Respectful Insolence

Death by homeopathic surgery

Normally, when I hear such a term as “homeopathic surgery” or of homeopaths doing surgery, I get the irresistable urge to make jokes about it, such as wondering if homeopathic surgery is surgery diluted down to the point where not a single cell in the body is injured or whether homeopathic surgeons make ultra-tiny incisions. Actually, that second quip risks confusing homeopathic surgeons with laparoscopic surgeons, and I’d never do that. I respect laparoscopic surgeons. Laparoscopic surgery is very difficult, and I have the utmost respect for my colleagues who can do complex operations through four or five tiny incisions, using long skinny instruments and a video camera. Unfortunately, via the Skepchick, I’ve learned of a combination of homeopathy and surgery that is no joke:

A homeopathic doctor was suspended Tuesday for his role in a botched liposuction operation earlier this month that resulted in the death of the patient.

A state regulatory board deemed Dr. Greg Page a “clear and present danger to the public.”

Page performed the liposuction procedure on July 3 at the Anthem office of Dr. Peter J. Normann, whose practice was restricted by the state in May after two other liposuction patients suffered cardiac arrest on the operating table and died.

Normann, who provided follow-up care in the July 3 surgery, was suspended last week, and both doctors are awaiting hearings with an administrative judge, who can revoke their licenses or reinstate them.

Page’s suspension by the Arizona Board of Homeopathic Medical Examiners followed a half-hour executive session and an hour of questioning. Page took part by phone.

This case, of course, raises a number of disturbing questions, the first and foremost of which is: WHAT WAS A HOMEOPATH DOING ANYWHERE NEAR AN OPERATING ROOM WITH SURGICAL INSTRUMENTS AND A HUMAN PATIENT ON THE TABLE?

Sorry, as a surgeon, I had to vent for a moment. This story is so amazingly tragic, but, even worse, it reveals something that I didn’t know about the state of Arizona:

Under state law, homeopaths may do “minor surgery,” and Dr. Bruce Shelton, president of the Arizona Homeopathic and Integrative Medical Association and former president of the Homeopathic Board, said whether liposuction can be considered minor surgery “is a huge gray area.”

“In my opinion, it (liposuction) is best left to plastic surgeons,” he said.

Ya think? That’s about as good a “well, duh!” statement as I’ve ever heard.

I’m flabbergasted that Arizona state law allows homeopaths anywhere near a patient with a scalpel, even if it’s just to remove a mole. They have zero training in surgery and zero appreciation of the complications that can occur as a result of surgery. Most plastic surgeons do a complete five year general surgery residency, followed by a two or three year fellowship to attain their skills. There are pathways that can shave a couple of years off of that process, but in the end there’s no way to be a fully trained, Board-certified plastic surgeon without at least five or six years of residency and fellowship training after medical school. Indeed, I know that part of the process of being Board-certified in plastic surgery includes a portfolio of case reports, complete with before-and-after photos. Moreover, there’s more than a little art to plastic surgery, given that the idea is to make the end result look as aesthetically pleasing as possible. As we say in surgery, you can teach a monkey how to operate. It’s knowing when and why to operate and knowing what to do when complications ensue that are hard to learn.

Why on earth would homeopaths even want to do surgery anyway? After all, we so often hear them criticizing “conventional” medicine for “cutting,” “burning,” or “poisoning,” particularly in reference to cancer treatment. Yet, here we have a homeopath cutting away. Moreover, he’s cutting away in the service of a cosmetic effect. Besides, wouldn’t the homeopathic treatment of excess fat involve the tried and true homeopathic principle of “like cures like,” you know, like taking a bit of fat from a piece of meat and then diluting it 100-fold 20 or 30 times to produce a 20C or 30C solution (which would have not a single molecule of fatty acid or cholesterol left in it) and then having the patient drink it? This homeopath seems to have fallen into something that is profoundly against homeopathic principles, at least as they are stated so frequently in the homeopathic literature that I’ve perused and by homeopaths who get all up in arms whenever I criticize homeopathy for the blatant quackery that it is.

Yes, I said it. Homeopathy is quackery. Period. I’m tired of being politically correct and dancing around it with words like “dubious” or “unproven.”

What’s even more depressing is looking at the confederacy of dunces who are “investigating” the incident, namely the Arizona Board of Homeopathic Medical Examiners, whose skill at getting to the bottom of this would embarrass Inspector Clouseau:

Dr. Garry Gordon, a member of the homeopathic board who practices in Payson, focused his questioning on the medications Page used during the procedure. Page said there was nothing out of the ordinary, but acknowledged that he did not know whether the patient had taken pre-surgical vitamins and minerals, as normally required.

No one on the homeopathic board asked whether liposuctions fall within the range of procedures that a homeopath is licensed to do. Chris Springer, executive director of the board, declined to comment on the matter because she is not a doctor, and the three doctors on the board also declined to comment.

That’s right. He seems to be saying that, if the patient had just taken her presurgical vitamins, she wouldn’t have died. I’ve seldom seen thinking so divorced from reality. Only in homeopathy-world could there be such medical idiocy stated with a completely straight face.

Sadly, though, when it comes to liposuction, it’s not necessarily just homeopaths who fall into the trap of thinking it’s just minor surgery. It’s not, especially when it takes 5 hours, as this case reportedly did, and when apparently a lot of fat was removed. Besides complications of unsightly contours that can result from removing fat carelessly without the eye for “sculpting” that good plastic surgeons doing the procedure develop, there can be life-threatening complications, including fluid imbalance, skin necrosis, serious infections, and fat embolism. Here’s what happened to the patient:

The patient that Page treated who died, identified only as LR, was a 250-pound woman who was having liposuction done on her thighs. It took about five hours, and Page left the premises an hour later, about 7 p.m., the medical board report said.

Normann stayed behind while the patient awaited a ride. He tried to rouse her from sleep at 9:50 p.m., was unable to do so, and 911 was called at about 10:10 p.m. The patient later died at the John C. Lincoln Deer Valley Hospital.

Page, a licensed homeopath since 2005, told the homeopathic board he considered the patient fine when he left.

“She was in a condition where I would have discharged her to her ride,” he said.

In other words, she was just “fine” until she keeled over dead.

I have to wonder: Did these incompetent boobs still have the patient hooked up to an IV? Were they monitoring vital signs? Urine output? It’s not surprising that Page would think the patient was “OK,” given that he had become a homeopath and thus had probably become used to assessing patients based on bullshit, but Dr. Normann should have known better. What was he doing to monitor the patient? What did he do between 7 PM and 9:50 PM? From the sketchy information here, my guess is that the patient probably died of fluid imbalances or a fat embolism. One has to wonder whether these clowns even knew that such complications were possible or that the mortality rate from liposuction procedures can be as high as 20 to 100 deaths per 100,000 liposuction procedures (making the very highest estimate for mortality 0.1%). Moreover, the highest risk is generally seen when large liposuction procedures are done at outpatient centers. I realize that a lot of nonhomeopathic incompetents who think liposuction is easy and know it’s lucrative have killed patients doing it (witness Dr. Peter Normann, Page’s nonhomeopathic enabler, who, according to the story had had two previous patients die of cardiac arrests while on the operating table for liposuction and apparently contracted Dr. Page to do liposuction for him). For example, I’ve heard of dermatologists trying to make a little extra dough doing liposuction and not realizing that it can have complications far worse than just cutting off skin lesions. However, I never thought that homeopaths would be interested in doing such surgery. It doesn’t fall within the purview of what homeopaths normally represent as homeopathy. Indeed, doing surgery seems inimical to the very concept of homeopathy. On the other hand, the concept of homeopathy is quite fluid, given that homeopaths frequently embrace all manner of woo other than homeopathy and incorporate it into their practice, making it sometimes difficult to tell what is and isn’t homeopathy. Even so, surgery always seemed out of bounds for homeopathy.

Of course, the utter absurdity of this case is to contemplate on what basis the homeopathic board would adjudicate and decide whether a violation of its standards has occurred. After perusing the statutes governing homeopathic practice in Arizona, I’m dumbfounded at how broad a scope of practice homeopaths are allowed there. It’s truly depressing (and unintentionally hilarious in places) reading. For one thing, apparently homeopaths are allowed to prescribe controlled substances! Looking over the website and seeing that homeopaths have to pass written and oral examinations to be licensed in Arizona made me profoundly curious about what, exactly, is on the examination. (Certainly, I’d love to add a question to ask a homeopath to calculate how many molecules of active substance one could find in a 30C homeopathic dilution.)

I once said that I thought, on the whole, that state regulation of professions such as homeopathy and chiropractic was probably better than no regulation at all, even though the regulatory bodies that regulate such “alternative” medical practices inevitably come under the sway of the very same dubious practitioners that they are supposed to regulate. This case makes me wonder if that assessment was incorrect. Either way, if I lived in Arizona, I’d be writing the Governor and my legislators demanding that this travesty of a “board” be disbanded. Whatever the faults of my own state in regulating medical professionals, I’m really glad that I don’t live in Arizona.

ADDENDUM: More on legalized quackery in the State of Arizona.

Comments

  1. #1 David D.G.
    July 24, 2007

    Excellent commentary. I’m glad you saw fit to address the issue.

    What I’d like to know, though, is why this hasn’t yet become a police matter, or at least led to a class-action malpractice suit of devastating proportions. This seems to me like the very definition of malpractice.

    ~David D.G.

  2. #2 TheProbe
    July 24, 2007

    It may seem a bit cold blooded, but I do not think that there was actionable malpractice, as the patient chose to run the risks with quacks.

    I dealt with a case of obsessive liposuction, where the patients hid her history of known risks where she had been rejected by several qualified surgeons.

    As for the killers…leave them in the Arizona desert for a few days to think it over. Let’s see if they can figure out fluid imbalance.

  3. #3 Dunc
    July 24, 2007

    Whisky Tango Foxtrot!?

    OK, so who else is licensed to perform “minor surgery” in Arizona? Can the mailman whip your tonsils out? And what, exactly, constitutes “minor”, anyway?

  4. #4 spudbeach
    July 24, 2007

    Wow. I would think that people getting surgery from a homeopathic physician would also get homeopathic dilutions on their pain medicines. Sounds really painful.

    If they don’t use homeopathic dilutions of pain and other medicines, I have to ask what makes them qualified to do so? Four years of homeopathic school where they’ve been told that real drugs aren’t necessary?

  5. #5 bob koepp
    July 24, 2007

    I, too, am puzzled by the notion of homeopathic surgery — about as puzzled as I would be by the notion of allopathic surgery.

  6. #6 sailor
    July 24, 2007

    “Homeopathy is quackery. Period.”
    If anyone wants the longer version here is randi on the subject:
    http://www.youtube.com/watch?v=BWE1tH93G9U

    Why are these guys not charges with manslaughter? How do quacks so successfully duck their responsibility?

  7. #7 The Uppity Atheist
    July 24, 2007

    You’ve got to be kidding me.

    Homeopaths are allowed to cut people open and when they inevitably kill someone they are disciplined by a board of their peers?

    One definition of unprofessional conduct from the State of Arizona Board of Homeopathic Medical Examiners:

    13. Offering, undertaking or agreeing to cure or treat a disease, injury, ailment or infirmity by a secret means, method, device or instrumentality.

    Um, isn’t that the technical definition of Homeopathy?

  8. #8 Andrew Dodds
    July 24, 2007

    That is shocking.

    I can’t believe the whole ‘They then called 911′; so they were, seriously, doing major surgery without the facilities of a hospital (never mind, say, training?)

  9. #9 rrt
    July 24, 2007

    TheProbe: FWIW, it’s possible the patient didn’t have an adequate understanding of these guys’ (lack of) qualifications. A formal regulatory process putting its stamp of approval on them might add to the confusion.

  10. #10 medrecga;
    July 24, 2007

    The famous saying goes that “minor surgery is that which is happening to someone else”. But good riddance, who in their right mind would allow someone without a medical license to perform ANY sort of surgery on them? Yikes!!! As a survivor of two procedures (one relatively minor, the other definitely major), I know I wouldn’t want anyone other than an experienced, properly licensed surgeon anywhere near me with anything even vaguely resembling a scalpel. Yes, allopathic medicine has its faults and problems, but I will take it any day over someone with unproven treatments and other forms of quackery. Surgery, by definition, cannot be “homeopathic”, so anyone attempting any sort of operation in the name of homeopathy is a blatant quack and should be disciplined as such…particularly if the patient dies or suffers other lasting consequences.

  11. #11 Blake Stacey, OM
    July 24, 2007

    Besides, wouldn’t the homeopathic treatment of excess fat involve the tried and true homeopathic principle of “like cures like,” you know, like taking a bit of fat from a piece of meat and then diluting it 100-fold 20 or 30 times to produce a 20C or 30C solution (which would have not a single molecule of fatty acid or cholesterol left in it) and then having the patient drink it?

    Wait a second. Isn’t meat gristle non-water-soluble?

  12. #12 bob koepp
    July 24, 2007

    medrecga (or anybody else) – Could you explain how you understand the contrast between allopathic and homeopathic medicine? Please understand that I have no desire to defend homeopathic practices. But I don’t see how the fact that a homeopath undertakes a surgical procedure warrants talk of ‘homeopathic surgery.’

  13. #13 Blake Stacey
    July 24, 2007

    OK, I guess the odd fatty-acid molecule might stick its hydrophilic head into the water. . . but yeesh, you wouldn’t have to dilute many times to eliminate those.

  14. #14 vlad
    July 24, 2007

    I’m fundamentally against liposuction unless there is a medical need. I’m against most cosmetic surgery as well, not including reconstruction or fixing major physical disfigurement. That said how can anyone except, well a surgeon perform surgery. I see the point of allowing dermatologists to remove things on the surface of the skin but beyond that? I though surgeons had to have additional training and specialization to perform surgery. I also thought that you needed to be a board certified surgeon to perform surgeries, not a board certified homeopath.

    How is liposuction considered a minor surgery? When liopsuction is performed don’t they have to be careful not to damage the blood supply to the skin? I’d imagine that that is not the simplest or most straight forward thing to do. I can’t see how liposuction is any less invasive then a lump ectomy.

  15. #15 Orac
    July 24, 2007

    OK, I guess the odd fatty-acid molecule might stick its hydrophilic head into the water. . . but yeesh, you wouldn’t have to dilute many times to eliminate those.

    Ethyl alcohol is a perfectly acceptable homeopathic diluant.

  16. #16 Warren
    July 24, 2007

    Licensure/certification to practice are available for both chiropractic and homeopathic “services” in Arizona. We also have certs for osteopaths.

    It’s unconscionable that homeopathic “doctors” would be permitted surgery status. This is clearly a loophole that needs to be closed; hopefully there aren’t chiropractors as well who can cure a “subluxation” by incision.

  17. #17 Joe
    July 24, 2007

    Actually, homeopaths make remedies from totally insoluble materials. They grind the material (which can be a gemstone or metal)under solvent in a mortar and pestle. As Blake S. has observed, it is odd to then undertake serial dilutions.

    Another disturbing aspect, here, is that in Arizona they refer to homeopaths as “doctor.” The patient may never have known he was not an MD/DO. This happens quite a bit- to bad effect. The New York Times restricts “doctor” to MD/DO diplomates.

  18. #18 mark
    July 24, 2007

    Is it true that Fox will begin filming a new reality tv show in Arizona, in which various celebrities will perform surgery on each other?

  19. #19 Russell
    July 24, 2007

    medrecga:

    The famous saying goes that “minor surgery is that which is happening to someone else”. ..who in their right mind would allow someone without a medical license to perform ANY sort of surgery on them?

    People in the field or on a boat or elsewhere that a trained surgeon isn’t soon available sometimes do minor surgery as a matter of exigency, e.g., “do you want a few sutures on that gash, or do you just want to leave it open until we get back?” This is becoming less common with modern communications, and now that air evac is so widely available, and that people generally have money enough that it has lowered the level of what counts as an emergency deserving a call for rescue.

    No doubt, Orac will roll his eyes at what people do under such circumstance. But it’s better than homeopathic surgery. ;-)

  20. #20 TheBlackCat
    July 24, 2007

    “People in the field or on a boat or elsewhere that a trained surgeon isn’t soon available sometimes do minor surgery as a matter of exigency, e.g., “do you want a few sutures on that gash, or do you just want to leave it open until we get back?”‘

    There is a difference between emergency medical attention and surgery where you get to choose the time, place, and surgeon. If I want someone to treat a heart condition I will go to a cardiologist, but that doesn’t mean I will object to someone with a bit of red cross training doing CPR on me in an emergency if no one else is available. The two situations are completely different.

  21. #21 S
    July 24, 2007

    Well, I guess it shows one thing: not all of them are charlatans, in the sense of knowingly deceiving people. They actually are stupid enough to believe the bogosity they are peddling. And I don’t know what’s worse: that this guy was comfortable foisting himself on his victim, or that the “board” thinks they’re qualified to oversee such travesty. It’s really appalling, and if the state of Arizona medical board doesn’t make at least an effort to do something about it, they are guilty, too. As are the legislators of that state. It’s beyond ridiculous.

  22. #22 Sid Schwab
    July 24, 2007

    The comment by “S” is mine. Don’t know what happened to the rest of my name…

  23. #23 Russell
    July 24, 2007

    Of course, BlackCat. I was just pointing out that there sometimes are unusual circumstances. I agree completely that someone is nuts, under ordinary circumstance, to go to a homeopath for surgery. Excise the last two words from the previous sentence, and it still holds.

  24. #24 Nomen Nescio
    July 24, 2007

    minor surgery being that which is done on somebody else sounds about right, yes. but for a more objective measure, i’d say if it takes more than ten minutes to perform, or requires any non-local anaesthesia, it’s certainly major. five hours of liposuction, and these kooks have to even ask the question?!

    i don’t like it when somebody without at least as much training as a nurse has even draws my blood; i can’t fathom what might convince somebody to let a non-M.D. (or dentist, if we’re quibbling) perform serious cutting on them. other than a con game bordering on the cultish, perhaps.

  25. #25 RavenT
    July 24, 2007

    Under state law, homeopaths may do “minor surgery,” and Dr. Bruce Shelton, president of the Arizona Homeopathic and Integrative Medical Association and former president of the Homeopathic Board, said whether liposuction can be considered minor surgery “is a huge gray area.”

    Wow–just, wow. Where to begin with the problems in that paragraph?

    The commenter above who pointed out the woman may not have fully understood the risks has a good point. She may have been relying in good faith on a very messed-up law for protection.

    Russell–don’t know if it’s still the case, but in the old days, people like anthropologists, wildlife biologists, aid workers, anyone who’s going to be away from a medical infrastructure for a while, would often have their appendix prophylactically removed, to avoid the risk of such a problem. That may no longer be a standard of care now, however.

  26. #26 PalMD
    July 24, 2007

    OMG! First, I can’t blame the poor, diluted deluded, deceased patient. Snake oil salesmen can be very persuasive. But how come this guy isn’t in jail for murder?!? I mean, I’m an internist, but if I somehow convinced someone to give me permission to operate at their facility, they should be arrested and thrown in the same cell as me.

  27. #27 Flyspeck
    July 24, 2007

    Minor surgery would be putting in a few stitches. Unless a butterfly bandage would suffice. Digging around inside the body is not minor, but major.

    I think we need to bring back firing squads. We can start with the idiots who passed this into Arizona law. Shooting them dead would be defending the public.

  28. #28 Tim Tesar
    July 24, 2007

    I certainly agree that this kind of quackery is outrageous and must be eliminated either by law or through education. On the other hand, I wonder if our concern about the safety of medical treatment is better directed toward “conventional” medicine. This article from AARP indicates that:

    “…[R]ecent estimates of the incidence of medical errors resulting in injuries reach as high as 17.7 percent of hospitalizations. … [T]he 1990 Harvard Medical Practice Study … found that nearly 4 percent of patients suffered an injury that caused their hospital stays to be prolonged, or resulted in measurable disability.”

    Undoubtedly the benefits of conventional care outweigh the risks, and I’m sure many work vigorously to lower these risks, and I will continue to avoid quacks and seek conventional care. But health consumers should be aware of these risks also as they make rational health care decisions.

    (I chose the AARP article because I did not want to take a lot of time looking for material to make my point. Even if you dispute the significance of those particular statistics, I think my point still stands.)

  29. #29 Calli Arcale
    July 24, 2007

    Five hours of liposuction? That has to have required general anesthesia. I would presume that any procedure requiring that would be considered major. After all, you can die from the anesthesia alone, which I why I have such tremendous respect for the brilliant men and women who undertake the profession of anesthesiologist.

    To Tim Tesar, I doubt anyone reading this blog is unaware of the risks of conventional medicine. That’s what this post is *about*. Liposuction is a conventional medical procedure, and it has enormous risks. If you go to a homeopath for it, you are being treated by someone who is unlikely to understand those risks or know what to do about them (as this tragic case demonstrates).

    Of course conventional medical care has risks. Everything has risks, and when it comes to surgery the stakes can be very high indeed. If any person tells you that the treatment they offer has no risks, get suspicious. That’s usually what the snake-oil salesmen will claim, and they are wrong.

  30. #30 sailor
    July 24, 2007

    “If any person tells you that the treatment they offer has no risks, get suspicious.”
    Not at all! homeopathy, as long as they keep away from surgury has no risks, unless you are allergic to water.

  31. #31 Laura
    July 24, 2007

    Wow that is terrible. I have heard about dentists and OB/GYN’s offering stuff like that in their office (I guess you can go to a seminar to learn how to do it) but a homeopath???. For starters plastic surgeons not only know how to contour and sculpt they also know that lipo isn’t appropriate for a 250lb women. I mean how much fat was removed I know the fatalities of lipo has come down when plastic surgeons perform the surgery because they no longer remove as much fat and it is definitly not safe to remove enough fat to make a difference on a 250 lb women even in a hospital.

  32. #32 J
    July 24, 2007

    I thought I read that “dr.” Page was a real doctor who was refused licensure, so he because licenced under the more lenient standard of a homeopath.

  33. #33 MarkH
    July 24, 2007

    Page said there was nothing out of the ordinary, but acknowledged that he did not know whether the patient had taken pre-surgical vitamins and minerals, as normally required.

    This is the dumbest thing I’ve ever heard.

    And five hours? Five! What the hell was he doing for 5 hours? This sounds like a classic example of an over-aggressive liposuction procedure. He probably took more than 10 lbs of fat and ended up putting her into shock. I also suspect that he had to have realized he screwed something up at some point, because there is no way he spent 5 hours doing liposuction (she certainly would have died on the table). I suspect something went wrong, they freaked out, got her stabilized enough to walk out, then she keeled.

  34. #34 scote
    July 24, 2007

    “It may seem a bit cold blooded, but I do not think that there was actionable malpractice, as the patient chose to run the risks with quacks.”

    I doubt the homeopathic “doctor” had a name badge that said “quack” on it. When the Page told the victim that he was licensed to perform surgery she had every expectation that such an assertion had a basis in fact and that he had been properly trained as a surgeon. She might have to sue for other than malpractice, I doubt homeopaths even have malpractice insurance. I’d think criminal charges of fraud and negligent homicide would be more appropriate.

  35. #35 MarkH
    July 24, 2007

    Scote and others, I suspect theProbe is a libertarian, and this is just an example of the market performing efficiently.

  36. #36 Mooser
    July 24, 2007

    Homeopaths can prescribe controlled substances? Which way to the nearest homeopath?

  37. #37 Ahistoricality
    July 24, 2007

    Dr. Normann should have known better.

    Actually, Dr. Normann was enjoined from doing these procedures because he’s had bad liposuction results before. The article you cite says Normann’s

    practice was restricted by the state in May after two other liposuction patients suffered cardiac arrest on the operating table and died.

    You’d think he’d be extra careful….

  38. #38 Ezekiel Buchheit
    July 24, 2007

    This just makes the point even louder that woo-woo is not harmless. This isn’t slippery-slope argumentative fallacy here, this is actual people(or I guess in this case one person) misled, lied to, misinformed, and then killed.

    If you are lieing to people and taking their money based upon those lies, I don’t understand why that isn’t fraud. And if you lie to people and then kill them based on those lies, I don’t understand why that isn’t murder.

  39. #39 Freud Wore A Slip?
    July 24, 2007

    “homeopathy, as long as they keep away from surgury has no risks, unless you are allergic to water.”

    Not quite true. If homeopathy is used in place of medical treatment for a real problem there is definite risk.

  40. #40 Koray
    July 24, 2007

    I offer my deepest outrage. Considering they had two patients die similarly before, I hope these greedy bastards go to jail for their ignorance and total disrespect for human life.

  41. #41 PalMD
    July 24, 2007

    OMG…they are basically allowed by statute to be woo-meisters!

    “under state law, homeopathic doctors may treat disease with acupuncture, chelation therapy, homeopathy, minor surgery, neuromuscular integration, nutrition, orthomolecular therapy and pharmaceutical medicine.”

  42. #42 Sastra
    July 24, 2007

    If you are lieing to people and taking their money based upon those lies, I don’t understand why that isn’t fraud. And if you lie to people and then kill them based on those lies, I don’t understand why that isn’t murder.

    To people who prefer alternative medicine, it all seems to come down to intention. Did the “healer” mean well? Did they believe and have faith and feel right about everything in their heart? If so, then they’re not to blame.

    A huckster in a suit trying to make a buck? Throw the book at him. An earnest spiritual seeker trying to holistically integrate mind, spirit, and body by going beyond scientism out of respect for the entire patient? You can’t punish or discourage that, it so often works: mistakes will happen. Tch tch.

  43. #43 Ezekiel Buchheit
    July 24, 2007

    “An earnest spiritual seeker trying to holistically integrate mind, spirit, and body by going beyond scientism out of respect for the entire patient? You can’t punish or discourage that, it so often works”

    – Nope. Still BS. Still woo. If you want a medicine man to chant over you and wave a stick to cure your cancer, that’s fine as long as you’re also being treated by actual medicine. If the medicine man is insisting that what he is doing will cure you and you don’t need medicine, it doesn’t matter how well-intentioned they are, it is fraud and may lead to manslaughter/murder.

  44. #44 Renee
    July 24, 2007

    Here’s the page from the Arizona medical board on Peter Normann, the doctor who owned the surgery center:

    http://www.azmd.gov/profile/profile.asp?LicenseType=MD&LicenseNum=33254

    This MD is not a plastic surgeon. He didn’t go through a 5+ year surgical residency plus fellowship. He isn’t board-certified to perform any type of surgery. He’s an internist. There’s no telling how much ‘training’ he’s actually had in performing any sort of surgery.

    Patients are easily mixed up about these issues. They see someone with an MD after their name, who runs a cosmetic surgery center, and the patient assumes that they are getting a trained plastic surgeon.

    I may catch some flak about this, but I believe Dr. Normann the internist should be held entirely responsible for this woman’s death. It is he who owned and ran this cosmetic surgery center. It was he who allowed a homeopathic doctor to perform liposuction on his premises. The homeopath didn’t just charge in there and commandeer the surgery suite; Dr. Normann let him in.

    Let’s call a spade a spade. Both Dr. Normann and the homeopath were performing liposuction because it is cash up front. They’re were doing this for money. Neither cared about the risks of liposuction on an obese person, nor about the importance of being properly trained to perform plastic surgery. Neither was contemplating the virtues of allopathic vs. homeopathic medicine. They were contemplating their wallets.

    People posting here are having lots of fun making fun of homeopathy. Well, why not. It’s strange to me, however, that no one is considering the internist’s serious role in all this, as if he’s blameless.

    P.S. There are plenty of free-standing plastic surgery centers run by plastic surgeons, complete with operating rooms equipped to administer general anesthesia. My brother had cosmetic surgery done last year under general anesthesia (all elective procedures), and it was done at a center owned by three plastic surgeons (all certified). They had a surgery suite; I don’t know if there was an anesthesiologist on site, or if it was a nurse anesthetist. To make the visit more enjoyable, the surgeons also operated a spa in the same building as the surgery suite. I was given a free coupon to use there while my brother was having himself redone.

  45. #45 Monado
    July 24, 2007

    I have been told that minor surgery is that which can be done under a local anaesthetic — presumably excluding Wilder-Penfield-like brain surgery. So if you have a general anaestheric, (fatality rate about 2/100,000), it’s major surgery.

  46. #46 Glenn
    July 24, 2007

    From Andrew Dodds:

    I can’t believe the whole ‘They then called 911′; so they were, seriously, doing major surgery without the facilities of a hospital (never mind, say, training?)

    Excellent point, Andrew.

    From the article:

    Page, a licensed homeopath since 2005, told the homeopathic board he considered the patient fine when he left.

    ‘She was in a condition where I would have discharged her to her ride,’ he said.

    Phew! At least she didn’t die of anything serious.

  47. #47 sailor
    July 24, 2007

    “Minor surgery would be putting in a few stitches. Unless a butterfly bandage would suffice.”
    On a boat I did that once many years ago, out at sea, on someone’s hand. Wrong reason (to stop bleeding). The thing that amazed me was how tough the flesh was – I had to use pliers to push the needle through. He must have been in shock he did not even flinch. Before dressing with antibiotic cream it was a red swolen mess. By the time we got ashore (some hours later) and got to a doctor, he took th bandage off and it looked like a perfectly sewn neat cut.
    Well I probably had the same qualification to do surgury as the homeopath. But the surgury was extremely minor and the patient survived. I wouldn’t want to try again.

  48. #48 Coin
    July 24, 2007

    Both Dr. Normann and the homeopath were performing liposuction because it is cash up front.

    This makes me wonder. Is it possible that, despite lacking the licensing, they’ve done this kind of thing before and this is just the first time anyone died?

  49. #49 Mike
    July 24, 2007

    Arizona is screwed up. These are the same dopes who let “Naturopaths” do residencies. Adn then licenses them to practice in hosptials! Don’t believe it? Check out this link.

    http://www.nat-med.com/etiportaldata/natmedonline/pdfs/Heartburn%20and%20GERD.pdf

    Read the bio of “Dr” Decker Weiss. What a joke.

  50. #50 medrecgal
    July 24, 2007

    bob koepp,

    Re: homeopathic vs. allopathic… As someone who grew up wanting to become some sort of surgeon and also had some experience as a patient, I learned a lot about allopathic medicine, at least as we know it here in the USA. Allopathic medicine is that scientifically-based, research oriented, innovative and very expensive discipline that uses all manner of knowledge in the name of easing human suffering and disease (at least that’s what it is in an ideal world; of course, in reality it can become something completely different). Homeopathic is a reference to the use of herbs, potions, and other “remedies” (often along the lines of “like cures like”, such that you’d give tiny amounts of arsenic to someone who had arsenic poisoning or something like this) that are supposedly “superior” to the more typical treatments (like drugs, therapies, or surgery) for disease, at least according to its practitioners. IMHO, it’s a huge form of what Orac often describes here as “woo”. This is different than, say, the discovery of digitalis, derived from a plant, which was found to be useful in the treatment of heart problems… Allopathic medicine is based upon sound research (at some point; incidental discoveries are also researched and their use refined, as with anesthesia or antisepsis); homeopathy is usually NOT.

  51. #51 medrecgal
    July 24, 2007

    Russell,

    That’s a different situation from the person who willingly accepts “homeopathic surgery”; if you’re out on the water effectively in the midst of nowhere and you find yourself needing a cut sutured or a boil lanced or something like that, such minor surgery isn’t foolish by any means, even if you or your “first mate” aren’t licensed MDs. But if you are on dry land and ignorant enough to shun the science of medicine for unproven remedies, that’s a whole different scenario entirely.

  52. #52 PalMD
    July 24, 2007

    I agree with the above comment that the MD should bear the brunt of the responsibility. And when it comes to killing patients, 3 strikes should definitely be an out.

  53. #53 Phoenix Woman
    July 24, 2007

    The Church of Latter-Day Saints (which you will remember is nearly as strong in Arizona as it is in Utah) is very big on nontraditional medicine. (Orrin Hatch is probably the friendliest Senator to the herbal-medicine industry.)

    But like Orac says, homeopaths normally never go near blades, so it sounds like this guy was both a fake surgeon AND a fake homeopath.

    Another factor: The extremely high (and growing) cost of traditional “allopathic” medicine. Most personal bankruptcies in America are due to medical expenses. This is probably the biggest factor in the growth of non-traditional medicine: People turn to it because they literally cannot afford anything else. When a diagnostic MRI costs $700, and it’s a crapshoot whether your insurance will cover it, the temptation to just take $20 worth of herbal pills instead is very strong for many persons.

  54. #54 Vyoma
    July 24, 2007

    Sastra said:

    To people who prefer alternative medicine…

    It’s “alternative”medicine because it’s an “alternative” to doing something actually useful.

    As far as all the “spiritual seeker” crap, Sastra, it’s exactly that. Crap. Doctors are for curing the sick and healing the injured, not for testing out the latest crystal-gazing, mantra babbling fad on the flesh of the gullible. If someone wants to go on a spiritual quest, the proper place to do that is as far away from an operating table as possible.

  55. #55 bug_girl
    July 24, 2007

    I mentioned this at Pharyngula, but I’ll repeat it here: the homeopathic board has a long, dirty history

    http://www.azcentral.com/arizonarepublic/news/articles/1009homeopathic09.html

    The Arizona Republic
    Oct. 9, 2005 12:00 AM

    “A California doctor spent five years in prison for performing thousands of unnecessary eye surgeries before being allowed to practice homeopathic medicine in Arizona.

    A New Mexico doctor illegally borrowed hundreds of thousands of dollars from more than 100 of his own patients before becoming a homeopathic physician in metropolitan Phoenix, a crime that recently resulted in felony convictions.

    Over the past five years, the Arizona Board of Homeopathic Medical Examiners has licensed four doctors who have been convicted of felonies in other states and six others who have lost their licenses or been disciplined elsewhere. A review of public records shows that homeopathic physicians rarely face sanctions from the board, even in instances when prescribed remedies reportedly caused serious harm or, in one case, death. “

  56. #56 Julia
    July 24, 2007

    I completely agree that doctor with the MD behind his name should also be the flack for this poor woman’s death. We are the ones who take the oath to “Do Not Harm” and we have a ethical, moral obligation to ourselves and to our profession to uphold that.

    The Church of Latter-Day Saints (which you will remember is nearly as strong in Arizona as it is in Utah) is very big on nontraditional medicine. (Orrin Hatch is probably the friendliest Senator to the herbal-medicine industry.)

    I must take exception to that. While many members of the Church may fall prey to the lure of homeopaths it is NOT church-endorsed nor believed or followed by the majority of its members. For example, Russell M. Nielsen, one of the church’s leaders, is a cardiovascular surgeon and was heavily involved with medical research in the past; President Hinckley has undergone surgical procedures for colon cancer by, oh my gosh, real surgeons! While we do live by a health code of not using tobacco, alcohol, tea, coffee, or other drugs, most of those have been supported by medical research for restraint in use.

  57. #57 HCN
    July 25, 2007

    medrecgal … and others: “Allopathy” was a term invented by Hahnemann to refer to anyone who did practice the homeopathy he invented. It is a derisive term that is applied to real medical doctors, acupuncturists, chiropractors, herbalists and others, including surgeons:
    http://skepdic.com/allopathy.html

  58. #58 HCN
    July 25, 2007

    Gah!!! I meant to say did NOT practice the homeopathy he invented!

    Anyway, the long and short of it is that “allopathy” is an insult term for those who are not homeopaths.

    In other words, unless you are a homeopath clinging to some distant hope that super-duper dilute solutions of remedies actually work through some kind of self-delusion (like Dana Ullman, http://forums.randi.org/showthread.php?t=82393 ) try not to use that term.

  59. #59 Bob
    July 25, 2007

    I wish more people would come forward and confront homeopathic practice for the illegitimate pile of woo that it is. Bravo for the blunt honesty, Orac.

  60. #60 scote
    July 25, 2007

    “Anyway, the long and short of it is that “allopathy” is an insult term for those who are not homeopaths.”

    I was just scrolling down to make the same point. There is no need to let the woo crowd frame the issue by adopting their labels. Medical Doctors practice **evidence-based medicine**. Woo-woo’s practice wish-based magical thinking.

    Woo-woo medicine is when grown ups play at medicine with pretend treatments the way kids do, except the grown ups no longer realize they are just pretending.

    As for the liposuction, letting homeopaths perform surgery of any kind is exactly like letting witch doctors do the same. Arizona has some esplaining to do…

  61. #61 HCN
    July 25, 2007

    Hey, Bob… I tried to confront my niece who is a big believer in her homeopath! But I was not allowed to respond to her testimony. I had to stifle my laugh when my niece started to describe the applied kinesiology used by her homeopath: http://forums.randi.org/showthread.php?t=63223

    Scote… You are great! I wish you could go to Colorado and knock some sense into my niece! My hope is that some day she will grow up (she is only in her late 20s!).

  62. #62 bushpigeon
    July 25, 2007

    For a great (if gory) send-up/expose of bogus plastic-surgery outfits (in Florida, not in Arizona, but it sounds like conditions are similar), read Carl Hiassen’s novel *Skin Tight.*

  63. #63 hoary puccoon
    July 25, 2007

    It does occur to me that if the patient had been satisfied with homeopathic doses of meat fat instead of snarfing down Big Macs, she wouldn’thave needed the surgery in the first place.

  64. #64 Bob
    July 25, 2007

    HCN, as thomps1d pointed out on the randi thread, it’s more akin to religion than science for the people on the receiving end of homeopathy. No amount of logic will sway irrational belief.

  65. #65 Sastra
    July 25, 2007

    Vyoma said

    If someone wants to go on a spiritual quest, the proper place to do that is as far away from an operating table as possible.

    I agree, but as Bob points out, what we’re dealing with here is another front on the Science-and Religion war. It’s not just Creationism. So-Called Alternative Medicine (SCAM) is really about science providing support for spiritual truths.

    “Try it for yourself and see” is the ‘alternative’ version of scientific rigor, and it comes right out of the personal testimony and inner confirmation of religious faith. If you tell a True Believer that homeopathy is faith healing, they’re not bothered at all. Faith works. Our minds control reality. Quantum physics proved that. Science supports woo. You know — the OPEN MINDED kind of science which respects people’s knowledge of their own experiences.

  66. #66 Sastra
    July 25, 2007

    Oh, and I’m another one taken aback by the use of the term “allopathic” by someone who is NOT into alt med. 86 it. It’s like supporting Orac and referring to him as a “pharma shill” — or like promoting the value of “scientism.” Those are negative frames.

  67. #67 Margaret
    July 25, 2007

    Is there any evidence that it was the homeopath who did the surgery rather than just being there to provide legal cover for the incompetent doctor who was no longer allowed to perform surgery?

  68. #68 HCN
    July 25, 2007

    Bob, I agree… it is more like clinging to a religion. Logic does not apply to either homeopathy or unseen gods in the sky.

  69. #69 Prometheus
    July 25, 2007

    Wow!

    First we have Naturopaths prescribing colchicine (and killing people) and now we have Homeopaths doing surgery (and killing people). What next? Chiropractors doing brain surgery?

    Here’s what I see as the bottom line to all of this horror:

    Medicine, even when practiced by the best-trained and most able, using the state-of-the-art equipment and up-to-date knowledge, causes deaths. Mind you, avoiding medical care (or not having access to it) causes even more deaths, a couple of orders of magnitude (i.e. 10 to 100 times) more.

    Medicine (i.e. surgery and real medications) practiced by people who are not trained and capable has the potential of being as dangerous or even more dangerous than avoiding medical care altogether.

    By analogy, driving a car is dangerous – people are killed every day, even when they are well-trained, experienced and follow the rules of the road. The fact that driving is dangerous in no way excuses the people who kill others (and perhaps are killed themselves) by driving while drunk, blind, or otherwise impaired.

    This homeopath and his physician employer were no more competent to do liposuction than they were to pilot the Space Shuttle. The fact that the Arizona Board of Homeopathic Medical Examiners cannot see that merely points out how useless they are.

    Their failure to revoke the phony-baloney homeopath license in this case speaks volumes. In Arizona, at least, the watchword around homeopaths is caveat emptor.

    Prometheus

  70. #70 medrecgal
    July 25, 2007

    HCN,

    Do we like the term “EBM” better? I’m supporting the science end, not the “woo” end. Didn’t realize the connection in the terminology when I said “allopathic”. Sorry, my bad.

  71. #71 Beach Bum
    July 25, 2007

    My take on the whole alternative medicine thing is that it’s a reaction to the idea that science and technology would make our lives perfect and easy. Well, we have all this scientific medicine (which is a good thing IMO), and our lives are still difficult.

    People are looking for the quick fix (and I don’t think this is a new thing). It’s just that since scientific medicine has turned out to not be the quick fix they were looking for, and their lives still suck, people are trying to find the next quick fix.

    The problem is not that people are turning to a more “natural” way of life. I think that getting rid of industrial poisons in our day to day lives is good idea, one who’s time has come. And I think that eating high-quality food and getting a large variety of micronutrients and interesting antioxidents from various sources is a good thing. The problem as I see it is that people are trading one pharmacopea which at least has the backing of the scientific method, for one which has anecdotal benefits at best.

    And the snake oil salesmen appear on cue to try and sell the dream of a perfect life. It’s the same thing the drug companies are doing. At least they are mandated to study their drugs.

  72. #72 TheProbe
    July 25, 2007

    Moi is not a libertarian, and I’ll skip the insult. :)

    My point is that there is a lot of quackery in Arizona, and people who rely on a title IN THAT STATE, albeit MD, DC, DO, etc. do so at their own risk. The *S*o-*C*alled *A*lternative *M*ovement is supposedly growing by bounds and leaps, and propagandizes itself as safer than evidence based medicine. If people buy into this crap, then I think that they buy into the whole steaming pile, and take their risks as they find them.

  73. #73 TheProbe
    July 25, 2007

    Julia, to call Orrin Hatch “friendly” to the magic potion industry is akin to calling the Grand Canyon (have to keep this in Arizona) a gully. He sponsored the DHSEA bill, and his son is a major lobbyist for the industry. Further, he owned stock in one company when he sponsored the bill.

  74. #74 HCN
    July 25, 2007

    Beach Bum said “People are looking for the quick fix (and I don’t think this is a new thing). It’s just that since scientific medicine has turned out to not be the quick fix they were looking for, and their lives still suck, people are trying to find the next quick fix.”

    Often times the “cure” offered by scientific medicine requires actual work by the patient. I knew one person who decided to try a naturapath who prescribed compounded meds and homeopathy because she did not like the prescription given to her by the real doctor: Go out and start exercising, starting with just taking walks around her neighborhood, plus eat a more balanced diet.

    This woman would rather drive to the compounding pharmacy than take a walk around the block.

    At a holiday gathering she was complaining about her constipation to her mother. I piped in that taking a walk often helped me in that area. She just answered me with an icy glare!

  75. #75 David / Homeopathy Zone
    August 4, 2007

    As a responsible representative of the homeopathic profession (insofar as such can be delineated), I would like to point out that it is never within the scope of a “homeopath” or “homeopathic doctor” or “homeopathic [anything]” to perform liposuction surgery. The only cases in which this can happen is if:

    (a) the person is also a medical doctor
    (b) there is something seriously wrong with Arizona medical legislature practices
    (c) the person misrepresents his credentials entirely

    You may rail against homeopathy on the standard grounds of skepticism about ultra-diluted substances having any medicinal effect, but not on the basis of a homepath performing surgery, anymore that you would reject dermatology on the basis of a dermatologist performing heart surgery. To conflate these lines of criticism is to reason, well, unscientifically.

  76. #76 Orac
    August 4, 2007

    Now that’s hilarious! A homeopath calling anyone “unscientific”!

    As for “conflating the two,” you’ll note that I made jokes about “homeopathic surgery” and made fun of the very concept. I know very well what homeopathy is and isn’t. What it is is quackery. The main point about homeopaths performing surgery is that the laws permitting homeopathy don’t just open the doors to the quackery that is homeopathy but to loads of other quackery as well.

  77. #77 David / Homeopathy Zone
    August 5, 2007

    Orac,

    I am well appraised of the problematic scientific status of homeopathy, as are many responsible homeopathic colleagues of mine. The fact that there are irresponsible or plain ignorant homeopaths is a reflection of lack of regulation rather than a flaw of the profession per se.

    As someone who has studied philosophy of science in depth, I am also aware of the simplicity of popular science/pseudoscience criteria of demarcation, such as the use of Popper’s popular falisfiability criterion without understanding it in sufficient depth.

    The question of whether each field of alternative medicine is quackery or not is very complex. Of course many choose to deal with this complexity by invoking simple criteria that can be applied wholesale. I do so myself – but I recognize that this is an expedience arising from my limited ability to confront each field and study it in depth, so I keep my opinion to myself.

    An intellectually responsible appraisal of homeopathy must involve quite a bit of clinical observation. This is because it is what I see in the clinic that makes me believe in homeopathy, even as my rational mind remains quite as baffled as yours.

    The standard trinity of placebo/sponteneous-remission/wrong-diagnosis explanations is too facile for dismissing cures of, say, autism (which takes 3-5 years of very disciplined prescribing), of which I have seen several live cases with ongoing followup over several years (at an estimated rate of cure of 20% from among the total number of autism cases seen, so this is hard to dismiss as a chance occurrence) in clinical observation of the work of senior colleagues, or of lightning-fast responses to acute prescribing in infants and animals.

    I understand your stance on homeopathy, but its fervour is unmatched by (my presumed level of) your depth of engagement with the subject-matter. I would like to suggest by the above that your proper stance about homeopathy should be cautious rather than self-assured skepticism.

    Finally, to return to the topic of this article, the fact that regulation of homeopathy opens the door to greater quackery is a manifestation of poor legislation. There is no necessary reason for a “bleed-over” effect between disciplines in alternative medicine, at least not one of the magnitude described. Of course people can get hurt by not receiving appropriate medical care and visiting quacks instead, but the danger from that pales in comparison to the documented dangers of medical treatment.

  78. #78 Orac
    August 5, 2007

    The standard trinity of placebo/sponteneous-remission/wrong-diagnosis explanations is too facile for dismissing cures of, say, autism (which takes 3-5 years of very disciplined prescribing), of which I have seen several live cases with ongoing followup over several years (at an estimated rate of cure of 20% from among the total number of autism cases seen, so this is hard to dismiss as a chance occurrence) in clinical observation of the work of senior colleagues, or of lightning-fast responses to acute prescribing in infants and animals.

    Give me a break. The reason homeopathy can appear to work for autism is the same reason that chelation therapy and other quackery can appear to work for it: Many autistic children develop out of it and now, as adults, live independent, more or less normal lives, even some who had had apparently severe cases of autism. Without very careful controls, your conclusion is completely untenable. Your assumption that these 20% represent “cures” is impossible to support; contrary to your claim that it’s hard to dismiss as “chance,” it’s actually very much in line with what is expected with no treatment at all.

    Don’t believe me? Ask the Autism Diva, among others.

  79. #79 HCN
    August 5, 2007

    Some homoepath said “The question of whether each field of alternative medicine is quackery or not is very complex.”

    No it isn’t. Either it works, or it does not. The trick is figuring out if it actually works. Sometimes it is quite easy to see that a bunch of wires hooked up to a galvanometer is actually worthless (but folks still buy “zappers!), or to know that a substance diluted past Avogadro’s number is a bunch of nothing.

    Some say that homeopathic drops will help cure influenza. So some folks did a study of it, and found that it did lesson the length of influenza by .28 days. Uh, wait… that is just a few hours!

    See http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=14973976 … “Oscillococcinum treatment reduced length of influenza illness by 0.28 days ”

    So, instead of the flu lasting 2 weeks, it lasted 1 week, 6 days and 17 hours.

    Which brings us to this statement: “The standard trinity of placebo/sponteneous-remission/wrong-diagnosis explanations is too facile for dismissing cures of, say, autism (which takes 3-5 years of very disciplined prescribing), of which I have seen several live cases with ongoing followup over several years (at an estimated rate of cure of 20% from among the total number of autism cases seen, so this is hard to dismiss as a chance occurrence) in clinical observation of the work of senior colleagues, or of lightning-fast responses to acute prescribing in infants and animals.”

    Which clinic? Where does this happen? And how do you differentiate between normal development and the treatment, especially since it only worked 20% of the time? For many kids who are diagnosed with autism (but may actually have some other developmental delays, or are just on a different developmental timescale) they actually grow out of the series of behaviors many people are now calling “autistic”. Perhaps 1 out of 5 times.

    I have one child who if he had been born 10 years later, might have been labeled autistic. But instead he got a much more accurate diagnosis of oral motor dyspraxia with functional dysarthria combined with mild dysphasia, which may or may not be related to a history of seizures. This means he got appropriate speech and language services.

    His brother on the other hand did seem to have a language delay as a toddler, with neo-linguistic approximations and repetitions (a little like echolia). Stuff that people would have labeled “autistic” if he were but 8 years younger. But with appropriate language therapy was caught up to normal speech and language before he started kindergarten (that was less than two years, compare that to your 3 to 5 year time line). He is a now a high school honor student and lifeguard, who is very good at teaching small children to swim.

    My point is that the autistic label is being used with too broad a brush, and possibly many more than 20% are not actually autistic at all.

    So your statements don’t mean a thing. Other than to show that you are clueless about autism, and child development in general.

  80. #80 Bronze Dog
    August 5, 2007

    The problem with claiming that infants and non-humans aren’t subject to the placebo effect: Typically, the person interpreting the condition is subject to wishful thinking and confirmation bias.

  81. #81 David D.G.
    August 5, 2007

    Bronze Dog,

    There’s also the Clever Hans effect to consider, which certainly applies to animals, since it was named for the animal in which it was first recognized. I see no reason why it couldn’t also apply to very young children as well.

    ~David D.G.

  82. #82 TheProbe
    August 5, 2007

    The definition of a resonsible homeopath is one who nevenr went to school and got a real job.

  83. #83 TheProbe
    August 5, 2007

    The definition of a resonsible homeopath is one who nevenr went to school and got a real job.

  84. #84 Sastra
    August 5, 2007

    An intellectually responsible appraisal of homeopathy must involve quite a bit of clinical observation. This is because it is what I see in the clinic that makes me believe in homeopathy, even as my rational mind remains quite as baffled as yours.

    Someone once described “clinical experience” as “making the same mistake over and over again with increasing confidence.” There are so many confounding factors in health that repeated, controlled studies are far more reliable than personal observations.

    Doctors swore by bleeding for hundreds of years. They knew it worked. They had seen it work. It had been confirmed by watching its beneficial effects on patients so many times by so many people that it’s effectiveness was beyond dispute.

    We humans are really not that good at evaluating without setting up controls against human errors in evaluating.

  85. #85 David / Homeopathy Zone
    August 6, 2007

    To Orac ad HCN: Your objections about the accuracy of diagnosis are well taken. I am well aware of the continuous spectrum from mild behavioural disturbances to profound autism. I’ve worked with quite a few ADHD cases and a few Asperger’s cases, and recognize that in some of those cases I couldn’t claim that it was homeopathy rather than normal development or other therapy that had produced the results.

    I therefore should have mentioned that the examples I included under autism were fully (modertaly to severaly) autistic individuals that were fully disconnected from the world, had mild to moderate intellectual deficits to the extent it was possible to determine, were essentially unreactive to outside stimuli, and engaged in constant staring, ritualistic behaviour, etc. I should have also mentioned that one of them was almost 18 at the beginning of treatment, semi-functional at home and apparently mildly retarded, and is now a 22-ear-old who is making friends, communicating freely, displaying average intelligence despite a remaining childish temperament, possessing above-average wit and sense of humour, and speaking freely albeit with unclear enunciation.

    Orac and HCN, such autism cases are utterly different from mere “autism spectrum disorder.” Please show me such results at a 20% rate of cure, or in an 18-year-old, and I will take my hat off. Although many cases may be misidentified, the cases I referred to were unmistakable cases of true autism, each typically diagnosed by multiple specialists and having undergone behavioural therapy before the parents ever arrived at homeopathy. The conventional medical literature classifies such cases as utterly incurable – it is simply untrue that some of them show natural remission. I’ll allow for the occasional chance remission of such cases, but 20% is remarkable, or, to quote some of the medical doctors’ reactions to the above cases as reported by their parents, “miraculous” and “impossible”.

    I could make my case with additional observations of other serious pathologies – obviously I do not base my faith in homeopathy on the above cases alone.

    Regarding the study mentioned by HCN: Your description of the study displays the sort of biases that I have encountered time and again. First, where did you get the 2-week period? Why not the 48h (hence 2-day) period as in at least one study of this substance? And what about qualitative improvements reported by the active-group patients? I suspect (forgive me if I am wrong) that your 2-week example was not based on the study but was intended simply to belittle the results.

    Second, time and again I see how clinically significant results are dismissed as “not rigorous enough”, and rigorous results (such as that study) as “not clinically significant”. We cannot have it both ways: studies by their nature are optimizable either for “internal validity” (statistical rigor) in which case their “external validity” (clinical significance) is reduced, or v.v. – this is simply a basic constraint of study design, a fact which influences all medical research equally and explains the complexities of trial interpretation also in conventional medicine, where things are rarely as clearcut as they are made to be in popular reports.

    In other words, you cannot reject a homeopathic study because it is not clinically significant (some, indeed, are not clinically relevant at all as they are laboratory investigations on cells or tissues), when the question in your mind is whether homeopathic preparations have any effect at all to begin with. To expect both criteria to be fulfilled at once and reject the result if one is not is patenly disingenuous.

    In the case of homeopathy, a standard preparation given indiscriminately based on the medical diagnosis is expected to have a small clinical effect at best, whereas proper homeopathic prescribing in an individualized fashion is more clinically effective but also extremely difficult to study because there is no one-to-one relation between diagnostic criterion and treatment (many homeopathic remedies can match a single diagnosis, depending on the differenting symptoms of each case).

    To Sastra: Clinical observation is potentially and habitually full of biases and susceptible to gross misinterpretation. It is, however, an indispensable aspect of all medicine, and remains the basis of the majority of medical interventions, which are not removed from use simply because there is no evidence for them – and rightly so.

    But there is little relation between the fact that clinical observation 200 years ago was prone to massive error and the claim that this remains so today: 200 years ago physicians were not trained in scientific thinking, their whole world view tended to be much more superstitious and magical than today, and so on. Highly refined clinical reasoning, supplemented with other forms of evidence, has a place in today’s medicine. Incidentally, I’ve written a large research paper on the problems of limitations of Evidence Based Medicine and the indispensability of clinical observation – you may contact me via my site and I will gladly e-mail it to anyone who wishes.

  86. #86 Joe
    August 6, 2007

    David/hom. Why not direct us to the high-quality research that supports each of your remedies. Don’t give me the vintage homeo whine about funding- the NCCAM exists to fund research into irrational and discredited notions.

    Of course, the knee-jerk response, taught in quackery 101, is to observe that not every medical procedure is evidence-based. So, let’s skip that and get to the point- I want evidence for homeopathy, not against anything else.

  87. #87 Orac
    August 6, 2007

    I agree. In particular, In particular, I’d like to see real evidence other than vague anecdotes for his claims about homeopathy and autism.

  88. #88 David / Homeopathy Zone
    August 6, 2007

    Joe,

    The available funding is mostly symbolic relative to the demand for the money, but that’s besides the point.

    Your demand for support for “each of your remedies” cannot be fulfilled. If we take but 300 homeopathic remedies (probably 95% of all homeopathic prescriptions are covered by this, although over 1000 remedies are in use), and just 30 medical diagnoses (which for the sake of argument let’s say cover 95% of all diagnoses), this would require 300 different experiments per diagnosis (because every remedy covers a wide range of symptoms and can in principle be used for any diagnosis, although there are clinical affinities to each remedy), each of which would then have to be reproduced, etc. So this is a non-starter. Novel study designs that consider the peculiar nature of homeopathic prescribing might bring this number down, but the research will still be more complex than in the one-to-one medication-to-diagnosis relation common in conventional medicine.

    Instead, if you are willing to allow for a build-up of an evidence base – for a gradual, realistic, and systematic approach to progressively covering more and more aspects of the evidence, then this is what is happening in homeopathic research, albeit at a snail’s pace (note that homeopathy has a highly evolved clinical approach to which studies are unlikely to contribute at this early stage of research, so clinical work can progress meanwhile [of course you will say that this work is baseless]). Mind you, even in medicine it is taking dozens of years.

    There are physical studies on the properties of water that might allow for the homeopathic phenomenon (these are needed because clinical studies are routinely rejected on the basis of a prior improbability due to lack of plausible mechanism), e.g.:
    Dixit et al., “Molecular segregation observed in a concentrated alcohol-water solution” Nature 416 (25), April 2002, pp. 829-832.

    There are top-notch clinical studies optimized for methodological rigor rather than clinical applicability, whose goal is to show that homeopathy produces a statistically significant clinical effect, e.g.:
    Reilly et al., “Is evidence for homoeopathy reproducible?” The Lancet 344 (1994) pp. 1601-06 and accompanying editorial on p. 1585.

    These are just two prongs of a many-pronged research enterprise that can, over time, produce the sort of evidence that you want presented instantaneously. Scientific process is incremental, not a la carte.

    Your quip about “funding research into irrational and discredited notions” reveals that you are not interested in the evidence as you consider the case already closed. Nevertheless, based on existing peer-reviewed research homeopathy can be classified as a “possible”, “suspected”, or “unlikely” anomaly, but certainly not as discredited, unless you simultaneously reject the authority of leading scientific journals which you otherwise trust, I presume on an ad hoc basis.

    Finally, I have seen more “Skepticism 101″ on this thread than “Quackery 101″. If I borrow a line from “Quackery 101″ it is because I have considered it myself and found it a valid point in the context in which I bring it up. In the context of your answer, for example, my preceding Quackery 101 point is spot on: What would you answer if I asked you to provide evidence for “all the medicinal and surgical procedures of conventional medicine”?

  89. #89 Bronze Dog
    August 6, 2007

    One of the things that’d get me to take homeopathy seriously: Apply for the Randi Challenge by claiming you can tell the difference between a homeopathic remedy and just the standard solution/pill/whatever that hasn’t gone through the magic ritual.

    Other than that, there’s one thing: Show me ONE homeopathic remedy that passes double-blind control studies.

  90. #90 Orac
    August 6, 2007

    Finally, I have seen more “Skepticism 101″ on this thread than “Quackery 101″. If I borrow a line from “Quackery 101″ it is because I have considered it myself and found it a valid point in the context in which I bring it up. In the context of your answer, for example, my preceding Quackery 101 point is spot on: What would you answer if I asked you to provide evidence for “all the medicinal and surgical procedures of conventional medicine”?

    I didn’t ask you for evidence for “all homeopathy.” That’s a straw man. I asked you for evidence to support your claim that homeopathy can cure autism, at least for a start. Instead of presenting your evidence, you whine about the burden of proof. You shouldn’t make the claim if you can’t support it.

    As for that Lancet article, I know homeopaths love to cite it, but it’s 13 years old and there have been quite a few studies since then that have been negative. For example, one from the Mayo Clinic. As for that Nature paper, I know that homeopaths like to cite that too, but it really doesn’t provide any positive evidence for homeopathy or the principles of homeopathy. For one thing, it doesn’t show that serially diluted solutions retain any sort of “memory” or therapeutic properties.

    The fact is that homeopathy is magical thinking, nothing more. Every study I’ve ever seen that purports to show a positive result has serious flaws, for example this one. Even in the 1840s, it was obvious that there was no scientific basis for its claims, as Oliver Wendell Holmes pointed out.

    But, hey, I could be wrong, although I doubt it. However, without some solid evidence to show that homeopathy is anything other than an elaborate placebo for some specific conditions, I’m difficult to convince. You could start with evidence consisting of something more solid than anecdotes that homeopathy can “cure” autism.

  91. #91 David / Homeopathy Zone
    August 6, 2007

    Bronze Dog,

    I was privy a few years ago to at attempt to set up a challenge with Randi. He repeatedly refused to accept the challenge even after multiple adjustments of the protocol as per his demands. The test was a simple one, of the effect of a homeopathic remedy on growth rate of sprouts, where the challenger claimed he was able to demonstrate a significant difference (the idea was that the bunch of sprouts growing in homeopathic water of a specific remedy that he used grew significantly more or less (I cannot recall which) than a control sample. Randi is a master politician who sincerely believes in his cause but goes about it in insincere ways, one of which is this dubious Million Dollar Challenge which he manages at his whim; thus the Challenge is subject to strong selection bias and consequently has no scientific bearing the issue at hand. I don’t understand why Randi is ocnsidered an authority in the first place, when he is so invested in his skeptical project that he cannot act as impartial administrator of the challenge (just as, say, I could not be one due to my own, opposite bias).

    Regarding one remedy that passes double-blind studies: there are several positive studies on Oscillococcinum that can be found through Medline(see also the link in a post by HCN above). Another one is the Reilly et al. study I quoted above, though there a customized preparation was given patients based on principal allergen to which each was most sensitive, but hopefully this will still satisfy your request.

    Finally here’s a detailed review of research articles with numerous references, among them likely ones relevant to your query:
    http://www.homeopathic.com/articles/view,71

  92. #92 Joseph
    August 6, 2007

    I should have also mentioned that one of them was almost 18 at the beginning of treatment, semi-functional at home and apparently mildly retarded, and is now a 22-ear-old who is making friends, communicating freely, displaying average intelligence despite a remaining childish temperament, possessing above-average wit and sense of humour, and speaking freely albeit with unclear enunciation.

    So you essentially started with an autistic adolescent and ended up with an autistic adult. Were there several IQ assessments before an after treatment? What were the results?

    Anecdotes like this are worse than worthless, to be frank, because they mislead and they are a waste of everyone’s time. Placebo effects are very robust in autism. So it’s not a surprise that parents and the persons providing the treatment – any made-up treatment – see “amazing” results.

    Even preliminary non-controlled trials are a waste of resources in my opinion when it comes to autism, because of the robust placebo effects. At the very least you’d need to compare against a placebo baseline of some kind.

  93. #93 Bronze Dog
    August 6, 2007

    I was privy a few years ago to at attempt to set up a challenge with Randi. He repeatedly refused to accept the challenge even after multiple adjustments of the protocol as per his demands.

    Citation, please. Reminds me of this one guy who pretended that Randi was going on about a camera when the chief complaint was the measurement method. Allow me to judge for myself.

    I don’t understand why Randi is ocnsidered an authority in the first place, when he is so invested in his skeptical project that he cannot act as impartial administrator of the challenge (just as, say, I could not be one due to my own, opposite bias).

    Bias is not sorcery. It can’t change the results if the protocols are designed to eliminate bias.

    As for authority: He isn’t. There’s really no such thing as authority in science. Randi just makes very good arguments and designs very reasonable protocols.

  94. #94 David / Homeopathy Zone
    August 6, 2007

    Joseph:
    1) A young adult who forms friendships, goes to work, and has plans for the future is different from a teenager who can do not much more than grunt, get up in the morning, eat, and take care of his basic physical needs. My claim for a cure centered about these facts. I don’t know about any IQ assessments done: all I said he was apparently mentally retarded and clearly wasn’t thereafter.
    2) As I explained above this degree of autism doesn’t display “robust placebo effects,” or at least the burden of proof is on you this time because this contradicts the conventional view of the disease. I therefore used the example precisely because of the lack of such placebo responsiveness as the most likely explanation.

    Bronze Dog:
    1) All I described was an event which shaped my basic level of trust in Randi; I was not making a scientific claim in need of a citation, just expressing my subjective skepticism of Randi. Unfortunately I don’t have a record of it and don’t even remember the challenger’s name.
    2) My point about selection bias stands: even if Randi or an appointee administers each accepted study impratially, the fact that Randi can choose which studies to accept in the first place (for example, studies that are likely to fail or that are methodologically poor and easy to reject post factum) is a clear and fatal source of bias.

    Orac:
    1) My reference to “proving all of homeopathy” was in reply to Joe, not to you.
    2) The fact that the Reilly Lancet paper is 13 years old is irrelevant, unless you have specific concerns with methods used therein that have since been discredited. It’s true that there are negative studies, but there are no negative replications or near replications of that study to my knowledge, and most meta-analyses of homeopathic research have tended to lean in favour of an effect, even when this fact was dampened in the Discussion. I am discounting the recent, widely publicized study (Shang A. et al. Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet 2005; 366 (9487): 726-732) because it is truly shoddy science – see my partial but sufficient rebuttal at: http://www.homeopathycourses.com/lancet.html#Article21.
    3) The autism cases I brought up were meant not as evidence for you to be influenced by, but as an illustration of the sort of evidence that influences me in the clinic, just as your surgery patients influence your views on conventional and alternative medicine. If you’d like evidence for autism you’d have to observe clinical work. A homeopath who treats many cases of autism is Paul Herscu who can be contacted through http://www.nesh.com/main.html – perhaps he accepts clinical observers or can provide video evidence as I know he tapes his consultations; there is unfortuntaely no shortcut I can offer.
    4) I’ve presued your critique of the Chest homeopathy study which I am not familiar with as I haven’t been keeping up with recent literature. Part of your criticism there concerns the peer-review process, and I must say I am glad to see that you do not regard the tools of science as free from bias and simple to use. I would like to suggest that this is the point I have been trying to make in my this thread:
    - I haven’t been trying to convince you and others of the reality of homeopathy (we cannot expect to sway each other significantly when our initial opinions diverge so much) but:
    - to argue and illustrate that the question of the reality of homeopathy is at least to a slight degree an open scientific question. If we can so much as see eye-to-eye on this then this, I believe, is as far as this debate can ever fruitfully progress.

  95. #95 Joseph
    August 6, 2007

    A young adult who forms friendships, goes to work, and has plans for the future is different from a teenager who can do not much more than grunt, get up in the morning, eat, and take care of his basic physical needs. My claim for a cure centered about these facts. I don’t know about any IQ assessments done: all I said he was apparently mentally retarded and clearly wasn’t thereafter.

    Are you claiming that the teenager was totally non-verbal and the adult was completely verbal? You apparently left that important part out of your initial claim.

    It is possible for autistics to form friendships (although even autistics considered “high functioning” such as myself admittedly do not). Many autistics report they like having friends. I’m sort of an exception in that regard apparently. Autistics do work. When they don’t work, it’s more a matter of they being considered unemployable by others, not always a matter of being incapable of working.

    As I explained above this degree of autism doesn’t display “robust placebo effects,” or at least the burden of proof is on you this time because this contradicts the conventional view of the disease. I therefore used the example precisely because of the lack of such placebo responsiveness as the most likely explanation.

    The conventional view of the “disease” is not science-based. I’m not sure what it’s based on frankly. A portion of autistics do have what they call “good outcomes” regardless of the type of intervention.

    BTW, it’s not clear that the adult you describe would be considered to have a “good outcome”.

    While placebo-controlled studies have mostly focused on young children, there’s no reason to suppose placebo effects don’t apply to adolescents or adults. In fact, you could argue you’d expect placebo effects to be more pronounced if the young adult is more likely to understand the notion of treatment than a young child.

    Furthermore, among the “placebo effects” we have observer bias, i.e. your bias. This is obviously a non-trivial bias, especially considering your ad-hoc observations, such as, < >

  96. #96 Joseph
    August 6, 2007

    (Sorry, message got cut off due to formatting).
    The ad-hoc observation is basically this: He appeared mildly retarded before; he doesn’t appear retarded now; however, there were no IQ tests to confirm this.

  97. #97 HCN
    August 6, 2007

    David the homeopath shows that he is clueless.

    First I did not link to a “study”, I linked to a review of several studies, and it basically said that homeopathy was not terribly helpful in influenza. Also, real influenza does not last for only 48 hours, it is a very serious disease that can knock a person flat on their back for two weeks.

    Second of all, I did check to see what studies have been done with homeopathy and autism at http://www.pubmed.gov (hey, it does index homeopathic journals!)… and the results are as follows:
    Result:
    0

    Try again, with some real evidence — not just some anecdote, especially when you do not seem to be aware of what the diagnostic guidelines are used for autism. Try listing the clinic, procedures, what testing was done and how the results were assessed. It might help if the clinic is located at one of these Autism Research Network centers listed here:
    http://www.autismresearchnetwork.org/AN/

    Or if you wish an equivalent from Canada, the UK, Israel or elsewhere. But it has to be real research, not your opinion of the folks who walk into your clinic for treatment (the clinic address was missing from your various websites).

  98. #98 David / Homeopathy Zone
    August 6, 2007

    Joseph: The mental retardation (which I mentioned in tentative terms) was indeed only a secondary clinical observation on my part as it is something diffiult to determine with passive observation alone – there may have been tests I was not aware of. But the main criterion of improvement and the one that showed unmistakable and striking progress was the huge advance in verbal communication, reactivity to the outside world, and eventually “proactivity” toward the outside world as well.

    HCN: I have to be psychoanalytical, but I strongly suspect you were told you were cluless while growing up, seeing that this is all you can (repeatedly) summon up against me. I never said your link was a single study, I specifically said that I could offer only clinical evidence and not studies of autism, and my local clinic address happens to appear in a strange script known to homeopaths alone (we are a truly medieval bunch!).

    —-

    I hereby sign off this thread – thanks to all for the discussion – though polite private followup is welcome – as I think we have come to a sufficient understanding of the other’s position and defense thereof.

  99. #99 HCN
    August 6, 2007

    You obviously have no clue what constitutes real science. I posted a real study, and listed a set of autism research centers to give you a hint of what kind evidence is credible.

    You said “The mental retardation (which I mentioned in tentative terms) was indeed only a secondary clinical observation on my part as it is something diffiult to determine with passive observation alone – there may have been tests I was not aware of. ”

    You based the diagnosis of mental retardation only on your observations. You did not do any tests, so how would you have known there would be improvements in math, reading, math reasoning or other measurements of cognitive ability. Something like the Wechsler Individual Achievement tests. there are many others.

    Perhaps the next time you do a miracle cure of an autistic adult you will start out with the preliminary testing, then follow through with rigorous documentation. Then you can submit a paper to some Homeopathic Journal showing how well your magic water/pills work.

    But if you are not aware of any of the standard tests used to evaluate the many forms of cognitive ability, or even of general health, then you have no business claiming any improvement in autism or other neurological conditions.

    Next thing you will tell is that you have cured hypertrophic cardiomyopathy!

  100. #100 HCN
    August 6, 2007

    David, you came here with an extraordinary claim. This requires extraodinary evidence for us to even consider it to be part of the realm of reality.

    You failed to provide any real evidence. Stories from your clinic really do not count.

  101. #101 Joseph
    August 6, 2007

    The mental retardation (which I mentioned in tentative terms) was indeed only a secondary clinical observation on my part as it is something diffiult to determine with passive observation alone – there may have been tests I was not aware of.

    That’s a key mistake and it shows your lack of familiarity with autism. Traditionally it has been assumed that mental retardation is common in autistics, mostly based on ad-hoc observations such as yours. This has been challenged recently. For example, read this.

    There are cases of autistic children who, because they are “untestable”, are presumed to have IQs of 30 or 40 (something like that). But they grow up and it turns out they are cognitively very capable. It happens.

    Michelle Dawson (an autistic researcher) and colleagues have written a paper (currently in press) on the IQ of autistics on different scales, such as the RPM and the Weschler scale. What’s interesting is the large gap between the scales for autistics (whereas there should be theoretically no gap for the general population). But also, for the group of autistics they tested, their RPM scores were higher than the norm. The RPM scores of “classic” autistics were higher than those of Asperger autistics. In one test case, a non-verbal adolescent was profoundly retarded according to the Weschler scale, but scored in the 95-percentile in the RPM.

  102. #102 Antiduck
    August 6, 2007

    Funny how a quack will dissolve into special water. And by special, I do mean retarded.

  103. #103 DuWayne
    August 6, 2007

    Joseph -

    One of my five year old son’s favorite friends, S, is autistic. It is interesting to me, that while in many respects he appears retarded, he is most definitely not. A great example, is a 3D puzzle we got my son. My son is a very bright kid, but for some reason has trouble getting this thing together right. I mean he can disassemble and reassemble electronic devices without much trouble, but this puzzle just stumps him. However, when S came over to visit and saw it for the first time, his only difficulty in putting it together, was his trouble with motor skills. He looked at it and just seemed to “know” how the pieces should go. It was really a blast watching him and my son (who has very good motor skills) working together to put it up. S does have trouble with cooperation, so it took quite some time, but they managed to get it put together.

    I did a job for a speech pathologist not too long ago, who told me that ADHD people and autistic people, tend to get along really well. I think there is definitely something to that. Both my son and I, seem to really enjoy our autistic friends – there is a certain symmetry to the relationships. Anyone who thinks that autism = retardation, obviously has no experience with the autistic. I would tend to think that retardation among the autistic is probably quite rare.

  104. #104 Joseph
    August 7, 2007

    DuWayne: I just read a blog post with the abstract of Michelle Dawson’s paper. You might be interested in it. It’s here. (Looks like there’s no free access to the paper yet).

    I did a job for a speech pathologist not too long ago, who told me that ADHD people and autistic people, tend to get along really well.

    I don’t know about that, but meet Janna, an ADHD adult who writes about autism and has a lot of experience with autistic kids.

  105. #105 DuWayne
    August 7, 2007

    Joseph, thanks for the links. I am checking out Janna’s site now. By the way, I will be visiting yours as well.

    I am going to try to find the paper at the library. I am in the process of going back to school and have a student ID that not only gives me access to the library of the community college that I will attend, but the library of Oregon Health and Science University, as well.

  106. #106 David / Homeopathy Zone
    August 7, 2007

    OK, a final wrap-up of the replies by clueful HCN and respectful Joseph to my last post:

    I have already mentioned that the issue of the mental retardation of the aforementioned patient was tentative (it is not my patient but a patient in an ongoing teaching clinic, so I didn’t have the opportunity for personal interaction), as I am fully aware of the difficulties in establishing intelligence in significantly autistic individuals. All I said was that he appeared retarded prior to treatment and is not at present (his remaining speech difficulties are motor rather than cognitive), to distniguish him from autists who do not appear retarded – it was part of the case description, not the pillar on which my claim stood. The claim I made, of a cure of autism, was based on the transition from non-verbal, unrepsonsive to outside stimuli to normality with respect to both over a four-year period, and it is immaterial for our purposes whether or not he actually or only apparently improved in intelligence. I therefore ask you to not miss the forest for the trees and see what is essential to the case.

    Finally, again I will mention that I gave the autism example to illlustrate what sort of evidence forms my opinion of homeopathy, not to provide formal evidence to convince you. And because my opinion of homeopathy is also informed by countless other cases of reversals of supposedly irreversible pathologies, the evidence on which I base my opinion is much broader than I have presented, so the claim I made is not as extraordinary as it seems to you, while the evidence is sufficienly extraordinary.

  107. #107 Cain
    August 7, 2007

    Finally, again I will mention that I gave the autism example to illlustrate what sort of evidence forms my opinion of homeopathy, not to provide formal evidence to convince you. And because my opinion of homeopathy is also informed by countless other cases of reversals of supposedly irreversible pathologies, the evidence on which I base my opinion is much broader than I have presented, so the claim I made is not as extraordinary as it seems to you, while the evidence is sufficienly extraordinary.

    It’s been said many times before, but it apparently needs to be said again: the plural of “anecdote” is not “data”.

    If you need to be explained why anecdotal evidence is not sufficient proof of anything, I feel sorry for you.

  108. #108 David D.G.
    August 7, 2007

    It’s been said many times before, but it apparently needs to be said again: the plural of “anecdote” is not “data”.

    I love a good sound bite for logic. This needs to be on bumper stickers, T-shirts, and billboards everywhere.

    ~David D.G.

  109. #109 HCN
    August 7, 2007

    Cain said “If you need to be explained why anecdotal evidence is not sufficient proof of anything, I feel sorry for you. ”

    I even explained what he had to do to even get his anecdote to be taken seriously. Test and document, make it a verifiable case report… but he still does not get it.

    Is it any surprise he is also an antivax loon:
    http://www.metamedicine.co.il/en/children
    “As a general rule, vaccinations seem to disrupt normal development in a significant number of children, and are definitely the cause of more major health consequences in a minority of children. These dangers have to be weighed against the protection that vaccines possibly afford against acute childhood illness. The only exception to this prudent approach appears to be the Tetanus vaccine, which has not been reported to cause side-effects and which protects from a dangerous illness that can occur even in a healthy, well-nourished child. This may be because Tetanus is transmitted via direct entry into the bloodstream, a mode of transmission which the injected vaccine imitates, whereas other childhood diseases enter the body through the airways but their vaccine versions bypass the airways and are instead injected directly into the bloodstream.”

    Oh, David the hopeless homeopath… Vaccines are not injected into the bloodstream.

  110. #110 Bronze Dog
    August 7, 2007

    Anecdotes are inherently ridden with observer bias, useless subjective measures, details usually can’t be verified, etcetera, etcetera, etcetera.

    Anecdotes are what allopathic bleeding and so forth lived on.

    Science creates controls to reduce or eliminate all of the problems anecdotes leave wide open and unaddressed.

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