An Open Letter to BMJ Case Report: Homeopathy-medicine induced severe alcoholic hepatitis

Dear Friends,

I recently came across a study published in BMJ Case Report titled, “Homeopathy-medicine induced severe alcoholic hepatitis“.

The authors have beautifully concluded that “the culprit ‘alcohol’ was found to be the homoeopathy medicines that the patient was consuming over a month for treatment of Gilbert’s syndrome” after which there was worsening of the chronic liver disease.

The study is a paid paper (and I don’t have access to said journal) thus I could not underwent in-depth of the complete study, but what I could understand from the abstract I am going to share that.

The study claims that a teetotaller (person who a person who never drinks alcohol) presented with non-alcoholic fatty-liver-disease related cirrhosis. There was worsening of his complaints after consuming of “homeopathy medicine” (18% alcohol based) for a month for Gilbert’s syndrome.

Now with the presented limited knowledge, the inference which could be possible made:

  1. “Patient was consuming….” – It may be meant that patient was on self medication and not necessary prescribed the so called “culprit alcohol”. In case is it ok enough to blame the entire system rather that blaming the patient, who may be at fault (OTC are nuisance in allopathic system too, but are covered under umbrella of pharmaceuticals).
  2. If it was Gilbert syndrome (which usually require no treatment) the homeopathic physician would be advised patient accordingly. If the physician was not registered or a lay practitioner, then he must be contacted before blaming the “pathy” as whole. It is said that, “It may be a fault of a path and not the pathy”.
  3. If we consider patient still consumed “18% of culprit alcohol”, of “name not mentioned in the abstract” then also the following calculation must be considered:
  • a) Usual doses of homeopathy medicines are 2-3 times a day,
  • b) On an average, the 30 ml contains around 1000 drops (as per standard dropper of homeopathic dilution in our clinical practice). This means each drop is equivalent to 0.03 ml and thus each drop has 18% of 0.03ml = 0.0054ml of alcohol.
  • c) If the patient is taking 15 drops thrice daily (as common dose) it means he is consuming 0.0054 ml x 45 drops = 0.243ml alcohol every day.
  • d) Thus over a month the quantity would be 7.29 ml.

So do you think this 7.29ml of alcohol over a month is sufficient enough to aggravate the already existing Non-Alcoholic-Fatty-Liver Disease. This is even less that if a patient consumes a lite beer in a month!

Even if the patient consumed medicine in syrup based he must have taken not more than 10.5 ml (3 tsp) a day which means – 1.89 ml alcohol a day!

They may be many more grey areas before concluding the “culprits” – medicine or doctor or self medication OTC. For this I request BMJ to make this paper OPEN ACCESS and put in public domain with all the requisite reports and evidences. This will also ensure that the journal has followed the publication and medical ethics before reporting such studies (at least in their abstracts).

I would like to request you to share your views in the discussion section.

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