- Email: [email protected]
DELTA INFECTION IN THE U.K.
305 similibus curentur), the fact that there is no trace of the parent substance in homoeopathic remedies, and the notion of a constitutional remedy specific for a particular person being prescribed irrespective of the disease. In determining the efficacy of homoeopathic remedies, controlled trials should first focus on remedies prescribed for acute conditions. For example, trials of Arnica in accidental or surgical trauma could evaluate pain relief, wound healing, postoperative complications such as thrombophlebitis and pulmonary embolism, and duration of convalescence and hospital stay; burns units can evaluate Cantharis; and Chelidonium can be assessed in patients with infective
hepatitis. In chronic diseases, constitutional remedies are invariably indicated, and homoeopathic treatment is needed for at least a year. As the clinical features change the patient may need different remedies. Thus in chronic conditions, a particular homoeopathic remedy alone cannot be evaluated; in osteoarthritis, for example, controlled trials should be of one system of treatment against another and should be of long duration. Mersey Regional Department of Homoeopathic Medicine, Mossley Hill Hospital, Liverpool L 18 8BU
if a large scale investigation of Pertussin is justified. The disadvantage of the homoeopathic prophylactic is that it is likely to be short-lasting. Nonetheless, even if it were shown to have only see
modest efficacy it would still be valuable for children for whom the orthodox vaccine was contraindicated and for contacts under 3 months of age. Clinical research-workers must get their designs right. Homoeopathy is based on a careful matching of the patient’s symptoms with those of the drug picture: anything less is not in accord with homoeopathic theory. The trial reported by Dr Shipley and colleagues takes no account of the patient’s total symptom picture and might therefore have been expected to fail. I regret this, especially since it encourages those prejudiced against homoeopathy to conclude that because this trial is negative, the method as a whole stands condemned. It is not, to adapt the title of your editorial, homoeopathy which is on trial, but simply a micropotency of Rhus tox. in the treatment of osteoarthritis. 44 The
Drive, Northwood, Middlesex
JOHN M. ENGLISH
A. GHOSH DELTA INFECTION IN THE U.K.
SIR,-Dr Shipley and colleagues state that "Only two previous ,controlled trials comparing homoeopathic remedies and conventional treatment have been reported". If they were referring in rheumatology conditions and if "conventional drugs they may be right. However, a controlled homoeopathic remedies with conventional management was published from this hospital in 19771 and was followed by a further report a year later in the same journal. Our trials, like Shipley’s, revealed no measurable advantage of homoeopathic remedies over conventional management. It seems extraordinary that properly controlled trials of homoeopathic remedies are only now being carried out 150 years after homoeopathy was proposed as an alternative therapeutic system. Perhaps the highly individualised therapeutic regimens used in homoeopathy make a conventional controlled trial virtually to controlled trials
treatment" means trial comparing
SIR,-Dr Tedder and colleagues (Oct. 2, p. 764) suggest that delta antigen has been introduced amongst U.K. drug addicts only recently since they were unable to find anti-6 in the serum of patients referred before 1982. Using fluorescein labelled anti-o antibody (kindly donated by Dr M. Rizzetto) in a direct immunofluorescence technique, we have found 6-antigen in the liver tissue of seven out of fifteen HBsAg positive drug addicts referred to the liver unit, King’s College Hospital, between 1976 and 1981. In none of the seven positive cases could hepatocyte nuclei be stained with a fluorescein conjugated high titre anti-HBc/anti-HBe serum, excluding crossreaction with this system. One of these patients, White and British, who died with decompensated cirrhosis in 1977, had liver biopsies in 1971, 1972, and 1973. 6-antigen was present in the liver cell nuclei on all occasions (see figure). Our findings show that 6-antigen
impossible to organise. Trinity Hospital, Taunton, Somerset
PETER F. ROE
SIR,-In our Jan. 15 paper on the use of Rhus tox. in osteoarthritis the description of the method may need some clarification. In this double-blind, double-dummy placebo controlled crossover.trial the patients took both capsules and drops every day. The three treatments referred to are those combinations of: (1) placebo capsules and placebo drops, (2) fenoprofen capsules and placebo drops, and (3) placebo capsules and Rhus tox. drops.
’, ’
Department of Rheumatology, Middlesex Hospital, London W1P 9PG
MICHAEL SHIPLEY
StR,-As homoeopathically oriented physician I wholeheartedly agree with your editorial about the need to establish the validity of homoeopathy on a scientific basis. The Midland Homoeopathic Research Group, was founded for this purpose in 1977, at the instigation of Dr R. Pinsent, late research adviser to the Royal College of General Practitioners. On the group’s behalf, I am attempting to undertake just such a study on Pertussin. The difficulties should not be underestimated. Despite a generation’s opportunity and enormous numbers of children available for investigation, there is still a 20% difference between different authorities’ estimates of the efficacy of orthodox pertussis vaccine. It is taking time to acquire sufficient cases even for a pilot study to a
Roe PF A double blind trial to assess the benefit of Arnica Montana stroke illness Br Homoeopath J 1977, 66: 207-20.
1 Savage RH, acute
in
Staining of liver cell nuclei using a fluorescein conjugated anti-a antibody in liver biopsy from a drug addict, obtained in 1971 (about 480). present in North European drug addicts as early as 1971-73, confirming the observation of Hansonn et al. who found serological evidence of ó-infection in 1973 in Sweden.
was
Departments of Immunology and Child Health and Liver
King’s College Hospital and Medical School, London SE5 8RX
Unit,
DIEGO VERGANI GIORGINA MIELI-VERGANI MUNTHER JAFAR HUSSAIN BERNARD PORTMANN ROGER WILLIAMS
BG, Moestrup T, Widell A, Mordenfelt E Infection with delta agent Sweden Introduction ofa new hepatitis agent J Infect Dis 1982, 146: 472-78
1 Hansonn
in
hepatitis. In chronic diseases, constitutional remedies are invariably indicated, and homoeopathic treatment is needed for at least a year. As the clinical features change the patient may need different remedies. Thus in chronic conditions, a particular homoeopathic remedy alone cannot be evaluated; in osteoarthritis, for example, controlled trials should be of one system of treatment against another and should be of long duration. Mersey Regional Department of Homoeopathic Medicine, Mossley Hill Hospital, Liverpool L 18 8BU
if a large scale investigation of Pertussin is justified. The disadvantage of the homoeopathic prophylactic is that it is likely to be short-lasting. Nonetheless, even if it were shown to have only see
modest efficacy it would still be valuable for children for whom the orthodox vaccine was contraindicated and for contacts under 3 months of age. Clinical research-workers must get their designs right. Homoeopathy is based on a careful matching of the patient’s symptoms with those of the drug picture: anything less is not in accord with homoeopathic theory. The trial reported by Dr Shipley and colleagues takes no account of the patient’s total symptom picture and might therefore have been expected to fail. I regret this, especially since it encourages those prejudiced against homoeopathy to conclude that because this trial is negative, the method as a whole stands condemned. It is not, to adapt the title of your editorial, homoeopathy which is on trial, but simply a micropotency of Rhus tox. in the treatment of osteoarthritis. 44 The
Drive, Northwood, Middlesex
JOHN M. ENGLISH
A. GHOSH DELTA INFECTION IN THE U.K.
SIR,-Dr Shipley and colleagues state that "Only two previous ,controlled trials comparing homoeopathic remedies and conventional treatment have been reported". If they were referring in rheumatology conditions and if "conventional drugs they may be right. However, a controlled homoeopathic remedies with conventional management was published from this hospital in 19771 and was followed by a further report a year later in the same journal. Our trials, like Shipley’s, revealed no measurable advantage of homoeopathic remedies over conventional management. It seems extraordinary that properly controlled trials of homoeopathic remedies are only now being carried out 150 years after homoeopathy was proposed as an alternative therapeutic system. Perhaps the highly individualised therapeutic regimens used in homoeopathy make a conventional controlled trial virtually to controlled trials
treatment" means trial comparing
SIR,-Dr Tedder and colleagues (Oct. 2, p. 764) suggest that delta antigen has been introduced amongst U.K. drug addicts only recently since they were unable to find anti-6 in the serum of patients referred before 1982. Using fluorescein labelled anti-o antibody (kindly donated by Dr M. Rizzetto) in a direct immunofluorescence technique, we have found 6-antigen in the liver tissue of seven out of fifteen HBsAg positive drug addicts referred to the liver unit, King’s College Hospital, between 1976 and 1981. In none of the seven positive cases could hepatocyte nuclei be stained with a fluorescein conjugated high titre anti-HBc/anti-HBe serum, excluding crossreaction with this system. One of these patients, White and British, who died with decompensated cirrhosis in 1977, had liver biopsies in 1971, 1972, and 1973. 6-antigen was present in the liver cell nuclei on all occasions (see figure). Our findings show that 6-antigen
impossible to organise. Trinity Hospital, Taunton, Somerset
PETER F. ROE
SIR,-In our Jan. 15 paper on the use of Rhus tox. in osteoarthritis the description of the method may need some clarification. In this double-blind, double-dummy placebo controlled crossover.trial the patients took both capsules and drops every day. The three treatments referred to are those combinations of: (1) placebo capsules and placebo drops, (2) fenoprofen capsules and placebo drops, and (3) placebo capsules and Rhus tox. drops.
’, ’
Department of Rheumatology, Middlesex Hospital, London W1P 9PG
MICHAEL SHIPLEY
StR,-As homoeopathically oriented physician I wholeheartedly agree with your editorial about the need to establish the validity of homoeopathy on a scientific basis. The Midland Homoeopathic Research Group, was founded for this purpose in 1977, at the instigation of Dr R. Pinsent, late research adviser to the Royal College of General Practitioners. On the group’s behalf, I am attempting to undertake just such a study on Pertussin. The difficulties should not be underestimated. Despite a generation’s opportunity and enormous numbers of children available for investigation, there is still a 20% difference between different authorities’ estimates of the efficacy of orthodox pertussis vaccine. It is taking time to acquire sufficient cases even for a pilot study to a
Roe PF A double blind trial to assess the benefit of Arnica Montana stroke illness Br Homoeopath J 1977, 66: 207-20.
1 Savage RH, acute
in
Staining of liver cell nuclei using a fluorescein conjugated anti-a antibody in liver biopsy from a drug addict, obtained in 1971 (about 480). present in North European drug addicts as early as 1971-73, confirming the observation of Hansonn et al. who found serological evidence of ó-infection in 1973 in Sweden.
was
Departments of Immunology and Child Health and Liver
King’s College Hospital and Medical School, London SE5 8RX
Unit,
DIEGO VERGANI GIORGINA MIELI-VERGANI MUNTHER JAFAR HUSSAIN BERNARD PORTMANN ROGER WILLIAMS
BG, Moestrup T, Widell A, Mordenfelt E Infection with delta agent Sweden Introduction ofa new hepatitis agent J Infect Dis 1982, 146: 472-78
1 Hansonn
in