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Homeopathy for fibromyalgia: The Huffington Post bombs again

Over the weekend, my wife and I happened to be in the pharmacy section of our local Target store. We happened to be looking for one of our favorite cold remedies, because both of us have been suffering from rather annoying colds, which have plagued both of us for the last week or two. As we perused the Cold and Flu section of the pharmacy, we were struck at how much shelf space was taken up by Airborne (which was “invented by a schoolteacher“). Nearly three years ago Airborne had to settle a case brought against it alleging false advertising to the tune of $23 million. Despite that, Airborne is still being sold, and there are even a whole bunch of knock-off products copying it. Then, as we continued to look for our favored cold remedy, we noted that, sitting right next to the extensive shelf space devoted to the various flavors and types of Airborne supplements, I saw Boiron’s homeopathic remedy for colds containing oscillococcinum, which is derived from duck liver and heart and diluted to 200C (a 10400-fold dilution).

Yes, I was a bit depressed after that. Now I know what my skeptical friends in the U.K. go through every time they walk into a Boots pharmacy.

Still, even though homeopathy is not as popular in the U.S. as it is in the U.K. and the rest of Europe, it’s obviously making some inroads if it’s being sold in Target. Steve Novella made a point at a panel at TAM8 in July to point out that it’s also being sold in Walmart, but since I rarely, if ever, shop at Walmart, I hadn’t noticed, although I had noticed various dubious concoctions being sold at Walgreens and CVS, two large pharmacy chains here in the U.S. Its relative popularity in different parts of the world aside, ever since I learned what homeopathy is and what its precepts are, I’ve always been fascinated how it can possibly be taken seriously. After all, a 200C homeopathic dilution is approximately 10377-fold more of a dilution than Avagadro’s number, meaning that it’s incredibly unlikely that such a remedy has even a single molecule of active ingredient in it. Homeopathy is water, nothing more, but that makes it the perfect form of quackery to examine when looking for reasons why people still believe it works. I’ve pointed this out, and Kimball Atwood has repeatedly pointed this out, arguing that homeopathy is the best “complementary and alternative medicine” modality to show the deficiencies in randomized clinical trials (RCTs) because, except in the case of adulterated remedies (which are all too common) or low dilution remedies less than approximately 12C (where there might actually be an incredibly tiny amount of active ingredient left), homeopathy is nothing more than water and sugar.

With these thoughts running through my head, not long after I got home, I noted an e-mail from a reader, who had forwarded me a link about homeopathy. My first thought was: Homeopathy? Not again. However, every so often I find it of value to examine the very best arguments that homeopathy apologists can put forth for their magic water and (hopefully) thereby understand a bit more how people can be persuaded that a system of “medicine” so unbelievably implausible from a basic science point of view that it is as close to being impossible as we can imagine in science can be so attractive to so many people. Also, it’s always fun to take on Dana Ullman particularly after having kept it rather serious over my last few turns here on SBM. I realize that some will criticize me for “slumming” here, but throw me a bone every once in a while. I have to have some fun every now and then. In any case, on Friday, everybody’s favorite clueless homeopathic apologist posted an article on–where else?–that wretched hive of scum and quackery, The Huffington Post, entitling it Exploring the Research on Homeopathic Treatment for Fibromyalgia. It is, as we like to say, a “target-rich” environment.

FIBROMYALGIA: A WOO MAGNET

Ullman likes to try to impress his readers with a boatload of “science-y” talk before he delves into the woo that is homeopathy, and in this case he starts out with a relatively straightforward description of what fibromyalgia is; that is, after he asserts that “the three to six million Americans who suffer with fibromyalgia will be pleased know that several studies published in leading medical journals have found outstanding results from homeopathic treatment.” Not so fast there, Dana, as we will soon see.

Basically, fibromyalgia is a somewhat amorphous syndrome, labeled a syndrome rather than a disease because we don’t have a good handle yet on the mechanisms resulting in the condition and there are no characteristic diagnostic tests that nail down the diagnosis. In brief, fibromyalgia is a condition of chronic pain and allodynia, which is a heightened painful response to a stimulus that doesn’t normally cause pain. In the case of fibromyalgia, that stimulus is pressure. Other symptoms can include tingling of the skin, muscle spasms, limb weakness, nerve pain, muscle twitching, palpitations, bowel disturbances, and sleep disturbances. Because of the plethora of symptoms that can fall under the mantle of a fibromyalgia diagnosis and the lack of scientific consensus on its cause or specific physical findings or lab abnormalities that define the disease, there are some physicians who do not accept fibromyalgia as a defined syndrome. In my own anecdotal experience, this number seems to be decreasing. Most physicians appear to accept fibromyalgia as a syndrome, even though most don’t know how to treat it.

As you might be able to guess, because fibromyalgia is a syndrome of unclear etiology with a wide variety of physical complaints, widely varying severity, and a clinical course that waxes and wanes, it is a woo magnet. Indeed, many conditions that scientists do not yet understand well and/or for which we do not yet have particularly good treatments are woo magnets. As I pointed out back in August when I described a deceptively framed study of tai chi in fibromyalgia:

These sorts of conditions are the most frustrating of conditions to deal with, particularly for patients but also for doctors. After all, no one goes into medicine to tell patients that there’s not much he can do for them; yet that’s what doctors all too often end up having no choice but to tell fibromyalgia patients. Not surprisingly, patients are neither happy nor satisfied with this, nor should they be. They’re suffering, and they want relief. Also not surprisingly they’re willing to try almost anything, including the rankest forms of quackery peddled by unscrupulous quacks.

Enter homeopathy.

“CONVENTIONAL MEDICINE DOESN’T WORK WELL, SO USE HOMEOPATHY”

Before delving into the “evidence” (such as it is) for homeopathy in fibromyalgia, Ullman catalogs the lack of efficacy of many of the pharmacological and other treatments currently used for fibromyalgia. It’s hard to disagree that the current treatments we have for fibromyalgia basically, to put it bluntly, suck, nor is it my intention to try to argue that they are better than they are. On the other hand, Dana misrepresents an editorial as a review article, and that’s not cool:

In 2010, a systematic review of the most recently used conventional drugs for fibromyalgia was published in a leading scientific journal (Clauw, 2010). Although some drugs had beneficial effects, the author acknowledged the significant limitations of these benefits and the need to utilize other treatment options. He wrote, “Because of the modest overall analgesic efficacy seen with any class of analgesic drug in any chronic pain state, we should be particularly aggressive about using more non-pharmacological therapies in treating patients with chronic pain.”

The article cited by Ullman was indeed published in Nature Reviews Rheumatology. However, the article by Daniel Clauw was in actuality describing a study published in a less prestigious journal, The Journal of Pain. What Dana cited was the commentary, not the original study. Dana also cherry-picked some quotes from Dr. Clauw’s commentary, leaving out, conveniently enough, passages like this:

The authors concluded that the three drugs were superior to placebo for all outcomes noted above, with the exceptions of duloxetine for fatigue, milnacipran for sleep disturbance, and pregabalin for depressed mood.

And:

An important lesson from these studies is that these first three approved drugs are likely to be working at the root pathogenic cause of symptom expression in fibromyalgia, rather than just ‘covering up’ a particular symptom such as pain. When individuals have a favorable response to any of these drugs, they typically improve across many symptom domains.

D’oh! How’s that for SBM “only treating the symptoms?

This is, of course, just Dana being Dana. It is also undeniably true that, advances over the last decade or so notwithstanding, we still have a long way to go in developing effective and safe treatments with few side effects for fibromyalgia patients. But does our current lack of highly effective treatments imply that we should be open to using homeopathy to treat fibromyalgia?

Not so fast, there pardner.

HOMEOPATHY AND FIBROMYALGIA

Before I move on to the discussion of the best evidence that Dana can produce for the use of homeopathy in fibromyalgia, I always find it instructive to see how a homeopath defines homeopathy, as Dana does here:

Homeopathic medicine is a 200+-year-old system of medicine that utilizes specially prepared doses of medicines made from various substances of the plant, mineral or animal kingdom. Each medicine is prescribed for its capacity to cause, if given in overdose to healthy people, symptoms similar to those that the sick person is experiencing. Because basic physiology recognizes that symptoms represent defenses of the body (and mind) in its efforts to fight infection and/or adapt to stress, a homeopathic medicine is selected for its capacity to mimic a person’s own symptoms, thereby augmenting their own defensive response.

Just as vaccines and allergy treatments are in part based on this same premise — whatever a substance causes in overdose, it will elicit an immune response when taken in small doses — homeopathic medicines are a system of helping the “wisdom of the body” defend and heal itself.

In other words, it’s the same nonsense that homeopaths have been saying for 200 years, with the added nonsense of comparing homeopathy to vaccination. Fortunately, Dr. Crislip just covered that very topic so that I don’t have to again. Perhaps most gratifying of all, Ullman admits:

In homeopathy, ALL ailments are considered “syndromes,” that is, all disease is a constellation of physical and psychological symptoms, and each patient has his or her own subtly different syndrome of a disease. The fact that people with fibromyalgia tend to have sometimes slightly or overtly differing symptoms from each other is no significant problem for homeopathic treatment. In fact, homeopathic treatment tends to be easier when patients have idiosyncratic or unusual symptoms.

Actually, I’ll buy that last sentence, but not for the reasons Ullman gives. The real reason that homeopathic treatment appears to “work” better for patients with idiosyncratic or unusual symptoms is not because homeopathy “works” for anything beyond placebo effects. Rather, it’s because such patients tend to have syndromes, conditions, or diseases that SBM currently can’t treat very well.

Conditions like fibromyalgia.

So let’s look at the evidence. Before we do, one should note that, as Kimball Atwood has pointed out time and time again, RCTs can be wrong. Indeed, in an ideal world, even a perfectly conducted RCT has a 5% chance of producing a false positive result by random chance alone. Add the factors described by John Ioannidis and the observation that, the more implausible the hypothesis being tested, the more likely there are to be false positive results in RCTs, it’s quite possible to find a clinical trial that appears to show efficacy for homeopathy. The key word is appears.

The first study (PDF here) cited by Ullman is actually somewhat interesting. It tested a 6C dilution, which is only a 1012-fold dilution, of Rhus toxicodendron. That means that, unlike most homeopathic remedies, there is actually some active substance left, which makes it possible, albeit unlikely, that whatever extract was in the homeopathic remedy might actually have a pharmacological effect. It was also a very small study (30 patients), which are exactly the sorts of studies that are most likely to have a false positive result. Moreover, it was done more than 20 years ago, which was an era when the diagnostic criteria for fibromyalgia hadn’t been firmed up. More importantly, Dana left out a huge bit of information, namely that David Colquhoun reanalyzed the data of Fisher et al and found that “this re-analysis shows that the trial of Fisher et al provides no firm evidence for the efficacy of homeopathic treatment for fibrositis.” In other words, Fisher’s trial is not compelling evidence–or even good evidence at all–for a specific effect due to homeopathy on fibromyalgia.

Next, Ullman cites four papers by Bell et al at the University of Arizona. Two of the studies were published in real journals (here and here), two in the woo journal Journal of Alternative and Complementary Medicine, whose history of publishing dubious CAM research makes it an unreliable source, at best. These studies are also fairly underwhelming, as is the trial by Relton et al published last year. For one thing, all the studies by Bell et al suffer from low numbers of patients, as usual. For another thing, Bell hasn’t published anything on fibromyalgia since 2004. Whenever someone like Dr. Bell publishes a flurry of papers in a single year and then nothing for six years after, it always raises red flags. Specifically, it makes me wonder whether Dr. Bell couldn’t replicate her own results in order to move on. Also, in the Rheumatology paper, I notice several flaws in the randomization in characteristics that are important disease endpoints, which means that the two groups aren’t the same when it comes to severity. Moreover, the treatment group and placebo group differed in the number on antihistamines; the authors claim this didn’t make a difference but present no evidence to show that this is so. Finally, in Table 2, one notes that there are no differences in any of the endpoints for the study groups until the results are “adjusted,” which always sends up red flags for me.

In the end, all Ullman has are a handful of studies, all of them relatively small, all of them with not particularly convincing results. As Edzard Ernst put it in his recent systematic review of homeopathy for the treatment of fibromyalgia, which includes a discussion of each of the RCTs cited by Ullman:

Even though our searches were thorough, we cannot be sure that all relevant RCTs were located. Negative studies tend to remain unpublished [24]. This bias could therefore have distorted the overall picture. All the four RCTs tested different homoeopathic treatments or approaches; this means that no independent replication of any of the tested approaches exists. The paucity and, at times, disappointing quality of the available RCTs render firm conclusions problematic.

In summary, the findings of the four existing RCTs all favour homoeopathy over controls. Yet none of the studies is sufficiently rigorous to provide a definitive answer. Future studies should minimise bias more effectively than did the trials available so far.

Another point is that, with the exception of the last study in which homeopaths could choose whatever remedies they wish, all of these studies used rather “weak” dilutions of the homeopathic remedy, usually on the order 6C. At such a dilution, it is quite possible that there remains a significant amount of remedy left in the homeopathic concoction, although it’s unlikely to be a pharmacologically relevant amount because it’s diluted 1012 times.

More to the point, Ernst writes:

When evaluating the evidence for or against homoeopathy one should briefly comment on the plausibility of this treatment. Homoeopathy is based on two main principles. The Law of Similars claims that, if a substance causes symptoms in healthy volunteers, it can be used to treat these symptoms effectively when they occur in patients. The law of the infinitesimal dose holds that, if a substance is serially diluted in the homoeopathic way, it becomes not weaker but stronger, even if the dilution is beyond Avogadro’s number. Currently, there is little scientific evidence to support these theoretical principles. It is therefore difficult to accept that homoeopathy is biologically plausible.

Actually, Ernst is actually understating the point. Perhaps the reviewers forced him to tone it down. As I’ve said before, homeopathy is beyond just “biologically implausible.” It’s so implausible from a basic science standpoint alone that, for homeopathy to work, huge swaths of our current understanding of physics, chemistry, and biology would have to be not just wrong, but spectacularly wrong. Huge sections of science textbooks would have to be rewritten. Of course, as a skeptic, I have to concede that it is possible that this is so. However, given the mountains of evidence that show that homeopathy can’t work, it would take mountains of evidence of similar size and rigor to make scientists start to think that homeopathy can work.

Believe it or not, I’d be perfectly willing to reconsider my skepticism of homeopathy if homepaths could produce in support of their woo 1% of the evidence that currently exists to show that homeopathy doesn’t work. Small clinical trials don’t count, particularly given their flaws and the very real possibility of publication bias, in which positive trials are far more likely to be published than negative trials. Couple that with the very nature of the condition upon which homeopathy was tested, and the results of these handful of trials are even less convincing. After all, fibromyalgia is very prone to placebo effects, regression to the mean, and confirmation bias when assessing therapies. Personally, I find the study testing tai chi on fibromyalgia to be far more convincing than any of the trials of homeopathy here. Of course, in that case, I also didn’t see any compelling evidence why tai chi would be any more effective than any other similar gentle exercise.

NASTY SKEPTICS

Apparently burned by past criticism, Ullman concludes his post with a hilarious “note to and about skeptics of homeopathy.” Dana being Dana, it’s an amusing bit of woo-ful weasel words. I find it particularly appropriate that, in light of recent posts by both Kimball and myself, Dana decides to pull out this hoary alt-med argument for homeopathy:

These fundamentalists also love to assert that “there is no plausible mechanism” for how homeopathic medicines work. Such statements display a serious ignorance of medical history because people who say this ignore the fact that it was only relatively recently did physicians understood how aspirin worked, and yet, no doctor (or patient) chose to not use this drug simply because the mechanism of action was not adequately understood.

Can you say “straw man” argument? Sure, I knew you could. Just read Kimball‘s and my posts if you don’t believe me. As Kimball so eloquently put it, “Plausibility ≠ Knowing the Mechanism.” The point is not that we have to know in detail the biological and chemical mechanisms by which any given treatment to be tested is thought to work. The point is that any proposed mechanism or mechanism that would have to be in force if a treatment worked, whether that mechanism is proposed or not, should not violate known physical laws whose foundation rests on, as Kimball put it, “far more solid ground than any number of equivocal, bias-and-error-prone clinical trials could hope to overturn.” Or, as I put it earlier in this post, implausibility is the key. If, based on well-established science, a therapy’s mechanism is so implausible that multiple well-established laws science would have to be totally wrong, then that particular therapy will require an equivalent amount of evidence in its favor to make us begin to doubt those physical laws. As Carl Sagan put it, extraordinary claims require extraordinary evidence, and homeopathy makes some doozies of extraordinary claims.

Dana pulls out some true howlers in his criticism of “skeptics” as well. For instance:

Some “deniers” are audacious enough to suggest that the “weight of evidence” evaluating homeopathy shows that these medicines do not have any benefit beyond that of a placebo. Was Thomas Edison’s discovery of electricity false because 999 experiments failed to produce electricity and only one that was successful? Is the weight of evidence that he failed?

Deniers will inevitably assert that Edison’s discovery is proven every day, and yet, homeopaths likewise will say that homeopathy is proven every day by the hundreds of millions of its users worldwide, including many of the most respected scientists, physicians, corporate leaders, political leaders, clergy and spiritual leaders, literary greats, sports superstars, and every day average people.

Thomas Edison’s work didn’t violate known physical laws, and, more importantly, the proof was undeniably in the pudding. His lights worked. Of course, to Dana homeopathy works, but I’d point out that it’s undeniable that lightbulbs work. It’s quote deniable that homeopathy does, even under the best circumstances. (Show me homeopathy curing a case or two of a deadly disease rather than conditions with waxing and waning symptoms prone to placebo effects–pancreatic cancer, for example–and I might reconsider.) It’s also amusing to see Dana, after having criticized skeptics for not knowing history, falsely attribute the discovery of electricity to Thomas Edison. Edison did some fantastic work with electricity and did invent the a practical electrical lightbulb that came to be the standard bulb used for over a century, but he didn’t discover electricity.

Ullman also can’t resist a couple of his favorite gambits. First, there’s special pleading, in essence, the claim that “you can’t study my woo in RCTs.” Then, of course, there’s the infamous pharma shill gambit, which Ullman applies with gusto:

Sadly, many people who claim to be skeptics are simply representatives of Big Pharma. In England, the leading anti-homeopathy organization, Sense about Science, is led by a former public relations expert who has a long history of representing Big Pharma companies (SourceWatch.org – see link in References).

Even if that were true, it would not change the fact that homeopathy is nothing more than sympathetic magic, combining the law of similars and the law of contagion. It’s magical prescientific thinking.

There’s a reason why homeopathy endured for nearly a hundred years as a “respectable” bit of medicine, even despite the knowledge among scientists that it was bunk dating back to the early 1800s. It’s because the “allopathic” medicine of the time frequently used remedies that were worse than useless; some were actively harmful, such as bleeding and purging with toxic metals like mercury and cadmium. In comparison, homeopathy could easily appear to do better, because, well, it’s water and therefore at least didn’t do any active harm. Many diseases would resolve spontanously for a significant fraction of patients anyway. However, as medicine became more science-based, it started to be able to offer actual treatments that did some good, and homeopathy had nothing to offer but magic.

Still, there are a lot of people who still believe in magic. Because RCTs are complicated and there are many conditions and diseases that are difficult to diagnose and treat, it will always be possible for people like Dana Ullman to use science-y-sounding language and cherry-picked studies to make it sound as though homeopathy is anything more than witchcraft (choice of words intentional).

And it will be possible for wretched hives of scum and quackery like HuffPo to give people like Ullman a platform.

Posted in: History, Homeopathy

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60 thoughts on “Homeopathy for fibromyalgia: The Huffington Post bombs again

  1. daijiyobu says:

    It’s interesting that when I search Huffington Post for “naturopathy” (see http://www.huffingtonpost.com/tag/naturopathy ), most hits are articles written by DU.

    Naturopathy, of course, is infamous for labeling homeopathy a “clinical science” on their North American boards (see http://www.nabne.org/nabne_page_23.php ).

    My favorite is the article by ND Lange — who is a big-time homeopath-ND, having written the homeopathy chapter in the Textbook of Natural Medicine (see http://www.andrewlange.com/andrewlange.com/Resources_files/3-Homeopathy.PDF ) — who labels, audaciously [!!!], an ND school of the mail-order type…

    a “quack school.”

    -r.c.

  2. Deetee says:

    One thing I noticed – this fibromyalgia trial does not specify what the placebo constituents were.

    Now the Altmed community has been quick to label all conventional placebo-controlled trials as “a fraud” (Mike Adams springs to mind), simply because many studies have failed to specifically state what was in their placebo tablets.
    http://www.naturalnews.com/030209_placebo_medical_fraud.html

    More in hope than anticipation, I look forward to the Altmed community rounding on this particular homeopathy trial, screaming “Fraud!” at the tops of their lungs.

    I won’t be holding my breath though…. awareness of hypocrisy is not one of Adam’s strong points. (In fact he doesn’t have any strong points)

  3. Just in response to the introduction that addresses cold remedies. (Which is an article in and of itself). One issue with “homeopathy” is that products that have active ingredients are also sold as homeopathic. Zicam for colds is one example*. It uses zinc well above the standard homeopathic dilutions. Of course if there is enough of an ingredient to possibly alleviate a symptom, there is also enough of it to cause a side-effect. With Zicam that appears to be the loss of smell.

    Before the FDA advisory on Zicam, I used to use it, because it did seem to ward off a bad cold when used at symptom onset. I can use very few of the conventional cold remedies because most of them contain pseudoephedrine, which seems to make me crazy (can’t sleep, irritable, anxious, etc) even at half the recommended dosage.

    Last year our schools health department sent home a notice regarding cold prevention and care. It said there is some evidence that a nasal swab or irrigation with saline solution at the onset of a cold may prevent more severe symptoms. A box of q-tips and a bottle of saline solution is much cheaper than a little box of Zicam. :)

    *http://www.sciencebasedmedicine.org/?p=530

  4. I get the sniffles a lot, so I’ve had lots of time to conclude that most OTC cold remedies are worse than what they are supposed to relieve. The best combination I have found that is better than the disease is:
    - NeilMed sinus irrigation bottle;
    - aspirin;
    - beer.

    Unfortunately, my boss doesn’t look kindly on bringing beer to the office and it’s not proper to get caught in the shared bathroom squirting saline solution through your sinuses. So aspirin-only on workdays.

  5. How would you determine outright fraud in homeopathy? How can you determine if something really was prepared as claimed since the end product is indistinguishable from water? What stops the maker of a homeopathic “remedy” from just bottling plain water and calling it a homeopathic preparation?

    It’s not really possible to have a genuine 200C dilution. That would be 1 part per 1E400 parts, and there are only about 1E80 fundamental particles in the entire observable universe.

    -Karl Withakay

  6. Mojo says:

    What stops the maker of a homeopathic “remedy” from just bottling plain water and calling it a homeopathic preparation?

    Some homoeopaths believe in “paper remedies”. These involve writing the name of the remedy on a piece of paper, putting a glass of water on the paper, and then giving the patient the water. I see no reason to think that that sticking a label on a bottle would not work just as well. ;)

  7. Scott says:

    It’s not really possible to have a genuine 200C dilution. That would be 1 part per 1E400 parts, and there are only about 1E80 fundamental particles in the entire observable universe.

    Since they discard 99% of the solution at each step, the amount of diluent required goes linearly with the number of dilutions, not exponentially. So this particular objection is inaccurate.

  8. Gregory Goldmacher says:

    Yes! I was hoping you’d take this on, and I’m delighted to see that you have. We’ve been trying to keep up the battle on HuffPo, but it’s a generally hostile audience over there.

  9. Zetetic says:

    While out shopping, I usually cruise over to the aisle where homeopathic products are sold in pharmacies, variety and grocery stores in my area for entertainment. Most of the pharmacies only have a couple of products, typically Zicam (homeopathic?) remedies and Boiron oscillococcinum. I often challenge the pharmacists about the ethics of offering these products but they usually just shrug and say the customers ask for them. “Shruggies” are everywhere! But the high end gourmet grocery stores are a cornucopia of nonsense! At most of them, the legitimate products were grossly outnumbered by the absurd! Last Saturday, I was browsing at an elite grocery store in Kirkland, WA and I engaged an employee restocking the homeopathics section. I queried her with “Were you aware that these homeopathic products have absolutely nothing in them?” She replied, “Yes, but they work on the molecular level.” I was waiting for the quantum” buzzword but it didn’t happen. Then I asked if I were to remove the label on the bottle and return it to manufacturer, would it be possible for them to identify the product. She said of course they could. I replied that there was no credible scientific evidence that homeopathic products produce anything other than a placebo effect and her response was millions of people in France and India just can’t be wrong. The mention of India brought to mind heavy metal contamination of Ayurvedic preparations but I didn’t pursue that with her. I finally gave up on this one – too well indoctrinated with the dogma, I surmised!

  10. WilliamLawrenceUtridge says:

    @Zetetic

    Rich people tend to have better medical coverage – therefore fewer real illnesses and more “worried well” complaints. Not to mention more disposable income to spend on worthless stuff. When you’re worrying about adequate calories rather than phytochemicals and megadoses of vitamins, you can only really afford to shell out for real medicine. So, more marketing to the wealthy for worthless nostroms. Plus, they tend to be better educated – just educated enough to think that “Big Pharma” is an argument, not a fallacy.

    I wonder if Dana has googled himself yet today?

    Yeah, no reason to harrass the person stocking the shelves, chances are they have no choice in the merchandise to be sold. Also, I don’t really mind fools being parted from their money as it helps keep the store so I can buy real medicine when I need to. So long as the pharmacist doesn’t try to convince the patient to substitute homeopathy for a prescription, I don’t really care that much. The nice thing is homeopathy can’t do direct harm – only indirect through its corrosive effect on critical thought.

    Sigh.

  11. @Scott
    >>>
    “Since they discard 99% of the solution at each step, the amount of diluent required goes linearly with the number of dilutions, not exponentially. So this particular objection is inaccurate.”

    Scott, thanks, but I understand the concept of serial dilution very well (read the word GENUINE in my comment). My point was not that is is not possible to perform the serial dilution process to 200C, but that such dilutions are not meaningful. The labeled dilution on such a homeopathic product is essentially a label of process and has no real meaning in regards to the actual dilution/concentration of the remedy as it implies.

    Once you get to a certain point in extreme dilutions, you have to start dealing with the probability that the next serial dilution will not alter the concentration of your sample, either because no molecules remain or because no molecules were removed.

    Once you theoretically have only one molecule left in a sample, it is possible to perform the steps for another successive dilution, but that step is pointless. It’s absurd to claim that a 200C dilution has any useful meaning or is distinguishable in any way from a 50C dilution.

    The only way a 200C dilution would have any real meaning is if the ***end product*** had 1E400 + 1 particles in it and 1 particle was “cure” and the rest water. (or any equal ratio where #of “cure particles is an integer greater than or = 1)

    This is a fundamental problem with homeopathy, that such dilutions have no scientific meaning. The only way such extreme dilutions have any meaning is if you invoke water memory, quantum woo, vitalism, etc.

  12. Gregory Goldmacher says:

    @ Mojo
    “Some homoeopaths believe in “paper remedies”. These involve writing the name of the remedy on a piece of paper, putting a glass of water on the paper, and then giving the patient the water.”

    My first thought upon reading that was “Are you serious?” Surely not! So I gogled this, and found this absolute gem in the Wikipedia entry on homeopathy:

    “Such practices [referring to paper remedies and others] have been strongly criticised by classical homeopaths as unfounded, speculative, and verging upon magic and superstition.”

    Oh, irony, how barbed thy sting.

  13. Joe says:

    Karl Withakay on 15 Nov 2010 at 10:28 am wrote “How would you determine outright fraud in homeopathy? How can you determine if something really was prepared as claimed since the end product is indistinguishable from water?

    Outright fraud can be detected when an actual drug is added to the preparation. You can also check if a 12C (24X) product is indistinguishable from water. Sometimes the homeopath gets lazy and skips several dilutions. In one case, a significant amount of arsenic was found in a prep. http://www.ncahf.org/pp/homeop.html

  14. qetzal says:

    Timely post. Over the weekend, I was dismayed to see a TV ad pimping oscillococcinum. I think it was even on one of our local network affiliates. It ended with Boiron’s name and logo splashed across the screen.

    Has anyone else seen these? Makes me suspect that Boiron is looking to increase their name-recognition (and market share) in the US.

  15. Mark Crislip says:

    How would you determine outright fraud in homeopathy?

    Er, the word homeopathic on the label?

  16. Joe, I hadn’t actually thought of that.

    I was more thinking about a manufacturer just bottling water without adding anything & going through the serial dilution process and claiming it was a homeopathic preparation, which would be fraudulent, but not dangerous. There’s really no way to detect such fraud other than close scrutiny of the manufacturing process.

  17. Zetetic says:

    With no regulation at all on the homeopathic manufacturers, how would a cunsumer EVER know if an homeopathic preparation was or wasn’t fraudulently produced?

  18. Badly Shaved Monkey says:

    @Karl

    Once you theoretically have only one molecule left in a sample, it is possible to perform the steps for another successive dilution, but that step is pointless. It’s absurd to claim that a 200C dilution has any useful meaning or is distinguishable in any way from a 50C dilution.

    My preferred description is ‘rinsing’ no diluting. The original material is simply replaced by solvent many stages prior to the end of the fatuous washing and shaking process.

  19. Badly Shaved Monkey says:

    Typo: ‘rinsing’ noT diluting

  20. Harriet Hall says:

    “I was more thinking about a manufacturer just bottling water without adding anything & going through the serial dilution process and claiming it was a homeopathic preparation, which would be fraudulent,”

    The same result can happen without fraud on the part of the manufacturer. I read an account by a former employee who said they often got tired of doing all the dilutions and succussions and just substituted tap water. And how could you ever tell the difference? The final product can’t be evaluated by any system of quality control.

  21. sfdyoung says:

    “Thomas Edison’s work didn’t violate known physical laws, and, more importantly, the proof was undeniably in the pudding.”

    I wish people would pay a bit more attention to the cliches they choose, and at least get them right. This misstatement is made almost as much as “I could care less.”

    It’s “The proof of the pudding is in the eating.”

    Okay, rant concluded. Thanks for indulging me.

  22. Anthro says:

    @micheleinmichigan

    I have the same problem with pseudoephedrine and in my case (and for my children) it’s because we have ADHD. None of us can take the stuff.

    ——–

    @ Everyone

    Why all the effort to treat a cold, which usually resolves in three or so days anyway? I rarely get them, but when I do, I simply follow the medical advice I’ve been given for 50 years. Rest, drink lots of fluids, take some aspirin if you have fever, aches, or headache. I think many people just won’t bother to get enough rest when they are ill–they keep pushing themselves until they are very ill. Oh, yeah, I also use a good cold as an excuse to have a couple of hot toddies made with good whiskey, fresh lemon, and honey. Way better than homeopathy or any OTC junk that’s overpriced and unproven. I don’t claim the hot toddy cures, but it sure makes the cold not bother me so much.

  23. DanaUllman says:

    Ooooo…I do love it when I make you folks spin and spin again, create your own straw man, and then create the spin cycle yet again.

    I love it that you critique the cross-over trial published in the BMJ by saying that it was published over 20 years ago before the “proper” diagnostics were worked out for this syndrome. The fact that this study treated sick people and found that a large number of people got better when they took the homeopathic medicine and did not get better when they took a placebo. Your crituqie suggests that we conclude that homeopathy is just helpful for sick people, not just those with fibromyalgia? Cool, thanx.

    Because this was a cross-over trial, you cannot criticize the placebo and the treatment groups as not being perfectly matched. Instead, you have the chutzpah of referencing Colquhoun’s weak critique, without providing any details! And because Colquhoun does not have any axe to grind (sure!), we should all believe precisely what he says (NOT!).

    And then, Gorski notes (properly) that THIS study used Rhus toxicodendron 6C, which still has some molecules in it, as though THIS is unusual in homeopathy (it isn’t!). As I have written at this website at least a dozen times, a large number of homeopathic medicines sold in pharmacies today are in the 6C potency.

    So, now that you all recognize that there are some molecules in some homeopathic medicines, and now that you know that there has been some research published in high-impact medical journals, are you going to feel comfortable prescribing THESE homeopathic drugs? Sure!?

    So, let me get this straight…you’re against homeopathy when they are in potencies beyond Avogadro’s number and when they are not, even though there is a large body of (non-homeopathic) research that confirms hypersensitivity of certain drugs/substances on certain biological systems…and but, heck, you’re all monkeys here, blinding yourself, not hearing, and not speaking…all combined.

    And I love it that the study in RHEUMATOLOGY utilized olfaction (smelling of the homeopathic alcohol solution) which created both clinically relevant improved symptoms AND different EEG readings…and yet, this information is conveniently missing from your critique (file this one under “whoooops”).

    Squirm and spin and spin again. I like to watch…

  24. Dr Benway says:

    Squirm and spin and spin again. I like to watch…

    creepypedobear.jpg

  25. AnthonyK says:

    Are you mad Dana Ullman?

    As I have written at this website at least a dozen times, a large number of homeopathic medicines sold in pharmacies today are in the 6C potency.

    Why would anyone in their right mind suggest a remedy as weak as that? What good, according to the sound principles of homeopathic could it possibly do?
    It’s dangerously close to the 0.01C (often only randomly succussed) of allopathic medicine – and we know how ineffective that is.
    No, when I want a cure for my self-limiting ailments I want it at least magicked down to atom-in-the solar system scale or the damn illness will just have to get better on its own.
    And you call yourself a homeopath?

  26. nitpicking says:

    Next, Ullman cites three papers by Bell et al at the University of Arizona. Two of the studies were published in real journals (here and here), two in the woo journal Journal of Alternative and Complementary Medicine, whose history of publishing dubious CAM research makes it an unreliable source, at best.

    (My emphasis.)

    If two were in real journals and two in a woo journal … is that not four papers?

  27. Doc says:

    Dana Ullman, you have to check out this “I’m a Skeptic” video.
    It pretty much says it all about “skeptics.”

    http://subversivethinking.blogspot.com/2010/11/daniel-drasin-video-im-skeptic.html

    Enjoy.

  28. Chris says:

    Doc, do you think Dana would really understand that video? Or more to the point: did you?

    (actually, I believe the blog it was on failed to understand it)

    Actually, Doc, we have asked several times for definitive proof that homeopathy has cured a non-self-limiting disease. We would change our mind if given enough evidence.

    At this point Dana has failed to provide actual evidence the homeopathy works. He excels at cherry picking. He will often cite Jennifer Jacobs’ study of homeopathy in Central America showing that homeopathy works, but fails to note her more recent work in another Central America country did not have positive results for homeopathy.

    Hey, Doc! There is a video of a naturapath, Andre Saine, claiming homeopathy works for rabies:

    He even claims that homeopathy can cure rabies with 100% success. Rabies is almost 100% fatal, even with modern treatment, so this is quite an astounding claim. An audience member helpfully suggested that we can test this claim on animals that contract rabies, since they are just put to death in any case.

    Do that test. Show us it works, and we will change our minds.

  29. JMB says:

    Was Thomas Edison’s discovery of electricity false because 999 experiments failed to produce electricity and only one that was successful? Is the weight of evidence that he failed?

    Those weren’t experiments that failed, those were tested substances that failed to meet engineering requirements for cost, brightness, and longevity. I’d venture that many if not most of those substances glowed when electrical current was passed through them. They just didn’t glow bright enough and or long enough. Take a cow pie and run enough amps of high voltage and I guarantee it will glow, we just wouldn’t want to use it in our house for light.

  30. Badly Shaved Monkey says:

    Since Dana’s back, let’s use he magic power of Cut & Paste;

    Dana, you failed to answer this at Quackometer, let’s pose you the questions here.
    1. Does Charles Darwin describe the dilutions used in his Drosera experiments in the manner you require for them to be homeopathic.
    Charles Darwin said;
    “The solution, moreover, in these experiments was diluted in the proportion of one part of the salt to 2,187,500 of water, or one grain to 5000 oz. The reader will perhaps best realise this degree of dilution by remembering that 5000 oz. would more than fill a 31-gallon cask; and that to this large body of water one grain of the salt was added”
    Dana Ullman says;
    What I now want to know is how did you come to believe your statement above: “After 12 times the container would be 100^12 (1000000000000000000000000) times bigger than your test tubes. If your test tube holds a decilitre, then the equivalent test tube size to get the same concentration in, from the same starting amount, is 10^23 litres.” In NO homeopathic literature has it ever said or implied that a larger container is needed for each stage of the potentization process. FINALLY…you’re realizing how much you (and others) have misconstrued homeopathy.
    2. Were Darwin’s dilutions succussed appropriately as is essential for homeopathic solutions?
    3. Were molecules of the test material present in Darwin’s dilutions?

  31. BillyJoe says:

    nitpicking,

    “If two were in real journals and two in a woo journal … is that not four papers?”

    And if one of them was published in both a woo journal and a real journal? … would that not make three papers?

  32. David Gorski says:

    It’s “The proof of the pudding is in the eating.”

    Okay, rant concluded. Thanks for indulging me.

    “Indulge” is correct. Personally, I dislike pedantry like this. I really do.

  33. @alison cummins & anthro – regarding colds

    Yes, Tylenol is works well for the sore throat, aches and pains. For temporary relief of the stuffy nose generous applications of vicks (methol gel) at night and the right foods during the day are helpful. My favorites are roasted garlic soup, chicken soup, thai food as spicy as I can tolerate, bi bim bop (with lots of kim chee and hot sauce) and udon. Oh and the local coffee shop make a mean lemon ginger tea that’s wonderful.

    Unlike beer and hot toddy, some of those you can actually eat (drink) at work, although I might not recommend the roasted garlic soup.

  34. DanaUllman says:

    Hey Chris…prove to us all how much homework you’ve done on those trials by Jacobs. Therefore, tell us what was different about that 4th trial that does not make it a “replication” of any trial that Jacobs had previously conducted?

    Mr. Monkey…The reader will benefit from knowing that the first quote you provide is from me; the 2nd quote seems to come from thin air (not me). Darwin proved that exceedingly small doses of ammonia salts had dramatic effects on the Drosera plant, and these effects were so significant that Darwin had his two sons replicate his work. Further, Darwin was so shocked at the significant effect that he bemoaned the fact that he would now have to publish his findings. This is all directly from Darwin’s letters…and is irrefutable.

    Yes, there were some molecules of the original ammonia salts in the final solution, just as there are some molecules in many homeopathic medicines sold in pharmacies today. Thank you for supporting me in acknowledging the power of these exceedingly small doses…

    And it is a real laugher that you are telling me that I am misconstruing homeopathy. You!? Please evolve, Mr. Monkey. Darwin supports your evolution too.

  35. Badly Shaved Monkey says:

    The reader might like to read what follows;

    Dana Ullman said

    “the 2nd quote seems to come from thin air (not me). ”

    The second quote, and a third, come from the Wikipedia user DanaUllman

    http://en.wikipedia.org/w/index.php?title=User_talk:DanaUllman&diff=prev&oldid=187152611
    To clarify, homeopaths do NOT use “dilutions” of anything! We use “potencies,” and our medicines are “potentized,” that is, they undergo sequential dilution, vigorous shaking, dumping out of 99% or 90% of the original liquid in the same glass vial or in a new glass vial, and the repeating of that process. The vast majority of medicines that are sold over-the-counter are in the 3rd to 12th potency (3X/3C to 12X/12C). The more a substance is potentized, the less number of molecules of the original substance remain.
    http://en.wikipedia.org/w/index.php?title=User_talk:DanaUllman&diff=prev&oldid=186838484
    Once again, I never said that 12C means 1 drop in 12 test tubes; it is MORE than that (and it has no relationship to an ocean of anything, except perhaps a “homeopathic ocean”). 12C uses 1% of sequential test tubes. I think that you and 88 are thinking that we need to increase by a 100-fold the amount of water in each dilution. No, that is not the case, and here is where you, 88, and Oliver Wendell Holmes have misunderstood homeopathy (the good news here is that YOU are getting clear of the facts, while Holmes prided himself on never talking to or consulting a homeopath, proving that ignorance is bliss). After doing the 1:100 dilution, the drug manufacturer dispenses with 99% of the water and adds more water into the test tube (some homeopathic manufacturing practices use the same test tube and other use a new test tube). Do you get it now? What I now want to know is how did you come to believe your statement above: “After 12 times the container would be 100^12 (1000000000000000000000000) times bigger than your test tubes. If your test tube holds a decilitre, then the equivalent test tube size to get the same concentration in, from the same starting amount, is 10^23 litres.” In NO homeopathic literature has it ever said or implied that a larger container is needed for each stage of the potentization process. FINALLY…you’re realizing how much you (and others) have misconstrued homeopathy.

    I had previously provided the weblinks.

    Obviously, I foolishly believed that Dana Ullman who posts here and the Wikipedia user DanaUllman were the same person. I am sorry for my mistake. Clearly Wikipedia user DanaUllman is a clueless fool and I am sure that you, Dana Ullman, will be happy to agree with me.

  36. Badly Shaved Monkey says:

    p.s. Arrange these phrases into an appropriate sentence.

    Dana Ullman
    pwned
    pure comedy gold

    Top prize: a mountain of gold!!

    [Term and Conditions: Mountain of gold has been prepared in the manner of a homeopathic paper remedy. Your home may be at risk if you borrow against the mountain of gold that you have won.]

  37. Mojo says:

    @Dana

    Darwin proved that exceedingly small doses of ammonia salts had dramatic effects on the Drosera plant…

    He found that dilute solutions of ammonium salts had an effect on Drosera. He also found that the effects got weaker as the concentration was reduced, eventually reaching a point at which no effect was observed, noting that spectroscopy could detect solutions more dilute that were more dilute than those which caused no effect on Drosera. This does not support homoeopathy since it contradicts the “law of infinitesimals”. There is no indication that Darwin’s ammonium solutions were prepared by serial dilution with succussion, and nothing to indicate that the results would have been any different if they had been. The fact that an experiment used dilute solutions does not necessarily mean that it was anything to do with homoeopathy – as you have repeatedly told people, there is more to the idea of homoeopathy than just the dilutions (although they do make it rather amusing).

    Further, Darwin was so shocked at the significant effect that he bemoaned the fact that he would now have to publish his findings.

    He was also unhappy at the prospect of publishing his theory of evolution, famously comparing it to confessing a murder. On the Origin of Species has nothing to do with homoeopathy either.

    This is all directly from Darwin’s letters…and is irrefutable.

    There is nothing in Darwin’s letters, or in any of his other writings, that supports your contention that the Drosera experiments had anything to do with homoeopathy.

  38. Dr Benway says:

    Yeah Dana can be an amusing chew toy. But his failure in this thread also includes kinky comments. That’s just “ew.”

    Dana, S&M is too low on the tone scale for this crowd and therefore is out-tech. Get your TRs in or have another go at the false purpose rundown.

    /moonbat

  39. DanaUllman says:

    Thanx Mr. Monkey…you’ve PROVEN that that quote was not from me. I was clearly quoting someone else. I was comment on someone else’s statement (jeez…this is so obvious, but please don’t let logic or rationale or even quotes get in the way of your monkey mind).

    Next time, it would help if you read your own comments here…and isn’t it interesting how your fellow people here ignore your frequent lapses in logic and substance. And you all have the sheer audacity to think of yourselves as “scientists!” Eeeeks, we’re doomed.

  40. Harriet Hall says:

    Dana,

    BSM asked you 3 specific questions. Please answer them.
    I’ll make it really easy for you to respond by repeating the questions here:
    1. Does Charles Darwin describe the dilutions used in his Drosera experiments in the manner you require for them to be homeopathic?
    2. Were Darwin’s dilutions succussed appropriately as is essential for homeopathic solutions?
    3. Were molecules of the test material present in Darwin’s dilutions?

  41. cloudskimmer says:

    What I really want to know is how homeopathic solutions can be distinguished from plain water? If the labels got mixed up, how could the “medications” be identified? And if some unscrupulous person were to put plain water into vials with pretty labels. or drip some on a sugar pill and sell it as homeopathic “medicine,” how could it be distinguished from the “real” homeopathic “medicine”? C’mon, homeopaths, try and answer this one!

  42. Badly Shaved Monkey says:

    Oh, OK “Dana Ullman”

    It’s reading comprehension time again. You’ve had this problem before. Let me separate out the reported quotes from the direct quotes.

    User “DanaUllman” said;
    To clarify, homeopaths do NOT use “dilutions” of anything! We use “potencies,” and our medicines are “potentized,” that is, they undergo sequential dilution, vigorous shaking, dumping out of 99% or 90% of the original liquid in the same glass vial or in a new glass vial, and the repeating of that process. The vast majority of medicines that are sold over-the-counter are in the 3rd to 12th potency (3X/3C to 12X/12C). The more a substance is potentized, the less number of molecules of the original substance remain.

    User “DanaUllman” also said;
    Once again, I never said that 12C means 1 drop in 12 test tubes; it is MORE than that (and it has no relationship to an ocean of anything, except perhaps a “homeopathic ocean”). 12C uses 1% of sequential test tubes. I think that you and 88 are thinking that we need to increase by a 100-fold the amount of water in each dilution. No, that is not the case, and here is where you, 88, and Oliver Wendell Holmes have misunderstood homeopathy (the good news here is that YOU are getting clear of the facts, while Holmes prided himself on never talking to or consulting a homeopath, proving that ignorance is bliss). After doing the 1:100 dilution, the drug manufacturer dispenses with 99% of the water and adds more water into the test tube (some homeopathic manufacturing practices use the same test tube and other use a new test tube). Do you get it now? What I now want to know is how did you come to believe your statement above: [SNIP: COPIED BELOW] In NO homeopathic literature has it ever said or implied that a larger container is needed for each stage of the potentization process. FINALLY…you’re realizing how much you (and others) have misconstrued homeopathy.

    User RDOlivaw said;
    “After 12 times the container would be 100^12 (1000000000000000000000000) times bigger than your test tubes. If your test tube holds a decilitre, then the equivalent test tube size to get the same concentration in, from the same starting amount, is 10^23 litres.”

    Charles Darwin said;
    “The solution, moreover, in these experiments was diluted in the proportion of one part of the salt to 2,187,500 of water, or one grain to 5000 oz. The reader will perhaps best realise this degree of dilution by remembering that 5000 oz. would more than fill a 31-gallon cask; and that to this large body of water one grain of the salt was added”

    So, again, to rephrase my first question. Does Charles Darwin’s description of a dilution equivalence resemble that of RDOlivaw or “DanaUllman”?

  43. Badly Shaved Monkey says:

    [Are we really discussing 150-year old experiments on sundew plants on a medical blog? I suppose it just goes to show how deep is the pit of silliness represented by homeopathy]

  44. Mojo says:

    @Dana

    …you’ve PROVEN that that quote was not from me. I was clearly quoting someone else.

    It looks very much as if it is in fact a quotation from you, albeit including a quotation from RDOlivaw.

    If you want to claim that the whole lot is a quotation from someone else you will need to cite the source(s) for the words “What I now want to know is how did you come to believe your statement above” and “In NO homeopathic literature has it ever said or implied that a larger container is needed for each stage of the potentization process. FINALLY…you’re realizing how much you (and others) have misconstrued homeopathy,” which look very much from the context and punctuation as if they are your own words.

  45. ConspicuousCarl says:

    > DanaUllmanon 15 Nov 2010 at 8:22 pm
    > And then, Gorski notes (properly) that THIS study used
    > Rhus toxicodendron 6C, which still has some molecules
    > in it, as though THIS is unusual in homeopathy (it isn’t!).
    > As I have written at this website at least a dozen times,
    > a large number of homeopathic medicines sold in
    > pharmacies today are in the 6C potency.

    Greetings.

    Just to clarify,

    1. Are you saying that the presence of actual molecules in homeopathic products is an important factor (i.e., do you think the diluted-beyond-presence preparations deserve their received criticism)?

    2. Exactly how many milligrams of this substance is remaining in 1 drop (not sure if that is the dose?) of a 6C preparation? If the presence of molecules matters, then we really need to talk about these things in terms of how much is actually present. Ratios like “6C” don’t tell us how much the patient received without knowing the amount of homeopathic water used to makes the pill (or applied directly if that was the case). Outside of homeopathy, medical research normally uses direct information about the amount of a substance used.

  46. daijiyobu says:

    An interesting study just came up on the radar in the journal Rheumatology,

    “Homeopathic Consultations — But Not Homeopathic Remedies — Linked to Benefits for Patients, Study Finds” (2010-11-13)

    (see http://rheumatology.oxfordjournals.org/content/early/2010/11/08/rheumatology.keq234 ) [ISRCTN09712705].

    Conclusion: “homeopathic consultations but not homeopathic remedies are associated with clinically relevant benefits for patients with active but relatively stable RA.”

    A RCT supporting homeopathy’s ACTUAL nonpharamacological effect.

    -r.c.

  47. Dr Benway says:

    A RCT supporting homeopathy’s ACTUAL nonpharamacological effect.

    So homeopathy = chatting with people?

    BRB, must homeopath my husband before I leave work…

  48. WilliamLawrenceUtridge says:

    I was preparing to write a response regarding the substance of Dana’s initial comment. But as I was doing so, I realized something – he was actually making essentially the same cogent points that Dr. Gorski was, from a different perspective. Both agree – 6C probably has molecules of the initial substance in it. Both agree – the study in question was 20 years old, and used a definition of fibromyalgia that is different from the current. Both agree – Dr. Gorski implicitly and Dana implicitly – that patients “got better”. I tried to criticize Dana’s criticism and couldn’t because, well, they’re right – in this study the patients did get better.

    And here is where the two part company.

    Dr. Gorski’s focus is broad. He looked at this study for methodological weaknesses, and found some. He expanded this to a broader context and included a re-analysis of the data (which was negative). This is situated within a broader context of “science based medicine”, which looks at prior probability on the basis of biology, chemistry and physics which fail to support the very existence and possibility of homeopathy.

    In contrast, Dana’s focus is laser-like. The study worked, and that’s it. Period. Again, this is situated within a context, but a narrow one. If a study “works”, then it works and that’s the final word. No mention is made of other, negative studies. No discussion of how it could work. When asked directly, point-blank, how homeopathy could work, the logical precepts underlying the very idea of it, the response is rarely a direct, thoughtful and straightforward answer. There is a lot of handwaving and condescension, but rarely a direct response to a simple question (witness, the comments by myself and Dana for http://www.sciencebasedmedicine.org/?p=4646 and http://www.sciencebasedmedicine.org/?p=4750 and probably my favourite, http://www.sciencebasedmedicine.org/?p=5978).

    Contrast this again with another science-based approach, that of the Cochrane Collaboration. Their approach is to take the broadest sets of trials, account for methodological rigour and combine. Emphasis is on taking the broadest review, amassing as much evidence as possible, including unpublished data if it can be found. The result is hoped to be the best information available on the subject, based on the fact that the evidence base is so wide. And I can’t recall a Cochrane review giving homeopathy a thumbs-up for any treatment (but I can recall Dana citing a lukewarm, borderline meaningless Cochrane review as if it supported homeopathy whole-heartedly in the treatment of influenza).

    So there’s the rub – Dr. Gorski and the Cochrane collaboration do their best to situate studies within a rational framework and broader context that allows decisions to be made on bodies of evidence be it from basic science in scientific methodology, chemistry, biology and physics, or randomized, controlled trials. Dana’s approach is to ignore all context, all disagreement within science or homeopathy itself (there are many different types of homeopathy – isopathic, classical, clinical, combination, all insisting they are the “true” homeopathy and all lacking any evidence-based reason to believe this), all possible methodological issues, type I versus type II errors, publication biases, subgroup analyses, everything, and simply insist that “it works”. Doesn’t matter if there are a dozen studies that are negative, so long as one small sample study somewhere out there with even marginally positive result, “it works.” There is no science in Dana’s insistence. Only relentless cherry-picking and blind faith in the perfect, Platonic ideal of homeopathy.

    I’ll take science, thanks. Context is important.

  49. Davdoodles says:

    “So homeopathy = chatting with people?”

    I suspect so, complete with the law of infinitessimals, and the paper remedy.

    The less time I spend reading Ulman’s nonsense, the better I feel.

  50. Mojo says:

    @daijiyobu

    “Homeopathic Consultations — But Not Homeopathic Remedies — Linked to Benefits for Patients, Study Finds” (2010-11-13)

    Here’s a comment from one of the authors from news coverage of that study

    Dr Sarah Brien, the study’s lead author, said that while previous research had suggested homeopathy could help patients with rheumatoid arthritis, the study provided the first scientific evidence to show such benefits were “specifically due to its unique consultation process”.

    Unfortunately this conclusion is contradicted by the results of a systematic review published earlier this year, which suggests that there isn’t anything particularly unique about the homoeopathic consultation process’s ability to evoke a placebo response: “CONCLUSIONS: Placebo effects in RCTs on classical homeopathy did not appear to be larger than placebo effects in conventional medicine.”

  51. BillyJoe says:

    I think he’s done a runner again. :D

  52. Deetee says:

    I think he’s done a runner again.

    Evidently.
    He is quite unable to respond to the pertinent questions put to him, but more importantly he may wish to avoid the huge embarrassment of confusing concepts like the LD50 and LSD, which he has previously muddled up, to much hilarity.

  53. Badly Shaved Monkey says:

    “I think he’s done a runner again. ”

    He’s a busy man. Homeopathy would be nothing without him.

    Or with him.

  54. WilliamLawrenceUtridge says:

    @BSM

    Don’t be cruel, homeopathy would still be water, with or without him. Sometimes alcohol. Usually sugar.

  55. gretemike says:

    They’re selling that oscillococcinum nonsense at Rite Aid pharmacies too:

    http://www.riteaidonlinestore.com/boiron-value-pack-oscillococcinum-natural-flu-relief-twin-pack/qxp37129

    Wouldn’t Reiki be even better than homeopathy in demonstrating deficiencies in RCTs? Reiki doesn’t even involve touching the patient, you don’t need to worry about adulterated remedies.

    Okay, I admit, I’m obsessed with Reiki. It fascinates me that a person can earn money by being a Jedi Knight in 2010 in the U.S.A.

    You folks put a lot of work into these blogs, my coworkers and I appreciate all the work and enjoy reading them.

  56. Badly Shaved Monkey says:

    In case anyone was wondering, “Dana Ullman” has not been run over by a truck rendering him incapable of typing;

    http://www.quackometer.net/blog/2010/11/on-the-the-reckless-physicking-of-amateur-females.html#comment-13423

    He just doesn’t want to type anything here.

    As BillyJoe said, I think he’s done a runner. Again.

  57. Badly Shaved Monkey says:

    It does look like Dana has truly run away.

    Does this mean we can declare victory? We’ve won the internet.

    Is there a trophy?

  58. David Gorski says:

    He’ll be back on this blog sooner or later. Dana always comes back.

  59. ConspicuousCarl says:

    Too bad. I actually did want to know if Ullman argued about the commonality of 6C dilutions as a matter of simple factual disagreement, or if he thinks it really matters that there are molecules of something besides water. I got the impression that this was some kind of defense, but in theory he shouldn’t care.

  60. Jeff1962 says:

    Hello all, new to the blog.

    One thing I haven’t seen mentioned, in this article at least, is whether the original “cures” have any actual effect on the disease when used at “full” potency? Doesn’t Homeopathy use the “like cures like” concept?

Comments are closed.