am indebted to this report – http://breathspakids.blogspot.com/2007/03/discouraging-news-from-review-of.html#links – of the House of Lords Science and Technology Committee allergy inquiry for one of the best laughs of the year. I am tempted to have it put on a tee shirt:

    Lord Broers: I have a simple, technical question about homeopathy and drugs. Is it possible to distinguish between homeopathic drugs after they have been diluted? Is there any means of distinguishing one from the other?

    Ms Chatfield [Society of Homeopaths]: Only by the label.

  • Dear Sirs,

    George Vithoulkas, who is considered today worldwide the most serious homeopath and teacher has made very storng critisism for all nonsense that is going on today in the name of homeopathy. I am sending you two texts of him
    http://blogs.nature.com/news/blog/2007/08/here_lies_one_whose_name_was_w.html#88722

    http://www.vithoulkas.com/EN/interview_bhatia_2007.html

    I am indicating the most interesting parts of the interview

    I would like to say here something very important that will clarify a lot of misconceptions that are going on in the name of classical homeopathy.
    The mechanism of action of both the “placebo effect” and the “homeopathic similimum” are the same.

    The placebo effect can be initiated by the autosuggestion of the patient which forces a mobilization of the defense mechanism through strong feelings of faith. That is how all spiritual healing, radionics, yoga, meditation and all the other fringe therapies are working.

    In homeopathy the cure takes place from a similar mobilization of the defense mechanism through the correct remedy, the similimum. I will say it more grossly in order to be understood more clearly. If the initial reaction of a defense mechanism mobilization is the discharge of serotonin in the blood then this reaction is similar in both cases. This placebo phenomenon, which I have been talking for years in my teachings, is responsible for the “miraculous” cures that very frequently are witnessed by some homeopaths from these “new” remedies. Whatever they might have given to such suggestive patients would have reacted in a similar way. What is not known is that these placebo cures are taking place only in conditions where the patient belongs to the uppermost layers of health according to the theory I brought out the last few years. Of course one must have listened to the information given in my teachings before one can understand fully what I am talking about now. In other words these placebo cases happen with patients that are considerably healthy, though the suffering and the pathology may look severe.

    In cases where the pathology is deep then the placebo effect will be superficial and the amelioration will last only a very short time, in the same way that the wrong but the close remedy will react as well.

    I have also said repeatedly that 40% of the cases treated by homeopaths all over the world belong to the placebo group. I know this is an outrageous statement I am making now but it is true. The real cured cases which are responding to the right homeopathic remedy need to have several parameters to confirm the action and these parameters differentiate them from the placebo group, such as return of old symptoms, etc.

    The placebo group also will never be effective in severe degenerative cases like neuromuscular diseases, multiple sclerosis, autoimmune diseases, severe mental disorders, in emphysema, in severe allergic conditions, etc. There you need to find, not only the first remedy, but also the correct sequence of remedies and knowledge of case management before you can attain curative results.

    MB: The argument of Jamie in the TIMES is a weak one as some people claim that we have proof that homeoprophylaxis is working.

    GV: Though I agree that the argument of Jamie Whyte is weak, I, on the other hand totally disagree that homeoparophylaxis is well documented. There is nothing really documented. There are only few trials and a lot of misunderstandings.

    MB: What do you mean?

    GV: I will explain. When Hahnemann wrote that Belladonna will protect from scarlet fever he gave it during the epidemic. In every epidemic we all know that there is one remedy, which is covering in a significant percentage the symptomatology of the epidemic. We call this remedy the “genius epidemicus”

    If this remedy is given in the whole population during the epidemic, it will probably prevent some cases in to going in to the full exposure of the epidemic. Unless we understand the mechanism of action of such an idea we will be making wrong assumptions.

    MB: What is you opinion concerning the action of Belladonna as a homeoprophylaxis in scarlet fever?

    GV: The explanation is that since the symptoms of the patients with scarlet fever were matching the symptomatology of Belladona then this remedy will act as a curative remedy only for these people of course, and not as a preventive. So a curative response were misunderstood and misinterpreted as prophylaxis. Under no circumstances we, homeopaths, could be talking about homeoprophylaxis in the way that vaccinations are used and acting today.

    MB: So there is no meaning in researching the idea of prevention through a homeopathic remedy?

    GV: If we want to research the hypothesis of Hahnemann’s idea of prevention then we can give remedies during an epidemic and this only after we have treated some cases and found out the “genius epidemicus” that covers well such an epidemic. After such a trial, we can compare these results with a group of no vaccinated population and after repeating it a few times publicize the results.

    In this case we may find some substantial difference in favor of homeopathy but to what extend we must say it with all honestly. But the practice of giving before hand potentised remedies without knowing whether an epidemic will manifest or not and claim that this remedy works as protection, is to say the least, irresponsible.

    A remedy will act and prevent only once the symptoms of this remedy are starting to manifest already, and the remedy could then act as a curative agent in the very beginning stage of the epidemic not as a prophylactic.

    The difference is enormous in explaining to the public what exactly we are doing, instead of giving the impression that we have discovered another way for preventing diseases.

    Yours sincerely,

    Martha Moschovitz

  • It is a cliche of horror movies that the evil monster is never really got rid of off. Homeopathy is a ravening zombie that will take a lot of work to finally put down. With any luck there will not be a sequel.

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