UWO/UNAM - TNSM - Homeopathy

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Final presentation for the class of Toxicology of Natural Sourced Medicine (EMK Lui)

March 31 st.

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  • Hi im…….
  • Alexander Beydeman (1826—1869) Painting by ABAllopathic medicine refers to the practice of conventional medicine, and especially the practices now referred to as heroic medicine. It was coined by Samuel Hahnemann (1755–1843) in 1810. Although allopathic medicine was rejected as a term by mainstream physicians, it was adopted by physicians with unconventional training to refer pejoratively to physicians who had undergone a more traditional course of educationAllo means different, Where homeo means same, consitent. Implying and underlying idiology
  • costunethicalaviodingconentional medicine
  • Many studies showing publication bias, poor methodological practices, and almost always homeopathic reports are positive and scientific reports are negetive
  • Some conventional remedies do follow this pattern but rarely. Likely not more often than chance
  • Difficult to argue. Beliefs do play a well documented role in medicine. Many accounts that placebo effect is greater if one trusts their physician. Or if treatment is carried about by a religious healer. That’s our perspective as sceintists, but maybe placebo affect and vital force are one in the same. If so patients have the right to retain their beliefs (especially considering in this case it only improves their health)
  • These will be discussed later. But briefly many studies have found effects of homeopathic solutions diluted to the point of no parent molecule still having an effect on cell cultures.How? They say water memory
  • Basophildegranulation assessed by counting cells with metachromatical propertiesPicture:http://image.bloodline.net/stories/storyReader$1676Toluidine blue – positive: basophile (large dark granules)Negative neutrophiles (2)
  • Degranulation observed after exposure of leukocyte preparations to low antiserum dilutionsSuccessive peaks of degranulation varying between 40-60% were found down to 1E60 dilutionWaves of basophildegranulation were also seen with substances other than anti-serum**less than one molecule of Ab….BUT experiments reported detected significant basophildegranulation down to the 1x10120 dilution
  • Observer bias: Lab assistants were being subconsciously selective in the way they interpreted data
  • Aimed to independently replicate former studiesSlightly different methodology: reported inhibitory effect of highly diluted histamine solutions on anti-IgE induced basophildegraulation using flow-cytometryComputer generated randomization
  • One minor statistically significant inhibitory effect at a histamine dilution of 10-22 M, when compared to the effect of water “diluted” to 10-22 MWhen same data were compared a posteriori to other reasonable controls, statistical significance lostPossibly: statistical significance was reached only because the standard deviation of the inhibition with this dilution level happened to be small. Since the p-value is rather modest (p=0.018), the evidence for rejecting the null hypothesis (“no difference between histamine and water dilutions”) is not overwhelming, i.e., it is possible that this result is due to chance only
  • Discussed further by Isboset/Monica…
  • If the hypothesis that all clinical effects of homeopathy are due to placebo is true, all properly conducted placebo-controlled trials on homeopathy would be comparing one placebo to anotherTherefore, overall results should vary randomly around a zero difference btw groups Could falsify placebo hypothesis if all properly conducted comparisons of homeopathy and placebo showed a pooled effect significant different from zero difference, or if there is independently replicated evidence for an effect over place in at least one consistently applied homeopathic approach
  • Are we they hurting anyone?-unethical practices (but we get that in conventional medicine too)-costFailure to use conventional medicine.No FDA regulations or governing body to standardize homeopathic and conventional therapies to eachother.If we could remedy this it would go a long way in harmonizing the two fields as I’m sure no Physician cares how a patient is getting better as long as they get there.section 11 of the Code of Ethics and Practice) states that 'Homeopaths report research findings and clinical experience methodically, honestly and without distortion. All speculative theories will be stated as such and clearly distinguishedSafety concern: some homeopathic practioners recommend against vaccination.
  • As scientists we must accept that we do not know everything; if we did science would cease to exist. Yet, we are often unwiling to accept unconventional methodsSoccer player analogy
  • As scientists we must accept that we do not know everything; if we did science would cease to exist. Yet, we are often unwiling to accept unconventional methodsSoccer player analogy
  • UWO/UNAM - TNSM - Homeopathy

    1. 1. University of Western OntarioDeparment of Physiology and PharmacologyToxicology of Natural Sourced Medicine<br />Jacob Matusinec<br />Isboset Nuñez Luna<br />Monica Rosas Calderón<br />Kristine Smit<br />(March 31th,2011)<br />
    2. 2. Homeopathy<br />
    3. 3. Homeopathy<br />Founded by Samuel Hahnemann in the late 18th century<br />Hahnemann had some prior training in conventional medicine but he found the practice barbaric and cruel .<br /><ul><li>Greatest popularity in 19th century with a revival in the late 20th century. </li></li></ul><li>“Homeopathy watching the Horrors of Allopathy”<br />
    4. 4. Benefits of Homeopathy<br /><ul><li>Generally less invasive and has less side effects than conventional medicine.
    5. 5. Associated with healthier lifestyles
    6. 6. Patients often do report improved symptoms
    7. 7. Even if unsupported by Medical Community it’s not “hurting anyone” (some debate)</li></li></ul><li>Potential criticisms of Homeopathy <br />Lacks scientific evidence<br />Experiments supporting homeopathy often poorly conducted and noreplicable by the scientific community<br /><ul><li>The “Three Pillars” of homeopathy are in conflict with the ideology that makes up Modern Science</li></li></ul><li>THREE PILLARS OF HOMEOPATHY<br />The principal of “Similars”<br /><ul><li>Remedy causes symptoms similar to the disease in healthy people.</li></ul>Quinine and Malaria—cured malaria but caused feverish symptoms in healthy individuals<br />
    8. 8. THREE PILLARS OF HOMEOPATHY<br />The Vital Force<br /><ul><li>Harmonize a person on all levels of their being
    9. 9. Diseases result from disharmonized Vital Force
    10. 10. Based on a belief system rather than science
    11. 11. Belief system that has a long history dating back to the Hippocrates.</li></li></ul><li>THREE PILLARS OF HOMEOPATHY<br />“Potentization” <br />
    12. 12. THREE PILLARS OF HOMEOPATHY<br />“Potentization”<br /><ul><li>Greater potency is achieved as the solution becomes diluted and violently agitated.
    13. 13. Most debated aspect of homeopathy.
    14. 14. Many studies done with differential results
    15. 15. Results tend to depend on the experimenter. </li></li></ul><li>Potentiation Concentration Scale<br /><ul><li>D scale: denotes the extent of dilution, i.e. D10 concentration=10-10
    16. 16. C scale: denotes the number of 1:100 dilutions performed.
    17. 17. D60=C30: Dilution advocated by Hahnemann for most purposes
    18. 18. C15: very unlikely that any of the original molecules of mother tincture still remaining. </li></li></ul><li>Explanations for Potentiation<br />Human basophil degranulation triggered by very dilute antiserum against IgE. Davern E, et al.<br />Many other studies found similar results even at dilutions that could probabilistically do not contain any parent molecules.<br />Usually explained by the concept of “water memory” <br />
    19. 19. History of the Memory of Water<br />Jacques Benveniste (March 1935–October 2004) <br />Benveniste J. Platelet-activating factor, a new mediator of anaphylaxis and immune complex deposition from rabbit and human basophiles. Nature1974; 249: 581-582.<br />“Homeopathy is still not understood, however his efforts started a new era of rigorous scientific investigation of the field”<br />- Alex Tournier (founding director of the Homeopathy Research Institute)<br />
    20. 20. History of the Memory of Water<br />Davenas E, Beauvais F, Amara J et al. HumanbasophildegranulationtriggeredbyverydiluteantiserumagainstIgE. Nature1988; 334: 287-290.<br />“Specific information must have been transmitted during the dilution /shaking process via some molecular organization occurring in the water”<br />
    21. 21. History of the Memory of Water<br />“There were no methodological flaws apparent at the time.” –James Maddox, Nature Editor<br />"There are good and particular reasons why prudent people should, for the time being, suspend judgment“ –JM<br />Committee: <br />James Randi: magician-cum-paranormal researcher<br />Walter Stewart: physicist and freelance debunker at the US NIH<br />
    22. 22. History of the Memory of Water<br />No memory effect was observed in the blinded experiments.<br />Although no fraudwasfound, thelack of reproducibilityledNaturetoconcludethattherewas no substantialbasisforBenveniste’sclaim.<br />
    23. 23. History of the Memory of Water<br />Benveniste and several collaborators worked to find the underlying mechanisms to the results on his original paper.<br />Jacques started working with homeopath E. Attias<br />“Digital Biology: biological interactions could be digitized”<br />
    24. 24. History of the Memory of Water<br />J. Benveniste; P. Jurgens, W. Hsueh and J. Aissa (February 21–26, 1997). "Transatlantic Transfer of Digitized Antigen Signal by Telephone Link". Journal of Allergy and Clinical Immunology.<br />J. Benveniste; Aissa, J., Guillonnet. "The molecular signal is not functional in the absence of "informed water"". Medical Hypotheses54<br />J. Benveniste; Thomas Y, Schiff M, Belkadi L, Jurgens P, Kahhak L (2000). "Activation of human neutrophils by electronically transmitted phorbol-myristate acetate". FASEB Journal13 (1): 33–39<br />
    25. 25. Homeopathy Research<br />
    26. 26. Homeopathy Research<br />Experimental research – study efficacy of homeopathic remedies<br />Basic research – elucidate nature of homeopathic remedies<br />Clinical trials – studies clinical efficacy<br />Theoretical models<br />
    27. 27. Experimental Researchin vitro, cell systems, or in vivo<br />Many models (both plant and animal) exist but only a few have been replicated independently (and quality often poor)<br />Examples: <br />Jacques Benveniste (1988) – IgEdegranulation<br />Independent replication of more recent studies <br />
    28. 28. <ul><li>Crosslinking of IgE molecules triggers granule exocytosis with the release of histamine and loss of metachromatic straining of basophil granules by a basic dye</li></ul>Serially diluted anti-IgE antiserum & measured basophildegranulation at each concentration<br />
    29. 29. Results<br />Successive peaks of degranulation from 40- 60% of the basophils over dilutions of anti-IgE that range from 102 to 10120<br />Less than one molecule of Ab is present when anti-IgE antiserum is diluted to 1014<br />
    30. 30. “Strengths”<br />HOWEVER…<br />Observer bias<br />Some participating laboratories withdrew because effect not consistent with results (not reported)<br />Variability of the positive results was smaller than the statistically expected error or microscopical cell count and found no effect of higher dilutions<br />Control: cells incubated in conditions identical to those with anti-IgE antiserum gave no significant degranulation (antihuman IgG antiserum)<br />Blind double-coded procedures<br />6 different laboratories (in 4 countries)<br />
    31. 31. More Recently (2005)…<br /><ul><li>Staining and microscopical counting of basophils prone to subjective influences (even if method blinded)
    32. 32. Experimenters used flow-cytometryto measure basophildegranulation
    33. 33. Determines % CD63-expressing basophils (those activated)
    34. 34. CD63 expression directly correlates with histamine release
    35. 35. All experiments performed with a blinded and randomised arrangement of dilutions and controls
    36. 36. Aimed to independently replicate former studies, which showed similar findings as Benveniste</li></li></ul><li>Results<br />In contrast to former studies, no large effect of highly diluted histamine solutions on anti-IgE induced basophildegranulation was found<br />
    37. 37. Basic Researchelucidating the nature of homeopathic remedies…<br />To understand mechanism, need to find a plausible theory and experimental backing to clarify how a highly diluted substance can affect a biological system<br />Must explain how a biological effect can be brought about without a sufficient number of molecules of the active agent (found in homeopathetic remedies)<br />
    38. 38. Clinical Research<br />Many scientists  Homeopathy violates natural laws and thus any effect must be a placebo effect<br />Public & some physicians  use of and belief in effectiveness of homeopathy is widespread<br />Is the effect seen with homeopathic remedies equivalent to that seen with placebo?<br />
    39. 39. If the hypothesis that all clinical effects of homeopathy are due to placebo is true:<br />All properly conducted place-controlled trials on homeopathy would be comparing one placebo to another<br />Thus, overall results should vary randomly around a zero difference between groups<br />
    40. 40.
    41. 41. Results not compatible with placebo hypothesis<br />However, insufficient evidence that any single type of homeopathic treatment is clearly effective in any one clinical condition<br />
    42. 42. Systemic Reviews of Clinical Trials on Homeopathy for Specific Conditions<br />
    43. 43. Efficacy/effectiveness paradox: Disputed evidence that homeopathy is different from placebo yet there is documented usefulness in general practice<br />~70% of all patients using homeopathy report they are considerably improved after treatment (effects remain stable during follow-up periods of 2-5 years)<br />Before clinical homeopathy research can proceed with success, needs a viable theory…<br />
    44. 44. Theoretical Models<br />Local<br />Conventional scientific positivism<br />Non-local: quantum theoretical concepts<br />Complementarity<br />Entanglement<br />
    45. 45. Local Mechanisms<br />Homeopathic remedies behave in a way similar to any other medicine<br />The production process produces some kind of template, image, or imprint of the original substance, and this “information” is the active ingredient<br />
    46. 46. Local Mechanisms<br />Hydrogen bonds and van der Waal’s interactions<br />Electric fields can be modified and modulated by their surrounding<br />Laws of thermodynamics?<br />
    47. 47. Examples of local mechanisms<br />Remaining material on surfaces<br />Nanobubbles<br />Remaining particle clusters<br />Ethanol solution complexity<br />Natural water clusters redox molecules produced from water<br />
    48. 48. Non-local Hypotheses<br />“Correlations are somehow established between patient, practitioner and remedy, ultimately leading to an observed change in the patient’s state of health”.<br />Even more controversial than local mechanisms: quantum theory applicable in our macroscopic domain??<br />
    49. 49. Non-local Hypotheses<br />“Quantum entanglement: property of the quantum mechanical state of a system containing two or more objects, where the objects that make up the system are linked in such a way that the quantum state of any of them cannot be adequately described without full mention of the others, even if the individual objects are spatially separated.”<br />
    50. 50.
    51. 51. Water Memory<br />
    52. 52. Empirical Approaches<br />Dr. Masaru Emoto.<br />He claims about the «resonance» present in words and how these vibrations change in health and disease.<br />
    53. 53. Emoto’s experimentsRice experiment<br />Three separate treatments to beakers containing rice and water: <br /> Thank the flask or say something nice<br />Tell nasty and rude phrases.<br />Ignore it.<br />
    54. 54. Emotto’sWaterCrystals (2003)<br />2000 people (Tokyo) prayedtowatersamplesstoredon a electromagneticshieldedroom. (CA,USA).<br />Control sampleswere in other place.<br />Pictures of bothsampleswereblindlytaken.<br />Afterthat, thepictureswereshownto 100 judges. (Theydidnotknowwhichcrystalwasfrowhichsample)<br />Statistically, judgesprefertheprayedcrystal.<br />
    55. 55.
    56. 56. Emoto’s experimentsWater crystals<br />Shape dependant on the kind of vibration given to the water sample.<br />
    57. 57. Water memory explanation?<br />In 2003, the physics journal: Physica published an experiment on water memory<br />Louis Rey.<br />Thermoluminescence:<br />The technique involves bathing a chilled sample with radiation. When the sample is warmed up, the stored energy is released as light in a pattern that reflects the atomic structure of the sample<br />
    58. 58. <ul><li>“Much to our surprise, the thermoluminescence glows of the three systems were substantially different”
    59. 59. Control – Double distilled water
    60. 60. Deuterium – Different arrengement of the bonds.
    61. 61. 10x 10-5 M of Sodium Chloride and Lithium Chloride.</li></ul>Water memory explanation?<br />
    62. 62. Water memory explanation?<br />
    63. 63. What did they measure?<br />
    64. 64. Zinc aggregates – Non Noble metals<br />
    65. 65. Gold aggregates – Noble metals<br />
    66. 66. SAED (SelectedAreaElectronDiffraction)<br />
    67. 67. What info we could get from this paper…? #1<br />
    68. 68.
    69. 69. <ul><li>The change in the properties of the treated water (sucussion) is dependant on time.
    70. 70. Sucussionorshaking leads totheformation of clusters.</li></li></ul><li>
    71. 71.
    72. 72. How are these clusters formed?Theodore Grotthus (1806)<br />
    73. 73.
    74. 74. The shaking of homeopathic dilutions generate dissipative structures.<br />“The physicochemical parameters electrical conductivity and heat of mixing are in fact functions of the number, size and shape of the dissipative structures”<br />
    75. 75. Expert Opinions Against Homeopathy<br />Steven Novella, Yale University, New Haven, CT.<br />Thelaw of similars & law of Infintesimals: nobiologicalplausability.<br />Homeopathyisstill a philosophy-based medicine<br />Hahnemann had his theory of illness, largely based on the notion of miasms.<br />Theorists invoking quantum mechanics?<br />
    76. 76. Expert Opinions Against Homeopathy<br />Donald Marcus. Baylor University, Waco, TX.<br />Professor Ernst, Exeter University in England: based on over 20 reviews since 1997 believes there is no evidence homeopathic remedies differ from placebos<br />ENHS conclusion: insufficient evidence to support the use of homeopathy.<br />The Lancet: “there’s no point in making further investments in research in clinical trials in homeopathy.”<br />
    77. 77. Expert Opinions Against Homeopathy<br />No FDA regulations<br />Safety concern: some homeopathic practioners recommend against vaccination.<br />Some people who practice homeopathy are unqualified to perform general medical evaluations and may miss serious and treatable conditions.<br />The Heisenberg principle concerns atomic and subatomic particles and it does not invalidate Newtonian physics: no justification for taking this concept from physics and applying it to health care.<br />
    78. 78. Is Homeopathy Unethical?<br />Unethical aspects of homeopathic dentistry<br /><ul><li>Homeopathic doctors/hospitals relatively common and there are a fair amount of homeopathic dentists in the UK.
    79. 79. Many documented effects of homeopathy attributed to placebo and the fact that Homeopathic professionals do not acknowledge this is against ethical guidelines defined by the Society of Homeopaths
    80. 80. Most studies referenced for the benefits of homeopathic medicine have since been discredited by scientific community.</li></li></ul><li>From the prospective of Scientific Community <br />“At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. “<br />
    81. 81. Conclusion<br />Jury is still out on whether or not “water memory” truly exists.<br />More research needed, but as of today Potentiation and the other pillars of homeopathy are not supported by the scientific community.<br />
    82. 82. Conclusion<br />Some empirical evidence shows structural cahnge in water but biological plausibility still uncertain.<br />Both Homeopathic practitioners and scientific community remain steadfast in their beliefs.<br />Possible that the truth lies somewhere between these two extremes<br />
    83. 83. Davenas E, Beauvais F, Amara J, Oberbaum M, Robinzon B, Miadonna A, Tedeschi A, Pomeranz B, Fortner P and Belon P (1988) Human basophil degranulation triggered by very dilute antiserum against IgE. Nature 333:816-818.<br />Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M and Kessler RC (1998) Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA 280:1569-1575.<br />EliaV, Baiano S, Duro I, Napoli E, Niccoli M and Nonatelli L (2004) Permanent physico-chemical properties of extremely diluted aqueous solutions of homeopathic medicines. Homeopathy 93:144-150.<br />EliaV, Baiano S, Duro I, Napoli E, Niccoli M and Nonatelli L (2004) Permanent physico-chemical properties of extremely diluted aqueous solutions of homeopathic medicines. Homeopathy 93:144-150.<br />References<br />
    84. 84. References<br />Elia V, Napoli E and Germano R (2007) The 'Memory of Water': an almost deciphered enigma. Dissipative structures in extremely dilute aqueous solutions. Homeopathy 96:163-169.<br />Guggisberg AG, Baumgartner SM, Tschopp CM and Heusser P (2005) Replication study concerning the effects of homeopathic dilutions of histamine on human basophil degranulation in vitro. Complement Ther Med 13:91-100.<br />KleijnenJ, Knipschild P and ter Riet G (1991) Clinical trials of homoeopathy. BMJ 302:316-323.<br />Maddox J, Randi J and Stewart WW (1988) "High-dilution" experiments a delusion. Nature 334:287-291.<br />Milgrom LR (2009) The eternal closure of the biased mind? The clinical and scientific relevance of biophysics, infinitesimal dilutions, and the memory of water. J Altern Complement Med 15:1255-1257.<br />
    85. 85. References<br />Milgrom LR (2006) Is homeopathy possible? J R SocPromot Health 126:211-218.<br />Milgrom LR (2006) Towards a new model of the homeopathic process based on quantum field theory. ForschKomplementmed13:174-183.<br />Radin D, Hayssen G, Emoto M and Kizu T (2006) Double-blind test of the effects of distant intention on water crystal formation. Explore (NY) 2:408-411.<br />Shaw D (2010) Unethical aspects of homeopathic dentistry. Br Dent J 209:493-496.<br />Walach H, Jonas WB, Ives J, van Wijk R and Weingartner O (2005) Research on homeopathy: state of the art. J Altern Complement Med 11:813-829.<br />

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