Rational Veterinary Medicine:
Papers, listed by lead author: B
Links: [full text with links to references -
Responses: (This is a reply to Hektoen 2005)
Ball, C., Dawson, S. and Williams, N. (2014) 'Leptospira cases and vaccination habits within UK vet-
''This study investigated the number of suspected and confirmed canine leptospirosis cases within UK vet-
'Twelve of the thirteen cases reported within the last 12 months had no current vaccination, emphasising the need for regular, annual Leptospira canine vaccinations. The majority of reported cases resulted in a high mortality rate (n=8/13; 61.54 per cent).
'We demonstrate that canine Leptospira infections are present in the UK despite vaccine availability, and that dogs are dying as a result of such infections... As all but one case was witnessed within non-
This paper convincingly demonstrates the need for UK dogs to have annual vaccination boosters. The authors looked at UK cases of canine leptospirosis in the previous 12 months and found that all but one of the 13 cases identified occurred in non-
Anyone who claims otherwise is at best ignorant of the facts and, at worst, out and out lying and, if you look more closely, in all probability selling ‘nosodes’ which they pretend will do the job of vaccination. The bottom line is dogs are dying of preventible diseases as a result of anti-
Balzarini, A., Felisi, E., Martini, A. and De Conno, F. (2000) ‘Efficacy of homeopathic treatment of skin reactions during radiotherapy for breast cancer: a randomized, double-
Weak and vague findings -
There are always people trying to exploit worried and vulnerable patients, but when it comes to cancer sufferers it is particularly disgusting.
A paper which looked at the time to first flatus during recovery in patients having undergone abdominal surgery. The authors mention that "several caveats preclude a definitive judgment".
A brilliant summary of all that is wrong with homeopathy with Stephen Barrett at his quiet, rational, informative best, methodically debunking the nonsense put out by those who profit from the sale of bogus remedies to desperate, worried victims. If there was any doubt about the self interested motives of CAM proponents just read some of the comments at the end of the article -
Links: [original article html]
Bauer, Matthew (2004) An Interview with Dr Paul Unschuld Acupuncture Today: Part One Vol 5, no 7; Part Two Acupuncture today Vol 5, no 8 [permalink]
Dr. Unschuld has degrees in Chinese studies, pharmacology, public health, and political sciences and is one of the world’s leading authorities on the history of Chinese medicine. He has a level of sympathy with acupuncture and feels it has benefits to offer, but like many serious scholars in this area is occasionally frustrated at the rather flagrant re-
"It is a fact that more than 95 percent of all literature published in Western languages on Chinese medicine reflect Western expectations rather than Chinese historical reality. Bestsellers are usually written by those who know no Chinese, have no access to Chinese medical history, and have never -
"... few people are aware that TCM is a misnomer for an artificial system of health care ideas and practices generated between 1950 and 1975 by committees in the People’s Republic of China, with the aim of restructuring the vast and heterogenous heritage of Chinese traditional medicine in such a way that it fitted the principles [of] Marxist-
"... before serious historical research on the origins and conceptual basis of Chinese medicine had been conducted, much of Western secondary and tertiary literature claimed a Daoist underpinning for TCM. This is incorrect for two reasons. First, TCM is a product... of Communist China... Second, even if we were to apply the term TCM to pre-
"Acupuncture, it appears, at no time played a dominant role in Chinese health care..."
"... All of that is to draw attention to the complexity of ancient Chinese medical history. This complexity is in stark contrast to the simplistic and often naive historical accounts found in modern Western secondary literature on acupuncture and Oriental medicine"
Bell, I.R., Lewis, D.A., Brooks, A.J., Schwartz, G.E., Lewis, S.E., Walsh, B.T. and Baldwin, C.M. (2004) ‘Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo’, Rheumatology, vol. 43, pp. 577–582.
"This pilot or feasability study replicates and extends a previous 1-
Although the placebo was claimed to be indistinguishable from the remedy no check was done of participants at the end of the trial to determine if they knew what group they were in. Somewhat unorthodox outcome variables were chosen -
Bell, I.R. (2005) ‘All evidence is equal, but some evidence is more equal than others: Can logic prevail over emotion in the homeopathy debate’, Journal of Alternative and Complementary Medicine, vol. 11, no. 5, pp. 763–769.
A guest editorial, this opinion piece is a homeopathic howl of anguish about a well conducted study (Shang et al 2005) which has found that homeopathy is ineffective.
It starts off reasonably well as Shang’s study is criticised for not disclosing which trials fulfilled the selection criteria for inclusion in their meta-
Some of the 110 homeopathic trials involved in the selection were “unhomeopathic” we are told; Bell complains that some are "isopathy" -
The howl intensifies as the author continues according to the familiar mantra: political bias, including a "heterogenous" set of cases treated with different types of homeopathy, the “forgetting” of the alleged "better overall well-
There is the usual complaint of the lack of funding for homeopathic trials (even though the profits of homeopathic pharmacies run into the billions every year) which is completely irrelevant as of course the Shang paper was actually an extremely good study of homeopathy. The problem here for the homeopaths is not lack of funding, it's lack of results.
Nice try, but no coconut I’m afraid.
Bell, I.R., Lewis, D.A., Brooks, A.J., Lewis, S.E. and Schwartz, G.E. (2003) ‘Gas discharge visualisation evaluation of ultramolecular doses of homeopathic medicines under blinded, controlled conditions’, Journal of Alternative and Complementary Medicine, vol.9, pp.25–38.
"The procedure generated measurable images at the two highest voltage levels. At 17 kV, the remedies exhibited overall lower image parameter values compared with solvents (significant for Pulsatilla and Lachesis), as well as differences from solvents in fluctuations over repeated images (exposures to the same voltage). At 24 kV, other patterns emerged, with individual remedies showing higher or lower image parameters compared with other remedies and the solvent controls... the present findings also highlight the need for additional research to evaluate factors that may affect reproducibility of results"
More weak and unconvincing stuff, many weaselly words in the abstract, slithering around the issue of statistical significance.
An uncritical, non-
Things start to get desperate when, at one point, the authors even include a trial that someone heard a mention of at a conference but where the complete paper appears to be unavailable to report on. Things get worse as they stop off at one point to briefly argue that hoary old chestnut that proper trials are unsuitable for testing homeopathy since homeopathy “depends on in-
In the final conclusion the authors claim there is an “efficacy/effectiveness paradox” where homeopathy is rubbish in proper trials but the people who use it and make money from it think it's great. Or, as we at RationalVetMed would prefer to say, “it doesn't work” (stop me if I’m getting too technical).
Belon, P., Cumps, J., Ennis, M., Mannaioni, P.F., Roberfroid, M., Sainte-
Nothing available on line.
Benveniste, J. et. al. (1988) ‘Human basophil degranulation triggered by very dilute antiserum against IgE’, Nature, vol. 333, no. 30, pp. 816–818.
This is the notorious ‘memory of water’ experiment by Jacques Benveniste’s team, a source of much agonising on both sides of the debate. Although it is normally referred to as Benveniste’s paper (because it was -
Berrebi, A., Parant, O., Ferval, F. et. al. (2001) ‘Treatment of pain due to unwanted lactation with a homeopathic preparation given in the immediate post-
The main article is in French -
Links: [abstract, pub med]
“At least ten kinds of errors and biases can convince intelligent, honest people that cures have been achieved when they have not.”
Links: [full text -
As examples of just how lame your average homeopath is about evidence have a look at the description of this paper (for which there is no offical, serious reference on line, just a load of pro-
The Homeopathic Research Institute describes what it calls the abstract, "The authors used randomized clinical experimentation that was controlled by a double-
It is difficult to believe that the first quote is an abstract from an actual scientific paper, even one published in a pro-
"Satisfactory" is a weasel word which (particularly when preceeded by its partner in crime "appeared") strongly suggests that the authors are desparately trying to squeeze more from the data than is justified from their actual findings, so although there was no statistical significance to the figures they never the less felt justified describing the treatment using a subjective and completely meaningless term which tells us more about the prejudices of whoever wrote this than about the effects of homeopathy.
We aren't told in the selected quotes available what the other parameters considered were but of the two where "statistical significance" is claimed (and we aren't given the figures behind the claim) both are extremely vague and subjective even according to the author of this "abstract". Remember, this is homeopathy versus a sugar tablet, a blank, in other words versus nothing at all, and the absolute best they can claim is an unspecified change in "burning sensation" and the patient's own, subjective opinion of the treatment, something which, however meaningful to the individual patient, has no place in a scientific study. We have no idea what other parameters were looked at, how significant those parameters might have been or how far short of the mark homeopathy fell. This is an excercise in cherry picking data.
The verdict here has to be "could do better"!
Links: [nothing available online]
Bodey, A.L., Almond, C.J. and Holmes, M.A. (2017) 'Double-
‘Abstract... There were no statistically significant differences in the changes seen between the two treatment arms following placebo or homeopathic treatment... or between the means of each parameter for either treatment arm before and after placebo or homeopathic treatment... The results of this study failed to provide any evidence of the efficacy of homeopathic treatment of feline hyperthyroidism.’
Hyperthyroidism (an over-
Some homeopaths claim you can treat an overactive thyroid by using homeopathy or, more precisely, isopathy with nosodes prepared from ground up thyroid glands (which, by the way, is an example of ‘sympathetic magic’, along the lines of the medicine man spitting on the ground to bring rain or a voodoo priest sticking pins in an effigy of someone who is ill). These homeopaths are most charitably described as ‘mistaken’.
What happens when truly hyperthyroid cats are treated homeopathically (i.e. with nothing) is that they stuggle on for months and months with heart failure and weight loss, becoming increasingly uncomfortable and breathless yet all the time, like most cats, just appearing to sit around quietly rather than making a fuss, right up until the point they go into acute heart failure and die, often in some considerable distress. And while this is happening the attending homeopath is either claiming success on the good days or claiming an ‘aggravation’ during the bad ones -
And it’s all nonsense -
Of course, the homeopaths are wingeing about it, as they always do when trials, no matter how well conducted, don’t give results they like, even when in this case homeopathic head honcho John Saxton personally gave his go ahead for the trial design.
The homeopathic practitioner, Chris Almond, who participated in the trial says he is expecting a hard time from his homeopathic colleagues -
Well why didn’t he say something sooner, one might well ask? Could it be he was waiting just in case the results were favourable to homeopathy first, in which case the triumphalist cries from the vet homs would have been deafening? But that didn’t happen, the results were entirely in line with expectations and it looks like Mr Almond is currently being hung out to dry by his erstwhile colleagues for consorting with the devil and participating in a well run, methodologically robust trial along with two other veterinary surgeons who were completely independent of any vested interest. Really, what was he thinking!.
I can do no better than to quote Andrew Bodey, the (conventional) veterinary practitioner whose idea it was to perform the trial in the first place, 'If the purpose of your efforts is to justify your own opinions rather than to answer a legitimate question, then that is not going to work…'
There’s no getting away from it, homeopaths are simply poor losers.
Boissel, J.P., Cucherat, M., Haugh, M. and Gauthier, E. (1996) ‘Critical literature review on the effectiveness of homoeopathy: overview of data from homoeopathic medicine trials’, In: Homoeopathy Medicine Research Group: report to the European Commission Directorate General XII: science, research and development. Brussels 1996: pp. 195–210.
This report is apparently unavailable online but, from the similarity of the authors and title, it seems to have given rise to the paper by Cucherat et al, (2000), published in the European Journal of Clinical Pharmacology. Since they are effectively the same a critique of both works can be found following the Cucherat citation on this site. It doesn’t stop homeopaths reporting both pieces as if they were two different works of course to increase their “evidence base” -
an antique paper, in French, apparently not available in English or on line, how convenient for anyone touting this as evidence in favour of homeopathy!
Bornhöft, G., Wolf, U., Ammon, K., Righetti, M., Maxion-
“Taking internal and external validity criteria into account, effectiveness of homeopathy can be supported by clinical evidence and professional and adequate application be regarded as safe”
Oh, wait, no it can’t... Just another uncritical and wildly optimistic trawl through what passes for research in the smoke and mirror world of homeopathy. Dozens of papers looked at, no mention of exclusion criteria, methods, numbers, power, significance or anything else. Only the abstract is available on line though.
Also, ”Forsch Komplementärmed” translates as “Research in Complementary Medicine” -
Bracho, G., Varela, E., Fernandez, R., Ordaz, B., Marzoa, N., Menendez, J., Garcia, L., Gilling, E., Leyva, R., Rufin, R., de la Torre, R., Solis, R.L., Batista, N., Borrero R. and Campa, C. (2010) ‘Large-
This paper describes a trial conducted (one might say inflicted) on Cuban citizens including children, in some cases as young as one year of age, who were at risk of dying from leptospirosis due to "environmental, socio-
According to homeopaths Roniger and Jacobs (2010), this paper was initially rejected by mainstream journals by virtue of its complete lack of randomisation and inadequate controls (the authors rather grandly claim the entire of Cuba's remaining population as their control arm -
When studied carefully, all this paper demonstrates is the incidence of leptospirosis in the areas under test, which had been badly affected by flooding for a number of years, merely returned to the same background levels (three to four cases per 100,000 of the population per week) as the unaffected, and untreated, surrounding areas, once the flooding had subsided. No need to invoke the magic of homeopathy here.
Which is just as well, since the trial didn't even use homeopathy. The technique employed, although disingenuously referred to by many homeopaths as "homeopathic" was so-
Apgaylard, Andy Lewis and Peter Lipson all have something to say about it in their various excellent blog entries, and Martin Whitehead’s critique is an object lesson in critical appraisal. Follow the links below for well-
Links: [abstract, science direct]:[full text -
Responses: [apgaylard 2010 -
Keywords: leptospira, nosode, Cuba
Brien, S., Lewith, G. and Bryant, T. (2003) ‘Ultramolecular homeopathy has no observable clinical effects. A randomized, double-
Conclusion: "Ultramolecular homeopathy had no observable clinical effects".
The clue is in the title ;-
Brien, S., Prescott, P., Owen, D. and Lewith, G. (2004) ‘How do homeopaths make decisions? An exploratory study of inter-
"The validity of clinical decision making in homeopathy is largely unexplored and little is understood about the process or its reliability. This exploratory study investigated... the extent to which decisions are based on clinical facts or intuition and how reliable decisions are. Three experienced, independent homeopathic clinicians/proving researchers rated the symptom diaries of the 206 subjects taking part... The level of agreement between raters was generally poor ... All raters used both facts and intuition. The rater's reliance on the facts was significantly associated with classifying those subjects who had no proving response. Raters used significantly higher intuition scores when classifying a prover..."
So, homeopaths use either "facts" -
Links: [abstract, pubmed]
Brien, S., Lachance, L., Prescott, P., McDermott, C. and Lewith, G. (2011) ‘Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy, a randomized controlled clinical trial’ Rheumatology’ vol. 50, no. 6, pp. 1070–1082.
“Homeopathic consultations but not homeopathic remedies are associated with clinically relevant benefits for patients with active but relatively stable rheumatoid arthritis”.
In other words it’s the long chat which makes the difference, not the homeopathic pills. There is nothing unique or special about homeopathy, it’s all in the bedside manner; the only difference between a homeopathic practitioner with a good bedside manner and a real doctor with a good bedside manner is that the real doctor doesn’t do that little thing at the end with the sugar tablet.
Brigo, B. and Serpelloni, G. (1991) ‘Homoeopathic treatment of migraines: a randomized double-
Brinkhaus, B., Wilkens, J.M., Lüdtke, R. et al. (2006) ‘Homeopathic arnica therapy in patients receiving knee surgery: results of three randomised double-
“CONCLUSIONS: In all three trials, patients receiving homeopathic arnica showed a trend towards less postoperative swelling compared to patients receiving placebo”
Well, that sounds fantastic, surely this is proof that homeopathy works (well, at least a “trend towards” it, that’s got to mean something hasn’t it?). Absolutely it is, oh, apart from the next bit “However, a significant difference in favour of homeopathic arnica was only found in the Cruciate Ligament Repair (CLR) group”, well, but surely... err, hang on the CLR trial only has 57 of the 319 patients looked at in total. But surely, significance is significance isn’t it? Well, is it? In this paper the authors admit that the difference in absolute terms between knee circumferences (designated merely as a secondary outcome) was nowhere near statistically significant in any of the trials, being only a few millimetres between the two groups (placebo and verum) out of a total of around 390 mm -
This paper also is a classic example of looking at indirect outcomes of an intervention. The authors have chosen to look at post-
So this is yet another homeopathic lemon I’m afraid. In all the ways that are meaningful to the patient homeopathy is useless and, even in the parameters which present homeopathy in its best light, the minute differences in knee circumference are only different when looked at as a percentage, not absolute measurements and then in only 57 out of 319 patients. And remember, the RationalVetMed elephant-
Finally, the authors also claim that they found 40 trials of homeopathic arnica (presented conveniently in a non-
There are other trials of Arnica, which the authors are strangely quiet about, which come to the conclusion that arnica as a treatment for bruising and swelling is a complete waste of time, for example Stevinson (2003), Ernst and Pittler (1998) and Ernst (2003). One even appears in the Homeopathy journal -
Brydak, L.B. and Denys, A. (1999) ‘The evaluation of humoral response and the clinical evaluation of a risk-
Despite this paper’s optimistic claim (“the clinical data we obtained indicate seroprotection against influenza after the administration of Gripp-
For a start there is selection bias as all participants were volunteers, so we have no way of telling whether or not patients were influenced by their own state of health, whether or not they believed in homeopathy or other factors when volunteering for the trial, in fact no selection criteria are given at all. The authors have conducted their trial in a population representative of the real world at-
The participants were living in nursing homes (how many isn’t specified but it is more than one) but we are not told whether patients were selected randomly across the whole group of them or whether all patients from one nursing home were put in one group. Obviously different conditions in one home compared with another would have a marked effect on the outcome so it is surprising that this isn’t even discussed. There is also no mention of whether or how the two populations were matched in order to make sure that the control group was comparable with the treatment group, an essential prerequisite to a study of this sort.
No blinding is mentioned and again this is crucial and throws real doubt on the paper’s methodology. Certainly there would have been no need to blind the participants, who would have presumably been unaware of their circulating antibody levels, but what about the people doing the analysis? It is not unheard of for a technician who gets an unexpected result to re-
It cannot be said with any certainty whether any of these types of bias were present of course but from the way the paper is laid out and from the limited data we are given there is no way to be sure, and when you are testing a claim that remedies which contain no active ingredients are effective in protecting vulnerable individuals against a life threatening disease, the onus is on the authors to make sure that such loose ends are well and truly tidied up before making such bold claims. Making clinical recommendations from these results is irresponsible and this paper is by no means evidence that homeopathy has any discernible effect.
Links: [full text, pdf, biopathica]
Buell, P.D., May, T. and Ramey, D. (2010) ‘Greek and Chinese horse medicine: deja vu all over again’, Sudhoffs Archiv, vol. 94, no. 1, pp. 31–56. [permalink]
Sinologist Paul Buel treats us to an enlightening and scholarly article about Ancient Chinese Veterinary Acupuncture and reveals it is actually far from ancient. Oh, and it’s not particularly Chinese either… and it’s not really what we’d call acupuncture.
"... while Chinese horse medicine developed in characteristically Chinese ways, it did so with major and fundamental borrowings from many other traditions. most probably Greek, including Greek medicine as mediated by Arabic translations, of which there are a great number."
“... the first surviving work in Chinese specifically devoted to veterinary medicine only dates from 1384. This is the Simu anji ji (SMAJJ) ‘Collections for Pacifying Stallions when Administering Flocks’...
"Conspicuously absent from the SMAJJ, and for that matter, from all pre-
Burger, J., Kirchner, M., Bramanti, B., Haak, W. and Thomas, M.G. (2007) ‘Absence of the lactase-
From the press release: “This study challenges the theory that certain groups of Europeans were lactose tolerant and that this inborn ability led the community to pursue dairy farming. Instead, they actually evolved their tolerance of milk within the last 8000 years due to exposure to milk.”
From the paper: “Although our data are consistent with strong selection for [lactase persistence] beginning with the introduction of cattle to Europe ~8800 B.P., it is unlikely that fresh milk consumption was widespread in Europe before frequencies of [the lactase gene] had risen appreciably during the millennia after the onset of farming”
What has this paper, on the evolution of stone-