Homeopathy and Loshon Hora

Following discussion with Rabbi Moshe Cohen, I though about sending this to Torah Forum:

A growing number of our friends are "into" homeopathic medications and other "alternative health" strategies. Priding myself in being an open-minded kind of guy, I decided to investigate the matter rather than take the standard party line in "traditional" medicine/ pharmacy circles (which is to dismiss it immediately). After spending 6 months reviewing "their" literatature (naturalists' books, pamphlets, articles) and "our" literature (articles of clinical trials in the medical literature), I have come to a clearer conclusion about homeopathy than my colleagues have.

I clearly and unambiguously conclude that it's 95% bunk.

The other 5% is a combination of rare (but real) efficacy in very limited situations, and the far more important issue that any perceived care-giver demonstrating true concern for a care-seeker will likely have palliative and potentially other therapeutic effects.

Now for the shayla.

Since there are people in the community - observant Jews - and one in particular - whose parnasa [livelihood] is largely dependent on providing alternative health to a growing number of my friends, is it considered lashon harah to speak harshly and pointedly about the nonsense of the art (I was tempted to say pseudoscience, but I wouldn't want to elevate it to something it is not) of homeopathy and herbology?

A bit more background: There are dozens and dozens of articles in the medical literature reporting on the unambiguous associations between several natural products touted as safe herb therapy. Safety claims continue. They are absolute lies. As you know, many drugs that are used in "traditional" medicine are "natural" products, as are quite a few know poisons. "Natural" does not necessarily mean healthy, beneficial, or even safe. HaKadosh Baruch Hu, in His Wisdom, did provide us with some pretty nasty stuff that grows from His Earth.

Homeopathy, although probably not dangerous (except rare allergic reactions) does pose another problem. Mental dependence (reliability) on something which does not truely work can lead to avoiding something that does work. Recently, a friend of ours with a small child sufferring (I do mean suffering) from some sort of rash, did not take the child to a "traditional" doctor; rather, she handled it with homeopathy. When asked if she wwas treating it with topical steroids (a perfectly safe medicine), she claimed that she cared too much for her child to subject her to such dangerous drugs. What if, Chas VeShalom, her child were to have asthma, and the mother decided not to give those "dangerous" chemicals, but instead relied on placebo.

The problem I have is that I am not always aware of my friends' medical issues. Can I, or should I, therefore, launcy an all-out verbal war against what I perceive a real danger. Or is it lashon harah?

Note: mind you, I have no direct or indirect monetary benefit either way. I do not own my own pharmacy (in fact, if I did, I might be tempted to sell the stuff -- quite a profit you know -- just kidding). Plus, I can't imagine the entire healthcare industry going bust as millions of consumers launch into placebo therapy.

---
I will conclude with this. The reason this question came up at all is that I am planning on dressing as a witch doctor for Purim. Because I have been listening to the Chofetz Chaim Foundation tapes, I was sensitized to consider this as a shayla. Rabbi Cohen spoke with R. Shmuel Kaminetzky, shlita, who advised not to advertise that I am peddling homeopathy, as a part of the get-up. I pray that HaKadosh Baruch Hu continues to inspire me to improve my Shmiras HaLashon as He has in this way.

Manny Saltiel

Let me first of all commend Manny Saltiel for being so careful with the detailed and critical laws of Gossip. It is indeed important not to say anything that would harm another person without cause.

Now, let's turn to the specific topic of homeopathy, regarding which Manny has said:

I clearly and unambiguously conclude that it's 95% bunk.

A bit more background: There are dozens and dozens of articles in the medical literature reporting on the unambiguous associations between several natural products touted as safe herb therapy. Safety claims continue. They are absolute lies.

Since there are people in the community - observant Jews - and one in particular - whose parnasa [livelihood] is largely dependent on providing alternative health to a growing number of my friends, is it considered lashon harah to speak harshly and pointedly about the nonsense of the art (I was tempted to say pseudoscience, but I wouldn't want to elevate it to something it is not) of homeopathy and herbology?

This is what I don't understand. People are making a living selling snake oil, and you're not allowed to tell the victims not to waste their money?

What if, Chas VeShalom, her child were to have asthma, and the mother decided not to give those "dangerous" chemicals, but instead relied on placebo.

The problem I have is that I am not always aware of my friends' medical issues. Can I, or should I, therefore, launch an all-out verbal war against what I perceive a real danger. Or is it lashon harah?

You should not accuse these people of intentional deception, because this is usually not the case - HaShem works miracles, and there are documented cases where chemotherapy has not helped, and a mixture of basil, parsley and dog food has managed to cure the patient. Never refer to the individuals involved; just say that those who practice homeopathy (I dare call it neither medicine nor art) do not have the full body of statistical evidence in hand.

I also wouldn't worry about their parnassah - who says people will listen to you? People go with whatever they like, not with what's actually healthy or effective.

Have you heard these "Ginsana" commercials? "Clinically tested for 25 years!" Fine - tested for what? What does "Ginsana" Ginseng extract actually do? Guess what it says on the box? NOTHING!! And yet they have a national radio campaign going for a very expensive sugar pill.

I hereby offer my own "natural" pick-me-up, guaranteed more effective than Ginsana. Purchase pure Columbian coffee beans. Pick up a manual grinder, made only of old-fashioned smelted iron and organically-grown woods. Grind the beans. Run through a coffee maker using only a natural, unbleached filter. The resulting concoction will be bitter, but can be quite pleasant with milk and/or sugar. Some even grow to like it plain. And it's all-natural!

Yaakov Menken

A reply to Manny Satiel.

While I respect his sensitivity to Hilchot Lashon Hara, and I personally feel that the Purim costume may violate those halachot, I believe that there is a responsibility of Pikuach Nefesh, Ushmartmem Meod Lenafshoteichem [You shall exceedingly guard your lives], to inform all of his friends about the dangers of homeopathy.

Rachmana Lizlan [Heaven save us], I know of a child that died because of lack of medical treatment. I believe strongly that Mr. Satiel has a chiuv to inform all of his friends of the dangers in avoiding medication. Hilchot Lashon Hara would prohibit him from maligning the homeopath, but not the medical practices he undertakes. All of his friends should be informed of the medical research and articles which document those facts. It is up to them to draw their own conclusions.

I wonder though whether halachically a frum person can become a homeopath? Is it Maaseh Chishuf [witchcraft]? I would be interested in your thoughts.

Judah Isaacs

Regarding the issue of alternative medicine, rather than engaging in a verbal war with fellow Yidden, engage a Beit Din [religious court]. If these practices are either dangerous or just plaim malarchy they would be prohibited by Torah so a Beit Din should order the offender to stop being involved with this.

From: "Manny, X5729, PHARMACY" <SALTIEL@CSMC.EDU>
Subject: Homeopathy & Lashon Harah [Gossip / Evil Tongue]

A growing number of our friends are "into" homeopathic medications and other "alternative health" strategies. Priding myself in being an open-minded kind of guy, I decided to investigate the matter rather than take the standard party line in "traditional" medicine/ pharmacy circles (which is to dismiss it immediately). After spending 6 months reviewing "their" literatature (naturalists' books, pamphlets, articles) and "our" literature (articles of clinical trials in the medical literature), I have come to a clearer conclusion about homeopathy than my colleagues have.

I clearly and unambiguously conclude that it's 95% bunk.

The other 5% is a combination of rare (but real) efficacy in very limited situations, and the far more important issue that any perceived care-giver demonstrating true concern for a care-seeker will likely have palliative and potentially other therapeutic effects.

Now for the shayla.

Since there are people in the community - observant Jews - and one in particular - whose parnasa [livelihood] is largely dependent on providing alternative health to a growing number of my friends, is it considered lashon harah to speak harshly and pointedly about the nonsense of the art (I was tempted to say pseudoscience, but I wouldn't want to elevate it to something it is not) of homeopathy and herbology?

Furthermore, the claim that herbology is also not a reasonable therapy is simply not supportable. Not only the so called alternative medicine uses of herbs, but the traditional western research into herbs has shown that herbs possess documentable medical properties. No less than the CRC has a huge handbook on the medicinal value and theraputic uses of herbs. Once again, to speak against a practitioner of herbal medicine on the basis of ignorance in a attempt to deprive them of their livelihood is certainly lashon hara.

A bit more background: There are dozens and dozens of articles in the medical literature reporting on the unambiguous associations between several natural products touted as safe herb therapy. Safety claims continue. They are absolute lies. As you know, many drugs that are used in "traditional" medicine are "natural" products, as are quite a few know poisons. "Natural" does not necessarily mean healthy, beneficial, or even safe. HaKadosh Baruch Hu, in His Wisdom, did provide us with some pretty nasty stuff that grows from His Earth.

Homeopathy, although probably not dangerous [...] does pose another problem. Mental dependence (reliability) on something which does not truely work can lead to avoiding something that does work. Recently, a friend of ours with a small child sufferring (I do mean suffering) from some sort of rash, did not take the child to a "traditional" doctor; rather, she handled it with homeopathy. When asked if she wwas treating it with topical steroids (a perfectly safe medicine), she claimed that she cared too much for her child to subject her to such dangerous drugs. What if, Chas VeShalom, her child were to have asthma, and the mother decided not to give those "dangerous" chemicals, but instead relied on placebo.

If the mother was relying on a placebo, then yes we might say that she acted irresponsibly, however, that is not the case here. She did not chose your treatment method, but that does not make it a placebo.

The problem I have is that I am not always aware of my friends' medical issues. Can I, or should I, therefore, launcy an all-out verbal war against what I perceive a real danger. Or is it lashon harah?

It is more than just lashon hara, it is lunacy.

Compiler's note: This posting contains quotes from both the original
posting on this subject and the first reply to it. It is quite clear in the
original email which quotes are from where - here instead of using copious 
amounts of pointy brackets or the indenting system I usually use, I will use 
the initials MS and YM to distinguish between the two sets of replies and IR 
to show the text of this message. If you are REALLY confused, send me email at
benezra@mit.edu and I will send you the original posting.

[Manny Saltiel asked:] (MS)
Since there are people in the community - observant Jews - and one in particular - whose parnasa [livelihood] is largely dependent on providing alternative health to a growing number of my friends, is it considered lashon harah to speak harshly and pointedly about the nonsense of the art (I was tempted to say pseudoscience, but I wouldn't want to elevate it to something it is not) of homeopathy and herbology?

(YM)
This is what I don't understand. People are making a living selling snake oil, and you're not allowed to tell the victims not to waste their money?

(IR)
If you know that it is snake oil, i.e., it will not help them and could harm them, then yes you can warn people away. If you simply disagree with the medicine, you are not allowed to commit lashon hara.

(MS)
What if, Chas VeShalom, her child were to have asthma, and the mother decided not to give those "dangerous" chemicals, but instead relied on placebo.

(YM)
Even better - appendicitis. Heaven forbid. Homeopathy is not innocuous, it's a hazard to public safety.

(IR)
This statement is lashon hara. Please substantiate the claim that it is a hazard. Since you are speaking against a group of people with the attempt to deprive them of their livelihood, you must substantiate these claims.

(MS)
The problem I have is that I am not always aware of my friends' medical issues. Can I, or should I, therefore, launch an all-out verbal war against what I perceive a real danger. Or is it lashon harah?

(YM)
Despite mumbling to myself that "it's not a shayla! [a question]", I spoke with a Talmid Chacham of stature before replying - I am certainly nowhere near a Halachic authority. His opinion was that if you clearly state that it is _your_ educated opinion that it's all rubbish, you are performing a public service and it is a Mitzvah to publicize your opinion.

(IR)
Right, that is the thing missing from this discussion so far. When a person makes a statement like "X is false" then the listeners will be inclined to believe the speaker. If the speaker was incorrect or speaking out of ignorance or out of malice, then it is a problem. The speaker should instead say "since I know this and that, X is false" and in this way the listeners can consider the testimony given in a context. To simply say "X is bunk" is pure lashon hara. Kal v'chomer (even more so) when the speaker goes on to say that they are not an expert or even learned in the field about which they are speaking and yet they claim to be able to relate a fact about the topic.

(YM)
You should not accuse these people of intentional deception, because this is usually not the case - HaShem works miracles, and there are documented cases where chemotherapy has not helped, and a mixture of basil, parsley and dog food has managed to cure the patient. Never refer to the individuals involved; just say that those who practice homeopathy (I dare call it neither medicine nor art) do not have the full body of statistical evidence in hand.

I also wouldn't worry about their parnassah - who says people will listen to you? People go with whatever they like, not with what's actually healthy or effective.

(IR)
Then by this argument one could say that people that use computers are child molsters since nobody will listen to this? I disagree.

(YM)
Have you heard these "Ginsana" commercials? "Clinically tested for 25 years!" Fine - tested for what? What does "Ginsana" Ginseng extract actually do? Guess what it says on the box? NOTHING!! And yet they have a national radio campaign going for a very expensive sugar pill.

(IR)
It is difficult for most companies to afford to make health claims on any product. The FDA is very strict about the requirements and the cost is simply too great for most companies to bear. As an example of the peculiar rulings of the FDA, acupuncture is still considered experimental even though there is 5,000 years of tradition (weak argument) and an enormous body of clinical evidence supporting the use of acupuncture in the treatment of chronic disorders (for which, btw, western medicine has no good treatment, e.g., asthma).

(YM)
I hereby offer my own "natural" pick-me-up, guaranteed more effective than Ginsana. Purchase pure Columbian coffee beans. Pick up a manual grinder, made only of old-fashioned smelted iron and organically-grown woods. Grind the beans. Run through a coffee maker using only a natural, unbleached filter. The resulting concoction will be bitter, but can be quite pleasant with milk and/or sugar. Some even grow to like it plain. And it's all-natural!

(IR)
But before you make health claims on the box, you better be prepared to do a lot of expensive documentation and so forth. Furthermore, there are plenty of people ready to bring evidence that coffee is involved in many diseases, so I'd advise against making health claims for the coffee and just drink it. It is good with milk and a little sweetening :-)

Israel Rosencrantz, Rabbinical College, Morristown NJ <peterr@planet.net>

From: ISAACSJ@aol.com Subject: Homeopathy and Loshon Hora [Gossip]

A reply to Manny Satiel.

While I respect his sensitivity to Hilchot Lashon Hara, and I personally feel that the Purim costume may violate those halachot, I believe that there is a responsibility of Pikuach Nefesh, Ushmartmem Meod Lenafshoteichem [You shall exceedingly guard your lives], to inform all of his friends about the dangers of homeopathy.

Rachmana Lizlan [Heaven save us], I know of a child that died because of lack of medical treatment. I believe strongly that Mr. Satiel has a chiuv to inform all of his friends of the dangers in avoiding medication.

Hilchot Lashon Hara would prohibit him from maligning the homeopath, but not the medical practices he undertakes. All of his friends should be informed of the medical research and articles which document those facts. It is up to them to draw their own conclusions.

I wonder though whether halachically a frum person can become a homeopath? Is it Maaseh Chishuf [witchcraft]? I would be interested in your thoughts.

In my community of Chabad-Lubavitch chassidim, which certainly qualify as frum by most people's standards, there is at least one M.D. that also uses homeopathic treatment. He finds it to be very successful. He does this with the knowledge of the Rav of the community (who is part of the Bet Din of Crown Heights). Is this sufficient evidence?

Israel Rosencrantz, Rabbinical College, Morristown NJ <peterr@planet.net>

Any herbalist or homeopath that would tell someone with appendicitis to forego emergency surgery is a "rodef" [pursuer with intent to murder]. This person could not be called a healer at all. As I said in a previous posting, a healer of any ilk that cannot tell a client to seek help elsewhere for the particular condition has failed the test. G-d gives one the permission and power to heal. This is a privilege.

Israel Rosencrantz of the Rabbinical College in New Jersey attacks R. Yaakov Menken and me for claims we made about homeopathy. I'd like to address an issue he brings out against R. Menken's tongue-in-cheek suggestion that coffee be advocated as a pick-me-up (instaed of ginseng). Mr. Rosencrantz states that one better be prepared to document such efficacy and safety claims, as the FDA needs a lot of very expensive studies.

To clarify to the readers, the relationship between the FDA and the homeopathy industry is loosely defined. The primary author of the Federal Food Drug and Cosmetic Act of 1938 -- which gives the FDA the power to regulate drugs in the US -- was a homepathic physician by the name of Royal Copeland. He wished to see homeopathy continue in the US, and therefore included entities listed in the Homeopathic Pharmacopeia of the United States (HPUS) in the official designation of "drug." Homeopathy was and remained unregulated until 1988, primarily because the FDA saw it as a very small entity with an equally small following. As it grew, however, the FDA decided to take a 2nd look. The Compliance Policy Guide (CPG) established guidelines for homeopathy, and was phased in between 1988 and 1990. Nonetheless, even today, the FDA does not require proof of of safety or efficacy for either prescription or over-the-counter (OTC) homeopathic remedies.

Therefore, for an advocate of homeopathy to hide behind the excuse that it costs too much to demonstrate that a product works is a bit deceiving. For a "drug" which is considered homeopathy, no study whatsoever is required; simple testimonial is fine. "I tried it in some patients, and it works" would be appropriate, it seems.

In this light, the concept of marketing coffee seems quite appropriate.

For more information, readers are urged to read the entire December 1994 issue of California Journal of Hospital Pharmacy. Let me quickly point out that almost all the articles were written by homeopathists or their advocates.

manny saltiel
csmc 310-855-5729

I have to say that I find the arguments of Israel Rosencrantz amazing. His defense of homeopathic medicine has been stout, but it is also deeply flawed.

Israel Rosencratz's basic argument is that one should not come out against homeopaths with concerns or criticisms in a community because homeopathy can and does work. Time and again he argues that the evidence "clearly" shows homeopathy works.

This is all well and good. But it still leaves us with a basic problem: if one believes, as I do, that homeopathy is evil, wrong, and often harmful, then how can you do otherwise than condemn it when lives may be at stake?

One writer (the individual who kicked the discussion off) wrote that he studied homeopathy for a time, and came to the conclusion that it is harmful. Israel replied that coming to such a hasty conclusion obviously shows a lack of learning. This is the response any of us might have to one who concludes, after a few months' study, that Judaism oppresses women (to choose an uncontroversial topic :-)).

But homeopathy is not the Torah. Clinical studies and "lay" doctors do matter and have an opinion. And these doctors, such as many related to me, make extremely persuasive cases that homeopathy is bunk and often dangerous bunk. In order to make the argument, I will deal with the extreme cases (not those sticking pins in themselves for migraines, but those who use homeopathy in dangerous situations).

So we are left with the original question: If some Doctors and Rabbis support homeopathy, as they obviously do, and others (greater in number) do not support homeopathy, we need to know to what extent are we justified or *commanded* to make our cases known?

According to Jewish law, can an intelligent individual who believes himself correct, stand up for what he believes? And if Pikuach Nefesh [threat to life] is present (as it can be, for example, in home births with potential complications) do we have any reason at all not to openly and publicly condemn homeopathic doctors?

Or take it a step further. If an influential Rav feels homeopathic medicine is dangerous and a threat to life, should he publicly condemn those who practice such approaches to medicine? Or should he simply (as those who practise tend to believe in what they do), try to convince those who might be interested in trying homeopathic solutions not to risk themselves?

This, I am afraid, starts to move outside the realm of Halacha and into politics. Nonetheless, the issue, especially as it may apply to other things (such as abortion), is very important. Do we practice what we believe?

Isaiah

Israel Rosencrantz suggests that one should abstain from warning a fellow Jew about the dangers of avoiding accepted medical care and opting instead for homeopathy. He asserts that "before you warn someone you must have good reason to believe that it (taking homeopathy and thereby avoiding real medicine) is a hazard. This is not supported by the evidence."

When it was suggested that perhaps practicing homeopathy may be akin to Maaseh Chisuf [witchcraft] (which I am not sure I agree with, but is certainly worth asking a shayla about), Mr. Rosencrantz responds that in his community in Crown Heights, there is "at least one M.D." (I suppose that means precisely one M.D.) that uses homeopathy, with the knowledge of the local Rav. This, he states should dispell any question.

In reference to the comment that there is "evidence" to the contrary of my assertions and most others who have posted comments on this question, I would challenge Mr. Rosencrantz to find any clear proof of efficacy to date. At all times willing to retract comments of lack of effectiveness when finding some, I assert that the existing data as of this writing is less than slim. The FDA does not require efficacy or safety studies in order for a homeopathy firm to market a prescription or over-the-counter (OTC) homeopathic preparation. This is in contradistinction to a requirement of 2 blinded placebo-controlled trials (i.e. one to confirm the findings of the other) for real medicine. Testimonial, the method of choice for homeopathic "trials," is inadequate, as a placebo response can be expected in up to 33% of patients with diseases or symptoms as divergant as cancer or dental surgery pain, depression, Parkinsonism, ulcerative colitis, congestive heart failure, sciatica, and dysmenorrhea (see Pearce, Quarterly Journal of Medicine 1995, volume 88, pages 215-220). In an interesting study, 21 Malawi students (Malawi is an east African nation) were told (falsely) that a neutral substance would elevate their body temperature and pulse. During one of the 2 sessions, the substance was disguised as a traditional African herbal concoction, whereas on the other session, it looked like a Western medicine. Both preparations had a significant effect on pulse and temperature, consistent with the subjects' beliefs. Placebo effect is a real effect, and therefore uncontrolled trials are discarded in the scientific community.

A recent study by David Reilly in Scotland has captured the hearts and minds of homeopathy advocates everywhere. The study, published in the Lancet (Decemebr 10, 1994, volume 344, pages 1601-6), concluded that homepathic preparation (which began -- prior to the dilution process -- as an allergen) had a beneficial effect in asthamtics. Although the results are intriguing, advocates would do well to read some of the criticisms by Rothwell and Gagnon (same journal, January 28, 1995, pages 251-2). The results are equivocal and require confirmation. The method of assessment has never been agreed to by allergy specialists (pulmonologists and allergists).

A review of 105 trials of homeopathy by 3 Dutch investigators concluded that 81 were favorable of homeopathy, an optimistic finding. However, the same groups admiitted that "most trials seemed to be of very low quality." (see British Medical Journal, February 9, 1991, volume 302, pages 316-323).

Advocates of homeopathy see those of us in the scientific community as proud embracers of the status quo, jealously protecting our professions and our images, and in the process blindly dismissing "alternative healthcare options." They quickly point to the example of chiropractic med, which until recently was repeatedly attacked by physicians, and is now creeping into western acceptance. Is this true?

The truth is that nothing could be further from the truth. Scientific medicine and therapeutics is, at its foundation, evidence-based. If and when something can be shown to be effective, it is embraced. Until then, it is shelved. The example of chiropractic stated above is a good place to explain this. Until recently (and I dare say even now in limited circles), many chiropracters advertised that their art could benefit a wide spectrum of disease from diabetes to cancer. This, the world of medicine found objectionable. More recently, controlled trials have established solid roles for chiropractic medicine, and all but a small number of western medicine folk accept this as important aspect of medical care.

When and if homeopathy can establish itself as a true medical option in the treatment of disease, there will by a hush of the criticism. Until then, a proper thinking Jew, it seems to me (and Yaakov Menken, if I may paraphrase him), may and should speak in strong and clear terms against fellow Jews depending on homeopathic preparations to treat themselves. Lo Sa'amod Al Dam Re'echa [do not stand by idly by your brother's blood) means do not be inactive when a fellow Jew -- through ignorance or otherwise -- may be harmed or harm himself.

Manny Saltiel, Pharm.D.
Cedars-Sinai Medical Center
310-855-5729
saltiel@csmc.edu

I am a fourth-year medical student (final year) in California and have a few comments about the homeopathy debate.

First, the _only_ way really to know if a substance works or does not work is by clinical trial. That is, you must (essentially) take this drug (or procedure, acupuncture, eg) and give it to a substantial number of people, and at the same time give a placebo, eg, to a similar number of people.=20 After the study, you will be able to tell what effects, if any, your agent has. It is not sufficient to review associations between health and your agent from the past -- there can be things that skew the results that you are not aware of. For example, if reviewing people's income and rate of cancer, you see that the lower the income, the higher the cancer rate. So you conclude that money is protective against cancer. In reality, maybe poorer people are more likely to smoke and live in polluted towns and they get cancer that way. The only way to prove a cause-effect is by a clinical trial. =20

This goes for personal anecdotes, too. There is clearly a placebo effect, and there are surely people whose cancer goes into remission after chemotherapy failed to work, and other wonder stories. This does not prove that prayer or sugar pills, or the grapefruit diet work. It only proves that nothing is 100% in medicine, and that anecdotes are interesting.

Next, there is also a lot of knowledge stored in ancient cultures. People from the West go into the Amazon to commune with the natives to find traditional (native) cures for their diseases. The medicines used by the natives are brought back to the States (or wherever) and processed to find active ingredients. I think this is how Digoxin was discovered, but don=D5t quote me. I am sure a lot of Chinese teas have active ingredients, and I also think that acupuncture has a lot of uses, too.

Nonetheless, without a clinical trial, it would be irresponsible to use any of these traditional medicines except as a last resort or as an alternative to western medicine. If western medicine is not working for you, fine. Go nontraditional. But without documented evidence by clinical trial, it is nonscientific.

Someone wrote in the last article about some clinical trials in some good journals (I noticed British Journal of Medicine, I think). It sounded, though, like the articles were summaries of others' evaluations of alternative medicine (I haven't had a chance to read them yet). I think it is crucial to read the exact experiments that were done, though. A summary of others=D5 experiments doesn't really give any information, I think. This is because an experiment is only as good as its protocols.=20 At UCSF (my school), our epidemiology/biostatistics class teaches us to attack all papers/experiments we read to find every flaw in the study.=20 When we find insignificant or no flaws, then we can believe. But there are times when the authors of the papers make some big mistakes that they are not aware of at the time, and these mistakes make those experiments irrelevant. I would be very interested to see the experiments and will check them out soon.

In summary: no clinical trial/no medicine.

Keith Brookenthal

I find this lengthy debate somewhat surprizing. A couple of points:
1. I am not an advocate of homeopathic medicine.
2. But, I have friends who are practitioners and recipients who are modeh to= it.
3. And: Homeopaths were the first to "proof," that is run clinical tests of their remedies! Large national samples and double-blind methods, of course, came long afterwards.
4. And: In the 19th century, nearly half of physicians were homeopaths, including some "greats" that have famous hospitals named for them!

But...let's move on!

Just some musings on the recent homeopathy debate: Please note that I am not making any claims as to the effectiveness or lack thereof of *any* form of medicine ( Eastern, Western or other ) Rather, I want to discuss the argument style that is being used here.

In order to make the argument, I will deal with the extreme cases (not those sticking pins in themselves for migraines, but those who=20 use homeopathy in dangerous situations).

I was told of a medrash ( to throw a little Torah in here to justify this posting :) ) that when Avraham sent away the b'nei ha-pilagshim and gave them gifts ( as is mentioned in the Torah ) that he gave the gift of medicine to the child sent eastward ( maybe an allusion to Eastern medicine ). I have not personally seen the medrash, but it sounds interesting.

Now, it is difficult to run double blind trials with acupuncture. So there must be a different standard. A tradition of success over the course of millenia is a good starting point. Of course this does not apply to homeopathy which has a much shorter time frame.=20

And if Pikuach Nefesh [threat to life] is present (as it can be, for=20 example, in home births with potential complications) do we have=20 any reason at all not to openly and publicly condemn homeopathic=20 doctors?

Also, pikuach nefesh is not necessarily present in home birthing. I notice, of course, that the poster wrote 'as it can be', but the initial reading to a casual reader leaves the impression that home birthing leads to pikuach nefesh situations.=20

Please, argue the merits or detractions of one thing at a time. For now it is homeopathy.

When it was suggested that perhaps practicing homeopathy may=20 be akin to Maaseh Chisuf [witchcraft] (which I am not sure I agree=20 with, but is certainly worth asking a shayla about),

Scientific medicine and therapeutics is, at its foundation, evidence-based. If and when something can be shown to be=20 effective, it is embraced. Until then, it is shelved.=20

We should not be married to the notion that Western science ( and medicine ) are the only true methods for reaching correct conclusions. To discuss anything honestly we must try and do things from an halachic method: look at the issues and evidence with cold objectivity, follow the evidence to its logical conclusion and there you will find the answer. But to bring in stipulations as to how the evidence will be viewed, and certainly to bring in totally unrelated issues, will cloud clear thinking and lead to predetermined results. =20

One last point: To have the Western medical profession assess alternatives to itself ( which would certainly be detrimental to the medical professionals ) is not looking at the issues through the most objective, unbiased eyes. Let scientists in fields other than medicine look into the claims of alternative medicines, as well as the claims of Western medicine, and see which has a better success rate. And this success rate should not be one for the entire field, but rather, for as many individual illnesses as possible. I would be interested to see those conclusions.

Eliyahu Teitz

Compiler's Note: If you are interested in learning about Hilchot Loshon
Hora (the laws of Loshon Hora, commonly translated as gossip) check out
the archives of the class, where you can gopher it.

After deciding that something may be said against homeopathy, we are=20 required to follow seven conditions. The Chafetz Chaim discusses these=20 conditions in detail in Sefer Chafetz Chaim, Hilchot Lashon Hora, Klal=20 (Chapter) 10:

1. The information must be true, not merely a supposition based on hearsay or circumstantial evidence. Manny's thorough research would qualify in this case; he has documented, scientific evidence about these practices.=20

2. The situation must pose a threat or constitute a violation of Torah law. In our case, we should distinguish between dangerous practices and those that are merely useless. Of course, if application of a useless treatment causes a person to neglect successful means of treatment, this would constitute a danger as well.=20

3. Before making the situation public, the speaker must approach the transgressor himself and attempt to pursuade him to change his ways.=20 Although we are not dealing with a problem person, but rather a problem practice, there are people behind the problem (which was Manny's original question: Can one speak against homeopathy when it can harm the income of Jewish homeopathic doctors?).

If possible, these homeopathists should be approached regarding the problem, first to find out what their methods of treatment are, and then to persuade them to recommend conventional medicine to help their patients. I think the keys here are (a) whether the homeopathic doctor advocates his cures to the exclusion of others (something which Isaiah referred to earlier), and (b) what ailments the person is treating (how severe, how treatable through conventional medicine). This may mean telling a homeopathic doctor to significantly limit his areas of professed expertise.= =20

Of course, this will not remove all deceptive propaganda from the homeopathic scene. Some of those approached may refuse to listen, and others will simply be unapproachable. The purpose here is to do one's best at approaching others on an individual basis before using more drastic means such as Lashon Hora.

4. The transgression or evil quality should be related accurately, not exaggerated in any way. This would be similar to #2, in that we should state--and not overstate--the dangers of homeopathy.

5. The speaker must have proper intentions. He should have no ulterior motives in his speech, not out of business competition, hatred or any other personal interest.=20

6. If the effect can be achieved in another way, it is forbidden to speak=20 Lashon Hora. In our case, a traditional doctor might approach the family=20 using "alternative" medicine to discuss the medical case of their son, and in the process of their discussion he might be able to suggest the traditional approaches which haven't been tried.

7. The Lashon Hora should not cause more damage to the guilty party than would be determined in a Jewish court of law (Beit Din). For example, if the court would demand that the Alternative Medicine Center close down its Leeching Dept., but it could continue to sell safe herbal treatments for minor, non-chronic sore throats and congestion, it would be forbidden to speak Lashon Hora that would cause the place to close down entirely.=20

Conditions 3 and 6 teach us a broader perspective about Lashon Hora,=20 namely, that we should minimize its impact. We should say the least=20 possible amount to the smallest possible audience for our purpose to be=20 achieved. =20

It logically follows also that we should say what we do in a way that it will have an effect. Waging an all-out war can make someone look more like a lunatic than an informed, concerned individual. Even the Rabbi of=20 a congregation must weigh whether his cries from the pulpit will be=20 taken seriously, or if he would be better off speaking to individuals.

Finally, evaluation of how specific homeopathic treatments should be viewed (condition 7) must be made with the guidance of a LOR. I would imagine that homeopathic research has produced some helpful treatments, when applied with a narrow, precise scope (chiropractics?); it is probably the homeopathic (for profit) industry, with its promises of miracle cures, that we are fighting.=20

---
Ellen Solomon