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| - | This is a transcription of a [[http://mediasite.uchc.edu/mediasite41/Play/f45177db9279460797ffe70714a3f5611d|video]] recording a talk on homeopathy that took place on the premises of the University of Connecticut, March 22<sup>nd</sup>, 2013. The topic of the talk was //Homeopathy: Great Medicine or Dangerous Pseudoscience?//, the opponents were Dr. André Saine and Dr. Steven Novella. | + | This is a transcription of a [[http://mediasite.uchc.edu/mediasite41/Play/f45177db9279460797ffe70714a3f5611d|video]] of a talk on homeopathy that took place on the premises of the University of Connecticut, March 22<sup>nd</sup>, 2013. The topic of the talk was //Homeopathy: Great Medicine or Dangerous Pseudoscience?//, the opponents were Dr. André Saine and Dr. Steven Novella. |
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| ===== Introduction ===== | ===== Introduction ===== | ||
| - | Presenter: Good Afternoon! Welcome to the University of Connecticut Health Center & to a debate that we're having today on - **Homeopathy: Great Medicine or Dangerous Pseudoscience?** We are honored today to have two of the experts debating this topic today. First of all Dr. André Saine who has been a student of homeopathy since 1976 and is likely the most knowledgeable person regarding homeopathic practice, research and literature and more particularly the early writings. He is an instructor and speaker on this topic, traveling throughout the world to do this. Since 1995 he has been the president of Québec Association of Naturopathic Physicians and has an active private practice in Montréal Canada. | + | Presenter: Good Afternoon! Welcome to the University of Connecticut Health Center & to a debate that we're having today on - **Homeopathy: Great Medicine or Dangerous Pseudoscience?** We are honored to have two of the experts debating this topic today. First of all Dr. André Saine who has been a student of homeopathy since 1976 and is likely the most knowledgeable person regarding homeopathic practice, research and literature and more particularly the early writings. He is an instructor and speaker on this topic, traveling throughout the world to do this. Since 1995 he has been the president of Québec Association of Naturopathic Physicians and has an active private practice in Montréal Canada. |
| - | Dr. Steven Novella is president of New England Skeptical Society and is a long time critic of the homeopathic medicine. He received his M.D. degree from George Washington University. Since 1996 he has been and is an assistant professor of Neurology and is an attending physician at Young New Haven Medical Center. To start with today, we first welcome you from wherever positions you sit in, we hope everybody comes here with an open mind and listens carefully to the debate. | + | Dr. Steven Novella is president of New England Skeptical Society and is a long time critic of the homeopathic medicine. He received his M.D. degree from George Washington University. Since 1996 he has been and is an assistant professor of Neurology and is an attending physician at Yale New Haven Medical Center. To start with today, we first welcome you from wherever positions you sit in, we hope everybody comes here with an open mind and listens carefully to the debate. |
| - | There was a roundtable discussion where these two gentlemen were involved in 2007, here at the Health Center and that's published in Complementary and Alternative Medicine, if you like to look it up. First of all, the format is very important for our debate, for us as listeners but also to our debaters and it would proceed in the following way: Each will have 30 minutes, starting with Dr. Saine. Then there will be 10 minutes each for the first rebuttal, 2 minutes each for the second rebuttal and then they'll have 20 minutes in which time they can cross-examine each other. Then there will be questions from the public, so, on your way in, you received cards -- Mr. Gold will be collecting cards throughout the presentation and he'll be bringing up to the front so that we can sort of collate them, so that we have a concise question-and-answer period. | + | There was a roundtable discussion where these two gentlemen were involved in 2007, here at the Health Center and that's published in Complementary and Alternative Medicine, if you like to look it up. First of all, the format is very important for our debate, for us as listeners but also to our debaters and it would proceed in the following way: Each will have 30 minutes, starting with Dr. Saine. Then there will be 10 minutes each for the first rebuttal, 2 minutes each for the second rebuttal and then they'll have 20 minutes in which time they can cross-examine each other. Then there will be questions from the public, so, on your way in, you received cards -- Mr. Gold will be collecting cards throughout the presentation and he'll be bringing [them] up to the front so that we can sort of collate them; so that we have a concise question-and-answer period. |
| Then there will be a conclusion, there will be a vote asking you whether or not you feel more or less favorably about homeopathic medicine at this time, based on the debate; and there'll be some closing remarks. We respectfully, for the presenters, ask you that there aren't interruptions until the part in the question-and-answer period and we'll have to stick to that. Okay? Thank you so much for your interest. (Audience clapping) Dr. Saine! | Then there will be a conclusion, there will be a vote asking you whether or not you feel more or less favorably about homeopathic medicine at this time, based on the debate; and there'll be some closing remarks. We respectfully, for the presenters, ask you that there aren't interruptions until the part in the question-and-answer period and we'll have to stick to that. Okay? Thank you so much for your interest. (Audience clapping) Dr. Saine! | ||
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| Dr. Saine: Good afternoon, we can feel spring in the air and time of renewal. First, I would like to thank Dr. Mary Guerrera for the invitation on behalf of UConn, it’s quite an honor to be able to be called to this historic debate, which I would like to dedicate to **Samuel Hahnemann—the founder of homeopathy**—who exactly two hundred years ago, in 1813, was put in charge of a typhus hospital following the battle of Leipzig, which is a famous battle, and reported having treated 183 cases of typhus without a single loss. Such stunning result greatly impressed the Russian Government, then in occupation, but very strangely went unnoticed by the medical community. This is very particular in view of the fact that this deadly epidemic would eventually take half a million victims among Napoleon’s army and the German population. | Dr. Saine: Good afternoon, we can feel spring in the air and time of renewal. First, I would like to thank Dr. Mary Guerrera for the invitation on behalf of UConn, it’s quite an honor to be able to be called to this historic debate, which I would like to dedicate to **Samuel Hahnemann—the founder of homeopathy**—who exactly two hundred years ago, in 1813, was put in charge of a typhus hospital following the battle of Leipzig, which is a famous battle, and reported having treated 183 cases of typhus without a single loss. Such stunning result greatly impressed the Russian Government, then in occupation, but very strangely went unnoticed by the medical community. This is very particular in view of the fact that this deadly epidemic would eventually take half a million victims among Napoleon’s army and the German population. | ||
| - | Ladies and Gentlemen, today, we have a rare opportunity to critically examine two completely opposite views of homeopathy. In theory, if Dr. Novella and I use the best of scientific thinking, and stick only to facts and sound reasoning on this purely scientific question, we should come to the same conclusion, as true scientists are self-critical, and true science is self-correcting. | + | Ladies and Gentlemen, today, we have a rare opportunity to critically examine two completely opposite views of homeopathy. In theory, if Dr. Novella and I use the best of scientific thinking, and stick only to facts and sound reasoning on this purely scientific question, we should come to the same conclusion -- as true scientists are self-critical, and true science is self-correcting. |
| I will now ask your unreserved attention for the next 30 minutes, as I will now present a very condensed summary of the evidence that supports homeopathy to be a great, and most scientific and beneficial medicine. So we will need all your neurons! | I will now ask your unreserved attention for the next 30 minutes, as I will now present a very condensed summary of the evidence that supports homeopathy to be a great, and most scientific and beneficial medicine. So we will need all your neurons! | ||
| - | Let me first address the argument of implausibility, the core issue in this 200 year-old dispute, which focuses in particular on the fact that homeopaths use ultra-molecular preparations. Ultra Molecular Preparations or UMPs are prepared from solutions that went through a process of serial succussions and dilutions usually exceeding, in theory, Avogadro’s limit. Skeptics commonly assume that UMPs are indistinguishable from placebo and from each other. We find, in this 2003 thermo luminescence study of UMPs published in Physica A that: | + | Let me first address the argument of implausibility, the core issue in this 200 year-old dispute, which focuses in particular on the fact that homeopaths use ultra-molecular preparations. Ultra Molecular Preparations or UMPs are prepared from solutions that went through a process of serial succussions and dilutions usually exceeding, in theory, Avogadro’s limit. Skeptics commonly assume that UMPs are indistinguishable from placebo and from each other. We find, in this 2003 thermoluminescence study of UMPs published in Physica A that: |
| //Ultra-high dilutions of lithium chloride and sodium chloride 10// <sup>//-30//</sup> //have been irradiated by x-rays and gamma-rays. It was found that, despite their dilution beyond the Avogadro’s number, the emitted light was specific of the original salts dissolved initially.// | //Ultra-high dilutions of lithium chloride and sodium chloride 10// <sup>//-30//</sup> //have been irradiated by x-rays and gamma-rays. It was found that, despite their dilution beyond the Avogadro’s number, the emitted light was specific of the original salts dissolved initially.// | ||
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| Now that we know that UMPs are more than just water with peculiar and totally unexpected physical-chemical properties, let’s look at another of skeptic common assumption, namely that UMPs are “diluted to the point that no active ingredient remains.” Again skeptics are contradicted by modern scientific research. The authors of this 2010 paper wrote: | Now that we know that UMPs are more than just water with peculiar and totally unexpected physical-chemical properties, let’s look at another of skeptic common assumption, namely that UMPs are “diluted to the point that no active ingredient remains.” Again skeptics are contradicted by modern scientific research. The authors of this 2010 paper wrote: | ||
| - | //We have demonstrated for the first time by Transmission Electron Microscopy, … <wrap hi>the presence of physical entities</wrap> in these extreme dilutions, in the form of nanoparticles of the starting metals and their aggregates. Here you can see pictures of Stannum metallicum or tin in dilutions equivalent to 10// <sup>//-60//</sup> //and 10// <sup>//-400//</sup>. | + | //We have demonstrated for the first time by Transmission Electron Microscopy, … <wrap hi>the presence of physical entities</wrap> in these extreme dilutions, in the form of nanoparticles of the starting metals and their aggregates.// |
| + | |||
| + | Here you can see pictures of Stannum metallicum or tin in dilutions equivalent to 10<sup>-60</sup> and 10 <sup>-400</sup>. | ||
| In another paper recently published in the high impact journal //Langmuir//, which is the journal of surfaces and colloids of the American Chemical Society, whose motto is -- “the most trusted, the most cited and the most read”. The authors wrote: | In another paper recently published in the high impact journal //Langmuir//, which is the journal of surfaces and colloids of the American Chemical Society, whose motto is -- “the most trusted, the most cited and the most read”. The authors wrote: | ||
| - | //Physicochemical studies of these solutions have unequivocally established the presence of the starting raw materials in nanoparticulate form <wrap hi>even in these extreme (super-Avogadro, >10 <sup>23</sup> ) dilutions</wrap>// //. We have demonstrated that lactose during grinding helped in the formation of nanoclusters.// | + | //Physicochemical studies of these solutions have unequivocally established the presence of the starting raw materials in nanoparticulate form <wrap hi>even in these extreme (super-Avogadro, >10 <sup>-23</sup> ) dilutions</wrap>// //. We have demonstrated that lactose during grinding helped in the formation of nanoclusters.// |
| Here you can see nanocluster of gold nanoparticles with lactose. | Here you can see nanocluster of gold nanoparticles with lactose. | ||
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| //Our conclusions arise from our experiments indicating that in the successive dilution process of manufacturing, beyond a certain stage, <wrap hi>the dilution is merely apparent and the concentration of the starting material in the diluted product reaches a zero asymptotic level no matter how much more the sample is diluted.</wrap>// | //Our conclusions arise from our experiments indicating that in the successive dilution process of manufacturing, beyond a certain stage, <wrap hi>the dilution is merely apparent and the concentration of the starting material in the diluted product reaches a zero asymptotic level no matter how much more the sample is diluted.</wrap>// | ||
| - | In a 2005 paper in Materials Research Innovations, entitled “ //The Structure Of Liquid Water; Novel Insights From Materials Research; Potential Relevance To Homeopathy//**”** we can read: | + | In a 2005 paper in Materials Research Innovations, entitled “//The Structure Of Liquid Water; Novel Insights From Materials Research; Potential Relevance To Homeopathy//**”** we can read: |
| //This paper <wrap hi>definitively</wrap> demolishes the objection against homeopathy. The burden of the proof on critics of homeopathy is to establish that the structure of processed remedy is not different from the original solvent. The principal conclusions of this paper concern only the plausibility of the biological action of ultradiluted water remedy, they are based on some very old (e.g. homeopathy) and some very new (e.g. metallic and nanobubble colloids) <wrap hi>observations which have been rejected on invalid grounds</wrap> or due to ignorance of the materials research literature and its theoretical basis.// | //This paper <wrap hi>definitively</wrap> demolishes the objection against homeopathy. The burden of the proof on critics of homeopathy is to establish that the structure of processed remedy is not different from the original solvent. The principal conclusions of this paper concern only the plausibility of the biological action of ultradiluted water remedy, they are based on some very old (e.g. homeopathy) and some very new (e.g. metallic and nanobubble colloids) <wrap hi>observations which have been rejected on invalid grounds</wrap> or due to ignorance of the materials research literature and its theoretical basis.// | ||
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| //In conclusion, our work and that of many other researchers suggests that <wrap hi>homeopathy is not only plausible, but constitutes one of the frontiers of medical science, and more specifically of complexity science, biophysics, and nanopharmacology.</wrap> For these reasons the tenet according to which ‘homeopathy is based on principles that are incompatible with well established science‘ cannot be accepted and <wrap hi>investigation of homeopathic treatments appears to be warranted and ethically justifiable.</wrap>// | //In conclusion, our work and that of many other researchers suggests that <wrap hi>homeopathy is not only plausible, but constitutes one of the frontiers of medical science, and more specifically of complexity science, biophysics, and nanopharmacology.</wrap> For these reasons the tenet according to which ‘homeopathy is based on principles that are incompatible with well established science‘ cannot be accepted and <wrap hi>investigation of homeopathic treatments appears to be warranted and ethically justifiable.</wrap>// | ||
| - | Now, that we have addressed the question of biological plausibility of these rather complex UMPs, the next question in order is to verify whether they are completely ineffective as medicine, as claimed by skeptic. | + | Now, that we have addressed the question of biological plausibility of these rather complex UMPs, the next question in order is to verify whether they are completely ineffective as medicine, as claimed by skeptics. |
| Let’s first look at the //in vitro// research. We find this 2007 //systematic assessment of the// //in vitro// //research on high potency effects which had an inclusive criteria of stepwise agitated dilutions <10//<sup>//−23//</sup>//; cells or molecules from human or animal. The results:// //From 75 publications, 67 experiments (1/3 of them replications) were evaluated. <wrap hi>Nearly 3/4 of them found a high potency effect</wrap>,... <wrap hi>Nearly 3/4 of all replications were positive.</wrap> Conclusion: Experiments with a high methodological standard... demonstrate an effect of high potencies.// | Let’s first look at the //in vitro// research. We find this 2007 //systematic assessment of the// //in vitro// //research on high potency effects which had an inclusive criteria of stepwise agitated dilutions <10//<sup>//−23//</sup>//; cells or molecules from human or animal. The results:// //From 75 publications, 67 experiments (1/3 of them replications) were evaluated. <wrap hi>Nearly 3/4 of them found a high potency effect</wrap>,... <wrap hi>Nearly 3/4 of all replications were positive.</wrap> Conclusion: Experiments with a high methodological standard... demonstrate an effect of high potencies.// | ||
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| My second epidemiological example relates to **pneumonia.** Before the introduction of antibiotics it was widely recognized that the average death rate from pneumonia was around 30%. | My second epidemiological example relates to **pneumonia.** Before the introduction of antibiotics it was widely recognized that the average death rate from pneumonia was around 30%. | ||
| - | In 1912, William Osler, the father of modern medicine, wrote: “ //The statistics at my clinic at the John Hopkins Hospital from 1889 to 1905 have been analyzed... there were 658 cases with 200 deaths, a mortality of 30.4%... a// //study of the pneumonia statistics at the London Hospital from 1854-1903 concluded that the fatality of the disease has not appreciably changed during this period...// //there is an extraordinary uniformity in the mortality// .” A recent meta-analysis on the mortality from pneumonia reported: | + | In 1912, William Osler, the father of modern medicine, wrote: “ //The statistics at my clinic at the John Hopkins Hospital from 1889 to 1905 have been analyzed... there were 658 cases with 200 deaths, a mortality of 30.4%... a// //study of the pneumonia statistics at the London Hospital from 1854-1903 concluded that the fatality of the disease has not appreciably changed during this period...// //there is an extraordinary uniformity in the mortality.//” A recent meta-analysis on the mortality from pneumonia reported: |
| //Community-acquired pneumonia remains a major cause of mortality at 14% while hospital-acquired pneumonia carries a higher mortality between 50 and 70 percent.// //Worldwide, more children younger than five die of pneumonia than AIDS, malaria and tuberculosis combined.// | //Community-acquired pneumonia remains a major cause of mortality at 14% while hospital-acquired pneumonia carries a higher mortality between 50 and 70 percent.// //Worldwide, more children younger than five die of pneumonia than AIDS, malaria and tuberculosis combined.// | ||
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| Between 1847 and 1849, Dr. Jean-Paul Tessier, one of the distinguished allopathic practitioners of medicine in Paris, conducted at the St. Marguerite Hospital experiments to investigate homeopathy in the treatment of pneumonia. He wrote: | Between 1847 and 1849, Dr. Jean-Paul Tessier, one of the distinguished allopathic practitioners of medicine in Paris, conducted at the St. Marguerite Hospital experiments to investigate homeopathy in the treatment of pneumonia. He wrote: | ||
| - | “ //I presented myself neither as a partisan nor as an opponent of homeopathy but as a scientist guarding myself against the misguiding bias of blind passion, and endeavored to strictly adhere to the legitimate demands of a scientific inquiry// **.”** | + | “//I presented myself neither as a partisan nor as an opponent of homeopathy but as a scientist guarding myself against the misguiding bias of blind passion, and endeavored to strictly adhere to the legitimate demands of a scientific inquiry//.” |
| In total, he reported very detailed cases with 37 recoveries and 3 deaths, a mortality rate of 7.5%. Instead of being hailed as a hero by his allopathic colleagues, Dr. Tessier was ridiculed for his experiments and banished forever from the allopathic circles. This means that by simply switching from allopathy to homeopathy he was saving 23 more lives out of 100 patients with pneumonia. This is really incredible but at same time appears almost too good to be true. | In total, he reported very detailed cases with 37 recoveries and 3 deaths, a mortality rate of 7.5%. Instead of being hailed as a hero by his allopathic colleagues, Dr. Tessier was ridiculed for his experiments and banished forever from the allopathic circles. This means that by simply switching from allopathy to homeopathy he was saving 23 more lives out of 100 patients with pneumonia. This is really incredible but at same time appears almost too good to be true. | ||
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| - The Law of Infinitesimals | - The Law of Infinitesimals | ||
| - | Now, these laws, in the 200 years since Hahnemann developed them, have not been established by mainstream scientific investigation. They remain pre-scientific notions that have not yet been validated. The notion of 'like cures like', really, what is a manifestation of the idea that was popular at the time called sympathetic magic -- the notion that things will cure things that they look like or they are similar to. From a homeopathic site describing what this principle means //“In other words the substance produces symptoms of illness in a well person when administered in large doses; if we administer the same substance in minute quantities it will cure the disease in a sick person -- like cures like!”// Although they don't actually follow that rule because they don't give minute quantities they give nonexistent quantities as you would see. | + | Now, these laws, in the 200 years since Hahnemann developed them, have not been established by mainstream scientific investigation. They remain pre-scientific notions that have not yet been validated. The notion of 'like cures like', really, what is a manifestation of the idea that was popular at the time called sympathetic magic -- the notion that things will cure things that they look like or they are similar to. From a homeopathic site describing what this principle means -- //“In other words the substance produces symptoms of illness in a well person when administered in large doses; if we administer the same substance in minute quantities it will cure the disease in a sick person -- like cures like!”// Although they don't actually follow that rule because they don't give minute quantities -- they give nonexistent quantities as you would see. |
| - | Now many homeopaths or proponents of homeopathy have likened that principle to vaccines, when we give vaccines to patients we give them a small dose and that prevents the disease to the same thing that we are giving them, but that's a very superficial analogy that doesn't hold up. Vaccines actually give measurable doses of a substance that are known to provoke an immune response and essentially what's happening is that the immune response can then fight off a later exposure to that same thing. This is not analogous in any way to any of the principles of homeopathy or how homeopathy is practiced. | + | Now many homeopaths or proponents of homeopathy have likened that principle to vaccines -- when we give vaccines to patients we give them a small dose and that prevents the disease to the same thing that we are giving them, but that's a very superficial analogy that doesn't hold up. Vaccines actually give measurable doses of a substance that are known to provoke an immune response and essentially what's happening is that the immune response can then fight off a later exposure to that same thing. This is not analogous in any way to any of the principles of homeopathy or how homeopathy is practiced. |
| It is also important to recognize that Hahnemann and many homeopaths even till today don't actually treat what we, in modern times, consider to be a disease. Actually, the concept of a disease is a fairly new one, meaning it's only about a couple of hundred years old and it didn't really come to dominate medicine until after scientific methodology matured and became systematically applied to medicine only about a 150 years ago. | It is also important to recognize that Hahnemann and many homeopaths even till today don't actually treat what we, in modern times, consider to be a disease. Actually, the concept of a disease is a fairly new one, meaning it's only about a couple of hundred years old and it didn't really come to dominate medicine until after scientific methodology matured and became systematically applied to medicine only about a 150 years ago. | ||
| - | Homeopaths treat illness. They treat something that is not well defined patho-physiologically. They take what many call a holistic approach considering personality, temperament, sometimes superficial characteristics, in designing their treatment -- not based upon any modern concept that we would know of as a disease. | + | Homeopaths treat illness. They treat something that is not well defined patho-physiologically. They take what many call a holistic approach; considering personality, temperament, sometimes superficial characteristics, in designing their treatment -- not based upon any modern concept that we would know of as a disease. |
| - | The Law of Cure -- again, these are notions were developed by Hahnemann at a time that we had, really, very little idea how human body works let alone how disease processes work. So he had notions that the remedy starts at the top of the body and works downward, works from within and then goes outwards, symptoms clear in reverse order of appearance -- none of these notions have any basis in scientific reality. | + | The Law of Cure -- again, these are notions that were developed by Hahnemann at a time that we had, really, very little idea how human body works, let alone how disease processes work. So he had notions that the remedy starts at the top of the body and works downward, works from within and then goes outwards, symptoms clear in reverse order of appearance -- none of these notions have any basis in scientific reality. |
| Homeopathy, actually, is an energy-based medicine. Hahnemann believed that what is transferred to the patient is the essence, not anything physical, but the essence of the treatments that he concocted. These are more of a spiritual treatment than a physical treatment. He believed that dilution and succussion release a spirit-like power or an essence from the remedy that would have a healing potential in the human person. | Homeopathy, actually, is an energy-based medicine. Hahnemann believed that what is transferred to the patient is the essence, not anything physical, but the essence of the treatments that he concocted. These are more of a spiritual treatment than a physical treatment. He believed that dilution and succussion release a spirit-like power or an essence from the remedy that would have a healing potential in the human person. | ||
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