This is a transcription1) of a YouTube video recording a talk on homeopathy that took place on the premises of McGill University, November 27th, 2012. The topic of the talk was Homeopathy: Mere Placebo or Great Medicine?, the opponents were Dr. André Saine and Dr. Joe Schwarcz.
After the debate, Drs. André Saine and Joe Schwarcz accepted to answer questions from the public by writing. Dr. Schwarcz also sent 18 questions to Dr. Saine. In return, Dr. Saine sent 27 questions to Dr. Schwarcz. These questions and answers were added to their corresponding pages:
Ilana Block: Welcome! Bienvenue! And welcome back to many of you. My name is Ilana Block. I’m a doctor of naturopathic medicine and I practice here in Montreal. I’d like to just take a moment to discuss the difference between homeopathy and naturopathy, because I get this question all the time. What’s the difference between homeopathy and naturopathy? So, homeopathy is its own system of medicine. It’s practiced by many naturopathic doctors, by some medical doctors and others, whereas homeopaths are trained exclusively in homeopathy. Naturopathic medicine is a profession that encompasses many different systems of medicine, which can include homeopathy as well.
(I’ll ask you all to please turn off your cell phones. That would be great. I’ve passed index cards and pencils around and there are a few sitting around everywhere if anyone is missing one. If you have any questions: if you could please write the questions down on the index cards and pass it to the aisle. And between the debate segments we’ll be walking through the aisles and collecting the questions. So, please just write the question down and pass it to the aisle. That would be great.)
So, I’ll introduce Dr. Mark Ware who will be our fantastic moderator for the evening. He did such an amazing job in May. We’re really happy to have him back. Dr. Mark Ware is Associate Professor in family medicine and anesthesia at McGill University and is Director of Clinical Research of the Alan Edwards Pain Management Clinic of the McGill University Health Center. We hope you enjoy the evening. Have a good one, and I’ll hand you over to Dr. Ware.
Mark Ware (Moderator): Thank you, Ilana! It is a pleasure to see so many people here tonight and, as a clinician practicing in a chronic pain management clinic, we get approached a lot by patients who come and their families asking about different kinds of treatments for different kinds of pain. Very often they’ve done their own searches. You can go on the internet and look for chronic pain and there are a tremendous number of therapies that are advertised or abdicated [sic] or which people do share with one another.
Naturopathic medicine and alternative and complementary approaches are very commonly used. In fact, it’s one of the most common reasons why people use alternative and complementary medicine, is the treatment of chronic pain.
So, I am well aware of the public interest and just as a show of hands, I know that Dr. Schwarcz’s course was being held here. Can I just have a show of hands: How many of you are McGill students or students in science? So that’s about half, maybe a bit more of the room. How many general public members here for interest? So we’re pretty evenly mixed. We’ve got about maybe, I would say about 40% public, 60% science. So, thank you for coming and sharing your interest for this topic.
I’m going to set a little bit of the ground rules here. The first thing to tell you is how the debate is going to be handled. This isn’t really a debate in the classical sense, in that we have a motion and that you’ll be asked to vote on in the end and there’s a winner and a loser. In this debate, everybody wins. And essentially the topic that is placed before us is: Homeopathy: Mere Placebo or Great Medicine?
And I can tell you that the only time I have ever been sworn at, at a scientific conference, was when I mentioned homeopathy. So you can imagine that this engenders pretty strong emotions and, as a result of that, I am going to ask you all to be, please, on your best behavior. You may hear things said by one or the other of our speakers that you disagree with, that you do agree with. Please keep your comments and mumbles and moans and boos and hisses to a minimum to allow our presenters and our speakers to do their best in presenting you their opinions and their judgments.
Having said that, you will have an opportunity to ask questions and, in the past –in some public sessions we’ve had– people, when offered the chance to give a question, can often go on a little bit longer than we might like. So, we’ve given you the index card option. And they will be collected and I will be going through them and picking out representative questions. So, several questions will come up several times. So, in order to avoid repetition, I’ll pick an example of the kinds of question that is being asked.
An example of just how engaging this topic is: I actually had a question emailed to me yesterday by somebody who couldn’t come and said, “ Please ask this question.” So, people have already begun asking questions, even before the debate has begun.
So, the way it’s going to work is, André, our first speaker, will present for 30 minutes. That will be countered by Dr. Joe Schwarcz, who will speak for 30 minutes. They will then each have ten minutes to rebut the other’s arguments. Then they will have a question and answer session between them and at that point we will open the floor to you for questions. And at the very end they will have the chance for a 2 minute summary. And I will hopefully conclude the session. And we will all be ready to go home by 9 o’clock.
I appreciate that it is a long session. It will be engaging. Somebody asked me this evening when they heard about it they asked me if there were going to be fireworks. I can’t promise you fireworks. I can promise you engaging discussion. I can promise you a lot of very interesting material and two very interesting speakers who I will introduce briefly now, before they begin.
And Professor Joe Schwarcz is professor of chemistry here at McGill University. He is the director of the Office of Science and Society, the author of many books, the most recent one is called, “The Right Chemistry” available at a bookstore near you. And it is a great pleasure to welcome Dr. Joe Schwarcz, known to most of you as “Dr. Joe.”
And without further ado, I am going to invite our speakers. I will be the timekeeper. I broke my arm recently playing hockey, so I am committed to a cause. If somebody goes on too long I will charge the stage and ram you with my cast. So, please, respect the time frame and please, respect each other. I ask for an air of respect from the audience and I expect, also, the same from my two debaters. If there are fisticuffs looming I will also step in and interrupt. And there is a reason for making those statements, as I’m sure you will experience.
Some minor changes to the order of words have occasionally been made to make this transcription grammatically correct and easier to read.
André Saine: Good evening. I’d like to dedicate this historic debate to Samuel Hahnemann, the founder of homeopathy, who 200 years ago exactly in the fall of 2012 began teaching homeopathy at the University of Leipzig. Also, I’d like to dedicate this debate to his most brilliant student, Adolph Lippe, whose 200th birth anniversary we are celebrating this year.
Ladies and gentlemen, tonight we are asked to debate a question that has been harshly argued for more than 200 years, and for more than 200 years the positions on either side have been stuck in a complete deadlock. It is astonishing to note that the arguments on either side have essentially not changed over this long period of time.
On one side, you have skeptics who from a mere theoretical point of view argue that homeopathy is implausible. Therefore, it can’t work. And any evidence in favor of homeopathy is logically flawed; is looked at as completely flawed.
Now, this position has led, not surprisingly, to harsh criticisms, such as, “Homeopathy is a pernicious quackery2),’” or that “the tenets of homeopathy are marinated in pseudoscience3).” And it has led, unfortunately, to intolerance, such as “ Homeopathy is ethically unacceptable and ought to be actively rejected by healthcare professionals,”4) and has called for the end of homeopathy and for the end of veterinary homeopathy.
On the other side of the conflict, we have generation after generation of homeopaths all over the world claiming, from a purely factual point of view, with loads of evidence, “And yet, it works!” and will denounce any trial showing that homeopathy is not better than placebo as being fundamentally flawed.
As a flagrant example of this: Shang et al meta-analysis in The Lancet, in 20055). They reported having analyzed eight trials of homeopathy. One of the major flaws contained in this meta-analysis is that 6 of the 8 trials were absolutely not testing homeopathy, but poor imitations of it.
Of the 8 trials of homeopathy in the Shang meta-analysis5), there were 2 trials testing individualized treatment with the single remedy but not with the individualized dosage.
As for the 6 other trials, none of them were individualized. This is, unfortunately, very bad science. Before going any further, it is very important to understand that Hahnemann was a man of science. He was recognized in his time as a great scientist, and particularly an expert chemist. Hahnemann was born and educated in the time of enlightenment in Europe, which was the time of rationality, and he tried to bring rationality in medicine, and he endeavored to do this all his life. And therefore, his first edition of the Organon (‘Organon’ means ‘the instrument of understanding’) was called the 'Organon of the Rational Art of Healing.’ This was in 1810.
In 1817, he wrote a most important note to his reviewer, in which he said, ‘Homeopathy appeals not chiefly, but solely to the verdict of experience – ‘repeat the experiment,’ it cries aloud, ‘but repeat them carefully and accurately, and you will find these observations ” – not theories, but these observations – “confirmed at every step’, insisting upon being judged by the result.”
In other words, Hahnemann makes the more than fair request that anyone who intends to make a trial of homeopathy, or wants to make a credible criticism of it, needs absolutely to obtain a minimum of competence in the principle and practice of homeopathy, which as a rule takes a minimum of 2 years of study.
Who is right and who is wrong in this conflict about homeopathy being mere placebo or great medicine? This is of great interest to the skeptics, who believe that people are being fooled and wasting their money on useless treatment, which can potentially be harmful, as they believe it can delay more effective treatment. On the other side, we have homeopaths from first and daily experience of the immense health benefit brought by homeopathy advocating that “ Every single person has the most fundamental right to have full access to this uniquely gentle, safe, effective and curative system of medicine.”
I believe this long-lasting and complete deadlock on the purely scientific question is, at minimum, bizarre, and certainly unique in the history of modern science, and that it can only be resolved by proceeding with nothing less than with the greatest scientific rigor every step of the way.
Science in general and homeopathy in particular, requires critical thinking, but at the same time openness of mind all the way. Scientists must be interested in new phenomena, and be prepared for new discoveries and changing paradigms.
Tonight I invite you all to approach the question before us with a complete non-biased mind, and use the best scientific thinking to make sense of this schism that has divided the medical profession so unfortunately from suffering humanity.
Let me now address the skeptics' argument of implausibility. The argument of implausibility focused particularly on one aspect of homeopathy, which is the fact that homeopaths use ultra-molecular preparations. “Ultra-molecular preparations (UMPs)” (so I’ll use this this evening – UMPs – so just be prepared that it is ultra-molecular preparation – “ are prepared from solutions that went through a process of serial succussion and dilution (usually) exceeding (in theory) Avogadro’s limit.”
The use of UMPs has certainly been the biggest stumbling block for the acceptance of homeopathy in scientific quarters. Indeed, skeptics commonly assume, first, that “There is not a single molecule of the original substance in the homeopathic remedy” and second, that homeopathic remedies are indistinguishable from each other. Maybe skeptics are right on the first point, that “ There is not a single molecule of the original substance in UMPs.”
However, on the second statement, that UMPs are indistinguishable from each other, they are wrong, according to current scientific data. Indeed, we find a 2003 paper published in Physica A6), in which “ultra-high dilutions of lithium chloride and sodium chloride 10-30 have been irradiated by x-rays and gamma rays. . . . It was found that, despite their dilution beyond the Avogadro number, the emitted light was specific of the original salts dissolved initially.”
Moreso, in the 2008 paper by the team of Rustum Roy7), Professor Emeritus of materials science at Penn State University, which is their signature lab, confirmed that it is possible not only to distinguish one UMP from another, but also one potency from another, with two different types of spectroscopy.8)
“The results show that the materials can be easily distinguished from the pure solvent, and from each other… Spectra show clear differences between two different remedies and different potencies of the same remedy .”
We find, also, other teams of researchers with other forms of spectroscopy also investigating the same phenomena, and they are finding the same thing. They find out that the change in the water is permanent, and they say, “ The nature of the phenomena here described still remains unexplained; nevertheless some significant experimental results were obtained.”9)
However, the same team of researchers here 9) investigated the age – how long does the change in the water last? And they found out that this change multiplied with time, and they found out that
“ The intriguing pattern does not seem to depend on the degree of dilution or on the nature of the initial substance. . . . The excess conductivity of all systems increased with a gentle slope, reaching a maximum, in some cases very pronounced, at an age of about 500 days. ”
Let’s look at this paper that was published in 2010 from the Indian Institute of Technology10), which is ranked 49th in the world in terms of its School of Engineering compared to 46th on the QS scale of top university, so it’s not too far from McGill - 46th place.
And they found out that, “ We have demonstrated for the first time by Transmission Electron Microscopy, the presence of physical entities in these extreme dilutions, in the form of nanoparticles of the starting metals and their aggregates .”
The same team published in the journal of Langmuir, which is a very, very prestigious journal of chemistry – actually, it’s one of the journals of the American Chemical Society, and they have a motto, which is: “The most trusted, the most cited, and the most read journal.” And this team from the Indian Institute of Technology confirmed that they found particles even at these extreme super-Avogadro dilutions, and they found out a process.11)
I’ll show you: here is the process of trituration, and here is the process of dilution. After three series of trituration, it goes into a solution, and then the succuss. And then as this process progresses, there are nano-bubbles that accumulate in an asymptotic manner. That means it never reaches zero. So as you are diluting and succussing, the nano-bubbles actually multiply.
And they concluded, “ Our conclusions arise from our experiments indicating that in the successive dilution process of manufacturing, beyond a certain stage, the dilution is merely apparent and the concentration of the starting material in the diluted product reaches a non-zero asymptotic level no matter how much more the sample is diluted.”
This statement is contrary to current scientific research, which supports the biological plausibility of UMPs. In a 2005 paper in Material Research Innovation entitled “The Structure of Liquid Water: Novel Insights From Materials Research; Potential Relevance to Homeopathy12),” we can read, “ This paper definitively demolishes the objection against homeopathy,” and I will skip the rest of the quotes there.
In a summary review of the literature, “On the Plausibility of Homeopathic ‘Similitude’,” published in 2011, the author who reviewed the literature concluded, “ in conclusion, our work and that of many other researchers suggests that homeopathy is not only plausible, but constitutes one of the frontiers of medical science, and more specifically of complexity science, biophysics, and nanopharmacology. For these reasons the tenet according to which ‘homeopathy is based on principles that are incompatible with well-established science’ cannot be accepted and investigation of homeopathic treatments appears to be warranted and ethically justifiable.”13)
Now, the question that we probably all have is, “ Fine. We have a remedy that makes sense. There are nanoparticles. There is a permanent change in the solution. But can they have a physiological effect?” Skeptics already conclude, “No.”
“Evidence of the Clinical Effectiveness of Homeopathy.” First we are going to look at in vitro research. We can read, in this 2007 systematic review of the in vitro research in homeopathy:14) “Systematic assessment of the in vitro research on high potency effects.” That was their objective:
The next question that needs to be answered is whether homeopathy really works clinically. That’s what we are here for, so let’s look at whether it works. First, let’s look at veterinary research. These are randomized controlled trials with positive evidence. Here we have infertility in cattle, mastitis in cattle, infectious diseases in pigs, and so on and so on, and here we have clinical outcome studies with positive evidence in animals. We have kennel-cough in dogs, epilepsy in dogs, Cushing’s syndrome, and so on.
Observational studies provide verifiable information that is complementary to the results of clinical trials, and here it is particularly helpful to evaluate real-life outcomes over many years. First, this 2005 review paper entitled “Research on Homeopathy: State of the Art16),” in which it is stated, “Observational research of homeopathic practice documents consistently strong therapeutic effects and sustained satisfaction in patients.”
The first one is out of the UK, in which the author reports, “ This was an observational study of 6544 consecutive follow-up patients during a 6-year period. . . . Results: Homeopathic intervention offered positive health changes to a substantial proportion (71%).”17)
The second study I’m going to show comes from Germany and Switzerland. It was published in 2008, and the authors report, “ In a prospective, multicentre cohort study with 104 homeopathic primary care practices in Germany and Switzerland, data from all patients (age >1 year) consulting the physician for the first time were observed. … Results: A total of 3,709 patients were studied, 73% contributed data to the 8-year follow-up. … Disease severity decreased significantly (p < 0.001),” – this is extraordinary: One chance in a thousand that it could have happened— “ between baseline, 2 and 8 years. Physical and mental quality of life scores also increased considerably… Conclusion: Patients who seek homeopathic treatment are likely to improve significantly. These effects last for as long as 8 years .”18)
There are all kinds of wonderful trials throughout the long history of homeopathy; however, I will focus on two RCTs (Randomized Control Trials). For the first one we are going to look at, the outcome is very interesting because the outcome is life or death, so it’s a bit more dramatic. This is a study on sepsis in an intensive care unit:
“ Mortality in patients with severe sepsis remains high despite the development of several therapeutic strategies. … The incidence of severe sepsis is between 70,000 to 300,000 patients in the United States each year. The aim of this randomized, double-blind, placebo-controlled trial was to evaluate whether homeopathy is able to influence long-term outcome in critically ill patients suffering from severe sepsis. .. Seventy patients with severe sepsis received homeopathic treatment or placebo. Five globules in a potency of 200 C were given at 12 h interval during the stay at the intensive care unit. Survival after 30 and 180 days was recorded. … Results: On day 180, survival was statistically significantly higher with verum homeopathy (75.8% vs. 50.0%, P=0.043). No adverse effects were observed.” 19)
Here we have a skeptic from England, in the Guardian stating, “ This RCT trial has been done, time and time again, with homeopathy … you find, overall, that the people getting the placebo sugar pills do just as well as those getting the real, posh, expensive, technical, magical homeopathy pills.”20)]
Now, a valid question to ask Goldacre is whether he considers the other 26% extra19) in the sepsis placebo group as doing just as well as the group receiving homeopathy.
This one is of great interest as researchers were able to isolate the strength of homeopathic response from the clinical skill of the homeopaths. It’s on hyperactivity in children:
“ An increasing number of parents turn to homeopathy for treatment of their hyperactive child. Two publications, a randomised, partially blinded trial and a clinical observation study, conclude that homeopathy has positive effects in patients with ADHD. The aim of the study was to obtain scientific evidence of the effectiveness of homeopathy in ADHD. Method: Prior to the randomised, double blind, placebo controlled crossover study, they were treated with individually prescribed homeopathic medications .”
So they found out who responded to the remedy. “ 62 of 83 patients [or 75% accuracy in prescribing], who achieved an improvement of 50% in the Conner’s’ Global Index (CGI), participated in the trial. … Results: At entry to the crossover trial, cognitive performance such as visual global perception, impulsivity and divided attention had improved significantly under open label treatment with a P value of P<0.0001.”21)
“ The trial suggests scientific evidence of the long-term effectiveness of homeopathy in the treatment of attention deficit hyperactivity disorder, particularly in the areas of behavioural and cognitive functions .”
I have a couple of minutes to start to look at systematic reviews and meta-analysis, and this is where skeptics say they rely much on the meta-analysis. In 2004, medical historian Michael Dean published the first systematic review of all clinical trials of homeopathy published in the medical literature from 1821 until 1998, and he found and analyzed 45 prospective trials and 205 controlled trials.22) Some of the main findings of this extensive search analysis are:
Skeptics, however, still rely heavily on the now much-discredited Shang et al. meta-analysis5), instead of referring to the recent and most comprehensive review ever conducted on the effectiveness, safety, cost-effectiveness, and real-world outcome of homeopathy, which is referring to the Swiss study which I will continue [to explain] after I come back.
Mark Ware (Moderator): Thank you. Challenging the very nature of water and making sure that you never pass a water filtration plant and look at it the same again, please, a big hand for André Saine. You’ve already heard from Joe Schwarcz tonight, by reading his words. Now, here to defend himself, in person, please Dr. Joe. You have 30 minutes.
Joe Schwarcz: Thank you. And those of you, who are new to McGill, welcome! I’m not sure why I’m needed. André made my case. He made it very well. He referred to me. I stand by everything that I said. But, you want some detail. So, the question before us is whether or not homeopathy is effective medicine or, is it a placebo? In fact, it’s the wrong question, because it means that a placebo cannot be an effective medicine. It can be both! There’s no dichotomy here. It is true that I believe that homeopathy is chemically and biologically implausible. But I also believe that it can be psychologically very compelling. Those are also not incompatible with each other.
It is not herbal medicine. It is not acupuncture. It is not reflexology, aromatherapy or any of those. It is a distinct system, and that already was described, of like curing like. A healthy person develops a symptom in [response] to a large dose [of a substance], that, used in smaller doses, is curative [of the very symptom it causes]. And those medicines can come from many, many areas; from plants, from animal stuffs, minerals et cetera. That’s the essence of homeopathy, as conceived by Samuel Hahnemann way back around 1800.
He was, indeed, a very, very interesting man. He graduated from medicine. He did not like the lancet, which was, of course, used to bleed people in those days. He did not like leeching. He didn’t like the horrific things that physicians did in those days, because, basically, when you got better, it was in spite of the physician, not because of him. Hahnemann wanted something different. He wanted a kinder, gentler therapy, and he is to be commended for that.
Malaria was a scourge at that time. As, unfortunately, it still is today. But there was a treatment, which was Cinchona bark. 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. He began to investigate other materials, arsenic, for example. In terms of ‘Provings’ as he called them, he would give it in increasing doses to friends, family members et cetera and cause symptoms, for example, in this case, gastric pain, vomiting, and diarrhea. He lost some friends and relatives along the way. But he concluded, that therefore, in smaller doses this would be a remedy for food poisoning,” because those are the symptoms one experiences with food poisoning.
And he developed a whole system of Materia Medica, numerous such ‘Provings’. And then he 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 [sic] 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.
So dilution, which of course, is still very, very much part of homeopathy: You dilute, dilute, dilute in water and alcohol, and –as was already mentioned—once you get to about 12C, there is not a single molecule of the original that is left. That of course can be calculated. So that when you buy a remedy –a homeopathic remedy like this one here, which is based on acetic acid—it doesn’t have a single molecule of the original substance. But that solution, which doesn’t have anything, has been impregnated into a sugar pill, which is not expected to somehow have any kind of an effect on the solution. Of course, once the water evaporates, there’s no water there left. So what is there is a ghost of the molecules. Well, when would you use this particular product? Well, the ‘Provings’ have shown it can be used if you have this particular issue (Source: “ Especially indicated in pale, lean persons, with lax, flabby muscles”) or if you suffer from sausage poisoning. I am not sure how they arrive at that, but that comes from the Materia Medica directly for this particular homeopathic product.
Once you get to the 30C dilution, which was favored by Hahnemann, a patient would have to consume an unbelievable amount of the so-called ‘remedy’ in order to encounter a single molecule. And furthermore, at that dilution, you’re not even going to encounter a water molecule that has encountered the original material. But this was, of course, not known to Hahnemann, because Avogadro and Dalton’s theories were basically just formulated in the middle 1800s about atoms, and Hahnemann knew nothing about that. So, within his frame of reference, it kind of made sense. And he based it all on his own experience; his patients got better and they loved him. Of course they did, because he didn’t make them vomit, he didn’t create diarrhea; he didn’t do the horrific bleeding that other physicians were doing.
Even Napoleon was into homeopathy. His pubic lice were treated with it. But history does not record whether this was successful. But no everyone was enamored. Sir John Forbes, Queen Victoria’s Physician, didn’t like the idea of homeopathy. He thought that it outstretched [sic] the boundaries of science.
But there were some remarkable homeopathic products developed in those days. Homeopathic cocoa, as you can see, it would last for 12,547,298 years. I am not sure exactly how that was calculated. But even Fry came out with homeopathic cocoa. I think in this case it is pretty descriptive, because there is nothing in there. So, I think we can really call this legitimate product.
But, of course, the whole issue really boiled to the fore, in terms of modern science in the journal Nature, a very reputable journal, in 1988, with this study that was carried out by Jacques Benveniste, a highly respected biochemist in those days. And he maintained that in his experiment, he found the solution that reacted to an antigen in spite of the fact that there was no molecule left. And he submitted this paper to Nature. Well, this, of course, caused a large controversy, especially when he said that his solution worked only when shaken and not when stirred. Well, James Bond perhaps was a homeopath. I don’t know. That has to be investigated whether or not the shaken or the stirred martini has any kind of chemical difference. But anyway, Nature agreed to publish this article with a proviso. This is the first time anything like that ever happened.
( Editorial Reservation: Readers of this article may share the incredulity of the many referees who have commented on several versions of it during the past several months. The essence of the result is that an aqueous solution of an antibody retains the ability to evoke a biological response even when diluted to such an extent that there is a negligible chance of there being a single molecule in any sample. There is not physical basis for such an activity. With the kind collaboration of Professor Benveniste, Nature has therefore arranged for independent investigators to observe repetitions of the experiments. A report of this investigation will appear shortly.)
They would publish the paper, but because all the referees said it was unbelievable, but they believed the data that Benveniste had done this, they would publish it with the proviso that an investigative group would go into Benveniste’s lab and, under his supervision, attempt to reproduce the experiment. This is just what happened: Now the homeopathic proponents, of course, stood behind this. They believed Benveniste. In fact, David Reilly, highly respected, said, “If we prove the observations wrong we will have exposed homeopathy as one of medical science’s greatest misadventures- a huge [sic] folly.” That’s what he said. Well, the group, of course, found that the experiment could not be reproduced, and it turned out Nature published that high-dilution was, in fact, delusion.
So, that is where Benveniste stood at that point. He didn’t give up. He said that his experiments were sound and that he would eventually reproduce it. That never happened. We’re not quite sure why. But the technician who worked on this had a very, very close relationship with Jacques Benveniste. Some would say too close. And that she was actually doctoring the data in order to please him. We cannot prove that one way or the other. But it seems to be a possible explanation, given all the information that we are now privy to.
Benveniste went on to found the company called ‘DigiBio.’ And he said that homeopathic information could actually be transmitted through the internet. And he carried out experiments whereby he said that this could, in fact, be done. Well, this, I think, does not stand up to the rigors 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. And this cannot be discounted, as I said, because we know a lot about how the world works. And water having memory is not plausible based upon the chemistry, the biology, and the physics that we know.
I’m not going to get into the battle of papers, because there are 6,500 peer reviewed journals in the world. Every minute of every day there are four new peer reviewed publications that come out. They can be put on a bell curve, like everything else in the world is. Some are excellent, some are terrible; most are mediocre. So, it is possible to take a look and cherry pick and show anything you want with the literature. That’s why we don’t get into the ‘paper vs. paper.’ That’s why plausibility is very important in terms of memory effects.
Water does not have memory. Water molecules move around all the time. Yes, there are momentary associations. Picoseconds. That’s an unbelievably small time frame. Water doesn’t hold any kind of memory and, if it did, why doesn’t it remember everything else that it came into contact with? That water has been down through sewers. It has been through taps. How come there is no memory of that? Well, some people say that is it because it can be wiped out.
This company sells a ‘filter’ to make homeopathic water. And they pass the water through the crystal so that it erases all its previous memories. I don’t think that that is particularly scientifically sound. But, of course, what we want is the evidence.
Never mind the impossibilities. Never mind the extreme delusion. I will accept the fact that there are some anomalous findings as André pointed out –and in respect to journals. But that is not the point. The point is: So what if there is something anomalous found? How does that translate to curing? To therapy? I would even grant the fact that water can hold memory. Okay, let’s say that it can. What does that have to do with healing anything?
So, let’s look at evidence. Some homeopaths say that they can actually detect which is a homeopathic remedy by dowsing, by swinging a pendulum over it. We’ve tested some of these people. The tests are very clear. They get it right about half the time, which is exactly what you would get randomly statistically.
Are there positive peer-reviewed trials of homeopathy? You bet there are! André pointed out some. This particular one, indeed, on sepsis makes use of a plant product in extreme dilution (Teucrium Marum Verum) and, indeed, the conclusion is that there is an effect.
Of course there is! You will find, in the scientific literature, positive and negative studies for anything. That’s why we look further than that. We look further than the journals of homeopathy and alternative medicine where most of these appear. We look at everything. We look at the meta-analyses. Meta-analyses are real. Of course some of them can be criticized, but this is what we look at. The first real meta-analysis was done in 1997, of homeopathy, and it came to an interesting conclusion: That it seemed that there was something more than the placebo effect. This is being quoted all the time. (Source: The results of this meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo.)
( The evidence of bias weakens the findings of our original meta-analysis. Since we completed our literature search in 1995, a considerable number of new homeopathy trials have been published. The fact that a number of the new high-quality trials… have negative results, and a recent update of our review for the most “original” subtype of homeopathy (classical or individualized homeopathy), seem to confirm the finding that more rigorous trials have less-promising results. It seems, therefore, likely that our meta-analysis at least overestimated the effects of homeopathic treatments. )
They realized that when further studies were done, the evidence just evaporated. And this is what we see. When better studies are done with more people, with more controls, the evidence seems to evaporate.
Then, of course, there was the analysis that André referred to, which I certainly don’t dismiss. There are problems with some of the papers in there, but they looked at a huge number of papers and even the criticism of this analysis has been widely criticized. But the basic conclusion was that there is no better than placebo.
The Cochrane Collaboration, one of the most reputable organizations in the world, they have no vested interest whatsoever, they have looked at homeopathy, did a meta-analysis, looked at all of the trials. Again the conclusion is that it is a placebo effect.
James Randi who we had here in this very room as a guest –some of you were probably here two years ago—he was asked to supervise a specific trial on Horizon, a wonderful British TV program. And they sent out samples to scientists who claimed that they could distinguish between homeopathic products and others. The result, as you can see, was that they were unable to do so.
(Source: Horizon takes up the challenge. Although many researchers now offered proof that the effects of homeopathy can be measured, none have yet applied for James Randi’s million dollar prize. For the first time in the programme’s history, Horizon decided to conduct their own scientific experiment. The programme gathered a team of scientists from among the most respected institutes in the country. The Vice-President of the Royal Society, Professor John Enderby oversaw the experiment, and James Randi flew in from the United States to watch. As with Benveniste’s original experiment, Randi insisted that strict precautions be taken to ensure that none of the experimenters knew whether they were dealing with homeopathic solutions or with pure water. Two independent scientists performed tests to see whether their samples produced a biological effect. Only when the experiment was over was it revealed which samples were real. The experiment was a total failure. The scientists were no better at deciding which samples were homeopathic than pure chance would have been. )
The experiment was a complete failure. This was repeated here in Canada. On Marketplace they did a very good analysis of this. You can get all the videos at that website (http://www.cbc.ca/marketplace/) and see what Canada was able to find.
“ The problem is if you try to prove homeopathy using a scientific paradigm, as by using double blind studies, you’re trying to standardize the therapy, but homeopathy is individualized to each patient, so if a remedy works in Andy, who says it will work in Bill? ”
It’s true. It is individualized. But that is also curious, because there have been studies where the same patient with the same symptoms has gone to numerous homeopaths and gets completely different advice. So, I am not sure how that makes sense.
As far as the animal homeopathy goes, it is true that animals are not susceptible to the placebo effect that humans are, but the humans who look after the animals are. And here, too, placebo trials have been done. We can, you know, get into this ‘who has the better trials’ et cetera, but just think about whether or not plausibility should play a role.
In Switzerland, the Swiss government has decided that homeopathy can be put on the national health scheme. This caused a lot of controversy, because they claim to have evidence for the benefits for homeopathy. This also has been investigated thoroughly and it turns out that all of the members on the committee who made that recommendation in Switzerland had some connection to homeopathy or a homeopathic producer.
In England, the House of Commons struck a committee, the Science and Technology Committee, to look into homeopathy and they came up with the recommendation that it should not be on the National Health Service, after consulting experts across England –and these were scientists themselves.
In Canada, homeopathy is legal, of course, and you can buy homeopathic products. They must have a DIN (DIN-HM) number, which I think, to many people, suggests that this is approved by Health Canada as ‘safe and effective.’ Not the case. It does not have to be proven effective. It is, of course, safe, because there is nothing in there. So, homeopathy is regulated in Canada in this rather bizarre way, but there is absolutely no requirement to prove any kind of efficacy.
Well, you can use Oscillococcinum for the flu. There’s not going to be any risk, because basically what you have here is a homeopathic preparation made from the liver and the heart of a duck. But it is at a concentration of 200c, which as we have seen is incredibly dilute. There’s not a single molecule. So, one duck is enough to supply the homeopathic demands of the world for several years with Oscillococcinum. But it won’t do you any harm. And, indeed, critics of homeopathy have clearly shown this by taking various homeopathic medications in huge doses. And they guzzle the bottles tablet after tablet after tablet and show that, of course, nothing happens. Of course, homeopaths will argue that this is the wrong way, because they are taking more and more of this stuff. Whereas potency increases as you take less and less. So of course nothing happens to them if they take more and more. If they want to really prove the toxicity of homeopathy, they should forget to take the pill. Then something would happen.
There are some incredibly strange homeopathic remedies and they’re out there on the market. Now, I would think that most honest homeopaths are not into this. And I would hope that André would agree with me: That homeopathic remedies based on Berlin Wall are not reputable. The idea here is that the Berlin Wall, in healthy people, caused anxiety. And, therefore, a homeopathic preparation made from the Berlin Wall relieves anxiety.
Well, now we are talking about more significant risk, because some homeopaths said, “Forget any kind of other protection. This is what you need: Homeopathic remedies that can protect against radiation.”
Homeopaths Without Borders, who have no connection to Doctors Without Borders, say that in Haiti, for example, when the rainy season comes, you have to worry about Dengue, Malaria et cetera. All of that is true.
And Jeremy Sherr, who is the founder of Homeopathy for Health in Africa, believed that AIDS can be cured homeopathically, “ I know, as all homeopaths do,” I don’t think that that is the case, “that you can just about cure AIDS in many cases.” But, of course, he’s not allowed to say this because the pharmaceutical companies would get after him, because he’s got this simple remedy for AIDS.
In England, unfortunately many homeopaths recommend homeopathic prophylaxis for people who are going into mosquito infested areas. Homeopathy does not work to protect you against Malaria. People have succumbed to this.
Now, some of these alternative websites that recommend homeopathy –and I don’t mean to suggest, at all, that all homeopaths would be in this category, but some are (But, of course, some doctors also do crazy things)—but, in this particular popular website, which recommends homeopathy, they also tell you that the American Medical Association really should be called the “American Murder Association,” because of all the terrible things that they do. And, they advise people to avoid chemotherapy and radiation in favor of homeopathy. That’s where we get into the real problems. Because there are homeopathic clinics that claim to treat and cure cancer. And desperate people will do desperate things.
There’s absolutely nothing wrong with experimenting with homeopathy when someone has a terrible disease and they have run the conventional gambit and nothing gets helped. I can certainly appreciate that. In fact, I can’t guarantee that I wouldn’t do that myself. But, when someone chooses that over some established conventional treatment, we have a real problem. And it has happened many times. But I give you just one particular case. It’s a very unfortunate case and it got a lot of publicity in Australia.
She was of the natural mind and she didn’t want to engage in chemotherapy. She didn’t’ want the surgery that was recommended. She went to a homeopath. This homeopath told her –we have the direct quote— (Francine Scrayen) “You must use homeopathy alone. Classical homeopathy will cure you…” whereas, chemo and surgery will not.
As you can imagine, the story has a very sad ending. And it is obviously a legal case. And it is going to be interesting to see just what happens here, but of course, the poor victim cannot be brought back. Here is the coroner’s report:
“ The unhealthy reliance placed on Mrs. Scrayen’s homeopathic “cures” by the deceased and her husband, Dr. Dingle, who appears to have been very much involved in the decision-making process, resulted in a tragic series of events and the deceased suffering extreme uncontrolled pain over an extended period of time at a level not normally experienced in societies where there is access to modern medical treatment.”
And you see that desperate people will do desperate things. The decision was made by herself and her husband, who was also a believer in alternative medicine. And she paid the price, because with the kind of cancer that she had, a cure probably would have been affected.
30-40% of the time it will work in almost any condition. It is just an amazing phenomenon. And it’s very real. The fact that it’s in the mind is irrelevant. If you feel better, you do feel better. It doesn’t mean that you are better. It doesn’t mean that there has been any kind of physiological cure inside, but you do feel better.
We also have the so-called ‘Regression to the Mean.’ I know that sounds scientific. But basically what it means is that many conditions are cyclical and one week you may feel good, the next week you don’t feel good. That’s when you go to the alternative therapist. And, of course, if you get naturally better, that gets the credit. That is the ‘Regression to the Mean.’
Very often, standard treatments are also being used and yet the alternative therapy gets the credit. And lifestyle changes –very often good lifestyle changes—are recommended by homeopaths (exercise, good diet, et cetera). That may make a difference. And there is the fear of conventional treatment. People don’t want chemo. They don’t want surgery; much, much safer –gentler—to swallow a sugar pill. So, all of these together make homeopathy acceptable.
Back to Hahnemann which is where we started. Remember that he 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 Wilhelm 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. And that’s what created his tenet. But he was a good man. There’s no question about that. He wanted to do good. He recognized the ills of conventional medicine at that time. He now rests in Switzerland.
And again, we can look at the studies and many experts, of course, have done that. And there are pro studies as André has pointed out. But I can tell you that for every one of those studies there are a large number of experts who will criticize it and will give you piles of other studies. But I certainly agree that while homeopathy itself is scientifically implausible, homeopaths can be beneficial to many people. Because when you do surveys, very often people will express their satisfaction. They’ll express their satisfaction on homeopathy, because the consultation is what is important.
The homeopath himself or herself is a wonderful placebo. Doctors these days don’t have much time. As soon as you sit down, they start looking at their watch. They’ll tell you, “You have two questions to ask” or, “I have ten minutes for you.” Actually, ten minutes is quite long. The average in North America is about seven minutes. So of course people are dissatisfied with the kind of conventional care that they are getting.
With a homeopath, you will sit down. They will discuss every aspect of your life. They will ask you probing questions. They really seem to care about what is going on, and very often that is what people need. They need their souls massaged. And that is not to be demeaning, because that is very important. Many diseases are cyclical and there is nothing you can do about them.
So, yeah, of course there is a lot of satisfaction from homeopaths. And there is no question, that when you go to a consulting homeopath who really knows the ins and outs, there are many people who benefit greatly from that. And, after all, you know, the Royal Family in England stands by this. Not that, you know, they’re a real beacon. I mean, obviously, when Prince Philip had a more serious problem, he ended up in a hospital. He didn’t go to a homeopath.
So, basically, André and I have different views on homeopathy. I certainly do not in any way suggest that homeopathy should be banned or that it should be legally controlled. That’s not my point at all. I think that homeopathy can serve a purpose. But I think one has to be very careful in making the choices about when homeopathy is appropriate and when conventional medicine is appropriate. And I think that whether or not the extreme dilution has some sort of strange property is irrelevant, because it has nothing to do with the potential of cure.
Why should that ghostly image in the water have anything to do with cure and how is that ghostly image transferred to the sugar pill and why doesn’t the sugar pill have any effect? Anyway, those are things that can be further debated. So, is homeopathy good medicine or is it a placebo? The truth, of course, is that it is both. And there is nothing wrong with having an effective placebo as long as it is honestly delivered and as long as the patient is not being tricked that something else is happening than what is actually going on. So, we will certainly be happy to take your questions and to discuss this back and forth. But there you have two distinct views on homeopathy and I guess it is up to you to make up your mind about which is the more scientific approach. So thanks very much for your attention.
So, you’ve heard two very conflicting opinions. We now turn to a bit of a rebuttal. I now invite André Saine - he has exactly 10 minutes to respond. Again, please no heckling from the audience; this is not what we want to get into. Please respect the speakers and keep your comments to yourselves.
There are question cards going around. Questions will be posed to the speakers if they are legible and I can read them. As a doctor, I can tell you, I can read almost anything. André, you have 10 minutes to rebut the statements of Dr. Schwarcz.
André Saine: Okay, thank you. Joe, with all due respect, I think you are behind science. Science is moving along, and there are a lot of articles, of course, and if you don’t look at it, it’s going to go beyond.
And to compare Randi and Marketplace with researchers from renowned centers – it is not equal. There are serious scientists out there doing serious research, and the work of Benveniste was replicated by several labs since, and it was published a long time ago – over 10 years ago.
In terms of history, Joe, you don’t know your history. The process of serial dilution and succussion was not an invention of Hahnemann. It has been known at least since Paracelsus. And Hahnemann used crude doses at least till 1822. In other words, he went to the process of serial dilution slowly, slowly over the years. It was only around 1812 that he went beyond Avogadro’s number.
He took many years. It was not a flash of genius; it was a process of experimentation. And as he experimented, he noticed greater response from the patients, and he said, “Let’s do it further.” Greater response. This is confirmed now from the work on nanobubbles, where there is an augmentation of the effect.11)
In terms of the placebo effect, Joe, I think you are in 1955 with Beaker’s study of the powerful placebo effect. This was reviewed many, many times since 1955, and the Cochrane collaboration came out, I think, this year with a review of all the trials where they compare placebo with effective treatment and the no-treatment arm. And when they used this, when they looked at about 200 trials with the no-treatment arm, and they found out that the placebo effect in clinical trials is really negligible.
I was telling you that I am going to present you the findings of the most comprehensive review of homeopathy. This was the one that I referred to before, and Joe also referred to – also called the Swiss study.23)
“This is a Health Technology Assessment conducted over a period of seven years by scientists for the Swiss government.” So these were independent scientists. There were eight scientists, and three of them were also practicing homeopathy, but the editors were a neurosurgeon and psychiatrist – nothing to do with homeopathy. They were scientists specialized to analyze trials – nothing to do with homeopathy.
A bit more advanced than here. Now, probably the most compelling of all evidence is the epidemiological evidence. In 2003, I began a review of the literature on homeopathy in times of epidemic. So far, I have accumulated over 7,000 references on this subject. 2,000 of these have already been read and integrated into a comprehensive text. And here you can appreciate the different diseases that have been investigated so far.
Now, the main finding of this comprehensive review of the literature, which included all the epidemics that homeopathy was involved in all over the world, from the earliest one in 1796, which was scarlet fever, until now with leptospirosis in Cuba.
The main findings were: “Results obtained by homeopathy during epidemics reveal a very important and clear constancy: a very low mortality rate. This constancy remains, regardless of the physician, time, place or type of epidemical disease, including diseases carrying a very high mortality rate, such as cholera, smallpox, diphtheria, typhoid fever , yellow fever and pneumonia.”
I’ll give you an example. In 1849, there was a major epidemic of cholera all over the world, but we’re going to focus only on Cincinnati. Pulte and Erhmann treated 2600 cases with only 35 deaths, or a mortality rate of 1.3%. The mortality rate for cholera in the 19th century was 50%, regardless of the physician, the place, the country or whether the patient was treated. In Asia, in Egypt, in Tunisia, in Turkey, they didn’t have treatment, and the mortality, was around 50%. Regardless of the treatment, the mortality was 50%. And “despite having 60-70 cases that were in a deep state of collapse ,” (Pulte and Ehrmann only had a mortality rate of 1.32%).
Now, there was a skeptic that said that they cheated. So there was a commission that was instigated, and the commission was chaired by Alphonso Taft, who became Secretary of War eventually under Grant, and his son became President of the United States, so he was a reputable person, and the commission’s outcome was that what the homeopaths had reported was exactly true to the point, in every single case.
Now, I’m going to look at a second disease, if I have one minute: pneumonia. Osler reported that the mortality of pneumonia since around 1850s has been steady at 30%; even himself at John Hopkins had 30%. Homeopaths will obtain results with less than 2%, and usually more like 1%. It’s remarkable when we consider that 1 out of 25 Canadians dies of pneumonia now, when we could lower the mortality dramatically just by using those little pills that Joe is talking about, those good placebos.
I have been in practice for 30 years. I have seen the worst cases of patients with acute and chronic disease, and I can testify to you that there is nothing in the history of medicine that I have studied more extensively. I have also written a thesis on the placebo effect in homeopathy, so I am very aware of the placebo effect, but there is nothing in the history of medicine that can come close to homeopathy. This is the future of medicine. If you want to move forward, move towards homeopathy. If you are a scientist in basic science, move toward the study of nanoparticles and so on – it’s the future! We’re not looking behind now! Science is moving forward, Hahnemann was a precursor of nanotechnology, and I have to stop here.
Mark Ware (Moderator): André Saine, demonstrating that it is possible to be told to stop on time and stop on time. Thank you, André. I know there’s more where that came from. Dr. Schwarcz, you have 10 minutes to provide your rebuttal for André Saine.
Joe Schwarcz: Well, André says the future of medicine is homeopathy; that leaves me speechless. That one I cannot argue with. The placebo effect – you know what, I will later defer to the world’s expert, we have Dr. Raz sitting in the front here, who probably is the world’s expert on the placebo effect. I think he can address your questions better on that and point you in the right direction.
André originally mentioned that the arguments today about homeopathy haven’t changed much since Hahnemann. Well, yeah, I think that makes for a very, very interesting case. How come we are arguing the same things?
Science tends to be a self-correcting discipline, and the corrections may take a little time – it may take a decade or two decades, but it gets corrected. How come we are still arguing about the same thing?
Just think of other medicines. Think of aspirin. Are we arguing about whether or not aspirin works? Do we argue about whether or not penicillin works? Do we argue about whether or not Vitamin C prevents scurvy? Do we argue about whether Vitamin D prevents rickets? No, we don’t argue about these things, but about every one of those, there were arguments, and there was a lot of controversy.
And I suspect that if we go back 100 years, we could have taken any one of those issues and had this kind of debate. I can tell you that when William Withering first introduced the idea that foxglove could cure dropsy, as they called it then, which of course was congestive heart disease, he was opposed.
Well, eventually, of course, it was proven, because the (scientific principles) became clear and today digitalis, of course, which was the active in there, is the accepted therapy. But we don’t go tell people to graze in a field of foxgloves if they have congestive heart disease. We have been able to isolate the active ingredient, standardize it, measure it, and know how much to recommend. There is a fixed amount, measurable in milligrams. That’s what we know is in there. It’s not the ghost of some molecule that is in there.
And of course, the same thing goes for the numerous effective interventions used. Almost everything at the beginning is opposed. That’s history. Not only in medication. When microwave-ovens were first introduced – a lot of criticism. We are now seeing that with cell phones and Wi-Fi. New technology breeds criticism, but eventually the truth comes out. So why are we arguing about exactly the same thing that we were arguing about 250 years ago?
André says that I’ve been left behind, that I don’t know my science. 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.
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. They tend to be highly vocal. The only way that you can get a really good feel for what is really going on is not by sitting here and listening to us and judging who has the bigger impact; that’s not how it works. You have to do the legwork. You have to go and read the literature yourself. You have to take a look at who is saying what.
Who are the reputable sources? Are you going to refer to someone who has spent their life working on research in this area, or someone who is just making money off of providing some sort of therapy? So it’s a question of really doing the work. No one can do this for you. If you are really interested in homeopathy, start reading. Go to the web. There is a tremendous amount of information. I would recommend that you take a look at Science-Based Medicine, which is an absolutely wonderful website. It’s a conglomerate of people, but they are all highly respected. I mean, even by their opponents they’re respected, because they have stellar careers; they have published in scientific literature hundreds and hundreds of articles. Science-Based Medicine. Take a look at how they evaluate homeopathy. And there is no acrimony there. It is all done scientifically.
Now, André also mentioned that the Horizon program that Randi was on was not reputable. It is an extremely reputable program. Those of you who watch the BBC probably know how the BBC works. It’s not like the CBC or the American channels. They do things right.
And they really did that one right. They really did that one right. They set up the experiments exactly the way the proponents of homeopathy wanted it set up. So they were asked to do what they claimed to be able to do – to differentiate between the solutions. The only reason Randi was called in was not because he was an expert on homeopathy - no. He’s an expert on how you get information and on how easily one can be misled inadvertently. So that’s why he was called in – just as a safeguard. And the results were very clear: they could not distinguish.
As you know, Randi has the $1 million offer to anyone who can experimentally demonstrate any of the so-called paranormal effects, and homeopathy is in that category. Randi offers $1 million to anyone who can distinguish whether or not a sugar pill is just a sugar pill, or is it a homeopathic sugar pill? Well, if all of these experiments that have been quoted here can do that, why aren’t all those people lining up for that million dollars? Research grants these days are very hard to come by. Let me tell you, a million dollars is a lot of money, right? If someone can do that, why aren’t they lining up?
After all, homeopaths claim that their product is different than an ordinary sugar pill. Why can that not be demonstrated? So again, I’m not at all saying that homeopaths don’t have value. I fully agree with what André is saying that his patients can be very, very satisfied. There’s no contesting that. The question is why they are being satisfied. And what I say is that the theory that non-existent molecules, succussed in some specific way, can actually have a physiological effect, I say is scientifically implausible and unacceptable because we have enough scientific evidence and knowledge on which to make that statement. And it is up to those who make an unusual claim to come up with the evidence. So, if homeopaths claim that their drugs are different than just a sugar pill, let it be proven in the laboratory in some way.
Mark Ware (Moderator): Thank you very much, Joe. Ok, this brings us to the portion of the evening where it is your turn to ask questions. You’ve done so. I’ve received a number of index cards. I now would like to invite both André and Joe to please come and take a seat on the seats up here, and I will begin to read questions. OK, before we get to the audience questions, I’d like to invite our two speakers – you have two questions each to ask. I’d like you to take it in turns to ask your question. I’ll let André, you begin. Your first question for Joe Schwarcz:
Joe Schwarcz: A properly controlled, randomized trial. That’s all we ask for in science. 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.
André Saine: Listen, I am a physician. I am a clinician. First of all, I don’t deal with magicians - first. Second, to do the work you would have to have access to spectroscopy equipment that only you and professors at universities would have access to. You are the one that could do it.
André Saine: OK. Joe, you have a loved one that is in ICU with sepsis. Studies show that there is 26% more death in the placebo group versus the verum group. Would you suggest that your loved one be treated with homeopathy, or would you say “don’t do it?” The person is unconscious.
André Saine: No, I refer patients to specialists. I need to extend my diagnostic field, so I will refer and say, “ Give me an opinion on what is the problem with this patient. I need to know.” A family physician cannot have access to all this equipment and laboratory studies. We need specialists who are capable of doing this. But in terms of therapeutics, I rely on methods that are sure, certain, gentle, not dangerous, and effective.
André Saine: No, I can interpret it. I have done a course of medicine; I am considered a physician in the state of Oregon. I sat my basic science exam sitting side by side with the graduates of the medical school.
Mark Ware (Moderator): OK, I’m going to stop this because this is not really an ad hominem argument; this is about homeopathy and not our professional qualifications. I am now going to turn to some questions from the audience. The first one for Dr. Schwarcz and this is asking, “ If homeopathic substances are purely psychological placebos, do you think the evidence that they can work in animals and plants has any weight?”
Joe Schwarcz: I thought that I addressed that. There have been many, many publications on homeopathy in animals. Each of those trials, the ones that have shown positive effect is outweighed by the ones that have not shown any effect. So if you look at the meta-analysis and you look at the properly controlled studies, there is nothing there. It is indeed very interesting, because people will interpret what their animals are doing or how they’re behaving in different ways subjectively, when the objective behavior is exactly the same.
People love their pets. And there have been studies that show this: you give your pet a homeopathic remedy, and you have an objective observer evaluate whether there is any difference, and they will say, “No, there isn’t,” but you as the pet owner will look at the pet and see that it’s getting better. We’ve actually many, many years ago we did a little experiment – it was not well enough done to be published – where we solicited students during the cold season. And we had, I think, about 20 students coughing and sneezing. And we recorded –in those days it was on a tape recorder—we recorded their coughing and sneezing frequency. So we had the data.
And then we gave them a sugar pill, but we told them that this was a new medication that had just come out for the cold. It was, of course, a sugar pill, so we didn’t have to go through any kind of hospital ethical committees for this, so we just did a sugar pill. And then I gave them a little talk about something totally different, and then later we asked them if they thought the sugar pill had worked. And about 40% of them said that they thought it had worked dramatically, that their cold symptoms got better.
Well, of course, we had kept a tape player going all the time, so we had the data. We had the coughing and the sneezing and everything on the tape, on record, which was exactly identical before and after, objectively. But subjectively, their mind made them think that they were coughing less and sneezing less, and of course they also felt better. But they weren’t better.
André Saine: Well, that’s a great question, because in homeopathy we’re treating the whole person, and it’s over the long-term. So in conventional medicine you’re looking for an effect on the physiological process. So you’re targeting symptoms, and you produce more symptoms because of the drugs, so you have to use more drugs.
In homeopathy, we’re not doing this. We’re treating the whole person over the long term. As you’re treating little Johnny with an ear infection at 7 years old, or at 3 years old, by treating little Johnny with homeopathy, the ear infection goes away, but also the susceptibility to get another infection changes –the susceptibility to be sick changes. So this is the best prophylaxis.
In other words, by treating people with homeopathy from a young age, you provide them with better health later on, because the susceptibility to be sick is dealt with as soon as there is a problem occurring throughout life. So treating the whole person without the side effect of medication; and medications typically in conventional medicine are palliative. They have an effect for a certain time. In homeopathy they’re curative, because there is a prolonged reaction to the remedy that changes the susceptibility to be sick.
It’s an extraordinary phenomenon that we have access too. Unfortunately it’s not well known enough, but like I said, it is the future of medicine, there is no doubt. You’ll see, Joe, one day, you’ll say, “You were right, André.”
Mark Ware (Moderator): OK, raising the specter of doubt. OK, this next question is going to go to both of you, and perhaps I’ll start with André, but the question is, and there are several questions along this line: Can you explain the mechanism of action of homeopathic remedies?
André Saine: Well, there are several mechanisms of action that are potential. Nothing has been confirmed. So we know, for instance, that the nanoparticles have a physiological effect that is completely different than other forms of medication.
You just have to Google “Nano medicine” to see the world that is opening there. It is extraordinary, the possibilities there. So the mechanism of action is not so clear. We could say we’re a bit like aspirin. Aspirin was used for many years, but until 1971 nobody knew why there was an effect, but people were using it. In ‘71 they found out it affects prostaglandin.
Now we’re about at that level because we have the tools now. Finally, we have the tools, very refined spectroscopy equipment to be able to see that the changes are happening by serial dilution. Not in the toilet; we’re talking about a serial process of dilution and succussion.
Rustum Roy at his signature lab at Penn State University – Professor Emeritus – showed that the succussion produced 10-15,000 atmosphere of pressure, which is enormous, on the molecule of water. And that permits a permanent change on the structure of water. So there is a beginning of understanding of the mechanism of the action, there are many papers – Iris Bell is one – who publish all the possible mechanisms of action, but it’s not right now proven.
Mark Ware (Moderator): Thank you. And the question I’m going to ask Dr. Schwarcz is a similar question with a slightly different twist. If the patient knows that they are getting a placebo, will they still have the placebo effect?
Dr. Raz: Sure, sure. My name is Dr. Raz, and placebo is one of my expertises, and it is completely unnecessary to know whether you have a placebo or not to have an effect, and if you do know that you received a placebo, you can still show a placebo effect. And as a matter of fact, when you know you are getting a placebo, you will show a heightened placebo effect. If I may just comment on one more thing: As I listen to this debate, it’s really fascinating for me to see particularly the interjections from the audience as you listen to what people are saying, and that’s because as I listen to this I can see that the only thing we can agreed on so far is where Sam Hahnemann is buried, and that’s in Paris.
But, you know, other than that, I feel like there’s very little in terms of what people are saying, and I have to say, that to somebody who knows the literature, it’s like science fiction versus reality.
André Saine: This is really the choice of an individual. The more a person is informed, the more a person can make an informed choice. So I would suggest that you study the potentiality of homeopathy for your family, for your loved ones, and see how it is.
But if you do it, you have to do it accurately and precisely. So if you cannot do it yourself because you don’t want to take the time to study it, make sure you consult somebody who is professionally trained. And I can assure you, because I’ve been in the field for almost 40 years now, that there are very few people that call themselves homeopaths that have actually reached a level of mastery that is worth considering, because it’s a very difficult field to study.
Here in Canada, we have no university teaching homeopathy, so people get courses right and left, and we are not even sure which one got the right course. And as Joe pointed out, there are people in the profession who say anything, and there’s no body to say, “This is pure quackery, what you are saying .”
However, there are homeopaths out there that are very serious, that are very learned people. It’s very interesting, also, that most homeopaths in Europe, say, and South America, are graduates of medical schools, scientific medical schools. And you will notice that throughout the history of homeopathy you will not see –if you consider that homeopathy is a belief system—there are no heretics. Almost none. There’s Ernst but Ernst cheated. He said he was a homeopath when he never completed a course of homeopathy.
But throughout history, you have all these scientifically-trained physicians that adopt homeopathy, but you don’t see people quitting. Once they are trained, they stay in it. They leave allopathy to go to homeopathy, but not the other way around. You don’t see that happening. Why? Why do they not switch?
Joe Schwarcz: There are the accusations that homeopaths may be invested in their own research, and some of these accusations have also been leveled against physicians and involvement with pharmaceutical companies. There have been a number of comments from the audience about that. Would you like to comment on the possible bias of medicine in the pharmaceutical industry?
Joe Schwarcz: Absolutely. Of course there are biases. There was a very big article, and a good article, just yesterday in the Washington Post that addresses that whole issue, where they looked at what happened with Avandia, the diabetes drug that had to be recalled, because indeed there was an obvious conflict of interest among the authors. It happens.
As I told you in the beginning, virtually everything in life works on the bell curve. Yeah, you have some rotten apples in every field, and you can pick at those. But we want to look at the bulk of the evidence. André asked, “ How come homeopathy is not taught in hospitals? Why is it not taught in hospitals?”
I think that is the question we have to ask. There is no conspiracy on the part of the scientific medical establishment to keep effective therapies away from people. I mean, that is such a naive argument. You see it being made, especially on the web these days all the time, you know, that only natural remedies really work, and this awful establishment is trying to sweep these under the carpet so that they can sell their expensive and ineffective medications.
It doesn’t work like that. Doctors –real doctors, physicians – want to cure people. They’re not out to destroy humanity. When something works, they embrace it. You think back to what happened with the Helicobacter story, for example. You know, when Barry Marshall first introduced the idea that ulcers were caused by a bacterium, what did the scientific establishment say? “ He’s crazy, because we know what causes it. It’s caused by stress; it’s caused by hyper-acidity. Are you crazy, saying that antibiotics can cure ulcers?”
And then he did something, a very foolhardy thing: he took a dose of bacteria and he cured himself with antibiotics. Within a year, so-called triple therapy with antibiotics was used around the world. It was embraced because it worked and it was clear. If the same could be said for homeopathy, it would be embraced. Physicians would love not to have to intervene with drugs that do have all kinds of side effects, if the kind, gentler therapy really worked. They’re not out there to fool people, they’re not out there to steal people’s money; they would be happy if everything worked the way that you say. But the evidence just isn’t there. If it were, it would be embraced.
Mark Ware (Moderator): Thank you, Dr. Schwarcz. I’m going to ask André to respond to that. You’ve got two minutes, and then we’re going to start to wrap up the session of the evening. André, you can respond to that.
Joe Schwarcz: If you remember Toe Blake, who was one of the coaches of the Canadians, one of the best coaches ever, when he was asked to predict what would happen in the Stanley Cup series for the Maple Leafs one year, he said, “Predictions are for gypsies.”
So I’m not going to predict the future, I’m not going to say which way homeopathy will go, but if I were a betting man, I’m betting on science. And I’m going to venture that the same tired old arguments are going to persist, and that homeopathy is not going to make any headway.
André Saine: Well, actually, I would say the following: Homeopathy has had difficulty in being recognized in scientific quarters, especially because of the remedies that are in ultra-molecular dilutions. However, now that we have the tools to study these remedies, there will be more and more interest and it will grow.
Now as the interest builds up, it will be used more. Now, when you say that homeopathy is not used in hospitals. That is wrong, because in India it is official medicine. It is official medicine in many other countries such as Brazil.
It is starting in hospitals, it is starting in universities; they are practicing it. In India, there are 250 state medical colleges teaching homeopathy. No, it is. It’s just that here it’s not happening.
In Montreal, we did have the Montreal General Homeopathic Hospital, which is still on Marlowe Street there. But there were hospitals; now there are none, but they will come back, because the future has to be. It will happen because we’re dealing with the truth, a real phenomenon, and it’s up to you to study it and look at it for your own benefit.
I don’t get any benefit if you are interested in homeopathy and you use it for your loved ones. It would be for you. It’s a gift that nature has for you, and it’s up to you to take it or not. Whether you use it or not, nature doesn’t care.
Ladies and gentlemen, as an educator, I’d like to ask one question before we close out the evening, and that is, please raise your hand if at any point during this evening you started to think a little differently about homeopathy, either for or against it. If you’re had any changes in the way you think about this subject, please raise your hand.
I’m just curious to see whether we’ve reached out and made any changes. I hear from the front row that perhaps this hasn’t made an impact. I hope that this evening has at least made you think a little bit about the nature of evidence, about the nature of scientific inquiry, about the nature of health, about the nature of the human and the healing profession. I’d like to ask you please to join me in thanking Professor Joe Schwarcz
I think we’ve all won. Thank you for your time, and thank you also to Ilana Block for organizing this. Please, a big thank you to Ilana for putting this all together. Have a very good evening, ladies and gentlemen, and be healthy.
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