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Pathology of an Old Disease

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Mefiante
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« on: September 07, 2006, 12:23:55 PM »

Pathology of an Old Disease (Alternativitis Intransigens) - Part I of II

One of the fundamental tenets of open scientific inquiry is that a theory or hypothesis that has consistently been shown to be untenable is destined for the scrapheap of worthless ideas.  Faced with this operating principle most people would readily agree that it is an eminently reasonable one.  However, when it comes to applying it in practice, many people prefer to jettison said principle, choosing instead to cling unreasonably to the unreasonable.  This phenomenon is especially rife in the domain where so-called New Age and/or post-modernist thinking are called into question, and nowhere more obviously dangerous than in their sub-genre of alternative medicine.

The intention of this essay is not to provide a detailed exposition of the specific failings of particular instances of such erroneous thinking; rather, the intention is to examine in a broader context the consequences, actual as well as potential, that can and do ensue from it, especially where alternative, or complementary, medicine is implicated since the consequences of error in this arena can be both severe and immediate.  Also, it is not intended to portray medical science and the medical profession as paragons of faultlessness (which they aren’t), or even to apologise for their mistakes.  Nor is it meant to suggest that absolutely all forms of alternative medicine are inherently and uniformly phoney.

Of late, medical science has received an alarmingly disproportionate amount of bad press, whereas alternative medicine is generally perceived to be, at worst, harmless.  Given the aforementioned immediacy and severity of mistakes or bad judgement in matters medical, it is not surprising that any such occurrences are reported on extensively.  However, this gravity alone does not sufficiently explain either the unequal attention bestowed on conventional medicine’s failings, or the often-venomous glee that attaches to retellings of such incidences, usually accompanied by such asinine pronouncements as, “See, these doctors have no clue.  If she had worn this naturally occurring, five-sided, cleansed quartz crystal* to ward off bad energies, she wouldn’t have died.”

On the other hand, everyone has heard, and many believe themselves to be the subject of, anecdotes telling of a homeopath, acupuncturist, herbalist, reflexologist, who has diagnosed and cured diseases that “conventional medicine deemed unknown or incurable,” but, even if such anecdotes are true (most are vastly overstated or simply untrue) and even if they could be considered good evidence (which they cannot), we hardly ever hear of the failings of alternative medicine, such failings being far more common than appearance might suggest.  As an aside, it is also worth noting that personal experience in such matters does not comprise good evidence in support of any form of medicine, whether conventional or alternative, since human physiology is hugely complex and relief from or cure of disease can result from any number of other, less apparent, factors, so that one cannot reliably ascribe particular instances of such relief or cure to a specific unproven cause.  The validity or otherwise of a proposed curative or diagnostic technique is established through the rigours of clinical trials.

Why does this disparity in the nature of the attention given to conventional and alternative medicine exist?  The reason is largely that New Age post-modern thinking has browbeaten society at large into accepting, or at least remaining silent on, two fallacious ideas.  Firstly, we are expected to agree that reality is subjective, and secondly, that it is therefore not only impolite and rude, but wholly invalid to point out the deficiencies in someone else’s beliefs.  But if reality were indeed subjective, the upshot of my throwing you off the top of a 50-storey building would then depend on our individual cultural and philosophical stances, an assertion that is patently absurd.  Also, most action is predicated on thought and deliberation, so that deficient thought is likely to produce inappropriate action.  This last is the motivation behind endeavours to curtail hate-speech, for example, and presents sufficient warrant for correcting demonstrably erroneous beliefs, especially where such might have significant deleterious consequences.  We are thus faced with the curious situation wherein criticism of alternative medicine is not permissible for reasons of political expediency, while such censure implicitly demands of conventional medicine that it improve, which indeed it does, but then further reproach is levelled at it for a perceived lack of celerity.

In the context of alternative medicine, its exponents have for many years been bleating about wanting their legitimacy recognised by the orthodoxy.  Medical science has subjected a great many of complementary medicine’s claims to detailed scrutiny, often repeatedly and always by exactly the same rules and criteria that are applied to its own ruminations.  Homeopathy, iridology, aromatherapy, naturopathy, applied kinesiology, and the like have one and all uniformly been found wanting, yet their practitioners and proponents refuse to accept these verdicts.  Each obstinately persists in trumpeting without modification the same old “explanations” and “benefits” of its own particular quackery, despite the unequivocal demonstrations of the hollowness of their respective claims.

We hear of mysterious meridians (that no one other than adherents can reliably find), ephemeral energies (that no one other than adherents can hope to detect), intangible interconnections (that no one other than adherents can appreciate), and vanishing vibrations (that no one other than adherents can measure), and are expected to believe in the objective existence of such.  Arbitrary conjectures posing as facts and/or good science are offered, often being in direct and blatant conflict with the actual findings of science.  Such explanations are clearly spurious since they do not explain anything – in the main they are post hoc inventions generated for the sole purpose of bolstering the practitioner’s own belief, convincing the mildly sceptical and ensuring continued support from the gullible by adding a superficial gloss of seeming reasonableness disguised in a cloak of pseudo-scientific jargon.  Needless to say, the proponent of such ideas is now left with additional facts or postulates to prove and explicate.  When pressed on these matters, the proponent will almost invariably attempt to escape by asserting the subjectivity of what is real, and thereby wrongly assume that his or her case is proved.

In contrast, medical science has changed with and adapted to new and/or discordant evidence, such usually emerging from painstaking and concerted research effort.  This adaptability lies at the core of its successes.  Thus, for example, we have the germ theory of disease replacing the idea that disease is the result of bad blood or an unbalanced humour.  Not one of medical science’s successes is in any way attributable to practitioners of alternative medicine, a fact that is never mentioned but often contested by alternativists.  Helicobacter pylori, the bacterium responsible for most peptic ulcers, was not identified, not hypothesised, not even suspected, by a crystal healer, iridologist, chiropractor or reflexologist, but by medical scientists.  Similarly, smallpox and tuberculosis did not almost completely disappear at the hands (or noses) of any aromatherapists.  Herbalists have been heard to claim for themselves successes in conventional circles regarding the use of certain plants to cure specific diseases, but this is not wholly accurate.  The overwhelming majority of cases where an herb is found to be efficacious stems from folk wisdom, rather than from the promptings of an herbalist.  In addition, the active ingredient of the herb is always identified and isolated (and possibly improved upon as derivative substances) by scientists, and not by herbalists, and many herbalist “cures” have been shown to be bogus.

Alternative medicine largely disdains objective research initiatives, preferring to rely on the supposed superiority of “revealed” or “ancient” wisdom, which is trotted out as unassailable at every opportunity.  Any rational appraisal must regard such obdurate inflexibility with deep suspicion, particularly in view of the contrary evidence mentioned above.  The alternativist often compounds his conceit with his favourite portrayal of medical science as a lethargic and narrow-minded monolith of ponderous inertia, when the rapidly growing number of peer-reviewed medical journals and published papers, not to mention advances in knowledge, all militate against this characterisation and expose its attendant irony: the alternativist lobby is much more accurately exemplified by such a description.  Conventional medicine’s failures and shortcomings may be many, and any fair-minded assessment will conclude this to be a result of the complexity of the subject; nevertheless, its remarkable successes continue to multiply and are grounded in objectivity, gauged by the litmus-test of reality, and far outweigh those credited, whether correctly or not, to alternative medicine.  Furthermore, conventional medicine has sufficient confidence to admit its weaknesses (and to address these by expending appropriate remedial effort), whereas much alternative medicine is given to pretending complete and infallible erudition.

A little reflection will then reveal the alternativist’s disingenuous hypocrisy for what it really is: he wants the respect, if not adulation, of the medical science fraternity, but refuses to abide by its rules.  The desire for such recognition from the orthodoxy is not hard to fathom.  Such recognition would bolster the alternativist practitioner’s respectability, not to mention his marketability.  But refusing to play by the rules, i.e. refusing to abandon concepts that have time and again been shown to be little else beside hot air, makes it very difficult to accord respect, and derisive scorn is far more apt a response.  Further reflection reveals that complementary medicine therefore does not even qualify as “medicine” at all, and the alternativist practitioner’s ministrations are in principle no different to those of a shaman consulting his tribal ancestors’ spirits for a diagnosis of, and cure for, an ailing member of his clan, since both rest their practices on equally frivolous epistemologies.  Worse yet, the alternativist is generally in a far better position than the shaman to assess and judge the merit of his own beliefs, given his cultural and educational background.  The question also arises why alternative medicine is so well represented in affluent Western societies, while poor and underdeveloped communities clamour for conventional Western medicine.  The answer is fairly simple and self-evident: Western medicine just works better.

Continued...


* Consult a geologist or crystallographer about such a quartz crystal, especially the “five-sided” part.
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Mefiante
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« Reply #1 on: September 07, 2006, 12:25:57 PM »

Pathology of an Old Disease (Alternativitis Intransigens) - Part II of II

Many conventional medical practitioners have experience of cases where patients have forsaken conventional in favour of alternative treatment, and have thereby unnecessarily imperilled, and in some cases permanently downgraded or even prematurely ended their own lives.  Many documented cases exist in which a parent’s rejection of conventional medicine has resulted in the avoidable disability or death of a child.  Such rejection of conventional medicine can almost always be traced back to the urgings of an alternative practitioner, but somehow this culpability escapes most people’s attention, probably because the conventional physician chooses not to publicise such information out of a misplaced sense of politeness, propriety or political correctness, or perhaps out of fear of being accused of alarmism, a closed mind or something similarly baseless.  Of course, the alternativist will disown any such blame and attempt to rationalise and hide it away behind the dubious principles and intricacies of his modalities.  Almost invariably such “defences” are “reinforced” by references to allopathic medicine’s failures, and by relegating dissenting views of complementary medicine to a status of mere opinion (on the implicit assumption that every opinion is equally valid), thereby muddying the debate with fallacious misdirection.

With regard to the first of the aforementioned two obfuscations, it should be obvious that failures of the allopathic approach can in no way validate the claims of the alternativist since such an argument commits an error of false dichotomy: it is akin to asserting that since one added to one does not yield three, it therefore follows that the sum in question must equal four.  Consequently, this argument does not relieve the alternative proponent of the burden of proof regarding the underlying mechanisms and/or efficacy posited by him or her.  Though it is semantically correct to label a dissenting view of alternative medicine as an “opinion,” it is equally correct to thus label that of the supporter thereof.  However, the assumption of equal validity of the opposing opinions can only be true if reality is indeed subjective.  An opinion regarding the merits of a thespian’s performance is obviously an entirely different beast to an opinion regarding the rising or not of the sun tomorrow: the former sits wholly in the domain of subjective appraisal and has little hope of validation other than through popular consensus, whereas the latter resides wholly in the domain of objective, empirical facts, theories and laws that can in principle be confirmed or disconfirmed by anyone.  The validity or otherwise of medical procedures clearly is an opinion of the latter class, and is therefore decidable on the basis of objective criteria.

What, then, are we to make of the alternativists’ individual and collective intransigence?  Elsewhere it is argued that alternative medicine is more “user-friendly” in the sense that the practitioner presents the patient with a sympathetic ear, thus effecting an improvement in the patient’s disposition and consequently his or her condition.  Medical science is well aware of and acknowledges the reality of the placebo effect, and every parent knows about the placebo effect’s success when comforting a hurt or sick child.  If alternativists generally agreed that their own value is chiefly or entirely in this regard, there would be no good reason to object to them.  However, most of them confidently affirm that their particular brand (or, often more than one brand) of hucksterism is much more than pure placebo, and actively and irresponsibly continue to discourage their clients from seeking an objectively proven diagnostic or curative method.  Also, and perhaps not unjustly, many conventional doctors are deemed to have a poor “bedside manner,” but such is primarily an issue among individuals and one to be addressed by suitable training – it certainly does not invalidate or even diminish medical science, and equally certainly stretches credulity very thin indeed when used to argue in favour of the veracity or utility of alternative medicine.

Upon closer inspection, we are left with but one explanation, namely anti-intellectualism, a trait that pervades New Age thought.  In essence, alternativist practitioners and proponents are mendacious charlatans, or, at best, intellectual cowards: faced with evidence that their claims are specious, they worm their way out of the dilemma (and compound their affront to both rationality and moral decency) by inventing wholly unconvincing reasons (for example, the inapplicability of the scientific method to “subtle energies” or some such tenuous allegation) that are meant to invalidate the studies, or, more commonly, by simply ignoring them and perpetuating their quackery more-or-less unperturbed and with undiminished fervour.  Whether these self-styled “experts” behave thus knowingly or out of ignorance, obstinacy or obtuseness makes little difference to the end result, and by no stretch of the imagination can any of these reasons be said to exonerate their behaviour.  Meanwhile, the hapless ordinary man is largely unaware of such goings-on and continues to be fed a decidedly one-sided diet of propaganda proclaiming the wonders that overpriced magnets, crystals, various flowers, copper bangles and nice smelling oils can work on his health.  Therein lies perhaps medical science’s greatest failing – a much more strident approach to denouncing counterfeit cures is mandated, and a good deal more publication and emphasis on the principles and application of what Carl Sagan called a “Baloney Detection Kit” is called for.

It is occasionally argued that expecting an alternativist to renounce his or her lifelong beliefs regarding his or her craft, and with them possibly his or her livelihood, is unreasonable, or at minimum asking too much.  Such an apologist attitude, though perhaps compassionate, ignores the fact that scientists are regularly expected to reject or revise their own cherished beliefs when these are shown to be indefensible; more importantly, the potential and actual dangers of maintaining false views in the area of medicine are empirically obvious.  A further, and rather more disturbing, apologist argument frequently offered in mitigation is that many alternative practitioners are unaware of the studies and research that discredit their practices.  Aside from seeming inordinately contrived, this contention, if true, would highlight a profound inadequacy in the education of the practitioners resulting from a similarly acute deficiency in their teachers’ knowledge of, or willingness to consider, fair criticism of their metier.  Ignorance of divergent analyses and their bases, not to mention unsatisfactory resolution thereof, summarily diminishes to negligible levels any entitlement to recognition as an “expert” in the relevant field of study: an evolutionist who champions the Lamarckian conception out of ignorance or improper understanding of the neo-Darwinian synthesis can hardly be credited or trusted as an expert on evolution.

However, apart from the fruitlessness of the counterarguments on offer, there is an even more compelling reason to insist that these and other persistent false beliefs be roundly denounced.  Accepting or failing to challenge a false belief as either harmless, or too tedious to address, or both, encourages intellectual lassitude, and makes it possible to defend and ultimately accept ever more egregious beliefs on ever more flimsy or flawed grounds.  Thus anti-intellectualism feeds off itself, and very soon we become its victims.  The anti-intellectualism that prompted, for example, the Inquisition, various witch hunts, the Reign of Terror, and, more recently, such follies as Lysenkoism, is manifest in the examples cited, and they are also demonstrative of its insidious dangers.

If alternative medicine wishes to be taken seriously and afforded the respect it covets by virtue of providing tangible and meaningful contributions to its professed area of expertise, it must embrace the yardstick by which such contributions are assessed: if massaging the soles of a patient’s feet or manipulating his spine affects not one jot the performance and behaviour of his kidneys, liver, pancreas or that of any other part of his body except the one directly stimulated (as has been amply demonstrated), then this observation should provoke a reappraisal of the theories that say it is otherwise, rather than evasive and obstinate denial.  When several iridologists each provide different, inconsistent, conflicting, vague and predominantly incorrect diagnoses from the same set of photographs of several patients’ irises, a reassessment of iridology’s basic assumptions is called for, rather than an adamant insistence on its inerrancy.  When a drop of lemon juice repeatedly diluted with water to the extent where, equivalently, the drop may just as well be stirred into Lake Victoria, and administering a cupful of the resultant dilution has no detectable effect on the course of the common cold, it is wiser to suppose that the underlying homeopathic premises need some work, rather than that the observation is flawed or biased.  When terminal cancer victims wearing “cleansed” crystal pendants show no discernible increase in remission rate over those wearing “uncleansed” or artificial specimens, or none at all, it is reasonable to infer that quackery is afoot, and that proponents of such a remedy who nevertheless resolutely insist on its efficacy are in dire need of a suitable remedy for terminal pig-headedness.

As demonstrated earlier, the further implications of uncritical and unreasonable doggedness in preserving the precepts of one’s favourite sham therapy go beyond the immediate potential endangerment of members of an uninformed and trusting public.  The attitudes espoused and promoted by various and sundry supporters of alternative cures actively, though perhaps not intentionally, foster anti-intellectualism, which in turn can only result in the ultimate degradation or trivialisation of those individuals who have over so many centuries and through much dedicated toil, strife and profound introspection fought tooth and nail to ensure that a rational search for objective truth is not merely an appealing abstraction to which occasional lip service is to be afforded, but a meaningful, fruitful and worthy pursuit.
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« Reply #2 on: July 14, 2008, 06:16:14 AM »

There is considerable EVIDENCE that the modern medical system does a disservice to patients when Doctors do not spend enough time with patients. Accusing that homeopathy works primarily due to the time spent by the practitioner with the patient, in a sense, is an admission that practitioners of allopathic medicine do not give their patients sufficient time (and there is plenty of evidence that that works).
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« Reply #3 on: July 14, 2008, 06:18:09 AM »

Conventional medicine is expensive and very profitable beside easily marketed.

the medical establishment is intrinsically conservative, blinkered and unreceptive to new ways of thinking. I think that the modern medical establishment needs to be a lot more open-minded and progressive.
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« Reply #4 on: July 14, 2008, 10:28:00 AM »

There is considerable EVIDENCE that the modern medical system does a disservice to patients when Doctors do not spend enough time with patients. Accusing that homeopathy works primarily due to the time spent by the practitioner with the patient, in a sense, is an admission that practitioners of allopathic medicine do not give their patients sufficient time (and there is plenty of evidence that that works).
Where, please, is this “considerable EVIDENCE?”  The “bedside manner” aspect of conventional medicine was in any case dealt with at some length in the article, so you haven’t added anything new.  Moreover, different patients expect different things from their doctors, and not all doctors are uniformly brusque and businesslike when attending to their patients.  Some people expect that their doctor is short, sharp and to the point, while others want to have a patient and sympathetic ear.  Finally, alternative medicine certainly doesn’t guarantee such behaviour on the part of the practitioner.  And there is no reliable evidence that it works more effectively than placebo.  If you claim otherwise I’d suggest citing the clinical trials that have demonstrated repeatable positive results.



Conventional medicine is expensive and very profitable beside easily marketed.

the medical establishment is intrinsically conservative, blinkered and unreceptive to new ways of thinking. I think that the modern medical establishment needs to be a lot more open-minded and progressive.
Utter nonsense.  If that was true we’d still be doing things like blood-letting and feeding people mercury salts.  The trouble is that alternative practitioners would rather wave a magic wand and deride conventional medicine’s stringent demands for evidence than allow for the possibility that they might be wrong.

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« Reply #5 on: July 15, 2008, 09:04:18 AM »

There is considerable EVIDENCE that the modern medical system does a disservice to patients when Doctors do not spend enough time with patients. Accusing that homeopathy works primarily due to the time spent by the practitioner with the patient, in a sense, is an admission that practitioners of allopathic medicine do not give their patients sufficient time (and there is plenty of evidence that that works).
there is no reliable evidence that it works more effectively than placebo.  If you claim otherwise I’d suggest citing the clinical trials that have demonstrated repeatable positive results.


animals and infants also benefit form homeopathic treatment and it is unlikely that they will react psychologically to a medicine they often do not know they are being given
Infants: Homeopathic remedies and treatments are successfully used by parents for common infant ailments such as colic, teething pain and some infections.

Animals: There are many veterinarians using homeopathic medicines to treat domestic pets such as cats, dogs and birds, as well as barnyard animals like goats, horses and cows. Is it possible to have a placebo effect with animals?
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« Reply #6 on: July 15, 2008, 13:42:39 PM »

animals and infants also benefit form homeopathic treatment…
By what objective criteria has any observed improvement been assessed?  How has expectation bias been eliminated?  How has the calming effect of both the person administering the preparation and its administration itself been catered for?

In short, where are the double blind, placebo-controlled clinical trials conducted by an independent authority – that is, a non-homoeopathic one – to substantiate these claims?

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« Reply #7 on: July 16, 2008, 00:26:15 AM »

@Luthon: Excellent Article. 

Conventional medicine is expensive and very profitable beside easily marketed.

Ever wondered why? Pharmaceutical companies spend a lot of money on researching and developing possible cures for diseases. New medicine is subjected to costly clinical trials, and if a product causes patients harm they can be held liable.

Medicine needs to be profitable in order to provide an incentive to these companies to develop new products. These companies spend lots of money with little guarantee that they will get anything back on what was spent.

Lastly, conventional medicine works and we know why it works. There is no real need to market it. If I know a pill is going to save my life, I’m going to buy it and not ask too many questions about the price. I will simply be glad they took the risk and developed that pill.

Contrast this to Homeopathy. No research, no clinical trials, no liability and no cures. Of course it is cheap.
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« Reply #8 on: July 16, 2008, 09:24:43 AM »

Quote
Animals: There are many veterinarians using homeopathic medicines to treat domestic pets such as cats, dogs and birds, as well as barnyard animals like goats, horses and cows. Is it possible to have a placebo effect with animals?
Who is being treaded here? The animal or owner? The body will fight back against most illnesses and win - we and the animals would not be here if it could not (no doctors or homeopaths 50,000 years ago). Why do we need doctors if the body can heal itself? Sometimes the immune system is not strong enough and you then want a qualified person to give you propper medicine - not some woo-woo crap.
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« Reply #9 on: July 16, 2008, 11:15:34 AM »

@Luthon: Excellent Article.
Thanks, much appreciated Smiley .  The article was prepared specifically because a family member was being repeatedly bilked in all sorts of perverse ways by one of these sCAMmers who insisted on being addressed as “Dr” and who always made a big fuss if one failed to do so.  Upon investigation, the degree turned out to be from a US diploma mill – one whose enrolment figures showed significantly more “doctoral” students than undergraduates.

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« Reply #10 on: July 16, 2008, 13:54:50 PM »

Conventional medicine is expensive and very profitable beside easily marketed.
And homeopathic treatments are not? What can be more profitable than selling a sugar pill with a drop of water. And I wouldn't exactly call the prices you pay for those homeopathic treatments cheap. Not to mention that homeopathy is also a multimillion dollar industry.
the medical establishment is intrinsically conservative, blinkered and unreceptive to new ways of thinking. I think that the modern medical establishment needs to be a lot more open-minded and progressive.
Why then are they willing to submit their cures to testing and are then willing to let it go if it proves ineffective? Why then have there been numerous breakthroughs and new developments in the last 200 years? If anything it is homeopathy that is close minded, stale and still stuck with an unproven 18th century theory.
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« Reply #11 on: July 16, 2008, 19:27:04 PM »

It's only the skeptics believe it to be sugar water, not homeopathy community,and neither millions of people around the lobe who have been benefiited from the medicine. They knew the truth.
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« Reply #12 on: July 16, 2008, 20:57:04 PM »

It's only the skeptics believe it to be sugar water, not homeopathy community,and neither millions of people around the lobe…
(We’ll just ignore that very unfortunate Freudian slip.)  Then please be so kind and enlighten us as to what these medications are and how they are prepared in order to be called “homoeopathic.”  Is it not true that the medications are extremely diluted by decimals or centesimals, succussed and administered in drops or sugar-based pills?



… who have been benefiited from the medicine. They knew the truth.
No, they’ve been systematically deceived and lied to because homoeopaths are apparently incapable of recognising how deeply foolish and devoid of substance and evidence their “science” actually is.  Alternatively, perhaps they’re simply too dishonest to admit it.

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« Reply #13 on: July 17, 2008, 06:35:41 AM »

he basic principles of Homeopathy are: -

a. A substance that causes symptoms in a healthy person can be used to treat these symptoms when they occur in an ill person.

b. Diluting the homeopathic medicine increases it collative powers and avoids unwanted side-effects.

c. Homeopathy treats the whole person and not just the illness. The totality of the symptoms is considered: Your complete symptom profile is taken into account, including mental, emotional, and physical aspects.

d. Like cures like: Substances that produce symptoms when given in large doses can clear up those symptoms when the substances are given in micro-doses.

e. A single remedy is given: One homeopathic medicine is chosen to perfectly match the totality of your symptoms.
 
f. A minimum of doses is given: Only a small stimulus is needed to stimulate your innate healing powers.
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« Reply #14 on: July 17, 2008, 10:51:26 AM »

he basic principles of Homeopathy are: -

This just affirms the homoeopathic principles of preparing medications.  The question I asked was, “Is it not true that the medications are extremely diluted by decimals or centesimals, succussed and administered in drops or sugar-based pills?”

Your answer seems to address the dilution part, but only indirectly in your points b., d. And possibly f.  Please provide some details concerning the nature of the dilutants that are commonly used.

'Luthon64
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