interesting Homeopathy article
by WDC (no login)

kind of neat, when you actually read the fine print.
Love those "vital force" kooks like the followers of Samual Hahneman, whose entire theory is a reaction to quinine hypersensitivity!

Stephen Barrett, M.D.
Varro E. Tyler. Ph.D.
Homeopathic remedies enjoy a unique status in the health marketplace: They are the only category of spurious products legally marketable as drugs. This situation is the result of two circumstances. First, the 1938 Federal Food, Drug, and Cosmetic Act, which was shepherded through Congress by a senator who was a homeopathic physician, recognizes as drugs all substances included in the Homeopathic Pharmacopoeia of the United States. Second, FDA has not held homeopathic products to the same standards as other drugs.

Basic Misbeliefs
Homeopathy dates back to the late 1700s, when Samuel Hahnemann (1755-1843), a German physician, began formulating its basic principles. Hahnemann was justifiably distressed about bloodletting, leeching, purging, and other medical procedures of his day that did far more harm than good. Thinking that these treatments were intended to balance the body's "humors" by opposite effects, he developed his "law of similars" -- a notion that symptoms of disease can be cured by extremely small amounts of substances that produce similar symptoms in healthy people when administered in large amounts [1]. The word "homeopathy" is derived from the Greek words homoios (similar) and pathos (suffering or disease) [2].

Hahnemann and his early followers conducted "provings," in which they administered herbs, minerals, and other substances to healthy people, including themselves, and kept detailed records of what they observed. These records were compiled into lengthy reference books that are used to match a patient's symptoms with a corresponding drug.

Hahnemann declared that diseases represent a disturbance in the body's ability to heal itself and that only a small stimulus is needed to begin the healing process. He also claimed that chronic diseases are manifestations of a suppressed itch, a kind of miasma or evil spirit. At first he used small doses of accepted medications, but later he used enormous dilutions and theorized that the smaller the dose, the more powerful the effect -- a principle he called the "law of infinitesimals." That, of course, is just the opposite of the dose-response relationship that pharmacologists have demonstrated.

The basis for inclusion in the Homeopathic Pharmacopoeia is not modern scientific testing, but homeopathic provings conducted during the 1800s and early 1900s. The current edition describes how more than a thousand substances are prepared for homeopathic use [3]. It does not identify the symptoms or diseases for which homeopathic products should be used; that is decided by the practitioner (or manufacturer). The fact that substances listed in the Homeopathic Pharmacopoeia are legally recognized as drugs does not mean that either the law or FDA recognizes them as effective [4,5].

Because homeopathic remedies were actually less dangerous than those of nineteenth-century medical orthodoxy, many medical practitioners began using them. At the turn of the twentieth century, homeopathy had about 14,000 practitioners and 22 schools in the United States. But as medical science and medical education advanced, homeopathy's popularity declined sharply in the United States, and its schools either closed or converted to modern methods. The last purely homeopathic school in this country closed during the 1920s [6].

Homeopathic products are made from minerals, botanical substances, and several other sources. If the original substance is soluble, one part is diluted with either 9 or 99 parts of distilled water or alcohol and shaken vigorously; if insoluble, it is finely ground and pulverized in similar proportions with powdered lactose. One part of the diluted medicine is then further diluted, and the process is repeated until the desired concentration is reached. Dilutions of 1:10 are designated by the Roman numeral X (1X = 1/10, 3X = 1/ 103, 6X = 1/106). Dilutions of 1:100 are designated by the Roman numeral C (1C = 1/100, 3C = 1/1003, and so on). Most remedies today range from 6X to 30X, but products of 30C or more are marketed.

A 30X dilution means that the original substance has been diluted 1030 times. Assuming that a milliliter of water contains 15 drops, 1010 drops of water would fill a container more than 50 times the size of the Earth. Imagine placing a drop of red dye into such a container full of water so that it disperses evenly. Homeopathy's law of infinitesimals is the equivalent of saying that any drop of water subsequently removed from that container will possess an "essence" of redness. Robert L. Park, Ph.D., a prominent physicist who is a professor of physics at the University of Maryland, has noted that, since the smallest amount of a substance that could exist in a solution is one molecule, a 30C solution would have to have at least one molecule of the original substance dissolved in a minimum of 1060 molecules of water. This would require a container more than 30 billion times the size of the Earth [7].

Hahnemann himself realized that there is virtually no chance that even one molecule of original substance would remain after extreme dilutions. However, he believed that the vigorous shaking or pulverizing with each step of dilution leaves behind a spirit-like essence -- no longer perceptible to the senses -- which cures by reviving the body's "vital force."' This notion is unsubstantiated. Moreover, if it were true, every substance encountered by a molecule of water might imprint an essence that could exert powerful (and unpredictable) medicinal effects when the water is ingested by a person.

Unimpressive Research
Since many homeopathic remedies contain no detectable amount of active ingredient, it is impossible to test whether they contain what their label says. Unlike most prescription and nonprescription drugs, homeopathic remedies have not been proven effective against disease by double-blind clinical testing.

Hill and Doyon analyzed 40 randomized trials that had compared homeopathic treatment with standard treatment, a placebo, or no treatment. All but three of the trials had major flaws in their design; only one of those three reported homeopathic treatment as more effective than standard treatment or placebo. The authors concluded that there is no evidence that homeopathic treatment has any more value than a placebo [8].

Proponents trumpet the few studies that support homeopathic treatments as proof that homeopathy works. Even if the results can be consistently reproduced (which seems unlikely), the most that the study of a single remedy for a single disease could prove is that the remedy is effective against that disease. It would not validate homeopathy's basic theories or prove that homeopathic treatment is useful for other diseases.

Placebo effects can be powerful, but the potential benefit of relieving symptoms with placebos should be weighed against the harm that can result from relying on -- and wasting money on -- ineffective products. Spontaneous remission is also a factor in homeopathy's popularity. We suspect that most people who credit a homeopathic product for their recovery would have fared equally well without it.

Homeopaths are working hard to have their services covered under national health insurance. They claim to provide care that is safer, gentler, more natural, and less expensive than conventional care, and they claim to be more concerned with prevention than conventional physicians. However, homeopathic treatments prevent nothing, and many homeopathic leaders preach against immunization [7].

Need for More Regulation
If FDA required homeopathic remedies to be proven effective in order to remain marketable -- the standard it applies to other categories of drugs -- homeopathy would face extinction in the United States. However, there is no indication that the agency is considering this. FDA officials regard homeopathy as relatively benign (compared, for example, with unsubstantiated products marketed for cancer and AIDS) and believe that other problems should get enforcement priority [9]. If FDA attacks homeopathy too vigorously, its proponents might even persuade a lobby-susceptible Congress to rescue them.

Regardless of this risk, FDA should not permit worthless drug products to be marketed with claims that they are effective. In August 1994, we and 40 other prominent critics of quackery and pseudoscience asked the agency to curb the sale of homeopathic products [10]. Our petition urged FDA to initiate a rulemaking procedure to require that all nonprescription homeopathic drugs meet the same standards of safety and effectiveness as nonprescription nonhomeopathic drugs. It also asked for a public warning that, although FDA has permitted homeopathic remedies to be sold, it does not recognize them as effective.

Meanwhile, we urge pharmacists not to stock homeopathic remedies and to inform customers that such products simply don't work. We also hope that pharmacy educators, journal editors, and pharmacy organizations will regard this as an important ethical issue.

References
Hahnemann S. Organon of Medicine, Edition 6, 1842. English translation: Los Angeles: J.P. Tarcher, Inc., 1982.
Cummings S, Ullman D. Everybody's guide to homeopathic medicines. Los Angeles: ****** P. Tarcher, 1984.
Homeopathic Pharmacopoeial Convention of the United States. Homeopathic Pharmacopoeia of the United States Revision Service. Washington, DC: Homeopathic Pharmacopoeia Convention of the United States, 1994.
Food and Drug Administration. Conditions under which homeopathic drugs may be marketed. FDA Compliance Policy Guide 7132.15. Rockville, MD: U.S. Department of Health and Human Services, 1988, revised 1995.
Skolnick AA. FDA petitioned to 'stop homeopathy scam.' JAMA 272:1154-1154, 1994.
Kaufman M. Homeopathy in America: the rise and fall of a medical heresy. Baltimore, MD: Johns Hopkins Press; 1971.
Barrett S, Herbert V. The vitamin pushers: how the "health food" industry is selling America a bill of goods. Amherst, NY: Prometheus Books, 1994.
Hill C, Doyon F. Review of randomized trials of homeopathy. Review of Epidemiology 38:139-142, 1990.
Rados B. Riding the coattails of homeopathy's revival. FDA Consumer 19(2):30-44, 1985.
Barrett S et al. Petition regarding homeopathic drugs. FDA docket no. 94P-0316/CP 1. Aug 25, 1994.
__________________________

Dr. Tyler, who died in 2001, was the Lilly distinguished professor of pharmacognosy (the science of medicines from natural sources) at Purdue University. A world-renowned authority, he wrote The Honest Herbal, an evaluation of popular herbs, and was senior author of the textbook Pharmacognosy. This article originally appeared in slightly different form in the May 1, 1995, issue of American Journal of Health System Pharmacists.


Posted on Feb 23, 2002, 11:15 AM
from IP address 170.57.50.31

by WDC (Login WDC)
Forum Moderator

similar to the first. Interesting reading though for the young physician as to what is out there!
If snake oil powered cars, we wouldn't need the Saudis!

Homeopathy: The Ultimate Fake
Stephen Barrett, M.D.
Homeopathic "remedies" enjoy a unique status in the health marketplace: They are the only category of quack products legally marketable as drugs. This situation is the result of two circumstances. First, the 1938 Federal Food, Drug, and Cosmetic Act, which was shepherded through Congress by a homeopathic physician who was a senator, recognizes as drugs all substances included in the Homeopathic Pharmacopeia of the United States. Second, the FDA has not held homeopathic products to the same standards as other drugs. Today they are marketed in health-food stores, in pharmacies, in practitioner offices, by multilevel distributors [A], through the mail, and on the Internet.

Basic Misbeliefs
Samuel Hahnemann (1755-1843), a German physician, began formulating homeopathy's basic principles in the late 1700s. Hahnemann was justifiably distressed about bloodletting, leeching, purging, and other medical procedures of his day that did far more harm than good. Thinking that these treatments were intended to "balance the body's 'humors' by opposite effects," he developed his "law of similars" -- a notion that symptoms of disease can be cured by extremely small amounts of substances that produce similar symptoms in healthy people when administered in large amounts. The word "homeopathy" is derived from the Greek words homoios (similar) and pathos (suffering or disease).

Hahnemann and his early followers conducted "provings" in which they administered herbs, minerals, and other substances to healthy people, including themselves, and kept detailed records of what they observed. Later these records were compiled into lengthy reference books called materia medica, which are used to match a patient's symptoms with a "corresponding" drug.

Hahnemann declared that diseases represent a disturbance in the body's ability to heal itself and that only a small stimulus is needed to begin the healing process. He also claimed that chronic diseases were manifestations of a suppressed itch (psora), a kind of miasma or evil spirit. At first he used small doses of accepted medications. But later he used enormous dilutions and theorized that the smaller the dose, the more powerful the effect -- a notion commonly referred to as the "law of infinitesimals." That, of course, is just the opposite of the dose-response relationship that pharmacologists have demonstrated.

The basis for inclusion in the Homeopathic Pharmacopeia is not modern scientific testing, but homeopathic "provings" conducted during the 1800s and early 1900s. The current (ninth) edition describes how more than a thousand substances are prepared for homeopathic use. It does not identify the symptoms or diseases for which homeopathic products should be used; that is decided by the practitioner (or manufacturer). The fact that substances listed in the Homeopathic Pharmacopeia are legally recognized as "drugs" does not mean that either the law or the FDA recognizes them as effective.

Because homeopathic remedies were actually less dangerous than those of nineteenth-century medical orthodoxy, many medical practitioners began using them. At the turn of the twentieth century, homeopathy had about 14,000 practitioners and 22 schools in the United States. But as medical science and medical education advanced, homeopathy declined sharply in America, where its schools either closed or converted to modern methods. The last pure homeopathic school in this country closed during the 1920s [1].

Many homeopaths maintain that certain people have a special affinity to a particular remedy (their "constitutional remedy") and will respond to it for a variety of ailments. Such remedies can be prescribed according to the person's "constitutional type" -- named after the corresponding remedy in a manner resembling astrologic typing. The "Ignatia Type," for example, is said to be nervous and often tearful, and to dislike tobacco smoke. The typical "Pulsatilla" is a young woman, with blond or light-brown hair, blue eyes, and a delicate complexion, who is gentle, fearful, romantic, emotional, and friendly but shy. The "Nux Vomica Type" is said to be aggressive, bellicose, ambitious, and hyperactive. The "Sulfur Type" likes to be independent. And so on. Does this sound to you like a rational basis for diagnosis and treatment?

The "Remedies" Are Placebos
Homeopathic products are made from minerals, botanical substances, and several other sources. If the original substance is soluble, one part is diluted with either nine or ninety-nine parts of distilled water and/or alcohol and shaken vigorously (succussed); if insoluble, it is finely ground and pulverized in similar proportions with powdered lactose (milk sugar). One part of the diluted medicine is then further diluted, and the process is repeated until the desired concentration is reached. Dilutions of 1 to 10 are designated by the Roman numeral X (1X = 1/10, 3X = 1/1,000, 6X = 1/1,000,000). Similarly, dilutions of 1 to 100 are designated by the Roman numeral C (1C = 1/100, 3C = 1/1,000,000, and so on). Most remedies today range from 6X to 30X, but products of 30C or more are marketed.

A 30X dilution means that the original substance has been diluted 1,000,000,000,000,000,000,000,000,000,000 times. Assuming that a cubic centimeter of water contains 15 drops, this number is greater than the number of drops of water that would fill a container more than 50 times the size of the Earth. Imagine placing a drop of red dye into such a container so that it disperses evenly. Homeopathy's "law of infinitesimals" is the equivalent of saying that any drop of water subsequently removed from that container will possess an essence of redness. Robert L. Park, Ph.D., a prominent physicist who is executive director of The American Physical Society, has noted that since the least amount of a substance in a solution is one molecule, a 30C solution would have to have at least one molecule of the original substance dissolved in a minimum of 1,000,000,000,000,000,000,000,000,000,000,000,000, 000,000,000,000,000,000,000,000 molecules of water. This would require a container more than 30 billion times the size of the Earth.

Oscillococcinum, a 200C product "for the relief of colds and flu-like symptoms," involves "dilutions" that are even more far-fetched. Its "active ingredient" is prepared by incubating small amounts of a freshly killed duck's liver and heart for 40 days. The resultant solution is then filtered, freeze-dried, rehydrated, repeatedly diluted, and impregnated into sugar granules. If a single molecule of the duck's heart or liver were to survive the dilution, its concentration would be 1 in 100200. This huge number, which has 400 zeroes, is vastly greater than the estimated number of molecules in the universe (about one googol, which is a 1 followed by 100 zeroes). In its February 17, 1997, issue, U.S. News & World Report noted that only one duck per year is needed to manufacture the product, which had total sales of $20 million in 1996. The magazine dubbed that unlucky bird "the $20-million duck."
Actually, the laws of chemistry state that there is a limit to the dilution that can be made without losing the original substance altogether. This limit, which is related to Avogadro's number, corresponds to homeopathic potencies of 12C or 24X (1 part in 1024). Hahnemann himself realized that there is virtually no chance that even one molecule of original substance would remain after extreme dilutions. But he believed that the vigorous shaking or pulverizing with each step of dilution leaves behind a "spirit-like" essence -- "no longer perceptible to the senses" -- which cures by reviving the body's "vital force." Modern proponents assert that even when the last molecule is gone, a "memory" of the substance is retained. This notion is unsubstantiated. Moreover, if it were true, every substance encountered by a molecule of water might imprint an "essence" that could exert powerful (and unpredictable) medicinal effects when ingested by a person.

Many proponents claim that homeopathic products resemble vaccines because both provide a small stimulus that triggers an immune response. This comparison is not valid. The amounts of active ingredients in vaccines are much greater and can be measured. Moreover, immunizations produce antibodies whose concentration in the blood can be measured, but high-dilution homeopathic products produce no measurable response. In addition, vaccines are used preventively, not for curing symptoms.

Stan Polanski, a physician assistant working in public health near Asheville, North Carolina, has provided additional insights:

Imagine how many compounds must be present, in quantities of a molecule or more, in every dose of a homeopathic drug. Even under the most scrupulously clean conditions, airborne dust in the manufacturing facility must carry thousands of different molecules of biological origin derived from local sources (bacteria, viruses, fungi, respiratory droplets, sloughed skin cells, insect feces) as well as distant ones (pollens, soil particles, products of combustion), along with mineral particles of terrestrial and even extraterrestrial origin (meteor dust). Similarly, the "inert" diluents used in the process must have their own library of microcontaminants.
The dilution/potentiation process in homeopathy involves a stepwise dilution carried to fantastic extremes, with "succussion" between each dilution. Succussion involves shaking or rapping the container a certain way. During the step-by-step dilution process, how is the emerging drug preparation supposed to know which of the countless substances in the container is the One that means business? How is it that thousands (millions?) of chemical compounds know that they are required to lay low, to just stand around while the Potent One is anointed to the status of Healer? That this scenario could lead to distinct products uniquely suited to treat particular illnesses is beyond implausible.
Thus, until homeopathy's apologists can supply a plausible (nonmagical) mechanism for the "potentiation"-through-dilution of precisely one of the many substances in each of their products, it is impossible to accept that they have correctly identified the active ingredients in their products. Any study claiming to demonstrate effectiveness of a homeopathic medication should be rejected out-of-hand unless it includes a list of all the substances present in concentrations equal to or greater than the purported active ingredient at every stage of the dilution process, along with a rationale for rejecting each of them as a suspect.
The process of "proving" through which homeopaths decided which medicine matches which symptom is no more sensible. Provings involved taking various substances recording every twitch, sneeze, ache or itch that occurred afterward -- often for several days. Homeopathy's followers take for granted that every sensation reported was caused by whatever substance was administered, and that extremely dilute doses of that substance would then be just the right thing to treat anyone with those specific symptoms.
Dr. Park has noted that to expect to get even one molecule of the "medicinal" substance allegedly present in 30X pills, it would be necessary to take some two billion of them, which would total about a thousand tons of lactose plus whatever impurities the lactose contained.

Cell Salts
Some homeopathic manufacturers market twelve highly diluted mineral products called "cell salts" or "tissue salts." These are claimed to be effective against a wide variety of diseases, including appendicitis (ruptured or not), baldness, deafness, insomnia, and worms. Their use is based on the notion that mineral deficiency is the basic cause of disease. However, many are so diluted that they could not correct a mineral deficiency even if one were present. Development of this approach is attributed to a nineteenth-century physician named W.H. Schuessler.

"Electrodiagnosis"
Some physicians, dentists, and chiropractors use "electrodiagnostic" devices to help select the homeopathic remedies they prescribe. These practitioners claim they can determine the cause of any disease by detecting the "energy imbalance" causing the problem. Some also claim that the devices can detect whether someone is allergic or sensitive to foods, vitamins, and/or other substances. The procedure, called electroacupuncture according to Voll (EAV), electrodiagnosis, or electrodermal screening, was begun during the late 1950s by Reinhold Voll, M.D., a West German physician who developed the original device. Subsequent models include the Vega, Dermatron, Accupath 1000, and Interro.

Proponents claim these devices measure disturbances in the flow of "electro-magnetic energy" along the body's "acupuncture meridians." Actually, they are fancy galvanometers that measure electrical resistance of the patient's skin when touched by a probe. Each device contains a low-voltage source. One wire from the device goes to a brass cylinder covered by moist gauze, which the patient holds in one hand. A second wire is connected to a probe, which the operator touches to "acupuncture points" on the patient's foot or other hand. This completes a circuit, and the device registers the flow of current. The information is then relayed to a gauge that provides a numerical readout. The size of the number depends on how hard the probe is pressed against the patient's skin. Recent versions, such as the Interro make sounds and provide the readout on a computer screen. The treatment selected depends on the scope of the practitioner's practice and may include acupuncture, dietary change, and/or vitamin supplements, as well as homeopathic products. Regulatory agencies have seized several types of electroacupuncture devices but have not made a systematic effort to drive them from the marketplace.

For more information about these devices and pictures of some of them, click here. If you encounter such a device, please read this article and report the device to the practitioner's state licensing board, the state attorney general, the Federal Trade Commission, the FBI, the National Fraud Information Center, and any insurance company to which the practitioner submits claims that involve use of the device. For the addresses of these agencies, click here.

Unimpressive "Research"
Since many homeopathic remedies contain no detectable amount of active ingredient, it is impossible to test whether they contain what their label says. Unlike most potent drugs, they have not been proven effective against disease by double-blind clinical testing. In fact, the vast majority of homeopathic products have never even been tested.

In 1990, an article in Review of Epidemiology analyzed 40 randomized trials that had compared homeopathic treatment with standard treatment, a placebo, or no treatment. The authors concluded that all but three of the trials had major flaws in their design and that only one of those three had reported a positive result. The authors concluded that there is no evidence that homeopathic treatment has any more value than a placebo [2].

In 1994, the journal Pediatrics published an article claiming that homeopathic treatment had been demonstrated to be effective against mild cases of diarrhea among Nicaraguan children [3]. The claim was based on findings that, on certain days, the "treated" group had fewer loose stools than the placebo group. However, Sampson and London noted: (1) the study used an unreliable and unproved diagnostic and therapeutic scheme, (2) there was no safeguard against product adulteration, (3) treatment selection was arbitrary, (4) the data were oddly grouped and contained errors and inconsistencies, (5) the results had questionable clinical significance, and (6) there was no public health significance because the only remedy needed for mild childhood diarrhea is adequate fluid intake to prevent or correct dehydration [4].

In 1995, Prescrire International, a French journal that evaluates pharmaceutical products, published a literature review that concluded:

As homeopathic treatments are generally used in conditions with variable outcome or showing spontaneous recovery (hence their placebo-responsiveness), these treatments are widely considered to have an effect in some patients. However, despite the large number of comparative trials carried out to date there is no evidence that homeopathy is any more effective than placebo therapy given in identical conditions.

In December 1996, a lengthy report was published by the Homoeopathic Medicine Research Group (HMRG), an expert panel convened by the Commission of the European Communities. The HMRG included homeopathic physician-researchers and experts in clinical research, clinical pharmacology, biostatistics, and clinical epidemiology. Its aim was to evaluate published and unpublished reports of controlled trials of homeopathic treatment. After examining 184 reports, the panelists concluded: (1) only 17 were designed and reported well enough to be worth considering; (2) in some of these trials, homeopathic approaches may have exerted a greater effect than a placebo or no treatment; and (3) the number of participants in these 17 trials was too small to draw any conclusions about the effectiveness of homeopathic treatment for any specific condition [5]. Simply put: Most homeopathic research is worthless, and no homeopathic product has been proven effective for any therapeutic purpose. The National Council Against Health Fraud has warned that "the sectarian nature of homeopathy raises serious questions about the trustworthiness of homeopathic researchers." [6]

In 1997, a London health authority decided to stop paying for homeopathic treatment after concluding that there was not enough evidence to support its use. The Lambeth, Southwark, and Lewisham Health Authority had been referring more than 500 patients per year to the Royal Homoeopathic Hospital in London. Public health doctors at the authority reviewed the published scientific literature as part of a general move toward purchasing only evidence-based treatments. The group concluded that many of the studies were methodologically flawed and that recent research produced by the Royal Homoeopathic Hospital contained no convincing evidence that homeopathy offered clinical benefit [7].

Proponents trumpet the few "positive" studies as proof that "homeopathy works." Even if their results can be consistently reproduced (which seems unlikely), the most that the study of a single remedy for a single disease could prove is that the remedy is effective against that disease. It would not validate homeopathy's basic theories or prove that homeopathic treatment is useful for other diseases.

Placebo effects can be powerful, of course, but the potential benefit of relieving symptoms with placebos should be weighed against the harm that can result from relying upon -- and wasting money on -- ineffective products. Spontaneous remission is also a factor in homeopathy's popularity. I believe that most people who credit a homeopathic product for their recovery would have fared equally well without it.

Homeopaths are working hard to have their services covered under national health insurance. They claim to provide care that is safer, gentler, "natural," and less expensive than conventional care -- and more concerned with prevention. However, homeopathic treatments prevent nothing, and many homeopathic leaders preach against immunization. Equally bad, a report on the National Center for Homeopathy's 1997 Conference described how a homeopathic physician had suggested using homeopathic products to help prevent and treat coronary artery disease. According to the article, the speaker recommended various 30C and 200C products as alternatives to aspirin or cholesterol-lowering drugs, both of which are proven to reduce the incidence of heart attacks and strokes [8].

Illegal Marketing
In a survey conducted in 1982, the FDA found some over-the-counter products being marketed for serious illnesses, including heart disease, kidney disorders, and cancer. An extract of tarantula was being purveyed for multiple sclerosis; an extract of cobra venom for cancer.

During 1988, the FDA took action against companies marketing "diet patches" with false claims that they could suppress appetite. The largest such company, Meditrend International, of San Diego, instructed users to place 1 or 2 drops of a "homeopathic appetite control solution" on a patch and wear it all day affixed to an "acupuncture point" on the wrist to "bioelectrically" suppress the appetite control center of the brain.

America's most blatant homeopathic marketer appears to be Biological Homeopathic Industries (BHI) of Albuquerque, New Mexico, which, in 1983, sent a 123-page catalog to 200,000 physicians nationwide. Its products included BHI Anticancer Stimulating, BHI Antivirus, BHI Stroke, and 50 other types of tablets claimed to be effective against serious diseases. In 1984, the FDA forced BHI to stop distributing several of the products and to tone down its claims for others. However, BHI has continued to make illegal claims. Its 1991 Physicians' Reference ("for use only by health care professionals") inappropriately recommended products for heart failure, syphilis, kidney failure, blurred vision, and many other serious conditions. The company's publishing arm issues the quarterly Biological Therapy: Journal of Natural Medicine, which regularly contains articles whose authors make questionable claims. An article in the April 1992 issue, for example, listed "indications" for using BHI and Heel products (distributed by BHI) for more than fifty conditions-including cancer, angina pectoris, and paralysis. And the October 1993 issue, devoted to the homeopathic treatment of children, includes an article recommending products for acute bacterial infections of the ear and tonsils. The article is described as selections from Heel seminars given in several cities by a Nevada homeopath who also served as medical editor of Biological Therapy. In 1993, Heel published a 500-page hardcover book describing how to use its products to treat about 450 conditions [9]. Twelve pages of the book cover "Neoplasia and neoplastic phases of disease." (Neoplasm is a medical term for tumor.) In March 1998, during an osteopathic convention in Las Vegas, Nevada, a Heel exhibitor distributed copies of the book when asked for detailed information on how to use Heel products.

Between October 1993 and September 1994, the FDA issued warning letters to four homeopathic manufacturers:

BHI was ordered to stop making claims that BHI Cold, which contained sulfur and pulsatilla, were effective against mumps, whooping cough, chronic respiratory diseases, herpes zoster, all viral infections, and measles. In addition, when combined with other BHI remedies, it had been illegally claimed to be effective against otitis, pleurisy, bronchitis or pneumonia, conjunctivitis, and tracheitis.
Botanical Laboratories, Inc., which distributed Natra-Bio products, was ordered to stop claiming that BioAllers was a homeopathic remedy for reliving symptoms of allergy due to pollen, animal hair, dander, mold, yeast, and dust. The products were promoted as homeopathic even though some ingredients were not in the Homeopathic Pharmacopeia.
L.B.L.-Bot.Bio.Hom.Corp, of Roosevelt, New York, was ordered to stop making false claims that products could prevent AIDS, reduce cholesterol, cure diabetes and other pancreas disorders, and cancerous blood disorders.
Nutrition Express, of Houston, Texas, was warned that products it was marketing for the temporary relief of infection, minor liver disorders, lymphatic disorders, and menstrual discomforts were misbranded because their labels or labeling included statements that represented that the products were intended to be used for curing or preventing disease.
Greater Regulation Is Needed
As far as I can tell, the FDA has never recognized any homeopathic remedy as safe and effecative for any medical purpose. In 1995, I filed a Freedom of Information Act request that stated:

I am interested in learning whether the FDA has: (1) received evidence that any homeopathic remedy, now marketed in this country, is effective against any disease or health problem; (2) concluded that any homeopathic product now marketed in the United States is effective against any health problem or condition; (3) concluded that homeopathic remedies are generally effective; or (4) concluded that homeopathic remedies are generally not effective. Please send me copies of all documents in your possession that pertain to these questions [10].

An official from the FDA Center for Drug Evaluation and Research replied that several dozen homeopathic products were approved many years ago, but these approvals were withdrawn by 1970 [11]. In other words, after 1970, no homeopathic remedy had FDA as "safe and effective" for its intended purpose. As far as I can tell, that statement is still true today.

If the FDA required homeopathic remedies to be proven effective in order to remain marketable -- the standard it applies to other categories of drugs -- homeopathy would face extinction in the United States [12]. However, there is no indication that the agency is considering this. FDA officials regard homeopathy as relatively benign (compared, for example, to unsubstantiated products marketed for cancer and AIDS) and believe that other problems should get enforcement priority. If the FDA attacks homeopathy too vigorously, its proponents might even persuade a lobby-susceptible Congress to rescue them. Regardless of this risk, the FDA should not permit worthless products to be marketed with claims that they are effective. Nor should it continue to tolerate the presence of quack "electrodiagnostic" devices in the marketplace.

In 1994, forty-two prominent critics of quackery and pseudoscience asked the agency to curb the sale of homeopathic products. The petition urges the FDA to initiate a rulemaking procedure to require that all over-the-counter (OTC) homeopathic drugs meet the same standards of safety and effectiveness as nonhomeopathic OTC drugs. It also asks for a public warning that although the FDA has permitted homeopathic remedies to be sold, it does not recognize them as effective. The FDA has not yet responded to the petition. However, on March 3, 1998, at a symposium sponsored by Good Housekeeping magazine, former FDA Commissioner ***** A. Kessler, M.D., J.D., acknowledged that homeopathic remedies do not work but that he did not attempt to ban them because he felt that Congress would not support a ban [13].

Note: We are interested in filing class-action and consumer-protection suits against homeopathic sellers. If you have purchased a homeopathic product within the past year and concluded that the product did not work as represented on packaging or in any advertisement, please contact us.

References
Kaufman M. Homeopathy in America. Baltimore, 1971, The Johns Hopkins University Press.
Hill C, Doyon F. Review of randomized trials of homeopathy. Review of Epidemiology 38:139-142, 1990.
Jacob J and others. Treatment of childhood diarrhea with homeopathic medicine: a randomized clinical trial in Nicaragua. Pediatrics 93:719-725, 1994.
Sampson W, London W. Analysis of homeopathic treatment of childhood diarrhea. Pediatrics 96:961-964, 1995.
Homoeopathic Medicine Research Group. Report. Commission of the European Communities, December 1996.
NCAHF Position Paper on Homeopathy. Loma Linda, CA.: National Council Against Health Fraud, 1994.
Wise, J. Health authority stops buying homoeopathy. British Medical Journal 314:1574, 1997.
Hauck KG. Homeopathy and coronary artery disease. Homeopathy Today 17(8):3, 1997.
Biotherapeutic Index. Baden-Baden, Germany: Biologishe Heilmittel Heel GmbH, 1993.
Barrett S. Letter to FDA Office of Freedom of Information, Feb 7, 1995.
Davis H. Letter to Stephen Barrett, M.D., April 24, 1995.
Pinco RG. Status of homeopathy in the United States: Important ominous developments. Memo to Williard Eldredge, president, American Association of Homeopathic Pharmacists, Jan 17, 1985.
Kessler DA. Panel discussion on herbal dietary supplements. Consumer Safety Symposium on Dietary Supplements and Herbs, New York City, March 3, 1998.


Posted on Feb 23, 2002, 11:44 AM
from IP address 170.57.50.31

placebo effect is strong!
by chicdoc (no login)

i was really unsure that the placebo effect was really as measureable as in some studies, i mean if you are sick and take a medicine that has been proven to work you should feel better and if it is a sugar pill you should not feel better right? but i was proven wrong last year when one of my patients that was begining to abuse xanax so i wanted her to decrease her dependence, she outright refused and said that if she did not take it she would "loose it" so i cahnged her from 1mg of xanax bid to benadryl but with the generic names she did not know what it was i just told her it would decrease her "itching" feeling she came back saying that she had never felt better this higher dose of xanax was working wonders, well i did a screen and there was no trace of benzos so she wasn't double dipping, later on the pharmacist asked her why was she getting the rx if she can buy it otc so she found out it was only benadryl, she came back the next day and all her symptoms had come back! so maybe a lot of things are only in our heads hugh?

Posted on Feb 23, 2002, 2:55 PM
from IP address 128.248.196.210

its called it was all in your head!
by chicdoc (no login)

homeopaths are the, next to insurance, the biggest scam legally running to date! there is absolutely no way that their "dilution" therapy had any effect on your medical condition what so ever! what was the product you used and what was the dilution factor?30X 20X 40X cound you even guarantee that it was the correct "dosage"? NO! its a good thing physics and chemistry are REQUIRED to be a real doctor because that type of dilution crap may fly with the sweet old ladies and goobers of the world but to an educated scientific mind the questions will always arise why?and how? and homeopathic medicine is a load of crap plaain and simple, it is a physical impossibility for a substance that is so diluted to have any effect on your body! want proof, see thats we in real medicine need to see if something works "proof", why don't we have reactions and immuno responses to the infinite amounts of crap we ingest daily, how about CO2, chlorine, trace amounts of radiation, or that dose of neutrinos from when Skylab came down? and i can tell you that these were in far more quatities than the dilutions in homeopathic medicine! now why did you not respond to therapy, who knows everybody's body and mind is different what works on one person may not work on others plus there are many onther issues that one can look at, bugs in your house, pet damder, mold in the a/c vents, mold in the carpet, smoking, being around smokers, hundreds of allergy triggers maybe you had an allergy to a detergent, a type or material of clothing, etc, etc the list goes on several of these will not be helped with meds so who knows maybe it was some little detail you may not even know about and changed that and your allregies/asthma are gone. whatever it is i hope the sugar water you bought was worth it. hey why don't you take some of the "medicine" and have it tested for active ingredients...just so you know the ingridients that will come up are water, lactose, sugar, and trace elements of minerals but no active ingridient becaue it is in too small of quantities to register on gas chromatography! and that is from personal experiments in undergrad!

Posted on Feb 27, 2002, 5:08 PM
from IP address 128.248.196.210

Asthma
by Luis (no login)

I have exercised induced asthma. I love playing soccer, but always get broncho-constriction. I also work out often, free weights, no problem there. Went jogging this morning from Oranjestadt to Zeelandia beach; I had to jog and walk. Please tell me what I can do for my exercised induced asthma. 4th semester student at Sint Eustatius.

Posted on Mar 2, 2002, 8:28 AM
from IP address 208.234.59.23

some homework
by WDC (no login)

Good news is there are very effective treatments, usually taken pre-exercise. The best thing for you to do is do some research on the subject, since after all you are a buddung physician, and then discuss the best treatments with one of the clinical instructors ( MD's at Statia ) or your own physician. rest assured that your symptoms can really be controlled, and for the most part eliminated with prophylactic MDI treatment.
I have pulled a typical pubmed search. Hopefuly your library there has some of these journals. You can also do your own library research. Feel free to log onto our library web page, where you can do a fair amount of research....www.library.tmc.edu

: Gruber W, Eber E, Malle-Scheid D, Pfleger A, Weinhandl E, Dorfer L, Zach MS. Related Articles

Laser acupuncture in children and adolescents with exercise induced asthma.
Thorax. 2002 Mar;57(3):222-5.
PMID: 11867825 [PubMed - in process]

2: Timmer W, Leclerc V, Birraux G, Neuhauser M, Hatzelmann A, Bethke T, Wurst W. Related Articles

The new phosphodiesterase 4 inhibitor roflumilast is efficacious in exercise-induced asthma and leads to suppression of LPS-stimulated TNF-alpha ex vivo.
J Clin Pharmacol. 2002 Mar;42(3):297-303.
PMID: 11865966 [PubMed - in process]

3: Strunk RC. Related Articles

Defining asthma in the preschool-aged child.
Pediatrics. 2002 Feb;109(2 Suppl):357-61.
PMID: 11826250 [PubMed - indexed for MEDLINE]

4: Baki A, Orhan F. Related Articles

The effect of loratadine in exercise-induced asthma.
Arch Dis Child. 2002 Jan;86(1):38-9.
PMID: 11806881 [PubMed - indexed for MEDLINE]

5: Guo Y, Sun T, Zhang H. Related Articles

[The relationship between eosinophils, activated T lymphocyte, leukotreine and the exercise-induced asthma]
Zhonghua Jie He He Hu Xi Za Zhi. 2001 Jun;24(6):360-4. Chinese.
PMID: 11802990 [PubMed - in process]

6: Sullivan MD, Heywood BM, Beukelman DR. Related Articles

A treatment for vocal cord dysfunction in female athletes: an outcome study.
Laryngoscope. 2001 Oct;111(10):1751-5.
PMID: 11801939 [PubMed - indexed for MEDLINE]

7: Beck KC, Joyner MJ, Scanlon PD. Related Articles

Exercise-Induced asthma: diagnosis, treatment, and regulatory issues.
Exerc Sport Sci Rev. 2002 Jan;30(1):1-3. No abstract available.
PMID: 11800494 [PubMed - in process]

8: Davis MS, McCulloch S, Myers T, Freed AN. Related Articles

Eicosanoids modulate hyperpnea-induced late phase airway obstruction and hyperreactivity in dogs.
Respir Physiol. 2002 Jan;129(3):357-65.
PMID: 11788138 [PubMed - in process]

9: Guo Y, Sun T. Related Articles

[Exercise induced asthma]
Zhonghua Jie He He Hu Xi Za Zhi. 2000 Jun;23(6):373-5. Review. Chinese. No abstract available.
PMID: 11778521 [PubMed - indexed for MEDLINE]

10: Liang Y, Cai Y. Related Articles

Effects of endothelin B receptor antagonists, BQ788 and ET-1(11-21) fragment on the bronchoconstriction elicited by isocapnic hyperpnea in guinea pigs.
Chin Med J (Engl). 2000 Mar;113(3):217-21.
PMID: 11775249 [PubMed - indexed for MEDLINE]

11: Medrala W, Wolanczyk-Medrala A, Tomkowicz T, Sycz R, Szczepaniak
CURING ASTHMA
by Alternative Med Doc (no login)


TO CURE ASTHMA:

Go to an alternative medical doc and get a blood test done for any food and environmental allergies....after the results come in, the alternative med doc will tell you how to fix your diet to help (since diet plays a role in the top 4 leading causes of death in the US)....next acupuncture for a couple of sessions should cure the problem and the doc might advise you to take a combination of oriental medicine, homeopathy, botanicals, and ayurvedic medicine for a certain period of time.....we as alternative med docs are trained to get to the bottom of the problem instead of just merely treating the symptoms....the time period of the cure depends on how severe your asthma is and how much you are willing to make the changes in your life for the better (the blood tests mentioned before might indicate what you are allergic to even if you aren't aware of it)....gradually work in combination with the alternative med doc and MD doc to lower your asthma medication until you don't need it anymore.....KEEP YOUR INHALER AT ALL TIMES DURING THE HEALING PROCESS UNTIL YOU ARE CURED !! you may have your body detoxified of the harmful allopathic drugs during the alternative treatments.....it worked for me and lots of other people....ALTERNATIVE MEDICINE WORKS WONDERS FOR MILLIONS OF PEOPLE!!! Also check out the website www.alternativemedicine.com and look for articles written by my former professor - Dr. Zamperion (he has also written a book on how to cure asthma)... He cured me...Remember the body has a remarkable ability to heal on its own..... Hope you feel better..... any other questions, respond back to this message....

Sincerely,

Alternative Med Doc

full of
by WDC (Login WDC)
Forum Moderator



Is there a skin test for the herbs you are going to prescribe?

"KEEP YOUR INHALER WITH YOU AT ALL TIMES WHILE YOU ARE BEING CURED" you mean that toxic inhaler?
HMMM, I thought these evil medications were the problem, or are you just trying to avoid a lawsuit and wrongful death charges. ( even alternative "practitioners" are in CYA mode these days )

since when do alternative natural people have the market on elimination of allergens??? Come on , get real.

The fact that you prescribe homeopathy, which is the ULTIMATE form of quackery, means you haven't the slightest idea what causes asthma, or what cures it.

what you are doing is practicing medicine without a license ( I have a license)

Perhaps you ought to read the second article on my pubmed search.......(and the references cited)

Snake oil peddlers begone!!

Posted on Mar 7, 2002, 11:49 AM
from IP address 128.249.237.75

nice political answer
by chicdoc (no login)

unfortunately we in the medical field require a little something called "scientific proof" in double blind studies to prove the efficacy of treatments. the way you describe the course of therapy is what an MD or DO should do. start by doing titers for asthma triggers and eliminate them and attempt to decrease or eliminate the need for meds, but there are several things to consider when doing your fuzzy math and the way you come up with allergy "cures". about only 20% of patients are actually compliant to medical advice for whatever reasons. my personal theory with allergies is that the type of people that seek alternative medicine are able to afford life style changes. since they can afford your fees, the snake arm pit oil, snot grass fungus and whatever else they are probably in a better position to target the triggers. "buffy" and "edward" can spend the money to pay for an exterminator to get rid of bug dander, get rid of carpet and install wood flooring to get rid of mites and dust, pay for a gardner to keep the plants in control, and make all the diet changes you want. But for some people it is just not feasable to do all those changes and diet is controled by what is on sale so guess what they are left with having to take the meds as their only choice. now to be clear asthma and allergies have NO CURES they can be controlled by eliminating the triggers but cahnces are that as soon as the triggers come back so will your symptoms. so since you are "CURED" how about taking a jog through an abandoned crack house with shag carpeting, three dogs, a roach problem, and pollen from the plants outside...hey since your asthma and/or allergies are cured you should not have any problems right? i would bring extra accupuncture needles and snap dragon root tea or whatever you use. please understand that while accupuncture has been around a long time and has some proven effects naturopathy and homeopathic medicine is faulted at many levels, and here is why:

-naturapathic medicine has at least the right intentions by trying to heal the body but the methods are arcaic since plant chemistry is a bit complex. the concentrations of any active chemical is nearly impossible to quantify since concentrations vary highly and depend on what part of the plant it was taken from, what the soil and nutrient conditions are, the temperature the plant is, amount of sunlight it got, and not in the least what time in the growing season it is being harvested. so with all these variables how do you know what dose you are giving your patients, oh..not to mention the hundreds of other chemicals in plants that could interact with other things. hey wouldn't it be great if we could somehow take the plants, try to isolate the active ingredients, and try to figure out what the most effective dose is for people...guess what its called a CLINICAL TRIAL!.

-homeopathic medicine is a scam there is no other way to put it. i have seen the gas chromatography analysis of some "medicines" and it came out as clucose lactose in water dilutions. there is no active ingredient in there because they are so dilute you would basically have to drink the volume of the earth to have a statistically significant chance of getting a molecule in your system. they claim that it works in the vaccine pathway where a small amount of the pathogen is used to produce a body response, this doesn't hold up with the dilutions since vaccines are billions of times more potent than the glucose water they peddle. look it up in your library or just read the artcle posted earlier here.

face it whatever good comes out of naturapathic medicine is masked by the inability to provide proof in an unbiased and scientific manner, and testimonials are worthless since they are qualitative highly subjective and open to interpretation and degree analysis. you will at some point need to provide a quantitative look at your practices and try to form a united front since two of you can't agree on a course of therapy...you recommend different things and your approaches differ from person to person. that is the reason why you will not answer the simple question of what exactly YOU took for your asthma! graet political answer by the way totally avoid the question by saying that you should follow what their particular ND says since chances are it is totally opposite from what you were told.

peace and remember you can con some of the people some of the time but your fuzzy science can't con all of the people all of the time

Posted on Mar 8, 2002, 4:03 PM
from IP address 128.248.196.169

So you were cured?
by Anonymous (no login)

Let me ask you: What class of asthma did you have? What was your FEV1/FVC ratio pre-treatment?. How about your DLCO? Now tell me what it is "post treatment". Of course since you're not a physician, do you even have an idea of what I am talking about? Now run these same parameters on a few HUNDRED patients in a double blind placebo controlled study, show me obljective signs of improvement, and then I'll give some credence to what you claim!

The difference between quackery and science is objective evidence. Until you can prove your claims in a manner that is universally acceptable to the scientific community, it is nothing more than anecdotal **!

And as to homeopathy, can you even give me a valid proposed mechanism of action? Don't give me that "like cures like" crap. That won't hold up in this day and age. When I was a chiropractor, I heard that ** over and over: "It just works!" "Ask an M.D. how an aspirin works and he can't tell you you". Well guess what, any second year medical student can tell you that aspirin is an irreversible inhibitor of the cycloxygenase pathway, and about prostaglandins as inflammatory mediators.

Posted on Mar 7, 2002, 1:16 PM
from IP address 208.188.113.19

yes
by chicdoc (no login)

i am a ob/gyn res and have already been offered a position at a big ob/gyn clinic in lincoln park, i will also be pcp to a few patients who i will evaluate and if they are critical i will send to vascular otherwise i will trust pod in the end i will do whatever is in the best interest of the patients, i know many pods who are good at what they do but they also know their limitations and do not have to brag about what they do or not do, in the same way that i don't exclaim what i do and i understand my limitations and the scope of my practice.

Posted on Mar 3, 2002, 2:21 PM
from IP address 128.248.196.129

limitations
by anon (no login)

I never said that a Podiatrist was equal in the medical community but has a place in it. I also believe that chiropractors are part of the system too. We(podiatrists)deserve some respect we have earned it too.

Posted on Mar 4, 2002, 2:30 AM
from IP address 152.163.204.189

American Association of International Medical Graduates (AAIMG)
by Info (no login)

This is my second post regarding the truth of networks of persons behind such vindictive acts of bashing international medical schools. My first post was to not only inform, but to end everyone's questions regarding interviews staged by foreign schools.

Now, I am going to recite my own investigations into the American Association of International Medical Graduates (a.k.a. AAIMG). AAIMG was carefully followed to assure that it was legitimate. They have staged their "so called" investigations via a personal website - www.aaimg.com.

This website is owned and continuously moderated by an individual who has failed to complete his medical educaiton at a foreign medical school that was subsequently shut down. The ex-student decided to create a website devoted to standardizing what makes an excellent foreign medical school.

This was an excellent idea. However, personal biases have intervene such investigations. Research methods were poorly done. It is best if this person perform the actual investigations by traveling to these foreign medical schools and make a natural effort to investigate.

But with little common sense, the owner of aaimg is using this forum and another, www.studentdoctor.com, as a guide to his "so called" fact.

Thus, AAIMG is not worth considering as an option to rely on. The picture depicted on the site of a women speaking in front of a crowd is a registered picture on Microsoft Office. Another consideration is how the association advertises its contact information. I have not yet heard of an association having a hotmail address attached to their site.

Another reason to doubt this association's reliability is that it is not registered in any state. This is in part of my own investigations since the introduction of AAIMG last year.

As far as their research is concern, I have to respond to their "slander." If in part this individual does openly state their title, I believe lawsuits will immediately be filed against the so called association.

In light of a current discussion of their evaluation of foreign schools operating in Cambridge, a few information is relatively true. However, at least 85% is false.

All of these schools do rent space in England to operate. I will concentrate on one school that was continuously mentioned - St. Christopher's College.

St. Christopher's College is operating in two locations in England - Luton and Cambridge. In Luton, St. Christopher's College has received an approval from the University of Luton (not Luton Polytechnic, as stated by AAIMG) as an affiliate. Students of St. Christopher's are allowed to use all facilities generally provided to Luton students. However, they are asked to register with the University at the time of their arrival. I was successfully able to contact the individual in charge of operations in Luton. There is an office located at the University of Luton's Park Square Campus. Courses are taught in the College's classrooms. As for the Anatomy and Neuroanatomy course, students are asked to travel to King's College in London (approximately five pounds per week or $120US for semester according to Britain's National Rail.) to engage in laboratory dissections. The student to faculty ratio in the anatomy laboratory course is 4:1. In Cambridge, students are situated at St. Andrews and St. Catherines. Courses are by far excellent in terms of teaching. All courses are taught by UK faculty members who are currently an employee of another registered UK medical school.

On the other hand, AAIMG has made it clear that a number of FMS in Mexico by far exceeds the standards of medical education. Most of these schools were not created for American students, except for UAG. Others have less than 5% American students enrolled in their courses.

Therefore, AAIMG is a total bias generated by an individual who decided to remain anonymous. Anyone can create a website. If you have $100US, you may register and open a 150MB website with a one-year contract. Hey, let's all open a website an individual website denoting our own investigations of FMS using this website! Isn't it a treat to have more websites devoted to FMS as it can relatively be standardized by individuals as fact!

If another hot topic comes around and I have info, I will continually share it. Good Luck to all of you.

Posted on Apr 3, 2002, 12:46 AM
from IP address 212.219.119.98

Thanks for your input! )
by Duncan MacLeod (no login)


Thank you again for giving a serious, well written response to those of us either searching for good info, or are affected by the often negative and untruthful information. Hope to see more of you on the forum! Kudos!

"Duncan"
St. Chris Student

Posted on Apr 4, 2002, 6:38 AM
from IP address 212.219.119.98