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Gout And Pseudogout

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Pseudogout is a type of arthritis that causes pain, redness, heat, and swelling in many joints, symptoms that resemble those of gout. Unlike gout, though, the symptoms of pseudogout are caused by deposits of tiny crystals of calcium pyrophosphate dihydrate rather than uric acid.

In pseudogout, the joint-most often affected is the knee. Over time, pseudogout may damage the cartilage of the joint. As this happens, the bones rub together and cause joint pain. Pseudogout usually affects people in their 60s and is rarely seen in people younger than 30.

Dear Doctor: What's The Difference Between Homeopathy And Allopathic Medicine?

DEAR DR. ROACH: Can you explain the difference between homeopathy and allopathic medicine? -- H.L.

ANSWER: Homeopathy is a pseudoscience based on two assumptions. The first is that the body always knows what to do, so treatment includes a substance that will cause the same symptom a sick person currently has in a healthy person. This seems like a reasonable hypothesis, and it is right some of the time, but not all of the time. For instance, in a person with heat stroke, it's not a good idea to give a substance that causes a fever.

The second assumption in homeopathy is that the less of a substance you give, the more effective it is. Homeopathy was founded around 1796, before atoms and molecules were understood. Most homeopathic remedies don't contain a single molecule of the active substance, so even when a useful treatment is given, it is usually given at a dose so low that it shouldn't be effective. High-quality clinical studies of homeopathy generally do not support their use, and the Food and Drug Administration has not approved any homeopathic preparations or products.

Many people confuse herbal medicine with homeopathy. They are not alike. Much of the pharmacopeia is based on herbal medicine, and for many conditions, herbal medicines are sometimes a valid alternative, if they aren't the current treatment. For example, the extract of autumn crocus (colchicine) is still a common treatment for pseudogout.

The term "allopathy" was not used by the regular doctors of the time, and we shouldn't use it to describe today's medical doctors. It was coined by the homeopaths in an attempt to create a kind of false equality between regular medicine and homeopathy. "Allopathy" comes from the Greek root word meaning "opposite feeling." So, going along with the previous example, an allopath might cool down the patient suffering from heat stroke. While allopathy, too, is a reasonable place to generate a hypothesis, treatments with allopathic properties are not always effective.

What really distinguishes modern medicine from homeopathy is science. To a scientist, it's not a question of whether the "same feeling" or "opposite feeling" is right; it's whether the treatment makes the patient feel better, cures the disease or saves lives. Some treatments that made sense for hundreds of years were proven to be worthless or harmful when subjected to scientific inquiry. Other treatments dismissed by generations of doctors as "old wives' tales" were proven to be beneficial, sometimes better than the accepted medical therapies of the time.

Allopathy versus homeopathy is a false choice. The real choice is between a system based on questionable assumptions and a system based on the scientific method. I won't say that modern medicine doesn't have any faults. I spend many columns discussing its shortcomings. However, homeopathy, when subjected to rigorous trials, has hardly ever been found to be helpful beyond the placebo effect of its treatments. There are scientists attempting to prove effectiveness of homeopathic treatments, but the evidence is against them thus far.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.Cornell.Edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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Dr. Roach: Distinguishing Between Homeopathy And Allopathy In Medicine

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