In a past life, before I became so specialized, I was a general surgeon. Like all surgical oncologists and even breast surgeons, before I became a specialist, I had to do a general surgery residency. In addition to the usual cancer problems a general surgeon faces, the two most common being breast and colon cancer, I learned to deal with the most common non-cancer problems that general surgeons deal with, such as gallbladder problems, hernias, bowel obstructions, and the like. Unfortunately, those problems include anorectal problems (not my favorite!) including hemorrhoids.
Basically, hemorrhoids are swollen veins in the anal canal. There are two kinds of hemorrhoids, external and internal. Because external hemorrhoids tend to be relatively easy to deal with, usually only requiring management when they thrombose (clot), which usually requires incision and drainage of the thrombosis ± removal of the vein. Internal hemorrhoids, too, usually only require surgical intervention when they cause severe symptoms, such as prolapse or bleeding, but the interventions are a bigger deal. The specific surgery, such as hemorrhoidectomy or rubber band ligation, the latter of which is often done as an office procedure, tends to be a bit harder and to have the chance of more complications. For purposes of this discussion, the exact surgery isn’t important. What is important is that the problem is anatomical, and the cure is anatomical. While it’s true that for less severe hemorrhoids nonsurgical management is the first choice, including Sitz baths, stool softeners, a high fiber diet, and sometimes topical agents, for serious hemorrhoids, a surgical procedure of some kind is the answer.
That’s why I’m so amused to have found an article entitled Hemorrhoids and Homeopathic Remedy Indications, so much so that I thought it worth a post. As regular readers know, homeopathy postulates two “laws”: The law of similars, which states that to alleviate a symptom you need to use something that causes that symptom in healthy adults, and the law of infinitesimals, which states that diluting a remedy makes it stronger. Often, remedies are diluted 30C, which basically means thirty 100-fold serial dilutions, or 10-60. Given that Avogadro’s number is on the order of 6 x 1023, that means a typical 30C homeopathic dilution is at least 1036-fold greater than Avogadro’s number, which further means that it’s highly unlikely that a single molecule remains.
So what’s the homeopathic treatment of hemorrhoids? This:
Local treatment
• apply the ointment, as needed: AESCULUS / HAMAMELIS / HYDRASTIS / PAEONIA / RATANHIA / VIBURNUM OPULUS / a.a. p. M.T. , 10%
Usual treatment
• alternate 3 granules, as needed :
• one dose, every 2 hours :
NUX VOMICA 9C, and then, AESCULUS 9C, then 12C, then 15C
amel. by cold sitzbaths
-- like grapes; intense itching and burning; rectal incontinence; diarrhea :
• 3 granules, as needed : ALOE 4C
-- very painful and itching, with ineffectual urging to stool :
• 3 granules, as needed : NUX VOMICA 4C
amel. by warm sitzbaths
-- feels full of small needles, itching; lumbosacral pains :
• 3 granules, as needed : AESCULUS 4C
-- bluish; hot; extremely sensitive to all touch; during pregnancy :
• 3 granules, as needed : MURIATIC ACID 5C
-- rectal constriction and sharp sticks; obstinate constipation; pregnancy :
• 3 granules, as needed : COLLINSONIA 4C
-- anal fissure and oozing; great constriction and burning like fire :
• 3 granules, as needed : RATANHIA 4C
Notice something? None of these are diluted anywhere near 30C. Most are diluted around 4C. A 4C dilution is 10-8, which, depending on the amount of starting material, could easily leave enough compound to have a pharmacological effect. Ointments can also, of course, constitute effective local therapy. However, that’s not the hilarious thing. The hilarious thing is that homeopathy is proposed for even hemorrhoids that are getting worse:
Complications
Strangulation-- when the general treatment does not quickly improve the patient, increase the general drainage and take 3 granules :
• every hour repeat as needed :
LACHESIS 4C, then ALOE 4C, then PAEONIA 4C, etc
• 3 times a day :
ARNICA / MURIATIC ACID / VIPERA REDI / a.a. p. 4C
Bleeding
• 3 granules, as needed : COLLINSONIA / HAMAMELIS / a.a. p. 4C
Of course, a strangulated hemorrhoid is a surgical disease that is rarely resolved without a procedure, usually a hemorrhoidectomy. Complications can include infection, gangrene, and sepsis, usually due to necrosis of the tissue of the hemorrhoidal tissue and formation of an abscess.
While these homeopathic remedies are clearly insufficiently diluted to be considered nonexistent, the way that most homeopathic remedies are, be assured that homeopaths remain just as delusional as ever. There are most definitely homeopathic remedies for hemorrhoids that are much more diluted. There are also homeopathic treatments for anal fissures:
A combination lifestyle changes and homeopathic treatment can be a great relief to a person suffering from piles, as it eliminates the possibility of surgery. Moreover, a thorough homeopathic treatment can remove the tendency and thereby prevent its recurrence.
Nux Vomica is one of the leading medicines for treating piles that are coupled with constipation. Aesculus is very effective for nearly all kinds of painful piles. Aloes is useful when the piles are swollen and painful and protrude out like a bunch of grape. Calc flour is very important medicine as it treats the tendency to develop piles. Hamemelis and Millefolium can handle bleeding from piles quite well.
Although 30 c potency of the above mentioned medicines can be used in an acute case, but for prolonged use, please consult a professional homeopath.
For those of you who have been fortunate enough not to have an anal fissure, I’ll tell you a bit about them. They’re basically ulcerations that occur, usually in the posterior midline of the anus, that are due to repeated minor trauma, usually from bowel movements and spasm of the internal anal sphincter. Conservative treatments include Sitz baths (of course), as well as a high fiber diet and stool bulking agents. Sometimes a surgical procedure known as partial lateral internal sphincterotomy is required. In any case, the “pile” is a tag of skin at the edge of the anus, with the thickened edges of the fissure observable. Homeopathy isn’t going to get rid of this.
Let me just put it this way. Patients with anal fissures are miserable, because they often have horrible pain when they defecate. They don’t need a professional homeopath. They need a colorectal surgeon or a general surgeon experienced in the management of anal fissures. Actually, no one needs a homeopath, as homeopaths represent the most useless pseudo-profession in existence. Any improvement in symptoms of hemorrhoids or anal fissures that seems to be due to homeopathy is almost certainly due to the other adjunctive measures recommended, not due to the quackery that is homeopathy.
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Well, at least unlike certain other homeopathic measure discussed lately, this does not create a severe epidemiological risk if followed.
Hurray for silver linings!
not related to topic but what's the most efficient way to screen for SCN1A mutations before vaccines?
If I read this right (and the blurb about "A combination lifestyle changes and homeopathic treatment " would strengthen my case), it's basically saying "get homeopathic stuff on top of mainstream treatment; if you get better, praise homeopathy".
Reminds me of this anti-acne homeopathic treatment I heard of. Main ingredients, listed as non-active substances: ethanol, tea tree oil.
Sure, "non-active".
At the bottom of this homeopath's ad-riddled page is a link for "Mesothelioma from Homeopathic (Treatment) Point of View" (http://homeoresearch.blogspot.com/2014/09/mesothelioma.html) ridiculously claiming homeopathic cure for mesotheliomia.
Homeopathy offers better treatment for Mesothelioma when compared to any other system. Single dose of above remedies according to symptoms will produce good relief in symptoms. If it can able to move disease from surface of lungs with constitutional Homeopathic treatment, remove suppression's layer by layer it can possible to cure mesothelioma completely.
There's a great homeopathic treatment for heart disease going around. Basically, it consists of taking 3 drops of a 60C solution of lard, 3 times a day. For best results, it is recommended to also remove the failing heart and replace it with a new one; people who have done this while taking the homeopathic remedy have noted dramatic improvements in cardiac function.
Uh, does anybody notice that the first two preperations listed (nux vomica and aesculus) are in fact fancy homeopathy names for strychnine and buckeye seeds ? two highly toxic vegetable alkaloids. Yeah. that's right. and a 9c dilution may not be enough dilutions to remove the toxic stuff. So be careful when using these, you might make yourself sick, especially if the snake-oil salesman was careless in his preparations. Of course, odds are you're just buying water, glycerine or adulterated K-Y jelly, but you never know.
Bwaaaa! Remind me not to read med blogs over breakfast.
Surgical details usually son't make me feel squeamish but Orac's descriptions arrive just a few days after viewing a friend's recent corrective surgery for Duputrens ( AND 3 subsequent plastic surgeries because of grafts, etc.- you don't want to know more details than that, believe me).
I don't feel nauseous or faint but I imagine pain too well.
@The Smith of Lie
That would be a different homeopathic ointment.
In this case, literally snake-oil. Lachesis is bushmaster snake venom. At first I mistakenly thought it was belladonna, in which case I would hope they include instructions to very thoroughly wash hands after use. Belladonna is extremely poisonous, and at such minor dilutions, you could actually get a dangerous exposure. As for snake venom, not sure what the effects would be if applied topically or accidentally ingested.
That should be DON'T and DUPUYTREN'S
Now that's what I call a shitty situation.
Working Where the Sun Don't Shine
http://www.youtube.com/watch?v=qwaenpu7ZhI
Hmmm. The treatment for a standard case of hemorrhoids is nux vomica 9C, but if it's "very painful and itching, with ineffectual urging to stool", which I assume is worse than an ordinary hemorrhoid, nux vomica 4C is called for. That seems to contradict the law of similars, which claims that higher dilution makes the substance more potent as a treatment.
Belief in homeopathy as treatment for hemorrhoids is a weird one, since apparently, no amount of knowledge in biochemistry and molecular biology and biophysics can dispel such a belief gathered from anecdata of family experiences. I once had a run-in with a friend (who was then a Grad student in - you guessed it - biochemistry and molecular biology and biophysics) regarding this, and recounted my experience here: http://www.scilogs.com/in_scientio_veritas/homeopathy-in-hemorrhoids-ou…
I often wonder of the attraction to woo-centric treatments increases whenever the SB treatment for a condition is extremely painful, embarasssing, frustrating or expensive. They want to believe that there's an easier way.
Hemorrhoids are proof that Darwin doesn't exist.
I had a faint recollection that Sitz baths might not be the best idea, but it was only when I remembered "the lavatory is not the library" that it came to me:
"Bathing in tubs with warm water universally eases painful perianal conditions. Relaxation of the sphincter mechanism and spasm is probably the etiology. Ice can relieve the pain of acute thrombosis. The author does not suggest mechanisms such as the sitz bath for symptom relief. The rigid structure of these portable bathing apparatuses can act in a similar fashion as a toilet seat, causing venous congestion in the perianal area and potentially exacerbating the problem. However, sitz baths do have a role with older patients and with immobile patients who cannot routinely get in and out of a bathtub."
"Patients with anal fissures are miserable, because they often have horrible pain when they defecate."
Should probably read:
"Patients with anal fissures are miserable, because they often have incredibly horrible pain when they defecate."
Speaking from experience.
afeman@#7 -- waiting until after lunch wasn't much better.
"I often wonder of the attraction to woo-centric treatments increases whenever the SB is extremely painful, embarasssing... They want to believe that there’s an easier way."
Sure, but I can't imagine this making a difference with hemmorhoid sufferers. The 'rhoids hurt a lot, and in a way I can't imagine would be significantly ameliorated by any placebo effect. So if sufferers try a homeopathic 'treatment', they're likely to still be yelping with pain the next time they take a dump, yes?
Thus, my first guess is that homeopath "BOUKO LEVY M." believes his/her own s*** [ :-) ] here. I'd think a 'snake-oil salesman' (con-artist) would be clever enough to offer his nostrums only for conditions the user could imagine they might effect — either chronic body pain the brain can dial down via suggestion, ills that only project effects into the future (cancer, heart disease), or diseases to which the risk of exposure is close to nil (smallpox, ebola).
The silver lining may be that by promoting homeopathetics-for-hemmoroids the homeopaths are undermining their own schtick as folks who try it might rightly conclude that homeopathy is just another plop of poo.
On the other hand, it's possible that homeopathy (and other pseudo-'healing arts') have a psychology that works something like this: The folks who buy into it have a sub-conscious understanding of it's limited plausibility, and DON'T actually try it for things like hemmorhoids or other more obviously anatomical problems — because they intuit both that it won't really help them, and that would indeed undermine their faith in a belief system they want to hold on to. However, that belief system IS reinforced by the IDEA that homeopathy is all-purpose magic, as long as you don't attempt to put that idea into actual practice.
Put more generally, the hypotheses would be:
1) Adherence to magical belief system is best maintained by attempting to support certain claims with 'common sense' evidence 'tests', and relegating other more outre claims to the realm of pure faith.
2) Thus, this is what adherents to magical belief systems do, though they are unaware of the distinction and it's contradictions.
If there's anything to those hypotheses, then "BOUKO LEVY M." is less delusional than damn clever.
People with minor, self-limiting complaints _get well_ on their own:
by taking a homeopathic placebo, they are rewarded in two ways- they avoid seeing a doctor and they DO feel better- which they attribute the placebo by mistake. Thus they'll continue until the problem becomes unmanageable.
As Orac has reported ( concerning breasr cancer), sometimes people persist with spurious treatment despite experiencing pain and disabling conditions.
Maybe I'll tell you a story about a problematic cyst some time.
Or not.
"4C dilution is 10-8, which, depending on the amount of starting material, could easily leave enough compound to have a pharmacological effect". Question: why would the amount of starting material affect the concentration of the final dilution? Isn't the total amount of diluent proportional to the starting amount of whatever is being diluted? In this case 1 part per 100M? Or am I missing something.
DW #21 I often wonder of the attraction to woo-centric treatments increases whenever the SB treatment for a condition is extremely painful, embarasssing, frustrating or expensive.
That's the thing - if I have an embarrassing ailment, I want to go to a doctor! I generally assume they've seen a LOT worse than whatever I bring waltzing in through the door... I'd rather a jaded professional see me and fix it rather than a very good friend at an inopportune time, as it were.
Also, I have had Mr Cash's Ring Of Fire stuck in my head throughout this article.
@ Roadstergal:
I mean that if the dedicated woo is merely magic water or handwaving, no one has to look at the inflamed whatever.
OT (but maybe not since a PITA is involved): who would have ever thought there was an Anti-Vaccination League of America? It sounds like a comic book series from an alternate universe of the sort that few people would want to visit.
But it's mentioned in an article that Mark Crislip found: http://www.journalgazette.net/article/20140914/LOCAL04/309149945
As someone who went through four "minor" surgeries for fissures and hemorrhoids a few years ago, I can literally relate to these folks' pain, but the idea of relying on woo makes me cringe. Not even Vicodin makes a chronic fissure or a thrombosed hemorrhoid feel better. When your preferred euphemism for a bowel movement is, "Well, I'm going to the bathroom to ruin my day," it's time to schedule repairs. Even a week of being sore after each procedure was worth it once the problems were finally solved for good.
I Googled, and could find only one other reference to the Anti-Vaccination League of America or it's mouthpiece Jim O'Kelley — another news story from Fort Wayne dated August 28 of this year: http://www.news-sentinel.com/apps/pbcs.dll/article?AID=/20140828/NEWS/1…
Highlight: "O'Kelly said he believed that the very diseases the vaccinations were supposed to prevent don't exist, and vaccinations are unnecessary."
I'm guessing the Anti-Vaccination League of America has exactly one chapter, located somewhere in Northern Indiana, and exactly one member, Jim O'Kelley. I'm also thinking the Fort Wayne press must be hard up for sources to use in click-bait stories to build their web-ad revenue.
Nevertheless, the notion of a JLA/GoG/Avengers-style comic book and movie franchise 'Anti-Vaccination League of America' offers opportunities for entertaining speculation. E.g. what would be the Super Hero monikers for Wakefield, Olmsted, Schneider, Hooker... who would be left off the team... what would be the Super Villain monikers of Orac, Novella, and the Big Pharma Evil Mastermind pulling their strings?
Ideas, anyone?
You know what actually amuses me about the suggested homeopathic remedies? The sheer number of them to take!
And this from a mindset that regularly criticises proper medicine and doctors for pushing drugs.
I'd rather use a topical application and eat more fibre/drink more water than have to remember all the bloody homepathiic remedies to take and in what sequence.
If it gets worse, get a surgical referral. Fixed.
Not suffering in pain waiting for the magic to kick in.
I'm still entirely confused about the nature of the proving here.
My poor ex suffered horribly from a perianal abcess. If only he'd known he could have fixed it up with some fancy water!
Take my wife
http://youtube.com/watch?v=bBUc_kATGgg
However, I did kinda fire my allopath after he recommended an SSRI, wouldn't renew my hydroxyzine, and was kinda a dick about it in general-- Me favoring 5-HTP, B6, Folate (NOT folic acid), magnesium, zinc, choline, inositol, vita C, sublingual b-12, pot, and prayer. Still looking into SAM-E and my ongoing copper buildup toxicity and how not to flood that out too quickly...
Here's another (non-homeopathic) way to treat hemorrhoids:
https://www.youtube.com/watch?v=M7T0_xWKmTo
Guy speaks in Russian there, but the basic principle is to insert cucumber into your rectum while it's still attached to plant it grows on. The way it supposed to work, as far as I understand, is forming a conduit that transfers some kind of "healing energy" from the Earth right into the patient's butthole.
Sadly, the whole procedure is not performed on video. In the video comment it says the full version is on the guy's site, but it doesn't work, so we have to use our imagination.
http://www.cdc.gov/maso/facm/pdfs/BSCOID/2013121112_BSCOID_Minutes.pdf
Theres this paragraph under resurgence of pertussis that worries me.
"Findings indicated that 85% of the isolates were PRN-deficient and vaccinated patients had significantly higher odds than unvaccinated patients of being infected with PRN-deficient strains. Moreover, when patients with up-to-date DTaP vaccinations were compared to unvaccinated patients, the odds of being infected with PRN-deficient strains increased, suggesting that PRN-bacteria may have a selective advantage in infecting DTaP-vaccinated persons."
I don't know what isolated strands mean but to my common eye, it looks like it says "85% of the bacteria present are PRN deficient strands, and these strands are more likely to infect people vaccinated with DtaP than unvaccinated."
I'm probably wrong but can someone tell me what that actually means?
Well, homeopathy might help in some cases but I personally have tried several homeopathic treatments to get rid of the hemorrhoids just to have them banded with the thd method in the end.... It got better which might have been thanks to the homeopathic treatment or (more likely) due to the lifestyle changes but getting rid of them completely without surgery is almost impossible in my opinion... So go ahead and try it but also consider surgery as an option if they won't go away.
If the principles of homeopathy are correct, the cure for a pain in the arse should be a sufficiently diluted extract of homeopath.
@Panda:
No. What it says is that when vaccinated people do get pertussis, it is disproportionately likely that they will get PRN deficient pertussis as opposed to PRN pertussis. If I understand correctly, this is a suggestion to modify the DTaP to also include antigens from PRN deficient pertussis strains.
Wanting to see if the leading chiroquacktor in the Phoenix area--one arrogant person by the name of Bob Martin (who is, of course, anti-vaccine and just had his weekly 3-hour radio show go national) had any similar hemorrhoid "cures", I came across his endorsement of something called Hem-tab (http://www.hemtab.com/index.php). Now what irks me about this "product" is they claim (1) "FDA Certified" and (2) "recommended by protcologists nationwide".
Just what the heck is "FDA Certified"?
@David #23
I believe you are confusing the present amount of dissolved substance (i.e. the concentration, e.g. 10 g/liter) with the initial volume to be diluted (e.g. 1 liter).
Dilution factors are always expressed in regards of the proportion between the used volumes, not of the concentrations, I believe. When you do a dilution of 1 in 10, you get a diluted solution of 1/10th of the initial concentration.
If you start at 100 g/liter, you get 10 g/liter. If you start at 1 g/liter, you get 0.1 g/liter.
Orac's point is that, for the same volume of extracted stuff from a plant or a duck or whatever, you may have very different concentrations of the active substances between batches, in function of the ripeness of the plant, the species of the duck (and its honesty), and so on....
"Just what the heck is “FDA Certified”?"
FDA = Fake Drug Advertising?
But seriously: Though the Hen-tab page has “FDA Certified” in the banner, down-page that is expanded to "FDA Certified Laboratory — DSHEA standards," a claim about the facility in which Hem-tab is manufactured, and the conditions of its production, not the product itself. I have seen this tactic before in promotion of other dubious remedies, but never so blatantly misleading. The repeated use of the FDA logo is clearly intended to make a false claim via visual communication that will over-ride any more qualified wording in the text. I don't know whether this meets the relevant statutory standards for false advertising, but you might want to call this to the attention of the FDA and/or whatever agency false ad issues for the Feds (DOJ?, Consumer Affairs?), and inquire whether a complaint would be in order.
“recommended by proctologists nationwide”
I would guess that means one proctologist in Seattle, one proctologist in Tampa, and one proctologist in Valparaiso, IN.
Hemtab looks like a pretty sophisticated scam, with numerous sock-puppet websites offering positive 'reviews.' Meanwhile, the only 'Contact Info' on Hemtab.com is a toll-free phone number, and Google reveals the absence of a business address on a website is a strong red flag of a swindle. After more Googling, I found a press release from Hemtab with an address at the bottom: P. O. Box 78009 Seattle, WA 98115. So, perhaps an inquiry to Washington State officials might also be in order (?).
insert cucumber into your rectum while it’s still attached to plant it grows on
That is going to limit your mobility (I assume the cure only works while the cucumber remains in place), and is likely to bring down the wrath of the cucumber farmer.
"If the principles of homeopathy are correct, the cure for a pain in the arse should be a sufficiently diluted extract of homeopath."
If the principles of homeopathy are correct, the cure for belief in homepathy would be to steal some stool from BOUKO LEVY M., create the appropriately infinitesimal dilution and introduce it into the water supply. (If only like cures like would work just one time...)
It is a long time since highschool French but I think "Beaucoup Levy" translates as "charge a lot".
@Sadmar
Most of Levy's remedies are inordinately complex and can prove to be kinda pricey as well as inviting 'uncomfortable' questions of strangers. Especially for a young woman trying to gather the ingredients from the local WalMart.
ex: http://homeoresearch.blogspot.com/2014/08/leukorrhea.html
Though that last step, nitric acid, probably does remove the 'whiteness' in favor of a more appetite-inducing natural yellow.
The correct treatment, for Laura Bush anyways, was to scrub it out with pinecones and donkey fat.
I had bad ones for years, but the last holdout resolved on its own, somehow. I'm assuming it burst and then just healed normally; all I know is that I went to the toilet to urinate, felt a slight sensation (but no pain, weirdly) back there, and looked to find the toilet water was dark pink with blood. Very strange, and a little unnerving, given how utterly painless it was.
I found that drinking more water helped a lot. There's a homeopathy joke lurking in there somewhere, but I've got some kind of odd upper respiratory infection right now, and I just can't find it.
@ hdb
I would have gone for "plenty of denim trousers", but your translation makes more sense in context.
Although, trousers and hemorrhoids sort of happen in the same general vicinity...
is likely to bring down the wrath of the cucumber farmer.
Perhaps zucchini are a good substitute? Speaking as the wife of an enthusiastic home gardener, we have plenty of those to dispose of. Not to mention yellow squash.
I am not a clinician but yellow squash does not sound like a good idea.