OK, shoot.

MRC_Hans · #1 (**permalink**) 7th November 2003, 07:04 PM

So, I came here to get knowledge on homeopathy. Several of you have helped me greatly, I am much wiser now. My view on homepathy has become much more nuanced. Only reasonable if I try to return the favor:

Wnat to know about my pardigm? My beliefs? My motives?

Shoot, and I'll try to answer.

Hans

kayveeh · #2 (**permalink**) 8th November 2003, 04:02 AM

Hello Mr Hans,

Just try to find out the awnser of the following questions as mentioned by me in other topic:-

Ask the following questions from the patients by visiting homeopathic clinics:

(a) Why they came there, when so much publicity contrary to homeopathy, don't you believe in scientific findings?

(b) If you take homeopathic treatment, if yes since how many years?

(c) Are you satisfied & healthy with the treatments?

(d) Do you get adverse or side effects?

(e) How much you spend on this treatment?

(f) Do the homeopath attend properly & gives sufficient time or not?

(g) Do you feel natural repulsion to visit here or not?

(h) Remarks......

[ 09. November 2003, 03:03: Message edited by: kayveeh ]

David Johnson · #3 (**permalink**) 8th November 2003, 04:50 AM

MRC Hans,

Okay--

Are you aware of any limitations which exist with double-blind placebo controlled testing?

'Not everything that can be counted counts, and not everything that counts can be counted.'--True or false?

In your opinion, are there any limitations to the left brain's ability to analyze?

'The predominance of mind is no more than a stage in the evolution of consciousness'--True or false?

Do you feel there are any inherent prejudices with respect to what is or is not accepted as part of medical practice? (Although this includes homeopathy, the question is not limited to that issue alone).

What limitations, if any, do you perceive in conventional medical practice?

Is it your opinion that most of what is practiced in conventional medicine is supported by research?

What is your opinion about how conventional medicine will view its current practices in 20 years? How about in 50 years? 100 years?

Have the indications for homeopathic sulphur, lycopodium, pulsatilla, sepia, calcarea carbonica, hepar sulphuricum, etc., etc., etc., substantially changed in 200 years?

Apart from the emergence of antibiotic-resistant organisms (hmm. . .) are the common diseases significantly different compared to 200 years ago?

Is a person who has little or no formal training in homeopathy able to competently discuss controversies which exist within homeopathic practice itself?

Just as the Zen master demonstrated to the student that one must empty their cup before they can begin understanding, I had to let go of my pre-conceived ideas and egocentric opinions before I could begin to grasp homeopathy. I saw you make the point elsewhere that the principles of homeopathy are easy to understand. On the surface, perhaps, but in reality, it takes years of disciplined study to achieve some degree of competency. In my opinion, far too many people are prepared to launch their opinions about homeopathy without due training or experience.

I truly wish you could be witness to the nearly daily experiences I'm privileged to have in my practice. These experiences are why leaving conventional practice, losing benefits and more than 50% of salary, losing nearly all the support of former colleagues, and patiently and repeatedly answering 'critiques' (which all homeopaths have heard many times over) has been a small, small price to pay in return. In my experience, there are huge rewards to be had by swimming against the current. No, homeopathy doesn't solve every problem, but a few of us have some understanding of the placebo effect, and have enough experience to recognize when there's something else at work.

Best of luck in your search for answers.

David

bwv11 · #4 (**permalink**) 8th November 2003, 12:07 PM

That’s called ‘piercing the veil.’ Nice work, David!

mrc - imo, these questions go to the heart of the 'paradigm shift.' you are to be congratulated once again, for creating an atmosphere in which these questions could be raised constructively.

thanks for visiting here - i say this especially as someone who was really really really really tired of arguing with a long string of vicious antagonists from the empirical camp. i look forward to seeing your handling of david's questions.

have a nice day,

bach

MRC_Hans · #5 (**permalink**) 8th November 2003, 08:36 PM

OK.

Kayveeh:
I do not know any patients who visit homeopaths. I think you yourself, and others here, will be better equipped to answer your questions.

David (my replies in bold):

Quote:

Are you aware of any limitations which exist with double-blind placebo controlled testing?

Several. The most important is that not all regimens are suitable for application of placebo. Accupunkture is a good example.

In the case of homeopathy, when assing efficiacy, the difference in the homepathic definition of disease, as compared to that of scientific medicine, is an obstacle, although, in my opinion, one that can be overcome.

Finally, DBPC test is solely suited to find objective differences between groups. Much of disease treatment is subjective.

Also, one has to realize that DBPC protocols are quite complex, and hence, expensive. Especially the need for stastistically significant sizes of groups.

'Not everything that can be counted counts, and not everything that counts can be counted.'--True or false?

No simple answer. As already mentioned, part of disease control is subjective; a person who feels well, even when objectively not, is better off in terms of life quality than a person who is objectively healthy, but feeling ill. Such circumstances are ill suited for stastistical alalysis.

In your opinion, are there any limitations to the left brain's ability to analyze?

We are not masters over which part of our brain we use. In principle, there is no limit to our ability to analyze. The limit lies in our ability to get useful results from analysis.

'The predominance of mind is no more than a stage in the evolution of consciousness'--True or false?

If I understand the question right, my working assumption is that this is true.

Do you feel there are any inherent prejudices with respect to what is or is not accepted as part of medical practice? (Although this includes homeopathy, the question is not limited to that issue alone).

There certainly are, but I do not see these as a real obstacle to vindication of alternative regimens, should they prove valid. Numerous people with backgrounds in conventional medicine study and use alternative regimens, including homeopathy.

What limitations, if any, do you perceive in conventional medical practice?

Apart from the already mentioned prejudices, Manly two:

1) Legal responsibility; if a doctor uses a recognized method and fails, there is less risk of legal consequences than if a non-recognized method fails.

2) Economical. Apart from the problem mentioned in #1, use of non-conventinal methods are economically more risky, albeit not neccessarily less profitable.

Is it your opinion that most of what is practiced in conventional medicine is supported by research?

Certainly.

What is your opinion about how conventional medicine will view its current practices in 20 years? How about in 50 years? 100 years?

Within the last century, conventional medicine has become predominantly research-based. Future research is bound to make us wiser. In that context, some present practices will in the future seem primitive, even faulty. It will, however, be acknowledged as lack of knowledge, not incompetence.

Have the indications for homeopathic sulphur, lycopodium, pulsatilla, sepia, calcarea carbonica, hepar sulphuricum, etc., etc., etc., substantially changed in 200 years?

Accoding to my knowledge not. The question, in my opinion, is whether those indications are based on fact.

Apart from the emergence of antibiotic-resistant organisms (hmm. . .) are the common diseases significantly different compared to 200 years ago?

Apart also from emergence of new diseases, no. The possibilities for treatment, and the understanding of causes for diseases have, however, changed dramatically (for the better )

Is a person who has little or no formal training in homeopathy able to competently discuss controversies which exist within homeopathic practice itself?

For the principal questions of objectivity, basis in verifiable facts, etc. I think so. Whatever our belief system, we live in the same reality. I also notice that persons, who may be well educated in homeopathy, but evidently not in scientific medicine, do not hesitate to discuss the latter.

Just as the Zen master demonstrated to the student that one must empty their cup before they can begin understanding, I had to let go of my pre-conceived ideas and egocentric opinions before I could begin to grasp homeopathy. I saw you make the point elsewhere that the principles of homeopathy are easy to understand. On the surface, perhaps, but in reality, it takes years of disciplined study to achieve some degree of competency. In my opinion, far too many people are prepared to launch their opinions about homeopathy without due training or experience.

Within my paradigms, the world we live in is observable and knowable. Facts and objective knowledge remain the same, no matter which path we follow to reach them.

I truly wish you could be witness to the nearly daily experiences I'm privileged to have in my practice. These experiences are why leaving conventional practice, losing benefits and more than 50% of salary, losing nearly all the support of former colleagues, and patiently and repeatedly answering 'critiques' (which all homeopaths have heard many times over) has been a small, small price to pay in return. In my experience, there are huge rewards to be had by swimming against the current. No, homeopathy doesn't solve every problem, but a few of us have some understanding of the placebo effect, and have enough experience to recognize when there's something else at work.

(The italicised part of the statement) Unless you can objectively define the limitations of placebo effect, you cannot make that statement.

Hans

MRC_Hans · #6 (**permalink**) 8th November 2003, 08:39 PM

And bach:

Thank you! I will try to live up to that.

Hans

kayveeh · #7 (**permalink**) 9th November 2003, 03:08 AM

Mr.Hans,

I do not know any patients who visit homeopaths.

I asked by 'visiting homeopathic clinics'.

I think you yourself, and others here, will be better equipped to answer your questions.

Then, how you will be convinced/satisfied?

[ 09. November 2003, 03:10: Message edited by: kayveeh ]

David Johnson · #8 (**permalink**) 9th November 2003, 05:10 PM

MRC Hans,

Since coronary artery bypass graft surgery is a billion dollar industry, we would expect the benefits to be supported by research. No double blind studies there, and when compared to medical management, except in limited cases, there is no significant difference in terms of quality of life or survival. So why do we keep on doing expensive CABG surgery when in most cases it's not necessary?

How about estrogen for post-menopausal women? First the research said nearly all women needed to take it for prevention of heart disease, but then the a subsequent study came along and showed that the increased risk for cancer contraindicates that practice. So where does that leave the women who've been on the estrogen replacement for years?

Another simple example: antibiotics for childhood ear infections. Billions of dollars have been spent on antibiotics for otitis media, and now the research says in the vast majority of cases, no antibiotics should be used. In the meantime, antibiotic resistance has become a major crisis in health care, and antibiotics for OM continue to be used almost routinely.

Maybe the above are some of the reasons it's become necessary to use the term 'Evidence-Based Medicine'. Shouldn't the term 'evidence-based' be redundant? A 1981 Study by the Office of Technogical Assessment concluded that only 10-15% of medical practices were supported by research. Maybe a whole lot has changed since then, or, maybe not.

I'm glad you feel confident using conventional medicine, and I have no interest in debating you out of that use. But after 12 years of working in and teaching clinical medicine, my experience was different.

Most placebo effects are seen to diminish within 6 months, and homeopaths don't present cases in the major journals or conferences with any less than one year of follow-up--some insist on at least four. The important thing is that people get better.

Here's a quotation from C. Everett Koop's autobiography--

'I can't remember a time when I didn't want to be a doctor. . One homeopathic physician, Dr. Justice Gage Wright, was a great model. . Although today few believe in the underlying precepts of homeopathy, few doubt the psychological benefits of the therapy. It was not a placebo effect. It was satisfaction with and confidence in the hands-on attention paid to the patient, still a potent adjunct to healing'.

So even though Koop doesn't accept homeopathic principles, he states it is not a placebo effect. Whether it is or isn't, he brings up an important question--if conventional medicine continues to improve, how frequently do you hear people praising their conventional physican's hands-on attention?

It's obvious you feel confident in critiquing homeopathic practice in spite of no direct experience, so I hope you'll consider using the same powers of observation in critiquing conventional medicine.

That's all--I'm signing off now. Best of luck with your search.

The Fat Man · #9 (**permalink**) 9th November 2003, 06:17 PM

" It was not a placebo effect. It was satisfaction with and confidence in the hands-on attention paid to the patient, still a potent adjunct to healing"

Is many time a problem with the homeopathy that people quote authorties not evidence. Sometimes the 'authority' does not talk good sense. This is a case.

In the quote, I say second sentence is good exact definition of how to make the placebo effect.

[ 09. November 2003, 18:19: Message edited by: The Fat Man ]

MRC_Hans · #10 (**permalink**) 9th November 2003, 08:12 PM

David:

Quote:

Since coronary artery bypass graft surgery is a billion dollar industry, we would expect the benefits to be supported by research. No double blind studies there, and when compared to medical management, except in limited cases, there is no significant difference in terms of quality of life or survival. So why do we keep on doing expensive CABG surgery when in most cases it's not necessary?

Obviously, surgery is not a field that lends itself to double-blind study. I do not know the details, my knowledge is restricted to anecdotical accounts of people, who have certainly had much improved quality of life from the procedure you mention.

How about estrogen for post-menopausal women? First the research said nearly all women needed to take it for prevention of heart disease, but then the a subsequent study came along and showed that the increased risk for cancer contraindicates that practice. So where does that leave the women who've been on the estrogen replacement for years?

It leaves them with certain benefits and certain draw-backs. In general, long-term effets cannot be established experimentally. There will always be cases where testing shows short-term benefits, but experience finds adverse long-term effects. The jury is still very much out on HRT regimens.

Another simple example: antibiotics for childhood ear infections. Billions of dollars have been spent on antibiotics for otitis media, and now the research says in the vast majority of cases, no antibiotics should be used. In the meantime, antibiotic resistance has become a major crisis in health care, and antibiotics for OM continue to be used almost routinely.

I do not agree with your major crisis assessment, otherwise, see above.

Maybe the above are some of the reasons it's become necessary to use the term 'Evidence-Based Medicine'. Shouldn't the term 'evidence-based' be redundant? A 1981 Study by the Office of Technogical Assessment concluded that only 10-15% of medical practices were supported by research. Maybe a whole lot has changed since then, or, maybe not.

Medical practices become increasingly research-based.

I'm glad you feel confident using conventional medicine, and I have no interest in debating you out of that use. But after 12 years of working in and teaching clinical medicine, my experience was different.

Most placebo effects are seen to diminish within 6 months, and homeopaths don't present cases in the major journals or conferences with any less than one year of follow-up--some insist on at least four. The important thing is that people get better.

Placebo effet is not a discrete effect, in the way understood by medical research. It is simply the sum of effects that cannot be ascribed to direct effect of treatment in question.

Here's a quotation from C. Everett Koop's autobiography--

'I can't remember a time when I didn't want to be a doctor. . One homeopathic physician, Dr. Justice Gage Wright, was a great model. . Although today few believe in the underlying precepts of homeopathy, few doubt the psychological benefits of the therapy. It was not a placebo effect. It was satisfaction with and confidence in the hands-on attention paid to the patient, still a potent adjunct to healing'.

I am convinced that the inherent great attention to the patient is one of the strengths in traditional homeopathic practice.

So even though Koop doesn't accept homeopathic principles, he states it is not a placebo effect. Whether it is or isn't, he brings up an important question--if conventional medicine continues to improve, how frequently do you hear people praising their conventional physican's hands-on attention?

An obvious caveat for scientific medicine is the temptation to focus on objective symptoms instead of a more holistic assessment of the patient. However, the holistic approach is being more and more recognized.

It's obvious you feel confident in critiquing homeopathic practice in spite of no direct experience, so I hope you'll consider using the same powers of observation in critiquing conventional medicine.

I hope so too.

Hans

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