PAAM Medical Newsletter, Vol. 2, Issue 3, July 15, 2015
Dear PAAM Members!
Welcome to another edition of the PAAM Medical Newsletter. Thank you to all who have renewed their membership and thank you also to all new members! We hope that belonging to PAAM will be worthwhile to you. Your membership certainly makes PAAM stronger and helps support the anthroposophical medical movement in the US and North America. Thank you. We appreciate your involvement.
Please note: This Letter is for your thoughtful consideration and personal research and is not to be taken as something dogmatic to believe in nor promote as something official from PAAM or the international anthroposophic medical movement.
This medical newsletter is about the complex topic of homeopathy, and anthroposophic medicine’s relationship to it. Most of you are probably aware that homeopathy is a controversial topic, especially in terms of its biological plausibility and its efficacy in treatment. Before we start I want to introduce a meditative saying that Rudolf Steiner gave to the members of the General Anthroposophical Society as a motto for how to orient oneself and work in the world:
Seek the truly practical life,
But seek it in such a way that you do not become blind
To the spirit working in it.
Seek the spirit,
But do not seek it out of spiritual greed,
But rather seek it
Because you wish to selflessly apply it
In the practical life in the material world.
Apply the ancient principle:
Spirit is never without matter,
Matter never without spirit
In such a way that you say:
We wish to work in all that is material in the light of the spirit,
And we wish to seek the light of the spirit,
That it may develop warmth for our practical work.
Rudolf Steiner
9/24/1924
May the above saying be a unfailing guide in our work as AM practitioners!
Now for a bit of historical perspective on homeopathy. In the 1990s and early 2000s there were several positive RCTs on homeopathic treatment for various human ailments. Most were small (less than 200), but not all. Then in the Lancet in 1997 there was a meta-analysis on 89 of 119 homeopathic RCTs done by Linde K, et. al. showing that the positive results on RCT data could not be due to chance or placebo (Linde K, et. al. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997; 350: 834-843). Linde’s group published another paper in 1999, showing that the higher quality RCTs on homeopathic treatment were less positive than when evaluating all the RCTs available for analysis (Linde K, et al. Impact of study quality on outcome in placebo-controlled trials of homeopathy. J Clin Epidemiol 1999; 52(7): 631-636).
As you can well imagine, these two papers, and others, created a controversy in the mainstream medical literature. Most allopaths were clearly against admitting that homeopathy would have any benefit beyond the accepted placebo effect. The positive placebo effect was thought to be from the “sugar pills” or from the time and attention given by the homeopath, or both. As it has been repeatedly argued, that there is no rational or material basis for using pills at such high dilutions, because any rational, scientific person knows there no original substance present in potencies higher than 24X (Recall that Avogrado’s number or constant, 6.022 x 10²³, relates the amount of substance, atoms or molecules, and its molecular weight. For example, 1 gram or mole of a pure substance, atom or molecule, has 6.022 x 10²³ particles in it). Therefore, since homeopathic remedies contradict what material science and modern atomic theory say, it doesn’t matter if some RCTs are positives, it can’t be because of any active remedy present in it but instead must be from the placebo effects associated with homeopathic treatment.
Then comes modern medicine’s definitive RCT to “debunk” homeopathy’s efficacy in Shang, et. al. meta-analysis in the Lancet, 2005 (Shang A, et. al. Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy. Lancet 2005; 366: 726-32). This paper looked at an arbitrarily defined group of large, well-designed RCTs and concluded that there was no statistical difference between the treated groups and placebo.
Attached Literature
Attachment #1. Here are a collection of letters criticizing the meta-analysis by Shang A, et.al. The point of many of the letters is that there were several potential and serious biases in the method of their meta-analysis. Since 2005, there have been more RCTs on homeopathy. In the journal, Homeopathy, there was a recent paper published showing their methodology of collecting all RCTs, even ones left out by previous meta-analyses and all new ones published since 2005. Their intent is to analyze these RCTs in an appropriate, transparent and fair way and publish their future results. Keep your eyes open for this study and bring it to my attention and we can put it in a future medical newsletter.
Attachment #2 and Attachment #3. These are two journal articles written by Dutch homeopaths and a supporter for research funding of homeopathy critiquing the methodology and conclusions of Shang et .al.’s 2005 meta-analysis. These two papers bring various and important methodological points. They certainly put in doubt the certainty of the negative conclusions by Shang et.al. These two papers cannot, however, prove (or disprove) the efficacy of homeopathy. They do help clinicians better understand research methodology and biostatistics and help us become better readers of the medical literature.
Attachment #4. This is a short commentary in the BMJ by a GP in Glasgow, Scotland. He is unable to think of homeopathy as scientific on the material sense of having efficacious substances, but still thinks it is “good medicine” because of the practitioners are good, caring people providing a good, therapeutic relationship and addressing complaints and ailments that conventional medicine is poor at handling. Moreover, conventional medicine can oftentimes do little good and has the potential for doing much harm, while homeopathy, in his opinion, is safe, with little potential harm and the potential to do much good. He seems to feel homeopathy is here to stay, must be accepted because patients desire it, seems to be cost effective, and its safety and regulation by the NHS is good. One can sense this GP’s rapprochement with the clinical facts related to homeopathy: patients desire it, medical practitioners are using it, it is safe and of low cost, and it seems to work for functional conditions and complaints. However, he doesn’t believe the remedies have any active ingredients (remember Avogrado’s number) nor can it treat any real disease that can “cure infection, degenerative conditions or cancer”. His materialist belief is so strong that he demands that any claims that homeopathy can treat real diseases as above “must be vigorously denounced”. No room for changing the materialist project and paradigm here; all notions of the supersensible working in the material world( “spirit is never without matter, matter never without spirit”) must be eradicated with missionary zeal!
Attachment #5. This is a newsletter article written by Dana Ullman, M.P.H., who is a leading homeopath and writer in the US. He writes an easy to read news article showing that some top scientists are interested in homeopathy and studying it real effects. He briefly reviews some of the more recent literature on hormesis, nanoparticles, and altered structure of water (“memory of water”) as aspects of science that gives credence to homeopathic treatment with potentized remedies. The references he has might be helpful to you.
Attachment #6. This is a fascinating research paper by Indian scientists showing how succussion, vortexing, ultrasonication, and other mixing processes, along with serial dilutions can still have the detectable presence of nanoparticles from the original source substance, even up to 12C to 14 C (10²⁴ to 10²⁸ dilution). They go over the mechanism in detail. Figure 8 in the paper gives a visual summary of how this occurs. They do point out, however, that at 12C to 15C potencies, there are more variations in the retained concentrations of nanoparticles, “pointing to the extreme sensitivity of the method in which the dilutions are actually carried out.” This alludes to the problem of reproducibility of results in homeopathy, and especially at higher dilutions. The researchers did not report on potencies higher than 15C (10³⁰ dilution).
Contributions
Attachment #7. Peter Hinderberger, the President of PAAM, offers us a report on how Rudolf Steiner recommended homeopathic remedies and their potency selection, as well as simple dilutions of substances for the cases Ita Wegman, M.D. asked for his consultation. Steiner wanted to use substances from the realms of nature, alchemically prepared, and used innovative dilutions and potencies. In terms of homeopathic potencies, he stayed in the “middle realm” where the dilutions and potencies worked on the 4 members of the human being, and where freedom and karma of the patient can be respected. He never recommended allopathic drugs that work very physically and can harden the person, nor did he recommend extremely high potencies that may work more spiritually and potently, but also more compellingly on the patient. As Peter points out, Steiner also didn’t recommend supplements. However, Steiner did recommend specially prepared supplements ( for example, a calcium preparation) for general hygienic purposes to the malnourished children at the Stuttgart Waldorf School. For Steiner it was axiomatic that popular supplements we see today couldn’t replace the health-giving benefits of organic, bio-dynamically prepared food, nor the importance of an accurate, anthroposophical diagnosis and treatment. Some may ask why Christ was mentioned in this report. First, Steiner was speaking to physicians and Christian Community priests who desired that he given a course on “pastoral medicine”. Second, in Steiner’s view Christ is a high, cosmic and universal Being that has united his life and being with all of humanity and with the earth for our, and the earth’s, eventual transformation and progression. Most religions have had some connection with the Christ Being, called by another name, and Steiner’s conception and perception of Christ goes in new directions in terms of the universality of his Being and his working in nature and the spiritual world.
This ends the PAAM Medical Newsletter on homeopathy and anthroposophic medicine, part 1! There will be a part 2 with the next medical newsletter.
Once again, thank you for your support of PAAM and for the contributions you bring to this newsletter.
For the PAAM Board,
Ricardo Bartelme, M.D.