User Tools

Site Tools


en:misc:talk-qa-saine-schwarcz

Differences

This shows you the differences between two versions of the page.

Link to this comparison view

Both sides previous revision Previous revision
Next revision
Previous revision
en:misc:talk-qa-saine-schwarcz [2013/02/08 15:39]
legatum [QUESTION 14]
en:misc:talk-qa-saine-schwarcz [2013/02/08 15:57] (current)
legatum
Line 5: Line 5:
 ===== QUESTION 1 ===== ===== QUESTION 1 =====
 **When you were asked during the debate a question from the public regarding the placebo effect, "If homeopathic substances are purely psychological placebos, do you think the evidence that they can work in animals and plants has any weight?,"​ you discussed the case of pets. It is well known that the placebo effect in animals is negligible, but you explained that perception can be biased in a pet’s owner. Now, please explain the role of the placebo effect in the numerous, measurable results obtained experimentally and clinically with homeopathy on measurable aspects, in: in vitro experimentations,​ experimentations with plants, farm animals (where the owner’s perception does not play a role, such as infertility,​ stillbirth, weight gain or helmintiasis),​ infants (again regarding measurable changes in the infants as opposed to qualitative changes), the unconscious persons, and the insane persons?** **When you were asked during the debate a question from the public regarding the placebo effect, "If homeopathic substances are purely psychological placebos, do you think the evidence that they can work in animals and plants has any weight?,"​ you discussed the case of pets. It is well known that the placebo effect in animals is negligible, but you explained that perception can be biased in a pet’s owner. Now, please explain the role of the placebo effect in the numerous, measurable results obtained experimentally and clinically with homeopathy on measurable aspects, in: in vitro experimentations,​ experimentations with plants, farm animals (where the owner’s perception does not play a role, such as infertility,​ stillbirth, weight gain or helmintiasis),​ infants (again regarding measurable changes in the infants as opposed to qualitative changes), the unconscious persons, and the insane persons?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 2 ===== ===== QUESTION 2 =====
  
 **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?​** **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?​**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 3 ===== ===== 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?** **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?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 4 ===== ===== 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?​** **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?​**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 5 ===== ===== 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?​** **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?​**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 6 ===== ===== 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?** **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?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 7 ===== ===== QUESTION 7 =====
Line 36: Line 48:
  
 **I am curious to know which research papers I presented in this debate on homeopathy represent "a plundering of science,"​ and can you please explain on what basis they don’t abide by the strictest scientific method?** **I am curious to know which research papers I presented in this debate on homeopathy represent "a plundering of science,"​ and can you please explain on what basis they don’t abide by the strictest scientific method?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 9 ===== ===== QUESTION 9 =====
 **You said in the debate, "And Hahnemann was aware of this and he experimented on himself. He wanted to know: What was the right dose to give to his patients? So, he kept taking bigger and bigger doses to see what would happen. And he took these doses and, eventually, he developed a fever, much like he saw in his malaria patients and then came to the conclusion that a substance that—in a healthy person—causes a certain disease can cure a sick person who has those symptoms. … Remember that Hahnemann started with the whole notion of taking cinchona in larger and larger doses to trigger the symptoms of malaria. That’s the foot upon which homeopathy stands originally. Has anyone ever tried to replicate that? Yes. In 1991, German Professor Wolfgang Hopff did the experiment, started to take cinchona bark in bigger and bigger doses and never got a fever; he never got the malaria symptoms. So we don’t know what happened in the case of Hahnemann. Maybe he was unlucky. He was taking the cinchona doses and he got the flu at the same time. And that’s what caused the fever."​ It is interesting to note, first, that Hahnemann never reported wanting "to know: What was the right dose to give to his patients?,"​ but instead clearly stated that he wanted to know the principle underlying the effectiveness of cinchona bark in malaria; second, that he never reported having taken increasing doses, but instead took the same dose twice a day; third, that he never reported having had developed a fever or the "​peculiar chilly shivering rigor" of malaria during his proving of cinchona bark tincture[(Hahnemann S. Annerhung Hahnemann zu seinem Seibstversuch mit Chinarinde. In: Cullen W. //​Abhandlung über die Materia medica. Aus dem Englischen mit mit Anmerkungen von Samuel Hahnemann//​. Band II. Leipzig: Schwickertschen Verlag,​1790,​ 108-109. A translation of this passage can be found in: Bradford TL. //The Life and Letters of Dr. Samuel Hahnemann//​. Philadelphia:​ Boericke & Tafel, 1895, 36-37.)] ; and fourth, that fever is a very common symptom of acute cinchonism[(Goldberg AM, Wexler LF. Quinine overdose: review of toxicity and treatment. //Clinical Cardiology//​ 1988; 11: 716-718)] , quinine "also has a mild antipyretic effect[(Bateman DN, Dyson EH. Quinine toxicity. //Adverse Drug Reactions and Acute Poisoning Reviews// 1986; 5: 215-233.)],"​ and that every single one of the eight most recent cases of acute cinchonism that I could find in the scientific literature had developed a fever.[(Katz B, Weetch M, Chopra S. Quinine-induced granulomatous hepatitis. //British Medical Journal// 1983; 86: 264-265. )] [(Bateman DN, Dyson EH. Quinine toxicity. //Adverse Drug Reactions and Acute Poisoning Reviews// 1986; 5: 215-233.)] [(Mathur S, Dooley J, Scheuer PJ. Quinine induced granulomatous hepatitis and vasculitis. //British Medical Journal// 1990; 300: 613.)] [(Punukollu RC, Kumar S, Mullen KD. Quinine hepatotoxicity:​ an underrecognized or rare phenomenon? //Archives of Internal Medicine// 1990; 150: 1112-1113. )] [(Wolf LR, Otten EJ, Spadafora MP. Cinchonism: two case reports and review of acute quinine toxicity and treatment. //Journal of Emergency Medicine// 1992; 10: 295-301. )] [(Perez JA, Stryker J, Arsura EL, Hewitt JM. Probable quinine-induced hepatotoxicity. //Western Journal of Medicine// 1994; 160: 59-60.)] [(Farver D, Lavin MN. Quinine-induced hepatotoxicity. //Annals of Pharmacology//​ 1999; 33: 32-34. )] Can you please provide primary source references documenting your version of Hahnemann’s proving of cinchona bark and why are you referring to a Professor Hopff’s experimentation[(Perhaps it is not Hopff in 1991 but Habermann in 1997 that carried a two-hour (?) proving with 3.3 grams of cinchona bark without noticing any rise in temperature,​ see: Krämer HJ, Habermann E. Ein Vorlesungsversuch zur Homöopathie. //Deutsches Ärzteblatt//​ 1997; 94: A1851-1852.)] when the scientific literature is extremely clear on this point, namely, that fever is a very common occurrence of acute cinchonism?​** **You said in the debate, "And Hahnemann was aware of this and he experimented on himself. He wanted to know: What was the right dose to give to his patients? So, he kept taking bigger and bigger doses to see what would happen. And he took these doses and, eventually, he developed a fever, much like he saw in his malaria patients and then came to the conclusion that a substance that—in a healthy person—causes a certain disease can cure a sick person who has those symptoms. … Remember that Hahnemann started with the whole notion of taking cinchona in larger and larger doses to trigger the symptoms of malaria. That’s the foot upon which homeopathy stands originally. Has anyone ever tried to replicate that? Yes. In 1991, German Professor Wolfgang Hopff did the experiment, started to take cinchona bark in bigger and bigger doses and never got a fever; he never got the malaria symptoms. So we don’t know what happened in the case of Hahnemann. Maybe he was unlucky. He was taking the cinchona doses and he got the flu at the same time. And that’s what caused the fever."​ It is interesting to note, first, that Hahnemann never reported wanting "to know: What was the right dose to give to his patients?,"​ but instead clearly stated that he wanted to know the principle underlying the effectiveness of cinchona bark in malaria; second, that he never reported having taken increasing doses, but instead took the same dose twice a day; third, that he never reported having had developed a fever or the "​peculiar chilly shivering rigor" of malaria during his proving of cinchona bark tincture[(Hahnemann S. Annerhung Hahnemann zu seinem Seibstversuch mit Chinarinde. In: Cullen W. //​Abhandlung über die Materia medica. Aus dem Englischen mit mit Anmerkungen von Samuel Hahnemann//​. Band II. Leipzig: Schwickertschen Verlag,​1790,​ 108-109. A translation of this passage can be found in: Bradford TL. //The Life and Letters of Dr. Samuel Hahnemann//​. Philadelphia:​ Boericke & Tafel, 1895, 36-37.)] ; and fourth, that fever is a very common symptom of acute cinchonism[(Goldberg AM, Wexler LF. Quinine overdose: review of toxicity and treatment. //Clinical Cardiology//​ 1988; 11: 716-718)] , quinine "also has a mild antipyretic effect[(Bateman DN, Dyson EH. Quinine toxicity. //Adverse Drug Reactions and Acute Poisoning Reviews// 1986; 5: 215-233.)],"​ and that every single one of the eight most recent cases of acute cinchonism that I could find in the scientific literature had developed a fever.[(Katz B, Weetch M, Chopra S. Quinine-induced granulomatous hepatitis. //British Medical Journal// 1983; 86: 264-265. )] [(Bateman DN, Dyson EH. Quinine toxicity. //Adverse Drug Reactions and Acute Poisoning Reviews// 1986; 5: 215-233.)] [(Mathur S, Dooley J, Scheuer PJ. Quinine induced granulomatous hepatitis and vasculitis. //British Medical Journal// 1990; 300: 613.)] [(Punukollu RC, Kumar S, Mullen KD. Quinine hepatotoxicity:​ an underrecognized or rare phenomenon? //Archives of Internal Medicine// 1990; 150: 1112-1113. )] [(Wolf LR, Otten EJ, Spadafora MP. Cinchonism: two case reports and review of acute quinine toxicity and treatment. //Journal of Emergency Medicine// 1992; 10: 295-301. )] [(Perez JA, Stryker J, Arsura EL, Hewitt JM. Probable quinine-induced hepatotoxicity. //Western Journal of Medicine// 1994; 160: 59-60.)] [(Farver D, Lavin MN. Quinine-induced hepatotoxicity. //Annals of Pharmacology//​ 1999; 33: 32-34. )] Can you please provide primary source references documenting your version of Hahnemann’s proving of cinchona bark and why are you referring to a Professor Hopff’s experimentation[(Perhaps it is not Hopff in 1991 but Habermann in 1997 that carried a two-hour (?) proving with 3.3 grams of cinchona bark without noticing any rise in temperature,​ see: Krämer HJ, Habermann E. Ein Vorlesungsversuch zur Homöopathie. //Deutsches Ärzteblatt//​ 1997; 94: A1851-1852.)] when the scientific literature is extremely clear on this point, namely, that fever is a very common occurrence of acute cinchonism?​**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 10 ===== ===== QUESTION 10 =====
 **On what basis do you claim that homeopathy is chemically and biologically implausible?​** **On what basis do you claim that homeopathy is chemically and biologically implausible?​**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 11 ===== ===== QUESTION 11 =====
Line 58: Line 76:
  
 **You said in the debate, "A properly controlled, randomized trial. That’s all we ask for in science."​ I presented during the debate two properly conducted RCTs one by Frass et al. and the other by Frei et al.[(Frass M, Linkesch M, Banyai S, Resch G, Dielacher C, Lölb T, Endler C, Haidvogl M, Muchitsch I, Schuster E. Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind,​ placebo-controlled trial in an intensive care unit. //​Homeopathy//​ 2011; 100: 95-100.)] [(Frei H, Everts R, Ammon KV, Kaufmann F, Walther D, Hsu-Schmitz SH, Collenberg M, Fuhrer K, Hassink R, Steinlin M, Thurneysen A. Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial. //European Journal of Pediatrics//​ 2005; 164: 758–767.)] It is noteworthy that Frass et al. had also found out in another RCT that Kali bichromicum 30 C helped to significantly reduce tracheal secretions (p < 0.0001) and extubation could be performed significantly earlier (p < 0.0001) in critically ill patients in ICU[(Frass M, Dielacher C, Linkesch M, Endler C, Muchitsch I, Schuster E, Kaye A. Influence of potassium dichromate on tracheal secretions in critically ill patients. //Chest// 2005; 127: 936-941. )]. Also, Frei et al. was a replication of the 1997 Lamont RCT with ADHD children that had found statistically significant differences in favor of homeopathy[(Lamont J. Homoeopathic treatment of attention deficit hyperactivity disorder. //British Homoeopathic Journal// 1997; 86: 196-200.)]. Have these RCTs affected at all your opinion on homeopathy?​** **You said in the debate, "A properly controlled, randomized trial. That’s all we ask for in science."​ I presented during the debate two properly conducted RCTs one by Frass et al. and the other by Frei et al.[(Frass M, Linkesch M, Banyai S, Resch G, Dielacher C, Lölb T, Endler C, Haidvogl M, Muchitsch I, Schuster E. Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind,​ placebo-controlled trial in an intensive care unit. //​Homeopathy//​ 2011; 100: 95-100.)] [(Frei H, Everts R, Ammon KV, Kaufmann F, Walther D, Hsu-Schmitz SH, Collenberg M, Fuhrer K, Hassink R, Steinlin M, Thurneysen A. Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial. //European Journal of Pediatrics//​ 2005; 164: 758–767.)] It is noteworthy that Frass et al. had also found out in another RCT that Kali bichromicum 30 C helped to significantly reduce tracheal secretions (p < 0.0001) and extubation could be performed significantly earlier (p < 0.0001) in critically ill patients in ICU[(Frass M, Dielacher C, Linkesch M, Endler C, Muchitsch I, Schuster E, Kaye A. Influence of potassium dichromate on tracheal secretions in critically ill patients. //Chest// 2005; 127: 936-941. )]. Also, Frei et al. was a replication of the 1997 Lamont RCT with ADHD children that had found statistically significant differences in favor of homeopathy[(Lamont J. Homoeopathic treatment of attention deficit hyperactivity disorder. //British Homoeopathic Journal// 1997; 86: 196-200.)]. Have these RCTs affected at all your opinion on homeopathy?​**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 14 ===== ===== QUESTION 14 =====
  
 **You also said in the debate, "Well, actually, we ask for more than one properly controlled, randomized trial, because one trial doesn’t mean much, but if we have a selection of properly controlled, randomized trials, yes, I would buy it. You show me what you consider is a properly controlled, randomized trial for a specific condition, where a specific homeopathic remedy cures that condition."​ Jacobs et al. conducted three RCTs in children with diarrhea and their combined results showed a decrease in the duration of the diarrhea with a p=0.008 and their meta-analysis showed a consistent effect-size difference of p=0.008. These trials, as well as the trials referred to in question 12, should indeed fulfill all your requirements. Will you now buy homeopathy? If not, please explain yourself?** **You also said in the debate, "Well, actually, we ask for more than one properly controlled, randomized trial, because one trial doesn’t mean much, but if we have a selection of properly controlled, randomized trials, yes, I would buy it. You show me what you consider is a properly controlled, randomized trial for a specific condition, where a specific homeopathic remedy cures that condition."​ Jacobs et al. conducted three RCTs in children with diarrhea and their combined results showed a decrease in the duration of the diarrhea with a p=0.008 and their meta-analysis showed a consistent effect-size difference of p=0.008. These trials, as well as the trials referred to in question 12, should indeed fulfill all your requirements. Will you now buy homeopathy? If not, please explain yourself?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 15 ===== ===== QUESTION 15 =====
Line 70: Line 92:
 ===== QUESTION 16 ===== ===== QUESTION 16 =====
 You said in the debate, "So if you look at the meta-analysis and you look at the properly controlled studies, there is nothing there."​ Please demonstrate the irrelevance of the evidence in the two systematic reviews[(Dean ME. //The Trials of Homeopathy. Origins, Structure and Development.//​ Essen: KVC Verlag, 2004. )] [(Bornhöft G, Matthiessen P. //​Homeopathy in Healthcare. Effectiveness,​ Appropriateness,​ Safety and Costs.// Herdecke: Springer, 2011.)] I presented in the debate? You said in the debate, "So if you look at the meta-analysis and you look at the properly controlled studies, there is nothing there."​ Please demonstrate the irrelevance of the evidence in the two systematic reviews[(Dean ME. //The Trials of Homeopathy. Origins, Structure and Development.//​ Essen: KVC Verlag, 2004. )] [(Bornhöft G, Matthiessen P. //​Homeopathy in Healthcare. Effectiveness,​ Appropriateness,​ Safety and Costs.// Herdecke: Springer, 2011.)] I presented in the debate?
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 17 ===== ===== QUESTION 17 =====
 **You said in the debate, "And then Hahnemann came to the conclusion—somehow—nobody seems to be able to explain exactly how he came to this conclusion: That less is more, the theory of infinitesimals. That if you dilute your product—your original solution—you make it more potent. Well, one day he made a house call. And he answered this house call in a horse-drawn carriage. And his homeopathic remedy worked extremely well on the patient. And he developed a second aspect of homeopathy, succussion. He believed that the cobblestones had shaken the medication and that potentiated it. So, the two aspects."​ Can you please give primary source references to document your statements, as according to reliable historical sources your story is a complete fabrication from one end to the other? **You said in the debate, "And then Hahnemann came to the conclusion—somehow—nobody seems to be able to explain exactly how he came to this conclusion: That less is more, the theory of infinitesimals. That if you dilute your product—your original solution—you make it more potent. Well, one day he made a house call. And he answered this house call in a horse-drawn carriage. And his homeopathic remedy worked extremely well on the patient. And he developed a second aspect of homeopathy, succussion. He believed that the cobblestones had shaken the medication and that potentiated it. So, the two aspects."​ Can you please give primary source references to document your statements, as according to reliable historical sources your story is a complete fabrication from one end to the other?
 ** **
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 18 ===== ===== QUESTION 18 =====
 **How different is the case of homeopathy from the many examples in the history of science where experimental results were denied plausibility prior to becoming well accepted?** **How different is the case of homeopathy from the many examples in the history of science where experimental results were denied plausibility prior to becoming well accepted?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 19 ===== ===== QUESTION 19 =====
  
 **You said in the debate, "Well, this, I think, does not stand up to the rigor of what we call science-based medicine, which has four basic pillars. Of course we rely on peer-review. We do rely on plausibility because we have a large fountain of scientific knowledge upon which we can stand and gaze out at the world and judge to see what makes sense and what doesn’t. And, of course, experience plays a role, as does critical thinking. But, really, the cornerstones are peer review and plausibility."​ Yet, you state that "​most"​ peer-review articles that come out every day are "​mediocre."​ How do you reconcile these two statements?​** **You said in the debate, "Well, this, I think, does not stand up to the rigor of what we call science-based medicine, which has four basic pillars. Of course we rely on peer-review. We do rely on plausibility because we have a large fountain of scientific knowledge upon which we can stand and gaze out at the world and judge to see what makes sense and what doesn’t. And, of course, experience plays a role, as does critical thinking. But, really, the cornerstones are peer review and plausibility."​ Yet, you state that "​most"​ peer-review articles that come out every day are "​mediocre."​ How do you reconcile these two statements?​**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 20 ===== ===== QUESTION 20 =====
  
 **Your story of Hahnemann’s proving of arsenic is incorrect, as Hahnemann didn’t publish his proving of arsenic trioxide until 1816, which is 26 years after his first experiment with cinchona. The proving was conducted in potencies and not in "​increasing doses."​ It would be interesting to know which "​friends and relatives Hahnemann lost along the way" and what actual primary source reference you used, if any, to state that he concluded, "that therefore, in smaller doses this would be a remedy for food poisoning."​** **Your story of Hahnemann’s proving of arsenic is incorrect, as Hahnemann didn’t publish his proving of arsenic trioxide until 1816, which is 26 years after his first experiment with cinchona. The proving was conducted in potencies and not in "​increasing doses."​ It would be interesting to know which "​friends and relatives Hahnemann lost along the way" and what actual primary source reference you used, if any, to state that he concluded, "that therefore, in smaller doses this would be a remedy for food poisoning."​**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 21 ===== ===== QUESTION 21 =====
Line 93: Line 125:
 ===== QUESTION 22 ===== ===== QUESTION 22 =====
 **Can you provide any primary source reference that Napoleon was actually treated with homeopathy for pubic lice?** **Can you provide any primary source reference that Napoleon was actually treated with homeopathy for pubic lice?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
  
 ===== QUESTION 23 ===== ===== QUESTION 23 =====
  
 **When you referred to the paper Benveniste published in Nature in 1988, you omitted to explain the fact that his experiments have since been successfully replicated by four independent laboratories in Europe and that the issue is now closed?​[(Belon P, Cumps J, Ennis M, Mannaioni PF, Sainte-Laudy J, Robertfroid M, Wiegant FAC. Inhibition of human basophil degranulation by successive histamine dilutions: results of a European multi-centre trial. //​Inflammation Research// 1999; 48: S17-S18.)] [(Belon P, Cumps J, Ennis M, Mannaioni PF, Robertfroid M, Sainte-Laudy J, Wiegant FAC. Histamine dilutions modulate basophil activation. //​Inflammation Research// 2004; 53: 181-188.)] Isn’t this, the proof—reproducible evidence that UMPs have biological effects—that you have been asking for? Please explain your criteria for rejecting this body of research?** **When you referred to the paper Benveniste published in Nature in 1988, you omitted to explain the fact that his experiments have since been successfully replicated by four independent laboratories in Europe and that the issue is now closed?​[(Belon P, Cumps J, Ennis M, Mannaioni PF, Sainte-Laudy J, Robertfroid M, Wiegant FAC. Inhibition of human basophil degranulation by successive histamine dilutions: results of a European multi-centre trial. //​Inflammation Research// 1999; 48: S17-S18.)] [(Belon P, Cumps J, Ennis M, Mannaioni PF, Robertfroid M, Sainte-Laudy J, Wiegant FAC. Histamine dilutions modulate basophil activation. //​Inflammation Research// 2004; 53: 181-188.)] Isn’t this, the proof—reproducible evidence that UMPs have biological effects—that you have been asking for? Please explain your criteria for rejecting this body of research?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
 +
 +===== QUESTION 24 =====
 +
 +**Please consider the following scenario recently related to me by a German colleague: As a young MD, she did an internship with a homeopathic pediatrician. Over the course of several weeks, she observed how one child after another recovered within days under homeopathic treatment from ailments like ear infections, UTI, bronchitis, bronchiolitis,​ pneumonia, impetigo and other acute diseases. No conventional medication was used, no side effects, no complications. If you were in a position of being a young doctor and watching these effects like she was, would you consider studying homeopathy more deeply?**
 +
 +Questions like #24 are so puerile and smack so strongly of the ignorance of scientific methodology that they don't merit further discussion.
 +
 +===== QUESTION 25 =====
 +
 +**On what philosophical or scientific basis, would you say skeptics consider their inexperience coupled with an immovable bias more reliable than the experience of many generations of homeopaths all over the world corroborated with loads of undeniable facts?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
 +
 +===== QUESTION 26 =====
 +
 +**Since our subject is the wellbeing of our fellow human beings, the outcome of this debate carries a certain amount of responsibility. In light of this responsibility,​ can you state that you have investigated homeopathy thoroughly and with an open mind, and have found out beyond reasonable doubt that it is nothing else than placebo, despite the many inaccuracies I have pointed out in your statements and the references I gave showing that they are contradicted by more reliable historical sources or recent scientific studies?**
 +
 +[[talk-qa-saine-schwarcz#​schwarcz_answers|Dr. Joe Schwarz’ answers.]]
 +
 +===== QUESTION 27 =====
 +
 +**You wrote, "​Choice consumers make is based on scientifically informed opinion. In the case of homeopathy, misinformation can have consequences ranging from a needless waste of money to forgoing more effective treatments[(Schwarcz J. A whole lot of sugar helps this pill go down. //Montreal Gazette//. April 21, 2012.)] ." I agree with you on this very point, and I have pointed out many serious inaccuracies in your statements or writings about homeopathy and referred you to more relevant historical sources or recent scientific research. To what extent, do you and the McGill Office for Science and Society take responsibility for the information you disseminate to the public, when it is contradicted by reliable sources or recent scientific evidence?**
 +
 +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?
  
 {{anchor:​schwarcz_answers}} {{anchor:​schwarcz_answers}}
en/misc/talk-qa-saine-schwarcz.1360337971.txt.gz · Last modified: 2013/02/08 15:39 by legatum