What can Anton Chekhov tell us about the placebo effect?
Chekhov is best known as a great writer of short stories. But he was also a doctor and wrote many tales of medicine and doctors in everyday life.
But recently, again, I have seen homeopaths claim that Chekhov “used [homeopathy] and swore by its curative effects”. No doubt, the source for such claims come from the American homeopathy entrepreneur, Dana Ullman. His book, The Homeopathic Revolution, Why Famous People and Cultural Heroes Choose Homeopathy, is full of claims of support for homeopathy where often this is highly dubious. (We have already extensively dismissed his attempts to co-opt people such as Charles Darwin and Florence Nightingale as a believer in homeopathy).
In his book, Ullman starts by undermining his own case that Chekhov was a “literary great who advocated for homeopathy” by saying,
We must be thankful that he wasn’t a homeopath because the joys and the benefits from homeopathic practice might have led him to forego his magnificent contributions to literature.
Nonetheless, Chekhov managed to combine the joys and benefits of being a real doctor with his literary career.
It would appear that homeopaths believe Chekhov was an advocate of homeopathy merely because he wrote about it, most significantly in his short story, Malingerers. Indeed, if you just read the first two-thirds, you may feel that Chekhov had sympathies to the beliefs of homeopaths. But the title of the short story ought to be a clue that it is not as simple as that.
In fact, the story shines light on a crucial aspect of why people can believe inert medicines work and he provides an interesting twist on the placebo effect. It is probably worth reading the whole story before we discuss its implications. It is short and well worth it.
Malingerers
MARFA PETROVNA PETCHONKIN, the General’s widow, who has been practising for ten years as a homeopathic doctor, is seeing patients in her study on one of the Tuesdays in May. On the table before her lie a chest of homeopathic drugs, a book on homeopathy, and bills from a homeopathic chemist. On the wall the letters from some Petersburg homeopath, in Marfa Petrovna’s opinion a very celebrated and great man, hang under glass in a gilt frame, and there also is a portrait of Father Aristark, to whom the lady owes her salvation — that is, the renunciation of pernicious allopathy and the knowledge of the truth. In the vestibule patients are sitting waiting, for the most part peasants. All but two or three of them are barefoot, as the lady has given orders that their ill-smelling boots are to be left in the yard.
Marfa Petrovna has already seen ten patients when she calls the eleventh: “Gavrila Gruzd!”
The door opens and instead of Gavrila Gruzd, Zamuhrishen, a neighbouring landowner who has sunk into poverty, a little old man with sour eyes, and with a gentleman’s cap under his arm, walks into the room. He puts down his stick in the corner, goes up to the lady, and without a word drops on one knee before her.
“What are you about, Kuzma Kuzmitch?” cries the lady in horror, flushing crimson. “For goodness sake!”
“While I live I will not rise,” says Zamuhrishen, bending over her hand. “Let all the world see my homage on my knees, our guardian angel, benefactress of the human race! Let them! Before the good fairy who has given me life, guided me into the path of truth, and enlightened my scepticism I am ready not merely to kneel but to pass through fire, our miraculous healer, mother of the orphan and the widowed! I have recovered. I am a new man, enchantress!”
“I… I am very glad…” mutters the lady, flushing with pleasure. “It’s so pleasant to hear that… Sit down please! Why, you were so seriously ill that Tuesday.”
“Yes indeed, how ill I was! It’s awful to recall it,” says Zamuhrishen, taking a seat. “I had rheumatism in every part and every organ. I have been in misery for eight years, I’ve had no rest from it… by day or by night, my benefactress. I have consulted doctors, and I went to professors at Kazan; I have tried all sorts of mud-baths, and drunk waters, and goodness knows what I haven’t tried! I have wasted all my substance on doctors, my beautiful lady. The doctors did me nothing but harm. They drove the disease inwards. Drive in, that they did, but to drive out was beyond their science. All they care about is their fees, the brigands; but as for the benefit of humanity — for that they don’t care a straw. They prescribe some quackery, and you have to drink it. Assassins, that’s the only word for them. If it hadn’t been for you, our angel, I should have been in the grave by now! I went home from you that Tuesday, looked at the pilules that you gave me then, and wondered what good there could be in them. Was it possible that those little grains, scarcely visible, could cure my immense, long-standing disease? That’s what I thought — unbeliever that I was! — and I smiled; but when I took the pilule — it was instantaneous! It was as though I had not been ill, or as though it had been lifted off me. My wife looked at me with her eyes starting out of her head and couldn’t believe it. ‘Why, is it you, Kolya?’ ‘Yes, it is I,’ I said. And we knelt down together before the ikon, and fell to praying for our angel: ‘Send her, O Lord, all that we are feeling!’”
Zamuhrishen wipes his eyes with his sleeve gets up from his chair, and shows a disposition to drop on one knee again; but the lady checks him and makes him sit down.
“It’s not me you must thank,” she says, blushing with excitement and looking enthusiastically at the portrait of Father Aristark. “It’s not my doing…. I am only the obedient instrument.. It’s really a miracle. Rheumatism of eight years’ standing by one pilule of scrofuloso!”
“Excuse me, you were so kind as to give me three pilules. One I took at dinner and the effect was instantaneous! Another in the evening, and the third next day; and since then not a touch! Not a twinge anywhere! And you know I thought I was dying, I had written to Moscow for my son to come! The Lord has given you wisdom, our lady of healing! Now I am walking, and feel as though I were in Paradise. The Tuesday I came to you I was hobbling, and now I am ready to run after a hare…. I could live for a hundred years. There’s only one trouble, our lack of means. I’m well now, but what’s the use of health if there’s nothing to live on? Poverty weighs on me worse than illness…. For example, take this… It’s the time to sow oats, and how is one to sow it if one has no seed? I ought to buy it, but the money… everyone knows how we are off for money….”
“I will give you oats, Kuzma Kuzmitch…. Sit down, sit down. You have so delighted me, you have given me so much pleasure that it’s not you but I that should say thank you!”
“You are our joy! That the Lord should create such goodness! Rejoice, Madam, looking at your good deeds!… While we sinners have no cause for rejoicing in ourselves…. We are paltry, poor-spirited, useless people… a mean lot…. We are only gentry in name, but in a material sense we are the same as peasants, only worse…. We live in stone houses, but it’s a mere make-believe… for the roof leaks. And there is no money to buy wood to mend it with.”
“I’ll give you the wood, Kuzma Kuzmitch.”
Zamuhrishen asks for and gets a cow too, a letter of recommendation for his daughter whom he wants to send to a boarding school, and… touched by the lady’s liberality he whimpers with excess of feeling, twists his mouth, and feels in his pocket for his handkerchief….
Marfa Petrovna sees a red paper slip out of his pocket with his handkerchief and fall noiselessly to the floor.
“I shall never forget it to all eternity…” he mutters, “and I shall make my children and my grandchildren remember it… from generation to generation. ‘See, children,’ I shall say, ‘who has saved me from the grave, who. ..’”
When she has seen her patient out, the lady looks for a minute at Father Aristark with eyes full of tears, then turns her caressing, reverent gaze on the drug chest, the books, the bills, the armchair in which the man she had saved from death has just been sitting, and her eyes fall on the paper just dropped by her patient. She picks up the paper, unfolds it, and sees in it three pilules — the very pilules she had given Zamuhrishen the previous Tuesday.
“They are the very ones,” she thinks puzzled. “… The paper is the same…. He hasn’t even unwrapped them! What has he taken then? Strange…. Surely he wouldn’t try to deceive me!”
And for the first time in her ten years of practice a doubt creeps into Marfa Petrovna’s mind…. She summons the other patients, and while talking to them of their complaints notices what has hitherto slipped by her ears unnoticed. The patients, every one of them as though they were in a conspiracy, first belaud her for their miraculous cure, go into raptures over her medical skill, and abuse allopath doctors, then when she is flushed with excitement, begin holding forth on their needs. One asks for a bit of land to plough, another for wood, a third for permission to shoot in her forests, and so on. She looks at the broad, benevolent countenance of Father Aristark who has revealed the truth to her, and a new truth begins gnawing at her heart. An evil oppressive truth….
The deceitfulness of man!
So, Chekhov was obvoiusly not writing a story about the wonders of homeopathy but about how one homeopath started to doubt the effectiveness of her sugar pills after discovering her patients mislead her.
It’s an example of the effects of placebo. Placebo effects do not just mislead patients, but also practitioners. And this story highlights very well that placebos can give rise to the appearance of effective treatments without any actual healing having taken place. This is an important point in understanding placebos. It is a common misrepresentation to say that placebo effects are about mind-body interactions actually changing the course of an illness for the better.
Indeed, apologists for homeopathy, such as the new leader of the Green Party, make this mistake. Nathalie Bennett commented on homeopathy,
We know the placebo effect is very powerful, and may in fact be the best treatment for some patients with some conditions, but the doctor can’t say “I’m prescribing a placebo”.
So that’s how homeopathy works, and if it is used through the NHS, it does mean people have been checked for cancer etc first.
Is the placebo effect ‘powerful’? Or more specifically, can it actually make a difference to the course of disease? The evidence for this is very poor.
Systematic reviews by Hróbjartsson & Götzsche suggest that there is little evidence that placebos can produce objective results (e.g. reducing death). They looked at studies where a placebo and a ‘no treatment’ group were included and concluded there was “little evidence in general that placebos had powerful clinical effects”. When subjective effects were looked at (e.g. experience of pain), there was a “possible small effect from patient-reported outcomes. ” The results were even less for observer-reported outcomes and results could not be clearly distinguished from bias.
Of course, subjective improvements can represent real benefits to patients. But not always. We need to be careful that we are not witnessing placebo effects arising from various biases and ways of misreporting outcomes.
The Chekhovian placebo response is a good example of where subjective, patient-reported outcomes mislead an observer into thinking a treatment is effective. One may think it is outlandish to think we can explain homeopathy because their patients are trying to gain favour in order to seek other benefits. But such scenarious are not ridiculous.
Indeed, placebo effects may arise from the natural human desire to reciprocate good deeds. A patient may report improvements are greater,or have been achieved earlier, in order to please their therapist. A homeopath may provide a much longer and more empathic consultation that a GP. There will be a natural desire to return that perceived kindness, even if that is done subconsciously. A homeopath may well base a career on the kind words of their clients who bother to come back and report results. It does not require Marfa Petrovna’s deceitful malingerers in order to be fooled by such reports.
But in reporting good results, patients may also be seeking extra benefits for themselves. If you have been following the stories of how UK patients are going to a highly dubious cancer clinic in Texas to receive unproven and questionable treatments for brain tumours, you may well be aware of recent patient blogs of how Dr Burzynski has been telling them they are cancer free (here and here) when their UK oncologists are being much more circumspect.
Telling a patient that they are cancer free at such a stage in their treatment is not just wrong but evil. Given the regime of surgery and drug treatments, it is quite possible that an MRI scan may show little signs of cancerous growth. But that does not mean the cancer is not still there. Telling someone they are cancer free simply will provide Dr Burzynski with more blog and video testimonials of the greatness of his treatments. For patients, the psychological gains to be had in reporting such news are obvious when the alternative is the more doubtful, uncertain and dark views of a real oncologist.
Placebo effects are about changing beliefs and expectations. Those beliefs may be in the patient’s mind. They may be in the practitioner’s mind. Or indeed they even may be in a pet owner’s mind when are talking about animal quackery. Chekhov’s story shows us that it is wrong to see placebo effects as powerful mind-over-body miracles. Placebo effects can be much darker, misleading and dangerous.
I’m surprised Ullman hasn’t claimed Jesus was a homeopath, or maybe he has.
Not sure about Jesus, but he seems to have claimed Moses.
“Moses did not know that he was using Aurum metallicum (gold) to treat despair and hopelessness, just as we homeopaths do today, thousands of years after Moses.”
Dilluted gold to treat depression? Well I guess I’ll buy the wife some Goldshlagger (sp) for our anniversery and she’ll be the happiest spouse ever.
Well, Jesus did turn water into wine. That’s the same as turning water into medicine, isn’t it?
No, if he had been a homoeopath he would have changed wine into (magically shaken) water.
But Jesus wouldn’t have have had a bible (leather bound or otherwise) to succuss it against, now would he!
Succussing against a scroll just wouldn’t have the same effect and a stone tablet would have been waaay too severe.
I think one of the sources of misunderstanding about this is that people tend to think that if a treatment is said to work no better than placebo, this means that it has a placebo effect and that any apparent improvement is down to this. All that it means is that the treatment is no better than a sham treatment, or basically no treatment at all. It is quite possible that much, or even all, of any improvement observed is just down to the natural history of the disease, regression to the mean, or any of the other factors (other than the placebo effect itself) that a placebo control controls for.
Good point, Mojo.
Yes, indeed, it’s a good point and a problem of sloppy terminology. You are right, benefit over placebo is the definition of efficacy, but it is all too easy to allow an equation of all other benefits occurring under trial conditions to be due to a placebos effect. In a formal sense we all know this is untrue, but it is too easy to allow placebo-therapists to implicitly claim the credit for all those other effects.
I think the evidence is concertedly pointing in one direction, the placebo effect on measurable objective outcomes is small to non-existent. Unfortunately, sceptics of a kind-hearted disposition have allowed placebists to co-opt all non-specific effects as placebo effects. Ben Goldacre has, I believe, not helped with this by allowing too much scope for a powerful placebo effect. I have speculated previously whether this because he comes at this from the perspective of a psychiatrist rather than a physician or, in my case, a vet where objective improvements are of overwhelming importance over perceived or reported benefits.
Sorry, poor grammar may have obscured my meaning.
“You are right, benefit over placebo is the definition of efficacy, but it is all too easy to allow an equation of all other benefits occurring under trial conditions WITH a placebo effect.”
this is so boring! it shows that you have ran out of ideas to attack homeopathy, this is a waste of time anyway don’t you have better things to do with your pathetic little life anyway?
Oh wow, you really got us all there. No skeptic has ever been told before that critiquing quackery is a waste of time and we should get a life. No sir, that’s a new one.
I am not criticising skepticism, i am saying that you start sounding like a bunch of old women.
you keep on repeating the same stuff, you have to dig some insignificant crap like this particular post, because you have run out of gas.
in 10 years time you will be still here, repeating ad nauseam the same poor jokes, same attacks that you find so ‘blistering”, homeopathy will still be going on as usual, and life is passing you by.
i was just browsing a few blogs, i have read some interesting stuff here and there on this site (Burzinsky in particular) but come on!
Anyway I am unlikely to be back, I know there is comfort and safety in repetition, but this is simply too much.
While homeopathy exists it remains wrong and it remains wrong in the same ways, so obviously it’s all variations on a theme. But intermittently, homeopaths take the bait and try to defend their nonsense and one has the chance to push them into exploring their views. There is always the hope that a homeopath will see the error of their ways one day, but they usually break and run rather than risk that. For me it’s like playing a game. Set up the pieces and off you go.
This blog has quite a high profile, so casual enquirers into homeopathy will find it. These people may have a vaguely benign view of homeopathy, or have it confused with herbalism. These people can and do learn from what they read.
Here’s the curious thing, udi: out of all the millions of pages of the interwebs you find this blog. You take the time to read it and can only manage one little snarky comment. You presumably are a professional sugar-retailer or one of their deluded fans. Why not stick around and make the best case you can for homeopathy rather than just leaving us with your silly drive-by comment?
Several of us on the same side of the debate are prepared to put in the time and effort. Homeopaths never are. Come on, give us your best shot.
“Why not stick around and make the best case you can for homeopathy”
Because there is no case for homeopathy.
‘Debunking of bad science should be the constant obligation of the science community, even if it takes time away from serious research or seems to be a losing battle’. (from The night is large, Martin Gardner, Penguin Books 1997, p. 171)
udi
I call it a scene from the Animal planet.
That was Udi’s best shot.
“New insights into placebo effect” at http://phys.org/news/2012-08-insights-placebo-effect.html is interesting (2012/08/31).
@Udi: If LGMs brought us homeopathic solutions in their UFOs wouldn’t the woo factor increase the placebo effect. The memory capacity in intergalactic water would surely be stronger than in earth water which has accumulated the dregs of billions of years of recirculation (1000s of years if you are a YEC)
Rule of the internet:
25. Relation to the original topic decreases with every single post
What would name an aggravation of symptoms after taking a homeopathic medicine?
Andy Lewis:
you wrote this message after Mojo located the report submitted to the UK parliamentary committee on Cholera treated by homeopathic medicines or before it?
That post could do with a little more context, you know.
And perhaps some intelligible content.
Give me an ‘L’. Give me another ‘L’.
And what have we got?
But to be serious for a moment, I shall answer your questions precisely and accurately.
1. A fool.
2. Yes.
Your writing matches your name.
The serifs may give my my posts a shaggy look but it’s the default and is the same for everyone else. I’m not sure of your problem. I find Helvetica a bit stark.
Schemeit, you’ve have been many chances to answer on-topic questions and have resolutely failed to do so. If you wish to adopt the startling new tactic of honest relevant discussion, then the option remains open to you. Meantime, I’m content to point and laugh.
I posted 2 links:
These reports very clearly demonstrate that medicines prepared homeopathically alleviate disease and in the defined conditions provided results far superior to the conventional drugs. This cannot be placebo effect. Cholera and the Spanish flu were not self limiting diseases.
The support paper was found by Mr. Mojo in the UK parliamentary proceeding show records exactly in line with the statement defined in the link.
It should come as a surprise to most that there are scientific rules that allow low dilutions with no apparent active chemical to work as medicines. Present laws of Chemistry and Physics do not explain this phenomenon. Authority was involved here, but the purpose was different- see below.
The conventional medical system not only does not acknowledge this possibility, but finds ways to suppress this information as was seen here by not including the Cholera treatment records at the London Homeopathic hospital. If Lord Robert Grosvenor (authority) would not have insisted upon, this report would not be available.
In the conventional medical system, full drug effects are not known and doctors continue to use these drugs on their patients. The patent of Bayer for Aspirin was granted in 1900 and it was killing people in 1918 and doctors were unaware of the reason! (Yes, real medicine has problems. Sometimes there are unwanted side effects, and sometimes people die. That is regrettable and the medical profession has to do their best to minimize them.) 675,000 people died in the USA from flu and effects of Aspirin.
contd.
One homeopathic doctor wrote in 1919: Aspirin and the other coal tar products are condemned as causing great number of unnecessary deaths. The omnipresent Aspirin is the most pernicious drug of all. It beguiles by its quick action of relief of pain, a relief which is but meretricious. In several cases Aspirin weakened the heart, depressed the vital forces (?), increased the mortality in mild cases and made convalesce slower. In all cases it masks the symptoms and renders immeasurably more difficult the selection of curative remedy. Apparently Aspirin bears no curative relation to any disease and it ought to be prohibited. Dr. Guy B. Stearns MD New York.
This is also acknowledged in the following article (after 90 years):
Recently, pulmonary edema was found at autopsy in 46% of 26 salicylate-intoxicated adults. Experimentally, salicylates increase lung fluid and protein levels and impair mucociliary clearance. In 1918, the US Surgeon General, the US Navy, and the Journal of the American Medical Association recommended use of aspirin just before the October death spike. If these recommendations were followed, and if pulmonary edema occurred in 3% of persons, a significant proportion of the deaths may be attributable to aspirin.(2009)
cid.oxfordjournals.org/content/49/9/1405.full
Placebo effect generally means that the patient recovers from disease but the reason is not necessarily the effect of medicine.
How would you define an aggravation in symptoms consequent to taking a medicine?
That is only partially right and for objectively measurable outcomes it is almost entirely wrong.
Read again Mojo’s comment in this blog at September 5, 2012 at 9:49 am.
If homeopathic remedies only elicit a placebo effect they are close to useless, but they are also not operating according to any of the basic principles of homeopathy. If you wish to co-opt the placebo effect then ‘like cures like’, potentisation and he whole of the rest of the homeopathic ritual are irrelevant.
I’m sorry, Schemeit, but you understand your own arguments so poorly that you become incoherent.
Udi should be more respectful after all no one appears to be breaking any laws posting on here. As a homeopathaic supporter I want this blog to continue in the same way with continued contributions from all the regulars.
So if Andy wants to bridge Dr Burzynski with homeopathy and the placebo effect then I say fine why not? Cant give a scientific answer for you regarding substances diluted 10^200 but I have a right to buy the stuff- its my money not yours. The government fortunately realises that.
I see Jeremy Hunt likes homeopathy:http://www.guardian.co.uk/politics/2012/sep/04/jeremy-hunt-nhs-tribute-homeopathy?
and Dr Robert Mathie, the British Homeopathic Association’s Research Adviser, is lead author on “Method for appraising model validity of randomised controlled trials of homeopathic treatment: multi-rater concordance study” at: http://www.biomedcentral.com/1471-2288/12/49.
The methodology is a post hoc review of a homeopathic RCT trial’s published results. Has there ever been a true RCT in homeopathy? How does voting by a board with a preconditioned bias prove anything?
I posted 2 links:
http://homeoint.org/morrell/londonhh/outbreak.htm
http://www.homeopathyforflu.com/dewey.pdf
These reports very clearly demonstrate that medicines prepared homeopathically alleviate disease and in the defined conditions provided results far superior to the conventional drugs. This cannot be placebo effect. Cholera and the Spanish flu were not self limiting diseases.
The support paper was found by Mr. Mojo in the UK parliamentary proceeding show records exactly in line with the statement defined in the link.
It should come as a surprise to most that there are scientific rules that allow low dilutions with no apparent active chemical to work as medicines. Present laws of Chemistry and Physics do not explain this phenomenon. Authority was involved here, but the purpose was different- see below.
The conventional medical system not only does not acknowledge this possibility, but finds ways to suppress this information as was seen here by not including the Cholera treatment records at the London Homeopathic hospital. If Lord Robert Grosvenor (authority) would not have insisted upon, this report would not be available.
In the conventional medical system, full drug effects are not known and doctors continue to use these drugs on their patients. The patent of Bayer for Aspirin was granted in 1900 and it was killing people in 1918 and doctors were unaware of the reason! (Yes, real medicine has problems. Sometimes there are unwanted side effects, and sometimes people die. That is regrettable and the medical profession has to do their best to minimize them.) 675,000 people died in the USA from flu and effects of Aspirin.
One homeopathic doctor wrote in 1919: Aspirin and the other coal tar products are condemned as causing great number of unnecessary deaths. The omnipresent Aspirin is the most pernicious drug of all. It beguiles by its quick action of relief of pain, a relief which is but meretricious. In several cases Aspirin weakened the heart, depressed the vital forces (?), increased the mortality in mild cases and made convalesce slower. In all cases it masks the symptoms and renders immeasurably more difficult the selection of curative remedy. Apparently Aspirin bears no curative relation to any disease and it ought to be prohibited. Dr. Guy B. Stearns MD New York.
This is also acknowledged in the following article (after 90 years):
Recently, pulmonary edema was found at autopsy in 46% of 26 salicylate-intoxicated adults. Experimentally, salicylates increase lung fluid and protein levels and impair mucociliary clearance. In 1918, the US Surgeon General, the US Navy, and the Journal of the American Medical Association recommended use of aspirin just before the October death spike. If these recommendations were followed, and if pulmonary edema occurred in 3% of persons, a significant proportion of the deaths may be attributable to aspirin.(2009)
http://cid.oxfordjournals.org/content/49/9/1405.full
Schemeit
……….The conventional medical system not only does not acknowledge this possibility, but finds ways to suppress this information as was seen here by not including the Cholera treatment records at the London Homeopathic hospital.
You seem surprised!
There is one simple word: Obfuscate.
Here is another: knob.
It’s ironic that homeopaths keep returning to the 1854 cholera epidemic since it is also an iconic moment in the history of epidemiology. This is the moment John Snow made the imaginative leap of plotting the locations of cholera cases onto a map. The map enabled the source of the outbreak to be traced to a water pump on Broad St. Snow famously removed the pump handle, and whether or not this speeded the end of the epidemic, his data and example became a driving force of social reform.
Homeopaths, with their belief in misaims and similars, would never have been able to make such a leap, but there are two larger lessons here:
The first lesson is that the contribution of science to human health extends far beyond medicine, to sewerage works, sanitary living, dry and heated homes, diet etc. This contribution is strengthened by the integration of knowledge. For example the same understanding of bacteria informs antibiotic treatment of infection in people and the maintenance of cleansing bacteria in water treatment plants. CAMs with their seductive “one true cause” or “one true treatment”, apart from being wrong, have nothing to say beyond their own narrow vision.
The second lesson is that if you want to do good in the world you must get your science right first. You must be able to predict the consequences of your actions so that good intentions may actually produce good results. When you confront power and public opinion, you must have robust results presented in a clear and compelling manor or else apathy and existing vested interests will prevail. It is a tragedy that so many people who are rightly dissatisfied with the current social, political and economic status quo, are drawn to CAM, where they are forced to abandon the only set of tools that provides the power to effect the change they seek.
Matt
You missed the second site?
http://www.homeopathyforflu.com/dewey.pdf
I didn’t. It contributes nothing useful. Take this quote as an example,
What aspects of that anecdote would be addressed by a controlled trial?
You’re very good at posting replies, but not very good at showing the ability to think for yourself. As a clue, start by thinking about whether we can possibly how know many of those patients treated “from the beginning” really had influenza.
So, in order to answer my first question, you need to give a specific answer to this: exactly how many of his 150 genuinely had infection by influenza virus? I’ll make it easy by making it multiple-choice.
A. 0
B. 150
C. 30
D. 76
E. 12
F. I don’t know
Badly Shaved Monkey
The word was Obfuscate. I hope you understand the meaning considering you practice it.
Please read it correctly: Very few of the flu patients the doctor treated had pneumonia, and NO one Developed pneumonia where the treatment started with homeopathy.
With Aspirin – read below:
” Recently, pulmonary edema was found at autopsy in 46% of 26 salicylate-intoxicated adults. Experimentally, salicylates increase lung fluid and protein levels and impair mucociliary clearance. In 1918, the US Surgeon General, the US Navy, and the Journal of the American Medical Association recommended use of aspirin just before the October death spike. If these recommendations were followed, and if pulmonary edema occurred in 3% of persons, a significant proportion of the deaths may be attributable to aspirin.(2009)
The difficult part to understand here is that the homeopath doctors saw the impact of Aspirin- “Aspirin and the other coal tar products are condemned as causing great number of unnecessary deaths. The omnipresent Aspirin is the most pernicious drug of all. It beguiles by its quick action of relief of pain, a relief which is but meretricious. In several cases Aspirin weakened the heart, depressed the vital forces (?), increased the mortality in mild cases and made convalesce slower.”
What were the allopaths doing? They had no observation power and no other drug?
Why limit your question to 150:
International Hahnemannian Association recorded 17,000 cases in New York. Connecticut recorded 6602. Philadelphia collected 26,795 cases. Michigan 8000 cases in one plant.
How many of these patients did not have flu? Or of these 150 did have flu? If not, then it gets even better.
Patients who come to homeopathy get well automatically.
BSM: It seems to be the word ‘anecdote’ that Avijit has no comprehension of.
Have Eejit,
You will make no progress by simply repeating the same things. And you very carefully avoid answering specific questions.
Answer my multichoice question. Do nothing else. If you find yourself unable to answer then tell us.
I think we can all agree with that.
Badly Shaved Monkey
There were over 150 genuinely had infection by influenza virus (> 56,000) and MOST were saved.
So in your multiple choice question, you should add, G:The question is incorrect. And the answer is G.
…..I think we can all agree with that.
One more reason why homeopathic treatment is better.
Nice try. No, there is no G, the correct answer is included in possibilities A to F. Is it too hard for you? Just say so and I’m sure BSM will cut it down to three possible answers – he really wants you to succeed!
I was about to write something else, but then I read Vicky’s reply and I like her suggestion.
So, I’ll reduce the options and give you another chance. And remember we are focusing on just one of those anecdotes. Please, concentrate and give your answer to this question and nothing else.
Exactly how many of his 150 genuinely had infection by influenza virus?
C. 30
D. 76
F. I don’t know
Why do I get the impression even cutting it down to three options will be two too many?
@avijit:
If you give people with influenza no treatment at all, MOST will be saved. Your anecdote is useless.
Mojo
……..If you give people with influenza no treatment at all, MOST will be saved.
You always manage to surprise me.
Why did 675,000 Americans die of flu? World wide the figure was > 30 million. Aspirin was a major killer but not all 675,000 died because of Aspirin, or did they?
These people could not be left alone to recover.
…..Your anecdote is useless.
I assumed anecdote is one case at a time. If a few thousand respond to treatment, it is still anecdote or anecdotes?
Badly Shaved Monkey, Alan Henness (aka Zeno),Vicky, Mojo
When I came to this site the first time and read the responses, there was a clear trend: I wrote this:
“I read some of the blogs and the follow up comments. The pattern is quite predictive. If one writer supports alternative medicine, there is a concerted rush to subdue him with multiple mails that include personal attacks, stupid questions, irrational comparisons….. asking for citation for references, if references, then write in your words.
These writers are the same for all blogs –Badly Shaved Monkey. Wills, Vicky, Mojo, Malleus homeopathicum, Andy lewis/Alan Henness . Looks like paid staff.
The scene enacted is right out of the Animal Plant episodes in which a pack of dogs attack a lion. Each dog makes an attack, that is a fake to create a diversion but not one has the capability to make a serious attempt to take on the lion. In between the pack continuously chatter between them to distract the lion. This continues until the lion gets hold of one of the dogs and breaks its neck. The pack then slinks away along with the leader to find a new hunting ground and a wait for a new prey.”
You all are quite predictable and repeatable. Should you not a new strategy.
How many people were infected? The number of deaths means little until you compare it to the number of infected Americans.
According to Taubenberger “Case-fatality rates were >2.5%, compared to <0.1% in other influenza pandemics."
In my eyes that means it’s fair to say that “most were safed” if 3% (I’m feeling generous today) of those infected died.
I’m tempted to say that you could be paid for your comments, but then again – who’d pay for that kind of nonsense?
Just so we’re clear: I’m not paid to comment anywhere on the entire internet, wherever I comment I do it for free. I’m quite sure BMS, Mojo, Alan Henness and the other regulars here aren’t paid.
There’s one exception: I hear that lecanardnoir is totally in Andy Lewis’s pocket.
Even if we were “paid staff” that would not affect the fact that we raise logical points and you reply with irrelevances and evasions. And you’re doing it again now!
We chat because it entertains us. We repeat and refine the questions in order to try to entice you into giving an honest and relevant answer. If you were ever to do that, the discussion would progress. Instead you fail to make any useful or valid arguments at all.
So, once again,
Exactly how many of his 150 genuinely had infection by influenza virus?
C. 30
D. 76
F. I don’t know
Try an honest reply and see what you will find out.
And, by the way, one anecdote or thousands have, for all practical purposes the same value as evidence. Near-zero. You seem genuinely not to understand this. That you can become an adult and have sufficient schooling to be able to use a computer while having such voids in your ability to reason is greatly to be regretted.
BSM said:
Hey, steady on there! Can trying to teach Critical Thinking 101 to someone who so far has shown no ability to learn be classed as ‘entertainment’?
I find masochism entertaining.
🙂
@Avijit
You thought that the majority of those infected with influenza die?
As I mentioned before, apologists for homoeopathy often appear obsessed by money, and unable to believe that anyone would do anything that they weren’t paid to do. Presumably their own personal experience informs this view.
They also often appear rather confused. There was one who showed up on the Grauniad website last week, accused pretty much every other poster in the thread of being a paid shill and of all being the same person, eventually accused himself of being a paid shill, and finally atarted shouting at himself. I hope it didn’t escalate to fisticuffs.
Vicky
……According to Taubenberger “Case-fatality rates were >2.5%, compared to <0.1% in other influenza pandemics."
The data is: World population 1.86 billion. Infected estimated 500 million. Dead estimated 50 million – 100 million. (Taubenberger).
At lower estimate – 50 million represents the 2.69% of the world population and 10% of the infected.
Assuming even the lower %, New York should have 457 dead from 4569 infections (17000), Connecticut 177 dead from 1775 infections (6602), Philadelphia 720 dead from 7203 infections (26795) and Michigan 215 dead from 2150 infections (8000) totaling 1570 dead statistically.
You have to help monkey rephrase his question.
Considering the doctors are talking of the infected cases, (remember homeopath doctors had better observation -Aspirin was pointed out to be a big culprit then-still under debate now) the deaths should be 15700 statistically.
s did not happen.Your question requires
Vicky
(the correct version)
……According to Taubenberger “Case-fatality rates were >2.5%, compared to <0.1% in other influenza pandemics."
The data is: World population 1.86 billion. Infected estimated 500 million. Dead estimated 50 million – 100 million. (Taubenberger).
At lower estimate – 50 million represents the 2.69% of the world population and 10% of the infected.
Assuming even the lower %, New York should have 457 dead from 4569 infections (17000), Connecticut 177 dead from 1775 infections (6602), Philadelphia 720 dead from 7203 infections (26795) and Michigan 215 dead from 2150 infections (8000) totaling 1570 dead statistically.
This did not happen.
Considering the homeopath doctors are talking of the infected cases, (remember homeopath doctors had better observation -Aspirin was pointed out to be a big culprit then-still under debate now) the deaths should be 15700 statistically.
You have to help Monkey rephrase his question.
No, you need to answer it.
The possible reasons debated now do not have much relevance. There was a time for it when this paper was presented in the American journal.
Also the doctors in this paper are writing of confirmed cases of flu being treated. The statistical average death rate for such numbers was over 10%. (3% of 27% at minimum.)
Assumptions now are invalid. The AMA did not dispute these figures. The reason is not difficult to understand. Their opposition to homeopathy would have suffered a serious set back.
Badly Shaved Monkey
This is an interesting site to refer to on the Spanish flu:
http://www.awesomestories.com/assets/dr-victor-vaughan
“The saddest part of my life was when I witnessed the hundreds of deaths of the soldiers in the Army camps and did not know what to do. At that moment I decided never again to prate about the great achievements of medical science and to humbly admit our dense ignorance in this case.”
This was September 1918.
I have a question for you:
In which year did the prescientific medical system change to the scientific medical system and the doctors stopped wrong practices?
Vicky
…..I’m tempted to say that you could be paid for your comments, but then again – who’d pay for that kind of nonsense?
I partly agree with you. I am not paid.
But what I write is not all mine. I string information together for you. It is available if you wish to see it.
…..I’m quite sure BMS, Mojo, Alan Henness and the other regulars here aren’t paid.
How would you know? You work out of the same office?
There’s one exception: I hear that lecanardnoir is totally in Andy Lewis’s pocket.
Which one? This is what Andy Lewis writes: “If I had a pound for every quack who has accused me of being in the pay of ‘Big Pharma’ I would be richer than if I was really in their pay.”
You know how rich he is?
I see your reading comprehension matches your reasoning skills.
I’ve seen those stories before. BSM is right, there are many unknown confounding factors that might have produced those results.
Science has to be built of discreet experiments that follow on from one another. Each successive study verifies earlier findings or rules out alternative explanations.
Where is the 50 year body of work studying homeopathic treatment of flue that shows systematic refinement both of the scientific methodology used in the studies and the homeopathic treatment itself?
[Looks behind sofa]Can’t find it. I think the dog may have eaten it.[/Gives up]
Matt
……I’ve seen those stories before.
The correct word is anecdote.
…….there are many unknown confounding factors that might have produced those results.
This always happens with homeopaths. Lady Luck?
I posted 2 links:
http://homeoint.org/morrell/londonhh/outbreak.htm
http://www.homeopathyforflu.com/dewey.pdf
These reports very clearly demonstrate that medicines prepared homeopathically alleviate disease and in the defined conditions provided results far superior to the conventional drugs. This cannot be placebo effect. Cholera and the Spanish flu were not self limiting diseases.
The support paper was found by Mr. Mojo in the UK parliamentary proceeding show records exactly in line with the statement defined in the link.
It should come as a surprise to most that there are scientific rules that allow low dilutions with no apparent active chemical to work as medicines. Present laws of Chemistry and Physics do not explain this phenomenon. Authority was involved here, but the purpose was different- see below.
Andy Lewis
Providing link to reference is not allowed?
The message with link was put under moderation?
Oh, I thought you meant the links you’d previously given in other discussion threads. If they are only further historical descriptions of cholera and flu outbreaks a hundred years ago, then they’re simply a waste of pixels on my screen.
It’s probably just some sort of anti-spam filter. I’ve had posts with more than one link in them held up in moderation, occasionally for several days. Try reposting them with only one link per post.
For example, I made a post over 11 hours ago that had two links in it. It still has “Your comment is awaiting moderation” above it.
“Cholera and the Spanish flu were not self limiting diseases.”
So, literally every single person who caught them died, did they.
Your links, appear not to be controlled trials (haven’t read them. Life’s too short and I know the stories from other sources). Unless they are controlled trials they are rightly dismissed. You can’t argue your way around this. There is no special way you can look at the anecdotal records to turn them into usable data.
Aspirin has toxicity. We know that. Could the use of drugs whose side effects outweigh their benefits be worse than doing nothing? That is inevitable from the arithmetic. But, you’d need to come up with more that just anecdotes to show that this was true in the specific instances you cite.
I’m quite happy for you to equate homeopathy with doing nothing. That is the point of this blog. You’ve ended up agreeing with us, but you think you have been going the opposite. Once again, it seems you understand your own arguments so poorly that you don’t recognise what you have done.
Well done, you’ve won the argument, by joining our side. It’s a pity you don’t realise this.
Badly Shaved Monkey
…haven’t read them. Life’s too short and I know the stories from other sources).
Is that why you are running a few generations behind?
…….Well done, you’ve won the argument, by joining our side. It’s a pity you don’t realise this.
This is wishful thinking or “I think so”, “therefore you think so”.
Or paste in the URL and write colon for : and dot for one or more of the . so we can see the address without it working as a link.
Aw, nuts. It’s also doing the posting out of sequence thing again.
I posted this;
Badly Shaved Monkey
September 8, 2012 at 11:05 am
Or paste in the URL and write colon for : and dot for one or more of the . so we can see the address without it working as a link.
at the bottom of the thread and it’s turned up higher.
Let’s spin the wheel and see where this goes.
@BSM September 8, 2012 at 11:08 am
Yes, I posted the one about my posts getting caught in moderation as a reply to Schemeit, but it appeared at the bottom.
Let’s see where this one shows up.
It’s just above this one.
Or is it?
In related news;
xkcd [dot] com/917/
Expanding on the problem of biases in uncontrolled data, here’s a link to a thread I’ve started at JREF, that itself links to a blog at SBM.
Unfortunately there have been no takers on the points I’ve made, perhaps it’s too dull.
http://forums.randi.org/showthread.php?t=243535
[See, Schemeit? This is expanding on the topic of a blog in a relevant and, hopefully, informative way]
Note that I am going to respond to this mainly for the sake of exercising my typing fingers.
1. While there may be some humorous name-calling and insults, I suspect what you call “personal insults” are simply the many comments pointing out how deluded and fallacious is your thinking. No apology is needed for that. If you don’t want to be the subject of personal criticism, start making some valid and useful contributions and answer straight questions with honest answers. You have not done this, so far.
2. You think the questions you have been asked are “stupid”. You have clearly misunderstood their intentions and have made no proper attempt to answer. If you did then you might learn that they are not stupid. What they do is cut to the heart of your stupid belief in homeopathy.
3. Show a single example of an “irrational comparison” and justify your choice. Again, I’m afraid that the failure to understand the validity of comparisons we make is at the heart of your problems.
4. Citations are requested for various reasons. An important one is to give context to an assertion so the evidence can be checked. Your citations do not support your assertions, but simply repeat them in the same fallacious manner.
5. You are asked to repeat arguments in your own words to confirm your understanding. You have failed to do this repeatedly so we reasonably conclude that your understanding is faulty.
If you paused for a moment and answered some of our questions simply and honestly then you would learn something useful.
Badly Shaved Monkey
………Citations are requested for various reasons.
I am providing a citation.
http://www.awesomestories.com/assets/dr-victor-vaughan
“The saddest part of my life was when I witnessed the hundreds of deaths of the soldiers in the Army camps and did not know what to do. At that moment I decided never again to prate about the great achievements of medical science and to humbly admit our dense ignorance in this case.”
This was September 1918.
Now answer the question I have for you:
In which year did the prescientific medical system change to the scientific medical system and the doctors stopped wrong practices?
I can answer your questions. There is no exact answer. The application of science to medicine is a continuing enterprise. If it was a done job we would not have idiots who qualify as doctors but then take up homeopathy.
Now you need to answer my questions.
Badly Shaved Monkey
….There is no exact answer. The application of science to medicine is a continuing enterprise.
You do not even attempt to answer the question- In which year did the prescientific medical system change to the scientific medical system and the doctors stopped wrong practices? Is it scientific now?
Then to cover your own weak position you write: If it was a done job we would not have idiots who qualify as doctors but then take up homeopathy. ( These were in their times the best of the group).
If you do not even understand the present status of medical science- if it is scientific or not and when can you put a date or year to the new science – how can you comment on homeopathy that you know nothing about?
Recall the Spanish flu write up: The homeopath doctors asked the conventional doctors to STOP USING Aspirin. This helped saving many possible deaths.
You’re wittering.
I have answered your question. Medicine is still not fully scientific.
However, we do know how to apply scientific methods and we do know, by their application, which things do not work. Homeopathy is one of them. Aspirin in the face of the Spanish flu of 1918-19 ay have been another, but you have not supplied adequate evidence on which to base a conclusion. It would seem to me that in the last 100 years medicine has moved on and this is not a live issue. However, the use of anti-pyretics in acute infectious illness is the subject of debate. If you had any real knowledge of medicine you might be interested in why this is.
I posted in haste. I should have said
“However, we do know how to apply scientific methods and we do know, by their application, some of the things which do not work.”
You might like to read this and see a real doctor discussing the treatment of fever.
http://www.sciencebasedmedicine.org/index.php/vital-signs/
You should read a great deal more at that site.
Avijit
You seem to struggle with the many valid criticisms of the anecdotal evidence that you produce to support your belief in homeopathy. You are deeply antagonistic to medicine. Here is an exercise that will let you employ that antagonism to useful effect.
Read this paper;
http://ctheriogenology.lsu.edu/ct/Issues/PastIssues/2003-1/2003-1FinalWeb.pdf
Answer this question;
Did the use of the drug, aciclovir, save the lives of the six surviving puppies?
You have three answers open to you;
1. Yes. Then give reasons.
2. No. Then give reasons.
3. We have no way of knowing. Then give reasons.
By this time in 2012 many thought that sceptics may have been in a position to celebrate the end of homeopathy. Instead all I see on this blog are posts such as about what happened in 1919 and over the benefits of aciclovir.
So what happened to the end of homeopathy then Andy, Malleus and all those who were so confident that regulation would end homeopathy. Was that all for the sake of exercising your fingers and your bored minds? Was it all just to to scare homeoapths? Maybe you are all really fed up?
Chekhov and bridging homeopathy to Burzynski- is that the best you can do now?
Looks like homeopathy has won hands down in 2012?
The homeopath doctors are of the opinion that the pharmaceutical industry has continued to find ways to marginalize all other medical systems over the past many years.
One of the simple methods used is to evaluate a drug with statistical back up. This looks good (objective values are understood by all), but if the results are any indication, the method is suspect. But this has allowed the industry to take control of the market as scientific medicine ( in turn making others obsolete).
There are many thinking doctors in the medical industry who now question drugs and effects. This is because their own children and family are at the receiving end. The information available on the internet has also made patients ask questions ( doctor is not always right).
In India I see a big hospitals offer more than one stream of doctors and patients are free to make their own choice. I also see the word of mouth publicity as the most important form of reference for a doctor. Alternative medicines are accepted as an alternative and respected.
Homeopathy has not won hands down. But it has a strong position in the medical area in India.
Badly Shaved Monkey
………Answer this question;Did the use of the drug, aciclovir, save the lives of the six surviving puppies?
I will repeat in my words.
The word was Obfuscate. I hope you understand the meaning considering you practice it.
From above:
@tijiva
I don’t expect you to understand this, but it has all to do with BSM’s question (which you still haven’t answered).
Be that as it may, and even if I agreed with you that Taubenberger incorrectly uses the term case fatality rate, your calculations regarding New York still wouldn’t be correct:
In 1918/1919 The state of New York had a population of 10.4 million (NYC: 5.6 million) (source).
10% infected = 1,040,000 (NYC: 560,000) cases
2.5% CFR = 26,000 (NYC: 14,000) deaths
Not that hard, is it?
I don’t mean to say that your other calculations weren’t incorrect, but I thought it would suffice to show how spectacularly wrong your NY calculation was (or do you seriously argue that the whole state of New York only had a population of 46,000 back then?).
Vicky
You cannot be that dumb. You understand statistics?
The figures were for cases that the homeopath doctors presented.
If the figures reported by the doctors was the universe, and the averages same for all cases, this would be the end figure. But as Schemeit says, these were confirmed cases and the average dead should number 10%.
Alternatively you look at Taubenberger’s figures for each state separately and compare. (But why would you?)
Let’s see who doesn’t understand statistics:
you take the International Hahnemannian Association’s records of CASES
and then try to calculate how many of these CASES were infected (according to the homeopaths all of them were infected, hence they called them CASES).
For your own good, stop digging.
(using the incidence rate from another source). ead from 4569 infections (17000), Connecticut 177 dead from 1775 infections (6602), Philadelphia 720 dead from 7203 infections (26795) and Michigan 215 dead from 2150 infections (8000) totaling 1570 dead statistically.
Vicky
You don’t understand medicine and now you show you have no understanding of statistics.
tijiva,
I’ll assume that you really don’t know how stupid your calculation was, so let me take it away from medicine (which you don’t seem to understand too well).
We know that about 10 – 30 % of the world population are left-handed. We also know that there are special shops for left-handed people, where they can buy everything “handedness-specific” from fountain pens to scissors. The “Association of Leftoria” (no need to google them, they’re made up) has published a report saying that in 2010, American left-handed stores had 15 million unique customers. You’re now trying to find out how many of these customers were left-handed by calculating how much 10 – 30 % of 15 million are (1.5 to 4.5 million).
Do you really think that’s a valid calculation? To take the rate of left-handedness in the ”general population” and apply it to ”a subset that very likely has a completely different rate” of left-handedness?
It isn’t, the 10 – 30 % is only applicable to the whole US population (300 million, so about 30 – 90 million Americans are left-handed).
Substitute ‘left-handedness’ with ‘flu’ and ‘left-handed store customers’ with ‘homeopathy flu patients’ and you have your own nonsensical calculation.
I don’t expect you to understand this (if you had you’d have stayed quiet after I pointed out that your calculation was nonsense).
It would really help if you correctly answered BSM’s question but it seems you’re unable to (showing, again, that you don’t know as much about medicine as you think you do – it’s a very easy, very basic question).
If it’s the medical theme you’re having problems with, just answer this: how many percent of left-handed store customers are left-handed?
A. 30
B. 76
C. I don’t know
Disregard the last paragraph – I accidentally hit the “post” button before I was finished.
Vicky
What you write is irrelevant. For homeopaths, each patient who comes in with symptoms is one case and has to be treated accordingly.
Statistics are for the modern(?) scientific medical system.
The results are how you want them to be.
McCormack J and Greenhalgh T. Seeing What You Want To See in Randomized Controlled Studies: versions and perversions of the UKPDS Data BMJ 2000; 320: 1720-1723
Showing you that you don’t know what you’re doing is certainly not irrelevant.
I hope you read the article you’re quoting here, because it offers a good explanation of why some studies of homeopathy claim to find a (small) benefit over placebo. McCormack and Greenhalgh argue that researchers make mistakes in interpreting their results, not that the results themselves are wrong.
Avijit
You have posted more evasions. It’s time for answers.
Read this paper;
http://ctheriogenology.lsu.edu/ct/Issues/PastIssues/2003-1/2003-1FinalWeb.pdf
Answer this question;
Did the use of the drug, aciclovir, save the lives of the six surviving puppies?
You have three answers open to you;
1. Yes. Then give reasons.
2. No. Then give reasons.
3. We have no way of knowing. Then give reasons.
Exactly how many of his 150 genuinely had infection by influenza virus?
C. 30
D. 76
F. I don’t know
Because I am a generous monkey, I’ll give you a quote from Wikipedia that might help with your answer to the flu question.
Badly Shaved Monkey
You require understanding, not generosity. Dr. David Eddy has this to write for the likes of you:
Is conventional medicine doing any better today? In recognizing the problem, yes. But in solving it, unfortunately, no.
Why do physicians vary so much in the way they practice medicine?
At first view, there should be no problem. There are diseases–neatly named and categorized by textbooks, journal articles, and medical specialty societies. There are various procedures physicians can use to diagnose and treat these diseases. It should be possible to determine the value of any particular procedure by applying it to patients who have a disease and observing the outcome. And the rest should be easy–if the outcome is good, the procedure should be used for patients with that disease; if the outcome is bad, it should not. Some variation in practice patterns can be expected due to differences in the incidence of various diseases, patients’ preferences, and the available resources, but these variations should be small and explainable.
The problem of course is that nothing is this simple. Uncertainty, biases, errors, and differences of opinions, motives, and values weaken every link in the chain that connects a patient’s actual condition to the selection of a diagnostic test or treatment.
Uncertainty creeps into medical practice through every pore. Whether a physician is defining a disease, making a diagnosis, selecting a procedure, observing outcomes, assessing probabilities, assigning preferences, or putting it all together, he is walking on very slippery terrain. It is difficult for non physicians, and for many physicians, to appreciate how complex these tasks are, how poorly we understand them, and how easy it is for honest people to come to different conclusions.
After the virus was isolated, what happened to the patients? Was a medicine found to save them from the virus that came with no adverse effects?
Um. I was giving you a clue about the answer as to how many of the 150 patients genuinely had influenza viral infection in the quote from Wm E Leonard taken from Homeopathy in Influenza – a Chorus of Fifty in Harmony. by W.A. Dewey, MD., University of Michigan. The Journal of the American Institute of Homeopathy, May 1921
The clue is in the date. I’m not going to give you any more hints. If my clue does not help you, then answer the questions from your own intellectual resources. Further trite homilies from you on the complexity of medicine are not necessary.
It appears obligatory to remind you yet again of what you are supposed to be answering. No more evasions, please.
Read this paper;
http://ctheriogenology.lsu.edu/ct/Issues/PastIssues/2003-1/2003-1FinalWeb.pdf
Answer this question;
Did the use of the drug, aciclovir, save the lives of the six surviving puppies?
You have three answers open to you;
1. Yes. Then give reasons.
2. No. Then give reasons.
3. We have no way of knowing. Then give reasons.
Exactly how many of Wm E Leonard’s 150 cases genuinely had infection by influenza virus?
C. 30
D. 76
F. I don’t know
Badly Shaved Monkey
I am not clear if the you are the problem or is it the scientific medical system.
The 150 cases reported by the doctor were all patients with flu. So the homeopath looked at each of the 150 patients.
In the scientific medical system, you kill 30% (45 with Aspirin) and then statistically save 105 patients. For the homeopath, because ALL got well: answer stupid questions.
C. 30
D. 76
F. I don’t know
This is the difference between medicines from drugs – especially when it is a matter between life and death.
How do you know that they were genuinely infected with the influenza virus?
Avijit said:
Ah! We’re edging ever closer to your ignorance.
What Alan and Mojo said.
“All” was not one of the remaining options I gave you and there was a good reason for that.
Now, answer the question.
……..How do you know that they were genuinely infected with the influenza virus?
I know as I can read simple English and understand it. I expect you can also read simple English but refuse to understand it, as you have taken a position against homeopathy and now you are facing facts that you find difficult to come to terms with. The problem is that facts are facts. As you saw for the Cholera in England. You dug out the facts.
It was the doctors then who wrote it down. Your grand uncles (in the AMA) did not contest it when the facts were fresh. The reason is understood. What are you trying to contest now?
The word was Obfuscate.
Alan, what new facts do you want to contest and with whom?
Badly Shaved Monkey: Your options are meaningless.
How did the doctors know that the patients were genuinely infected with the influenza virus?
Dowsing?
Ah, but can you dowse for what you don’t know exists?
Oops, Spoilers!!
Another clue for Avijit: look at the title of this paper, which is a favourite with homoeopaths (who like to torture its conclusion into something it doesn’t say). Also, find out what “Oscillococcus” was supposed to be.
Mojo
…..How do you know that they were genuinely infected with the influenza virus?…..
I don’t need to know. There were doctors on the scene. The homeopaths and those trained in the scientific medical system.
The homeopathic doctors knew what the problem was – stupidity and hand wringing of the scientific doctors.
Stupidity as they could not observe that Aspirin was killing patients- ” The mortality rate in a camp was for pneumonia 25.8%. The lieutenant in charge was persuaded to discontinue Aspirin, Digitalis and Quinine and the mortality dropped speedily to 15% with no medicine whatever.”
Hand wringing of Dr. Victor Vaughan – former president of the American Medical Association and then-dean of the Medical School at the University of Michigan – you have noted. He was no push off- medical practice and research. And result: lot of science, statistics and dead patients.
Not an answer.
Try again.
Give a proper answer. Then we can discuss the 100-yr old reports of the use of aspirin and the mortality being ascribed to its use. But not until you answer the questions properly. Because, unless you answer those two simple questions and show some acceptance and understanding of the correct answers you are not going to understand the explanations about the aspirin.
So, try again.
@Avijit
How did the doctors know that the patients were genuinely infected with the influenza virus?
Badly Shaved Monkey
This is rather funny.
During September of 1918, Dr. Victor Vaughan – former president of the American Medical Association and then-dean of the Medical School at the University of Michigan – was summoned to try and figure out why so many people were getting the flu – and dying from it. During the course of his investigation, he observed many sobering situations and reached several startling conclusions:
“The saddest part of my life was when I witnessed the hundreds of deaths of the soldiers in the Army camps and did not know what to do. At that moment I decided never again to prate about the great achievements of medical science and to humbly admit our dense ignorance in this case.”
Homeopathy in Influenza – a Chorus of Fifty in Harmony. by W.A. Dewey, MD., University of Michigan. The Journal of the American Institute of Homeopathy, May 1921.
Both the doctors from were from Michigan(neighbors?) and such differing views?
How is it that Dr. Victor Vaughan missed to direct the questions at Dr. W.A. Dewey, that you are trying to raise now? Statistics was invented after his death in 1929?
[blockquote]Statistics was invented after his death in 1929?[/blockquote]
No, but something else wasn’t discovered until after then…
(But, also, statistics were a less well-established analytical tool in medicine in those days, so it’s partly true)
Anyway, we’re still waiting for you to answer both those multichoice questions. You’ve only got three options in each. Make a guess if you must, but you do then need to try to think of a reason why your guess could be the right answer.
BSM: Perhaps Avijit is confused by having too much choice – maybe you need to cut down the number of choices?
Let’s see what they could be:
C or D
C or F
D or F
Does that help?
Badly Shaved Monkey
……But, also, statistics were a less well-established analytical tool in medicine in those days, so it’s partly true.
Earlier the doctors tried to cure all patients. Statistics was not required. A % value for lost cases was sufficient.
When the scientific medical system realized, that with the drugs available to them, curing 100% patients was impossible, statistics was borrowed from Mathematics to provide cover for failure.
Special words were added to the medical vocabulary – anecdote, argumentum ad populum, RCT, Reductio ad absurdum. New words were added -bollocks,fecking eejit.
You know what you are up to :Obfuscate.
This is what YOU write: “There is no exact answer. The application of science to medicine is a continuing enterprise.” Quite surprising after you continued to ask the question “Iqbal, why were all those prescientific doctors wrong?” joined in chorus with your pack.
As of 1921 September, the system was prescientific. In 2012 you will not commit. Good because for a change you think like one decorated doctor:
“The problem of course is that nothing is this simple. Uncertainty, biases, errors, and differences of opinions, motives, and values weaken every link in the chain that connects a patient’s actual condition to the selection of a diagnostic test or treatment.
Uncertainty creeps into medical practice through every pore. Whether a physician is defining a disease, making a diagnosis, selecting a procedure, observing outcomes, assessing probabilities, assigning preferences, or putting it all together, he is walking on very slippery terrain. It is difficult for non physicians, and for many physicians, to appreciate how complex these tasks are, how poorly we understand them, and how easy it is for honest people to come to different conclusions.”
Take a guess: In which year will the conventional medical system become scientific?
Homeopathy is better in a sense: in epidemics when people start dropping dead, homeopaths are able to save people.
Badly Shaved Monkey
……But, also, statistics were a less well-established analytical tool in medicine in those days, so it’s partly true.
Earlier the doctors tried to cure all patients. Statistics was not required. A % value for lost cases was sufficient.
When the scientific medical system realized, that with the drugs available to them, curing 100% patients was impossible, statistics was borrowed from Mathematics to provide cover for failure.
Special words were added to the medical vocabulary – anecdote, argumentum ad populum, RCT, Reductio ad absurdum. New words were added -bollocks,fecking eejit.
You know what you are up to :Obfuscate.
This is what YOU write: “There is no exact answer. The application of science to medicine is a continuing enterprise.” Quite surprising after you continued to ask the question “….., why were all those prescientific doctors wrong?” joined in chorus with your pack.
As of 1921 September, the system was prescientific. In 2012 you will not commit. Good because for a change you think like one decorated doctor:
“The problem of course is that nothing is this simple. Uncertainty, biases, errors, and differences of opinions, motives, and values weaken every link in the chain that connects a patient’s actual condition to the selection of a diagnostic test or treatment.
Uncertainty creeps into medical practice through every pore. Whether a physician is defining a disease, making a diagnosis, selecting a procedure, observing outcomes, assessing probabilities, assigning preferences, or putting it all together, he is walking on very slippery terrain. It is difficult for non physicians, and for many physicians, to appreciate how complex these tasks are, how poorly we understand them, and how easy it is for honest people to come to different conclusions.”
Take a guess: In which year will the conventional medical system become scientific?
Homeopathy is better in a sense: in epidemics when people start dropping dead, homeopaths are able to save people.
Badly Shaved Monkey
Last paragraph again:
Homeopathy is better in a sense: in epidemics when people start dropping dead, homeopaths are able to save people while scientific doctors kill people and prepare complex statistics to show it was not a medical problem in the first place. (How did the doctors know that the patients were genuinely infected with the influenza virus?)
Oh, and don’t forget about those cute puppies.
Did the use of the drug, aciclovir, save the lives of the six surviving puppies?
You have three answers open to you;
1. Yes. Then give reasons.
2. No. Then give reasons.
3. We have no way of knowing. Then give reasons.
Badly Shaved Monkey
In exchange of the time you spend on learning statistics, you spend on reading homeopathy you would be able to save all the pups all the time.
Not an answer.
Try again.
Nope, still nowhere, Avijit. You’re reading the words, but you are still not comprehending.
Think. It was 1918-19. You have all the facts necessary to answer correctly and then explain your answer. It really is very easy.
Exactly how many of Wm E Leonard’s 150 cases genuinely had infection by influenza virus?
C. 30
D. 76
F. I don’t know
The question about the puppies is easy as well yet you’ve not even tried an answer to that one.
ANDY LEWIS
I AM AMAZED. IF A RESPONSE APPEARS WITH LABQI (Name reversed) the message is put in moderation?
What is the problem?
Why would you want to comment under yet another name?
To make it look as if there’s someone who agrees with him.
Vicky
I wrote
“This is what YOU write: “There is no exact answer. The application of science to medicine is a continuing enterprise.” Quite surprising after you continued to ask the question “….., why were all those prescientific doctors wrong?” joined in chorus with your pack.”
The name appeared at …. and the message was put in arbitration. When I re did the message by removing the name, I could post it.
For arbitration read moderation.
Avijit
You have posted another stream of words, but you have still not made any attempt to answer the two multichoice questions. They’re still there and all you do is make yourself look scared of committing to an answer.
Look, I can answer your questions they’re easy.
I do not know. There are too many doctors still today basing their practice on pre-scientific tropes. It may be that medicine will never become fully scientific, which means that good clinical decision-making will countinue to be unnecessarily diluted by the poor. We will never have perfect knowledge but that is not an excuse for deliberately fostering and perpetuating bad practice.
I notice you have made no attempt to answer the question, “Why were all those prescientific doctors wrong?”. Well, you cannot deny having read it, so let’s add it to the list and call upon you to answer that as well as the two multichoice questions.
Try again…
Badly Shaved Monkey
I see no reason to reply to your question on statistics. In homeopathy a doctor is required to cure EACH patient to the best of his ability.
I think your inability to see the reason exemplifies your problem exactly.
They’re not really questions about “statistics”. I can only assume you are using this as an excuse not to engage seriously with the issues. Your steadfast refusal, thus far, speaks volumes. You have been evading these very simple questions for day after day. I will keep asking them. If you leave and do not return we will still use your behaviour as an example of how homeopaths act when confronted with simple logical argument. It would be so much better just to give it your best shot and answer.
So, let’s try again to get you to answer:
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
No longer? Has avijit/tijiva ever tried to engage in a serious discussion? He’s now pretty much claiming that homeopaths cure all their patients, a claim so ridiculous that not even homeopaths would make it (and, as you know, they do make some ridiculous claims).
I was being polite. Probably a waste of time.
Badly Shaved Monkey
I will expect you to continue to ask irrelevant questions. You remember the report Mojo dug out from the British Parliamentary records. The reason it was included in the first instance:
“That by introducing the returns of homœopathic practitioners they (the Treatment Committee) would not only compromise the value and utility of their averages of Cure, as deduced from the operation of known remedies, but they would give an unjustifiable sanction to an empirical practice, alike opposed to the maintenance of truth and to the progress of science.”
What are you driving at?
Please read: The reason it was NOT included in the first instance:
I’m not going to tell you. It’s obvious to everyone else and it should be obvious to you. By long and bitter experience of discussing with homeopaths if one lays out the arguments and all the explanations, the homeopath will carry on with their nonsense as if the explanation has never been given. Either it does not register in their brains or they consciously avoid what they are being told. I have come to the conclusion that the only chance of getting people like you to accept and understand the arguments that oppose you is to get you to accept explicitly the necessary individual steps.
At the moment you are performing absolutely according to a very familiar pattern of wanting to talk about absolutely anything except answering a question in a manner that you at least suspect will render unsustainable your core belief in homeopathy. I can see why you do it, all I can do is suggest strongly that you stop it.
So, no, I will not give you the answers. Do the work yourself.
Badly Shaved Monkey
………I have come to the conclusion that the only chance of getting people like you to accept and understand the arguments that oppose you is to get you to accept explicitly the necessary individual steps.
This is simple method to cover up of failures. You can do without it.
Why don’t you concentrate upon Mrs. M. Take her to a good homeopath doctor. You will be exposed to another anecdote.
Check SANGUINARIA CAN. But this will only work after the internals of Mrs. M are cleaned of drug effects of what you would have pumped in earlier.
Are you sure her present state is not because of adverse effects of drugs she would have taken earlier on your advice?
More irrelevant wittering instead of answering three simple questions.
Mrs M. is just fine thank you. She’s rather of the ‘get a grip’ persuasion rather than the ‘fetch the quack’ variety. Therein lies another difference between us and you.
Still waiting.
Badly Shaved Monkey
This is EXACTLY the scientific mindset that drove most of the cholera patients to the Middlesex Hospital in place of the homeopathic hospital at the Golden Square and to their death and to be statistics for your breed.
Repeat AGAIN for the flu patients in New York, Connecticut, Philadelphia and the world over.
But that was history and others.
Now it is your own wife. Surprising how you allowed Mrs. M to try acupuncture considering your medical science with statistics does not support it.
Acupuncture long derided by your likes has allowed Mrs. M some comfort.
You should have continued to watch her discomfort, provide pain killers (remember, these have to be continuously repeated and will have some adverse effects. … Yes, real medicine has problems. Sometimes there are unwanted side effects, and sometimes people die. That is regrettable and the medical profession has to do their best to minimize them. Sometimes procedures don’t hold what they promise. People are given medication or operated on in the hopes of prolonging their life or improving their quality of life, and later it is found out that the medication or procedure didn’t do that. The medical profession has to do their best to prevent that. We know of that because of statistics, reviews and meta-analyses…..).
But you did not: However, I see there remains a little nugget of sensible self-preservation and common sense.
This surely is better than: “There is no exact answer. The application of science to medicine is a continuing enterprise.”
You should move back to the scientific medical system and I expect you will have firsthand knowledge of one situation.
You can then discuss the link between medicine and statistics again.
History repeats itself. We should learn from history.
Which one do you prefer?
OK, what that reveals about your attitude to women is actually more offensive than your stonewalling over homeopathy. Mrs. M. does not my need permission to be “allowed to try acupuncture. ”
You also seem not to have understood the arguments I presented in the Spinning Acupuncture blog. I suggest you re-read them if you wish to debate it any further, but to summarise, the relationship of “dry-needling” to ‘real’ acupuncture vests in the coincidence of both involving needles. If dry-needling works, having defined with adequate care what “works” means, then it tells us nothing about chi-based acupuncture.
Badly Shaved Monkey
…..Mrs. M. does not my need permission to be “allowed to try acupuncture. ”
I am sorry, I forgot you are not a doctor, you are a vet.
But what about the scientific reasoning behind it? Mrs. M would not listen to you or not understand?
I regret I missed again, there is nothing in your scientific medical system that you can offer her to improve her condition. Or is there?
…and yet again the attempts to market homoeopathy as complementary to medicine, rather than an alternative to medicine, are shown for the sham that they are.
Mojo
…and yet again the attempts to market homoeopathy as complementary to medicine,
Market what? Homeopathic medicines are always better than drugs. This is proved many times over.
You forgot your hard work in digging out the homeopathic report of the cholera epidemic?
” The question you’re avoiding is why did homoeopathy appear to work spectacularly well during these historical epidemics when good quality modern research shows, at best, results roughly equivalent to statistical ‘noise’?”
You see how “work spectacularly well” can get converted into
“statistical ‘noise’” with the help of statistics.
The reverse of this is equally true.
You forget that it has been pointed out to you that those reports don’t rise above the level of anecdotes.
Properly conducted research into homoeopathy, carried out over the last 20-30 years, fails to establish that homoeopathy works.
Which do you think more likely:
a) homoeopathy worked in 1854 but has for some reason stopped working since then; or
b) the apparent success of homoeopathy in 1854 was the result of other confounding factors, such as the groups of patients not being directly comparable.
He also forgot to actually read the thing – of those few the homeopathic hospital treated, quite a few died.
Avijit said:
No, you’ve forgotten the homeopathic report of the cholera epidemic: how many had influenza, Avijit?
Vicky
……..of those few the homeopathic hospital treated, quite a few died.
I regret I am repeating myself: You don’t understand medicine and now you show you have no understanding of statistics.
Mojo
………the apparent success of homoeopathy in 1854 was the result of other confounding factors, such as the groups of patients not being directly comparable.
Repeat: you have taken a position against homeopathy and now you are facing facts that you find difficult to come to terms with. The problem is that facts are facts. As you saw for the Cholera in England. You dug out the facts.
It was the doctors then who wrote it down. Your great grand uncles (in the reporting section) did their best to avoid the entries as it destroyed their statistics.
“That by introducing the returns of homœopathic practitioners they (the Treatment Committee) would not only compromise the value and utility of their averages of Cure, as deduced from the operation of known remedies, but they would give an unjustifiable sanction to an empirical practice, alike opposed to the maintenance of truth and to the progress of science.”
Anything that you do not understand cannot be the truth.
What are you trying to prove now? And to whom? And what are the “confounding factors” that you have now found? And where from?
Har, har, farkin’ har, har, har.
That was priceless.
Now answer the questions that you keep ignoring.
I’m sorry, but you can’t have it both ways. Either the LHH’s letter is proof of homeopathy’s “superiority” to real medicine, or it isn’t. Above you claimed
yet about 20 % of the LHH’s in-patients died. Did they not receive homeopathy? Or was dying their way of getting well?
btw: What is the standard treatment of cholera? Any idea?
Vicky
….“Patients who come to homeopathy get well automatically.”
You are dumb. You don’t understand sarcasm?
….btw: What is the standard treatment of cholera? Any idea?
It would always depend upon the patient’s symptoms. Treatment is easier in epidemics.
” The great advantage of the homeopathic treatment of epidemics is that the individuality of the patient is not an issue, nor is the skills of individual homeopaths. Once a successful (group of) remedy(ies) is identified any homeopath will be successful. The case is a lot simpler and the skills of the homeopath have less influence on the results. Another reason why these amazing figures come forward from ancient records is that penicillin had not been discovered yet, so the means to treat epidemic diseases was largely absent in allopathic hospitals. And as we know from Hahnemann, a lot of what they did rather speed the process toward death.”
And we know today that Penicillin brought along with Super bugs for which new improved penicillin is under development.
Badly Shaved Monkey
Har, har, farkin’ har, har, har.
From which side of your face did this laughter come from?
As you say, “facts are facts”.
The problem, as far as you are concerned, is that the spectacular effects claimed for homoeopathy in anecdotal accounts are not confirmed in properly conducted trials.
How do you account for the discrepancy between the effects homoeopathy apparently had in 1854 and the lack of efficacy it currently has? You have two* options: either the apparent effects in 1854 were an illusion, or homoeopathy has stopped working at some point in the last 150 years. Which do you think it is?
*Actually, you have a third option: you can ignore the question and the facts, and carry on handwaving. I wonder which option you will take.
Avijit, here’s a passage you quoted yesterday:
Please explain, in your own words, how this is relevant to the discrepancy between the apparent efficacy of homoeopathy (as compared with the “orthodox” treatments of the time) in reports from the 1854 cholera epidemic and the lack of efficacy for homoeopathy found in properly conducted placebo controlled trials.
Come on, Avijit.
When you posted, “as we know from Hahnemann, a lot of what [allopathic hospitals] did rather speed the process toward death”, you were so close to the reason that the reports from the 1854 cholera epidemic can’t offer any real evidence that homoeopathy works.
Just have a little think about it.
Mojo
Please explain, in your own words, how this is relevant to the discrepancy between the apparent efficacy of homoeopathy (as compared with the “orthodox” treatments of the time) in reports from the 1854 cholera epidemic and the lack of efficacy for homoeopathy found in properly conducted placebo controlled trials.
You understand homeopathy? No.
You read the rationale behind REASON for success of homeopathy during epidemics – yes. Did you understand? No. Your position is the same as that of the conventional doctors during the Spanish flu: they continued to give aspirin and the patients continued to die. No observation. No intellect. No analysis capability.
“The great advantage of the homeopathic treatment of epidemics is that the individuality of the patient is not an issue, nor is the skills of individual homeopaths.”
Can you understand the difference in treating an illness and in treating a patient by reading above? Does the ”
properly conducted placebo controlled trials” address this difference?
The term coined for this is anecdote.
What you have posted there has nothing to do with what I asked you.
Please try to think about this. You have cited two sources, one of which says that during a 19th century epidemic a smaller proportion of patients treated at a homoeopathic hospital died than patients at an orthodox hospital, and the other of which says that the treatments used by orthodox hospitals at the time were actually harmful and “did rather speed the process toward death”.
Do you understand why the second source means that we cannot use the first source as evidence that homoeopathy works?
Avijit,
I think your answer to Mojo might usefully include the phrase “appropriate controls”. It’s just a hint.
But, it is a phrase that you might use in other answers as well.
That’s another hint.
I think your answer to Mojo might usefully include the phrase “appropriate controls”. It’s just a hint.
But, it is a phrase that you might use in other answers as well.
That’s another hint.
You’re talking about “individualisation” here, right? It is a common claim of apologists for homoeopathy that controlled trials are not a valid test of homoeopathy because they cannot test an individualised treatment. This is nonsense, of course.
It is trivially easy to come up with a design for a placebo controlled trial of individualised homoeopathy: all you need do is to get a homoeopath to go through their usual consultation process with each patient, and then give the patients in the control group plain sugar pills instead of the magic sugar pills that the homoeopath prescribes.
Bringing up this objection to controlled trials betrays a profound ignorance of the published literature. Not only is it possible to conduct such a trial, and not only have the results of such trials been published, but there’s even been a systematic review of them published 14 years ago. Homoeopaths don’t seem to like to mention it, perhaps because the results were just like the rest of the research into homoeopathy: “The results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. The evidence, however, is not convincing because of methodological shortcomings and inconsistencies”, and crucially, that “when the analysis was restricted to the methodologically best trials no significant effect was seen.”
Oh, and you get points for the extra added irony in your post. You raised the issue of individualisation (“Can you understand the difference in treating an illness and in treating a patient”) directly after a quotation saying that “The great advantage of the homeopathic treatment of epidemics is that the individuality of the patient is not an issue”. In other words, that in epidemics they treat the illness and not the patient.
Mojo
……In other words, that in epidemics they treat the illness and not the patient.
In an epidemic, most patients would show the same symptoms.
……Bringing up this objection to controlled trials betrays a profound ignorance of the published literature. Not only is it possible to conduct such a trial, and not only have the results of such trials been published, but there’s even been a systematic review of them published 14 years ago.
“I wrote that 100 page book a couple of years ago about controlled clinical trials because I got so tired of hearing the medical profession talking about the controlled clinical trial as the gold standard for proving drugs. The idea of the controlled clinical trial as being the standard is based on a completely false supposition – that you can assemble homogeneous groups of patients. We in homeopathy know that this is not possible. In allopathy they’ll take a group of people and arbitrarily designate them as a homogeneous group. Then they’ll give their medicines and placebos and see how many get well and how many don’t get well, etc. The procedure is vicious at its very root. You can’t get a homogeneous group of people no matter how hard you try and the rest is just window dressing. The ultimate effect is to favor the large pharmaceutical manufacturers at the expense of the small pharmaceutical manufacturers. The controlled trials are very expensive. They cost between the 10s and 100s of millions of dollars so that no small manufacturer can afford this, so only the big companies can put the new drugs on the market.” (Harris L. Coulter)
“Be that as it may, the cohort studies of matched controls are flawed from its beginning. Control studies, claimed to be the best way to study drug effects and many other areas in medicine, do not reflect the real future events. As discussed earlier, time evolution being dependent on the complete organism-genotype, phenotype and consciousness, controlled studies only match the phenotype. Many of those studies, if not all of them, have given wrong signals. (Benson K and Hartz AJ. Comparison of Observational Studies and Random Controlled Studies. N.Engl.J.Med 2000; 342: 1878-86.)
“Cross sectional studies of cohorts in quantitative research many times lead to wrong conclusions because of the inherent defects in the reductionist science. Small cohorts many times give favourable results, while larger number of patients included in the study could reverse the outcome.” (Valezquez EJ, Califf RM.All that glitters is not Gold. Lancet 2000;355: 1568-69.)
“A lot of things we absolutely believe in at the moment, based on our intuition, are ultimately absolutely wrong. Large randomized studies did not deliver the goods as expected because we have been treating the human body as bio-medical electro-mechanical machine like a car engine. Human body is much more complicated and follows totally different rules of the game. We need to think afresh. So it’s no surprise that up to one-third of clinical studies lead to conclusions that are later overturned, according to a recent paper in JAMA. (Dr. B M Hegde)
Why should most patients suffering from the same disease in an epidemic show the same symptoms if this is not the case for patients suffering from the same disease outside epidemics?
Incidentally, I notice that you quote an article from the New England Journal of Medicine (Benson K and Hartz AJ. Comparison of Observational Studies and Random Controlled Studies. N.Engl.J.Med 2000; 342: 1878-86.). Unfortunatley for you, the full text of that article is available onlne here. Your quotation does not appear in it.
And the same goes for the Lancet article you cite (Valezquez EJ, Califf RM.All that glitters is not Gold. Lancet 2000;355: 1568-69.), full text available here. The quotation you have posted does not appear in it.
And I’m sure you don’t understand the irony of someone who is arguing that we should take anecdotal accounts over controlled trials posting, “a lot of things we absolutely believe in at the moment, based on our intuition, are ultimately absolutely wrong.”
Did you even read the Lancet paper you cited? Here’s a quotation from its first paragraph: “Rather than being surprised when planned “confirmatory” large-scale randomised controlled trials do not support and even contradict the findings of observational studies, small clinical trials, or secondary analyses, clinicians should be sceptical of therapies for serious chronic diseases that have not been evaluated in clinical trials of adequate size and in populations relevant to typical clinical use.”
The paper is not objecting to the use of RCTs, or calling for anecdotes to be favoured over them. It is arguing that adequately sized trials, on appropriate populations, are needed to assess treatments, because small trials (such as the small pilot studies that homoeopaths so often cite as proof of homoeopathy) may give false positives.
Your NEJM paper doesn’t support your argument that RCTs are flawed either. It actually says that the results of observational studies may be similar to those from RCTs. It certainly doesn’t suggest that RCTs don’t work.
No Mojo, you misunderstand – tijiva has taken up the habit of one of his previous incarnations and is copying the writings of his personal hero Dr Hegde – of course without naming him as the source. If Hegde says that this is what Benson&Hartz and Valezquez&Califf say then how can we doubt that this is what the studies show us? Who are we to think that we can read the sources and interpret them ourselves? We’re not supposed to do that, we’re supposed to find some other “teacher” and throw quotes of him/her at tijiva, otherwise we might accidentally have an intelligent discussion with each other.
BSM, Mojo: pass the popcorn, please.
Avi, I am forced at this point to open my copy of A Young Person’s Guide to the Interwebs: wherein are laid out and explicated all forms of parlance essential to this our digital age and I find the appropriate entry, thus,
Mojo just pwned yo’ sorry ass, ignorant mo’fo”.
At least I think that’s what it says, I have blown coffee down my nostrils and obscured some of the text.
The quotes Ajavit wrongly attributed in fact both come essays by Dr Hegde, a homeopath, published on his own website.
You’re welcome.
skepticat
Dr. Hegde is NOT a homeopath. He is a highly decorated conventional doctor. Check his website again. Do you recognize medical degrees:F.R.C.S., F.R.C.P etc.
I used the summary of his articles.
Mojo
Go through the articles again. Check the outcomes. How long do you require to see results having no meaning before the process is thrown out as irrelevent?
100 years?
“There is no exact answer. The application of science to medicine is a continuing enterprise.”
This will be cited as the reason for throwing out the RCT and bringing in a new trial method.
Alan Henness
You require somthing for your head, popcorns fill in the emptiness?
The articles do not say what you claim they say, as anyone can see by following the links and reading them.
Correction:
The quotes Tijiva wrongly attributed in fact both come essays by Dr Hegde, an apologist for homeopathy, published on his own website.
The point is, Tij, that you lifted quotes from Hegde’s essays and attributed them to other people and claimed they were published in reputable journals.
You’re not quackery’s greatest ambassador.
Dear god avijit, just answer the bloody question(s) and then the discussion can move on. They really are very easy and straight forward, and don’t need to be to long. Seriously, what on earth are you afraid of?
Indeed!
ben lee said:
Just think what it’ll be like if we do ever manage to get an answer and then we start asking difficult questions…
Alan Henness (aka Zeno)
Stupid questions to which you have no answers either?
Stupidity has a degree also? Easy, difficult, more difficult, most difficult, extra difficult and extremely difficult?
Which level are you at?
LOL!
Now, just answer the question: How many?
A new entry to the pack?
4 more posts and STILL no answer, alongside more distractions (homeopathic meds always better than drugs…I won’t rise to that one!). Presumably this is because you can’t answer the 3 very very simple questions put to you?
“A new entry to the pack”. Yup. Long time reader of this blog and have been watching you steadfastly avoid even trying to reply to simple questions for a while now. As BSM said, this is typical behaviour. Prove us wrong and answer them!
Yep, Avijit, blurts another litany of irrelevances, distractions and the incoherently dumb, but still will not answer three simple questions.
This thread is becoming a perfect case-study that can be cited as illustration of how homeopaths react to rational debate. What makes this example interesting is that Avijit has hung around. Usually they run away more quickly. They do then pop up elsewhere, or even back at the same site after an interval and behave as if their prior history did not exist. DUllman is the master of that tactic. Goldfish have a more attentive memory.
Come on, Avijit, give us your answers.
Badly Shaved Monkey
………..This thread is becoming a perfect case-study that can be cited as illustration of how homeopaths react to rational debate. What makes this example interesting is that Avijit has hung around. Usually they run away more quickly.
I believe my tolerance to handle your stupidity levels is higher to those you met with earlier. Also I refuse to be drawn into useless question answer session where a fool asks a question because he does not know the answer himself and does not understand the answer. This is typical behavior repeated in each question answer portion of the blogs.
We are discussing 2 reports based upon case studies, available in official records, showing the effectiveness of homeopathic medicines that were thrown at the faces of people like you in their times. The scientific medicine system had no option but to accept the truth- that homeopathic medicines work better than the chemicals like Aspirin.
Where does the requirement of answering stupid questions raised by you come into this discussion? You know better than the doctors who prepared the report or the doctors who were forced to accept the truth?
If you plan to use statistics to refute the earlier results you prove what the alternative medical system have been saying all along: Statistics are used to cover up failures of the scientific medical system.
Well, let’s focus on one of the “reports”:
About 20% of LHH’s in-patients died. Did they not receive homeopathy? Or was dying their way of getting well?
Vicky
You are wasting time.
Yes, it looks that way.
They do nothing of the sort. If you answered my questions you would begin to find out why. Instead, through your extraordinary arrogance born of deep ignorance you bluster on and on with evasions and irrelevances.
Answer the questions, Avijit. You spend so much time telling us you won’t, yet it would take a fraction of that time to just give answers. And, of course, I know the answers to my questions. So do Vicky, Alan, Mojo, LCN and probably at least two of my dogs. The puppy may not because she is only five months old and has the wits of a peanut. Do you have more wit than a peanut?
Badly Shaved Monkey
……They do nothing of the sort.
Off course not. An objection was raised for accepting the treatment figures of cholera patients from the homeopathic hospital. Only the statistics used then was no. of patients with disease, no. of patients cured, and no. of patients died.
I would recommend that with your science, you travel back in time and inform “orthodox” doctors of the time, the new tool developed by their descendants to get over such embarrassing situation.
2 more posts and STILL no answers. Are you really not able to answer, succinctly and honestly?
Badly Shaved Monkey
………So do Vicky, Alan, Mojo, LCN and probably at least two of my dogs. The puppy may not because she is only five months old and has the wits of a peanut. Do you have more wit than a peanut?
When I equated your actions to a pack of dogs, there was indignation. Now you have put all in the same bracket.
You should have realized, I was writing metaphorically.
No. You are writing bollocks.
Answer the questions.
Psst… has he gone away for good?
Sssshhhh!
Badly Shaved Monkey
Who are you trying to con? Your self?
The objection of the allopaths for not including the data on patients treated for cholera homeopathic medicines is recorded. It was exactly what you are trying to state today. Only the term “empirical practise” is changed to statistics.
The comment for the Spanish flu was even worse. NO discussion taken up on the success of the homeopathic treatment.
” Historical evidence suggests that power players, as early as the founding of the American Medical Association, have used the heavy hand of government to squelch homeopathic physicians. Regulations and license were used to stifle the growth of homeopathy by narrowly restricting which schools can produce new doctors and what their curriculum must teach.”
“To make matters worse insurance companies – another tightly regulated industry – do not cover homeopathic medicine. It is a problem, indeed, for patients who choose alternative medicine to mainstream medicine.”
There is a much larger strategy, you are a small pawn.
Avijit, I missed your reply because it fell off the Recent Posts list very quickly because of the traffic on the WDDTY thread.
But, here you are, determinedly missing the point yet again.
Here are the three questions that you steadfastly refuse even to attempt to answer. Come on, man. Show a bit of intellectual courage and at least try to answer. I’ll not repeat the context of the questions, I think you know it by now;
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
I missed your reply because it fell off the Recent Posts list very quickly because of the traffic on the WDDTY thread.
But, here you are, determinedly missing the point yet again.
Here are the three questions that you steadfastly refuse even to attempt to answer. Come on, man. Show a bit of intellectual courage and at least try to answer. I’ll not repeat the context of the questions, I think you know it by now;
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
Avi
You have now descended to fly-by inanities and are not even pretending to discuss the issues any more. I think you are done here. When you cannot respond to the arguments, you have lost. Please, go away.
Avi has used this formulation before. I cannot shake the image of this Hegde bloke covered from head to foot in brightly coloured paint and pretty ribbons
Badly Shaved Monkey
….. I cannot shake the image of this Hegde bloke covered from head to foot in brightly coloured paint and pretty ribbons..
Dr. Hegde has earned degrees in conventional medicine and surgery that a person of your intellect and education can only dream of. Probably not even understand the meaning of. See if you understand and compare with your academic achievement:
National Academy of Medical Sciences, New Delhi FAMS 2002
Royal College of Physicians, Dublin.(Honorary Fellowship Conferred for Distinction) FRCPI 1999
Royal College of Physicians , Edinburgh. FRCPE 1986
Royal College of Physicians and Surgeons, Glasgow. FRCPG 1985
American College of Cardiology, Bethesda Md.. FACC 1984
Royal College of Physicians, London. FRCP 1981
Royal Colleges of Physicians, UK. MRCP 1969
King George’s Medical College, University of Lucknow. MD 1962-64
Stanley Medical College, Madras University. MBBS 1956-60
Heart and Chest Association of United Kingdom fellowship for training at Brompton Hospital, London.
Commonwealth Fellowship in Cardiology -TWICE- for Cardiology training at the Middlesex Hospital and National Heart Hospital, London.
Research Referee ship award of the Faculty of Medicine, Kuwait University.
Member, International Editorial Board, British Postgraduate Medical Journal, London.
Member, Editorial Board Current Medical Research, Newbury, England.
International Adviser, Royal College of Physicians of London.
None of this means that he is automatically correct about everything.
Mojo
In medical science he surely knows many times more than your pack’s cumulative knowledge.
Unfortunately your secondhand version of what he apparently knows has not enabled you to answer some rather simple questions for yourself. I’ll repeat them shortly.
MSB
So, what? Perhaps you would like to deal with issues that are actually relevant to the topic.
Answer the questions that Avi has run from;
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
And;
4. What did Linus Pauling win his first Nobel Prize for?
Ooh, I forgot that discussion! But now that you mention it, I knew I had a reason to think that the ‘highly decorated doctor’ was a bit past his prime.
btw: Why does “MSB” keep changing his name(and he’s not even very creative, is he)? What comes next, Ojom, Ydna, Riondranacel, Ssennehnala, Onez, Ykciv?
Vicky
Andy Lewis only wants his pack to bark. Others are blocked at will.
MSB is antithesis to BSM. Am I giving hime more than his due? When this new name is blocked, I will use yours.
OK with you?
Nah, Andy does tolerate quite a bit of trolling, but once you fall back to your old bad habits (avoiding even the simplest questions, no actual conversation but instead “cut&paste” of someone else’s material) there’s no point in letting you continue. FFS, if you have to troll this blog at least put some effort in it!
You like big words, don’t you? Better learn their meaning then. The word you’re looking for is “ananym”.
WTF?
Be my guest. Still won’t help you ditch those questions you refuse to answer:
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
4. What did Linus Pauling win his first Nobel Prize for?
You mean Avijit’s not answered these very simple questions yet?
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
4. What did Linus Pauling win his first Nobel Prize for?
Why ever not, I wonder?
Vicky
You are correct for a change.
This is what I expect to do if Andy does not have the understanding to respect opposition to his idiotic writing and block comment as he has continued to do in the past.
Avi
Enough with the prevarications! Just answer these questions.
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
4. What did Linus Pauling win his first Nobel Prize for?
Badly Shaved Monkey
Avi is blocked. I am Avi with a new avatar.
Do not waste time on asking irrelevant questions. Read the texts written by the doctors of the time and try to answer the questions yourself.
Some interesting reading:
Why has allopathy so thoroughly dominated the medical landscape? Has allopathy taken the lion’s share of the market because it is superior to that of homeopathy? If not, why not?
Historical evidence suggests that power players, as early as the founding of the American Medical Association, have used the heavy hand of government to squelch homeopathic physicians. Regulations and licensure were used to stifle the growth of homeopathy by narrowly restricting which schools can produce new doctors and what their curriculum must teach. Today, students must endure roughly ten years of allopathic medicine education and testing before being allowed to practice homeopathy. After being taught for so long that homeopathy is akin to quackery is it any wonder so few aspiring doctors choose to practice homeopathic medicine?
To make matters worse insurance companies – another tightly regulated industry – do not cover homeopathic medicine. It is a problem, indeed, for patients who choose alternative medicine to mainstream medicine. However, so long as individuals may opt out of the corporate circle there exists a healthy market for homeopathy. In come new regulations mandating all individuals purchase corporate insurance and few people will have money left for alternative medicine, such as homeopathy.
With new governmental regulations becoming more asinine by the day one need not try too hard to imagine a future where homeopathy is strictly criminalized. Our hope then lies in patients and doctors willing to break the rules to receive and provide truly free health care. Anarchists of all professions, including doctors, should take the time to better understand the fascism that pervades American medicine. It will surely serve as an excellent recruiting tool for potential fed-up citizens of all backgrounds alike.
I highly recommend a short, yet scary, book on one doctor’s lifelong struggle to practice medicine and the history of American health care. The book is called Medical Conspiracy In America and is available for free online.
You re a small pawn.
Another load of unattributed copy and paste that you show no sign of understanding.
Mojo
…..The book is called Medical Conspiracy In America and is available for free online.
I am aware you are a great digger of information on the internet. Remember the information on Cholera Epidemic of London and the homeopathic results buried in Parliamentary records.
The “Medical Conspiracy …” is available rather easily.
Why not read some pages that you don’t agree and put a rejoinder under “Should WHSmith Stock WDDTY Magazine?”
This information in the book is much more damaging what Andy Lewis is crying about.
…..
Yes, and I remember you posting some copy and paste that said that the medical treatment of the time was harmful and “did rather speed the process toward death”.
That means that all we can say from the 1854 cholera epidemic records is that homoeopath is better then something harmful. This does not mean that homoeopathy works.
And of course, we must not forget that they remain uncontrolled observations- the central fact that Avi seems not to grasp at all.
Badly Shaved Monkey
…..So what..
It is important in specialist area to take seriously a comment from an expert who surely knows better than you.
Time for you to add some paint and understanding.
Avi,
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
4. What did Linus Pauling win his first Nobel Prize for?
P.S. If you don’t understand why those questions are relevant then you are revealed as even more astoundingly ignorant.
The fact that you have evaded them for weeks speaks volumes about you and your ideas.
P.P.S.
I don’t need to read the texts to answer the questions, you twerp. Nor do you. All that is required is at least half a brain and an ounce of common sense. At the moment you seem to have neither.
Badly Shaved Monkey
…..I don’t need to read the texts to answer the questions,…
Of course not. Killing patients with drugs is easy and burying them under statistical data easier.
If you spend more time understanding the way body works, you will be a better doctor.
But of course, you are only a vet.
Checked your credentials against Dr. Hegde? How many coats of paint are required by you?
Avi, once again, here are those questions that you don’t want to try answering;
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
4. What did Linus Pauling win his first Nobel Prize for?
None of them is difficult. You haven’t answered any of them.
You are good bloger.Your writing queality is very nice, and i got so much to learn from your blog. It is in point of fact a great and helpful piece of information. I am glad that you simply shared this useful info with us.
Has Avi finally given up? But, those questions were so easy.
Just as well you didn’t ask him any difficult ones!
I wouldn’t want to have scared him off.
Oh, but he ran away anyway.
Oops. They don’t like it up ’em, Captain.
Alan Henness/Badly Shaved Monkey
Most of us get naueseated with the repeat drivel that your pack posts and walk away.
This is not new to you.
Awww…How cute.
Avi, so you’re still reading these pages and still evading these questions;
1. How many of the patients really had influenza virus?
2. Were the puppies saved by the drug aciclovir?
3. Why did prescientific doctors believe in leeching, purging etc?
4. What did Linus Pauling win his first Nobel Prize for?
This constant evasion makes you look dishonest and clueless.
Let me narrow it down. Just answer the question about the puppies. It’s very easy and plays to your favourite prejudices. Won’t that be fun?
Badly Shaved Monkey
….This constant evasion makes you look dishonest and clueless…
These questions have no bearing on effect of homeopathic remedies as also the 2 cases discussed above.
You are making these dumb questions as you have a closed mind and comment on this blog for some(?) consideration. You seem to do this routinely and the interesting point is that you have no answer to it yourself. Remember the Question: Why were the prescientific…
The red herring?
Were the puppies saved by the drug aciclovir?
Us? I think it’s just you at the moment Avi. Blustering and evading.
But if you are part of a group, why is it that none of you have the ability to engage in this discussion?
Come on, Avi. Answer just one of these easy questions and show us you can think.
Hi Dr. Lewis,
Many thanks for the highly interesting and intriguing header about Tolstoyan medicine as a literary genre. I reckon the story raises a number of important themes for practitioners, especially about the significance and value of clinical judgement.