Rational Veterinary Medicine:
Papers, listed by lead author: V-
van Bree, F.O.J, Bokken, G.C.A.M., Mineur, R., Franssen, F., Opsteegh, M., van der Giessen, J.W.B., Lipman, L.J.A. and Paul A M Overgaauw, P.A.M. (2018) 'Zoonotic bacteria and parasites found in raw meat-
Yet another paper has just been published confirming the less than startling fact that raw diets for dogs contain what we professionals call 'germs and bugs'. A team of Dutch researchers looked at thirty five samples from eight commercially available brands of raw meat based diets (RMBD) and discovered bacteria such as E. coli, Listeria, and Salmonella, as well as parasites including Sarcocysts and Toxoplasma gondii in them. A staggering eighty per cent of the samples contained antibiotic resistant E. coli bacteria. This seething mass
of fascinating flora and fauna are zoonotic, which is to say they can cause illness in humans ranging from gastro-
The study concludes, in that typically dispassionate way that published papers do, that owners should be made aware of the risks of feeding raw food to pets. RationalVetMed would venture a step further -
Objective. To evaluate the efficacy and safety of a homeopathic gel vs an NSAID (piroxicam) gel in the treatment of osteoarthritis of the knee.
Method. One hundred and eighty-
Results. One hundred and seventy-
Conclusion. The homeopathic gel was at least as effective and as well tolerated as the NSAID gel. The presence of a clinically relevant difference between treatment groups cannot be excluded. The homeopathic gel supplemented by simple analgesics if required may provide a useful treatment option for patients with osteoarthritis.
I posted the excerpts from the abstract above a few years ago, meaning to get back to this paper at some point and have a proper look at it. The citation originally came from one of those endless lists homeopaths have of peer-
For some reason it slipped my mind to do the follow up and it was only the other day, while doing some housekeeping on the page, that I re-
So I did what I originally intended and started to have a closer look at the paper itself; I discovered my fears were entirely justified. In fact this is the worst type of homeopathic spin, the abstract bears little resemblance to the main body of the paper at certain crucial points and the paper is no more proof of homeopathy’s effectiveness than fly in the air (as my old mum would have said).
For a start the term ‘pragmatic trial’, particularly when used by homeopaths, equates to ‘sloppy’ and is a cover for trials which although claimed to be blinded, randomised, placebo-
But there’s more. It turns out this ‘homeopathic’ gel stretches the definition of homeopathy to breaking point. In fact SRL gel is herbal and although, as well as the above mentioned pine oil, it contains ingredients sometimes found in homeopathic remedies such as comfrey, poison ivy and marsh-
To recap, this is an unblinded trial, looking at a gel which, although it has the word ‘homeopathic’ on the label is nothing of the sort, and actually contains many questionable ingredients along with other herbal components such as witch-
So that’s another few hours of my life wasted!
“In summary, it can be concluded that there has been a great deal of research on the effectiveness of homeopathy. Much of this research is methodologically weak and justifies no conclusion about the effectiveness of homeopathy. But there has also been good research, from which it is apparent that the effect of homeopathy is no greater than that of placebo.”
A useful summary by a Dutch veterinary surgeon of the state of veterinary homeopathy today.
Links: [original article]
Vickers, A., Goyal, N., Harland, R. and Rees, R. (1998) ‘Do certain countries produce only positive results? A systematic review of controlled trials’, Control Clin Trials, vol. 19, no. 2, pp. 159-
Objective: To determine whether clinical trials originating in certain countries always have positive results.
Data Sources: Abstracts of trials from Medline (January 1966-
Study Selection: Two separate studies were conducted. The first included trials in which the clinical outcome of a group of subjects receiving acupuncture was compared to that of a group receiving placebo, no treatment, or a nonacupuncture intervention. In the second study, randomized or controlled trials of interventions other than acupuncture that were published in China, Japan, Russia/USSR, or Taiwan were compared to those published in England.
Data Synthesis: In the study of acupuncture trials, 252 of 1085 abstracts met the inclusion criteria. Research conducted in certain countries was uniformly favorable to acupuncture; all trials originating in China, Japan, Hong Kong, and Taiwan were positive, as were 10 out of 11 of those published in Russia/USSR. In studies that examined interventions other than acupuncture, 405 of 1100 abstracts met the inclusion criteria. Of trials published in England, 75% gave the test treatment as superior to control. The results for China, Japan, Russia/USSR, and Taiwan were 99%, 89%, 97%, and 95%, respectively. No trial published in China or Russia/USSR found a test treatment to be ineffective.
Conclusions: Some countries publish unusually high proportions of positive results. Publication bias is a possible explanation. Researchers undertaking systematic reviews should consider carefully how to manage data from these countries.
Links: [abstract, pubmed]
“Conclusions:There is a lack of independent replication of any pre-
Vickers, A. J., Van Haselen, R. and Heger, M. (2001) ‘Can homeopathically prepared mercury cause symptoms in healthy volunteers? A randomized, double-
“This pilot study failed to find evidence that mercury 12C causes significantly more symptoms in healthy volunteers than placebo... If drug proving phenomena exist, they appear to be rare.”
Links: [abstract -
The Cochrane database is one of the most respected resources of its kind in the world -
The call for large sample sizes is significant. Often the conditions where homeopathy publicly claims its best results (what they claim in private is another matter) are mild, self limiting ones where it is difficult to define a proper start and finish time and where the course of the disease is variable and difficult to quantify. "Influenza-
N.B. The full text of this article has been superceded by a more current review in the Cochrane database on the same subject. Have a look at Mathie et al 2012 for the latest conclusions (hint: homeopathy still doesn’t come up smelling of roses).
Links: [abstract, pub med]
This is George Vithoulkas ticking homeopathic extremists off for believing you can make remedies out of far fetched stuff like moonlight and storms. As if mainstream homeopathic ingredients -
Walach, H. (1993) ‘Does a highly diluted homeopathic drug act as a placebo in healthy volunteers? Experimental study of Belladonna 30C in a double blind crossover design -
‘Is homeopathy a placebo?’ the authors ask, and the answer, in a word, is ‘Yes’! But that doesn’t stop them twisting the evidence in the abstract to make it sound like it isn’t!
Links: [abstract pubmed]
Walach, H. (2000) ‘Magic of signs: a non-
Homeopaths hate it when sceptics describe homeopathy as magic; they hate it even more when one of their leading proponents does the same. Starting with a discussion of the work of eminent scholar of Jewish mysticism Gershom Scholem who contends that simply telling stories about the achievements of ancient gods enables us to replicate those same achievements, the author goes on to claim about homeopathy, "Although the original substance is diluted, it is still in some way 'present' and effective. This presence, I will contend in this paper, is a magical, not a causal presence... Magical presence and effects are wrought by signs, not by causes. In this sense, homeopathy is effective in a non-
The author also confesses "The pillar of homeopathy, pathogenetic trials rests on shaky ground. The experiments conducted and published since World War II are not very persuasive from a scientific point of view. The ones conducted in the United Kingdom are... not very persuasive either. The experiments which I have conducted myself do not show a clear pattern of different or more symptoms with homeopathic substance than placebo. Modern homeopathic researchers like Jeremy Sherr or David Riley admit in personal discussions that very specific symptoms can be observed with placebo, however, these are rarely published. It seems to be an open secret that true homeopathic symptoms... can also be observed with placebo...".
This paper is a real revelation about the true mind-
Walach, H., Lowes, T., Mussbach, D., Schamell, U., Springer, W., Stritzl, G. and Haag, G. (2001) ‘The long-
“... There is no indication of a specific, or of a delayed effect of homeopathy.”
Links: [abstract -
Walach, H., Koster, H., Hennig, T. and Haag, G. (2001) ‘The effects of homeopathic belladonna 30CH in healthy volunteers -
A randomized, double blinded, placebo controlled clinical trial with a good number of participants conducted by a prominent homeopath trying to find out whether it is possible to tell the difference between a homeopathic remedy and an inert sugar tablet, exactly the sort of trial that homeopaths are continually clamouring for. The conclusion: ‘... There is no indication that belladonna 30CH produces symptoms different from placebo or from no intervention. Symptoms of a homeopathic pathogenetic trial (HPT) are most likely chance fluctuations.’ Oops! No wonder this one never appears on homeopathic evidence lists.
Walach, H., J Sherr, J., Schneider, R., Shabi, R., Bond, A. and Rieberer, G. (2004) ‘Homeopathic proving symptoms: result of a local, non-
‘Is there evidence that homeopathic medicines produce specific symptoms different from placebo response?’
‘Qualitative Findings: The materia medica expert was not able to determine the correct medicine, either in step 1 (unrestricted choice), or step 2 (restricted choice)’
‘There was no significant difference between groups (Cantharis vs. placebo) either for typical or atypical symptoms during the proving period.’
‘... more typical symptoms found for [the] Cantharis intake were…accompanied by more symptoms typical for Cantharis in those provers who took placebo’
‘The materia medica expert was unable to determine the correct medicine from the randomly organised experimental data she was given’
Once this somewhat abstruse paper is examined it becomes apparent it is actually the perfect object lesson on the attitude of the homeopathic researcher to evidence.
To summarise; the research team got a group of healthy homeopathic students to keep a symptom diary for a while. Then, to test the effect of the proving of a homeopathic remedy, half of them were given a remedy (Cantharis), randomly chosen from a list of twelve different remedies, and the other half were given placebo, which they took for another period while continuing to record their symptom diary.
Once the test period was over, the diaries were scrutinised to see which symptoms coincided with those listed in the homeopathic materia medica for the chosen remedy before and after starting the proving and a comparison made between the control and verum groups for both periods. In addition the symptoms described by the participants were shown to an expert, ‘knowledgeable about materia medica and a well trained homeopathic doctor’ who attempted to identify which remedy had been given on the basis of what the participants had experienced.
The conclusion was that during the entire test period there was no significant difference between the control and verum groups with regards to reported symptoms, and the materia medica expert was unable to identify which remedy had been tested, even after she had been given a massive clue and told the twelve remedies from which the test remedy had been selected.
And you might be forgiven for thinking, well that’s that -
You’d be wrong though. This is homeopathic thinking remember -
As it happens, during the test period of the trial, once the participants started taking their pills the variety and number of symptoms recorded in both groups rose compared with baseline. Analysis also showed an increased correlation with symptoms found in the materia medica entry for Cantharis, again in both groups. The increase was sudden and, most importantly, was identical in both groups -
At this point most researchers would have smelled a rat and had a jolly good look at the effectiveness of the blinding process to see if participants knew which remedy had been chosen from the list of twelve -
But no -
They go on to state “If a non-
For once, words fail me. By this logic there seems to be no possible way for a homeopathic remedy to fail to perform in any sort of trial. If homeopathy appears to cause an effect greater than placebo then hooray, homeopathy works; if homeopathy performs no better than placebo then, hooray, homeopathy works and what’s more, as an added bonus, it also turns the placebo into the same remedy so everyone benefits!
As someone once said, why would anyone need to buy a homeopathic remedy ever again?
Walach, H., Jonas, W. and Lewith, G. (2005) ‘Are the clinical effects of homoeopathy placebo effects?’, Lancet, vol. 366, no. 9503, p. 2081. (this article is a response to Shang et al, 2005)
Walach, H., Jonas, W.B., Ives, J.,D., Van Wijk, R. and Weingartner, O. (2005) ‘Research on Homeopathy: State of the Art’, Journal of Alternative and Complementary Medicine, vol. 11, no. 5, pp. 813-
White, A., Slade, P., Hunt, C., Hart, A. and Ernst, E. (2003) ‘Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised placebo controlled trial’, Thorax, vol. 58, pp. 317-
This is a randomised, double blind, placebo controlled trial of individualised homeopathic treatments, prescribed by experienced homeopathic practitioners, looking at quality of life indices which provides no evidence whatsoever that homeopathic remedies are superior to placebo in children with mild to moderate asthma. This is everything a homeopath could possibly wish for in a trial and still it shows it's utterly ineffective.
White, P., Bishop, F.L., Prescott, P., Scott, C., Little, P. and Lewith, G. (2012) ‘Practice, practitioner, or placebo? A multifactorial, mixed-
“Improvements occurred from baseline for all interventions with no significant differences between real and placebo acupuncture...
... acupuncture has no specific efficacy over either placebo. The individual practitioner and the patient's belief had a significant effect on outcome. The 2 placebos were equally as effective and credible as acupuncture.”
Responses: [skeptvet blog]
“If you must, borrow this book from a library. It will give you some insight into the homoeopath’s mind if you are curious but in this reviewer’s opinion, it has no place on the shelves of a veterinary practice.”
This is a review of arch veterinary homeopath Chris Day’s book, published in the prestigious Journal of Small Animal Practice. The reviewer pulls no punches, at one point stating ‘[Day] is very keen on what he calls the logic of homoeopathy but his attempts at logical argument are thin and woolly’ and describing Day’s peculiar theories about the homeopathic treatment of dental disease as ‘utter rubbish’. No argument from the chaps at RationalVetMed there.