by Dana Ullman
Published on Huffington Post 10/09/14
Dysfunction at Wikipedia on Homeopathic Medicine
In April, 2014, I had the happenstance to run into Jimmy Wales, the co-founder of Wikipedia, on the streets of Vancouver. I was there to lecture to a group of medical professionals, while he was attending the TED talks. I expressed my appreciation to him for creating Wikipedia. I also then expressed concern to him about the “unencyclopedic” tone and information in Wikipedia’s article on homeopathy. He then encouraged me to express my concerns in writing, and this is that response.
It may surprise and even shock most people to learn that, according to the Washington Post, the two most controversial subjects on Wikipedia in four leading languages (English, French, German, and Spanish) are the articles on “Jesus Christ” and “homeopathy.”
Because I know that you want Wikipedia to be the best modern resource of reliable information, my intent in writing is to show you where Wikipedia is falling below your high standards, and in fact, Wikipedia’s article on homeopathy is providing strongly biased, inaccurate information.
[…] After reading the below body of scientific evidence on the subject of homeopathic medicine, I hope that we can engage in a dialogue that will help reduce the amount of misinformation that pervades certain subjects, such as homeopathy.
[…] I will first focus on the second sentence of the first paragraph of the article and the 6 references which purport to substantiate these claims:
Homeopathy i/ˌhoʊmiˈɒpəθi/ (also spelled homoeopathy or homœopathy; from the Greek ὅμοιος hómoios “like-” and πάθος páthos “suffering”) is a system of alternative medicine created in 1796 by Samuel Hahnemann, based on his doctrine of like cures like, according to which a substance that causes the symptoms of a disease in healthy people will cure similar symptoms in sick people. Homeopathy is a pseudoscience and its remedies have been found to be no more effective than placebos. 
Is Homeopathy Really a “Pseudoscience”?
Wikipedia asserts that “Pseudoscience is a claim, belief or practice which is presented as scientific, but does not adhere to a valid scientific method, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status.”
The “editors” at Wikipedia have deemed homeopathy to be a “pseudoscience” even though randomized double-blind and placebo controlled studies that have been published in many of the best medical journals in the world have shown efficacy of homeopathic treatment for many common and serious health problems (list of such studies : Appendix 1).
Jimmy, can you name ONE other system of “pseudoscience” that has a similar body of randomized, double-blind, and placebo-controlled clinical trials published in high-impact medical journals showing efficacy of treatment?
It is more than a tad ironic that this first paragraph in the Wikipedia article on homeopathy references only one article that was published in a peer-review medical journal. This one article by Shang, et al. has been thoroughly discredited in an article written by Lüdtke and Rutten that was published in a leading “high impact” journal that specializes in evaluating clinical research. The Shang meta-analysis is highlighted on Wikipedia without reference to any critique of it. The fact that there is no hint of any problems in the Shang review, let alone a reference to the Lüdtke and Rutten article that provided evidence of bias, is itself a cause for concern.
The Shang article is also the primary reference used by the widely ridiculed “Evidence Check” reports issued by the Science and Technology Committee of the British House of Commons, which also conveniently omits reference to the severe limitations of this one review of research. Further, the “Evidence Check” was signed off by just three of the 15 members of the original committee, never discussed or endorsed by the whole UK Parliament, and had its recommendations ignored by the UK Department of Health.
It should be made clear that the Shang meta-analysis was co-authored by M. Egger who is a well-known skeptic of homeopathy and who wrote to the Lancet that his hypothesis before conducting the review was that homeopathy was only a placebo effect. Readers were never informed of this bias.
[…] Just because a study was conducted with a randomized double-blind and placebo controlled method does NOT mean that the study gave the appropriate homeopathic medicine for each patient or even each group of patients. This ignorance is akin to someone saying that antibiotics are ineffective for “infections” without differentiating between bacterial infections, viral infections, and fungal infections. Ironically, skeptics of homeopathy consistently show a very sloppy attitude about scientific investigations.
What the Most Comprehensive Review of Homeopathic Research Found…
Skeptics commonly assert that various meta-analyses verify that homeopathy doesn’t work and that homeopathic medicines are equivalent to the effects of a placebo. These skeptics typically chose to ignore various meta-analyses that were published in highly respected medical journals and that show positive benefits from homeopathic medicines. Skeptics also ignore the largest and most comprehensive review of research ever conducted…one that was funded by the government of Switzerland.
It is useful to know that the Shang/Egger meta-analysis was funded by the same Swiss government’s Complementary Medicine Evaluation Program that also funded a much more detailed and comprehensive review of clinical research, preclinical research (fundamental physio-chemical research, botanical studies, animal studies, and in vitro studies with human cells), epidemiological evidence, and cost-effectiveness studies.
This more comprehensive Swiss government-funded report found a particularly strong body of evidence to support the homeopathic treatment of Upper Respiratory Tract Infections and Respiratory Allergies. The report cited 29 studies in “Upper Respiratory Tract Infections/AllergicReactions,” with 24 studies having a positive result in favor of homeopathy. Six out of seven controlled studies that compared homeopathic treatment with conventional medical treatment showed homeopathy to be more effective than conventional medical interventions. When the researchers evaluated only the randomized placebo controlled trials, 12 out of 16 studies showed a positive result in favor of homeopathy.
Ironically, the Shang/Egger meta-analysis acknowledged that there have been at least eight clinical trials of patients with acute infections of the upper respiratory tract and that there is “robust evidence that the treatment under investigation works.” And yet, Shang/Egger assert that this limited number of trials is inadequate for evaluating homeopathy, while at the same time they assert that eight other trials provided unquestionable evidence for damning homeopathy (it should be noted that Shang/Egger somehow determined that some of the studies on respiratory infection and allergy were not “high quality,” even though numerous other meta-analyses have unanimously defined three trials by David Reilly as high quality (two were published in the British Medical Journal and one was published in the Lancet). […]
Is Homeopathy Really “Implausible”?
The third paragraph in the Wikipedia article continues to show both strong bias against homeopathy and inaccurate information.
Homeopathy lacks biological plausibility and the axioms of homeopathy have been refuted for some time. The postulated mechanisms of action of homeopathic remedies are both scientifically implausible and not physically possible. Although some clinical trials produce positive results, systematic reviews reveal that this is because of chance, flawed research methods, and reporting bias. Overall there is no evidence of efficacy. Continued homeopathic practice, despite the evidence that it does not work, has been criticized as unethical because it increases the suffering of patients by discouraging the use of real medicine, with the World Health Organisation warning against using homeopathy to try to treat severe diseases such as HIV and malaria. The continued practice, despite a lack of evidence of efficacy, has led to homeopathy being characterized within the scientific and medical communities as nonsense, quackery, or a sham.
Ironically, the article makes reference to articles written by known antagonists to homeopathy (such as E. Ernst and K. Atwood) that have not even been published in peer-review scientific or medical journals. Reference #10 by Ernst was published in “The Skeptical Inquirer,” a magazine that is not listed in Index Medicus or any other respected scientific indexing service, and reference #11 by Atwood wasn’t even published in a magazine but at a website. If and when any person tried to edit the article on homeopathy in any way in which homeopathy is presented in a positive light and makes reference to a “magazine” or a “website,” that person would be laughed off of Wikipedia, and yet, the editors of the homeopathy article allow and even encourage the use of inappropriate skeptical references (according to Wikipedia’s usual standards).
[…] The journal, Langmuir, is the journal of the American Chemical Society, and in 2012, they published an important article that provided a plausible explanation for the actions of homeopathic medicines. First, they verified using three different types of spectroscopy that clearly showed that nanoparticles of six original medicinal agents persisted in solutions even after they were diluted 1:100 six times, thirty times, and even two-hundred times.
Avogadro’s number predicts that none of the original medicinal agents would have ANY persisting molecules of the original medicinal substance would remain after 12 dilutions of 1:100. However, the scientists describe reasonable and even predictable factors that lead to the persistence of nanoparticles after their multiple dilutions. The scientists note that the use of double-distilled water in glass vials leads to varying amounts of silica fragments that fall into the water, as much as 6ppm. The vigorous shaking of the glass vial creates bubbles and “nanobubbles” that bring oxygen into the water and that increase substantially the water pressure (William Tiller, PhD, the former head of Stanford’s Department of Material Science, estimated this pressure to be 10,000 atmospheres).
Ultimately, this increased water pressure forces whatever medicinal substance is in the double-distilled water into the silica, and every substance will interact with the silica in its own idiosyncratic way. Then, when 90% of the water is dumped out, the silica fragments predictably cling to the glass walls.
When skeptics of homeopathy reference Avogadro’s number as “evidence” that homeopathic medicines beyond 24X or 12C have “no remaining molecules left,” they are simply verifying their own ignorance of Avogadro’s number because this widely recognized principle in chemistry does NOT account for the complexities of the silica fragments, the bubbles or nanobubbles, nor the increased water pressure. In fact, any serious scientist or educated individual who asserts that a homeopathic medicine is “beyond Avogadro’s number” has no ground on which they stand. And yet, Avogadro’s number is prominently a part of Wikipedia’s article on homeopathy.
[…] The creation of nanodoses actually increases various characteristics of a substance’s properties. Once a substance has an extremely small size but has larger surface area to volume ratio, the nanodose properties create increased chemical and biological reactivity, electromagnetic, optical, thermal, and quantum effects. Further, the idiosyncratic properties of nanomedicines reduce the required doses by orders of magnitude and predictably reduce toxicity.
In light of the above, it is stunning and shocking that Wikipedia’s article on “Nanomedicine” has no mention of homeopathy, which rightly is deemed to be the original nanomedicine and nanopharmacology. At a time in the history of medicine and science in which the field of nanomedicine is becoming increasingly accepted and respected, Wikipedia seems stuck in the 20th century, or perhaps the 18th century. It is not surprising that there is an international and inter-disciplinary journal that focuses on the power of extremely small doses in various biological systems, not just medicine.
Given the above, it is no longer accurate to consider homeopathic doses to be “implausible.”
[…] Further, just one of the theories of how homeopathic medicines work has been described as the “memory of water.” The Wikipedia article refers to this concept as “erroneous” without any acknowledgement that it is inaccurate to assert such a black-and-white statement. It is more accurate to say that this theory is “controversial” because there is, in fact, evidence of a “memory in water,” as both verified by the above research on nanoparticles remaining in homeopathically potentized water and as evidenced by research conducted by the French virologist Luc Montagnier who discovered the AIDS virus and who won the Nobel Prize for doing so. Dr. Montagnier has not only published research that provides evidence of this “memory of water,” he was interviewed in the prestigious journal, Science, and on July 5, 2014, the French government’s public television station showed an hour-long documentary entitled “We Found the Memory in Water” (“On a retrouvé la mémoire de l’eau”)
What is shocking about Wikipedia’s article of homeopathy is that there is NO reference to this Nobel Prize winner or to his interview in one of the most respected scientific journals in the world today or any reference to French government’s documentary on this very subject. Obviously, the people who are editing the homeopathy article have a profound bias.
Brian Josephson, Ph.D., won a Nobel Prize in 1973 when he was only 23 years old and is presently professor emeritus at Cambridge University. Josephson contends that many scientists today suffer from “pathological disbelief” — that is, an unscientific attitude that is typified by the statement “even if it were true I wouldn’t believe it” (Josephson, 1997).
[…] Dr. Luc Montagnier won a Nobel Prize in 2008 for discovering the AIDS virus, and in an interview in Science (Dec. 24, 2010), he similarly expressed real concern about the unscientific atmosphere that presently exists on certain unconventional subjects such as homeopathy, “I am told that some people have reproduced Benveniste’s results (showing effects from homeopathic doses), but they are afraid to publish it because of the intellectual terror from people who don’t understand it.”
Montagnier concluded this interview when asked if he is concerned that he is drifting into pseudoscience. He responded adamantly: “No, because it’s not pseudoscience. It’s not quackery. These are real phenomena which deserve further study.”
Jimmy, I assume that you want your website to be the most reliable resource possible, but it can and will never become one unless you, as the founder of Wikipedia, provide some guidance and guidelines so that information for OR against a subject are fair and accurate. In 2009, at a TED talk, you claimed that Wikipedia’s most important virtue is its objective reporting of information; you asserted, “the biggest and the most important thing (about Wikipedia) is our neutral point-of-view policy.”
Larry Sanger, a co-founder of Wikipedia, quit the organization several years ago due to serious concerns about its integrity. He maintained:
“In some fields and some topics, there are groups who “squat” on articles and insist on making them reflect their own specific biases. There is no credible mechanism to approve versions of articles…The people with the most influence in the community are the ones who have the most time on their hands–not necessarily the most knowledgeable–and who manipulate Wikipedia’s eminently gameable system.”
Ultimately, there are indeed subjects at Wikipedia that will probably remain highly controversial no matter what is or isn’t said, and it makes sense to inform readers about this issue. However, at present, the article on homeopathy strongly suggests that there is no or inconsequential evidence that homeopathic medicines have biological activity and/or clinical efficacy, and this letter clearly dispels that myth. Objective reviews of both basic science research and clinical studies suggest that there are simply too many high quality laboratory and clinical trials that show positive results. […]
Because this letter proves that Skeptics are incapable of presenting information on homeopathy with even a modicum of objectivity, perhaps the best solution is to enable both viewpoints to be able to express themselves. […]
This letter was also signed by:
Michael Frass, MD, Professor of Medicine, Medical University of Vienna (Austria)
Paolo Bellavite, MD, Professor, Università of Verona (Italy), Department of Pathology and Diagnostics
Paolo Roberti di Sarsina, MD, Observatory and Methods for Health, University of Milano-Bicocca, Italy; Charity for Person Centered Medicine-Moral Entity, Bologna, Italy; Expert for Non-Conventional Medicine (2006-2013), High Council for Health, Ministry of Health, Italy
Dr Clare Relton, Senior Research Fellow (Public Health), School of Health & Related Research, University of Sheffield (UK)
Stephan Baumgartner, PhD, Institute of Complementary Medicine, University of Bern, Switzerland; Institute of Integrative Medicine, University of Witten-Herdecke, Germany
Lex Rutten MD, homeopathic physician, independent researcher.
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Appendix # 1
- Chronic obstructive pulmonary disease: Frass, M, Dielacher, C, Linkesch, M, et al. Influence of potassium dichromate on tracheal secretions in critically ill patients, Chest, March, 2005;127:936-941. The journal, Chest, is the official publication of the American College of Chest Physicians.
- Hayfever: Reilly D, Taylor M, McSharry C, et al., Is homoeopathy a placebo response? controlled trial of homoeopathic potency, with pollen in hayfever as model,” Lancet, October 18, 1986, ii: 881-6.
- Asthma: Reilly, D, Taylor, M, Beattie, N, et al., “Is Evidence for Homoeopathy Reproducible?” Lancet, December 10, 1994, 344:1601-6.
- Fibromyalgia: Bell IR, Lewis II DA, Brooks AJ, et al. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo, Rheumatology. 2004:1111-5. This journal is the official journal of the British Society of Rheumatology.
- Fibromyalgia: Fisher P, Greenwood A, Huskisson EC, et al., “Effect of Homoeopathic Treatment on Fibrositis (Primary Fibromyalgia),” BMJ, 299(August 5, 1989):365-6.
- Childhood diarrhea: Jacobs, J, Jimenez, LM, Gloyd, SS, Treatment of Acute Childhood Diarrhea with Homeopathic Medicine: A Randomized Double-blind Controlled Study in Nicaragua, Pediatrics, May, 1994,93,5:719-25.
- ADD/ADHD: Frei, H, Everts R, von Ammon K, Kaufmann F, Walther D, Hsu-Schmitz SF, Collenberg M, Fuhrer K, Hassink R, Steinlin M, Thurneysen A. Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial. Eur J Pediatr., July 27,2005,164:758-767.