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The Dull-Man Law

Kimball Atwood is obviously trying to throw mud at Harvard and at homeopathy, but when you throw mud, you get dirty…

(Sigh) So little time, so much misinformation. Hence the Dull-Man Law:

In any discussion involving science or medicine, being Dana Ullman loses you the argument immediately…and gets you laughed out of the room.

This will be the last time that I don’t invoke that law, because it is the perfect opportunity to explain why it is such a useful shortcut. The occasion is the current series about my alma mater, Harvard Medical School (HMS), and its regrettable dalliances with quackery.† The series consists mostly of correspondence that occurred between Dean Daniel Federman and me in 2002. Some of it refers to homeopathy.*

Mr. Ullman, a self-styled expert on homeopathy who lacks any medical training, is a darling of the ‘integrative medicine’ movement, as explained here. He has posted several comments objecting to my assertions in the HMS series. Other commenters have skillfully refuted some of his arguments. Some have been left unchallenged, however, and a naive reader might therefore assume that they are valid. They are not, but explaining why takes time and a modest acquaintance with the topic. Other than to clarify the issues for the uninitiated, then, such time would be wasted. Henceforth, let it not be so: From now on, this post can be cited by anyone wanting to avoid the drudgery of refuting Mr. Ullman’s claims.

First, this comment by Mr. Ullman:

One cannot help but notice how little research is referenced.

Ullman then cited Linde, Clausius, Ramirez, Jonas et al., (1997), Jonas, Kaptchuk, Linde (2003), Jacobs, Jonas et al (2003), and later the David Reilly series on allergic rhinitis, implying that I’d missed the boat by failing to cite these wonderful papers. Regarding the Linde/Jonas 1997 review, whose conclusion had been, “The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo,” Mr. Ullman wrote:

Even a leading skeptic who wrote an editorial in this issue of the Lancet referred to this meta-analysis as “completely state of the art.” No other meta-analysis on homeopathy has been acclaimed by both sides of the fence.

Ullman must have overlooked this statement in my post:

Much of the content of [the homeopathy] treatise has been covered by the series on homeopathy with which I began my stint here on SBM, so here I’ll post only the parts relevant to promotions by academic physicians, including those at Harvard.

That series (and my entire essay for Dr. Federman) covered, among other reports, the Linde/Jonas 1997 meta-analysis, the 1994 Jacobs childhood diarrhea paper, and the Reilly allergic rhinitis series. It showed that each of these projects has not survived methodologic scrutiny. Several re-analyses of the Linde/Jonas 1997 data, in particular, have demonstrated that they were, well, compatible with the clinical effects of homeopathy being completely due to placebo. Two of those re-analyses were done by Linde and Jonas themselves (!), a point that Mr. Ullman failed to make. Either he knows this (in which case his comment was dishonest) or he does not (in which case he relinquishes his claim to being an expert on the topic).

But wait a minute: Ullman must know these things, because this was only one of several times that he has graced the comments of this blog with his sophistry, including responses to my previous citings of…Linde/Jonas 1997, Jacobs 1994, and Reilly’s allergic rhinitis series. I answered him there in some detail, as did other commenters, and I enlarged on that answer in the post that followed. Mr. Ullman might also consider that in 2002, when I wrote to Dr. Federman at HMS, I could not have cited papers published in 2003—not that it matters, for reasons previously explained.

Atwood considers any comparison between homeopathy and vaccination to be inappropriate. And yet, it was none other than Emil Adolf von Behring (1854–1917) who was one of the early scientists to make this assertion. Behring broke from orthodox medical tradition by recognizing the value of the homeopathic law of similars:

And by what technical term could we more appropriately speak of this influence [ie, smallpox vaccination], exerted by a similar virus than by Hahnemann’s word “homeopathy”?

What I wrote was: “the vaccine analogy is erroneous.” That is correct: the active ingredient in a vaccine is real, measurable, and works because its antigenicity, ie, its ability to elicit a specific immune response, is similar to that of the infectious agent that causes the disease in question—but not because of some fanciful ‘similarity’ of ‘symptom’ production. A vaccine’s dose, moreover, is determined by rational dose-reponse trials, and every competent physician and biologist knows that if it were diluted into non-existence its effect would also become non-existent.

The word “similar” above gives homeopaths an irresistible urge to claim some profound insight into immunology and pharmacology, but it does nothing of the sort. Even looked at solely from Ullman’s superficial, linguistic point of view, where his hero Behring also apparently stood—ignoring, that is, the molecular basis for the immune response and the absurdity of infinitesimals—the technical term most applicable to immunization is isopathy, not ”Hahnemann’s word ‘homeopathy’.” But then Ullman, in his Heinous Hyping of the Hogwash that is Homeopathy, regularly Appeals to Irrelevant Authority, including the Holy See itself.

Hahnemann, of course, knew nothing of the immune system (nor did anyone else at the time), and famously railed against anything that could have suggested even the possibility of infectious vectors. For Hahnemann, diseases were “purely dynamic deranging irritations of the vital force,” and “to regard those diseases that are not surgical as a peculiar distinct thing residing in the human frame is an absurdity which has rendered allopathy so pernicious.”

Ullman again:

Even the British Medical Journal (BMJ) named my website their “website of the week” on August 19-26, 2000.

Too bad for the British Medical Journal and for the level of scientific discourse in what now passes for academic medicine. That is the whole point of the HMS series and of Science-Based Medicine in general.

I was, however, surprised that you chose to make reference to a popular magazine (the Utne Reader) as some type of unimpeachable source…are you next going to quote the National Enquirer without fact-checking?…Ironically, the editor of FASEB also chose to use this same error of fact that was printed in this magazine…When I was granted the right of reply, I chose to reply to sustentative [sic] issues on homeopathy rather than specious personal attacks against me. I will simply say that the Utne Reader mis-reported and has appropriately withdrawn that story from their website.

Hmmm. The article in question appeared during the anthrax scare of 2001 that followed closely on the heels of ’9/11′. Its every statement is consistent with other claims by Ullman; several are direct quotations. That Ullman offered “homeopathic anthrax treatments” for sale on his website is corroborated here. What, then, is the “error of fact,” and how might I have “fact-checked” if, as he admits, he failed to explain it at the time? Does Ullman not really believe that homeopathic ‘nosodes’ can prevent or treat anthrax? If so, we’d love to hear it.

In a sidebar to the Utne Reader article is this:

Dosage

The pills used in homeopathic medicines can vary in size from an aspirin down to the size of poppy seeds. While Dana Ullman says it is generally recommended to take one to five pills per dose, the amount of dose changes depending on the size of pellets. If the pills are aspirin-sized, one or two should be taken per dose. If the pellets are poppy seed-sized, five pills should be taken per dose.–Kate Garsombke

Ah, perhaps that is the ‘error of fact’: surely, according to ‘potentization,’ Dana Ullman must have told Ms. Garsombke that the smaller the pill, the fewer should be taken. Otherwise the patient would risk an overdose.

Also, for the record, I was the [Utne Reader] health book reviewer about 15 years ago and have not held that position since then. It would be nice if you made a little effort in your own fact-checking.

OK, here was my fact-checking. I went to Mr. Ullman’s website, archived in 2002 (when I wrote what I wrote); I clicked on About Dana Ullman, MPH; I scrolled down to the very last paragraph, where I read:

Dana Ullman is the health book reviewer for the Utne Reader.

It must depend on what your definition of “is” is.

Atwood also made reference to Edward Chapman, MD, a homeopath who formerly was an instructor at Harvard. It might have been nice for you to have completed a little homework, for you would have discovered a trial that he conducted at a Harvard-affiliated hospital…

I am well aware of Chapman’s report on “Homeopathic Treatment of Mild Traumatic Brain Injury,” yet another example of a silly, small clinical trial being incompatible with how the universe works, and thus another embarrassment to Harvard Medical School and to academic medicine in general.

Regarding homework, if Mr. Ullman had done his own he might have discovered this entry in a 2003 press release from the Massachusetts Board of Medicine:

In the first matter, in a Final Decision and Order, the Board revoked the medical license of Dr. Edward H. Chapman, a board-certified family practitioner from Newton. The Board found that Dr. Chapman had engaged in numerous boundary violations with two patients and had engaged in conduct that calls into question his competence to practice medicine. The Board also concluded that Dr. Chapman was guilty of malpractice and of conduct that undermines public confidence in the integrity of the medical profession. The revocation will go into effect on August 15, 2003, to allow for appropriate termination and transfer of patients. Prior to that date, Dr. Chapman’s practice will be subject to the terms of a monitoring agreement.

Ouch. (Funny: Harvard Medical School didn’t mention that, either.)

Finally, I am forever amazed that Atwood uses O.W. Holmes as his hero. My comments about his unscientific attitude towards homeopathy and his questionable ethics were previously provided in Part II of your recent series on Harvard.

Oliver Wendell Holmes, Sr. (the father of the Supreme Court Justice) is a hero of the Harvard Medical School, of American medicine, and of the human race as a whole, for numerous reasons. The most important is that he proposed, even prior to Ignaz Semmelweis, that puerperal fever was contagious. He published his paper on the topic in 1843 when, according to Mr. Ullman, he shouldn’t have been taken seriously because “he was a medical ‘adolescent’.” His public lecture of the prior year, “Homeopathy and its Kindred Delusions,” was a systematic dismantling of the tenets of homeopathy (as promulgated by Hahnemann himself), and was as scientific as current knowledge allowed in its criticism of the utterly unscientific homeopathy. It still stands as an eloquent, learned criticism, although it was composed prior to an understanding of Avagadro’s number, modern biochemistry, physiology, pharmacology, microbiology, genetics, diagnostics, and everything else that would propel medicine into the modern era.

In the just-linked comment, Ullman repeatedly referred to the “errors” in Holmes’s homeopathy lecture, but the only example he gave was this:

Dr. Holmes got his calculations confused, and he incorrectly assumed that the homeopathic manufacturer had to have 10 times or 100 times more water than in the previous dilution. Dr. Holmes estimated that the ninth dilution would require ten billion gallons of water and the seventeenth dilution required a quantity equal to 10,000 Adriatic Seas.

Well, OK, let’s see exactly what Holmes wrote (emphasis added):

So much ridicule has been thrown upon the pretended powers of the minute doses that I shall only touch upon this point for the purpose of conveying, by illustrations, some shadow of ideas far transcending the powers of the imagination to realize. It must be remembered that these comparisons are not matters susceptible of dispute, being founded on simple arithmetical computations, level to the capacity of any intelligent schoolboy. A person who once wrote a very small pamphlet made some show of objecting to calculations of this kind, on the ground that the highest dilutions could easily be made with a few ounces of alcohol. But he should have remembered that at every successive dilution he lays aside or throws away ninety-nine hundredths of the fluid on which he is operating, and that, although he begins with a drop, he only prepares a millionth, billionth, trillionth, and similar fractions of it, all of which, added together, would constitute but a vastly minute portion of the drop with which he began. But now let us suppose we take one single drop of the Tincture of Camomile, and that the whole of this were to be carried through the common series of dilutions.

A calculation nearly like the following was made by Dr. Panvini, and may be readily followed in its essential particulars by any one who chooses.

For the first dilution it would take 100 drops of alcohol.

For the second dilution it would take 10,000 drops, or about a pint.

For the third dilution it would take 100 pints.

For the fourth dilution it would take 10,000 pints, or more than 1,000 gallons, and so on to the ninth dilution, which would take ten billion gallons, which he computed would fill the basin of Lake Agnano, a body of water two miles in circumference. The twelfth dilution would of course fill a million such lakes. By the time the seventeenth degree of dilution should be reached, the alcohol required would equal in quantity the waters of ten thousand Adriatic seas. Trifling errors must be expected, but they are as likely to be on one side as the other, and any little matter like Lake Superior or the Caspian would be but a drop in the bucket.

Swallowers of globules, one of your little pellets, moistened in the mingled waves of one million lakes of alcohol, each two miles in circumference, with which had been blended that one drop of Tincture of Camomile, would be of precisely the strength recommended for that medicine in your favorite Jahr’s Manual, against the most sudden, frightful, and fatal diseases!

Does Ullman not know the meaning of “let us suppose,” or that the subjunctive “were” refers to something that is not, in fact, the case? Ullman, unwittingly, is playing the same fool for us as the “person who once wrote a very small pamphlet” played for Holmes. Holmes, of course, used the exercise to illustrate how implausible the ‘law of infinitesimals’ was, considering the vast improbability that the original, “active” ingredient could exert any effect, much less a ‘potentized’ one, when the “seventeenth degree of dilution” was the equivalent of it having been dropped into a quantity of water the volume of “ten thousand Adriatic seas.” In the years before Avagadro’s number was known, this was about as rational and rigorous a critique of homeopathic ‘infinitesimals’ as one could hope to find. It is Ullman who has made incorrect assumptions, and in so doing has betrayed his inability to decipher well-written English.

Ullman’s claim that Holmes was a racist (at a time when nearly all white Americans were), whether true or not, is obviously irrelevant to Holmes’s or anyone else’s arguments against homeopathy, as are Ullman’s implications that 19th century homeopaths were somehow politically progressive in the late 20th century sense.

The above is more than enough to justify the Dull-Man Law, but here’s the dessert:

I don’t know why my name would be a part of any writing you may do on Harvard. If you are getting your information from wikipedia, you are not standing on firm ground (wikipedia is notorious for not having reliable information). If veritas is your goal, my name should not have any role in an article about Harvard because I have no affiliation with them, and the one short affiliation that I had was one which can be described as extremely tangenial at best.

I didn’t get my information from Wikipedia; I got it from Mr. Ullman himself:

Dana Ullman has served as an instructor in a course on homeopathy at the University of California at San Francisco for three years. He will also be a member of the Advisory Council of the Alternative Medicine Center at Columbia University’s College of Physicians and Surgeons and is a consultant to Harvard Medical School’s Center to Assess Alternative Therapy for Chronic Illness.

There’s that old ‘is’ word again. Is Mr. Ullman now confessing that he, er, exaggerated his affiliation with Man’s Best Medical School?

Ergo,

In any discussion involving science or medicine, being Dana Ullman loses you the argument immediately…and gets you laughed out of the room.

Q.E.D.

……………………..

†The Harvard Medical School series:

  1. Dummy Medicine, Dummy Doctors, and a Dummy Degree, Part 2.3: Harvard Medical School and the Curious Case of Ted Kaptchuk, OMD (concluded)

………………………

* The Homeopathy Series:

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

Posted in: Health Fraud, Homeopathy, Humor, Medical Academia, Science and Medicine

Leave a Comment (106) ↓

106 thoughts on “The Dull-Man Law

  1. David Gorski says:

    In any discussion involving science or medicine, being Dana Ullman loses you the argument immediately…and gets you laughed out of the room.

    But what does citing Dana Ullman get you? :-)

  2. sowellfan says:

    Very nice takedown. I think this will be very useful to link to in the future.

  3. But what does citing Dana Ullman get you?

    That depends on what your definition of “is” is.

  4. Joe says:

    David Gorski on 10 Apr 2009 at 3:00 pm “But what does citing Dana Ullman get you? :-)”

    Membership in the “What the @%*! do I Know” brigade?”

  5. David Gorski says:
    But what does citing Dana Ullman get you

    That depends on what your definition of “is” is.

    Don’t you mean it depends on what your definition of “does” is?

    I forgot to comment on this bit of yours from the post:

    Ullman’s claim that Holmes was a racist (at a time when nearly all white Americans were), whether true or not, is obviously irrelevant to Holmes’s or anyone else’s arguments against homeopathy, as are Ullman’s implications that 19th century homeopaths were somehow politically progressive in the late 20th century sense.

    This is the same gambit creationists use against Charles Darwin, some of whose views by today’s standards strike us as racist but who by the standards of his time was actually far less racist than the vast majority of Englishmen.

  6. Karl Withakay says:

    Another great post.

    Behold the power of the Way Back Machine!
    Be warned, if you want to be indexed for search engines, you’re also going to get archived.

    >>> “But what does citing Dana Ullman get you?”

    That would depend whether you are citing him as an authoritative source or as a textbook example of wrongness and willful ignorance.

  7. Don’t you mean it depends on what your definition of “does” is?

    Stupid is as stupid does.

  8. yeahsurewhatever says:

    Why you shouldn’t waste time with people like Mr. Ullman.

    Woo-based theoretical physics books are just as popular as woo-based medicine. Anything with the word “quantum” in the title is guaranteed to sell. There is some overlap between physics and medicine in this “quantum” phenomenon, in the neighborhood of Deepak Chopra.

    So once upon a time, a not so gentle man in Brazil named Wladimir Guglinski wrote a book. You can easily Google for it. I dissected this book sentence-by-sentence, point-by-point, for over a year, and argued with him directly about it. He knows my name, and he fears it.

    The book has not even the slightest bit of scientific validity between its pages. None. He knows this. I know he knows this. I had repeatedly gotten him to do all but actually say the words. But he will never acknowledge it, and certainly not publicly.

    Towards the end he was reduced to rambling incoherently about being right because Einstein once said something about elephants (I’m not making this up).

    Mr. Ullman and Mr. Guglinski are only differentiable by their chosen flavor of crap, and the fact that one is currently more in vogue. But they’re not, by themselves, fooling a great many people, despite their PR claims. And in truth they’re not making a great deal of money at it either, and never will. Their flavors of crap as a whole defraud many and much money changes hands, but as individuals they see little of that action. Because they’re second-rate, and not smart enough to do better.

  9. Harry says:

    Dr. Atwood,

    +1 Internets to you sir!

  10. Infophile says:

    Interesting that Dana would bring up Wikipedia out of nowhere. He was banned from there last year. I wonder if it’s still smarting?

  11. gimpyblog says:

    Nice take down. DUllman is like the candyman of homeopathy, except you only have to mention his name once to bring him spamming your blog. The guy must have the most efficient Google Alerts set up of any quack.
    Actually the most curious thing about Dana is that to all intents and purposes he is indistinguishable from a conman taking advantage of homeopaths and their ilk. He does not practice homeopathy (he had an unfortunate run in with the law when a long haired hippy) he just sells products to homeopaths, often including tickets for events he has been given for free, and springs up all over the place hawking his books. If you wanted to take advantage of the gullibility of homeopaths to fleece them of their money then you would act exactly as Dana does.
    I almost admire him for this. Quack or criminal?

  12. Joe says:

    Infophile on 11 Apr 2009 at 1:13 am “Interesting that Dana would bring up Wikipedia out of nowhere. He was banned from there last year. I wonder if it’s still smarting?”

    If he is as well-informed as you are, he probably went to a chiropractor to take advantage of their great healing powers.

  13. overshoot says:

    Quack or criminal?

    False dichotomy.

  14. storkdok says:

    Nice takedown! I’m learning a lot from your series.

  15. Joe says:

    DullMan wrote “when you throw mud, you get dirty.”

    Does anyone else find that as funny as I do?

  16. Prometheus says:

    Outstanding post, Dr. Atwood! You have – once again – defeated Mr. Ullman in detail.

    I doubt that this will dissuade Mr. Ullman or the myriad other apologists for homepathy. Their faith is made of sterner stuff. For that matter, many of them make a good living providing over-priced water and sugar pills to the gullible and the worried well. Such a lucrative “faith” is hard to quench.

    I appreciate that you are not trying to “convert” the homeopathological faithful, but are speaking to those who are still capable of being reached, whose minds are not yet closed.

    I, too, find it disturbing that so many of our universities have elected to give their marketing departments priority over their obligation to provide quality medical care. My own university some years ago opened an “Integrative Health Clinic” in response to a perceived “community need” – or was it a perceived “market”?

    Medicine, sadly, is not the practice of giving people what they want but what they need – which are often two very distinct things.

    If doctors are to provide homeopathy, chiropractic, naturopathy and “energy healing” simply because the patients want it, why are they not handing out opiates and amphetamines to people who want those as well?

    Isn’t there an inherent contradiction in saying that giving a heroine addict unlimited access to clean, pure, sterile morphine is wrong and giving a patient access to “supervised” homeopathy is right?

    In both cases, the patient is merely asking for something they want and that they feel will fulfill their medical needs. Why is it that we feel that providing pharmaceuticals on demand is “bad” and yet providing pseudo-medical care on demand is “good”?

    If the answer is that the “alternative” therapies are all placebos and are unlikely to harm (or help) anybody, why are the hospitals using them? Also, is it ethical for the hospital to charge for them if they are known to be useless?

    A treatment that we know is useless is a placebo and giving a patient a placebo – outside of a defined research protocol where the patient is aware they might receive a placebo – is not ethical. Charging for placebo treatment is also not ethical.

    Of course, the marketing department doesn’t deal in ethics, just money.

    Prometheus

  17. DanaUllman says:

    Your smugness in everything you write is classic. It is almost as though you think that just because you write something, it is true. Sadly, your smugness dis-ables you from maintaining a truly scientific mindset…and yet, you smugly think that everybody else is “wrong,” except you and your small group of fundamentalists.

    Heck, you ever assert that that British Medical Journal AND academic medicine is unworthy. I am obviously in good company. Thank you!

    You wrote: Ullman then cited Linde, Clausius, Ramirez, Jonas et al., (1997), Jonas, Kaptchuk, Linde (2003), Jacobs, Jonas et al (2003), and later the David Reilly series on allergic rhinitis, implying that I’d missed the boat by failing to cite these wonderful papers. Regarding the Linde/Jonas 1997 review, whose conclusion had been, “The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo.”

    And yet, Linde (1997) found that there was a 2.45 times (!) greater effect from homeopathic treatment vs. placebo…thus, his 1999 article which asserted that the effect from newer studies reduced this effect, and yet, he never said that new studies made erased effect… Show me the specific statement in which you think he said this (it doesn’t exist).

    Interestingly, you chose to not cite any GOOD criticisms of Reilly’s 4 studies and Jacobs’ 3 studies.

    Show me where a “critique” of David Reilly’s studies have been published…and please (!) don’t refer me to one of your silly non-peer review blogs. Please reference a peer-review journal…and to maintain YOUR standards, please refer me to a high impact journal’s article.

    Even Jacbos’ diarrhea studies stand, though your buddy Wallace Sampson made numerous ridiculous criticisms of her 1st study (he actually asserted that despite randomization of patients that showed no statistically significant differences, he wanted each patient who was given a different homeopathic medicine to be randomized according to the medicine that they were given into treatment or placebo groups…as though this could or would change something).

    Show me which high impact journal published a critique of Jacobs’ meta-analysis of 3 studies?

    You choose to split hairs between “homeopathy” and “isopathy” but homeopaths use BOTH…and most important, both use the potentized medicine. Please do not fret over isopathy because your real issue with it and homeopathy is the potentized dose. Please don’t pull a “James Randi” act of mis-direction.

    Finally, just having all of your friends gang up on me or just by yelling louder does NOT make your voice stronger and more true.

  18. Dr Benway says:

    Ceiling cat say:

    Dis post no haz homeopathic dose uf wurds. Moar liek homeopathetic, LOL!

    We noes it: homeopathy iz water.

    Lurk moar, dullman.

    Kthxbai!

  19. Karl Withakay says:

    Your smugness in everything you write is classic. It is almost as though you think that just because you write something, it is true. Sadly, your smugness dis-ables you from maintaining a truly scientific mindset…and yet, you smugly think that everybody else is “wrong,” except you and your small group of fundamentalists.

    Dana,
    Please step away from the mirror.

    Pot to kettle, pot to kettle……I have a message for you…..

  20. David Gorski says:

    Sadly, your smugness dis-ables you from maintaining a truly scientific mindset

    Is “dis-ables” anything like “dis-ease”? :-)

  21. Karl Withakay says:

    What’s an “aster”?
    I’d like to know so I can properly understand what a “dis-aster” is.

    dis-tance
    dis-cord
    dis-sent (Polite or otherwise)
    dis-hwater

    This is fun…

  22. weing says:

    I got at least 2. dis-aster, bad star. Ties in with astrology. dis-cord would be bad heart. dissent, bad feeling. Dis-hwater it too tough.

  23. Joe says:

    I guess one should not dis homeopathy.

  24. DanaUllman says:

    Good ones, gents…but you proved my point by providing misdirection (again). Rather than respond in a substantative way, you instead choose to dis-engage with silly dis-sing (see, anyone can write silly things…but what is your response to the real issues I raised?).

    As for smugness, I am an advocate of “integrative health care.” There’s nothing smug about taking the best of all worlds.

    In comparison, you “dis-tance” yourself from anything other than conventional Rx, even though so much of that is not evidence-based.

  25. Zetetic says:

    D.Ullman’s eloquent justifications for impossible hypotheses using gross misinterpretations of theoretical quantum physics is not a new game. Look up the web site of Dr. Robert Sungenis, PhD. In particular, take gander at his web pages about geocentrism!

  26. Karl Withakay says:

    >>>”Rather than respond in a substantative way, you instead choose to dis-engage with silly dis-sing (see, anyone can write silly things…but what is your response to the real issues I raised?).”

    We know you can write silly things, we’ve seen you write many number silly things here, one of which was YOUR use of “dis-ables”, so….you started it.

    You also fail to appreciate the cosmic scale of the irony in your entire, “Your smugness in everything you write is classic…..” statement

  27. DanaUllman says:

    I am many things…but I am not smug.

    As for “impossibilities,” please simply do a little homework and read about hormesis (low dose effects). You might even surprise yourself at the depth and breadth of this literature AND at the power of exceedingly small doses of certain substances on certain systems, for as Kepler once said, “Nature uses as little as possible of everything.”

    You might even become a bit more humble…

    I’m not smug, but I am an optimist (actually, a realistic optimist)

  28. Prometheus says:

    He still doesn’t get it…

    As for “impossibilities,” please simply do a little homework and read about hormesis (low dose effects).

    Yes, we know about hormesis – and even hormesis involves concentrations/doses that are unimaginably larger than those encountered in homeopathy.

    You are aware, aren’t you, Mr. Ullman, that homeopathic remedies have a less than one in a billion chance of containing so much as one single molecule of the “active” ingredient?

    That’s why I said “unimaginably larger”, since division by zero is undefined.

    I’ll agree that you’re not smug – you are, however, consumed by the arrogance of ignorance. If you would spend a little more time trying to comprehend why people on this ‘blog (and elsewhere) don’t agree with you, you might learn something.

    Or not – it’s hard to break a habit of years.

    Prometheus

  29. pmoran says:

    “Interestingly, you chose to not cite any GOOD criticisms of Reilly’s 4 studies and Jacobs’ 3 studies. ”

    (Mr Ullman, I also cringe at name-calling and ridicule in a supposed science-based forum. I am sure some of the others here will feel the same way. )

    Nevertheless you don’t yet fully understand our position and may not for a long time yet, or never.

    We don’t have to be able to find obvious fault with every positive study to be holding the view that homeopathy is an excellent placebo, based upon bunkum. That conclusion is based upon knowledge from many sources. Some seriously contradicts the core principles of homeopathy. Some fully explains why homeopaths like you can be so sure the methods have intrinsic medical activity when they have no reason to. Some explains why outlying positive results can be legitimately given much less weight than at least equally prevalent negative ones.

    This is the big picture. You seem to be able to see only the micro one.

    Re the studies, we medical skeptics are very easily drawn into preening our scientific feathers. We will go into excruciating detail about all the possible faults in scientific studies. But this should not be interpreted as meaning that any apparently good quality studies (as I admit Reilly’s seem to be to me) have to be accepted as showing real effects.

    Some will supply false positive results merely by chance.

    We can also never know for sure from the published material that everything has been done with the rigor described. It is so easy to find reasons for excluding a few patients, and conscious and unconscious manipulations of data have been found to be more prevalent than we once thought even within previously trusted hands.

    Also, no one else has been able to produce such consistent clinical results as Reilly’s, so that the test of replicability has not yet been fully reached. As it is, Reilly’s last study contains at least one serious unexplained conflict with the previous ones, as I pointed out in a previous post that you chose not to respond to.

    This last post of yours seems to be a blatant appeal to the authority of what is published in medical journals. I think neither my views nor your views can be regarded as invalid simply through not being echoed in the BMJ.

  30. pmoran says:

    Which reminds me of something,

    Mr Ullman, I am sure that even your own belief in homeopathy has little to do with the studies you produce. I suspect you believe homeopathy works because you have seen it work and you cannot see how you could possibly have been misled by the placebo and other non-specific influences of medical interactions.

    The thrust of present placebo research is that many of your observations may well have been valid. It is making hasty scientific deductions from them that can be faulted, especially if paranoid perceptions of the mainstream prevent you from accepting all that we have learnt the hard way about interpreting clinical observations.

    Peter Fisher (the Queen’s of England’s homeopath) in a similar bind when his major rheumatoid arthritis study gave negative results. He , perhaps also with some justification, was unable to entirely give up the evidence of his own eyes.

    He said (1) “Over these years we have come to believe that conventional RCTs [randomised controlled trials] are unlikely to capture the possible benefits of homeopathy . . . . It seems more important to define if homeopathists can genuinely control can genuinely control patients’ symptoms and less relevant to have concerns about whether this is due to a ‘genuine’ effect or to influencing the placebo response”.

    1: Rheumatology (Oxford) 2001 Sep;40(9): A randomized controlled trial of homeopathy in rheumatoid arthritis. Fisher P, Scott DL.

    (In that study the placebo performed statistically better than homeopathic remedies for pain at three months, confirming the the ease with which clinical studies can throw up meaningless “positives”.)

  31. DanaUllman says:

    pmoran…wow, finally, a person who is actually interested in conversing without silliness. Cool.

    I have known Peter Fisher for several decades, and he is a man FULL of integrity. He, like other homeopaths and those who research homeopathy, are honest people who are simply searching for truth and evidence of it.

    Just because this one trial was negative (and just because he has engaged in other negative trials too) doesn’t mean that “the body of evidence” for homeopathy is negative. Neither Peter or anyone I know simply bases his/her own beliefs on his/her own studies. Do YOU know anyone who does? If so, as they say, “I pity the fool.”

    As for Reilly’s allergy work, you seem to be familiar with a limited number of allergy studies because there are others that have found similar experiences as Reilly’s. The one trial (by Lewith, et al) that did not have a “positive” result did find that the homeopathic patients (vs the placebo patients) had a different ebb and flow of their symptoms (you HAVE to read the studies in detail, not just skim the abstracts, to uncover real truth, not just simplistic evaluations of a single primary result).

    And yes, I know the differences between homeopathy and hormesis, even though a large number of over-the-counter homeopathic medicines are IN the range of hormetic effects. THAT is why people who say that “homeopathy is hokum” are simplistic fools.

  32. Mojo says:

    Have you seen this?

  33. Dr Benway says:

    LOL, Mojo. “Nanopharmacology” sure sounds sciency!

  34. Mojo says:

    Oh, he’s been on about “nanopharmacology” for ages. What concerns me there, though, is the suggestion that homoeopathy is an appropriate treatment for head injuries such as Natasha Richardson’s. I’m not sure that’s so funny.

  35. David Gorski says:

    It’s not funny at all.

    Dana is utterly clueless about traumatic brain injury. An epidural hematoma, which is what Richardson died of, is not a “mild traumatic head injury.” In fact, her course was completely consistent with an epidural hematoma, and that’s what I and many others who are familiar with trauma thought she had. It turns out that’s what she, in fact, did have:

    http://www.webmd.com/brain/news/20090319/natasha-richardson-dies-of-epidural-hematoma

    Frequently in an epidural hematoma, there is a so-called “lucid interval,” where the victim seems perfectly fine and often will refuse medical care, thinking her injury not to be serious. As the blood continues to leak out of the injured artery, pressure builds up on the brain, leading to decreasing levels of consciousness and focal neurological signs (such as one dilated pupil).

    In the case of epidural hematomas that aren’t small and clearly stable in size, the only treatment that has a chance of saving the victim’s life and preserving neurological function as much as possible is surgical. Unless it is stable and very small, the hematoma must be drained. Indeed, an expanding epidural hematoma is a true surgical emergency. That’s what puzzled me: Why Richardson was apparently never operated on.

    In any case, homeopathy could not have done one thing to save Richardson’s life and implying that it could have is despicably idiotic. Only surgical steel could have.

  36. tmac57 says:

    “Homeopathic Medicines for Traumatic Head Injury “. Hmmm, sounds like someone has ‘water’ on the brain.

  37. Dr. Skeptizmo says:

    Dana-
    I would like the names of a few homeopathic remedies available OTC with actual measurable active ingredients please. Just for my own edification.

  38. Mojo says:

    I would like the names of a few homeopathic remedies available OTC with actual measurable active ingredients please.

    Well, Dana may claim that remedies that are not individualised (for example OTC remedies) are not really homoeopathy (“You still don’t get it. The “new” Jacobs trials tested a homeopathic combination medicine, where every treated child was given the same formula, as distinct from her previous THREE trials that tested individually chosen medicines for the kids.”).

    On the other hand, he might recommend them.

    Take your pick.

  39. Mojo says:

    Sorry, that last post should have included this link in the comment about Dana recommending non-individualised homoeopathic remedies:

    http://www.naturalnews.com/023595.html

    I evidently messed up the formatting again.

  40. Dr. Skeptizmo says:

    I was hoping he would fall into that trap that you mentioned Mojo! Dang you for springing it too early! *)

    He made an off the cuff remark, “a large number of over-the-counter homeopathic medicines are IN the range of hormetic effects” and I was hoping that he would give me that tired line about “real” homeopathy being individualized. Either that or he would give me a pedantic soliloquy and never answer the question.

    The question is still open though Dana. I would really be interested to know the specific compounds that you were referencing in your post- in a brief way if possible.

  41. Dr Benway says:

    Individualized homeopathy, LOL.

    “Ordinarily I’d prescribe a bit of water for people with your symptoms, Mrs. Jones. But you are unique in many ways. Therefore, for your condition, I recommend some water.”

  42. pmoran says:

    Resuming a discussion –.

    Dana> “Just because this one trial was negative (and just because he has engaged in other negative trials too) doesn’t mean that “the body of evidence” for homeopathy is negative. Neither Peter or anyone I know simply bases his/her own beliefs on his/her own studies. Do YOU know anyone who does? If so, as they say, “I pity the fool.””

    I am not sure what all this is supposed to mean.

    Surely when seeking vindication in clinical studies homeopaths choose to test treatments that they expect to work upon conditions that they expect to be responsive, those expectations being based upon the very same anecdotal experiences that justify their belief in homeopathy in the first place. Peter Fisher’s discomfort at his negative results attests to this. In fact he STILL believes the methods “work” , but he seems to be on the verge of allowing that any true benefits to patients are from placebo and other non-specific influences of medical attentions, which would remove most of the sources of conflict between homeopathy and real science.

    How close are you to following that logic? What effects do you observe that are outside the range of those observed with placebo/non-specific influences?

  43. DanaUllman says:

    Skeptisimo…duh…you’d think that you (and others) who spew venom on homeopathy would have “some” knowledge of it. Well, so much for being informed and so much for having a “scientific attitude.” Have you ever heard of the medicine Traumeel? It is a homeopathic formula…and the journal, CANCER, has published some research on it. Heck, there was just international news about it as a result of that Cochrane report…but heck, people here are antagonistic to “academic medicine,” to the BMJ, and now to the Cochrane.

    Check out the basic science research on the homeopathic formula “Canova.” I bet that all of the basic science research shows the power of “placebo.” You skeptics can be so so creative.

    I find it interesting that people here are also not even intrigued by the couple thousand (!) studies on hormesis. Follow the science (though, for interesting reasons, people here don’t like to do “homework” but prefer to spout doctrinaire credo and spew personal attacks.

    Pmoran’s comments are LOL. Your fantasies about Fisher are just that…your personal fantasies. They certainly have no basis in reality.

    As for others’ comments about water, is there SOMEONE here who is knowledgeable about water and its many mysteries? Get back to me when you have some credibility. In the meantime, I stand with Martin Chaplin, an expert on water. People here are standing on jello.

    And hey, what will you say WHEN studies show that homeopathic medicines (even in doses beyond Avogadro’s number) have an effect on genetic expression? Come on, say it.

  44. Aaron S. says:

    Ahh, just started this nice little page recently:

    http://en.wikipedia.org/wiki/User:Voice_of_All/General_Bullshit_Defense

  45. Aaron S. says:

    “Five patients on TRAUMEEL S had no stomatitis, compared to only one patient in the placebo group.”

    Just 5 vs 1 out of 32 people…hmmmm

    “The researchers conclude that additional studies are necessary to confirm these findings and are planning larger protocols to explore the efficacy of TRAUMEEL S in the treatment of adults experiencing chemotherapy-induced stomatitis. ( Cancer, Vol 92, No 3, pp 684-690, 2001) ”

    Gee, you think?

  46. pmoran says:

    “Pmoran’s comments are LOL. Your fantasies about Fisher are just that…your personal fantasies. They certainly have no basis in reality. ”

    This is the way you respond to anything that would rather not think about. I have quoted Fisher’s own words here.

    I also really do wish to understand what it is that stops you from entertaining even the possibility that the effects homeopaths observe in their patients are due to placebo and other non-specific influences. Whence this sense of inner conviction?

  47. Dr Benway says:

    As for others’ comments about water, is there SOMEONE here who is knowledgeable about water and its many mysteries?

    “Knowledgeable about mysteries,” hmm.

    Kids, this is what happens to your brain when you accept contradictory ideas without remaining mindful of the unresolved contradiction. Over time, the entire organ slowly turns to useless mush.

  48. Prometheus says:

    Mr. Ullman cites (indirectly) a study published in Cancer about the homeopathic remedy “Traumeel S”. In this study, there were 15 subjects in each “arm” (treatment and placebo) and 5 of the 15 receiving “Traumeel S” did not develop stomatitis and only 1 in the placebo arm did not.

    Now, if you do a simple Chi Square, this looks very statistically significant (p less than 0.001). However, since one of the expected value was less than five, the Chi Square test is not valid.

    One way to get around this is to use the Chi Square with the Yates correction for continuity. This gives a p-value of 0.07 (the difference is NOT statistically significant).

    A better way is to use the Fisher Exact Probability Test, which gives a p-value of 0.17 (the difference is NOT statistically significant).

    Failure to use appropriate statistical tests is unfortunately very common, even in highly rated journals. I suspect this is because most researchers elect to use statistical software packages and fail to consult a real statistical expert prior to making their calculations.

    So, what Mr. Ullman has shown is that – despite the erroneous report of statistical significance – the homeopathic remedy “Truameel S” is no better than placebo in this study.

    Perhaps if larger numbers were used, the true efficacy of “Traumeel S” could be discovered.

    It is also worth mentioning that “Traumeel S” is not a “homeopathic” remedy in the usual sense of the word. Looking at the manufacturer’s website, most of the components are at “1X” (i.e. 10%) dilution. If it were to be effective, this would not support either the “Law of Infinitesimals” (i.e. that more dilute remedies are more potent) or the general concept of homeopathy.

    In fact, “Traumeel S” is not more homeopathic than 1% hydrocortisone or 1% lidocaine.

    Prometheus

  49. Mojo says:

    It is also worth mentioning that “Traumeel S” is not a “homeopathic” remedy in the usual sense of the word. Looking at the manufacturer’s website, most of the components are at “1X” (i.e. 10%) dilution. If it were to be effective, this would not support either the “Law of Infinitesimals” (i.e. that more dilute remedies are more potent) or the general concept of homeopathy.

    If you think that’s not homeopathic in the usual sense of the word, you should see the other positive study the Cochrane review found:

    Pommier et al.: Phase III Randomized Trial of Calendula Officinalis Compared With Trolamine for the Prevention of Acute Dermatitis During Irradiation for Breast Cancer. Journal of Clinical Oncology, Vol 22, No 8 (April 15), 2004: pp. 1447-1453

    http://jco.ascopubs.org/cgi/content/full/22/8/1447

    Hint: try looking for any variant of the word “homeopathy”, or any mention of dilution, succussion, individualisation, or the “law of similars” in it.

  50. DanaUllman says:

    Homeopathic medicine is based on the “principle of similars” (also called resonance). Its founder, Hahnemann, took three decades (that’s right, 30 years) of utilizing the principle of similars before he began using the “high potencies” that many homeopaths today use.

    First and foremost, homeopathy is the principle of similars. The high potencies are simply Hahnemann’s and the millions of homeopaths since him who have found that the potentization process increases the benefits of the similiar principle (remember: there IS hypersensitivity from resonance…a very simply physics principle…also, a basic principle in music!).

    As for consider the possibility that homeopathic medicines could be placeboes, heck, I consider every day…and I also realize every day that this explanation is simply inadequate…and only the most simple-minded and inexperienced people would think that the placebo explanation is worthy.

    As for Peter Fisher’s words? What were his precise words and where did he write them? A reference and link is a reasonable request…

    All that said, I’m glad that people here have such respect for relatively low doses of botanical agents and other minerals that are in Traumeel and other homeopathic medicines. Once again, the body of evidence on hormesis and low-dose effect is quite substantial…and yet, ironically (again), people here seem to be quite proud of their ignorance on the subject.

    In the meantime, let’s all voice our support for the sale of homeopathic medicines that are not beyond Avogadro’s number because, as you all suggest, there is real medicine in them.

  51. pmoran says:

    Dana “As for consider the possibility that homeopathic medicines could be placeboes, heck, I consider every day…and I also realize every day that this explanation is simply inadequate…and only the most simple-minded and inexperienced people would think that the placebo explanation is worthy.”

    Thankyou for responding. Just what kind of phenomenon are you referring to, and how do they differ from those being tested for in the RCTs?

    Are you also n0t aware of innumerable instances throughout medical history where highly esteemed and extremely experienced doctors have been misled by therapeutic illusions of their various kinds? (Note that I am not here saying that such experiences may not be of genuine value to some patients –the first, but not necessarily the last, question for science is whether the agents being used have intrinsic medical activity. )

  52. pmoran says:

    Dana: “As for Peter Fisher’s words? What were his precise words and where did he write them? A reference and link is a reasonable request…”

    You have already forgotten this from me a few posts back?

    Quote

    Me> “Peter Fisher (the Queen’s of England’s homeopath) was in a similar bind when his major rheumatoid arthritis study gave negative results. He , perhaps also with some justification, was unable to entirely give up the evidence of his own eyes.

    He said (1) “Over these years we have come to believe that conventional RCTs [randomised controlled trials] are unlikely to capture the possible benefits of homeopathy . . . . It seems more important to define if homeopathists can genuinely control patients’ symptoms and less relevant to have concerns about whether this is due to a ‘genuine’ effect or to influencing the placebo response”.

    1: Rheumatology (Oxford) 2001 Sep;40(9): A randomized controlled trial of homeopathy in rheumatoid arthritis. Fisher P, Scott DL.

    (In that study the placebo performed statistically better than homeopathic remedies for pain at three months, confirming the the ease with which clinical studies can throw up meaningless “positives”.)”

    End quote

    Within limits I can actually agree with Fisher, since it is likely that in various parts of the world homeopathy is satisfying some of the needs that people bring into medical interactions, mainly when there is no “working better than placebo” EBM treatment available.

  53. DanaUllman says:

    Pmoran has absolutely no understanding of homeopathy or Peter Fisher because you consistently misrepresent them both.

    If that is the best you got for your above statement, you’ve got nothing.

    Are you now going to call all surgery “quackery” just because there are an inadequate number of double-blind placebo controlled trials? Are you now going to insist that no insurance companies or government cover any of their expenses?

    Your double standard is showing…

  54. Eric Jackson says:

    Last I heard, resonance involved waves propagating through media, electromagnetic waves, generally physical objects oscillating. What exactly’s oscillating here?

    Let’s see, in your last few comments you have:

    Advanced claims about Traumeel, citing a study study that is statistically weak, with a small number of members, did not show statistical significance, and used Traumeel, which if I’ve followed up on correctly is an extract from several plant species (http://www.cancer.gov/Templates/drugdictionary.aspx?CdrID=360844) several of which are known to have a wide variety of biologically active alkaloids. In the trial it was used in a 10% solution, a range where it is more than any of these active alkaloids could have been, and likely were at biologically active concentrations.

    And then accused the community here of not doing their homeworl. Yeah.

    Then you accused Pmoran of making up fantasies about Fisher, then implied he made it up, then when shown a direct, sourced quote with context and accused him of misrepresentation.

  55. Joe says:

    DanaUllmanon 28 Apr 2009 at 12:05 am “pmoran is a mean, mean meanie!”

    Fixed that for you.

  56. Aaron S. says:

    @Prometheus:
    Yeah, I was suspecting the dilution level would be higher than infinitesimal nonsense if it did have any effect. So the 10% figure is not a surprise. The fact the people try to equivocate on the dilution level to “prove” homeopathy is equally unsurprising…just the same old sophistry.

  57. Dr Benway says:

    dullman is fond of the “reset” gambit:

    Dullman makes dodgy claim A.
    Reader refutes A effectively.
    Dullman seems not to notice. Makes dodgy claim B.
    Reader refutes B effectively.
    Dullman resets. He repeats dodgy claim A afresh.
    Reader points out that A has been refuted.
    Dullman offers a non-sequitur. Makes dodgy claims C, D, and E.

    Has the man every surrendered any refuted position?

    DISCLAIMER: What follows is personal association and not a clinical diagnosis.

    Dullman illustrates the “sliding of meanings” that’s typical of narcissistic personality disorder. Debate with persons with NPD isn’t productive. They are always correct. You are always incorrect.

    But even when not productive, debate can be fun in an experimental sort of way, if you find human behavior puzzling and interesting.

  58. weing says:

    Does anyone really expect him to admit that he is wrong about homeopathy? It appears he has way too much invested in being right. The way I see it, it would be a miracle if he ever abandoned it in favor of SBM.

  59. Eric Jackson says:

    Hm. That probably explain these:

    http://en.wikipedia.org/wiki/Talk:Homeopathy/Article_probation/Incidents#An_analysis_of_Mr._Ullman.27s_claims_as_to_studies

    http://en.wikipedia.org/wiki/Wikipedia:Requests_for_arbitration/Homeopathy

    Wikipedia may not be a great source for a lot of things, but they certainly do document abuse well.

  60. DanaUllman says:

    Let’s see…you folks insist that the BMJ is wrong because they have published studies verifying the efficacy of homeopathic medicines in the treatment of respiratory allergies (similar work was published in the Lancet).

    You insist that the Traumeel study that was published in “Cancer” and reviewed very positively by the Cochrane Report is wrong.

    You insist that “academic medicine” is wrong…and of course, everybody is wrong, except you.

    As for avoiding questions and answers…no one (!) has voiced knowledge of hormesis. Does anyone know anything about it (or not)? And once again, because a large number of homeopathic medicines sold in pharmacies and health food stores is in the low-dose range of the thousands of studies in hormesis, let’s all agree that THESE homeopathic medicines fit within your worldview.

    I have also previously posed a question that no one has yet to respond: What would you think if one or two or more homeopathic medicines in post-Avogadro’s number dose were found to have an influence on genetic expression? Would THAT be of interest? Come on…go on record…

  61. Karl Withakay says:

    “In the meantime, let’s all voice our support for the sale of homeopathic medicines that are not beyond Avogadro’s number because, as you all suggest, there is real medicine in them.”

    How about we voice our support for any medicine scientifically shown (in repeatable, high quality RCT’s) to be effective and safe.

    I don’t believe anyone but you suggested that just because something has real chemicals in it, that it should be supported.

    We suggest that it is plausible that so called homeopathic medications that contain actual chemicals beyond water may actually have an effect beyond placebo. If such a medication, labeled as homeopathic but containing measurable levels of active ingredients was found to be genuinely effective that would not in any way be a validation of homeopathy, succession, or the law of similars. It would only be a validation of the medicinal value of the chemicals in question.

  62. Karl Withakay says:

    “What would you think if one or two or more homeopathic medicines in post-Avogadro’s number dose were found to have an influence on genetic expression? Would THAT be of interest? Come on…go on record…”

    Please clarify a little. Are you asking what we would think if a homeopathic medicine that was unlikely to contain any molecules of the original substance based on the level of dilution and succession was shown to have an influence on genetic expression?

    Not that my thoughts carry any authoritative weight on the matter, but I’ll go on record and say if that was your question then the following is my response:

    I wouldn’t be the least bit surprised if a study showed that.

    I would, however, be surprised if it were a good quality study and it held up well to vigorous scientific review. I would be more surprised if it was independently repeated and verified to the point where science would be compelled to accept those findings.

    Maybe I’m off the mark in my understanding of the way you phrased the question, and you had something else in mind.

  63. Mojo says:

    @Dana:

    I have also previously posed a question that no one has yet to respond: What would you think if one or two or more homeopathic medicines in post-Avogadro’s number dose were found to have an influence on genetic expression? Would THAT be of interest? Come on…go on record…

    Where, and when, has a study showing this been published?

  64. Mojo says:

    Do you have another “bomb” to drop?

  65. weing says:

    What if the tooth fairy and the easter bunny were shown to have an influence on gene expression? Would you be interested in that?

  66. weing says:

    BTW,
    What’s the problem with hormesis? You can look up the literature on it if you want to. The truth is out there.

  67. Prometheus says:

    Quoth D. Ullman:

    All that said, I’m glad that people here have such respect for relatively low doses of botanical agents and other minerals that are in Traumeel and other homeopathic medicines. Once again, the body of evidence on hormesis and low-dose effect is quite substantial…and yet, ironically (again), people here seem to be quite proud of their ignorance on the subject.

    I don’t think Mr. Ullman got the point. Although “Traumeel S” was reported to have a statistically significant effect, proper statistical testing – using the data provided by the authors – shows that it did not show a statistically signficant effect. So, all of Mr. Ullman’s expostulations about the “effect” of this remedy are moot.

    It wasn’t shown to be effective.

    Now, if Mr. Ullman thinks this is a “slam” against the journal Cancer, he is equally wrong. There are a number of articles published each year in well-regarded journals – like Cancer – with methodological or statistical errors. Most of these are caught by readers, and later corrected by the authors. This one apparently was not.

    If Mr. Ullman is considering 4X (0.01%) and even 1X (10%) dilutions to be “homeopathic”, then his definition of “homeopathic” is eccentric at the least. By that definition, 1% hydrocotisone (2X) and 0.1 mg/ml glucagon (4X) are “homeopathic remedies”. I’m sure their manufacturers would be surprised to hear this.

    If Mr. Ullman is planning to expand “his” definition of homeopathy to include these concentrations, he will almost certainly find some that “work”, since this is the realm where real physiological effects are seen.

    Prometheus

  68. Eric Jackson says:

    Since this has become relevant I’ll quote Shoemaker’s Holiday in the above Wikipedia discussion relating to the ban:

    “While there is strong evidence of Ullman making systematic errors and grandiose claims, I do not believe that Ullman’s behaviour is evidence of intent to deceive. There is quite a bit of evidence to show that Ullman is simply very sloppy, and has an inflated opinion of his own abilities, which combined with the significant investment he’s made by having spent his entire adult life advocating for homeopathy, causes him to rate things that support his views much higher than he should, while rejecting anything that does not support his views as unimportant or insignificant. While this does mean that he probably genuinely believes what he says at the time, unfortunately, this causes him to be an unreliable source.

    “…prone to confabulation, creating false information that sounds like it might be true but evaporates when investigated.”

    I quote these, because they are specifically relevant to what we’re seeing here. The constant barrage of red herrings, the mischaracterization of present chemistry, biology and pharmacology, and the apparent inability to follow the discussion.

    A prime example here is the constant references to the study in Cancer, which Ullman presented as some sort of widespread vindication of homeopathic principals. It clearly is not that, it is clearly not statistically robust and the inability to reconcile what the study actually says, and how he is presenting it is a characteristic of this entire debate here.

  69. pmoran says:

    Yes, Eric, exactly what we are seeing here , especially the unresponsiveness on critical matters.

    .

  70. DanaUllman says:

    It is not simply I who thinks that the study in CANCER shows benefits from homeopathic medicines, but also that journal AND the Cochrane Report. But heck, you folks look down your noses at everyone, except yourselves. How convenient.

    And once again, homeopathy refers to the principle of similars, not “potentization.” As I have said before, potentization is only a method that increases the benefits of the principle of similars. Traumeel is a legally recognized homeopathic medicine. So, now you want to make up your own definitions of what homeopathy is and isn’t and make up your own laws too? You folks are scary.

    As for Shoemaker’s Holiday, his own POV is so fundamentalist, he has no credibility.

    And yes, there will be some research published showing genetic expression down-regulation, but closed minds won’t let anything in. Wow, what a scientific attitude…

  71. pmoran says:

    Dana, given the potential for artifact and contamination and random outcomes in biological research. and a history of similar, mostly unreproducible, positive results from Benveniste and others, it would be bloody astonishing if someone somewhere was not able to show modest statistical effects of homeopathic agents on gene expression in a study or two.

    It seems you just don’t get what we are trying to convey concerning well-proved pitfalls in biological research and the limited ability of the individual medical practitioner to assess the true worth of his methods. I suppose you must keep dodging these matters if you are to sustain entrenched beliefs.

    Another constant — if those studies ptoved negative you would find some way in which they do not reflect “true” homeopathy. That seems to be evolving as we speak.

  72. Karl Withakay says:

    Dana,
    “Traumeel is a legally recognized homeopathic medicine. ”

    Please provide support for this statement, state what government or legal entity has legally recognized it as such, and also provide the criteria for what is required for something to be “legally recognized” as homeopathic by said entity.

    Also, to repeat, if one or more certain remedies classified as homeopathic (atypical from most the vast majority of homeopathic remedies in their concentration) were shown to be effective beyond placebo, that in and of itself would not validate the principle of similars or any other principles of homeopathy, especially if such hypothetical effective homeopathic medicines constituted a fractional percentage of the sum total of homeopathic remedies among hundreds or thousands of others either not shown to be effective or shown to have no greater effect beyond palcebo.

  73. weing says:

    I think we can tell when a study is just a lot of stercus bovis. We don’t need the Cochrane review to tell us what to think. We are capable of making up our own minds.

  74. Aaron S. says:

    Perhaps this clinging to Homeopathy with plausible *sounding* (but false upon closer inspection) arguments is a sort of self-deception, what Dennet would call the Concorde Fallacy.

  75. Badly Shaved Monkey says:

    Dana

    “And once again, homeopathy refers to the principle of similars, not “potentization.””

    It would be refreshing if you did not assess our level of knowledge by your own low standards.

    I think I can say for any contributor here that we all know what “homeo” means, but that’s not really the point. What makes homeopathy’s claims particularly contentious is the use of remedies where inert carrier has replaced the allegedly active principle. But, this does not, by inference, vindicate the “Law” of Similars at non-zero concentrations where there is supposed biologically active principle still present.

    The Law of Similars is merely wrong, it’s the use of inert carrier as remedy that renders homeopathy actually ridiculous.

    You are conflating two different propositions. Homeopathy, as practised, needs evidence for two different claims.

    Tests of content-free remedy test the principle of dilution. These are overwhelmingly negative apart from the statistical noise in the margins that is only to be expected.

    I am unaware of any high-quality tests of the “Law” of Similars. These would need to state a clear hypothesis invoking that “law” and establish an appropriate control group. Tests of products labelled as “homeopathic” for marketing purposes but not giving according to good homeopathic doctrine do not count. It is curious that you wish to cite Traumeel as an example of this. Can you cite a reference for its “proving” against a control to reveal the symptoms that should be listed under its entry in a Materia Medica? That would be a necessary first step before a homeopathically valid trial could be designed. Or are you so desperate to be able to dredge up any support for homeopathy that you are willing to throw out as many basic homeopathic principles as necessary to squeeze out a piece of trial data that looks superficially favourable. Individualisation? Single remedy prescribing? Are these optional provided the trial generates an answer you like (even if, as it turns out, that the positive result was an error anyway.)

    And no, hormesis does not rescue you. It has not properly been shown to be genuinely a valid theory even in the small number of fields where it has been invoked, never mind being operative as a general biological mechanism when the original material has been replaced by carrier.

  76. Mojo says:

    In any case, hormesis is irrelevant to homoeopathy as it is practised: homoeopathic remedies are proved using the potentised remedies, not crude substances (see, for example, Hahnemann’s Organon, 5th or 6th edition aphorism 128, or Kayne & Caldwell (2006): Homeopathic Pharmacy: theory and practice (2 ed.), Elsevier Health Sciences, p. 52.), and these same remedies are then supposed to treat patients exhibiting the same symptom picture as that produced in the proving.

    Although Hahnemann originally proved remedies using the crude substance, he also originally attempted to apply the “law” of similars by using those same crude substances to treat patients until he had to abandon this because of, to quote Kayne & Caldwell, “dangerous toxic reactions”.

    The idea that dilute substances may have opposite effects to crude doses is simply not relevant to this.

  77. Badly Shaved Monkey says:

    Dana, just to be clear, and for the avoidance of doubt, it would be most helpful if you could list the features of a good trial of homeopathy, one in which the results should be taken seriously. Thus far, your only criterion of a high-quality trial seems to be that it seems to show a positive result for homeopathy.

    I’ll do this as a check-list and a simple set of direct responses would be very straightforward. You should justify the answer if it is ‘no’.

    1. Blinded, randomised and placebo-controlled? yes or no
    2. Individualised prescribing? yes or no
    3. High-potency prescribing, i.e. beyond C12? yes or no
    4. Single-remedy prescribing? yes or no

    I’d welcome any additions to that list.

    I’ll take it as read that no single trial counts for much without independent replication.

  78. Mojo says:

    An addition:

    5. Remedy has been prepared by serial dilution and succussion? Yes or no.

  79. “I am unaware of any high-quality tests of the ‘Law’ of Similars.”

    Correct. There was a low quality test that failed, but that Hahnemann misinterpreted as having succeeded. I discussed it here:

    http://www.sciencebasedmedicine.org/?p=35

  80. DanaUllman says:

    Thanx Monkey! Your statement that asserts that hormesis has “been shown to be genuinely a valid theory even in the small number of fields where it has been invoked” CONFIRMS that you have NOT reviewed this wide body of evidence. Jeez. And I love that you used the word “invoked” rather than so many other possible words (in order to hedge your bet!).

    I hope that you will be a LOT more humble on those subjects about which you know so little. Can’t you simply say that you don’t know (when clearly you don’t know)?

    As for quality studies, this is too complex a question for simple yes/no answers. It all depends on what one is testing and whether one is striving for internal and/or external validity. One can test either high or low potencies. Individualization of treatment is usually necessary but there are some exceptions.
    One can develop a high quality study of only a SINGLE medicine, though only a very small # of single medicines would have external validity (such as Oscillococcinum in the TREATMENT of the flu, Kali bic in tracheal secretions in COPD patients, and Arnica in facial plastic surgery.

    There cannot be a single test of the law of similars.

    And thanx Mojo, you are right about about Hahnemann “using those same crude substances to treat patients until he had to abandon this because of, to quote Kayne & Caldwell, “dangerous toxic reactions”.” THAT is why he began experiment with potentization…though it took around 30 years of practice before he began experimenting with potencies beyond the 30C (and you folks love to over-simplify Hahnemann and his teachings). Come back to me in 30 years AFTER you too have tested potencies…

  81. Mojo says:

    “Potencies” have already been tested:

    http://www.ncbi.nlm.nih.gov/pubmed/14651731

  82. Mojo says:

    And I’m not sure why you’re thanking me, Dna; all I did was point out why your suggestion that hormesis is relevant to homoeopathy’s claims is wrong.

    While the fact that Hahnemann’s early experiments with crude substances showed adverse effects explains why he then tried something else, it has no bearing at all on whether the diluted remedies he subsequently experimented with actually worked.

    Pretending that what I posted (or indeed what the BSM posted) supports your position will not make it so.

  83. Badly Shaved Monkey says:

    “One can develop a high quality study of only a SINGLE medicine, though only a very small # of single medicines would have external validity (such as Oscillococcinum in the TREATMENT of the flu, Kali bic in tracheal secretions in COPD patients, and Arnica in facial plastic surgery”

    OK, I see where you are coming from. Your criterion for a study that we should pay attention to is that it can be scientifically compromised and weak and based on dubious homeopathic practice, but provided it shows a positive result for homeopathy then it’s OK. I think we had already guessed that, but it’s interesting to see you brazenly try to sustain that position.

    What are we to make of the large number of rather better studies that follow better homeopathic doctrine that show no effect? Or, the meta-analyses that show that the higher the quality of the study the less chance there is of there being a positive effect?

    Those are, by the way, rhetorical questions. We know your answer and I confidently predict that it orientates to align with your financial interest.

  84. Badly Shaved Monkey says:

    Mojo,

    “And I’m not sure why you’re thanking me, Dna; all I did was point out why your suggestion that hormesis is relevant to homoeopathy’s claims is wrong.”

    I think this would be an ideal opportunity for Dana from his lofty intellectual position to explain to us mere mortals exactly how hormesis lends support to homeopathy and to cite some high-quality experimental evidence to support his contentions. I expect he would want to cite evidence from reputable sources that shows clear and strong effects and that those effects fit precisely with the predictions necessary for homeopathy to work.

    Of course, we cannot object that hormesis itself is theoretically unfeasible. We would only question its relevance to homeopathy. Just as we do not doubt that quantum mechanics is a powerful explanatory framework yet doubt it has any part to play in explaining the claimed effects of homeopathy.

    He does style himself as a homeopathic educator so I am sure he will find this to be no challenge at all. Obviously it would be essential for the hormetic effect to produce a dose-response curve identical to that claimed for homeopathic remedies, otherwise it is, as you say, irrelevant. Also, he’s also going to need to explain how a low-dose that might create an hormetic effect is actually the same as a homeopathic no-dose remedy.

    Do you think he can do those things?

    p.s. don’t you think it would just be easier to look at high-quality evidence that shows whether homeopathy works at all and worry about any potential mechanistic explanation only once an effect has been shown? I think that would be a much better idea. Sometimes I think that speculating about grand sounding scientific mechanisms whether it is hormesis or quantum mechanics is just a diversionary tactic, though homeopaths have proven themselves to be so honest in debate that this seems unlikely.

  85. Dr Benway says:

    p.s. don’t you think it would just be easier to look at high-quality evidence that shows whether homeopathy works at all and worry about any potential mechanistic explanation only once an effect has been shown?

    A typical doctor’s response. Sadly, this response has caused much misery and is responsible for the wrong-headed money-pit that is NCCAM.

    Doctors don’t consider themselves experts in physics or chemistry and are more comfortable evaluating blinded, randomized, placebo-controlled trials. So it’s no wonder they want to skip the pseudoscience claims regarding molecular memory and quantum mechanics in order to cut to the chase, the RCT results.

    But RCTs are designed to study treatments with a fairly high prior plausibility. They’re ill suited for extraordinary claims that challenge fundamental principles of physics and chemistry.

    The charlatans would much rather take on doctors than the physicists or chemists.

    Doctors are like weak little girls who can’t throw a baseball. They define experimental results as “significant” if they’re associated with a p-value less than 1/20. This low evidential bar lets in a lot of ineffective treatments, unfortunately. But it also means we don’t miss so many effective treatments. And when you’re helping desperate, sick people, that’s important.

    The physicists laugh at that 1/20 significance level. They are real men, mass macho. They don’t even think to submit a paper for publication unless the obtained p-value is less than 1/10,000.

    See Homeopathy: the p-value argument.

    In short: we should send all the homeopaths over to the physicists and chemists. Then, once one of them wins the Nobel Prize, we can invite them back for a few RCTs.

  86. In any discussion involving science or medicine, being Dana Ullman loses you the argument immediately…and gets you laughed out of the room.

    I know this rule wasn’t going to be invoked with this article, but I’ve certainly read enough. As one of the individuals involved in the ultimate banning of Dana from Wikipedia, it’s interesting to note that the same personal attacks, misinformation, and delusions of grandeur that Dana exhibited in Wikipedia is being employed here.

    Dana spends too much time defending the two or three articles that might support homeopathy, and ignores the thousands that do not. Trying to argue this point is rather pointless. That Dana thinks a BMJ comment on his website is the height of endorsement is laughable at best, and pathetic at worst.

    I’m not going to argue with Dana, because it usually digresses into a series of ad hominem attacks, personal attacks, strawman arguments, and whatever else he employs. Moreover, his language becomes confusing, digressing, and ultimately, sad.

    Anyways, I think he’s repeated himself to the point of nonsense. Can the editors of this fine blog invoke the new rule, and we can move on?

  87. weing says:

    If we accept the criteria that these SCAM artists want us to accept as evidence of efficacy, the we can all make big bucks performing sham orthopedic arthroscopies as Harriett mentioned in a comment to another post that I can’t find now.

  88. Harriet Hall says:

    Hormesis is defined as “Providing stimulus by nontoxic amounts of a toxic agent.”

    The higher homeopathic dilutions don’t involve nontoxic amounts, they involve nonexistent amounts. Hormesis cannot possibly provide a rationale for homeopathy, any more than vaccination can.

  89. DanaUllman says:

    Thanx Mojo (again) for that reference, but I guess you didn’t see the response to that “study” that destoyed it.

    http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15327599

    As for hormesis, it is simply interesting to note how little people here seem to know about the subject, even though there are now thousands of studies in a WIDE variety of scientific disciplines.

    And in fact, this research does have implications on homeopathy because it verifies the power of exceedingly small doses of various substances on certain systems. I certainly recognize that hormesis research has not yet investigated the post-Avogado’s number doses…but a large number of homeopathic medicines sold over-the-counter today are in the range of doses regularly tested in hormesis research.

    And thanx Dr. Benway…perhaps you and I have a lot upon which we can agree about the serious deficiencies in evidence based medicine today.

  90. Dana, you completely misunderstood Dr. Benway. Typical.

  91. Harriet Hall says:

    The hormesis effect works for some things and not for others. It is not a general principle applicable to everything in the world. Each case must be studied individually. By definition, hormesis cannot apply to solutions where there are no molecules left, just as vaccination wouldn’t work if no molecules were left.

    Claiming that hormesis supports homeopathy because it shows that small amounts of a substance can have an effect is as logically fallacious as claiming that quantum theory justifies non-evidence based treatments because it shows that strange things can happen.

  92. David Gorski says:

    By the way, Dana, Wally has posted another excellent analysis of a homeopathy trial:

    http://www.sciencebasedmedicine.org/?p=472

  93. Dr Benway says:

    And thanx Dr. Benway…perhaps you and I have a lot upon which we can agree about the serious deficiencies in evidence based medicine today.

    Excellent!

    I shall alert the NIH that all future grant proposals involving homeopathy should be directed to the NSF not the NIH or any of its subdivisions, such as NCCAM.

    It was nice chatting with you, Dana. Have fun with the physicists!

  94. Badly Shaved Monkey says:

    Dr Benway

    “A typical doctor’s response. Sadly, this response has caused much misery and is responsible for the wrong-headed money-pit that is NCCAM.”

    I do accept your point.

    Obviously I’m not expecting DU or any homeopath to actually produce any high-quality evidence in favour of homeopathy.

    I suppose I make the request in a persistent, though vain, attempt to let the woos demonstrate for themselves that there is no such evidence and that there is nothing supporting their belief system. They are generally beyond that kind of self-revelatory enlightenment, though, so I probably only do it for the amusement of seeing how they respond to the request and DU never fails to come up with something funny, like his continued pimping of that trivial handful of defective papers. I think he must sleep with them under his pillow because they are so precious to him.

  95. @Badly Shaved Monkey,

    They shall be an heirloom of his kingdom. All those who follow in his bloodline shall be bound to their fate for he will risk no hurt to the Papers. They are precious to him, though he buys them with great pain. The writing, which at first was as clear as red flame, has all but disappeared, a secret now that only fire can tell.

    (With apologies to Tolkien and the LoTR screenwriters) ;)

  96. DanaUllman says:

    Harriet,

    Perfecto. Yes! Hormesis does not in every case…and yes, every case has to be determined INDIVIDUALLY. Cool, you’re getting to homeopathy.

    Homeopathy is based on similars, aka resonance. Receptors can and will only be sensitive to certain messages.

    And yeah, I saw Wally’s article. He acknowledges that the effect of the homeopathic medicines was so strong that he suspects that they were tainted with antibiotics. Gotta love that, especially since the EFFECT was there but the antibiotics were not there.

    As for Wally’s assumption that homeopathy is revolutionary. Sure. Just as quantum physics is and was…and just as quantum physics is a better tool for understanding very large OR very small systems, there IS a place for conventional medical doses AS WELL AS homeopathic doses in this world of quantum effects.

    But heck, you’ll prefer to stick with your rotary phones and your manual typewriters…

  97. But quantum effects are measurable and well-described by equations.

  98. pmoran says:

    We seem to be seeing a version of the “Law of Similars” in action. Hormesis looks a bit like homeopathy, so it can be recruited as evidence for the validity of that apparently poorly deliniated medical modality, even though when/if hormesis exists it is a property of certain biological systems rather the consistent, fundamental property of ultradilute solutions that homeopaths are otherwise trying to advance with the “water can have memory” stuff and mystical versions of quantum physics.

    It seems almost anything can “look a bit like what homeopaths do”.

    It is time Ullman skipped the ridiculous, grandiose posturing and ad hominems and responded to some very pertinent direct questions as to what he believes and why. That is how scientiific discussions usually work.

    For example, I have to ask (again) why it is “simple-minded” to believe that the effects observed by homeopaths in medical practice are due to a combination of placebo influeces, spontaneous events and other non-specific features of medical interactions — the very matters we try to “control for” in the clinical trials.

    It is the obvious and most economical explanation, given ALL the known facts including the extreme improbability of several necessary processes. It does not depend upon layer upon layer upon layer of unsupported speculations. It is explanatory not only of homeopathy but of dozens of modalities with similar clinical characteristics and pretentions to evidence but discordant theory and method — those that lumped together comprise “alternative” medicine. Homeopathy is by no means the only “impossible thing” we are asked to believe before breakfast. and, again, the above is THE obvious explanation for so many contradictory understandings of reality.

    Incidentally it is mostly with these other modalities that you are competing for a place in the sun, rather than scientific medicine. Go and talk to them if you are not up for laying your own beliefs out for critical examination.

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