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The UK's New Minister For Magic 526

Posted by Soulskill
from the pure-and-undiluted dept.
An anonymous reader sends this depressing excerpt from New Scientist: "A serious blow to science-based medical practices has been dealt in the UK with the appointment of Jeremy Hunt as Health Secretary. The fortunes of the UK's National Health Service (NHS) are about to be transformed with the help of the magical waters of homeopathic medicine. Top marks to The Telegraph's science writer Tom Chivers for quickly picking up on talk that the UK's new health minister, Jeremy Hunt – who replaced Andrew Lansley yesterday in a government reshuffle – thinks that homeopathy works, and should be provided at public expense by the NHS."
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The UK's New Minister For Magic

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  • by fuzzyfuzzyfungus (1223518) on Wednesday September 05, 2012 @05:18PM (#41239585) Journal

    The NHS should begin a program of providing him with a homeopathic salary. The less they pay him, the more motivated he will become!

    • by Desler (1608317) on Wednesday September 05, 2012 @05:20PM (#41239623)

      No, you just pay him in a currency of significantly diluted value. Zimbabwe dollars should work since they are worth about .0017 GBP each.

    • Re:I propose... (Score:5, Interesting)

      by buchner.johannes (1139593) on Wednesday September 05, 2012 @06:10PM (#41240271) Homepage Journal

      EU just rolled out a new directive. Traditional (also herbal) and homeopathic medicine has the burden of proof now for safety and quality. If the EU does one thing well, it's consumer protection.

      You can apply for funding to be able to afford the clinical trial. This is an excellent move sorting out the effectiveness and at the same time preserving traditional "household" medicine. In the end, that's what science is about: Whether it is aesthetically pleasing or illogical that drops are diluted in a huge amount of water is irrelevant. All you have to answer is does it work (better than placebos in a double-blind trial)?

      • Re:I propose... (Score:5, Informative)

        by ffflala (793437) on Wednesday September 05, 2012 @07:24PM (#41241191)

        All you have to answer is does it work (better than placebos in a double-blind trial)?

        This seems terribly unfair, given the increasing effectiveness of placebos over time.

        Seriously. http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect?currentPage=all [wired.com] Given that particular standard, current drugs be more effective than they would have in the past in order to successfully pass clinical trials.

        • by ffflala (793437)
          Whoops, looks like I some words.
        • Re:I propose... (Score:5, Interesting)

          by geekoid (135745) <dadinportland@ya ... m minus math_god> on Wednesday September 05, 2012 @07:43PM (#41241387) Homepage Journal

          Oh, a wired article about a know clinical process that they don't understand.

          Hint: Placebos are not increasing effectiveness.
          In fact, they have no effectiveness.

          They just decrease the perception of pain or other subjective symptoms.

          • Re:I propose... (Score:5, Insightful)

            by AdamWill (604569) on Wednesday September 05, 2012 @08:09PM (#41241633) Homepage

            So placebo is, in fact, an effective remedy for pain and other subjective symptoms. This is a perfectly correct formulation. Pain is an entirely subjective phenomenon. If a sugar pill causes a person to perceive less pain, it is an effective form of pain relief, pure and simple.

            • by richlv (778496)

              placebo is a method, not the substance. and it could be ethically applied by a doctor, without extracting money from the patient.
              grabbing money for inefficient substances and claiming that "it's ok because that's placebo" is unethical, pretty much stealing from those who have a health problem.

            • Re: (Score:3, Insightful)

              by lhunath (1280798)

              The point here is that while placebos may have an effect when taken, the extent of that effect should be no greater than that of targeted medication.

              If medication designed to cure depression works better than a placebo does (ie. MORE people are cured, or symptoms are reduced FURTHER), then the medication is considered to "work". If the medication doesn't work, it will either be AS effective as a placebo (likely the case for homeopathic medicine) or LESS effective (adverse effects).

              It really doesn't matter

          • Re:I propose... (Score:5, Informative)

            by lgw (121541) on Wednesday September 05, 2012 @08:13PM (#41241697) Journal

            perception of pain

            I don't think that word means what you think it means. Pain is the perception of injury. Pain is a psychological entity. You cannot be wrong about the amount of pain you feel. If you feel pain from an amputated limb, the pain is completely real.

            Anything that reduces pain is effective in treating pain. It may be useless in treating injury, but a lot of modern medicine is around pain management for the vast array of problems we can't actually cure.

  • Hold still (Score:3, Funny)

    by puddingebola (2036796) on Wednesday September 05, 2012 @05:19PM (#41239601) Journal
    Hold still, I have to place the leech in just the right spot to suck the evil spirit out.
    • Re:Hold still (Score:5, Interesting)

      by Anonymous Coward on Wednesday September 05, 2012 @05:26PM (#41239691)

      At least leeches actually *do* have genuine and well-demonstrated medical applications [wikipedia.org].

      Homeopathy doesn't.

      • Re:Hold still (Score:5, Insightful)

        by DanTheStone (1212500) on Wednesday September 05, 2012 @05:31PM (#41239775)

        Homeopathy doesn't.

        Sure it does. And I'm no fan of homeopathy. The areas listed in the "Mote Prime" article are areas strongly influenced by the placebo effect (pain, fatigue, depression, anxiety, etc.). I assume that Homeopathy would have the same influence as any other placebo in treating those problems.

        • Re:Hold still (Score:5, Insightful)

          by lazybeam (162300) on Wednesday September 05, 2012 @05:32PM (#41239799) Homepage

          Mummy's kisses fixes my toddler's owies. All better!

        • Re:Hold still (Score:5, Insightful)

          by Twinbee (767046) on Wednesday September 05, 2012 @05:46PM (#41239987) Homepage
          In that case, I have a million other ideas, all differing to some extent, and each with the same profound properties that a placebo provides. Each one has an inventive story and reason for why it works behind it (I haven't tested most of them admittedly, but I DO think they're all great). The government should allow these million other methods on the market too, and make me a millionaire.
        • Re: (Score:3, Interesting)

          by Inda (580031)
          It treats earache too.

          My daughter, as a toddler, had one earache after another. Every time the doctor examined her ears, there was nothing wrong. Eventually he prescribed homoeopathic pills, on the NHS, it's not a new thing here. The pills looked and tasted like mints. The earaches stopped.

          I'm no fan of magic and witchcraft. I know it was something other than earache but those pills worked.
          • Re:Hold still (Score:4, Insightful)

            by F.Ultra (1673484) on Wednesday September 05, 2012 @07:16PM (#41241095)
            Of course it had to be the pills, no chance in hell that your daughter simply got older and stopped having ear infections like many other children...
          • by geekoid (135745)

            Or maybe the parents assumed it worked and quit applying there bias to the toddler.

            And by maybe, I mean definitively.
            .

          • Interesting. My friends daughter was having a similar issue with ear aches as well. Giving her some gum cleared the issue up in a matter of minutes. If I had to guess, barometric pressure was causing her pain and chewing gum caused her ears to "pop" and equalize. Essentially the same symptoms you get in a plane but on the ground instead as the ears are more sensitive.

          • Re:Hold still (Score:4, Insightful)

            by Tom (822) on Thursday September 06, 2012 @02:56AM (#41244409) Homepage Journal

            I'm no fan of magic and witchcraft. I know it was something other than earache but those pills worked.

            I don't mind utilizing the placebo effect.

            What I do mind is that the NHS could've paid 1/100th for the same thing by simply setting up its own sugar pill factory and labelling the product with whatever strikes their fancy.

      • by LordLucless (582312) on Wednesday September 05, 2012 @08:34PM (#41241917)

        Homeopathy doesn't.

        It's a perfectly valid treatment for dehydration :P

  • by jo_ham (604554) <joham999 @ g m a i l.com> on Wednesday September 05, 2012 @05:19PM (#41239603)

    Rupert Murdoch is best buddies with Hunt, and all of his actions are "guided" by what News Corps wants, so as long as Sky doesn't believe in homeopathy then we'll be fine.

  • What a sham (Score:5, Informative)

    by Anonymous Coward on Wednesday September 05, 2012 @05:22PM (#41239643)

    There is zero scientific evidence homeopathy works. Absolutely none.

    I can only assume this guy is either a moron who believes in homeopathy, or, more likely, he is receiving bribes from companies that make homeopathic products. If the NHS were to pay for homeopathic medicine there would be a huge amount of profit to be made.

    What he is doing is a disservice to all the UK citizens who will need real medical care in their lives and may be misdirected to rely on homeopathy, which cannot ever heal or cure them in any way.

    It's like having government-funded exorcisms or voodoo rituals to cleanse the bad mojo out of a person. Sounds crazy, right?

    • It's like having government-funded exorcisms or voodoo rituals to cleanse the bad mojo out of a person.

      Man, I could have used that for some people I've worked with! The only thing was that I was waiting for the government to pay for it...

    • by joebok (457904)

      Homeopathy DOES work - the placebo effect is well documented!

      • Re:What a sham (Score:5, Insightful)

        by Rhywden (1940872) on Wednesday September 05, 2012 @06:19PM (#41240399)
        Then it's not homeopathy which works - it's the placebo effect which works. And for that we don't need overpriced sugar which has danced around the table twelve times at midnight or somesuch nonsense.
        • Re: (Score:3, Informative)

          by mellyra (2676159)

          Then it's not homeopathy which works - it's the placebo effect which works. And for that we don't need overpriced sugar which has danced around the table twelve times at midnight or somesuch nonsense.

          The placebo needs to be credible in order to work - if the patient can easily distinguish it from "real" medicine (by name or by price) it won't work as well,

          There are a lot of real and imaginary diseases where a placebo is really all the patient needs - while use of homeopathy to "treat" severe diseases should of course be prohibited indiscriminately destroying its public credibility does probably a lot more damage than good.
          If there is one thing that "school medicine" has learned from all the "alternative

      • Re:What a sham (Score:5, Insightful)

        by subreality (157447) on Wednesday September 05, 2012 @07:57PM (#41241511)

        In a medical context, "Working" means performing better than a placebo. By this definition, homeopathy DOES NOT work.

    • by iiii (541004) on Wednesday September 05, 2012 @06:20PM (#41240413) Homepage

      There is zero scientific evidence homeopathy works. Absolutely none.

      Wrong. Your problem is in your definition of "works". Works mean achieves some goal you were trying to reach, and perhaps the goal you are thinking of is not the one NHS is trying to reach. Their job is not to cure everyone of everything. Their job is to *control expenses* while *minimizing complaints*. And it is very likely that providing homeopathy will help achieve those goals. Therefore it "works". Remember, even the homeopathy supporters admit that often treatments do not contain even a single molecule of the diluted substance. (cite [wikipedia.org] ) I cannot think of a more cost effective treatment than water, maybe with a bit of food coloring. Even a small reduction in whining would make it cost effective. From an institutional health perspective it's pure genius!!

    • Re: (Score:3, Informative)

      by AK Marc (707885)

      There is zero scientific evidence homeopathy works. Absolutely none.

      There is plenty. Control groups improve better than untreated. Why? Placebo effect. Homeopathy is professional placebos. They do work. Proven to work. Maybe not any better than a placebo, but if you walked out of your doctor's office with a prescription for "sugar pill placebo - generic" that wouldn't work as well.

      Again, there is scientific proof that placebos work, and homeopathy, if medically ineffective, is still an effective treatment scientifically proven to work

      Well, that and "homeopathy" doe

      • Re: (Score:3, Informative)

        by geekoid (135745)

        " They do work. "
        Wrong.
        "Proven to work."
        False.

        " Maybe not any better than a placebo, "
        Do you even know What The FUCK the placebo effect is? No, you don't.

        " there is scientific proof that placebos work,
        no, no, NO. shut the fuck up you ignorant SOB.
        By DEFINITION, they have no effect on the disease. Was that sentence to hard for your tiny stupid egocentric brain?

        " chiropractors (mostly) don't believe that spinal adjustments will cure cancer"
        70 percent do. 90 percent believe in a 'magical' method of some sort

  • The real lesson (Score:5, Interesting)

    by jmorris42 (1458) * <jmorris@bea u . org> on Wednesday September 05, 2012 @05:24PM (#41239671)

    And this is why all centralized power is dangerous. Eventually an idiot WILL be put in charge. If it were one hospital, insurance provider, pharma company, whatever it is bad but survivable. But when it is a government with a virtual monopoly on something important like medicine and a real monopoly on the use of force to back it up, shit gets serious.

    • Re: (Score:3, Insightful)

      by MightyMartian (840721)

      Because when medicine was left to individual practitioners, things were sooooo much better.

      • by Hazel Bergeron (2015538) on Wednesday September 05, 2012 @06:17PM (#41240359) Journal

        *expecting to meet surgeon before procedure, patient walks into empty room*

        *voice comes out of nowhere*

        "Do not be afraid, for I am the invisible hand of the free market. And I shall be operating on you today."

        • Re:The real lesson (Score:5, Insightful)

          by MightyMartian (840721) on Wednesday September 05, 2012 @07:39PM (#41241367) Journal

          The Libertarians can't help but mod me down even when I don't directly reference them.

          Well, it's bloody we'll true. Medicine in ye olden days where you could only judge a doctor's fitness by how many patients lived or died (in other words pure market forces) wasn't exactly a stellar success, and it's only when certification boards and similar bodies, with the force of legislation behind them, did you at least gain some trust as to basic credentials and competency, and some way to remove doctors who failed to maintain that competency.

          A pure free market in health care would be a nightmare, where the worst aspects of the current system would be magnified in horrific fashion.

    • Re: (Score:3, Interesting)

      by mapsjanhere (1130359)
      You are aware that the US recognizes homeopathy as valid, and even exempts homeopathic remedies from FDA regulations requiring efficacy? Nothing to do with centralized power, one idiot senator in the 1930s was enough to get this written permanently into law.
      • by Hatta (162192)

        The US recognizes homeopathy as valid, but still doesn't recognize the medical efficacy of cannabis. Fuck this country.

    • Re:The real lesson (Score:5, Informative)

      by Hazel Bergeron (2015538) on Wednesday September 05, 2012 @05:37PM (#41239865) Journal

      No, not really.

      0) The NHS is excellent - far better than American healthcare. I say that using all the data I have seen and from personal experience of both systems.

      1) The UK government does not have a "virtual monopoly" - it has no exclusive right to provide healthcare at all. It does provide some forms of healthcare so well (e.g. emergency) that alternative providers are fairly rare, and other forms of healthcare with waiting lists (e.g. elective hip replacements) such that there's a healthy variety of private providers. I belong to a mutual much older than the NHS which provides discretionary treatment for elective conditions.

      2) Thatcher was an idiot put in charge, but the NHS soldiered on. Blair was an idiot put in charge, but the NHS soldiered on. Major and Brown stuck their dicks in a bit but didn't do anything remarkable compared to their superior predecessors. It was Lansley who has done the most damage to the NHS with the Health and Social Care Act 2012, not because he is an idiot but because he's a fucking smart and fucking nasty man. Cunt, already widely known in Britain as corrupt, silly little man, is just pissing on the wreckage.

      3) The NHS didn't really exist before 1948, and that was in the wake of something far worse than we're facing now. If things get shit, we regroup, re-educate and rebuild. It's not like history has a linear progression - we're always repeating the same mistakes and having to correct them.

    • by Tom (822)

      You make an interesting, but unsubstantiated, claim. It works on the hidden assumption that idiots put in charge is the exception and in general, the people in charge are not idiots.

      I fail to see how you can support that assumption.

  • by GauteL (29207) on Wednesday September 05, 2012 @05:25PM (#41239681)

    No need to buy thousands of doses of penicillin or heart medication. Just buy one dose and it'll serve the entire population.

  • by pushing-robot (1037830) on Wednesday September 05, 2012 @05:30PM (#41239761)

    [homeopathic remedies should be] provided at public expense by the NHS

    Why didn't I think of this? Give away bottles of water, er, "remedies", and take the profit away from the snake oil salesmen.

    Genius.

  • by yakovlev (210738) on Wednesday September 05, 2012 @05:30PM (#41239765) Homepage
    If you read Jeremy Hunt's response letter, what he actually says is that some PATIENTS want and/or believe in homeopathic medicine, so we should let them have it. Basically he's saying that the NHS should agree to pay for any treatment that the general populous wants, since it is a "patient-focused" organization. This argument is also significantly easier to defend if it's a treatment that they are already paying for, and it sounds like they are.

    In short, Jeremy Hunt is a politician. He made a calculated determination that people who like homeopathic treatments are more likely to be supportive of him due to this decision than others are to be against him for deciding the other way. I can see why, since most scientists will think of him as a "typical stupid politician" (not much of an insult for an actual politician) while most homeopathic believers will see him as a "defender of their cause."
    • Re: (Score:3, Informative)

      by mt42 (1906902)
      If you read the Early Day Motion [parliament.uk] he signed in 2007, he says is that he "believes that complementary medicine has the potential to offer clinically-effective and cost-effective solutions to common health problems faced by NHS patients" (emphasis mine). To be fair, he was only one of 206 MPs (including such luminaries as Nick Clegg, the Deputy Prime Minister) who signed the motion. That's almost a third of British MPs who believe the NHS should be spending upwards of £4 million* per year treating sick
  • by istartedi (132515) on Wednesday September 05, 2012 @05:32PM (#41239791) Journal

    The homeopathc process activates placebetrinos in dihydrogen monoxide. Ordinary DHO can be deadly, but in the proper hands it works wonders. The placebetrino hasn't actually been observed, but future upgrades to the LHC are expected to run with high enough energies to reveal it as well as the anti-placebetrino.

  • by Ichoran (106539) on Wednesday September 05, 2012 @05:35PM (#41239833)

    The placebo effect works, and homeopathy should be a tremendously inexpensive way to induce it. The placebo effect does not mean that people do not get better--it is that people get better even when you give them something inert! How better to generate something inert that feels like it should help than to take something that should help and dilute it? Granted, the effects of placebo are limited, but if you only need something limited anyway, why not give them a microcent's worth of water in a 20-cent vial, sold for $2, to make the patient feel as much relief as they can generate from their own beliefs? (How different is this from bottled water, anyway? The tap water in most places affluent enough to afford bottled water is perfectly safe.)

    I'm only partly joking.

    (Blasted democracies, requiring informed citizenry and spoiling all our plans to dupe them into thinking they're fine!)

  • by DoofusOfDeath (636671) on Wednesday September 05, 2012 @05:36PM (#41239847)

    I think I've heard two definitions for homeopathic. The first is the silliness of infinite dilution creating a water with some non-water quality. The other is more what I'd call folk medicine, which is simply a greater willingness to assume that traditional, low-cost solutions such as various teas for various ailments work until proven otherwise.

    • by frank_adrian314159 (469671) on Wednesday September 05, 2012 @06:12PM (#41240303) Homepage

      The latter is more correctly categorized as "naturopathy". For some ailments, it can work as well as traditional medicine because plants do have various chemicals that can cure disease.

      Now there's the issue of those chemicals not being "clean" (i.e., mixed with other undesirable substances), not knowing the dosage (because the amount of the useful chemical varies from plant to plant), and, of course, misidentification of plants (which can lead to one ingesting the wrong chemical). And though all of the issues mentioned can arise when a chemical (which, in this usage, is referred to as a drug) in pill, elixer, injection, or suppository form is prescribed by a physician and used as directed by the patient, the likelihood of an undesired outcome is lowered considerably when the forces of science and modern manufacturing technology are brought to bear.

      Of course, feel free to chew on a willow branch instead of taking an aspirin for your dose of acetylsalicylic acid - I certainly won't stop you. But when you end up with your muscles still aching because your jaw muscles and teeth gave out before the pain was gone, don't come crying to me.

  • by Stirling Newberry (848268) on Wednesday September 05, 2012 @05:44PM (#41239959) Homepage Journal
    The Tories plan to apply the same theories to medicine that they have to economics.

    Serves the brits right for voting for this nonsense.

    • by John Allsup (987)
      We've got a choice between two bunches and a little extra bunch, all composed of professional politicians. We can't vote the political class out as a bloc and are basically stuffed until we do. Thus: we're stuffed.
  • Unfortunate lumping (Score:5, Interesting)

    by Grayhand (2610049) on Wednesday September 05, 2012 @05:48PM (#41240019)
    Unfortunately herbal remedies and Homeopathy tends to get lumped together. I know first hand many herbal remedies work and some legit doctors have been prescribing them for decades. Athletes use Arnica for muscle strain and I found it works pretty well on migrains for lessening the symptoms. Cinnamon has been found to be at least as effective as most of the diabetes medicines used for controlling blood sugar peaks and it's also recognized as a stimulant. There are hundreds of medically proven herbs that are cheap and effective with potentially thousands more untested that are in traditional medicines. Homeopathy on the other hand to me is mostly snake oil. Things like diluting a compound and having it still be effective is just plain silly. I'd consider most of it placebos. The problem is there's no clear line between herbal and homeopathy. For back aches I call Tiger Balm, Arnica and ice packs the holly trinity. To me they are herbal remedies but you find them in the homeopathic section of health food stores and some drug stores. Herbal remedies should be government funded because they are inherently cheaper than factory drugs and with fewer side effects. The problem is there's been so little testing since the drug companies don't stand to get rich or get exclusive rights to them so it's hard to make rules as to which are truly effective. There's things like Goat Weed that is a herbal Viagra that is effective but then again people still take ground up Rhino horn which is expensive snake oil. With all the hundreds of billions a year that are spent on drugs there should be government testing on herbal remedies if for no other reason than saving money. The problem comes in the form of resistance from drug companies. Cheaper solutions threaten profits so don't expect government standardized testing of most herbs any time soon if ever.
    • by radio4fan (304271)

      There's plenty of research on herbal medicine. Searching pubmed for arnica alone gives me 15 pages of results. Among which I find this one [nih.gov] which shows arnica to be less effective than placebo on muscle strains: it makes muscle strain worse.

      With all the hundreds of billions a year that are spent on drugs there should be government testing on herbal remedies if for no other reason than saving money. The problem comes in the form of resistance from drug companies.

      Companies which produce herbal remedies also have huge piles of money, why don't they spend some of that proving their remedies work? Hint: it's because they largely don't work.

      Many effective pharmacological do compounds come from plants. These are isolated, tested for sa

  • Reshuffles (Score:4, Interesting)

    by wonkey_monkey (2592601) on Wednesday September 05, 2012 @05:56PM (#41240093) Homepage
    Does it strike anyone else as odd that you can go from Secretary of State for Culture, Olympics, Media and Sport to Secretary of State for Health in a day, or from Transport to Defence? Do any of these people have any actual experience or qualification in the departments they get dumped on? It's all just a load of old bollocks, isn't it?
    • > It's all just a load of old bollocks, isn't it?
      Yes. At that level it's apparantly all about leadership and vision, not actual knowledge or qualification. I worked at a bank where the CEO (who was actually quite good) used to work for a biscuit firm and went on to run a high street shop chain. WTF?
  • by gmuslera (3436) on Wednesday September 05, 2012 @06:08PM (#41240239) Homepage Journal
    People already thinks that is fine to have imaginary property, imaginary money, imaginary democracy, imaginary rights, imaginary gods, etc, why not have imaginary medicine? Could be a few for whom the placebo effect won't be enough, there maybe some other imaginary medicine could work, or then they could go to real one.
  • by wisnoskij (1206448) on Wednesday September 05, 2012 @06:45PM (#41240745) Homepage

    Even if homeopathic med. does absolute nothing, the placebo effect would still make it better, and in some cases more effective, medicine than many mainstream medicines.
    And let us not get too cocky, most people have thought they, or at least society in general, have known everything there is to know since the beginning of time. Do you really think we are actually their yet?
    Most disproofs of most homeopathic med. is entirely based on "this cannot work in theory" logic, and only valid if you really think we know everything there is to know.

  • by Kozar_The_Malignant (738483) on Wednesday September 05, 2012 @06:48PM (#41240777)
    Since homeopathy is:
    • 1. Cheap, and
    • 2. Doesn't work,

    People will die much more quickly saving National Health billions of pounds.

  • by nedlohs (1335013) on Wednesday September 05, 2012 @07:33PM (#41241273)

    "Seems strange that Jeremy Hunt is getting a hard time for believing in homeopathy. The Education Secretary believes in God. " - http://twitter.com/frankieboyle/status/242964690030960640 [twitter.com]

  • by MrL0G1C (867445) on Thursday September 06, 2012 @03:26AM (#41244585) Journal

    The placebo effect of homeopathy cured me of headaches for life, I didn't even believe in homeopathy at the time and only went at the insistence of my parent. I guess the placebo effect fooled some part of my subconscious as I went from having several headaches per week to approx' 1-2 mild headaches per year.

    I think it is worth leaving homeopathy in place, just because you don't understand the value of placebo doesn't mean homeopathy doesn't have value.

    Drugs don't cure you, they help the body heal itself, many drugs don't even do that, they just mask the symptoms rather than deal with the cause of the symptoms.

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