From: rkaplan@netcom.com (Richard Kaplan)
Subject: Re: Analysis of Homeopathy Literature
Organization: Netcom Online Communications Services (408-241-9760 login: guest)
Date: Tue, 12 Jan 1993 01:24:13 GMT

In article <BSIMON.93Jan11070344@elvis.stsci.edu> bsimon@stsci.edu
 (Bernie Simon) writes:

>Since the system of homeopathic threapeutics predates the widespread
>use of clinical trials to evaluate therapeutic treatments, it's hard
>for me to see how you can criticize homeopathy for using treatments
>before they have been clincally tested. I also think you misunderstand
>how homeopathic medicines are prescribed. Medicines are prescribed on
>the basis of the totality of patient's symptoms according to the law
>of similars. There isn't one set of medicines that are prescribed for
>colds, another for headaches, etc.. So homeopathic therapeutics stands
>or falls as a whole and not as each individual medicine.

This issue was discussed very well in one of the articles
you quoted in support of homeopathy (Br J Clin Pharm 27:329).
According to that article, an alternate school of homeopathic
treatment lead by Finella since 1877 advocates treatment
of diseases (including acute diseases) with substances tailored
to the disease alone -- and therefore fully amenable to
double-blinded studies.  Why have not more of these studies
been done?  If the answer is cost, I still await your 
estimate of what the costs really are.  

Even symptom-oriented homeopathy is perfectly amenable to 
double-blinded analysis.  All you need to do is have
the homeopath meet with his patient to determine a
treatment for the symptoms and then have an independent
party randomize the patient to placebo vs. the prescribed
treatment, with both the patient and the prescribing
doctor blinded.  

In fact, this could even be extended to 
a double-blinded comparison of allopathy vs. homeopathy.
I could ask 50 consecutive patients who complain of cold symptoms,
for example, if they wish to participate in the study.  After
making my diagnosis I could prescribe either antibiotics
or placebo and give the prescription to an independent 
party.  The patient could then follow the same procedure
with a homeopath, who could determine his own diagnosis and
treatment.  Finally the patient could be randomly assigned
to the allopathic or homeopathic treatment and both
allopath and homeopath could see the patient for follow-up
to assess efficacy and/or modify the blinded treatment.

>By licensed homeopath, I mean M.D. or D.O. Here in Maryland, a
>non-licensed medical practitioner can only receive a patient after
>referral from a licensed doctor. I am sure the law is the same in most
>states. So I think your legitimate concerns are answered by this sort
>of arangement.

Well, I am certainly reassured by a large extent by 
seeing this reasoning.  However, it is important to 
point out that although this policy promotes patient 
safety by furthering early diagnosis of serious 
disorders, this referral pattern by its very nature 
lends itself to anecdotal patient acceptance of 
homeopathy since (1) the natural history of many diseases
is to improve with time; and (2) by law homeopaths
see patients after allopaths/osteopaths.  Therefore 
it is very important to test homeopathic treatments
scientifically in order to avoid falling into this potential 
fallacy.
-- 
Richard Kaplan M.D.           Medical Software Exchange BBS
806 2nd St. SW # 104          (507) 281-1989 14,400 HST
Rochester, MN  55902          (507) 281-1689 Voice
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