The Danger of Science Denial - "Alternative Medicine"-Split

GenesForLife · **#761** by **GenesForLife** » Jun 16, 2010 5:35 pm

Of course, it is also prudent to note that diagnostic methods aren't targeted against a 1:1 mapping of symptoms to disease either, symptoms are just a set of observations that are employed to narrow down the range of suspected causative phenomena, and that is all that is required, or used, for the vast majority of cases involving the prescription of conventional medicine, it only runs into problems, when, as you say, there isn't an obvious physical connection between a pathology and symptoms, which is a gap science is attempting to fill up with ever improving diagnostics, cue, for instance, PCR for tuberculosis diagnosis.

DST70 · **#762** by **DST70** » Jun 16, 2010 9:56 pm

GenesForLife wrote:if there is no obvious underlying physical pathology, investigations must continue until it is rendered obvious, which is why medical science and biology in general has not come to a standstill, but then again, "obvious" is a term that is very much grounded in the inadequacies of our current diagnostic and analytical tools to pinpoint it.

Now, you argue it is unobtainable, care to back that up with evidence?

The trouble is, those investigations might continue a while - possibly years, decades or even centuries. All sorts of treatment currently goes on for conditions for which the physical pathology doesn't correspond well to symptoms, and for where no physical pathology is known. E.g. fybromyalgia, migraine, and a lot of psychiatric disorders - I'm sure Shrunk could explain this better than me though. You have a lot of faith that it's just a small matter of time and technology, which many don't share.

(What's unobtainable would be a 1:1 mapping of symptoms to disease - I'm talking about uncommon as well as common symptoms. Despite even the best efforts of the materia medica, that would be too unwieldy.)

DST70 · **#763** by **DST70** » Jun 16, 2010 9:59 pm

GenesForLife wrote:Of course, it is also prudent to note that diagnostic methods aren't targeted against a 1:1 mapping of symptoms to disease either, symptoms are just a set of observations that are employed to narrow down the range of suspected causative phenomena, and that is all that is required, or used, for the vast majority of cases involving the prescription of conventional medicine, it only runs into problems, when, as you say, there isn't an obvious physical connection between a pathology and symptoms, which is a gap science is attempting to fill up with ever improving diagnostics, cue, for instance, PCR for tuberculosis diagnosis.

I think this is the crux of it - whether those observations are indicators of underlying pathology or whether they count as meaningful empirical data in their own right. If symptoms are seen only as pointers to underlying pathology, it doesn't account for the variance from case to case, from patient to patient. Plus, like I mentioned before, there should be a plausible account for why those symptomatic observations are, in themselves, not relevant to the disease.

thanks.

Mr.Samsa · **#764** by **Mr.Samsa** » Jun 16, 2010 11:28 pm

Why are we discussing real medicine?

For the sake of argument, let's just assume that there is absolutely no evidence for real medicine. All the information in peer-reviewed journals is made up and funded by money hungry Pharma companies, with drugs being pumped into people that are full of poison. With this terrible state of affairs in real medicine, every single patient that ever sees a real doctor dies instantly and painfully on the spot. In summary, real medicine not only has no evidence for it's practices and treatments, but it also has a 100% death rate as a result.

Now, how is this supposed to support homeopathy?

GenesForLife · **#765** by **GenesForLife** » Jun 17, 2010 12:11 am

You mean, DST, when you talk about fibromyalgia, investigations like this?

http://www3.interscience.wiley.com/jour ... 1&SRETRY=0

Abstract

Objective
To investigate the metabolic and functional status of muscles of fibromyalgia (FM) patients, using P-31 magnetic resonance spectroscopy (MRS).

Methods
Twelve patients with FM and 11 healthy subjects were studied. Clinical status was assessed by questionnaire. Biochemical status of muscle was evaluated with P-31 MRS by determining concentrations of inorganic phosphate (Pi), phosphocreatine (PCr), ATP, and phosphodiesters during rest and exercise. Functional status was evaluated from the PCr/Pi ratio, phosphorylation potential (PP), and total oxidative capacity (Vmax).

Results
Patients with FM reported greater difficulty in performing activities of daily living as well as increased pain, fatigue, and weakness compared with controls. MRS measurements showed that patients had significantly lower than normal PCr and ATP levels (P < 0.004) and PCr/Pi ratios (P < 0.04) in the quadriceps muscles during rest. Values for PP and Vmax also were significantly reduced during rest and exercise.

Conclusion
P-31 MRS provides objective evidence for metabolic abnormalities consistent with weakness and fatigue in patients with FM. Noninvasive P-31 MRS may be useful in assessing clinical status and evaluating the effectiveness of treatment regimens in FM.

Or how about this?

Objectives

To evaluate the intracellular levels of the high energy adenosine triphosphate nucleotide ATP and essential divalent cations, calcium and magnesium, in platelets of patients affected by primary fibromyalgia syndrome (FMs).
Design and method

Platelet ATP and cation concentrations were measured in 25 patients affected by FMs and 25 healthy volunteers through a chemiluminescent and a fluorimetric assay, respectively.
Results

Significant lower ATP levels were observed inside platelets of FM patients (fmol ATP/plt: 0.0169 ± 0.0012 vs. healthy controls, fmol ATP/plt: 0.0306 ± 0.0023, mean ± SEM) (low asterisklow asterisklow asteriskP < 0.0001). A trend towards higher calcium concentrations (P = 0.06) together with significant increased magnesium levels were also reported in platelets of patients by comparison with controls (P = 0.02).

Conclusions

This preliminary study suggests that disturbances in the homeostasis of platelet ATP metabolism-signaling and calcium-magnesium flows might have a relevance in the pathogenesis of FMs.

Keywords: Fibromyalgia; Platelets; Adenosine triphosphate; Calcium; Magnesium

http://www.sciencedirect.com/science?_o ... efa9eb8f23

Talking of migraines...

http://www3.interscience.wiley.com/jour ... 7/abstract

ABSTRACT

Objective.—The periaqueductal gray matter (PAG) is at the center of a powerful descending antinociceptive neuronal network. We studied iron homeostasis in the PAG as an indicator of function in patients with episodic migraine (EM) between attacks and patients with chronic daily headache (CDH) during headache. High-resolution magnetic resonance techniques were used to map the transverse relaxation rates R2, R2*, and R2' in the PAG, red nucleus (RN), and substantia nigra (SN). R2' is a measure of non-heme iron in tissues.

Methods.—Seventeen patients diagnosed with EM with and without aura, 17 patients diagnosed with CDH and medication overuse, and 17 normal adults (N) were imaged with a 3.0-tesla magnetic resonance imaging system. For each subject, mean values of the relaxation rates, R2 (1/T2), R2* (1/T2*), and R2' (R2* − R2) were obtained for the PAG, RN, and SN. R2, R2*, and R2' values of the EM, CDH, and N groups were compared using analysis of variance, Student t test, and correlation analysis.

Results.—In the PAG, there was a significant increase in mean R2' and R2* values in both the EM and CDH groups (P<.05) compared with the N group, but no significant difference in these values was demonstrated between the EM and CDH groups, or between those with migraine with or without aura in the EM group. Positive correlations were found for duration of illness with R2' in the EM and CDH groups. A decrease in mean R2' and R2* values also was observed in the RN and SN of the CDH group compared with the N and EM groups (P<.05), explained best by flow activation due to head pain.

Conclusions.—Iron homeostasis in the PAG was selectively, persistently, and progressively impaired in the EM and CDH groups, possibly caused by repeated migraine attacks. These results support and emphasize the role of the PAG as a possible "generator" of migraine attacks, potentially by dysfunctional control of the trigeminovascular nociceptive system.

they found another diagnostic marker, see?

Contemporary concepts of migraine pathogenesis
K.M. A. Welch

From the Department of Neurology, Finch University of the Health Sciences and the Chicago Medical School, Chicago, Illinois.

The pathogenesis of migraine is incompletely understood. Recent discoveries have shed light on the neuronal events mediating both the aura and the headache phases of migraine, identifying a cerebral cortical origin of migraine aura, susceptibility to attacks based on cortical hyperexcitability, and headache originating in the trigeminovascular system and its central projections. Abnormal modulation of brain nociceptive systems, at first transient but becoming permanent with continuing illness and, predisposing to central sensitization, may explain the prolonged headache of the migraine attack and the shift of the migraine phenotype from episodic to chronic headache. Migraine attacks might also originate in abnormal nociceptive neuromodulator centers in the brainstem.

http://www.neurology.org/cgi/content/ab ... suppl_4/S2

This isn't symptom to symptom mapping, it is a matter of direct observation for underlying pathologies, and these are highly specific, care to tell me why it's going to take a bloody long time to improve the field for rapid and effective diagnosis, which can bypass the limitations of the usage of signs and symptoms alone?

natselrox · **#766** by **natselrox** » Jun 17, 2010 3:36 am

Mr.Samsa wrote:Why are we discussing real medicine?

For the sake of argument, let's just assume that there is absolutely no evidence for real medicine. All the information in peer-reviewed journals is made up and funded by money hungry Pharma companies, with drugs being pumped into people that are full of poison. With this terrible state of affairs in real medicine, every single patient that ever sees a real doctor dies instantly and painfully on the spot. In summary, real medicine not only has no evidence for it's practices and treatments, but it also has a 100% death rate as a result.

Now, how is this supposed to support homeopathy?

Dudely · **#767** by **Dudely** » Jun 17, 2010 12:06 pm

Mr.Samsa wrote:Why are we discussing real medicine?

For the sake of argument, let's just assume that there is absolutely no evidence for real medicine. All the information in peer-reviewed journals is made up and funded by money hungry Pharma companies, with drugs being pumped into people that are full of poison. With this terrible state of affairs in real medicine, every single patient that ever sees a real doctor dies instantly and painfully on the spot. In summary, real medicine not only has no evidence for it's practices and treatments, but it also has a 100% death rate as a result.

Now, how is this supposed to support homeopathy?

I was just thinking that. This discussion of the efficacy of current diagnostic methods is a non-starter. It's like arguing against evolution and then inferring from its lack of ability to explain the origin of life that Jesus is the son of god.

TMB · **#768** by **TMB** » Jun 17, 2010 2:00 pm

Shrunk, you said,

Not really. All of the effective interventions you identified above are part of "allopathic" medicine, and you have not provided a single instance where "alternative" diagnostic or therapeutic techniques were helpful.

In fact I did, the useful diagnoses of most was either by myself asking for confirmation, or getting an issue with an organ diagnosed by iridologist, unless you are suggesting that iridology is allopathic medicine. In which case perhaps we are talking at cross purposes. To diagnose that a bacterial infection exists if my sinus is blocked and has green discharge, and I feeling unwell, I don’t classify as diagnosis.

It's fortunate that the alternative practitioners you encountered were well-versed enough in conventional medicine to be able to identify the possible correct diagnoses and refer to the appropriate specialists,

No I took myself to the correct specialists. The alternates were effective in their treatment of symptoms, presumably without side effects, and were better able to integrate their treatment once an underlying cause was identified. You are correct that none of them was able to identify a root cause, and even my own diagnosis that the root cause I have found (and had confirmed) is celiac disease. I am assuming there is a good chance that something underlies this pathology.

Your account is very revealing, however, of how "alternative" medicine manages to thrive. If we look at what treatments have been helpful for you in your own account:

Let me expand and make this clearer then.

Treatment of acute bacterial infection with antibiotics.

Although this was prescribed, I did not use antibiotics (expect perhaps for one early infection), instead I used herbals and homeopathic treatments as I did not want to carry the damage associated with excessive use of antibiotics. Also note that steroid sprays are prescribed for nasal congestion in allergy, something I avoided. Consequently I did not suffer issues caused by repeated use of steroids (ie. mucous membrane dependence). Instead I looked for causes, not symptoms.

I will add that prior to the acute attacks, I also had one drawn out (3months), chronic malaise that never progressed past low grade fever and general weakness, similar to mild ME. The allopathic diagnosis was just to let it pass as it must be due to an untreatable virus. It was only severe enough to stop me playing competitive sport, but I was OK to function otherwise. Iridology diagnosed a stressed liver, which was treated with herbs and homeopathic pillules My liver was struggling to get rid of the toxins produced by the allergens. Whatever they gave me cleared it up in dramatic fashion, in a few days I was bouncing with energy. I also had severe bout of hepatitis as a 18 year old. Allopathic treatment was bed rest, no alcohol for 12 months and go easy on fatty foods. As I learned later alternative treatments would have given me herbs to boost liver function and possibly avoid liver reactions later when allergies. The point here is that allopathy looked at the pathogen, in this case the hepatitis virus, and did not diagnose or look for any way to fix collateral damage – ie. my liver.

Identification of dust mite allergy, and interventions to reduce exposure to allergen.

Actually allergy was once alternative medicine, and only repeated pressure from people who worked hard to show that non pathogens can cause illness, something conventional medicine could not understand. Conventional medicine has opened its eyes somewhat since then, but it illustrates the same issue. As recently as 30 years ago many MDs considered asthma reactions to dust mites as being psychosomatic.

Identification of celiac disease, implementation of dietary modification with resolution of symptoms.

The same applies to food intolerances as allergy. This was all alternative a few years ago, and some older conventional practitioners still struggle to understand illness in the absence of pathogens. I accept this is an issue of education on making sure knowledge is socialised, but it also illustrates a narrow approach that makes this education very difficult. The idea that disease of pathogen based instead of something that needs addressing in the patient is still an issue in conventional medicine.

All of the above are evidence based, "allopathic" interventions.

Like I said, only time has saved these from being alternative, and note that each system wastes precious health in trying to educate the established medical systems.

On top of these, you make references to herbal remedies and iridology, but with nothing to suggest that these have actually produced any benefit beyond your conviction that they have.

You are not in a position to judge this. Based upon my experience of the symptoms, and granted I could be delusional, or perhaps even have been abducted by aliens. I doubt that having an iridologist look into my eyes and note a stressed liver, prescribe something, feel better within days might be placebo, but I also tried allopaths because I believed they were capable of diagnosing me – so why no placebo effect? If I did not believe, I would not have gone to them in the first place. Yet they had no idea of how to diagnose this.

However, because of the type of interactions you have had with the "alternative" practitioners, you are inclined to give them credit for your improvement, while suggesting that allopathic treatments only succeeded despite themselves.

If you consider allergy diagnosis and food intolerance as conventional, then fair enough, but even they were only able to take a thin slice and their remedies were very limited. The allergy avoidance measures they offered were initially inadequate. It was only after I educated myself and bought books that I understood just how to make the avoidance effective. I am not suggesting any practitioner needs to take responsibility for my health, but when I offer advice to similar sufferes I provide plenty more that I was given.

In my experience, where alternative practitioners do tend excel, in comparison to conventional doctors, is in interpersonal skills and "bedside manner", the ability to make a client feel that they are being listened to and that their problems are being taken seriously and given individual attention.

I would say this arises because they are trying to look deeper than the symptoms, they are looking for causes. By asking about a person dietary habit, bowel habits, reactions to various things, and not just the external symptom, of course they develop better empathy. However, I have worked with iridologists who although personable only take a few minutes and get all they need from the eyes without drawn out discussions. Still they are effective.

Take another personal example in skin reaction. My health causes skin rashes and itching. Conventional medicine will prescribe topical steroid creams, that certainly work. They also damage the skin, and perhaps do internal damage as well, and make the patient reliant and dependent upon them, and do not look for a cause. Most MDs will look no deeper, while alternate practitioners will recognise that the skin is just reflecting a deeper problem. Their topical treatments wont be as effective as steroids, but they have more chance of finding the cause.

Your are quite right to suggest that modern medicine's emphasis on high tech interventions and funding models that reward high-volume practices have increasingly tended to render such traditional values as anachronistic. That's a real problem and an unfortunate situation, but it is not an indictment of "allopathic"medicine as a whole, so much as of the social, political and economic conditions under which it is currently typically practiced.

I think its all related. The idea that treatment of symptoms are sufficient is an ethic that appears imbedded in medical practice. I have been treated by a sports doctor for a broken foot, and when I noted that I was having pain elsewhere in my lower limbs after the bone had been set, he dismissed them as not being his reason to treat me. As it was I had to get physio to rebalance to muscles following this, I thought it typified the narrow approach that seems endemic in conventional medicine.

I have no issue making use of medical treatments from either side of the fence, I do have an issue with the medical establishment not looking deeper into causes, or side effects of their treatments. The surrounding industry and ethic just seems to feed of the basic approach.

I applaud your generosity and courage in sharing your personal story with us, and am genuinely happy that you have at least been able to have some resolution of your illnesses. However, I think your story only serves to further demonstrate that the successes of "alternative" medicine are ones of marketing and persuasion, not of actually efficacy.

Like I said earlier, I do not think you are in a position to judge how I have been affected by the various treatments, except to take at face value my own judgement. Its possible that I am delusional, or keep getting abducted by aliens who feed me these ideas, but I don’t see the evidence that either happens. I would add that I have not found every homeopathic treatment has helped, and some practitioners have been downright weird.

Conventional medicine is evolving and better testing is available for allergy and food intolerances, however conventional medical are often limited by their tools and protocols, and have difficulty setting them aside in the face of evidence to do so. I have worked with some that have, but they are rare.

I have personal experience of our gynae who followed a protocol for a possible premature birth for my wife. He insisted on the steroid treatment for lung development in the foetus as it was standard protocol. However when we pushed back hard, he did find a way that allowed us to get the best of both worlds. This is more a reflection on human nature to be blindly compliant to protocol, but conventional medicine is more subject to this. I also accept that such protocols are required in the mass consumptions of standardised training and treatments. The problem with this is that it treats societies and not individuals, but if you do not protect the health of individuals, you will end up with a sick society. There is evidence to suggest that its not just environmental issues that create allergy epidemics, but also conventional medical practice, and simple behaviours like excessive hygiene not allowing infants to develop strong immune systems. Measles vaccinations create issues with immune systems that seem to rewire after infection. Steroid jabs for premature foetus appear to cause diabetes in later life.

DST70 · **#769** by **DST70** » Jun 17, 2010 2:48 pm

GenesForLife -

You're right, although just from a quick look those 3 clinical trials have very small sample sizes and show possible correlations - it's hardly a meta analysis, and it's the sort of criticism that I see studies of alternative medicine attract. But yes, I was wrong when I said there was no known physical pathology, my bad.

As long as diagnosis and treatment is centered around discrete disease entities with homogeneous causation and progression, it underplays symptomology that greatly varies from case to case and from patient to patient. It underestimates variation in human health and illness, variation in real world cases that clinical trials can not so easily replicate.

DST70 · **#770** by **DST70** » Jun 17, 2010 2:53 pm

Mr.Samsa wrote:Why are we discussing real medicine?

For the sake of argument, let's just assume that there is absolutely no evidence for real medicine. All the information in peer-reviewed journals is made up and funded by money hungry Pharma companies, with drugs being pumped into people that are full of poison. With this terrible state of affairs in real medicine, every single patient that ever sees a real doctor dies instantly and painfully on the spot. In summary, real medicine not only has no evidence for it's practices and treatments, but it also has a 100% death rate as a result.

Now, how is this supposed to support homeopathy?

Homeopathy is said to be ineffective mostly because it gives inconclusive or poor results in clinical trials. Clinical trials are the product of a medical paradigm that assumes a 'normal' level of diversity in human health. It's focussed on diagnosing and grouping common symptoms, and doesn't acknowledge the variation of individual response to disease and treatment. It's not a surprise to me that homeopathy doesn't show a lot of success in clinical trials.

David

Dudely · **#771** by **Dudely** » Jun 17, 2010 2:59 pm

DST70 wrote:
Mr.Samsa wrote:Why are we discussing real medicine?

For the sake of argument, let's just assume that there is absolutely no evidence for real medicine. All the information in peer-reviewed journals is made up and funded by money hungry Pharma companies, with drugs being pumped into people that are full of poison. With this terrible state of affairs in real medicine, every single patient that ever sees a real doctor dies instantly and painfully on the spot. In summary, real medicine not only has no evidence for it's practices and treatments, but it also has a 100% death rate as a result.

Now, how is this supposed to support homeopathy?

Homeopathy is said to be ineffective mostly because it gives inconclusive or poor results in clinical trials. Clinical trials are the product of a medical paradigm that assumes a 'normal' level of diversity in human health. It's focussed on diagnosing and grouping common symptoms, and doesn't acknowledge the variation of individual response to disease and treatment. It's not a surprise to me that homeopathy doesn't show a lot of success in clinical trials.

David

I seriously doubt that if there was evidence to show that homeopathy works that the mere fact that a clinical trial "doesn't acknowledge the variation of individual response to disease and treatment" would prevent that from coming to light. As I said earlier in this thread- if it does work there is a reason, and you should be able to figure out why and witness this happening.

That being said, wouldn't the variation of individual response to disease and treatment be a problem for ALL methods of treatment?

Shrunk · **#772** by **Shrunk** » Jun 17, 2010 3:14 pm

DST70 wrote:
Homeopathy is said to be ineffective mostly because it gives inconclusive or poor results in clinical trials. Clinical trials are the product of a medical paradigm that assumes a 'normal' level of diversity in human health. It's focussed on diagnosing and grouping common symptoms, and doesn't acknowledge the variation of individual response to disease and treatment. It's not a surprise to me that homeopathy doesn't show a lot of success in clinical trials.

Wrong. It is precisely because of the "variation of individual response to disease and treatment" that randomized controlled trials are necessary. If there was uniformity in response, then trials would be unecessary.

To say that homeopathy varies too much in its response to be detected under controlled conditions is just another way of saying that it is no more effective than placebo.

GenesForLife · **#773** by **GenesForLife** » Jun 17, 2010 3:22 pm

DST70 wrote:GenesForLife -

You're right, although just from a quick look those 3 clinical trials have very small sample sizes and show possible correlations - it's hardly a meta analysis, and it's the sort of criticism that I see studies of alternative medicine attract. But yes, I was wrong when I said there was no known physical pathology, my bad.

As long as diagnosis and treatment is centered around discrete disease entities with homogeneous causation and progression, it underplays symptomology that greatly varies from case to case and from patient to patient. It underestimates variation in human health and illness, variation in real world cases that clinical trials can not so easily replicate.

Those are NOT clinical trials, clinical trials are those which are designed to test drug efficacy, these are just good old scientific studies, with focus on empiricism, and those don't need meta-analysis because they only serve as a scientific foundation for further work, please learn the difference between medicine and the scientific knowledge that drives medical progress. Thanks.

The reason Homeopathy doesn't work is that it's physicochemical/biological "foundations" are bullshit, nuff said.

Shrunk · **#774** by **Shrunk** » Jun 17, 2010 3:36 pm

Relevant:

Save Taxpayer $$$: Eliminate Alternative Medicine Research

Steven Salzberg
Forbes.com
June 16, 2010

This past week, President Obama called on all federal agencies to voluntarily propose budget cuts of 5%. Well, Mr. President, you might be surprised to learn that there's a way for you that cut the National Institutes of Health budget without hurting biomedical research. In fact, it will help.

Here's my proposal: save over $240 million per year in the NIH budget by cutting all funding for the two centers that fund alternative medicine research--the National Center for Complementary and Alternative Medicine (NCCAM) and the Office of Cancer Complementary and Alternative Medicine (OCCAM). Both of them exist primarily to promote pseudoscience. For the current year, NCCAM’s budget is $128.8 million, an amount that has rapidly grown from $2 million in 1992, despite the fact that not a single “alternative” therapy supported by NCCAM has proven beneficial to health. OCCAM’s budget was $121 million in 2008 (the latest I could find) and presumably higher in 2010. That’s over $240M, not counting money these programs got from the stimulus package (and yes, they did get some stimulus funding).

These two organizations use our tax dollars – and take money away from real biomedical research – to support some of the most laughable pseudoscience that you can find. To take just one example, NCCAM has spent $3.1 million supporting studies of Reiki, an “energy healing” method. Energy healing is based on the unsupported claim that the human body is surrounded by an energy field, and that Reiki practitioners can manipulate this field to improve someone's health. Not surprisingly, the $3.1 million has so far failed to produce any evidence that Reiki works. But because there was never any evidence in the first place, we should never have spent precious research dollars looking into it.

(Continued...)

Shrunk · **#775** by **Shrunk** » Jun 17, 2010 3:44 pm

BTW, TMB, I haven't ignored your post. Given the time an effort you obviously put into it, I thought it deserved a response at least as detailed. However, the only response I believe required is this: Anecdotal evidence, no matter how extensive and sincerely believed, remains anecdotal evidence.

Paul · **#776** by **Paul** » Jun 17, 2010 3:56 pm

GenesForLife wrote:
DST70 wrote:GenesForLife -

You're right, although just from a quick look those 3 clinical trials have very small sample sizes and show possible correlations - it's hardly a meta analysis, and it's the sort of criticism that I see studies of alternative medicine attract. But yes, I was wrong when I said there was no known physical pathology, my bad.

As long as diagnosis and treatment is centered around discrete disease entities with homogeneous causation and progression, it underplays symptomology that greatly varies from case to case and from patient to patient. It underestimates variation in human health and illness, variation in real world cases that clinical trials can not so easily replicate.

Those are NOT clinical trials, clinical trials are those which are designed to test drug efficacy, these are just good old scientific studies, with focus on empiricism, and those don't need meta-analysis because they only serve as a scientific foundation for further work, please learn the difference between medicine and the scientific knowledge that drives medical progress. Thanks.

The reason Homeopathy doesn't work is that it's physicochemical/biological "foundations" are bullshit, nuff said.

Exactly.

Which was why I kept pushing Nancy for some answers about testing homoeopathic medicines in the lab rather than clinical trials.

If there is a difference between a sample of a medicine 'properly' prepared according to the rules of homoeopathy and that hasn't been shaken properly, then that difference should be detectable in the laboratory.

Why aren't particle physicists spending as much time and money looking for water's 'memory' as they are for the Higgs boson? Because the idea is complete tosh - that's why.

tytalus · **#777** by **tytalus** » Jun 17, 2010 4:11 pm

It is interesting to me that defenders of homeopathy frequently speak of how it cannot be applied clinically, that this "doesn't acknowledge the variation of individual response to disease and treatment". Yet these same people have no problem with hawking standardized bottles of sugar pills and etc. as if there should be no "variation of individual response" at all. If homeopathy only works at the individual practitioner-patient level, then what is that one-size-fits-all manufactured crap doing in a store?

TMB · **#778** by **TMB** » Jun 18, 2010 1:10 pm

Shrunk, you said,

BTW, TMB, I haven't ignored your post. Given the time an effort you obviously put into it, I thought it deserved a response at least as detailed.

Its more a matter of articulating what my experience has been

However, the only response I believe required is this: Anecdotal evidence, no matter how extensive and sincerely believed, remains anecdotal evidence.

I sense the semantic bog beckoning to us. Lets drill down a bit into personal experience, or anecdotal evidence.

Had I decided to place my faith in medical science and its methods of validation, I am not sure when, if ever, I would have arrived at a valid diagnosis or avoided the side effects of conventional treatments, however this is a hypothetical case, so lets look at others that are more solid.

My daughter reacted badly to a vaccination, swelling and paralysis down the side of her body with the vaccination. The paediatrician (specialist allopathic doctor) suggested that we should avoid any vaccinations as her reaction was too severe. On what basis could this doctor make this recommendations? Based upon repeatable, confirmed issues around this particular vaccination? In other words did she base her diagnosis and treatment options upon a validated, double blind testing? Actually she used her professional judgement and all the experience gathered in her years practicing, all of it anecdotal. Yet I suggest it was the right choice for my daughter.

Consider another case. After taking a tested drug called Thalidomide in the 1950/60s mothers were giving getting birth defects in their children. This was just anecdotal evidence of course, as the testing required for the drug meant that only when another properly conducted trial that proved conclusively that indeed the drug was harmful and responsible for the birth defects, should it be necessary to stop administering the drug. Of course the gathering weight of anecdotal evidence became a political issue long before the issues were proven in clinical trials. This extreme example shows that many things medical begin with anecdotal evidence. It does not mean that anecdotal evidence is therefore the means to prove effective treatment, and we chuck out all conventional testing. It means that judgement of what works and does not work, regardless of belief, should guide our choices.

Going back to thalidomide, do you think that your argument of

Anecdotal evidence, no matter how extensive and sincerely believed, remains anecdotal evidence

Would have been a good position to take, especially once it was validated. Unless we apply our judgement to medicine, how can you be sure that another more subtle form of thalidomide is happening? Thalidomide simply provides us with an example, it does not mean that we fixed that problem and there are no others, and never will be, therefore we only do what the testing says we should do.

If I recall correctly you are a psychiatrist. How does the practice of this, the medical treatment of mental disorders operate with repeatable, double blind studies on what is efficacious? Is there a whole lot of off the shelf medical treatments that one can apply on a homogenous basis like broad spectrum antibiotics to patients, or is there are requirement to apply your experience, based upon anecdotal case histories in many cases, on what might work for specific patients?

Alan C · **#779** by **Alan C** » Jun 18, 2010 9:47 pm

Paul wrote:
GenesForLife wrote:
DST70 wrote:GenesForLife -

You're right, although just from a quick look those 3 clinical trials have very small sample sizes and show possible correlations - it's hardly a meta analysis, and it's the sort of criticism that I see studies of alternative medicine attract. But yes, I was wrong when I said there was no known physical pathology, my bad.

As long as diagnosis and treatment is centered around discrete disease entities with homogeneous causation and progression, it underplays symptomology that greatly varies from case to case and from patient to patient. It underestimates variation in human health and illness, variation in real world cases that clinical trials can not so easily replicate.

Those are NOT clinical trials, clinical trials are those which are designed to test drug efficacy, these are just good old scientific studies, with focus on empiricism, and those don't need meta-analysis because they only serve as a scientific foundation for further work, please learn the difference between medicine and the scientific knowledge that drives medical progress. Thanks.

The reason Homeopathy doesn't work is that it's physicochemical/biological "foundations" are bullshit, nuff said.

Exactly.

Which was why I kept pushing Nancy for some answers about testing homoeopathic medicines in the lab rather than clinical trials.

If there is a difference between a sample of a medicine 'properly' prepared according to the rules of homoeopathy and that hasn't been shaken properly, then that difference should be detectable in the laboratory.

Why aren't particle physicists spending as much time and money looking for water's 'memory' as they are for the Higgs boson? Because the idea is complete tosh - that's why.

Wow, what a thread. I too would like an answer to this.
I thought 'Enemies of Reason' did a good look at this sort of nonsense.

TMB · **#780** by **TMB** » Jun 18, 2010 11:31 pm

Shrunk wrote:
DST70 wrote:
Homeopathy is said to be ineffective mostly because it gives inconclusive or poor results in clinical trials. Clinical trials are the product of a medical paradigm that assumes a 'normal' level of diversity in human health. It's focussed on diagnosing and grouping common symptoms, and doesn't acknowledge the variation of individual response to disease and treatment. It's not a surprise to me that homeopathy doesn't show a lot of success in clinical trials.

Wrong. It is precisely because of the "variation of individual response to disease and treatment" that randomized controlled trials are necessary. If there was uniformity in response, then trials would be unecessary.

I would say wrong again. Randomised, controled trials exists to ensure that causation is not mixed with correlation, when it comes to efficacy of various drugs and treatments. However it also highlights just how much of any medical process is taken as self evident. We do not conduct randomised, controled trials to confirm that swelling arises following a bone break, we infer this on anecdotal evidence and using our judgement of inference. If someone does not feel well and they are also running a fever, we do not run a trial to make sure we are not confusing cause with correlation. This are extreme examples, but it highlights just how much we rely upon self-evident things in any human system, not only conventional medicine.

To dismiss judgement and inference in experienced practitioners as anecdotal evidence, would also mean that much of conventional medicine also is dismissed for the same reason. The actual scope of trils is very limited and mnay doctos infer from anecdotes.

This also applies to normal life. If a kid at school gets bullied and then feels upset, next time around he infers that bullying makes him upset, he does not need a trial to confirm this for him. The process around just about every form of human behavior is based upon direct experience and inference, not trials. This does not mean that trials are not useful to ensure that causation and correlation are not confused, but it means they are just a small part of conventional medicine.

The range of apparent symptoms arising from food intolerances seems bewildering. Should we suspend judgement and treatment until every one of these has been verified by a trial? If we consider food intolerances to be part of conventional medicine, imagine how limited we would be if we could only operate on the basis of things proven in multiple trials. There is also a big difference between using trials to ensure that treatment works and does not have side effects, and trials that are conducted to establish cause and correlation.

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