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“It’s just a theory”

I am afraid that the experiments you quote, M. Pasteur, will turn against you. The world into which you wish to take us is really too fantastic.

La Presse, 1860

It’s just a theory. Not evolution. Germ theory. Just a theory, one of many that account for the etiology of diseases.

I should mention my bias up front. I am, as some of you are aware, an Infectious Disease doctor. My job is simple: me find germ, me kill germ, me go home. I think there are three causes of disease: wear and tear, genetic, and germs. Perhaps a bit of an exaggeration, but not much. My professional life for the last 22 years has been spent preventing, diagnosing, and treating the multitudinous germs that a continually trying to kill or injure us. It is a fundamentally futile job, as in the end I will be consumed by the organisms I have spend a lifetime trying to kill.

I would have though that the germ theory of disease was a concept that was so grounded in history, science and reality that there would be little opposition to the idea that germs (a broad term for viruses, bacteremia, fungi, parasite etc) cause infections and some other diseases.

Wrong. There are people who deny the validity of germ theory. Add there are people who deny gravity. And evolution.

Opponents of germ theory come in two flavors:

  1. Germ theory deniers.
  2. Those who propose alternative mechanisms of disease.

There is great overlap between the two categories, and the division serves more as a literary device for the sake of exposition than a true description of reality.

Germ Deniers

The germ deniers put forth as their patron Saint Antoine Bechamp, a contemporary of Louis Pasteur. Bechamp lived from 1816 to 1908, the dawn of modern medicine and the beginning of microbiology. No one had a clue in the 1800′s as to the cause and treatment of diseases and there were many speculations and experiments performed in an attempt to understand and treat diseases. Most people had a life expectancy less than 50 years and the predominant cause of morbidity and morality was infectious. Since we do not die young of infections and we get to live long enough to die of cancer, heart and vascular disease. Before the 1900′s, if you could understand what caused infections, you could understand most diseases.

The foundations of microbiology and infectious diseases are based on the work of Pasteur and Robert Koch. Like Darwin, the insights of Pasteur and Koch are not the end of understanding of infectious diseases, but the beginning. The world is far more complicated and subtle than Pasteur and Koch could appreciate with the scientific tools of the time.

Pasteur, of course, performed the experiments that proved that germs existed and were a cause of some diseases. His name is well known and lives on in pasteurization, the heating of milk to kill microorganisms and prevent the spread of disease, one of many contributions he made to medical sciences. His insights, which lead to antibiotics, hygiene, and vaccines have undoubtedly prevented more morbidity and mortality than any human in history.

Another contemporary of Pasteur was Robert Koch, who, among many accomplishments formulated Koch’s postulates, conditions that were to be met to prove the infectious cause of disease:

  1. The organism has to found in all cases of the disease
  2. The organism has to prepared and maintained in a pure culture
  3. The organism had to be capable of producing the original infection, even after several generations in culture
  4. The organism retrievable from an inoculated animal and cultured again.

Modern biochemistry and molecular techniques have refined Kochs postulates. We can’t always grow the organism but we can isolated its DNA. Given the species specificity of some germs, we cannot always infect animals to prove causation. I doubt anyone would want to prove the cause of Ebola by re-inoculating a human with cultured virus. Also, there is great variability in the ability of many germ strains to cause disease and great variability in the hosts immune system to combat diseases. Some germs are more virulent than others. Some people are some or less susceptible to disease, and the last 10 years have seen an explosion in understanding of the variability in the human immune system (polymorphism’s) that explain why some people get ill from a given pathogen and others do not.

The combination of germ theory and Koch’s postulates, improved and refined by biotechnology, are still the cornerstones of infectious diseases. Pasteur, Koch and their contemporaries began the science of infectious diseases and microbiology, a field that has lead to more benefits to mankind than perhaps any other.

What do the germ deniers offer as a alternative to Pasteur et. al.? The theory of Antoine Bechamp and others called pleomorphism (1).

CELLULAR THEORY (BECHAMP)

  1. Disease arises from micro-organisms within the cells of the body.
  2. These intracellular microorganisms normally function to build and assist in the metabolic processes of the body.
  3. The function of these organisms changes to assist in the catabolic (disintegration) processes of the host organism when that organism dies or is injured, which may be chemical as well as mechanical.
  4. Microorganisms change their shapes and colours to reflect the medium
  5. Every disease is associated with a particular condition.
  6. Microorganisms become “pathogenic” as the health of the host organism deteriorates. Hence, the condition of the host organism is the primary causal agent.
  7. Disease is built by unhealthy conditions.
  8. To prevent disease we have to create health.

Bechamp’s hypothesis was, at the time, no more or no less reasonable than other ideas. Unfortunately for him, a century and a half of research has demonstrated that there he was wrong on all the particulars of his ideas, except for 7 and 8. Postulates 1, 2, 3, 4, and 6 are all flat out false. From 1950 to November 2nd 2008 at 9:50 am PST, there were 909, 599 citations on Pubmed relating to infections. How many papers and experiments were done in the 100 years prior to 1950 I do not know, but it is a safe bet that germ theory is supported by over a million studies and experiments. A Pubmed for terms to support pleomorphism finds zero references. Germ theory is as confirmed a concept as science can offer. Cellular theory lost the battle to experiment. Reality and science supports the ideas of Pasteur, not Bechamp.

Alternative practitioners are drawn to the concepts of Bechamp because the reason for disease is that the body fails. Alternative providers are all about supporting health to allow the body to heal itself. Bechamp lends credibility to many alternative practices.

Here is where it gets weird.

Rather than look at the mountains of evidence to support germ theory and the complete lack of evidence to support pleomorphism as the reason for the dominance of germ theory, they resort to paranoid sounding conspiracy theories.

The Whale is a good source for this kind of thinking and is representative of what you will find if you browse the web:

How did Pasteur’s ideas become the foundation of organized medicine? Politics. Pharmaceutical economics.

Early in his career, Pasteur was decorated by the Emperor Napoleon. His position as a scientist was thereby secured, even though he was only a chemist and had no credentials at all in medicine or physiology…..

For the first time in history, things were coming into focus. Discoveries were being made about fundamental issues, but in a piecemeal fashion. It was perfect timing for an opportunist to take advantage of the general uncertainty and lack of understanding and to claim that he understood all the issues involved, and furthermore had thought of them first. Pasteur was noted for his habit of playing both sides of the fence on issues he didn’t understand, and then later, to quote the parts of his earlier writing that supported the later finding, always with the claim that he had been there first. Only the scientists understood the complexities of these emerging ideas. The royal court and the press just knew that something was going on, and though they didn’t know what, were going to act as though they did. And for them, a chameleon like Pasteur was the perfect frontman.

Politics never changes. The same type of thinking that imprisoned Galileo long ago for discovering that the earth went around the sun, the rulers’ eternal attempt to control the minds of their subjects, these are the forces that cast Pasteur, an ambitious opportunist, into a position he may not have deserved – the supposed Trailblazer in the science of modern biomedicine.

Funny how things often don’t really get “discovered” until the commercial aspects of that discovery have been worked out.

or

Béchamp’s research revealed that the inner condition of a person’s cellular terrain determined whether disease would manifest or spread in the body. He proved through rigorous scientific method that disease was not due to germs attacking the body from the outside as Louis Pasteur later convinced the world. What you eat, breathe, drink, and bathe in are the primary factors that determine your body’s inner condition.

Instead of incorporating Béchamp’s discoveries to bring about a health revolution in the world and save countless lives, greedy, power hungry industrialists decided to ostracize his work and put their dollars behind Louis Pasteur’s “Germ Theory of Disease” because it was a way for them to build a colossal pharmaceutical/medical empire for profit. No pharmaceutical company in the world today cares one iota about curing disease. They want to control disease and focus on symptom suppression so they can make huge profits by getting you to become a lifelong user until you die from their poison. That’s why they go to war against disease with all their “anti” this and “anti” that medications instead of addressing the inner condition of a patient and re-establishing homeostasis in the body. (2)

This is weird not only because it denies over a million interrelated studies that confirm germ theory, but Pasteur’s fundamental ideas were confirmed about 60 years before the discovery of penicillin. That is just how subtle and clever big Pharma is: they suppressed a theory because they knew that 60 years in the future they would make a fortune selling antibiotics. Someone needs to send Big Pharma the JREF million dollar prize.

Then there are HIV deniers, who live in a bizarro world of their own. My medical career started with the onset of the HIV epidemic. I have seen HIV go from zero understanding about the disease and a 9 month life expectancy to amazing detail about the biochemistry and pathophysiology of HIV and an almost normal life expectancy for many AIDS patients. There are 191,000 plus articles on Pubmed concerning HIV research. The astounding accumulation of data to support HIV as a cause of AIDS and the benefits of applying that understanding to the treatment of AIDS is triumph of the modern medical-industrial complex. It is why I have one AIDS patient die this century after a decade of AIDS deaths. Application of germ theory saves lives. Millions and millions of lives.

Of course, that is just what they told me to say.

Alternative mechanisms of disease

There are a multitude of alternative mechanisms of disease: blocked chi in acupuncture, blocked innate intelligence in chiropractic, toxin build up in the colon, etc etc. What these alternative therapies share is a lack of appreciation or understanding of germ theory. Since germs cannot be seen, and since it is not germs but their alternative theory that causes disease, why would you expect alternative providers to behave as if germs exist? The result of believing that germs do not exist is infections. The germs will always win.

Acupuncture and Infections

Acupuncture is unique compared to most alternative practices in that it is invasive and because acupuncturists actually do something to accomplish nothing. Stick needles into people and you can drag in all kinds of germs. I have a healthy respect for needles and the damage they can cause by practitioners who understand germ theory. A review of adverse events associated with acupuncture demonstrated that “Infection accounted for 204 primary reports and 91 secondary reports. Over 60% of these cases were hepatitis B. The next most common infection was of the external ear, as a complication of auricular acupuncture (3).”

Cellulitis, bacteremia, endocarditis, empyema, osteomyelitis, endophthalmitis, abdominal abscesses, epidural abscesses and infected joints are well described complications of acupuncture. Blood borne pathogens such as HIV, hepatitis C and hepatitis B are associated with acupuncture. Mycobacterium abscesses and Mycobacterium chelonae outbreaks have occurred due to acupuncture. Needles are dangerous, and while the body has good defenses against infectious complications of minor trauma, the defenses fail on occasion.

One would think acupuncturists would clean the skin before needle insertion, but a review of skin disinfection for acupuncture states: “Disinfection of clean skin before injection is not generally considered necessary and observations of lack of infection following injections without prior skin disinfection support this (4).” Another review suggests that “none the less, good infection control is essential” but that assumes the practitioner understands and appreciates germ theory as a cause of infectious diseases. Infection after penetrating trauma is uncommon, a rare event under most circumstances. I would guess that many reading this have evidence of minor skin trauma right now and are not infected. It is what the immune system is for.

One of the lessons you learn in medicine is there is a difference between what one can get away and what is the best practice for all patients. Most of the time you do not need to wash your hands or prep the skin or do any of the procedures that decrease the risk of infections. Most of the time you can get away with being sloppy. But the more you practice infection control procedures, the greater the odds that the patient will avoid infection. Of course, there is the underlying assumption that you think germs cause disease. If not, why bother? There are a smattering of infections treated with acupuncture (UTI, skin infections, arthritis) in the medical literature; one can only wonder why. I suppose the acupuncture will support immune health a foster the innate healing process. I would rather kill bacteria. But then, I would.

Chiropractic and Infections

Two studies have cultured chiropractic exam tables and found pathogens, including methicillin resistant staphylococcus. Apparently chiropractors are not particularly fastidious at disinfecting their exam tables. Why would they? Germs are not necessarily the cause of disease in their world view.

I am particularly drawn to one of the conclusions: “Rudimentary behavioral changes to improve chiropractic clinic infection control are needed.” Rudimentary. Not an enthusiastic vote that the education chiropractors received in school was in infection control. I note chiropractic schools offer microbiology, and again I wonder why. It would not appear to be for the purpose of learning rudimentary infection control. But why should they feel inclined towards good infection control practices? The cause of disease is not germs, it is due to blocked innate intelligence.

It maybe less of an issue currently, but chiropractors long opposed germ theory and a google using chiropractor and germ theory as search terms finds no shortage of chiropractors who oppose the concept of germs causing disease. Given the huge variability in chiropractic practice, it is difficult to know if such lack of understanding of germ theory is typical of the field or not.

Other practices

There was an outbreak of colonic amoebiasis associated with colonic irrigation. Thirty six people developed the disease and 10 required colectomy. “Tests of the colonic-irrigation machine after routine cleaning showed heavy contamination with fecal coliform bacteria. The severity of disease in this outbreak may have been related to the route of inoculation.” Colonic irrigation is done to cleanse the colon of toxin build up that causes disease. It is an idea for the cause of diseases that has no bearing on reality and colonic irrigation is useless for removing toxins or curing diseases. Why concern yourself with germs and their transmission to others, since they are not a cause of disease. It is no surprise that the cleaning was not optimal

Moxibustion has been associated (and yes I know association is not causation) with a spinal epidural abscess and with a Pasturella abscess. The other complication of moxibustion is burn injury, which is fertile soil for infections. It is no surprise that this procedure would be associated with infection.

Naturopathic care is associated with a case of prosthetic valve endocarditis with P. acnes after unnecessary vitamin injections.

Other alternative modalities have fewer or no reported infections associated with them probably because they do not do anything. The recent 50 facts about homeopathy suggested “The chances of contracting MRSA or C. Difficile at a Homeopathic Hospital are extremely rare.” Of course it is. An intervention that does nothing cannot have an infectious complication. Doing nothing results in nothing.

What unites many alternative practitioners is their opposition to vaccines. Germs don’t cause disease, so why prevent infections with vaccines? Like many practices with alternative medicine practitioners, it is difficult to know how pervasive anti-vaccine sentiments are.

CAM also lends support to the “anti-vaccination movement. In particular, sections of the chiropractors, the (non-medically trained) homoeopaths and naturopaths tend to advise their clients against immunization. The reasons for this attitude are complex and lie, at least in part in the early philosophies which form the basis of these professions (5).” In other words belief in magic prevents understanding of infectious diseases and germ theory.

Chiropractors often advise against vaccination and do not vaccinate their own children. There is a contingent chiropractors of who are against vaccines, but to what degree they represent chiropractors as a whole I cannot say. Since Chiropractors are not required to use evidence to base their practice, there appears to be fewer standards and greater variability as to what what constitutes chiropractic practice. Attitude by health care professionals can influence decisions to vaccinate, and 27% of chiropractors in one survey advised against childhood vaccination (7). In another series where a fictitious patient asked for vaccination advice on the internet, of 93 homeopaths and chiropractors, “no homeopath and only one chiropractor advised in favor of the MMR vaccination (8).”

Advice from chiropractors, homeopaths, naturopaths and other alternative practitioners against vaccinations abounds on the web, it is difficult to tell from the published studies if this dangerous advice is the norm for these practitioners or the deviant recommendations of the more extreme of the already irrational. The studies are few and small in number, but disturbing in their implications. Chiropractors and naturopaths are pro childhood infection.

Anti-vaccination is often spun as an issue of choice “Concerning immunization information, a much higher proportion of faculty (91%) and students (80%) than practitioners (62%) felt chiropractors should provide both pro and con information to patients (6).”

It may be that the biggest source of infections from alternative medicine practitioners is not what they do but what they do not do. The only studies I can find on vaccine refusal concerns religious exemptions. I wonder how many who refuse vaccinations do so because of information obtained from chiropractors, homeopaths, naturopaths and other alternative practitioners.

I looked for, and could not find, studies that examined how compliant various alternative providers are with rudimentary hand hygiene and other infection control recommendations. In science based medicine, where germs are an accepted etiology of disease, compliance with hand hygiene has historically been poor. Rates for hand washing have typically been less than 50% in a group of people who allegedly think germs exist. Thanks to intensive education and focus this century, hand hygiene rates have gone up at all my hospitals. It has been gratifying to see as the compliance with infection control has increased, the rates of hospital acquired infections have dropped. The last 19 years that I have been the Chair of our Infection Control committee has seen the continuous and relentless decline in infections at all my hospitals. That is one of the side effects of applying evidence based medicine and germ theory to the hospital: infections decrease.

Any useless anecdotes from readers? Did your chiropractor wash her hands? Your naturopath? Your primary care doc? If not, you should perhaps seek care elsewhere.

All of the infections associated with alternative medicine modalities are unusual. I also suspect that the infectious complications associated with alternative medicine are under reported because it takes time and effort to report cases. I have seen a handful of infections (and other complications) associated with alternative therapies and have neither the time nor inclination to report them formally to a journal.

I am certain someone will mention in the comments all the morbidity and mortality us real doctors cause on a regular basis. Health care is not, unfortunately, risk free, and I know all too well the improvements that could be done to improve patient safety. I also know the enormous strides we have made in preventing hospital acquired infections during my career. I used to be able to make a living off hospital acquired infections and the last 19 years have shown a steady decrease in nosocomial infections at my hospitals to the point where some have not had a nosocomial pneumonia in over a year.

In medicine we have to weigh the risks of what we do with the benefits we hope to gain. In the world of alternative medicine, there is all risk with no benefit. See http://whatstheharm.net/ for more anecdotes (not data).

Beliefs in disease causation have consequences. Believing that germs do not cause disease doesn’t affect the germs. They are out there waiting for the opportunity to invade and try and kill you. Job security.

———

(1) http://whale.to/p/bechamp.html

(2) http://www.healthtruthrevealed.com/full-page.php?page=article&&id=11421316206

http://whale.to/v/bechamp1.html

Acupuncture references:

(3) Acupunct Med. 2004 Sep;22(3):122-33. A cumulative review of the range and incidence of significant adverse events associated with acupuncture.

(4) Acupunct Med. 2001 Dec;19(2):112-6. Skin disinfection and acupuncture.

Outbreak of invasive methicillin-resistant Staphylococcus aureus infection associated with acupuncture and joint injection. Infect Control Hosp Epidemiol. 2008 Sep;29(9):859-65. PMID: 18684094.

Acupuncture-associated Listeria monocytogenes arthritis in a patient with rheumatoid arthritis. Joint Bone Spine. 2008 Jul;75(4):502-3. Epub 2008 May 2. PMID: 18455948

Outbreak of acupuncture-associated cutaneous Mycobacterium abscessus infections.J Cutan Med Surg. 2006 Jul-Aug;10(4):166-9.PMID: 17234114

[Risk of hepatitis C related to traditional medicine: a case control study in Ho Chi Minh City, Vietnam] Rev Epidemiol Sante Publique. 2007 Apr;55(2):107-12. French. PMID: 17 442516

Paraplegia caused by spinal infection after acupuncture.Spinal Cord. 2006 Apr;44(4):258-9.PMID: 16151454

Multiloculated pleural empyema following acupuncture.Infection. 2005 Aug;33(4):297-8. PMID: 16091905

HIV infection after Chinese traditional acupuncture treatment.Complement Ther Med. 2003 Dec;11(4):272. PMID: 1496979

Soft tissue abscess and osteomyelitis secondary to acupuncture.ANZ J Surg. 2003 Sep;73(9):770. PMID: 12956798

Group B Streptococcus endogenous endophthalmitis : case reports and review of the literature.Ophthalmology. 2002 Oct;109(10):1879-86. Review. PMID: 12359609

Chiropractic References

Chiropr Osteopat. 2007 Jun 7;15:8. Assessment and risk reduction of infectious pathogens on chiropractic treatment tables.

Am J Infect Control. 2006 Apr;34(3):155-7. The role of chiropractic adjusting tables as reservoirs for microbial diseases.

Chiropr Hist. 1996 Jun;16(1):72-87 Chiropractic’s tension with the germ theory of disease.

Other Practices

N Engl J Med. 1982 Aug 5;307(6):339-42.Links An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic.

Spinal epidural abscess associated with moxibustion-related infection of the finger. J Spinal Cord Med. 2008;31(3):319-23. PMID: 18795486

Pasteurella multocida infection of the calf in a patient who had moxa cautery treatment for degenerative arthritis. Yonsei Med J. 1982;23(1):65-70

Tidsskr Nor Laegeforen. 1991 Sep 20;111(22):2741-2. [Bacterial endocarditis after treatment by a natural healer]

Vaccines and alt med

(5) Vaccine. 2001 Oct 15;20 Suppl 1:S90-3; discussion S89. Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination.

(6) J Manipulative Physiol Ther. 2004 Jun;27(5):287-98. A survey of US chiropractors on clinical preventive services.

http://www.chirobase.org/06DD/chiroimmu.html

(7) Vaccine. 2004 Dec 2;23(3):372-9. here to read Beliefs and behaviours: understanding chiropractors and immunization; Association between Health Care Providers’ Influence on Parents Who Have Concerns about Vaccine Safety and Vaccination Coverage.: Smith PJ, Kennedy AM, Wooten K, Gust DA, Pickering LK.Pediatrics, November 2006; 118(5):e1287-e1292

(8) Vaccine. 2003 Mar 7;21(11-12):1044-7. MMR vaccination advice over the Internet.

Posted in: Acupuncture, Chiropractic, Homeopathy, Science and Medicine, Vaccines

Leave a Comment (37) ↓

37 thoughts on ““It’s just a theory”

  1. DVMKurmes says:

    I have an anectote related to this post; When I was a new graduate from veterinary school, I worked in a small town for 4 years or so. The local chiropractor had kids the same age as mine, and we did a few things together. We went to his home for dinner, and they grilled chicken. when the chicken was done, he put it back on the original dish with the raw chicken juice. I had to insist that he put the chicken back on the grill and get a clean dish before my (and his) toddlers ate the chicken.
    That was my first exposure to the idea that some CAM practitioners did not subscribe to the germ theory.

  2. overshoot says:

    What you fail to mention regarding the “alternative theories of health” is that they make no attempt to account for contagion and in fact are driven to deny it. This, despite the fact that disease contagion has been observed for millennia. In one exchange a denialist tried to avoid dealing with the 1937 smallpox epidemic by blaming it on agricultural soil depletion by the Crow and Blackfoot!

    Totally OT: wrt hospital infection control, I’m a bit surprised that at least in the hospitals I’ve been (involuntarily) in lately, the logistics aren’t well suited to good hand health. I would have expected a supply of gloves at the entrance to each patient room and a receptacle for disposal of used ones, with expectations that there would be no gloves outside of rooms and no bare hands in them. Discussing this with my caregivers, they found the idea radical. I was not comforted.

  3. delaneypa says:

    As a PCP I really wish I saw some of Bechamps believers. Pick any symptom, and a significant fraction of patients will think antibiotics is the cure. With them, I could skip the 10 minute explanation about why they do not actually need antibiotics.

  4. Harriet Hall says:

    From their own surveys, it appears that about half of American chiropractors do not support immunization. I don’t know how many of those actively discourage it. One chiropractor I know says “If germs caused disease, we’d all be dead.” I know of a chiropractor who treated his son’s meningitis with spinal adjustments; the child died.

    A raw foods advocate told me the germ theory is a lie and all disease is caused by toxicity from bad practices like eating cooked foods. She claiims if you eat only raw fruit you can’t get sick. She doesn’t wash her hands. I asked her why she thought smallpox vanished. She said it didn’t, it’s just being diagnosed as chickenpox and there’s really no such thing as smallpox. I told her we can see the virus on electron micrographs – she said that’s just cellular debris. And you can’t present any scientific evidence to her because she discounts the whole of modern medical science as a plot to support doctors’ livelihoods.

  5. Zetetic says:

    There’s another dynamic with “It’s just a theory”. In the general public’s mind, a “Theory” is more akin to a “Hunch” or some kind of spontaneous idea. The scientific community would, of course, call this an “hypothesis”. Most people don’t understand that to earn the right to be a the scientific “Theory”, there must be a whole heck of a lot of supporting scientific evidence.

  6. eblonk says:

    I ran into the blog today and to read such a coherent, well-written article is a feast for a mind tired of shoddy reasoning by true believers. It has been a long time my grey matter has been tickled like this. No quick-and-easy read but who wants that anyway.

  7. David Gorski says:

    Actually, even a “hypothesis” isn’t usually the equivalent of a hunch as far as being a “spontaneous idea,” although sometimes it is. A hypothesis is usually a postulate that makes predictions that can be tested experimentally, and it’s usually based on a fair amount of previous evidence.

    But you’re right. the reason that the public believes it when cranks dismiss evolution or the germ theory of disease as “just a theory,” it’s because they have no idea what scientific theories are. Scientific theories are generally the highest form of scientific knowledge, backed up by enormous quantities of evidence to the point where they are accepted provisionally and operationally as “true” because of their usefulness and predictive power. That’s not to say that they are “true” or “truth,” just that they are so well supported and so useful in their predictive value that they behave that way.

    When one theory supplants another, in fact, it still must account for all the observations supporting the old theory, and in general a new theory explains all the old observations AND the observations that didn’t fit in so well with the old theory. In other words, the old theory ends up being folded into the new, and the new theory explains more than the old one.

    A great example of this is when Einstein’s theory of relativity supplanted Newtonian physics. Newtonian physics work perfectly well at speeds very much below the speed of light, which is where all of us live and what all of us observe. Indeed, Newtonian physics are still widely used as the basis for most engineering and predictions of flight because Newton’s laws are predictive to a high degree of accuracy at speeds that are a very small fraction of the speed of light. And, not surprisingly, at low speeds, where the ratio of speed/speed of light is very close to zero and can thus be approximated for all intents and purposes as zero, all the relativistic terms in Einstein’s equations drop out, and we’re left with Newton’s equations.

    Unfortunately, most people don’t understand that and still equate a “theory” with a “hunch.”

  8. daedalus2u says:

    David, a hypothesis has to be consistent with what is already known. If it isn’t, then it isn’t a hypothesis, it is a wrong idea.

    Einstein’s ideas were a hypothesis because they were consistent with Newtonian physics to the accuracy available at the time, all measurements being well below the speed of light where relativistic effects were not measurable. People rejected it not because of data showing it was wrong but because it offended the sensibilities of those used to thinking only in terms of absolute space and Newtonian physics.

  9. The Blind Watchmaker says:

    Idea = Hypothesis

    Hypothesis Tested and Passed = Good Idea

    Good Idea Makes Accurate Predictions = Theory

    Hypothesis Tested and failed = Bad Idea

    Do Bad Idea Anyway = CAM

  10. David Gorski says:

    Good Idea Makes Accurate Predictions = Theory

    Actually, a theory is much more than just this. It is a set of ideas/postulates that not only make accurate predictions but also useful predictions. It is a framework that explains a major issue in science.

  11. I had a friend who was a “You Create Your Own Reality” true believer and a germ theory denialist. She told me there was no reason to accept germ theory, as there were MANY paradigms to choose from as the cause of disease! She described one study which claimed the color underwear the sample group wore was strongly correlated to overall health! (Apparently wearing red underwear was strongly correlated with good health, while white or grey underwear was not.) Of course, this study apparently took place around 1900, but who’s counting?

    The last I heard from her, she was attempting to get pregnant via immaculate conception.

  12. Jules says:

    Disease arises from micro-organisms within the cells of the body

    Technically there are microorganisms within the cells of the body :-)

    I especially love the use of [Pastuer'sposition as a scientist was thereby secured, even though he was only a chemist and had no credentials at all in medicine or physiology… as a reason why he couldn’t possibly be credible in medicine or physiology–and yet they seem to think that someone who doesn’t have an MD after his name understands everything everything about the body.

    Some thoughts, in no particular order:

    It does seem like the fear of germs is highly overrated in our society, where decent hygiene (I hesitate to say “good”, because teenagers do run places like McDonalds, after all) is a predominant practice and every trace of bacteria seems to make it into the news as an “outbreak”.

    I think what confuses people is that there’s been a whole loada new information about our “natural and good bacteria”. Wasn’t there a yogurt commercial about how L. acidophilus enhances your immunity or something? There’s not enough of a distinction between the bacteria that are part of your natural fauna and the bacteria that causes germs–and frankly, I don’t think there should be, since E. coli in large quantities isn’t good for anybody except the pathologist. Besides, the only difference between your average run-of-the-mill strep that occupies 99.999% of your skin and MRSA is a gene (probably several), a difference which eludes most minds (part of me is tempted to correlate the ability to understand genetics with belief in Intelligent Design).

    One last minor nit to pick: “building health”, according to my reading of most magazines that purport to tell you how to do that, amounts to eating a good diet, getting enough exercise, sleeping well, and not stressing yourself out. I would think that, if you did those things, you’d be pretty healthy to begin with, and not likely to get dangerously ill from germs. Of course I don’t believe that “building health” will render you impermeable to all things microscopic, but you can’t deny that being in good health goes a long way towards how well you resist an onslaught of, say, influenza.

  13. Jules says:

    @ daedalus2 and David Gorski:

    It should amuse you to know, I think, that Einstein, after working out special and general relativity, realized that the equations showed that the universe was expanding. This offended his sensibilities, and he spent a few years tinkering with the math to come up with a constant that would keep the universe, well, constant. His solution was to announce that, under certain conditions, gravity would be repulsive. He shelved it in 1929, after Edwin Hubble’s observations proved without a doubt that the universe was expanding, but I get the feeling that he was never fond of general relativity afterwards. He also spent years fighting the development of quantum mechanics, the origin of his oft-quoted, “God does not play dice with the universe.”

    I recount this, because, interestingly enough, 80 years after he wrote off the constant, cosmologists (not to be confused with astrologists) rediscovered that there is, in fact, a universal constant–that gravity is indeed repulsive depending on the state of the Higg’s field (The Fabric of the Cosmos by Brian Greene has a far more complete and intelligible description of what this all means). Einstein, because he was searching for a static universe, arbitrarily chose his constant because it allowed the universe to stay constant, it turns out that the real constant is apparently far, far greater.

    So theories can be completely right, even if they’re completely wrong :-) Or can they be completely wrong, even if they’re completely right?

  14. The Blind Watchmaker says:

    @David Gorski

    Good Idea Makes Accurate Predictions = Theory

    “Actually, a theory is much more than just this. It is a set of ideas/postulates that not only make accurate predictions but also useful predictions. It is a framework that explains a major issue in science.”

    Sorry, I was only making a brief statement to lead up to a punchline. Obviously “a theory is much more than this”.

  15. yeahsurewhatever says:

    (Heinrich) Robert Koch won a Nobel Prize in Physiology or Medicine in 1905 for conclusively proving that bacteria exist and are a vector of disease. Specifically, that anthrax, tuberculosis, and cholera have bacteriological origins.

    Wendell M. Stanley won a Nobel Prize in Chemistry in 1946 for conclusively proving that viruses exist and are a vector of disease. Specifically, that the tobacco mosaic virus causes the mottling disease of the tobacco plant.

    Stanley Prusiner won a Nobel Prize in Physiology or Medicine in 1997 for conclusively proving that prions exist and are a vector of disease. Specifically, that particular (and similar) protein structures cause BSE in bovines and CJD in humans.

    Anyone who doesn’t believe in germs should put their money where their mouths are and stop consuming pasteurized and irradiated foods and drinks, stop using antiseptic soaps, and stop brushing their teeth. Those are just conspiracies by The Man to keep you down.

  16. yeahsurewhatever says:

    “I recount this, because, interestingly enough, 80 years after he wrote off the constant, cosmologists (not to be confused with astrologists) rediscovered that there is, in fact, a universal constant–that gravity is indeed repulsive depending on the state of the Higg’s field”

    Sorry, that’s complete crap, and Brian Greene is largely a fraud when it comes to physics.

  17. Chris Noble says:

    But everybody knows that Pasteur confessed on hid deathbed that “the germ is nothing and the terrain is all”.

    I read it on whale-to so it must be true!

    On another issue it’s always amusing when HIV denialists simultaneously deny the germ theory of disease and complain that HIV doesn’t fulfil Koch’s postulates. Syncretism is bliss.

  18. yeahsurewhatever says:

    It is interesting that deniers of germ theory still typically use antibacterial products (and, one would hope, condoms) in the same way that it’s interesting that deniers of evolution still typically vaccinate their children.

    I remember someone pointing out to me back in 2005 that, within a few months of each other, President Dubya first publicly said “the jury is still out” on evolution, and then he suggested that avian influenza H5N1 represented a significant treat to humanity because it might EVOLVE from being mainly zoonotic to being highly infectious from person-to-person. But apparently the jury is still out in his opinion, even today.

    This is the sort of doublethink that permeates fringe science and pseudoscience. They don’t question the benefits they receive from the scientific paradigms they claim are wrong, and are happy to continue receiving those benefits while they attack the very foundations of producing them. They truly want it both ways.

  19. Jules says:

    @ yeahsurewhatever:

    Why do you say that Brian Greene is a fraud? Are you a theoretical physicist who knows better?

    I’m just curious because if his work for the public doesn’t accurately reflect our current understanding of actual string theory/quantum mechanics/cosmology then I’ll have to reassess everything that I’ve read by him. Of course I’m willing to make exceptions for data that wasn’t available at the time of print (new discoveries, y’know, that science “thing”), but are you saying that his facts are wrong?

    FWIW, I’ve looked through most of the endnotes of his books, and while I’m not in a position to assess whether his sources for the theoretical physics is sound (though maybe you are?), I do find his biographical sources tend to come from single books, which could be wrong or biased.

  20. pmoran says:

    Mark, I don’t think many other than John Scudamore of the “whaleto” site take the Bechamp theory seriously, and even he has a tendency use such stuff to push skeptical buttons.

    More widely encountered is a modern variant of Bechamps theory sometimes described as “the soil theory”. It allows that germs exist but that infections only occur as the result of a general impoverishment of human immunity. This is usually put forward with simplistic ideas as to why, and often as part of an antivaccination agenda.

    This is less easy to dispose of in few words. Any thoughts?

  21. Mark Crislip says:

    who knows? when I seach using bechamp as a google term I get plenty of hits that are similar to the whale. I do not know if this is the standard approach or an atypical approach. I tend to think the goofier woo is over represented in the web. Reasonable people tend to make for poor bloggers and dull web conributors :).

  22. overshoot says:

    Mark, I don’t think many other than John Scudamore of the “whaleto” site take the Bechamp theory seriously, and even he has a tendency use such stuff to push skeptical buttons.

    Bear in mind that by the time you get to the germ-theory denialists you’re into serious woo. These are the folks who have absolutely no problem with ditching molecular biology totally; they don’t blink at “energy medicine” and quite a few consider the Second Law of Thermodynamics to be a fraud on the world pushed by the Rockefellers and Big Oil/Big Pharma.

    Which is another way of saying that they don’t need no steenkin’ mechanism under the hood of their magic. It just does, much as homeopathy.

    As a result, they have no real problem with simultaneously believing in pleomorphism, spontaneous generation, protean genomes, and an immune system. The last is thrown in because “the immune system” is essential to all woo today, even if (as some of them do) you presume that there’s nothing to be immune to.

    The really scary thing is that of the regulars on MHA, Scudamore is actually one of the more nearly rational.

  23. HCN says:

    I remember someone somewhere pushing Bechamp… with a bit of searching, it turns out to be one of the trolls on http://scienceblogs.com/aetiology/ (js preen … remove the space to google, I don’t want him to find himself here by vanity googling).

  24. pmoran says:

    I was mainly looking for suggestions as to the strongest and simplest argument against “the soil theory”. The problem with it is that it is partly true.

  25. yeahsurewhatever says:

    Hi Jules.

    First of all, this is a medicine blog, not a theoretical physics blog, so I’m not going to do this “more information than you ever wanted to know about what you’re glibly mistaken about” thing again after today unless it’s relevant to SBM. And if it’s relevant to SBM, it won’t be on me to say it. Someone else here would probably be better informed in that case.

    Hubble’s law and the metric expansion of space have nothing to do with repulsive gravity. “Dark energy” is not repulsive gravity. Dark energy is understood to be a negative pressure field permeating the universe. Negative pressure does not produce gravitational repulsion. In fact, to produce the observed results (accelerating cosmological expansion), dark energy must have a positive energy density, since the equation of state — the ratio of pressure to energy density (w=p/ρ) — must be negative, or more precisely, w < -1/3, and hopefully -1 <= w = -1, but that’s not important here.

    As of the current date, there is no empirical reason to suppose, and no scientific way to justify any claim, that this large-scale expansion has anything at all to do with gravity. If Greene makes this claim, then it is because dark energy as it is understood by mainstream physics is not possible to reconcile with current versions of string theory, for which Greene is a mouthpiece and apologist. Apparently, some form of antigravity is much easier to square with the fringe science to which he is philosophically committed, and for some reason he thinks that’s a feather in their cap rather than evidence of their fringe nature. Does he have any evidence for this viewpoint? Absolutely not. There isn’t any for him to use.

    Greene, like Michio Kaku, is mostly comfortable making hand-waving statements to scientifically naive readers. Statements which have not been, and often cannot be, backed up by real science. His loud endorsement of string theory as though it is the new Standard Model is just one example of this. As of the current date, and for the foreseeable future, string theory doesn’t even qualify as science. It is “not even wrong”. Its scientific validity cannot be evaluated because it is not presented coherently enough to be empirically meaningful. Author Thomas Harris, while not an authority, has nevertheless put it best when he wrote that string theory is a series of “equations that begin brilliantly and end in wishful thinking”. Probably the only reason it still exists in physics departments is that there’s a small hard core of people who are simply unwilling to admit that they’ve been chasing a fantasy, combined with the fact that people are still willing to shell out grant money for string theory “research”.

    If you want better pop sci books than what Greene writes, consider these:

    http://www.amazon.com/dp/0465092756/

    http://www.amazon.com/dp/061891868X/

    Even better, don’t read pop sci books at all. They’re not much of a step up from arXiv articles when it comes to the scientific rigor of most of the claims being made. The good ones are few and far between, and reading most of them will rot your brain. Especially theoretical physics ones, which almost as a rule mischaracterize the science, and seek to persuade rather than inform.

  26. yeahsurewhatever says:

    Erratum:

    “hopefully -1 <= w = -1″ shold read “hopefully -1 <= w < -1/3″.

  27. yeahsurewhatever says:

    Actually, that whole thing should read “hopefully -1 <= w = -1, but that’s not important here.”

    Don’t know how it got so messed up in the paste. I’m pasting from a notepad window, not a website, just to be clear. This is not coming from somewhere else.

  28. yeahsurewhatever says:

    Okay, I can’t paste the end of that paragraph for whatever reason.

    This is what it should say:

    http://img171.imageshack.us/my.php?image=itsaysthisui5.png

  29. yeahsurewhatever says:

    You know what, it’s because it interpreted it as HTML tags. It removed everything between the less-than and the greater-than. It’s all WordPress’ fault.

  30. Jules says:

    @ yeahsurewhatever:

    If I gave you the impression that Greene’s book pins the universe’s expansion on repulsive gravity and the Higgs’ field, that’s my mistake: he does go on later to elaborate upon the effects of dark energy and dark matter (but that particular chapter only dealt with the Higgs field). I was paraphrasing, not quoting, and of course I’m going to leave out a lot of the points that lead up to the punch line, and everything else that follows.

    I’m aware that string theory is “out” (for now? hard to say), and that there have always been limitations to it, as there are for any theory. I actually stopped reading The Fabric of the Cosmos when he started seriously talking about string theory, because every other line was, “Well, we don’t really know this for sure”–a big letdown from the surety with which he described special/general relativity and funky quantum experiments.

    Wholeheartedly agree that most books in general are crap. But how else are scientists supposed to impress upon the public (and the elite public, at that–you don’t see high school dropouts carrying around The Selfish Gene in their pants pockets) the nature of their research, and its importance?

  31. Calli Arcale says:

    I remember someone pointing out to me back in 2005 that, within a few months of each other, President Dubya first publicly said “the jury is still out” on evolution, and then he suggested that avian influenza H5N1 represented a significant treat to humanity because it might EVOLVE from being mainly zoonotic to being highly infectious from person-to-person. But apparently the jury is still out in his opinion, even today.

    If you hang out around Creationists very often, you’ll discover that some of the more sophisticated ones ascribe to what they call “microevolution” but not “macroevolution” — that is, they accept (because it’s so bloody obvious, quite frankly) that organisms can change quite dramatically within a species, but deny that speciation can occur. The usual problem, I think, is that they overestimate the differences between species, and they certainly overestimate the “species barrier”.

  32. Chris Noble says:

    A high proportion of HIV denialists embrace the neo-bechampian style of germ theory denial. Some of them think that bacteria and viruses exist but don’t do anything unless the ‘terrain’ is weakened, some think that bacteria and viruses are just the signs of illness and not the cause and some deny the existence of them altogether.

    These people also seem to be able to live in the same woo-space as the Denialists who claim that HIV doesn’t cause AIDS because it doesn’t fulfil Koch’s postulates

  33. khiggens says:

    I’m humbled by the intellect I have discovered here on this site… what a shame it is accompanied by such closed minds, and I quote:

    “What these alternative therapies share is a lack of appreciation or understanding of germ theory. Since germs cannot be seen, and since it is not germs but their alternative theory that causes disease, why would you expect alternative providers to behave as if germs exist? The result of believing that germs do not exist is infections. The germs will always win.

    Acupuncture and Infections

    Acupuncture is unique compared to most alternative practices in that it is invasive and because acupuncturists actually do something to accomplish nothing. ”

    Mr Crislip… is there a small chance you are being a tinsy bit hypocritical?

    “acupuncturists actually do something to accomplish nothing” and “alternative therapies share a lack of appreciation or understanding of germ theory”

    Me thinks some people are so much up their own botties they start talking out of them! :-)

  34. Mark Crislip says:

    whether or not I am a hypocrite, I cannot say, but evidently I am dense.

    I am not certain what you are trying to say in your comment. I will note that I have never seen an ad for acupuncture where gloves are worn by the practitioner. be that as it may, could you spell it out for me?

    However, when the issue of open minded is raised in the blog, I am forever going to reply: watch the video.

    http://scienceblogs.com/worldsfair/2009/04/pseudoscience_and_its_flawed_m.php

  35. khiggens says:

    I am not suggesting you are dense… the hypocritical comment you made referred to the following two comments:

    “acupuncturists actually do something to accomplish nothing” and “alternative therapies share a lack of appreciation or understanding of germ theory”

    I am most certainly not experienced in the world of acupuncture as I’m only in the process of a 2 out of 4 year qualitifcation and there would be others far better qualified than me… to be honest I haven’t even got to use a needle yet as we have been busy learning the theory behind it all up to this point.

    With regards to wearing gloves… it is not that I don’t believe in the germ theory because I do but I hope you never will see acupuncturists wearing gloves. Touch is an extremely important element of what we do. Have you ever seen a masseur wearing gloves? We need to palpate and feel what we are doing and that doesn’t just refer to feeling for anatomical structures… the acupuncture points themselves can produce very strong sensations but only to a refined touch trained to listen. It’s not magic or gobledegook (I don’t know how to spell that word). I feel it myself often as we practice touch along with psychoilogy, anatomy and pathology (both western (from the Royal College of Orthoeadic Surgeons) and eastern).

    I would say that ever single practitioner and teacher I have ever seen or heard has stressed the importance of hygience and safety… it is not taken lightly. The washing of hands with surgical liquids is practiced without fail.

    With regards to acupuncture accomplishing nothing… if I thought that was the case through my many observations and personal experiences to date I most certainly would not be paying to have my daughter treated in this fashion – it improves her quality of life no end and I have seen it do the same for others.

    I will watch the video but right now I am emersed in a psychiology project which is due and then I have a research project which requires my attention.

    I hope I did not offend… it is not my intention to insinuate that what you do is not of importance – I have been searching for scientific evidence of acupuncture on the internet and I was rather appalled and shocked by the amount of people out there who are so quick to slander and belittle that which they quite obviously have no understanding of whatsoever.

    Happy germ hunting.

  36. Dr Benway says:

    I don’t mind sharing personal observation myself, although I must warn that I’m easily fooled.

    There’s a BDSM fair in Boston annually. I went once years ago. Saw some people being playfully whipped and a lot of interesting haberdashery.

    The intensification of trust needed to allow someone to do something a little unpleasant to one’s body can be calming and even pleasurable. Some name this experience, “masochism.” But that word fails to capture the caring between the top and the bottom that must be present for the whole thing to work.

    It’s possible that the trust and touching of acupuncture are mildly pleasurable for patients wired more like bottoms than tops. If so, there’s nothing special about the needles, the meridian lines or the chi. Any manual therapy that puts the patient in a passive state should be as effective. Which, I believe, is what the research shows.

    Sham acupuncture is as good as real acupuncture.

  37. Mark Crislip says:

    sorry, I do not see hypocrisy:

    Hypocrisy (or the state of being a hypocrite) is the act of preaching a certain belief, religion or way of life, but not, in fact, holding these same virtues oneself.

    “I thought that was the case through my many observations and personal experiences to date”

    If there is an overarching theme in this blog, it is that this is profoundly flawed way to determine the value of a theraputic intervention.

    the more patient and doctor bias is removed, the less acupuncture and other cam modalities work, until you remove all bis and you lose all efficacy.

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