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Homeopathy and Evidence-Based Medicine: Back to the Future Part IV

 

 

Homeopathy and Science

This week’s entry† is a summary of some of the tests of homeopathy. It is a necessary prelude to a discussion of how homeopaths and their apologists promote the method. Several tenets of homeopathy lend themselves to tests. The doctrine of similia similibus curantur (“like cures like”) was tested by Hahnemann himself, as introduced in Part I of this blog. It is a special case that will be discussed further below. Hahnemann’s second doctrine, “infinitesimals,” suggests laboratory, animal, and clinical studies looking for specific effects of homeopathic preparations.

“Provings,” also called “homeopathic pathogenic trials,” suggest testing “provers” for the ability to distinguish between homeopathic preparations and placebos, and suggest asking homeopaths to identify specific remedies solely by the “symptoms” they elicit in “provers.” The homeopathic interview and prescribing scheme, gathering copious “symptoms” and matching them to the appropriate “remedy” in the Materia Medica, suggests testing homeopaths for consistency in symptom interpretations and prescriptions. The clinical practice suggests outcome studies, both of individual “conditions” (with the caveat that, strictly speaking, homeopathy does not recognize disease categories—only “symptom” complexes) and of the practice as a whole.

Several of these categories overlap. Several have been tested: the results have overwhelmingly failed to confirm homeopathy’s claims. I will mention a few of the more conspicuous examples.

Cinchona Bark: the Sole Test of the “Law of Similars”

Similia similibus curantur is the sine qua non of homeopathy: Hahnemann’s “eternal, infallible law of nature.” In Part I of this series I asserted that it had been “definitively disproved.” A few dissenting comments from readers have convinced me that I did not adequately explain the nature and the limitations of the experimental basis for Hahnemann’s first “law,” and therefore that I had not justified my categorical assertion. What follows is an attempt to remedy that failing.

Hahnemann took cinchona in 1790 believing, as did most of his contemporaries, that it was curative of “intermittent fever” (or “marsh ague”). He wondered how it worked, and hoped that he might learn something by testing it on himself. His reactions, as quoted in Part I of this blog, seemed to him to be similar to (“ordinarily characteristic of”) the symptoms of intermittent fever. Thus Hahnemann had his “eureka moment”: “like cures like,” he decided, must be a universal fact of nature.

Now comes the rub: we know that cinchona actually did cure most cases of intermittent fever, the disease that we call “malaria.” Cinchona was one of the few effective remedies known to European physicians at the time. Thus the first “proving” was partly evidence-based, if only by happy coincidence: in Hahnemann’s “n-of-1” pharmacodynamic trial, he began with the correct assumption that he would study an effective treatment. In all subsequent “provings,” however, he worked in the other direction: he began by assuming the truth of the “law of similars” and sought only to collect “symptoms.” He eventually “proved” the popular “allopathic” medicines of the era, but in doing so he no longer considered what “allopaths” used those medicines for, other than to disparage such uses.

Among the 65 substances listed in Hahnemann’s Materia Medica, cinchona (“china”) was probably the only one that specifically cured a disease*—although Hahnemann could not have known that at the time. Thus even if he had thought that he experienced the “symptoms” of syphilis after taking mercury, for example, it would not have supported his doctrine of “similars”; mercury is not a specific cure for syphilis, although it was prescribed for that at the time. Many substances that Hahnemann “proved”—opium, ipecac, belladonna, digitalis, etc.—had useful physiologic effects but were not curative of diseases per se. In any event Hahnemann disparaged even the few rational uses of those drugs (e.g., digitalis to “diminish the frequency of the quick, irritated pulse”), as he discussed at length in the Introduction to his Organon.

Thus, although Hahnemann and all homeopaths since his time have held that every “proving” is further proof of the doctrine that defines homeopathy, in fact none are so. Only the very first “proving” was even partly based on a medical fact (even if Hahnemann didn’t know it), and is thus the sole test of Hahnemann’s “first law.” The rest of the evidence relevant to that first “proving,” moreover, is not flattering to similia similibus curantur. In 1820 Pelletier and Caventou isolated quinine, the active anti-malarial ingredient of cinchona bark. [1] By the late 19th century, during the flowering of the Germ Theory of disease, Alphonse Laveran had established that malaria is caused by a blood-borne parasite. In the latter part of the 20th century the mechanism of action of quinine and other anti-malarial drugs was largely elucidated, and in each case it involves killing the protozoa that cause the disease. As previously stated, “it has nothing to do with ‘like cures like,’ vitalism, ‘dynamism,’ ‘inducing the self-healing response,’ or any other process proposed by Hahnemann or his followers.”

That is why we in the modern world may assert, with utter confidence, that “the very foundation of homeopathy has been definitively disproved.” There is irony in this history. One might expect, after Hahnemann’s famous encounter with cinchona bark, that homeopaths ought to be particularly adept at curing malaria. They are not. Not only do they frequently prescribe “remedies” that have no known or plausible role in eradicating malaria parasites, but even if they prescribe “cinchona” itself they don’t actually give any; their dilutions see to that. By the time Hahnemann assembled his thoughts for the cinchona entry in his Materia Medica, the therapeutic reality of treating malaria had become unrecognizable.

Testing the “Law of Infinitesimals”: the Benveniste Affair

Modern homeopaths grant that most of their “remedies” contain none of the original substances, but claim that since they “work” there must be a reason, as yet unexplained by science. Some of their favorite explanatory candidates are “spirit-like essence” and “water memory.” The latter is the explanation that homeopaths most commonly ascribe to a series of highly publicized experiments in the 1980s by the late Frenchman Jacques Benveniste, who reported persistence of biological activity of certain antibodies even after diluting them far past the point at which any could have remained in the solution.

Benveniste’s claims were not actually consistent with homeopathy per se: the activity that he reported did not increase progressively with each new dilution, as “potentizing” would have predicted, but sputtered in a series of peaks and troughs, never exceeding the potency of the original, most concentrated sample. The qualitative biological activity, moreover, remained the same whatever the dilution—whereas homeopathy’s “like cures like” doctrine would have predicted a very different, roughly opposite effect at high dilutions (“potencies”).

Nevertheless, any biological activity referable to a substance no longer in a preparation diluted 10^120-fold would have been news, had it been convincing. The journal Nature, with admitted trepidation, published Benveniste’s paper in 1988 after he had satisfied various requirements of reviewers. Subsequently, a three-person team visited Benveniste’s lab to give him the opportunity to repeat his experiments under their observation. The team included John Maddox, the editor of Nature; Walter Stewart, an expert in scientific error and fraud; and James (“The Amazing”) Randi, a professional magician and investigator of paranormal claims. The three found multiple flaws in the project, including a lack of checks against contamination, inadequate controls, a “disregard for statistical principles,” previously undisclosed sponsorship by a supplier of homeopathic medicines, a general belief among all in the laboratory, bordering on religious fervor, in the truth of their claims, no attempts to control for observer bias, lack of blinding in general, and no consideration of even the possibility of sampling errors.

Most importantly, the observers found that Benveniste’s results were not reproducible even when performed by his own group under lax controls, and that the experiments were a complete failure when performed under strict, double-blind conditions. Later, at least three other European labs were also unable to replicate Benveniste’s results.

In spite of these problems, or more likely because of them, Benveniste became a legend in “alternative medicine” circles. Thus Daniel Eskinazi of Columbia University’s Rosenthal Center for Complementary and Alternative Medicine complained in the JAMA “Complementary, Alternative, and Integrative Medicine” series of November, 1998, that “established academic researchers have been discredited and have had difficulties when attempting to conduct alternative medicine research,” citing Benveniste as an example. But the discrediting of Benveniste was entirely justified, as reviewers of Eskinazi’s manuscript could have easily discovered. Benveniste was later the recipient of two “Ig Nobel” prizes, the first in 1991 for the project just discussed, and the second in 1998 after he had claimed to “digitize” biological messages from homeopathic dilutions and transmit them over the Internet. He died in 2004.

Other “Pre-Clinical” Tests…

…, at least until 1999, have suffered from “a lack of independent replication of any pre-clinical research in homoeopathy. In the few instances where a research team has set out to replicate the work of another, either the results were negative or the methodology was questionable.”

Clinical Tests: “Provings,” “Symptoms,” and Outcomes

As previously cited, several tests of “provings” have failed to demonstrate what homeopaths claim. Homeopaths also demonstrate poor “inter-rater reliability” in evaluating symptom diaries. Outcome studies of homeopathic treatments have not provided real evidence for specific effects. Two “meta-analyses” are worth mentioning only because they have been touted as supporting the claims of homeopaths. The first, in 1991, concluded: “The amount of positive evidence even among the best studies came as a surprise to us. Based on this evidence we would be ready to accept that homoeopathy can be efficacious, if only the mechanism of action were more plausible.” The second, in 1997, concluded: “The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition.”

Subsequent reviews of those and other reports found that when corrections were made for publication bias and other method flaws, the apparent findings disappeared. Two projects involving trials of homeopathy for specific conditions are worth mentioning because they, too, are touted by proponents: the first is the series by David Reilly, mentioned at the beginning of this series. As stated, the results were “inconsistent and largely subjective.” The second was a trial of “individualized” homeopathic “remedies” for childhood diarrhea. It reported a slight, but statistically significant, reduction in the number and duration of loose stools. Subsequently our fellow blogger Wally Sampson, with co-author William London, wrote a damning critique of the diarrhea paper.

Next week: Homeopathy and Evidence-Based Medicine


* The modern reader will recognize that Bismuthum may also be able to make that claim, but that wouldn’t have been known to Hahnemann.


[1] Tracy JW and Webster LT. Drugs used in the chemotherapy of protozoal infections: malaria. In: Hardman JG, Limbird LE, Gilman AG. Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 10thEdition. McGraw-Hill, New York 2001. pp. 1069-1095

………………………..

The Homeopathy Series:

  1. Homeopathy and Evidence-Based Medicine: Back to the Future – Part I
  2. Homeopathy and Evidence-Based Medicine: Back to the Future – Part II
  3. Homeopathy and Evidence-Based Medicine: Back to the Future–Part III
  4. Homeopathy and Evidence-Based Medicine: Back to the Future Part IV
  5. Homeopathy and Evidence-Based Medicine: Back to the Future Part V
  6. Harvard Medical School: Veritas for Sale (Part III)
  7. The Dull-Man Law
  8. Smallpox and Pseudomedicine

Posted in: Clinical Trials, Homeopathy, Science and Medicine

Leave a Comment (156) ↓

156 thoughts on “Homeopathy and Evidence-Based Medicine: Back to the Future Part IV

  1. pec says:

    “at least three other European labs were also unable to replicate Benveniste’s results.”

    But you carefully avoid mentioning that they have been replicated in some labs.

    And the investigating team was hardly unbiased. Randi is a passionate crusader against science that questions the status quo.

  2. Pol Lambert says:

    pec,

    Which other labs?

    Are you saying Randi had a direct influence on the failure of Benveniste’s lab to reproduce their own results in their own lab?

  3. qetzal says:

    And the investigating team was hardly unbiased. Randi is a passionate crusader against science that questions the status quo.

    So Benveniste was biased in favor of water memory, and Maddox’s team was biased against. Who should we believe?

    Benveniste et al.’s positive claims were based on a subjective, non-quantitative test method, and the experiments were poorly controlled and unblinded. Maddox et al.’s negative claims were based on well controlled, double blinded tests (using the same method). Which is more likely – that Benveniste et al.’s positive bias influenced the outcome when they knew which samples ‘should’ be positive? Or that Maddox et al.’s negative bias influenced the outcome when there was no way to know which sample was which?

    I guess if you’re like pec, you just shout “bias” and call it a draw.

  4. pec says:

    As I understood it, Benveniste had spent many years on this research. It was not just one experiment. The crusaders marched in and discovered that Benveniste had no understanding of standard methodology. Doesn’t that make you wonder at all?

    And other labs were able to replicate the result. Some did, some didn’t. I doubt that anyone has the definitive answer at this point. It’s fun to ridicule homeopathy I suppose, but the principles are not yet understood, and you have no sound basis for dismissing it.

    (And if you go back to the 18th century to find things to ridicule, why not do the same for allopathic medicine? They had some pretty amusing beliefs back then also.)

    There is no scientific reason for your certainty that water can’t hold information. If science does not yet understand something, that does not necessarily mean it cannot possibly happen.

  5. Roy Niles says:

    Water is actually a physical manifestation of cumulative life forces of all organisms that have existed since the formation of life on Mars.

    But don’t quote me on that.

  6. Pol Lambert says:

    pec,

    There may have been multiple experiments but the ball got rolling when Benveniste published one article in Nature. Could you give me some citations on the results of the other labs so I can try to track down this stuff?

    However, there is a scientific reason for the fact the water can’t hold information. You can calculate the relaxation time of bouncing water molecules and see that the time they need to go from a small perturbation back to the statistical average is many orders smaller than the time between preparation of a dilution and the drinking of that dilution. I’m not saying this is physically very rigorous but at the very least, the nul-hypothesis is that water doesn’t have memory.

  7. It turns out that Beneveniste was being scammed by one of his own technicians. The technician was cheating, not Beneveniste.

    The labs that “replicated” his results – guess what: they were performed by the same cheating lab technician who was visiting other labs to show them the protocol.

    Objective replications were all negative.

    There is no possible way within current laws of physics and chemistry for water to hold information as would be necessary for a physiological effect from a homeopathic remedy – which would include surviving ingestion, dilution in the blood, and transport to whatever end organ is that target of the effect. This makes homeopathy extremely implausible.

    No one has proposed a viable mechanism for water memory, experiments so far show no water memory. Those that claim this have not survived peer-review – their methods were worthless.

    The burden of proof is on homeopaths to either show a clear and undeniable clinical effect and/or to show a viable mechanism of action. They have done neither.

  8. qetzal says:

    It’s fun to ridicule homeopathy I suppose, but the principles are not yet understood, and you have no sound basis for dismissing it.

    You’re kidding, right?

    Everything we know about water, pharmacology, physiology, physics, chemistry, biochemistry, etc., provides an excellent basis for dismissing homeopathy. Add to that, homeopathy is generally unable to show reproducible effect in well-controlled, well-designed studies. Add to that, if homeopathy were true, we should see a lot of other effects that we don’t, in fact, see (e.g., all water should be chock full of memories of everything it ever contacted).

    You’re either a parody or a fool.

  9. pec says:

    “There is no possible way within current laws of physics and chemistry for water to hold information”

    So if something can’t happen within your current laws, it can’t happen? In other words, science has completed its mission?

    “No one has proposed a viable mechanism for water memory, experiments so far show no water memory. Those that claim this have not survived peer-review”

    Right, no one wants to sacrifice their career for a taboo subject like water memory, so they reject every paper that mentions it.

  10. PalMD says:

    “So if something can’t happen within your current laws, it can’t happen?”

    Finally, we have reached pec!

  11. Roy Niles says:

    The problem with water is that it doesn’t know when it’s being lied to.

  12. “So if something can’t happen within your current laws, it can’t happen? In other words, science has completed its mission?”

    Straw man – I never said that. I said that it creates the burden of proof for homeopaths to either postulate a viable mechanism (vague references to “energy” or “information” is not enough) and/or provide adequate evidence of efficacy. They have not met this burden – not by a long shot, not even close, after two centuries they have met total failure.

    In my opinion this is sufficient to toss homeopathy on the scrap heap of failed science, along with so many other things, many of which were more plausible than homeopathy.

    But even if you are not ready to give up on homeopathy yet (which is a dubious position) saying that it should be a widely used, government sanctioned, and publicly funded legitimate form of health care is absurd. Homeopathy should be scrapped unless and until sufficient evidence of efficacy emerges.

  13. David Gorski says:

    So if something can’t happen within your current laws, it can’t happen? In other words, science has completed its mission?

    Straw man argument.

    The real argument goes more like this: Under the currently understood laws of physics, chemistry, and biology, homeopathy cannot work. That does not mean it’s completely impossible, as our understanding of science is never complete. However, the theories and laws that say that homeopathy cannot work are about as well-established as laws and theories in the sciences can be, supported by a massive weight of mutually supporting converging evidence from a variety of disciplines. This makes homeopathy incredibly implausible from a scientific standpoint, so much so that we can safely say, in the absence of truly compelling evidence, that it doesn’t work. For us to conclude that the understanding of science that leads us to this conclusion is as massively incorrect as it would have to be for homeopathy to work, we must see evidence that is at least as compelling as all the evidence supporting the science that says homeopathy cannot work. This evidence would take the form of either (1) undeniable, striking evidence of clinical efficacy (homeopathy reliably curing incurable cancers by itself, for example) that has been replicated by many different researchers in many locations with no particular axe to grind or (2) clear and convincing scientific evidence suggesting a mechanism by which homeopathy can work that has been replicated by many different researchers in many locations with no particular axe to grind. Preferably both should be proffered. There is no such evidence supporting homeopathy. All there is are generally poorly designed trials with small effects that are almost certainly due to a combination of chance, poor trial design, and publication bias.

    If one or the other were true, then we would be justified in starting to question whether our understanding of physics, chemistry, and biology might be in error and homeopathy might be something more than prescientific magical thinking. Until one or the other (or preferably both) of the above conditions are met, there is no reason to consider homeopathy as anything more scientific than blaming disease on imbalances of the humors or on evil spirits.

  14. PalMD says:

    “So if something can’t happen within your current laws, it can’t happen? In other words, science has completed its mission?”

    One more thing: yes, it’s a straw man, but it makes an important point. If an idea is inconsistent with all known physical laws, why give it the time of day?

    It does not follow from that that “science is over”, although others have argued that. Science never ends, but calling something science does not make it so.

    For example, if I say that purple shirts cure cancer, that doesn’t make it a fruitful area of scientific inquiry, and failing to investigate it doesn’t mean that science has ended.

    And, to ad an ad hominem, pec, you need to read a few books to catch up here. I have plenty of suggestions.

  15. Roy Niles says:

    I recommend the following: Water Logic: An Elemental Logic Novel

    http://www.powells.com/biblio?PID=26490&cgi=product&isbn=9781931520232

  16. pec says:

    “saying that it should be a widely used, government sanctioned, and publicly funded legitimate form of health care is absurd. ”

    Right. Homeopathic health care should not be publicly funded until it has some scientific evidence and theory behind it. So stop trying to block the research.

    And I can’t see why you think the idea of water holding some kind of electromagnetic information is so absurd. How would that defy your established laws?

  17. DBonez says:

    pec,

    Have you ever flown a commercial jet? How about pointing out the failings of science and the scientific method regarding aeronautics? I’d say with medicine, just like aviation, science is doing its job very well. It will never be perfect, but is better than ever and constantly improving.

    Where is the homeopathic law of infinitesimals or water memory with regards to jet fuel? Would you like to be flying at 500 knots at 30,000 feet and suddenly have your jet fuel switched to homeopathic fuel diluted 10^120 times? Would your questions and criticality of science be founded then?

    That’s because when the results of science are obvious and immediate to the five senses, science is applauded and most people can comprehend the apparent mechanism i.e. jets. But when the results are blurred and not obvious because of human interpretations over time or are obscured through emotions and anecdotal observations, suddenly science is ineffective and limited in its functionality. So when the results are not immediately observable, such as with anesthesia or trauma, homeopathy and CAM is able to jump in claim fill that fuzzy chasm with misleading claims and conspiracies.

  18. DBonez says:

    Last sentence should read:
    So when the results are not immediately observable, such as with anesthesia or trauma, homeopathy and CAM is able to jump in to fill that fuzzy chasm with misleading claims and conspiracies.

  19. “Right. Homeopathic health care should not be publicly funded until it has some scientific evidence and theory behind it. So stop trying to block the research.”

    First – practitioners should stop using homeopathy. If they don’t base their practices on research, why should we spend time and money on research?

    Second – if some person or private group wants to study homeopathy, go ahead. No one is stopping them (as long as their human trials are ethical, and that can be a big if).

    But if you are applying for public funds to do medical research you have to justify why that is public research money well spent – why is it better than all the other applications for research money. A vanishingly small prior probability is a rational reason not to spend limited research dollars on a particular topic.

    Regarding water information – water is a liquid. All structures in liquid water are highly transient. Please name a specific physical or chemical mechanism by which water can retain chemical information through dilution, dissolving into a pill, ingestion, digestion, dilution in the blood and transport throughout the body to or even inside of cells.

    Also – many homeopathic “remedies” are diluted in alcohol not water, so whatever mechanism you propose would have to work for alcohol too.

  20. Roy Niles says:

    Pec said: “And I can’t see why you think the idea of water holding some kind of electromagnetic information is so absurd. How would that defy your established laws?”

    Ah, so our life energy might plausibly emanate from having water on the brain!

    Why didn’t anybody think to test for electromagnetic auras in homeopathic remedies? And also check the area around the heads of any consumers.

    And take pictures if at all possible.

    Also read more about this energy here: http://www.visionsofheaven.com/articles_docs/ARauras.html

  21. Roy Niles says:

    Great stuff about photographing auras on this site:

    http://www.buyamag.com/kirlian_camera_photography.php

    And they do come in colors.

  22. Simon says:

    Pec-

    “And I can’t see why you think the idea of water holding some kind of electromagnetic information is so absurd. How would that defy your established laws?”

    There are several reasons this would be impossible, some technical and some that only require simple logic.

    The most obvious logical one is that if water can maintain a memory of a solute during a passage through the gut then why does it not retain the qualities of everything it’s come into contact with ever? Since homeopathy states that dilution should increase potency, and that (assumedly) everything soluble will have dissolved in the earth’s total water at some point and since been dissolved massively, any glass of water should show an incredible range of physiological effects, and every homeopathic remedy would become lost under all of these side effects.

    Technical reasons would take more time to go into but here are two overviews off the top of my head (solely biochemical as that is all I am familiar with, I am not a physicist):
    1. Water uptake in the gut is through very small points of ingress, either between cells or through cell membranes, where the phospholipids are very tightly packed. Just as trying to push a matchstick sculpture through a tight rubber tube would lead to a lot of broken matches and no model ship, a collection of water molecules forming a “memory” of a large organic compound would be subject to forces likely to demolish it.

    2. To interact with a drug receptor the water molecule would have to resemble the original drug. Let us say for argument that our drug is a perfect sphere- for water to retain a memory of it it could form a shell around the sphere so that when the sphere is removed (by dilution, which would remove the shell as well- it is getting very difficult to reach my point here as there are so many technical issues on EVERY step). This shell must have a larger diameter than the original drug sphere so it cannot activate the receptor itself. It could act as a mould for other molecules to form into a sphere within, but it is hard to imagine why other molecules should do this, which other molecules are they, how do they have exactly the right charges in the same places as the original etc. If you maintain that the water molecules themselves act to activate the receptor, in the form of the original drug, then you have to come up with a mechanism by which the drug can pass the information of its structure to the water completely accurately and precisely. This is so implausible I will go as far as to say impossible (Yes, I know about crystals- they are covered by the “shell” argument).

    I am sorry these examples are so clunky but that is because the initial proposition is so weakly laid out.

  23. daedalus2u says:

    No one here is trying to block homeopathic research. People are trying to stop limited public research funds from being wasted on something that has an infinitesimally small chance of actually working. There are many things that have a higher chance of working than homeopathic stuff. Those things should be funded before homeopathic research is funded.

    If those who believe in homeopathy are unwilling to fund research in it, why should anyone else?

    There is about as much chance of homoeopathy actually working as there is of random nonsense “magic words” working. Until we actually test a certain string of sounds to see if it has magical properties, we don’t really know “for sure” if it does or if it does not have magical properties. There are many strings of sounds that have never been uttered by any human alive or dead. Do they have magical properties? Should we start testing them? Maybe one string will turn water into gasoline. That would solve the energy crisis. What fraction of the DOE research budget should be spent trying to find magic words that turn water into gasoline? How much money should be diverted from research into wind power, solar power, nuclear power, biomass power to pay for research into magic words that might turn water into gasoline?

    There is as much a priori basis for magic words turning water into gasoline as there is for homeopathy. That would be none as far as we understand reality. Our understanding of reality may be flawed, and if magic words were discovered that turned water into gasoline, I would be prepared to change my understanding of reality. But not until that is demonstrated to a degree of reliability at least equal to that of the reality it is replacing.

  24. pec says:

    “practitioners should stop using homeopathy. If they don’t base their practices on research, why should we spend time and money on research?”

    “A vanishingly small prior probability is a rational reason not to spend limited research dollars on a particular topic.”

    Catch-22?

    “Please name a specific physical or chemical mechanism by which water can retain chemical information”

    It does not seem at all plausible that water could store information chemically. More likely it would involve something like electromagnetism.

  25. Simon says:

    Pec- “Catch-22?”
    No, the simple solution is that the homeopaths use some of their ill-gotten gains to try and prove their theories themselves. When they’ve done this and it’s been verified they can march in Trafalgar Square singing 4 verses of “We Were Right, You Were Wrong, Nah nah na nah nah” and I will personally kiss them on the anus.

  26. Roy Niles says:

    Now that John Edwards has some free time, maybe someone can get him interested in organizing class action fraud litigation against homeopathic (and related) practitioners and their “medicines” for the damages caused by recommending ineffective treatment and remedies for life threatening illnesses. That might get some research funds released in a big hurry.

  27. daedalus2u says:

    Electromagnetism? Water is diamagnetic, as is alcohol. Pure water and pure alcohol are dielectrics with very small electrical conductivities. There are no charge carriers in water or alcohol, or forces to move them in order to generate a magnetic field by the well known Maxwell’s Equations.

    http://en.wikipedia.org/wiki/Maxwells_equations

    In any case, there are no known “electromagnetic” receptors in humans for any effect of “electromagnetic memory” of water to be transduced. The only known receptors are chemical receptors which interact with chemicals via the well known and well understood principles of chemistry.

    Known materials that acquire a remnant magnetic field are susceptible to having that magnetic field erased or changed by exposure to a field stronger than the initial forming field. This is a common occurrence in examining the orientation of magnetic minerals in geological samples.

    http://en.wikipedia.org/wiki/Paleomagnetism

    To prevent this from happening during transport, such samples are enclosed in magnetically shielded containers. The magnetic properties of such materials then remain as they were without being affected by transport in the Earth’s magnetic field.

    Homeopathic agents contain no magnetic materials, are not made using magnetic fields, are never stored or transported with any regard as to orientation with the Earth’s magnetic field.

    What basis is there for thinking there might be an “electromagnetic memory” in water? If there were, violent shaking would be expected to destroy it, not preserve it or amplify it.

  28. pmoran says:

    Pec, can you explain your position on homeopathy further? What is it that bothers you about a skeptical position that asserts, using extensive evidence ranging from our own personal everyday experiences of the behaviout of solutes to now quite extensive clinical research, that homoepathy works, to the extent that it “works”, as placebo?

    Do you see homeopathy as contributing to any of medicine’s major unsolved problems? Or is the issue a scientific one for you– you think we are being too dismissive of the scraps of positive evidence homeopathy can marshal? Have you had personal experiences that mold your views?

  29. pec says:

    I do not have a position on homeopathy. I am a skeptic — that is, I don’t make up my mind based on ideological affiliation. I like to see reasons and evidence.

    Homeopathy has a long history and many believers. I don’t think they are all self-deceiving idiots and frauds. Usually when millions of people believe in something there is at least a little truth in it. I don’t share the prevailing current mainstream science attitude that non-scientists are ignorant fools, or that non-mainstream science is all pseudoscience.

    Yes human beings have some talent for deception and self-deception, but it is not nearly as powerful as you seem to think. It is wrong to draw a hard line between common sense and the scientific method. The scientific method is just a formalization of the methods people have always used for acquiring knowledge. The scientific method is an ideal, and is never fully realized.

    Science has tried to separate itself from, and rise above, the superstitions held by the great majority of humans at all times and places. We do see many people believing devoutly in things that range from unlikely to ludicrous. And science was supposed to be the cure for all that.

    But what you don’t realize is that most things are unknown. Most of the things we want to know are not available to us. It is our nature to fill in the gaps, and scientists are every bit as likely to do this as non-scientists. Contemporary science is as full of mythology and conjecture as any religion.

    A real skeptic is someone who constantly reminds him or herself of how much he/she does not know. The temptation is to rush in and fill those gaps with something, anything.

    I strongly suspect that there are energies and substances that science has no knowledge of. And that is why I do not discount the experiences and testimony of millions, and why I have an open mind about energy medicine and homeopathy.

    I once bought a homeopathic allergy remedy and tried it. It had no effect and I have not tried homeopathy since. But that little experiment proved nothing, and I did not conclude that homeopathy is worthless. I think the philosophy behind it may have some validity (or maybe not), but that in no way leads to the conclusion that every make of homeopathy remedies is honest or competent.

    Having an open mind is hard work and requires more conscious thought than joining a sub-culture and swallowing its entire ideology.

  30. David Gorski says:

    Ah, as I suspected. Pec is using the “appeal to other ways of knowing” and “science doesn’t know everything” gambits.” Now that it’s clear that postmodernism is the name of his game after his reference to “joining a sub-culture and swallowing its entire ideology”…

  31. Roy Niles says:

    Pec: “Having an open mind is hard work and requires more conscious thought than joining a sub-culture and swallowing its entire ideology.”

    Don’t look now but your brains fell out some time ago.

  32. Roy Niles says:

    Postmodernism? Perhaps there was some structure to what pec has been trying to tell us after all. I for one may have been a bit unfair in my zeal to concentrate my arguments into somewhat inadequate jibing and barbing forms.

    And I did note that there was some support for pec’s surmises in a published paper about “A Methodology for the Typical Unification
    of Access Points” which could be helpful in establishing once and for all whether water can not only retain information, but do so in a form that can be retrieved based on the time and date of the entry.

    http://pdos.csail.mit.edu/scigen/rooter.pdf

  33. Psychotic_Chimp says:

    Pec appears to me to be simply playing the devil’s advocate. He can offer no valid support for his oppositions but seems to think it’s his duty to throw the out anyways.

    The devil has nothing but sympathy from me since his support is so poor.

  34. DanaUllman says:

    In due respect, this review of research on homeopathy is dated and it has omitted several important studies that are notable and that have been replicated.

    The author quoted a 1999 review of research that said there were no studies that have been replicated testing homeopathic medicines that had successful results and were methodologically sound. That fact is no longer true. The below link is to a Cochrane report on 3 large clinical trials using homeopathic Oscillococcinum in the treatment of influenza (please note that although this medicine has consistently been found to be effective in the treatment of the flu, it is not effective in its prevention…nor is it promoted as such)
    http://www.cochrane.org/reviews/en/ab001957.html

    Four university laboratory successfully replication this basic science trial:
    Belon P, Cumps J, Ennis M, Mannaioni PF, Roberfroid M, Ste-Laudy J, Wiegant FAC. Histamine dilutions modulate basophil activity. Inflamm Res 2004; 53:181-8. (this is that famous study that the BBC said that they “repeated,” though over a year after the study was conducted, Ennis was finally shown the protocol that was used, and she was shocked at its extremely flawed design that destined it to failure. See HERE [http://www.homeopathic.com/articles/view,55]. You can see a copy of the protocol yourself that was developed by a “medical technologist” who has no history of publishing research[http://www.homeopathic.com/articles/view,130].

    In addition to having five independent investigators replicate an interesting experiment using homeopathic doses of Thyroxin on tadpoles that showed shown that it slows down morphogenesis into frogs, this new study shows that exposing the homeopathic Thyroxin to old-fashion microwave ovens or cells phones obliterated this biological effect, while airport Xrays had no influence on the medicine. HERE: [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WXX-4RJXWNR-3&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=a2dec25eb712443248bd93689561a2c6] (the journal, “Homeopathy”, January 2008.

    Three independent systematic reviews of placebo-controlled trials on homeopathy reported that its effects seem to be more than placebo, and one review found its effects consistent with placebo. There is also evidence from randomized, controlled trials that homeopathy may be effective for the treatment of influenza, allergies, postoperative ileus, and childhood diarrhea. Evidence suggests that homeopathy is ineffective for migraine, delayed-onset muscle soreness, and influenza prevention.
    http://www.annals.org/cgi/content/full/138/5/393 (Annals in Internal Medicine)

    For those of you who want to explore some interest theoretical issues about “the memory of water” or what scientists today prefer to call “the structure of water,” see:
    Chaplin, Martin, Water Structure and Behavior, http://www.sbu.ac.uk/water/

    Domenico Mastrangelo, Hormesis, epitaxy, the structure of liquid water, and the science of homeopathy. Med Sci Monit. 2006 Dec 18;13 (1):SR1-8 17179919. http://lib.bioinfo.pl/pmid:17179919

    This is an excellent reference to the logic of the homeopathic principle of similars and of its very small doses:
    Eskinazi D. Homeopathy re-revisited: is homeopathy compatible with biomedical observations? Arch Intern Med 1999 Sep 27;159:1981-7.

    One of my own articles may be of interest: Why Homeopathy Makes Sense and Works: http://www.homeopathic.com/articles/view,98

    These references are enough to keep you busy. I have more.

  35. Roy Niles says:

    And pec, I’m done posting on this blog because for one thing, your persistent lack of understanding is irritating, and you waste everybody’s time.
    You’re apparently flattered by the attention and fear that any substantive agreement will end the dialog, as you otherwise have nothing positive to offer.

    You are the type who has no trust in the probable and are instead fascinated by the improbable. I actually think I know why and can lay out the strategy behind this type of behavior – as in my business I deal with this contrary behavior all the time.

    Not revealing your identity, and misstating your occupation, etc., are not signs of confidence in any of your ever backtracking positions here. It has become a waste of time to read anything written not to win or learn, but only to avoid losing.

  36. fls says:

    If anyone is interested, Mr. Ullman’s references have been thoroughly discussed at the JREF forums in these threads:

    http://forums.randi.org/showthread.php?t=99751
    http://forums.randi.org/showthread.php?t=99630
    http://forums.randi.org/showthread.php?t=82393

    Linda

  37. David Gorski says:

    And pec, I’m done posting on this blog because for one thing, your persistent lack of understanding is irritating, and you waste everybody’s time.

    You’re apparently flattered by the attention and fear that any substantive agreement will end the dialog, as you otherwise have nothing positive to offer.

    I hope you won’t stop commenting totally. If pec’s continually being a Ferrous Cranus irritates you, just ignore him, as many around here appear to do.

  38. DanaUllman says:

    I am a tad baffled how or why Roy Niles would become so “irritated” by the remarks by Pec. If Pec’s mild questions about the “possiblity” of biological activity and/or clinical efficacy is so infuriating to you, it seems that either you have very thin skin or that you’ve never before been questioned about the possiblity that you may not be right about your limited knowledge of homeopathy.

    I can only assume that I must be irritating you too. THAT is not my intent. Really.

    I hope that the many links to which I referred to you above is helpful. By the way, here’s a better link to that fascinating trial (replicated 5 times) on the use of homeopathic thyroxin and its effects on the morphogenesis of tadpoles into frogs:
    http://www.homeopati.dk/data/images/Artikel%20Homeopathic%20Thyroxin%20results%20on%20frogs.pdf

    I simply ask that our discussion be respectful and research-based.

  39. Psychotic_Chimp says:

    DanaUllman, to understand why Roy and many others are generally fed up with pec it’s necessary to look at older blog entries and the comments made by pec.

  40. Harriet Hall says:

    James Randi offers a million dollars to anyone who can distinguish a dilute homeopathic remedy from plain water. If homeopathy is real, this shouldn’t be too difficult. Randi would allow the homeopaths to devise their own test and there would be independent observers agreed on by both parties. The BBC televised one challenge that failed. I suspect others are unwilling to try because they realize on some level that they can’t succeed. Winning Randi’s million dollars would vindicate homeopathy, provide funds for further research, and get the attention of the entire world. What do you guys have to lose? Step up to the plate!

  41. Wallace Sampson says:

    One of the major themes in this comments section to Dr. Atwood’s summaries is reference to reports confirming homeopthy claims. Most of these have already been disproved or discredited up to 20 years ago. Thus we have to re-plod ground. Memories are short and it is human to forget. It is dishonest to remember and to ignore.

    Thus, starting with the reference to the Annals of int. Medicine review of homeopathy of 2002, above:
    Start with the fact that it was one of twelve reviews of sectarian medicine systems – all but one or two written by prominent advocates and practitioners of the methods. The series was a source of criticism and of distress to many medical scientists, being not only biased in author selection (Eisenberg and Kaptcuk were the organizers,) but was also source of questioning about the competence of Annals’ editorial staff. This has extended to the Americal College of Physicians leadership competence and biases.
    The homeopathy review was written by 2 homeopaths (Jonas and Linde) and an acupuncturist (Kaptchuk.) Their conclusions of homeopathic efficacy included: influenza, allergies, and childhood diarrhea.
    I had opporunity to review the oscillococcinum/flu references as witness in a legal proceeding. The major papers made the conclusions on basis of selected end points and analysis of selected data. The Cochrane group concluded the possibility of efficacy based on 2-3 evaluable papers, and a shortening of illness by 0.28 (6 hrs) of a day? Perhaps their abstract is incorrect, or else…
    London and I reviewed the first childhood diarrhea paper and showed a multiplicity of disqualifying defects. The second report showed a degree of differences between verum and placebo groups similar to the differeces in weight or age. It was a negative study. The systematic review by the same authors claiming efficacy, was based on only those 2 studies plus a pilot study, merely combined those inadequate and erroneous data and obtained a barely significant difference – garbage in.
    The allergy claim was based on 2 or 3 studies by Reilly showing data t hat were at least inconsistent and at worst, contradictory. The differences were clinically not significant, anyway, even if true. I have not studied the post op ileus claim so will not coment on it.
    So claims for three of the conditions mentioned for efficacy in the Jonas review were clearly wrong.
    I reviewed the Benveniste study as requested by a national magazine and submitted a letter to Nature showing that the study 1) proved that giving homeopathic dilutions would have had the same effect as the original physiological stimulus – thus inducung more asthma or hay fever, not relieving it, and 2) from the dilution effect curves, a homeopath could not know whether each successive dose would cause improvement or would worsen the disease, thus could not even know which dilution to choose. Nature’s editor agreed with the conclusions but had declared the issue “closed” and rejected the letter. He later re-opened to more articles, but I had already discussed it in two separate articles in Skeptical Inquirer. The Annals authors must have known of them, but did not refer to them.

    We have called attention before to the inadequate reviews and bias in journal aricle publication, but offenses persist. I was even asked to prsent this problem to an annual session of the Society of Science Editors a few years ago, and many of the editors were aware of the problem.
    Yet the band plays on…

  42. pmoran says:

    I think we should be seeing if there is anything we can learn from pec because, frankly, our attempts to reason people out of beliefs that we think are silly aren’t spectacularly successful, are they? Is it all their all fault or partly ours?

    He says some things that I can wholly agree with e.g. “It is wrong to draw a hard line between common sense and the scientific method. The scientific method is just a formalization of the methods people have always used for acquiring knowledge. The scientific method is an ideal, and is never fully realized.”

    His answer to my last post reveals something extra about his position He thinks that when millions of people and doctors think that homeopathy can help them it is unwise to be blithely dimissing them as “idiots or frauds”. He is absolutely right about that; what I once called the “therapeutic illusion” has been shown to deceive a lot of intelligent and eminent doctors, and the available evidence is consistent with people being symptomatically helped to small to moderate effect sizes by placebo-related influences. If that is left out of considerations then we are not being frathful to what the science actually shows.

    Yet pec sees this as offering support for homeopathy’s collection of otherwise undemonstrable processes and principles. He doesn’t need to have people going over the usual scientific arguments against homeopathic theory, he needs to see the copious evidence showing how poor we really are at assessing the intrinsic activity of treatments. He needs to be shown how doctors are even worse than patients, superimposing another layer of misperceptions and biases on material that is already grossly distorted by the many factors Steve has described. Inactive treatments can seem to be 80% succesful to doctors – more than enough to produce millions of believers. (references on request)

    Perhaps there is also a perfectiionistic character trait showing through. Pec seems to want absolute proof before being prepared to commit himself to any position on homoeopathy, yet he is mistrustful of the scientific methods and reasoning that might get us closer to that. Because they are not perfect he is scarcely prepared to rely on them at all. Such suspicions make it almost impossible for him to thoroughly weigh up ALL the available evidence, apportion *appropriate weight* to each component, and arrive at a “very probable truth” — to make the provisional judgements that are the true basis of what we call scientific knowledge and especially of medicine.

    Pec, I am not claiming that the above analysis is perfectly accurate. I am trying, probably somewhat clumsily, to encourage better communication.

  43. Roy Niles says:

    If someone is pretending to be a tad baffled by my stance, I’ll try one more time to point out the obvious – that innocence on their part should no longer be the presumption.

    Homeopathy is a lot like a cult religion organized with fraudulent intent to enrich its founders. Given enough time, they gull enough people into believing they have saved them from whatever seemed to ail them at the time, and start to acquire a veneer of respectability. The organization grows over time in ways that result in what evolutionary biologists like David Sloan Wilson are now referring to as a superorganism.

    The personnel that make up this type of organism change, but its purpose remains essentially the same. If it was fashioned as a mechanism to commit fraud under the guise of altruistic purpose, and has evolved a way to do so successfully (somewhat like the strategies of successful psychopaths) that even some in its present population may not recognize the actual purposes of the structure and the hollowness of its construction, not to mention its products.

    Yet those who populate that structure for the most part will have to face at some point the possibility that they are complicit in a fraudulent enterprise. They will sense that just by the nature of the indoctrination most receive, and the lack of respect from other professions which necessitated such indoctrination. And by the lies they will have to tell that don’t convincingly justify the ends.

    Some will leave as a result but many will find ways to live with any doubts and be in fact captivated by the accomplishments of an operation that has found a way to violate the public trust by successfully building a trustworthy facade. Hey, if the tobacco companies have made fraud respectable, why shouldn’t they be entitled to the same?

    What they will (and have) become is a super confidence-game organism. People like pec, whether a shill for the operation or not, will be among its victims. But people who are an integral part of the organism will in the end be just as responsible for the fraud that is being perpetrated than those who set that fraud in motion. Because they are now in control of the consequences.

    These people include those actively promoting clearly bogus products through internet ads and sales, and writing promotional propaganda, and writing comments on reputable blogs that are a clear attempt to shore up a crumbling facade of respectability.

    They are predatory parasites of the worst variety – the closest thing we have to blood suckers. Pleas for understanding and sympathy play right into their game. They are aggressively demonstrating they no longer deserve the benefit of any doubts as to their organism’s true nature.

    Enough already.

  44. fls says:

    “I hope that the many links to which I referred to you above is helpful. By the way, here’s a better link to that fascinating trial (replicated 5 times) on the use of homeopathic thyroxin and its effects on the morphogenesis of tadpoles into frogs:
    http://www.homeopati.dk/data/images/Artikel%20Homeopathic%20Thyroxin%20results%20on%20frogs.pdf

    I simply ask that our discussion be respectful and research-based.”

    It is a fascinating trial in that it did not show a significant difference between treated and untreated groups, yet it is presented as though one can conclude from it that homeopathic treatments have an effect.

    I was surprised at how often this is the case when it comes to the research in ‘support’ of homeopathy.

    Linda

  45. pmoran wrote: “His answer to my last post reveals something extra about his position He thinks that when millions of people and doctors think that homeopathy can help them it is unwise to be blithely dimissing them as “idiots or frauds”. He is absolutely right about that; what I once called the “therapeutic illusion” has been shown to deceive a lot of intelligent and eminent doctors, and the available evidence is consistent with people being symptomatically helped to small to moderate effect sizes by placebo-related influences. If that is left out of considerations then we are not being frathful to what the science actually shows.”

    This point is actually a straw man. First, the rejection of homeopathy is not “blithely dismissive.” It is based upon a careful analysis of scientific plausibility, clinical studies, and history. All of this leads to a very carefully considered and highly reliable conclusion that the chance of any efficacy from homeopathy is vanishingly small.

    Second – I don’t think anyone has suggested that those convinced of homeopathy’s efficacy from use are idiots or frauds. We have, in fact written about the placebo effect and how easy it is for intelligent and well-meaning people to be deceived.

    However, we will accuse homeopathy promoters who make idiotic arguments, misrepresent the data, do bad science, or rely upon logical fallacies to promote pseudoscience as medicine of being “idiots or frauds.” Even still, this is not done in an a-priori dismissive fashion, but only perhaps as commentary following exhaustive demonstration of their idiocy or dishonesty.

  46. David Gorski says:

    Second – I don’t think anyone has suggested that those convinced of homeopathy’s efficacy from use are idiots or frauds. We have, in fact written about the placebo effect and how easy it is for intelligent and well-meaning people to be deceived.

    Indeed. I would point out to readers that in the first month of this blog’s existence, already you and I have both written about this very issue, and in both cases we pointed out that people who believe anecdotes and testimonials are often intelligent and well-educated. The problem is that even intelligent and well-educated people are often unaware of just how easy it is for us humans to fool ourselves or be fooled. Indeed, the scientific method became necessary not because scientists are any better than anyone else on this score. It’s because we realize that we aren’t and that we need a method to minimize the possibility of self-deception and bias. That’s all the scientific method is, really, when you boil it down: A method to minimize the effect of our human foibles when it comes to observation and pattern seeking.

  47. Roy Niles says:

    I wrote: “But people who are an integral part of the organism will in the end be just as responsible for the fraud that is being perpetrated than those who set that fraud in motion. Because they are now in control of the consequences.”

    Sorry for the lack of proof-reading. I meant to say they are just as responsible AS those who set the fraud in motion.

    The blood-sucker bit was not a typo.

  48. DanaUllman says:

    Friends,
    I’m a little confused by Linda’s comment about the tadpole experiments because they clearly show a 5-10% reduced speed of morphogenesis of tadpoles into frogs. Perhaps you are confusing the parts of the study in which the homeopathic Thyroxin was exposed to extremely close proximity to old-style microwave ovens and cell phones which were found to obliterate the effect of the homeopathic medicine.
    I thought that these results might intrigue the scientifically-minded people here. I still think it should.
    As for Wallace Sampson’s responses, he acknowledged that the three large clinical trials testing Oscillococcinum had a clinical effect beyond a placebo. Great. Although this effect was relatively small, please note that Tamilfu had less than a 24-hour benefit (and its side effects are considerably greater than Oscillococcinum’s.
    Speaking of Oscillo, did you know that it is made from the heart and liver of ducks. Homeopaths have been hip to avian sources of the flu since 1928 (not bad).
    Ultimately, good scientifically-minded people assert that the doses that homeopaths use is simply too small to have ANY effect. And yet, there are hundreds of clinical trials and even more basic science trials (and numerous meta-analyses) that show some type of effect beyond a placebo.
    Even Sampson (above) acknowledges that several meta-analyses have shown a benefit from homeopathy.
    If I were to brag that I could fly, I would only have to show you ONCE that this was true…as long as I really proved it. Please don’t then say that because I cannot fly as high as or as fast as a jet that my verified skill isn’t real.

  49. DanaUllman says:

    Roy…
    You’re right: I do not know about the previous dialogues you’ve had with Pec, though the above discussion certainly doesn’t seem to warrant your hyper-irritability…but I’m only looking at a small slice of this dialogue.
    That said, I’m curious if you have as much venom for the Big Pharma companies as you have for homeopathic ones. When you consider than the sales of homeopathic medicines in the US may be around $300-$450 million (in retail dollars) and when you consider that most Big Pharma companies spend this amount of money on advertising of a single drug, I cannot help but sense that your anger may be a tad displaced.
    Few companies are making much money from the sales of homeopathic medicines (relatively speaking), and most MDs who add homeopathy to their practice usually make less money than their allopathic colleagues due to the labor-intensive nature of good homeopathic practice.
    Once again, there may be some displaced anger here…but perhaps Big Pharma will have a drug for this new disease, right after it sucks money for drugs for “restless leg syndrome.”

  50. Roy Niles says:

    I can prove that some flyers are blood-suckers.

  51. Roy Niles says:

    And it’s not anger you pretend to sense from me but a cold antipathy that one hopes you will become more and more familiar with.

  52. Roy Niles says:

    Hey, if “big pharma”companies have made fraud respectable, why shouldn’t your bunch be entitled to the same?

  53. fls says:

    “I’m a little confused by Linda’s comment about the tadpole experiments because they clearly show a 5-10% reduced speed of morphogenesis of tadpoles into frogs.”

    A difference that was present at the start of the study and simply shows that the researchers didn’t do a very good job of sorting the tadpoles into groups at equal stages of morphogenesis.

    Linda

  54. We should have a healthy skepticism toward all claims, including those made by corporations in their own financial interests. The pharmaceutical industry, as part of the health care industry, should be held to a very high standard, and they don’t always meet that standard. That is not an excuse for marketing fraudulent and pseudoscientific remedies.

    I will also note that restless leg syndrome is a perfectly legitimate neurological disorder. I dealt with the myth that it is a fabrication of Big Pharma here: http://www.theness.com/neurologicablog/index.php?p=183

    It is very telling that Dana Ullman is skeptical of RLS but not homeopathy.

  55. Harriet Hall says:

    DanaUllman,

    Have you read Bausell’s “Snake Oil Science”? He is a research methodologist and he explains why it is not only possible but highly probable that positive studies and even positive meta-analyses will be found for treatments that are in reality no better than placebo. It’s lame to suggest we read another frog study, because the scientific enterprise depends on the community of scientists to evaluate all the evidence in context. Homeopaths have been failing to convince the scientific community for nearly two centuries now. Science quickly reaches a consensus when the evidence is convincing. It took only 10 years from the first suggestion of Helicobacter’s role in ulcers to antibiotics becoming standard treatment.

    I noticed in your comments you try to divert the discussion with “tu quoque” arguments and economic issues. The question is whether homeopathy works. I think Jay Shelton got it right in his book: he says homeopathy works, but its effects have nothing to do with the content of the remedies. In other words, all the existing data is compatible with the hypothesis that homeopathy is just an elaborate placebo system.

    Are you really seriously saying that homeopaths were hip to avian sources of the flu? I don’t see how that could make sense either in the homeopathic paradigm or the scientific paradigm. As I said in an article in Skeptic magazine, homeopaths start with duck liver and dliute the duck out of it until all that is left is the quack.

    As I suggested before, the best thing you could possibly do to convince skeptics that homeopathy is real is to take the James Randi Million Dollar Challenge and simply show that you can distinguish a dilute homeopathic remedy from plain water in a double-blind test with independent observers.

    If a scientist could win the million dollars for distinguishing penicillin from placebo, he would do it in a heartbeat, and his only problem would be deciding which of several different reliable methods to use to tell them apart in the lab or in clinical settings. If homeopathy is real, it seems very odd to me that no homeopath has stepped up to the plate (except for the failed BBC trial).

    By the way, ever since I read Shelton’s book, I’ve been wondering how homeopaths manage to collect “eclipsed moonlight,” one of the remedies listed in their texts. Perhaps you can enlighten us.

  56. HCN says:

    Mr. Ullman is over here posting the same studies and arguments that were stripped apart on JREF (see links in fls’s postings) because his efforts to do the same at Wikipedia have placed all articles pertaining to homeopathy under probation:
    http://en.wikipedia.org/wiki/User_talk:Danaullman

    I see he tried to compare water memory to the writing of information onto a CD-rom, using the exact same phrasing:
    http://forums.randi.org/showthread.php?p=2675330&highlight=water+cd-rom#post2675330

  57. DanaUllman says:

    Linda,
    You’ve mis-read the tadpole study. I have gotten confirmation from the author that all tadpole groups started off at the same size and same stage of morphogenesis.
    Helen, and yes, I can say with authority that Oscillococcinum has been used since the 1920s. It is easy to make fun of Oscillococcinum because it is made from the heart and liver of a duck, but it is equally easy to make fun of Premarin or penicillin or nitroglycerin or many others. I just hope that you are not so cynical about the scientific methodology of double-blind placebo controlled and randomized studies. As one editorial in the Lancet noted after publishing one of the four trials conducted by David Reilly and co-investigators at the University of Glasgow), either homeopathy works or double-blind placebo controlled trials don’t (you decide).
    So, yes, homeopaths have been aware of the avian connection to the flu, and more important, they have integrated this information within our therapeutics.

    Please note that Linda and HCN may think that they ripped apart various studies testing homeopathic medicines, but I insist otherwise. Actually, I debased against 20-40 different people concurrently and often successfully. It is a matter of record.

    As for James Randi, I have little respect for him. He knowingly engaged in the “tests” conducted by the BBC and ABC’s 20/20, and even though he was informed that these studies were not “repeats” of the famous Ennis trials and were seriously and significantly flawed, he has remained silent about these discrepancies. Junk science created “junk journalism,” and anyone with a serious interest in scientific research should not stand for this type of “tv science.” For details about these junk science experiments, go to:
    http://www.homeopathic.com/articles/view,58
    http://www.homeopathic.com/articles/view,55

    For further detail, including access to see the actual protocol that was designed by Wayne Turnbull (the “medical technologist” without graduate training who designed and conducted the trial), go to: http://www.homeopathic.com/articles/by_category.jsp?id=37

  58. Roy Niles says:

    What are the odds that pec was or is really Ullman?

  59. David Gorski says:

    Actually, I debased against 20-40 different people concurrently and often successfully. It is a matter of record.

    “Debased”? A Freudian slip, perhaps? ;-)

  60. fls says:

    “Linda,
    You’ve mis-read the tadpole study. I have gotten confirmation from the author that all tadpole groups started off at the same size and same stage of morphogenesis.”

    I assume that you are referring to the graph at the beginning of the article, which represents pooled data from other studies. I should have stated that it shows that the researchers didn’t do a very good job of sorting the tadpoles into groups at equal rates of morphogenesis at the start (blame my rush to get to a Superbowl party :)). However, other than that initial difference, the speed at which the groups are undergoing morphogenesis is the same. Again, it does not support your conclusion that the speeds were different, nor does a single observation at the start of the study serve to tell you what the speed was at the start of the study (you need at least two observations for a rate).

    As for the results of the study in the link, even the researchers admit that the experimental and control groups were not significantly different. They did find a few differences when they pooled some of the results, but if an appropriate correction is made for multiple comparisons, those differences are not statistically significant.

    “Please note that Linda and HCN may think that they ripped apart various studies testing homeopathic medicines, but I insist otherwise. Actually, I debased against 20-40 different people concurrently and often successfully. It is a matter of record.”

    Simply ignoring the multiple criticisms levied against the various studies is not usually considered successful debate.

    Linda

  61. Pol Lambert says:

    Dana,

    If I’ve read the tadpole article correctly, it was not a double-blind study.
    Moreover, your critisism on the BBC trials where Randi participated doesn’t stem from the most neutral of sources (homeopathic.com). It would not be unfair to regard that critisism as suspect.
    Finally, my problem with the tadpole experiment is that they do not give error bars (for example on the magnetic field measurements) This signals to me shoddy research.

  62. HCN says:

    Mr. Ullman, you are predictable and prone to repeating the same arguments over and over again. Repeating a flawed study or a flawed statement does not make it true.

    Your behavior has been noted, see:
    http://www.quackometer.net/blog/2007/12/homeopathic-revolution-by-dana-ullman.html

    The conversation even continues after this exchange:
    HCN said…
    Don’t worry, he will come back spouting the same drivel about Gully being a homeopath, that the Chest paper showed homeopathy worked, that Oscillococcinum works for flu and that water is like a CD-ROM.

    Then we will go and send the links where he was told multiple times that he was wrong.

    ACH wrote about his mode of operation here:
    http://badscience.net/forum/viewtopic.php?t=3902&sid=21f71e6dc700d656412ccd9fbba4a1fd

    Thursday, 20 December, 2007
    Le Canard Noir said…
    And, as if by magic, the bookwriter appeared – back on my Darwin post, “spouting the same drivel about Gully being a homeopath”.

    Wow. are you psychic, hcn?

    Friday, 21 December, 2007
    HCN said…
    Sadly, I am not psychic.

    Brave Sir Dullman is just too predictable.

  63. Harriet Hall says:

    DanaUllman

    Helen? Are you referring to me? My name is Harriet. If that is an example of your attention to details, perhaps that helps explain your overenthusiasm for experiments the rest of the scientific community considers unconvincing.

    If you “have little respect for James Randi” why would that interfere with your taking his million dollars? You sound like Sylvia Browne. She agreed to take his test, then decided she wouldn’t because he was a Godless person. That was just a silly excuse. The truth was she knew her supposed abilities couldn’t pass an objective scientific test.

    No matter what you think of Randi, the million dollars is there for the taking, and if homeopathy is as real as penicillin, there is no conceivable reason you should not be able to devise a simple test and pass it under independent observation. In fact, if you don’t respect him, isn’t that all the more reason to prove him wrong and take his money?

    The fact that Oscillococcinum has been used since the 1920′s doesn’t indicate to me that homeopaths were aware of the avian connection to the flu. It just indicates to me that homeopathic provings produced reports of symptoms similar to those of flu. Hahnemann’s response to chinchona didn’t mean the bark was connected to the cause of malaria. Perhaps you could explain. By analogy, how is “eclipsed moonlight” connected to whatever it is supposed to treat? And please, please, explain to us how one collects eclipsed moonlight and gets it into a remedy.

  64. Mojo says:

    Pec wrote (01 Feb 2008 at 5:31 pm), “I once bought a homeopathic allergy remedy and tried it. It had no effect and I have not tried homeopathy since.”

    Perhaps you should have given it a bit longer. After all, only a few days earlier you had never tried a homoeopathy:

    Pec wrote (21 Jan 2008 at 4:32 pm), “By the way, I have never tried homeopathy and have no opinion on whether or not it works.”

    Or perhaps you just need to work harder at keeping your story straight.

  65. _Arthur says:

    Kimball or Gorsky,

    Will there be a post detailing the dilution/succussion technique, with emphasis on the succussions ?

    I’m curious how the optimal succussion technique was established, and if all homeopathic water makers follow that recipe precisely.

  66. pec says:

    I didn’t realize I was on trial here. I never tried homeopathy in the sense of actually visiting a homeopathic physician. I just bought something in a drug store that said it was homeopathic.

  67. Harriet Hall says:

    Arthur,
    According to Jay Shelton’s book “Homeopathy – How It Really Works” Hahnemann didn’t initially use succussion to prepare his remedies. He observed that when he visited patients in their homes they seemed to do better than when the patients came to his office. He convinced himself that it was due to the jostling in his saddlebags as he rode his horse to the patient’s house. A more parsimonious explanation might be that patients get a bigger dose of placebo when you make them feel special by coming to their bedside in their own home.

    Hahnemann’s instructions were: “Give the tightly corded vial 100 strong succussions with the hand against a hard but elastic body (such as a leather-bound book).” Today some manufacturers use an automated procedure. And I have read the confessions of employees who decided to save themselves some work and not bother with the prescribed manufacturing procedures and found that no one ever complained. Of course they didn’t. No one can tell homeopathic remedies from plain water anyway.

  68. Roy Niles says:

    “I once bought a homeopathic allergy remedy and tried it. It had no effect and I have not tried homeopathy since.”

    Doesn’t this boil down to saying, I tried homeopathy once and have not tried it again.

    To say before that “I have never tried homeopathy” does seem to involve a clear contradiction.

    Unless of course pec/Ullman bought the remedy some time between 1-21 and 2-1 of 2008.

    And if pec is not really Ullman.

  69. “Either homeopathy works or controlled trials don’t!”

    Actually, it was David Reilly himself who made that statement, as quoted at the very beginning of this series of blogs. And the answer is: controlled trials don’t. Not, at least, when the prior probability of the hypothesis being tested is so low that the inevitable lack of rigor in such trials cannot overcome the inevitable biases, unconscious or otherwise, also common to them. Even bench experiments, which ought to be far more rigorous than clinical trials, will yield erroneous results from time to time (think: “cold fusion”), but in those cases it is a simpler and quicker matter for the scientific sorting process (replication or not by several independent labs) to clarify the issue—assuming that the question warrants it.

    In the case of tadpoles and non-existent thyroxine, the project is so silly and inconsequential that reputable scientists shouldn’t bother to repeat it. As reported, the results can’t be taken seriously: there are ample opportunities for “breaking the blind”; it implies findings that aren’t there (the suggestive graphic depictions in Figure 2 are belied by the paucity of asterisks denoting “statistical significance”); it pools data to claim “statistical significance” for effects that were not significant in individual experiments—resulting in a high probability of false findings—and more. The depiction in Figure 1 of control and experimental tadpoles demonstrating a significant difference in maturity at time “1,” as noted by fls, shows that the two groups were not comparable at the outset and therefore explains the rest of the figure as having merely followed from that difference: a “type I” error. Mr. Ullman claims to know that “all tadpole groups started off at the…same stage of morphogenesis” (time “0” perhaps?), but if so why weren’t they reported as such?

    The data regarding exposure of non-existent thyroxine to a mobile phone at distances of either “0” or 25 cm suggest “crackpot” to anyone with a passing knowledge of physics. That the two distances purportedly resulted in the same effect is unlikely, because the inverse square rule dictates that the density of radiofrequency radiation at 25 cm is far less than that at “0” cm, and could easily be near the household background level of “a few tens of µW/m^2.” I don’t know what the level is at 25cm for a given cell phone (they vary, by the way), but it was incumbent upon the authors to recognize it as an important variable, to measure it, and to report it, just as they did for “0” cm. But wait: their “0” cm levels—300-339 nW/m^2 [sic]—are much lower than background levels, assuming that “n” stands for “nano-.” A typo, maybe, but it doesn’t inspire confidence.

    Regarding oscillococcinum and other “positive” homeopathy studies, there are cranks everywhere. The world abounds with fantastic medical claims cloaked in the trappings of “evidence” (here and here and here and ad nauseam). Because the calling card of “science” is so influential, more and more cranks now carry a fake one. It doesn’t help that ignorance and politics have usurped scientific policy and funds to a significant extent both here and abroad. The listing of Homeopathy and many other advocacy journals by the National Library of Medicine, at least partly a result of the bullying of NLM Director Donald Lindberg by Rep. Dan Burton (“organized quackery’s best friend in Congress”), adds to the confusion.

    The evidence against homeopathy consists of the overwhelming, accumulated evidence against each of its most sacred tenets—“similars,” “infinitesimals,” and “provings”—weighed against recent clinical and laboratory attempts to demonstrate their validity, which have now been more than adequately discussed here. Those recent attempts have produced, at best, weak and equivocal results—as summarized by Mr. Ullman—which is precisely what would be expected if the claims are false. The results are more likely to be equivocal than merely “negative,” for reasons that have been previously discussed in several places on this blog and that I will discuss in more detail this week.

    More points:

    Popularity and tradition do not constitute evidence. Consider the following religions: Hinduism, Judaism, Christianity, Islam. There isn’t a reader out there who believes that more than one of them is true; to paraphrase Bertrand Russell, since they disagree more than one can’t be true. Yet each has many more adherents and has existed for far longer than homeopathy. We can each think of more examples of popular delusions that have stood the test of time: racism, sexism, voodoo, anti-semiticism, killing in the name of god, etc.

    Dr. Sampson did not “acknowledge that the three large clinical trials testing Oscillococcinum had a clinical effect beyond a placebo.”

    Whatever the failings or successes of modern (not “allopathic”) medicine may be, they are irrelevant to the case against homeopathy.

    Yes, we on this blog do take the pharmaceutical companies to task, and in a far more sophisticated way than do quacks. We are worried about bias in clinical studies wherever it may arise. Not that Big Pharma is relevant to the case against homeopathy, of course.

  70. pmoran says:

    Steve said “Second – I don’t think anyone has suggested that those convinced of homeopathy’s efficacy from use are idiots or frauds. We have, in fact written about the placebo effect and how easy it is for intelligent and well-meaning people to be deceived. ”

    The placebo effect indicates a disconnection between the intrinsic activity of a medical treatment and its ability to serve as medicine and even, apparently, genuinely ease symptoms. We skeptics rarely take this fully into account when, fueled by righteous scientific fervor, we lambast (and we DO lambast and ridicule, even here) quite sincere alternative practitioners and the believers in weird medicines.

    Have we ever dispassionately considered the full implications of placebo influences? How can we argue that a treatment method is wholly useless, or imply that every time we open our mouths, if we are also going to invoke placebo benefits to explain it’s popularity with users and practitioners?

    Another question: what is our objective as medical skeptics in relation to treatments like homeopathy? Before we can answer that we need to have considered whether placebo medicines do still have a function in a society that is only a century or so away from a medicine utterly dominated by placebo medicines and old superstitions. It is still very early on in the evolution of medical science. Science has not yet come close to providing entirely safe and 100% effective solutions for all mankind’s ills and discomforts, while expectations of medicine have never been higher. The public also doesn’t much care what it uses as medicine — people will try anything, without necessarily investing prior belief, or even thinking that they are making a scientific statement. Only skeptics get all twisted up over that.

    As an example, might there be sound reasons why literally every pharmacy in Europe displays “Homeopathie” (or language equivalents) in large letters outside? Would skeptics prefer those using such remedies for their minor and self-limiting complaints to use NSAIDs or antibiotics or antidepressants instead, remedies that often also perform no more than placebo, but with greater risks, despite having the cachet of proper science? I wouldn’t.

    Is the public in general so ignorant of the limitations of alternative medicines that they they are in constant danger? We pretend so, but I think if we are honest it is really the corruption of our precious science that is anathema to us. The evidence says not — AM is mostly used in a complementary capacity or for lifestyle concerns that the mainstream has little interest in. . Yes there are occasional unnecessary sad outcomes, but there is no assurance that eliminating a lot of “quack” medicine will lead users to turn to more effective conventional methods. My experience with cancer quackery suggests many won’t.

    And another question — why, when we know that we are so obviously right about certain matters do we find it difficult to convince persons who are not already themselves skeptical? Most people can’t be bothered reading long, technical explanations. Even if they did they don’t have a broad enough grounding in the relevant sciences to know whether it is the full truth They can, however, readily understand pec’s argument that if so many people seem to be deriving benefit from a treatment there might just be something to it. When we allow the possibility of placebo benefits from alternative methods we are tacitly admitting that this line of evidence has some force. How can we at the same time seem to want to consign such treatments to oblivion, which is how we are perceived. Do we have anything obviously better to offer in each instance where someone claims to have derived benefits from homeopathy? Very often these methods are used when conventional methods have already failed — do we really wish to deny users any small benefits they may derive from them?

    A more relaxed stance, one of amused tolerance for what is mostly a harmless foible may enable us to look less like rampaging zealots and enable us to better focus upon our most important message — that these methods won’t cure any serious physical illness.

    There is no question in my mind that we are right about the mechanistic aspects of the science, I think we are dignifying homeopathy with more scientific credibility than it deserves by even bothering to discuss that aspect further. We may not, however, have fully considered the practical medical implications of what we know about it and other alternative methods.

    I know it is odd that a skeptic should speak in such terms. But I am sure these questions will arise eventually. It is, after all, the final fall-back position for alternative methods.

  71. DanaUllman says:

    I have no idea who Pec is, though I love the fact that you folks think that we are the same person (after all, there can’t be two people who might believe in homeopathy, can there?).

    Here’s another study for you to consider…

    A study published in the highly respected journal, Rheumatology (published by the British Society for Rheumatology) found statistically significant results from homeopathic treatment. Researchers from the University of Arizona in collaboration with homeopaths conducted a double-blind, randomized, placebo-controlled trial with 62 fibromyalgia patients (Bell, Lewis, Brooks, et al., 2004). Patients were randomized to receive an oral daily dose of an individually chosen homeopathic medicine in LM potency (or a placebo). Patients were evaluated at baseline, 2 months, and 4 months.

    The study found that 50% of patients given a homeopathic medicine experienced a 25% or greater improvement in tender point pain on examination, as compared to only 15% of those who were given a placebo experienced a similar degree of improvement (P=0.008). After 4 months, the homeopathic patients also rated the “helpfulness of the treatment” significantly greater than did those who were given a placebo (P=0.004). It is therefore not surprising that the study also showed that the average number of remedies recommended by the homeopaths was substantially higher to those in the placebo group as compared with the real treatment group.

    One special additional feature of this trial was that the first dose of medicine was given by olfaction (by smell) and that both groups were monitored with EEG. The researchers found that there was a significant and identifiable difference in the EEG readings in patients who were given the real homeopathic medicine as compared to those given the placebo (Bell, Lewis, Schwartz, et al, 2004a). Each patient had three laboratory sessions, including at baseline, at 3 months, and at 6 months after initial treatment. The researchers found that the active treatment group experienced significant increases in the EEG relative alpha magnitude, while patients given a placebo experienced a decrease in this measurement (P=0.003).

    The combined evidence of clinical improvement along with objective physiological response from the homeopathic medicine makes the results of this trial of additional significance.

    Bell, IR, Lewis, DA, Brooks, DJ, Schwartz, GE, Leis, SE, Walsh, BT, and Baldwin, DM, Improved Cilnical Status in Fibromyalgia Patients Treated with Individualized Homeopathic Remedies Versus Placebo, Rheumatology, January 20, 2004:1111-7.

    Bell IR, Lewis Ii DA, Lewis SE, Schwartz GE, Brooks AJ, Scott A, Baldwin CM.
    EEG Alpha Sensitization in Individualized Homeopathic Treatment of Fibromyalgia.
    Int J Neurosci. 2004;114(9):1195-1220.

    As for Harriett, just because you don’t know how to spell Cinchona doesn’t mean anything, anymore than my accidental reference to you as “Helen” is similarly meaningless. I previously hoped that our conversation could be respectful, and I still have this hope.

    And yes, HCN, I will continue to discuss and educate others about the many high quality basic science and clinical trials because I believe in the scientific method (though I also believe in its limitations). Heck, if anyone thinks that double-blind placebo controlled trials are the only means to obtaining valid information, then, I guess we’ll have to do without surgery. How many DBPC trials are there here?

  72. Harriet Hall says:

    DanaUllman,
    My name is spelled Harriet with one t. I have never understood why everyone seems to want to double the t.

    I found multiple instances of “chinchona” as well as “cinchona” in various Internet dictionaries and other sources. It appears that you are correct that the cinchona spelling is preferred, but if I spelled it wrong I am in good company. Perhaps my favoring the “chinchona” spelling was because I am fluent in Spanish, and the name was originally derived from the Countess of Chinchon. I found one reference that said Linnaeus spelled it wrong when he named the genus, removing the H so it would look more like Latin: http://books.google.com/books?id=OHkKAAAAIAAJ&pg=RA1-PA793&lpg=RA1-PA793&dq=chinchona+etymology&source=web&ots=sy33TunCIk&sig=RHwJh2PFL0ePkwJ5ujxMixUumC0#PRA1-PA794,M1

    If you want our conversation to be respectful, please do me the common courtesy of responding to my previous comments by (1) explaining why you think homeopathy’s use of Oscillococcinum indicated an awareness of the link between birds and flu, (2) telling us why you won’t take Randi’s million dollars, and (3) explaining how to collect eclipsed moonlight.

  73. Roy Niles says:

    Ullman: “I have no idea who Pec is, though I love the fact that you folks think that we are the same person (after all, there can’t be two people who might believe in homeopathy, can there?).”

    Perhaps you have multiple personalities you don’t know about, because you may not know pec but pec knows you.

    There are clear similarities in the use of arcane words and phrases between his writings and yours. Pec writes in a less consistent manner, but this is one of the “red flag” mistakes people make when trying to disguise their writing. Because he has failed to disguise the significant correlation between sentence and paragraph structures, syntax, level of perceivable education and sophistication, etc., etc.

    Now you might say that if so, it’s he who is copying you, rather than you who are channeling him. Unfortunately there are more reasons to believe that anything you say will be a lie than to presume otherwise.

    And its odd that he disappears from sight, as it were, just before you show up. And that you both rise to which ever bait is most appropriate for that personality, and right on cue.

    And the best way to accomplish the shill’s work is sometimes just to do it yourself. And it has already been established that you have done that elsewhere.

    But why am I trying to convince you of something at least one of your personalities already knows. (That’s one of my telltale idiosynchracies – ending with a rhetorical question – another is to always keep something in reserve.)

  74. HCN says:

    Dana was never one to get a person’s username correct. Here I am using a simple 3 character set of initials, and he often gets it wrong (it is really quite simple, just figure out how to take hydrogen, carbon and nitrogen and make them deadly!).

    Dana, I will believe you will use the scientific method when you actually understand how it is used. I would sincerely suggest your read (with comprehension) the book Dr. Hall reviewed here called “Snake Oil Science” by Dr. Bausell:
    http://www.amazon.com/Snake-Oil-Science-Complementary-Alternative/dp/0195313682/

    Your often touted “Chest” paper is a classic in a case of bad science. First for its too small sample, and the fact that the “placebo” group was so different (sicker) than the group that got the homeopathic remedy. As it stands, you complain that the drubbing the paper received at Respectful Insolence was inadequate, you have NEVER ever given a proper response or rebuttal to that or any other critique of that piss poor article. Perhaps you should attempt that soon before attempting to use it as “proof” homeopathy has any validity. Here it is in case your forgot, it has been six months and we are still waiting for your learned critique:
    http://scienceblogs.com/insolence/2007/07/homeopathy_in_thecringeicu_1.php

    (and for Ed’s sake… please learn how a computer stores information onto a CD-rom! Good grief, you are as bad as Rustom Roy who does not understand what the energy differences are between in the carbon matrices in graphite versus diamond!)

    I will ignore your rantings until you answer this one simple question that only requires basic high school level chemistry and algebra:

    How many sodium and chlorine ions are in one cubic centimeter of Nat Mur 30C ?

    (or NaCl molecules in the case of one cubic centimeter of Nat Mur 30C in a lactose tablet)

    By the way, the answer is a NUMBER! Not an analogy some mystical water memory to CD-rom technology that you obviously do not understand.

    Good grief, man… look at the business side of a CD after it has been burned (that is how I can tell if the CDs I use to back up financial data is full!). Can’t you see where the dye has been modified? Do that with a bottle of homeopathic remedy within the next couple of years and you can win a million dollars!

  75. David Gorski says:

    Now you might say that if so, it’s he who is copying you, rather than you who are channeling him. Unfortunately there are more reasons to believe that anything you say will be a lie than to presume otherwise.

    And its odd that he disappears from sight, as it were, just before you show up. And that you both rise to which ever bait is most appropriate for that personality, and right on cue.

    Pec and Dana Ullman do not post from the same IP address, and their IP addresses resolve to parts of the country that are quite far apart. They do not appear to be the same person as far as I can tell.

  76. fls says:

    Mr. Ullman,

    As you well know, the fibromyalgia study that you cite did not show significant differences between the untreated and treated goups on any of the nine measures. A ‘significant’ difference in one variable (taking multiple comparisons into consideration) is found only after the data are ‘adjusted’ – a suspicious decision considering that the pilot study on which this study was based made no mention of the need for adjustment, nor is any a priori justification given for this adjustment, and the outcome variable in which this significant difference is found is not the same outcome variable used in the pilot study.

    Linda

  77. daedalus2u says:

    pmoran, there is a (somewhat) unified hypothesis of how the placebo effect works. I discuss it on my blog.

    http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html

    I see the placebo effect as the normal allocation of metabolic resources an organism does to optimize survival vs reproduction. Healing has a lower priority than survival does, and under times of “stress”, healing is put off until that time of stress is over and resources can be diverted to healing instead of being maintained in a ready state to deal with what ever “stressor” is causing the stress. I use the example of “running from a bear” a lot, where to be caught is certain death. Any injury short of death is infinitely better than being caught, so physiology configures itself to survive by diverting all available resources to running from the bear. Spending resources on healing while running from a bear will reduce the likelihood of survival so organisms don’t heal as well while under stress because they have evolved to allocate metabolic resources in pretty optimal ways.

    The placebo effect is mediated by physiology (as are all traits and reactions that organisms exhibit). I think a large part of that physiology is mediated through the use of NO as a signaling molecule, where low NO signals between cells that the organism is in a state of stress and stress responses must be invoked.

    I see virtually all of the stress responses as adaptive in the short term and maladaptive in the long term. Those maladaptive stress responses are not “disorders” per se, they are normal physiology acting normally and regulating physiology normally, but in a bad operating point. The would be adaptive for a few minutes or even a few hours while running from a bear, they are not adaptive when not in preparation for something like “running from a bear”, they are not adaptive when continued for weeks, months or even years.

    I see the placebo effect as a neurogenic mechanism for switching physiology from a “fight or flight” state where healing is put off to the “rest and relaxation” state where healing is turned back on. One of the most recognized placebos is the treatment by a mother known as “kiss it and make it better”. It instructs the child that the stress is over and the child’s physiology can return to the default state of low stress.

    If this hypothesis is correct, then once the placebo effect is maximally evoked, there is nothing more that any placebo can do. I think the placebo effect can be invoked pharmacologically (to some extent) (by raising NO levels), but that is complicated (because physiology is complicated) and idiosyncratic. NO physiology is under intense regulation and is very difficult to perturb.

  78. Roy Niles says:

    David Gorski said: “Pec and Dana Ullman do not post from the same IP address, and their IP addresses resolve to parts of the country that are quite far apart. They do not appear to be the same person as far as I can tell.”
    There are any ways to spoof an IP address, unfortunately. Child’s play for the Ullmans of the world.

  79. David Gorski says:

    I doubt it; Dana hasn’t exactly revealed himself to be exceedingly computer-savvy in his other online ramblings.

  80. Roy Niles says:

    If you are in the fraud business, you are constantly searching for ways to effectively conceal that fact. All you need for posting (as opposed to e-mailing, etc.) is an anonymizer service, such as one of the following:

    http://web2proxy.net/
    http://www.anonymizer.com/hide_your_ip.html
    http://www.securenetics.com/?gaps
    http://www.megaproxy.com/freesurf/

    Your blog may have been set up to defeats such tactics, but from what I can tell, it hasn’t.

  81. pmoran wrote:

    what is our objective as medical skeptics in relation to treatments like homeopathy?…

    Is the public in general so ignorant of the limitations of alternative medicines that they they are in constant danger? We pretend so, but I think if we are honest it is really the corruption of our precious science that is anathema to us…

    A more relaxed stance, one of amused tolerance for what is mostly a harmless foible may enable us to look less like rampaging zealots…

    I think we are dignifying homeopathy with more scientific credibility than it deserves…”

    I agree with you that we oughtn’t dignify homeopathy with more scientific credibility than it deserves. It isn’t we, however, who have done the dignifying. It’s the apologists for homeopathy and other highly implausible claims, in academic medicine and government. They are the real problem, because it is their efforts that have led to the current charade of homeopathy being portrayed to an unwitting public as merely “unproven,” or “more than placebo,” or “promising,” or whatever—all in the name of “respectful” or “balanced” discussion. We have merely reacted to such silly and dangerous statements.

    They are silly for all the reasons that are being discussed here and will continue to be discussed. They are dangerous in ways that go beyond the folksy notion of people taking sugar pills with a wink and a prayer and feeling a little better. Homeopaths like Dana Ullman are dangerous because they tell people things that aren’t true about disease and medicine: witness his statments about asthma in children that I quoted here. After the anthrax scare in the fall of 2001, Utne Reader Online reported that Ullman recommended “homeopathic nosodes” for the prevention of anthrax. Here is Ullman on AIDS, quoted from a 2005 article available on his own website:

    The medical community, however, has focused its AIDS resources on creating antiviral medications, which despite great hope and expectation have not achieved the results anticipated. In fact, the leading AIDS drug, AZT, has been found to prolong the lives of people with AIDS by only seven or eight months,1 but due to its side effects, the quality of life during this time is not high…

    What is yet to be understood by the medical community is that they need to direct more attention and research to ways to augment immune response, rather than ways to inhibit viral replication. By strengthening a person’s own defenses, the body is best enabled to defend itself…

    It therefore seems prudent to avoid the factors that inhibit immune response and to utilize those that augment it. The factors that inhibit immune response include an unhealthy lifestyle (i.e., smoking, poor diet, significant stress, sedentary habits) and the use of therapeutic and recreational drugs, while those that augment immune response tend to be a healthy lifestyle and utilizing natural therapeutics, including homeopathic medicines…

    A study performed by a government research center in India with 129 asymptomatic HIV+ patients (120 male and 9 female) showed that during homeopathic treatment over a period of 3 to 16 months, 11 patients changed from HIV+ to HIV-.5 No conventional drugs of any type were prescribed to these patients…

    A San Francisco Bay Area homeopath, Lawrence Badgley, MD, reported on a six month study of 36 patients with AIDS or HIV whom he treated with homeopathic and other natural medicines. He observed a 13% increase in T4 helper cells and an average weight gain of two pounds.8 AIDS tends to have increasingly degenerating effects on the body, and improvement in the immune profile and weight gain seem to be rarely experienced under conventional medical treatment…

    Because of the seriousness of this disease, the treatment of people with HIV or AIDS requires professional health care, even when their ailments are seemingly minor. Ideally, they should receive treatment from a homeopath who is an M.D. or a D.O., but otherwise the best care is one that integrates homeopathic treatment with appropriate medical diagnosis and, in emergency situations, with appropriate medical treatment…

    In Summary

    The history of homeopathy’s successes in treating infectious disease epidemics, the research that suggests the immunomodulatory effects of homeopathic medicines, and the clinical research on HIV+ and AIDS patients that indicates beneficial response to homeopathic medicines should command attention by physicians, scientists, and public health officials. Despite this body of work, it is both surprising and depressing that homeopathic medicine has been consistently ignored as a viable part of a comprehensive program in treating HIV+ and AIDS patients.

    This sort of drivel is the norm for Ullman’s articles. Yet he and his books are recommended in numerous contexts that can only betray their managers as either naive or scoundrels: the Dana-Farber Cancer Institute in Boston, Columbia University College of Physicians and Surgeons, and many more.

    More later.

  82. Until a couple of years ago Dana Ullman was listed as a member of the advisory board of Integrative Medicine: the Worldwide Authority on Integrated Care, a position he shared with four representatives of the Harvard Medical School “CAM” project along with representatives of the medical schools of Johns Hopkins, George Washington University, SUNY Stony Brook, and the Universities of Arizona, Colorado, Hawaii, Maryland, and Minnesota. On his website he offers more examples of his influence in the medical academy:

    In addition to writing and publishing, Dana Ullman co-taught a ten-week course on homeopathy at the University of California at San Francisco School of Medicine from 1993 to 1995 and again in 1998, a course which averaged 120 students. He also has served as a member of advisory boards of alternative medicine institutes at Columbia University, and he was asked to develop and coordinate the curriculum in homeopathy to the physicians who are in the University of Arizona’s Program in Integrative Medicine (founded by Andrew Weil, MD).

    That might explain why he is so enthusiastic about the fibromyalgia study of Bell et al, from the U of Arizona Program in Integrative Medicine. Dr. Bell, a homeopath, is Director of Research. One of her co-authors, Gary Schwartz, is best known for his 2002 book, The Afterlife Experiments, in which he claims to have proved that mediums, including John Edward, can communicate with the dead. His experiments were flawed in the most elementary of ways, but that didn’t dissuade the NCCAM from granting him funds in 2004 to run the “Center for Frontier Medicine in Biofield Science.” According to the NCCAM, “Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the human body.”

    But back to Mr. Ullman. At least some of the medical students and residents (!) that he has taught at Arizona and elsewhere must have thought that they were expected to accept assertions such as these:

    It is time that parents and physicians seek safe, natural and effective alternatives to conventional, potentially harmful drugs. Homeopathic medicine is one such alternative…

    Many parents consider homeopathy a godsend to their children as well as to themselves. Homeopathic medicines can be quick and effective for treating infant teething or colic, turning cranky babies into giggling cherubs. They can reduce the pain and discomfort of a child’s earache, which sharply decreases the need for antibiotics or ear tubes. They can strengthen the child’s own natural defenses so that he can fight off that cold or flu that every other kid in school seems to be getting…

    The short-term effects of most drugs on infants and children are often unknown, and the long-term effects are not simply unknown but can be frightening. A 1990 study by the U.S. Government’s General Accounting Office reviewed the 198 new drugs which were approved by the F.D.A. between 1976 and 1985. The study discovered that more than half of these drugs caused serious reactions that had gone undetected until several years after widespread use. The report also showed that the drugs reviewed by the F.D.A. for use by children were twice as likely to lead to serious reactions as those approved for use by adults. Some of the most severe reactions included heart failure, anaphylactic shock, convulsions, kidney and liver failure, severe blood disorders, birth defects, blindness, and even death. The seriousness of these side effects is enough to send chills up any parent’s spine; hopefully, parents and physicians will soon understand the importance of using conventional drugs more conservatively…

    Additional risks arise when a physician prescribes more than one drug at a time. Surveys have shown that over 20% of all visits to a doctor by children under 15 years of age include a prescription for two or more drugs per visit. Many types of drugs, which may be relatively safe when given alone, can become dangerous when prescribed along with another drug. The long-term effect of giving certain drugs to infants, especially two or more drugs at a time, remains unknown. One day in the future we might consider frequent prescription of such drugs on infants and children to be a form of medical child abuse…

    It is little wonder that in a 2000 survey of homeopaths who treat children in MA, only 8 of 23 said that they “actively recommend immunizations” and only 5 of the 10 who were not physicians said that “if presented with a 2-week-old neonate with a temperature of 38.6°C (101.5°F)” they would refer the baby immediately to a physician. It is odd that the authors neglected to ask the physician-homeopaths the same question, because my anecdotal experience suggests that they may be no more likely to do the right thing (rush the child to an emergency room) than are non-physician homeopaths.

    In the UK (where the Prince of Wales and the rest of the royal family famously sing the praises of homeopaths) and elsewhere, homeopathy is also discouraging parents from having their children immunized.

    So, to get back to pmoran’s statement about our being more worried about the corruption of our precious science and perhaps considering a more relaxed stance: this is essentially the stance I take with some other practices that overlap with woo, such as yoga and massage (although they still should not get public money for frivolous “research”), and I would feel the same way about homeopathy if it were similarly benign, but it isn’t. It claims, in the NCCAM’s unctuous terminology, to be a “whole medical system.” That positions it well for mischief-making, and its recent, presumptuous sidling out of the shadows could not have happened without the invitations of demagogues (Burton), mediocre MDs (Jonas), wealthy magical thinkers funding woo (Osher, Fetzer, Bravewell), duplicitous or cowardly administrators in medical schools and government, and naive or cowardly editors, reviewers, and plain-old MDs.

  83. _Arthur says:

    Thank you Harriet for explaining to me how Hannemann came by the concept of “succussions”, the deep observations that led to this discovery, and the battery of tests he performed.

    I notice that Hanneman’s initial saddlebags succussions were post-dilution…

  84. DanaUllman says:

    Friends,
    Yes, the integrative medicine movement IS significant. Virtually every leading medical school in the US has courses in it, and in England there are a couple dozen or so degree courses in homeopathy alone in established universities.

    My assessment is that homeopathy is being attacked because it is achieving greater and greater integration within mainstream society, and THAT is scary to some people.

    My intention is not to scare anyone. My intention is to promote the Hippocratic tradition of “First, do no harm.” Safer methods of healing should be considered first before bringing out the big guns. That said, bless the big guns when you need them.

    Harriet (got it right!), For “fast” relief, “slow” down a tad. I answered your question about Randi upstairs where I wrote: As for James Randi, I have little respect for him. He knowingly engaged in the “tests” conducted by the BBC and ABC’s 20/20, and even though he was informed that these studies were not “repeats” of the famous Ennis trials and were seriously and significantly flawed, he has remained silent about these discrepancies. Junk science created “junk journalism,” and anyone with a serious interest in scientific research should not stand for this type of “tv science.” For details about these junk science experiments, go to:
    http://www.homeopathic.com/articles/view,58
    http://www.homeopathic.com/articles/view,55

    As for the use of Oscillococcinum, it is either from knowledge of the connection between avian sources of flu viruses or impressive psychic abilities of homeopaths in the 1920s. The third possibility is that they did provings on this medicine, where they gave the 30th or 200th potency of a medicine on a daily basis to healthy subject until symptoms (in this case, of the flu) were established. But heck, if provings are true, then, the homeopathic doses are active after all. So, which is it? Hmmmm. What fun.

    As for eclipsed moonlight, who cares and why is this truly notable? (No, I don’t care for whatever answer you insist upon giving)

    HCN thinks that the randomized DBPC study conducted at the University of Vienna Hospital and published in CHEST was “piss-poor,” but even one of the big-mouth skeptics didn’t question its statistical analysis or its results in his published letter. He primarily questioned the decision to simply try homeopathy at all, despite the “substantial significance” in various measures (tracheal secretions, extubation rates, length of hospital stay). Not bad for a medicine that is safe and that can be used in conjunction with other medical measures.

    Linda…I assert that you’re misreading the article and you’re ignoring (again) the EEG readings that were different between treatment and control groups. But then again, you claim to be smarter than the editorial boards of RHEUMATOLOGY and CHEST and any other journal that happens to publish DBPC studies that just happen to evaluate homeopathic care.

    Finally, I invite you all to consider reading my newest book, “The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy.” You can see the Table of Contents, a sample chapter on “Literary Greats,” and some quotes of support from various distinguished physicians and professors at: http://www.HomeopathicRevolution.com

    I know that some of the Randi-aholics will now complain that Dana is hawking his book again. Hey, I do like to educate others, especially since writing short responses in these blogs just ain’t enough for the academician in me.

  85. David Gorski says:

    Regarding Dana’s book, Le Canard Noir has a good analysis of the dubiousness of some of his claims in it, particularly his claims regarding Charles Darwin and homeopathy.

  86. DanaUllman says:

    Ok…if you want to bring up Darwin, please take a serious look at this evidence. Enjoy this article with direct links to his letters.

    http://www.homeopathic.com/articles/view,128

    To me, the body of evidence on homeopathy resides in the basic science research, clinical studies, outcome studies, the historical evidence derived from data comparing results of homeopathic and allopathic treatment of various infectious disease epidemics, AND in select cases of respected individuals.

    No one case is proof, but this story of Darwin is simply fascinating. Enjoy it.

  87. Harriet Hall says:

    The reason Ullman gives for not wanting to take Randi’s challenge (he doesn’t respect Randi) is just as reasonable as Sylvia Browne’s reason (Randi is Godless).

    Gee, I don’t know. If I thought someone was disreputable I would just want that much more to take their money away from them and make a fool of them. And if I had something that I believed was as real as penicillin, I think I could easily devise a test to demonstrate that.

    I have really REALLY wanted to learn how eclipsed moonlight was collected ever since I read about it on a list of homeopathic remedies. Since Ullman is unwilling to enlighten us, perhaps someone else can.

    By the way, I think there is a simple answer to why famous people choose homeopathy. It’s called human nature. Fame does not imply any particular skills in critical thinking or applying the scientific method, and experts in one field are often gullible in another.

  88. fls says:

    “Linda…I assert that you’re misreading the article and you’re ignoring (again) the EEG readings that were different between treatment and control groups.”

    The results for the EEG readings were also only different after ‘adjustment’ (and various other subgroup/non-intention-to-treat analyses), and were not significantly different once you take multiple comparisons into account.

    “But then again, you claim to be smarter than the editorial boards of RHEUMATOLOGY and CHEST and any other journal that happens to publish DBPC studies that just happen to evaluate homeopathic care.”

    All one can conclude from the publication of an article is that the editors thought it may be of interest to some of the readers. I’m hardly claiming to know better than the editors what is of interest to their readers. The purpose of publication is to provide the reader with the information necessary to evaluate the research, not to evaluate the research for the reader.

    Linda

  89. fls says:

    “To me, the body of evidence on homeopathy resides in the basic science research, clinical studies, outcome studies, the historical evidence derived from data comparing results of homeopathic and allopathic treatment of various infectious disease epidemics, AND in select cases of respected individuals.”

    Exactly. And it seems the point of this series of articles is to examine just what is contained in that body of evidence.

    Linda

  90. “To me, the body of evidence on homeopathy resides in the basic science research, clinical studies, outcome studies, the historical evidence derived from data comparing results of homeopathic and allopathic treatment of various infectious disease epidemics, AND in select cases of respected individuals.”

    Well, not entirely. If by “select cases of respected individuals” the writer means that we should accept the opinions of such individuals without examining their arguments, then he is wrong.

    “Data comparing results of homeopathic and allopathic treatment of various infectious disease epidemics” is a canard that homeopaths love to cite, but is baseless. It refers to claims by 19th century homeopaths, including Hahnemann, of lower death rates in epidemics of cholera and other infectious diseases. The “data,” such as they were, are unfalsifiable. Even if they were accurate, it would be unsurprising if patients with cholera in 1830, treated with nothing by homeopaths, did better than other patients treated with bloodletting and various poisons by the “regular” physicians of the day. On the other hand, the soon-to-be-discovered cause and mode of transmission of the disease were among the countless, definitive refutations of one of Hahnemann’s claims: “to regard those diseases that are not surgical as a peculiar distinct thing residing in the human frame is an absurdity which has rendered allopathy so pernicious.” Recall that another series of discoveries about an infectious disease, those that elucidated the cause and mode of transmission of malaria and the molecular basis for its effective treatment by quinine (the active ingredient in cinchona bark), is the definitive refutation of homeopathy’s core claim, similia similibus curantur.

    Finally, in the case of homeopathy the evidence from basic science research overwhelms that from clinical studies, for all the reasons that have been and will continue to be developed here.

  91. DanaUllman says:

    There are many references to the evidence of the significant successes of homeopathy during the 19th century epidemics. A book called THE LOGIC OF FIGURES compared the morbidity and mortality rates in homeopathic and allopathic hospitals, and the death rates in the allopathic hospitals were typically 2X to 8X (!) higher by percentage. This data was obtained from dozens of public hospitals and was a matter of public record.

    What is also interesting about this book is that it compares the morbidity and mortality rates in jails and “insane asylums,” and because these institutions sometimes had medical superintendents who were homeopathic physicians, this book again shows a 2X to 8X (!) difference in mortality rates.

    However, perhaps you think that a criminal mastermind could commit a crime, psychically determine that he would go to a jail with a homeopathic MD, and then get a “mild” case of cholera, typhoid, or yellow fever, thereby skewing the evidence in favor of homeopathy.

    By the way, my new book has reference to seven Popes who either gave high honors to homeopathic doctors or who sought homeopathic care. Several 19th century popes gave high honors to homeopathic MDs who successfully treated large numbers of people during cholera epidemics. Skeptics love to make fun to monarchs who advocate for homeopathy. Are you now going to make fun of the Vatican?

  92. David Gorski says:

    Oh, come on, Dana. This is just plain silly. Claiming “success” based on 19th century anecdotes? That won’t fly at all.

    There’s a reason why homeopathy seemed better than “allopathy” for a significant chunk of the 19th century, and that’s because “conventional” medicine of the time was not really science-based either. The difference is that the “conventional” medicine of the time had as part of its armamentarium purgings with toxic metals like cadmium and arsenic, bleedings, etc., nasty therapies all that likely did more harm than good. Homeopathy, on the other hand, was nothing more than a placebo and consisted of nothing more than water. Given the nastiness of some of the remedies in vogue at the time, it was quite possible that doing nothing (homeopathy) could produce better results than the therapies of the time.

    Fast forward 175 years and such is no longer the case.

  93. “Are you now going to make fun of the Vatican?”

    No, Mr. Ullman, but I’m going to make fun of you for invoking it. To claim that popes having favored homeopathy constitutes evidence is ridiculous, as everyone reading this blog must know. At the risk of belaboring the obvious, it’s another example of the logical fallacy known as “the appeal to authority,” of which your previous invocations of the monarchy and “select cases of respected individuals” are also examples.

  94. Roy Niles says:

    I can’t help but notice that when dealing with Ullman and his ilk, and pointing to the commonly known fallacies in his “positions,” many of you fail to consider several that apply to your counter-arguments, such as (to mention only two) the “psychopaths are amenable to persuasion” fallacy, and the “nobody is immune to ridicule” fallacy.

  95. HCN says:

    Actually, I’m not in much of a mood to deal with the psychopaths right now. One of our extended family members was taken to the hospital last night. Apparently she had decided to substitute homeopathy for her real medicine.

    Turns out the homeopathic remedy didn’t work.

  96. Zetetic says:

    I’ve been thinking about this homeopathic concept of increased potency with increased dilutions and I just might stop drinking ordinary tap water! I’ve seen the trace element chemical analysis of my own tap water; in fact my regional water company publishes it for public disclosure. There are accepted upper limits of chemical elements like cadmium, arsenic, boron, chromium, copper, iron, magnesium, mercury, lead, molybdenum, selenium, argon, zinc, and uranium. Most of these elements are known to be particularly nasty in terms of detrimental health efects in higher concentrations. HOWEVER, using the homeopathic model, if they are present in tap water in minute quantities, wouldn’t the health effects be exaggerated by some sort of homepathic “potenizing” action?

  97. Roy Niles says:

    No, because you would need a homeopath to talk to the water before that could happen.

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