An embarrassing critique of "The Enemies of Reason"

A couple of weeks ago, before I went on vacation, the BBC aired a two-part documentary by Richard Dawkins entitled The Enemies of Reason. Part One dealt primarily with the paranormal and various New Age phenomena, while Part Two, which aired mere days before my London trip, dealt squarely with alternative medicine in an uncompromising fashion. One key segment of Part Two discussed the bizarre magical thinking that is known as homeopathy. Although I quibbled a bit about certain aspects of how Dawkins presented homeopathy, overall I thought it was the best deconstruction on video of the ridiculousness of the concepts behind homeopathy designed for a mass audience that I had ever seen, particularly the scene where Dawkins showed just how much dilution was required for a homeopathic remedy.

Not surprisingly, homeopaths were none too pleased with Dawkins' deconstruction (more on that in a moment). But, first, so inspired was I by this bit of video skepticism, that when I was in London last week I just had to go the Royal London Homeopathic Hospital. Sadly, I didn't manage to get there until around 6 PM, when it looked as though it were closing up for the day. I had wanted to go in and see it and perhaps, if I could get up the guts, to walk into the lobby. Here's Richard Dawkins under one of the signs of the hospital:

i-095e02a5c0d5f710f156b56baf1eff40-DawkinsLRHH.jpg

Here's a photo I took of the same sign walking the path that Dawkins walked:

i-6446e490d61b6b2cb52fe9b9a8b20137-rlhhsign.jpg

I really wanted to see the big emblem on the floor that greets visitors, as it did when Dawkins entered:

i-409c80096ed7c34a88230eea6828c37b-DawkinsLRHH2.jpg

Here's me peering plaintively through those very same doors through which Dawkins passed:

i-01e92e0628e35523b4779b8beb665215-oracshowshisloverlhh.jpg

That I appear to be taking a leak on the Royal London Homeopathic Hospital is no more than mere coincidence, I assure you. I would never do such a thing. For one thing, it was still daylight, and there were lots of people around. For another thing, there were security cameras everywhere. I am much more mature than that. (Surely my EneMan and Hitler Zombie posts should be evidence enough of my high level of maturity to convince anyone.) So believe me when I tell you that I was just trying to get a look at the emblem without entering the building.

Really. Take my word for it.

Now that I've used this post as an excuse to post a couple of pictures that I took during my London trip, I'll get back to business. As I mentioned earlier, homeopaths were not at all pleased with Dawkins' treatment of their favored woo. One in particular, a London-based homeopath named Sue Young, reposted a particularly silly review of Dawkins' documentary by Louise McLean. The howlers begin in the very first paragraph:

Professor Richard Dawkins is a man on a mission. His task seems to be to bring down anything that conflicts with his belief in Science. To this end he presents two programmes - one on mediums, astrologers, psychics and dowsers, the other on alternative medicine including Ayurvedic, homeopathy, kinesiology and other therapies.

The wag in me is tempted to retort: "She says this as if it were a bad thing." But the entertainment doesn't stop there. McLean goes on to define the term "science" from Webster's dictionary, and then tries to argue that homeopathy is science:

Homeopathy, for example, is a science because all knowledge pertaining to homeopathic medicines is derived from observation, study and experimentation. In fact it is known to be an art and a science. It has been said many times that if homeopathy is proven to work (as we homeopaths know it does), it would literally turn established science as we know it, on its head. Hence it is very threatening to orthodox science. Yet even in the programme it was admitted that countless millions worldwide use homeopathy and swear by its efficacy.

Really? Perhaps McLean would like to explain upon what "observation, study, and experimentation" Samuel Hahnemann based his hypothesis that "like cures like," that dilution makes a remedy more potent, and that succussion is necessary to release the power of a homeopathic remedy. Appeals to quantum theory, information theory, and the memory of water don't count, because these "explanations" for the alleged efficacy of homeopathy came are post hoc justifications. After all, quantum theory and information theory were unknown in 1796, which is around the time that Hahnemann first started putting his ideas into practice or 1807, when he coined the term "homeopathy." Moreover, Dawkins was absolutely correct to point out that appeals to the memory of water are nothing more than "boldly paddling up the creek of pseudoscience." In addition, perhaps McLean would like to explain upon what scientific basis today's homeopaths can show that homeopathy "works."

Homeopaths won't like this, but, although a bit simplistic in his explanation (no doubt compressed for the brief time allotted in the special), Dawkins is also correct when, as he cited the 2005 Lancet meta-analysis showing no efficacy of homeopathy, he explains that the larger and better-designed the study of homeopathy, the less likely it is to show any sort of effect. Most "positive" studies of homeopathy are either small or have serious methodological flaws. Also, remember, even among perfectly designed studies with enough patients to give a high level of statistical power, because of the somewhat arbitrarily chosen cutoff of a p-value of less than 0.05 as designating statistical significance, on average, one out of 20 studies will be "positive" just by random chance alone. Naturally, homoepaths will always be able to cherry pick those studies, which is what they generally do, ignoring the far larger body of negative studies. That's why, when assessing clinical studies of homeopathy, one has to look at the totality of evidence.

None of that stops McLean from bolding stating:

The truth is that no homeopathic medicine can be made using only dilution - without Succussion (vigorous shaking between each numerical potency) and no mention that the medicines are made using 40% distilled water and 60% alcohol to preserve the original substance, i.e. a plant, mineral, metal, etc. being made up.

Indeed, another homeopath also lodges the same complaint:

Dawkins blatantly omits the fact that homeopathic dilutions undergo a specific process of shaking ('succussion') that could produce some "memory-of-water" effect. While this description is speculative and metaphorical (as no one has yet explained scientifically how homeopathic information might be stored in water), describing the preparation process of homeopathic remedies as based on dilution alone is factually incorrect and leaves out a crucial step, as dilution alone (without succussion) produces homeopathically inactive remedies that are truly no better than placebo.

Quite frankly, from the perspective of a scientist and skeptic, appealing to succussion is not exactly a convincing argument against Dawkins' characterization, particularly when coupled with appeals to metaphor (although I do appreciate being referred to as a "prominent skeptical blog"). Indeed, the contention that "vigorous shaking" at each step in the dilution is necessary to produce the potency of the homeopathic medicine is just as pseudoscientific as homeopaths' contentions that "like cures like," that water has memory of a sort that allows it to have a therapeutic effect after all the active substance has been diluted out, and that increasing dilution increases potency. There is no physical or scientific basis to claim that vigorous shaking, whether you call it succussion or something else, will do any more to make homeopathy "work" than diluting substances to nonexistence. It's magical ritual that homepaths believe to imbue their remedies with their potency, nothing more.

The rest of the article is so full of antiscientific idiocy that it's hard to know how to address them all without making this article balloon up to be ridiculously long even by Orac-ian standards. Even so, a few of them must be mentioned. Let's see. Fallacious appeal to ancient knowledge? Yep, it's there:

The fact of the matter is that acupuncture, ayurvedic, homeopathy, Chinese medicine, herbs, etc. ARE NOT ALTERNATIVE MEDICINE because these therapeutics have been practised for hundreds, if not thousands of years!

I would argue that modern medicine is in fact ALTERNATIVE MEDICINE, only having been in existence since the advent and discovery of antibiotics by Fleming in 1928 - 79 years ago!!

Which would you rather trust, something that has been used for hundreds of years, which has stood the test of time, or medicines which have only just been invented?!?

The fact is that people are turning their backs on untried and for the most part improperly tested pharmaceutical drugs and reaching back to discover the ancient and timeless wisdom and knowledge of the past.

The stupid, it really does burn. In considering this bit of idiocy by McLean, remember that "alternative medicine" is in reality more a politically correct term to describe unscientific, non-evidence-based medicine than anything else. It's a term that has now morphed into "complementary and alternative" medicine, where the "complementary" refers to the use of unproven remedies alongside proven remedies, as if the two were equivalent. (How this "complements" scientific medicine, I fail to see.) As Dawkins points out and as I and others have mentioned many times, "alternative medicine" that passes scientific muster and shows its efficacy in properly designed clinical trials ceases to be "alternative" and becomes simply "medicine." The reason "alternative" medicine is "alternative" is because it is either unproven or has failed to demonstrate efficacy. Besides, science does respect "ancient knowledge" that it tests and finds to have value. That's how, for instance, we discovered aspirin, digoxin, and various other drugs that derived from herbs and plants long used for therapeutic purpose.

Once again, it's not hard to point out that medicine men and shamans believed for thousands of years (and, sadly, many still believe) that disease is caused by evil spirits. Does that mean we should respect such "ancient wisdom" and accept the hypothesis that disease is caused be evil spirits as being the equal of the scientific contention that infectious disease, for example, is caused by bacteria and viruses? I think not. The same is true of aspects of alternative medicine. Its practitioners invoke mystical concepts such as the "memory" of water, life force (qi) undetectable by any scientific instrument, treatments involving the "unblocking" of the flow of qi without any evidence that qi exists or that what the practioner is doing has any effect on it, ridiculous claims that our DNA once had twelve strands instead of two, and many others. Holding such claims on par with scientifically tested and verified claims is ludicrous and a false equivalency.

Naturally, McLean is an antivaxer as well:

Vaccines is one of the great hallmarks of modern medicine. The injecting of disease and poisons into the healthy body. These cause all manner of new and increasingly difficult to treat chronic illnesses such as the epidemic of autism through massive accumulative doses of mercury which lodges on the brain, impeding its functions.

Anyone who regularly reads this blog knows what a steaming, stinking pile of B.S. the above statement is.

Of course, McLean can't resist topping off one legitimate criticism of modern medicine (i. e., the overuse of antibiotics) with pure silliness:

The liberal use of antibiotics which suppress, not cure an illness, also causes candida. Antibiotics can be lifesaving in certain instances but not in people who have had too many of them and there will always be a homeopathic medicine that can equally successfully do the job without the side effects.

Germ theory was trundled out in the programme and its discovery hailed as a great landmark. In fact the theory is incorrect. It is one of the basics of modern medicine. Not long ago I watched 'How Clean is Your House', a programme most Brits have heard of. The childless couple living in West London had a FILTHY house, filled with dogs. They could not have cared less about the dirt and the wife was filmed allowing the dogs to lick her lips as she kissed them. Items were sent off to laboratories and they were severely rebuked for their unhygenic lifestyle, yet the wife assured the presenters that they had never suffered any ill health.

What about all the doctors and nurses who go about their healing in virulent epidemics, yet never 'catch' the illness. Many so called epidemics, especially the so called Spanish Flu were caused by mass vaccination and those unvaccinated remained well.

Personally, I'd be very interested in seeing which homeopathic remedy can "equally successfully do the job" treating bacterial diseases as antibiotics. Perhaps McLean would volunteer to be exposed to a particularly virulent bacteria, allowed to develop the illness it causes, and then to cure herself with homeopathy. My only suggestion to her, should she be foolish enough to agree to such an experiment, would be not to buy any long playing records. (Yes, I know that quip reveals just how old a fart I am.) As for the bit about doctors and nurses in epidemics, I would point out that the history of epidemics is littered with tales of doctors, nurses, and other health care professionals who have fallen in epidemics, along with the patients they treated. They may not get the diseases at the same rate, because, after all, they do take precautions, but no precaution is foolproof.

McLean finishes up in a flurry of appeals to conspiracy:

Running Zeus Information Service for 4 ½ years and reading extensively has shown me quite clearly that there is a relatively small number of very powerful people who dictate international policy and who control the money flow of this planet. These people want to continue that way and anything, whether it be alternative medicine, whether it be free energy, whether it be true democracy, will not be aired in the media which they control and suppress to prevent all attempts at revealing the truth.

You knew it wouldn't be long before she devolved into tinfoil hat territory. She and Mike Adams would make beautiful woo together.

Of course, the problem is not, as McLean laments, that people like Dawkins get "so much airtime," but rather that people like Dawkins get so little time in the media. In reality, there the forces of woo rule supreme. Credulous stories about homeopathy and all manner of alternative medicine abound, both here in the U.S. an in the U.K. The reason that The Enemies of Reason stands out is not because documentaries like it are so common, but rather because they are so rare. Despite the major tendency towards woo in the U.K., our British friends do win out in at least one respect: There's no way a documentary like The Enemies of Reason would ever be produced in the U.S, much less aired during prime time on a major broadcast network.

More like this

Well, you can't deny that shaking unleashes the power of some substances. Just try with cola and you'll see !

We've got an interesting idea for a test here. shaken and unshaken homeopathic preparations should be compared in a randomised, double-blind trial.

And I like the anti-vaccination rant. Homeopaths used to compare their products with vaccines. Is this now out of fashion?

By Christophe Thill (not verified) on 04 Sep 2007 #permalink

Which would you rather trust, something that has been used for hundreds of years, which has stood the test of time, or medicines which have only just been invented?!?

Well, I can tell just by looking at you that you have too much blood. Where's my jar of leeches?

Oh, that wasn't what you had in mind? ;)

Orac,

Have you ever read "Snake Oil" by John Diamond. If not, can I recommend it to you. The author was British journalist who died of cancer (initially throat but with lung secondaries) in 2001. Before he dies he started a book he described as "an uncomplimentary look at complimentary medicine". He only completed the first 6 chapters before his death but it is still well worth reading. There are also some of his journalism reproduced in the rest of the book. The forward was written by Richard Dawkins.

By Matt Penfold (not verified) on 04 Sep 2007 #permalink

Well, you can't deny that shaking unleashes the power of some substances. Just try with cola and you'll see !

I'd love to see some succussion with nitroglycerin.

Great post. I'm not that familar with Homeopathic medicine but you did a good job shooting down the proponents.

"dilution alone (without succussion) produces homeopathically inactive remedies that are truly no better than placebo."

As opposed to homeopthically active remedies that are truly no better than placebo, I suppose. I particularly like the irony of someone who espouses a theory based on "like cures like" being against "injecting of disease and poisons into the healthy body".

I think Randi's takedown was slightly better than Dawkins's. He did the shaking and everything.

By Ginger Yellow (not verified) on 04 Sep 2007 #permalink

Sadly, your conclusion that this show would never get prime time airtime in the U.S. is all too true. Perhaps on PBS we could look forward to a running of this show?

On the definition of 'alternative' vs. mainstream medicine being whether there is scientific backing.

This is certainly one aspect. However, there is another: is it backed by the mainstream medical community and pharma companies? If a scientifically sound medical treatment came about that threatened the status quo and profits of mainstream medicine, then it would be discredited and thrown into the 'alternative' bin. One example is DHEA. There are hundreds of scientific studies backing its efficacy, and it is not mainstream medicine. It is also does not fit your definition of "alternative medicine".

But don't take my word for it, look up the scientific studies yourself. There are plenty of references in this article:
http://www.lef.org/magazine/mag2004/mar2004_cover_dhea_01.htm

Dr. Michael Uschold

By Michael Uschold (not verified) on 04 Sep 2007 #permalink

Dr Uschold,

I suggest you try reading "Snake Oil" as well. You may well find it a cheaper solution than seeking psychiatric help for your paranoia.

By Matt Penfold (not verified) on 04 Sep 2007 #permalink

So called 'alternative' medical treatments may lack science proving their efficacy. BUT: the same is true for a very large portion of mainstream medical treatments.

The human body is just to complex. Randomized, double-blind placebo-controlled human clinical trials are just too expensive, or impractical to carry out in many situations.

Don't believe me, just read the May 29, 2006 issue of Business Week. The main article reports on an investigation of major medical procedures - everything from heart surgery to prostate care and treatments for breast cancer... The conclusion was that 75% of these procedures are "pure guesswork." Educated guesses, of course, but wholly lacking in rigidly controlled human clinical trials.

Of course the guesses are educated by scientific thinking, but they are still guesses. It may be that what distinguishes most mainstream treatments from alterative ones is that the origin of the idea was scientifically motivated.

Google on "Medical Guesswork" and check int out.

Here is the Business Week article: http://www.businessweek.com/magazine/content/06_22/b3986001.htm

By Dr. Michael Uschold (not verified) on 04 Sep 2007 #permalink

Minor quibble: it was not broadcast by the BBC. It was on Channel 4.

By Dylan Llyr (not verified) on 04 Sep 2007 #permalink

It may be true that alternative medical people cherry pick studies.

But don't kid yourselves.

The major pharma companies do the same thing. They choose the studies that show better effectiveness and fewer side effects.

Dr. Michael Uschold

By Dr. Michael Uschold (not verified) on 04 Sep 2007 #permalink

Bob Parks, in Voodoo Science: The Road from Foolishness to Fraud devotes a chapter to homeopathy. I have been tempted to print off some copies of that chapter to have on hand for when any of my woo-loving acquaintances refer positively to homeopathy. The chapter is a good intro to the subject, and is easy to read.

I just popped into amazon before writing this, figured I'd check out the 1-star comments. One reviewer writes,

"As he successively diluted his medicines, both side effects and curative effects decreased, as one would expect. Only when he added succussion to his procedure did the medicines retain their healing power. This process is called potentization, as opposed to mere dilution. Park blurs the distinction between the two; even though he mentions the succussion step briefly, he continues to refer to homeopathic preparations as "dilutions"."

So, yep, its all in the shaking i guess.

"I'd love to see some succussion with nitroglycerin."

Couldn't nitroglycerin almost be seen as an example of homeopathy, if one was being deliberately obtuse about it? In its potent form, it blows up people. In its dilute form, it... stops your heart from blowing up? I suppose?

Of course, it's not homeopathy, because it's still present in measurable amounts when you use it, it produces experimentally verified results, and it sure as hell ain't succussable, at least initially.

(Actually, if anyone can clue me in on how medical nitro is prepared, I'd be much obliged!)

Remember Power Sauce bars from The Simpsons? They allegedly contained "a secret ingredient that unleashes the amazing power of apples.'' Turns out they were mostly shredded Chinese newspapers. I don't know if you were supposed to shake them, too.

What does that imposing looking hospital treat its patients with? Do they do surgery at all? Is it just a old hold over name that nobody has changed yet?
Never mind I just Googled it and read their blurb. What a wank and a scary one at that.

I remember first reading about what Homeopathy was while working in a water quality testing lab.
The first description I read was from the American Institute, so they were all for it. I couldn't believe how completely dumb it sounded. I was tempted to run down to the Microbiology Lab and warn them that all those serial dilutions and shaking was creating bigger, stronger, eviler strains of bacteria and we should all run for our lives before they consumed us all.
Sadly that didn't happen, boring little bacterias.

If you want to get a better understanding of the placebo effect (and the less well understood nocebo effect), I blogged about it here

http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html

There is nothing mystical or woo-like about it. It is simply phyisology and efficient allocation of resources. When you need to "do stuff", your body diverts resources away from repair. The placebo effect is a way of shifting those resources back to repair.

How does human complexity stop randomized control studies from providing meaningful data? If it's too complex for them, then how can you learn anything by decreasing the rigor?

Don't believe me, just read the May 29, 2006 issue of Business Week. The main article reports on an investigation of major medical procedures...

I don't read Business Week, but somehow, I don't think they'd know how to do that kind of reporting.

Also, remember, even among perfectly designed studies with enough patients to give a high level of statistical power, because of the somewhat arbitrarily chosen cutoff of a p-value of less than 0.05 as designating statistical significance, on average, one out of 20 studies will be "positive" just by random chance alone.

You know, that's not a point I've ever seen made before. It's true, it's very simple, but I honestly never thought of it like that. I'm shocked (though, to be fair, if I'd ever taken statistics I might have run into this idea sooner)! Now I really understand the value of meta-analysis.

I don't understand why homeopaths are hostile to vaccination. It operates on a similar principle, after all: the introduction of a small quantity of a similar substance to stimulate the body's natural healing properties. They should be touting it as the model for their work, frankly, holding it up as something "stolen" from their intellectual ancestors.....

They do that pretty often, Ahistoricality, at which point, we're forced to describe the physical mechanism through which the immune system works from the vaccine and then demand the math for the quantum homeopathy quackery as to how the anti-miasma vibrations or whatever do anything. Oh, and, of course, ask for evidence of efficacy in the first place.

Many so called epidemics, especially the so called Spanish Flu were caused by mass vaccination and those unvaccinated remained well.

I hadn't seen this particular 'fact' from the woo brigade before. Any idea where it comes from?

Honestly Orac, can't you see that it's all just a marketing problem. Homeopaths use outdated terms like "dilution" and "succussion" for adding water and shaking. All they really need to do is say it's "The James Bond Method" - add water and "shaken, not stirred." A fictional remedy named after a fictional character.

Honestly Orac, can't you see that it's all just a marketing problem. Homeopaths use outdated terms like "dilution" and "succussion" for adding water and shaking. All they really need to do is say it's "The James Bond Method" - add water and "shaken, not stirred." A fictional remedy named honoring a fictional character.

Honestly Orac, can't you see that it's all just a marketing problem. Homeopaths use outdated terms like "dilution" and "succussion" for adding water and shaking. All they really need to do is say it's "The James Bond Method" - add water and "shaken, not stirred." A fictional remedy named to honor a fictional character.

How Mumbo Jumbo Conquered the World by Francis Wheen, another spot on debunking of homeopathy et al, along with slaughtering a few other sacred woocows. Well written, entertaining and worrying.

"After all, quantum theory and information theory were unknown in 1800, which is around the time that Hahnemann."

Incomplete sentence/typo alert!

Of course you could use many of the same arguments you use above to argue that general anaesthesia is not science: after all, the first general anesthetic was discovered mostly by chance, and their mechanism of action is still not clear.

(Of course the difference is that general anaesthetics *work*.)

Wait, I'm confused - Kinesiology? Maybe it's not the most difficult undergraduate degree, but putting it in the same category as homeopathy? That seems a little harsh doesn't it?

Stevo, applied kinesiology has nothing to do with the real "kinesiology". Some chiropractors took the word of a real discipline (the study of how humans move, often used in sports medicine), and appropriated to a goofy form of "testing for allergies".

Essentially, an applied kinesiologist places something in a person's hand and then pushes on their arm. If the arm "loses strength", then the person is allergic to that substance. See http://skepdic.com/akinesiology.html

The article is worth where I sent it- Take a print and throw in the Dustbin.

Sorry for being late off the mark, but...
a hospital that closes at 6 pm? Is it also part of homeopathy to never have patients sick at three in the morning?

(Hint for the quiz: exactly when does a 3-year-old wake up with a middle ear infection?)

fusilier
James 2:24

fusilier -

Homeopathy has best results in healthy people.

By Andrew Dodds (not verified) on 05 Sep 2007 #permalink

Many so called epidemics, especially the so called Spanish Flu were caused by mass vaccination and those unvaccinated remained well.

I hadn't seen this particular 'fact' from the woo brigade before. Any idea where it comes from?

I read the excellent book Catching Cold not too long ago and it did mention an this incident. Due to my crap memory I can't recall the exact details of it though, but the vaccine was withdrawn for a safer one.

On a side note isn't it amazing that the alties love to use much older "Modern medicine has gone wrong!" examples than most people would consider relevant.

The Spanish Flu epidemic was 90 years ago and since then the book has been re-written 4 or 5 times (A colleague has a British Pharmacopeia from the 50's, most of the items in it haven't been in reference books for 20 years now).

I had a grandfather who died in the Spanish Flu epidemic. I didn't know they had flu vaccinations then..............

Anyone know if/when Hahneman University in Philadelphia gave up on homeopathy?

I really hope they did abandon it. My alma mater, Drexel University, merged with Hahneman a few years back.

Orac:

As the author of a critique of Dawkins' take on homeopathy that you briefly referred to in your article, I would hope that you would have picked on me for the title of "embarrassing critique"! But, alas, you pick easy targets such as McLean's. At the risk of sounding pompous, I'd say that's cherrypicking!

In any case, some rebuttals to your comments:

- Your oft-repeated claim that there the notion of dilution and succussion is nonsense is not good science. The question is not whether the notion makes a priori rational-scientific sense but whether it is amenable to testing, to falsification, or whether can form the foundation of a viable research program (the exact criteria to satisfy depend on subtleties of methodological allegiance, but my basic point is clear enough). I fail to see why these concepts are not in-principle amenable to scientific investigation and deserve to be labelled pseudoscientific.

- Your point that succussion is just a ritual with no scientific basis also misses the point of our criticism: describing the homeopathic-remedy preparation process without reference to succussion is a classic straw-man argument regardless of the scientific status of succussion. Simple as that.

- Your claim that given the 0.05 cutoff rate for P values 1 in 20 studies should be positive by chance is true but trite: over half of studies show an effect other than placebo, and the ratio remains above 1:20 even once better studies are isolated. Moreover, most studies show a far lower p-value, meaning that if one were to isolate only the studies with p less than 0.01 there would be more than 1:100 positive studies, likewise for studies with p less than 0.001 (there would be more than 1:1000 positive studies), and so on. In other words, for any cut-off value the argument fails.

- Studies showing that better-quality studies show smaller effects have to be taken in the context of all medical research: I'd like to see that this trend is unique to homeopathy or alternative therapies but not to conventional ones, before this point can be made relevant to the debate.

- Finally:

Naturally, homoepaths will always be able to cherry pick those studies, which is what they generally do, ignoring the far larger body of negative studies.

Cherrypicking is precisely what you have to resort to in arguing your case against homeopathy. The "far larger body of negative studies" is a fictive statement of yours with no basis in truth.

Orac:

As the author of a critique of Dawkins' take on homeopathy that you briefly referred to in your article, I would hope that you would have picked on me for the title of "embarrassing critique"! But, alas, you pick easy targets such as McLean's. At the risk of sounding pompous, I'd say that's cherrypicking!

In any case, some rebuttals to your comments:

- Your oft-repeated claim that there the notion of dilution and succussion is nonsense is not good science. The question is not whether the notion makes a priori rational-scientific sense but whether it is amenable to testing, to falsification, or whether can form the foundation of a viable research program (the exact criteria to satisfy depend on subtleties of methodological allegiance, but my basic point is clear enough). I fail to see why these concepts are not in-principle amenable to scientific investigation and deserve to be labelled pseudoscientific.

- Your point that succussion is just a ritual with no scientific basis also misses the point of our criticism: describing the homeopathic-remedy preparation process without reference to succussion is a classic straw-man argument regardless of the scientific status of succussion. Simple as that.

- Your claim that given the 0.05 cutoff rate for P values 1 in 20 studies should be positive by chance is true but trite: over half of studies show an effect other than placebo, and the ratio remains above 1:20 even once better studies are isolated. Moreover, most studies show a far lower p-value, meaning that if one were to isolate only the studies with p less than 0.01 there would be more than 1:100 positive studies, likewise for studies with p less than 0.001 (there would be more than 1:1000 positive studies), and so on. In other words, for any cut-off value the argument fails.

- Studies showing that better-quality studies show smaller effects have to be taken in the context of all medical research: I'd like to see that this trend is unique to homeopathy or alternative therapies but not to conventional ones, before this point can be made relevant to the debate.

- Finally:

Naturally, homoepaths will always be able to cherry pick those studies, which is what they generally do, ignoring the far larger body of negative studies.

Cherrypicking is precisely what you have to resort to in arguing your case against homeopathy. The "far larger body of negative studies" is a fictive statement of yours with no basis in truth.