Another debunker debunked
Dr. Bernado Merizalde,
assistant clinical professor at Thomas Jefferson University in Philadelphia
Dr. Gleb Tsipursky, an assistant professor of history at Ohio State University, wrote in a recent issue of the Scientific American, "Unfortunately, non-specialists—'community members'—are too easily fooled by false but emotionally appealing claims. For instance, the homeopathy industry is a multi-billion dollar business. Homeopathy is based on the false claim of the benefit of super-diluted substances and the principle of 'like cures like.' While it has been debunked by hundreds of studies, people still want to believe in magic-like cures. Homeopathy is not harmless, yet despite the fact that it kills people every day, only recently has the federal government taken steps to address this problem. But under the new guidelines, these steps could be rolled back, and the CDC might have to take homeopathy 'under consideration.'"
Dr. Bernado Merizalde, assistant clinical professor at Thomas Jefferson University in Philadelphia, responded to the above piece by Dr. Tsipursky's in the following:
Biology & Medicine
Dear Mrs. Brainard,
In the Scientific American on-line column "Observations" from December 16, 2017, Dr. Tsipursky rightfully denounces the current US administration's unconscionable attack on science, risking a regression to the dark ages and the hard-earned accomplishments of modern civilization. However, an "all-or-none" stance in this matter is equally troublesome, and illogical.
Though the benefits of "science-based" and "evidence-based" approaches to life matters and medicine are significant and important, standards set with rigid pronouncements around these concepts are also problematic. It is not uncommon, and a remarkable aspect of science, that yesterday's evidence based theory is replaced with new findings. These reviews and revisions of theories is done, usually and necessarily, based on concrete, empirical, evidence. The challenge is to determine how that empirical data is gathered and analyzed.
Science is based on concrete facts, recorded through repeated observations and experiments, and with the requisite replication by independent and non-biased individuals. There is no such thing as "alternative facts," they are just different interpretations of facts; often, such interpretations can be found to violate the principles of logic and reason, and suffer from readily identifiable errors. According to these premises, your piece is gravely imbued with such errors.
Most of his statements regarding homeopathy suffer from unwarranted exaggerations, hasty generalizations, arguments from consequence, and other errors that betray the overall reasonableness and accuracy of your piece. These errors are even more flagrant considering you are supposed to be a historian of science. Other historians of science and medicine: Harris L. Coulter; John S Haller, Jr; and Naomi Rogers, have published truly objective and unbiased work as unaffiliated professionals outside of the homeopathic community. Their work should be consulted to get the greater picture.
The first misrepresentation in that piece is to state that the homeopathic industry is a "multi-billion dollar business." In fact, it is no more than 2-3 billion, and this represents only about 2-3% of the market of pharmaceutical products. Homeopathic products are not patentable, and the profit margins and revenues are comparatively very small for these manufacturers.
The second error, which exemplifies your ignorance about the subject, is to assert that homeopathy is solely based on "super-diluted substances." The fact is, a large number of homeopathic treatments are carried out with what are called "low dynamizations," which are well within the range of modern scientific measurement instruments. In addition, there are dozens of studies showing the biological effects of dynamizations (potentized solutions by the homeopathic pharmaceutical methodology) that are beyond the so called "Avogadro's number".
The third error is and to reject the principle of similarity, "let likes cure likes." Contrary to common assumptions, Samuel Hahnemann was a prominent physician and scientist prior to his developing and espousing the principles of homeopathy. He came to such conclusions after years of study and research, acknowledging that the idea was not original but had been articulated by Hippocrates hundreds of years before. Hahnemann followed the scientific standards of his time, influenced by Aristotle and Francis Bacon, pioneers of the scientific method. Accordingly, his explanations of the homeopathic phenomenon were based on ideas and theories of his time. Yet there is usually a double standard when scientists pass judgement on Hahnemann, focusing on his shortcomings, while individuals like Harvey, Newton and Galileo are forgiven their blunders.
Hahnemann was the first individual to seriously make note of the biphasic action of various substances, such as the initial activation of alcohol or coffee followed by depressing effects. Such phenomena have been evaluated through hundreds of experiments around the world, led by professor Edward Calabrese from the University of Massachussetts, and his colleagues. Such research can be easily found under the name of "hormesis," according to which low dosages of substances can produce the opposite effect from high dosages. This has been confirmed in hundreds of in-vitro and in-vivo studies, in plants, animals and humans.
Fourthly, there are no "hundreds of studies' proving that homeopathy doesn't work; there are less than two dozen studies in this category, and the great majority of them are flawed. The irony is that most of the valid negative studies about homeopathy have been conducted within the homeopathic community. Though it is true that the evidence for homeopathy coming from systematic reviews is very slim, it still accounts as evidence; some is more than none and it is illogical and irrational to dismiss data just because it is anomalous.
The negative systematic reviews of homeopathy are based on flawed studies that do not follow in any way, the original protocol to test homeopathy. This is a violation of the scientific paradigm, which stresses the need to follow closely the research protocol if the experiment is to be replicated.
Those, so called experts, which are no more than pseudo-skeptics with an ax to grind while justifying their odious role as "debunkers," have, with prejudice, ignored basic steps in the research protocol, such as the need to individualize the medicine to the patient and not use a medicine based on the general pathology. Therefore, studies performed without following the basic tenets of homeopathy, and without following the external validity standards from two hundred years of experienced homeopaths, is anti-scientific. They should be ashamed of themselves and their work.
Conversely, thousand of educated professional have individually and independently replicated and corroborated Hahnemann's original scientific protocol, and have expanded the paradigm to include hundreds of medicines, treated hundreds of diseases and clarified practice parameters.
There are at least six meta-analysis for randomized controlled studies showing that there is evidence for the positive effect of homeopathy beyond the placebo effect. There are hundreds of positive studies showing homeopathy's efficacy. Nonetheless, as pointed out by these reviews, a majority of studies, showing positive effective, follow defective methodology. Yet, the analysis still comes out slightly positive despite that fact and still leaves hundreds of studies showing a reliable positive effect, without counting the thousands of reliable and significant case reports published in the literature.
The fifth error regards the slanderous statement that homeopathy kills people daily. Homeopathy has been proven basically harmless, especially when compared to the toxic effects of conventional pharmaceuticals, the third cause of mortality in the world. This evidence was presented, at the hearings called by the Food and Drug Administration during April 20 & 21, 2015, by Dr. Edward P. Krenzelok, from the Rocky Mountain Poison and Drug Center. Dr Krenzelok's data concluded that: "over 98% of the exposures to the homeopathic agents resulted in either no affect or only a minor affect." This corresponds to the results found in the over two hundred years of the use of homeopathy by hundreds of thousands of practitioners around the world treating millions of people.
The recent case of Belladonna toxicity from "teething tablets" is caused by misunderstanding and misattribution of what is homeopathy and its effects. However, it is true that the teething tablets evaluated showed inconsistent concentrations of the active products and the FDA's requirement to follow manufacturing standards is understandable and well within it's function in assuring the greatest product safety for the public.
It is true that some patients may be harmed by delaying medical treatment while relying exclusively on homeopathic medicines. Homeopathy is a medical treatment and should be directed and followed by a duly trained and licensed healthcare practitioner, even if, as in conventional medicine, such products are available over the counter. That is the reason there are warnings and directions on the product's packaging recommending a consultation with a physician is symptoms don't improve in a reasonable timeframe.
Finally, the most significant evidence of Dr. Tsipurski's ignorance about homeopathy and homeopathy's history, something that should have been well within his area of specialty, is the fact that homeopaths used homeopathy for the effective treatment of deadly infectious diseases and epidemics for over 100 years before the advent of antimicrobials. Hundreds of case reports are published in hundreds of peer reviewed journals during the time. The mortality rate during influenza, pneumonia, scarlet fever, cholera and yellow fever, was extraordinarily lower than the conventional approaches, even when the most harmful and aggressive conventional approaches, which contributed to the death of many, were out of favor.
Homeopathic medicine is a historically and scientifically proven method of healing, which is clinically and cost effective, if you look at all the available evidence. It is not just insensate to limit its use but unethical to withhold such a treatment.
Dismissing it because the data is anomalous is contrary to the history of science, built on the advance of knowledge and technology through the explanation of anomalies. Dismissing homeopathy because there is, currently, no plausible mechanism of action is like rejecting the law of gravity because we don't understand it. Of course, the law of gravity is more evident and convincing through its effects, but homeopathy's effects can be evidenced when you take the trouble to research it dispassionately and objectively.
It is puzzling to see a supposed professional err so gravely in his own field of specialization. It should give pause to explore the underlying bias. Otherwise, he is falling short of his Pro-Truth movement, and its espousal of "science-based strategies to fight against fake news, alternative facts, and post-truth politics."
As pointed out in this piece, Dr. Tsipursky has not carefully fact-checked his data to confirm whether his statements are true or false; he has shown not to be balanced and shared the whole truth regarding homeopathy; has not cited his sources; has not distinguished between his opinions and the facts; has not acknowledged the true information within the homeopathic history and literature, even if he disagrees with it.
Hopefully, in the spirit of the espoused values he will re-evaluate his statements, and consider the totality of facts. Homeopathy has several weaknesses for sure, and they should be open to inquiry and criticism. There are true experts in homeopathy; not anybody has the experience or knowledge to sort out the valid and reliable data within the field."
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