13 April 2008

What do homeopaths recommend people do about malaria?

Oh dear, homeopaths have been caught suggesting ineffective anti-malarial medicines again:
A shop in [Exeter's] Princesshay centre will come under the spotlight tonight when it is featured in an investigative TV programme.
BBC One's Inside Out South West has investigated claims by Neal's Yard that homeopathic remedies it sells in its stores can help prevent and treat serious fatal diseases such as malaria.
Neal's Yard do sell malaria remedies, which are so diluted they contain no active ingredient. As far as recommending homeopathic-only prophylaxis - instead of effective pharmaceutical prophylaxis - goes, they sell a book titled 'Homoeopathic Alternatives To Immunisation' which "contains practical information on preventing and treating major infectious diseases, including hepatitis, flu, malaria, measles and whooping cough" (my emphases) by Susan Curtis, who is a member of the Society of Homeopaths and works as the Medicines Director at Neal's Yard.
For the programme Janine Jansen also interviewed Susan Curtis, medicines director for Neal's Yard and author of the book Homeopathic Alternatives to Immunisation.
Ms Curtis called an abrupt halt to the interview after about 15 minutes, when being questioned about the scientific evidence that homeopathic remedies worked.
She said during the interview that: "I do say that there is no guarantee that the remedy will prevent malaria. There are no clinical trials that we know of that show that the homeopathic remedies work for malaria. However, there is some evidence by extension that homeopathy can be very effective in certain epidemic diseases."
Well I suppose just getting up and walking out of the interview is one way of dealing with criticism. I don't know what "evidence by extension" is supposed to be, so I've written to her to ask what she meant, as well as to ask her for her evidence of homeopathic effectiveness against epidemic diseases.

But perhaps this is just a blip or some kind of unfortunate misunderstanding - the Society of Homeopaths was quick to say after earlier cases of homeopaths giving bad anti-malarial advice that proper professional homeopaths - such as its members - wouldn't suggest anything as reckless as relying exclusively on homeopathy to protect against a fatal disease.

In an attempt to find what professional homeopaths - such as members of the SoH - do recommend against malaria I decided to see what they say about it in books they write. This way there is no possibility that someone accidentally says something they don't mean, or that an unfortunate turn of phrase might be tricked out of them during undercover filming. So on Saturday I went to my local library where I found two books written by fully-trained accredited professional homeopaths and aimed at a general public readership, which gave advice about malaria:
  1. 'The Practical Handbook of Homoeopathy: The How, When, Why and Which of Home Prescribing' by Colin Griffith RSHom, and
  2. 'Homoeopathy: The Modern Prescriber - A Practical Guide to Treatment' by Henrietta Wells RSHom.
Both books are intended, according to their introductions, to be read and used by the layperson. Let's take them in turn and see what each has to say about the prevention and treatment of malaria.

All emphases - whether bold or italic - in the quoted excerpts are present in the original text. Any typing errors are almost certainly my fault. The texts sometimes refer to "allopathic" medicine: this is homeopathic slang for modern conventional scientific medicine which uses real medicines which - unlike homeopathic preparations - contain active ingredients.

The Practical Handbook of Homoeopathy

(By Colin Griffith, published by Watkins Publishing in 2006).
The advice given on the prevention of malaria is straightforward - that malaria tablets should not be taken and that homeopathic methods should be used instead. From the 'Travelling Abroad' chapter, on page 331:
The official recommendation for tropical disease innoculations would leave us feeling like a pin cushion and often quite unwell ... Malaria tablets are recommended for mosquito-infested areas though these are not a good idea as the drug seriously undermines liver function and can cause side effects (China is the main remedy for malaria).
No hiding behind ifs, buts and maybes with that advice: "Malaria tablets are recommended for mosquito-infested areas though these are not a good idea". It is well recognised that pharmaceutical anti-malaria tablets can have side effects, which is why people are advised to stop taking them if they suffer problems. These problems don't happen to everyone and the claim that the drugs "seriously undermine liver function", as if this happens to all who take them, is baseless. Set against possible side effects of the drugs is the fact that infection with malaria can have pretty severe effects as well, up to and frequently including death. Having advised against effective prevention medications (and having avoided any mention of mosquito nets, insect repellents or other ways to prevent mosquito bites) the author promptly recommends homeopathic prophylaxis instead:
For homeopathic cover of the main diseases you should consult your practitioner ... Prescribing potentised disease material (or vaccine material) may not be 'good homeopathy' but it is effective. Malaria 30, Hepatitis A 30, Typhoid 30 etc. are remedies which have successfully been used prophylactically for many years. (Dr Dorthy Shepherd was one of the first to do so when she used Diptherinum 200 in an epidemic in London in the 1920s.) The beauty of these remedies is that they do not have any danger of side effects and they hold their efficacy as prophylactics only for a limited time thus avoiding the permanent state of 'on guard' immunity which is so taxing (and toxic) to the ecology of the body.
Certainly homeopathic "remedies" do not have side effects - for the simple reason that they have no effect whatsoever, including in warding off any disease.

That concludes the book's advice on malaria to the layperson.

Homoeopathy: The Modern Prescriber

(By Henrietta Wells, published by Watkins Publishing in 2002, reprinted 2004)
This book does at least mention that measures should be taken to avoid mosquito bites. Unfortunately it also advises that homeopathic prevention is preferrable to pharmaceuticals, and if you contract malaria it can be effectively treated by homeopathy without the need for conventional medicine. It begins on page 173 in Section 47 ('Malaria'):
Although the latest drug, Lariam, has been successful in dealing with malaria, it is reported to have many serious, unpleasant and lasting side effects; people have become anxious about the risk of taking it because the side effects can be so horrible.
As with 'The Practical Handbook of Homoeopathy' above, the side effects of anti-malarial drugs can be real, but so are their protective powers.
HOMOEOPATHIC PREVENTION FOR BOTH TYPES OF MALARIA
No preventative methods are 100% reliable against malaria, whether allopathic or homoepoathic, but the following are good and well worth trying; they are not as complicated as they may at first seem. They are also preferable to the possibility of getting the side effects from allopathic drugs. You should choose whichever one of the following regimes suits you best according to the length of time you will be in the malarial area, and also according to your susceptibility to getting bitten generally.
Homeopathic prevention is "preferable to the possibility of getting the side effects from allopathic drugs". Only in so far as being completely unprotected from malaria is preferable to being protected.
Details of homeopathic prevention regimes follow on pages 174, 175 and 176 which are taken up with different suggested dosages of "Malaria 30", "Sea Salt 30", "Staphisagria 30" (none of which contain any active ingredient) and "China 6" (million-millionfold diluted cinchona tree bark), depending on how long the traveller needs protection. Followed by:
GENERAL PREVENTION ADVICE
Apart from taking the preventative homoeopathic remedies it is very important that you use Pyrethrum 0 to stop the mosquitoes from biting you instead of any of the conventional medical smelly sprays.
By "Pyrethrum 0" she means the undiluted neat extract of certain species of Chrysanthemum, which contains insecticidal compounds called pyrethrins. I will leave it up to homeopaths to fight it out regarding how homeopathically-correct it is to recommend using undiluted ingredients but some credit is due to the author for recommending an actual insecticide, containing molecules actually poisonous to insects, as a means of preventing mosquito bites.
The conventional sprays, creams and burners must not be used if they contains substances which antidote homoeopathic remedies. If you used them it would spoil all your efforts in taking the homoeopathic remedies. Pyrethrum 0 does not affect the homoeopathic remedies and you can get this as a spray from homoeopathic pharmacies ... It is very important to sleep inside a mosquito net soaked in Pyrethrum as well as keeping as much of the body covered up as possible, particularly in the evenings.
Further credit due: although the traveller following this author's advice will not be protected by preventative drugs, they are at least being advised to sleep under a net, keep well covered during evenings when mosquitoes are most active and apply insecticide. Restricting them to a single insecticide is unfortunate instead of recommending they deploy a full battery of repellents and insecticides, but at least it's much better than nothing.
Remember also to avoid all the medicaments and other things which can make the homoeopathic remedies inefficient, or even may antidote them (see sections 6 and 8).
This is slightly problematic. Section 6 of the book ("Can one use homoepathic remedies at the same time as taking allopathic remedies?") advises that taking conventional drugs can reduce the effect of any homeopathic remedy being taken:
Homoeopathic remedies do not interfere with allopathic medicine; it is perfectly safe to take homoeopathic remedies for the acute situation if you are also having to take allopathic medicines for some other chronic condition. On the other hand, allopathic medication for chronic conditions can make the homoeopathic remedy less effective although this is less likely during acute homoeopathic prescribing. When treating acute conditions with with homoeopathic remedies it is not a good idea to give ordinary medicines at the same for the same acute condition. ... Allopathic medication for chronic diseases can make homoeopathic treatment for chronic disease less effective, but usually this homoeopathic treatment should decrease the need for allopathic medication until eventually it is should not be needed at all.
So homeopathic-only prophylaxis is not just "preferable to the possibility of getting the side effects from allopathic drugs" but also using a pharmaceutical anti-malarial will, the reader is told, make the homeopathic prevention less effective. It won't, of course: the homeopathic prevention measures are perfectly useless to begin with. Things quickly get worse as Wells moves on from advising people about preventing malaria to advising them what to do if they get it, on page 178:
INTRODUCTION TO TREATING MALARIA
Malaria, particularly the more severe kind, cerebral malaria, which is caused by Plasmodium falciparum, can be very dangerous partly because of the speed with which the patient can sink. Both kinds are particularly dangerous for pregnant women and young children, As there is no time to waste it is obviously best not to attempt to treat it yourself. If you cannot get immediate homoeopathic help you should always have allopathic treatment and not waste any time. The following remedy details for this illness are given so as to inform the layperson that this type of serious disease can be treated successfully with homoeopathy, not on the understanding that that he or she will actually try it without professional help.
The general symptoms may include rigor (shivering fit/chill), headache, intense fever delirium, sweating, diarrhoea, vomiting, cough, malaise, muscle pains, jaundice (yellow skin/yellow whites of the eyes).
Note the advice to seek "allopathic" (ie conventional, scientific, effective) medical care if a homeopath can't help, and that malaria can be treated successfully with homeopathy. This is dangerously bad advice. Cerebral malaria can kill within hours, and no homeopathic treatment is going to do anything to stop it or slow its progress. The only result of consulting a homeopath about a case of malaria is to waste time seeking effective treatment, and thereby put the patient's life at risk.
The rest of pages 178 through to 181 are taken up with different suggested dosages of homeopathic remedies for "treatment of the less severe type of malaria, also known as benign malaria". On page 182 we have...
SYMPTOMS AND TREATMENT FOR THE MORE SEVERE TYPE OF MALARIA CAUSED BY PLASMODIUM FALCIPARUM, ALSO KNOWN AS CEREBRAL MALARIA
This is mostly found in West Africa and is the kind which causes most deaths. The incubation period is 9-14 days, but can be as long as one month, or may be longer if prophylactic drugs have been taken ... Mental and general symptoms should guide you to the choice of remedy in severe cases, helping you choose between Stramonium, Hyoscyamus, Belladonna and Opium. It is possible that sometimes one of the other remedies already mentioned for the less severe serious (benign malaria) is indicated, so check them too.
Yes, do be sure to check those other remedies are indicated while you choose between Stramonium, Hyoscyamus and Belladonna: that's really important. Oh, and don't forget to get the patient to a hospital where they can be treated by real doctors with proper medicines. I can only repeat what appallingly bad advice is being given here. Involving a homeopath in a case of malaria is only going to have the effect of wasting time seeking effective treatment, and this is a disease which can quickly kill.
In summary, of the two books I found in which professional homeopaths gave malaria advice to the general public, both recommended homeopathic-only prevention and 1 claimed that homeopathy is an appropriate way of treating malaria once contracted.
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