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--- en:misc:talk-qa-saine-schwarcz [2013/02/07 11:55]
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 **You said in the debate, "I think I’m pretty up to date on science. I’m pretty up to date on the literature. I’ve read all of those papers about the nanoparticles. They have absolutely nothing to do with homeopathy. They have to do with some anomalous findings and some solutions. Virtually all of them have been explained, whether or not its particles dissolving from the glass, or whether it’s an overgrowth of bacteria that were inadvertently introduced. I mean, there are explanations there." Can you be more precise on the problems encountered in the experiments published in Langmuir by Chikramane et al.[(Chikramane PS, Kalita D, Suresh AK, Kane SG, Bellare JR. Why extreme dilutions reach non-zero asymptotes: a nanoparticulate hypothesis based on froth flotation. //Langmuir// 2012; 28: 15864-15875.)] in 2012 and their cause? In fact, I presented their evidence that there were nanoparticles of starting materials in ultra-molecular preparations (UMPs). How can the presence of these nanoparticles in these UMPs be irrelevant? Are you aware of studies showing the properties often unexpected of nanoparticles?[(Roduner E. Size matters: why nanomaterials are different. //Chemical Society Reviews// 2006; 35: 583–592. )] [(Thierry B, Textor M. Nanomedicine in focus: opportunities and challenges ahead. //Biointerphases// 2012; 7: 19. )] [(Bell IR, Schwartz GE. Adaptive network nanomedicine: an integrated model for homeopathic medicine. Frontiers in //Bioscience// 2013; S5: 685-708.)] [(Paulter M, Brenner S. Nanomedicine: promises and challenges for the future of public health. //International Journal of Nanomedicine// 2010; 5: 803–809.)] [(Bell IR, Koithan M. A model for homeopathic remedy effects: low dose nanoparticles, allostatic cross-adaptation, and time-dependent sensitization in a complex adaptive system. //BMC Complementary and Alternative Medicine// 2012; 12: 191.)] [(Bell IR, Schwartz GE, Boyer NN, Koithan M, Brooks AJ. Advances in integrative nanomedicine for improving infectious disease treatment in public health. //European Journal of Integrative Medicine// xxx (2012) xxx.e1–xxx.e15. http://www.sciencedirect.com/science/article/pii/S1876382012011146)] Are you aware that the homeopathic preparation process of trituration followed by dilution and succussion is in fact an inexpensive, top down way of manufacturing highly reactive nanoparticles from the original bulk materials?**
+===== QUESTION 3 =====
+**If you are really concerned about patients being injured and duped, then why don’t you place an equal energy into warning people about the dangers of allopathic medicine that by the most conservative estimates say are responsible for at least 10,000 deaths a year in Canada? You do not seem interested in warning the public against cough and cold medicines for children that resulted in many deaths with no proven efficacy? What about polypharmacy which results in many deaths but is extremely common in conventional medicine?**
+===== QUESTION 4 =====
+**It is interesting to note that since the middle of the nineteenth century neither you nor any other skeptic have ever commented with an in-depth analysis on the extraordinary results obtained by homeopathy in epidemics, namely a consistent and extremely low mortality rate. For instance, it is very well documented that the mortality of cholera remained consistent at about 50% until rehydration was introduced in the 1960’s, and this was regardless of the type of treatment provided or even in the absence of treatment. In the debate, I reported one of many hundreds of similar occurrences, namely, the results obtained by two homeopaths in Cincinnati who had published their daily records in the local press during the 1849 cholera epidemic. In total, they treated 2,646 cases with 35 deaths, or a mortality rate of 1.32%, despite seeing 60-70 cases that were in a deep stage of collapse. After the epidemic, they were accused by a skeptic of having falsified their records. A public commission was set up to inquire the matter, which was chaired by Alphonso Taft who would later become Secretary of War under President Grant and whose son became the 27th President of the United States. In the end, the commission confirmed that the results reported by the two homeopathic physicians were absolutely correct down to every single case reported during the epidemic. In your dismissal of the efficacy of homeopathy, can you please explain your complete silence on the overall extraordinary, consistent and predictable results obtained by homeopathy in epidemics, which I briefly addressed in the debate and have been greatly authenticated by a number of reputable medical historians?**
+===== QUESTION 5 =====
+**It is astonishing to note that a "man of science" would consider the Shang et al. 2005 meta-analysis published in the Lancet the "definitive meta-analysis[(Schwarcz J. Answer to a homeopath’s criticism. //Chemically Speaking// June 5, 2012.)]" —notwithstanding the fact that major flaws have been underlined by a large number of scientists[(Bornhöft G, Matthiessen P. Homeopathy in Healthcare. //Effectiveness, Appropriateness, Safety and Costs//. Herdecke: Springer, 2011, 39-46. )] [(Frass M, Schuster E, Muchitsch I, Duncan J, Gei W, Kozel G, Kastinger-Mayr C, Felleitner AE, Reiter C, Endler C, Oberbaum M. Bias in the trial and reporting of trials of homeopathy: a fundamental breakdown in peer review and standards? //Journal of Alternative and Complementary Medicine// 2005; 11: 780.)] [(Iris R. Bell. All evidence is equal, but some evidence is more equal than others: can logic prevail over emotion in the homeopathy debate? //Journal of Alternative and Complementary Medicine// 2005; 11: 763-769.)] [(Walach H, Jonas W, Lewith G. Are the clinical effects of homoeopathy placebo effects? //Lancet// 2005; 366: 2081.)] [(Haselen RV. The end of homeopathy: wishful thinking? //Complementary Therapies in Medicine// 2005; 13: 229-230.)] [( Reilly D. Sir: is that bias? //Journal of Alternative and Complementary Medicine// 2005; 11: 785.)] [(Milgrom LR. Homeopathy and the new fundamentalism: a critique of the critics. //Journal of Alternative and Complementary Medicine// 2008; 14: 589-594.)] [(Jobst KA. Homeopathy, Hahnemann, and The Lancet 250 years on: a case of the emperor's new clothes? //Journal of Alternative and Complementary Medicine// 2005; 11: 751-754. )] [(Kiene H, Kienle GS, Schön-Angerer TV. Failure to exclude false negative bias: a fundamental flaw in the trial of Shang et al. //Journal of Alternative and Complementary Medicine// 2005; 11: 783.)] [(Peters D. Shang et al. Carelessness, collusion, or conspiracy? //Journal of Alternative and Complementary Medicine// 2005; 11: 779-780. )] [(Rutten ALB, and Stolper CF. The 2005 meta-analysis of homeopathy: the importance of post-publication data. //Homeopathy// 2008; 97: 169–177. )] [(Lüdtke R, Rutten ALB. The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. //Journal of Clinical Epidemiology// 2008; 61: 1197- 204. )] [(Flávio Dantas. Are the clinical effects of homoeopathy placebo effects? //Lancet// 2005: 366: 2083. )] [(Frass M, Singer SR, Oberbaum M. Homeopathic research after the Lancet meta analysis—A moment for introspection. //Complementary Therapies in Medicine// 2005; 13: 303-305 )] [(Fisher P, Berman B, Davidson J, Reilly D, Thompson T, Bell IR, Belon P, Bolognani F, Brands M, Connolly T, Dantas F, Endle PC, De Freitas F, Dean ME, Eizayaga F, Eizayaga J, Jansen JP, Jobst K, Koster D, Lewith G, Mathie R, Mercer S, Nicolai T, Oberbaum M, Peters D, Poitevin B, Rutten L, Schwartz G, Spence D, Steinsbekk A, Thompson E, Walach H, Whitehouse PJ. Are the clinical effects of homoeopathy placebo effects? //Lancet// 2005: 366: 2082-2083. )]) —if only for the fact that six of the eight large studies used in the final analysis were not following the rule of individualization, which is fundamental to homeopathy. Do you still think that this meta-study, which is composed of a majority of studies that violate this fundamental principle, can be used as proof against homeopathy? How do you explain that the accompanying editorial of the Lancet[(Editorial. The end of homeopathy. //Lancet// 2005; 366: 690.)] was able to come up to such radical conclusions, despite the fact that the study didn’t even adhere to the QUORUM guidelines for meta-analyses[(Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. //Lancet// 1999; 354: 1896-1900.)], and that the body of scientific evidence on homeopathy extends much beyond the limitations of the Shang et al. meta-analysis?**
+===== QUESTION 6 =====
+**In the debate, you said of Professor Rustum Roy of Penn State University, "Rustum Roy, who was referred to, is not highly regarded in the scientific community. He is one of those outliers. And there are many such." On what basis do you base your opinion that Professor Roy is not highly regarded in the scientific community? Are you aware that in 2003 the ISI (Phila) rated his lab the #1 in the world on the basis of highly cited scholars[(Roy R. Interdisciplinary materials research: the reluctant reformer of Western science. //Facets// 2005; 4: 18-21. )] and that he has published over 1,000 papers in peer-review journals? Which ones of his results are therefore not trustworthy? How do you decide whether a scientific article published in a peer-reviewed journal is trustworthy, such as the one of Roy in Materials Science[(Roy R, Tiller WA, Bell I, Hoover MR. The structure of liquid water; novel insights from materials research; potential relevance to homeopathy. //Materials Research Innovations// 2005; 9: 577-608.)] in 2005 or the one of Chikramane in Langmuir[(Chikramane PS, Kalita D, Suresh AK, Kane SG, Bellare JR. Why extreme dilutions reach non-zero asymptotes: a nanoparticulate hypothesis based on froth flotation. //Langmuir// 2012; 28: 15864-15875.)] in 2012?**
+{{anchor:schwarcz_answers}}
+===== DR. JOE SCHWARCZ’S ANSWERS =====
+As far as this second set of questions goes, I'm just not willing to devote any more time to this discussion. I think I have already spent far more time discussing homeopathy than the subject deserves. I'm not going to get into it any more for the same reason I don't get into discussion with Creationists or various conspiracy theorists. Furthermore I have essentially answered these questions either in the attached or in previous writings. I will make just a couple of comments though.
+I certainly do warn about the dangers of conventional medicine when appropriate and have written extensively on the issue. (incidentally the term "allopathic" was devised as a derogatory term by Hahnemann ) But that is not the question here. The question is whether homeopathy is bogus or not.
+Andre is totally unaware that the issues he brings up have been the subject of numerous scientific discussions and that books have been written on them. The claims about cholera and flu and homeopathy have been addressed and the explanation is obvious. "Heroic" treatments were actually harmful while homeopathic ones were just useless. It is true that homeopathic hospitals had better hygiene, but that had nothing to do with the concept of homeopathy.
+To suggest that Edzard Ernst has no credibility is pure folly. His writings are all thoroughly documented. He never claimed to be a homeopath ( why would anyone who isn't one do that? Hardly a badge of honour). He just claimed to have worked in a homeopathic hospital where he was exposed to all the tenets of homeopathy. In any case what does whether he was a homeopath or not have to do with anything? Let the facts speak.
+If Andre claims to have cured a patient of cystic fibrosis with homeopathy he should submit the data to a reputable journal as a case report. If he can reproduce the cure he should be nominated for a Nobel Prize, or at least a Lasker Award.
+As far as consulting fees, the sum total is $0. My salary comes from McGill.
+Andre, as one might expect, is not familiar with chemical history. Avogadro's number was named after him, not by him. Hahnemann could not have had any idea about the number of atoms or molecules in a mole.
+The motive behind the lawsuit is simple. Homeopathic medications are claimed to have active ingredients without any proof that they contain such. Therefore they are mislabeled. The lawsuit is being funded totally by a group of lawyers who initiated it. I had nothing to do with it but of course I do support it because I think all products that make medical claims should be held to the same standards of safety and efficacy. Homeopathic products are getting a free ride.
+Questions like #24 are so puerile and smack so strongly of the ignorance of scientific methodology that they don't merit further discussion.
+As to the final question, we take full responsibility for whatever information we disseminate. The scientific community stands firmly behind the notion that homeopathy is nothing other than an example of the placebo effect. Data can be dredged up to attempt to counter the evidence the same way that Creationists publish all sorts of papers that sound scientific and appear to be so to the uninitiated. But of course Creationism is bogus. How many serious scientists think the Earth is 5700 years old? How many think that homeopathy is more than placebo?
+Anyway, as I said, this discussion has gone far enough and I do not want to devote more time to it. If Andre would like to publicize his ideas further, there is a way to do it. The lawyers are actually looking for a homeopath to include in the lawsuit, and if Andre desires I could put him in touch with them. He could state his case then in a very public forum and get lots of attention.
+===== References =====
+~~REFNOTES~~
+====== DOCUMENT DESCRIPTOR ======
+^ Source: | http://www.homeopathy.ca/debates_2012-11-27_FromDrSaine-to-DrSchawrtz.shtml |
+^ Description: | Debate about Homeopathy: Mere Placebo or Great Medicine?  |
+^ Year: | 2013 |
+^ Editing: | errors only; interlinks; formatting |
+^ Attribution: | http://www.homeopathy.ca |

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