Reply to Milgrom and Moebius


Edzard Ernst, MD, PhD, FRCP, FRCPEd, Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, 25 Victoria Park Road, Exeter EX2 4NT, UK. E-mail:

My article was invited by the Editor of the Journal and did indeed mention a comprehensive homeopathic research programme which was conducted during the Third Reich. Milgrom and Moebius ask ‘why raise the issue . . . now?’. The question is misleading. I (and many others) have referred to this programme many times before. There are more than 1000 website on Google about this. Years ago, I even wrote an article specifically dedicated to this subject in the UK homeopaths' journal [1], and it was I who decided 18 years ago to publish Donner's detailed eye-witness account of the programme in my journal Perfusion[2–5]. ‘Why now’ is therefore a nonsensical question. Why again, would be better – and the answer is, because it may be important, both historically and scientifically.

However, Milgrom and Moebius go much further in deceiving the reader by likening this homeopathic research programme to Nazi concentration camp experiments. Had they only glanced at Donner's original report (in German) [2–5] or read my article about it (in English) [1], they could not have failed to notice that this is very far from the truth. The programme was overseen by the most competent German scientists of that period, including the internationally respected pharmacologist Kuschinski, and there is not a shred of evidence that it was in any way unethical; and certainly it was not conducted in concentration camps! So no skeletons in this closet, and hence not much of a struggle with the ethics of utilizing the information.

Next, Milgrom and Moebius accuse me of using just three references (two of them my own) to back up the conclusion that the clinical effects of homeopathic medicine fail to generate effects that are different from those of placebo. Conveniently, they do not actually name all these references, but instead take issue with Shang's meta-analysis. However, there are good and obvious reasons for citing exactly these three references: the first one [6] is the only published summary of all recent systematic reviews on the subject, and the other two [7, 8] are those that emerged after its publication. So, by using these three references, I backed up my statement with the complete list of more than a dozen recent systematic reviews. Shang et al.[7] may be criticised for this or that reason but, if a plethora of systematic reviews all arrive at very similar conclusions, perhaps even homeopathic evangelists should face the facts.

Finally, Milgrom and Moebius imply that telling the truth about homeopathy would restrict the ‘freedom of choice of many patients’. This, I think, is a truly disturbing thought. If it were true and relevant, we should urgently abandon the principles of evidence-based medicine and replace them with a supermarket full of ill-informed choices for convenient self-service. Milgrom and Moebius call me ‘unethical’ and ‘unscientific’; I leave it to the reader to decide who best fits this description.