Alternative medicine

As a profession, we are brought up on scientific principles - we all accept that Boyle's law works, or that gravity pulls things down instead of making them go up, then why do some of our profession refuse to accept that going beyond Avogadro's number in a dilution, renders that solution devoid of any of the original molecules present? "Because water has a memory!!" they say, "..the original molecule has "imprinted" itself in the water and that's how it acts" Prof. Ernst in his book "Trick or Treatment" debunks this, with the tale of Jaques Benaviste and his paper published in Nature, where he seemed to show water had a memory - don't forget that this is the cornerstone of homeopathy, and if it was proved, then it was plain sailing for the homeopaths. The experiment was shown to have operator bias, and thus false. In his book, Prof. Ernst takes a number of alternative therapies and subjects them to analysis, and shows that on the whole, they are false. Where does this leave pharmacists? We are a profession that (I hope) will only accept that which is true, and has been proven in trials, no matter how distastfull they may be to us. It is the concensus of a large body of evidence, eg The Cochrane Collaboration or Bandolier, that gives us the facts that we use in our daily practice. Prof Ernst does the profession of pharmacy a very great service in giving impartial knowledge that we all can use. I would urge fellow pharmacists to go beyond Prof. Ernst's popular scientific works and read some of his scholarly papers, and the true genius of this man shines through. In writing his letter to the Journal, he has opened up a debate that will run and run. Ezard Ernst has said that - in effect - if the evidence proves this alternative therapy to be worng then it is so!! The homeopaths and their fellow travellers in the CAM (Complementary and Alternate Medicine) field seem to operate on the premise of The Bellman, in Lewis Carrols' " The Hunting of the Snark" - "...what i tell you three times is true." However,.... however, I will leave this posting with a parting shot: 1992 saw the hundreth aniversary of Kekules' discovery of the structure of benzene, how he sat in front of his fire and dreamed that the smoke rising was a snake taking hold of it's tail and thus the essential ring structure of aromatic compounds was born, and experimental evidence seemed to prove it was so. The American Chemical Society decided to mark this anniversary with a special meeting to celebrate how far aromatic chemistry had come since Kekule. The meeting ended up in a brawl!! There were chemists there who disagreed with Kekule's structure,the one that we are all familiar with, and put up equally viable (to them) structures of their own and would brook no argument, which lead to fisticuffs. Thus there is always the element of doubt, however small. Remember, only two things in life are certain - death and taxes!! Regards Bob Dunkley

In your editorial (PJ, 19 July 2008, p58), why single out homoeopathic products to bear the burden of proof of efficacy?

If over-the-counter products were subjected to a similar demand for evidence of effectiveness in the form and strengths available, pharmacy shelves would be far less crowded, starting with the cough and cold section.

As a community pharmacist, I find it is not always possible to adhere to the code of ethics requiring that I ensure safe and effective use of medicinal products.

Primum non nocere, or “first do no harm”, may be a fine principle for physicians, but for community pharmacists the absence of harm is a tenuous basis on which to promote and sell OTC products.

Peter Dawson

Ilkley, West Yorkshire

Is there some inconsistency here? Your leading article (PJ, 19 July 2008, p58) discussed critically the ethics of supplying homoeopathic products. In the same issue you published a letter (PJ, 19 July 2008, p69) and an article (PJ, 19 July 2008, p75) on the subject by Edzard Ernst, both of which could reasonably be said to take a negative view of homoeopathy.

However, on pA8 and pA12 you carried two colour advertisements for books on, respectively, homoeopathic prescribing and homoeopathic practice, both of which are stated to be published by the Pharmaceutical Press.

If pharmacists should consider the ethics of supplying homoeopathic products, surely that extends to the Pharmaceutical Press.

Miall E. James

Colchester, Essex

By offering for sale homeopathic and other unregulated products the profession offers a legitamacy to this area which it does not deserve. Friendly words are used like "alternative medicine" and "complimentary medicine" which suggests to the consumer that they are purchasing something purporting to be a medication. In the vast majority of cases this is not true. It would be closer to the truth to call them "improbable therapies", thus Prof. Ernst would become Professor of Improbable Therapies! As pharmacists we are trained in the scientific method and condoning improbable therapies in this way is the antithesis of this principle. I am all for informed consumer choice, but the consumers are being misinformed by the fact they are buying these products from pharmacies and not from the local witch-doctor.

"There are thousands of trials that show that homoeopathy is better than placebo, but these are ignored." No, there aren't. Not good quality trials. Go and read the evidence. I assume you're not deliberately lying, but instead misinformed.