Respectful Insolence

Sometimes a comment in the comment thread after one of my posts ends up turning into the inspiration for another post. This is especially likely to happen if I respond to that comment and end up writing a comment of myself that seems way too good to waste, forever buried in the comments where, as soon as the commenting on the post dies down, it remains, unread again. So it was after my post on the “integration” of quackery into academic medical centers. In that post, I applied some of my inimitable not-so-Respectful Insolence to a deal between Georgetown University, what should be a bastion of academia emphasizing science-based medicine, and Bastyr University, probably the most famous school of naturopathy in the United States. A commenter objected to my lumping naturopathy in with quackery like homeopathy and reiki.

Quoth Kelly:

Bastyr has a good reputation. Do they embrace woo there? Sure, but they also don’t force it on anyone, and they embrace the scientific method in their research and teaching.

Lumping in naturopathy along with homeopathy, reiki, and so forth, just makes you look ignorant in the end. And that’s a shame, especially since so much of medicine is moving forward to acknowledge that reductionism in medicine (and pharma, thanksomuch) is a bad thing.

Leaving aside that this quote is self-contradictory (the part about admitting that Bastyr embraces woo but embraces the scientific method in research and teaching), it’s also plain wrong. It demonstrates a fundamental ignorance of what naturopathy is. In fact, there is no woo that I’ve yet been able to find that naturopathy doesn’t embrace. As an example, I thought I’d take a look at homeopathy and how naturopathy not only embraces it, but requires it. Let’s start by looking at Bastyr University itself. Here is what the Bastyr University website says about homeopathy. First, it describes homeopathy as “natural” and “nontoxic” (the latter of which is hard to argue with, given that it’s nothing more than water). Moreover, Bastyr even offers homeopathy services in its clinics.

More pertinent to the question of whether naturopathy embraces homeopathy is this answer to a question in Bastyr’s FAQ about homeopathy:

Q. Do all naturopathic physicians use homeopathy?

A. All naturopathic physicians are trained in the use of homeopathy, but not every naturopathic physician will use it as part of their treatment.

Let’s repeat that: All naturopathic physicians are trained in the use of homeopathy. All of them.

Of course, there’s a lot of homeopathy going on at Bastyr University. For example, if you look at its curriculum to become a doctor of naturopathic medicine, you’ll rapidly see that Bastyr requires a full year of homeopathy courses spread out over three classes for a total of 8 credit hours. The same is true for Bastyr’s five year track and its combined degree of Doctor of Naturopathic Medicine (ND)/Master of Science in Acupuncture (MSA) or Acupuncture and Oriental Medicine (MSAOM). In addition, Bastyr has a clinical homeopathy department and homeopathy teaching clinic. The department chair is a naturopath and homeopath named Richard Mann, ND (the “ND” stands for “not a doctor,” as far as I’m concerned).

Then there’s the American Association of Naturopathic Physicians (AANP). If you take a look at its blog and search it for the word “homeopathy, you’ll rapidly see that the largest “professional” organization of naturopaths not only embraces homeopathy but defends it against attacks. Perhaps the best example of the attitude of of the AANP towards homeopathy is found in this post from several months ago entitled Getting over it. In it, a naturopath named Christopher Johnson gets all indignant about recent “1023” campaigns that skeptics and proponents of science-based medicine have been using with some success to demonstrate the utter ridiculousness of homeopathy. (Indeed, one such event is scheduled for February 6.) In response, Johnson writes:

They named their campaign “10:23″, a reference to Avogadro’s number. This number is significant to chemists in that it supposedly sets the limit below which no material elements are likely to be present in a given dilution. Homeopathic remedies are made with solutions far more dilute than Avogadro’s number.

Do these “skeptics” really think the public cares about Avogadro’s number when homeopathy has just significantly improved their toddler’s autism or offered help with any of a vast range of diseases which respond so well to homeopathic (and often not to conventional) treatment?

This is just another tantrum by the clueless wing of the scientific/medical community that can’t understand why the people don’t praise them for their ideological purity and courage, even when the fruits of their scientific labors rot like a brown banana. Note to protestors: maybe they’re just not that into you.

Remember, this is the official blog of the AANP, and it’s attacking a valid criticism of homeopathy, namely that many, if not most, homeopathic remedies are diluted far, far more than Avagadro’s number, meaning that it’s highly unlikely (damned near impossible, actually) that a single molecule of the original starting material for the homeopathic remedie remains. When a typical homeopathic dilution is 30C (thirty 100-fold dilutions, or a 1060 dilution), that’s almost 1037-fold higher than Avagadro’s number. The magnitude of this dilution is simply incredible, and the odds against a single molecule remaining are just as incredible.

Particularly amusingly, Johnson likens these 1023 events to the persecution of Galileo in what is arguably one of the most hilariously over-the-top invocations of the “Galileo gambit” I’ve ever seen before. Behold:

These hooligans purport to stand up for scientific principles, while in fact their zealous dogmatism and denial of evidence would make Galileo’s persecutors proud. Score one for book burning and witch trials.

Because making fun of pseudoscience like homeopathy in such a way as to point out to nonscientists why it is pseudoscientific nonsense is exactly like putting Galileo under house arrest and burning books and witches. I am thankful for small favors in that Johnson restrained himself from comparing skeptics to Hitler or Nazis. Just barely. (Come on, Mr. Johnson, let it out. Compare skeptics to Nazis! You know you really, really want to.)

Of course, so far, all I’ve looked at is Bastyr University and the official blog of the AANP. Maybe that’s not enough to convince you that homeopathy is part and parcel of naturopathy. In fact, though, every school of naturopathy whose curriculum I’ve looked at includes a heapin’ helpin’ of homeopathy. It’s no wonder, too. the NPLEX (Naturopathic Physicians Licensing Examinations), which is required for naturopaths to be licensed in the 16 states in the U.S. and 5 provinces in Canada that license naturopathic physicians tests naturopaths on homeopathy:

The current examination, based on these original blueprints, forms the Core Clinical Science Examination now required by every state and province that regulates the practice of naturopathic medicine. The Core Clinical Science Examination is a case-based examination that covers the following topics: diagnosis physical, clinical, lab), diagnostic imaging, botanical medicine, nutrition, physical medicine, homeopathy, counseling, behavioral medicine, health psychology, emergency medicine, medical procedures, public health, pharmacology, and research. Two additional treatment examinations (Minor Surgery and Acupuncture) may also be required for eligibility to become licensed to practice as a naturopathic physician in some jurisdictions.

[...]

The NPLEX Part II – Core Clinical Science Examination is designed to test your knowledge of: diagnosis (physical, clinical, and lab), diagnostic imaging, botanical medicine, nutrition, physical medicine, homeopathy, counseling, behavioral medicine, health psychology, medical procedures, emergency medicine, public health, pharmacology, and research. The examination is comprised of a series of clinical summaries followed by several questions pertaining to each patient’s case. For example, you might be asked to provide a differential diagnosis, to select appropriate lab tests, to prescribe therapies which safely address the patient’s condition, and to respond to acute care emergencies.

I don’t know whether to laugh or cry to read about the NPLEX. Think about it this way. There is actually a North American Board of Naturopathic Examiners, just like medicine’s National Board of Medical Examiners. the NABNE even has a certifying examination, just like real doctors! It’s all science-y and medicine-y, with all the trappings of science-based medicine but none of the rigor, despite the seeming appearance of having them. Worse, there are far too many states and far too many provinces that actually legitimize naturopathy by licensing it.

Naturopaths like to present naturopathy as the “respectable” face of “complementary and alternative medicine” (CAM). To that end, institutions like Bastyr have tried their best to forge relationships with reputable universities like Georgetown or the University of Washington, among many others. Indeed, Bastyr has forged a collaboration with the Fred Hutchinson Cancer Center at the University of Washington in order to study woo:

Founded with the help of a generous donation by Cleavage Creek Cellars, BIORC is collaborating with the Fred Hutchinson Cancer Research Center in Seattle on a matched controlled-outcomes study. This study will compare the ‘disease free survival’ and quality of life of participants treated at BIORC to the experience of similar cancer patients living in Washington state who do not include complementary, alternative or integrative therapies in their treatment. We anticipate that men, women, and children with cancer who are treated at the Bastyr Integrative Oncology Research Center will live longer and healthier lives.

In 2010 Bastyr, along with the Hutchinson Center, received a $3.1 million grant for the study of complementary and integrative care for breast cancer. The grant, awarded by the National Institutes of Health (NIH), National Center for Complementary and Alternative Medicine (NCCAM), funds a project entitled “Breast Cancer Integrative Oncology: Prospective Matched Controlled Outcomes Study.” The five-year award will allow clinical investigators at the Bastyr University Research Institute and the Hutchinson Center to undertake a rigorous outcomes-based research study. Investigators will track clinical outcomes for participants with breast cancer who, in addition to standard conventional care, receive integrative care at BIORC. Those outcomes will then be compared with outcomes for participants with breast cancer who do not receive integrative care along with conventional care.

Are either of these trials randomized? Nope, it doesn’t look like it. It’s a prospective trial, but the patients decide which group they’re in. Granted, sometiems such studies are all that is possible when studying interventions that can’t easily be randomized, but in this case I see the potential for confounding factors to be so strong as to make a study like this pretty much pointless. How much do you want to bet that the patients who receive “integrative care” with their conventional care will be found to do better by some measure, probably in quality of life measures. Whether or not there is a difference in disease-free survival, I don’t know. However, what I don’t doubt is that there will be significant differences between the two groups in composition. Most likely, the “integrative” group will live in different places, have more money, and have more time to indulge themselves in “integrative” therapies. Comparison will be particularly difficult given that the study will be comparing patients who have received a wide variety of CAM modalities in addition to their conventional cancer therapy.

The bottom line is that, for how badly its practitioners want to represent naturopathy as science-based and rational, in reality naturopathy is anything but. It embraces virtually any form of CAM therapy, no matter how irrational, and its practitioners simply choose what subset of woo they want to use in their practice. If you want to know just how credulous and pseudoscientific naturopathy is, just remember that not only is homeopathy embraced by naturopaths, but knowledge of homeopathic practice is mandatory. It’s taught by naturopathy schools, and naturopaths have to know enough about it to pass the NPLEX, which includes homeopathy on it.

Homeopathy and naturopathy: Two crappy woos that taste crappy together.

Comments

  1. #1 Christophe Thill
    January 28, 2011

    In other words :

    Who cares if it’s just sugar pills? I know people who gave some to their sick kid. Later on, he felt better. That settles it!

    (But… autism, really???)

  2. #2 Just Sayin'
    January 28, 2011

    the NABNE even has a certifying examination, just like real doctors! It’s all science-y and medicine-y, with all the trappings of science-based medicine but none of the rigor, despite the seeming appearance of having them.

    In other words, homeopathy, naturopathy and the like are cargo cult science. No surprise there.

  3. #3 mad the swine
    January 28, 2011

    Science cannot explain how homeopathy works.

    Therefore, homeopathy does not work.

    Therefore, the many, many studies showing the benefits of homeopathy must all be fraudulent.

    Is that how it goes?

    When Darwin wrote On The Origin Of Species, there was no scientific explanation for how traits were inherited or how those traits gradually modified over time. (Gregor Mendel’s work was necessary to understand the very basics of inheritance, and that didn’t become known to the scientific community until the early 20th century.) Should Darwin not have written his book, or should the scientific community have suppressed his theory, merely because they had no explanation for how it worked? Of course not! The facts were as they were: organisms did pass down their traits to their offspring, and those traits did change over time. That science could not explain it was a limitation of science, not a flaw in the theory; the task of science was to expand their knowledge until the mechanism behind the theory came to light.

    I applaud Bastyr University and the other medical schools who are willing to teach healing methods from every vital tradition, including Western science, and who are guided by the principle ‘does this help patients heal?’ rather than ‘is this result explainable within my materialist, Western, patriarchical worldview?’ In fact, Bastyr et al. are very likely to usher in a true revolution in our understanding of physics. It’s only after we accept that homeopathy works that we can search for the natural laws that explain why.

  4. #4 Todd W.
    January 28, 2011

    @Christophe Thill

    Let’s see, 12 oscillococcinum pills for $15-$20 or a 4-pack of Tic-Tacs for about $4. I think the Tic-Tacs are the better value, by far. Similar product, same result, significantly lower price.

  5. #5 Todd W.
    January 28, 2011

    @mad the swine

    Science cannot explain how homeopathy works.

    Therefore, homeopathy does not work.

    Therefore, the many, many studies showing the benefits of homeopathy must all be fraudulent.

    Is that how it goes?

    Nope. Here’s how it goes:

    Homeopaths cannot demonstrate that homeopathy works in robust, well-designed and controlled studies.

    Therefore, homeopathy doesn’t work.

    The studies that show benefits typically have pretty significant flaws.

    The fact that it breaks so many well-established laws of nature (biology, chemistry, physics, etc.) is just icing on the cake.

  6. #6 tnt
    January 28, 2011

    Let’s see, 12 oscillococcinum pills for $15-$20 or a 4-pack of Tic-Tacs for about $4. I think the Tic-Tacs are the better value, by far. Similar product, same result, significantly lower price.

    Tic-Tacs are actually way better. You end up with minty breath with the Tic-Tacs; the oscillococcinum pill, I’m guessing won’t make your breath kissably sweet…

  7. #7 Lindsay
    January 28, 2011

    Mad –

    You’re completely right. Except for the part about all the studies that show benefits of homeopathy, of course.

    When Darwin wrote the Origins, there was no theory of inheritance, which is part of the reason why evolution via natural selection was such a leap of genius on his part. However, unlike homeopathy his theory was grounded in observation of the natural world and the science of his time. Evolution and natural selection were completely consistent with what was known then (and now), whereas homeopathy runs against fundamental tenants of physics and biology, in addition to not actually working.

    Darwin stood on the shoulders of giants to form his theory, he didn’t kick them in the nuts.

  8. I actually haven’t had time to read this yet, but I’m really glad you posted this. I had book marked your reply to the comment from the post that triggered this as an excellent resource to be referred to regarding naturopathy & homeopathy, but now this post will be much easier to find and refer to.

    Hopefully I get time to read this today.

    -Karl Withakay

  9. #9 debunzo
    January 28, 2011

    Eight credit hours to learn homeopathy?

    Anyone with a trace of intelligence should be able to learn all they need to know in about 8 minutes.

  10. #10 Mephistopheles O'Brien
    January 28, 2011

    @mad the swine:

    Science cannot explain how homeopathy works.
    Therefore, homeopathy does not work.
    Therefore, the many, many studies showing the benefits of homeopathy must all be fraudulent.
    Is that how it goes?

    No, that’s not how it goes. It really goes:
    There is a dearth of good studies that show that homeopathy works.
    According to all science, homeopathy shouldn’t work.
    Therefore, homeopathy doesn’t work.

    If there were high quality studies showing that homeopathy actually worked, that would be really exciting and could lead to entire new developments in physics, chemistry, and biology. However, the fact that homeopathy would appear to contradict so many known things rather raises the bar for the quality of study that must be done. Extraordinary claims tend to require extraordinary proof.
    If you can show that the “many, many studies showing the benefits of homeopathy” actually do conclusively show the benefits of homeopathy (not simply experimenter bias and placebo effect), please do so. In particular, it would be fascinating to know how you can tell the difference between two homeopathic preparations besides looking at the label on the bottle.

  11. #11 Poodle Stomper
    January 28, 2011

    Science cannot explain how homeopathy works. Therefore, homeopathy does not work. Therefore, the many, many studies showing the benefits of homeopathy must all be fraudulent. Is that how it goes?

    Are there actually “many, many” well controlled study that show any effect above the placebo? Please do post references then. As far as I know, science can’t explain how homeopathy works for the same reason it can’t explain how Santa clause reaches every kid in the world in one night; because it doesn’t.

  12. #12 Todd W.
    January 28, 2011

    Actually, a slight correction to my earlier post about Tic Tacs. It’s $4 for a 4-pack of Tic Tac Big Packs, not the regular size. Normal size has about 36 tic tacs. Big Packs have about 60 tic tacs each, so that’s 240 tic tacs, give or take, for $4.

    So, taking the $15 price for oscillococcinum, that’s $1.25 per pill.

    For the Tic Tac Big Pack 4-Pack, it’s about $.02/tic tac.

  13. #13 turnipseed
    January 28, 2011

    Being from Seattle, I also looked at Bastyr’s website after reading your post. I love my hometown, but Bastyr is a huge embarrassment, kind of like the John Birch Society being headquartered in Wisconsin is a huge embarrassment now that I live in Wisconsin.

    What I noticed was that their programs require a host of science courses that should knock the woo out of any serious student. But then, certain Christian colleges also turn out graduates who think that the earth is 4- 6 thousand years old, that people and dinosaurs coexisted, and that all species were “created” in their present form. Some of them probably go on to medical school.

    This is frightening. At my last visit to my (very young) gynecologist, discussing hot flashes, he asked if I’d tried “soy products”. I asked if there was any evidence of that being a valid approach. He shrugged. I made it clear I was looking for science-verified treatment and we moved on, but there it was. It’s bad enough when patients request woo, but when the doc starts suggesting it…..Yikes! Not my first experience of this either, just the latest.

  14. #14 lilady
    January 28, 2011

    “the NABNE even has a certifying examination…..” I believe there are fourteen states that “recognize” (license) naturopathy “doctors”. A quick tour of their State Associations reveals that their collective agendas in all 50 states is to gain acceptance and licensing in every state, so that they can become “your primary care provider”. It seems to me that they want a larger piece of health care insurance dollars.

    Wow, if we think the debate about using federal funding for Medicare and Medicaid and private insurance dollars is complicated now, once these alternative/complementary practitioners get “credentialed/licensed” we will all be paying for woo medicine.

  15. #15 Dangerous Bacon
    January 28, 2011

    “I applaud Bastyr University and the other medical schools who are willing to teach healing methods from every vital tradition, including Western science.”

    Homeopathy is about as “Western” as it gets.

  16. #16 MikeMa
    January 28, 2011

    The idjit doesn’t like Avagadro’s number? More likely he doesn’t understand the significance. Sad really.

  17. If only I had had this information when I went on a date with a woman (nurse) who believed homeopathy was bogus, but had absolute respect for Naturopathy (and acupuncture).

  18. #18 Dianne
    January 28, 2011

    At my last visit to my (very young) gynecologist, discussing hot flashes, he asked if I’d tried “soy products”. I asked if there was any evidence of that being a valid approach. He shrugged. I made it clear I was looking for science-verified treatment and we moved on, but there it was.

    There are, in fact, several randomized controlled trials of the use of soy products on menopausal symptoms. Some are even positive. Interpret with caution, though, since menopausal symptoms do decrease spontaneously over time. (I’m going to be lazy and simply refer you to Medline for relevant trials.)

  19. #19 Denice Walter
    January 28, 2011

    The HealthRanger, on his eponymous website, warns against consulting MD’s and “western doctors”: choose only “naturopathic physicians”, says he. If they’re good enough for Mikey…..

    Actually, perhaps the best advice the HR and other woo-meisters give us is that they frequently brag: “I am *not* a doctor”, or “I’m not a *conventional* doctor”, which should be a cue that we shouldn’t take medical advice from them. Advice about selling stuff, maybe. Advice about putting up a false front, definitely.

  20. Hummm, my date was originally form Seattle.

    Must…remember….correlation does not equal causation.

    -Karl Withakay

  21. #21 Aaron
    January 28, 2011

    Todd: The tic tacs aren’t as effective because there’s no placebo effect. Of course, that doesn’t validate the significant price difference nor the efficacy of depending entirely on the placebo effect.

  22. #22 The Gregarious Misanthrope
    January 28, 2011

    My company offers 3 or 4 different medical plans and one of them actually covers naturopathy. At least two coworkers have chosen that plan because they use naturopaths. I sure hope the plan doesn’t pay for homeopathic “remedies” too.

    10:23 FTW!

  23. #23 Kimberly
    January 28, 2011

    Color me appalled, but slightly amused, at the idea of the NPLEX. Why? Because I’m a psychometrician who has blogged about the common, public understanding of psychometric ideas, with some focus on those who insist that standardized tests are bad/evil/wrong. I’ve noticed that there’s more than a bit of overlap between people who think standardized tests composed of multiple-choice questions don’t actually measure anything, and people who have a tenuous grasp of science and a love of woo. People who love woo also love to say that people just don’t all learn in the same way and can’t be expected to recall knowledge or solve problems in a standardized way; indeed, I’d expect someone who believed in homeopathy to eschew, along with SBM, any ideas about test standardization, reliability, and the like. A test item about homeopathy should involve interpretative dance, at the very least.

    Thus, it’s entertaining to see that these purveyors of woo have gone for something as boring and science-based as a standardarized test, which is pretty much the assessment world’s version of the controlled clinical trial. I’m guessing this is their attempt to seem more scientific, as though the use of MCQ’s and the Angoff standard setting method would add to the valididty evidence of an exam whose content is complete nonsense.

  24. #24 Timberwoof
    January 28, 2011

    mad the swine, how do you rinse your dishes? Can you get the soap off them by diluting it?

  25. #25 Giliell
    January 28, 2011

    It’s really sickening to see how much “naturopathy” is practised by regular MDs around here. You will hardly find a pediatrician who doesn’t do homeopathy.
    On the one side, it gives the whole thing undue credibility.
    But I can also see the “upside”: If means that the patients remain in the care of a “real” doctor, the kids get their vaccines and when things become “bad”, the doctor will give out real medicine and not just sugar pills.
    BTW, I’ve noticed the trend to sell stuff that has active ingredients as “homeopathy”, which gives the whole thing further credibility

  26. #26 Composer99
    January 28, 2011

    I’m sorry to say that most of you were successfully Poe’d by mad the swine. He has been known to do that sort of thing over at Dispatches from the Culture Wars in the past.

    (If you were being serious, mts, please do correct me, of course!)

  27. #27 Todd W.
    January 28, 2011

    @Aaron

    Todd: The tic tacs aren’t as effective because there’s no placebo effect. Of course, that doesn’t validate the significant price difference nor the efficacy of depending entirely on the placebo effect.

    Depends on who’s giving the tic tacs, how they are given, and if any story is woven around them. If I put on a white lab coat, accoutre myself with medical-y gadgets and tell someone who believes in homeopathy and who comes to see me about a problem that they can take these little green pills that I claim are homeopathic, there will be a placebo response. If I do so in a New Age-y office, there will probably be even more of a response.

    In short, tic tacs can have as much of a placebo response as any homeopathic pill. The difference is just in the presentation.

  28. #28 Todd W.
    January 28, 2011

    @Composer99

    I kinda suspected that, since I thought I remembers mts posting reasonable, rational comments here in the past. But, on the off chance they were serious…

  29. #29 jre
    January 28, 2011

    Just to nitpick: Whenever the topic of homeopathy comes up, an explanation is usually needed of precisely why homeopathic claims are preposterous, and this explanation is usually much like Orac’s above:

    … many, if not most, homeopathic remedies are diluted far, far more than Avogadro’s number, meaning that it’s highly unlikely (damned near impossible, actually) that a single molecule of the original starting material for the homeopathic remedy remains.

    That statement is true, but it is incomplete, because it leaves out a key point. Steve Novella got it exactly right in your linked post:

    … Avogadro’s number (6.02214179×10^23), [is] the number of atoms or molecules of a substance in one unit called a mole. (emphasis added)

    The key point is not that you can’t dilute any quantity of anything by a factor much greater than 6 x 1023 and still expect to have a single molecule remaining. Rather it’s that you can’t dilute one mole of anything by that factor and still have a molecule left. It may seem like useless pedantry to insist on this, but I think the issue becomes fuzzy in many people’s minds without a concrete image of what Avogadro’s number means.

    “Why is all the active ingredient gone when I dilute to a homeopathic concentration?”

    “Well, take this salt, here. Its molecular weight is about 58.4, so one mole of salt is 58.4 grams, or about ten teaspoons. We know that one mole of anything contains about 6 x 1023 molecules. That’s six times ten followed by twenty-three zeros. Every time we do a 1C dilution, we divide by 100, or two zeros, which is like splitting the salt into a hundred tiny boxes and taking just one. Every time we do another 1C dilution, we tack on another two zeros to our number of boxes. By the time we’ve done twelve 1C dilutions, we have divided our ten teaspoons of salt into a lot of tiny boxes — ten followed by twenty-four zeros worth, in fact — which is more boxes than we had molecules to start with. That’s why the active ingredient is all gone.”

  30. #30 WLU
    January 28, 2011

    @Orac

    Master of Science in Acupuncture

    So…it’s a history class? As a pre-scientific discipline, the only way to get a Master of Science degree related to acupuncture would be history, right? Because science hasn’t found any acupuncture points, or meridians, or qi, or merit to the diagnostic tests, so what you’re really doing is…training to be an archeologist in China? Linguistics and language training to understand pre-Yellow Emperor writing? This doesn’t make sense on any level.

    @mad the swine

    Science cannot explain how homeopathy works.

    Actually, even your first premise is wrong. Science can explain how homeopathy works. The explanation, which is in line with the scientific understanding of biology, chemistry, physics and medicine, is that it is essentially a placebo effect – one strongly enhanced by a long, careful consultation with a sympathetic practitioner, a plausible-sounding rational, several unsubstantiated attacks on actual medicine and it’s attendant side effects, an actual physical pill with an elaborate ritual around taking it (not too close to a meal, dissolve under your tongue, etc.), good packaging (both in terms of physical packaging – those pills come in a fancy bottle and there’s lots of numbers printed on the side – and marketing-packaging by calling it natural, safe and effective) and the complete lack of side effects (unless you’re a diabetic). This is further enhanced by elaborate rationalizations and pseudoexplanations for unexpected effects – “healing crises”, the symptom-matching isn’t precise, sometimes you have to adjust for the personality and time of day, you used the wrong type of homeopathy, etc. And to ice the cake – most symptoms are themselves cyclical, most diseases get better on their own, most patients are willing to rationalize if it fails because they don’t want to feel dumb. I recommend three books that together address these topics pretty substantively: Mistakes Were Made (but not by me) by Carol Tavris and Elliot Aaronson, Homeopathy: How it REALLY Works by Jay W. Shelton, and Snake Oil Science by R. Barker Bausell. If you want to round that out to an even four, I also suggest Trick or Treatment by Edzard Ernst and Simon Singh.

    Therefore, homeopathy does not work.

    Well this is probably true.

    Therefore, the many, many studies showing the benefits of homeopathy must all be fraudulent.

    Nope, your third premise is also wrong. Some may be fraudulent. Some are almost certainly due to random chance. Some results are probably not published (because they do not support homeopathy). Some probably did not blind the subjects or researchers. Some probably lacked control groups entirely (i.e. “I gave a homeopathic preparation to a guy with a sore throat and it went away”). Some are probably due to the use of concomitant real medicine and the credit was, for some reason given to the homeopathic preparation. Some patients probably reported improvements that can’t be measured objectively (which again relates to blinding). If you wanted to choose an overall statement here, it would probably be “Therefore, the many, many studies showing the benefits of homeopathy must all be fraudulent are probably the result of badly-done, selectively reported research.” These problems are not unique to homeopathy, it’s hard to do nearly any medical study well. It’s just that actual medicine makes a point of evaluating its own claims and attempting to improve both its research and its practice, while homeopathy ducks, handwaves and special-pleads away the results it doesn’t like. Medicine will abandon a treatment that hasn’t been demonstrated to work (witness the decline in hormone replacement therapy for postmenopausal women) while that hasn’t happened in the 200 years since homeopathy came into existence.

    Is that how it goes?

    Well, for my modified version, pretty much. Yeah.

  31. #31 Gizmo
    January 28, 2011

    Orac, please, please, please tell me you’re working on a “response” to Wakefield’s production yesterday of “proof” that he didn’t fake his work and his demand of an apology from Deer and the BMJ!!! He’s making a big stink in the NaturalNews fever swamp!

  32. #32 Becky
    January 28, 2011

    Do ND’s get any training in all of the other primary care medicine areas? Minor surgery like sewing up minor lacerations or treating simple fractures or sprains? Cleaning wax out of ears or diabetic foot care? Are they certified in starting IV’s? Can they do a developmental screening for pediatric evaluation? How to evaluate for depression, drug or alcohol abuse? Or, are all of their classes about woo?

  33. #33 Redattack34
    January 28, 2011

    Does anybody have a link to the list of states/provinces Orac mentioned above, that license naturopathy? I might have some letters to write.

  34. #34 Pablo
    January 28, 2011

    The key point is not that you can’t dilute any quantity of anything by a factor much greater than 6 x 1023 and still expect to have a single molecule remaining.

    Um, this is not really true.

    In practice, it is generally true, yes, but the “any quantity of anything” makes it false.

    For example, if I start with 2000 tons of hydrogen gas (let’s call it 2e6 kg, or 2e9 grams), that constitutes 1 billion moles of hydrogen, which is 6e32 hydrogen molecules. If divide that into 6e23 samples, I would get 1 billion atoms/sample. That works just fine.

    Now, solutions are more challenging because there is a solubility limit, so let’s work in the realm of solubility constraints. I don’t know the solubility of hydrogen in any actual solvent, but I suspect that you can create a solution that is 1 molal (1 mole/kg solvent). A 1 molal solution that contains 2000 tons of H2 would have a solvent mass of 1 billion kgs (if it is water, you are talking about 1 billion L). Therefore, if I did a 1 C dilution, I could 10 million L of that solution and dilute it back to 1 billion L. Do that until the concentration is 1e-24 of the original, and I will have almost a billion molecules left. I could dilute it by a factor of a hundred a couple of more times and still have thousands of molecules remaining.

    Granted, that is thousands of molecules in 1 billion L of solvent, but still, you said any amount of anything.

    1 billion L of water is a lot, but not unfathomable. It is 1 million cubic meters, so could be just a cube that is 100 m by 100 m by 100 m. For comparison, the Metrodome in Minneapolis has a volume of about 1.75 million cubic meters (when the roof isn’t collapsed), so your solution wouldn’t fill it.

    So an 1e-28 molal (essentially molar, that point) solution of H2 in water would contain about 10 000 atoms, if the solution had a volume of 1 million cubic liters.

    Granted, if you grabbed a 10 mL sample of that solution, the probability that you get a single hydrogen molecule is pretty darn small (probably 1e-7), and THAT is the basis for claiming that dilution beyond avagrado’s number is meaningless. IF you start with 1 L of a 1 molar solution, then going beyond 1e23 means your chance of getting a single atom is vanishingly small. However, if you start with 1 mole of neat substance, it might have an initial molarity of 10. Or if you have an exceptionally good solution, you could start with a molarity near 10, which means you have more room to play. Or you could just work with massive volumes (remember, particles = concentration*volume, so you can offset very small concentrations with very large volumes)

    In practice, this of course doesn’t happen, and, moreover, by the time you are talking 30C, it’s all meaningless.

  35. #35 Scott Cunningham
    January 28, 2011

    That AANP blog is something else. Sections of it read like the script of a Dr. Who episode. It’s hard to believe people think its for real. That’d be like listing a Dr. Who Christmas special as “Documentary.”

    Wow. My mind is boggled.

    Check out how much liberal political stuff makes up the content of that blog. It’s… I’m a progressive lefty myself, but the sheer amount of reason-free, evidence-free let’s hold hands and sing “we are the world” stuff on there is making me uncomfortable.

    Simply wow.

    So this is what happens if you substitute politics and feel-good aphorisms in the place of chemistry and calculus!

    From Bastyr, quoted above.

    We anticipate that men, women, and children with cancer who are treated at the Bastyr Integrative Oncology Research Center will live longer and healthier lives.

    Sure they will. And I’d bet the Doctor will always triumph over the Cybermen, too. Because it’s fiction. Twenty to one says they’ll steer patients into the experimental groups they want and falsify the results until homeopathy cures all patients and conventional care causes a giant talking brain fungus.

    Unbelievable stuff. No wonder public statements and explanations I’ve seen for woo are short and vague. That’s a deep rabbit hole. Most people would be afraid of heights looking at that!

  36. #36 Yojimbo
    January 28, 2011

    I didn’t read the Bastyr site very closely (obviously) and missed the homeopathy. Anyway, in looking today I note in Richard Mann’s bio a sort of unexpected “truth in advertising”. He gives the derivation of “homeopathy” (“homoios” in Greek means similar, and “pathos” means suffering”).

    So, after taking a homeopathic remedy your suffering will be similar to what it was before.

    @13 Turnipseed – Seattle is doubly blessed, with both Bastyr and the Discovery Institute. Dampness will do that.

  37. #37 JohnV
    January 28, 2011

    @mad the swine

    Any chance you could constrain you trolling to dispatches? :p

  38. #38 mcsnebber
    January 28, 2011

    As a physician, I am also amused (but not really because it is so dangerous) that there are standardized tests based on knowledge of NON-scientific crap. I am also surprised at the curriculum–anatomy lab (waste of scarce resources in training “ND”s) and other truly natural sciences–physiology, pathology of infectious disease, etc. (also a huge waste of resources) “living” in the same curriculum as homeopathy—and you are tested on both! WTF?? Is the contradiction not obvious to those “scientifically” designing the tests? So the students are taught correctly about the human body and its function/dysfunction and then taught crap in how to treat it…oh wait, I saw an emergency medicine course—does that include an emergency homepathic treatment? WWWTTTFFFF?
    As a breast cancer patient, I am appalled that a woman with breast cancer might go to someone who believes they can treat it with an “ND”. Talk about needing to be criminalized–what exactly do they treat??and with what?
    I also was offerred “Integrative & Complementary Medicine Services” at Johns Hopkins Hospital. However, when researched, these seem to fall more into the “prevention and wellness” category of treatments that have BEEN SHOWN to be effective when undergoing stress or just to stay physically and mentally healthy—massage “therapy” (who doesn’t INTUITIVELY feel that a massage makes one feel better and decreases stress), psychotherapy (OK..), nutritionists (ditto), exercise therapy..(YES)..I suppose all of these could be defined as COMPLEMENTARY or INTEGRATIVE semantically but they are all evidence based. The only straying off the course is that they offer acupuncture, which is sad, but I guess now even the bastions of EBM are supplying what the public demands. I am beginning to think that just the offer of “Complementary and Integrative Medicine” is like a PLACEBO itself, implying that…..here is Much More we can do for you….than just the doctor’s medicine….when most of it is EBM itself. Just making it a “CENTER” and offering a long bullet-pointed list may offer optimism to the chronically ill, and they have lots of “something more to do”…I don’t know how this could be tested though.
    Although the acupuncture is woo, and what you’ve described in your post is more woo–we physicians must keep the states where “ND”s are NOT licensable continue to be “ND” free while offering the EBM behavioral medicine above as evidenced-based to our patients.

  39. #39 Matthew Cline
    January 28, 2011

    @Gizmo:

    Orac, please, please, please tell me you’re working on a “response” to Wakefield’s production yesterday of “proof” that he didn’t fake his work and his demand of an apology from Deer and the BMJ!!! He’s making a big stink in the NaturalNews fever swamp!

    Does he add “and if you don’t apologize I’ll sue for libel”? If not, you have to wonder why he wouldn’t sue over being accused of committing medical research fraud.

  40. #40 Giliell
    January 28, 2011

    It’s really sickening to see how much “naturopathy” is practised by regular MDs around here. You will hardly find a pediatrician who doesn’t do homeopathy.
    On the one side, it gives the whole thing undue credibility.
    But I can also see the “upside”: If means that the patients remain in the care of a “real” doctor, the kids get their vaccines and when things become “bad”, the doctor will give out real medicine and not just sugar pills.
    BTW, I’ve noticed the trend to sell stuff that has active ingredients as “homeopathy”, which gives the whole thing further credibility

  41. #41 Todd W.
    January 28, 2011

    @Matthew Cline

    So, out of curiosity, I took a look at the document Wakefield put together that cites the report written by Walker-Smith, available as a PDF here. But even that doesn’t jive with the evidence presented by Deer. E.g., child 2 is listed in the report as having first symptoms of autism start 2 weeks after MMR, but according to Deer’s report, the symptoms started, at the earliest, months after MMR.

    The other thing, if it was written in 1996, why has it taken 15 years to come to light? Not only is Wakefield a liar and a fraud, but he’s an incompetent moron, too.

    Agree with your “and if you don’t apologize I’ll sue for libel” bit. If he’s got the right on his side, then he should have no problem suing for libel. And, understanding how English libel laws work, he would manage it at Deer’s expense.

  42. #42 Gizmo
    January 28, 2011

    @Matthew:

    Why, yes, he, does!!! He warns of “consequences” if Deer and the BMJ don’t become contrite post haste!

    http://www.naturalnews.com/031117_BMJ_Dr_Andrew_Wakefield.html

  43. #43 Todd w.
    January 28, 2011

    @Giliell

    BTW, I’ve noticed the trend to sell stuff that has active ingredients as “homeopathy”, which gives the whole thing further credibility

    Like the Zicam nasal spray from a few years ago that contained measurable amounts of zinc and caused loss of smell in quite a few people who used it.

    Over at Silenced by Age of Autism, I wrote up an article on homeopathy, answering some questions that one of Orac’s commenters asked. One aspect I touched on was the inherent dishonesty of homeopathy, such as using a notation for the amount of active substance that is unique to homeopathy (and is therefore hard to impossible for the average person to really comprehend) and which, really, is meaningless, anyway.

  44. #44 MaryP
    January 28, 2011

    @17 Maybe she has a friend like me. My after exercise coffee group is full of alternative/natural believers. When I explain what homeopathy is most of them cross it off their believable list. Because NDs are regulated and can now prescribe real drugs in my province I think their treatments have been given greater credibility. It makes me angry when they give homeopathic flu prevention to seniors instead of recommending they get a flu shot. I am still working on trying to convince some of those seniors that they really should have flu shots.

  45. #45 jre
    January 28, 2011

    Pablo, you seem to have taken my point, but missed the double negative in the passage you quoted:

    The key point is not that you can’t dilute any quantity of anything … (emphasis added)

    Sorry if that was confusing. As I was trying to point out, and as you correctly observed, Avogadro’s number does not set a limit to dilution, it sets a limit to dilution from a given starting quantity. I think it is important to bring this out in discussion, because most people find it easier to understand the concept if it is framed as a bucket (one mole) of stuff comprising a certain number (Avogadro’s) of molecules. As you also correctly observed, the phrase “per mole” has limited practical relevance here, since homeopathic dilutions are so absurdly high. For example, by my back-of-the-envelope reckoning, a 20C dilution would have to start with about 1040/6*1023, or 1.66*1016 moles to have an even-money chance of containing one molecule at the end[1].
    To continue using salt as an example, that would be 9.7*1017 grams of salt, or a cube 7.6 km (4.7 miles) on a side. I suspect even Laboratoires Boiron does not have a mixing vat up to the task.

    [1] There is a probability density function for the number of molecules remaining, but it tails off pretty quickly. So the chance of having, say, a thousand molecules in your final dilution is not exactly zero, but it’s close enough that God can’t tell the difference.

  46. #46 Giliell
    January 28, 2011

    Sorry for the double-post, my computer got a hick-up

  47. #47 Matthew Cline
    January 28, 2011

    @Gizmo:

    Why, yes, he, does!!! He warns of “consequences” if Deer and the BMJ don’t become contrite post haste!

    If he doesn’t sue, I wonder what his remaining supporters will say. If we’re to go by the comments of One Queer Fish, it would be that it’s strategically/tactically unwise for Wakefield to sue now, but at some point in the future he’ll unleash his legal wrath upon Deer. As to why it’s in Wakefield’s interest to wait, well, you’re not expecting OQF to reveal Wakefield’s legal strategy to Deer, are you?

  48. #48 rob
    January 28, 2011

    ever heard of the Ceasar’s last breath caclulation?n google it! it shows that in any breath you take, there is a very good chance that one of the atoms you just inhaled was exhaled by Ceasar in his last breath.

    similarly, there is Ceasar’s last piss. in the last glass of water you drank there is a good chance that you consumed a water molecule expelled from Ceasar’s bladder during his last urination.

    do homeopaths know that the “medicine” they cell actually contains more of Ceasar’s piss than any active ingredient?

    heh.

  49. #49 daijiyobu
    January 28, 2011

    Oh, this is such a juicy post topic, Orac.

    But I can’t write on it until tomorrow, as I’ve a ten hour teaching day and papers to grade on top of that. But I will, promise, tomorrow! [I'm sure SOMEONE cares...]

    I promise I’ll expand upon the issue, because it’s not just the little aspect of ‘to homeo. or not to homeo.’.

    That’s a canard, really.

    Hint: there is a worldview that naturopathy has constructed that permits homeo. AND KIND to be falsely labeled “science-based”.

    To pun from the naturo. crowd: homeo. is just a symptom and let’s not just treat symptomatically; I can take you to the underlying cause.

    In the mean time, perhaps readers / commentators would be interested in “Naturopaths Against Homeopathy.”

    An organization of ONE naturo. A fried so be kind. We agree on homeopathy, galore:

    https://sites.google.com/a/doingwellness.com/naturopaths-against-homeopathy/

    -r.c.

  50. #50 turnipseed
    January 28, 2011

    @Dianne, #18

    Thanks, but I looked into soy after the doc brought it up, and found nothing conclusive. There may be some effects in cultures that use soy over a lifetime, but to start drinking tons of (rather fatty) soy milk would wreck my calorie intake. I’m staying with my very low dose patch in spite of the big study that scared so many women, as I am very low risk.

    I took another look at Medline, however, just to be fair and only found references to CAM. This is the danger of looking at anything sponsored by NIH–they have to include the stuff from the ridiculous CAM studies of the NCCAM. Sorry, but I’m not impressed.

    Also, several docs have told me that some women NEVER get rid of hot flashes and I appear to be one of the “lucky” ones. I’m older and it’s a quality of life issue at this point.

  51. #51 Dianne
    January 28, 2011

    turnipseed: Yeah, I wasn’t terribly convinced either. Then again, my current plan for the hot flashes I’m expecting in the next decade involves ignoring them and hoping they’ll go away. It works for menses, right?

    If you use the limit function and limit to randomized controlled trials, there are some that suggest that soy is at least moderately effective. I didn’t see anything definitive either, though. Also I’m not convinced that soy is completely “safe”. If it does have an effect on hot flashes then it is probably modulating estrogen production and therefore could have the same cancer risks as traditional hormone replacement.

    In short, intriguing but unproven and no definitive safety data. Treat with the same caution as you would an unproven new drug. (Actually, treat with more caution because a new drug has at least been examined by the FDA. A “natural product”…hasn’t. And so pills being sold as “soy” could contain anything. Even buying tofu doesn’t guarantee a set dose of soy isoflavanes…I’m sure you know this lecture already.)

  52. #52 Chris
    January 28, 2011

    Turnipseed, does it help that women who get hot flashes are less likely to get breast cancer? I read that in the news, so it must be true. ;-) See:
    http://healthland.time.com/2011/01/28/why-those-agonizing-hot-flashes-may-not-be-all-bad/

    (oh, and if it helps you feel better, Bastyr has moved to Kirkland to the former seminary at St. Edwards State Park)

  53. #53 Onkel Bob
    January 28, 2011

    @mad the swine
    Any chance you could constrain you trolling to dispatches? :p

    MTS, Well played, you brought in a mighty haul with that one.

    MTS schools the amateurs in trolling.

  54. #54 Mephistopheles O'Brien
    January 28, 2011

    I concede I have been Poe’d and recognize Mad the Swine for the insane, twisted, comic genius that he/she/it is.

  55. #55 Dangerous Bacon
    January 28, 2011

    Does anyone else have that old commercial jingle going through their head now?

    You can take naturopathy out of the homeopath, but
    You can’t take homeopathy out of naturopathy

    There’s a reason I don’t miss cigarette advertising on TV.

  56. #56 titmouse
    January 28, 2011

    Hard to believe, but there exists a woo even more retarted than homeopathy, and that is anthroposophy. Go on, click my link to see who’s a fan.

    If you’ve never heard of anthroposophy before, I shall summarize:

    anthroposophy = homeopathy + ghosts

    I used to wonder how large groups of people could suddenly turn full moonbat and start roasting Jews or slicing up Tutsis or spiking the communal cool aide. Thanks to “integrative medicine,” at least I now know that the highly educated are no safer from mass delusion than anyone else.

    Enjoy your Reiki and Dianetics, America. I cannot give you reason if you no want.

  57. #57 lilady
    January 28, 2011

    @Redattack 34 Earlier today I posted that there were 14 states that license naturopathic physicians; information that I got from the New York State Association of Naturopathic Physicians. (NYS does not license them but they practice in NYS anyway because they have licensure from neighboring states.)

    According to the Colorado Association of Naturopathic Physicians there are 15 states that license them in addition to Washington D.C. and the US territories of Puerto Rico and Virgin Islands. You will find the specific fifteen states if you visit the Colorado Association of Naturopathic Physicians and click on “About Naturopathic Medicine” scrolling down to the header “Naturopathic Medicine Today” My computer technical skills to paste the site on to this posting are dreadful…apology.

    Of particular interest at that Colorado site is fund raising/activism to defeat a bill that was enacted recently whereby Colorado will issue “cease and desist” orders to non-licensed practitioners. According to that site “we may not be able to practice as early as this summer (2011).”

  58. #58 Sam C
    January 28, 2011

    Slightly off the topic, but do real doctors get taught about homeopathy, naturopathy, etc?

    I don’t mean do they get trained to apply them, but are they expected to know enough about them to respond to a patient’s questions and say “well, you can chuck your money away if you want to, but it’s rubbish because …”?

    Seems to me that any SBM/EBM/reality based medic probably needs some knowledge of the dark side, if only to wield his vorpal blade against the bandersnatch.

  59. #59 G.Shelley
    January 28, 2011

    Do these “skeptics” really think the public cares about Avogadro’s number when homeopathy has just significantly improved their toddler’s autism or offered help with any of a vast range of diseases which respond so well to homeopathic (and often not to conventional) treatment?

    This is just another tantrum by the clueless wing of the scientific/medical community that can’t understand why the people don’t praise them for their ideological purity and courage, even when the fruits of their scientific labors rot like a brown banana. Note to protestors: maybe they’re just not that into you.

    On the first point, the anecdotal responses from the first point suggested people did care that homeopathy was ridiculous magic, rather than herbal medicine.
    On the second,the people behind the campaign are not scientists, just skeptics concerned that promotion of nonsense by the NHS and respectable pharmacies such as Boots leads people to believe it isn’t nonsense and can reduce the chances of taking real medicine.

  60. #60 Melody
    January 28, 2011

    I can see how someone could make that mistake about naturopathy. After all, look at how many people buy homeopathic products thinking they’re herbal remedies.

    The Tic-Tac comparison is interesting – when I was ten-years-old I actually used Tic-tacs as a “medicine” when I imagined I was a doctor. I guess homeopaths/naturopaths using homeopathy just never kicked the sugar-pill habit (or the imagining to be a doctor habit).

  61. #61 prn
    January 28, 2011

    No use for homeopathy here, but “regular” medicine loses some credibility and moral imperative when a best selling drug is obviously injurious and ineffective on the largest uses. Obvious simply by reading the published literature and knowing a cheaper, better performing generic off label alternative, from the published literature.

    Oh, yes. In a recent case, the FDA somewhat agreed with my thoughts a month later in a public announcement, and then later, withdrawal of the biggest use’s approval. The local company branch’s response was to host a big oncology society black tie dinner to emphasize dr “incentives” 2-3 weeks later for the contraindicated use.

    Medicine’s failures to clean its own house on any dangerous, ineffective remedies probably partly drive homeopathy (from arsenicals of old to some recent block busters). Medicine’s failure to adequately address many common chronic problems, drive naturopathy in herbalsim and nutrition. Regular medicine’s answer is not more legal and political opprobrium, the answer is cost effective performance and more open, less biased information on common problems that “regular medicine” doesn’t treat effectively.

    Expensive, even harmful medical failures are a great recruiter for even half baked, half cocked competition.

  62. #62 Chris
    January 28, 2011

    prn, broad strokes against all medicine is worthless, especially when you claim a best selling drug

  63. #63 titmouse
    January 28, 2011

    No use for homeopathy here, but “regular” medicine loses some credibility and moral imperative…

    Medical science may not make you happy, sorry. The fact you aren’t happy and want an alternative doesn’t mean an alternative exists.

    Slightly off the topic, but do real doctors get taught about homeopathy, naturopathy, etc?

    The Institute of Medicine’s 2005 report to congress recommended integrating alt med into med school training “at al levels” –meaning not just, “this is what the quacks are telling your patients” during the pre-clinical years, but also, “prescribe this quackery to your patients” during the clinical rotations.

    It’s happening now, everywhere in the US, as mandated.

    Pity that forced cognitive dissonance causes brain damage. I’d prefer the young docs caring for me when I’m in the old folks’ home to be capable of organized thought.

    the teaching of alt med causes brain damage

    Ergo, “infiltrative medicine” departments at all medical schools today.

  64. #64 Chris
    January 28, 2011

    HTML fail… (must remember to use preview!)

    prn, broad strokes against all medicine is worthless, especially when you claim a best selling drug. has issues or the FDA made an announcement without naming the specifics. It makes little sense when the average lifespan has more than doubled in the last century. It also has absolutely nothing to do with the topic of this article: homeopathy.

    If you have evidence that a homeopathic remedy works as well for inflammation and pain as ibuprofen, or that ibuprofen is an evil drug I will pay attention. This is particularly important to me since a I injured myself in a fall a while ago, and I cannot tolerate any narcotic.

    So stay on topic, please.

  65. #65 titmouse
    January 28, 2011

    Oh bother, hit the send button too soon. Forgive the stray sentences at the bottom and typos plz.

  66. #66 prn
    January 29, 2011

    I’m well within the bounds of Orac’s text. He spent quite a lot of space on the scientific irrationalism of homeopathy. I merely pointed out an ignorant or uncertain individual’s possible economic calculus, and the favorable relative “payoff” in particular cases, however ill advised in general.

    When a “regular medicine” has net negative “benefits” in the individual, it is axiomatic that the homeopathic water was a better choice for that specific occasion, even if still a poor choice against some presumed biologically effective remedy.

    Also I’m not against all medicine. I am against dirty medicine with recalcitrantly marketed and hyped, known dangerous drugs. There have been a lot of them. I think highly of cheaper, more effective medicines. Cheap medicines often ignored, subtly attacked, or not so subtly attacked by makers of expensive (sometimes bad) ones.

    My medical oncology example from this summer will be obvious to many participants here, because of the unusual FDA retraction. I simply did not name names on a blue “rock”, that is not the Hope Diamond.

    Sorry about the injury and pain. You might consider temporarily avoiding comprehension and conceptual issues that cause you stress and more pain.

  67. #67 RFW
    January 29, 2011

    @ prn “Medicine’s failures to clean its own house on any dangerous, ineffective remedies probably partly drive homeopathy”

    You are mistaken in thinking that Medicine-with-a-capital-M is a monolith wherein everybody sings in the same choir. It isn’t. The physicians are one group, the pharmaceutical companies another, and the regulators yet another, in a simple analysis. (Admittedly, the AMA doesn’t have entirely clean hands, but at least the better medical journals do something to keep people down to earth in their claims.)

    A real problem arises from political interference with the FDA, which is the public body tasked with determining whether new drugs are approved or not. Unfortunately, the FDA doesn’t have the staff or budget to do its own clinical studies, hence has to depend on those carried out by industry.

    And since industry has a vested interest in getting drugs approved because of monetary issues (e.g. greed), you may be sure that the documentation they submit to the FDA is often biased.

    No, I can’t suggest any simple, easy, or cheap solution.

  68. #68 prn
    January 29, 2011

    @63
    Oh, I know that multiple alternatives exist for most technical problems. I see them in the journals myself, and sometimes take pains to measure their results. The phrase, “more than one way to skin a cat,” comes to mind.

    …the teaching of alt med causes brain damage
    ROFLOL. Worst, when an herbal or nutritional answer works? I notice when people don’t understand something completely different, they often don’t see, hear or remember so well.

  69. #69 Mikey
    January 29, 2011

    I read this stuff and just giggle the whole time. Is there something wrong with me? I guess this is the only way I can deal with the inanity of the quackmeisters

  70. #70 Chris
    January 29, 2011

    prn:

    Also I’m not against all medicine. I am against dirty medicine with recalcitrantly marketed and hyped, known dangerous drugs. There have been a lot of them. I think highly of cheaper, more effective medicines.

    Then name them! Don’t just say that a med is found bad. That implies all real medicine is bad.

    And if it all that freaking important to you, make your own blog. Name it something like “These are Bad Meds.” Otherwise, stick with the topic. Despite your feeble excuses, you were really very off topic.

  71. #71 Andrew
    January 29, 2011

    The only thing missing from this article is the fact that “naturopathy” could have been used to mean something scientific and worthwhile, if the quacks hadn’t co-opted it. We need to stop letting them co-opt so many terms.

  72. #72 titmouse
    January 29, 2011

    No, I can’t suggest any simple, easy, or cheap solution.

    Maybe homeopathy?

    No wait, bad idea. When you bend the rules of evidence to justify a nutty idea like magic water for every disease, a few weeks later you’ll have people chelating their autistic kids.

    No the rules have to be the same for everyone. Dox or GTFO for everyone. That includes the greedy pharma companies, the hippies who like herbs, people named “Herb,” the theocrats using healthcare as a wedge strategy, Oprah, and Dr. Oz’s sexy Reiki wife.

    BTW, those posting, “BIG PHARMA MAKES POISON PILLZ!!” –please kill yourselves. You work-from-home MLMs or PR drones are ruining the Internet for everyone else. Go eat some vitamins and find another job and/or religion ASAP.

  73. #73 Chris
    January 29, 2011

    prn:

    ROFLOL. Worst, when an herbal or nutritional answer works? I notice when people don’t understand something completely different, they often don’t see, hear or remember so well.

    Which ones? Vitamin C has been shown to work for scurvy and Vitamin D for rickets. Herbal medicine had morphed to foxglove extract turning into digitalis, willow bark tea into aspirin and yew bark into taxol.

    If something that is alternative is proven to work, it stops being “alternative” and becomes real medicine. In your world view, is there a problem with that?

  74. #74 titmouse
    January 29, 2011

    The only thing missing from this article is the fact that “naturopathy” could have been used to mean something scientific and worthwhile, if the quacks hadn’t co-opted it.

    Not really, no. Either people weigh the evidence for some treatment correctly or they do not. Doesn’t matter what words you use to describe the groups the people belong to.

    Alt med claims are mostly lies. “Conventional” medical doctors have decided to allow these lies into the hospitals and med schools. So everyone is guilty of trying to make a buck without the insurance hassle. Sad, but there you have it.

  75. #75 titmouse
    January 29, 2011

    ROFLOL. Worst, when an herbal or nutritional answer works?

    Pop quiz: What do they call an herb or nutritional supplement that actually works?

    A. Alternative medicine
    B. Medicine

  76. #76 prn
    January 29, 2011

    “works”, “recognized” and “offically approved” are status events that may be separated by decades. In the 20th century, some of the greatest advances in corporations that made fortunes before being “recognized,” in academia, government or, hopefully, competitors.

    An herb or nutritional supplment that works but is neither recognized nor officially approved is (A) Alternative medicine.

  77. #77 titmouse
    January 29, 2011

    Sorry, you can’t say an herb works and it doesn’t work. That’s contradictory. And the stuff about “official” is just handwaving for the children. The people here are official enough to weigh the evidence on their own, when not feeling lazy.

    You don’t know how stuff is proven to work. That’s ok. Just don’t pretend that you do.

    Go eat your vitamins and do some chanting or Dianetics with the New Age crystal waving gang. You’ll have more fun.

  78. #78 Chris
    January 29, 2011

    prn:

    An herb or nutritional supplment that works but is neither recognized nor officially approved is (A) Alternative medicine.

    And they are? List them or be laughed at!

  79. #79 Phasma Phasmatis
    January 29, 2011

    “If something that is alternative is proven to be patentable, it stops being “alternative” and becomes patentable medicine. In your world view, is there a problem with that?”

    Fixed that for ya!

  80. #80 Kirsi
    January 29, 2011

    Could you please stop writing “an herb”. Or has the ‘h’ become silent lately?

  81. #81 Kirsi
    January 29, 2011

    About the Avogadro’s number. It’s not dependent of the amount of substance you start with, because it’s about dilution, which refers to concentration, not amount. The substance doesn’t go anywhere (unless you make your dilution in successions and pour the solutions from one vessel to another, when some loss is inevitable), but the concentration becomes so low that it’s unlikely that you can catch the molecules of the original substance, when you take your sample.

  82. #82 Jarred C
    January 29, 2011

    Kirsi,

    In America, herb is pronounced “urb,” so when speaking, it just sounds more appropriate to use “an” instead of “a.” From what I understand, in Britain, it’s pronounced “hurb.”

  83. #83 idlemind
    January 29, 2011

    Some folks (like me) actually pronounce the word “herb” as “erb.” Pretty common on this side of the pond, I believe.

    In any case, an herb which actually has a curative effect beyond placebo would be a medicine in the conventional sense. Extracting and perhaps synthesizing the active chemicals and using those instead of the raw herb is, I think, a good idea (to calibrate the dose and avoid unwanted side effects). The idea that the whole herb (with variable content which may consist of harmful as well as helpful components) is somehow better because it is “more natural” is magical thinking, pure and simple, with no evidentiary basis. But many common medicines are either purified from plant or other “natural” sources or were originally discovered in those places and later synthesized. (And, of course, many deadly poisons have been found in the same places!)

  84. #84 Steve K.
    January 29, 2011

    Long time reader, first time poster…

    What galls me the most about these remedies is that in order for Homeopathy, Naturopathy, or CAM modalities to appear to work it requires that the recipient of the treatment be kept in a state of ignorance, about their bodies, about the solution, about chemistry. One must agree to be hoodwinked, to be mesmerized, in order for this nonsense to seem effective. How can a practitioner of homeopathy make any curative claim if they are not hoodwinked themselves, or intentionally deceptive, or stupid? Do these people have any ethical compass apart from self-aggrandizement?

    As a practice, homeopathy does not raise the intellect of either the recipient or the practitioner. It does not challenge the mind to understand anything about the human condition, apart from the psychology of the placebo. The practice does not take part in the intellectual progress of humanity but rather seems to be regressive of it.

    As I’ve said to my students, a degree in Homeopathy is for those who do not have the patience, intelligence, perseverance or integrity to pursue an honest scientific degree. You can expect your path to a scientific degree to take many years of hard, incessant work. You will receive little recognition or even pay, but you will graduate with the knowledge that you are part of a great intellectual tradition, honestly acquired. The purveyors of Homeopathy can say no such thing, even despite a piece of paper from Baystr or Georgetown that says so.

  85. #85 Laura
    January 29, 2011

    A few years ago I complained to a therapist that my doctors were pushing prescription medicine on me rather than trying to find the root of the problem; that they didn’t really think.
    She suggested, in a kind, nurturing way, “You could try a homeopathic doctor. They wouldn’t be pushing drugs on you.”
    I exclaimed loudly, “OH F***!”.
    She was really offended and told me later that I’d insulted a good friend of hers who was a homeopath.
    On the other hand many naturopaths (from what I’ve heard) have been way ahead of their time in suggesting people try a gluten/dairy free diet, and probably helped a lot of people who wouldn’t have been helped by mainstream doctors.

  86. #86 Militant Agnostic
    January 29, 2011

    Laura @85

    On the other hand many naturopaths (from what I’ve heard) have been way ahead of their time in suggesting people try a gluten/dairy free diet, and probably helped a lot of people who wouldn’t have been helped by mainstream doctors.

    The problem with this is that they were mostly right in a stopped clock way. By recommending this diet to many if to most of their clients they are bound to get some hits, especially with lactose intolerant people. They aren’t doing the majority of lactose intolerant people much of a favour by telling them to avoid gluten. The latter is a big pain in the ass as anyone who is celiac can tell you.

  87. #87 Militant Agnostic
    January 29, 2011

    Kirsi @

    The substance doesn’t go anywhere (unless you make your dilution in successions and pour the solutions from one vessel to another, when some loss is inevitable), but the concentration becomes so low that it’s unlikely that you can catch the molecules of the original substance, when you take your sample.

    Actually the substance does go away because at each step of the process most of the solution (99% if you are being rigorous) from the prior step is is discarded. There isn’t enough water in the galaxy to make a 100C homeopathic dilution of anything if you don’t do it in steps discarding most of the solution from the previous step as you go.

  88. #88 Domestigoth
    January 29, 2011

    Really? All these comments, and nobody’s nit-picked about the diction choice in the title yet?

    This isn’t to say that I don’t agree that IN PRACTICE, naturopathy and homeopathy are USUALLY lumped together due to ignorance and bad schooling. HOWEVER, by the very definition of these things, they CAN exist separately. Homeopathy has a very strict definition: it’s the practice, designed by Hahnemann, of the false premise that “like cures like” and that diluting and shaking something makes it stronger.

    Naturopathy, however, refers only to a choice to avoid using chemical products and drugs in treatment. A doctor who suggests that you rest and drink lots of tea and orange juice to speed your recovery from a cold could technically be said to be practicing “naturopathy”.

    The trouble comes of ceasing to use words like “natural” as soon as something has become common within the medical profession. It sets up this false dichotomy which quacks and charlatans take advantage of to sucker people out of their money and their health. There is also the problem outlined by Laura @ 85 of doctors often becoming over-reliant on prescription drugs and thus either alienating their patients (pushing too many drugs may = pushing patients away) or overlooking a simple-but-effective solution (as in Laura’s example with gluten-free diets).

    What really needs to happen here is a change in the LANGUAGE of health care. I think we can all agree that words like “alternative medicine” are harmful. There are no “alternative medicines”, only “medicine” and “alternatives TO medicine” (which nobody should want, as they’re blatantly NOT medicine and won’t help you). By the same token, the medical profession’s choice to not embrace words like “natural” is setting up and reinforcing that false perception of doctors = chemicals. And there are already a lot of uneducated or under-educated people out there who have decided or been convinced by the media that chemicals = unequivocally bad.

    What we’ve got here is a PR situation, and the title of this blog post is a perfect example of an attitude and mode of language that needs to be changed before progress can be made.

  89. #89 Militant Agnostic
    January 29, 2011

    Domestigoth @88

    Naturopathy, however, refers only to a choice to avoid using chemical products

    The active components in herbs are chemicals – chemicals which are usually beneficial to the plant and which occasional by coincidence have some hopefully beneficial effect on humans in certain circumstances.

  90. #90 Todd W.
    January 29, 2011

    @prn

    I would agree that the medical industry does deserve some (though not all) blame for the public’s love affair with alt med. I just finished reading Simon Singh and Edzard Ernst’s book Trick or Treatment, and they listed their top 10 categories of people (in no particular order) that share in the blame of why alt med is so popular. It ranges from celebrities and the media to doctors, scientists and the World Health Organziation. To some extent, I agree with their assessment and their suggestions for what these groups need to do. It’s a utopian dream and will likely never happen, but at least there are some concrete suggestions, nonetheless.

  91. #91 daijiyobu
    January 29, 2011

    Here’s a great web page by pediatric Homeopath-ND Cohen (CCNM 1990) in Toronto, Canada that shows the amalgamation of naturopathy and homeopathy as

    “homeopathy has been an integral part of naturopathic medicine since its inception”,

    claims that homeopathy is a science as

    “homeopathy is a holistic medical science”,

    and that naturopathy’s principles are based on science as

    “naturopathic medicine is distinguished by the principles which underlie and determine its practice. These principles are based upon the objective observation of the nature of health and disease, and are continually reexamined in the light of scientific advances”.

    The page, in typical ND fashion, does not transparently communicate the science-ejected vitalism that is their central principle.

    Below is the Archive.org page, because why should an ND’s site benefit from more traffic!

    (http://web.archive.org/web/20050215144022/http://moonland.com/Library/Dictionary/Dictionary.html ).

    -r.c.

  92. #92 Travis
    January 29, 2011

    Militant Agnostic,
    That point stuck out to me as well. I am tired of the word chemical being a byword for something unnatural and man-made. The food you eat is made of chemicals, the herbs people take are just chemicals. Naturopaths, homeopaths and modern medicine all use chemicals, just some of these people give you chemicals that will do less for your specific ailment than others.

    It is as though people think herbal medicine is made of magic and not those nasty chemicals.

  93. #93 jre
    January 29, 2011

    A tangential note:
    I went to the website for the American Association of Naturopathic Physicians (AANP) linked to by Orac, and posted a brief comment (a quote, actually). This was my comment in its entirety:

    Alas, to wear the mantle of Galileo it is not enough that you be persecuted by an unkind establishment, you must also be right.
    - Robert Park

    Upon posting the comment, I was informed that it would appear “after approval.” So far, I do not see it. However, I consider it likely that the AANP liked my comment so much that they decided to give it even more prominent display by successive potentiation and dilution until there was less than one byte left.

  94. #94 dean
    January 29, 2011

    On the other hand many naturopaths (from what I’ve heard) have been way ahead of their time in suggesting people try a gluten/dairy free diet, and probably helped a lot of people who wouldn’t have been helped by mainstream doctors.

    Shotgun approach, similar to the old trick of convincing people you have a “skill” for picking NFL winners.

    Week 1: Send out 500 cards to folks, introducing yourself and describing yourself as a football psychic wishing to sell your services so people can make a little extra cash. As a demonstration, pick one high profile game and give the winning team: give one team to 250 people, the other team to the other people.

    Week 2: Send 250 cards to the folks who received the previous week’s winning card, reminding them of your correct prediction and, for their benefit, picking a winner for the current week’s big game. 125 cards have one team, 125 have the other team

    Week 3: Send 125 cards to the folks who “won” in week 2, you see the pattern.

    You’re wrong for most of the people you first contact, but there will be a few for whom your prowess is “demonstrated”. These are you suckers. Same type of thing the medical scammers under discussion do.

  95. #95 Narad
    January 29, 2011

    He warns of “consequences” if Deer and the BMJ don’t become contrite post haste!

    Needless ileocolonoscopies, no doubt.

  96. #96 Domestigoth
    January 29, 2011

    @ Militant Agnostic and Travis:

    Good point; I overlooked that when proofreading my comment. I meant ‘man-made’, as you pointed out.

    This is actually just another illustration of my larger point, though, and so my error is convenient. We can’t fight the media or hope to change perceptions on a large scale unless we work with the language that has already been embedded into the general public. Because words like “chemical” have been given a negative connotation, it’s easier to just stop using those words until public perceptions have changed. Using a more media-friendly word like “extract”, or adding qualifying words like “naturally sourced”, makes things immediately less intimidating to your average person. Pointing out that this chemical is actually something which comes from a tree or a rock or is something that naturally occurs in your brain and wasn’t created by some crazy mad-scientist type in their underground lair makes it all seem friendlier.

    Yes, it’s kinda stupid and manipulative. Yes, it would be nice if we could just be straight-up about everything and everyone would understand it and see the logic. But we live in a world populated by a lot of stupid people, and we’re constantly being bombarded by propaganda. If we don’t play the game at all, we’ve already lost, because the other team isn’t quitting. So we need to play their stupid game, use the stupid words, and PR the hell out of it.

  97. #97 Inflatus medicus
    January 29, 2011

    “Shotgun approach, similar to the old trick of convincing people you have a “skill” for picking NFL winners.”

    Allopaths do this with diagnoses of stress/depression. Pretty much any symptom you describe can be attributed to stress/depression and since there are no real tests for these diagnoses, the patient is prescribed an anti-anxiety medication or an antidepressant. Some percentage of patients will come back saying they feel better and then stay on them indefinitely while their real medical problem is ignored.

  98. #98 Travis
    January 29, 2011

    Domestigoth,
    I still have a problem with that. I think we lose when we decide to put everything in those terms. A person who sees “naturally sourced” and thinks it sounds like a particularly convincing reason might end up choosing the science-based alternative labelled this way but is still as vulnerable to woo as ever. How hard is it to change someone’s mind back to woo when they made their mind based on something meaningless or comforting? All it has to do is sound good. I think all we end up doing is equating medicine with these other things and bring it down to that level.

  99. #99 nybgrus
    January 29, 2011

    @96: Not exactly bucko. Stress/depression do have positive diagnostic criteria in the DSM manual of psychiatric illness. Somatoform disorders (i.e. physical manifestations of psychological illness/depression) are made by exclusion. You keep whittling your way down until you are left with no diagnosis except psychological.

    Along the way, you may prescribe anti-depressants or other mind altering drugs. If a better diagnosis is reached or the core problem is resolved then the medications can be withdrawn (correct to not here that this step is indeed too often overlooked). However, the fact that some anti-depressants work for some people and others do not is a complicated thing based upon the fact that brain chemistry is not fully understood and that everyone has slightly different brain chemistry, genetics, pharmacokinetcs/dyanmics, and responses to drugs. Additionally, unlike something such as anaphylaxis, the molecular level changes incurred via antidepressants take days to weeks to have a noticeable effect on the conscious level – a facet of consciousness being an emergent phenomenon of basic neurobiology. Thus, given the complex, not fully understood (as of yet) nature of neurobiology, the wide range of responses to medication, and the lag time and variable nature of effect of such drugs it only makes sense that we do the best we can – which is attempt a best case diagnosis using established criteria, diagnose by exclusion when necessary, and then utilize the best pharmaceuticals over time switching as necessary to illicit the desired clinical effect.

    Cognitive behavioral therapy concomitantly is also of high utility, but in general underused as the state of mental health care in America is quite abysmal.

    This has nothing to do with a shotgun effect or ignoring a real medical problem. Nice try though.

  100. #100 prn
    January 29, 2011

    @98 I suspect the naturopaths would say you’re skipping several steps, especially nutrition and digestion, along the pathway of “psychiatic / psychological, by exclusion”.

  101. #101 prn
    January 29, 2011

    @93, dean
    “Shotgun [gluten/dairy free]…old trick…scammers” sounds uninformed. The naturopath is going to be alive to food intolerances generally as a digestive issue. I’ve seen plenty of complaints in celiac and cystic fibrosis forums about lack of knowledgeable digestive support or years (and years) to diagnostic identification in the MD sector.

    I googled around, and I can see naturopaths discussing various diets, from (near) vegetarian and juicing to Paleo and ketogenic diets. So there seems to be plenty of range in basic staples.

    The other important part would be items like supplements and medicine to substitute, heal, or stimulate digestive organs’ function.

    I am going to say this again. Naturopathy partly thrives because regular doctors don’t address many digestive issues well, or at all. If an army lives on its stomach, they can say “f— the science, I’m going with my/your gut”, and “win” by simple numbers.

    Naturopaths may also be implementing better science on basic digestion and nutrition, by simple absence or neglect of “modern” MDs on some important elements of basic GI care, parts of which the old docs knew.

  102. #102 titmouse
    January 29, 2011

    Naturopathy, however, refers only to a choice to avoid using chemical products and drugs in treatment.

    But what if the chemical products work better?

  103. #103 Inflatus medicus
    January 29, 2011

    “Stress/depression do have positive diagnostic criteria in the DSM manual of psychiatric illness.”

    Oh yes, that great work of fiction. It takes one person to have a real disease, but it takes two people to have a mental illness.

    Nice try though.

  104. #104 daijiyobu
    January 29, 2011

    Hey, I put something UP.

    You may like it, if you are of the OBVIOUS mannerism that I belong too.

    of course, if you are a [and I'm sure many will regal in this irony] a naturopath now my supervisor…

    you may as many have stated to me but I refuse to comment upon, steal material from me…literally, like the recent TTC course transcript material stolen out of my mailbox from me at work, …

    be unhappy.

    It doesn’t mean you are right, and the low-road is of course [literally] unethical…but, as we have little recourse being that we are not going to disclose the contents of the NANNY CAM currently…

    Cushla ma crae.

    -r.c.

  105. #105 Chemmomo
    January 30, 2011

    Domestigoth

    Because words like “chemical” have been given a negative connotation, it’s easier to just stop using those words until public perceptions have changed.

    I disagree.

    Chemical free = vacuum.

    End of story.

    The world is made up of chemicals. Get over it.

    Natural = good/man made = bad is a stupid dichotomy as well, because there are plenty of completely natural, horribly toxic substances out there in the world.

    You’re playing the wrong PR game.

    The bottom line is that no matter what the substance is or where it came from, people should focus on the question of whether there’s a reasonable expectation that the substance in question
    (a) has the effect we’re looking for and
    (b) its side effects aren’t going make our quality of life worse than it was with the original condition (for the long term; some conditions require short term decrease in quality of life in order to provide long term benefit).

    That’s the battle.

    Your desire to dress it all up with “friendly” or “non-intimidating” words shoots all of this in the foot.

    Yes, it’s kinda stupid and manipulative. Yes, it would be nice if we could just be straight-up about everything and everyone would understand it and see the logic. But we live in a world populated by a lot of stupid people, and we’re constantly being bombarded by propaganda. If we don’t play the game at all, we’ve already lost, because the other team isn’t quitting. So we need to play their stupid game, use the stupid words, and PR the hell out of it.

    Playing the stupid, manipulative game only works as long as the “stupid” don’t understand that you’ve manipulated them. At that point your PR strategy backfires.

    Frankly, I don’t think people are as stupid as you seem to think.

    My “PR” goal is to educate people about what the word “chemical” actually means.

  106. #106 Domestigoth
    January 30, 2011

    @ Travis:

    Two things – first, there’s the simple fact that even if it’s manipulative and kinda kooky, it could save lives. Even one person convinced to go to a REAL doctor instead of to some quack with a good soundbite is a GOOD thing.

    Secondly, once they’re in the door you can start changing their minds. Breaking down the false dichotomy also breaks down the flimsy reasoning that most people use for choosing woo. When you ask most people why they choose to go to a naturopath/homeopath/acupuncturist/reiki master/whatever other crap, it’s usually that they want something “more natural”. Once the woo-flingers lose that edge, they’re going to lose a BIG client base.

  107. #107 Domestigoth
    January 30, 2011

    @Chemmomo

    Good luck with that. ‘Cause frankly, you’re overestimating the general public’s ability to think critically. But I obviously won’t be able to change your mind, here, so I think we’ll just have to agree to disagree.

  108. #108 Chemmomo
    January 30, 2011

    Domestigoth,
    I agree to disagree.

    Go ahead, keep that bar low. That will definitely get the critical thinking going. Just keep this in mind: Stupid is as stupid sounds. Feel free to keep “us[ing] the stupid words.”

  109. #109 Phoenix Woman
    January 30, 2011

    The irony is that homeopathy is such a hot-selling concept among certain circles that all manner of stuff is labeled homeopathic even when it’s not mostly water and sugar.

    If you ever run across a “homeopathic” remedy that seems oddly effective, cast your eyes over the “inactive” ingredients — chances are some stuff that actually works resides there. (Nelsons acne gel, in addition to the 6x dilutions of various homeopathic hoo-has, has among the inactive ingredients… tea tree oil. Which has been shown by modern scientific testing to have antibacterial properties, which explains why the acne gel actually fights acne.)

  110. #110 nybgrus
    January 30, 2011

    @102: sorry I fed the troll. No more soup for you!

  111. #111 titmouse
    January 30, 2011

    Two things – first, there’s the simple fact that even if it’s manipulative and kinda kooky, it could save lives. Even one person convinced to go to a REAL doctor instead of to some quack with a good soundbite is a GOOD thing.

    Die in a fire.

  112. #112 Denice Walter
    January 30, 2011

    Mike Adams gives us another _perfectly_ good reason** to only consult NDs :”Doctors in training taught to physically violate unconscious patients( Expicit)”- see esp.- ” Now for good news”; NaturalNews, today).

    ** I took a very nice day trip yesterday- we got away from the snow-encapsulated fiasco otherwise known as the NY metro area for about 12 hours- and *then*- today, I had to find *this* article by Mike- Be forewarned !

  113. #113 Jarred C
    January 30, 2011

    Chemomo, Demistigoth, whomever else…

    Unfortunately, I have real world experience on the subject your talking about (I’m fairly sure we all do, actually). Let me regal upon you my family:

    When I received my first associates degree, I became the most educated person in my family.

    I have two older brothers (M and K). M recently saw “Food, Inc.” and now believes that anything that comes from the FDA is not to be trusted, because “corporations” completely control them. He believes that organic foods are natural, and the use of pesticides is unnatural, because they’re chemicals (yes, I’ve tried to explain to him what chemicals are; I do have a BS in chemistry, as well as one in toxicology). He also believes (as the rest of my family) that organic foods are actually more nutritious and healthy for you, and taste better! He doesn’t believe that the liver eliminates toxins from the body; and he believes that over time, small amounts of toxins will build up in your body and reduce your life-span (I’m talking about picogram amounts here). M’s wife has a masters in botany (and, believe it or not, thinks the same way). I thought that I could easily explain to her about the science of toxin elimination, such as our body’s use of P450 enzymes and more. Her excuse was, quite literally, “well, scientists use statistics to manipulate results, so you can really get any answer you want.” They then tried telling me that the science isn’t settled because you can get 5 scientists to claim one thing, and 5 to claim the opposite; therefore, organic food is better. They ignored me when I stated that I could give a rats ass about what 10 scientists say; I want the results of 10,000 experiments.

    Now let’s move onto my other brother, K. K doesn’t care. He’s so surrounded by woo that he’s given up. His wife, who has a masters in psychology, but her career is teaching dance, is the most woo filled person I’ve ever met. Her mother had breast cancer ~20 years ago, and despite surgery (which she often fails to mention), she claims that it was her diet (macrobiotics) that cured her from cancer. She’s made this claim so often that my entire family believes her; despite my urging that no, it was the surgery that removed the tumor, not her diet. My mother often understands me, but about 2 days later my mother reverts back to her previous notions. K’s wife believes that she is more of an expert on nutrition and toxins and chemistry than I am (despite my years in school), because she used to work in a health food store for a few years. In fact, my entire family holds her words above mine when it comes to many subjects in science.

    My father doesn’t believe evolution is true, because it doesn’t explain the big bang. And even if it is true, something had to have caused the big bang, and we might as well call it God. My father thinks that no pesticide is better than 1 nanogram of pesticide; therefore buy organic (besides, organic is healthier for you, and tastes better!). He understands me when I tell him that it’s not toxic if you’re not getting above the threshold level of a dose/response curve, but that doesn’t change his mind. My father believes that vaccines cause autism. I’m still not sure why.

    My mother is the only person in my entire family that will even listen to my words when it comes to science. But my words last about 2 days. Give it a week, and she’s right back to the same talking points again. I really think that it’s because I only talk to her about once a week, and the rest of my woo filled family talks to her every day (I’m her only child who hasn’t given her grandkids, so I don’t see her as often).

    My entire family believes in the power of supplements (and I often receive supplements as gifts). My father keeps trying detox programs for his liver from the recommendation of my sisters-in-law, and ignores me when I explain how and why they don’t work (that foot-detox one is obviously fake, but this liver one works!). They believe in acupuncture and acupressure (which are completely different things in their minds). My parents take the advice of a chiropractor over that of a medical doctor (and even my mother’s surgeon for a shoulder surgery she just had a few months ago). They believe that vaccines cause autism, but it’s worth the risk for the protection they provide (some vaccines aren’t worth the risk, though; never did find out which ones or why, they won’t tell me). They think “chemicals” are causing cancer; and therefore we must go as natural as we can. The cancer rate in America is obviously on the rise, because my mother knows more people who have cancer now than she did 30 years ago.

    This is what I’m up against every day. My entire family asks me to produce evidence for them, to back my statements and arguments (which is perfectly reasonable); yet none of them read or respond to any evidence that I provide. They just ignore it and keep stating the same old talking points. They never provide evidence for their side of the argument.

    I once asked everyone in my family, why do you think I’m wrong? I have relevant degrees in the areas we’re talking about (chem and tox). I’ve provided evidence backing my claims.

    And the only response I’ve received (from my brother) is, “you’re not wrong, just mistaken.”

    Ladies and Gentlemen, my family represents the average American. They are all intelligent people (albeit mostly uneducated). This is what you’re up against when you want people to understand that chemicals are in everything, and that the chemical = bad / natural = good dichotomy doesn’t exist. They don’t care that it doesn’t exist. It makes sense to them, and they’ll ignore anything which requires extra effort to understand.

    Just remember, critical thinking requires effort – and most people just don’t want to give it.

    (sorry for the length)

  114. #114 Jarred C
    January 30, 2011

    Oh, and I forgot to mention: my sister-in-law, K’s wife – she sees both a naturopathic doc and a homeopathic doc on a regular basis.

  115. #115 Luna_the_cat
    January 30, 2011

    @Jarred C

    ….I feel as if I could have written that.

    I’ll second everything you said.

    I’ll add another: one of my best friends has a BS in Chemistry and even worked briefly as an industrial chemist, but she believes in homeopathy. I’ve challenged her on it, pointing out that she knows perfectly well that there is no chemical or physical reason to think there could even be any active substance left in a homeopathic remedy, nor is there any physical justification for believing in “water memory” beyond a few picoseconds at most. She knows that. But her justification for believing in homeopathy: she believes in magic. Literally. The existence of a magical world of spirit beyond the reach of science, which science cannot explain, but homeopathy works because it taps into causality there much as doing a ritual spell would! And yes, she is very serious about believing that.

    All the rationality in the world can’t fight some of this.

  116. #116 Inflatus medicus
    January 30, 2011

    “if you’re not getting above the threshold level of a dose/response curve”

    Not sure what the point of your rant against your own family is. Is it part of some hazing ritual?

    Anyway, this egregious ruse is one I am particularly tired of hearing. “The dose makes the poison” has a nice reassuring ring to it, but its a ruse all the same. Its not “the dose makes the poison” its the “bioaccumulative dose, collateral damage and current health status of the patient that makes the poison”. Ever heard of a peanut allergy? Same dose, different patient, very different result. As usual, the devil is in the details and any nonlinearality is patently ignored by the trained monkeys that pass for MDs these days.

  117. #117 Chemmomo
    January 30, 2011

    Jarred C @113,
    Therefore, we should all just quit and let the misinformed have their way?

  118. #118 Denice Walter
    January 30, 2011

    @ Jarred C – your ability, to acquire a reality-based education and maintain your views independently of those closely surrounding you, should be appluaded. You’ve come to the right place- RI.

  119. #119 Militant Agnostic
    January 30, 2011

    Jared C

    I often receive supplements as gifts

    That is worse than socks.

    my mother knows more people who have cancer now than she did 30 years ago

    One of the best examples I have seen how personal experience can be misleading. Have you ever asked her if she has noticed that she knows more people with grey hair than she knew 30 years ago. I guess that revelation would only last a couple of days though.

    It makes sense to them, and they’ll ignore anything which requires extra effort to understand.

    Typical gnorons. I feel your pain – my wife is a Reiki master and is involved in MLM Supplement selling (fortunately not too seriously). She did however, burst out laughing when she found out that Gerson therapy involved coffee enemas.

  120. #120 Jarred C.
    January 30, 2011

    Chemmemo @116.

    You were claiming that Demistigoth is wrong because he was setting the bar too low, and that we have to rely on logic and critical thinking. I claim that logic and critical thinking will not work on everyone (especially my family, who believes they are being logical and using critical thinking skills to reach their conclusions, and obviously you must not be, because your views are different).

    On the other hand, Demistigoth was trying to convince us that people won’t respond to words we commonly use here, because they’re using a different definition than we are. To us scientists, a chemical is simple that. According to Demistigoth, for the lay person a chemical is something a scientist invented in a lab.

    Technically, you’re both right. Different techniques will work with different people. When I was confused about vaccines, Orac’s blog here was a great technique for me. I really don’t think it would be a good technique to convince my mother, who believes that if you hurt someone’s feelings, it means your argument is wrong.

  121. #121 Jan Willem Nienhuys
    January 30, 2011

    Remarkably most of the things naturopaths like bear great resemblance to 18th century medicine, e.g. cupping, various herbs, enemas, bloodletting, purging and acupuncture (which was a kind of hype in that time). Now who was the guy railing against this type of ‘medicine’, calling it allopathy = healing with improper methods? It was Hahnemann, inventor of homeopathy.

  122. #122 Lee
    January 30, 2011

    How do autologous stem cells fit into this picture? All natural, but are they effective? for anything? and is this the right blog for this question?

  123. #123 Vicki
    January 30, 2011

    The other problem with “naturally sourced” is that it can mean “gathered from the wild, rather than made in a lab.” And there may not be enough of the wild plants to fill the demand. I wonder how many woo-enthusiasts would say that it would be worth wiping out the Pacific yew in order that they could have “naturally sourced” rather than synthetic taxol.

  124. #124 Jarred C.
    January 30, 2011

    Regarding the standardized tests in which Naturopaths must take to graduate:

    I’m in the middle of reading a case file on the admissibility of fingerprints (in this case, Judge Soder said that fingerprints were inadmissible, but then later reversed her decision), I found a nice quote that could be easily applied to naturopaths.

    “In this case, as in others, the State introduced evidence that fingerprint experts take and pass proficiency tests. There is no basis for a conclusion that these tests reflect real world conditions.” (Maryland V. Rose, page 27)

  125. #125 prn
    January 30, 2011

    Now who was the guy railing against this type of ‘medicine’, calling it allopathy …It was Hahnemann, inventor of homeopathy.

    Ironic, since 99%+ of medical students declare themselves for “allopathic medicine”.

  126. #126 prn
    January 30, 2011

    Now who was the guy railing against this type of ‘medicine’, calling it allopathy …It was Hahnemann, inventor of homeopathy.

    Ironic, since 99%+ of medical students declare themselves for “allopathic medicine”.

  127. #127 Jarred C
    January 30, 2011

    Ironic, since 99%+ of medical students declare themselves for “allopathic medicine”.

    Really? Has the term really been accepted by nearly all medical students in the medical community today as the proper representative term for medical doctors? I didn’t think the term was that pervasive. But then, I’m not immersed in the medical field.

    On the reverse, I was slightly amused by this quote from 1902, “Remember that the term ‘Allopath’ is a false nickname not chosen by regular physicians at all, but cunningly coined, and put in wicked use against us, in his venomous crusade against Regular Medicine by its enemy, Hahnemann, and ever since applied to us by our enemies with all the insinuations and derisive use the term afford. ‘Allopathy’ applied to regular medicine is both untrue and offensive and is no more accepted by us that the term ‘Heretics’ is accepted by the Protestants, or ‘Niggers’ by the Blacks. The terms ‘allopath’ and ‘allopathy’ are often used in reference to Medical Doctors and standard medicine by medical writers. Such use generally reflects an alternate definition of allopathy: ‘a system of medical practice making use of all measures proved of value in treatment of disease.’ This definition accurately describes modern, science-based medicine, but is inconsistent with its root words ‘allos’ and ‘pathos.’ The duplicity of the term aids those who wish to misrepresent medicine as ideologically allopathic (i.e., symptom suppression). NCAHF recommends that these terms not be used in reference to standard medicine or MDs.” (source: http://www.ncahf.org/articles/a-b/allopathy.html )

  128. #128 Domestigoth
    January 30, 2011

    @ Jared C

    Thank you for the example you posted; it’s a great illustration of what I’m trying to get at here.

    Even otherwise intelligent, lovely people can be completely impossible to talk to about science. I work with a few of them; I have a few of them in my family. As you said yourself, I’m sure we all do.

    These people aren’t going to be convinced by data. They’re so innundated with pro-woo propaganda that they’ve internalized it and created logic blocks. Even if they’re otherwise very smart and educated, on this particular subject they are stupid.

    In order to break down those logic blocks, you need to come at them in a roundabout way. I’m not advocating LYING, ever. The truth is very important. But how you present that truth can make all the difference. Where you place the emphasis can change a person’s mind.

    Being non-confrontational is the first step. Telling a person “you’re wrong” immediately puts them on the defensive and makes them less receptive to new information. You need to get them to come around to your side on their own — plant the seeds of the idea, and then let them make their own conclusions. People are much more accepting of ideas when they feel that it was something they decided all by themselves. This is why things like anecdotal evidence have such power — it seems more personal, appeals to people’s emotions, and they feel that they have some sort of intuitive understanding of the topic at hand.

    Take vaccines, for example. They’re often portrayed in the pro-woo media as being full of those “evil chemicals, zomg so bad!” What’s needed from the scientific community, then, is a sort of “re-branding” that makes vaccines sound “safer” (even if it’s exactly the same thing it always was, because it’s always been perfectly safe and doesn’t need a change). Call them “immune boosters” and shift the focus to how they “naturally” increase your body’s defenses against infection by “stimulating” your “natural” immune response. Sounds like woo, right? But that’s what they do.

    Once you get people actually going to the doctor to get their “immune boosters”, you’ve got them in the door. They start realizing that hey, I didn’t get the flu this year. No one in my family did. These shots really work! And then you can start explaining to them WHY they work, teaching them the science. They’ll compare that against the claims of the homeopaths and reiki masters and other woo-practitioners, and start seeing the logic holes and the bad science. They’ll decide all on their own which is better.

    You wind up with a healthier AND more educated public, because you played the propaganda game.

  129. #129 Chemmomo
    January 30, 2011

    Domestigoth:
    thank you for clarifying your position. I don’t disagree that much with what you’ve said @128. Your approach probably would work well on some people.

    But as Jarred C pointed out, different approaches work for different people.

    And I’ll admit the demonization of the word “chemical” is a major peeve for me (hmmm . . . why might that be?).

    From my perspective, correcting the deficiencies in the basics is a worthwhile goal. And that includes critical thinking skills. It can be done – I’ve been in arguments with people who started to rethink their positions. It doesn’t happen by spoon feeding people data, and it doesn’t happen by feeding them propaganda.

    Probably the real trick is being able to recognize when to apply which approach.

  130. #130 titmouse
    January 31, 2011

    Eh my family will believe anything. But I can live with that.

    It’s the MDs I worry about. Too many are hopping on the “integrative medicine” bus. They really should know better.

  131. #131 nybgrus
    January 31, 2011

    This thread has become amazingly onerous and unwieldy. and Mr. Inflatus Medicus is giving our usual trolls a run for their money. Blech.

  132. #132 prn
    January 31, 2011

    …been accepted by nearly all medical students
    yes, for a number of application years

    …as the proper representative term for medical doctors
    Think more about one of the desperate premed sterotypes (e.g. kneepads, or…), trying to buck the stern god(s) of AAMC, the makers of the MCAT, being a rebel at registration, and NOT checking the “allopathic” box….

    The primary way to get into a med school w/o the MCAT, most of that remaining 1%, afaik, is/was to get into one of a few undergraduate program slots that conditionally guarantee entry into their allied medical program 3-4 years later w/o requirement (or pressure) for the MCAT itself. Good luck.

    I’m not immersed in the medical field.
    I would contend the whole country is, witting, willing or not.

  133. #133 prn
    January 31, 2011

    @127 Jared C
    I did find the NCAHF’s article’s 1902 citation precious. ‘Allopathy’…is no more accepted by us [than] ‘Heretics’ is accepted by the Protestants, or ‘N… seems refreshingly characteristic of the site’s currency and world view.

  134. #134 Chef
    January 31, 2011

    “Call them “immune boosters” and shift the focus to how they “naturally” increase your body’s defenses against infection by “stimulating” your “natural” immune response. Sounds like woo, right? But that’s what they do.”

    And its a surprise that the public no longer trusts organized medicine? Your solution is to just change the PR? Lol.

  135. #135 Dave
    February 1, 2011

    Nothing new, I just have to vent. As the non-medically trained parent of an autistic toddler, this shat me:

    “Do these “skeptics” really think the public cares about Avogadro’s number when homeopathy has just significantly improved their toddler’s autism or offered help with any of a vast range of diseases which respond so well to homeopathic (and often not to conventional) treatment?”

    Produce a credible body of evidence for any of those miracles and I will shut my unbelieving mouth. In the meantime, either be clear and unashamed of the fact that your “treatment” falls outside of this significant scientific boundary or better still, stop exploiting desperate parents with deception and magical thinking.

    OK, I feel better now. Keep up the good work Orac :-)

  136. #136 Jay Gordon
    February 1, 2011

    This is one of the comments threads I’ve ever read!!

    Well done, all of you.

    And no one had the temerity to mention “allergy shots.”

    Best,

    Jay

  137. #137 LW
    February 1, 2011

    I find myself filled with temerity this morning, so I will share this: I received allergy shots for two years starting when I was eighteen. They seem to have been somewhat effective in reducing my allergy symptoms, and would probably have been more effective had I not given up due to the side-effects.

    The shots contained measurable and increasing doses of allergens, so they certainly were not homeopathic, and they were prescribed and administered by real doctors, so they had nothing to do with naturopathy.

    Having worked off my morning temerity, I return you to the topic of the post, namely, that the naturopathic establishment is deeply invested in homeopathy.

  138. #138 David N. Andrews M. Ed., C. P. S. E.
    February 2, 2011

    “critical thinking requires effort – and most people just don’t want to give it.”

    Exactly! Critical thinkers are few and far between on this planet; and the most people cannot be arsed to put in the effort to do that. The most effort they can be bothered to expend is spent in knocking those of us who are prepared to be critical in our thinking.

    That’s why idiots like Doherty, augustine, bensmyson, and the rest of them never learn anything from comment boards like this one: even if they had the intellectual wherewithal to think critically, they’re just to bloody lazy to do it.

  139. #139 jre
    February 3, 2011

    As I expected would happen, the AANP has applied its imprimatur to my comment by homeopathically moderating it into invisibility. Thanks, AANP!

    But that’s not what tickled me most. I see that homeopathy’s own Dr. Bronner’s label, Dr. Nancy Malik, has also appeared in comments, albeit at a much lower dilution. If you want to see Dr. Malik and colleagues in exactly the right context, you absolutely have to visit Dr. Boli’s posts on the subject. Trust me on this one.

  140. #140 Fuddpuckle
    February 3, 2011

    I will be on vacation for two weeks. Having just read this – when I returnI pl an on posting a serious reply on the circular reasoning represented in this article.

    There is a considerable difference in medical practice and the exact science of physics – which apparently is confusing so many people.

    Fuddpuckle

  141. #141 Composer99
    February 3, 2011

    Fuddpuckle,

    Back in the summer, I bought, at a museum dedicated to Earth sciences and biological offshoots where I live, a book called Scientifica.

    I would say the book is an attempt to synthesize, in a rudimentary fashion, the current state of the sciences.

    Curiously, that book included ‘Medicine’ as a scientific discipline.

    Between the editors and contributors of Scientifica, who concluded that medicine can be scientific, and your opinion, which on first reading appears to suggest otherwise, with whom ought I to agree and why?

    =====
    Chef:

    Contra your cynicism, that is, in fact, what vaccines do. That Domestigoth suggested marketing vaccines using woo-ish language does not change that in the slightest. Funny thing about facts, that.

  142. #142 SHie
    October 17, 2011

    I find it frustrating that homeopathy and other pseudo-sciences are required learning for naturopaths. I am actually quite interested in becoming a complimentary medical practioner, but I cannot, and will not, prescribe (pun intended) to untestable forms of treatment. I hypothesize that the body has an ability to heal better and faster when given the right treatment of nutrition, exercise and sleep. And that is testable. I would like to see these “treatments” as front-runners to more intense medications when possible and as complements to medical treatment when necessary. But when natural medicines are ignored by physcians because they are “groundless” and the alternative practices are embraced out of hand by natural practitioners because they are “based in centuries of practice”, we end up with a chasm between sense and non-sense. Ginger, for example, has been shown to be more effective in the treatment of sea-sickness than any other anti-nausea medications, but it is rarely suggested by physcians. On the other hand, homeopathy has been shown to be hocus-pocus by all scientific study, but is still fully embraced by the natural “medical” field.

  143. #143 Chris
    October 17, 2011

    Then become a physical therapist, or go into research in pharmaceuticals based on botanical sources like this blogger:
    http://cenblog.org/terra-sigillata/

    Around here “ND” stands for “Not a Doctor.”

    Remember if it works, it is real medicine. Even if it was originally sourced from plants, like taxol, aspirin, digitalis, etc. From the blogger above I found this cool link:
    http://www.pharmacognosy.us/journal-of-natural-products/

  144. #144 W. Kevin Vicklund
    October 17, 2011

    Ginger, for example, has been shown to be more effective in the treatment of sea-sickness than any other anti-nausea medications,

    It has also been shown to be less effective in the treatment of sea-sickness than other anti-nausea medications. The studies are too small to be conclusive. It does generally do better than placebo, though.

  145. #145 lilady
    October 18, 2011

    Ginger, in some studies decrease episodes of vomiting associated with seasickness…the studies indicate that the chemicals in ginger calm the pyloric valve at the base of the stomach. It doesn’t however, eliminate the nausea associated with seasickness.

The site is currently under maintenance and will be back shortly. New comments have been disabled during this time, please check back soon.