Sir, When I started in general practice 25 years ago patients used to come to see me when they felt unwell and I would attempt to diagnose their illness and provide medication that made them feel better. Now the vast bulk of my work is searching for “abnormal” blood results and elevated blood pressures and treating “abnormal” results with medication.

It used to be that we would prescribe one drug to control abnormal blood pressure but now it is commonplace to have a patient on four anti-hypertensives because so few of them actually seem to reduce the blood pressure. Add to that the lipid-lowering agents, along with aspirin, and it is common to have patients on as many as 15 drugs a day. It amazes me that patients actually find the time to take all this stuff and cope with all the side-effects.

The drive to prescribe these new medicines, with their huge expense and panoply of side- effects, such as swollen ankles, dizziness, breathlessness and impotence, comes from a pharmaceutical industry which is desperate to create new problems from which we all might suffer unless we take their latest expensive offering.

The letter from medicine’s great and good that disparaged certain alternative treatments, such as homoeopathy (report, May 23), needs to be compared with the crippling NHS costs and patient suffering from side- effects. The significant reason for hospital admission in the over-seventies are drug sideeffects; this is never a homoeopathic drug reaction.

The authors of this letter are the guardians and beneficiaries of a malign era of conventional medicine that seems more concerned with the health of the pharmaceutical industry than the health of our nation.

DR COLIN GUTHRIE
Glasgow

Sir, Two weeks ago the British Medical Association reported that at least a quarter of a million people each year are admitted to hospital with an adverse reaction to a drug, the annual cost of which to the health service is about £466 million (report, May 12). Perhaps the scientists should put their own house in order before condemning safe and popular remedies whose efficacy is supported by the reliable evidence of customer satisfaction.

MARION STANDING
Member, International Council of Holistic Therapists
Shoreham-by-Sea, W Sussex

Sir, The Society of Homeopaths strongly rejects the assertion by Professor Michael Baum and others that homoeopathy is an “implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness”.

There is considerable evidence to show that homoeopathy is effective in the treatment of a wide range of illnesses, including a large study last year of the outcomes over six years from 6,500 patients at the Bristol Homoeopathic Hospital, in which 75 per cent reported improvement.

In questioning the provision of complementary and alternative medicine on the NHS, Baum et al ignore that 70 per cent of GPs feel complementary medicine should be freely available on the NHS and that substantial savings could be made by introducing homoeopathy into general practice.

Access to alternative therapies should be a matter of choice. Describing homoeopathy as an “implausible treatment” patronises the one in four members of the public who want to see complementary medicine on the NHS.

PAULA ROSS
Chief Executive
The Society of Homeopaths
Northampton

Sir, Complementary medicines are used to control symptoms, not to modify a disease process. It is irrelevant to the individual patient if other members of his scientific cohort derive benefit or not — this does not impair the satisfaction in the reduction in pain and suffering he experiences.

It is thought that some complementary treatments activate descending inhibitory nerve pathways to produce a subjective reduction in pain. Professor Baum’s statistical tools seek to exclude this process, based not upon scientific rigour, but upon the archaic notion that the mind and body are separate entities. The overwhelming evidence accumulating in the discipline of neurobiology that they are a fully integrated system suggests the contrary.

If we are to ignore descending inhibitory processes (placebo), we condemn the already excluded patient population suffering from chronic pain to yet more suffering.

DR A. D. DODDS
Consultant Anaesthesia and Pain medicine
Sunderland Royal Hospital

Sir, When so many people use a system of health, it needs more, not less, investigation. As one who works in India and China on a policy of integrating biomedicine with the systems used by populations, because poverty alleviation depends on it, I know more money, not less, should be spent on safety and efficacy studies and public education.

One of the greatest needs is to reduce ineffective prescribing of both biomedicine and alternative medicine and to identify effectiveness where it clearly exists. This cannot be done by abandoning research or education by the NHS into any system of medicine used by not just millions but by billions of people.

TERENCE J. RYAN
Emeritus Professor of Dermatology
Oxford

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