Rational Veterinary Medicine:
Papers, listed by lead author: E-
EASAC (European Academies’ Science Advisory Council) statement (2017) Homeopathic products and practices; assessing the evidence and ensuring consistency in regulating medical claims in the EU [Online]:[permalink].
"Veterinary practice — we conclude... that there is no rigorous evidence to substantiate the use of homeopathy in veterinary medicine and it is particularly worrying when such products are used in preference to evidence-
"There should be consistent regulatory requirements to demonstrate efficacy, safety and quality of all products for human and veterinary medicine, to be based on verifiable and objective evidence, commensurate with the nature of the claims being made. In the absence of this evidence, a product should be neither approvable nor registrable by national regulatory agencies for the designation medicinal product.
"3.4 Veterinary applications -
“… if the homeopathic remedy is found ineffective, this risks delay with potential harm for livestock and spread of the infection to other animals.
“A recent comprehensive systematic review of the scientific literature on homeopathy in farming (Doehring and Sundrum, 2016) evaluated whether such remedies could replace the use of antibiotics for infectious disease or growth promotion... The results from those studies supporting homeopathy lacked reproducibility and the systematic review concluded, ‘Within the studies considered, the use of the same remedy administered to the same species with a comparable medical condition was never repeated’ and ‘Replacing or reducing antibiotics with homeopathy currently cannot be recommended unless evidence of efficacy is reproduced by randomised clinical trials and proven in various farm practice conditions’.
“Thus, while EASAC recognises the strategic importance of attempts to reduce antibiotic use in animals.., the use of non-
This statement is a response to European Commission Regulation EC No 889-
Links: [full text (pdf)]
Ebert, F., Staufenbiel, R., Simons, J. and Pieper, L. (2017) 'Randomized, blinded, controlled clinical trial shows no benefit of homeopathic mastitis treatment in dairy cows', Journal of Dairy Science, Mar 22. pii: S0022-
‘We observed no significant differences in time to recovery, somatic cell count, risk of clinical cure within 14 d after disease occurrence, mastitis recurrence risk, or culling risk. The results indicated no additional effect of homeopathic treatment compared with placebo.’
A well conducted, triple-
As Prof Ernst says, ‘How much more evidence is needed before homeopaths abandon their bogus claims?’
Comments: [Edzard Ernst]
Edwards, D.S., Henley, W.E., Ely, E.R. and Wood, J.L.N. (2004) ‘Vaccination and ill-
This is the strangely named POOCH survey (it stands for Practice Overview Of Canine Health) 9055 pre-
Links: [Abstract, science direct]
“... there was no evidence of any benefit being obtained either in eliminating bacteria or reducing milk somatic cell count (SCC ) from using this [homeopathic] preparation.”
Links: [abstract, vet record]
Egan, J. (1998) ‘Homeopathic mastitis control: a study on the uptake and efficacy of products in the Republic of Ireland’, Proceedings of the British Mastitis Conference, Axient/Institute for Animal Health, Milk Development Council/Novartis Animal Health pp. 22-
“In a joint study between the research centres at Abbotstown and Moorepark the efficacy of a homoeopathic nosode was evaluated in three herds... A total of 188 lactating cows were assigned at random, in a double blind trial, into two groups and treated with either a nosode or placebo for a period of 12 months. The homoeopathic preparation used in this experiment was formulated at 30c potency... A placebo was also used.
“A total of 148 cases of clinical mastitis cases developed in 70 of the cows on experiment... There were no significant differences between the two treatments in the number of new cases of clinical mastitis either within herds or in all herds collectively. There was also no significant difference in the frequency of isolation of individual pathogens from animals on each treatment.
“In a separate study Meaney evaluated the efficacy of a nosode... One group of 13 animals was treated with the nosode and a further group of 13 cows acted as an untreated control. The nosode was administered using a vulva spray technique and the experiment was conducted over an eight-
Elliott, M. (2001) ‘Cushing's disease: a new approach to therapy in equine and canine patients’, British Homeopathic Journal, vol. 90, no. 1, pp. 33-
This certainly is a ‘new’ approach, even for something as bizarre as homeopathy. This trial makes no attempt at “individualising” patients for the treatment of this potentially life threatening disorder of the adrenal glands. Individualisation is normally considered crucially important to the homeopathic treatment of disease as most homeopaths will tell you, and even more so during studies which have produced negative results when lack of individualisation provides an excellent excuse for dismissing conclusons which don’t concur with homeopathic preconceptions. This study however claims positive findings so lack of individualisation no longer matters; as far as homeopaths are concerned it’s results that count after all.
Another extremely important foundation of homeopathic treatment is the lengthy consultation with each patient, or in the case of veterinary patients, with the owner. This is necessary to obtain the vast list of “symptoms” which the homeopath needs to obtain the “simillimum”, i.e. the remedy which best suits the patient. How else is the homeopath supposed to find out important information like whether the patient has a “fear of clams” or a headache on one side of the head which is worse in the early hours (these are genuine examples)? In this case however the author has skipped past all that tedious and time consuming nonsense and has obtained the correct remedy by using “radiesthetic principles”, which is to say dowsing. Rather flying in the face of traditional homeopathy you may think, and you’d be right. But the beauty about a bogus treatment like homeopathy is that you really can just make it up as you go along -
“Surely though”, (comes the inevitable cry), “surely that’s all irrelevant, you’re just nit-
Well, not quite... Only 12 of the 18 dogs in this study were diagnosed using even the most basic blood test, one which is readily available to the practitioner. None of them had their adrenal glands examined by ultrasound, something which is less common in practice but which a researcher ought to have considered, or at least discussed. The rest were diagnosed by clinical signs alone, which is a highly unreliable (some would say impossible) way of making a definitive diagnosis, despite the author’s claim that they were showing “classic symptoms” -
So, there we have it. Animals in this trial were denied the well researched and effective medications commonly available at the time to treat Cushing’s syndrome in order to test sugar tablets and dowsing on them and even that testing was inadequate as no follow up blood tests were carried out. In my opinion this trial was highly unethical by any standards; others hold even stronger views. Not a great day for the veterinary profession I’m afraid.
A year or so after Mr Elliot’s paper was published it was referenced in a proper paper on equine Cushing’s disease by Dr Harold Schott of Michigan State University, published in a proper journal (Schott 2002). In it he mentions all sorts of tests that can be done to diagnose and monitor equine Cushing’s syndrome (every one of which Mr Elliott appears to be unaware of) yet strangely fails to mention dowsing -
“After over 20 years research trying to find out if high dilutions of histamine have a negative feedback effect on the activation of basophils by anti-
Ernst, E., Saradeth, T. and Resch, K.L. (1990) ‘Complementary therapy of varicose veins -
The aim of this study was to test the effectiveness of a combined homeopathic medication in primary varicosity. A well-
The journal Phlebology’s online archive doesn’t go back as far as the publication of this paper and their pub-
This study was conducted by Edzard Ernst (now the bête noir of the homeopathic industry), during his time at the Department of Physical Medicine and Rehabilitation in Vienna. An obscure work, it hasn’t escaped the attention of eagle eyed homeopathic bloggers though, who have gleefully siezed upon it as conclusive proof of the Proff’s perfidiousness, suggesting this one, ancient paper which allegedly finds that homeopathy works, fatally undermines all his later research which proves it doesn’t.
This claim is ridiculous of course although it is very revealing about the attitudes of homeopaths who regard research as something to be used in a point-
One of the most damning of his disclosures is that the substance under test, Poikiven®, isn’t actually a homeopathic remedy atall, it’s a herbal one. Oh sure, it’s got ‘homeopathy’ written on the label, but according to the ingredients list it’s got, well... ingredients. And that’s something no homeopathic remedy should have. One of the central tenets of homeopathy is that less is more (the so-
Neither is the paper itself terribly convincing about the ability of Poikiven® to successfully treat varicose veins – for a start the sample size was tiny, at only sixty-
So, any claims made by homeopaths that this paper is proof homeoathy works are completely wrong, unless the definition of homeopathy is so elastic as to be meaningless. This is just more homeopathic hype from people who don’t understand how science works.
"... The claim that homeopathic arnica is efficacious beyond a placebo effect is not supported by rigorous clinical trials."
Links: [full text, pub med, pdf]
Ernst, E. and Pittler, M.H. (2000) ‘Re-
“Viewed in this way, the re-
"Our knowledge regarding the potential benefit and harm of CAM is insufficient."
“... there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.”
"Following the publication of a randomised controlled trial of Arnica in hand surgery, a number of reports of apparently beneficial effects of Arnica came to the author's attention. Many of these apparent responses could have been due to other factors including the use of herbal (non-
Links: [abstract, pubmed]
Well, between 55% and 97% according to Professor Ernst -
“Contrary to many claims by homeopaths,there is no conclusive evidence that highly dilute homeopathic remedies are different from placebos... Contrary to widespread belief, homeopathy is not entirely devoid of risk. Thus, the proven benefits of highly dilute homeopathic remedies, beyond the beneficial effects of placebos, do not outweigh the potential for harm that this approach can cause.”
We’ll take that as a ‘no’ then!
“INTRODUCTION: Homeopathy is ‘a therapeutic method of using preparations of substances whose effects when administered to healthy subjects correspond to the manifestation of the disorder in the individual patient’. The discipline was developed by Samuel Hahnemann (1755–1843) about 200 years ago. Hahnemann postulated that
“• if a remedy causes a symptom in a healthy volunteer, then it can be used to treat that symptom in a patient (the “like cures like” principle).
• if a remedy is potentized (that is, diluted and sucussed), it becomes more rather than less effective (the “memory of water” theory).
• all diseases originate from the “itch” (psora), gonorrhea (sycosis), or syphilis (lues).
“The third of these assumptions is now all but forgotten (I suspect that homeopaths feel embarrassed by its overt incorrectness), but despite the fact that the two other axioms also fly in the face of science, they still form the basis of homeopathy today.
“Initially Hahnemann was remarkably successful, and homeopathy conquered much of the world. With hindsight, this early popularity probably accrued because, unlike many other therapies of the time, homeopathy was not outright harmful. With the eventual emergence of conventional treatments that generated more good than harm, homeopathy’s popularity faded.
“Considering the biologic implausibility of high potency homeopathy, my conclusions have to be conservative. There is no evidence at all that homeopathic remedies can change the natural history of any cancer. The few RCTs of homeopathy are in the realm of cancer palliation and supportive care and have not generated convincing evidence of a beneficial effect.
“For indications other than cancer, the evidence from rigorous RCTs is also not convincing. As a result, there is no reason to believe that homeopathic medicines have anything to offer to patients suffering from cancer or other conditions apart from non-
“The findings of currently available Cochrane reviews of studies of homeopathy do not show that homeopathic medicines have effects beyond placebo”
This is a response to Brien (2011).
Links: [full text, html, rheumatology]
Only 7.4% of CAM is based on decent evidence, and even that may be a gross over estimate.
“This review was aimed at critically evaluating systematic reviews of acupuncture as a treatment of pain and at summarizing reports of serious adverse effects published since 2000... Numerous contradictions and caveats emerged. Unanimously positive conclusions from more than one high-
So, acupuncture doesn’t really work and it can kill you. Methinks RationalVetMed will be sticking to good old paracetamol!
European Union (2008) COMMISSION REGULATION (EC) No 889/2008 of 5 September 2008 laying down detailed rules for the implementation of Council Regulation (EC) No 834/2007 on organic production and labelling of organic products with regard to organic production, labelling and control [Online] [permalink]
This is the piece of legislation which ensures that organically farmed animals are denied the benefit of safe, effective, tried and tested medicines when they are ill or suffering, and given drops of water or sugar tablets instead. The fact something like this is even in existence is a sign of how badly infiltrated the EU bureaucracy is by those promoting the pseudoscientific dogma of complementary and alternative medicine and just how political this sort of document is, favouring public opinion over science. If any organic farmers are reading who care more about their animals than homeopathic fairytales there is a handy get out clause though. It does say homeopathy shall be used ‘provided that their therapeutic effect is effective for the species of animal, and the condition for which the treatment is intended.’ So there you are; there is absolutely no homeopathic remedy which is effective in any species or for any condition, so that lets you off the hook. Just as long as you are prepared to abide by the draconian meat, milk and egg witholding times laid down again, in contradiction to the proper science.
One thing, when searching in this document the EU has used some archaic spelling, so search on homoeopathy, not homeopathy.
“1. Where despite preventive measures to ensure animal health as laid down in Article 14(1)(e)(i) of Regulation (EC) No 834/2007 animals become sick or injured they shall be treated immediately, if necessary in isolation and in suitable housing.
“2. Phytotherapeutic, homoepathic products, trace elements and products listed in Annex V, part 3 and in Annex VI, part 1.1. shall be used in preference to chemically-
“3. If the use of measures referred to in paragraph 1 and 2 is not effective in combating illness or injury, and if treatment is essential to avoid suffering or distress of the animal, chemically-
“4. With the exception of vaccinations, treatments for parasites and compulsory eradication schemes where an animal or group of animals receive more than three courses of treatments with chemically-
“Records of documented evidence of the occurrence of such circumstances shall be kept for the control body or control authority.
“5. The withdrawal period between the last administration of an allopathic veterinary medicinal product to an animal under normal conditions of use, and the production of organically produced foodstuffs from such animals, is to be twice the legal withdrawal period as referred to in Article 11 of Directive 2001/82/EC or, in a case in which this period is not specified, 48 hours.”
Responses: [EASAC statement]
Ferley, J.P., Zmirou, D., D’Adhemar, D. and Balducci, F. (1989) ‘A controlled evaluation of a homoeopathic preparation in the treatment of influenza like syndromes’, British Journal of Clinical Pharmacology, vol. 27, pp. 329-
This rather old, practice-
Interestingly the authors describe Oscillococcinum rather grandly as being "made of a highly diluted autolysate of animal organs" -
Patients recorded their own rectal temperatures as well as five cardinal signs (headache, stiffness, lumbar and articular pain and shivers) in a study diary at home, although not every part of the diary was completed by all patients. During the trial many participants used antibiotics as well as other conventional drugs to treat pain, fever and cough (which pretty much covers the five cardinal signs) in addition to the test substances.
The authors mention "the treatment allocation of active drug or placebo was made on a randomized double-
The findings are far from spectacular and the authors state "The effect was modest (the increase in proportion of recoveries within 48 h was less than 7%)" and "it would be unwise to claim that the study has demonstrated a cause and effect relationship between the drug and the recoveries".
I wonder if the duck they got the Oscillococcinum from was lame? That would certainly explain the results.
Fisher, P., Berman, B., Davidson, J., Reilly, D. and Thompson, T. (2005) ‘Are the clinical effects of homoeopathy placebo effects?’, Lancet, vol. 366, no. 9503, pp. 2082 -
Links: [full text, Lancet]
Fisher, P. and Dantas, F. (2004) ‘Homeopathy: do not condemn what we do not understand (letter)’, Rev. Hosp. Clin., vol.59, no.3 [response to Almeida (2003)].
“We found no evidence that active homeopathy improves the symptoms of RA”
Peter Fisher, head of the London homeopathic hospital (or whatever name it is trading under at the time of reading) not only concludes in this study that homeopathy makes no difference in patients suffering rheumatoid arthritis but also seems to concede the general point that is is useless to try to tell the difference between homeopathy and placebo: “It seems more important to define if homeopathists can genuinely control patients’ symptoms and less relevant to have concerns about whether this is due to a ‘genuine’ effect or to influencing the placebo response.” says Doctor F. -
Francoz, D., Wellemans, V., Dupré, J.P., Roy, J.P., Labelle, F., Lacasse, P. and Dufour, S. (2017) 'A systematic review and qualitative analysis of treatments other than conventional antimicrobials for clinical mastitis in dairy cows', Journal of Dairy Science, vol. 100, pp. 7751–7770 (doi.org/10.3168/jds.2016-
"The objective of this systematic review was to identify treatments other than conventional antimicrobials for the treatment of clinical mastitis in lactating dairy cows. A systematic review was performed with studies written in English or French selected from CAB Abstracts, PubMed, and Web of Science from January 1970 to June 2014. Controlled clinical trials, observational studies, and experimental challenges were retained. Lactating dairy cows with clinical mastitis were the participant of interest. All treatments other than conventional antimicrobials for clinical mastitis during lactation were retained. Only studies comparing the treatment under investigation to a negative or positive control, or both, were included... Assessment of risk of bias was evaluated using the Cochrane Collaboration tool for systematic review of interventions. A total of 2,451 manuscripts were first identified and 39 manuscripts corresponding to 41 studies were included. Among these, 22 were clinical trials, 18 were experimental studies, and 1 was an observational study. The treatments evaluated were conventional anti-
Responses: [Edzard Ernst]
Frass, M., Dielacher, C., Linkesch, M., Endler, C., Muchitsch, I., Schuster, E. and Kaye, A. (2005) ‘Influence of potassium dichromate on tracheal secretions in critically ill patients’, Chest, vol. 127, pp. 936-
There is quite a lot for the sceptic to be suspicious about with this paper. For starters the authors have seen fit to ignore one of homeopathy's basic tenets -
The sample sizes are small for such a common problem (only 25 in each group), some of the end points are vague ('stringiness' of mucus for example) and, most importantly, the two groups are unbalanced; the placebo arm having more patients at an advanced stage of COPD than the verum. In particular, at the start of the trial, there were a greater number of patients on home oxygen in the placebo group than the verum. This suggests these patients had worse pre-
The most serious criticism though of papers such as this, extend to the wider picture, away from nit-
At this point this paper is a one off. It is always possible, no matter how convincing the probability value, that one or two papers, even if perfectly conducted, will show positive results for an ineffective treatment purely by chance and the greater the number of trials carried out the more likely it is that such chance results will arise. At the moment, given the body of evidence against homeopathy, it looks like this paper may be one of those, a so-
At the time of writing the original paper is 10 years old and research projects take time to set up so there may be more to come about this. It will be interesting to see whether homeopaths decide to continue down the research line and build on what this paper seems to hint at or will content themselves with repeated citing of a solitary paper as if a mere 50 patients could prove homeopathy was even slightly more effective than a blank sugar tablet.
Links: [abstract, pubmed]:[full text, Chest]:[full text, pdf, chest]
Responses: [Gorski, D., 2010 -
Frei, H., Everts, R., von Ammon, K., et al. (2005) ‘Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomized, double blind, placebo controlled crossover trial’, European Journal of Pediatrics, vol. 164, pp. 758–767.
Frenkel, M., Mishra, B.M., Sen, S., Yang, P., Pawlus, A., Vence, L., Leblanc, A., Cohen, L., Banerji, P. and Banerji P. (2010) ‘Cytotoxic effects of ultra-
This trial, conducted on cells in test tubes, not actual patients, by a team affilliated with the Integrative Medicine (i.e. CAM) Program-
Unfortunately for the team the paper has been critiqued by someone called Maggie who is a cell biologist and really knows what she is talking about (see ‘responses’ below) and it seems that in fact the paper is so full of holes you could use it as a colander. Even one of the authors thought it was not a sound study, calling into question the quality of the controls and suggesting that any differences seen between the remedies and ‘controls’ was due to variations in alcohol content (alcohol is toxic when applied directly to cells as was done here). Why it should have appeared in a reputable peer reviewed journal is a mystery. Maggie, our sceptical reviewer, suspects the reviewers may have been dozing -
A special place should be reserved in hell for people who claim homeopathy can treat cancer -
Friese, K.H. and Zabalotnyi, D.I. (2007) ‘Homeopathy in acute rhinosinusitis: A double-
A german language paper unavailable online without a hefty subscription -