//Homeopathy, Health and Animals

Homeopathy, Health and Animals

Last night I attended a splendid talk by one of Britain’s most famous homeopathic veterinary surgeons, try Chris Day. It was most inspiring to hear about this gentleman’s career in veterinary medicine and the huge part that homeopathy  has played in his many decades of practice.

For many people, story the fact that homeopathy appears to work on animals, cure is all the evidence they need. I guess some of our critics will disparagingly say this is also the placebo effect because somehow a dog or cat ‘picks up’ the enthusiasm of the homeopathic vet and its owner. Even if it did work that way, it would be pretty miraculous. But what about a cow? Are cows with mastitis also susceptible to suggestion? Or is it the homeopathic remedy in the drinking trough that protected the herd that drank from that trough – but not the cows that were randomly selected to drink from another trough.

Chris Day has many devoted farmers as clients. For professional farmers the bottom line has to be money – so it just would not be cost-effective for them to employ homeopathic veterinary services unless the results were really good. I was amazed to hear Chris say that he went a whole year once without prescribing a single antibiotic! There is huge concern about the overuse of antibiotics on farm animals these days, so this is an incredible achievement.

For the Disciples of Scientism, I am naïve, less-than-scientific and believe that medicines with ‘nothing in them’ can help humans as well as animals. But hey, I’m not the only one. The EU recently voted to spend £1.8 million (sic) on research into the treatment of farm animals with homeopathy. This has to be the right and ethical approach. If critics of human homeopathy think it’s all placebo, they should be very enthusiastic about preserving NHS institutions that get people better just by talking to them as such places are – at the very least – a valuable teaching resource for all doctors and medical students. They should also keep an eye on those cows doing well on homeopathic medicines!


By | 2012-02-03T18:46:36+01:00 February 3rd, 2012|Homeopathy|54 Comments

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54 Comments

  1. Mohammed February 3, 2012 at 8:32 pm

    I think that humans are animals and if the medicine works on other animals it will work on us. Homeopathy is the most amassing thing. It fixes the patient with no side effects. Thank you Dr. Kaplan on your great contribution to the cause of homeopathy and libertarianism!

  2. liana felton February 3, 2012 at 8:39 pm

    Persuasive stuff Dr. K. Yes your detractors don’t seem to bleat so much when it comes to animal welfare. Taking the safer option is best…even if its homeopathic!

  3. Andy Lewis February 4, 2012 at 10:27 pm

    It is tiring to have to keep responding to the same old canards.

    Here is a substantial post I wrote about Christopher Day and animal homeopathy. I trust this answers your points and will put them to bed for once.

    http://www.quackometer.net/blog/2008/03/vets-who-make-people-feel-better.html

    • Dr. Kaplan February 5, 2012 at 2:12 pm

      Hi Andy, Sorry about your fatigue but spending your time trying to trump democracy and liberty with scientism really is a Sisyphian task and you have my sympathy. Did read your post as recommended. Again
      it seems the gullible and suggestible people (including animal owners) need to be disciplined and regulated because educated scientific authorities such as yourself know better than them what’s good for them and their animals. The war cry of homeopathy’s detractors is simply: “We know better than you what’s good for you and will do anything to force our views on you!” Still, your post did make me laugh when it referred to comments from the orthodox vets saying that homeopathy has the opposite effect of conventional medicines. Doesn’t quite resonate with the war cry “Homeopathy: There’s nothing in it!” does it?

  4. Rob February 6, 2012 at 12:31 am

    Dr Kaplan says “[Andy Lewis’] post did make me laugh when it referred to comments from the orthodox vets saying that homeopathy has the opposite effect of conventional medicines.”
    Where do orthodox vets say that in the article Andy Lewis posted? I’ve just read it and find no claim by any orthodox vet that homeopathy has any effect.

  5. Alex February 6, 2012 at 12:31 am

    Was the EU’s £1.8 million for new research into homeopathy or was it to gather details about research that has already been done?

    Do you know who is doing this research?

    • Dr. Kaplan February 6, 2012 at 12:42 pm

      Hi Alex,
      Sorry the link is all I have.

  6. Andy Lewis February 6, 2012 at 9:51 am

    Your attempt to characterise me as some sort of ‘know it all’ you ‘knows better’ is obviously an attack on me and not my arguments.

    In this case, there is a clear disagreement, and it is likely that one party does indeed ‘know better’.

    For me, I like to know things based on evidence, reason and thought. Homeopaths, I contented, like to know things based on authority, anecdote and uncritical assumption.

    Which side ‘knows better’?

    You will of course characterise my position as ‘scientism’. This charge would hold if it was somehow improper to subject the question of the efficacy of homeopathy to scientific reasoning.

    I see know reason why the claims of homeopathy should not be subjected to scientific analysis. And such an analysis would strongly suggest that this small band of vets who believe in the power of homeopathy are misleading themselves and others.

  7. Andy Lewis February 6, 2012 at 9:56 am

    And I think you need to re-read my blog post properly.

    Of course, I do not agree with the ‘orthodox vets’ I quote. Indeed, they are not ‘orthodox vets’ but homeopathic vets who quite clearly believe that conventional medications antidote homeopathic pills and so should be avoided.

    I quote them not to endorse their views (obviously) but to show how a textbook written by homeopathic vets registered in the UK have quite fundamentalist homeopathic views and are in no way to be considered ‘complementary’. Indeed, their views are not just absurd but likely to lead to animal suffering.

    A shameful position to be in.

    • Dr. Kaplan February 6, 2012 at 1:35 pm

      Okay Andy I’ll respond to your points:

      On the the post in your blog you referred me to: You are correct. I read it quickly initially and can see now that those comments were made by orthodox vets trained in homeopathy which is quite a different matter. So I withdraw my previous comment in relation to that post. As for veterinary homeopathy causing ‘animal suffering’ I could not disagree more. I have spent clinical time with homeopathic vets and to charecterise them as having ‘absurd’ views and causing animal suffering could not be more wrong in my opinion.

      On ‘obviously an attack on me and not my arguments’: In the immortal phraseology of John McEnroe: ‘You cannot be serious!’ Do I post comments on your blog using words and phrases such as: ‘shameful’, ‘disgraceful’, ‘deluded’, ‘self-serving’ and many more – as you regularly do on my blog? Check out the psychological concept of ‘projection’, Andy and much should become clear to you. I simply have an utterly different position to you politically, not only with regard to homeopathy and whether it should be ‘allowed’ on the NHS but with regard to liberty and democracy itself. Let’s be utterly clear about our positions: The report of the S&T committee on NHS homeopathy illustrates our differing political opinions: A number of people testified to that committee and gave what they thought were strong reasons for NHS funding of homeopathy to be stopped. You know exactly who these people are and you supported them. I did not and made my position crystal clear. You can only get homeopathy on the NHS if your NHS doctor refers you. So the essence of homeopathy’s detractors’ position was to THWART NHS GPs from referring patients (who wanted homeopathy) to other fully qualified NHS doctors practising homeopathy. Thus these people who testified against NHS homeopathy (and please let me know if I am wrong in assuming you supported them) are essentially politically saying:
      We seek to THWART (rather than dissuade) NHS GPs from sending patients for NHS homeopathy – because homeopathy is placebo etc. etc.
      From this I infer: These people clearly think they know better than sick patients and better than those sick patients’ GPs what is good for them. I hope this explains the meaning, the context and to whom my quote We know better than you what’s good for you quote applies.

      As to scientism: It’s not ‘improper’ to subject anything to scientific reasoning. It is highly improper and anti-democratic to try to force the views of the Disciples of Scientism on the public without asking them what they think or want as Andrew Sikorski makes clear in an excellent article in Pulse. Mike O’Brien (Labour) and Anne Milton (Coalition) and the Queen of course, all clearly have more respect for the views of a significant minority of British citizens than you and the people to whom I refer above. The Disciples of Scientism really don’t ‘get’ democracy do they? Aren’t you aware that there are Christian Democratic Parties that get voted into power in Europe? I only mention this because to a scientismist, this must look utterly absurd because s/he has raised science to an ideology far superior to Christianity which looks very un- scientific to such people.
      An honorable route for the Disciples of Scientism would be to try to dissuade GPs and medical students to have anything to do with homeopathy. If that were successful, NHS homeopathy would go away naturally and democratically. But no, the hobnail boot approach had to be used and fortunately was treated with the contempt it deserved when the Government kicked ALL the recommendations of that S&T committee firmly into touch.

  8. Andy Lewis February 6, 2012 at 3:10 pm

    It is interesting that you always try to frame the debate in terms of politics and democracy. These issues are not paramount. For me, the issues are about evidence and ethics.

    For you treating human patients, you can always fall back on the idea that you are dealing with adults capable of making their own decisions. In that, you are right – although we would probably disagree on what informed choice means for patients of homeopaths.

    Animals, though, do not have any capability to offer their own consent to be treated. This places vets in a very special and quite difficult ethical world. And places a significant demand on the vet to ensure their actions are based on best evidence.

    If a small minority of vets wish to choose 18th Century pre-scientific forms of treatment, then there must come a point when it moves from being a question of professional choice into a matter of professional incompetence. In that scenario, I think there is a moral requirement that others speak out and condemn such choices. The animals can’t do this. And it is to the shame of the vets’ regulators that they turn a blind eye to it.

    • Dr. Kaplan February 6, 2012 at 3:42 pm

      So now you are advocating on behalf of animal rights? Well you can actually take action against vets and people who abuse animals. In fact if there is one thing that British people really care about – it’s cruelty to animals but until your comment above, I’d not heard it applied to homeopathic vets who as I’ve said are some of the most humanely compassionate people I’ve ever met.

      As to framing the debate: Of course it’s about politics and democracy! You can think and say what you like about homeopathy and the patients who want it and the doctors who use it and that is fine with me. However when people advocate removing NHS funding of homeopathy then that is politics pure and simple. And yes indeed, my position is profoundly political. I advocate libertarian politics where the people are entitled to choose and vote for homeopathy, The Royal Family (and related inherited privileged people) and even a Christian Democratic Party if they want it – whether Christianity is scientific enough for you or not. People who feel differently should form a Party of Science or Party of Scientism where you write an open manifesto stating science/evidence as your ideology. That way we will see exactly how many people support your views. My guess is that the Raving Monster Loony Party candidates will get many more votes than your candidates.

  9. Alex February 6, 2012 at 5:23 pm

    Thanks for repeating the link, but I was looking for something more than a Daily Mail article! Surely there is a better source of information on this?

    • Dr. Kaplan February 7, 2012 at 10:49 am

      Sorry Alex, That’s my source. I’m not involved in any way myself.

  10. Andy Lewis February 7, 2012 at 3:11 am

    Do you think that it is not possible for people to call for the cessation of certain treatments based on considerations of ethics and evidence? Or can all such calls only be construed in terms of power and politics?

    • Dr. Kaplan February 7, 2012 at 11:11 am

      Of course it’s ‘possible’ to call for anything, Andy, but the obnoxious, jeering way this has been done (and continues to be done) with regard to ending NHS funding of homeopathy is egregiously disingenuous for the following reasons:
      The NHS uses many non-evidence based approaches. Indeed as my Pieman illustrates, huge swathes of conventional approaches (NOT attacked by you and homeopathy’s detractors) have little or no evidence behind them. Even if you don’t agree with the BMJ’s figures it’s still quite clear that many ‘conventional’ approaches are far from evidence based. An honest disciple of Scientism would call for the NHS only to use EBM and apply this across the board to all medical interventions. But no – they attack homeopathy exclusively. They could of course look at the issue of antidepressants whose NHS bill dwarfs that of homeopathy and whose efficacy beyond placebo has been called into question.

      Homeopathy has WON the political battle. This issue went to Parliament! The Labour Party, the Coalition and the Queen supported it, but still its detractors whinge on, aided and abetted by the apparently ‘neutral’ BBC. They obviously don’t care about the health budget or the health of the people otherwise they would use their self righteous, high pitched whine to attack the use of antidepressants (NHS budge £232m to homeopathy’s £10) In my view they are affronted by the ‘unseen’ element in homeopathy (what they call ‘implausibility’) which clashes with their extremely mechanistic and deterministic view about life.

      So Andy, I hope you realise that it’s not me that’s made this political. I am merely defending what’s left of democracy and the way that homeopathy is being attacked (the S&T committee and those people who testified was a perfect example of how disingenuous this attack has been.) But two Governments wouldn’t have a thing to do with their authoritarian recommendations. So homeopathy’s detractors are bad losers in going on about it so long after losing the fight at Westminster. There are more important things to discuss now but the attack on homeopathy remains an example of the erosion of democracy and liberty in the UK. Surely I’ve made my position clear on these pages before? A synopsis of my political position wrt to NHS homeopathy can be seen here. Enjoy.

  11. Andy Lewis February 7, 2012 at 3:06 pm

    I am happy for you to think you have won the political battle.

  12. David Eyles February 11, 2012 at 12:46 pm

    As a farmer who has received basic training in homoeopathy, and who has gone on to use it regularly, I make the following observations:
    1. Homoeopathy has helped me take much more charge of the welfare of my own animals, because it has empowered me to deal with problems that often would not be sorted out by the vet anyway – for example the reduction of stress when weaning.
    2. The biggest part of our enterprise is sheep, and it is very rare to see a vet dealing with sheep on a more conventionally run farm because of the unit cost of vet callout vs. the value of the animal. This has not always been the case on our farm because I have used vets extensively for advice and testing to deal with the disease spectrum on the farm (every farm has its own disease problems).
    3. Homoeopathy has helped me to reduce the antibiotic and vaccine usage, not just by using homoeopathy itself, but also by making me think more deeply about management issues. For example, our use of minerals has increased as a result of this veterinary advice; housing and ventilation are very important and so on.
    4. The number of farmers receiving training in the use of homoeopathy is rising every year. Farmers are a careful lot who don’t spend money on technology that does not work. In particular, as livestock keepers, we have legal and ethical responsibilities, as well as financial ones. If homoeopathy did not work, we would not use it.

  13. Dr. Kaplan February 11, 2012 at 3:55 pm

    @Andy Lewis: ‘think you have won’. Isn’t it obvious? The Government rejected ALL(sic) ALL (repeated) the suggestions of the S&T committee and decided to keep NHS homeopathy. Am not sure how this cannot seem like a political victory. Perhaps you confuse the political battle with the PR battle? You have done well to keep your anti-democratic campaign against homeopathy alive after it has been rejected by Labour, Alliance and obviously is seen as distasteful (at least) by the Royal Family.

  14. Dr. Kaplan February 11, 2012 at 3:58 pm

    @ David Eyles: Many thanks for you comment here. V. good to hear the experiences of a farmer using homeopathy on his animals. Trust you disagree with Andy’s comments above in which he suggests that using homeopathy on animals increases their suffering?

  15. David Eyles February 12, 2012 at 1:14 pm

    I have read some of Andy Lewis’ polemic before and his link above has just reminded me of his mode of argument. A couple of points which he raises in his article need clarification:

    1. Vets are, as Andy says, the only professionals entitled to treat other people’s animals. But there is an exclusion in the Act that applies to the owner of the animal. This allows me, as a farmer and livestock owner to treat my own animals with whatever form of medicine that I like, and this includes homoeopathy. If the treatment I have administered turns out to be inadequate and manifest neglect or cruelty arises then I am liable under various animal welfare regulations in the usual way. That is why I still engage and have good relations with my farm vets, even though they are “conventional”. In the past, I have expended large sums of money trying to get to the bottom of a problem which manifested itself in very poor disease resistance in lambs. After extensive blood tests and analysis of carcasses by the excellent Veterinary Laborartory in Winchester, we isolated two problems: the first was a virus which was brought in by some orphan lambs. This had to be culled out of the flock. The second was an almost complete lack of selenium and cobalt in our soils which dropped the natural immune response to “empty” in many of our lambs.

    2. Andy raises the issue of placebo effect in animals. I do not agree with his assertion that it is all down to comforting the owners of the animals. I have always assumed that our animals are individual characters and are sentient. If you talk to many farmers or stockmen, that assumption is also common from the way that they talk about the animals in their charge. For example, a ewe who is having difficulty lambing, whilst initially shy in being caught, will usually submit and get on with her contractions, once she has been lain down on her side for assistance. Usually, I can take my left hand off her shoulder (so that I can keep her lying down) and get on with helping the lamb out. There is undoubtedly a knowledge that I am there to help her. There are many other instances where there is tacit admission that you are the boss (or the leader of the flock) and that you are there to help rather than act as a predator. Another example is at weaning (or loss of progeny because it has died). This is a source of stress and so is an example of sentience and therefore is an area where placebo effect can take place in experimental conditions. I therefore feel very strongly that the placebo effect can take place between animal and keeper, and animal with animal.

    So, in answer to your question, of course I disagree with Andy. Homoeopathy, properly applied, will usually reduce animal suffering. Homoeopathy does not always work but then neither does conventional medicine. It needs to be borne in mind that Andy is a journalist and he holds a very black-and-white view of the world. Were he to receive adequate training and then the responsibility of treating enough patients (animal or human), it just possible that he would begin to appreciate the sheer range of patient responses to any intervention (alternative or otherwise). And then, maybe, he would see for himself just how difficult it really is to be absolutist and dogmatic in the real world of treating the sick.

    • Dr. Kaplan February 12, 2012 at 5:21 pm

      Many thanks for sharing these honest and insightful observations with us.

  16. Andy Lewis February 12, 2012 at 11:04 pm

    Dr Kaplan

    I believe I have discussed this with you before about the Government’s response to the S&T committee report into homeopathy. You continue to misrepresent it.

    You (rather melodramatically) claim ” The Government rejected ALL(sic) ALL (repeated) the suggestions of the S&T committee and decided to keep NHS homeopathy.”

    Let us quote from the report… (the key passage),

    “We [the government] agree with many of the Committee’s conclusions and recommendations. However, our continued position on the use of homeopathy within the NHS is that the local NHS and clinicians, rather than Whitehall, are best placed to make decisions on what treatment is appropriate for their patients – including complementary or alternative treatments such as homeopathy – and provide accordingly for those treatments.”

    So, what they did was say that although central government was not going to get involved. They pushed such decisions downwards.

    Whilst I would say that is a politically opportunistic response to an overwhelming case that homeopathy is nonsense, the effects on the ground are of course continuing. I hear Bristol, the last named homeopathic hospital, is close to closing as local clinicians are deciding not to fund it.

    But as I say, I am happy for you to believe you have won ‘the political battle’.

    • Dr. Kaplan February 13, 2012 at 1:15 pm

      Yes, of course Andy. I agree with that Government statement. However the whole point of that vile S&T committee was to persuade the Government to take
      central action against NHS homeopathy and it decided NOT to do so. I agree with the Government thinking that GPs are the ones who are in the best position to decide what treatments their patients get. Less so local NHS health authoriites Nevertheless this was a significant victory for NHS homeopathy which led to a vitriolic spilling of bile by one of the people who agree with you, Michael Baum – ending in ‘Shame on you Minister!’ Read it? If GPs don’t send patients for NHS homeopathy, then so be it. I will accept the consequences of that IF that happens. As I’ve always said, I strongly object to GPs being thwarted rather than dissuaded from referring patients for NHS homeopathy.

  17. Andy Lewis February 12, 2012 at 11:35 pm

    David,

    Do you not think there are good reasons why only vets can treat animals (bar owners)?

    Every false therapy that has been mistaking assumed to work for thousands of years can be explained by a simple mistake: that those giving the therapy have assumed improvements are due to the therapy.

    That is why we have evidence based medicine now – so that treatments can be assessed free from the many biases and reasoning errors that plague understanding the effects of treatments. (There are a few doctors and vets who hold out of course and accuse those that ask for good evidence as being guilty of ‘scientism’ whatever that is).

    Your skills lay in herdsmanship and farming. Not in assessing the effectiveness of treatments. Do you ever have pause for thought as to what you do?

  18. David Eyles February 13, 2012 at 9:32 am

    I have accused Andy Lewis of being a journalist. In so doing I was confusing him with another skeptic entirely, so my aplogies to him. Nevertheless, the remainder of my comments stand.

  19. David Eyles February 14, 2012 at 12:26 am

    Andy,

    The basis for all EBM is the recording of outcomes. Without outcomes, there would no EBM pyramid: no case studies, no observational studies and no RCTs or meta-analyses.

    This is what happens on a farm if the vet comes to treat an animal: The vet arrives, examines the animal, hopefully listens to what the farmer/stockman/dairyman has to tell him and then treats the animal. The vet then drives off to the next client, leaving the farmer to care for the animal. What happens then is that the animal either makes a full recovery, thrives and takes its place back in the herd or flock; or the animal survives but only just and never fully recovers which means that it is culled at the next available opportunity; or the animal dies and the farmer has to pay for its disposal. Only in fairly rare cases does the vet actually record the outcome of his or her treatment (at least in my experience over the years). The only outcome they really record is whether the farmer pays the bill or not, and whether that vet is invited back onto the farm the next time there is a problem.

    Because the only consistent recording of outcomes is done by the farmer, it means that the farmer is always the best person to judge whether a treatment is effective and/or whether the vet is any good, along with the cost effectiveness of that treatment. Farmers would call this “experience” but for the purposes of this conversation, we can call it “the evidence base”. As the farmer also records his own treatment and medication of animals and often the outcomes of events such as calving or lambing this evidence base is usually far more complete than anything the vet is able to record. The vet records the time taken to treat the animal, its eartag number and the drugs/consumables used, but unless they have actually had to euthanase the animal, they are rarely present to record the outcome of their treatment.

    Don’t misunderstand me, I have great respect for the veterinary profession because the farm vets in particular do a difficult job and it is not as well paid as small animal vets in a cosy practice. But, over the years, I have had New Zealand, Australian and South African vets through my farm, as well as Brits. Some have been exceptional and a welcome relief when they arrive on the farm because I am worrying about an animal. Some have been mediocre. And a small number, two or three from memory, who I would not let back on my farm even if you paid their fees.

    So, yes, I do think about what I do. You are wrong because I am the best person to decide objectively what treatment worked and what did not; and that is why I can be confident that my use of homoeopathy is as effective as conventional medicine when I use it as such, or that it is better to rely upon antibiotics in some (limited) cases, or that it is often the only available treatment because there are no alternative conventional medicines available to use. So I am the best person to objectively decide whether homoeopathy works or not an my animals, and it is my choice and my right to continue to do so whether you or any vet thinks I should be doing otherwise.

  20. Andy Lewis February 14, 2012 at 2:54 pm

    David Eyles – it is quite clear you do not understand evidence based medicine. Merely recording outcomes is insufficient. These are the outdated beliefs of an 18th century empiricist (and 21st Century homeopaths).

    What is important is coming up with good explanations for those outcomes. It is philosophically naive to think that you can conclude homeopathy works on the basis of simply observing a healthy animal after a treatment. It is making the same mistake as observing the outcome of a magician sawing a woman in half and concluding the woman was sawn in half. It is the same mistake a dog makes in believing the postman goes away because of the barking. Yes observation confirms this every time, but the observation in itself tells you nothing about what is going on with the interaction between the dog and the postman. The dog’s explanation fails as soon as someone comes who is not the postman.

    EBM uses controlled experiments to reduce the impact of biases and misinterpretations on observational data. The biases and limitations inherent in your observations are likely to mislead you – as they mislead the barking dog – as they have misled everyone chasing false cures since the dawn of time.

    EBM exists for the very purpose of overcoming the inherent weaknesses of the position you have taken. It is the opposite of what you describe. It is a act of arrogance to assume that you are the best person to decide what works and in so doing to ignore what controlled experiments say and what the science says might work.

    I would go further and say that it is a position of professional irresponsibility to assume such a position and not to appreciate the limits of your own capabilities.

    I pull no punches here because these things are important. The animals cannot advocate for themselves – and someone else has to do it.

  21. David Eyles February 15, 2012 at 12:56 am

    Andy,

    Whilst I am sure that I shall eventually bow to your superior knowledge on EBM, on little thing puzzles me from your statements above:

    If recording outcomes is merely outmoded 18th Century empiricism, then what exactly comprises “evidence” in Evidence Based Medicine?

  22. Andy Lewis February 16, 2012 at 12:44 am

    David,

    There is a difference between evidence and data.

    Recording outcomes provides you with data. But that data – in itself – may not provide you with evidence to support your hypothesis that homeopathy works.

    This is because the data may be explained by a number of competing hypothesis. Data becomes evidence when it can be used to rule out hypotheses.

    Let’s take my example of the barking dog and the dog’s hypothesis that the barking makes the postman go away. The dog may be convinced by accumulated data points over many months that after barking the postman always leaves. The Data is consistent with this hypothesis but the dog has failed to rule out any alternatives.

    That is why controlled experiments are required where a fair test is made that can rule out one or more hypothesis as a result of collecting the data. That data then becomes evidence for a surviving hypothesis. (More experiments and repetitions may be required to turn this data into convincing evidence of course).

    For our dog, simply keeping quiet on randomly selected days produces data that allows you to compare barking and non-barking days to see if there is a significant difference in the data. We are testing to see if the barking is an important component of postmen going away.

    For homeopathy, you might want to compare application of the remedies with randomly selected equivalent inert pills or drops and record the differences between the two. You then start turning data into evidence as the homeopathic hypothesis can be ruled out if you fail to spot differences.

    One of the ways that makes an activity scientific is this willingness to subject your ideas to challenges, through the collection of controlled data, that could falsify your beliefs. Merely collecting uncontrolled data does not do this. That is why homeopaths are so keen to promote ‘observational studies’. They can never really be challenged by them.

    And as you might guess, when you look at the totality of evidence for homeopathy gathered under well run quality trials with enough data points, the difference between homeopathy and placebos tends to zero.

  23. Dr. Kaplan February 16, 2012 at 1:25 am

    Not at all, Andy. Much of what you have said ‘above’ (probably ‘below’ now) is well expressed, scientific and logical. It is only when you call for the removal of NHS funding for homeopathy that you elevate science to an ideology, that ideology being scientism. The people, including the Queen, are entitled to homeopathic medicine prescribed by qualified doctors – if they want it. If they wanted to vote for a Christian Democratic Party they could vote that in to power too – no matter how scientific or not Christianity is to those I have dubbed ‘The Disciples of Scientism’.

  24. Andy Lewis February 16, 2012 at 1:29 am

    As this thread is about treating animals, it is maybe worth pointing out that the animals have no vote.

    • Dr. Kaplan February 16, 2012 at 1:56 am

      🙂 Off the thread, but it was you who brought up science and scientism.

  25. Andy Lewis February 16, 2012 at 11:32 pm

    OK – So back on track. Are you happy that a farmer may be led to believe that they are in a good position to tell what treatments work from just observation of their own animals?

    • Dr. Kaplan February 17, 2012 at 1:55 am

      Yes of course. Who better to judge the health of an animal than a man who lives with them?

  26. Andy Lewis February 17, 2012 at 11:21 am

    So, did anything I say above about the problems with uncontrolled data collecting mean anything at all?

    • Dr. Kaplan February 17, 2012 at 1:22 pm

      Yes, but I trust the farmer’s assessment of his animals more. One day you will finally understand that it doesn’t matter how homeopathy works – only that it works. That’s why you should call for long term outcome studies on NHS homeopathic clinics and find a way of comparing them to non-homeopathic clinics. Even if you think it’s placebo – you should do this because clearly something very important is happening to animals and humans who benefit from homeopathic treatment.

  27. Andy Lewis February 17, 2012 at 2:08 pm

    Dr Kaplan. What is your basis in your trust for farmers being able to tell what works or not?

    It would rather put them is a rather unique position, wouldn’t it? Since the majority of the medical world has abandoned a naive empirical approach to determining efficacy, what attributes do farmers have that doctors don’t?

    • Dr. Kaplan February 17, 2012 at 3:02 pm

      Andy. in my ideal world patients should be ‘allowed’ to choose which doctors they want. The same goes for farmers. Farmers tend to love their animals but even those who don’t have an interest in their animals being healthy. Scientists may give their opinion and attempt to dissuade patients and farmer from using homeopathic medicine but when they actively seek to thwart them from receiving homeopathic treatment from medically qualified doctors and vets, they are not simply being scientists, they are embracing and attempting (very anti-democratically) to enforce scientism on others. Has this not always been my total position on this subject? What do I need to do or say to be more clear about my position?

  28. David Eyles February 17, 2012 at 4:58 pm

    Andy,

    I find your proposed experiment interesting, by which I mean the barking dog and the postman. You seem to be saying that there is only one way to conduct an experiment which will successfully determine the true cause of the effect, and that is the Randomised Controlled Trial.

    So if we examine your experiment, we see that there are two possible outcomes: either the postman leaves; or the postman stays for a chat and a coffee (not unheard of in rural areas like ours – relationships have formed as a result, but I digress). There are two treatments: Barking and Not Barking. The simplest statement we can make from this which can be tested is that the dog’s barking has no effect upon the departure of the postman. This is your null hypothesis. The alternative hypothesis is that the barking does cause the postman to go away. Assuming we run the experiment, say 60 times with an approximately equal number of Barking and Not Barking days, and that the Barking/Not Barking events are independent, then in all likelyhood the vast majority of events in both Barking and Not Barking days will be departures by the postman.

    On the face of it, this would confirm the null hypothesis. But actually a standard statistical test will only return a non-significant result in favour of the alternative hypothesis. And this demonstrates the oft repeated phrase that “No evidence of effect is not the same as evidence of no effect.” You will find this statement repeated at least three times in, for instance, the Cochrane Handbook for Systematic Reviews of Interventions (Higgins J P T and Green S, 2008, Wiley Blackwell).

    I also note that your experiment is not a Randomised Controlled Trial because it has only one participant, the dog, who cannot be randomised; and neither is the experiment blinded. In fact what you have suggested seems more like an observational study with a cross-over because the dog acts as his own control on his Not Barking days. This is a pity for two reasons. The first is that you don’t seem to like observational studies very much; and the second is that you haven’t convincingly demonstrated causation, or the lack of it.

    Perhaps it would be better to refer to real studies which have been well conducted in order to determine whether there is an effect or not. Two classic studies which spring to mind are the famous Doll and Hill studies which spanned the 1950s until the mid 70s on the risks of lung cancer by daily cigarette smoking. The second is Vessey M, Hermon C, Kay C, Hannaford P, Darby S Reeves G. Mortality associated with oral contraceptive use: 25 years follow up of cohort of 46 000 women from Royal College General practitioners’ oral contraception study. BMJ 1999;318:96-100.

    Both of these are cohort observation studies and demonstrate causation to most peoples’ satisfaction, which in my ever so humble opinion shows that RCTs are not always the bee’s knees in medical or veterinary science. This comment applies particularly when a well run observational study is compared with a badly designed RCT which fluffs its design and does not answer the question very well.

    Nevertheless, there are well designed and executed RCTs out there which show good effect sizes, demonstrate internal, external and model validity, are adequately statistically powered and show homoeopathy is an improvement over placebo.

  29. Andy Lewis February 18, 2012 at 12:03 am

    Firstly. David. You are stretching my dog example to an extreme. And in doing so, failing to grasp the central elements.

    What is important is collecting evidence that is convincing and free from enough biases and confounding factors to be able to rule out alternatives with conviction.

    Yes. Large RCTs may well be over kill for some kinds of evidence (do parachutes save lives), but that does not mean that RCTs are not the best way be have of establishing causality.

    When we do not have RCT evidence, we may still draw rational conclusions, but have to acknowledge the provisionality and incompleteness of such conclusions. Homeopath have a tendency of misinterpreting Sackett in this regard. When dealing with the highly implausible, such as homeopathy, then high quality evidence is vital.

    For example, all evidence, albeit epidemiological in nature, points to a strong link between cancer and smoking. With homeopathy there is huge conflict between very strong basic science that suggests homeopathy is nonsense and some weak observational data that suggest otherwise. Given as much, it is irrational to draw strong conclusions that homeopathy works. Homeopaths know this so try to suggest that somehow conventional physics is wrong. An absurd and ludicrous position.

    PS Can you cite the good studies that show an effect of homeopathy over placebo?

    Secondly, you ignored my question. I guess you have no answer – and actually are quite aware of your contradictory beliefs.

  30. Andy Lewis February 18, 2012 at 1:12 am

    That last point was aimed at BK obviously.

    • Dr. Kaplan February 18, 2012 at 1:56 am

      To which BK must courteously reply: It doesn’t matter how homeopathy works, only that it works. If it works by placebo effect as AL obviously believes, then NHS homeopathic clinics should be seen by people like him (if they have the benefit of humanity at heart) as perfect places for scientists to study the placebo effect, not only in the short term but in the long and very long term. This would be a marvellous subject for a prospective study, performed with scientific rigour. Of course the homeopathic doctors involved must necessarily be experienced homeopathic doctors who believe that homeopathy works over and above the placebo effect. As to financing this, we must be able to afford it if we can run up a bill of hundreds of millions for the use of anti-depressives which have been shown to be no better than placebo in cases of mild and moderate depression – in other words, depression treated mainly by GPs than NHS psychiatrists.

      Apropos: ‘Conventional physics Fritjof Capra, no lightweight physist, strongly disagrees that physics has to be somehow wrong to take seriously as theory that infinitesimal doses of medicines can have physical effects.

  31. Andy Lewis February 18, 2012 at 7:37 pm

    Firstly, you know full well that we are discussing if homeopathy works not how homeopathy works.

    Secondly, you are coming mightily close to suggesting ant perceived effects are just placebo effects.

    Finally, Fritjof Capra is utterly a ‘lightweight’ with his best selling book based on physics that was disproven 30 years ago and is nothing more than a drug-fuelled fantasy that some words used by physicists bear a resemblance to words used in Eastern religions. His is appeal is purely to New Agers. Just so you know.

    • Dr. Kaplan February 18, 2012 at 7:51 pm

      I don’t know much about physics (Physics 101 only) except that the physisists I know, are much less anti-homeopathy than chemists, pharmocologists and biologists such as His Grace, the Archbishop of Scientism, Richard Dawkins.

      Getting off the point about animals. Imo, homeopathy obviously works. The question is how. Prospective studies should be done on humans and animals. Attempts to remove it from the NHS before doing this are disingenuous. Two successive Governments agree. Enough said.

  32. Andy Lewis February 18, 2012 at 10:13 pm

    Every person who has ever believed in the effectiveness of a useless therapy has thought it was obvious. Your position for including homeopathy might be fine were it not for too rather large problems: the utter absurdity of homeopathy, and the simple explanations for why people like you believe in it.

    Talking of absurdity. It may be true that more physicists are more open minded about homeopathy than, say, biologists. But I would suggest that is for two reasons. They are less likely to be aware of the actual claims of homeopaths and instead believe it to be a form of herbalism. They are less likely to be aware the human biases that mislead people in such areas.

    In my experience, physicists are your biggest critics – once they discover what homeopaths actually claim. All the talk of quantum explanations is obvious bunk to the vast majority of physicists who tend to be scalding of people appropriating quantum theory to support their own mysteries.

    • Dr. Kaplan February 19, 2012 at 12:34 am

      Strangely enough Andy, I am indeed a student of Absurdity – a necessary qualification for being a Provocative Therapist. I recommend Theatre of the Absurd by Martin Esslin. That homeopathy is ‘absurd’ is far from proven though.

  33. David Eyles February 19, 2012 at 4:13 pm

    Andy,

    My apologies for being slow to come back to you. Things have been busy in the last couple of days.

    So, to answer your question, I will give you an instance of one RCT which was conducted upon pigs using homoeopathy, and that is: Camerlink I, Ellinger L, Bakker EJ, Lantinga EA. Homeopathy as replacement to antibiotics in the case of Escherichia coli diarrhoea in neonatal piglets. Homeopathy(2010) 99, 57-62.

    This was a well conducted double blind RCT and ticks just about all the boxes in terms of quality of the trial. If you went through this and scored it using the JADAD scoring system, it would score top marks. However, JADAD is merely an assessment of the RISK of bias and is not sufficient to assess quality and that is why it is not often used these days. For RCTs, the modern approach is to use the CONSORT checklist (not a scoring system) including standards approaches to Intention To Treat analysis and so on. I have one or two very minor gripes under one or two headings of CONSORT when applied to this study; but really, it is pretty much all there, including sufficient numerical data for a later study to assess effect size, confidence limits, standard error and so on. Statistical power was easily sufficient to give significance at the P<0.05 level.

    The trial was designed to answer the question as to whether homoeopathy was able to reduce the use of antibiotics in treating piglets with E.coli diarrhoea. It did this by applying a homoeopathic E.coli nosode (30c) to a total of 52 sows about a month before farrowing, 26 sows in each group. The control was a placebo preparation and the person applying the verum/control was blinded and the randomisation was computer generated. When the piglets were born, they were checked daily for diarrhoea and clincial signs noted for each piglet, and then continued to be monitored for seven days until recovery. There were 265 piglets in the placebo group and 260 in the verum group, so a very good sample size. The results showed that the placebo group were six times more likely to suffer from diarrhoea than the verum (homoeopthy) group. Of those piglets in the homoeopathy group which did contract E. coli there was a slight, but non-significant, improvement in the speed of recovery. 63 piglets contracted E. coli in the placebo group and 10 contracted E. coli in the homoeopthy group (P<.0001).

    What is astonishing to me is that this trial demonstrates that homoeopathy can be used as a sort of vaccine. The vaccination of dams before giving birth with conventional vaccines in order to pass on immunity via the dams' colostrum is standard within agriculture, and this seems to do the same job homoeopathically, as well as cut down the use of antibiotics in the food chain. This has to be a good thing.

    So Andy, I have done my bit. Now think it is only fair if you do some work and justify one or two of your more categorical statements by reference to papers which confirm your beliefs, such as this one: "….when you look at the totality of evidence for homeopathy gathered under well run quality trials with enough data points, the difference between homeopathy and placebos tends to zero."

  34. Andy Lewis February 19, 2012 at 8:34 pm

    There you go with your scientism again wondering if homeopathy has been ‘proved’ absurd.

    Can you imagine how that might be done? Does it need to pass a threshold of absurdity on some International Scale of Nonsense?

    I suspect you are too far deep in homeopathy to see its central absurdity anymore. Let me remind you. Homeopath depends on a magical property of remedies – that they can have an effect when no longer there. It is the similar magical thinking that leads to poppets and voodoo dolls. Indeed, the anthropological phenomenon of sympathetic magic has two central features – similarity and contagion – both present in homeopathic thinking.

    There are of course homeopaths who continue this magical thinking and produce things such as paper remedies and hair transmission remedies. Do you believe those aspects of homeopathy are absurd? Or would you hold out until it was proven that writing a remedy on paper has effects like the actual remedy?

    • Dr. Kaplan February 19, 2012 at 10:17 pm

      Your argument that homeopathy ‘depends on magic’ is over 200 years old now. The intangibility of the active ingredient of homeopathy was the same as it was when I started studying homeopathy 30 years ago. Nothing has changed other than our detractors becoming more vocal aggressive and organised. My position is political.

      1. Homeopathy was just as ‘implausible’ as it was in 1948 when it was INVITED to become part of the health service. To steal those hospitals from the people who want homeopathy on the NHS would be daylight robbery.
      2. It does not matter HOW homeopathy works or HOW ‘implausible’ it is. As long as doctors using it are accountable for their actions, they should be allowed to use it.
      3. Apparently ‘stupid’ doctors (like myself) and apparently ‘stupid patients’ (including the Queen) do not need to be protected from our own apparent stupidity by legislation or by people such as yourself – thank you very much.
      4. Huge swathes of NHS medicine lacks the requisite evidence you demand for homeopathy: Eg. psychoanalysis and anti-depressants fo
      r mild and moderate depression.
      Please see my post on authoritarian and libertarian politics here. THIS is my position pure and simple.

  35. Andy Lewis February 19, 2012 at 10:36 pm

    David – thank you for coming back with that study. So, how would I interpret that study?

    Well. In the broadest terms, I would be reluctant to come to any conclusion as a result of a single study. (I did ask for studies) Given homeopathy’s long history, one would expect enough trials to perform a systematic review – which would be more convincing. Single studies can give misleading results for many reasons. Given the prior probability for homeopathy working is near zero, very strong evidence is required to supports its claims.

    But what makes me think this study is worthless is one rather large whopper – the study failed to show that any of the piglets had colibacillary diarrhoea. The authors just assume this. It makes it hard to take anything else seriously. I can’t see how this passed peer review.

    Actually I can. It is published in Homeopathy. I have a rule of thumb: never trust a journal dedicated to a technique. Journals dedicated to issues tend to be less wedded to forms of treatment. A journal focused on one technique quickly slides into advocacy rather than dispassionate appraisal.

    As with all small studies like these, published in trade papers like Homeopathy and not in proper peer reviewed journals, the probability that we are seeing experimental “artifacts” is always higher than we are seeing a ground breaking piece of work.

    PS In answer to your question re reviews of homeopathy: Shang. (and please no boring ‘its been discredited’) Utter nonsense.

  36. David Eyles February 19, 2012 at 11:33 pm

    Poor Andy, he is weighed down by the enormity of his task. He is visibly failing to persuade those of us who insist upon dragging our knuckles along the ground, of the pure beautiful logic that he purveys. Whilst he sits in the sunlight of the uplands of scientific method and process, we continue to lurk in the shadows of the dark primeval forest of ignorance; insisting upon our democratic right to cure our own bodies as we please. Oh! what stubborn and intractable churls we are to resist his blandishments and promises of the blissful afterlife that he will give to us, if only we will repent of our sins and listen to the sweet music of his reason.

    On the other hand: “absurdity” and “implausibility”? Now, I wonder just how absurd and implausible we really are? Another little paper, a mere smidge you understand, but one by Wolf U, Wolf M, Heusser P, Thurneysen A and Baumgartner S: Homeopathic preparations of Quartz, sulfur and copper sulfate assessed by UV-spectroscopy. Evidence Based Complementary and Alternative Medicine (2011) Article ID 692798.

    This is a double blind randomised controlled trial to examine the UV transmission for homeopathically prepared solutions at ultra high dilutions for the above chemicals against placebos prepared in exactly the same way. And it came to pass that the CuSo4 in 11c to 30c dilutions reduced the transmission of UV light significantly, and reduced transmission for the other two slightly but not significantly. And this was tested in not one but two US laboratories whose results were found to be similar.

    And so we begin to establish that practical trials to answer the question “Does it work?” and the evidence base is suggesting that, well, yes, maybe it does. And that is followed by another question of: “Well if it works, what is it that is different?” which begins to be answered by the very tentative “It seems that there are actual measurable physical differences between homoeopathy and placebo”. Some day soon we will be getting more definite ideas about the structure. And then after that there remains only the great big question of : “How does it work? What happens when homoeopathy hits an organism that causes changes in that organism to assist self healing?”

    And then maybe the great, slow rolling stone of science will begin to confirm what homoeopaths have known for two hundred years.

    • Dr. Kaplan February 20, 2012 at 1:13 am

      Poetry too 😉

  37. Andy Lewis February 20, 2012 at 2:35 am

    I think all I can say is you are easily convinced. This is junk science of the highest order.

    Firstly, why do these tests? Why this analytical technique? Why these homeopathoc remedy choices? All arbitrary. That ought to ring alarm bells. That one can get differences between different samples at the detection limits is not suprising. But there is nothing at the outset to say what differences you would expect and for what samples in order to have a positive result. This study has merely seen some arbitraty difference in one of the arbitrary samples and then claims “It’s homeopathy!”.

    Nonsense.

    Laughable.

    This experiment is like blinding a gunman and then asking them to fire at a barn door. When you see a few bullet holes clustered together, you shout ‘There is the target!’

    Do you see the problem?

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