The Journal does a disservice to its readers when it presents a homeopathic jargon filled discussion as if a scientific discussion is taking place. There was no editorial explaining the reasoning behind publishing such an article. One of the characteristics of science is its coherence. The sciences of pharmacology, physiology and toxicology build upon and are consistent with the laws of chemistry and physics. To talk about diluting a substance to the point where it is undetectable and then explaining how it works to heal flies in the face of the principles of those disciplines. It is too late to write a letter to the editor but I hope someone did.
Well, eventually some people did: Treating Critically Ill Patients with Sugar Pills. Like Retired Doc, the letter writers are surprised Chest would accept such a paper.
The authors of the paper, in effect, admit that the study drug is mere water with this statement:
Since the potentiation (dilution and vigorously shaking) of the study drug beyond the Avogadro number imposes no interaction with the patient’s metabolism, and due to the low cost of the drug, its use in the ICU may be beneficial, minimizing morbidity and mortality.
The fact that this paper appeared in Chest impresses me with just how deep pseudoscience has penetrated the mainstream. I’d have expected something like this in BMJ, but not the revered Chest!