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The World Has Moved On

I do a lot of driving as part of my job.  I am the sole Infectious Disease doctor at three hospitals and I can spend an hour or two a day in the car, depending on traffic.  What prevents me from going crazy sitting in traffic is listening to podcasts and audible books.    I especially like reading (and yes, audio books is reading, pedant) multivolume epics.   Currently I am reading Steven King’s Dark Tower series, which occurs in a universe “where the world has moved on.”  In Mid-world there was once a world with science and beauty and art, but something changed, what I do not know yet (I am only on the third volume; no spoilers in the comments), and the world moved on, leaving behind some artifacts of science and technology, but it appears to be an increasingly primitive world.  Being fantasy, there is, unlike the world I live in, magic as well.

I like that phrase: “the world has moved on.” I have an understanding of the world and medicine, based mostly, but not entirely, on science.  My understanding of the natural world is not complete, but mostly consistent and validated by hundreds of years of research.  My undergraduate degree was in physics, and, like all premeds and medical school students, have an extensive education in chemistry, biology, biochemist, physiology, anatomy, biochemistry, etc.  It all ties together nicely, especially in my specialty , where I have the most knowledge.  I consider infections at many levels, from issues of single molecule changes that may confer antibiotic resistance, up through the patient and their family, and sometimes at the level of the entire planet.  Truly wholistic, not the pseudo-wholism of SCAM.

The sciences gives a mostly coherent understanding of the world.  Mostly coherent. It does give an understanding of the possible, the probable, the improbable and the impossible.  Most of the sciences, unlike parts of medical science,  are not concerned with the impossible.  There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering.  These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned.   Perpetual motion is not considered seriously by any academic physicist; if perpetual motion were an alternative medicine it would be offered at a Center by a Harvard Professor of Medicine.

Most scientists outside of medicine are aware of how easy it is to fool themselves and, by extension, others. As Richard Feynman said.

“We’ve learned from experience that the truth will come out. Other experimenters will repeat your experiment and find out whether you were wrong or right. Nature’s phenomena will agree or they’ll disagree with your theory. And, although you may gain some temporary fame and excitement, you will not gain a good reputation as a scientist if you haven’t tried to be very careful in this kind of work. And it’s this type of integrity, this kind of care not to fool yourself, that is missing to a large extent in much of the research in cargo cult science.”

My archetype for scientists fooling themselves, and others, is the story of N-rays, which I have discussed before.

For whatever reason, and I do not pretend to understand why, medical people are occasionally unable to incorporate the simple concept that unless they are very careful, they can be fooled.  The result is complementary and alternative medicine.  It is the place that remains after the world has moved on.

That phase constantly popped into my head as I looked at the Huffington Post sections on Intergratve Medicine. The world of medicine, at least, has moved on and left the Huffington Post behind.  So much on the HuffPo Intergrative medicine site is at odds with reality that I will mention only a few of the more egregious examples of medical nonsense.  HuffPo is giving Natural News a run for their money in the production of fantasy. Most striking was the homeopathic (the facts being seriously deluded; isn’t that an underlying principle of homeopathy?) article by Dana Ulman entitled Homeopathy for Radiation Poisoning.  Water for radiation toxicity.  Seriously.  And not even heavy water, which might catch the extra neutron.  And the reasoning for its use is even more goofy, if possible, than that of oh-so-silly-ococcinum.

“Because one of the basic premises of homeopathic medicine is that small doses of a treatment can help to heal those symptoms that large doses are known to cause, Ludlam suggested to Grubbe that radiation may be a treatment for conditions such as tumors because it also causes them. This incident is but one more example from history in which an insight from a homeopathic perspective has provided an important breakthrough in medical treatment.”

I suppose since smoking causes cancer you should treat lung cancer with cigarettes and since alcohol causes cirrhosis you should treat cirrhosis is with vodka and guns cause acute lead poisoning so maybe we should shoot gunshot victims. That I suppose, would be reasonable conclusions from homeopathic theory derived from metaphor and faulty metaphor that.

What nostrums are recommend for radiation therapy? Cadmium iodatum, Ceanothus, and Cadmium sulphuratum, for which there are no Pubmed references to support treating radiation toxicity, even though the author says they are a well-known remedies for that condition. Not well known to medical science I suppose.  Ah the wisdom of homeopathy, where saying it makes it so.

Then the author suggests

Calendula (marigold) is a well-known herbal and homeopathic medicine. Highly respected research has found excellent results in using Calendula ointment on people who experienced radiotherapy-induced dermatitis.”

Now why is Calendula a homeopathic medicine? I went to the original reference and it appears from the literature to be a worthwhile agent  for the prevention of radiation term burns. But  I am not so sure I would classify Calendula as a homeopathic preparation. According to the producers site it is “Calendula Fresh Plant 4%” and in the original article it is “is fabricated from a plant of the marigold family, Calendula officinalis. The digest is obtained by incubation at 75°C in petroleum jelly to extract the liposoluble components of the plant.”  The authors  do not use the word homeopathic anywhere in the reference.

Real product came containing real parts of the plant at a measurable concentrations, hardly homeopathic in natureCalendula ointment has not been subjected to proving, nor has it been potentiated, as if either are helpful.  It is not a homeopathic preparation  just because a preparation made by a producer of homeopathic nostrums, although that appears to be the reason. It is a new definition of a homeopathic preparation: if it is made by a homoepathic producer it is therefore a homeopathic preparation. By this standard, the effluent of the Boiron toilets would also be considered homeopathic preparations.

When it comes to homeopathy, not only has the world moved on,  rational thought and consistency has moved on.

And there is acupuncture. There is a link to an article entitled As Medical Costs Rise More Americans Turn to Acupuncture. This is an article from AOL linked from the Huffington Post (now owned by AOL). If you want to get the heebie-jeebies take a look at the opening picture on that page. The text says “Practitioners must use needles produced and manufactured according to U.S. Food and Drug Administration standards, which require needles to “be sterile, nontoxic, and labeled for single use by qualified practitioners only.” The needles may be sterile, but what good is a sterile needle used by a bare hand?

Look at the accompanying photograph. That middle finger does not inspire confidence. It is no wonder that acupuncture is associated with outbreaks of hepatitis C, hepatitis B, and MRSA infections. Most the pictures of acupuncture on this website  demonstrate that acupuncturists lack understanding of basic technique. It is hard to infect people with an injection.  Heroin users inject themselves with a rich melange of bacteria every day without getting infections.  It is hard to infect patients in the hospital with blood draws and IV’s.  But if an infection can happen, it will happen. And those fingers, just recently in a nose, or picking a tooth, or scratching a butt, will spread an infection with an acupuncturist’s needle to one unlucky patient. Not only has the world moved on for acupuncture, it took with it an appreciation of germ theory.

The Huffington Post  seems to be immune from advances in understanding of all of so-called intergrative medicines, or even basic anatomy and physiology. They  link to a video entitled The Meridian System in Oriental Medicine. They might have linked to the anatomy of Orcs or the physiology of Dementors, for all the application to reality it represents.   The video is gibberish when compared to nature as we understand it. The world has moved on.

When Huffington Post published absolute nonsense, I have to wonder how good their analysis is on issues like politics, war,  the environment and other important areas. I was always taught to judge a man by the company he keeps. I have the same problem with my local newspaper, the Oregonian, which publishes the occasional nonsense piece in the Living section.  They often get things wrong in Infectious Diseases, the one area I have expertise.  If they are wrong in areas I know,  can I trust their writings on other topics?

When I finish the series, I’ll let you know, metaphorically, what the alt med Dark Tower is.

Posted in: Acupuncture, Homeopathy, Science and the Media

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28 thoughts on “The World Has Moved On

  1. windriven says:

    (the facts being seriously deluded; isn’t that an underlying principle of homeopathy?)

    I had the misfortune of a mouth full of coffee when I read that. You should probably bill me for a sinus irrigation.

  2. slarti45 says:

    Dark Tower frigging rocks. For years Stephen didn’t continue on from the original first 3. He eventually said it was the most gruelling and challenging book/series/challenge ever and that he was never sure if he could continue. It took years but he eventually pulled the finger out. When he did, there was a collective sigh of relief from the fans. Roland / Jake /Susannah / Oi etc. were to continue…

  3. daijiyobu says:

    The ‘moderate Left’, so to speak, used to value facticity but now seems as ideologically rabid (and therein is ‘far Left’) as what is offered now as the ‘moderate Right’ (which is truly the ‘far Right’).

    Some say we are highly polarized now, politically, without even a desire for compromise or an acceptance that compromise leads to a position middleward (e.g., the pending Federal shut-down, which in my view is an attempt by super-Right influences to destroy the public commons in favor of privatization).

    But, in some manner that I can’t really graphically get my mind around, the extremes of the political spectrum are dovetailing.

    Both political extremes, with very straight faces, spew ideological fantasy and eschew:

    science and objective fact.

    -r.c.

  4. Jan Willem Nienhuys says:

    If they are wrong in areas I know, can I trust their writings on other topics?

    This reminds me of the Dutch airplane pilot (Viruly) who used to comment: This newspaper (a well known Dutch newpaper) is quite good, except when they write about aviation, that’s mostly poppycock.

    About homeopathic preparation: there are standard homeopathic ways to obtain a socalled mother tincture. Section 267 of Hahnemann’s Organon, footnote 2 gives an impression: for fresh plants equal amounts of freshy squeezed juice and alcohol is the preferred way to obtain a mother tincture (usually denoted by a circle with a slash through it).

    So when a homeopathic company sells mother tincture prepared in the Hahnemann way, it is formally homeopathy too. I doubt that

    incubation at 75°C in petroleum jelly

    belongs to the recognized homeopathic rituals.

  5. Ed Whitney says:

    Alasdair MacIntyre begins his book After Virtue by asking the reader to imagine that the natural sciences were to suffer a catastrophe, perhaps a series of environmental disasters blamed by the public on scientists. Riots occur, physicists are lynched, laboratories burned, and books and instruments are destroyed. An anti-science Know Nothing movement takes political power and successfully abolishes science from schools and universities. After a few generations, a reaction takes place and people try to revive science, but they have forgotten what it was. Fragments of books are retrieved from the rubble of science libraries, half-shattered instruments are dug up and restored to the best of people’s understanding, and an attempt is made to restore the sciences. Experiments are undertaken, but they have become detached from the theoretical context that made them interpretable. Adults debate among themselves about evolutionary theory, relativity theory, and phlogiston theory, but the canons of coherence that would make these discussions scientific have been lost. Children memorize surviving parts of the periodic table and recite geometric theorems as incantations. Subjectivist theories of science would abound, to be contested by people who held that the notion or scientific truth is incompatible with subjectivism.

    MacIntyre presents this metaphor to advance the idea that the world we inhabit stands in a similar state with respect to the language of morality, inherited from philosophers like Aristotle and Aquinas but torn from the context in which the concepts gained their significance. This has left us with fragments of a conceptual scheme lacking the context from which they derived their meaning. We possess simulacra of morality and continue to use many of the key expressions, but have lost our comprehension of them.

    That would take this discussion in a different direction, which I have no interest in taking it. However, MacIntyre’s image is powerful, and presents a point of view from which to look at what is happening on the Huffington Post and other places. The vocabulary of science is deployed, but is torn from the frame of reference that gives it meaning. Words are used in ways that distort their relationships to the concepts which frame them and make them comprehensible. People possess simulacra of science and use many of its expressions, but in a way which has no relationship to the context which makes science science.

    You can see the first few pages of Macintyre’s book at Amazon. Worth a look if you are curious.

  6. wales says:

    MC said “It [science] does give an understanding of the possible, the probable, the improbable and the impossible. Most of the sciences, unlike parts of medical science, are not concerned with the impossible.”

    This brings to mind a book I read by physicist Michio Kaku “Physics of the Impossible”, a very entertaining read. Kaku categorizes the “impossible” as follows (quoted from Publisher’s Weekly review) “His Class I impossibilities include force fields, telepathy and antiuniverses, which don’t violate the known laws of science and may become realities in the next century. Those in Class II await realization farther in the future and include faster-than-light travel and discovery of parallel universes. Kaku discusses only perpetual motion machines and precognition in Class III, things that aren’t possible according to our current understanding of science.”

    Things that once seemed impossible or improbable, simply because humans did not have adequate information, can and do change to “probable” upon closer examination, as in the field of astrobiology.

    http://astrobiology.nasa.gov/about-astrobiology/

    Anyhow, it seems that MC’s post is meant to imply that the world has “moved on” from such things as acupuncture and homeopathy. I am not sure the data support that supposition, in terms of the number of people using acupuncture, homeopathy, etc.

  7. Wicked Lad says:

    It all ties together nicely, especially in my specialty , where I have the most knowledge.

    More than everyone else? Your insatiable ego has taken you too far, Crislip.

  8. Antiboty says:

    @Wicked Lad I’m pretty sure Dr. Crislip was suggesting his knowledge of infectious disease surpasses his knowledge of other fields such as physics, and not that his knowledge of infectious disease surpasses anyone else’s knowledge of infectious disease.

    Or maybe its Friday (Friday) looking forward to the weekend, and I can’t detect sarcasm.

  9. Mark Crislip says:

    although I have a zaphod beeblebrox sense of self esteem, it is antiboty who got my drift, not wicked lad

  10. As entertaining and charismatic as Kaku is, he lends too much credibility to somewhat fanciful things that are fun to believe in but are likely to remain perpetually impossible/improbable.

    By his definition (as listed above), FTL travel is a class III impossibility, directly prohibited by the laws of the universe as we currently understand them.

    Classifying telepathy as something likely to be achieved someday isn’t thinking critically. Telepathy lacks any physical explanation and requires invoking either duality (which has no scientific basis) or some unseen form of energy transfer. The various laws of conservation conflict with duality and require the effects of telepathy have physical effects which should be detectable and measurable, but as yet, have not been detected. Even if the energy itself was beyond our ability to currently detect, the effects on the recipient’s brain should be detectable. It’s not really a good fit for his class II.

    Kaku seems to be intermixing the concepts of currently impossible due to current technical limitations and absolutely impossible (for wont of a better term), as in prohibited by the laws of physics as we currently understand them. Yes, it’s possible some things we consider to be absolutely impossible today will turn out not to be impossible, but it’s a fallacy to assume anything/ something currently prohibited will be necessarily possible someday with enough advancement of our scientific understanding of the universe.

    Sure it’s worth investigating whether Einstein was right or not, but we shouldn’t assume that we’ll eventually find out that he was wrong.

    Frankly if you’re going to classify telepathy and FTL as future possibilities, I don’t see why precognition would be a class III impossibility. Almost by current definition, FTL (violating causality) + telepathy -> precognition.

  11. BobbyG says:

    I love to have y’all weigh in on “CER,” shortly to be in full throttle.

    See, e.g.,

    http://www.healthbeatblog.com/2011/04/the-illusory-side-of-comparative-effectiveness-research-.html

    to wit:

    “Comparative effectiveness research” is now legislated as a priority for translational research. The goal is to inform decision making by assessing relative effectiveness in practice. An impressive effort has been mobilized to target efforts and establish a methodological framework. We argue that any such exercise requires a comparator with known and meaningful efficacy; there must be at least one anchoring group or subset for which a particular intervention has reproducible and meaningful benefit in randomized controlled trials. Without such, there is a likelihood that the effort will degenerate into comparative ineffectiveness research.”

  12. daedalus2u says:

    “The Moving Finger writes: and, having writ,
    Moves on: nor all thy Piety nor Wit
    Shall lure it back to cancel half a Line,
    Nor all thy Tears wash out a Word of it.”

    Edward Fitzgerald’s translation of the poem The Rubáiyát of Omar Khayyam, 1859:

  13. Wicked Lad says:

    @Crislip and antiboty, that was just my lame attempt at humor.

    (Note to self: Start using emoticons.)

  14. CLK says:

    I am raising two small men currently, and I spend a lot of time thinking about how to educate them to be impervious to irrational thinking. My sons may never want to be doctors or scientists. It doesn’t mean they don’t need to be able to spot logical fallacies and evaluate claims based on an understanding of the laws of science. How much is enough education in these areas? Can the non- scientists of the world genuinely hope to resist the fall into the dark side of CAM or other hot button environmental issues when they lack training in research and statistics or more advanced science?
    It is interesting to consider what, as a society we could develop as a unifying body of science education, or training in “good thinking” because I don’t think we are reaching the goal post.

  15. BillyJoe says:

    Wicked Lad,

    For what its worth, I read you exactly.
    And, despite his ultimately fatal stab, even Antiboty got half a wind.
    But, unless zaphod beeblebrox is fiss parting around, he drew the short and curly one

  16. GLaDOS says:

    CLK, start listening to the Skeptics Guide to the Universe podcasts. The rogues do a good job talking about all kinds of stuff in a curious and questioning way. If your kids are old enough, they might enjoy parts of it, like “science or fiction.”

    Something simple: anything involving magic is pure crap. Lots of other words mean “magic” but sound less crazy, so learn to spot the magic. Eg, using words to control other people –NLP; basically magic.

    Qi is obviously magic.

    Magic water aka homeopathy –a no brainer.

    I’m not sure but I think they teach magic at those MBA programs.

  17. Jann Bellamy says:

    I wish the world would move on a little faster and farther.

    Last night at a party: Woman tells of her experience with foot surgery, was concerned about swelling. Orthopedic surgeon who did procedure looks at foot, tells woman these things take time, all is ok, the usual reassurance. Woman then goes to acupuncutrist and after 5 weeks swelling has resolved, ergo the acupunture cured the swelling.

    Hard to know what to do in these situations.

  18. BillyJoe says:

    Jann,

    “Hard to know what to do in these situations.”

    Well, you could scream in exasperation
    …or you could stand on her newly healed foot and make her scream in exasperation. ;)

  19. TsuDhoNimh says:

    But homeopathic Calendula is great if you have “Heartburn with horripilations”, Warts at the os externum, and other things.

    In an involuntary proving on a baby, Calendula caused screaming, twitching of the hands and face, with colicky pains (seemingly from flatulence). There were even convulsions with fixed eyes, a dark round mouth and vomiting of milk with slime. This was accompanied by extreme nervousness, and the sensitivity to noise mentioned above. Another symptom was a decidedly yellow tint of the skin and also of the stools (‘the colour of marigold’). Clarke, who relates this involuntary proving, reports that cases of jaundice have been successfully treated with Calendula.

    **********
    OTOH, it makes a nice-smelling hand cream with mild antiseptic properties like many aromatic herbs.

  20. GLaDOS says:

    In an involuntary proving on a baby…[evil sh_t snipped]

    ^This is why. Every treatment thought to be helpful will be used on babies, whether “alternative” or not.

    If you do not hate alt med with a burning passion, there is something seriously wrong with you.

  21. Ed Whitney says:

    An anecdote: back when I was still seeing patients for a living, I had frequent headaches (now rare, having discovered the virtues of epidemiology). Although I would never have tried homeopathy on a patient, I looked in the homeopathy books for a “match” to my headache pattern. One big feature was that they were made worse with movement. Well, Bryonia was the closest match to what I had, so I went to the Dolphin Spring Holistic Wellness Center (not its real name) and got a little tube of Bryonia to try next time I had a headache. No ethical problems involved, no risk to myself, no reasons not to try.

    When I had a free day, I was in the habit of driving an hour and a half to spend the day at the nearest decent medical library. I had a headache while preparing to leave, and popped some teeny weensy Bryonia pellets under my tongue and took off.

    An hour later, I suddenly had an extreme urge to evacuate. No diarrhea, no GI upset, just a dramatic sense of an impending accident the likes of which I last had in nursery school. I did not even have time to get to an exit and find a bathroom. Luckily, I had an empty box in the car, pulled into a parking lot away from where I could be seen, and narrowly averted an in-the-pants catastrophe with a fully formed bowel movement. Luckily, there was a dumpster at the end of the parking lot, and I could dispose of the evidence of my crime and proceed to the library, where the rest of the day went just fine.

    Never repeated the experiment. Never wanted, or had, a repeat of the experience. And never, never would experiment on a baby.

  22. Toiletman says:

    You are wrong that this only exists in medicine.
    You also have pseudo-biology –> “intelligent design” etc.
    But there is maybe most pseudo-physics/engineering with big communities that look for free energy, try to debunk Einstein and propose very obscure versions.

    Besides that, there actually people who are doing something that is called speculative biology where people make scientific guesses how evolution could work in other environments or in many million years or so and kind of stick to science. The difference is, they all know it’s fiction :D

  23. BillyJoe says:

    Ed Whitney,

    What can I say? You are an idiot.
    I mean, do you find any plausibility at all in homoeopathy? If you don’t then what would possess you to try it for your headaches? And you didn’t even take the precaution of ensuring that is was diluted beyond avagadro! You thoroughly deserved your misfortune. It’s just a pity it wasn’t worse, though come to think of it, what did you wipe your ass with?

    :D

    What’s even funnier is that the very next poster is called Toiletman.

  24. Sure huffpo is bad for health, but where else can you catch up on the latest exploits of Courtney Love, Paris Hilton AND have some little comfort that the whole world hasnt gone completely union busting, antigovernment, homeschooling, creationist, insane.

    I do admit it’s a bit of choir following, but it’s a guilty pleasure.

  25. Ed Whitney says:

    Billy Joe:

    “You are an idiot.”

    True enough; see explanation below.

    “do you find any plausibility at all in homoeopathy? If you don’t then what would possess you to try it for your headaches?”

    Well, there was a certain New Age bookstore with a section on healing and homeopathy and such, and the owner was one of the most absolutely beautiful women you could ever hope to meet. If you heard her talk about homeopathy, and saw her smile when you said you would give it a whirl, you would understand. If you heard her discuss current world events in the context of Saturn going retrograde, you would listen with rapt attention and probably buy the current issue of “The Mountain Astrologer” just because she recommended it.

    Also, I at the time I was interested in vitalism, Hermeticism, Paracelsus, how science emerged from magic in the Renaissance, Jungian approaches to alchemy, and similar themes. Astronomy as a study of the interaction of man and the cosmos, while it had not yet pulled itself away from astrology–this stuff remains interesting. Paracelsus saying that the influence of Mars on the strong man is to endow him with warlike courage, but its effect on the weak man is to make him irritable and quarrelsome–that has a real appeal as a deep metaphor for considering the human condition.

    Edward Whitmont, who ran the C.G. Jung Training Center in New York, had written “Psyche and Substance,” which is all about homeopathy and archetypal philosophy. He considered homeopathy as demonstrating that non-material fields of influence can aid in psychosomatic transformation and benefit health–an explicitly “placebo” oriented approach to the subject.

    I mention all of this because of Jungian synchronicity. Having Toiletman (hey, could I have used you!) contribute the very next comment is a nice example.

    ” And you didn’t even take the precaution of ensuring that is was diluted beyond avagadro”

    Well, speaking of dilution, try this: take a drop of beer, dilute it in a pint of grain alcohol, shake the bejeezus out of it, repeat a few times, and chug-a-lug the final product. You will see what “potentiation” means in a hurry.

    “what did you wipe your ass with?”

    One advantage of a cluttered car is that you not only have boxes you haven’t bothered to remove; you also have rolls of paper towels and even have plastic grocery bags to line the box with.

  26. BillyJoe says:

    Ed Whitney,

    If my car happened to contain these items just when I needed them, I would indeed be at least tempted to believe in synchronicity. On the other hand, I’ve often thought it would be a good idea keeping a bag of items for emergency situations, but I have never quite gotten around to doing it. All I’d have to work with in a situation like yours is perhaps a lolly wrapper. Now how smart is that.

  27. AbelAbbot says:

    Nice information. I really appreciate your work. You give wonderful information about homeopathic preparation. Fragments of books are retrieved from the rubble of science libraries, half-shattered instruments are dug up and restored to the best of people’s understanding, and an attempt is made to restore the sciences. Experiments are undertaken, but they have become detached from the theoretical context that made them interpretable. Adults debate among themselves about evolutionary theory, relativity theory, and phlogiston theory, but the canons of coherence that would make these discussions scientific have been lost. The various laws of conservation conflict with duality and require the effects of telepathy have physical effects which should be detectable and measurable, but as yet, have not been detected. Even if the energy itself was beyond our ability to currently detect, the effects on the recipient’s brain should be detectable. It’s not really a good fit for his class II. I feel fervently about this and I like learning about this subject. If possible, as you gain information, please update this blog with more information. I have found it really useful.
    Slips and trips Toronto

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